The feasibility, acceptability, safety, and effects of early weight bearing in humeral fractures - a scoping review.

PURPOSE: Non-weight bearing is often recommended after humeral fractures. This review aims to summarise the extent and nature of the evidence for the feasibility, acceptability, safety, and effects of early weight bearing (EWB) in people with humeral fractures, treated operatively or non-operatively. . METHODS: Data sources identified published (PUBMED, EMBASE, CINAHL) and unpublished (ClinicalTrials.gov, CENTRAL, NIHR Open Research, OpenGrey) literature. Independent data extraction was conducted by two reviewers. RESULTS: 13 901 records were retrieved. Ten studies, involving 515 post-operative patients and 351 healthcare professionals, were included. EWB was found to be feasible in nine studies. There was limited evidence regarding adherence to EWB. Trauma and orthopaedic surgeons reported that EWB was acceptable. This depended on surgery type and whether it was a post-operative polytrauma case. No acceptability data was reported from patients' perspectives. Only one study reported two patients who developed unsatisfactory outcomes from excessive post-operative EWB. Positive effects of EWB were reported on disability level, pain, shoulder and elbow motion, and union. CONCLUSION: There is some evidence for the feasibility, safety, and effectiveness of post-operative EWB after humeral fractures. There was limited data on the acceptability of EWB. Heterogeneous study designs, and variations in EWB protocols limit conclusions.

There is some evidence to support the feasibility, safety, and effectiveness of early weight bearing following operative management of humeral fractures.Early weight bearing after some humeral fractures is acceptable to some subspecialities of orthopaedic surgeons but is not universally accepted.Rehabilitation professionals should discuss the option of early weight bearing after operative management of humeral fracture with patients and their multidisciplinary team.

Productivity, photosynthetic light-use efficiency, nitrogen metabolism and nutritional quality of C4 halophyte Portulaca oleracea L. grown indoors under different light intensities and durations.

Portulaca oleracea L. (known as purslane), is a nutritious facultative C4 halophyte. Recently, it has been successfully grown indoors under LED lightings by our team. However, basic understanding about the impacts of light on purslanes are lacking. This study aimed to investigate the effects of light intensity and duration on productivity, photosynthetic light use efficiency, nitrogen metabolism and nutritional quality of indoor grown purslanes. All plants were grown in 10% artificial seawater hydroponically under different photosynthetic photon flux densities (PPFDs) and durations and thus different daily light integrals (DLI). They are, L1 (240 µmol photon m-2 s-1, 12 h, DLI = 10.368 mol m-2 day-1); L2 (320 µmol photon m-2 s-1, 18 h, DLI = 20.736 mol m-2 day-1); L3 (240 µmol photon m-2 s-1, 24 h, DLI = 20.736 mol m-2 day-1); L4 (480 µmol photon m-2 s-1, 12 h, DLI = 20.736 mol m-2 day-1), respectively. Compared to L1, higher DLI promoted root and shoot growth and thus increased shoot productivity by 2.63-,1.96-, 3.83-folds, respectively for purslane grown under L2, L3, L4. However, under the same DLI, L3 plants (continuous light, CL) had significantly lower shoot and root productivities compared those with higher PPFDs but shorter durations (L2 and L4). While all plants had similar total chlorophyll and carotenoid concentrations, CL (L3) plants had significantly lower light use efficiency (Fv/Fm ratio), electron transport rate, effective quantum yield of PSII, photochemical- and non-photochemical quenching. Compared to L1, higher DLI with higher PPFDs (L2 and L4) increased leaf maximum nitrate reductase activity while longer durations increased leaf NO 3 - concentrations and total reduced nitrogen. There were no significant differences in leaf total soluble protein, total soluble sugar and total ascorbic acid concentrations in both leaf and stem regardless of light conditions. However, L2 plants had the highest leaf proline concentration but leaf total phenolic compounds concentration was higher in L3 plants instead. Generally, L2 plants had the highest dietary minerals such as K, Ca, Mg and Fe among the four different light conditions. Overall, L2 condition is the most suitable lighting strategy in enhancing productivity and nutritional quality of purslane.

A robotic leg inspired from an insect leg.

