Modified FOLFIRINOX compared to Gemcitabine & nab-Paclitaxel in advanced pancreatic ductal adenocarcinoma - results of a match-pair analysis

Background & objectives: FOLFIRINOX and gemcitabine plus nab-paclitaxel (GN) are the most commonly used regimens in advanced pancreatic ductal adenocarcinomas (PDACs). As there is limited data on comparison of these two regimens, the present study was aimed to compare survivals and tolerance for both regimens through a match-pair analysis. Methods: The data of 350 patients with metastatic and locally advanced PDAC, treated between January 2013 and December 2019, were retrieved. A 1:1 matching, using age and performance status, without replacement was performed by using nearest neighbour matching method. Results: A total of 260 patients (130 modified FOLFIRINOX and 130 GN) were matched. The median overall survival (OS) was 12.98 months [95% confidence interval (CI) 7.257-8.776 months] in modifications of FOLFIRINOX (mFOLFIRINOX) cohort and 12.06 months (95% CI 6.690-8.88 months) in GN group (P=0.080). The incidence of grade 3 and 4 infections, diarrhoea, oral mucositis, and fatigue was higher with mFOLFIRINOX. Patients who received second line therapy had improved OS as compared to those who did not (14.06 vs. 9.07 months, P<0.001). Interpretation & conclusions: GN and mFOLFIRINOX appear to have similar survival outcomes in an unselected match paired patient population with advanced PDAC. A markedly increased incidence of non-myelosuppressive grade 3 and grade 4 side-effects and lack of survival improvements suggest a need for nuanced use of the mFOLFIRINOX regimen. Administration of second-line chemotherapy improves OS in patients with advanced PDAC.

Shedding light on tactical performance and tactical behavior concepts with a particular reference to soccer / Lançando luz sobre os conceitos de desempenho tático e comportamento tático com uma referência especial ao futebol

Abstract Tactical aspects play a significant role in soccer, as a team sport, considering the inherent unpredictability of the actions during a game. Therefore, measuring tactical variables is essential for training planning in soccer and other team sports. However, previous studies have interchangeably used the terms "tactical behavior" and "tactical performance" to refer to the collected variables, which has become a source of questioning in recent literature. In this point-of-view article, the tactical behavior and tactical performance concepts are defined, discussed, and exemplified based on previous studies. While tactical behavior measures are associated with descriptions of the actions, tactical performance variables are assumed to classify and interpret such behaviors considering reference values. Finally, examples of instruments for collecting each data are provided.

Resumo Aspectos táticos representam um ponto chave no futebol enquanto um esporte coletivo considerando a imprevisibilidade das ações durante um jogo. Medir variáveis táticas é importante para o planejamento do treinamento no futebol e nos outros esportes coletivos. Estudos prévios, contudo, utilizaram de forma intercambiável os termos "comportamento tático" e "desempenho tático" para se referir às variáveis coletadas, o que se transformou em um ponto de dúvida na literatura recente. Neste artigo de ponto de vista, os conceitos de comportamento e desempenho tático são definidos, discutidos e exemplificados com base em estudos prévios. Enquanto comportamento tático está associado à descrição das ações, o desempenho tático é assumido como a classificação e a interpretação destes comportamentos considerando valores de referência. Finalmente, exemplos de instrumentos para a recolha de cada dado são apresentados.

Perioperative transfusion analysis and blood ordering schedule update for total knee arthroplasty / 中国输血杂志

【Objective】 To investigate the perioperative rate of allogeneic red blood cell (RBC) transfusion in patients who underwent total knee arthroplasty (TKA) and its risk factors, and to identify its cross-match to transfusion ratio (C∶T ratio). 【Methods】 Anesthetic data of patients who underwent TKA from January 2014 to October 2019 in Peking Union Medical College Hospital were collected and analyzed retrospectively. Perioperative allogeneic RBC transfusion rate was calculated, and binary Logistic regression analysis was performed to identify its risk factors in these patients. The overall C∶T ratio was calculated and divided into subgroups based on surgery type and age group. 【Results】 The study enrolled 2 903 patients. The perioperative rate of allogeneic RBC transfusion in TKA patients was 10.9% (95% CI 9.8%~12.0%) and overall C∶T ratio was 5.6∶1. The independent risk factors leading to perioperative allogeneic RBC transfusion included advanced age(OR=1.025, 95% CI 1.009~1.042, P<0.01), preoperative hemoglobin level(OR=0.966, 95% CI 0.954~0.978, P<0.001), preoperative anemia(OR=3.543, 95% CI 2.052~6.119, P<0.001), hematological diseases(OR=6.462, 95% CI 2.479~16.841, P<0.001), bilateral surgery(OR=7.681, 95% CI 5.759~10.245, P<0.01) and revision surgery(OR=9.584, 95% CI 4.360~21.065, P<0.001). 【Conclusion】 The risk factors for perioperative allogeneic RBC transfusion in TKA patients included advanced age, preoperative low hemoglobin level, preoperative anemia, hematological diseases, bilateral surgery and revision surgery. Only type and screen tests are recommended if patients receiving unilateral primary TKA surgery are less than 75 years old without anemia and hematological diseases, while at least one to four units of blood should be cross-matched if patients are with preoperative anemia and hematological diseases or will receive bilateral and revision arthroplasty.

