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We propose and experimentally demonstrate a parallel pulsed chaos light detection and ranging (LiDAR) system with a high peak power, parallelism, and anti-interference. The system generates chaotic microcombs based on a chip-scale Si3N4 microresonator. After passing through an acousto-optic modulator, the continuous-wave chaotic microcomb can be transformed into a pulsed chaotic microcomb, in which each comb line provides pulsed chaos. Thus, a parallel pulsed chaos signal is generated. Using the parallel pulsed chaos as the transmission signal of LiDAR, we successfully realize a 4-m three-dimensional imaging experiment using a microelectromechanical mirror for laser scanning. The experimental results indicate that the parallel pulsed chaos LiDAR can detect twice as many pixels as direct detection continuous wave parallel chaos LiDAR under a transmission power of -6 dBm, a duty cycle of 25%, and a pulse repetition frequency of 100 kHz. By further increasing the transmission power to 10 dBm, we acquire an 11â cm × 10â cm image of a target scene with a resolution of 30 × 50 pixels. Finally, the anti-jamming ability of the system is evaluated, and the results show that the system can withstand interferences of at least 15â dB.
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INTRODUCTION: Comorbidities, such as gastroesophageal reflux disease (GERD), are common in patients with rhinosinusitis (RS). However, the link between RS and GERD has not been fully understood. This study aimed to investigate the causal relationship between GERD and acute (ARS) or chronic RS (CRS), providing references for the pathogenesis and management of RS. METHODS: The data were obtained from the Integrative Epidemiology Unit Open GWAS project and FinnGen. A total of 972,838 individuals were included. The inverse variance-weighted (IVW) method was applied to obtain the primary results of the study. Weighted median, MR-Egger, and mode-based methods were used to determine the robustness of the results. Cochran's Q statistic and MR-Egger method were applied to detect heterogeneity and pleiotrophy in instrumental variables (IVs). Other sensitivity analyses included MR-PRESSO and leave-one-out analysis. RESULTS: The MR study showed that GERD was associated with an increased risk of CRS (OR: 1.36, 95% CI: 1.18-1.57, p < 0.001). The results of other analysis methods were broadly consistent with the IVW estimate. No heterogeneity was detected by Cochran's Q test (p = 0.061) and MR-PRESSO (p = 0.074). No horizontal pleiotropy was shown in IVs (p = 0.700). GERD was also associated with an increased risk of ARS (OR: 1.31, 95% CI: 1.17-1.48, p < 0.001). Some analytical results were inconsistent with the IVW estimate. No heterogeneity and pleiotropy were observed. There was no sufficient evidence for a reverse causal effect of RS on GERD. CONCLUSION: Our study supported that GERD promoted the risk of CRS and may be a potential risk factor for ARS. This provides additional support for further investigation into the mechanisms of GERD on RS.
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Refluxo Gastroesofágico , Rinossinusite , Humanos , Análise da Randomização Mendeliana , Refluxo Gastroesofágico/complicações , Refluxo Gastroesofágico/epidemiologia , Fatores de Risco , Estudo de Associação Genômica AmplaRESUMO
The Ambassador Bridge between Detroit, Michigan, and Windsor, Ontario, has served for almost 100 years as North America's busiest international border crossing. But in 2025, the Ambassador will be replaced by the new Gordie Howe International Bridge. The Gordie Howe is a cable-stayed bridge, with two massive 220 m tall concrete piers on opposite banks of the St. Claire River, a single clear span of 853 m, and 42 m of clearance over this busy waterway. To ensure durability in this harsh freeze-thaw environment, air-entrained concrete is specified throughout. And, to ensure the quality of air entrainment, the ASTM C 457 Procedure C, Contrast Enhanced Method is employed. While a similar automated microscopic approach has been in use for well over a decade according to EN 480-11 Determination of air void characteristics in hardened concrete, this is the first large-scale application of automated air void assessment in North American infrastructure. According to the ASTM Procedure C, the air void characteristics are determined through digital image processing, while the paste content may be determined by either mix design parameters, manual point count, or 'other means'. Of these three options, point counting is used for Gordie Howe; but in parallel, during each point count, the digital image coordinates and phase identifications for each evaluated stop are recorded. This allows for training of a neural network, for automated determination of paste content, as demonstrated here.
