ABSTRACT Objective: The optimal target for blood glucose concentration in critically ill patients is unclear. We will perform a systematic review and meta-analysis with aggregated and individual patient data from randomized controlled trials, comparing intensive glucose control with liberal glucose control in critically ill adults. Data sources: MEDLINE®, Embase, the Cochrane Central Register of Clinical Trials, and clinical trials registries (World Health Organization, clinical trials.gov). The authors of eligible trials will be invited to provide individual patient data. Published trial-level data from eligible trials that are not at high risk of bias will be included in an aggregated data meta-analysis if individual patient data are not available. Methods: Inclusion criteria: randomized controlled trials that recruited adult patients, targeting a blood glucose of ≤ 120mg/dL (≤ 6.6mmol/L) compared to a higher blood glucose concentration target using intravenous insulin in both groups. Excluded studies: those with an upper limit blood glucose target in the intervention group of > 120mg/dL (> 6.6mmol/L), or where intensive glucose control was only performed in the intraoperative period, and those where loss to follow-up exceeded 10% by hospital discharge. Primary endpoint: In-hospital mortality during index hospital admission. Secondary endpoints: mortality and survival at other timepoints, duration of invasive mechanical ventilation, vasoactive agents, and renal replacement therapy. A random effect Bayesian meta-analysis and hierarchical Bayesian models for individual patient data will be used. Discussion: This systematic review with aggregate and individual patient data will address the clinical question, ‘what is the best blood glucose target for critically ill patients overall?’ Protocol version 0.4 - 06/26/2023 PROSPERO registration: CRD42021278869

RESUMO Objetivo: Não está claro qual é a meta ideal de concentração de glicose no sangue em pacientes em estado grave. Realizaremos uma revisão sistemática e uma metanálise com dados agregados e de pacientes individuais de estudos controlados e randomizados, comparando o controle intensivo da glicose com o controle liberal da glicose em adultos em estado grave. Fontes de dados: MEDLINE®, Embase, Cochrane Central Register of Clinical Trials e registros de ensaios clínicos (Organização Mundial da Saúde, clinical trials.gov). Os autores dos estudos qualificados serão convidados a fornecer dados individuais de pacientes. Os dados publicados em nível de ensaio qualificado que não apresentem alto risco de viés serão incluídos em uma metanálise de dados agregados se os dados individuais de pacientes não estiverem disponíveis. Métodos: Critérios de inclusão: ensaios clínicos controlados e randomizados que recrutaram pacientes adultos, com meta de glicemia ≤ 120mg/dL (≤ 6,6mmol/L) comparada a uma meta de concentração de glicemia mais alta com insulina intravenosa em ambos os grupos. Estudos excluídos: aqueles com meta de glicemia no limite superior no grupo de intervenção > 120mg/dL (> 6,6mmol/L), ou em que o controle intensivo de glicose foi realizado apenas no período intraoperatório, e aqueles em que a perda de seguimento excedeu 10% até a alta hospitalar. Desfecho primário: Mortalidade intra-hospitalar durante a admissão hospitalar. Desfechos secundários: Mortalidade e sobrevida em outros momentos, duração da ventilação mecânica invasiva, agentes vasoativos e terapia de substituição renal. Utilizaremos metanálise bayesiana de efeito randômico e modelos bayesianos hierárquicos para dados individuais de pacientes. Discussão: Essa revisão sistemática com dados agregados e de pacientes individuais abordará a questão clínica: Qual é a melhor meta de glicose no sangue de pacientes graves em geral? Protocolo versão 0.4 - 26/06/2023 Registro PROSPERO: CRD42021278869

ABSTRACT Objective: Determine the characteristics of ocular trauma in patients diagnosed with traumatic cataract. Methods: A cross-sectional descriptive observational study was carried out with 335 patients diagnosed with traumatic cataract. The variables included age, sex, affected eye, location of trauma occurrence, use of protection in the work environment, type of ocular trauma, associated damage, cataract morphology and area of injury. Results: The average age of the patients was 52.2 ± 14.8 years. A predominance of males was observed (75.5%) and the majority of cases presented blunt ocular trauma (70.4%). The right eye was more affected (64.8%). Regarding the place of occurrence of ocular trauma, 49.9% of cases occurred in the work context, and the majority of patients who experienced open ocular trauma did not use eye protection. The most common associated injuries were increased intraocular pressure, capsule rupture and synechiae, iris dialysis. Regarding the morphology of the cataracts, it was observed that total opacity predominated. Conclusions: This study highlights the importance of preventive strategies, especially in work environments prone to eye injuries. The lack of eye protection in cases of open eye trauma emphasizes the need to raise public awareness about the importance of adequate safety measures. These findings may guide clinical interventions and public health policies to reduce the incidence and sequelae of traumatic cataract.

