Activity Restriction Research Articles

Effects of Middle-Aged Women's Demographics, Health Behavior, And Health Status on Health-Related Quality of Life by Economic Activity Participation: Panel Evidence from Korea.

Middle-aged women have lower health-related quality of life (HRQoL) than men, and women's participation in economic activities is an important issue. In this study, the middle-aged female population was classified by economic activity participation to explore HRQoL and to identify related factors. We obtained data from the 2017 Korea Health Panel Survey (N = 1857 women aged 50-64 years), analyzed with chi-squared tests, t-tests, analyses of variance, and multiple regression analyses. HRQoL was measured with the Euro QoL-5 Dimensions index, and four demographic factors, four health behavior factors, and ten health status factors were entered. HRQoL was lower in the economically inactive group compared to the active group. Education, physical activity, chronic disease, vision problem, dental problem, activity restriction, frustration, and anxiety were associated with HRQoL in both groups. Spouse and household income were additional predictors identified only in the economically inactive group, and the 10 factors explained 36.0% of the variance. In the economically active group, drinking, sleeping time, hearing problem, stress, and depression were additional predictors identified, and the 13 factors explained 23.0% of the variance. Healthcare providers should consider both common predictors between economically active and inactive middle-aged women as well as predictors that were unique to each group to improve their HRQoL.

Healthcare burden changes by restricted physical activities in lumbar spinal stenosis and spondylolisthesis: a retrospective large cohort study during the COVID-19 pandemic

BackgroundLumbar spinal stenosis (LSS) and spondylolisthesis (SPL) are characterized as degenerative spinal pathologies and share considerable similarities. However, opinions vary on whether to recommend exercise or restrict it for these diseases. Few studies have objectively compared the effects of daily physical activity on LSS and SPL because it is impossible to restrict activities ethnically and practically. We investigated the effect of restricting physical activity due to social distancing (SoD) on LSS and SPL, focusing on the aspect of healthcare burden changes during the pandemic period.MethodsWe included first-visit patients diagnosed exclusively with LSS and SPL in 2017 and followed them up for two years before and after the implementation of the SoD policy. As controls, patients who first visited in 2015 and were followed for four years without SoD were analyzed. The common data model was employed to analyze each patient’s diagnostic codes and treatments. Hospital visits and medical costs were analyzed by regression discontinuity in time to control for temporal effects on dependent variables.ResultsAmong 33,484 patients, 2,615 with LSS and 446 with SPL were included. A significant decrease in hospital visits was observed in the LSS (difference, -3.94 times/month·100 patients; p = 0.023) and SPL (difference, -3.44 times/month·100 patients; p = 0.026) groups after SoD. This decrease was not observed in the data from the control group. Concerning medical costs, the LSS group showed a statistically significant reduction in median copayment (difference, -$45/month·patient; p < 0.001) after SoD, whereas a significant change was not observed in the SPL group (difference, -$19/month·patient; p = 0.160).ConclusionRestricted physical activity during the SoD period decreased the healthcare burden for patients with LSS or, conversely, it did not significantly affect patients with SPL. Under circumstances of physical inactivity, patients with LSS may underrate their symptoms, while maintaining an appropriate activity level may be beneficial for patients with SPL.

Technological methods of limiting the reproductive activity of queen bees in conditions of honey collection

The study of the biological characteristics of the development of bee colonies, the ethology of bees, the influence of the various factors on their life activities contributes to the development and implementation of new highly efective technologies of keeping and reproduction. Of particular interest is the study of the stimulating efect of diferent numbers of brood of diferent ages in the nest of a bee colony on the trophic connections of honey bees with the biological diversity of entomophilous plants, the change in physiological characteristics of diferent generations of bees in modern changing natural and climatic conditions of unstable ecotypes. This paper presents the data of experimental studies on the influence on the biological potential of bee colonies of various technological methods of regulating the reproductive activity of queen bees. The work aims to study the technological methods of regulating the reproductive activity of queen bees. The following research methods were used: zootechnical (selection of groups of analogues, signs of bee purebredness, brood accounting), analytical (analysis of literature data and research results) and statistical. Biometric data processing was carried out on a PC using MS Excel software with built-in statistical functions. Results. As a result of the study, it was found that bee families, where the reproductive activity of queen bees was limited by the use of an isolation cage, had the highest productivity indicators. It has been proved that prolonged (15 days or more) restriction of the reproductive activity of queen bees negatively afects the strength of bee colonies and their preparation for a prolonged state of hypobiosis. Conclusions. It was found that there is a complex relationship between brood rearing by bee colonies and their productivity. The absence of brood has led to an increase in the supply of nectar only for 12-15 days. Currently, due to the lack of replenishment with young bees, bee colonies have lost their strength and weakened. It has been proven that the most efective technological method of regulating the reproductive activity of queen bees in hull hives is the use of dividing grids and the mandatory presence of brood of diferent ages. For the efective use of honey collection, it is important not only to increase the maximum number of bees before the start of the main honey collection, but also to limit the feeding of a large number of larvae in time when they are no longer needed. During a short-term honey collection, it is necessary to limit the reproductive activity of the queen bee, and during the long one, it should be limited only in the second half of honey collection. Key words: bee colony, Ukrainian steppe breed, isolation, brood, reproductive activity, honey collection, honey productivity.

