In order to balance the conflicts among mass flow rate, total pressure ratio, adiabatic efficiency and stall margin in a low-bypass transonic fan, the optimization of the rotor blade is implemented in this study. An advanced 3D optimization design system is adopted, and flow diagnostic methods based on vorticity dynamics are employed to discuss the flow field. Results indicate that by controlling the blade camber line curvature, significant improvements in the aerodynamic performance for the fan stage are achieved, the total pressure ratio is increased by 1.90%, while the adiabatic efficiency and mass flow rate are increased by 4.45% and 5.82%, respectively. Vorticity diagnosis suggest that there exists a close link between performance parameters and vorticity parameters in the axial fan/compressor, both azimuthal vorticity and boundary vortex flux have significant influences on the stage performance. Moreover, the boundary layer separation is accompanied by the spike of entropy and static pressure, while the derivation/gradient of these flow parameters would also suffer drastic changes under the effect of shock wave. The vorticity parameters could provide detailed flow information about the on-wall flow with high accuracy, which provides the researchers with a novel method for the turbomachinery aerodynamic design and analysis.

Toshiba devised the bladeless fan (or Air Multiplier) concept in 1981. Researchers like James Dyson and Jafari et al. further developed it. Bladeless fans are more energy-efficient, safer due to the hidden blades, easier to clean, and more adjustable than conventional fans. From a performance point of view, bladeless fans are better because they multiply mass flow rate, eliminate buffeting, consume less power, and are quieter. This paper investigates the influence of the airfoil’s outlet slit thickness on the discharge ratio by varying the outlet slit thickness of an Eppler 473 airfoil from 1.2 mm to 2 mm in intervals of 0.2 mm. Results indicated that smaller slits showed higher discharge ratios. The airfoil with a 1.2 mm slit thickness showed a discharge ratio of 18.78, a 24% increase from the discharge ratio of the 2 mm slit. The effect of outlet angle on the pressure drop across the airfoil was also studied. Outlet angles were varied from 16∘ to 26∘ by an interval of 2∘. The airfoil profile with a 24∘ outlet angle showed a maximum pressure difference of 965 Pa between the slit and leading edge. In contrast, the 16∘ outlet angle showed the least pressure difference of 355 Pa. Parameters such as average velocity, turbulent kinetic energy, the standard deviation of velocity and outlet velocity magnitude was used to assess the performance of airfoil profiles used in bladeless fan.

Deterministic-stochastic empirical mode decomposition (EMD) is used to obtain low-frequency (non-diffusive, i.e., background velocity) and high-frequency (diffusive, i.e., eddies) components from a Lagrangian drifter‘s trajectory. Eddy characteristics are determined from the time series of eddy trajectories from individual Lagrangian drifter such as the eddy radial scale, eddy velocity scale, eddy Rossby number, and eddy-background kinetic energy ratio. A long-term dataset of the SOund Fixing And Ranging float time series obtained near the California coast by the Naval Postgraduate School from 1992 to 2004 at depth between 150 and 600 m (http://www.oc.nps.edu/npsRAFOS/) is used as an example to demonstrate the capability of the deterministic-stochastic EMD.

Low-sodium salt substitute (LSSS) has the potential in regulating sodium and potassium intake and has been available in China market for years. However, its real-world use and impact to sodium\potassium intake is unclear. Baseline data of 4000 adult participants who participated in three similar-designed randomized controlled trails were pooled together for this study. Self-reported awareness and use of LSSS were collected using the uniform questionnaire, and the 24-h urinary sodium and potassium excretion was used to estimate their dietary intake. Mixed-effects models were developed to assess the relationship between LSSS and 24-h urinary sodium and potassium excretion. 32.0% of the participants reported awareness of LSSS and 11.7% reported its current use. After adjusting location, sex, age, and education, compared with the group of participants unaware of LSSS, participants who were aware but not using LSSS and those who were using LSSS had a lower 24-h urinary sodium excretion by –356.1(95% CI: –503.9, –205.9) mg/d and –490.6(95% CI: –679.2, –293.7), respectively (p<0.001). No significant difference was found for 24-h urinary potassium excretion and sodium-to-potassium ratio among the three groups (p>0.05). In conclusion, although associated with lower sodium intake, the awareness and real-world use of LSSS are still very low in China.

The lattice reduction aided(LRA) algorithm has attracted widely attention of researchers in MIMO systems because of its low complexity to achieve full diversity. However, most lattice reduction auxiliary algorithms do not directly improve system performance. In this paper, a modified lattice reduction successive interference cancellation (SIC) algorithm is proposed for MIMO OFDM system mild changing the complexity of LRA algorithm. At present, the MMSE SQRD algorithm has the problem of regarding too much useful signals as the residual interference which cannot be cancelled by successive interference cancellation. Since the diagonal elements of useful signals are non-zero, the components of the symbols to be detected still present in the interference term, treating all the signals as interference will be resulted in performance loss. To solve this problem, the modified matrix is proposed.by moving this symbol component into the signal term, the proposed algorithm can provide the better performance than MMSE SQRD algorithm. The analysis shows that the LRA-MMSE-SIC algorithm of proposed in this paper significantly improves the system performance with mild increasing the complexity. The simulation results show that the performance of the proposed algorithm is improved by 1dB and 8dB compared with the comparison algorithm when the bit error rate is 10−3.

Obesity is a troubling public health problem worldwide as it increases risks of respiratory complications, systemic arterial hypertension, type 2 diabetes mellitus, sleep disorders, cardiovascular diseases, and metabolic syndrome (MetS). As a measure to counteract comorbidities associated with severe obesity, bariatric surgery stands out. This study aimed to investigate the adiponectin/leptin ratio in women with severe obesity with and without MetS undergone Roux-en-Y Gastric Bypass (RYGB) and to characterize the biochemical, glucose, and inflammatory parameters of blood in women with severe obesity before and after RYGB. Were enrolled female with severe obesity undergoing RYGP with MetS (n=11) and without (n=39). Anthropometric data and blood samples were obtained before and 6 months after RYGB to analyze total cholesterol, low-density lipoprotein (LDL), high- density lipoprotein (HDL), non-HDL total cholesterol, and glucose; and circulating levels of adiponectin and leptin. Significant reductions in weight, body mass index, and glucose, total cholesterol, LDL, and leptin were observed after surgery, with higher levels of HDL, adiponectin, and adiponectin/leptin ratio observed after surgery compared to preoperative values. This study demonstrated that weight loss induced by RYGB in patients with severe obesity with or without MetS improved biochemical and systemic inflammatory parameters, particularly the adiponectin/leptin ratio.

The influence of the Fe2O3 addition amount on the dephosphorization of hot metal at 1623 K with the slag of the low basicity (CaO/SiO2) of about 1.5 was investigated by using high-temperature laboratorial experiments. With increasing the Fe2O3 addition amount, the contents of [C], [Si], [Mn] and [P] in hot metal at the end of dephosphorization decrease, and the corresponding removal ratios increase. The P2O5 content in slag increases, and the CaO and SiO2 contents in slag decrease. The phosphorus mainly exists in the form of the nCa2SiO4-Ca3(PO4)2 solid solution in the phosphorus-rich phase and the value of coefficient n decreases from 20 to 1 with increasing the Fe2O3 addition amount from 5 g to 30 g. With increasing the Fe2O3 addition amount, the oxygen potential and activity at the interface between the slag and hot metal increase. When the oxygen potential and the oxygen activity at the interface are greater than 0.72×10-12 and 7.1×10-3, respectively, the dephosphorization ratio begins to increase rapidly. With increasing the Fe2O3 addition amount to 30 g, the ratio of the Fe2O3 addition amount to theoretical calculation consumption is around 175%, and the dephosphorization ratio reaches the highest value of 83.3%.

In the environments of all kinds open coal storage sites , mining-affected coalbeds, and goafs, parts of coal body at low moisture content (≤8%) are prone to spontaneous combustion under the influence of some external environmental factors. In order to examine the influence effect of low moisture content on the spontaneous combustion tendency of coals with different metamorphic grade, we conducted temperature programmed oxidation (TPO) experiment and differential scanning calorimetry (DSC) experiment to study the spontaneous combustion characteristics of coals with different metamorphic grade at four different low moisture content, and comparatively analyzed the change laws of the characteristic parameters of four different metamorphic grade coals at four different low moisture content. The experimental results indicate that: 1) Compared other low moisture content, anthracite and fat coal at low moisture content of 1.2% show stronger tendency to undergo spontaneous combustion, long flame coal and lignite at low moisture content of 3.4% and 5.6% are more prone to spontaneous combustion. 2) Four different metamorphic grade coals at low moisture content of 7.8% are less prone to spontaneous combustion; 3) Coals with different metamorphic grade have different tendency to undergo spontaneous combustion.