RESUMEN Objetivo: Determinar las características del trauma ocular en pacientes diagnosticados con catarata traumática. Métodos: Se realizó un estudio observacional descriptivo de corte transversal con 335 pacientes diagnosticados con catarata traumática. Las variables incluyeron edad, sexo, ojo afectado, lugar de ocurrencia del trauma, uso de protección en el entorno laboral, tipo de trauma ocular, daños asociados, morfología de la catarata y zona de lesión. Resultados: La edad promedio de los pacientes fue de 52,2 ± 14,8 años. Se observó un predominio del sexo masculino (75,5 %) y la mayoría de los casos presentaron un trauma ocular cerrado (70,4 %). El ojo derecho fue más afectado (64,8 %). En cuanto al lugar de ocurrencia del traumatismo ocular, el 49,9 % de los casos se produjo en el contexto laboral, y la mayoría de los pacientes que experimentaron un trauma ocular abierto no utilizaban protección ocular. Las lesiones asociadas más comunes fueron el aumento de la presión intraocular, la ruptura de la cápsula y las sinequias, la diálisis del iris. En cuanto a la morfología de las cataratas, se observó que predominaba la opacidad total. Conclusiones: Este estudio subraya la importancia de estrategias preventivas, especialmente en entornos laborales propensos a lesiones oculares. La falta de protección ocular en casos de trauma ocular abierto enfatiza la necesidad de concienciar a la población sobre la importancia de medidas de seguridad adecuadas. Estos hallazgos pueden guiar intervenciones clínicas y políticas de salud pública para reducir la incidencia y las secuelas de la catarata traumática.

Abstract Objective: With the increasing incidence and mortality of laryngeal squamous cell carcinoma worldwide, researchers continue to search for novel prognostic factors and treatment methods for preventing early laryngeal squamous cell carcinoma from becoming advanced laryngeal squamous cell carcinoma. This study aims to determine if tumor budding is an independent risk factor associated with the survival of patients with laryngeal squamous cell carcinoma. Methods: 268 cases of laryngeal squamous cell carcinoma were studied, and tumor budding was analyzed for associations with clinicopathological features and clinical outcomes. Results: Tumor budding was divided into low-grade tumor budding (0-6/0.785mm2) and high-grade tumor budding (≥7/0.785 mm2) based on the results of the receiver operating characteristics curve analysis. Logistic regression analysis showed that smaller tumor cell nests, the low levels of tumor-infiltrating lymphocytes, and higher pathological T staging were the risk factors for high-grade tumor budding (p < 0.05). In the low-grade tumor budding group, there was no statistic difference in survival between patients without tumor budding and those with 1 -6/0.785 mm2 tumor budding. Multivariate survival analysis showed high-grade tumor budding (p < 0.001) was independent prognostic factors for disease-free survival and overall survival in laryngeal squamous cell carcinoma. High-grade tumor budding was also an independent prognostic factor for disease-free survival (p = 0.037) and overall survival (p = 0.009) in T1-2N0 laryngeal squamous cell carcinoma. Conclusions: Smaller tumor cell nests, the low levels of tumor-infiltrating lymphocytes, and higher pathological T staging were closely associated with high-grade tumor budding in laryngeal squamous cell carcinoma. High-grade tumor budding may be an adverse risk factor that affects not only the disease-free survival and overall survival of laryngeal squamous cell carcinoma patients but also the survival of T1-2N0 laryngeal squamous cell carcinoma patients. Level of Evidence: Level 4.

