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Background: Non-cystic fibrosis bronchiectasis is associated with airway pathogen colonization. We planned to investigate the inflammatory markers in patients with different airway pathogens and their correlation with disease severity. Methods: We enrolled patients aged between 20 and 75 from October 2021 to August 2022. All patients had sputum evaluation for bacterial and fungal cultures before enrollment, and were classified into four groups according to the culture results. Results: Forty-four patients with non-CF bronchiectasis and six controls were enrolled and categorized as follows: Group 1, no pathogens identified in sputum cultures (n = 14); Group 2, positive fungal culture results (n = 18); Group 3, positive P. aeruginosa culture results (n = 7); and Group 4, positive culture results for both fungi and P. aeruginosa (n = 5). Group 4 had significantly higher serum defensin α1, IL-6 and tissue inhibitors of MMP (TIMP)-1 levels than group 1 patients. The serum levels of IL-6 and TIMP-1 were positively correlated with the FACED score and negatively correlated with distance-saturation product. Conclusion: Significantly higher levels of serum IL-6 and TIMP-1 were found in the patients who had concomitant fungal and P. aeruginosa colonization, and were closely related to clinical severity and may have important roles in disease monitoring.
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PURPOSE: Children with Special Health Care Needs (CSHCN) may experience disruptions in education due to extended hospitalizations. The purpose of this study was to describe how CSHCN experience educational supports during inpatient rehabilitation and identify the ongoing challenges when planning to return to school. MATERIALS AND METHODS: Semi-structured focus groups were conducted with parents (n = 12), former patients (n = 20), and rehabilitation professionals (n = 8). RESULTS: Through qualitative thematic analysis based on descriptive phenomenology, we developed three themes: 1) Inpatient educational support such as instruction and schoolwork helped reduce the learning loss during hospitalization. However, these supports were sometimes complicated by lags in school approvals and challenges in coordination between systems. 2) Transition planning involved establishing necessary services to support CSHCN's educational and healthcare needs at school re-entry. However, families reported limited information and guidance as key barriers. 3) Dynamic courses of school re-entry required continued support after discharge. The participants recommended that reassessment and adjustment of transition plans were often necessary to account for evolving developmental and educational needs but were not always received. CONCLUSIONS: There is an ongoing need to improve communication between clinicians and educators, information for families, and long-term follow-up on the changing educational needs for CSHCN after rehabilitation.
School re-entry after extended hospitalization is challenging for children with special health care needs (CSHCN) due to school disruption, social disconnection, and change in functional abilities.The hospital-to-school transition processes include inpatient educational programs during hospitalization, pre-discharge transition planning, and the subsequent implementation and adjustment of transition plans to facilitate individualized school re-entry.Key areas in need of improving school re-entry include coordination between the hospital and school about rehabilitation and educational goals and information provided to families about transition processes, particularly for newly acquired health conditions.A common need expressed by parents and CSHCN is to simplify and accelerate the process to establish services that support children's educational and healthcare needs.
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Network meta-analysis, also known as mixed treatments comparison meta-analysis or multiple treatments meta-analysis, extends conventional pairwise meta-analysis by simultaneously synthesizing multiple interventions in a single integrated analysis. Despite the growing popularity of network metaanalysis within comparative effectiveness research, it comes with potential challenges. For example, within-study correlations among treatment comparisons are rarely reported in the published literature. Yet, these correlations are pivotal for valid statistical inference. As demonstrated in earlier studies, ignoring these correlations can inflate mean squared errors of the resulting point estimates and lead to inaccurate standard error estimates. This paper introduces a composite likelihood-based approach that ensures accurate statistical inference without requiring knowledge of the within-study correlations. The proposed method is computationally robust and efficient, with substantially reduced computational time compared to the state-of-the-science methods implemented in R packages. The proposed method was evaluated through extensive simulations and applied to two important applications including a network meta-analysis comparing interventions for primary open-angle glaucoma, and another comparing treatments for chronic prostatitis and chronic pelvic pain syndrome.
