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Physical function following total knee arthroplasty for osteoarthritis: a longitudinal systematic review with meta-analysis
No full textObjectives: To explore the extent of functional improvement following primary total knee arthroplasty for knee osteoarthritis and to compare the trajectories of self-reported and performance-based measures of physical function. DESIGN: Longitudinal systematic review with meta-analysis METHODS: We searched 3 electronic databases from January 2005 to February 2023 for longitudinal cohort studies involving adults with knee osteoarthritis undergoing primary total knee arthroplasty. Estimates of self-reported and performance-based physical function were extracted presurgery and up to 5 years postsurgery. Risk of bias was assessed using a 6-item checklist. Self-reported function scores were converted to a 0-100 scale (higher scores indicate worse function). Mixed models provided pooled estimates after excluding low-quality studies. RESULTS: Out of 230 relevant studies, 72 (n = 19 063) of high quality were included in meta- analyses. Self-reported function significantly improved from presurgery (55.6/100; 95% confidence interval [CI], 53.1 to 58.1) to 3-6 months postsurgery (21.1; 95% CI, 17.9 to 24.3; P <.001). A small decline in self-reported function occurred at 6-12 months (31.0; 95% CI, 25.8 to 36.2; P <.001), with no further change at 12-24 months (30.9; 95% CI, 23.2 to 38.6; P = .919). Performance-based measures exhibited variable trajectories, with most estimates indicating no clinically meaningful improvement following total knee arthroplasty. CONCLUSION: Total knee arthroplasty resulted in clinically meaningful improvements in self-reported function at 3-6 months postoperatively. There was some deterioration in function after 6 months, and at no other time point did the estimate reach a clinically important change. There was limited evidence of clinically meaningful improvements in performance-based measures of physical function at any time point.
Methods: We searched 3 electronic databases from January 2005 to February 2023 for longitudinal cohort studies involving adults with knee osteoarthritis undergoing primary total knee arthroplasty. Estimates of self-reported and performance-based physical function were extracted presurgery and up to 5 years postsurgery. Risk of bias was assessed using a 6-item checklist. Self-reported function scores were converted to a 0-100 scale (higher scores indicate worse function). Mixed models provided pooled estimates after excluding low-quality studies. RESULTS: Out of 230 relevant studies, 72 (n = 19 063) of high quality were included in meta- analyses. Self-reported function significantly improved from presurgery (55.6/100; 95% confidence interval [CI], 53.1 to 58.1) to 3-6 months postsurgery (21.1; 95% CI, 17.9 to 24.3; P <.001). A small decline in self-reported function occurred at 6-12 months (31.0; 95% CI, 25.8 to 36.2; P <.001), with no further change at 12-24 months (30.9; 95% CI, 23.2 to 38.6; P = .919). Performance-based measures exhibited variable trajectories, with most estimates indicating no clinically meaningful improvement following total knee arthroplasty. CONCLUSION: Total knee arthroplasty resulted in clinically meaningful improvements in self-reported function at 3-6 months postoperatively. There was some deterioration in function after 6 months, and at no other time point did the estimate reach a clinically important change. There was limited evidence of clinically meaningful improvements in performance-based measures of physical function at any time point.
Results: Out of 230 relevant studies, 72 (n = 19 063) of high quality were included in meta- analyses. Self-reported function significantly improved from presurgery (55.6/100; 95% confidence interval [CI], 53.1 to 58.1) to 3-6 months postsurgery (21.1; 95% CI, 17.9 to 24.3; P <.001). A small decline in self-reported function occurred at 6-12 months (31.0; 95% CI, 25.8 to 36.2; P <.001), with no further change at 12-24 months (30.9; 95% CI, 23.2 to 38.6; P = .919). Performance-based measures exhibited variable trajectories, with most estimates indicating no clinically meaningful improvement following total knee arthroplasty. CONCLUSION: Total knee arthroplasty resulted in clinically meaningful improvements in self-reported function at 3-6 months postoperatively. There was some deterioration in function after 6 months, and at no other time point did the estimate reach a clinically important change. There was limited evidence of clinically meaningful improvements in performance-based measures of physical function at any time point.
