Evaluation of Quality of Some Rehabilitated Mined Soils within the AngloGold-Ashanti Concession in Ghana

Land degradation caused by surface mining of gold has been extensive in Ghana. In recent years rehabilitation of some degraded lands by re-vegetation has been undertaken. This study provides quantitative data on the quality of some rehabilitated and un-rehabilitated mined soils within the AngloGold-Ashanti gold concession in parts of the semi-deciduous forest zone of Ghana. Soil properties determined included texture, bulk density and aggregate stability, pH, organic carbon, available phosphorus, total nitrogen, cation exchange capacity, exchangeable bases, exchange acidity, Fe, Mn, Ni, Cu, Zn, Cd, and Pb. Aggregate stability as a physical quality indicator revealed that aggregates of the rehabilitated mined soil had become more stable and similar to the control unmined soil due to litter and carbon additions from planted trees. The nutrient levels were very low because of the presence of low activity clays inherent in the native soil. Organic carbon content in the rehabilitated soil had increased above that of the unrehabilitated soil. Variability in soil properties, especially organic carbon and aggregate stability, was minimal in the unmined and rehabilitated soils implying that soils at the two sites were most robust and resistant to crushing and rupture. Quality index of the unmined control soil was 36.5% indicating that the quality of the soil was 63.5% relative to the optimum quality because of inherent poor soil properties. The mined rehabilitated and unrehabilitated soil had index values of 32.5% and 24.4 %, respectively. The marginal difference of 4% in soil quality between the control and rehabilitated soil shows that it is possible to maintain the health of soils with inherent physical and biochemical deficiencies if reclamation regulations are adhered to. In this way, the socio-economic dilemma of exploiting natural resources for the benefit of societies is ameliorated while maintaining an ecosystem balance.

Performance Assessment of the Rehabilitated Mudor Sewage Treatment Plant at James Town Accra-Ghana

The Rehabilitated Mudor sewage treatment plant at James Town was monitored over a period of 4 months (October 2017 to January 2018). This study analyzed the physical, chemical and biological parameters of the raw sewage and the treated effluent from the plant. The result indicates that the total removal efficiencies were 98.8%, 91.2%, 62.8%, 28.6%, 81.7%, 43.6%, 82.5% and 99.6% for BOD, COD, TSS, Nitrate-Nitrogen, Phosphate-Phosphorus, Ammonia-nitrogen, Sulphate and faecal coliform respectively. More than 13 parameters needed to be met according to the Ghana Environmental Protection Agency (EPA) guideline were satisfactorily met whiles ammonia, total suspended solids and phosphate were slightly out of range. From the results obtained, the overall performance of the rehabilitated plant was satisfactory and has seen some improvement with respect to the former recorded performance of the plant. With monitoring operation parameters for waste water plants discharge guidelines becoming stringent over the past years, it could be said that management of the Mudor rehabilitated treatment plant is on the right cause with full scale operation of the plant barely less than a year. Increase in the process steps through rehabilitation resulted in several significant improvements in effluent quality parameters.

A Social Intervention Approach to Rehabilitate the Health Psychology of Leftbehind Children with Psychological Problems in Healthcare Settings

Background:Left-behind children are more inclined to generate psychological problems relative to non-leftbehind children,thus how to rehabilitate their health psychology and promote the psychological health development of this special disadvantaged group in healthcare settings should be paid more attention to.Objective:This paper attempts to present a social intervention approach and explore its impact on the rehabilitation of rural leftbehind children’s psychological problems in healthcare settings.Methods:This study firstly designed a social intervention program based on the health psychology theory and the generation causes of left-behind children’s psychological problems,and then three groups were applied to test the effectiveness of the program with comparison analysis.Results:Compared with the control left-behind children(group 2),the left-behind children in the experimental group 1 had positive changes in learning anxiety,physical symptoms,anxiety about people,loneliness tendency,self-blame tendency,allergy tendency,terror tendency and impulse tendency.And their mental health can be rehabilitated to the level of non-left-behind children in group 3.Conclusion:This study revealed positive effects of specially designed social intervention program on the rehabilitation of left-behind children’s psychological problems in healthcare settings.The results have both theoretical and practical implications.

