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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.
Subject(s)
Air Pollutants , Air Pollution , Environmental Monitoring , Particulate Matter , Vehicle Emissions , Vehicle Emissions/analysis , China , Air Pollutants/analysis , Air Pollution/prevention & control , Air Pollution/statistics & numerical data , Environmental Monitoring/methods , Particulate Matter/analysis , Motor VehiclesABSTRACT
The microstructure and mechanical properties of coal measure rocks (CMR) are critical factors in the successful geological storage of CO2. While previous research has predominantly focused on coal seams, the overlying and underlying bedrock strata are equally significant yet often overlooked. This study addresses this gap by selecting coal and adjacent strata from the Twelve Mine as representative samples. A comprehensive suite of analyses was conducted, including thin section identification, X-ray diffraction (XRD), nuclear magnetic resonance (NMR), uniaxial compression, and acoustic emission tests. These analyses were used to determine the mineralogical composition and pore structure characteristics of the CMR, elucidate the mechanical failure mechanisms of different CMR types, and explore the relationships between rock strength, mineral composition, and pore characteristics. The findings indicate that the primary minerals in coal are clay minerals, while mudstone is composed predominantly of clay minerals and quartz, sandstone is rich in quartz and feldspar, and limestone contains significant amounts of calcite. The porosity of CMR varies between 1.73â¯% and 10.12â¯%, with 82.72â¯% of the pores being micro- to mesopores and the remaining 17.28â¯% being macropores. The pore structures exhibit fractal characteristics, with the fractal dimension of mesopores ranging from 2.581 to 2.902, and that of macropores from 2.968 to 2.997. Coal predominantly fails through a combination of tensile and shear failure mechanisms, mudstone and limestone through tensile failure, and sandstone through shear failure. Furthermore, the results suggest that rock strength is positively correlated with quartz content and negatively correlated with kaolinite content and porosity. In terms of their influence on coal rock strength, the factors in descending order of impact are kaolinite, quartz, calcite, microporosity, macroporosity, dolomite, and mesoporosity. Thus, while the mechanical properties of these rocks are primarily governed by their mineralogical composition, the pore structure also plays a significant role.
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The cosmetic industry is now changing or rather having an ecological transition in which formulations such as creams, lotions, and powders for make-up, skin and hair care must not contain microplastics, now a taboo word in this field. Nowadays, many companies are intensifying their research and development work to align with recent and future legislation that provides for their elimination to safeguard the ecosystem. The production of new eco-sustainable materials is currently a hot topic which finds its place in a market worth above 350 billion dollars which will reach more than 700 billion dollars in a short time. This review offers an overview of the main advantages and adverse issues relating to the use of microplastics in cosmetics and of their impact, providing an insight into the properties of the polymeric materials that are currently exploited to improve the sensorial characteristics of cosmetic products. In addition, the various regulatory restrictions in the different geographical areas of the world are also described, which is matter for reflection on future direction. Finally, a prospective vision of possible solutions to replace microplastics with sustainable alternatives complete the picture of the next generation personal care products to support decision-making in the cosmetic marketplace.
