Equivalent Scores Research Articles

Staged Bilateral Hip Arthroscopy for Femoroacetabular Impingement Syndrome: Index Surgery Patient Reported Outcome Measures Predict Contralateral Surgery Results at 2 Years

To determine whether (1) patient-reported outcome (PRO) scores after index hip arthroscopy correlate with PRO scores for the contralateral hip in patients undergoing staged bilateral hip arthroscopy and (2) patients who achieved minimal clinically important difference (MCID) or patient-acceptable symptom state (PASS) for the index hip were more likely to achieve MCID or PASS for the contralateral hip. Patients who underwent staged bilateral hip arthroscopy for femoroacetabular impingement syndrome were retrospectively reviewed. PRO scores were prospectively collected at preoperative and 1- and 2-year timepoints. Odds ratios for achievement of MCID and PASS for the contralateral hip given achievement for the index hip were calculated. Improvements from before surgery to 2 years after surgery were correlated between both hips. A total of 143 patients (286 hips) were included in the final analysis. Average time between surgeries was 8.5 months (range, 0.7-57.2). Both hips demonstrated significant improvement (P<.05 for all) in all PROs at 2 years. Achievement of MCID in Hip Outcome Score Activities of Daily Living (HOS-ADL) at the 1-year timepoint for the index hip was predictive of achievement of MCID in HOS-ADL at 2 years for the contralateral hip. Achievement of PASS in all PROs at the 1-year timepoint for the index hip were predictive of achievement of PASS in the equivalent outcome score at the 2-year mark for the contralateral hip. Achievement of MCID or PASS at the 2-year timepoint for the index hip was predictive of achievement of the equivalent outcome at the 2-year timepoint for the contralateral hip. The strongest correlation between improvement in PRO scores for the index and contralateral hips was noted in patients who underwent staged hip arthroscopy within less than 3 months. Patients experience significant clinical benefit in both hips after staged bilateral hip arthroscopy. Results from the initial hip arthroscopy at either 1- or 2-year follow-up can be used to predict outcomes on the contralateral side; however, there is a higher degree of predictive value using 2-year results. Average correlations between 2-year PROs on the index and contralateral hips were moderate to strong, regardless of the time between surgeries. Level III, retrospective cohort study.

Identification and applicability of emoji appropriate to describe food experiences in child-centred studies: A comparison between food names and images

This study aimed to identify a group of emoji appropriate to describe food experiences in studies with schoolchildren and to evaluate their applicability expressing food-evoked emotions in terms of sample discrimination. The effect of liking, product category, and the nature of the food stimuli regarding emoji’s performance was also examined. To achieve these goals two studies were performed with a total of 249 schoolchildren aged from 6 to 12. As a result, 14 facial emoji were associated to seven varied evoked contexts. The study of their applicability showed that all emoji had individual discrimination ability when samples were evoked as food names, but not for food images. Positive emoji were frequently selected to represent the emotional response evoked by liked and very liked products, while neutral and negative emoji were associated to neutral and disliked products. The Correspondence Analysis (CA) suggested that the 14 emoji appropriate to describe food experiences were able to discriminate the emotion profiles elicited by samples from the same product category as well as samples with equivalent liking scores, but only when they evoked a different arousal response. This research expands the existing knowledge on children’s and preadolescent’s interpretation and uses of facial emoji in the food domain to a younger group (over the age of 6). It also provides relevant information about the influence of product-dependent variables on emoji’s applicability (i.e. product category, expected liking, and the food stimulus’ nature), which could be relevant to researchers interested in using emoji as a research tool.

Conversion Between the Mini-Mental State Examination and the Montreal Cognitive Assessment for Patients With Different Forms of Dementia.

The Mini-Mental Status Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) are 2 frequently used brief cognitive screening tasks. Here, we provide a conversion method from MMSE to MoCA for patients with Alzheimer's dementia, frontotemporal dementia, and Parkinson dementia/Lewy body dementia, as well as for patients with dementia and with or without previous stroke. This conversion is needed as everyday clinical practice varies in their use of the 2 scales, which makes comparisons between studies, meta-analysis, and patient cohorts difficult. Observational cohort study. A total of 387 patients with recently diagnosed dementia in memory clinics from the Swedish registry for cognitive/dementia disorders (SveDem) from 2007 to2018. Overall, 387 patients of the Swedish registry for cognitive/dementia disorders with both MMSE and MoCA scores were evaluated. An equipercentile equating method was used to convert MMSE to MoCA scores in the different patient populations. Furthermore, receiver operating curves were used to examine whether MMSE or MoCA scores can distinguish between patients with different dementia types. MMSE scores were converted to MoCA scores for all dementia types and depicted in a conversion table. Results show that the equipercentile equating method and log-linear smoothing allow the creation of a conversion table in which for each test score of the MMSE, the equivalent score of the MoCA for each investigated group can be looked up (and vice-versa). This study reports a reliable and easy conversion for transforming MMSE to MoCA scores (and vice-versa) in patients with Alzheimer's dementia, frontotemporal dementia, Parkinson dementia or Lewy body dementia, as well as patients with dementia with and without previous stroke.

