Differences in gait patterns, pain, function and quality of life between males and females with knee osteoarthritis: a clinical trial

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to gain a deeper understanding of the gender differences in knee osteoarthritis (OA) by evaluating the differences in gait spatio-temporal parameters and the differences in pain, quality of life and function between males and females suffering from knee OA.</p> <p>Methods</p> <p>49 males and 85 females suffering from bilateral medial compartment knee OA participated in this study. Each patient underwent a computerized gait test and completed the WOMAC questionnaire and the SF-36 health survey. Independent t-tests were performed to examine the differences between males and females in age, BMI, spatio-temporal parameters, the WOMAC questionnaire and the SF-36 health survey.</p> <p>Results</p> <p>Males and females had different gait patterns. Although males and females walked at the same walking speed, cadence and step length, they presented significant differences in the gait cycle phases. Males walked with a smaller stance and double limb support, and with a larger swing and single limb support compared to females. In addition, males walked with a greater toe out angle compared to females. While significant differences were not found in the WOMAC subscales, females consistently reported higher levels of pain and disability.</p> <p>Conclusion</p> <p>The spatio-temporal differences between genders may suggest underlying differences in the gait strategies adopted by males and females in order to reduce pain and cope with the loads acting on their affected joints, two key aspects of knee OA. These gender effects should therefore be taken into consideration when evaluating patients with knee OA.</p> <p>Trial Registration</p> <p>The study is registered in the NIH clinical trial registration, protocol No. NCT00599729.</p

Regulation of inflammation in Japanese encephalitis

Uncontrolled inflammatory response of the central nervous system is a hallmark of severe Japanese encephalitis (JE). Although inflammation is necessary to mount an efficient immune response against virus infections, exacerbated inflammatory response is often detrimental. In this context, cells of the monocytic lineage appear to be important forces driving JE pathogenesis

SPARC 2018 Internationalisation and collaboration : Salford postgraduate annual research conference book of abstracts

Welcome to the Book of Abstracts for the 2018 SPARC conference. This year we not only celebrate the work of our PGRs but also the launch of our Doctoral School, which makes this year’s conference extra special. Once again we have received a tremendous contribution from our postgraduate research community; with over 100 presenters, the conference truly showcases a vibrant PGR community at Salford. These abstracts provide a taster of the research strengths of their works, and provide delegates with a reference point for networking and initiating critical debate. With such wide-ranging topics being showcased, we encourage you to take up this great opportunity to engage with researchers working in different subject areas from your own. To meet global challenges, high impact research inevitably requires interdisciplinary collaboration. This is recognised by all major research funders. Therefore engaging with the work of others and forging collaborations across subject areas is an essential skill for the next generation of researchers

Comparative proteomic analysis on fruit ripening processes in two varieties of tropical mango (Mangifera indica)

Mango (Mangifera indica L.) is an economically important fruit. However, the marketability of mango is affected by the perishable nature and short shelf-life of the fruit. Therefore, a better understanding of the mango ripening process is of great importance towards extending its postharvest shelf life. Proteomics is a powerful tool that can be used to elucidate the complex ripening process at the cellular and molecular levels. This study utilized 2-dimensional gel electrophoresis (2D-GE) coupled with MALDI-TOF/TOF to identify differentially abundant proteins during the ripening process of the two varieties of tropical mango, Mangifera indica cv. ‘Chokanan’ and Mangifera indica cv ‘Golden Phoenix’. The comparative analysis between the ripe and unripe stages of mango fruit mesocarp revealed that the differentially abundant proteins identified could be grouped into the three categories namely, ethylene synthesis and aromatic volatiles, cell wall degradation and stress-response proteins. There was an additional category for differential proteins identified from the ‘Chokanan’ variety namely, energy and carbohydrate metabolism. However, of all the differential proteins identified, only methionine gamma-lyase was found in both ‘Chokanan’ and ‘Golden Phoenix’ varieties. Six differential proteins were selected from each variety for validation by analysing their respective transcript expression using reverse transcription-quantitative PCR (RT-qPCR). The results revealed that two genes namely, glutathione S-transferase (GST) and alpha-1,4 glucan phosphorylase (AGP) were found to express in concordant with protein abundant. The findings will provide an insight into the fruit ripening process of different varieties of mango fruits, which is important for postharvest management

