RESUMO
OBJECTIVE: To investigate the biomechanical effects of percutaneous vertebroplasty combined with cement pedicle plasty (PVCPP) on the unstable osteoporotic vertebral fractures (OVFs) through finite element (FE) analysis. The study compares the biomechanical stability of finite element models between percutaneous vertebroplasty (PVP) and percutaneous vertebroplasty combined with cement pedicle plasty. METHODS: Two patients with unstable OVFs underwent computed tomography (CT) examination at the thoracolumbar vertebral body levels, respectively. The CT images were reconstructed into three-dimensional finite element models to simulate stress conditions across six dimensions and to evaluate the vertebral von Mises stress before and after bone cement reinforcement. RESULTS: The study found that stress distribution differed between groups mainly at the pedicle base. In the surgical vertebral bodies, the maximum stress in the PVP group decreased during flexion and left bending, while it increased in other states. In the PVCPP group, all maximum stresses decreased. In the inferior vertebral bodies, the maximum stress in the PVP group generally increased, while it decreased in the PVCPP group. In the superior vertebral bodies, postoperatively, the maximum stress in the PVP group generally increased, while it almost remained unchanged in the PVCPP group. PVP group had higher cement stress and displacement. CONCLUSION: PVCPP is an effective treatment method for patients with unstable OVFs. It can quickly relieve pain and enhance the stability of the three columns, thereby reducing the risk of some complications.
Assuntos
Cimentos Ósseos , Análise de Elementos Finitos , Vértebras Lombares , Fraturas por Osteoporose , Fraturas da Coluna Vertebral , Vertebroplastia , Humanos , Vertebroplastia/métodos , Fenômenos Biomecânicos/fisiologia , Fraturas da Coluna Vertebral/cirurgia , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas da Coluna Vertebral/fisiopatologia , Feminino , Vértebras Lombares/cirurgia , Vértebras Lombares/diagnóstico por imagem , Idoso , Fraturas por Osteoporose/cirurgia , Fraturas por Osteoporose/diagnóstico por imagem , Fraturas por Osteoporose/fisiopatologia , Vértebras Torácicas/cirurgia , Vértebras Torácicas/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Masculino , Estresse Mecânico , Idoso de 80 Anos ou maisRESUMO
OBJECTIVE: Currently, there is no established guideline on whether to opt for percutaneous endoscopic lumbar discectomy (PELD) or traditional transforaminal lumbar interbody fusion (TLIF) surgery based on specific types of lumbar disc herniation (LDH). Based on the Michigan State University (MSU) classification system, this study conducted a medium- to long-term follow-up analysis of two surgical methods over 5 years for the first time, aiming to provide empirical evidence to assist in making more informed decisions before surgery for LDH treatment. METHODS: This was a retrospective study that included 273 patients with single-level LDH who underwent PELD or TLIF treatment at our hospital between January 1, 2016, and December 31, 2018. Detailed metrics included preoperative and postoperative visual analogue scale (VAS) scores and Oswestry disability index (ODI) at 1-day, 1-week, 1-year, and 5-year follow-ups. Complications, recurrences, and 5-year postoperative modified MacNab criteria scores were also recorded. Statistical methods included independent sample t-tests, repeated measures analysis of variance (ANOVA), and χ2 tests. RESULTS: Classified into seven groups according to the MSU classification, it was found that there was an improvement in the VAS and ODI scores at four postoperative follow-ups (p < 0.001). PELD showed better results than TLIF in reducing pain and improving the ODI scores in the classifications of 3B, 2B, and 2C (p < 0.05). TLIF demonstrated consistent superiority over PELD in 2A, 2AB, 3A, and 3AB classifications (p < 0.05). The total recurrence rate in the PELD group (11.05%) within 5 years after surgery was higher (p < 0.05) than that in the TLIF group (3.96%). These were mainly concentrated in the 2A, 2AB, 3A, and 3AB types. Moreover, the rate of excellent and good outcomes in the PELD was higher than in the TLIF but no significant difference (χ2 = 1.0568, p = 0.5895). CONCLUSION: This study suggests that PELD and TLIF may relieve LDH, but have advantages under different MSU classifications. The MSU classification has specific guiding significance and could aid in the surgical selection of PELD or TLIF to achieve optimal treatment outcomes for patients with lumbar disc herniation.
