Background Chronic low back pain (CLBP) significantly impacts patients' quality of life. While fascial release therapy is widely used, its comprehensive efficacy remains underexplored. Objective This study aimed to evaluate the effects of fascial release therapy combined with routine care on CLBP patients over 8 weeks. Methods This retrospective cohort study analyzed 90 CLBP patients (2021-2025), divided into the fascial release therapy group (n = 45) and the conventional rehabilitation group (n = 45). Outcomes included pain intensity [numerical rating scale (NRS)], disability [Roland-Morris disability questionnaire (RMDQ)], balance [timed up and go (TUG)], psychological status [depression, anxiety, and stress scale-21 items (DASS-21)], quality of life [12-item short form survey (SF-12)], and exercise compliance [exercise adherence rating scale (EARS)]. Results The fascial release therapy group demonstrated significantly greater improvements than the conventional group in all measures: lower NRS (1.92 +/- 0.83 vs 4.51 +/- 1.22) and RMDQ scores (4.83 +/- 2.34 vs 9.72 +/- 3.52); reduced depression, anxiety, and stress (DASS-21); better physical (48.54 +/- 5.11 vs 41.83 +/- 5.93) and mental (52.34 +/- 5.79 vs 46.51 +/- 6.32) health (SF-12); improved balance (TUG: 7.21 +/- 1.13 s vs 9.42 +/- 1.63 s); and higher exercise compliance (16.52 +/- 2.94 vs 11.82 +/- 3.53). All between-group differences were statistically significant (P < 0.05). Conclusion In this study, fascial release therapy, combined with conventional care, was associated with multidimensional clinical improvements in patients with CLBP, particularly in pain relief, functional recovery, psychological status, and exercise adherence. These findings suggest that the combined intervention may offer comprehensive benefits. However, due to limitations in the study design, the results should be interpreted as evidence of association. Causal inferences require further validation through prospective, randomized controlled trials.
Background: New-onset altered level of consciousness (ALC) is a frequent and critical presentation in emergency departments (EDs), requiring prompt recognition and management. The coronavirus disease-19 pandemic has significantly affected emergency care systems, yet its impact on ALC remains poorly understood. This study aimed to compare the etiology, patient flow, and outcomes of ALC before (BC) and after (AC) the COVID-19 pandemic. Methods: In this retrospective multicenter study, board-certified faculty from emergency medicine, internal medicine, and neurology reviewed 17,913 patients with ALC from four university-affiliated EDs serving a population of approximately five million individuals in South Korea. Patients were classified into BC (February 2018-January 2020) and AC (March 2021-February 2023). ALCs in the ED were categorized into 10 etiologies by multidisciplinary consensus review. Results: The incidence of ALC in the ED was 3.1%. The incidence of ALC increased significantly from 2.5% in BC to 3.7% in AC (P<0.001). Metabolic cause was the most common etiology (24.8%), followed by systemic infection (18.0%). Intracranial etiologies accounted for 29.7% of the total. Admission rate increased from 54.5% to 59.3% (P<0.001), while ICU admissions declined and ED deaths rose. Overall mortality increased from 13.5% to 18.4% (P < 0.001), and post-admission mortality from 16.3% to 21.3% (P<0.001). The highest mortality was associated with ALCs due to cardiogenic and vascular etiologies (26.8%). Conclusion: The observed shifts in etiologies, patient flow, and mortality between BC and AC reflect pandemic-driven changes in emergency care, underscoring the need for multidisciplinary strategies and scalable emergency care systems.
