Poor Mobility Research Articles

A Comprehensive Review on Smartphone Overuse: Analysing Its Influence on Physical Health and Social Relationships in the Digital Age

The aim of this paper is to analyse trends by reviewing the growing body of research on smartphone overuse in humans. This literature review focuses exclusively on original research articles. It begins by explaining key concepts, such as the levels and symptoms of smartphone usage excessively. There is a term “Nomophobia” which is frequently linked to poor mobile technology use. It, often known as "no-mobile-phone phobia," is the anxiety of not being able to use or reachable via one's cell phone. Additionally, it highlights the fundamental challenges and methodological issues discussed in the existing studies. The paper explores the relationship between student smartphone overuse and academic performance. While some researchers have identified gender differences in smartphone usage, others have found minimal correlation between gender and smartphone use. Several studies also link smartphone usage pattern to musculoskeletal problems. Moreover, research indicates that mobile phone use while driving is a major contributor to road accidents today. Also, it is crucial to understanding the impact of negative side of mobile phone usage on mental health, academic performance, and social interactions. Researches on this topic helps in developing effective interventions and policies to promote healthier usage habits. Therefore, raising awareness about smartphone overuse and its consequences is crucial. Parents should actively monitor their children’s schedules to help prevent them from developing a dependency on mobile devices.

Observation of the Clinical Efficacy of Self-Modified Skin-Stretching Device in the Treatment of Soft-Tissue Defects of the Heel: A Retrospective Single-Arm Cohort Study.

Due to the poor skin mobility of the heel, there are few reports on the efficacy and safety of skin-stretching devices in the treatment of soft-tissue defects of the heel. Redesigning the claws of the stretching devices may be one of the solutions to the problem. This study was designed to investigate the clinical effect of self-modified skin-stretching device in the treatment of soft-tissue defects in the heel. From December 2017 to March 2022, 23 patients with heel soft-tissue defects were enrolled. There were 15 males and 8 females, with a mean age of 50 years (range, 28-73 years). Defect size, time of wound closure, duration of stretching time, and complications were documented. The American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot score was used to evaluate functional outcomes, and pain was assessed by the visual analog scale (VAS) at the last follow-up. Statistical analysis was performed using t-tests and Mann-Whitney U test. The mean follow-up time was 14.2 months. Primary wound closure was performed in 6 patients and delayed wound closure in 17 patients. The average time of wound closure was 14.3 days, and the average duration of stretching time was 23.5 days. Complications were observed in 9 patients. Finally, all wounds were healed. At the last follow-up, the average AOFAS score was 86.7, with 9 excellent, 13 good, and 1 fair results. The mean VAS score was 2.6. Self-modified skin-stretching device is another option for treating heel soft-tissue defects. The technique can achieve good appearance and function with a low price and easy to install.

Analyzing the Accessibility of Trolley Bus Stops in the City of Salzburg

Public transport promotes sustainable mobility by enhancing connectivity, safety, comfort and health. The location, type, condition and spacing of stops play a pivotal role in determining the accessibility to public transport. Poor accessibility to public transport can lead to increased cost and time of travel, poor mobility, traffic congestion and social exclusion. This study uses Multi Criteria Analysis to provide a holistic measure of accessibility in terms of Transit Accessibility Index (TAI) for all the trolley bus stops in the city of Salzburg. Five quantitative indicators are combined and weighted appropriately to obtain the final accessibility score. An overall accessibility assessment is performed to further classify the bus stops into five performance categories based on their final accessibility score. Ideal Point Method is employed to determine the values of indicators for the ideal bus stop and compare the values with those of the existing stops. The result from the analysis shows that the most accessible trolley bus stops are located in the core region of Salzburg city near the city center and the main train station. This kind of analysis is crucial for sustainable transport planning and thus helps to promote smart mobility and better habitability of the city.

