Reduction In Mobility Research Articles

Effectiveness of Aerobic Training on Lung Volume, Exercise Capacity and Gait Speed in Individuals with Chronic Kidney Disease

Background: Kidney disease (CKD) is a disorder in which the kidneys have been damaged and are unable tofilter blood as effectively as they should. As a result, extra fluid and waste from the circulation linger in the body,potentially leading to various health issues like heart disease and stroke. This also causes swelling in the lowerlimb causing reduced mobility and altered lung volume. This reduction in mobility can be improved with exercise.Aerobic training has been proved to be one of the most effective treatments for improving lung volume capacity.Aerobic training using cycling exercise can improve both lung volume capacity and mobility together.Purpose: To analyze the Effect of Aerobic training and lung volume and gait speed capacity in individuals withchronic kidney disease.Materials and Methods: Sixty individuals with chronic kidney disease were selected according to inclusionand exclusion criteria in which 48 individuals completed the study and 12 quit. These individuals were treatedwith bed side cycling and spirometry for 8 weeks, 1 session per day. Their Pretreatment Gait speed test scoring,3-minute walk test, were recorded. After the treatment duration the same test was repeated.Results: There is an Improvement in Gait speed and 3-minute walk test after giving incentive spirometry stage ofCKD Individuals. No adverse events were observed during and after the treatment.Conclusion: Individuals with CKD need aerobic training to improve their lung volume capacity. The currentstudy concludes that there is an improvement in Gait speed and 3-minute walk test after the treatment session ofincentive spirometry and Bedside cycle ergometer.Clinical Significance: This study’s clinical significance lies in assessing how aerobic training impacts lung volumecapacity in chronic kidney disease patients. Improved lung function may lead to better cardiovascular health,enhanced quality of life, and reduced complications. These findings could support tailored exercise programs toimprove the well-being and overall health of individuals with chronic kidney disease.

Physical and psychosocial outcomes among burn-injured people with heterotopic ossification: A burn model system study

IntroductionHeterotopic ossification (HO), or ectopic bone formation in soft tissue, is a not so rare and poorly understood debilitating sequela of burn injury. Individuals developing HO following burn injuries to their hands often experience reductions in mobility, significant contractures, and joint pain. This study identifies demographic characteristics of individuals who develop HO and compares their physical and psychosocial outcomes to the general burn population. MethodsParticipant demographics, injury characteristics, and PROMIS-29 scores across three time points (discharge, six- and 12- months after injury) were extracted from the Burn Model System National Longitudinal Database representing participants from 2015–2022. Mixed-effects linear regression models were used to compare PROMIS scores across all three longitudinal measurements. Models were adjusted for age, sex, race/ethnicity, HO status, and burn size. ResultsOf the 861 participants with data concerning HO, 33 were diagnosed with HO (3.8% of participants). Most participants with HO were male (n = 24, 73%) and had an average age of 40 + /− 13 years. Participants with HO had significantly larger burn size (49 +/−23% Total Body Surface Area (TBSA)) than those without HO (16 +/−17%). Participants with HO reported significantly worse physical function, depression, pain interference and social integration scores than those without HO. After adjusting for covariables, participants with HO continued to report statistically significantly worse physical function than those without HO. Although physical functioning was consistently lower, the two populations did not differ significantly among psychosocial outcome measures. ConclusionsWhile HO can result in physical limitations, the translation to psychosocial impairments was not evident. Targeted treatment of HO with the goal of maximizing physical function should be a focus of their rehabilitation. Level of Evidence2b Type of StudySymptom Prevalence Study

Tailoring ohmic contact of CdZnTe based device using a ZnTe:Cu film interlayer

ZnTe materials exhibit distinctive characteristics that render them exceptionally suitable for the utilization in circumventing the electrode contact issue for the CdZnTe based devices for photoelectric applications. This work employed the co-sputtering technique to fabricate ZnTe:Cu films, probing the influences of Copper (Cu) sputtering power on the film's structural, morphological, optical, and electrical properties. It is disclosed that the sputtering power of the Cu target leads to a proportional increase in CuxTe compounds within the ZnTe:Cu films. Notably, an increase in the sputtering power of the Cu target is found to enhance the carrier concentration of the film, but not decrease the resistivity. This unnormal arose is due to a substantial reduction in carrier mobility at higher Cu target sputtering powers. The ZnTe:Cu film exhibits relatively lower resistivity when the sputtering power of the Cu target is approximately 3 W. The optimized ZnTe:Cu film as a buffer layer for the electrode is favor of remarkable improving the ohmic contact properties between the electrode and the CdZnTe, exhibiting a low contact resistivity of 0.62 Ω cm2. This work offers a promising approach to ameliorate the contact performance for the CdZnTe devices with high performance and high reliability.

