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Introduction: A recently emerging respiratory disease named coronavirus disease 2019 (COVID-19) has quickly spread across the world. This disease is initiated by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and uncontrolled cytokine storm, but it remains unknown as to whether a robust antibody response is related to clinical deterioration and poor outcome in COVID-19 patients. Methods: Anti-SARS-CoV-2 IgG and IgM antibodies were determined by chemiluminescence analysis (CLIA) in COVID-19 patients at a single center in Wuhan. Median IgG and IgM levels in acute and convalescent-phase sera (within 35 days) for all included patients were calculated and compared between severe and non-severe patients. Immune response phenotyping based on the late IgG levels and neutrophil-to-lymphocyte ratio (NLR) was characterized to stratified patients into different disease severities and outcomes. Results: A total of 222 patients were included in this study. IgG was first detected on day 4 of illness, and its peak levels occurred in the fourth week. Severe cases were more frequently found in patients with high IgG levels, compared to those with low IgG levels (51.8 vs. 32.3%; p = 0.008). Severity rates for patients with NLRhiIgGhi, NLRhiIgGlo, NLRloIgGhi, and NLRloIgGlophenotype were 72.3, 48.5, 33.3, and 15.6%, respectively (p < 0.0001). Furthermore, severe patients with NLRhiIgGhi, NLRhiIgGlohad higher inflammatory cytokines levels including IL-2, IL-6 and IL-10, and decreased CD4+ T cell count compared to those with NLRloIgGlophenotype (p < 0.05). Recovery rates for severe patients with NLRhiIgGhi, NLRhiIgGlo, NLRloIgGhi, and NLRloIgGlophenotype were 58.8% (20/34), 68.8% (11/16), 80.0% (4/5), and 100% (12/12), respectively (p = 0.0592). Dead cases only occurred in NLRhiIgGhiand NLRhiIgGlophenotypes. Conclusions: COVID-19 severity is associated with increased IgG response, and an immune response phenotyping based on the late IgG response and NLR could act as a simple complementary tool to discriminate between severe and non-severe COVID-19 patients, and further predict their clinical outcome.
Immune Phenotyping Based on the Neutrophil-to-Lymphocyte Ratio and IgG Level Predicts Disease Severity and Outcome for Patients With COVID-19
The distinction between face-to-face and distant digitally-mediated educational engagement is a complex one, and the two modes are often combined in practice, via 'blended learning' or the use of a VLE to support campus-based teaching. The current Covid-19 pandemic has thrown this distinction into relief, in a context where educationalists have been forced to move to fully distant engagement in a very short timeframe. This paper explores how this predicament has brought to the fore the nature of our engagement with digital knowledge practices and screen-based communication, arguing that the notion of'virtual learning' is a flawed one. Instead, adopting a sociomaterial perspective, it argues that all aspects of digital engagement are in fact grounded in material and embodied entanglements with devices and other artefacts.
There Is No 'Virtual Learning': The Materiality of Digital Education
Friedreich Ataxia (FA) is a neurodegenerative disease caused by the deficiency of frataxin, a mitochondrial protein. In primary cultures of dorsal root ganglia neurons, we showed that frataxin depletion resulted in decreased levels of the mitochondrial calcium exchanger NCLX, neurite degeneration and apoptotic cell death. Here we describe that frataxin-deficient dorsal root ganglia neurons display low levels of ferredoxin 1, a mitochondrial Fe/S cluster-containing protein that interacts with frataxin and, interestingly, is essential for the synthesis of calcitriol, the active form of vitamin D. We provide data that calcitriol supplementation, used at nanomolar concentrations, is able to reverse the molecular and cellular markers altered in DRG neurons. Calcitriol is able to recover both ferredoxin 1 and NCLX levels and restores mitochondrial membrane potential indicating an overall mitochondrial function improvement. Accordingly, reduction of apoptotic markers and neurite degeneration was observed and, as a result, cell survival was also recovered. All these beneficial effects would be explained by the finding that calcitriol is able to increase the mature frataxin levels in both, frataxin-deficient DRG neurons and cardiomyocytes; remarkably, this increase also occurs in lymphoblastoid cell lines derived from FA patients. In conclusion, these results provide molecular bases to consider calcitriol for an easy and affordable therapeutic approach for FA patients.