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BACKGROUND: One-fourth of men older than 70 years have lower urinary tract symptoms (LUTS) that impair their quality of life. Transurethral resection of the prostate (TURP) is considered the gold standard for surgical treatment of LUTS caused by benign prostatic hyperplasia (BPH) that cannot be managed conservatively or pharmacologically. However, TURP is only an option for patients fit for surgery and can result in complications. Transurethral microwave thermotherapy (TUMT) and prostatic artery embolisation (PAE) are alternative minimally invasive surgical therapies (MISTs) performed in an outpatient setting. Both treatments have shown to reduce LUTS with a similar post-procedure outcome in mean International Prostate Symptom Score (IPSS). It is however still unknown if TUMT and PAE perform equally well as they have never been directly compared in a randomised clinical trial. The objective of this clinical trial is to assess if PAE is non-inferior to TUMT in reducing LUTS secondary to BPH. METHODS: This study is designed as a multicentre, non-inferiority, open-label randomised clinical trial. Patients will be randomised with a 1:1 allocation ratio between treatments. The primary outcome is the IPSS of the two arms after 6 months. The primary outcome will be evaluated using a 95% confidence interval against the predefined non-inferiority margin of + 3 points in IPSS. Secondary objectives include the comparison of patient-reported and functional outcomes at short- and long-term follow-up. We will follow the patients for 5 years to track long-term effect. Assuming a difference in mean IPSS after treatment of 1 point with an SD of 5 and a non-inferiority margin set at the threshold for a clinically non-meaningful difference of + 3 points, the calculated sample size was 100 patients per arm. To compensate for 10% dropout, the study will include 223 patients. DISCUSSION: In this first randomised clinical trial to compare two MISTs, we expect non-inferiority of PAE to TUMT. The most prominent problems with MIST BPH treatments are the unknown long-term effect and the lack of proper selection of candidates for a specific procedure. With analysis of the secondary outcomes, we aspire to contribute to a better understanding of durability and provide knowledge to guide treatment decisions. TRIAL REGISTRATION: ClinicalTrials.gov NCT05686525. Registered on January 17, 2023, https://clinicaltrials.gov/study/NCT05686525 .
Subject(s)
Embolization, Therapeutic , Equivalence Trials as Topic , Lower Urinary Tract Symptoms , Prostate , Prostatic Hyperplasia , Humans , Male , Prostatic Hyperplasia/complications , Prostatic Hyperplasia/therapy , Embolization, Therapeutic/methods , Embolization, Therapeutic/adverse effects , Lower Urinary Tract Symptoms/etiology , Lower Urinary Tract Symptoms/therapy , Lower Urinary Tract Symptoms/diagnosis , Treatment Outcome , Prostate/blood supply , Time Factors , Microwaves/therapeutic use , Microwaves/adverse effects , Transurethral Resection of Prostate , Severity of Illness Index , Hyperthermia, Induced/methods , Quality of Life , Randomized Controlled Trials as Topic , Multicenter Studies as Topic , AgedABSTRACT
BACKGROUND: Medication Treatment Satisfaction (M-TS) from the patients' perspective is important for comprehensively evaluating the effect of medicines. The extent to which current patient-reported outcome measures (PROMs) for M-TS are valid, reliable, responsive, and interpretable remains unclear. To assess the measurement properties of existing PROMs for M-TS and to highlight research gaps. METHODS: Using PubMed, Embase (Ovid), Cochrane library (Ovid), IPA (Ovid), PsycINFO, Patient-Reported Outcome and Quality of Life Questionnaires biomedical databases, and four Chinese databases, we performed a systematic search for studies addressing the development and validation of PROMs for M-TS. Based on the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) guideline, pairs of reviewers independently assessed the measurement properties of the PROMs and rated the quality of evidence on the measurement properties of each PROM. (The Open Science Framework registration: https://doi.org/10.17605/OSF.IO/8S5ZM ). RESULTS: This review identified 69 PROMs for M-TS in 114 studies (four generic, 32 disease-specific, and 33 drug-specific) of which 60 were intended for adults. All provided limited or no information regarding interpretability. Most demonstrated appropriate construct validity including convergent validity (39/69) and discriminative or known-groups validity (40/69) (high to moderate quality of evidence). Only a few provided evidence of sufficient content validity (8/69), structural validity (13/69), and internal consistency (11/69). Of 38 PROMs reporting test-retest reliability, results in 24 provided evidence of satisfactory test-retest reliability (18 with high to moderate, 6 with low to very low quality of evidence). Few PROMs reported responsiveness (16/69). Two generic PROMs (Treatment Satisfaction Questionnaire for Medication initial Version 1.4, TSQM-1.4; Treatment Satisfaction with Medicines Questionnaire, SATMED-Q) and one drug-specific PROM (Insulin Treatment Satisfaction Questionnaire, ITSQ) demonstrated both satisfactory validity and reliability. CONCLUSIONS: Most existing PROMs for M-TS require further exploration of measurement properties. Reporting guidelines are needed to enhance the reporting quality of the development and validation of PROMs for M-TS.