Neurostimulation for Advanced Parkinson Disease and Quality of Life at 5 Years

Deep brain stimulation of the subthalamic nucleus (STN-DBS) improves quality of life (QOL) in patients with advanced Parkinson disease (PD). However, controlled studies with more than 3 years of follow-up are lacking. To investigate the long-term effects of STN-DBS on QOL compared with standard-of-care medication (MED). In this prospective, observational, quasi-experimental, longitudinal nonrandomized controlled trial, 183 patients were screened for eligibility and 167 were enrolled from March 1, 2011, to May 31, 2017, at 3 European university centers. Propensity score matching for demographic and clinical characteristics was applied to 108 patients with PD (62 in the STN-DBS group and 46 in the MED group), resulting in a well-balanced, matched subcohort of 25 patients per group. Data analysis was performed from September 2022 to January 2023. Treatment for PD of STN-DBS or MED. Assessments included Parkinson's Disease Questionnaire 8 (PDQ-8), Unified PD Rating Scale-motor examination, Scales for Outcomes in PD-activities of daily living (ADL) and motor complications, and levodopa-equivalent daily dose. Within-group longitudinal outcome changes, between-group differences, and correlations of change scores were analyzed. The study population in the analysis included 108 patients (mean [SD] age, 63.7 [8.3] years; 66 [61.1%] male). At 5-year follow-up, PDQ-8 and ADL worsened only in the MED group (PDQ-8 change, -10.9; 95% CI, -19.0 to -2.7; P = .01; ADL change: -2.0; 95% CI, -3.1 to -0.8; P = .002), whereas both outcomes remained stable in the STN-DBS group (PDQ-8 change, -4.3; 95% CI, -13.2 to 4.7; P = .34; ADL change, -0.8; 95% CI, -2.5 to 1.0; P = .38). Changes in PDQ-8 and ADL correlated moderately (rs = .40, P = .008). Furthermore, STN-DBS outcomes were favorable for motor complications (median difference in change scores between STN-DBS and MED, -2.0; 95% CI, -4.0 to -1.0; P = .003), mobility (-1.0; 95% CI, -2.0 to 0; P = .03), and levodopa-equivalent daily dose reduction (-821.4; 95% CI, -1111.9 to -530.8; P < .001). This study provides evidence of differences in QOL outcomes at 5-year follow-up between STN-DBS (stable) and MED (worsened), mainly driven by the favorable effect of STN-DBS on mobility (class IIb evidence). The association between changes in QOL and ADL, but not motor impairment or complications, highlights the relative importance of ADL outcomes for long-term DBS assessments. German ClinicalTrials Registry: DRKS00006735.

There goes the neighborhood? The public safety enhancing effects of a mobile harm reduction intervention

BackgroundBuprenorphine is a gold-standard treatment for opioid use disorders, but most people with these disorders do not access it. Barriers to treatment access may be diminished by low-threshold mobile treatment programs but concern regarding their impact on local public safety challenges their adoption. MethodsThis quasi-experimental study uses difference-in-differences analyses to measure the impact of four mobile buprenorphine clinics in Pittsburgh on neighborhood arrest rates. The study period spans 2018 to 2022, with a pre-intervention period of 11 to 12 quarters and a post-intervention period of 7 to 8 quarters (dependent on neighborhood). A treatment group of 84 census block groups in the areas surrounding clinics during the time period after their establishment were compared to a control group of city census blocks not within one mile of a clinic plus treated block groups in the two years prior to clinic establishment. Outcome variables include drug, non-drug, and total arrests, measured quarterly per 100 in population. ResultsCompared to block groups further than 1 mile from a clinic, arrests fell by 34.13 % (b = −0.358, 95 % CI = −0.557, −0.158), drug arrests by 33.85 % (b = −0.087, 95 % CI = −0.151, −0.023), and non-drug related arrests by 22.29 % (b = −0.179, 95 % CI = −0.302, −0.057). Drug arrests declined significantly on days when the clinics were not present (b = −0.015, 95 % CI = −0.025, −0.006), with no significant change on clinic operational days (b = −0.002, 95 % CI = −0.016, −0.013). Total arrests declined significantly on days when clinics were and were not present (b = −0.045, 95 % CI = −0.078, −0.012; and b = −0.052, CI = −0.082, −0.023, respectively). ConclusionsMobile clinics providing medication for opioid use disorders were associated with reduced neighborhood arrest rates. Expansion of mobile services could promote health equity and public safety.