Calcitriol increases frataxin levels and restores mitochondrial function in cell models of Friedreich Ataxia
COVID-19 has elevated anew the import of holistically conceiving human-environmental well-being and tackling the overarching precarities of our ecologies, societies and public health in strategies of securitization. This paper considers the key challenge of reimagining securitization in the aftermath of COVID-19 and makes two core arguments. The first is that in addressing precarity a key starting point lies in being mindful of how it is differentially experienced across multiple social hierarchies in the human world. The paper draws upon Judith Butler's work on 'frames of seeing' to consider how our current moment can elicit a contrapuntal concern for those who have always been precarious but not in view. The second core argument is that it is vital to move beyond a concern for human precarity to a concern for a broader sense of planetary precarity, which in turn prompts the need to strategize for a 'more-than-human' sense of security. Developing the concept of 'human security', the paper reflects on how we can usefully envision a 'more-than-human security' for a more biologically stable and sustainable planet.
Planetary Precarity and 'More-Than-Human Security': The Securitization Challenge in the Aftermath of COVID-19
The Japanese manufacturing industry is facing a shortage of new employees and an aging workforce due to the declining birthrate and aging population. In addition, the manufacturing industry needs new employees who can learn independently and cooperatively, and possess knowledge and skills in manufacturing. Project-based learning (PBL) is a learning method that allows independent and cooperative learning. Students who learned this method at the Tokyo University of Science in 2019 formed a small group and acquired not only technical skills in the manufacturing field but also interpersonal skills through communication and discussion with group members. However, the impact of COVID-19 in 2020 made it difficult to conduct face-to-face classes, making it was necessary to conduct online classes. As such, online education has attracted attention, as its allows learners and instructors to connect via the Internet and conduct classes remotely. However, in online learning, communication among learners may be insufficient. This study aims to encouraged students to share information by providing them with different information on how to improve their assembly skills and by giving them opportunities to communicate. It specifically investigates the effect of online PBL on the development of students in the manufacturing industry and examines the effect of PBL by introducing the LEGO block assembly training. With repeated assembly trainings, students improved their LEGO assembly skills and created assembly manuals for anyone to complete the task within a standard timeframe. The results show that students who are given different information and encouraged to communicate under online PBL improve their assembly skills more effectively than other students. ? 2021 IEEE.
Effect of division of roles on learners in online manufacturing education
Background: Patient-reported outcomes (PROs) and PRO measures (PROMs) are real-world evidence that can help capture patient experiences and perspectives regarding a clinical intervention such as genetic testing. Objective: To identify and capture methods and qualitative PRO themes among studies reporting PROs following genetic testing for FH, breast and ovarian cancer syndrome, and Lynch syndrome. Methods: A systematic review was conducted via PubMed/MEDLINE, EMBASE, and Yale Universitys TRIP Medical Databases on articles published by April 2021. Results: We identified 24 studies published between 1996 and 2021 representing 4279 participants that reported PROs following genetic testing for FH, breast and ovarian cancer syndrome, and Lynch syndrome. Studies collected and reported PROs from validated PROM instruments (n = 12; 50%), validated surveys (n = 7; 26%), and interviews (n = 10; 42%). PRO themes ranged across all collection methods (e.g., psychological, knowledge, coping and satisfaction, concern about stigma/discrimination, etc.). Conclusions: Important gaps identified include (1) most studies (n = 18; 75%) reported PROs following genetic testing for breast and ovarian cancer, and (2) populations reporting PROs overall were largely of White/Caucasian/Northern European/Anglo-Saxon descent. We offer recommendations and describe real-world implications for the field moving forward.
