Mobility Status Research Articles

Physical activity and influencing factors in people post stroke or transient ischemic attack across diverse regions in Sweden

Background and purposePhysical activity (PA) and sedentary behavior are key targets for secondary stroke prevention, yet their characteristics and contributing factors are not well understood. This study aims to explore PA and sedentary behavior in individuals' post-stroke or transient ischemic attack (TIA) and identify factors linked to low PA (≤5,000 steps/day) and prolonged sedentary time (≥8 h/day).MethodsA cross-sectional study comparing sensor-derived (activPAL) PA and sedentary time among community-dwelling individuals post stroke or TIA residing in diverse geographical regions of Sweden. Multiple logistic regression models were performed to determine potential factors associated with low PA and prolonged sedentary time.ResultsThe study included 101 participants post-stroke (n = 68) and TIA (n = 33), with a mean age of 70.5 years (65% female), mostly with no or mild disability (91%), living in metropolitan (69%) and rural (31%) areas of Sweden. Most participants (72%) had ≥ 8 h of sedentary time per day and 38% performed ≤5,000 steps per day. Using a walking aid (OR = 11.43, p = 0.002) was independently associated with low PA, whereas contextual factors; living alone (OR = 3.49, p = 0.029) and living in metropolitan areas (OR = 2.79, p = 0.036), were associated with prolonged sedentary time.Discussion and conclusionsIn this study encompassing people post stroke or TIA from diverse geographical regions across Sweden, PA was associated with mobility status whereas sedentary behavior was associated with contextual factors. The results also showed a large variation in PA highlighting the need for tailored strategies to promote PA post stroke or TIA.

Factor influencing taxpayer compliance on voluntary tax disclosure program initiative: Case of Kenya revenue authority southern region

Tax is the primary source of government revenue, its vital component in running daily government activities. Not collecting enough tax causes the government to strain or stalling of its mandates, therefore its role of every government to mitigate and maximize its tax collection scope. The research sought to investigate the factors influencing taxpayer compliance on voluntary tax disclosure program in Kenya Revenue Authority, case of Southern region. The specific objectives of these research included, to assess the effects of Tax Sanctions on the taxpayer on participation in a voluntary tax disclosure program. To determine the impact of subjective norms of taxpayer participation on the Voluntary tax disclosure program. To evaluate the influence of taxpayer knowledge on participation in a voluntary tax disclosure program. The main challenge that was thematic for investigation, why despite the opportunity to declare asset without punitive punishment, still there is few uptakes for the program. The geographical location of the research was in Southern Region Domestic Taxes department on its six tax office namely; Voi, Mombasa South, Lamu, Malindi, Mombasa North and Diani for the financial year 2023/2024. The study sought to use descriptive approach, where a sample size of 150 was derived from a population of 230 staffs in Compliance Domestic taxes. Data collection was done using online well-structured questionnaire via Kobo-Collect in a random sampling and analyzed using SPSS version 28. To test validity and reliability of the data pilot test was conducted and Cronbach alpha and KMO-test proved data to be reliable and valid. The output of the analysis showed the regression model whose covariates, Tax sanction (t=2.448, P<0.016) subjective norm (t=3.347, P<0.001) and taxpayer Knowledge (t=7.827, P<0.00) were all significant at 95% level. Moreover, the R2 =0.951 which means the exploratory variables explained 95.1% variation of Compliance to the Voluntary tax disclosure. The ANOVA result showed the data was fit to the model was good at (F=942.61, p<0.00). The study concluded indeed, Subjective norms, Tax Sanction and Taxpayer Knowledge influences greatly compliance of Taxpayer towards Voluntary tax disclosure. The research implied that proper use of tax sanction such us fines, penalties, and interest on taxpayers would increase compliance. Also educating taxpayer is essential as the decisions made by some taxpayers depend on the knowledge they have acquired. Also on subjective norms, some behaviors are traceable as some are based on influence of association hence compliance officer need to continuous encourage taxpayer to comply. This research recommends that the authority through the compliance officer, use of subjective norms, Taxpayer knowledge and Tax sanction as a mitigating strategy to mitigate on Voluntary tax disclosure, through this it will increase tax base and revenue mobilization and compliance status of Taxpayers.

