PCS Scores Research Articles

Exploring differences in reported mental health outcomes and quality of life between physically restrained and non-physically restrained ICU patients; a prospective cohort study.

Physical restraints are frequently used in ICU patients, while their effects are unclear. To explore differences in patient reported mental health outcomes and quality of life between physical restrained and non-physical restrained ICU patients at 3- and 12-months post ICU admission, compared to pre-ICU health status. Prospective cohort study. Patients were included when 16years or older, admitted for at least 12h and provided informed consent. Differences between groups were analysed using linear mixed model analyses. Two ICUs, a 35 bed academic ICU and a 12 bed ICU in a teaching hospital in the Netherlands. Symptoms of anxiety and depression were measured using the Hospital Anxiety and Depression Scale, post-traumatic stress disorder using the Impact of Event Scale-Revised, and Quality of life using the Short Form-36 scores. 2,764 patients were included, of which 486 (17.6%) were physically restrained for median 2 [IQR 1-6] days. Significantly worse outcomes were reported at 3-months by physically restrained patients (symptoms of depression 0.89, 95%CI 0.37 to 1.41, p<0.001; PCS -2.82, 95%CI -4.47 to -1,17p<0.001; MCS -2.67, 95%CI -4.39 to -0.96, p<0.01). At 12-months, only the PCS scores remained significantly lower (-1.71, 95%CI -3.42 to -0.004, p<0.05). Use of physical restraints is associated with worse self-reported symptoms of depression and decreased quality of life 3-months post ICU, and lower physical quality of life after 12-months. Use of physical restraints is associated with statistical significant worse mental and physical outcomes.

Impact of rotational shiftwork related sleep deprivation on quality of life and job satisfaction among healthcare professionals in Southern India from the SNORE study findings

Abstract Background Sleep is essential for cognitive function and overall well-being, yet healthcare providers often experience sleep deprivation due to long hours and night shifts. This study evaluates how sleep deprivation affects Quality of Life (QoL) and job satisfaction among these workers. Methods We conducted a cross-sectional study at a tertiary healthcare facility in Chengalpattu District, Tamil Nadu, India, including 293 healthcare providers working rotational night shifts. Participants were selected through stratified random sampling. QoL was assessed using the Short Form-12 QoL Questionnaire (SF-12). Sleepiness was assessed using Epworth Sleepiness Scale (EPSS). Statistical analyses included Pearson chi-square tests for associations, independent samples t-tests for comparing QoL scores between sleep-deprived and non-sleep-deprived participants, and binary logistic regression to evaluate the impact of sociodemographic factors and shift work patterns on SF-12 scores. Results Significant associations were observed between sociodemographic factors, shift work patterns, and SF-12 QoL scores. Married participants had nearly four times higher odds (OR = 3.97, 95%CI 1.87–8.43) of scoring &lt; 40. Diploma holders had nearly three times higher odds (OR = 2.94, 95%CI 1.48–5.83) compared to graduates. Paramedical professionals had over three times higher odds (OR = 3.48, 95%CI 1.55–7.82) compared to doctors. Sleep deprivation was associated with lower PCS (aOR = 2.45, 95%CI 1.40–4.27) and MCS scores (aOR = 3.80, 95%CI 1.56–9.23). Increased night work hours correlated with higher odds of poor work satisfaction (OR = 1.39, 95%CI 1.18–1.63). Conclusion Sleep deprivation significantly impacts physical and mental QoL scores among healthcare providers working rotational night shifts. Current shift work patterns also affect QoL, highlighting the need for targeted interventions to improve sleep and manage shift work.

Clinical features and outcomes of basilar invagination.

Basilar invagination has been classified into two types by Goel: Type A is defined mechanical instability of the atlantoaxial joint with upward displacement of the odontoid process while Type B is characterized by stable atlantoaxial joints. This study reviews the association between radiological features and symptomatology and prognosis of two types of basilar invagination for better clinical management. A retrospective analysis was conducted including 141 patients diagnosed with basilar invagination who underwent surgical treatment from January 2016 to December 2020. The neurological function was assessed by the JOA scores, and Short-Form 12 scores. Logistic univariate and multivariate analyses were performed to predict prognostic risk factors. Type A patients (21/101, 20.8%) with more cases of dizziness, lower preoperative JOA scores and SF-12 PCS scores (JOA, 13.0 vs. 13.9, P = 0.042; SF-12 PCS, 37.48 vs. 38.42, P = 0.034) compared to type B (2/40, 5%) (P = 0.022). Type B (22/40, 55%) with more cases of ataxia than type A (35/101, 34.7%) (P = 0.026). Patients with type B demonstrated a significantly higher improvement rate in SF-12 PCS than type A (P = 0.018). Further logistic regression revealed that onset age ≥ 45 years (OR 4.654, 95% CI 1.645-13.165; p = 0.004) and basal angle ≥ 125° (OR 28.139, 95% CI 1.090-726.239; p = 0.044) were independent risk factors for type A and type B, respectively. Type A patients with more cases of dizziness, and type B patients with more cases of ataxia, can achieve better long-term prognosis following clinical intervention.

