Category: Nevin Manimala

J Sport Rehabil. 2021 Jun 10:1-6. doi: 10.1123/jsr.2020-0468. Online ahead of print.

ABSTRACT

CONTEXT: Performance in strength and assessment of patellar tracking is important for patients with arthrofibrosis after anterior cruciate ligament (ACL) reconstruction.

OBJECTIVE: The study was to examine the difference of patellofemoral kinematics between the affected and the contralateral limb and to evaluate the relationship between knee extensor strength and patellofemoral kinematics in patients with arthrofibrosis after ACL reconstruction.

DESIGN: Cohort study (diagnosis); level of evidence, 3.

SETTING: Laboratory.

PATIENTS: A prospective cohort of 20 patients with arthrofibrosis after ACL reconstruction was recruited.

INTERVENTIONS: A total of 20 patients who underwent arthroscopic reconstruction of the double-bundle ACL with a hamstring tendon autograft received standardized patellofemoral kinematics testing and knee extensor strength testing within 6 months after primary ACL reconstruction. Computed tomography and dual fluoroscopic imaging were used to evaluate in vivo patellofemoral kinematics of affected and contralateral knees during a lunge task. Knee extensor mechanism strength was measured using a handheld dynamometer.

MAIN OUTCOME MEASURES: A limb symmetry index of knee strength and patellar mobility was calculated and satisfactory performance defined as ≥90%.

RESULTS: There was a statistically significant decrease in the range of patellar inferior shift (P = .020; d = 0.81), flexion (P = .026; d = 0.95), lateral tilt (P = .001; d = 1.04), and lateral rotation (P < .001; d = 0.89) in the affected knee compared with the contralateral knee from 15° to 75° of knee flexion. There was a strong positive linear correlation between knee extensor strength and patellar inferior shift (r = .747; P = .008). A knee extensor strength limb symmetry index <90% was 89% sensitive and 9% specific for limited patellar inferior shift.

CONCLUSIONS: Patients with arthrofibrosis after ACL reconstruction presented decreased patellar mobility in the arthrofibrotic knee compared with the contralateral knee. The strong correlation between knee extensor strength and patellar inferior shift of the arthrofibrotic knee demonstrates the importance of knee extensor strength in the diagnosis and treatment of patients with knee arthrofibrosis. The knee extensor mechanism strength has high sensitivity but low specificity in identifying a decrease in patellar inferior shift in patients with arthrofibrosis after ACL reconstruction.

PMID:34111841 | DOI:10.1123/jsr.2020-0468

Stud Hist Philos Sci. 2021 Apr 11;87:125-135. doi: 10.1016/j.shpsa.2021.03.005. Online ahead of print.

ABSTRACT

Fitness contribution alone should not be the criterion of ‘function’ in molecular biology and genomics. Disagreement over the use of ‘function’ in molecular biology and genomics is still with us, almost eight years after publicity surrounding the Encyclopedia of DNA Elements project claimed that 80.4% of the human genome comprises “functional elements”. Recent approaches attempt to resolve or reformulate this debate by redefining genomic ‘function’ in terms of current fitness contribution. In its favour, this redefinition for the genomic context is in apparent conformity with predominant experimental practices, especially in biomedical research, and with ascription of function by selective maintenance. We argue against approaches of this kind, however, on the grounds that they could be seen as non-Darwinian, and fail to properly account for the diversity of non-adaptive processes involved in the origin and maintenance of genomic complexity. We examine cases of molecular and organismal complexity that arise neutrally, showing how purifying selection maintains non-adaptive genomic complexity. Rather than lumping different sorts of genomic complexity together by defining ‘function’ as fitness contribution, we argue that it is best to separate the heterogeneous contributions of preaptation, exaptation and adaptation to the historical processes of origin and maintenance for complex features.

PMID:34111815 | DOI:10.1016/j.shpsa.2021.03.005

Stud Hist Philos Sci. 2021 Apr 24;87:136-146. doi: 10.1016/j.shpsa.2021.04.006. Online ahead of print.

