Search

Background: Stroke frequently results in upper limb motor dysfunction, with traditional therapies often failing to yield sufficient improvements. Emerging technologies such as virtual reality (VR) and noninvasive brain stimulation (NIBS) present promising new rehabilitation possibilities. Objectives: This study systematically reviews and meta-analyses the effectiveness of VR and NIBS in improving upper limb motor function in stroke patients. Methods: Registered with PROSPERO (CRD42023494220) and adhering to the PRISMA guidelines, this study conducted a thorough search of databases including PubMed, MEDLINE, PEDro, REHABDATA, EMBASE, Web of Science, Cochrane, CNKI, Wanfang, and VIP from 2000 to December 1, 2023, to identify relevant studies. The inclusion criterion was stroke patients receiving combined VR and NIBS treatment, while exclusion criteria were studies with incomplete articles and data. The risk of bias was assessed using the Cochrane Collaboration tool. Statistical analysis was performed using Stata SE 15.0, employing either a fixed-effects model or a random-effects model based on the level of heterogeneity. Results: A total of 11 studies involving 493 participants were included, showing a significant improvement in Fugl-Meyer Assessment Upper Extremity (FMA-UE) scores in the combined treatment group compared to the control group (SMD = 0.85, 95% CI [0.40, 1.31], p = 0.017). The Modified Ashworth Scale (MAS) scores significantly decreased (SMD = − 0.51, 95% CI [− 0.83, − 0.20], p = 0.032), the Modified Barthel Index (MBI) scores significantly increased (SMD = 0.97, 95% CI [0.76, 1.17], p = 0.004), and the Wolf Motor Function Test (WMFT) scores also significantly increased (SMD = 0.36, 95% CI [0.08, 0.64], p = 0.021). Subgroup analysis indicated that the duration of treatment influenced the outcomes in daily living activities. Conclusions: The combination of VR and NIBS demonstrates significant improvements in upper limb motor function in stroke patients. The duration of treatment plays a critical role in influencing the outcomes, particularly in activities of daily living. This systematic review has limitations, including language bias, unclear randomization descriptions, potential study omissions, and insufficient follow-up periods. Future studies should focus on exploring long-term effects and optimizing treatment duration to maximize the benefits of combined VR and NIBS therapy. [ABSTRACT FROM AUTHOR]

Existing studies have limited evidence about the complex nonlinear impact mechanism of road network topology and built environment on bike-sharing systems' greenhouse gas (GHG) emission reduction benefits. To fill this gap, we examine the nonlinear effects of road network topological attributes and built environment elements on the potential GHG emission reduction of dockless bike-sharing (DBS) trips in Shenzhen, China. Various methods are employed in the research framework of this study, including a GHG emission reduction estimation model, spatial design network analysis (sDNA), gradient boosting decision tree (GBDT), and partial dependence plots (PDPs). Results show that road network topological variables have the leading role in determining the potential GHG emission reduction of DBS trips, followed by land use variables and transit-related variables. Moreover, the nonlinear impacts of road network topological variables and built environment variables show certain threshold intervals for the potential GHG emission reduction of DBS trips. Furthermore, the impact of built environment on the potential GHG emission reduction of DBS trips is moderated by road network topological indicators (closeness and betweenness). Compared with betweenness, closeness has a greater moderating effect on built environment variables. These findings provide empirical evidence for guiding bike-sharing system planning, bike-sharing rebalancing strategy optimization, and low-carbon travel policy formulation. [ABSTRACT FROM AUTHOR]

The cellulose pyrolysis processes under the individual and synergistic effects of CaO and K2HPO4∙3H2O were studied by the thermogravimetric-mass spectrometric analysis (TG-MS) technique, mainly focusing on the changes of some important products such as CH4 during the pyrolysis process under different conditions. The experimental results showed that after the addition of CaO, the amounts of CO, CH4, and other species decreased. CaO could fix the "CO2-like reactive intermediate" produced during the cellulose pyrolysis process, thus reducing the evolution of CO2 in the temperature range of 300–440°C and continuing the CO2 evolution in the temperature range of 520–710°C. When K2HPO4∙3H2O was added, the amounts of CO, CH4, CO2, and other gaseous species increased, indicating that K2HPO4∙3H2O could significantly change the pyrolysis reaction process, such as promoting the benzene ring formation reactions involving small molecules such as toluene. When the mixture of CaO and K2HPO4∙3H2O was added, the weight loss at the initial stage of pyrolysis was relatively moderate compared to that adding K2HPO4∙3H2O alone. At the same time, an obvious weight loss appears in the pyrolysis process in the temperature range of 600–770°C, and the amounts of various species generated increased compared to those generated in the single catalytic pyrolysis. Therefore, CaO and K2HPO4∙3H2O exhibited a strong synergistic effect in the pyrolysis process. [ABSTRACT FROM AUTHOR]