Malaria is generally considered a major public health problem in Somalia. Providing early diagnosis and effective treatment is the key element of malaria control strategies in malaria-endemic countries, including Soma...Malaria is generally considered a major public health problem in Somalia. Providing early diagnosis and effective treatment is the key element of malaria control strategies in malaria-endemic countries, including Somalia. This required to advocate and ensure health worker’s adherence to the national malaria guidelines at all levels of health care service. A well-designed in-service training program may improve the level of health worker’s adherence to national malaria treatment guidelines, although results have been inconsistent. This is an interventional health facility-based pre and post comparative study aimed to assess the effect of an in-service training program on the practice of healthcare workers toward malaria prevention and treatment guidelines, during in pregnancy in health facilities in Jowhar district, Middle Shabelle region of Somalia. The study was implemented in three phases: pre-intervention phase, intervention phase and post-intervention phase. The sample size consisted of (n = 150) health workers who were selected from ten public health facilities using proportional to size sampling;the data collection adopted in this research is composed of a structured interview questionnaire and observational checklist. Data was analyzed through the application of descriptive statistical analysis that includes frequency and percentage and the Chi-square (x<sup>2</sup>) test was used to test the associations among variables using SPSS software version 25. The study showed that the level of health workers’ awareness of the national malaria guidelines in the treatment and prevention of malaria in pregnancy was found to be good before the intervention 89 (59.3%) and this proportion increased to 150 (100%) post-intervention of the training program. A significance difference has been observed between health workers’ awareness and their adherence to the malarial guidelines at pre-test and post-test with a p-value 0.000. The proportion of health workers who attended previous training on national malaria guidelines in the treatment and prevention of malaria in pregnancy increased from 46 (30.7%) at the pre-test to 150 (100%) after the post-test. A significant difference was observed in the training status among different categories of health worker and their adherence to the guidelines during the pre- and post-intervention of the training program, with a p-value of 0.000. The result showed that health workers were adhering to the guidelines at the pre-test 33 (22%), this increased after the post-test to 87 (58%). The knowledge of the need to adhere led to an increase in the adherence rate after the training program intervention. The study reveals that inadequate awareness was most reason for the non-adherence in the majority of the health workers as indicated by 89 (59.3%) at the pre-test and 56 (37.3%) in the post-test. However, difference was not significant between the availability of anti-malaria drugs in the facilities and the health workers’ adherence to the guidelines p-value 0.355 at the pretest and p-value 0.258 at post-test. The study concluded that the in-service training program significantly improved health workers’ knowledge and practice to the national malaria guidelines in the treatment, and prevention of malaria in pregnancy. The researcher recommends that the national malaria control programme (NMCP) of the Federal Ministry of Health should provide continuous regular in-service training to frontline healthcare workers at (facility and Community-based) to upgrade their skills and knowledge towards the malaria guidelines, disseminate job aids to the health facilities and undertake regular monitoring to ensure effective implementation of the national malaria treatment guidelines in the treatment and prevention of malaria in pregnancy in achieving desired proper case-management practices of malaria in pregnancy at all levels of health care service.展开更多
BACKGROUND Orthopaedic surgical education has traditionally depended on the apprenticeship model of“see one,do one,teach one”.However,reduced operative exposure,stricter work-hour regulations,medicolegal constraints...BACKGROUND Orthopaedic surgical education has traditionally depended on the apprenticeship model of“see one,do one,teach one”.However,reduced operative exposure,stricter work-hour regulations,medicolegal constraints,and patient safety concerns have constrained its practicality.Simulation-based training has become a reliable,safe,and cost-efficient alternative.Dry lab techniques,especially virtual and augmented reality,make up 78%of current dry lab research,whereas wet labs still set the standard for anatomical realism.AIM To evaluate the effectiveness,limitations,and future directions of wet and dry lab simulation in orthopaedic training.METHODS A scoping review was carried out across four databases-PubMed,Cochrane Library,Web of Science,and EBSCOhost-up to 2025.Medical Subject Headings included:"Orthopaedic Education","Wet Lab","Dry Lab","Simulation Training","Virtual Reality",and"Surgical Procedure".Eligible studies focused on orthopaedic or spinal surgical education,employed wet or dry lab techniques,and assessed training effectiveness.Exclusion criteria consisted of non-English publications,abstracts only,non-orthopaedic research,and studies unrelated to simulation.Two reviewers independently screened titles,abstracts,and full texts,resolving discrepancies with a third reviewer.RESULTS From 1851 records,101 studies met inclusion:78 on dry labs,7 on wet labs,4 on both.Virtual reality(VR)simulations were most common,with AI increasingly used for feedback and assessment.Cadaveric training remains the gold standard for accuracy and tactile feedback,while dry labs-especially VR-offer scalability,lower cost(40%-60%savings in five studies),and accessibility for novices.Senior residents prefer wet labs for complex tasks;juniors favour dry labs for basics.Challenges include limited transferability data,lack of standard outcome metrics,and ethical concerns about cadaver use and AI assessment.CONCLUSION Wet and dry labs each have unique strengths in orthopaedic training.A hybrid approach combining both,supported by standardised assessments and outcome studies,is most effective.Future efforts should aim for uniform reporting,integrating new technologies,and policy support for hybrid curricula to enhance skills and patient care.展开更多
Conventional surgical teaching techniques face several challenges,highlighting a necessity for ongoing innovation in ophthalmology education to align with the evolving demands of clinical practice.The recent rapid adv...Conventional surgical teaching techniques face several challenges,highlighting a necessity for ongoing innovation in ophthalmology education to align with the evolving demands of clinical practice.The recent rapid advancement of computer technology has enabled the integration of virtual reality(VR)into medical training,thereby revolutionizing ophthalmic surgical education through VRbased educational methods.VR technology offers a safe,risk-free environment for trainees to practice repeatedly,enhancing surgical skills and accelerating the learning curve without compromising patient safety.This research outlines the application of VR technology in ophthalmic surgical skills training,particularly in cataract and vitreoretinal surgery.Including assessing the effectiveness of intraocular surgery training systems,evaluating skills transfer to the operating room,comparing it with wet lab cataract surgery training,and enhancing non-dominant hand training for cataract surgery,among other aspects.Additionally,this paper will identify the limitations of VR technology in ocular surgical skills training,offer improvement strategies,and detail the advantages and prospects,with the objective of guiding subsequent researchers.展开更多