Satellite communication is expected to play a vital role in realizing Internet of Remote Things (IoRT) applications. This article considers an intelligent reflecting surface (IRS)-assisted downlink low Earth orbit (LEO) satellite communication network, where IRS provides additional reflective links to enhance the intended signal power. We aim to maximize the sum-rate of all the terrestrial users by jointly optimizing the satellite’s precoding matrix and IRS’s phase shifts. However, it is difficult to directly acquire the instantaneous channel state information (CSI) and optimal phase shifts of IRS due to the high mobility of LEO and the passive nature of reflective elements. Moreover, most conventional solution algorithms suffer from high computational complexity and are not applicable to these dynamic scenarios. A robust beamforming design based on graph attention networks (RBF-GAT) is proposed to establish a direct mapping from the received pilots and dynamic network topology to the satellite and IRS’s beamforming, which is trained offline using the unsupervised learning approach. The simulation results corroborate that the proposed RBF-GAT can achieve approximate performance compared to the upper bound with low complexity.

Rapeseed (Brassica napus) is one of the most important oil crops in the world; however, drought significantly curtails its growth and productivity. Identifying drought-tolerant germplasm is an efficient and low-cost strategy for addressing water shortages. Using water loss ratio (WLR) as an index of drought tolerance, we screened a panel of 265 B. napus lines. We identified eight low-WLR and six high-WLR accessions, which were regarded as drought-tolerant and drought-sensitive, respectively. Further validated these selected accessions at the seedling stage under drought-stress conditions. The drought-tolerant accessions had significantly greater fresh and dry weights under drought stress than the drought sensitive accessions. Using RT-qPCR, we showed that a set of previously reported drought-adaptive marker genes were expressed at higher levels in the drought-tolerant lines than in the drought-sensitive lines. These results indicated that the drought-tolerant genotypes could be identified from natural populations using WLR. Then, we performed a genome-wide association study to identify loci harboring single nucleotide polymorphisms (SNPs). A total of 139 SNPs were significantly associated with the WLR, of which chromosome A10 harbored the largest number. Furthermore, four putative candidate genes were selected by combining the SNP–WLR association results and transcriptional expression data with the changes in drought tolerance. Thus, we have identified two drought-tolerant B. napus cultivars and uncovered genome-wide variation differentiating B. napus lines related to WLR, in addition to providing insights for further research into WLR-related drought mechanisms.

The origin of neurodegenerative diseases is linked to the abnormal folding of disease-associated proteins. The traditional amyloid hypothesis has been a focal point of research, but recent findings suggest a more complex picture. This review explores the role of physiological conformation of aggregation-prone domain (also known as prion-like low complexity domain) and multiple co-misfolded proteins in neurodegenerative diseases. We highlight the importance of targeting multi-heterotypic misfolded proteins for effective treatments and emphasize the irreversible neurodegeneration stemming from the loss of physiological folding in prion-like disease-causing proteins underscores the criticality of refolding. Additionally, we introduce the concept of ReproFold Therapeutics, a novel approach aimed at restoring the cellular prion-like folding of disease-causing proteins to rebuild normal cross-β interactomes and mitigate neurodegeneration. Baicalein, a potential drug candidate for this approach, shows promise in vitro and in animal models. Moreover, prion-like low complexity domains implicated in neurodegeneration are also associated with other disorders such as diabetes, cancers, and mental illnesses. Understanding the core pathology of neurodegenerative diseases and the broader implications of prion-like LC domains could revolutionize healthcare approaches and policies worldwide.

In this paper, the Fourier-based synchrosqueezing transform (FSST) method is introduced into the power system to realize low frequency oscillation identification. Firstly, the modal components of low frequency oscillation signal are separated by FSST, and calculating the instantaneous parameters including magnitude, frequency and phase of every mode component with Hilbert transform. Then , calculating the damping ration of every modal component based on above parameters and derived the formulas. Thus, it realized effective identification of of modal parameters of low frequency oscillation signal. The experimental results of simulated data and 16-generator system demonstrate the validity and correctness of the FSST method. Comparing with the classical Prony method shows that the FSST method is better in the identification accuracy when the low frequency oscillation signal is polluted by noise. Finally, the effectiveness of the FSST in Actual power grid is verified based on the real data from Sichuan power grid.

Objective: The aim of this study was to evaluate the clinical outcome of patients suffering from chronic limb threatening ischemia (CLTI) and tissue loss treated with primary isolated femoral bifurcation endarterectomy (FBE) or with FBE combined with bypass surgery. Methods: This retrospective study was performed in a tertiary university based care center. Between January 2008 and December 2019 a prospectively collected database of patients suffering from CLTI and tissue loss and undergoing either primary FBE (group A) or FBE in combination with bypass surgery (group B) was analysed. Study endpoints were ulcer healing, primary and secondary patency rate, limb salvage and survival. Results: In total, FBE was performed in 73 and FBE with bypass in 60 patients. Between both groups there were no significant differences regarding demographic data or the Global Limb Anatomic Staging System (GLASS) grade III and IV of femoropopliteal lesions. After 3 years, ulcer healing could be achieved in 72% of FBE and in 75% of FBE with bypass patients. The primary patency rate was 95% and 91% for FBE and 83% and 80% for FBE with bypass after one and three years, respectively. The 3-year limb salvage rate was 78% for FBE and 84% for FBE with bypass. The secondary patency rate after one and three years was 99% and 97% for FBE and 93% and 88% for FBE with bypass. Conclusion: FBE and FBE with bypass are equally effective for ulcer healing in cases of combined CFA and superficial femoral artery lesions. There was no significant difference between both groups regarding primary and secondary patency

The C/N ratio is an extremely important parameter in the composting process, which is directly responsible for the growth of microorganisms. A low C/N ratio contributes to higher emissions of greenhouse gases and odorous substances, such as ammonia (NH3), which is formed by nitrogen mineralization. Due to the highly toxic effects of ammonia, it is a particularly unwanted by-product that can disrupt the composting process because it poisons microorganisms and cause environmental issues. The activity of anammox bacteria, so far analyzed only in wastewater treatment processes, is a particularly efficient method of nitrogen removal, having an advantage over the conventional methods used previously. Our study proofs the presence of anammox bacteria during composting, what gives an opportunity to improve the process and reduce its impact on atmospheric pollution. Despite the aerobic nature of this process, the composted mass of waste presents conditions conducive to the development of these ammonia oxidizing bacteria, as well as other strains of microorganisms cooperating with them. This makes it possible to compost at a low C/N ratio; in addition, there is no need for additional energy supply through aeration, as the processes carried out by anammox bacteria do not require oxygen.

The ridge-furrow plastic mulching (RFPM) system and nitrogen application have been effective strategies for improving crop productivity in the Loess Plateau of China. However, it is not clear how the ridge-furrow ratio and nitrogen fertilizer type (NT) affect the utilization of water, nitrogen, heat and radiation resources for increased rain-fed wheat production. Two nitrogen fertilizer types [Traditional urea (TU) and controlled-release urea (CRU)] and four planting patterns [conventional flat planting (F) and the RFPM system of 20 cm ridge with 40 cm furrow (R2F4), 40 cm ridge with 40 cm furrow (R4F4), and 60 cm ridge with 40 cm furrow (R6F4)] were tested from September, 2018 to June, 2021 during winter wheat growing season. The results showed that the RFPM system can increase the soil thermal time (TTsoil) by 41.0–152.1°C d compared to F. The thermal effect of the RFPM system shortens the vegetative growth period and extends the reproductive growth period by 2–7 days, promoting the increase of the leaf area index (LAI) and final dry matter (DM) accumulation. These significantly increased the grain yield (GY) in the RFPM system by 51.6–115.2% and enhanced the thermal time use efficiency (TUE) by 48–99.5%, water productivity (WP) by 37.4–76.3%, radiation use efficiency (RUE) by 16.3–34.4%, and partial factor productivity of nitrogen (PFPN) by 51.6–115.2% compared to F. Although a high ridge-furrow ratio combined with CRU increased GY and resources use efficiency, it also exacerbated the soil water depletion, especially in the 40–140 cm soil layer. Overall, applying CRU in combination with the RFPM system of 40 cm ridge with 40 cm furrow maximized resources use efficiency and increased wheat production in the Loess Plateau of China.

