Effectiveness of Interventions Aimed at Changing Movement Patterns in People With Patellofemoral Pain: A Systematic Review With Network Meta-analysis.

OBJECTIVE: To summarize the effectiveness of interventions for changing movement during weight-bearing functional tasks in people with patellofemoral pain (PFP). DESIGN: Systematic review with network meta-analysis (NMA). LITERATURE SEARCH: Medline, Embase, CINAHL, SPORTDiscus, and Cochrane Library were searched from inception up to May 2023. STUDY SELECTION CRITERIA: Randomized controlled trials involving people with PFP and nonsurgical, nonpharmacological interventions on task kinematics were included. DATA SYNTHESIS: NMA was conducted for frontal knee movement data, and pairwise meta-analysis was used to pool data when NMA was not possible. Reduced movements were those changes that indicated movements occurring with less amplitude. The GRADE approach was used to grade the certainty of the evidence. RESULTS: Thirty-seven trials were included (n = 1235 participants). Combining knee/hip exercises with internal feedback had the strongest effect on reducing frontal knee movements (standardized mean difference [SMD] from NMA = -2.66; GRADE: moderate evidence). On pairwise comparisons, the same combination of interventions reduced frontal hip movements (SMD = -0.47; GRADE: moderate evidence) and increased sagittal knee movements (SMD = 1.03; GRADE: moderate evidence), with no effects on sagittal hip movements (GRADE: very low evidence), compared to knee/hip exercises alone. There was no effect for single applications of braces on the frontal knee movement (GRADE: very low evidence) and taping on movements of the knee, hip, and ankle (GRADE: very low to low evidence) compared to no intervention. CONCLUSION: Knee/hip exercises combined with internal feedback techniques may change knee and hip movements in people with PFP. The combination of these interventions can reduce frontal knee and hip movements, and can increase sagittal knee movements. J Orthop Sports Phys Ther 2023;53(12):1-13. Epub 14 September 2023. doi:10.2519/jospt.2023.11956.

Head-to-head comparison of the WHO STEPwise approach with immediate unattended and delayed unattended automated blood pressure measurements during household-based screening: a diagnostic accuracy study in Lesotho.

Background: WHO introduced the STEPwise approach to surveillance (STEPS) to monitor trends in non-communicable diseases. For arterial hypertension, the STEPS protocol takes the average of the last two out of three standard blood pressure measurements (SBPM). This study assesses the diagnostic accuracy of SBPM, same-day and next-day unattended automated measurement (uABP), with 24 h ambulatory measurement (24 h-ABPM) as reference. Methods: This diagnostic accuracy study was done within a population-based household survey on cardiovascular risk factors in two districts in Northern Lesotho. Adults (aged ≥ 18 years) with elevated SBPM (defined as ≥140/90 mmHg), and 2:1 age- and sex-matched participants with normal SBPM during the survey were recruited. Following SBPM, first uABP readings were obtained on survey day. Afterwards, participants received a 24 h-ABPM device. Second uABP readings were taken 24 h later, after retrieval of the 24 h-ABPM. The main outcome was overall diagnostic accuracy of all screening measurements (SBPM, first uABP, and second uABP), determined using area under the receiver operating characteristic curve (AUROC), with 24 h-ABPM as a reference. Findings: Between November 2, 2021 and August 31, 2022, 275 participants (mean age 58 years (SD: 16 years), 163 (59%) female) were enrolled, 183 of whom had elevated and 92 had normal SBPM. Mean difference between systolic daytime 24 h-ABPM and screening measurements was highest for SBPM (mean difference: -13 mmHg; 95% CI: -14 to -11). Mean difference between diastolic daytime 24 h-ABPM and diastolic SBPM was -2 mmHg (95% CI: -4 to -1), whereas no difference was found for mean diastolic first uABP (mean difference: -1 mmHg; 95% CI: -2.0 to 0.3); and mean diastolic second uABP (mean difference: 1.0 mmHg; 95% CI: -0.4 to 2.3). White coat hypertension was highest with SBPM (55 [20%]), followed by first uABP (27 [9.8%]), and second uABP (18 [6.5%]). Using systolic daytime 24 h-ABPM as a reference, the uABPs had higher AUROC (first uABP: 87% [95% CI: 83-91]; second uABP: 88% [95% CI: 84-92]); SBPM: (79% [95% CI: 74-85]). This difference was significant between first uABP and SBPM (P = 0.0024), and between second uABP and SBPM (P = 0.0017). Interpretation: uABP had better diagnostic performance than SBPM. Integration of uABP into STEPS protocol should be considered. Funding: Swiss Agency for Development and Cooperation under the ComBaCaL project, and the World Diabetes Foundation.

