Emission control status and future perspectives of diesel trucks in China.

Chinese diesel trucks are the main contributors to NOx and particulate matter (PM) vehicle emissions. An increase in diesel trucks could aggravate air pollution and damage human health. The Chinese government has recently implemented a series of emission control technologies and measures for air quality improvement. This paper summarizes recent control technologies and measures for diesel truck emissions in China and introduces the comprehensive application of control technologies and measures in Beijing-Tianjin-Hebei and surrounding regions. Remote online monitoring technology has been adopted according to the China VI standard for heavy-duty diesel trucks, and control measures such as transportation structure adjustment and heavy pollution enterprise classification control continue to support the battle action plan for pollution control. Perspectives and suggestions are provided for promoting pollution control and supervision of diesel truck emissions: adhere to the concept of overall management and control, vigorously promote the application of systematic and technological means in emission monitoring, continuously facilitate cargo transportation structure adjustment and promote new energy freight vehicles. This paper aims to accelerate the implementation of control technologies and measures throughout China. China is endeavouring to control diesel truck exhaust pollution. China is willing to cooperate with the world to protect the global ecological environment.

The effects of social determinants of health on anterior cruciate ligament injury recovery.

Context: Over 200,000 anterior cruciate ligament (ACL) injuries occur in the United States each year. While many patients choose to pursue ACL reconstruction (ACLR), the impact of social determinants of health (SDOH) on outcomes is unclear. Objective: The purpose of this study was to review and synthesize current literature to determine the impact of SDOH on outcomes following ACL reconstruction. Data sources: A systematic search of PubMed, CINAHL, Medline, PsychINFO, and Scopus was completed. Study selection: Articles reporting outcomes following ACLR were included if they discussed at least one SDOH and provided ACLR failure rates. Study design: Systematic review. Level of evidence: Level I. Results: After screening 712 studies, 13 were found that met inclusion criteria and were analyzed. Studies commonly examined the correlations between race, income, location, education, and insurance on outcomes following ACLR. Three studies found that the ACL revision risk for Black patients compared to White patients ranged from 0.23 to 0.78, while the revision risk for Hispanic patients compared to White patients ranged from 0.7 to 0.83. One study reported finding that the odds ratio of revision for the White patients was 1.32. Another study reported no difference in revision risk based on race. Patients living in urban areas were found to have improved outcomes compared to rural areas (Mean IKDC (Urban 85.3 vs Rural 81.87) and Tegner-Lysholm (Urban 88.26 vs Rural 84.82)). Lower socioeconomic status was correlated with decreased post-operative functional scores (KOOS, Marx and IKDC). Conclusion: Several SDOH such as White race, rural location, and low socioeconomic status may be independently correlated with worse ACLR outcomes in the form of increased revision rates or worse post-operative functional scores. However, further research is needed to better elucidate the degree of impact and interconnectedness of SDOH domains on ACLR patient outcomes.

Adherence to COVID-19 measures and the associated factors: evidence from a two-wave longitudinal study in Singapore.

BACKGROUND: At the onset of the Coronavirus disease (COVID-19) pandemic when pharmaceutical interventions were not readily available, governments relied on public health mandates and social distancing measures to counter rising infection rates. In order to address the dearth of longitudinal studies, this study sought to identify factors associated with continued adherence to COVID-19 preventive behaviours in Singapore. METHODS: Data were from a two-wave longitudinal cohort study; baseline study was conducted from May 2020 to June 2021 and follow-up study from October 2021 to September 2022. Participants (n = 858) were Singapore residents, aged 18 and above, and able to speak English, Chinese or Malay. Weighted multivariable logistic regressions were conducted to identify factors associated with adherence to the COVID-19 measures. RESULTS: Adherence rates of 'avoid dining out', 'crowded places', 'people with flu symptoms' and 'small group gatherings' at baseline were 39.41%, 60.82%, 79.82%, and 44.82% respectively. All measures had a decrease in adherence rates across the two-waves. Older age groups were associated with greater adherence to 'avoid dining out' and 'avoid crowded places'. Having high trust in local public health experts was associated with greater adherence to 'avoid crowded places' and 'avoid people with flu symptoms'. Fear of family and friends getting infected with COVID-19 was associated with 'avoid dining out' and 'avoid crowded places'. CONCLUSIONS: Soft interventions like nudges can be implemented at crowded places to remind the public of the ease of transmitting the virus to their loved ones. Increasing media presence of public health experts can be a viable alternative to improve adherence.

