The effect of variability in maturational tempo and midparent height on variability in linear body measurements

Background: Information on the effect of variability in maturational tempo on variability in height attained at the same age is not readily available.

Aim: The study obtained this information from the data of the First Zurich Longitudinal Study.

Subjects and methods: Yearly measurements of standing height, sitting height and leg length, yearly assessments of bone age (RUS (Radius, Ulna and Short bones), TW3 method) and midparent height for 232 children from the First Zurich Longitudinal Growth Study are included in a correlational analysis.

Results: The course of the squared correlations of standing height, sitting height and leg length with attained RUS bone age, midparent height and both as a function of age are presented.

Conclusions: During puberty, up to 50% of the height variation in boys and 40% in girls is explained by maturational tempo.

Résumé. Arrière plan: L’information concernant l’effet de la variabilitè du rythme de la maturation sur celle de la stature á un âge donnè, n’est pas disponible.

But: Cette ètude a obtenu de l’information á partir de la première ètude longitudinale de Zurich.

Sujet0s y mèthodes: Une analyse de corrèlation est effectuèe á partir de mensurations annuelles de la stature, de la taille assis et de la longueur de la jambe, de contröles annuels de l’âge osseux (RUS, TW3) et de la stature mèdiale des parents pour 232 enfants de la première ètude de croissance de Zurich.

Résultats: On prèsente les valeurs des carrès des corrèlations pour la stature, la taille assis et la longueur de la jambe avec l’âge osseux atteint (RUS radius, ulna et os courts), avec la stature mèdiale des parents et les deux comme une fonction de l’âge.

Conclusions: Pendant la pubertè, jusqu’á 50% de la variation de la stature des garons et 40% de celle des filles, sont expliquès par le rythme de maturation.

Zusammenfassung. Hintergrund: Informationen über die Auswirkungen von Schwankungen im reifungsbedingten Wachstumstempo auf unterschiedliche im gleichen Alter erzielte Größen sind nicht in geeigneter Form verfügbar.

Ziel: Die vorliegende Arbeit versucht, Informationen zur angesprochenen Problematik aus den Daten der ersten Züricher Longitudinalstudie zu erlangen.

Inhalt und Methodik: Die jährlichen Daten aus Größenmessungen in den Positionen Stehen, Sitzen sowie Beinlänge und die jährlichen Bewertungsergebnisse der Knochenalter (RUS, TW3) als auch die Medium-Elterngrößen von 232 Kindern aus der ersten Züricher Longitudinalgrößenstudie werden in einer Wechselbeziehungsanalyse erfaßt.

Ergebnisse: Die Verläufe der quadrierten Verhältnisse von Steh-, Sitzgröße beziehungsweise Beinlänge mit denen von Knochenaltern nach RUS-Methode (Radius [Speiche], Ulna [Elle], Short bones [kleine Knochen]) beziehungsweise Medium-Elterngröße werden präsentiert. Beide Datenmengen werden außerdem als Funktionen des Alters dargestellt.

Schlußfolgerungen: Während des Stadiums der Pubertät lassen sich Größenunterschiede bei bis zu 50% der Jungen und bis zu 40% der Mädchen mit den Schwankungen im reifungsbedingten Wachstumstempo erklären.

Resumen. Antecedentes: No es fácil disponer de información acerca del efecto que tiene la variabilidad en el ritmo madurativo sobre la variabilidad estatural alcanzada a la misma edad.

Objetivo: El estudio obtuvo esta información a partir de los datos del Primer Estudio Longitudinal de Zurich (First Zurich Longitudinal Study).

Sujetos y métodos: Se han incluido en un análisis de correlaciones las medidas anuales de la estatura, la talla sentado y la longitud de la pierna así como las estimaciones anuales de la edad ósea (RUS, TW3) y la estatura media de los progenitores, de 232 niños del Primer Estudio Longitudinal de Zurich (First Zurich Longitudinal Study).

