Early fever in patients with primary intracerebral hemorrhage is associated with worse long-term functional outcomes: a prospective study.

BACKGROUND: Primary intracerebral hemorrhage (ICH) accounts for 85% of ICH cases and is associated with high morbidity and mortality rates. Fever can cause secondary injury after ICH; however, relevant studies have reported inconsistent results regarding the effects of fever on functional outcomes after ICH. This study examined the effects of early fever on the prognosis of ICH, particularly on long-term functional outcomes. METHODS: This prospective study recruited patients with primary ICH at a tertiary medical center between 2019 and 2021. Early fever was defined as a tympanic body temperature of ≥ 38 °C upon admission. Barthel Index (BI) and modified Rankin scale (mRS) were examined at 1 year after ICH. A BI of ≤ 60 or mRS of ≥ 4 was considered as indicating severe disability. RESULTS: We included 100 patients, and early fever was significantly associated with less functional independence at 1 year post-ICH, as determined using the mRS (p = 0.048; odds ratio [OR] = 0.23), and with severe functional dependency at 1 year post-ICH, as determined using the BI (p = 0.043; OR = 3) and mRS (p = 0.045; OR = 3). In addition, patients with early fever had a longer length of hospital stay (p = 0.002; 95% confidence interval = 21.80-95.91). CONCLUSIONS: Fever is common among patients with primary ICH. Our data indicate a significant association between early fever and worse functional outcomes in ICH survivors at 1 year after ICH. Additionally, patients with early fever had a significantly longer length of hospital stay after ICH.

Interactive effects of dispositional mindfulness and PETTLEP imagery training on basketball shooting performance: A randomized controlled trial.

The purpose of this study was to examine the interactive effects of dispositional mindfulness and visualized PETTLEP imagery training on basketball mid-range shooting performance and retention. Seventy-three participants (M age = 20.32 ± 1.09) with high/low dispositional mindfulness (high n = 35; low n = 38) selected out of 302 college students were randomly assigned into the following six groups: (a) high mindfulness internal imagery (H-II, n = 13); (b) high mindfulness external imagery (H-EI, n = 11); (c) high mindfulness control (H-CO, n = 11); (d) low mindfulness internal imagery (L-II, n = 13); (e) low mindfulness external imagery (L-EI, n = 12); and (f) low mindfulness control (L-CO, n = 13). Participants engaged in a pretest to measure their basketball shooting performance, then participated in a 6-week (3 times/per-week) intervention, plus a posttest and retention test. A three-way 2 (high/low mindfulness) X 3 (treatments: internal-, external imagery, and control) X 3 (measurement time: pretest, posttest, and retention) mixed ANOVA statistical analysis found dispositional mindfulness interacted with treatments and measurement time. The main effects showed high dispositional mindfulness performed better than low dispositional mindfulness, and internal imagery training performed better than external imagery training on mid-range basketball performance at retention. The 3-way interaction indicated that when using either internal or external imagery, high dispositional mindfulness performed better than low mindfulness on retention but not posttest. For 2-way interaction, high dispositional mindfulness performed better than low dispositional mindfulness on retention but not posttest. Our results extended current knowledge on sport imagery and dispositional mindfulness and gained several theoretical implications for researchers. The limitations, future research directions, and practical implications were also discussed.

Sonographic evaluations of the skeletal muscles in patients with Pompe disease.

BACKGROUND: Pompe disease usually has muscle weakness due to glycogen accumulation. Heckmatt scale is commonly used to grade the pertinent findings of ultrasound. Nonetheless, it is difficult to detect subtle changes of the muscle. Besides, no ultrasonographic parameter has been proposed to predict the motor functions of Pompe disease. Therefore, we aimed to find out an ultrasonographic parameter that can quantify the muscle involvement and correlate with the motor functions in Pompe disease. METHODS: Eighteen patients with Pompe disease were enrolled. The echo heterogeneity index (standard deviation divided by mean echogenicity values by ImageJ analysis) and shear modulus were recorded from rectus femoris, biceps femoris, tibialis anterior, medial gastrocnemius, biceps brachii and triceps brachii muscles. Motor functions, including manual muscle strength, 6-min walk and four-limb stair climb tests were assessed. Correlations between ultrasonographic parameters and Heckmatt scale and motor functions were analyzed. RESULTS: The echo heterogeneity index, but not the shear modulus, was negatively correlated with the Heckmatt scale rating in all muscles. The echo heterogeneity indices of tibialis anterior (r = 0.698, p = 0.008) and medial gastrocnemius (r = 0.615, p = 0.025) muscles showed positive correlations with the walking distance. Besides, the echo heterogeneity indices of four lower limb muscles were negatively correlated with the duration of stair climbing. CONCLUSION: The echo heterogeneity index but not the shear modulus can be used to quantitatively describe the muscle involvement in Pompe disease. In addition, lower echo heterogeneity indices of lower limb muscles are associated with worse motor functions in these patients.