Subject(s)
Patient Reported Outcome Measures , Patient Satisfaction , Humans , Quality of Life , Surveys and Questionnaires , Reproducibility of ResultsABSTRACT
Implicit learning plays an important role in the acquisition of various skills that are often deficient in individuals with autism spectrum disorder (ASD). The present study examines the implicit learning ability of children and adolescents with ASD, by comparing it to that of a typical group of peers, using the Artificial Grammar Learning (AGL) task. Additionally, this study investigates whether the above ability is associated with individual characteristics, namely, intelligence quotient (IQ), ASD symptoms severity, and individual perception style (global/holistic or local/focused). The sample consisted of 20 individuals with mild to relatively severe ASD symptoms and 20 age- and gender-matched typically developing individuals (TD). The unconscious (implicit) nature of learning was assessed via a subjective measure, the "no loss gambling" method, which allows an unbiased evaluation of the confidence accompanying each judgement. The results provided evidence of implicit learning, which was preserved in the ASD group, although reduced relative to the typical group. Multiple linear regressions with interaction terms between Group and participants' scores on the Wechsler Abbreviated Scale of Intelligence (WASI), the Childhood Autism Rating Scale (CARS), and performance on a Navon-type task examined whether the possible relationships between each of the above scores and AGL and implicit learning differ in the two groups. Implicit learning was not significantly associated with IQ, ASD symptoms severity or individual perception style (except for perception style in terms of RTs for the TD group). These results confirm and extend earlier findings supporting the resilience of implicit learning to individual differences.
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Background: Mycoplasma pneumoniae (MP) is a significant cause of community-acquired pneumonia with high macrolide resistance rates. Various COVID-19 pandemic restrictions have impacted the prevalence of MP. Objective: To assess the changes in the pattern of MP infections among children before, during, and after the COVID-19 pandemic. Methods: A total of 36685 enrolled patients, aged 0-18 years, diagnosed with pneumonia and admitted to Children's Hospital of Chongqing Medical University from January 2019 to December 2023, were retrospectively reviewed in this study. The epidemiological characteristics of pediatric MP infection were analyzed. Results: Among 36685 patients, 7610 (20.74%) tested positive for MP. The highest positive rate was observed among children aged over 6 years (55.06%). There was no gender disparity in MP infection across the three phases of the COVID-19 pandemic. Hospital stays were longest for children during the COVID-19 pandemic (P <0.001). MP infection was most prevalent in the summer (29.64%). The lowest positive rate was observed during the pandemic, with the highest rate found after easing the measures across all age groups (P <0.001). There was a surge in the positive rate of MP in the third year after the COVID-19 pandemic. Regression analyses demonstrated a shift in the age range susceptible to MP infection, with children aged 3.8 to 13.5 years post-pandemic compared to the pre-pandemic range of 5.3 to 15.5 years old. Additionally, the average macrolide resistance rate was 79.84%. We observed a higher resistance rate during the pandemic than in the pre- and post-pandemic phases (P <0.001). Conclusion: The restrictive measures implemented during the COVID-19 pandemic have influenced the spread of MP to some extent and altered demographic and clinical characteristics, such as age, age group, season, length of stay, and macrolide resistance. We recommend continuous surveillance of the evolving epidemiological characteristics of MP infection in the post-pandemic period when restrictions are no longer necessary.