Analysis of goal scoring patterns and match outcome during the Intercontinental Beach Soccer Cup Dubai 2019

Abstract Aim: To characterize the goal-scoring patterns and investigate the goal process on match outcome during the Intercontinental Beach Soccer Cup Dubai 2019. Methods: A set of 35 goal-scoring patterns were grouped into nine macro-categories: Match-period, Court-zone, Set-play, Open-play, Touching by players before the goal, Offensive method, Goalkeeper-line, Number of passes before the goal, and Ball trajectory. Match outcome in regular time was considered the matches resulting in a loss (n=16), draw (n=8), or win (n=16). The offensive sequences that resulted in the goal were analyzed in all 20 matches during the competition (n=138 goals). Results: The most goals were scored in Open-play (69%), during the 2nd and 3rd periods (36% for each), near to goal (Zone 4; 50%), preceded by 1-touch (67%) and 0-pass (29%), using positional attack (46%), without goalkeeper-line (68%), and with high-ball trajectory (51%). In addition, won matches presented a higher number of goals in Zone 4, 1-touch, Counterattack, 4v4 goal-successful, Receiving pass, Sand-touch, and High-ball compared to draw and loss matches (p<0.001−0.03; Effect Size [ES]=1.24−2.58, large). Conclusion: In summary, winning teams scored their goals mainly in open-play situations and without a goalkeeper-line, using counterattacks to achieve zones near the opponent's goals, and implementing a direct offensive style. In addition, goals scored were usually preceded by 1-touch, both through high-ball and sand-touch ball trajectory. Coaches and practitioners may consider these goal processes to train prescription and deep understanding of the process to goal in elite Beach soccer.

Frequência e eficácia dos arremessos por classe funcional e zonas de ataque na elite do basquetebol em cadeira de rodas / Throw frequency and effectiveness compared by functional classification and attack zones in elite wheelchair basketball / Frecuencia y efectividad de los lanzamientos por classe functional y zonas de ataque en la élite de baloncesto en silla de ruedas

Objetivo: O objetivo do estudo foi comparar as tentativas e eficácia dos arremessos entre as classes funcionais e zonas de ataque do basquetebol masculino em cadeira de rodas. Métodos: Os relatórios técnicos oficiais de todas as 42 partidas dos Jogos Paralímpicos Rio 2016 foram analisados e a quantidade de tentativas e eficácia por classe e quatro zonas de ataques foram anotadas. Para a comparação das distribuições de tentativas de arremessos por classes funcionais e zonas de ataque foi utilizado o teste qui-quadrado. Já o ANOVA one-way foi utilizado para verificar os efeitos principais das porcentagens do total de acertos e tentativas dos arremessos para cada zona da quadra e entre classes funcionais. Resultados e conclusão: Os principais resultados demonstraram que as classes mais elevadas (i.e., 3.0, 3.5, 4.0 e 4.5) representam 76% de todos os arremessos do jogo. Jogadores da classe 3.0 obtiveram significativamente maior frequência de arremessos nas zonas 1, 2 e 4 (áreas mais próximas da cesta). Enquanto os atletas da classe 4.0, apresentaram mais tentativas na zona 3 (área mais distante da cesta). Os jogadores das classes 3.5 e 4.0, comparados à classe 1.0, apresentaram maior eficácia na zona 1 (dentro do garrafão).

Objective: The aims of this study was to compare the frequency and effectiveness of throws by sport classes and attack zones of male wheelchair basketball. Methods: Official reports of all 42 matches from Rio 2016 Paralympics were analyzed. To compare the distributions of throws attempts by sport classes and attacking zones it was utilized the chi-square test. The ANOVA one-way was utilized to verify the main effects of the percentage of the total right throws and throwing attempts for each court zone and between sport classes. The frequency of throws and its effectiveness per class and four attack zones were noted. Results and conclusion: Our results showed that higher sport classes (i.e., 3.0, 3.5, 4.0 and 4.5) represent 76% of all throws performed during the matches. Players eligible by 3.0 sport class had significantly greater throws in zones 1, 2 and 4 (closest to the basket). Athletes of 4.0 class presented higher throw frequency in zone 3 (furthest from the basket). The players with 3.5 and 4.0 sport classes, compared to those with 1.0 class, showed greater effectiveness in zone 1 (in the painted area).

Objetivo: El objetivo del estudio fue comparar los intentos y la efectividad de los lanzamientos entre las clases funcionales y las zonas de ataque del baloncesto masculino en una silla de ruedas. Métodos: Se analizaron los informes técnicos oficiales de los 42 partidos de los Juegos Paralímpicos de Río 2016 y se anotó el número de intentos y efectividad por clase y cuatro zonas de ataque. Para comparar la distribución de los intentos de lanzamiento por clases funcionales y zonas de ataque, se utilizó la prueba de chi-cuadrado. El ANOVA de una vía se utilizó para verificar los efectos principales de los porcentajes del número total de golpes correctos e intentos de tiros para cada zona de la cancha y entre clases funcionales. Resultados y conclusión: Los resultados principales mostraron que las clases más altas (es decir, 3.0, 3.5, 4.0 y 4.5) representan 76% de todos los lanzamientos en el juego. Los jugadores de la clase 3.0 tuvieron lanzamientos significativamente más altos en las zonas 1, 2 y 4 (áreas más cercanas a la canasta). Mientras que los atletas de la clase 4.0, presentaron más intentos en la zona 3 (área más alejada de la canasta). Los jugadores de las clases 3.5 y 4.0, en comparación con la clase 1.0, mostraron una mayor efectividad en la zona 1 (dentro de la zona pintada).

