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The diffusion tensor imaging (DTI) parameters (fractional anisotropy [FA] and apparent diffusion coefficient [ADC]) are commonly used to provide quantitative information on tissues. This study aimed to evaluate the predictive value of preoperative DTI of the spinal nerve roots in the surgical outcome of lumbar disc herniation (LDH).A total of 117 LDH patients were included. According to the postoperative improvement rate, the patients were dichotomized into the unfavouratble group (n=35) and favourable group (n=82).The favourable group had a younger age (p=0.005) and a shorter disease course (P0.001) than the unfavourable group. The favourable group had higher affected side FA and ADC and lower healthy/affected FA and ADC ratio than the unfavourable group (all P0.05). Logistic regression analysis showed that younger age, shorter disease course, higher affected side FA and ADC, lower healthy/affected FA and ADC ratio, and lower healthy side ADC were the independent factors associated with positive surgical outcome. ROC analysis showed that the affected side FA had an excellent predictive performance for the surgical outcome (AUC=0.900). The Healthy/affected FA ratio had a good predictive performance (AUC=0.846). The overall predictive accuracy ranged from 0.91 to 0.92. However, ADC had poor predictive performance (AUC ranged from 0.626 to 0.663).These results suggested the preoperative affected side FA value had an excellent predictive performance for the surgical outcome of LDH patients. The LDH patients with a higher preoperative affected side FA value were more likely to have a positive surgical outcome.

Objectives To systematically evaluate the efficacy and safety of Arbidol and lopinavir/ritonavir (LPV/r) in the treatment of coronavirus disease 2019(COVID-19) using a meta-analysis method. Methods The China Knowledge Network, VIP database, WanFang database PubMed database, Embase database, and Cochrane Library were searched for a collection of comparative studies on Arbidol and lopinavir/ritonavir in the treatment of coronavirus disease 2019. Meta-analysis was used to evaluate the efficacy and safety of Arbidol and lopinavir/ritonavir in the treatment of COVID-19. Results The results of the systematic review indicated that Arbidol had a higher positive-to-negative conversion rate of SARS-CoV-2 nucleic acid on Day 7 [P=0.03], a higher positive-to-negative conversion rate of SARS-CoV-2 nucleic acid on Day 14 [P=0.006], a higher improvement rate of chest CT on Day 14 [P=0.02], a lower incidence of adverse reactions [P=0.002] and lower rate of mortality[P=0.007]. There was no difference in the rate of cough disappearance on Day 14 [P=0.24] or the rate of severe/critical illness [P=0.07] between the two groups. Conclusions Arbidol may be superior tolopinavir/ritonavir in the treatment of COVID-19. However, due to the small number of included studies and the number of patients, high-quality multi-centre large-sample randomized double-blind controlled trials are still needed for verification. This article is protected by copyright. All rights reserved.

AIMS To compare efficacy and safety between neurogenic and non-neurogenic women after adjustable continence therapy (ACT®) balloons implantation to treat stress urinary incontinence (SUI) due to intrinsic sphincter deficiency. METHODS In the present retrospective multicentric study, all neurogenic and non-neurogenic women implanted with ACT® balloons between 2000 and 2018 were considered for inclusion. Efficacy was compared 1 year after implantation, and women were allocated in three different groups as follows. Success: maximum 1 pad per day and patient's impression of improvement assessed using a numeral rating scale (NRS) ≥8/10. Improvement: decrease of daily pad use and/or NRS ≥5/10. Failure: increase or stability of daily pad use or NRS

Background Barbed polydioxanone (PDO) sutures allowing for minimally invasive skin lifting are broadly and increasingly used in aesthetic dermatology. Objectives To describe utilization of diverse barbed PDO sutures for aesthetic facial corrections in Caucasian patients, to evaluate long-term safety and to demonstrate effectiveness in skin tightening, redefinition of facial contours, and tissue elevation. Methods A retrospective chart review of patients routinely treated with barbed PDO sutures on face was performed. Aesthetic improvement was evaluated at 6-, 12- and 24-week posttreatment by the treating physician, patients, and an independent photographic reviewer. Patient’s satisfaction with treatment outcome was evaluated. Procedure effects were also objectively measured by markerless tracking analysis. Results Sixty patients were treated with a total of 388 barbed sutures in various anatomical areas and followed-up for 24 weeks. At Week 24, the aesthetic improvement rate was 80% to 100% (depending on the evaluator), skin movements related to pre-treatment photographs showed significant changes across several different anatomical regions, and 97% of patients were satisfied with the overall treatment outcome. Transient, mild, and short-lasting adverse events, mostly pain and hematoma, occurred in 15% of patients. Conclusions Barbed PDO sutures are safe and highly effective for aesthetic corrections, with results lasting for at least 24 weeks. Level of Evidence: 4

Purpose The aims of this study were to propose an alternative method to assess an optimal performance improvement rate (PIR) that would be used as a tool for coaches and elite athletes willing to reach their personal best, mainly those seeking for national, continental or even world record (WR) in middle-distance events. We further compared the improvement rate of women vs. men of the top-10 ranked athletes in the IAAF running these middle-distance events Method The top 10 athletes in the IAAF ranking of 800 m, 1500 m, and 3000 m events for each sex were assessed for their history of race times before achieving their personal record (PR). The difference between PR (‘actual’ season) and the best race time in the last season was defined as the 1st season improvement rate (1-SIR), whereas the average improvement rate in the last and preceding seasons was the multi-season improvement rate (M-SIR). 1-SIR and M-SIR were calculated for each athlete. Result There were sex differences in the 1500 m with a large effect size (d = − 0.746) in 1-SIR (P = 0.001) and very large (d = − 2.249) in M-SIR (P = 0.001). Women improved more than men before the PR/WR achievements in the 800 m and 1500 m events (P = 0.001) and had similar improvement rates before performing PR/WR in 3000 m events (P = 0.533). Conclusion Women improve more before PR/WR achievement in 800 m and 1500 m races. However, in the 3000 m men and women have similar improvement rates in previous seasons before the PR/WR achievement.

