Objective Cachexia occurs in approximately half of hepatocellular carcinoma(HCC)patients as the disease progresses and is correlated with a poor prognosis.Therefore,early identification of HCC patients at risk of deve...Objective Cachexia occurs in approximately half of hepatocellular carcinoma(HCC)patients as the disease progresses and is correlated with a poor prognosis.Therefore,early identification of HCC patients at risk of developing cachexia and their prognosis is crucial.This study investigated the functional liver imaging score(FLIS)derived from gadoxetic acid-enhanced magnetic resonance imaging(MRI)to identify cachexia in HCC patients and their prognosis.Methods Pretreatment clinical and MRI data from 339 HCC patients who underwent gadoxetic acid-enhanced MRI scans were retrospectively collected.Patient weights were recorded for 6 months following the MRI scan to diagnose cachexia.The FLIS was calculated as the sum of the enhancement quality score,the excretion quality score,and the portal vein sign quality score.A Cox proportional hazards model was used to determine the significant factors affecting overall survival(OS).Multivariable logistic regression was then conducted to identify variables predicting cachexia in HCC patients,which were subsequently used to predict OS.Results Cox regression analysis revealed a significant association between cachexia and worse OS.Both FLIS(0–4 vs.5–6 points)(OR,9.20;95%CI:4.68–18.10;P<0.001)andα-fetoprotein>100 ng/mL(OR,4.08;95%CI:2.13–7.83;P<0.001)emerged as significant predictors of cachexia in patients with HCC.Furthermore,FLIS(0–4 vs.5–6 points)(HR,1.73;95%CI:1.19–2.51;P=0.004)was significantly associated with OS.Patients in the FLIS 0–4 points group had shorter OS than those in the FLIS 5–6 points group[20 months(95%CI,14.7–25.3)vs.43 months(95%CI,27.7–58.3);P=0.001].Conclusion Cachexia was associated with worse OS.The functional liver imaging score emerged as a significant predictor of cachexia in HCC patients and their prognosis.展开更多
Using score function in a matrix game is very rare. In the proposed paper we have considered a matrix game with pay-off as triangular intuitionistic fuzzy number and a new ranking order has been proposed using value j...Using score function in a matrix game is very rare. In the proposed paper we have considered a matrix game with pay-off as triangular intuitionistic fuzzy number and a new ranking order has been proposed using value judgement index, available definitions and operations. A new concept of score function has been developed to defuzzify the pay-off matrix and solution of the matrix game has been obtained. A numerical example has been given in support of the proposed method.展开更多
AIM To develop a new scoring system, nutech functional scores(NFS) for assessing the patients with spinal cord injury(SCI).METHODS The conventional scale, American Spinal Injury Association's(ASIA) impairment scal...AIM To develop a new scoring system, nutech functional scores(NFS) for assessing the patients with spinal cord injury(SCI).METHODS The conventional scale, American Spinal Injury Association's(ASIA) impairment scale is a measure which precisely describes the severity of the SCI.However, it has various limitations which lead to incomplete assessment of SCI patients.We have developed a 63 point scoring system, i.e., NFS for patients suffering with SCI.A list of symptoms either common or rare that were found to be associated with SCI was recorded for each patient.On the basis of these lists, we have developed NFS.RESULTS These lists served as a base to prepare NFS, a 63 point positional(each symptom is sub-graded and get points based on position) and directional(moves in direction BAD → GOOD) scoring system.For non-progressive diseases, 1, 2, 3, 4, 5 denote worst, bad, moderate, good and best(normal), respectively.NFS for SCI has been divided into different groups based on the affected part of the body being assessed, i.e., motor assessment(shoulders, elbow, wrist, fingers-grasp, fingers-release, hip, knee, ankle and toe), sensory assessment, autonomic assessment, bed sore assessment and general assessment.As probability based studies required a range of(-1, 1) or at least the range of(0, 1) to be useful for real world analysis, the grades were converted to respective numeric values.CONCLUSION NFS can be considered as a unique tool to assess the improvement in patients with SCI as it overcomes the limitations of ASIA impairment scale.展开更多