Ultrasound elastography for the evaluation of plantar fasciitis: A systematic review and meta-analysis.

PURPOSE: This meta-analysis aimed to investigate the utility of ultrasound (US) elastography in the assessment of plantar fasciitis (PF). METHODS: We searched PubMed, Embase, and Scopus and systemically reviewed clinical studies that used US elastography for imaging PF. The primary outcome was the comparison of plantar fascia stiffness between healthy controls and patients with PF, quantified using the weighted mean difference (WMD) and standardized mean difference (SMD). RESULTS: Eleven studies were included in the final systematic review and meta-analysis. In six studies that employed shear wave elastography, patients with PF had a lower shear wave velocity, with a WMD of -1.772 m/s (95 % confidence interval [CI], -2.663 to -0.880) and an SMD of -1.239 m/s (95 % CI, -1.876 to -0.603), compared to those with asymptomatic heels. One study using the strain ratio showed that the WMD and SMD of patients with diseased heels vs healthy controls were -0.400 (95 % CI, -0.850 to 0.050) and -0.442 (95 % CI, -0.946 to 0.062), respectively. In six articles that use the color histogram of strain elastography, less stiffness was consistently reported in the diseased plantar fascia compared with healthy controls. CONCLUSION: This meta-analysis showed that the plantar fasciae were less stiff in the PF group than in asymptomatic subjects. The diagnostic performance of US elastography (over B-mode) warrants further investigation.

Ultrasound Imaging in Predicting the Autograft Size in Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis.

Anterior cruciate ligament (ACL) reconstruction is widely used to restore knee stability after injury, but the risk of revision surgery increases when the autograft size is inadequate. Ultrasound (US) measurements of preoperative target tendons have been applied to predict the intraoperative autograft size, with various outcomes across different studies. This systematic review and meta-analysis aimed to summarize the evidence and investigate the usefulness of US in predicting autograft size. Electronic databases were searched for relevant studies from inception to 19 January 2022. The primary outcome was the correlation between the preoperative US measurements of donor tendons and intraoperative autograft size. The secondary outcomes encompassed the predictive performance of US for autograft size and the comparison between US and magnetic resonance imaging (MRI) for preoperative tendon measurements. Nine studies, comprising 249 patients, were enrolled. The preoperative US measurements of the donor tendons demonstrated a significant positive correlation with their intraoperative autograft diameter, with a pooled correlation coefficient of 0.443 (95% confidence interval [CI], 0.266−0.591, p < 0.001) for the gracilis and semitendinosus autograft, 0.525 (95% CI, 0.114−0.783, p = 0.015) for the semitendinosus autograft, and 0.475 (95% CI, 0.187−0.687, p = 0.002) for the gracilis autograft. The pooled sensitivity and specificity of US imaging in predicting the autograft diameter were 0.83 (95% CI 0.57−0.95) and 0.70 (95% CI, 0.36−0.91), respectively. Moreover, no significant differences were observed between US and MRI measurements in predicting the sizes of the gracilis and semitendinosus autografts. Preoperative US measurements of the target tendons were moderately correlated with the intraoperative autograft size. US imaging has a discriminative performance similar to that of MRI in predicting the autograft size. A standardized US scanning protocol is needed for future studies to minimize the variations in tendon measurements across different investigators and increase the comparability of US imaging with intraoperative findings.

Osteoarthritis Is Associated With an Increased Risk of Age-Related Macular Degeneration: A Population-Based Longitudinal Follow-Up Study.

