Speeding up: Discrete mediolateral perturbations increased self-paced walking speed in young and older adults.

BACKGROUND: In uncertain environments and with increasing age, humans often walk, slower while taking shorter, quicker, and wider steps, reflective of a cautious gait., Understanding when humans opt to use a cautious gait and the differences in gait, strategies used as people age could be examined with perturbations on a self-paced, treadmill that allows participants to adjust their walking speed. Adding varying degrees, of unpredictability, an inherent element of real-world walking, could also improve, understanding of when specific gait strategies are used RESEARCH QUESTION: We investigated how healthy young and older adults adjust their, gait strategies when responding to perturbations of varying unpredictability. We, hypothesized that more unpredictable perturbations would produce more cautious gait, strategies and be more pronounced in older adults than young adults METHODS: Ten young and ten older adults walked on a self-paced treadmill with, discrete mediolateral treadmill shift perturbations. We changed the shift magnitude, and/or the timing of the perturbations during the gait cycle to vary perturbation, unpredictability. We analyzed walking speed and step kinematics from treadmill and, motion capture data RESULTS: Surprisingly, participants walked faster, not slower, for the conditions with, perturbations. Even more surprising, older adults walked faster overall than young, adults. As expected, participants took faster and wider steps for the most unpredictable, perturbation but also took longer steps, which was not expected. Step kinematic, variability and average step width also increased as perturbation unpredictability, increased, suggesting that the more unpredictable conditions demanded greater, balance control. Additionally, older adults had greater step kinematic variability, highlighted further using detrended step length variability, compared to young adults SIGNIFICANCE: Overall, these findings provide new insights about gait strategies and, suggest that perturbations such as discrete mediolateral treadmill shifts can potentially, be designed to encourage participants to walk faster, if it is beneficial.

Sentido de vida y su asociación con la ansiedad y la depresión en jóvenes / Meaning in life and its association with anxiety and depression in young people

Resumen El sentido de vida se ha convertido en una importante variable salutogénica en las poblaciones más jóvenes. La investigación ha evidenciado que el sentido de vida está relacionado con la disminución de comportamientos de riesgo, como el consumo de sustancias psicoactivas, y es un factor protector frente a diferentes problemáticas de salud, que van desde los eventos cardiovasculares hasta la disminución de la aparición de sintomatología ansiosa y depresiva. El objetivo de este estudio fue identificar cómo esta variable se asocia con la ansiedad y la depresión en un grupo de adolescentes y jóvenes. Se analizaron los datos de 596 participantes colombianos cuyas edades oscilaron entre 18 y 24 años (M = 21; DE = 1.74; 68 % mujeres y 32 % hombres). Se utilizaron la Escala Dimensional de Sentido de Vida y la Escala para la Depresión, la Ansiedad y el Estrés (DASS-21). En primer lugar, se encontraron diferencias significativas en las puntuaciones de sentido de vida en las siguientes variables: los participantes que reportaron algún diagnóstico de enfermedad, consumo de sustancias psicoactivas y estrato socioeconómico. Se presenta un modelo resultante de un análisis de ecuaciones estructurales basado en cuadrados mínimos parciales. El modelo tuvo índices de ajuste adecuado (NFI = .84; SRMR = .06). El sentido de vida se asoció negativa y significativamente con la ansiedad y la depresión. Los resultados encontrados presentan implicaciones para la investigación al tiempo que se constituyen en sustento empírico para incluir la variable en programas de intervención y prevención, de tal forma que puedan evaluarse objetivamente y consigan disminuir las puntuaciones de ansiedad y depresión en jóvenes.

