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Comparing Before-And After-School Neurocognitive Performance In High School Athletes- Implications For Concussion Management, Morgan Anderson May 2017

Comparing Before-And After-School Neurocognitive Performance In High School Athletes- Implications For Concussion Management, Morgan Anderson

Graduate Theses and Dissertations

There are several factors that influence computerized neurocognitive testing performance however, one factor that has not been examined is the potential deleterious effects of cognitive fatigue from an academic school day combined with time of computerized neurocognitive testing (CNT) administration. The primary purpose of this study was to compare before-and after-school CNT performance and total symptoms in non-concussed high school student athletes. The secondary purpose of this study was to compare before-school and after-school CNT performance and total symptoms and chronotypes in non-concussed student athletes. A crossover design was used to compare before-and after-school CNT performance and total symptoms of …


Environmental And Climatic Constraints On Large-Scale Camelina Production In Eastern Arkansas, Benjamin Robert Tracy May 2017

Environmental And Climatic Constraints On Large-Scale Camelina Production In Eastern Arkansas, Benjamin Robert Tracy

Graduate Theses and Dissertations

Camelina sativa is a cold weather crop that is typically grown in semi-arid environments in the Western United States, usually as a spring crop, but sometimes during the winter. Research analyzing climate data and soil hydrology is important to better understand the environmental and terrain conditions necessary for Camelina farming wherever it is proposed for large-scale production. This study focused on various conditions and constraints pertaining to the potential for Camelina as a crop biofuel in Eastern Arkansas. Due to interest in the economic potential of crop biofuels in this area, and in particular the low input costs for Camelina, …


Value Of Cover Crops In Suppressing Weeds And Protecting Cotton Yields And Likelihood Of Residual Herbicide Carryover To Cover Crops, Matheus Gabriel Palhano May 2017

Value Of Cover Crops In Suppressing Weeds And Protecting Cotton Yields And Likelihood Of Residual Herbicide Carryover To Cover Crops, Matheus Gabriel Palhano

Graduate Theses and Dissertations

Weed-resistance management has become a topic of concern for modern agriculture. Cost related to herbicide usage has increased greatly due to evolution and proliferation of resistant weeds. Therefore, experiments were conducted to investigate the potential for using cover crops to suppress problematic weeds in cotton as well as chemical options for cover crop dessication, and sensitivity of cover crops to residual herbicides were evaluated. No differences were observed for cereal rye biomass production and consequently weed suppression between broadcast and drilled planting methods. Total amount of cover crop biomass was vital to effectively suppress weeds. Hence, of the cover crops …


Examining Fear Of Re-Injury In High School Athletes With Sport-Related Concussion, Melissa Nicole Anderson May 2017

Examining Fear Of Re-Injury In High School Athletes With Sport-Related Concussion, Melissa Nicole Anderson

Graduate Theses and Dissertations

Recent consensus statements have advocated for research on the emotional sequelae that is associated with sport-related concussion (McCrory et al., 2012). However, changes in fear of re-injury throughout SRC recovery are understudied. The purpose of this study was two-fold: 1) to describe fear of re-injury in high school athletes with SRC, and 2) to document changes in fear of re-injury throughout SRC recovery. This study addressed several exploratory questions regarding fear of re-injury in high school athletes with SRC that pertain to identifying predictors of fear of re-injury as well as examining the relationship between fear of re-injury and locus …


Willingness To Pay For Irrigation Water Under Scarcity Conditions, Tyler Robert Knapp Dec 2016

Willingness To Pay For Irrigation Water Under Scarcity Conditions, Tyler Robert Knapp

Graduate Theses and Dissertations

Reliance of Arkansas agricultural producers on groundwater for irrigation has led to depletion of the Mississippi River Valley alluvial aquifer. Without intervention, consequences include insufficient groundwater to meet irrigation demand as well as drawdown of the deeper Sparta Aquifer, upon which communities in eastern Arkansas rely for non-agricultural use. Among proposed solutions to combat groundwater decline is the construction of off-farm surface water infrastructure to meet the irrigation needs of producers. Despite the importance of irrigated agriculture to Arkansas, there is little know about the economic value of irrigation water to producers. Thus, we implement a double-bounded dichotomous choice contingent …


Daily Variability Of Body Weight And Hydration Markers In Free Living Men And Women, Lynndee Grace Summers Dec 2016