ABSTRACT Objective: To determine corneal aberrometric parameters for the detection of subclinical keratoconus. Methods: An observational, analytical, cross-sectional study was performed including 36 patients with subclinical keratoconus (study group) and 36 students with apparently healthy corneas (control group), who attended the cornea consultation at the Cuban Institute of Ophthalmology Ramón Pando Ferrer, between May 2018 and June 2022. Corneal topography and aberrometry were analyzed with the Pentacam AXL corneal tomographer. Results: The subclinical keratoconus group showed similar values for keratometry, corneal asphericity, pachymetry and total deviation value compared to the normal group. There were statistically significant differences in aberrometric parameters, such as coma at 90° (Z3-1), and root mean square of high-order anterior, posterior and total corneal aberrations in subclinical keratoconus compared to the normal group. The 90° posterior coma presented a higher area under the curve (0.894) within the aberrometries, with a cutoff point of -0.013 μm, with sensitivity of 86.1 % and specificity of 88.9 %. Conclusions: Coma posterior to 90º (aberrometric parameter) presents high sensitivity and specificity for the diagnosis of subclinical keratoconus, using Pentacam AXL tomographic analysis.

RESUMEN Objetivo: Determinar parámetros aberrométricos de la córnea para la detección del queratocono subclínico. Métodos: Se realizó un estudio observacional, analítico de corte transversal que incluyó 36 pacientes con queratocono subclínico (grupo de estudio) y 36 estudiantes con córneas aparentemente sanas (grupo control), que asistieron a la consulta de córnea del Instituto Cubano de Oftalmología Ramón Pando Ferrer, entre mayo de 2018 y junio de 2022. Se analizaron topografía y aberrometría corneal con el tomógrafo corneal Pentacam AXL. Resultados: El grupo queratocono subclínico mostró valores similares para la queratometría, asfericidad corneal, paquimetría y el valor total de desviación en comparación con el grupo normal. Hubo diferencias estadísticamente significativas en los parámetros aberrométricos, como el coma a 90º (Z3 -1), y la raíz cuadrada media de las aberraciones de alto orden, de cara anterior, posterior y total corneal, en queratocono subclínico en comparación con el grupo normal. El coma posterior a 90º presentó un área bajo la curva (0,894) mayor dentro de las aberrometrías, con un punto de corte de -0,013 μm, con sensibilidad del 86,1 % y especificidad del 88,9 %. Conclusiones: El coma posterior a 90º (parámetro aberrométrico) presenta una alta sensibilidad y especificidad para el diagnóstico de queratocono subclínico, mediante el análisis tomográfico Pentacam AXL.

Abstract Objectives: to determine the effects of vitamin B12 supplementation on neuropsychological function and disease progression in middle aged and elderly patients with cognitive impairment. Methods: this was a prospective case-control study. From May 2020 to May 2021, 307 participants clinically diagnosed with cognitive impairment in the Department of Neurology of the First Affiliated Hospital of Chongqing Medical University were enrolled. A total of 115 patients were included in this study. Meanwhile, 115 participants with cognitive impairment were randomly assigned in equal proportions to two groups: vitamin B12 treatment group (n = 58, vitamin B12 500 mg/d intramuscularly for seven days, followed by cobamamide 0.25 mg/d and methylcobalamin 0.50 mg/d) and the control group (n = 57). Demographic characteristics and blood biochemical variables were obtained from all participants. Cognitive performance was measured using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Cognitive performance was measured at baseline and after six months. Results: the vitamin B12 supplementation treatment patients who presented with cognitive impairment showed significant improvement, especially in attention, calculation (p < 0.01) and visual-constructional ability (p < 0.05), in their neuropsychological function compared to their matched group. Conclusion: vitamin B12 supplementation may improve frontal function in patients with cognitive decline. Vitamin B12 levels should be investigated in all patients with cognitive impairment.