Abstract Around 300 million people in the world suffer from depression and anxiety. Both have become, according to the main organizations, one of the first causes of disability and lost work years on the planet. Not to mention that depression is one of the main antecedents of deaths by suicide. Both have a special impact on young populations and adolescents. In Colombia the data is not more encouraging, around 53 % of the young people has at least one symptom of anxiety and 80 % have at least one symptom of depression. Given this data, anxiety and depression constitute important health problems that require sufficient attention. On the other hand, the meaning in life has become an important salutogenic variable in younger populations. Recent research has shown that the meaning in life is related to the reduction of risk behaviors, such as the consumption of psychoactive substances, and is a protective factor against different health problems, ranging from cardiovascular events to the reduction of the appearance of anxious and depressive symptoms. Based on the above, the objective of this study was to identify how the meaning in life is associated with anxiety and depression in adolescents and young people. The data of 596 Colombian participants whose ages ranged between 18 and 24 years (M = 21; SD = 1.74; 68 % women and 32 % men) were analyzed, the only condition to participate was knowing how to read and write. The Dimensional Meaning Life Scale and the Scale for Depression, Anxiety and Stress (DASS-21) were used. Firstly, significant differences were found in the meaning in life scores in the participants who reported a diagnosis of disease, consumption of psychoactive substances and socioeconomic condition. The highest meaning scores were obtained by people who did not have a diagnosis of medical or psychological illness, who did not consume any psychoactive substances, and people in the highest socioeconomic status. Likewise, there were differences for anxiety and depression, people with a diagnosis of disease and who consume psychoactive substances had higher scores for both anxiety and depression. Women had higher anxiety scores, and people from the lowest socioeconomic conditions had the highest scores for depression. A model resulting from an analysis of structural equations based on partial least squares is presented. The model had adequate fit indices (NFI = .84; SRMR = .06). The meaning in life was negatively and significantly associated with anxiety and depression. The path coefficients of the latent variable meaning in life show an impact of -.49 on anxiety and -.71 on depression. According to the R squared values, the meaning of life explains 24 % of the presence of anxiety symptoms and around 51 % of depression. Regarding the measurement model, both the Dimensional Meaning in Life Scale and the Scale for Depression, Anxiety and Stress (DASS-21) showed excellent adjustments in the measurement and operationalization of the latent variables. The results found present implications for research, and they also constitute empirical support to include the variable in intervention and prevention programs that can be objectively evaluated and reduce anxiety and depression scores in adolescents and young people, which would also allow to reduce all the negative consequences associated with both pathologies. Other projections and limitations associated with what was found in this research are discussed.

Speed-related but not detrended gait variability increases with more sensitive self-paced treadmill controllers at multiple slopes.

Self-paced treadmills are being used more frequently to study humans walking with their self-selected gaits on a range of slopes. There are multiple options to purchase a treadmill with a built-in controller, or implement a custom written self-paced controller, which raises questions about how self-paced controller affect treadmill speed and gait biomechanics on multiple slopes. This study investigated how different self-paced treadmill controller sensitivities affected gait parameters and variability on decline, level, and incline slopes. We hypothesized that increasing self-paced controller sensitivity would increase gait variability on each slope. We also hypothesized that detrended variability could help mitigate differences in variability that arise from differences in speed fluctuations created by the self-paced controllers. Ten young adults walked on a self-paced treadmill using three controller sensitivities (low, medium, and high) and fixed speeds at three slopes (decline, -10°; level, 0°; incline, +10°). Within each slope, average walking speeds and spatiotemporal gait parameters were similar regardless of self-paced controller sensitivity. With higher controller sensitivities on each slope, speed fluctuations, speed variance, and step length variance increased whereas step frequency variance and step width variance were unaffected. Detrended variance was not affected by controller sensitivity suggesting that detrending variability helps mitigate differences associated with treadmill speed fluctuations. Speed-trend step length variances, however, increased with more sensitive controllers. Further, detrended step length variances were similar for self-paced and fixed speed walking, whereas self-paced walking included substantial speed-trend step length variance not present in fixed speed walking. In addition, regardless of the self-paced controller, subjects walked fastest on the level slope with the longest steps, narrowest steps, and least variance. Overall, our findings suggest that separating gait variability into speed-trend and detrended variability could be beneficial for interpreting gait variability among multiple self-paced treadmill studies and when comparing self-paced walking with fixed speed walking.

Safety and Performance of Titanium Suture Anchors Used in Knee Ligament Repair Procedures.

