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Matsunuma S, Koshiishi T, Sunaga S, Otsuka K, Okumura E, Yoshimoto K, Jimbo H. Evaluation of high-dose methotrexate completion for primary central nervous system lymphoma using modified Geriatric 8 for functional assessment: A retrospective descriptive study. J Geriatr Oncol 2024; 15:101704. [PMID: 38245426 DOI: 10.1016/j.jgo.2024.101704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 11/21/2023] [Accepted: 01/09/2024] [Indexed: 01/22/2024]
Affiliation(s)
- Satoru Matsunuma
- Department of Pharmacy, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo 193-0988, Japan.
| | - Toru Koshiishi
- Department of Pharmacy, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo 193-0988, Japan.
| | - Shigeki Sunaga
- Department of Neurosurgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo 193-0988, Japan.
| | - Kunitoshi Otsuka
- Department of Neurosurgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo 193-0988, Japan.
| | - Eitaro Okumura
- Department of Neurosurgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo 193-0988, Japan.
| | - Koichi Yoshimoto
- Department of Pharmacy, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo 193-0988, Japan.
| | - Hiroyuki Jimbo
- Department of Neurosurgery, Tokyo Medical University Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo 193-0988, Japan.
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Zhang M, Gao Y, Xue J, Li K, Zhang L, Yu J, Yan T, Hou X. Development of the assessment standards of the International Classification of Functioning, Disability, and Health (ICF) Geriatric Core Set through a modified Delphi method. BMC Geriatr 2024; 24:239. [PMID: 38454354 PMCID: PMC10921752 DOI: 10.1186/s12877-024-04816-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 02/15/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND There is currently a lack of functional assessment tools based on the International Classification of Functioning, Disability, and Health (ICF) theoretical framework that are specific for older adults. OBJECTIVE The aim of the present study was to develop Chinese assessment standards of the ICF Geriatric Core Set for functional evaluation of older adults. METHODS A two-stage study process was conducted to develop the assessment standards of the ICF Geriatric Core Set: establishment of candidate assessment standards, and a modified Delphi consensus process including a pilot survey and two-round formal expert survey. Thirty participants in the field of ICF and geriatric rehabilitation were recruited. The suitability of the assessment standards in the questionnaires was rated using a Likert 5-level scoring method. The arithmetic mean, the full mark ratio and the coefficient of variation (CV) were used as screening indicators for the assessment standards, and modification was made for several standards, in line with the Delphi results and the expert panel discussion. RESULTS Thirty-three candidate assessment standards belonging to 17 categories were generated. A total of 26 and 24 experts in the field of ICF and geriatric rehabilitation participated in the two-round survey, respectively. Five standards belonging to four categories entered into the second-round survey directly, five standards belonged to five categories entered with minor modification, and nine standards belonging to seven categories were redesigned based on the literature and discussion of the expert panel. In the second-round survey,15 assessment standards belonging to 15 categories met the screening requirements and four assessment standards belonged to the two remaining categories that needed a criterion and which the expert panel discussed for the final decision. CONCLUSIONS Using the modified Delphi method, the assessment standards of the ICF Geriatric Core Set have been developed.Future work should focus on the reliability and validity of the the assessment standards and their application to the health management of older adults.
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Affiliation(s)
- Malan Zhang
- Department of Exercise Rehabilitation, College of Exercise and Health, Guangzhou Sport University, Guangzhou, China
| | - Yan Gao
- Department of Rehabilitation Medicine, Shenzhen Second People's Hospital, First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Jingjing Xue
- Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Kun Li
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Lifang Zhang
- School of Nursing, Youjiang medical university for nationalities, Baise, China
| | - Jiani Yu
- Department of Rehabilitation, GuangDong Province Hospital of Chinese Medicine, Guangzhou, China
| | - Tiebin Yan
- Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
| | - Xiaohui Hou
- Department of Exercise Rehabilitation, College of Exercise and Health, Guangzhou Sport University, Guangzhou, China.
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Bueno Yáñez O, Calvo Aguirre JJ, Uranga Zaldua J, Alustiza Navarro J, Ugartemendia Yerobi M. [Alusti test as a premonitory variable of adverse health events in a nursing home. Two-years follow-up]. Rev Esp Geriatr Gerontol 2024; 59:101476. [PMID: 38417197 DOI: 10.1016/j.regg.2024.101476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 01/25/2024] [Accepted: 01/29/2024] [Indexed: 03/01/2024]
Abstract
INTRODUCTION Functional capacity is a good indicator of health, quality of life, and a good predictor of morbimortality. It is a priority to functionally assess the geriatric population through objective, precise, and simple instruments. The Alusti Test in its two versions, complete (TA) and abbreviated (TAA), is a scale that meets these criteria. OBJECTIVE To determine the usefulness of the Alusti Test as a predictor of adverse health events: falls, hospitalizations, cognitive deterioration, and mortality in the elderly institutionalized population, with a two-year follow-up. MATERIAL AND METHODS This observational study's sample included 176 persons admitted to a nursing home for 32months, with a mean age of 85.5years. The TA was performed on 138 and the TAA on 38. RESULTS The ratio of falls is much higher in residents with mild dependence than in those with total dependence (P<.001). Hospitalizations increase as the results of the Alusti Test are more favorable. The risk of hospitalization in dependent patients is 50% lower (P<.001) than in those with preserved mobility. Cognitive impairment is similar in all the populations with some mild-moderate level of functional dependence and decreases in the population with preserved mobility. Categorization as total and mild/severe dependence is related to a 3-4times higher mortality at six months follow-up. CONCLUSIONS A higher mild-moderate level of dependence on the AT correlates with a lower risk of falls, a lower rate of hospitalization, and a higher risk of mortality at six months.
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Affiliation(s)
- Olga Bueno Yáñez
- Osakidetza, Centro de Salud Beraun, Errenteria, Guipúzcoa, España
| | | | | | | | - Maider Ugartemendia Yerobi
- Departamento de Enfermería, Facultad de Medicina y Enfermería, Universidad del País Vasco UPV/EHU, San Sebastián, España.
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Backhaus PJ, Wardrop DH, McCarty GW, Brooks RP. Developmental framework for a desktop hydrogeomorphic wetland functional assessment derived from field-based data. Environ Monit Assess 2024; 196:217. [PMID: 38286914 PMCID: PMC10824798 DOI: 10.1007/s10661-024-12373-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 01/15/2024] [Indexed: 01/31/2024]
Abstract
With loss of wetlands and their associated ecosystem services within landscapes, it is imperative to be able to understand the change in ecological functions underlying these services. Field-based functional assessments can produce a range of specific scores among a robust set of functions but are time and cost prohibitive as the number of wetlands assessed increases. Remote-based functional assessments are an alternative for broad scale assessments, but trade-off cost for limitations in scoring and functional assemblage. To address these concerns, we created a framework for the development of the Hydrogeomorphic Remote Assessment of Wetland Function (HGM-RAWF). Rooted in the hydrogeomorphic approach of an existing field-based functional assessment and its underlying models, this remote functional assessment substitutes field-based assessment methods with remotely assessed proxies. As potential remote proxies were determined through literature review and statistically screened for use in the remote assessment, a field-based reference wetland database of 222 freshwater wetlands in the Mid-Atlantic Region provided a baseline by which remote data could be compared and calibrated. The resulting HGM-RAWF protocol remotely assesses seven hydrology and biogeochemistry functions in the Mid-Atlantic with assessment scores similar to its field-based counterparts. With noted limitations, the HGM-RAWF framework provides the means to create desktop functional assessments across broad geographic scales with the diversity and specificity of field-based assessments at the reduced costs associated with remote assessments. Its basis in the HGM approach and use of public spatial datasets allows the framework to be adopted regionally and can be used as a model for national wetland functional assessment.
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Affiliation(s)
- Peter J Backhaus
- Riparia, Department of Geography, Pennsylvania State University, 302 Walker Building, University Park, State College, PA, 16802, USA.
| | - Denice H Wardrop
- Riparia, Department of Geography, Pennsylvania State University, 302 Walker Building, University Park, State College, PA, 16802, USA
- Chesapeake Research Consortium, Riparia, Department of Geography, Pennsylvania State University, 302 Walker Building University Park, State College, PA, 16802, USA
| | - Gregory W McCarty
- Hydrology and Remote Sensing Laboratory, USDA Agricultural Research Service (ARS), 10300 Baltimore Avenue, Beltsville, MD, 20705, USA
| | - Robert P Brooks
- Riparia, Department of Geography, Pennsylvania State University, 302 Walker Building, University Park, State College, PA, 16802, USA
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de Moura TG, da Rocha IF, Guedes LS, Alves AT, Garcia PA. Is prehospital physical performance a predictor of functional capacity decline at discharge in hospitalized Brazilian older adults? Braz J Phys Ther 2024; 28:100576. [PMID: 38217948 PMCID: PMC10825594 DOI: 10.1016/j.bjpt.2023.100576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 11/17/2023] [Accepted: 11/28/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Hospitalization contributes to functional decline in older adults. OBJECTIVE To assess the relationship between physical performance on admission and functional capacity and functional capacity decline at discharge, and to investigate tools capable of predicting this decline. METHODS Prospective longitudinal study with 75 older adults admitted to a public hospital between July 2021 and February 2022. The independent variable was physical performance evaluated on admission by handgrip strength (HGS) and the Short Physical Performance Battery (SPPB). The dependent variables were functional capacity for basic activities of daily living (BADLs) and instrumental activities of daily living (IADLs) and their decline between admission and discharge. Statistical analyses were performed using linear and logistic regression and ROC curves. RESULTS The median time between admission and participant assessment was 1 day (IQR=1-2 days). Median hospitalization time was 18 days (IQR= 7.5-30 days). Functional capacity for BADLs and IADLs declined in 39% and 79% of the participants, respectively. Performance in HGS and the SPPB at baseline, in adjusted models, explained 29.3 to 35.3% of functional capacity at discharge. One additional point in the SPPB decreased the risk of functional capacity decline for BADLs by 20.9% (OR=0.79, 95% CI: 0.68, 0.91). The AUC values for the SPPB (AUC=0.67) and HGS (AUC=0.65) were significant in identifying functional decline for BADLs, but not IADLs. CONCLUSION In Brazilian older adults, physical performance on admission was related to functional capacity and its decline at discharge. Physical performance on admission is predictive of functional decline at discharge.
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Affiliation(s)
- Tayla Gomes de Moura
- Postgraduate Program in Rehabilitation Sciences, Faculty of Ceilândia, Universidade de Brasilia, Centro Metropolitano, Brasília, DF, Brazil.
| | | | | | - Aline Teixeira Alves
- Postgraduate Program in Rehabilitation Sciences, Faculty of Ceilândia, Universidade de Brasilia, Centro Metropolitano, Brasília, DF, Brazil
| | - Patrícia Azevedo Garcia
- Postgraduate Program in Rehabilitation Sciences, Faculty of Ceilândia, Universidade de Brasilia, Centro Metropolitano, Brasília, DF, Brazil
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Ntouniadakis E, Sundh J, Söderqvist J, von Beckerath M. How can we identify subglottic stenosis in patients with suspected obstructive disease? Eur Arch Otorhinolaryngol 2023; 280:4995-5001. [PMID: 37540269 PMCID: PMC10562276 DOI: 10.1007/s00405-023-08141-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 07/17/2023] [Indexed: 08/05/2023]
Abstract
PURPOSE Subglottic stenosis, a rare condition of the upper airway, is frequently misdiagnosed as obstructive lung disease. The aim of this study was to investigate whether subglottic stenosis could be identified and distinguished from asthma and chronic obstructive pulmonary disease (COPD) using spirometry or the dyspnea index (DI). METHODS The study population included 43 patients with asthma, 31 patients with COPD and 50 patients with subglottic stenosis planned to undergo endoscopic intervention. All patients completed the DI and underwent dynamic spirometry registering both inspiratory and expiratory volumes and flows, including the expiratory disproportion index (EDI), the ratio of forced expiratory volume in 1 s to peak expiratory flow. One-way analysis of variance assessed the discrepancy of the variables among the study groups, and receiver operating curve (ROC) analysis determined the measurement with the best discriminatory power providing a cutoff value, maximizing both sensitivity and specificity. RESULTS The only statistically significant variables differing between all three groups were the EDI and the DI. The EDI showed an excellent area under the ROC curve (0.99, p < 0.001) with a cutoff value of 0.39 (98% sensitivity, 96% specificity), followed by DI (0.87, p < 0.001) with a cutoff score of > 25 (83% sensitivity and 78% specificity). CONCLUSION In patients with dyspnea of unknown cause, an increase in EDI should arouse a suspicion of extrathoracic airway obstruction, advocating for further evaluation with laryngotracheoscopy.
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Affiliation(s)
- Eleftherios Ntouniadakis
- Department of Ear Nose and Throat, Faculty of Medicine and Health, Örebro University Hospital, Södra Grev Rosengatan, 701 85, Örebro, Sweden.
| | - Josefin Sundh
- Department of Respiratory Medicine, Faculty of Medicine and Health, Örebro University, 70182, Örebro, Sweden
| | - Jeanette Söderqvist
- Department of Clinical Physiology, Faculty of Medicine and Health, Örebro University, 70182, Örebro, Sweden
| | - Mathias von Beckerath
- Department of Ear Nose and Throat, Faculty of Medicine and Health, Örebro University Hospital, Södra Grev Rosengatan, 701 85, Örebro, Sweden
- Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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Peng L, Shi Y, Ding M, Wei W. A novel method for functional assessment of the circle of Willis before aortic arch surgery. Asian J Surg 2023; 46:3877-3878. [PMID: 37068993 DOI: 10.1016/j.asjsur.2023.03.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 03/28/2023] [Indexed: 04/19/2023] Open
Affiliation(s)
- Ling Peng
- Department of Anesthesiology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, China
| | - Yinhui Shi
- Department of Anesthesiology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, China
| | - Meng Ding
- Department of Anesthesiology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, China
| | - Wei Wei
- Department of Anesthesiology, West China Hospital, Sichuan University, 37 Guo Xue Xiang, Chengdu, 610041, China.