Intravenous acetaminophen for postoperative pain control after open abdominal and thoracic surgery in pediatric patients: a systematic review and meta-analysis.

Pediatric opioid exposure increases short- and long-term adverse events (AE). The addition of intravenous acetaminophen (IVA) to pediatric pain regimes to may reduce opioids but is not well studied postoperatively. Our objective was to quantify the impact of IVA on postoperative pain, opioid use, and AEs in pediatric patients after major abdominal and thoracic surgery. Medline, Embase, CINAHL, Web of Science, and Cochrane Library were searched systematically for randomized controlled trials (RCTs) comparing IVA to other modalities. Five RCTs enrolling 443 patients with an average age of 2.12years (± 2.81) were included. Trials comparing IVA with opioids to opioids alone were meta-analyzed. Low to very low-quality evidence demonstrated equivalent pain scores between the groups (-0.23, 95% CI -0.88 to 0.40, p 0.47) and a reduction in opioid consumption (-1.95 morphine equivalents/kg/48h, 95% CI -3.95 to 0.05, p 0.06) and minor AEs (relative risk 0.39, 95% CI 0.11 to 1.43, p 0.15). We conclude that the addition of IVA to opioid-based regimes in pediatric patients may reduce opioid use and minor AEs without increasing postoperative pain. Given the certainty of evidence, further research featuring patient-important outcomes and prolonged follow-up is necessary to confirm these findings.

Tissue specific age acceleration patterns in the sperm of oligozoospermic men.

To determine if disease can modify aging patterns in an affected tissue without altering the aging patterns of other tissues, blood and semen of individuals with oligozoospermia (n = 10) were compared to the blood and semen of individuals with normozoospermia (n = 24). DNA methylation data was obtained via Illumina's 850 K array. The Horvath and Jenkins age calculators were then utilized to predict the epigenetic age of blood and sperm. Epigenetic age of sperm was approximated using germ-line age differential (GLAD) values. Using nonpaired t-tests, it was found that sperm of oligozoospermic men (mean GLAD score of 0.078) were predicted to be significantly older than the sperm of normozoospermic men (mean GLAD score of -0.017), returning a p-value of 0.03. However, there was not a significant epigenetic age difference between the blood of those with oligozoospermia (mean GLAD equivalent score of -0.027) and normozoospermia (mean GLAD equivalent score of 0.048), producing a p-value of 0.20. These results lead to the conclusion that tissue specific aging is occurring in sperm of oligozoospermic individuals but not in unaffected somatic tissues (in this case, blood).

Physical Activity Is Inversely Associated With Severe Intracranial Stenosis in Stroke-Free Participants of NOMAS.

Although protective in secondary stroke prevention of intracranial arterial stenosis (ICAS), it is uncertain if the benefits of leisure time physical activity (LTPA) extend to asymptomatic ICAS or extracranial carotid stenosis (ECAS). Therefore, we sought to determine LTPA's relationship with ECAS and ICAS in a stroke-free, race-ethnically diverse cohort. This cross-sectional study included participants from the magnetic resonance imaging substudy of the Northern Manhattan Study, of whom 1274 had LTPA assessments at enrollment. LTPA was represented continuously as metabolic equivalent score (MET-score) and ordinally as model-based cluster analysis (LTPA-cluster), both based on the same LTPA assessments. We evaluated ECAS sonographically using carotid intima-media thickening and number of carotid plaques. ICAS was assessed with time-of-flight magnetic resonance angiograph and defined as ≥50% or ≥70% stenosis. We applied regression analyses to evaluate the association between LTPA with ECAS and ICAS, adjusting for confounders. Of 1274 included participants (mean age 71±9 years; 60% women; 65% Hispanic), the mean MET-score was 10±16 and 60% were in a LTPA-cluster with any activity. Among those with carotid ultrasound (n=1234), the mean carotid intima-media thickening was 0.97±0.09 mm, and 56% of participants had at least one carotid plaque identified. Among those with magnetic resonance angiograph (n=1211), 8% had ≥50% ICAS and 5% had ≥70% ICAS. For ICAS, MET-score was associated with ≥70% ICAS (adjusted odds ratio per unit increase in MET-score [95% CI, 0.97 [0.94-0.99]) but not with ECAS measures (carotid intima-media thickening, adjusted β-estimate per unit increase in MET-score [95% CI], 0.002 [-0.003 to 0.006] or number of plaques, adjusted β-estimate [95% CI], 0.0001 [-0.0001 to 0.0003]). Substituting MET-score with LTPA-clusters replicated the association between ≥70% ICAS and LTPA (adjusted odds ratio per each increased LTPA-cluster [95% CI], 0.83 [0.70-0.99]). In this diverse stroke-free population, we found LTPA most strongly associated with asymptomatic ≥70% ICAS. Given the high-risk nature of ≥70% ICAS, these findings may emphasize the role of LTPA in people at risk for ICAS.

