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Journal of Family Medicine and Primary... May 2024Osteoarthritis (OA) is a noninflammatory joint disease. If OA of the knee causes pain, decreased muscle strength and joint stiffness, exercise therapy is one of the most...
INTRODUCTION AND AIM
Osteoarthritis (OA) is a noninflammatory joint disease. If OA of the knee causes pain, decreased muscle strength and joint stiffness, exercise therapy is one of the most effective treatments for the disease. The aim of the present study was to evaluate the effect of aquatherapy on pain intensity and performance in women with OA with the assumption that it causes weightlessness.
METHODS
This is a quasiexperimental study. The sample size included 60 people who were randomly divided into experimental and control groups. The visual analogue scale was used to assess pain and timed up and go test (TUG), 30 Second Sit to Stand Test (30-S-CS), and 40-meter fast-paced walk test (40 MW) were used to assess performance. Data analysis was carried out using SPSS ver. 22.
RESULTS
The results of the present study showed a decrease in pain intensity from moderate to mild intensity. Also, physical performance dimensions in patients with OA were improved, so that the average TUG increased from 14.06 to 8.8 s. The average S-CS frequency increased from 4.86 to 8.4 s and 90 MW decreased from the average 93.43 to 72.66 s.
DISCUSSION AND CONCLUSION
Lower limb muscle strength, and physical performance can be improved and pain intensity can be reduced in patients with OA by performing aquatherapy three times a week for 8 weeks.
PubMed: 38948627
DOI: 10.4103/jfmpc.jfmpc_1088_23 -
Frontiers in Bioengineering and... 2024The simulation-to-reality (sim2real) problem is a common issue when deploying simulation-trained models to real-world scenarios, especially given the extremely high...
The simulation-to-reality (sim2real) problem is a common issue when deploying simulation-trained models to real-world scenarios, especially given the extremely high imbalance between simulation and real-world data (scarce real-world data). Although the cycle-consistent generative adversarial network (CycleGAN) has demonstrated promise in addressing some sim2real issues, it encounters limitations in situations of data imbalance due to the lower capacity of the discriminator and the indeterminacy of learned sim2real mapping. To overcome such problems, we proposed the imbalanced Sim2Real scheme (ImbalSim2Real). Differing from CycleGAN, the ImbalSim2Real scheme segments the dataset into paired and unpaired data for two-fold training. The unpaired data incorporated discriminator-enhanced samples to further squash the solution space of the discriminator, for enhancing the discriminator's ability. For paired data, a term targeted regression loss was integrated to ensure specific and quantitative mapping and further minimize the solution space of the generator. The ImbalSim2Real scheme was validated through numerical experiments, demonstrating its superiority over conventional sim2real methods. In addition, as an application of the proposed ImbalSim2Real scheme, we designed a finger joint stiffness self-sensing framework, where the validation loss for estimating real-world finger joint stiffness was reduced by roughly 41% compared to the supervised learning method that was trained with scarce real-world data and by 56% relative to the CycleGAN trained with the imbalanced dataset. Our proposed scheme and framework have potential applicability to bio-signal estimation when facing an imbalanced sim2real problem.
PubMed: 38948382
DOI: 10.3389/fbioe.2024.1334643 -
World Journal of Orthopedics Jun 2024Elderly patients maintaining functional independence can now be candidates for primary wrist hemiarthroplasty to manage acute irreparable distal radius fractures (DRFs)....
BACKGROUND
Elderly patients maintaining functional independence can now be candidates for primary wrist hemiarthroplasty to manage acute irreparable distal radius fractures (DRFs). However, further investigation with long-term follow-up is required to validate these initial findings.
AIM
To review the literature on the outcomes of distal radius hemiarthroplasty with available implants to assess its viability as a treatment option.
METHODS
A comprehensive review of the literature was conducted using electronic databases, including PubMed, Medline, and Scopus. The search terms employed were "distal radius fracture" , "hemiarthroplasty" , "wrist arthroplasty" , and related terminology. The search was restricted to articles published in English from 1980 until June 2023. Inclusion criteria encompassed cases or case series of DRF treated with hemiarthroplasty, providing clinical or radiographic outcomes, and published in peer-reviewed journals.
RESULTS
A total of 2508 articles from PubMed and 883 from Scopus were identified initially. Following screening and removal of duplicates, 13 articles met the inclusion criteria. These articles, predominantly clinical retrospective studies, provided insights into hemiarthroplasty outcomes, including functional improvements and complications. Hemiarthroplasty was a treatment option for complex DRF, particularly those cases with severe comminution, intraarticular involvement, or severe osteoporosis. Functional outcomes demonstrated improvements in pain relief, wrist mobility, and grip strength, with variability across studies. Complications included implant loosening, infection, nerve injury, and stiffness, with varying incidence rates influenced by surgical techniques and implant choice. Long-term outcomes were inadequately documented, warranting further research.
