Straw return is a promising strategy for managing soil organic carbon(SOC)and improving yield stability.However,the optimal straw return strategy for sustainable crop production in the wheat(Triticum aestivum L.)-cott...Straw return is a promising strategy for managing soil organic carbon(SOC)and improving yield stability.However,the optimal straw return strategy for sustainable crop production in the wheat(Triticum aestivum L.)-cotton(Gossypium hirsutum L.)cropping system remains uncertain.The objective of this study was to quantify the long-term(10 years)impact of carbon(C)input on SOC sequestration,soil aggregation and crop yields in a wheat-cotton cropping system in the Yangtze River Valley,China.Five treatments were arranged with a single-factor randomized design as follows:no straw return(Control),return of wheat straw only(Wt),return of cotton straw only(Ct),return of 50%wheat and 50%cotton straw(Wh-Ch)and return of 100%wheat and 100%cotton straw(Wt-Ct).In comparison to the Control,the SOC content increased by 8.4 to 20.2%under straw return.A significant linear positive correlation between SOC sequestration and C input(1.42-7.19 Mg ha^(−1)yr^(−1))(P<0.05)was detected.The percentages of aggregates of sizes>2 and 1-2 mm at the 0-20 cm soil depth were also significantly elevated under straw return,with the greatest increase of the aggregate stability in the Wt-Ct treatment(28.1%).The average wheat yields increased by 12.4-36.0%and cotton yields increased by 29.4-73.7%,and significantly linear positive correlations were also detected between C input and the yields of wheat and cotton.The average sustainable yield index(SYI)reached a maximum value of 0.69 when the C input was 7.08 Mg ha^(−1)yr^(−1),which was close to the maximum value(SYI of 0.69,C input of 7.19 Mg ha^(−1)yr^(-1))in the Wt-Ct treatment.Overall,the return of both wheat and cotton straw was the best strategy for improving SOC sequestration,soil aggregation,yields and their sustainability in the wheat-cotton rotation system.展开更多
Directly modulated 850-nm vertical-cavity surface-emitting lasers(VCSELs)with the advantages of low cost,high modulation speed,good reliability,and low power consumption,are the key sources in the optical interconnect...Directly modulated 850-nm vertical-cavity surface-emitting lasers(VCSELs)with the advantages of low cost,high modulation speed,good reliability,and low power consumption,are the key sources in the optical interconnects with multimode fibers for the supercomputers,data centers,and machine learning applications[1−3].Typically,non-return-tozero(NRZ)modulation format is used.展开更多
Purpose The aim of the study was to identify factors associated with prolonged time to return to full performance(RTFP)in athletes with recent severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.Metho...Purpose The aim of the study was to identify factors associated with prolonged time to return to full performance(RTFP)in athletes with recent severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.Methods Prospective cohort study with cross sectional analysis.A total of 84 athletes with confirmed SARS-CoV-2 infection assessed at a coronavirus disease 2019 recovery clinic gave a history of age,sex,type/level of sport,co-morbidities,pre-infection training hours,and 26 acute SARS-CoV-2 symptoms from 3 categories(“nose and throat”,“chest and neck”,and“whole body”/systemic).Data on days to RTFP were obtained by structured interviews.Factors associated with RTFP were demographics,sport participation,history of co-morbidities,pre-infection training history,and acute symptoms(type,number).Outcomes were:(a)days to RTFP(median,interquartile range(IQR))in asymptomatic(n=7)and symptomatic athletes(n=77),and(b)hazard ratios(HRs;95%confidence interval)for symptomatic athletes with vs.without a factor(univariate,multiple models).HR<1 was predictive of higher percentage chance of prolonged RTFP.Significance was p<0.05.Results Days to RTFP were 30 days(IQR:23–40)for asymptomatic and 64 days(IQR:42–91)for symptomatic participants(p>0.05).Factors associated with prolonged RTFP(univariate models)were:females(HR=0.57;p=0.014),endurance athletes(HR=0.41;p<0.0001),co-morbidity number(HR=0.75;p=0.001),and respiratory disease history(HR=0.54;p=0.026).In symptomatic athletes,prolonged RTFP(multiple models)was significantly associated with increased“chest and neck”(HR=0.85;p=0.017)and“nose and throat”(HR=0.84;p=0.013)symptoms,but the association was more profound between prolonged RFTP and increased total number of“all symptoms”(HR=0.91;p=0.001)and“whole body”/systemic(HR=0.82;p=0.007)symptoms.Conclusion A larger number of total symptoms and specifically“whole body”/systemic symptoms during the acute phase of SARS-CoV-2 infection in athletes is associated with prolonged RTFP.展开更多
1.Legacy matters The withdrawal of Australia as hosts for the Commonwealth Games in 2026 demonstrates that large international sporting events are more than just sporting mastery,medals,and memories.Money also matters...1.Legacy matters The withdrawal of Australia as hosts for the Commonwealth Games in 2026 demonstrates that large international sporting events are more than just sporting mastery,medals,and memories.Money also matters.1 The cost of hosting a major international tournament is eye-wateringly high.Host governments need to show that the billions of dollars of investment deliver a return beyond sporting glory to justify the resources that are spent.展开更多
Background Sex hormones play important roles in the estrus return of post-weaning sows.Previous studies have demonstrated a complex and bi-directional regulation between sex hormones and gut microbiota.However,the ext...Background Sex hormones play important roles in the estrus return of post-weaning sows.Previous studies have demonstrated a complex and bi-directional regulation between sex hormones and gut microbiota.However,the extent to which the gut microbiota affects estrus return of post-weaning sows is largely unknown.Results In this study,we first screened 207 fecal samples from well-phenotyped sows by 16S rRNA gene sequencing and identified significant associations between microbes and estrus return of post-weaning sows.Using metagenomic sequencing data from 85 fecal samples,we identified 37 bacterial species that were significantly associated with estrus return.Normally returning sows were characterized by increased abundances of L.reuteri and P.copri and decreased abundances of B.fragilis,S.suis,and B.pseudolongum.The changes in gut microbial composition significantly altered the functional capacity of steroid hormone biosynthesis in the gut microbiome.The results were confirmed in a validation cohort.Significant changes in sex steroid hormones and related compounds were found between normal and non-return sows via metabolome analysis.An integrated analysis of differential bacterial species,metagenome,and fecal metabolome provided evidence that normal return-associated bacterial species L.reuteri and Prevotella spp.participated in the degradation of pregnenolone,progesterone,and testosterone,thereby promoting estrogen biosynthesis.Furthermore,the microbial metabolites related to sow energy and nutrient supply or metabolic disorders also showed relationships with sow estrus return.Conclusions An integrated analysis of differentially abundant bacterial species,metagenome,and fecal metabolome revealed the involvement of L.reuteri and Prevotella spp.in sow estrus return.These findings provide deep insight into the role of gut microbiota in the estrus return of post-weaning sows and the complex cross-talk between gut microbiota and sex hormones,suggesting that the manipulation of the gut microbiota could be an effective strategy to improve sow estrus return after weaning.展开更多