Resultados: Se presentan las variaciones de las correlaciones cuadráticas de la estatura, la talla sentado y la longitud de la pierna con la edad ósea alcanzada basada en el mètodo RUS (radio, ulna y huesos cortos), la estatura media de los progenitores y ambas en función de la edad.

Conclusiones: Durante la pubertad, hasta el 50% de la variación estatural de los chicos y el 40% de la de las chicas se explica por el ritmo madurativo.     

Effect of temporary school closure due to COVID-19 on musculoskeletal function in elementary school children

Objective: In 2020, coronavirus disease-2019 (COVID-19) became the cause of a pandemic. In response, the Japan Sports Agency issued warnings about secondary damage to health, such as the threat to physical and mental well-being due to the lack of exercise in this situation. In this study, we report on cross-sectional and longitudinal examinations of standing trunk flexion to evaluate how temporary long-term school closures affected musculoskeletal function in elementary school students.Patients and Methods: All children in one public elementary school in T-city during the school years 2019 and 2020 were included in this study. A digital forward flexion meter was used to measure standing trunk flexion.Results: In this study, 284 (284/289: 98.3%) and 266 (266/274: 97.1%) children in school years 2020 and 2019, respectively, were found to have valid data for cross-sectional analysis. The standing trunk flexion did not show significant differences between grades or sexes. In the longitudinal analysis, the results of the comparison of standing trunk flexion in children for two consecutive years revealed significant differences only between grades 3 and 4 (P<0.05) and between girls in grades 3 and 4 (P<0.01), but no significant differences in other grades or among boys or girls were observed.Conclusion: Initially, we expected that there would be a difference in the results of functional assessment using standing trunk flexion depending on the period of absence from school. However, the results of this study showed no significant changes in standing trunk flexion. Moreover, since children’s musculoskeletal functions may be affected by various factors during the COVID-19 pandemic, they should be carefully monitored in the future.     

Effects of prolonged load carriage on angular jerk of frontal and sagittal knee motion

BackgroundDuring training, service members routinely walk with heavy body borne loads for long periods of time. These loads alter knee biomechanics and may produce jerky knee motions that reportedly increase joint loading and risk of musculoskeletal injury. Yet, it is unknown if service members use jerky knee motions during prolong walking with body borne load.Research questionTo quantify the effects of body borne load and duration of walking on the jerkiness of sagittal and frontal plane knee motion.MethodsEighteen participants had angular jerk of knee motion quantified while they walked (1.3 m/s) for 60-min with three body borne loads (0, 15, and 30 kg). Peak and cost of angular jerk for sagittal and frontal plane knee motion was quantified and submitted to a repeated measures linear model to test the main effects and interaction of load (0, 15, and 30 kg) and time (0, 15, 30, 45, and 60 min).ResultsBody borne load increased peak and cost of angular jerk for sagittal plane knee motion up to 35 % and 110 %, respectively, and frontal plane knee motion up to 20 % and 51 %, respectively (all p<0.001), while jerk cost of frontal plane knee motion (p=0.001) increased 31 % after walking 45 min.SignificanceBody borne load produced large (between 20 % and 110 %), incremental increases in angular jerk for both sagittal and frontal plane knee motion; whereas, duration of walking led to a 31 % increase in jerkiness of frontal plane knee motion. Service members who often walking for long periods of time with heavy body borne loads may have greater risk of developing musculoskeletal injury and disease due to large increases in jerky knee motions.     

Negative Impacts of Prolonged Standing at Work on Musculoskeletal Symptoms and Physical Fatigue: The Fifth Korean Working Conditions Survey

