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Yilmaz T, Siegel M, Taghizadeh E, Fuchs A, Niemeyer P, Schmal H, Izadpanah K. The transepicondylar distance is a reliable and easily measured parameter for estimating femoral cartilage surface area using MRI. Knee Surg Sports Traumatol Arthrosc 2024. [PMID: 39314020 DOI: 10.1002/ksa.12482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 09/07/2024] [Accepted: 09/10/2024] [Indexed: 09/25/2024]
Abstract
PURPOSE Different cartilage repair techniques are widely used to regenerate cartilage, such as autologous chondrocyte implantation (ACI), osteochondral autograft transfer, microfracturing and minced cartilage. Defect size is a key parameter for selecting the best procedure to repair cartilage. However, the defect's size is not related to the patient's total cartilage surface. This is because assessing the femoral cartilage surface area is time-consuming and therefore unsuitable in the daily clinical routine. It has been proposed that the femur's total cartilage area correlates positively with the transepicondylar distance (TEA). METHODS The knees of 40 subjects were analysed. Their average age was 30.1 ± 8.6 years. Twenty-four female and 16 male subjects were examined. Their mean body height was 176.2 ± 8.8 cm. MRI scans were performed via 3-Tesla MRI. These data were postprocessed and quantified using the browser-based, customizable SATORI platform (Fraunhofer MEVIS). This software computed the femoral cartilage surface area (FeCA), the patella cartilage surface area (PCA), the TEA and the patella length. RESULTS Body height reveals a good correlation (r = 0.722, p < 0.001) with the distal femur's cartilage area surface. However, regression analysis shows only moderate dependence (R2: 0.514). A very good correlation (r = 0.830, p < 0.001) was observed between the TEA distance and the total cartilage surface area of the distal femur. The regression analysis yields a good value (R2: 0.684). The cranio-caudal length of the patella was chosen as a suitably measurable two-dimensional parameter for correlation analysis with the patella's total cartilage surface area. Those results yield a poor correlation (r = 0.577, p < 0.001) between the two parameters, and regression analysis reveals a low value (R2: 0.384). CONCLUSION The TEA is a reliable parameter for estimating the femur's cartilage area using MRI. A simple determination of this parameter allows the estimation of the femur's total cartilage area as well as the surface-corrected defect size (SCDS) in daily routine. LEVEL OF EVIDENCE Level II.
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Affiliation(s)
- Tayfun Yilmaz
- Department of Orthopedic Surgery and Traumatology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Markus Siegel
- Department of Orthopedic Surgery and Traumatology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Elham Taghizadeh
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
| | - Andreas Fuchs
- Department of Orthopedic Surgery and Traumatology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Philipp Niemeyer
- Department of Orthopedic Surgery and Traumatology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Hagen Schmal
- Department of Orthopedic Surgery and Traumatology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
- Department of Orthopedic Surgery, University Hospital Odense, Odense C, Denmark
| | - Kaywan Izadpanah
- Department of Orthopedic Surgery and Traumatology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
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Donahue PT, Balasubramanian A, Davoudi A, Wanigatunga AA, Schrack JA, Carlson MC. Population reference equations for handheld peak expiratory flow in older U.S. adults. Respir Med 2024; 234:107811. [PMID: 39305967 DOI: 10.1016/j.rmed.2024.107811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 09/18/2024] [Accepted: 09/19/2024] [Indexed: 09/28/2024]
Abstract
BACKGROUND Peak expiratory flow (PEF) is a simple, inexpensive measure of respiratory effort and is a valuable predictor of health outcomes in older adults. Yet, there is a lack of epidemiological data validating PEF prediction equations among older adult populations, especially those ≥80 years. The National Health and Aging Trends Study (NHATS) is a large, nationally representative sample of U.S. adults ages ≥65 years that offers a unique opportunity to develop PEF population reference equations. METHODS Using a healthy subsample from the NHATS 2011 cohort (N = 1740; 68.9 % female; mean [SD] age = 77.0 [7.9] years), sex-specific reference equations were generated for PEF, measured via a handheld flow meter, using height and age as predictors. Reference equations for both sexes were validated against the NHATS 2015 cohort by testing measured vs. predicted PEF values. Additionally, new reference equations were compared to spirometry PEF reference equations from the National Health and Nutrition Examination Survey (NHANES). RESULTS After applying NHATS 2011 reference equations to the NHATS 2015 cohort, measured vs. predicted PEF values were not significantly different (Ps > 0.05). The NHANES equations tended to slightly overestimate handheld PEF measurements in the NHATS 2015 cohort by an average of 29.3 L/min and 10.1 L/min in males and females, respectively. CONCLUSIONS Results demonstrate the comparability of PEF reference equations from a handheld meter to spirometry reference equations in older adults. New reference equations can be applied to a traditionally undersampled population with an easily obtained and low-cost measure.
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Affiliation(s)
- Patrick T Donahue
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, USA; Center on Aging and Health, Johns Hopkins University, USA.
| | | | - Anis Davoudi
- Center on Aging and Health, Johns Hopkins University, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, USA
| | - Amal A Wanigatunga
- Center on Aging and Health, Johns Hopkins University, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, USA
| | - Jennifer A Schrack
- Center on Aging and Health, Johns Hopkins University, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, USA
| | - Michelle C Carlson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, USA; Center on Aging and Health, Johns Hopkins University, USA.
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Kilic KK, Kose O, Egerci OF, Dogruoz F, Aykanat F. Prediction Of Palmaris Longus Tendon Length And Thickness Through Simple Anthropometric Measurements. HANDCHIR MIKROCHIR P 2024; 56:368-375. [PMID: 38359865 DOI: 10.1055/a-2239-6341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024] Open
Abstract
OBJECTIVE This study aimed to test whether palmaris longus tendon (PLT) length and thickness can be predicted from simple anthropometric measurements. MATERIALS AND METHODS 120 healthy volunteers with bilateral PL muscles were enrolled in this prospective study. PLT length and thickness were measured by ultrasonographic examination. Anthropometric measurements included body height, weight, forearm length, and wrist circumference. Correlation, linear regression, and Bland-Altman plot were used for analysis. RESULTS The mean PLT length and thickness were 10.8±1.4 cm and 4.0±0.9 mm, respectively. Body height and PLT length had a moderate positive correlation (r:0.407, p:0.001), and forearm length and PLT thickness had a weak positive correlation (r:0.229, p:0.001). The regression analysis showed that body height was the best predictor for PLT length, and forearm length was the best predictor for PLT thickness. The regression equations were as follows: PLT length=0.276+(0.062×height) (r2=0.165, p<0.001) and PLT thickness=1.373+(0.108×forearm length) (r2=0.052, p<0.001). The predicted PLT lengths and thicknesses were calculated using these regression formulas and compared with the actual thicknesses and lengths using the Bland-Altman plot. The upper and lower limits of agreement (95% CI) ranged from -2.54 cm to 2.51 cm for actual PLT length and predicted PLT length and from -1.76 mm to 1.74 mm for actual PLT thickness and predicted PLT thickness in the Bland-Altman plot with a weak agreement and proportional bias. CONCLUSIONS These findings indicate that height and forearm length have limited accuracy in predicting PLT length and thickness. The preoperative ultrasonographic examination can provide valuable assistance, particularly in cases that require grafts with precise length and thickness requirements.
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Affiliation(s)
- Koray Kaya Kilic
- Radiology Department, Antalya Training and Research Hospital, Antalya, Turkey
| | - Ozkan Kose
- Orthoapedics and Traumatology Department, Antalya Training and Research Hospital, Antalya, Turkey
| | - Omer Faruk Egerci
- Orthoapedics and Traumatology Department, Antalya Training and Research Hospital, Antalya, Turkey
| | - Firat Dogruoz
- Orthoapedics and Traumatology Department, Antalya Training and Research Hospital, Antalya, Turkey
| | - Faruk Aykanat
- Vocational School of Health Services, Sanko Universitesi, Gaziantep, Turkey
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Cordes CMA, Leonardis JM, Samet J, Schnorenberg AJ, England M, Mukherjee S, Vogel LC, Seitz AL, Slavens BA. Handrim kinetics and quantitative ultrasound parameters for assessment of subacromial impingement in wheelchair users with pediatric-onset spinal cord injury. Gait Posture 2024; 113:561-569. [PMID: 39182433 PMCID: PMC11388546 DOI: 10.1016/j.gaitpost.2024.08.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 08/12/2024] [Accepted: 08/14/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND Most manual wheelchair users with pediatric-onset spinal cord injury (SCI) will experience shoulder pain or pathology at some point in their life. However, guidelines for preservation of the upper limb in children with SCI are limited. RESEARCH QUESTION What are the relationships between manual wheelchair handrim kinetics and quantitative ultrasound parameters related to subacromial impingement in individuals with pediatric-onset SCI? METHODS Subacromial impingement risk factors including supraspinatus tendon thickness (SST), acromiohumeral distance (AHD), and occupation ratio (OR; SST/AHD) were measured with ultrasound in 11 manual wheelchair users with pediatric-onset SCI. Handrim kinetics were acquired during the stroke cycle, including peak resultant force (FR), peak rate of rise of resultant force (ROR) and fractional effective force (FEF). Variability of handrim kinetics was computed using the coefficient of variation and linear regression was performed to assess correlations between handrim metrics and quantitative ultrasound parameters. RESULTS Peak resultant force significantly increased 1.4 % and variability of FEF significantly decreased 8.0 % for every 0.1 cm increase in AHD. FEF decreased 3.5 % for every 0.1 cm increase in SST. Variability of peak resultant force significantly increased 3.6 % and variability of peak ROR of resultant force significantly increased 7.3 % for every 0.1 cm increase in SST. FEF variability significantly decreased 11.6 % for every 0.1 cm increase in SST. Peak ROR significantly decreased 1.54 % with every 10 % increase in OR. FEF variability significantly decreased 1.5 % with every 10 % increase in OR. SIGNIFICANCE This is the first study to investigate relationships among handrim kinetics and shoulder structure in manual wheelchair users with pediatric-onset SCI. Associations were identified between subacromial impingement risk factors and magnitude and variability of wheelchair handrim kinetics. These results indicate the critical need to further explore the relationships among wheelchair handrim kinetics, shoulder joint dynamics, and shoulder pathology in manual wheelchair users with pediatric-onset SCI.
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Affiliation(s)
- Caleb M A Cordes
- University of Wisconsin-Milwaukee, Department of Rehabilitation Sciences and Technology, Milwaukee, WI 53211, USA; University of Wisconsin-Milwaukee, Department of Mechanical Engineering, Milwaukee, WI 53211, USA.
| | - Joshua M Leonardis
- University of Wisconsin-Milwaukee, Department of Rehabilitation Sciences and Technology, Milwaukee, WI 53211, USA; University of Illinois Urbana-Champaign, College of Applied Health Sciences, Urbana, IL 61801, USA; University of Illinois Urbana-Champaign, Beckman Institute for Advanced Science and Technology, Urbana, IL 61801, USA
| | - Jonathan Samet
- Ann and Robert H. Lurie Children's Hospital, Department of Medical Imaging, Chicago, IL 60611, USA; Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Alyssa J Schnorenberg
- University of Wisconsin-Milwaukee, Department of Mechanical Engineering, Milwaukee, WI 53211, USA
| | - Mark England
- Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Shubhra Mukherjee
- Shriners Children's Chicago, Chicago, IL 60707, USA; Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA
| | | | - Amee L Seitz
- Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Brooke A Slavens
- University of Wisconsin-Milwaukee, Department of Rehabilitation Sciences and Technology, Milwaukee, WI 53211, USA; University of Wisconsin-Milwaukee, Department of Mechanical Engineering, Milwaukee, WI 53211, USA
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Gräper PJ, Scafoglieri A, Clark JR, Hallegraeff JM. Sensory Profiles Predict Symptoms of Central Sensitization in Low Back Pain: A Predictive Model Research Study. J Clin Med 2024; 13:4677. [PMID: 39200819 PMCID: PMC11355633 DOI: 10.3390/jcm13164677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 08/01/2024] [Accepted: 08/06/2024] [Indexed: 09/02/2024] Open
Abstract
Background: Acute low back pain has a high prevalence, and when persisting into chronicity, it results in enormous socio-economic consequences. Sensory preferences may be key factors in predicting central sensitization as the main mechanism of nociplastic pain and chronicity. Objectives: Build a model to predict central sensitization symptoms using sensory profiles based on the PROGRESS framework. Methods: A Prognostic Model Research study was carried out to predict central sensitization symptoms at 12 weeks, using baseline sensory profiles, based on 114 patients with acute low back pain. Independent variables were sensory profiles, state and trait anxiety, age, duration, pain severity, depressive symptoms, and pain catastrophizing. Results: This model, based on continuous data, significantly predicts central sensitization symptoms at 12 weeks. It contains two significantly contributing variables: sensory profile Sensory Sensitive (unstandardized B-value = 0.42; p = 0.01) and trait anxiety (unstandardized B-value = 0.53; p ≤ 0.001). The model has a predictive value of R2 = 0.38. Conclusions: This model significantly predicts central sensitization symptoms based on sensory profile Sensory Sensitive and trait anxiety. This model may be a useful tool to intervene in a bottom-up and top-down approaches to prevent chronicity in clinical practice, including individual sensory preferences and behavioral responses to sensory stimulation in rehabilitation strategies.
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Affiliation(s)
- Pieter J. Gräper
- Experimental Anatomy Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; (A.S.); (J.M.H.)
| | - Aldo Scafoglieri
- Experimental Anatomy Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; (A.S.); (J.M.H.)
- Department of Master Education, SOMT University of Physiotherapy, Softwareweg 5, 3821 BN Amersfoort, The Netherlands
| | - Jacqueline R. Clark
- Pains & Brains, 8 Beach Grove, Omokoroa 3114, New Zealand;
- Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Joannes M. Hallegraeff
- Experimental Anatomy Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium; (A.S.); (J.M.H.)