Improved multi-cluster overlapping k-means extension (IMCOKE) uses median absolute deviation (MAD) in detecting outliers in datasets makes the algorithm more effective with regards to overlapping clustering. Nevertheless, analysis of the applied MAD positioning was not considered. In this paper, the incorporation of MAD used to detect outliers in the datasets was analyzed to determine the appropriate position in identifying the outlier before applying it in the clustering application. And the assumption of the study was the size of the cluster and cluster that are close to each other can led to a higher runtime performance in terms of overlapping clusters. Therefore, additional parameters such as radius of clusters and distance between clusters are added measurements in the algorithm procedures. Evaluation was done through experimentations using synthetic and real datasets. The performance of the eHMCOKE was evaluated via F1-measure criterion, speed and percentage of improvement. Evaluation results revealed that the eHMCOKE takes less time to discover overlap clusters with an improvement rate of 22% and achieved the best performance of 91.5% accuracy rate via F1-measure in identifying overlapping clusters over the IMCOKE algorithm. These results proved that the eHMCOKE significantly outruns the IMCOKE algorithm on mosts of the test conducted.

To evaluate the efficacy and safety of laser alone therapy and laser combination therapy (mainly combined with other kinds of laser or steroids) for keloid. PubMed, Embase and Web of Science were searched for relevant articles from inception to June 2020. Comprehensive Meta-Analysis software 2.0 (CMA) was used to perform the meta-analysis. A total of 29 articles were included in this meta-analysis. During the mean follow-up of 14 (1–84) months, the overall improvement rates of baseline Vancouver scar scale (VSS) score and itch were 0.454 (95%CI 0.351–0.561, I2 = 0) and 0.786 (95%CI 0.613–0.895, I2 = 0) in the laser combination therapy group. The improvement rates of scar height and flexibility in the laser combination therapy group were 0.629 (95%CI 0.519–0.727, I2 = 52.089) and 0.784 (95%CI 0.251–0.975, I2 = 89.420). The average improvement rate of the scar score in laser combination therapy was 0.338 (0.201–0.510); however, there were insufficient data for laser alone therapy comparison. The laser combination therapy had a greater pain improvement rate, 0.580 (0.389–0.750) versus 0.420 (0.224–0.645), compared to laser alone therapy, and a greater degree of good or excellent (> 50%) improvement in the overall scar, 0.636 (95%CI 0.347–0.852) versus 0.149 (95%CI 0.032–0.482), with laser alone therapy. Moreover, a lower regrowth rate of 0.187 (0.129–0.263) versus 0.249 (0.060–0.631), a lower post-treatment pigmentation rate of 0.125 (0.091–0.169) versus 0.135 (0.058–0.282), and a lower infection rate of 0.047 (0.009–0.209) versus 0.076 (0.012–0.351) were observed in the laser combination therapy compared with those rates in the laser alone therapy. The overall effect of laser combination therapy was better than that of laser alone therapy, and the incidence of adverse reactions was lower in laser combination therapy than in laser alone therapy.

INTRODUCTION The use of mesh for vaginal repairs is currently problematic and as a consequence, there is increased interest in native tissue repair. We describe the follow-up data of a sub-analysis of a prospective and multi-center study focusing on the combination of pectopexy and native tissue repair. Patients were followed up for 12-18 months after surgery (+ SD: 15). Two-hundred and sixty-four patients attended the clinics for physical examination and were integrated into the follow-up. Cystocele repair was performed laparoscopically in 84 patients and vaginally in 52 patients. Posterior repair was performed vaginally in 40 patients and laparoscopically in 53 patients. Results: Clinical success rate, patient recommendations and patient satisfaction rates were similar in both groups. The laparoscopic anterior repair resulted in an 89% cure or anatomical improvement rate; this compared to 94.2% for the vaginal approach. In the posterior group, laparoscopy resulted in a 94.3% cure or improvement rate compared to 97.5% in the second group. Conclusions: The outcomes of both strategies showed satisfactory results in our study. Consequently, surgeons may choose between the two strategies according to their preference and skill. The two approaches only differed with regard to vaginal scarring. We suggest future research investigating the long-term impact of scarring.

Chieh-Chen Huang, Haw-Yueh Thong Department of Dermatology, Shin Kong Wu Ho Su Memorial Hospital, Taipei, TaiwanCorrespondence: Haw-Yueh ThongDepartment of Dermatology, Shin Kong Wu Ho Su Memorial Hospital, No. 95, Wenchang Road, Shilin Dist., Taipei City, 111045, Taiwan (R.O.C.)Tel +886-926-612-880Email drkellytang@gmail.comObjective: There are several clinical cases on the application of PRP (platelet-rich plasma) therapies. To improve disadvantages such as the inability to be standardized and stored long term, we proposed a novel platelet-lyophilized treatment (PLT) to enhance the wound healing rate and improve acne scarring.Study Design: A single-blinded study at a single health care center was performed. All subjects were treated with a fractional carbon dioxide laser. On the right side of the face, 2 mL PLT solution (dissolved in normal saline) was applied, while on the left side of the face (control group), 2 mL normal saline was applied. The treatment described above was repeated every 3 to 4 weeks, and 4 treatments were performed in total. Assessments were performed prior to each treatment and at the one-month follow-up after the fourth treatment. Subjective assessments included questionnaires administered by the principal investigator and a self-assessment questionnaire completed by the subjects. Moreover, VISIA complexion analysis was used for objective data collection, and spots, wrinkles, texture, pores, UV spots, brown spots, red areas, and porphyrins were objectively analyzed.Results: Our data indicated that the PLT side showed a more rapid recovery than the saline side; on average, the sloughing off of the crusts was noted on day 5 and day 6. The improvement rate for skin spots, texture, and pores was significantly increased on the PLT side, with the pigment and pore size both having a statistically significant improvement of p< 0.001, while the texture had a significant improvement of p< 0.01.Conclusion: The results suggested that the application of PLT could be a novel method to enhance wound healing and improve acne scarring after laser skin rejuvenation.Keywords: platelet-lyophilized treatment, PLT, wound healing, acne scars, ablative fractional carbon dioxide laser

