bluuebunny/crossref_metadata_2025 huggingface dataset:
Can Autologous Matrix-Induced Chondrogenesis (AMIC) provide positive outcomes in the treatment of retropatellar chondral lesions?
Authors: Gille Justus , Reiss Eric , Behrens Peter , Jakob Roland , Piontek Tomasz
Published: April 2023

Background The patellofemoral joint is a challenging environment for treating chondral defects. Among the surgical options for the treatment of chondral defects, the single-stage AMIC procedure uses a collagen I/III membrane to enhance bone-marrow stimulation. However, longer term outcomes data are rare for this specific indication. In order to provide real-world information, an ongoing registry has been established in order to record patient data and outcomes when AMIC is used to treat chondral and osteochondral lesions, which for this study were those of the patella.Methods Patient data were retrieved from an ongoing, prospective, multisite registry of patients who had undergone surgical repair of chondral defects via AMIC. We identified 65 patients, all of whom had been treated by one of the authors and for whom pre-operative and at least 1 post-operative score was available. Outcomes were assessed via the KOOS and the Lysholm scores. Outcomes at the post-operative time-points were analysed using a factorial ANOVA with post-hoc testing while linear regression was used to assess associations between the change in the Lysholm score and lesion size.Results The mean lesion size was 3.1 ± 1.4 cm2. The most common surgical approach was mini-open, the most common fixation was via fibrin glue and the mean length of follow-up of 5.8 years (range 1–10 years). There was a significant improvement in the KOOS scores from pre-operative to the 1st year post-operative (p < 0.001), which was maintained during the follow-up. Likewise, a significant improvement in the sports-recreation score (p > 0.001) as well as in ADL and QOL (p > 0.001 for both) were maintained throughout the follow-up.Conclusions The forces exerted on the patellofemoral joint make this a challenging scenario for chondral repair. Our data demonstrates that the AMIC procedure is an effective treatment for retropatellar cartilage lesions, and provides reliable results, with decreased pain and improved function. Importantly, these improvements were maintained through the follow-up period.
Comparative hyperaccumulator of Azolla pinnata and Lemna minor for livestock wastewater treatment: morpho-physiological and genetic approach
Authors: Na Nor Anis Nadhirah Md , Zakarya Irnis Azura , Kamaruddin Saadi Ahmad
Published: April 2023

The potential of two different aquatic macrophytes, A. pinnata and L. minor to treat livestock wastewater through phytoremediation were investigated. The physiological includes the removal efficiency of Manganese (Mn) from livestock wastewater by AAS, morphological observation was performed under visual and SEM. RAPD analysis were applied to observe the DNA expression. It was observed that the removal efficiency of Mn, was higher in L. minor with 92% removal rate, while in A.pinnata RE was at 77% rate. A.pinnata exhibits symptoms of cell death by shrinking when exposed to livestock effluent as early as 24 hours but L.minor showed no changes. RAPD analysis showed that there are 19% of polymorphism in L.minor, in A.pinnata there is increase in band intensities. It can be concluded that L. minor performed better as a hyperaccumulator in livestock wastewater than A. pinnata which exhibits signs of cell death.
How does world economic policy uncertainty influence the carbon dioxide emission reporting and performance? Study of Global Fortune 500 firms
Authors: Persakis Antonios , Fassas Athanasios , Koutoupis Andreas
Published: April 2023

Using the measure of uncertainty, i.e., the World Economic Policy Uncertainty Index (WUI) developed by Ahir et al. (2018), this study analyses the effect of uncertainty on carbon dioxide emission reporting and performance. The methodological approach uses the Generalized Method of Moments (GMM), utilising a comprehensive set of 604 firms that are obtained from the Fortune Global 500 list and covering the period 2005–2020. We demonstrate that WUI positively influences carbon dioxide emission reporting and negatively influences carbon dioxide emission reporting in order to mitigate the negative effects of uncertainty and increase firm trust by engaging in more sustainable practices. Additionally, our findings illustrate that carbon dioxide emission reporting is greater in firms operating in emissions-intensive industries in order to strengthen investors’ confidence and trust, especially during periods of high WUI. Finally, the study finds that higher emitters have lower carbon dioxide emission performance due to political and social pressures on these firms to incorporate environmental considerations, especially during periods of high WUI. Particularly for the regulatory body and the industry association when creating improved legislation and recommendations on environmental and social reports relating carbon emission reporting and performance, our empirical findings should have urgent practical ramifications.
Immobilization Period for Non-Operative Treatment of Proximal Humerus Fracture: Systematic Review and Meta-analysis
Authors: Ataei Mehdi , Moradi Ali , Ebrahimzadeh Mohammad-H , Rastaghi Sedigheh , Daliri Mahla
Published: April 2023