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BACKGROUND: Previous studies have demonstrated that trans fatty acids (TFAs) intake was linked to an increased risk of chronic diseases. As a novel systemic inflammatory biomarker, the clinical value and efficacy of the systemic immune-inflammation index (SII) have been widely explored. However, the association between TFAs and SII is still unclear. Therefore, the study aims to investigate the connection between TFAs and SII in US adults. METHODS: The study retrieved data from the National Health and Nutrition Examination Survey (NHANES) for the years 1999-2000 and 2009-2010. Following the exclusion of ineligible participants, the study encompassed a total of 3047 individuals. The research employed a multivariate linear regression model to investigate the connection between circulating TFAs and SII. Furthermore, the restricted cubic spline (RCS) model was utilized to evaluate the potential nonlinear association. Subgroup analysis was also conducted to investigate the latent interactive factors. RESULTS: In this investigation, participants exhibited a mean age of 47.40 years, with 53.91% of them being female. Utilizing a multivariate linear regression model, the independent positive associations between the log2-transformed palmitelaidic acid, the log2 transformed-vaccenic acid, the log2-transformed elaidic acid, the log2-transformed linolelaidic acid, and the log2-transformed-total sum of TFAs with the SII (all P < 0.05) were noted. In the RCS analysis, no nonlinear relationship was observed between the log2-transformed palmitelaidic acid, the log2 transformed-vaccenic acid, the log2-transformed elaidic acid, the log2-transformed linolelaidic acid, the log2-transformed-total sum of TFAs and the SII (all P for nonlinear > 0.05). For the stratified analysis, the relationship between the circulating TFAs and the SII differed by the obesity status and the smoking status. CONCLUSIONS: A positive association was investigated between three types of TFA, the sum of TFAs, and the SII in the US population. Additional rigorously designed studies are needed to verify the results and explore the potential mechanism.
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Inflamação , Ácidos Graxos trans , Humanos , Ácidos Graxos trans/sangue , Feminino , Pessoa de Meia-Idade , Masculino , Estudos Transversais , Adulto , Inflamação/sangue , Inflamação/imunologia , Inquéritos Nutricionais , Ácidos Oleicos , Modelos Lineares , Biomarcadores/sangueRESUMO
BACKGROUND AND PURPOSE: Flow-diversion treatment for intracranial aneurysms has been associated with the development of in-stent stenosis (ISS) for unclear reasons. We assess whether the size of the stent relative to that of the vessel (the stent-to-vessel diameter ratio, or SVR) may be predictive of the development of ISS after treatment with flow diverters. METHODS: We retrospectively reviewed patients with unruptured intracranial aneurysms who underwent flow-diversion treatment using either the Pipeline or Tubridge embolization device from September 2018 to September 2022. The relationship between SVR and ISS was analyzed. Multiple logistic regression models were used to determine the significant predictors. RESULTS: A total of 458 patients with 481 aneurysms were included. In a mean angiographic follow-up of 10.73 ± 3.97 months, ISS was detected in 68 cases (14.1 %). After adjusting for candidate variables, a higher distal SVR (DSVR) was associated with an increased risk of ISS (adjusted odds ratio [aOR] = 3.420, 95 % confidence interval [CI] = 1.182 - 9.889, p = 0.023). We conducted a subgroup analysis of the two different flow diverters to assess the effects of their individual characteristics. Our results showed a significant association between the DSVR and the incidence of ISS in both the Pipeline (aOR = 4.033, 95 % CI = 1.156-14.072, p = 0.029) and Tubridge groups (aOR = 11.981, 95 % CI=1.005-142.774, p = 0.049). CONCLUSION: A higher DSVR was associated with an increased risk of ISS. This may help neurointerventionalists select an appropriate stent size when conducting flow-diversion treatment for intracranial aneurysms.
