The effect of induced joint restriction on plantar pressure during gait – a pilot study

BackgroundThe aim of this study was to analyse the effect of induced lower limb joint restriction on plantar pressures during gait. Focusing on restricting a single joint, without the effect of other co-morbidities, would provide better understanding as to the resultant plantar loadings during gait, which would be especially beneficial in patients requiring offloading procedures.Research QuestionDoes induced lower limb joint restriction affect plantar pressure distribution during gait?MethodsA prospective, quasi-experimental study was conducted, recruiting ten healthy, adult participants who were instructed to walk barefoot over a Tekscan HR Mat™. This procedure was repeated after separately inducing restriction of the hip, knee and ankle joints. Mean peak plantar pressure (MPP) and pressure-time integral (PTI) data were analysed to compare between unrestricted and restricted data.ResultsSignificant plantar pressure changes were observed in the heel and first metatarsal regions. Rearfoot PTIs were increased with restriction of the contralateral hip (left p <0.001) (right p =0.02) and knee joints (left p =0.01) (right p =0.04). Both MPPs (left p =0.01; right p =0.01) and PTIs (left p =0.004; right p =0.03) were increased in the first metatarsal when restricting the hip joint of the same limb. MPP was decreased in the left first metatarsal with induced knee (left p =0.01; right p =0.04) and ankle (left and right p <0.001) joint restriction. Finally, MPP was decreased in the right first metatarsal with knee (left and right p =0.01) and ankle (left p =0.04; right p =0.01) joint restriction.SignificanceLimited joint mobility may have a direct effect on plantar pressure, particularly with restriction in the hip and knee joints, hence careful attention should be given especially in patients with conditions involving plantar loadings. Results in this study also show that PTI changes during gait should be equally evaluated clinically along with peak plantar pressure analysis.     

Multi-Frequency Contrast Source Inversion for Reflection Seismic Data

In the contrast source inversion (CSI) method, the contrast sources (equivalent scattering sources) and the contrast (parameter perturbation) are iteratively reconstructed by an alternating optimization scheme. Traditionally integral equation CSI method is formulated for transmission tomography using analytic Green's function in homogeneous background. To extend the method to the case of reflection seismology, in this paper, we use WKBJ method to compute the Green's function of depth dependent background media and the solving method of equations to initialize the contrast source of different frequencies, resulting in an efficient method to invert multi-frequency reflection seismic data – multi-frequency contrast source inversion method (MFCSI). Numerical results for the Marmousi model show that MFCSI method can obtain good results even when low frequency data are missing, in which case the conventional FWI fails.     

哈尔滨市农村癫痫患者健康相关生命质量评价研究

目的 评价哈尔滨市农村癫痫患者健康相关生命质量并分析其影响因素。方法 通过简单随机抽样方法，随机选取哈尔滨市236例惊厥型癫痫患者，基于中国人群的EQ-5D效应值积分体系计算癫痫患者健康效应值，采用秩和检验和Tobit回归模型方法对癫痫患者健康水平影响因素进行分析。结果 调查的236名癫痫患者在5个维度有困难者占比排序为:焦虑或沮丧（42.74%）、疼痛或不适（30.77%）、日常活动（28.63%）、自己照顾自己（18.80%）、行动（16.67%），基于中国积分体系计算癫痫患者健康效应值为0.85，Tobit回归模型结果表明，职业（95%CI = 0.004～0.313，P = 0.045）、体育运动（95%CI = 0.001～0.438，P = 0.049）、最近一次发作时间（95%CI = - 0.316～- 0.020，P = 0.027）、总病程（95%CI = - 0.051～- 0.387，P = 0.011）对癫痫患者的健康效用值得分有统计学差异。结论 癫痫对患者心理方面的影响程度大于生理方面，应加大对癫痫患者心理方面的关注。脑力劳动者、体育运动的癫痫患者健康效用值相对较高，发作时间在0～3个月内、总病程较长的癫痫患者健康效用值相对较低。     

金匮肾气丸临症加减治疗甲状腺功能减退临床观察

目的探究甲状腺功能减退(甲减)患者实施重要金匮肾气丸随症加减治疗的临床疗效及对甲状腺功能的影响。方法从2018年4月-2019年7月期间在本院进行治疗的甲减患者中随机抽取84例参与研究,根据数字表法随机分成观察组和对照组,每组42例患者。对照组采用常规西医疗法,观察组在西医疗法基础上采用金匮肾气丸随症加减治疗。就两组患者治疗前后的中医症状积分、甲状腺功能指标、甲状腺过氧化物酶抗体(TPOAb)和甲状腺球蛋白抗体(TGAb)进行对比分析。结果治疗后两组患者中医正装积分显著低于治疗前,且观察组患者中医症状积分显著低于对照组,差异有统计学意义(P<0.05);治疗后两组游离三碘甲状腺原氨酸(free triiodothyronine,FT3)和游离四碘甲状腺原氨酸(free tetraiodothyronine,FT4)水平高于治疗前,促甲状腺激素(thyroid stimulating hormone,TSH)水平显著低于治疗前,且观察组患者治疗后FT3和FT4水平高于对照组,TSH水平显著低于对照组,差异有统计学意义(P<0.05);治疗后两组患者的TPOAb和TGAb水平均明显低于治疗前,且观察组患者治疗后的TPOAb和TGAb水平低于对照组,差异有统计学意义(P<0.05)。结论甲减患者的临床治疗中给药金匮肾气丸能够有效改善患者的症状体征,改善其异常的甲状腺激素、TPOAb和TGAb水平,可促进患者尽快恢复。     