High-impact chronic pain in sickle cell disease: insights from the Pain in Sickle Cell Epidemiology Study (PiSCES).

The US National Pain Strategy recommends identifying individuals with chronic pain (CP) who experience substantial restriction in work, social, or self-care activities as having high-impact chronic pain (HICP). High-impact chronic pain has not been examined among individuals with CP and sickle cell disease (SCD). We analyzed data from 63 individuals with SCD and CP who completed at least 5 months of pain diaries in the Pain in Sickle Cell Epidemiology Study (PiSCES). Forty-eight individuals met the definition for HICP, which was operationalized in this study as reporting pain interference on more than half of diary days. Compared with individuals without HICP, individuals with HICP experienced higher mean daily pain intensity, particularly on days without crises. They also experienced a greater proportion of days with pain, days with healthcare utilization, and days with home opioid use and higher levels of stress. They did not have a statistically significantly higher proportion of days with crises or experience higher mean daily pain intensity on days with crises. Individuals with HICP experienced worse physical functioning and worse physical health compared with those without HICP, controlling for mean pain intensity, age, sex, and education. The results of this study support that HICP is a severely affected subgroup of those with CP in SCD and is associated with greater pain burden and worse health outcomes. The findings from this study should be confirmed prospectively in a contemporary cohort of individuals with SCD.

Restraining geometrically-necessary dislocations to the active slip systems in a crystal plasticity-based finite element framework

Strain gradients have been cast in the form of geometrically-necessary dislocations (GND) to relate the length-scale dependence of strength and to determine potential sites for failure initiation. The literature contains various different incompatibility measures, the main ones being: the total form (∇×Fp), the rate form for large displacements (∇×γ̇anaFp), and the slip gradient form (∇γ̇a). Here, these different approaches are compared rigorously for the first time. Obtaining GND densities when using the total form is a rank-deficit linear problem, solved by singular value decomposition (SVD) known as the Least Squares Minimization (L2 method). Alternative methods for finding GND densities such as Karush–Kuhn–Tucker (KKT) optimization are also investigated. Both L2 and KKT methods predict unrealistic GND densities on inactive slip systems leading to excessive strain hardening; even for a single crystal single slip case. Therefore, the restriction of GNDs to the active slip systems by using a threshold based on the total slip is proposed. This restriction reveals relatively consistent results for various single crystal single slip cases including: simple shear, uniaxial tension, and four-point bending. In addition, the small numerical differences in the slip leads to large discrepancies in the flow stress due to error accumulation, even for strain-gradient-free uniaxial tension, hence a threshold for the GND density increment (2×102 m−2) is used in all models to avoid formation of erroneous GND densities. Finally, the proposed method is applied to the evolution of the GND density for a grain inside a polycrystal aggregate that posses a complex stress state. The lowest incompatibility error is obtained by both of the total forms that use the curl of the plastic deformation gradient with the active slip system restriction suggesting them to be the most reliable GND measures.

#2130 Pregnancy in patients with chronic kidney disease stage 3 to 5: what to expect?