Abstract: As a low-input crop, Miscanthus offers numerous advantages that, in addition to agricultural applications, permits its exploitation for energy, fuel, and material production. Depending on the Miscanthus genotype, season, and harvest time as well as plant component (leaf versus stem), correlations between structure and properties of the corresponding isolated lignins differ. Here, a comparative study is presented between lignins isolated from M. x giganteus, M. sinensis, M. robustus and M. nagara using a catalyst-free organosolv pulping process. The lignins from different plant constituents are also compared regarding their similarities and differences regarding monolignol ratio and important linkages. Results showed that the plant genotype has the weakest influence on monolignol content and interunit linkages. In contrast, structural differences are more significant among lignins of different harvest time and/or season. Analyses were performed using fast and simple methods such as nuclear magnetic resonance (NMR) spectroscopy. Data was assigned to four different linkages (A: b-O-4 linkage, B: phenylcoumaran, C: resinol, D: b-unsaturated ester). In conclusion, A content is particularly high in leaf-derived lignins at just under 70 % and significantly lower in stem and mixture lignins at around 60 % and almost 65 %. The second most common linkage pattern is D in all isolated lignins, the proportion of which is also strongly dependent on the crop portion. Both stem and mixture lignins, have a relatively high share of approximately 20 % or more (maximum is M. sinensis Sin2 with over 30 %). In the leaf-derived lignins, the proportions are significantly lower on average. Stem samples should be chosen if the highest possible lignin content is desired, specifically from the M. x giganteus genotype, which revealed lignin contents up to 27 %. Due to the better frost resistance and higher stem stability, M. nagara offers some advantages compared to M. x giganteus. Miscanthus crops are shown to be very attractive lignocellulose feedstock (LCF) for second generation biorefineries and lignin generation in Europe.

Glutamine is the main amino acid which is substrate for gluconeogenesis in postoperative period. It is suggested that this leads to a substantial and a long-term decline in glutamine concentration. Glutamine is a source of energy for the synthesis of nucleotides, lymphocytes and cells of gastrointestinal tract. In this study, 79 patients were qualified to a coronary artery bypass surgery (Group I) or a surgery in the large intestine area (Group II). The objectives of this study were: evaluation of the impact of surgical procedures on the serum concentration of glutamine of the operated patients, assessment of gender, weight and BMI impact on glutamine concentration and analysis of the correlation between glutaminę serum concentration and laboratory parameters. The mean concentration of glutamine before surgery, the 3rd and 5th day after surgery was higher in Group I. CRP level in the 3rd and 5th postoperative day was higher in Group II. There were no significant differences betweengroups when it comes to BMI and the concentration of CRP (p <0.05). Glutamine concentration depends on the severity of inflammation, the operated body cavity and the intensified catabolism which results from different pathophysiology of digestive system diseases and coronary arterial disease.

Knowledge of the temperature evolution is crucial to understand and control laser beam welding of low-melting materials. Existing temperature determination approaches are restricted to i) one-dimensional temperature information (e.g. ratio-pyrometers), ii) a priori knowledge of the emissivity (e.g. thermography) and iii) high temperature regions (e.g. two-wavelength imaging). In this paper, a ratio-based two-color-thermography approach is developed that allows for two-dimensional temperature determination in low-melting temperature ranges (< 1200 K). For static measurement situations it is demonstrated, that temperature can be determined despite variation in signal intensity and emissivity with high accuracy. The two-color-thermography set-up is further transferred into a commercial laser beam welding machine and experiments are conducted for varying process parameters. The direct application of the developed two-color-thermography system in dynamic process situations is limited as image artifacts presumably caused by internal reflections inside the optical beam path are present.

(1) Infective endocarditis is a severe inflammatory disease associated with substantial mortality and morbidity. Alkaline phosphatase (AP) levels have been shown to change significantly during sepsis additionally we previously found higher initial AP drop after cardiac surgery is associat-ed with unfavorable outcomes. Therefore, the course of AP after surgery for endocarditis is of special interest. (2) 314 patients with active isolated left-sided infective endocarditis at the De-partment of Cardiac Surgery (Medical University of Vienna, Austria) between 2009 and 2018 were enrolled in this retrospective analysis. Blood samples were analyzed at different time points (baseline, postoperative day 1-7, postoperative days 14, and 30). Patients were categorized ac-cording to relative alkaline phosphatase drop (≥30% vs. <30%). (3) The rate of postoperative renal replacement therapy with or without prior renal replacement therapy (7.4 vs. 21.8%; p=0.001 and 6.7 vs. 15.6%; p=0.015, respectively) and extracorporeal membrane oxygenation (2.2 vs. 19.0%; p=0.000) was observed after a higher initial alkaline phosphatase drop. Short-term (30-day mor-tality 3.0 vs. 10.6%; p=0.010) and long-term mortality (p=0.008) were significantly impaired after a higher initial alkaline phosphatase drop. (4) The higher initial alkaline phosphatase drop was accompanied by impaired short and long-term outcomes after cardiac surgery for endocarditis. Future risk assessment scores for cardiac surgery should consider alkaline phosphatase.

INTRODUCTION: Achalasia is a pathology with an incidence of 1 in 100,000 inhabitants per year. There are very limited data on achalasia in the obese population, especially in those undergoing bariatric surgery. The approach of choice for cases of achalasia is fundoplication to correct the reflux; however, lacking a fundus due to a previous gastrectomy, an alternative that offers optimal results should be chosen. Here we present the surgical approach in a case of esophageal achalasia and a history of vertical sleeve gastrectomy, where we performed simultaneous Heller's cardiomyotomy and laparoscopic Roux-en-Y gastric bypass, as well as the results obtained. CASE PRESENTATION: 44-year-old woman with no chronic degenerative diseases, with a previous record of vertical sleeve gastrectomy 5 years ago, who started 1 year and 5 months earlier with dysphagia to liquids, then to solids, in addition to weight loss of 10 kilograms in 4 months. The BMI before vertical sleeve gastrectomy was 32 kg/m2, her BMI at the time of admission was 20 kg/m2; she also presented regurgitation and generalized weakness. After analyzing the surgical options, it was decided to perform a Heller cardiomyotomy and a Roux-en-Y gastric bypass. DISCUSSION AND CONCLUSIONS: The procedure turned out to be safe and successful in treating achalasia symptomatology, in addition to complete resolution of the reflux symptom.

Selected glasses with 10 Na₂O + (90-x) P₂O₅ + x BCD where bypass cement dust (BCD) x value =10, 20, 30 in mol% were synthesized by recognizable melting annealing technique. Cooperative characterization of the prepared glasses were carried out through FTIR and SEM analysis before and after immersed in simulated body fluid (SBF) solution for 13 and 23 days at 37 ^oC. After immersion in SBF, apatite layer is produced on the glass surface after 13 day and increase after 23 day, showing good bioactivity after immersion in the SBF especially for bioglass sample with 30% BCD. A porous hydroxy apatite layer produced on the surface of SBF-glass composite and this layer became denser after more soaking time, periods were extended from 13 to 23 days. Atomic absorption spectroscopy explained the early period of soaking that cause release of both Si and Ca ions through the glass beside decreasing of phosphrous ions. Bioglass (BCD-30) is studied as shielding for gamma, protons and alphas by using Phy-X software, SRIM Monte Carlo simulation code and its subroutine TRIM. The gamma shielding parameters, mass stopping power (MSP), range for both proton (H- ions) and alpha (He- ions) in bioglass- BCD-30 and human bone tissue have estimated. Also, comparison between them is calculated in predicting the radiation damage and atomic displacements per atom (dpa).

Infective endocarditis (IE) is a rare but severe disease with high mortality and healthcare burden. Cardiac surgery plays a major role in the contemporary clinical management of IE patients. During cardiac surgery, cardiopulmonary bypass significantly contributes to an increased risk for organ dysfunction and mortality by inducing an acute inflammatory response, vascular endothelial cell injury, impairment of the coagulation cascade, and ischemia‒reperfusion injury. During the past decade, the use of extracorporeal hemoadsorption therapy with the CytoSorb® hemoadsorber has been proposed as an adjuvant therapy to mediate inflammatory responses in IE patients receiving cardiac surgery with cardiopulmonary bypass. However, there is currently a lack of systemic evaluation of the effect of CytoSorb® hemoadsorption on clinical outcomes such as hemodynamics, organ dysfunction, and mortality in patients with IE. Therefore, in this review, we exclusively discuss contemporary findings concerning the rationale, clinical evidence and future perspectives for CytoSorb® hemoadsorption therapy in IE patients.

Background: The current standard technique for vascular grafting in cerebral revascularization surgery is through the interposition of an autologous blood vessel. Technical complications have necessitated the development of a synthetic alternative, but classical biomaterials are not suited for small caliber vascular grafting due to neointimal hyperplasia and thrombosis. Electrospinning of polymers is a promising technique for the development of small vascular grafts. The in vivo performance and efficacy of electrospun polyurethane (ePU) grafts with an internal diameter of < 1.5 mm have thus far not been evaluated. Methods: We developed a novel ePU graft with a diameter of 1.25 mm for implantation into the infrarenal aorta of rats. Results: Patency rates of grafts after a four-month-period were equal to those reported in other studies with larger ePU graft diameters, and equal or higher than in studies with other biomaterials. We observed some loss in flow velocity throughout the grafts, which suggests a decreased elasticity of the graft compared to native rat aorta. However, the grafts demonstrated good neo-endothelialization and minimal neointimal hyperplasia. Their porosity promoted cellular infiltration, as shown on tissue slide examination. Conclusion: Our results show that ePU vascular grafts with internal diameter of < 1.5 mm are promising candidates for vascular grafting in cerebral revascularization surgery.

