The automotive industry is growing worldwide with new technologies and seeking maximum cost savings. This sector is essential for the economic development of the country, with modern industries that invest in technological innovations and control of the activities of the production process. With this, the workstations become increasingly dynamic and characterized in the logic of productivity. Therefore, this study aimed to evaluate the work activity of operators of an assembly line of automotive components, from the ergonomic analysis. Through a descriptive and exploratory field study, the work activity of 30 operators of an assembly line of metallic components of the automotive industry was evaluated. Using instruments such as sociodemographic questionnaire; Nordic questionnaire; open interview, with collective questions about the development of the function, listed in an ergonomic demand items (EDIs) ranking; and complementary application of the NIOSH and OCRA methods. As a result, all respondents were male, with an average age of 30.13 ± 8.57 years, most had completed high school (76.7%), with an average working time in the company of almost two years (21.93 ± 12 months). Regarding relationships with coworkers, it was observed that the sector has a great relationship during the activities, with both colleagues and the boss. This study demonstrated a lower frequency of musculoskeletal symptoms in operators when compared to other studies. Symptoms that caused work leave were neck (3.3%), shoulders (3.3%), upper (6.7%) and lower back (6.7%), and hips/thighs (6.7%), ankle/foot (6.7%) were reported.
Aim: The aim was to review several aspects of work using ultrasound in diagnosing developmental dysplasia of the hip and analyze the application status of the Graf technique in Beijing over 15 years.
Methods: First, data on the promotion and development of the Graf technique in Beijing over the past 15 years were retrospectively analyzed. Second, data on hip ultrasound (US) screening and the effect of consecutive brace therapy were collected and analyzed. Infants were divided into subgroups according to Graf type, age at initiation of treatment, sex, and affected side.
Results: The ultrasound detection rate of developmental dysplasia of the hip (DDH) was high at Beijing Jishuitan Hospital. The total detection rate of type IIa, IIb, IIc, D, III and IV (abbreviated as: types IIa and worse) was 4.58%, and that of type IIb, IIc, D, III and IV (abbreviated as: types IIb and worse) was 1.40%. Clinicians should pay attention to DDH, and early treatment is important; therefore, it is recommended that infants and young children undergo DDH ultrasound screening as soon as possible. Our research shows that when the α angle was more than 43°, the efficacy of brace therapy was 95.95%.
Conclusions: It was confirmed that the Graf technique has greater practicality and accuracy. The Graf technique, as an important means for the early screening of DDH, has been widely recognized around the world, and it is recommended to be widely used in China to preserve future health in as many children as possible.
Gout is common in people with chronic kidney disease and in general is sub-optimally managed. Lack of evidence due to the exclusion of people with chronic kidney disease from the majority of clinical trials, concerns about adverse effects and conflicting gout management guidelines all contribute to suboptimal management. Herein we review the evidence for the pharmacological treatment of gout, both flares and long-term urate-lowering, in people with concomitant chronic kidney disease.
Aim: To ascertain the prevalence of calcium pyrophosphate arthritis (CPPA) at diagnosis and during follow-up of patients with gout.
Methods: Inception cohort of patients with gout prospectively recruited and followed-up from 1994–2023. Gout-case was defined as crystal-proved tophus or arthritis, or the presence of tophus plus double contour with ultrasonography. CPPA was defined as the presence of intra-leukocyte calcium pyrophosphate (CPP) crystals in synovial fluid (SF) and neat chondrocalcinosis in plain radiographs. Age, gender, time from onset of symptoms, number of flares, joint distribution, previous and prescribed treatments, colchicine prophylaxis, comorbidities, alcohol intake, use of diuretics, renal function, and previous vascular disease were available for analysis.
Results: A total of 1,544 patients with gout, with an average of 4-year follow-up, were available for analysis. CPPA was observed in 127/1,544 cases (8.2%). In 37/1,544 patients (2.4%) CPP and monosodium urate (MSU) crystals were observed in the same SF sample at gout diagnosis, and 90/1,544 (5.8%) showed CPP crystals apart from the diagnosis of gout. CPPA-gout cases had more flares per year, but no more frequent polyarticular distribution at baseline compared to non-CPPA-gout. CPPA-gout cases were older at baseline and showed lower renal function. Women, patients using diuretics, patients with hypertension, and those with previous vascular events showed CPPA more frequently. Multivariate analysis showed that only age and use of diuretics were independently associated with CPPA, as other variables apparently associated were dependent on aging. Interestingly, an analysis of the prevalence in the three decades available showed an increased CPPA diagnosis through time, probably associated with increased awareness of the association.
