Activity Scale Research Articles

Matrix-assisted autologous chondrocyte transplantation is effective at mid/long-term for knee lesions: A systematic review and meta-analysis.

This systematic review with meta-analysis evaluates the long-term efficacy of matrix-assisted autologous chondrocyte transplantation (MACT) in terms of functional scores using scaffolds made of hyaluronic acid (HA) or collagen (C). Nineteen articles met the eligibility criteria for the analysis. Fourteen studies focused on patients treated with MACT with HA-based scaffolds, four studies with C-based scaffolds, and one study compared both scaffold types. A higher percentage of patients in the HA subgroup had undergone previous cartilage repair procedures, whereas multiple lesions were more common in the C subgroup. Both HA- and C-treated patients showed significant functional improvement in terms of International Knee Documentation Committee with overall mean differences at 2 and 5 years, and for HA-treated patients at 10 years. Likewise, concerning the Tegner activity scale, both subgroups demonstrated significant improvement at 2 years, with the HA subgroup showing more sustained improvement up to 10 years. The HA subgroup also had EQ-VAS reduction at 2, 5 and 10 years. Failure rates were similar between and within groups, with a range from 0% to 42% at different follow-ups. Patients experienced mid-term benefits from MACT, using both HA-based and C-based scaffolds, and long-term benefits from using HA-based scaffolds. The low failure rate and the fact that most patients did not require knee replacement surgery are encouraging. Accordingly, despite their complexity and high costs, regenerative techniques like MACT are effective, as they can significantly delay or even prevent the need for total knee replacement. Level IV.

Early pain findings in infants with brachial plexus birth injury: Relationship with function and comorbidities, and cut-off point for fractures

BackgroundInfants with birth brachial plexus injury (BPBI) may have various comorbidities such as fractures, torticollis, plagiocephaly, central nervous system disorders. In infants with BPBI, it is important to identify fractures, which are common among comorbidities, objectively assess pain, and investigate factors that may be associated with pain. AimThe aim of this study is to determine the pain level, comorbidities, and motor function in infants with BPBI and to examine the relationship between these parameters. The second aim is to determine the cut-off value of the pain score that may be a sign of fracture in patients with BPBI, in order to suspect and predict a fracture in the shoulder region and to request additional examinations. Subjects and measurements59 infants with BPBI aged 15–90 days were included in the study. Comorbidities, active joint movements, and total upper extremity function assessed with the Active Movement Scale and pain scores measured with the FLACC Pain Scale were retrospectively analyzed. In addition, pain, comorbidities and motor function were investigated according to types of Narakas, which indicates the degree of nerve injury. ResultsOf the 59 participants, 18 (30.5 %) had at least one comorbidity and 12 (20.3 %) had fractures. The number of comorbidities (p = 0.41), the number of fractures (p = 0.84), and the level of pain (p = 0.71) did not differ by types of Narakas. There was a moderate negative correlation between pain level and upper extremity motor function in upper trunk injuries (p < 0.5, −0.67 < r < −0.46). There was a difference in pain level measured by palpation (p < 0.01) and passive joint movement (p < 0.01) in infants with and without comorbidities. To suspect a fracture in the shoulder region and to request further evaluation, the cut-off value of the Flacc pain level, which may predict a fracture, was 3.5 points for palpation and passive shoulder abduction and 4.5 points for passive external rotation. ConclusionThis is the first study in the BPBI to measure pain in infants using a quantifiable and widely used assessment. Pain level was ranked from high to low as infants with fractures, infants with comorbidities other than fractures and infants without comorbidities. Increased pain adversely affects motor function and pain above the cut-off values is a predictor of fracture.

Disease Progression of GNE Myopathy and Its Relationship With Genotype: A Retrospective, Observational Study in Chinese Patients.