Background\ud \ud Depression is a heterogeneous condition, with multiple possible symptom-profiles leading to the same diagnosis. Descriptive depression subtypes based on observation and theory have so far proven to have limited clinical utility.\ud \ud \ud Aim\ud \ud To identify depression subtypes and to examine their time-course and prognosis using data-driven methods.\ud \ud \ud Methods\ud \ud Latent transition analysis was applied to a large (N = 8380) multi-service sample of depressed patients treated with cognitive behavioral therapy (CBT) in outpatient clinics. Patients were classed into initial latent states based on their responses to the Patient Health Questionnaire-9 of depression symptoms, and transition probabilities to other states during treatment were quantified. Qualitatively similar states were clustered into overarching depression subtypes and we statistically compared indices of treatment engagement and outcomes between subtypes using post hoc analyses.\ud \ud \ud Results\ud \ud Fourteen latent states were clustered into five depression subtypes: mild (2.7%), severe (9.8%), cognitive-affective (23.7%), somatic (21.4%), and typical (42.4%). These subtypes had high temporal stability, and the most common transitions during treatment were from severe toward milder states within the same subtype. Differential response to treatment was evident, with the highest improvement rate (63.6%) observed in the cognitive-affective subtype.\ud \ud \ud Conclusion\ud \ud Replicated evidence indicates that depression subtypes are temporally stable and associated with differential response to CBT.

Objective. To compare the efficacy in patients with different genotypes, identify the potential predictive factors, and summarize the complications of globus pallidus deep brain stimulation (GPi-DBS) treating early-onset dystonia. Methods. Three electronic databases (PubMed, Embase, and Cochrane databases) were searched with no publication data restriction. The primary outcomes were the improvements in Burke–Fahn–Marsden Dystonia Rating Scale motor (BFMDRS-M) and disability (BFMDRS-D) score. Pearson’s correlation coefficients and a metaregression analysis were used to identify the potential predictive factors. This article was registered in Prospero (CRD42020188527). Results. Fifty-four studies (231 patients) were included. Patients showed significant improvement rate in BFMDRS-M (60.6%, p < 0.001 ) and BFMDRS-D (57.5%, p < 0.001 ) scores after treatment with GPi-DBS. BFMDRS-M score improved greater in the DYT-1-positive ( p = 0.001 ) and DYT-11-positive ( p = 0.008 ) patients compared to DYT-6-positive patients. BFMDRS-D score improved greater in the DYT-11 (+) compared to DYT-6 (+) patients ( p = 0.010 ). The relative change of BFMDRS-M ( p = 0.002 ) and BFMDRS-D ( p = 0.010 ) scores was negatively correlated with preoperative BFMDRS-M score. In the metaregression analysis, the best predictive model showed that preoperative BFMDRS-M, disease duration ( p = 0.047 ), and the age at symptom onset ( p = 0.027 ) were important. Conclusion. Patients with early-onset dystonia have a significant effect after GPi-DBS treatment, and DYT-1 (+) and DYT-11 (+) patients are better candidates for GPi-DBS. Lower preoperative score, later age of onset, and an earlier age at surgery probably predict better clinical outcomes.

The purpose of this study was to evaluate the relationship between the correction rate in Cobb angle and the improvement in quality of life profile in terms of Scoliosis Research Society (SRS)-22 values.Between January 2007 and December 2013, posterior instrumentation and fusion was performed to 30 patients with adolescent idiopathic scoliosis (AIS). Patients were grouped according to their improvement rate in Cobb angles after surgery. Patients with an improvement rate of 80% were grouped as Group A; those with an improvement rate of 60% and ≤ 80% as Group B and those with an improvement rate of ≤ 60% were grouped as Group C. The SRS-22 questionnaire of these three groups was calculated and their relationship with the improvement in Cobb angle was evaluated.No statistical difference was found among the three groups in terms of pain, appearance, function, spirit, satisfaction, and SRS-22 values (all p 0.05).The results of this study demonstrate that the degree of correction rate does not correlate with the degree of improvement in the SRS-22 questionnaire in patients with AIS that underwent posterior fusion and instrumentation.Das Ziel dieser Studie ist es, die Beziehung zwischen der Korrekturrate im Cobb-Winkel und der Verbesserung des Lebensqualitätsprofils in Bezug auf SRS-22-Werte (SRS: Scoliosis Research Society) zu bewerten.Dorsale Instrumentierung und Fusion wurden im Zeitraum von Januar 2007 bis Dezember 2013 bei 30 Patienten mit adoleszenter idiopathischer Skoliose (AIS) durchgeführt. Die Patienten wurden nach ihrer Verbesserungsrate im Cobb-Winkel nach der Operation gruppiert. Patienten mit einer Verbesserungsrate von 80% wurden als Gruppe A, diejenigen mit einer Rate von 60% und ≤ 80% wurden als Gruppe B und diejenigen mit einer Rate von ≤ 60% wurden als Gruppe C gruppiert. Der SRS-22-Fragebogen dieser 3 Gruppen wurde berechnet und der jeweilige Zusammenhang mit der Verbesserung des Cobb-Winkels bewertet.Es wurde kein statistischer Unterschied zwischen den Gruppen in Bezug auf Schmerz, Aussehen, Funktion, psychische Verfassung, Zufriedenheit und SRS-22-Werte gefunden (p 0,005).Die Ergebnisse dieser Studie zeigen, dass bei Patienten mit AIS, die einer dorsalen Fusion und Instrumentierung unterzogen wurden, der Grad der Korrekturrate mit dem Grad der Verbesserung des SRS-22-Wertes nicht korreliert.