Daily Variability Of Body Weight And Hydration Markers In Free Living Men And Women, Lynndee Grace Summers

Graduate Theses and Dissertations

Body weight and hydration markers change greatly during strenuous exercise, especially in the heat. However, in a non-athletic population, changes in body weight and hydration markers may not be so obvious. It is important to classify the normal fluctuation of these measurements for future studies in order to delineate when an intervention results in a change outside of what can be expected during normal daily living. PURPOSE: The purpose of this study was to describe the normal fluctuations in body weight and urine hydration markers over the course of 29 days. METHODS: One-hundred two male and female participants, ranging from …


Immunotherapeutic Strategies To Reverse Tumor Associated Immunosuppression In Breast Cancer, Sruthi Ravindranathan Dec 2016

Immunotherapeutic Strategies To Reverse Tumor Associated Immunosuppression In Breast Cancer, Sruthi Ravindranathan

Graduate Theses and Dissertations

Heterogenous cancers such as breast carcinoma, would highly benefit from personalized vaccine approaches such as autologous tumor cell vaccines (ATCVs). By using cancer cells that are isolated from self, this approach has the potential to generate a polyclonal immune response against tumor antigens, that are specific to the individual. However, so far, ATCVs against breast cancers have not had any clinical success due to the poor immunogenicity of the malignant cells.

In this study, for the first time, we determined tumor derived G-CSF to play a major role in affecting immune response against breast cancer ATCVs. By using CRISPR/Cas9 genome …


Phenotypic Analysis And Localization Of Leukocytes At The Site Of Intradermal Injection Of Phytohemagglutinin In Chickens, Kallie Alyce Sullivan Dec 2016

Phenotypic Analysis And Localization Of Leukocytes At The Site Of Intradermal Injection Of Phytohemagglutinin In Chickens, Kallie Alyce Sullivan

Graduate Theses and Dissertations

Phytohemagglutinin (PHA) is commonly used to gain insight into an individual’s cellular immuno-competence. PHA is typically injected intradermally (i.d.) into the skin (e.g. wing web) and the tissue swelling response is then monitored, whereby the extent of the swelling positively relates to the individual’s cellular immune system capabilities. Although i.d. injected PHA was shown to stimulate mononuclear cell- and basophil-infiltration to the site of injection, reports on temporal, qualitative and quantitative aspects of the local PHA response are limited. The objective of this study was to use the growing feather (GF) as a cutaneous test-site to assess and monitor the …


Liming Characteristics Of A High-Calcium, Dry Flue Gas Desulfurization By-Product And Its Effects On Runoff Water Quality, Jason Richard Burgess-Conforti Dec 2016

Liming Characteristics Of A High-Calcium, Dry Flue Gas Desulfurization By-Product And Its Effects On Runoff Water Quality, Jason Richard Burgess-Conforti

Graduate Theses and Dissertations

In 2013, only 37% of the 32 million Mg of flue gas desulfurization (FGD) by-products generated in the United States were reused beneficially. If FGD by-products could be used as a beneficial soil amendment, millions of megagrams may be diverted away from surface impoundments and landfills. The purpose of this research was to identify the liming characteristics of a high-Ca dry FGD (DFGD) by-product in comparison to a Class-C fly ash (FA) and reagent-grade CaCO3, and to evaluate the effects of land application to a managed grassland on runoff, plant, and soil quality. Liming characteristics were determined by measuring the …


Effect Of Delayed Wrapping And Wrapping Source On Intake And Digestibility Of Alfalfa Silage In Gestating Sheep, Valens Niyigena Dec 2016

Effect Of Delayed Wrapping And Wrapping Source On Intake And Digestibility Of Alfalfa Silage In Gestating Sheep, Valens Niyigena

Graduate Theses and Dissertations

Baling silage with oxygen can result in dry matter deterioration and reduce silage intake by animals. This study was conducted to investigate the effects of two different wrapping sources and time intervals between baling and wrapping on intake and digestibility of alfalfa silage. The second objective was to assess the correlation of alfalfa silage fermentation parameters with intake and digestibility parameters in gestating sheep. Alfalfa silage was baled in large round bales then wrapped with plastic either with (KURA) or without (SUN) an oxygen-limiting barrier either the day of baling or 1, 2 or 3 d after baling. Beginning in …