Effect of waiting time before colonoscopy on bowel preparation quality in hospitalized elderly patients / 中国实用护理杂志

Objective:To explore the influencing factors of bowel preparation quality in hospitalized elderly patients, and to find the appropriate waiting time from the end of bowel preparation to the beginning of colonoscopy.Methods:Baseline and clinical data of elderly patients over 60 years old who underwent colonoscopy in the Tenth People′s Hospital, Tongji University from February 2021 to August 2021 were collected. Multivariate analysis was used to screen the factors that might affect the quality of bowel preparation in hospitalized elderly patients. Patients were grouped according to waiting time before colonoscopy. After eliminating confounding factors using propensity matching analysis, the difference of bowel preparation quality among groups was compared.Results:251 patients were included in the study. Multivariate analysis revealed that, hypertension ( OR=3.530, 95% CI 1.295-9.618), chronic constipation ( OR=3.302,95% CI 1.132-9.632), dietary compliance ( OR=0.161, 95% CI 0.070-0.371), medication and drinking water compliance ( OR=0.167, 95% CI 0.070-0.397), exercise compliance after medication ( OR=2.245, 95% CI 1.040-4.845), The frequency of defecation after medication ( OR=0.446, 95% CI 0.308-0.647) and waiting time ( OR=0.537, 95% CI 0.387-0.745) were important factors affecting the quality of bowel preparation in hospitalized elderly patients ( P<0.05). There were differences in bowel preparation quality between groups of waiting times. The overall quality of bowel preparation in 120-180 min group was significantly better than that in 241-300 min group, 301-360 min group and>360 min group ( P<0.05). The overall quality of bowel preparation in 181-240 min group was better than that in >360 min group ( P<0.05). There were no significant differences among other groups( P>0.05). The scores of cecum and ascending colon were the best in 120-180 min group, and the cleanliness of descending colon, sigmoid colon and rectum was significantly higher in 241-300 min group, 301-360 min group and > 360 min group. The scores of descending colon, sigmoid colon and rectum showed that the intestinal preparation quality of 181-240 min group was better than that of 301-360 min group and > 360 min group. Conclusions:The best examination time for elderly patients is about 180 minutes after bowelpreparation. Medical workers should flexibly guide the medication time to ensure that patients are in the best clean state of intestinal tract during examination.

Retrasplante pulmonar con cross-match positivo en trasplante pulmonar primario complicado con rechazo mediado por anticuerpos / Lung Retransplantation with Positive Crossmatch in Primary Lung Transplantation Complicated by Antibody-Mediated Rejection

La hipertensión arterial pulmonar (HAP) representa el 2,6% de los trasplantes pulmonares (TP), con una mediana de supervivencia condi cional (desde los 30 días del TP) de 9,8 años. Son frecuentes, el rechazo celular agudo (ACR) y la disfunción crónica del injerto (CLAD), mientras que es infrecuente el rechazo mediado por anticuerpos (AMR). El retrasplante pulmonar (RTP) constituye el 4% del TP mundial, debido a complicaciones en la vía aérea, disfunción primaria del injerto, ACR y CLAD. Mujer de 22 años, portadora de HAP idiopática (HAPI) desde el año 2013, trasplantada bipulmonar (TBP) en enero de 2018. A los 16 meses presentó neumonía adquirida en la comuni dad. En una internación posterior, presentó ACR y a pesar de pulsos de metilprednisolona, progresó a requerimientos de cánula de alto flujo y ventilación mecánica no invasiva hospitalaria, caída del VEF1, y tomografía de tórax con vidrio esmerilado difuso y engrosamiento irregular reticular del intersticio subpleural; interpretándose como CLAD a predominio de síndrome de bronquiolitis obliterante (BOS), con presencia de anticuerpos específicos contra el donante (DSA). En enero de 2020 se realizó nuevo TP y ante cross-match positivo, se realizó plasmaféresis y reposición de IgG. Al mes del egreso, no se observaron signos de rechazo en control de biopsias transbronquiales. Entre 2 y 10% de los pacientes con indicación primaria de TP por HAPI son sometidos a retrasplante pulmonar (RTP). La presencia de DSA y el miss-match de HLA, no son contraindicaciones para el RTP.

Pulmonary arterial hypertension (PAH) represents 2.6% of lung transplantations (LT), with a conditional median survival (from 30 days after LT) of 9.8 years. Acute cellular rejection (ACR) and chronic lung allograft dysfunction (CLAD) are common; whereas the antibody-mediated rejection (AMR) is not. Lung retransplantation (LR) accounts for 4% of global LTs for complications in the airways, primary allograft dys function, ACR and CLAD. 22-year-old woman with idiopathic PAH (IPAH) since 2013, who underwent a double-lung transplantation (DLT) in January 2018. 16 months after transplantation she presented community-acquired pneumonia. During a subsequent hospitalization, she presented ACR. Despite the fact that she received pulse methylprednisolone, she required high-flow cannula therapy and hospital non-invasive mechanical ventilation; the FEV1 was reduced and she underwent a chest tomography with diffuse ground glass opacities and irregular reticular thickening of the subpleural interstitium; interpreting the predominance of BOS (bronchiolitis obliterans syndrome) as CLAD, with presence of donor-specific antibodies (DSA). In January 2020, she received a new DLT and due to a positive crossmatch, she was treated with plasmapheresis and IgG replacement. One month after hospital discharge, no signs of rejection were observed at the BTB (bone-patellar tendon-bone) control. Between 2 to 10% of patients with primary indication of LT for IPAH are subjected to lung retransplantation (LR). The presence of DSA and HLA (human leucocyte antigen) mismatch aren't contraindications to LR.