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Abstract
Objective: Given the negative health outcomes associated with functional loss, there is need to better understand the trajectory of functional change and compensation use with age. Many older adults successfully age in place, and there is not a one-to-one relationship between cognitive changes and ability to live independently. This study compared healthy age cohorts' performance and approach on a functional measure, particularly examining compensatory strategy use to support task performance. Methods: 57 young adults (YAs; ages 18-39), 42 young-old adults (YOAs; ages 60-69) and 47 old-old (OOAs; ages 70+) completed the Night Out Task (NOT); an open-ended functional assessment in which participants complete eight subtasks in preparation for a night out with a friend (e.g. prepare tea and gather items for a recipe). The NOT measures both primary outcome variables (e.g. time and accuracy), error types and 'compensation variables', which are process-approach variables intended to map on to the types of compensatory strategies individuals use in their everyday lives (e.g. planning and checking). Results: Results revealed that YAs performed better than the oldest group on the NOT in accuracy, execution time and number of both inefficient and inaccurate/incomplete errors. YAs additionally used fewer compensatory strategies than both older groups. Only one compensation variable had a positive relationship to outcome; double-checking was related to improved accuracy and fewer inaccurate/incomplete errors within the oldest cohort. Conclusion: Together these findings support a spectrum of functional change with age. While compensation use increased with age, the relationship between compensation use and outcome was unclear. Future work is needed to understand under what conditions older adults' self-initiate compensation use and to understand the relationship between compensation use and outcome.
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Tafazoli A, Mikros J, Khaghani F, Alimardani M, Rafigh M, Hemmati M, Siamoglou S, Golińska AK, Kamiński KA, Niemira M, Miltyk W, Patrinos GP. Pharmacovariome scanning using whole pharmacogene resequencing coupled with deep computational analysis and machine learning for clinical pharmacogenomics. Hum Genomics 2023; 17:62. [PMID: 37452347 PMCID: PMC10347842 DOI: 10.1186/s40246-023-00508-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND This pilot study aims to identify and functionally assess pharmacovariants in whole exome sequencing data. While detection of known variants has benefited from pharmacogenomic-dedicated bioinformatics tools before, in this paper we have tested novel deep computational analysis in addition to artificial intelligence as possible approaches for functional analysis of unknown markers within less studied drug-related genes. METHODS Pharmacovariants from 1800 drug-related genes from 100 WES data files underwent (a) deep computational analysis by eight bioinformatic algorithms (overall containing 23 tools) and (b) random forest (RF) classifier as the machine learning (ML) approach separately. ML model efficiency was calculated by internal and external cross-validation during recursive feature elimination. Protein modelling was also performed for predicted highly damaging variants with lower frequencies. Genotype-phenotype correlations were implemented for top selected variants in terms of highest possibility of being damaging. RESULTS Five deleterious pharmacovariants in the RYR1, POLG, ANXA11, CCNH, and CDH23 genes identified in step (a) and subsequent analysis displayed high impact on drug-related phenotypes. Also, the utilization of recursive feature elimination achieved a subset of 175 malfunction pharmacovariants in 135 drug-related genes that were used by the RF model with fivefold internal cross-validation, resulting in an area under the curve of 0.9736842 with an average accuracy of 0.9818 (95% CI: 0.89, 0.99) on predicting whether a carrying individuals will develop adverse drug reactions or not. However, the external cross-validation of the same model indicated a possible false positive result when dealing with a low number of observations, as only 60 important variants in 49 genes were displayed, giving an AUC of 0.5384848 with an average accuracy of 0.9512 (95% CI: 0.83, 0.99). CONCLUSION While there are some technologies for functionally assess not-interpreted pharmacovariants, there is still an essential need for the development of tools, methods, and algorithms which are able to provide a functional prediction for every single pharmacovariant in both large-scale datasets and small cohorts. Our approaches may bring new insights for choosing the right computational assessment algorithms out of high throughput DNA sequencing data from small cohorts to be used for personalized drug therapy implementation.
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Affiliation(s)
- Alireza Tafazoli
- Department of Analysis and Bioanalysis of Medicines, Faculty of Pharmacy With the Division of Laboratory Medicine, Medical University of Bialystok, 15-089, Białystok, Poland
- Laboratory of Pharmacogenomics, Department of Molecular Neuropharmacology, Maj Institute of Pharmacology Polish Academy of Sciences, Kraków, Poland
| | - John Mikros
- Laboratory of Pharmacogenomics and Individualized Therapy, Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece
| | - Faeze Khaghani
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Guilan University of Medical Sciences, Rasht, Iran
| | - Maliheh Alimardani
- Department of Medical Genetics and Molecular Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahboobeh Rafigh
- Medical Genetics Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahboobeh Hemmati
- Department of Medical Genetics and Molecular Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Stavroula Siamoglou
- Laboratory of Pharmacogenomics and Individualized Therapy, Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece
| | | | - Karol A Kamiński
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Białystok, Poland
- Department of Cardiology, Medical University of Bialystok, Białystok, Poland
| | - Magdalena Niemira
- Clinical Research Centre, Medical University of Bialystok, Białystok, Poland
| | - Wojciech Miltyk
- Department of Analysis and Bioanalysis of Medicines, Faculty of Pharmacy With the Division of Laboratory Medicine, Medical University of Bialystok, 15-089, Białystok, Poland.
| | - George P Patrinos
- Laboratory of Pharmacogenomics and Individualized Therapy, Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece.
- Zayed Center for Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.
- Department of Genetics and Genomics, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates.
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Jardon M, Nguyen J, Casaletto E, Ko L, Wolff A, Daluiski A, Nwawka OK. Utilization of shear wave elastography to quantify and predict response to upper extremity botulinum toxin injections in patients with cerebral palsy: A pilot study. Clin Neurol Neurosurg 2023; 230:107798. [PMID: 37236005 DOI: 10.1016/j.clineuro.2023.107798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 05/15/2023] [Accepted: 05/21/2023] [Indexed: 05/28/2023]
Abstract
OBJECTIVE Shear wave elastography (SWE) was used to quantify change in upper extremity muscle stiffness in patients with unilateral spastic cerebral palsy (USCP) following botulinum toxin A (BTX-A) therapy. We hypothesized that SWE measures would decrease following ultrasound-guided BTX-A injection, and correlate with functional improvement. METHODS SWE measures of BTX-A treated muscles were recorded immediately pre-injection, and at 1-, 3- and 6-months post-injection. At the same timepoints, functional assessment was performed using the Modified Ashworth Scale (MAS), and passive and active range of motion (PROM and AROM) measures. Correlation of SWE with MAS, PROM and AROM, as well as the relationship between change in SWE and change in MAS, PROM and AROM was determined using Spearman's rank correlation coefficient and generalized estimating equation modeling. RESULTS 16 muscles were injected and longitudinally assessed. SWE and MAS scores decreased following BTX-A injection (p = 0.030 and 0.004, respectively), reflecting decreased quantitative and qualitative muscle stiffness. Decreased SWE reached statistical significance at 1- and 3-months, and 1-, 3- and 6-months for MAS. When comparing relative change in SWE to relative change in AROM, larger change in SWE strongly correlated with positive change in AROM (p-value range:<0.001-0.057). BTX-A responders also demonstrated lower baseline SWE (1.4 m/s) vs. non-responders (1.9 m/s), p = 0.035. CONCLUSION Ultrasound-guided BTX-A injections in patients with USCP resulted in decreased quantitative and qualitative muscle stiffness. Strong correlation between change in SWE and AROM, as well as the significant difference in baseline SWE for BTX-A responders and non-responders, suggests SWE may provide a useful tool to predict and monitor BTX-A response.
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Affiliation(s)
- Meghan Jardon
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, USA
| | - Joseph Nguyen
- Biostatistics Core, Research Administration, Hospital for Special Surgery, New York, NY, USA
| | - Emily Casaletto
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, USA
| | - Lydia Ko
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, USA
| | - Aviva Wolff
- Leon Root, MD Motion Analysis Laboratory, Hospital for Special Surgery, New York, NY, USA
| | - Aaron Daluiski
- Division of Hand and Upper Extremity Surgery, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY, USA
| | - O Kenechi Nwawka
- Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY, USA.
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Subramaniam AP, Oyedeji CI, Parikh JS, Feld JA, Strouse JJ. Cognitive-motor dual-task interference in adults with sickle cell disease. Gait Posture 2023; 102:164-170. [PMID: 37023564 PMCID: PMC10906011 DOI: 10.1016/j.gaitpost.2023.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 01/31/2023] [Accepted: 03/15/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND Sickle cell disease (SCD) is a genetic disorder that causes physical and cognitive impairment due to hemolysis, painful vaso-occlusion episodes, joint avascular necrosis, and strokes. As individuals with SCD age and develop conditions impacting their physical and cognitive function, their ability to multitask successfully and safely may decline. Cognitive-motor dual-task interference occurs when there is deterioration in one or both tasks while dual-tasking relative to single-tasking. Dual-task assessment (DTA) is a valuable measure of physical and cognitive function; however, there is limited data on DTA in adults with SCD. RESEARCH QUESTION Is DTA a feasible and safe method of measuring physical and cognitive function in adults with SCD? What patterns of cognitive-motor interference occur in adults with SCD? METHODS We enrolled 40 adults with SCD (mean age 44 years, range 20-71) in a single-center prospective cohort study. We used usual gait speed as the measure of motor performance and verbal fluency (F, A, and S) as the measure of cognitive performance. We measured feasibility as the proportion of consented participants able to complete the DTA. We calculated the relative dual-task effect (DTE %) for each task and identified patterns of dual-task interference. RESULTS Most consented participants completed the DTA (91%, 40/44) and there were no adverse events. There were 3 main dual-task interference patterns for the first trial using letter 'A': Motor Interference (53%, n = 21), Mutual Interference (23%, n = 9), and Cognitive-Priority Tradeoff (15%, n = 6). For the second trial using letter 'S', there were two main dual-task interference patterns: Cognitive-Priority Tradeoff (53%, n = 21) and Motor Interference (25%, n = 10). STATEMENT OF SIGNIFICANCE DTA was feasible and safe in adults with SCD. We identified specific patterns of cognitive-motor interference. This study supports further evaluation of DTA as a potentially useful tool to measure physical and cognitive function in ambulatory adults with SCD.
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Affiliation(s)
- Arvind P Subramaniam
- Department of Medicine, Division of Hematology, Duke University School of Medicine, 40 Duke Medicine Circle - Clinic 1E, Durham, NC 27710, United States; Duke Comprehensive Sickle Cell Center, Duke University School of Medicine, 40 Duke Medicine Circle - Clinic 2N, Durham, NC 27710, United States
| | - Charity I Oyedeji
- Department of Medicine, Division of Hematology, Duke University School of Medicine, 40 Duke Medicine Circle - Clinic 1E, Durham, NC 27710, United States; Duke Comprehensive Sickle Cell Center, Duke University School of Medicine, 40 Duke Medicine Circle - Clinic 2N, Durham, NC 27710, United States; Duke Claude D. Pepper Older Americans Independence Center, Duke Aging Center, Duke University Medical Center, Unit 3003, Durham, NC 27710, United States
| | - Jhana S Parikh
- Department of Anesthesiology, Duke University, 134 Research Drive, Durham, NC 27710, United States
| | - Jody A Feld
- Doctor of Physical Therapy Division, Department of Orthopaedic Surgery, Duke University School of Medicine, 311 Trent Drive, Durham, NC 27710, United States
| | - John J Strouse
- Department of Medicine, Division of Hematology, Duke University School of Medicine, 40 Duke Medicine Circle - Clinic 1E, Durham, NC 27710, United States; Duke Comprehensive Sickle Cell Center, Duke University School of Medicine, 40 Duke Medicine Circle - Clinic 2N, Durham, NC 27710, United States; Duke Claude D. Pepper Older Americans Independence Center, Duke Aging Center, Duke University Medical Center, Unit 3003, Durham, NC 27710, United States; Division of Pediatric Hematology-Oncology, Duke University, 2301 Erwin Road, Fourth Floor, Durham, NC, United States.
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Waterson H, Walker R, Koopmans P, Stroud R, Phillips J, Mandalia V, Eyres K, Toms A. Gap balanced adjusted mechanical alignment versus measured resection mechanical alignment: a randomised controlled trial. Arch Orthop Trauma Surg 2023; 143:2141-2151. [PMID: 35690965 PMCID: PMC10030405 DOI: 10.1007/s00402-022-04487-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 05/16/2022] [Indexed: 11/02/2022]
Abstract
INTRODUCTION Alignment goals in total knee replacement (TKR) is a topical subject. This study compares the short-term functional outcomes and patient reported outcome measures (PROMs) of two philosophies for knee arthroplasty alignment: measured resection (MR) and an individualised alignment philosophy, with the tibia mechanically aligned and an instrumented gap balancer (GB) to align the femur in both flexion and extension. PATIENTS AND METHODS 94 knees were enrolled in this randomised controlled trial. The surgical protocol used a MR technique for mechanical alignment or a GB technique for individualised alignment. Primary outcome was quadriceps strength. Secondary outcomes included validated functional tests and PROMs as well as patient satisfaction. Outcomes were assessed pre-operatively, at 6 weeks, 3, 6 and 12 months post-operatively. RESULTS At 12-month follow-up, there was no significant difference in the change from baseline mean quadriceps peak torque between the two groups (p = 0.988). Significant improvement in the change in range of motion (ROM) in the GB group compared to the MR group at 3 months (13° vs 6° p = 0.028) but this improvement was not significant at 1 year (20° vs 17° p = 0.21). The functional test of balance showed statistically significant improvement at 6 weeks (p = 0.03) in the GB group but this difference was not maintained. PROMs favoured the GB group, with the KOOS pain scoring statistically better (p ≤ 0.05) at 6 weeks, 3, 6 and 12 months. CONCLUSIONS Individualised alignment philosophy utilising a GB technique did not demonstrate an improvement in the primary outcome measure quadriceps peak torque. Improvement was seen in the GB group in PROM pain scores that was significant, both statistically and clinically, out to at least 1 year. Gains that were seen in functional assessment with GB, although significant at some time points, were no longer significant at 1 year and no difference was seen in quads strength. Compared to a MR technique, the individualised GB technique appears to confer some improvement in pain, ROM and some functional tests following TKR in the short-term.