Helping athletes return to sports participation is a primary goal of anterior cruciate ligament(ACL)reconstruction rehabilitation.To facilitate the achievement of this goal,decades of research studies have sought to i...Helping athletes return to sports participation is a primary goal of anterior cruciate ligament(ACL)reconstruction rehabilitation.To facilitate the achievement of this goal,decades of research studies have sought to identify knee impairments that reduce knee function as well as interventions to resolve them.1Yet,over the past 10 years,research pertaining to psychological responses(i.e.,cognitions and emotions)after ACL reconstruction has grown exponentially—a phenomenon that can be visualized by entering the search terms"psychological"and"anterior cruciate ligament reconstruction"into the PubMed search engine.展开更多
Cardiac arrest poses a significant global public health challenge,manifesting in approximately 550,000 cases annually within the United States.[1]In-hospital cardiac arrest(IHCA)is commonly attributed to airways and r...Cardiac arrest poses a significant global public health challenge,manifesting in approximately 550,000 cases annually within the United States.[1]In-hospital cardiac arrest(IHCA)is commonly attributed to airways and respiratory issues.[2]Recommendations emphasize the expertise of responders in airway management.[3]Various options exist,such as chest compression-only cardiopulmonary resuscitation(CPR),bag-mask ventilation(BMV),and advanced airways.The BMV and advanced airways are not deemed equivalent or superior based on previous evidence.[4]Achieving consistency in choosing and timing the optimal airway approach during IHCA is crucial.The current American Heart Association guidelines suggest an advanced airway strategy when endotracheal intubation(ETI)success rates are high,but the optimal time for advanced airway management remains unclear.[5]Wong et al[6]revealed that survival improved by less than 5 min with advanced airway management.According to a subgroup analysis of IHCA patients in emergency departments(EDs),early intubation was associated with a 1.5-fold greater rate of return of spontaneous circulation(ROSC)than in other locations.[7]ED patients’constant monitoring and immediate management,with readily available intubation equipment,enhance early intubation and survival rates.[6]Nonetheless,IHCA patients intubated within the first 15 min had a lower ROSC rate.展开更多
International guidelines for post-cardiac arrest care recommend using multi-modal strategies to avoid the withdrawal of life-sustaining therapy(WLST)in patients with the potential for neurological recovery.[1]However,...International guidelines for post-cardiac arrest care recommend using multi-modal strategies to avoid the withdrawal of life-sustaining therapy(WLST)in patients with the potential for neurological recovery.[1]However,a clear methodology for multi-modal approaches has yet to be developed.Neuron-specific enolase(NSE)is currently the only recommended biomarker,and the European Resuscitation Council(ERC)and the European SocietyofIntensiveCareMedicine(ESICM)have proposed a cutoff value of 60μg/L at 48 and/or 72 h after the return of spontaneous circulation(ROSC)as a multimodal prognostic tool for predicting poor neurological outcomes.展开更多
We investigate the dynamics of convergent shock compression in solid cylindrical targets irradiated by an ultrafast relativistic laser pulse.Our particle-in-cell simulations and coupled hydrodynamic simulations reveal...We investigate the dynamics of convergent shock compression in solid cylindrical targets irradiated by an ultrafast relativistic laser pulse.Our particle-in-cell simulations and coupled hydrodynamic simulations reveal that the compression process is initiated by both magnetic pressure and surface ablation associated with a strong transient surface return current with density of the order of 10^(17) A/m^(2) and lifetime of 100 fs.The results show that the dominant compression mechanism is governed by the plasma β,i.e.,the ratio of thermal pressure to magnetic pressure.For targets with small radius and low atomic number Z,the magnetic pressure is the dominant shock compression mechanism.According to a scaling law,as the target radius and Z increase,the surface ablation pressure becomes the main mechanism generating convergent shocks.Furthermore,an indirect experimental indication of shocked hydrogen compression is provided by optical shadowgraphy measurements of the evolution of the plasma expansion diameter.The results presented here provide a novel basis for the generation of extremely high pressures exceeding Gbar(100 TPa)to enable the investigation of high-pressure physics using femtosecond J-level laser pulses,offering an alternative to nanosecond kJ-laser pulse-driven and pulsed power Z-pinch compression methods.展开更多
Background:Return to play(RTP)in elite rugby is managed using a 6-stage graduated RTP protocol,which can result in clearance to play within 1 week of injury.We aimed to explore how symptom,cognitive,and balance presen...Background:Return to play(RTP)in elite rugby is managed using a 6-stage graduated RTP protocol,which can result in clearance to play within 1 week of injury.We aimed to explore how symptom,cognitive,and balance presentation and evolution during concussion screens 2 h(head injury assessment(HIA2)and 48 h(HIA3)after injury were associated with time to RTP)to identify whether a more conservative graduated RTP may be appropriate.Methods:A retrospective cohort study was conducted in 380 concussed rugby players from elite men’s rugby over 3 consecutive seasons.Players were classified as shorter or longer returns,depending on whether RTP occurred within 7 days(allowing them to be considered to play the match 1 week after injury)or longer than 8 days,respectively.Symptom,cognitive,and balance performance during screens was assessed relative to baseline(normal or abnormal)and to the preceding screen(improving or worsening).Associations between sub-test abnormalities and RTP time were explored using odds ratios(OR,longer vs.shorter).Median day absence was compared between players with abnormal or worsening results and those whose results were normal or improving.Results:Abnormal symptom results during screens 2 h and 48 h after concussion were associated with longer return time(HIA2:OR=2.21,95%confidence interval(95%CI):1.39-3.50;HIA3:OR=3.30,95%CI:1.89-5.75).Worsening symptom number or severity from the time of injury to 2 h and 48 h post-injury was associated with longer return(HIA2:OR=2.49,95%CI:1.36-4.58;HIA3:OR=3.34,95%CI:1.10-10.15).Median days absence was greater in players with abnormal symptom results at both HIA2 and HIA3.Cognitive and balance performance were not associated with longer return and did not affect median days absence.Conclusion:Symptom presentation and evolution within 48 h of concussion were associated with longer RTP times.This may guide a more conservative approach to RTP,while still adhering to individualized concussion management principles.展开更多
