Category: Nevin Manimala

BMC Sports Sci Med Rehabil. 2024 Jul 19;16(1):157. doi: 10.1186/s13102-024-00946-x.

ABSTRACT

BACKGROUND: The relationship between hip strength deficiency in various planes and musculoskeletal injuries within the movement system has been well-established in numerous studies. The present study sought to explore the relationships between hip strength and specific aspects of lower extremity running kinematics.

METHODOLOGY: To achieve this objective, the three-dimensional running kinematics of 21 male elite middle-distance runners (mean age: 19.7 ± 1.2 years; mean experience 6.5 ± 1.0 years) were assessed using nine high-speed cameras on a treadmill at a speed of 16 km·h⁻¹. Concurrently, isokinetic hip strength was measured at a speed of 60 deg·s⁻¹ in both the dominant and non-dominant legs. The Pearson correlation coefficient and Paired Samples t-test were utilized.

RESULTS: While no significant differences were found in several isokinetic strength measurements, notable differences in running kinematics were observed. Specifically, pelvic drop at midstance (MS) was significantly lower in the DL (5.79 ± 3.00°) compared to the NDL (8.71 ± 1.39°) with a large effect size (t=-4.04, p < 0.001, Cohen’s d = 1.25). Additionally, knee adduction at maximum showed a moderate effect size difference, with the DL at 2.99 ± 1.13° and the NDL at 3.81 ± 1.76° (t=-2.74, p = 0.03, Cohen’s d = 0.55). Results indicated a moderate to highly positive association between running knee adduction in the dominant leg and hip external rotation (r = 0.67, p < 0.05), concentric extension (r = 0.77, p < 0.05), and concentric abduction (r = 0.78, p < 0.05). Additionally, the running tibial external rotation angle in the dominant leg exhibited an inverse relationship with all strength measurements, with statistical significance observed only for concentric extension force (r=-0.68, p < 0.05). Furthermore, hip internal rotation force demonstrated a highly inverse correlation with foot pronation in the dominant leg (r=-0.70, p < 0.05) and anterior pelvic tilt in the non-dominant leg (r=-0.76, p < 0.05).

CONCLUSIONS: These findings underscore the interrelation between hip strength and running kinematics, particularly on the dominant side. In light of these observations, it is imperative to consider hip strength exercises as integral components for correcting running kinematics. Coaches should also be mindful that kinematic deviations contributing to running injuries may manifest unilaterally or specifically in the dominant leg.

PMID:39030608 | DOI:10.1186/s13102-024-00946-x

Cancer Cell Int. 2024 Jul 20;24(1):254. doi: 10.1186/s12935-024-03449-4.

ABSTRACT

BACKGROUND: Breast cancer is the most common cancer in women. Cancer cells can persist in a prolonged dormant state for years without any clinical evidence of disease creating an urgent need to better understand the molecular mechanisms leading to relapse. This study aimed to identify extracellular matrix (ECM) components associated with hypoxia-induced breast cancer dormancy. The effects of selected ECM proteins on breast cancer cell proliferation were analyzed, along with their correlation with established prognostic markers in human breast cancer tissue.

MATERIALS AND METHODS: Screening of extracellular matrix proteins was performed in hypoxia-induced dormant MCF-7 breast cancer cells. Proliferation of MCF-7 cells in vitro was subsequently determined in the presence of recombinant ColVII. Adipose tissue-derived mesenchymal stem cells (AdMSCs) subpopulation overexpressing ColVII were indirectly isolated by ColVII receptor integrin-α6 specific antibodies. AdMSCs- MCF-7 3D spheroid cultures were generated to model solid tumour conditions. In addition, the association between ColVII and various prognostic markers was evaluated in clinical samples of human breast cancer tissue.

RESULTS: Dormant MCF-7 cells showed an elevated expression of ColVII while MCF-7 cells cultured on ColVII exhibited reduced proliferation in vitro. In AdMSCs-MCF-7 3D spheroids, a reduced proliferation of MCF-7 cells was observed in Int-α6⁺/ ColVII_high compared with Int-α6^-/ ColVII_low AdMSCs spheroids. In human tissue, high ColVII expression correlated to several positive prognostic markers. Staining for Cytokeratin-5 revealed that ColVII_high-expressing cells were predominantly myoepithelial cells.