EQ-5D in Central and Eastern Europe : 2000-2015

Objective: Cost per quality-adjusted life year data are required for reimbursement decisions in many Central and Eastern European (CEE) countries. EQ-5D is by far the most commonly used instrument to generate utility values in CEE. This study aims to systematically review the literature on EQ-5D from eight CEE countries. Methods: An electronic database search was performed up to July 1, 2015 to identify original EQ-5D studies from the countries of interest. We analysed the use of EQ-5D with respect to clinical areas, methodological rigor, population norms and value sets. Results: We identified 143 studies providing 152 country-specific results with a total sample size of 81,619: Austria (n=11), Bulgaria (n=6), Czech Republic (n=18), Hungary (n=47), Poland (n=51), Romania (n=2), Slovakia (n=3) and Slovenia (n=14). Cardiovascular (20%), neurologic (16%), musculoskeletal (15%) and endocrine/nutritional/metabolic diseases (14%) were the most frequently studied clinical areas. Overall 112 (78%) of the studies reported EQ VAS results and 86 (60%) EQ-5D index scores, of which 27 (31%) did not specify the applied tariff. Hungary, Poland and Slovenia have population norms. Poland and Slovenia also have a national value set. Conclusions: Increasing use of EQ-5D is observed throughout CEE. The spread of health technology assessment activities in countries seems to be reflected in the number of EQ-5D studies. However, improvement in informed use and methodological quality of reporting is needed. In jurisdictions where no national value set is available, in order to ensure comparability we recommend to apply the most frequently used UK tariff. Regional collaboration between CEE countries should be strengthened

Bieten Visiten eine effektive Lehre und Ausbildung? Hindernisse für das Lernen, und was macht eine gute Lehre an einem großen Krankenhaus der Tertiärversorgung aus Sicht von Ärzt*innen in der Ausbildung aus

