ABSTRACT Cachexia affects up to 60% of patients with lung cancer, with its prevalence rising up to 80% in advanced stages of disease. In approximately 20% of cases, it is the primary cause of mortality. Five studies, including a total of 4467 patients, across range of cancer types reported data on weight gain in cancer patients undergoing chemotherapy. Across all five studies, an average of 18.3% of patients experienced weight gain > 5% (816 out of 4467 patients). The frequency of weight gain > 5% was highest among breast cancer patients, 18.9% in Pedersini et al (n = 169) and 33.0% in Sella et al (n = 687). In NSCLC patients, weight gain was reported in 18.3% in patients in Patel et al (n = 2301) and 11.7% in Roeland et al (n = 1030). In contrast, colorectal cancer patients showed only 5.7% of weight gain > 5% (Zutphen et al, n = 280). Additionally, weight loss > 5% was reported in 15.1% of breast cancer patients and 28.3% of colorectal cancer patients. Despite weight loss being quantified as a common endpoint in clinical trials focused on cancer cachexia, there is limited data on the impact of weight gain as a marker of a positive outcome among cancer patients. Studies have shown that weight gain of more than 5% within 3 months in NSCLC patients can be associated with improvement in overall survival (OS) and progression‐free survival (PFS) scores. In this post hoc analysis by Roeland et al., the authors defined different percentage cut‐off values for maximum weight gain among patients with non–small cell lung cancer within 3 months of starting platinum‐based chemotherapy. Among all categories, namely, weight gain > 0%, > 2.5% and > 5%, a significant benefit in overall and progression‐free survival was seen and was comparable among all groups. These findings highlight the clinical significance of incorporating strategies that encourage weight gain and to prevent weight loss at the least among cancer patients. Along with further delving into the prognostic value of weight gain and developing methods to encourage this response among cancer patients, future studies should use standardized assessment tools to identify weight gain that could be attributed to underlying pathologic processes such as oedema and congestion. We also suggest that monitoring and reporting of weight changes should be done in all cancer trials.
Diseases of the musculoskeletal system, Human anatomy
Sara García-Bautista, Antonio Gómez-Bernal, Javier Alfaro-Santafé
et al.
<b>Background:</b> Cavus foot, defined by an increased medial longitudinal arch and often forefoot plantarflexion, alters biomechanics and increases peak plantar pressures, raising the risk of musculoskeletal disorders such as metatarsalgia, Achilles tendinopathy, and gait instability. Custom foot orthoses are the preferred conservative treatment, offering plantar support, pressure redistribution, and reduction in compensatory muscle activity. This study evaluated the medium- and long-term effectiveness of custom orthoses in 71 patients with cavus feet using surface electromyography (sEMG) and the same shoes. <b>Methods:</b> Muscle activity of the peroneus longus, peroneus brevis, and gastrocnemius was recorded during treadmill gait after one and four months of orthotic use. <b>Results:</b> Significant reductions in muscles were observed, especially after four months, confirming greater long-term effectiveness. No residual benefits were found when participants walked without orthoses. <b>Conclusions:</b> These findings support the clinical value of insoles in reducing the compensatory muscle activity in cavus feet and emphasize the importance of investigating their long-term role in biomechanics and potential pathology risk reduction.
Taehyeung Kim, Marta Martínez-Bonet, Qiang Wang
et al.
AbstractFine-mapping and functional studies implicate rs117701653, a non-coding single nucleotide polymorphism in the CD28/CTLA4/ICOS locus, as a risk variant for rheumatoid arthritis and type 1 diabetes. Here, using DNA pulldown, mass spectrometry, genome editing and eQTL analysis, we establish that the disease-associated risk allele is functional, reducing affinity for the inhibitory chromosomal regulator SMCHD1 to enhance expression of inducible T-cell costimulator (ICOS) in memory CD4+ T cells from healthy donors. Higher ICOS expression is paralleled by an increase in circulating T peripheral helper (Tph) cells and, in rheumatoid arthritis patients, of blood and joint fluid Tph cells as well as circulating plasmablasts. Correspondingly, ICOS ligation and carriage of the rs117701653 risk allele accelerate T cell differentiation into CXCR5-PD-1high Tph cells producing IL-21 and CXCL13. Thus, mechanistic dissection of a functional non-coding variant in human autoimmunity discloses a previously undefined pathway through which ICOS regulates Tph development and abundance.