Resumen Objetivos: determinar los efectos de la suplementación con vitamina B12 en la función neuropsicológica y la progresión de la enfermedad en pacientes de mediana edad y adultos mayores con deterioro cognitivo. Métodos: se realizó un estudio prospectivo de casos y controles; se estudiaron 307 participantes, desde mayo de 2020 a mayo de 2021, diagnosticados clínicamente con deterioro cognitivo en el Departamento de Neurología, el Primer Hospital Anexado a la Universidad Médica de Chongqing. En el estudio se incluyeron un total de 115 pacientes con deterioro cognitivo que fueron asignados aleatoriamente en proporciones iguales a dos grupos: un grupo de tratamiento con vitamina B12 (n = 58, vitamina B12 500 mg/d intramuscular durante 7 días, seguido de cobamamida 0,25 mg/d y metilcobalamina 0,50 mg/d) y un grupo de control (n = 57). Se obtuvieron las características demográficas y las variables bioquímicas sanguíneas de todos los participantes. El rendimiento cognitivo se midió mediante el miniexamen del estado mental (MMSE) y la evaluación cognitiva de Montreal (Moca) al inicio del estudio y a los 6 meses. Resultados: los pacientes con deterioro cognitivo que recibieron tratamiento de suplementación con vitamina B12 mostraron una mejora significativa, especialmente en la atención, el cálculo (p < 0,01) y la capacidad visuoespacial (p < 0,05), en su función neuropsicológica en comparación con el grupo control. Conclusión: la suplementación con vitamina B12 puede mejorar la función frontal en pacientes con deterioro cognitivo. Los pacientes con deterioro cognitivo deben conocer sus propios niveles de vitamina B12.

SUMMARY: The objective of this study was to evaluate the changes of head and cervical spine posture of skeletal class malocclusion in adolescent with maxillary protraction. Thirty cases of skeletal class malocclusion were randomly selected from the Stomatological Hospital of Shanxi Medical University. High-quality lateral cephalograms were collected including pre- and posttreatment to compare the changes of head and cervical spine posture. Data were processed using SPSS 26.0 statistical software. The paired-t test was used to compare pre- and posttreatment mean angular measurements.A significant difference in the SNA(p<0.001), SNB(p<0.01), and ANB(p<0.001) between T1 and T2 showed an improvement in the sagittal relationships. A significant change was observed in middle cervical spine posture, while upper cervical spine posture variables showed no significant difference after treatment. Skeletal class with maxillary protraction appliance not only led to the improvement of sagittal relationship, but also changed the middle cervical spine posture.

RESUMEN: El objetivo de este estudio fue evaluar los cambios en la postura de la cabeza y la columna cervical debido a la maloclusión clase esquelética en adolescentes con protracción maxilar. Treinta casos de maloclusión de clase esquelética fueron seleccionados al azar del Hospital Estomatológico de la Universidad Médica de Shanxi. Se recogieron cefalogramas laterales de alta calidad, incluidos el tratamiento previo y posterior, para comparar los cambios en la postura de la cabeza y la columna cervical. Los datos se procesaron con el software estadístico SPSS 26.0. Se utilizó la prueba t pareada para comparar las medidas angulares medias antes y después del tratamiento. Una diferencia significativa en SNA (p <0,001), SNB (p <0,01) y ANB (p <0,001) entre T1 y T2 mostró una mejora en las relaciones sagitales. Se observó un cambio significativo en la postura de la columna cervical media, mientras que las variables de postura de la columna cervical superior no mostraron diferencias significativas después del tratamiento. La clase esquelética con aparato de protracción maxilar no solo condujo a la mejora de la relación sagital, sino que también cambió la postura de la columna cervical media.

Resumen Objetivo: Este caso clínico presentó casos con hemoperitoneo espontáneo durante el embarazo. Reporte del caso: El caso 1 presentó dolor abdominal agudo con signos de shock, los casos 2 y 3 se presentaron ambos con signos vitales estables y la disminución repentina de la frecuencia cardíaca fetal. La cesárea se realizó a las 27, 36 + 4 y 34 semanas de gestación, respectivamente. Los sitios de sangrado se encontraron en la superficie del útero o el parametrio. Conclusión: Un control estricto de los signos vitales y una intervención quirúrgica oportuna son fundamentales para mejorar el pronóstico.

Abstract Objectives: This case report presented cases with spontaneous hemoperitoneum during pregnancy. Case report: Case 1 presented with acute abdominal pain with signs of shock. Cases 2 and 3 both presented with stable vital signs and the sudden decline of fetal heart rate. Cesarean section was performed at 27, 36+4, and 34 gestational weeks, respectively. Bleeding sites were founded on the surface of the uterus or the parametrium. The perinatal outcome was stillbirth, live birth, and neonatal severe asphyxia. Conclusion: Careful physical examination, strict monitoring of vital signs, and timely surgical intervention are critical for improving the prognosis.