Aims: To investigate the long-term risk of age-related macular degeneration (AMD) in persons with osteoarthritis (OA). Methods: This retrospective cohort study first enrolled 71,609 subjects diagnosed with OA, and 236,169 without such a diagnosis between January 1, 2002 and December 31, 2005, from the Longitudinal Health Insurance Database 2005. All were aged 40-69. After excluding subjects who had pre-existing AMD and/or who had missing socioeconomic data, frequency matching by sex and age was performed. This resulted in there being 60,274 subjects in each of the final matched OA and non-OA groups. The study participants were followed up to the occurrence of AMD, death, or the end of 2011. We used Cox proportional-hazards regression to estimate the impact of OA on the risk of developing AMD, and performed subgroup analyses stratified by sex and age. Results: The median follow-up time was 8.9 years, with an interquartile range of 1.4 years. The incidence rate of AMD in the OA group was 2.77 per 1,000 person-years [95% confidence interval (CI), 2.62-2.92], and in the non-OA group, 2.06 per 1,000 person-years (95% CI, 1.94-2.19). The adjusted hazard ratio (HR) of AMD for the OA group was therefore 1.30 (95% CI, 1.20-1.41). In the subgroup analysis stratified by sex for the OA group, the adjusted HRs of AMD were 1.29 in the women's stratum and 1.31 in the men's. When stratified by age, the adjusted HRs of AMD for the younger (40-54 years) and older (55-69 years) strata were 1.28 and 1.31, respectively. Conclusions: Persons with OA have an increased risk of developing AMD, regardless of age and sex.

Combinations of action observation and motor imagery on golf putting's performance.

Motor imagery (MI) and action observation (AO) have been found to enhance motor performance, but recent research found that a combination of action observation and motor imagery (AOMI) together is even better. Despite this initial finding, the most effective way to combine them is unknown. The present study examined the effects of synchronized (i e., concurrently doing AO and MI), asynchronised (i.e., first doing AO then MI), and progressive (first asynchronised approach, then doing synchronized approach) AOMI on golf putting performance and learning. We recruited 45 university students (Mage = 20.18 + 1.32 years; males = 23, females = 22) and randomly assigned them into the following four groups: synchronized group (S-AOMI), asynchronised group (A-AOMI), progressive group (A-S-AOMI), and a control group with a pre-post research design. Participants engaged in a 6-week (three times/per-week) intervention, plus two retention tests. A two-way (group × time) mixed ANOVA statistical analysis found that the three experimental groups performed better than the control group after intervention. However, we found progressive and asynchronised had better golf putting scores than synchronized group and the control group on the retention tests. Our results advance knowledge in AOMI research, but it needs more research to reveal the best way of combining AOMI in the future. Theoretical implications, limitations, applications, and future suggestions are also discussed.

Impacts of Cancer-associated Mutations on the Structure-Activity Relationship of BAP1.

BRAC1 associated protein-1 (BAP1) is a major tumor suppressor involved in many cancers. The deubiquitinase (DUB) activity of BAP1 is essential for its nuclear localization, histone remodeling and proteostasis associated with mitochondrial calcium flux. Loss of the DUB activity due to catalytic mutations within the ubiquitin C-terminal hydrolase (UCH) domain of BAP1 (BAP1-UCH) directly contributes to oncogenesis. Nevertheless, it is non-trivial to rationalize how the other high-frequency but non-catalytic mutations within the BAP1-UCH lead to malignancies. Here we used multiplex spectroscopic, thermodynamic and biophysical analyses to investigate the impacts of eleven high-occurrence mutations within BAP1-UCH on the structure, folding and function. Several mutations significantly destabilize BAP1-UCH and increase its aggregation propensity. Hydrogen-deuterium exchange mass spectrometry data revealed allosteric destabilizations caused by mutations distant from the catalytic site. Our findings gave a comprehensive and multiscale account of the molecular basis of how these non-catalytic mutations within BAP1-UCH may be implicated in oncogenesis.

Ultrasound guidance may be beneficial for localizing the atrophied muscles in electromyography.

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Interactive Effects on Motor Performance of Mindfulness, Performance Under Pressure, Self-Talk, and Motor Task Characteristics.

High mindfulness individuals have been found to perform better on motor tasks under various conditions, but it is unknown whether mindfulness and performance relate when performing under pressure or using different types of self-talk with different motor tasks. In this study, 46 male participants (Mage = 21.4, SD = 1.72 years) with high mindfulness (n = 23) and low mindfulness (n = 23) performed dart-throwing and two-hand coordination tasks under pressure and non-pressure conditions and when using instructional and unrelated self-talk. First, on the two-hand coordination task, a three-way mixed ANOVA found: (a) a significant 3-way interaction in which a significantly poorer performance occurred under pressure (vs. without pressure), with low (vs. high) mindfulness and when using unrelated (vs. instructional) self-talk and (b) a significant interaction in which, both under pressure and not, both high and low mindfulness participants performed comparably when using instructional (vs. unrelated) self-talk. Second, on the dart-throwing task, mindfulness interacted with self-talk such that both high and low mindfulness participants performed better when using instructional self-talk, and pressure interacted with self-talk such that participants using instructional (vs. unrelated) self-talk performed better in both pressure and non-pressure conditions. We concluded that instructional self-talk was a useful cognitive strategy, perhaps particularly in pressure conditions and regardless of the degree of mindfulness, and its effectiveness extended to two different motor tasks. We discussed the theoretical implications of these findings, in terms of attention theory, self-talk, and motor control; and we highlighted our study's limitations and practical applications and gave recommendations for future research.

