Search Results (79)

Energy resources are a material basis for regional sustainable development and ecological security. However, this issue has not been adequately studied in Northwest China. Here, we consider the five northwestern provinces of China and break down the change in energy use intensity. Results show that the total energy intensity in the five northwestern provinces decreased from 2.389 tons/10⁴ Chinese yuan (CNY) in 2000 to 0.92 tons/10⁴ CNY in 2021. The main influencing factors for the decline in energy intensity are the industrial energy intensity followed by the industrial structure and the energy structure. There are eight industrial sub-sectors that contributed to the decrease in industrial energy intensity. Conversely, there are seven sub-sectors that increased industrial energy intensity. In addition, there are six sub-sectors with an energy intensity of more than 1 ton/10⁴ CNY. The convergence parameters demonstrate that the energy intensities of the five northwestern provinces did not converge to the same steady-state level, and their gap did not narrow in the short term. While the region’s overall energy intensity has shown a consistent downward trajectory, sectors heavily reliant on traditional fossil fuels—such as coal chemical processing, petroleum refining, and coking—have experienced a paradoxical upward trend in energy consumption. To address this, governments must implement targeted sector-specific measures, including upgrading technical capabilities through advanced coal gasification technologies, optimizing heat integration systems in petroleum refining processes, and streamlining intermediate production stages to minimize energy waste. Full article

Ribavirin, 1-(β-D-Ribofuranosyl)-1H-1,2,4-triazole-3-carboxamide, which is included in the list of drugs recommended in the guidelines for the diagnosis and treatment of SARS-CoV-2 infection, has been the subject of experimental and theoretical investigation. The most thermodynamically stable polymorphic form was studied using ¹H-¹⁴N NQR cross-relaxation, periodic DFT/QTAIM/RDS/3D Hirshfeld surfaces, and molecular docking. For the first time, a ¹H-¹⁴N cross-relaxation spectrum of ribavirin was recorded and interpreted. Twelve resonance frequencies were assigned to four inequivalent nitrogen positions in the molecule using combined experimental techniques and solid-state quantum chemical calculations. The influence of the structural alteration on the NQR parameters was modeled using GGA/RPBE. The differences in the binding pattern of ribavirin, acadesine, inosine, guanosine, and favipiravir-ribofuranosyl in the solid state and the protein-ligand complex were assessed to elucidate the differences in the binding mechanism at the molecular level due to aglycone modification. The replacement of the carbon adjacent to the ribose with nitrogen, in conjunction with the absence of oxygen at the 2-position of the ring, resulted in an increased flexibility of the RBV structure in comparison to the favipiravir-ribofuranosyl structure. The present study identified the intramolecular hydrogen bond NH···N in RBV as playing a crucial role in the formation of a quasi-five-membered ring. However, this bond was proven to be too weak to force positioning of the amide group in the ring plane. The ribofuranosyl in RBV inhibits tautomerism and freezes the conformation of the amide group. The results of the molecular dynamics simulations demonstrated that RBV and favipiravir-ribofuranosyl incorporated into the RNA primer exhibited comparable stability within the protein binding region. The titular anti-butterfly (inverted butterfly) effect is associated with the consequences of both the changes in aglycone moiety and the neighborhood alteration. Seven structure-binding strength indices and six novel quadrupolar indices defined in this study have been proven to facilitate the evaluation of the similarity of binding motifs in the solid state and protein-ligand complex. Full article

