Anfibios y reptiles del departamento de Ica con comentarios sobre su distribución

En este trabajo se presenta el listado actualizado de anfibios y reptiles de Ica. Las especies son comentadas, acompañadas de mapas de distribución y claves de identificación para reptiles y anfibios. Se recopiló información de registros en colecciones científicas, artículos científicos, informes de agencias gubernamentales de vida silvestre y bases de datos taxonómicas especializadas. Adicionalmente, entre los años 2019 y 2020 se realizaron evaluaciones de campo en zonas con vacíos de información. Se encontraron un total de 22 especies (anfibios 3 y reptiles 19). Los nuevos registros de reptiles para Ica incluyen la lagartija Liolaemus evaristoi y la serpiente Incaspis tachymenoides en la provincia de Chincha a 4200 y 3200 m de altitud respectivamente, la lagartija Stenocercus ornatissimus y la serpiente ciega Epictia tesselata en la provincia de Pisco a 3500 y 2800 m respectivamente. Los nuevos registros de anfibios incluyen a Pleurodema marmoratum en la provincia de Chincha (3900 m) y Telmatobius rimac en las provincias de Chincha y Palpa a 3900 y 2350 m respectivamente. La mayor riqueza y endemismos locales se encontraron en el desierto costero, mientras que, las ampliaciones de distribución y endemismos regionales se registraron en la vertiente occidental de los Andes. También, se observa que las familias Leptotyphlopidae y Viperidae, y los géneros Dicrodon, Stenocercus y Oxyrophus terminan su distribución en la vertiente occidental y la zona costera de los departamentos de Ica y Arequipa sin representantes en el extremo sur del Perú y Chile.

This paper presents the updated list of amphibians and reptiles of Ica. Species are commented, accompanied by distribution maps and identification keys for reptiles and amphibians. Information was collected from scientific collections, scientific articles, governmental wildlife agency reports, and specialized taxonomic database. Additionally, between 2019 and 2020, field surveys were carried out in areas with information gaps. A total of 22 species were found (amphibians 3 and reptiles 19). The new records of reptiles include the Liolaemus evaristoi lizard and the Incaspis tachymenoides snake from Chincha province at 4200 and 3200 m altitude respectively, the Stenocercus ornatissimus lizard and the blind snake Epictia tesselata from Pisco province at 3500 and 2800 m respectively. New amphibian records include Pleurodema marmoratum in Chincha province (3900 m) and Telmatobius rimac in Chincha and Palpa provinces at 3900 and 2350 m respectively. The greatest richness and local endemism were found in the coastal desert, while the expansion of distribution and regional endemism were recorded on the western slope of the Andes. Also, it is observed that the families Leptotyphlopidae and Viperidae, and the genera Dicrodon, Stenocercus and Oxyrophus are finishing their distribution in the western slope and the coastal zone of the departments of Ica and Arequipa without representatives in the extreme south of Peru and Chile.

Desigualdades sociales en la mortalidad maternal, República Dominicana, 2016 / Social inequalities in maternal mortality, Dominican Republic, 2016

Esta investigación pretende cuantificar las diferencias en la razón de mortalidad materna en las provincias de la República Dominicana, considerando las distintas condiciones sociales a la que estas mujeres están expuestas. Se utilizó la información proveniente de registro de estadísticas vitales. Se calculó la asociación entre la razón de mortalidad materna y ciertos indicadores socioeconómicos seleccionados. Se calcularon las métricas de desigualdad tomando en cuenta los indicadores socioeconómicos que se hallaron significativamente asociados con la razón de mortalidad materna, resultando esta dos veces mayor en los territorios más desfavorecidos socialmente, comparados con los territorios que se encontraron en mejores condiciones sociales.

This research aims to quantify the differences in the ma-ternal mortality rate in the provinces of the Dominican Republic, considering the different social conditions to which these women are exposed. Information from the vital statistics registry was used. The association be-tween the maternal mortality rate and certain selected socioeconomic indicators was calculated. The inequality metrics were calculated considering the socioeconomic indicators that were found to be significantly associated with the maternal mortality rate, resulting in two times higher in the most socially disadvantaged territories, compared to the territories that were found in better social conditions.

