Nevin Manimala

Eur Geriatr Med. 2022 Mar 3. doi: 10.1007/s41999-022-00629-1. Online ahead of print.

ABSTRACT

PURPOSE: We assess feasibility of wearable gait analysis in geriatric wards by testing the effectiveness and acceptance of the system.

METHODS: Gait parameters of 83 patients (83.34 ± 5.88 years, 58/25 female/male) were recorded at admission and/or discharge to/from two geriatric inpatient wards. Gait parameters were tested for statistically significant differences between admission and discharge. Walking distance measured by a wearable gait analysis system was correlated with distance assessed by physiotherapists. Examiners rated usability using the system usability scale. Patients reported acceptability on a five-point Likert-scale.

RESULTS: The total distance measures highly correlate (r = 0.89). System Usability Scale is above the median threshold of 68, indicating good usability. Majority of patients does not have objections regarding the use of the system. Among other gait parameters, mean heel strike angle changes significantly between admission and discharge.

CONCLUSION: Wearable gait analysis system is objectively and subjectively usable in a clinical setting and accepted by patients. It offers a reasonably valid assessment of gait parameters and is a feasible way for instrumented gait analysis.

PMID:35243600 | DOI:10.1007/s41999-022-00629-1

Environ Sci Pollut Res Int. 2022 Mar 4. doi: 10.1007/s11356-022-19284-x. Online ahead of print.

ABSTRACT

This study empirically estimates the impact of clean and non-clean energy consumption on economic growth and carbon dioxide emissions within the framework of the environmental Kuznets curve and pollution haven hypothesis in the case of PIMC countries from 1980 to 2019. The results of the panel cointegration test proposed by Westerlund (2007) show a long-term equilibrium relationship among the variables of each designated model. The long-term elasticities of economic growth and carbon emission estimated by AMG, CCEMG, and MG estimators indicate that both clean and non-clean energy consumption has a significant impact on economic growth, while carbon emission hinders growth. The results also reveal that economic growth, non-clean energy consumption, and interaction between trade openness and non-clean energy consumption have a driving effect on carbon dioxide emission; however, clean energy consumption is found to reduce carbon emission. In addition, the analysis confirms the existence of the inverted U-shaped environmental Kuznets curve and pollution haven hypothesis in the panel of PIMC economies. Finally, there is a one-way causality from non-clean energy consumption to economic growth, but no such causation exists between clean energy consumption and economic growth. The objective of sustained economic growth with a safe environment may be achieved by encouraging clean energy consumption in the PIMC economies.

PMID:35243579 | DOI:10.1007/s11356-022-19284-x

J Assist Reprod Genet. 2022 Mar 3. doi: 10.1007/s10815-022-02449-5. Online ahead of print.

ABSTRACT

PURPOSE: Anti-Müllerian hormone (AMH) and antral follicle count (AFC) are correlated with the ovarian response, but their reliability and reproducibility are questionable. This large multicenter study describes their distribution, inter-cycle and inter-center variability, and their correlation.

METHODS: A total of 25,854 IVF cycles among 15,219 patients were selected in 12 ART centers. Statistical distribution of AMH and AFC was studied by using the Kolmogorov-Smirnov test and Shapiro goodness of fit test. The reproducibility of AFC and AMH was measured using a mixed model regressing the logarithmic transformation of AFC with age.

RESULTS: The distribution of AMH and AFC was characterized by a wide dispersion of values, twice more important for AFC, and a logarithmic distribution. The faster decline in AMH than in AFC with age suggests that their correlation changes with age. AMH and AFC showed a very low proportion of concordance in the range of expected poor responders according to Bologna cutoffs. The heterogeneity for AMH and AFC across centers was small, but much larger across patients within each center. Concerning the patients with several successive cycles, the reproducibility for AMH seemed much better than for AFC. Comparing respective performances of AMH and AFC for the prediction of ovarian response depended on the local conditions for measuring these indicators and on the reproducibility of results improved over time.

CONCLUSION: Distribution of AMH and AFC was characterized by the wide dispersion of values, and a logarithmic distribution. Establishing cutoffs or a direct relationship AMH/AFC without considering age seems hazardous. Correlation between AMH and AFC was very poor in the range of poor responders.

PMID:35243569 | DOI:10.1007/s10815-022-02449-5

Oral Radiol. 2022 Mar 3. doi: 10.1007/s11282-022-00601-6. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to assess peri-implantitis-induced lymphadenopathy on diffusion-weighted imaging (DWI).

