Tag: nevin manimala

J Autism Dev Disord. 2023 Sep 10. doi: 10.1007/s10803-023-06101-8. Online ahead of print.

ABSTRACT

Studies on the impact of the COVID-19 pandemic on autistic children’s psychosocial outcomes have shown mixed results. In the current study we aimed to gain a better insight into the effect of the COVID-19 pandemic by comparing psychosocial outcomes collected pre-pandemic with data collected during the pandemic. We used the Strengths and Difficulties Questionnaire (SDQ) to examine change over time in psychosocial outcomes of autistic children from pre-pandemic (T0) to lockdown I (T1) and lockdown II (T2) in the Netherlands. We expected a deterioration in psychosocial outcomes. There were 224 participants in T0 and T1, of which 141 also participated in T2. The results showed a surprising improvement in psychosocial outcomes from T0 to T1. Special education and female gender were associated with increased difficulties over time, while higher age was associated with decreased difficulties. At the subdomain level we found that emotional problems remained stable, while hyperactivity, conduct problems, and peer problems decreased, and prosocial behavior increased. Attending special education predicted increased peer problems over time, while higher age predicted both decreased conduct problems and increased prosocial behavior over time. The COVID-19 pandemic may have temporarily improved the fit between the psychosocial needs and the environment for children with autism in the Netherlands.

PMID:37690082 | DOI:10.1007/s10803-023-06101-8

Environ Monit Assess. 2023 Sep 10;195(10):1178. doi: 10.1007/s10661-023-11764-y.

ABSTRACT

Investigating the impacts of climatic factors and human activities on sedimentary records of heavy metal (HM) contamination in lakes is essential for decision-making in global environmental monitoring and assessment. Spatiotemporal distributions of grain size (GS) and HM (Al, Cr, Mn, Ni, Cu, Zn, As, and Pb) concentrations have been conducted in core sediments that are collected from two adjacent plateau fault-bound lakes in southwest China with contrasting environments, i.e., deep oligotrophic Lake Fuxian (FX) and shallow hypertrophic Lake Xingyun (XY). Results showed that the average value of d₅₀ in FX (4.61 μm) was lower than that in XY (8.35 μm), but the average concentrations of HMs (except Cr and Mn) in XY were higher than those in FX. Heavy metal burial rates (HMBR) were mainly controlled by sediment accumulation rates (SARs) rather than HM concentrations. The correlation coefficients between GS and HM concentrations became strong as the increasing water depths were associated with a stable sedimentary environment. Time-integrated enrichment factors (EF) and source identification of HMs between FX and XY represented that Cr, Ni, and Cu originated from natural sources but Mn, Zn, As, and Pb from anthropogenic sources, respectively. Regardless of FX and XY, the transition times of HMs from natural to anthropogenic sources occurred in the mid-1960s. Comparison of qualification impacts of climatic factors and human-induced factors on increased anthropogenic HMBR by the partial least squares path modeling (PLS-PM) implied that socio-economic activities, such as population density (PD) and gross domestic product (GDP), provided higher contributors to increased anthropogenic HMBR in XY (0.23/0.71) than FX (0.11/0.18). The comparative results of this study provided new insights into environmental monitoring and management of HM contamination for adjacent lakes with contrasting environments.

PMID:37690077 | DOI:10.1007/s10661-023-11764-y

Diabetes Metab Res Rev. 2023 Sep 10:e3722. doi: 10.1002/dmrr.3722. Online ahead of print.

ABSTRACT

Diabetes prevalence is rising worldwide, calling for public health concerns and interventions to improve prevention and management. Self-care is an important component in reducing the incidence of complications from diabetes, but it must be taught. This systematic review aims to synthesise the evidence for education videos for people with diabetes. Electronic databases, including Ovid (Medline, Embase, EmCare), PsychInfo, CINAHL, Web of Science and Scopus, were searched for studies on educational videos for patients with diabetes that met the inclusion criteria. A total of 36 studies met the inclusion criteria. Data extracted were synthesised through narrative synthesis. Studies examined outcomes including biological (i.e., glycated haemoglobin (HbA1C), weight, BMI), non-biological (health literacy, self-efficacy) and subjective feedback (i.e., acceptability, cultural appropriateness). The most common length of video was ≤10 min. Online dissemination was the most common method of video distribution. A statistically significant decrease (ranging from -0.1% to -2.1%) in HbA1C was noted in 7 of 12 studies examining this outcome. Other studies also found evidence of improvement in health literacy, self-efficacy, physical activity, medication adherence and other outcomes. Feedback from participants was generally positive, and emphasis was placed on the need for cultural appropriateness and representation in the educational videos.

