Comparative Effectiveness of Orthoses for Thumb Osteoarthritis: A Systematic Review and Network Meta-analysis.

OBJECTIVE: To evaluate the best option among orthoses for carpometacarpal (CMC) osteoarthritis (OA) of the thumb, using a network meta-analysis. DATA SOURCES: Medline, Embase, Cochrane, and ClinicalTrials.gov registry databases were used. PubMed, Embase, Cochrane Controlled Trials Register, Cochrane, and other databases were used without language restrictions. STUDY SELECTION: We searched randomized controlled trials (RCTs) on adults with OA of the thumb by studying any orthosis from the beginning to March 10, 2020. DATA EXTRACTION: Data were extracted and checked for accuracy and completeness by pairs of reviewers. Outcomes were pain and function. Comparative treatment effects were analyzed by random-effects model for direct pairwise comparisons and Bayesian network meta-analyses to integrate direct and indirect evidence. DATA SYNTHESIS: Eleven RCTs involving 619 patients were included. We evaluated 5 groups, for 4 different orthoses: short thermoplastic CMC splint (rigid CMC) (n=5), long thermoplastic carpometacarpal-metacarpophalangeal splint (rigid CMC-MCP) (n=7), short neoprene CMC splint (soft CMC) (n=1), long neoprene CMC-MCP splint (soft CMC-MCP) (n=5), and one as a control group (n=5). Our results show that all splints were superior to placebo to reduce pain intensity and the top-ranked intervention was the rigid CMC-MCP (surface under the cumulative ranking curve analysis [SUCRA], score: 65.4). In function evaluation, we report a 71.6 SUCRA for rigid CMC. CONCLUSIONS: Although the current evidence is unclear on the use of the splint in OA of the thumb, it is not known which orthosis is more effective and whether the orthosis is more effective than other interventions. The network meta-analysis shows that a long thermoplastic splint it is the best choice for pain relief and the short thermoplastic CMC splint is the best treatment to increase function. These results may suggest initial treatment with a long rigid orthosis and then a short rigid orthosis.

Comparative effectiveness of breathing exercises in patients with chronic obstructive pulmonary disease.

BACKGROUND AND PURPOSE: This study aims to determine the best choice of breathing exercises (BE) for patients with chronic obstructive pulmonary disease (COPD) via a network meta-analysis. METHODS: We searched randomized controlled trials (RCTs) of adults with COPD investigating any BEs in MEDLINE, Embase, Cochrane Library, and ClinicalTrials.gov databases. The effects of comparative treatment on the St. George Respiratory Questionnaire as the outcome were analysed and ranked according to a surface under the cumulative classification curve (SUCRA) analysis. RESULTS: The network meta-analysis included six RCTs involving 280 patients with four intervention groups, comprising control, diaphragmatic breathing training (DBT), yoga, and singing course. Performing SUCRA, we reported that yoga is 75% likely to be the best treatment available as DBT with 66%, instead of 35% for singing and 21% for control. CONCLUSION: DBT and yoga seem to be the best choices for breathing exercises in people with COPD.

Rehabilitation in primary lateral sclerosis mimicking parkinsonism: A case report.

BACKGROUND: Primary lateral sclerosis (PLS) is an upper motor neurons disease that on rare occasions may determine bradykinesia and motor fatigue. To date, no rehabilitative treatment has been described as useful for these patients. CASE PRESENTATION: A 68-year-old male developed dysarthria, spastic laugh, impairments of handwriting and fine motor, gait and dysphagia disorders for both solids and liquids over the period from 2015 to December 2018, with normal DaT scans and no clinical benefits from therapy with levodopa, pramipexole and baclofen. The patient underwent exercises for gait training and balance control with sensory treadmill and stabilometric platform and kinesiotherapy to improve fine motor skills of both hands and postural changes, five days a week for two weeks. Based on our data, the patient showed an improvement in balance and gait parameters in T2 compared to T1. CONCLUSION: Thanks to the synergistic action of a combined treatment of physical and instrumental therapy, despite the rare pathology and complex disability, the patient had important benefits in terms of performance and independence in daily activity.