This study aims to understand the in-service training needs,training transfer,and training effectiveness of teachers in local normal universities in China,while also proposing a continuous professional development pla...This study aims to understand the in-service training needs,training transfer,and training effectiveness of teachers in local normal universities in China,while also proposing a continuous professional development plan for teachers.Descriptive research methods were employed,with questionnaires serving as the primary data collection tool.The survey revealed that the educational background of teachers in local normal universities is characterized by an unreasonable distribution of academic qualifications,with a shortage of teachers holding postgraduate and higher degrees.Additionally,the training effectiveness for female teachers was found to be lower than that of male teachers.There is a lack of personalization in training needs,which tends to be more generalized.The transfer effect of training is moderate,and there is a need for further enhancement at the behavioral level of training effectiveness.A continuous professional development plan for teachers has been formulated to improve training effectiveness and promote professional development.展开更多
Objective:The objective of this study is to develop and evaluate a structured clinical rotation-based emergency response training program to enhance nurses’emergency competence,theoretical knowledge,and technical ski...Objective:The objective of this study is to develop and evaluate a structured clinical rotation-based emergency response training program to enhance nurses’emergency competence,theoretical knowledge,and technical skills.Methods:A comprehensive emergency training program was developed,and a randomized controlled trial was implemented from June 2022 to May 2023 at a tertiary general hospital in Chongqing,China.The study involved 214 nurses,with 106 participants in the intervention group receiving a 3-month innovative emergency response competence training and 108 in the control group undergoing conventional training.Postintervention assessments evaluated emergency response capabilities using the Emergency Response Ability Assessment Scale for Nurses in Public Health Emergencies,theoretical knowledge through a self-designed comprehensive theoretical assessment instrument,technical skills using a standardized skill assessment form,and training satisfaction through two distinct feedback instruments.Results:The emergency response ability scores were significantly higher in the intervention group compared to controls(3.99±0.18 vs.2.53±0.25,P<0.05).Theoretical assessment scores showed marked improvement in the intervention group versus the control group(85.31±4.40 vs.52.45±6.19,P<0.05).Technical skill performance was significantly better in the intervention group than that in controls(94.47±1.64 vs.86.39±2.36,P<0.05).Training satisfaction was higher among intervention group nurses compared to controls(4.53±0.23 vs.4.00±0.38,P<0.05),with nursing managers also reporting greater satisfaction with the intervention program versus conventional training(4.57±0.49 vs.3.92±0.79,P<0.05).Conclusion:The clinical rotation-based structured emergency response training program effectively enhances nurses’emergency competencies,theoretical knowledge,and technical skills.These findings provide both theoretical foundations and practical guidelines for developing emergency response and specialized nursing competence training programs.展开更多
软测量技术为工业过程中重要变量及难测变量的预测提供了一个有效的解决办法。然而,由于工业过程的复杂化和高昂的数据获取成本,使得标记数据与未标记数据分布不平衡。此时,构建高性能的软测量模型成为一个挑战。针对这一问题,提出了一...软测量技术为工业过程中重要变量及难测变量的预测提供了一个有效的解决办法。然而,由于工业过程的复杂化和高昂的数据获取成本,使得标记数据与未标记数据分布不平衡。此时,构建高性能的软测量模型成为一个挑战。针对这一问题,提出了一种基于时差的多输出tri-training异构软测量方法。通过构建一种新的tri-training框架,采用多输出的高斯过程回归(multi-output Gaussian process regression,MGPR)、相关向量机(multi-output relevance vector machine,MRVM)、最小二乘支持向量机(multi-output least squares support vector machine,MLSSVM)三种模型作为基线监督回归器,使用标记数据进行训练和迭代;同时,引入时间差分(time difference,TD)改进模型的动态特性,并通过卡尔曼滤波(Kalman filtering,KF)优化模型的参数,提高其预测性能;最后通过模拟污水处理平台(benchmark simulation model 1,BSM1)和实际污水处理厂对该模型进行了验证。结果表明,与传统的软测量建模方法相比,该模型能显著提高数据分布不平衡下软测量模型的自适应性和预测性能。展开更多
In recent years,railway construction in China has developed vigorously.With continuous improvements in the highspeed railway network,the focus is gradually shifting from large-scale construction to large-scale operati...In recent years,railway construction in China has developed vigorously.With continuous improvements in the highspeed railway network,the focus is gradually shifting from large-scale construction to large-scale operations.However,several challenges have emerged within the high-speed railway dispatching and command system,including the heavy workload faced by dispatchers,the difficulty of quantifying subjective expertise,and the need for effective training of professionals.Amid the growing application of artificial intelligence technologies in railway systems,this study leverages Large Language Model(LLM)technology.LLMs bring enhanced intelligence,predictive capabilities,robust memory,and adaptability to diverse real-world scenarios.This study proposes a human-computer interactive intelligent scheduling auxiliary training system built on LLM technology.The system offers capabilities including natural dialogue,knowledge reasoning,and human feedback learning.With broad applicability,the system is suitable for vocational education,guided inquiry,knowledge-based Q&A,and other training scenarios.Validation results demonstrate its effectiveness in auxiliary training,providing substantial support for educators,students,and dispatching personnel in colleges and professional settings.展开更多
Throughout history,cultural norms and stereotypes have discouraged resistance training in women.Today,as awareness and acceptance of resistance training in women has grown,supported by scientific research and advocacy...Throughout history,cultural norms and stereotypes have discouraged resistance training in women.Today,as awareness and acceptance of resistance training in women has grown,supported by scientific research and advocacy,more women are achieving health and performance benefits from resistance training.This narrative review discusses the current scientific literature on sexual dimorphisms,the mechanisms underlying health and performance adaptations of resistance training in women,with implications for program design.In general,the physiological adaptations to resistance training in women are mediated largely by the neuroendocrine and immune systems,similar to in men albeit via some distinct predominant pathways involving sex hormones estrogen,testosterone,growth hormone(GH),and insulin-like growth factor-I(IGF-I).As a result,women may have unique adaptations in terms of muscle hypertrophy,substrate utilization,fatiguability,and recovery.Despite subtle physiological differences,women achieve measurable increases in strength,power and athletic performance via engaging in resistance training programs of sufficient frequency,intensity,and duration.Moreover,beyond performance,resistance training has a favorable impact on women’s health including metabolic health,body composition,bone health,cardiovascular health,mental health,self-esteem,and body image.Resistance training recommendations for men and women are highly similar and goal-dependent,with some specific caveats that need to be addressed in women.As resistance training has become regarded as a key element of programs for achieving performance and health improvements in women,additional research may further our understanding.展开更多
Here we compare the efficacy of anti-obesity drugs alone or combined with exercise training on body weight and exercise capacity of obese patients.Randomized clinical trials that assessed the impact of any anti-obesit...Here we compare the efficacy of anti-obesity drugs alone or combined with exercise training on body weight and exercise capacity of obese patients.Randomized clinical trials that assessed the impact of any anti-obesity drug alone or combined with exercise training on body weight,body fat,fat-free mass and cardiorespiratory fitness in obese patients were retrieved from Pubmed and EMBASE up to May 2024.Risk of bias assessment was performed with RoB 2.0,and the GRADE approach assessed the certainty of evidence(CoE)of each main outcome.We included four publications summing up 202 patients.Two publications used orlistat as an anti-obesity drug treatment,while the other two adopted GLP-1 receptor agonist(liraglutide or tirzepatide)as a pharmacotherapy for weight management.Orlistat combined with exercise was superior to change body weight(mean difference(MD):−2.27 kg;95%CI:−2.86 to−1.69;CoE:very low),fat mass(MD:−2.89;95%CI:−3.87 to−1.91;CoE:very low),fat-free mass(MD:0.56;95%CI:0.40–0.72;CoE:very low),and VO_(2)Peak(MD:2.64;95%CI:2.52–2.76;CoE:very low).GLP-1 receptor agonist drugs combined with exercise had a great effect on body weight(MD:−3.96 kg;95%CI:−5.07 to−2.85;CoE:low),fat mass(MD:−1.76;95%CI:−2.24 to−1.27;CoE:low),fat-free mass(MD:0.50;95%CI:−0.98 to 1.98;CoE:very low)and VO_(2)Peak(MD:2.47;95%CI:1.31–3.63;CoE:very low).The results reported here suggest that exercise training remains an important approach in weight management when combined with pharmacological treatment.展开更多