Evaluating sexual function among women after recurrent pelvic organ prolapse transvaginal mesh repair

We aimed to evaluate women’s sexual function before and after pelvic organ prolapse (POP) surgery utilising light transvaginal mesh after a prior hysterectomy. Only sexually active women with recurrent cystocele stage 3–4 according to POP-Q, who had previously undergone vaginal hysterectomy with anterior native tissue repair without apical fixation, were enrolled in the study. Women with previous mesh implant POP surgery, persistent vaginal infection or pelvic inflammatory disease were excluded. All patients were surgically treated between 2012 and 2015 using single-incision transvaginal mesh Calistar A. Sexual function was evaluated before a surgery and two years postoperatively. The assessment was accomplished via the standardised validated Czech translation of PISQ-12SF questionnaire. For each patient, age, BMI and parity were monitored. Out of all (89) eligible patients, 48 patients met inclusion criteria and were subsequently enrolled in our study. Two years postoperatively, 31 women (79.5%) improved their PISQ-12 score; five (12.8%) had equivalent scores, and three patients (7.7%) reported lower scores. Overall PISQ-12 score was 37.1 ± 2.6 postoperatively with a 2.9 ± 2.3 statistically significant positive difference compared to the score preceding surgery. The majority of patients undergoing surgery using Calistar A experienced a significant improvement in sexual function. IMPACT STATEMENT What is already known on this subject? Pelvic organ prolapse has a significant impact on women’s sexual functioning in an adverse manner. Mesh implant repair is associated with lower rates of prolapse awareness and prolapse re-operation; however, it is linked with safety concerns. One of these concerns is the negative impact on women’s sexual function. Evaluative study results following sexual function among women with mesh implant transvaginal repair are contradictory. What do the results of this study add? The results showed, that contrary to finding some of the previous studies, transvaginal mesh implant use could benefit patients with previous native tissue POP surgery failure with a low risk of sexual function deterioration. What are the implications of these findings for clinical practice and/or further research? The study provides clinical data for vaginal mesh implants on women’s sexual function in the mid-term outcome. These data can be crucial for selecting the right POP surgical technique and evaluating its benefits and risks.

Biscuits Prepared with Enzymatically-Processed Soybean Meal Are Rich in Isoflavone Aglycones, Sensorially Well-Accepted and Stable during Storage for Six Months.

Soybean meal (SBM) is a co-product of the soybean oil industry that is rich in bioactive compounds, such as isoflavones. We aimed to study the effects of processing SBM by fermentation (Saccharomyces cerevisiae) (FSBM) and enzymatic hydrolysis (CelluMax C, a commercial cellulase) (ESBM) on its chemical composition, with emphasis on isoflavones. Fermentation increased protein content by 9%, ash content by 7%, dietary fiber by 11% and minerals by up to 38%, except for iron, which decreased by 26%. Fermentation completely removed oligosaccharides from SBM, while enzymatic processing decreased oligosaccharides by 45% in SBM. Both processes converted glycosylated isoflavones into the corresponding aglycones, the content of which increased by up to 7.7-fold. Biscuits containing SBM, FSBM and ESBM could be labeled as dietary sources of dietary fibers, potassium, phosphorous, calcium and zinc, as well as high in proteins, copper, iron, manganese and magnesium. While FSBM biscuits had lower sensory scores compared to SBM biscuits, ESBM biscuits had equivalent scores. During storage for 180 days at room temperature, the isoflavone profile of all biscuits remained stable. Moreover, storage did not impair microbiological and sensory qualities of any biscuits. Altogether, ESBM biscuits show great marketing potential.

