Tag: nevin manimala

BMC Musculoskelet Disord. 2022 Jun 7;23(1):549. doi: 10.1186/s12891-022-05489-1.

ABSTRACT

BACKGROUND: Postural control is associated with fall risk. Patients with rheumatoid arthritis (RA) have a higher risk to fall than healthy subjects. The objective of this study was to identify associations between variables of postural control with prospective falls in patients with RA.

METHODS: For the baseline, the balance performance of 289 men and women with RA, ages 24-85 years, was evaluated by SPPB, FICSIT-4 and Romberg tests. Postural sway for Romberg, semitandem, tandem and one-leg stands were measured with the Leonardo Mechanograph®. Self-reported disability was assessed using the Health Assessment Questionnaire (HAQ) and the Activity-specific Balance Confidence Scale (ABC-scale). Falls were reported in quarterly reports over a year. Univariate and multiple logistic regression analysis were used to explore any associations with falling. Receiver-operating characteristics were determined, and the area under the curve is reported.

RESULTS: A total of 238 subjects completed the 1-year follow-up, 48 (20.2%) experienced at least one fall during the observational period. Age (OR = 1.04, CI 1.01-1.07), HAQ (OR = 1.62, 1.1-2.38), FICSIT-4 scoring 0-4 (OR = 2.38, 1.13-5.0), and one-leg standing (OR = 2.14, 1.06-4.31) showed significant associations with falls. With regard to the SPPB and ABC-scale, no statistically significant associations with falls were found. The quartiles containing the worst results of medio-lateral sway of Romberg (OR = 2.63, CI 1.03-6.69), total sway of semitandem (OR = 3.07, CI 1.10-8.57) and tandem (OR = 2.86, CI 1.06-7.69), and area of sway of semitandem (OR = 2.80, CI 1.11-7.08) stands were associated with falls.

CONCLUSIONS: The assessment of a one-leg stand seems to be a good screening tool to discriminate between high and low risk of falls in RA patients in clinical practice. A low FICSIT-4 score and several sway parameters are important predictors of falls.

TRIAL REGISTRATION: The study has been registered at the German Clinical Trials Register and the WHO International Clinical Trials Registry Platform (ICTRP) since 16 March 2017 ( DRKS00011873 ).

PMID:35672724 | DOI:10.1186/s12891-022-05489-1

Telemed J E Health. 2022 Jun 7. doi: 10.1089/tmj.2022.0118. Online ahead of print.

ABSTRACT

Background: The widespread use of telemedicine systems and medical information networks has made telemedicine one of the current trends in health care. The purpose of this article is to propose a community health intervention with remote monitoring and teleconsultation during COVID-19 for the prevention and control of COVID-19 at the rural level. Methods: In this intervention study, a randomized group of 1,500 community residents was selected. A questionnaire with acceptable validity and reliability was used to collect data. The study was conducted with the test group itself as a control, and the questionnaire was completed again 6 months after the health intervention through remote monitoring. The extent of the effect of the remote monitoring intervention on community health during COVID-19 was measured. The data were entered into SPSS 26, and the data were analyzed using the K-S normality test, t-test, and chi-square test. Results: After 6 months of the intervention, the differences in mean scores of the test group were statistically significant (p < 0.05) in cognition, perceived benefits, self-efficacy, and behavioral outcomes, with a substantial increase in mean scores for all variables. Conclusions: The application of remote monitoring during COVID-19 in rural communities can influence the health perception, benefit perception, self-efficacy, and behavior of community residents, thus effectively preventing and controlling the spread of COVID-19 in rural communities. It reduces medical barriers for rural areas while meeting.

PMID:35671521 | DOI:10.1089/tmj.2022.0118

ACS Appl Bio Mater. 2022 Jun 7. doi: 10.1021/acsabm.2c00119. Online ahead of print.