Oral functions in adult persons with spinal muscular atrophy compared to a healthy control group: a prospective cross-sectional study with a multimodal approach.

BACKGROUND: Oral function tests have been shown to reliably detect impaired bulbar function in adults with spinal muscular atrophy (SMA). Although not routinely recorded, it is known that persons with SMA are affected to varying degrees. Detecting differences in bite and tongue force, endurance, and maximum mouth opening has become particularly promising since the introduction of causal therapy for SMA. This study aimed to compare oral function among adult persons with SMA with different SMA types, walking abilities, and treatment status to a healthy control group. METHODS: Data from oral function tests conducted on 58 persons with SMA and 45 healthy individuals were analyzed. Differences in oral function between SMA subgroups were pairwise tested and compared to the healthy control group using Wilcoxon rank sum tests. RESULTS: In an overall comparison, three out of five oral function tests revealed lower values for the SMA group compared to the control group. Subgroup analyses indicated lower scores for most oral function tests in non-ambulatory, untreated patients with SMA type 2 compared to controls. Ambulatory, treated patients with SMA type 3 achieved strength and endurance values comparable to those of healthy individuals. CONCLUSIONS: The impairment of oral function varies across persons with SMA. Routine measurement of oral function is warranted to determine individual bulbar involvement stages. Further evaluation should be scheduled if indicators such as restricted maximum mouth opening arise. Trial registration DRKS, DRKS00015842. Registered 30 July 2019, https://drks.de/register/de/trial/DRKS00015842/preview .

Current and future advances in practice: SAPHO syndrome and chronic non-bacterial osteitis (CNO).

Synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome is a rare, underdiagnosed disease with a wide clinical spectrum. Sterile bone inflammation, predominantly of the anterior chest, and skin manifestations (palmoplantar pustulosis, psoriasis vulgaris and acne) are the key features of SAPHO, which shares certain similarities with SpA. SAPHO is closely related to paediatric chronic non-bacterial osteitis (CNO), a spectrum of autoinflammatory bone diseases. The aetiology of SAPHO is considered multifactorial based on a complex interplay of genetic, immune and infectious factors. Despite the increasing awareness of SAPHO/CNO, diagnostic delay is common, as validated classification and diagnostic criteria are lacking. Treatment of SAPHO represents a challenge and includes anti-inflammatory drugs, antibiotics, bisphosphonates, synthetic conventional DMARDs and off-label use of anti-cytokine biologics and Janus kinase inhibitors. This review summarizes the current diagnostic and practical treatment approach to SAPHO/CNO and highlights the ongoing research endeavours concerning the definition and validation of diagnostic criteria, core domains and treatment.

Large angular correction of arithmetic coronal alignment is associated with residual lateral laxity after total knee arthroplasty in varus knees for Japanese patients.

Purpose: One of the most common types of coronal plane alignment of the knee (CPAK) is type I, which is characterised by varus alignment and apex distal joint line obliquity. The purpose of this study was to evaluate the association of changes in arithmetic hip-knee-ankle angle (aHKA) with both postoperative joint laxity and patient-reported outcome measures (PROMs) in patients with CPAK type I following mechanical alignment (MA) total knee arthroplasty (TKA). Methods: Of 111 consecutive knees in 92 patients with osteoarthritis who underwent primary TKA, 80 knees (72.0%) with CPAK type I phenotype preoperatively were evaluated. All TKAs were performed to achieve neutral MA by a medial stabilising gap balancing technique. Pre- to postoperative change in aHKA was defined as ΔaHKA. The 80 CPAK type I knees were divided into a larger ΔaHKA group (>7°) and a smaller ΔaHKA group (≤7°). PROMs, including the Knee Society Score and Forgotten Joint Score-12, were assessed before and 2 years after surgery. Pre- and postoperative joint laxity was assessed using a Telos arthrometer. Results: Twenty-two knees showed a larger ΔaHKA, and postoperative lateral joint laxity in varus stress was significantly greater in these patients than in those with a smaller ΔaHKA (6.8° vs. 4.5°, p = 0.006). There were no significant differences between the groups in PROMs (p = n.s.). Conclusions: Postoperative lateral laxity was associated with larger aHKA changes than smaller aHKA changes in CPAK type I knees after TKA. However, no statistically significant differences in PROMs were found according to the amount of change in aHKA. Level of Evidence: Level III.