Inner ear morphology in wild versus laboratory house mice.

The semicircular canals of the inner ear are involved in balance and velocity control. Being crucial to ensure efficient mobility, their morphology exhibits an evolutionary conservatism attributed to stabilizing selection. Release of selection in slow-moving animals has been argued to lead to morphological divergence and increased inter-individual variation. In its natural habitat, the house mouse Mus musculus moves in a tridimensional space where efficient balance is required. In contrast, laboratory mice in standard cages are severely restricted in their ability to move, which possibly reduces selection on the inner ear morphology. This effect was tested by comparing four groups of mice: several populations of wild mice trapped in commensal habitats in France; their second-generation laboratory offspring, to assess plastic effects related to breeding conditions; a standard laboratory strain (Swiss) that evolved for many generations in a regime of mobility reduction; and hybrids between wild offspring and Swiss mice. The morphology of the semicircular canals was quantified using a set of 3D landmarks and semi-landmarks analyzed using geometric morphometric protocols. Levels of inter-population, inter-individual (disparity) and intra-individual (asymmetry) variation were compared. All wild mice shared a similar inner ear morphology, in contrast to the important divergence of the Swiss strain. The release of selection in the laboratory strain obviously allowed for an important and rapid drift in the otherwise conserved structure. Shared traits between the inner ear of the lab strain and domestic pigs suggested a common response to mobility reduction in captivity. The lab-bred offspring of wild mice also differed from their wild relatives, suggesting plastic response related to maternal locomotory behavior, since inner ear morphology matures before birth in mammals. The signature observed in lab-bred wild mice and the lab strain was however not congruent, suggesting that plasticity did not participate to the divergence of the laboratory strain. However, contrary to the expectation, wild mice displayed slightly higher levels of inter-individual variation than laboratory mice, possibly due to the higher levels of genetic variance within and among wild populations compared to the lab strain. Differences in fluctuating asymmetry levels were detected, with the laboratory strain occasionally displaying higher asymmetry scores than its wild relatives. This suggests that there may indeed be a release of selection and/or a decrease in developmental stability in the laboratory strain.

Twitter social mobility data reveal demographic variations in social distancing practices during the COVID-19 pandemic

The COVID-19 pandemic demonstrated the importance of social distancing practices to stem the spread of the virus. However, compliance with public health guidelines was mixed. Understanding what factors are associated with differences in compliance can improve public health messaging since messages could be targeted and tailored to different population segments. We utilize Twitter data on social mobility during COVID-19 to reveal which populations practiced social distancing and what factors correlated with this practice. We analyze correlations between demographic and political affiliation with reductions in physical mobility measured by public geolocation tweets. We find significant differences in mobility reduction between these groups in the United States. We observe that males, Asian and Latinx individuals, older individuals, Democrats, and people from higher population density states exhibited larger reductions in movement. Furthermore, our study also unveils meaningful insights into the interactions between different groups. We hope these findings will provide evidence to support public health policy-making.

Being a child in Morelia: child spatial mobility over the years

ABSTRACT The systemic crisis in Latin America, exacerbated by market-driven urban development, has led to heightened social segregation and diminished public spaces for mobility and recreation. In Mexico, childhood is particularly affected, with the last two decades witnessing a decline in children's autonomy within public areas due to escalating violence and militarization. Employing a childhood geography approach, this article examines the gradual reduction in children's spatial mobility across four generations in Morelia, Mexico. It explores key factors influencing mobility: play activities, perceived risks, and the impact of motility, all viewed through a gender lens. The study involves four cohorts of 10-year-olds from different decades, employing qualitative methods like interviews and mental maps. Results reveal the detrimental effects of rapid, fragmented urban growth and increased violence on creating spaces for children. Consequently, interactions have shifted indoors, leading to supervised play in semi-private spaces and a shift from collective, autonomous play to limited social interactions