Purpose
Proximal humerus fractures (PHFs) are common fractures in the elderly and are typically treated conservatively with immobilization. However, there is no consensus on whether to choose early or conventional late mobilization and their outcomes into account. This paper reviews comparative studies on the one and three weeks’ immobilization period clinical outcomes in terms of 1) limb function, 2) pain intensity, and 3) complications, following the adoption of the PHF non-surgical treatment.
Method
Current systematic review searches PubMed, Scopus, and Web of science databases, looking for randomized clinical trials on patients with PHF, comparing clinical outcomes between two groups who immobilized for one week (early mobilization) or three weeks (late mobilization). We also performed a meta-analysis to compare the two groups' limb function and pain levels at three and six months of follow-up.
Result
Five of the seven RCTs had adequate data to be included in the meta-analysis. The quantitative results show that early mobilized patients have improved limb function at three (std mean difference: 0.42, CI 95%: 0.137–0.707) and six (std mean difference: 0.37, CI 95%: 0.098–0.644) months’ follow-up. At either three or six months, there was no difference in pain intensity between the two groups.
Conclusion
This review supports adoption of early mobilization at one week for PHFs non-operative management. However, to compare the long-term effects, more clinical trials with longer follow-ups are beneficial.
Level of Evidence: level I (systematic review and meta-analysis)
combined pedicled superficial circumflex iliac artery perforator flap for lower extremity defect reconstruction
Authors: Ou changliang , Li ji , Luo xuchao , Sun li , Zou yonggen
Published: April 2023

BACKGROUND Extensive lower extremity tissue defects pose difficulties for surgeons. Considering the natural contour, aesthetics, and restoration of motor function, the ideal solution should match and customize a flexible and large flap, and restore circulation as soon as possible to reduce the risk of infection and flap necrosis. As superficial circumflex iliac artery perforator flaps (SCIP flaps) have matured to cover multiple defects in the body, we present a combined pedicled SCIP flap for repair and reconstruction of lower extremity tissue defects.METHODS From September 2015 to January 2018, seven patients (all men) had a mean age of 45.5 years (39–47 years). We used a combined pedicled SCIP flap to repair large defects of the lower extremity. Dissecting the appropriate pedicle length to participate in intra-flap anastomosis and increase blood circulation. The average cutting area of the flap was 10.0 cm × 8.0 cm (6.0 × 3.0 cm-27.0 × 10.0 cm). We followed up all patients and the donor sites were successfully closed.RESULTS 7 flaps have completely survived. One flap was large (27.0×10 cm) and had slight necrosis at the distal end of the flap on postoperative 7th day; the flap survived after debridement and dressing change. one flap had mild venous obstruction and was re-explored for arterial vascular anastomosis, and the flap was completely viable without other complications. All patients were followed up for a mean of 10.5 months (9 to 14 months). The donor area healed well; the flap achieved a natural contour in appearance, with a soft texture and no pressure pain, and the affected limb recovered function and walked without deformity.Conclusion For patients seeking primary coverage of lower extremity tissue defects, the combined pedicled SCIP flap, with covering large defects with lower morbidity, is a great alternative.
Exploring L-isoleucine riboswitches for enhancing 4-hydroxyisoleucine production in Corynebacterium glutamicum
Authors: Xiang Youhe , Chen Rui , Shi Feng , Lai Wenmei
Published: April 2023

Objectives
To explore an L-isoleucine (Ile)-induced biosensor for down-regulation of Ile synthesis pathway and enhancement of 4-hydroxyisoleucine (4-HIL) production in Corynebacterium glutamicum SN01.
Results
Four Ile-induced riboswitches (IleRSN) with different strength were screened from mutation library based on TPP riboswitch. Firstly, IleRSN were integrated into the chromosome of strain SN01 immediately upstream of ilvA gene. The 4-HIL titer of strains carrying PtacM-driven IleRS1 or IleRS3 (14.09±1.07, 15.20±0.93 g 4-HIL L-1) were similar with control strain S-D5I (15.73±2.66 g 4-HIL L-1). Then, another copy of IleRS3-ilvA was integrated downstream of the chromosomal cg0963 gene in SN01-derived strain D-RS with down-regulated L-lysine (Lys) biosynthesis. The Ile supply and 4-HIL titer increased in ilvA two-copy strains KIRSA-3-D5I and KIRSA-3-9I, and Ile concentration was maintained less than 35 mmol L-1 under the control of IleRS3 during fermentation. The resulting strain KIRSA-3-9I produced 22.46±0.96 g 4-HIL L-1.
Conclusion
The screened IleRS was effective in the dynamic down-regulation of Ile synthesis pathway in C. glutamicum, and IleRSN with different strength can be applied in various conditions.
Classification Based on Event in Survival Machine Learning Analysis of Cardiovascular Disease Cohort
Authors: Ahmad Shokh Mukhtar , Ahmed Nawzad Muhammed
Published: April 2023

