Tag: pubmed

J Athl Train. 2021 Apr 22. doi: 10.4085/1062-6050-0548.20. Online ahead of print.

ABSTRACT

CONTEXT: Prior research has not established if overloading or underloading movement profiles are present in symptomatic and asymptomatic athletes with patellar tendon structural abnormality (PTA) compared to healthy athletes.

OBJECTIVE: The purpose was to compare involved limb landing biomechanics between male athletes with and without patellar tendinopathy.

DESIGN: Cross-sectional study Setting: Laboratory Patients or Other Participants: 43 males were grouped based on patellar tendon pain & ultrasound imaging of the proximal patellar tendon: symptomatic with PTA (SYM-PTA; n=13; 20±2yrs; 1.8±0.1m; 84±5kg), asymptomatic with PTA (ASYM-PTA; n=15; 21±2yrs; 1.8±0.1m; 82±13kg), and healthy control (CON; n=15; 20±2yrs; 1.8±0.1m; 79±12kg).

MAIN OUTCOME MEASURES: 3D biomechanics were collected during double-limb jump-landing. Kinematic (knee flexion angle (KF)) and kinetic (vertical ground reaction force (VGRF); internal knee extension moment (KEM); patellar tendon force (FPT)) variables were analyzed as continuous waveforms during the stance phase for the involved limb. Mean values were calculated for each 1% of stance, normalized over 202 data points (0-100%), and plotted with 95% confidence intervals. Statistical significance was defined as a lack of 95% CI overlap for ≥ 6 consecutive data points.

RESULTS: SYM-PTA had lesser KF than CON throughout the stance phase. ASYM-PTA had lesser KF than CON in the early and late stance phase. SYM-PTA group had lesser KEM and FPT than CON in early stance, as well as ASYM-PTA in mid-stance.

CONCLUSIONS: Male athletes with SYM-PTA demonstrated a patellar tendon load-avoidance profile compared to ASYM-PTA and CON athletes. ASYM-PTA did not show evidence of overloading compared to CON. Our findings support the need for individualized treatments for athletes with tendinopathy to maximize load-capacity.

TRIAL REGISTRY: ClinicalTrials.gov (#XXX).

PMID:33887762 | DOI:10.4085/1062-6050-0548.20

Int J Clin Pract. 2021 Apr 22:e14253. doi: 10.1111/ijcp.14253. Online ahead of print.

ABSTRACT

BACKGROUND: Medication adherence in chronic diseases patients is a worldwide concern. Not achieving the goal of treatments because of nonadherence will lead to more complications and eventually may lead to death. In Saudi Arabia we have insufficient data for interpretation. Hence, this study aims to have a better perspective at the number of the nonadherent patients with chronic diseases to their medications and its associated factors.

MATERIAL AND METHOD: Cross-sectional quantitative study was conducted among chronic diseases patients living in Saudi Arabia throughout social media and hospital visits from August 2018 to April 2019. A three sections questionnaire consists of patient’s health, medications, and Adherence characteristics. Adherence to Refills and Medication Scale (ARMS) was used to identify the level of adherence among chronic diseases patients. Univariate descriptive statistics and independent sample t-test with one-way ANOVA were used as bivariate analysis. Finally, significant predictors of medical adherence with adjusted coefficient were determined by multivariable linear regression.

RESULTS: A total of 385 patients were included in the analysis for the current study. Overall, 96.62% (n=372) were non-adherent to their medications according to ARMS scale. Multiple linear regression model found types of co-morbidities, medication dosage form and dosage regimen to be independent predictors of medical adherence.

CONCLUSION: Medication adherence is alarmingly low among chronic disease patients in Saudi Arabia. There is a clear need for in-depth understanding for barriers. It is therefore important to conduct a qualitative study.

PMID:33887799 | DOI:10.1111/ijcp.14253

Ann Nutr Metab. 2021 Apr 22:1-10. doi: 10.1159/000515057. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Parenteral nutrition (PN) has become an efficient, safe, and convenient treatment over years for patients suffering from intestinal failure. Home PN (HPN) enables the patients to have a high quality of life in their own environment. The therapy management however implies many restrictions and potentially severe lethal complications. Prevention and therapy of the latter are therefore of utmost importance. This study aims to assess and characterize the situation of patients with HPN focusing on prevalence of catheter-related complications and mortality.

