Rate of torque development is the primary contributor to quadriceps avoidance gait following total knee arthroplasty

BackgroundFollowing rehabilitation for total knee arthroplasty, “quadriceps avoidance gait”, defined by limited knee flexion angle excursion during walking, persists and contributes to poor long-term outcomes. Given the presence of several post-surgical impairments, identifying the contribution of multiple factors to knee flexion angle excursion is important to developing targeted interventions to improve recovery after total knee arthroplasty.Research questionsWhich outcomes continue to improve following rehabilitation for total knee arthroplasty? What are the primary contributors to impaired knee flexion angle excursion during walking following total knee arthroplasty?MethodsPeak muscle strength and rate of torque development of the quadriceps, hip abductors, and hip external rotators, five-time sit-to-stand test, Knee Injury & Osteoarthritis Outcome Score, and gait mechanics were assessed in 24 participants at three and six months post-surgery. Paired sample t-tests or Wilcoxon Signed-Rank tests were used to compare outcomes between assessments. Stepwise multiple linear regression were used to assess the contribution of each measure to knee flexion angle excursion.ResultsSignificant improvements were noted in all outcomes except hip external rotation rate of torque development, gait speed, and knee flexion angle excursion. Quadriceps rate of torque development and knee pain significantly contributed to knee flexion angle excursion at three months (Adjusted R² = 0.342), while quadriceps rate of torque development and peak hip external rotation strength significantly contributed at six months (Adjusted R² = 0.436).SignificanceWhile higher pain levels at three months and greater peak hip external rotation muscle strength at six months contribute to impaired knee flexion angle excursion, quadriceps rate of torque development was the primary contributor to knee flexion angle excursion at both three and six months after surgery. Implementing strategies to maximize quadriceps rate of torque development during rehabilitation may help to reduce quadriceps avoidance gait after total knee arthroplasty.     

Determinants of life satisfaction and self-perception of ageing among elderly people in China: An exploratory study in comparison between physical and social functioning

ObjectiveThis study attempted to figure out the difference between physical and social functioning in determining life satisfaction and self-perception of ageing among community-dwelling elderly people in China.MethodsA representative random sample of 2161 participants aged 60 years or older was surveyed by face-to-face interview. Sociodemographic factors were measured by age, educational level, and marital status. Physical functioning was identified in terms of self-perceived health, basic and instrumental activities of daily living, and number of chronic illnesses. Social functioning was characterized in terms of number of people living together, social support network, and sense of loneliness. Hierarchical multiple linear regressions were performed to identify significant determinants of life satisfaction and self-perception of ageing.ResultsOlder age and lower educational level were related to higher degree of life satisfaction; whereas younger age and higher educational level were related to higher level of self-perception of ageing. Social functioning took precedence over physical functioning in contributing to life satisfaction. In contrast, physical functioning outweighed social functioning in promoting a positive self-perception of ageing.ConclusionA sense of companionship and a supportive social network are vital in enhancing life satisfaction, whereas perceived physical health and functional independence are essential in facilitating a positive self-perception of ageing. Understanding the underlying determinants can provide a novel insight into the mechanism involved in achieving successful ageing.     

非脑瘫早产儿早期全身运动质量评估结果与神经认知发育情况的关联性研究

目的 了解早期全身运动(GMs)评估结果为异常/可疑的非脑瘫早产儿与筛查正常的早产儿在婴幼儿期神经、认知等各方面整体发育水平的差异,以探索GMs评估与儿童轻微神经功能障碍的关系。方法 选取2009-2017年在上海市闵行区妇幼保健院扭动阶段或不安阶段至少进行过1次GMs评估的早产儿,于矫正后9、12、24月龄评估其智力指数(MI)、发育商(DQ)。结果 单因素分析显示,扭动阶段/不安阶段结果为异常/可疑的非脑瘫早产儿与正常结果相比,MI与DQ差异均无统计学意义(P>0.05);多因素分析显示,不安运动结果为异常/可疑与正常相比,发育异常结局的可能性大(9月龄:OR=3.075,95%CI:1.013~9.331;12月龄:OR=3.638,95%CI:1.552~8.527;24月龄:OR=2.750,95%CI:1.213~6.242);不安运动评估结果对不同年龄发育异常结局预测的灵敏度较低(8.82%~18.60%),特异度较高(＞95%)。结论 GMs评估在预测婴幼儿后期神经、运动发育情况存在局限性,不可取代后续的各类发育评估与监测。     