Zwitterionic 2-Phosphaethene-thiolates [(LC)P=CS(LC/P)]+ as PCS Building Blocks (LC=NHC, LP=PR3).

The zwitterionic compounds [(LC)P=CS(LC/P)]+ (3+, LC=NHC, LP=PR3), featuring cationic substituents at the phosphorus and carbon atoms, are synthesized as their triflate salts at a multi-gram scale from the reaction of Lewis base adducts of CS2, namely LC/P-CS2 (4), with a combination of [(LCP)4][OTf]4 (1[OTf]4) and Ph3P. The feasibility of using 3+ as PCS building blocks is showcased in their reactions with representative electrophiles (MeOTf) and nucleophiles (MesMgBr, Ph3PCH2), leading to selective functionalization of the PCS core at the S- and P-terminus, respectively. Additionally, it is reported that 3+ can function as ambident nucleophiles with AgOTf (2 equivalents), affording unprecedented linear coordination polymer [Ag2(OTf)3-μ2:κP,κS-((LC)P=CS(PCy3))]+ (6 b), where the PCS moiety acts as a bridging ligand in transition metal complexes for the first time. Reduction of 3+ facilitates the cleavage of the P- and C-bound substituents leading to the formation of the [PCS]- anion. Moreover, cycloaddition reactions of 3+ with 1[OTf]4 are shown to selectively yield five- and eight-membered polyphosphorus heterocycles. Preliminary results suggest the possibility of activating the C-S bond in [(LC)P=CS(LC)]+, resulting in the formation of [(LC)P=C(LC)-P(LC)][OTf]2, 12[OTf]2, which may serve as a synthon for the PCP unit in future studies.

Zwitterionic 2‐Phosphaethene‐thiolates [(LC)P=CS(LC/P)]+ as PCS Building Blocks (LC = NHC, LP = PR3)

The zwitterionic compounds [(LC)P=CS(LC/P)]+ (3+, LC = NHC, LP = PR3), featuring cationic substituents at the phosphorus and carbon atoms, are synthesized as their triflate salts at a multi‐gram scale from the reaction of Lewis base adducts of CS2, namely LC/P–CS2 (4), with a combination of [(LCP)4][OTf]4 (1[OTf]4) and Ph3P. The feasibility of using 3+ as PCS building blocks is showcased in their reactions with representative electrophiles (MeOTf) and nucleophiles (MesMgBr, Ph3PCH2), leading to selective functionalization of the PCS core at the S‐ and P‐terminus, respectively. Additionally, it is reported that 3+ can function as ambident nucleophiles with AgOTf (2 equivalents), affording unprecedented linear coordination polymer [Ag2(OTf)3‐μ2:κP,κS–((LC)P=CS(PCy3))]+ (6b), where the PCS moiety acts as a bridging ligand in transition metal complexes for the first time. Reduction of 3+ facilitates the cleavage of the P‐ and C‐bound substituents leading to the formation of the [PCS]– anion. Moreover, cycloaddition reactions of 3+ with 1[OTf]4 are shown to selectively yield five‐ and eight‐membered polyphosphorus heterocycles. Preliminary results suggest the possibility of activating the C–S bond in [(LC)P=CS(LC)]+, resulting in the formation of [(LC)P=C(LC)–P(LC)][OTf]2, 12[OTf]2, which may serve as a synthon for the PCP unit in future studies.