An Intelligent Scheduling Approach on Mobile OS for Optimizing UI Smoothness and Power

Mobile devices need to respond quickly to diverse user inputs. The existing approaches often heuristically raise the CPU/GPU frequency according to the empirical rules when facing burst inputs and various changes. Although doing so can be effective sometimes, the existing approaches still need improvements. For instance, raising processors’ frequency can lead to high power consumption when the frequency is over-provisioned or fails to meet user demands when the frequency is under-provisioned. To this end, we propose MobiRL, a reinforcement learning-based scheduler for intelligent adjusting CPU/GPU frequency to satisfy user demands accurately on mobile systems. MobiRL monitors the mobile system status and autonomously learns to optimize UI smoothness and power consumption by conducting CPU/GPU frequency-adjusting actions. The experimental results on the latest delivered smartphones show that MobiRL outperforms the widely used commercial scheduler on real devices – reducing the frame drop rate by 4.1% and reducing power consumption by 42.8%, respectively. Moreover, compared with a study using Q-Learning for CPU frequency scheduling, MobiRL achieves up to 2.5% lower frame drop rate and reduces power consumption by 32.6%, respectively. Our approach has been deployed in mobile phone products.

Scabies in 604 Patients: A Glimpse into the Disease Burden and Its Associated Mortality in Hong Kong.

Scabies is a worldwide parasitic dermatosis with a significant health burden on the young and the elderly. Statistics about the prevalence of scabies in Hong Kong are not available. This is a retrospective study of patients from a regional hospital cluster in Hong Kong with microscopy-documented Sarcoptes scabiei infestations from January 2018 to December 2022. The condition was categorised into classical scabies and crusted scabies upon clinical presentation. Demographic data, comorbid diseases, mobility and residential status, seasonal variability, secondary bacterial infection, treatment and outcomes were described. These were compared between classic and crusted scabies. In total, 604 patients were identified, representing 51.65 per 100,000 discharged patients during the study period. The median age was 84 years and 54.5% were male. The majority (506 or 83.8%) came from residential care homes for the elderly. The mean time from admission to diagnosis was 8.8 days for community-acquired infestation. There were 564 and 40 cases of classic and crusted scabies, respectively. The two groups of patients were comparable in terms of residence in elderly homes, co-existing chronic illnesses, mobility, and time from admission to diagnosis. Forty-five (7.5%) patients had positive blood cultures temporally associated with scabies. Patients with crusted scabies were at higher risk for bacteraemia (7/40 versus 38/564, p = 0.022). Permethrin and benzyl benzoate were the most popular treatment regimens, with treatment failure observed in 59/397 (14.4%) and 18/173 (10.4%), respectively. There were 172 (28.5%) mortalities within 30 days of scabies diagnosis. Thus, the burden of scabies infestation is significant in Hong Kong. Hospitalised patients diagnosed with scabies are mainly senior citizens living in residential care homes for the elderly, suggesting reservoirs of S. scabiei in the community. Of concern, bacteraemic illnesses are common and significant mortality is temporarily associated with infestation. With a rising elderly population, there is a pressing need to understand and control scabies in Hong Kong. Our study did not find that common medical illness, besides immunosuppressive therapy, predisposed patients to crusted scabies. The crusted form of scabies was associated with a higher risk of bacteraemia. The current study provides a better perspective of the disease load of scabies in Hong Kong.

Association of crop commercialization and rural households' multidimensional poverty using targeted maximum likelihood estimation