Estratégias ofensivas e defensivas eficazes no Goalball / Effective offensives and defensives strategies in Goalball / Estrategias ofensivas y defensivas efectivas en Goalball

O objetivo deste estudo foi caracterizar e descrever as variáveis ofensivas e defensivas mais frequentes e eficazes na elite masculina do goalball e, compará-las entre times vencedores e perdedores e, equipes de nível superior e inferior. Através do método de observação sistemática e com amostra composta por 25 partidas do torneio masculino de goalball dos Jogos Paralímpicos Rio 2016, sendo registrados 4635 arremessos e 4520 defesas. Os principais achados foram que, para o ataque, existe uma maior probabilidade de marcar gol após as interrupções do jogo e para a defesa, fazer o balanço defensivo é melhor do que não o realizar, já que a probabilidade de sofrer gol é maior quando ele não ocorre. Além disso, utilizar o tronco como segmento corporal para realizar as defesas também é mais indicado, pois a probabilidade de sofrer gol é maior quando as defesas são realizadas pelas pernas ou braços.

The aim of this study was to characterize and describe the most frequent and effective offensive and defensive variables in the male goalball elite and compare them between winning and losing teams and higher and lower-level teams. Through the method of systematic observation and with a sample consisting of 25 matches of the men's goalball tournament at the Rio 2016 Paralympic Games, 4635 pitches and 4520 saves were recorded. The main findings were that, for the attack, there is a higher probability of scoring after the game's interruptions and for the defense, making the defensive balance is better than not doing it, as the probability of conceding a goal is higher when it does not occur. In addition, using the trunk as a body segment to make defenses is also more effective, as the probability of suffering a goal is higher when the defenses are performed by the legs or arms.

El objetivo de este estudio fue caracterizar y describir las variables ofensivas y defensivas más frecuentes y efectivas en la élite del goalball masculino y compararlas entre equipos ganadores y perdedores, y equipos de mayor y menor nivel. Mediante el método de observación sistemática y con una muestra compuesta por 25 partidos del torneo de goalball masculino de los Juegos Paralímpicos Río 2016, se registraron 4635 lanzamientos y 4520 paradas. Los principales hallazgos fueron que, para el ataque, hay una mayor probabilidad de marcar tras las interrupciones del juego y para la defensa, hacer que el equilibrio defensivo sea mejor que no hacerlo, ya que la probabilidad de encajar un gol es mayor cuando no se ocurrir. Además, utilizar el tronco como segmento corporal para realizar defensas también es más adecuado, ya que la probabilidad de sufrir un gol es mayor cuando las defensas las realizan las piernas o los brazos.

Blood transfusion efficacy in patients with major and minor cross-match incompatibility: analysis of 17 cases / 中国输血杂志

【Objective】 To compare the transfusion effects of ABO homotype leukocyte depleted suspended RBC and washed RBC in patients, who present major and minor cross-match incompatibility, DAT+, IAT+ and autoantibody+ . 【Methods】 The hemoglobin and total bilirubin of patients before and after transfusion were detected, and statistical analysis was conducted by IBM SPSS Statistics 22.0 software. 【Results】 34 transfusions were performed in 17 patients with major and minor cross-match incompatibility. Both leukocyte depleted suspended RBC and washed RBC significantly increased Hb level(P0.05), with similar transfusion efficacy(P>0.05). After t, Hb levels(g/L) increased by 11.35±8.07 and 13.94±9.017, and TBIL(μmol/L) decreased by 25.76±88.63 and 6.91±9.39, respectively, after the transfusion of leukocyte depleted suspended RBC and washed RBC per unit. 【Conclusion】 For blood recipients with major and minor cross-match incompatibility, both ABO homotype leukocyte depleted suspended RBC and washed RBC, given in time, were effective. However, washed RBC is secondary choice due to long preparation time and short storage time.

Analysis of the impact of maternal and child health care institution accreditation on the service improvement of secondary maternal and child health hospital in China / 中华医院管理杂志

Objective:To analyze the status of secondary maternal and child health hospital accreditation in China and the impact of such accreditation on their service improvement.Methods:The paper used the propensity score matching method to match the accreditation group and the non-accreditation group in 1∶1 ratio, and compared the related indicators of service capability of maternal and child health hospitals between the two groups by non-parametric test and Chi-square test.Results:A total of 842 maternal and child health care hospitals were matched. A comparison was made between the accreditation group and the non-accreditation group, and the differences of the following indicators of individual services within the hospital were statistically significant( P<0.01). These indicators were annual emergency attendance, the number of types of health services for women and children, the utilization rate of beds, the average daily hospital bed of each practicing physician; the following indicators of service management within their coverage were statistically significant: namely the proportion of institutions carrying out health education evaluation within their coverage, that of institutions producing uniform " Mother and Child Health Handbook", that of institutions carrying out information quality control, as well as analysis and utilization.These indicators of the accreditation group were higher than those in the non-accreditation group( P<0.01). Conclusions:Given the role played by maternal and child health institution accreditation in promoting secondary maternal and child health hospital regarding better service content, quantity, efficiency and the quality of business management within their coverage, there is still room for improvement.