BACKGROUND Cognitive frailty and depression are prevalent among the elderly,significantly impairing physical and cognitive functions,psychological well-being,and quality of life.Effective interventions are essential t...BACKGROUND Cognitive frailty and depression are prevalent among the elderly,significantly impairing physical and cognitive functions,psychological well-being,and quality of life.Effective interventions are essential to mitigate these adverse effects and enhance overall health outcomes in this population.AIM To evaluate the effects of exercise-cognitive dual-task training on frailty,cognitive function,psychological status,and quality of life in elderly patients with cognitive frailty and depression.METHODS A retrospective study was conducted on 130 patients with cognitive frailty and depression admitted between December 2021 and December 2023.Patients were divided into a control group receiving routine intervention and an observation group undergoing exercise-cognitive dual-task training in addition to routine care.Frailty,cognitive function,balance and gait,psychological status,and quality of life were assessed before and after the intervention.RESULTS After the intervention,the frailty score of the observation group was(5.32±0.69),lower than that of the control group(5.71±0.55).The Montreal cognitive assessment basic scale score in the observation group was(24.06±0.99),higher than the control group(23.43±1.40).The performance oriented mobility assessment score in the observation group was(21.81±1.24),higher than the control group(21.15±1.26).The self-efficacy in the observation group was(28.27±2.66),higher than the control group(30.05±2.66).The anxiety score in the hospital anxiety and depression scale(HADS)for the observation group was(5.86±0.68),lower than the control group(6.21±0.64).The depression score in the HADS for the observation group was(5.67±0.75),lower than the control group(6.27±0.92).Additionally,the scores for each dimension of the 36-item short form survey in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).CONCLUSION Exercise-cognitive dual-task training is beneficial for improving frailty,enhancing cognitive function,and improving psychological status and quality of life in elderly patients with cognitive frailty and depression.展开更多
Impairments on body function,activities of daily living(ADL)and cognition are common after stroke.Eccentric resistance training(ERT)may be implemented to improve them.The primary objectives were to evaluate whether ER...Impairments on body function,activities of daily living(ADL)and cognition are common after stroke.Eccentric resistance training(ERT)may be implemented to improve them.The primary objectives were to evaluate whether ERT improves body function,ADL and cognition after stroke.The secondary objectives were to evaluate whether ERT improves strength,gait,quality of life,and self-perceived health.Seven electronic databases were searched:Cochrane Central Register of Controlled Trials,Cochrane Stroke Group Trials Register,PubMed,Epistemonikos,Embase,SPORTDiscus,and WHO International Clinical Trials Registry Platform.Last search was run in December 2023,including studies since 2012.Selection criteria were studies with stroke participants of both sexes,aged 18 or more,with an intervention based on ERT.Accepted languages were English,Spanish or French.First search was done in pairs.Authors removed duplicate studies and those which did not meet inclusion criteria through title and abstracts.Finally,all authors,independently,screened the final search results and extracted data.Of 68 records identified,15 were eligible and 6 were finally included(with moderate risk of bias),analyzing 159 participants.Body function(4 interventions,n=84),gait(4 interventions,n=115)and strength(3 interventions,n?78)showed significantly better results when ERT was performed.Meta-analysis could not be done because of the few studies and their heterogeneity.This review provided low-moderate quality evidence suggesting that ERT might be effective at improving body function,strength,and gait after stroke.Besides,no harm was documented,and it was well-accepted.展开更多
This study explores the feasibility of electromagnetic acoustic transducers(EMATs)for ultrasonic rail inspection,focusing on bulk wave generation from the rail head and on defect detection at the central part of the r...This study explores the feasibility of electromagnetic acoustic transducers(EMATs)for ultrasonic rail inspection,focusing on bulk wave generation from the rail head and on defect detection at the central part of the rail foot.As a contactless method,EMATs could overcome some known limitations of conventional ultrasonic techniques,but require further validation.Differ-ent campaigns of experimental tests were performed,evaluating,by means of a probability of detection approach,the response of the technique to several artificial semi-elliptical flaws of increasing size and by considering two sensors characterized by different working frequencies.In contact,static tests allowed to assess the basic feasibility of the inspection technique and showed a linear response to defect size,saturating when defect width exceeded the rail web thickness.Dynamic tests allowed to introduce the effects of lift-off on signal responses.During all tests,the higher-frequency sensor outperformed the lower-frequency one.Finally,full-scale bogie tests on an indoor permanent track installation,comprehensive of defec-tive rails,confirmed the higher flaw detection rates of the higher-frequency sensor,with minimal detection failures despite occasional false alarms.EMATs showed encouraging results for in-motion rail inspection:with further technical development and optimization,this technique could enhance ultrasonic rail inspection by diagnostic trains.展开更多
Exercise is a therapeutic approach in cancer treatment,providing several benefits.Moreover,exercise is associated with a reduced risk for developing a range of cancers and for their recurrence,as well as with improvin...Exercise is a therapeutic approach in cancer treatment,providing several benefits.Moreover,exercise is associated with a reduced risk for developing a range of cancers and for their recurrence,as well as with improving survival,even though the underlying mechanisms remain unclear.Preclinical and clinical evidence shows that the acute effects of a single exercise session can suppress the growth of various cancer cell lines in vitro.This suppression is potentially due to altered concentrations of hormones(e.g.,insulin)and cytokines(e.g.,tumor necrosis factor alpha and interleukin 6)after exercise.These factors,known to be involved in tumorigenesis,may explain why exercise is associated with reduced cancer incidence,recurrence,and mortality.However,the effects of short-(<8 weeks)and long-term(≥8 weeks)exercise programs on cancer cells have been reported with mixed results.Although more research is needed,it appears that interventions incorporating both exercise and diet seem to have greater inhibitory effects on cancer cell growth in both apparently healthy subjects as well as in cancer patients.Although speculative,these suppressive effects on cancer cells may be driven by changes in body weight and composition as well as by a reduction in low-grade inflammation often associated with sedentary behavior,low muscle mass,and excess fat mass in cancer patients.Taken together,such interventions could alter the systemic levels of suppressive circulating factors,leading to a less favorable environment for tumorigenesis.While regular exercise and a healthy diet may establish a more cancer-suppressive environment,each acute bout of exercise provides a further“dose”of anticancer medicine.Therefore,integrating regular exercise could potentially play a significant role in cancer management,highlighting the need for future investigations in this promising area of research.展开更多