Dysphagia After Occipitocervical Fixation in a Patient with Atlantoaxial Subluxation.

We report a rare case of dysphagia after occipitocervical fixation, and aim to emphasize the importance of occiput-C2 angle. The kyphotic change of occiput-C2 alignment after operation might lead to dysphagia due to decreased oropharyngeal cross-section area and increased basal pressure of upper esophageal sphincter. Carefully align the occiput-C2 angle during occipitocervical fixation might reduce the incidence of postoperative dysphagia.

Increased Risk of Carpal Tunnel Syndrome in People With Spinal Cord Injury: A Nationwide Longitudinal Follow-Up Study.

OBJECTIVE: To investigate the long-term risk of carpal tunnel syndrome (CTS) in people with spinal cord injury (SCI). DESIGN: Retrospective cohort study. SETTING: Taiwan's Longitudinal Health Insurance Database 2005, containing data about 1 million people randomly sampled from among those registered in the National Health Insurance Program as of 2005. PARTICIPANTS: The SCI group consisted of 1681 subjects with SCI, and the comparison group comprised 6724 propensity score-matched subjects without SCI (N=8405). The variables included in propensity-score matching were age, sex, comorbid conditions, and socioeconomic status. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The occurrence of newly diagnosed CTS, defined by at least 1 hospital discharge or 2 outpatient visits with a diagnosis of CTS. RESULTS: The incidence density of CTS in the SCI group was 7.55 per 1000 person-years (95% confidence interval [CI], 6.03-9.33), and in the comparison group, 4.61 per 1000 person-years (95% CI, 4.08-5.19). The hazard ratio (HR) of CTS for the SCI group was therefore 1.59 (95% CI, 1.24-2.03). Additionally, the HR of CTS for the cervical-SCI subgroup, 1.90 (95% CI, 1.21-2.97) was considerably higher than that of its noncervical counterpart, 1.47 (95% CI, 1.09-1.98). CONCLUSIONS: People with both cervical and noncervical SCI have an increased risk of developing CTS, as compared with those without SCI. Moreover, the CTS risk appears to be higher for individuals with cervical SCI than their noncervical SCI counterparts.

Radiation-induced swallowing dysfunction in patients with head and neck cancer: A literature review.

Swallowing dysfunction is a prevailing state following radiotherapy in patients with head and neck cancer. Following the advancement of cancer treatment in recent years, the survival rate of head and neck cancer has gradually increased. Simultaneously, patients with head and neck cancer suffer due to the long-duration and more prominent swallowing dysfunction states. Based on an extensive literature review, we aimed to explore the mechanisms, risk factors, and clinical evaluations of swallowing dysfunction and their related symptoms following radiotherapy. These include functional changes of the muscles, trismus, xerostomia, neuropathy, and lymphedema. When swallowing dysfunction occurs, patients usually seek medical help and are referred for rehabilitation therapy, such as muscle strengthening and tongue resistance exercise. Furthermore, clinicians should discuss with patients how and when to place the feeding tube. Only through detailed evaluation and management can swallowing dysfunction resolve and improve the quality of life of patients with head and neck cancer following radiotherapy.

Comparative Effectiveness of Botulinum Toxin Injections and Extracorporeal Shockwave Therapy for Post-Stroke Spasticity: A Systematic Review and Network Meta-Analysis.