Research progress concerning match between femoral anterior arch and intramedullary nail / 中华创伤骨科杂志

The femoral anterior arch is an important factor that must be considered when intramedullary nailing is used to treat a femoral intertrochanteric fracture, as its curvature decides the radius, length and diameter of the curvature of a proximal femoral intramedullary nail and selection of a proper entry point for the nail as well. Mismatch between an intramedullary nail and the femoral anterior arch can lead to poor stability, postoperative pain in the anterior thigh, irritation of the anterior femoral cortex and even a perforation fracture. In order to ensure fine curative effects for femoral intertrochanteric fractures, it is necessary to have a full understanding of the femoral anterior arch. The curvature of the femoral anterior arch can be expressed by the radius of curvature (ROC) or the angle of femoral anterior arch, with the former more widely used. This article mainly discusses the issues concerning ROC and the match between femoral anterior arch and intramedullary nail so as to clarify how an intramedullary nail can be stable enough to reduce postoperative complications.

Analysis of risk factors of nosocomial death in patients with cardiogenic shock / 中华急诊医学杂志

Objective:To investigate the risk factors of death in patients with cardiogenic shock (CS) in the Intensive Care Unit (ICU).Methods:This retrospective cohort study was conducted to collect the clinical data on critically ill patients from a number of hospitals in the United States released by the eICU Collaborative Research Database v2.0 (eICU-CRD v2.0) as of May 2018. The patients diagnosed with CS were selected and categorized into the survival and death groups according to the death in the hospital. The age, sex, and body mass index (BMI) of the enrolled patients were recorded, along with the acute physiology and chronic health evaluation Ⅳ (APACHE Ⅳ) score, simplified acute physiology score Ⅱ (SAPS Ⅱ), ethnicity, ICU type, clinical complications, diagnosis at admission, hemodynamic parameters, important treatments, and clinical outcomes. A propensity score was used to match age, BMI, and APACHE Ⅳ score, and SAPS Ⅱ. Multivariate Logistic regression analysis was performed to analyze the risk factors influencing ICU and hospital mortality, and the receiver operator characteristic (ROC) curve was used to evaluate its clinical utility.Results:In total, 33 998 in-hospital patients were included, among whom 27 596 patients survived and 6 402 died (18.83%), and 6 301 pairs were matched in preference. After matching, there were statistically significant differences between the two groups in the incidence of acute renal failure (29.33% vs. 31.82%), duration of mechanical ventilation [(6.05 ± 5.77) d vs (4.97 ± 5.11) d], length of ICU stay [(101.35 ± 154.59) h vs (110.15 ± 175.58) h] and length of hospital stay[ (12.73 ± 10.53) d vs (9.53 ± 10.35) d, P<0.01]. Multivariable logistic regression analysis revealed that age, BMI, APACHE Ⅳ score, SAPS Ⅱ, partial complications (except pacemaker implantation), diagnosis at admission (cardiac arrest, acute myocardial infarction, heart failure, respiratory system diseases, and digestive tract bleeding), and some treatments (noninvasive mechanical ventilation, blood purification, coronary artery bypass graft surgery, and vascular active drug application) were risk factors for hospital mortality in patients with CS ( P<0.05). Implantation of a ventricular assist device (VAD) was a protective measure against in-hospital death in patients with CS [hazard ratio ( HR)=0.49; 95% confidence interval (95% CI): 0.24-0.98; P=0.045). Multivariate ROC curve analysis revealed that the model could better predict ICU mortality [the area under the curve (AUC) =0.80 (95% CI: 0.784-0.816)] and hospital mortality [AUC=0.779 (95% CI, 0.765-0.793)] ( P <0.01). Conclusions:For patients with CS in ICU, age, BMI, APACHE Ⅳ score, SAPS Ⅱ, partial complications, diagnosis at admission (cardiac arrest, acute myocardial infarction, heart failure, respiratory system diseases and digestive tract bleeding), and some treatments (noninvasive mechanical ventilation, blood purification, CABG surgery, vascular active drug application) are independent risk factors for death. Implantation of a VAD can reduce the hospital mortality rate of patients with CS. The ROC curve of the related factors revealed that the model can better predict the clinical outcomes.

Efficacy and manner of execution of the serve in top-level womens beach volleyball players / Eficácia e maneira de execução do serviço em jogadoras de voleibol de praia de alto nível

ABSTRACT The study of the manner of execution (technique, and spatial aspects) can provide useful information to understand the game dynamics in beach volleyball and to obtain references values for the analysis of the game and the establishment of training goals. The aim of the study was to determine the influence of the manner of execution on serve and rally performance in elite women's beach volleyball players. A total of 3,009 serves from 44 women's players were analyzed. The variables studied were: serve technique, serve zone, serve destination, serve performance, and rally performance. An observational punctual, nomothetic, multidimensional, and intragroup design was used. A descriptive and inferential analysis of the data (Chi-Square Test) was done using SPSS v.21.0 software. The level of significance was set at p < .05. The manner of execution influences the serve performance. The jump float serve was the most used. The most effective destination was the zone between players, probability due to the players' displacement and interference between them. An absence of association between serve technique and rally performance was found. These findings showed possible connections between the way of executing the serve with the following actions done by the players and the players' strategies to control their physical load. These values may be useful to guide to players training, or to evaluate players in competition.