CONCLUSION
Hemiarthroplasty is a promising treatment for irreparable DRF in the elderly. Long-term outcomes and complications require further study.
PubMed: 38947262
DOI: 10.5312/wjo.v15.i6.578 -
World Journal of Orthopedics Jun 2024Cheilectomy of the 1 metatarsophalangeal joint (MTPJ) is one of the most common procedures for the management of hallux rigidus. However, there is no consensus regarding...
BACKGROUND
Cheilectomy of the 1 metatarsophalangeal joint (MTPJ) is one of the most common procedures for the management of hallux rigidus. However, there is no consensus regarding outcomes following minimally invasive dorsal cheilectomy (MIDC) for the management of hallux rigidus.
AIM
To evaluate outcomes following MIDC for the management of hallux rigidus.
METHODS
During November 2023, the PubMed, EMBASE and Cochrane Library databases were systematically reviewed to identify clinical studies examining outcomes following MIDC for the management of hallux rigidus.
RESULTS
Six studies were included. In total, 348 patients (370 feet) underwent MIDC for hallux rigidus at a weighted mean follow-up of 37.9 ± 16.5 months. The distribution of patients by Coughlin and Shurna's classification was recorded in 4 studies as follows: I (58 patients, 27.1%), II (112 patients, 52.3%), III (44 patients, 20.6%). Three studies performed an additional 1 MTPJ arthroscopy and debridement following MIDC. Retained intra-articular bone debris was observed in 100% of patients in 1 study. The weighted mean American orthopedic foot and ankle society score improved from a preoperative score of 68.9 ± 3.2 to a postoperative score of 87.1. The complication rate was 8.4%, the most common of which was persistent joint pain and stiffness. Thirty-two failures (8.7%) were observed. Thirty-three secondary procedures (8.9%) were performed at a weighted mean time of 8.6 ± 3.2 months following the index procedure.
CONCLUSION
This systematic review demonstrated improvements in subjective clinical outcomes together with a moderate complication rate following MIDC for the management of hallux rigidus at short-term follow-up. A moderate re-operation rate at short-term follow-up was recorded. The marked heterogeneity between included studies and paucity of high quality comparative studies limits the generation of any robust conclusions.
PubMed: 38947256
DOI: 10.5312/wjo.v15.i6.585 -
Nanoscale Jul 2024Metallizing σ electrons provides a promising route to design high-temperature superconducting materials, such as MgB and high-pressure hydrides. Here, we focus on two...
Metallizing σ electrons provides a promising route to design high-temperature superconducting materials, such as MgB and high-pressure hydrides. Here, we focus on two MgB-like layered carborides LiBC and LiBC; their bulk does not have superconductivity because the B-C σ states are far away from the Fermi level (), however, based on first-principles calculations, we found that when their bulk systems are cleaved into surfaces with B-C termination, high of ∼80 K could be observed in the exposed B-C layer on the surfaces. Detailed analysis reveals that surface symmetry reduction, due to lattice periodic breaking, not only introduces hole self-doping into surface B-C layers and shifts the σ-bonding states towards the - associated with emergent large electronic occupation, but also makes in-plane stretching modes on the surface layer experience significant softness. The enhanced σ states and softened phonon modes work to produce strong coupling, thus yielding high- surface superconductivity, which distinctly differs from the superconducting features of the MgB film, which generates phonon stiffness accompanied by suppressed superconductivity. Our findings undoubtedly provide a novel platform to realize high- surface superconductivity, and also clearly elucidate the microscopic mechanism of surface-enhanced superconductivity in favor of creating more high- surface superconductors among MgB-like layered materials.
PubMed: 38946398
DOI: 10.1039/d4nr01482k -
PloS One 2024Pain changes how we move, but it is often confounded by other factors due to disease or injury. Experimental pain offers an opportunity to isolate the independent effect...
Pain changes how we move, but it is often confounded by other factors due to disease or injury. Experimental pain offers an opportunity to isolate the independent effect of pain on movement. We used cutaneous electrical stimulation to induce experimental knee pain during locomotion to study the short-term motor adaptions to pain. While other models of experimental pain have been used in locomotion, they lack the ability to modulate pain in real-time. Twelve healthy adults completed the single data collection session where they experienced six pain intensity conditions (0.5, 1, 2, 3, 4, 5 out of 10) and two pain delivery modes (tonic and phasic). Electrodes were placed over the lateral infrapatellar fat pad and medial tibial condyle to deliver the 10 Hz pure sinusoid via a constant current electrical stimulator. Pain intensity was calibrated prior to each walking bout based on the target intensity and was recorded using an 11-point numerical rating scale. Knee joint angles and moments were recorded over the walking bouts and summarized in waveform and discrete outcomes to be compared with baseline walking. Knee joint angles changed during the swing phase of gait, with higher pain intensities resulting in greater knee flexion angles. Minimal changes in joint moments were observed but there was a consistent pattern of decreasing joint stiffness with increasing pain intensity. Habituation was limited across the 30-90 second walking bouts and the electrical current needed to deliver the target pain intensities showed a positive linear relationship. Experimental knee pain shows subtle biomechanical changes and favourable habituation patterns over short walking bouts. Further exploration of this model is needed in real-world walking conditions and over longer timeframes to quantify motor adaptations.