Recent evidence shows the highest prevalence of multidimensional poverty in the world. To alleviate poverty, Ethiopia is investing in stimulating agricultural commercialization for poverty reduction, driving sustainable economic growth, and creating jobs. Therefore, this study investigated the causal relationship between crop commercialization and multidimensional poverty across Ethiopian rural households using the Ethiopia Socioeconomic Survey 2018/19 data, which included 1129 crop commercialized and 1585 completely subsistence rural households. Moreover, this study also examined the causal effect of crop commercialization on the multidimensional poverty mediated by mobile phone ownership status. The study used the double robust method of the augmented inverse probability of treatment weighted (AIPTW) and targeted maximum likelihood estimation (TMLE) methods. The result showed that crop commercialization has an association with multidimensional poverty. Specifically, the TMLE with a default super learner model estimates were the most precise and suggest that the prevalence of risk of being multidimensionally poor among rural households who were crop commercialized is 12.2 % lower than for those who were completely subsistence households. Thus, it is important to have more robust policies like crop commercialization to target rural multidimensional poverty reduction. Moreover, the controlled direct effect estimation analyses showed that crop-commercialized rural households reduced the adjusted risk of multidimensional poverty by; 12 % for those who owned mobile phones and 7.8 % for those who did not. To ensure sustainable livelihoods for rural multidimensional poor households, it is necessary to have a multidisciplinary policy intervention to promote crop commercialization through the spread of mobile phones in rural areas.

Do facilitators and barriers to community ambulation differ among stroke survivors in low resource settings? A cross-sectional study in Nigeria

ABSTRACT Purpose Stroke survivors (SSV) in many low- and middle-income countries experience frustrating participation restriction in community ambulation (CA), which impedes community life. This study assessed facilitators and barriers to CA among community-dwelling SSV in a southwest state of Nigeria. Methods This cross-sectional study involved 66 community-dwelling ambulating SSV, purposively recruited from physiotherapy out-patient clinics of selected hospitals in southwest Nigeria. Semi-structured questionnaire containing physical and social environment elements of the ICF domains was administered on respondents. Mobility status at home and community, socio-demographic and clinical data of SSV were also obtained. Responses from open-ended questions were triangulated with appropriate close ended options. Data were analyzed using descriptive statistics and logistic regression at p < 0.05 Alpha value. Results Majority of the SSV were independent in their homes (59.1%), used mobility aids (87.9%) and assisted in CA (66.7%). They identified limited physical accessibility by crowds 25 (37.9%), lack of inclined surfaces 40 (95.2%), uneven floors 36 (87.8%), public seating arrangements 33 (78.6%), rain (73.8%) and inability to use services, systems and policies (77.3%) as barriers to CA. Built physical environment was a significant predictor of home (OR = 0.754, p = 0.001) and community mobility (OR = 0.850; p = 0.018), while post-stroke depression was a significant predictor of community mobility (OR = 1.038; p = 0.014). Conclusion Mobility aids, social attitudes and general support were identified as facilitators, whereas barriers to CA included built physical environment, services and policies, products and technology. Facilitators and barriers to CA are similar to some HIC contexts, perceived difficulties and experiences differ for infrastructural and social reasons among others.

Optical Fiber‐Based Wearable Sensors for Remote Health Monitoring [Invited

AbstractThe wearable optical fiber sensors have demonstrated significant promise in the realm of health monitoring in recent times. These sensors utilize the flexibility and exceptional sensitivity of optical fibers to precisely measure many physiological aspects of the human body, including heart rate, breathing rate, mobility status, and body temperature. Optical fiber sensors usually have good biocompatibility and anti‐interference capabilities, can be integrated into flexible materials, and are suitable for long‐term wear. It can be integrated into clothing, patches, or accessories to provide continuous, real‐time health data monitoring, providing important support for personalized medicine and remote health management. This paper primarily presents the fundamental operating concept of wearable optical fiber sensors and their use in monitoring physiological signals across multiple domains. In conclusion, this paper provides a summary of the limitations and future prospects of wearable fiber sensors using optical fiber technology.

Outcomes and Management of Dislocated Hip Hemiarthroplasty.