Abstract Background and Aims Chronic Kidney disease (CKD) has long been recognized as a risk factor for adverse pregnancy outcomes. Advanced CKD is also associated with decrease fertility, raising the importance of an early approach of pre- menopausal CKD women to discuss pregnancy planning and avoid long term kidney function deterioration or prematurity sequelae in their child-to-be. Method Retrospective analysis of maternal, obstetric and perinatal outcomes of patients with CKD stage 3 to 5, followed by the Nephro-obstetric clinical team between 2011 until 2023. Results We evaluated 31 gestations in 28 patients, with mean age of 32 years [19-43], 21 Caucasian and 7 African, 15 nulliparous, 21/28 with hypertension (HTN), 6/28 diabetic, 2/28 with HIV and 3/28 with systemic lupus erythematosus (SLE). CKD diagnosis occurred during pregnancy in 4/28 patients. Mean pre-pregnancy SCr was 2,1 ± 1 mg/dL [1,1-4,3] and mean proteinuria was 1535 ± 1874 mg/day [5 - 6000], and 11 patients had proteinuria &amp;gt;1 g/day. At gestation baseline, patients evaluated in each pregnancy were in CKD stage 3a (9/31), 3b (10/31), 4 (8/31) and 5 (4/31). CKD etiologies were heterogenous, with most common diagnosis being hereditary nephropathies (7/28), Diabetic nephropathy (6/28) and lupus nephritis (3/28). Exposure to teratogenic therapy occurred in 10/31 gestations (mean time of 11 weeks; 2 - 15), generally ACE/ARBs. Medical termination of pregnancy occurred in 3 gestations due to active SLE and severe growth restriction, 1 abortion at 16 weeks and 1 stillbirth due to cervical insufficiency. HTN aggravation occurred in 16/31 (52%) gestations and de novo proteinuria or proteinuria increase occurred in 7/31(22,5%) and 20/31 (64.5%) gestations, respectively due to pregnancy hyperfiltration, active lupus nephritis and preeclampsia. Considering pregnancies that progressed, renal function (RF) deterioration occurred 10/19 (53%) patients in CKD stage 3 with 20%/60%/20% with full/partial and no RF recovery, respectively. In CKD4 6/7 patients (86%) had RF aggravation with 17% and 83% with partial or no RF recovery. Of the 2 Patients in CKD stage 5 with gestation &amp;gt;20 weeks, 1 started dialysis during pregnancy and the other 4 months postpartum. Dialysis was initiated in 3 patients during pregnancy (2 CKD stage 4 and 1 CKD stage 5) due to urea level &amp;gt;100 mg/dL. RF deterioration was mainly due to pregnancy hyperfiltration and preeclampsia (11/26 gestations; 42%). Mean gestation age at delivery was 34 ± 4 weeks (28-41), with 73% and 53,8% pregnancies with gestational age &amp;lt;37 and 34 weeks, respectively. Mean birth weight was 1866 ± 707 g (555–3095 g), with 73% low birth weight (&amp;lt;2500 g). Mean Apgar 1/5/10 was 9/10/10, respectively. Cesarean was performed in 53,8% gestations and 61,5% newborns were admitted to the neonate care unit (NICU) due to prematurity Conclusion CKD patients with stage 3 to 5 are at increased risk of worse maternal outcomes, namely HTN aggravation (52%), de novo or increase proteinuria (87%) and RF deterioration (53% stage 3 and 86% stage 4) with significant permanent loss of kidney function. Obstetric and perinatal results were also significantly worse with a high incidence of preeclampsia (42%), prematurity (73%), low birth weight (73%) and the need of NICU (61.5%). It is of sum importance, that advanced CKD patients are previously counseled about those risks and are managed in a multidisciplinary feto- maternal clinic experienced in CKD pregnancy care that has a dialysis unit.

Vegan gummy candies with low calorie based on celery (Apium graveolens) puree and boswellia gum (Boswellia thurifera).

Gummy candy is one of the main snacks for children, and conventional samples with high calorie illustrate no nutritional value; therefore, the aim of present research was to develop functional product on priority. Celery (Apium graveolens) puree (25%-50%), boswellia gum (10%-20%), lemon essential oil (0.25%-0.50%), and sugar (10%-20%) in two levels were considered for vegan gummy candy production. Based on central composite design, the 30 types of gummy candies were prepared; afterward, response surface methodology was applied to optimize results determined by texture (hardness, springiness, adhesiveness, gumminess, chewiness, and elasticity characteristics), physicochemical attributes (pH, sugar content, water activity, antioxidant function, and calorie restriction), and also sensory evaluation. In general, elevated concentration of celery puree and boswellia gum-enhanced hardness, chewiness, and also gumminess for treated products. On the other hand, higher sugar with lemon essential oil improved adhesion, springiness, and elasticity features. More boswellia gum, celery, lemon essential oil, and reduction in sugar elevated water activity and also declined pH for treated samples. The celery puree, boswellia gum, and lemon essential oil significantly enhanced antioxidant function of treated gummy candies. According to attained results, sugar had a remarkable influence on acceptability and in treated samples calorie decreased. Based on all investigated factors, optimal formulation was achieved including 25% celery puree, 20% boswellia gum, 0.450% lemon essential oil, and 13.55% sugar. Regarding the results, obtained gummy candy with high nutritional value and low calorie demonstrated the potential to produce extensively in food sector.

