Search Results (15)

Introduction: Carbapenem-resistant Gram-negative bacteria (CR-GNB) are rapidly spreading pathogens that increase morbidity and mortality in hospital settings and significantly restrict available treatment options worldwide. The lack of molecular epidemiological data and the limited use of next-generation sequencing (NGS) in South Lebanon have hindered comprehensive surveillance efforts. This study represents the first molecular characterization of CR-GNB in this region. Methods: A total of 477 clinical Gram-negative bacterial isolates were collected from intensive care unit (ICU) patients admitted to various hospitals in South Lebanon in 2023. Of these, 131 CR-GNB were subjected to whole-genome sequencing using the Illumina MiSeq platform. K-mer-based species identification, multilocus sequence typing (MLST), antimicrobial resistance (AMR) gene profiling, and plasmid analysis were performed using multiple bioinformatic tools. Phylogenetic analysis was conducted using SaffronTree. Results: K-mer-based identification revealed that the predominant species among CR-GNB isolates were Pseudomonas spp. and Escherichia coli (26.7% each), followed by Klebsiella pneumoniae (19.8%), Acinetobacter baumannii (17.6%), Proteus mirabilis (4.6%), Enterobacter cloacae (2.3%), Achromobacter spp. (1.5%), and Citrobacter freundii (0.8%). Based on antimicrobial susceptibility testing, isolates were classified as follows: 0.8% as pan drug-resistant (PDR), 40.5% as extensively drug-resistant (XDR), and 52.7% as multidrug-resistant (MDR) and 6.1% as antimicrobial-resistant (AMR). All isolates harbored AMR genes, with the following distribution: 2% bla_VIM, 5% bla_NDM-1, 27% bla_NDM-5, 65% bla_OXA-type, and 1% bla_DIM-1. Plasmid-associated AMR genes were detected in 58% of isolates; among these, 96% carried Inc-family plasmids, 57% Col plasmids, and 11% replication-associated elements (rep). Phylogenetic analysis demonstrated that certain isolates exhibited both hospital-specific and shared genetic profiles, indicating widespread dissemination across multiple healthcare facilities, as well as evidence of local emergence and ongoing transmission. Conclusions: The high prevalence of CR-GNB harboring resistance genes and plasmids underscores the urgent need for NGS-based genomic surveillance in South Lebanon. Implementing such strategies is essential for tracking resistance genes, identifying clonal outbreaks, and guiding effective infection control interventions to mitigate the spread of CR-GNB. Full article

Prolonged periods of standing are linked to low back pain (LBP). Evaluating lumbar spine biomechanics in real-world contexts can provide novel insights into these links. This study aimed to determine if standing behaviour can be quantified, in individuals with LBP, in real-world environments. A three-stage design was used, (i) Verification of a bespoke algorithm characterising lumbar standing behaviour, (ii) Day-long assessment of standing behaviours of individuals with posture-related low back discomfort, and (iii) Case study application to individuals with clinical LBP. Analysis of standing posture across time included variability, fidgeting, and amplitude probability distribution function analysis. The study demonstrated that accelerometers are a valid method for extracting standing posture from everyday activity data. There was a wide variety of postures throughout the day in people with posture-related low back discomfort and people with clinical LBP. Frequency profiles ranged from slightly flexed to slightly extended postures, with skewed bell-shaped distributions common. Postural variability ranged from 3.4° to 7.7°, and fidgeting from 1.0° to 3.0°. This work presents a validated accelerometer-based method to capture, identify, and quantify real-world lumbar standing postures. The distinct characteristics of people with low back discomfort or pain highlight the importance of individualised approaches. Full article