While most insect-inspired robots come with a simple tarsus, such as a hemispherical foot tip, insect legs have complex tarsal structures and claws, which enable them to walk on complex terrain. Their sharp claws can smoothly attach and detach on plant surfaces by actuating a single muscle. Thus, installing an insect-inspired tarsus on legged robots would improve their locomotion on complex terrain. This paper shows that the tendon-driven ball-socket structure provides the tarsus with both flexibility and rigidity, which is necessary for the beetle to walk on a complex substrate such as a mesh surface. Disabling the tarsus' rigidity by removing the socket and elastic membrane of a tarsal joint, means that the claws could not attach to the mesh securely. Meanwhile, the beetle struggled to draw the claws out of the substrate when we turned the tarsus rigid by tubing. We then developed a cable-driven bio-inspired tarsus structure to validate the function of the tarsus as well as to show its potential application in the legged robot. With the tarsus, the robotic leg was able to attach and retract smoothly from the mesh substrate when performing a walking cycle.

Remote radio control of insect flight reveals why beetles lift their legs in flight while other insects tightly fold.

In the research and development of micro air vehicles, understanding and imitating the flight mechanism of insects presents a viable way of progressing forward. While research is being conducted on the flight mechanism of insects such as flies and dragonflies, research on beetles that can carry larger loads is limited. Here, we clarified the beetle midlegs' role in the attenuation and cessation of the wingbeat. We anatomically confirmed the connection between the midlegs and the elytra. We also further clarified which pair of legs are involved in the wingbeat attenuation mechanism, and lastly demonstrated free-flight control via remote leg muscle stimulation. Observation of multiple landings using a high-speed camera revealed that the wingbeat stopped immediately after their midlegs were lowered. Moreover, the action of lowering the midleg attenuated and often stopped the wingbeat. A miniature remote stimulation device (backpack) mountable on beetles was designed and utilized for the free-flight demonstration. Beetles in free flight were remotely induced into lowering (swing down) each leg pair via electrical stimulation, and they were found to lose significant altitude only when the midlegs were stimulated. Thus, the results of this study revealed that swinging down of the midlegs played a significant role in beetle wingbeat cessation. In the future, our findings on the wingbeat attenuation and cessation mechanism are expected to be helpful in designing bioinspired micro air vehicles.

Acupuncture in Post-Stroke Shoulder Pain Syndrome with Multiple Sclerosis: A Case Study.

The present case study illustrates the case of a 47-year-old female (Ms X) with primary progressive Multiple Sclerosis (MS) who presented with central post-stroke pain (CPSP) over her left shoulder and underwent acupuncture treatment (AT) since she appeared irresponsive to conventional treatment. The aim of this case study is to explore the effectiveness of acupuncture as a complimentary treatment in improving central neurogenic pain in MS patients affected by CPSP. AT lasted six weeks, some modification of the conventional AT points was required to ensure continuity and safety of the treatment plan. In fact, Ms X suffered from gingivitis that led to hypersensitivity of her left upper limb (UL) to acupuncture needling; moreover, she experienced sensation loss in her legs as a result of post-stroke complications. The outcome showed that the subject's shoulder range of motion (ROM), Disabilities of the Arm, Shoulder and Hand (DASH) score and pain improved remarkably, enabling Ms X to resume post-stroke rehabilitation and reduce her analgesic intake.

Smooth and slipless walking mechanism inspired by the open-close cycle of a beetle claw.

This study investigated the function of the beetle's claw for its smooth and slipless walking and designed an artificial claw open-close cycle mechanism to mimic the beetle's walking. First, the effects of claw opening and closing on beetles' ability to attach to surfaces were examined. A beetle does not have an attachment pad, and only its claws work to grip the ground; its claw opens and closes and attaches with two sharp hooks. With their claws, beetles can smoothly walk, neither slipping on nor having their claws stuck in the surface. How do they perform smooth walking with sharp claws? In this study, we observed that beetles close their claws when they raise and swung their legs forward, while they open their claws when they lowered their legs to the ground. We then conducted non-destructive tests: their claws were forced open or closed. There was a significant difference in the trajectories of forced-closed claws compared to intact claws and forced-open claws. When their claws were forced-closed, this caused slippage in walking. On the other hand, when a claw was forced-open and its rotation was also inhibited, the claw stuck heavily in the surface, and the beetle could not walk. Based on these findings, we designed an artificial claw to open and close in the same cyclic manner as in the case of natural beetles. The performance of the artificial claw was consistent with the conclusions drawn from natural beetles: the locomotive robot with the artificial claw smoothly moved without slippage. Through these observations, non-destructive tests and performance of the bio-inspired artificial claws, this study confirmed the function of the open-close cycle of beetle claws and demonstrated and successfully adopted it for a locomotive robot.

Three new spider species of Irura Peckham & Peckham, 1901 from China (Araneae: Salticidae).

Three new species of the genus Irura are described from China: I. montiformis sp. nov., I. zhangae sp. nov. and I. yinae sp. nov. Distributional data, detailed morphological characteristics, and illustrations of body and genital organs are presented.