Hasil untuk "Special situations and conditions"

L. Rapoport, Y. Bilik, Y. Feldman et al.

Soichiro Ogi, V. Stepanenko, K. Sugiyasu et al.

Piotr Górka, Julia Frączek, Karolina Borówka et al.

Background: Hamstring muscle injuries (HMI) remain the most prevalent non-contact injury in high-speed sports, particularly football and athletics. Despite sports medicine advancements, HMI is characterised by high recurrence rates (12–33%), causing significant time loss and performance decrements. Aim: This paper provides a comprehensive literature review regarding the functional anatomy, risk factors, diagnostic classification, and evidence-based treatment strategies for HMI. Material and methods: A narrative literature review was conducted using PubMed and MEDLINE. We focused on high-quality studies (systematic reviews, randomised controlled trials, clinical guidelines) published between 2010 and 2025, covering conservative and surgical management. Results: The biceps femoris long head's bi-articular architecture and dual innervation predispose it to eccentric strain during sprinting. Diagnosis has evolved with the British Athletics Muscle Injury Classification (BAMIC), which identifies intratendinous involvement as predicting prolonged recovery. Conservative management remains the gold standard for mid-substance injuries; L-protocol (lengthening) and eccentric strengthening show superior outcomes over concentric training. Surgery is indicated for complete proximal avulsions or high-grade partial tears with retraction (>2 cm); acute repair yields better outcomes than chronic reconstruction. Conclusions: Effective HMI management requires a multimodal approach. While conservative care resolves most injuries, precise MRI diagnosis is crucial to identify surgical candidates early. Return to play must be criteria-based, prioritising restored eccentric strength, fascicle length, and sprint mechanics over time-based protocols or imaging clearance.

J. Chatkin, L. Corrêa, U. Santos

Air pollution is a worrisome risk factor for global morbidity and mortality and plays a special role in many respiratory conditions. It contributes to around 8 million deaths/year, with outdoor exposure being responsible for more than 4.2 million deaths throughout the world, while more than 3.8 million die from situations related to indoor pollution. Pollutant agents induce several respiratory symptoms. In addition, there is a clear interference in numerous asthma outcomes, such as incidence, prevalence, hospital admission, visits to emergency departments, mortality, and asthma attacks, among others. The particulate matter group of pollutants includes coarse particles/PM 10 , fine particles/PM 2.5 , and ultrafine particles/PM 0.1 . The gaseous components include ground-level ozone, nitrogen dioxide, sulfur dioxide, and carbon monoxide. The timing, load, and route of allergen exposure are other items affecting allergic disease phenotypes. The complex interaction between pollutant exposures and human host factors has an implication in the development and rise of asthma as a public health problem. However, there are hiatuses in the understanding of the pathways in this disease. The routes through which pollutants induce asthma are multiple, and include the epigenetic changes that occur in the respiratory tract microbiome, oxidative stress, and immune dysregulation. In addition, the expansion of the modern Westernized lifestyle, which is characterized by intense urbanization and more time spent indoors, resulted in greater exposure to polluted air. Another point to consider is the different role of the environment according to age groups. Children growing up in economically disadvantaged neighborhoods suffer more important negative health impacts. This narrative review highlights the principal polluting agents, their sources of emission, epidemiological findings, and mechanistic evidence that links environmental exposures to asthma.

Peter S Andrus, Claire J Standley, J Russell Stothard et al.

Lake Victoria is a well-known hot spot for intestinal schistosomiasis, caused by infection with the trematode Schistosoma mansoni. The snail intermediate hosts of this parasite are Biomphalaria snails, with Biomphalaria choanomphala being the predominant intermediate host within Lake Victoria. The prevalence of S. mansoni infection within snail populations is influenced by both biotic and abiotic factors, including the physical and chemical characteristics of their environment, the incidence of infection in human populations (and reservoir hosts) and the level of genetic compatibility between the parasite and the host. Using molecular xenomonitoring, we measured the prevalence of S. mansoni infection within B. choanomphala populations along the Kenyan, Tanzanian and Ugandan shorelines of Lake Victoria and related this to the abiotic (habitat type, water depth, turbulence, temperature, conductivity, total dissolved solids, salinity, pH level) and biotic (B. choanomphala abundance, genetic diversity of host snail populations) factors of the lake. The overall mean prevalence of S. mansoni infection at Lake Victoria was 9.3%, with the highest prevalence of infection occurring on the Tanzanian shoreline (13.1%), followed by the Ugandan (8.2%) and Kenyan (4.7%) shorelines. There was a significant difference in B. choanomphala abundance, water temperature, conductivity, salinity, total dissolved solids and major anion/cation concentrations between the Kenyan, Tanzanian and Ugandan shorelines of Lake Victoria. A Spearman's rank analysis found that the prevalence of S. mansoni infection had a significant, positive relationship with higher levels of B. choanomphala abundance, water acidity, and cation (Ca2+, Mg2+) concentrations. Additionally, we observed that sites with S. mansoni infection correlated with B. choanomphala populations with a higher mean haplotype diversity score compared to sites found without infection, though there was no significant relationship between the prevalence of infection and B. choanomphala haplotype diversity scores. Although our analysis is based upon an archival and unique collection of Biomphalaria snails, the abiotic and biotic relationships uncovered are useful for eco-epidemiological comparisons of intestinal schistosomiasis across Lake Victoria in future.

