In severe shoulder dystocia,when in itial maneuvers fail,either episiotomy or fetal manipula tion(Rubin,Woods’screw,or posterior arm release)is recommended.We sought to compare maternal and neonatal outcomes between ...In severe shoulder dystocia,when in itial maneuvers fail,either episiotomy or fetal manipula tion(Rubin,Woods’screw,or posterior arm release)is recommended.We sought to compare maternal and neonatal outcomes between severe shoulder dystocia deliverie s managed with episioto-my versus fetal manipulation.We identified severe shoul-der dystocia deliveries from three d atabases:all shoulder dystocia deliveries(1993-2003and 1994-1997)from two teaching institutions and litig ated cases of shoulder dystocia -associated permanent bra chial plexus palsy from multiple U.S.institutions.Pair -wise comparisonswere made among three groups of deliverie s:those managed by fetal manipulation without episiotomy (fetal manipula-tion -only),those managed by episiotomy withou t fetal manipulation(episiotomy -only),and those managed with both(episiotomy +fetal manipulation).Rates of brachial plexus palsy,neonatal dep ression,and anal sphincter trauma were compared amon g groups usingχ2,with significance at P<.05.Among episiotomy -only,13of 22(59.1%)sustained brachial plexus palsy,co mpared with 20of 57(35.1%)among fetal manipulation -only(P =.05).Twenty -eight of 48(58.3%)-in epi-siotomy +fetal manipulation had bra chial plexus palsy,which did not differ from episiotomy -only(P =.95)but was higher than fetal manipulation -only(P =.02),suggesting that the addition of epis iotomy conferred no benefit in averting neonatal injury.Anal sphincter trauma was significantly more common among episiotomy -only and episiotomy +fetal manipulation,compared with fetal manipulation -only.In severe shoul der dystocia,if fetal manipulation can be performedwithout episiotomy,severe perineal trauma can be averted without incurring greater risk of brachial plexus palsy.展开更多
The Cambrian explosion was coined to describe the geologically sudden appearance of numerous bilaterian body plans(Phyla)around the Ediacaran-Cambrian transition,around 565-520million years ago.Many explanations and c...The Cambrian explosion was coined to describe the geologically sudden appearance of numerous bilaterian body plans(Phyla)around the Ediacaran-Cambrian transition,around 565-520million years ago.Many explanations and conjectures have been postulated in order to explain the pattern and duration of this explosive radiation of many different phyla of early metazoans.Here,we focus on the evolution of a phylum of marine suspension-feeding animals—the brachiopods,as exemplified by the exceptionally preserved taxa from the celebrated Chengjiang Konservat Lagerst(a|¨)tte(Yunnan,China).The abundant soft-bodied preservation at these fossil quarries gives us the only firm insights into what brachiopods looked like and how they functioned and lived when they first appeared on the Earth.Studies of Chengjiang brachiopods demonstrate that the early animals developed a remarkably varied organization of tissues and organs shortly after the onset of Cambrian explosion.In the marine suspension-feeding brachiopods,most importantly the tentaculate feeding structure of early brachiopods is already differentiated into two shapes of lophophore,anteriorly coiled(spiralled)and posteriorly arching tentacle crowns and the unique latter type was previously not documented from fossil and living brachiopods.Also unlike any known Recent brachiopod,all the known Cambrian brachiopods from Chengjiang have an open digestive tract that was disposed either as a Ushaped gut in linguliform and stem group brachiopods,or straight gut with a posterior anus in some calcareous-shelled stocks.Moreover,in contrast toliving lingulids,all the Cambrian brachiopods have an epibenthic lifestyle either cemented by a ventral valve or attached by variable pedicles to establish complex ecological community encompassing primary tierers and variable secondary tierers.It is therefore assumed that brachiopods were the first benthic metazoan that achieved their success in ecological stratification and tiering complexity by late Atdabanian.The setae are also important for the brachiopod suspension-feeding life style,and in the Chengjiang braehiopods they include two types cilia-like and spine-like setae.The mantle canals of different braehiopod species are also distinctly variable in arrangement,mainly disposed in pinnate,baeulate and peripheral conditions.Of these,the peripheral disposition of mantle canals is for the first time proposed here so as to differentiate from the bifurcate condition in recent lingulids in that the former is devoid of posteriorly extending main trunks of sinus,but possesses a diverging dorsal vascula media in dichotomy.展开更多
Continuous estimation of wrist torque from surface electromyography(EMG) signals has been studied by some research institutes. Hysteresis effect is a phenomenon in EMG force relationship. In this work, a path-dependen...Continuous estimation of wrist torque from surface electromyography(EMG) signals has been studied by some research institutes. Hysteresis effect is a phenomenon in EMG force relationship. In this work, a path-dependent model based on hysteresis effect was used for continuously estimating wrist torque from surface EMG signals. The surface EMG signals of the flexor carpi ulnaris(FCU) and extensor carpi radialis(ECR) were collected along with wrist torque of flexion/extension degree-of-freedom. EMG signal of FCU was used to estimate the torque of wrist flexion and EMG signal of ECR to estimate the torque of wrist extension. The existence of hysteresis effect has been proven either during wrist flexion or extension on all subjects.And the estimation performance of path-dependent model is much better than the overall model. Thus, the path-dependent model is suitable to improve the wrist torque's estimation accuracy.展开更多