Motor symptoms in genetic frontotemporal dementia: developing a new module for clinical rating scales

ObjectiveTo investigate the optimal method of adding motor features to a clinical rating scale for frontotemporal dementia (FTD).MethodsEight hundred and thirty-two participants from the international multicentre Genetic FTD Initiative (GENFI) study were recruited: 522 mutation carriers (with C9orf72, GRN and MAPT mutations) and 310 mutation-negative controls. A standardised clinical questionnaire was used to assess eight motor symptoms (dysarthria, dysphagia, tremor, slowness, weakness, gait disorder, falls and functional difficulties using hands). Frequency and severity of each motor symptom was assessed, and a principal component analysis (PCA) was performed to identify how the different motor symptoms loaded together. Finally, addition of a motor component to the CDR® plus NACC FTLD was investigated (CDR® plus NACC FTLD-M).Results24.3% of mutation carriers had motor symptoms (31.7% C9orf72, 18.8% GRN, 19.3% MAPT) compared to 6.8% of controls. Slowness and gait disorder were the commonest in all genetic groups while tremor and falls were the least frequent. Symptom severity scores were similar to equivalent physical motor examination scores. PCA revealed that all motor symptoms loaded together so a single additional motor component was added to the CDR® plus NACC FTLD to form the CDR® plus NACC FTLD-M. Individual global scores were more severe with the CDR® plus NACC FTLD-M, and no patients with a clinically diagnosed motor disorder (ALS/FTD-ALS or parkinsonism) were classified anymore as asymptomatic (unlike the CDR® plus NACC FTLD alone).ConclusionsMotor features are present in mutation carriers at all disease stages across all three genetic groups. Inclusion of motor symptoms in a rating scale that can be used in future clinical trials will not only ensure a more accurate severity measure is recorded but that a wider spectrum of FTD phenotypes can be included in the same trial.

Free-breathing cardiac cine MRI with compressed sensing real-time imaging and retrospective motion correction: clinical feasibility and validation.

To prospectively evaluate the feasibility and biventricular assessment accuracy of a free-breathing cardiac cine imaging technique (RTCSCineMoCo) combined with highly accelerated real-time (RT) acquisition, compressed sensing (CS) reconstruction, and fully automated non-rigid respiratory motion correction. We evaluated 80 patients scheduled for clinical cardiac MRI. Cardiac cine images of the same long-axis and short-axis stacks were acquired using three techniques: (1) SegBH: standard segmented cine with breath-hold; (2) RTCSCineMoCo; (3) RTCSCine: single-shot RT CS cine at 3.0 T. Image quality (IQ) was evaluated using a qualitative 5-point Likert scale and the European CMR registry standardized criteria. Quantitative parameters including left (LV) and right ventricular (RV) ejection fractions (EF), end-diastolic volumes (EDV), end-systolic volumes (ESV), stroke volumes (SV), and LV mass (LVM) were measured and compared. RTCSCineMoCo and SegBH had equivalent IQ scores (4.4 ± 0.7 vs. 4.2 ± 0.8, p = 0.066), while RTCSCine had a significantly lower IQ score than SegBH (4.0 ± 0.8 vs. 4.2 ± 0.8, p = 0.031). In a quantitative analysis, RTCSCineMoCo and SegBH yielded similar measurements for all parameters, while the majority of RTCSCine parameters were significantly different compared with SegBH, except for LVEDV. RTCSCineMoCo is a promising method for robust free-breathing cardiac cine imaging, achieving better IQ and more precise quantitative analysis results for both ventricles compared with RTCSCine. • RTCSCineMoCo is a promising method for free-breathing cardiac MR cine imaging in daily practice. • RTCSCineMoCo provided better IQ and more precise quantitative measurements compared with RTCSCine, by extending RT data acquisition to multiple heartbeats, performing non-rigid respiratory motion correction, and signal averaging. • RTCSCineMoCo may be suitable for routine clinical use for vulnerable patients who may otherwise pose a challenge to image successfully with the conventional segmented cine technique.