BACKGROUND: The anti-spasticity efficacy of botulinum toxin (BoNT) injection has been well established for patients with chronic stroke; however, extracorporeal shock wave therapy (ESWT), i.e. focused shockwave (FSW) and radial shockwave (RSW), has recently been applied. We aimed to investigate the comparative effectiveness of BoNT vs. ESWT in the reduction of spasticity among stroke survivors. METHODS: PubMed, EMBASE, MEDLINE and Cochrane CENTRAL were searched from the earliest record to September 2021 for randomized controlled trials. Weighted mean differences (WMDs) on the reduction of the Modified Ashworth Scale before or at the 6th post-treatment week (short-term) and between the 7th and 12th weeks (mid-term) after the intervention were calculated. Ranking probabilities of the WMD were simulated to determine which treatment had the potential to possess the best effectiveness. inplasy.com registration: INPLASY202170018. FINDINGS: A total of 33 studies comprising 1,930 patients were enrolled. The network meta-analysis revealed that BoNT injections, FSW and RSW were better in spasticity reduction than the control treatment(s) at the short term, with WMDs of -0.69 (95% CI, -0.87 to -0.50), -0.36 (95% CI, -0.69 to -0.03) and -0.62 (95% CI, -0.84 to -0.40), respectively. Likewise, mid-term effects of BoNT injections, FSW and RSW also revealed superiority, with WMDs of -0.44 (95% CI, -0.62 to -0.26), -0.74 (95% CI, -1.26 to -0.23) and -0.79 (95% CI, -1.07 to -0.51), respectively. Ranking probability analysis revealed that RSW had the highest probability of being the best treatment for spasticity reduction at the short-term (62.2%) and mid-term (72.3%) periods during the follow up. INTERPRETATION: BoNT injections and ESWT are effective in alleviating post-stroke spasticity at the mid-term. The effectiveness of ESWT was comparable to BoNT injections, and RSW had the potential to be the best treatment for spasticity reduction among the three treatment options. More prospective trials incorporating head-to-head comparisons of BoNT injections vs. ESWT are needed to validate the role of ESWT in reducing post-stroke spasticity. FUNDING: The current research project was supported by (1) National Taiwan University Hospital, Bei-Hu Branch; (2) Ministry of Science and Technology (MOST 106-2314-B-002-180-MY3 and 109-2314-B-002-114-MY3); 3) Taiwan Society of Ultrasound in Medicine.

Sustained Effects of Acute Resistance Exercise on Executive Function in Healthy Middle-Aged Adults.

The present study examined the sustained effects of acute resistance exercise on inhibitory function in healthy middle-aged adults. Seventy healthy middle-aged adults (mean age = 46.98 ± 5.70 years) were randomly assigned to exercise or control groups, and the Stroop test was administered before, immediately after, and 40 min after exercise. The resistance exercise protocol involved two sets of seven exercises performed for a maximum of 10 repetitions, with 60 s between sets and exercises. Acute resistance exercise resulted in higher Stroop test performance under the incongruent (inhibition) and interference conditions immediately post-exercise and 40 min post-exercise. Furthermore, the difference in scores after 40 min was significant. The findings indicate that a moderately intensive acute resistance exercise could facilitate Stroop performance and has a more beneficial effect on sustaining of cognition that involves executive control at least 40 min.

Comparative Effectiveness of Injection Therapies for Hemiplegic Shoulder Pain in Stroke: A Systematic Review and Network Meta-Analysis.

Hemiplegic shoulder pain (HSP) hampers post-stroke functional recovery and is not well managed with conservative treatments. This systematic review aimed to examine the various injection therapies for HSP and investigate their effectiveness at different time points. The protocol of this meta-analysis was registered on INPLASY with a registration number of INPLASY202180010. PubMed, EMBASE, and Scopus were searched from their inception to 4 August 2021 for the clinical studies investigating comparative effectiveness of different injection regimens for treating hemiplegic shoulder pain in patients with stroke. The primary outcome was the weighted mean difference (WMD) on the visual analog scale (VAS) of pain reduction in the fourth-week and between the fourth and twenty-fourth weeks. Ranking probabilities of the WMD for each treatment were obtained using simulations. Seventeen studies with 595 participants were included. The network meta-analysis showed that at the fourth-week, intra-muscular botulinum toxin (BoNT) injections and suprascapular nerve blocks (SSNB) were superior to a placebo, with WMDs of 1.55 (95% CI, 0.09 to 3.01) and 1.44 (95% CI, 0.07 to 2.80), respectively. SSNB possessed the highest probability (53.3%) and appeared to be the best treatment in the fourth-week, followed by intra-muscular BoNT injections (42.6%). Intramuscular BoNT injections were better than the placebo, with a WMD of 1.57 (95% CI, 0.30 to 2.84) between the 4th and 24th weeks. Intramuscular BoNT injections had the highest probability (79.8%) as the best treatment between the 4th and 24th weeks. SSNB was likely to rank first in relieving HSP at the fourth post-treatment week, whereas intra-muscular BoNT injections had the highest probability to achieve the best treatment effectiveness in the post-injection period between the fourth and twenty-fourth weeks. However, as some of the included studies used a non-randomized controlled design, more randomized controlled trials are needed in the future to validate and better understand the short- and long-term efficacy of different injection therapies for management of HSP.