Low back pain affects 619 million people worldwide and is commonly provoked by sitting. Current assessment methods constrain task variability, removing real-world, task-switching behaviors. This study utilized accelerometers to provide an original validated method of in vivo real-world assessment of lumbar sitting behavior throughout a full day. A three-stage study design was used, which involved (1) blinded verification of our sitting detection algorithm, (2) full-day data collection from participants with low back discomfort, quantifying lumbar angles, and end-user acceptability explored, (3) case study application to two clinical low back pain (LBP) patients, incorporating measurement of provocative sitting. Focus group discussions demonstrated that data collection methods were acceptable. Sitting ‘windows’ were created and analyzed using novel histograms, amplitude probability distribution functions, and variability, demonstrating that sitting behavior was unique and varied across individuals. One LBP patient demonstrated two frequent lumbar postures (<15% flexion and ~75% flexion), with pain provocation at 62% lumbar flexion. The second patient demonstrated a single dominant posture (~90% flexion), with pain provoked at 86% lumbar flexion. Our in vivo approach offers an acceptable method to gain new insights into provocative sitting behavior in individuals with LBP, allowing individualized unconstrained data for full-day postures and pain provocation behaviors to be quantified, which are otherwise unattainable. Full article

Background: Chronic back pains are progressively disabling working individuals, including 60–80% of the general population, for which their diagnosis is challenging to healthcare workers worldwide, thereby becoming a burden to nations. Purpose: The study aimed to investigate the efficacy of core strengthening exercise (CSE) and intensive dynamic back exercise (IDBE) on pain, core muscle endurance, and functional disability in patients with chronic non-specific low back pain (LBP). Methods: The study was based on a three-arm parallel-group randomized control design. Forty-five participants with chronic non-specific LBP were recruited and randomly divided into the CSE, IDBE, and Control groups. The CSE and IDBE groups received CSE and IDBE, respectively. However, the Control group received no intervention. Numeric pain rating scale, Oswestry Disability Index, core flexors, extensors, and side bridge tests assessed pain intensity, functional disability, and endurance of core muscles. Outcome scores for the dependent variables were collected at baseline (pre-intervention) and six-week post-intervention. There were no follow-up measurements in this study. A one-way multivariate analysis of covariance (MANCOVA) was used to analyze the intervention effects on the outcomes within groups and between groups, respectively; keeping the significance-level alpha at 95%, i.e., p < 0.05. A univariate F-test was performed to observe the superiority of one treatment over another. Pearson’s correlation coefficient test was conducted to determine a relation between the dependent variables. In all statistical analyses, the level of significance α was kept at 0.05. Results: All forty-five out of sixty-three participants with chronic non-specific low back pain (male, 32 and female, 23; average age, 20.24 ± 1.46 years; average pain duration, 19.6 ± 5.42 weeks) completed the study and their data were analyzed. The MANCOVA test showed a significant difference between the treatment groups on the combined multiple endurance tests for the core muscles (flexors, extensors, side bridge tests to the right and left), Visual Analog Scale (VAS), and Oswestry Disability Index (ODI) scores after controlling for baseline scores of all the dependent variables: F (6, 12) = 23.381; p < 0.05; Wilks’ Λ = 0.033; partial η² = 0.819. A post hoc pair-wise comparison followed by a univariate F-test indicated that a significant improvement was found between the CSE vs. IDBE vs. Control groups on the post-test scores of all the dependent variables except VAS and EET (CSE vs. IDBE only). A Pearson’s correlation coefficient test revealed a notable relation between the dependent variables. Conclusions: The experimental group CSE was found to be more effective than IDBE on improving functional disability, cores’ flexors, and side bridges’ endurance tests than IDBE. The magnitude of this improvement exceeded the minimal clinically important difference (MCID), suggesting a clinically relevant enhancement in functional disability, core flexors, and side bridge endurance for participants engaged in CSE. However, CSE vs. IDBE revealed non-significant differences on reducing pain and core extensors’ endurance. The absence of statistically significant differences suggests that the observed changes did not exceed the established MCID for pain intensity and core extensors’ endurance. In addition, partial eta-squared value revealed the superiority of CSE over IDBE and Control groups. This suggests that the observed differences between the two interventions are not only statistically significant, but also clinically relevant, surpassing the established MCID. Full article