BACKGROUND:Unsustained return of spontaneous circulation(ROSC)is a critical barrier to survival in cardiac arrest patients.This study examined whether end-tidal carbon dioxide(ETCO_(2))and pulse oximetry photoplethysm...BACKGROUND:Unsustained return of spontaneous circulation(ROSC)is a critical barrier to survival in cardiac arrest patients.This study examined whether end-tidal carbon dioxide(ETCO_(2))and pulse oximetry photoplethysmogram(POP)parameters can be used to identify unsustained ROSC.METHODS:We conducted a multicenter observational prospective cohort study of consecutive patients with cardiac arrest from 2013 to 2014.Patients’general information,ETCO_(2),and POP parameters were collected and statistically analyzed.RESULTS:The included 105 ROSC episodes(from 80 cardiac arrest patients)comprised 51 sustained ROSC episodes and 54 unsustained ROSC episodes.The 24-hour survival rate was significantly higher in the sustained ROSC group than in the unsustained ROSC group(29.2%vs.9.4%,P<0.05).The logistic regression analysis showed that the difference between after and before ROSC in ETCO_(2)(ΔETCO_(2))and the difference between after and before ROCS in area under the curve of POP(ΔAUCp)were independently associated with sustained ROSC(odds ratio[OR]=0.931,95%confi dence interval[95%CI]0.881-0.984,P=0.011 and OR=0.998,95%CI 0.997-0.999,P<0.001).The area under the receiver operating characteristic curve ofΔETCO_(2),ΔAUCp,and the combination of both to predict unsustained ROSC were 0.752(95%CI 0.660-0.844),0.883(95%CI 0.818-0.948),and 0.902(95%CI 0.842-0.962),respectively.CONCLUSION:Patients with unsustained ROSC have a poor prognosis.The combination ofΔETCO_(2) andΔAUCp showed signifi cant predictive value for unsustained ROSC.展开更多
BACKGROUND Besides return to work(RTW)and return to sports(RTS),patients also prefer to return to daily activities(RTA)such as walking,sleeping,grocery shopping,and domestic work following total knee arthroplasty(TKA)...BACKGROUND Besides return to work(RTW)and return to sports(RTS),patients also prefer to return to daily activities(RTA)such as walking,sleeping,grocery shopping,and domestic work following total knee arthroplasty(TKA).However,evidence on the timelines and probability of patients’RTA is sparse.AIM To assess the percentage of patients able to RTA,RTW,and RTS after TKA,as well as the timeframe and influencing factors of this return.METHODS A retrospective cohort study with prospectively collected data was conducted at a medium-sized Dutch orthopedic hospital.Assessments of RTA,RTW,and RTS were performed at 3 mo and/or 6 mo following TKA.Investigated factors en-compassed patient characteristics,surgical characteristics,and preoperative patient-reported outcomes.RESULTS TKA patients[n=2063;66 years old(interquartile range[IQR]:7 years);47%male;28 kg/m2(IQR:4 kg/m2)]showed RTA ranging from 28%for kneeling to 94%for grocery shopping,with 20 d(IQR:27 d)spent for putting on shoes to 74 d(IQR:57 d)for kneeling.RTW rates varied from 62%for medium-impact work to 87%for low-impact work,taking 33 d(IQR:29 d)to 78 d(IQR:55 d).RTS ranged from 48%for medium-impact sports to 90%for low-impact sports,occurring within 43 d(IQR:24 d)to 90 d(IQR:60 d).One or more of the investigated factors influenced the return to each of the 14 activities examined,with R²values ranging from 0.013 to 0.127.CONCLUSION Approximately 80%of patients can RTA,RTW,and RTS within 6 mo after TKA.Return is not consistently in-fluenced by predictive factors.Results help set realistic pre-and postoperative expectations.展开更多
X-ray fluorescence(XRF)sensor-based ore sorting enables efficient beneficiation of heterogeneous ores,while intraparticle heterogeneity can cause significant grade detection errors,leading to misclassifications and hi...X-ray fluorescence(XRF)sensor-based ore sorting enables efficient beneficiation of heterogeneous ores,while intraparticle heterogeneity can cause significant grade detection errors,leading to misclassifications and hindering widespread technology adoption.Accurate classification models are crucial to determine if actual grade exceeds the sorting threshold using localized XRF signals.Previous studies mainly used linear regression(LR)algorithms including simple linear regression(SLR),multivariable linear regression(MLR),and multivariable linear regression with interaction(MLRI)but often fell short attaining satisfactory results.This study employed the particle swarm optimization support vector machine(PSO-SVM)algorithm for sorting porphyritic copper ore pebble.Lab-scale results showed PSO-SVM out-performed LR and raw data(RD)models and the significant interaction effects among input features was observed.Despite poor input data quality,PSO-SVM demonstrated exceptional capabilities.Lab-scale sorting achieved 93.0%accuracy,0.24%grade increase,84.94%recovery rate,57.02%discard rate,and a remarkable 39.62 yuan/t net smelter return(NSR)increase compared to no sorting.These improvements were achieved by the PSO-SVM model with optimized input combinations and highest data quality(T=10,T is XRF testing times).The unsuitability of LR methods for XRF sensor-based sorting of investigated sample is illustrated.Input element selection and mineral association analysis elucidate element importance and influence mechanisms.展开更多
It is important to calculate the reachable domain(RD)of the manned lunar mission to evaluate whether a lunar landing site could be reached by the spacecraft. In this paper, the RD of free return orbits is quickly eval...It is important to calculate the reachable domain(RD)of the manned lunar mission to evaluate whether a lunar landing site could be reached by the spacecraft. In this paper, the RD of free return orbits is quickly evaluated and calculated via the classification and regression neural networks. An efficient databasegeneration method is developed for obtaining eight types of free return orbits and then the RD is defined by the orbit’s inclination and right ascension of ascending node(RAAN) at the perilune. A classify neural network and a regression network are trained respectively. The former is built for classifying the type of the RD, and the latter is built for calculating the inclination and RAAN of the RD. The simulation results show that two neural networks are well trained. The classification model has an accuracy of more than 99% and the mean square error of the regression model is less than 0.01°on the test set. Moreover, a serial strategy is proposed to combine the two surrogate models and a recognition tool is built to evaluate whether a lunar site could be reached. The proposed deep learning method shows the superiority in computation efficiency compared with the traditional double two-body model.展开更多
With the accelerated evolution of the global transformation unseen in a century,the year of 2023 came to an end amid turmoil and uncertainty in the world.The crisis in Ukraine was not resolved,the Palestinian-Israeli ...With the accelerated evolution of the global transformation unseen in a century,the year of 2023 came to an end amid turmoil and uncertainty in the world.The crisis in Ukraine was not resolved,the Palestinian-Israeli conflict resumed,the world economy was in a downturn,and the restructuring of global industrial and supply chains was accelerating.Under the“scar eff ect”of the COVID-19 pandemic,the world entered a new normal of political turmoil and economic mediocrity.The change of the times and the transformation of the international system and order are the root causes of turbulence in the contemporary world.People in the world do not want to go to a“new Cold War”,but it is diffi cult to return to the“old-day cooperation”.With the call for“cool war”and“cold peace”rising,the international order has entered an“era of uncertainty”.展开更多