Long-Term Efficacy and Safety of Risankizumab for csDMARD-IR Patients With Active Psoriatic Arthritis: 196-Week Results From the KEEPsAKE 1 Trial

Introduction &amp; Objectives: Here, we report the long-term efficacy and safety of risankizumab (RZB) in patients with active psoriatic arthritis (PsA) through week 196 from the KEEPsAKE 1 trial. Materials &amp; Methods: The ongoing KEEPsAKE 1 clinical trial is a global, phase 3, multicenter study to evaluate the efficacy and safety of RZB versus placebo (PBO) in patients with active PsA. Patients are at least 18 years old and demonstrated an inadequate response, intolerance or contraindication to ≥1 conventional synthetic disease modifying antirheumatic drug (csDMARD-IR). Following a 24-week double-blind, PBO-controlled, parallel-group treatment period (period 1), all patients received open-label RZB every 12 weeks thereafter (period 2). Safety assessments were based on monitoring of treatment-emergent adverse events (TEAEs) reported as events per 100 patient-years (PY). Efficacy and safety analyses were conducted in all randomized patients who received ≥1 dose of the study drug. Results: Overall efficacy results were maintained at week 196 of the KEEPsAKE 1 trial, as compared to previously reported timepoints. At week 196, 39.4% of patients receiving continuous RZB and 38.1% of PBO/RZB patients achieved ACR50; 39.6% of RZB and 35.2% of PBO/RZB patients achieved MDA. In patients with psoriasis severity of ≥ 3% of body surface area (BSA) at baseline, 65.2% on RZB and 62.9% on PBO/RZB achieved PASI90 at week 196. mNAPSI and PGA-F scores improved from baseline by 14.99 and 1.5 points, respectively, for RZB, and by 14.73 and 1.5 points for PBO/RZB patients. In patients with enthesitis at baseline, 60.1% on RZB and 63.4% on PBO/RZB achieved resolution. For patients with dactylitis at baseline, 72.3% on RZB and 77.6% on PBO/RZB achieved resolution. HAQ-DI (RZB -0.40, PBO/RZB -0.33), SF-36 PCS (RZB 8.98, PBO/RZB 7.21) and FACIT-Fatigue (RZB 7.7, PBO/RZB 5.6) scores maintained improvement from baseline to week 196. The overall rates of TEAEs (121.4 E/100PY), serious TEAEs (7.7 E/100PY) and AEs leading to discontinuation of study drug (1.8 E/100PY) have remained stable and comparable to those reported in period 1. Conclusion: The 196-week results of the ongoing KEEPsAKE 1 trial demonstrate the durable efficacy of RZB 150 mg in treating the different clinical manifestations and improving health-related quality of life in csDMARD-IR patients with PsA. RZB continued to be well-tolerated, with no new safety signals.

The effects of vitamin D levels on physical, mental health, and sleep quality in adults: a comprehensive investigation.

Vitamin D, essential hormone for endocrine, autocrine, and paracrine functions. A billion people are deficient globally which contributing to numerous health issues. This study explores the link between vitamin D levels and sleep quality, impacting mental and physical health in adults. This prospective cross-sectional study was conducted at Nims Hospital, Jaipur, involving 484 adults' participants. Blood samples were collected for serum 25(OH) D measurements. Data were gathered using the SF-36 and ISI questionnaires to assess health and sleep quality. Higher vitamin D levels were strongly linked to better physical health, including physical function (r = 0.642, p < 0.001), general health (r = 0.560, p < 0.001), and PCS score (r = 0.441, p < 0.001). Vitamin D also positively impacted social functioning (r = 0.096, p = 0.035) and was negatively related to ISI scores (r = -0.112, p = 0.014). The study highlights a strong link between higher vitamin D levels and improved physical and mental health, with significant negative correlation to ISI scores. This underscores the importance of adequate vitamin D for overall well-being. The findings call for urgent measures to address vitamin D deficiency and further research into its health impacts.

Treatment of the terrible triad of the elbow by olecranon osteotomy: a retrospective cohort study.