Attempting to document and rehabilitate Aleppo between 1994 and 2011: the ramifications of pre-conflict built heritage mismanagement and the effects of the scarcity of documentation on options available for post-conflict conservation

This paper examines several aspects of the attempt at rehabilitating Aleppo and the data available about the city prior to the start of the Syrian conflict in 2011.It discusses documentation,rehabilitation and conservation practices in Aleppo,focusing on the operations between 1994 and 2011 that were coordinated by several institutions managed primarily by the Directorate of the Old City of Aleppo(DOCA)and the Gesellschaft fur Technische Zusammenarbeit(GTZ).The analysis considers not only the old city,which is inscribed on the World Heritage List,but also other historic and culturally significant areas in Aleppo.This research primarily uses notes from other scholarly resources,statements by various relevant experts,and the reports and documents produced by the DOCA,the GTZ,and UNESCO to argue that some of the practices during that period were in part responsible for overlooking important aspects and places of the city's built heritage.The paper then explains the ramification of these approaches,which are still perceptible today,on the prospects for any future efforts to safeguard the city's built heritage.

Reasonable grazing may balance the conflict between grassland utilization and soil conservation in the semi-arid hilly areas, China

Soil erosion caused by unsustainable grazing is a major driver of grassland ecosystem degradation in many semi-arid hilly areas in China.Thus,grazing exclusion is considered as an effective method for solving this issue in such areas.However,some ecological and economic problems,such as slow grassland rejuvenation and limited economic conditions,have become obstacles for the sustainable utilization of grassland ecosystem.Accordingly,we hypothesized that the conflict between grassland use and soil conservation may be balanced by a reasonable grazing intensity.In this study,a two-year grazing fence experiment with five grazing intensity gradients was conducted in a typical grassland of the Loess Plateau in China to evaluate the responses of vegetation characteristics and soil and water losses to grazing intensity.The five grazing intensity gradients were 2.2,3.0,4.2,6.7,and 16.7 goats/hm2,which were represented by G1-G5,respectively,and no grazing was used as control.The results showed that a reasonable grazing intensity was conducive to the sustainable utilization of grassland resources.Vegetation biomass under G1-G4 grazing intensity significantly increased by 51.9%,42.1%,36.9%,and 36.7%,respectively,compared with control.In addition,vegetation coverage increased by 19.6%under G1 grazing intensity.Species diversity showed a single peak trend with increasing grazing intensity.The Shannon-Wiener diversity index under G1-G4 grazing intensities significantly increased by 22.8%,22.5%,13.3%,and 8.3%,respectively,compared with control.Furthermore,grazing increased the risk of soil erosion.Compared with control,runoff yields under G1-G5 grazing intensities increased by 1.4,2.6,2.8,4.3,and 3.9 times,respectively,and sediment yields under G1-G5 grazing intensities were 3.0,13.0,20.8,34.3,and 37.7 times greater,respectively,than those under control.This result was mainly attributed to a visible decrease in litter biomass after grazing,which decreased by 50.5%,72.6%,79.0%,80.0%,and 76.9%,respectively,under G1-G5 grazing intensities.By weighing the grassland productivity and soil conservation function,we found that both two aims were achieved at a low grazing intensity of less than 3.5 goats/hm2.Therefore,it is recommended that grassland should be moderately utilized with grazing intensity below 3.5 goats/hm2 in semi-arid hilly areas to achieve the dual goals of ecological and economic benefits.The results provide a scientific basis for grassland utilization and health management in semi-arid hilly areas from the perspective of determining reasonable grazing intensity to maintain both grassland production and soil conservation functions.