Purpose and aims Hip hemiarthroplasty (HHA) is a common procedure undertaken to manage intracapsular neck of femur fractures. Dislocation of HHA is one of the most dreadful complications. There is a paucity of clinical evidence to guide decision-making for managing these patients. The aim of this study was to describe the operative management and outcomes of patients with dislocated hemiarthroplasties of the hip and outline a treatment strategy for their management. Methods We conducted a retrospective analysis of all the patients presenting to University Hospitals of Derby and Burton, UK with hip fractures between 2016-2022. We included all the patients who underwent a hemiarthroplasty for their fracture. We excluded patients who had malignancy and if clinical data was missing. Each operative intervention and subsequent dislocationswere recorded. We recorded the following outcome measures: dislocation, surgical interventions, mortality, revision surgery, cognition status, residential status, and mobility. We also compare these outcomes with the patients who had HHA and did not sustain any dislocation. Results Of the 1134 patients treated with HHA during this period, 33 patients sustained dislocation. Of the 33 patients, 29 were female and 4 were male with mean ages of87.4±7.4 and89.25±9.54,​ respectively. Following the first dislocation, 25 patients were treated with closed reduction, six patients had excision arthroplasty (EA), and two patients were treated non-operatively. About 21 patients went on to have second and third dislocations, none of these had EA and others had conversion to total hip replacement (THR). Nearly 80% of dislocations occurred within two months of the initial procedure. The mean mental test score was 7.91±2.01 (p=0.001) and was significantly higher in patients who underwent conversion to THR. The average ASA grade was significantly higher in patients who had closed reduction (2.93±0.25, p=0.001)and EA (3.28±0.46, p=0.002)compared to the patients who had no dislocation. Patients who underwent EA had significantly higher acute length of hospital stay23.5±13.5(p=0.02) and mortality (p=0.001)compared to other groups. We found no significant difference in dislocation rates where the initial procedure was carried out by registrars or consultants (p=0.567). Conclusion We concluded that the dislocation risk is higher in females and within the first two months of the index procedure. More than 80% of patients had a second dislocation following a successful closed reduction. In our cohort, 45% of patients had EA (Girdlestone procedure) and 36% had a conversion to THR. EA was associated with increased mortality rates, acute length of hospital stays, and significant change to premorbid mobility status. Amultidisciplinary team (MDT) approachis necessary following the second dislocation to prevent further morbidity associated with recurrent dislocations.

Longitudinal impact of multi-segment spinal fixation surgery on mobility status and clinical outcomes in adult spinal deformity: a multicenter retrospective study.

To investigate changes in postoperative mobility status in patients with ASD, and the determining factors that influence these changes and their impact on clinical outcomes, including the rate of home discharge and long-term mobility. A total of 299 patients with ASD who underwent multi-segment posterior spinal fusion were registered in a multi-center database were investigated. Patient mobility status was assessed using walking aids and classified into five levels (1: independent, 2: cane, 3: walker, 4: assisted, and 5: wheelchair) preoperatively, at discharge, and after 2years. We determined improvements or declines in the patient's mobility based on changes in the classification levels. The analysis focused on the factors contributing to the deterioration of postoperative mobility. Two years postoperatively, 87% of patients maintained or improved mobility. However, 27% showed decreased mobility status at discharge, associated with a lower rate of home discharge (49% vs. 80% in the maintained mobility group) and limited improvement in mobility status (35% vs. 5%) after 2years. Notably, postoperative increases in thoracic kyphosis (7.0 ± 12.1 vs. 2.0 ± 12.4°, p = 0.002) and lower lumbar lordosis (4.2 ± 13.1 vs. 1.8 ± 12.6°, p = 0.050) were substantial factors in mobility decline. Postoperative mobility often temporarily decreases but generally improves after 2years. However, an overcorrection in sagittal alignment, evidenced by increased TK, could detrimentally affect patients' mobility status. Transient mobility decline associated with overcorrection may require further rehabilitation or hospitalization. Further studies are required to determine the biomechanical effects of surgical correction on mobility.

The Difference In Fitness And Lower Body Power Based On Mobility Status In First Responders

The Difference In Fitness And Lower Body Power Based On Mobility Status In First Responders

