Associations between levels of physical literacy and adherence to the 24-h movement guidelines among university students: A cross-sectional study.

Objectives: Emerging evidence indicates that the composition of movement behaviours within a 24-h period is associated with multiple health benefits across the lifespan. A concept that emphasises an individual's active lifestyle is physical literacy (PL), yet empirical research exploring the potential associations between PL and 24-h movement guidelines remains scarce. This study aimed to evaluate the associations between levels of PL and adherence to the guidelines among Chinese university students. Study design: A cross-sectional study. Methods: Seven hundred and ninety-eight university students (390 male, 19.2 ± 1.2 years) completed all the measurements. Levels of PL and participants' adherence to guidelines including physical activity, sedentary behaviour and sleep were self-reported through Perceived Physical Literacy Instrument, International Physical Activity Questionnaire and Pittsburgh Sleep Quality Index, respectively. Two-way ANOVA was conducted to determine the associations between the number of guidelines met (0, 1, 2, or 3) and levels of PL. Results: The results demonstrate that 36.5% (n = 291) of the participants met all the three guidelines, while 4.1% (n = 33) met none. Further analysis indicated that meeting physical activity or sedentary behaviour guidelines was associated with significantly higher total PL scores, and scores in the sub-domains of Confidence and Physical Competence and Motivation. Conclusions: The findings provide evidence that young adults who obtained higher PL scores may meet more guidelines during a 24-h period. Future studies should incorporate accelerometer-based physical activity measurements and investigate the causal relationship between PL and adherence to the movement guidelines.

A pseudo-planar metasurface for a polarization rotator.

New demonstrations of effective interaction between light and artificially electromagnetic interface, or the metasurface, have stimulated intensive research interests on control of light to realize applications in beam steering, optical imaging and light focusing, etc. Here we reported a new type of planar metasurface of which every individual metamolecule is single metallic layer with stereo structure and the metasurface is name as Pseudo-Planar Metasurface (PPM). The metamolecule of the PPM is a chiral structure and therefore derives significant optical activity.

Regenerated host axons form synapses with neurons derived from neural stem cells transplanted into peripheral nerves.

It is reported that neural stem cells (NSC) can arrest denervated muscle atrophy and promote nerve regeneration when transplanted into injured peripheral nerves, and that regenerated host axons can form synapses with transplanted and differentiated NSC. In this study, F344 rat nerve segments and F344 rat NSC were transplanted into host green fluorescence protein (GFP) transgenic F344 rats. This allowed transplanted F344 rat tissue to be used as a nonluminous background for the clear visualization of regenerated host GFP axons. Regenerated host axons grew into the transplanted F344 nerve segment 2 weeks after nerve anastomosis. Immunohistochemical staining and confocal microscope analysis revealed that regenerated host axons formed synapses with NSC-derived neurons. The findings confirmed that regenerated peripheral axons form synapses with neurons in peripheral nerves, possibly forming the basis for clinical application in peripheral nerve injury.

Computer simulation of stress distribution in the metatarsals at different inversion landing angles using the finite element method.

Metatarsal fracture is one of the most common foot injuries, particularly in athletes and soldiers, and is often associated with landing in inversion. An improved understanding of deformation of the metatarsals under inversion landing conditions is essential in the diagnosis and prevention of metatarsal injuries. In this work, a detailed three-dimensional (3D) finite element foot model was developed to investigate the effect of inversion positions on stress distribution and concentration within the metatarsals. The predicted plantar pressure distribution showed good agreement with data from controlled biomechanical tests. The deformation and stresses of the metatarsals during landing at different inversion angles (normal landing, 10 degree inversion and 20 degree inversion angles) were comparatively studied. The results showed that in the lateral metatarsals stress increased while in the medial metatarsals stress decreased with the angle of inversion. The peak stress point was found to be near the proximal part of the fifth metatarsal, which corresponds with reported clinical observations of metatarsal injuries.

Designing a 20 mm incision to protect the dorsal branch of the ulnar nerve during arthroscopic repair of triangular fibrocartilage complex injuries: Cadaver study and preliminary clinical results.