Patient-Reported Outcomes following Genetic Testing for Familial Hypercholesterolemia, Breast and Ovarian Cancer Syndrome, and Lynch Syndrome: A Systematic Review
COVID-19 spreads across the world with a strong impact on populations and health systems. Lung Ultrasound is increasingly employed in clinical practice but a standard approach and data about the accuracy of Lung Ultrasound are still needed. Our study's objective is to evaluate Lung Ultrasound diagnostic and prognostic characteristics in patients with suspected COVID-19. We conducted a monocentric, prospective, observational study. Patients with respiratory distress and suspected COVID-19 consecutively admitted in the Emergency Medicine Unit were enrolled. Lung Ultrasound examinations were performed blindly to clinical data. Outcomes were diagnosis of COVID-19 pneumonia and in-hospital mortality. 159 patients were included in our study, 66% were males and 63.5% had a final diagnosis of COVID-19. COVID-19 patients had a higher mortality rate (18.8% vs 6.9%, P=.04) and Lung Ultrasound Severity Index (16.14 [8.71] vs 10.08 [8.92], P<.001) compared to non-COVID-19 ones. This model proved able to distinguish between positive cases from negative ones with an Area Under the Receiver Operating Characteristic (AUROC) equal to 0.72 (95% CI 0.64-0.78) and to predict in-hospital mortality with an AUROC equal to 0.81 (95% CI 0.74-0.86), in the whole population, and an AUROC equal to 0.76 (95% CI 0.66-0.84) in COVID-19 patients. Lung Ultrasound Severity Index can be a useful tool in diagnosing COVID-19 in patients with a high pretest probability to have the disease and - among them - identify those with worse prognosis.
Lung Ultrasound Severity Index: Development and Usefulness in Patients with Suspected SARS-Cov-2 Pneumonia. A Prospective Study
BACKGROUND: Zoonotic coronaviruses have caused several endemic and pandemic situations around the world. SARS caused the first epidemic alert at the beginning of this century, followed by MERS. COVID-19 appeared to be highly contagious, with human-to-human transmission by aerosol droplets, and reached nearly all countries around the world. A plethora of studies were performed, with reports being published within a short period of time by scientists and medical physicians. It has been difficult to find the relevant data to create an overview of the situation according to studies from accumulated findings and reports. In the present study we aimed to perform a comprehensive study in the context of the case fatality ratios (CFRs) of three major human Coronavirus outbreaks which occurred during the first twenty years of 21st century. METHODS: In this study, we performed meta-analyses on SARS, MERS and COVID-19 outbreak events from publicly available records. Study analyses were performed with the help of highly reputable scientific databases such as PubMed, WOS and Scopus to evaluate and present current knowledge on zoonotic coronavirus outbreaks, starting from 2000 to the end of 2020. RESULTS: A total of 250,194 research studies and records were identified with specific keywords and synonyms for the three viruses in order to cover all publications. In the end, 41 records were selected and included after applying several exclusion and inclusion criteria on identified datasets. SARS was found to have a nearly 11% case fatality ratio (CFR), which means the estimated number of deaths as a proportion of confirmed positive cases; Taiwan was the country most affected by the SARS outbreak based on the CFR analysis. MERS had CFRs of 35.8 and 26 in Saudi Arabia during the 2012 and 2015 outbreaks, respectively. COVID-19 resulted in a 2.2 CFR globally, and the USA reported the highest mortality ratio in the world in the end of first year of COVID-19 pandemic. CONCLUSION: Some members of the Coronaviridae family can cause highly contagious and devastating infections among humans. Within the last two decades, the whole world has witnessed several deadly emerging infectious diseases, which are most commonly zoonotic in nature. We conclude that pre-existing immunity during the early stages of a pandemic might be important, but case control and management strategies should be improved to decrease CFRs. Finally, we have addressed several concerns in relation to outbreak events in this study.