Subject(s)
COVID-19 , Mycoplasma pneumoniae , Pneumonia, Mycoplasma , SARS-CoV-2 , Humans , Child , COVID-19/epidemiology , Child, Preschool , China/epidemiology , Female , Male , Infant , Adolescent , Pneumonia, Mycoplasma/epidemiology , Mycoplasma pneumoniae/drug effects , Mycoplasma pneumoniae/isolation & purification , Retrospective Studies , Infant, Newborn , Prevalence , SARS-CoV-2/isolation & purification , Hospitalization/statistics & numerical data , Pandemics , Macrolides/therapeutic use , Drug Resistance, Bacterial , Anti-Bacterial Agents/therapeutic use , Anti-Bacterial Agents/pharmacology , Child, Hospitalized/statistics & numerical data , Seasons , Community-Acquired Infections/epidemiology , Community-Acquired Infections/microbiologyABSTRACT
The 2024 Paris Olympics and Paralympics face concerns over dengue virus transmission, despite Paris's lower mosquito activity. Preventive measures include eliminating breeding sites, insecticide spraying, and public awareness. Health systems will monitor and respond to cases. Large gatherings like the Olympics can amplify disease spread, as seen with Zika in Rio 2016. Recent reports confirm dengue presence in Europe, highlighting global risks. While Paris's overall dengue risk is low, even a few cases could impact global health. Collaboration among health authorities, researchers, and event organizers is crucial to ensure participant and public safety during the games.
Subject(s)
Dengue Virus , Dengue , Sports , Humans , Dengue/epidemiology , Dengue/transmission , Dengue/prevention & control , Paris , Animals , Mosquito ControlABSTRACT
Multi-site diffusion MRI data is often acquired on different scanners and with distinct protocols. Differences in hardware and acquisition result in data that contains site dependent information, which confounds connectome analyses aiming to combine such multi-site data. We propose a data-driven solution that isolates site-invariant information whilst maintaining relevant features of the connectome. We construct a latent space that is uncorrelated with the imaging site and highly correlated with patient age and a connectome summary measure. Here, we focus on network modularity. The proposed model is a conditional, variational autoencoder with three additional prediction tasks: one for patient age, and two for modularity trained exclusively on data from each site. This model enables us to 1) isolate site-invariant biological features, 2) learn site context, and 3) re-inject site context and project biological features to desired site domains. We tested these hypotheses by projecting 77 connectomes from two studies and protocols (Vanderbilt Memory and Aging Project (VMAP) and Biomarkers of Cognitive Decline Among Normal Individuals (BIOCARD) to a common site. We find that the resulting dataset of modularity has statistically similar means (p-value <0.05) across sites. In addition, we fit a linear model to the joint dataset and find that positive correlations between age and modularity were preserved.
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BACKGROUND: There is little guidance available, and no uniform assessment battery is used in either in-person or remote evaluations of people who are experiencing persistent physical symptoms post concussion. Selecting the most appropriate measures for both in-person and remote physical assessments is challenging because of the lack of expert consensus and guidance. OBJECTIVE: This study used expert consensus processes to identify clinical measures currently used to assess 5 physical domains affected by concussion (neurological examination, cervical spine, vestibular, oculomotor, or effort) and determine the feasibility of applying the identified measures virtually. METHODS: The Delphi approach was used. In the first round, experienced clinicians were surveyed regarding using measures in concussion assessment. In the second round, clinicians reviewed information regarding the psychometric properties of all measures identified in the first round by at least 15% (9/58) of participants. In the second round, experts rank-ordered the measures from most relevant to least relevant based on their clinical experience and documented psychometric properties. A working group of 4 expert clinicians then determined the feasibility of virtually administering the final set of measures. RESULTS: In total, 59 clinicians completed survey round 1 listing all measures they used to assess the physical domains affected by a concussion. The frequency counts of the 146 different measures identified were determined. Further, 33 clinicians completed the second-round survey and rank-ordered 22 measures that met the 15% cutoff criterion retained from round 1. Measures ranked first were coordination, range of motion, vestibular ocular motor screening, and smooth pursuits. These measures were feasible to administer virtually by the working group members; however, modifications for remote administration were recommended, such as adjusting the measurement method. CONCLUSIONS: Clinicians ranked assessment of coordination (finger-to-nose test and rapid alternating movement test), cervical spine range of motion, vestibular ocular motor screening, and smooth pursuits as the most relevant measures under their respective domains. Based on expert opinion, these clinical measures are considered feasible to administer for concussion physical examinations in the remote context, with modifications; however, the psychometric properties have yet to be explored. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/40446.
