Motion Index Research Articles

Fast-track surgery and telerehabilitation protocol in unicompartmental knee arthroplasty leads to superior outcomes when compared with the standard protocol: a propensity-matched pilot study

BackgroundSeveral strategies have been devised to reduce the length of stay after orthopedic surgery. Telerehabilitation has proved effective in functional outcomes after orthopedic procedures and is appreciated by patients. There is limited information on fast-track surgery and telerehabilitation protocols for unicompartmental knee arthroplasty (UKA). The purpose of this pilot study was to report and compare functional outcomes and satisfaction levels during first 12 months of recovery in patients who underwent UKA according to a fast-track and telerehabilitation protocol (G1) or standard surgery and rehabilitation program (G2).MethodsData were retrospectively collected and reviewed for all elective UKAs from January 2018 to November 2019. A total of seven patients undergoing UKA according to the fast-track and telerehabilitation protocol were propensity score matched (1:3 ratio) to 21 patients undergoing standard surgery and rehabilitation. Patients were matched for age, sex, body mass index (BMI), and laterality. The Western Ontario and McMaster University (WOMAC) osteoarthritis index and range of motion (ROM) were collected pre- and postoperatively in both groups for 12 months. In addition, patient’ satisfaction was collected at 40 days.ResultsThe G1 group demonstrated significantly better outcomes in WOMAC index scores at 2, 15, and 40 days (p < 0.001, p < 0.001, p < 0.020, respectively) and a significantly greater knee ROM after surgery and at 2, 15, 40, and 12 months (p < 0.001, p < 0.001, p = 0.014, p < 0.001, p = 0.003, respectively). No patients in either group had postoperative complications. One patient was not completely satisfied in the G2, while no one in G1 reported not being completely satisfied (p = 1.000).ConclusionsThis fast-track and telerehabilitation protocol after UKA can potentially be applied to patients as it is safe and effective. At 12-months follow-up, both groups reported favorable outcomes after UKA. However, the G1 score was better regarding WOMAC and ROM when compared with the propensity score-matched G2 program. A larger study is warranted to explore the role of fast-track and telerehabilitation in clinical and functional outcomes of UKA.

Quantifying Neck Fibrosis: Establishing the Domain Structure of the Neck Fibrosis Scale.

We recently described the development of the Neck Fibrosis Scale (NFS). In this submission, we confirm domain structure and validate a scoring system for the NFS. Prospective cross-sectional study. Between January 2020 and December 2021, 127 head and neck cancer patients with varying degrees of cutaneous neck fibrosis completed the original 15 item NFS. Exploratory factor analysis was used to identify optimal groupings with similar underlying factors. The association between the domains of the NFS and various measures of neck morbidity (i.e., construct validity) were assessed using gamma regression. Exploratory factor analysis confirmed 13 of the 15 items from the NFS mapped onto two factors, which were labelled 'physical' and 'emotional' domains. Of the remaining two items, 'energy' did not load uniquely onto one factor and was removed. 'Neck-swelling' did not load on either factor (loadings <0.3) but was retained within the physical domain based on clinical importance. This resulted in a revised 14-item questionnaire. Internal consistency for these two domains was high (>0.8, p < 0.01). Both the physical and emotional domains of the revised NFS show strong correlation with the neck dissection impairment index and neck range of motion. The physical domain strongly correlated with neck elasticity (0.902 [95%CI 0.839-0.972], p < 0.01). Patients receiving multimodal therapy had physical domain scores that were 31.6% [95% 13.9-51.8] higher (worse) than unimodal therapy patients. A domain structure and scoring strategy have been developed for the NFS. Future efforts should be directed toward an evaluation of responsiveness. NA Laryngoscope, 133:2198-2202, 2023.

CFD-DEM study on mixing characteristics of ZrO2 particles using the fluidized bed-chemical vapor deposition method

Fluidized bed-chemical vapor deposition (FB-CVD) is the key method to prepare low-temperature isotropic pyrolytic carbon (LTIC) for artificial heart valve. In the process of FB-CVD of pyrolytic carbon, ZrO 2 hollow particles are not only the bed particles forming the fluidized bed, but also play the role of heat carrier in the pyrolysis reaction of carbon source gas. The mixing degree of particles directly affects the coating quality of pyrolytic carbon. In this paper, a coarse-grained CFD-DEM model is used to conduct 3D numerical simulation of fluidized bed to investigate the effect of fluidization wind speed on the mixing characteristics (particle distribution, particle motion and Lacey index) of ZrO 2 hollow particles from the particle perspective. The results show that the mixing process can be accelerated by increasing the fluidization wind speed within a reasonable range, and radial mixing is more sensitive to fluidization wind speed than axial mixing. In addition, due to the different densities of particles in the furnace along the radial direction, the number of particle collisions and the influence of traction also differ greatly, resulting in more significant changes of particle velocity in the fountain area, while the velocity distribution in the annular gap area near the wall is relatively smooth.

