ABSTRACT
Introduction: In this study we explored the efficacy of nerve hydrodissection for mild‐to‐moderate carpal tunnel syndrome (CTS). Methods: Thirty‐four participants were randomly assigned to ...an intervention group or a control group. One 5‐ml dose of normal saline was injected into the intracarpal and subcutaneous regions in subjects of both groups, respectively. The primary outcome measure was the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) score. Secondary outcomes were cross‐sectional area of the median nerve and electrophysiological studies. Assessments were performed before the injection and at 1, 2, 3, and 6 months postintervention. Results: Compared with the control group, the intervention group showed significantly greater improvement at the second and third posttreatment months according to BCTQ severity score and at all time‐points for cross‐sectional area of the median nerve (P < 0.01). Discussion: Our study demonstrates the therapeutic effects of nerve hydrodissection for mild‐to‐moderate CTS. Muscle Nerve 59:174–180, 2019
It is unclear whether entecavir (ETV) and tenofovir disoproxil fumarate (TDF) differ in their effectiveness for preventing hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB).
...This retrospective cohort study analyzed an international consortium that encompassed 19 centers from 6 countries or regions composed of previously untreated CHB patients then treated with either ETV or TDF monotherapy. Those who developed HCC before antiviral treatment or within 1 year of therapy were excluded. The association between antiviral regimen and HCC risk was evaluated using competing-risk survival regression. We also applied propensity score matching (PSM) to 1:1 balance the 2 treatment cohorts. A total of 5,537 patients were eligible (n = 4,837 received ETV and n = 700 received TDF) and observed for HCC occurrence until December 23, 2018. Before PSM, the TDF cohort was significantly younger and had generally less advanced diseases.
In the unadjusted analysis, TDF was associated with a lower risk of HCC (subdistribution hazard ratio SHR, 0.45; 95% confidence interval CI, 0.26-0.79; P = 0.005). The multivariable analysis, however, found that the association between TDF and HCC no longer existed (SHR, 0.81; 95% CI, 0.42-1.56; P = 0.52) after adjustment for age, sex, country, albumin, platelet, α-fetoprotein, cirrhosis, and diabetes mellitus. Furthermore, the PSM analysis (n = 1,040) found no between-cohort differences in HCC incidences (P = 0.51) and no association between regimens (TDF or ETV) and HCC risk in the multivariable-adjusted analysis (adjusted SHR, 0.89; 95% CI, 0.41-1.92; P = 0.77).
TDF and ETV did not significantly differ in the prevention of HCC in patients with CHB.
The gallium nitride (GaN)-on-Si low-side gate driver proposed in this article has four main features: First, the self-pumped drive enhance (SPDE) technique achieves fast transients. Second, ...short-period negative voltage (SPNV) technique avoids the Miller coupling effect and improves efficiency. Third, a dual-mode Voltage regulator ensures sufficient current and minimizes power dissipation. Finally, monolithic low-side gate drivers provide robust drive capability. This work can suppress the ringing caused by high dV / dt of Formula Omitted, thereby minimizing the tail time Formula Omitted, achieving a Formula Omitted reduction in tailing current loss, suppressing abnormal conduction, and reducing reverse conduction loss by 37.0%.
In this article, a monolithically integrated driver fabricated by 12-V depletion mode gallium nitride (dGaN) and enhanced mode GaN (eGaN) driver is proposed. The proposed driver features an internal ...temperature-compensated (T-compensated) controller to drive an integrated 650-V eGaN power switch. Due to T-compensated characteristics, a slew-rate enhancement driver can be well-controlled by the fast turn-on (FTO) technique which is supplied by an on-chip regulator with reference voltage circuit. Therefore, the Miller plateau voltage can be tracked correctly by the proposed controller so that the switching frequency can be raised up to 50 MHz and the <inline-formula> <tex-math notation="LaTeX">\textit {dV}_{\mathrm {DS}} </tex-math></inline-formula>/ dt slew rate can reach 118.3 V/ns for high efficiency and high switching operation.