Studies on the natural disease progression of detailed motor dysfunction in patients with GNE myopathy are rare. This study aimed to investigate motor function involvement during disease progression and its relationship with the genotype among Chinese patients with GNE myopathy. This retrospective observational cohort study included all patients with genetically confirmed GNE myopathy enrolled at Peking University First Hospital between 2000 and 2023. Patients with GNE myopathy were stratified into 2 subgroups based on with or without p.D207V mutation. Data on clinically significant muscular problems were collected from patients' medical history and follow-up assessments to evaluate motor function using the GNE Myopathy Functional Activity Scale and the modified Rankin Scale. Eighty-three patients with GNE myopathy were included, with a median age at examination of 36 years (range 25-57) and a median age at onset (AAO) of 26 years (range 16-46). The Kaplan-Meier curves revealed that patients with the p.D207V mutation experienced a significantly later AAO (27 years [95% CI 25-29]) and onset age of wheelchair dependency (50 years [95% CI 46-54]) compared with those without the mutation, who had an AAO of 24 years (95% CI 22-26) and an onset age of wheelchair dependency of 45 years (95% CI 36-54). Multivariate Cox regression analysis, adjusted for sex and disease duration, revealed that patients without the p.D207V mutation had a higher risk of wheelchair dependency, with an adjusted hazard ratio of 2.361 (95% CI 1.030-5.411). Barthel indexes (BIs) were negatively correlated with the disease duration and positively correlated with AAOs. Patients with GNE with earlier AAO exhibited a shorter disease duration of developing functional dependency (BIs <60) than did those with later AAOs. Our results provide insights into the motor function involvement observed during disease progression in Chinese patients with GNE myopathy, and relatively mild disease severity was observed in those with the p.D207V mutation.

Correlation between Quality of Life and Erythrocyte Sedimentation Rate with Disease Activity in Rheumatoid Arthritis.

Inflammatory markers are crucial in diagnosing and monitoring rheumatoid arthritis. Patients with rheumatoid arthritis (RA) live with constant pain that limits their daily activities. Our study highlights the effects of disease activity on the quality of life in patients with rheumatoid arthritis. Swollen joint count (SJC), tender joint count (TJC), and visual activity scale (VAS) were utilized to acquire patients' subjective feelings of wellness and their performance of routine daily activities to determine the disease activity. The patient's erythrocyte sedimentation rate (ESR) was measured at the clinical hematology laboratory using the Westergren method. The Quality of Life was rated on a scale of 1 to 10. Our study found that disease activity is inversely proportional to the quality of life. Out of 111 patients, 3 (2.7%) were in remission, 1 (0.9%) had mild disease, 51 (45.9%) had moderate disease, and 56 (50.5%) had high disease activity. The ESR was normal (<20) in 11 patients (9.9%), moderately elevated (20-50) in 56 (50.5%) patients, and very high (>50) in 44 (39.6%) patients. The study revealed that 66% of patients in remission had normal, while 33% had moderately elevated ESR. 12.5% of patients with moderate disease activity had normal ESR, and none with high disease activity had normal ESR. Of 44 patients with high ESR, 7 had moderate disease activity, and 37 had high disease activity. In our study, 60% of patients had a less than 50% quality of life compared to patients with pre-arthritis. High disease activity affects the productivity and quality of life in patients with rheumatoid arthritis. Assessing the impact of different interventions on the QOL should be an essential task that can help define a holistic and integrative treatment and rehabilitation model for RA patients.

Measurement Properties of the Pediatric Anesthesia Emergence Delirium Scale: A Confirmatory Factor Analysis-Based Study.

Emergence delirium is a well-known and common problem in children recovering from anesthesia. The five-item Pediatric Anesthesia Emergence Delirium scale is one of the most commonly used instruments for assessing this condition, but the scale has been questioned regarding its latent structure, i.e., whether its items cover just one underlying construct. It has been suggested that the scale's first three items might identify emergence delirium better than the last two. The aim of this study was to evaluate the measurement properties of the Pediatric Anesthesia Emergence Delirium scale with a focus on its latent structure and cutoff scores, using appropriate statistical methods for ordinal data. A total of 350 children under 7 years of age, undergoing adenoidectomy, with or without additional tonsillotomy or minor procedures like paracentesis, tongue-tie release, or cerumen removal, were enrolled in the study. At the recovery unit, emergence delirium and pain were registered. The confirmatory factor analyses demonstrated that the two-factor model, including emergence delirium-specific behaviors (first three items) and emergence delirium-nonspecific behaviors (last two items), established an excellent model fit according to the χ2 goodness-of-fit statistics, Root Mean Square Error of Approximation, Comparative Fit Index, Tucker-Lewis Index, and Standardized Root Mean Square Residual. The ordinal alpha of 0.98 and the ordinal omega of 0.96 supported the internal consistency reliability of the emergence delirium-specific behaviors. The convergent validity was supported due to a strong correlation between emergence delirium-nonspecific behaviors and the Face, Legs, Activity, Cry, and Consolability scale. The receiver-operating characteristic curve analyses resulted in two tentative cutoff scores for emergence delirium-specific behaviors¸ ≥ 6 and ≥ 8. The Pediatric Anesthesia Emergence Delirium scale's first three items are a more valid and reliable measure of emergence delirium than its original five items.