The International Classification of Functioning, Disability and Health to map leprosy-related disability in rural and remote areas in Indonesia.

The International Classification of Function, Disability, and Health (ICF-WHO, 2001) recognizes several dimensions of disability, such as body structure and function (and impairment thereof), activity (and activity restrictions) and participation (and participation restriction) and their interactions with contextual factor (personal and environmental). In this study, we map and analyse the relationship between the components of ICF in leprosy patients from two rural areas in Indonesia: Lewoleba (East Nusa Tenggara) and Likupang (North Minahasa). This study was part of a community outreach program by the KATAMATAKU team from Universitas Indonesia. The body structure was graded using the WHO hand and feet disability grade and the number of enlarged nerves, while the body function was measured by the Jebsen Taylor Hand Function Test (JTT) and Timed-up and Go (TUG). Activity limitation and participation restriction were measured using the Screening Activity Limitation Safety Awareness (SALSA) Scale and Participation Scale (P-scale), respectively. There were 177 leprosy patients from the two regions and 150 patients with complete data were included in the analysis. We found 82% (95% CI: 75.08%-87.32%) of subjects with multibacillary leprosy, 10.67% (95% CI: 6.67%-16.62%) of subjects with grade 2 WHO hand disability, and 9.33% (95% CI: 5.64%-15.06%) of subjects with grade 2 WHO foot disability. Assessment using the SALSA Scale showed 29.33% of subjects with limitation activity and 11.33% with participation restriction. Age was shown to have positive correlations with SALSA, JTT, and TUG. Inter-dimensional analysis showed that the SALSA scale had significant positive correlations with the number of nerve enlargements, P-scale, JTT, and TUG. SALSA scores of grade 2 WHO hand and foot disability were also significantly higher than grades 1 and 0. The participation scale also had a positive correlation with JTT but not TUG. Hand disability seemed to affect societal participation while foot did not. We used the ICF to describe and analyse dimensions of leprosy-related disability in Indonesia.

Total patellectomy in a dog: Long term outcome

Patellectomy alters stifle biomechanics and has been demonstrated to result in degenerative joint lesions and to increase the force required for its extension. A 3-year-old male dog was admitted with right hindlimb lameness due to a penetrating wound in the stifle. After exploratory arthrotomy, diagnosis of straight patellar ligament avulsion and patellar fracture was established. In three months, the dog underwent three surgeries to repair the straight patellar ligament, drainage of the stifle, and total patellectomy. Antimicrobial and anti-inflammatory drugs were administered. Restriction of activity and physiotherapy were also advised. Patellectomy was performed because the patella was no longer adhered to its adjacent soft tissues and appeared to be necrotic. Follow-up information for seven years showed mild lameness in the affected limb and a body attempt to substitute the patella.

Use of SWOT analysis to select feasible businesses as the mainstay business of BUMDes and MSMEs

COVID-19 pandemic, which lasted from 2020 to 2022, has affected the global economy. Activity restrictions had hampered the progress of various business sectors. As a result, there was a decline in economic growth globally. There was even an economic contraction of -13.7% in 2020 and many businesses experienced either setbacks or bankruptcies. Indonesia’s government made various recovery efforts, such as business assistance through village-owned enterprises (BUMDes) activities and capital assistance for MSMEs in the form of people’s business credit (Kredit Usaha Rakyat/KUR). Various trainings and assistance were conducted, but these activities focused more on reporting and administration of funds. The establishment of BUMDes mainly aims to improve the villages’ economy. The selection of BUMDes' mainstay business is highly important to realize the smooth running of the business chosen. For this reason, it is necessary to conduct training on how to select of the mainstay business and calculate the feasibility of the business chosen to be developed so that BUMDes and MSME actors can manage and develop their business properly. The selection can use SWOT analysis, namely by analyzing the strengths, weaknesses, opportunities, and threats of the potential business options. In this community services activity, BUMDes and MSME training was held in Bogorejo Village, Pesawaran Regency, Lampung Province. The results of SWOT analysis reveal that the feasible business options are digital financial services (BRI-Link), agricultural trading (waserda), and waste collection and waste bank. Waserda business aims to help market the local community's products. Waste management business economically generates small profits, but has long-term positive effects, both environmentally and socially. Meanwhile, tourism park and savings and loan are considered not feasible in the long-term, as these businesses are susceptible to bottlenecks and large losses so that they must be managed very carefully.

