THE EFFECT OF ARCH-SUPPORTED FUNCTIONAL INSOLES TO AVOID OVERUSED INJURIES DURING RACE WALKING

This study investigates the effectiveness of functional insoles on plantar pressure distribution during race walking in order to reduce the high plantar pressure and force on race walkers, who tend to suffer from overuse injury. A total of 20 male race walkers were recruited as subjects. Each participant completed a race walk with and without functional insoles. Plantar pressure insoles were used to collect plantar pressure data. A two-way analysis of variance with a mixed design was used to determine the difference between the two conditions. Results show that the use of functional insoles reduced the peak pressure and the impulse in the metatarsal heads and heels and thus suggest that functional insoles reduce the overuse injury risks of these parts. The first ground reaction force peak also decreased. This result suggests that functional insoles reduce the risks of foot and leg injuries

Thymosin alpha 1 in the prevention of infected pancreatic necrosis following acute necrotising pancreatitis (TRACE trial): protocol of a multicentre, randomised, double-blind, placebo-controlled, parallel-group trial

Introduction Infected pancreatic necrosis (IPN) and its related septic complications are the major causes of death in patients with acute necrotising pancreatitis (ANP). Therefore, the prevention of IPN is of great clinical value, and immunomodulatory therapy with thymosin alpha 1 may be beneficial. This study was designed to test the hypothesis that the administration of thymosin alpha 1 during the acute phase of ANP will result in a reduced incidence of IPN. Methods and analysis This is a randomised, multicentre, double-blind, placebo-controlled study. 520 eligible patients with ANP will be randomised in a 1:1 ratio to receive either the thymosin alpha 1 or the placebo using the same mode of administration. The primary endpoint is the incidence of IPN during the index admission. Most of the secondary endpoints will be registered within the index admission including in-hospital mortality, the incidence of new-onset organ failure and new-onset persistent organ failure (respiration, cardiovascular and renal), receipt of new organ support therapy, requirement for drainage or necrosectomy, bleeding requiring intervention, human leucocyte antigens-DR(HLA-DR) on day 0, day 7, day 14, and so on and adverse events. Considering the possibility of readmission, an additional follow-up will be arranged 90 days after enrolment, and IPN and death at day 90 will also be served as secondary outcomes. Ethics and dissemination This study was approved by the ethics committee of Jinling Hospital, Nanjing University (Number 2015NZKY-004-02). The thymosin alpha 1 in the prevention of infected pancreatic necrosis following acute necrotising pancreatitis(TRACE) trial was designed to test the effect of a new therapy focusing on the immune system in preventing secondary infection following ANP. The results of this trial will be disseminated in peer-reviewed journals and at scientific conferences. Trial registration number ClinicalTrials.gov Registry (NCT02473406)

T2DM Self-Management via Smartphone Applications: A Systematic Review and Meta-Analysis.

BACKGROUND:Mobile health interventions (mHealth) based on smartphone applications (apps) are promising tools to help improve diabetes care and self-management; however, more evidence on the efficacy of mHealth in diabetes care is needed. The objective of this study was to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) assessing the effect of mHealth apps on changes in hemoglobin A1c (HbA1c), blood glucose, blood pressure, serum lipids, and body weight in type 2 diabetes mellitus (T2DM) patients. METHODS:Two independent reviewers searched three online databases (PubMed, the Cochrane Library, and EMBASE) to identify relevant studies published between January 2005 and June 2016. Of the 2,596 articles retrieved, 13 RCTs were included. We used random effects model to estimate the pooled results. RESULTS:Thirteen studies were selected for the systematic review, six of which with data available containing 1,022 patients were included for the meta-analysis. There was a moderate effect on glycemic control after the mHealth app-based interventions. The overall effect on HbA1c shown as mean difference (MD) was -0.40% (-4.37 mmol/mol) (95% confidence interval [CI] -0.69 to -0.11% [-7.54 to -1.20 mmol/mol]; p = 0.007) and standardized mean differences (SMD) was -0.40% (-4.37 mmol/mol) (95% confidence interval [CI] -0.69 to -0.10% [-7.54 to -1.09 mmol/mol]; p = 0.008). A subgroup analysis showed a similar effect with -0.33% (-3.61 mmol/mol) (95% CI -0.59 to -0.06% [-6.45 to -0.66 mmol/mol]; p = 0.02) in MD and -0.38% (-4.15 mmol/mol) (95% CI -0.71 to -0.05% [-7.76 to -0.55 mmol/mol]; p = 0.02) in SMD in studies where patients' baseline HbA1c levels were less than 8.0%. No effects of mHealth app interventions were found on blood pressure, serum lipids, or weight. Assessment of overall study quality and publication bias demonstrated a low risk of bias among the six studies. CONCLUSIONS:Smartphone apps offered moderate benefits for T2DM self-management. However, more research with valid study designs and longer follow-up is needed to evaluate the impact of mHealth apps for diabetes care and self-management