Multivariate correlation analysis of T1S and C7S / 中国骨伤

OBJECTIVE@#To determine whether C7 angles (C7 slope, C7S) could replace T1 angles (T1 slope, T1S) by correlation analysis of T1S and C7S.@*METHODS@#A total of 442 patients from July 2015 to July 2020 in outpatient and inpatient department were enrolled retrospectively, and 259 patients who could identify the upper endplate of T1 were screened out . Of them, there were 145 males and 114 females, aged from 20 to 83 years old with an average of (58.6±11.2) years, including 163 patients with cervical spine surgery and 96 non-surgical patients. Patients were stratified by sex, age, cervical kyphosis, cervical alignment imbalance, and cervical spine surgery. These 259 patients included 145 cases in the male group, 114 cases in the female group;76 cases in the youth group (<40 years old), 109 cases in the middle-aged group (40 to 60 years old), and 74 cases in the elderly group(>60 years old); 92 cases in the cervical kyphosis group, 167 cases in the non-kyphosis group;51 cases in the cervical sequence imbalance group, 208 cases in the non-imbalance group;163 cases in the cervical surgery group, 96 cases in the non-operation group. The correlations of C7S and T1S in various modalities groups were analyzed.@*RESULTS@#Of 442 patients, the recognition rate of upper endplate of T1 was 58.6%(259/442), and that of C7 was 90.7%. The mean T1S and C7S of the 259 patients were (24.5±8.0)° [(25.9±7.7)° in the male group and (23.7±6.9)° in the female group] and (20.8±7.3)° [(22.5±7.5)° in the male group and(19.7±5.8)° in the female group], respectively. The total correlation coefficient between C7S and T1S was r=0.89, R2=0.79, and the linear regression equation was T1S=0.91×C7S+4.35. In the above general information and the grouping of deformity factors, T1S was highly correlated with C7S(r value 0.85 to 0.92, P<0.05).@*CONCLUSION@#There is a high correlation between T1S and C7S in different factor groups. For cases where T1S cannot be measured, C7S can be used to provide guidance and reference for evaluating the sagittal balance of the spine, analyzing the condition, and formulating surgical plans.

Risk factors for contralateral anterior cruciate ligament injury after primary anterior cruciate ligament reconstruction / 中国修复重建外科杂志

OBJECTIVE@#To investigate the risk factors of contralateral anterior cruciate ligament (ACL) injury after primary ACL reconstruction.@*METHODS@#A retrospective review was conducted on the 716 patients with ACL injury who received primary ACL reconstruction surgery and met the selection criteria between January 2012 and September 2018. After a mean follow-up period of 7.6 years (range, 4-10 years), 65 patients (9.1%) experienced contralateral ACL injury (injured group) and 651 patients (90.9%) did not (uninjured group). There was no significant difference in age, body mass index, and preoperative Lachman test degree between groups ( P>0.05). However, the proportion of female in the injured group was significantly higher than that of male ( P<0.05), and the preoperative posterior tibial slope (PTS) was significantly higher than that of the uninjured group ( P<0.05). Using the outcome of contralateral ACL injury as the dependent variable, the clinical data of the patient was first used as the independent variable, and univariate COX regression was used to analyze the prognostic influencing factors. Then, the indicators with differences in univariate COX regression were used as the independent variable, and multivariate COX regression was used to analyze the independent risk factors affecting prognosis. Log-Rank (Mantel-Cox) test was used to test and analyze the occurrence time of contralateral ACL injury in patients of different genders; X-tile software was used to analyze the occurrence time of contralateral ACL injury in patients with different PTS using Log-Rank (Mantel-Cox) test and PTS cut-off values.@*RESULTS@#Univariate COX regression analysis showed that gender and PTS were influence factors for contralateral ACL injury ( P<0.05); further multivariate COX regression analysis showed that female and increased PTS were independent risk factors for contralateral ACL injury ( P<0.05). The Log-Rank (Mantel-Cox) test results showed that the contralateral ACL injury occurred in female at 8.853 (8.600, 9.106) years, which was significantly shorter than that in male [9.661 (9.503, 9.819) years] ( χ 2=20.323, P<0.001). Using X-tile software to analyze the cut-off value of PTS, it was found that the cut-off value of PTS for contralateral ACL injury was 10.92°. According to the Log-Rank (Mantel-Cox) test, it was found that the contralateral ACL injury occurred in 5.762 (4.981, 6.543) years in patients with PTS≥10.92°, which was significantly shorter than patients with PTS<10.92° [9.751 (9.650, 9.853) years]( χ 2 =302.479, P<0.001).@*CONCLUSION@#Female and PTS≥10.92° after primary ACL reconstruction are independent risk factors for contralateral ACL injury.

Study on application of posterior tibial slope angle in anterior cruciate ligament / 中国骨伤

Posterior tibial slope angle (PTSA) is a risk factor for anterior cruciate ligament (ACL) injury and has attracted a lot of attention, but its mechanism of action and diagnosis are still not systematically studied in the field of sports medicine. In this paper, we believe that PTSA should be measured by full-length lower extremity films and combined with multiple imaging data for comprehensive assessment to reduce errors. A large PTSA may increases risk of anterior cruciate ligament injury, so patients with more than 12 degrees of PTSA should be treated by preserving meniscus as much as possible during ACL reconstruction and combining with tibial osteotomy if necessary, which could effectively prevent risk of ligament re-injury. At the same time, gait analysis has an important reference value for preoperative pathogenic pattern and postoperative rehabilitation function, so the author believes that it will have a guiding significance for the development of individualized rehabilitation strategy based on PTSA, in order to achieve the best treatment effect.