PMID:37690072 | DOI:10.1002/dmrr.3722

World J Urol. 2023 Sep 10. doi: 10.1007/s00345-023-04572-z. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare the long-term effectiveness, complications, and outcomes of primary obstructive megaureter (POM) treated by endoscopic balloon dilation under fluoroscopic guidance versus not using radioscopy during the procedure.

PATIENTS AND METHODS: A comparative study between POM cases treated at our institution by endoscopic balloon dilation (EBD) under fluoroscopic guidance (FG) (n = 43) vs no fluoroscopic guidance (NFG) (n = 48) between the years 2004 and 2018 was conducted. The procedure in FG consisted of performing a retrograde pyelography before dilation. Then, a guidewire is introduced to the renal pelvis, and the dilation of the vesicoureteral junction is performed using high-pressure balloon catheters under fluoroscopic vision. Finally, a double-J stent is placed between the renal pelvis and bladder. The procedure in NFG was performed exclusively under cystoscopic vision without radiological exposure. Complications, outcomes, and success rates were analyzed using Spearman’s correlation test. Mean follow-up was 12.5 ± 2.2 years in FG and 6.4 ± 1.3 years in NFG.

RESULTS: MAG-3 showed significant differences in renal drainage before and after endoscopic treatment in both groups (p < 0.001 T-test). Statistical analysis did not reveal differences between groups in initial technical failure (r: – 0.035, p = 0.74), early postoperative complications (r: – 0.029, p = 0.79), secondary VUR (r: 0.033, p = 0.76), re-stenosis (r: 0.022, p = 0.84), long-term ureteral reimplantation (r: 0.065, p = 0.55), and final outcome (r: – 0.054, p = 0.61). The endoscopic approach of POM had a long-term success rate of 86.5% in FG VS 89.6% in NFG.

CONCLUSIONS: Endoscopic balloon dilation of POM can be done with no radiation exposure with similar results, effectiveness, and outcomes.

PMID:37690062 | DOI:10.1007/s00345-023-04572-z

Eur J Appl Physiol. 2023 Sep 10. doi: 10.1007/s00421-023-05293-2. Online ahead of print.

ABSTRACT

BACKGROUND: It is now well established that physical exercise is an effective preventive method to reduce and treat certain chronic diseases, particularly musculoskeletal disorders. At the bone level, running exercise is well known for its positive effects on various parameters of bone quality. There is, however, no consensus regarding the effects of different running exercise modalities on bone quality.

AIM: The objective of this study was to compare the effects of three treadmill running modalities: intermittent, moderate continuous, and a combination of both-on bone quality parameters in rats.

METHODS: Thirty-nine, 5-week-old, male Wistar rats were randomly divided in 4 groups: sedentary control (SED; n = 10), intermittent running exercise (IE; n = 10), continuous running exercise (CE; n = 10) and combined running exercise (COME; n = 9). Rats in running groups were exercised 45 min/day, 5 days/week, for 8 consecutive weeks. Femoral micro-architectural parameters were assessed by micro-CT; femoral osteocyte apoptosis, osteoclast resorption and bone histomorphometry were assessed by histology.

RESULTS: Femoral trabecular thickness in the combined running group was increased (p < 0.0001) compared to respective results in the other running groups (0.13 mm vs 0.11 mm). The cortical thickness, osteocyte lacunae occupancy rate in the whole femur, numbers of apoptotic osteocytes and osteoclastic resorption surfaces were not significantly different between groups. Statistical differences were occasionally noted depending on the femoral anatomical region.