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Lim B, Song W. Exploring CrossFit performance prediction and analysis via extensive data and machine learning. J Sports Med Phys Fitness 2024; 64:640-649. [PMID: 38916087 DOI: 10.23736/s0022-4707.24.15786-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
BACKGROUND The analysis of athletic performance has always aroused great interest from sport scientist. This study utilized machine learning methods to build predictive models using a comprehensive CrossFit (CF) dataset, aiming to reveal valuable insights into the factors influencing performance and emerging trends. METHODS Random forest (RF) and multiple linear regression (MLR) were employed to predict performance in four key weightlifting exercises within CF: clean and jerk, snatch, back squat, and deadlift. Performance was evaluated using R-squared (R2) values and mean squared error (MSE). Feature importance analysis was conducted using RF, XGBoost, and AdaBoost models. RESULTS The RF model excelled in deadlift performance prediction (R2=0.80), while the MLR model demonstrated remarkable accuracy in clean and jerk (R2=0.93). Across exercises, clean and jerk consistently emerged as a crucial predictor. The feature importance analysis revealed intricate relationships among exercises, with gender significantly impacting deadlift performance. CONCLUSIONS This research advances our understanding of performance prediction in CF through machine learning techniques. It provides actionable insights for practitioners, optimize performance, and demonstrates the potential for future advancements in data-driven sports analytics.
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Affiliation(s)
- Byunggul Lim
- Health and Exercise Science Laboratory, Department of Physical Education, Seoul National University, Seoul, South Korea
- Institute on Aging, Seoul National University, Seoul, South Korea
| | - Wook Song
- Health and Exercise Science Laboratory, Department of Physical Education, Seoul National University, Seoul, South Korea -
- Institute on Aging, Seoul National University, Seoul, South Korea
- Institute of Sport Science, Seoul National University, Seoul, South Korea
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Segning CM, da Silva RA, Ngomo S. An Innovative EEG-Based Pain Identification and Quantification: A Pilot Study. SENSORS (BASEL, SWITZERLAND) 2024; 24:3873. [PMID: 38931657 PMCID: PMC11207749 DOI: 10.3390/s24123873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE The present pilot study aimed to propose an innovative scale-independent measure based on electroencephalographic (EEG) signals for the identification and quantification of the magnitude of chronic pain. METHODS EEG data were collected from three groups of participants at rest: seven healthy participants with pain, 15 healthy participants submitted to thermal pain, and 66 participants living with chronic pain. Every 30 s, the pain intensity score felt by the participant was also recorded. Electrodes positioned in the contralateral motor region were of interest. After EEG preprocessing, a complex analytical signal was obtained using Hilbert transform, and the upper envelope of the EEG signal was extracted. The average coefficient of variation of the upper envelope of the signal was then calculated for the beta (13-30 Hz) band and proposed as a new EEG-based indicator, namely Piqβ, to identify and quantify pain. MAIN RESULTS The main results are as follows: (1) A Piqβ threshold at 10%, that is, Piqβ ≥ 10%, indicates the presence of pain, and (2) the higher the Piqβ (%), the higher the extent of pain. CONCLUSIONS This finding indicates that Piqβ can objectively identify and quantify pain in a population living with chronic pain. This new EEG-based indicator can be used for objective pain assessment based on the neurophysiological body response to pain. SIGNIFICANCE Objective pain assessment is a valuable decision-making aid and an important contribution to pain management and monitoring.
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Affiliation(s)
- Colince Meli Segning
- Department of Applied Sciences, UQAC (Université du Québec à Chicoutimi), Chicoutimi, QC G7H 2B1, Canada;
- Biomechanical and Neurophysiological Research Laboratory in Neuro-Musculoskeletal Rehabilitation (Lab BioNR), Department of Health Sciences, UQAC (Université du Québec à Chicoutimi), Chicoutimi, QC G7H 2B1, Canada;
| | - Rubens A. da Silva
- Biomechanical and Neurophysiological Research Laboratory in Neuro-Musculoskeletal Rehabilitation (Lab BioNR), Department of Health Sciences, UQAC (Université du Québec à Chicoutimi), Chicoutimi, QC G7H 2B1, Canada;
- Centre Intégré de Santé et Services Sociaux du Saguenay-Lac-Saint-Jean (CIUSSS SLSJ), Specialized Geriatrics Rehabilitation Services at the La Baie Hospital, CIUSSS-SLSJ, Saguenay, QC G7H 7K9, Canada
| | - Suzy Ngomo
- Biomechanical and Neurophysiological Research Laboratory in Neuro-Musculoskeletal Rehabilitation (Lab BioNR), Department of Health Sciences, UQAC (Université du Québec à Chicoutimi), Chicoutimi, QC G7H 2B1, Canada;
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Zimney KJ, Puentedura E, Kolber MJ, Louw A. The relationship between trust and outcomes during physical therapy care for chronic low back pain. Physiother Theory Pract 2024; 40:1164-1171. [PMID: 36282774 DOI: 10.1080/09593985.2022.2138731] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 09/14/2022] [Accepted: 10/07/2022] [Indexed: 10/31/2022]
Abstract
INTRODUCTION Enhancing the therapeutic alliance has been associated with improved outcomes for patients with chronic low back pain (CLBP). Qualitatively trust has been described to be part of the therapeutic alliance, but it has not been measured quantitatively within the physical therapy literature. OBJECTIVE Examine the relationship between trust and outcomes during physical therapy for CLBP. METHODS Observational study of patients with CLBP being seen for physical therapy were assessed through self-report measures. The Primary Care Assessment Survey (PCAS) trust measurement scale was completed by patients at initial, post-initial, and discharge visit. These measurements were compared for correlations with patient reported outcome measures for pain and function recorded at initial visit and discharge. RESULTS A convenience sample of 29 patients (49.3 ± 15 years old) with CLBP were measured. The PCAS showed correlations for changes in trust throughout treatment for improvements in pain and discharge pain rating. Average discharge pain rating correlated to changes in the PCAS (rs = -0.692, p < .001), with lower pain ratings relating to higher changes in trust over time. Average change in pain (rs = 0.745, p < .001) throughout treatment also correlated with higher changes in trust. Higher trust scores at discharge also correlated with improved Global Rating of Change and Oswestry Disability Index scores at discharge. The linear regression model showed adjusted R2 values for the trust scores and outcomes varied between 0.247 and 0.642. CONCLUSION Both increases in trust throughout the treatment and end trust scores during physical therapy were related to improved outcomes for patients with CLBP.
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Affiliation(s)
- Kory J Zimney
- School of Health Sciences, Department of Physical Therapy, University of South Dakota, Vermillion, SD, USA
| | | | - Morey J Kolber
- Department of Physical Therapy, Nova Southeastern University, Fort Lauderdale, FL, USA
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Tan SSH, Law GW, Kim SS, Sethi E, Lim AKS, Hui JHP. Trochleoplasty Provides Good Outcomes for Recurrent Patellofemoral Dislocations with No Clear Superiority across Different Techniques. J Clin Med 2024; 13:3009. [PMID: 38792556 PMCID: PMC11122057 DOI: 10.3390/jcm13103009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Literature is sparse on outcome comparisons between different trochleoplasty techniques in the treatment of patella instability. To date, it is unclear whether there is a technique that offers superior outcomes. This systematic review and meta-analysis aims to compare and evaluate the outcomes of trochleoplasty techniques in the treatment of patellofemoral instability in trochlea dysplasia to establish whether there is an ideal choice of trochleoplasty technique for superior outcomes. Methods: 21 studies involving 880 knees were included. The mean age of the patients was 21.7 years (range 8-49 years). Mean follow-up timeframe of 43.5 months (range 8.8-100 months). Clinical outcomes assessed included rates of recurrence of patellofemoral dislocation, patient satisfaction, Kujala score, International Knee Documentation Committee (IKDC) score, Tegner score, and Lysholm score. Egger's test showed no publication bias across all outcomes assessed. Results: Favourable results were seen across all outcomes assessed and patient satisfaction. Improvements were seen with Kujala, IKDC, and Lysholm scores. Tegner scores showed good return to function. Post-operative dislocation and complication rates were low across the different techniques. Meta-regression for Kujala and IKDC scores showed good outcomes regardless of trochleoplasty technique used (Kujala, p = 0.549, relative risk 492.06; IKDC, p = 0.193, RR 0.001). The exact risk that trochleoplasty poses to the cartilage remains uncertain, as no study had a conservatively managed arm for comparison. Conclusions: Trochleoplasty yielded good outcomes irrespective of technique used with no clear superiority demonstrated in any technique in terms of outcome scores, satisfaction, post-operative dislocation rates or complications.
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Affiliation(s)
| | - Gin Way Law
- Department of Orthopaedic Surgery, National University Health System, Singapore 119228, Singapore; (S.S.H.T.); (S.S.K.); (E.S.); (A.K.S.L.); (J.H.P.H.)
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Armstrong DP, Davidson JB, Fischer SL. Determining whether biomechanical variables that describe common 'safe lifting' cues are associated with low back loads. J Electromyogr Kinesiol 2024; 75:102867. [PMID: 38325138 DOI: 10.1016/j.jelekin.2024.102867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 01/17/2024] [Accepted: 01/25/2024] [Indexed: 02/09/2024] Open
Abstract
Lift technique training programs have been implemented to help reduce injury risk, but the underlying content validity of cues used within these programs is not clear. The objective of this study was to determine whether biomechanical variables, that commonly used lifting cues aim to elicit, are associated with resultant low back extensor moment exposures. A sample of 72 participants were recruited to perform 10 repetitions of a floor-to-waist height barbell lift while whole-body kinematics and ground reaction forces were collected. Kinematic, kinetic, and energetic variables representative of characteristics commonly targeted by lifting cues were calculated as predictor variables, while peak and cumulative low back moments were calculated as dependent measures. Multiple regression revealed that 56.6-59.2% of variance in low back moments was explained by predictor variables. From these regression models, generating motion with the legs (both greater hip and knee work), minimizing the horizontal distance of the body to the load, maintaining a stable body position, and minimizing lift time were associated with lower magnitudes of low back moments. These data support that using cues targeting these identified variables may be more effective at reducing peak low back moment exposures via lift training.
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Affiliation(s)
- Daniel P Armstrong
- Department of Kinesiology, Faculty of Health Sciences, University of Waterloo, Waterloo, Canada
| | - Justin B Davidson
- Department of Kinesiology, Faculty of Health Sciences, University of Waterloo, Waterloo, Canada
| | - Steven L Fischer
- Department of Kinesiology, Faculty of Health Sciences, University of Waterloo, Waterloo, Canada.
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Vafaie A, Raveshi MR, Devendran C, Nosrati R, Neild A. Making immotile sperm motile using high-frequency ultrasound. SCIENCE ADVANCES 2024; 10:eadk2864. [PMID: 38354240 PMCID: PMC10866541 DOI: 10.1126/sciadv.adk2864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 01/12/2024] [Indexed: 02/16/2024]
Abstract
Sperm motility is a natural selection with a crucial role in both natural and assisted reproduction. Common methods for increasing sperm motility are by using chemicals that cause embryotoxicity, and the multistep washing requirements of these methods lead to sperm DNA damage. We propose a rapid and noninvasive mechanotherapy approach for increasing the motility of human sperm cells by using ultrasound operating at 800 mW and 40 MHz. Single-cell analysis of sperm cells, facilitated by droplet microfluidics, shows that exposure to ultrasound leads to up to 266% boost to motility parameters of relatively immotile sperm, and as a result, 72% of these immotile sperm are graded as progressive after exposure, with a swimming velocity greater than 5 micrometer per second. These promising results offer a rapid and noninvasive clinical method for improving the motility of sperm cells in the most challenging assisted reproduction cases to replace intracytoplasmic sperm injection (ICSI) with less invasive treatments and to improve assisted reproduction outcomes.
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Affiliation(s)
- Ali Vafaie
- Department of Mechanical and Aerospace Engineering, Monash University, Clayton, Victoria 3800, Australia
| | - Mohammad Reza Raveshi
- Department of Mechanical and Aerospace Engineering, Monash University, Clayton, Victoria 3800, Australia
| | - Citsabehsan Devendran
- Department of Mechanical and Aerospace Engineering, Monash University, Clayton, Victoria 3800, Australia
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Brna PM, Gordon KE. Epilepsy in Canadian households: The financial pinch. Epilepsy Behav 2023; 149:109519. [PMID: 37995537 DOI: 10.1016/j.yebeh.2023.109519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 11/02/2023] [Accepted: 11/02/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND It has long been recognized that epilepsy has a substantial economic impact on populations including health care costs and employment impact. There is a paucity of data on the individual and household impact of epilepsy on financial income. METHODS Canadian data on households containing persons with epilepsy were derived from the National Population Health Survey of Neurological Conditions within the Canadian Community Health Survey (CCHS), a Canadian population-based cross-sectional survey that collects information related to health status (2010-2011). We determined the number of households in Canada reporting at least one member with epilepsy. We examined the difference in reported household income between households reporting at least one member with epilepsy with those not reporting any members with epilepsy. We then developed a model of reported household income within Canada in order to adjust the estimated impact on household income of having at least one member with epilepsy. RESULTS In 2010-2011, 122,911 respondents to the CCHS identified 1,254 households containing individuals with epilepsy, representing ∼ 594,200 households in Canada (95 % CI: 534,900-650,500). These respondents reported that household income for households with members with epilepsy was reduced by CDN$ 14,000 when compared to the mean reported household income of CDN$ 83,000, (p < 0.001). In a model of income, the adjusted impact of a household member with epilepsy was CDN$ 14,700 (95 % CI: 10,000-19,500). CONCLUSION The financial impact on Canadian households of persons with epilepsy is profound. While we can only speculate on the rationale driving this, the differential in average household income in households living with an individual with epilepsy is clear. This places an additional financial burden on persons with epilepsy (PWE) who may already face substantial medication, health care and caregiver costs.