METHODS: Swiss multicentre prospective observational study collecting demographic, anthropometric, and catheter-related data by means of questionnaires every sixth month from 2017 to 2019 (24 months), focusing on survival and complications. Data were analysed using descriptive statistics. Logistic regression models were fitted to investigate association between infection and potential co-factors.

RESULTS: Seventy adult patients (50% women) on HPN were included (≈5 patients/million adult inhabitants/year). The most common underlying diseases were cancer (23%), bariatric surgery (11%), and Crohn’s disease (10%). The most prevalent indication was short bowel syndrome (30%). During the study period, 47% of the patients were weaned off PN; mortality rate reached 7% for a median treatment duration of 1.31 years. The rate of catheter-related infection was 0.66/1,000 catheter-days (0.28/catheter-year) while the rate of central venous thrombosis was 0.13/1,000 catheter-days (0.05/catheter-year).

CONCLUSION: This prospective study gives a comprehensive overview of the adult Swiss HPN patient population. The collected data are prerequisite for evaluation, comparison, and improvement of recommendations to ensure best treatment quality and safety.

PMID:33887736 | DOI:10.1159/000515057

J Trace Elem Med Biol. 2021 Apr 15;66:126762. doi: 10.1016/j.jtemb.2021.126762. Online ahead of print.

ABSTRACT

BACKGROUND: Aluminium salts are the most common adjuvants in infant vaccines. The aluminium content of a vaccine is provided by the manufacturer and is indicated on the patient information leaflet. There is no independent verification, for example by the European Medicines Agency, of the aluminium content of infant vaccines.

METHODS: We have measured the aluminium content of thirteen infant vaccines using microwave-assisted acid and peroxide digestion followed by transversely heated graphite furnace atomic absorption spectrometry. Our data are compared with manufacturer’s data using full statistical analyses including Bayesian methods.

RESULTS: We found that only three vaccines contained the amount of aluminium indicated by the manufacturer. Six vaccines contained a statistically significant (P < 0.05) greater quantity while four vaccines contained a statistically significant (P < 0.05) lower quantity. The range of content for any single vaccine varied considerably, for example, from 0.172 to 0.602 mg/vaccine for Havrix.

CONCLUSIONS: The data have raised specific questions about the significance of the aluminium content of vaccines and identified areas of extremely limited information. Since aluminium is a known toxin in humans and specifically a neurotoxin, its content in vaccines should be accurate and independently monitored to ensure both efficacy and safety.

PMID:33887692 | DOI:10.1016/j.jtemb.2021.126762

Physiol Meas. 2021 Apr 22. doi: 10.1088/1361-6579/abfae5. Online ahead of print.

ABSTRACT

OBJECTIVE: Disease may cause changes in the individual’s respiratory pattern, which can be measured as parameters for evaluating disease, usually through manually annotated polysomnographic recordings. In this study, a machine learning model based on nasal airflow and respiratory effort of chest and abdomen is proposed to automatically identify respiratory events, including normal breathing event, hypopnea event and apnea event.

APPROACH: The nasal airflow and chest-abdominal respiratory effort signals were collected from Polysomnography (PSG). Time/frequency domain features, fractional fourier transform features and sample entropy were calculated to obtain feature sets. And selected features through statistical analysis were used as input variables of the machine learning model. The performance of different input combinations on different models was studied and cross-validated.

MAIN RESULTS: The dataset included PSG sleep records of 60 patients provided by the Chinese People’s Liberation Army General Hospital. The eXtreme Gradient Boosting (XGBoost)-based model performed best in several models with an accuracy of 0.807 and an f1-score of 0.807, depending on the combination of nasal airflow and two respiratory effort signals. The precision for normal breathing, hypopnea and apnea event were 0.764, 0.789 and 0.871 respectively. In addition, the recall score were 0.833, 0.768 and 0.823 for normal breathing, hypopnea and apnea event, respectively. Moreover, it was found that the standard deviation and kurtosis of nasal airflow were the most important features of respiratory event detection model.

