Objective Radiographic measures of the pathologic changes of knee osteoarthritis (OA) have shown modest associations with clinical pain. We sought to evaluate possible differences in quantitative sensory testing (QST) results and psychosocial distress profiles between knee OA patients with discordant versus congruent clinical pain reports relative to radiographic severity measures. Methods A total of 113 participants (66.7% women; mean ± SD age 61.05 ± 8.93 years) with knee OA participated in the study. Radiographic evidence of joint pathology was graded according to the Kellgren/ Lawrence scale. Central sensitization was indexed through quantitative sensory testing, including heat and pressure–pain thresholds, tonic suprathreshold pain (cold pressor test), and repeated phasic suprathreshold mechanical and thermal pain. Subgroups were constructed by dichotomizing clinical knee pain scores (median split) and knee OA grade scores (grades 1–2 versus 3–4), resulting in 4 groups: low pain/low knee OA grade (n = 24), high pain/high knee OA grade (n = 32), low pain/high knee OA grade (n = 27), and high pain/low knee OA grade (n = 30). Results Multivariate analyses revealed significantly heightened pain sensitivity in the high pain/low knee OA grade group, while the low pain/high knee OA grade group was less pain-sensitive. Group differences remained significant after adjusting for differences on psychosocial measures, as well as age, sex, and race. Conclusion The results suggest that central sensitization in knee OA is especially apparent among patients with reports of high levels of clinical pain in the absence of moderate-to-severe radiographic evidence of pathologic changes of knee OA.
The quality of the constructed social infrastructure project has been considered a necessary measure for the sustainability of projects. Studies on factors affecting project quality have used various techniques and methods to explain the relationships between particular variables. Unexpectedly, Structural Equation Modeling (SEM) has acquired very little concern in factors affecting project quality studies. To address this limitation in the body of knowledge, the objective of this study was to apply the SEM approach and build a model that explained and identified the critical factors affecting quality in social infrastructure projects. The authors developed a quantitative approach using smart-PLS version 3.2.7. This study shed light on the views of different experts based on their experience in public construction projects in Pakistan. Particularly, the authors aimed to find out the relationships between construction, stakeholders, materials, design, and external factors, and how these relate to project quality. The findings of this study revealed that the R 2 value of the model was scored at 0.749, which meant that the five exogenous latent constructs collectively explained 74.9% of the variance in project quality. The Goodness-of-Fit of the model was 0.458. The construction related factor was the most important out of the five constructs. This study determined that better planning and monitoring and evaluation should be developed to better address and control the quality defects by decision-makers, project managers as well as contractors. These findings might support practitioners and decision makers to focus on quality related problems that might occur in their current or future projects.
HighlightsPentavalent reassortant rotavirus vaccine was tested for efficacy in infants.The vaccine (BRV-PV) showed excellent tolerability and a good safety profile.Primary analysis efficacy was 36% against SRVGE and up to 60.5% against VSRVGE.The efficacy through 2 years of age was 39.5% (SRVGE) and 54.7% (VSRVGE).The intent to treat analyses confirmed all the per protocol analyses.
ContextHashimoto's thyroiditis (HT) and Graves' disease (GD), two autoimmune thyroid diseases (AITD), occur more frequently in women than in men and show an increased incidence in the years following parturition. Persisting fetal cells could play a role in the development of these diseases.ObjectiveAim of this study was to detect and characterize fetal cells in blood of postpartum women with and without an AITD.ParticipantsEleven patients with an AITD and ten healthy volunteers, all given birth to a son maximum 5 years before analysis, and three women who never had been pregnant, were included. None of them had any other disease of the thyroid which could interfere with the results obtained.MethodsFluorescence in situ hybridization (FISH) and repeated FISH were used to count the number of male fetal cells. Furthermore, the fetal cells were further characterized.ResultsIn patients with HT, 7 to 11 fetal cells per 1.000.000 maternal cells were detected, compared to 14 to 29 fetal cells in patients with GD (p = 0,0061). In patients with HT, mainly fetal CD8+ T cells were found, while in patients with GD, fetal B and CD4+ T cells were detected. In healthy volunteers with son, 0 to 5 fetal cells were observed, which was significantly less than the number observed in patients (p<0,05). In women who never had been pregnant, no male cells were detected.ConclusionThis study shows a clear association between fetal microchimeric cells and autoimmune thyroid diseases.
Project delays are a large and prevalent problem in the Gilgit-Baltistan construction industry, and delays can distinctly affect project duration, budget, and also community needs. The purpose of this study is to highlight and rank delaying factors in the Annual Development Programme public sector building infrastructure projects and examine them through a relative importance index. A total of 52 delaying factors were identified through a detailed literature review and categorized into eight major groups, and a pilot study with 16 experienced construction experts was conducted. A questionnaire survey was conducted to collect the importance of each factor from public construction experts. In total, 102 respondents participated in the survey. The study determined that difficulties in financing projects by contractors, delays in progress payments, dispute on land usage, improper project feasibility studies, award project to the lowest bid price, extreme weather conditions, inadequate contractor experience, and insufficient data collection and survey before design were among the top eight critical delaying factors. In addition, Spearman's rank correlation tests revealed that there was no difference in perception between owners and contractors. A comparison of the top five delay factors was done with eight preferred construction industries in Asia to validate the results of this study. The findings are likely to be a solid contribution to the Gilgit-Baltistan construction industry in mitigating future construction delays.
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