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BACKGROUND: The ability to determine severity of encephalopathy is crucial for early neuroprotective therapies and for predicting neurodevelopmental outcome. The objective of this study was to assess a novel brain state of newborn (BSN) trend to distinguish newborns with presence of hypoxic ischemic encephalopathy (HIE) within hours after birth and predict neurodevelopmental outcomes at 2 years of age. METHOD: This is a prospective cohort study of newborns at 36 weeks' gestation or later with and without HIE at birth. The Total Sanart Score (TSS) was calculated based on a modified Sarnat exam within 6 h of life. BSN was calculated from electroencephalogram (EEG) measurements initiated after birth. The primary outcome at 2 year of age was a diagnosis of death or disability using the Bayley Scales of Infant Development III. RESULTS: BSN differentiated between normal and abnormal neurodevelopmental outcomes throughout the entire recording period from 6 h of life. Additionally, infants with lower BSN values had higher odds of neurodevelopmental impairment and HIE. BSN distinguished between normal (n = 86) and HIE (n = 46) and showed a significant correlation with the concomitant TSS. CONCLUSION: BSN is a sensitive real-time marker for monitoring dynamic progression of encephalopathy and predicting neurodevelopmental impairment. IMPACT: This is a prospective cohort study to investigate the ability of brain state of newborn (BSN) trend to predict neurodevelopmental outcome within the first day of life and identify severity of encephalopathy. BSN predicts neurodevelopmental outcomes at 2 years of age and the severity of encephalopathy severity. It also correlates with the Total Sarnat Score from the modified Sarnat exam. BSN could serve as a promising bedside trend aiding in accurate assessment and identification of newborns who may benefit from additional neuroprotection therapies.
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An atmospheric pressure plasma jet (APPJ) is used to process electrochemically deposited NiFe on carbon paper (NiFe/CP). The reactive oxygen and nitrogen species (RONs) of the APPJ modify the surface properties, chemical bonding types, and oxidation states of the material at the self-sustained temperature of the APPJ. The APPJ treatment further enhances the hydrophilicity and creates a higher disorder level in the carbon material. Moreover, the metal carbide bonds of NiFe/CP formed in the electrochemical deposition (ED) process are converted to metal oxide bonds after APPJ processing. The potential application of APPJ treatment on NiFe/CP in alkaline water electrolysis is demonstrated. With more oxygen-containing species and better hydrophilicity after APPJ treatment, APPJ-treated NiFe/CP is applied as the electrocatalyst for the oxygen evolution reaction (OER) in alkaline water electrolysis. APPJ-treated NiFe/CP is also used in a custom-made anion-exchange membrane water electrolyzer (AEMWE); this should contribute toward realizing the practical large-scale application of AEM for hydrogen production.
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The controlled vapor-phase synthesis of two-dimensional (2D) transition metal dichalcogenides (TMDs) is essential for functional applications. While chemical vapor deposition (CVD) techniques have been successful for transition metal sulfides, extending these methods to selenides and tellurides often faces challenges due to uncertain roles of hydrogen (H2) in their synthesis. Using CVD growth of MoSe2 as an example, this study illustrates the role of a H2-free environment during temperature ramping in suppressing the reduction of MoO3, which promotes effective vaporization and selenization of the Mo precursor to form MoSe2 monolayers with excellent crystal quality. As-synthesized MoSe2 monolayer-based field-effect transistors show excellent carrier mobility of up to 20.9 cm2/(V·s) with an on-off ratio of 7 × 107. This approach can be extended to other TMDs, such as WSe2, MoTe2, and MoSe2/WSe2 in-plane heterostructures. Our work provides a rational and facile approach to reproducibly synthesize high-quality TMD monolayers, facilitating their translation from laboratory to manufacturing.