文摘In severe shoulder dystocia,when in itial maneuvers fail,either episiotomy or fetal manipula tion(Rubin,Woods’screw,or posterior arm release)is recommended.We sought to compare maternal and neonatal outcomes between severe shoulder dystocia deliverie s managed with episioto-my versus fetal manipulation.We identified severe shoul-der dystocia deliveries from three d atabases:all shoulder dystocia deliveries(1993-2003and 1994-1997)from two teaching institutions and litig ated cases of shoulder dystocia -associated permanent bra chial plexus palsy from multiple U.S.institutions.Pair -wise comparisonswere made among three groups of deliverie s:those managed by fetal manipulation without episiotomy (fetal manipula-tion -only),those managed by episiotomy withou t fetal manipulation(episiotomy -only),and those managed with both(episiotomy +fetal manipulation).Rates of brachial plexus palsy,neonatal dep ression,and anal sphincter trauma were compared amon g groups usingχ2,with significance at P<.05.Among episiotomy -only,13of 22(59.1%)sustained brachial plexus palsy,co mpared with 20of 57(35.1%)among fetal manipulation -only(P =.05).Twenty -eight of 48(58.3%)-in epi-siotomy +fetal manipulation had bra chial plexus palsy,which did not differ from episiotomy -only(P =.95)but was higher than fetal manipulation -only(P =.02),suggesting that the addition of epis iotomy conferred no benefit in averting neonatal injury.Anal sphincter trauma was significantly more common among episiotomy -only and episiotomy +fetal manipulation,compared with fetal manipulation -only.In severe shoul der dystocia,if fetal manipulation can be performedwithout episiotomy,severe perineal trauma can be averted without incurring greater risk of brachial plexus palsy.
基金supported by the National Natural Science Foundation of China(4070200541072017+8 种基金40830208)the 973 Project(2013CB835002)111 Project of China(P201102007)Swedish Research Council(VR 2009-43952012-1658 to LEH)ZZF acknowledges grants from the Fok Ying Tung Education Foundationthe China Scholarship Counciland the Ministry of Education of China(FANEDD200936NCET-11-1046)
文摘The Cambrian explosion was coined to describe the geologically sudden appearance of numerous bilaterian body plans(Phyla)around the Ediacaran-Cambrian transition,around 565-520million years ago.Many explanations and conjectures have been postulated in order to explain the pattern and duration of this explosive radiation of many different phyla of early metazoans.Here,we focus on the evolution of a phylum of marine suspension-feeding animals—the brachiopods,as exemplified by the exceptionally preserved taxa from the celebrated Chengjiang Konservat Lagerst(a|¨)tte(Yunnan,China).The abundant soft-bodied preservation at these fossil quarries gives us the only firm insights into what brachiopods looked like and how they functioned and lived when they first appeared on the Earth.Studies of Chengjiang brachiopods demonstrate that the early animals developed a remarkably varied organization of tissues and organs shortly after the onset of Cambrian explosion.In the marine suspension-feeding brachiopods,most importantly the tentaculate feeding structure of early brachiopods is already differentiated into two shapes of lophophore,anteriorly coiled(spiralled)and posteriorly arching tentacle crowns and the unique latter type was previously not documented from fossil and living brachiopods.Also unlike any known Recent brachiopod,all the known Cambrian brachiopods from Chengjiang have an open digestive tract that was disposed either as a Ushaped gut in linguliform and stem group brachiopods,or straight gut with a posterior anus in some calcareous-shelled stocks.Moreover,in contrast toliving lingulids,all the Cambrian brachiopods have an epibenthic lifestyle either cemented by a ventral valve or attached by variable pedicles to establish complex ecological community encompassing primary tierers and variable secondary tierers.It is therefore assumed that brachiopods were the first benthic metazoan that achieved their success in ecological stratification and tiering complexity by late Atdabanian.The setae are also important for the brachiopod suspension-feeding life style,and in the Chengjiang braehiopods they include two types cilia-like and spine-like setae.The mantle canals of different braehiopod species are also distinctly variable in arrangement,mainly disposed in pinnate,baeulate and peripheral conditions.Of these,the peripheral disposition of mantle canals is for the first time proposed here so as to differentiate from the bifurcate condition in recent lingulids in that the former is devoid of posteriorly extending main trunks of sinus,but possesses a diverging dorsal vascula media in dichotomy.
基金National Basic Research Program of Chinagrant number:2011CB013305+1 种基金State Key Laboratory of Robotics and Systemgrant number:SKLRS-2012-ZD-04
文摘Continuous estimation of wrist torque from surface electromyography(EMG) signals has been studied by some research institutes. Hysteresis effect is a phenomenon in EMG force relationship. In this work, a path-dependent model based on hysteresis effect was used for continuously estimating wrist torque from surface EMG signals. The surface EMG signals of the flexor carpi ulnaris(FCU) and extensor carpi radialis(ECR) were collected along with wrist torque of flexion/extension degree-of-freedom. EMG signal of FCU was used to estimate the torque of wrist flexion and EMG signal of ECR to estimate the torque of wrist extension. The existence of hysteresis effect has been proven either during wrist flexion or extension on all subjects.And the estimation performance of path-dependent model is much better than the overall model. Thus, the path-dependent model is suitable to improve the wrist torque's estimation accuracy.