Optimization and validation of LLE-LTP to determine florpyrauxifen-benzyl herbicide in water samples by HPLC-DAD.

Florpyrauxifen-benzyl is a systemic herbicide which acts on weeds of common occurrence in rice cultivation areas using flooded or rainfed systems. The Brazilian Health Regulatory Agency (ANVISA) authorized the commercialization of this pesticide, but did not establish guidelines with an extraction and quantification method of residues of this compound as a form of environmental monitoring. Therefore, the present study aimed to optimize and validate the liquid-liquid extraction with low temperature purification (LLE-LTP) to determine florpyrauxifen-benzyl content in water samples by high performance liquid chromatography with diode array detection (HPLC-DAD). The recovery ranged from 95.84 to 105.4% with a relative standard deviation less than 1.5. LLE-LTP was selective, precise, accurate, linear in the range from 4.00 to 150 µg L-1, and the limit of quantification was 4.00 µg L-1. The stability study of the compound in water revealed its degradation in 25 days and DT50 in approximately 5 days. LLE-LTP coupled to HPLC-DAD presented itself as a simple, easy and efficient method of extracting and analyzing it in water samples.

Catharanthus roseus potential for phyto-stabilizing metals in sewage sludge.

This work evaluated the potential of Catharanthus roseus in phytoremediation of As, Ba, Cd, Cu, Cr, Ni, Pb, Se and Zn in sewage sludge-based substrates. C. roseus was cultivated for 108 days in a treatment containing sewage sludge:vermiculite (70:30%) and in the control with 100% commercial substrate. The plants cultivated in sludge showed approximately four times greater height, number of leaves and stem diameter, as well as 89% higher fresh mass than those of the control. The highest concentrations of the metals were obtained in the roots of plants grown in the sludge, and ranged from 2.04 (Cd) to 1121 mg kg-1 (Zn). Cu, Cd and Zn had a higher bioconcentration factor than 1 in both treatments. On the other hand, the translocation factor value in the control was greater than 1 for Ba, Cd, Cu, Ni, Se and Zn. The results showed that C. roseus was efficient in the phytoremediation of the evaluated metals, in which the translocation process was progressive in the treatment that presented higher metal content.

Easy and fast extraction methods to determine organochlorine pesticides in sewage sludge, soil, and water samples based at low temperature.

Organochlorine pesticides present in sewage sludge can contaminate soil and water when they are used as either fertilizer or agricultural soil conditioner. In this study, the technique solid-liquid extraction with low temperature purification was optimized and validated for determination of ten organochlorine pesticides in sewage sludge and soil samples. Liquid-liquid extraction with low temperature purification was also validated for the same compounds in water. Analyses were performed by gas chromatography-mass spectrometry operating in the selective ion monitoring mode. After optimization, the methods showed recoveries between 70% and 115% with relative standard deviation lower than 13% for all target analytes in the three matrices. The linearity was demonstrated in the range of 20 to 70 µg L-1, 0.5 to 60 µg L-1, and 3 to 13 µg L-1, for sludge, soil, and acetonitrile, respectively. The limit of quantification ranged between 2 and 40 µg kg-1, 1 and 6 µg kg-1, and 0.5 µg L-1 for sludge, soil, and water, respectively. The methods were used in the study of pesticide lixiviation carried out in a poly vinyl chlorine column filled with soil, which had its surface layer mixed with sludge. The results showed that pesticides are not leached into soil, part of them is adsorbed by the sewage sludge (4-40%), and most pesticides are lost by volatilization.