Many different roads lead to Rome: equivalence of time-use for activity, sedentary and sleep behaviours and dietary intake profiles among adolescents

BackgroundHow we spend our time and what we eat have important implications for our health. Evidence suggests that health-equivalent behaviour change options which result in the same benefit are available within both time use (physical activities, sedentary behaviours and sleep) and diet (e.g., fruit and vegetables, snack foods). However, it is not yet known if health-equivalent choices exist across both time-use and diet behaviours. This study aimed to explore if a variety of different time-use and dietary profiles were associated with equivalent physical functioning score among adolescents.MethodsThis study used cross-sectional data from 2123 adolescent participants from the Longitudinal Study of Australian Children (LSAC) (mean age = 14.4 ± 0.5 years), including time-use diaries (min/day of sleep, self-care, screen time, quiet time, physical activity, school-related and domestic/social), diet questionnaires (serves/day of fruit and vegetables, discretionary (snack) foods and sugar-sweetened beverages) and a measure of physical functioning (PedsQL™ 4.0 physical functioning scale for teens). Multiple linear regression models were used to find the association of 24-h time-use composition (expressed as isometric log ratios) and dietary variables with physical functioning score. The models were used to estimate which time-use and diet profiles (within a feasible range from the sample average) were associated with equivalent physical functioning scores. Finally, an interactive app was developed to make the results accessible to end users.ResultsWithin 30 min and 1.5 servings of the average adolescent’s time-use and dietary behaviours, 45 equivalent options were associated with a ~ 0.2 SD improvement in physical functioning scale. All options associated with this improvement in physical function involved increasing physical activity and increasing fruit and vegetable intake, whilst also reducing discretionary food intake and sugar-sweetened beverages. Most behavioural options also increased sleep and reduced time spent in self-care, screen time and quiet time activities.ConclusionsThere are a range of time-use and diet profiles that may result in equivalent benefits in physical functioning among adolescents. Communicating these options using decision tools such as interactive apps may allow for tailored interventions across both time use and diet which are based on an individual’s needs, preferences and constraints.

A retrospective investigation of the relationship between neuroblastoma response to anti-GD2 monoclonal antibodies and exposure to opioids for pain management.

Recent increased awareness and research studies reflect possible associations between opioid exposure and cancer outcomes. Children with neuroblastoma (NB) often require opioid treatment for pain. However, associations between tumor response to chemotherapy and opioid exposure have not been investigated in clinical settings. This is a single-institution retrospective review of patients with NB treated between 2013 and 2016. We evaluated opioid consumption quantified in morphine equivalent doses (mg/kg) based on nurse- or patient-controlled analgesia during antibody infusions. We also analyzed their associations with change in primary tumor volume and total tumor burden. Of 42 patients given opioids for pain related to anti-disialoganglioside monoclonal antibodies (anti-GD2 mAb), data completion was achieved for 36, and details of statistical analyses were entered. Median total weight-based morphine equivalent (over 8days) was 4.71mg/kg (interquartile range 3.49-7.96). We found a statistically insignificant weak negative relationship between total weight-based morphine equivalents and tumor volume ratio (correlation coefficient -.0103, p-value .9525) and a statistically insignificant weak positive relationship between total weight-based morphine equivalent and Curie score ratio (correlation coefficient .1096, p-value .5247). Our study found no statistically significant correlation between opioid consumption and natural killer (NK) cell-mediated killing of NB cells as measured by effects on tumor volume/tumor load.

Measuring Comprehensive, General Health Literacy in the General Adult Population: The Development and Validation of the HLS19-Q12 Instrument in Seventeen Countries.

For improving health literacy (HL) by national and international public health policy, measuring population HL by a comprehensive instrument is needed. A short instrument, the HLS19-Q12 based on the HLS-EU-Q47, was developed, translated, applied, and validated in 17 countries in the WHO European Region. For factorial validity/dimensionality, Cronbach alphas, confirmatory factor analysis (CFA), Rasch model (RM), and Partial Credit Model (PCM) were used. For discriminant validity, correlation analysis, and for concurrent predictive validity, linear regression analysis were carried out. The Cronbach alpha coefficients are above 0.7. The fit indices for the single-factor CFAs indicate a good model fit. Some items show differential item functioning in certain country data sets. The regression analyses demonstrate an association of the HLS19-Q12 score with social determinants and selected consequences of HL. The HLS19-Q12 score correlates sufficiently highly (r ≥ 0.897) with the equivalent score for the HLS19-Q47 long form. The HLS19-Q12, based on a comprehensive understanding of HL, shows acceptable psychometric and validity characteristics for different languages, country contexts, and methods of data collection, and is suitable for measuring HL in general, national, adult populations. There are also indications for further improvement of the instrument.

How many observations in the reference dataset are required to compute a consistent Gait Deviation Index & Gait Profile Score?