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Affiliation(s)
- P M Brna
- Division of Pediatric Neurology, Department of Pediatrics Dalhousie University, 5850 University Avenue, Halifax, NS B3K6R8, Canada.
| | - K E Gordon
- Division of Pediatric Neurology, Department of Pediatrics Dalhousie University, 5850 University Avenue, Halifax, NS B3K6R8, Canada
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Labus KM, Wolynski J, Easley J, Stewart HL, Ilic M, Notaros B, Zagrocki T, Puttlitz CM, McGilvray KC. Employing direct electromagnetic coupling to assess acute fracture healing: An ovine model assessment. Injury 2023; 54:111080. [PMID: 37802738 PMCID: PMC10843464 DOI: 10.1016/j.injury.2023.111080] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/13/2023] [Accepted: 09/26/2023] [Indexed: 10/08/2023]
Abstract
OBJECTIVES This study explored the efficacy of collecting temporal fracture site compliance data via an advanced direct electromagnetic coupling (DEC) system equipped with a Vivaldi-type antenna, novel calibration technique, and multi-antenna setup (termed maDEC) as an approach to monitor acute fracture healing progress in a translational large animal model. The overarching goal of this approach was to provide insights into the acute healing dynamics, offering a promising avenue for optimizing fracture management strategies. METHODS A sample of twelve sheep, subjected to ostectomies and intramedullary nail fixations, was divided into two groups, simulating normal and impaired healing scenarios. Sequential maDEC compliance or stiffness measurements and radiographs were taken from the surgery until euthanasia at four or eight weeks and were subsequently compared with post-sacrifice biomechanical, micro-CT, and histological findings. RESULTS The results showed that the maDEC system offered straightforward quantification of fracture site compliance via a multiantenna array. Notably, the rate of change in the maDEC-measured bending stiffness significantly varied between normal and impaired healing groups during both the 4-week (p = 0.04) and 8-week (p = 0.02) periods. In contrast, radiographically derived mRUST healing measurements displayed no significant differences between the groups (p = 0.46). Moreover, the cumulative normalized stiffness maDEC data significantly correlated with post-sacrifice mechanical strength (r2 = 0.80, p < 0.001), micro-CT measurements of bone volume fraction (r2 = 0.60, p = 0.003), and density (r2 = 0.60, p = 0.003), and histomorphometric measurements of new bone area fraction (r2 = 0.61, p = 0.003) and new bone area (r2 = 0.60, p < 0.001). CONCLUSIONS These data indicate that the enhanced maDEC system provides a non-invasive, accurate method to monitor fracture healing during the acute healing phase, showing distinct stiffness profiles between normal and impaired healing groups and offering critical insights into the healing process's progress and efficiency.
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Affiliation(s)
- Kevin M Labus
- Orthopaedic Bioengineering Research Laboratory, Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
| | - Jakob Wolynski
- Orthopaedic Bioengineering Research Laboratory, Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
| | - Jeremiah Easley
- Preclinical Surgical Research Laboratory, Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Holly L Stewart
- Preclinical Surgical Research Laboratory, Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Milan Ilic
- University of Belgrade, School of Electrical Engineering, Belgrade, Serbia
| | - Branislav Notaros
- Electromagnetic Laboratory, Department of Electrical and Computer Engineering, Colorado State University, Fort Collins, Colorado, USA
| | - Taylor Zagrocki
- Orthopaedic Bioengineering Research Laboratory, Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
| | - Christian M Puttlitz
- Orthopaedic Bioengineering Research Laboratory, Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA
| | - Kirk C McGilvray
- Orthopaedic Bioengineering Research Laboratory, Department of Mechanical Engineering, Colorado State University, Fort Collins, CO, USA.
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Song Y, Jin Q, Qiu J, Ye D. A systematic review and meta-analysis on the correlation between HIV infection and multidrug-resistance tuberculosis. Heliyon 2023; 9:e21956. [PMID: 38034813 PMCID: PMC10682624 DOI: 10.1016/j.heliyon.2023.e21956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/22/2023] [Accepted: 11/01/2023] [Indexed: 12/02/2023] Open
Abstract
Background The emergence of multidrug-resistant tuberculosis (MDR-TB) in HIV-positive people poses a significant challenge to international efforts to eradicate tuberculosis (TB). Many studies found conflicting results when examining the correlation between HIV and MDR-TB. The purpose of the present investigation was to comprehensively review the literature on the association between HIV infection and MDR-TB in order to evaluate the impact of HIV on MDR-TB worldwide. Methods Utilizing the databases PubMed, Scopus, Google Scholar, and ScienceDirect, studies published between January 2000 and March 2023 that are eligible for meta-analysis were selected. Using the random-effects model, the aggregated odds ratio of the empirical relationship between HIV and MDR-TB was calculated, along with a confidence interval ranging from 0 to 95 %. Examining the asymmetry of the funnel plot and utilizing Egger's and Begg's test, the possibility of publication bias was investigated. The extent of heterogeneity was determined using the I2 statistics. Results Through a database search, we identified 1214 studies, from which we ultimately selected 15 studies involving 9667 patients. The odds ratio of 2.78 (95 % confidence interval: 1.07-7.20) between HIV/AIDS and MDR-TB indicates a significant positive correlation. Tau 2 = 3.46, chi 2 = 1440.46, df = 14, I2 = 99.0 %, z = 2.10, and p 0.05 indicate that there is substantial heterogeneity among pooled studies. Since I2 is 99 % (>50 %), a random effect model was employed. The percentage of multidrug-resistant HIV-positive patients across all included studies follows a normal distribution, as shown by a Box and whisker plot with a symmetric skewness and a mesokurtic tail and a scatter plot with a significant R2 value below 1 [R2 = 0.2476] showed the positive correlation between multidrug resistance and HIV infection. Conclusion HIV infection increases MDR-TB risk, and the preceding pooled analysis showed an increased risk trend. Thus, MDR-TB, especially in HIV-positive patients, requires early case detection, quality-assured bacteriology diagnosis, and an effective infection control program.
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Affiliation(s)
- Yulong Song
- Department of Infectious Disease,Taizhou Municipal Hospital, Tai Zhou City, Zhejiang Province, 318000, China
| | - Qian Jin
- Department of Infectious Disease,Taizhou Municipal Hospital, Tai Zhou City, Zhejiang Province, 318000, China
| | - Jihai Qiu
- Department of Infectious Disease,Taizhou Municipal Hospital, Tai Zhou City, Zhejiang Province, 318000, China
| | - Dan Ye
- Department of Infectious Disease,Taizhou Municipal Hospital, Tai Zhou City, Zhejiang Province, 318000, China
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15
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Chokphukiao P, Poncumhak P, Intaruk R, Thaweewannakij T, Somboonporn C, Amatachaya S. The Use of Practical Measures to Determine Body Composition of Older People. Malays J Med Sci 2023; 30:129-143. [PMID: 37928794 PMCID: PMC10624436 DOI: 10.21315/mjms2023.30.5.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 01/28/2023] [Indexed: 11/07/2023] Open
Abstract
Background Older adults frequently experience body composition changes-decreased lean body mass (LBM) and bone mineral content (BMC), along with increased body fat mass (FM)-which affect their health and independence. However, the need for standard complex and costly imaging modalities could delay the detection of these changes and retard treatment effectiveness. Thus, this study explored the ability of practical measures, including simple muscle strength tests and demographic data, to determine the body composition of older adults. Methods Participants (n = 111, with an average age of 77 years old) were cross-sectionally assessed for the outcomes of the study, including upper limb loading during a seated push-up test (ULL-SPUT), hand grip (HG) strength test and body composition. Results The ULL-SPUT significantly correlated with body composition (r or rs, = 0.370-0.781; P < 0.05), particularly for female participants and was higher than that found for the HG strength test (rs = 0.340-0.614; P < 0.05). The ULL-SPUT and HG strength test, along with gender and body mass index (BMI), could accurately determine the LBM and BMC of the participants up to 82%. Conclusion The ULL-SPUT along with gender and BMI can be used as a practical strategy to detect the LBM and BMC of older adults in various settings. Such a strategy would facilitate timely managements (i.e. standard confirmation or appropriate interventions) in various settings.
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Affiliation(s)
- Pakwipa Chokphukiao
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand
- Department of Physical Therapy, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Puttipong Poncumhak
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao, Thailand
| | - Roongnapa Intaruk
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Thiwabhorn Thaweewannakij
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Charoonsak Somboonporn
- Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand
- Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sugalya Amatachaya
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand
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Bartholomeus GA, van Amsterdam WAC, Harder AMD, Willemink MJ, van Hamersvelt RW, de Jong PA, Leiner T. Robustness of pulmonary nodule radiomic features on computed tomography as a function of varying radiation dose levels-a multi-dose in vivo patient study. Eur Radiol 2023; 33:7044-7055. [PMID: 37074424 PMCID: PMC10511375 DOI: 10.1007/s00330-023-09643-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 03/16/2023] [Accepted: 03/28/2023] [Indexed: 04/20/2023]
Abstract
OBJECTIVE Analysis of textural features of pulmonary nodules in chest CT, also known as radiomics, has several potential clinical applications, such as diagnosis, prognostication, and treatment response monitoring. For clinical use, it is essential that these features provide robust measurements. Studies with phantoms and simulated lower dose levels have demonstrated that radiomic features can vary with different radiation dose levels. This study presents an in vivo stability analysis of radiomic features for pulmonary nodules against varying radiation dose levels. METHODS Nineteen patients with a total of thirty-five pulmonary nodules underwent four chest CT scans at different radiation dose levels (60, 33, 24, and 15 mAs) in a single session. The nodules were manually delineated. To assess the robustness of features, we calculated the intra-class correlation coefficient (ICC). To visualize the effect of milliampere-second variation on groups of features, a linear model was fitted to each feature. We calculated bias and calculated the R2 value as a measure of goodness of fit. RESULTS A small minority of 15/100 (15%) radiomic features were considered stable (ICC > 0.9). Bias increased and R2 decreased at lower dose, but shape features seemed to be more robust to milliampere-second variations than other feature classes. CONCLUSION A large majority of pulmonary nodule radiomic features were not inherently robust to radiation dose level variations. For a subset of features, it was possible to correct this variability by a simple linear model. However, the correction became increasingly less accurate at lower radiation dose levels. CLINICAL RELEVANCE STATEMENT Radiomic features provide a quantitative description of a tumor based on medical imaging such as computed tomography (CT). These features are potentially useful in several clinical tasks such as diagnosis, prognosis prediction, treatment effect monitoring, and treatment effect estimation. KEY POINTS • The vast majority of commonly used radiomic features are strongly influenced by variations in radiation dose level. • A small minority of radiomic features, notably the shape feature class, are robust against dose-level variations according to ICC calculations. • A large subset of radiomic features can be corrected by a linear model taking into account only the radiation dose level.
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Affiliation(s)
| | | | | | - Martin J Willemink
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Pim A de Jong
- University Medical Center Utrecht, Utrecht, the Netherlands
| | - Tim Leiner
- University Medical Center Utrecht, Utrecht, the Netherlands
- Mayo Clinic, Rochester, MN, USA
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Scala A, Trunfio TA, Improta G. Classification and regression model to manage the hospitalization for laparoscopic cholecystectomy. Sci Rep 2023; 13:14700. [PMID: 37679406 PMCID: PMC10485042 DOI: 10.1038/s41598-023-41597-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/29/2023] [Indexed: 09/09/2023] Open
Abstract
Gallstone disease (GD) is one of the most common morbidities in the world. Laparoscopic Cholecystectomy (LC) is currently the gold standard, performed in about 96% of cases. The most affected groups are the elderly, who generally have higher pre- and post-operative morbidity and mortality rates and longer Length of Stay (LOS). For this reason, several indicators have been defined to improve quality and efficiency and contain costs. In this study, data from patients who underwent LC at the "San Giovanni di Dio e Ruggi d'Aragona" University Hospital of Salerno in the years 2010-2020 were processed using a Multiple Linear Regression (MLR) model and Classification algorithms in order to identify the variables that most influence LOS. The results of the 2352 patients analyzed showed that pre-operative LOS and Age were the independent variables that most affected LOS. In particular, MLR model had a R2 value equal to 0.537 and the best classification algorithm, Decision Tree, had an accuracy greater than 83%. In conclusion, both the MLR model and the classification algorithms produced significant results that could provide important support in the management of this healthcare process.
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Affiliation(s)
- Arianna Scala
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | - Teresa Angela Trunfio
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.
| | - Giovanni Improta
- Department of Public Health, University of Naples "Federico II", Naples, Italy
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples "Federico II", Naples, Italy
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Lalji R, Hincapié CA, Macpherson A, Howitt S, Marshall C, Tamim H. Association Between First Attempt Buffalo Concussion Treadmill Test and Days to Recovery in 855 Children With Sport-Related Concussion: A Historical Cohort Study and Prognostic Factors Analysis. Clin J Sport Med 2023; 33:505-511. [PMID: 36881442 PMCID: PMC10467809 DOI: 10.1097/jsm.0000000000001134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 01/19/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVE Little is known about the prognostic value of the Buffalo Concussion Treadmill Test (BCTT) after the acute phase of sport-related concussion (SRC). We examined the added prognostic value of the BCTT performed 10 to 21 days after SRC in children, in addition to participant, injury, and clinical process characteristics on days to recovery. DESIGN Historical clinical cohort study. SETTING Network of approximately 150 Canadian multidisciplinary primary-care clinics. PARTICIPANTS 855 children (mean age 14 years, range 6-17 years, 44% female) who presented between January 2016, and April 2019 with SRC. ASSESSMENT OF RISK FACTORS Participant, injury, and clinical process characteristics, with focus on BCTT exercise intolerance assessed 10 to 21 days after injury. OUTCOME Days to clinical recovery. RESULTS Children who were exercise intolerant experienced an increase of 13 days to recovery (95% CI, 9-18 days). Each additional day between SRC and first BCTT was associated with a recovery delay of 1 day (95% CI, 1-2 days), and prior history of concussion was associated with a recovery delay of 3 days (95% CI, 1-5 days). Participant, injury, and clinical process characteristics, and the first attempt BCTT result explained 11% of the variation in recovery time, with 4% accounted for by the BCTT. CONCLUSION Exercise-intolerance assessed 10 to 21 days after SRC was associated with delayed recovery. However, this was not a strong prognostic factor for days to recovery.
