Category: Nevin Manimala

J Sports Med Phys Fitness. 2023 May;63(5):674-684. doi: 10.23736/S0022-4707.22.14376-8.

ABSTRACT

BACKGROUND: Supraspinatus tendinopathy is a significant cause of pain and function loss. It has been suggested that platelet-rich plasma (PRP) and prolotherapy are effective treatments for this condition. This study was done to assess and compare the effects of PRP and prolotherapy on shoulder function and pain. The secondary aim was to evaluate the effect of the treatment on shoulder range of motion, supraspinatus tendon thickness, patient satisfaction, and adverse effects.

METHODS: This was a randomized, double-blind clinical trial. The study included 64 patients over the age of 18 who had supraspinatus tendinopathy and had not responded to at least three months of conventional treatment. Patients were assigned to either receive 2 mL of PRP (N.=32) or prolotherapy (N.=32). The Shoulder Pain and Disability Index (SPADI) and the Numerical Rating Scale (NRS) were the primary outcomes. Secondary outcomes included shoulder range of motion (ROM), supraspinatus tendon thickness, and adverse effects, which were measured at baseline, 3, 6, and 6 months after injection. At six months, patient satisfaction was assessed.

RESULTS: Repeated measures ANOVA showed there was a statistically significant effect of time on total SPADI scores (F [2.75, 151.11], = 2.85, P=0.040) and the NRS (F [2.69, 147.86], = 4.32, P=0.008) within each group. There were no other significant changes over time or between groups. Significantly more patients in the PRP group experienced increased pain lasting less than two weeks after injection (χ²=11.94, P=0.030).

CONCLUSIONS: PRP and prolotherapy resulted in improved shoulder function and pain for patients with chronic supraspinatus tendinopathy who did not response to conventional treatment.

PMID:37132278 | DOI:10.23736/S0022-4707.22.14376-8

Biometrics. 2023 May 3. doi: 10.1111/biom.13873. Online ahead of print.

ABSTRACT

Gene-environment (G-E) interactions have important implications for cancer outcomes and phenotypes beyond the main G and E effects. Compared to main-effect-only analysis, G-E interaction analysis more seriously suffers from a lack of information caused by higher dimensionality, weaker signals, and other factors. It is also uniquely challenged by the “main effects, interactions” variable selection hierarchy. Effort has been made to bring in additional information to assist cancer G-E interaction analysis. In this study, we take a strategy different from the existing literature and borrow information from pathological imaging data. Such data is a “byproduct” of biopsy, enjoys broad availability and low cost, and has been shown as informative for modeling prognosis and other cancer outcomes/phenotypes in recent studies. Building on penalization, we develop an assisted estimation and variable selection approach for G-E interaction analysis. The approach is intuitive, can be effectively realized, and has competitive performance in simulation. We further analyze The Cancer Genome Atlas (TCGA) data on lung adenocarcinoma (LUAD). The outcome of interest is overall survival, and for G variables, we analyze gene expressions. Assisted by pathological imaging data, our G-E interaction analysis leads to different findings with competitive prediction performance and stability. This article is protected by copyright. All rights reserved.

PMID:37132273 | DOI:10.1111/biom.13873

Nucl Med Commun. 2023 May 3. doi: 10.1097/MNM.0000000000001703. Online ahead of print.

ABSTRACT

In this pilot study, we investigated the feasibility of response prediction using digital [18F]FDG PET/computed tomography (CT) and multiparametric MRI before, during, and after neoadjuvant chemoradiation therapy in locally advanced rectal cancer (LARC) patients and aimed to select the most promising imaging modalities and timepoints for further investigation in a larger trial. Rectal cancer patients scheduled to undergo neoadjuvant chemoradiation therapy were prospectively included in this trial, and underwent multiparametric MRI and [18F]FDG PET/CT before, 2 weeks into, and 6-8 weeks after chemoradiation therapy. Two groups were created based on pathological tumor regression grade, that is, good responders (TRG1-2) and poor responders (TRG3-5). Using binary logistic regression analysis with a cutoff value of P ≤ 0.2, promising predictive features for response were selected. Nineteen patients were included. Of these, five were good responders, and 14 were poor responders. Patient characteristics of these groups were similar at baseline. Fifty-seven features were extracted, of which 13 were found to be promising predictors of response. Baseline [T2: volume, diffusion-weighted imaging (DWI): apparent diffusion coefficient (ADC) mean, DWI: difference entropy], early response (T2: volume change, DWI: ADC mean change) and end-of-treatment presurgical evaluation MRI (T2: gray level nonuniformity, DWI: inverse difference normalized, DWI: gray level nonuniformity normalized), as well as baseline (metabolic tumor volume, total lesion glycolysis) and early response PET/CT (Δ maximum standardized uptake value, Δ peak standardized uptake value corrected for lean body mass), were promising features. Both multiparametric MRI and [18F]FDG PET/CT contain promising imaging features to predict response to neoadjuvant chemoradiotherapy in LARC patients. A future larger trial should investigate baseline, early response, and end-of-treatment presurgical evaluation MRI and baseline and early response PET/CT.

