The effects on lumbar disc herniation of supplementing rehabilitation training with repeated transcranial magnetic stimulation / 中华物理医学与康复杂志

Objective:To observe any effect of supplementing conventional rehabilitation training with repeated transcranial magnetic stimulation (rTMS) in the treatment of lumbar disc herniation (LDH).Methods:Seventy-two LDH patients were randomly divided into an rTMS group ( n=24), a training group ( n=24), and a combined group ( n=24). The rTMS group received 2Hz rTMS at an intensity of 80% resting motor threshold with a total of 1000 pulses, the training group was given Mackenzie therapy and lumbar core muscle stability training, while the combined group was provided with both. Each group was treated once a day, 6 times a week for 8 weeks. The participants rated their pain using a visual analog scale (VAS), and the Oswestry dysfunction index (ODI) was also used to evaluate the degree of pain and dysfunction in all three groups before and right after the treatment, as well as 8 weeks later. After the treatment, its therapeutic effect was evaluated using the improved Macnab standard. Each patient was followed up for 12 months and any recurrence was recorded. Results:Before treatment there was no significant difference in average VAS ratings or ODI scores among the three groups. Afterward, pain and dysfunction were relieved significantly in all three groups. Compared with the rTMS group, the average VAS rating in the training group was significantly higher and the average ODI score was significantly lower after the treatment and during the follow-up. Moreover, the average VAS rating and ODI score of the combined group were significantly lower than those in the other two groups after the treatment and during follow-up. The total effectiveness rate in the rTMS group was assessed as 62.5% compared with 95.8% in the training group and 100% in the combined group-a significant difference for the rTMS group. Follow-up showed that the recurrence rates of the rTMS group, training group and combined group were 37.5%, 25% and 8.3%, respectively-a significant difference in the case of the combined group.Conclusion:rTMS combined with rehabilitation training can relieve pain, improve lumbar function and reduce the recurrence of LDH.

Explicit Duration Recurrent Networks.

Recurrent neural networks (RNNs) can be used to operate over sequences of vectors and have been successfully applied to a variety of problems. However, it is hard to use RNNs to model the variable dwell time of the hidden state underlying an input sequence. In this article, we interpret the typical RNNs, including original RNN, standard long short-term memory (LSTM), peephole LSTM, projected LSTM, and gated recurrent unit (GRU), using a slightly extended hidden Markov model (HMM). Based on this interpretation, we are motivated to propose a novel RNN, called explicit duration recurrent network (EDRN), analog to a hidden semi-Markov model (HSMM). It has a better performance than conventional LSTMs and can explicitly model any duration distribution function of the hidden state. The model parameters become interpretable and can be used to infer many other quantities that the conventional RNNs cannot obtain. Therefore, EDRN is expected to extend and enrich the applications of RNNs. The interpretation also suggests that the conventional RNNs, including LSTM and GRU, can be made small modifications to improve their performance without increasing the parameters of the networks.

Evaluation of individual and ensemble probabilistic forecasts of COVID-19 mortality in the US

Short-term probabilistic forecasts of the trajectory of the COVID-19 pandemic in the United States have served as a visible and important communication channel between the scientific modeling community and both the general public and decision-makers. Forecasting models provide specific, quantitative, and evaluable predictions that inform short-term decisions such as healthcare staffing needs, school closures, and allocation of medical supplies. Starting in April 2020, the US COVID-19 Forecast Hub (https://covid19forecasthub.org/) collected, disseminated, and synthesized tens of millions of specific predictions from more than 90 different academic, industry, and independent research groups. A multi-model ensemble forecast that combined predictions from dozens of different research groups every week provided the most consistently accurate probabilistic forecasts of incident deaths due to COVID-19 at the state and national level from April 2020 through October 2021. The performance of 27 individual models that submitted complete forecasts of COVID-19 deaths consistently throughout this year showed high variability in forecast skill across time, geospatial units, and forecast horizons. Two-thirds of the models evaluated showed better accuracy than a naive baseline model. Forecast accuracy degraded as models made predictions further into the future, with probabilistic error at a 20-week horizon 3-5 times larger than when predicting at a 1-week horizon. This project underscores the role that collaboration and active coordination between governmental public health agencies, academic modeling teams, and industry partners can play in developing modern modeling capabilities to support local, state, and federal response to outbreaks. Significance StatementThis paper compares the probabilistic accuracy of short-term forecasts of reported deaths due to COVID-19 during the first year and a half of the pandemic in the US. Results show high variation in accuracy between and within stand-alone models, and more consistent accuracy from an ensemble model that combined forecasts from all eligible models. This demonstrates that an ensemble model provided a reliable and comparatively accurate means of forecasting deaths during the COVID-19 pandemic that exceeded the performance of all of the models that contributed to it. This work strengthens the evidence base for synthesizing multiple models to support public health action.