This study aims to evaluate the surgical techniques and outcomes of treating elbow dislocations with coronoid and radial head fractures, commonly referred to as the terrible triad of the elbow (TTE), through a single olecranon osteotomy. A retrospective analysis was performed on 73 patients diagnosed with TTE between January 2015 and April 2022. The cohort included 44 men and 29 women, with an average age of 40.0±15.1 years (range, 18-68 years). Among these patients, Mason Type I, II, and III fractures were identified in 11, 42, and 20 cases, respectively, while Morrey Type I, II, and III fractures were observed in 45, 23, and five cases, respectively. All patients underwent treatment via a single olecranon osteotomy. The average interval between injury and surgery was 5.6±1.6 days (range, 3-8 days). Elbow function was assessed using the Mayo Elbow Performance Score (MEPS), pain was measured via the Visual Analogue Scale (VAS), and quality of life was evaluated using the SF-36 questionnaire. Patients were followed for 15 to 60 months (mean, 37.1±13.3 months). All coronoid and radial head fractures achieved complete healing, with an average recovery time of 4.3±1.1 months (range, 3-6 months). By the final follow-up, all patients had regained normal elbow function. The mean elbow flexion was 124.4°±9.2°, extension was 9.6°±6.5°, and the total range of flexion-extension was 114.8°±11.7°. Forearm pronation averaged 77.3°±4.8°, supination 79.2°±6.5°, and total forearm rotation 156.5°±8.4°. The mean MEPS was 89.3±6.4, with 36 patients achieving excellent scores and 37 obtaining good scores. Preoperative VAS scores averaged 8.78±1.11, which significantly dropped to 0.97±0.83 at the final follow-up (p=0.000). The SF-36 preoperative PCS and MCS scores were 45.77±3.59 and 60.67±3.91, respectively, with postoperative improvements to 93.85±2.65 (p=0.000) and 95.79±3.11 (p=0.000). This retrospective analysis indicates that a single olecranon osteotomy could be a viable treatment option for TTE. However, additional research involving a control group is essential to substantiate the efficacy of this technique.

Comparative Effects of Spinal Anesthesia and Combined Spinal with Peripheral Nerve Blocks on Postoperative Outcomes in Anterior Cruciate Ligament Repair.

Objectives: This study aimed to compare the effectiveness of spinal anesthesia (SA) alone versus combined spinal anesthesia with adductor canal block (ACB) and sciatic nerve block (SNB) (SA + ACB + SNB) in patients undergoing arthroscopic anterior cruciate ligament (ACL) reconstruction. We hypothesized that SA + ACB + SNB would provide better analgesia, greater patient satisfaction, and shorter postanesthesia recovery times than SA alone. Methods: A prospective randomized controlled trial was conducted with 60 patients aged 15-49 years scheduled for elective arthroscopic ACL reconstruction. Participants were randomly assigned to receive either SA or SA + ACB + SNB. Postoperative pain was assessed using the Visual Analog Scale (VAS) at 4, 12, and 24 h post-operation. General health was evaluated using the 12-item Short Form Survey (SF-12) at 1 month postoperatively. Range of motion and analgesic consumption were also recorded. Results: The median VAS score at 4 h post-operation was significantly lower in the SA + ACB + SNB group compared to the SA group (0 [IQR: 0-1] vs. 2 [IQR: 1-3], p = 0.0137). No significant differences in VAS scores were found at 12 h (p = 0.9282) and 24 h (p = 0.5809). PCS-12 and MCS-12 scores did not differ significantly between groups. The SA group had a lower postoperative range of motion (ROM) compared to the SA + ACB + SNB group, with a mean active ROM of 40.67 degrees (±23.52) versus 72.17 degrees (±24.69), respectively (p < 0.0001). Analgesic consumption was similar, with 53.33% of participants in each group using postoperative analgesics (p = 1.0). The mean surgery duration was 74.6 min. The gender distribution was 83% male and 17% female, with an average age of 27.7 years. Conclusions: Adding ACB and SNB to spinal anesthesia improved immediate postoperative pain relief and preserved range of motion in patients undergoing ACL reconstruction, suggesting potential clinical benefits in pain management and functional recovery.

QOL-16. POSTOPERATIVE MOTOR FUNCTION AND PROCESSING SPEED PREDICT QUALITY OF LIFE IN PATIENTS WITH GLIOBLASTOMA AT CHRONIC-PHASE

Abstract The quality of life (QOL) in patients with glioblastoma (GBM) should be paid attention. The aim of this study is to identify brain functions that influence the QOL of patients with GBM by objectively assessing neurocognitive functions. Data from 40 patients with newly diagnosed GBMs were analyzed. All patients completed the assessment of various neurological and neurocognitive functions and QOL at 6 months postoperatively. QOL was assessed using the 36-Item Short Form Survey (SF-36). In the SF-36, the physical, mental, and role and social component summary (PCS, MCS, and RCS, respectively) scores were calculated. Multiple logistic regression analyses and chi-square tests were used to evaluate the association between SF-36 scores and brain functions. The MCS was maintained, whereas the PCS and RCS scores were significantly lower in patients with GBMs than in healthy controls (p=0.0081 and p&amp;lt;0.0001, respectively). Among a variety of brain functions, motor function and processing speed were significantly correlated with PCS and RCS scores, respectively (p=0.0048 and p=0.030, respectively). Patients whose PCS or RCS remained stable had a higher probability of motor function or processing speed preservation than those whose RCS or PCS decreased (p=0.0026). Taken together, motor function and processing speed may be predictors of QOL in patients with GBMs.