Do Chair Based Exercises Help in Improving Balance, Physical Fitness, and Quality of Life in Various Populations? A Systematic Review

Background: Due to different medical conditions as well as aging and sedentary lifestyle we have a population living with balance problems, reduced physical function and, poor quality of life. Chair-based exercises are exercises performed while sitting in a chair, which include upper and lower body movements led by an instructor while listening to music and sitting in a straight-back chair. Chair-based exercises have specific benefits as a training method as they stabilize the lower spine by providing a fixed base, and facilitate a greater range of movement by providing points of leverage and support; it minimizes load-bearing and reduces balance requirements in those with particular poor mobility and balance. Purpose: To summarize the current evidence on the effect of chair-based exercise on balance, physical fitness and, quality of life in different populations. Methodology: English literatures about CBE published between 2017 – 2024, was systematically searched on Google scholar, PubMed, Research gate and Cochrane. Only RCTs (PEDRO>5) were included in which chair-based exercises was an intervention. Improvement in balance, strength and, exercise tolerance was reviewed as per PRISMA guidelines. Result: 8 studies met inclusion criteria. Studies included different sample size (30-100), age (40-80) and different study populations (Psychiatric disorders, older individuals, Premenopausal women, Sedentary individuals) with protocol applied for 3 times/week for 8 to 16 weeks. Overall Chair-based exercises appear to be feasible and safe in improving Balance (Tinetti test), coordination (finger-to-nose test), strength (HHD& portable strength dynamometer), exercise capacity(6MWT) and, quality of life (SF-36). Conclusion: Chair based exercises are simple, effective and easily implemented activities to improve balance, muscle strength, exercise tolerance and, Quality of Life in various populations who has poor mobility and balance. Keywords: chair-based exercise, balance, Quality of life, exercise tolerance, strength.

Comparing Austin Moore and Bipolar Prostheses for Management of Femoral Neck Fractures in Low-Resource Hospitals in Rural India.

Femoral neck fractures in elderly individuals cause significant morbidity, and their management is particularly challengingin rural areas where healthcare access is limited. The recommended treatment for displaced femoral neck fractures in elderly patients with poor mobility, cognitive dysfunction and multiple comorbidities is a hemiarthroplasty, which can be performed with various implants, including monopolar implants like Austin Moore prosthesis (AMP) and bipolar prosthesis (BP). In developing countries like India, rural areas often have constraints with healthcare resources. Furthermore, the per-capita income is low, limiting access to affordable healthcare.As a result, treatment is often tailored to ensure affordability, and AMP continues to be used as it is a relatively inexpensive implant. The objective of our study is to assess and compare themortality, infection rate andfunctional outcomes (Harris hip score [HHS]) of AMP and BP in treating femoral neck fractures one year following surgery in a resource-constrained setting in a rural district general hospital in India. This retrospective observational study analysed all patients who underwent a hemiarthroplasty for acutely displaced femoral neck fractures between 1 January 2017 and 31 December 2017, with a minimum one-year follow-up following surgery. Pathological hip fractures, patients with pre-existing hip pathologies and those with an abbreviated mental test score of six or less were excluded. Medical records were reviewed, and demographic data, mortality, infection ratesand HHS one year following surgery were recorded and compared for patients who underwent hemiarthroplasty with an AMP and BP. A total of 118 patients underwent hemiarthroplasty, with two (1.69%) lost to follow-up. Therefore, 116 patients were included, comprising 81 (69.83%) women and 35 (30.17%) men, with similar demographics between both groups. No statistically significant difference was found in mortality rate (AMP 1, 1.79%, vs. BP 1, 1.67%, P= 0.96), infection rate (AMP 1, 1.82%, vs. BP 1, 1.69%, P= 0.96) and HHS (AMP 85.2 vs. BP 88.5; P= 0.08). No dislocations or periprosthetic fractures were noted at one-year follow-up in both groups. While AMP and BP have similar clinical and functional outcomes, AMP is more cost-effective and perhaps more suitable in low socioeconomic demographics and low-resource settings. Further research is suggested to evaluate long-term outcomes inunderserved populations with a low per-capita income.