P Blanco-Giménez, J. Vicente-Mampel, P Gargallo
et al.
Abstract The importance of incorporating lumbo-pelvic stability core and controlling motor exercises in patients with chronic low back pain (CLBP) reinforces the use of strategies to improve biopsychosocial beliefs by reducing biomedical postulations. However, clinical practice guidelines recommend multimodal approaches incorporating exercise and manual therapy (MT), and instead reject the application of kinesiotape (KT) in isolation. Therefore, the objectives of this study were to analyze the effects of 12 weeks of exercises combined with MT or KT on perceived low back pain using the visual analog scale (VAS) and muscle electric activity measured with electromyography (EMG) of the rectus abdominis and multifidus in CLBP (mild disability) and to explore the relationship between the rectus abdominis and multifidus ratios and pain perception after intervention. A blinded, 12-week randomized controlled trial (RCT) was carried out, involving three parallel groups of patients with CLBP. The study was registered at Clinicaltrial.gov and assigned the identification number NCT05544890 (19/09/22). The trial underwent an intention-to-treat analysis. The primary outcome revealed a multimodal treatment program supplemented by additional therapies such as MT and KT, resulting in significant reductions in perceived low back pain. The subjective assessment of individuals with CLBP indicated no discernible distinction between exclusive core stability exercises and control-motor training when combined with MT or KT. Notably, our findings demonstrated positive alterations in both the mean and peak EMG values of the right rectus abdominis in the exercise group, suggesting a beneficial impact on muscle activation. This study focused on assessing the activation levels of the trunk musculature, specifically the rectus abdominis (RA) and multifidus (MF), in individuals with CLBP exhibiting mild disability according to the Oswestry Disability Index. Importantly, improvements in the VAS values were observed independently of changes in muscle electrical activity.
Javier Rivera, Juan Molina-Collada, Julia Martínez-Barrio
et al.
Abstract Background Opioids are not recommended for fibromyalgia. Objective To investigate the frequency of opioid use in a large cohort of fibromyalgia patients and to identify factors associated with opioid consumption. Methods A retrospective, observational study of a large fibromyalgia cohort in a tertiary care center. We assessed fibromyalgia severity, functional capacity, anxiety, depression, drugs consumption and the patient’s impression of change. We compared strong opioid consumers (SOC) and non-SOC. Inferential statistical and logistic regression analysis were used to identify factors associated with opioid consumption, and ANOVA for repeated measurements. Results We found a prevalence of 9.2% of SOC (100 patients) among 1087 patients in the cohort. During the last four years there was a significant increase on the incidence of SOC up to 12.8% (p = 0.004). There were no differences in demographic variables between SOC and non-SOC. Clinical variables were significantly more severe in SOC, and they consumed more non-opioid drugs (p < 0.0001). Opioid consumption was independently associated with other non-opioid drugs (Odds ratio 1.25, CI: 1.13–1.38), but not with the fibromyalgia severity. At three months, 62% of the patients had opioid withdrawal. There were no statistical differences in the fibromyalgia severity at the initial evaluation, or the patient’s impression of change compared with those patients who continued opioids. Coping strategies were better in those patients who withdrew opioids (p = 0.044). Conclusions We observed an increase in opioid prescriptions during the last four years. Opioid consumption was associated with concomitant use of non-opioid drugs, but it was not associated with fibromyalgia severity.
Rare diseases affect millions worldwide but often face limited research focus due to their low prevalence. This results in prolonged diagnoses and a lack of approved therapies. Recent advancements in Large Language Models (LLMs) have shown promise in automating the extraction of medical information, offering potential to improve medical diagnosis and management. However, most LLMs lack professional medical knowledge, especially concerning rare diseases, and struggle to handle the latest rare disease information. They also cannot effectively manage rare disease data and are not directly suitable for diagnosis and management tasks. Our objective is to create an end-to-end system called AutoRD, which automates the extraction of information from medical texts about rare diseases, focusing on entities and their relations. AutoRD integrates up-to-date structured knowledge and demonstrates superior performance in rare disease extraction tasks. We conduct various experiments to evaluate AutoRD's performance, aiming to surpass common LLMs and traditional methods.