The ulnar-sided approach for arthroscopic peripheral triangular fibrocartilage complex (TFCC) repair may be associated with injury to the dorsal branch of the ulnar nerve (DBUN). The goal of this study was to develop a small incision to help minimize DBUN injury. Ten cadaveric upper limbs were used to measure the anatomic parameters of the DBUN. Based on these measured anatomical relationships, a 20 mm longitudinal incision with the ulnar styloid process as the midpoint was designed to explore and protect the DBUN. Three additional cadaveric upper limbs were used to test the feasibility of this method. Then this method was applied in 15 patients with TFCC injury (IB type). In 10 cadavers, the DBUN was located volar to the ulnar styloid process. The mean linear distance between the DBUN and the ulnar styloid process was 8.04 mm (range: 7.02-8.82mm) in the transverse-volar direction and 13.78 mm (range: 11.06-16.02mm) in the longitudinal-distal volar direction. In three additional cadavers, the DBUN was successfully explored and retracted with this incision, creating a safer space for passing sutures and tying knots. This modified method was used successfully in 15 patients, and the DBUN was protected during surgery. There were no complications, and most importantly, no injuries to the DBUN at the 6-month follow-up visit. Therefore, we recommend that a 20 mm longitudinal incision with the ulnar styloid process as the midpoint be made prior to passing sutures during the arthroscopic repair of TFCC tears to avoid injuring the various branches of the DBUN.

Plantar loading reflects ulceration risks of diabetic foot with toe deformation.

Diabetes has been one of the most common chronic diseases all over the world. The purpose of this study was to quantitatively assess the foot loading characteristics of diabetic patients with fifth-toe deformity through a comparative analysis with diabetic patients with healthy and normal feet. Six neuropathic diabetic female subjects with the fifth-toe deformation and six age-matched neuropathic diabetic controls without any feet deformities participated in the walking test. Dynamic barefoot plantar pressure was measured with Novel EMED force plate. Peak pressure and pressure-time integral for all 7 foot regions (rearfoot, midfoot, lateral forefoot, central forefoot, medial forefoot, great toe, and other toes) were collected. Peak pressure was significantly higher in the patients with toe deformity in rearfoot, central forefoot, and great toe regions compared with the control group. Meanwhile, loading sustaining period extended longer in great toe region of deformed group than in that of the control group, and the center of pressure was nearly in the big toe region during toe offstage. Diabetic patients with fifth-toe deformity could have plantar contact area reduction in the other toes part and increased loading to the great toe part. The result showed that fifth-toe deformity was associated with potential ulceration risk especially in hallux region.

The Kinematics and Kinetics Analysis of the Lower Extremity in the Landing Phase of a Stop-jump Task.

Large number of studies showed that landing with great impact forces may be a risk factor for knee injuries. The purpose of this study was to illustrate the different landing loads to lower extremity of both genders and examine the relationships among selected lower extremity kinematics and kinetics during the landing of a stop-jump task. A total of 35 male and 35 female healthy subjects were recruited in this study. Each subject executed five experiment actions. Lower extremity kinematics and kinetics were synchronously acquired. The comparison of lower extremity kinematics for different genders showed significant difference. The knee and hip maximum flexion angle, peak ground reaction force and peak knee extension moment have significantly decreased during the landing of the stop-jump task among the female subjects. The hip flexion angle at the initial foot contact phase showed significant correlation with peak ground reaction force during landing of the stop-jump task (r=-0.927, p<0.001). The knee flexion angle at the initial foot contact phase had significant correlation with peak ground reaction force and vertical ground reaction forces during landing of the stop-jump task (r=-0.908, p<0.001; r=0.812, P=0.002). A large hip and knee flexion angles at the initial foot contact with the ground did not necessarily reduce the impact force during landing, but active hip and knee flexion motions did. The hip and knee flexion motion of landing was an important technical factor that affects anterior cruciate ligament (ACL) loading during the landing of the stop-jump task.

Fibrillation potential amplitude to quantitatively assess denervation muscle atrophy.

Denervated muscle fibers exhibit spontaneous, repetitive single muscle fiber discharges and display fibrillation potentials detectable by electromyography. To explore the changing pattern of fibrillation potential amplitude after peripheral nerve injury and its relationship to the degree of muscle atrophy, fibrillation potential amplitudes were recorded on completely denervated biceps brachii of 173 patients with brachial plexus injury. Biceps brachii biopsies were taken at the same sites as the electromyogram recordings in 63 patients. The biopsies were analyzed by ATPase staining and the cross-sectional areas of fast and slow-twitch fibers were calculated. We found that the fibrillation potential amplitude and the cross-sectional areas of denervated muscle decay over time (P < 0.05), and both correlate negatively with denervation time (P < 0.01-0.05) within the first 15 months. The fibrillation potential amplitude correlates positively with both type I and II fiber cross-sectional areas (P < 0.0005-0.01). Our results show that fibrillation potential amplitude is closely correlated with muscle fiber size during the first 15 months after nerve injury, and it may therefore serve as a convenient index to evaluate quantitatively the degree of atrophy of denervated muscles. Electromyographic studies thus may help in designing treatment strategies.

