bluuebunny/crossref_metadata_2025 huggingface dataset:
Modelling the potential health and economic benefits of reducing population sitting time in Australia
Authors: Nguyen Phuong , Ananthapavan Jaithri , Tan Eng Joo , Crosland Paul , Bowe Steve J. , Gao Lan , Dunstan David W. , Moodie Marj
Published: March 2022

Background

Strong evidence indicates that excessive time spent sitting (sedentary behaviour) is detrimentally associated with multiple chronic diseases. Sedentary behaviour is prevalent among adults in Australia and has increased during the COVID-19 pandemic. Estimating the potential health benefits and healthcare cost saving associated with reductions in population sitting time could be useful for the development of public health initiatives.

Methods

A sedentary behaviour model was developed and incorporated into an existing proportional, multi-state, life table Markov model (ACE-Obesity Policy model). This model simulates the 2019 Australian population (age 18 years and above) and estimates the incidence, prevalence and mortality of five diseases associated with sedentary behaviour (type 2 diabetes, stroke, endometrial, breast and colorectal cancer). Key model inputs included population sitting time estimates from the Australian National Health Survey 2014–2015, healthcare cost data from the Australian Institute of Health and Welfare (2015) and relative risk estimates assessed by conducting literature reviews and meta-analyses. Scenario analyses estimated the potential change in disease incidence as a result of changes in population sitting time. This, in turn, resulted in estimated improvements in long term health outcomes (Health-adjusted life years (HALYs)) and healthcare cost-savings.

Results

According to the model, if all Australian adults sat no more than 4 h per day, the total HALYs gained would be approximately 17,211 with health care cost savings of approximately A$185 million over one year. Under a more feasible scenario, where sitting time was reduced in adults who sit 4 or more hours per day by approximately 36 min per person per day (based on the results of the Stand Up Victoria randomised controlled trial), potential HALYs gained were estimated to be 3,670 and healthcare cost saving could reach A$39 million over one year.

Conclusions

Excessive sedentary time results in considerable population health burden in Australia. This paper describes the development of the first Australian sedentary behaviour model that can be used to predict the long term consequences of interventions targeted at reducing sedentary behaviour through reductions in sitting time. These estimates may be used by decision makers when prioritising healthcare resources and investing in preventative public health initiatives.
Associations between food-specific IgG and health outcomes in an asymptomatic physical examination cohort
Authors: Wu Mingxia , Wang Xiaofang , Sun Li , Chen Zongtao
Published: March 2022

Background

Although the association of food-specific IgG with the development and progression of specific diseases was shown by many studies, it is also present in the population without clinical symptoms. However, the association between food-specific IgG and physical examination outcomes in healthy people has not been studied yet.

Methods

An asymptomatic physical examination cohort (APEC) was selected according to the inclusion and exclusion criteria, the physical examination data were compared between IgG positive and IgG negative groups, and their odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using multivariable logistic regression.

Results

The data of 28,292 subjects were included in the analysis. The overall IgG positive rate was up to 52.30%, mostly with mild to moderate IgG positivity. The multivariable Logistic regression showed the prevalence of hypertriglyceridemia, abnormal fasting blood glucose and overweight was lower in the IgG (+) positive group (OR 0.87, 95% CI 0.83–0.92; OR 0.93, 95% CI 0.87–0.99; OR 0.92, 95% CI 0.87–0.96) but there was a higher prevalence of thyroid disease (OR 1.09, 95% CI 1.04–1.15).

Conclusion

Food-specific IgG positivity was widespread in the APEC and was associated with lower prevalence of hypertriglyceridemia, abnormal fasting blood glucose and overweight. The underlying physiological mechanism merits further study.
The impact of age in acute type A aortic dissection: a retrospective study
Authors: Wang Jun-Xia , Xue Yun-Xing , Zhu Xi-Yu , Chong Ho-Shun , Chen Zhong , Zhou Qing , Qu Jason-Zhensheng , Wang Dong-Jin
Published: March 2022

Background

Acute type A aortic dissection (aTAAD) is a lethal disease and age is an important risk factor for outcomes. This retrospective study was to analyze the impact of age stratification in aTAAD, and to provide clues for surgeons when they make choices of therapy strategies.

Methods

From January 2011 to December 2019, 1092 aTAAD patients from Nanjing Drum Tower Hospital received surgical therapy. Patients were divided into 7 groups according to every ten-year interval (20–80 s). The differences between the groups were analyzed in terms of the baseline preoperative conditions, surgical methods and postoperative outcomes of patients of different age groups. During a median follow-up term of 17 months, the survival rates were compared among 7 groups through Kaplan–Meier analysis.

Results

The median age was 52.0 years old in whole cohort. The multiple comorbidities were more common in old age groups (60 s, 70 s, 80 s), while the 20 s group patients had the highest proportion of Marfan syndrome (28.1%). Preoperative hypotension was highest in 80 s (16.7%, P = 0.038). Young age groups (20–60 s) had a higher rate of root replacement and total arch replacement, which led to a longer duration of operation and hypothermic circulation arrest. The overall mortality was 14.1%, the tendency of mortality was increased with age except 20 s group (33.3% in 80 s, P = 0.016). The postoperative morbidity of gastrointestinal bleeding and bowel ischemia were 16.7% and 11.1% in 80 s group.