CONCLUSION: ColVII is associated with reduced proliferation of breast cancer cells in vitro. ColVII is strongly expressed in myoepithelial cells and in breast cancer tissue the high ColVII expression correlates with several well-known positive prognostic markers, highlighting its potential as a prognostic marker in breast cancer.

PMID:39030607 | DOI:10.1186/s12935-024-03449-4

Chin Neurosurg J. 2024 Jul 19;10(1):22. doi: 10.1186/s41016-024-00372-5.

ABSTRACT

BACKGROUND: To assess the clinical effects of hybrid surgery, which includes spinal angiography-assisted microsurgery, in the treatment of spinal dural arteriovenous fistulas (SDAVF).

METHODS: We retrospectively reviewed 45 patients who underwent hybrid Spinal dural arteriovenous fistula (SDAVF) resection between September 2019 and June 2022. The hybrid surgery involved intraoperative digital subtraction angiography (DSA) of the spinal vessels to determine the source of the blood-supplying artery, location of the fistula and draining vein, indocyanine green fluorescence (ICG)-assisted microsurgical resection of the fistula, and postoperative DSA to verify therapeutic efficacy. The Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Visual Analog Scale (VAS), Barthel score, modified Rankin Scale (mRS) and modified Aminoff-Logue score (key indicator) were used to assess the clinical effects of SDAVF resection.

RESULTS: A series of 45 patients with SDAVF were successfully treated with hybrid surgery without fistula recurrence. There were no intraoperative complications related to spinal angiography, and none of the patients died. Postoperatively, two patients experienced clinical deterioration of spinal cord function, which manifested as bilateral lower extremity paralysis and bladder sphincter dysfunction. Postoperatively, improvement in mALS scores was observed in 16 cases (35.6%) within 1-2 days, 12 cases (26.7%) at 1 week, and 7 cases (15.6%) at 6 months. No SDAVF recurrence was detected in the spinal MRA examination 6 months after surgery. When compared with preoperative mALS scores, 35 cases (77.8%) showed significant improvement in symptoms, 8 cases (17.8%), remained unchanged, and 2 cases (4.4%) deteriorated. Compared with the preoperative scores, the postoperative mALS score was significantly decreased [postoperative vs. preoperative: 2(1,3) vs. 3(2,4)], HAMD score [(12.2 ± 5.5) vs. (19.6 ± 6.3)], HAMA score [(15.6 ± 5.5) vs. (20.5 ± 6.5)], and VAS score [3(2,5) vs. 5(4,8)]. Conversely, Barthel scoresshowed significant increase [(74.6 ± 8.7) vs. (67.8 ± 9.2)] (P < 0.05). However, the mRS scores were lower than preoperatively [1(1,2) vs. 2(1,2.5)], but the difference was not statistically significant (P > 0.05). There was a significant increase in “good” neurological outcomes at follow-up compared with preoperative function (62.2% vs. 33.3%) (P = 0.023).

CONCLUSION: Hybrid surgery is a safe and effective treatment for patients with SAVF, which is beneficial for improving anxiety, depression, spinal cord, and neurological function, and relieving pain. However, the treatment of patients with SDAVF is a complex, long-term process requiring further multidisciplinary interventions, including clinical care, psychosocial interventions, and neurorehabilitation.

PMID:39030604 | DOI:10.1186/s41016-024-00372-5

BMC Med Educ. 2024 Jul 19;24(1):772. doi: 10.1186/s12909-024-05770-y.

ABSTRACT

BACKGROUND: The key step in evaluating the quality of clinical nursing practice education lies in establishing a scientific, objective, and feasible index system. Current assessments of clinical teaching typically measure hospital learning environments, classroom teaching, teaching competency, or the internship quality of nursing students. As a result, clinical evaluations are often insufficient to provide focused feedback, guide faculty development, or identify specific areas for clinical teachers to implement change and improvement. Therefore, the purpose of our study was to to construct a scientific, systematic, and clinically applicable evaluation index system of clinical nursing practice teaching quality and determine each indicator’s weight to provide references for the scientific and objective evaluation of clinical nursing practice teaching quality.

METHODS: Based on the “Structure-Process-Outcome” theoretical model, a literature review and Delphi surveys were conducted to establish the evaluation index system of clinical nursing practice teaching quality. Analytic Hierarchy Process (AHP) was employed to determine the weight of each indicator.