Plant growth analysis provides insight regarding the variation behind yield differences in tested genotypes for plant breeders, but adopting this application solely for traditional plant phenotyping remains challenging. Here, we propose a procedure of using uncrewed aerial systems (UAS) to obtain successive phenotype data for growth analysis. The objectives of this study were to obtain high-temporal UAS-based phenotype data for growth analysis and investigate the correlation between the UAS-based phenotype and biomass yield. Seven different energy cane genotypes were grown in a random complete block design with four replications. Twenty-six UAS flight missions were flown throughout the growing season, and canopy cover (CC) and canopy height (CH) measurements were extracted. A five-parameter logistic (5PL) function was fitted through these temporal measurements of CC and CH. The first- and second-order derivatives of this function were calculated to obtain several growth parameters, which were then used to assess the growth of different genotypes with respect to weed competitiveness and biomass yield traits. The results show that CC and CH growth rates significantly differed among genotypes. TH16-16 was outstanding for its ground cover growth; therefore, it was identified as a weed-competitive genotype. Furthermore, TH16-22 had a higher CH maximum growth rate per day, yielding a higher biomass compared to other genotypes. The CH-based multi-temporal data as well as the growth parameters had a better relationship with biomass yield. This study highlights the application of UAS-based high-throughput phenotyping (HTP), along with growth analysis, for assisting plant breeders in decision-making. Full article

Objectives: This prospective clinical study investigated the efficacy of adjunctive antibiotic therapy (doxycycline) and the patient’s risk factors during initial healing of autogenous canine tooth transplantations. Methods: Sixty-seven patients (ranging from 11 to 37 years of age) treated with tooth transplantations were allocated to three parallel groups based on the tooth’s intraoperative extraoral storage time (EST 0–3, 4–6, and 7–15 min) receiving different antibiotic regimens: (1) no antibiotics; (2) intraoperative intravenous (i.v.) single-shot antibiotics; and (3) intraoperative i.v. single-shot plus postoperative oral antibiotics for five days. Initial healing was rated according to pain intensity and clinical signs of pathology over a 21-day period. The influence of the following parameters was investigated using RStudio (linear regression and partial eta squared statistics): group, sex, age, nicotine abuse, tooth apex condition, preoperative ankylosis, displacement severity, jaw location, the number of simultaneous transplantations and other interventions, preoperative orthodontic extrusion, EST, and intraoperative complications. Results: No significant influence for sex (43 females, 24 males), tooth apex condition (19 open, 48 closed), displacement severity, jaw location (51 upper, 16 lower jaw), EST (mean 4.99 min), intraoperative complications (n = 13), or antibiotic regimen on pathology signs or pain intensity were found. Six patients reported medication side effects. Preoperative ankylosis (n = 15) and unsuccessful orthodontic extrusion (n = 16) increased postoperative pain (p = 0.020, ηP² = 0.08; p = 0.035, ηP² = 0.07). Multiple transplants (n = 14) and interventions in multiple regions (n = 27) affected pain and pathology (p = 0.002, ηP² = 0.14; p = 0.001, ηP² = 0.17). Increased age and nicotine abuse (n = 6) were associated with increased pathology signs (p = 0.024, ηP² = 0.08; p = 0.029, ηP² = 0.07). Conclusions: The results suggest that personalized rather than routine antibiotic therapy might be sufficient for initial healing in canine tooth transplantation. Deteriorating factors include preoperative ankylosis, orthodontic extrusion, an increased number of surgical sites, age, and nicotine abuse. Clinical Significance: Routine antibiotic prevention regimes may not be mandatory for initial healing in autogenous tooth transplantation, but a nuanced antibiotic strategy tailored to each patient’s specific risk factors, which is in line with the principle of antibiotic stewardship, is needed. Full article