Measuring progress of smart cities: Indexing the smart city indices

The ‘smart city’ represents a core feature of modern urban development. The appearance of numerous smart city indices, which claim to successfully evaluate and compare smart city performances, is the manifestation of the concept's growing popularity. The central objective of this paper is to address the integrity and quality of the existing smart city indices, and identify those ones which are fit for international comparison. We propose a method for evaluating the integrity and quality of the existing smart city indices in terms of five criteria – Credibility, Reliability, Methodology, Versatility, Precision. The article critically evaluates six smart city indices and concludes that the Cities in Motion Index from the IESE Business School has the best overall performance. To improve the versatility of the existing smart city indices, this paper proposes a new approach based on respecting three main criteria: refining the types of indicator, defining the smart city domains and adopting context-sensitive measurements. These elements are deemed to be essential for any smart city index.

Municipal Waste Management in Polish Cities—Is It Really Smart?

Efficient municipal waste management is one of the key aspects of smart cities. In the literature, modern technological solutions are mainly analyzed in this context on the example of specific case studies. However, the author of this article attempts a more fundamental, holistic and comparative assessment of waste management in cities, recognized as smart and aspiring to this title. The objective of this attempt is to answer the following question: What results do the designated cities achieve in terms of waste volume reduction, waste segregation and collection costs? The research was carried out on 16 Polish provincial cities used as examples, including two (Warsaw and Wrocław) classified as smart cities in ranking of the Cities in Motion Index 2020. The analysis period covers 2019–2021, and during the research, in addition to the parameters listed above, a multi-criteria analysis was used to allow a collective assessment of the effectiveness of municipal management in the surveyed cities. The results obtained allow the conclusion that the volume of waste per capita in most of the analyzed cities is steadily increasing. The cost of waste management is also growing significantly. These unfavorable phenomena are particularly acute for smart cities, which in the holistic assessment were ranked among the three least effective units in terms of waste management (Lublin, Warsaw, Wrocław).

Comparative Short-Term and Long-Term Effects of Neck Massage and Self-Massage on Tension Type Headache

Background. Tension-type headache is a common complaint in modern society. Self-massage or massage can be prescribed to reduce it, but it is still unclear which of these techniques is more effective in reducing tension-type headaches. The aim of the study is to determine the short-term and long-term effects of neck massage and self-massage in tension-type headache. Methods. 30 people participated in the study, who were randomly divided into two groups: massage and self-massage, 15 people in each group. Outcome measures were subjects’ headache intensity, active head range of motion, fatigue, and functional and emotional disability index pre and post the nine-week interventions and long-term effect – one month after the interventions. Results. Both massage and self-massage after the 9-week interventions significantly reduced pain-related indicators. One month after the interventions, the headache intensity, fatigue, functional and emotional disability of subjects in the self-massage group were significantly (p &lt; 0.05) lower, and the active amplitudes of neck movements were significantly higher (p &lt; 0.05) than in the massage group. Conclusions. Both massage and self-massage significantly reduced subjects’ headaches, increased head range of motion, reduced fatigue, and functional and emotional disability. However, one month after the interventions, the long-lasting effect of self-massage was significantly superior to the massage group. Keywords: pain, functional disability, emotional disability, fatigue.