Conclusions

Age is a major impact factor for aTAAD surgery. Old patients presented more comorbidities before surgery, the mortality and complications rate were significantly higher even with less invasive and conservative surgical therapy. But the favorable long-term survival indicated that the simple or less extensive arch repair is the preferred surgery for patients over 70 years old.
Medical error in treatment of Amanita phalloides poisoning in pre-hospital care
Authors: Smędra Anna , Wochna Katarzyna , Zawadzki Dariusz , Berent Jarosław
Published: March 2022

Background

Geopolitical and climate changes form the background of the current migration crisis. It has many faces. One of them are the tragic cases of poisoning of refugees due to eating wild forest mushrooms for socioeconomic reasons in the Western and Northern European countries. The most serious food poisonings in Europe, but not only, are caused by lamellar mushrooms, the most dangerous being Amanita phalloides. Its poisonous properties can be attributed to α-amanitin, an RNA polymerase II inhibitor. Unfortunately, as it is characterized by a delayed onset of symptoms, A. phalloides poisoning has a high risk of complications.

Case presentation

Our article presents a case of A. phalloides poisoning in a 28-year-old man, in which the responding medical emergency unit made errors in diagnosis and treatment. Since the correct diagnosis was made too late, the typical treatment of A. phalloides poisoning was ineffective. The patient suffered a life-threatening liver failure and needed liver transplant from a deceased donor.

Conclusions

Mushroom poisoning is a particularly important problem not only in countries with a mushroom picking tradition, but also—due to the inflow of refugees—in countries where mushroom poisoning was very rare until recently. In such cases it is crucial to quickly implement the correct procedure, as this can prevent the need for liver transplant or even death. This is a particularly important consideration for the first medical professionals to contact the patient, especially in cases where the patient reports mushrooms consumption and presents alarming symptoms of the gastrointestinal tract. Such situations cannot be underestimated and ignored.
The differential diagnosis of IgG4-related disease based on machine learning
Authors: Yamamoto Motohisa , Nojima Masanori , Kamekura Ryuta , Kuribara-Souta Akiko , Uehara Masaaki , Yamazaki Hiroki , Yoshikawa Noritada , Aochi Satsuki , Mizushima Ichiro , Watanabe Takayuki , Nishiwaki Aya , Komai Toshihiko , Shoda Hirofumi , Kitagori Koji , Yoshifuji Hajime , Hamano Hideaki , Kawano Mitsuhiro , Takano Ken-ichi , Fujio Keishi , Tanaka Hirotoshi
Published: March 2022

Introduction

To eliminate the disparity and maldistribution of physicians and medical specialty services, the development of diagnostic support for rare diseases using artificial intelligence is being promoted. Immunoglobulin G4 (IgG4)-related disease (IgG4-RD) is a rare disorder often requiring special knowledge and experience to diagnose. In this study, we investigated the possibility of differential diagnosis of IgG4-RD based on basic patient characteristics and blood test findings using machine learning.

Methods

Six hundred and two patients with IgG4-RD and 204 patients with non-IgG4-RD that needed to be differentiated who visited the participating institutions were included in the study. Ten percent of the subjects were randomly excluded as a validation sample. Among the remaining cases, 80% were used as training samples, and the remaining 20% were used as test samples. Finally, validation was performed on the validation sample. The analysis was performed using a decision tree and a random forest model. Furthermore, a comparison was made between conditions with and without the serum IgG4 concentration. Accuracy was evaluated using the area under the receiver-operating characteristic (AUROC) curve.

Results

In diagnosing IgG4-RD, the AUROC curve values of the decision tree and the random forest method were 0.906 and 0.974, respectively, when serum IgG4 levels were included in the analysis. Excluding serum IgG4 levels, the AUROC curve value of the analysis by the random forest method was 0.925.

Conclusion

Based on machine learning in a multicenter collaboration, with or without serum IgG4 data, basic patient characteristics and blood test findings alone were sufficient to differentiate IgG4-RD from non-IgG4-RD.
Do old urinary biomarkers have a place in the new definition of hepatorenal syndrome in the Egyptian cirrhotic patients? A single-center experience
Authors: El-Makarem Mona Abd El-Rahman Abu , Mahmoud Yehia Zakaryia , Moussa Mahmoud Mohammed , El-Saghir Shereen Mohammed Mohammed , Keryakos Hesham Kamal Habeeb
Published: March 2022

Background

Hepatorenal syndrome is still a diagnosis of exclusion despite new classification.

Aims

To validate the accuracy of urinary neutrophil gelatinase-associated lipocalin, interleukin-18, and kidney injury molecule-1 in the new diagnostic criteria of hepatorenal syndrome in Egyptian patients with hepatitis C virus-related liver cirrhosis using serum creatinine as a gold standard test for acute kidney injury.

Methods

One-hundred twenty cirrhotic patients with ascites were recruited and divided into two groups depending on the presence or absence of renal impairment, and 40 age- and sex-matched cirrhotic patients without ascites used as controls participated in the study. Urinary biomarkers were measured and compared with conventional biomarkers used to assess kidney function (serum creatinine, estimated glomerular filtration rate).

Results

The mean urinary neutrophil gelatinase-associated lipocalin, interleukin-18, and kidney injury molecule-1 were statistically significantly higher in patients with hepatorenal syndrome and were found to be helpful in the early detection with cutoff values of 125 ng/ml, 34.8 pg/ml, and 3.1 pg/ml, respectively.