Assuntos
Discotomia Percutânea , Endoscopia , Deslocamento do Disco Intervertebral , Vértebras Lombares , Fusão Vertebral , Humanos , Estudos Retrospectivos , Deslocamento do Disco Intervertebral/cirurgia , Deslocamento do Disco Intervertebral/classificação , Discotomia Percutânea/métodos , Masculino , Feminino , Vértebras Lombares/cirurgia , Pessoa de Meia-Idade , Fusão Vertebral/métodos , Adulto , Endoscopia/métodos , Medição da Dor , Avaliação da Deficiência , IdosoRESUMO
Inonotus obliquus, a medicinal fungus, has garnered significant attention in scientific research and medical applications. In this study, protoplasts of the I. obliquus HS819 strain were prepared using an enzymatic method and achieved a regeneration rate of 5.83%. To enhance polysaccharide production of I. obliquus HS819, atmospheric and room temperature plasma (ARTP) technology was employed for mutagenesis of the protoplasts. Through liquid fermentation, 32 mutant strains exhibiting diverse characteristics in morphology, color of the fermentation broth, mycelial pellet size, and biomass were screened. Secondary screening identified mutant strain A27, which showed a significant increase in polysaccharide production up to 1.67 g/L and a mycelial dry weight of 17.6 g/L, representing 137.67% and 15% increases compared to the HS819 strain, respectively. Furthermore, the fermentation period was reduced by 2 days, and subsequent subculture cultivation demonstrated stable polysaccharide production and mycelial dry weight. The genome resequencing analysis of the HS819 strain and mutant strain A27 revealed 3790 InDel sites and mutations affecting 612 functional genes associated with polysaccharide synthesis. We predict that our findings will be helpful for high polysaccharide production through genetic engineering of I. obliquus.
RESUMO
Spinal infections, notably those induced by Aspergillus flavus (A. flavus), represent a complex and uncommon clinical challenge. In individuals with diabetes mellitus, the risk is exacerbated due to a compromised immune response and a heightened vulnerability to non-standard pathogens. This case report chronicles the intricate diagnostic and treatment journey of a 59-year-old diabetic patient grappling with a spinal infection attributed to A. flavus. The diagnosis was delayed due to non-specific symptoms and unclear radiological signs. The administration of voriconazole, a targeted antifungal treatment, resulted in a significant clinical and radiological improvement, underscoring its effectiveness in treating such unusual fungal spinal infections; meanwhile, we found that terbinafine hydrochloride also has a similar effect in treating fungal spinal infections. This case underscores the importance of considering fungal causes in spinal infections among diabetic patients and highlights prompt diagnosis and individualized targeted antifungal therapy.
RESUMO
OBJECTIVE: This study introduces a minimally invasive technique for efficient three-column reconstruction, augmentation, and stabilization of osteoporotic thoracolumbar burst fractures (OTLBFs). METHODS: Sixty-eight patients with OTLBFs and no neurological deficits were included from July 2019 to September 2020. The patients were divided into two groups: the simple percutaneous kyphoplasty (PKP) group (n = 32) and the percutaneous kyphoplasty combined with pediculoplasty (PKCPP) group (n = 36). The clinical and radiological outcomes were assessed during a minimum 1-year follow-up period. Clinical outcomes were assessed via the visual analog scale (VAS) and modified MacNab grading criteria. The radiological outcomes included the Cobb angle (CA), anterior wall height (AWH), and posterior wall height (PWH). The surgery duration, postoperative analgesic dosage, length of hospital stay, and complications were recorded. RESULTS: Surgery duration was not significantly different between the two groups (P > 0.05). The PKCPP group had a lower analgesic dosage and shorter hospital stay (P < 0.05). Postoperatively, the PKCPP group exhibited better VAS scores and modified MacNab scale scores (P < 0.05), but the differences at the last follow-up assessment were not significant (P > 0.05). Postoperative CA, AWH, and PWH correction were not significantly different on the first postoperative day (P > 0.05). However, the PKCPP group had significantly less CA and PWH loss of correction at the last follow-up visit (P < 0.05). The PKCPP group had significantly fewer complications (P < 0.05). CONCLUSIONS: The PKCPP technique complements simple PKP for OTLBFs. It quickly relieves pain, maintains the vertebral body height and Cobb angle, ensures cement stabilization, and offers more stable three-column support.