Factors Associated With Incident and Recurrent Falls Among Men Enrolled in Evidence-Based Fall Prevention Programs: An Examination of Race and Ethnicity.

We examined factors associated with incident (one) and recurrent (2+) falls among 7207 non-Hispanic White (NHW) (89.7%), non-Hispanic Black (NHB) (5.0%), and Hispanic (5.3%) men ages ≥60years with ≥1 chronic conditions, enrolled in an evidence-based fall program. Multinomial and binary regression analyses were used to assess factors associated with incident and recurrent falls. Relative to zero falls, NHB and Hispanic men were less likely to report incident (OR = 0.55, p < .001 and OR = 0.70, p = .015, respectively) and recurrent (OR = 0.41, p < .001 and OR = 0.58, p < .001, respectively) falls. Men who reported fear of falling and restricting activities were more likely to report incident (OR = 1.16, p < .001 and OR = 1.32, p < .001, respectively) recurrent and (OR = 1.46, p < .001 and OR = 1.71, p < .001, respectively) falls. Men with more comorbidities were more likely to report recurrent falls (OR = 1.10, p < .001). Compared to those who experienced one fall, men who reported fear of falling (OR = 1.28, p < .001) and restricting activities (OR = 1.31, p < .001) were more likely to report recurrent falls. Findings highlight the importance of multi-component interventions to prevent falls.

A Comparison of the Functioning and Disability Levels of Children With Hemiplegic and Diplegic Cerebral Palsy Based on ICF-CY Components.

We compared children with hemiplegic and diplegic cerebral palsy (CP) using the conceptual framework of the International Classification of Functioning, Disability and Health: Child and Youth version (ICF-CY). We enrolled 42 children with CP aged 5 - 13 years old (M age = 9.57, SD = 2.8 years). We assessed their trunk control and dynamic balance with the Trunk Control Measurement Scale (TCMS) and the Timed Up and Go test (TUG), and we used ABILHAND-Kids and Assessment of Life Habits (Life-H) to assess their manual ability and participation with activities of daily living. We administered the European Child Environment Questionnaire (ECEQ) to identify relevant environmental factors. We employed structural equation modeling (SEM) to identify specific factors contributing to potential differences between these CP groups. Children with hemiplegic CP demonstrated significantly better outcomes in terms of trunk control, dynamic balance, and environmental factors compared to those with diplegic CP (p < .05). In contrast, children with diplegic CP demonstrated superior outcomes regarding manual ability, compared to those with hemiplegic CP (p < .001). In our structural equation models, trunk control strongly predicted both dynamic balance (0.75) and environmental factors (0.74). Moreover, the relationships between trunk control and participation in daily and social activities were 0.54 and 0.47, respectively. Impaired trunk control and dynamic balance were significant contributors to increased activity restrictions and environmental barriers in children with diplegic CP. This suggests that improving disability and functioning in children with diplegic CP requires a focus on trunk control training and dynamic balance exercises.

Establishment of a digital electrocardiogram telemonitoring system and remote consultation service.

The use of telemonitoring electrocardiogram (ECG) improves the detection rate of various arrhythmias as it offers an extended recording time and does not impose activity restrictions. However, many community hospitals lack the resources to conduct this test due to a lack of cardiac function specialists and antiquated screening equipment. To establish a digital ECG telemonitoring system and remote consultation service between tertiary hospitals and community medical service stations to improve diagnosis and treatment effectiveness. We used the PI ECG telemonitoring data acquisition system, with a personal digital assistant (PDA) or computer serving as the platform for ECG acquisition, storage, display, printing, and transmission. We introduced this system to standardize the storage and transmission of ECG telemonitoring data, and ensure accurate transmission, reproducibility, and preservation of data. The implementation of the PI ECG telemonitoring data acquisition system enabled the sharing of remote ambulatory electrocardiography data between Beijing Shijitan Hospital and its affiliated community hospitals. This has resulted in reduced waiting times for patients to receive reports (from 0.3 to 1 hour, to 0.1 or less), shortened consultation times (from 2 hours to 0.1 hour), and improved patient satisfaction with consultations (> 20% of the patients reported they were highly satisfied). The system successfully combined the goals of intelligence, real-time synchronization, and efficiency, revolutionizing ECG telemonitoring diagnosis in the network era. Sharing digital telematics information between tertiary and community hospitals enables a tiered approach to diagnosis and treatment and allows for more efficient, accurate, and convenient remote diagnostics.