Abstract Background stewart-treves syndrome (STS) is an angiosarcoma associated with chronic lymphedema. Objectives This article analyses the characteristics of twenty-two patients and proposes active intervention in lymphedema and the early diagnosis of STS. Methods Twenty-two patients with STS were diagnosed at the centre over an 11-year period. Clinical manifestations, a series of conventional analyses, and histopathology were used to study these cases retrospectively. Results The age range of 22 patients with STS was 15 to 78 years. The main clinical manifestations included multiple skin and subcutaneous nodules and scattered red or purplish-red rashes in the lymphoedematous limbs. These patients often showed clinical symptoms such as lymphedema, weakness, emaciation, pain, mass, lymphadenopathy and so on. The positive rates of ultrasonography, MRI and radionuclide imaging were 66.7% (6/9), 92.3% (12/13) and 18.2% (2/11), respectively. The main points regarding active intervention in lymphedema and early diagnosis of STS were summarized. Study limitations Since this was a retrospective study, the main points summarized by the author need to be further quantified in clinical work to guide the diagnosis of this kind of disease more conveniently. In addition, further clinical trials are needed to evaluate the role of lymphedema in the occurrence and development of malignant tumors. Conclusions STS can appear in lymphoedematous tissue many years after lymphedema onset. To avoid delays in the diagnosis and therapy of STS, physicians should actively look for signs or symptoms of malignant lymphedema during the follow-up period and promptly manage patients developing problems.

Abstract Objective To explore whether Cyclic Adenosine Monophosphate (cAMP)-Epac1 signaling is activated in 1-Desamino-8-D-arginine-Vasopressin-induced Endolymphatic Hydrops (DDAVP-induced EH) and to provide new insight for further in-depth study of DDAVP-induced EH. Methods Eighteen healthy, red-eyed guinea pigs (36 ears) weighing 200-350 g were randomly divided into three groups: the control group, which received intraperitoneal injection of sterile saline (same volume as that in the other two groups) for 7 consecutive days; the DDAVP-7d group, which received intraperitoneal injection of 10 mg/mL/kg DDAVP for 7 consecutive days; and the DDAVP-14d group, which received intraperitoneal injection of 10 μg/mL/kg DDAVP for 14 consecutive days. After successful modeling, all animals were sacrificed, and cochlea tissues were collected to detect the mRNA and protein expression of the exchange protein directly activated by cAMP-1 and 2 (Epac1, Epac2), and Repressor Activator Protein-1 (Rap1) by Reverse Transcription (RT)-PCR and western blotting, respectively. Results Compared to the control group, the relative mRNA expression of Epac1, Epac2, Rap1A, and Rap1B in the cochlea tissue of the DDAVP-7d group was significantly higher (p< 0.05), while no significant difference in Rap1 GTPase activating protein (Rap1gap) mRNA expression was found between the two groups. The relative mRNA expression of Epac1, Rap1A, Rap1B, and Rap1gap in the cochlea tissue of the DDAVP-14d group was significantly higher than that of the control group (p< 0.05), while no significant difference in Epac2 mRNA expression was found between the DDAVP-14d and control groups. Comparison between the DDAVP-14d and DDAVP-7d groups showed that the DDAVP-14d group had significantly lower Epac2 and Rap1A (p< 0.05) and higher Rap1gap (p < 0.05) mRNA expression in the cochlea tissue than that of the DDAVP-7d group, while no significant differences in Epac1 and Rap1B mRNA expression were found between the two groups. Western blotting showed that Epac1 protein expression in the cochlea tissue was the highest in the DDAVP-14d group, followed by that in the DDAVP-7d group, and was the lowest in the control group, showing significant differences between groups (p< 0.05); Rap1 protein expression in the cochlea tissue was the highest in the DDAVP-7d group, followed by the DDAVP-14d group, and was the lowest in the control group, showing significant differences between groups (p< 0.05); no significant differences in Epac2 protein expression in the cochlea tissue were found among the three groups. Conclusion DDAVP upregulated Epac1 protein expression in the guinea pig cochlea, leading to activation of the inner ear cAMP-Epac1 signaling pathway. This may be an important mechanism by which DDAVP regulates endolymphatic metabolism to induce EH and affect inner ear function. Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence Level 5.