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Multivariate network meta-analysis has emerged as a powerful tool in evidence synthesis by incorporating multiple outcomes and treatments. Despite its advantages, this method comes with methodological challenges, such as the issue of unreported within-study correlations among treatments and outcomes, which potentially lead to misleading conclusions. In this paper, we proposed a calibrated Bayesian composite likelihood approach to overcome this limitation. The proposed method eliminated the need to specify a full likelihood function while allowing for the unavailability of within-study correlations among treatments and outcomes. Additionally, we developed a hybrid Gibbs sampler algorithm along with the Open-Faced Sandwich post-sampling adjustment to enable robust posterior inference. Through comprehensive simulation studies, we demonstrated that the proposed approach yielded unbiased estimates while maintaining coverage probabilities close to the nominal level. Furthermore, we implemented the proposed method on two real-world network meta-analysis datasets; one comparing treatment procedures for the root coverage and another comparing treatments for anaemia in chronic kidney disease patients.
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In human leukocyte antigen (HLA)-mismatched allogeneic stem cell transplantation settings, donor-specific anti-HLA antibodies (DSAs) can independently lead to graft failure, including both primary graft rejection and primary poor graft function. Although several strategies, such as plasma exchange, intravenous immunoglobulin, rituximab, and bortezomib, have been used for DSA desensitization, the effectiveness of desensitization and transplantation outcomes in some patients remain unsatisfactory. In this review, we summarized recent research on the prevalence of anti-HLA antibodies and the underlying mechanism of DSAs in the pathogenesis of graft failure. We mainly focused on desensitization strategies for DSAs, especially novel methods that are being investigated in the preclinical stage and those with promising outcomes after preliminary clinical application.
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Recent development of information technology and wearable devices has led to the analysis of multidimensional sports information and the enhancement of athletes' sports performance convenient and potentially more efficient. In this study, we present a novel data platform tailored for capturing athletes' cognitive, physiological, and body composition data. This platform incorporates diverse visualization modes, enabling athletes and coaches to access data seamlessly. Fourteen elite female football players (average age=20.6±1.3years; 3 forwards, 5 midfielders, 4 defenders, and 2 goalkeepers) were recruited from National Taiwan Normal University, Taiwan, as the primary observational group, and 12 female university students without regular sport/exercise habits (average age=21.6±1.3years) were recruited as control group. Through multidimensional data analysis, we identified significant differences in limb muscle mass and several cognitive function scores (e.g., reaction times of attention and working memory) between elite female football varsity team and general female university students. Furthermore, 1-month heart rate data obtained from wearable devices revealed a significant negative correlation between average heart rate median and cognitive function scores. Overall, this study demonstrates the potential of this platform as an efficient multidimensional data collection and analysis platform. Therefore, valuable insights between cognitive functions, physiological signals and body composition can be obtained via this multidimensional platform for facilitating sports performance.
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Rendimiento Atlético , Dispositivos Electrónicos Vestibles , Humanos , Femenino , Adulto Joven , Rendimiento Atlético/fisiología , Atletas , Fútbol/fisiología , Cognición/fisiología , Adulto , Frecuencia Cardíaca/fisiología , Taiwán , Composición Corporal/fisiologíaRESUMEN
Regular physical activity can potentially prevent cognitive decline. While most studies focused on the general decline of the elderly and child and adolescent population, aging is a gradual process and cognitive decline can commence in middle age. Other than the middle-aged working population, gender-specific nuances are another overlooked area regarding the relationship between physical activity and cognitive performance. Therefore, this study examines the associations and benefits of maintaining regular physical activity habits with cognitive function and body composition in middle-aged female office workers. The results show that middle-aged females exhibited age-related declines in working memory, while no significant age-related changes are observed in reaction time and executive function. However, the regular exercise group demonstrates the ability to maintain their cognitive performance across age, unlike the sedentary group, who experiences declines in reaction time and executive function with age. Our findings highlight the significant impact of age on specific cognitive functions in middle-aged females and the positive influence of regular exercise on cognitive performance. Furthermore, this study demonstrates the potential of "the Brain Gym" App for efficient cognitive function assessment. The findings underscore the importance of regular exercise for cognitive well-being in middle-aged females and provide valuable insights into the relationship between body composition and cognitive function.