Background: Diabetes mellitus (DM) is a metabolic disorder characterized by hyperglycemia. The symptoms of hyperglycemia include polyuria, polydypsia, polyphagia, blurred vision and weight loss. Various diagnostic tes...Background: Diabetes mellitus (DM) is a metabolic disorder characterized by hyperglycemia. The symptoms of hyperglycemia include polyuria, polydypsia, polyphagia, blurred vision and weight loss. Various diagnostic tests are used for the diagnosis of DM in patients, but the findings of these tests cannot be assumed to be completely valid. This study aimed at developing a novel scoring system to assess the patients suffering from DM. Method: We assessed the patients based on various diagnostic tests available for DM and prepared a single list of these tests. The tests were categorized and graded based on the World Health Organization (WHO) criteria. Further, we coverted the grades into numeric values for easy use. Results: NFS for diabetes is an 11-point scoring system that assesses the patient’s condition before and after therapy. To facilitate the conduct of probability based studies, we have converted the scores into numeric values in the range of (0, 1). Each symptom is graded as (1, 2, 3, 4, 5) that runs in BAD → GOOD direction. Conclusion: NFS is a beneficial scoring system that can be used worldwide to assess the patients with DM.展开更多
Background: Primary knee Osteoarthritis (OA) is the commonest articular disease in middle age and elderly people. Primary total knee replacement (TKR) is a known world-wide standard and definitive treatment of primary...Background: Primary knee Osteoarthritis (OA) is the commonest articular disease in middle age and elderly people. Primary total knee replacement (TKR) is a known world-wide standard and definitive treatment of primary knee OA following failed adequate non-operative management. It is of clinical importance to assess the clinical and functional outcome of TKR to prognosticate the severity of primary knee OA. The new (2011) knee society scoring system (nKSS) is both surgeons and patients’ assessment tool for the treatment outcome of TKR. Study Design: Prospective interventional analytical study. Aim and Objective: The aim of the study was to determine early clinical and functional outcome of primary total knee replacement in patients with primary knee osteoarthritis using nKSS. The objectives were: 1) To determine the pre-operative nKSS and post operative nKSS;2) To determine relationships between pre-operative nKSS and post operative nKSS at 6 weeks, 3, 6, 9 and 12 months;3) To determine the complication rates in patients undergoing primary TKR in the study centre. Methods: A prospective interventional study of 59 patients aged 51 to 70 years who had 67 Total Knee Replacements (TKRs) participated in the study between November 2015 to June 2018 at National Orthopaedics Hospital, Lagos, Nigeria. Patients’ sociodemographic data, pre-operative and post-operative nKSS system were recorded at 6 weeks, 3, 6, 9 and 12 months during follow up. The data were analyzed using Statistical Package for Social Science (SPSS). Results: There were 41 females and 18 males (M:F = 1:2.3). There were total of 67 TKRs with 31 right TKRs, 20 left TKRs and 8 staged bilateral TKRs. The participants’ age ranged from 51 to 70 years with the mean age of 59.5 (±8.5) years. Four patients did not complete the study due to various reasons. The remaining 55 participants completed the study period with progressive improvement of their post-operative nKSS at 6 weeks, 3, 6, 9 and 12 months post-operatively when compared with pre-operative nKSS (P value 0.5). Conclusion: This study revealed improved early clinical and functional outcome of primary total knee replacement in primary knee osteoarthritis using nKSS in all the studied patients. There is no significant negative effect of lower pre-operative nKSS (and its components) on the post-operative nKSS outcome.展开更多
AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint condition...AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.展开更多
Objective: to discuss the application of TCM hot compress combined with TCM nursing in elderly patients with knee osteoarthritis. Methods: 90 elderly patients with knee osteoarthritis treated in our hospital were rand...Objective: to discuss the application of TCM hot compress combined with TCM nursing in elderly patients with knee osteoarthritis. Methods: 90 elderly patients with knee osteoarthritis treated in our hospital were randomly selected and divided into groups according to the random way. Among them, 45 cases were given routine nursing intervention (control group) and the other 45 cases were given traditional Chinese medicine hot compress combined with traditional Chinese medicine nursing intervention (observation group). Through observation and comparison, the conclusion was drawn. Results: for the comparison of each data, each data of the treatment method in the observation group has more advantages, and the difference is statistically significant (P < 0.05). After treatment, the cure rate of the observation group was higher than that of the control group, and the difference was statistically significant (P < 0.05). Conclusion: traditional Chinese medicine nursing combined with hot compress of traditional Chinese medicine can effectively improve knee joint function and patients' compliance in the treatment of senile knee osteoarthritis, which is worthy of clinical application.展开更多