China has resolved its overall regional poverty in 2020 by attaining moderate societal prosperity.The country has entered a new development stage designed to achieve its second centenary goal.However,ecological fragil...China has resolved its overall regional poverty in 2020 by attaining moderate societal prosperity.The country has entered a new development stage designed to achieve its second centenary goal.However,ecological fragility and risk susceptibility have increased the risk of returning to ecological poverty.In this paper,the Liupan Mountain Region of China was used as a case study,and the counties were used as the scale to reveal the spatiotempora differentiation and influcing factors of the risk of returning to poverty in study area.The indicator data for returning to ecological poverty from 2011-2020 were collected and summarized in three dimensions:ecological,economic and social.The autoregressive integrated moving average model(ARIMA)time series and exponential smoothing method(ES)were used to predict the multidimensional indicators of returning to ecological poverty for 61 counties(districts)in the Liupan Mountain Region for 2021-2030.The back propagation neural network(BPNN)and geographic information system(GIS)were used to generate the spatial distribution and time variation for the index of the risk of returning to ecological poverty(RREP index).The results show that 1)ecological factors were the main factors in the risk of returning to ecological poverty in Liupan Mountain Region.2)The RREP index for the 61 counties(districts)exhibited a downward trend from 2021-2030.The RREP index declined more in medium-and high-risk areas than in low-risk areas.From 2021 to 2025,the RREP index exhibited a slight downward trend.From 2026 to2030,the RREP index was expected to decline faster,especially from 2029-2030.3)Based on the RREP index,it can be roughly divided into three types,namely,the high-risk areas,the medium-risk areas,and the low-risk areas.The natural resource conditions in lowrisk areas of returning to ecological poverty,were better than those in medium-and high-risk areas.展开更多
The European Union’s foreign and security policy has come into being and developed in the process of European integration.It’s influenced by both internal and external factors.After the international financial crisi...The European Union’s foreign and security policy has come into being and developed in the process of European integration.It’s influenced by both internal and external factors.After the international financial crisis in 2008,the return of major country competition coupled with the EU’s internal challenges has pushed the EU to adjust and reform its foreign and security policy.A Global Strategy for EU Foreign and Security Policy,released in 2016,advocates“European strategic autonomy”and reshapes the EU foreign and security policy at the level of concepts,capacity building and operation.In recent years,along with the geopolitical shift in EU power,its foreign and security policy has shown new features such as the orientation to major country competition and the strengthening of EU-US and EU-NATO cooperation.展开更多
The year 2023 marked an important year of change, in which multiple old orders have given way to new arrangements. “The end of the post-Cold War era,” “the beginning of the post-pandemic era,” “the ebb of the era...The year 2023 marked an important year of change, in which multiple old orders have given way to new arrangements. “The end of the post-Cold War era,” “the beginning of the post-pandemic era,” “the ebb of the era of economic globalization,” “the return of the era of geopolitical conflict.”展开更多
BACKGROUND Lateral ankle sprains are the most common traumatic musculoskeletal injuries of the lower extremity,with an incidence rate of 15%-20%.The high incidence and prevalence highlights the economic impact of this...BACKGROUND Lateral ankle sprains are the most common traumatic musculoskeletal injuries of the lower extremity,with an incidence rate of 15%-20%.The high incidence and prevalence highlights the economic impact of this injury.Ankle sprains lead to a high socioeconomic burden due to the combination of the high injury incidence and high medical expenses.Up to 40%of patients who suffer from an ankle sprain develop chronic ankle instability.Chronic instability can lead to prolonged periods of pain,immobility and injury recurrence.Identification of factors that influence return to work(RTW)and return to sports(RTS)after a lateral ankle sprain(LAS)may help seriously reduce healthcare costs.AIM To explore which factors may potentially affect RTW and RTS after sustaining an LAS.METHODS EMBASE and PubMed were systematically searched for relevant studies published until June 2023.Inclusion criteria were as follows:(1)Injury including LAS or chronic ankle instability;(2)Described any form of treatment;(3)Assessment of RTW or RTS;(4)Studies published in English;and(5)Study designs including randomized controlled clinical trials,clinical trials or cohort studies.Exclusion criteria were:(1)Studies involving children(age<16 year);or(2)Patients with concomitant ankle injury besides lateral ankle ligament damage.A quality assessment was performed for each of the included studies using established risk of bias tools.Additionally quality of evidence was assessed using the GRADEpro tool in cases where outcomes were included in the quantitative analysis.A best evidence synthesis was performed in cases of qualitative outcome analysis.For all studied outcomes suitable for quantitative analysis a forest plot was created to calculate the effect on RTW and RTS.RESULTS A total of 8904 patients were included in 21 studies,10 randomized controlled trials,7 retrospective cohort studies and 4 prospective cohort studies.Fifteen studies were eligible for meta-analysis.The overall RTS rate ranged were 80%and 83%in the all treatments pool and surgical treatments pool,respectively.The pooled mean days to RTS ranged from 23-93 d.The overall RTW rate was 89%.The pooled mean time to RTW ranged from 5.8-8.1 d.For patients with chronic ankle instability,higher preoperative motivation was the sole factor significantly and independently(P=0.001)associated with the rate of and time to RTS following ligament repair or reconstruction.Higher body mass index was identified as a significant factor(P=0.04)linked to not resuming sports or returning at a lower level(median 24,range 20-37),compared to those who resumed at the same or higher level(median 23,range 17-38).Patients with a history of psychological illness or brain injury,experienced a delay in their rehabilitation process for sprains with fractures and unspecified sprains.The extent of the delayed rehabilitation was directly proportional to the increased likelihood of experiencing a recurrence of the ankle sprain and the number of ankle-related medical visits.We also observed that 10%of athletes who did return to sport after lateral ankle sprain without fractures described non-ankle-related reasons for not returning.CONCLUSION All treatments yielded comparable results,with each treatment potentially offering unique advantages or benefits.Preoperative motivation may influence rehabilitation after LAS.Grading which factor had a greater impact was not possible due to the lack of comparability among the included patients.展开更多