The goal of this paper is to evaluate supervised learning classification models in a survival analysis problem of cardiovascular patients with a significant cured fraction. A sample include 919 patients referred to Sulaymaniyah Cardiac Hospital (including 365 females and 554 male) were followed up for a maximum of 650 days in 2021 to 2023. In the sample, 162 patients (17.6%) during research time died. Cure fraction in this cohort was confirmed based on the Mahler and Zhu test (P<0.01), so for this case several machine learning classifications are applied to find the best patient status prediction procedure. Using several machine learning algorithms, the patients were classified into alive and dead. The results based on several indicators were almost the same. But in general, the random forest was identified as the best method in most of the indicators and of course with the Area under ROC = 0.934. The just weakness point of this method is that it did not work relatively well in the correct diagnosis of the deceased, and instead, the SVM with FP Rate = 0.263 performed better. After that, logistic and simple regression with Area under ROC = 0.911 and 0.909 showed better performance than others.
Physiological effects of lung protective ventilation in patients with lung fibrosis and usual interstitial pneumonia pattern versus primary ARDS: a matched-control study
Authors: Tonelli Roberto , Grasso Salvatore , Cortegiani Andrea , Ball Lorenzo , Castaniere Ivana , Tabbì Luca , Fantini Riccardo , Andrisani Dario , Gozzi Filippo , Moretti Antonio , Bruzzi Giulia , Manicardi Linda , Cerri Stefania , Samarelli Anna Valeria , Raineri Giulia , Murgolo Francesco , Carzoli Andrea , Mussi Rossella Di , Busani Stefano , Rizzoni Raffaella , Grasselli Giacomo , Clini Enrico , Marchioni Alessandro
Published: April 2023

Background Although patients with AE-ILD and UIP pattern may experience severe acute respiratory failure requiring invasive MV, physiological data on lung mechanics during these events are lacking. We aimed to describe the physiological effect of lung protective ventilation in patients with AE-ILD-UIP and to compare it with primary ARDS.Methods Partitioned lung and chest wall mechanics were compared between patients AE-ILD-UIP and 1:1 matched primary ARDS (based on BMI and PaO2/FiO2 ratio) within a PEEP trial performed within 24 h from intubation and comprising three levels of PEEP [(ZEEP), 4–8 cmH2O (PEEPLOW) and PEEP titrated to achieve positive end-expiratory transpulmonary pressure (PL,EE) (PEEPTITRATED)]Results Ten patients with AE-ILD-UIP and 10 matched with primary ARDS were included. In AE-ILD-UIP median PL,EE at ZEEP was − 4.3 [-7.6 – -2.3] cmH2O and lung elastance (EL) 44 [40–51] cmH2O/L. At PEEPLOW, PL,EE remained negative and EL did not change (p = 0.995) versus ZEEP. At PEEPTITRATED, PL,EE increased to 0.8 [0.3–1.5] cmH2O and EL to 49 [59–43] (p = 0.004 and p < 0.001 compared to ZEEP and PEEPLOW, respectively). ΔPL decreased at PEEPLOW (p = 0.018) and increased at PEEPTITRATED (p = 0.003). Differently than AE-ILD-UIP, in ARDS matched controls PEEP titration to obtain a positive PL,EE did not result in changes in EL and ΔPL.Conclusions In mechanically ventilated AE-ILD-UIP, lower PEEP levels did not impact on EL and ΔPL whereas, differently than in patients with primary ARDS, PEEP titrated to obtain a positive PL,EE worsened EL and ΔPL.
Domains matter: Cross-sectional associations between mental well-being and domain specific physical activity and sedentary behaviour in n=31,818 adults in Scotland
Authors: Niven Ailsa , Strain Tessa
Published: April 2023

Background Mental well-being is an important protective factor for health, and interest in the relationship between mental well-being and physical activity and sedentary behaviour is growing. Previous research indicates that domain and type of activity matter to fully understand the relationship, and that the association may differ across levels of mental well-being. This study aimed to investigate the domain-specific associations for physical activity and sedentary behaviours with different levels of mental wellbeing using population-level data.Methods We pooled data from the nationally representative 2012–2019 Scottish Health Survey. Respondents aged ≥ 16 years reported domain-specific physical activity over the previous four weeks and average domain-specific daily sitting time for week and weekend days. Mental wellbeing was assessed using the Warwick-Edinburgh Mental Wellbeing Scale. Associations were investigated using cubic spline and multinomial regressions, progressively adjusted for demographic variables, body mass index, self-reported general health, and other movement behaviours.Results The sample comprised of 31,818 adults (52.3% female). The majority (71.2%) had a medium MWB score with 15.2% and 13.5% in the low and high categories respectively. The findings indicated that home-based heavy manual (including gardening and DIY), walking, sport and exercise, and leisure time sitting were all positively associated with mental well-being. There was no association evident for heavy housework or occupational sitting, and high levels of TV/screen time sitting were negatively associated with mental well-being. Activity at work presented a mixed picture. For walking and sport and exercise, the relationship differed by mental well-being level with any increase in activity reducing the likelihood of low mental well-being but only the highest levels of activity increasing the likelihood of high mental well-being.Conclusions The findings of this large population level study extend the argument that domains and types of activity matter, and not all physical activity and sedentary behaviour is equal in terms of mental well-being. Additionally, the relationship between some activity and mental well-being can vary depending on levels of mental-well-being. In order to enhance mental well-being, physical activity and sedentary behaviour messaging and promotion should be nuanced to highlight the most promising activities and target those who may most benefit.
An Unexplored Equity Factor During Pre-Implementation of Contingency Management: Differential Beliefs and Attitudes by Providers’ Ethnicity
Authors: Oluwoye Oladunni , Weeks Douglas L. , McDonell Michael G.
Published: April 2023