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Affiliation(s)
- Rahim Lalji
- EBPI-UWZH Musculoskeletal Epidemiology Research Group, University of Zurich and Balgrist University Hospital, Zurich, Switzerland
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Switzerland
- University Spine Centre Zurich (UWZH), Balgrist University Hospital, University of Zurich, Switzerland
| | - Cesar A. Hincapié
- EBPI-UWZH Musculoskeletal Epidemiology Research Group, University of Zurich and Balgrist University Hospital, Zurich, Switzerland
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Switzerland
- University Spine Centre Zurich (UWZH), Balgrist University Hospital, University of Zurich, Switzerland
| | - Alison Macpherson
- School of Kinesiology and Health Science, York University, Toronto, Canada
| | - Scott Howitt
- Canadian Memorial Chiropractic College (CMCC), Toronto, Canada; and
| | | | - Hala Tamim
- School of Kinesiology and Health Science, York University, Toronto, Canada
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Madara KC, Aljehani M, Marmon A, Dellose S, Rubano J, Zeni J. Factors Related to Expectations in Individuals Waiting for Total Knee Arthroplasty. Physiother Can 2023; 75:257-263. [PMID: 37736415 PMCID: PMC10510534 DOI: 10.3138/ptc-2020-0141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 10/27/2021] [Accepted: 11/21/2021] [Indexed: 09/23/2023]
Abstract
Purpose There is no consensus on how age and expectations influence planning for total knee arthroplasty (TKA). This study developed and evaluated a new expectation questionnaire and assessed the relationship between preoperative expectations and patient characteristics. Method The questionnaire evaluated expectations for mobility, pain, participation, and rate of recovery after surgery. Fifty-five participants completed a 6-minute walk test and expectation questionnaire prior to TKA; 17 participants repeated the questionnaire one week later for reliability testing. Analysis of the questionnaire included intra-class correlation coefficient (ICC), homoscedasticity, skewness, kurtosis, multicollinearity, and descriptive measures. A four-step hierarchical linear regression was completed to determine the relationship of patient age, BMI, previous contralateral TKA, and 6-minute walk test scores to expectations. Results The questionnaire showed good/high test-retest reliability (ICC 0.84; 95% CI: 0.57, 0.94; p > 0.001). The final model was significant in predicting expectation scores R2 = 0.19 (p = 0.017). Conclusions This questionnaire reliably measures patient expectations before TKA; however, further research is needed. Although we anticipated younger age to be related to higher expectations, higher function prior to TKA appears to be more strongly associated with higher expectations.
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Affiliation(s)
- Kathleen C. Madara
- From the:
Rehabilitation Sciences, Moravian University, Bethlehem, Pennsylvania, United States
| | - Moiyad Aljehani
- Physical Therapy, University of Delaware, Newark, Delaware, United States
- Physical Therapy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Adam Marmon
- LiteCure, Limited Liability Company, New Castle, Delaware, United States
| | - Steven Dellose
- Christiana Care Health System, Department of Orthopaedics, Wilmington, Delaware, United States
- Delaware Orthopaedic Specialists, Newark, Delaware, United States
| | - James Rubano
- Christiana Care Health System, Department of Orthopaedics, Wilmington, Delaware, United States
- Delaware Orthopaedic Specialists, Newark, Delaware, United States
| | - Joseph Zeni
- Rutgurs University, Newark, New Jersey, United States
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Pavelchek C, Lee DS, Walia A, Michelson AP, Ortmann A, Gentile B, Herzog JA, Buchman CA, Shew MA. Responsible Imputation of Missing Speech Perception Testing Data & Analysis of 4,739 Observations and Predictors of Performance. Otol Neurotol 2023; 44:e369-e378. [PMID: 37231531 PMCID: PMC10330090 DOI: 10.1097/mao.0000000000003903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To address outcome heterogeneity in cochlear implant (CI) research, we built imputation models using multiple imputation by chained equations (MICEs) and K-nearest neighbors (KNNs) to convert between four common open-set testing scenarios: Consonant-Nucleus-Consonant word (CNCw), Arizona Biomedical (AzBio) in quiet, AzBio +5, and AzBio +10. We then analyzed raw and imputed data sets to evaluate factors affecting CI outcome variability. STUDY DESIGN Retrospective cohort study of a national CI database (HERMES) and a nonoverlapping single-institution CI database. SETTING Multi-institutional (32 CI centers). PATIENTS Adult CI recipients (n = 4,046 patients). MAIN OUTCOME MEASURES Mean absolute error (MAE) between imputed and observed speech perception scores. RESULTS Imputation models of preoperative speech perception measures demonstrate a MAE of less than 10% for feature triplets of CNCw/AzBio in quiet/AzBio +10 (MICE: MAE, 9.52%; 95% confidence interval [CI], 9.40-9.64; KNN: MAE, 8.93%; 95% CI, 8.83-9.03) and AzBio in quiet/AzBio +5/AzBio +10 (MICE: MAE, 8.85%; 95% CI, 8.68-9.02; KNN: MAE, 8.95%; 95% CI, 8.74-9.16) with one feature missing. Postoperative imputation can be safely performed with up to four of six features missing in a set of CNCw and AzBio in quiet at 3, 6, and 12 months postcochlear implantation using MICE (MAE, 9.69%; 95% CI, 9.63-9.76). For multivariable analysis of CI performance prediction, imputation increased sample size by 72%, from 2,756 to 4,739, with marginal change in adjusted R2 (0.13 raw, 0.14 imputed). CONCLUSIONS Missing data across certain sets of common speech perception tests may be safely imputed, enabling multivariate analysis of one of the largest CI outcomes data sets to date.
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Affiliation(s)
- Cole Pavelchek
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - David S Lee
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Amit Walia
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
| | | | - Amanda Ortmann
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Brynn Gentile
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Jacques A Herzog
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Craig A Buchman
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
| | - Matthew A Shew
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri
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Lunevicius R, Nzenwa IC. Multiple logistic regression model to predict bile leak associated with subtotal cholecystectomy. Surg Endosc 2023; 37:5405-5413. [PMID: 37016083 PMCID: PMC10072799 DOI: 10.1007/s00464-023-10049-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 03/26/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND There are no prediction models for bile leakage associated with subtotal cholecystectomy (STC). Therefore, this study aimed to generate a multivariable prediction model for post-STC bile leakage and evaluate its overall performance. METHODS We analysed prospectively managed data of patients who underwent STC by a single consultant surgeon between 14 May 2013 and 21 December 2021. STC was schematised into four variants with five subvariants and classified broadly as closed-tract or open-tract STC. A contingency table was used to detect independent risk factors for bile leakage. A multiple logistic regression analysis was used to generate a model. Discrimination and calibration statistics were computed to assess the accuracy of the model. RESULTS A total of 81 patients underwent the STC procedure. Twenty-eight patients (35%) developed bile leakage. Of these, 18 patients (64%) required secondary surgical intervention. Multivariable logistic regression revealed two independent predictors of post-STC bile leak: open-tract STC (odds ratio [OR], 7.07; 95% confidence interval [CI], 2.191-25.89; P = 0.0170) and acute cholecystitis (OR, 5.449; 95% CI, 1.584-23.48; P = 0.0121). The area under the receiver-operating characteristic curve was 82.11% (95% CI, 72.87-91.34; P < 0.0001). Tjur's pseudo-R2 was 0.3189 and the Hosmer-Lemeshow goodness-of-fit statistic was 4.916 (P = 0.7665). CONCLUSIONS Open-tract STC and acute cholecystitis are the most reliable predictors of bile leakage associated with STC. Future prospective, multicentre studies with higher statistical power are needed to generate more specific and externally validated prediction models for post-STC bile leaks.
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Affiliation(s)
- Raimundas Lunevicius
- Department of General Surgery, Liverpool University Hospitals NHS Foundation Trust, Aintree Hospital, Lower Lane, Liverpool, L9 7AL, UK.
| | - Ikemsinachi C Nzenwa
- School of Medicine, University of Liverpool, Cedar House, Ashton St, Liverpool, L69 3GE, UK
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Wiyanad A, Amatachaya S, Amatachaya P, Suwannarat P, Chokphukiao P, Sooknuan T, Gaogasigam C. The seventh cervical vertebra is an appropriate landmark for thoracic kyphosis measures using distance from the wall. Hong Kong Physiother J 2023; 43:43-51. [PMID: 37584052 PMCID: PMC10423679 DOI: 10.1142/s1013702523500038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 10/20/2022] [Indexed: 08/17/2023] Open
Abstract
Background Hyperkyphosis is frequently found nowadays due to the change in current lifestyles and age-related system decline. A simple hyperkyphosis measurement can be made easily using the perpendicular distance from the landmark to the wall. However, the existing evidence applied two different landmarks [occiput and the seventh cervical vertebra (C7)] and the measurement using rulers was susceptible to error due to their misalignment. Objective To assess an appropriate landmark for thoracic kyphosis measurement using distance from the wall (KMD), by comparing between occiput and C7, as measured using rulers and verified using data from a specially developed machine, the so-called infrared-gun kyphosis wall distance tool (IG-KypDisT), and the Cobb angles. Methods Community-dwelling individuals with a risk of thoracic hyperkyphosis (age ≥ 10 years, n = 43 ) were cross-sectionally assessed for their thoracic hyperkyphosis using the perpendicular distance from the landmarks, occiput and C7, to the wall using rulers and IG-KypDisT. Then the Cobb angles of these participants were measured within seven days. Results The outcomes from both landmarks differed by approximately 0.8 cm (p = 0.084). The outcomes derived from C7 were more reliable (ICCs>0.93, p < 0.001), with greater concurrent validity with the radiologic data (r = 0.738, p < 0.001), with the overall variance predicted by the regression models for the Cobb angles being higher than that from the occiput (47-48% from C7 and 38-39% from occiput). The outcomes derived from rulers and IG-KypDisT showed no significant differences. Conclusion The present findings support the reliability and validity of KMD assessments at C7 using rulers as a simple standard measure of thoracic hyperkyphosis that can be used in various clinical, community, and research settings.
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Affiliation(s)
- Arpassanan Wiyanad
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand
- Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Sugalya Amatachaya
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand
- Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Pipatana Amatachaya
- Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Patcharawan Suwannarat
- Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen 40002, Thailand
- Department of Physical Therapy, School of Integrative Medicine, Mae Fah Luang University, Chiang Rai, Thailand
| | - Pakwipa Chokphukiao
- Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen 40002, Thailand
- Department of Physical Therapy, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Thanat Sooknuan
- Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen 40002, Thailand
- Department of Electronics Engineering, Faculty of Engineering and Architecture, Rajamangala University of Technology Isan, Nakhon Ratchasima, Thailand
| | - Chitanongk Gaogasigam
- Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen 40002, Thailand
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand
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Riveros-Perez E, Polania-Gutierrez JJ, Avella-Molano B. Fetal heart rate changes and labor neuraxial analgesia: a machine learning approach. BMC Pregnancy Childbirth 2023; 23:329. [PMID: 37211590 DOI: 10.1186/s12884-023-05632-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 04/21/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND Neuraxial labor analgesia has been associated with fetal heart rate changes. Fetal bradycardia is multifactorial, and predicting it poses a significant challenge to clinicians. Machine learning algorithms may assist the clinician to predict fetal bradycardia and identify predictors associated with its presentation. METHODS A retrospective analysis of 1077 healthy laboring parturients receiving neuraxial analgesia was conducted. We compared a principal components regression model with tree-based random forest, ridge regression, multiple regression, a general additive model, and elastic net in terms of prediction accuracy and interpretability for inference purposes. RESULTS Multiple regression identified combined spinal-epidural (CSE) (p = 0.02), interaction between CSE and dose of phenylephrine (p < 0.0001), decelerations (p < 0.001), and the total dose of bupivacaine (p = 0.03) as associated with decrease in fetal heart rate. Random forest exhibited good predictive accuracy (mean standard error of 0.92). CONCLUSION Use of CSE, presence of decelerations, total dose of bupivacaine, and total dose of vasopressors after CSE are associated with decreases in fetal heart rate in healthy parturients during labor. Prediction of changes in fetal heart rate can be approached with a tree-based random forest model with good accuracy with important variables that are key for the prediction, such as CSE, BMI, duration of stage 1 of labor, and dose of bupivacaine.
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Affiliation(s)
- Efrain Riveros-Perez
- Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia, Augusta University, 1120 15th street BI-2144, Augusta, GA, 30912, USA.
| | - Javier Jose Polania-Gutierrez
- Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia, Augusta University, 1120 15th street BI-2144, Augusta, GA, 30912, USA
| | - Bibiana Avella-Molano
- Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia, Augusta University, 1120 15th street BI-2144, Augusta, GA, 30912, USA
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McDonald O, Perraton L, Osadnik C. Validity and clinical applicability of the 60-secondecond sit-to-stand test in people with acute exacerbations of COPD. Respir Med 2023:107264. [PMID: 37217083 DOI: 10.1016/j.rmed.2023.107264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 04/19/2023] [Accepted: 04/30/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND The 60-second sit-to-stand test (60STS) is a simple and increasingly popular test of physical function, however evidence to support its appropriateness for assessing people with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is lacking. AIMS To evaluate the concurrent, convergent, predictive and discriminant validity, and responsiveness of the 60STS against the six-minute walk test (6MWT) in people hospitalised due to AECOPD. METHODS Prospective cohort study involving 54 inpatients with AECOPD (53% males, mean age 69.0 years, FEV1 46.5% predicted). 60STS was performed 30 min after a six-minute walk test (6MWT) upon discharge, with follow-up testing repeated one-month later (n = 39). Outcome measures included 60STS repetitions (60STSr), six-minute walk distance (6MWD), heart rate, oxyhaemoglobin saturation (SpO2), perceived dyspnoea (Borg scale), and rate of perceived exertion (RPE). Concurrent validity was assessed via correlation, convergent validity via Bland-Altman plots, predictive validity via multivariate linear regression (adjusted for confounders), discriminant validity via unpaired t tests and responsiveness via Chi (Jenkins, 2007) [2] tests. RESULTS Discharge 60STSr and 6MWD were strongly correlated (r = 0.61). Bland-Altman plots for nadir SpO2, peak HR, Borg and RPE scores showed acceptable agreement in terms of mean differences, but wide limits of agreement. Poor 60STSr performers were older, had weaker quadriceps, and had lower 6MWD than high performers (p < 0.05 for all). 60STSr was not retained as a significant predictor of 6MWD in multivariate regression analyses. 80% of 60STSr improvers also improved >30m on 6MWT at follow-up. CONCLUSION The 60STS demonstrates satisfactory validity and responsiveness as a measure of exercise performance in people with AECOPD.
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Affiliation(s)
- Olivia McDonald
- Department of Physiotherapy, Monash University, Melbourne, Australia.
| | - Luke Perraton
- Department of Physiotherapy, Monash University, Melbourne, Australia.
| | - Christian Osadnik
- Department of Physiotherapy, Monash University, Melbourne, Australia.