Prevalence of Pain and Impact of Joint Strength on Perceived Physical Function in Pediatric Patients with Ehlers-Danlos Syndrome.

ObjectiveTo identify how pediatric patients with hypermobile Ehlers Danlos syndrome (hEDS) present to physical therapy (PT) and to better understand their musculoskeletal dysfunction. DesignPatients were included in the study if they had a diagnosis of hEDS and at least one completed PT evaluation after diagnosis. A chart review was conducted to assess joint strength and pain characteristics at the initial PT assessment. Physical Function Mobility (PF-Mobility; four domains with 1-5 scale with higher score representative of better physical function) as part of Patient-Reported Outcome Measurement Information System and pain intensity score (visual analog scale, 0-10 scale where a lower number indicates less pain) was completed by participants. SettingMidwestern tertiary care center. ParticipantsSixty-nine participants were included in the study with an average age of 16.4 years (SD 2.8) at the initial PT visit and 96% were female. InterventionNot applicable. Main Outcome measuresJoint strength, pain intensity and location, and PF-Mobility. ResultsThe knee was the most reported location with pain (68%) followed by the shoulder (46%), hip (41%), and back (39%). Average pain intensity was 5.0 (SD 1.8), joint strength scores ranged from 8.2 (SD 0.9) to 9.9 (SD 0.4), and PF-Mobility mean was 3.3 (SD 0.6). No correlation was noted between joint pain intensity and strength at the joint. ConclusionWhile participants perceived poor mobility and significant pain, PT-assessed strength did not reveal significant muscle weakness. Additional work is needed to explore this discrepancy, including altered biomechanics, evaluation methods, and non-musculoskeletal factors such as neuropathic and psychological components,

Evaluating the Effectiveness of Practicum in Teachers’ Training Programs in Perspective of Technology

This research assesses the quality of technology integration in practicum experiences of teacher training programs. The purpose is to evaluate their readiness to integrate technology into their practices as teachers of practice. Relevant research questions focus on the effectiveness of practicum, the level of technology awareness among the prospective teachers, and issues of concern in implementing technology. This research uses surveys to collect data on pre-service teachers’ use of technology in practice teaching contexts. This includes preparedness, perceived ways of implementing the technology expectations of the degree of success that would be achieved in increasing the engagement of students, and the extent of improvement in the learning outcomes that would be achieved. Studies showed that most pre-service teachers lacked self-confidence and were not well-prepared as regards the use of technology in teaching. Constraints such as lack of mentorship, shortage of practice and poor resource mobility were realized. These findings are consistent with past work regarding the utility of the TPACK framework specifically for connecting content, pedagogy, and technology knowledge. Based on the findings of the study, it is argued that teacher training programs require structural changes that should focus on the improvement of the mentorship process, practical experience, and objectives concerning technology integration into learning. These improvements are important to prepare future educators to function in digital classrooms efficiently.

Fear of movement interacts with trunk mobility, and pain intensity to predict disability in patients with chronic low back pain: a classification and regression tree (CART) analysis.

Low back pain significantly impacts global health, particularly in low-income areas where primary care challenges are prevalent. Assessing both biophysical and psychological factors associated with low back pain-related disability is crucial for developing effective screening and management strategies. This study aimed to examine the association between fear of movement, trunk mobility, pain intensity, physical activity, and low back pain-related disability, and to identify key factors contributing to higher disability levels in patients with chronic low back pain. This cross-sectional study analyzed data from 381 chronic low back pain patients aged over 18, collected at a primary care ambulatory between 2015 and 2019. Variables measured included pain intensity, fear of movement, physical activity, trunk mobility, and disability. A Classification and Regression Tree approach was used to model disability predictors. Fear of movement was the main driver of high disability (OR = 17.3, 95%CI 8.9-33.7). Two profiles were particularly prone to higher disability: patients with high fear of movement (>47.5) and pain intensity > 1.5; and those with lower fear of movement but poor trunk mobility (>36.5 cm). Patients with better trunk mobility and low pain intensity (≤3.5) showed significantly less disability (OR = 0.06, 95%CI 0.02-0.17). The findings highlight the need for integrating better psychological and biophysical assessments in managing chronic low back pain. Understanding how fear of movement, trunk mobility, and pain interaction can improve screening accuracy and optimize care in resource-limited settings, using valid and feasible tools for these scenarios.