Abstract 10445: Detection of Viability and Clinical Implications Using Pet/Mri in Patients With Acute Myocardial Infarction

Background: The purpose of this study is to evaluate the role of viability on PET-MRI to predict improvement of echocardiographic findings such as regional wall motion index and left ventricular ejection fraction after successful percutaneous coronary intervention (PCI) for patients with acute myocardial infarction (AMI). Method: A total of 154 patients with AMI who was performed cardiac PET/MRI within 7 days after PCI were enrolled were enrolled. We performed TTE twice before and after in We performed TTE twice before and after PCI in 103 patients. We categorized these patients according to presence of viability on PET-MRI: group A (N=53, patients with viability on PET-MRI) and group B (N=50, patients without viability on PET-MRI) and compared. The primary end point is improvement of regional wall motion abnormality (RWMA) on TTE. Results: Clinical and angiographic findings were similar between the two groups during follow-up of 11months. Among 53 patients in group A, 30 patients (56.6%) showed the result of slight improvement of RWMA on TTE and among them 13 patients (24.5%) showed result of disappeared RWMA on TTE. In contrast, among 50 patients in group B, 22 patients (44%) showed the result of slight improvement and among them, only 4 patients (8%) showed result of disappeared RWMA on TTE. The proportion of patients who showed slight improvement of RWMA between two groups are not statistically significant (p=0.201). But, the proportion of patients who showed disappeared RWMA between two groups are statistically significant (p=0.024). Conclusions: PET/MRI is useful tool to detect viability in patients with AMI. It seems to be predictable to improve cardiac function for the patients with viability on PET-MRI.

Clinical and functional evaluation of bone marrow aspirate concentrate vs autologous conditioned serum in the treatment of knee osteoarthritis.

The aim of this study was to compare the efficacy of a single Bone Marrow Aspirate Concentrate (BMAC) with a cycle of 4 Autologous Conditioned Serum (ACS) injections in the treatment of early-stage knee osteoarthritis (OA). Two groups of 12 patients with degenerative knee OA were treated with a single BMAC injection and with a cycle of 4 ACS injections respectively. Follow-up was set at baseline (t0), one-month (t1) and six-months (t2) evaluating VAS for pain, WOMAC index and range of motion (ROM). We reported a significant improvement in WOMAC after BMAC injection both at t1 (p= 0,001) as well as t2 (p< 0,001), plus a reduction of VAS values in BMAC group at six months follow-up (p = 0,024). In contrast, no significant differences in ROM between the two groups were observed. Both the approaches are safe and effective in the treatment of knee OA, with a major efficacy of BMAC.

Multi-Ship Encounter Situation Identification and Analysis Based on AIS Data and Graph Complex Network Theory

In order to detect multi-ship encounter situations and improve the safety of navigation, this paper proposed a model which was able to mine multi-ship encounter situations from Automatic identification system (AIS) data and analyze the encounter spatial-temporal process and make collision avoidance decisions. Pairwise encounters identification results and ship motion index were combined into a ship encounter graph network which can use the complex network theory to describe the encounter spatial-temporal process. Network average degree, network average distance and network average clustering coefficient were selected. Based on the recognition results of pairwise encounter identification results, a discrete multi-ship encounter network is constructed. The process of multi-ship encounters from simple to complex to simple is mined based on the process of average network degree from 0 to 0 to obtain a continuous spatial-temporal process. The results can be used for multi-ship encounter situation awareness, multi-ship collision avoidance decision-making and channel navigation evaluation, and also provide data for machine learning. Quaternary dynamic ship domain, fuzzy logic and the weighted PageRank algorithm were used to rank the whole network risk, which is critical to “key ship collision avoidance.” This method overcame the problem that the traditional collision risk evaluation method is only applicable to the difference between two ships and ship perception. The risk rank combined with the artificial potential field method was used. Compared with the traditional artificial potential field method, this method has fewer turns and a smoother trajectory.

Effect of Gleno-humeral-capsulo-Ligamentous Stretch Maneuvers on Range of motion in Bilateral Frozen Shoulder