CONCLUSION: These results suggest that the femur should not be considered as the better bone to study the effects of running protocols.

PMID:37690048 | DOI:10.1007/s00421-023-05293-2

Acta Chir Orthop Traumatol Cech. 2023;90(4):251-258.

ABSTRACT

PURPOSE OF THE STUDY Total arthroplasty of the first metatarsophalangeal joint is one of the surgical treatment options for patients with advanced hallux rigidus. This study evaluates the pressure changes in the propulsion phase of the gait cycle using dynamic pedobarography after the total arthroplasty of the first metatarsophalangeal joint by Medin PH-Flex and their comparison with the control groups of patients with hallux rigidus and with asymptomatic patients. MATERIAL AND METHODS Dynamic pedobarograph was used to evaluate 15 first MTP joint replacements by Medin PH-Flex implants in 12 female patients, the average time since joint replacement was 3.5 years (1.5 to 5.5 years). The control group consisted of 13 forefeet in 12 patients with hallux rigidus of Grade 3 and Grade 4 according to the Coughlin classification and 17 healthy patients with no clear foot deformity, i.e. of a total of 34 forefeet. A zone for each metatarsal (M1-M5) and the big toe area (T1) were defined with the use of an integrated software. The difference between the pressure under the big toe area and the first metatarsal bone – hallux stiffness (T1-M1) and the forefoot balance parameter, i.e. the difference between the pressures under the medial and lateral half of the forefoot ((M1+M2)-(M3+M4+M5)), was obtained. The parameters were evaluated for each group during the propulsion phase of the gait, i.e. from 55% to 100% of the stance phase and from 75% to 100% of the stance phase, i.e. that part of propulsion when the greatest pressure is exerted on the big toe. RESULTS For the HS parameter (T1-M1) in 55% to 100% of the stance phase, the median value was -0.66 ± 1.22 (-1.90 to 1.45) in the control group, -0.85 ± 1.94 (-1.40 to 3.80) in patients with hallux rigidus, and -0.10 ± 1.48 (-1.30 to 2.40) in patients after the first MTP joint replacement. The median forefoot balance parameter from 55% of the stance phase was -3.48 ± 2.45 (-6.90 to 0.68) in healthy patients and -4.43 ± 2.72 (-6.98 to 0.23) in hallux rigidus patients. In patients after the joint replacement, the value was -3.00 ± 2.46 (-6.20 to 0.40). The data were statistically analysed by the Dunnett’s and Tukey’s multiple comparison tests. The hallux stiffness parameter showed a significant improvement after the joint replacement compared to patients with hallux rigidus (p<0.0001). No statistical significance was confirmed when comparing the joint replacement cases and the healthy patients from the control group (p=0.0007 and p=0.0010, respectively). As concerns the forefoot balance parameter, a significant difference was reported in patients with joint replacement compared to healthy patients from the control group and patients with hallux rigidus (p <0.0001). DISCUSSION The published pedobarographic studies differ in terms of the methodology used, the patient population and the parameters examined. The pedobarographic studies after the replacement of the first MTP joint or after its arthrodesis present inconclusive outcomes. According to the available literature, the joint replacement has the potential to improve mediolateral forefoot loading and to partially restore the weight-bearing function of the first ray. Our analysis of the HS parameter suggests that the MTP joint replacement can improve the big toe function compared to patients with hallux rigidus but fails to achieve the functional outcomes of healthy patients. When evaluating the forefoot balance (FB) parameter, we can observe less loading on the lateral half of the forefoot in the propulsion phase compared to hallux rigidus. Nonetheless, the joint replacement is unable to restore the physiological loading of the foot. CONCLUSIONS The first MTP joint replacement has the potential to improve forefoot function and to bring it closer to that of a healthy person, even though achieving physiological loading of the forefoot is unrealistic. Additional studies will be needed to confirm that the indication for the first MTP joint replacement is justified in hallux rigidus in terms of the effect on forefoot biomechanics. Key words: hallux rigidus, total replacement of the first MTP joint, dynamic pedobarography, footscan.

PMID:37690038

Acta Chir Orthop Traumatol Cech. 2023;90(4):239-250.