BACKGROUND Long-term treatment of attention deficit/hyperactivity disorder(ADHD)is associated with adverse events,such as nausea and vomiting,dizziness,and sleep disturbances,and poor maintenance of late ADHD medicati...BACKGROUND Long-term treatment of attention deficit/hyperactivity disorder(ADHD)is associated with adverse events,such as nausea and vomiting,dizziness,and sleep disturbances,and poor maintenance of late ADHD medication compromises treatment outcomes and prolongs the recovery of patients’social functioning.AIM To evaluate the effect of non-pharmacological treatment on the full recovery of social functioning in patients with ADHD.METHODS A total of 90 patients diagnosed with ADHD between May 2019 and August 2020 were included in the study and randomly assigned to either the pharmacological group(methylphenidate hydrochloride and tomoxetine hydrochloride)or the non-pharmacological group(parental training,behavior modification,sensory integration therapy,and sand tray therapy),with 45 cases in each group.Outcome measures included treatment compliance,Swanson,Nolan,and Pelham,Version IV(SNAP-IV)scores,Conners Parent Symptom Questionnaire(PSQ)scores,and Weiss Functional Impairment Rating Scale(WFIRS)scores.RESULTS The non-pharmacological interventions resulted in significantly higher compliance in patients(95.56%)compared with medication(71.11%)(P<0.05).However,no significant differences in SNAP-IV and PSQ scores,in addition to the learning/school,social activities,and adventure activities of the WFIRS scores were observed between the two groups(P>0.05).Patients with non-pharmacological interventions showed higher WFIRS scores for family,daily life skills,and self-concept than those in the pharmacological group(P<0.05).CONCLUSION Non-pharmacological interventions,in contrast to the potential risks of adverse events after longterm medication,improve patient treatment compliance,alleviate patients’behavioral symptoms of attention,impulsivity,and hyperactivity,and improve their cognitive ability,thereby improving family relationships and patient self-evaluation.展开更多
基金supported by grants from National Natural Science Foundation of China(No.82272064)Jiangsu Provincial Science and Technique Program(No.BK20221461)Zhongda Hospital Affiliated to Southeast University,Jiangsu Province High-level Hospital Paring Assistance Construction(No.zdlyg08).
文摘Objective Cachexia occurs in approximately half of hepatocellular carcinoma(HCC)patients as the disease progresses and is correlated with a poor prognosis.Therefore,early identification of HCC patients at risk of developing cachexia and their prognosis is crucial.This study investigated the functional liver imaging score(FLIS)derived from gadoxetic acid-enhanced magnetic resonance imaging(MRI)to identify cachexia in HCC patients and their prognosis.Methods Pretreatment clinical and MRI data from 339 HCC patients who underwent gadoxetic acid-enhanced MRI scans were retrospectively collected.Patient weights were recorded for 6 months following the MRI scan to diagnose cachexia.The FLIS was calculated as the sum of the enhancement quality score,the excretion quality score,and the portal vein sign quality score.A Cox proportional hazards model was used to determine the significant factors affecting overall survival(OS).Multivariable logistic regression was then conducted to identify variables predicting cachexia in HCC patients,which were subsequently used to predict OS.Results Cox regression analysis revealed a significant association between cachexia and worse OS.Both FLIS(0–4 vs.5–6 points)(OR,9.20;95%CI:4.68–18.10;P<0.001)andα-fetoprotein>100 ng/mL(OR,4.08;95%CI:2.13–7.83;P<0.001)emerged as significant predictors of cachexia in patients with HCC.Furthermore,FLIS(0–4 vs.5–6 points)(HR,1.73;95%CI:1.19–2.51;P=0.004)was significantly associated with OS.Patients in the FLIS 0–4 points group had shorter OS than those in the FLIS 5–6 points group[20 months(95%CI,14.7–25.3)vs.43 months(95%CI,27.7–58.3);P=0.001].Conclusion Cachexia was associated with worse OS.The functional liver imaging score emerged as a significant predictor of cachexia in HCC patients and their prognosis.