Subject(s)
Brain Concussion , Delphi Technique , Humans , Brain Concussion/diagnosis , Brain Concussion/physiopathology , Male , Psychometrics/methods , Female , Surveys and Questionnaires , Neurologic Examination/methods , Neurologic Examination/standards , AdultABSTRACT
OBJECTIVES: The workplace is an important setting for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure and transmission. Using data from a large case-control study in Colorado during 2021 and 2022, we aimed to evaluate working outside the home and SARS-CoV-2 infection, the racial and ethnic distribution of workers in occupations associated with infection, and workplace face mask use. METHODS: Cases were Colorado adults with a positive SARS-CoV-2 test by reverse transcription-polymerase chain reaction (RT-PCR) reported to Colorado's COVID-19 surveillance system selected from surveillance data ≤12 days after their specimen collection date. Control participants were randomly selected adult Coloradans with a RT-PCR-confirmed negative SARS-CoV-2 test result reported to the same surveillance system. RESULTS: Working outside the home was associated with infection (odds ratio [OR] = 1.46, 95% confidence interval [CI]: 1.39-1.54). Among participants working outside the home, "Food Preparation and Serving Related" (aOR = 2.35, 95% CI: 1.80-3.06), "Transportation and Material Moving" (aOR = 2.09, 95% CI: 1.62-2.69), "Construction and Extraction" (aOR = 1.88, 95% CI: 1.36-2.59), "Protective Service" (aOR = 1.60, 95% CI: 1.15-2.24), and "Sales and Related" (aOR = 1.44, 95% CI: 1.22-1.69) were occupational categories most strongly associated with infection. American Indian/Alaskan Native, Black, and Hispanic/Latino participants were more likely than others to work in occupational categories with the highest odds of infection (p < 0.05). Cases were less likely than controls to report always wearing a mask (31.9% vs. 41.5%) and wearing a KN95/N95/KF94 mask (16.8% vs. 27.2%) at work. CONCLUSIONS: These findings emphasize the importance of occupation and workplace mask use in the COVID-19 pandemic and its disproportionate racial/ethnic impact on workers.
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Introduction: Robotic total knee arthroplasty (rTKA), with its purported advantages of more accurate alignment, greater functional outcomes and patient satisfaction, is gaining popularity in patients undergoing TKA. The purpose of our study was to compare these parameters along with gait pattern and kneeling ability in a cohort of patients who underwent simultaneous TKA with manual instrumentation (mTKA) and rTKA in contralateral knees at a 1-year follow-up. Methods: This was a retrospective review of 135 consecutive patients who underwent simultaneous bilateral TKA using robotic assistance on one side and manual instrumentation on the contralateral side between January 2022 and June 2022. The target alignment in both cohorts was adjusted mechanical. Patients were followed up at 3, 6 and 12 months to assess and compare alignment, range of motion (ROM) and patient-reported outcome measures (PROM) data. Gait parameters and kneeling ability were assessed at 1-year follow-up. Results: While adjusted mechanical alignment was achieved in all rTKA patients, we recorded five outliers (≥3° with relation to 180° HKA axis) in the mTKA cohort (three varus and two valgus). There were no significant differences between both cohorts with regards to ROM, PROM scores, gait analysis parameters and kneeling ability at 1-year follow-up. Conclusion: rTKA helps in achieving the adjusted mechanical alignment more consistently than mTKA. This, however, does not contribute to better functional outcomes and patient satisfaction at 1-year follow-up. Level of Evidence: Level III.