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Procedimentos Endovasculares , Aneurisma Intracraniano , Desenho de Prótese , Stents , Humanos , Aneurisma Intracraniano/terapia , Aneurisma Intracraniano/diagnóstico por imagem , Aneurisma Intracraniano/fisiopatologia , Masculino , Feminino , Estudos Retrospectivos , Pessoa de Meia-Idade , Fatores de Risco , Idoso , Resultado do Tratamento , Procedimentos Endovasculares/efeitos adversos , Procedimentos Endovasculares/instrumentação , Medição de Risco , Fatores de Tempo , Embolização Terapêutica/instrumentação , Embolização Terapêutica/efeitos adversos , Adulto , Angiografia Cerebral , Circulação Cerebrovascular , Grau de Desobstrução VascularRESUMO
Optical power splitters with ultra-broadband and ultra-low insertion loss are desired in the field of photonic integration. Combining two inverse design algorithms for staged optimization, we present the design of a Y-junction photonic power splitter with 700â nm wavelength bandwidth (from 1200â nm to 1900â nm) within a 0.2â dB insertion loss, corresponding to a 93 THz frequency bandwidth. The average insertion loss is approximately -0.057â dB in the valuable C-band. Moreover, we comprehensively compared the insertion loss performance of different types and sizes of curved waveguides, and also give the cases of 1:4 and 1:6 cascaded power splitters. These scalable Y-junction splitters provide new alternatives for high-performance photonic integration.
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Electromagnetic wave analog computing is an effective method to overcome the bottleneck of electronic computing, which has attracted the attention of scientists. However, many spatial analog signal processing systems based on electromagnetic waves can only execute one unique mathematical operator and cannot provide multiple operators for users to choose arbitrarily. In order to enhance the function of the current spatial analog computing system, we design a coding structure with amplitude-phase decoupling modulation to realize the analog signal processor that supports the switching of mathematical operators and demonstrate the precise switching from the first-order spatial differential operator to the first-order spatial integral operator. Our design idea can be used as a paradigm for designing small reconfigurable analog computing systems, paving the way for the construction of high-speed, multifunctional, and universal signal processing systems. This idea can be extended to any other range of waves.
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The autophagy/apoptosis interaction has always been a focus of study in pathogenicity models. Neuritin is a neurotrophic factor that is highly expressed primarily in the central nervous system. Our previous study revealed that it protects against apoptosis in cortical neurons subjected to oxygen-glucose deprivation (OGD)/reoxygenation (OGD/R), and later animal experiments revealed that it can increase the expression of the autophagy-related protein LC3. Whether this neuroprotective effect is closely related to autophagy is still unclear. In this study, we hypothesized that neuritin can promote autophagic flux to protect nerve cells after OGD/R. To verify this hypothesis, we induced OGD/R in primary cortical neurons and assessed cell viability by the CCK8 and LDH assays. Cell apoptosis was assessed by Annexin V-FITC/PI, staining, and the contents and mRNA abundances of the autophagy-related proteins LC3 and p62, the apoptotic protein Caspase3 were quantified by Western blotting and RT-PCR. Autophagic flux was assessed by immunofluorescence after RFP-GFP-LC3 virus transfection, and ultrastructural changes in autophagosomes were observed by transmission electron microscopy (TEM). The results showed that cell viability was decreased, apoptosis was increased and autophagy was enhanced after OGD/R. Neuritin significantly increased cell viability, decreased apoptosis, further increased the expression of the autophagic flux-related protein LC3, further decreased p62 expression, and significantly increased the autophagosome number and autophagosome to lysosome ratio. Bafilomycin A1 (BafA1) is a late autophagy inhibitor, aggravated cell damage and apoptosis and counteracted the enhancement of autophagy activation and protective effects of neuritin. In conclusion, neuritin may promote the completion of autophagic flux by ameliorating neuronal damage after OGD/R.