Background: Painful restriction of shoulder movement, without an underlying cause, which results in complete loss of motion of the glenohumeral joint is called Frozen Shoulder. The process is started with an inflammation of the lining of the joint within the shoulder. Gradually this area thickens and results in the shoulder becoming stiffer and more painful. It is seen commonly at the age of 40-65 years and more often in women. Overall, this condition affects work, leisure, and quality of life. Frozen shoulder often progresses in three stages: the freezing, frozen and thawing phases. Risk factors for frozen shoulder are diabetes, thyroid, history of shoulder trauma, cervical radiculopathy, post-operative immobilization, and shoulder surgery. Cyriax described the typical capsular patterns of the gle¬no humeral joint in the frozen shoulder with abduction more limited than external rotation, and external rota¬tion more limited than internalrotation. This study aims to establish the effect of gleno humeral capsulo ligamentous stretch maneuvers on bilateral frozen shoulder. Methods: A total of 40 subjects diagnosed with bilateral frozen shoulder were selected for the study. Subjects received low load prolonged stretching, mobilization and shoulder range of motion exercises. Each session was conducted for 30 minutes duration, 5 days per week for 4 weeks. Outcome measures used were Numerical pain rating scale (NPRS), Goniometer and Shoulder Pain and Disability Index (SPADI). Results: The results of the study demonstrate that there was a significant effect of gleno humeral capsulo ligamentous stretch on numerical pain rating scale (p&lt;0.0001), range of motion (Shoulder flexion, abduction, internal rotation and external rotation (p&lt;0.0001), Shoulder pain and disability index (p&lt;0.0001) during the pre and post intervention assessment. Conclusion: It is concluded that that the use of low load prolonged stretch and mobilization was very effective in reducing pain and improving range of motion. Shoulder range of motion exercises was effective in improving strength and flexibility of shoulder musculature. KEYWORDS: Low load prolonged stretch, mobilization, numerical pain rating scale, Shoulder pain and disability index, Bilateral frozen shoulder.

Prognostic impact of aborted cardiac arrest in patients with acute myocardial infarction

Abstract Background Aborted cardiac arrest (ACA) during the acute ischaemic phase is a relatively frequent but often undervalued complication of acute myocardial infarction (AMI). The aim of this study was to evaluate the clinical and prognostic impact of aborted cardiac arrest in AMI patients and investigate its correlation with infarct size. Methods We conducted a single-centre retrospective study enrolling consecutive patients admitted for AMI, from January 2016 to December 2018. ACA was defined as the need for advanced life support measures and defibrillation, either out-of-hospital or in-hospital, up until culprit vessel revascularisation. Infarct size was estimated using peak serum troponin T, impact on left ventricular ejection fraction (LVEF ≤50%) and echocardiographic wall motion index (WMI). Clinical outcomes included cardiogenic shock (SCAI C or more), need for mechanical circulatory support (MCS), major bleeding events (BARC ≥3) during in-hospital phase and all-cause mortality during follow-up. Results A total of 571 patients were included (65±13 years old, 72% male). Overall, 237 had anterior STEMI, 39 patients (6,8%) suffered ACA (21 out of hospital), 60 progressed into cardiogenic shock throughout the hospitalisation, 7 needed MCS, and 52 had BARC ≥3 bleeding. During a mean follow-up of 32 months, 96 patients died. ACA was significantly associated with higher peak serum troponin T (4802 [1950; 9420] vs 2659 [555; 6708] ng/L – p=0.004), higher proportion of patients with reduced or mildly reduced LVEF (60% vs. 36.5%, p=0.018) and higher WMI (1.7 [1.4; 2.3] vs. 1.5 [1.2; 1.8], p=0.016). Moreover, ACA was also associated with higher risk of cardiogenic shock occurrence (64.1% vs. 6.6%, p&amp;lt;0.001 – OR 25.357 (12.115–53.073)), higher need for MCS (7.9% vs 0.8%, p&amp;lt;0.001 – OR 11.271 (2.427–52.343)) and higher incidence of BARC ≥3 bleeding events (28.2% vs. 8.4%, p&amp;lt;0.001 – OR 4.705 (2.185–10.128)) – Table 1. On univariate Cox regression, ACA showed significant association with all cause death, which remained highly significant after multivariable adjustment (OR 2.431 (1.181; 5.002); p=0.016). Conclusion The occurrence of aborted cardiac arrest in patients with AMI was associated with increased morbidity and mortality. This may be driven by a larger area of arrhythmia prone ischemic myocardium. Funding Acknowledgement Type of funding sources: None.