Vagus nerve stimulation in cerebral stroke:biological mechanisms,therapeutic modalities,clinical applications,and future directions

Stroke is a major disorder of the central nervous system that poses a serious threat to human life and quality of life.Many stro ke victims are left with long-term neurological dysfunction,which adversely affects the well-being of the individual and the broader socioeconomic impact.Currently,poststroke brain dysfunction is a major and difficult area of treatment.Vagus nerve stimulation is a Food and Drug Administration-approved exploratory treatment option for autis m,refractory depression,epilepsy,and Alzheimer’s disease.It is expected to be a novel therapeutic technique for the treatment of stroke owing to its association with multiple mechanisms such as alte ring neurotransmitters and the plasticity of central neuro ns.In animal models of acute ischemic stroke,vagus nerve stimulation has been shown to reduce infarct size,reduce post-stroke neurological damage,and improve learning and memory capacity in rats with stroke by reducing the inflammatory response,regulating bloodbrain barrier permeability,and promoting angiogenesis and neurogenesis.At present,vagus nerve stimulation includes both invasive and non-invasive vagus nerve stimulation.Clinical studies have found that invasive vagus nerve stimulation combined with rehabilitation therapy is effective in im proving upper limb motor and cognitive abilities in stroke patients.Further clinical studies have shown that non-invasive vagus nerve stimulation,including ear/ce rvical vagus nerve stimulation,can stimulate vagal projections to the central nervous system similarly to invasive vagus nerve stimulation and can have the same effect.In this paper,we first describe the multiple effects of vagus nerve stimulation in stroke,and then discuss in depth its neuroprotective mechanisms in ischemic stroke.We go on to outline the res ults of the current major clinical applications of invasive and non-invasive vagus nerve stimulation.Finally,we provide a more comprehensive evaluation of the advantages and disadvantages of different types of vagus nerve stimulation in the treatment of cerebral ischemia and provide an outlook on the developmental trends.We believe that vagus nerve stimulation,as an effective treatment for stroke,will be widely used in clinical practice to promote the recovery of stroke patients and reduce the incidence of disability.

High-frequency repetitive transcranial magnetic stimulation promotes neural stem cell proliferation after ischemic stroke

Prolife ration of neural stem cells is crucial for promoting neuronal regeneration and repairing cerebral infarction damage.Transcranial magnetic stimulation(TMS)has recently emerged as a tool for inducing endogenous neural stem cell regeneration,but its underlying mechanisms remain unclea r In this study,we found that repetitive TMS effectively promotes the proliferation of oxygen-glucose deprived neural stem cells.Additionally,repetitive TMS reduced the volume of cerebral infa rction in a rat model of ischemic stro ke caused by middle cerebral artery occlusion,im p roved rat cognitive function,and promoted the proliferation of neural stem cells in the ischemic penumbra.RNA-sequencing found that repetitive TMS activated the Wnt signaling pathway in the ischemic penumbra of rats with cerebral ischemia.Furthermore,PCR analysis revealed that repetitive TMS promoted AKT phosphorylation,leading to an increase in mRNA levels of cell cycle-related proteins such as Cdk2 and Cdk4.This effect was also associated with activation of the glycogen synthase kinase 3β/β-catenin signaling pathway,which ultimately promotes the prolife ration of neural stem cells.Subsequently,we validated the effect of repetitive TMS on AKT phosphorylation.We found that repetitive TMS promoted Ca2+influx into neural stem cells by activating the P2 calcium channel/calmodulin pathway,thereby promoting AKT phosphorylation and activating the glycogen synthase kinase 3β/β-catenin pathway.These findings indicate that repetitive TMS can promote the proliferation of endogenous neural stem cells through a Ca2+influx-dependent phosphorylated AKT/glycogen synthase kinase 3β/β-catenin signaling pathway.This study has produced pioneering res ults on the intrinsic mechanism of repetitive TMS to promote neural function recove ry after ischemic stro ke.These results provide a stro ng scientific foundation for the clinical application of repetitive TMS.Moreover,repetitive TMS treatment may not only be an efficient and potential approach to support neurogenesis for further therapeutic applications,but also provide an effective platform for the expansion of neural stem cells.