PMID:37132268 | DOI:10.1097/MNM.0000000000001703

Nurs Open. 2023 May 3. doi: 10.1002/nop2.1773. Online ahead of print.

ABSTRACT

AIMS: To report on the engagement of Swiss nursing homes and of nurses in expanded roles in quality improvement.

DESIGN: A cross-sectional study (2018-2019).

METHODS: Survey data from a sample of 115 Swiss nursing homes and 104 nurses in expanded roles. Descriptive statistics were used.

RESULTS: Most participating nursing homes reported carrying several quality improvement activities (median of eight out of 10 activities surveyed) but some were only engaged in five activities or less. Nursing homes working with nurses in expanded roles (n = 83) showed greater engagement in quality improvement than those working with none. Nurses with more advanced qualifications (Bachelor’s or Master’s degree) engaged more in quality improvement than nurses with standard training. Specifically, higher educated nurses were more involved in data-focused activities. Using nurses in expanded roles can be a way forward for nursing homes seeking to actively carry out quality improvement in their facilities.

CONCLUSION: Although a large proportion of nurses in expanded roles surveyed were implementing quality activities, their level of engagement depended on their educational level. Our findings support the principle that higher level competencies are a key aspect of data-based quality improvement in nursing homes. However, as Advance Practice Registered Nurses will remain difficult to recruit in nursing homes, using nurses in expanded roles might contribute to quality improvement.

PMID:37132255 | DOI:10.1002/nop2.1773

Sports Biomech. 2023 May 3:1-14. doi: 10.1080/14763141.2023.2207554. Online ahead of print.

ABSTRACT

The modularisation of sports science curricula allows students to individualise degrees to fit their interests and aspirations via elective modules. The aim of this study was to explore the factors which influence sports science students’ elective biomechanics enrolment decisions. A total of 45 students completed an online survey focussing on personal and academic characteristics which may influence enrolment decisions. Significant differences were found for three personal characteristics. Biomechanics module enrolees were more positive in their self-concept of subject ability, had a greater like for their previous subject experience, and displayed a higher agreement in requiring the knowledge for future career aspirations. Although, statistical power was reduced when respondents were categorised into demographic sub-groups, exploratory analysis highlighted self-concept of subject ability may differentiate female students’ enrolment, while previous subject experience may distinguish male students’ enrolment and academic entry route students’ enrolment. Undergraduate sports science core biomechanics modules should consider adopting learning pedagogies which help to increase individual students’ self-concept of ability and inspires them to recognise the value of biomechanics in their potential career aspirations.

PMID:37132254 | DOI:10.1080/14763141.2023.2207554

Blood Press. 2023 Dec;32(1):2203267. doi: 10.1080/08037051.2023.2203267.