METHODS: This retrospective study was conducted from October 2017 to March 2020 in patients with and without peri-implantitis who underwent magnetic resonance imaging (MRI). Patients in the peri-implantitis group had radiographically confirmed loss of alveolar bone > 2.0 mm and clinical findings such as bleeding on probing, suppuration of tissues surrounding the teeth, probing-pocket depth of > 4 mm, pain on implant function, and clinical implant mobility, whereas those without peri-implantitis had none of the abovementioned clinical findings. The Mann-Whitney U test was used to compare groups, using lymph node (LN) short-axis diameters and apparent diffusion coefficients (ADCs) as the criterion variables and presence or absence of peri-implantitis as the explanatory variable. Receiver operating characteristic (ROC) analysis was done to investigate the effectiveness of LN size and ADC use in detecting peri-implantitis-induced lymphadenopathy. Statistical significance was established at P < 0.05.

RESULTS: There were 66 lymph nodes from 12 patients analyzed. The mean LN size and ADC were significantly higher in patients with peri-implantitis than in those without (P < 0.01). ROC curve analysis showed cut-off LN sizes of 4.78 and 4.84 mm and cut-off ADCs of 1.12 and 1.09 for lymphadenopathy affected by peri-implantitis corresponding to levels IB and II, respectively.

CONCLUSIONS: Cervical lymphadenopathy may be an inflammatory finding associated with peri-implantitis.

PMID:35243567 | DOI:10.1007/s11282-022-00601-6

Cult Med Psychiatry. 2022 Mar 3. doi: 10.1007/s11013-022-09777-2. Online ahead of print.

ABSTRACT

Susto is one of the most common disorders referenced in the medical anthropological and cultural psychiatric literature. This article questions if “susto” as understood in cultural psychiatric terms, especially in the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM), is in fact a single “cultural concept of distress.” There is extensive cross-cultural and intracultural variability regarding fright-related disorders in the ethnographic literature. What is often labeled “susto” may be in reality a variety of distinct disorders, or lacking in the two signature components found in the cultural psychiatric literature: the existence of a “fright,” and subsequent soul loss. There has been significant polysemic and geographical drift in the idiom label, the result of colonialism in Mesoamerica, which has overlayed but not necessarily supplanted local knowledge. Using data from fifteen years of research with Q’eqchi’ (Maya) healers and their patients, we demonstrate how important variability in signs, symptoms, diagnosis, treatment, and prognosis of fright-related disorders renders any simple declaration that this is a singular “susto” problematic. We argue for a careful consideration of the knowledge of Indigenous medical specialists charged with treating fright-related disorders and against the inclination to view variability as insignificant. Such consideration suggests that Indigenous forms of fright-related disorder are not susto as presented commonly in the DSM and cultural psychiatric literature.

PMID:35243566 | DOI:10.1007/s11013-022-09777-2

Clin Oral Investig. 2022 Mar 3. doi: 10.1007/s00784-021-04333-5. Online ahead of print.

ABSTRACT

OBJECTIVES: Calcification is a common finding in endodontic cases after regenerative endodontic therapy (RET). We aimed to identify the prevalence of intracanal calcification after RET and to compare intracanal calcification outcomes in RET using either calcium hydroxide [Ca(OH)₂] or antibiotics.

MATERIALS AND METHODS: We searched PubMed, Web of Science, ProQuest Dissertations & Theses, and Scopus databases for clinical, cross-sectional, case-control, and cohort RET studies published until May 2020 in the English language and reporting a calcified case after RET. The Cochrane risk-of-bias tool for randomized trials and Risk of Bias In Non-randomized Studies of Interventions were used for bias assessment. Meta-analyses were performed, overall and separately, for intracanal medicaments using a random-effects model with weighted inverse variance methods. Subgroup analysis was performed according to the calcification type.

RESULTS: Eight studies were included. The overall prevalence of intracanal calcification after RET was 30.7% (95% confidence interval [CI]: 0.15-0.45,[Formula: see text]=92.6%), 46.5% with Ca(OH)₂ vs. 25.8% with antibiotic-based intracanal medicaments. Subgroup analyses for complete calcification outcome showed a higher prevalence of complete calcification in the Ca(OH)₂ group (46.5%, 95% CI: 0.17-0.68,[Formula: see text]%) than in the antibiotic group (10%, 95% CI: – 0.04-0.43,[Formula: see text]%).

CONCLUSIONS: Based on the studies included, available evidence shows a statistically significant association between complete calcification and Ca(OH)₂ paste as an intracanal medicament. Other contributing factors, such as blood clot formation and follow-up time, might also play an essential role in forming intracanal calcification.

