Structure Design of Hip Joint Parallel Rehabilitation Exoskeleton / 中国医疗器械杂志

At present, most of the research on hip exoskeleton robots adopts the method of decoupling analysis of hip joint motion, decoupling the ball pair motion of hip joint into rotational motion on sagittal plane, coronal plane and cross section, and designing it into series mechanism. Aiming at the problems of error accumulation and man-machine coupling in series mechanism, a parallel hip rehabilitation exoskeleton structure is proposed based on the bionic analysis of human hip joint. The structure model is established and the kinematics analysis is carried out. Through the OpenSim software, the curve of hip flexion and extension, adduction and abduction angle in a gait cycle is obtained. The inverse solution of the structure is obtained by the D-H coordinate system method. The gait data points are selected and compared with the inverse solution obtained by ADAMS software simulation. The results show that the inverse solution expression is correct. The parallel hip exoskeleton structure can meet the requirements of the rotation angle of the hip joint of the human body, and can basically achieve the movement of the hip joint, which is helpful to improve the human-computer interaction performance of the exoskeleton.

Parental Factors Associated With Physical Activity Among East Asian Children/Youth: A Meta-Analysis Based on the Active Healthy Kids Report Cards.

Insufficient physical activity (PA) is a leading risk factor for mortality. The Active Healthy Kids Report Cards provide comprehensive evidence related to PA in children/adolescents. Associations of (1) parental support for PA with amount of moderate-to-vigorous-intensity PA (MVPA) performed by children/adolescents and (2) amount of MVPA performed by parents with amount of MVPA performed by children/adolescents, as indicated by Report Cards, have not been critically synthesized in meta-analysis. We selected data in Asian countries/regions Report Cards and performed meta-analyses to assess pooled associations of influence indicators and behavior indicators among children/adolescents in Asian countries/regions. Our meta-analyses included five studies that assessed association of parental support or MVPA performance with child/adolescent MVPA performance. Positive association was observed between the amount of time spent by parents on MVPA per week, regardless of gender, and the amount of time spent by children and adolescents on MVPA per week (r = .11; I2 = 40%). In East Asia, the amount of MVPA performed by parents appears to be an important factor influencing the participation of children/adolescents in PA.

Incidence of acute kidney injury following pancreaticoduodenectomy and related risk factors in elderly patients / 中华肾脏病杂志

Objective:To investigate the incidence of acute kidney injury (AKI) following pancreaticoduodenectomy and related risk factors in elderly patients.Methods:The clinical data of elderly patients who underwent pancreaticoduodenectomy in Henan Provincial People′s Hospital from January 2017 to June 2020 were collected retrospectively. According to the changes of serum creatinine within 48 h or 7 days after operation, the patients were divided into AKI group and non-AKI group. The basic clinical characteristics of the two groups were compared, and the incidence of AKI was calculated. Multivariate logistic regression model was used to analyze the risk factors of postoperative AKI.Results:A total of 322 elderly patients were enrolled, with age of (67.1±5.2) years old (60-85 years old) and 186 males (57.76%). Among 322 elderly patients, there were 41 patients (12.73%) suffering from AKI following pancreaticoduodenectomy. Compared with the non-AKI group, the level of bilirubin in AKI group was higher ( Z=-2.012, P=0.044), and the level of hemoglobin in AKI group was lower ( Z=-2.111, P=0.035). Multivariate logistic regression analysis showed that increased preoperative total bilirubin ( OR=1.003, 95% CI 1.000-1.006, P=0.027) and postoperative exploratory laparotomy ( OR=3.936, 95% CI 1.071-14.460, P=0.039) were the independent influencing factors for AKI after pancreaticoduodenectomy in elderly patients. Conclusions:The incidence of AKI after pancreaticoduodenectomy in elderly patients is 12.73%. Preoperative high bilirubin and postoperative exploratory laparotomy may be the independent risk factors for AKI after pancreaticoduodenectomy in elderly patients.

Clinical features and prognostic factors of patients with metastatic renal cell carcinoma stratified by age.

This study compared the clinicopathological characteristics and survival of patients with metastatic renal cell carcinoma (mRCC) stratified by age to identify clinical features and prognostic factors. Patients with renal cell carcinoma (RCC) between 2010 and 2015 were identified from the Surveillance, Epidemiology and End Results database. Age was an independent prognostic factor for patients with RCC, mRCC, mRCC of clear cell renal cell carcinoma and lung-related metastases. There were many significant differences between the younger and older groups, including differences in marital status, race, sex, year of diagnosis, histology grade, laterality, T stage, N stage, tumor size, type of treatment, including surgery, radiation or chemotherapy, and pattern of organic metastasis to the liver, lung, or brain (P<0.05). Moreover, different natural metastasis patterns and poorer overall survival were observed in the older group compared with the younger group (P<0.05). Parameters, including marital status, sex, year of diagnosis, histological grade, N stage, surgery, chemotherapy, lung metastasis and liver metastasis, were independent prognostic factors for elderly patients (P<0.05). Age plays a significant role in mRCC, and elderly patients with mRCC are a special group of individuals whose clinical characteristics and prognostic factors are different from those of younger patients; therefore, these patients require special attention.