Background Although considered one of the most effective interventions for substance use disorders (SUD), the widespread uptake of contingency management (CM) has remained limited. Prior studies at the provider-level have explored beliefs about CM among SUD treatment providers and have tailored implementation strategies based on identified barriers and training needs. However, there have been no implementation strategies that have actively sought to identify or address potential differences in the beliefs about CM that could be influenced by the cultural background (e.g., ethnicity) of treatment providers. To address this knowledge gap, we examined beliefs about CM among a sample of inpatient and outpatient SUD treatment providers.Methods A cross-sectional survey of SUD treatment providers was completed by 143 respondents. The survey asked respondents about their attitudes toward CM using the Contingency Management Beliefs Questionnaire (CMBQ). Linear mixed models were used to examine the effect of ethnicity on CMBQ subscale (general barriers, training-related barriers, CM positive-statements) scores.Results Fifty-nine percent of respondents self-identified as non-Hispanic White and 41% as Hispanic. Findings revealed that SUD providers who identified as Hispanic had significantly higher scores on the general barriers (p < .001) and training-related barriers (p = .020) subscales compared to the non-Hispanic White SUD providers. Post-hoc analyses identified differences in the endorsement of specific individual scale items on the general barriers and training-related subscales.Conclusions Dissemination and implementation strategies for CM among treatment providers need to consider equity-related factors at the provider-level that may be associated with the adoption and uptake CM.
Maternal health education and social support needs across the perinatal continuum of care in India: A thematic analysis
Authors: Sharma Preetika , Bagga Rashmi , Khan Maliha , Duggal Mona , Basavarajappa Darshan Hosapatna Basavarajappa Hosapatna , Ahuja Alka , Kankaria Ankita , Diamond-Smith Nadia , Kumar Vijay , Kashyap Manju , Singh Pushpendra , Kaur Jasmeet , Ayadi Alison El
Published: April 2023

Background
Social support and maternal education throughout the antenatal, delivery, and postpartum phases contribute to the optimization of health and well-being of mothers and infants. Understanding deficits among support and educational resources can contribute to improved public health decision-making and maternal and child healthcare and wellbeing.
Methods
We conducted a qualitative study among 20 postpartum North Indian women to better understand current resources and identify gaps in support across the perinatal continuum of care. Data was analyzed thematically.
Results
Participants in this study have considerably low maternal knowledge surrounding delivery, in addition to low levels of maternal knowledge and social support around postpartum care and practices. Participants received the most social and educational support during the antenatal phase of pregnancy, which is consistent with the implementation of government and community program goals to increase antenatal care among pregnant women. Notable issues among women during these phases involved consent, and satisfaction and comfort with childbirth care. Participant narratives described the important role of both formal and informal support structures in addressing maternal health needs. Formal structures of support include health systems at the community and facility levels whereas informal structures include family, friends, and the community. Participants also relied heavily on advice from formal modes of support including community health workers (ASHAs), midwives, and doctors. While many participants’ support needs were met by their support networks, our study identified certain areas where support needs remained unmet such as post cesarean section diet and care, institutional delivery, support of ASHA etc., in addition to areas of discrepancy between the advice provided compared to evidence-based practices.
Conclusion
This study identified a major lack of informational support during the delivery and postpartum phases of pregnancy, which may lead to complications for pregnant women. Programs targeting improved maternal health and wellbeing throughout the continuum of care need to educate pregnant women more about the institutional delivery process. Additionally, programs need to further supply women with support and education with regard to the postpartum phase, which remains neglected.
Trial registration: This research is part of the formative phase of a larger intervention trial prospectively registered with Clinical trial registry of India. (CTRI/2020/12/029800 [Registered on: 15/12/2020] and clinicaltrials.gov (phase 1: NCT04636398, phase 2: NCT04693585)
Noise Resilient Exceptional-Point Sensing based on Neuromorphic functionalities
Authors: Suntharalingam Arunn , Fernández-Alcázar Lucas , Kononchuk Rodion , Kottos Tsampikos
Published: April 2023

Exceptional point degeneracies (EPD) of linear non-Hermitian systems have been recently utilized for hypersensitive sensing. This proposal exploits the sublinear response that the degenerate frequencies experience once the system is externally perturbed. The enhanced sensitivity, however, might be offset by excess (fundamental and/or technical) noise. Here, we developed a self-oscillating nonlinear platform that supports transitions between two distinct neuromorphic functionalities – one having a spatially symmetric steady-state, and the other with an asymmetric steady-state – and displays nonlinear EPDs (NLEPDs) that can be employed for noise-resilient sensing. The experimental setup incorporates a nonlinear electronic dimer with voltage-sensitive coupling and demonstrates two-orders signal-to-noise enhancement of voltage variation measurements near NLEPDs. Our results resolve a long-standing debate on the efficacy of EPD-sensing in active systems above self-oscillating threshold.
Adherence of Doctors to Diabetes Clinical Guidelines in Sudan
Authors: Abdelgadir Hiba Salah , Altayb Mustafa , Salih Mogahid , Ahmed Mohammed , Abdelgadir Hind Salah , Ahmed Mosab Abdelgader
Published: April 2023