Background: Ward rounds (WR) have been integral to the process of teaching and learning medicine and also provides a vital opportunity to communicate with the patient, their relatives, and other healthcare professionals. Yet in recent years trainees' perception of the educational value of WRs seems to have declined. Objectives: The aim of this study to assess trainees' perception of the educational value of WRs at King Abdulaziz Medical City(KAMC), Riyadh, a 1500 bed academic hospital in Saudi Arabia.Methods: A self-administered, paper-based survey was distributed to physicians in training at KAMC between October and December 2019. All residents who attended WRs were invited to participate. The questionnaire was adapted from a survey used in a previous study. The demographic section requested details of the respondent's age, gender, specialty, and seniority. The second and third sections asked about the logistics of current ward round practices. It included several questions on the structure as well as the duration and frequency of ward rounds. The fourth and fifth sections asked for participant's perception of the opportunities for, and the obstacles to, learning on ward rounds. The subsequent sections asked several questions onward round structure and the clinical teacher. Responses were requested on a 5-point Likert-type scale (strongly disagree, disagree, neutral, agree, strongly agree). The last section asked the participant for general comments and feedbackResult: The study targeted 250 residents in specialties that routinely performed WRs. Only 166 residents returned the questionnaire (response rate of 66.4%). Male 89 (53.6%), medical 108 (65.1%), surgical 58 (34.9%), resident in first year 81 (48.8%). The overall average time spent on WR was 13 (± 11 SD) hours per week. The WR was perceived as a good opportunity to learn about diagnostic investigation 138 (83%) and patient management 133(80.1%), history taking114 (68.7%) physical examination 103 (62.0%), and time management skills 86 (51.8%). The majority of our trainees felt that the WR was educationally very useful to 86 (52%) and attribute to at least a third of the education they receive during their training. They also reported that about the quarter of the time spent on WRs is devoted to teaching. The good teacher described as enthusiastic to teach 137 (82.5%), provide feedback to trainees 135 (81%), do not rush 139(83.7), communicate to trainee 144 (86.7), and consultant level,101 (60.8). Trainees also identify a few factors that hinder their training such as lack of time 130 (79%), and the number of patients 129 (78.3). Conclusion: This study identifies the strengths and weaknesses of WR in our institution. Finding will help training supervisors in addressing and rectifying these shortcoming and factors hinder training.Hintergrund: Visiten sind ein integrativer Bestandteil des Lehrprozesses und des Lernens in der Medizin und bieten zudem eine sehr wichtige Möglichkeit, um mit Patient*innen, deren Verwandten und anderem Gesundheitspersonal zu kommunizieren. Und trotzdem scheint in den letzten Jahren der Ausbildungswert von Visiten in der Wahrnehmung der Ärzt*innen in der Ausbildung nachzulassen. Ziele: Ziel dieser Studie ist es, die Wahrnehmung der Ärzt*innen in der Ausbildung hinsichtlich des Ausbildungswertes von Visiten in König Abdulaziz Medical City (KAMC), Riad, einem akademischen Lehrkrankenhaus mit 1.500 Betten in Saudi-Arabien, zu untersuchen.Methoden: Unter den Ärzt*innen in der Ausbildung am KAMC wurde zwischen Oktober und Dezember 2019 eine selbsterstellte Umfrage in Papierform verteilt. Alle Assistenzärzt*innen, die an Visiten teilnahmen, wurden zur Beteiligung aufgerufen. Der Fragebogen wurde anhand einer Umfrage erstellt, die bei einer früheren Studie verwendet wurde. Der demografische Teil erfragte Angaben zu Alter, Geschlecht, Fachrichtung und Dienstalter der Befragten. Der zweite und dritte Teil fragte nach der Logistik der gegenwärtigen Visitenpraxis. Sie umfassten verschiedene Fragen zu Struktur sowie Dauer und Häufigkeit von Visiten. Der vierte und fünfte Teil befragte die Teilnehmer*innen nach ihrer Wahrnehmung der Möglichkeiten und Hindernisse von Visiten für das Lernen. Die nachfolgenden Abschnitte stellten verschiedene Fragen zu Visitenstruktur und klinischen Ausbildern. Antworten wurden in Form einer 5-Punkte Likert-Skala erbeten (stimme überhaupt nicht zu, stimme nicht zu, unentschieden, stimme zu, stimme völlig zu). Der letzte Teil bat die Teilnehmer*innen um allgemeine Anmerkungen, Hinweise und FeedbackErgebnis: Die Studie richtete sich an 250 Assistenzärzt*innen in Fachrichtungen, die routinemäßig Visiten durchführen. Nur 166 Assistenzärzt*innen reichten den Fragebogen wieder ein (Rücklaufquote von 66,4%), davon: männliche (89; 53,6%), innere (108; 65,1%), chirurgische (58; 34,9%), Assistenzärzt*innen im ersten Ausbildungsjahr (81; 48,8%). Die Gesamtdurchschnittszeit, die für Visiten aufgewendet wurde, lag bei 13 (± 11 SD) Stunden pro Woche. Die Visiten wurden als gute Möglichkeit angesehen, um etwas über diagnostische Untersuchung (138; 83%) und Patientenmanagement (133; 80,1%), Anamnese (114; 68,7%), körperliche Untersuchung (103; 62,0%) und Zeitmanagementfähigkeiten (86; 51,8%) zu lernen. Die Mehrzahl unserer Ärzt*innen in der Ausbildung hatten den Eindruck, dass die Visiten für ihre Ausbildung sehr nützlich sind (86; 52%) und zu mindestens einem Drittel der Ausbildung, die sie während ihres Studiums erhalten, beitragen. Sie berichteten auch, dass etwa ein Viertel der bei Visiten verbrachten Zeit auf die Lehre verwendet wird. Gute Ausbilder*innen wurden beschrieben als engagierte Lehrer*innen (137; 82,5%), jemand, der den Lernenden Feedback gibt (135; 81%), sie nicht antreibt (139; 83,7%), mit den Lernenden kommuniziert (144; 86,7%) und ihnen beratend zur Seite steht (101; 60,8%). Die Ärzt*innen in der Ausbildung identifizierten auch einige Faktoren, die ihre Ausbildung behindern, wie z. B. Zeitmangel (130; 79%) und die Anzahl der Patient*innen (129; 78,3%). Schlussfolgerung: Diese Studie identifiziert die Stärken und Schwächen von Visiten in unserer Einrichtung. Die Ergebnisse werden den Ausbildungsbetreuer*innen dabei helfen, diese Mängel und Faktoren, die die Ausbildung behindern, anzugehen und zu korrigieren