Chronic low back pain (CLBP) substantially impacts quality of life through a multifarious interplay of physical and psychological elements. A comprehensive understanding of this relationship is imperative for developing effective treatment strategies. This study recruited 64 participants (35 males and 29 females) experiencing chronic low back pain to explore the associations between psychological factors, muscle endurance, and functional impairments. The study was conducted over six months in an outpatient department and a rehabilitation unit. The study utilized established outcome measures, such as the Biering-Sorensen Test and the Roland Morris Disability Questionnaire, and psychological variants as the core dependent variables, including the Beck Depression Inventory (BDI), STAI questionnaire, the FABQ-PA, and the Pain Catastrophizing Scale (PCS). The findings uncovered pronounced gender disparities, with females exhibiting elevated levels of depression (BDI: 27.68 ± 9.43, p < 0.001) and anxiety (STAI: 42.34 ± 8.94, p < 0.001) and diminished muscle endurance (130.47 ± 30.56 sec, p = 0.001). These revelations are congruent with the prevailing literature, emphasizing the need for gender-sensitive and personalized interventions. Bivariate correlations presented robust associations between psychological distress and decreased muscle endurance (r values ranging from −0.82 to −0.88, p < 0.001) alongside elevated functional impairments (r values from 0.89 to 0.94, p < 0.001) for both genders. Additionally, linear regression analyses illuminated the consequential impact of specific psychological variables such as the BDI, FABQ-PA, and PCS on muscle endurance and functional impairments (all p < 0.001). This study reveals gender-specific variations in chronic back pain, highlighting the influence of psychological factors on pain perception. It underscores the necessity for gender-sensitive treatment strategies. Future research is needed to explore these differences further and assess treatment efficacy to improve care and quality of life for chronic low back pain sufferers through personalized treatment plans. Full article

Background and Objectives: Chronic low back pain, frequently attributed to Sacroiliac Joint Dysfunction (SIJD), remains a prevalent concern in orthopedic and physiotherapy arenas. Despite the recognition of motor control exercises (MCEs) and balance training (BT) as potential rehabilitative measures, studies elucidating their combined efficiency for SIJD are scarce. This research study aimed to ascertain the combined and individual efficacies of MCE and BT in alleviating SIJD symptoms. Methods: A double-blinded randomized controlled trial was conducted, enrolling 120 SIJD-diagnosed patients aged 30–60 years. Participants were randomly allocated into four groups: MCEs alone, BT alone, combined MCEs and BT, and a control group receiving usual care. Interventions spanned 12 weeks, with evaluations at the start and end and a 24-week follow-up. Primary outcomes encompass pain intensity (assessed via Visual Analog Scale), functional disability (utilizing the Oswestry Disability Index), and life quality (using the Short Form-36). Results: Post a 12-week intervention, participants receiving combined MCE and BT demonstrated substantial improvements in VAS (Median: 3.5, IQR: 2–5; p = 0.0035), ODI (Median: 15%, IQR: 10–20%; p = 0.0035), and SF-36 scores (Median: 70, IQR: 65–75; p = 0.0035) compared to baseline. In contrast, standalone MCE or BT and control groups exhibited lesser efficacy. By the 24-week follow-up, the combined group maintained their gains, outperforming the other groups. The research tools employed showed high reliability with Cronbach’s alpha >0.85. Conclusions: Our findings underscore the superior efficacy of integrating motor control exercises (MCEs) and balance training (BT) for Sacroiliac Joint Dysfunction (SIJD)-related chronic low back pain. This combined approach promises enhanced patient outcomes, highlighting its potential as a primary strategy in SIJD management. Future studies should further explore its long-term benefits and integration with other therapeutic modalities. Full article