The precise determination of microseismic source locations is one of the core components of theoretical research in microseismic monitoring technology. Multi-objective intelligent optimization is an effective approach for microseismic source positioning, but it faces challenges such as unclear rationality of model combinations, susceptibility to local optima, and significant variability in positioning results. To address these issues, four distinct mathematical models for microseismic source positioning were designed based on the arrival time difference model and the arrival time difference quotient model. These models were then combined in pairs to form six different microseismic source positioning model combinations, which were used as the optimization objective functions for the multi-objective computational algorithm. A set of microseismic source forward modeling experiments based on three-dimensional polyhedral array shapes, two sets of engineering microseismic data validation experiments,and one set of multi-objective computational method comparison experiments were designed. the multi-objective grasshopper optimization algorithm (MOGOA) was introduced to solve the six model combinations and employed in four sets of microseismic source positioning experiments. Multiple statistical metrics were applied to evaluate the performance of each model combination. The experimental results indicate that the microseismic inversion mathematical model combination (TDA, TDA-P1), combined with the MOGOA algorithm's multi-objective optimization positioning strategy, can achieve high microseismic source positioning accuracy under relatively reliable microseismic event data, and the model calculations are relatively robust. Under microseismic blasting data, the average positioning error over 100 rounds reached 27.6035 m, with standard deviation and interquartile range averages of only 3.2114 m and 5.5896 m, respectively, outperforming other inversion model combinations and similar multi-objective positioning methods. For microseismic event data with significant systematic errors, the microseismic inversion mathematical model combination (TDA-P1,TDQA-P1) demonstrates superior positioning performance, with an average positioning error of 151.1915 mover 100 iterations, significantly outperforming other model combinations. These model combination positioning performance studies hold practical application value in the field of microseismic monitoring.
This study aimed to overcome the limitations of silicone monomers by synthesizing the silicone monomer 3(3-(bis(trimethylsiloxy)(methyl)silyl) propanoyloxy)-2-hydroxy propylmethacrylate (SiGMA-O) and fabricating a polymer contact lens using it to confirm its potential as a contact lens material. The structure of the synthesized monomer was confirmed through( 1)H NMR and( 13)C NMR analyses, and the fabricated lenses were evaluated for moisture content, contact angle, oxygen permeability, light transmittance, refractive index and protein adsorption. The performance was compared with that of 3-[tris(trimethylsiloxy)silyl]propyl methacrylate (Tris) and 3-methacryloxy-2-hydroxypropoxy) propylbis(trimethylsiloxy)methylsilane (SiGMA), which are mainly used in existing contact lenses. The SiGMA-O-based lenses had higher water content and oxygen permeability than the conventional monomers, and improved wettability with a low contact angle. In addition, protein adsorption to the contact lens was reduced. This confirms that the newly synthesized SiGMA-O is a material applicable to contact lenses with improved performance.
This study aimed to describe the technical feasibility and clinical outcome of unilateral biportal endoscopy (UBE)-assisted posterior C1-2 fusion for irreducible traumatic atlantoaxial rotatory dislocation (AARD) with facet fracture and locking. A 67-year-old man presented with severe neck pain following a motor vehicle accident. Computed tomography revealed C1-2 rotatory dislocation with a right C2 facet fracture and locking, while magnetic resonance imaging demonstrated left vertebral artery hypoplasia without cord compression. Traction for 3 days failed to achieve reduction. Surgery was subsequently performed using UBE under continuous saline irrigation. Following muscle-splitting exposure, facet release and reduction were achieved with a curette. Because the bulky right C2 nerve root obstructed access, it was transected proximal to the dorsal root ganglion. Facet distraction was then performed, the articular cartilage removed, and the subchondral bone prepared. Bilateral screws were inserted, and a polyether ether ketone cage filled with demineralized bone matrix was placed for fusion. The procedure was completed successfully without complications. Blood loss was minimal. The patient's visual analogue scale score improved from 8 preoperatively to 2 on postoperative day 1. He was discharged uneventfully on postoperative day 7. At the 3-month follow-up, he remained pain-free with stable fixation and no loss of reduction on imaging. UBE-assisted posterior C1-2 fusion enables precise facet release, safe instrumentation, and minimal tissue trauma in irreducible AARD with facet fracture and locking. This minimally invasive approach may yield favorable short-term outcomes and represents a viable alternative to conventional open posterior fusion techniques.