ABSTRACT

Purpose: A limited number of studies have suggested a nonlinear association between spot urine (SU) sodium concentration and office blood pressure (BP). We examined how SU sodium concentration and dietary salt obtained from a food frequency questionnaire are associated with more accurately measured home BP in a large, nationwide population sample.Materials and methods: We included 1398 participants in cross-sectional and 851 participants in 11-year longitudinal analyses. We investigated associations between baseline salt/sodium variables and (i) baseline and follow-up home BP; and (ii) prevalent and incident hypertension with linear and logistic regression models.Results: We observed positive associations (β ± standard error) between salt/sodium variables and BP in unadjusted models. SU sodium concentration associated with baseline systolic (0.04 ± 0.01, p < 0.001) and diastolic (0.02 ± 0.01, p < 0.001) BP and follow-up systolic (0.03 ± 0.01, p = 0.003) and diastolic (0.02 ± 0.01, p < 0.001) BP. Dietary salt intake was associated with baseline (0.52 ± 0.19, p = 0.008) and follow-up (0.57 ± 0.20, p = 0.006) systolic BP. Compared to the lowest quintile of SU sodium concentration, the highest quintile had greater odds of prevalent hypertension (odds ratio [OR] 1.57, 95% confidence interval [CI] 1.12-2.19) and the second highest quintile with incident hypertension (OR 1.86, 95% CI 1.05-3.34). Unadjusted odds of incident hypertension were higher in the highest as compared to the lowest quintile of dietary salt intake (OR 1.83, 95% CI 1.01-3.35). After adjustments for sex, age, plasma creatinine concentration and alcohol intake, none of the aforementioned associations remained statistically significant. We found no evidence of a J-shaped association between the salt/sodium variables and BP or hypertension.Conclusion: SU sodium concentration and dietary salt intake are associated with home BP and hypertension only in some of the unadjusted models. Our results underscore that feasible estimation of sodium intake remains challenging in epidemiology.

PMID:37132246 | DOI:10.1080/08037051.2023.2203267

Proc Biol Sci. 2023 May 10;290(1998):20222531. doi: 10.1098/rspb.2022.2531. Epub 2023 May 3.

ABSTRACT

Male sexual ornaments often evolve rapidly and are thought to be costly, thus contributing to sexual size dimorphism. However, little is known about their developmental costs, and even less about costs associated with structural complexity. Here, we quantified the size and complexity of three morphologically elaborate sexually dimorphic male ornaments that starkly differ across sepsid fly species (Diptera: Sepsidae): (i) male forelegs range from being unmodified, like in most females, to being adorned with spines and large cuticular protrusions; (ii) the fourth abdominal sternites are either unmodified or are converted into complex de novo appendages; and (iii) male genital claspers range from small and simple to large and complex (e.g. bifurcated). We tracked the development of 18 sepsid species from egg to adult to determine larval feeding and pupal metamorphosis times of both sexes. We then statistically explored whether pupal and adult body size, ornament size and/or ornament complexity are correlated with sex-specific development times. Larval growth and foraging periods of male and female larvae did not differ, but the time spent in the pupal stage was ca 5% longer for sepsid males despite emerging 9% smaller than females on average. Surprisingly, we found no evidence that sexual trait complexity prolongs pupal development beyond some effects of trait size. Evolving more complex traits thus does not incur developmental costs at least in this system.

PMID:37132233 | DOI:10.1098/rspb.2022.2531

Phys Act Nutr. 2023 Mar;27(1):9-15. doi: 10.20463/pan.2023.0002. Epub 2023 Mar 31.

ABSTRACT

PURPOSE: This study aims to examine the physical activity and eating habits of elite athletes to identify changes in their weight and participation levels in competitions pre- and post-COVID-19, and to establish a database of the abovementioned factors for the post-COVID-19 period.

METHODS: This study surveyed 913 elite adult athletes from 22 sports. They were divided into two groups: weight loss athletes’ group (WLG) and non-weight loss athletes’ group (NWLG). In addition to demographic factors, the questionnaire included questions about physical activity, sleep, and eating habits pre- and post-COVID-19 pandemic. The survey included 46 questions requiring short subjective answers. Statistical significance was set at p&lt;0.05.

RESULTS: In the post-COVID-19 pandemic period, physical activity and sitting decreased in athletes of both groups. The difference in the number of meals consumed by both groups varied, and the number of tournaments the athletes participated in decreased for all sports. The success or failure of weight loss is essential for maintaining athletes’ performance and health.

CONCLUSION: Coaches play an important role in investigating and managing the weight loss regimen of athletes during crisis situations like a pandemic. Additionally, athletes must find the best way to maintain their competencies to the standards set before COVID-19. Adhering to such a regimen will have the greatest impact on their tournament participation in the post-COVID-19 pandemic period.

PMID:37132206 | DOI:10.20463/pan.2023.0002

Diabetes Metab Res Rev. 2023 May 2:e3649. doi: 10.1002/dmrr.3649. Online ahead of print.