Aim. Atherosclerotic complex femoropopliteal lesions have traditionally been treated with bypass surgery. A prosthetic graft is used to save the vein graft for more distal revascularization or when unavailable. However, the endovascular approach has gained popularity and is offered as first-line strategy for complex lesions. This study aimed to evaluate whether endovascular procedures for complex femoropopliteal native lesions can be a first-line treatment strategy over open surgery with prosthetic bypass in patients with peripheral arterial disease (PAD). Methods. A retrospective study was conducted between 2013 and 2021 to identify patients with symptomatic PAD who required limb revascularization at the femoropopliteal segment and complex lesions (TASC II C and D). Primary endpoints were technical success, primary patency, freedom from clinically driven target lesion revascularization (cdTLR), freedom from major adverse limb and cardiovascular events (MALE and MACE), freedom from limb loss, and survival. Secondary endpoints were length of in-hospital stay, duration of the procedure, and costs. Results. We identified 185 limbs among 174 suitable candidates for comparison, wherein 105 were treated with endovascular procedure and 80 with femoral popliteal prosthetic bypass. Most patients in both groups presented with chronic limb-threatening limb ischemia, and all were ASA >3. There were more octogenarians (p = 0.02) and patients with coronary disease (p = 0.004) in the endovascular group. Median follow-up was 30 months. Technical failure rate for endovascular procedures was 4.8% vs 0% in the open group (p 0.003). Freedom from MACE was similar in both groups. The endovascular group showed superior primary patency (p<0.0001), cdTLR (p<0.0001), MALE (p<0.0001), and freedom from limb loss (p = 0.0018) at 24 months. Further analysis performed for the open above-the-knee subgroup showed that the aforementioned endpoints were similar at 12 months, and favoured the endovascular group at 24 months. Procedural time and in-hospital stay were longer in the open group (p<0.0001 and p<0.001). Finally, procedural cost was 10-fold lower in the endovascular bypass group than in the prosthetic bypass group. Conclusion. Endovascular procedures for complex femoropopliteal lesions are safe in patients at high risk for surgery and show better outcomes at 24 months than prosthetic bypasses. The latter may be considered as an alternative in cases of endovascular failure.

The saphenous vein is the conduit of choice for bypass grafting. Unfortunately, the hemodynamic stress associated with the arterial environment of the bypass vein graft leads to the development of intimal hyperplasia (IH), an excessive cellular growth and collagen deposition that results in restenosis and secondary graft occlusion. Hydrogen sulfide (H2S) is a ubiquitous redox-modifying gasotransmitter that inhibits IH. H2S is produced via the reverse trans-sulfuration pathway by 3 enzymes: cystathionine γ-lyase (CSE), cystathionine β-synthase (CBS), and 3-mercaptopyruvate sulfurtransferase (3-MST). However, the expression and regulation of these enzymes in the human vasculature remains unclear. Here, we investigated the expression of CSE, CBS and 3-MST in segments of native human saphenous vein and large arteries. Furthermore, we evaluated the regulation of these enzymes in vein segments cultured under static, venous (7 mmHg pressure) or arterial (100 mmHg pressure) pressure. CSE was expressed in the media, neointima and intima of the vessels and was negatively regulated by arterial shear stress. Adenoviral-mediated CSE overexpression or RNA interference-mediated CSE knock-down revealed that CSE inhibited primary human VSMC migration but not proliferation. We propose that high shear stress in arteriovenous bypass grafts inhibits CSE expression in both the media and endothelium, which may contribute to increased VSMC migration in the context of IH.

Background: Transit-time flow measurement (TTFM) is frequently used to evaluate intraoperative quality control during coronary artery bypass grafting (CABG). Although TTFM has the ability to assess graft failure intraoperatively, the perioperative factors affecting TTFM during CABG surgery remain poorly understood. Methods: Patients who underwent CABG surgery at a single institution between July 2016 and May 2018 were prospectively evaluated. Patients’ demographic characteristics, previous medical history, Euroscore, the results of preoperative blood tests, and intraoperative data were recorded. TTFM and blood viscosity were measured hemodynamically, and mean flow (mL/min) and pulsatility index (PI) were recorded. Arterial blood gas was analyzed immediately after anastomosis of the left internal mammary artery (LIMA) to the left descending artery (LAD) and before sternal closure. Factors associated with TTFM were assessed by multiple linear regression analysis. Results: Of the 62 patients who underwent CABG surgery during the study period, 57 were evaluated, including 49 who underwent off-pump and eight who underwent on-pump surgery. Blood viscosity was not significantly associated with TTFM (p > 0.05). However, TTFM was significantly associated with body mass index (BMI), systolic blood pressure, and cardiac index (p < 0.05 each). Conclusions: Blood viscosity was not significantly associated with intraoperative graft flow. Blood flow of graft vessels, however, was significantly associated with BMI, systolic blood pressure, and cardiac index.

In public health literature the risk of death or disease associated with a dietary, environmental of behavioral factor is most commonly denoted by odds ratio (OR), hazard ratio (HR) or risk ratio (RR). The ratio indices have several desirable statistical properties. However, the most important question is whether there are some evolved innate norms of perception of risk that people use and what they are. We conducted a simple one question survey of 98 individuals with different age, sex, educational and professional backgrounds. The respondents were asked to judge the relative perceived risk of four different hypothetical habits for which data on the percentage of people affected by the disease with and without the habit was given. They were asked to rank the risks for the four habits. Results showed that the habits that had the highest difference between probability of acquiring the disease were ranked high on risk perception. The probability ratios did not affect risk perception significantly. Further age, sex, profession or formal training in statistics did not affect the response significantly. Even individuals that were formally trained to use OR and HR as risk indicators, preferred using probability differences over ratios for judging their own risk in the perceived context. This preliminary inquiry into intuitive statistical perception suggests that designing statistical indices based on people’s innate perception may be a better strategy than trying to train people to understand the indices designed by expert statisticians.

Background: Psoriasis is a chronic immune-mediated skin disease in which systemic inflammation plays an important role in the pathogenesis. In recent years, neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-monocyte ratio (NMR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) have been shown to be important indicators of inflammation. In this study, our aim is to investigate NLR, NMR, PLR, and SII levels in psoriasis patients treated with biologic agents. Method: Clinical and biochemical data of 209 patients who received systemic therapy for psoriasis were obtained by retrospectively reviewing their medical records. NLR, NMR, PLR, and SII values were calculated from the hemogram values of the patients. Results: In the third month of follow-up, the mean CRP, NLR, NMR, PLR, and SII values were significantly decreased compared to the baseline values. SII values showed strong positive correlations with NLR, NMR and PLR. Adalimumab, etanercept, and infliximab, which are TNF-α blockers, were observed to be more effective on PLR and NLR and especially NMR. Conclusion: NLR, NMR, PLR, and SII, which are data obtained from routine blood tests, can be used in the monitoring of treatment of psoriasis, especially with TNF- α blockers.

Background and Objectives. Prevalence of GERD is increased among individuals with obesity and RYGB is considered as the most effective procedure to control GERD and obesity. However, some patients continue to have GERD after RYGB. The aim of the study was to investigate the prevalence and the risk factors of GERD after RYGB. Material and Methods. This prospective study included 180 patients operated with RYGB and followed for on average of 12.2 (0.6) years. 126 (70%) patients agreed to participate in online consultations and provided data on weight, GERD symptoms, filled GERD-HRQL, TFEQ-18 and GSRS questionnaires. Results. The average age before surgery was 42.7 (10.5) years and BMI was 45.2 (6.4) kg/m2. 128 (71.1%) were females and preoperative GERD was diagnosed in 74 (41.1%) patients. At 12 years follow-up the mean %EBMIL and %TWL were 60.37 and 25.73, respectively. The median %WR was 18.0 (39.0). The GERD was present in 30 (23.8%) patients, of whom 12 (40%) continued to have GERD symptoms and 18 (60%) developed de novo GERD. The GERD-HRQL score significantly decreased from 3.0 (8.0) at baseline to 2.0 (5.0) (p=0.028) at 12 years. GSRS Diarrhea and Indigestion median scores increased significantly, from 1.33 (0.67) to 1.5 (2.42) (p 3.2.