Influencing factors of death in intensive care unit patients with acute respiratory distress syndrome combined with acute kidney injury after continuous renal replacement therapy / 中华肾脏病杂志

Objective:To analyze the influencing factors of death in patients with acute respiratory distress syndrome (ARDS) combined with acute kidney injury (AKI) in intensive care unit (ICU) after continuous renal replacement therapy (CRRT).Methods:The demographic and clinical data of ICU patients with ARDS combined with AKI after CRRT at Henan Provincial People's Hospital from January 1, 2018 to December 31, 2018 were collected. According to the final treatment results of this hospitalization, the patients were divided into death group and survival group. Survival was defined as the improved patient's condition and hospital discharge. Death was defined as the patient's death during the ICU hospitalization or confirmed death after abandoning treatment and automatically being discharged from the hospital in the follow-up. The basic clinical characteristics and CRRT status between the two groups were compared. Multivariate logistic regression method was used to analyze the influencing factors of death in patients.Results:A total of 132 patients were enrolled, of which 90 patients (68.2%) died, with 84 males (63.6%) and median age of 59(45, 73) years. Compared with the survival group, the death group had higher age, proportion of malignant tumors, sequential organ failure assessment (SOFA) score, number of organ dysfunction and proportion of positive balance of fluid accumulation at 72 hours, longer time from entering ICU to CRRT, and lower mean arterial pressure (minimum value) and oxygenation index (all P<0.05). Multivariate logistic regression analysis results showed that the age≥60 years old ( OR=4.382, 95% CI 1.543-12.440, P=0.006), large number of organ dysfunction ( OR=1.863, 95% CI 1.109-3.130, P=0.019), high SOFA score ( OR=1.231, 95% CI 1.067-1.420, P=0.004) and long time from ICU admission to CRRT ( OR=1.224, 95% CI 1.033~1.451, P=0.020) were independent influencing factors of death in patients with ARDS combined with AKI after CRRT, and high oxygenation index ( OR=0.992, 95% CI 0.986-0.998, P=0.010) was an independent protective factor for patients' prognosis. Conclusions:The mortality of patients with ARDS combined with AKI after CRRT is still high. The age≥60 years old, large number of organ dysfunction, high SOFA score and long time from ICU admission to CRRT are independent influencing factors for death, and high oxygenation index is an independent protective factor for prognosis in patients with ARDS combined with AKI after CRRT.

COVID-19 pandemic brings a sedentary lifestyle: a cross-sectional and longitudinal study

ObjectivesThe coronavirus disease 2019 (COVID-19) pandemic continues to pose profound challenges on society. Governments around the world have managed to mitigate its spread through strategies including social distancing; however, this may result in the adoption of sedentary lifestyle. This study aimed to investigate: 1) physical activity (PA) levels, sedentary behavior (SB) and sleep among young adults during COVID-19 epidemic, and 2) the change in these behaviors before and during the pandemic. MethodsA total of 631 young adults (38.8% males) participated in the cross-sectional study and completed an online survey that included five components: general information, COVID-19 related issues, PA, SB, and sleep. For longitudinal study, PA, SB, and sleep data collected from 70 participants before and during COVID-19 pandemic were analyzed. ResultsParticipants reported engaging in low PA, high SB and long sleep duration during COVID-19 pandemic. Females had greater concern for COVID-19 related issues and engaged in more prevention strategies than males. Moreover, a significant decline in PA while increase in both times spent in SB and sleep were determined after COVID-19 outbreak. ConclusionThe results of this study demonstrated a sedentary lifestyle in young adults in responses to social distancing during the COVID-19 pandemic, which will assist health policy makers and practitioners in the development of population specific health education and behavior interventions during this pandemic and for other future events. What are the new findings?O_LIThis is the first study to investigate lifestyle behaviors in young adults during the COVID-19 pandemic and the changes in these behaviors after its outbreak. C_LIO_LILow physical activity (PA) level, high sedentary behavior (SB) and long sleep duration were found in young adults during the COVID-19 pandemic. C_LIO_LIAll types of PA and both time spent in SB and sleep significantly decreased and increased after COVID-19 outbreak, respectively. C_LI How might it impact on clinical practice in the future?The current study provided evidences that young adults engaged in sedentary lifestyle during the COVID-19 pandemic, which may assist in the development and provision of appropriate and tailored health education and behavior interventions during and after this or other future global pandemics.