Meta-analysis and comprehensive study of coronavirus outbreaks: SARS, MERS and COVID-19
We report a case of vaccine-induced immune thrombotic thrombocytopenia (VITT) in a young man diagnosed 13 days after Ad26.COV2.S COVID-19 (Johnson & Johnson/Janssen) vaccination. He presented to us with five days of progressive left leg pain, thrombocytopenia, hypofibrinogenemia, and markedly elevated D-dimers, but without radiographically-demonstrable thrombosis. Despite negative imaging, we initiated treatment for presumptive VITT given the striking clinical picture that included the timing of his recent adenovirus-based COVID-19 vaccine, leg symptoms, marked thrombocytopenia, and consumptive coagulopathy. He received intravenous immune globulin (IVIG), prednisone, and argatroban and was discharged seven days later much improved. His positive Platelet Factor 4 (PF4) ELISA antibody test returned after treatment was initiated. To our knowledge, this is the first reported case of VITT following Ad26.COV2.S vaccination presenting without radiographically-demonstrable thrombosis. Our patient highlights the importance of knowing vaccine status and initiating treatment as soon as possible in the right clinical setting, even in the absence of radiographic evidence of thrombus. Early VITT recognition and treatment provides an opportunity to prevent serious thrombotic complications.
VITT following Ad26.COV2.S vaccination presenting without radiographically demonstrable thrombosis
Introduction: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has spready globally. This report describes the person-to-person transmission of the virus in a hospital setting. Presentation of case: A 63-year-old man with pneumonia and a 70-year-old man without symptoms were admitted to a tertiary hospital with SARS-CoV-2 infection. Both men were accompanied by their wives, who stayed with their husbands during their hospitalisation. The wives of Patient 1 and Patient 2 tested positive and negative for SARS-CoV-2, respectively. Of the environmental samples tested, 1/21 and 0/25 from the rooms of Patient 1 and Patient 2, respectively, tested positive for SARS-CoV-2. Patient 1s wife appeared to have acquired infection during her husband's hospitalisation. Discussion: The study had several limitations, including methodology inconsistencies. Additionally, a viral culture was not performed to demonstrate the viability of the virus identified in the environmental sample. Finally, the wife of Patient 1 stayed on the Diamond Princess cruise ship for 4 days before being transferred to the hospital and may have been infected on the ship and not while in the hospital. Conclusion: Our study suggests that airborne transmission of SARS-CoV-2 may be limited. However, owing to the abovementioned limitations, the results should be interpreted with caution.
Possibility of transmission of severe acute respiratory syndrome coronavirus 2 in a tertiary care hospital setting: A case study
It is well-known that it is crucial to insert either a single InGaN underlayer or an InGaN superlattice (SLS) structure (both with low InN content) as a pre-layer prior to the growth of InGaN/GaN multiple quantum wells (MQWs) served as an active region for a light-emitting diode (LED). So far, this growth scheme has achieved a great success in the growth of III-nitride LEDs on c-plane substrates, but has not yet been applied in the growth of any other orientated III-nitride LEDs. In this paper, we have applied this growth scheme in the growth of semi-polar (11-22) green LEDs, and have investigated the impact of the SLS pre-layer on the optical performance of semi-polar (11-22) green LEDs grown on patterned (113) silicon substrates. Our results demonstrate that the semi-polar LEDs with the SLS pre-layer exhibit an improvement in both internal quantum efficiency and light output, which is similar to their c-plane counterparts. However, the performance improvement is not so significant as in the c-plane case. This is because the SLS pre-layer also introduces extra misfit dislocations for the semi-polar, but not the c-plane case, which act as non-radiative recombination centres.
Influence of an InGaN superlattice pre-layer on the performance of semi-polar (11-22) green LEDs grown on silicon.