Purpose:The purpose of this narrative review is to:1)summarize findings from the three Studies of a Targeted Risk Reduction Intervention through Defined Exercise(STRRIDE)randomized trials regarding the differential ef...Purpose:The purpose of this narrative review is to:1)summarize findings from the three Studies of a Targeted Risk Reduction Intervention through Defined Exercise(STRRIDE)randomized trials regarding the differential effects of exercise amount,intensity,and mode on metabolic syndrome(MetS);and 2)compare the STRRIDE findings with other published randomized exercise trials related to changes in MetS.Methods:A literature review was performed to investigate the effects of exercise on composite measures of MetS.PubMed was searched between October 2023 and December 2023.To be included in this review,studies must have employed a randomized study design,whereby exercise amount,intensity,or mode was varied.Results:Findings from the STRRIDE trials and other randomized exercise trials suggest:1)there is a relationship between exercise energy expenditure(ExEE)and improvements in composite measures of MetS;2)there may be an asymptotic effect for ExEE beyond which further improvements in MetS are negligible or counterproductive;3)improvements in composite measures of MetS are closely linked to insulin sensitivity;and 4)without controlling for total ExEE,combined aerobic and resistance training interventions offer the most robust improvements for composite MetS outcomes compared to either mode alone.Conclusion:Additional,large-scale,randomized exercise trials should be designed to investigate the potential asymptotic effect and associated threshold for ExEE,the interaction between exercise intensity and baseline insulin sensitivity,and the independent effects of exercise mode on MetS.展开更多
Standardized residency training programs primarily focus on developing clinical diagnostic and treatment skills,often allocating limited time to research activities.However,enhancing research skills is of paramount im...Standardized residency training programs primarily focus on developing clinical diagnostic and treatment skills,often allocating limited time to research activities.However,enhancing research skills is of paramount importance for residents,as it fosters critical thinking,problem-solving abilities,and a deeper understanding of applying scientific principles to clinical practice.This paper explores the necessity and significance of integrating research training into residency programs,emphasizing its role in cultivating well-rounded physicians capable of advancing medical knowledge.This study proposes a competency-based research training model that encompasses research literacy,study design,biostatistics,and scientific writing.Additionally,online asynchronous training modules,robust mentorship,and balanced time management strategies are recommended to enhance residents’research engagement without compromising clinical training.By implementing these measures,residency programs can improve residents’research capabilities,contributing to both individual professional growth and the broader advancement of medical science.展开更多
Objective:Stress urinary incontinence(SUI)is a common condition among women that severely impairs quality of life.Pelvic floor proprioceptive training(PFPT)has attracted increasing attention for its potential to enhan...Objective:Stress urinary incontinence(SUI)is a common condition among women that severely impairs quality of life.Pelvic floor proprioceptive training(PFPT)has attracted increasing attention for its potential to enhance pelvic floor muscle function and alleviate SUI symptoms.This study aims to observe and compare the clinical efficacy of PFPT combined with electroacupuncture,electrical stimulation,and biofeedback therapy versus conventional therapy consisting of electroacupuncture,electrical stimulation,and biofeedback alone in women with SUI,and to explore the role of PFPT in improving symptom and functional outcomes.Methods:In this randomized controlled trial,72 women with mild to moderate SUI were recruited from the Department of Rehabilitation Medicine at Third Xiangya Hospital,Central South University,between December 2021 and October 2023.Participants were randomly assigned to an experimental group(n=36)or a control group(n=36).Both groups received health education.The control group underwent electroacupuncture combined with electrical stimulation and biofeedback therapy,while the experimental group additionally received PFPT 3 times per week for 4 weeks.The primary outcome was assessed using the International Consultation on Incontinence Questionnaire-Short Form(ICIQ-SF).Secondary outcomes included pelvic floor muscle strength,bladder neck mobility,and balance ability.The ICIQ-SF was reassessed at 1,3,6,and 12 months post-treatment.Results:Both groups showed statistically significant improvements in all parameters after treatment(all P<0.05).However,there were no statistically significant differences between groups in most measures(all P>0.05).The experimental group demonstrated longer singleleg stance duration with eyes closed than the control group(left leg:P=0.026;right leg:P=0.006),with a significant increase from baseline(P<0.001).At 6 months post-treatment,the cure rate in the experimental group was significantly higher than that in the control group(P=0.037).Conclusion:Conventional therapy effectively improves SUI symptoms,but adding PFPT provides notable additional benefits,including enhanced balance ability and sustained midterm cure rates.These findings suggest that PFPT is a valuable adjunct to standard SUI management strategies.展开更多
Purpose We aimed to determine:(a)the chronic effects of interval training(IT)combined with blood flow restriction(BFR)on physiological adaptations(aerobic/anaerobic capacity and muscle responses)and performance enhanc...Purpose We aimed to determine:(a)the chronic effects of interval training(IT)combined with blood flow restriction(BFR)on physiological adaptations(aerobic/anaerobic capacity and muscle responses)and performance enhancement(endurance and sprints),and(b)the influence of participant characteristics and intervention protocols on these effects.Methods Searches were conducted in PubMed,Web of Science(Core Collection),Cochrane Library(Embase,ClinicalTrials.gov,and International Clinical Trials Registry Platform),and Chinese National Knowledge Infrastructure on April 2,with updates on October 17,2024.Pooled effects for each outcome were summarized using Hedge's g(g)through meta-analysis-based random effects models,and subgroup and regression analyses were used to explore moderators.Results A total of 24 studies with 621 participants were included.IT combined with BFR(IT+BFR)significantly improved maximal oxygen uptake(VO2_(max))(g=0.63,I^(2)=63%),mean power during the Wingate 30-s test(g=0.70,I^(2)=47%),muscle strength(g=0.88,I^(2)=64%),muscle endurance(g=0.43,I^(2)=0%),time to fatigue(g=1.26,I^(2)=86%),and maximal aerobic speed(g=0.74,I^(2)=0%)compared to IT alone.Subgroup analysis indicated that participant characteristics including training status,IT intensity,and IT modes significantly moderated VO2_(max)(subgroup differences:p<0.05).Specifically,IT+BFR showed significantly superior improvements in VO2_(max)compared to IT alone in trained individuals(g=0.76)at supra-maximal intensity(g=1.29)and moderate intensity(g=1.08)as well as in walking(g=1.64)and running(g=0.63)modes.Meta-regression analysis showed cuff width(β=0.14)was significantly associated with VO2_(max)change,identifying 8.23 cm as the minimum threshold required for significant improvement.Subgroup analyses regarding muscle strength did not reveal any significant moderators.Conclusion IT+BFR enhances physiological adaptations and optimizes aspects of endurance performance,with moderators including training status,IT protocol(intensity,mode,and type),and cuff width.This intervention addresses various IT-related challenges and provides tailored protocols and benefits for diverse populations.展开更多