Background. Carotid artery disease is prevalent among patients with coronary heart disease. The concomitant severe lesions in the carotid and coronary arteries may necessitate either simultaneous or staged revascularization, involving coronary bypass and carotid endarterectomy. However, there is presently a lack of consensus on the optimal choice of surgical treatment tactics for patients with significant stenoses in both carotid and coronary arteries. The aim of the current study was to compare the 30-day and long-term outcomes of coronary and carotid artery revascularization surgery based on the simultaneous or staged surgical tactics. Material and Methods. The single-center, non-randomized retrospective study involved 192 patients with concurrent coronary artery disease and carotid artery stenosis ≥70%, of whom 106 patients underwent simultaneous intervention (CABG+CEA), and 86 patients underwent staged CABG/CEA. The mean time between stages ranged from 1 to 4 months (mean 1.88±0.9 months). Endpoints included death from any cause, nonfatal stroke, nonfatal myocardial infarction (MI), and major adverse cardiovascular events (MACE) (death + nonfatal MI + nonfatal stroke) within 30 days after the last intervention and in the long-term follow-up period (median follow-up - 6 years). Results: The 30-day all-cause mortality, incidence of postoperative nonfatal MI, nonfatal stroke, and MACE did not exhibit differences between the groups after single-stage and staged interventions. However, the overall risk of postoperative complications (adjusted for the risk of any complication per patient) (OR 2.214, 95% CI 0.214-0.954, p=0.034), as well as the duration of ventilatory support (p=0.004), were elevated in the group after simultaneous interventions compared with the staged intervention group. However, this difference did not result in an increased incidence of death and MACE in the group after simultaneous interventions. In the long-term follow-up period, there were no significant differences observed when comparing simultaneous or staged surgical tactics in terms of overall survival (54.9% and 62.6% in groups 1 and 2, respectively, P log-rank = 0.068), nonfatal stroke-free survival (45.6% and 33.6% in groups 1 and 2, respectively, P log-rank = 0.364), nonfatal MI-survival (57.6% and 73.5% in groups 1 and 2, respectively, P log-rank = 0.169), and MACE-free survival (7.1% and 30.2% in groups 1 and 2, respectively, P log-rank = 0.060). Risk factors associated with an unfavorable outcome included age, smoking, BMI, LV EF, and atherosclerosis of lower limb arteries. Conclusions: This study revealed no significant difference in the impact of simultaneous CABG+CEA or staged CABG/CEA on the incidence of death, stroke, MI, and MACE over a 30-day and long-term follow-up period. Although the immediate results indicated an increased risk of a complicated course (attributable to overall complications) after simultaneous CABG+CEA compared with staged CABG/CEA, this did not lead to an increase in fatal complications. Therefore, performing both tactics is deemed safe and eligible after a meticulous postoperative risk assessment.

Introduction: In recent years, platelets have been in short supply and high demand. Approximately one in five cardiac surgery patients require platelets. In our safety-net hospital, however, the incidence is over 40%. Renal dysfunction, long cardiopulmonary bypass (CPB) times, and absence of tranexamic acid (TXA) are common risk factors for requiring platelet transfusions. Methods: Our hypothesis was fewer platelets would be transfused within two hours after bypass under these three conditions: creatinine is low, predicted surgery duration is short, and TXA is uniformly administered. Our anesthesia department designed this retrospective before-and-after observational study when the surgery department decided to narrow preoperative criteria respective to these three elements. The Institutional Review Board of Louisiana State University Health Sciences Center Shreveport approved of the protocol and waived individual informed consent. We compared timing of platelet transfusions (within 7 days) in consecutive patients who had CPB during the first ninety days of 2022 to those in 2023 using t-tests in SAS 9.3. Confounders included age, weight, anticoagulants, gender, and the platelet counts and hemoglobin immediately prior to platelet transfusion. Secondary outcomes were postoperative day two creatinine and other components transfused. Results: Preoperatively creatinine tended to be higher in 2022 at 1.5 vs 1.1, reaching significance postoperatively at 1.9 vs 1.1 (p=0.02). Bypass times decreased from 174 to 124 minutes (p=0.06). TXA use increased from 18 of 28 to 26 of 29 patients. Platelet counts increased on bypass from 142 to 173 (p=0.06). Platelet and hemoglobin nadirs were higher (day 3: 8g/dL vs 8.8, p=0.04; 98 vs 138, p=0.005). Platelet units transfused per patient tended to increase (0.75+/-1 vs 0.93+/-1.5); if exposed, patients tended to receive more units (2.1+/-1.3 vs 2.5+/-1.4) sooner. Changes in transfusions for red cells were nonsignificant at 1.97 per patient to 1.21, cryoprecipitate 0.36 to 0.69, and FFP 0.93 to 0.83. Conclusions: This is the first study examining timing of platelet transfusions after bypass. In the present investigation, we measured platelet count during bypass and prothrombin hours after arrival in the intensive care. Platelets were often administered in sets of two because of scarce immediate supply, partly from lack of an agitator table. More importantly, these data support a need for point-of-care thromboelastograms intraoperatively, but the cost has been prohibitive. Some centers’ algorithms list triggers for transfusion by fibrinogen and prothrombin times, available immediately after separation from bypass.

: Clay covers a substantial portion of the Earth. Such soil covers Iraq’s central and southern regions, where the depth of the clay may reach 150 m. All enhancement techniques and methods for transporting large loads cease to function or become prohibitively expensive in such soils. In this case, thermal treatment is the most effective method. In this study, a novel heating system was created and produced utilizing gas as the heat source via boreholes that simulate reality. The borehole heating cases were planted inside soft clay soil to enhance the soil. Different parameters were investigated, including the spacing between boreholes (3, 4, and 5 times the outer diameter of the borehole), the heating depth (1, 1.5, 2, and 2.5 times the width of the model footing), the duration of heating (2, 4, 6, 8, and 10 hrs), and the pattern (square, circular, triangular). The results showed the strength and behavior of the soil treated with heated boreholes at varying spacings, depths, patterns, and heating periods. The best results were found for a spacing, depth, and heating time of three times the outer diameter of the borehole, two times the width of the footing model, and eight hours, respectively. The effect of the heated borehole casing pattern was small when the heated borehole casing was used. The experiments conducted on heated soil showed that the undrained shear strength (Cu) increased from 14 to 360 kPa and then dropped to 140 kPa (as an average with depth). In contrast, the average angle of internal friction (Ø) rose from 0 to 52 degrees and decreased to 16 degrees (as an average with depth) from the center of the heating model to the furthest point affected by heating. In addition, the EDS pattern showed that components like silicon, aluminum, and iron dropped at 300 °C and rose at 400 °C in the treated soils. At 200 °C, the calcium content rose, and then dropped dramatically at 400 °C. The carbon percentage increased at 300 °C and decreased at 400 °C. The elements’ proportions showed little change or remained stable at temperatures between 400 °C and 600 °C.

The application of the sensors optical fiber in the areas of scientific instrumentation and industrial instrumentation is very attractive due to its numerous advantages. In the industry of civil engineering for example, quasi-distributed sensors made with optical fiber are used for reliable strain and temperature measurements. Here, a quasi-distributed sensor in the frequency domain is discussed. The sensor consists of a series of low-finesse Fabry-Perot interferometers where each Fabry-Perot interferometer acts as a local sensor. Fabry-Perot interferometers are formed by pairs of identical low reflective Bragg gratings imprinted in a single mode fiber. All interferometer sensors have different cavity length, provoking the frequency-domain multiplexing. The optical signal represents the superposition of all interference patterns which can be decomposed using the Fourier transform. The frequency spectrum is analyzed and sensor´s properties were defined. Following, a quasi-distributed sensor was numerically simulated. Our sensor simulation considers sensor properties, signal processing, noise system and instrumentation. The numerical results show the behavior of resolution vs. signal-to-noise ratio. From our results, the Fabry-Perot sensor has high resolution and low resolutions. Both resolutions are conceivable because the FDPA algorithm elaborates two evaluations of Bragg wavelength shift

Solar photovoltaic (PV) generation suffers from multiple serious issues, for example shading effects directly affect the performance of installed PV arrays. By studying these issues, it can play a key role in improving the limitations and performance of PV panels. The study of PV arrays under partial shading conditions is mentioned in many papers as a part of other studies and as an independent phenomenon. Therefore, it is essential to improve these studies and update them with new research and study this problem in detail to know how to limit the effects of partial shading irradiance conditions on PV arrays performances, including economical aspects. This paper proposes to study the effects of different partial shading irradiance conditions for a PV array in various configurations. The analysis is proved in detail through the simulation of the proposed PV array in the Matlab/Simulink environment. The obtained results show the performances of interconnected PV arrays under different partial shading irradiance and temperature conditions, including the solar array I-V and P-V characteristics. In addition, different PV array configurations with and without bypass and blocking protection diodes improve and minimize the effect of partial shading conditions and avoid the reductions in output power.