Introduction: Motorcyclists bear a disproportionate burden of morbidity and mortality from road accidents. In addition, the consequences of these accidents affect the ability of victims to return to work. This study a...Introduction: Motorcyclists bear a disproportionate burden of morbidity and mortality from road accidents. In addition, the consequences of these accidents affect the ability of victims to return to work. This study aimed to determine the prevalence and factors associated with non-return to work among surviving motorcyclists involved in road accidents 12 months after the event. Materials and Methods: It was a cross-sectional study conducted using data from a cohort of motorcyclists involved in accidents and recruited in five hospitals in Benin from July 2019 to January 2020. The dependent variable was non-return to work 12 months after the accident (yes vs no). The independent variables were categorized into two groups: baseline and 12-month follow-up variables. Logistic regression was used to determine the factors associated with non-return to work at 12 months among the participants. Results: Among the 362 participants, 55 (15.19%, 95% CI = 11.84 - 19.29) had not returned to work 12 months after the accident. Risk factors for non-return to work identified were: smoking (aOR = 4.41, 95% CI = 1.44 - 13.56, p = 0.010), hospitalization (aOR = 2.87, 95% CI = 1.14 - 7.24, p Conclusion: The prevalence of non-return to work at 12 months was high among surviving motorcyclists involved in road accidents in Benin. Integrated support for patients based on identified risk factors should effectively improve their return to work.展开更多
基金supported by the National Natural Science Foundation of China(32071968)the Jiangsu Agricultural Science and Technology Innovation Fund,China(CX(22)2015))the Jiangsu Collaborative Innovation Center for Modern Crop Production,China。
文摘Straw return is a promising strategy for managing soil organic carbon(SOC)and improving yield stability.However,the optimal straw return strategy for sustainable crop production in the wheat(Triticum aestivum L.)-cotton(Gossypium hirsutum L.)cropping system remains uncertain.The objective of this study was to quantify the long-term(10 years)impact of carbon(C)input on SOC sequestration,soil aggregation and crop yields in a wheat-cotton cropping system in the Yangtze River Valley,China.Five treatments were arranged with a single-factor randomized design as follows:no straw return(Control),return of wheat straw only(Wt),return of cotton straw only(Ct),return of 50%wheat and 50%cotton straw(Wh-Ch)and return of 100%wheat and 100%cotton straw(Wt-Ct).In comparison to the Control,the SOC content increased by 8.4 to 20.2%under straw return.A significant linear positive correlation between SOC sequestration and C input(1.42-7.19 Mg ha^(−1)yr^(−1))(P<0.05)was detected.The percentages of aggregates of sizes>2 and 1-2 mm at the 0-20 cm soil depth were also significantly elevated under straw return,with the greatest increase of the aggregate stability in the Wt-Ct treatment(28.1%).The average wheat yields increased by 12.4-36.0%and cotton yields increased by 29.4-73.7%,and significantly linear positive correlations were also detected between C input and the yields of wheat and cotton.The average sustainable yield index(SYI)reached a maximum value of 0.69 when the C input was 7.08 Mg ha^(−1)yr^(−1),which was close to the maximum value(SYI of 0.69,C input of 7.19 Mg ha^(−1)yr^(-1))in the Wt-Ct treatment.Overall,the return of both wheat and cotton straw was the best strategy for improving SOC sequestration,soil aggregation,yields and their sustainability in the wheat-cotton rotation system.
基金supported by the National Natural Science Foundation of China(Nos.62075209,62275243,and 61675193)the Beijing Natural Science Foundation(No.Z200006).
文摘Directly modulated 850-nm vertical-cavity surface-emitting lasers(VCSELs)with the advantages of low cost,high modulation speed,good reliability,and low power consumption,are the key sources in the optical interconnects with multimode fibers for the supercomputers,data centers,and machine learning applications[1−3].Typically,non-return-tozero(NRZ)modulation format is used.
基金supported by funding from the International Olympic Committee(IOC)CS received a scholarship made possible through funding by the South African Medical Research Council(SAMRC)through its Division of Research Capacity Development under the SAMRC Clinician Researcher ProgrammeResearch reported in this publication was also supported by the SAMRC under a Self-Initiated Research Grant to MS.
文摘Purpose The aim of the study was to identify factors associated with prolonged time to return to full performance(RTFP)in athletes with recent severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.Methods Prospective cohort study with cross sectional analysis.A total of 84 athletes with confirmed SARS-CoV-2 infection assessed at a coronavirus disease 2019 recovery clinic gave a history of age,sex,type/level of sport,co-morbidities,pre-infection training hours,and 26 acute SARS-CoV-2 symptoms from 3 categories(“nose and throat”,“chest and neck”,and“whole body”/systemic).Data on days to RTFP were obtained by structured interviews.Factors associated with RTFP were demographics,sport participation,history of co-morbidities,pre-infection training history,and acute symptoms(type,number).Outcomes were:(a)days to RTFP(median,interquartile range(IQR))in asymptomatic(n=7)and symptomatic athletes(n=77),and(b)hazard ratios(HRs;95%confidence interval)for symptomatic athletes with vs.without a factor(univariate,multiple models).HR<1 was predictive of higher percentage chance of prolonged RTFP.Significance was p<0.05.Results Days to RTFP were 30 days(IQR:23–40)for asymptomatic and 64 days(IQR:42–91)for symptomatic participants(p>0.05).Factors associated with prolonged RTFP(univariate models)were:females(HR=0.57;p=0.014),endurance athletes(HR=0.41;p<0.0001),co-morbidity number(HR=0.75;p=0.001),and respiratory disease history(HR=0.54;p=0.026).In symptomatic athletes,prolonged RTFP(multiple models)was significantly associated with increased“chest and neck”(HR=0.85;p=0.017)and“nose and throat”(HR=0.84;p=0.013)symptoms,but the association was more profound between prolonged RFTP and increased total number of“all symptoms”(HR=0.91;p=0.001)and“whole body”/systemic(HR=0.82;p=0.007)symptoms.Conclusion A larger number of total symptoms and specifically“whole body”/systemic symptoms during the acute phase of SARS-CoV-2 infection in athletes is associated with prolonged RTFP.
文摘1.Legacy matters The withdrawal of Australia as hosts for the Commonwealth Games in 2026 demonstrates that large international sporting events are more than just sporting mastery,medals,and memories.Money also matters.1 The cost of hosting a major international tournament is eye-wateringly high.Host governments need to show that the billions of dollars of investment deliver a return beyond sporting glory to justify the resources that are spent.
基金supported by the National Key R&D Program of China(2022YFA1304204)National Natural Science Foundation of China(31772579).