COMPARAÇÃO DA DOR NA FUNCIONALIDADE E NÍVEL DE ATIVIDADE FÍSICA EM MULHERES PÓS-PARTO E PREFERÊNCIAS PELA VIA DE PARTO

Objective: To compare pain in functional activities and physical activity among postpartum women and analyze reasons for choosing the route of delivery. Methods: Fifteen participants answered a questionnaire during pregnancy (Google Forms) with personal information and up to 96 hours postpartum, another related to pregnancy and childbirth, also the Visual Analog Pain Scale (VAS) for functional activities and another on physical activity in the last quarter. Analyzes included descriptive statistics, Shapiro-Wilk test and unpaired Student's t test (p &lt; 0.05). Results: Significant predominance of mobility pain in the cesarean section (CG) group (p &lt; 0.0001). There was no difference in energy expenditure between groups and reasons for choosing the method of delivery included quick recovery from natural birth (60%) and previous cesarean section experiences. Conclusion: Preference for cesarean section is related to a higher level of mobility pain, suggesting the need for multidisciplinary support to encourage natural birth.

Особливості формування виробничого потенціалу підприємств харчової промисловості

The study aims to determine the characteristics of the production potential of food industry enterprises, assess their current state, and determine directions for increasing the efficiency of production potential in martial law conditions. The research methodology involved using existing modern scientific and empirical achievements and recommendations regarding the peculiarities of the formation of the production potential of food industry enterprises. Official statistical data were used to analyze the size and scope of production, the efficiency of using labor resources, and the volume of capital investments. The time range covered 2021-2023. Indicators characterizing the efficiency of the functioning of enterprises include the volume of manufactured and sold products, the value of which increased by 15.5% and 20.6%, respectively. The number of workers employed in the production of products tended to decrease (-6.8%). The main problems accompanying food enterprises as a result of hostilities were loss of relations with suppliers, lack of stable sales directions for manufactured products, reduction in the number of personnel due to the mobilization of part of the employees, reduction in the number of personnel due to departure abroad; instability of the credit and financial sphere (high interest rates on loans, instability of the national monetary unit); absence or instability of the supply of raw materials and materials, including gas, electricity, water; occupation of territories where enterprises operate. Despite the troubles, food industry enterprises restored the pre-war level of capital investment and exceeded it by 4.3%. The state needs to focus its efforts on the following areas: financial and credit and tax incentives and infrastructure support to increase the production potential. The following programs have already been implemented and are operating to support enterprises affected by military actions: loans for working purposes at 1% per annum; an increase in the provision of state guarantees to 80; increasing the limit under the “5-7-9%” program to 150 million hryvnias; conclusion of international trade agreements for the export of manufactured products; reduction of dependence on imported raw materials; quotas for the import of products that have a higher competitive position compared to domestic types of products; reduction of bureaucracy; referral of employees to retraining and training; stimulation of innovations, etc. Keywords: production potential, resources, size and scale of activity, food industry enterprises.

Lateral Extraarticular Tenodesis in Revision Anterior Cruciate Ligament Reconstruction: An Analysis of Clinical Outcomes and Failure Rates