Assuntos
Cifoplastia , Fraturas por Osteoporose , Humanos , Coluna Vertebral , Estatura , Cimentos Ósseos/uso terapêutico , Fraturas por Osteoporose/diagnóstico por imagem , Fraturas por Osteoporose/cirurgia , AnalgésicosRESUMO
INTRODUCTION: Chronic constipation (CC) is a highly prevalent health challenge that is particularly challenging to treat in elderly patients. Although lifestyle guidance and laxative therapy often yield positive outcomes, patients occasionally struggle with maintaining dietary control. Therefore, identifying an economical and safe alternative therapy to the existing treatment methods documented in the international literature is necessary. This systematic review and meta-analysis aims to evaluate the efficacy and safety of abdominal massage in elderly patients with CC to provide a basis for future mechanistic research. METHODS AND ANALYSIS: Electronic searches will be conducted to identify clinical randomised controlled trials in various databases, including Web of Science, PubMed, Cumulated Index to Nursing and Allied Health Literature, Cochrane Library, Embase, Airiti Library, Chinese National Knowledge Infrastructure Databases, Chinese Science and Technology Periodical Database (VIP), Chinese Biomedical Literature Database and Wan Fang Database. Relevant data will be extracted, and a meta-analysis will be conducted using Reviewer Manager V.5.4. Quality and risk assessments of the included studies will be performed, and the outcome indicators of the trials will be observed. This review will evaluate abdominal massage as a treatment option for relieving symptoms and improving quality of life in elderly patients with CC. Moreover, it will provide additional insights for clinical treatment and mechanistic studies. The search will be performed following the publication of this protocol (estimated to occur on 30 December 2023). ETHICS AND DISSEMINATION: As this is a literature review, ethics approval will not be required. We will disseminate the findings of this study to publications in peer-reviewed journals as well as presentations at relevant national and international conferences. PROSPERO REGISTRATION NUMBER: CRD42023408629.
Assuntos
Massagem , Qualidade de Vida , Idoso , Humanos , Constipação Intestinal , Metanálise como Assunto , Literatura de Revisão como Assunto , Revisões Sistemáticas como Assunto/métodosRESUMO
Recent two-stage detector-based methods show superiority in Human-Object Interaction (HOI) detection along with the successful application of transformer. However, these methods are limited to extracting the global contextual features through instance-level attention without considering the perspective of human-object interaction pairs, and the fusion enhancement of interaction pair features lacks further exploration. The human-object interaction pairs guiding global context extraction relative to instance guiding global context extraction more fully utilize the semantics between human-object pairs, which helps HOI recognition. To this end, we propose a two-stage Global Context and Pairwise-level Fusion Features Integration Network (GFIN) for HOI detection. Specifically, the first stage employs an object detector for instance feature extraction. The second stage aims to capture the semantic-rich visual information through the proposed three modules, Global Contextual Feature Extraction Encoder (GCE), Pairwise Interaction Query Decoder (PID), and Human-Object Pairwise-level Attention Fusion Module (HOF). The GCE module intends to extract the global context memory by the proposed crossover-residual mechanism and then integrate it with the local instance memory from the DETR object detector. HOF utilizes the proposed pairwise-level attention mechanism to fuse and enhance the first stage's multi-layer feature. PID outputs multi-label interaction recognition results with the input of the query sequence from HOF and the memory from GCE. Finally, comprehensive experiments conducted on HICO-DET and V-COCO datasets demonstrate that the proposed GFIN significantly outperforms the state-of-the-art methods. Code is available at https://github.com/ddwhzh/GFIN.