Bimarsha Khanal, Paras Poudel, Anish Chapagai
et al.
Plant diseases significantly impact our food supply, causing problems for farmers, economies reliant on agriculture, and global food security. Accurate and timely plant disease diagnosis is crucial for effective treatment and minimizing yield losses. Despite advancements in agricultural technology, a precise and early diagnosis remains a challenge, especially in underdeveloped regions where agriculture is crucial and agricultural experts are scarce. However, adopting Deep Learning applications can assist in accurately identifying diseases without needing plant pathologists. In this study, the effectiveness of various computer vision models for detecting paddy diseases is evaluated and proposed the best deep learning-based disease detection system. Both classification and detection using the Paddy Doctor dataset, which contains over 20,000 annotated images of paddy leaves for disease diagnosis are tested and evaluated. For detection, we utilized the YOLOv8 model-based model were used for paddy disease detection and CNN models and the Vision Transformer were used for disease classification. The average mAP50 of 69% for detection tasks was achieved and the Vision Transformer classification accuracy was 99.38%. It was found that detection models are effective at identifying multiple diseases simultaneously with less computing power, whereas classification models, though computationally expensive, exhibit better performance for classifying single diseases. Additionally, a mobile application was developed to enable farmers to identify paddy diseases instantly. Experiments with the app showed encouraging results in utilizing the trained models for both disease classification and treatment guidance.
Kento Kawaharazuka, Manabu Nishiura, Yuya Koga
et al.
For a robot with redundant sensors and actuators distributed throughout its body, it is difficult to construct a controller or a neural network using all of them due to computational cost and complexity. Therefore, it is effective to extract functionally related sensors and actuators, group them, and construct a controller or a network for each of these groups. In this study, the functional and spatial connections among sensors and actuators are embedded into a graph structure and a method for automatic grouping is developed. Taking a musculoskeletal humanoid with a large number of redundant muscles as an example, this method automatically divides all the muscles into regions such as the forearm, upper arm, scapula, neck, etc., which has been done by humans based on a geometric model. The functional relationship among the muscles and the spatial relationship of the neural connections are calculated without a geometric model.
Yuta Sahara, Akihiro Miki, Yoshimoto Ribayashi
et al.
The complex ways in which humans utilize their bodies in sports and martial arts are remarkable, and human motion analysis is one of the most effective tools for robot body design and control. On the other hand, motion analysis is not easy, and it is difficult to measure complex body motions in detail due to the influence of numerous muscles and soft tissues, mainly ligaments. In response, various musculoskeletal simulators have been developed and applied to motion analysis and robotics. However, none of them reproduce the ligaments but only the muscles, nor do they focus on the shoulder complex, including the clavicle and scapula, which is one of the most complex parts of the body. Therefore, in this study, a detailed simulation model of the shoulder complex including ligaments is constructed. The model will mimic not only the skeletal structure and muscle arrangement but also the ligament arrangement and maximum muscle strength. Through model predictive control based on the constructed simulation, we confirmed that the ligaments contribute to joint stabilization in the first movement and that the proper distribution of maximum muscle force contributes to the equalization of the load on each muscle, demonstrating the effectiveness of this simulation.
Aim The aim of this article is to present the method and results of the data quality control system and audit within the Netherlands Heart Registration (NHR) using data of patients treated with percutaneous coronary intervention (PCI) in the Netherlands as an example. Methods The NHR is a Dutch nationwide registry of all cardiac interventions, comprising data from all 71 hospitals, of which 30 are cardiac intervention or heart centres. Each year, within the NHR, data validation and verification is performed by standard quality controls and monitoring visits (audits). For the audit in 2019, a sample of 50–100 medical records of patients treated with PCI in 2016 and 2017 were reviewed in each hospital by an independent auditor. The data received by the NHR were compared with the information in the hospitals’ medical records. In total 12 patient characteristics, 5 intervention variables and 3 outcome variables were screened. The value of a variable was considered discrepant if more than 10% of the medical records reviewed regarding this variable were not consistent with the reported data received by the NHR. Results For all variables together, the consistency was high, 97.6%. All variables, except multivessel disease (9.3% discrepancy in the 2622 medical records reviewed), had an accuracy above 95%. Conclusion The results of the audit of the PCI medical records show that the overall quality of the data is high. For variables such as multivessel disease it is important to improve knowledge of the definitions and to train all those involved in the registration process.