There are limited studies on the associations among parenting style, postpartum depression, and mother-infant bonding.
The aims of this study are investigating how the parenting style of maternal ...grandparents predicted the mothers' bonding with their infants. The mediating roles of postpartum depression were also explored.
A community sample of 227 postpartum women participated in this study. The participants primarily consisted of women who gave birth within six months (89.9%).
A cross-sectional and convenient sampling strategy was applied. Instruments were Parental Bonding Instrument, Edinburgh Postnatal Depression Scale, Postpartum Bonding Questionnaire, and Background Form.
In the young infant group (i.e. mothers with infants not older than three months), the results indicated that maternal protection could predict “impaired bonding” (β = 0.20, p < .05). This prediction was mediated by postpartum depression (β = 0.32, p < .001). In the older infant group, paternal and maternal care could directly predict “rejection and anger” (β = −0.20, −0.22 respectively, p < .05). Maternal protection could predict three bonding factors (β = 0.25–0.29, p < .05, 0.01). Postpartum depression acted as total mediator for “impaired bonding”(β = 0.45, p <. 001), and acted as partial mediators in “rejection and anger” and “anxiety about care” (β = 0.45, 0.28, ps < .001, .01).
Perceived parenting style (especially maternal protection) has impacts on adverse mother-infant bonding. Furthermore, the impact is more prominent on mothers of older infants. “Rejection and anger” could be the most vulnerable bonding factor affected by parenting style. Since postpartum depression mediates the predictions, interventions could concurrently address maternal parenting style and postpartum depression.
This paper proposes a series-parallel bond wire auxiliary fully integrated step-up switched-capacitor (SC) converter with conversion ratio expansion to improve the trade-off between power loss and ...output voltage ripple. The series-parallel switching strategy reduces the burden of delivering charges in a 1:2 SC and also extends the output-input voltage ratio range. In addition, the L<inline-formula> <tex-math notation="LaTeX">_{\mathbf{BOND}}</tex-math> </inline-formula> mismatch calibration (LMC) technique can eliminate the mismatch between bond wires. Moreover, the binary flying capacitor scaling technique automatically optimizes the capacitance of the flying capacitor to ensure a well-controlled output voltage ripple over a wide load range. With only 250pF total capacitors in use, the experimental results show a well-controlled ripple under 23.86mV and efficiency greater than 75% over a load range of 1mA to 20mA. Furthermore, this technique has a smooth efficiency profile within an input voltage level of 0.63V to 0.9V with a peak efficiency of 85% and an output voltage of 0.95V.
Constant-on-time (COT) control with an additional current feedback path in conventional buck converters can remove the need of large equivalent series resistance (ESR) at the output capacitor but it ...induces degraded output voltage regulation accuracy and slow transient response owing to opposite reaction between the output voltage and the additional current feedback information. Therefore, this paper proposes the pseudowave tracking (PWT) technique to reduce the load-dependent dc offset voltage of output load regulation while keeping the fast transient response similar to conventional COT buck converter with large ESR. The PWT technique further improves the transient response instantly by extending on-time and off-time periods during light-to-heavy and heavy-to-light load changes, respectively. The test chip fabricated in 28 nm CMOS process has demonstrated the improvement of offset voltage from 42 to 4 mV, while the transient response can be improved to 4 and 5 μs with load changes from 0.3 to 1.7 A and vice versa, respectively.
Objectives
To determine the optimal surgical timing in high‐risk patients with Fournier's gangrene by the Simplified Fournier's Gangrene Severity Index.