BACKGROUND: Observational studies have consistently described poor clinical outcomes and increased ICU mortality in patients with severe coronavirus disease 2019 (COVID-19) who require mechanical ventilation (MV). Our study describes the clinical characteristics and outcomes of patients with severe COVID-19 admitted to ICU in the largest health care system in the state of Florida, United States. METHODS: Retrospective cohort study of patients admitted to ICU due to severe COVID-19 in AdventHealth health system in Orlando, Florida from March 11th until May 18th, 2020. Patients were characterized based on demographics, baseline comorbidities, severity of illness, medical management including experimental therapies, laboratory markers and ventilator parameters. Major clinical outcomes analyzed at the end of the study period were: hospital and ICU length of stay, MV-related mortality and overall hospital mortality of ICU patients. RESULTS: Out of total of 1283 patients with COVID-19, 131 (10.2%) met criteria for ICU admission (median age: 61 years [interquartile range (IQR), 49.5-71.5]; 35.1% female). Common comorbidities were hypertension (84; 64.1%), and diabetes (54; 41.2%). Of the 131 ICU patients, 109 (83.2%) required MV and 9 (6.9%) received ECMO. Lower positive end expiratory pressure (PEEP) were observed in survivors [9.2 (7.7-10.4)] vs non-survivors [10 (9.1-12.9] p = 0.004]. Compared to non-survivors, survivors had a longer MV length of stay (LOS) [14 (IQR 8-22) vs 8.5 (IQR 5-10.8) p< 0.001], Hospital LOS [21 (IQR 13-31) vs 10 (7-1) p< 0.001] and ICU LOS [14 (IQR 7-24) vs 9.5 (IQR 6-11), p < 0.001]. The overall hospital mortality and MV-related mortality were 19.8% and 23.8% respectively. After exclusion of hospitalized patients, the hospital and MV-related mortality rates were 21.6% and 26.5% respectively. CONCLUSIONS: Our study demonstrates an important improvement in mortality of patients with severe COVID-19 who required ICU admission and MV in comparison to previous observational reports and emphasizes the importance of standard of care measures in the management of COVID-19.
ICU outcomes and survival in patients with severe COVID-19 in the largest health care system in central Florida
Ivermectin (IVM), an avermectin-derivative anthelmintic, specifically binds to glutamate-gated chloride ion channels (GluCls), causing paralysis in invertebrates. IVM also exhibits other biological activities such as Wnt/-catenin pathway inhibition in vertebrates that do not possess GluCls. This study showed that affinity purification using immobilized IVM B1a isolated TELO2, a cofactor of phosphatidylinositol 3-kinase-related kinases (PIKKs), as a specific IVM B1a-binding protein. TELO2 knockdown reduced cytoplasmic -catenin and the transcriptional activation of -catenin/TCF. IVM B1a bound to TELO2 through the C-terminal -helix, in which mutations conferred IVM resistance. IVM reduced the TELO2 and PIKK protein levels and the AKT and S6 kinase phosphorylation levels. The inhibition of mTOR kinase reduced the cytoplasmic -catenin level. Therefore, IVM binds to TELO2, inhibiting PIKKs and reducing the cytoplasmic -catenin level. In conclusion, our data indicate TELO2 as a druggable target for human diseases involving abnormalities of the Wnt/-catenin pathway and PIKKs, including mTOR.
Ivermectin represses Wnt/-catenin signaling by binding to TELO2, a regulator of phosphatidylinositol 3-kinase-related kinases
OBJECTIVE: Diabetes is common in COVID-19 patients and associated with unfavorable outcomes. We aimed to describe the characteristics and outcomes and to analyze the risk factors for in-hospital mortality of COVID-19 patients with diabetes. RESEARCH DESIGN AND METHODS: This two-center retrospective study was performed at two tertiary hospitals in Wuhan, China. Confirmed COVID-19 patients with diabetes (N = 153) who were discharged or died from 1 January 2020 to 8 March 2020 were identified. One sex- and age-matched COVID-19 patient without diabetes was randomly selected for each patient with diabetes. Demographic, clinical, and laboratory data were abstracted. Cox proportional hazards regression analyses were performed to identify the risk factors associated with the mortality in these patients. RESULTS: Of 1,561 COVID-19 patients, 153 (9.8%) had diabetes, with a median age of 64.0 (interquartile range 56.0-72.0) years. A higher proportion of intensive care unit admission (17.6% vs. 7.8%, P = 0.01) and more fatal cases (20.3% vs. 10.5%, P = 0.017) were identified in COVID-19 patients with diabetes than in the matched patients. Multivariable Cox regression analyses of these 306 patients showed that hypertension (hazard ratio [HR] 2.50, 95% CI 1.30-4.78), cardiovascular disease (HR 2.24, 95% CI 1.19-4.23), and chronic pulmonary disease (HR 2.51, 95% CI 1.07-5.90) were independently associated with in-hospital death. Diabetes (HR 1.58, 95% CI 0.84-2.99) was not statistically significantly associated with in-hospital death after adjustment. Among patients with diabetes, nonsurvivors were older (76.0 vs. 63.0 years), most were male (71.0% vs. 29.0%), and they were more likely to have underlying hypertension (83.9% vs. 50.0%) and cardiovascular disease (45.2% vs. 14.8%) (all P values <0.05). Age ≥70 years (HR 2.39, 95% CI 1.03-5.56) and hypertension (HR 3.10, 95% CI 1.14-8.44) were independent risk factors for in-hospital death of patients with diabetes. CONCLUSIONS: COVID-19 patients with diabetes had worse outcomes compared with the sex- and age-matched patients without diabetes. Older age and comorbid hypertension independently contributed to in-hospital death of patients with diabetes.