Measuring empathic stress - A systematic review of methodology and practical considerations for future research.

Aside from stressors that each of us experience directly, we also share the stress of the people around us. Such empathic stress exists on psychological and physiological levels, including subjective, sympathetic, parasympathetic and endocrine activation. The objective of this review is to offer an overview of methodology over the past fifteen years of empathic stress research and derive practical considerations for future research endeavors in the field. We used a keyword search strategy in the databases Web of Science, PsycInfo and PubMed to find empathic stress studies published until December 2023, and included 17 studies into our review. The reviewed laboratory studies provide initial yet consistent evidence for the existence of empathic stress across different populations, in intimate and stranger dyads, with direct and virtual contact, across multiple levels of the stress system, and based on diverse statistical analysis methods. We discuss all findings and derive practical considerations for future empathic stress research. The diversity of methods established provides a solid foundation upon which future studies can expand.

Treatment effects of conservation trenching on regulating and provisioning ecosystem services.

United Nation Sustainable Development Goal 15.3 make a note of growing significance of management and restoration strategies for degraded land, and advocating globally for collaborative frameworks of innovative applied research and policy. Present study, quantified the impacts of the staggered contour trenching (SCT) technology in conjunction with silvi-pasture production system on regulating and provisioning ecosystem services of degraded mini-watersheds. Impacts of the SCT on hydrologic regulating ecosystem services were quantified by employing the paired watershed approach. Concept of watersheds with and without treatments was employed for computing non-hydrologic regulating and provisioning ecosystem services of the SCT in conjunction with silvi-pasture system. Results of analyses revealed that the SCT density of 505 trenches ha-1 had the highest reduction in the hydrologic regulating services namely, mean annual runoff event, runoff amount and soil loss, which were 35.5, 63.3, and 3.73%, respectively followed by 378, and 186 trenches ha-1. The highest improvement in the effective rainfall (9.9%) and effective rainfall efficiency (15.0%) was also with 505 trenches ha-1. The SCT density of 505 trenches ha-1 had retained silt 23.1 and 1.2 times higher than that of 378 and 186 trenches ha-1. The values of the post-treatment non-hydrologic regulating services of 505 trenches ha-1 were many folds higher compare to other trenching densities. Improvement in the non-hydrologic regulating services of the available -nitrogen, -potash and -potassium, and soil organic carbon values of the post-treatment of 505 trenches ha-1 were 36.7, 44.2, 25.8, and 25.0% than their pre-treatment values, respectively. Provisioning ecosystem services in term of the yields of the wood biomass of the Acacia nilotica and the Cenchrus ciliaris were the highest with 505 trenches ha-1 than the control (no trench) by 166.2 and 21.5%, respectively. Study indicated that 505 trenches ha-1 SCT density in the silvi-pasture production system was the best practices in conserving and maintaining the degraded land ecosystem services. These findings would be very supportive to the policy makers and degraded land managers for reclaiming and improving the sustainability and ecosystem functioning of the degraded land ecosystem for achieving the SDG 5.3 and maintaining the land degradation neutrality.

Parent Views on Parent & Child-reported Outcomes in Pediatric Advanced Cancer: A Qualitative Study.

BACKGROUND: Research on concurrent parent and patient-reported outcomes has primarily focused on reaching agreement. However, little is known about how to interpret and address discrepancies, which are not uncommon, between both viewpoints. OBJECTIVES: To explore parents' perspectives on reporting about child symptoms and quality of life (QoL) concurrently with their child in the context of pediatric advanced cancer. METHODS: This qualitative study was embedded in the PediQUEST Response Study, a randomized controlled trial of timely palliative care integration in children with advanced cancer. Over 18 weeks, study dyads (children ≥5 years old and one parent) completed weekly e-PROs assessing symptoms and QoL. Using a grounded theory approach, we ran a secondary analysis of end-of-study semi-structured parent interviews to examine their views on concurrent reporting of symptoms. RESULTS: Out of 110 randomized dyads included in this analysis, 77 parents completed an exit interview. Most were White non-Hispanic mothers. Parent reflections on concurrent reporting of child symptoms and QoL are summarized in the following themes: symptom experience is subjective, parent and child viewpoints are unique, parents ask fewer questions as they adapt to child treatment, and children may hesitate to share symptoms. To better grasp their child's experience, parents developed proactive communication strategies. CONCLUSION: Interviewed parents acknowledged that parent report and child self-report are distinct and complementary. Their perspectives provide guidance to clinicians and researchers about the implementation and interpretation of concurrent outcomes measurement in pediatric advanced cancer care.