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Composición Corporal , Cognición , Función Ejecutiva , Ejercicio Físico , Humanos , Femenino , Ejercicio Físico/fisiología , Composición Corporal/fisiología , Cognición/fisiología , Persona de Mediana Edad , Función Ejecutiva/fisiología , Adulto , Memoria a Corto Plazo/fisiología , Tiempo de Reacción/fisiología , Envejecimiento/fisiologíaRESUMEN
Efficient hydrogen generation from water splitting underpins chemistry to realize hydrogen economy. The electrocatalytic activity can be effectively modified by two-dimensional (2D) heterostructures, which offer great flexibility. Furthermore, they are useful in enhancing the exposure of the active sites for the hydrogen evolution reaction. Although the 1T-metallic phase of the transition metal dichalcogenides (TMDs) is important for the hydrogen evolution reaction (HER) catalyst, its practical application has not yet been much utilized because of the lack of stability of the 1T phase. Here, we introduce a novel approach to create a 1T-WS2/1T-WSe2 heterostructure using a low-temperature plasma-assisted chemical vapor reaction (PACVR), namely plasma-assisted sulfurization and plasma-assisted selenization processes. This heterostructure exhibits superior electrocatalytic performance due to the presence of the metallic 1T phase and the beneficial synergistic effect at the interface, which is attributed to the transfer of electrons from the underlying WS2 layer to the overlying WSe2 layer. The WS2/WSe2 heterostructure catalyst demonstrates remarkable performance in the HER as evidenced by its small Tafel slope of 57 mV dec-1 and exceptional durability. The usage of plasma helps in replacing the top S atoms with Se atoms, and this ion bombardment also increases the roughness of the thin film, thus adding another factor to enhance the HER performance. This plasma-synthesized low-temperature metallic-phase heterostructure brings out a novel method for the discovery of other catalysts.
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The study of long-range transport effects on marine fine particles (PM2.5), particularly in remote sites such as the Dongsha Islands, is pivotal for advancing our understanding of air pollution dynamics on a regional scale and for formulating effective environmental policies. PM2.5 concentrations were examined over three consecutive years and grouped based on their transport routes. The backward trajectory simulation revealed that high PM2.5 concentrations were observed in the West Channel, originating from North and Central China, the Korean Peninsula, and the Japanese Islands, opposed to the East Channel. High PM2.5 concentrations, commonly observed in winter and spring, were mainly attributed to the Asian Northeastern Monsoons. Water-soluble inorganic ions constituted the major components, accounting for 37.8-48.7% of PM2.5, and followed by metal elements (15.5-20.0%), carbons (7.5-13.3%), levoglucosan (0.01-0.17%), and organic aerosols (0.2-2.2%). Secondary inorganic aerosols as the dominant source accounted for 8.3-24.7% of PM2.5, while sea salts were the secondary major contributor. High levoglucosan contribution (3.8-7.2%) in winter and spring was attributed to biomass burning, mainly from the Indochina Peninsula. Chemical mass balance receptor modeling resolved that major sources of PM2.5 were secondary sulfate, sea salts, fugitive dust, and industrial boilers. This study concluded that the long-range transport of PM2.5 gradually increased since fall, contributing 52.1-74.3%, highlighting its substantial impact on PM2.5 in all seasons except summer.
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Contaminantes Atmosféricos , Monitoreo del Ambiente , Material Particulado , Material Particulado/análisis , China , Contaminantes Atmosféricos/análisis , Monitoreo del Ambiente/métodos , Contaminación del Aire/estadística & datos numéricos , Estaciones del Año , Islas , Aerosoles/análisis , Agua de Mar/química , Tamaño de la PartículaRESUMEN
Atomically thin 2D films and their van der Waals heterostructures have demonstrated immense potential for breakthroughs and innovations in science and technology. Integrating 2D films into electronics and optoelectronics devices and their applications in electronics and optoelectronics can lead to improve device efficiencies and tunability. Consequently, there has been steady progress in large-area 2D films for both front- and back-end technologies, with a keen interest in optimizing different growth and synthetic techniques. Parallelly, a significant amount of attention has been directed toward efficient transfer techniques of 2D films on different substrates. Current methods for synthesizing 2D films often involve high-temperature synthesis, precursors, and growth stimulants with highly chemical reactivity. This limitation hinders the widespread applications of 2D films. As a result, reports concerning transfer strategies of 2D films from bare substrates to target substrates have proliferated, showcasing varying degrees of cleanliness, surface damage, and material uniformity. This review aims to evaluate, discuss, and provide an overview of the most advanced transfer methods to date, encompassing wet, dry, and quasi-dry transfer methods. The processes, mechanisms, and pros and cons of each transfer method are critically summarized. Furthermore, we discuss the feasibility of these 2D film transfer methods, concerning their applications in devices and various technology platforms.