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25
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Guillot AJ, Martínez-Navarrete M, Garrigues TM, Melero A. Skin drug delivery using lipid vesicles: A starting guideline for their development. J Control Release 2023; 355:624-654. [PMID: 36775245 DOI: 10.1016/j.jconrel.2023.02.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/02/2023] [Accepted: 02/02/2023] [Indexed: 02/14/2023]
Abstract
Lipid vesicles can provide a cost-effective enhancement of skin drug absorption when vesicle production process is optimised. It is an important challenge to design the ideal vesicle, since their properties and features are related, as changes in one affect the others. Here, we review the main components, preparation and characterization methods commonly used, and the key properties that lead to highly efficient vesicles for transdermal drug delivery purposes. We stand by size, deformability degree and drug loading, as the most important vesicle features that determine the further transdermal drug absorption. The interest in this technology is increasing, as demonstrated by the exponential growth of publications on the topic. Although long-term preservation and scalability issues have limited the commercialization of lipid vesicle products, freeze-drying and modern escalation methods overcome these difficulties, thus predicting a higher use of these technologies in the market and clinical practice.
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Affiliation(s)
- Antonio José Guillot
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, University of Valencia, Avda. Vicente A. Estelles SN, Burjassot (Valencia), Spain
| | - Miquel Martínez-Navarrete
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, University of Valencia, Avda. Vicente A. Estelles SN, Burjassot (Valencia), Spain
| | - Teresa M Garrigues
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, University of Valencia, Avda. Vicente A. Estelles SN, Burjassot (Valencia), Spain
| | - Ana Melero
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, University of Valencia, Avda. Vicente A. Estelles SN, Burjassot (Valencia), Spain.
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Huber M, Agarwal D, Schmitt RH. Similarity assessment and model migration for measurement processes. INTERNATIONAL JOURNAL OF QUALITY & RELIABILITY MANAGEMENT 2023. [DOI: 10.1108/ijqrm-09-2022-0268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
PurposeThe determination of the measurement uncertainty is relevant for all measurement processes. In production engineering, the measurement uncertainty needs to be known to avoid erroneous decisions. However, its determination is associated to high effort due to the expertise and expenditure that is needed for modelling measurement processes. Once a measurement model is developed, it cannot necessarily be used for any other measurement process. In order to make an existing model useable for other measurement processes and thus to reduce the effort for the determination of the measurement uncertainty, a procedure for the migration of measurement models has to be developed.Design/methodology/approachThis paper presents an approach to migrate measurement models from an old process to a new “similar” process. In this approach, the authors first define “similarity” of two processes mathematically and then use it to give a first estimate of the measurement uncertainty of the similar measurement process and develop different learning strategies. A trained machine-learning model is then migrated to a similar measurement process without having to perform an equal size of experiments.Similarity assessment and model migrationFindingsThe authors’ findings show that the proposed similarity assessment and model migration strategy can be used for reducing the effort for measurement uncertainty determination. They show that their method can be applied to a real pair of similar measurement processes, i.e. two computed tomography scans. It can be shown that, when applying the proposed method, a valid estimation of uncertainty and valid model even when using less data, i.e. less effort, can be built.Originality/valueThe proposed strategy can be applied to any two measurement processes showing a particular “similarity” and thus reduces the effort in estimating measurement uncertainties and finding valid measurement models.
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Griffin C, Block R, Silverman JD, Croad J, Lennon RP. Race, employment, and the pandemic: An exploration of covariate explanations of COVID-19 case fatality rate variance. PLoS One 2023; 18:e0274470. [PMID: 36730260 PMCID: PMC9894486 DOI: 10.1371/journal.pone.0274470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 08/25/2022] [Indexed: 02/03/2023] Open
Abstract
We derive a simple asymptotic approximation for the long-run case fatality rate of COVID-19 (alpha and delta variants) and show that these estimations are highly correlated to the interaction between US State median age and projected US unemployment rate (Adj. r2 = 60%). We contrast this to the high level of correlation between point (instantaneous) estimates of per state case fatality rates and the interaction of median age, population density and current unemployment rates (Adj. r2 = 50.2%). To determine whether this is caused by a "race effect," we then analyze unemployment, race, median age and population density across US states and show that adding the interaction of African American population and unemployment explains 53.5% of the variance in COVID case fatality rates for the alpha and delta variants when considering instantaneous case fatality rate. Interestingly, when the asymptotic case fatality rate is used, the dependence on the African American population disappears, which is consistent with the fact that in the long-run COVID does not discriminate on race, but may discriminate on access to medical care which is highly correlated to employment in the US. The results provide further evidence of the impact inequality can have on case fatality rates in COVID-19 and the impact complex social, health and economic factors can have on patient survival.
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Affiliation(s)
- Christopher Griffin
- Applied Research Laboratory, Pen State University, University Park, State College, PA, United States of America
- * E-mail:
| | - Ray Block
- Departments of Political Science and African American Studies, Penn State University, University Park, State College, PA, United States of America
| | - Justin D. Silverman
- College of Information Science and Technology, Penn State University, University Park, State College, PA, United States of America
| | - Jason Croad
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA, United States of America
| | - Robert P. Lennon
- Department of Family and Community Medicine, Penn State College of Medicine, Hershey, PA, United States of America
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Association Between Cannabis and Violence in Community-Dwelling Patients With Severe Mental Disorders: A Cross-sectional Study Using Machine Learning. J Nerv Ment Dis 2023; 211:88-94. [PMID: 36716062 DOI: 10.1097/nmd.0000000000001604] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The objective of this cross-sectional study was to identify cannabis-related features and other characteristics predictive of violence using a data-driven approach in patients with severe mental disorders (SMDs). A Least Absolute Shrinkage and Selection Operator regularization regression model was used on the database consisting of 97 patients with SMD who completed questionnaires measuring substance use and violence. Cannabis use, particularly related to patients' decision to consume or time spent using, was a key predictor associated with violence. Other patterns of substance use and personality traits were identified as strong predictors. Regular patterns of cannabis use and interpersonal issues related to cannabis/stimulant abuse were inversely correlated to violence. This study identified the effect of several predictors correlated to violence in patients with SMD using a regularization regression model. Findings open the door to better identify the profiles of patients that may be more susceptible to perpetrate violent behaviors.
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Burma JS, Rattana S, Johnson NE, Smirl JD. Do mean values tell the full story? Cardiac cycle and biological sex comparisons in temporally derived neurovascular coupling metrics. J Appl Physiol (1985) 2023; 134:426-443. [PMID: 36603050 DOI: 10.1152/japplphysiol.00170.2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Previous reports have noted cerebrovascular regulation differs across the cardiac cycle, with greater regulation occurring within systole. However, this methodological notion has not been meticulously scrutinized during temporally deduced neurovascular coupling (NVC) metrics with additional respect to biological sex. Analyses of 111 healthy individuals (40 females/71 males) were performed where participants engaged in the "Where's Waldo?" paradigm. All NVC parameters were quantified in the posterior and middle cerebral arteries at 310 unique timepoints. Several individuals completed repeat testing which enabled for between-day (3 timepoints) and within-day (7 timepoints) reliability comparisons in 17 and 11 individuals, respectively. One-way analysis of variance compared NVC metrics between diastole, mean, and systole values, as well as differences between biological sexes. Greater absolute cerebral blood velocity (CBv; baseline and peak) and total activation (area under the curve) were noted within systole for both posterior cerebral artery (PCA; P < 0.001) and middle cerebral artery (MCA; P < 0.001) values; however, the relative percent increase in CBv was greater within diastole (P < 0.001). Females had an elevated diastolic and mean CBv and a greater diastolic cerebrovascular conductance (P < 0.050). No sex differences were present for systolic CBv measures and within parameters quantifying the NVC response (area under the curve/relative CBv increase) across the cardiac cycle (P > 0.072). Future investigations seeking to differentiate cerebral regulatory mechanisms between clinical populations may benefit by performing their analyses across the cardiac cycle, as certain pathogenesis may affect one aspect of the cardiac cycle independently. Minimal differences were noted between females and males for metrics characterizing the NVC response across the cardiac cycle.NEW & NOTEWORTHY Neurovascular coupling (NVC) studies commonly assess the mean cerebral hemodynamic response with little consideration for diastole, systole, and biological sex. Greater total activation expressed as the area under the curve was seen within systole compared with mean and diastole. Resting cerebral blood velocity sex differences were more prevalent during diastole when the cerebrovasculature was pressure-passive. Future studies should assess the NVC response across the cardiac cycle as it may help delineate the underlying pathophysiology of various clinical populations.
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Affiliation(s)
- Joel S Burma
- Faculty of Kinesiology, Cerebrovascular Concussion Lab, University of Calgary, Calgary, Alberta, Canada.,Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada.,Faculty of Kinesiology, Human Performance Laboratory, University of Calgary, Calgary, Alberta, Canada.,Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.,Integrated Concussion Research Program, University of Calgary, Calgary, Alberta, Canada
| | - Selina Rattana
- Faculty of Kinesiology, Cerebrovascular Concussion Lab, University of Calgary, Calgary, Alberta, Canada
| | - Nathan E Johnson
- Faculty of Kinesiology, Cerebrovascular Concussion Lab, University of Calgary, Calgary, Alberta, Canada
| | - Jonathan D Smirl
- Faculty of Kinesiology, Cerebrovascular Concussion Lab, University of Calgary, Calgary, Alberta, Canada.,Faculty of Kinesiology, Sport Injury Prevention Research Centre, University of Calgary, Calgary, Alberta, Canada.,Faculty of Kinesiology, Human Performance Laboratory, University of Calgary, Calgary, Alberta, Canada.,Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.,Integrated Concussion Research Program, University of Calgary, Calgary, Alberta, Canada
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Naik S, Burk KS, Budiawan E, Lacson R, Lee LK, Fennessy FM, Tempany C, Cole AP, Trinh QD, Kibel AS, Khorasani R. Radiologists' Contribution to Variation in Detecting Clinically Significant Prostate Cancer in Men With Prostate MRI. J Am Coll Radiol 2022; 19:1312-1321. [PMID: 36244674 DOI: 10.1016/j.jacr.2022.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/30/2022] [Accepted: 08/04/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Assess radiologists' contribution to variation in clinically significant prostate cancer (csPCa) detection in patients with elevated prostate-specific antigen (PSA) and multiparametric MRI (mpMRI). METHODS This institutional review board-approved, retrospective cohort study was performed at a tertiary, academic, National Cancer Institute-designated Comprehensive Cancer Center with a multidisciplinary prostate cancer program. Men undergoing mpMRI examinations from January 1, 2015, to December 31, 2019, with elevated PSA (≥4 ng/mL) and biopsy within 6 months pre- or post-MRI or prostatectomy within 6 months post-mpMRI were included. Univariate and multivariable hierarchical logistic regression assessed impact of patient, provider, mpMRI examination, mpMRI report, and pathology factors on the diagnosis of Grade Group ≥ 2 csPCa. RESULTS Study cohort included 960 MRIs in 928 men, mean age 64.0 years (SD ± 7.4), and 59.8% (555 of 928) had csPCa. Interpreting radiologist was not significant individually (P > .999) or combined with mpMRI ordering physician and physician performing biopsy or prostatectomy (P = .41). Prostate Imaging Reporting and Data System (PI-RADS) category 2 (odds ratio [OR] 0.18, P = .04), PI-RADS category 4 (OR 2.52, P < .001), and PI-RADS category 5 (OR 4.99, P < .001) assessment compared with no focal lesion; PSA density of 0.1 to 0.15 ng/mL/cc (OR 2.46, P < .001), 0.15 to 0.2 ng/mL/cc (OR 2.77, P < .001), or ≥0.2 ng/mL/cc (OR 4.52, P < .001); private insurance (reference = Medicare, OR 0.52, P = .001), and unambiguous extraprostatic extension on mpMRI (OR 2.94, P = .01) were independently associated with csPCa. PI-RADS 3 assessment (OR 1.18, P = .56), age (OR 0.99, P = .39), and African American race (OR 0.90, P = .75) were not. DISCUSSION Although there is known in-practice variation in radiologists' interpretation of mpMRI, in our multidisciplinary prostate cancer program we found no significant radiologist-attributable variation in csPCa detection.
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Affiliation(s)
- Sachin Naik
- Center for Evidence-Based Imaging and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; and Harvard Medical School, Boston, Massachusetts
| | - Kristine S Burk
- Quality and Safety Officer, Center for Evidence-Based Imaging and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Dana Farber Cancer Institute, Boston, Massachusetts; and Harvard Medical School, Boston, Massachusetts.
| | - Elvira Budiawan
- Center for Evidence-Based Imaging and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; and Harvard Medical School, Boston, Massachusetts
| | - Ronilda Lacson
- Associate Director of the Center for Evidence Based Imaging and Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; and Harvard Medical School, Boston, Massachusetts
| | - Leslie K Lee
- Center for Evidence-Based Imaging and Director of MRI, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Dana Farber Cancer Institute, Boston, Massachusetts; and Harvard Medical School, Boston, Massachusetts
| | - Fiona M Fennessy
- Vice Chair of Faculty Affairs, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Dana Farber Cancer Institute, Boston, Massachusetts; and Harvard Medical School, Boston, Massachusetts
| | - Clare Tempany
- Vice Chair of Radiology Research, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Dana Farber Cancer Institute, Boston, Massachusetts; and Harvard Medical School, Boston, Massachusetts
| | - Alexander P Cole
- Department of Urological Surgery, Brigham and Women's Hospital, Boston, Massachusetts; Dana Farber Cancer Institute, Boston, Massachusetts; and Harvard Medical School, Boston, Massachusetts
| | - Quoc-Dien Trinh
- Director of Ambulatory Clinical Operations and Co-Director of the Prostate Cancer Program, Department of Urological Surgery, Brigham and Women's Hospital, Boston, Massachusetts; Dana Farber Cancer Institute, Boston, Massachusetts; and Harvard Medical School, Boston, Massachusetts
| | - Adam S Kibel
- Chief of Urology, Department of Urological Surgery, Brigham and Women's Hospital, Boston, Massachusetts; Dana Farber Cancer Institute, Boston, Massachusetts; and Harvard Medical School, Boston, Massachusetts
| | - Ramin Khorasani
- Director, Center for Evidence-Based Imaging and Vice Chair of Quality and Safety, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts; Dana Farber Cancer Institute, Boston, Massachusetts; and Harvard Medical School, Boston, Massachusetts; Vice Chair of Quality and Safety, Mass General Brigham
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Amick M, Ottesen TD, O'Marr J, Frenkel MY, Callahan B, Grauer JN. Effects of anode position on pedicle screw testing during lumbosacral spinal fusion surgery. Spine J 2022; 22:2000-2005. [PMID: 35843532 DOI: 10.1016/j.spinee.2022.07.090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/11/2022] [Accepted: 07/11/2022] [Indexed: 02/03/2023]
Abstract
OF BACKGROUND DATA Pedicle screws are commonly placed with lumbar/lumbosacral fusions. Triggered electromyography (tEMG), which employs the application of electrical current between the screw and a complementary anode to determine thresholds of conduction, may be utilized to confirm the safe placement of such implants. While previous research has established clinical thresholds associated with safe screw placement, there is variability in clinical practice of anode placement which could lead to unreliable measurements. PURPOSE To determine the variance in pedicle screw stimulation thresholds when using four unique anode locations (ipsilateral/contralateral and paraspinal/gluteal relative to tested pedicle screws). STUDY DESIGN Prospective cohort study. Tertiary medical center. PATIENT SAMPLE Twenty patients undergoing lumbar/lumbosacral fusion with pedicle screws using tEMG OUTCOME MEASURES: tEMG stimulation return values are used to assess varied anode locations and reproducibility based on anode placement. METHODS Measurements were assessed across node placement in ipsilateral/contralateral and paraspinal/gluteal locations relative to the screw being assessed. R2 coefficients of correlation were determined, and variances were compared with F-tests. RESULTS A total of 94 lumbosacral pedicle screws from 20 patients were assessed. Repeatability was verified using two stimulations at each location for a subset of the screws with an R2 of 0.96. Comparisons between the four anode locations demonstrated R2 values ranging from 0.76 to 0.87. F-tests comparing thresholds between each anode site demonstrated all groups not to be statistically different. CONCLUSION The current study, a first-of-its-kind formal evaluation of anode location for pedicle screw tEMG testing, demonstrated very strong repeatability and strong correlation with different locations of anode placement. These results suggest that there is no need to change the side of the anode for testing of left versus right screws, further supporting that placing an anode electrode into gluteal muscle is sufficient and will avoid a sharp ground needle in the surgical field.