Background In several previous studies, Charlson comorbidity index (CCI) score was associated with postoperative complications, mortality, and re-admission. There are few reports about the influence of CCI score on postoperative clinical outcome. The purpose of this study was to investigate the influence of comorbidities as calculated with CCI on postoperative clinical outcomes after PLIF. Methods Three hundred sixty-six patients who underwent an elective primary single-level PLIF were included. Postoperative clinical outcome was evaluated with the Japanese Orthopaedic Association lumbar score (JOA score). The correlation coefficient between the CCI score and postoperative improvement in JOA score was investigated. Patients were divided into three groups according to their CCI score (0, 1, and 2+). JOA improvement rate, length of stay (LOS), and direct cost were compared between each group. Postoperative complications were also investigated. Results There was a weak negative relationship between CCI score and JOA improvement rate (r = − 0.20). LOS and direct cost had almost no correlation with CCI score. The JOA improvement rate of group 0 and group 1 was significantly higher than group 2+. LOS and direct cost were also significantly different between group 0 and group 2+. There were 14 postoperative complications. Adverse postoperative complications were equivalently distributed in each group, and not associated with the number of comorbidities. Conclusions A higher CCI score leads to a poor postoperative outcome. The recovery rate of patients with two or more comorbidities was significantly higher than in patients without comorbidities. However, the CCI score did not influence LOS and increased direct costs. The surgeon must take into consideration the patient’s comorbidities when planning a surgical intervention in order to achieve a good clinical outcome.

The topical antifungal efinaconazole was applied to 27 nails (17 patients), and the treatment effects were monitored over a stipulated period (after 3, 6, and 12 months). Fourteen nails were observed for 18 months. Effects of the treatment were determined on the basis of the improvement rate of the turbidity ratio compared with that before treatment. After 12 months, five nails were cured and marked improvement was noted, whereas moderate and marked improvements were noted in 11 and six nails, respectively. The cured patients exhibited a significantly better improvement rate at 6 months (68.8%) than the other groups. Only 10.6% improvement was observed at the same point in time for the mild improvement group. Thus, in cases where the improvement rate after 6 months of treatment was 10% or less, it was judged that oral treatment should be considered. Furthermore, of the nails monitored for 18 months, those that exhibited further growth in improvement rates at 12 months was 51.6%, suggesting that an improvement rate of 50% at 12 months after starting treatment could be used as an indicator to determine switching to oral treatment.

To review available evidence to assess the efficacy and safety of thrombolysis therapy for non-cirrhosis-related portal vein thrombosis (PVT) that has not improved with anti-coagulation. A literature search of databases MEDLINE, EMBASE, PUBMED, Cochrane and World Wide Web identified studies after 2000 utilizing portal vein thrombolysis in non-cirrhotic patients, with a minimum of 5 patients. Nine studies met criteria with 134 patients. The primary outcome evaluated was radiological re-canalization of the portal vein and symptomatic improvement post treatment. Secondary data points obtained included morbidity, mortality, thrombolysis approach and technique. The re-canalization rate following thrombolysis was 84% (0.67–1.02 CI 95%) and the symptomatic improvement rate 86% (0.70–1.01 CI 95%). The major complication rate was 7% (0.01–0.14 CI 95%) and the overall complication rate 25% (0.08–0.41 CI 95%). The direct and systemic thrombolysis approach showed no significant re-canalization rates with an odds ratio of 0.78 (0.24–2.55 CI 95%, P = 0.68). Thrombectomy in conjunction with thrombolysis demonstrated no improved patency or symptom relief with an odds ratio of 1 (0.17–6.03 CI 95%, P = 1.00). Thrombolysis is an effective and safe therapy for portal vein thrombosis in non-cirrhotic patients where systemic anti-coagulation has failed. The heterogenicity of study thrombolysis protocols limits the evaluation of secondary outcomes, and future data should be standardized to determine the role of the thrombolysis access route and thrombectomy.

Background: To cope with the rising demand for psychological treatment, evidence-based low-intensity cognitive behavioural therapy (LiCBT) delivered by trained para-professionals was introduced internationally. Aims: This pilot study aimed at examining the effectiveness of LiCBT in Hong Kong. Method: This study was of an uncontrolled pre- and post-treatment design, testing LiCBT at a local community mental health centre in Hong Kong. Two hundred and eighty-five Chinese adult help-seekers to the centre attended two or more sessions of LiCBT delivered by trained para-professionals. These participants also rated their depression and anxiety on the Patient Health Questionnaire-9 (PHQ-9) and Generalised Anxiety Disorder Scale-7 (GAD-7), respectively, at pre- and post-treatment. Results: Comparison of the pre- and post-treatment PHQ-9 and GAD-7 scores of 285 participants indicated significant improvements in depression and anxiety with large effect sizes (depression: d = 0.87; anxiety: d = 0.95). For those participants reaching the clinical level of either depression and/or anxiety at pre-treatment (n = 229, 80.4%), they reported even larger effect sizes (depression: d = 1.00; anxiety: d = 1.15). The recovery rate was 55.9% with a reliable improvement rate of 63.9%. An average of 5.6 sessions was offered to the participants with each session spanning a mean of 42 minutes. The baseline clinical conditions and participants’ educational level were predictive of post-treatment recovery. Conclusions: The results supported the effectiveness and cost-efficiency of LiCBT for depression and anxiety at a Hong Kong community mental health centre. The effect sizes and the recovery and reliable improvement rates achieved were comparable to those reported from countries such as the UK and Australia.