Kristine Røren Nordén, Anne Grete Semb, Hanne Dagfinrud
et al.
Abstract Background Inflammatory joint diseases (IJD) are accompanied by an increased risk of cardiovascular disease (CVD). Cardiorespiratory fitness (CRF) is a modifiable CVD risk factor and low levels of CRF associate with an elevated CVD risk. This study aimed to investigate the associations between CVD risk factors, disease activity and CRF in patients with IJD and to explore differences between patients with normal versus low levels of CRF. Methods CRF was measured as peak oxygen uptake (VO2peak) with a cardiopulmonary exercise test. Participants were also evaluated for: Body composition, blood pressure, blood lipids, inflammatory markers and disease activity. Patient-reported use of cigarettes/snuff, medication, disease duration, pain, fatigue, CVD history, habitual physical activity and exercise beliefs and self-efficacy were collected by questionnaire. Cross-sectional associations between CVD risk factors, disease-related factors and CRF were analyzed by multiple linear regression. CRF was categorized to normal CRF (VO2peak ≥ 80%) or low CRF (VO2peak < 80%) according to age- and gender-stratified reference data. Differences in demographic, CVD and disease-related factors between patients with normal versus low CRF were explored. Results In 60 Norwegian patients with IJD [34 females, age 59 years (IQR: 52–63)], mean VO2peak was 30.2 (± 6.9) mL/kg/min, corresponding to 83% (± 18) of normative reference values. Age (coefficient: − 0.18 years, p = 0.01) and fat mass (coefficient: − 0.67 %, p < 0.001) were inversely associated with CRF, while physical activity index (coefficient: 0.13 points, p = 0.05) was positively associated with CRF (R2 = 0.66). There were no significant associations between CRF, classical CVD risk factors and disease-related variables. Compared to patients with low CRF (n = 30), patients with normal CRF (n = 30) had higher peak oxygen uptake (+ 9.4 mL/kg/min, p < 0.001), high-density lipoprotein cholesterol (+ 0.5 mmol L−1, p < 0.001), and exercise self-efficacy (+ 6.9, p < 0.01) as well as lower fat mass (− 8.7%, p < 0.001), resting heart rate (− 8.0 beats/min, p < 0.01) and triglycerides (− 0.5 mmol L−1, p < 0.01). Conclusions In this sample of IJD-patients, age, fatmass and physical activity level were associated with CRF. CRF was lower than reference values and patients with normal CRF presented with a more favorable health profile. There is a continued need for exercise interventions to improve CRF in patients with IJD. Trial registration: NCT04922840.
Orthobiologics are used with increasing frequency in equine musculoskeletal disease to improve the quality of the repair tissue and prevent reinjury. Autologous blood-based products, or hemoderivatives, are made by processing the patient's blood using different systems to produce a final therapeutic product. Autologous conditioned serum (ACS) and autologous protein solution (APS) are commonly used to treat joint disorders and can also be used treat tendon and ligament injuries. Hemoderivatives contain increased concentrations of anti-inflammatory and immunomodulatory cytokines, and growth factors that help direct tissue healing and repair. The specifics of ACS and APS for treatment of musculoskeletal injuries are discussed.
J. DeShazo, Ingrid Kouwijzer, Sonja de Groot
et al.
Illness cognitions (IC) influence how a patient adapts to a chronic disease. The aim was (1) to determine if training for a handcycling mountain time trial (HandbikeBattle) improves IC and (2) to identify factors associated with IC change scores. Persons with a chronic disability (N = 220; including N = 151 with spinal cord disorder) trained 5 months and participated in the time trial. The IC Questionnaire measured helplessness, acceptance, perceived benefits and was assessed before training (T1), after training (T2), and four months after the event (T3). Age, sex, body mass index (BMI), time since injury (TSI), disability characteristics, self-efficacy, mental health (MH) and musculoskeletal pain were obtained at T1. Multilevel regression analyses showed that helplessness decreased (from 11.96 to 11.28, p < 0.01) and perceived benefits increased (from 16.91 to 17.58, p < 0.01) from T1 to T2. For helplessness this decrease persisted during follow-up (11.16 at T3). Changes in helplessness were associated with self-efficacy (p = 0.02), MH (p = 0.02) and lesion completeness (p = 0.02), and were independent of disability type (p = 0.66), lesion level (p = 0.30) and demographics such as sex (p = 0.29) and age (p = 0.67). Training with peers may improve helplessness and perceived benefits in individuals with a chronic disability. Especially individuals with MH problems might benefit from training for an athletic challenge with peers to improve illness cognitions, and ultimately, quality of life.