Conclusions

Urinary neutrophil gelatinase-associated lipocalin, interleukin-18, and kidney injury molecule-1 levels are higher in patients with cirrhotic ascites complicated by HRS-AKI using the new definition of HRS, but IL-18 has lower sensitivity and specificity for the prediction of HRS-AKI as compared to NGAL and KIM-1.
Three-dimensional magnetotelluric modeling in a mixed space-wavenumber domain
Authors: Dai Shikun , Zhao Dongdong , Wang Shunguo , Li Kun , Jahandari Hormoz
Published: March 2022

We have developed a new 3D magnetotelluric modeling scheme in a mixed space-wavenumber domain. The modeling scheme is based on using a 2D Fourier transform along two horizontal directions to solve a vector-scalar potential formula derived from Maxwell’s equations based on the primary-secondary potential separation. The derived 1D governing equations in a mixed space-wavenumber domain are solved by using the finite-element method (FEM) together with a chasing method, and then the 2D inverse Fourier transform is used to recover the final solution of the electromagnetic (EM) fields in the 3D spatial domain. An iterative scheme is applied to approximate the true solution by repeating the previous steps because the governing equations cannot be solved directly due to an unusual primary-secondary potential field separation used. Nevertheless, the new method is capable of reducing the memory requirement and computational time in the mixed domain, and the 1D governing equations are highly parallel among different wavenumbers. For each of the 1D equations, the two- or four-node Gaussian quadrature rule can be used in both horizontal directions for Gauss fast Fourier transform. It is worth mentioning that the linear matrix equation to be solved is a fixed bandwidth system, and the chasing method is more efficient and convenient than solvers with preconditioners for the 1D matrix equations. The reliability and efficiency of the newly proposed method are verified with three synthetic 3D models by comparisons with a classical integral equation solution, an adaptive FEM solution, and a nonadaptive FEM solution. The proposed algorithm will be used in electrical resistivity tomography and controlled-source EM methods in future studies.
Modeling of pure visco-qP-wave propagation in attenuating tilted transversely isotropic media based on decoupled fractional Laplacians
Authors: Mu Xinru , Huang Jianping , Yang Jidong , Zhang Jianfeng , Wang Zhiliang
Published: March 2022

The pseudoviscoacoustic anisotropic wave equation is widely used in the oil and gas industry for modeling wavefields in attenuating anisotropic media. Compared to the full viscoelastic anisotropic wave equation, it can greatly reduce the computational cost of wavefield modeling while maintaining the visco-qP-wave kinematics very well. However, even if we place the source in a thin isotropic layer, there will be some unwanted S-wave artifacts in the qP wavefield simulated by the pseudoviscoacoustic anisotropic wave equation due to the stepped approximation of inclined layer interfaces. Furthermore, the wavefield simulated by the pseudoviscoacoustic anisotropic wave equation may suffer from numerical instabilities when the anisotropy parameter epsilon is less than delta. To overcome these problems, we derive a pure-viscoacoustic tilted transversely isotropic (TTI) wave equation in media with anisotropy in velocity and attenuation based on the exact complex-valued phase velocity formula. The pure-viscoacoustic TTI wave equation has decoupled amplitude dissipation and phase dispersion terms, which is suitable for further reverse time migration with Q compensation. For numerical simulations, we adopt the second-order Taylor series expansion to replace the mixed-domain spatially variable fractional Laplacian operator, which guarantees the decoupling of the wavenumber from the space-related fractional order. Then, we use an efficient and stable hybrid finite-difference and pseudospectral method (HFDPSM) to solve the pure-viscoacoustic TTI wave equation. Numerical tests indicate that the simulation results of the newly derived pure-viscoacoustic TTI wave equation are stable, free from S-wave artifacts, and accurate. We further demonstrate that HFDPSM outperforms the pseudospectral method in terms of numerical simulation stability and computing efficiency.
Building subsurface models with horizon-guided interpolation and deep learning: Application to the Volve field data
Authors: Yan Shangsheng , Sun Xiaoming , Wu Xinming , Zhang Sibo , Si Hongjie
Published: March 2022

Subsurface modeling plays an important role in hydrocarbon exploration but remains a challenging task that typically requires a full and reasonable integration of geophysical observations and geologic constraints. We have developed a workflow to fully use seismic amplitudes, well-log properties, and interpreted seismic structures to build geologically reasonable models. We take the Volve field data as an example and apply our workflow step by step as follows. First, we perform some preprocessing on the provided Volve seismic data, horizons, and well logs to remove anomalous values and adjust seismic-well ties in the depth domain. Second, we use a dynamic-programming-based method to infill gaps and refine the vertical positions of the provided horizons and efficiently pick more horizons. We further use the horizon surfaces to interpolate a relative geologic time (RGT) volume which can be considered as an implicit structural model representing seismic structural and stratigraphic features. Third, we integrate the provided well logs and the computed RGT volume to interpolate a subsurface model that conforms to well-log properties and seismic structural and stratigraphic features. Finally, we propose a multiscale neural network to predict a final subsurface model by using a combination of the seismic data and the interpolated model as inputs and using the well-log data as training labels. Inputting the interpolated model to the network helps to provide a low-frequency control for obtaining a more stable prediction. The results indicate that our workflow is able to produce geologically reasonable subsurface models with high lateral continuity and vertical resolution.
Cycle-skipping mitigation using misfit measurements based on differentiable dynamic time warping
Authors: Chen Fuqiang , Peter Daniel , Ravasi Matteo
Published: March 2022