هدف البحث التعرف على تأثير البرنامج المقترح على اللياقة القلبية التنفسية المتمثلة في معدل النبض، السعة الحيوية للرئتين، کثافة الرئتين أثناء الزفير، أقصى حجم للزفير خلال الثانية، واستخدمالباحثالمنهج التجريبي، نظرا لملائمته لطبيعة البحث مستخدما تصميم القياس القبلي والبعدي للمجموعة التجريبية، واشتمل مجتمع البحث على مجموعة من العينة من المقلعيين عن ن عن التدخين وعددهم (25) فرد، وبلغت المجموعة الاستطلاعية عدد (5) فرد، وبلغت المجموعة التجريبية عدد (20) فرد، ، قام الباحث بإجراء التجربة الاستطلاعية على عدد (5) من العينة من المقلعيين عن ن عن التدخين من خارج عينة البحث، وأظهرت نتائج البحث أن البرنامج التأهيلي البدني المستخدم أدى إلى التحسن في اللياقة القلبية التنفسية، ويظهر ذلک في الفرق بين القياس القبلي والبعدي لصالح القياس البعدي للمجموعة التجريبية، وارتفاع نسبة التحسن في قياس اختبار اللياقة القلبية والتنفسية کمتغير فسيولوجي هام تعتمد عليه برامج تأهيل حالات العينة من المقلعيين عن ن عن التدخين لتحسين وظائف عمل القلب والجهاز التنفسي، وفي ضوء هذه النتائج يوصي الباحث بالاهتمام بوضع برامج تأهيلية مقننة على أسس علمية تتناسب مع نوعية المشکلة التي يعاني منها الأفراد، واستخدام البرنامج التأهيلي قيد البحث لتحسين اللياقة القلبية التنفسية للأفراد أصحاب المشکلات بالجهاز التنفسي. The aim of the research is to identify the effect of the proposed program on cardiorespiratory fitness represented in the pulse rate, the vital capacity of the lungs, the density of the lungs during exhalation, and the maximum volume of exhalation within the second. Research on a group of (25) people who quit smoking, and the survey group reached (5) individuals, and the experimental group reached (20) individuals, the researcher conducted a pilot experiment on a number (5) who quit smoking from outside the research sample The results of the research showed that the physical rehabilitation program used led to improvement in cardiorespiratory fitness, and this is evident in the difference between the pre and post measurement in favor of the post measurement in favor of the experimental group, and the increase in the improvement rate in the measurement of the cardiovascular and respiratory fitness test as an important physiological variable on which the rehabilitation programs depend on Smoking to improve the functioning of the heart and respiratory system, and in light of these results, the researcher recommends paying attention to establishing rehabilitative programs codified on scientific grounds commensurate with the type of problem. Of individuals suffering from, and the use of the rehabilitation program under investigation to improve the cardiorespiratory fitness of individuals with respiratory problems

Polypropylene; Polyvinylidene fluoride; Stress urinary incontinence Polipropileno; Fluoruro de polivinilideno; Incontinencia urinaria de esfuerzo Polipropilè; Fluorur de polivinilidè; Incontinència urinària d'esforç Aims: To compare the effectiveness and safety of polypropylene (PP) and polyvinylidene fluoride (PVDF) transobturator tapes (TOT) for the treatment of female stress urinary incontinence (SUI). Methods: This is a multicentre randomized trial. Women with SUI or stress-predominant mixed urinary incontinence and scheduled for a TOT procedure were randomized to PP or PVDF slings. The primary outcome was 1-year cure or improvement rate using composite criteria. Complications were also compared. Relationships with outcomes were analyzed using multivariable logistic regressions models. Results: From April 2016 to January 2018 285 participants were randomized. PP and PVDF slings showed similar high cure or improvement rate (91.0% vs. 95.6%, p = .138). Improvement in validated questionnaires was also similar. PVDF slings were associated with a lower rate of de novo urgency incontinence (adjusted odds ratio = 0.35; 95% confidence interval = 0.15-0.80). We found no statistical differences in complications rates, although a higher incidence of long-term pain events were observed in the PP group. The study is underpowered to find differences in specific complications owing to the low number of events. Conclusion: PP and PVDF TOTs are equally effective, although PVDF is associated with fewer cases of de novo urgency incontinence. Further studies are needed to give robust conclusions on safety profiles.

This paper aims to explore the maze task as a pedagogical tool to enhance learners’ knowledge of the L2. Recent evidence suggests that linguistic training can modify linguistic knowledge (Wells et al., 2009; Enkin; Forster, 2014, Fraundorf; Jager, 2016, Hopp, 2016, 2020). We analyzed the behavior of Brazilian learners of English with respect to the double-object construction after they performed an online maze task training by comparing the results from a pretest and a posttest, in which we measured acceptability ratings and reaction times. The results suggest improvement in both measures. However, the improvement rate was not significant compared to that in a control group trained on other structures and that in a third group that watched a short lecture on English structures.

Objectives To examine improvement in acute low back pain (LBP) using ultrasound‐guided hydrorelease of the multifidus muscle. Methods This prognostic cohort study was conducted in a private clinic on samples of 75 patients with acute LBP diagnosed based on physical and imaging findings. Hydrorelease of the multifidus muscle was performed at the L4/5 level. The LBP visual analog scale (VAS) scores (cm) before and 5 minutes after hydrorelease were statistically evaluated. We defined improvement rate (%) as {LBP VAS scores (cm) immediately before hydrorelease – LBP VAS scores (cm) 5 minutes after hydrorelease} × 100 / LBP VAS scores (cm) immediately before hydrorelease and examined the correlation of the Heckmatt score and average age with the improvement rate. Results LBP VAS scores (cm) before and 5 minutes after hydrorelease were 7.19 ± 1.01 (mean ± SD) and 2.85 ± 1.25, respectively (p