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Autofagia , Glucose/deficiência , Neurônios/efeitos dos fármacos , Neuropeptídeos/metabolismo , Fármacos Neuroprotetores/farmacologia , Oxigênio/metabolismo , Traumatismo por Reperfusão/prevenção & controle , Animais , Apoptose , Sobrevivência Celular , Células Cultivadas , Proteínas Ligadas por GPI/genética , Proteínas Ligadas por GPI/metabolismo , Neurônios/metabolismo , Neurônios/patologia , Neuropeptídeos/genética , Ratos , Ratos Sprague-Dawley , Traumatismo por Reperfusão/etiologia , Traumatismo por Reperfusão/patologiaRESUMO
In the Lixiahe region of China, co-culture has been rapidly promoted in flooded paddy fields owing to its ecological and economic benefits. Rice-prawn co-culture can reduce the damage of crab and shrimp to rice growth and paddy field and substantially change the soil microbial community and soil fertility. In this study, we compared changes in the soil microbial community and soil fertility in waterlogged paddies under conventional rice culture (CR), rice-prawn (Macrobrachium nipponense) co-culture (RP), and pond culture (PC). The microbial abundance in RP was significantly higher than that in CR. RP soil microbial diversity was significantly higher than PC soil microbial diversity. The dominant bacteria in RP soil were Proteobacteria, Chloroflexi, and Bacteroidetes. Compared with those in CR, total organic matter (TOM) and total nitrogen in RP were relatively stable, available potassium and available phosphorus (AP) decreased, and other indicators increased significantly. Soil fertility significantly benefited from co-culture, with total organic carbon (TOC) increasing. Interactive relationship analysis showed that TOM, TOC, AP, and NH4+-N were the main factors affecting the microbial community. Co-occurrence network analyses showed that network modularity increased with co-culture, indicating that a unique soil microbial community formed under co-culture, improving the adaptability and tolerance to co-culture. Thus, RP is a suitable culture method for this commercially important species. The results of this study can inform the practical operation of fertilizer use and sustainable development of rice-prawn aquaculture systems. KEY POINTS: ⢠Microbial abundance and diversity increased under rice-prawn co-culture. ⢠Co-culture significantly improved soil fertility, with an increase in TOC. ⢠Rice-prawn co-culture is an ecologically suitable culture method for prawns.
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Microbiota , Oryza , Palaemonidae , Animais , Solo , Fertilizantes/análise , Oryza/microbiologia , Microbiologia do Solo , Técnicas de Cocultura , Nitrogênio/análise , Fósforo , Potássio , Carbono , Agricultura/métodosRESUMO
We report a unique case of a 25-year-old man who was incidentally identified to have a mass in the left adrenal gland region by computerized tomography scan. The image revealed a 1.8 × 1.6 cm, well-defined adrenal mass with moderately homogeneous enhancement. The mass was laparoscopically completely removed, and the diagnosis of a solid variant glomus tumor of the adrenal gland was rendered. There were no histologic features indicating atypia or malignance and no primary tumors anywhere else. The patient was free of disease at the 6-month follow-up. To our knowledge, this is the first case of primary adrenal glomus tumor described in the literature.
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Neoplasias das Glândulas Suprarrenais , Tumor Glômico , Neoplasias das Glândulas Suprarrenais/diagnóstico por imagem , Neoplasias das Glândulas Suprarrenais/cirurgia , Adulto , Tumor Glômico/diagnóstico por imagem , Tumor Glômico/cirurgia , Humanos , Masculino , Tomografia Computadorizada por Raios XRESUMO
The pathogenesis and development of ankylosing spondylitis (AS) is concealed and complicated. In recent years, alterations in gut microbiota of AS patients have been largely investigated, although the underlying mechanisms remain unclear. This article reviews the recent studies on changes of gut microbiota in AS patients, and discusses the possible correlation between intestinal dysbiosis and AS development from aspects including genetic factor HLA-B27, mucosal immune responses and the depression accompanying AS.