Sub-acromial Impingement Syndrome (SIS) is a prevalent shoulder pathology characterized by pain, muscle weakness, and altered joint position sense (JPS). This prospective study aimed to comprehensively assess the relationship between shoulder muscle strength, JPS, and pain in individuals with SIS. A total of 100 participants, including 50 with SIS and 50 healthy controls, underwent shoulder muscle strength testing and JPS evaluation in various directions (flexion, abduction, medial rotation, and lateral rotation). Pain intensity was quantified using a visual analog scale. Correlation analyses were conducted to explore the associations between muscle strength, JPS, and pain, with Cohen’s d values indicating the effect size. Individuals with SIS exhibited significantly lower shoulder muscle strength and greater JPS errors compared to the healthy controls (p < 0.001, Cohen’s d = 0.51 to 0.84). The results showed strong positive correlations between muscle strength and JPS in all assessed directions (p < 0.001, with r values ranging from 0.35 to 0.62). Mediation analysis revealed that pain partially mediated the relationship between muscle strength and JPS in all directions (p < 0.005). This study highlights the multifaceted nature of SIS, emphasizing the coexistence of muscle weakness, proprioceptive impairments, and pain. The findings underscore the importance of addressing these factors in the comprehensive rehabilitation of individuals with SIS to optimize functional outcomes and enhance their quality of life. Full article

Lumbar spondylosis, characterized by degenerative changes in the lumbar spine, often leads to pain, reduced spinal stability, and musculoskeletal dysfunction. Understanding the impact of lumbar spondylosis on musculoskeletal function, particularly lumbar extensor endurance, functional balance, and limits of stability, is crucial for improving the management and well-being of affected individuals. This study aimed to assess lumbar extensor endurance, functional balance, and limits of stability in individuals with lumbar spondylosis compared to age-matched healthy individuals and explore the correlations among these parameters within the lumbar spondylosis group. The lumbar spondylosis group consisted of 60 individuals initially screened by an orthopedician and referred to physical therapy. Age-matched healthy controls (n = 60) were recruited. Inclusion criteria encompassed adults aged 45–70 years for both groups. Lumbar extensor endurance was assessed using the Sorensen test, functional balance with the Berg Balance Scale, and limits of stability using a computerized stabilometric force platform. Lumbar extensor endurance was significantly lower in individuals with lumbar spondylosis compared to healthy controls (23.06 s vs. 52.45 s, p < 0.001). Functional balance, as assessed by the Berg Balance Scale, demonstrated a significant decrement in the lumbar spondylosis group (48.36 vs. 53.34, p < 0.001). Additionally, limits of stability variables, under both eyes-open and eyes-closed conditions, exhibited marked impairments in the lumbar spondylosis group (p < 0.001 for all variables). Within the lumbar spondylosis group, lumbar extensor endurance exhibited significant positive correlations with functional balance (0.46, p < 0.001) and negative correlations with limits of stability variables (r ranging from −0.38 to −0.49, p < 0.01 for all variables). This study underscores the significance of addressing lumbar extensor endurance, functional balance, and stability impairments in the comprehensive management of lumbar spondylosis. Full article

In this research, the aim was to introduce innovation to the pharmaceutical field through the exploration of an underutilized plant matrix, the red araçá, along with the utilization of sodium alginate for the development of membranes designed for active topical dressings. Within this context, optimal extraction conditions were investigated using the central composite rotational statistical design (CCRD) to obtain a red araçá epicarp extract (RAEE) rich in bioactive compounds utilizing the maceration technique. The extract acquired under the optimized conditions (temperature of 66 °C and a hydroalcoholic solvent concentration of 32%) was incorporated into a sodium alginate matrix for the production of active membranes using a casting method. Characterization of the membranes revealed that the addition of the extract did not significantly alter its morphology. Furthermore, satisfactory results were observed regarding mechanical and barrier properties, as well as the controlled release of phenolic compounds in an environment simulating wound exudate. Based on these findings, the material produced from renewable matrices demonstrates the promising potential for application as a topical dressing within the pharmaceutical industry. Full article