Background Clinical guideline is systemically derived statement that help practitioners to make clinical decision in specific circumstances, and it should be research or evidence based, designed to standardize clinical practice, reducing financial burden on both patient and health care system, offering time and reduce medical error, despite of these benefits there is poor adherence to guideline which lead to decrease quality of health services and un satisfied patients outcome. This study aim to assess adherence of doctors to diabetes clinical guidelines in Sudan .Method A cross-sectional analytic study was conducted during the period from December 2021 to July 2022 on a sample of 465 doctors. Adherence of doctors to diabetes clinical guidelines was measured through online questionnaire. Data analyzed by frequency tables. Chi square test used to determine associations among categorized variables. Logistic regression conducted to determine the relation between adherence to diabetes guidelines and the explanatory variables. All statistical tests were considered significant when p value < 0.05.Results Of the 465 responded, 76.8% were familiar of diabetes clinical guidelines. 72.7% reported the implementation of guidelines recommendations in their practice. 46.5% were following updated guidelines .44.5% were aware about local Sudanese diabetes guidelines. Adherence rate was highly statistically associated with age of the participants (p = 0.000), job title (p = 0.000), department (p = 0.000) and duration of clinical experience (p = 0.000) .Conclusion The study clarify the weakness of health authority in the role of providing easy access to algorithm or regular training program and limitation of facilities which consist the major barrier to familiarity and adherence to clinical guidelines. Establishing posters in hospitals and regular training programs are suggested as important intervention to improve adherence to guideline.
Socio-political cost of accelerating coal phase-out
Authors: Nacke Lola , Vinichenko Vadim , Cherp Aleh , Jakhmola Avi , Jewell Jessica
Published: April 2023

While macroeconomic models highlight rapid coal phase-out as an urgent climate mitigation measure, its socio-political feasibility is unclear. The negative impacts of coal phase-out for companies, workers and coal-dependent regions, and the unequal global distribution of the coal phase-out burden has triggered resistance and calls for just transitions. Here, we construct a database of domestic and international just transition policies and partnerships that compensate affected actors of coal phase-outs. By comparing coal phase-out in countries which have compensation plans with those that don’t, we show that compensation policies are essential to realizing premature retirement of coal. The cost we estimate associated with these policies clarifies the financial cost of making coal phase-out politically feasible. We find that compensation costs are proportional to avoided emissions resulting from coal phase-out and are generally consistent with recent carbon prices. We find that the cost of implementing similar compensation policies in case of 1.5°C -consistent coal phase-out for China and India is 17 times higher than all existing compensation, and roughly comparable to global Official Development Assistance in 2021. We show that in the case of coal phase-out, political will and social acceptance have a tangible economic component which should be factored in to assessing the feasibility of achieving climate targets.
Hematopoietic Stem Cell Transplantation in patients with Fanconi Anemia: A report of late effects and psychosocial adjustment in life
Authors: Ayas Mouhab , Al-Hashem Fatima , Siddiqui Khawar , Al-Jefri Abdullah , Al-Ahmari Ali , GHEMLAS IBRAHIM , ALSAEDI HAWAZEN , AlAnazi Awatif , Khan Saadiya , Qattan Donya , Al-Seraihy Amal
Published: April 2023

Stem cell transplantation (HCT) restores normal hematopoiesis in Fanconi anemia patients but survivors remain prone to long-term complications. This study was conducted to review the late effects and psychosocial adjustment in life for long term survivors of FA patients. Medical records of 149 patients with FA who underwent allogeneic HCT were reviewed. Cumulative probabilities of OS at 10- and 15 years were 76.6%±3.6% and 69.8%±4.4% respectively. Median OS time was 22.8 years. Eighty-seven patients were successfully contacted for follow up. Late-effects were reported by 47. The most commonly reported late-effects were hypothyroidism, amenorrhea and ocular problems. About two-third of our alive patients (n = 58, 66.7%) had achieved a minimum of high school education; only three (3.4%) got married. None had children. Of those 45 patients who were above 20 years of age at last contact, 42 (93.3%) were still living with their parents, two (5.0%) had rental accommodation and one female was living independently. Only nine (20%) of recipients who were above 20 years of age were able to secure an employment, two of whom were self-employed. Long term close follow-up is crucial to detect such complications. Psychological and social counseling should be an integral part of their follow up.
Prognostic Significance of positive lymph node regression grade to Neoadjuvant Chemoradiation for Esophageal Squamous Cell Carcinoma
Authors: Zhou Yehan , Liu Ying , Guo Peng , Huang Zongyao , Zhou Chengmin , Yang Hong , Qin Sheng , Zhu Jie , Wang Yi , Leng Xuefeng , He Wenwu , Wang Qifeng , Liu Yang
Published: April 2023

