Effects of trunk training using motor imagery on trunk control ability and balance function in patients with stroke.

OBJECTIVE: To explore the effects of trunk training using motor imagery on trunk control and balance function in patients with stroke. METHODS: One hundred eligible stroke patients were randomly divided into a control group and trial group. The control group was given routine rehabilitation therapy, while the trial group was given routine rehabilitation therapy and trunk training using motor imagery. RESULTS: Prior to treatment, there was no significant difference between the two groups (P > 0.05) in Sheikh's trunk control ability, Berg rating scale (BBS), Fugl-Meyer assessment (FMA), movement length, movement area, average front-rear movement speed, average left-right movement speed, and surface electromyography (sEMG) signal of the bilateral erector spinae and rectus abdominis. After treatment, Sheikh's trunk control ability, FMA, and BBS in the two groups were significantly higher than those before treatment (P < 0.05). The movement length, movement area, the average front-rear movement speed, and the average left-right movement speed in the two groups decreased significantly (P < 0.05). The differences of these indicators between the two groups were statistically significant (P < 0.05). After treatment, the rectus abdominis and erector spinae on the affected side of the two groups improved when compared with those before treatment (P < 0.05). The rectus abdominis and erector spinae on the healthy side of the trial group descended after treatment (P < 0.05), while little changes were observed on the healthy side of the control group after treatment (P > 0.05). The rectus abdominis and erector spinae on the affected side of the trial group improved when compared with those in the control group (P < 0.05). There was no significant difference between the two groups in the decline of abdominalis rectus and erector spinal muscle on the healthy side. CONCLUSION: Trunk training using motor imagery can significantly improve the trunk control ability and balance function of stroke patients and is conducive to promoting the recovery of motor function.

Revitalizing quality of life: a case report on the beneficial impact of comprehensive rehabilitation therapy in treating upper-limb lymphedema following breast cancer surgery.

Objective: To underscore the paramount significance of incorporating comprehensive rehabilitation therapy as a crucial aspect of managing lymphedema caused by breast cancer surgery, and to illuminate our first-hand experience and insights gained in utilizing this approach. Methods: We present a case report of a breast cancer survivor who had been suffering from persistent left upper-limb edema for over 15 years, who was effectively treated with a combination of conventional rehabilitation (seven-step decongestion therapy) and a comprehensive rehabilitation program (seven-step decongestion therapy, along with core and respiratory function training, as well as functional brace wearing). The efficacy of the rehabilitation therapy was evaluated through a comprehensive assessment. Results: Although the patient underwent the conventional rehabilitation program for one month, only limited improvement was observed. However, after an additional month of comprehensive rehabilitation treatment, the patient exhibited significant improvement in both lymphedema and the overall function of the left upper limb. The patient's progress was quantified by measuring the reduction in arm circumference, which demonstrated a notable decrease. Furthermore, improvements in joint range of motion were observed, with forward flexion of the shoulder enhancing by 10°, forward flexion improving by 15°, and elbow flexion increasing by 10°. In addition, manual muscular strength tests revealed an increase in strength from Grade 4 to Grade 5. The patient's quality of life was also significantly improved, as evidenced by the increase in the Activities of Daily Living score from 95 to 100 points, the increase in the the Functional Assessment of Cancer Therapy: Breast score from 53 to 79 points, and the decrease in the Kessler Psychological Distress Scale score from 24 to 17 points. Conclusion: While seven-step decongestion therapy has been shown to be effective in reducing upper-limb lymphedema caused by breast cancer surgery, it has limitations in treating more chronic cases of the condition. However, when combined with core and respiratory function training and functional brace wearing, seven-step decongestion therapy has been shown to be even more effective in reducing lymphedema and improving limb function, ultimately leading to significant improvements in quality of life.

State and Topology Estimation for Unobservable Distribution Systems using Deep Neural Networks.