Topics: Humans; Male; Adult; Biomechanical Phenomena; Female; Knee Joint; Pain; Gait; Locomotion; Walking; Young Adult; Electric Stimulation; Range of Motion, Articular
PubMed: 38941337
DOI: 10.1371/journal.pone.0302752 -
JACC. Advances Jul 2023Arterial stiffness leads to several adverse events in the older population, but there is a lack of data on its association with frailty, disability, and mortality in the...
BACKGROUND
Arterial stiffness leads to several adverse events in the older population, but there is a lack of data on its association with frailty, disability, and mortality in the same population.
OBJECTIVES
The purpose of this study was to evaluate the role of arterial stiffness in the loss of functional ability (frailty and disability) and mortality.
METHODS
Data were taken from community-dwelling aged 65 years participants without diabetes in the Toledo Study of Healthy Ageing cohort. Pulse wave velocity (PWV), assessed through SphygmoCor, was recorded at baseline. Median follow-up time were 2.99 years for frailty (frailty phenotype [FP] and Frailty Trait Scale-5 [FTS5]) and disability (Katz Index) and 6.2 for mortality. Logistic regressions models were built for disability and frailty and Cox proportional hazards model for death, adjusted by age and sex, comorbidity, cardiovascular risk factors, asymmetric dimethylarginine levels, and polypharmacy.
RESULTS
Overall, 978 (mean age 74.5 ± 5.6 years, 56.7% female) participants were included. Different cut-off points were shown for each outcome. PWV >11.5 m/s was cross-sectionally associated with frailty (FP: OR fully-adjusted model: 1.69, 95% CI: 1.45-1.97; FTS5: OR: 1.51, 95% CI: 1.22-1.87) and disability (OR: 1.51, 95% CI: 1.26-1.79); PWV >10 m/s with incident frailty by FP (OR: 1.36, 95% CI: 1.10-1.68) and FTS5 (OR: 1.40, 95% CI: 1.12-1.75), and PWV >11 m/s with death (HR: 1.28, 95% CI: 1.09-1.50). For incident (OR: 1.28, 95% CI: 1.06-1.55) and worsening disability (OR: 1.21, 95% CI: 1.02-1.45) the threshold was 12.5 m/s. Below these cut-off points, age was the best predictor of adverse outcomes.
CONCLUSIONS
Arterial stiffness predicts frailty, disability, and mortality in older people, with different cut-off points, ie,severity degrees, for each of the assessed outcomes.
PubMed: 38939008
DOI: 10.1016/j.jacadv.2023.100423 -
Voprosy Kurortologii, Fizioterapii, I... 2024Thermal lesions in children leave behind cicatricial contractions, contractures, deformations of the wrists, feet, face. Sanatorium-resort treatment using balneotherapy... (Observational Study)
Observational Study
UNLABELLED
Thermal lesions in children leave behind cicatricial contractions, contractures, deformations of the wrists, feet, face. Sanatorium-resort treatment using balneotherapy is an integral part of rehabilitation measures in such patients.
OBJECTIVE
To analyze the results of hydrogen sulfide balneotherapy in children with consequences of thermal injury.
MATERIAL AND METHODS
A single-center observational retrospective non-controlled study was carried out, in which sanatorium-resort treatment concerning post-burn scars in 812 children aged 5-17 years was analyzed. Hydrogen sulfide balneotherapy was prescribed to patients depending on the age in mild (5-6 years) or moderate-to-high (7-17 years) exposure modes. The imported hydrogen sulfide mineral water from the T-2000 well of the Matsesta field with the HS total concentration of 410-420 mg/l was used for treatment. The applications were performed to children alternate days, 8 procedures of balneotherapy per course.
RESULTS
Lightening of the affected areas of the skin, reduction of the sensation of contraction and tension of the scars, which became softer, more elastic and more mobile with regard to the subjacent tissues have been noted in patients after the course of balneotherapy. The head mobility increased after applications in the presence of scars. The large joints' range of motion grew up. In addition, an increase in the mobility of the fingers of wrists and feet, a decrease in the stiffness of movements, increase or recovery of the affected skin's tactile sensitivity have been observed. Children well tolerated procedures, adverse events were seen in 0.7% of cases in the form of mild reactions at the beginning of the applications' course, namely of balneological (0.6%) and toxico-allergic (0.1%) nature.