Interrelationships Among Individual Factors, Family Factors, and Quality of Life in Older Chinese Adults: Cross-Sectional Study Using Structural Equation Modeling.

China's rapidly aging population necessitates effective strategies for ensuring older adults' quality of life (QOL). While individual factors (IF) and family factors (FF) are known to influence QOL, existing research often examines these factors in isolation or focuses on specific subpopulations, overlooking potential interactions and mediating pathways. This study aims to examine both direct and indirect pathways connecting IF and FF to older adults' QOL, focusing on the mediating roles of health risks (HR) and health care service demand (HSD). This study uses structural equation modeling (SEM) to analyze cross-sectional data from 8600 older participants in the 2015 China Health and Retirement Longitudinal Study (CHARLS), a nationally representative study using a multistage probability proportional to size sampling method. Among the 8600 participants, the majority (5586/8502, 65.7%) were aged 60-70 years, with a near-equal distribution of males and females at around 50%. The average PCS score was 76.77, while the MCS score averaged 59.70. Both IF (β=0.165, P<.001) and FF (β=0.189, P<.001) had a direct positive effect on QOL. Furthermore, the indirect effects of IF (β=0.186, P<.001) and FF (β=0.211, P<.001) through HR and HSD were also significant. In the direct model, IF and FF had a greater impact on MCS (β=0.841) than on PCS (β=0.639). However, after including the 2 mediating factors, HR and HSD, the influence of IF and FF on MCS (β=0.739) became consistent with that on PCS (β=0.728). Subgroup analyses revealed that the direct effect of IF on QOL was significant in the 60-70 age group (β=0.151, P<.001) but not in those over 70 years old (β=0.122, P=.074). Comorbidity status significantly influenced the pathway from HR to HSD, with older adults having 2 or more chronic diseases (β=0.363) showing a greater impact compared to those with fewer than 2 chronic diseases (β=0.358). Both IF (education, per capita disposable income, and endowment insurance) and FF (satisfaction with a spouse and children) directly impact the QOL in older people. Meanwhile, IF and FF have equal influence on QOL through the mediating role of HR and HSD. Recognizing the interplay among these factors is crucial for targeted interventions to enhance the well-being of older adults in China.

Physical and Mental Health of Informal Carers from Culturally and Linguistically Diverse (CALD) and Non-CALD Groups in Australia.

Empirical evidence shows that many family carers, especially immigrants, experience considerable health disadvantages and poorer quality of life. Australia has a rapidly increasing multicultural population, officially referred to as Culturally and Linguistically Diverse (CALD) people. This paper explores similarities and differences in the carer profile and physical and mental health of CALD and non-CALD family carers. A cross-sectional anonymous survey was conducted of self-reported family carers aged 18 years and older. Identical paper and online survey modes were provided to enable choice. Key variables included demographic and carer profile, diagnosed chronic physical health conditions, and validated scales such as CESD-12 and MOS-SF12, including derivative composite Physical and Mental Component Summary (PCS and MCS, respectively) scores. The sample comprised 649 participants (CALD = 347, non-CALD = 302). The analyses included univariate, bivariate, and multivariable linear regression analyses for three outcome variables: PCS, MCS, and CESD-12. CALD carers were comparatively younger and married, and 54% had university-level education (29% in the gfvnon-CALD group). Women were primary carers in both groups (67.4% versus 72.2%). The weekly care hours were higher for non-CALD carers. Both groups had below population-referenced scores for mean PCS and MCS values. For CESD-12, non-CALD respondents had higher scores (17.5 vs. 11.2, p < 0.022). Regression analyses showed significant differences for demographic, carer, and physical health variables across the three outcome variables. Women have a higher domestic workload, which, when combined with high care hours, adversely impacts physical and mental health. The need for improved and culturally aligned care support systems is required.

Responsiveness of the P4, Patient Specific Functional Scale 2.0, Satisfaction and Recovery Index, and SF-12 in Patients With Musculoskeletal Disorders.

