Hasil untuk "Diseases of the musculoskeletal system"

Whasil Lee, Robert J. Nims, Alireza Savadipour et al.

Significance Osteoarthritis is a global health problem that affects load-bearing joints, causing loss of mobility and enormous healthcare costs. However, disease-modifying approaches are lacking. Here, we report a cellular mechanism of inflammatory signaling in chondrocytes, the cellular component of cartilage. We show how osteoarthritis-relevant levels of interleukin-1α reprogram articular chondrocytes so that they become more susceptible to mechanical trauma, which chondrocytes sense via Piezo1/2-mechanosensitive ion channels. We uncover that IL-1α enhances gene expression of P iezo 1 in primary articular chondrocytes underlying Piezo1 enhanced function. We elucidate signaling from membrane to nucleus, including transcription factors that enhance Piezo1 expression. We also define consequences of increased expression of Piezo1, for mechanotransduction and at rest, that implicate this reprogramming mechanism in osteoarthritis pathogenesis.

Pavlos Texakalidis, Stavros Matsoukas, Constantine L. Karras et al.

Lumbar spondylolisthesis can cause a significant disability due to back and lower extremity pain. Degenerative spondylolisthesis (DS) and isthmic spondylolisthesis (IS) are the two most common types. DS results from arthritic changes and degenerative disc disease, whereas IS occurs secondary to a pars interarticularis defect. This study compared surgical outcomes between IS and DS. A systematic literature review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Twenty studies comprising 3136 patients were included (DS: 1944; IS: 1192). No differences were identified in terms of estimated blood loss (mean difference [MD]: 5.79, 95% confidence interval [CI]: 42.88, 54.46; I2 = 81.7%), length of stay (MD: 0.24, 95% CI: 1.38–0.90; I2 = 87.7%), duration of operation (MD: 2.73, 95% CI: 20.61–15.16; I2 = 84.7%), reduction of Visual Analog Scale (VAS) for back pain before and after surgery (MD: 0.01, 95% CI: 0.68–0.65; I2 = 87.5%), reduction in Oswestry Disability Index before and after surgery (MD: 1.37, 95% CI: 2.39–5.12; I2 = 75.5%), return to operating room for any reason (odds ratio [OR]: 1.01, 95% CI: 0.48–2.15; I2 = 0%), successful fusion at the last follow-up (OR: 0.68, 95% CI: 0.26–1.77; I2 = 60.5%), adjacent segment disease during follow-up (OR: 0.45, 95% CI: 0.18–1.13; I2 = 0%), and subjective unsatisfactory outcome (OR: 1.53; 95% CI: 0.99–2.35; I2 = 0%). IS was associated with significantly higher odds for reporting subjective unsatisfactory outcome compared to DS (OR: 1.56; 95% CI: 1.00–2.43, I2: 0%) in the subgroup analysis of posterior lumbar interbody fusion/transforaminal lumbar interbody fusion. DS showed greater VAS back pain reduction than IS with posterolateral fusion alone (MD: -1.06, 95% CI: -1.90–0.22, I2:0%). Surgical outcomes are largely comparable between IS and DS, though etiology-specific differences in patient-reported outcomes may depend on fusion technique.

Shaheer Ahmad Khan, Muhammad Usamah Shahid, Muddassar Farooq

Chronic diseases are long-lasting conditions that require lifelong medical attention. Using big EMR data, we have developed early disease risk prediction models for five common chronic diseases: diabetes, hypertension, CKD, COPD, and chronic ischemic heart disease. In this study, we present a novel approach for disease risk models by integrating survival analysis with classification techniques. Traditional models for predicting the risk of chronic diseases predominantly focus on either survival analysis or classification independently. In this paper, we show survival analysis methods can be re-engineered to enable them to do classification efficiently and effectively, thereby making them a comprehensive tool for developing disease risk surveillance models. The results of our experiments on real-world big EMR data show that the performance of survival models in terms of accuracy, F1 score, and AUROC is comparable to or better than that of prior state-of-the-art models like LightGBM and XGBoost. Lastly, the proposed survival models use a novel methodology to generate explanations, which have been clinically validated by a panel of three expert physicians.

Kate Tokareva, Alexander C. Peterson, Aaron Baraff et al.