A Study To Investigate Fear Of Falling On An Age-Related Rehabilitation Unit

Abstract Background Fear of falling (FOF) is a lasting concern about falling that can lead an individual to avoid activities that he/she remains capable of preforming. Due to a FOF many older adults restrict their activities and subsequently increase their risk of falls. The aim of this study was to 1. Obtain a profile of FOF in an age-related inpatient population 2. Determine the severity of their FOF 3. Collect mobility status and falls history. Methods All current inpatients on two age-related rehabilitation units (age &amp;gt;/= 65 years) with sufficient communication were included. Patients were facilitated to complete The Falls Efficacy Scale International (FES-I) which is a 16-point scale that is valid and reliable. A score of 16-19 indicates a low concern, 20-27 moderate concern and 28-64 a high concern about falling. A two-point convenience sampling at summer and winter period was used. Data was anonymized and recorded using Microsoft excel. Results 68 questionnaires were collected. 40% of patients were independently mobile (+/- a walking aid), 16% required supervision, 26% assistance of one and 18% assistance of two. 100% of patients had a FOF (FES-I score &amp;gt;16). 80% (N=54) of patients had a high FOF, 13% (N=9) had a medium FOF, and 7% (N=5) a low FOF. 75% (N=51) of patients had a documented falls history. 80% (N=41) of people with a falls history had a high FOF. 76% (N=13) of those with no falls history had a high FOF. Conclusion This the first profile of FOF in our age-related rehabilitation unit. 93% of patients reported a high or medium FOF with high rates reported independent of a history of falling. Addressing FOF with evidence-based interventions and psychological support may reduce length of stay and increase successful discharges from older person rehabilitation units.

Mediating Effect of the Stay-at-Home Order on the Association between Mobility, Weather, and COVID-19 Infection and Mortality in Indiana and Kentucky: March to May 2020

(1) Background: The association of COVID-19 infection and mortality with mobility and weather in Indiana and Kentucky was compared for the period from 1 March to 15 May 2020. (2) Methods: The risk of COVID-19 infection and mortality was evaluated using Cox regressions with the following covariates: mobility (retail/recreation, grocery/pharmacy, and workplace), weather (precipitation, minimum and maximum temperature, ultraviolet [UV] index), and metropolitan status. (3) Results: A higher maximum temperature (adjusted hazard ratioinfection (aHRi) = 1.01; adjusted hazard ratiodeath (aHRd) = 1.001), metropolitan status (aHRi = 1.12; aHRd = 2.05), and a higher minimum temperature (aHRi = 1.01) were associated with increased risks of COVID-19 infection and/or mortality. Protection against COVID-19 infection and/or mortality was associated with retail/recreation (aHRi = 0.97; aHRd = 0.937), grocery/pharmacy (aHRi = 0.991; aHRd = 0.992), workplace (aHRi = 0.99; aHRd = 0.965), precipitation (aHRi = 0.999; aHRd = 0.9978), UV index (aHRi = 0.37; aHRd = 0.748), and a higher minimum temperature (aHRd = 0.994). COVID-19 infection (aHRi = 1.18) and mortality (aHRd = 1.59) risks were higher in Indiana compared to Kentucky. (4) Conclusions: COVID-19 infection and mortality were 18% and 59% more likely among Indiana residents compared to Kentucky residents, respectively. This may be attributed to variations in stay-at-home order compliance and enforcement between Indiana and Kentucky.

Fractionation of Sediment-Bound Nitrogen: Bioavailability and Contamination Status of the Nutrient in Thrissur Kole Wetlands, Southwest India

ABSTRACT Fractionation of sediment-bound nitrogen (N) in Thrissur Kole wetland was carried out to assess the mobility, bioavailability, and nutrient contamination status. Various N fractions were extracted using KCl equilibrium extraction method, and the concentration of each N fraction was analyzed by spectrophotometric method. Dominance of ammonia during all seasons was due to dissimilatory NO3 − reduction to NH4 + and direct inputs from agriculture fields. Enrichment of urea during post-monsoon (181.78 ± 8.47 ppm) was attributed to fertilizer sources. NO3 −-N deficit at central zone of the study area (monsoon and post-monsoon) was due to the anoxia. Comparatively higher values of NO2 −-N during monsoon (0.07 ± 0.02 ppm) was due to the land run-off, leaching of fertilizers from agriculture fields, and higher rate of denitrification. Elevated content of total N [1819.94 ± 40.20 ppm (pre-monsoon); 3061.62 ± 13.21 ppm (monsoon); 2763.44 ± 9.65 ppm (post-monsoon)] reflected the inputs from in-situ production, agriculture, terrestrial run-off, waste disposal, and guano as well as carcass of birds. Average contribution of bioavailable N to total N was higher (36.16%) indicated the possibility for eutrophication risk during pre-monsoon. Agriculture dominated regions recorded severe contamination and eutrophication risk as indicated by organic pollution index, organic nitrogen index, and phosphorous pollution index.