ABSTRACT Objective: To evaluate corneal densitometry in patients with keratoconus. Methods: A cross-sectional descriptive observational cross-sectional study was performed including 90 patients with keratoconus (study group) and 30 students with apparently healthy corneas (control group), who attended the cornea consultation at the Cuban Institute of Ophthalmology Ramón Pando Ferrer, between May 2018 and June 2019. The right eye of each case was selected. Corneal densitometry was analyzed with the Pentacam AXL corneal tomographer. Results: Densitometry was higher in keratoconus relative to apparently healthy cornea, from 0 to 2 mm, in the anterior, central, and posterior layer, respectively (p < 0.001). Densitometry increased in the 0 to 2 mm in the anterior layer in the moderate group and in the advanced group (p < 0.001), and between 2-6 mm in the central layer, from 10.86 ± 0.54 in the control, in the advanced keratoconus to 12.35 ± 1.16 and in the moderate to 12.16 ± 1.45 (p < 0.001). Densitometry increased in advanced from 27.64 ± 3.81, from 22.77 ± 2.14 in mild, and from 24.04 ± 2.83 in the moderate and 0-2 mm, in the anterior layer. Conclusions: Densitometry is higher in the keratoconic cornea with respect to the apparently healthy cornea, moreover it increases with increasing severity of keratoconus in the central area.

RESUMEN Objetivo: Evaluar la densitometría corneal en pacientes con queratocono. Métodos: Se realizó un estudio observacional descriptivo de corte transversal que incluyó 90 pacientes con queratocono (grupo de estudio) y 30 estudiantes con córneas aparentemente sanas (grupo control), que asistieron a la consulta de córnea del Instituto Cubano de Oftalmología Ramón Pando Ferrer, entre mayo del 2018 y junio del 2019. Se seleccionó el ojo derecho de cada caso. Se analizaron densitometría corneal con el tomógrafo corneal Pentacam AXL. Resultados: La densitometría fue mayor en el queratocono respecto a la córnea aparentemente sana, de 0 a 2 mm, en la capa anterior, central, y posterior, respectivamente (p < 0,001). La densitometría aumentó en los 0 a 2 mm en la capa anterior en el grupo moderado y en el grupo avanzado (p < 0,001), y entre los 2-6 mm en la capa central, de 10,86 ± 0,54 en el control, en el queratocono avanzado a 12,35 ± 1,16 y en el moderado a 12,16 ± 1,45 (p < 0,001). La densitometría aumentó en el avanzado de 27,64 ± 3,81, de 22,77 ± 2,14 en el leve, y de 24,04 ± 2,83 en el moderado y en los 0-2 mm, en la capa anterior. Conclusiones: La densitometría es mayor en la córnea queratocónica respecto a la córnea aparentemente sana, además que se incrementa al aumentar la gravedad del queratocono en el área central.

Abstract Background Migraine underdiagnosis and undertreatment are so widespread, that hence is essential to diagnose migraine sufferers in nonclinical settings. A systematic review of validation studies on migraine diagnostic tools applicable to nonclinical settings can help researchers and practitioners in tool selection decisions. Objective To systematically review and critically assess published validation studies on migraine diagnostic tools for use in nonclinical settings, as well as to describe their diagnostic performance. Methods A multidisciplinary workgroup followed transparent and systematic procedures to collaborate on this work. PubMed, Medline, and Web of Science were searched for studies up to January 17, 2022. The QUADAS-2 was employed to assess methodological quality, and the quality thresholds adopted by the Global Burden Disease study were used to tail signaling questions. Results From 7,214 articles identified, a total of 27 studies examining 19 tools were eligible for inclusion. There has been no high-quality evidence to support any tool for use of migraine diagnosis in nonclinical settings. The diagnostic accuracy of the ID-migraine, structured headache and HARDSHIP questionnaires have been supported by moderate-quality evidence, with sensitivity and specificity above 70%. Of them, the HARDSHIP questionnaire has been the most extensively validated. The remaining 16 tools have provided poor-quality evidence for migraine diagnosis in nonclinical populations. Conclusions Up till now, the HARDSHIP questionnaire is the optimal choice for diagnosing migraine in nonclinical settings, with satisfactory diagnostic accuracy supported by moderate methodological quality. This work reveals the crucial next step, which is further high-quality validation studies in diverse nonclinical population groups.