Background Recently, estimation of intervention effects has been recommended using minimum important change (MIC). This study aimed to investigate the responsiveness of the four-item pain intensity measure (P4), Patient Specific Functional Scale 2.0 (PSFS 2.0), Satisfaction and Recovery Index (SRI), and physical (PCS) and mental component summary (MCS) scores of the SF-12v2® Health Survey Acute (QualityMetric Inc. & Fukuhara S, Kyoto) in patients with musculoskeletal disorders and to estimate their MICs. Methodology Data of outpatients receiving musculoskeletal physical therapy were collected using a survey in multi-center cohorts. The participants completed the first survey before their first physical therapy session and the second survey after the third to seventh sessions. Responsiveness was assessed by investigating the area under the receiver operating characteristic curve (AUC) and by investigating prior hypotheses with correlations between change scores. In the former method, the AUCs of the measures were calculated for discriminating improved cases (i.e., 11-point Global Rating of Change Scale (GRCS) ≥ 2) and non-improved cases (i.e., GRCS < 2). The MIC scores were estimated with GRCS using the predictive modeling method. Results Data from 100 participants were analyzed. The PSFS 2.0 satisfied both acceptable responsiveness criteria, the P4 and SRI satisfied the moderate responsiveness criterion of the construct approach only, and the PCS and MCS satisfied both poor responsiveness criteria. The MICs were 1.64, 2.92, 6.16, 4.49, and 1.67 for the P4, PSFS 2.0, SRI, and PCS and MCS scores, respectively. Conclusion The PSFS 2.0 has acceptable responsiveness and can be used to determine treatment effects in clinical practice, while the P4 and SRI can also be used in some cases.

Physical and mental health trajectories: A longitudinal SF-36 analysis in Alpha-1 antitrypsin deficiency-associated COPD

BackgroundThe Short Form 36-Item Health Survey (SF-36) is a health-related quality of life (HRQoL) measure validated in people with chronic obstructive pulmonary disease (COPD). While physical health is often more impaired than mental health in people with COPD, research on alpha-1 antitrypsin deficiency (AATD)-associated COPD is limited. This longitudinal study examines changes in physical and mental health in individuals with AATD and associated factors. MethodsAnalyses included participants of AlphaNet, a disease management program for individuals with AATD-associated lung disease who are prescribed augmentation therapy. Norm-based SF-36 scores for mental and physical component summaries (MCS and PCS) and 8 scales were analyzed. Linear mixed models evaluated mean changes in SF-36 scores over time. ResultsThe study included 2165 participants (mean age 56.9 ± 10.0 years, 47.0 % female). At enrollment, mean PCS score was 37.5 ± 9.6, and mean MCS score was 51.9 ± 10.5. Mean mMRC dyspnea score was 2.3 ± 1.3; 54.6 % had ≥2 exacerbations annually, and 46.5 % used oxygen regularly. Average follow-up was 6.6 ± 3.2 years. The HRQoL remained stable; MCS improved by 0.16 points/year (p < 0.0001), while the PCS score declined by 0.49 points/year (p < 0.0001). Subscales followed similar trends. ConclusionsAt baseline, mental HRQoL scores were higher than physical HRQoL scores, indicating better mental health than physical health in this cohort with AATD-associated lung disease. Stable HRQoL with a slight improvement in mental scores over time and a small decrease in physical scores may be a unique feature of this cohort. Further studies are needed to correlate these findings with disease-specific instruments and patient physiology.

Health-related quality of life among women and men living with migraine: a Canada-wide cross-sectional study.

Migraine is a prevalent neurologic disorder that affects women more than men. Examining health-related quality of life (HRQoL) by gender can aid decision makers in prioritizing future treatment and prevention programs. We aimed to quantify HRQoL by different levels of migraine disability and by gender. As part of a Canada-wide cross-sectional study, we administered an online survey to employed adults who self-reported a diagnosis of migraine. Migraine disability level was assessed using the Migraine Disability Assessment questionnaire (MIDAS). MIDAS scores were used to categorize respondents as having little to no, mild, moderate, or severe level of migraine-related disability. Physical and mental component summary scores (PCS and MCS) and health utilities were derived from responses to the Veterans Rand 12 Item Health Survey. PCS, MCS, and health utilities were summarized by migraine-related disability levels and gender. Covariate-adjusted linear regressions were used to examine the association between migraine disability level and health utility by gender. A total of 441 participants completed the survey. The sample was predominantly women (60.1%), White race (75.5%), and had a mean age of 37 years. Mean health utility, PCS, and MCS scores were 0.61 (0.22), 45.0 (7.7), and 43.4 (11.0), respectively. All three scores decreased with increased migraine disability level. Gender differences on HRQoL within each migraine disability level were not statistically significant, except in the little to no disability level where women had lower mean MCS scores and health utility relative to men [mean (SD) MCS: women 44.0 (11.3); men 55.1 (8.1), p < 0.001; health utility: women 0.66 (0.18); men 0.81 (0.18), p < 0.001]. Linear regressions showed women with severe migraine-related disability had reduced health utility compared to women with little to no disability [adjusted difference: -0.16 (95%CI -0.24,-0.09)]. Associations among men increased in magnitude with migraine disability level [adjusted differences: mild - 0.16 (95%CI -0.24,-0.09); moderate - 0.18 (95%CI -0.26,-0.10); severe - 0.28 (95%CI -0.37,-0.20)]. Findings contribute to the literature on the association between migraine disability level and HRQoL by examining trends by gender. Model results emphasize the importance of future treatments reducing severe disability due to migraine among both women and men.