Desigualdades no uso dos serviços de saúde em um município no Sul do Brasil em 2019: estudo transversal / Inequalities in the use of health services in a municipality in Southern Brazil in 2019: a cross-sectional study / Desigualdades en el uso de los servicios de salud en un municipio del Sur de Brasil en 2019: estudio transversal

Objective: to assess inequalities in the use of health services in a municipality in Southern Brazil. Methods: This was a population-based cross-sectional study conducted with adults living in the urban area of the municipality of Criciúma, state of Santa Catarina, Brazil, between March and December 2019; the research outcomes were medical consultation, dental visit, nutritional counseling and the use of the Brazilian National Health System (Sistema Único de Saúde − SUS); the exposures were age, schooling and income; inequalities were analyzed using the Slope index of inequality and equiplots. Results: A total of 820 individuals were studied; medical consultation was higher (14.2 percentage points [p.p.]), and dental visit was lower (-29.5 p.p.), in older adults, when compared to young people; dental visit (41.1 p.p.) and nutritional counseling (18.0 p.p.) were higher in individuals with higher level of education, when compared to those with lower level of education; the use of SUS was higher in older adults (21.3 p.p.), with lower level of education (-61.2 p.p.) and lower income (-51.6 p.p.), when compared to their peers. Conclusion: in order to develop public policies, these inequalities should be taken into consideration.

Objetivo: Evaluar desigualdades en el uso de los servicios de salud en un municipio del sur de Brasil. Métodos: Estudio transversal de base poblacional con adultos residentes en área urbana de la ciudad de Criciúma, estado de Santa Catarina, Brasil, entre marzo y diciembre de 2019. Variables de resultado fueron citas médicas y dentales, consejería nutricional y uso del Sistema Único de Salud (Sistema Único de Saúde − SUS). Exposiciones fueron edad, educación, ingreso. Desigualdad se presentó por Índice de desigualdad de la pendiente y gráficos equiplots. Resultados: Se estudiaron 820 individuos. Cita médica fue mayor (14.2 puntos porcentuales [p.p.]) y cita dental menor (-29,5 p.p.) en ancianos, en comparación con jóvenes. Cita dental (41,1 p.p.) y consejería nutricional (18,0 p.p.) fueron mayores en más educados en comparación con menos educados. Uso del SUS fue mayor en ancianos (21,3 p.p.), menos educados (-61,2 p.p.) y con menores ingresos (-51,6 p.p.) en comparación con sus pares. Conclusiones: Desigualdades evidenciadas demuestran que políticas públicas deben considerarlas en su desarrollo.

Objetivo: avaliar desigualdades no uso dos serviços de saúde em um município do Sul do Brasil. Métodos: estudo transversal de base populacional com adultos residentes na área urbana do município de Criciúma, no estado de Santa Catarina, Brasil, entre março e dezembro de 2019; desfechos do estudo foram consulta médica, consulta odontológica, orientação nutricional e uso do Sistema Único de Saúde (SUS); exposições foram idade, escolaridade e renda; desigualdades foram analisadas pelo índice absoluto de desigualdade e gráficos equiplots. Resultados: foram incluídos 820 indivíduos; realização de consulta médica foi maior (14,2 pontos percentuais [p.p.]), e de consulta odontológica, menor (-29,5 p.p.), em idosos, comparados a jovens; realização de consulta odontológica (41,1 p.p.) e orientação nutricional (18,0 p.p.) foi maior nos mais escolarizados, comparados aos menos escolarizados; uso do SUS foi maior em idosos (21,3 p.p.), menos escolarizados (-61,2 p.p.) e com menor renda (-51,6 p.p.), comparados a seus pares. Conclusão: para seu desenvolvimento, as políticas públicas devem considerar essas desigualdades.

Efecto del slope tibial en la recuperación funcional, en pacientes sometidos a reconstrucción de ligamento cruzado anterior / Effect of tibial slope on functional recovery in patients undergoing anterior cruciate ligament reconstruction

Resumen: Introducción: El slope tibial (inclinación) se ha identificado como uno de los factores asociados a la falla del injerto tras una reconstrucción de ligamento cruzado anterior (LCA); sin embargo, su relación con los resultados funcionales ha sido poco estudiada. El objetivo de este estudio es determinar el efecto del slope tibial en la recuperación funcional, en pacientes sometidos a reconstrucción de LCA. Material y métodos: Se incluyeron los pacientes con lesión de LCA sometidos a reconstrucción primaria, de Mayo de 2018 a Mayo de 2019, midiendo el slope tibial y recabando los puntajes de IKDC y Lysholm. Se elaboró un análisis descriptivo de primera intención y para alcanzar los objetivos se realizó una comparativa de 25 pacientes con slope tibial normal seleccionados aleatoriamente contra 25 pacientes con slope tibial aumentado. Resultados: Se incluyeron 98 pacientes, 73 contaban con un slope tibial normal y 25 con un slope tibial aumentado. Los puntajes de IKDC y Lysholm al final del seguimiento fueron mejores en los pacientes con slope tibial normal. La falla del injerto sólo se identificó en el grupo con slope tibial aumentado. Por otro lado, al análisis comparativo con el grupo control demostró un mejor resultado funcional al final del seguimiento valorado por IKDC en el grupo con slope tibial normal. Conclusión: Los pacientes sometidos a reconstrucción de LCA y slope tibial aumentado tienen un resultado funcional inferior al año de seguimiento evaluado por IKDC en comparación con pacientes con slope tibial dentro de parámetros normales.