BackgroundThe Gait Deviation Index (GDI) and the Gait Profile Score (GPS) are the most used scores to sum up gait deviations and are used as primary outcomes in many clinical studies. They are considered as equivalent scores. The computation of these scores is based on a reference dataset but often no description is provided. Among other characteristics, the number of observations needed and its possible influence on the computation of the scores remains unknown. Research questionDefine the number of observations needed in the reference dataset to compute consistent and reliable GDI and GPS. MethodsFifty individuals with cerebral palsy (CP) were randomly selected from our laboratory database. Both scores were computed based on the reference dataset of Schwartz et al. (2008). A bootstrap analysis was performed, for every individual, to assess the effect of the number of observations on both scores. N number of observations were randomly selected, with replacement, from the reference dataset. This procedure was repeated 2000 times for every individual and every N and performed from N = 5 to N = 165 with an increment of 5. The 95 % of the absolute error distribution was considered for every individual and every N. The smallest detectable change (SDC) for both scores was considered as a threshold (GDI: 10.8; GPS:1.3°) to determine the minimum N required. Results and SignificanceA minimum of 90 and 20 observations are required to compute consistent GDI and GPS, respectively. The number of observations has a higher impact on the GDI than the GPS, mainly because the GPS calculation does not rely on the standard deviation (SD). Furthermore, the GDI absolute error seems to be higher in individuals with greater gait deviations, i.e. lower GDI value. This effect was not observed on the GPS. In the case of a small reference dataset, the GPS should therefore be preferred.

Image quality improvement in low-dose chest CT with deep learning image reconstruction.

To investigate the clinical utility of deep learning image reconstruction (DLIR) for improving image quality in low-dose chest CT in comparison with 40% adaptive statistical iterative reconstruction-Veo (ASiR-V40%) algorithm. This retrospective study included 86 patients who underwent low-dose CT for lung cancer screening. Images were reconstructed with ASiR-V40% and DLIR at low (DLIR-L), medium (DLIR-M), and high (DLIR-H) levels. CT value and standard deviation of lung tissue, erector spinae muscles, aorta, and fat were measured and compared across the four reconstructions. Subjective image quality was evaluated by two blind readers from three aspects: image noise, artifact, and visualization of small structures. The effective dose was 1.03±0.36mSv. There was no significant difference in CT values of erector spinae muscles and aorta, whereas the maximum difference for lung tissue and fat was less than 5HU among the four reconstructions. Compared with ASiR-V40%, the DLIR-L, DLIR-M, and DLIR-H reconstructions reduced the noise in aorta by 11.44%, 33.03%, and 56.1%, respectively, and had significantly higher subjective quality scores in image artifacts (all p <0.001). ASiR-V40%, DLIR-L, and DLIR-M had equivalent score in visualizing small structures (all p >0.05), whereas DLIR-H had slightly lower score. Compared with ASiR-V40%, DLIR significantly reduces image noise in low-dose chest CT. DLIR strength is important and should be adjusted for different diagnostic needs in clinical application.

Effects of different monochromatic lights on umami and aroma of dried Suillus granulatus

Dried edible mushrooms have a unique flavor which is worth exploring to preserve and improve their flavor.Light can improve flavor for dried edible mushrooms, but there are few reports about monochromatic light. In this study, effects of red-light, yellow-light, green-light, blue-light and white-light on the umami taste and aroma of dried Suillus granulatus were investigated. The results showed that contents of umami amino acids and 5-nucleotides, equivalent umami concentration (EUC) and electronic tongue umami scores were higher under blue-light treatment. Principal component analysis (PCA) of volatiles showed that comprehensive scores under blue-light treatment were higher. The flavor was better under five light treatments at 6 and 9 days. Partial least squares-discrimination analysis (PLS-DA) further revealed the detailed differences between various light treatments, which were mainly caused by umami amino acids, alcohols, ketones and pyrazines. Collectively,blue-light treatment can be used as a processing technology to improve the flavor quality of dried edible mushrooms.

Association of Preoperative Opioid Use With Postoperative Opioid Use and Patient-Reported Outcomes in Ankle Fracture Fixation Patients.