ABSTRACT

Thermodynamics has a clear arrow of time, characterized by the irreversible approach to equilibrium. This stands in contrast to the laws of microscopic theories, which are invariant under time-reversal. Foundational discussions of this “problem of irreversibility” often focus on historical considerations, and do therefore not take results of modern physical research on this topic into account. In this article, I will close this gap by studying the implications of dynamical density functional theory (DDFT), a central method of modern nonequilibrium statistical mechanics not previously considered in philosophy of physics, for this debate. For this purpose, the philosophical discussion of irreversibility is structured into five problems, concerned with the source of irreversibility in thermodynamics, the definition of equilibrium and entropy, the justification of coarse-graining, the approach to equilibrium and the arrow of time. For each of these problems, it is shown that DDFT provides novel insights that are of importance for both physicists and philosophers of physics.

PMID:34111817 | DOI:10.1016/j.shpsa.2021.04.006

Sci Total Environ. 2021 May 28;790:148067. doi: 10.1016/j.scitotenv.2021.148067. Online ahead of print.

ABSTRACT

Many areas around the world are affected by Groundwater Level rising (GWLr). One of the most severe consequences of this phenomenon is Groundwater Flooding (GF), with serious impacts for the human and natural environment. In Europe, GF has recently received specific attention with Directive 2007/60/EC, which requires Member States to map GF hazard and propose measures for risk mitigation. In this paper a methodology has been developed for Groundwater Flooding Susceptibility (GFS) assessment, using for the first time Spatial Distribution Models. These Machine Learning techniques connect occurrence data to predisposing factors (PFs) to estimate their distributions. The implemented methodology employs aquifer type, depth of piezometric level, thickness and hydraulic conductivity of unsaturated zone, drainage density and land-use as PFs, and a GF observations inventory as occurrences. The algorithms adopted to perform the analysis are Generalized Boosting Model, Artificial Neural Network and Maximum Entropy. Ensemble Models are carried out to reduce the uncertainty associated with each algorithm and increase its reliability. GFS is mapped by choosing the ensemble model with the best predictivity performance and dividing occurrence probability values into five classes, from very low to very high susceptibility, using Natural Breaks classification. The methodology has been tested and statistically validated in an area of 14,3 km² located in the Metropolitan City of Naples (Italy), affected by GWLr since 1990 and GF in buildings and agricultural soils since 2007. The results of modeling show that about 93% of the inventoried points fall in the high and very high GFS classes, and piezometric level depth, thickness of unsaturated zone and drainage density are the most influencing PFs, in accordance with field observations and the triggering mechanism of GF. The outcomes provide a first step in the assessment of GF hazard and a decision support tool to local authorities for GF risk management.

PMID:34111794 | DOI:10.1016/j.scitotenv.2021.148067

Knee. 2021 Jun 7;31:46-53. doi: 10.1016/j.knee.2021.05.001. Online ahead of print.

ABSTRACT

BACKGROUND: Mobile-bearing medial-unicompartmental knee arthroplasty (mUKA) has a documented learning curve. New instrumentation has been designed with the aim of reducing the technical challenges of this procedure. The primary aim of this study was to evaluate the technical performance of mUKA using new (Microplasty) versus older (Phase III) instrumentation, performed by expert surgeons and trainees. Secondary aims were to evaluate functional outcome and mid-term survivorship.

METHODS: A time-based comparative cohort study was performed between 2009 and 2015 at a high-volume centre. 273 patients (273 knees, 49.5% female) of mean age 67.8 (standard deviation 10.1) years underwent mUKA. 153 (56.0%) procedures used Microplasty instruments and 120 procedures (44.0%) used Phase III instruments.

RESULTS: Non-optimal bearing usage was less frequent with Microplasty than Phase III instruments (24 knees [15.7%] versus 33 knees [27.5%], p = 0.024), with differences due to improved trainee performance. Femoral component sagittal alignment outliers were less frequent with Microplasty, but this was not statistically significant (9 knees [5.9%] versus 13 knees [10.8%], p = 0.18). Post-operative Oxford Knee Scores (OKS) were better with Microplasty (median 42 points [interquartile range 38-44]) compared to Phase III (median 39.5 points [IQR 33-44]), which was statistically significant (p = 0.023), but not clinically meaningful. The overall 5-year Kaplan-Meier (KM) survival estimate was 99.3% (95% CI 97.0-99.8%), with no differences between Microplasty and Phase III instrumentation.