Early Biomarkers in the Prediction of Later Functional Impairment in Preterm Children With Cerebral Palsy

BackgroundTo identify early biomarkers that could predict later functional capabilities in preterm children with later cerebral palsy (CP). MethodsData from 968 preterm children with later CP were extracted from the Canadian Cerebral Palsy Registry. One hundred eighty-two infants were born before 27 weeks of gestation, 461 infants were born between 27 and 33 weeks, and 325 infants were born between 34 and 37 weeks. Univariate and chi-square analyses were conducted to measure the association between early objective biomarkers and later mobility status defined as Gross Motor Function Classification System (GMFCS) levels IV and V as well as tube feeding dependence. ResultsUnivariate analysis suggested no significant association between GMFCS levels IV and V or impaired feeding status and bilateral white matter injury on magnetic resonance imaging, high-grade intraventricular hemorrhage on head ultrasound, chorioamnionitis, a birth weight of 1000 to 1500 g or <1000 g, as well as an Apgar score of ≤5 at five minutes of life. Similar results were found for gestational age <28 weeks at birth. Only a significant association between GMFCS levels IV and V and a cord or first hour of life pH of ≤7 was reported (mobility status: odds ratio [OR] 1.95, 95% confidence interval [CI] 1.09 to 3.57) and feeding status: OR 2.23, CI 0.97 to 4.65)]. ConclusionsPrediction of functional outcomes based on specific early biomarkers appears hard to obtain in children with CP born preterm in contrast to those born at term. The complications and causal pathways inherent to prematurity may contribute to making prognostication less determinant.

A longitudinal study of parents’ home-safety practices to prevent injuries during infancy

Unintentional injury represents a significant health threat to children, and infancy marks a particularly vulnerable stage. This multi-method study (questionnaire, diary) measured parents’ (N = 143) use of three popular home-safety practices (teaching about safety, environment modification to reduce access to hazards, supervision) and child injury rates at two stages of motor development during infancy (sitting, walking). Associations between these three safety practices and parental beliefs (protectiveness needed, perceived benefits of the child experiencing minor injuries) were examined, as was the effectiveness of these three practices to prevent injury. Results revealed that different parental beliefs were associated with implementing different safety strategies at each motor development stage. Strategies were differentially effective depending on mobility status of the infant, with supervision being the only strategy that was effective to prevent injury at both motor development stages. Implications for developing safety messages to promote parents’ injury-prevention strategies are discussed.

Posterior Malleolus Fracture Fixation In Lateral Decubitus Position: Surgical Technique and Results in 60 Patients

The present study shows how posterior malleolus fractures (PMFs) and distal fibular fractures were fixed using the posterolateral approach with the patient in lateral decubitus position, not previously described in the literature. This technique has been used in 60 consecutive patients (42 women and 18 men; mean age 54.7; range 21-92 years), 33 of which presented as fracture dislocations from March, 2021 to December, 2023. After PMFs fixation in lateral decubitus position, release of the sacral support allowed patients to be placed supine (without de-sterilizing the operative field), in order to proceed with medial malleolus or posteromedial fragment fixation. Fractures were classified according to the Lauge Hansen classification as SER4 (n = 50), PER4 (n = 7), SAD (n = 1), and PAB (n = 2). Fractures were classified according to Rammelt & Bartonicek, as type B (n = 40), C (n = 13), and D (n = 7). During the same period of time 14 fractures involving the PM, classified as type A, were treated with indirect fixation, whilst 6 geriatric and/or poor mobility patients with fracture dislocations were treated with retrograde hindfoot nail fixation. Follow-up period ranged from 4-36 months (mean = 14.4; SD = 8.8). Complications occurred in 5 patients (8.3%; 3 had delayed (medial) wound healing, one developed CRPS and one required implants removal and arthroscopy because of metal irritation and stiffness). No deep infections, thromboembolic events, fracture malreductions or malunions were recorded and all patients returned to the preinjury mobilization status. In conclusion, PM fracture fixation was feasible and safely performed with patients in lateral decubitus position.