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Affiliation(s)
- Hugh Waterson
- Exeter Knee Reconstruction Unit, RD+E Hospital, Exeter, UK.
| | - Robert Walker
- Exeter Knee Reconstruction Unit, RD+E Hospital, Exeter, UK
| | | | - Rowenna Stroud
- Exeter Knee Reconstruction Unit, RD+E Hospital, Exeter, UK
| | | | - Vipul Mandalia
- Exeter Knee Reconstruction Unit, RD+E Hospital, Exeter, UK
| | - Keith Eyres
- Exeter Knee Reconstruction Unit, RD+E Hospital, Exeter, UK
| | - Andrew Toms
- Exeter Knee Reconstruction Unit, RD+E Hospital, Exeter, UK
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13
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Labanca L, Brizola E, Luciani D, Luppi G, Sangiorgi L, Benedetti MG. Clinical-functional features of individuals with Osteogenesis Imperfecta and Ehlers-Danlos syndromes: A scoping review of assessment tools and ICF model. Musculoskelet Sci Pract 2023; 64:102742. [PMID: 36905741 DOI: 10.1016/j.msksp.2023.102742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 02/23/2023] [Accepted: 03/03/2023] [Indexed: 03/13/2023]
Abstract
BACKGROUND Clinical-functional assessment of patients affected by Osteogenesis Imperfecta and Ehlers-Danlos Syndromes is essential for clinical management. However, there is no clear information on disease-specific tools of assessment for clinical practice, thus limiting quantification and management of the diseases-related impairments. OBJECTIVE The present scoping review was aimed at investigating the most common clinical-functional features and assessment tools in individuals with Osteogenesis Imperfecta and Ehlers-Danlos Syndromes, and to provide an updated International Classification of Functioning (ICF) model related to functional impairments for each disease. METHODS The literature revision was conducted on PubMed, Scopus and Embase databases. Articles reporting an ICF model of clinical-functional features and assessment tools for Osteogenesis Imperfecta and Ehlers-Danlos Syndromes individuals were included. RESULTS A total of 27 articles were included, 7 reporting an ICF model, and 20 reporting clinical-functional assessment tools. It was reported that patients with Osteogenesis Imperfecta and Ehlers-Danlos Syndromes show impairments in both Body Function and Structure, and Activities and Participation domains of the ICF. A heterogeneous number of assessment tools was found for both diseases regarding proprioception, pain, endurance to exercise, fatigue, balance and motor coordination, and mobility. CONCLUSION Patients with Osteogenesis Imperfecta and Ehlers-Danlos Syndromes show several impairments and limitations in Body Function and Structure, and Activities and Participation domains of the ICF. Thus, an appropriate and ongoing assessment of the disease-related impairments is necessary to improve clinical practice. Several functional tests and clinical scales can be used to assess the patients despite the heterogeneity of assessment tools found in previous literature.
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Affiliation(s)
- Luciana Labanca
- Physical Medicine and Rehabilitation Unit, IRCCS - Istituto Ortopedico Rizzoli, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
| | - Evelise Brizola
- Department of Rare Skeletal Disorders, IRCCS - Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Deianira Luciani
- Physical Medicine and Rehabilitation Unit, Single Regional Health Company - Large Area 4, Porto San Giorgio, Italy
| | - Giulia Luppi
- Physical Medicine and Rehabilitation Unit, IRCCS - Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Luca Sangiorgi
- Department of Rare Skeletal Disorders, IRCCS - Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Maria Grazia Benedetti
- Physical Medicine and Rehabilitation Unit, IRCCS - Istituto Ortopedico Rizzoli, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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14
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Zhu J, Han J, Liu L, Liu Y, Xu W, Li X, Yang L, Gu Y, Tang W, Shi Y, Ye S, Hua F, Xiang G, Liu M, Sun Z, Su Q, Li X, Li Y, Li Y, Li H, Li Y, Yang T, Yang J, Shi L, Yu X, Chen L, Shao J, Liang J, Han X, Xue Y, Ma J, Zhu D, Mu Y. Clinical expert consensus on the assessment and protection of pancreatic islet β-cell function in type 2 diabetes mellitus. Diabetes Res Clin Pract 2023; 197:110568. [PMID: 36738836 DOI: 10.1016/j.diabres.2023.110568] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 01/08/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
Islet β-cell dysfunction is a basic pathophysiological characteristic of type 2 diabetes mellitus (T2DM). Appropriate assessment of islet β-cell function is beneficial to better management of T2DM. Protecting islet β-cell function is vital to delay the progress of type 2 diabetes mellitus. Therefore, the Pancreatic Islet β-cell Expert Panel of the Chinese Diabetes Society and Endocrinology Society of Jiangsu Medical Association organized experts to draft the "Clinical expert consensus on the assessment and protection of pancreatic islet β-cell function in type 2 diabetes mellitus." This consensus suggests that β-cell function can be clinically assessed using blood glucose-based methods or methods that combine blood glucose and endogenous insulin or C-peptide levels. Some measures, including weight loss and early and sustained euglycemia control, could effectively protect islet β-cell function, and some newly developed drugs, such as Sodium-glucose cotransporter-2 inhibitor and Glucagon-like peptide-1 receptor agonists, could improve islet β-cell function, independent of glycemic control.
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Affiliation(s)
- Jian Zhu
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Junfeng Han
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China
| | - Liehua Liu
- Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yu Liu
- Endocrinology Department, Sir Run Run Hospital of Nanjing Medical University, Nanjing, China
| | - Wen Xu
- Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Diabetology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiaomu Li
- Department of Endocrine and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Lin Yang
- National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yong Gu
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Wei Tang
- Department of Endocrinology, Geriatric Hospital of Nanjing Medical University, Nanjing, China
| | - Yongquan Shi
- Department of Endocrinology, Changzheng Hospital, The Navy Military Medical University, Shanghai, China
| | - Shandong Ye
- Department of Endocrinology, Anhui Provincial Hospital, Hefei, China
| | - Fei Hua
- Department of Endocrinology, The First People's Hospital of Changzhou, Changzhou, China
| | - Guangda Xiang
- Department of Endocrinology, General Hospital of Central Theater Command of Chinese People' s Liberation Army, Wuhan, China
| | - Ming Liu
- Department of Endocrinology, General Hospital, Tianjin Medical University, Tianjin, China
| | - Zilin Sun
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| | - Qing Su
- Department of Endocrinology, Xinhua Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Xiaoying Li
- Department of Endocrine and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yuxiu Li
- Department of Endocrinology, Peking Union Medical College Hospital, Beijing, China
| | - Yanbing Li
- Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hong Li
- Department of Endocrinology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yiming Li
- Department of Endocrinology, Huashan Hospital, Fudan University, Shanghai, China
| | - Tao Yang
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jing Yang
- Department of Endocrinology, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Lixin Shi
- Department of Endocrinology, Guiqian International General Hospital, Guiyang 550018, China
| | - Xuefeng Yu
- Department of Endocrinology, Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Li Chen
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, China
| | - Jiaqing Shao
- Department of Endocrinology, the Affiliated Jinling Hospital of Nanjing Medical University, General Hospital of Eastern Theater Command, Nanjing, China
| | - Jun Liang
- Department of Endocrinology, Xuzhou Central Hospital, Xuzhou, China
| | - Xiao Han
- Key Laboratory of Human Functional Genomics of Jiangsu Province, School of Basic Medical Science, Nanjing Medical University, Nanjing, China
| | - Yaomin Xue
- The First Clinical Medical Institute, Southern Medical University, Guangzhou, China
| | - Jianhua Ma
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
| | - Dalong Zhu
- Department of Endocrinology, Drum Tower Hospital Affiliated to Nanjing University Medical School, Nanjing, China.
| | - Yiming Mu
- Department of Endocrinology, Chinese PLA General Hospital, Beijing, China.
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Bongiolatti S, Salvicchi A, Mugnaini G, Vokrri E, Viggiano D, Gonfiotti A, Lavorini F, Voltolini L. Does thoracoscopic basal pyramid segmentectomy really offer functional advantages in comparison with thoracoscopic lower lobectomy? Interdiscip Cardiovasc Thorac Surg 2023; 36:7005201. [PMID: 36847673 PMCID: PMC9901411 DOI: 10.1093/icvts/ivad018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/08/2022] [Accepted: 01/24/2023] [Indexed: 01/28/2023]
Abstract
OBJECTIVES The functional impact of thoracoscopic basal segmentectomy in comparison with lower lobectomy has not been investigated in-depth and the aim of this study was to clarify this topic. METHODS We retrospectively analysed a cohort of patients who underwent surgery between 2015 and 2019 for non-small-cell lung cancer, peripherally located lung nodules, far enough from both the apical segment and the lobar hilum to allow an oncologically safe thoracoscopic lower lobectomy or basal segmentectomy. Pulmonary function tests (PFTs) including spirometry and plethysmography were performed 1 month after surgery and forced expiratory volume in 1 s, forced vital capacity (FVC) and diffusing capacity for carbon monoxide (DLCO) were collected; the difference, the loss and the recovery rate of pulmonary function were calculated and compared with the Wilcoxon-Mann-Whitney test. RESULTS During the study period, n = 45 and n = 16 patients for video-assisted thoracoscopic surgery (VATS) lower lobectomy and for VATS basal segmentectomy, respectively, completed the study protocol: the 2 groups were homogeneous as to preoperative variables and PFT values. Postoperative outcomes were similar and PFTs revealed significant differences between postoperative forced expiratory volume in 1 s %, FVC%, ΔFVC and ΔFVC%. The loss percentage of FVC%, DLCO% and the recovery rate was better for FVC and DLCO in the VATS basal segmentectomy group. CONCLUSIONS Thoracoscopic basal segmentectomy seems to be associated with a more preserved lung function, maintaining more FVC and DLCO levels than lower lobectomy, and could be performed in selected cases ensuring also adequate oncological margins.
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Affiliation(s)
- Stefano Bongiolatti
- Corresponding author. Thoracic Surgery Unit, Careggi University Hospital, Largo Brambilla, 1, 50134 Florence, Italy. Tel: +39-55-7946807; fax: +39-55-7949557; e-mail: (S. Bongiolatti)
| | | | | | - Eduart Vokrri
- Thoracic Surgery Unit, Careggi University Hospital, Florence, Italy
| | | | - Alessandro Gonfiotti
- Thoracic Surgery Unit, Careggi University Hospital, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Federico Lavorini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Luca Voltolini
- Thoracic Surgery Unit, Careggi University Hospital, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Affiliation(s)
- Artur Dziewierz
- 2(nd) Department of Cardiology, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland; Clinical Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland.
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See JE, Kim Y. Functional Analysis of Variants in BRCA1 Using CRISPR Base Editors. Methods Mol Biol 2023; 2606:73-85. [PMID: 36592309 DOI: 10.1007/978-1-0716-2879-9_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
To date, methods such as fluorescent reporter assays, embryonic stem cell viability assays, and therapeutic drug-based sensitivity assays have been used to evaluate the function of the variants of uncertain significance (VUS) of the BRCA genes. However, these methods have limitations as they are associated with overexpression and do not apply to post-transcriptional regulation. Therefore, there are several VUS whose functions are unclear. Recently, we devised a new way to assess the functionality of variants in BRCA1 via a CRISPR-mediated base editor to overcome these limitations. We precisely introduced the target nucleotide substitution in living cells and identified variants whose functions were not defined. Here, we describe the methods for the functional appraisal of BRCA1 variants using CRISPR-based base editors.
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Conneely M, Leahy S, Trépel D, Robinson K, Boland F, Moriarty F, Galvin R. Is There Evidence of an Association Between Acute Health Care Utilization and Function in Older Adults Over Time? A Population-Based Cohort Study. Innov Aging 2022; 7:igac072. [PMID: 36760657 PMCID: PMC9904187 DOI: 10.1093/geroni/igac072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Indexed: 12/03/2022] Open
Abstract
Background and Objectives Acute health care use varies by age, with older adults the highest users of acute health care services. Using data from The Irish Longitudinal Study on Ageing (TILDA), the aim of this study was to investigate the association between acute health care utilization (emergency department [ED] visit with or without hospitalization) at baseline and subjective and objective measures of function measured at 4-year follow-up. Research Design and Methods This study represents a secondary analysis of a prospective cohort study, where data from Wave 1 (baseline) and Wave 3 of TILDA were analyzed in conjunction with a public and patient involvement group of older adults. Acute health care utilization was defined as an ED visit with or without hospitalization in the previous 12 months. Function was assessed objectively using the Timed Up and Go (TUG) test and a measure of grip strength, and subjectively using self-report limitations in activities of daily living (ADL) and instrumental ADL (IADL). Results A total of 1 516 participants met the study inclusion criteria. Mean age was 70.9 ± 4.6 years and 48% were male. At baseline, 1 280 participants reported no acute health care use. One hundred and eighteen indicated an ED visit but no hospitalization in the previous 12 months and 118 reported both an ED visit and hospitalization. Adjusting for all covariates, compared to those with no acute health care utilization, those with an ED visit with no hospital admission had poorer TUG performance at follow-up (β = 0.67, 95% confidence interval: 0.34, 1.29, p = .039). Discussion and Implications This paper supports previous research that acute health care events, specifically ED usage, are associated with reduced function for older adults as assessed by TUG at follow-up. No associations were observed for grip strength, ADL, or IADL. Further research is required in this area, exploring ED visits and the possible benefits of evaluating older adults at this stage.
