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Virome inside roof-harvested rain water of an densely urbanized low-income location.
Background Norton scoring system is used to assess frailty of hospitalized patients with various medical conditions. We aimed to evaluate whether admission Norton scoring system predicts adverse outcomes among heart failure patients. Methods The study population comprised 4388 acute heart failure patients between the years 2008 and 2017. Patients were allocated to 3 groups according to their admission Norton score [(≤15-low, 16-18-intermediate, and ≥19-high)]. Primary outcome included all-cause mortality at 30, 90 days, and 1 year. Multivariate Cox proportional hazards regression modeling was used to assess the independent association between Norton score and mortality. MCC950 molecular weight Net reclassification improvement (NRI) analysis was used to asses Norton's additive predictive ability upon known prognostic factors. Results Among 4388 study patients, 32% (n=1611) had low Norton score, 28% (n=1384) intermediate score, and 40% (n=1900) high score. Kaplan-Meier analysis demonstrated significantly higher 30-day mortality among patients with a low Norton score as compared with those with intermediate or high score (2.6%, 6.3%, and 16.1%; log rank p less then 0.001). A similar trend was noted at 90 days and 1 year. Multivariate analysis found Norton score to be an independent predictor of mortality with each one-point decrement associated with a significant 15% increased risk for 30-day mortality [HR=1.15 (95%CI, 1.12-1.17) p less then 0.001]. NRI analysis showed an improvement of 21.5% (95%CI 18.3-25.1%) predicting 1-year mortality. Conclusion Our findings show that the admission Norton score is a powerful marker of short- and long-term mortality. These data suggest that the scale should be added as a risk stratification tool in this high-risk population.Chronic ankle instability predominantly occurs due to multiple exercise-related diseases. Conservative treatment methods regarding this condition have not effectively improved in recent years, which is why more focus has been put on exploring different novel reconstruction procedures of the lateral ankle ligament for the treatment of chronic ankle instability. Objectives This study aims to obtain the overall effectiveness of various lateral ankle ligament reconstruction methods for chronic ankle ligament instability. Methods We gathered data from PubMed and EMBASE databases using the keywords ankle, malleolar, and reconstruction. Newcastle - Ottawa quality assessment was carried out for the obtained studies; effect volume combination and image drawing were performed by Stata14, and Excel was used for data statistics. Results A total of 12 articles were included in the quantitative analysis by performing full-text reading and data inclusion. Among them, 476 patients (485 ankle joints) were treated. The results showed that the overall valid efficiency of "excellent" was 59% and "good" lateral ligament reconstruction was 26%, I2=87.3%, P = 0.000; the subgroup analysis anatomic reconstruction group I2=0.0%, P = 0.993; the autograft group I2=0.0%, P = 1.000; allograft group I2=0.0%, P = 0.993. Conclusion Reconstruction of the lateral ankle ligament is a relatively stable treatment for chronic ankle instability.Background Obesity is a growing public health concern. While diabetes mellitus is associated with obesity and is a risk for infection and other complications, effects of obesity on outcomes remains less clear. The purpose was to determine effect of obesity on complications, secondary operations, and functional outcomes after surgical treatment of ankle fracture. Methods 955 adult patients treated surgically for torsional ankle injury were reviewed. Obese patients (body mass index (BMI) ≥30), and patients without obesity were matched for age, sex, race, diabetes, and fracture pattern. Patient reported outcomes, measured by Foot Function Index (FFI) and Short Musculoskeletal Function Assessment (SMFA), were obtained after 12 months. Results 632 patients (316 obese [mean BMI 36.7] and 316 non-obese [mean BMI 25.5]) with mean age 44.6 years were analyzed. Each group was 52.5% female, and 6.6% had diabetes mellitus. 75.6% of fractures in each group were AO/OTA type 44B and 24.4% were 44C. Non-obese patients were m more prone to dislocations. A trend was noted for obese patients to experience more complications and wound healing issues, although rates of secondary operations were no different. Level of evidence III.Objective Patient activation has been identified as an important predictor of how patients manage their own health, but little is known about its determinants. In this scoping review, we aim to address this research gap by (1) identifying literature on psychosocial/psychological factors associated with patient activation, and (2) extracting and synthesizing major results reported on that relationship. Methods Using a systematic search of four electronic databases (Web of Science, PubMed, PsychInfo, CINAHL), our search algorithm combined related terms for "psychosocial factors" or "psychological factors" and "patient activation". Results Of the 1128 records identified, we included 13 studies in this scoping review. In these, we identified 21 psychosocial/psychological factors that were significantly associated with patient activation. The four most frequently investigated factors were depression, self-efficacy, hope, and health status. Overall, the methodological quality of studies was low. The majority were cross sectional in design, and only one assessed causality. Conclusions Our results suggest that psychosocial/psychological factors explain variations in patient activation. However, further research is needed to identify causal relationships between psychosocial/psychological factors and patient activation. Practice implications The insights from our review could be used for designing and evaluating interventions to improve patient activation.The purpose of this study was to assess the efficacy of 3-dimensional, printed, patient-specific guides to direct virtual gap arthroplasties that were designed for five patients with advanced unilateral ankylosis of the temporomandibular joint. The guides were used to mimic the intraoperative creation of five preplanned osteotomies, as well as simulating the width and depth of the bone cleavage. The accuracy of the devices in guiding the surgical simulation was assessed by superimposing the preoperative and postoperative computed tomographic scans. The devices were easily put in place with smooth uniform surgical bone cleavage, and favourable postoperative outcomes. The statistical analysis between the planned and surgical gaps, showed that the difference in dimensions was not significant (p=0.1018). The patient-specific gap arthroplasty was neither too near the skull base nor did it jeopardise the height of the mandibular ramus.
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