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Disbiose/imunologia , Disbiose/microbiologia , Espondilite Anquilosante/imunologia , Espondilite Anquilosante/microbiologia , Citocinas/metabolismo , Disbiose/complicações , Microbioma Gastrointestinal , Antígeno HLA-B27/imunologia , Humanos , Imunidade nas Mucosas , Imunoglobulina A , Inflamação/imunologia , Intestinos/imunologia , Intestinos/microbiologia , Espondilite Anquilosante/complicaçõesRESUMO
Objectives This article assessed the balance between industry and drug policy objectives in the pharmaceutical sector in China. Methods The articles were mainly identified through databases such as Elsevier, Google Scholar, and SpringerLink, among others. Related articles were mainly separated into three categories: studies on drug policies, studies related to China's new health-care reform policy, and studies concerning patent policies. Results A relatively healthy environment for continuous innovation and drug patent protection in the pharmaceutical industry has been created in China, and the public's drug benefits have also significantly improved. However, the balance between industrial and drug policy objectives in the pharmaceutical sector in China requires additional attention. Discussion and conclusions The results suggest that the government should pay more attention to incentivizing enterprises' innovation, but the current Essential Medicines System in China has limited innovation. Hence, the mechanism for selecting essential medicines should be reformed, and certain appropriate and reasonably innovative medicines should be included. Additionally, medicine coverage, especially the coverage of essential drugs for primary care should be expanded to improve public health benefits. Furthermore, the pharmaceutical industry should be incorporated into the prospective National Drug Policy to achieve a balance between public benefits and pharmaceutical industry development in the future.
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Background: Cuspidevia Jäch & Boukal, 1995 is a member of the tribe Macronychini which has the following features: antennae short, 6-10 segmented, aedeagus long and cylindrical, paramere very small, slender or lacking. This genus currently comprises only three species. All species are distributed in China. New information: Cuspideviapilosus sp. nov. is reported from Guangdong, Guangxi and Jiangxi Provinces in China. Habitus and diagnostic features of the new species are illustrated.
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Recently, transformer-based backbones show superior performance over the convolutional counterparts in computer vision. Due to quadratic complexity with respect to the token number in global attention, local attention is always adopted in low-level image processing with linear complexity. However, the limited receptive field is harmful to the performance. In this paper, motivated by Octave convolution, we propose a transformer-based single image super-resolution (SISR) model, which explicitly embeds dynamic frequency decomposition into the standard local transformer. All the frequency components are continuously updated and re-assigned via intra-scale attention and inter-scale interaction, respectively. Specifically, the attention in low resolution is enough for low-frequency features, which not only increases the receptive field, but also decreases the complexity. Compared with the standard local transformer, the proposed FDRTran layer simultaneously decreases FLOPs and parameters. By contrast, Octave convolution only decreases FLOPs of the standard convolution, but keeps the parameter number unchanged. In addition, the restart mechanism is proposed for every a few frequency updates, which first fuses the low and high frequency, then decomposes the features again. In this way, the features can be decomposed in multiple viewpoints by learnable parameters, which avoids the risk of early saturation for frequency representation. Furthermore, based on the FDRTran layer with restart mechanism, the proposed FDRNet is the first transformer backbone for SISR which discusses the Octave design. Sufficient experiments show our model reaches state-of-the-art performance on 6 synthetic and real datasets. The code and the models are available at https://github.com/catnip1029/FDRNet.
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Autistic Children often struggle with social interaction and communication, studies have found that many of them prefer to interact with objects than people. However, there is a lack of research exploring the specific characteristics and factors involved in interactions within families with autistic children where objects are the center of the interaction. This paper describes the process and findings of a diary study exploring how young autistic children interact with their families through objects in natural scenarios. A one-week diary study was conducted with six families with young autistic children. Diary videos were recorded onsite and coded later according to a social interaction behavior scheme with corresponding diary entries. Qualitative data analysis was conducted to reveal possible patterns. Results revealed ongoing difficulties in establishing and maintaining family interaction and identified influential factors of object-centered family interaction. The most prevalent pattern observed was parents taking the lead in interactions, followed by the child's confirmation response. Remarkably, daily necessities emerged as potential physical mediums for enhancing family interactions, opening avenues for exploring tangible designs in human-computer interaction. These findings offer valuable implications for future research and the development of innovative designs that promote enriching interactions for autistic children and their families.