RESULTS: The effective response rate for the two rounds of expert surveys was 100%. The expert authority coefficients were 0.961 and 0.975, respectively. The coefficient of variation for the indicators at each level ranged from 0 to 0.25 and 0 to 0.21, and the Kendall harmony coefficients were 0.209 and 0.135, respectively, with statistically significant differences (P < 0.001). The final established index system included 3 first-level, 10 second-level, and 29 third-level indicators. According to the weights computed by the AHP, first-level indicators were ranked as “Process quality” (39.81%), “Structure quality” (36.67%), and “Outcome quality” (23.52%). Among the secondary indicators, experts paid the most attention to “Teaching staff” (23.68%), “Implementation of teaching rules and regulations (14.14%), and “Teaching plans” (13.20%). The top three third-level indicators were “Level of teaching staff” (12.62%), “Structure of teaching staff” (11.06%), and “Implementation of the management system for teaching objects” (7.54%).

CONCLUSION: The constructed evaluation index system of clinical nursing practice teaching quality is scientific and reliable, with reasonable weight. The managers’ focus has shifted from outcome-oriented to process-oriented approaches, and more focus on teaching team construction, teaching regulations implementation, and teaching design is needed to improve clinical teaching quality.

PMID:39030603 | DOI:10.1186/s12909-024-05770-y

Anim Microbiome. 2024 Jul 19;6(1):40. doi: 10.1186/s42523-024-00320-9.

ABSTRACT

Radiation enteritis is a frequently encountered issue for patients receiving radiotherapy and has a significant impact on cancer patients’ quality of life. The gut microbiota plays a pivotal role in intestinal function, yet the impact of irradiation on gut microorganisms is not fully understood. This study explores the gastroprotective effect and gut microbiome-modulating potential of ubiquinol (Ubq), the reduced form of the powerful antioxidant CoQ-10. For this purpose, male albino rats were randomly assigned to four groups: Control, IRR (acute 7 Gy γ-radiation), Ubq_Post (Ubq for 7 days post-irradiation), and Ubq_Pre/Post (Ubq for 7 days pre and 7 days post-irradiation). The fecal microbiomes of all groups were profiled by 16S rRNA amplicon sequencing followed by bioinformatics and statistical analysis. Histopathological examination of intestinal tissue indicated severe damage in the irradiated group, which was mitigated by ubiquinol with enhanced regeneration, goblet cells, and intestinal alkaline phosphatase expression. Compared to the irradiated group, the Ubq-treated groups had a significant recovery of intestinal interleukin-1β, caspase-3, nitric oxide metabolites, and thio-barbituric reactive substances to near-healthy levels. Ubq_Pre/Post group displayed elevated peroxisome proliferator-activated receptor (PPAR-γ) level, suggesting heightened benefits. Serum insulin reduction in irradiated rats improved post-Ubq treatment, with a possible anti-inflammatory effect on the pancreatic tissue. Fecal microbiota profiling revealed a dysbiosis state with a reduction of bacterial diversity post-irradiation, which was re-modulated in the Ubq treated groups to profiles that are indistinguishable from the control group. These findings underscore Ubq’s gastroprotective effects against radiation-induced enteritis and its potential in restoring the gut microbiota’s diversity and balance.

PMID:39030597 | DOI:10.1186/s42523-024-00320-9

J Neurosurg Spine. 2024 Jul 19:1-10. doi: 10.3171/2024.4.SPINE24282. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to assess the correlation between patient-perceived changes in health and commonly utilized patient-reported outcome measures (PROMs) in lumbar spine surgery.

METHODS: This was a retrospective review of prospectively collected data on consecutive patients who underwent lumbar microdiscectomy, lumbar decompression, or lumbar fusion at a single academic institution from 2017 to 2023. Correlation between the global rating of change (GRC) questionnaire, a 5-item Likert scale (much better, slightly better, about the same, slightly worse, and much worse), and PROMs (Oswestry Disability Index, visual analog scale for back and leg pain, 12-Item Short Form Health Survey Physical Component Summary and Mental Component Summary, and PROMIS physical function) was assessed using Spearman’s rank correlation coefficients.