Background and Purpose To assess the relationship between metastatic lymph node (LN) responder status and recurrence-free survival (RFS) in patients undergoing neoadjuvant chemoradiotherapy (NCRT).Materials and Methods We retrospectively reviewed 304 patients with local advanced esophageal squamous cell carcinoma received NCRT followed by esophagectomy. For 112 patients with positive node, according to the proportion of residual viable tumor cells area within the whole tumor beds of all metastatic LNs, we classified LN-tumor regression grade (LN-TRG) into four categories: grade 1, 0%; 2, < 10%; 3, 10–50%; 4, > 50%. Patients with grade 1 LN-TRG of were considered LN responders, and those with grades 2–4, as LN nonresponders. Univariate and multivariate analyses of recurrence-free survival (RFS) were estimated by a Cox regression model, Kaplan-Meier curve, and log-rank test.Results The median follow-up time of a total of 112 patients was 29.6 months. 52 (46.4%) patients have experienced recurrence. In Cox univariate analysis, LN responder status, nerve invasion, and lymphovascular invasion significantly correlated with RFS. Multivariate analysis for RFS revealed that LN responder status (P < 0.05) was an independent prognostic factor. The 3-year RFS rates for patients with LN-TRG of 1 to 4 grades were 72.7%, 76.5%, 37.4%, and 28.5%, respectively, and the median RFS times were not reach, 43.56 months, 28.09 months, 22.77 months, respectively.Conclusions LN responder status is an independent prognostic factor for RFS in esophageal cancer patients who received NCRT.
Exploring learner profiles among low-educated adults in second-chance education: individual differences in quantity and quality of learning motivation and learning strategies used
Authors: Mertens Bea , De Maeyer Sven , Donche Vincent
Published: April 2023

Research on learning strategies and learning motivation in different educational contexts has provided valuable insights, but in this field, low-educated adults remain an understudied population. This study addresses this gap by means of a person-oriented approach and seeks to investigate whether quantitatively and qualitatively different learner profiles can be distinguished among low-educated adults in second-chance education (SCE) by relating three key components of learning: learning motivation, regulation and processing strategies. 512 adult learners of six SCE-institutions filled in a Learning and Motivation questionnaire. Latent profile analysis shows the presence of motivational profiles differing both in quantity and quality (i.e., good- versus poor-quality and high- versus low-quantity motivational profiles) and regulatory profiles being distinct in the use of regulation strategies (i.e., self-regulated versus unregulated profiles). Mainly quantitatively different processing profiles were found among low-educated adults (i.e., active, moderate, inactive processing profiles). When integrating all three components of learning, analyses identified two more optimal motivational-learning profiles, combining good-quality motivation with a moderately-active use of self-regulation and processing strategies (i.e., good-quality motivation – self-regulated – active processing profile and good-quality motivation – moderate profile) and two more suboptimal profiles in which poor-quality or low-quantity motivation is combined with the inactive use of self-regulation and processing strategies (i.e., poor-quality motivation – unregulated – inactive processing profile, low-quantity motivation – unregulated – inactive processing profile). A fifth motivational-learning profile exhibits a pattern of poor-quality motivation combined with a moderately-active use of self- regulation and processing strategies.
Puerperal Preeclampsia among Women with no History of Perinatal Preeclampsia
Authors: Mzuri Shaveen , Raouf Nazdar , Shamdeen Maida
Published: April 2023

To study the characteristics of delayed puerperal preeclampsia/eclampsia in women after delivery and its clinical management. This multicenter retrospective study involved analysis of cases diagnosed with delayed-onset puerperal preeclampsia/eclampsia upon readmission, from 48 hours-6 weeks after delivery. Total of 170 women were included in the study, out of which 50 were included in case group, and 120 in control group. The identification of cases was made by using the International Classification of Diseases (ICD-9). Data were collected by chart review, and the current version of the SPSS software package was used for data analysis. Case group had mostly non-white racial origin women, 16% of whom were found to be smokers with an elevated maternal pre-pregnancy BMI. There was an increased risk factor for readmission in association with gestational diabetes, and 50% in the case group had a C-section for delivery. Greater birth weight is observed in women with delayed puerperal preeclampsia than those in the control group. Multiple gestations were correlated with a higher risk for readmission. About 34% of patients had a prior history of eclamptic fit at home and were admitted with headaches as a typical symptom observed. HELLP syndrome was observed in 10% of patients. Intracranial hemorrhage was secondarily responsible for 4% of maternal deaths, and 8 women were admitted to the ICU. Postpartum women should be monitored for early detection of symptoms of preeclampsia. Especially women with this risk factor need appropriate treatment to reduce maternal mortality.
Distributed Cracking Mechanisms in Micro-Polypropylene Based Textile Reinforced Concrete
Authors: Dey Vikram , Li Anling , Bauchmoyer Jacob , Dittel Gozdem , Gries Thomas , Schaef Steve , Mobasher Barzin
Published: April 2023

A pultrusion system was developed for manufacturing micro polypropylene textile-reinforced concrete (PP-TRC) composites. Warp-knitted textiles with pillar and tricot knitted patterns were produced from micro multifilament PP yarns and fed into the mortar in a computer-controlled production setup. Instrumented uniaxial tension mechanical tests were conducted on specimens with tricot and pillar knitting patterns of textiles at different volume fractions. Tensile properties of PP-TRC composites were compared to unidirectional fiber composites from a previous study. The strain-hardening mechanism was observed due to the formation of distributed cracking and enhanced tensile response. Digital Image Correlation (DIC) was used to measure the crack spacing and width distributions as a function of applied strain. The nature of crack formation shows the extent of parallel cracking in TRC to be more uniform and densely packed compared to the uniaxial PP fiber composites. The homogeneous distribution of cracks is observed in both textile knitting patterns as measured by the distributed cracking parameters. A significant difference between the average crack width-strain curves of pillar and tricot knits is not observed. The strain measured from DIC was correlated with the damage parameters, the sequence of evolution of cracks, crack spacing, and crack width. A procedure is developed to measure the allowable stress at the ultimate crack width limit. Results show that a limit state of 1 mm crack opening will correspond to the maximum allowable stress of 7.5 MPa that corresponds to a nominal strain of about 7% as the limit state for PP-TRC materials.
An economic evaluation of pharmacopuncture versus usual care for chronic neck pain: A pragmatic randomized controlled trial
Authors: Kim Doo-Ri , Kim Eun-San , Song Hyun-Jin , Park Sun-Young , Park Kyoung-Sun , Lee Yoon-Jae , Ha In-Hyuk
Published: April 2023