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Affiliation(s)
- Mairéad Conneely
- Address correspondence to: Mairéad Conneely, Masters of Sports Physiotherapy, School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, University of Limerick, Limerick V94 T9PX, Ireland. E-mail:
| | - Siobhán Leahy
- Department of Sport, Exercise & Nutrition, School of Science & Computing, Atlantic Technological University, Galway, Ireland
| | - Dominic Trépel
- Trinity Institute of Neurosciences, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Katie Robinson
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Fiona Boland
- Data Science Centre and the Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Frank Moriarty
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Rose Galvin
- School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
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Li C, Fu Y, Yi X, Guan X, Liu L, Chen BT. Application of radiomics in adrenal incidentaloma: a literature review. Discov Oncol 2022; 13:112. [PMID: 36305962 PMCID: PMC9616972 DOI: 10.1007/s12672-022-00577-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/13/2022] [Indexed: 11/05/2022] Open
Abstract
Assessment of adrenal incidentaloma relies on imaging analysis and evaluation of adrenal function. Radiomics as a tool for quantitative image analysis is useful for evaluation of adrenal incidentaloma. In this review, we examined radiomic literature on adrenal incidentaloma including both adrenal functional assessment and structural differentiation of benign versus malignant adrenal tumors. In this review, we summarized the status of radiomic application on adrenal incidentaloma and suggested potential direction for future research.
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Affiliation(s)
- Cheng Li
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China
| | - Yan Fu
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Xiangya Hospital, Changsha, 410008, Hunan, People's Republic of China
| | - Xiaoping Yi
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China.
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Xiangya Hospital, Changsha, 410008, Hunan, People's Republic of China.
- National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Central South University, Changsha , 410008, Hunan, People's Republic of China.
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China.
- Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China.
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China.
| | - Xiao Guan
- Department of Urological Surgery, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China.
| | - Longfei Liu
- Department of Urological Surgery, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China.
| | - Bihong T Chen
- Department of Diagnostic Radiology, City of Hope National Medical Center, Duarte, CA, USA
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Pulido I, Nunes C, Botelho A, Lopes M, Martins S, Tomé L, Dinis F, Boto P. Comprehensive geriatric assessment of older patients and associated factors of admission to Emergency Departments in pre-covid 19 Era - A Portuguese study. Rev Esp Geriatr Gerontol 2022; 57:250-256. [PMID: 36115748 PMCID: PMC9444501 DOI: 10.1016/j.regg.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 08/21/2022] [Accepted: 08/29/2022] [Indexed: 11/09/2022]
Abstract
Objectives Identifying frequent users’ (≥3 admissions/year) associated factors in an emergency department (ED), using a comprehensive geriatric assessment (CGA), describing the characteristics of patients over 65 years of age. Methods A cross-sectional study was performed between August 2017 and June 2018 in an ED in Lisbon, Portugal. CGA was applied and completed with clinical records. Clinical, functional, mental and social scores were created based in Portuguese Society of Internal Medicine, and a statistical model was developed. Results CGA was applied to 426 patients over 64 years old in an ED. The mean age was 79.3, 84.7% had multimorbidity. 51.2%, 75.6%, and 40% had dependence on basic, instrumental, and walking activities, respectively. 52% had depressive symptoms, 65.7% had cognitive impairment, 63% were undernourished/at risk for malnutrition. 33.1% were socially at risk. Polypharmacy was present with a use on average of 6.5 drugs daily. Social, clinical, functional, and mental scores were unfavourable in 48.6%, 79.6%, 54.9% and 83.1% of the population, respectively. There were 2.7 hospital admissions/year and 39.9% were frequent ED users (≥3/year). The logistic regression model was weak, but showed that patients with polypharmacy, elevated Charlson Comorbidity index and an impairment nutritional status presented higher risk of being frequent users. Conclusions This study showed that 97.1% of patients had needs that would justify an interventional care plan. This intervention should be extended to primary care and nursing homes. While not providing a robust model, our study has indicated nutritional problems, polypharmacy, and an elevated Charlson index as the features with more weight in frequent users’ admissions.
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Affiliation(s)
- Isabel Pulido
- Consultant Physician in Internal Medicine, Emergency Department, Hospital Santa Maria, Portugal; Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Portugal.
| | - Carla Nunes
- Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Portugal; Associate Professor of Statistics and Member of the Public Health Research Centre (CISP/UNL), Portugal
| | - Amália Botelho
- Assistant Professor of Clinical Medicine, Researcher in the Comprehensive Health Research Centre (CHRC), Nova Medical School/Faculdade de Ciências Médicas (NMS/FCM), Portugal
| | - Manuel Lopes
- Coordinating Professor, Department of Nursing, University of Évora, Researcher in the Comprehensive Health Research Centre (CHRC), Portugal
| | - Sónia Martins
- Integrated Researcher in the Centre for Health Technology and Services Research (CINTESIS) and the Department of Clinical Neurosciences and Mental Health of the Faculty of Medicine, University of Porto (FMUP), Portugal
| | - Luis Tomé
- Registered Nurse, Masters in Critical Care, Charge Nurse in CHULN Central Emergency Department, Portugal
| | - Francisco Dinis
- Emergency Department Social Worker, Hospital Santa Maria, Portugal
| | - Paulo Boto
- Public Health Research Centre, NOVA National School of Public Health, Universidade NOVA de Lisboa, Portugal; Assistant Professor, Department of Health Systems Policy and Management and Member of the Public Health Research Centre (CISP/UNL), Portugal
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Nesselrode R, Falcomata TS, Hills L, Erhard P. Functional Analysis in Public School Settings: A Systematic Review of the Literature. Behav Anal Pract 2022; 15:958-970. [PMID: 36465593 PMCID: PMC9582058 DOI: 10.1007/s40617-022-00679-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2022] [Indexed: 10/18/2022] Open
Abstract
Previous studies have shown that variations of experimental functional analysis (FA) can be used effectively as part of the functional behavioral assessment process in educational settings. The purpose of the current study was to review the literature pertaining to FA of problem behavior in schools focusing on method, topographies, and results. Results of this review showed that analog functional analysis (AFA) are conducted most often in school settings; but recent trends show that use of adapted formats (e.g., trial-based FA and brief FA) are increasing. Analysis of FA results identified most frequent topographies and maintaining variables of problem behavior in the reviewed studies. Trends in teacher-implemented FA are discussed, as well as discrepancies surrounding the terminology of FA in the literature base. Implications for further research, such as social validity of FA in public schools and use of multiple targeted topographies within school-based FA are presented.
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Affiliation(s)
- Ross Nesselrode
- Department of Special Education, University of Texas at Austin, Austin, TX 78712 USA
| | - Terry S Falcomata
- Department of Special Education, University of Texas at Austin, Austin, TX 78712 USA
| | - Lauren Hills
- Department of Special Education, University of Texas at Austin, Austin, TX 78712 USA
| | - Patricio Erhard
- Department of Special Education, University of Texas at Austin, Austin, TX 78712 USA
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22
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Molander O, Ramnerö J, Bjureberg J, Berman AH. What to target in cognitive behavioral treatment for gambling disorder-A qualitative study of clinically relevant behaviors. BMC Psychiatry 2022; 22:510. [PMID: 35902829 PMCID: PMC9331573 DOI: 10.1186/s12888-022-04152-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 07/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND From a clinical perspective, knowledge of the psychological processes involved in maintaining gambling disorder has been lacking. This qualitative study formulated hypotheses on how gambling disorder is maintained by identifying clinically relevant behaviors at an individual level, as a means to guide the development of new cognitive behavioral interventions. METHODS Six individuals from a treatment study, diagnosed with gambling disorder and with diverse symptom profiles of psychiatric comorbidity, were recruited. Participants were interviewed using an in-depth semi-structured functional interview and completed self-report measures assessing gambling behavior. RESULTS Functional analysis was used as a theoretical framework for a thematic analysis, which yielded the following categories: 1) antecedents that may increase or decrease gambling; 2) experiences accompanying gambling; 3) control strategies; 4) consequences of gambling behavior; and 5) events terminating gambling behavior. Few differences were identified in relation to symptom profiles of psychiatric comorbidity, although some gamblers did not report experiencing abstinence when not being able to gamble. CONCLUSIONS Gambling is a secluded activity mainly triggered by access to money. Positive and negative emotions could be both antecedents and functions of gambling behavior. Avoidance-based strategies used to control gambling might result in a failure to learn to control gambling behavior. Anticipation, selective attention, and chasing could be important reinforcers, which should be addressed in new developments in cognitive behavioral treatment for gambling disorder.
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Affiliation(s)
- Olof Molander
- Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet, Norra stationsgatan 69, plan 7, 113 64, Stockholm, Sweden. .,Stockholm Region Health Services, Stockholm, Sweden.
| | - Jonas Ramnerö
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet, Norra stationsgatan 69, plan 7, 113 64 Stockholm, Sweden ,Stockholm Region Health Services, Stockholm, Sweden
| | - Johan Bjureberg
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet, Norra stationsgatan 69, plan 7, 113 64 Stockholm, Sweden ,Stockholm Region Health Services, Stockholm, Sweden
| | - Anne H. Berman
- grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet, Norra stationsgatan 69, plan 7, 113 64 Stockholm, Sweden ,Stockholm Region Health Services, Stockholm, Sweden ,grid.8993.b0000 0004 1936 9457Department of Psychology, Uppsala University, Uppsala, Sweden
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23
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Targosinski S, Henzi A, Engmann AK, Rushing EJ, Barth AA, Klein HJ, Kim BS, Giovanoli P, Schwab ME, Plock JA, Schweizer R. A swim test for functional assessment of rodent peripheral nerve regeneration. J Neurosci Methods 2022; 379:109663. [PMID: 35809863 DOI: 10.1016/j.jneumeth.2022.109663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 06/08/2022] [Accepted: 07/04/2022] [Indexed: 10/17/2022]
Affiliation(s)
- Stefan Targosinski
- Department of Plastic Surgery and Hand Surgery, UniversitätsSpital Zürich, Zurich, Switzerland
| | - Anna Henzi
- Institute of Neuropathology, UniversitätsSpital Zürich, Zurich, Switzerland
| | - Anne K Engmann
- Department of Health Sciences and Technology, ETH Zurich, Switzerland; Brain Research Institute, University of Zurich, Zurich, Switzerland
| | | | - André A Barth
- Department of Plastic Surgery and Hand Surgery, UniversitätsSpital Zürich, Zurich, Switzerland
| | - Holger J Klein
- Department of Plastic Surgery and Hand Surgery, UniversitätsSpital Zürich, Zurich, Switzerland; Department of Plastic Surgery and Hand Surgery, Kantonsspital Aarau, Aarau, Switzerland
| | - Bong-Sung Kim
- Department of Plastic Surgery and Hand Surgery, UniversitätsSpital Zürich, Zurich, Switzerland
| | - Pietro Giovanoli
- Department of Plastic Surgery and Hand Surgery, UniversitätsSpital Zürich, Zurich, Switzerland
| | - Martin E Schwab
- Institute for Regenerative Medicine, University of Zurich, Zurich, Switzerland
| | - Jan A Plock
- Department of Plastic Surgery and Hand Surgery, UniversitätsSpital Zürich, Zurich, Switzerland; Department of Plastic Surgery and Hand Surgery, Kantonsspital Aarau, Aarau, Switzerland
| | - Riccardo Schweizer
- Department of Plastic Surgery and Hand Surgery, UniversitätsSpital Zürich, Zurich, Switzerland.
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Moldvai J, Orsós M, Herczeg E, Uhrin E, Kivovics M, Németh O. Oral health status and its associated factors among post-stroke inpatients: a cross-sectional study in Hungary. BMC Oral Health 2022; 22:234. [PMID: 35701775 PMCID: PMC9195382 DOI: 10.1186/s12903-022-02259-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 05/30/2022] [Indexed: 11/11/2022] Open
Abstract
Background Post-stroke inpatients are at risk of poor oral health for a number of reasons. The aim of this study was to assess the oral health status of post-stroke patients and also to explore the factors that may influence it. Methods This cross-sectional study was organised at National Institute for Medical Rehabilitation in Hungary. Altogether 410 post-stroke patients were enrolled in the survey. Personal medical history and functional assessment was obtained from the final medical reports of the patients. The clinical examination and data collection were conducted according to the World Health Organization (2013) criteria. Socio-demographic background and behaviours related to oral health were assessed using a questionnaire. The dental status was explained by the number of Decayed, Missing and Filled Teeth (DMFT). The association of socio-demographic factors, stroke and functional assessment with oral health status and behaviour was evaluated. Chi-square test, Fisher’s exact test, Welch test, Mann–Whitney U test, Kruskal–Wallis test, ANOVA model and correlation analysis were used to analyse our data. The level of significance was set at p < 0.05. Results Mean age of stroke patients was 59.21(Standard Deviation [SD] 14.74) years. Mean DMFT score was 20.13 (8.08), including 3.28 (4.24) decayed teeth, 15.02 (10.29) missing teeth and 1.83 (2.94) filled teeth score. Factors that influenced the oral health status were gender, age, occupational status, level of education, type and risk factors for stroke. Significant correlation was found between the Functional Independence Measure and oral health-related behaviours with patients brushing their teeth once a month showing the lowest value. Conclusion According to the results, low socio-demographic and economic status, low level of education and the Functional Independence Measure score, unemployment, the combination of risk factors for stroke and residual dysfunctions are associated with poor oral health status. The data indicate that a series of changes are needed, for special attention and care in oral health for patients who have had a stroke. Based on the findings of this research, a new model of prevention and care can be developed, with an interdisciplinary collaboration, to promote the quality of life of these individuals. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02259-2.