Don’t waste the crisis: The COVID-19 Anthropause as an experiment for rethinking human–environment relations

The COVID-19 pandemic sparked radical changes in the way life was lived around the globe. With the rapid reduction in human mobility, short-term environmental improvements were seen across the world. Work and social routines were altered, and political action to reduce case numbers seemed to open a window of opportunity for socio-environmental change in a post-pandemic world. Inspired by conversations around the “COVID-19 Anthropause,” this paper probes the lived experiences and reflections that emerged in the pandemic pause. Three years after the onset of the pandemic, many initial environmental gains have been limited. Nonetheless, the COVID-19 Anthropause has brought human–environment relations into new light, sparking introspection and forms of broader social critique surrounding what kinds of socio-political courage and structural change is necessary to achieve new post-pandemic realities. Our research shows the heterogeneity of experiences of the Anthropause, highlighting the ways that uncritical engagement with the concept can obscure overlapping structural inequalities, and reinforce harmful binaries around the presence and absence of humans in nature. Drawing on longitudinal, qualitative data from Latin America and Europe, we enrich debates over the implications of the pandemic for human–environment relations and underscore the need to attend to radical forms of difference amid any global environmental concept.

Counterfactual mobility network embedding reveals prevalent accessibility gaps in U.S. cities

Living in cities affords expanded access to various resources, infrastructures, and services at reduced travel costs, which improves social life and promotes systemic gains. However, recent research shows that urban dwellers also experience inequality in accessing urban facilities, which manifests in distinct travel and visitation patterns for residents with different demographic backgrounds. Here, we go beyond simple flawed correlation analysis and reveal prevalent accessibility gaps by quantifying the causal effects of resident demographics on mobility patterns extracted from U.S. residents’ detailed interactions with millions of urban venues. Moreover, to efficiently reveal micro neighborhood-level accessibility gaps, we design a novel Counterfactual RANdom-walks-based Embedding (CRANE) method to learn continuous embedding vectors on urban mobility networks with confounding effects disentangled. Our analysis reveals significant income and racial gaps in mobility frequency and visitation rates to sports and education venues. Besides, bachelor’s degree holders experience greater mobility reduction during the COVID-19 crisis. With extensive experiments on neighborhood-level accessibility prediction and visualizing accessibility gaps with embeddings vectors, we demonstrate that the counterfactual mobility network embeddings can improve the explanatory capacity and robustness of revealed accessibility gaps by extending them from aggregate statistics to individual neighborhoods and allowing for cross-city knowledge transfer. As such, urban mobility networks can reveal consistent accessibility gaps in the U.S., calling for urgent urban design policies to fill in the gaps.

Enhanced hydrogen sequestration through hydrogen foam generation with SDS Co-Injection in subsurface formations

Inherent obstacles of hydrogen injection encompass preferential channeling through larger pathways, hampering microscopic sweep efficiency within porous media. This work pioneers hydrogen foam generation via co-injection with aqueous sodium dodecyl sulfate (SDS) to enhance subsurface hydrogen trapping capacity. SDS addition substantially reduces hydrogen-water interfacial tension and enhances viscoelasticity. In contrast to robust hydrogen foam stability, CO2 foams display compromised integrity, stemming from surfactant aggregation and ensuing infiltration channels that permit aqueous phase CO2 dissolution. Hydrogen foams conversely sustain uniform surfactant films, forestalling hydrogen ingress into water. Synergetic microfluidic and pore-scale simulations visualise mechanisms underlying intensified hydrogen capture and mobility reduction attributed to deformation and flow resistance when traversing constricted pores. Introducing the amphiphilic SDS surfactant considerably promotes hydrogen adsorption through its hydrophobic tail. Core flooding experiments quantify over 2 times hydrogen storage ratio amplification with SDS relative to sole hydrogen injection. The framework contributes pragmatic strategies to harness high-efficiency hydrogen foam for scalable clean energy storage.

Community mobility and participation assessment of manual wheelchair users: a review of current techniques and challenges.

