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The aim of this research was to investigate the best methodology for disc hernia diagnosis using foot force measurements from the designed platform. Based on the subjective neurological examination that examines muscle weakness on the nerve endings of the skin area on feet and concludes about origins of nerve roots between spine discs, a platform for objective recordings of the aforementioned muscle weakness has been designed. The dataset included 33 patients with pre-diagnosed L4/L5 and L5/S1 disc hernia on the left or the right side, confirmed with the MRI scanning and neurological exam. We have implemented 5 different classifiers that were found to be the most suitable for smaller dataset and investigated the accuracy of classification depending on the normalization method, linearity/non-linearity of the algorithm, and dataset splitting variation (32-1, 31-2, 30-3, 29-4 patients for training and testing, respectively). The classifier is able to distinguish between four different diagnoses L4/L5 on the left side, L4/L5 on the right side, L5/S1 on the left side and L5/S1 on the right side, as well as to recognize healthy subjects (without disc herniation). The results show that non-linear algorithms achieved better accuracy in comparison to tested linear classifiers, suggesting the expected non-linear connection between the foot force values and the level of disc herniation. Two algorithms with highest accuracy turned out to be Decision Tree and Naïve Bayes, depending on the normalization method. The system is also able to record and recognize improvements in muscle weakness after surgical operation and physical therapy.

Internationally, adult asthma medication adherence rates are low. Studies characterizing variations in barriers by country are lacking.

To conduct a scoping review to characterize international variations in barriers to asthma medication adherence among adults.

MEDLINE, EMBASE, Web of Science (WOS), and CINAHL were searched from inception to February 2017. English-language studies employing qualitative methods (eg, focus groups, interviews) were selected to assess adult patient- and/or caregiver-reported barriers to asthma medication adherence. Two investigators independently identified, extracted data, and collected study characteristics, methodologic approach, and barriers. Barriers were mapped using the Theoretical Domains Framework and findings categorized according to participants' country of residence, countries' gross national income, and the presence of universal health care (World Health Organization definitions).

Among 2942 unique abstracts, we reviewed 809 full texts. Among these, we identint for trends.

To compare reproductive and oncologic outcomes of patients diagnosed with early-stage epithelial ovarian carcinoma, borderline ovarian tumors, or nonepithelial ovarian carcinoma according to receipt of fertility-sparing surgery or conventional surgery.

PubMed was searched from January 1, 1995, to May 29, 2020.

Studies were included if they (1) enrolled women of childbearing age diagnosed with ovarian cancer between the ages of 18 years and 50 years, (2) reported on oncologic and/or reproductive outcomes after fertility-sparing surgery for ovarian cancer, and (3) included at least 20 patients.

The initial search identified 995 studies. After duplicates were removed, we abstracted 980 unique citations. Of those screened, 167 publications were identified as potentially relevant, and evaluated for inclusion and exclusion criteria. The final review included 44 studies in epithelial ovarian cancer, 42 in borderline ovarian tumors, and 31 in nonepithelial ovarian carcinoma. check details The narrative synthesis demonstrated that overall survival does not seem to be compromised in patients undergoing fertility-sparing surgery compared with those undergoing conventional surgery, although long-term data are limited. Areas of controversy include safety of fertility-sparing surgery in the setting of high-risk factors (stage IC, grade 3, and clear cell histology), as well as type of surgery (salpingo-oophorectomy vs cystectomy). link2 It seems that although there may be some fertility compromise after surgery, pregnancy and live-birth rates are encouraging.

Fertility-sparing surgery is safe and feasible in women with early-stage low-risk ovarian cancer. Pregnancy outcomes for these patients also seem to be similar to those of the general population.

Fertility-sparing surgery is safe and feasible in women with early-stage low-risk ovarian cancer. Pregnancy outcomes for these patients also seem to be similar to those of the general population.

To demonstrate the importance of planning all the steps of laparoscopic myomectomy, including incision, techniques to reduce blood loss, and suturing.

Step-by-step video demonstration of the technique, with narration in the background. The video was approved by the local institutional review board.

Live surgery at Hospital PIO XII, Institute for Research into Cancer of the Digestive System and American Institute of Telesurgery, Barretos.

We describe a case of a 33-year-old woman with no pregnancy and diagnosed with endometriosis and chronic pelvic pain associated with a 5-cm posterior transmural myoma. link3 We performed a laparoscopic myomectomy, with temporary clipping of the uterine arteries associated with the treatment of endometriosis lesions. Specimen extraction was performed inside a bag [1]. The patient was discharged the next day with no complications. Ten months after the procedure, the patient reported that there was no pain, and that her menses were normal.