Abstract Background Biologic (b) and targeted synthetic (ts) disease-modifying anti-rheumatic drugs (DMARDs) used in the management of rheumatoid arthritis (RA) target inflammatory pathways implicated in the pathogenesis of multiple myeloma (MM). It is unknown whether use of b/tsDMARDs affects the incidence of MM. Methods In this cohort study using Veterans Health Administration (VHA) data, we identified Veterans newly diagnosed with RA from 1/1/2002 to 12/31/2018 using diagnostic codes and medication fills. DMARD exposure was categorized as follows: conventional synthetic (cs)DMARDs; bDMARDs, which included tumor necrosis factor inhibitors (TNFi), non-TNFi; and a tsDMARD, tofacitinib. A Cox proportional hazards model with time-varying exposure was used to estimate the hazard ratio for developing MM among those who received b/tsDMARD medications relative to b/tsDMARD-naïve persons. Results 27,540 veterans with RA met eligibility criteria of whom 8322 (30%) took a b/tsDMARD during follow-up. There were 77 incident cases of MM over 192,000 person-years of follow-up. The age-adjusted incidence rate (IR) of MM among b/tsDMARD-naïve patients was 0.37 (95% CI 0.28–0.49) per 1000 person-years and 0.42 among current or former b/tsDMARD users (95% CI 0.25–0.65). Adjusting for age and other demographic characteristics, the hazard ratio for MM associated with use of b/tsDMARDs was 1.32 (95% CI 0.78, 2.26). Conclusion In this study of Veterans with RA, the rate of MM did not differ between b/tsDMARD and csDMARD users. The relatively short duration of follow-up and few events limited our power to detect treatment-related differences in MM risk.

Paola F. Antonietti, Mattia Corti, Sergio Gómez et al.

This work presents a structure-preserving, high-order, unconditionally stable numerical method for approximating the solution to the Fisher-Kolmogorov equation on polytopic meshes, with a particular focus on its application in simulating misfolded protein spreading in neurodegenerative diseases. The model problem is reformulated using an entropy variable to guarantee solution positivity, boundedness, and satisfaction of a discrete entropy-stability inequality at the numerical level. The scheme combines a local discontinuous Galerkin method on polytopal meshes for the space discretization with a $ν$-step backward differentiation formula for the time integration. Implementation details are discussed, including a detailed derivation of the linear systems arising from Newton's iteration. The accuracy and robustness of the proposed method are demonstrated through extensive numerical tests. Finally, the method's practical performance is demonstrated through simulations of $α$-synuclein propagation in a two-dimensional brain geometry segmented from MRI data, providing a relevant computational framework for modeling synucleopathies (such as Parkinson's disease) and, more generally, neurodegenerative diseases.

Kaitlin R McCarter, Taylor Wolfgang, Senada Arabelovic et al.

Antonina D.S. Pavilanis, Vanessa Vita, Heather Adams et al.

Aim: Numerous investigations have revealed sex differences in recovery outcomes in individuals who have sustained work-related musculoskeletal injuries (WRMIs). Previous research has also revealed significant sex differences in the prevalence and severity of post-traumatic stress symptoms (PTSS) following musculoskeletal injury. This study investigated whether PTSS mediated sex differences in recovery outcomes in individuals receiving treatment for a work-related musculoskeletal injury. The recovery outcomes of interest in the present study were pain severity and pain-related disability. Methods: The study sample included 137 individuals (68 men; 69 women) with WRMIs who were enrolled in a 7-week physical rehabilitation program. Participants completed measures of pain severity, pain disability and PTSS at admission and termination of the physical rehabilitation program. Results: Consistent with previous research, independent samples t-tests revealed that women obtained significantly higher baseline scores on measures of pain severity (P < 0.01), number of pain sites (P < 0.001), depression (P < 0.001) and PTSS (P < 0.001) compared to men. Also consistent with previous research, the measure of PTSS, assessed at baseline, was prospectively associated with treatment-related disability reduction (P < 0.01), and return to work (P < 0.01). Bootstrap regression analyses revealed that PTSS partially mediated the relation between sex and pain-related disability. Conclusions: The results of the present study suggest that the experience of PTSS might be one of the factors that explain sex differences in recovery outcomes following a WRMI. The results call for greater attention to the assessment and intervention of PTSS in individuals who have sustained WRMIs.

Jingyi Rao, Shuping Qian, Xuan Li et al.

Laura Churchill, Michael John Bade, Ryan C. Koonce et al.