SIGNIFICANCE: Since nasal airflow and respiratory effort of chest and abdomen contain the characteristics of respiratory events, their combined use can improve the classification performance in identifying respiratory events. With this method, respiratory events can be automatically detected and labeled from the PSG records, which can be used to screen for patients with Sleep Apnea Hypopnea Syndrome (SAHS).

PMID:33887711 | DOI:10.1088/1361-6579/abfae5

Lung Cancer. 2021 Apr 19;156:31-40. doi: 10.1016/j.lungcan.2021.04.005. Online ahead of print.

ABSTRACT

INTRODUCTION: Randomized controlled trials have shown that screening with computed tomography reduces lung cancer mortality but is most effective when applied to high-risk individuals. Accurate lung cancer risk prediction models effectively select individuals for screening. Few pilots or programs have implemented risk models for enrolling individuals for screening in real-world, population-based settings. This report describes implementation of the PLCOm2012 risk prediction model in the Ontario Health (Cancer Care Ontario) lung cancer screening Pilot.

METHODS: In the Pilot’s Health Technology Assessment, 576 categorical age/pack-years/quit-years scenarios were evaluated using MISCAN microsimulation modeling and cost-effectiveness analyses. A preferred model was selected which provided the most life-years gained per cost. The PLCOm2012 was compared to the preferred MISCAN scenario at a threshold that yielded the same number eligible (risk ≥2.0 %/6-years).

RESULTS: The PLCOm2012 had significantly higher sensitivity and predictive value (68.1 % vs 59.6 %, p < 0.0001; 4.90 % vs 4.29 %, p = 0.044), and an Expert Panel selected it for use in the Pilot. The Pilot cancer detection rate was significantly higher than in the NLST (p = 0.009) or NELSON (p = 0.003) and there was a significant shift to early stage compared to historical Ontario Cancer Registry statistics (p < 0.0001). Pre- and post-Pilot evaluations found that conducting quality risk assessments were not excessively time consuming or difficult, and participants’ satisfaction was high.

CONCLUSIONS: The PLCOm2012 was efficiently implemented in the Pilot in a real-world setting and is being used to transition into a provincial program. Compared to categorical age/pack-years/quit-years criteria, risk assessment using the PLCOm2012 can lead to effective and efficient screening.

PMID:33887677 | DOI:10.1016/j.lungcan.2021.04.005

J Mech Behav Biomed Mater. 2021 Mar 19;119:104474. doi: 10.1016/j.jmbbm.2021.104474. Online ahead of print.

ABSTRACT

Three-point bending is often used during the mechanical determination of tissue material properties. When taken to failure, the test samples often experience high deformations. The objective of this study was to present beam and plate theories as analytical tools for determining tensile and compressive elastic moduli during the transition from flexure to membrane stress states. Samples of cartilage, a highly flexible connective tissue having differing tensile and compressive moduli, were tested. Three-point bending tests were conducted on auricular (ear) and costal (rib) cartilage harvested from pigs. The influence of span length variation and Poisson’s ratio assumptions were statistically assessed. Tensile elastic moduli of the ear (3.886 MPa) and rib (6.131 MPa) were derived from high-deformation bending tests. The functional assessment described here can be applied as a design input approach for tissue reconstruction and tissue engineering, considering both hard and soft tissue applications.

PMID:33887626 | DOI:10.1016/j.jmbbm.2021.104474

J Environ Manage. 2021 Apr 19;290:112610. doi: 10.1016/j.jenvman.2021.112610. Online ahead of print.

ABSTRACT

River sediments have the capability to accumulate and absorb traces of anthropic environmental degradation. In this work, we investigated the effects of urban land use on the composition of physical sediment. For this purpose, sediment profiles were collected in the wet and dry seasons and in locations with mixed land-use. For the sediment analysis, particle size separation, organic matter degradation, visual analysis of the thickest fraction using a magnifying glass and stereomicroscope analysis of the particle size material corresponding to the sands were performed. It was observed that the sedimentation of synthetic materials and plastics (fragments and fibres) were the most frequently found materials. More intense urban occupation areas and with less riparian vegetation suffer more from this degradation than rural areas or areas with preserved riparian vegetation. The dam in the basin accumulates more materials (macro and microplastics) and has the role of containing and preventing these residues from being transported downstream. The importance of investing in environmental management measures is emphasized, and based on the sampled sites assessed, the restoration of riparian vegetation, greater inspection of inadequate waste disposal and public cleaning actions are suggested, including actions in the Tibiriçá dam.