Sex hormone replacement therapy for patients with Prader-Willi syndrome

Objective To analyze the sex hormonal therapy present status in patients with Prader-Willi syndrome (PWS) and to provide guidance for the future sex hormone application. Methods Pubertal development, abnormal behavior, bone mineral density, sex hormone treatment and parents' attitude to sex hormone application were analyzed by a self-designed questionnaire. Results A total of 41 PWS patients were included (21 males and 20 females) and the median age was 15 years old (13-24 years). For boys, all had cryptorchidism, of which 6 patients (28.6%) had no pubertal development. None of the patients were receiving additional androgen therapy. For girls, 13 (65%) had primary amenorrhea. Only 2 patients had received or was continuing estrogen replacement therapy. Considering the inconveniences of drug application and other reasons, 16 cases (39%) of parents were unwilling to undergo sex hormone therapy. Conclusions Almost all patients with PWS are hypogonadism. Lack of medical recommendations and limited knowledge on sex hormones for their parents, may contribute to low prevalence of sex hormone therapy in this population

Spatiotemporal Characteristics of Soil Moisture and Land–Atmosphere Coupling over the Tibetan Plateau Derived from Three Gridded Datasets

Soil moisture is a crucial component of the water cycle and plays an important role in regional weather and climate. However, owing to the lack of In Situ observations, an accurate understanding of the spatiotemporal variations of soil moisture (SM) on the Tibetan Plateau (TP) is still lacking. In this study, we used three gridded SM products to characterize the spatiotemporal features of SM on the TP during the warm season (May to August). We analyzed the fifth-generation European Centre for Medium-Range Weather Forecasts atmospheric reanalysis (ERA5), Global Land Data Assimilation System (GLDAS), and Soil Moisture Active Passive (SMAP) datasets and used station observation data and triple collocation to quantify product accuracy and consistency. Results of the evaluation based on observation data show that both ERA5 and GLDAS overestimate SM, while the accuracy of SMAP is high. In terms of capturing the temporal variations of SM measured at stations, the performance of ERA5 and that of SMAP are superior to that of GLDAS. According to the evaluation based on triple collocation, SMAP exhibits the smallest random error over the TP and the highest temporal correlation with the unknown true SM in eastern TP. For SMAP, SM variability is the largest in the southern TP. For ERA5 and GLDAS, variability in the western TP is substantially larger than that for SMAP. Low-frequency (30–90 days) variations are the largest contributor to TP SM intraseasonal variability. Relative to SMAP, the contribution of high-frequency variations is low in ERA5 and GLDAS. Land-atmosphere coupling is stronger (weaker) in the western (southeastern) TP, which is relatively dry (wet). Our evaluation of SM product performance over the TP may facilitate the use of these products for disaster monitoring and climate and hydrological studies

Correlation between different FGFR1 mutations and congenital hypogonadotropic hypogonadism

Objective To investigate whether multiple gene mutations were existed to cause congenital hypogonadotropic hypogonadism(CHH), by screening genes in CHH patients with FGFR1 mutations. Methods FGFR1 mutations were identified in 15 CHH patients. Other CHH-related genes were screened in these patients. Bioinformatics software was used to analyze the pathogenicity of gene variant. Results 1)Mutations in FGFR1 were inherited from parents in 9 patients (inherited mutation group)in spite of the fact, their parents showed normal reproductive axis function. 2)In the inherited mutation group, 6 patients harbored another mutation including PROKR2(W178S), FGF8(T121N), HS6ST1(P242L), SEMA3A(R734W), LZTR1(Q10Rfs*15) and FGFR1 compound heterozygous mutation. Multiple gene mutations may lead to CHH. 3)Six patients were found to have de novo mutations in FGFR1(de novo mutation group) but not no other pathogenic CHH related gene mutations. Conclusions FGFR1 mutations inherited from parents may require another blow from CHH-related genes to cause CHH. This study expands our understanding of the pathogenesis of CHH caused by digenic mutation