Background: UPLC-Q-TOF-MS (Ultra-Performance Liquid Chromatography–Quadrupole Time-of-Flight Mass Spectrometry) is a high-precision, high-density technology for lipid analysis. Sensitive skin is a sub-stable condition, and it has been reported that the population of sensitive skin in China is predominantly female. Meanwhile, women with sensitive skin have different physiological parameters as well as lipid compositions at different ages. The Yellow Emperor’s Classic of Internal Medicine states that the number of women’s life cycles is seven, that major changes are manifested every 7 years, and that aging begins at age 35. At present, the correlation between facial lipid composition and aging indicators of sensitive skin in women aged 36–42 and 43–49 years has not been reported. Objective: This study reveals the relationship between key lipid composition of the facial skin and the aging of sensitive skin in women aged 36–42 and 43–49 years. Methods: We used UPLC-Q-TOF-MS technology to study the changes in lipid composition in the sensitive skin of woman aged 36–42 and 43–49 years, using a multi-probe adapter system with different types of skin-testing probes to test physiological parameters. Three types of multivariate data—questionnaires, physiological indicators, and lipid composition—were used together to assess differences in aging in a population of women with sensitive skin at different ages. Results: 1. In the questionnaire part, the T1 group was more susceptible to sunburn and the T2 group was more susceptible to tanning. 2. In the physiological index part, the aging characteristics of facial skin in the T2 group were obvious, with the b-value, as well as the brown area size, being significantly higher than the T1 group, while the TWEL, sebum, R2 value, ITA value, pore count, and concentration of the red area were significantly lower than the T1 group. 3. In the lipid part, the total facial lipid content was higher in the T2 group, with a significantly higher GP lipid, and the 47 VIP lipids obtained were analyzed by ROC curves, narrowing down to six lipids, PS(2-OMe-21:0/0:0), PS(O-18:0/20:5 (5Z,8Z,11Z,14Z,17Z)), PA(O-16:0/20:5 (5Z,8Z,11Z,14Z,17Z)), PS (P-16:0/12:0, PA (O-16:0/22:2 (13Z,16Z)), and PC (19:3 (10Z,13Z,16Z)/0:0)), and all six lipids were higher in the T2 group. 4. In Spearman correlation analysis, PS(O-18:0/20:5(5Z,8Z,11Z,14Z,17Z)), PS(P-16:0/12:0), PS(2-OMe-21:0/0:0), PA(O-16:0/20:5(5Z,8Z,11Z,14Z,17Z)), and PC(19:3( 10Z,13Z,16Z)/0:0), which are five lipids and skin aging indicators (TWEL, sebum, ITA value, b-value, pore count, concentration of red area, and brown area size) were significantly correlated. Conclusions: Through correlation analysis, it was found that changes in the composition of skin surface lipids (SSLs) in both age groups have an important influence on facial physiological indicators (aging manifestations) and played an important role in furthering the understanding of sensitive skin aging. Therefore, these lipid components also provide theoretical support for the development of cosmetic ingredients that slow down the aging of sensitive skin. Full article

The objectives of the present study were to analyze the influence of the stallions employed in the Dülmen wild horses on the genetic diversity and population substructure using Bayesian cluster analysis. The Dülmen wild horse is maintained as a unique horse population exposed to the natural conditions all year round in the Merfelder Bruch near Dülmen in Westphalia, Germany. Stallions selected for breeding have to prove their abilities to survive under this harsh environment. We used multilocus genotypic information from a set of 29 autosomal microsatellites to determine the paternity of 185 male foals sired by nine stallions. As females could not be sampled, we could not make inferences on all yearlings and test whether there are differences in the genetic population parameters between both sexes. The mean number of progeny was 19.92 with a range of 2–32, caused by the length of the service period per stallion. The average observed and unbiased expected heterozygosity was 0.688 and 0.631, the mean number of alleles was 4.448, and Wright’s F_IS was −0.173. Pairwise genetic distances (F_ST and Nei’s unbiased genetic distances) were significant and varied between 0.038 to 0.091 and 0.085 to 0.290, respectively. Neighbor-joining dendrogram plots clustered a large proportion of the paternal progeny groups in different branches. Posterior Bayesian analyses using seven paternal half-sib groups with 10–74 members supported a maximum of six clusters, with two paternal progeny groups not differing, and a median of five clusters, with two groups of two sires each falling into the same clusters. When sires were employed in non-consecutive years, progeny from these different years of the same sires were grouped in the same cluster, whereas the progeny of one sire from two consecutive years were in different clusters. We were able to distinguish male progeny from Dülmen wild horse stallions and to show the effects of stallion use on the genetic substructure in the Dülmen wild horse herd. In conclusion, the analyses showed the genetic potential of the Dülmen wild horse stallions to maintain a high genetic diversity and also the effects in which breeding seasons and for how long stallions are used to sire foals. The selection of stallions may be sensitive for the further development of genetic diversity and preserve this closed population as a valuable resource for further studies on the evolution of the horse. Full article