Extracellular Matrix Remodeling And The Inflammatory Response During Skeletal Muscle Regeneration In Sarcopenic Obese Mice, Lemuel Arthur Brown Dec 2016

Extracellular Matrix Remodeling And The Inflammatory Response During Skeletal Muscle Regeneration In Sarcopenic Obese Mice, Lemuel Arthur Brown

Graduate Theses and Dissertations

AIM: Sarocpenic obesity is a national concern within the United States because this metabolic syndrome is tied with reduced mobility and quality of life. Both obesity and aging are associated with insulin-resistance, chronic low-grade inflammation and muscle weakness. Skeletal muscle regeneration is a process that involves the coordinated effort of myogenic regulatory factors (MRFs), inflammatory signaling, and extracellular matrix (ECM) remodeling for optimal regeneration. It has been demonstrated that obesity and aging have a reduction in muscle regeneration. It has not been examined if sarcopenic obesity will further reduce muscle mass and the regenerative process. The purpose of this study …


Identification Of Biomarkers Associated With Rous Sarcoma Virus-Induced Tumors In Two Divergently Selected Chicken Lines, Ashley Hayden Aug 2016

Identification Of Biomarkers Associated With Rous Sarcoma Virus-Induced Tumors In Two Divergently Selected Chicken Lines, Ashley Hayden

Graduate Theses and Dissertations

Poultry has become especially important to genetic research due to breeding feasibility, short generation turnover, and ease of maintaining large populations. The discovery of virus induced cancer has paved the way for further genetic studies. Rous Sarcoma Virus (RSV) is a tumor-causing virus that infects poultry. While not prevalent today, it can serve as a model for virus-induced cancer in humans and create additional insight to marker assisted selection in poultry. Genetically selected Arkansas Progressor (AP) and Arkansas Regressor (AR) chicken lines have been established and maintained at the Arkansas Experimental Station (AES) in Fayetteville, AR. Previous research has investigated …


Effect Of Hydration Status On Thermoregulatory Responses In Non-Obese And Obese Males, Matthew Tucker Aug 2016

Effect Of Hydration Status On Thermoregulatory Responses In Non-Obese And Obese Males, Matthew Tucker

Graduate Theses and Dissertations

During heat stress the human body thermoregulates via cutaneous vasodilation and sweating. Hypohydration can impair thermoregulatory responses that stem from the central nervous system (CNS), but it is unknown if impairments also occur post-synaptically in the microcirculation. Moreover, obese individuals may have impaired thermoregulation, possibly due to microvascular dysfunction. Purpose: The purpose of these studies was two-fold: 1) to determine if obese (OB) individuals exhibit impairments in thermoregulatory responses during exercise heat-stress (centrally-mediated) and intradermal infusion of vasoactive substances (peripherally-mediated) versus non-obese (N-OB), and 2) to determine if hypohydration subsequently affects these thermoregulatory responses differently between groups. Methods: Twenty-one healthy, …


Rice Consumption And Effects Of Rice Cake, Seolgitteok, On Human Health, Ellen Joy Pottgen Aug 2016

Rice Consumption And Effects Of Rice Cake, Seolgitteok, On Human Health, Ellen Joy Pottgen

Graduate Theses and Dissertations

Within the United States type 2 diabetes is an ever growing health epidemic. The prevalence in the adult population has quadrupled over the past 30 years and is expected to continue on a similar path in the coming decades. While the cause of type 2 diabetes is multifactorial, it is considered to be an acquired condition related to environmental contributors including poor diet, obesity, and physical inactivity, which may be managed to alter the course or progression of the disease. Preventative or maintenance measures emphasize nutritional intervention strategies, including encouraging individuals to follow a nutrient-dense, high-fiber diet with ample whole-grains, …


In Vitro Fermentation Patterns Of Rice Bran Components By Human Gut Microbiota, Tung Minh Pham Aug 2016

In Vitro Fermentation Patterns Of Rice Bran Components By Human Gut Microbiota, Tung Minh Pham

Graduate Theses and Dissertations

The prevalence of colorectal cancer (CRC) has been increasing in recent years worldwide. In the United States, it is ranked the second leading cause of cancer death. Risks of CRC increase with age and are associated with several lifestyle factors such as diet, drinking and smoking habits, and levels of physical activity. There is an abundance of scientific literature demonstrating the protective roles of several dietary components including fibers and polyphenolic compounds. These compounds have been shown to be able to positively modulate gastrointestinal ecology by increasing the production of short-chain fatty acids (SCFA) and promoting the population of beneficial …