Background This study aimed to evaluate the cost utility of pharmacopuncture in comparison with usual care for patients with chronic neck pain.Methods A 12-week, multicenter, pragmatic randomized controlled trial was conducted, and 101 patients suffering from chronic neck pain for more than six months were randomly placed into the pharmacopuncture and usual care groups to receive four weeks of treatment and 12 weeks of follow-up observations. The quality-adjusted life year (QALY) was calculated using EQ-5D and SF-6D. Concerning costs in 2019, a primary analysis was performed on societal perspective cost, and an additional analysis was performed on healthcare perspective cost.Results Compared to usual care, pharmacopuncture was superior as it showed a slightly higher QALY and a lower incremental cost of $1,157 from a societal perspective. The probability that pharmacopuncture would be more cost-effective at a willingness-to-pay (WTP) of $26,374 was 100%. Pharmacopuncture was also superior from a healthcare perspective, with a lower incremental cost of $26. The probability that pharmacopuncture would be more cost-effective at a WTP of $26,374 was 83.7%.Conclusions Overall, pharmacopuncture for chronic neck pain was found to be more cost-effective compared to usual care, implying that clinicians and policy makers should consider new treatment options for neck pain.
Design and Realization of a Logistics Management Information System for Modern Logistics Enterprises Based on Java Stability and Robustness
Authors: Ma Mingze
Published: April 2023

In order to standardize the logistics management process of Chinese logistics enterprises, we analyzed the current state of logistics management of many large logistics enterprises in China and designed, researched, and developed a logistics management information system for modern logistics enterprises in China from the perspective of information integration. This research addresses several key issues and requirements in China’s logistics information management, such as complete basic information and management index system based on project and business contract management methods and linked logistics enterprise contract management subsystem, personnel management subsystem, transportation management subsystem, quality management subsystem, warehouse management subsystem, loading and unloading management subsystem, labor management subsystem, insurance management subsystem, property management subsystem, and system integration of the basic information subsystem. The information system is designed, researched and developed by Java, the information system has passed the function test and robustness test, and runs stably with remarkable economic benefits.
Spatio-temporal Characteristics of Meteorological Drought based on the MCI of Penman-Monteith
Authors: Yu Haixia , Yang Dandan , Liu Bingjun , Fu Jianyu , Liang Zhihao
Published: April 2023

The severity of global climate change is increasing, resulting in more frequent occurrences of drought disasters. Accurate evaluation of Spatio-temporal changes in drought using drought indices is of significant practical importance. This study employed the MCI based on Penman-Monteith, in combination with Kriging spatial interpolation, linear trend analysis, Mann-Kendall mutation test, and the EOF analysis to analyze annual and seasonal variations of different drought level days, drought station ratio, drought impact range, and drought cumulative intensity, and to study their interrelationships. The focus of this article is on the Spatio-temporal characteristics of meteorological drought in the Pearl River Basin over the past 60 years. The findings indicate that the annual average number of drought days exhibits a decreasing trend from the central to the eastern and western parts of the basin, with the western region experiencing more drought days than the eastern region. Furthermore, the highest frequency of drought occurs in winter, followed by spring and autumn, while summer experiences the lowest frequency. Additionally, there is a positive correlation between the drought impact range and drought cumulative intensity. Based on the EOF decomposition, the drought cumulative intensity can be primarily divided into two modes, the drought consistently changes throughout the entire basin, and the wet-dry distribution is opposite in the western and eastern parts. Studying the drought conditions in the Pearl River Basin based on the MCI can not only provide reference for drought research in different regions of the world but also provide a scientific basis for global climate change response and drought management and forecasting.
Delayed intracranial hemorrhage after head trauma seems rare and rarely needs intervention - even in antiplatelet or anticoagulation therapy
Authors: Bergenfeldt Henrik , Forberg Jakob Lundager , Lehtinen Riikka , Anefjäll Ebba , Vedin Tomas
Published: April 2023