文摘Using score function in a matrix game is very rare. In the proposed paper we have considered a matrix game with pay-off as triangular intuitionistic fuzzy number and a new ranking order has been proposed using value judgement index, available definitions and operations. A new concept of score function has been developed to defuzzify the pay-off matrix and solution of the matrix game has been obtained. A numerical example has been given in support of the proposed method.
文摘AIM To develop a new scoring system, nutech functional scores(NFS) for assessing the patients with spinal cord injury(SCI).METHODS The conventional scale, American Spinal Injury Association's(ASIA) impairment scale is a measure which precisely describes the severity of the SCI.However, it has various limitations which lead to incomplete assessment of SCI patients.We have developed a 63 point scoring system, i.e., NFS for patients suffering with SCI.A list of symptoms either common or rare that were found to be associated with SCI was recorded for each patient.On the basis of these lists, we have developed NFS.RESULTS These lists served as a base to prepare NFS, a 63 point positional(each symptom is sub-graded and get points based on position) and directional(moves in direction BAD → GOOD) scoring system.For non-progressive diseases, 1, 2, 3, 4, 5 denote worst, bad, moderate, good and best(normal), respectively.NFS for SCI has been divided into different groups based on the affected part of the body being assessed, i.e., motor assessment(shoulders, elbow, wrist, fingers-grasp, fingers-release, hip, knee, ankle and toe), sensory assessment, autonomic assessment, bed sore assessment and general assessment.As probability based studies required a range of(-1, 1) or at least the range of(0, 1) to be useful for real world analysis, the grades were converted to respective numeric values.CONCLUSION NFS can be considered as a unique tool to assess the improvement in patients with SCI as it overcomes the limitations of ASIA impairment scale.
文摘Background: Diabetes mellitus (DM) is a metabolic disorder characterized by hyperglycemia. The symptoms of hyperglycemia include polyuria, polydypsia, polyphagia, blurred vision and weight loss. Various diagnostic tests are used for the diagnosis of DM in patients, but the findings of these tests cannot be assumed to be completely valid. This study aimed at developing a novel scoring system to assess the patients suffering from DM. Method: We assessed the patients based on various diagnostic tests available for DM and prepared a single list of these tests. The tests were categorized and graded based on the World Health Organization (WHO) criteria. Further, we coverted the grades into numeric values for easy use. Results: NFS for diabetes is an 11-point scoring system that assesses the patient’s condition before and after therapy. To facilitate the conduct of probability based studies, we have converted the scores into numeric values in the range of (0, 1). Each symptom is graded as (1, 2, 3, 4, 5) that runs in BAD → GOOD direction. Conclusion: NFS is a beneficial scoring system that can be used worldwide to assess the patients with DM.