Conclusion: Total knee arthroplasty resulted in clinically meaningful improvements in self-reported function at 3-6 months postoperatively. There was some deterioration in function after 6 months, and at no other time point did the estimate reach a clinically important change. There was limited evidence of clinically meaningful improvements in performance-based measures of physical function at any time point
PHARMA-Care National Quality Framework
No full textThis is a draft report on the development of the national quality indicator framework to assist credentialed pharmacists and aged care providers in monitoring and evaluating pharmacy services in aged care homes. The report summarises findings from the project activities, including the framework domains, definitions, and quality indicators aligned with each domain
Mixed methods systematic review of consumer engagement in rural health practice, research, and education
No full textThis systematic review aimed to synthesize evidence on consumer engagement in rural health practice, research, and education. It was conducted using the JBI mixed methods methodology, specifically the convergent integrated approach. PubMed, PsychINFO, Cochrane Library, SCOPUS, Web of Science, EMBASE, and CINAHL were searched, along with gray literature sources—Google, ProQuest Dissertation, and Theses Global. Primary research studies published globally in English, from 2011 to 2024 were included. Dual reviewer screening occurred in two stages, title and abstract, then followed by full text. Critical appraisals of included studies were undertaken using McMaster Critical Appraisal Tool for quantitative and qualitative studies, respectively, and the Mixed Methods Appraisal Tool. Extracted data was synthesized to develop themes for reporting per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. This review identified 25 studies that explored the top three levels of consumer involvement in rural healthcare settings, namely Partnership, Involving, and Consumer-led, adapted from the 2011 National Framework for Consumer Involvement in Cancer Control. Five key themes were developed from the data: positive impacts of co-design, importance of relationship building, sustainability of interventions, power issues in co-design, and the importance of context. Findings showed that interventions utilizing the top three partnership levels (consumer-led, partnership, and involving) consistently lead to positive impacts on health outcomes of rural communities with higher levels of sustained engagement. Enablers and barriers were identified and categorized into a macro, micro, and meso framework for direct comparison between studies. Rural healthcare initiatives involving consumer engagement appear to have several benefits including strengthening community-researcher relationships, enhanced sustainability, and enriching local contexts while addressing power imbalances to enhance healthcare outcomes.Talisker Broadhurst, Yu Jin Cha, Caitlin Bartlett, Johanna Van Heerden, Lauren Smith, Lucylynn Lizarondo, Matthew McGrail, Bushra Nasir, Adam Hulme, Srinivas Kondalsamy-Chennakesavan, Priya Marti
Naturally derived donor-π-acceptor compounds for efficient long-wavelength LEDs/sunlight-induced polymerization and high-Precision multiple 3D printing
No full textPhotopolymerization driven by long-wavelength visible LEDs offers a promising approach for biocompatible, low-energy 3D printing, minimizing light scattering and photodamage compared to conventional ultraviolet (UV) and near-UV systems. However, the inherently slow polymerization kinetics of long-wavelength photoinitiators (PIs) typically necessitate high light intensities, extended curing times, or excessive PI loadings, limiting their practical applications. To address these challenges, the design and synthesis of two novel donor-pi-acceptor (D-pi-A) PIs are reported, incorporating 2-phenylnaphtho[2,3-d]thiazole-4,9-dione as an electron acceptor and two naturally derived aldehydes (furfural and butyraldehyde) as electron donors. These compounds enable exceptionally rapid polymerization under blue and green light LEDs, as well as natural sunlight, even at low light intensities and minimal PI concentrations. The unprecedented curing speed and efficiency are further demonstrated through the fabrication of intricate 3D structures using three distinct printing techniques-direct laser writing (DLW), digital light processing (DLP), and liquid crystal display (LCD) printing. This work expands the frontiers of long-wavelength photopolymerization by combining high efficiency with eco-friendly, low-energy activation, paving the way for advanced applications in biocompatible additive manufacturing
