Notes

Case Studies of Tooth enamel Microabrasion Associated with At-home Dentistry Bleaching Soon after Orthodontic Class Elimination.
Continuous routine adjustments in fairy sectors.
About the look at edgeless diode devices regarding patient-specific QA inside high-dose stereotactic radiosurgery.
Moreover, 3DOM* can not only be regarded as a "controller" of other reactive intermediates, but also effectively promote the photodegradation of bezafibrate, which is classified as a persistent organic contaminant. This study gives deep insights into effects of UV/chlorine on the photophysical and photochemical properties of DOM, and is helpful for understanding the dynamic roles of DOM in the photodegradation of micropollutants.
Emerging data suggest that higher radiation doses in post-mastectomy radiotherapy may be associated with an increased risk of reconstruction complications. see more This study aimed to validate previous findings regarding the impact of radiation dose on complications among women with breast cancer using a multi-center dataset.

Fifteen institutions participated, and women with breast cancer who received radiotherapy after either autologous or prosthetic breast reconstruction were included. The primary endpoint was major post-radiation therapy complications requiring re-operation for explantation, flap failure, or bleeding control.

In total, 314 patients were included. Radiotherapy was performed using both conventional fractionation and hypofractionation in various schedules. The range of the radiation therapy dose in Equivalent Dose in 2Gy fractions (EQD2; α/β=3.5) varied from 43.4 to 71.0Gy (median dose 48.6Gy). Boost radiation therapy was administered to 49 patients. Major post-radiation therapy complications won outcomes. Our multi-center prospective observational study (NCT03523078) is underway to further validate this hypothesis.
The effects of the menstrual cycle and primary dysmenorrhea (PD) on phase-related cognitive and physical functions are controversial. This study was carried out to examine whether women with PD showed a different physical function or dual-tasking response than women without PD at times other than menstruation.

Women with or without PD were recruited for the study. link2 Individuals assessed on the first day of the menstruation and the day they reported themselves as well being (feeling good day-FGD). Zebris © FDM Type Force Platform was used to evaluate postural stability. Individuals have were asked to perform to a 3-step balance test protocol; the first session comfortable upright standing; the second session standing with a motor task; the third session standing with a cognitive task (counting backward). Correctly calculated numbers were also recorded.

The number of correct answers given by individuals during the cognitive dual-task was similar on the first day of menstruation and FGD (p > 0.05). In thes study showed that the primary dysmenorrhea is not only a problem for females during menstruation, primary dysmenorrhea causes impaired ability of the individual to perform dual-tasking and continuously affects postural stability.
In three-dimensional gait analysis, anatomical axes are defined by and therefore sensitive to marker placement. Previous analysis of the Oxford Foot Model (OFM) has suggested that the axes of the hindfoot are most sensitive to marker placement on the posterior aspect of the heel. Since other multi-segment foot models also use a similar marker, it is important to find methods to place this as accurately as possible. The aim of this pilot study was to test two different 'jigs' (anatomical alignment devices) against eyeball marker placement to improve reliability of heel marker placement and calculation of hindfoot angles using the OFM.

Two jigs were designed using three-dimensional printing a ratio caliper and heel mould. OFM kinematics were collected for ten healthy adults; intra-tester and inter-tester repeatability of hindfoot marker placement were assessed using both an experienced and inexperienced gait analyst for 5 clinically relevant variables.

For 3 out of 5 variables the intra-tester and inter-tester variability was below 2 degrees for all methods of marker placement. The ratio caliper had the lowest intra-tester variability for the experienced gait analyst in all 5 variables and for the inexperienced gait analyst in 4 out of 5 variables. see more However for inter-tester variability, the ratio caliper was only lower than the eyeball method in 2 out of the 5 variables. The mould produced the worst results for 3 of the 5 variables, and was particularly prone to variability when assessing average hindfoot rotation, making it the least reliable method overall.

The use of the ratio caliper may improve intra-tester variability, but does not seem superior to the eyeball method of marker placement for inter-tester variability. The use of a heel mould is discouraged.
The use of the ratio caliper may improve intra-tester variability, but does not seem superior to the eyeball method of marker placement for inter-tester variability. The use of a heel mould is discouraged.
The use of virtual reality (VR) in clinical settings has increased with the introduction of affordable, easy-to-use head-mounted displays (HMDs). However, some have raised concerns about the effects that HMDs have on posture and locomotion, even without the projection of a virtual scene, which may be different across ages.

How does HMD wear impact the kinematic measures in younger and older adults?

Twelve healthy young and sixteen older adults participated in two testing conditions 1) TUG with no HMD and 2) TUG with an HMD displaying a scene of the actual environment (TUG
). see more The dependent variables were the pitch, yaw, and roll peak trunk velocities (PTVs) in each TUG component, turning cadence, and the time to complete the TUG and its components - SIT-TO-STAND, TURN, WALK, and STAND-TO-SIT.