ABSTRACT

PURPOSE OF THE STUDY Dislocation is one of the most common early complications of total hip arthroplasty (THA). In this manuscript, 20 years of experience with the management of this complication are presented, particularly in relation to the type of instability. MATERIAL AND METHODS In the period between January 1999 and December 2020, at least one dislocation occurred in 157 of 8 286 (1.9%) THA patients, of which 117 dislocations (1.6%) in primary and 40 (3.4%) in revision THAs. Almost all patients were operated on from the anterolateral approach during the follow-up period. The type of dislocation was evaluated using the modified Dorr classification. In the first dislocations, conservative approach was usually opted for, except for cases with a clear malposition, irreducible or unstable hips after the reduction. The minimum follow-up period was 18 months (18-240). The success rate of the chosen treatment approach was assessed by means of standard statistical methods. RESULTS The total dislocation rate in the follow-up period was 1.6% for primary THAs and 3.4% for revision THAs. The dislocation rate was slightly higher between 1999 and 2009 compared to the following decade (2.1% versus 1.3% for primary THAs; p=0.009). The most common type of dislocation was the positional dislocation (62%), followed by dislocations due to a combination of causes (17%) and component malposition (11%). Treatment of dislocation was successful in a total of 130 patients (130/157; 83%). Even though a stable hip was achieved in 21 patients (13%), the functional outcome was unsatisfactory, and in 6 patients (4%) we failed to achieve a stable hip. In the positional type of dislocation, the success rate of closed reduction following the first-time dislocation was 86.4% and a similar success rate was reported for reoperations in the first-time dislocations due to the malpositioned components (85.7%). In the second-time dislocation, the surgical therapy was significantly more reliable compared to closed reduction regardless of the type of dislocation (78.6% versus 46%). The treatment of dislocations following primary THAs showed comparable outcomes to those of the treatment of dislocations following revision THAs. Overall, the worst outcomes were achieved in patients with a combined type of dislocation. In total, the THA had to be removed in 11.5% of hips (18/157). The probability of final THA removal increased with the increasing order of dislocation. DISCUSSION In our group of patients, the dislocation rate in THA was comparable or lower than the published data. With the use of preventive measures, i.e. dual mobility cup or larger head diameters in high-risk patients, we managed to reduce the dislocation rate over time. The positional type of dislocation prevails in our group of patients just as in the previously published series, followed by instability from malposition of components. The modified Dorr classification is used to guide the treatment since it allows us not only to make good decision about the treatment modality but to some extent also to estimate the final outcome, particularly with respect to restoring a functional and stable hip. CONCLUSIONS The total dislocation rate was 1.6% for primary THAs and 3.4% for revision THAs. The first-time dislocation of the positional type shall be treated conservatively. Conversely, in the other types of dislocations and in recurrent dislocations, surgical treatment is more likely to achieve a good clinical outcome. The worst outcomes are to be expected in an instability due to combination of multiple causes, which leads to the removal of THA more often than in other types of dislocations. Also, the benefit of preventive measures in high-risk patients over time has been confirmed. Key words: total hip arthroplasty, dislocation, Dorr’s classification, treatment strategy, outcomes, complications.

PMID:37690037

Environ Monit Assess. 2023 Sep 10;195(10):1180. doi: 10.1007/s10661-023-11646-3.

ABSTRACT

The air quality index (AQI) prediction is important to evaluate the effects of air pollutants on human health. The airborne pollutants have been a major threat in Delhi both in the past and coming years. The air quality index is a figure, based on the cumulative effect of major air pollutant concentrations, used by Government agencies, for air quality assessment. Thus, the main aim of the present study is to predict the daily AQI one year in advance through three different neural network models (FF-NN, CF-NN and LR-NN) for the year 2020 and compare them. The models were trained using AQI values of previous year (2019). In addition to main air pollutants like PM₁₀/PM_2.5, O₃, SO₂, NOx, CO and NH₃, the non-criteria pollutants and meteorological data were also included as input parameter in this study. The model performances were assessed using statistical analysis. The key air pollutants contributing to high level of daily AQI were found to be PM_2.5/PM₁₀, CO and NO₂. The root mean square error (RMSE) values of 31.86 and 28.03 were obtained for the FF-NN and CF-NN models respectively whereas the LR-NN model has the minimum RMSE value of 26.79. LR-NN algorithm predicted the AQI values very closely to the actual values in almost all the seasons of the year. The LR-NN performance was also found to be the best in post-monsoon season i.e., October and November (maximum R² = 0.94) with respect to other seasons. The study would aid air pollution control authorities to predict AQI more precisely and adopt suitable pollution control measures. Further research studies are recommended to compare the performance of LR-NN model with statistical, numerical and computational models for accurate air quality assessment.

