RESUMEN
Purpose: To evaluate the utility of supine roll test (SRT) and alternative positional tests, such as head-shaking test (HST), seated supine positioning test (SSPT), bow and lean test (BLT), and rapid axial roll test (RART) in determining the affected semicircular canal of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV). Methods: In an observational cohort study, 553 patients diagnosed with HSC-BPPV were divided into five groups in terms of different positional tests received: SRT group (n = 110), HST+ SRT (n = 112), BLT + SRT (n = 114), SSPT+SRT (n = 108) and RART+SRT (n = 109). The same method was used for the last four groups: The patients were first subjected to different alternative positional tests and then to SRT, and the nystagmus was observed separately to determine the affected side. The primary outcomes compared included the accuracy and sensitivity of these tests in the determination of the affected semicircular canal in HSC-BPPV. Results: Patients with nystagmus elicited by positional tests accounted for 84.99% (470/553). The elicitation rate of nystagmus of SRT was lowest, being 77.27% (85/110). The elicitation rate of nystagmus were higher in the test groups than in the control group, and RART+SRT group yielded the highest elicitation rate of nystagmus (95.41%, 104/109). Among the alternative positional tests, RART attained the highest elicitation rate of nystagmus (101/109, 92.66%). Comparison between alternative positional tests and SRT, RART and SRT showed obviously better agreement in determining the affected semicircular canal (85.45%, 96/109) and eliciting nystagmus (95.41%, Kappa = 0.642), but no difference was found in curative effect when the affected side was accurately determined (χ2 = 1.618, p = 0.655). Conclusion: All alternative positional tests are helpful for eliciting nystagmus in patients with HSC-BPPV, and the significant advantages of RART include high-sensitivity in eliciting nystagmus and high accuracy in determining the affected semicircular canal, which provided objective support for the correct diagnosis of HSC-BPPV and the successful reduction of otolith.
RESUMEN
Climate-smart agriculture (CSA) management practices (e.g., conservation tillage, cover crops, and biochar applications) have been widely adopted to enhance soil organic carbon (SOC) sequestration and to reduce greenhouse gas emissions while ensuring crop productivity. However, current measurements regarding the influences of CSA management practices on SOC sequestration diverge widely, making it difficult to derive conclusions about individual and combined CSA management effects and bringing large uncertainties in quantifying the potential of the agricultural sector to mitigate climate change. We conducted a meta-analysis of 3,049 paired measurements from 417 peer-reviewed articles to examine the effects of three common CSA management practices on SOC sequestration as well as the environmental controlling factors. We found that, on average, biochar applications represented the most effective approach for increasing SOC content (39%), followed by cover crops (6%) and conservation tillage (5%). Further analysis suggested that the effects of CSA management practices were more pronounced in areas with relatively warmer climates or lower nitrogen fertilizer inputs. Our meta-analysis demonstrated that, through adopting CSA practices, cropland could be an improved carbon sink. We also highlight the importance of considering local environmental factors (e.g., climate and soil conditions and their combination with other management practices) in identifying appropriate CSA practices for mitigating greenhouse gas emissions while ensuring crop productivity.