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Affiliation(s)
- Júlia Moldvai
- Department of Community Dentistry, Faculty of Dentistry, Semmelweis University, Szentkirályi str. 40, Budapest, 1088, Hungary.
| | - Mercédesz Orsós
- Department of Community Dentistry, Faculty of Dentistry, Semmelweis University, Szentkirályi str. 40, Budapest, 1088, Hungary
| | - Eszter Herczeg
- Department of Rehabilitation Post-Stroke, National Institute for Medical Rehabilitation, Budapest, Hungary
| | - Eszter Uhrin
- Department of Community Dentistry, Faculty of Dentistry, Semmelweis University, Szentkirályi str. 40, Budapest, 1088, Hungary
| | - Márton Kivovics
- Department of Community Dentistry, Faculty of Dentistry, Semmelweis University, Szentkirályi str. 40, Budapest, 1088, Hungary
| | - Orsolya Németh
- Department of Community Dentistry, Faculty of Dentistry, Semmelweis University, Szentkirályi str. 40, Budapest, 1088, Hungary
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Abstract
A comprehensive mobility assessment goes beyond the orthopedic or neurologic examination for the localization of pathology. This assessment involves attention to the dog's posture and stance, a hands-on examination with special attention to soft tissue structures, and the performance of functional assessments. A comprehensive mobility assessment can guide advanced diagnostic testing as well as providing a foundation in the formulation of a successful treatment plan.
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26
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Han Y, Zhang L, Fang Y. Novel subgroups of functional ability in older adults and their associations with adverse outcomes. BMC Geriatr 2022; 22:390. [PMID: 35505297 PMCID: PMC9066860 DOI: 10.1186/s12877-022-03081-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 04/22/2022] [Indexed: 11/27/2022] Open
Abstract
Background There is no general agreement on a standard form of functional classification in older adults and is mainly assessed by Activities of Daily Living (ADL) and/or Instrument Activity of Daily Living. A refined classification based on evaluation the limitations of intrinsic capacity, environment and social interaction, could provide a basis to predict the future disability and identify individuals with increased risk of adverse outcomes. Methods A new functional classification among older adults aged 60 and over was conducted by latent class analysis and compared with the traditional classifications, based on the China Health and Retirement Longitudinal Study. To further investigate the scientific validity of this new classification, associations with 7-year mortality and ADLs impairments among categories were tested by using Survival curves and Cox proportional hazard models. This was followed by the confirmatory analysis related to the prospective data. Competing risk analysis was also performed to analysis the sensitivity to further support our conclusions. Results Five categories were identified among 5,992 older adults which gave the best fitting, yielding a significant Bootstrap Likelihood Ratio Test (p < 0.001) and Lo-Mendell-Rubin adjusted likelihood ratio test (p < 0.001), with an entropy over 0.80. The presence of five categories: “health” (34.0%), “sub-disorder status” (36.6%), “acute diseases” (10.3%), “somatic functional disorder” (7.7%), and “viability disorder” (11.4%), which matched well with the functional independence rates by the international classifications. Among them, those in “sub-disorder status” were considered as an intermediate status between disability and health. The findings also revealed that those who were in “acute disease”, “somatic functional disorders”, “health” and “sub-disorder status” had a significant lower risk of mortality and ADLs limitations than “viability disorder”. And the risks gradually increased towards the less functionally independent end of the classification. However, the distribution of characteristics among five categories were in a synchronous change, indicating a stable classification. Conclusions A new classification representing the functional heterogeneity of older adults could effectively stratify the risk of mortality and ADLs limitations. Identifying the clusters of functional decline might be useful in predicting subsequent ageing trends, designing personalized intervention, and delaying the progression of disability and preventing its occurrence. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03081-9.
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Affiliation(s)
- Ying Han
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian, 361102, PR China
| | - Liangwen Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian, 361102, PR China.,School of Economics, Xiamen University, 422 Siming South Road, Xiamen, Fujian, 361005, PR China
| | - Ya Fang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, Fujian, 361102, PR China.
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Fernández Sanz A, Ruiz Serrano J, Tejada Meza H, Marta Moreno J. Validation of the Spanish-language version of the simplified modified Rankin Scale telephone questionnaire. Neurologia 2022; 37:271-276. [PMID: 31153685 DOI: 10.1016/j.nrl.2019.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 02/09/2019] [Accepted: 03/03/2019] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The modified Rankin Scale (mRS) is the main functional assessment tool used after stroke. The simplified mRS questionnaire (smRSq) has recently been validated in English, and represents a simpler, reliable scale with an excellent reproducibility via telephone. The present study aims to validate a Spanish-language version of the telephone smRSq. METHOD We conducted a prospective cohort study, assessing 50 patients 3 months after they presented an ischaemic stroke. We assessed the Spanish-language smRSq by telephone and in person, the mRS with a structured interview, the Spanish-language smRSq, and the Stroke Impact Scale-16. Inter-rater reliability, test-retest reliability, construct validity, and criterion validity were assessed. RESULTS Inter-rater reliability showed strong agreement (k=0.810); test-retest reliability and criterion validity showed moderate agreement (k=0.639 and k=0.759, respectively), and construct validity showed moderate agreement (Spearman correlation coefficient=-0.728). CONCLUSIONS The Spanish-language telephone smRSq is reliable and simple, and saves time in the functional assessment after a stroke.
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Affiliation(s)
- A Fernández Sanz
- Servicio de Neurología, Hospital Universitario Miguel Servet, Zaragoza, España.
| | - J Ruiz Serrano
- Servicio de Medicina Física y Rehabilitación, Hospital Universitario Miguel Servet, Zaragoza, España
| | - H Tejada Meza
- Servicio de Neurología, Hospital Universitario Miguel Servet, Zaragoza, España
| | - J Marta Moreno
- Servicio de Neurología, Hospital Universitario Miguel Servet, Zaragoza, España
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28
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Oyedeji CI, Hall K, Luciano A, Morey MC, Strouse JJ. The Sickle Cell Disease Functional Assessment (SCD-FA) tool: a feasibility pilot study. Pilot Feasibility Stud 2022; 8:53. [PMID: 35246265 PMCID: PMC8895638 DOI: 10.1186/s40814-022-01005-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 02/16/2022] [Indexed: 01/15/2023] Open
Abstract
Background The life expectancy for individuals with sickle cell disease (SCD) has greatly increased over the last 50 years. Adults with SCD experience multiple complications such as cardiopulmonary disease, strokes, and avascular necrosis that lead to limitations that geriatric populations often experience. There are no dedicated instruments to measure functional decline and functional age to determine risk of future adverse outcomes in older adults with SCD. The objective of this study was to assess the feasibility of performing the Sickle Cell Disease Functional Assessment (SCD-FA). Methods We enrolled 40 adults with SCD (20 younger adults aged 18–49 years as a comparison group and 20 older adults aged 50 years and older) in a single-center prospective cohort study. Participants were recruited from a comprehensive sickle cell clinic in an academic center in the southeastern United States. We included measures validated in an oncology geriatric assessment enriched with additional physical performance measures: usual gait speed, seated grip strength, Timed Up and Go, six-minute walk test, and 30-second chair stand. We also included an additional cognitive measure, which was the Montreal Cognitive Assessment, and additional patient-reported measures at the intersection of sickle cell disease and geriatrics. The primary outcome was the proportion completing the assessment. Secondary outcomes were the proportion consenting, duration of the assessment, acceptability, and adverse events. Results Eighty percent (44/55) of individuals approached consented, 91% (40/44) completed the SCD-FA in its entirety, and the median duration was 89 min (IQR 80–98). There were no identified adverse events. On the acceptability survey, 95% (38/40) reported the length as appropriate, 2.5% (1/40) reported a question as upsetting, and 5% (2/40) reported portions as difficult. Exploratory analyses of physical function showed 63% (25/40) had a slow usual gait speed (< 1.2 m/s). Conclusion The SCD-FA is feasible, acceptable, and safe and physical performance tests identified functional impairments in adults with SCD. These findings will inform the next phase of the study where we will assess the validity of the SCD-FA to predict patient-important outcomes in a larger sample of adults with SCD.
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Affiliation(s)
- Charity I Oyedeji
- Department of Medicine, Division of Hematology, Duke University School of Medicine, Durham, NC, USA. .,Duke Claude D. Pepper Older Americans Independence Center, Durham, NC, USA. .,Department of Medicine, and Duke Comprehensive Sickle Cell Center, Duke University School of Medicine, Durham, NC, USA.
| | - Katherine Hall
- Duke Claude D. Pepper Older Americans Independence Center, Durham, NC, USA.,Department of Medicine, Division of Geriatrics, Duke University, Durham, NC, USA.,Geriatric Research, Education and Clinical Center, Durham Veterans Affairs Medical Center, Durham, NC, USA
| | - Alison Luciano
- Duke Claude D. Pepper Older Americans Independence Center, Durham, NC, USA
| | - Miriam C Morey
- Duke Claude D. Pepper Older Americans Independence Center, Durham, NC, USA.,Department of Medicine, Division of Geriatrics, Duke University, Durham, NC, USA.,Geriatric Research, Education and Clinical Center, Durham Veterans Affairs Medical Center, Durham, NC, USA
| | - John J Strouse
- Department of Medicine, Division of Hematology, Duke University School of Medicine, Durham, NC, USA.,Duke Claude D. Pepper Older Americans Independence Center, Durham, NC, USA.,Department of Medicine, and Duke Comprehensive Sickle Cell Center, Duke University School of Medicine, Durham, NC, USA.,Division of Pediatric Hematology-Oncology, Duke University, Durham, NC, USA
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Carmassi C, Dell'Oste V, Bui E, Foghi C, Bertelloni CA, Atti AR, Buselli R, Di Paolo M, Goracci A, Malacarne P, Nanni MG, Gesi C, Cerveri G, Dell'Osso L. The interplay between acute post-traumatic stress, depressive and anxiety symptoms on healthcare workers functioning during the COVID-19 emergency: A multicenter study comparing regions with increasing pandemic incidence. J Affect Disord 2022; 298:209-216. [PMID: 34728285 PMCID: PMC8556686 DOI: 10.1016/j.jad.2021.10.128] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 07/30/2021] [Accepted: 10/20/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Healthcare workers (HCWs) deployed to the frontline during the COVID-19 pandemic are at risk for developing mental disorders, with a possible impact on their wellbeing and functioning. The present study aimed at investigating post-traumatic stress symptoms (PTSS), anxiety and depressive symptoms and their relationships with impairment in the functioning impairment among frontline HCWs from three Italian regions differently exposed to the first wave of the COVID-19 emergency: Tuscany (low), Emilia-Romagna (medium) and Lombardy (high). METHODS 514 frontline HCWs were consecutively enrolled in hospital units devoted to the treatment of COVID-19 patients. They completed the IES-R, PHQ-9 and GAD-7 to assess PTSS, depressive and anxiety symptoms respectively, and the WSAS to investigate functioning impairment. RESULTS A total of 23.5% of HCWs reported severe PTSS, 22.4% moderate-severe anxiety symptoms, 19.3% moderate-severe depressive symptoms and 22.8% impairment in global functioning. HCWs from the higher-exposure regions reported significantly higher scores in all instruments than those from lower-exposure regions. In a multiple linear regression model, PTSS, depressive and anxiety symptoms presented a significant positive association with the functioning impairment. Both PTSS and depression resulted to be independently related to functioning impairment. LIMITATIONS The cross-sectional design and the use of self-report instruments. CONCLUSIONS Depressive and PTSS appear to be the greatest contributors to functioning impairment in HCWs exposed to a massive stressful sanitary event as the COVID-19 pandemic. A more accurate assessment of work-related mental health outcomes in such population could help planning effective prevention strategies and therapeutic interventions.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Valerio Dell'Oste
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy.
| | - Eric Bui
- Department of Psychiatry, Caen University and Caen University Hospital, Caen, France
| | - Claudia Foghi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Anna Rita Atti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Rodolfo Buselli
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Marco Di Paolo
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Arianna Goracci
- Department of Molecular and Developmental medicine, University of Siena, Siena, Italy
| | - Paolo Malacarne
- Anaesthesia and Intensive Care Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Maria Giulia Nanni
- Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Camilla Gesi
- Department of Mental Health and Addiction, ASST Fatebenefratelli-Sacco, Milan, Italy
| | | | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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30
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Abstract
Geriatric assessment is a multidimensional and interdisciplinarily deployed diagnostic process to evaluate functional capacities and impairments in geriatric patients. The results of geriatric assessment are the basis for planning of therapeutic interventions in the multidisciplinary geriatrics team. Geriatric assessment adds essential information to the state-of-the-art diagnostic tests, such as physical examination, laboratory tests, or imaging techniques, to acquire a holistic picture about health and functional problems and needs of geriatric patients. Studies have demonstrated that geriatric assessment and the following geriatric treatment improves prognosis and increases the chance of older patients remaining in their own home after discharge from hospital after admission for an acute disease.
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Affiliation(s)
- Walter Schippinger
- Medical Director and Head of the Department of Internal Medicine, Albert Schweitzer Hospital, Geriatric Health Centres of the City of Graz, Albert-Schweitzer-Gasse 36, 8020, Graz, Austria.
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31
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Abstract
Extensive progress has been made in developing engineered models for elucidating human cardiac disease. Cardiac fibrosis is often associated with all forms of cardiac disease and has a direct deleterious effect on cardiac function. As currently there is no effective therapeutic strategy specifically designed to target fibrosis, in vitro diagnostic platforms for drug testing have generated significant interest. In this context, we have developed an innovative approach to generate human cardiac fibrotic tissues on Biowire II platform and established a compound screening system. The disease model is constructed to recapitulate contractile, biomechanical, and electrophysiological complexities of fibrotic myocardium. Additionally, an integrated model with fibrotic and healthy cardiac tissues coupled together can be created to mimic focal fibrosis. The methods for constructing the Biowire fibrotic model will be described here.
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Affiliation(s)
- Erika Yan Wang
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Jacob Smith
- Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, ON, Canada
| | - Milica Radisic
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada.