Total knee arthroplasty (TKA) improves patient-reported function by alleviating joint pain, however the surgical trauma exacerbates already impaired muscle function, which leads to further muscle weakness and disability after surgery. This early postoperative strength loss indicates a massive neural inhibition and is primarily driven by a deficit in quadriceps muscle activation, a process known as arthrogenic muscle inhibition (AMI). To enhance acute recovery of quadriceps muscle function and long-term rehabilitation of individuals after TKA, AMI must be significantly reduced in the early post-operative period. The aim of this narrative review is to review and discuss previous efforts to mitigate AMI after TKA and to suggest new approaches and interventions for future efficacy evaluation. Several strategies have been explored to reduce the degree of post-operative quadriceps AMI and improve strength recovery after TKA by targeting post-operative swelling and inflammation or changing neural discharge. A challenge of this work is the ability to directly measure AMI and relevant contributing factors. For this review we focused on interventions that aimed to reduce post-operative swelling or improve knee extension strength or quadriceps muscle activation measured by twitch interpolation. For individuals undergoing TKA, the use of anti-inflammatory medications, tranexamic acid, cryotherapy, intra-articular drains, torniquets, and minimally invasive surgical techniques for TKA have limited benefit in attenuating quadriceps AMI early after surgery. However, interventions such as inelastic compression garments, voluntary muscle contractions, and neuro-muscular electrical stimulation show promise in mitigating or circumventing AMI and should continue to be refined and explored.

Chen Liu, Yin Geng, Yifeng Li

Ümit Aygün, Eyüp Şenocak, Mehmet Fatih Aksay et al.

Abstract Background This study aimed to assess important criteria, including osteoporosis, fracture type, implant position within the bone, fracture reduction, and radiographic union, in patients with intertrochanteric femoral fractures treated with proximal femoral nail (PFN) fixation and to show their effect on clinical outcomes. Methods PFN fixation was applied in 73 patients (41 females, 32 males; mean age: 64.5 ± 6.2). The T score, fracture type according to the AO Foundation and Orthopedic Trauma Association (AO/OTA), implant-related complications (IRCs), Harris hip score (HHS), Jensen social function (JSF) score, and Parker-Palmer mobility score (PPMS), postoperative reduction classification, screw position according to the Cleveland zone, Radiographic Union Scale for the Hip (RUSH) score, and tip-apex distance (TAD) were recorded. Results Most screws were in central-central (n = 42) and inferior-central (n = 11) positions. IRCs were seen mostly in cases of screws placed in peripheral zones (n = 10) and were not observed in almost any patient with a TAD ≤ 25 mm (n = 52) (p < 0.001). Most of the patients with acceptable or good fracture reduction did not have IRCs (n = 11 and 50, respectively) (p < 0.001). Half of type 3A1 (n = 13) and most type 3A2 (n = 20) fractures showed radiographic union at 3 months, and most type 3A3 (n = 9) fractures showed radiographic union at 5 months (p < 0.05). At 12 months, type 3A2 fractures had the highest HHS (79.2 ± 5.3) and PPMS (3.9 ± 1.5), while type 3A3 fractures had the lowest HHS (70.3 ± 4.6) and PPMS (0.6 ± 2.8) (p < 0.05). At 12 and 24 months, type 3A3 fractures had higher JSF scores (2.8 ± 0.4 and 3.5 ± 0.5, respectively); at 3 months, type 3A1 fractures had higher JSF scores (3.1 ± 0.3) (p < 0.05). The radiographic bone union time was prolonged in patients with a T score ≤ -2.5 standard deviation (SD) (p < 0.05). The HHS and PPMS increased while the RUSH score, considered as the radiographic union, was going towards the 4th month and decreased after the 4th month (p < 0.05). Conclusions Considering the criteria (osteoporosis, fracture type, implant position within the bone, fracture reduction, and radiographic union) examined in this study, satisfactory results can be obtained with PFN fixation in the treatment of patients with intertrochanteric femoral fractures.

Xue Liu, Yue Deng, Jingying Huang et al.

The global public health landscape is perpetually challenged by the looming threat of infectious diseases. Central to addressing this concern is the imperative to prevent and manage disease transmission during pandemics, particularly in unique settings. This study addresses the transmission dynamics of infectious diseases within conference venues, presenting a computational model designed to simulate transmission processes within a condensed timeframe (one day), beginning with sporadic cases. Our model intricately captures the activities of individual attendees within the conference venue, encompassing meetings, rest intervals, and meal breaks. While meetings entail proximity seating, rest and lunch periods allow attendees to interact with diverse individuals. Moreover, the restroom environment poses an additional avenue for potential infection transmission. Employing an individual-based model, we meticulously replicated the transmission dynamics of infectious diseases, with a specific emphasis on close-contact interactions between infected and susceptible individuals. Through comprehensive analysis of model simulations, we elucidated the intricacies of disease transmission dynamics within conference settings and assessed the efficacy of control strategies to curb disease dissemination. Ultimately, our study proffers a numerical framework for assessing the risk of infectious disease transmission during short-duration conferences, furnishing conference organizers with valuable insights to inform the implementation of targeted prevention and control measures.