According to the World Health Organization, hundreds of individuals commence wheelchair use daily, often due to an injury such as spinal cord injury or through a condition such as a stroke. However, manual wheelchair users typically experience reductions in individual community mobility and participation. In this review, articles from 2017 to 2023 were reviewed to identify means of measuring community mobility and participation of manual wheelchair users, factors that can impact these aspects, and current rehabilitation techniques for improving them. The selected articles document current best practices utilizing self-surveys, in-clinic assessments, and remote tracking through GPS and accelerometer data, which rehabilitation specialists can apply to track their patients' community mobility and participation accurately. Furthermore, rehabilitation methods such as wheelchair training programs, brain-computer interface triggered functional electric stimulation therapy, and community-based rehabilitation programs show potential to improve the community mobility and participation of manual wheelchair users. Recommendations were made to highlight potential avenues for future research.

Influence of partial titanium substitution by its hydride on structure and mechanical properties of TNM-B1 heat-resistant alloy, obtained by SHS powder hot isostatic pressing

This paper investigates the influence of partial substitution of titanium by its hydride on the microstructure and mechanical properties of TNM-B1 alloy obtained by powder metallurgy technology. The impact of the Ti:TiH2 ratio in the reaction mixture and heat treatment modes on the microstructure and mechanical properties of TNM-B1+1%Y2O3 alloy, obtained using high-energy ball milling (HEBM), selfpropagating high-temperature synthesis (SHS), and hot isostatic pressing (HIP) methods, has been examined. It was observed that a 10 % substitution of titanium with its hydride in the reaction mixtures reduces the oxygen content in SHS products from 1 % to 0.8 % due to the generation of a reducing atmosphere during the decomposition of TiH2 in the combustion wave. When the Ti : TiH2 ratio is 90 : 10, highest mechanical properties of TNM-B1+1%Y2O3 alloy were achieved: a compressive strength (σu) of 1200±15 MPa and a yield strength (YS) of 1030±25 MPa. An increase in the proportion of TiH2 results in a higher content of oxygen impurity, leading to the formation of Al2O3, which reduces the strength and ductility of the material. With additional heat treatment of TNM-B1+1%Y2O3 alloy, the globular structure transforms into a partially lamellar one, leading to an increase in σu by 50–300 MPa, depending on the TiH2 content. This attributed to a decrease in the average grain size and a reduction in dislocation mobility during deformation.

Determination of the Long-Haul Routes Attractiveness in Railway Passenger Transport in Europe

A crucial component and system of public passenger transportation that must serve as the foundation for the national and global comprehensive integrated system of passenger transport is high-quality, appealing, and efficient long-distance railway passenger transport. The demand for public passenger transport has drastically dropped from March 2020 in numerous European countries as a result of various COVID-19 limitations. The performance of passenger transportation has been impacted by the reduction in mobility. Even though the situation has already improved, finding fresh, workable solutions is still essential for a well-functioning rail passenger transport system. The contribution proposes a method for attractiveness determining of long-haul routes for railway passenger transport in Europe. Three key indicators that have a substantial impact on this issue are suggested based on specific scientific methodologies. The paper also includes real examples and calculations for the practical use of indicators determination of chosen long-distance transport routes.

Significant reduction of lattice thermal conductivity observed in CuInTe2-CuAlTe2 solid-solution alloys.

CuInTe2 and CuAlTe2, which are ternary chalcogenide compounds with the same tetragonal structure, are considered as thermoelectric materials owing to high Seebeck coefficients with large bandgaps of ∼1.08 and 1.96 eV, respectively. In this study, the electrical, thermal, and thermoelectric properties of a CuInTe2-CuAlTe2 solid solution alloy system were systematically investigated by synthesizing a series of CuIn1-xAlxTe2 (x = 0, 0.2, 0.4, 0.6, 0.8, and 1.0) compositions. CuInTe2 and CuAlTe2 form the complete solid solutions as reported, and the electrical conductivity and Seebeck coefficient decrease simultaneously to x = 0.8 due to a significant reduction in carrier mobility, thereby reducing the power factor. For CuAlTe2, the power factor suddenly increased owing to its very high electrical conductivity. On the other hand, the total and lattice thermal conductivity is greatly reduced by additional phonon scattering originating from solid-solution alloying. For instance, the largely reduced lattice thermal conductivity was measured to be 1.8 and 1.9 W m-1 K-1 for the sample with x = 0.4 and x = 0.6 at 300 K, whereas those for CuInTe2 and CuAlTe2 were 4.8 and 5.6 W m-1 K-1, respectively. Nevertheless, the thermoelectric figure of merit zT was significantly reduced by the solid solution alloying due to a significant reduction of power factors despite the reduction in thermal conductivity.