Background/Objectives: Lateral extraarticular tenodesis (LET) has been advocated in revision anterior cruciate ligament reconstruction (ACLR) to improve knee stability and furthermore, decrease failure rates. The aim of this study was to compare clinical outcomes, knee laxity, and failure rates after revision ACLR with LET (ACLR + LET) versus without LET. It was hypothesized that ACLR + LET improves clinical outcomes and reduces the failure rate. Methods: A retrospective analysis of prospectively collected data was conducted to examine patients who underwent revision ACLR with and without LET between 2017 and 2021 with a minimum follow-up of 24 months. Patients with coronal malalignment (&gt;5°), posterior tibial slope &gt;12°, and concomitant injuries to collateral ligaments were excluded. Patient reported outcome measures (PROMs) included the International Knee Documentation Committee (IKDC) subjective knee score, the Lysholm score, and the Tegner activity scale (TAS). Anterior knee laxity was measured with a Rolimeter and side-to-side difference (SSD) was determined. Revision ACLR failure was defined as ACL revision surgery and SSD &gt; 5 mm. Group comparisons were performed using chi-square-, independent-samples students t-test or Mann–Whitney–U tests. Results: Of 56 eligible patients, 45 (80%, follow up, 23 isolated rACLR vs. 22 rACLR + LET) were included with a mean follow-up of 45.6 ± 15.8 months. Postoperative PROMs were not statistically different between rACLR and rACLR + LET groups (IKDC: 73.0 ± 18.9 vs. 68.7 ± 16.6, n.s.; Lysholm: 84.8 ± 12.3 vs. 77.7 ± 16.2, n.s.). Both groups showed similar TAS (rACLR vs. rACLR +LET (5; range 4–6 vs. 4; range 3–5; n.s.). Anterior knee laxity SSD was 2.4 ± 1.3 mm in the rACLR group and 1.8 ± 1.8 mm in the rACLR + LET group (n.s.). The failure rate was 13% in the rACLR group compared to 4.5% in the rACLR + LET group (n.s.). Conclusions: Isolated revision ACLR showed comparable postoperative patient-reported outcome measures and anterior knee laxity compared to ACLR + LET at mid-term follow up. The addition of a LET demonstrated a lower, though non-significant, failure rate after revision surgery. However, future studies with a prospective, randomized design and an increased number of patients are needed to clearly identify the exact indication for the use of additional LET.

Examining the Psychometric Properties of the 10-Item Active Movement Scale (AMS) for Assessing Musculoskeletal Function in Adults

Examining the Psychometric Properties of the 10-Item Active Movement Scale (AMS) for Assessing Musculoskeletal Function in Adults

Establishing an Advocacy Activities Scale for Parents of Individuals With Intellectual and Developmental Disabilities.

Advocacy has long been heralded as a way to create change for individuals with intellectual and developmental disabilities (IDD) and their families. However, without an established measure, it is difficult to accurately characterize advocacy activities. Drawing from extant research, the Advocacy Activities Scale was developed to assess three domains of parent advocacy: advocacy for one's own children, advocacy for other families, and advocacy for systemic change. Factor analyses were conducted using data from two projects reflecting 382 parents of individuals with IDD from seven states and the District of Columbia. The scale confirmed the three moderately correlated domains of parent advocacy and demonstrated that the scale has high: reliability, validity, test-retest reliability, and moderate correlations with related measures.

Comparison of anterior lateral ligament reconstruction and anterior lateral complex repair in the treatment of anterior cruciate ligament combined with anterior lateral ligament injury with high-grade pivot shift

To retrospectively analyze the clinical efficacy of anterior cruciate ligament (ACL) reconstruction combined with anterolateral complex repair and ACL reconstruction combined with ALL reconstruction in the treatment of anterior cruciate ligament injuries with high-grade pivot shift. From January 2018 to June 2022, 49 patients combined ACL and ALL injuries with high-grade pivot shift were retrospectively studied from three hospitals, 29 of them underwent ACL reconstruction with anterolateral complex repair (repair group), including 23 males and 6 females with an average age of (27.5±4.8) years old, ranged from 20 to 37 years old;the injured sides were 13 on the left and 16 on the right, and 11 patients were suffered with meniscus injury. The other 20 patients underwent ACL and ALL reconstruction (reconstruction group) including 17 males and 3 females with the mean age of (27.1±4.5) years old, ranged from 20 to 38 years old;the injured sides were 8 on the left and 12 on the right, and 6 patients were suffered with meniscus injury. Knee stability (pivot shift test, KT-2000), range of motion, knee function (Lysholm scoring scale, Cincinnati sports activity scale (CSAS) scoring scale, and Tegner activity level score between two groups were compared. A total of 49 patients were followed up, the repair group receiving 13 to 20(15.3±1.8) months and the reconstruction group receiving 12 to 21(16.0±2.2) months. There was no statistically significant difference in the preoperative pivot shift test grading distribution between two groups (P>0.05). At the last postoperative follow-up, there were 24 patients with grade 0 and 5 patients with grade 1 in the repair group, and there were 18 patients with grade 0 and 2 patients with grade 1 in the reconstruction group, there is no significant difference in the distribution of axial shift test grading between two groups(P>0.05). The preoperative KT-2000 tibial displacement of two groups were (9.39±0.77) mm (repair group) and (9.14±0.78) mm (reconstruction group) respectively, with no statistically significant difference (P>0.05). At the final postoperative follow-up, there were 24 patients with KT-2000 tibial displacement <3 mm and 5 patients with 3 to 5 mm in the repair group, while 18 patients with <3 mm and 2 patients with 3 to 5 mm in the reconstruction group, KT-2000 tibial displacement distribution of two groups was no significant difference (P>0.05), but the KT-2000 tibial displacement in the reconstruction group (1.30±0.86) mm was significantly smaller than that in the repair group (1.99±1.11) mm (P<0.05). The final postoperative follow-up range of motion of the contralateral side knee between two groups was no significant difference (P>0.05). The range of motion of the suffering knee in the repair group was less than that in the reconstruction group (P<0.05). There was no significant difference in preoperative Lysholm and CSAS scores between two groups (P>0.05). At the final postoperative follow-up, both groups showed significant improvement in Lysholm and CSAS scores, while the Lysholm and CSAS scores of the reconstruction group were better than those of the repair group, and the difference was statistically significant (P<0.05). Significant differences was found in Tegner scores between two groups, which 16 patients in the repair group returned to their pre-injury activity level, and 17 patients in the reconstruction group returned to their pre-injury level (P<0.05). Compared to anterolateral complex repair, combined ACL and ALL reconstruction in the treatment of ACL injuries with high-grade pivot shift results in better knee joint function and stability. This is advantageous in reducing the risk of ACL reconstruction failure.