A considerable number of infective endocarditis (IE) patients require cardiac surgery with an increased risk for postoperative sepsis. Intraoperative hemoadsorption may diminish the risk of postoperative hyperinflammation with potential economic implications for intensive care unit (ICU) occupation. The present study aimed to theoretically investigate the budget impact of a reduced length of ICU stay in IE patients treated with intraoperative hemoadsorption in the German healthcare system. Data on ICU occupation were extrapolated from a retrospective study on IE patients treated with hemoadsorption. An Excel-based budget impact model was developed to simulate the patient course over the ICU-stay. A base-case scenario without therapy reimbursement and a scenario with full therapy reimbursement were explored. The annual eligible German IE patient population was derived from official German Diagnostic Related Group (DRG) volume data. One-way deterministic sensitivity analysis and bootstrap analysis were performed to evaluate the uncertainty over the model results. Use of intraoperative hemoadsorption resulted in 2,298€ saved per patient in the base-case scenario without therapy reimbursement. Savings increased to 3,804€ per patient in case of full device-specific reimbursement. Deterministic and probabilistic sensitivity analyses confirmed the robustness of savings, with a probability of savings of 99% and 100% in the base-case and full reimbursement scenario, respectively. Intraoperative hemoadsorption in IE patients might have relevant economic benefits related to reduced ICU stay, resulting in improved resource use. Further evaluations in larger prospective cohorts are warranted.

Background: Infections are a major cause of morbidity and mortality in patients with pemphigus vulgaris (PV). One of the most common infections in these patients is candidiasis. This is probably due to the use of systemic immunosuppressant, including oral and intravenous corticosteroids, mainly in megadoses (pulse therapy), although it is unknown if there are other associated factors in addition to immunosuppressive treatment. We determine the factors associated with candidiasis in PV patients in two Second-Care hospitals in Mexico. Methods: We reviewed 100 cases with PV. Cases were randomly selected from the databases of two second-care hospitals between January 2010 and December 2019 (10 years). The primary endpoint was the incidence of candidiasis in patients with PV. Results: One hundred patients with PV were enrolled in this retrospective study. Candidiasis was observed in 79 patients (79%). A maximum corticosteroid dose of 55 mg/day during the last year (p = 0.001) and higher neutrophil/lymphocyte ratio were associated with candidiasis in patients with PV (p = 0.001). Conclusion: Risk factors favoring candidiasis in patients with PV are not only related to the use of corticosteroids, but also to demographic factors, the activity of the disease, and the systemic inflammation associated with autoimmunity.

Academic and corporate research has been focusing on analyzing stock performances, financial markets, and investment strategies for decades. According to Lynch and Rothchild (1989), certain investments can be described as plays. In this work, the authors use the term for investments in value stocks, spin-offs, and turnarounds to analyze the long-term stock performance and risk-adjusted excess returns of up to five years for those stocks. Additionally, stocks with a supe-rior return performance are identified within an investment play based on low P/E and P/B mul-tiples. The study finds that value stocks, spin-offs, and turnarounds outperform the S&P 500 on average on a one-, three- and five-year investment horizon. The analysis of the three investment plays confirms earlier studies that investment plays constitute a profitable investment opportunity. Moreover, the research exemplifies that private investors could achieve an excess return (alpha) through a passive buy-and-hold investment strategy. Overall, the analysis provides a deeper in-sight into the long-term performance of value stocks, spin-offs, and turnarounds.

In estimating the maximum and minimum index void ratios for mixtures of sand and silt, the values of several empirical constants must be determined based on the type of sand and silt involved. These empirical constants are the filling coefficient, a, and embedment coefficient, b, both of which can be determined either through lab testing or correlations. These constants are then used in equations to predict the maximum and minimum index void ratios of the sand-silt mixtures. The study reported here developed simple correlations for estimating the filling and embedment coefficients using readily obtained laboratory data. These models were found to be excellent in developing filling and embedment coefficients that accurately (R2 values typically of 0.94 or greater.) predicted values of the index void ratios for sand and silt mixtures.

As a major coal country, China faces the issue of significant gas emissions during the coal mining process. This study aims to improve the utilization efficiency of mine gas, reduce greenhouse gas emissions, and promote the low-carbon and green transformation of the coal industry. A 10kW gas regenerative thermal oxidation (RTO) experimental system was constructed. The effects of initial methane concentration, low-temperature flue gas proportion, and operating load on combustion temperature, methane oxidation rate, high-temperature flue gas energy, and system thermal efficiency were studied. The results show that when the combustion temperature is below 600°C, the CH4 combustion reaction cannot proceed effectively, and the system temperature continuously decreases and cannot be maintained stable. The experiment determines the stable operating methane concentration range of RTO. In this experimental system, the lower limit of the initial methane concentration is 0.28%, corresponding to an 86% methane oxidation rate. As the initial methane concentration decreases, the combustion temperature also decreases, and the methane oxidation rate follows suit. The higher the low-temperature flue gas proportion, the higher the combustion temperature, and the system thermal efficiency and output heat decrease with the increase of the low-temperature flue gas proportion. This experiment explores multiple factors affecting regenerative thermal oxidation, providing an basis for ensuring the safe and stable operation of the system and optimization. Improving the thermal insulation and heat exchange performance of the storage body can expand the lower limit of the initial methane concentration, thereby increasing the stability and thermal efficiency of the system.

Objectives: Minimally invasive direct coronary artery bypass (MIDCAB) is an alternative for revascularisation of isolated left anterior descending (LAD) or as multi-vessel (MV) procedure for diagonal branch (RD) or circumflex artery (RCX) region. Methods: From 2021 to 2022 91 patients underwent MIDCAB procedure in our heartcenter. 80% were male. Eighty percent of the patients had two or three vessel coronary artery disease. Mean age was 65±10 years. The left internal mammary artery (LIMA) was anastomosed to the left anterior descending via left minithoracotomy approach in all patients. Fourteen patients received multi-vessel MIDCAB (15%) with two or three anastomoses a saphenous vein graft (as T-graft to LIMA) was anastomosed to RD or RCX. Results: Mean operation time was 2.6±0.8 hours. The 30-day mortality was 0. Mean required packed red blood cells (pRBC) was 0.4±1.2 unit. The intensive care unit stay (ICU) was 1.5±1.6 days mean. We observed two patients (2%) with wound infections postoperatively. Four patients underwent rethoracotomy because of bleeding. Mean follow-up time was 1.5±0.5 years. Seventy-eight patients (86%) were in New York Heart Association (NYHA) class 1, 11 patients (12%) were in NYHA class 2. One patient received percutaneous coronary intervention due to de novo stenosis of the RCA. Late mortality was 2%. The Kaplan-Meier survival rate was 98.8% at 1 and 2 years. Conclusion: MIDCAB is technically demanding. Our postoperative and short-term clinical results demonstrate that this procedure is safe and feasible. Optimal patient selection and an experienced surgical team are mandatory.

Metabolic surgery can promote integrated physiologic improvement to ameliorate metabolic illness, particularly type 2 diabetes. Nevertheless, the therapeutic scope has been limited by unexpectedly inconsistent surgical outcomes. Therefore, the purpose of this study is to overcome the obstacles by determining the core mechanism of conflicting results. The surgical anatomy, clinical course, and outcomes of various metabolic surgeries, including modified types of duodenal-jejunal bypass procedures, were compared to comprehend specific surgical patterns from distinctive perspectives. Patients in exclusively nonobese groups are subjected to avoid compounding by weight fluctuations. During intestinal anastomosis, the epithelial identity of the succeeding intestine is replaced by that of the proximal epithelium through altered crosstalk between the epithelium and opposing mesenchymal cells. The rapid turnover rate and compensatory proliferation of the succeeding intestine accelerate the propagation of the replaced epithelium. Propagation of replaced epithelium could provoke inconsistent outcomes of metabolic surgery. The major determinants of the conflicting results of metabolic surgery are inadequate duodenal exclusion and inappropriate length of the biliopancreatic limbs. The replaced enteroendocrine cells during regeneration provoke inconsistent outcomes of metabolic surgery. The critical factors are the type and density of enteroendocrine cells distributed at the terminal end of the preceding proximal intestine.

In the diagnosis of olfactory neuroblastoma (ONB), the presence of S-100–positive sustentacular cells surrounding the tumor is important; however, these are also present in normal nasal sinus epithelium. Although ONB often has a different final diagnosis, complete resection of the tumor has a good prognosis and minimally affects the patient's treatment plan. When the tumor extends around the internal carotid artery (ICA), complete resection is difficult due to the high risk of vascular injury; revascularization using a high-flow bypass can avoid this complication. In the present case, the tumor was located in the left sphenoid sinus and extended around the ICA. Preoperative biopsy tissue was positive for neuroendocrine markers and slightly positive for S-100 protein, leading to a diagnosis of ectopic ONB. High-flow bypass revascularization with trapping of the ICA allowed complete tumor resection. The postoperative histopathological diagnosis was neuroendocrine carcinoma, showing no S-100 protein–positive cells. There was no sign of recurrence two and a half years after surgery without additional treatment. This case demonstrates that the presence of S-100 protein–positive cells in ONB may be misleading. Although misdiagnosis of ectopic ONB should be anticipated, a complete resection of the tumor is an effective treatment strategy.

A single coronary artery is a very rare condition, commonly associated with other congenital anomalies. It could be generally classified as neither benign nor malignant form of congenital coronary artery anomalies since its pathophysiological and clinical implications grossly depend on different anatomical patterns defined by the site of origin and distribution of the branches. By presenting the patient with an isolated single coronary artery, who underwent successful combined aortic valve replacement and coronary artery bypass grafting surgery, we intend to distinguish casual from causal in this extremely rare clinical and surgical scenario. This is the first-ever case published, combining such underlying pathology, clinical presentation, and surgical treatment.

