Correlation between current intensity and effective duration in the treatment of botulinus toxin for cerebral palsy by myoelectricity locating

BACKGROUND： Researches prove that the treatment of cerebral palsy by botulinus toxin （BTX-A） can improve effect and prolong effective duration. Current intensity is the important factor during injection. OBJECTIVE： To observe the changes of motor function and muscular intensity of children with spastic cerebral palsy after injecting BTX-A and analyze correlation between current intensity and effective duration. DESIGN： Cases control trial before and after nerves block SETTING： Capital University of Medical Sciences, China Rehabilitation Research Center PARTICIPANTS： From June 2002 to November 2004, 14 children with spastic cerebral palsy were treated by BTX-A block. All children were hospitalized in the Children Rehabilitation Department of China Rehabilitation Research Center. The children included 9 male and 5 female, and ranged from 4 to 13 years old, and average age was （6±2） years. Muscular tension ranged from grade 1 to grade 3. The diagnosis and the tape of cerebral palsy based on standard of the Fist Nationwide Cerebral Palsy Symposium, and all children were diagnosed with electroencephalogram （EEG）, CT and MRI, and permitted by their guardians. METHODS： （1） Locating and calculation： To locate block points by G6805-2A electro-therapeutic apparatus （Shanghai Huayi Electronic Instrument Plant） at the least stimulating current （continuous wave; impulse frequency; 2.667-83.333 Hz; current intensity： 0-6 mA; voltage： 6 V） to touch off muscles contraction. The current intensity of each point was recorded, and the average current intensity of each patient was calculated at the same time. （2） Dose of BTX-A： Basing upon the spastic degree and weight of patients, the dose was made certain： dose （IU）=（scores of Modified Ashworth Scale ＋2.5） xweight （kg）. The number of the block points was in all 4. The dose of injection ranged from 50 IU to 160 IU with the average of （73.6＋25.8） IU. The BTX-A was made by Lanzhou Institute of Biological Products, and each bottle contains 100 IU BTX-A. Muscular tension was evaluated by Modified Ashworth Scale. The scale ranged from grade 0 to grade 4, and the scores were from 0 to 4. The higher the scores were, the higher the muscular tension was. （3） Effect： Changes of muscular tension were evaluated by modified Ashworth Scale before and after block. Motor function was evaluated by Physician Rating Scale （PRS） before and after treatment. It contained Gait pattern, Hindfoot （ankle） position （stance-floor contact）, Hindfoot position （foot strike）, Knee position （degree of recurvation）, Crouch and Speed of gait. The scores ranged from 0 to 14. The higher the points were, the better the motor function was. （4） Effective duration： The duration was definited by the recovering of the Modified Ashworth Scale. （5） Statistic analysis： Firstly, the current intensity and the effect duration were analyzed by One-Sample Kolmogorov-Smirnov Test, the current intensity： Z= 0.456, P= 0.985, the effective duration： Z= 0.557, P= 0.915. Both data were normal distribution. Secondly, both data were analyzed by Linear Regression. The efficiency of the BTX-A block was analyzed by paired-samples t test. MAIN OUTCOME MEASURES： （1） Changes of motor function of muscular tension; （2） correlation between current intensity and effective duration. RESULTS： Fourteen children with spastic cerebral palsy were all involved in the final analysis. （1） Therapeutic effect： The average score of Ashworth scale after block was lower than that before block [（1.02±0.34） points vs. （2.12±0.48） points, t= 3.644, P〈 0.01]. The average score of RPS after block was higherthan that before block [（9.75±2.78） points vs. （6.16±0.58） points, t =13.222, P〈 0.01]. （2） Relation between the current intensity and the effective duration： The current intensity was （0.1857±0.0506） mA, and the effective duration was （26.36±4.48） weeks. The current intensity was negative correlation with effective duration （r = -0.775, P = 0.01 ）. CONCLUSION： （1） BTX-A occlusion can decrease muscular tension and improve motor function of lower limbs of children with spastic cerebral palsy. （2） The lower the current intensity is, the longer the effective duration is.