Adrian Gheorghiu, Iulian-Marius Tăiatu, Dumitru-Clementin Cercel et al.

The detection and classification of diseases in Robusta coffee leaves are essential to ensure that plants are healthy and the crop yield is kept high. However, this job requires extensive botanical knowledge and much wasted time. Therefore, this task and others similar to it have been extensively researched subjects in image classification. Regarding leaf disease classification, most approaches have used the more popular PlantVillage dataset while completely disregarding other datasets, like the Robusta Coffee Leaf (RoCoLe) dataset. As the RoCoLe dataset is imbalanced and does not have many samples, fine-tuning of pre-trained models and multiple augmentation techniques need to be used. The current paper uses the RoCoLe dataset and approaches based on deep learning for classifying coffee leaf diseases from images, incorporating the pix2pix model for segmentation and cycle-generative adversarial network (CycleGAN) for augmentation. Our study demonstrates the effectiveness of Transformer-based models, online augmentations, and CycleGAN augmentation in improving leaf disease classification. While synthetic data has limitations, it complements real data, enhancing model performance. These findings contribute to developing robust techniques for plant disease detection and classification.

Joy S. Park, Andras Perl

Endocytic recycling regulates the cell surface receptor composition of the plasma membrane. The surface expression levels of the T cell receptor (TCR), in concert with signal transducing co-receptors, regulate T cell responses, such as proliferation, differentiation, and cytokine production. Altered TCR expression contributes to pro-inflammatory skewing, which is a hallmark of autoimmune diseases, such as systemic lupus erythematosus (SLE), defined by a reduced function of regulatory T cells (Tregs) and the expansion of CD4+ helper T (Th) cells. The ensuing secretion of inflammatory cytokines, such as interferon-γ and interleukin (IL)-4, IL-17, IL-21, and IL-23, trigger autoantibody production and tissue infiltration by cells of the adaptive and innate immune system that induce organ damage. Endocytic recycling influences immunological synapse formation by CD4+ T lymphocytes, signal transduction from crosslinked surface receptors through recruitment of adaptor molecules, intracellular traffic of organelles, and the generation of metabolites to support growth, cytokine production, and epigenetic control of DNA replication and gene expression in the cell nucleus. This review will delineate checkpoints of endosome traffic that can be targeted for therapeutic interventions in autoimmune and other disease conditions.

Mingzheng Zhang, Wenxuan Chen, Shengru Wang et al.

Abstract Background The preoperative flexibility of the scoliotic spine is a key aspect of surgical planning, as it provides information on the rigidity of the curve, the extent of structural changes, the levels to be fused and the amount of correction. The purpose of this study was to assess whether supine flexibility can be used to predict postoperative correction in patients with adolescent idiopathic scoliosis (AIS) by determining the correlation between these two characteristics. Methods A total of 41 AIS patients who underwent surgical treatment between 2018 and 2020 were retrospectively enrolled for analysis. Preoperative and postoperative standing radiographs and preoperative CT images of the entire spine were collected and used to measure supine flexibility and the postoperative correction rate. T tests were used to analyse the differences in supine flexibility and postoperative correction rate between groups. Pearson’s product-moment correlation analysis was performed, and regression models were established to determine the correlation between supine flexibility and postoperative correction. Thoracic curves and lumbar curves were analysed independently. Results Supine flexibility was found to be significantly lower than the correction rate but showed a strong correlation with the postoperative correction rate, with r values of 0.68 for the thoracic curve group and 0.76 for the lumbar curve group. The relationship between supine flexibility and postoperative correction rate could be expressed by linear regression models. Conclusion Supine flexibility can be used to predict postoperative correction in AIS patients. In clinical practice, supine radiographs may be used in place of existing flexibility test techniques.

Xiaoxing Lai, Hongwei Zhu, Zhao Wu et al.