ABSTRACT

Transparent yttria-stabilized zirconia (YSZ) ceramics are promising for cranial window applications because of their good mechanical and optical properties as well as biocompatibility. YSZ discs with different yttria concentrations were either processed via current-activated pressure-assisted densification (CAPAD) using commercial nanoparticles or densified via spark plasma sintering (SPS) using pyrolysis-synthesized nanoparticles in-house. This study provided critical results to screen composition, processing, microstructure, and cytocompatibility of transparent YSZ discs for cranial window applications. CAPAD-processed YSZ discs with 6 or 8 mol % yttria (6YSZ and 8YSZ) and SPS-densified YSZ discs with 4 mol % yttria (4YSZ_P) showed 200-350 nm polycrystalline grains containing 20-30 nm crystallite domains. SPS-densified YSZ discs with 8 mol % yttria (8YSZ_P) showed larger polycrystalline grains of 819 ± 155 nm with 29 ± 5 nm crystallite domains. CAPAD-processed YSZ discs with 3 mol % yttria (3YSZ) showed 39 ± 9 nm grains. Bone-marrow-derived stem cells (BMSCs) on the polished YSZ discs showed statistically higher spreading areas than those on the unpolished YSZ discs of the same compositions. Generally, polished 8YSZ, 4YSZ_P, and 8YSZ_P discs and unpolished 8YSZ_R, 4YSZ_PR, and 8YSZ_PR discs had lower average cell adhesion densities than other YSZ discs under direct contact conditions. Under indirect contact conditions, all the YSZ disc groups showed similar average cell adhesion densities to the Cell-only control. The groups of polished 4YSZ_P and 8YSZ_P discs, unpolished 4YSZ_PR and 8YSZ_PR discs, and particle control of 8YSZ_Pnp showed higher Y³⁺ ion concentrations than other groups. No mineral deposition was detected on the polished YSZ discs after cell culture. Considering multiple factors such as cytocompatibility, cell adhesion density, Y³⁺ ion release, mineral deposition, and optical transparency collectively, 8YSZ may be the best candidate for the cranial window applications. Further studies are needed to evaluate the long-term transparency and biocompatibility of YSZ discs.

PMID:35671525 | DOI:10.1021/acsabm.2c00119

J Laparoendosc Adv Surg Tech A. 2022 Jun 7. doi: 10.1089/lap.2021.0752. Online ahead of print.

ABSTRACT

Background: Using ultrasound guidance has been demonstrated as a feasible alternative method for gastrostomy tube placement in the pediatric population. The aim of this study is to evaluate short- and long-term postoperative complications after ultrasound-guided gastrostomy tube placement (USGTP) and to compare them with complications after laparoscopic gastrostomy tube placement (LGTP). Methods: A retrospective chart review evaluated patients who underwent USGTP (n = 41) and LGTP (n = 120) at the same institution. Comparisons were made between the two groups in the context of demographics as well as 30-day and 6-month postoperative complications. A phone survey (n = 26) further identified USGTP complications potentially not captured in the electronic medical records. Results: There were no significant differences in age, gender, and indication for procedure between the two groups. Chart review revealed that USGTP and LGTP had statistically comparable rates of emergency department (ED) visits for postoperative complications. Among USGTP patients, 8% had a recorded ED visit within 30 days of the operation and 13% presented to the ED within 6 months, compared with 6% and 11%, respectively, in the LGTP group (P = .65, P = .69). The USGTP phone survey reported total complications over an average postoperative follow-up time of 34.6 months (range 8-87) and revealed a total ED visit rate of 35%, which is comparable with rates reported in the literature for minimally invasive feeding tube placement. Conclusion: USGTP is a safe and feasible alternative option for gastrostomy tube placement in the pediatric population and it has postoperative complication rates that are comparable with LGTP.

PMID:35671516 | DOI:10.1089/lap.2021.0752

Telemed J E Health. 2022 Jun 7. doi: 10.1089/tmj.2022.0138. Online ahead of print.

ABSTRACT

Aim: To investigate factors influencing delayed or forgone care due to the coronavirus pandemic and examine patterns in overall virtual care use and virtual care related to the coronavirus pandemic. Methods: The cross-sectional study used the 2020 National Center for Health Statistics, National Health Interview Survey. Individuals (17,586) who responded to delayed or forgone care questions were included. A generalized linear model estimated prevalence ratios (PRs) for delayed care, forgone care, and virtual care. Results: Approximately 26.5% of participants reported either having delayed (23.6%) or forgone care (15.7%). Females showed 1.29 (95% confidence interval [CI] 1.20-1.38; p ≤ 0.000) and 1.29 (95% CI 1.17-1.48; p ≤ 0.000) times greater risk of delayed and forgone care than males, respectively. Being insured and having chronic conditions were associated with more delayed and forgone care. About 32.5% of adults reported 1 year of virtual care, and of these, 83.6% were related to the coronavirus pandemic. Patterns of virtual care use of 1 year and the one related to the coronavirus pandemic varied. In the coronavirus pandemic-related virtual care, adults of 85 years old or above had a lower likelihood (PR 0.87, 95% CI 0.77-1.00; p = 0.043) of receiving virtual care. Low education attainment and nonmetro areas showed less virtual care usage. Conclusions: The coronavirus pandemic greatly affected health care. While virtual care significantly increased, historically underserved populations, such as older adults, rural residents, and those with low education attainment, experienced disparities in virtual care use. The findings provide important implications for sustained health care in a rapidly changing public health landscape.

PMID:35671515 | DOI:10.1089/tmj.2022.0138

Am J Occup Ther. 2022 Jul 1;76(4):7604345010. doi: 10.5014/ajot.2022.049022.