Satisfactory outcomes following a second autologous hematopoietic cell transplantation for multiple myeloma in poor stem cell mobilizers: a retrospective study on behalf of the Chronic Malignancies Working Party of the EBMT.

Autologous hematopoietic cell transplants (auto-HCTs) remain the standard of care for transplant-eligible MM patients. The general practice has been to undergo upfront apheresis following induction to collect sufficient number of CD34+ cells to facilitate two auto-HCTs. However, 5-30% of MM patients do not initially mobilise a sufficient number of hematopoietic stem cells and are classified as poor mobilizers (PM). We compared the baseline characteristics and outcomes of 61 PMs and 816 non-PM patients who underwent a second auto-HCT and who were enrolled in the non-interventional CALM study (NCT01362972). Only patients who collected CD34+ prior to auto-HCT1 were included. Auto-HCT2 comprised both tandem and salvage transplants. PMs were re-mobilized with plerixafor (n = 24, 39.3%) or non-plerixafor-based regimens (n = 37, 60.7%). There were no significant differences in engraftment, progression-free survival (PFS) or overall survival (OS) after the second auto-HCT between PM and non-PM patients. There was a trend to shorter PFS in PM patients undergoing salvage auto-HCT (median 9.6 vs. 12.9 months; p = 0.08) but no significant difference in OS. The median OS was 41.1 months for PM and 41.2 months for non-PM patients (p = 0.86). These data suggest that salvage mobilization is effective and does not affect overall outcomes after a second auto-HCT.

Abstract 4119926: Inadequate calorie and macronutrient intake in a population with congestive heart failure in a non-cardiovascular tertiary hospital.

Introduction: Chronic Heart Failure (HF) is a clinical syndrome that as a consequence of the compensatory mechanisms to maintain an adequate level of perfusion, causes dyspnea, peripheral edema, fatigue, lack of appetite, changes in body weight, cachexia, sarcopenia, among others. The presence of these signs and symptoms, with other factors such as restrictions on salt and water consumption, early satiety, and poor mobility, producing changes in the patient's nutritional status that can indirectly increase the risk of inadequate dietary intake, which over a prolonged period will lead to the development of nutritional deficiencies. Objective: To analyze the dietary intake of energy, macronutrients, and micronutrients of patients with chronic HF in outpatient care. Methods: Cross-sectional study, including 75 outpatients with HF, who attended a Heart Failure Clinic. Data collection on dietary intake was obtained using a multi-step 24-hour recall. The ESHA Food Processor program was used to calculate the energy, macronutrient, and micronutrient intake. The presence of congestion was evaluated by bioelectrical impedance vectorial analysis and VEXUS. Results: The baseline characteristics of the population are shown in Table 1. Of the total population, 34% presented with deficient caloric intake, and the subjects who presented congestion also ingested significant fewer calories compared with those who do not present congestion (p= 0.031). Only 15% of patients had an adequate protein intake that resulted in lower NYHA class; among those subjects with a deficient protein intake, 72% had congestion measured by VExUS or bioelectrical impedance. For the sodium intake in the subjects' diet, 45% exceeded the recommendation stated in the guidelines of less than 2,400 mg of sodium per day which was not statistically significant (p=0.077). Discussion and Conclusions: The inadequate intake of calorie or macronutrients in patients with CHF led the patients to more congestion and higher NYHA class, this provide a perspective on the importance of adequate nutritional advice by an expert in the area, which is also essential to improve the clinical course of heart failure. Likewise, future studies are deeded to investigate whether this poor dietary intake is inversely related to some clinical manifestations such as congestion, suggesting that improving these conditions could positively impact patients' volume status and improve functional class.