The aim was to evaluate the reoperation rate and outcomes in women who underwent transvaginal non-absorbable monofilament polypropylene mesh placement for the treatment of cystocele. The retrospective cohort study included 63 patients who underwent transvaginal surgery using a synthetic polypropylene mesh (Gynemesh™) for cystocele. Patients were evaluated using a clinical examination (POP-Q) and validated questionnaires (PGI-I, PFDI-20, PFIQ-7) at 18 years of follow-up (median 18 years [IQR 16–19]). Cumulative death rate was 13 out of 63 (20%) and rate of total loss to follow-up was 21 out of 50 (42%). Finally, among the 63 women who underwent surgery, 29 completed maximum follow-up and 21 underwent a clinical examination. The cumulative reoperation rate was 35% (22 out of 63). Three patients were reoperated on because of recurrence of pelvic organ prolapse. Among the 63 patients initially operated, vaginal mesh exposure occurred in 16 (25%) during follow-up and 11 women (17%) needed a reintervention for vaginal mesh exposure. One patient was reoperated on for bladder mesh exposure. Among the 29 women who completed follow-up, the overall postoperative improvement rate was 93% after 18 years (PGI-I: 1–3). Mean overall satisfaction rate was 80 out of 100. Functional success rate was 76% (22 out of 29) and anatomical success rate was 62% (13 out of 21). The median score of the POP-DI-6 was 4.1 (IQR: 0–11) and the median score of the PFDI-20 was 30.7 (IQR: 13–60) in the 29 women who completed maximum follow-up. At very long-term follow-up, the recurrence rate of cystocele following polypropylene mesh placement by the vaginal route remained low and the satisfaction rate was high. However, we found high cumulative reoperation and mesh exposure rates.

This study aimed to analyze the effectiveness and safety of ablative fractional carbon dioxide laser systems (CO2 AFL) combined with autologous platelet-rich plasma (PRP) in the treatment of acne scars through the retrieval and collection of related literature to further guide the treatment of acne scars. We searched Web of Science, PubMed, Embase, Wanfang Data, Chinese National Knowledge Infrastructure, and VIP Database. All randomized and nonrandomized controlled trials on CO2 AFL combined with PRP in the treatment of acne scars were included, and Revman5.3 systematic review software was used in the meta-analysis. Nine studies were included in this meta-analysis. The data analysis results showed that the CO2 AFL combined with PRP treatment group showed significantly better results than the pure CO2 AFL control group in terms of clinical improvement score, clinical improvement rate, patient satisfaction, and crusting period. The results of this meta-analysis showed that CO2 AFL combined with PRP in the treatment of acne scars is more effective and safer than CO2 AFL alone.

Effectiveness of Agility Ladder Drills on Some Physical Variables and the Level of Technical Performance of some Dismounts on High Bar Apparatus in Gymnastics. Dr: Shady Mohamad Alhenawy This research aims to identify the effectiveness of agility ladder drills on some physical variables and the level of technical performance of some dismounts on high bar apparatus in gymnastics, and the experimental approach was used using the experimental design for the pre-post measurement of one group to suit the nature of the research, the research sample was chosen Intentionally from the gymnastics team at the Qassim University, and the basic research sample included (10) players, while the exploratory study consisted of (2) players with the aim of selecting the appropriate agility ladder drills and codifying their training loads, and the most important results were that the agility ladder drills used during the skill setting on high bar apparatus has a positive impact on the physical variables and the level of technical performance of the skills under discussion, as the improvement rate for the bass test of dynamic balance (34.8%), and the improvement rate in the stork stand test for static balance (29.2%), and the improvement rate in the agility test (27.6%), while the improvement in the level of technical performance of Back Somersault Tucked, (26.4%), reached The improvement rate for Back Somersault Piked (23.8%), Back Somersault Stretched (19.3%), and the researcher recommends the use of agility ladder drills to improve and develop the technical performance level of dismounts on high bar apparatus in gymnastics

This study aims to develop the level of technical performance of the understudy skills on the floor exercise apparatus in gymnastics, by developing the dimensions of mental imagery of the individuals in the sample being researched and designing exercises for mental imagery to develop the level of technical performance of the skills understudy and identify the percentage of improvement in the level of technical performance of the skills under research, and the researcher used the approach the experimental using the experimental design for one group and by performing the two measurements (pre - post), and the basic study sample was chosen intentionally by the gymnastics team players in the Qassim University, and the sample included (10) players, as well as (3) players to conduct the exploratory study in order to codify the special training loads With the proposed mental imagery exercises, the percentage of improvement for the experimental group in the dimensions of mental imagery ranged between (46.4%, 57.6%) and the highest percentage of improvement was visual imagery of (57.6%) and the lowest improvement rate was for auditory imagery by (46.4%) and the rest of the dimensions ranged between them . While the percentage of improvement for the experimental group in the technical performance variables ranged between (37.2%, 52.7%) and the highest percentage improvement was for the second skill (Back Handspring) by (52.7%) and the lowest improvement rate was the first skill (Round Off) by (37.2%) and the rest of the variables ranged between them.

Treatment of cutaneous leishmaniasis (CL) continues to be a health concern, and alternative therapies with fewer side effects are substantially needed. This study aimed to determine the efficacy of intense pulsed light (IPL) with wavelength spectrum affecting vascular lesions on acute cutaneous leishmaniasis. In this randomized clinical trial study, 30 patients with acute CL were enrolled. Baseline clinical and demographic data were recorded in the checklist after obtaining written informed consent. Patients were randomly allocated to receive either IPL fortnightly (intervention group) or intralesional meglumine antimoniate (MA) weekly (control group) over 10 weeks. Patients were assessed every 2 weeks to determine the size of induration and improvement rate of lesions. Follow-up visits were arranged at 3rd and 6th months. Overall, 15 patients (21 lesions) in the intervention group and 15 patients (22 lesions) in the control group were studied. The size of lesions in the control group was significantly higher at the baseline (P = 0.014) and the second week (P = 0.034), and significantly lower in the eighth week (P = 0.009), compared with the intervention group. The size of lesions in the control group changed during the study (P