RESULTS: A total of 1871 patients (397 microdiscectomies, 965 decompressions, and 509 fusions) were included. A majority of patients in each group rated their lumbar condition as much better at each postoperative time point compared with preoperatively and reported improved health status at each postoperative time point compared with the previous follow-up visit. Statistically significant but weak to moderate correlations were found between GRC and change in PROM scores from the preoperative time point. Correlation between GRC and change in PROM scores from the prior visit showed some statistically significant correlations, but the strengths ranged from very weak to weak.

CONCLUSIONS: A majority of patients undergoing lumbar microdiscectomy, decompression, or fusion endorsed notable improvements in health status in the early postoperative period and continued to improve at late follow-up. However, commonly used PROMs demonstrated very weak to moderate correlations with patient-perceived changes in overall lumbar spine-related health status as determined by GRC. Therefore, currently used PROMs may not be as sensitive at detecting these changes or may not be adequately reflecting changes in health conditions that are meaningful to patients undergoing lumbar spine surgery.

PMID:39029123 | DOI:10.3171/2024.4.SPINE24282

J Neurosurg Pediatr. 2024 Jul 19:1-8. doi: 10.3171/2024.5.PEDS23372. Online ahead of print.

ABSTRACT

OBJECTIVE: The Hydrocephalus Clinical Research Network (HCRN) implemented a perioperative infection prevention bundle for all CSF shunt surgeries in 2007 that included the relatively unproven technique of intrathecal instillation of the broad-spectrum antibiotics vancomycin and gentamicin into the shunt. In the meantime, the field debated the use of antibiotic-impregnated catheter (AIC) shunt tubing using clindamycin and rifampin, an increasingly widespread, but expensive and controversial, technique. It is unknown whether there were changes in infecting organisms associated with the use of these techniques during CSF shunt surgery at the hospital level. Key comparison periods include during the use of intrathecal antibiotics (period 1 from June 1, 2007, to December 31, 2011, at HCRN hospitals) and AIC (period 2 from January 1, 2012, to December 31, 2015, at HCRN as well as increasing over time at non-HCRN hospitals) and only standard use of routine prophylactic antibiotics (period 1 at non-HCRN hospitals). The aim of this study was to examine rates of CSF shunt surgery-related infections from 2007 to 2012 at the hospital level, including HCRN and non-HCRN hospitals, with a focus on infections with gram-negative organisms.

METHODS: The authors conducted a retrospective observational cohort study at 6 children’s hospitals with enrollment from 2007 to 2012 and surveillance through 2015. Bimonthly rates of shunt surgery-related infections were summarized to produce an overall hospital-specific time series, as well as by HCRN/non-HCRN status. An interrupted time series analysis was performed to assess the impact of change in HCRN perioperative infection prevention bundle on overall bimonthly infection rates. Quarterly rates of gram-negative shunt surgery-related infections were summarized to produce an overall hospital-specific time series.

RESULTS: The overall bimonthly CSF shunt infection rate over time did not change significantly from 2007 to 2012. There was no difference in the trajectory of infection rates between HCRN and non-HCRN hospitals during the entire study period. No change in distributions of gram-negative organism infections was observed in hospitals from 2007 to 2015.

CONCLUSIONS: There were no differences observed in hospital-level infection rates for low-risk patients undergoing CSF shunt surgery. This included analyses based on participation in the HCRN network, given their regular use of intrathecal antibiotics in period 1 and a focus on gram-negative infections with increasing adoption of AICs in period 2.

PMID:39029119 | DOI:10.3171/2024.5.PEDS23372

J Neurosurg Spine. 2024 Jul 19:1-10. doi: 10.3171/2024.4.SPINE23707. Online ahead of print.

ABSTRACT

OBJECTIVE: Foraminal and extraforaminal lumbar disc herniation (FELDH) is an important pathological condition that can lead to lumbar radiculopathy. The paraspinal muscle-splitting approach introduced by Reulen and Wiltse is a reasonable surgical technique. Minimally invasive procedures using a tubular retractor system have also been introduced. However, surgical treatment is considered more challenging for FELDH than for central or subarticular lumbar disc herniations (LDHs). Some researchers have proposed uniportal extraforaminal endoscopic lumbar discectomy through a posterolateral approach as an alternative for FELDH, but heterogeneous clinical results have been reported. Recently, the biportal endoscopic (BE) paraspinal approach has been suggested as an alternative. The aim of this study was to compare the clinical outcomes of BE and microscopic tubular (MT) paraspinal approaches for decompressive foraminotomy and lumbar discectomy (paraLD) in patients with FELDH.