The dynamic time warping (DTW) misfit function has been used for full-waveform inversion to mitigate the local minima issue. However, it is not a smooth measurement and can yield strong discontinuities in the adjoint source. Such a weakness hampers the convergence of waveform inversion to informative minima. We have introduced a smooth DTW misfit function to remedy this shortcoming. The fundamental idea of the smooth DTW is to replace the min operator with its smooth relaxation. This replacement results in differentiable misfit measurements. Moreover, considering that the optimal warping plan indicates the traveltime difference between the observed and synthetic trace, we can construct a penalization term such that the penalized differentiable DTW distance further highlights the traveltime difference. Numerical examples demonstrate the advantage of the penalized differentiable DTW misfit function over the conventional nondifferentiable one.
Laminar structure differences and heterogeneities in reservoirs in continental organic-rich shales: The Cretaceous Nenjiang Formation in the Songliao Basin
Authors: Hua Ganlin , Wu Songtao , Zhang Jinyou , Yu Xinghe , Guan Modi , Zhao Yue , Liu Rongchang
Published: March 2022

Shale has a unique laminar structure that is currently the focus of considerable interest and a great deal of research in the academic community and industry. Studies have focused primarily on the differences among laminar combinations, whereas only a few have investigated the structure of individual lamina. In this study, we use typical organic-rich shale from the Cretaceous Nenjiang Formation in the Songliao Basin as an example and analyze each individual lamina of the shale on a millimeter scale. We have investigated heterogeneities among the different laminae by using X-ray fluorescence analysis, rock slicing, laser scanning confocal microscopy, field emission scanning electron microscopy, total organic carbon (TOC), rock pyrolysis, X-ray diffraction mineral analysis, electronic computer tomography (nano-CT), nitrogen adsorption, and other experimental methods. Four laminar units — composed of clay minerals, feldspar-quartz, and calcite — are distinguished based on their different levels of Ca, K, and Fe. We designate these units as UA, UB, UC, and UD (from the top to bottom in the formation). The palaeoenvironment, organic geochemical parameters, and mineral compositions of the different laminar structures are “two-stage” in character. From UD to UA, TOC values indicate a slightly decreasing trend, whereas the calcite content indicates a substantial increase, which is related to gradual reduction in the paleodepth, increasing aridity of the climate, increase of salinity, and decrease of reducibility during the sedimentary period. Different laminae correspond to different pore structures. The pore types in units UC and UD are mainly clay mineral-related pores and pyrite intergranular pores. In contrast, calcite dissolution pores are common in units UA and UB. Nitrogen adsorption and nano-CT data indicate that the pore development degree and pore size of organic matter in units UC and UD are better than those of units UA and UB. The porosity of UD is 2.6 times higher than that of UA. Laminae have an important influence on shale quality. The traditional approach to shale evaluation takes laminar combinations in shale strata as the research unit. Switching the focus to the heterogeneity of individual lamina could help in the selection of “sweet spots” and identification of optimal locations for shale oil exploration and development.
Vasoinhibin is Generated and Promotes Inflammation in Mild Antigen-induced Arthritis
Authors: Ortiz Georgina , Ledesma-Colunga Maria G , Wu Zhijian , García-Rodrigo Jose F , Adan Norma , Martinez-Diaz Oscar F , De Los Ríos Ericka A , López-Barrera Fernando , Martínez de la Escalera Gonzalo , Clapp Carmen
Published: March 2022

Inflammatory arthritis defines a family of diseases influenced by reproductive hormones. Vasoinhibin, a fragment of the hormone prolactin (PRL), has antiangiogenic and proinflammatory properties. We recently showed that vasoinhibin reduces joint inflammation and bone loss in severe antigen-induced arthritis (AIA) by an indirect mechanism involving the inhibition of pannus vascularization. This unexpected finding led us to hypothesize that a severe level of inflammation in AIA obscured the direct proinflammatory action of vasoinhibin while allowing the indirect anti-inflammatory effect via its antiangiogenic properties. In agreement with this hypothesis, here we show that the intra-articular injection of an adeno-associated virus type-2 vector encoding vasoinhibin reduced joint inflammation in a severe AIA condition, but elevated joint inflammation in a mild AIA model. The proinflammatory effect, unmasked in mild AIA, resulted in joint swelling, enhanced leukocyte infiltration, and upregulation of expression of genes encoding proinflammatory mediators (Il1b, Il6, Inos, Mmp3), adhesion molecule (Icam1), and chemokines (Cxcl1, Cxcl2, Cxcl3, Ccl2). Furthermore, vasoinhibin induced the expression of proinflammatory mediators and chemokines in cultured synovial fibroblasts through nuclear factor-κB. Finally, matrix metalloproteases and cathepsin D, upregulated in the arthritic joint, cleaved PRL to vasoinhibin, and vasoinhibin levels increased in the circulation of mice subjected to AIA. We suggest that vasoinhibin is generated during inflammatory arthritis and acts on synovial fibroblasts and endothelial cells to initially promote and later inhibit inflammation, respectively. These opposite effects may work together to help keep joint inflammation under balance.
Study on the effects of the use of therapeutic ultrasound in the treatment of osteoarticular diseases
Authors: Silișteanu Andrei-Emanuel , Szakács Juliánna
Published: March 2022