Multivariate Time Series Anomaly Detection by Capturing Coarse-Grained Intra- and Inter-Variate Dependencies
No full textMultivariate time series anomaly detection is essential for failure management in web application operations, as it directly influences the effectiveness and timeliness of implementing remedial or preventive measures. This task is often framed as a semi-supervised learning problem, where only normal data are available for model training, primarily due to the labor-intensive nature of data labeling and the scarcity of anomalous data. Existing semi-supervised methods often detect anomalies by capturing intra-variate temporal dependencies and/or inter-variate relationships to learn normal patterns, flagging timestamps that deviate from these patterns as anomalies. However, these approaches often fail to capture salient intra-variate temporal and inter-variate dependencies in time series due to their focus on excessively fine granularity, leading to suboptimal performance. In this study, we introduce MtsCID, a novel semi-supervised multivariate time series anomaly detection method. MtsCID employs a dual network architecture: one network operates on the attention maps of multi-scale intra-variate patches for coarse-grained temporal dependency learning, while the other works on variates to capture coarse-grained inter-variate relationships through convolution and interaction with sinusoidal prototypes. This design enhances the ability to capture the patterns from both intra-variate temporal dependencies and inter-variate relationships, resulting in improved performance. Extensive experiments across seven widely used datasets demonstrate that MtsCID achieves performance comparable or superior to state-of-the-art benchmark methods.Yongzheng Xie, Hongyu Zhang, Muhammad Ali Baba
Cost of a Mediterranean diet and walking intervention to reduce risk of dementia and improve quality of life in independent living populations in Australia: the MedWalk randomised controlled trial
No full textData source: Supplementary material, https://doi.org/10.1017/S0007114525105333There is growing evidence that optimising dietary quality and engaging in physical activity (PA) can reduce dementia and cognitive decline risk and improve psychosocial health and quality of life (QoL). Multimodal interventions focusing on diet and PA are recognised as significant strategies to tackle these behavioural risk factors; however, the cost-effectiveness of such interventions is seldom reported. A limited cost consequence based on a 12-month cluster-randomised Mediterranean diet (MedDiet) and walking controlled trial (MedWalk) was undertaken. In addition, QoL data were analysed. Programme costs (2695 AUD per participant and control group cost at 2530. Mean change in utility scores from baseline to 12 months was not statistically significant between groups. Nevertheless, the MedWalk group was significantly less likely to experience a reduction in their QoL (203 % MedWalk v. 426 % control group) (P = 0020). A MedDiet and walking intervention may have a role in preventing decline in QoL of older Australians; however, longer-term follow-up would be beneficial to see if this is maintained
EEG is better when cleaning effectively targets artifacts
No full textObjective Electroencephalography (EEG) data are contaminated by a range of non-neural artifacts. The confounding influence of artifacts is often addressed by using independent component analysis (ICA) to decompose data into components, subtracting artifactual components, then reconstructing data into the electrode space. Due to imperfect component separation, this common approach can remove neural signals as well as artifacts. Here, we demonstrate the counterintuitive finding that this can artificially inflate event-related potential and connectivity effect sizes and bias source localisation estimates, while also removing neural signals. Methods We developed a novel method that targets cleaning to artifact periods of eye movement components and artifact frequencies of muscle components, and tested our method across different EEG systems and cognitive tasks. Results Our targeted artifact reduction method was effective in cleaning artifacts while also reducing the artificial inflation of effect sizes and minimizing source localisation biases. Conclusions EEG pre-processing of Go/No-go and N400 task data is better when targeted cleaning is applied, which better preserves neural signals and mitigates effect size inflation and source localisation biases that result from subtracting artifact components. Significance These improvements enhance the reliability and validity of EEG analyses. Our method is provided in the RELAX pipeline, which is freely available as an EEGLAB plugin (https://github.com/NeilwBailey/RELAX).Neil W. Bailey, Aron T. Hill, Kate Godfrey, M. Prabhavi N. Perera, Nigel C. Rogasch, Bernadette M. Fitzgibbon, Paul B. Fitzgeral