Effect of dynamic cupping therapy vs. vibrating foam roller on pain, range of motion, function, and quality of life in elderly with subacute and chronic osteoarthritis of knee

Background: Knee osteoarthritis (KOA) is a frequent degenerative disease of joints. The prevalence is approximately 28% among the Indian elderly. Recently complementary and alternative medicine therapies have been used in managing pain and disability. Dynamic cupping therapy is one of the forms used nowadays. Foam rolling and vibration therapy is also a popular intervention in musculoskeletal conditions such as osteoarthritis, osteoporosis, sarcopenia, and low back pain. Nowadays, these two have been combined for the development of vibrating foam rollers. Objectives: This research aimed to compare the result of dynamic cupping therapy to that of a vibrating foam roller on pain, range of motion, function, and quality of life in elderly with sub-acute and chronic KOA. Materials and Methods: The research was carried out on 45 subjects with subacute to chronic KOA who were given thrice a week sessions for 4 weeks’ intervention. Through the randomized method, subjects were divided into a conventional group, dynamic cupping group and vibrating foam roller group outcome measures Numeric Pain Rating Scale, knee range of motion, Western Ontario and McMaster Universities Arthritis Index (WOMAC), and brief Older People's Quality of Life Questionnaire (OPQOL-brief) were used. Results: Wilcoxon rank test revealed a pre-post difference in all three groups with significant P-values which were &lt;0.05 and heterogeneously favored different outcome measures used. Kruskal–Wallis test revealed no difference between the groups. Conclusion: This study concluded that dynamic cupping therapy and vibration foam roller protocols used for the management of KOA are equally effective.

Effects of cervical traction mobilization with mulligan’s SNAGS on Pain, cardiovascular and respiratory outcomes among young adults with cervical pain.

Objective: To determine the effect of Mulligan’s Cervical Sustained natural Apophyseal glide and cervical traction cardiovascular and respiratory outcomes; systolic blood pressure, diastolic blood pressure, heart rate, ventilation rate, oxygen saturation, neck disability index and cervical range of motion. Study Design: Randomized Control Trial. Setting: Shifa Tameer-e-Millat University, Islamabad Pakistan. Period: November 2021 to March 2022. Material &amp; Methods: A total of 84 participants with age range of 18 to 24 years of either gender with cervical pain and hypo mobility were included in the study whereas individuals with history of cervical trauma or injury, any structural deformity, vertebral instability, cardiac and respiratory complications were excluded. These participants were randomly allocated into two groups by using toss and trial method. Experimental group received sustained natural apophyseal glide and traction while the control group was subjected to traction alone. A total of four sessions were provided over a course of four weeks, with two weeks interval between them. Pre and post vitals including blood pressure, heart rate, respiratory rate and oxygen saturation were monitored at each session along with Numeric Pain Rating scale, Neck disability index and cervical range of motion. Results: Mean age of the participants was 21.70±2 years. Both groups showed significant reduction in pain with p value&lt; 0.05 whereas heart rate was significantly increased in experimental group with pre median 81.75(16.6) and post median 82.00(15.05). Flexion range of motion was significantly improved in experimental group with pre median 69.00(15) and post median 71.00(11.7). Cervical left side bending was significantly improved with p value 0.04. Other variables including ventilation rate, oxygen saturation, systolic and diastolic blood pressure, Neck Disability Index, and other cervical range of motion showed no statistically significant difference with p value &gt;0.05. Conclusion: The study results show improvement in both groups in terms of cardiovascular and respiratory outcomes but experimental group has more significant reduction in pain and change in pulse rate.

Mobile bearing versus fixed bearing medial unicompartmental knee replacement: an independent two center matched-pairs analysis

IntroductionThe aim of the present study was to compare clinical outcome between patients following fixed-bearing (FB) or mobile-bearing (MB) unicompartmental knee replacement (UKR) for antero-medial knee osteoarthrosis (OA) at two independent orthopedic centers.Materials and methodsMatched-pairs were built between 35 patients receiving FB-UKR and 52 patients following MB-UKR regarding age at time of surgery, body mass index (BMI) and range of motion (ROM) preoperatively. Clinical and functional outcome was measured postoperatively by the American Knee Society Score (AKSS-O/AKSS-F), ROM, Tegner Activity Scale (TAS) as well as the Short Form 36 Health Survey (SF-36).ResultsThe average treatment effect of the treated (ATT) after propensity score matching showed a significantly superior ROM in patients following MB-UKR (FB: 118°, MB: 124°). All remaining parameters had no statistically significant differences between both groups involving TAS, AKSS and SF-36.ConclusionsThe present study suggests that MB-UKR can provide a greater ROM compared to FB-UKR on comparable patients. The authors believe that both designs are suitable for adequate improvement of clinical outcome and ROM for patients suffering from antero-medial osteoarthrosis of the knee joint.Level of evidenceRetrospective cohort study, Level IV.