Abstract: Introduction: The tibial slope has been identified as one of the factors associated with graft failure after anterior cruciate ligament (ACL) reconstruction; however, its relationship with functional results has been little studied. The main purpose of this study is to determine the effect of the tibial slope on functional recovery in patients undergoing reconstruction of the anterior cruciate ligament. Material and methods: We included patients with a diagnosis of anterior cruciate ligament injury undergoing primary reconstruction, from May 2018 to May 2019, who had a complete radiographic and clinical record; also, the scores from questionnaires of the International Knee Documentation Committee (IKDC) and Lysholm scores were collected pre surgical procedures and throughout the one-year follow-up. The measurement of the tibial slope was performed in lateral knee X-rays from the electronic clinical record. A descriptive analysis of first intention was done, and to achieve the objectives, we compared 25 patients who had normal tibial slope that were selected randomly with 25 patients who had increased tibial slope. Results: A total of 98 patients were included, 73 had a normal tibial slope (equal to or less than 12 degrees) and 25 with an increased tibial slope (greater than 12 degrees), the average age in both groups was 28.43 years for the group with normal tibial slope and 28.26 for patients with increased tibial slope. Regarding the functional assessment, the IKDC and Lysholm scores at the end of the follow-up were better for patients with normal tibial slope. Graft failure was only identified in the group with increased tibial slope. On the other hand, the comparative analysis with the control group randomly selected who had normal tibial slope, showed a better functional result assessed by IKDC score at the end of the follow-up for the group with normal tibial slope. Conclusion: Patients undergoing ACL reconstruction and increased Tibial Slope have an inferior functional result at one year of follow-up assessed by IKDC, when compared with patients with normal tibial slope.

Reasonably conduct the multiple Logistic regression analysis combined with the multilevel model analysis / 四川精神卫生

The purpose of this paper was to introduce how to reasonably analyze the multiple Logistic regression models in combination with the multilevel model analysis. Firstly， four basic concepts related to the multilevel model analysis were introduced. Secondly， three steps for building a multilevel model were given. Thirdly， through an example of a multicenter drug clinical trial， the whole process of how to use SAS software for the analysis was presented. The contests were as follows： ① testing whether the odds ratios of each center were homogenous； ② building the multiple Logistic regression model after generating dummy variables for the trial center； ③ constructing a multiple Logistic regression model with the trial center as a stratified variable； ④ building a random intercept multilevel multiple Logistic regression model； ⑤ constructing a random intercept and random slope multilevel multiple Logistic regression model. The conclusion was that when there were differences among the data at different hierarchies with binary outcome variables， the most appropriate approach was to build a multilevel multiple Logistic regression model.

Combining ventilation efficiency and peak systolic blood pressure in prognostic assessment of patients with chronic heart failure / 中华全科医师杂志

Objective:To analyze the value of minute ventilation to carbon dioxide production slope (VE/VCO 2 slope) combined with peak systolic blood pressure (SBP) in predicting prognosis for patients with chronic heart failure (CHF). Methods:A total of 170 patients with CHF who visited the Cardiac Rehabilitation Center of Tongji Hospital Affiliated to Tongji University and completed cardiopulmonary exercise test from March 2007 to December 2018 were enrolled in the study. The clinical data, cardiopulmonary exercise testing results and follow-up information of patients were collected to explore the predictors of all-cause mortality in patients with CHF.Results:The median follow-up time was 647 (182-1 764) days. All-cause death occurred in 34 patients. Compared with surviving patients, the proportion of diabetes and angiotensin-converting enzyme inhibitor/angiotensin Ⅱ receptor blocker (ACEI/ARB) use in fatal patients was significantly higher ( P<0.01). The VE/VCO 2 slope and peak SBP*VE/VCO 2 in the fatal patients were significantly higher, and the peak oxygen consumption (peak VO 2) was lower than those in the surviving patients ( P<0.01). The areas under the receiver operating characteristic curve (AUC) of VE/VCO 2 slope and peak SBP*VE/VCO 2 in predicting all-cause mortality in patients with CHF were 0.648 ( P=0.008) and 0.681 ( P=0.001), respectively; the optimal thresholds were >40.95 ( P=0.008) and > 5 423.50 mmHg (1 mmHg=0.133 kPa, P=0.006), the sensitivity was 0.559 and 0.588, and the specificity was 0.728 and 0.735, respectively. Multivariate Cox regression analysis showed that after adjusting for age, gender, diabetes and ACEI/ARB use, VE/VCO 2 slope ( HR=2.12, P=0.036) and peak SBP*VE/VCO 2 ( HR=2.42, P=0.016) were independent risk factors for all-cause mortality in patients with CHF. Conclusion:Compared to the traditional index VE/VCO 2 slope, a novel index peak SBP* VE/VCO 2 provides a relatively better predictive value for all-cause death of CHF patients.