With the launch of OpenAI’s ChatGPT, large language models have garnered significant attention, and applications based on these models have proliferated. A critical challenge has emerged: how to rapidly enhance the capabilities of general LLMs in specialized domains. Compared to fine-tuning and other methods, prompt engineering has proven to be a cost-effective approach for improving the performance of LLMs on specific tasks, yielding remarkable results. However, current prompt example construction methods are numerous and lack a universally applicable approach that spans different models and tasks. Furthermore, existing research is predominantly tested and evaluated on a limited range of specific datasets, failing to explore the broader impact of these methods on a wider array of tasks. This paper proposes a prompt example construction method based on clustering and semantic similarity, which combines clustering algorithms with semantic similarity techniques to significantly improve the quality of prompt examples. In comparative tests conducted on six LLMs and seven datasets, the overall accuracy and stability of the proposed method significantly outperforms five other common methods, demonstrating broad applicability and the potential to enhance the output performance of all LLMs. Through comparative experiments, this paper also identifies that as the parameter scale of LLMs increases, the improvement effect of the prompt example construction method on LLM output performance tends to diminish. Additionally, diversified prompt example sets provide a more pronounced enhancement in LLM output performance. Full article

Objectives: There are several endovascular treatment options to treat aortic arch and thoracic aortic pathologies with custom-made or surgeon-modified aortic stent grafts. This study seeks to assess endovascular treatment methods for aortic arch and thoracic aortic pathologies with no acceptable proximal landing zone for standard thoracic endovascular aortic repair (TEVAR), comparing different treatment methods and evaluating technical success, intraoperative parameters and short-term outcomes. Methods: All patients undergoing elective or emergency endovascular treatment of aortic arch and thoracic aortic pathologies, with no acceptable landing zone for standard TEVAR, between 1 January 2010 and 31 March 2024, at the University Hospital Düsseldorf, Germany were included. An acceptable landing zone was defined as a minimum of 2 cm for sufficient sealing. All patients were not suitable for open surgery. Patients were categorized by an endovascular treatment method for a comprehensive comparison of pre-, intra- and postoperative variables. IBM SPSS29 was used for data analysis. Results: The patient cohort comprised 21 patients, predominantly males (81%), with an average age of 70.9 ± 9 years with no acceptable proximal landing zone for standard TEVAR procedure. The most treated aortic pathologies were penetrating aortic ulcers and chronic post-dissection aneurysms. Patients were sub-grouped according to the applied procedure as follows: five patients with chimney thoracic endovascular aortic repair (chTEVAR), seven patients with in situ fenestrated thoracic endovascular aortic repair (isfTEVAR), six patients with custom-made fenestrated thoracic endovascular aortic repair (cmfTEVAR) and three patients with custom-made branched thoracic endovascular aortic repair (cmbTEVAR). Emergency procedures involved two patients. There were significant differences in the total procedure and fluoroscopy time, as well as in contrast agent usage among the treatment groups. cmfTEVAR had the shortest total procedure time, while chTEVAR exhibited the highest contrast agent usage. The overall mortality rate among all procedures was 9.5% (two patients) and 4.7% for elective procedures, respectively. Deaths were associated with either retrograde type A dissection or stent graft infection. Both patients were treated with chTEVAR. There was one minor and one major stroke; these patients were treated with isfTEVAR. No endoleak occurred during any procedure. The reintervention rate for chTEVAR was 20% and 0% for all other procedures during the in-hospital stay. The patients who were treated with cmfTEVAR had no complications, the shortest operating and fluoroscopy time, and less contrast agent was needed in comparison with other treatment methods. Conclusions: Complex endovascular procedures of the aortic arch with custom-made or surgeon-modified aortic stent grafts offer a safe solution, with acceptable complication rates for patients who are not suitable for open aortic arch repair. In terms of procedure-related parameters and complication rates, a custom-made fenestrated TEVAR is potentially advantageous compared to the other endovascular techniques. Full article