Poly(isatin biphenylene) anion exchange membranes based on functionalization of long side chain N-spirocyclic

N-spirocyclic cations have high alkali resistance stability, but their poor mobility hinders the aggregation of cationic groups, which makes it difficult to form a good microphase-separated structure for OH− ion transport. In this work, two kinds of bicationic N-spirocyclic cations containing spacer side chains (BM-DSU and BM-DSD) were designed and synthesized, and a series of poly(isatin biphenylene) anion exchange membranes containing bicationic N-spirocyclic side chains were prepared by grafting different ratios of N-spirocyclic cations onto the poly(isatin biphenylene) polymer backbone. The bicationic N-spirocyclic quaternary ammonium salts containing spacer side chains increased the migration rate of the cationic groups and constructed a more continuous ion transport channel. The OH− ionic conductivities of BM-DSD-PIB-40 and BM-DSU-PIB-40 were 67.8 mS cm−1 and 63.4 mS cm−1 at 80 °C. After soaking at 80 °C in 1 M NaOH for 730 h, the residual conductivities of BM-DSD-PIB-30 and BM-DSU-PIB-30 were 73.19 % and 78.02 %, respectively.

Investigation of the pore structure characteristics and fluid components of Quaternary mudstone biogas reservoirs: a case study of the Qaidam Basin in China

Quaternary mudstone biogas reservoirs in the Qaidam Basin have shown great potential. However, complex pore structures with high clay contents and high heterogeneity limit the understanding of the storage and migration principles of these reservoirs. In this paper, HPMI and nitrogen adsorption experiments, in combination with NMR experiments under water saturation, centrifugation, various drying temperatures and other conditions, were adopted to determine the pore structure characteristics. Specifically, the reservoir space types and pore radius distribution characteristics were clarified. The cutoff values for different types of pores were identified based on the water-saturated mudstone NMR T2 spectra for full aperture distribution scales jointly characterized by mercury injection and nitrogen adsorption experiments. Furthermore, the three pore components and the saturation of different fluids were obtained. The research results indicate that the mudstone biogas reservoir has developed various reservoir spaces, and the pore size is primarily in the micronanometer range. The average total porosity reaches 27.28%, but the proportion of movable water pores is only 9.23% with poor fluid mobility, and the fluids in the pores are mostly capillary-bound water and clay-bound water. Among the different lithologies, argillaceous sand is more likely to become a good production layer.

The Impact of Executive Function on Retention and Compliance in Physical Therapy in Veterans

ObjectiveTo examine retention and compliance to a novel physical therapy (PT) treatment among Veterans with and without executive function deficits (EFD+/EFD−). DesignThis study was a preplanned secondary analysis of an ongoing randomized controlled trial. SettingOutpatient PT at Department of Veterans Afffairs Boston Healthcare System. ParticipantsSeventy-two community-dwelling middle-aged and older Veterans (mean age, 72 years [range 51-91]; 87% male) with gait speed between 0.5 and 1.0 m/second were recruited from primary care practices. InterventionsEight-week moderate-to-vigorous intensity PT program. Main outcome measureVeterans’ baseline mobility, retention (dropouts), and treatment compliance and posttreatment exercise compliance to 8-week PT treatment were evaluated based on their baseline EFD status. ResultsOf the 72 participants, 22% (n=16) were EFD+. Veterans with EFD+ at baseline had worse mobility performance (Short Physical Performance Battery [SPPB], 7.7 vs 9.5, P<.001) and patient-reported mobility (Activity Measure for Post-Acute Care [AM-PAC], 57.6 vs 62.2, P<.01) after adjusting for age, gender, number of comorbidities, depressive symptoms, and pain interference. Dropout rates for EFD+ and EFD− were 44% and 25%, respectively (P>.05). In multivariable logistic regression modeling, pain interference, depressive symptoms, mobility, and living alone but not EFD status were associated with dropping out. There was no evidence of significant differences in treatment compliance or posttreatment exercise compliance, measured by the number of attended sessions and the number of posttreatment exercise days by EFD status. ConclusionEFD+ was associated with poor baseline mobility. Although the dropout rate was higher among Veterans with EFD+, we were unable to conclude whether EFD status impacts retention or compliance due to the small sample size. Further investigation is needed to determine whether EFD status may identify individuals who need additional support during and/or after rehabilitation treatment.