Status of vaccine research and development for Helicobacter pylori

Gastric adenocarcinoma is globally the third leading cause of death due to malignancy, with the bulk of this disease burden being suffered by low and middle income countries (LMIC), especially in Asia. The majority of these cancers develop as a result of a chronic gastritis that arises in response to infection with the stomach-dwelling bacterium, Helicobacter pylori. A vaccine against this pathogen would therefore be a powerful tool for preventing gastric adenocarcinoma. However, notwithstanding a proof-of-concept that vaccination can protect children from acquisition of H. pylori infection, there are currently no advanced vaccine candidates with only a single vaccine in Phase I clinical trial. Further, the development of a vaccine against H. pylori is not a current strategic priority of major pharmaceutical companies despite the large global disease burden. Given the involvement of such companies is likely to be critical for late stage development, there is therefore a need for an increased appreciation of the burden of this disease in LMIC and more investment to reinvigorate research in H. pylori vaccine Research and Development.     

Using advocacy to increase investment in enteric vaccine development

Catalyzing and sustaining momentum for long-term research investments can be a challenge, especially for enteric pathogens like ETEC and Shigella that are most threatening to the health of children in low-resource areas, and whose vaccines would not be for global use. The 2018 Vaccines Against Shigella and ETEC (VASE) Conference included a workshop focused on building the capacity of scientists to communicate about their own research and advocate for additional attention and funding for enteric disease and vaccines research. Workshop presenters shared best practices and examples of advocacy, communications, and messaging tactics that have been used successfully during early stages of vaccine development research for other pathogens. The presentations were followed by an interactive, hands-on training for real-life communication opportunities for scientists that could result in increased research funding, including developing resonant messaging for relevant audiences and practicing interviews.     

Does exclusive breastfeeding correlate with infant's early language milestone?

Objective

This study aims to assess the correlation between the exclusive breastfeeding status with infant's early language milestone.

Trends in Physical Fitness Among 12-Year-Old Children in Urban and Rural Areas During the Social Transformation Period in China

Aims

To investigate the 29-year (1985–2014) trends in body dimensions and physical fitness test performances among 12-year-old Chinese children living in urban and rural areas.

Social adaptive skills and psychopathology in adults with intellectual disabilities of non-specific origin and those with Down syndrome

The present study aimed to assess the psychometric proprieties of a new social adaptive skills questionnaire and examine the impact of maladaptive behaviour on social functioning in adults with ID of non-specific aetiology and those with Down syndrome.The results of an exploratory factor analysis led to the exclusion of 20 items out of 48 and yielded a four-factor structure. The Confirmatory Factor Analysis conducted on 28 remaining items confirmed a four-factor structure explaining 43% of the total variance. The results computed on the global sample (n = 567) showed a “very good” internal consistency for the global score (.89) for all four factors with a very good fit (.97). Thus, this new assessment tool presented a good conceptual validity for assessing social-adaptive skills in adults with ID. The results also showed that participants with DS (no = 92) exhibited a higher global score of social adaptive skills on three subscales (sociability, social relating and respect for social rules) compared to adults with ID of non-specific aetiology (no = 328), and presented a lower level of psychopathology problems. Although aetiology was significantly related to these group differences even after controlling for level of ID and chronological age, the general level of psychopathology fully mediated these relations.In conclusion, the regression coefficient analyses showed that the general level of psychopathology fully mediated the relationship between aetiology and social adaptive skills. A combined assessment of these dimensions should provide information about their predictive value for social functioning in ID adults and target specific remediation goals.