Background: Liver resection is a critical surgical procedure for treating various hepatic pathologies. Minimally invasive approaches have gradually gained importance, and, in recent years, the introduction of robotic surgery has transformed the surgical landscape, providing potential advantages such as enhanced precision and stable ergonomic vision. Among robotic techniques, the single-site approach has garnered increasing attention due to its potential to minimize surgical trauma and improve cosmetic outcomes. However, the full extent of its utility and efficacy in liver resection has yet to be thoroughly explored. Methods: We conducted a comprehensive systematic review to evaluate the current role of the single-site robotic approach in liver resection. A detailed search of PubMed was performed to identify relevant studies published up to January 2024. Eligible studies were critically appraised, and data concerning surgical outcomes, perioperative parameters, and post-operative complications were extracted and analyzed. Results: Our review synthesizes evidence from six studies, encompassing a total of seven cases undergoing robotic single-site hepatic resection (SSHR) using various versions of the da Vinci© system. Specifically, the procedures included five left lateral segmentectomy, one right hepatectomy, and one caudate lobe resection. We provide a summary of the surgical techniques, indications, selection criteria, and outcomes associated with this approach. Conclusion: The single-site robotic approach represents an option among the minimally invasive approaches in liver surgery. However, although the feasibility has been demonstrated, further studies are needed to elucidate its optimal utilization, long-term outcomes, and comparative effectiveness against the other techniques. This systematic review provides valuable insights into the current state of single-site robotic liver resection and underscores the need for continued research in this rapidly evolving field. Full article

This review aimed to examine the effects of curcumin on chronic inflammatory metabolic disease by extensively evaluating meta-analyses of randomized controlled trials (RCTs). We performed a literature search of meta-analyses of RCTs published in English in PubMed^®/MEDLINE up to 31 July 2023. We identified 54 meta-analyses of curcumin RCTs for inflammation, antioxidant, glucose control, lipids, anthropometric parameters, blood pressure, endothelial function, depression, and cognitive function. A reduction in C-reactive protein (CRP) levels was observed in seven of ten meta-analyses of RCTs. In five of eight meta-analyses, curcumin intake significantly lowered interleukin 6 (IL-6) levels. In six of nine meta-analyses, curcumin intake significantly lowered tumor necrosis factor α (TNF-α) levels. In five of six meta-analyses, curcumin intake significantly lowered malondialdehyde (MDA) levels. In 14 of 15 meta-analyses, curcumin intake significantly reduced fasting blood glucose (FBG) levels. In 12 of 12 meta-analyses, curcumin intake significantly reduced homeostasis model assessment of insulin resistance (HOMA-IR). In seven of eight meta-analyses, curcumin intake significantly reduced glycated hemoglobin (HbA1c) levels. In eight of ten meta-analyses, curcumin intake significantly reduced insulin levels. In 14 of 19 meta-analyses, curcumin intake significantly reduced total cholesterol (TC) levels. Curcumin intake plays a protective effect on chronic inflammatory metabolic disease, possibly via improved levels of glucose homeostasis, MDA, TC, and inflammation (CRP, IL-6, TNF-α, and adiponectin). The safety and efficacy of curcumin as a natural product support the potential for the prevention and treatment of chronic inflammatory metabolic diseases. Full article