Balance confidence and associated factors among patients with knee osteoarthritis

IntroductionKnee osteoarthritis (KOA) is a progressive condition that results in decreased mobility, self-imposed restriction of activity, and impaired functions such as loss of self-efficacy, fear of falling, and balance impairments. This study assessed balance confidence and associated factors among patients with KOA. MethodsThis cross-sectional study involved 115 patients with KOA. The Western Ontario and McMaster University Osteoarthritis Index was used to evaluate pain, stiffness, and physical function while the Activity Specific Balance Confidence scale was used to assess the balance confidence. Pearson's chi-square test, Pearson's correlation and Spearman's rank correlation coefficient determined the association between variables. ResultsGreater number [67(58.3%)] of the participants had low levels of functioning in balance confidence. Significant associations were observed between balance confidence and pattern of KOA (X2 = 7.08, p = 0.029, φc = 0.248), fear of fall (X2 = 38.32, p = 0.001, φc = 0.577) and history of fall (X2 = 11.49, p = 0.003, φc = 0.316). Significant negative correlations were observed between balance confidence and pain (r = −0.498, p = 0.001), stiffness (r = −0.564, p = 0.01) and physical function (r = −0.676, p = 0.001). ConclusionThe low levels of balance confidence and related factors are a cause for concern and highlight the need to assess and monitor balance confidence in KOA rehabilitation using balance confidence ratings. This could prompt the integration of physical therapy rehabilitation programs that target balance confidence and related factors to improve mobility, quality of life and outcome of rehabilitation.

Age-specific reference scores for the PISQ-12 on female sexual functioning in the Netherlands: a retrospective population-based survey.

Female sexual dysfunction is common in the general population, with age emerging as a significant determinant of sexual activity and functioning. To establish age-specific reference scores for the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) in the general Dutch female population. A retrospective, cross-sectional, questionnaire-based study was conducted in the Netherlands. The study population comprised 2518 Dutch-speaking women aged ≥18years, representing a cross section of the general Dutch population. The PISQ-12 was used to assess sexual functioning in heterosexual women. The Groningen Defecation and Fecal Continence questionnaire was utilized to demonstrate demographic factors. We established age-specific reference scores for the PISQ-12 in the general Dutch population. Of the 2518 women, 1592 (63.2%) were sexually active and 926 (36.8%) were not. Further analysis focused on the sexually active group: we found a decrease in mean total PISQ scores, ranging from 38.34 among 18- to 34-year-olds to 36.98 among ≥65-year-olds. Older women scored lower in the behavior domain, specifically pertaining to sexual desire (P < .001) and sexual excitement (P <.001). They also had lower scores in the partner-related domain regarding partner problems of erection (P < .001) and orgasm perception (P < .001). With increasing age, negative emotional reaction scores were higher (P <.001). In the physical domain, we observed significantly different scores for pain during sexual intercourse (P < .001) and restrictions in sexual activity due to fear of urinary leakage (P < .001), with the lowest scores in the youngest group. These age-specific references scores of the PISQ-12 provide an overview of sexual functioning of a general population, which enables caregivers to assess and interpret patients' individual scores more accurately. We included only sexually active women in our subanalyses, potentially introducing selection bias for older women with better physical conditions. The study's strength lies in its extensive sample size, representing a cross section of the general Dutch population. Furthermore, the self-administered questionnaire approach helped minimize embarrassment and obtain realistic responses. Our study demonstrated age-specific PISQ-12 reference scores and highlighted associations between aging and diminishing scores of sexual desire, sexual excitement, erection problems, and orgasm perception, while women aged 18 to 34years reported the lowest scores for pain during intercourse and limited sexual activity due to fear of urinary leakage.