The relevance of combined testing of cerebrospinal fluid glial fibrillary acidic protein and ubiquitin C-terminal hydrolase L1 in multiple sclerosis and peripheral neuropathy.

This study investigates the significance of glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCHL-1) in cerebrospinal fluid (CSF) of patients with multiple sclerosis (MS) and peripheral neuropathy (PN). We included 41 MS patients, 35 PN patients, and 36 controls across 5 sites. MS patient data included lesion counts, disease activity, albumin quotient, and Expanded Disability Status Scale (EDSS) scores. PN patients included those with acute and chronic inflammatory demyelinating polyneuropathy and sensorimotor neuropathy based on nerve conduction studies. CSF concentrations of GFAP and UCHL-1 were measured using the MILLIPLEX Map Human Neuroscience Magnetic Bead Panel 1. Both GFAP and UCHL-1 levels were significantly higher in the two patient groups compared to controls. In the MS group, GFAP showed a strong correlation with disease duration, EDSS score, non-enhancing lesions, and the CSF/blood albumin quotient. UCHL-1 levels were significantly higher in patients with active disease (gadolinium-enhancing lesions). The combination of UCHL-1 and GFAP improved diagnostic accuracy (AUC 0.895, 95% CI 0.780-1.000) compared to the independent measurement of either marker for indicating Gd-negative lesions. In the PN group, CSF GFAP levels were significantly lower in patients with purely demyelinating neuropathy compared to those with axonal or mixed neuropathy. GFAP serves as a sensitive marker for axonal damage in PN, while UCHL-1 closely correlates with disease activity in MS patients.

Fear of falling and its related factors in older adults following a fall in Kashan, Iran (2023–2024)

BackgroundFalling is a significant challenge in old age, often leading to isolation, self-imposed limitation, reduced movement, and muscle strength. This study aimed to explore the fear of falling and its related factors in older adults following a fall in Kashan, Iran.MethodsThis cross-sectional study followed 200 older adults who visited medical centers in Kashan from July 2023 to May 2024. Continuous sampling was carried out. Data collection involved a background information questionnaire, the shortened version of the falls efficacy scale-international in older adults, the independence scale of activities of daily living, and the short-form state-trait anxiety inventory. Data were gathered before, one month, and three months after the fall. Data analysis utilized SPSS-24, including t-test, ANOVA, Pearson’s correlation coefficient, and repeated measures analysis of variance.ResultsParticipants had a mean age of 71.34 ± 8.36 years (ranging from 65 to 96 years). There was a significant increase in fear of falling scores one month and three months after the fall (P < 0.001). Multiple linear regression revealed that factors such as illiteracy, old age, and previous falls were predictors of fear of falling before the fall (P < 0.05). One month after the fall, predictors included illiteracy, hip fracture, and high anxiety scores (P < 0.05). Three months after the fall, predictors encompassed illiteracy, hip fracture, high anxiety score, and internal fixator placement as a treatment intervention (P < 0.05), explaining 15% of the variance in fear of falling.ConclusionsIdentifying predictive factors for fear of falling can assist health policymakers in developing a holistic care plan to enhance the quality of life for older adults post-fall. It is essential to screen for fear of falling levels, particularly after trauma, offer educational counseling services, particularly in mental health, after discharge, and prepare training programs related to fall prevention.