Addressing the pressing issue of food waste is vital for environmental sustainability and resource conservation. While computer vision has been widely used in food waste reduction research, existing food image datasets are typically aggregated into broad categories (e.g., fruits, meat, dairy, etc.) rather than the fine-grained singular food items required for this research. The aim of this study is to develop a model capable of identifying individual food items to be integrated into a mobile application that allows users to photograph their food items, identify them, and offer suggestions for recipes. This research bridges the gap in available datasets and contributes to a more fine-grained approach to utilising existing technology for food waste reduction, emphasising both environmental and research significance. This study evaluates various (n = 7) convolutional neural network architectures for multi-class food image classification, emphasising the nuanced impact of parameter tuning to identify the most effective configurations. The experiments were conducted with a custom dataset comprising 41,949 food images categorised into 20 food item classes. Performance evaluation was based on accuracy and loss. DenseNet architecture emerged as the top-performing out of the seven examined, establishing a baseline performance (training accuracy = 0.74, training loss = 1.25, validation accuracy = 0.68, and validation loss = 2.89) on a predetermined set of parameters, including the RMSProp optimiser, ReLU activation function, ‘0.5’ dropout rate, and a $160\times 160$ image size. Subsequent parameter tuning involved a comprehensive exploration, considering six optimisers, four image sizes, two dropout rates, and five activation functions. The results show the superior generalisation capabilities of the optimised DenseNet, showcasing performance improvements over the established baseline across key metrics. Specifically, the optimised model demonstrated a training accuracy of 0.99, a training loss of 0.01, a validation accuracy of 0.79, and a validation loss of 0.92, highlighting its improved performance compared to the baseline configuration. The optimal DenseNet has been integrated into a mobile application called FridgeSnap, designed to recognise food items and suggest possible recipes to users, thus contributing to the broader mission of minimising food waste. Full article

This systematic review and meta-analysis evaluated the combined effects of clinician-led and community-based group exercise interventions on a range of health outcomes in adults with type 2 diabetes mellitus. Our literature search spanned Medline, Scopus, PubMed, Embase, and CINAHL databases, focusing on peer-reviewed studies published between January 2003 and January 2023. We included studies involving participants aged 18 years and older and articles published in English, resulting in a dataset of eight studies with 938 participants. Spanning eight peer-reviewed studies with 938 participants, the analysis focused on the interventions’ impact on glycemic control, physical fitness, and anthropometric and hematological measurements. Outcomes related to physical fitness, assessed through the six-minute walk test, the 30 s sit-to-stand test, and the chair sit-and-reach test, were extracted from five studies, all of which reported improvements. Anthropometric outcomes from seven studies highlighted positive changes in waist circumference and diastolic blood pressure; however, measures such as body mass index, systolic blood pressure, weight, and resting heart rate did not exhibit significant changes. Hematological outcomes, reviewed in four studies, showed significant improvements in fasting blood glucose, triglycerides, and total cholesterol, with glycemic control evidenced by reductions in HbA1c levels, yet LDL and HDL cholesterol levels remained unaffected. Ten of the fifteen outcome measures assessed showed significant enhancement, indicating that the intervention strategies implemented may offer substantial health benefits for managing key type 2 diabetes mellitus-related health parameters. These findings in combination with further research, could inform the refinement of physical activity guidelines for individuals with type 2 diabetes mellitus, advocating for supervised group exercise in community settings. Full article

Indoor air quality and respiratory health have always been an area of prime interest across the globe. The significance of low-cost air quality sensing and indoor public health practices spiked during the pandemic when indoor air pollution became a threat to living beings, especially human beings. Problem Definition: Indoor respiration-associated diseases are hard to diagnose if they are due to indoor environmental conditions. A major challenge was observed in establishing a baseline between indoor air quality sensors and associated respiratory diseases. Methods: In this work, 10,000+ articles from top literature databases were reviewed using six bibliometric analysis methods (Lorenz Curve of Citations, Hirch’s H-Index, Kosmulski’s H2-Index, Harzing’s Hl-Norm-Index, Sidoropolous’s HC-Index, and Schrieber’s HM-index) to formulate indoor air quality sensor and disease correlation publication rubrics to critically review 482 articles. Results: A set of 152 articles was found based on systematic review parameters in six bibliometric indices for publications that used WHO, NIH, US EPA, CDC, and FDA-defined principles. Five major respiratory diseases were found to be causing major death toll (up to 32%) due to five key pollutants, measured by 30+ low-cost sensors and further optimized by seven calibration systems for seven practical parameters tailored to respiratory disease baselines evaluated through 10 cost parameters. Impact: This review was conducted to assist end-users, public health facilities, state agencies, researchers, scientists, and air quality protection agencies. Full article