In situ propagation-based lung computed tomography for large animal models
No full textThe lung is a complex organ with a hierarchical structure, containing four times more air than tissue. It is in constant contact with environmental factors such as pollution and pathogens, leading to pathological alterations at various hierarchical levels. Because of its intricate structure and continuous movement, lung imaging presents significant challenges for most existing techniques. Recent advancements in phase-contrast computed tomography and photon-counting detectors have greatly enhanced lung imaging capabilities. Specifically, propagation-based imaging (PBI), a phase-contrast method that does not require optical elements, has proven particularly effective at low X-ray dose rates due to the strong phase shifts between lung tissue and aerated regions. This study introduces an in situ imaging approach for large-scale lungs using PBI at the Imaging and Medical Beamline (IMBL) of the Australian Synchrotron. We investigated optimal conditions for PBI, including energy and propagation distance settings, and found that an X-ray beam energy of 70 keV combined with a 7 m propagation distance yields the highest image quality in terms of contrast-to-noise ratio while also delivering the lowest radiation dose. Furthermore, Monte Carlo simulations were performed on the reconstructed volume to calculate absorbed radiation doses in tissues. These findings provide valuable insights for designing future experiments aimed at minimizing radiation exposure and potentially enable in vivo applications in larger animals or even humans.Lorenzo D'Amico, Lucy Costello, Yakov Nesterets, Martin Donnelley, Timur Gureyev, Anton Maksimenko, Cathy Beck, Jannis Ahlers, Ronan Smith, Ying Ying How, David Parsons, Chris Hall, Daniel Hausermann, Matthew Cameron, Mitzi Klein, Marcus Kitchen, Giuliana Tromba, Christian Dullin, Kaye Morgan
E-cigarettes and cancer: a qualitative risk assessment
No full textIn Australia and like countries, an increasing number of young people are using vapes, and transitioning to tobacco smoking. There is no perception in the community of cancer risk attributable to usage of ecigarettes. COSA has the leadership authority and breadth of cancer-based expertise to assess all aspects of e-cigarettes. In this report the term e-cigarettes is identified with electronic nicotine delivery systems. This report is intended for a multidisciplinary healthcare professional readership
Special needs, special risks? A comparative oral health study in children and adolescents
No full textBackground: Despite improvements in children’s oral health, disparities persist, particularly among children with special needs. This study compares oral health risks between children attending schools for specific purposes (SSPs) and their mainstream school (MS) peers to inform targeted interventions. Methods: A retrospective cross-sectional analysis was conducted using data from school-based oral health assessments and caregiver questionnaires. Descriptive statistics, Chi-squared test and logistic regression were applied. Results. Data from 610 students (320 SSPs, 290 MS), aged 5–19 years, were analysed. Chi-squared analyses revealed MS students were more likely to consume sweet snacks several times a week (χ² = 20.06, P < 0.001), whereas untreated caries were more common among MS students than SSPs students (χ² = 8.6, P = 0.003). Logistic regression indicated that SSPs students were less likely to visit a dentist in the past year (OR 0.56, P < 0.01), had higher bodu mass index (OR 1.71, P < 0.001), were less likely to brush their teeth twice daily (OR 0.41, P < 0.001) and were more likely to consume sweet drinks daily (OR 1.38, P < 0.05). These findings highlight unique oral health challenges among SSPs students, who have high rates of disabilities and medical needs. Conclusion: Incorporating occupational therapists and speech pathologists into SSPs and school nurses in MS schools, through collaboration with oral health professionals, can enhance access to dental care and promote healthy oral care routines. For SSPs students, strategies should address sensory sensitivities, fine and oral-motor challenges and sugar drink consumption. For MS students, incorporating oral health into school health programs can identify at-risk children, facilitate referrals and strengthen connections to dental services, reducing disparities and improving well-being.Grace Wong, Kyle Cheng, Tanya Kumar, Marija Saponja, Kirrily Wright, Audrey Ng, Sanjana D'Hary, Anna Cheng, and Wenpeng Yo