Absorption spectra of natural pigments as sensitizers in solar cells by TD-DFT and MRPT2: protonated cyanidin.

The study of molecular species suitable as sensitizers in solar cells involves the understanding of their visible absorption spectrum. In this article we present a detailed theoretical study of the visible band which has been observed for cyanidin in acid solution. We performed accurate DFT and MRPT2 calculations on the protonated cyanidin in vacuo and in solution, where we have also computed the lineshape profile by including the effects of nuclear degrees of freedom in the harmonic approximation.

Isotopic effects on stereodynamics for the two reactions: H + LiH+(v = 0, j = 0) --> H2 + Li+ and H+ + LiH(v = 0, j = 0) --> H2(+) + Li.

The isotopic effects on stereodynamic properties for the title reactions occurring on the two lowest-lying electronic potential energy surfaces (PESs) of LiH(2)(+) are investigated in detail by means of the quasi-classical trajectory (QCT) method at a collision energy of 0.5 eV, using the ab initio potential energy surfaces (PESs) of Martinazzo et al. (J. Chem. Phys., 2003, 119, 11241). The corresponding reactions comprise: (i) H/D/T + LiH(+) --> HH/HD/HT + Li(+) and H + LiH(+)/LiD(+)/LiT(+) --> HH/HD/HT + Li(+); (ii) H(+)/D(+)/T(+) + LiH --> HH(+)/HD(+)/HT(+) + Li and H(+) + LiH/LiD/LiT --> HH(+)/HD(+)/HT(+) + Li. Differential cross sections (DCSs) and alignments of the product rotational angular momentum for all of these reactions are reported. The results illustrate that the reason for the abnormal behavior of the DCSs for the title reactions reported in the previous work is ascribed to the sensitive role of the projectile atomic mass, and indicate that the long-range interactions play a more important role than the mass factor in ion-molecule reactions. The current topic for this special mass combination system shows some new features of the stereodynamics differing from the previous studies for "typical" mass-combination reactions.

The stereodynamics of the two reactions: H + LiH+ (v = 0, j = 0) --> H2 + Li+ and H+ + LiH (v = 0, j = 0) --> H2(+) + Li.

Quasi-classical trajectory (QCT) calculations have been carried out to study the stereodynamics of the reactions H + LiH(+) (v = 0, j = 0) --> H(2) + Li(+) and H(+) + LiH (v = 0, j = 0) --> H(2)(+) + Li which proceed on the two lowest-lying electronic states of the LiH(2)(+) system, using the ab initio potential energy surfaces (PESs) of Martinazzo et al. [J. Chem. Phys., 2003, 119, 11241]. Differential cross sections (DCSs) and alignments of the product rotational angular momentum for the two reactions are reported. Though the two PESs employed in the current calculations have significant differences, the tendencies of the product rotational alignment are same on the whole, and some common features emerge. This interesting phenomenon probably indicates that, for this system, the characters of the PESs have a weak influence on the alignments of the products. The conclusion is confirmed by a further discussion of rotational alignment parameter which also indicates that the two PESs are repulsive, i.e., the exoergic processes of the reactions taking place on the exit valleys of the PESs.

Quasi-classical trajectory study of the adiabatic reactions occurring on the two lowest-lying electronic states of the LiH2+ system.

Quasi-classical trajectory calculations have been performed on the adiabatically allowed reactions taking place on the two lowest-lying electronic states of the LiH2+ system, using the ab initio potential energy surfaces of Martinazzo et al. (J. Chem. Phys., 2003, 119, 11 241). These reactions comprise: (i) the exoergic H2 and H2+ formation occurring through LiH+ + H and LiH + H+ collisions in the ground and in the first electronically excited state, respectively; (ii) the endoergic (ground state) LiH+ dissociation induced by collisions with H atoms; and (iii) the endoergic (excited state) Li + H2+ --> LiH + H+ reaction. The topic is of relevance for a better understanding of the lithium chemistry in the early universe. Thermal rate constants for the above reactions have been computed in the temperature range 10-5000 K and found in reasonably good agreement with estimates based on the capture model.