CONCLUSIONS: New instrumentation improved the reliability of the proximal tibial resection in trainees. Further research is warranted to investigate whether Microplasty instrumentation shortens the learning curve for medial UKA.

PMID:34111801 | DOI:10.1016/j.knee.2021.05.001

Public Health. 2021 Jun 7;195:142-144. doi: 10.1016/j.puhe.2021.04.022. Online ahead of print.

ABSTRACT

OBJECTIVES: This study examined the prevalence and factors associated with paid sick leave benefits among direct service providers who work with people experiencing homelessness.

STUDY DESIGN: Cross-sectional study using an online survey disseminated during the second wave of the COVID-19 pandemic in Canada.

METHODS: Survey data from 572 direct service providers working in the homeless, supportive housing, and harm reduction service sectors were analyzed for this study. Univariate and multivariate logistic regression models were used to examine predictors of paid sick leave benefits.

RESULTS: One hundred one (17.7%) participants did not have any paid sick leave benefits. In the univariate models, paid sick leave was associated with older age, greater family income, full-time work, specific employment settings (supportive housing and not emergency shelters or harm reduction programs), having a regular medical doctor, and fewer occupational impacts of the COVID-19 pandemic. Older age, full-time work, and non-receipt of emergency financial benefits remained statistically significant predictors in the multivariate model.

CONCLUSIONS: Although the majority of service providers working with people experiencing homelessness have some amount of paid sick leave benefits, there is a precariously employed subset of individuals who are younger and working part-time in the sector. Temporary expansion of paid sick leave and removal of waiting periods for new employees to qualify for benefits are recommended.

PMID:34111803 | DOI:10.1016/j.puhe.2021.04.022

Comput Biol Chem. 2021 Jun 5;93:107528. doi: 10.1016/j.compbiolchem.2021.107528. Online ahead of print.

ABSTRACT

Intron is a non-coding sequence of a broken gene and participates in important biological processes, such as transcription regulation, alternative splicing, and nuclear export. With the development of plant genomes, a comprehensive platform for intron analysis in plants must be established. Plant Intron Database (PID), a publicly available searchable database, was developed to efficiently store, query, analyze, and integrate intron resources in plants. The information of intron, exon, and gene can be searched by key words in PID. Users cannot only view intron length distribution pie chart and 5′ and 3′ splice site sequence feature maps in a statistical interface but can also browse intron information in a graphical visualization interface through JBrowse. ViroBlast for sequence homology searches, Intron detection and sequence interception tools were also provided. PID contains annotated genes from 118 sequenced plants, 24,782,048 introns, 30,843,049 exons, and 414 visual maps. This tool will greatly accelerate research on the distribution, length characteristics, and functions of introns in plants. PID is accessible at http://biodb.sdau.edu.cn/PID/index.php.

PMID:34111777 | DOI:10.1016/j.compbiolchem.2021.107528

Epilepsy Behav. 2021 Jun 7;121(Pt A):108097. doi: 10.1016/j.yebeh.2021.108097. Online ahead of print.

ABSTRACT

AIM: This study was performed to analyze the attitudes of individuals in eastern Turkey toward epilepsy and the factors associated with these attitudes.

METHODS: Designed as a cross-sectional descriptive study, this study was performed from January 28 to February 8, 2021. A snowball sampling technique was used to select the study sample, and a survey was sent online to individuals aged 18 or above. A total of 617 individuals who filled in this online survey form were included in this research. Data were collected via a personal information form and the Public Attitudes Toward Epilepsy (PATE) scale.