CCUS-EOR is a crucial technology for reducing carbon emissions and enhancing reservoir recovery. It enables the achievement of dual objectives: improving economic efficiency and protecting the environment. To explore a set of CCUS-EOR reservoir screening criteria suitable for continental reservoirs in China, this study investigated and compared the CCUS-EOR reservoir screening criteria outside and in China, sorted out the main reservoir parameters that affect CO₂ flooding, and optimized the indices and scope of CCUS-EOR reservoir screening criteria in China. The weights of parameters with respect to their influences on CCUS-EOR were determined through principal component analysis. The results show that there are 14 key parameters affecting CO₂ flooding, which can be categorized into four levels. For the first level, the crude oil-CO₂ miscibility index holds the greatest weight of 0.479. It encompasses seven parameters: initial formation pressure, current formation pressure, temperature, depth, C₂–C₁₅ molar content, residual oil saturation, and minimum miscibility pressure. The second level consists of the crude oil mobility index, which has a weight of 0.249. This index includes four parameters: porosity, permeability, density, and viscosity. The third level pertains to the index of reservoir tectonic characteristics, with a weight of 0.141. It comprises two parameters: permeability variation coefficient and average effective thickness. Lastly, the fourth level focuses on the index of reservoir property change, with a weight of 0.131, which solely considers the pressure maintenance level. Based on the CCUS-EOR reservoir screening criteria and index weights established in this study, comprehensive scores for CCUS-EOR were calculated for six blocks in China. Among these, five blocks are deemed suitable for CCUS-EOR. Based on the comprehensive scoring results, a planning for field application of CCUS-EOR is proposed. The study provides a rational method to evaluate the CCUS-EOR reservoir screening and field application in continental reservoirs in China. Full article

Background: Falling on stairs is a major health hazard for older people. Risk factors for stair falls have been identified, but these are mostly examined in controlled biomechanics/gait laboratory environments, on experimental stairs with a given set of step dimensions. It remains unknown whether the conclusions drawn from these controlled environments would apply to the negotiation of other domestic staircases with different dimensions in real houses where people live. Objectives: The aim of this paper is to investigate whether selected biomechanical stepping behavior determined through stair gait parameters such as foot clearance, foot contact length and cadence are maintained when the staircase dimensions are different in real houses. Methods: Twenty-five older adults (>65 years) walked on a custom-made seven-step laboratory staircase. Older adults were classified into two groups (fallers and non-fallers) based on recent fall history. Among the 25 participants, 13 people had at least one fall, trip, or slip in the last six months and they were assigned to the fallers group; 12 people did not experience any fall in the last six months, so they were assigned to the non-fallers group. In addition, these participants walked on the stairs in three different real exemplar houses wearing a novel instrumented shoe sensor system that could measure the above stair gait parameters. MATLAB was used to extract fall risk parameters from the collected data. One-way ANOVA was used to compare fall risk parameters on the different staircases. In addition, the laboratory-based fall risk parameters were compared to those derived from the real house stairs. Results: There was a significant difference in selected stair-fall biomechanical risk factors among the house and laboratory staircases. The fall risk group comparisons suggest that high-risk fallers implemented a biomechanically riskier strategy that could increase overall falling risk. Conclusions: The significant differences due to the main effects of the fallers and non-fallers groups were obtained. For example, when ascending, the fallers group had less foot clearance on the entry (p = 0.016) and middle steps (p = 0.003); in addition, they had more foot clearance variability on the entry steps (p = 0.003). This suggests that the fallers group in this present study did not adopt more conservative stepping strategies during stair ascent compared to low-risk older adults. By showing less foot clearance and more variability in foot clearance, the risk for a trip would be increased. Full article