Objective: To discuss the epidemiological characteristics of hand foot mouth disease (HFMD) among children in Jiujiang City, and its correlation with meteorological factors, so as to provide scientific evidence for developing targeted HFMD prevention and control measures. Methods: HFMD incidence data among children and meteorological factor records from Jiujiang City during 2019-2023 were collected. Pearson correlation analysis and Quasi-Poisson regression analysis of generalized additive model were used to analyze the relationship between the number of cases and meteorological factors, calculating correlation coefficients (r) and excess risk (ER). Results: The annual reported children HFMD cases in Jiujiang City during 2019-2023 were 4 299, 4 671, 2 560, 3 230, and 3 584, respectively. Except for a peak in autumn-winter in 2020, outbreaks occurred mainly in spring and summer in other years. The majority of cases involved scattered children (71.11%) and children in daycare centers (26.64%). Pearson correlation analysis showed that total case counts, cases among scattered children, and cases among children in daycare centers were positively correlated with average temperature ( r =0.36, 0.39, 0.23), maximum temperature ( r =0.32, 0.36, 0.20), minimum temperature ( r =0.37, 0.41, 0.24), and average relative humidity ( r =0.19, 0.20, 0.15) (all P <0.05). Quasi-Poisson regression analysis of generalized additive model revealed that total cases, cases among scattered children, and cases among daycare children were positively associated with average temperature ( r =0.05, 0.06, 0.03) and average relative humidity ( r =0.03, 0.02, 0.02) (all P <0.01). Excess incidence risk analysis indicated that for every 10 ℃ increase in average temperature, the ER (95% CI ) values were 72.16 (45.91-103.14), 79.76 (52.99- 111.23 ) and 39.30 (14.45-69.54) among total children, scattered children and daycare children, respectively; for every 10% increase in average relative humidity, the ER (95% CI ) values were 28.69 (12.22-47.56), 27.81 (12.01-45.84) and 24.42 (5.56-46.65), respectively. Conclusions The incidence level of HFMD among children in Jiujiang City is positively correlated with the average temperature and average relative humidity. Higher temperature and humidity are associated with an increased risk of excess HFMD incidence in scattered children compared to children in daycare centers.

Objective To investigate the factors influencing international normalized ratio (INR)>3.0 in patients undergoing warfarin anticoagulation therapy after mechanical heart valve replacement. Methods A retrospective analysis was performed on the clinical data of patients who underwent mechanical heart valve replacement surgery and received warfarin anticoagulation therapy at West China Hospital of Sichuan University from January 1, 2011 to June 30, 2022. Based on the discharge INR values, patients were divided into two groups: an INR≤3.0 group and an INR>3.0 group. The factors associated with INR>3.0 at the time of discharge were analyzed. Results A total of 8901 patients were enrolled, including 3409 males and 5492 females, with a median age of 49.3 (43.5, 55.6) years. The gender, body mass index (BMI), New York Heart Association (NYHA) cardiac function grading, INR, glutamic oxaloacetic transaminase, and preoperative prothrombin time (PT) were statistically different between the two groups (P<0.05). Multivariate logistic regression analysis revealed that lower BMI, preoperative PT>15 s, and mitral valve replacement were independent risk factors for INR>3.0 at discharge (P<0.05). Conclusion BMI, preoperative PT, and surgical site are factors influencing INR>3.0 at discharge in patients undergoing warfarin anticoagulation therapy after mechanical heart valve replacement. Special attention should be given to patients with lower BMI, longer preoperative PT, and mitral valve replacement to avoid excessive anticoagulation therapy.

Objective To investigate the effects of different foot strike patterns during running on Achilles tendon(AT)morphology and mechanical loading.Methods Fourteen habitual rearfoot strike runners and 14 habitual forefoot strike runners were recruited.Morphological characteristics(tendon length,cross-sectional area,and thickness)of the AT were collected using ultrasound imaging.The AT loading characteristics(plantar flexion moment,tendon force,load rate,impulse,and stress)of subjects wearing cushioned running shoes while running at a speed of 10 km/h were collected and calculated using a three-dimensional force measurement treadmill.Results Compared to habitual rearfoot strike runners,habitual forefoot strike runners showed a significant increase in peak plantar flexion moment of ankle joint,AT peak force,average loading rate,and peak loading rate(P<0.05).However,the differences in AT length,cross-sectional area,and thickness between the two groups were not statistically significant(P>0.05).Conclusions Long-term forefoot strike patterns can adaptively enhance the mechanical loading characteristics of the AT during repetitive stretch-shortening cycles.