Time comparison of artificial airway establishment in operating room and on slope using endotracheal intubation and laryngeal mask / 北京大学学报(医学版)

OBJECTIVE@#To compare the completion time of endotracheal intubation and laryngeal mask implantation in operating room and on slope of ski resort, and to discuss the optimal method of estab-lishing artificial airway on slope of ski resort.@*METHODS@#The simulator was placed with the head under the feet on slope of ski resort. The artificial airway was established by tracheal intubation assisted by video laryngoscope (endotracheal intubation group) and laryngeal mask placement (laryngeal mask group) respectively by an anesthesiologist who wore full set of ski suits, helmets, goggles, gloves and ski boots. Each method was repeated 5 times, and the operation time of artificial airway establishment was recorded. While the simulated human was placed flat on the operating table in an operating room of a hospital, and the artificial airway was established by the same anesthesiologist using the same methods. Time was recorded and repeated for 5 times. The completion time of endotracheal intubation and laryngeal mask placement in the operating room and on the ski slope were compared.@*RESULTS@#The operating time of tracheal intubation in the operating room was longer than that of laryngeal mask placement [(79.8±10.4) s vs. (53.4±2.7) s, P=0.005], and the operating time of endotracheal intubation on the ski slope was longer than that of laryngeal mask placement [(209.2±32.7) s vs. (72.2±3.1) s, P=0.001]. The time of endotracheal intubation group on the slope of the ski resort was longer than that in the opera-ting room(t=-7.851, P=0.001). The time of laryngeal mask group on the slope was longer than that in the operating room (t=-19.391, P < 0.001).@*CONCLUSION@#On ski slope, both of tracheal intubation assisted by video laryngoscope and laryngeal mask placement can quickly complete the establishment of artificial airway, but the time required is longer than that in the operating room. The time of laryngeal mask placement to establish artificial airway is shorter than that of tracheal intubation assisted video laryngoscope, which may have a certain advantage in ski rescue.

Clinical value of ultrasound shear wave dispersion imaging for assessing the hepatic inflammation activity of chronic hepatitis B / 中华超声影像学杂志

Objective:To investigate the clinical value of ultrasound shear wave dispersion (SWD) imaging in assessing the hepatic inflammation activity in patients with chronic hepatitis B.Methods:Fifty-two patients with chronic hepatitis B who underwent liver biopsy in Peking University Third Hospital and Beijing Ditan Hospital Affiliated to Capital Medical University from December 2020 to December 2021 were prospectively enrolled.Liver stiffness (LS) and shear wave dispersion slope (SWDS) were measured by SWD imaging in all participants. Baseline data and laboratory indexes of liver function were collected.Liver inflammation grading(G0-G4) and fibrosis staging (S0-S4) were determined by pathological examination. The relationship between SWDS and various indicators was analyzed by univariate and multivariate linear regression analysis. The participants were grouped according to the pathological grading of hepatic inflammatory activity. The differences of various indexes among three groups were compared, and the correlations between SWDS, LS and laboratory indicators and hepatic inflammatory activity were analyzed. The ROC curve was used to evaluate the diagnostic performances of ultrasound and laboratory indicators for hepatic inflammation activity, and the diagnostic accuracy of different indicators was compared by Delong test.Results:Inflammation and fibrosis were both independent affecting factors of SWDS (all P<0.05); there were significant differences in alanine transaminase(ALT), aspartate aminotransferase(AST), LS and SWDS among groups with different inflammatory activities (all P<0.05). The SWDS and LS of the G3 and G2 groups were statistically higher than those of the G1 group (all P<0.001). ALT was only significantly different between G1 group and G2 group ( P<0.05), and AST was only significantly different between G1 group and G3 group ( P<0.05); The SWDS and LS showed strongly positive correlation ( rs=0.728, P<0.001) and moderately positive correlation ( rs=0.679, P<0.001) with hepatic inflammatory activity, respectively; while the correlations between ALT, AST and hepatic inflammatory activity were weaker( rs=0.376, P<0.05; rs=0.485, P<0.001). The area under the ROC curve, sensitivity and specificity of SWDS for diagnosing hepatic inflammation ≥G2 grade were 0.965, 0.933 and 0.865, respectively. Conclusions:SWDS has certain value in evaluating the hepatic inflammatory activity of ≥G2 grade in patients with chronic hepatitis B.

Interlaboratory method validation of slope ratio determination for anticoagulant activity of leeches / 中国药理学通报

Aim To investigate the slope ratio method for the determination of anticoagulant activity of leeches. Methods Three batches of leeches, four groups of Japanese medical vermiculite yinpian and fifteen groups of leech preparations were chosen, with contrast medicinal leeches herbs and Philippine cattle leech contrast medicinal materials, and different concentrations of leaching solutions were prepared in parallel. APTT value was determined after anticoagulant activity was determined by slope ratio method for the joint validation of laboratory, intermediate precision and accuracy between the linear range. Results The slope ratio method was accurate and accurate in the determination of anticoagulant activity of leeches, with linearity between 64% and 156% relative titer level. Conclusion Slope ratio method can be used to determine the anticoagulant activity of leeches.