The significance of venous drainage in free flap transfer.

A skin flap in the anterior abdominal wall of the S-D rat was designed so that it was supplied by the superficial epigastric branch of the femoral artery on the right side. Venous drainage was effected through one of five designs: (1) the superficial epigastric vein on the same side, (2) the lateral abdominal vein on the same side, (3) the lateral abdominal vein on the opposite side, (4) the superficial epigastric vein on the opposite side, or (5) a combination of the latter three. Seventy-seven rats were available for final analysis. The surviving percentage area of the flap was found to improve with increased venous drainage and when the arterial blood had to traverse the flap to reach the diagonally situated draining vein. The use of venae commitante as the draining vein is not satisfactory.

Introduction of a modified Krukenberg operation.

A modified Krukenberg operation was used in 25 patients to reconstruct their limb function. We modified the operation as follows: (1) only pronator teres and supinator are preserved as motor muscles, (2) the flexor carpi ulnaris is included in the ulnar ray flap and the brachioradialis in the radial ray flap, and (3) the length of the forearm trunk is kept 12 to 15 cm. Having undergone strict postoperative training, 22 of 25 patients got excellent or good results.

Free toe transfer for thumb and finger reconstruction in 300 cases.

From 1966 to 1989, we performed free toe transfer for thumb and finger reconstruction in 300 patients, with 286 survivals and 14 failures, a total survival rate of 95.55 percent. Follow-up for 2 to 23 years showed that movement and sensation of the reconstructed thumbs and fingers were satisfactory in all of the 286 cases. The optimal indications for the operation were defect of the thumb at the plane of the metacarpophalangeal joint and defects of the second to fifth fingers. Besides atraumatic isolation of the second toe and sophisticated microsurgical suturing technique, special attention was paid to intraoperative vascular variations, to providing the double arterial blood supply system if necessary, and to the identification and management of postoperative circulatory crisis.

Femoral nerve transfer for treatment of brachial plexus root avulsion.

Femoral nerve transfer to the muscular branches of the thenar and hypothenar muscles was performed to determine its protective effect on the hand intrinsic muscles. Seven cases of brachial plexus root avulsion treated from May of 1989 to October of 1991 were involved. The femoral nerve transfer to the muscular branches of the thenar and hypothenar muscles was done at the same stage of multiple neurotization. The muscular branches derived from the femoral nerve were isolated and coapted with the thenar muscle branch of the median nerve and the deep branch of the ulnar nerve. A groin flap was harvested simultaneously to form a skin-tube pedicle that covered the nerve bridge. At the second stage, when regeneration of the median and ulnar nerves was found to reach as far as the level of the wrist, the femoral nerve was divided and the muscular branches of the thenar and hypothenar muscles were anastomosed with the regenerated median and ulnar nerves. All the cases were followed up for more than 6 years. Six months after femoral nerve transfer, muscle power of the interosseous muscles and adductor pollicis recovered to MRC3, whereas that of the abductor pollicis brevis recovered to MRC1 to 2. Five cases underwent second-stage transfer. Four to five years of follow-up revealed that the muscle power of the interosseous muscles and adductor pollicis was MRC2 in one case, MRC1 in three cases, and MRC0 in one case. As for the donor area, muscle power of the quadriceps femoris reduced to M3 to 4 within 1 month after femoral nerve transfer and recovered to normal at 3 months. In conclusion, femoral nerve transfer to the muscular branches of the thenar and hypothenar muscles has some protective effect on the hand intrinsic muscles. The outcome of the second stage, however, is not satisfactory.

A new embedding method for tendon suturing.

A new embedding method in tendon suture was designed for interembedding of tendon ends to obtain interlock and strengthen antitension strength. Experiments showed that the embedding method might result in greater antitension strength than the conventional end-to-end method (Bunnell's method) or weaving method. Statistically, difference was significant. Dynamic studies on tendon healing showed that a prominent reaction of surrounding tissues occurred in 3 to 5 days after operation. In this period the antitension strength is likely to decrease and be broken with a rate of 28.1% in Bunnell's method, 5.25% in weaving method and 0% in embedding method. Clinically, the embedding method has been used in 125 cases of tendon-broken repair in which a 87.8% of good and excellent effect was resulted.