ABSTRACT

BACKGROUND: Most interventions to prevent foot ulcers in people with diabetes do not seek to reverse the foot abnormalities that led to the ulcer. Foot-ankle exercise programs target these clinical and biomechanical factors, such as protective sensation and mechanical stress. Multiple RCTs exist investigating the effectiveness of such programs, but these have never been summarised in a systematic review and meta-analysis.

METHODS: We searched the available scientific literature in PubMed, EMBASE, CINAHL, Cochrane databases and trial registries for original research studies on foot-ankle exercise programs for people with diabetes at risk of foot ulceration. Both controlled and non-controlled studies were eligible for selection. Two independent reviewers assessed the risk of bias of controlled studies and extracted data. Meta-analysis (using Mantel-Haenszel’s statistical method and random effect models) was performed when >2 RCTs were available that met our criteria. Evidence statements, including the certainty of evidence, were formulated according to GRADE.

RESULTS: We included a total of 29 studies, of which 16 were RCTs. A foot-ankle exercise programme of 8-12 weeks duration for people at risk of foot ulceration results in: (a) no increase or decrease risk of foot ulceration or pre-ulcerative lesion (Risk Ratio (RR): 0.56 (95% CI: 0.20-1.57)); (b) no increase or decrease risk of adverse events (RR: 1.04 (95% CI: 0.65-1.67)); (c) not increase or decrease barefoot peak plantar pressure during walking (Mean Difference (MD): -6.28 kPa (95% CI: -69.90-57.34)); (d) no increase or decrease health-related quality of life (no meta-analysis possible). Likely results in increases in ankle joint and first metatarsalphalangeal joint range of motion (MD: 1.49° (95% CI: -0.28-3.26)) may result in improvements in neuropathy signs and symptoms (MD: -1.42 (95% CI: -2.95-0.12)), may result in a small increase in daily steps in some people (MD: 131 steps (95% CI: -492-754)), and may not increase or decrease foot and ankle muscle strength and function (no meta-analysis was possible).

CONCLUSIONS: In people at risk of foot ulceration, a foot-ankle exercise programme of 8-12 weeks duration may not prevent or cause diabetes-related foot ulceration. However, such a programme likely improves the ankle joint and first metatarsalphalangeal joint range of motion and neuropathy signs and symptoms. Further research is needed to strengthen the evidence base, and should also focus on the effects of specific components of foot-ankle exercise programs.

PMID:37132203 | DOI:10.1002/dmrr.3649

Am J Psychiatry. 2023 May 3:appiajp20220459. doi: 10.1176/appi.ajp.20220459. Online ahead of print.

ABSTRACT

OBJECTIVE: This study assessed the efficacy and safety of a 14-day treatment course of once-daily zuranolone 50 mg, an investigational oral positive allosteric modulator of the γ-aminobutyric acid type A (GABA_A) receptor, for the treatment of major depressive disorder.

METHODS: Patients 18-64 years of age with severe major depressive disorder were enrolled in this randomized, double-blind, placebo-controlled trial. Patients self-administered zuranolone 50 mg or placebo once daily for 14 days. The primary endpoint was change from baseline in total score on the 17-item Hamilton Depression Rating Scale (HAM-D) at day 15. Safety and tolerability were assessed by incidence of adverse events.

RESULTS: Of 543 randomized patients, 534 (266 in the zuranolone group, 268 in the placebo group) constituted the full analysis set. Compared with patients in the placebo group, patients in the zuranolone group demonstrated a statistically significant improvement in depressive symptoms at day 15 (least squares mean change from baseline HAM-D score, -14.1 vs. -12.3). Numerically greater improvements in depressive symptoms for zuranolone versus placebo were observed by day 3 (least squares mean change from baseline HAM-D score, -9.8 vs. -6.8), which were sustained at all visits throughout the treatment and follow-up periods of the study (through day 42, with the difference remaining nominally significant through day 12). Two patients in each group experienced a serious adverse event; nine patients in the zuranolone group and four in the placebo group discontinued treatment due to adverse events.

CONCLUSIONS: Zuranolone at 50 mg/day elicited a significantly greater improvement in depressive symptoms at day 15, with a rapid time to effect (day 3). Zuranolone was generally well tolerated, with no new safety findings compared with previously studied lower dosages. These findings support the potential of zuranolone in treating adults with major depressive disorder.

PMID:37132201 | DOI:10.1176/appi.ajp.20220459