Development and initial testing of a brief, generic self-reported disability questionnaire: The Universal Disability Index.

Disability is an important multifaceted construct. A brief, generic self-reported disability questionnaire that promises a broader and more comparable measure of disability than disease-specific instruments does not currently exist. The aim of this study was to develop and evaluate such a questionnaire: the Universal Disability Index (UDI). An online survey was used to collect general population data. Data were randomly divided into training and validation subsets. The dimensionality and structure of eight UDI questionnaire items were evaluated using exploratory factor analysis (EFA, training subset) followed by confirmatory factor analysis (CFA, validation subset). To assess concurrent validity, the UDI summed score from the full dataset was compared to the Groningen Activity Restriction Scale (GARS) and the Graded Chronic Pain Scale (GCPS) disability scores. Internal consistency and discriminant validity were also assessed. Bootstrapping was used to evaluate model stability and generalisability. 403 participants enrolled; 364 completed at least one UDI item. Three single-factor versions of the UDI were assessed (8-item, 7-item, and 6-item). All versions performed well during EFA and CFA (182 cases assigned to each), but none met the RMSEA (Root Mean Square Error of Approximation) criterion (≤ 0.08). All versions of the UDI had high internal consistency (Cronbach's α > 0.90), were strongly correlated (Pearson's r > 0.7) with both GARS and GCPS disability scores, indicating concurrent validity, and could accurately discriminate between upper and lower quartiles of these comparators. Confidence intervals of estimates were narrow, suggesting model stability and generalisability. A brief, generic self-reported disability questionnaire was found to be valid and to possess good psychometric properties. The UDI has a single factor structure and either a 6-item, 7-item or 8-item version can be used to measure disability. For brevity and parsimony, the 6-item UDI is recommended, but further testing of all versions is warranted.

Quality-of-Life Assessment in Children with Mild to Moderate Bronchial Asthma.

Background and Objectives: Assess the quality of life of children aged 2-10 with mild to moderate bronchial asthma. To evaluate the general health condition of children with mild and moderate severity bronchial asthma. To determine health changes in children with mild- and moderate-severity bronchial asthma as they grow older. To evaluate the impact of mild- and moderate-severity bronchial asthma on children's daily and social activities, physical health, emotional state, and general well-being. Materials and Methods: A comparative cross-sectional study was conducted in March-June 2020. Parents or guardians of 2-10-year-old children without bronchial asthma and children with mild to moderate bronchial asthma were interviewed after receiving their written informed consent. The questionnaire was based on the standardized quality-of-life quiz SF-36. A total of 248 questionnaires were collected-106 from the parents or guardians of children with bronchial asthma and 142 from parents/guardians of children without bronchial asthma. For further analysis, 106 children without bronchial asthma and with no chronic conditions were selected. Quantitative variables were compared using the Mann-Whitney U test and qualitative data using the chi-square (χ2) criteria. Quantitative data were described by giving means, medians, and standard deviations (SD); qualitative features by giving relative frequencies. Statistical data were analyzed using SPSS and Excel 2020. Results: Children with mild and moderate asthma exhibit poorer health compared to their healthy counterparts. Only 20.7% of respondents with asthma reported excellent or very good health, contrasting with 64.1% of healthy children (p < 0.001). As children with asthma age, their general condition improves, with 46.2% showing improvement in the past year, while 42.5% of healthy children had a stable condition (p < 0.05). In various activities, children with asthma face more constraints than healthy children (p < 0.05), including energetic activities (sick-59.5%; healthy-10.3%), moderate activities (sick-24.5%; healthy-4.7%), climbing stairs (sick-22.7%; healthy-3.8%), and walking over 100 m (sick-9.4%; healthy-0%). Children with asthma are more likely to experience exhaustion, anxiety, tiredness, lack of energy, and restraint in public activities (p < 0.05). Conclusions: Parents/caregivers of children with mild to moderate bronchial asthma rate their health worse than those of healthy children do. As children with mild to moderate bronchial asthma grow, the disease impact on their overall well-being decreases. Children with mild to moderate bronchial asthma, compared to healthy children, experience more limitations in vigorous or moderate activities; face more difficulties climbing stairs or walking more than 100 m; frequently feel exhaustion, anxiety, fatigue, or lack of energy; and encounter restrictions in social activities.