文摘Background Sex hormones play important roles in the estrus return of post-weaning sows.Previous studies have demonstrated a complex and bi-directional regulation between sex hormones and gut microbiota.However,the extent to which the gut microbiota affects estrus return of post-weaning sows is largely unknown.Results In this study,we first screened 207 fecal samples from well-phenotyped sows by 16S rRNA gene sequencing and identified significant associations between microbes and estrus return of post-weaning sows.Using metagenomic sequencing data from 85 fecal samples,we identified 37 bacterial species that were significantly associated with estrus return.Normally returning sows were characterized by increased abundances of L.reuteri and P.copri and decreased abundances of B.fragilis,S.suis,and B.pseudolongum.The changes in gut microbial composition significantly altered the functional capacity of steroid hormone biosynthesis in the gut microbiome.The results were confirmed in a validation cohort.Significant changes in sex steroid hormones and related compounds were found between normal and non-return sows via metabolome analysis.An integrated analysis of differential bacterial species,metagenome,and fecal metabolome provided evidence that normal return-associated bacterial species L.reuteri and Prevotella spp.participated in the degradation of pregnenolone,progesterone,and testosterone,thereby promoting estrogen biosynthesis.Furthermore,the microbial metabolites related to sow energy and nutrient supply or metabolic disorders also showed relationships with sow estrus return.Conclusions An integrated analysis of differentially abundant bacterial species,metagenome,and fecal metabolome revealed the involvement of L.reuteri and Prevotella spp.in sow estrus return.These findings provide deep insight into the role of gut microbiota in the estrus return of post-weaning sows and the complex cross-talk between gut microbiota and sex hormones,suggesting that the manipulation of the gut microbiota could be an effective strategy to improve sow estrus return after weaning.
文摘Helping athletes return to sports participation is a primary goal of anterior cruciate ligament(ACL)reconstruction rehabilitation.To facilitate the achievement of this goal,decades of research studies have sought to identify knee impairments that reduce knee function as well as interventions to resolve them.1Yet,over the past 10 years,research pertaining to psychological responses(i.e.,cognitions and emotions)after ACL reconstruction has grown exponentially—a phenomenon that can be visualized by entering the search terms"psychological"and"anterior cruciate ligament reconstruction"into the PubMed search engine.
基金granted by the Faculty of Medicine,Chiang Mai University(Grant No.MC017-65)supported by the National Center for Advancing Translational Sciences,National Institutes of Health,through grant number UL1 TR001860(to WW).
文摘Cardiac arrest poses a significant global public health challenge,manifesting in approximately 550,000 cases annually within the United States.[1]In-hospital cardiac arrest(IHCA)is commonly attributed to airways and respiratory issues.[2]Recommendations emphasize the expertise of responders in airway management.[3]Various options exist,such as chest compression-only cardiopulmonary resuscitation(CPR),bag-mask ventilation(BMV),and advanced airways.The BMV and advanced airways are not deemed equivalent or superior based on previous evidence.[4]Achieving consistency in choosing and timing the optimal airway approach during IHCA is crucial.The current American Heart Association guidelines suggest an advanced airway strategy when endotracheal intubation(ETI)success rates are high,but the optimal time for advanced airway management remains unclear.[5]Wong et al[6]revealed that survival improved by less than 5 min with advanced airway management.According to a subgroup analysis of IHCA patients in emergency departments(EDs),early intubation was associated with a 1.5-fold greater rate of return of spontaneous circulation(ROSC)than in other locations.[7]ED patients’constant monitoring and immediate management,with readily available intubation equipment,enhance early intubation and survival rates.[6]Nonetheless,IHCA patients intubated within the first 15 min had a lower ROSC rate.
基金supported by the research fund of Chungnam National University in 2022。
文摘International guidelines for post-cardiac arrest care recommend using multi-modal strategies to avoid the withdrawal of life-sustaining therapy(WLST)in patients with the potential for neurological recovery.[1]However,a clear methodology for multi-modal approaches has yet to be developed.Neuron-specific enolase(NSE)is currently the only recommended biomarker,and the European Resuscitation Council(ERC)and the European SocietyofIntensiveCareMedicine(ESICM)have proposed a cutoff value of 60μg/L at 48 and/or 72 h after the return of spontaneous circulation(ROSC)as a multimodal prognostic tool for predicting poor neurological outcomes.
文摘We investigate the dynamics of convergent shock compression in solid cylindrical targets irradiated by an ultrafast relativistic laser pulse.Our particle-in-cell simulations and coupled hydrodynamic simulations reveal that the compression process is initiated by both magnetic pressure and surface ablation associated with a strong transient surface return current with density of the order of 10^(17) A/m^(2) and lifetime of 100 fs.The results show that the dominant compression mechanism is governed by the plasma β,i.e.,the ratio of thermal pressure to magnetic pressure.For targets with small radius and low atomic number Z,the magnetic pressure is the dominant shock compression mechanism.According to a scaling law,as the target radius and Z increase,the surface ablation pressure becomes the main mechanism generating convergent shocks.Furthermore,an indirect experimental indication of shocked hydrogen compression is provided by optical shadowgraphy measurements of the evolution of the plasma expansion diameter.The results presented here provide a novel basis for the generation of extremely high pressures exceeding Gbar(100 TPa)to enable the investigation of high-pressure physics using femtosecond J-level laser pulses,offering an alternative to nanosecond kJ-laser pulse-driven and pulsed power Z-pinch compression methods.
文摘Background:Return to play(RTP)in elite rugby is managed using a 6-stage graduated RTP protocol,which can result in clearance to play within 1 week of injury.We aimed to explore how symptom,cognitive,and balance presentation and evolution during concussion screens 2 h(head injury assessment(HIA2)and 48 h(HIA3)after injury were associated with time to RTP)to identify whether a more conservative graduated RTP may be appropriate.Methods:A retrospective cohort study was conducted in 380 concussed rugby players from elite men’s rugby over 3 consecutive seasons.Players were classified as shorter or longer returns,depending on whether RTP occurred within 7 days(allowing them to be considered to play the match 1 week after injury)or longer than 8 days,respectively.Symptom,cognitive,and balance performance during screens was assessed relative to baseline(normal or abnormal)and to the preceding screen(improving or worsening).Associations between sub-test abnormalities and RTP time were explored using odds ratios(OR,longer vs.shorter).Median day absence was compared between players with abnormal or worsening results and those whose results were normal or improving.Results:Abnormal symptom results during screens 2 h and 48 h after concussion were associated with longer return time(HIA2:OR=2.21,95%confidence interval(95%CI):1.39-3.50;HIA3:OR=3.30,95%CI:1.89-5.75).Worsening symptom number or severity from the time of injury to 2 h and 48 h post-injury was associated with longer return(HIA2:OR=2.49,95%CI:1.36-4.58;HIA3:OR=3.34,95%CI:1.10-10.15).Median days absence was greater in players with abnormal symptom results at both HIA2 and HIA3.Cognitive and balance performance were not associated with longer return and did not affect median days absence.Conclusion:Symptom presentation and evolution within 48 h of concussion were associated with longer RTP times.This may guide a more conservative approach to RTP,while still adhering to individualized concussion management principles.