Assisted reproductive techniques with congenital hypogonadotropic hypogonadism patients: a systematic review and meta-analysis

Abstract Background After hormonal replacement therapy (HRT) including androgen replacement or sequential therapy of estrogen and progesterone, The combination of human chorionic gonadotropin (hCG) and human menopausal gonadotropin (hMG) and pulsatile GnRH, is not sufficient to produce sufficient gametes in some patients with Congenital hypogonadotropic hypogonadism (CHH). A Systematic review and meta-analysis was performed to determine that assisted reproductive techniques (ART) can effectively treat different causes of infertility. Methods To determine the effect of ART on fertility of CHH patients and investigate whether outcomes are similar to infertility due to other causes, we conducted a systematic review and meta-analysis of retrospective trials. Clinical trials were systematically searched in Medline, Embase, and the Cochrane central register of controlled trials databases. The keywords and major terms covered “hypogonadotropic hypogonadism”, “kallmann syndrome”, “assisted reproductive techniques”, “intrauterine insemination”, “intracytoplasmic sperm injection”, “testicular sperm extraction”, “in vitro fertilization”, “embryo transplantation” and “intra-Fallopian transfer”. Results A total of 388 pregnancies occurred among 709 CHH patients who received ART (effectiveness 46, 95% confidence interval 0.39 to 0.53) in the 20 studies we included. The I2 in trials assessing overall pregnancy rate (PR) per embryo transfer (ET) cycle was 73.06%. Similar results were observed in subgroup analysis by different gender. Regression indicates pregnancy rate decreases with increasing age. Fertilization, implantation and live birth rates (72, 36 and 40%) showed no significant differences as compared to infertility due to other causes. Conclusions Despite CHH patients usually being difficult to generate gametes, their actual chances of fertility are similar to subjects with other non-obstructive infertility. ART is a suitable option for CHH patients who do not conceive after long-term gonadotropin treatment

Triglyceride glucose-waist circumference: the optimum index to screen nonalcoholic fatty liver disease in non-obese adults

Abstract Background Non-alcoholic fatty liver disease (NAFLD) is easily neglected in the non-obese population. TyG index (triglyceride glucose Index) and TG/HDL-c (triglyceride to high-density lipoprotein cholesterol) are new indicators to evaluate insulin resistance (IR). Fibroscan is a non-invasive way to assess hepatic steatosis [by control attenuation parameters (CAP)] and fibrosis [by liver stiffness measurement (LSM)].The purpose of this study was to explore the correlation of TyG and its combination with obesity indicators [TyG-waist circumference (WC), TyG-body mass index (BMI)] and TG/HDL-c with CAP and LSM. Method One thousand seven hundred seventy-six adults (age ≥ 20 years, BMI < 30 kg/m2) in the National Health and Nutrition Examination Survey (NHANES) 2017–2018 were included. The correlations of CAP and LSM to the indexes were assessed by generalized linear models.. Receiver operating characteristic (ROC) curve was performed to evaluate the diagnostic capability of the indicators on NAFLD and liver stiffness. Results Survey-weighted percentage of NAFLD in non-obese was 38.6%. In the fully adjusted models, there were positive associations of TyG, TyG-BMI, TyG-WC and TG/HDL-c to CAP, with the βs of 24.810, 0.704, 0.29 and 2.983 (all p < 0.05), respectively. There were positive associations of TyG, TyG-BMI, TyG-WC, and TG/HDL-c to NAFLD, with ORs of 3.387, 1.03, 1.010 and 1.281 ((all p < 0.05)).The positive association was detected for TG/HDL-c and TyG-WC and LSM with βs of 0.057 and 0.004(p = 0.021 and p = 0.003).TyG-WC were positively associated with liver stiffness with OR of 1.006(95%CI = 1.002, 1.012). Furthermore, the TyG-WC had the strongest diagnostic capability (ROC = 0.806; 95%CI: 0.785–0.826) on NAFLD in non-obese participants, with a specificity of 0.737 and sensitivity of 0.746. Conclusion In US non-obese population, the TyG, TyG-BMI, TyG-WC, and TG/HDL-c are positively correlated with CAP and NAFLD. TyG-WC has clinical importance in identifying NAFLD in the non-obese population