Introduction. The use of therapeutic ultrasounds is a method that proved its efficiency in articu-lar and periarticular pathology, in the subacute and chronic stages. The biological effects of the ultrasound use are determined by their interaction with the cellular structures whereas the re-sults depend on the used parameters. The purpose of the survey is to evaluate / identify the ef-fects of using ultrasounds in the treatment of musculoskeletal conditions (lumbar discopathy), knee osteoarthritis). Material and method. The survey was conducted on an outpatient basis in a period of 7 months and it is of the longitudinal type. It included 151 patients diagnosed with low back pain and knee osteoarthritis. The evaluated parameters were: pain, functional skills, articu-lar rigidity and the quality of life. Results. The effects of the use of ultrasounds is found in the decrease of pain, the stiffness of the joints and the contracture of the muscles, as shown by the re-sults of several surveys. Our survey proves that the use of ultrasounds decreases pain and in-creases the functional skills, it influences the physical function more obviously in patients with knee osteoarthritis, which is an aspect found in others surveys. Discussion. The use of a complex ultrasound treatment (in the pulsed way to avoid thermal effects) and kinesiotherapy enabled in our research the decrease of the pain and of the rigidity in the joints, the increase of the function-al skills and the quality of life, whereas these obtained results are in accordance with those of others surveys. Conclusions. The use of the therapeutic ultrasounds can have the following ef-fects: the decrease of the pain and of the joint rigidity, the improvement of the physical capacity for daily activities and the improvement of the quality of life. The use of low intensity ultra-sounds can determine biological effects with actions for a short period or for an average one. Keywords: therapeutic ultrasound, treatment, osteoarticular diseases, quality of life
Clinical particularities regarding rehabilitation treatment of a young patient with right pontine ischemic stroke, resulting in dysarthria and left side brachial and crural hemiparesis, and quite recent COVID-19 history
Authors: Cristea Ana Andreea , Ionescu Theodora , Spînu Aura , Busnatu Ștefan , Ion Alexandru , Popescu Cristina , Onose Gelu
Published: March 2022

Introduction. Cerebrovascular attacks are one of the leading causes of mortality and morbidity in the world. The most severe are considered to be pontine strokes, because of the high risk of vital functions impairment. The clinical presentation of a pontine stroke can vary from the clas-sical crossed syndrome (ipsilateral cranial nerve palsy and contralateral motor and/or sensory impairment) to pure motor hemiplegia or pure sensory stroke, which are less common.1
Materials and methods. This presentation describes the case of a 39-year-old patient with a re-cent history of untreated SARS-COV 2 infection that was followed in the next month by a sudden onset of facial paralysis, dysarthria and a progressive left hemiplegia. The patient’s functional status was assessed in our Neuromuscular Clinical Division and he underwent a rehabilitation program consisting of physical, occupational and speech therapies. Multidisciplinary efforts were made in order to find the underlying cause of the pontine ischemic stroke.
Results. The patient had a personal history of cardiovascular disease risk factors (essential hy-pertension and hyperlipidaemia), without other pathological brain imagining outcomes and normal bleeding tests. The suspicion of an interatrial communication was raised. The patient managed to rapidly maintain the standing posture and to practice walking with unilateral sup-port. At discharge, the facial paralysis and dysarthria were almost completely remitted. The left brachial extremity also showed signs of improvement, as the patient was able to perform flexion and extension movements of the fingers, wrist and forearm.
Conclusion. To conclude, the patient’s evolution was favourable, although the certain cause of the underlying stroke has not been clarified. The neurological complications of COVID-19 in-clude ischemic strokes, and cases were reported in young adults too2,3. If this were the case, pre-vention of further cerebrovascular attacks and their complications is necessary1. Caution in terms of medium/long-term prophylactic anticoagulant therapy and careful control of associated cardiovascular disease risk factors has been proposed and discussed in the multidisciplinary team: rehabilitation physician, neurologist, cardiologist.

Keywords: cerebrovascular attacks, COVID-19, cardiovascular disease risk factors, ischemic strokes, reha-bilitation
Clinical and rehabilitative considerations in a complex case of spastic tetraplegia, mixed aphasia, secondary encephalopathy – post severe traumatic brain injury with hemorrhagic and is-chemic lesions – with favorable late evolution and post-symptomatic status after SARS-COV-2 infection
Authors: Postoiu Ruxandra Luciana , Mocanu Elena-Madalina , Schek Simona , Lapadat Magdalena , Chipăruș Carmen Elena , Onose Gelu
Published: March 2022

The traumatic brain injury remains a current research topic considering the severity and the in-creased incidence of this pathology. Both physical and neuro-psychological sequelae require a complex rehabilitation program. Material and methods. We describe the evolution of a 20-year-old case, victim of a severe traumatic brain injury due to physical aggression, with spastic te-traplegia, extended ischemia in the left cerebral hemisphere, mixed aphasia, post-traumatic en-cephalopathy, left eyelid ptosis, right paresis of nerve III, post remitted status of left subdural hematoma, post remitted status of right fronto-parietal subarachnoid hemorrhage, severe joint stiffness (right elbow and fist, bilateral hips and knees), cachexia and SARS-COV-2 infection. In our clinic the patient followed medical, complex kinetotherapeutic treatments and was functio-nally assessed using the following scales: modified Ashworth, Penn Spasm Frequency Scale ( Penn), Life Quality Assessment ( QOL ), Montreal Cognitive Assessment ( MoCA ), FAC Interna-tional Scale, Glasgow Outcome Scale-Extended (GOS-E), modified Rankin scale (mRS ). Results. During the hospitalization, the patient presented a favorable late evolution with a great impro-vement of motor and neurological deficit, aphasia in remision, improvement of eyelid ptosis and joint stiffness, fact also confirmed by the increasing scores from the evaluated scales. Con-clusions. Consequently in traumatic brain injury the proper medication, personalized rehabilita-tion program, ergotherapy, speech therapy, a great deal of involvement and documentation of current information is required to improve the patient's quality of life.