Background: Since the previous study dealing with the case fatality ratio and infection fatality ratio caused by COVID-19, the author has received many comments that prompted the question: "Why did an optimistic prognosis fail?" To answer this question, a more detailed and expanded analysis was carried out in a new study. Objective: To evaluate the dynamics of monthly numbers of cases, deaths, tests and CFR worldwide during three phases of the COVID-19 pandemic. Material and Methods: Twenty three sets of databases, dated the 22nd of each month from January 2020 to November 2021, for 213 countries were collected from the Worldometer website. The number of cases, deaths, tests, CFR, IFR, etc. were counted for various periods of time for each of the 213 countries, then results related to different periods of time were compared. Results: The analysis of the main epidemiological parameters led to the division of three phases of the global pandemic evolution. The first phase (23.01.20-22.07.20), the second phase (23.07.20-22.01.21) and the third phase (23.01.21-22.07.21) were different in terms of the number of tests performed, new cases, and mortality due to COVID-19. By the end of the second phase, the worldwide statistics indicated the imminent end of the pandemic, but the third phase was characterized by a sudden rise in the number of new cases and deaths that could not be explained rationally. The most dramatic evolution of the epidemic curve occurred in the countries where doctors had successfully battled COVID-19 during the first two phases of the pandemic. Conclusions: Despite the decrease in overall death numbers during the latest months analyzed, additional study is necessary to identify the cause for the increase in the number of new cases and deaths during the third phase of the pandemic. Only complete information regarding the positive and negative impact of medical and non-medical methods of diagnostics and prophylaxis of COVID-19 can help to organize effective measures to end the current pandemic and prevent a similar one from occurring in the future. Presumably, there are several causes of the negative evolution of the current pandemic, including the overreliance on PCR tests, application of non-specialized premises for quarantine and treatment, decrease in herd and individual immunity, inadequate change of therapeutic protocols, and ignoring prophylactic treatment. It can be suggested that the use of immunemodulatory drugs, for example, thymus extract or thymic peptides, in groups of people with compromised immunity is necessary, and prophylactic and therapeutic protocols should be changed from the 'standard' types to 'personalized' ones.

During the conceptual and preliminary design stage of a ship, designers need to ensure that the selected principal dimensions and parameters are good enough to deliver a stable ship (statically and dynamically) besides deadweight and speed. To support this, the initial intact stability of the proposed ship is required to be calculated, and in doing so, the lightship weight and its detailed breakdown are necessary to be known. After hull steel weight, machinery weight, mainly, marine propulsion and power generation machinery, play a vital role in the lightship weight estimate of a ship due to its robustness. The correct estimation of respective weights improves the accuracy of calculating a ship's initial stability typically to be designed and built. Hence, it would be advantageous for the designer to convince the ship owner. A total of 3006 marine propulsion (main marine diesel) engines and 348 power generation (auxiliary marine diesel) engines/generators of various power output (generators output for auxiliary engines), engine RPM and cylinder number of different engine makers are collected. These are analyzed and presented in both tabular and graphical forms to demonstrate the possible relationship between marine propulsion engine weight and power generation engine weight, and their respective power output, RPM, cylinder number, power-RPM ratio and power-RPM ratio per cylinder.In this article, the authors have attempted to investigate the behavior of marine propulsion engine weight and power generation engine/generator weight regarding engine power output, generator power output, engine RPM and cylinder number (independent variables). Further attempts have been made to identify those independent variables that influence the weight of the marine propulsion engine and power generation engine/generator (dependent variables), and their interrelationships. A mathematical model has thus been developed and proposed, as a guiding tool, for the designer to estimate the weight of main and auxiliary engines more accurately during the conceptual and preliminary design stage.

The German government's ambitious goal of achieving CO2-neutrality by 2045 has prompted a focus on improving building insulation as a vital step toward energy efficiency. However, in this process, existing radiators and boilers are often left unchanged, leading to inefficiencies due to oversized heating systems. This paper presents various approaches to reduce the required radiator inlet temperature, drawing on data from 100 multifamily buildings. The approaches include heat reserve reduction, heat power shifting, uniform radiator usage, and heat requirement analysis. These approaches collectively aim to lower flow temperatures and decrease peak heat loads, reducing energy consumption, and minimizing waste in compliance with the user comfort temperature. The findings reveal that the application of these methods can lead to substantial temperature reductions, with an average decrease of 20.82 K and 7.28 K for the highest necessary flow temperature in the provided example. Furthermore, peak load reductions of 21.07% and 13.65% were achieved, demonstrating the potential to enhance energy efficiency. While each approach can be applied individually, their synergistic implementation can highly increase the efficiency of water to x heat pumps, due to the lower required flow temperatures.

Manufactured sand and natural sand have great differences in terms of physical properties, chemical composition, and so on. In the mix ratio design of manufactured sand concrete, the traditional common concrete ratio cannot be used. The water-cement ratio playing a crucial role in the mix ratio design. The optimum water-cement ratio can not only improve concrete performance, it can also reduce cement consumption and costs. The present study examines the working performance indicators and mechanical performance indicators of manufactured sand concrete using Fujian granite with three strength grades (C35, C40 and C50) at different water-cement ratios. The impact of water-cement ratio on the operational and mechanical performance of manufactured sand concrete with different strength grades is analyzed and summarized. Revised sentence: The findings suggest that the workability of Fujian granite concrete is directly influenced by the water-cement ratio. Additionally, the water-cement ratio indirectly affects the mechanical properties of manufactured sand concrete. Finally, when changing the water-cement ratio, cube compressive strength, splitting tensile strength and bending strength exhibit similar trends. The optimal water-cement ratio for C35 concrete is determined to be 0.39, considering the workability and mechanical properties of Fujian granite manufactured sand concrete. Similarly, the optimal water-cement ratio for C40 concrete is 0.34, while for C50 concrete it is 0.32.

Background: The hypothesis is that a hypoxic-hyperoxic preconditioning (HHP) is associated with a protective effect on myocardial function by reducing endothelial damage and a beneficial effect on postoperative outcome in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Methods: Patients (n=120) were randomly assigned to an HHP and a control group. A safe inhaled oxygen fraction for the hypoxic preconditioning phase (10-14% oxygen for 10 minutes) was determined by measuring the anaerobic threshold. At hyperoxic phase, 75-80% oxygen fraction was used during 30 minutes. Results: The cumulative frequency of postoperative complications was 14 (23.3%) in the HHP vs 23 (41.1%), p=0.041. The nitrate decreased after surgery by up to 20% in the HHP group and up to 38% in the control group. Endothelin-1 and nitric oxide metabolites were stable in HHP but remained low more than 24 h in control group. The endothelial damage markers appeared to be predictors of postoperative complications. Conclusion: The HHP with individual parameters based on the anaerobic threshold is a safe procedure, it can reduce the frequency of postoperative complications. The endothelial damage markers appeared to be predictors of postoperative complications.

Climate change is increasing air temperatures and altering the precipitation and hydrological re-gime on a global scale. Challenges arise when assessing the impacts of climate change on the local scale for water resources management proposes, especially for low mountain headwater catch-ments that not only serve as important water towers for local communities, but also have distinct hydrological characteristics. Until now, no low flow or hydrological drought studies have been carried out on the Lauter River. This study is unique in that it compares the Lauter River, a transboundary Rhine tributary with a nearby station on the River Rhine just below its confluence at the French-German border. The Lauter catchment is a mostly natural, forested catchment, however, its water course has been influenced by past and present cultural activities. Climate change disturbances cascade through the hydrologic regime right down to the local scale. As we are expecting more low flow events, the decrease in water availability could cause conflicts be-tween different water user groups in the Lauter catchment. However, the choice of different methods for identifying low flow periods may cause confusion for local water resources manag-ers. Using flow rate time series of the Lauter River between 1956 and 2022 we compare for the first time three low flow identification methods: the variable threshold method (VT), the fixed threshold method (FT), and the Standardized Streamflow Index (SSI). Similar analyses are applied and compared to the adjacent Maxau station on the Rhine River for the same time period. This study aims at 1) interpreting the differences amongst the various low flow identification methods and 2) revealing the differences in low flow characteristics of the Lauter catchment compared to the Rhine River. It appears that the FT reacts faster to direct climate or anthropogenic impacts whereas VT is more sensitive to indirect factors such as decreasing subsurface flow which is typical for small headwater catchments, such as the Lauter where flow dynamics react faster to flow disturbances. Abnormally low flow during the early Spring in tributaries such as the Lauter can help predict low flow conditions of the Rhine River during the following half year and espe-cially for the summer. The results could facilitate Early Warning of hydrological droughts and drought management for water users in the Lauter catchment and further downstream along some of the Rhine.