Time Series Methods to Assess the Impact of Regulatory Action: A Study of UK Primary Care and Hospital Data on the Use of Fluoroquinolones.

PURPOSE: To illustrate the interest in using interrupted time series (ITS) methods, this study evaluated the impact of the UK MHRA's March 2019 Risk Minimisation Measures (RMM) on fluoroquinolone usage. METHODS: Monthly and quarterly fluoroquinolone use incidence rates from 2012 to 2022 were analysed across hospital care (Barts Health NHS Trust), primary care (Clinical Practice Research Datalink (CPRD) Aurum and CPRD GOLD), and linked records from both settings (East Scotland). Rates were stratified by age (19-59 and ≥ 60 years old). Seasonality-adjusted segmented regression and ARIMA models were employed to model quarterly and monthly rates, respectively. RESULTS: Post-RMM, with segmented regression, both age groups in Barts Health experienced nearly complete reductions (> 99%); CPRD Aurum saw 20.19% (19-59) and 19.29% ( ≥ $$ \ge $$ 60) reductions; no significant changes in CPRD GOLD; East Scotland had 45.43% (19-59) and 41.47% ( ≥ $$ \ge $$ 60) decreases. Slope analysis indicated increases for East Scotland (19-59) and both CPRD Aurum groups, but a decrease for CPRD GOLD's ≥ $$ \ge $$ 60; ARIMA detected significant step changes in CPRD GOLD not identified by segmented regression and noted a significant slope increase in Barts Health's 19-59 group. Both models showed no post-modelling autocorrelations across databases, yet Barts Health's residuals were non-normally distributed with non-constant variance. CONCLUSIONS: Both segmented regression and ARIMA confirmed the reduction of fluoroquinolones use after RMM across four different UK primary care and hospital databases. Model diagnostics showed good performance in eliminating residual autocorrelation for both methods. However, diagnostics for hospital databases with low incident use revealed the presence of heteroscedasticity and non-normal white noise using both methods.

Wechsler Adult Intelligence Scale - IV México versus U.S. versions in the assessment of Mexican Americans.

OBJECTIVE: To delineate score differences between the Wechsler Adult Intelligence Scale-IV (WAIS-IV) and the WAIS-IV México in the assessment of balanced bilingual Mexican Americans and to determine the efficacy of five hold measures in predicting summary scores in each version. METHODS: Hold measures were WAIS-IV Information, Vocabulary, and Matrix Reasoning subtests, picture vocabulary, and the Test of Premorbid Function (English)/Word Accentuation Test (Spanish). Using a repeated measures design, 60 neurologically intact participants were tested in a counterbalanced order, with WAIS-IV version as the repeated measure (mean intertest interval = 5.68 days). To minimize practice effects, the five visual-perceptual subtests, which contain the same items in each version, were administered only once during the initial session. RESULTS: All mean WAIS-IV México index/subtest scores were significantly higher than the U.S. equivalents (Full-Scale IQ by about .5 SD). Unexpectedly, most (83%) participants educated in the US to at least a high school level had numerically equal or higher scores on the U.S. version. Means on WAIS-IV language format indices/subtests were lower than those of visual-perceptual format indices/subtests within both versions (excepting Processing Speed Index/subtests in the U.S. version). All hold measures significantly predicted WAIS-IV summary scores for the U.S. version. Similarly for the México version, except for the Word Accentuation Test. CONCLUSIONS: When evaluating a balanced bilingual Mexican American, opting for the WAIS-IV México version will yield higher scores across the Full-Scale IQ, indices, and all core subtests unless the patient was educated in the US to at least a high school level.

Investigating the long-term outcomes and efficacy of surgical intervention in patients with adolescent idiopathic scoliosis and Cobb angles ranging between 40 and 50 degrees.