CLINICAL RELEVANCE: This study highlights the significant association between complete calcification and Ca(OH)₂ paste.

PMID:35243550 | DOI:10.1007/s00784-021-04333-5

Int J Legal Med. 2022 Mar 4. doi: 10.1007/s00414-022-02774-5. Online ahead of print.

ABSTRACT

Massively parallel sequencing (MPS) of mitochondrial (mt) DNA allows forensic laboratories to report heteroplasmy on a routine basis. Statistical approaches will be needed to determine the relative frequency of observing an mtDNA haplotype when including the presence of a heteroplasmic site. Here, we examined 1301 control region (CR) sequences, collected from individuals in four major population groups (European, African, Asian, and Latino), and covering 24 geographically distributed haplogroups, to assess the rates of point heteroplasmy (PHP) on an individual and nucleotide position (np) basis. With a minor allele frequency (MAF) threshold of 2%, the data was similar across population groups, with an overall PHP rate of 37.7%, and the majority of heteroplasmic individuals (77.3%) having only one site of heteroplasmy. The majority (75.2%) of identified PHPs had an MAF of 2-10%, and were observed at 12.6% of the nps across the CR. Both the broad and phylogenetic testing suggested that in many cases the low number of observations of heteroplasmy at any one np results in a lack of statistical association. The posterior frequency estimates, which skew conservative to a degree depending on the sample size in a given haplogroup, had a mean of 0.152 (SD 0.134) and ranged from 0.031 to 0.83. As expected, posterior frequency estimates decreased in accordance with 1/n as the sample size (n) increased. This provides a proposed conservative statistical framework for assessing haplotype/heteroplasmy matches when applying an MPS technique in forensic cases and will allow for continual refinement as more data is generated, both within the CR and across the mitochondrial genome.

PMID:35243529 | DOI:10.1007/s00414-022-02774-5

Zhonghua Er Ke Za Zhi. 2022 Mar 2;60(3):237-241. doi: 10.3760/cma.j.cn112140-20210923-00814.

ABSTRACT

Objective: To evaluate the efficacy and safety of intra-articular injection of adalimumab (ADA) in the treatment of refractory oligoarticular juvenile idiopathic arthritis (JIA). Methods: This was a retrospective study. Clinical data on age, gender, and symptoms of joint swelling and pain were collected from 11 children with refractory oligoarticular JIA involving only knee joints admitted to Department of Rheumatism and Immunology of Children’s Hospital, Capital Institute of Pediatrics from November 2019 to October 2020. The physician and parent-child evaluation of disease activity, the number of active joints, and the level of erythrocyte sedimentation rate (ESR) at different treatment time points were analyzed at every 4-week observation point after drug administration, and the non-parametric Kruskal-Wallis test was used to compare the differences in clinical evaluation indicators and changes in laboratory tests at different treatment times. The follow-up period was 6 months. Results: Among the 11 children, 5 were boys and 6 were girls. The age was 3.0 (2.8) years. All 11 children had symptoms of joint swelling and pain as well as limitation of movement. After 3 intra-articular injections of ADA, the joint symptoms of 11 children were better than before treatment; the joint symptoms of 7 children disappeared completely, and no recurrence occurred during the 6-month follow-up period. At different treatment times, physician and parent-child evaluation of disease activity, a gradual decrease in the number of active joints in the children, ESR, and juvenile arthritis disease activity score with 27 joints were all statistically significant (χ²=53.99, 59.37, 32.87, 40.07, 54.00, all P<0.001).No significant adverse drug reactions were observed in any of the 11 children during treatment and follow-up. Conclusion: Intra-articular injection of ADA in the treatment of refractory oligoarticular JIA has a significant effect in controlling joint symptoms and is relatively safe.

PMID:35240745 | DOI:10.3760/cma.j.cn112140-20210923-00814

Zhonghua Er Ke Za Zhi. 2022 Mar 2;60(3):209-214. doi: 10.3760/cma.j.cn112140-20211027-00908.