Ankle fracture surgery is a common procedure with many patients receiving opioid medications for postoperative pain control. Whether there are factors associated with higher medication quantities or patient-reported outcomes, however, remains largely unknown. Patients with isolated, rotational ankle fractures who underwent surgical fixation between January 2018 and March 2020 were retrospectively reviewed. Patient demographics, injury characteristics, and preoperative and postoperative opioid prescription information were recorded. Clinical follow-up and Foot and Ankle Ability Measure (FAAM) questionnaires were collected at 6 weeks and 3 months postoperatively. Multiple linear regression was used to examine the influences of age, sex, body mass index (BMI), fracture characteristics, medical comorbidities, and preoperative opioid use (OU) on postoperative opioid morphine milligram equivalent (MME) amount and FAAM scores. A total of 294 patients were included with an average age of 52.11 ± 17.13 years (range, 18-97). Fracture types were proportional to one another. Chronic pain (mean = 145.89, 95% CI = 36.72, 255.05, P = .0009), preoperative OU (mean = 178.22, 95% CI = 47.46, 308.99, P = .0077), psychiatric diagnoses (mean = 143.81, 95% CI = 58.37, 229.26, P = .001), tobacco use (mean = 137.37, 95% CI = 33.35, 229.26, P = .0098), and trimalleolar fractures (mean = 184.83, 95% CI = 86.82, 282.84, P = .0002) were associated with higher postoperative opioid MME amounts. Older age (mean = ‒0.05, 95% CI = ‒0.08, -0.02, P = .0014) and higher BMI (mean = ‒0.06, 95% CI = ‒0.12, 0.00, P = .048) were both independently associated with lower FAAM scores at 6 weeks. At 3 months, higher BMI (mean = ‒0.09, 95% CI = ‒0.13, -0.04, P = .0002), bimalleolar fractures (mean = ‒1.17, 95% CI = ‒2.17, -0.18, P = .021), and higher postoperative MME amounts (mean = ‒0.10, 95% CI = ‒0.19, -0.01, P = .0256) were each independently associated with lower FAAM scores. In this study, we found that patients with chronic pain, preoperative OU, psychiatric diagnoses, tobacco use, and trimalleolar fractures were more likely to have higher amounts of opioid prescribed following ankle fracture surgery. However, only age, BMI, bimalleolar fractures, and postoperative MME amount were associated with lower FAAM scores postoperatively. Level III, retrospective cohort study.

Mid-Term Follow-Up of Patient Reported Outcomes and Reoperation Rates for Minimal-Resection Total Ankle Arthroplasty

Category: Ankle Arthritis; Ankle Introduction/Purpose: The utilization of total ankle arthroplasty (TAA) is increasing in treatment of end-stage ankle arthritis. Modern implants show improved survival at 10-year and greater follow-up with patient reported outcomes exceeding those obtained with arthrodesis.1-5 Other benefits include maintaining ankle range of motion and decreased rate of adjacent joint arthrosis. The Infinity (Stryker, Mahwah, NJ), Salto-Talaris (Salto) (Smith &amp; Nephew, Memphis, TN), and Scandanavian Total Ankle Replacement (STAR) (DJO Global, Lewisville, TX) TAA have become highly utilized implants due to minimal bone resection to preserve both tibial and talar bone stock. The purpose of this study is to determine implant survival, reoperation rate, and patient reported outcomes of minimal-resection total ankle implants. Methods: After obtaining IRB approval, a retrospective review was performed of all patients who underwent TAA between January 1, 2007 - December 31, 2018. Inclusion criteria, including minimum 2 year follow-up, and exclusion criteria left ninety- eight (98) patients for review. Primary outcome measures included patient-reported outcome measure information systems (PROMIS) scores preoperatively, 1-year and last follow-up. Secondary outcomes measures included reoperation and need for revision surgery as well as radiographic analysis at 3-months, 1-year, 2-year, 5-years and last follow up to identify loosening and lucency. Demographics including age, gender, race, body mass index (BMI), smoking status and diabetes were tabulated. Student's T-test compared PROMIS outcomes between the Infinity and Other groups. Chi-squared test investigated differences in categorical variables and a repeated-measure analysis of variance (ANOVA) was used to investigate differences between PROMIS scores for the Infinity group. Results: 75 Infinity and 23 STAR or Salto patients were identified, average follow up of 3.4 years (range of 5-months to 10.75- years). PROMIS scores for depression and anxiety were significantly lower at most recent follow-up for the Infinity group (p&lt;0.05). Physical function and pain interference scores were not significantly different between groups (p&gt;0.05). Infinity patients saw favorable improvements in anxiety, depression, physical function and pain interference scores postoperatively (p&lt;0.05). A higher incidence of revision with Salto and STAR was observed when compared to Infinity (1 Infinity, 1 Salto, 4 STAR) (p&lt;0.05). Salto and STAR groups presented more 5-year cysts than the Infinity group (p&lt;0.05). Evidence of loosening was higher in the Infinity group at 5-years compared to Salto and STAR (1 Infinity, 0 Other, p&lt;0.05). Finally, more lucency zones were identified at 3 months in Infinity group compared to Salto and STAR (p&lt;0.05). Conclusion: TAA is a durable treatment for ankle osteoarthritis demonstrating equivalent physical function and pain inference PROMIS scores across all minimal resection implants. Patients who received Infinity had significant improvements in depression and anxiety PROMIS scores when compared to other implants at an average 3.4 year follow-up suggesting significant improvement in quality of life as measured by PROMIS between the preoperative and early/late term follow-up periods. Patients who underwent TAA with Infinity experienced lower rates of revision and a trend toward lower need for reoperation when compared to other minimal resection implants.