Conclusions: (1) CPPA is not infrequent in patients with gout; (2) it is associated with aging and diuretic use; (3) awareness of this association may increase the rate of diagnosis.
Aim: To evaluate the impact of prescription, cost, and switching policy on the rate of switching from reference products to biosimilars.
Methods: Analysis of an administrative database for prescription in a rheumatology division. Biosimilars for adalimumab and etanercept were available in 2019. Blinded costs and prescription data were not shared with prescribing physicians until 2021. The rate of prescription, persistence of therapy after switching, and reduction of cost were analyzed from 2019 to 2022. A new etanercept biosimilar was prioritized in 2022, and a new switching wave from biosimilar to biosimilar etanercept was implemented.
Results: Overall switching from 2019 to 2022 comprised 132/135 (97.8%) of patients. The rate of switching increased from 13.3% to 34%, 79%, and 95.5% of patients on reference products during 2019, 2020, 2021, and 2022, respectively. In 2022, after sharing information, the switch comprised 55/135 (40.7%) of overall switching. The rate of persistence on therapy after switching was 86.8% for etanercept and 79.7 for adalimumab. During 2023, a rate of 76.6% switching etanercept reference-biosimilar-biosimilar was achieved. The reduction in the overall biologic budget in 2021 was 19.2% and 29.0% for the patient-year cost.
Conclusions: Information to prescribers may improve switching policies. Persistence on biosimilar medications after switching is as high as previously reported.
Background: The aim of the study was to conduct a literature review within the fields of sports and orthopedic rehabilitation to evaluate the efficacy of interventions incorporating electromyographic feedback (EMG FB) training compared to same interventions without EMG FB.
Methods: A systematic search of three databases (PubMed, Cochrane, and Web of Science) was conducted until February 2023, without limitation on the publication date. The search strategy adhered to the PRISMA guidelines. Inclusion criteria and data extraction protocol were established a priori. The methodological quality of the included primary studies was assessed by using the PEDro scale.
Results: A total of ten randomized controlled trials (RCTs; 2 in sports and 8 in orthopedic rehabilitation) involving 397 participants were included. The outcomes were categorized into three areas: 1) muscle strength and activation, 2) pain perception, and 3) functionality and joint range of motion. The quality of these studies ranges from 5 to 8 on the PEDro scale. The findings demonstrate both significant and non-significant differences between the interventions with and without EMG FB across all categories. The calculated effect sizes vary from small to large.
Discussion: This review suggests that EMG FB training can be effective to enhance muscle strength, muscle control, pain reduction, functionality, and joint range of motion. The studies provide evidence for the varying impacts of EMG FB training, demonstrating both significant and non-significant outcomes across different populations and intervention types. These differences within the findings not only highlight the potential of EMG FB, but also emphasize the need for further research to identify the conditions and populations in which EMG FB is most effective.
Aim: Physical activity (PA) is increasingly used as a patient-centered means to treat and/or cope with pain and other symptomology resulting from clinical health conditions. Despite the increasing use of wearable sensors to track PA in healthy and patient cohorts, few algorithms are equally accurate in assessing sedentary and light PA as moderate and vigorous. Given that many older adults and patient cohorts are less active, there is a need for simple algorithms that are easily implemented and valid for the assessment of even low activity levels. Thus, the purpose of this study was to test a simple nonlinear modification to a validated linear algorithm for hip- and wrist-worn accelerometry to measure human PA energy expenditure.
Methods: Triaxial accelerometers were worn on the wrist and hip during 14 standardized laboratory-based activities in 37 healthy adults across the lifespan [19–65 years, 19 females (F)]. Combined with previously reported energy expenditure data, linear and power equations transforming accelerations to estimates of oxygen consumption (VO2) were compared.
Results: The nonlinear algorithm provided equally accurate measures of PA energy expenditure as linear approaches, with the added advantage of being able to estimate even low energy expenditure, a necessary outcome to differentiate sedentary and light PA. Further, the nonlinear algorithm produced a slightly better estimate of PA when using wrist than hip accelerometry.
Conclusions: A simple nonlinear algorithm provides a better means for monitoring PA in populations with low activity levels due to its improved ability to discern sedentary from light PA. This is particularly relevant for older and clinical populations as even light levels of PA may provide therapeutic benefits.