METHODS: Ninety-one consecutive patients with unilateral lumbar radiculopathy and FELDH underwent paraLD. Demographic and perioperative data were collected. Clinical outcomes were evaluated using the visual analog scale (VAS) for back and leg pain, the Oswestry Disability Index (ODI) for spinal disability, and the modified Macnab criteria for patient satisfaction. Postoperative complications and reoperation rates were also evaluated.

RESULTS: In total, 76 patients were included in the final analysis. Among them, 43 underwent BE paraLD (group A) and the remaining 33 underwent MT paraLD (group B). The demographic and preoperative data were not statistically different between the groups. All patients showed significant improvements in VAS back, VAS leg, and ODI scores compared with baseline values (p < 0.05). The improvement in VAS back scores was significantly better in group A than in group B on postoperative day 2 (p < 0.001). However, all clinical parameters were comparable between the two groups after postoperative year 1 (p > 0.05). According to the modified Macnab criteria, 86.1% and 72.7% of the patients had excellent or good outcomes in groups A and B, respectively. No intergroup differences were observed (p = 0.367). In addition, there were no differences in the total operation time or amount of surgical drainage. Postoperative complications were not significantly different between the two groups (p = 0.301); however, reoperation rates were significantly higher in group B (p = 0.035).

CONCLUSIONS: BE paraLD is an effective treatment for FELDH and is an alternative to MT paraLD. In particular, BE paraLD has advantages of early improvement in postoperative back pain and low reoperation rates.

PMID:39029114 | DOI:10.3171/2024.4.SPINE23707

J Acoust Soc Am. 2024 Jul 1;156(1):573-599. doi: 10.1121/10.0027914.

ABSTRACT

In this paper, we introduce the foundations of the Statistical Wave Field Theory. This theory establishes the statistical laws of waves propagating in a closed bounded volume, that are mathematically implied by the boundary-value problem of the wave equation. These laws are derived from the Sturm-Liouville theory and the mathematical theory of dynamical billiards. They hold after many reflections on the boundary surface, and at high frequency. This is the first statistical theory of reverberation which provides the closed-form expression of the power distribution and the correlations of the wave field jointly over time, frequency, and space inside the bounded volume, in terms of the geometry and the specific admittance of its boundary surface. The Statistical Wave Field Theory may find applications in various science fields, including room acoustics, electromagnetic theory, and nuclear physics.

PMID:39029095 | DOI:10.1121/10.0027914

Medicine (Baltimore). 2024 Jul 19;103(29):e38880. doi: 10.1097/MD.0000000000038880.

ABSTRACT

The prevalence of obesity and hypertension is increasing, particularly in the urban areas. However, there is limited research on the relationship between obesity and hypertension in the rural areas of southeastern Nigeria. The present study aimed to investigate the association between anthropometric parameters and adiposity indicators and the risk of hypertension with obesity-related conditions, based on a descriptive study of people living in the southeastern rural areas of Nigeria. The cluster sampling procedure randomly recruited study participants. Finally, 200 participants (100 male and 100 female) aged 18 to 25 years were included in the study. A simplified correlation analysis was used to derive the adjusted indicators in relation to age and sex. This study found that females generally had a higher body mass index (BMI), waist circumference (WC), and Z-score, whereas systolic blood pressure (SBP) was higher in men. A high correlation was found between the body shape index (ABSI) and BMI (r = -.529, P < .001), WC (r = .399, P < .001) and Z-score (r = .982, P < .001) in male participants. In females, there was a high correlation between ABSI and BMI, blood pressure (BP), and Z score in female participants (r = -.481, P < .000; r = -.267, P = .007; r = .941, P < .000). In male participants, BMI was correlated with diastolic blood pressure (DBP; r = .236, P = .018), SBP (r = .282, P = .005), Z score (r = -.539, P < .000), and WC (r = .541, P < .001). This study highlights the importance of considering a range of anthropometric measurements and health parameters when assessing health risks and identifying potential interventions. In addition, the body shape index may be a particularly useful tool for predicting health risks in both men and women. In contrast, correlations between various health parameters can provide insights into the underlying mechanisms and risk factors.

PMID:39029085 | DOI:10.1097/MD.0000000000038880