Keywords: traumatic brain injury, neuro-rehabilitation program, spastic tetraplegia
Case report and related comments in a relatively young male patient with right hemiplegia after left thalamo- mesencephalic hemorrhage and a consequent Parinaud syndrome – interdisci-plinary therapeutic – rehabilitative approach
Authors: Spînu Aura , Ionescu Theodora , Cristea Ana- Andreea , Băilă Mihai , Daia Cristina , Andone Ioana , Popescu Cristina , Brumă Elena , Constantin Elena , Onose Gelu
Published: March 2022

Thalamo- mesencephalic hemorrhage is a devasting event, with a increased morbidity and mor-tality rate. Parinaud’s syndrome, also known as the dorsal midbrain syndrome, is characterized by a supranuclear vertical gaze disturbing, resulting from an insult to the mesencephalic tectum. Matherial and Method. We report the case of a 45-year-old man with personal antecedents of ar-terial hypertension, obesity and type 2 Diabetus mellitus, who was first admitted in the Neuro-logy Clinic Division of the Teaching Emergency Hospital Bucharest with a sudden onset of com-plete right hemiplegia, mixed aphasia and right central– type facial palsy on 17.04.2021, being diagnosed – following complex paraclinic investigations -with a left thalamo- mesencephalic hemorrhage. Results and discusssion. The patient followed a neuro- muscular rehabilitation program in our Neuro- Rehabilitation Clinic Division with favorable outcomes, the case repre-senting a real challenge regarding the complexity of the factors involved. Conclusions. The cli-nical outcomes and the quality of life of patients suffering from thalamo- mesencephalic hemor-rhage depend both on the prompt diagnosis and the efficient treatment, followed by an appro-priate rehabilitation program.

Keywords: neuro-rehabilitation, thalamo-mesencephalic hemorrhage, Parinaud syndrome
Successful rehabilitation program after AIS/Frankel C paraplegia through a recently operated lumbar disc hernia
Authors: Daia Cristina , Cocolos Alexandra , Ohriniuc Andrei , Marinescu Bogdan , Bruma Elena , Constantin Elena , Spinu Aura , Andone Ioana , Popescu Cristina , Onose Gelu
Published: March 2022

Intervertebral disc herniation is the pathological process by which fragments of the nucleus pul-posus tear the fibers of the annulus fibrosus and come into contact with the root of the spinal nerve (1). The most significant functional damage generated by the lumbar disc herniation is paraplegia and can be ameliorated by an early and staged specific rehabilitation program.
Materials and Methods: This paper presents the case of a 56-year-old patient who was admitted to the Neurosurgery Clinic (NCH) III of SCUBA for low back pain and motor deficit, AIS Frankel C paraplegia. The left lower limb was more affected than the right one. It occurred following a thoraco-lumbar medullary compression and a paramedian lumbar disc herniation L3. The pa-tient was treated surgically. Subsequently, the patient was transferred to the Neuro-Muscular Recovery Clinic of SCUBA for the specific rehabilitation treatment, with indication for mobiliza-tion. He was dynamically evaluated using the following scales: quality of life assessment (QOL), modified Ashworth scale, Functional Assessment Classification, FAC, Activities of daily living (ADL), Spinal Cord Independence Measure (SCIM), evaluation of muscle strength on Medical Re-search Council, MRC, scale, evaluation of American Spinal Injury Association Impairment Scale (AIS).
Results: The patient benefited from a complex program of neuro-muscular rehabilitation, hav-ing a favorable evolution with an improving score of the evaluating scales and finally gaining his gait balance, including ascending and descending stairs (instrumentally assisted for left plan-tar dorsiflexion movement with orthosis walking). At discharge the patient’s neurological defi-cit was reclassified as AIS D paraplegia, with the neurogenic bladder and bowel having been remitted.
Discussions: The disc herniation at L3 level generated a cauda equina syndrome, which initially generated a paraplegia. When the inflammation remitted it became clear that the left L4 root was affected, with a complete deficit of plantar dorsiflexion. In conclusion it was not a case of spinal cord syndrome (as the spinal cord ends at L2 level) or conus medullaris syndrome.
Conclusions: The interdisciplinary therapeutic approach together with a specific, customized re-habilitation program for a patient with AIS C paraplegia after a surgically treated disc hernia is successfully improving the neuromuscular deficit and upgrading the patient's quality of life.

Keywords: rehabilitation, disc hernia, low back pain, paraplegia
The importance of a multidisciplinary approach to improve the life quality for patients with Parkinson's disease
Authors: Condurache Iustina , Filip Genoveva , Ancuța Paula , Turnea Marius , Rotariu Mariana , Ionițe Cătălin
Published: March 2022