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Introduction: Stroke-induced upper limb disabilities can be characterized by both motor impairments and activity limitations, commonly assessed using Fugl-Meyer Motor Assessment for Upper Extremity (FMMA-UE) and Action Research Arm Test (ARAT), respectively. The relationship between the two assessments during recovery is largely unstudied. Expectedly they diverge over time when recovery of impairment (restitution) plateaus, but compensation-driven improvements still occur. The objective of this study is to evaluate the alignment between FMMA-UE and ARAT in defining upper limb functional recovery categories by ARAT scores. We aimed to establish cut-off scores for both measures from the acute/early subacute, subacute and chronic stages of stroke recovery. Methods: Secondary analysis of four prospective cohort studies (acute/early subacute: n = 133, subacute: n = 113, chronic: n = 92) stages post-stroke. Receiver operating characteristic curves calculated the area under the curve (AUC) to establish optimal FMMA-UE cut-offs based on predefined ARAT thresholds distinguishing five activity levels from no activity to full activity. Weighted kappa was used to determine agreement between the two assessments. We used minimally clinically important difference (MCID) and minimal detectable change (MDC95) for comparison. Results: FMMA-UE and ARAT scores showed no relevant divergence across all recovery stages. Results indicated similar cut-off scores in all recovery stages with variability below MCID and MDC95 levels. Cut-off scores demonstrated robust AUC values from 0.77 to 0.86 at every recovery stage. Only in highly functional patients at the chronic stage, we found a reduced specificity of 0.55. At all other times sensitivity ranged between 0.68 and 0.99 and specificity between 0.71 and 0.99. Weighted kappa at the acute/early subacute, subacute and chronic stages was 0.76, 0.83, and 0.81, respectively. Discussion: Our research shows a strong alignment between FMMA-UE and ARAT cut-off scores throughout stroke recovery, except among the subgroup of highly recovered patients at the chronic stage. Discrepancies in specificity potentially stem from fine motor deficits affecting dexterity outcomes that are not captured by FMMA-UE. Additionally, the high congruence of both measures suggests they are not suited to distinguish between restitution and compensation. Calling for more comprehensive assessment methods to better understand upper limb functionality in rehabilitation.
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BACKGROUND: The Activities-specific Balance Confidence Scale was developed for testing the balance confidence of elderly individuals, and it has been used extensively for evaluating various patients. No such scale has been adapted for the Hungarian population. OBJECTIVE: To translate and culturally adapt the Activities-specific Balance Confidence Scale and test the reliability and validity of the Hungarian version. METHODS: The study included 167 independently mobile subjects, of whom 39 filled in the questionnaire twice, 1 week apart. Beaton's six-step principle was applied for cross-cultural adaptation. Reliability was assessed by internal consistency measured by Cronbach's alpha and through test-retest analysis. Types of validity evaluated were concurrent validity using the Berg Balance Scale and cross-cultural validity. RESULTS: Excellent internal consistency was shown by Cronbach's alpha = 0.977. Test-retest analysis resulted in an Intra-Class Correlation Coefficient of 0.962 (0.865-0.961, 95% CI, p < .001) for the whole test; no floor or ceiling effects were found. The convergent validity of the scale was tested by Spearman's rank correlation analysis using the Berg Balance scale for external validation and showed a strong positive correlation (Rho = 0.755, p < .001). Receiver Operating Characteristic curve analysis showed an Area Under the Curve of 0.821 (CI 95% 0.75, 0.892). Mean detectable change based on the 95% confidence interval was 10.49% on the scale ranging from 0 to 100%. CONCLUSIONS: The Hungarian version of the Activities-Specific Balance Confidence Scale provides a valid and reliable picture of the patients' self-assessed balance. It is recommended both for clinicians and for clinical studies.