RESUMO O estudo da forma de execução (técnica e aspectos espaciais) pode fornecer informações úteis para compreender a dinâmica do jogo no vôlei de praia e obter valores de referência para a análise do jogo e o estabelecimento de metas de treinamento. O objetivo do estudo foi determinar a influência da forma de execução no desempenho de saque e rali em jogadores de vôlei de praia de alto nível. Um total de 3.009 saques de 44 jogadoras de alto nível foram analisados. As variáveis ​​estudadas foram: técnica de saque, zona de saque, destino do saque, desempenho de saque e desempenho de rali. Um desenho observacional pontual, nomotético, multidimensional e intragrupo foi utilizado. Foi realizada uma análise descritiva e inferencial dos dados (Teste Qui-Quadrado) utilizando o software SPSS v.21.0. O nível de significância foi estabelecido em p <0,05. A maneira de execução influencia o desempenho do saque. O saque flutuante de salto foi o mais usado. O destino mais efetivo foi a zona entre jogadoras, provavelmente devido ao deslocamento das jogadoras e a interferência entre elas. Não foi encontrada associação entre a técnica de saque e o desempenho de rally. Esses achados mostraram possíveis associações entre a maneira de executar o saque com as ações seguintes realizadas pelas jogadoras e as estratégias das jogadoras para controlar sua carga física. Esses valores podem ser úteis para orientar o treinamento de jogadoras ou avaliar jogadoras em competição de vôlei de praia.

Strength and power training improve skill performance in volleyball players

Abstract Aim: This study aimed to test the influence of functional improvements in volleyball skills performance. Methods: Twenty-eight amateur female volleyball players were assigned to Skill (S: n = 14, 19.5 ± 4.6 yrs; 169.7 ± 7.2 cm; 62.9 ± 12.7 kg) or Skill and Strength/Power (S+SP: n = 14; 18.6 ± 3.5 yrs; 169.7 ± 5.1 cm; 63.3 ± 9.2 kg). S+SP performed eight weeks of volleyball and conditioning training. S maintained only volleyball training. Functional variables (i.e. strength, power, and agility measures) and volleyball skills performance in a game-situation context were assessed before and after training. Results: 1-RM squat and bench press, time at modified agility T-test, peak power at bench throw and medicine-ball throw distance improved for the S+SP (p<0,05). S group increased only in medicine-ball throw distance (p<0.05). There were no differences between groups in the functional variables tested (p>0.05). The probabilities of a perfect set and an attack 'kill' in S+SP improved (¶>0.90). Changes from pre to post-training were higher in S+SP than in S for a perfect set, 'stuff block' and defense with displacement (¶>0.90). Conclusion: Our data suggest that functional improvements may positively affect volleyball skills performance. Although functional variables revealed only within-group changes, S+SP produced greater improvements in skill performance than S, supporting the use of conditioning training to improve volleyball performance.

Interferon-α2b spray inhalation did not shorten virus shedding time of SARS-CoV-2 in hospitalized patients: a preliminary matched case-control study / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

BACKGROUND@#Currently, there are no drugs that have been proven to be effective against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Because of its broad antiviral activity, interferon (IFN) should be evaluated as a potential therapeutic agent for treatment of coronavirus disease 2019 (COVID-19), especially while COVID-19-specific therapies are still under development.@*METHODS@#Confirmed COVID-19 patients hospitalized in the First Affiliated Hospital, School of Medicine, Zhejiang University in Hangzhou, China, from January 19 to February 19, 2020 were enrolled in a retrospective study. The patients were separated into an IFN group and a control group according to whether they received initial IFN-α2b inhalation treatment after admission. Propensity-score matching was used to balance the confounding factors.@*RESULTS@#A total of 104 confirmed COVID-19 patients, 68 in the IFN group and 36 in the control group, were enrolled. Less hypertension (27.9% vs. 55.6%, P=0.006), dyspnea (8.8% vs. 25.0%, P=0.025), or diarrhea (4.4% vs. 19.4%, P=0.030) was observed in the IFN group. Lower levels of albumin and C-reactive protein and higher level of sodium were observed in the IFN group. Glucocorticoid dosage was lower in the IFN group (median, 40 vs. 80 mg/d, P=0.025). Compared to the control group, fewer patients in the IFN group were ventilated (13.2% vs. 33.3%, P=0.015) and admitted to intensive care unit (ICU) (16.2% vs. 44.4%, P=0.002). There were also fewer critical patients in the IFN group (7.4% vs. 25.0%, P=0.017) upon admission. Although complications during admission process were comparable between groups, the discharge rate (85.3% vs. 66.7%, P=0.027) was higher and the hospitalization time (16 vs. 21 d, P=0.015) was shorter in the IFN group. When other confounding factors were not considered, virus shedding time (10 vs. 13 d, P=0.014) was also shorter in the IFN group. However, when the influence of other factors was eliminated using propensity score matching, virus shedding time was not significantly shorter than that of the control group (12 vs. 15 d, P=0.206).@*CONCLUSIONS@#IFN-α2b spray inhalation did not shorten virus shedding time of SARS-CoV-2 in hospitalized patients.