Report on Cardiovascular Health and Diseases in China 2023:An Updated Summary

Since 1990,China has made considerable progress in resolving the problem of“treatment difficulty”of cardiovascular diseases(CVD).The prevalent unhealthy lifestyle among Chinese residents has exposed a massive proportion of the population to CVD risk factors,and this situation is further worsened due to the accelerated aging population in China.CVD remains one of the greatest threats to the health of Chinese residents.In terms of the proportions of disease mortality among urban and rural residents in China,CVD has persistently ranked first.In 2021,CVD accounted for 48.98%and 47.35%of deaths in rural and urban areas,respectively.Two out of every five deaths can be attributed to CVD.To implement a national policy“focusing on the primary health institute and emphasizing prevention”and truly achieve a shift of CVD prevention and treatment from hospitals to communities,the National Center for Cardiovascular Diseases has organized experts from relevant fields across China to compile the“Report on Cardiovascular Health and Diseases in China”annually since 2005.The 2024 report is established based on representative,published,and high-quality big-data research results from cross-sectional and cohort population epidemiological surveys,randomized controlled clinical trials,large sample registry studies,and typical community prevention and treatment cases,along with data from some projects undertaken by the National Center for Cardiovascular Diseases.These firsthand data not only enrich the content of the current report but also provide a more timely and comprehensive reflection of the status of CVD prevention and treatment in China.

Pathophysiological changes of muscle after ischemic stroke:a secondary consequence of stroke injury

Sufficient clinical evidence suggests that the damage caused by ischemic stroke to the body occurs not only in the acute phase but also during the recovery period,and that the latter has a greater impact on the long-term prognosis of the patient.However,current stroke studies have typically focused only on lesions in the central nervous system,ignoring secondary damage caused by this disease.Such a phenomenon arises from the slow progress of pathophysiological studies examining the central nervous system.Further,the appropriate therapeutic time window and benefits of thrombolytic therapy are still controversial,leading scholars to explore more pragmatic intervention strategies.As treatment measures targeting limb symptoms can greatly improve a patient’s quality of life,they have become a critical intervention strategy.As the most vital component of the limbs,skeletal muscles have become potential points of concern.Despite this,to the best of our knowledge,there are no comprehensive reviews of pathophysiological changes and potential treatments for post-stroke skeletal muscle.The current review seeks to fill a gap in the current understanding of the pathological processes and mechanisms of muscle wasting atrophy,inflammation,neuroregeneration,mitochondrial changes,and nutritional dysregulation in stroke survivors.In addition,the challenges,as well as the optional solutions for individualized rehabilitation programs for stroke patients based on motor function are discussed.

Surgical intervention combined with weight-bearing walking training promotes recovery in patients with chronic spinal cord injury:a randomized controlled study

For patients with chronic spinal cord injury,the co nventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection,pressure sores,osteoporosis,and deep vein thrombosis.Surgery is rarely perfo rmed on spinal co rd injury in the chronic phase,and few treatments have been proven effective in chronic spinal cord injury patients.Development of effective therapies fo r chronic spinal co rd injury patients is needed.We conducted a randomized controlled clinical trial in patients with chronic complete thoracic spinal co rd injury to compare intensive rehabilitation(weight-bearing walking training)alone with surgical intervention plus intensive rehabilitation.This clinical trial was registered at ClinicalTrials.gov(NCT02663310).The goal of surgical intervention was spinal cord detethering,restoration of cerebrospinal fluid flow,and elimination of residual spinal cord compression.We found that surgical intervention plus weight-bearing walking training was associated with a higher incidence of American Spinal Injury Association Impairment Scale improvement,reduced spasticity,and more rapid bowel and bladder functional recovery than weight-bearing walking training alone.Overall,the surgical procedures and intensive rehabilitation were safe.American Spinal Injury Association Impairment Scale improvement was more common in T7-T11 injuries than in T2-T6 injuries.Surgery combined with rehabilitation appears to have a role in treatment of chronic spinal cord injury patients.

Cardiac rehabilitation after cardiac surgery:An important underutilized treatment strategy

Physical inactivity remains in high levels after cardiac surgery,reaching up to 50%.Patients present a significant loss of functional capacity,with prominent muscle weakness after cardiac surgery due to anesthesia,surgical incision,duration of cardiopulmonary bypass,and mechanical ventilation that affects their quality of life.These complications,along with pulmonary complications after surgery,lead to extended intensive care unit(ICU)and hospital length of stay and significant mortality rates.Despite the well-known beneficial effects of cardiac rehabilitation,this treatment strategy still remains broadly underutilized in patients after cardiac surgery.Prehabilitation and ICU early mobilization have been both showed to be valid methods to improve exercise tolerance and muscle strength.Early mobilization should be adjusted to each patient’s functional capacity with progressive exercise training,from passive mobilization to more active range of motion and resistance exercises.Cardiopulmonary exercise testing remains the gold standard for exercise capacity assessment and optimal prescription of aerobic exercise intensity.During the last decade,recent advances in healthcare technology have changed cardiac rehabilitation perspectives,leading to the future of cardiac rehabilitation.By incorporating artificial intelligence,simulation,telemedicine and virtual cardiac rehabilitation,cardiac surgery patients may improve adherence and compliance,targeting to reduced hospital readmissions and decreased healthcare costs.