Background Traumatic brain injury causes morbidity, mortality and many emergency department visits. Computerized tomography of the head is the gold standard to detect traumatic intracranial hemorrhage. Some are not diagnosed at the first scan and they are denoted “delayed intracranial hemorrhages”. To detect these delayed hemorrhages, current guidelines for head trauma recommend observation and/or rescanning for patients on anticoagulation therapy but not for patients on antiplatelet therapy. The aim of this study was to investigate the prevalence and need for interventions of delayed intracranial hemorrhage after head trauma.Methods The study was a retrospective review of medical records of adult patients with isolated head trauma presenting at Helsingborg General Hospital between January 1 2020 to December 31, 2020. Univariate statistical analyses were performed.Results In total, 1627 patients were included and four (0.25%, 95% confidence interval 0.06–0.60%) patients had delayed intracranial hemorrhage. One of these patients was diagnosed within 24 hours and three within 2–30 days. The patient diagnosed within 24 hours and one of the patients diagnosed within 2–30 days were on antiplatelet therapy. None of these four patients were prescribed anticoagulation therapy and no intensive care, no neurosurgical operations or deaths were recorded.Conclusion Traumatic delayed intracranial hemorrhage seems rare and consequences mild and antiplatelet and anticoagulation therapy might confer similar risk. Because serious complications appear rare, observing and/or rescanning all patients with either of these medications can be debated. Risk stratification of these patients might have the potential to identify the patients at risk while safely reducing observation times and rescanning.
Giant ionospheric density hole near the 2022 Hunga-Tonga volcanic eruption: Multi-point satellite observations
Authors: Choi Jong-Min , Lin Charles , Rajesh P. K. , Lin Jia-Ting , Chou Marty , Kwak Young-Sil , Chen Shih-Ping
Published: April 2023

A giant ionospheric hole was simultaneously detected in the in-situ measurements of FORMOSAT-7/COSMIC-2 (F7/C2), Ionospheric Connection Explorer (ICON), Swarm missions, and ground-based total electron content (TEC) by global navigation satellite system receivers, and F7/C2 Global Ionosphere Specification (GIS) data near Tonga, following the explosive volcano eruption on 15 January 2022. The TEC maps displayed the huge depletions that developed near Tonga after the eruption and gradually evolved. The ICON IVM, F7/C2 IVM and Swarm-LP detected large depletions not only near Tonga but also in the EIA trough region. The GIS observations clearly show the ionospheric hole that extends spatially near Tonga, especially strongly south/southward. The simultaneous observations showed that the ionosphere hole near Tonga combined with the EIA trough and finally evolved into a giant ionosphere hole around 07 UT. The ionospheric hole, which occurred at 05 UT near Tonga, extended over a wide area of 160°-200°E and 25°S-20°N and lasted for about 11 hours. The F7/C2 and ICON satellites overpasses showed large ion density depletions by the hole at orbit altitudes, accompanied by enhancements in ion temperature and field-aligned and vertical ion drift. Such a long-lasting giant ionospheric hole by a seismic event has not been reported earlier, creating a unique ionospheric environment near Tonga after the eruption. The strong successive impulses by multiple volcano eruptions, together with O/N2 decrease in the summer hemisphere, interhemispheric wind, and water vapor injection into high altitudes apparently yielded such a giant ionospheric hole, 4 ~ 6 times larger than that observed during the Tohoku earthquake.
Study protocol of short-course radiotherapy combined with CAPOX and PD-1 inhibitor for locally advanced colon cancer: a randomized, prospective, multicentre, phase Ⅱ trial (TORCH-C)
Authors: Zhang Hui , Li Yaqi , Xia Fan , Sun Yiqun , Shen Lijun , Wan Juefeng , Chen Yajie , Wang Yaqi , Zhou Menglong , Wu Ruiyan , Zhou Shujuan , Wang Yan , Liu Fangqi , Cai Sanjun , Zhang Zhen
Published: April 2023

Background The preliminary result of the TORCH trial has showed promising complete response (CR) for managing locally advanced rectal cancer (LARC) with neoadjuvant short-couse radiotherapy (SCRT) combined with chemotherapy and PD-1 inhibitor. For locally advanced colon cancer (LACC) with bulky nodal disease and/or clinically T4, neoadjuvant chemotherapy followed by colectomy with en bloc removal of regional lymph nodes is the suggested treatment. However, the CR rate is less than 5%. TORCH-C will aim to investigate neoadjuvant short-couse radiotherapy combined with chemotherapy and PD-1 inhibitor in LACC.Methods TORCH-C is a randomized, prospective, multicentre, double-arm, open, phase Ⅱ trial of SCRT combined with chemotherapy and immunotherapy in LACC with microsatellite-stable (MSS) patients and cT4 or bulky nodes. Eligible patients will be identified by the multidisplinary team. 120 patients will be randomized 1:1 to the intervention or control arm. The patients in the control arm will receive 4 cycles of capecitabine plus oxaliplatin (CAPOX). The patients in the intervention arm will receive SCRT, followed by 4 cycles of CAPOX and PD-1 inhibitor (Serplulimab). Both arms will receive curative surgery, followed by 4 cycles of CAPOX. The primary endpoint is pathologic complete regression (pCR).Discussion TORCH-C trial aims to investigate whether the combination of immunotherapy and chemoradiotherapy improves the treatment effect in LACC with MSS. TORCH-C will establish the TORCH platform, a key part of our long-term strategy to develop neoadjuvant treatment for colorectal cancer (CRC).Trial registration: The trial has been registered in ClinicalTrials.gov on Feburary 16, 2023 (Registration No. NCT05732493).