This paper reports a case of cerebral stem infarction with quadriplegia and complete dependence on daily life.The course of the disease lasted more than 7 months.Frenchay's improved articulation Disorder Assessmen...This paper reports a case of cerebral stem infarction with quadriplegia and complete dependence on daily life.The course of the disease lasted more than 7 months.Frenchay's improved articulation Disorder Assessment Form has been assessed as severe articulation disorder.The patient has significantly improved his speech function and quality of life after systematic head control training,respiratory function training,articulation motor training,and articulation training.In the course of treatment,emphasis was placed on head postural control training and respiratory function training,and emphasis was placed on the strength and coordination training of articulatory organs,and the results were remarkable.After the patient was discharged from the hospital,the follow-up of basic daily life communication was not limited.展开更多
文摘Malaria is generally considered a major public health problem in Somalia. Providing early diagnosis and effective treatment is the key element of malaria control strategies in malaria-endemic countries, including Somalia. This required to advocate and ensure health worker’s adherence to the national malaria guidelines at all levels of health care service. A well-designed in-service training program may improve the level of health worker’s adherence to national malaria treatment guidelines, although results have been inconsistent. This is an interventional health facility-based pre and post comparative study aimed to assess the effect of an in-service training program on the practice of healthcare workers toward malaria prevention and treatment guidelines, during in pregnancy in health facilities in Jowhar district, Middle Shabelle region of Somalia. The study was implemented in three phases: pre-intervention phase, intervention phase and post-intervention phase. The sample size consisted of (n = 150) health workers who were selected from ten public health facilities using proportional to size sampling;the data collection adopted in this research is composed of a structured interview questionnaire and observational checklist. Data was analyzed through the application of descriptive statistical analysis that includes frequency and percentage and the Chi-square (x<sup>2</sup>) test was used to test the associations among variables using SPSS software version 25. The study showed that the level of health workers’ awareness of the national malaria guidelines in the treatment and prevention of malaria in pregnancy was found to be good before the intervention 89 (59.3%) and this proportion increased to 150 (100%) post-intervention of the training program. A significance difference has been observed between health workers’ awareness and their adherence to the malarial guidelines at pre-test and post-test with a p-value 0.000. The proportion of health workers who attended previous training on national malaria guidelines in the treatment and prevention of malaria in pregnancy increased from 46 (30.7%) at the pre-test to 150 (100%) after the post-test. A significant difference was observed in the training status among different categories of health worker and their adherence to the guidelines during the pre- and post-intervention of the training program, with a p-value of 0.000. The result showed that health workers were adhering to the guidelines at the pre-test 33 (22%), this increased after the post-test to 87 (58%). The knowledge of the need to adhere led to an increase in the adherence rate after the training program intervention. The study reveals that inadequate awareness was most reason for the non-adherence in the majority of the health workers as indicated by 89 (59.3%) at the pre-test and 56 (37.3%) in the post-test. However, difference was not significant between the availability of anti-malaria drugs in the facilities and the health workers’ adherence to the guidelines p-value 0.355 at the pretest and p-value 0.258 at post-test. The study concluded that the in-service training program significantly improved health workers’ knowledge and practice to the national malaria guidelines in the treatment, and prevention of malaria in pregnancy. The researcher recommends that the national malaria control programme (NMCP) of the Federal Ministry of Health should provide continuous regular in-service training to frontline healthcare workers at (facility and Community-based) to upgrade their skills and knowledge towards the malaria guidelines, disseminate job aids to the health facilities and undertake regular monitoring to ensure effective implementation of the national malaria treatment guidelines in the treatment and prevention of malaria in pregnancy in achieving desired proper case-management practices of malaria in pregnancy at all levels of health care service.
文摘BACKGROUND Orthopaedic surgical education has traditionally depended on the apprenticeship model of“see one,do one,teach one”.However,reduced operative exposure,stricter work-hour regulations,medicolegal constraints,and patient safety concerns have constrained its practicality.Simulation-based training has become a reliable,safe,and cost-efficient alternative.Dry lab techniques,especially virtual and augmented reality,make up 78%of current dry lab research,whereas wet labs still set the standard for anatomical realism.AIM To evaluate the effectiveness,limitations,and future directions of wet and dry lab simulation in orthopaedic training.METHODS A scoping review was carried out across four databases-PubMed,Cochrane Library,Web of Science,and EBSCOhost-up to 2025.Medical Subject Headings included:"Orthopaedic Education","Wet Lab","Dry Lab","Simulation Training","Virtual Reality",and"Surgical Procedure".Eligible studies focused on orthopaedic or spinal surgical education,employed wet or dry lab techniques,and assessed training effectiveness.Exclusion criteria consisted of non-English publications,abstracts only,non-orthopaedic research,and studies unrelated to simulation.Two reviewers independently screened titles,abstracts,and full texts,resolving discrepancies with a third reviewer.RESULTS From 1851 records,101 studies met inclusion:78 on dry labs,7 on wet labs,4 on both.Virtual reality(VR)simulations were most common,with AI increasingly used for feedback and assessment.Cadaveric training remains the gold standard for accuracy and tactile feedback,while dry labs-especially VR-offer scalability,lower cost(40%-60%savings in five studies),and accessibility for novices.Senior residents prefer wet labs for complex tasks;juniors favour dry labs for basics.Challenges include limited transferability data,lack of standard outcome metrics,and ethical concerns about cadaver use and AI assessment.CONCLUSION Wet and dry labs each have unique strengths in orthopaedic training.A hybrid approach combining both,supported by standardised assessments and outcome studies,is most effective.Future efforts should aim for uniform reporting,integrating new technologies,and policy support for hybrid curricula to enhance skills and patient care.
基金Supported by the Key Special Project of“Cutting-Edge Biotechnology”in the National Key Research and Development Program of China(No.2024YFC3406200)Sanming Project of Medicine in Shenzhen(No.SZSM202411007)Shenzhen Science and Technology Program(No.JCYJ20240813152704006).
文摘Conventional surgical teaching techniques face several challenges,highlighting a necessity for ongoing innovation in ophthalmology education to align with the evolving demands of clinical practice.The recent rapid advancement of computer technology has enabled the integration of virtual reality(VR)into medical training,thereby revolutionizing ophthalmic surgical education through VRbased educational methods.VR technology offers a safe,risk-free environment for trainees to practice repeatedly,enhancing surgical skills and accelerating the learning curve without compromising patient safety.This research outlines the application of VR technology in ophthalmic surgical skills training,particularly in cataract and vitreoretinal surgery.Including assessing the effectiveness of intraocular surgery training systems,evaluating skills transfer to the operating room,comparing it with wet lab cataract surgery training,and enhancing non-dominant hand training for cataract surgery,among other aspects.Additionally,this paper will identify the limitations of VR technology in ocular surgical skills training,offer improvement strategies,and detail the advantages and prospects,with the objective of guiding subsequent researchers.