Background and Objectives: To investigate the effect of whole-body stretching (WBS) exercise during lunch break for reducing musculoskeletal pain and physical exertion among healthcare professionals. Methods: Full-time healthcare professionals working in hospitals with more than one year of experience were invited to participate. Sixty healthcare professionals (age 37.15  ±  3.9 Years, height 1.61  ±  0.04 m, body mass 67.8  ±  6.3 kg, and BMI 26.5 ± 2.1 kg/m²) participated in this single-blinded, two-arm randomized controlled trial (RCT). Participants were divided into WBS (n = 30) and control (n = 30) groups. The WBS group performed a range of stretching exercises targeting the entire body during a lunch break period for 3 times a week for 6 weeks. The control group received an education program. Musculoskeletal pain and physical exertion were assessed using the Nordic musculoskeletal questionnaire and Borg rating of perceived exertion scale, respectively. Results: The 12-month prevalence of musculoskeletal discomfort among all healthcare professionals was highest in the low back region (46.7%), followed by the neck (43.3%), and then the knee (28.3%). About 22% of participants said that their neck discomfort impacted their job, while about 18% reported that their low back pain impacted their job. Results indicate that the WBS and education program had a beneficial impact on pain and physical exertion (p < 0.001). When comparing the two groups, the WBS group experienced a significantly greater decrease in pain intensity (mean difference 3.6 vs. 2.5) and physical exertion (mean difference 5.6 vs. 4.0) compared to an education program only. Conclusions: This study suggests that doing WBS exercises during lunchtime can help lessen musculoskeletal pain and fatigue, making it easier to get through the workday. Full article

Background: This study aims to determine the effects of kinesio tape (KT) application on acute-onset muscle soreness and the extensibility of the calf muscles in endurance athletes. Methods: A one-arm repeated-measures randomized cross-over controlled study design investigated 55 endurance athletes, including 10 cyclists, 30 badminton players, and 15 long-distance runners (mean age 16.40 ± 2.69) from different stadia in Delhi NCR, India. KT and sham tapes (ST) were applied randomly to right and left legs (prone position) in a cross-over manner with a gap of 72 h. Ankle dorsiflexion range of motion (ADFROM) and pain due to acute-onset muscle soreness were assessed immediately and 10 min and 30 min after treadmill running, using a universal goniometer and numeric pain rating scale (NPRS), respectively, along with the time to fatigue. Results: A statistically significant difference was observed for the NPRS when the mean scores obtained for the KT and ST groups were compared immediately after cessation of running; however, the difference was not statistically significant in the NPRS score that was recorded ten or thirty minutes after. The range of motion increased significantly after the application of both the KT and the ST. After running on a treadmill, the range of motion decreased significantly with both the KT and ST, and the decrease was similar. Conclusion: KT was more effective in reducing the pain intensity immediately after running and increased the time spent running on the treadmill before fatigue set in among endurance athletes. In addition, the two taping methods (KT or ST) were equally effective in enhancing calf muscle extensibility (for both right and left legs) immediately after application. However, both taping methods failed in limiting the decrease in ankle ADFROM after treadmill running. Full article

To curb the COVID-19 pandemic, the knowledge, attitude, and practice (KAP) of preventive measures play an essential role, and healthcare workers have had to endure a burden to care for COVID-19 patients. Thus, this study aimed to assess the weight of the KAP of physiotherapists in Saudi Arabia during the COVID-19 pandemic. This was a cross-sectional study, where we circulated an online KAP questionnaire to 1179 physical therapists, and among those, 287 participated and completed the questionnaire. The collected responses were analyzed using descriptive statistics, t-test, ANOVA, correlation, and regression analyses, and p-value ≤ 0.05 was considered statistically significant. Both males and females participated in almost equal numbers; most of the participants were <40 years, had a bachelor’s level of education, and were from the central region of Saudi Arabia. Social media and the internet were the primary sources of COVID-19-related information (74.6%). Knowledge components A (92%) and B (73.9%) were excellent among most participants. Approximately half of the participants (50.5%) had a moderate attitude toward COVID-19, and regarding the practice component, most participants (74.6%) scored moderately. Correlation analysis showed a low positive relationship between knowledge A, attitude, and practice components. Still, there was a very low positive relationship between knowledge B, attitude, and practice components, but both were statistically significant. Our study showed that physical therapists in Saudi Arabia exhibit good knowledge, attitude, and practice toward COVID-19. Full article