- Department of Chemical Engineering and Applied Chemistry, University of Toronto, Toronto, ON, Canada.
- Toronto General Research Institute, University Health Network, Toronto, ON, Canada.
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Ezzeddine Angulo A, Elía Martínez JM, Iñigo Huarte V, Máñez Añón I, Tenías Burillo JM, Peydro de Moya F. [Severe SARS-CoV-2 infection: Clinical assessment and biomechanical functional evaluation one month after hospital discharge]. Rehabilitacion (Madr) 2022; 56:142-149. [PMID: 34561107 PMCID: PMC8339570 DOI: 10.1016/j.rh.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 07/08/2021] [Accepted: 07/28/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To describe by an observational cross-sectional study the clinical and functional situation, at one month after hospital discharge, of patients admitted with COVID-19 in the hospital ICU between March and December 2020. MATERIAL AND METHODS 59 patients were studied using different clinical scales and biomechanical analysis tests (hand dynamometry, fall risk assessment, gait and balance analysis). RESULTS At one month after discharge, patients reported persistent symptoms: dyspnea (47.5%), arthromyalgia (45%) and cough (22%). In the EQ-5D-5L questionnaire up to 73% of patients reported levels of anxiety or depression. 74.6% and 69.5% presented alterations in the strength of the right and left hand, respectively. The risk of falls in 38% of patients was moderate to very high. The somatosensory index remained within normal parameters, while the vestibular and, to a lesser extent, the visual indexes were altered. In gait, 81.4% of patients showed no abnormalities outside the normal range, with a normal average walking speed. CONCLUSIONS In the short term after severe COVID-19, patients have persistent symptomatology, anxiety/depression, impaired balance with increased risk of falls and loss of grip strength in both hands.
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Affiliation(s)
- A Ezzeddine Angulo
- Servicio de Medicina Física y Rehabilitación, Consorcio Hospital General Universitario de Valencia, Valencia, España; Facultad de Medicina, Universidad Católica de Valencia San Vicente Mártir, Valencia, España.
| | - J M Elía Martínez
- Servicio de Medicina Física y Rehabilitación, Consorcio Hospital General Universitario de Valencia, Valencia, España
| | - V Iñigo Huarte
- Servicio de Medicina Física y Rehabilitación, Consorcio Hospital General Universitario de Valencia, Valencia, España
| | - I Máñez Añón
- Servicio de Medicina Física y Rehabilitación, Consorcio Hospital General Universitario de Valencia, Valencia, España
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Labanca L, Ciardulli F, Bonsanto F, Sommella N, Di Martino A, Benedetti MG. Balance and proprioception impairment, assessment tools, and rehabilitation training in patients with total hip arthroplasty: a systematic review. BMC Musculoskelet Disord 2021; 22:1055. [PMID: 34930190 PMCID: PMC8690357 DOI: 10.1186/s12891-021-04919-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 11/28/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Osteoarthritis and subsequent total hip arthroplasty (THA) lead to damages to hip joint mechanoceptors, which in turns lead to impairments in proprioception. One of the abilities mainly affected by an altered joint proprioception is balance. The aim of this work was to investigate the balance and proprioception impairments, current assessment tools, and rehabilitation training after THA. METHODS A systematic literature revision was conducted on PubMed, Web of Science and Cochrane databases. Articles reporting balance and proprioception impairments, current assessment tools, or rehabilitation interventions were included. Methodological quality was assessed using the Downs and Black checklist. A total of 41 articles were included, 33 discussing balance and proprioception assessment, and 8 dealing with training. Data related to type of surgical approach, type and timing of assessment protocols, assessment instrumentation, and type, volume and duration of the rehabilitation training were extracted from each study. RESULTS Thirty-one studies were of high quality, 2 of moderate quality and 8 of low-quality. Literature review showed an improvement in balance following THA in comparison with the pre-operative performance, although balance abnormalities persist up to 5 years after surgery, with THA patients showing an increased risk for falls. Balance training is effective in all the rehabilitation phases if specifically structured for balance enhancement and consistent in training volume. It remains unclear which assessments are more appropriate for the different rehabilitation phases, and if differences exist between the different surgical procedures used for THA. Only two studies assessed proprioception. CONCLUSION Balance and proprioception show impairments up to 5 years after THA, increasing the risk of falls. However, patients with THA may benefit of an adequate balance training. Further research is needed to investigate the gaps in balance and proprioception assessment and training following THA surgery.
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Affiliation(s)
- Luciana Labanca
- Physical Medicine and Rehabilitation Unit, IRCCS - Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy. .,Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
| | - Francesca Ciardulli
- Physical Medicine and Rehabilitation Unit, IRCCS - Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy
| | - Fabio Bonsanto
- Physical Medicine and Rehabilitation Unit, IRCCS - Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy
| | - Nadia Sommella
- Physical Medicine and Rehabilitation Unit, IRCCS - Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy
| | - Alberto Di Martino
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,I Orthopaedic Clinic, IRCSS- Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Maria Grazia Benedetti
- Physical Medicine and Rehabilitation Unit, IRCCS - Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy.,Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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Edelstein ML, Sloman K, Selver K. Effects of Demand Complexity on Echolalia in Students With Autism. Behav Anal Pract 2021; 14:984-90. [PMID: 34868811 DOI: 10.1007/s40617-020-00535-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2020] [Indexed: 10/22/2022] Open
Abstract
Echolalia is a linguistic phenomenon common in individuals with autism spectrum disorder. We examined the relationship between demand complexity and immediate echolalia in four students with an autism diagnosis in a university-based academic setting. Mastered and novel antecedent verbal demands that required an intraverbal response were systematically alternated using a multielement design to test whether participants' immediate echolalia was socially mediated. Results showed that immediate echolalia was more likely to occur during complex novel intraverbal tasks than in any other condition. Implications for function-based treatment strategies are discussed. Supplementary Information The online version contains supplementary material available at 10.1007/s40617-020-00535-7.
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Freitas SA, Nienow D, da Costa CA, Ramos GDO. Functional Coronary Artery Assessment: a Systematic Literature Review. Wien Klin Wochenschr 2021; 134:302-318. [PMID: 34870740 DOI: 10.1007/s00508-021-01970-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 10/11/2021] [Indexed: 11/28/2022]
Abstract
Cardiovascular diseases represent the number one cause of death in the world, including the most common disorders in the heart's health, namely coronary artery disease (CAD). CAD is mainly caused by fat accumulated in the arteries' internal walls, creating an atherosclerotic plaque that impacts the blood flow functional behavior. Anatomical plaque characteristics are essential but not sufficient for a complete functional assessment of CAD. In fact, plaque analysis and visual inspection alone have proven insufficient to determine the lesion severity and hemodynamic repercussion. Furthermore, the fractional flow reserve (FFR) exam, which is considered the gold standard for stenosis functional impair determination, is invasive and contains several limitations. Such a panorama evidences the need for new techniques applied to image exams to improve CAD functional assessment. In this article, we perform a systematic literature review on emerging methods determining CAD significance, thus delivering a unique base for comparing these methods, qualitatively and quantitatively. Our goal is to guide further studies with evidence from the most promising methods, highlighting the benefits from both areas. We summarize benchmarks, metrics for evaluation, and challenges already faced, thus shedding light on the requirements for a valid, meaningful, and accepted technique for functional assessment evaluation. We create a base of comparison based on quantitative and qualitative indicators and highlight the most relevant geometrical metrics that correlate with lesion significance. Finally, we point out future benchmarks based on recent literature.
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Affiliation(s)
- Samuel A Freitas
- Software Innovation Laboratory, Graduate Program in Applied Computing, Universidade do Vale do Rio dos Sinos, São Leopoldo, Brazil
| | - Débora Nienow
- Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Cristiano A da Costa
- Software Innovation Laboratory, Graduate Program in Applied Computing, Universidade do Vale do Rio dos Sinos, São Leopoldo, Brazil
| | - Gabriel de O Ramos
- Software Innovation Laboratory, Graduate Program in Applied Computing, Universidade do Vale do Rio dos Sinos, São Leopoldo, Brazil.
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Saeidian AH, Youssefian L, Huang J, Touati A, Vahidnezhad H, Kowal L, Caffet M, Wurst T, Singh J, Snook AE, Ryu E, Fortina P, Terry SF, Schoenecker JG, Uitto J, Li Q. Genetic heterogeneity of heritable ectopic mineralization disorders in a large international cohort. Genet Med 2021; 24:75-86. [PMID: 34906475 DOI: 10.1016/j.gim.2021.08.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/17/2021] [Accepted: 08/16/2021] [Indexed: 12/25/2022] Open
Abstract
PURPOSE Heritable ectopic mineralization disorders comprise a group of conditions with a broad range of clinical manifestations in nonskeletal connective tissues. We report the genetic findings from a large international cohort of 478 patients afflicted with ectopic mineralization. METHODS Sequence variations were identified using a next-generation sequencing panel consisting of 29 genes reported in association with ectopic mineralization. The pathogenicity of select splicing and missense variants was analyzed in experimental systems in vitro and in vivo. RESULTS A total of 872 variants of unknown significance as well as likely pathogenic and pathogenic variants were disclosed in 25 genes. A total of 159 distinct variants were identified in 425 patients in ABCC6, the gene responsible for pseudoxanthoma elasticum, a heritable multisystem ectopic mineralization disorder. The interpretation of variant pathogenicity relying on bioinformatic predictions did not provide a consensus. Our in vitro and in vivo functional assessment of 14 ABCC6 variants highlighted this dilemma and provided unambiguous interpretations to their pathogenicity. CONCLUSION The results expand the ABCC6 variant repertoire, shed new light on the genetic heterogeneity of heritable ectopic mineralization disorders, and provide evidence that functional characterization in appropriate experimental systems is necessary to determine the pathogenicity of genetic variants.
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Affiliation(s)
- Amir Hossein Saeidian
- Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, PA; Department of Dermatology & Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA; Genetics, Genomics & Cancer Biology PhD Program, College of Life Sciences, Thomas Jefferson University, Philadelphia, PA
| | - Leila Youssefian
- Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, PA; Department of Dermatology & Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Jianhe Huang
- Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, PA; Department of Dermatology & Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA; PXE International Center of Excellence in Research & Clinical Care, Thomas Jefferson University, Philadelphia, PA
| | - Andrew Touati
- Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, PA; Department of Dermatology & Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Hassan Vahidnezhad
- Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, PA; Department of Dermatology & Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Luke Kowal
- Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, PA
| | | | | | - Jagmohan Singh
- Department of Pharmacology & Experimental Therapeutics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, PA
| | - Adam E Snook
- Department of Pharmacology & Experimental Therapeutics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, PA
| | - Ellen Ryu
- Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, PA
| | - Paolo Fortina
- Department of Cancer Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | | | - Jonathan G Schoenecker
- Department of Orthopedics and Vanderbilt Center for Bone Biology, Vanderbilt University Medical Center, Nashville, TN
| | - Jouni Uitto
- Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, PA; Department of Dermatology & Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA; PXE International Center of Excellence in Research & Clinical Care, Thomas Jefferson University, Philadelphia, PA
| | - Qiaoli Li
- Jefferson Institute of Molecular Medicine, Thomas Jefferson University, Philadelphia, PA; Department of Dermatology & Cutaneous Biology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA; PXE International Center of Excellence in Research & Clinical Care, Thomas Jefferson University, Philadelphia, PA.
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Atasavun Uysal S, Yildiz Kabak V, Karakas Y, Karabulut E, Erdan Kocamaz D, Keser İ, Özdemir K, Düger T. Investigation of the validity and reliability of the Turkish version of the Functional Assessment of Cancer Therapy-Cognitive Function in cancer patients. Palliat Support Care 2021;:1-7. [PMID: 34470680 DOI: 10.1017/S147895152100136X] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) is a questionnaire that is used to evaluate the quality of life and cognitive functions according to individual self-reports. The aim of this study was to investigate the validity and reliability of the Turkish version of the FACT-Cog. METHODS Cancer patients who were treated with chemo or radiotherapy and had a score of 24/30 and more in Mini-Mental State Examination (MMSE) were included in this study. Cognitive functions assessed with the FACT-Cog and the European Organization of Research and Treatment of Cancer Quality of Life Core Questionnaire Core 30: Cognitive Function subscale (EORTC QLQ-CF). RESULTS One hundred and forty cancer patients [female = 87 (62.1%), male = 53 (37.9%)] were included. The mean age of the participants was 47.93 ± 11.90 years. The Cronbach's α of the FACT-Cog scale was 0.82. Test-retest intraclass correlation coefficient values of the FACT-Cog questionnaire were varied from 0.855 to 0.954. There were found low correlations between the total score of the FACT-Cog and the MMSE (r = 0.26, p = 0.002), and moderate correlations between the EORTC QLQ-CF subscale and the FACT-Cog (r = -0.43; p < 0.001). SIGNIFICANCE OF RESULTS It showed the validity and reliability of the Turkish version of the FACT-Cog questionnaire for cancer patients. It may be beneficial to use this questionnaire for the effects of cancer treatment.
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Lew-Koralewicz A, Gagat-Matuła A. QABF - Polish adaptation and validation of the tool for assessing the functions of challenging behaviors. Res Dev Disabil 2021; 116:104032. [PMID: 34293633 DOI: 10.1016/j.ridd.2021.104032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/15/2021] [Accepted: 07/12/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Autism spectrum disorders are a diagnostic unit predisposing the occurrence of challenging behaviors. Depending on their frequency and severity, behavioral problems may significantly limit the developmental possibilities of people with ASD, and also significantly affect family life and the therapeutic process. Aggressive, self-injury, destructive or stereotypic behaviors require intervention based on individualized support, the basis of which should be a functional assessment. AIMS The aim of the study was to develop and adapt the Polish version of the Question About Behavioral Function (QABF) questionnaire by Matson and Vollmer used to assess the functions of challenging behaviors. METHOD Data was obtained from 107 people with ASD. Material was analyzed relating to 168 problem behaviors manifested by these people. To determine the psychometric properties of the tool, reliability and validity analyses were carried out with confirmatory factor analysis using the maximum likelihood method. The Fornell and Larcker method (1981) was used to estimate the convergent and differential validity. RESULT The analysis confirmed the structure of 5-factor QABF. Composite reliability (CR) achieved values at a level of 0.855 and higher. An AVE value of above 0.5 for all factors, while at the same time lower than the CR value, confirmed the convergent validity of the tool. The differential value was confirmed on the basis of the AVE and MSV values. The results obtained confirm that the analyzed tool is accurate and reliable. CONCLUSION QABF, in the Polish language version, is a reliable tool for assessing the behavioral functions of people with ASD. The limitations of the research are also discussed.