文摘This study aims to understand the in-service training needs,training transfer,and training effectiveness of teachers in local normal universities in China,while also proposing a continuous professional development plan for teachers.Descriptive research methods were employed,with questionnaires serving as the primary data collection tool.The survey revealed that the educational background of teachers in local normal universities is characterized by an unreasonable distribution of academic qualifications,with a shortage of teachers holding postgraduate and higher degrees.Additionally,the training effectiveness for female teachers was found to be lower than that of male teachers.There is a lack of personalization in training needs,which tends to be more generalized.The transfer effect of training is moderate,and there is a need for further enhancement at the behavioral level of training effectiveness.A continuous professional development plan for teachers has been formulated to improve training effectiveness and promote professional development.
基金supported by a research grant from the Medical Research Program of Chongqing University Three Gorges Hospital(No.2022YJKYXM-017).
文摘Objective:The objective of this study is to develop and evaluate a structured clinical rotation-based emergency response training program to enhance nurses’emergency competence,theoretical knowledge,and technical skills.Methods:A comprehensive emergency training program was developed,and a randomized controlled trial was implemented from June 2022 to May 2023 at a tertiary general hospital in Chongqing,China.The study involved 214 nurses,with 106 participants in the intervention group receiving a 3-month innovative emergency response competence training and 108 in the control group undergoing conventional training.Postintervention assessments evaluated emergency response capabilities using the Emergency Response Ability Assessment Scale for Nurses in Public Health Emergencies,theoretical knowledge through a self-designed comprehensive theoretical assessment instrument,technical skills using a standardized skill assessment form,and training satisfaction through two distinct feedback instruments.Results:The emergency response ability scores were significantly higher in the intervention group compared to controls(3.99±0.18 vs.2.53±0.25,P<0.05).Theoretical assessment scores showed marked improvement in the intervention group versus the control group(85.31±4.40 vs.52.45±6.19,P<0.05).Technical skill performance was significantly better in the intervention group than that in controls(94.47±1.64 vs.86.39±2.36,P<0.05).Training satisfaction was higher among intervention group nurses compared to controls(4.53±0.23 vs.4.00±0.38,P<0.05),with nursing managers also reporting greater satisfaction with the intervention program versus conventional training(4.57±0.49 vs.3.92±0.79,P<0.05).Conclusion:The clinical rotation-based structured emergency response training program effectively enhances nurses’emergency competencies,theoretical knowledge,and technical skills.These findings provide both theoretical foundations and practical guidelines for developing emergency response and specialized nursing competence training programs.
文摘软测量技术为工业过程中重要变量及难测变量的预测提供了一个有效的解决办法。然而,由于工业过程的复杂化和高昂的数据获取成本,使得标记数据与未标记数据分布不平衡。此时,构建高性能的软测量模型成为一个挑战。针对这一问题,提出了一种基于时差的多输出tri-training异构软测量方法。通过构建一种新的tri-training框架,采用多输出的高斯过程回归(multi-output Gaussian process regression,MGPR)、相关向量机(multi-output relevance vector machine,MRVM)、最小二乘支持向量机(multi-output least squares support vector machine,MLSSVM)三种模型作为基线监督回归器,使用标记数据进行训练和迭代;同时,引入时间差分(time difference,TD)改进模型的动态特性,并通过卡尔曼滤波(Kalman filtering,KF)优化模型的参数,提高其预测性能;最后通过模拟污水处理平台(benchmark simulation model 1,BSM1)和实际污水处理厂对该模型进行了验证。结果表明,与传统的软测量建模方法相比,该模型能显著提高数据分布不平衡下软测量模型的自适应性和预测性能。
基金the Talent Fund of Beijing Jiaotong University(Grant No.2024XKRC055).
文摘In recent years,railway construction in China has developed vigorously.With continuous improvements in the highspeed railway network,the focus is gradually shifting from large-scale construction to large-scale operations.However,several challenges have emerged within the high-speed railway dispatching and command system,including the heavy workload faced by dispatchers,the difficulty of quantifying subjective expertise,and the need for effective training of professionals.Amid the growing application of artificial intelligence technologies in railway systems,this study leverages Large Language Model(LLM)technology.LLMs bring enhanced intelligence,predictive capabilities,robust memory,and adaptability to diverse real-world scenarios.This study proposes a human-computer interactive intelligent scheduling auxiliary training system built on LLM technology.The system offers capabilities including natural dialogue,knowledge reasoning,and human feedback learning.With broad applicability,the system is suitable for vocational education,guided inquiry,knowledge-based Q&A,and other training scenarios.Validation results demonstrate its effectiveness in auxiliary training,providing substantial support for educators,students,and dispatching personnel in colleges and professional settings.
文摘Throughout history,cultural norms and stereotypes have discouraged resistance training in women.Today,as awareness and acceptance of resistance training in women has grown,supported by scientific research and advocacy,more women are achieving health and performance benefits from resistance training.This narrative review discusses the current scientific literature on sexual dimorphisms,the mechanisms underlying health and performance adaptations of resistance training in women,with implications for program design.In general,the physiological adaptations to resistance training in women are mediated largely by the neuroendocrine and immune systems,similar to in men albeit via some distinct predominant pathways involving sex hormones estrogen,testosterone,growth hormone(GH),and insulin-like growth factor-I(IGF-I).As a result,women may have unique adaptations in terms of muscle hypertrophy,substrate utilization,fatiguability,and recovery.Despite subtle physiological differences,women achieve measurable increases in strength,power and athletic performance via engaging in resistance training programs of sufficient frequency,intensity,and duration.Moreover,beyond performance,resistance training has a favorable impact on women’s health including metabolic health,body composition,bone health,cardiovascular health,mental health,self-esteem,and body image.Resistance training recommendations for men and women are highly similar and goal-dependent,with some specific caveats that need to be addressed in women.As resistance training has become regarded as a key element of programs for achieving performance and health improvements in women,additional research may further our understanding.
基金supported by Brazilian agencies CAPES(Finance Code 001)CNPq through PQ productivity scholarship.
文摘Here we compare the efficacy of anti-obesity drugs alone or combined with exercise training on body weight and exercise capacity of obese patients.Randomized clinical trials that assessed the impact of any anti-obesity drug alone or combined with exercise training on body weight,body fat,fat-free mass and cardiorespiratory fitness in obese patients were retrieved from Pubmed and EMBASE up to May 2024.Risk of bias assessment was performed with RoB 2.0,and the GRADE approach assessed the certainty of evidence(CoE)of each main outcome.We included four publications summing up 202 patients.Two publications used orlistat as an anti-obesity drug treatment,while the other two adopted GLP-1 receptor agonist(liraglutide or tirzepatide)as a pharmacotherapy for weight management.Orlistat combined with exercise was superior to change body weight(mean difference(MD):−2.27 kg;95%CI:−2.86 to−1.69;CoE:very low),fat mass(MD:−2.89;95%CI:−3.87 to−1.91;CoE:very low),fat-free mass(MD:0.56;95%CI:0.40–0.72;CoE:very low),and VO_(2)Peak(MD:2.64;95%CI:2.52–2.76;CoE:very low).GLP-1 receptor agonist drugs combined with exercise had a great effect on body weight(MD:−3.96 kg;95%CI:−5.07 to−2.85;CoE:low),fat mass(MD:−1.76;95%CI:−2.24 to−1.27;CoE:low),fat-free mass(MD:0.50;95%CI:−0.98 to 1.98;CoE:very low)and VO_(2)Peak(MD:2.47;95%CI:1.31–3.63;CoE:very low).The results reported here suggest that exercise training remains an important approach in weight management when combined with pharmacological treatment.