Clinical Characteristics and Risk Factors for Mortality of COVID-19 Patients With Diabetes in Wuhan, China: A Two-Center, Retrospective Study
Emerging evidence indicate that both neutralizing and Fc-mediated effector functions of antibodies contribute to protection against SARS-CoV-2. It is unclear if Fc-effector functions alone can protect against SARS-CoV-2. Here, we isolated CV3-13, a non-neutralizing antibody, from a convalescent individual with potent Fc-mediated effector functions. The cryo-EM structure of CV3-13 in complex with the SARS-CoV-2 Spike reveals that the antibody binds from a distinct angle of approach to an N-terminal domain (NTD) epitope that only partially overlaps with the NTD supersite recognized by neutralizing antibodies. CV3-13 does not alter the replication dynamics of SARS-CoV-2 in K18-hACE2 mice, but its Fc-enhanced version significantly delays virus spread, neuroinvasion and death in prophylactic settings. Interestingly, the combination of Fc-enhanced non-neutralizing CV3-13 with Fc-compromised neutralizing CV3-25 completely protects mice from lethal SARS-CoV-2 infection. Altogether, our data demonstrate that efficient Fc-mediated effector functions can potently contribute to the in vivo efficacy of anti-SARS-CoV-2 antibodies.
A Fc-enhanced NTD-binding non-neutralizing antibody delays virus spread and synergizes with a nAb to protect mice from lethal SARS-CoV-2 infection
For many social science scholars, the COVID-19 pandemic has forced us to re-think our approaches to research As a result of new social distancing measures, those of us who conduct in-person qualitative and ethnographic research have faced significant challenges in accessing the populations and fields we study Technology served as an incredibly useful tool for social interaction and research prior to the pandemic, and it has since become even more important as a way to engage with others Although not all types of social research, or even all projects, lend themselves to online activities, digital communication platforms like Zoom, Skype, and Facebook have allowed many of us to continue our studies from a distance?in some cases, significant temporal and spatial distances away from our research sites As such, it is important to consider how these different methodological approaches challenge our understandings of fieldwork While the disadvantages of not physically accessing the places we study are clear, can mediated approaches offer (any) hope of the immersion we experienced with in-person fieldwork? If many of us are able to continue ethnographic research (in some form) without co-locating with our participants in our field sites, how are our studies fundamentally affected, as well as the ways we conceptualize the ?field? more largely? This paper explores these methodological and epistemological questions through reflections on conducting online research during the beginning of the COVID-19 pandemic
Looking at the field through a Zoom lens: Methodological reflections on conducting online research during a global pandemic
SARS-CoV-2 infection of children leads to a mild illness and the immunological differences with adults are unclear. Here, we report SARS-CoV-2 specific T cell responses in infected adults and children and find that the acute and memory CD4(+) T cell responses to structural SARS-CoV-2 proteins increase with age, whereas CD8(+) T cell responses increase with time post-infection. Infected children have lower CD4(+) and CD8(+) T cell responses to SARS-CoV-2 structural and ORF1ab proteins when compared with infected adults, comparable T cell polyfunctionality and reduced CD4(+) T cell effector memory. Compared with adults, children have lower levels of antibodies to -coronaviruses, indicating differing baseline immunity. Total T follicular helper responses are increased, whilst monocyte numbers are reduced, indicating rapid adaptive co-ordination of the T and B cell responses and differing levels of inflammation. Therefore, reduced prior -coronavirus immunity and reduced T cell activation in children might drive milder COVID-19 pathogenesis.