CONCLUSION
Hydrogen sulfide balneotherapy in combination with rehabilitation exercises and other sanatorium-resort factors is an effective mean of post-burn scars correction in children.
Topics: Humans; Child; Child, Preschool; Health Resorts; Adolescent; Male; Female; Burns; Balneology; Cicatrix; Hydrogen Sulfide; Retrospective Studies
PubMed: 38934956
DOI: 10.17116/kurort202410103132 -
Frontiers in Veterinary Science 2024Intracapsular reconstruction (ICR) has long been recommended as a treatment for cranial cruciate ligament deficiency (CCLD) in dogs, but it has fallen out of favor due...
Intracapsular reconstruction (ICR) has long been recommended as a treatment for cranial cruciate ligament deficiency (CCLD) in dogs, but it has fallen out of favor due to its inferior long-term functional outcomes. These outcomes may be attributed to the poor stiffness and strength of the graft in the early period before ligamentization is completed. Additional placement of extracapsular sutures to mechanically protect the graft during the ligamentization process may be a viable method to address this problem. However, the biomechanical effect of this combined surgical approach remains unknown. This study aimed to evaluate the 3D kinematics of the CCLD stifle in dogs in response to ICR and combined extra- and intracapsular reconstruction (CEICR). Twelve hindlimbs were collected from nine cadavers of mature dogs. The limbs were tested using a custom-made testing apparatus that reproduces their sagittal plane kinematics during the stance phase. Four statuses of stifle joints were tested, namely, (a) cranial cruciate ligament (CCL) intact; (b) CCLD; (c) CCLD stifle stabilized by CEICR; and (d) CCLD stifle stabilized by ICR only. Three-dimensional stifle kinematics at the 5 instances of the stance phase were measured with an optoelectronic system. The results showed that ICR marginally corrects the increased adduction, internal rotation, and caudodistal stifle joint center displacement that occur as a result of CCLD. CEICR led to better restoration of the stifle kinematics, especially with respect to the internal rotation and cranial translation stabilities. Furthermore, CEICR only resulted in minor excessive restraints on other motion components. The findings indicated that the additional lateral fabellotibial suture offers immediate stability to the stifle, consequently lowering the risk of graft over-elongation in the short term postoperatively. Considering the propensity for the extracapsular suture to degrade over time, further studies are warranted to explore the long-term effects of the CEICR procedure.
PubMed: 38933704
DOI: 10.3389/fvets.2024.1336797 -
Pharmaceutics Jun 2024Graphene has become a prominent material in cancer research in recent years. Graphene and its derivatives also attract attention as carriers in drug delivery systems. In...
Graphene has become a prominent material in cancer research in recent years. Graphene and its derivatives also attract attention as carriers in drug delivery systems. In this study, we designed a graphene oxide (GO)-based methotrexate (MTX)-loaded and folic acid (FA)-linked drug delivery system. MTX and FA were bound to GO synthesized from graphite. MTX/FA/GO drug delivery system and system components were characterized using Fourier transform infrared spectroscopy (FTIR), differential calorimetric analysis (DSC), scanning electron microscopy (SEM), transmission electron microscopy (TEM), zeta potential analysis, and dimension measurement (DLS) studies. SEM and TEM images confirmed the nanosheet structure of GO synthesized from graphite, and it was shown that MTX/FA binding to GO transformed the two-dimensional GO into a three-dimensional structure. FTIR and DSC graphs confirmed that oxygen atoms were bound to GO with the formation of carboxylic, hydroxyl, epoxide, and carbonyl groups as a result of the oxidation of graphite, and GO was successfully synthesized. Additionally, these analyses showed that MTX and FA bind physicochemically to the structure of GO. The in vitro Franz diffusion test was performed as a release kinetic test. The release kinetics mathematical model and correlation coefficient (R2) of MTX-loaded GO/FA nanomaterials were found to be the Higuchi model and 0.9785, respectively. Stiffness analyses showed that adding FA to this release system facilitated the entry of the drug into the cell by directing the system to target cells. As a result of the stiffness analyses, the stiffness values of the control cell group, free MTX, and MTX/FA/GO applied cells were measured as 2.34 kPa, 1.87 kPa, and 1.56 kPa, respectively. According to these results, it was seen that MTX/FA/GO weakened the cancer cells. Combined use of the MTX/FA/GO drug delivery system had a higher cytotoxic effect than free MTX on the MDA-MB-231 breast cancer cell line. The results showed that the synthesized MTX/FA/GO material has promising potential in cancer cell-specific targeted therapy for MTX as a drug delivery system.
PubMed: 38931957
DOI: 10.3390/pharmaceutics16060837