Multivariate analysis in chickpea genotypes under timely sown condition

Abstract Yield, a multifaceted trait influenced by genetic and environmental factors, requires a comprehensive assessment beyond emphasizing only on yield alone. Thus, understanding the intricate relationship between yield and its associated traits across diverse chickpea genotypes is essential. The current investigation was undertaken at the Breeder seed production unit, JNKVV, Jabalpur, Madhya Pradesh, during the 2021-22 cropping season. Significant variations were found by analysis of variance (ANOVA) among the 40 genotypes under study, indicating substantial variability. Post hoc DMRT analysis further confirmed notable genetic diversity across all traits. Regression and Principal component analysis highlighted the significance of optimizing biological yield per plant, effective pods, total number of pods, and secondary branches to enhance grain yield. Strategic selection prioritizing these traits can facilitate the development of high-yielding chickpea varieties with enhanced agronomic characteristics. This analysis identified five principal components explaining 80.74% of genotypic variability. Ultimately, the genotypes ICCV 211210, RVG-204, and ICCV 211206 emerged as promising based on PC scores. Keywords: Chickpea, DMRT, Regression, PCA, Yield

Effects of Adalimumab-adbm Versus Adalimumab Reference Product on Patient-Reported Outcomes in Rheumatoid Arthritis: Results from VOLTAIRE-RA.

This post hoc analysis of VOLTAIRE-RA compared patient-reported outcomes, including health-related quality of life (HRQoL), in patients with rheumatoid arthritis (RA) before and after treatment with biosimilar adalimumab-adbm or adalimumab reference product. HRQoL was assessed by 36-Item Short Form Survey (SF-36) Physical and Mental Component Summary (PCS and MCS, respectively) and domain scores at baseline and weeks12/24. Results were considered clinically meaningful if improvements were greater than or equal to minimum clinically important differences (MCIDs) of 2.5 for PCS and MCS and 5.0 for domain scores. Comparisons with age- and sex-matched norms and treatment-associated changes in domain scores from baseline were quantified using spydergrams and the health utility SF-6D measure. All comparisons between treatment groups were descriptive in nature. No differences in PCS scores were reported between treatment groups at baseline or weeks12/24. MCS scores slightly favored the reference product group at baseline, and differences in scores at weeks12/24 generally reflected those differences. Improvements in PCS scores greater than or equal to MCID at weeks12/24 were reported by over 65% of patients in both treatment groups, while over 56% experienced improvements in MCS scores greater than or equal to MCID at weeks12/24. Similar proportions receiving reference product and adalimumab-adbm reported scores greater than or equal to US age- and sex-matched normative values at week24: 14-39% versus 15-36%, respectively, compared with baseline (1-17%). In patients with moderate to severely active RA, adalimumab-adbm and adalimumab reference product were both associated with clinically meaningful improvements in SF-36 PCS, MCS, and domain scores that were highly similar at weeks12/24. The high proportion of patients reporting scores greater than or equal to normative values in both treatment groups is notable, as this represents a treatment goal that was difficult to achieve in earlier RA trials. Video abstract available for this article. VOLTAIRE-RA (ClinicalTrials.gov number, NCT02137226; EudraCT number, 2012-002945-40). Video abstract (MP4 29755 KB).

The Effects of Telerehabilitation-Based Exercise Therapy on Motor and Non-Motor Clinical Outcomes in Adults With Facial Palsy: A Randomized Controlled Trial.