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Affiliation(s)
- Michael Amick
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 800 Howard Ave, New Haven, CT, 06510, USA
| | - Taylor D Ottesen
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 800 Howard Ave, New Haven, CT, 06510, USA; Harvard Combined Orthopaedic Residency Program, 55 Fruit St, Boston, MA, 02114, USA
| | - Jamieson O'Marr
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 800 Howard Ave, New Haven, CT, 06510, USA
| | - Mikhail Y Frenkel
- Nuvasive Clinical Services 10275 Little Patuxent Pkwy Ste 300 Columbia, MD 21044, USA; UConn Main Campus 2131 Hillside Road, Unit 3088 Storrs, CT 06269-3088
| | - Brooke Callahan
- Nuvasive Clinical Services 10275 Little Patuxent Pkwy Ste 300 Columbia, MD 21044, USA
| | - Jonathan N Grauer
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 800 Howard Ave, New Haven, CT, 06510, USA.
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Burma JS, Van Roessel RK, Oni IK, Dunn JF, Smirl JD. Neurovascular coupling on trial: How the number of trials completed impacts the accuracy and precision of temporally derived neurovascular coupling estimates. J Cereb Blood Flow Metab 2022; 42:1478-1492. [PMID: 35209741 PMCID: PMC9274868 DOI: 10.1177/0271678x221084400] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Standard practices for quantifying neurovascular coupling (NVC) with transcranial Doppler ultrasound (TCD) require participants to complete one-to-ten repetitive trials. However, limited empirical evidence exists regarding how the number of trials completed influences the validity and reliability of temporally derived NVC metrics. Secondary analyses was performed on 60 young healthy participants (30 females/30 males) who completed eight cyclical eyes-closed (20-seconds), eyes-open (40-seconds) NVC trials, using the "Where's Waldo?" visual paradigm. TCD data was obtained in posterior and middle cerebral arteries (PCA and MCA, respectively). The within-day (n = 11) and between-day (n = 17) reliability were assessed at seven- and three-time points, respectively. Repeat testing from the reliability aims were also used for the concurrent validity analysis (n = 160). PCA metrics (i.e., baseline, peak, percent increase, and area-under-the-curve) demonstrated five trials produced excellent intraclass correlation coefficient (ICC) 95% confidence intervals for validity and within-day reliability (>0.900), whereas between-day reliability was good-to-excellent (>0.750). Likewise, 95% confidence intervals for coefficient of variation (CoV) measures ranged from acceptable (<20%) to excellent (<5%) with five-or-more trials. Employing fewer than five trials produced poor/unacceptable ICC and CoV metrics. Future NVC, TCD-based research should therefore have participants complete a minimum of five trials when quantifying the NVC response with TCD via a "Where's Waldo?" paradigm.
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Affiliation(s)
- Joel S Burma
- Cerebrovascular Concussion Lab, Faculty of Kinesiology, University of Calgary, Alberta, Canada.,Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.,Integrated Concussion Research Program, University of Calgary, Calgary, AB, Canada
| | - Rowan K Van Roessel
- Cerebrovascular Concussion Lab, Faculty of Kinesiology, University of Calgary, Alberta, Canada
| | - Ibukunoluwa K Oni
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.,Integrated Concussion Research Program, University of Calgary, Calgary, AB, Canada.,Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jeff F Dunn
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.,Integrated Concussion Research Program, University of Calgary, Calgary, AB, Canada.,Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jonathan D Smirl
- Cerebrovascular Concussion Lab, Faculty of Kinesiology, University of Calgary, Alberta, Canada.,Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.,Integrated Concussion Research Program, University of Calgary, Calgary, AB, Canada
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Alinda Shaly A, Hannah Priya G, Mahendiran M, Mary Linet J. A behavioural study of hydrothermally derived novel alumina/magnesia/hydroxyapatite (Al 2O 3/MgO/HA) bioceramic nanocomposite. J Mech Behav Biomed Mater 2022; 133:105313. [PMID: 35749932 DOI: 10.1016/j.jmbbm.2022.105313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/03/2022] [Accepted: 06/06/2022] [Indexed: 11/16/2022]
Abstract
Regeneration and regrowth of human bones is a gradual and time-consuming process. Therefore scaffolds are required to hold the bones in position and give them time to heal well. Though hydroxyapatite (HA) is a potential candidate, its weak mechanical nature has made it undesirable. To overcome this hurdle, a novel nanocomposite of HA with alumina (Al2O3) and magnesia (MgO) was prepared by hydrothermal method in this study. The constitution, composition and conformation of the Al2O3/MgO/HA nanocomposite were affirmed via X-ray Diffraction (XRD), Fourier-Transform Infra-Red (FTIR) and imaging tests. Vicker's hardness test evinces the mechanical calibre of the nanocomposite. A perspective load-displacement analysis was done by means of Onitsch and Kick's power laws. The nanocomposite excelled above par with a hardness of 5.19 GPa and fracture toughness of 1.27 MPam1/2. This holistic progress makes this nanocomposite a very desirable bone implant material.
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Affiliation(s)
- A Alinda Shaly
- Department of Physics, Loyola College, Chennai, 600034, India
| | - G Hannah Priya
- Department of Physics, Loyola College, Chennai, 600034, India
| | - M Mahendiran
- Department of Physics, Hindu College, Chennai, 600072, India
| | - J Mary Linet
- Department of Physics, Loyola College, Chennai, 600034, India.
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Olsen MH, Riberholt CG, Capion T, Berg RMG, Møller K. Reliability of non-invasive arterial blood pressure measurement in patients with aneurysmal subarachnoid haemorrhage. Physiol Meas 2022; 43. [PMID: 35688136 DOI: 10.1088/1361-6579/ac77d3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/10/2022] [Indexed: 11/12/2022]
Abstract
Objective Invasively measured arterial blood pressure (ABP) is associated with complications, while non-invasively measured ABP is generally considered risk-free. This study aimed to investigate the reliability of non-invasive ABP measured using finger-cuff volume-clamp device compared to invasive ABP measured by an arterial catheter in patients with aneurysmal subarachnoid haemorrhage (SAH). Approach In 30 patients admitted for neurointensive care with SAH, invasive and non-invasive ABP were recorded simultaneously. Reliability was assessed for mean, diastolic and systolic ABP separately using intraclass correlation coefficient (ICC) agreement for each full period and each 3-second average. Main results A median of 3 (IQR: 2-3) periods were included for each participant. The full periods (n = 81) showed an ICC of 0.34 (95% CI: 0.14-0.52), 0.31 (95% CI: 0.10 to 0.49), and 0.20 (95% CI: 0.00 to 0.39) for mean, diastolic, and systolic ABP, respectively. Three-second averages (n = 33,786) for mean (ICC: 0.35; 95% CI: 0.33 to 0.36), diastolic (ICC: 0.25; 95% CI: 0.25 to 0.28), and systolic ABP (ICC: 0.26; 95% CI: 0.18 to 0.33) yielded similar findings. Pearson's correlation coefficient showed an R2 of 0.15 (p < 0.001), 0.15 (p < 0.001), 0.06 (p = 0.027) for mean, diastolic and systolic ABP, respectively. Significance In patients with SAH, non-invasive measurement of ABP using the widely used Nano system from Finapres Medical Systems - a finger-cuff volume-clamp device (Finapres, Chennai, India) showed poor reliability and therefore cannot be used interchangeably with invasively measured ABP.
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Affiliation(s)
- Markus Harboe Olsen
- Department of Neuroanaesthesiology, Rigshospitalet, Blegdamsvej 9, Copenhagen, 2100, DENMARK
| | | | - Tenna Capion
- Department of Neurosurgery, Rigshospitalet, Blegdamsvej 9, Kobenhavn, 2100, DENMARK
| | - Ronan M G Berg
- Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, Blegdamsvej 9, Kobenhavn, 2100, DENMARK
| | - Kirsten Møller
- Department of Neuroanaesthesiology, Rigshospitalet, Blegdamsvej 9, Copenhagen, 2100, DENMARK
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Assessing Conservation and Mitigation Banking Practices and Associated Gains and Losses in the United States. SUSTAINABILITY 2022. [DOI: 10.3390/su14116652] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Conservation and mitigation banks allow their proponents to buy credits to offset the negative residual impacts of their development projects with the goal of no net loss (NNL) in the ecosystem function and habitat area. However, little is known about the extent to which these bank transactions achieve NNL. We synthesized and reviewed 12,756 transactions in the United States which were related to meeting area and ecological equivalence (n = 4331) between the approved negative impact and offset. While most of these transactions provided an offset that was equal to or greater than the impacted area, approximately one quarter of the transactions, especially those targeting wetlands, did not meet ecological equivalence between the impact and offset. This missing ecological equivalence was often due to the significantly increasing use of preservation, enhancement, and rehabilitation over creating new ecosystems through establishment and re-establishment. Stream transactions seldom added new ecosystem area through creation but mainly used rehabilitation in order to add offset benefits, in many cases leading to a net loss of area. Our results suggest that best practice guidance on habitat creation as well as the incentivization of habitat creation must increase in the future to avoid net loss through bank transactions and to meet the ever-accelerating global changes in land use and the increased pressure of climate change.
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Glen LZQ, Wong JYS, Tay WX, Weng J, Cox G, Cheah AEJ. Forecasting the rate of hand injuries in Singapore. J Occup Med Toxicol 2022; 17:9. [PMID: 35509052 PMCID: PMC9066836 DOI: 10.1186/s12995-022-00350-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 04/11/2022] [Indexed: 11/12/2022] Open
Abstract
Purpose This study aims to analyse the correlation between the incidence rate of hand injuries and various major economic indicators in Singapore. We hypothesise that the number of hand injuries is correlated to activity in the construction and manufacturing industries in Singapore. Methods Twenty thousand seven hundred sixty-four patients who underwent hand surgeries in a tertiary institution between 2012 to 2018 were reviewed. Two independent, blinded observers extracted the frequency of hand surgeries performed from Electronic Medical Records. Economic indicators pertinent to Singapore’s economic activity were collected and smoothed by simple moving average of the prior 3 months. Results were analysed using IBM SPSS v25.0. Results Significant independent univariate variables were Purchasing-Manager-Index and Industrial-Production-Index. Multiple linear regression of quarterly reported figures showed that Total-Livestock-Slaughtered, Total-Seafood-Handled, Purchasing-Manger-Index, Industrial-Production-Index, Gas-Tariffs, Construction-Index, Consumer-Price-Index, Total-Air-Cargo-Handled, Total-Container-Throughput, Total-Road-Traffic-Accident-Casualties, Food-&-Beverage-Services-Index were significantly correlated (p < 0.05) with hand injuries, with R2 = 62.3%. Conclusion Quarterly economic indicators from major economic industries can be used to predict the incidence of hand injuries with a 62.3% correlation. These findings may be useful for anticipating healthcare resource allocation to treat hand injuries. Type of study and level of evidence Economic and decision, Level II.