ABSTRACT

IMPORTANCE: Persistence on task-the voluntary continuation of a goal-directed action despite difficulties-is described as a behavioral component of involvement in an occupation; however, it has not yet been extensively studied in the context of pediatric occupational therapy.

OBJECTIVE: To describe persistent children, compared with their less persistent peers, in terms of age, sex, executive functions (EF), and perceived meaning of occupations and to assess whether intrapersonal factors, EF, and the perceived meaning of occupations can predict persistence.

DESIGN: Cross-sectional.

SETTING: A community in Israel.

PARTICIPANTS: Typically developing healthy children (N = 180) ages 6.0 to 12.5 yr and their parents.

OUTCOMES AND MEASURES: The Tower of Hanoi task (TOH; seven discs) was used to assess persistence on task. EF were assessed with the TOH (three discs) and the Verbal Working Memory test. Occupational meaning-challenge, value, sense of time, and autonomy-was assessed with the Perceived Meaning of Occupation Questionnaire.

RESULTS: Twenty-six children (14%) completed the task. They were older than their peers, performed better on most of the EF tests, and perceived more autonomy in their everyday activities (Mann-Whitney U = 1,185.0, p < .001). However, only the perceived autonomy of occupations was found to be a statistically significant factor that predicted persistence on task (B = -0.12, SE = 0.05, Wald = 7.60, p = .01).

CONCLUSIONS AND RELEVANCE: Perceived autonomy in everyday activities is crucial for persistence on task. Occupational therapy practitioners can promote children’s involvement and persistence in cognitive tasks by supporting a sense of autonomy in everyday activities, although further study is needed. What This Article Adds: This article highlights the contribution of perceived autonomy in everyday activities to children’s involvement and persistence on task by providing empirical data on children’s persistence on task with regard to their EF and perceived meaning of occupations. Children who persisted longer and completed tasks differed from their less persistent peers in terms of age and EF. However, perceived autonomy in everyday activities was the only predictor of task completion.

PMID:35671507 | DOI:10.5014/ajot.2022.049022

Am J Respir Crit Care Med. 2022 Jun 7. doi: 10.1164/rccm.202111-2657OC. Online ahead of print.

ABSTRACT

RATIONALE: The associations between ambient coarse particulate matter (PM2.5-10) and daily mortality is not fully understood at a global scale.

OBJECTIVES: To evaluate the short-term associations between PM2.5-10 and total, cardiovascular, and respiratory mortality across multiple countries/regions worldwide.

METHODS: We collected daily mortality (total, cardiovascular, respiratory) and air pollution data from 205 cities in 20 countries/regions. Concentrations of PM2.5-10 were computed as the difference between inhalable and fine particulate matter. A two-stage time-series analytic approach was applied, with over-dispersed generalized linear models and multilevel meta-analysis. We fitted two-pollutant models to test the independent effect of PM2.5-10 from co-pollutants (fine particulate matter, nitrogen dioxide, sulfur dioxide, ozone, and carbon monoxide). Exposure-response relationship curves were pooled and regional analyses were conducted.

MEASUREMENTS AND MAIN RESULTS: A 10 μg/m3 increase in PM2.5-10 concentration on lag 0-1 day was associated with increments of 0.51% (95% confidence interval [CI]: 0.18%, 0.84%), 0.43% (95%CI: 0.15%, 0.71%) and 0.41% (95%CI: 0.06%, 0.77%) in total, cardiovascular, and respiratory mortality, respectively. The associations varied by country and region. These associations were robust to adjustment by all co-pollutants in two-pollutant models, especially for PM2.5. The exposure-response curves for total, cardiovascular, and respiratory mortality were positive, with steeper slopes at lower exposure ranges and without discernible thresholds.

CONCLUSIONS: This study provides novel global evidence on the robust and independent associations between short-term exposure to ambient PM2.5-10 and total, cardiovascular and respiratory mortality, suggesting the need to establish a unique guideline or regulatory limit for daily concentrations of PM2.5-10.

PMID:35671471 | DOI:10.1164/rccm.202111-2657OC

Plast Reconstr Surg. 2022 Jun 8. doi: 10.1097/PRS.0000000000009321. Online ahead of print.

ABSTRACT

PURPOSE: The Pulvertaft weave continues as a staple technique for tendon coaptations. Many have proposed minor alterations to the original technique to improve its strength, though a lack of consensus exists. Our aim was to explore how the number of weaves and suture characteristics contribute to the overall strength of the coaptation.

METHODS: A comprehensive electronic search was conducted using PubMed, Cochrane Library, and Scopus. Criteria for inclusion consisted of cadaveric human or animal biomechanical studies evaluating ultimate failure load (Newtons, N) as well as number of weaves, suture characteristics, tendon source, and number of coaptations. Weaves with minimum averages of 75 N were deemed successful, and those with >120 N were considered high performing.