Trajectories of physical activity after ischaemic stroke: Exploring prediction of change.

Physical activity (PA) is associated with lower risk of stroke and better functional outcome. However, low levels of PA after stroke are prevalent. The aim was to identify predictors of PA change after first-time ischaemic stroke and to develop prediction models to predict change in PA. Pre-stroke and 6 months post-stroke PA were quantified with the Physical Activity Scale for the Elderly (PASE). Considered predictors were clinical data and demographics including data on socioeconomic status (SES). PASE change was analysed using mixed models of repeated measures. Elastic net regression models were used to predict decrease from higher PASE quartile to the lowest and increase from lowest to higher. A total of 523 first-time ischaemic stroke patients were included. Median (interquartile range, IQR) age was 69 years (IQR 59, 77), 181 (35%) were female and median National Institutes of Health Stroke Scale score was 3 (IQR 2, 5). Overall PASE score did not change, but 20% of patients decreased to the lowest PASE quartile whereas 48% from the lowest quartile increased to a higher. Prediction performance measured by area under the receiver operating curve was 0.679 for PA decrease and 0.619 for increase. SES factors were the most consistent predictors. Half of the least active patients increased PA level after stroke whereas a fifth decreased with SES being the most consistent predictor. Despite comprehensive data, the prediction models only performed modestly. Efforts to optimize PA should include all stroke survivors to increase PA for least active patients and to prevent PA decrease.

Multicentre randomised controlled trial comparing Bankart repair with remplissage and Latarjet procedure in shoulder instability with subcritical bone loss (STABLE): study protocol

IntroductionRecurrent shoulder dislocations often cause attrition of the labrum and progressive loss of the anterior bony contour of the glenoid. Treatment options for this pathology involve either soft tissue repair...

A Novel Scale of Lifestyle Physical Activity: Measure Description and Intervention Responsiveness.

Lifestyle physical activity (LPA) interventions emphasize small bouts of movement that can be flexibly integrated into one's everyday routine. Despite research illustrating benefits for LPA on health outcomes, few LPA interventions and measurement tools have been developed and tested. The purpose of this study was to present a novel LPA self-report scale, including its content, scoring, and internal consistency reliability, and summarize its intervention responsiveness. The LPA scale was administered in a pilot randomized controlled trial that tested a 12-week LPA + Fitbit intervention against a health education (HE) control (matched to LPA + Fitbit on contact time) in a sample of 50 women with depression in alcohol treatment. The LPA scale includes 22 items covering five domains relevant to LPA. Results demonstrated good internal consistency reliability for the total score (ω = 0.84) but poor-to-acceptable internal consistency reliability for the domain scores (ω range: 0.43-0.80). Participants randomized to the LPA + Fitbit intervention had significantly greater improvements in the LPA total score and two domain scores compared to HE participants. Overall, results demonstrate good internal consistency reliability and intervention responsiveness of the LPA scale total score. A larger, more comprehensive psychometric evaluation is needed for validation of this scale.

Application of clinical thinking training system based on entrustable professional activities in emergency teaching

BackgroundStandardized training for resident physicians (STRP) is essential for improving their clinical skills. The standardized training for resident physicians in emergency medicine differs from other disciplines, focusing more on knowledge related to medical emergencies and emergency care skills requiring urgency and real-time response. There are specific differences in knowledge content, teaching methods, curriculum design, and career development compared to other specialties. As a national-level teaching base for emergency medicine, our hospital continuously explores and innovates in teaching models, discovering a model more suitable for emergency medicine.ObjectiveThis study summarizes practical experience in teaching and assessment integration (TAA), evaluates teaching training effectiveness with the Clinical Thinking Training System (CTTS), and examines integrating this system with innovative teaching and assessment models' impact on resident physicians' clinical abilities.MethodsIn our study, we selected residents who rotated in our department from July-December 2023 and randomly divided them into a reform group (n = 106) and a control group (n = 104). The reform group received training using the Clinical Thinking Training System (CTTS) while the control group received standard training consistent with the existing STRP framework. We integrate innovative teaching and assessment (TAA) models and the Entrustable Professional Activities (EPAs) scale to assess students' abilities, stratifying by grade level, background, and major to evaluate students' departmental rotation examination (DRE) and EPAs scores.ResultThe DRE scores and Mini-CEX scores were significantly higher in the reformed group compared to the control group. The final assessments showed the reform group scored significantly higher in first-case documentation and overall clinical thinking decision-making. Specifically, the reform group had significantly higher scores in first-case documentation for second-year, third-year, undergraduate, and graduate students, and non-emergency specialty students. The clinical thinking decision-making scores of the reform group were significantly higher across different years, specialties, and educational backgrounds. All the EPAs results indicated the CTTS improved treatment decision-making abilities among students with different years of training, educational backgrounds, and specialties. Moreover, the ability for continuous patient management improved to some extent among students in different years and with different educational backgrounds.ConclusionThe integration of innovative teaching and assessment models with the CTTS is more conducive to improving the examination performance and confidence in professional behavior of resident physicians.