Combination therapy with ciprofloxacin and third-generation cephalosporin versus third-generation cephalosporin monotherapy in Escherichia coli meningitis in infants: a multicentre propensity score–matched observational study

ObjectivesEscherichia coli is the second cause of bacterial meningitis in neonates. Despite the use for 35 years of third-generation cephalosporins (3GCs), high morbidity and mortality rates with E. coli meningitis continue to occur. Because ciprofloxacin has good microbiologic activity against E. coli and good penetration in cerebrospinal fluid and brain, some authors have suggested adding ciprofloxacin to a 3GC regimen. The objective of this study was to assess combining 3GCs with ciprofloxacin versus 3GCs alone in a cohort of infants with E. coli meningitis.MethodsWe included all cases of E. coli meningitis diagnosed in infants <12 months of age that were prospectively collected through the French paediatric meningitis surveillance network between 2001 and 2016. The main outcome was the proportion of short-term neurologic complications with versus without ciprofloxacin. The analysis was conducted retrospectively by multivariable regression and propensity score (PS) analysis.ResultsAmong the 367 infants enrolled, 201 (54.8%) of 367 had ciprofloxacin and 3GC cotreatment and 166 (45.2%) of 367 only a 3GC. Median age and weight were 15 days (range, 1–318 days) and 3.42 kg (range, 0.66–9.4 kg). A total of 86 (23.4%) of 367 infants presented neurologic complications (seizures, strokes, empyema, abscesses, hydrocephalus, arachnoiditis); 57 received ciprofloxacin cotreatment. Complications were associated with ciprofloxacin cotreatment on multivariable analysis (odds ratio (OR) = 1.9; 95% confidence interval (CI), 1.1–3.4) and PS analysis (OR = 1.9; 95% CI, 1.1–3.3). Mortality rate did not differ with and without ciprofloxacin: 22 (10.9%) of 201 versus 16 (9.6%) of 166 deaths (OR = 0.7; 95% CI, 0.3–1.6; PS analysis).ConclusionsCiprofloxacin added to 3GCs at least offers no advantage for neurologic outcome and mortality in infants with E. coli meningitis.     

A Promising Energetic Polymer from Posidonia oceanica Brown Algae: Synthesis,Characterization, and Kinetic Modeling

In this study, microcrystalline cellulose nitrate (MCCN) as energetic polymer is successfully obtained from Posidonia oceanica brown algae (POBA). Fourier transform infrared spectroscopy (FTIR) results show alterations in the intensities of some absorption bands, suggesting a significant difference in the chemical structure between microcrystalline cellulose and the emergent MCCN samples. X‐ray diffraction (XRD) measurements indicate that MCCNs are more crystalline than conventional nitrocellulose (NC). According to scanning electron microscopy (SEM), both NC and MCCN reveal a compact structure and a rough surface. Differential scanning calorimetry (DSC) displays that the thermal degradation of MCCNs shifts to lower temperatures compared to the respective NCs. Furthermore, in comparison with NC samples, MCCN samples exhibit high density, high nitrogen content, low viscosity‐average molecular weight, and good thermal stability. On the other hand, kinetic modeling based on DSC data is carried out by isoconversional integral methods to determine Arrhenius parameters and the decomposition mechanisms. It is found that MCCNs present lower activation energies than conventional NCs with a decrease of ≈6%. Finally, this work opens a new pathway to prepare MCCN from POBA, and it is expected to have applications in several areas such as propellants, energetic binders, and gas generators.     

Delay‐dependent feedforward control of time‐delay systems with parametric uncertainties via dynamic IQCs

This paper studies the design problem of a robust delay‐dependent H _∞ feedforward controller design for a class of linear uncertain time‐delay system having state and control delays when the system is subject to ‐type disturbances. The proposed controller scheme involves two main controllers, which are static state‐feedback and dynamic feedforward controllers. The state‐feedback controller is used for stabilizing the delay and uncertainty‐free system, whereas the feedforward controller performs disturbance attenuation. Dynamic type integral quadratic constraints (IQCs), which consist of frequency‐dependent multipliers, have been introduced to represent the delays and parametric uncertainties in the system where the degree of the multiplier used in IQC representation is in an adjustable nature. This scheme allows the designer to obtain less conservative controllers with increasing precision. Sufficient delay‐dependent criteria in terms of linear matrix inequalities are obtained such that the uncertain linear time‐delay system is guaranteed to be globally, uniformly, asymptotically stable with a minimum disturbance attenuation level. Several numerical examples together with the simulation studies provided at the end illustrate the usefulness of the proposed design. Copyright © 2012 John Wiley & Sons, Ltd.     

枳实消痞丸联合黄芪建中汤治疗功能性消化不良(脾胃虚弱)疗效观察

目的观察枳实消痞丸联合黄芪建中汤治疗功能性消化不良(脾胃虚弱)疗效。方法将86例患者按就诊顺序号随机分治疗组和对照组各43例。对照组多潘立酮,10 mg/次,3次/d;法莫替丁,20 mg/次,2次/d。治疗组黄芪建中汤,1剂/d,水煎200 mL,早晚两次温服;枳实消痞丸,6 g/次,3次/d。连续治疗4周为1疗程。观测临床表现、证候积分、尼平消化不良指数(NDI)评分、汉密尔顿抑郁量表(HAMD)评分、不良反应。治疗1疗程(4周),判定疗效。结果证候积分两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。NDI、HAMD评分两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。结论枳实消痞丸联合黄芪建中汤治疗功能性消化不良(脾胃虚弱),疗效满意,无严重不良反应,值得推广。