Treatment of hemolymphangioma by robotic surgery: A case report

BACKGROUND Hemolymphangioma of the jejunum is rare and lacks clinical specificity,and can manifest as gastrointestinal bleeding,abdominal pain,and intestinal obstruction.Computed tomography,magnetic resonance imaging,and other examinations show certain characteristics of the disease,but lack accuracy.Although capsule endoscopy and enteroscopy make up for this deficiency,the diagnosis also still re-quires pathology.CASE SUMMARY A male patient was admitted to the hospital due to abdominal distension and abdominal pain,but a specific diagnosis by computed tomography examination was not obtained.Partial resection of the small intestine was performed by robotic surgery,and postoperative pathological biopsy confirmed the diagnosis of hemo-lymphangioma.No recurrence in the follow-up examination was observed.CONCLUSION Robotic surgery is an effective way to treat hemolymphangioma through minima-lly invasive techniques under the concept of rapid rehabilitation.

Application value research of swallowing treatment device combined with swallowing rehabilitation training in the treatment of swallowing disorders after stroke

BACKGROUND Stroke is a common disabling disease,whether it is ischemic stroke or hemorrhagic stroke,both can result in neuronal damage,leading to various manifestations of neurological dysfunction.AIM To explore of the application value of swallowing treatment device combined with swallowing rehabilitation training in the treatment of swallowing disorders after stroke.METHODS This study selected 86 patients with swallowing disorders after stroke admitted to our rehabilitation department from February 2022 to December 2023 as research subjects.They were divided into a control group(n=43)and an observation group(n=43)according to the treatment.The control group received swallowing rehabilitation training,while the observation group received swallowing treatment device in addition to the training.Both groups underwent continuous intervention for two courses of treatment.RESULTS The total effective rate in the observation group(93.02%)was higher than that in the control group(76.74%)(P=0.035).After intervention,the oral transit time,swallowing response time,pharyngeal transit time,and laryngeal closure time decreased in both groups compared to before intervention.In the observation group,the oral transit time,swallowing response time,and pharyngeal transit time were shorter than those in the control group after intervention.However,the laryngeal closure time after intervention in the observation group was compared with that in the control group(P=0.142).After intervention,average amplitude value and duration of the genioglossus muscle group during empty swallowing and swallowing 5 mL of water are reduced compared to before intervention in both groups.After intervention,the scores of the chin-tuck swallowing exercise and the Standardized Swallowing Assessment are both reduced compared to pre-intervention levels in both groups.However,the observation group scores lower than the control group after intervention.Additionally,the Functional Oral Intake Scale scores of both groups are increased after intervention compared to pre-intervention levels,with the observation group scoring higher than the control group after intervention(P<0.001).The cumulative incidence of complications in the observation group is 9.30%,which is lower than the 27.91%in the control group(P=0.027).CONCLUSION The combination of swallowing therapy equipment with swallowing rehabilitation training can improve the muscle movement level of the genioglossus muscle group,enhance swallowing function,and prevent the occurrence of swallowing-related complications after stroke.