PURPOSE: Patients with adolescent idiopathic scoliosis (AIS) are either managed with non-operative strategies or surgery depending on the severity of lateral curvature and impact on quality of life. However, supportive evidence for the appropriate treatment approach is lacking in AIS patients with Cobb angles between 40 and 50 degrees. Therefore, we investigated differences in long-term patient-centered outcomes in AIS patients with Cobb angles between 40 and 50 degrees who received either operative or non-operative management. METHODS: A total of 919 patients aged 10-21 years old with adolescent idiopathic scoliosis and 40-50 degree Cobb angles were identified from the HARMS Study Group (HSG) registry and dichotomized based on operative or non-operative management. Baseline and 2 year follow-up SRS-22 scores from these patients were analyzed for significant differences between the total score values, domain values, and the magnitude of score change over time using multiple comparisons analyses. Multivariable regressions adjusting for age, body mass index, location of spinal deformity, and management strategy were also performed. RESULTS: Operative versus non-operative strategy was significantly, independently associated with differences in SRS-22 total and domain scores over time (effect likelihood ratio test, p < 0.03 for all regressions). Operatively managed patients had significantly greater improvement in SRS-22 total and domain scores over the follow-up duration compared to non-operatively managed patients (p < 0.02 for all comparisons). CONCLUSIONS: This preliminary analysis suggests that operatively managed patients may have had better long-term outcomes than non-operatively managed patients within this AIS subpopulation. These findings support the need for further prospective investigation to determine the optimal management strategy to improve evidence-based, patient-reported outcomes for AIS patients with Cobb angles between 40 and 50 degrees. LEVEL OF EVIDENCE: Level III.

Cognitive reserve in individuals with frontotemporal dementia: a systematic review.

As the literature related to cognitive reserve (CR) in individuals with frontotemporal dementia (FTD) is only emerging, a clear consensus on the relationship among CR proxies, brain status, and clinical performance has not been reached. The primary aim of this systematic review was to examine the relationship among sociobehavioral proxies of CR, brain status, and clinical performance in individuals with various types of FTD. Additionally, characteristics of patient population, sociobehavioral proxies, disease severity tools, and brain status measures used were identified. The systematic review was conducted using comprehensive search terms in Medline, PsychINFO, PubMed, and Web of Science. Eligibility criteria were for studies to include at least one CR and one brain status measure for individuals with FTD, be published in a peer-reviewed journal, and be published in English. The Newcastle-Ottawa Quality Assessment Scale was used to assess study quality and bias risk. A total of 237 titles and abstracts were screened, with 13 studies meeting inclusion criteria. Together, these studies report 1,423 participants with FTD. Based on the included studies, partial support was demonstrated for CR in individuals with FTD when education, occupation, and leisure were utilized as CR proxies. The variability in results among studies could be related to the different tools used to measure CR, brain status, and disease severity. This review provides recommendations for future studies: incorporating longitudinal designs, in depth neuropsychological testing, consistent disease duration measure, and transparant statistical output reporting.

The impact of institutional measures on optimal use of intravenous immunoglobulin.

BACKGROUND: Intravenous immunoglobulin (IVIG) shortage represents an emerging issue in transfusion medicine. Limited data are available to determine effective strategies for optimal use. The objective of this retrospective observational study was to determine the impact of institutional measures on IVIG use at a large academic center. METHODS: IVIG infusions from November 26, 2018 to September 25, 2022 were categorized according to their appropriateness (Recommended, Option of treatment, or Unrecommended), based on provincial guidelines, and separated into three phases: Reference, Transition, and Post-Implementation phases, the latter following the adoption of restrictive measures, including mandatory standardized order forms, a blood bank gatekeeping strategy, and the creation of a stewardship committee. RESULTS: A total of 5431 IVIG infusions were administered to 544 patients, accounting for 295,033 g. The most common indication categories were neurology (30.4%), immunology (29.0%), and hematology (17.4%). From Reference to Post-Implementation phase, IVIG infusions decreased from 2275 to 2000 with unrecommended indications dropping from 9.5% to 7.4% (p = 0.01), and a global reduction of 23.0% (from 131,163 g to 100,936 g of IVIG). Decrease in chronic immunomodulation accounted for 48.3% of total reduction (14,610 g of 30,227 g), whereas single-use immunomodulation, 40.5% (12,237 g of 30,227 g). Moreover, an absolute reduction of 16.9% was observed in orders exceeding the recommended doses (20.8% to 3.9%; p < 0.0001). Together, the unrecommended and excessive IVIG doses decreased from 19,975 g (15.2%) to 6670 g (6.6%). CONCLUSIONS: A global reduction in IVIG use and a preferential decrease in the unrecommended orders were observed, most likely attributable to the bundle of restrictive strategies implemented.