Guoliang Wang, Y. Ren, Zhiqiang Li

This article addresses the almost surely exponential (ASE) stabilization problem of continuous-time semi-Markov jump systems (s-MJSs) by a stochastic scheduling controller. A scheduling control method based on an earliest deadline first (EDF) algorithm is proposed, where the blank time (no controller added) could exist but be smaller. Sufficient conditions for the existence of such a scheduling controller are given with solvable forms. Two special situations on Markovian and renewal process switchings are further investigated. The utility and superiority of the given methods are shown by applying a practical example.

Isobel Jacob, Gareth Jones, Peter Francis et al.

Background: The purpose of this review was to synthesise and determine the age-related change per annum in muscle thickness of the anterior thigh across the adult lifespan. Methods: Electronic databases (PubMed, SPORTDiscus and MEDLINE) were searched for primary studies that were screened for eligibility. Results: Following screening against eligibility criteria, 27 studies were included in the quantitative analysis. Linear regression revealed a 0.02 cm (95 % CI: −0.01, −0.03, p < 0.05) decline in mean muscle thickness per annum from 18 to 80 years of age, a 0.03 cm (95 % CI: −0.01 to −0.05) decline per annum between 20 and 49 years of age and a 0.05 cm (95 % CI: −0.03, −0.07) decline per annum between 50 and 80 years of age. There was a 1.5 cm (t (25) = 6.12, p < 0.05; 95 % CI= 0.98- 1.97 cm) mean difference in muscle thickness between the youngest (18–29yrs: 5.13 cm ± 0.38) and oldest adults (70–80yrs) 3.63 cm ± 0.63). There was no difference in the rate of decline of mean muscle thickness between males (−0.05 cm/annum, 95 % CI= −0.08, −0.02) and females (−0.04 cm/annum, 95 % CI= −0.07, −0.02). There was a larger difference in anterior thigh muscle thickness between the youngest and oldest in females (4.98 cm vs. 3.34 cm, 33 %, p < 0.05) compared with males (5.23 cm vs. 3.98 cm, 24 %, p < 0.05). Conclusion: Mean anterior thigh thickness was estimated to decrease at a rate of 0.02 cm per annum and this rate of decrease was greater after 50 years of age. Females were more susceptible to age-related reductions in anterior thigh muscle thickness than males.

Haoran Zhang, Yuwei Wang, Yaping Zhang et al.

Abstract Background Housing has been associated with dementia risk and disability, but associations of housing with differential patterns of neuropsychiatric symptoms (NPS) among dementia-free older adults remain to be explored. The present study sought to explore the contribution of housing status on NPS and subsyndromes associated with cognitive dysfunction in community-dwelling dementia-free elderly in Singapore. Methods A total of 839 dementia-free elderly from the Epidemiology of Dementia in Singapore (EDIS) study aged ≥ 60 were enrolled in the current study. All participants underwent clinical, cognitive, and neuropsychiatric inventory (NPI) assessments. The housing status was divided into three categories according to housing type. Cognitive function was measured by a comprehensive neuropsychological battery. The NPS were assessed using 12-term NPI and were grouped into four clinical subsyndromes: psychosis, hyperactivity, affective, and apathy. Associations of housing with composite and domain-specific Z-scores, as well as NPI scores, were assessed using generalized linear models (GLM). Binary logistic regression models analysed the association of housing with the presence of NPS and significant NPS (NPI total scores ≥ 4). Results Better housing status (5-room executive apartments, condominium, or private housing) was associated with better NPS (OR = 0.49, 95%CI = 0.24 to 0.98, P < 0.05) and significant NPS profile (OR = 0.20, 95%CI = 0.08 to 0.46, P < 0.01), after controlling for demographics, risk factors, and cognitive performance. Compared with those living in 1–2 room apartments, older adults in better housing had lower total NPI scores (β=-0.50, 95%CI=-0.95 to -0.04, P = 0.032) and lower psychosis scores (β=-0.36, 95%CI=-0.66 to -0.05, P = 0.025), after controlling for socioeconomic status (SES) indexes. Subgroup analysis indicated a significant correlation between housing type and NPS in females, those of Malay ethnicity, the more educated, those with lower income, and those diagnosed with cognitive impairment, no dementia (CIND). Conclusions Our study showed a protective effect of better housing arrangements on NPS, especially psychosis in a multi-ethnic Asian geriatric population without dementia. The protective effect of housing on NPS was independent of SES and might have other pathogenic mechanisms. Improving housing could be an effective way to prevent neuropsychiatric disturbance among the elderly.