Time-synchronized state estimation for reconfigurable distribution networks is challenging because of limited real-time observability. This paper addresses this challenge by formulating a deep learning (DL)-based approach for topology identification (TI) and unbalanced three-phase distribution system state estimation (DSSE). Two deep neural networks (DNNs) are trained for time-synchronized DNN-based TI and DSSE, respectively, for systems that are incompletely observed by synchrophasor measurement devices (SMDs) in real-time. A data-driven approach for judicious SMD placement to facilitate reliable TI and DSSE is also provided. Robustness of the proposed methodology is demonstrated by considering non-Gaussian noise in the SMD measurements. A comparison of the DNN-based DSSE with more conventional approaches indicates that the DL-based approach gives better accuracy with smaller number of SMDs.

Targeted Enrollment of Medical Students for Rural China: Prospects and Challenges.

PURPOSE: Most countries are faced with the challenge of inadequate human resources for health in rural and remote areas. In China, approximately 41% of the total population reside in rural areas where there is a severe shortage of qualified practicing physicians. The Chinese government adopted a plan to strengthen the primary healthcare workforce by increasing enrollment of students from rural areas and providing free medical education. The purpose of this study is to examine the design and implementation of this plan in China, including its construct, outcomes, and challenges. METHODS: Three databases and Baidu were searched to find literature relating to targeted enrollment of medical students for rural China. Official government documents were also reviewed. RESULTS: Targeted enrollment of medical students from rural areas was implemented in 2010 throughout China. For example, under financial support from the Ministry of Finance, over 5000 5-year medical students per year were admitted from central and western China. Most graduates went to rural primary care settings to provide health services in accordance with their signed commitments to provide service as intended by the government. These medical school initiatives are faced with a number of challenges, including unfilled enrollment vacancies, low motivation to study among these students along with a reluctance to serve a rural population, and unguaranteed job opportunities. CONCLUSION: Targeted enrollment of medical students and free medical education in exchange for obligatory services contribute to improve the allocation of physicians in rural China. However, there are opportunities to improve the design and implementation of these programs. This review of the approach taken in China may be informative to other countries in their efforts to address the shortage of health professionals in rural and remote areas.

Facile synthesis of substituted diaryl sulfones via a [3 + 3] benzannulation strategy.

A base-mediated [3 + 3] benzannulation strategy for the conversion of 1,3-bis(sulfonyl)propenes and ß,γ-unsaturated α-ketoesters to diaryl sulfones has been developed. This method provides facile, metal-free and efficient access to highly substituted diaryl sulfones in good to excellent yields. In addition, the sulfonyl group could be easily removed or converted to other functional groups via an organostannane intermediate.

Annulation of ß-naphthols and 4-hydroxycoumarins with vinylsulfonium salts: synthesis of dihydrofuran derivatives.

A new synthetic approach to dihydrofuran derivatives via the annulation reaction of ß-naphthols and 4-hydroxycoumarins with vinylsulfonium salts has been developed. A variety of dihydrofuran derivatives were prepared in moderate to good yields under mild conditions. The products could be readily transformed to the corresponding furans via the dehydrogenation with DDQ.

Metal-Ion Induced In Situ Ligand Oxidation for Self-Assembled Clusters: from Bis(5-(2-pyridine-2-yl)-1,2,4-triazole-3-yl)methane to Alcohol or Ketone.

Hydrothermal reactions of metal nitrates and ligand bis(5-(pyridine-2-yl)-1,2,4-triazol-3-yl)methane (H2 L1 ) gave three cluster compounds, {Cr2 }, {Zn12 } and {Fe8 }. Notably, methylene group of H2 L1 was in situ oxidized either to hydroxymethylated (L2 -O)3- in the metallo-ring {Zn12 } or to a rigid carbonylated (L3 =O)2- in the screw-type {Fe8 }. In light of comparative experimental results, NO3- was deduced to be of a catalytic role in the ligand oxidation. Metal ion could be regarded as an "induced" tool for clusters generation in self-assembly process.

Direct inter- and intramolecular addition of amides to arylalkenes promoted by KOt-Bu/DMF.

Direct addition of tetrahydroisoquinoline derived amides to arylalkenes has been achieved in the presence of KOt-Bu/DMF. Both intermolecular and intramolecular reactions could occur in good yields. α-Amido alkyl radicals are proposed to be generated under the reaction conditions. The reaction is efficient for the synthesis of seven-membered nitrogen heterocycles. A homoprotoberberine was prepared conveniently via this method.