Parkinson's disease is defined as a complex degenerative neurological disease with progressive evolution, which is part of motor system of the brain disorders, being the second degenerative disease as a frequency after Alzheimer's disease. It is characterized by tremor when muscles are at rest (rest tremor), increased muscle tone (stiffness), slow voluntary movements and difficulty maintaining balance (postural instability). Occupational therapy helps Parkinson's patients im-prove their ability to perform daily tasks. The intervention consists in assisting patients in deve-loping a self-care routine, taking into account the limitations of functional mobility, encoura-ging patients to maintain maximum function of daily activities for as long as possible, learning adaptive techniques to reduce tremor. Materials and methods. The devices used for this purpose are commercially available but they are quite expensive, which is why we wanted to make devi-ces made of material as cheap and affordable as possible. Some of the devices can be successfully made of material that every person has in their home. We also took into account the variant of making them without the need to use complicated tools and devices that are not available to pa-tients. Starting from these premises, we thought and made in our occupational therapy laborato-ry various devices designed to offer patients a variety of techniques and exercises and also a fle-xible work environment. On a pallet plate we fixed a series of elements such as zippers, snap button, hook-and-eye closure, systems that patients use on a regular basis. We also manufactu-red a device designed to help patients with household chores such as dish washing. The device is provided at one end with a washing sponge, its handle being a detergent tank. The size and sha-pe have been adapted to the needs of patients with Parkinson's disease. Results and discussions. In order to obtain the devices, cheap materials were used at the disposal of every person eager to make them. It started with simple objects that any patient uses for personal hygiene and more. The technique of making the devices was a very simple one, from the very beginning the steps that must be followed in order to make them were clearly established. Conclusions. Using the devices made during the physiotherapy sessions, significant improvements of the life quality for patients with Parkinson's disease were observed.

Keywords: Parkinson, Occupational therapy, Devices, ADL
Anal dyspareunia – biological and psychosocial correlates of painful anal intercourses in population
Authors: Plewka Aleksandra , Haak Dominik
Published: March 2022

Anodyspareunia (dyspareunia analna) jest zjawiskiem związanym z odczuwaniem przez stronę pasywną w seksie analnym bólu lub też dyskomfortu podczas próby lub całkowitej penetracji odbytu. Dysfunkcja ta została po raz pierwszy opisana w 1998 roku przez zespół Rossera badającego jej biopsychospołeczne korelaty na próbie mężczyzn uprawiających seks z mężczyznami. Praca ma charakter teoretyczny i stanowi próbę integracji aktualnej wiedzy na temat zjawiska anodyspareunii. Przedstawia próby zdefiniowania zjawiska oraz dane dotyczące jego rozpowszechnienia, możliwe przyczyny jego występowania oraz dalsze kierunki badawcze. Przeanalizowane badania pokazują, że chociaż na występowanie anodyspareunii wpływ mają zarówno czynniki fizjologiczne (np. brak lubrykacji, oralnej lub ręcznej stymulacji odbytu przed penetracją) jak i psychologiczne, to jednak te ostatnie wydają się odgrywać decydującą rolę w doświadczaniu bólu. Nie wszystkie bowiem osoby uprawiające seks analny zgłaszają dolegliwości bólowe z nim związane, co może skłaniać do traktowania dyspareunii analnej jako dysfunkcji seksualnej podlegającej zbliżonym do pochwicy i dyspareunii waginalnej oddziaływaniom terapeutycznym.
Analysis of the Frequency of Low Back Pain Syndrome Depending on Body Type and Gender
Authors: Baranowska Agata , Machoy-Mokrzyńska Anna , Bulsa Marek
Published: March 2022

Wstęp. Otyłość jest jedną z przyczyn występowania i nasilania się dolegliwości bólowych odcinka lędźwiowego kręgosłupa. Rozluźnienie gorsetu mięśniowego w odcinku lędźwiowo-krzyżowym, spowodowane otyłością brzuszną, często doprowadza do niestabilności tego odcinka kręgosłupa. Celem pracy było zbadanie wpływu otyłości mierzonej za pomocą BMI oraz wskaźników WHR i Rohrera  na występowanie dolegliwości bólowych, pochodzących z dolnego odcinka kręgosłupa. Materiał i metody. Badaniem objęto 114 pacjentów ze zdiagnozowanymi zmianami zwyrodnieniowymi kręgosłupa, leczonych w Poradni Fizjoterapii Samodzielnego Publicznego Zakładu Opieki Zdrowotnej Szkół Wyższych w Szczecinie. Zastosowano technikę ankietowania bezpośredniego połączoną z wywiadem, wykorzystując specjalnie zaprojektowaną autorską ankietę, połączoną z badaniem klinicznym. Stopień otyłości oraz typ budowy ciała określono posługując się BMI oraz wskaźnikami WHR i Rohrera. Wyniki.  W badanej grupie pacjentów BMI wykazuje, iż mężczyzn charakteryzuje nadwaga (59%, n=20), natomiast masa ciała kobiet częściej zawiera się w granicach normy (48%, n=36). W przypadku wskaźnika WHR stwierdza się przewagę androidalnego typu budowy ciała u kobiet w stosunku do mężczyzn (60% vs. 56,4%). Rzadziej występujący typ gynoidalny częściej dotyczy mężczyzn niż kobiet (43,6% vs. 40%). Wskaźnik Rohrera wykazuje, iż mężczyźni częściej prezentują pykniczy typ budowy ciała (69,2%, n=27), natomiast kobiety zdecydowanie częściej mają atletyczną (30,7%, n=23), a rzadziej leptosomiczną (9,3%, n=7) budowę ciała. Częstość występowania dolegliwości bólowych lędźwiowego odcinka kręgosłupa zależy w sposób istotny statystycznie od BMI (p<0,05).  Wnioski. Ocena masy ciała dokonana przy pomocy wskaźników antropometrycznych wykazała wyższe wartości BMI i wskaźnika Rohrera u mężczyzn. Ponadto stwierdzono statystyczną zależność między BMI, a częstością występowania dolegliwości bólowych w odcinku lędźwiowym kręgosłupa.
Causes of circadian rhythm disorders and methods of their treatment
Authors: Machaj Damian , Mazurek Aleksandra , Cyboran Katarzyna , Kuc Monika , Machaj Dominik
Published: March 2022

The circadian rhythm is the main biological rhythm to which man is subject.During the day periods of activity and sleep, eating habits, body temperature, secretion of certain hormones and frequency of urination all change.In anatomical terms, the biological clock is located in the suprachiasmatic nuclei in the hypothalamus[3].The most important factor in the circadian rhythm is sunlight.They are particularly vulnerable to disturbances of the circadian rhythmschool students and shift workers,however, please note thatphenomenonthiscan occur in anyone.The consequences of circadian rhythm disorders include: reduced work efficiency, reduced social contacts, mood disorders, depression, obesity or metabolic diseases[1].