Assuntos
Reconhecimento Psicológico , Semântica , Humanos , Percepção VisualRESUMO
Mpox (MPX) has escalated into a public health emergency of international concern, necessitating urgent prophylactic and therapeutic measures. The primary goal of this investigation was to systematically extract Wan Quan's expertise in treating smallpox, as documented in Exclusive Methods for Treating Pox (Dou Zhen Xin Fa in Chinese), with the aim of identifying potential prescriptions, herbs, and components for alternative MPX therapies or drugs. This research utilized data mining to identify high-frequency Chinese Medicines (CMs), high-frequency CM-pairs, and CM compatibility rules. Network pharmacology, molecular docking, and molecular dynamic simulation were employed to reveal the potential molecular mechanisms of the core CM-pair. 119 prescriptions were extracted from Exclusive Methods for Treating Pox. We identified 25 high-frequency CMs and 23 high-frequency CM pairs among these prescriptions. Combined association rule mining analysis, Gancao (Glycyrrhiza uralensis Fisch.), Renshen (Panax ginseng C. A. Mey.), Danggui (Angelica sinensis (Oliv.) Diels), Shengma (Cimicifuga foetida L.), and Zicao (Lithospermum erythrorhizon Siebold & Zucc.) were selected as the core CM-pair for further investigation. Network pharmacology analysis yielded 131 active components and 348 candidate targets for the core CM-pair. Quercetin and celabenzine were chosen as ligands for molecular docking. GO and KEGG enrichment analyses revealed that the core CM-pair could interact with targets involved in immune, inflammatory, and infectious diseases. Moreover, key mpox virus targets, F8-A22-E4 DNA polymerase holoenzyme and profilin-like protein A42R, were docked well with the selected core components. And molecular dynamic simulation indicated that the component (quercetin) could stably bind to the target (profilin-like protein A42R). Our findings identified potential prescriptions, herbs, and components that can offer potential therapies or drugs for addressing the MPX epidemic.
Assuntos
Medicina Tradicional Chinesa , Mpox , Humanos , Simulação de Acoplamento Molecular , Profilinas , QuercetinaRESUMO
Osteosarcomas are prevalent in children and young adults and have a high recurrence rate. Cisplatin, doxorubicin, and methotrexate are common adjuvant chemotherapy drugs for treatment of osteosarcoma, but multidrug resistance is a growing problem. Therefore, understanding the molecular mechanisms of chemotherapy resistance in osteosarcoma cells is crucial for developing new therapeutic approaches and ultimately improving the prognosis of osteosarcoma patients. To identify genes associated with cisplatin resistance in osteosarcoma, we screened a large-scale mutant library generated by transfecting human osteosarcoma cells with a piggyBac (PB) transposon-based gene activation vector. Several candidate genes were identified by using Splinkerette-PCR paired with Next Generation Sequencing. We created a disease-free survival predictor model, which includes ZNF720, REEP3, CNNM2, and CGREF1, using TARGET (Therapeutically Applicable Research to Generate Effective Treatments) datasets. Additionally, the results of our enrichment analysis between the Four_genes_high group and Low_group suggested that these four genes may participate in cisplatin resistance in osteosarcoma through cross talk between various signaling pathways, especially the signaling pathway related to bone formation. These data may help guide future studies into chemotherapy for osteosarcoma.
Assuntos
Neoplasias Ósseas , Osteossarcoma , Criança , Humanos , Adulto Jovem , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Ósseas/tratamento farmacológico , Neoplasias Ósseas/genética , Neoplasias Ósseas/metabolismo , Cisplatino , Doxorrubicina/uso terapêutico , Osteossarcoma/tratamento farmacológico , Osteossarcoma/genética , Osteossarcoma/metabolismo , Resistencia a Medicamentos AntineoplásicosRESUMO
BACKGROUND: Inflammatory bowel diseases (IBDs) are characterized by sustained inflammation and/or ulcers along the lower digestive tract, and have complications such as colorectal cancer and inflammation in other organs. The current treatments for IBDs, which affect 0.3% of the global population, mainly target immune cells and inflammatory cytokines with a success rate of less than 40%. RESULTS: Here we show that berberine, a natural plant product, is more effective than the frontline drug sulfasalazine in treating DSS (dextran sulfate sodium)-induced colitis in mice, and that berberine not only suppresses macrophage and granulocyte activation but also promotes epithelial restitution by activating Lgr5+ intestinal stem cells (ISCs). Mechanistically, berberine increases the expression of Wnt genes in resident mesenchymal stromal cells, an ISC niche, and inhibiting Wnt secretion diminishes the therapeutic effects of berberine. We further show that berberine controls the expression of many circadian rhythm genes in stromal cells, which in turn regulate the expression of Wnt molecules. CONCLUSIONS: Our findings suggest that berberine acts on the resident stromal cells and ISCs to promote epithelial repair in experimental colitis and that Wnt-ß-Catenin signaling may be a potential target for colitis treatment.