Optimal MoCA cutoffs for detecting biologically-defined patients with MCI and early dementia

ObjectiveIn this phase II psychometric study on the Montreal cognitive assessment (MoCA), we tested the clinicometric properties of Italian norms for patients with mild cognitive impairment (PwMCI) and early dementia (PwD) and provided optimal cutoffs for diagnostic purposes.MethodsRetrospective data collection was performed for consecutive patients with clinically and biologically defined MCI and early dementia. Forty-five patients (24 PwMCI and 21 PwD) and 25 healthy controls were included. Raw MoCA scores were adjusted according to the conventional 1-point correction (Nasreddine) and Italian norms (Conti, Santangelo, Aiello). The diagnostic properties of the original cutoff (< 26) and normative cutoffs, namely, the upper limits (uLs) of equivalent scores (ES) 1, 2, and 3, were evaluated. ROC curve analysis was performed to obtain optimal cutoffs.ResultsThe original cutoff demonstrated high sensitivity (0.93 [95% CI 0.84–0.98]) but low specificity (0.44 [0.32–0.56]) in discriminating between patients and controls. Nominal normative cutoffs (ES0 uLs) showed excellent specificity (SP range = 0.96–1.00 [0.88–1.00]) but poor sensitivity (SE range = 0.09–0.24 [0.04–0.36]). The optimal cutoff for Nasreddine’s method was 23.50 (SE = 0.82 [0.71–0.90]; SP = 0.72 [0.60–0.82]). Optimal cutoffs were 20.97, 22.85, and 22.29 (SE range = 0.69–0.73 [0.57–0.83], SP range = 0.88–0.92 [0.77–0.97]) for Conti’s, Santangelo’s, and Aiello’s methods, respectively.ConclusionUsing the 1-point correction, combined with a cutoff of 23.50, might be useful in ambulatory settings with a large turnout. Our optimal cutoffs can offset the poor sensitivity of Italian cutoffs.

Assessment of physical activity and its facilitators and barriers among Syrian refugees living in Amman City, Jordan: a cross-sectional study

BackgroundPhysical inactivity is one of the major risk factors for non-communicable diseases. Few studies about physical activity have been conducted among refugees from neighbouring countries. Given changes in the situation of Syrians, assessment of physical activity among Syrian refugees is required to understand their situation. This study aimed to evaluate the degree of self-reported physical activity and to identify perceived facilitators of and barriers to physical activity among Syrian refugees living in Amman, Jordan, in 2017.MethodsThis community-based cross-sectional study was conducted using a structured questionnaire and the short form of the International Physical Activity Questionnaire. Participants were eligible for the study if they were Syrian refugees aged 18–64 years, living in Amman city, and were either registered with the United Nations High Commissioner for Refugees, waiting for their registration, or had a service card issued by the Jordanian Ministry of Interior. The relationship between physical activity level and sex was assessed using the chi-square test and Cochran–Armitage tests. The Mann–Whitney U test was performed to assess the relationship between the median metabolic equivalent scores of physical activity and gender. Backward stepwise logistic regression analysis was used to analyse the association between predictors of physical inactivity and physical activity level.ResultsAmong the 173 participants, the majority (91.9%) reported moderate to a high level of physical activity, and 8.1% were physically inactive. The metabolic equivalent scores for the walking activity of males (median: 1039.5, IQR: 0, 2772) was significantly higher than that of females (median: 396, IQR: 0, 1188) (p < 0.01). “Perceived change in the amount of physical activity” was a significant predictor of physical inactivity (adjusted OR = 3.00; 95%CI: 1.27–7.26). Common facilitators of physical activity were “psychological wellbeing”(49.7%) and “prevent diseases”(46.8%). The greatest barriers to physical activity were “time limitation”(43.4%) and “high cost”(57.8%).ConclusionThis study revealed the physical activity level among Syrian refugees in Amman. The perceived facilitators and barriers to physical activity identified among Syrian refugees were similar to those in previous studies conducted among non-refugees. These results provide a valuable baseline for future examinations of physical activity level and to verify its possible facilitators and barriers.