Cardiopulmonary exercise test in patients with refractory angina: functional and ischemic evaluation

Abstract Objectives Refractory angina (RA) is a chronic condition clinically characterized by low effort tolerance; therefore, physical stress testing is not usually requested for these patients. Cardiopulmonary exercise testing (CPET) is considered a gold standard examination for functional capacity evaluation, even in submaximal tests, and it has gained great prominence in detecting ischemia. The authors aimed to determine cardiorespiratory capacity by using the oxygen consumption efficiency slope (OUES) in patients with refractory angina. The authors also studied the O2 pulse response by CPET and the association of ischemic changes with contractile modifications by exercise stress echocardiography (ESE). Methods Thirty-one patients of both sexes, aged 45 to 75 years, with symptomatic (Canadian Cardiovascular Society class II to IV) angina who underwent CPET on a treadmill and exercise stress echocardiography on a lower limb cycle ergometer were studied. ClinicalTrials.gov: NCT03218891. Results The patients had low cardiorespiratory capacity (OUES of 1.74 ± 0.4 L/min; 63.9±14.7% of predicted), and 77% of patients had a flattening or drop in O2 pulse response. There was a direct association between Heart Rate (HR) at the onset of myocardial ischemia detected by ESE and HR at the onset of flattening or drop in oxygen pulse response detected by CPET (R = 0.48; p = 0.019). Conclusion Patients with refractory angina demonstrate low cardiorespiratory capacity. CPET shows good sensitivity for detecting abnormal cardiovascular response in these patients with a significant relationship between flattening O2 pulse response during CEPT and contractile alterations detected by exercise stress echocardiography. Highlights OUES analysis is useful for assessing functional capacity in refractory angina. O2 pulse curve is correlated with contractile alterations in exercise echocardiogram. Cardiopulmonary exercise test is useful toll in patients with refractory angina.

Effect of posterior tibial slope on the short-term outcome in mobile-bearing unicompartmental knee arthroplasty / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the relationship between postoperative knee function and the sagittal position of tibial component in unicompartmental knee arthroplasty (UKA).@*METHODS@#We retrospectively enrolled the patients who underwent UKA from January 2016 to May 2020. They were assigned into 2 groups according to postoperative posterior tibial slope (PTS): the normal PTS group (PTS≥3° and PTS < 8°) and the abnormal PTS group (PTS < 3° or ≥8°). The patients were followed up for at least 12 months. The postoperative Knee Society Clinical Score (KSS-C), Knee Society Functional Score (KSS-F) and knee range of motion (ROM) were compared between the two groups.@*RESULTS@#A total of 72 patients (82 knees) were included with 51 patients (58 knees) in PTS normal group and 21 patients (24 knees) in PTS abnormal group. All the patients were followed up with median of 23.6 months. There was no significant difference in the general data [gender, age, body mass index (BMI)], pre-operative knee range of motion, preoperative KSS-C score and KSS-F score (P > 0.01). The KSS-C score, KSS-F score, and knee range of motion significantly improved after surgery (P < 0.01) for all the patients. The postoperative KSS-C score in normal PTS group (88.76±2.79) was significantly higher than the KSS-C score in abnormal PTS group (84.42±3.35, P < 0.01), but no significant difference between the 2 groups was observed in postoperative KSS-F score and knee range of motion (P > 0.01). In addition, there was no correlation between the change of PTS and postoperative KSS-C score (r=-0.034, 95%CI: -0.247 to 0.186, P = 0.759), KSS-F score (r = -0.014, 95%CI: -0.238 to 0.198, P = 0.901) and knee range of motion (r= 0.045, 95%CI: -0.214 to 0.302, P = 0.686).@*CONCLUSION@#The posterior tibial slope between 3° and < 8° can be recommended to improve knee joint function in mobile UKA, and excessive or insufficient PTS should be avoided.

Effects of Different Posterior Tibial Slopes in Unicompartmental Knee Arthroplasty on the Wear and Function of Prosthesis / 医用生物力学

Objective To establish the three-dimensional (3D) finite element model of unicompartmental knee arthroplasty (UKA) with 3° and 7° posterior tibial slope at different knee flexion angles, and to study biomechanical properties and prosthetic wear of the knee joints with two types of posterior tibia slope and their effects on knee function. Methods Combining CT and MRI images of human knee joints with the 3rd-generation Oxford prosthesis, the finite element UKA model with 3° and 7° posterior tibia slope were established. The 1 kN load was applied to center point of the medial and lateral condyles of the femur to simulate the standing load of human body. The maximum stresses and distributions of the prosthesis and articular cartilage at different knee flexion angles were analyzed. ResultsThe maximum stress of the meniscus liner with 3° posterior tibia slope at 0°, 30°, 60°, 90°, 120° knee flexion angles increased by 28.06%, 68.99%, 19.45%, 21.06% and 53.38%, the distribution area was concentrated from the side of the meniscus liner to the central area, and the stress concentration was obvious at 120° knee flexion. The maximum stress of prosthesis with 3° posterior tibia slope was greater than that with 7 ° posterior tibia slope. The expansion of stress concentration area would cause wear and loosening of the prosthesis, contact stress and concentration area of the articular cartilage would subsequently increase with posterior tibia slope increasing, and stress concentration would be more obvious at high knee flexion angles. Conclusions Tibial prosthesis has the higher stress and greater wear under the condition of 3° posterior tibia slope than 7° posterior tibia slope. The research findings provide theoretical basis for the UKA design in clinic.