Circulatory crisis caused by cigarette smoking in tissue transfer. Clinical and experimental studies.

Cigarette smoking-induced circulatory crisis occurred in two patients receiving toe transfer and one patient having musculocutaneous flap. After anticoagulation and antispasm treatment, one survived and two failed. Experimental studies demonstrated that cigarette smoking is harmful to the healing of endothelia at the anastomotic site of vessels. Five days after operation, the complete recovery rate of the endothelium over sutures of anastomotic sites was 16%-19% in smoking groups, but 75% in the control group. The mechanism and characteristics of circulatory crisis caused by cigarette smoking are discussed.

Microsurgical treatment of brachial plexus irreversible avulsion.

A new combined measure of nerve transfer, including antebrachial medial cutaneous nerve, and free musculocutaneous flap transfer was applied to the treatment of irreversible avulsion of the brachial plexus. 12 patients underwent this operation for restoring elbow and finger flexion. Good result was obtained in 71% for elbow and 60% for finger flexion restoration. The definition of irreversible avulsion and the methods, key points and value of the operation are described and discussed in detail.

Arterialized free flap. Report of four cases.

In 1985, we applied an arterialized vein stem free flap in 4 cases with success in 3. In making this flap the superficial vein with the covered skin of the limb was used. In operation the flap was inverted and the 2 ends of the vein stem were anastomosed with the artery of the recipient area. Rapid arterial blood flow not only provided blood supply to the flap, but through the "venous network shunt" and "tidal pressure difference of artery" maintained blood circulation of the flap. The details of technique and the changes of blood circulation after flap transfer are described, as are indications advantages and mechanism of blood circulation of the flap, and factors affecting the circulation.

Root avulsion of brachial plexus in infants and children.

Twenty-one patients, under 6 years of age, with root avulsion of the brachial plexus were treated from 1975 to 1987. Among them, 9 had root avulsion of the upper trunk, 2 root avulsion of the lower trunk with middle trunk broken, and 10 root avulsion of the whole brachial plexus. Follow-up of 16 patients showed excellent results in 2 patients, good in 11, fair in 1 and poor in 2. It is suggested that good results can be obtained if multi-paired nerve transfer is adopted in treatment. We conclude that owing to anatomical and physiological characteristics of the respiratory system in children, it is harmful to perform phrenic nerve transfer concomitantly with intercostal nerve transfer. Advisably, two-stage operation is required, otherwise dyspnea and pneumonia are liable to occur. In addition, the time of the operation could be extended to 4-5 years after injury in children, but best results are obtained if the operation is performed within 1 year.

Entrapment of posterior interosseous nerve of forearm. Report of 25 cases.

Of the 25 cases of entrapment, or compression syndrome of the posterior interosseous nerve of the forearm reported, 23 were treated surgically. The compressing or entrapping factors found during the operations consisted of 14 sites in tendinous tissues, 12 in vessels, 6 in scar adhesions, and 3 unclear. Of 11 cases each had 2 or more compression sites. 19 patients underwent local decompression. And 4 cases had membranous and degenerated nerves resection and end-to-end anastomoses. Hypertrophy and inflammation appeared to be the main pathological changes in 10 cases. The causes and pathology are discussed and the early diagnosis and treatment emphasized.

Cervical nerve root transfer from contralateral normal side for treatment of brachial plexus root avulsions.

The authors had designed cervical root nerve transfer from the contralateral normal side for the treatment of brachial plexus root avulsions in August 1986. Since then, the operation was performed in 50 cases. Follow-up studies showed that resection of C-7 root from the healthy side produced no long-term ill effect except numbness and pain of the fingers and weakness of gripping strength shortly after the procedure. In 10 recipient nerves of 9 cases with follow-ups of more than 2 years, satisfactory results were seen in 7. This is a new approach for the treatment of persistent cases of brachial plexus avulsion.

Phrenic nerve transfer for treatment of root avulsion of the brachial plexus.

Phrenic nerve transfer was performed in 164 patients with root avulsion of the brachial plexus. The methods of operation consisted of phrenic nerve transfer to and anastomosis with the musculocutaneous nerve, the phrenic nerve bridging to the musculocutaneous nerve, phrenic nerve anastomosis with or bridging to the median nerve, and phrenic nerve anastomosis with other nerves. Follow-up of 65 patients for more than 2 years showed an effective rate of 84.6%. The result indicated that this operation has no deleterious effects on respiration, and the surgical effects are related to severity of injury, duration, mode of operation and patient's age.