Potential Clinical Risk of Inflammation and Toxicity from Rare-Earth Nanoparticles in Mice / 中华医学杂志(英文版)

<p><b>Background</b>Nanotechnology is emerging as a promising tool to perform noninvasive therapy and optical imaging. However, nanomedicine may pose a potential risk of toxicity during in vivo applications. In this study, we aimed to investigate the potential toxicity of rare-earth nanoparticles (RENPs) using mice as models.</p><p><b>Methods</b>We synthesized RENPs through a typical co-precipitation method. Institute of Cancer Research (ICR) mice were randomly divided into seven groups including a control group and six experimental groups (10 mice per group). ICR mice were intravenously injected with bare RENPs at a daily dose of 0, 0.5, 1.0, and 1.5 mg/kg for 7 days. To evaluate the toxicity of these nanoparticles in mice, magnetic resonance imaging (MRI) was performed to assess their uptake in mice. In addition, hematological and biochemical analyses were conducted to evaluate any impairment in the organ functions of ICR mice. The analysis of variance (ANOVA) followed by a one-way ANOVA test was used in this study. A repeated measures' analysis was used to determine any significant differences in white blood cell (WBC), alanine aminotransferase (ALT), and creatinine (CREA) levels at different evaluation times in each group.</p><p><b>Results</b>We demonstrated the successful synthesis of two different sizes (10 nm and 100 nm) of RENPs. Their physical properties were characterized by transmission electron microscopy and a 980 nm laser diode. Results of MRI study revealed the distribution and circulation of the RENPs in the liver. In addition, the hematological analysis found an increase of WBCs to (8.69 ± 0.85) × 10/L at the 28 day, which is indicative of inflammation in the mouse treated with 1.5 mg/kg NaYbF:Er nanoparticles. Furthermore, the biochemical analysis indicated increased levels of ALT ([64.20 ± 15.50] U/L) and CREA ([27.80 ± 3.56] μmol/L) at the 28 day, particularly those injected with 1.5 mg/kg NaYbF:Er nanoparticles. These results suggested the physiological and pathological damage caused by these nanoparticles to the organs and tissues of mice, especially to liver and kidney.</p><p><b>Conclusion</b>The use of bare RENPs may cause possible hepatotoxicity and nephritictoxicity in mice.</p>

Analysis of endemic fluorosis of Xinbaerhuyouqi in Hulunbeir city of Inner Mongolia in 2000 - 2009 / 中国地方病学杂志

Objective To investigate the dynamics and development trends of drinking water type of endemic fluorosis after water improvement in Xinbaerhuyouqi of Hulunbeir city, Inner Mongolia and to provide a scientific evidence for the development of countermeasures. Methods We mainly selected Adunchulusumu and Kerlunsumu in Xinbaerhuyouqi of Hulunbeir city as the two monitoring points after water improvement in 2000 -2009. Of these, 1 sample of centralized water supply source water and 3 samples of tap water and 5 samples of noncentralized water supply source water according to water well locations of east, west, south, north and center were collected and the levels of water fluoride were tested; the prevalence of dental fluorosis of school children aged 8 to 12 were examined; from 2002 onwards, the urine samples of 30 children aged 8 to 12(five age groups, six urine samples for each age group) were collected, and all urine samples were collected in the case of less than 30, and urine fluoride was tested. Dental fluorosis was diagnosed using Dean method; water fluoride was tested using fluoride ion selective electrode(WS/T 106-1999); urinary fluoride was tested by determination of fluoride in urine using ion-selective electrode(WS/T 89-1996). Results In 2000 - 2009, the mean levels of fluorine in drinking water in Adunchulusumu and Kerlunsumu were 1.79 - 4.35 mg/L and 1.38 - 3.18 mg/L, respectively; the detection rate of dental fluorosis of children aged 8 to 12 were 45.24％(19/42) - 89.78％(123/137) and 40.00％ (28/70) - 74.47％ (70/94), respectively; the median urinary fluoride of them were 2.30 - 4.15 mg/L and 2.73 - 4.55 mg/L, respectively. ConclusionsThe detection rate of children's dental fluorosis remains high in Xinbaerhuyouqi during the past 10 years after changing water. The endemic fluorosis remains a serious disease. Effective prevention and control measures must be taken to control the occurrence of fluorosis in the future.