基金supported by National Natural Science Foundation of China General Program (82172179)Mathematics Tianyuan Fund (12126604)Central High-level Hospital Clinical Research Project (2022-PUMCH-B-110)
文摘BACKGROUND:Unsustained return of spontaneous circulation(ROSC)is a critical barrier to survival in cardiac arrest patients.This study examined whether end-tidal carbon dioxide(ETCO_(2))and pulse oximetry photoplethysmogram(POP)parameters can be used to identify unsustained ROSC.METHODS:We conducted a multicenter observational prospective cohort study of consecutive patients with cardiac arrest from 2013 to 2014.Patients’general information,ETCO_(2),and POP parameters were collected and statistically analyzed.RESULTS:The included 105 ROSC episodes(from 80 cardiac arrest patients)comprised 51 sustained ROSC episodes and 54 unsustained ROSC episodes.The 24-hour survival rate was significantly higher in the sustained ROSC group than in the unsustained ROSC group(29.2%vs.9.4%,P<0.05).The logistic regression analysis showed that the difference between after and before ROSC in ETCO_(2)(ΔETCO_(2))and the difference between after and before ROCS in area under the curve of POP(ΔAUCp)were independently associated with sustained ROSC(odds ratio[OR]=0.931,95%confi dence interval[95%CI]0.881-0.984,P=0.011 and OR=0.998,95%CI 0.997-0.999,P<0.001).The area under the receiver operating characteristic curve ofΔETCO_(2),ΔAUCp,and the combination of both to predict unsustained ROSC were 0.752(95%CI 0.660-0.844),0.883(95%CI 0.818-0.948),and 0.902(95%CI 0.842-0.962),respectively.CONCLUSION:Patients with unsustained ROSC have a poor prognosis.The combination ofΔETCO_(2) andΔAUCp showed signifi cant predictive value for unsustained ROSC.
文摘BACKGROUND Besides return to work(RTW)and return to sports(RTS),patients also prefer to return to daily activities(RTA)such as walking,sleeping,grocery shopping,and domestic work following total knee arthroplasty(TKA).However,evidence on the timelines and probability of patients’RTA is sparse.AIM To assess the percentage of patients able to RTA,RTW,and RTS after TKA,as well as the timeframe and influencing factors of this return.METHODS A retrospective cohort study with prospectively collected data was conducted at a medium-sized Dutch orthopedic hospital.Assessments of RTA,RTW,and RTS were performed at 3 mo and/or 6 mo following TKA.Investigated factors en-compassed patient characteristics,surgical characteristics,and preoperative patient-reported outcomes.RESULTS TKA patients[n=2063;66 years old(interquartile range[IQR]:7 years);47%male;28 kg/m2(IQR:4 kg/m2)]showed RTA ranging from 28%for kneeling to 94%for grocery shopping,with 20 d(IQR:27 d)spent for putting on shoes to 74 d(IQR:57 d)for kneeling.RTW rates varied from 62%for medium-impact work to 87%for low-impact work,taking 33 d(IQR:29 d)to 78 d(IQR:55 d).RTS ranged from 48%for medium-impact sports to 90%for low-impact sports,occurring within 43 d(IQR:24 d)to 90 d(IQR:60 d).One or more of the investigated factors influenced the return to each of the 14 activities examined,with R²values ranging from 0.013 to 0.127.CONCLUSION Approximately 80%of patients can RTA,RTW,and RTS within 6 mo after TKA.Return is not consistently in-fluenced by predictive factors.Results help set realistic pre-and postoperative expectations.
基金supported by State Key Laboratory of Mineral Processing (No.BGRIMM-KJSKL-2022-16)China Postdoctoral Science Foundation (No.2021M700387)+1 种基金National Natural Science Foundation of China (No.G2021105015L)Ministry of Science and Technology of the People’s Republic of China (No.2022YFC2904502)。
文摘X-ray fluorescence(XRF)sensor-based ore sorting enables efficient beneficiation of heterogeneous ores,while intraparticle heterogeneity can cause significant grade detection errors,leading to misclassifications and hindering widespread technology adoption.Accurate classification models are crucial to determine if actual grade exceeds the sorting threshold using localized XRF signals.Previous studies mainly used linear regression(LR)algorithms including simple linear regression(SLR),multivariable linear regression(MLR),and multivariable linear regression with interaction(MLRI)but often fell short attaining satisfactory results.This study employed the particle swarm optimization support vector machine(PSO-SVM)algorithm for sorting porphyritic copper ore pebble.Lab-scale results showed PSO-SVM out-performed LR and raw data(RD)models and the significant interaction effects among input features was observed.Despite poor input data quality,PSO-SVM demonstrated exceptional capabilities.Lab-scale sorting achieved 93.0%accuracy,0.24%grade increase,84.94%recovery rate,57.02%discard rate,and a remarkable 39.62 yuan/t net smelter return(NSR)increase compared to no sorting.These improvements were achieved by the PSO-SVM model with optimized input combinations and highest data quality(T=10,T is XRF testing times).The unsuitability of LR methods for XRF sensor-based sorting of investigated sample is illustrated.Input element selection and mineral association analysis elucidate element importance and influence mechanisms.
基金supported by the National Natural Science Foundation of China (12072365)the Natural Science Foundation of Hunan Province of China (2020JJ4657)。
文摘It is important to calculate the reachable domain(RD)of the manned lunar mission to evaluate whether a lunar landing site could be reached by the spacecraft. In this paper, the RD of free return orbits is quickly evaluated and calculated via the classification and regression neural networks. An efficient databasegeneration method is developed for obtaining eight types of free return orbits and then the RD is defined by the orbit’s inclination and right ascension of ascending node(RAAN) at the perilune. A classify neural network and a regression network are trained respectively. The former is built for classifying the type of the RD, and the latter is built for calculating the inclination and RAAN of the RD. The simulation results show that two neural networks are well trained. The classification model has an accuracy of more than 99% and the mean square error of the regression model is less than 0.01°on the test set. Moreover, a serial strategy is proposed to combine the two surrogate models and a recognition tool is built to evaluate whether a lunar site could be reached. The proposed deep learning method shows the superiority in computation efficiency compared with the traditional double two-body model.
文摘With the accelerated evolution of the global transformation unseen in a century,the year of 2023 came to an end amid turmoil and uncertainty in the world.The crisis in Ukraine was not resolved,the Palestinian-Israeli conflict resumed,the world economy was in a downturn,and the restructuring of global industrial and supply chains was accelerating.Under the“scar eff ect”of the COVID-19 pandemic,the world entered a new normal of political turmoil and economic mediocrity.The change of the times and the transformation of the international system and order are the root causes of turbulence in the contemporary world.People in the world do not want to go to a“new Cold War”,but it is diffi cult to return to the“old-day cooperation”.With the call for“cool war”and“cold peace”rising,the international order has entered an“era of uncertainty”.