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Nursing information systems are becoming increasingly prevalent in our medical institutions. However, changes in the social environment and imbalances between the demands of caregivers and care recipients mean that current nursing information systems are inadequate in terms of quality and operational needs. This article was written to provide insights into opportunities to leverage technology to further promote care quality by applying a "data, information, knowledge, and wisdom" system development structure to develop intelligent technology products that equitably meet the needs of patients, caregivers, and nursing processes. Applied in clinical settings, these products should help satisfy patient needs and facilitate nursing work.
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Informática Aplicada a la Enfermería , HumanosRESUMEN
One-dimensional (1D) Zn-based heterostructures have attracted considerable interest in the field of photodetection because of their tunable properties, flexibility, and unique optoelectronic properties. However, designing 1D multi-component Zn-based heterostructures for advanced photodetectors is still a great challenge. Herein, comb-like 1D-1D ZnO-ZnSe heterostructures with ZnO and ZnSe nanowires (NWs) comprising the shaft and teeth of a comb are reported. The length of the ZnO NWs can be modulated in the range of 300-1200 nm. Microstructural characterizations confirm that the 1D heterostructure clearly shows the spatial distribution of individual components. The well-designed structure displays an extended broadband photoresponse and higher photosensitivity than pure ZnSe NWs. Furthermore, ZnSe NWs with an appropriate length of ZnO branches show increased photoresponses of 3835% and 798% compared to those of pure ZnSe NWs under green and red-light irradiation, respectively. In addition, the integrated flexible photodetector presents excellent folding endurance after 1000 bending tests. This well-designed structure has significant potential for other 1D-based semiconductors in optoelectronic applications.
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Accumulation of abnormal chondroitin sulfate (CS) chains in breast cancer tissue is correlated with poor prognosis. However, the biological functions of these CS chains in cancer progression remain largely unknown, impeding the development of targeted treatment focused on CS. Previous studies identified chondroitin polymerizing factor (CHPF; also known as chondroitin sulfate synthase 2) is the critical enzyme regulating CS accumulation in breast cancer tissue. We then assessed the association between CHPF-associated proteoglycans (PGs) and signaling pathways in breast cancer datasets. The regulation between CHPF and syndecan 1 (SDC1) was examined at both the protein and RNA levels. Confocal microscopy and image flow cytometry were employed to quantify macropinocytosis. The effects of the 6-O-sulfated CS-binding peptide (C6S-p) on blocking CS functions were tested in vitro and in vivo. Results indicated that the expression of CHPF and SDC1 was tightly associated within primary breast cancer tissue, and high expression of both genes exacerbated patient prognosis. Transforming growth factor beta (TGF-ß) signaling was implicated in the regulation of CHPF and SDC1 in breast cancer cells. CHPF supported CS-SDC1 stabilization on the cell surface, modulating macropinocytotic activity in breast cancer cells under nutrient-deprived conditions. Furthermore, C6S-p demonstrated the ability to bind CS-SDC1, increase SDC1 degradation, suppress macropinocytosis of breast cancer cells, and inhibit tumor growth in vivo. Although other PGs may also be involved in CHPF-regulated breast cancer malignancy, this study provides the first evidence that a CS synthase participates in the regulation of macropinocytosis in cancer cells by supporting SDC1 expression on cancer cells.