SARS-CoV-2 specific T cell responses are lower in children and increase with age and time after infection
With the appearance of the COVID-19 virus, the world faces new challenges in almost every area of social life. Social distancing and protection measures provide new challenges in business relations. This also holds true for criminal trials in general, and for international criminal trials, in particular. In Germany, several trials concerning charges of crimes under international law, established by the German Code of Crimes Against International Law (V?lkerstrafgesetzbuch), are currently in progress. In particular, the trial against two former Syrian intelligence officers, which is currently taking place before the Higher Regional Court in Koblenz, has received international attention and will possibly be affected by the restrictions imposed.
COVID-19 and International Crimes Trials in Germany
Aufgrund der COVID-19-Pandemie wurde fr viele Selbsthilfegruppen Online-Kommunikation zur einzigen M?glichkeit, sich zu begegnen. Virtuelle Treffen sto?en zwar nicht berall auf Gegenliebe, bieten aber die Chance, dem etwas verstaubten Image der Selbsthilfe-Kultur entgegenzuwirken und neue Zielgruppen anzusprechen.
Zoomen statt Sesselkreis
INTRODUCTION: Individuals with hip dysplasia report significant functional disability that improves with periacetabular osteotomy (PAO). Four physical performance measures (PPMs) have been recently validated for use with nonarthritic hip conditions; however, their ability to detect functional improvement and correlate with improvements in popular hip-specific patient-reported outcome (PRO) instruments after PAO is unknown. The purpose of this study was to evaluate the responsiveness of four PPMs up to 1 year after PAO, compare PPMs with established PRO measures at these time points, and report the acceptability and utility of PPMs for assessing outcomes after PAO. METHODS: Twenty-two participants aged 15 to 39 years completed the timed stair ascent (TSA), sit-to-stand five times (STS5), self-selected walking speed, four-square-step test, and seven hip-specific PRO measures before surgery and at approximately 6 months and 1 year after PAO. They completed questions regarding acceptability and utility of both types of testing. Wilcoxon rank sum test and unpaired Student t-tests were used to assess differences between time points; Spearman correlation and generalized linear modeling were used to determine the relationship between PPMs and PRO measures. RESULTS: Six months after PAO, participants showed significant improvements on all seven PRO instruments (P < 0.001) and on the STS5 (P = 0.01). At one year, these improvements were maintained and TSA also improved (P = 0.03). Improvement in other PPMs did not reach significance (P = 0.07 and 0.08). The STS5 test demonstrated moderate to strong correlation (|r| = 0.43 to 0.76, P < 0.05) with all PRO measures, and the TSA test demonstrated moderate to strong correlation with almost all measures (|r| = 0.43 to 0.58, P < 0.05). Correlations strengthened on subanalysis of participants with unilateral disease (n = 11) (|r| = 0.56 to 0.94, P < 0.05). All participants (100%) found PPM testing acceptable despite disability; 25% preferred PPMs to PRO measures, whereas 75% of participants found them equal in usefulness. DISCUSSION: The STS5 and TSA tests demonstrated moderate to very strong correlation with PRO measures at six and 12 months after PAO for dysplasia. These tests could be used as a functional outcome to supplement PRO instruments after PAO.
Physical Performance Tests Correlate With Patient-reported Outcomes After Periacetabular Osteotomy: A Prospective Study