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BACKGROUND: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy that occurs when the median nerve is compressed within the carpal tunnel. Electromyography (EMG) is accepted as the most frequently used and important diagnostic method for CTS. Recently, magnetic resonance imaging (MRI) has begun to be used in CTS patients to directly visualize the median nerve and examine the changes occurring in the nerve structure. OBJECTIVES: In this study, the area of the median nerve was measured at various levels in the wrist in patients with CTS using MRI, examining its relationship with signal increase, and comparing this to results obtained with EMG. MATERIAL AND METHODS: Overall, 35 patients diagnosed with CTS were included in the study. Patients with normal-mild and moderate-severe EMG tests were included in the study; wrist MRI was taken to investigate the area/mm2 of the median nerve at various levels and whether there was an increase in signal. Thenar muscles included in the imaging were also evaluated. RESULTS: Of the 35 patients included in the study, 24 were women (68.6%) and 11 were men (31.4%). Measurements of the average median nerve area measured in mm2 at the distal radioulnar junction (DRUJ) and the median nerve area measured in mm2 at the hamate bone level were obtained, showing that DRUJ and hamate bone distance measurements were higher in patients with positive EMG. Electromyography findings were also significantly positive in patients with increased signal. CONCLUSIONS: In some cases, the diagnosis of CTS can be easily made with history and physical examination or employing confirmatory tests such as EMG, which is considered the gold standard. Magnetic resonsnace imaging can be used as an alternative method for imaging the median nerve in patients with CTS. In our study, EMG findings were also significantly positive in patients with increased signal on MRI, making it a preferable method, especially in soft tissue-related pathological cases.
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BACKGROUND: Musculoskeletal injuries are prevalent in the NBA and are associated with a significant number of games missed. There is a lack of reference data for clinical measures in NBA players, making it difficult for sports medicine professionals to set goals and develop programs. HYPOTHESIS: Values for clinical measures in NBA players will differ from those of the general population but will not differ between dominant (D) and nondominant (ND) limbs. STUDY DESIGN: Descriptive laboratory study. LEVEL OF EVIDENCE: Level 3. METHODS: Clinical measures were taken on 325 players invited to NBA training camp (2008-2022). Measures included range of motion for great toe extension, hip rotation, weightbearing ankle dorsiflexion, flexibility, arch height (AH) indices, and tibial varum. RESULTS: Clinical values for NBA players differ from reference norms of the general population. Results for NBA players include great toe extension (D, 40.4°; ND, 39.3°), 90/90 hamstring (D, 41.5°; ND, 40.9°), hip internal rotation (D, 29.0°; ND, 28.8°), hip external rotation (D, 29.7°; ND, 30.9°), total hip rotation (D, 60.2°; ND, 60.4°), Ely (D, 109.9°; ND, 108.8°), AH difference (D, 0.5 mm; ND, 0.5 mm), AH index (D, 0.310; ND, 0.307), arch stiffness (D, 0.024; ND, 0.024), arch rigidity (D, 0.924; ND, 0.925), tibial varum (D, 4.6°; ND, 4.5°), and weightbearing ankle dorsiflexion (D, 35.4°; ND, 35.6°). Descriptive statistics are presented; 2-tailed paired t tests show that, whereas most measures demonstrated differences between sides, the results were not statistically significant. CONCLUSION: Clinical measures of NBA players differ from those reported for the general population and athletes of other sports although there were no statistically significant differences between D and ND limbs. CLINICAL RELEVANCE: Establishing a reference database may help clinicians develop more sensitive and more effective preseason and return-to-play screening processes, aiding the management of player orthopaedic care and reducing injury risk.