Comparative advantages of activities with lumbosacral preservation for adult spinal deformity surgery: a retrospective Japanese cohort study.

Retrospective cohort study. This study aimed to demonstrate the advantages of preservation of the lumbosacral segment (LSS) in adult spinal deformity (ASD) surgery. Sacroiliac foundation enables sufficient restoration in ASD surgery; however, it could result in poor mobility. Thus, whether LSS provides better activities is still unknown. Among 399 patients who underwent ASD surgery, 62 (≥5 levels fused, >2-year follow-up) underwent fusion from T9-10 to L5 (group L, n=21) or to S2-alar-iliac (group S, n=41). Spinal alignments, Scoliosis Research Society (SRS)-22 scores, performance of activities (clipping toenail, wiping buttock, and wearing socks), proximal and distal junctional failure (PJF+DJF), rod fractures (RFs), and overall revision rates (RRs) were compared between the groups. Group L included younger patients and had longer follow-ups when compared with group S. Although the preoperative pelvic incidence and SRS sagittal modifiers were better in group L, postoperative spinal restorations were nonpathological in both groups. Both groups showed similar deformity progression at the 2-year follow-up; however, group L had lower SRS-22 pain scores. Although "wiping buttocks" did not differ between the groups, the performance of "clipping toenails" and "wearing socks" was poorer in group S at 2 years (possible, group S; 40% vs. group L; 85%-90%). The RRs did not differ between the groups; however, the PJF+DJF rate was higher in group L. DJF was not observed in group S, but occurrence of RFs was noted. Although poorer SRS-22 pain scores might be related to lumbosacral mobility, sufficient restoration, equivalent deformity progression, and similar RRs with better activity imply that lumbosacral preservation should be considered in younger patients with moderate deformities.

Factors influencing hospital stay duration in an elective cardiac surgery cohort

Abstract Cardiac surgery has become more complex in recent years, with increases in patient age, complexity, and associated costs. The use of a multidisciplinary strategy to analyze and standardize patient management offers significant benefits. The development of Enhanced Recovery After Surgery (ERAS) programs has proven useful in various types of surgery, recently including cardiac surgery, yielding good results. One of the primary objectives of ERAS programs is the reduction of the Inpatients' length of stay (LOS), with the subsequent improvement in the patient experience and a reduction in costs. The aim of this study is to analyze preoperative and postoperative factors related to the LOS reduction in a cohort of elective cardiac surgery patients included in the Cardiac ERAS program at our hospital. All patients included in the ERAS program, corresponding to elective cardiac surgery, were included in the analysis. 138 patients were divided into four quartiles based on the inpatient’s LOS. An extensive search was conducted in our quality control database, which contains 470 variables on the factors more strongly associated with LOS. The results were analyzed using Chi-Square test for categorical and the Kruskal-Wallis test for continuous variables, generally of non-normal distribution. The results are summarized in the table. Age, poor mobility, surgery other than coronary bypass, and reoperation were the non-modifiable factors most associated with a prolonged LOS. Lower preoperative hemoglobin and albumin levels were associated with an increase in LOS. A class 3 or 4 NYHA functional class, chronic pulmonary disease, and anticoagulation use were associated with higher LOS. Classic cardiovascular risk factors, such as dyslipidemia, hypertension, and tobacco use, were not associated with differences in hospitalization duration. Postoperative and intraoperative factors associated with higher LOS included extubation in the operating room or within six hours, ICU stay duration, mobilization on postoperative days one and two, time to oral food tolerance and gut motility recovery, hyperglycemia on postoperative day one, the duration of arterial, venous, and urinary catheters, the amount of fluids on postoperative day one and the opioid use in POD 2. The complications most associated with a prolonged duration were any infectious complication, any respiratory complication, reoperation, readmission to intensive care, transfusion after 12 hours or at any time during hospitalization, prolonged postoperative sedation, and any rhythmic complication. Conclusion In our cohort of elective patients for cardiac surgery, factors traditionally addressed by ERAS programs were identified as being associated with a longer inpatient’s length of stay. Pre-operative nutritional and anemia optimization, early extubation and mobilization, and the prevention of respiratory and infectious complications should be targeted to improve hospital stay duration.