L Test Subtask Segmentation for Lower-Limb Amputees Using a Random Forest Algorithm.

Functional mobility tests, such as the L test of functional mobility, are recommended to provide clinicians with information regarding the mobility progress of lower-limb amputees. Smartphone inertial sensors have been used to perform subtask segmentation on functional mobility tests, providing further clinically useful measures such as fall risk. However, L test subtask segmentation rule-based algorithms developed for able-bodied individuals have not produced sufficiently acceptable results when tested with lower-limb amputee data. In this paper, a random forest machine learning model was trained to segment subtasks of the L test for application to lower-limb amputees. The model was trained with 105 trials completed by able-bodied participants and 25 trials completed by lower-limb amputee participants and tested using a leave-one-out method with lower-limb amputees. This algorithm successfully classified subtasks within a one-foot strike for most lower-limb amputee participants. The algorithm produced acceptable results to enhance clinician understanding of a person's mobility status (>85% accuracy, >75% sensitivity, >95% specificity).

Pamidronate Response in a Novel Biallelic CREB3L1 Gene Mutation-Associated Osteogenesis Imperfecta: A Case Report.

We report a 15-year-old adolescent boy being followed up for 6 years with osteogenesis imperfecta (OI). Genetic testing of this child revealed a novel missense variant c.925C>T p.Arg309Cys in the CREB3L1 gene. Treatment with regular pamidronate therapy showed increased bone mineral density and a reduced fracture rate. His lower limb rush rodding improved his mobility. His withdrawal from bisphosphonate therapy worsened his mobility status but started improving after he restarted treatment, suggesting a response to pamidronate therapy. We report a novel biallelic missense variant c.925C>T, p.Arg309Cys, in the CREB3L1 gene causing OI, which responded to bisphosphonate therapy and corrective surgery.

Comparative Outcomes and Failure Rates of Total Femur Replacement in Oncologic and Nononcologic Indications: A Systematic Review and Meta-analysis.

Total femur replacement (TFR) has become increasingly significant as a salvage procedure for both oncologic reconstruction and complex nononcologic conditions such as revision arthroplasty. Despite its effectiveness in limb salvage, TFR is associated with high complication and failure rates, which vary depending on the underlying indication. This systematic review and meta-analysis adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of MEDLINE, EMBASE, Web of Science, and Cumulative Index to Nursing and Allied Health Literature databases was conducted, focusing on studies that reported outcomes of TFR in oncologic and nononcologic cases. Primary outcomes included failure mode and rates according to the Henderson classification, functional outcomes scores, and mobility status. Data were analyzed using random-effects models and generalized linear mixed models. A total of 35 studies involving 1,002 patients were included. The majority of TFRs were performed for oncologic reasons (63.7%). The mean Musculoskeletal Tumor Society (MSTS) score was 66%, with a limb salvage rate of 89%. The meta-analysis revealed a combined failure rate of 34%. For type 4 failures (infection), nononcologic patients exhibited a significantly higher rate at 18% (95% confidence interval [CI], 12%-26%, I2 = 46%, p < 0.01) compared with 8% in oncologic patients (95% CI, 6%-12%, I2 = 0%). Regarding combined types 1 to 4 failures, oncologic patients had a rate of 20% (95% CI, 25%-52%, I2 = 60%), whereas nononcologic patients faced a higher rate of 37% (95% CI, 12%-26%, I2 = 63%) (p < 0.05), indicating a significant difference. There were no significant differences in the MSTS score. In addition, there were no notable differences when comparing failure modes 1, 2, and 3 independently. Mobility analysis showed that approximately 70% of patients required walking aids after surgery. TFR offers a valuable limb salvage option in both oncologic and nononcologic scenarios, despite its high failure rates. Although functional outcomes were similar between groups, the higher failure rate in nononcologic cases and the poor overall quality of evidence warrant further comprehensive assessments into predictors of outcomes to optimize results. Level III. See Instructions for Authors for a complete description of levels of evidence.

Effect of postoperative hip joint exercises therapy on physical mobility status among patients with hip fracture surgery

Effect of postoperative hip joint exercises therapy on physical mobility status among patients with hip fracture surgery