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2.
J Orthop Surg (Hong Kong) ; 32(2): 10225536241256245, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38763777

RESUMO

BACKGROUND: While previous research has demonstrated potential advantages of unicompartmental knee arthroplasty (UKA) over total knee arthroplasty (TKA), particularly in terms of clinical outcomes such as function and pain relief, the specific impact on health-related quality of life (HRQOL) remains unclear. This systematic review and meta-analysis aim to address this gap by comparing HRQOL outcomes between UKA and TKA, providing valuable insights for clinical decision-making. METHODS: We conducted a literature search in the PubMed, Embase, Cochrane Controlled Register of Trials (CENTRAL), and Web of Science databases up to July 15, 2023. Eligible studies assessed HRQOL using EQ-5D, SF-36, or SF-12 and were assessed for methodological quality using the Newcastle-Ottawa Scale (NOS). RESULTS: Seven eligible studies were included, comprising a total of 64,585 patients with 35,809 undergoing TKA and 28,776 undergoing UKA. Patient age ranged from 52.0 to 67.7 years with an average BMI ranging from 27.2 to 31.0 kg/m2. Follow-up periods ranged from 6 months to 10 years. Five studies (63,829 patients) that evaluated HRQOL using EQ-5D showed significantly better outcomes for UKA compared to TKA (MD -0.04, 95% CI -0.05 to -0.02). Two studies (756 patients) that evaluated HRQOL using SF-36 showed no significant difference between TKA and UKA. Five studies (63,286 patients) that evaluated functional outcomes using Oxford Knee Score (OKS) showed significantly better functional scores for UKA compared to TKA (MD -1.29, 95% CI -1.86 to -0.72). Four studies (24,570 patients) that reported patient satisfaction showed no statistically significant difference between TKA and UKA (MD 0.97, 95% CI 0.90 to 1.05). Further subgroup analysis did not affect the conclusions. CONCLUSIONS: Our meta-analysis suggests that UKA is associated with better HRQOL and knee function, as well as similar patient satisfaction, compared to TKA for patients with unicompartmental osteoarthritis.


Assuntos
Artroplastia do Joelho , Osteoartrite do Joelho , Qualidade de Vida , Humanos , Artroplastia do Joelho/métodos , Osteoartrite do Joelho/cirurgia
3.
Quant Imaging Med Surg ; 14(1): 814-823, 2024 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-38223102

RESUMO

Background: Few studies about the association between computed tomography (CT) perfusion imaging parameters and invasiveness in lung adenocarcinoma (LUAD) have been conducted using low dose spectral CT perfusion imaging. The purpose of this study was to investigate application of spectral revolution CT low-dose perfusion imaging in the differential diagnosis of different pathological subtypes of LUAD. Methods: This was a cross-sectional study based on historical data from January 2018 to May 2019 in Peking University Cancer Hospital & Institute. A total of 62 cases were enrolled, including 2 cases of atypical adenomatous hyperplasia (AAH), 3 cases of adenocarcinoma in situ (AIS), 4 cases of minimally invasive adenocarcinoma (MIA), and 53 cases of invasive adenocarcinoma (IAC), all confirmed with pathology. The inclusion and exclusion criteria were regulated. Using Revolution low-dose CT perfusion imaging (GE, USA), the CT perfusion parameters of hemodynamics were obtained: blood flow (BF), blood volume (BV), impulse residue function time of arrival (IRF TO), maximum slope of increase (MSI), mean transit time (MTT), permeability surface area product (PS), positive enhancement integral (PEI), and maximum enhancement time (Tmax). Univariate analysis of variance (ANOVA) or Kruskal-Wallis test was used to compare the differences of CT perfusion quantitative parameters among AAH, AIS, MIA, and IAC. Mann-Whitney test was used to compare the difference of CT perfusion imaging parameters between preinvasive lesions (AAH and AIS) and invasive lung cancer (MIA and IAC). Results: Statistically significant differences in IRF TO were observed in LUAD with different invasiveness, namely, among AIS, MIA, and IAC groups (0.56±0.74 vs. 0.54±1.08 vs. 4.39±2.19, P=0.004). Statistically significant differences in IRF TO were also observed between pre-invasive lesions group (AAH and AIS) and invasive lung cancer group (MIA and IAC) (1.12±1.27 vs. 3.75±2.79, P=0.031), and between AAH + AIS + MIA groups and IAC group (0.83±1.13 vs. 4.12±2.69, P<0.001). There were no statistically significant differences in other CT perfusion parameters of hemodynamics among different pathological subtypes of LUAD (P>0.05). Conclusions: The low-dose perfusion parameter IRF TO of revolution CT has the potential to be employed in the differential diagnosis of different pathological subtypes of LUAD.

4.
Physiol Behav ; 273: 114390, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-37890605

RESUMO

Exercise has shown to have beneficial effects on cognition in older adults. The purpose of this study was to investigate the cortical hemodynamic responses during the word-color Stroop test (WCST) prior and after acute walking and Tai Chi exercise by functional near-infrared spectroscopy (fNIRS). Twenty participants (9 males, mean age 62.8 ± 5.2), first underwent a baseline WCST test, after which they took three WCST tests in a randomized order, (a) after sitting rest (control), (b) after 6 minutes performing Tai Chi Quan, and (c) after a bout of 6 minutes brisk walking. During these four WCST tests cortical hemodynamic changes in the prefrontal area were monitored with fNIRS. Both brisk walking and Tai Chi enhanced hemodynamic activity during the Stroop incongruent tasks, leading to improved cognitive performance (quicker reaction time). Brisk walking induced a greater hemodynamic activity in the right dorsolateral prefrontal cortex (DLPFC) and ventrolateral prefrontal cortex (VLPFC) area, whereas Tai Chi induced a greater bilateral hemodynamic activity in the DLPFC and VLPFC areas. The present study provided empirical evidence of enhanced hemodynamic response in task- specific regions of the brain that can be achieved by a mere six minutes of brisk walking or Tai Chi in older adults.


Assuntos
Tai Chi Chuan , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Encéfalo/fisiologia , Cognição , Córtex Pré-Frontal/diagnóstico por imagem , Córtex Pré-Frontal/fisiologia , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Caminhada , Feminino
5.
Front Public Health ; 11: 1290841, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38259753

RESUMO

To effectively address the mental health risks associated with public health emergencies, it is crucial to actively manage rumors. This study explores the dynamic evolutionary process of rumor diffusion and its collaborative governance in public health emergencies. A game-theoretic model is constructed, involving three main actors: regulators, parties involved in public health emergencies (PIPHE), and whistle-blowers. The behaviors and game outcomes of each party are analyzed, and the effectiveness and feasibility of the model are validated through numerical simulations. The findings of this study reveal that various factors, such as regulatory costs, penalty income, reputation damage for regulators; image loss, reputation enhancement, penalty expenditure for PIPHE; and time costs, social responsibility, and reward income for whistle-blowers, all influence the behavioral choices and game equilibrium of each party. Optimization strategies for rumor governance are proposed in this study, including enhancing the sense of responsibility and capability among regulators, increasing transparency and credibility among PIPHE, and encouraging and protecting the participation of whistle-blowers. This study provides a comprehensive analytical framework for rumor governance in public health emergencies, contributing to improving the governance of public health emergencies and maintaining online public health orders for social sustainability.


Assuntos
Emergências , Denúncia de Irregularidades , Humanos , Saúde Pública , Gastos em Saúde , Renda
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