Bin Jiang, Qi Liu, Jian-Peng Li et al.

Abstract Background With the aging population, the number of individuals with dementia in China is increasing rapidly. This community-based study aimed to investigate the prevalence and risk factors for dementia and mild cognitive impairment (MCI) among older adults in China. Methods In this study, 20,070 individuals aged ≥ 65 were recruited between January 1, 2022, and February 1, 2023, from ten communities in Xiamen City, China. We collected data on age, sex, level of education, and medical history, as well as global cognition and functional status. The prevalence of dementia and MCI was examined, and the risk factors for different groups were assessed. Results The overall prevalence of dementia and MCI was approximately 5.4% (95% confidence interval [CI], 5.1–5.7) and 7.7% (95% CI, 7.4–8.1), respectively. The results also indicated that dementia and MCI share similar risk factors, including older age, female sex, hypertension, and diabetes mellitus. Compared with individuals with no formal education, those with > 6 years of education had an odds ratio for MCI of 1.83 (95% CI, 1.49–2.25). We also found that only 5.5% of the positive participants chose to be referred to the hospital for further diagnosis and treatment during follow-up visits. Conclusions This study estimated the prevalence and risk factors for dementia and MCI among individuals aged ≥ 65 years in Southeast China. These findings are crucial for preventing and managing dementia and MCI in China.

Guoliang Wang, Siyong Song, Chao Huang

Isabelle Bourdel-Marchasson, S. Maggi, A. Abdelhafiz et al.

We present an executive summary of a guideline for management of type 2 diabetes mellitus in primary care written by the European Geriatric Medicine Society, the European Diabetes Working Party for Older People with contributions from primary care practitioners and participation of a patient’s advocate. This consensus document relies where possible on evidence-based recommendations and expert opinions in the fields where evidences are lacking. The full text includes 4 parts: a general strategy based on comprehensive assessment to enhance quality and individualised care plan, treatments decision guidance, management of complications, and care in case of special conditions. Screening for frailty and cognitive impairment is recommended as well as a comprehensive assessment all health conditions are concerned, including end of life situations. The full text is available online at the following address: essential_steps_inprimary_care_in_older_people_with_diabetes_-_EuGMS-EDWPOP___3_.pdf.

M. Woźniak, M. Wieczorek, Jakub Siłka et al.

Mixed reality environments give better chances to provide constant help to the people in need. Applied there artificial intelligence models will provide ad hoc monitoring measures, which may be the best chance to protect life in dangerous conditions. In this article, we present our research on mixed reality system developed to detect symptoms of unusual poses at work, home, or other environments. Recurrent neural network is using sensor readings to evaluate the situation by the minimum necessary number of body sensors working as safe indicators. Research results show that the developed system is working with very high accuracy of 99.89% using just two body sensors working in a separate mode. The system can work without any special infrastructure or development in various environments to help workers and elder people in dangerous situations.

Pattanasin Areeudomwong, Thidarat Duangyod, Chatchada Sutalangka et al.