Assuntos
Berberina , Colite , Camundongos , Animais , Berberina/farmacologia , Berberina/uso terapêutico , Sulfato de Dextrana/efeitos adversos , Modelos Animais de Doenças , Colite/induzido quimicamente , Colite/tratamento farmacológico , Células-Tronco/metabolismo , Receptores Acoplados a Proteínas G/genética , Receptores Acoplados a Proteínas G/metabolismo , Inflamação/tratamento farmacológico , Inflamação/metabolismo , Mucosa Intestinal/metabolismoRESUMO
Objective: Systematic review and meta-analysis to assess the efficacy of Manual therapy and related interventions in the treatment of carpal tunnel syndrome (CTS) based on Boston carpal tunnel questionnaire. Design: Systematic review and meta-analysis. Subjects: Carpal tunnel syndrome. Interventions: Manual therapy and related interventions versus other therapies or manual therapy and related interventions plus other therapies versus other therapies. Outcomes measures: Boston carpal tunnel questionnaire. Results: A total of 6 studies were included, including 211 cases in the manual therapy group and 211 cases in the control group. The quality of the included articles was high, and the results of meta-analysis showed that manual therapy and related interventions were superior in terms of improving the Boston carpal tunnel questionnaire Symptom Severity score in patients with CTS (standardised mean difference [SMD] -1.13, 95% CI -1.40 to -0.87), were superior to control groups in terms of improving the Boston carpal tunnel questionnaire functional capacity scale in patients with CTS (SMD -1.01,95% CI -1.24 to -0.77). Conclusion: The results of this meta-analysis suggested that manual therapy and related interventions were better than control groups in treating CTS. Manual therapy and related interventions could relieve the symptoms of patients with CTS and promote the recovery of hand function. Manual therapy and related interventions should be considered clinically effective methods for treating CTS. Registration: The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO; No. CRD 42020201389). Contribution of the Article: Manual therapy and related interventions could relieve the symptoms of patients with CTS and promote the recovery of hand function. Manual therapy and related interventions should be considered clinically effective methods for treating CTS.
Assuntos
Síndrome do Túnel Carpal , Manipulações Musculoesqueléticas , Humanos , Boston , Síndrome do Túnel Carpal/diagnósticoRESUMO
Objective: This systematic review and meta-analysis was conducted to assess the efficacy of acupuncture treatment for postprandial distress syndrome (PDS). Methods: Search the Web of Science, the Cochrane Library, PubMed, and Embase databases with acupuncture randomized controlled trials for the treatment of patients with PDS. Strictly according to inclusion and exclusion quality assessment standards, the qualified ones are used to study the optimum extraction and data by two independent reviewers. Stata 15.0 software was used for meta-analysis. Result: We initially identified 63 studies, of which five (1253 participants) were eventually included in our analysis. There were 643 cases in the experimental group and 610 cases in the control group. Acupuncture had a significant effect on the total therapeutic effect (OTE) at week 4 (OR 4.74, 95% CI 02.88-7.83, Z = 6.10, P = 0 < 0.05). Significantly improved NDI (Nepean dyspepsia index) scores of PDS patients at week 4 (SMD 0.61, 95% CI 0.48 to 0.74). Significantly improved NDI scores in PDS patients at week 16 (SMD 0.49, 95% CI 0.27 to 0.71). After acupuncture treatment, the SID (dyspepsia symptom index) score of PDS patients decreased significantly at week 4 (SMD-0.52, 95% CI -0.73 to -0.32) and week 16 (SMD-0.59, 95% CI -0.81 to -0.36). Postprandial satiety scores (SMD-0.63, 95% CI -0.76 to -0.50) and early satiety scores (SMD-0.51, 95% CI -0.64 to -0.37) were also significantly lower at week 4 after acupuncture. Conclusion: This study highlighted that the acupuncture could significantly improve the overall therapeutic effect of PDS patients, alleviate the symptoms of postprandial fullness and early satiety, and improve the quality of life of patients. Our results supported that acupuncture was an effective therapeutic strategy for postprandial distress syndrome.