Generating DNA profile from low copy number DNA: Strategies and associated risks

Many shreds of evidence found on the crime scenes contain a trace amount of DNA which results in insignificant profiling results for subsequent comparison. This can nullify the potential evidence material and hamper investigation process. Over the years, different strategies have been employed by various DNA testing laboratories to create interpretable DNA profiles generated from low template of DNA. This review highlights different strategies used by forensic laboratories worldwide for creating complete DNA profiles from low copy number template for comparison purposes along with its associated risks for forensic purposes.

Interferon-α2b spray inhalation did not shorten virus shedding time of SARS-CoV-2 in hospitalized patients: a preliminary matched case-control study / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Background: Currently, there are no drugs that have been proven to be effective against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Because of its broad antiviral activity, interferon (IFN) should be evaluated as a potential therapeutic agent for treatment of coronavirus disease 2019 (COVID-19), especially while COVID-19-specific therapies are still under development. Methods: Confirmed COVID-19 patients hospitalized in the First Affiliated Hospital, School of Medicine, Zhejiang University in Hangzhou, China, from January 19 to February 19, 2020 were enrolled in a retrospective study. The patients were separated into an IFN group and a control group according to whether they received initial IFN-α2b inhalation treatment after admission. Propensity-score matching was used to balance the confounding factors. Results: A total of 104 confirmed COVID-19 patients, 68 in the IFN group and 36 in the control group, were enrolled. Less hypertension (27.9% vs. 55.6%, P=0.006), dyspnea (8.8% vs. 25.0%, P=0.025), or diarrhea (4.4% vs. 19.4%, P=0.030) was observed in the IFN group. Lower levels of albumin and C-reactive protein and higher level of sodium were observed in the IFN group. Glucocorticoid dosage was lower in the IFN group (median, 40 vs. 80 mg/d, P=0.025). Compared to the control group, fewer patients in the IFN group were ventilated (13.2% vs. 33.3%, P=0.015) and admitted to intensive care unit (ICU) (16.2% vs. 44.4%, P=0.002). There were also fewer critical patients in the IFN group (7.4% vs. 25.0%, P=0.017) upon admission. Although complications during admission process were comparable between groups, the discharge rate (85.3% vs. 66.7%, P=0.027) was higher and the hospitalization time (16 vs. 21 d, P=0.015) was shorter in the IFN group. When other confounding factors were not considered, virus shedding time (10 vs. 13 d, P=0.014) was also shorter in the IFN group. However, when the influence of other factors was eliminated using propensity score matching, virus shedding time was not significantly shorter than that of the control group (12 vs. 15 d, P=0.206). Conclusions: IFN-α2b spray inhalation did not shorten virus shedding time of SARS-CoV-2 in hospitalized patients.

Estudio preliminar sobre patrones fonológicos según la fonología no lineal de niños chilenos de entre 3. 0 y 3. 11 años con Desarrollo Fonológico prolongado (DFP) / A preliminary study about phonological patterns according to the non-linear phonology of chilean children between 3. 0 and 3. 11 years with Protracted Phonological Development (PPD)

El Desarrollo Fonológico Prolongado (DFP) presenta patrones de simplificación que persisten más allá de la edad esperada, disminuyendo la inteligibilidad en los niños (Dubasik & Ingram, 2013). En el presente trabajo se describen los patrones fonológicos, según la Fonología No Lineal, en niños chilenos de entre 3.0 y 3.11 años con DFP. Este objetivo surgió de la necesidad de conocer los patrones suprasegmentales y segmentales de niños chilenos con DFP, puesto que no se ha realizado un estudio basado en la Teoría No Lineal en la población chilena. La muestra estuvo conformada por cinco niños pertenecientes a jardines infantiles de la Región de Valparaíso, Chile. A estos niños se les aplicó la Lista de Palabras del Español, obteniendo un corpus de 500 palabras. Este fue analizado a través de las medidas suprasegmentales Whole Word Match (WWM) o coincidencia de la palabra completa, Word Shape Match (WSM) o coincidencia de la estructura de la palabra, patrones acentuales; y medidas segmentales, en Porcentaje de Consonantes Correctas (PCC). Como resultado se obtuvo que los niños con DFP presentan puntajes altos en patrones acentuales (99.2%), pero muestran una alteración en las medidas de WWM, con un 52.2% de aciertos; WSM, con un 73.4%, y PCC, con un 89.2%. En consecuencia, se evidenció alteración suprasegmental y segmental en niños con DFP, pues los valores obtenidos no coinciden con el Desarrollo Típico (DT) observados en otras investigaciones.

Protracted Phonological Development (PPD) features phonological patterns that persist beyond expected during development, decreasing intelligibility (Dubasik & Ingram, 2013). This study aims at describing the phonological patterns in Chilean children (3.0 to 3.11 years of age) with PPD, within the Nonlinear Phonology background. This objective sprung from the need to study the suprasegmental and segmental patterns of Chilean children with PPD, given that no research has been conducted based on the Nonlinear Theory among Chilean children. The sample consisted of 5 Chileanchildren. They had all been diagnosed with PPD and attended kindergartens in Valparaíso, Chile. These children were administered the Spanish Word List, which allowed to obtain a corpus of 500 words. The corpus was later analyzed by means of the suprasegmental measures: i.e.: Whole Word Match (WWM), Word Shape Match (WSM) and segmental measures, expressed in Percentage of Correct Consonants (PCC). Results showed that these children with PPD performed high on accent patterns (99.2%), but at deficit levels on the WWM measures (with 52.2% of correct answers), on the WSM measures (with 73.4%), and on PCC measures (with 89.2%). Consequently, this research provides empirical evidence regarding suprasegmental and segmental alterations in children with PPD, since the values herein obtained are not aligned with the Typical Development (TD) observed in other studies.