PMID:33887637 | DOI:10.1016/j.jenvman.2021.112610

J Stroke Cerebrovasc Dis. 2021 Apr 19;30(7):105794. doi: 10.1016/j.jstrokecerebrovasdis.2021.105794. Online ahead of print.

ABSTRACT

INTRODUCTION: Flow diversion of the distal anterior circulation cerebral vasculature may be used for management of wide necked aneurysms not amenable to other endovascular approaches. Follow-up angiography sometimes demonstrates neo-intimal hyperplasia within or adjacent to the stent, however there is limited evidence in the literature examining the incidence in MCA and ACA aneurysms. We present our experience with flow diversion of the distal vasculature and evaluate the incidence of neo-intimal hyperplasia.

MATERIALS AND METHODS: Retrospective review of patients who underwent Pipeline embolization device (PED) treatment for ruptured and unruptured anterior circulation aneurysms.

RESULTS: A total of 251 anterior circulation aneurysms were treated by pipeline flow diversion, of which 175 were ICA aneurysms, 14 were ACA aneurysms and 18 were MCA aneurysms. 6-month follow-up angiography was available in 207 patients. The incidence of neo-intimal hyperplasia was 15.9%, 21.4%, and 61.1% in ICA, ACA, and MCA aneurysms, respectively. MCA-territory aneurysms developed neo-intimal hyperplasia at a significantly higher rate than aneurysms in other vessel territories. Rates of aneurysmal occlusion did not significantly differ from those patients who did not exhibit intimal hyperplasia on follow-up angiography.

CONCLUSION: In our experience, flow diversion of distal wide-necked MCA and ACA aneurysms is a safe and effective treatment strategy. The presence of neo-intimal hyperplasia at 6-month angiography is typically clinically asymptomatic. Given the statistically higher rate of neo-intimal hyperplasia in MCA aneurysms at 6-month angiography, we propose delaying initial follow-up angiography to 12-months and maintaining dual antiplatelet therapy during that time.

PMID:33887663 | DOI:10.1016/j.jstrokecerebrovasdis.2021.105794

Health Place. 2021 Apr 19;69:102571. doi: 10.1016/j.healthplace.2021.102571. Online ahead of print.

ABSTRACT

BACKGROUND: Population ageing and air pollution have become two major public health concerns in China. Longitudinal evidence on the body weight impacts of air pollution among older adults is rare. This study aims to investigate the impacts of ambient particulate matter with aerodynamic diameters ≤2.5 μm (PM_2.5) on weight status of older adults in China and the potential behavioral and metabolic pathways through which PM_2.5 influences weight status.

METHODS: The longitudinal data from the China Health and Retirement Longitudinal Study (body mass index-BMI, n = 9053; waist/height ratio-WHR, n = 9064) were linked to the air pollution data at the city-level with a rural-urban distinction. We used mixed-effects linear models to evaluate the impacts of PM_2.5 on individual weight status and multiple mediation analysis to examine potential pathways.

RESULTS: After adjusting for relevant socioeconomic and city-level risk factors, significant and robust positive impacts of PM_2.5 on BMI (0.025, 95%CI: 0.018, 0.031) and WHR*100 (0.058, 95%CI: 0.044, 0.072) were found among older adults in China. The PM_2.5-weight status relationship among older adults may be mediated through metabolic and inflammatory dysfunction pathways particularly HbA1c and C-reactive protein (CRP). As PM_2.5 deteriorates, the detrimental impacts tend to be more severe for rural-urban migrants and rural residents, compared to their urban counterparts. The worsening rural PM_2.5 profiles in some areas, such as the northern parts of the Central and the Eastern, may leave them particularly vulnerable to air pollution air .

CONCLUSIONS: PM_2.5 has an independent and significant detrimental impact on weight status including BMI and WHR of older adults in China, especially among rural adults and rural-urban migrants. PM_2.5 may affect weight status of older adults through biomarkers such as HbA1c and CRP. More research is needed to confirm our findings.

PMID:33887573 | DOI:10.1016/j.healthplace.2021.102571