The laparoscopic approach remains tleeding, reduced operating time, decrease in hospital length of stay, and fewer complications.Herein, we reported a facile strategy to prepare bimetal-polyphenol complexes coating on carbon nanotube (CNT) as a highly efficient OER catalyst. Tannic acid was used as an organic ligand to simultaneously coordinate with Ni and Fe ions and at the same time wrapped the surface of CNT. The obtained Ni3Fe/TA@CNT catalyst showed superior catalytic activity with a low overpotential of 287 mV to reach the current density of 10 mA cm-2 under a small Tafel slope of 70.24 mV dec-1 and exhibited persistent stability in alkaline environment. Experimental results and density functional theory (DFT) calculations revealed that the electron transfer from CNT to Ni3Fe/TA on the heterointerface modified the local electronic environment of the catalyst at atomic level and decreased the binding energies of adsorbed species, thus greatly accelerating the OER kinetic process and enhancing electrocatalytic activity.Nanofiber-structured hydrogels with robust mechanical properties are promising candidates for the development of multifunctional materials in advanced fields. However, creating such materials that combine the virtues of high elongation, robust strength, and good elasticity remains an enormous challenge. Here, we demonstrate a nature-inspired methodology to fabricate dermis-mimicking network structured electrospun nanofibrous hydrogels with robust mechanical properties by combining the advantages of sustainable plant-based zein and elastic waterborne polyurethane (WPU). The reversible hydrogen bonding and strong covalent bonding between zein and WPU molecules are constructed in the double-network (DN) structured nanofibrous hydrogels (NFHs) with tunable stretchability and strength. The resulting NFHs exhibit the integrated characteristics of a stretch of 683%, a fracture strength of 6.5 MPa, a toughness of 20.7 MJ m-3, and complete recovery from large deformation. This nature-inspired structural design strategy may pave the way for designing mechanically robust nanofibrous hydrogels in structurally adaptive and scalable form.Electrospun poly(vinylidene fluoride) (PVDF) fiber membranes doped with different ionic liquids (ILs) and sharing the same anion were produced and their potential as separator membranes for battery applications was evaluated. Different types of ILs containing the same anion, bis(trifluoromethylsulfonyl)imide [TFSI]-, were used with IL concentrations ranging between 0 and 15 wt% The morphology, microstructure, thermal and electrical properties (ionic conductivity and electrochemical window) of the membranes were evaluated. The presence of ILs in the PVDF polymer matrix influences the fiber diameter and the content of the polar β phase within the polymer, as well as the degree of crystallinity. The thermal stability of the membranes decreases with the incorporation of IL. Impedance spectroscopy tests show a maximum ionic conductivity of 2.8 mS.cm-1 for 15% of 1-ethyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide ([Emim][TFSI]) at room temperature. The electrochemical stability of the samples ranges from 0.0 to 6.0 V. When evaluated as battery separator membranes in C-LiFePO4 half-cells, a maximum discharge capacity of 119 mAh.g-1 at C-rate was obtained for the PVDF membrane with 15% [Emim][TFSI], with a coulombic efficiency close to 100%. The results demonstrate that the produced electrospun membranes are suitable for applications as separators for lithium ion batteries (LIBs).Oral delivery of protein or peptide drugs confronts several barriers, the intestinal epithelium and the mucus barrier on the gastrointestinal tract is deemed to be the toughest obstacles. However, overcoming these two obstacles requires contradictory surface properties of a nanocarrier. In the present work, mesoporous silica nanoparticles (MSNs) were modified with deoxycholic acid (DC) and coated with sulfobetaine 12 (SB12) for the first time to achieve both improved mucus permeation and transepithelial absorption. MSNs modified with stearic acid and coated with dilauroylphosphatidylcholine (DLPC) or Pluronic P123 were also prepared as controls. The SB12 coated DC modified MSN had high drug loading of 22.2%. The zwitterion coating endows the MSN improved mucus penetrating ability. In addition, the carrier also showed remarkable affinity with epithelial cells. The cellular uptake was significantly improved (10-fold for Caco-2 cells and 8-fold for E12 cells). The results also indicated that the DC modified carrier was able to avoid entry into lysosomes. It can increase the absorption of loaded insulin in all intestine segments and showed outstanding hypoglycemic effect in diabetic rats. The results suggest the zwitterion-functionalized MSNs might be a good candidate for oral protein delivery.

Decompressive hemicraniectomy is a life-saving procedure for the treatment of space-occupying middle cerebral artery infarctions (malignant stroke); however, patients may survive severely disabled. Comprehensive data on long-term sequelae outside randomized controlled trials are scarce.

We retrospectively evaluated the survival rates, quality of life, ability to perform activities of daily living, and caregiver burden of 61 patients (aged from 37 to 83) who had previously undergone decompressive hemicraniectomy for malignant stroke between 2012 and 2017.

The mortality rate was higher among patients older than 60 years than among younger patients (71.0 % vs 36.7 %, p = 0.007; odds ratio 4.222, 95 % confidence interval 1.443-12.355). The mean survival time was 37.9 ± 6.0 months for 19 survivors of the younger group and 22.6 ± 5.7 months for 9 survivors of the older group. Among the 28 surviving patients, 22 (78.6 %) were interviewed, and we found that age was a determining factor for functional outcome (Barthel indices of 65.

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