Background Reducing the risk of falling by improving balance and leg strength may be a preventive strategy. This study evaluated the integrated effects of Thai essential oil and balance exercises on parameters associated with Falls in community-dwelling older adults at risk of falling. Methods Fifty-six participants were randomly allocated to either the intervention group (IG), which performed balance exercises while smelling Thai essential oil scents of Zanthoxylum limonella (Dennst.) Alston, or the control group (CG), which performed balance exercises while receiving a control patch. Balance exercises were practiced for 12, 30-minute sessions over 4 weeks. Static and dynamic balance with eyes open and eyes closed (EC), leg muscle strength, agility, and fear of falling were assessed at baseline, after the 4-week intervention, and at 1 month after the last intervention session. Results Both groups showed significant improvements in static and dynamic balance, ankle plantarflexor strength, and agility after the 4-week intervention (p<0.05), which persisted at the 1-month follow-up (p<0.05). Compared to the CG, the IG demonstrated significantly better static balance in terms of elliptical sway area (p=0.04) and center of pressure (CoP) velocity (p=0.001) during EC, as well as ankle plantarflexor strength (p=0.01). The IG also maintained a significantly greater improvement in CoP velocity during EC (p=0.01). Conclusion Integrated Thai essential oil and balance exercises improved static balance and ankle plantarflexor strength compared to the balance exercise with a control patch in older adults at risk of falling.

Julia R. Varshavsky, Swati D. G. Rayasam, Jennifer B. Sass et al.

Abstract A key element of risk assessment is accounting for the full range of variability in response to environmental exposures. Default dose-response methods typically assume a 10-fold difference in response to chemical exposures between average (healthy) and susceptible humans, despite evidence of wider variability. Experts and authoritative bodies support using advanced techniques to better account for human variability due to factors such as in utero or early life exposure and exposure to multiple environmental, social, and economic stressors. This review describes: 1) sources of human variability and susceptibility in dose-response assessment, 2) existing US frameworks for addressing response variability in risk assessment; 3) key scientific inadequacies necessitating updated methods; 4) improved approaches and opportunities for better use of science; and 5) specific and quantitative recommendations to address evidence and policy needs. Current default adjustment factors do not sufficiently capture human variability in dose-response and thus are inadequate to protect the entire population. Susceptible groups are not appropriately protected under current regulatory guidelines. Emerging tools and data sources that better account for human variability and susceptibility include probabilistic methods, genetically diverse in vivo and in vitro models, and the use of human data to capture underlying risk and/or assess combined effects from chemical and non-chemical stressors. We recommend using updated methods and data to improve consideration of human variability and susceptibility in risk assessment, including the use of increased default human variability factors and separate adjustment factors for capturing age/life stage of development and exposure to multiple chemical and non-chemical stressors. Updated methods would result in greater transparency and protection for susceptible groups, including children, infants, people who are pregnant or nursing, people with disabilities, and those burdened by additional environmental exposures and/or social factors such as poverty and racism.

Chawin Sarinukul, Taweesak Janyacharoen, Wanida Donpunha et al.

Background Hypertension is a common disease, particularly in older adults. In a previous study, we found that an eight-week course of stepping exercise improved physical performance in healthy older adults as measured using the six-minute walk test (468 vs. 426 m in controls; p = .01). This study aims to further evaluate the effects of stepping exercise on blood pressure, physical performance, and quality of life in older adults with stage 1 hypertension. Methods This was a randomized, controlled trial comparing older adults with stage 1 hypertension who performed stepping exercise with controls. The stepping exercise (SE) was performed at moderate intensity three times/week over an eight-week period. Participants in the control group (CG) received verbal and written (pamphlet) lifestyle modification advice. Blood pressure at Week 8 was the primary outcome, while quality of life score and physical performance on the 6-minute walk test (6MWT), timed up and go test (TUGT), and five times sit to stand test (FTSST) were secondary outcomes. Results There were 17 female patients in each group (total of 34). After eight weeks of training, participants in the SE group showed significant improvements in systolic blood pressure (SBP; 132.0 vs. 145.1 mmHg; p<.01), diastolic blood pressure (DBP; 67.3 vs. 87.6 mmHg; p<.01), 6MWT (465.6 vs. 437.0; p<.01), TUGT (8.1 vs. 9.2 sec; p<.01), and FTSST (7.9 vs. 9.1 sec; p<.01) compared to controls. Regarding within-group comparison, participants in the SE also showed significant improvement in all outcomes from baseline, while any such outcomes in the CG were comparable from baseline (SBP: 144.1 to 145.1 mmHg; p = .23; DBP: 84.3 to 87.6 mmHg; p = .90). Conclusions The stepping exercise examined is an effective non-pharmacological intervention for blood pressure control in female older adults with stage 1 hypertension. This exercise also resulted in improvements in physical performance and quality of life.