Exposures to the toxic element mercury (Hg) are exceptionally high among recycling workers globally. Recycling is a growing sector in Colombia, yet workers who directly handle e-waste are often unaware of the risks of exposure to mercury from post-consumer lighting products (e.g., fluorescent lamps). This qualitative study aimed to understand how recycling workers perceive their own risks from mercury exposure and how they find information about these risks, through interviews (n = 35) at the three largest formal recycling facilities in Colombia. Workers’ risk perception was generally disconnected from their likely actual exposure to mercury, instead often seen juxtaposed to co-workers who worked more directly with hazardous waste. Recycling workers, who were predominantly men from lower-income socioeconomic backgrounds, had limited knowledge of health risks due to mercury exposure and were more likely to receive health-related information from informal sources. Over a third of interviewees had searched online for information about occupational health risks of mercury, but these searches were perceived as unsatisfactory due to information being difficult to find, not available in Spanish, or related to mercury exposure via seafood or mining rather than recycling. Workers expressed (over)confidence in personal protective equipment and concern about frequent employee turnover. This study points to weaknesses in environmental health literacy and public health communication around toxic exposures to mercury in the workplace. Stronger regulation and enforcement are needed to prevent toxic exposures and promote worker health equity. Full article

In recent years, there has been a significant increase in global smartphone usage driven by different purposes. This study aimed to explore the effect of smartphone usage on neck muscle (flexors and extensors) endurance, hand grip, and pinch strength among young, healthy college students. In total, 40 male students were recruited for this study; 20 of them belonged to the smartphone-addicted group, while the other 20 were in the non-addicted group based on their smartphone addiction scale—short version (SAS-SV) scores (the threshold for determining smartphone addiction: 31/60). Neck flexor endurance time, the ability to perform a neck extensor muscle endurance test, and hand and pinch grip strength were assessed. Multivariate analysis of variance (MANOVA) was used to assess between-group differences in the mean values of neck flexor endurance time, hand grip, and pinch grip. A significant group effect (Wilks’ lambda = 0.51, F _(5,34) = 6.34, p = 0.001, partial eta squared = 0.48) was found. A decrease in neck flexor endurance time was observed in the smartphone-addicted group compared with that of the non-addicted group (p < 0.001). However, there was no notable difference in the neck extensor muscle endurance test or in hand grip and pinch grip strength of both hands between groups (p > 0.05). Using a smartphone for a prolonged time might affect neck flexor muscle endurance; however, more research is needed to explore the long-term effects of using smartphones on neck muscle endurance and hand/pinch grip strength and the risk of developing upper limb neuromusculoskeletal dysfunction. Full article

A unicellular microalga, Chlamydomonas reinhardtii, was isolated from rice paddy-field soil and water samples and used in the biotransformation of hydrocortisone (1). This strain has not been previously tested for steroid bioconversion. Fermentation was carried out in BG-11 medium supplemented with 0.05% substrate at 25ºC for 14 days of incubation. The products obtained were chromatographically purified and characterized using spectroscopic methods. 11b,17b-Dihydroxyandrost-4-en-3-one (2), 11b-hydroxyandrost-4-en-3,17-dione (3), 11b,17a,20b,21-tetrahydroxypregn-4-en-3-one (4) and prednisolone (5) were the main products of the bioconversion. The observed bioreaction features were the side chain degradation of the substrate to give compounds 2 and 3 and the 20-ketone reduction and 1,2-dehydrogenation affording compounds 4 and 5, respectively. A time course study showed the accumulation of product 2 from the second day of the fermentation and of compounds 3, 4 and 5 from the third day. All the metabolites reached their maximum concentration in seven days. Microalgal 18S rRNA gene was also amplified by PCR. PCR products were sequenced to confirm their authenticity as 18S rRNA gene of microalgae. The result of PCR blasted with other sequenced microalgae in NCBI showed 100% homology to the 18S small subunit rRNA of two Chlamydomonas reinhardtii spp. Full article