基金Under the auspices of National Natural Science Foundation of China(No.42071230)。
文摘China has resolved its overall regional poverty in 2020 by attaining moderate societal prosperity.The country has entered a new development stage designed to achieve its second centenary goal.However,ecological fragility and risk susceptibility have increased the risk of returning to ecological poverty.In this paper,the Liupan Mountain Region of China was used as a case study,and the counties were used as the scale to reveal the spatiotempora differentiation and influcing factors of the risk of returning to poverty in study area.The indicator data for returning to ecological poverty from 2011-2020 were collected and summarized in three dimensions:ecological,economic and social.The autoregressive integrated moving average model(ARIMA)time series and exponential smoothing method(ES)were used to predict the multidimensional indicators of returning to ecological poverty for 61 counties(districts)in the Liupan Mountain Region for 2021-2030.The back propagation neural network(BPNN)and geographic information system(GIS)were used to generate the spatial distribution and time variation for the index of the risk of returning to ecological poverty(RREP index).The results show that 1)ecological factors were the main factors in the risk of returning to ecological poverty in Liupan Mountain Region.2)The RREP index for the 61 counties(districts)exhibited a downward trend from 2021-2030.The RREP index declined more in medium-and high-risk areas than in low-risk areas.From 2021 to 2025,the RREP index exhibited a slight downward trend.From 2026 to2030,the RREP index was expected to decline faster,especially from 2029-2030.3)Based on the RREP index,it can be roughly divided into three types,namely,the high-risk areas,the medium-risk areas,and the low-risk areas.The natural resource conditions in lowrisk areas of returning to ecological poverty,were better than those in medium-and high-risk areas.
文摘The European Union’s foreign and security policy has come into being and developed in the process of European integration.It’s influenced by both internal and external factors.After the international financial crisis in 2008,the return of major country competition coupled with the EU’s internal challenges has pushed the EU to adjust and reform its foreign and security policy.A Global Strategy for EU Foreign and Security Policy,released in 2016,advocates“European strategic autonomy”and reshapes the EU foreign and security policy at the level of concepts,capacity building and operation.In recent years,along with the geopolitical shift in EU power,its foreign and security policy has shown new features such as the orientation to major country competition and the strengthening of EU-US and EU-NATO cooperation.
文摘The year 2023 marked an important year of change, in which multiple old orders have given way to new arrangements. “The end of the post-Cold War era,” “the beginning of the post-pandemic era,” “the ebb of the era of economic globalization,” “the return of the era of geopolitical conflict.”
文摘BACKGROUND Lateral ankle sprains are the most common traumatic musculoskeletal injuries of the lower extremity,with an incidence rate of 15%-20%.The high incidence and prevalence highlights the economic impact of this injury.Ankle sprains lead to a high socioeconomic burden due to the combination of the high injury incidence and high medical expenses.Up to 40%of patients who suffer from an ankle sprain develop chronic ankle instability.Chronic instability can lead to prolonged periods of pain,immobility and injury recurrence.Identification of factors that influence return to work(RTW)and return to sports(RTS)after a lateral ankle sprain(LAS)may help seriously reduce healthcare costs.AIM To explore which factors may potentially affect RTW and RTS after sustaining an LAS.METHODS EMBASE and PubMed were systematically searched for relevant studies published until June 2023.Inclusion criteria were as follows:(1)Injury including LAS or chronic ankle instability;(2)Described any form of treatment;(3)Assessment of RTW or RTS;(4)Studies published in English;and(5)Study designs including randomized controlled clinical trials,clinical trials or cohort studies.Exclusion criteria were:(1)Studies involving children(age<16 year);or(2)Patients with concomitant ankle injury besides lateral ankle ligament damage.A quality assessment was performed for each of the included studies using established risk of bias tools.Additionally quality of evidence was assessed using the GRADEpro tool in cases where outcomes were included in the quantitative analysis.A best evidence synthesis was performed in cases of qualitative outcome analysis.For all studied outcomes suitable for quantitative analysis a forest plot was created to calculate the effect on RTW and RTS.RESULTS A total of 8904 patients were included in 21 studies,10 randomized controlled trials,7 retrospective cohort studies and 4 prospective cohort studies.Fifteen studies were eligible for meta-analysis.The overall RTS rate ranged were 80%and 83%in the all treatments pool and surgical treatments pool,respectively.The pooled mean days to RTS ranged from 23-93 d.The overall RTW rate was 89%.The pooled mean time to RTW ranged from 5.8-8.1 d.For patients with chronic ankle instability,higher preoperative motivation was the sole factor significantly and independently(P=0.001)associated with the rate of and time to RTS following ligament repair or reconstruction.Higher body mass index was identified as a significant factor(P=0.04)linked to not resuming sports or returning at a lower level(median 24,range 20-37),compared to those who resumed at the same or higher level(median 23,range 17-38).Patients with a history of psychological illness or brain injury,experienced a delay in their rehabilitation process for sprains with fractures and unspecified sprains.The extent of the delayed rehabilitation was directly proportional to the increased likelihood of experiencing a recurrence of the ankle sprain and the number of ankle-related medical visits.We also observed that 10%of athletes who did return to sport after lateral ankle sprain without fractures described non-ankle-related reasons for not returning.CONCLUSION All treatments yielded comparable results,with each treatment potentially offering unique advantages or benefits.Preoperative motivation may influence rehabilitation after LAS.Grading which factor had a greater impact was not possible due to the lack of comparability among the included patients.
文摘Introduction: Motorcyclists bear a disproportionate burden of morbidity and mortality from road accidents. In addition, the consequences of these accidents affect the ability of victims to return to work. This study aimed to determine the prevalence and factors associated with non-return to work among surviving motorcyclists involved in road accidents 12 months after the event. Materials and Methods: It was a cross-sectional study conducted using data from a cohort of motorcyclists involved in accidents and recruited in five hospitals in Benin from July 2019 to January 2020. The dependent variable was non-return to work 12 months after the accident (yes vs no). The independent variables were categorized into two groups: baseline and 12-month follow-up variables. Logistic regression was used to determine the factors associated with non-return to work at 12 months among the participants. Results: Among the 362 participants, 55 (15.19%, 95% CI = 11.84 - 19.29) had not returned to work 12 months after the accident. Risk factors for non-return to work identified were: smoking (aOR = 4.41, 95% CI = 1.44 - 13.56, p = 0.010), hospitalization (aOR = 2.87, 95% CI = 1.14 - 7.24, p Conclusion: The prevalence of non-return to work at 12 months was high among surviving motorcyclists involved in road accidents in Benin. Integrated support for patients based on identified risk factors should effectively improve their return to work.