PurposeWe aimed to investigate variations in the risk of low back pain (LBP), lower extremity muscle pain, and whole body fatigue according to differences in prolonged standing work hours in relation to risk factor exposure and rest frequency.Materials and MethodsFrom the fifth Korean Working Conditions Survey data collected in 2017, data for 32970 full-time workers who worked for more than 1 year at their present job were analyzed. We classified the workers according to exposure to fatigue or painful postures, carrying heavy objects, performance of repetitive movements that burden the musculoskeletal system, and how often they took a break. Relationships between time spent in a standing posture at work and risks of LBP, lower extremity muscle pain, and whole body fatigue were analyzed by multivariate logistic regression.ResultsOf the full-time workers in the survey, 48.7% worked in a standing position for more than half of their total working hours. A higher odds ratio (OR) value for lower extremity muscle pain was observed in female not exposed to carrying heavy objects [OR: 3.551, 95% confidence interval (CI): 3.038–4.150] and not exposed to performing repetitive movements (OR: 3.555, 95% CI: 2.761–4.557).ConclusionChanges in work methodologies are needed to lower the number of hours spent in a prolonged standing posture at work, including being able to rest when workers want to do so, to reduce pain and fatigue.     

Use of face mask by blood donors during the COVID-19 pandemic: Impact on donor hemoglobin concentration: A bane or a boon

BackgroundCOVID-19 virus has caused the world’s deadliest pandemic. Early April 2020, the Delhi Government made it compulsory for people to wear face masks while going outdoors to curb disease spread. Prolonged use of surgical masks during the pandemic has been reported to cause many adverse effects. Intermittent hypoxia has been shown to activate erythropoietin (EPO leading to increased hemoglobin mass.AimTo analyze whether face mask induced intermittent hypoxia has any effect on the hemoglobin levels of healthy blood donors.Materials and methodsWe retrospectively analyzed donor data from 1st July 2019-31st December 2020 for hemoglobin distribution across hemoglobin ranges and donor deferral on basis of hemoglobin. Study population was divided into two cohorts Group 1- (1st July 2019-31 st March 2020): before implementation of mandatory face masks Group 2- (1st April 2020-31 st December 2020): after implementation of mandatory face masksResultsMean Hb of blood donors in Group 2 (15.01 ± 1.1 g/dl) was higher than Group1 (14.49 ± 1.15 g/dl), (p < 0.0001). 47.1 % group2 donors had Hb of 16.1−18 g/dl compared to group1 (38.4 %). 52.9 % group 2 donors had Hb between 12.5−15 g/dl compared to 61.6 % Group 1 (p < 0.05). Deferral due to anemia was lesser in group 2 compared to group 1 (p < 0.00001). Group 2 had significantly higher deferral due to high Hb (>18 gm/dl) was than Group 1 (p = 0.0039).ConclusionThis study including 19504 blood donors spanning over one and a half year shows that prolonged use of face mask by blood donors may lead to intermittent hypoxia and consequent increase in hemoglobin mass.     

右美托咪定混合罗哌卡因用于缓解上肢长时间手术中止血带反应的效果观察

目的：探讨右美托咪定混合罗哌卡因在肌间沟复合腋路臂丛神经阻滞应用于上肢长时间手术中的疗效观察。方法60例急诊断指（多指）、断腕或断臂手术患者,ASAⅠ~Ⅱ级,手术时间8~10 h,随机分配为2组（n =30）：罗哌卡因组（R 组）采用1%罗哌卡因15 mL +2%利多卡因10 mL 加生理盐水至40 mL;右美托咪定混合罗哌卡因组（DR 组）采用1%罗哌卡因15 mL+2%利多卡因10 mL +盐酸右美托咪定1μg/ kg 加生理盐水至40 mL。以神经刺激器定位肌间沟臂丛神经分支（腋神经）及腋路臂丛神经主分支（尺神经、桡神经、正中神经和肌皮神经）,止血带充气压力200~250 mmHg,压迫时间90 min。观察并记录入室时（T0）、阻滞后1.5 h（T1）、3 h（T2）、4.5 h（T3）、6 h（T4）、7.5 h（T5）、9 h（T6）及术毕（T7）患者的一般生命体征（MAP、HR）,同时以VAS 评分法评估患者止血带反应的程度,若无法忍受止血带反应,臂丛加药后试验结束。记录患者止血带耐受情况,并以 Ramsay评分评价 R 组及 DR 组的镇静程度,记录术中出现的不良反应。结果与 R 组相比,DR 组患者对止血带耐受率明显升高,且差异有统计学意义（P ﹤0.05）,止血带疼痛时间出现延迟（P ﹤0.05）;与 R 组比较,DR 组 T1~ T5时 HR 减慢（P ﹤0.05）,DR 组有7例出现窦性心动过缓,两组均未出现止血带严重并发症。结论1μg/ kg 右美托咪定混合1%罗哌卡因对减轻上肢长时间手术带来的止血带疼痛安全、有效,并可延迟止血带疼痛出现的时间。     