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Background: Complications of total knee arthroplasty (TKA) had been widely discussed. However, whether TKA influence risk of rheumatoid arthritis (RA) in osteoarthritis patients remained uncertain. We intend to evaluate the risk of RA in osteoarthritis patients underwent TKA. Methods: In this retrospective cohort study, data was retrieved from the US collaborative networks in TriNetX research network. Within the study period between 2005 and 2017, osteoarthritis patients underwent TKA were enrolled as case cohort whereas osteoarthritis patients never underwent TKA were enrolled as control cohort. Covariates were matched via propensity score matching. Risk of RA in TKA patients were valuated under various follow-up time and sensitivity models. Results: Under 1-year, 3-year and 5-year of follow-up, TKA patients were associated with significantly elevated risk of RA, especially under 1-year follow-up (HR=1.74; 95% CI, 1.39-2.18). Subgroup analysis demonstrated a significant increase in the risk of RA following TKA in the female subgroup (HR=1.42; 95% CI, 1.24-1.63), the subgroup aged 18-64 years (HR=1.48; 95% CI, 1.11-1.97), and the subgroup aged greater than 65 years old (HR=1.38; 95% CI, 1.21-1.58) based on 5-year follow-up. Conclusion: Clinicians should be concerned about uncharted association between TKA and RA reported our current study. Additional prospective studies and in-depth mechanistic inquiries were warranted to determine the causation.
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Artritis Reumatoide , Artroplastia de Reemplazo de Rodilla , Osteoartritis de la Rodilla , Humanos , Artroplastia de Reemplazo de Rodilla/efectos adversos , Artritis Reumatoide/cirugía , Artritis Reumatoide/complicaciones , Femenino , Masculino , Persona de Mediana Edad , Anciano , Estudios Retrospectivos , Osteoartritis de la Rodilla/cirugía , Osteoartritis de la Rodilla/epidemiología , Osteoartritis de la Rodilla/etiología , Adulto , Factores de Riesgo , Adulto Joven , Adolescente , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Estudios de Seguimiento , Medición de Riesgo/estadística & datos numéricos , Medición de Riesgo/métodosRESUMEN
BACKGROUND: Skeletal muscle development plays a crucial role in yield and quality of pork; however, this process is influenced by various factors. In this study, we employed whole-genome bisulfite sequencing (WGBS) and transcriptome sequencing to comprehensively investigate the longissimus dorsi muscle (LDM), aiming to identify key genes that impact the growth and development of Duroc pigs with different average daily gains (ADGs). RESULTS: Eight pigs were selected and divided into two groups based on ADGs: H (774.89 g) group and L (658.77 g) group. Each pair of the H and L groups were half-siblings. The results of methylation sequencing revealed 2631 differentially methylated genes (DMGs) involved in metabolic processes, signalling, insulin secretion, and other biological activities. Furthermore, a joint analysis was conducted on these DMGs and the differentially expressed genes (DEGs) obtained from transcriptome sequencing of the same individual. This analysis identified 316 differentially methylated and differentially expressed genes (DMEGs), including 18 DMEGs in promoter regions and 294 DMEGs in gene body regions. Finally, LPAR1 and MEF2C were selected as candidate genes associated with muscle development. Bisulfite sequencing PCR (BSP) and quantitative real-time PCR (qRT-PCR) revealed that the promoter region of LPAR1 exhibited significantly lower methylation levels (P < 0.05) and greater expression levels (P < 0.05) in the H group than in the L group. Additionally, hypermethylation was observed in the gene body region of MEF2C, as was a low expression level, in the H group (P < 0.05). CONCLUSIONS: These results suggest that the differences in the ADGs of Duroc pigs fed the same diet may be influenced by the methylation levels and expression levels of genes related to skeletal muscle development.