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Affiliation(s)
- Liau Zi Qiang Glen
- Department of Orthopaedic Surgery, National University Health System, Singapore, Singapore. .,Department of Orthopaedic Surgery, NUHS Tower Block, Level 11, 1E Kent Ridge Road, Singapore, 119288, Singapore. .,University Orthopaedic, Hand and Reconstructive Microsurgery Cluster, National University Health System, 5 Lower Kent Ridge Rd, Main Building 1, Level 2, Singapore, 119074, Singapore.
| | - Joel Yat Seng Wong
- University Orthopaedic, Hand and Reconstructive Microsurgery Cluster, National University Health System, 5 Lower Kent Ridge Rd, Main Building 1, Level 2, Singapore, 119074, Singapore
| | - Wei Xuan Tay
- University Orthopaedic, Hand and Reconstructive Microsurgery Cluster, National University Health System, 5 Lower Kent Ridge Rd, Main Building 1, Level 2, Singapore, 119074, Singapore
| | - Jiayi Weng
- University Orthopaedic, Hand and Reconstructive Microsurgery Cluster, National University Health System, 5 Lower Kent Ridge Rd, Main Building 1, Level 2, Singapore, 119074, Singapore
| | - Gregory Cox
- Department of Economics, National University of Singapore, 1 Arts Link, Singapore, 117568, Singapore
| | - Andre Eu Jin Cheah
- University Orthopaedic, Hand and Reconstructive Microsurgery Cluster, National University Health System, 5 Lower Kent Ridge Rd, Main Building 1, Level 2, Singapore, 119074, Singapore.,Department of Hand & Reconstructive Microsurgery, National University Hospital, 5 Lower Kent Ridge Rd, Main Building 1, Level 2, Singapore, 119074, Singapore
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Abstract
BACKGROUND During quarantine, both physical and mental health are a concern. To the same extent that physicians are a scarce resource during this crisis, psychiatrists and psychologists are also limited in number. To help practitioners and public managers decide where to invest their resources, the present research investigated the relationships of stress, depression and state anxiety levels with sociodemographic and behavioural variables. METHODS Data were collected in Brazil between March, 18 and 22, 2020 in 1,468 volunteers during quarantine. Participants with a history of or current mental health illnesses were excluded leaving 1,460 individuals in the final sample. The online assessment included instruments for psychological stress, depression and state anxiety. A sociodemographic and behavioural questionnaire with 15 items was used to assess other factors. Multiple linear regression was performed for each psychological outcome to determine a hierarchy of significant predictors. FINDINGS Stress, depression and state anxiety levels were all predicted by gender (women higher than men), quality of nutrition, attendance in tele-psychotherapy, exercise frequency, presence of elderly persons in quarantine with the person, obligation to work outside the home, level of education (more educated, lesser risk for mental illness) and age (younger age, greater risk). Having a perceived risk factor for COVID-19 predicted depression and state anxiety, but not stress. Finally, the presence of children in quarantine with the participant was a protective factor for depression. INTERPRETATION Even though this research is limited by its cross-sectional design, it is possible to infer that mental health varies by demographic attributes, obligations and health behaviours. Those who report higher distress must work outside the home during quarantine, live with an elderly person and carry a risk factor for COVID-19, among other factors. Identifying those who are most vulnerable would help to prioritize those who may need the greatest psychological aid and assist public health practitioners in developing support strategies.
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Affiliation(s)
- Alberto Filgueiras
- Department of Cognition and Human Development, Rio de Janeiro State University, Rio de Janeiro, Brazil
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38
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Theis S, Poesch M. Current capacity, bottlenecks, and future projections for offsetting habitat loss using Mitigation and Conservation banking in the United States. J Nat Conserv 2022. [DOI: 10.1016/j.jnc.2022.126159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Finnegan M, Duffy E, Morrin A. The determination of skin surface pH via the skin volatile emission using wearable colorimetric sensors. SENSING AND BIO-SENSING RESEARCH 2022. [DOI: 10.1016/j.sbsr.2022.100473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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PROMIS Scores Should Not be Used in Isolation to Measure Outcomes in Lumbar Stenosis Patients. Spine (Phila Pa 1976) 2021; 46:E1262-E1268. [PMID: 34747910 DOI: 10.1097/brs.0000000000004092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Retrospective cross-sectional analysis. OBJECTIVE The aim of this study was to establish the strength of relationship between the Patient-reported Outcomes Measurement Information System (PROMIS) Adult Depression (AD), Physical Function (PF), and Pain Interference (PI) with the Swiss Spinal Stenosis Questionnaire (SSSQ) in assessing lumbar spinal stenosis (LSS). SUMMARY OF BACKGROUND DATA In 2009, there were >35,000 surgeries for LSS, which amounted to $1.65 billion in health care cost. By 2021, there will be >2.4 million people in the United States with symptomatic LSS. There is an increasing emphasis on patient-reported outcomes (PROs) to define value in medicine. Therefore, it would be beneficial to compare PROMIS, a universal PRO, against the SSSQ, the "criterion standard" for assessing LSS. METHODS Eighty-two patients with LSS completing the PROMIS and SSSQ were enrolled. Per existing institutional protocol, PROMIS AD, PF, and PI were completed at every clinic visit. Linear regression analysis was then performed to evaluate how well the SSSQ and PROMIS scores correlated to each other. RESULTS When linear regression was performed for pre-treatment values, the R2 value for the SSSQ PF versus PROMIS PF was 0.14 (P = 0.0008), whereas the R2 value for the SSSQ symptom severity versus PROMIS PI was 0.03 (P = 0.13). The R2 value for the combined SSSQ physical function and symptom severity versus PROMIS AD was 0.07 (P = 0.02). When post-treatment SSSQ satisfaction scores were correlated to postoperative PROMIS AD, PI, and PF scores, the R2 values for a good linear fit were 0.13, 0.25, and 0.18 respectively (P values: 0.01, 0.003, and 0.003). CONCLUSION Pre-treatment PROMIS scores do not adequately capture the disease-specific impact of spinal stenosis, but postoperative PROMIS scores better reflect outcomes after surgery for LSS. PROMIS scores should not be used in isolation to assess outcomes in patients with LSS.Level of Evidence: 4.
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Personalized prediction of rehabilitation outcomes in multiple sclerosis: a proof-of-concept using clinical data, digital health metrics, and machine learning. Med Biol Eng Comput 2021; 60:249-261. [PMID: 34822120 PMCID: PMC8724183 DOI: 10.1007/s11517-021-02467-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/06/2021] [Indexed: 11/29/2022]
Abstract
Predicting upper limb neurorehabilitation outcomes in persons with multiple sclerosis (pwMS) is essential to optimize therapy allocation. Previous research identified population-level predictors through linear models and clinical data. This work explores the feasibility of predicting individual neurorehabilitation outcomes using machine learning, clinical data, and digital health metrics. Machine learning models were trained on clinical data and digital health metrics recorded pre-intervention in 11 pwMS. The dependent variables indicated whether pwMS considerably improved across the intervention, as defined by the Action Research Arm Test (ARAT), Box and Block Test (BBT), or Nine Hole Peg Test (NHPT). Improvements in ARAT or BBT could be accurately predicted (88% and 83% accuracy) using only patient master data. Improvements in NHPT could be predicted with moderate accuracy (73%) and required knowledge about sensorimotor impairments. Assessing these with digital health metrics over clinical scales increased accuracy by 10%. Non-linear models improved accuracy for the BBT (+ 9%), but not for the ARAT (-1%) and NHPT (-2%). This work demonstrates the feasibility of predicting upper limb neurorehabilitation outcomes in pwMS, which justifies the development of more representative prediction models in the future. Digital health metrics improved the prediction of changes in hand control, thereby underlining their advanced sensitivity. This work explores the feasibility of predicting individual neurorehabilitation outcomes using machine learning, clinical data, and digital health metrics. ![]()
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Ahmed T, Rana MR, Zzaman W, Ara R, Aziz MG. Optimization of substrate composition for pectinase production from Satkara ( Citrus macroptera) peel using Aspergillus niger-ATCC 1640 in solid-state fermentation. Heliyon 2021; 7:e08133. [PMID: 34693058 PMCID: PMC8517159 DOI: 10.1016/j.heliyon.2021.e08133] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 07/10/2021] [Accepted: 10/01/2021] [Indexed: 11/26/2022] Open
Abstract
Pectinase is an enzyme having a broad industrial and commercial application. However, higher production costs may be the major constraint for the wide-scale application of pectinase. Therefore, researchers are trying to reduce the pectinase production cost for subsequent application in the industrial processes by using a unique substrate and optimizing the fermentation medium components and process conditions. The main purpose of the current study was to optimize medium composition for pectinase production using Aspergillus niger-ATCC 1640 in the solid-state fermentation. The Response Surface Methodology (RSM) was performed to evaluate the effects of variables, specifically the concentrations of Satkara peel, urea, (NH4)2PO4, NH4NO3, KH2PO4, ZnSO4, and MgSO4.7H2O on pectinase production in the solid substrate. Firstly, a two-factorial design, Plackett-Burman design (PBD) was applied to screen the variables that significantly influenced the pectinase production. After finding the critical variables, 15 experimental runs were carried out using a Box-Behnken design (BBD) to derive a statistical model for optimizing the concentrations of the selected variables. The PBD model revealed that Satkara peel, urea, and (NH4)2SO4 significantly affected the pectinase production. RSM results indicated that the predicted response for pectinase production was in good agreement with experimental data (R2 = 0.9836). Under the optimized condition of Satkara peel (8.4 g/L), urea (0.5 g/L), and (NH4)2SO4 (2.7 g/L), the pectinase activity was predicted to be 0.6178 μmol/mL. In the present study, the experimental pectinase production achieved 0.6045 μmol/mL. The study revealed that optimization through RSM could improve the pectinase production from Satkara peel.
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Affiliation(s)
- Tanvir Ahmed
- Department of Food Engineering and Tea Technology, Shahjalal University of Science and Technology, Sylhet, 3100, Bangladesh
| | - Md Rahmatuzzaman Rana
- Department of Food Engineering and Tea Technology, Shahjalal University of Science and Technology, Sylhet, 3100, Bangladesh
| | - Wahidu Zzaman
- Department of Food Engineering and Tea Technology, Shahjalal University of Science and Technology, Sylhet, 3100, Bangladesh
| | - Rowshon Ara
- Department of Food Engineering and Tea Technology, Shahjalal University of Science and Technology, Sylhet, 3100, Bangladesh
| | - Mohammad Gulzarul Aziz
- Department of Food Technology and Rural Industries, Bangladesh Agricultural University, Mymensingh, 2202, Bangladesh
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Lee JA, Qu K, Gainey M, Kanekar SS, Barry MA, Nasrin S, Alam NH, Schmid CH, Levine AC. Continuous diagnostic models for volume deficit in patients with acute diarrhea. Trop Med Health 2021; 49:70. [PMID: 34488910 PMCID: PMC8422628 DOI: 10.1186/s41182-021-00361-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/27/2021] [Indexed: 12/30/2022] Open
Abstract
Background Episodes of acute diarrhea lead to dehydration, and existing care algorithms base treatment around categorical estimates for fluid resuscitation. This study aims to develop models for the percentage dehydration (fluid deficit) in individuals with acute diarrhea, to better target treatment and avoid the potential sequelae of over or under resuscitation.
Methods This study utilizes data from two prospective cohort studies of patients with acute diarrhea in Dhaka, Bangladesh. Data were collected on patient arrival, including weight, clinical signs and symptoms, and demographic information. Consecutive weights were obtained to determine the true volume deficit of each patient. Data were entered into two distinct forward stepwise regression logistic models (DHAKA for under 5 years and NIRUDAK for 5 years and over). Results A total of 782 patients were included in the final analysis of the DHAKA data set, and 2139 were included in the final analysis of the NIRUDAK data set. The best model for the DHAKA data achieved an R2 of 0.27 and a root mean square error (RMSE) of 3.7 (compared to R2 of 0.06 and RMSE of 5.5 with the World Health Organization child care algorithm) and selected 6 predictors. The best performance model for the NIRUDAK data achieved an R2 of 0.28 and a RMSE of 2.6 (compared to R2 of 0.08 and RMSE of 4.3 with the World Health Organization adolescent/adult care algorithm) and selected 7 predictors with 2 interactions. Conclusions These are the first mathematical models for patients with acute diarrhea that allow for the calculation of a patient’s percentage dehydration (fluid deficit) and subsequent targeted treatment with fluid resuscitation. These findings are an improvement on existing World Health Organization care algorithms. Supplementary Information The online version contains supplementary material available at 10.1186/s41182-021-00361-9.
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Affiliation(s)
- J Austin Lee
- Department of Emergency Medicine, Warren Alpert Medical School, Brown University, 55 Claverick Street, Providence, RI, 02903, USA.
| | - Kexin Qu
- Department of Biostatistics, Brown University School of Public Health, Providence, RI, USA
| | | | | | - Meagan A Barry
- Department of Emergency Medicine, Warren Alpert Medical School, Brown University, 55 Claverick Street, Providence, RI, 02903, USA
| | - Sabiha Nasrin
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Nur H Alam
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Christopher H Schmid
- Department of Biostatistics, Brown University School of Public Health, Providence, RI, USA
| | - Adam C Levine
- Department of Emergency Medicine, Warren Alpert Medical School, Brown University, 55 Claverick Street, Providence, RI, 02903, USA
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Bhattacharyya SS, Goswami S, Mehta R, Nayak B. Examining the factors influencing adoption of over the top (OTT) services among Indian consumers. JOURNAL OF SCIENCE AND TECHNOLOGY POLICY MANAGEMENT 2021. [DOI: 10.1108/jstpm-09-2020-0135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to identify and predict the key factors that influenced the usage intention of over the top (OTT) services by consumers. This was done by applying the modified unified theory of acceptance and use of technology 2 (UTAUT2) model.
Design/methodology/approach
An online survey questionnaire assessed the proposed motivational factors for the adoption of OTT services. Confirmatory factor analysis and structural equation modelling were conducted on collected data (n = 598) to demonstrate the reliability and validity of the measurement and structural model.
Findings
The model consisted of nine factors, namely, value expectancy (VE), ease of effort (EE), social influence (SI), favourable infrastructure conditions (FIC), hedonistic motivation for usage (HMU), favourable economic position (FEP), content quality (CQ), habitual behaviour (HB) and security conditions (SC). SC, VE, SI, HB and EE were the antecedent variables. FEP, CQ and FIC were the mediating variables and HMU was the dependant variable. SI and CQ of OTT services were positively associated with HMU of OTT services, FEP had no significant effects on HMU. The results also supported the explanatory strength and predictability of UTAUT2 as a model. It further extended UTAUT2 boundaries and paved the way for an extended UTAUT2 model to be developed.
Originality/value
The promising role of OTT services in the entertainment and media industry had gained consumer attention, however, limited empirical investigations had been conducted on explicating how user attitude and usage intention were shaped regarding the use of OTT services in the Indian context. This study served as one of the first attempts to empirically examine the adoption process, with implications for the HMU regarding OTT services. This was one of the first studies to extend the UTAUT2 theoretical model.
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Genetic Variations Associated with Long-Term Treatment Response in Bipolar Depression. Genes (Basel) 2021; 12:genes12081259. [PMID: 34440433 PMCID: PMC8391230 DOI: 10.3390/genes12081259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/09/2021] [Accepted: 08/16/2021] [Indexed: 11/17/2022] Open
Abstract
Several pharmacogenetic-based decision support tools for psychoactive medication selection are available. However, the scientific evidence of the gene-drug pairs analyzed is mainly based on pharmacogenetic studies in patients with major depression or schizophrenia, and their clinical utility is mostly assessed in major depression. This study aimed at evaluating the impact of individual genes, with pharmacogenetic relevance in other psychiatric conditions, in the response to treatment in bipolar depression. Seventy-six patients diagnosed with bipolar disorder and an index major depressive episode were included in an observational retrospective study. Sociodemographic and clinical data were collected, and all patients were genotyped using a commercial multigene pharmacogenomic-based tool (Neuropharmagen®, AB-Biotics S.A., Barcelona, Spain). Multiple linear regression was used to identify pharmacogenetic and clinical predictors of efficacy and tolerability of medications. The pharmacogenetic variables response to serotonin-norepinephrine reuptake inhibitors (SNRIs) (ABCB1) and reduced metabolism of quetiapine (CYP3A4) predicted patient response to these medications, respectively. ABCB1 was also linked to the tolerability of SNRIs. An mTOR-related multigenic predictor was also associated with a lower number of adverse effects when including switch and autolytical ideation. Our results suggest that the predictors identified could be useful to guide the pharmacological treatment in bipolar disorder. Additional clinical studies are necessary to confirm these findings.