Elective versus emergency caesarean section: differences in maternal outcome

Background: Caesarean section is a life-saving surgical procedure when certain complications arise during pregnancy or labour. The use of CS worldwide has increased worldwide unprecedented levels although the gap between higher- and lower-resource settings remains. The present study evaluates the difference in maternal outcome in elective versus emergency caesarean sections in our institute.Methods: The study included first 65 cases of emergency caesarean section (group A) and during the study period, first 65 elective caesarean section (group B) if they fulfilled the inclusion criteria. Various intra operative and postoperative events were recorded which included intra operative complications, postpartum haemorrhage and transfusion indices.Results: The most common indication of caesarean section in group A was fetal distress (27.7%). In group B most caesarean sections were classified under 5 followed by class 6, the most common indication being previous caesarean section (27.6%). It was observed that pre-operative mean haemoglobin in group A was 10.6 g/dl and in group B was 11.2g/dl. A drop of 1.36 g/dl in group A and 1.10 g/dl in group B was observed in the post-op period. Cross match / transfusion ratio 1.5 in group A and  2 in group B, transfusion probability ratio was 60 % in group A and  66.7%  in group B and transfusion index was 1 in group A and  group B. There was significantly higher contraception acceptance in group B compared to group A.Conclusions: Elective caesarean section has more favourable maternal outcome as compared to emergency caesarean section as the former is done under controlled and planned circumstances.  However, there should be stringent audit to scrutinise indication of caesarean section, outcome of caesarean and blood transfusion practices.

Princípios da análise do comportamento aplicados à análise de jogo / Principles of behavior analysis applied to match analysis / Principios del análisis de comportamiento aplicados al análisis de juego

O recurso da análise de jogo é frequentemente usado por técnicos, atletas e cientistas do esporte no contexto esportivo, mas esse recurso não inclui a análise funcional dos comportamentos dos jogadores, uma ferramenta comum aos analistas do comportamento. O presente estudo visou: (a) apresentar uma síntese de alguns princípios da Análise do Comportamento e caracterizar a análise funcional descritiva do comportamento, (b) caracterizar análise de jogo, (c) fazer uma análise funcional do fundamento pênalti, com base nos princípios da Análise do Comportamento e (d) descrever as possíveis contribuições da associação da análise funcional e da análise de jogo. Para isso, após a apresentação dos princípios básicos da Análise do Comportamento aplicados à análise do pênalti, realizou-se uma análise funcional descritiva da cobrança de pênalti, sob a óptica do goleiro e do cobrador da penalidade. Realizar uma análise funcional do fundamento pênalti permitiu especificar as variáveis que determinam jogadas que têm sucesso e insucesso. A partir disso, sugere-se que os dados produzidos pela análise funcional dos comportamentos podem complementar os produzidos pela análise de jogo para possibilitar o planejamento e a avaliação de intervenções aperfeiçoando o treinamento esportivo.

Match analysis in the sporting context has been used by coaches, athletes, and sports scientists, but it doesn't include the functional analysis of players' behaviors, a common tool to behavior analysts. The present study aims to: (a) present a synthesis of some principles of Behavior Analysis and characterize descriptive functional analysis of behavior, (b) characterize match analysis, (c) perform a functional analysis of the penalty, based on the principles of Behavior Analysis and (d) describe the contributions of the association of functional analysis and match analysis. For this, after the presentation of the principles of Behavior Analysis applied to the penalty, a descriptive functional analysis of the penalty kick was performed, from the point of view of the goalkeeper and the penalty taker. A descriptive functional analysis allows to evaluate the variables that determine successful and unsuccessful moves. From this, it is suggested that data produced by the functional analysis can complement those produced by the match analysis to enable the planning and evaluation of interventions improving the sports training.

El recurso de análisis de juego a menudo es utilizado por entrenadores, atletas y científicos del deporte en el contexto deportivo, pero este recurso no incluye el análisis funcional del comportamiento de los jugadores, una herramienta común a los analistas de comportamiento. El objetivo de este estudio fue: (a) presentar una síntesis de algunos principios del Análisis de Comportamiento y caracterizar el análisis funcional descriptivo de comportamiento, (b) caracterizar el análisis de juego, (c) realizar un análisis funcional del penal, basado en los principios del Análisis de Comportamiento y (d) describir las aportaciones de la asociación del análisis funcional y del análisis de juego. Por lo tanto, después de la presentación de los principios básicos del Análisis de Comportamiento aplicado al análisis de los penales, se realizó un análisis descriptivo funcional del penal, desde la perspectiva del portero y del penalizador. Realizar un análisis funcional del fundamento penal nos permitió especificar las variables que determinan jugadas exitosas y no exitosas. A partir de esto, se sugiere que los datos producidos por el análisis funcional de los comportamientos pueden complementar los producidos por el análisis de juego para permitir la planificación y evaluación de intervenciones que mejoren la capacitación deportiva.