How Late Nights Influence Brain Cortical Structures: Distinct Neuroanatomical Measures Associated With Late Chronotype in Young Adults.

Chronotype is an inherent physiological trait reflecting an individual's subjective preference for their sleep awakening time, exerting a substantial influence on both physical and mental well-being. While existing research has established a close relationship between chronotype and individual brain structure, prior studies have predominantly focused on individual measurements of brain structural scales, thereby limiting the exploration of the underlying mechanisms of structural changes. This study seeks to validate previous research findings and enhance our understanding of the correlation between circadian rhythm preference and diverse cortical indicators in healthy young individuals. Magnetic resonance imaging (MRI) scans and chronotype assessments were conducted once for all participants, comprising 49 late chronotype (LC) young adults and 49 matched early chronotype young adults. The Chronotype Questionnaire was utilized to assess morningness and eveningness preferences. Surface-based analysis of structural MRI data revealed that LC young adults exhibited thinner cortical thickness of left pars orbitalis and lower cortical mean curve of right paracentral gyrus. Overall, this study represents a significant advancement in elucidating the connection between brain structure and function within the context of chronotypes.

Agreement between patient-reported and clinician-rated speech and swallowing outcomes - Understanding the trend in post-operative oral cavity cancer patients.

AIM: To find the agreement between clinician-rated and patient-reported speech and swallowing outcomes in post-operative oral cavity cancer patients. METHODS: In this prospective observational study, a total of 53 post-operative oral cavity cancer patients were recruited. The Speech Handicap Index - Kannada (SHI-K) and the Dysphagia Handicap Index - Kannada (DHI-K) were used as the patient-reported outcome measures (PROMs), and the Mann Assessment of Swallowing Ability-Cancer (MASA-C) and Ali Yavar Jung National Institute of Speech & Hearing Disabilities (DIVYANGJAN) AYJNISHD(D)'s speech intelligibility rating scale were used as the clinician-rated scales to evaluate speech and swallowing status. RESULTS: Intraclass correlation coefficient (ICC) was poor, with a value of 0.480 between clinician-rated speech AYJNISHD(D)'s scale and patient-reported SHI-K scale. ICC was poor, with a value of 0.471 between clinician-rated swallowing MASA-C and patient-reported swallowing DHI-K. CONCLUSION: In our study, there was no agreement between patient-reported and clinician-rated speech and swallowing outcomes in post-operative oral cavity cancer patients. Incorporating PROMs into routine clinical practice is advisable, and clinicians need to balance PROMs with clinical and instrumental speech and swallowing assessments to ensure comprehensive care.

Doppler ultrasound, a noninvasive tool for the study of mesenteric arterial flow in systemic sclerosis: a cross-sectional study of a patient cohort with review and meta-analysis of the literature.

Gastrointestinal involvement (GI) is a frequent and troublesome complication of systemic sclerosis (SSc), whose etiology is poorly understood, though it is hypothesized that autoimmunity and progressive vasculopathy may play a role. Vasculopathy is considered one of the main pathogenetic pathways responsible for many of the clinical manifestations of SSc, and, therefore, studying the principal splanchnic vessels (i.e., superior mesenteric artery-SMA and inferior mesenteric artery-IMA) with Doppler Ultrasound (DUS) may provide further insights into measuring the progression of vasculopathy, evaluating its possible association with SSc GI symptoms, and determining whether it plays a role in the development or severity of SSc GI disease. A cohort of SSc patients consecutively recruited underwent DUS examination, and associations with GI (UCLA-GIT 2.0 questionnaire) and extraintestinal SSc characteristics were evaluated. Semiquantitative DUS parameters (resistive index-RI and pulsatility index-PI), were applied for splanchnic vessel assessment in SSc patients and healthy subjects (HS). Moreover, a review and meta-analysis of the literature to understand which the values of the main semiquantitative DUS parameters (RI and PI) are both in SSc patients and HS has been conducted. Seventy-eight patients completed DUS examinations and clinical assessments. 30 (39%) were classified as diffuse cutaneous SSc (dcSSC), 35 (45%) as limited cutaneous SSc (lcSSc) and 13 (17%) as sine scleroderma. A significant difference was found both for SMA RI (p for trend = 0.032) and SMA PI (p for trend = 0.004) between patients with sine scleroderma, lcSSc and dcSSc, with lower values observed in the sine scleroderma and lcSSc groups. IMA RI and PI were significantly correlated with GI symptoms such as fecal incontinence (á¿¥ - 0.33, p = 0.008 and á¿¥ - 0.30, p = 0.021, respectively). By multivariate analysis, significant associations were confirmed between SMA RI and SMA PI and mRSS (ß 0.248, p = 0.030 and ß 2.995, p = 0.004, respectively) and with bosentan (ß 0.400, p = 0.003 and ß 3.508, p = 0.001, respectively), but not with anticentromere antibody (ACA). No significant differences were found between the weighted median values of SMA RI and SMA PI of SSc patients compared to those of HS that were derived from the meta-analysis of the literature (p = 0.72 and p = 0.64, respectively). This cross-sectional study confirms that the splanchnic vasculature of SSc patients can noninvasively been studied with DUS. Vascular splanchnic involvement correlates with the presence and/or severity of specific clinical features in SSc, including GI. Larger and prospective studies are needed to confirm these preliminary observations and to examine the role of DUS in SSc-risk stratification and GI progression and to obtain definitive data regarding both HS and SSc patients splanchnic DUS parameters.