Optimization of nursing interventions for postoperative mental status recovery in patients with cerebral hemorrhage

BACKGROUND Hypertensive cerebral hemorrhage(HCH),the most common chronic diseases,has become a topic of global public health discussions.AIM To investigate the role of rehabilitative nursing interventions in optimizing the postoperative mental status recovery phase and to provide clinical value for future rehabilitation of patients with HCH.METHODS This randomized controlled study included 120 patients with cerebral HCH who were contained to our neurosurgery department between May 2021–May 2023 as the participants.The participants have randomly sampled and grouped into the observation and control groups.The observation group received the rehabilitation nursing model,whereas the control group have given conventional nursing.The conscious state of the patients was assessed at 7,14,21,and 30 d postoperatively.After one month of care,sleep quality,anxiety,and depression were compared between the two groups.Patient and family satisfaction were assessed using a nursing care model.RESULTS The results showed that the state of consciousness scores of the patients in both groups significantly increased(P<0.05)after surgical treatment.From the 14th day onwards,differences in the state of consciousness scores between the two groups of patients began to appear(P<0.05).After one month of care,the sleep quality,anxiety state,and depression state of patients were significantly better in the observation group than in the control group(P<0.05).Satisfaction with nursing care was higher in the observation group than in the control group(P<0.05).CONCLUSION The rehabilitation nursing model has a more complete system compared to conventional nursing,which can effectively improve the postoperative quality of life of patients with cerebral hemorrhage and improve the efficiency of mental state recovery;however,further analysis and research are needed to provide more scientific evidence.

Assistive Robotics for Upper Limb Physical Rehabilitation:A Systematic Review and Future Prospects

Physical assistive robotics are oriented to support and improve functional capacities of people.In physical rehabilitation,robots are indeed useful for functional recovery of affected limb.However,there are still open questions related to technological aspects.This work presents a systematic review of upper limb rehabilitation robotics in order to analyze and establish technological challenges and future directions in this area.A bibliometric analysis was performed for the systematic literature review.Literature from the last six years,conducted between August 2020 and May 2021,was reviewed.The methodology for the literature search and a bibliometric analysis of the metadata are presented.After a preliminary search resulted in 820 articles,a total of 66 articles were included.A concurrency network and bibliographic analysis were provided.And an analysis of occurrences,taxonomy,and rehabilitation robotics reported in the literature is presented.This review aims to provide to the scientific community an overview of the state of the art in assistive robotics for upper limb physical rehabilitation.The literature analysis allows access to a gap of unexplored options to define the technological prospects applied to upper limb physical rehabilitation robotics.

A tendon system to re-center steel moment frames with weak stories

A wide open bottom story of a frame building is often expected by owners for use as a garage or shops.However,this leads to weak stories due to abrupt changes in lateral stiffness and often results in unexpected story collapse as observed in many previous earthquakes.To retrofit frame buildings that have experienced weak story damage,a tendon system is proposed in this study,which consists of a set of swaying columns and tendons.The swaying columns are used to uniformly redistribute the lateral deformation along the height,while the tendons provide extra lateral stiffness and renders the entire structural system a re-centering capability.To avoid unnecessary forces to swaying columns,pin-connections are used at the bottom.Tendons are placed over the entire story to gain large elastic displacements.Parametric analysis reveals that the swaying column,with a stiffness of about 0.9 times that of the weak story,and the tendons attached at the roof,with a stiffness of 0.04 times that of the weak story,can provide the optimal performance with a maximum residual story drift angle of less than 0.5%.Online hybrid tests were carried out,which demonstrated that uniformly distributed story drifts and acceptable residual deformation could be achieved by the proposed tendon system.

Type Synthesis of Self-Alignment Parallel Ankle Rehabilitation Robot with Suitable Passive Degrees of Freedom

The current parallel ankle rehabilitation robot(ARR)suffers from the problem of difficult real-time alignment of the human-robot joint center of rotation,which may lead to secondary injuries to the patient.This study investigates type synthesis of a parallel self-alignment ankle rehabilitation robot(PSAARR)based on the kinematic characteristics of ankle joint rotation center drift from the perspective of introducing"suitable passive degrees of freedom(DOF)"with a suitable number and form.First,the self-alignment principle of parallel ARR was proposed by deriving conditions for transforming a human-robot closed chain(HRCC)formed by an ARR and human body into a kinematic suitable constrained system and introducing conditions of"decoupled"and"less limb".Second,the relationship between the self-alignment principle and actuation wrenches(twists)of PSAARR was analyzed with the velocity Jacobian matrix as a"bridge".Subsequently,the type synthesis conditions of PSAARR were proposed.Third,a PSAARR synthesis method was proposed based on the screw theory and type of PSAARR synthesis conducted.Finally,an HRCC kinematic model was established to verify the self-alignment capability of the PSAARR.In this study,93 types of PSAARR limb structures were synthesized and the self-alignment capability of a human-robot joint axis was verified through kinematic analysis,which provides a theoretical basis for the design of such an ARR.