Assuntos
Terapia por Acupuntura , Dispepsia , Gastropatias , Terapia por Acupuntura/métodos , Dispepsia/diagnóstico , Dispepsia/terapia , Humanos , Período Pós-Prandial , Qualidade de VidaRESUMO
OBJECTIVE: This study aims to evaluate the efficacy and safety of traditional Chinese medicine (TCM) therapy of tonifying kidney and activating blood circulation (TKABC) based on the theory of "kidney deficiency and blood stasis" for the treatment of immune infertility. METHODS: Six electronic databases, including the Cochrane Library, PubMed, EMBASE, the China National Knowledge Infrastructure, Wanfang Data, and VIP information database, were searched from inception to January 2021 to identify eligible studies of randomized controlled trials (RCTs). The primary outcome measurements were the total effective rate and pregnancy rate, and the secondary outcome measurements included the negative conversion rate of serum antibodies and the incidence of adverse effects. The quantitative synthesis was performed using the Review Manager 5.3 software. The chi-square statistic and I 2 statistic were employed to investigate statistical heterogeneity. The fixed-effects model was used for a low heterogeneity (I 2 < 50%), and the random-effects model was applied if heterogeneity was moderate (50% < I 2 < 75%). Funnel plots were used to evaluate potential reporting bias when more than ten eligible studies were included. RESULTS: Thirteen RCTs involving 1298 patients with immune infertility of kidney deficiency and blood stasis were included. Compared with conventional group, TCM TKABC therapy showed a significant improvement on the total effective rate (RR: 1.38; 95% CI: 1.30,1.47; and I 2 = 0%), pregnancy rate (RR: 2.04; 95% CI: 1.73, 2.40; and I 2 = 30%), negative conversion rates of AsAb (RR: 1.42; 95% CI: 1.12,1.79; and I 2 = 62%), AEmAb rates (RR: 1.21; 95% CI: 1.04,1.41; and I2 = 0%), and AhCGAb with less adverse effects (RR: 0.24; 95% CI: 1.73, 2.40; and I 2 = 55%). However, the negative conversion rate of AoAb and ACAb showed no significant statistical difference. CONCLUSIONS: Our review suggests that TCM TKABC therapy based on the theory of kidney deficiency and blood stasis appears to be an effective and safe approach for patients with immune infertility. However, the methodological quality of included RCTs was unsatisfactory, and it is necessary to verify its effectiveness with more well-designed and high-quality multicenter RCTs.
RESUMO
Puerarin is a predominant component of Radix Puerarin. Despite its anti-tumor and anti-virus effects and efficacy in improving cardiovascular or cerebrovascular diseases and preventing osteoporosis, it has been shown to protect against diabetes and its complications. This review summarizes the current knowledge on Puerarin in diabetes and related complications, aiming to provide an overview of antidiabetic mechanisms of Puerarin and new targets for treatment.
RESUMO
A multi-resolution estimation method for interference spectrum separation from a one-dimensional broadband acoustic intensity is presented in this letter. The key of the proposed method is the recursion reconstruction and singular value decomposition of a 2×L Hankel matrix, which is constructed by a broadband intensity data sequence of length L + 1. Numerical simulation results show that this method can be used to achieve the zero-phase-shift estimation of each interference spectrum without any prior environmental information.
RESUMO
A U-Net is trained to recover acoustic interference striations (AISs) from distorted ones. A random mode-coupling matrix model is introduced to generate a large number of training data quickly, which are used to train the U-Net. The performance of AIS recovery of the U-Net is tested in range-dependent waveguides with nonlinear internal waves (NLIWs). Although the random mode-coupling matrix model is not an accurate physical model, the test results show that the U-Net successfully recovers AISs under different signal-to-noise ratios and different amplitudes and widths of NLIWs for different shapes.
