Identifying discriminative features for diagnosis of Kashin-Beck disease among adolescents

Introduction Diagnosing Kashin-Beck disease (KBD) involves damages to multiple joints and carries variable clinical symptoms, posing great challenge to the diagnosis of KBD for clinical practitioners. However, it is still unclear which clinical features of KBD are more informative for the diagnosis of Kashin-Beck disease among adolescent. Methods We first manually extracted 26 possible features including clinical manifestations, and pathological changes of X-ray images from 400 KBD and 400 non-KBD adolescents. With such features, we performed four classification methods, i.e., random forest algorithms (RFA), artificial neural networks (ANNs), support vector machines (SVMs) and linear regression (LR) with four feature selection methods, i.e., RFA, minimum redundancy maximum relevance (mRMR), support vector machine recursive feature elimination (SVM—RFE) and Relief. The performance of diagnosis of KBD with respect to different classification models were evaluated by sensitivity, specificity, accuracy, and the area under the receiver operating characteristic (ROC) curve (AUC). Results Our results demonstrated that the 10 out of 26 discriminative features were displayed more powerful performance, regardless of the chosen of classification models and feature selection methods. These ten discriminative features were distal end of phalanges alterations, metaphysis alterations and carpals alterations and clinical manifestations of ankle joint movement limitation, enlarged finger joints, flexion of the distal part of fingers, elbow joint movement limitation, squatting limitation, deformed finger joints, wrist joint movement limitation. Conclusions The selected ten discriminative features could provide a fast, effective diagnostic standard for KBD adolescents.

Forced Duction Test: Is It Necessary after the Scleral Buckling Procedure?

A 14-year-old boy who had ocular motility disorder which started 2 weeks following retinal surgery (scleral buckling) secondary to rhegmatogenous retinal detachment, was referred to the strabismus clinic. He had significant ocular movement limitations in adduction and elevation under general anesthesia. The forced duction test (FDT) was positive in both adduction and elevation. After buckle removal, FDT was negative. The eye was orthotropic without ocular movement limitation at final follow-up. In conclusion, FDT at the end of the scleral buckling procedure needs to be performed. It may prevent restrictive strabismus after scleral buckling surgery.

Effect of Massage Therapy With and Without Elastic Bandaging on Pain, Edema, and Shoulder Dysfunction After Modified Radical Mastectomy: A Clinical Trial

Objectives: Pain and shoulder dysfunction are among the adverse and prevalent conditions in post-mastectomy women. Therefore, the present study aimed to examine massage therapy with and without elastic bandaging on pain, edema, and shoulder dysfunction after modified radical mastectomy. Materials and Methods: This was a clinical trial conducted at Imam Reza hospital, Tabriz, Iran, from December 22, 2018, to May 5, 2019. Ninety women participated in this study and were randomly divided into three groups of 30 (i.e., Manual lymph drainage, Manual lymph drainage plus reduced-compression bandaging, and control) based on a random number table. Patients and their companions were instructed on the intervention to be performed at home on a daily basis 24 hours after surgery with the help of a trained research assistant. Data were entered in the relevant forms before and after the intervention, including demographic information, shoulder pain and dysfunction index (SPDI), and edema checklist. Data were analyzed through descriptive statistics, one-way ANOVA, and the Kruskal-Wallis test in SPSS 19. P<0.05 was considered statistically significant. Results: The comparison of the main variables between the three groups before and after the intervention showed no statistically significant difference (P>0.0560). The intervention could significantly change pain intensity and shoulder movement limitation (P=0.001). However, there was no difference in the edema variable before and after the intervention (P=0.25). Conclusions: In general, massage therapy with and without elastic bandaging had a positive effect on shoulder movement limitation and pain whereas it had no such effect on edema drainage.

Impact ways of limiting train traffic for the duration of subgrade works

The article contains the results of the analysis of the method of limiting train traffic for the duration of the reconstruction of the subgrade based on the experience of modernization of the fragment of the railway line No. 6. Described the track closures types influencing the scale of train movement limitation, used in the repair and modernization subgrade works. Presented the conditions of conducting works at each type of closures.

Preferential factors and usability effects on vehicle modifications for the Malaysian independent disabled driver

The usability of driving modifications for a person with disabilities is known to be an important aspect in addressing the independent vehicle’s driving capabilities. The existence of assistive modifications such as hand control, secondary control, foot control, and also the wheelchair assisted vehicle, which were developed to accommodate limitations were found to be widely used. A survey was conducted on 202 Malaysian independent disabled drivers from Kuala Lumpur, Selangor, Perak, Johor Baharu, Terengganu, and also Melaka. The components evaluated in the survey include the origin of modification used for driving, factors influencing the decision on the type of vehicle modification, usability difficulties when modification is in use, the satisfaction level of product appearance, as well as to understand user preferences when making decisions between modifications. A Likert scale of 1 to 5 was used as measurement, in order to rate the score given by the responses for each question in the survey. As a result, it was discovered that aspects such as the modification colour, shape, the toggle, pedal grip, regulation, modification availability, and movement limitation on the involved body part are among the major factors influencing the driver to make modification for driving purposes. Major factors were also found to influence the driving modification preferences to suit the category of disabilities. It was also discovered that components such as the availability of modification information and emergency driving situations are some of the least important factors influencing the decision to make and select a suitable driving modification. However, these less important components must not be ignored as it also contributes to the improvement for independent disabled driving, and also for the purpose of assistive product development.

The relevance of a fast and early diagnosis of necrotizing fasciitis in the Emergency Department: a case report

We report a case of necrotizing fasciitis in an 84 year-old man affected by diabetes mellitus. The patient was admitted in the Emergency Department of our hospital because of an acute and strong left leg pain that began almost 8 hours before admission. The left leg had an increased size and a movement limitation, with a hard haemathoma in the left thigh with subcutaneous crepitus. The lesion became worse and larger rapidly, with a wide extension from the back to the popliteal fossa. An antimicrobial therapy was immediately started with morphine for pain. A surgical debridment was performed, but the patient died for multiorgan failure. Necrotizing fasciitis is a rare and mortal disease, the early diagnosis is a challenge for the Emergency Department where patients are admitted and assessed primarly.

Gabapentin Treatment for Neuropathic Pain in a Child with Sciatic Nerve Injury

There are a restricted number of studies about usage of gabapentin for neuropathic pain treatment of pediatric patients. We shared a 12-year-old male case with severe neuropathic pain that hindered the rehabilitation programme for the loss of muscle power and movement limitation. Neuropathic pain developed after peripheral sciatic damage due to firearm traumatisation did not respond to other medical treatments but healed nearly completely after gabapentin usage.