International student mobility and poverty reduction: A cross-national analysis of low- and middle-income countries

While educational expansion is often acknowledged as a driving force in poverty reduction, there has been limited scholarly exploration of the influence of international higher education on poverty alleviation. With the dramatic surge of international student mobility, tripling from two million in 1997 to over six million by 2021, previous research has predominantly focused on individual benefits such as skill acquisition and labour market outcomes, overlooking the broader societal effects in students’ home countries. This study examines how international higher education influences poverty reduction in the home countries of students from low- and middle-income nations, drawing on a theoretical framework rooted in transnationalism. Employing dynamic panel data analysis with the System Generalised Method of Moments approach on data from 1999 to 2018, this study finds that while the immediate effect of international student mobility on reducing extreme poverty is not significant, its long-term association over a fifteen-year period is significant. These results suggest the transformative potential of international higher education for sustainable development, emphasising its systemic and long-term effects in poverty alleviation. Our research highlights that policy interventions expanding access to international higher education could be an important element of poverty reduction strategies in low- and middle-income countries.

Blue sensitive sub-band gap negative photoconductance in SnO2/TiO2 NP bilayer oxide transistor.

Large negative photoconductance (NPC) of SnO2/TiO2 nanoparticles (NPs) heterostructure has been observed with thin film transistor (TFT) geometry and has been investigated using sub-bandgap light (blue) illumination. This negative photoconduction has been detected both in accumulation and depletion mode operation, which effectively reduces the carrier mobility (μ) of the TFT. Moreover, the threshold voltage (Vth) widely shifted in the positive direction under illumination. The combined effects of the reduction of mobility and Vth shifting led to a faster reduction of On (or Off) state current under illumination. The negative photosensitivity of this system is as high as 3.2 A W-1, which has been rarely reported in the earlier literature. Moreover, the variation of On (or Off) current, μ and Vth shift is linear with low-intensity blue light. This SnO2/TiO2NPbilayer channel has been deposited on top of an ionic dielectric (Li-Al2O3) that reduces its operating voltage of this TFT within 2 V. Furthermore, the device has achieved a saturation mobility of 0.4 cm2 V-1 s-1 with an on/off ratio of 7.4 × 103 in the dark. An energy band diagram model has been proposed based on the type-II heterostructure formation between SnO2/TiO2 semiconductors to explain this NPC mechanism. According to the energy band diagram model, adsorbed H2O molecules of TiO2 NPs created a depleted layer in the heterostructure that accelerated the recombination process of photo-generated carriers rather than its transport.

Quantifying the Effect of Quarantine Control and Optimizing Its Cost in COVID-19 Pandemic.

The novel coronavirus has been spreading worldwide and emerged as a public health crisis. As the rapid rise of infected population count, a wide variety of stringent non-pharmaceutical interventions have been taken by cities and countries around the globe, including mobility reduction, social distancing and regional lockdown. The efficacy of these interventions is hard to quantify as individuals violate policies, travel inadvertently or deliberately, and spread the virus without themselves being infected. Furthermore, the publicly available pandemic data on infectious rates and other epidemiological data are unreliable and limited, and are even underestimated. In this paper, we intend to interpret and forecast the spreading dynamics of Covid-19 and quantify the efficacy of quarantine control adopted by Wuhan, Italy, South Korea and the United States of America, employing a hybrid model of an epidemiological model and a data-driven neural network model. Furthermore, since the Covid-19 has prompted global travel restrictions, aggravated unemployment, and influenced the global economy, which exemplify the great societal cost of interventions in the battle of halting Covid-19 spreading. We intend to develop optimal quarantine control under which the tradeoff between Covid-19 containment and the societal cost of quarantine control can be optimized. Optimal quarantine control enables communities have opportunities to catch their breath to reserve healthcare resources preemptively, while the Covid-19 spreading can be halted. Our results unequivocally indicate that governments that taken stringent interventions starting from the initial stage can efficiently halt the spreading of Covid-19; furthermore, the total societal cost of such interventions is greatly smaller.