文摘BACKGROUND Cognitive frailty and depression are prevalent among the elderly,significantly impairing physical and cognitive functions,psychological well-being,and quality of life.Effective interventions are essential to mitigate these adverse effects and enhance overall health outcomes in this population.AIM To evaluate the effects of exercise-cognitive dual-task training on frailty,cognitive function,psychological status,and quality of life in elderly patients with cognitive frailty and depression.METHODS A retrospective study was conducted on 130 patients with cognitive frailty and depression admitted between December 2021 and December 2023.Patients were divided into a control group receiving routine intervention and an observation group undergoing exercise-cognitive dual-task training in addition to routine care.Frailty,cognitive function,balance and gait,psychological status,and quality of life were assessed before and after the intervention.RESULTS After the intervention,the frailty score of the observation group was(5.32±0.69),lower than that of the control group(5.71±0.55).The Montreal cognitive assessment basic scale score in the observation group was(24.06±0.99),higher than the control group(23.43±1.40).The performance oriented mobility assessment score in the observation group was(21.81±1.24),higher than the control group(21.15±1.26).The self-efficacy in the observation group was(28.27±2.66),higher than the control group(30.05±2.66).The anxiety score in the hospital anxiety and depression scale(HADS)for the observation group was(5.86±0.68),lower than the control group(6.21±0.64).The depression score in the HADS for the observation group was(5.67±0.75),lower than the control group(6.27±0.92).Additionally,the scores for each dimension of the 36-item short form survey in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).CONCLUSION Exercise-cognitive dual-task training is beneficial for improving frailty,enhancing cognitive function,and improving psychological status and quality of life in elderly patients with cognitive frailty and depression.
文摘Impairments on body function,activities of daily living(ADL)and cognition are common after stroke.Eccentric resistance training(ERT)may be implemented to improve them.The primary objectives were to evaluate whether ERT improves body function,ADL and cognition after stroke.The secondary objectives were to evaluate whether ERT improves strength,gait,quality of life,and self-perceived health.Seven electronic databases were searched:Cochrane Central Register of Controlled Trials,Cochrane Stroke Group Trials Register,PubMed,Epistemonikos,Embase,SPORTDiscus,and WHO International Clinical Trials Registry Platform.Last search was run in December 2023,including studies since 2012.Selection criteria were studies with stroke participants of both sexes,aged 18 or more,with an intervention based on ERT.Accepted languages were English,Spanish or French.First search was done in pairs.Authors removed duplicate studies and those which did not meet inclusion criteria through title and abstracts.Finally,all authors,independently,screened the final search results and extracted data.Of 68 records identified,15 were eligible and 6 were finally included(with moderate risk of bias),analyzing 159 participants.Body function(4 interventions,n=84),gait(4 interventions,n=115)and strength(3 interventions,n?78)showed significantly better results when ERT was performed.Meta-analysis could not be done because of the few studies and their heterogeneity.This review provided low-moderate quality evidence suggesting that ERT might be effective at improving body function,strength,and gait after stroke.Besides,no harm was documented,and it was well-accepted.
基金funded in the frame of the Joint Research Centre (JRC) Trasporti, established at Fondazione Politecnico di Milano, through contract C40/2019 “JRC Trasporti-Metodologie per l’ispezione delle rotaie nei riguardi della formazione di cricche”
文摘This study explores the feasibility of electromagnetic acoustic transducers(EMATs)for ultrasonic rail inspection,focusing on bulk wave generation from the rail head and on defect detection at the central part of the rail foot.As a contactless method,EMATs could overcome some known limitations of conventional ultrasonic techniques,but require further validation.Differ-ent campaigns of experimental tests were performed,evaluating,by means of a probability of detection approach,the response of the technique to several artificial semi-elliptical flaws of increasing size and by considering two sensors characterized by different working frequencies.In contact,static tests allowed to assess the basic feasibility of the inspection technique and showed a linear response to defect size,saturating when defect width exceeded the rail web thickness.Dynamic tests allowed to introduce the effects of lift-off on signal responses.During all tests,the higher-frequency sensor outperformed the lower-frequency one.Finally,full-scale bogie tests on an indoor permanent track installation,comprehensive of defec-tive rails,confirmed the higher flaw detection rates of the higher-frequency sensor,with minimal detection failures despite occasional false alarms.EMATs showed encouraging results for in-motion rail inspection:with further technical development and optimization,this technique could enhance ultrasonic rail inspection by diagnostic trains.
文摘Exercise is a therapeutic approach in cancer treatment,providing several benefits.Moreover,exercise is associated with a reduced risk for developing a range of cancers and for their recurrence,as well as with improving survival,even though the underlying mechanisms remain unclear.Preclinical and clinical evidence shows that the acute effects of a single exercise session can suppress the growth of various cancer cell lines in vitro.This suppression is potentially due to altered concentrations of hormones(e.g.,insulin)and cytokines(e.g.,tumor necrosis factor alpha and interleukin 6)after exercise.These factors,known to be involved in tumorigenesis,may explain why exercise is associated with reduced cancer incidence,recurrence,and mortality.However,the effects of short-(<8 weeks)and long-term(≥8 weeks)exercise programs on cancer cells have been reported with mixed results.Although more research is needed,it appears that interventions incorporating both exercise and diet seem to have greater inhibitory effects on cancer cell growth in both apparently healthy subjects as well as in cancer patients.Although speculative,these suppressive effects on cancer cells may be driven by changes in body weight and composition as well as by a reduction in low-grade inflammation often associated with sedentary behavior,low muscle mass,and excess fat mass in cancer patients.Taken together,such interventions could alter the systemic levels of suppressive circulating factors,leading to a less favorable environment for tumorigenesis.While regular exercise and a healthy diet may establish a more cancer-suppressive environment,each acute bout of exercise provides a further“dose”of anticancer medicine.Therefore,integrating regular exercise could potentially play a significant role in cancer management,highlighting the need for future investigations in this promising area of research.