The Network-on-Chip (NoC) is an alternative pattern that is considered as an emerging technology for distributed embedded systems. The traditional use of multi-cores in computing increase the calculation performance; but affect the network communication causing congestion on nodes which therefore decrease the global performance of the NoC. To alleviate this problematic phenomenon, several strategies were implemented, to reduce or prevent the occurrence of congestion, such as network status metrics, new routing algorithm, packets injection control, and switching strategies. In this paper, we carried out a study on congestion in a 2D mesh network, through various detailed simulations. Our focus was on the most used congestion metrics in NoC. According to our experiments and performed simulations under different traffic scenarios, we found that these metrics are less representative, less significant and yet they do not give a true overview of reading within the NoC nodes at a given cycle. Our study shows that the use of other complementary information regarding the state of nodes and network traffic flow in the design of a novel metric, can really improve the results. In this paper, we put forward a novel metric that takes into account the overall operating state of a router in the design of adaptive XY routing algorithm, aiming to improve routing decisions and network performance. We compare the throughput, latency, resource utilization, and congestion occurrence of proposed metric to three published metrics on two specific traffic patterns in a varied packets injection rate. Our results indicate that our novel metric-based adaptive XY routing has overcome congestion and significantly improve resource utilization through load balancing; achieving an average improvement rate up to 40 compared to adaptive XY routing based on the previous congestion metrics.

Although economic theory suggests that both sales and fuel costs affect technology adoption by vehicle manufacturers, there is very little empirical evidence on either effect. We document a strong connection between a vehicle's sales and its energy efficiency. Using a demographics‐driven demand shifter to isolate demand‐side changes in sales, we find that a one standard deviation increase in sales raises efficiency by 0.2%, compared with a mean improvement rate of 1.4% per year between 1997 and 2013. Higher fuel prices also increase technology adoption directly by increasing willingness to pay for fuel cost savings. The results have two implications: manufacturers will continue to focus technological improvements on top selling vehicles; and fuel taxes will have larger effects on technology adoption than fuel economy standards and feebates.

To assess the efficacy and safety of Adjustable Transobturator Male System (ATOMS) compared to male Readjustment Mechanical External (REMEEX) system for post-prostatectomy incontinence (PPI). A systematic review and meta-analysis on adjustable device ATOMS compared to male REMEEX is presented. Studies on female or neurogenic incontinence were excluded. Primary objectives were evaluation of dryness (the proportion of patients with no-pad or one safety pad/day after device adjustment) and improvement between devices. Secondary objectives were complications and explant rate. They were estimated using a random-effect model. Statistical heterogeneity among studies was assessed using Cochran’s Q test, Higgins’s I2 statistics and tau2. Combined data of 29 observational studies with 1919 patients showed an equivalent proportion of patients treated with radical prostatectomy (p = .125) and previous radiation (p = .126). Dryness rate was 69.3% for ATOMS and 53.4% for male REEMEX (p = .008). Improvement rate was 90.8% for ATOMS and 80.2% for REMEEX (p = .007). Complication rate was 18.9% for ATOMS and 35.8% for REMEEX (p = .096) and explant rate was 5.5% for ATOMS and 13.9% for REMEEX (p = .027). Significant heterogeneity was evidenced, due to absence of randomized studies, variable incontinence severity baseline, difficulties for a common reporting of complications and difference in the follow-up. Differences observed between devices remained statistically significant when only studies with silicone-covered scrotal port (SSP) ATOMS and male REMEEX system II were considered. Despite the absence of direct comparison and the limitations observed ATOMS appears more effective than male REMEEX to treat PPI, and with less explant rate as reported in the literature.

Background The diagnosis and treatment of partial-thickness rotator cuff tears remain controversial, and only a few studies have carried out clinical evaluation and comparison based on different types of tears. The aim of this study was to compare the clinical outcomes of arthroscopic cuff repairs using the suture bridge technique in patients with articular partial-thickness rotator cuff tears (APRCTs) vs. those with bursal partial-thickness rotator cuff tears (BPRCTs). Methods We retrospectively evaluated 29 patients with APRCTs and 22 patients with BPRCTs who underwent arthroscopic cuff repair using the suture bridge technique with a minimum 2-year follow-up. Clinical outcomes were evaluated preoperatively and postoperatively using the visual analog scale score, Japanese Orthopaedic Association (JOA) score, Constant score (CS), active range of motion (ROM) of shoulder flexion and abduction, improvement rate for each score, and retear rate. Results The APRCT group had more women, fewer cases of subacromial decompression, and more patients whose condition changed intraoperatively and transitioned into a complete tear. Preoperatively, the JOA score, CS, ROM of shoulder flexion, ROM of shoulder abduction, and external shoulder rotation strength were lower in the APRCT group. Postoperatively, all scores improved significantly in both groups, and the JOA score, CS, and external shoulder rotation strength remained significantly lower in the APRCT group. Improvement and retear rates were not significantly different between the groups. Conclusions The suture bridge technique significantly improved the clinical outcomes of patients with APRCTs and BPRCTs. Preoperative and postoperative functional parameters were worse in APRCT patients.

The highly diverse cultural and social backgrounds of students from around the world, in this case, from Spanish-speaking countries, has driven a redesign of traditional, f2f (face-to-face) Master's programs in a business school, leading to a blended learning format. Identifying how much time is needed to reach the optimum quality level, looking at mirror (compared) with the f2f is essential for the process of improving overall teaching and optimal use of blended strategies. A satisfaction survey was administered and data was analyzed using the Mann Whitney test. How many editions does it take to obtain the best quality level? How do the different quality factors evolve over time? And how is the comparison with f2f program's evolution over time? Some unexpected results were found, including that, when compared to f2f programs, general satisfaction was statistically higher in the blended modality even from the first edition, and waiting until the second edition shows higher results in almost all of the factors considered. Comparing different editions of the same blended program, the highest level of improvement in the perception of quality occurs when comparing the first and third edition. In this comparison, the most essential factors are those involving people: professors and students. This research provides valuable insights for institutions and/ or faculty members who are considering or currently offering online or blended learning.