Functional Outcomes of Open Reduction and Internal Fixation in Proximal Humerus Fractures by Philos Plate

INTRODUCTION Proximal humerus fractures are one very common and usually occur in elderly people. These fractures are usually associated with some degree of comminution and deformity. Therefore, good anatomical reduction of fracture fragments and early mobilization are the main component for optimal outcomes of involved limb. This study was intended to evaluate the functional outcome of proximal humerus fracture in adults managed by open reduction and internal fixation (ORIF) by proximal humerus interlocking osteosynthesis (PHILOS) plate. MATERIAL AND METHODS This prospective and observational hospital based study was carried out in Orthopedics Department of Universal College of medical Sciences-Teaching Hospital (UCMS-TH) from October 2021 to September 2023. All patients with proximal humerus fractures who fulfilled the inclusion criteria and who underwent open reduction and internal fixation by PHILOS plate were enrolled in the study. Functional outcome was assessed according to Constant murley scoring system and Visual analogue score. Post-operatively patients were regularly followed at 6 weeks, 3 months and 6 months. RESULTS In this study of 60 cases, the mean age group was 55.38±11.40 years and male patients outnumbered female patients (39 males and 21 females). 36 cases (60%) were of right side and 24 (40%) were of left side. Majority of the fractures were due to fall injury (57%) followed by road traffic accident (35%). The mean Constant Murley Score was 78.15±5.620 and VAS (visual analogue score) was 1.88±0.865. CONCLUSION Open reduction and internal fixation by PHILOS plate is an effective procedure providing good anatomical restoration and early mobilization in proximal humerus fracture thus providing good functional outcome.

Adipose Tissue Stem Cells for Knee Arthritis and Cartilage Lesions: A Three-Year Follow Up.

The purpose of this research article is to evaluate the efficacy and the safety of injections of stromal vascular fraction (SVF), obtained with mini-lipoaspiration of fat tissue for knee osteoarthritis and cartilage lesions. Between January 2018 and February 2021, a total of 76 patients (45 females and 31 males, mean age 64 years; range 53-75 years, body mass index [BMI] no more than 30%, with symptomatic primary osteoarthritis of the knee, without previous arthroscopic intervention) underwent a local tumescent lipoaspiration procedure of 60-80cc of fat tissue from the abdomen. SVF was obtained after centrifugation according to the AdiPrep® Adipose Transfer System (Harvest-Terumo, Plymouth, Massachusetts) technique. The final product was checked with flow cytometry for absolute numbers, vitality, and the cluster of differentiation (CD) population. It was injected intraarticularly into the patients knees. Patients were divided in two groups: Group 1 had patients with knee osteoarthritis Kellgren-Lawrence grade early 4 and Group 2 with osteoarthritis K-L grade 2-3. The International Knee Documentation Committee (IKCD) and Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaires were used to evaluate clinical effects and measure patient's subjective assessment of pain, joint mobility, and physical disability before the injections. They were repeated at six months, one year, two years, and three years post injections. Knee cartilage lesions patients were divided in two subgroups: Group A (11 patients with OA K-L grade 2-3 and Outerbridge cartilage lesions grade 2-3) and Group B (7 patients with OA K-L grade early 4 and cartilage lesions Outerbridge grade late 3 to early 4) were estimated with quantitive analysis of magnetic resonance imaging (MRI) at one, two, and three years post injections. The average IKDC score in Group 1 was 45.9, 63.2, 62.4, 60, and 52. The KOOS score of the same group was 53, 79, 72, 69, and 62 at the end of the third year. At baseline, the average total IKDC score in Group 2 was 48.3, at 6 months 78.2, at one year 77, at two years 70.4, and at three years 61. The KOOS score of this group was 57, 84, 86, 79, and 69 at three years, respectively. For the patients with cartilage lesions, Group A presented lesser volume mean numbers of the lesion: 74% at the end of the first year post injection, 61% at the second, and 52% at the end of the third year with two out of seven patients in the group. The rest had no significant difference. Lesser volume mean number of the lesions in Group B was 85-88%, 70%, and 61% at the end of the third year in 5 out of 11 patients in the group. The rest had no significant difference. Adipose-derivedSVF, injected intraarticularly in arthritic knees, seems to provide good to excellent clinical results for three years and radiological results for cartilage lesions for two years post injections. All patients were satisfied with this treatment with reduction in pain and better joint mobility, especially after two to three months and up to three years. No serious side effects or complications were reported.