Recent case reports have emphasized the essential clinical contribution of telerehabilitation in the treatment of facial palsy. However, no randomized controlled trial has yet demonstrated the effects of telerehabilitation-based facial exercise therapy. Thus, we aimed to investigate the effectiveness of video exercise-based telerehabilitation on motor and non-motor clinical outcomes in adults with facial palsy. We conducted a randomized controlled trial with 40 peripheral facial palsy patients. Those in the experimental group (EG) received four weeks of telerehabilitation-based video exercises and routine care. Those in the control group (CG) received only routine care. All participants were evaluated with the Facial Disability Index (FDI), the Facial Clinimetric Evaluation Scale (FaCE), Short Form-12 (SF-12), the Hospital Anxiety and Depression Scale (HADS), the House-Brackmann Scale (H-B) and the Telemedicine Satisfaction and Usefulness Questionnaire (TSUQ), both before and after the interventions. Both groups demonstrated a significant improvement in FDI, FaCE, and SF-12 PCS scores (p < .05). In addition, there was a significant improvement only in EG on the SF-12 MCS score (p < .05), and there was a significant gain only in CG on the HADS-Depression score (p < .05). While these results provide a further contribution to our understanding of telerehabilitation benefits in mental health variables related to quality of life for facial palsy patients, we found no EG and CG differences on the physical components of treatment.

Is Age but a Number? Age-Related Outcomes for Total Ankle Replacement

Category: Ankle Arthritis; Ankle Introduction/Purpose: Total ankle replacement (TAR) is increasingly performed on patients across a wide age spectrum, though historically it has been reserved for older patients (&gt;60). In this study, we seek to determine how age influences patient outcomes. Methods: This is a retrospective, comparative cohort study of consecutive patients that underwent TAR from 2004-2021. Patients were categorized into three age groups: &lt; 55, 56-70, and &gt;70. We evaluated surgical complications and patient-reported outcome measures, including Ankle Osteoarthritis Pain &amp; Disability Scores (AOS) and Short Form-36 Health Survey (SF-36). Analysis of covariance was performed, adjusting for patient factors. Results: We reviewed 812 consecutive TARs from a single-centre with 407 (50.1%) male and mean BMI of 29.8±5.78. The median follow up was 64.0 months (IQR,76.0). Patients ≤55 had worse pain preoperatively than both older patient groups (p=0.03) and worse mental health (p&lt; 0.001), however, this difference was not observed in postoperative AOS pain (p=0.15) or SF-36 MCS scores (p=0.87). Patients &gt;70 had worse physical health than patients 56-70 (p=0.02) and less change in pre- to postoperative SF-36 PCS scores (p=0.02). Patients from all groups improved similarly according to the AOS pain (p=0.15) and disability (p=0.12). Conclusion: These results show that TAR patients younger than 55 have worse pain and mental health preoperatively but have similar long-term clinical outcomes to patients 56 and older.

Gender Differences in Clinical Performance Assessment of Internal Medicine Residents: A Longitudinal Analysis of the Influence of Faculty and Trainee Gender.

Competency-based medical education relies on equitable assessment. This study examined the influence of faculty and trainee gender on assessments of internal medicine (IM) resident performance over time. A longitudinal analysis of clinical performance assessments from 7 U.S. IM residency programs (July 2014-June 2019) was conducted. Core competency scores (patient care [PC], medical knowledge [MK], practice-based learning and improvement [PBLI], systems-based practice [SBP], professionalism [PROF], and interpersonal and communication skills [ICS]) were standardized across programs. Cross-classified mixed-effects linear regression evaluated the relationship between gender and standardized competency scores within training programs, while adjusting for multiple variables including IM In Training Examination percentile rank. Data included 9,346 evaluations by 1,011 faculty (552 [55%] men, 459 [45%] women) for 664 residents (358 [54%] men, 306 [46%] women). Initially, women residents' scores were significantly lower than men's in PC (estimated difference [standard error], -0.097 [0.033]; P = .004), MK (-0.145 [0.034], P < .001), and PBLI (-0.090 [0.040], P = .022). PC, MK, PBLI, and SBP scores increased more over time for women residents than men (PC: 0.050 [0.015], P = .001; MK: 0.052 [0.015], P = .001; PBLI: 0.036 [0.018], P = .048; SBP: 0.036 [0.016], P = .027). PROF and ICS scores were comparable across gender. There was a significant interaction between faculty gender and postgraduate year (PGY) across all competencies but none between resident gender, faculty gender, and PGY, indicating that men and women faculty rated residents differently over time but were consistent in how they rated men and women residents. Gender-based assessment differences were variable across competencies and time. Women residents had lower scores initially but greater gains in "hard skill" (MK, PC, and PBLI) than in "soft skill" (ICS and PROF) competencies, suggesting assessment inequities. Efforts to ensure equitable assessment are needed.