Validity and internal consistency of the thoracic outlet syndrome index for patients with thoracic outlet syndrome

Background: No validated scales exist specifically for measuring quality of life (QoL) and functioning level in patients with thoracic outlet syndrome (TOS). This cross-sectional survey examined whether some items adopted from validated QoL scales could be suitable for patients with TOS.Methods: To find an optimal thoracic outlet syndrome index (TOSI), a panel of 14 specialists experienced in treating TOS independently evaluated the relevance of 19 items adopted from scales used in other upper-extremity syndromes. After undergoing surgery for TOS, 52 patients rated the relevance of those items found by experts to be relevant. Content validity was measured by a content validity index, content validity ratio, and modified κ. The internal consistency of 15 retained items was assessed with the Cronbach α, and its construct validity was assessed by an exploratory factor analysis.Results: Of the 19 items, 15 were considered relevant for TOS by the panelists, with an overall test content validity index of 0.93. The internal consistency of these 15 items was excellent. The exploratory factor analysis accompanied by a parallel analysis confirmed the uni-dimensionality of the TOSI. All 15 items that the panelists considered relevant were also items that the patients marked with scores over 7 points on an 11-point scale of relevance.Conclusion: The internally consistent, face- and content-valid TOSI scale is proposed for use in evaluating specifically the QoL in TOS patients, as well as improving future longitudinal studies comparing functioning before and after interventions or spontaneous recovery in TOS patients.</p

Acute and overuse injuries among sports club members and non-members: the Finnish Health Promoting Sports Club (FHPSC) study

BackgroundPhysical activity in adolescence is promoted for its multi-dimensional health benefits. However, too intensive sports participation is associated with an increased injury risk. Our aim was to compare the occurrence of acute and overuse injuries in Finnish sports club members and non-members and to report training and competing habits associated with a higher injury risk in sports club members.MethodsIn this cross-sectional survey targeted at 14-16-year-old adolescents, a structured questionnaire was completed by 1077 sports club members and 812 non-members. The main outcome measures were self-reported acute and overuse injuries, their location and type.ResultsAt least one acute injury in the past year was reported by 44.0% of sports club members and 19.8% of non-members (P<0.001). The sex-adjusted odds ratio (OR) for acute injury in sports club members compared to non-members was 3.13 (95% confidence interval (95% CI) 2.54-3.87). Thirty-five percent of sports club members and 17.4% of non-members (P<0.001) reported at least one overuse injury during the past year. The overuse injury OR for sports club members was 2.61 (95% CI 2.09-3.26). Sports club members who trained 7-14h per week during training (OR 1.61, 95% CI 1.21-2.12, P=0.001) or competition season (OR 1.55, 95% CI 1.18-2.06, P=0.002) were more likely to report an injury compared to members who trained 3-6h per week. Those sports club members who participated in forty competitions or more compared to 7-19 competitions per year were more likely to report an acute injury (OR 1.55, 95% CI 1.05-2.08, P=0.028) or for an overuse injury (OR 1.53, 95% CI 1.02-2.30, P=0.038).ConclusionsBoth acute and overuse injuries are common among youth sports club members, and the number increases along with increasing amounts of training and competitions. More effective injury prevention is needed both for adolescents engaging in sports club activities and for other adolescents

Comprehensive evaluation of coding region point mutations in microsatellite-unstable colorectal cancer

Microsatellite instability (MSI) leads to accumulation of an excessive number of mutations in the genome, mostly small insertions and deletions. MSI colorectal cancers (CRCs), however, also contain more point mutations than microsatellite-stable (MSS) tumors, yet they have not been as comprehensively studied. To identify candidate driver genes affected by point mutations in MSI CRC, we ranked genes based on mutation significance while correcting for replication timing and gene expression utilizing an algorithm, MutSigCV. Somatic point mutation data from the exome kit-targeted area from 24 exome-sequenced sporadic MSI CRCs and respective normals, and 12 whole-genome-sequenced sporadic MSI CRCs and respective normals were utilized. The top 73 genes were validated in 93 additional MSI CRCs. The MutSigCV ranking identified several well-established MSI CRC driver genes and provided additional evidence for previously proposed CRC candidate genes as well as shortlisted genes that have to our knowledge not been linked to CRC before. Two genes, SMARCB1 and STK38L, were also functionally scrutinized, providing evidence of a tumorigenic role, for SMARCB1 mutations in particular. © 2018 The Authors. Published under the terms of the CC BY 4.0 licensePeer reviewe

Custom-made hinged total knee arthroplasties in the context of extra-articular deformity : a case series

Purpose Treatment of secondary knee osteoarthritis with a significant extra-articular deformity can be challenging. In such cases, an osteotomy or a custom-made hinged knee arthroplasy (CMH) are treatment options. However, there are limited data on the outcomes of using CMHs. Thus, the aim of this retrospective study was to assess the clinical results and subjective outcomes of CMHs. Methods We reviewed 9 CMHs (Endo-Model, LINK) in 7 patients with a minimum of 2-year follow-up. Upon the last follow-up, we evaluated MA, stability and range of movement (ROM). Oxford Knee Score (OKS) was used to evaluate patient-reported outcomes. Results The average age upon surgery was 61 years (48-76 years), and the follow-up period was 66 months. There were no early complications. Two CMHs were revised, one due to aseptic loosening and one due to late-onset haematogenic infection. Pre-operatively, MA varied from 18 degrees (average 11 degrees) valgus-deformity to 30 degrees (average 17 degrees) varus-deformity. Post-operatively, 7/9 (78%) of patients achieved better MA. Upon follow-up, the average OKS was 41/48, and ROM was 113 degrees. Conclusions Patients treated with CMHs achieved good clinical and patient-reported outcomes. There were no early reoperations, and revision rate was relatively low. Overall, CMH could be considered for low-demand patients with increased operative risks.Peer reviewe

Surface analysis of tissue paper using laser scanning confocal microscopy and micro-computed topography

Abstract Tissue paper softness relies on two major factors, the bulk softness, which can be indicated by the elasticity of the sheet, and surface softness. Measurement of surface softness is complicated and often requires a multi-step process. A key parameter defining surface softness is the topography of the surface, particularly the crepe structure and its periodicity. Herein, we present a novel approach to measure and quantify the tissue paper surface crepe structure and periodicity based on the detection of waviness along the sample using laser scanning confocal microscopy (LSM) and X-ray tomography (XRT). In addition, field emission scanning electron microscope (FESEM) was used to characterize the tissue paper surface. We demonstrate that surface topography is directly correlated to the erosion of the doctor blade, which is used to remove the dry tissue paper from the Yankee cylinder. Because of its accuracy and simplicity, the laser confocal microscopy method has the potential to be used directly on the production line to monitor the production process of the tissue paper. XRT revealed more structural details of the tissue paper structure in 3D, and it allowed for the reconstruction of the surface and the internal structure of the tissue paper