This technical report describes ChinaTelecom system for Track 1 (closed) of the VoxCeleb2023 Speaker Recognition Challenge (VoxSRC 2023). Our system consists of several ResNet variants trained only on VoxCeleb2, which were fused for better performance later. Score calibration was also applied for each variant and the fused system. The final submission achieved minDCF of 0.1066 and EER of 1.980%.
Shirley N. Tang, Andres F. Bonilla, Nadeen O. Chahine
et al.
AbstractIntervertebral disc degeneration is a common cause of low back pain, the leading cause of disability worldwide. Appropriate preclinical models for intervertebral disc research are essential to achieving a better understanding of underlying pathophysiology and for the development, evaluation, and translation of more effective treatments. To this end, in vivo animal and ex vivo organ culture models are both widely used by spine researchers; however, the relative strengths and weaknesses of these two approaches are a source of ongoing controversy. In this article, members from the Spine and Preclinical Models Sections of the Orthopedic Research Society, including experts in both basic and translational spine research, present contrasting arguments in support of in vivo animal models versus ex vivo organ culture models for studies of the disc, supported by a comprehensive review of the relevant literature. The objective is to provide a deeper understanding of the respective advantages and limitations of these approaches, and advance the field toward a consensus with respect to appropriate model selection and implementation. We conclude that complementary use of several model types and leveraging the unique advantages of each is likely to result in the highest impact research in most instances.
Dominic S. Carreira, J. Robison, S. Robison
et al.
According to the World Health Organization, obesity is a global health epidemic, which has nearly tripled in prevalence since 1975. Worldwide in 2016, 13% of adults 18 years and older had obesity (body mass index ≥ 30 kg/m2) and 39% were overweight (body mass index 25.0 to 29.9 kg/m2). In the United States, approximately 35% of adults have obesity and 31% are overweight. Obesity increases stress throughout the musculoskeletal system and carries a higher risk for the development of osteoarthritis and various other musculoskeletal conditions. When patients with obesity undergo orthopaedic procedures, weight loss is a critical aspect to appropriate preoperative counseling and treatment. Weight loss can improve obesity-related comorbidities such as metabolic syndrome, diabetes, cardiovascular disease, and obstructive sleep apnea, which in turn may reduce complications, minimize long-term joint stress, and improve outcomes among patients undergoing orthopaedic procedures. The effects of obesity on patients undergoing total joint arthroplasty has been previously described, with reported associations of increased risk of infection, revision, blood loss, venous thromboembolism, and overall costs. The purpose of this article was to provide orthopaedic surgeons with strategies for obesity treatment.
Abstract Background The nucleotide-binding domain, leucine-rich repeat, and pyrin domain-containing protein 3 (NLRP3) inflammasome has been reported to be involved in the pathological process of osteoarthritis (OA) inflammation. Here, we investigated the ketogenic diet (KD), which has been previously demonstrated to inhibit NLRP3 inflammasome activation, to elucidate its protective mechanism against OA in rats. Methods Anterior cruciate ligament transaction (ACLT) together with partial medial meniscectomy was used to create a rat knee joint OA model. After treatment with KD or standard diet (SD) for 8 weeks, the knee specimens were obtained for testing. Results The KD significantly increased the content of β-hydroxybutyrate (βOHB) in rats. Compared to the SD group, the KD significantly reduced the damage caused by OA in the articular cartilage and subchondral bone. The NLRP3 inflammasome and inflammatory cytokines interleukin-1 β (IL-1β) and IL-18 were significantly increased in the SD group compared with the sham group, while their expression was significantly decreased in rats treated with the KD. In addition, MMP13 was significantly decreased in the KD group compared to that in the SD group, while COL2 was significantly increased. Conclusions KD can protect the articular cartilage and subchondral bone in a rat OA model by inhibiting NLRP3 inflammasome activation and reducing the OA inflammatory response.