PMID:37690033 | DOI:10.1007/s10661-023-11646-3

Top Stroke Rehabil. 2023 Sep 10:1-12. doi: 10.1080/10749357.2023.2253629. Online ahead of print.

ABSTRACT

BACKGROUND: Post stroke, motor paresis has usually been considered to be a crucial factor responsible for the disability; other impairments such as somatosensory deficits may also play a role.

OBJECTIVE: To determine the relation between the sensory deficits (paretic and non-paretic upper limbs) and the motor recovery of the paretic upper limb and to predict the potential of motor recovery based on the sensory deficits among stroke subjects.

METHODS: The study was a cross-sectional study conducted in a rehabilitation institute. Ninety-five poststroke hemiparetic subjects having sensory impairment in any of the modalities were considered for this study. Sensory deficits were assessed on both the upper limbs (paretic and non-paretic) primarily using Erasmus MC modification of the revised version of Nottingham Sensory Assessment (Em-NSA) and Nottingham Sensory Assessment (Stereognosis) (NSA-S). The motor recovery was assessed using the Fugl-Meyer assessment (FMA).

RESULTS: The measures of sensory deficits exhibited weak but significant correlation [the paretic (Em-NSA and NSA; r = .38 to .58; p < .001) and the non-paretic (Em-NSA and NSA; r = .24 to .38; p = .03 to .001)] with the motor recovery of the paretic upper limb as measured by FMA. The potential of favorable recovery of the paretic upper limb may be predicted using the cutoff scores of Em-NSA (30, 21, and 24) and NSA-S (5, 8, and 5) of the paretic side.

CONCLUSION: In stroke, sensory deficits relate weakly with the recovery of the paretic upper limb and can predict recovery potential of the paretic upper limb.

PMID:37690032 | DOI:10.1080/10749357.2023.2253629

JPEN J Parenter Enteral Nutr. 2023 Sep 10. doi: 10.1002/jpen.2560. Online ahead of print.

ABSTRACT

BACKGROUND: Patients in the intensive care unit (ICU) are at high risk for refeeding syndrome (RFS), yet there is uncertainty regarding how RFS should be operationalized in the ICU. We evaluated different definitions for RFS and tested how they associated with patient-centered outcomes in the ICU.

METHODS: This was a retrospective comparison study. Patients age ≥ 18 were eligible if they were newly initiated on enteral feeding while hospitalized in the ICU. Eight definitions for RFS were operationalized, including that from the American Society of Parenteral and Enteral Nutrition (ASPEN), all based on electrolyte levels from immediately before until up to 5 days after initiation of enteral nutrition. Patients were followed for death or for ICU-free days, a measure of healthcare utilization.

RESULTS: 2,123 patients were identified including 406 (19.1%) who died within 30 days of ICU admission and 1,717 (80.9%) who did not. Prevalence of RFS varied from 1.5% to 88% (ASPEN definition) depending on the RFS definition used. The excess risk for death associated with RFS varied from 33% to 92% across definitions. Development of RFS based on the ASPEN definition was associated with a greater decrease in ICU-free days compared to other definitions, but the relationship was not statistically significant.

CONCLUSION: Eight definitions for RFS were evaluated, none of which showed strong associations with death or ICU-free days. It may be challenging to achieve a standardized definition for RFS that is based upon electrolyte values and predicts mortality or ICU-free days. This article is protected by copyright. All rights reserved.

PMID:37689982 | DOI:10.1002/jpen.2560