ABSTRACT

Objective: To summarize the clinical features of Streptococcus pneumoniae-associated hemophagocytic syndrome (SP-HLH), and the serotypes and drug-resistant characteristics of the isolated strains. Methods: There were 15 children with SP-HLH admitted to the Pediatric Intensive Care Unit (PICU) of Beijing Children’s Hospital, Capital Medical University from January 2013 to December 2020 were included in this study. Clinical data including children’s general characteristics, clinical features, laboratory examinations, treatments, prognosis and the outcomes of follow-up by May 2021 were analyzed retrospectively. The serotypes and drug resistance of the isolated strains were identified. All children were divided into the clinical improvement group and the death group. Mann-Whitney U test, Fisher’s exact test were used to compare the data of the two groups. Results: Among the 15 children with SP-HLH, 8 were males and 7 were females. The age of these children was 1.0 (1.0, 2.5) years. Regarding the primary infection, there were 9 cases of severe pneumonia, 3 cases of meningitis and 3 cases of blood stream infection. None of these children had received pneumoniae conjugate vaccine (PCV) and all of them were admitted to the PICU. Respiratory failure was observed in 10 patients, acute renal injury in 5, and hemolytic uremic syndrome in 3 patients. All children received glucocorticoids and high-dose intravenous immunogloblin (IVIG) in addition to anti-infective treatment. Eight of the children were cured while the other 7 died. The neutrophil count in the death group was lower than that in the clinical improvement group ((5.0 (1.7, 9.3) × 10⁹vs. 5.2 (3.4, 10.5) ×10⁹/L, Z =-2.43, P<0.015), and the length of hospital stay and days of PICU stay in the death group were both shorter than those in the improvement group statistically (3 (1, 11) vs. 39 (34, 48) d, 2 (1, 4) vs. 19 (12, 31) d, Z=-3.25, -3.24, both P=0.001). Ten serotypes of Streptococcus pneumoniae were identified, including 4 strains of 19F, 3 of 19A, 1 of 23F, 1 of 15A and 1 of 14, among which 9 strains (9/10) were covered by PCV13. All strains were resistant to erythromycin yet sensitive to vancomycin and linezolid. Conclusions: SP-HLH is more common in children under the age of 3, with a high mortality rate. The death cases have lower neutrophil count and rapid disease progression. The comprehensive treatment is anti-infective combined with glucocorticoids and high-dose IVIG. The predominant serotypes are 19F and 19A and all isolated strains were susceptible to vancomycin and linezolid.

PMID:35240740 | DOI:10.3760/cma.j.cn112140-20211027-00908

J Knee Surg. 2022 Mar 3. doi: 10.1055/s-0042-1743230. Online ahead of print.

ABSTRACT

Total knee arthroplasty (TKA) in cases of complex deformity (e.g., ligamentous laxity, posttraumatic arthritis) may require prostheses with inherent varus-valgus stability greater than that of traditional posterior stabilized or cruciate-retaining implants. Here, we investigate the clinical and radiographic outcomes of TKA using a midlevel constraint (MLC) prosthesis. A retrospective review of 53 patients (62 knees) who underwent primary TKA with an MLC implant was performed. Short tibial stem extensions were utilized in 49 knees, and 13 knees received no stem extension. Mean follow-up time was 31.6 months (standard deviation [SD] = 10.0, range = 24-53). Preoperative and postoperative range of motion (ROM) were assessed. Plain radiographs were reviewed for alignment, radiolucent lines, component loosening, and osteolysis. Patients who developed postoperative arthrofibrosis underwent manipulation under anesthesia (MUA). Failure was defined as instability, component loosening, or need for revision surgery. Mean ROM significantly improved from 114.1 degrees (SD = 19.7 degrees) preoperatively to 123.5 degrees (SD = 12.2 degrees) at final follow-up (t = -3.43, p = 0.001). Thirty-seven knees initially presented with varus deformity (mean = 7.5 degrees, SD = 4.8 degrees), whereas 23 had valgus deformity (mean = 10.6 degrees, SD = 6.5 degrees), and 2 knees had neutral alignment. Following surgery, mean alignment was 4.3 degrees valgus (SD = 1.7 degrees, range = 0-8 degrees), representing a statistically significant improvement (t = 5.29, p < 0.001). Six patients (9.7%) developed arthrofibrosis requiring MUA, which was irrespective of baseline ROM (p = 0.92) and consistent with 12% incidence reported in the literature. There were no significant differences in postoperative ROM (t = 0.38, p = 0.71), alignment (t = -0.22, p = 0.83), or incidence of arthrofibrosis (χ² = 0.07, p = 0.79) between short-stemmed and nonstemmed implants. There was no radiographic evidence of radiolucent lines, component loosening, or osteolysis in any patients. No patients required revision surgery. Use of an MLC prosthesis with primary femoral component in TKA resulted in satisfactory clinical and radiographic results with no evidence of component loosening, osteolysis, instability, or need for revision at minimum 2-year follow-up.

PMID:35240717 | DOI:10.1055/s-0042-1743230