Trend Analysis of Precipitation and Temperature over Different Districts of Karnataka: An Aid to Climate Change Detection and Cropping System Option

Aims: To know the rainfall and temperature trend for all the districts of Karnataka state to develop suitable coping mechanisms for changing weather conditions during the cropping season. Study Design: The available daily data of rainfall (1971-2011) and minimum and maximum temperature (1971-2007) for each district was collected from NICRA-ICAR website. A non-parametric model such as the Mann-Kendall (MK) test complemented with Sen’s slope estimator was used to determine the magnitude of the trend. Place and Duration of Study: The rainfall data of 41 years (1971-2011) and temperature data of 37 years (1971-2007) was collected for all 27 districts of Karnataka. Methodology: Basic statistics related to rainfall like mean, standard deviation (SD), the coefficient of variation (CV) and the percentage contribution to annual rainfall were computed for monthly and season-wise. Mann-Kendall test was used to detect trend for rainfall as well as temperature. Results: An increasing trend in rainfall during winter, monsoon and annual basis for all most all the districts of Karnataka and decreasing trend of rainfall during pre and post-monsoon season was noticed. An early cessation of rainfall during September month in all most all the districts of Karnataka was observed. Similarly, monthly mean, maximum and the minimum temperature had shown an increasing trend over the past 37 years for all the districts of Karnataka. Conclusion: The more variation in rainfall during the pre-monsoon season was observed, which is more important for land preparation and other operations. The increasing trend of maximum and minimum temperature throughout the year may often cause a reduction in crop yield. It is necessary to change crops with its short duration varieties in order to avoid late season drought.

Ontogenetic and phylogenetic allometry (bivariate and multivariate) for young morphologists / Alometría ontogenética y filogenética (bivariada y multivariada) para jóvenes morfólogos

The current young morphologist has a background in cellular and molecular biology, where the production of knowledge is very intense and rapid. However, as demonstrated in this review, quantitative methods in morphology, especially allometry, may be significant in demonstrating relationships between size and shape, ontogeny, and phylogeny. These themes are essential to the morphologist and should not be neglected because it improves the morphologists capacity for criticism and proposing projects. In this text, both ontogenetic and phylogenetic allometries in bivariate and multivariate studies are commented. Therefore, it is an initial text for those who have not yet been introduced to the topic, which gives the basis for being increased in the future, with more specific literature.

El joven morfólogo actual tiene una formación en biología celular y molecular, donde la producción de conocimiento es muy intensa y rápida. Sin embargo, como expusimos en esta revisión, métodos cuantitativos en morfología, en especial la alometría, pueden ser significantes en demostrar relaciones entre el tamaño y la forma, la ontogenia y la filogenia. Estos temas son importantes para el morfólogo y no deben ser descuidados porque mejora la capacidad de crítica y la propuesta de proyectos. En este texto, presentamos la alometría ontogenética y la filogenética, en estudios bivariados y multivariados. Por lo tanto, es un texto inicial para quienes aún no se han introducido al tema y que dará las bases para ser acrescentado en el futuro, con literatura más específica.

Observations on Sagittal Alignment of Lumbo-Sacral Spine in Asymptomatic Adults in Kashmir

Introduction: Sacropelvic parameters in various spine and hipdisorders have been published in various studies. We aimed tostudy the normal sacropelvic parameters and curvatures of thespine and their correlation in asymptomatic Indian adults inrelation to variations in sex and age.Material and Methods: 200 Volunteers were taken fromgeneral population with age ranging from 18-50. Patientwas made to stand and left lateral radiograph exposing C7 toS1 and both the hips with a long 30x90 cm cassette placedat 230 cm from the X-ray tube was performed by a singleradiographer to avoid bias.Results: The average LL, SS, PI, PT, and SVA values wereaverage 55.61±10.68, 38.38±8.33,47.94±10.24,10.16±6.23 and 17.27±9.72 respectively. No statistically significantdifference was observed in statistical values with regardsto sex. Our study showed that PI has significant positivecorrelations with SS, LL and PT, and also affects LL. SS hassignificant positive correlation with LL.Conclusion: The current results could contribute to not onlythe understanding of normal sagittal spinal alignment, but alsoserve as a basis for realignment strategies in young Kashmiriadults.

Evaluation of respiratory dynamics by volumetric capnography during submaximal exercise protocol of six minutes on treadmill in cystic fibrosis patients / Avaliação da dinâmica respiratória por capnografia volumétrica durante o protocolo de exercício submáximo por seis minutos em esteira em pacientes com fibrose cística