Resumo Antecedentes O sub-diagnóstico e o subtratamento da enxaqueca são tão difundidos que, portanto, é essencial para diagnosticar os portadores de enxaqueca em ambientes não-clínicos. Uma revisão sistemática dos estudos de validação das ferramentas de diagnóstico da enxaqueca aplicáveis a ambientes não-clínicos pode ajudar os pesquisadores e profissionais nas decisões de seleção de ferramentas. Objetivo Revisar sistematicamente e avaliar criticamente estudos de validação publicados sobre ferramentas de diagnóstico da enxaqueca para uso em ambientes não-clínicos, bem como descrever seu desempenho diagnóstico. Métodos Um grupo de trabalho multidisciplinar seguiu procedimentos transparentes e sistemáticos para colaborar neste trabalho. PubMed, Medline e Web of Science foram pesquisados por estudos até 17 de janeiro de 2022. O QUADAS-2 foi empregado para avaliar a qualidade metodológica, e os limites de qualidade adotados pelo estudo da Global Burden Disease foram usados para responder a questões de sinalização. Resultados De 7.214 artigos identificados, um total de 27 estudos examinando 19 ferramentas foram elegíveis para inclusão. Não houve evidência de alta qualidade para apoiar qualquer ferramenta para o uso de diagnóstico de enxaqueca em ambientes não clínicos. A precisão diagnóstica do ID-Migraine, questionário de dor de cabeça estruturada e questionário HARDSHIP foram apoiados por evidências de qualidade moderada, com sensibilidade e especificidade acima de 70%. Deles, o questionário HARDSHIP foi o mais amplamente validado. As 16 ferramentas restantes forneceram provas de má qualidade para o diagnóstico de enxaqueca em populações não-clínicas. Conclusões Até agora, o questionário HARDSHIP é a escolha ideal para o diagnóstico da enxaqueca em ambientes não-clínicos, com precisão diagnóstica satisfatória apoiada por uma qualidade metodológica moderada. Este trabalho revela o próximo passo crucial, que é a realização de mais estudos de validação de alta qualidade em diversos grupos populacionais não-clínicos.

Abstract Anthocyanin/polyvinyl alcohol/chitosan composite membrane was prepared by solution casting method using chitosan (CS) and polyvinyl alcohol (PVA) as matrix and natural pigment anthocyanin as filler. The structures of the composite films were characterized by Uv-visible reflectance spectrum (UV-VIS), Fourier infrared spectroscopy (FT-IR) and the scanning electron microscopy (SEM). The effects of adding anthocyanins on the physical properties, water resistance, degradation, antibacterial properties and pH responsiveness of the films were investigated. The experimental results showed that the prepared anthocyanin/polyvinyl alcohol/chitosan composite indicator films show color changes from pink to purple to blue and then to yellow-green when the pH value ranges from 2 to 14. The total color difference ΔE value is greater than 12. The antibacterial properties and other properties of the composite film can enhance by adding anthocyanin. The tensile strength of anthocyanin/polyvinyl alcohol/chitosan film is more than 70 MPa, which is larger than that of polyvinyl film and polyvinyl alcohol/chitosanfilm. The film has excellent physical, antibacterial properties and obvious pH response performance, making it ideal for food packaging.

Abstract: Cryptomeria fortunei has been widely planted in many cities in southern China. Eventually some of this material may be utilized for timber, but there are relatively few studies of durability of this resource. There is also some question as to whether Cryptomeria fortunei is a synonym for Cryptomeria japonica or Japanese cedar (Sugi). Evaluating the durability of the Chinese resource will help ensure that the decay resistance of this urban plantation resource is properly categorized. The decay resistance of Cryptomeria fortunei wood was assessed in soil block and agar block tests against Trametes versicolor, Gloeophyllum trabeum and Rhodonia placenta. Hot water and ethanol extractive contents of the heartwood were determined on sections from various distances above ground and then FTIR spectroscopy was used to characterize the wood before and after fungal exposure. Weight losses in sapwood were consistent with the minimal decay resistance of this portion of the wood. Inner and outer heartwood weight losses were more variable suggesting that the heartwood of this species would be considered to be only moderately durable. Extractives were weakly correlated with decay resistance. FTIR results were more variable, although they suggested heavier attack of lignin components by the brown rot fungi. The results suggest that Cryptomeria fortunei would need to be protected from the weather unless supplemental preservative treatments were applied.