Mainandcausesanddisturbances of the circadian rhythmis reduced exposure to natural sunlight[1,2].Studies have shown that the biological rhythm may be disturbed by: the aging process [3],incorrect concentrationsuch hormones asmelatoninandand cortisol[4,8-27], symptoms of various diseases such as schizophrenia and medications taken[6],extension of the circadian cycle[7,28]and factors such associal life, time spent using multimedia devices, putting off homeworkby the studentslate evening hours, decreased parental control, increased frequency of anxiety disorders,non-compliance with the rules of sleep hygiene and consumption of caffeine-containing products[7,28,29, 30].

     The treatment of circadian rhythm disorders is primarily based on the patient's adherence to the rules of sleep hygiene.The use of phototherapy is also an effective method. In case ofthe ineffectiveness of the above methodsdrug treatment may be considered. Melatonin is the drug of choice.In the case of treatment with melatonin, the correct time of administration is crucialand his dose.Pharmacotherapy with hypnotic drugs has a modest, short-term efficacy and should be used inlast resort[7.31]
Exploration of double-dart injection technique as a supplemental application for remote drug delivery system for zoo and wild animals
Authors: Pattanarangsan Rattapan , Kulnanan Pawinee , Mitsuwan Watcharapong , Wongtawan Tuempong
Published: March 2022

Background and Aim: Remote drug delivery has become an essential tool for safely delivering medication and vaccines to free-ranging, non-domestic, or dangerous animals. All dart guns currently use a single dart per injection, and it might occasionally be not practical with large animals. Shooting the dart more than once on an animal may cause flight, injury, stress, and ultimately unsuccessful delivery. Furthermore, purchasing many dart guns and hiring and training more staff may be unfeasible in developing countries. Therefore, employing the double-dart injection technique may help reduce the cost of operation, save time for capturing animals, minimize stress and injury, and improve animal welfare. The objectives of this study were to test the possibility of using the double-dart injection technique and optimizing the guidelines for this procedure.

Materials and Methods: A standard brand-calibrated darting rifle was used to deliver the darts to the target board constructed from paper, polypropylene, and ethylene-vinyl acetate foam. The shot stage and shooter were fixed, and the shooting range was 5-20 m. The pressure of the gun was varied according to a company's recommendation. The single dart (control dart) was first shot to the target point, and then the double darts were shot 3 times for each condition. The experiment was done in the field with no wind. The inclusion criteria were that two darts must hit the target and not penetrate the target board deeply. The distances between the control dart and double darts (first and second darts) and between each dart of the double darts were measured, and the standard curve graphs and formulas were created.

Results: The results showed that the distance between the control dart and the double darts was shortened as the pressure was increased. All double-dart injections hit the target below the control dart. We were able to create many formulas to predict the optimal gun pressure and aim point for double-dart injection in each shot range. It usually requires more pressure settings than a single-dart injection, particularly the long shot range. It also needs to aim the target point above the original point.

Conclusion: Double-dart injection technique can be used efficiently in 5-20 m distance, and it usually requires increasing the pressure from the company's recommendation and adjusting the injecting point.
Percutaneous radiofrequency ablation of solitary hepatic metastases from colorectal cancer: risk factors of local tumor progression-free survival and overall survival
Authors: Lee Hyun Jae , Lee Min Woo , Ahn Soo Hyun , Cha Dong Ik , Ko Seong Eun , Kang Tae Wook , Song Kyoung Doo , Rhim Hyunchul
Published: March 2022

Purpose: This study aimed to evaluate local tumor progression-free survival (LTPFS) and overall survival (OS) after percutaneous radiofrequency ablation (RFA) for solitary colorectal liver metastases (CLM) <3 cm and to identify the risk factors associated with poor LTPFS and OS after percutaneous RFA.Methods: This study screened 219 patients who underwent percutaneous RFA for CLM between January 2013 and November 2020. Of these, 92 patients with a single CLM <3 cm were included. LTPFS and OS were calculated using the Kaplan-Meier method, and the differences between curves were compared using the log-rank test. Risk factors for LTPFS and OS were assessed using Cox proportional-hazard regression models.Results: Technical efficacy was achieved in the first (n=91) or second (n=1) RFA sessions. During the follow-up (median, 20.0 months), cumulative LTPFS rates at 1, 3, and 5 years were 92.4%, 83.4%, and 76.5%, respectively. During the follow-up (median, 27.8 months), the corresponding OS rates were 97.5%, 81.3%, and 74.8%, respectively. In multivariable Cox regression analyses, the group with both tumor-puncturing RFA and a T4 stage primary tumor (hazard ratio, 3.3; 95% confidence interval, 1.1 to 10.2; P=0.037) had poor LTPFS. In the univariable analysis, no factors were significantly associated with poor OS.Conclusion: Both LTPFS and OS were promising after percutaneous RFA for a single CLM <3 cm. The group with both tumor-puncturing RFA and a T4 stage primary tumor showed poor LTPFS. No risk factors were identified for poor OS.