The prevalence of falls and associated factors in older adults of the Torres Strait.

To assess the prevalence of falls and examine associations between falls and potential risk factors in older adults of the Torres Strait Region of Australia. Two hundred and fifty people aged ≥45 years residing in the Torres Strait, who identified as Torres Strait Islander, Aboriginal or both, were asked whether they had sustained any falls in the past year. Associations between self-reported falls and predictor variables were examined using logistic regression. 21% of participants reported at least one fall; 9% reported ≥2 falls. Participants who reported any falls in the past year were more than twice as likely to have urinary incontinence and poor mobility (p < .01) compared to participants who did not report any falls. Around one in five respondents reported one or more falls in the past year, demonstrating that falls are a significant issue for older adults of the Torres Strait. Fall prevention strategies that are effective in other populations are likely to be beneficial to the region but need to be informed by local consultation and implemented in partnership with the people of the Torres Strait.

Tips for percutaneous nephrolithotomy for transplant kidney stone

IntroductionThe management of urinary tract stones, particularly de novo kidney allograft stones, presents unique challenges for kidney transplant recipients because of their prevalence and specific clinical considerations. Here, we describe a case in which percutaneous nephrolithotomy was successfully used to fragment a large kidney allograft stone ≥20 mm in size.Case presentationA 57‐year‐old woman who underwent ureteroureterostomy post simultaneous pancreas–kidney transplantation presented with gross hematuria after 15 years. Computed tomography revealed a 23‐mm stone in the transplanted kidney. Initial attempts at endoscopic combined intrarenal surgery were changed to percutaneous nephrolithotomy because of poor ureter mobility and tortuosity. Stone fragmentation was achieved using pneumatic and ultrasonic lithotripsy. A second procedure using Swiss LithoClast® Trilogy enabled complete stone clearance and ureteral stent placement.ConclusionBy understanding the peculiarities of the percutaneous approach, we demonstrated the safe and effective use of a pneumatic and ultrasonic lithotripter for kidney allograft stone fragmentation.

Electrostatic fence induced assembly of low-concentration colloidal nanospheres to form liquid photonic crystals

Liquid photonic crystals (LPCs) have great application potential in sensors, anti-counterfeiting materials and detection due to their sensitive dynamic responsiveness. Currently, the preparation of LPCs mainly relies on the supersaturation of colloidal nanospheres. However, the supersaturation method usually fails to obtain LPCs based on low-concentration colloidal nanospheres. In turn, the use of high-concentration colloidal nanospheres results in poor mobility of LPCs, which makes them inappropriate for subsequent utilization in responsive systems. In this study, self-assembly of LPCs with vibrant structural colors is achieved through the electrostatic fence effect by introducing an anionic carboxylate-containing polymer as an inducer into the system of low-concentration negatively charged colloidal nanospheres (≥1.25 wt%). It is shown that the anionic carboxylate groups on the inducer molecules and the appropriate molecular chain length are the decisive factors for the inducing effect. The obtained LPCs exhibit a typical non-close-packed structure with a face-centered cubic arrangement of nanospheres. The nearest inter-nanosphere surface distance is 12.10 nm, and the farthest one is as long as 40.30 nm. The LPCs possess good dynamic recovery performance and sensitive optical response characteristics, which are conducive to application in responsive optical sensors directly or after filling.

Relationships of post-stroke fatigue with mobility, recovery, performance, and participation-related outcomes: a systematic review and meta-analysis.