RESUMO Introdução O exercício no solo é um evento de alto nível da ginástica feminina chinesa. Manter a força dominante do exercício físico feminino na China tornou-se uma das questões que treinadores, atletas e pesquisadores de ginástica devem discutir ativamente. Uma análise de pesquisa sobre a competição dos atletas nos Jogos Nacionais pode refletir e ilustrar melhor o nível fundamental dos atletas e seu status geral de desenvolvimento. Objetivo Verificar a relação entre as habilidades de exercício do solo feminino e o desempenho na competição. Métodos Foi efetuada a análise e estudo de 65 atletas femininas que participam de exercícios de solo nos Jogos Nacionais. Neste trabalho, o método estatístico no local é utilizado para realizar estatísticas sobre as habilidades e a conclusão dos atletas nos quatro jogos. Foram consultados especialistas em treino de movimento e coreografia. Resultados Discutiu-se o desempenho dos exercícios de piso feminino nos Jogos Nacionais a partir de três aspectos: a dificuldade e a disposição dos movimentos, a pontuação inicial e os pontos de bônus, e a conclusão dos movimentos. Conclusão A maioria dos atletas pode se adaptar às mudanças nas novas regras e dominar muitos movimentos complexos. Isto também obtém uma pontuação mais alta. Entretanto, a coreografia dos movimentos completos dos atletas é relativamente simples e carece de características. O treinamento da força nos membros inferiores deve ser a chave para melhorar a habilidade das atletas no exercício do solo. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

ABSTRACT Introduction Ground exercise is a high-level event of Chinese women's gymnastics. Maintaining the dominant strength of women's floor exercise in China has become one of the issues that coaches, athletes and gymnastics researchers should actively discuss. A research analysis on athletes’ competition in the National Games can better reflect and illustrate the fundamental level of athletes and their overall developmental status. Objective To verify the relationship between women's floor exercise skills and competition performance. Methods The analysis and study of 65 female athletes participating in floor exercises at the National Games was carried out. In this paper, the on-the-spot statistical method is used to perform statistics on the skills and the athletes’ completion in the four games. Movement training and choreography experts were consulted. Results The performance of women's floor drills in the National Games was discussed from three aspects: the difficulty and arrangement of movements, the initial score and bonus points, and the completion of movements. Conclusion Most athletes can adapt to the changes in the new rules and master many complex movements. This also gets them a higher score. However, the choreography of the athletes’ complete movements is relatively simple and lacks features. Strength training in the lower limbs should be the key to improving the athletes’ ability in floor exercise. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMEN Introducción El ejercicio en el suelo es una prueba de alto nivel de la gimnasia femenina china. Mantener la fuerza dominante del ejercicio de suelo femenino en China se ha convertido en una de las cuestiones que entrenadores, atletas e investigadores de la gimnasia deben debatir activamente. Un análisis de la investigación sobre la competición de los atletas en los Juegos Nacionales puede reflejar e ilustrar mejor el nivel fundamental de los atletas y su estado de desarrollo general. Objetivo Verificar la relación entre las habilidades del ejercicio de suelo de las mujeres y el rendimiento en la competición. Métodos Se llevó a cabo el análisis y estudio de 65 atletas femeninas que participaron en ejercicios de suelo en los Juegos Nacionales. En este trabajo se utiliza el método estadístico in situ para realizar estadísticas sobre las habilidades y la realización de los atletas en los cuatro partidos. Se consultó a expertos en formación del movimiento y coreografía. Resultados El rendimiento de los ejercicios de suelo de las mujeres en los Juegos Nacionales se analizó desde tres aspectos: la dificultad y la disposición de los movimientos, la puntuación inicial y los puntos de bonificación, y la finalización de los movimientos. Conclusión La mayoría de los atletas pueden adaptarse a los cambios de las nuevas reglas y dominar muchos movimientos complejos. Esto también obtiene una mayor puntuación. Sin embargo, la coreografía de los movimientos completos de los atletas es relativamente simple y carece de características. El entrenamiento de la fuerza en los miembros inferiores debe ser la clave para mejorar la capacidad de los atletas en el ejercicio de suelo. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.