文摘Background: Primary knee Osteoarthritis (OA) is the commonest articular disease in middle age and elderly people. Primary total knee replacement (TKR) is a known world-wide standard and definitive treatment of primary knee OA following failed adequate non-operative management. It is of clinical importance to assess the clinical and functional outcome of TKR to prognosticate the severity of primary knee OA. The new (2011) knee society scoring system (nKSS) is both surgeons and patients’ assessment tool for the treatment outcome of TKR. Study Design: Prospective interventional analytical study. Aim and Objective: The aim of the study was to determine early clinical and functional outcome of primary total knee replacement in patients with primary knee osteoarthritis using nKSS. The objectives were: 1) To determine the pre-operative nKSS and post operative nKSS;2) To determine relationships between pre-operative nKSS and post operative nKSS at 6 weeks, 3, 6, 9 and 12 months;3) To determine the complication rates in patients undergoing primary TKR in the study centre. Methods: A prospective interventional study of 59 patients aged 51 to 70 years who had 67 Total Knee Replacements (TKRs) participated in the study between November 2015 to June 2018 at National Orthopaedics Hospital, Lagos, Nigeria. Patients’ sociodemographic data, pre-operative and post-operative nKSS system were recorded at 6 weeks, 3, 6, 9 and 12 months during follow up. The data were analyzed using Statistical Package for Social Science (SPSS). Results: There were 41 females and 18 males (M:F = 1:2.3). There were total of 67 TKRs with 31 right TKRs, 20 left TKRs and 8 staged bilateral TKRs. The participants’ age ranged from 51 to 70 years with the mean age of 59.5 (±8.5) years. Four patients did not complete the study due to various reasons. The remaining 55 participants completed the study period with progressive improvement of their post-operative nKSS at 6 weeks, 3, 6, 9 and 12 months post-operatively when compared with pre-operative nKSS (P value 0.5). Conclusion: This study revealed improved early clinical and functional outcome of primary total knee replacement in primary knee osteoarthritis using nKSS in all the studied patients. There is no significant negative effect of lower pre-operative nKSS (and its components) on the post-operative nKSS outcome.
基金National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health,No.U01AR067138.
文摘AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.
文摘Objective: to discuss the application of TCM hot compress combined with TCM nursing in elderly patients with knee osteoarthritis. Methods: 90 elderly patients with knee osteoarthritis treated in our hospital were randomly selected and divided into groups according to the random way. Among them, 45 cases were given routine nursing intervention (control group) and the other 45 cases were given traditional Chinese medicine hot compress combined with traditional Chinese medicine nursing intervention (observation group). Through observation and comparison, the conclusion was drawn. Results: for the comparison of each data, each data of the treatment method in the observation group has more advantages, and the difference is statistically significant (P < 0.05). After treatment, the cure rate of the observation group was higher than that of the control group, and the difference was statistically significant (P < 0.05). Conclusion: traditional Chinese medicine nursing combined with hot compress of traditional Chinese medicine can effectively improve knee joint function and patients' compliance in the treatment of senile knee osteoarthritis, which is worthy of clinical application.
基金Supported by Ningbo Science and Technology Plan Project Public Welfare Plan(Municipal Level),No:2019C50099Ningbo Medical Key Supporting Discipline Child Health Science,No:2022-F26。
文摘BACKGROUND Long-term treatment of attention deficit/hyperactivity disorder(ADHD)is associated with adverse events,such as nausea and vomiting,dizziness,and sleep disturbances,and poor maintenance of late ADHD medication compromises treatment outcomes and prolongs the recovery of patients’social functioning.AIM To evaluate the effect of non-pharmacological treatment on the full recovery of social functioning in patients with ADHD.METHODS A total of 90 patients diagnosed with ADHD between May 2019 and August 2020 were included in the study and randomly assigned to either the pharmacological group(methylphenidate hydrochloride and tomoxetine hydrochloride)or the non-pharmacological group(parental training,behavior modification,sensory integration therapy,and sand tray therapy),with 45 cases in each group.Outcome measures included treatment compliance,Swanson,Nolan,and Pelham,Version IV(SNAP-IV)scores,Conners Parent Symptom Questionnaire(PSQ)scores,and Weiss Functional Impairment Rating Scale(WFIRS)scores.RESULTS The non-pharmacological interventions resulted in significantly higher compliance in patients(95.56%)compared with medication(71.11%)(P<0.05).However,no significant differences in SNAP-IV and PSQ scores,in addition to the learning/school,social activities,and adventure activities of the WFIRS scores were observed between the two groups(P>0.05).Patients with non-pharmacological interventions showed higher WFIRS scores for family,daily life skills,and self-concept than those in the pharmacological group(P<0.05).CONCLUSION Non-pharmacological interventions,in contrast to the potential risks of adverse events after longterm medication,improve patient treatment compliance,alleviate patients’behavioral symptoms of attention,impulsivity,and hyperactivity,and improve their cognitive ability,thereby improving family relationships and patient self-evaluation.