RESULTS: The results showed that the mean scores of the participants on the PATE scale, on its general domain, and on its personal domain were 1.79±0.63, 1.70±0.63, and 1.96±0.77, respectively. Comparing the participants’ mean PATE scale scores on the basis of their descriptive characteristics revealed statistically significant differences in the mean scores on the scale and its two domains in terms of age, place of residence, educational level, knowing anyone who had epilepsy or experienced epileptic seizures, and witnessing a person having an epileptic seizure (p < 0.05).

CONCLUSION: Individuals living in eastern Turkey have positive attitudes toward epilepsy. Moreover, it was found that, among all the participants, those who were relatively young, those who lived in a provincial center, those who had a relatively high educational level, those who knew an individual with epilepsy, and those who had witnessed an epileptic seizure have more positive attitudes toward epilepsy than their counterparts.

IMPLICATIONS: It is recommended to design educational programs focusing on raising the level of public awareness and knowledge regarding epilepsy.

PMID:34111764 | DOI:10.1016/j.yebeh.2021.108097

JMIR Med Educ. 2021 Jun 10;7(2):e22745. doi: 10.2196/22745.

ABSTRACT

BACKGROUND: Shared decision-making (SDM) is a process in which clinicians and patients work together to select tests, treatments, management, or support packages based on clinical evidence and the patient’s informed preferences. Similar to any skill, SDM requires practice to improve. Virtual patients (VPs) are simulations that allow one to practice a variety of clinical skills, including communication. VPs can be used to help professionals and students practice communication skills required to engage in SDM; however, this specific focus has not received much attention within the literature. A multiple-choice VP was developed to allow students the opportunity to practice SDM. To interact with the VP, users chose what they wanted to say to the VP by choosing from multiple predefined options, rather than typing in what they wanted to say.

OBJECTIVE: This study aims to evaluate a VP workshop for medical students aimed at developing the communication skills required for SDM.

METHODS: Preintervention and postintervention questionnaires were administered, followed by semistructured interviews. The questionnaires provided cohort-level data on the participants’ views of the VP and helped to inform the interview guide; the interviews were used to explore some of the data from the questionnaire in more depth, including the participants’ experience of using the VP.

RESULTS: The interviews and questionnaires suggested that the VP was enjoyable and easy to use. When the participants were asked to rank their priorities in both pre- and post-VP consultations, there was a change in the rank position of respecting patient choices, with the median rank changing from second to first. Owing to the small sample size, this was not analyzed for statistical significance. The VP allowed the participants to explore a consultation in a way that they could not with simulated or real patients, which may be part of the reason that the VP was suggested as a useful intervention for bridging from the early, theory-focused years of the curriculum to the more patient-focused ones later.

CONCLUSIONS: The VP was well accepted by the participants. The multiple-choice system of interaction was reported to be both useful and restrictive. Future work should look at further developing the mode of interaction and explore whether the VP results in any changes in observed behavior or practice.

PMID:34110299 | DOI:10.2196/22745

Z Kinder Jugendpsychiatr Psychother. 2021 Jun 10:1-7. doi: 10.1024/1422-4917/a000810. Online ahead of print.

ABSTRACT

Objective: The problematic use of computer games was included in the DSM-5 and in the ICD-11. Initial research revealed associations between problematic gaming (PG) and quality of life (QoL). However, clarification is needed concerning which dimensions of the multidimensional construct QoL are particularly relevant for PG. Method: To answer this question empirically, we asked 503 parents (mean age: 47.63 years) to rate their 503 children (average age: 14.60 years) regarding QoL and PG, using validated questionnaires on parental assessments of adolescent PG and health-related QoL to collect the data. Correlation analyses were calculated to determine bivariate relations, and a multiple linear regression was used to conduct a multivariable analysis. Results: In the bivariate analyses, a higher severity of PG was associated with a lower health-related QoL in all five surveyed dimensions. In the multivariable model (corrected R² = 0.35), we observed statistically significant associations between higher severity of PG and male sex and lower age of the adolescent as well as lower QoL in the dimensions of physical well-being and school environment. Conclusions: According to the findings of the present study, physical well-being and school environment should be especially focused on in preventive approaches against the development of PG in youth.

PMID:34110245 | DOI:10.1024/1422-4917/a000810