RESULTS: A total of 347 tendon transfers from 15 studies met inclusion criteria. Average strength by number of weaves was 36.4 N (n=52) for 1 weave; 54.2 N (n=58) for 2 weaves; 115.9 N (n=174) for 3 weaves; and 81.7 N (n=63) for 4 weaves. Statistical differences were observed between 1 and 2 weaves (p<0.0001); 2 and 3 weaves (p<0.0001); 3 and 4 weaves (p<0.003); and 2 and 4 weaves (p<0.0001). High performing tendon transfers utilized 3 weaves, 3-0 or 4-0 braided sutures, and figure-of-eight or mattress core sutures.

CONCLUSIONS: Contrary to the current dogma of ‘the more the better’, our findings show that Pulvertaft weave strength is optimized when 3 weaves are used to combine donor and recipient tendons. Braided sutures with either figure-of-eight or mattress sutures were associated with highest strength of repair.

PMID:35671455 | DOI:10.1097/PRS.0000000000009321

Plast Reconstr Surg. 2022 Jun 8. doi: 10.1097/PRS.0000000000009352. Online ahead of print.

ABSTRACT

BACKGROUND: Alveolar bone grafting is an important component of cleft lip and palate treatment, with iliac crest as the most common donor site. Although studies have attempted to quantify alveolar bone graft resorption, few have directly compared the outcomes of graft techniques. This study compared the long-term success rates of corticocancellous block to trephine cancellous-only alveolar bone grafting from the iliac crest.

METHODS: A retrospective review of all cleft lip and palate patients undergoing alveolar bone grafting over 14 years was performed. Power analysis was performed to determine sample size. Data including patient demographics, surgical technique, need for repeat grafting, complications, length of hospitalization, and follow-up were collected. Statistical analyses of outcomes were performed based on initial graft technique.

RESULTS: A total of 106 initial operations met criteria, with 73 using trephine technique, 30 utilizing corticocancellous block, and 3 undergoing open cancellous harvest. The overall regraft rate was 40% with an average follow-up of 43.5 months. Patients with corticocancellous block grafting had significantly lower rates of repeat grafting compared to trephine technique (16.7% vs. 47.9%, p<0.001). There was no significant difference in complications rates or length of admission between treatment groups.

CONCLUSIONS: The use of corticocancellous block alveolar bone grafting demonstrated significantly higher success rates when compared to cancellous-only trephine techniques with no difference in complication rates. Although this must be weighed against the minor disadvantages of open iliac harvest, surgeons should consider incorporating en bloc corticocancellous bone to optimize outcomes in alveolar bone grafting.

PMID:35671445 | DOI:10.1097/PRS.0000000000009352

Cancer Nurs. 2022 Mar 2. doi: 10.1097/NCC.0000000000001076. Online ahead of print.

ABSTRACT

BACKGROUND: Unrelieved chemotherapy-induced nausea (CIN) occurs 48% of patients undergoing chemotherapy and is one of the most debilitating symptoms that patients report.

OBJECTIVE: The aims of this study were to identify subgroups of patients with distinct CIN profiles and determine how these subgroups differed on demographic and clinical characteristics; severity, frequency, and distress of CIN; and the co-occurrence of common gastrointestinal symptoms.

METHODS: Patients (n = 1343) completed demographic questionnaire and Memorial Symptom Assessment Scale 6 times over 2 cycles of chemotherapy. Latent class analysis was used to identify subgroups of patients with distinct CIN profiles. Differences among these subgroups were evaluated using parametric and nonparametric statistics.

RESULTS: Four distinct CIN profiles were identified: none (40.8%), increasing-decreasing (21.5%), decreasing (8.9%), and high (28.8%). Compared with the none class, patients in the high class were younger, had a lower annual household income, had child care responsibilities, had a lower Karnofsky Performance Status score and a higher Self-administered Comorbidity Questionnaire score, and were more likely to have received chemotherapy on a 14-day cycle and a highly emetogenic chemotherapy regimen. In addition, patients in the high class reported high occurrence rates for dry mouth, feeling bloated, diarrhea, lack of appetite, abdominal cramps, difficulty swallowing, mouth sores, weight loss, and change in the way food tastes.

CONCLUSIONS: That 60% of the patients reported moderate to high CIN occurrence rates confirms that this unrelieved symptom is a significant clinical problem.

IMPLICATIONS FOR PRACTICE: Nurses need to evaluate patients’ level of adherence to their antiemetic regimen and make appropriate referrals for physical therapy, psychological services, and dietary counseling.

PMID:35671438 | DOI:10.1097/NCC.0000000000001076