Wearing the HMD decreased turning cadence and pitch and yaw PTVs in all TUG components, decreased roll PTV in SIT-TO-STAND and TURN, and increased the time taken to complete all TUG components in all participants. Wearing the HMD decreased the pitch PTV in SIT-TO-STAND in older relative to younger adults. link2 link2 Wearing an HMD affected TUG performance in younger and older adults, which should be considered when an HMD is used for VR applications in rehabilitation.

Our findings highlight the importance of considering the physical effect of HMD wear in clinical testing, which may not be present with non-wearable VR technologies.
Our findings highlight the importance of considering the physical effect of HMD wear in clinical testing, which may not be present with non-wearable VR technologies.
Age-related changes of human gait characteristics associated with muscle weakness have been reported in previous studies. Human gait is considered as a cyclic motion adapted to individual body-characteristics and the surrounding-environment based on motion criteria. Based on this hypothesis, elderly gait characteristics may be caused by an adaptation to muscle weakness.

What role does gait adaptation to muscle weakness play in the development of elderly gait, and what criteria are used in elderly gait adaptation?

We examined the effects of gait adaptation to muscle weakness on steady gait characteristics using computational forward dynamics simulation with a two-dimensional neuro-musculo-skeletal model. link3 For gait adaptation, we tested two motion criteria (i) energy cost minimization, which is a widely used criterion for healthy adults; and (ii) energy rate minimization, based on existing measurements of elderly gait characteristics.

Progression of muscle weakness enhanced the reduction of joint angle m muscle weakness plays an essential role in the development of stable gait characteristics, whereas elderly people might use a different motion criterion compared with healthy adults in gait adaptation.
Multidirectional walking, including backward walking, is integral to daily activities, and seems particularly challenging in older age, and in people with pathology affecting postural control such as dementia.

Does exercise influence backward walking speed in people with dementia, when tested using habitual walking aids and without, and do effects differ according to walking aid use?

This study included 141 women and 45 men (mean age 85 years) with dementia from the Umeå Dementia and Exercise (UMDEX), a cluster-randomized controlled trial study set in 16 nursing homes in Umeå, Sweden. Participants were randomized to a High-Intensity Functional Exercise (HIFE) program targeting lower limb strength-, balance and mobility exercise or to a seated attention control activity. Blinded assessors measured 2.4-meter usual backward walking speed, at baseline, 4 - (intervention completion) and 7-month follow-up; tested 1) with habitual walking aids allowed, and 2) without walking aids.

Linear mixed models showed no between-group effect in either backward walking speed test at 4 or 7 months; test 1) 0.005 m/s, P = .788 and -0.006 m/s, P = .754 and test 2) 0.030 m/s, P = .231 and 0.015 m/s, P = .569, respectively. In interaction analyses, exercise effects differed significantly between participants who habitually walked unaided compared with those that used a walking aid at 7 months (0.094 m/s, P = .027).

In this study of older people with dementia living in nursing homes, the effects of exercise had no overall effects on backwards walking speed. Nevertheless, some benefit was indicated in participants who habitually walked unaided, which is promising and merits further investigation in future studies.
In this study of older people with dementia living in nursing homes, the effects of exercise had no overall effects on backwards walking speed. Nevertheless, some benefit was indicated in participants who habitually walked unaided, which is promising and merits further investigation in future studies.
Early conversations about patients' goals and values in advancing serious illness (serious illness conversations) can drive better healthcare. However, these conversations frequently happen during acute illness, often near death, without time to realize benefits of early communication.

The Speaking About Goals and Expectations (SAGE) Program, adapted from the Serious Illness Care Program, is a multicomponent intervention designed to foster earlier and more comprehensive serious illness conversations for patients admitted to the hospital. We present a quality improvement study of the SAGE Program assessing older adults admitted to a general medicine service at the Brigham & Women's Hospital in Boston, Massachusetts. Our primary outcomes included the proportion of patients with at least one documented conversation, the timing between first conversation documented and death, the quality of conversations, and their interprofessional nature. Secondary outcomes assessed evaluations of the training and hospital utilization.

We trained 37 clinicians and studied 133 patients split between the SAGE intervention and a comparison population. link3 Intervention patients were more likely to have documented serious illness conversations (89.1% vs. link3 26.1%, p<0.001); these conversations occurred earlier (mean of 598.9 vs. 180.8 days before death, p<0.001) and included more key elements of conversation (mean of 6.56 vs. 1.78, p<0.001).

This study demonstrated significant differences in the frequency and quality of serious illness conversations completed earlier in the illness course for hospitalized patients.

Programs designed to drive serious illness conversations earlier in the hospital may be an effective way to improve care for patients not reached in the ambulatory setting.

Prospectively designed trial, non-randomized sample.
Prospectively designed trial, non-randomized sample.
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