Injuries to the knee ligaments can be particularly disabling in young patients, given the risk of long-term disability if adequate fixation is not achieved during initial repair. The TWINFIX™ titanium (Ti) suture anchor with ULTRABRAID™ Suture (Smith and Nephew, London, UK) was designed to secure tendon and ligament reconstructions with increased boney ingrowth at the anchor site with minimal invasive technique. This retrospective analysis looked at 33 patients (41 implants) operated with this device between 2015 and 2019 at a single institution. The average age of patients was 33.18 years (standard deviation [SD], 15.26), with an average body mass index of 24.88 (SD, 3.49). The indications were lateral extra-articular tenodesis during anterior cruciate ligament reconstruction, medial patellofemoral ligament reconstruction, quadriceps or patellar tendon repair and medial collateral ligament repair. After an average follow up of 24.3 + 6.53 months, there was no reports of clinical failure or radiographic evidence of implant failure or loosening. One patient experienced a complication unrelated to the study device, requiring manipulation under anesthesia with resolution of symptoms. This case series supports the safety and performance of this implants for the knee procedures in which its use is indicated. Additional follow-up will be required to determine whether these effects are sustained at medium- and long-term durations.

Peer review versus editorial review and their role in innovative science.

Peer review is a widely accepted instrument for raising the quality of science. Peer review limits the enormous unstructured influx of information and the sheer amount of dubious data, which in its absence would plunge science into chaos. In particular, peer review offers the benefit of eliminating papers that suffer from poor craftsmanship or methodological shortcomings, especially in the experimental sciences. However, we believe that peer review is not always appropriate for the evaluation of controversial hypothetical science. We argue that the process of peer review can be prone to bias towards ideas that affirm the prior convictions of reviewers and against innovation and radical new ideas. Innovative hypotheses are thus highly vulnerable to being "filtered out" or made to accord with conventional wisdom by the peer review process. Consequently, having introduced peer review, the Elsevier journal Medical Hypotheses may be unable to continue its tradition as a radical journal allowing discussion of improbable or unconventional ideas. Hence we conclude by asking the publisher to consider re-introducing the system of editorial review to Medical Hypotheses.

Cáncer cérvicouterino y embarazo: experiencia de cinco años en el Hospital de Gineco-Obstetricia No. 3, C. M. La Raza del Instituto Mexicano del Seguro Social / Cervicouterine cancer and pregnancy: five years experience at Hospital of ginecoobstetricia No. 3 C. M. La Raza Instituto Mexicano del Seguro Social

De un total de 300 expedientes clínicos de mujeres embarazadas, 22 presentaron la asociación de cáncer más embarazo en un período de cinco años, siete fueron excluidas en el estudio. Quince pacientes con el diagnóstico de CaCu y embarazo, fueron vistas en el Hospital de gineco-Obstetricia No. 3, C.M. La Raza del IMSS, en un período comprendido del 1o. de enero de 1988 al 31 de diciembre de 1992. La aparición temprana de la menarca y la vida sexual activa iniciada antes de los 15 años, la multiparidad y el tabaquismo intenso adquieren un papel muy importante en la mujer mexicana como factores predisponentes para CaCu. La colposcopía con biopsia dirigida del cérvix, es el procedimiento diagnóstico de elección, con 99.5 por ciento de confiabilidad en la mujer embarazada. En los 15 casos estudiados, la estirpe epidermoide fue la única encontrada en nuestras pacientes. La edad del embarazo en que se hizo el diagnóstico fue en la gran mayoría de las pacientes en el primer trimestre de la gestación. Sólo en tres pacientes (20 por ciento) se encontró lesión visible, lo que apoya la necesidad de realizar pesquisa del CaCu durante el embarazo, tomando muestra rutinariamente del Papanicolaou. Las etapas preinvasoras e invasoras tempranas durante el embarazo son altamente curables. Se observó peor pronóstico por invasión y racaída temprana en las pacientes, en comparación con las no embarazadas etapa por etapa. Por lo tanto el cáncer cérvicouterino sí modifica su pronóstico de sobrevida al estar asociado con embarazo, lo anterior respaldado en la revisión de la literatura al respecto, siendo estadísticamente significativa la presencia del embarazo como factor de recaída temprana por mayor agresividad invasora de la neoplasia, comparándola con la no embarazada