Objective To investigate the effects of high-definition transcranial direct current stimulation(HD-tDCS)on the modulation of the H-reflex and M-wave during ankle dorsiflexion-plantar flexion fatigue tasks to provide direction for the application of HD-tDCS in mitigating neuromuscular fatigue.Methods Twenty healthy young male participants were recruited and randomly assigned to either the real stimulation or sham stimulation group,with 10 participants in each group.The intervention consisted of a 5-day single-blind HD-tDCS application(duration:20 min;intensity:2 mA;target:Cz).Baseline measurements of the H-reflex and M-wave under resting conditions,M-wave during maximal voluntary isometric contraction(MVIC)of the dorsiflexor muscle,and MVIC torque of the dorsiflexor and plantar flexor muscles were obtained.An ankle dorsiflexion fatigue task was performed to determine the time to achieve fatigue for the task.The same fatigue task was repeated and evaluated one day after the intervention.A repeated-measures two-factor(stimulation condition x pre/post fatigue)analysis of variance(ANOVA)was used to analyze the effects of independent variables on the mechanical properties of the muscles and α-motoneuron conduction characteristics.Results After fatigue,voluntary activation(VA),maximal H-reflex(Hmax),maximal M-wave(Mmax),and dorsiflexor and plantar flexor MVIC torques in both groups were significantly reduced compared with pre-fatigue levels(P＜0.05).However,compared to the real stimulation group,the sham stimulation group showed a more significant decline in VA and plantar flexor MVIC torque(P＜0.05).Conclusions A continuous 5-day HD-tDCS intervention can effectively increase α-motoneuron activity at the spinal segment.It can also exert an inhibitory effect on reducing information transmission capacity at the peripheral neuromuscular junction under the ankle dorsi-plantarflexion fatigue task.

Humans ; Female ; Mastectomy, Segmental ; Margins of Excision ; Reoperation ; Breast Neoplasms/surgery* ; Retrospective Studies ; Carcinoma, Ductal, Breast/surgery* ; Neoplasm Recurrence, Local

Sports fatigue of the lower limbs is one of the important factors affecting sports performance. How to improve the anti-fatigue ability of the lower limbs during endurance exercise is the focus of the research field of human sports biomechanics. This study systematically reviewed the relevant literature on transcranial direct current stimulation (tDCS) intervention on lower limb endurance performance, summarized the effect of tDCS on lower limb endurance performance, and analyzed the influencing factors and potential mechanisms. The results showed that: tDCS intervention has a significant effect on the endurance performance of the whole lower limbs, but there is no unified conclusion on the effect on the endurance performance of the knee joint. The researchers deem that tDCS can increase the excitability of the primary motor cortex and reduce the activation of the supplementary motor area and the premotor area to producing a lower rating of perceived exertion, but cannot affect the perception of exercise-induced pain, and stimulation protocols varied across studies, which may be partly responsible. This study can provide a theoretical basis for exploring the central mechanism of tDCS to improve endurance performance, formulating rehabilitation and sports training programsfor different groups of people, and developing new stimulation equipment to enhance the human body’s anti fatigue ability.

The technical deficiencies in traditional medical imagining methods limit the study of
Ankle ; Ankle Joint ; Biomechanical Phenomena ; Range of Motion, Articular ; Technology

Objective To explore the correlation between foot morphology and toe/metatarsophalangeal joint muscle strength. Methods Twenty-six male recreational runners were recruited. Foot length, truncated foot length, foot width, navicular height, dorsum height at 50% of the foot length, metatarsophalangeal joint strength, tensile force of the first and remaining four toes were measured by using digital caliper, metatarsophalangeal joint strength tester and dynameter, respectively. Partial correlations were used to analyze the correlation between foot morphology and foot muscle strength. ResultsWith adjusted age and body mass index (BMI), the foot width in standing position and truncated foot length in sitting and standing position were positively correlated to tensile force of the first toe; the foot length, foot width and truncated foot length were positively correlated to tensile force of the remaining four toes in both positions, and the arch height index in sitting position was negatively associated with tensile force of the remaining four toes; the foot width was positively correlated to metatarsophalangeal joint strength in both positions. Conclusions The longer foot length, foot width, truncated foot length, and the lower arch height in normal range might be related to the larger foot muscle strength. The consideration of the differences in foot morphological characteristics in different positions during the measurement of foot morphology can provide references for predicting foot muscle strength and preventing foot injury.