The Relationship Between Physical Activity Level and Exercise Capacity and Respiratory Parameters in Individuals With Spinal Cord Injury.

Spinal cord injury (SCI) detrimentally impacts individuals' exercise capacity and respiratory parameters depending on sensory, motor, and autonomic dysfunctions. Regular physical activity (PA) positively impacts cardiovascular health and pulmonary function in these individuals. This study determined the relationship between PA and exercise capacity and respiratory parameters in individuals with SCI. This cross-sectional study included 40 individuals with paraplegia. Assessments included the Physical Activity Scale for Individuals With Physical Disabilities (PASIPD), 6-min manual wheelchair propulsion test (MWPT6min), MWPT slalom test (MWPTslalom), 20-m MWPT propulsion test (MWPT20m), pulmonary function test (FVC, FEV1, FEV1/FVC, and peak expiratory flow [PEF]), maximum inspiratory pressure (PImax), and maximum expiratory pressure (PEmax). Subjects' mean age and body mass index were 46 ± 13 y and 26.8 ± 5.2 kg/m2, respectively. PASIPD total score was significantly associated with MWPT6min (r = 0.657, P < .001), MWPTslalom (r = 0.403, P = .17) and MWPT20m (r = 0.477, P = .056), FEV1 (r = 0.552, P < .001), FEV1/FVC (r = 0.532, P = .02), PEF (r = 0.683, P = .004), PImax (r = 0.484, P = .01), and PEmax (r = 0.481, P = .16). However, PASIPD total score was not significantly associated with FVC (r = 0.168, P = .41). PA level influenced exercise capacity and pulmonary function in individuals with SCI and may play an important role in delimiting physical fitness.

Effects of loneliness on short video addiction among college students: the chain mediating role of social support and physical activity.

A sample of 388 college students was selected, and the questionnaires included the Loneliness Scale Short Version, the Short Video Addiction Scale, the Social Support Scale, and the Physical Activity Scale. The data were analyzed using SPSS for correlation analysis and PROCESS macros for mediation effect analysis. (1) Loneliness significantly positively affected short video addiction. (2) The association between loneliness and short video addiction was independently mediated by social support. (3) Physical activity independently mediated loneliness and short video addiction. (4) Social support and physical activity play a chain mediating role in the association between loneliness and short video addiction. Our research improves the literature on loneliness and short video addiction, enhances comprehension of the impacts, and offers college students effective ways to combat the addiction.

The Methodology of Adaptive Levels of Interval for Laser Speckle Imaging.

A methodology is proposed for use in the laser speckle imaging field. This methodology modified the graphical and numerical speckle pattern imaging methods to improve their extraction and discrimination capabilities when processing the embedded temporal activity in the images of laser speckle patterns. This is through enabling these methods to adapt the levels of speckle images' interval during processing to speed up the process and overcome the lack of discrimination when they deal with a complex scattering medium having regions of various scales of activity. The impact of using the new methodology on the imaging methods' performance was evaluated using graphical and numerical evaluation tests, in addition, an exceptional laser speckle imaging system was designed and implemented to undertake a series of experimental validation tests on this methodology. The evaluation and experimental validation tests show the effectiveness of this methodology on the extraction and discrimination capabilities for the standard imaging speckle pattern methods and prove its ability to provide high performance with the real images of speckle patterns. The results also show an improvement in the processing speed for both graphical and numerical methods when the adaptive levels methodology is applied to them, which reaches 78% for the graphical and 87% for the numerical speckle processing methods.