RESUMO
To investigate the association of the sarcopenia index (SI, serum creatinine value/cystatin C value × 100) with 3-year mortality and readmission among older inpatients, we reanalyzed a prospective study in the geriatric ward of a teaching hospital in western China. Older inpatients aged ≥ 60 years with normal kidney function were included. Survival status and readmission information were assessed annually during the 3-year follow-up. We applied Cox regression models to calculate the hazard ratio (HR) and 95% confidence intervals (CIs) of sarcopenia for predicting mortality and readmission. We included 248 participants (mean age: 81.2 ± 6.6 years). During the follow-up, 57 participants (23.9%) died, whereas 179 participants (75.2%) were readmitted at least one time. The SI was positively correlated with body mass index (BMI) (r = 0.214, p = 0.001), calf circumference (CC) (r = 0.253, p < 0.001), handgrip strength (r = 0.244, p < 0.001), and gait speed (r = 0.221, p < 0.001). A higher SI was independently associated with a lower risk of 3-year all-cause mortality after adjusting for potential confounders (HR per 1-SD = 0.80, 95% CI: 0.63-0.97). The SI was not significantly associated with readmission (HR per 1-SD = 0.97, 95% CI: 0.77-1.25). In conclusion, the SI is associated with 3-year all-cause mortality but not readmission in a study population of hospitalized older patients.
Assuntos
Creatinina/sangue , Cistatina C/sangue , Sarcopenia/mortalidade , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , China/epidemiologia , Creatinina/análise , Cistatina C/análise , Feminino , Seguimentos , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Modelos de Riscos Proporcionais , Fatores de Risco , Sarcopenia/sangue , Sarcopenia/fisiopatologiaRESUMO
When a feed-forward neural network (FNN) is trained for acoustic source ranging in an ocean waveguide, it is difficult evaluating the FNN ranging accuracy of unlabeled test data. The label is the distance between source and receiver array. A fitting-based early stopping (FEAST) method is introduced to evaluate the FNN ranging error on test data where the distance to the source is unknown. Based on FEAST, when the evaluated ranging error is minimum on test data, training is stopped. This will improve the FNN ranging accuracy on the test data. The FEAST is demonstrated on simulated and experimental data.
Assuntos
Acústica , Redes Neurais de Computação , Som , Algoritmos , Aprendizado de MáquinaRESUMO
OBJECTIVE: To review the advances in perioperative pain management of pediatric and adolescent spinal deformity corrective surgery. METHODS: Regular analgesics, drug administrations, and analgesic regimens were reviewed and summarized by consulting domestic and overseas related literatures about perioperative pain management of pediatric and adolescent spinal deformity corrective surgery in recent years. RESULTS: As for perioperative analgesis regimens of pediatric and adolescent spinal deformity corrective surgery, regular analgesics include non-steroidal anti-inflammatory drugs, opioids, antiepileptic drugs, adrenergic agonists, and local anesthetic, etc. Besides drug administration by mouth, intravenous injection, and intramuscular injection, the administration also includes patient controlled analgesia, epidural injection, and intrathecal injection. Multimodal analgesia is the most important regimen currently. CONCLUSION: Heretofore, a number of perioperative pain managements of pediatric and adolescent spinal deformity corrective surgery have been applied clinically, but the ideal regimen has not been developed. To design a safe and effective analgesic regimen needs further investigations.
Assuntos
Manejo da Dor , Dor Pós-Operatória , Doenças da Coluna Vertebral/cirurgia , Adolescente , Analgésicos , Analgésicos Opioides , Anestésicos Locais , Criança , HumanosRESUMO
The waveguide invariant ß is typically discussed in terms of either a range-independent environment or a range-dependent environment under the adiabatic approximation, with few studies considering the effects of mode coupling. In this work, how internal solitary waves (ISWs) affect the waveguide invariant is investigated, and it is shown that mode-coupling effects introduce many additional components in the acoustic interference intensity. It is found that the striation slope and value of ß for these additional components are determined not only by the acoustic modal dispersion, but are also dependent on the position where the mode coupling occurs. This can lead to a very complicated acoustic interference pattern and result in multiple peaks in the distribution of ß. The sensitivity of ß to the parameters of ISWs, such as amplitude, horizontal scale, and position, is analyzed. It is found that although all parameters can affect the energy of the peaks, only the position of the internal wave has an obvious impact on the peak values. This indicates that the peak values of ß can be utilized for monitoring the position of the internal wave.