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Transtorno Autístico , Criança , Humanos , Comunicação , Meios de Cultura , Pais , Exame FísicoRESUMO
Objective: This study aims to determine whether the live birth rates were similar between GnRH antagonist original reference product Cetrotide® and generic Ferpront®, in gonadotropin-releasing hormone (GnRH) antagonist protocol for controlled ovarian stimulation (COS). Methods: This retrospective cohort study investigates COS cycles utilizing GnRH antagonist protocols. The research was conducted at a specialized reproductive medicine center within a tertiary care hospital, spanning the period from October 2019 to October 2021. Within this timeframe, a total of 924 cycles were administered utilizing the GnRH antagonist originator, Cetrotide® (Group A), whereas 1984 cycles were undertaken using the generic, Ferpront® (Group B). Results: Ovarian reserve markers, including anti-Mullerian hormone, antral follicle number, and basal follicular stimulating hormone, were lower in Group A compared to Group B. Propensity score matching (PSM) was performed to balance these markers between the groups. After PSM, baseline clinical features were similar, except for a slightly longer infertile duration in Group A versus Group B (4.43 ± 2.92 years vs. 4.14 ± 2.84 years, P = 0.029). The duration of GnRH antagonist usage was slightly longer in Group B than in Group A (6.02 ± 1.41 vs. 5.71 ± 1.48 days, P < 0.001). Group B had a slightly lower number of retrieved oocytes compared to Group A (14.17 ± 7.30 vs. 14.96 ± 7.75, P = 0.024). However, comparable numbers of usable embryos on day 3 and good-quality embryos were found between the groups. Reproductive outcomes, including biochemical pregnancy loss, clinical pregnancy, miscarriage, and live birth rate, did not differ significantly between the groups. Multivariate logistic regression analyses suggested that the type of GnRH antagonist did not independently impact the number of oocytes retrieved, usable embryos, good-quality embryos, moderate to severe OHSS rate, clinical pregnancy, miscarriage, or live birth rate. Conclusion: The retrospective analysis revealed no clinically significant differences in reproductive outcomes between Cetrotide® and Ferpront® when used in women undergoing their first and second COS cycles utilizing the GnRH antagonist protocol.
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Hormônio Liberador de Gonadotropina , Antagonistas de Hormônios , Indução da Ovulação , Humanos , Hormônio Liberador de Gonadotropina/antagonistas & inibidores , Hormônio Liberador de Gonadotropina/análogos & derivados , Feminino , Estudos Retrospectivos , Indução da Ovulação/métodos , Gravidez , Adulto , Antagonistas de Hormônios/uso terapêutico , Antagonistas de Hormônios/administração & dosagem , Antagonistas de Hormônios/efeitos adversos , Taxa de Gravidez , Coeficiente de Natalidade , Medicamentos Genéricos/uso terapêutico , Reserva Ovariana/efeitos dos fármacosRESUMO
BACKGROUND: Emerging clinical evidence has been discovered associating Inflammatory bowel disease (IBD) with Henoch-Schönlein purpura (HSP) and immune thrombocytopenia (ITP). However, it is unclear whether a cause-effect relationship exists between them. We aimed to examine the casual effect of IBD on the risk of HSP and ITP. METHODS: Based on summary statistics from International IBD Genetics (IIBDG) Consortium and FinnGen study, a two-sample Mendelian randomization study was carried out to determine whether IBD including ulcerative colitis (UC) and Crohn's disease (CD) is causally related to HSP, ITP or secondary thrombocytopenia. To support the results, a variety of sensitivity analyses were performed. RESULTS: Significant causal relationships between IBD and HSP (odds ratios = 1.20, 95% confidence interval: 1.07-1.36, adjusted P = 0.006) and ITP (odds ratios =1.22, 95% confidence interval: 1.08-1.38, adjusted P = 0.006) were found. Both genetically predicted UC and CD were positively related with ITP, while CD alone may be responsible for the higher risk of HSP. Besides, no significant association was observed between IBD and secondary thrombocytopenia. CONCLUSIONS: The results of this Mendelian randomization study supported the causal association of IBD with HSP and ITP. Taken together, our findings may present implications for management of IBD.