Mental Toughness, Grit, And Motivational Differences In Single-Sport And Multi-Sport Athletes, Cole Justin Shewmake Aug 2016

Mental Toughness, Grit, And Motivational Differences In Single-Sport And Multi-Sport Athletes, Cole Justin Shewmake

Graduate Theses and Dissertations

Whether it is at work, school or sports, mental toughness (MT), grit and motivation are essential to accomplishing goals. Sports can be an integral platform for developing MT, grit, and factors that increase motivation levels, and it is during childhood and adolescence that these characteristics may develop. All of this could prove beneficial into adulthood. Therefore, the purpose of this study was to examine MT, grit and motivational orientations of single-sport and multi-sport athletes at different levels of competition. Considering MT, a 2 x 2 ANOVA indicated no significant interaction effect between athlete type and competition level, F(1, 387) = …


Observing Renal Responses To Endurance Cycling In The Heat, Cody Smith Aug 2016

Observing Renal Responses To Endurance Cycling In The Heat, Cody Smith

Graduate Theses and Dissertations

AIM: To observe the effects of endurance cycling in the heat on renal function, and determine if the extent of impairment is related to hydration. METHODS: 40 cyclists (34 male, 6 female, 52 ± 9 y, 21.7 ± 6.5 % body fat) completed an endurance cycling event (5.7 ± 1.2 hours) in the heat (33.2 ± 5.0ºC, 38.4 ± 10.7% RH). Body mass was assessed to determine net fluid loss, muscle damage in the legs was assessed with a pain scale, a urine sample was collected to analyze hydration status, and a blood sample was drawn. All measurements were taken …


Innate Immunity In Chickens: In Vivo Responses To Different Pathogen Associated Molecular Patterns, Kristen Alicia Byrne Aug 2016

Innate Immunity In Chickens: In Vivo Responses To Different Pathogen Associated Molecular Patterns, Kristen Alicia Byrne

Graduate Theses and Dissertations

Pattern recognition receptors (PRRs) on host cells recognize motifs known as pathogen associated molecular patterns (PAMPs) that are common to groups of microbes. Examples include LPS on Gram-negative bacteria, the structural motif PGN common to all bacteria, MDP the smallest immunostimulatory unit of PGN, and poly I:C the dsRNA analog. PAMP recognition by and stimulation of the innate immune system is crucial to an individual’s ability to quickly limit microbial growth and stimulate the adaptive immune system. Characterization of the in vivo immune responses initiated by PAMPs has not been directly addressed. Using growing feathers (GF) as a novel intradermal …


Long-Term Supplementation With Leucine Does Not Prevent Development Of Obesity In Rats Fed A High-Fat Diet, Dameon Smith Aug 2016

Long-Term Supplementation With Leucine Does Not Prevent Development Of Obesity In Rats Fed A High-Fat Diet, Dameon Smith

Graduate Theses and Dissertations

Excess dietary fat consumption has been implicated in the development of obesity and diabetes. Obesity can be characterized by a disproportionate increase in fat mass compared to lean body mass. However, if muscle mass can be increased or maintained in obesity, this may facilitate weight loss by increasing the body’s overall metabolic capacity. Historically, supplementation with the branched-chain amino acid leucine has been shown to increase muscle protein synthesis via the protein kinase mTORC1. Recent studies suggest that supplementation with leucine also has the potential to reduce weight gain and fat deposition in high-fat fed, obese mice. The objective of …


Culinary Competence: Skills And Knowledge Assessment For Dietetic Students, Nancy Harris Buckley Aug 2016

Culinary Competence: Skills And Knowledge Assessment For Dietetic Students, Nancy Harris Buckley

Graduate Theses and Dissertations

Graduates of didactic programs in dietetics are entering internships with little cooking experience. The Food and Culinary Professionals’ Dietetic Practice Group (FCP DPG) has identified 11 core competencies that were developed as a recommendation to dietetic educators to include more culinary knowledge into existing programs. The purpose of this study was to determine if developing and incorporating experiential learning targeted to the competencies would increase dietetic students’ culinary skills and knowledge at a southern land-grant university. Food and Culinary Professionals’ DGP core competencies were used to guide the development of curriculum, experiential learning, and assessment in the Principles of Foods …