基金Leanna M.Ross is supported by the American Heart Association Career Development Award 23CDA1051777National Institute on Aging grant 5P30AG028716-18。
文摘Purpose:The purpose of this narrative review is to:1)summarize findings from the three Studies of a Targeted Risk Reduction Intervention through Defined Exercise(STRRIDE)randomized trials regarding the differential effects of exercise amount,intensity,and mode on metabolic syndrome(MetS);and 2)compare the STRRIDE findings with other published randomized exercise trials related to changes in MetS.Methods:A literature review was performed to investigate the effects of exercise on composite measures of MetS.PubMed was searched between October 2023 and December 2023.To be included in this review,studies must have employed a randomized study design,whereby exercise amount,intensity,or mode was varied.Results:Findings from the STRRIDE trials and other randomized exercise trials suggest:1)there is a relationship between exercise energy expenditure(ExEE)and improvements in composite measures of MetS;2)there may be an asymptotic effect for ExEE beyond which further improvements in MetS are negligible or counterproductive;3)improvements in composite measures of MetS are closely linked to insulin sensitivity;and 4)without controlling for total ExEE,combined aerobic and resistance training interventions offer the most robust improvements for composite MetS outcomes compared to either mode alone.Conclusion:Additional,large-scale,randomized exercise trials should be designed to investigate the potential asymptotic effect and associated threshold for ExEE,the interaction between exercise intensity and baseline insulin sensitivity,and the independent effects of exercise mode on MetS.
基金Research on the Construction of a Course Ideological and Political Education System and Evaluation Framework for the“Traditional Chinese Medicine Internal Medicine”Course(Project No.:2025J0459)Open Research Fund Program of Yunnan Key Laboratory of Integrated Traditional Chinese(Project No.:CWCD2023-002,CWCD2023-003&CWCD2023-009)+2 种基金Western Medicine for Chronic Disease in Prevention and TreatmentYunnan 047 Key Laboratory of Yi Dai Medicine and Yi Medicine(Project No.:2024SS24047)Yunnan 025 Key Laboratory of Yi Dai Medicine and Yi Medicine(Project No.:2024SS24025)。
文摘Standardized residency training programs primarily focus on developing clinical diagnostic and treatment skills,often allocating limited time to research activities.However,enhancing research skills is of paramount importance for residents,as it fosters critical thinking,problem-solving abilities,and a deeper understanding of applying scientific principles to clinical practice.This paper explores the necessity and significance of integrating research training into residency programs,emphasizing its role in cultivating well-rounded physicians capable of advancing medical knowledge.This study proposes a competency-based research training model that encompasses research literacy,study design,biostatistics,and scientific writing.Additionally,online asynchronous training modules,robust mentorship,and balanced time management strategies are recommended to enhance residents’research engagement without compromising clinical training.By implementing these measures,residency programs can improve residents’research capabilities,contributing to both individual professional growth and the broader advancement of medical science.
基金supported by the Natural Science Foundation of Hunan Province(2024JJ8121,2024JJ6626)the Hunan Provincial Key Research and Development Program(2023SK2038),China.
文摘Objective:Stress urinary incontinence(SUI)is a common condition among women that severely impairs quality of life.Pelvic floor proprioceptive training(PFPT)has attracted increasing attention for its potential to enhance pelvic floor muscle function and alleviate SUI symptoms.This study aims to observe and compare the clinical efficacy of PFPT combined with electroacupuncture,electrical stimulation,and biofeedback therapy versus conventional therapy consisting of electroacupuncture,electrical stimulation,and biofeedback alone in women with SUI,and to explore the role of PFPT in improving symptom and functional outcomes.Methods:In this randomized controlled trial,72 women with mild to moderate SUI were recruited from the Department of Rehabilitation Medicine at Third Xiangya Hospital,Central South University,between December 2021 and October 2023.Participants were randomly assigned to an experimental group(n=36)or a control group(n=36).Both groups received health education.The control group underwent electroacupuncture combined with electrical stimulation and biofeedback therapy,while the experimental group additionally received PFPT 3 times per week for 4 weeks.The primary outcome was assessed using the International Consultation on Incontinence Questionnaire-Short Form(ICIQ-SF).Secondary outcomes included pelvic floor muscle strength,bladder neck mobility,and balance ability.The ICIQ-SF was reassessed at 1,3,6,and 12 months post-treatment.Results:Both groups showed statistically significant improvements in all parameters after treatment(all P<0.05).However,there were no statistically significant differences between groups in most measures(all P>0.05).The experimental group demonstrated longer singleleg stance duration with eyes closed than the control group(left leg:P=0.026;right leg:P=0.006),with a significant increase from baseline(P<0.001).At 6 months post-treatment,the cure rate in the experimental group was significantly higher than that in the control group(P=0.037).Conclusion:Conventional therapy effectively improves SUI symptoms,but adding PFPT provides notable additional benefits,including enhanced balance ability and sustained midterm cure rates.These findings suggest that PFPT is a valuable adjunct to standard SUI management strategies.
文摘Purpose We aimed to determine:(a)the chronic effects of interval training(IT)combined with blood flow restriction(BFR)on physiological adaptations(aerobic/anaerobic capacity and muscle responses)and performance enhancement(endurance and sprints),and(b)the influence of participant characteristics and intervention protocols on these effects.Methods Searches were conducted in PubMed,Web of Science(Core Collection),Cochrane Library(Embase,ClinicalTrials.gov,and International Clinical Trials Registry Platform),and Chinese National Knowledge Infrastructure on April 2,with updates on October 17,2024.Pooled effects for each outcome were summarized using Hedge's g(g)through meta-analysis-based random effects models,and subgroup and regression analyses were used to explore moderators.Results A total of 24 studies with 621 participants were included.IT combined with BFR(IT+BFR)significantly improved maximal oxygen uptake(VO2_(max))(g=0.63,I^(2)=63%),mean power during the Wingate 30-s test(g=0.70,I^(2)=47%),muscle strength(g=0.88,I^(2)=64%),muscle endurance(g=0.43,I^(2)=0%),time to fatigue(g=1.26,I^(2)=86%),and maximal aerobic speed(g=0.74,I^(2)=0%)compared to IT alone.Subgroup analysis indicated that participant characteristics including training status,IT intensity,and IT modes significantly moderated VO2_(max)(subgroup differences:p<0.05).Specifically,IT+BFR showed significantly superior improvements in VO2_(max)compared to IT alone in trained individuals(g=0.76)at supra-maximal intensity(g=1.29)and moderate intensity(g=1.08)as well as in walking(g=1.64)and running(g=0.63)modes.Meta-regression analysis showed cuff width(β=0.14)was significantly associated with VO2_(max)change,identifying 8.23 cm as the minimum threshold required for significant improvement.Subgroup analyses regarding muscle strength did not reveal any significant moderators.Conclusion IT+BFR enhances physiological adaptations and optimizes aspects of endurance performance,with moderators including training status,IT protocol(intensity,mode,and type),and cuff width.This intervention addresses various IT-related challenges and provides tailored protocols and benefits for diverse populations.
基金Teaching and Research Project of Anhui Urban Management Vocational College(Project No.:2024kfkc001)。
文摘This paper reports a case of cerebral stem infarction with quadriplegia and complete dependence on daily life.The course of the disease lasted more than 7 months.Frenchay's improved articulation Disorder Assessment Form has been assessed as severe articulation disorder.The patient has significantly improved his speech function and quality of life after systematic head control training,respiratory function training,articulation motor training,and articulation training.In the course of treatment,emphasis was placed on head postural control training and respiratory function training,and emphasis was placed on the strength and coordination training of articulatory organs,and the results were remarkable.After the patient was discharged from the hospital,the follow-up of basic daily life communication was not limited.