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Colite Ulcerativa , Doença de Crohn , Vasculite por IgA , Doenças Inflamatórias Intestinais , Púrpura Trombocitopênica Idiopática , Trombocitopenia , Humanos , Púrpura Trombocitopênica Idiopática/genética , Análise da Randomização Mendeliana , Vasculite por IgA/complicações , Vasculite por IgA/genética , Doenças Inflamatórias Intestinais/complicações , Doenças Inflamatórias Intestinais/genética , Doença de Crohn/genética , Colite Ulcerativa/complicações , Colite Ulcerativa/genéticaRESUMO
OBJECTIVES: Analyzing the lower limb coronal morphological parameters in populations without knee osteoarthritis (KOA) holds significant value in predicting, diagnosing, and formulating surgical strategies for KOA. This study aimed to comprehensively analyze the variability in these parameters among Chinese non-KOA populations, employing a substantial sample size. METHODS: A cross-sectional retrospective analysis was performed on the Chinese non-KOA populations (n = 407; 49.9% females). The study employed an in-house developed artificial intelligence software to meticulously assess the coronal morphological parameters of all 814 lower limbs. The parameters evaluated included the hip-knee-ankle angle (HKAA), weight-bearing line ratio (WBLR), joint line convergence angle (JLCA), mechanical lateral-proximal-femoral angle (mLPFA), mechanical lateral-distal-femoral angle (mLDFA), mechanical medial-proximal-tibial angle (mMPTA), and mechanical lateral-distal-tibial angle (mLDTA). Differences in these parameters were compared between left and right limbs, different genders, and different age groups (with 50 years as the cut-off point). RESULTS: HKAA and JLCA exhibited left-right differences (left vs. right: 178.2° ± 3.0° vs. 178.6° ± 2.9° for HKAA, p = 0.001; and 1.8° ± 1.5° vs. 1.4° ± 1.6° for JLCA, p < 0.001); except for the mLPFA, all other parameters show gender-related differences (male vs. female: 177.9° ± 2.8° vs. 179.0° ± 3.0° for HKAA, p < 0.001; 1.5° ± 1.5° vs. 1.8° ± 1.7° for JLCA, p = 0.003; 87.1° ± 2.1° vs. 88.1° ± 2.1° for mMPTA, p < 0.001; 90.2° ± 4.0° vs. 91.1° ± 3.2° for mLDTA, p < 0.001; 38.7% ± 12.9% vs. 43.6% ± 14.1% for WBLR, p < 0.001; and 87.7° ± 2.3° vs. 87.4° ± 2.7° for mLDTA, p = 0.045); mLPFA increase with age (younger vs. older: 90.1° ± 7.2° vs. 93.4° ± 4.9° for mLPFA, p < 0.001), while no statistical difference exists for other parameters. CONCLUSIONS: There were differences in lower limb coronal morphological parameters among Chinese non-KOA populations between left and right sides, different genders, and age.