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Metilación de ADN , Músculo Esquelético , Transcriptoma , Animales , Músculo Esquelético/metabolismo , Músculo Esquelético/crecimiento & desarrollo , Porcinos/genética , Epigenoma , Desarrollo de Músculos/genética , Perfilación de la Expresión GénicaRESUMEN
OBJECTIVE: To investigate the associations between time interval from myomectomy to pregnancy (TIMP) and subsequent pregnancy and obstetric complications, and to explore whether these associations vary according to maternal age at birth. METHODS: A retrospective population-based cohort study was conducted from 2008 to 2017. Data were extracted from the National Health Insurance Research Database and the Taiwan Maternal and Child Health Database, comprising 2024 379 births from 1 391 856 pregnancies. Eligible cases were identified using diagnostic and procedure codes; 4006 first singleton births in 4006 women after their first laparotomic myomectomy were identified. We estimated the risks of pregnancy and obstetric outcomes according to TIMP (<6, 6-11, and ≥12 months). Subgroup analysis was performed by further dividing according to maternal age at birth (18-34 vs ≥35 years old). RESULTS: We observed higher risks of gestational hypertensive disorders (adjusted odds ratio [aOR] 1.97, 95% confidence interval [CI] 1.22-3.18, P = 0.005) and neonatal death (aOR 4.59, 95% CI 1.49-14.18, P = 0.008) for TIMP of <6 months versus TIMP of 6-11 months. Likewise, a TIMP ≥12 months was associated with increased risks of gestational hypertensive disorders (aOR 1.72, 95% CI 1.14-2.58, P = 0.010), and neonatal death (aOR 3.27, 95% CI 1.16-9.24, P = 0.025) versus a TIMP of 6-11 months. In subgroup analysis, women over 35 years old still had higher risks of gestational hypertensive disorders when TIMP was <6 months (aOR 2.26, 95% CI 1.17-4.37, P = 0.015) or ≥12 months (aOR 2.04, 95% CI 1.17-3.54, P = 0.012), and a higher risk of neonatal death when TIMP was <6 months (aOR 4.05, 95% CI 1.06-15.53, P = 0.041); whereas women aged 18-34 years old did not. CONCLUSIONS: This study suggests that a TIMP between 6 and 11 months is associated with lower risks of gestational hypertensive disorders and neonatal death compared with a TIMP <6 months or ≥12 months, especially for women over 35 years old.
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PURPOSE: The capacity to explosively contract quadriceps within the critical timeframe associated with anterior cruciate ligament (ACL) injury, quantified by the rate of torque development, is potentially essential for safe landing mechanics. This study aimed to investigate the influence of explosive quadriceps strength on ACL-related sagittal-plane landing mechanics in females with and without ACL reconstruction (ACLR). METHODS: Quadriceps explosive strength and landing mechanics were assessed in 19 ACLR and 19 control females during isometric contractions and double- and single-leg jump landings. A stepwise multiple linear regression model determined the variance in each of the landing biomechanics variables for the ACLR limb and nondominant limb of controls that could be explained by the group, rate of torque development and/or their interaction. If peak kinetic variables could be predicted by the rate of torque development or interaction, additional analyses were conducted, accounting for knee flexion as a covariate in the regression model. RESULTS: During single-leg landings, ACLR females exhibited greater knee flexion at initial contact than controls (p = 0.04). Greater quadriceps rate of torque development predicted higher peak posterior ground reaction force and anterior tibial shear force in both groups (p = 0.04). However, after controlling for knee flexion angle at those peak forces, quadriceps rate of torque development was not predictive. In double-leg landings, greater explosive quadriceps strength was associated with quicker attainment of peak knee extension moment and posterior ground reaction force in the ACLR limb (p = 0.03). CONCLUSION: Regardless of ACL injury status, females with greater explosive quadriceps strength adopted safer single-leg landings through increased knee flexion, potentially mitigating ACL loading despite encountering higher peak forces. During double-leg landings, a greater explosive quadriceps strength of the ACLR limb is associated with faster achievement of peak force upon landing. Incorporating explosive quadriceps strengthening into post-ACLR rehabilitation and injury prevention programmes may enhance landing mechanics for reducing primary and subsequent ACL injury risks. LEVEL OF EVIDENCE: Level II.