Spatiotemporal changes of gross primary productivity and its response to drought in the Mongolian Plateau under climate change

Gross primary productivity(GPP)of vegetation is an important constituent of the terrestrial carbon sinks and is significantly influenced by drought.Understanding the impact of droughts on different types of vegetation GPP provides insight into the spatiotemporal variation of terrestrial carbon sinks,aiding efforts to mitigate the detrimental effects of climate change.In this study,we utilized the precipitation and temperature data from the Climatic Research Unit,the standardized precipitation evapotranspiration index(SPEI),the standardized precipitation index(SPI),and the simulated vegetation GPP using the eddy covariance-light use efficiency(EC-LUE)model to analyze the spatiotemporal change of GPP and its response to different drought indices in the Mongolian Plateau during 1982-2018.The main findings indicated that vegetation GPP decreased in 50.53% of the plateau,mainly in its northern and northeastern parts,while it increased in the remaining 49.47%area.Specifically,meadow steppe(78.92%)and deciduous forest(79.46%)witnessed a significant decrease in vegetation GPP,while alpine steppe(75.08%),cropland(76.27%),and sandy vegetation(87.88%)recovered well.Warming aridification areas accounted for 71.39% of the affected areas,while 28.53% of the areas underwent severe aridification,mainly located in the south and central regions.Notably,the warming aridification areas of desert steppe(92.68%)and sandy vegetation(90.24%)were significant.Climate warming was found to amplify the sensitivity of coniferous forest,deciduous forest,meadow steppe,and alpine steppe GPP to drought.Additionally,the drought sensitivity of vegetation GPP in the Mongolian Plateau gradually decreased as altitude increased.The cumulative effect of drought on vegetation GPP persisted for 3.00-8.00 months.The findings of this study will improve the understanding of how drought influences vegetation in arid and semi-arid areas.

Determination and application of path duration of seismic ground motions based on the K-NET data in Sagami Bay,Japan

Duration models are one of the important parameters in ground-motion simulations.This model varies in different study areas,and plays a critical role in nonlinear structural response analysis.Currently,available empirical models are being globally used in ground-motion simulations,with limited research focusing on path duration in specific regions.In this study,we collected 6,486 sets of three-component strong-motion records from 29 K-NET stations in the Sagami Bay,Japan,and its surrounding areas between January 2000 to October 2018.We extracted the effective duration of 386 pieces of ground-motion records by manually picking up the S-wave arrival time and calculating the significant duration.We then obtained the path duration model of the study area based on the empirical equation of dynamic corner frequency and source duration of Boore(2009).Compared with the results of the available empirical models,the Fourier spectrum of the simulated ground motion from our effective duration model showed higher accuracy in the long-term range,with less fitting residuals.This path duration model was then applied to simulate two earthquakes of M_(W)5.4 and M_(W)6.2,respectively,in the region using the stochastic finite-fault method with a set of reliable source,path,and site parameters determined for the study area.The simulation results of most stations fit well with observation records in the 0-30 Hz frequency band.For the M_(W)5.4 earthquake,the simulated ground motions at KNG005/KNG010/SZO008 stations were relatively weak in the mid to high frequency band(1-30 Hz)because the quality factor and geometric diffusion model used in the simulation were the averages of the entire Sagami Bay region,causing a bias in the results of a few stations owing to local crustal velocity anomalies and topographic effects.For the M_(W)6.2 earthquake,the simulated ground motions were relatively weak at all SZO and TKY stations,mainly because of the close distance from these stations to the epicenter and the complex seismic-wave propagation paths.The analysis suggests that the differences between the simulation results of the two earthquakes were mainly related to complex geological conditions and seismic-wave propagation paths.

Distribution characteristics of wave energy in the Zhe-Min coastal area

A 10-year(2003–2012)hindcast was conducted to study the wave field in the Zhe-Min coastal area(Key Area OE-W2)located off Zhejiang and Fujian provinces of China.Forced by the wind field from a weather research and forecasting model(WRF),high-resolution wave modelling using the SWAN was carried out in the study area.The simulated wave fields show a good agreement with observations.Using the simulation results,we conducted statistical analysis of wave power density in terms of spatial distribution and temporal variation.The effective duration of wave energy in the sea area was discussed,and the stability of wave energy was evaluated using the coefficient of variation of wave power density.Results indicate that the wave energy resource in the study area was about 4.11×10^(6) kW.The distribution of wave energy tends to increase from the north(off Zhejiang coast)to the south(off Fujian coast),and from near-shore area to the open sea.The sea areas with wave power density greater than 2 kW/m are mostly distributed seaward of the 10-m isobath,and the contours of the wave power density are almost parallel to the shoreline.The sea areas around the islands that are far from the mainland are rich in wave energy,usually more than 6 kW/m,and therefore are of obvious advantages in planning wave energy development and utilization.The effective duration of wave energy in the offshore area shows an increasing trend from north(off Zhejiang coast)to south(off Fujian coast),with values of∼3500 h in the north and∼4450 h in the south.The coefficient of variation of wave energy in this region is mostly in the range of 1.5–3.0,and gradually decreases from the north to the south,suggesting that the wave energy in the south is more stable than that in the north.