The Impact Of Fast Food Marketing On Millennials, Kabo Tuelo Segokgo Aug 2016

The Impact Of Fast Food Marketing On Millennials, Kabo Tuelo Segokgo

Graduate Theses and Dissertations

Fast food marketing is an effective tool used by businesses to build food brand recognition among their consumers. Increased fast food consumption has been linked to the increase in high calorie consumption. This study sought among Millennials to assess the association between fast food marketing and consumption of fast food. It further dealt with perceptions on the relationship between fast food consumption and weight gain. A convenience sample of 507 participants was used to collect data from University of Arkansas’ students through an online survey and an in person survey. An independent sample t test and multivariate analysis of variance …


Agro-Climatic Change, Crop Production And Mitigation Strategies-Case Studies In Arkansas, Usa And Kenya, John Westley Magugu Aug 2016

Agro-Climatic Change, Crop Production And Mitigation Strategies-Case Studies In Arkansas, Usa And Kenya, John Westley Magugu

Graduate Theses and Dissertations

Although climate change impacts vary geographically and temporally, studies at local levels are not readily available for stakeholders to better understand how their local communities would be affected and what remedial measures could be more effective in their local contexts. This dissertation has examined climate change and its impacts in two different local contexts: eastern Arkansas in the USA and Nyando in Kenya. The first part of this dissertation develops agro-meteorological indicators and examines the relationship between agro-meteorological indicators and crop yields in eastern Arkansas between 1960 and 2014. Results reveal that temperature based indicators were more strongly correlated to …


The Influence Of Strength-Training Exercises On The Functional Fitness In Older Adults, Susie Engle Aug 2016

The Influence Of Strength-Training Exercises On The Functional Fitness In Older Adults, Susie Engle

Graduate Theses and Dissertations

The purpose of this study was to examine the influence of strength-training exercises on the functional fitness in older adults. The original convenience sample consisted of 658 participants who attended group strength-training classes offered through the Cooperative Extension Service. The Senior Fitness Test was used to assess baseline fitness levels at the beginning and end of the 12-week strength-training program. Data was collected from 2008 to 2015. Of the 658 participants, 110 were aged 60 to 94 and presented posttest scores occurring approximately 12 weeks after pretest dates. Of the 110 subjects, 99 were female and 11 were male. The …


Eucalyptus In Kenya; Impacts On Environment And Society, Brandy M. Garrett Kluthe Aug 2016

Eucalyptus In Kenya; Impacts On Environment And Society, Brandy M. Garrett Kluthe

Graduate Theses and Dissertations

Eucalyptus trees were introduced to Kenya a little over a century ago. European colonization along with the development of a railway system increased the demand for a fast growing wood source. The expansion of the tree across the fertile lands in Kenya raises concerns about the environmental impact on ecosystems where it has been introduced. These concerns include degraded soils, loss of water resources, co-introduction of ectomycorrhizal species, and allelopathy. Economic benefits to local landowners were also explored as well as the potential for large Eucalyptus woodlots to maximize the sequestration of CO₂ from the atmosphere. This was examined through …


Nutritional Deficiencies During The Harvest Season According To Household Consumption And Level Of Nutritional Knowledge: A Case Study Of Northern Mozambique, Maggie Jo Hansen May 2016

Nutritional Deficiencies During The Harvest Season According To Household Consumption And Level Of Nutritional Knowledge: A Case Study Of Northern Mozambique, Maggie Jo Hansen

Graduate Theses and Dissertations

Mozambique is classified as a low income country, the lowest development classification defined by the World Bank. It is underdeveloped in food security, agricultural production, and nutritional status, and research shows its residents are not foreign to poverty and malnutrition. Low protein, starchy foods (maize, rice, wheat, cassava) comprise the majority of the Mozambican diet; these starchy foods are the most available for consumption. Although availability impacts diet, educational barriers may also threaten the knowledge of nutrition and perceptions of healthy foods. Illiteracy and lack of education are extreme challenges to disseminating nutritional education efforts in the rural Nampula region. …


The Effects Of Hypohydration On Neurocognitive, Balance, Vestibular Ocular Motor Functions And Mood State, Satoshi Iida May 2016