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Osteoartrite do Joelho , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Osteoartrite do Joelho/diagnóstico por imagem , Osteoartrite do Joelho/cirurgia , Estudos Retrospectivos , Estudos Transversais , Inteligência Artificial , Extremidade Inferior/diagnóstico por imagem , Tíbia/cirurgia , Articulação do Joelho , ChinaRESUMO
OBJECTIVES: Older individuals with multimorbidity are at an elevated risk of infection and complications from COVID-19. Effectiveness of post-COVID-19 interventions or care models in reducing subsequent adverse outcomes in these individuals have rarely been examined. This study aims to examine the effectiveness of attending general outpatient within 30 days after discharge from COVID-19 on 1-year survival among older adults aged 85 years or above with multimorbidity. DESIGN: Retrospective cohort study emulating a randomised target trial using electronic health records. SETTING: We used data from the Hospital Authority and the Department of Health in Hong Kong, which provided comprehensive electronic health records, COVID-19 confirmed case data, population-based vaccination records and other individual characteristics for the study. PARTICIPANTS: Adults aged 85 years or above with multimorbidity who were discharged after hospitalisation for COVID-19 between January 2020 and August 2022. INTERVENTIONS: Attending a general outpatient within 30 days of last COVID-19 discharge defined the exposure, compared to no outpatient visit. MAIN OUTCOME MEASURES: Primary outcome was all-cause mortality within one year. Secondary outcomes included mortality from respiratory, cardiovascular and cancer causes. RESULTS: A total of 6183 eligible COVID-19 survivors were included in the analysis. The all-cause mortality rate following COVID-19 hospitalisation was lower in the general outpatient visit group (17.1 deaths per 100 person-year) compared with non-visit group (42.8 deaths per 100 person-year). After adjustment, primary care consultations within 30 days after discharge were associated with a significantly greater 1-year survival (difference in 1-year survival: 11.2%, 95% CI 8.1% to 14.4%). We also observed significantly better survival from respiratory diseases in the general outpatient visit group (difference in 1-year survival: 6.3%, 95% CI 3.5% to 8.9%). In a sensitivity analysis for different grace period lengths, we found that the earlier participants had a general outpatient visit after COVID-19 discharge, the better the survival. CONCLUSIONS: Timely primary care consultations after COVID-19 hospitalisation may improve survival following COVID-19 hospitalisation among older adults aged 85 or above with multimorbidity. Expanding primary care services and implementing follow-up mechanisms are crucial to support this vulnerable population's recovery and well-being.
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COVID-19 , Multimorbidade , Atenção Primária à Saúde , Humanos , COVID-19/mortalidade , COVID-19/terapia , COVID-19/epidemiologia , Feminino , Masculino , Idoso de 80 Anos ou mais , Estudos Retrospectivos , Hong Kong/epidemiologia , SARS-CoV-2 , Hospitalização/estatística & dados numéricosRESUMO
BACKGROUND: Older adults with multimorbidity are at high risk of mortality following COVID-19 hospitalisation. However, the potential benefit of timely primary care follow-up on severe outcomes post-COVID-19 has not been well established. AIM: To examine the effectiveness of attending general outpatient within 30 days after discharge from COVID-19 on 1-year survival among older adults aged ≥85 years, with multimorbidity. METHOD: We emulated a target trial using a comprehensive public healthcare database in Hong Kong. The cloning-censoring-weighting technique was used to minimise immortal time bias and confounding bias by adjusting for demographics, hospitalisation duration and ICU admission, baseline chronic conditions, and medication history. The outcome included all-cause and cause-specific mortality. RESULTS: Of 6183 eligible COVID-19 survivors, the all-cause mortality rate following COVID-19 hospitalisation was lower in general out-patient clinics (GOPC) group compared to non-GOPC group (17.1 versus 42.8 deaths per 100 person-year). After adjustment, primary care consultations within 30 days after discharge were associated with a significantly greater 1-year survival (difference in 1-year survival: 11.2%, 95% CI = 8.1% to 14.4%). We also observed better survival from respiratory diseases in the GOPC group. In a sensitivity analysis for different grace period lengths, we found that the earlier participants had a GOPC visit after COVID-19 discharge, the better the survival. CONCLUSION: Timely primary care consultations after discharge may improve survival following COVID-19 hospitalisation among older adults aged ≥85 years, with multimorbidity. Expanding primary care services and implementing follow-up mechanisms are crucial to support this vulnerable population's recovery and well-being.