Methods
From 1989 to 2018, 118 male patients ...diagnosed with Fournier's gangrene with complete medical records were retrospectively reviewed. Patients’ demographics, laboratory parameters at initial diagnosis, Fournier's Gangrene Severity Index and Simplified Fournier's Gangrene Severity Index, and the time interval from emergency room arrival to surgical intervention were collected. The Fournier's gangrene patients were categorized into low‐risk (Simplified Fournier's Gangrene Severity Index ≤2) and high‐risk groups (Simplified Fournier's Gangrene Severity Index >2). Differences between the variables within the two groups were analyzed. The optimal surgical timing was analyzed with the receiver operating characteristic curve in high‐risk Fournier's gangrene patients.
Results
The overall mortality of 118 Fournier's gangrene patients was 14.4%. After risk stratification with the Simplified Fournier's Gangrene Severity Index scoring system, the mortality of low‐risk and high‐risk Fournier's gangrene patients was 1.3% and 41.0%, respectively. In the high‐risk group, the time interval from emergency room arrival to surgical intervention was the only variable with a significant difference between survivors and non‐survivors (P = 0.039). The optimal surgical timing was determined at 14.35 h, which allowed the highest sensitivity (0.688) and specificity (0.762) to affect mortality. The mortality was significantly lower in high‐risk Fournier's gangrene patients with early surgical intervention compared with late intervention (23.8% vs 68.8%, P = 0.007).
Conclusions
The Simplified Fournier's Gangrene Severity Index is a quick and reliable screening tool for first‐line physicians to identify high‐risk patients with Fournier's gangrene (Simplified Fournier's Gangrene Severity Index >2) who have poor survival outcomes. We recommended early surgical intervention within 14.35 h to maximize the survival of high‐risk Fournier's gangrene patients.
In this article, the proposed monolithic gallium nitride (GaN)-based driver uses the diode-emulated technique to reduce reverse conduction through a meta-stable fast (MSF) comparator with sub-0.2-ns ...deadtime. In addition, an active bootstrap controller with a fast discharge loop is used to reduce parasitic effects to improve the driving capability, thereby increasing the switching frequency. Furthermore, the proposed gate driver with dual <inline-formula> <tex-math notation="LaTeX">dv/dt </tex-math></inline-formula> control can reduce the gate-ringing during turn-on/turn-off. Experimental results show that the GaN-based monolithic driver can achieve an operating frequency of 50 MHz and a slew rate of 120 V/ns. At 50 MHz, the conversion of 48-to-5 V can achieve a peak efficiency of 95.4% at the load current of 3.5 A.
This article proposes an envelope tracking supply modulator (ETSM) that recycles the originally wasted energy in the linear amplifier (LA) to generate negative voltage <inline-formula> <tex-math ...notation="LaTeX">V_{\mathrm {NEG}} </tex-math></inline-formula> and achieve fast down tracking. With the insertion of <inline-formula> <tex-math notation="LaTeX">V_{\mathrm {NEG}} </tex-math></inline-formula>, the negative slope of <inline-formula> <tex-math notation="LaTeX">I_{\mathrm {BUCK}} </tex-math></inline-formula> becomes 25% larger. <inline-formula> <tex-math notation="LaTeX">V_{\mathrm {NEG}} </tex-math></inline-formula> is also used to boost the input voltage of buck converter from 2<inline-formula> <tex-math notation="LaTeX">V_{\mathrm {BAT}} </tex-math></inline-formula> to 2.6<inline-formula> <tex-math notation="LaTeX">V_{\mathrm {BAT}} </tex-math></inline-formula> and raise the positive slope of <inline-formula> <tex-math notation="LaTeX">I_{\mathrm {BUCK}} </tex-math></inline-formula> by 93%, which improves the transient response of buck converter and decreases <inline-formula> <tex-math notation="LaTeX">\vert I_{\mathrm {LA}}\vert </tex-math></inline-formula> by 37%. With energy recycling and high-bandwidth LA replica, ETSM supports 150-MHz 5G new radio (5G NR) application and achieves 89.7% efficiency when output power is 3.7 W. In addition, the proposed differential feedforward technique controls the operation of energy recycling precisely with the calibration logic.
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