The Effects Of Hypohydration On Neurocognitive, Balance, Vestibular Ocular Motor Functions And Mood State, Satoshi Iida

Graduate Theses and Dissertations

Inconsistent findings have been observed on the impact of hydration state on cognitive functions. The isolated effect of hypohydration on neurocognitive performance, balance, vestibular ocular motor function and mood outcomes in widely used concussion assessment tools has not been studied. The purpose of this study was to investigate how hypohydration affected the results in concussion testing batteries. A single-blind randomized crossover design was used. Thirteen healthy males (22 ± 4y, 180.9 ± 5.7cm) without history of concussion within the past six months or any condition or disease that could influence outcome measurements participated in this study. Each subject completed concussion …


Proteomic Characterization Of Eggshell Membranes And Their Effect On Poultry Physiology And Immunity, Sarbjeet Kaur Makkar May 2016

Proteomic Characterization Of Eggshell Membranes And Their Effect On Poultry Physiology And Immunity, Sarbjeet Kaur Makkar

Graduate Theses and Dissertations

The use of antibiotics in poultry growth and disease control has led to antibiotics resistant problem in human beings, which is a big concern among consumers. With the necessity for judicious use of antibiotics in poultry production, alternative strategies to improve disease resistance in poultry production are necessary. The research is more inclined towards using the natural products available to grow healthier and antibiotic free meat animals. In the context of exploring natural and sustainable resource of alternative to antibiotics, the biochemical milieu of eggshell membranes (ESM) were analyzed by using mass spectrometry techniques including matrix assisted laser desorption ionization …


Comparative Efficacy Of Foaming And Non-Foaming Handsoap In Reduction Of Microorganisms In Handwashing, Danielle Marie Conover May 2016

Comparative Efficacy Of Foaming And Non-Foaming Handsoap In Reduction Of Microorganisms In Handwashing, Danielle Marie Conover

Graduate Theses and Dissertations

Handwashing (HW) is a long established method to prevent disease transmission. Ensuring effectiveness of current HW methods is essential for optimal HW and enhanced disease prevention. The objectives of this research were to 1) conduct a survey of soap type and volume in food service establishments in Washington County, Arkansas; 2) investigate how soap type impacts HW behavior; and 3) determine the difference in microbial reduction between foaming (F) and liquid (L) handsoap. For Objective 1, food service establishments in Washington County, AR were selected based on exclusion criteria and random number generations, and handsoap samples were collected to determine …


The Effect Of Protein Quantity And Quality At Breakfast On Energy Metabolism, Appetite And Metabolic Health, Brianna Lynne Neumann May 2016

The Effect Of Protein Quantity And Quality At Breakfast On Energy Metabolism, Appetite And Metabolic Health, Brianna Lynne Neumann

Graduate Theses and Dissertations

Obesity is a global health concern and, within the United States, the current obesity rate is 36% and projected to double within the next two decades. Obesity is linked to many chronic diseases such as cancer, heart disease and type 2 diabetes. In young females, weight gain (5-11 kg) between the ages of 20-30 years increases the risk of developing type 2 diabetes and cardiovascular disorders later in life. The cause of obesity is multifactorial in nature, however fundamentally weight gain occurs when energy intake is greater than energy expended (i.e. calories in > calories out). Therefore, identifying and validating nutritional …


A Prediction Model For Acute Core And Lower Extremity Injuries In Division 1 Collegiate Football Players, Alexandra Aline Mcdonald May 2016

A Prediction Model For Acute Core And Lower Extremity Injuries In Division 1 Collegiate Football Players, Alexandra Aline Mcdonald

Graduate Theses and Dissertations

Context: Various intrinsic factors such as high exposure, poor endurance of core muscles, previous injury, strength deficits, suboptimal neurocognitive function, and orthopedic abnormalities have been found as predictors for sprains and strains among collegiate football players. Objective: Assess the applicability of pre-participation assessments as predictors of core or lower extremity injury. Design: Cohort Study. Setting: National Collegiate Athletic Association Division I football program. Patients or Other Participants: Athletes who underwent mandatory pre-participation examinations before preseason football training over two consecutive seasons (n=225). Main Outcome Measure(s): Associations between preseason protocols and injury incidence for core and lower extremity injuries were established …