Effective post-stroke mobility, recovery, performance, and participation are key goals for stroke survivors. However, these outcomes may be hindered by post-stroke fatigue (PSF), which can affect numerous aspects of post-stroke mobility, recovery, performance, functioning, community participation, and return to work. This review aimed to assess the scientific evidence on the relationship between PSF and mobility function, functional recovery, functional performance, and participation-related outcomes among stroke survivors. A comprehensive search of Cochrane Central, PubMed, Embase, and Web of Science (WoS) databases was conducted from inception to December 2023. Observational, cross-sectional, and longitudinal studies were included. The methodological quality of the included studies was assessed using the National Institute of Health's quality assessment tool, while the risk of bias was assessed using the Quality in Prognostic Studies tool. A total of 28 studies (n = 2,495 participants, 1,626 men, mean age ranging from 52.5 ± 9.5 to 71.1 ± 9.9 years) were included. The data analysis was conducted using narrative and quantitative synthesis. Fixed and random effects meta-analyses were conducted to explore the relationships between PSF and relevant outcomes. Chronic PSF was found to have significant negative correlations with mobility (meta r = -0.106, p < 0.001), balance performance (meta r = -0.172; 95%; p = 0.004), and quality of life (meta r = -0.647; p < 0.001). It also showed significant positive correlations with stroke impairment (meta r = 0.144, p < 0.001) and disability (meta r = 0.480, p < 0.001). Additionally, exertion/acute PSF had significantly negative correlations with walking economy (meta r = -0.627, p < 0.001) and walking endurance (meta r = -0.421, p = 0.022). The certainty of evidence was deemed moderate for these relationships. Our findings indicate that higher levels of PSF are associated with poorer mobility, balance, and participation, as well as greater disability and stroke impairment. Future studies, especially prospective longitudinal and randomized controlled trials, are warranted to substantiate our findings. PROSPERO, identifier: CRD42023492045.

Postthoracotomy Pain: The Unanswered Question Yet – A Clinical and Technical Report

Abstract Thoracotomy which is a major surgical procedure of making an incision through the thoracic wall in order to gain access to the thoracic organs, is a cornerstone of diagnosis and management of numerous cardiopulmonary disorders. Nonetheless, most essential area of patient care, postoperative pain management, presents several obstacles. Published literature shows that about three-quarters of the thoracotomy patients reported immediate pain or discomfort during the early postoperative period, and up to 30%–50% patients might even develop chronic pain that has implications on their health related quality of life. Consequently, the causes of continued pain after thoracotomy are numerous and range from the intricacy of the procedure, patients’ tolerance to pain and diseases among others. Pain control is essential to avoid the risk of the deterioration of lung function, poor patient mobilization, and prolonged hospital stay. It is therefore undoubted that if pain continues for a long period, one may develop chronic pain syndromes that drag down the quality of life even further. In attempts to resolve these problems, different types of analgesic measures have been attempted. Some interventional procedures have been reported recently to be useful: Fascial plane blocks, which interfere with the flow of pain messages. Routes such as thoracic paravertebral block, intercostal nerve block, serratus anterior plane block, pectoral nerve block, and the retrolaminar block give variable levels of anesthesia in the required area. Some newer blocks such as the rhomboid intercostal and serratus sparing (RISS) block seem to provide a wide complete analgesia of the posterior and lateral chest walls. Thus, in an intermediate-term pain management strategy, fascial plane blocks can be used together with medications such as paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs). It is a kind-of medicine that is frequently used because of its effectiveness accompanied by a tendency to produce minimal side effects and interact well with opioids without posing the risks inherent in the application of NSAIDs. They have significant analgesic and anti-inflammatory properties thus decreasing the dependence on opioids. Their use, therefore, comes with a lot of precautions due, prompt for example per both gastrointestinal bleeding and renal impairment, hence, requires patient spotlight and assessment. Therefore, in enhancing postthoracotomy pain regime, a multimodal approach that includes the use of fascial plane blocks in combination with paracetamol and prudent use of NSAID can improve the recovery process and henceforth the patient’s outcomes without subjecting the patients to adverse effects.