Abstract Background Effective exercise for the frail elderly has been found to contribute to healthy aging; the corresponding relationship between intensity and volume of exercise and health effects remains unclear. The present study aimed to investigate the dose–response effects of resistance training on muscle strength and physical fitness in frail older adults. Methods In this randomized controlled trial, participants were randomized into seven groups: moderate‐volume low‐intensity, moderate‐volume moderate‐intensity, moderate‐volume high‐intensity, high‐volume low‐intensity, high‐volume moderate‐intensity, high‐volume high‐intensity and routine care, receiving 12 weeks of resistance training of different intensities and volumes of exercise. The outcomes were muscle strength (assessed by ergonomics force gauges) and physical fitness function (assessed by the 6‐min walking test [6MWT], the 30‐s sit‐to‐stand test [30sSTST] and the 8‐foot up‐and‐go test [8‐FUGT]) before and at 6 and 12 weeks of intervention. Results A total of 161 participants completed the exercise intervention. There were no significant differences in age, sex, height, body weight and body mass index among the seven groups. The exercise volume of resistance training showed linear relationships with muscle strength of the lower limbs, 30sSTST and 6MWT results and a non‐linear relationship with 8‐FUGT. Resistance training intensity was found to have a linear relationship with muscle strength of the lower limbs and 6MWT and non‐linear relationships with 30sSTST and 8‐FUGT. The mixed linear model analysis revealed that the lower limb muscle strength differed significantly before and during the intervention (W = 8571.5, Padj < 0.001), before and after the intervention (W = 6968, Padj = 0.001) and during and after the intervention (W = 2834.5, Padj < 0.001); that the 6MWT performance differed during and after the intervention (W = 3184, Padj < 0.001); and that the 30sSTST was different between before and during the intervention (W = 2350.5, Padj = 0.012) and between during and after the intervention (W = 2290.5, Padj = 0.045). Conclusions Resistance training was found to be associated with muscle strength and physical fitness in frail older adults in a dose‐dependent manner. High‐intensity resistance training could be more effective for improving the muscle strength of frail older adults, and the improvement of 6MWT performance was even higher. High‐volume resistance training significantly improved muscle strength, with even greater improvement in the 30sSTST and 6MWT performances. Both the intensity and volume of exercise were found to greatly value physical function in frail older adults. Low–moderate‐intensity resistance training and low–moderate‐volume resistance training also had some advantages in terms of safety, efficacy and acceptance in elderly with frailty.

Eaman Alhassan, Kevin K. Wu, Stratos Christianakis et al.

Salahaldeen Rababa, Asma Yamin, Shuxia Lu et al.

Currently, many researchers and analysts are working toward medical diagnosis enhancement for various diseases. Heart disease is one of the common diseases that can be considered a significant cause of mortality worldwide. Early detection of heart disease significantly helps in reducing the risk of heart failure. Consequently, the Centers for Disease Control and Prevention (CDC) conducts a health-related telephone survey yearly from over 400,000 participants. However, several concerns arise regarding the reliability of the data in predicting heart disease and whether all of the survey questions are strongly related. This study aims to utilize several machine learning techniques, such as support vector machines and logistic regression, to investigate the accuracy of the CDC's heart disease survey in the United States. Furthermore, we use various feature selection methods to identify the most relevant subset of questions that can be utilized to forecast heart conditions. To reach a robust conclusion, we perform stability analysis by randomly sampling the data 300 times. The experimental results show that the survey data can be useful up to 80% in terms of predicting heart disease, which significantly improves the diagnostic process before bloodwork and tests. In addition, the amount of time spent conducting the survey can be reduced by 77% while maintaining the same level of performance.

Pui Y Lee, Grant S Schulert, Scott W Canna et al.

Han Lu, Limin Wang, Weijiao Zhou et al.

Abstract Background Both knee osteoarthritis (KOA) and depressive symptoms (DS) are major public health issues affecting the quality of life. This study aimed to examine the association between KOA and DS. Methods Data were gathered from the China Health and Retirement Longitudinal Study in 2011–2015 which surveyed middle-aged to elderly individuals and their spouses in 28 provinces in China. An adjusted Cox proportional hazards regression model was used to estimate hazard ratios (HRs). Results The analysis for baseline KOA and the subsequent risk of DS was based on 2582 participants without baseline DS. During the follow-up, KOA patients were more likely to have DS than non-KOA participants (adjusted HR = 1.38: 95% CI = 1.23 to 1.83). The analysis for baseline DS and the subsequent risk of KOA was based on 4293 participants without baseline KOA, those with DS were more likely to develop KOA than non-DS participants (adjusted HR = 1.51: 95% CI = 1.26 to 1.81). Subgroup analysis showed sex and age had no significant moderating effect on the KOA-DS association. Conclusions Our results provide evidence that the association between KOA and DS is bidirectional. Therefore, primary prevention and management of KOA and DS should consider this relationship.