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Riley SP, Harris J, O'Halloran BJ, Showalter CR, Learman KE. Symptom response to mobilization and outcomes in patients with subacromial pain syndrome: A cohort study. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2021; 26:e1914. [PMID: 34028940 DOI: 10.1002/pri.1914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 03/20/2021] [Accepted: 05/13/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVES The objectives of this study were the following: (1) to determine if there was a difference in outcomes between immediate responders to glenohumeral mobilizations at the initial evaluation, 2-week, 4-week, and 6-month follow-up as compared to those that do not respond in participants with subacromial pain syndrome; (2) to see if there were statistically significant differences in outcomes within these groups between these time frames of interest, and (3) to see if symptom response at the initial evaluation was predictive of a favorable recovery. METHODS This was a prospective, single-group observational design. Clinicians pragmatically identified positive responders as improving at least two points on the Numeric Pain Rating Scale and/or a 20° improvement in shoulder active range of motion (AROM) following shoulder mobilization at the initial evaluation. Data were collected for the subjective and objective variables of interest at the initial evaluation, 2-week, 4-week, and 6-month follow-up. RESULTS The prevalence of responders at the initial evaluation was 99 (81.8%). There were no statistically significant between-group differences for the variables of interest except for the Global Rating of Change (GRoC; f = 2.79, p = 0.006). The shoulder abduction AROM between-group difference exceeded the minimal detectable change at 4 weeks. The pair-wise comparison showed statistically significant differences for the outcomes of interest at each time point except for the GRoC between 4 weeks and 6 months. There was a statistically significant correlation between responders at the initial evaluation and shoulder abduction AROM at the 4-week follow-up (rpb (112) = 0.27, p = 0.004). CONCLUSION Individuals with SAPS may benefit from shoulder mobilization independent of their within-session response to shoulder mobilization at the initial evaluation. Future research should seek to differentiate if these improvements are related to the within-session positive treatment response at the initial evaluation in individuals who are randomized to receive shoulder mobilization or not.
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Affiliation(s)
- Sean P Riley
- Doctor of Physical Therapy Program, Sacred Heart University, Fairfield, Connecticut, USA
| | - Jonathan Harris
- Doctor of Physical Therapy Program, Sacred Heart University, Fairfield, Connecticut, USA
| | | | | | - Kenneth E Learman
- Department of Graduate Studies in Health and Rehabilitation Sciences, Youngstown State University, Youngstown, Ohio, USA
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Ng HM, MacDonell S, Yap J, Peddie MC, Scott T, Haszard JJ. Predicting height from ulna length for the determination of weight status in New Zealand adolescents: A cross-sectional study. J Hum Nutr Diet 2021; 35:406-414. [PMID: 33999481 DOI: 10.1111/jhn.12918] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/27/2021] [Accepted: 05/11/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The measurement of height is crucial for weight status assessment. When standing height is difficult to measure, ulna length may offer a convenient and accurate surrogate of height measure. Adolescence is a period of accelerated linear growth; hence, the validation of age-specific equations that predict height from ulna length in adolescents is warranted. The present study aimed to develop and validate age- and sex-specific equations for predicting height from ulna length in New Zealand adolescents. METHODS Height, weight and ulna length were measured in 364 adolescents (n = 110 males, n = 254 females) aged 15.0-18.8 years, who were enrolled in the SuNDiAL (Survey of Nutrition Dietary Assessment and Lifestyle) project, a cross-sectional survey performed in 2019 and 2020. Regression models were used to determine equations to predict height from ulna length. Agreement between measured and predicted height, body mass index (BMI) and BMI z-score was assessed with intra-class correlation coefficients (ICC) and Bland-Altman plots. Sensitivity and specificity were calculated for classifying obesity. RESULTS Strong agreement was found between predicted and measured height (ICC = 0.78; mean difference = 0; 95% confidence interval = -0.5 to 0.5 cm) and BMI (ICC = 0.95; mean difference = 0; 95% confidence interval = -0.1 to 0.1 kg m-2 ). Predicted height was 88.1% accurate when classifiying weight status, showing high sensitivity (93.8%) and specificity (99.4%) for classifying obesity. CONCLUSIONS Ulna length measurement can accurately estimate height and subsequently weight status in New Zealand adolescents aged 15-18 years.
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Affiliation(s)
- Hwei Min Ng
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Sue MacDonell
- Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
| | - Jia Yap
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Meredith C Peddie
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Tessa Scott
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
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O’Hara S, Zelesco M, Sun Z. Use of shear wave elastography on the maternal cervix to recognise cervical insufficiency using a transabdominal ultrasound approach. Australas J Ultrasound Med 2021; 24:89-98. [PMID: 34765416 PMCID: PMC8412007 DOI: 10.1002/ajum.12236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/04/2020] [Accepted: 10/26/2020] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION The ramifications of preterm birth on society and the role of cervical length in identifying cervical insufficiency are well known. The main goal of this work was to apply shear wave elastography to the maternal cervix to assess the stiffness of the cervix and identify cervical insufficiency, using a transabdominal ultrasound approach. METHODS Measurements of shear wave speed were obtained using a transabdominal ultrasound approach, at the anterior and posterior portions of the internal and external cervical os on 504 participants. A total of 455 participants were contacted following the expected date of birth of the fetus and birth details were obtained. RESULTS The anterior and posterior portions of the internal os showed a significant correlation between shear wave speed and time until delivery of the fetus for women who gave birth spontaneously, with R 2 Linear being 0.024 (P = 0.012) and 0.017 (P = 0.05) respectively, and these correlations increased for the group of participants that were scanned between the 18th and end of the 20th week of pregnancy to R 2 Linear = 0.043 (P = 0.001) and 0.021 (P = 0.040) respectively. A ratio of internal os/external os anteriorly also showed a correlation of R 2 Linear = 0.030 (P = 0.009). CONCLUSION A transabdominal ultrasound technique has identified a reduction in shear wave speeds at the internal os in the mid-trimester, in women who had a subsequent preterm birth.
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Affiliation(s)
- Sandra O’Hara
- SKG RadiologyPerthWestern AustraliaAustralia
- Discipline of Medical Radiation SciencesSchool of Molecular and Life SciencesCurtin UniversityPerthWestern AustraliaAustralia
| | - Marilyn Zelesco
- Department of Medical ImagingFiona Stanley HospitalMurdochWestern AustraliaAustralia
| | - Zhonghua Sun
- Discipline of Medical Radiation SciencesSchool of Molecular and Life SciencesCurtin UniversityPerthWestern AustraliaAustralia
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Burma JS, Graver S, Miutz LN, Macaulay A, Copeland PV, Smirl JD. The validity and reliability of ultra-short-term heart rate variability parameters and the influence of physiological covariates. J Appl Physiol (1985) 2021; 130:1848-1867. [PMID: 33856258 DOI: 10.1152/japplphysiol.00955.2020] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Ultra-short-term (UST) heart rate variability (HRV) metrics have increasingly been proposed as surrogates for short-term HRV metrics. However, the concurrent validity, within-day reliability, and between-day reliability of UST HRV have yet to be comprehensively documented. Thirty-six adults (18 males, age: 26 ± 5 yr, BMI: 24 ± 3 kg/m2) were recruited. Measures of HRV were quantified in a quiet-stance upright orthostatic position via three-lead electrocardiogram (ADInstruments, FE232 BioAmp). All short-term data recordings were 300 s in length and five UST time points (i.e., 30 s, 60 s, 120 s, 180 s, and 240 s) were extracted from the original 300-s recording. Bland-Altman plots with 95% limits of agreement, repeated measures ANOVA and two-tailed paired t tests demarcated differences between UST and short-term recordings. Linear regressions, coefficient of variation, intraclass correlation coefficients, and other tests examined the validity and reliability in both time- and frequency domains. No group differences were noted between all short-term and UST measures, for either time- (all P > 0.202) or frequency-domain metrics (all P > 0.086). A longer recording duration was associated with augmented validity and reliability, which was less impacted by confounding influences from physiological variables (e.g., respiration rate, carbon dioxide end-tidals, and blood pressure). Conclusively, heart rate, time-domain, and relative frequency-domain HRV metrics were acceptable with recordings greater or equal to 60 s, 240 s, and 300 s, respectively. Future studies employing UST HRV metrics should thoroughly understand the methodological requirements to obtain accurate results. Moreover, a conservative approach should be utilized regarding the minimum acceptable recording duration, which ensures valid/reliable HRV estimates are obtained.NEW & NOTEWORTHY A one size fits all methodological approach to quantify HRV metrics appears to be inappropriate, where study design considerations need to be conducted upon a variable-by-variable basis. The present results found 60 s (heart rate), 240 s (time-domain parameters), and 300 s (relative frequency-domain parameters) were required to obtain accurate and reproducible metrics. The lower validity/reliability of the ultra-short-term metrics was attributable to measurement error and/or confounding from extraneous physiological influences (i.e., respiratory and hemodynamic variables).
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Affiliation(s)
- Joel S Burma
- Cerebrovascular Concussion Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Concussion Research Laboratory, Faculty of Health and Exercise Science, University of British Columbia, Kelowna, British Columbia, Canada
| | - Sarah Graver
- Cerebrovascular Concussion Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Lauren N Miutz
- Cerebrovascular Concussion Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada
| | - Alannah Macaulay
- Concussion Research Laboratory, Faculty of Health and Exercise Science, University of British Columbia, Kelowna, British Columbia, Canada
| | - Paige V Copeland
- Concussion Research Laboratory, Faculty of Health and Exercise Science, University of British Columbia, Kelowna, British Columbia, Canada
| | - Jonathan D Smirl
- Cerebrovascular Concussion Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.,Concussion Research Laboratory, Faculty of Health and Exercise Science, University of British Columbia, Kelowna, British Columbia, Canada
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Guillot AJ, Jornet-Mollá E, Landsberg N, Milián-Guimerá C, Montesinos MC, Garrigues TM, Melero A. Cyanocobalamin Ultraflexible Lipid Vesicles: Characterization and In Vitro Evaluation of Drug-Skin Depth Profiles. Pharmaceutics 2021; 13:pharmaceutics13030418. [PMID: 33804652 PMCID: PMC8003749 DOI: 10.3390/pharmaceutics13030418] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/03/2021] [Accepted: 03/16/2021] [Indexed: 12/17/2022] Open
Abstract
Atopic dermatitis (AD) and psoriasis are the most common chronic inflammatory skin disorders, which importantly affect the quality of life of patients who suffer them. Among other causes, nitric oxide has been reported as part of the triggering factors in the pathogenesis of both conditions. Cyanocobalamin (vitamin B12) has shown efficacy as a nitric oxide scavenger and some clinical trials have given positive outcomes in its use for treating skin pathologies. Passive skin diffusion is possible only for drugs with low molecular weights and intermediate lipophilicity. Unfortunately, the molecular weight and hydrophilicity of vitamin B12 do not predict its effective diffusion through the skin. The aim of this work was to design new lipid vesicles to encapsulate the vitamin B12 to enhance its skin penetration. Nine prototypes of vesicles were generated and characterized in terms of size, polydispersity, surface charge, drug encapsulation, flexibility, and stability with positive results. Additionally, their ability to release the drug content in a controlled manner was demonstrated. Finally, we found that these lipid vesicle formulations facilitated the penetration of cyanocobalamin to the deeper layers of the skin. The present work shows a promising system to effectively administer vitamin B12 topically, which could be of interest in the treatment of skin diseases such as AD and psoriasis.
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Affiliation(s)
- Antonio José Guillot
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, Faculty of Pharmacy, University of Valencia, Avda. Vicent Andrés Estellés s/n, 46100 Burjassot, Spain; (A.J.G.); (E.J.-M.); (N.L.); (C.M.-G.); (A.M.)
| | - Enrique Jornet-Mollá
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, Faculty of Pharmacy, University of Valencia, Avda. Vicent Andrés Estellés s/n, 46100 Burjassot, Spain; (A.J.G.); (E.J.-M.); (N.L.); (C.M.-G.); (A.M.)
| | - Natalia Landsberg
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, Faculty of Pharmacy, University of Valencia, Avda. Vicent Andrés Estellés s/n, 46100 Burjassot, Spain; (A.J.G.); (E.J.-M.); (N.L.); (C.M.-G.); (A.M.)
| | - Carmen Milián-Guimerá
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, Faculty of Pharmacy, University of Valencia, Avda. Vicent Andrés Estellés s/n, 46100 Burjassot, Spain; (A.J.G.); (E.J.-M.); (N.L.); (C.M.-G.); (A.M.)
| | - M. Carmen Montesinos
- Department of Pharmacology, Faculty of Pharmacy, University of Valencia, Avda. Vicent Andrés Estellés s/n, 46100 Burjassot, Spain
- Center of Molecular Recognition and Technological Development (IDM), Polytechnic University of Valencia and University of Valencia, Avda. Vicent Andrés Estellés s/n, 46100 Burjassot, Spain
- Correspondence: (M.C.M.); (T.M.G.)
| | - Teresa M. Garrigues
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, Faculty of Pharmacy, University of Valencia, Avda. Vicent Andrés Estellés s/n, 46100 Burjassot, Spain; (A.J.G.); (E.J.-M.); (N.L.); (C.M.-G.); (A.M.)
- Correspondence: (M.C.M.); (T.M.G.)
| | - Ana Melero
- Department of Pharmacy and Pharmaceutical Technology and Parasitology, Faculty of Pharmacy, University of Valencia, Avda. Vicent Andrés Estellés s/n, 46100 Burjassot, Spain; (A.J.G.); (E.J.-M.); (N.L.); (C.M.-G.); (A.M.)
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