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Affiliation(s)
- Aneta Lew-Koralewicz
- University of Rzeszów, Institute of Pedagogy, Ks. Jałowego 24 St., 35-010, Rzeszów, Poland.
| | - Anna Gagat-Matuła
- Pedagogical University of Krakow, Institute of Special Needs Education, R. Ingardena 4 St., 30-060, Cracow, Poland.
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Bachy M, Victoria C, Martinot-Lagarde C, Romana C, Vialle R, Fitoussi F. Global assessment of pollicization outcomes: an analysis in 27 patients. J Hand Surg Eur Vol 2021; 46:754-761. [PMID: 33789509 DOI: 10.1177/17531934211003460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Outcomes measurements after pollicization remains difficult due to the lack of a standardized assessment protocol. This study reports our experience of a global assessment of pollicized thumbs that includes a specific questionnaire for subjective evaluation, a detailed clinical assessment focused on functional outcomes incorporating function and usage of the pollicized thumb. Twenty-seven patients completed the questionnaire, and nine hands were clinically evaluated by a multidisciplinary team composed of hand surgeons and occupational therapists. Subjective evaluations revealed that 24 patients would recommend pollicization. Clinical evaluations revealed that only four out of nine patients properly integrated their pollicized thumb during bimanual activities; however, occupational therapy input allowed the children to compensate for the lack of strength and other difficulties. We propose the use of this global assessment package to analyse function and usage at various capacities, which can be useful for the surgeon, child and parents.Level of evidence: IV.
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Affiliation(s)
- Manon Bachy
- Service de Chirurgie Orthopédique et Réparatrice de l'Enfant, Sorbonne Université - Hôpital Trousseau APHP, Paris, France.,Centre de référence Malformation des Membres CEREFAM, Hôpital National de Saint Maurice, Saint-Maurice, France
| | - Christian Victoria
- Hand and Upper Extremity Service, Hospital for Special Surgery, New York, NY, USA
| | - Coline Martinot-Lagarde
- Centre de référence Malformation des Membres CEREFAM, Hôpital National de Saint Maurice, Saint-Maurice, France
| | - Claudia Romana
- Service de Chirurgie Orthopédique et Réparatrice de l'Enfant, Sorbonne Université - Hôpital Trousseau APHP, Paris, France.,Centre de référence Malformation des Membres CEREFAM, Hôpital National de Saint Maurice, Saint-Maurice, France
| | - Raphael Vialle
- Service de Chirurgie Orthopédique et Réparatrice de l'Enfant, Sorbonne Université - Hôpital Trousseau APHP, Paris, France
| | - Franck Fitoussi
- Service de Chirurgie Orthopédique et Réparatrice de l'Enfant, Sorbonne Université - Hôpital Trousseau APHP, Paris, France.,Centre de référence Malformation des Membres CEREFAM, Hôpital National de Saint Maurice, Saint-Maurice, France
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Abstract
The history of American policing, behavior criminalization, and carceral justice is rooted in racist practice dating back to the 1700s. In addition to racially disproportionate punishment doled out by these systems, they are not designed to support behavioral punishment of harm or reinforcement of prosocial behavior for socially significant change. One alternative to this retributive carceral justice system is restorative justice. This article offers a conceptually systematic examination of restorative justice for behavior change, an examination of the functional utility of various restorative approaches, alignment of restorative justice with behavior analytic ethics, and suggestions for incorporating anti-oppressive practices.
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Takahashi T, Theodoropoulos K, Latib A, Okura H, Kobayashi Y. Coronary physiologic assessment based on angiography and intracoronary imaging. J Cardiol 2021:S0914-5087(21)00184-2. [PMID: 34384666 DOI: 10.1016/j.jjcc.2021.07.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 07/08/2021] [Indexed: 01/20/2023]
Abstract
Despite the current evidence supporting clinical benefits of fractional flow reserve (FFR), its uptake in the cardiac catheterization laboratory has been slow due to procedural cost and increased time with the need for maximum hyperemia. Recently, novel physiological indices derived from coronary angiography and intracoronary imaging have emerged to overcome issues with a wire-based FFR. Angiography-based FFR can be measured without vessel instrumentation and has shown excellent diagnostic performance using wire-based FFR as the reference standard. Thus, angiography-based FFR may facilitate coronary functional assessment before and after percutaneous coronary intervention (PCI). Angiography-based index of microcirculatory resistance (IMR) is another new computational index for assessing the coronary microcirculation. Although angiography-derived IMR remains in an early phase of development and requires further validation, its less-invasive nature may help broaden the adoption of microvascular functional assessment in various conditions such as myocardial infarction and cardiac allograft vasculopathy. Lastly, computational FFR based on intravascular ultrasound and optical coherence tomography allows detailed lesion assessment from both morphological and functional standpoints. Given a growing interest in physiology-guided PCI optimization strategies, intravascular imaging-based FFR may become the main assessment tool to confirm successful PCI.
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Abdelnaby M, Fathy M, Abdallah E, Balata M, Arnous M, Mikhail HM, Emile SH. Laparoscopic Ventral Mesh Rectopexy Versus Transvaginal Posterior Colporrhaphy in Management of Anterior Rectocele. J Gastrointest Surg 2021; 25:2035-2046. [PMID: 33051805 DOI: 10.1007/s11605-020-04823-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 10/03/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND Management of rectocele is challenging. Treatment usually starts with conservative measures and may involve surgical intervention in non-responding patients. We compared the outcomes of transvaginal posterior colporrhaphy (PC) and laparoscopic ventral mesh rectopexy (LVMR) in treatment of anterior rectocele. METHODS Patients with anterior rectocele who underwent PC or LVMR were functionally assessed using Cleveland Clinic Constipation Score (CCCS) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Pelvic Organ Prolapse Quantification System (POP-Q) was used for clinical assessment, defecography for anatomic assessment, and manometry for physiologic assessment. In addition, quality of life was assessed. RESULTS A total of 231 female patients with a mean age of 39 years were included to the study. One hundred fifty-nine underwent PC and 72 underwent LVMR. The LVMR group showed significantly a better functional outcome as compared with the PC group (p < 0.0001). The mean of CCCS at 1 year after LVMR was 6 ± 2.3 vs 9.2 ± 1.2 after PC. The mean of PISQ-12 at 1 year after LVMR was 39.3 ± 2.8 vs 35.8 ± 2.2 after PC. LVMR showed better anatomic correction by defecography, had significantly higher quality of life scores, and had a longer operative time as compared with PC, yet with comparable incidence of complications. CONCLUSION PC and LVMR are both effective treatment options for treatment of rectocele. LVMR was associated with better anatomic correction and greater improvement in constipation, sexual symptoms, and quality of life compared with PC. Although LVMR had a longer operation time than PC, the complication rate of the two procedures was comparable.
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Affiliation(s)
- Mahmoud Abdelnaby
- General Surgery Department, Mansoura University Hospitals, Mansoura University, 60 El-Gomhouria Street, Mansoura, Dakahlia, 35516, Egypt
| | - Mohammad Fathy
- General Surgery Department, Mansoura University Hospitals, Mansoura University, 60 El-Gomhouria Street, Mansoura, Dakahlia, 35516, Egypt
| | - Emad Abdallah
- General Surgery Department, Mansoura University Hospitals, Mansoura University, 60 El-Gomhouria Street, Mansoura, Dakahlia, 35516, Egypt
| | - Mohamed Balata
- General Surgery Department, Mansoura University Hospitals, Mansoura University, 60 El-Gomhouria Street, Mansoura, Dakahlia, 35516, Egypt
| | - Mohamed Arnous
- General Surgery Department, Mansoura University Hospitals, Mansoura University, 60 El-Gomhouria Street, Mansoura, Dakahlia, 35516, Egypt
| | - Hany Maurice Mikhail
- General Surgery Department, Qasr Al-Ainy Hospitals, Cairo University, Giza, Egypt
| | - Sameh Hany Emile
- General Surgery Department, Mansoura University Hospitals, Mansoura University, 60 El-Gomhouria Street, Mansoura, Dakahlia, 35516, Egypt.
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Mui AWL, Lee AWM, Lee VHF, Ng WT, Vardhanabhuti V, Man SSY, Chua DTT, Law SCK, Guan XY. Prognostic and therapeutic evaluation of nasopharyngeal carcinoma by dynamic contrast-enhanced (DCE), diffusion-weighted (DW) magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS). Magn Reson Imaging 2021; 83:50-56. [PMID: 34246785 DOI: 10.1016/j.mri.2021.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/11/2021] [Accepted: 07/05/2021] [Indexed: 12/11/2022]
Abstract
Nasopharyngeal carcinoma (NPC) is an aggressive head and neck malignancy, and radiotherapy (with or without chemotherapy) is the primary treatment modality. Reliable tumour assessment during the treatment phase, which can portend the efficacy of radiotherapy and early identification of potential treatment failure in radioresistant disease, has been implicit for better cancer management. Technological advancement in the last decade has fostered the development of functional magnetic resonance imaging (fMRI) techniques into a promising tool for diagnostic and therapeutic assessments in head and neck cancer. Apart from conventional morphological assessment, early detection of the physiological environment by fMRI allows a more thorough investigation in monitoring tumour response. This article discusses the relevant fMRI utilities in NPC as an early prognostic and monitoring tool for treatment. Challenges and future developments of fMRI in radiation oncology are also discussed.
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Affiliation(s)
- Alan W L Mui
- Department of Radiotherapy, Hong Kong Sanatorium and Hospital, Hong Kong; Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
| | - Anne W M Lee
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Victor H F Lee
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - W T Ng
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Varut Vardhanabhuti
- Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Shei S Y Man
- Department of Radiotherapy, Hong Kong Sanatorium and Hospital, Hong Kong
| | - Daniel T T Chua
- Department of Medicine, Hong Kong Sanatorium and Hospital, Hong Kong
| | - Stephen C K Law
- Department of Medicine, Hong Kong Sanatorium and Hospital, Hong Kong
| | - X Y Guan
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
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Frykberg GE, Grip H, Alt Murphy M. How many trials are needed in kinematic analysis of reach-to-grasp?-A study of the drinking task in persons with stroke and non-disabled controls. J Neuroeng Rehabil 2021; 18:101. [PMID: 34130716 PMCID: PMC8207615 DOI: 10.1186/s12984-021-00895-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 06/09/2021] [Indexed: 12/27/2022] Open
Abstract
Background Kinematic analysis of the 3D reach-to-grasp drinking task is recommended in stroke rehabilitation research. The number of trials required to reach performance stability, as an important aspect of reliability, has not been investigated for this task. Thus, the aims of this study were to determine the number of trials needed for the drinking task to reach within-session performance stability and to investigate trends in performance over a set of trials in non-disabled people and in a sample of individuals with chronic stroke. In addition, the between-sessions test–retest reliability in persons with stroke was established. Methods The drinking task was performed at least 10 times, following a standardized protocol, in 44 non-disabled and 8 post-stroke individuals. A marker-based motion capture system registered arm and trunk movements during 5 pre-defined phases of the drinking task. Intra class correlation statistics were used to determine the number of trials needed to reach performance stability as well as to establish test–retest reliability. Systematic within-session trends over multiple trials were analyzed with a paired t-test. Results For most of the kinematic variables 2 to 3 trials were needed to reach good performance stability in both investigated groups. More trials were needed for movement times in reaching and returning phase, movement smoothness, time to peak velocity and inter-joint-coordination. A small but significant trend of improvement in movement time over multiple trials was demonstrated in the non-disabled group, but not in the stroke group. A mean of 3 trials was sufficient to reach good to excellent test–retest reliability for most of the kinematic variables in the stroke sample. Conclusions This is the first study that determines the number of trials needed for good performance stability (non-disabled and stroke) and test–retest reliability (stroke) for temporal, endpoint and angular metrics of the drinking task. For most kinematic variables, 3–5 trials are sufficient to reach good reliability. This knowledge can be used to guide future kinematic studies.
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Affiliation(s)
- Gunilla Elmgren Frykberg
- Department of Neuroscience, Rehabilitation Medicine, Uppsala University, Box 256, 751 05, Uppsala, Sweden.
| | - Helena Grip
- Department of Radiation Sciences, Biomedical Engineering, Umeå University, Umeå, Sweden
| | - Margit Alt Murphy
- Institute of Neuroscience and Physiology, Clinical Neuroscience, Rehabilitation Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Pizarro-Pennarolli C, Sánchez-Rojas C, Torres-Castro R, Vera-Uribe R, Sanchez-Ramirez DC, Vasconcello-Castillo L, Solís-Navarro L, Rivera-Lillo G. Assessment of activities of daily living in patients post COVID-19: a systematic review. PeerJ 2021; 9:e11026. [PMID: 33868804 PMCID: PMC8034364 DOI: 10.7717/peerj.11026] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 02/08/2021] [Indexed: 12/15/2022] Open
Abstract
Background Coronavirus disease has provoked much discussion since its first appearance. Despite it being widely studied all over the world, little is known about the impact of the disease on functional ability related to performing activities of daily living (ADL) in patients post COVID-19 infection. Objectives To understand the impact of COVID-19 on ADL performance of adult patients and to describe the common scales used to assess performance of ADL on patients post-COVID-19. Methods A systematic review was conducted. We included studies that applied a physical capacity test in COVID-19 patients, post-infection. Two independent reviewers analyzed the studies, extracted the data, and assessed the quality of the evidence. Results A total of 1,228 studies were included, after removing duplicates, 1,005 abstracts were screened and of those 983 were excluded. A final number of nine studies which met the eligibility criteria were included. The findings revealed worsening of physical function and ADL performance in all patients post COVID-19 infection. Conclusion All included studies found a reduction of ADL beyond the test or scale used, revealing a vital worsening of functional ability in ADL performance and consequently loss of independence in COVID-19 patients after the acute phase of infection. Functional ability status previous to COVID-19 is crucial for predicting the severity of the disease and mortality. Barthel Index and ADL score were the most used assessment tools across subjects with different intrinsic capacity and context levels.