Seismic Behavioural study of A-Shaped Pylon Cable-stayed Bridge through Seismic Fragility Assessment

The global acceptance of cable-stayed bridges (CSB) has increased due to their aesthetic appearance and suitability for relatively longer spans. CSBs are the most flexible structure. The behavioural study of CSB under natural disasters i.e. earthquake is a new frontier of research. The current research focused on seismic fragility assessment (SFA) of an A-shaped pylon CSB for Indian seismic zone-V using 25 ground motions. Spectral acceleration 𝑠𝑎(𝑔) is the best IM for a CSB. For the four performance criteria, the fragility curves (FC) have been built using incremental dynamic analysis (IDA). Developed seismic FC illustrates the damage probability of CSB as a function of strong ground motions. It can be used to assess the probability of damage for a specific ground motion index. The pylon drift ratio and bearing displacement have been adopted to produce component FCs. The traditional IDA approach is adopted which involves linear regression. The overall system fragility of CSB has been derived using the Riemannian Manifold Hamiltonian Monte Carlo-based subset simulation (RMHMC-SS). The bound limits exemplify the bridge behaviour under different LSs. Analysis results prove that bearings are the most fragile component; their placements and hinge formulations govern the overall bridge performance.

Motorized Plate Lengthening of the Femur in Children: A Preliminary Report.

Limb lengthening by distraction osteogenesis can be performed with motorized internal devices, but intramedullary implants risk avascular necrosis of the femoral head in young children. A method of internal limb lengthening using a motorized expandable plate has been developed and preliminary results are presented. Seven skeletally immature patients (ages 2.7 to 9.7y) with congenital femoral deficiencies underwent femoral lengthening with the use of a magnetic expandable plate. Surgical details, lengthening parameters, Limb Lengthening and Reconstruction Society-Angular deformity, Infection, Motion index, and complications were reviewed and classified according to the modified Clavien-Dindo system. An average lengthening was 4.1cm (range, 3.3 to 4.4cm) comprising 18% of initial femoral segment length (range, 14% to 21%). The average lengthening phase was 50.2 days (range, 40 to 57d) and weight-bearing was initiated at an average of 13 weeks from surgery (range, 8 to 18wk). Limb deformities and length discrepancies were of moderate complexity, with an Limb Lengthening and Reconstruction Society-Angular deformity, Infection, Motion score of 6.57 (range, 6 to 7). Complication rates were comparable to previously reported methods of femoral lengthening. One patient underwent reoperation for patellar instability and 1 patient experienced radiographic hip subluxation which was observed. Small magnitude varus was observed in regenerate in 3 of 7 cases, none requiring treatment. Preoperative planning consisted of careful localization of the corticotomy site, acute deformity correction at the lengthening site in 3 cases, and implant orientation. Limb lengthening with motorized internal plates is feasible for young children with congenital femoral deficiency for whom intramedullary lengthening is unsafe or if external fixation is to be avoided. However, the fundamental principles of distraction osteogenesis and risks of lengthening for congenital discrepancies remain unchanged. Specific considerations herein include: careful planning of implant length and positioning, adjacent joint protection with adjunctive means, and mitigating deformity of the regenerate during distraction. Level IV, retrospective case series.

Effect of high-intensity laser on upper trapezius myofascial pain syndrome

Aim of the study: As high intensity laser therapy (HILT) is capable of reaching and stimulating deeper and larger tissues than traditional physiotherapy modalities, so we studied its influence on cervical myofascial pain. Subject and methods: 50 patients with chronic upper trapezius muscle myofascial trigger points (MTrPs) within age range of 20 to 40 years old were assigned into group A that received traditional treatment only (transcutaneous electrical nerve stimulation (TENS), ultrasound massage (US), stretch and exercise), while group B received HILT with traditional treatment. Outcome measures included pain severity via visual analogue scale (VAS), pressure pain threshold (PPT) by pressure algometer, neck functional activities by neck disability index (NDI) and cervical range of motion by CROM apparatus. Results: both groups showed significant improvement in the posttreatment outcome measures, but the HILT group (group B) showed a more significant improvement than the control group (group A) with p-value &gt;0.001. Conclusion: HILT is a supportive physical therapy modality that may provide preferable results for a cervical MTrP patient.