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OBJECTIVES: This paper describes the changes made to the collection of cognitive measures when the National Social Life, Health, and Aging Project (NSHAP) introduced remote modes of data collection. METHODS: In Round 4 (2021-23), the longitudinal study transitioned from being conducted in-person to collecting data via multiple modes including in-person and remote modes: web, phone, and paper-and-pencil. The team began with the measures used in Rounds 2 and 3 of NSHAP-the survey-adapted Montreal Cognitive Assessment (MoCA-SA)-and evaluated which measures could be administered remotely, introducing new measures for each cognitive subdomain, as needed, to compensate for items that could not be administered remotely. RESULTS: Cognitive items used in Rounds 2 and 3 that could not be administered remotely were dropped from the respective modes, and items selected from the Rush Alzheimer's Disease Center's (RADC) global cognition battery were added as substitutes. For comparison, the RADC substitute items were added to the in-person mode making it longer in R4. DISCUSSION: The changes in cognitive measures resulted in different numbers of cognitive items across the four modes of survey administration in Round 4. Analysts should be aware of these changes when creating a single global cognition score for the entire NSHAP sample in Round 4, and aware that there may be mode effects that could impact cognition scores.
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OBJECTIVES: Idiopathic Inflammatory Myopathies (IIM) are rare and characterized by heterogeneous manifestations and clinical trajectories. Utilizing tele-research methods has the potential to improve participant recruitment and advance the understanding of the disease. We aimed to evaluate disease characteristics in IIM patients throughout the U.S. and compare these parameters between patients recruited remotely through mobile application or website vs those recruited locally in myositis clinics. METHODS: "Myositis Patient Centered Tele-Research" (My PACER) is a multicentre prospective observational study of U.S. IIM subjects, competitively recruited through traditional in-person clinic visits (Center-Based Cohort [CBC]), and remotely using mobile application or website and social media (Tele-Research Cohort [TRC]). Data collection comprised baseline demographic and clinical variables, encompassing symptoms, organ involvement, diagnostic tests results and medication use. RESULTS: The study included 120 IIM patients, 82 in the TRC and 38 in the CBC. The average age was 55 ± 13.4, 75% females and 81% Caucasians. Both cohorts exhibited similar demographic characteristics. Overall, 41% dermatomyositis, 27% polymyositis, 23% anti-synthetase syndrome, and 9% necrotizing myositis patients were enrolled, with comparable subtypes prevalence among cohorts (p= 0.85). The groups demonstrated similarities in multiple clinical factors, including muscle enzymes, diagnostic delay, employment status, various patient and physician-reported outcomes, functional tests, and the frequency of abnormal findings in chest CT, pulmonary function tests, and electromyography. TRC patients received biologics and csDMARDs more frequently (p< 0.001 and p= 0.013, respectively). CONCLUSION: Tele-research recruitment yielded a patient cohort resembling traditionally recruited patients demographically and clinically, indicating its effectiveness for robust and diverse patient recruitment in clinical studies.
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Transient synovitis (TS) is a self-limiting inflammatory condition of the joints, predominantly affecting children and characterized by symptoms such as pain, swelling, warmth, and erythema. It is often triggered by an immune response to a viral infection, leading to acute inflammatory arthritis. Diagnosis involves a combination of patient history, physical examinations, imaging techniques, and laboratory tests, although there are no specific laboratory tests for TS. Treatment primarily consists of symptom management through rest, analgesics, and nonsteroidal anti-inflammatory drugs. The condition underscores the importance of distinguishing TS from more serious joint diseases to prevent unnecessary interventions and to ensure appropriate management.
Subject(s)
Synovitis , Humans , Synovitis/diagnosis , Synovitis/etiology , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Diagnosis, DifferentialABSTRACT
Medicinal plants play a pivotal role in traditional medicine and modern pharmacology due to their various bioactive compounds. However, heat stress caused by climate change will seriously affect the survival and quality of medicinal plants. In this review, we update our understanding of the research progress on medicinal plants' response mechanisms and control measures under heat stress over the last decade. This includes physiological changes, molecular mechanisms, and technical means to improve the heat tolerance of medicinal plants under heat stress. It provides a reference for cultivating heat-resistant varieties of medicinal plants and the rational utilization of control measures to improve the heat resistance of medicinal plants.