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Affiliation(s)
| | - Carlos Sánchez-Rojas
- Department of Physical Therapy, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Rodrigo Torres-Castro
- Department of Physical Therapy, Faculty of Medicine, Universidad de Chile, Santiago, Chile.,International Physiotherapy Research Network (PhysioEvidence), Barcelona, España
| | - Roberto Vera-Uribe
- Department of Physical Therapy, Faculty of Medicine, Universidad de Chile, Santiago, Chile.,International Physiotherapy Research Network (PhysioEvidence), Barcelona, España
| | - Diana C Sanchez-Ramirez
- Department of Respiratory Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Luis Vasconcello-Castillo
- Department of Physical Therapy, Faculty of Medicine, Universidad de Chile, Santiago, Chile.,International Physiotherapy Research Network (PhysioEvidence), Barcelona, España
| | - Lilian Solís-Navarro
- Department of Physical Therapy, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Gonzalo Rivera-Lillo
- Department of Physical Therapy, Faculty of Medicine, Universidad de Chile, Santiago, Chile.,Research and Development Unit, Clínica Los Coihues, Santiago, Chile.,Department of Neuroscience, Faculty of Medicine, Universidad de Chile, Santiago, Chile
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Abstract
Background: A significant consequence of peripheral arterial disease (PAD) is an impaired functional capacity and deteriorated quality of life. Therefore, our study aimed to investigate the usefulness of a symptom questionnaire and walk tests for the determination of the functional capacity of patients with intermittent claudication. Patients and methods: The study included 53 patients (38 males) with stable claudication distance (50-300m). A detailed history and physical examination, ankle-brachial index (ABI), treadmill exercise test, and 6-minute walk test were performed and compared to walking impairment questionnaire (WIQ). Results: Claudication distance reported from patients' history and 6-minute walk test were significantly correlated with ABI (p=0.033, p=0.044). There were no significant correlations between ABI and treadmill walk test or WIQ. Results of WIQ were significantly correlated with the history and the most of performed walk tests: treadmill initial and maximal claudication distance (p=0.004 and 0.012, respectively) and 6-minute walk test (p=0.026). 6-minute walk test was correlated with maximal claudication distance of treadmill (p=0.018), but not with an initial claudication distance. Conclusions: The validity of WIQ is comparable to walk tests and represents the useful technique for the investigation of the functional capacity of patients with PAD. A self-report based on WIQ enables a longer period of observation. It should be routinely used as a basic diagnostic tool for the estimation of the functional capacity of PAD patients with stable intermittent claudication.
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Affiliation(s)
- Pavel Poredos
- Department of Vascular Disease, University Medical Center Ljubljana, Slovenia.,Department of Advanced Cardiopulmonary Therapies and Transplantation, The University of Texas Health Science Center at Houston, Texas, USA
| | - Urska Zlajpah
- Department of Vascular Disease, University Medical Center Ljubljana, Slovenia
| | - Peter Poredos
- Department of Anesthesiology and Intensive Care, University Medical Center Ljubljana, Slovenia
| | | | - Mateja K Jezovnik
- Department of Advanced Cardiopulmonary Therapies and Transplantation, The University of Texas Health Science Center at Houston, Texas, USA
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Marino M, Ni P, Kazis L, Brandt D, Jette A. Demographic and functional differences among social security disability claimants. Qual Life Res 2021; 30:1757-68. [PMID: 33611754 DOI: 10.1007/s11136-021-02765-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2021] [Indexed: 12/27/2022]
Abstract
PURPOSE Sociodemographic characteristics may influence responses on self-reported measures. Differential item functioning (DIF) is when individuals expected to have the same ability level on a construct of interest have a different probability of endorsing an item on an item response theory (IRT) scale due to population characteristics. The goal of this study was to identify DIF for items in an outcome instrument by sociodemographic factors and, one controlling for DIF, assess true differences in function by those same factors. METHODS The Work Disability Functional Assessment Battery 2.0 (WD-FAB 2.0) is an IRT-based self-reported measure of activity limitations relevant to work. Two samples from WD-FAB developed were used: 3793 SSA disability claimants randomly drawn from a pool of 16,500 claimants and a general sample if 2100 working age adults. We used a two-step IRT-based DIF method for three pairs of respondent characteristics: age, gender, and race/ethnicity, and calculated the weighted absolute difference between item characteristic curves. Independent two-group T-tests assessed differences in scores across groups. RESULTS Seventeen items displayed DIF. Men had higher scores than women on two physical and two mental function scales. Older respondents had lower physical and higher mental function scores. The lower education group had lower mental function scores. CONCLUSION DIF impacts function measurement and is important when assessing psychometric characteristics of instruments. Self-report measures should include diverse samples to conduct similar analyses. WD-FAB 2.0 scores are now reflections of function with reduced bias related to gender, race/ethnicity, or age.
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48
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Forte R, De Vito G, Boreham CAG. Reliability of walking speed in basic and complex conditions in healthy, older community-dwelling individuals. Aging Clin Exp Res 2021; 33:311-317. [PMID: 32277431 DOI: 10.1007/s40520-020-01543-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 03/24/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND There is a paucity of reliability data for walking speed tests in complex conditions to assess functioning in healthy older individuals. AIMS To evaluate the absolute intra- and intertest reliability of walking speed performed in basic and complex conditions in healthy older individuals. METHODS Fifty-two men and women of mean age 69.7 ± 3.2 years were tested for habitual and maximal walking speed. Maximal speed was also assessed under different conditions, including walking on a path of reduced width; picking up objects; stepping over hurdles; stepping over hurdles wearing sunglasses and finally, carrying a box. Two testing sessions (separated by 4 weeks) of two trials each were administered. Reliability was analysed by intra-class correlation coefficient (ICC), minimal detectable change (MDC) and Bland-Altman plots with limits of agreement (LOA). RESULTS Intrasession ICCs ranged from good to excellent (0.89-0.95) except for picking up objects (0.44). Intersession ICCs were moderate to good (0.60-0.78) and %MDCs were acceptable (14-24%). Bland-Altman plots suggested a good agreement between the two testing sessions at group level (mean differences from - 0.02 to - 0.11 m/s), and limited agreement between testing sessions at individual level (upper LOA from 0.13 to 0.37 m/s and lower LOA from - 0.29 to - 0.49 m/s). CONCLUSIONS Complex walking speed tests are generally reliable measures displaying good and moderate intra- and inter-session reliability. Such tests seem a more suitable functional assessment tool for heathy older subjects compared with simple walking. Some learning effect may be present and further reliability studies are needed.
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Affiliation(s)
- Roberta Forte
- Department of Human Movement and Sports Sciences, University of Rome Foro Italico, Piazza Lauro de Bosis 15, 00135, Rome, Italy.
- Institute for Sport and Health, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Giuseppe De Vito
- Institute for Sport and Health, University College Dublin, Belfield, Dublin 4, Ireland
- Department of Biomedical Sciences, University of Padova, Padua, Italy
| | - Colin A G Boreham
- Institute for Sport and Health, University College Dublin, Belfield, Dublin 4, Ireland
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Montiel Terrón V, Vitoria M, Lamo de Espinosa Vázquez de Sola JM, Valentí Nin JR, Valentí Azcárate A. Do we really improve life quality after total knee arthroplasty in patients with Parkinson's disease? Arch Orthop Trauma Surg 2021; 141:313-319. [PMID: 33165682 DOI: 10.1007/s00402-020-03644-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 10/15/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The knee in Parkinson's disease (PD) patients is a problematic joint due to pain, stiffness and gait instability. The aim of this study is to evaluate the functional outcome and degree of pain relief achieved after total knee arthroplasty (TKA) in PD patients. MATERIALS AND METHODS This is a retrospective review of 26 PD patients (32 knees) with osteoarthritis who underwent a TKA between 1994 and 2013. Comorbidities, anesthetic procedures and complications were recorded. Patient functional status was assessed with the Knee Society Function Score (KFS) and the Knee Society Score (KSS). PD stage was classified with the Hoehn and Yahr Scale. RESULTS The mean follow-up was 3.5 years (range 2-9). The mean age was 71 years (range 61-83) with a mean time since PD diagnosis of 11.8 years (range 4-24). PD severity on the Hoehn and Yahr Scale was 1.5 points before surgery and 2 points postoperatively. Pain on the visual analogic scale improved from 8 points preoperatively to 5 points at 1-year follow-up; function improved from 32 (range 20-45) to 71 (range 50-81) and from 34 (range 28-52) to 59 (range 25-76) on the KSS and KFS, respectively. The mean postoperative hospital stay was 9.8 days (range 5-21). Confusion and flexion contracture were the most frequent perioperative complications. CONCLUSION TKA successfully provided pain relief in PD patients. However, the functional outcome is related to disease progression and, therefore, variable. Perioperative complications are difficult to avoid and manage.
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Affiliation(s)
- Verónica Montiel Terrón
- Orthopedic Surgery and Traumatology Department, Clínica Universidad de Navarra, Av. Pio XII, 36, 31008, Pamplona, Spain.
| | - María Vitoria
- Orthopedic Surgery and Traumatology Department, Clínica Universidad de Navarra, Av. Pio XII, 36, 31008, Pamplona, Spain
| | | | - Juan Ramón Valentí Nin
- Orthopedic Surgery and Traumatology Department, Clínica Universidad de Navarra, Av. Pio XII, 36, 31008, Pamplona, Spain
| | - Andrés Valentí Azcárate
- Orthopedic Surgery and Traumatology Department, Clínica Universidad de Navarra, Av. Pio XII, 36, 31008, Pamplona, Spain
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Arruda F, Rosselli M, Greig MT, Loewenstein DA, Lang M, Torres VL, Vélez-Uribe I, Conniff J, Barker WW, Curiel RE, Adjouadi M, Duara R. The Association Between Functional Assessment and Structural Brain Biomarkers in an Ethnically Diverse Sample With Normal Cognition, Mild Cognitive Impairment, or Dementia. Arch Clin Neuropsychol 2021; 36:51-61. [PMID: 32890393 DOI: 10.1093/arclin/acaa065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/13/2020] [Accepted: 07/27/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To investigate the association between the functional activities questionnaire (FAQ) and brain biomarkers (bilateral hippocampal volume [HV], bilateral entorhinal volume [ERV], and entorhinal cortical thickness [ERT]) in cognitively normal (CN) individuals, mild cognitive impairment (MCI), or dementia. METHOD In total, 226 participants (137 females; mean age = 71.76, SD = 7.93; Hispanic Americans = 137; European Americans = 89) were assessed with a comprehensive clinical examination, a neuropsychological battery, a structural magnetic resonance imaging, and were classified as CN or diagnosed with MCI or dementia. Linear regression analyses examined the association between functional activities as measured by the FAQ on brain biomarkers, including HV, ERV, and ERT, controlling for age, education, global cognition, gender, and ethnicity. RESULTS The FAQ significantly predicted HV, ERV, and ERT for the entire sample. However, this association was not significant for ERV and ERT when excluding the dementia group. The FAQ score remained a significant predictor of HV for the non-dementia group. Age, education, gender, ethnicity, Montreal Cognitive Assessment score, and FAQ were also significant predictors of HV for the overall sample, suggesting that younger Hispanic females with fewer years of education, higher global mental status, and better functioning, were more likely to have larger HV. CONCLUSION FAQ scores were related to HV in older adults across clinical groups (CN, MCI, and dementia), but its association with the entorhinal cortex was driven by individuals with dementia. Demographic variables, including ethnicity, additionally influenced these associations.
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Affiliation(s)
- Fernanda Arruda
- Department of Psychology, Florida Atlantic University, Davie, FL, USA
| | - Mónica Rosselli
- Department of Psychology, Florida Atlantic University, Davie, FL, USA.,1Florida Alzheimer's Disease Research Center, Miami Beach, FL, USA
| | - Maria T Greig
- 1Florida Alzheimer's Disease Research Center, Miami Beach, FL, USA.,Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
| | - David A Loewenstein
- 1Florida Alzheimer's Disease Research Center, Miami Beach, FL, USA.,Department of Psychiatry and Behavioral Sciences, Center for Cognitive Neuroscience and Aging, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Merike Lang
- Department of Psychology, Florida Atlantic University, Davie, FL, USA
| | - Valeria L Torres
- Department of Psychology, Florida Atlantic University, Davie, FL, USA
| | - Idaly Vélez-Uribe
- Department of Psychology, Florida Atlantic University, Davie, FL, USA
| | - Joshua Conniff
- Department of Psychology, Florida Atlantic University, Davie, FL, USA
| | - Warren W Barker
- 1Florida Alzheimer's Disease Research Center, Miami Beach, FL, USA.,Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
| | - Rosie E Curiel
- 1Florida Alzheimer's Disease Research Center, Miami Beach, FL, USA.,Department of Psychiatry and Behavioral Sciences, Center for Cognitive Neuroscience and Aging, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Malek Adjouadi
- 1Florida Alzheimer's Disease Research Center, Miami Beach, FL, USA.,Engineering Center, Florida International University, Miami, FL, USA
| | - Ranjan Duara
- 1Florida Alzheimer's Disease Research Center, Miami Beach, FL, USA.,Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
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