Abstract Objectives: Volumetric capnography provides the standard CO2 elimination by the volume expired per respiratory cycle and is a measure to assess pulmonary involvement. Thus, the objective of this study was to evaluate the respiratory dynamics of healthy control subjects and those with cystic fibrosis in a submaximal exercise protocol for six minutes on the treadmill, using volumetric capnography parameters (slope 3 [Slp3], Slp3/tidal volume [Slp3/TV], and slope 2 [Slp2]). Methods: This was a cross-sectional study with 128 subjects (cystic fibrosis, 64 subjects; controls, 64 subjects]. Participants underwent volumetric capnography before, during, and after six minutes on the treadmill. Statistical analysis was performed using the Friedman, Mann-Whitney, and Kruskal-Wallis tests, considering age and sex. An alpha = 0.05 was considered. Results: Six minutes on the treadmill evaluation: in cystic fibrosis, volumetric capnography parameters were different before, during, and after six minutes on the treadmill; the same was observed for the controls, except for Slp2. Regarding age, an Slp3 difference was observed in cystic fibrosis patients regardless of age, at all moments, and in controls for age ≥ 12 years; a difference in Slp3/TV was observed in cystic fibrosis and controls, regardless of age; and an Slp2 difference in the cystic fibrosis, regardless of age. Regarding sex, Slp3 and Slp3/TV differences were observed in cystic fibrosis regardless of sex, and in controls in male participants; an Slp2 difference was observed in the cystic fibrosis and female participants. The analysis between groups (cystic fibrosis and controls) indicated that Slp3 and Slp3/TV has identified the CF, regardless of age and sex, while the Slp2 showed the CF considering age. Conclusions: Cystic fibrosis showed greater values of the parameters before, during, and after exercise, even when stratified by age and sex, which may indicate ventilation inhomogeneity in the peripheral pathways in the cystic fibrosis.

Resumo Objetivos: A capnografia volumétrica fornece o padrão de eliminação do CO2, pelo volume expirado por ciclo respiratório e avalia o comprometimento pulmonar. O objetivo do estudo foi avaliar a dinâmica respiratória de indivíduos controles saudáveis e em indivíduos com fibrose cística, em um protocolo de exercício submáximo por seis minutos em esteira, por parâmetros da capnografia volumétrica [slope 3(Slp3), Slp3/volume corrente (Slp3/TV) e slope 2(Slp2)]. Métodos: Estudo de corte transversal com 128 indivíduos [(fibrose cística) 64 indivíduos; (controles) 64 indivíduos]. Os participantes realizaram capnografia volumétrica antes, durante e após seis minutos em esteira. Análise estatística realizada pelos testes de Friedman, Mann-Whitney e Kruskal-Wallis, considerado a idade e o sexo. Alpha = 0,05. Resultados: Avaliação de seis minutos em esteira: na fibrose cística, os parâmetros da capnografia volumétrica foram diferentes antes, durante e após seis minutos em esteira, o mesmo ocorreu nos controles, exceto para o Slp2. Considerando a idade: (Slp3) diferença na FC, independentemente da idade, em todos os momentos e nos controles apenas para ≥ 12 anos; (Slp3/TV) diferença para fibrose cística e controles independentemente da idade; (Slp2) diferença apenas para o grupo fibrose cística, independentemente da idade. Considerando o sexo: (Slp3 e Slp3/TV) diferença para fibrose cística, independentemente do sexo, e controles apenas no sexo masculino; (Slp2) diferença para fibrose cística e sexo feminino. Análise entre grupos (fibrose cística versus controles): Slp3 e Slp3/TV identificou a fibrose cística, independentemente da idade e sexo, enquanto o Slp2 evidenciou a fibrose cística considerando a idade. Conclusão: A fibrose cística apresentou maiores valores dos parâmetros antes, durante e após exercício, inclusive quando se considerou idade e sexo, podendo indicar não homogeneidade da distribuição da ventilação nas vias periféricas.

Photoacoustic imaging and photoacoustic spectrum analysis in mouse models of cutaneous squamous cell carcinoma / 中华皮肤科杂志

Objective To establish a photoacoustic detection system and data processing methods for skin tumors,and to explore photoacoustic imaging and photoacoustic spectrum in mouse models of cutaneous squamous cell carcinoma (CSCC).Methods A total of 60 healthy specific pathogen-free (SPF) female BALB/C nude mice aged 6-8 weeks were randomly and equally divided into 2 groups to be inoculated with a murine CSCC cell line XL50 and a human CSCC cell line A431 respectively on the right back near the upper limbs,and mouse models of murine CSCC (n =20) and human CSCC (n =20) were successfully established.The 850-nm photoacoustic detection system was applied in the above 2 kinds of mouse models,and photoacoustic imaging and photoacoustic spectrum data were collected.The fitted slope of acoustic power spectrum curves was compared between squamous cell carcinoma tissues and normal skin on the left back of the mouse model.After the photoacoustic detection,tumor tissues and normal skin at the opposite side were excised from the 2 kinds of mouse models,and subjected to histopathological examination.The fitted slope of different tissues was compared by using t test.Results Photoacoustic imaging showed higher photoacoustic signals of hemoglobin in squamous cell carcinoma tissues compared with the normal skin tissues.In the model of murine CSCC,the fitted slope of acoustic power spectrum curve was significantly lower in the tumor tissues (-1.827 ± 0.153 1) than in the normal skin tissues (-1.059 ± 0.117 8,t =3.973,P ＜ 0.001).In the model of human CSCC,the fitted slope of acoustic power spectrum curve was also significantly lower in the tumor tissues (-1.537 ± 0.125 5) than in the normal skin tissues (-0.960 ± 0.259 7,t =2.166,P =0.043).Histopathological examination showed that the number of vessels increased in the tumor tissues compared with the normal skin tissues.Conclusion CSCC tissues are different from normal skin tissues in photoacoustic imaging signals and the fitted slope of acoustic power spectrum,which may lay a foundation for non-invasive photoacoustic diagnosis of CSCC.