Predictive factors of heart failure in acute coronary syndrome: Institutional cross-sectional study

BackgroundHeart failure complicating acute coronary syndrome (ACS) remains a challenge because it is associated with a high risk of mortality at 1 year.Our objective is to highlight the factors frequently associated with heart failure following an ACS and thus deduce the predictive factors for the occurrence of heart failure. MethodsACS patients who were managed between 01/01/2021 to 06/30/2021 at the authors’ institution were included retrospectively in the analysis. ResultsOne hundred twenty-one patients (121) included. Eighty-seven were males (72%), and the mean age was 59.4 ± 8.8. Most patients were smokers (58.7%),40% were diabetic, and 40.5% were hypertensive. Dyslipidemia was found in 37.2% of cases. 75% of patients were admitted for STEMI, and 25% for NSTEMI. The majority of patients (67.5%) were admitted out of time. The anterior electrical territory was found as a factor in the occurrence of heart failure (OR = 5.47, 95% CI (2.16–15.26), P = 0.0005). Among the patients who presented a heart failure, 64% had an LVEF <40%, and only 3% with an LVEF >50% (P < 0.001). Also, 76% had a Wall Motion Index Score (WMSI) of 1.5 (P < 0.001). Angioplasty was the treatment of choice in 65%, aortocoronary bypass in 7% of cases, and medical treatment alone, associated or not with ischemia/viability tests in 28% of cases. Patients admitted out of time (>12 h) were found to be a factor in the occurrence of HF (OR = 3.31,95% CI (1.21–10,60), P = 0.02). The outcome was favorable in 93% of cases. We observed 9 cases of complications including 4 deaths from cardiogenic, septic, and hemorrhagic shock. ConclusionsThis study allows us to identify patients at risk of developing heart failure and patients with a more reserved prognosis. Besides, our findings will allow our peers and colleagues to be able to detect early these factors and optimize adequate management to avoid heart failure.

Effect of Transfer Energy Capacitive and Resistive Therapy on Shoulder Pain, Disability, and Range of Motion in Patients With Adhesive Capsulitis: A Study Protocol for a Randomized Controlled Trial

ObjectiveWe describe a protocol to evaluate the effectiveness of transfer energy capacitive and resistive (TECAR) therapy on shoulder passive range of motion, shoulder pain, and disability index in patients with adhesive capsulitis. MethodsThis study will be a double-blinded randomized clinical trial with a 1-month follow-up. For the purpose of this research, 30 patients with a 3-month history of shoulder pain and disability diagnosed as adhesive capsulitis will be selected and then randomized into 2 groups, including conventional physiotherapy consisting of electrophysical modalities and therapeutic exercises, which will be given to the control group. In the intervention group, after conventional physiotherapy, 10 minutes of TECAR therapy in resistive mode will be applied on both the anterior and inferior aspects of the shoulder joint. Outcome measures will be related to shoulder passive range of abduction, flexion, and external rotation that will be measured using a digital inclinometer, as well as shoulder pain and disability index that will be assessed by the validated questionnaire. Assessment will be done at baseline, 1 day after the intervention, and by passing 1 month. ResultsThe statistical analysis will describe within-group and between-group comparisons; the findings will be illustrated in tables and charts. ConclusionGiven the reason that the effectiveness of TECAR therapy has not been widely evaluated in adhesive capsulitis, the findings of this pilot study would provide baseline information on the effectiveness and complications of this treatment method and possibly propose a more appropriate protocol for patients with adhesive capsulitis.

Smart city indexes, criteria, indicators and rankings: An in‐depth investigation and analysis

AbstractThere are many indexes and ranking bodies on Smart Cities. However, most of these rankings have their own specific evaluation criteria and ranking methodologies. Currently, there are no uniformly and universally accepted methods for comprehensive and fair evaluation of smart cities. This is a problem as no ranking is widely accepted and universally agreed upon. This not only creates chaos but also confusion as to what indexes to follow. In this paper, 6 current smart city indexes (IMD‐SUTD Smart City Index, AT Kearney Global Cities Index, IESE Cities in Motion Index, EasyPark Cities of the Future Index, Mori‐Foundation Global Power City Index and Smart EcoCity Index) produced by major organisations are examined, discussed, and compared. Commonalities and differences are highlighted, revealing insights into the accuracy, comprehensiveness, shortcomings, acceptance and usage of these indexes and rankings. Finally, new evaluation factors are suggested and the rationale behind them are provided, in addition to the essential 8 criteria of economy, governance, technology, health, transport, environment, living and sustainability.