Objective To investigate the mechanical properties of Achilles tendon (AT) during running under different shoe conditions (minimalist vs conventional shoes). MethodsSixteen healthy male runners with habitual rearfoot strike patterns were recruited to complete the running trials at the speed of 3.16~3.50 m/s under two shoe conditions. The cross-sectional area of the AT was obtained by ultrasound imaging. Sagittal plane ankle kinematics and ground reaction forces were recorded by motion capture system and three-dimensional force platform simultaneously. Mechanical properties of the ankle and AT were calculated. Paired t test was used to compare the effects of two shoe conditions on various parameters (ankle angle, strike angle, AT force, stress, strain, etc). ResultsCompared with conventional shoes, foot inclination angle was significantly reduced by 39.9% with minimalist shoes. Obvious increase in ankle moment, peak AT force, peak AT loading rate, average loading rate, and obvious decrease in time to peak AT force were observed with minimalist shoes. Peak AT stress, peak AT strain and corresponding stress rate, peak strain rate also increased significantly with minimalist shoes. ConclusionsGreater AT loading was observed when runners with habitual rearfoot strike pattern in conventional shoes begin to wear minimalist shoes. Therefore, a gradual transition to minimalist shoes was recommended for them so as to improve the ability to load adaptively.

Objective:To investigate the correlation between antiplatelet agents and the risk of ruptured intracranial aneurysm.Methods:Patients with intracranial aneurysm admitted to the Department of Neurology, East Hospital Area of Qingdao Municipal Hospital from June to December 2018 were selected retrospectively. The baseline data of patients and the characteristics of intracranial aneurysms were collected. The independent correlation between antiplatelet agents and the risk of ruptured intracranial aneurysm was identified by the univariable analysis and multivariate logistic regression analysis. Results:A total of 90 patients with intracranial aneurysm were included in the study. There were 31 males (34.44%) and 59 females (65.56%). The median diameter of the aneurysm was 4 mm. Forty-six patients taking antiplatelet agents before being diagnosed with intracranial aneurysm, of which 36 taking aspirin, 3 taking clopidogrel, and 7 taking aspirin+ clopidogrel. There were 31 patients (34.44%) with ruptured aneurysm and 59 (65.56%) with unruptured aneurysm. There were statistical differences in the proportion of patients with age <60 years ( P<0.05), diabetes ( P<0.1), ischemic heart disease ( P<0.05), history of previous stroke or transient ischemic attack ( P<0.01), internal carotid artery aneurysm ( P<0.01), anterior communicating artery aneurysm ( P<0.05), posterior communicating artery aneurysm ( P<0.01) and taking antiplatelet agents before diagnosis ( P<0.1) between the ruptured group and the unruptured group. Multivariate logistic regression analysis showed that age <60 years (odds ratio[ OR] 4.116, 95% confidence interval [ CI] 1.337-12.673; P=0.014), anterior communicating artery aneurysm ( OR 5.015, 95% CI 1.155-22.559; P=0.032) and posterior communicating artery aneurysm ( OR 68.796, 95% CI 6.762-699.951; P<0.001) were the independent risk factors for ruptured intracranial aneurysm, and taking antiplatelet agents was an independent protective factor for ruptured intracranial aneurysm ( OR 0.320, 95% CI 0.104-0.992; P=0.048). Conclusions:Taking antiplatelet agents, especially aspirin, does not increase the risk of ruptured intracranial aneurysm, but may be a protective factor of ruptured intracranial aneurysm. Unruptured aneurysms are not contraindications for antiplatelet therapy in patients with clear indications.