Katarzyna Wódka, Alicja Michalczyk, Agnieszka Jankowicz-Szymańska

Aim of the study: The aim of the study was to assess the relationship between the position of the sacrum, lumbar and thoracic spine and the mobility of the trunk in the sagittal plane in young women and men. Material and methods: 64 students (33 women and 31 men) were studied. The mean age in the study group was 22.94 ± 1.51 years. The following tests were performed on each subject once: measurement of height and weight, assessment of spinal alignment and mobility in the sagittal plane using Zebris Pointer. Results: The results obtained were analyzed using appropriate statistical tools. Statistically significant correlations were obtained: in the alignment of the sacrum in relation to the lumbar spine (strong correlation), in the alignment of the lumbar spine in relation to the thoracic spine and, in the male group only, between the alignment of the thoracic spine and mobility in the direction of flexion in the thoracic segment (moderate correlation). Conclusions: In women, horizontal sacral alignment coexisting with deepened lordosis was most frequently observed. In addition, women were more likely to have a deepened thoracic kyphosis, less range of motion in the direction of thoracic flexion and extension, and greater mobility in the direction of lumbar flexion and extension than men. In men, the vertical alignment of the sacrum was accompanied by a shallowing of the physiological lordosis. In addition, in this group, a decrease in lordosis influenced an increase in movement to flexion in the thoracic spine. When planning a physiotherapy exercise program for a person in whom abnormalities in the alignment of the lumbopelvic complex have been noted, an individual exercise program should be selected. The study should take into account not only the evaluation of the alignment of the lumbosacral spine, but also the mobility of the segments above and below the examined area taking into account intergender differences.

Kevin Tran-Nguyen, Caroline Berger, Roxanne Bennett et al.

BackgroundPostfracture acute pain is often inadequately managed in older adults. Mobile health (mHealth) technologies can offer opportunities for self-management of pain; however, insufficient apps exist for acute pain management after a fracture, and none are designed for an older adult population. ObjectiveThis study aims to design, develop, and evaluate an mHealth app prototype using a human-centered design approach to support older adults in the self-management of postfracture acute pain. MethodsThis study used a multidisciplinary and user-centered design approach. Overall, 7 stakeholders (ie, 1 clinician-researcher specialized in internal medicine, 2 user experience designers, 1 computer science researcher, 1 clinical research assistant researcher, and 2 pharmacists) from the project team, together with 355 external stakeholders, were involved throughout our user-centered development process that included surveys, requirement elicitation, participatory design workshops, mobile app design and development, mobile app content development, and usability testing. We completed this study in 3 phases. We analyzed data from prior surveys administered to 305 members of the Canadian Osteoporosis Patient Network and 34 health care professionals to identify requirements for designing a low-fidelity prototype. Next, we facilitated 4 participatory design workshops with 6 participants for feedback on content, presentation, and interaction with our proposed low-fidelity prototype. After analyzing the collected data using thematic analysis, we designed a medium-fidelity prototype. Finally, to evaluate our medium-fidelity prototype, we conducted usability tests with 10 participants. The results informed the design of our high-fidelity prototype. Throughout all the phases of this development study, we incorporated inputs from health professionals to ensure the accuracy and validity of the medical content in our prototypes. ResultsWe identified 3 categories of functionalities necessary to include in the design of our initial low-fidelity prototype: the need for support resources, diary entries, and access to educational materials. We then conducted a thematic analysis of the data collected in the design workshops, which revealed 4 themes: feedback on the user interface design and usability, requests for additional functionalities, feedback on medical guides and educational materials, and suggestions for additional medical content. On the basis of these results, we designed a medium-fidelity prototype. All the participants in the usability evaluation tests found the medium-fidelity prototype useful and easy to use. On the basis of the feedback and difficulties experienced by participants, we adjusted our design in preparation for the high-fidelity prototype. ConclusionsWe designed, developed, and evaluated an mHealth app to support older adults in the self-management of pain after a fracture. The participants found our proposed prototype useful for managing acute pain and easy to interact with and navigate. Assessment of the clinical outcomes and long-term effects of our proposed mHealth app will be evaluated in the future.

S. Mischler

Inger Hilde Zahl, O. Samuelsen, A. Kiessling

Qisti Aufa Afifah

Purpose of this study was to know the impact of COVID-19 on family harmony. The research method used is a case study of 4 people who have families with different backgrounds, roles, and conditions (with and without people with special needs). Results showed that impact of COVID-19 to the family harmony caused decreases in domestic income, increases in frequency of family fights, financial management difficulties, and the double burden of the family, especially parents. These results come because there are actions that emerged after COVID-19 appeared, namely home quarantine and implementation of health protocols. This then necessitated adaptation in various sectors where working from home, school from home, and layoffs of employees. This research has an impact on analyzing family harmony during the COVID-19 pandemic for the development of sustainable family harmony to prepare families for unexpected future situations.