Assessing the effect of COVID 19 lockdowns on the composition of organic compounds and potential source of PM2.5 in Hanoi, Vietnam.

The ambient air quality during COVID-19 lockdowns has been improved in many cities in the world. This study is to assess the changes in persistent organic pollutants in PM2.5 during the COVID-19 lockdown in Hanoi. Individual organic species in PM2.5 ((e.g., polycyclic aromatic hydrocarbons (PAHs), polychlorobiphenyls (PCBs), and organochlorine pesticides (OCPs)) were measured in an urban residential area in Hanoi from before the March 10th to April 22nd, 2020, including before the partial lockdown (BL) and the partial lockdown (PL) phases. During the PL phase, the concentration of Σ14PAHs and Σ28PCBs was reduced by 38 and 52% compared with the BL period, respectively. The diagnostic ratio method implied that the sources of PAHs within the PL phase had a less effect on traffic and industrial activities than in the BL phase. The characteristic ratio method indicated that PCBs were mixed by commercial product and combustion process in both the BL and the PL periods, however, the source of PCBs in the BL phase was influenced by municipal waste incineration more than those in the PL phase. The decreasing concentration of Σ20OCPs during the partial lockdown was attributed to the restriction of human activities during the quarantine period. The results suggested that the source of OCPs was probably derived from the usage of pesticides in current and, historical degradation or the transportation of pesticides from the soil to the atmosphere.

Postoperative Activity Restrictions After Slings: A Randomized Controlled Trial.

Restricting activity after midurethral slings is an unproven practice. The objective of this study was to evaluate the effect of postoperative activity restriction on satisfaction and outcomes after slings. This was a multicenter, 2-arm, noninferiority randomized controlled trial. Patients aged 18-85 years undergoing treatment with a midurethral sling were randomized 1:1 to postoperative activity restriction or liberal activity. Restrictions included avoidance of strenuous exercise and heavy lifting. The liberal group was allowed to resume activity at their discretion. Our primary outcome was satisfaction with postoperative instruction at 2 weeks. Secondary outcomes included surgical failure, mesh exposure rates, and other adverse events. In total, 158 patients were randomized with 80 to the liberal group and 78 to the restricted group. At 2 weeks, 54 (80.6%) of patients in the liberal group and 48 (73.9%) of patients in the restricted group were satisfied. We found statistical evidence supporting the hypothesis that postoperative liberal activity instruction is noninferior to activity restriction with regard to patient satisfaction (P = 0.0281). There was no significant difference in strenuous activity at 2 weeks (P = 0.0824). The liberal group reported significantly more moderate activity at 2 weeks (P = 0.0384) and more strenuous activity at 6 weeks and 6 months (P = 0.0171, P = 0.0118, respectively). The rate of recurrent or persistent stress incontinence for liberal versus restricted groups was 18.52% versus 23.53% (P = 0.635). There were no statistically significant differences in complication rates. Postoperative liberal activity was noninferior to activity restriction with regard to patients' satisfaction. There was no evidence supporting a statistically significant association between postoperative instruction and negative surgical outcomes.

Effect of Left Ventricular Diastolic Dysfunction on the Cardiopulmonary Exercise Test in Patients With Cardiovascular Disease

Left ventricular diastolic dysfunction exists in patients with heart failure with reduced ejection fraction and causes activity restriction and a poor prognosis, but there have been few reports about exercise tolerance in patients with diastolic dysfunction, regardless of left ventricular ejection fraction (LVEF). In this study, 294 cardiovascular disease patients who performed a cardiopulmonary exercise test (CPX) with an adequate examination by echocardiography at Fukuoka University Hospital from 2011 to 2020 were investigated. Patients were divided into groups with grade I and grade II or III diastolic dysfunction according to diagnostic criteria, regardless of LVEF, by echocardiography. After adjusting for age, gender, body mass index, smoking, and LVEF by propensity score matching, we compared the results of CPX between the grade I and grade II/III groups. There were no significant differences in hemodynamic parameters, or in the respiratory exchange ratio, oxygen uptake per body weight, oxygen uptake per heart rate, or parameters of ventilatory volume. Ventilatory equivalents per oxygen uptake and per carbon dioxide output were significantly worse in the grade II/III group from the rest to peak periods during CPX. In conclusion, left ventricular diastolic dysfunction worsens ventilatory efficacy during CPX. This effect potentially contributes to a poor prognosis in left ventricular diastolic dysfunction.