Backgrounds and Aims. Elobixibat is a bile acid transporter inhibitor indicated for constipation. Previous studies were performed mainly for the nonelderly and were biased to female. We analyzed the efficacy of elobixibat also for the elderly and male. Materials and Methods. This was a multicenter retrospective cohort study. The subjects were patients aged ≥20 years treated for chronic constipation from May 2018 to November 2019 at 12 related institutions. Patients were divided into ≤74 years and ≥75 years old. Elobixibat at 10 mg/day was prescribed for two weeks. We then analyzed the discontinuation due to ineffectiveness, change of spontaneous bowel movements (SBM), stool consistency, the time until the first SBM, adverse events, and effect-related factors. Results. There were 140 cases (61 males) evaluated, with an average age of 72.1±13.6 years (≤74 years: 71 cases; ≥75 years: 69 cases). The discontinuation rate was 7.9%. The SBM (times/week) increased from 2.86 to 6.08 (p<0.001). The overall SBM improvement rate was 74.0% (≤74 years: 78.2% vs. ≥75 years: 68.9%, p=0.31; male: 75.0% vs. female: 73.3%, p=0.78). The overall improvement rate of stool consistency was 59.6% (≤74 years: 62.9%, ≥75 years: 56.1%, p=0.42). The time until the first SBM (hours) for those ≤74 years and ≥75 years was 17.2±14.3 and 11.2±8.4 (p=0.04). Adverse event rates for those ≤74 years and ≥75 years were 28.2% and 10.1% (p<0.01). There were no significant effect-related factors for gender, age, and use of laxatives. Conclusions. Short-period elobixibat is shown to be effective also for the elderly and male.

Background. Previous studies found levodopa could improve the activity of the ankle joints of patients with Parkinson’s disease (PD). But ankle joint movement is composed of four motion ranges. The specific changes of four motion ranges in PD remain unknown. Objective. The purpose of this study was to decompose the complex ankle joint movement, measure ankle joint changes before and after the acute levodopa challenge test (ALCT), and investigate the effects of these parameters on gait performance. Methods. 29 PD patients and 30 healthy control subjects (HC) completed the Instrumented Stand and Walk (ISAW) test and gait parameters were collected by the JiBuEn gait analysis system. The percentage of improvement of gait data and the UPDRS III in the on-drug condition (ON) were determined with respect to the off-drug condition (OFF). Results. We observed a reduction in the heel strike angle (HS), 3-plantarflexion (3-PF) angle, and 4-dorsiflexion (4-DF) angle of ankle joints. We did not find significant difference in the toe-off angle (TO), 1-plantarflexion (1-PF) angle, and 2-dorsiflexion (2-DF) angle among three groups. Stride length improvement rate was significantly correlated with HS (rs = 0.616, P<0.001) and 3-PF (rs = 0.639, P<0.001) improvement rates. The improvement in the sum of rigidity items (UPDRS motor subsection item 22) was also correlated with HS (rs = 0.389, P=0.037) and 3-PF (rs = 0.373, P=0.046) improvement rates. Conclusions. Exogenous levodopa supplementation can significantly reduce the rigidity of patients with PD, improve their 3-PF and 4-DF of ankle joint kinematic parameters, and ultimately enhance their gait.

Background: The Japanese guidelines for the treatment of alopecia areata list topical immunotherapies as a drug therapy for this condition. However, there is insufficient evidence of its efficacy to support this recommendation. Thus, we sought to clarify the effect of topical immunotherapy on the progression and severity of alopecia areata in Japanese patients. Methods: To evaluate the effect of topical immunotherapy with squaric acid dibutylester (SADBE) in alopecia areata patients, we performed a retrospective cohort study on 49 alopecia patients who had received topical immunotherapy with SADBE. Patients were evaluated by the change in alopecia severity at 6 and 12 months after the initiation of topical immunotherapy. The improvement rate was calculated by determination of the complete and partial responses rate to treatment with topical immunotherapy by application of SADBE. Results: The improvement rate in all alopecia patients treated with SADBE topical immunotherapy was 57.8% (complete response; 11.1% and partial response; 46.7%). Conclusions: Topical immunotherapy with SADBE is an effective treatment for alopecia areata. Therefore, the current treatment recommendations for alopecia areata with topical immunotherapies are appropriate. Keywords: Alopecia, Cohort study, Severity, Topical immunotherapy, Response rate

Background With the steadily increasing trend of functional cosmetics consumption, the public is increasingly expecting the efficacy of cosmetics, and in order to meet these consumer needs, the development of various effective raw materials, as well as products through technical convergence research, has been activating focusing on dermatology. In the Republic of Korea, much attention was paid to cosmetic raw materials using human stem cells as a new growth engine at the end of the 2000s. Accordingly, the Ministry of Food and Drug Safety implemented the Regulations on Cosmetic Safety Standards, etc., which contains the safety standards of human-derived cell and tissue culture as raw materials for cosmetics. Methods Twice a day, morning and evening, for 28 days, 3 mL of the sample provided for each subject was applied onto the entire face using an airbrush. The subjects were divided into a control group (C), an experimental group 1 (ADSC-CM 5% group, E1) and an experimental group 2 (polymersome-containing of ADSC-CM 5% group, E2), and there were 20 subjects in each group. Results Moisture content on the U-zone, melanin and erythema of lid-cheek, overall size and depth of eye wrinkles, and skin roughness of the items showed significant differences among all three groups. More specifically, E1 had a higher rate of skin improvement than C, and E2 had the highest skin improvement rate in all items: skin moisture content, transepidermal water loss (TEWL), melanin and erythema of lid-cheek, eye wrinkles, and skin roughness of lid-cheek. Conclusions The effectiveness of ADSC-CM was verified in all items: increases in moisture content, decrease in TEWL, and improvements of whitening and wrinkles. Moreover, the effectiveness of ADSC-CM was observed as higher in samples of polymersome-containing ADSC-CM than those of raw material ADSC-CM. Furthermore, percutaneous absorption was improved compared with previous studies on formulations in relation to polymersome at the same concentration of ADSC-CM, thereby resulting in higher effectiveness. Trial registration Korea National Institute for Bioethics Policy, P01–201809–13-001, Registered 06 September 2018, http://public.irb.or.kr/.