Configuration and Kinematics of a 3-DOF Generalized Spherical Parallel Mechanism for Ankle Rehabilitation

The kinematic equivalent model of an existing ankle-rehabilitation robot is inconsistent with the anatomical structure of the human ankle,which influences the rehabilitation effect.Therefore,this study equates the human ankle to the UR model and proposes a novel three degrees of freedom(3-DOF)generalized spherical parallel mechanism for ankle rehabilitation.The parallel mechanism has two spherical centers corresponding to the rotation centers of tibiotalar and subtalar joints.Using screw theory,the mobility of the parallel mechanism,which meets the requirements of the human ankle,is analyzed.The inverse kinematics are presented,and singularities are identified based on the Jacobian matrix.The workspaces of the parallel mechanism are obtained through the search method and compared with the motion range of the human ankle,which shows that the parallel mechanism can meet the motion demand of ankle rehabilitation.Additionally,based on the motion-force transmissibility,the performance atlases are plotted in the parameter optimal design space,and the optimum parameter is obtained according to the demands of practical applications.The results show that the parallel mechanism can meet the motion requirements of ankle rehabilitation and has excellent kinematic performance in its rehabilitation range,which provides a theoretical basis for the prototype design and experimental verification.

What aspects do we overlook in the rehabilitation of patients with inflammatory bowel disease?

In this editorial,we comment on the article by Stafie et al.Inflammatory bowel disease(IBD)constitutes a cluster of chronic and progressive inflammatory disorders affecting the digestive system.IBD can impede an individual’s capacity to perform daily activities,hinder work productivity,limit physical capabilities,and negatively impact medical outcomes.Although physical activity and structured exercise programs are becoming increasingly important in many chronic inflammatory diseases,they are not being sufficiently implemented in IBD patients.Effective prevention of future disability and drug dependence in IBD patients requires timely diagnosis and treatment of musculoskeletal problems,including sarcopenia,as well as decreased muscle strength,aerobic capacity,and bone mineral density.To improve treatment outcomes for IBD patients,it is crucial to develop individualized rehabilitation programs tailored to their unique needs.Equally critical is the active participation of pertinent departments in this process.It is imperative to highlight the significance of creating a personalized rehabilitation program with a multidisciplinary approach in IBD management.

Pulmonary rehabilitation protocols in urgent lung transplantation patients

BACKGROUND:Prolonged invasive respiratory support and extracorporeal membrane oxygenation(ECMO)in patients requiring urgent lung transplantation(ULTx)present signifi cant challenges to clinical practice due to severe underlying diseases and complex conditions.The aim of the study was to report the clinical outcomes of patients who received ULTx and followed the perioperative rehabilitation protocol implemented in a lung transplant center.METHODS:A retrospective analysis was conducted in ULTx patients who required preoperative invasive mechanical ventilation(IMV)and ECMO between January 2018 and January 2023.Data were retrieved from electronic medical records at our lung transplant center.RESULTS:Fourteen patients(mean age 57.43±10.97 years;12 males,2 females)underwent ULTx with bridging ECMO and IMV.The mean body mass index was 23.94±3.33 kg/m²,and the mean Acute Physiology and Chronic Health Evaluation(APACHE)II score was 21.50±3.96.The Nutritional Risk Screening 2002(NRS 2002)scores were≥3.ULTx was performed after an 8.5-day waiting period(interquartile interval[IQR]5.0-26.5 d).Following the surgeries,the average lengths of ECMO and IMV were 1.0(IQR 1.0-2.0)d and 5.0(IQR 3.0-7.3)d,respectively.The total length of hospital stay was 60.1±30.8 d,with an average intensive care unit stay of 38.3±22.9 d and post-operative hospitalization stay of 45.8±26.1 d.Two patients died within 30 d after ULTx,with a 30-day survival rate of 85.71%.CONCLUSION:Patients receiving ULTx showed an acceptable short-term survival rate,validating the practicality and safety of the treatment protocols implemented in our center.