Kinect-Based Gait Analysis System Design and Concurrent Validity in Persons with Anterolateral Shoulder Pain Syndrome, Results from a Pilot Study.

As part of an investigation to detect asymmetries in gait patterns in persons with shoulder injuries, the goal of the present study was to design and validate a Kinect-based motion capture system that would enable the extraction of joint kinematics curves during gait and to compare them with the data obtained through a commercial motion capture system. The study included eight male and two female participants, all diagnosed with anterolateral shoulder pain syndrome in their right upper extremity with a minimum 18 months of disorder evolution. The participants had an average age of 31.8 ± 9.8 years, a height of 173 ± 18 cm, and a weight of 81 ± 15 kg. The gait kinematics were sampled simultaneously with the new system and the Clinical 3DMA system. Shoulder, elbow, hip, and knee kinematics were compared between systems for the pathological and non-pathological sides using repeated measures ANOVA and 1D statistical parametric mapping. For most variables, no significant difference was found between systems. Evidence of a significant difference between the newly developed system and the commercial system was found for knee flexion-extension (p < 0.004, between 60 and 80% of the gait cycle), and for shoulder abduction-adduction. The good concurrent validity of the new Kinect-based motion analysis system found in this study opens promising perspectives for clinical motion tracking using an affordable and simple system.

Recommended Physiotherapy Modalities for Oncology Patients with Palliative Needs and Its Influence on Patient-Reported Outcome Measures: A Systematic Review.

BACKGROUND: This review aims to explore the role of physiotherapy in early and traditional palliative care (PC) for oncology patients, focusing on its impact on six patient-reported outcomes (PROMs), namely fatigue, pain, cachexia, quality of life (QoL), physical functioning (PHF), and psychosocial functioning (PSF). The purpose is to assess the effectiveness of various physiotherapy interventions and identify gaps in the current research to understand their potential benefits in PC better. METHODS: A systematic literature search was conducted across PubMed, Embase, and Web of Science, concluding on 21 December 2023. Two independent reviewers screened the articles for inclusion. The Cochrane Risk of Bias Tool 2 was employed to assess the risk of bias, while the GRADE approach was used to evaluate the certainty of the evidence. RESULTS: Nine randomized controlled trials (RCTs) were included, with most showing a high risk of bias, particularly in outcome measurement and missing data. Cognitive behavioral therapy (CBT) was the only intervention that significantly reduced fatigue, enhanced PHF, and improved QoL and emotional functioning. Graded exercise therapy (GET) did not yield significant results. Combined interventions, such as education with problem-solving or nutritional counseling with physical activity, showed no significant effects. Massage significantly improved QoL and reduced pain, while physical application therapies were effective in pain reduction. Mindful breathing exercises (MBE) improved QoL but had a non-significant impact on appetite. The overall certainty of the evidence was low. CONCLUSIONS: Physiotherapy can positively influence PROMs in oncology PC; however, the low quality and high risk of bias in existing studies highlight the need for more rigorous research to confirm these findings and guide clinical practice.