老年重症患者哌拉西林/他唑巴坦延长输注的药代/药效学参数

目的 研究老年重症患者哌拉西林/他唑巴坦延长输注的血药浓度-时间曲线,并计算哌拉西林/他唑巴坦的药代/药效学参数.方法 收集在重症医学科住院且满足入组条件的老年重症患者5例,给予哌拉西林/他唑巴坦(4.5 g/q8h)3 h延长输注治疗,于注射开始的0h、0.25 h、0.5h、1h、2h、3h、4h、5h、6h、8h采静脉血2 ml,3 500 r/min离心10 min,取上清液,置于-23℃冰箱中保存备检.用超高效液相色谱法-串联质谱法测定哌拉西林/他唑巴坦的血药浓度,应用noncompartmental模型估计哌拉西林/他唑巴坦的药代学参数,利用蒙特卡洛模拟10 000例患者的治疗·比较哌拉西林/他唑巴坦传统输注(0.5 h)与延长输注(3～4 h)下各MIC值(1～64 μg/ml)的达标概率(PTA),将％fT、MIC≥50％设置为有效药效学目标.结果 哌拉西林的血浆峰浓度、半衰期、分布容积、清除率分别为(97.64±27.16) mg/L、(2.32±0.81)h、(30.51±15.2)L、(9.27±2.69) L/h.在哌拉西林/他唑巴坦4.5 g/q8h.3h延长输注中,当MIC≤16 μg/ml时.PTA达到或接近100％;MIC=32 ug/ml时,PTA为42.54％.结论 本文描述了哌拉西林/他唑巴坦在老年重症患者的药代学参数,这与已发表文献的结果明显不同.蒙特卡洛模拟显示,老年重症患者采用哌拉西林/他唑巴坦4.5 g/q8h.3h输注可以获得较佳的药效学目标,尤其在MIC≤16μg/ml时.     

医疗器械清洗后放置时间与污染度的关系

目的 探讨复用医疗器械清洗后放置时间与污染度的关系,为提高灭菌质量提供最佳的包装时间.方法 将清洗后检测合格的360件复用关节器械裸露放置于消毒供应中心器械检查包装区,随机分成6组各60件,分别放置15 min、30 min、1h、2h、3h、4h后采用ATP生物荧光技术进行污染度监测.结果 器械放置15 min、30 min、1h、2h、3h、4h合格率分别为100％、96.7％、83.3％、58.3％、33.3％、16.7％,不同时间合格率比较,差异有统计学意义(P＜0.01).放置15 min、30 min与放置1h合格率比较,差异无统计学意义(均P＞0.00313);其他时间合格率显著低于1h合格率(均P＜0.00313).结论 清洗后的器械不宜超过1h包装.     

Dissemination and implementation of prolonged exposure therapy for posttraumatic stress disorder

Posttraumatic stress disorder (PTSD) is a highly prevalent, often chronic and disabling psychiatric disorder that is associated with significant adverse health and life consequences. Although several evidence-based treatments (EBTs), including Prolonged Exposure therapy (PE), have been found effective and efficacious in reducing PTSD symptomology, the majority of individuals with this disorder receive treatments of unknown efficacy. Thus, it is imperative that EBTs such as PE be made available to PTSD sufferers through widespread dissemination and implementation. We will review some of the efforts to increase the availability of PE and the common barriers to successful dissemination and implementation. We also discuss novel dissemination strategies that are harnessing technology to overcome barriers to dissemination.