As the PCIe 6.0 specification places higher requirements on signal integrity and transmission la-tency, it becomes especially important to improve signal transmission performance at the physical layer of the transceiver interface. Retimer circuit as a key component of high-speed serial interface, its delay and jitter size directly affect the overall performance of PCIe. For the conventional Retimer circuit with large latency and low jitter performance, this paper proposes a low latency and low jitter Retimer circuit based on CDR+PLL architecture for PCIe 6.0, using a jitter canceling filter circuit to eliminate the frequency difference between the retiming clock and data, reduce the retiming clock jitter, and improve the quality of Retimer output data; The data is sampled using the retiming clock and then output, avoiding the problem of large penetration latency of con-ventional Retimer circuits. The circuit is designed using CMOS 28nm process. Simulation results show that when 112Gbps PAM4 data is input to the Retimer circuit, the Retimer penetration la-tency is 27.3 ps, which is 83.5% lower than the conventional Retimer structure; the output data jitter is 741 fs, a 31.4% reduction compared to the conventional Retimer structure.

Objective: To explore three novel fasting blood glucose (FBG)-based novel indicators, including FBG-to-albumin ratio (FAR), FBG-to-lymphocytes ratio (FLR), and FBG-to-hemoglobin ratio (FHR), in predicting prognosis and detecting metastasis for patients with pancreatic neuroendocrine neoplasms after resection. Materials and methods: A total of 178 pNEN patients underwent surgical resection were included in this study. Receiver operating characteristic (ROC) curves were used to evaluate the diagnosis values of FAR, FLR, and FHR, and the cut-off values were obtained for further analyses. Univariate and multivariate analyses were conducted to determine the independent predictors. The Kaplan-Meier method was used to evaluate the progression-free survival (PFS) and overall survival (OS) of the pNEN patients. Results: The optimal cut-off values of FAR, FLR, and FHR were 0.17, 2.85, and 0.028, respectively. As for PFS, the area under the curve (AUC) was 0.693 for FAR, 0.690 for FLR, and 0.661 for FHR, respectively. The AUC was 0.770, 0.692, and 0.715 accordingly for OS. The groups with lower FAR, FLR, and FHR were significantly associated with prolonged PFS and OS (p < 0.05). In patients with metastasis, the lower FAR group was correlated with significantly longer PFS and OS (p = 0.022 and 0.002, respectively). The FLR was an independent predictor of PFS in pNEN patients, and the FAR was a predictor of OS. FAR was an independent indicator of PFS in patients with metastasis. Conclusion: Preoperative FAR, FLR, and FHR are effective in predicting the prognosis of pNEN patients and detecting the synchronous metastases.

Objective: The current study aimed to delineate the relationship of furin with inflammation while cervical intraepithelial neoplasia progresses to cancer. Study Design:This cross-sectional study included 81 women who required colposcopic examinations. The study groups were formed based on pathological results: Group I included women with cervical intraepithelial neoplasia (CIN) I (n=30); Group II included women with CIN II-III (n=28); and Group III included women with cervical cancer (CC) (n=23). Furin, ki-67, and p16 levels were evaluated based on immunostaining intensity. The inflammatory indices were calculated parallel with the literature from routine blood samples retrieved within one week before the procedure. Results:Furin expression gradually increased from CIN I to CIN II-III and from CIN II-III to CC, respectively (p < .001, p = .005). The NLR, MLR, PLR, and SII were significantly higher in the CC group (p < .001). ROC curve analysis unveiled that NLR, MLR, PLR and SII predicted the presence of CC with a cutoff value of 2.39 for NLR (sensitivity: 91.3%, specificity: 63.8%, AUROC: 0.79, p < .001); a cutoff value of 0.27 for MLR (sensitivity: 78.3%, specificity: 72.4%, AUROC: 0.77, p = .009); a cutoff value of 123 for PLR (sensitivity: 100%, specificity: 41.4%, AUROC: 0.70, p = .04); and a cutoff value of 747 for SII (sensitivity: 69.6%, specificity: 90.7%, AUROC: 0.71, p = .014). Conclusion:Furin expression increased gradually in parallel to the severity of cervical intraepithelial neoplasia. The inflammatory indices were higher in the presence of CC and denoted good discrimination ability for predicting cervical cancer.

Previous studies generally reckon that the full converter-base wind power generation (FCWG) is a ’decoupled’ power source from the grid, which hardly participates in electromechanical oscillations. However, it is found recently that strong interaction could be induced which might incur severe resonance incidents in electromechanical dynamic timescale. In this paper, the participation of FCWG in electromechanical dynamics is extensively investigated, and particularly, an unusual transition of electromechanical oscillation mode (EOM) is uncovered for the first time. The detailed mathematical models of open-loop and closed-loop power systems are firstly established, and modal analysis is employed to quantify the FCWG participation in electromechanical dynamics, with two new mode identification criteria, i.e., FCWG dynamics correlation ratio (FDCR) and quasi-electromechanical loop correlation ratio (QELCR). On this basis, the impact of different wind penetration levels and controller parameter settings on the participation of FCWG is investigated. It is revealed that if an FOM has a similar oscillation frequency to the system EOMs, there is a high possibility to induce strong interactions between FCWG dynamics and system electromechanical dynamics of the external power systems. In this circumstance, an interesting phenomenon may occur that an EOM may be dominated by FCWG dynamics, and hence is transformed into a quasi-EOM, which actively involves the participation of FCWG quasi-electromechanical state variables.

A Savonius wind turbine is one of the simplest vertical-axis turbines. Several researchers have been attracted to it because of its simple structure, low noise, appropriate torque, and independence from wind direction. SR3345 and SR5050 blade profiles will be investigated for their effects on the performance of Savonius wind turbines. First, the fabricated wind turbine is placed in front of an open circuit wind tunnel with a velocity of 6 m/s. Furthermore, governing relationships are used to calculate power and torque coefficients as well as tip speed. In this study, the power and torque coefficients of the turbine are compared with the two profiles considered based on overlap ratios between 0 and 0.3. Despite its increased stability, the central shaft reduced the power coefficient of the turbine. For blade SR3345, the best performance occurs at tip speed ratios of less than 1, while for blade SR5050, the best performance occurs at higher tip speed ratios. Both blades SR3345 and SR5050 achieve the highest power coefficients at overlap ratios of 0 and 0.18 when a central shaft is present.

Acute kidney injury (AKI) following surgery with cardiopulmonary bypass (CPB-AKI) is common in pediatrics. Urinary liver-type fatty acid binding protein (uL-FABP) increases in some kidney diseases and may indicate CPB-AKI earlier than current methods. The aim of this systematic review with meta-analysis was to evaluate the potential role of uL-FABP in early predicting CPB-AKI. Databases Pubmed/MEDLINE, Scopus, and Web of Science were searched on November 12th, 2023, using the MeSH terms “Children”, “CPB”, “L-FABP”, and “Acute Kidney Injury”. Included papers were revised. AUC values from similar studies were pooled by meta-analysis, performed using random- and fixed-effect models, with p

The aim of the study was to examine the long-term prognostic value of changes in cardio-ankle vascular index (CAVI) within a year after coronary artery bypass grafting (CABG). Methods. Patients with coronary artery disease (n = 251) in whom cardio-ankle vascular index (CAVI) was assessed using the VaSera VS-1000 device before and in a year after CABG. Groups with improved CAVI (CAVI decreased from pathological value to normal or the index remained within normal values) or worsened CAVI (persistent pathological index value or an increase in CAVI to pathological values or an increase of 1 unit or more) were identified. The groups were compared for the following events at 10-year follow-up: death from all causes, myocardial infarction, stroke/transient ischemic attack, and the combined endpoint. Results. A year after CABG surgery, 45% of patients showed positive dynamics or stable normal CAVI values. Death from all causes was significantly more common in the group with CAVI progression - 32 (27.6%) than in the group with CAVI improvement - 14 (14.8%; p = 0.029). Patients with CAVI progression were more likely to have MACE (death, MI, stroke/TIA) in 49 (42.2%) cases, compared with patients with CAVI improvement - in 23 (24.5%; p=0.008). Negative dynamics of CAVI (p = 0.024), number of shunts (p = 0.006), and the presence of carotid stenosis more than 30% (p = 0.051) were independent predictors of death from all causes at 10-year follow-up after CABG. The presence of carotid stenosis more than 30% (p = 0.002) and the group with negative dynamics of CAVI after a year (p = 0.008) were independent predictors of the development of the combined endpoint during long-term follow-up. Conclusions. Patients with negative dynamics of CAVI one year after CABG were more likely to experience death from all causes and combined endpoint in the long-term follow-up than patients with normal CAVI. In further studies, it is advisable to evaluate the dynamics of CAVI and, based on this, identify the most effective interventions to improve the prognosis of patients after CABG.

BACKGROUNDː The so-called Low Cardiac Output Syndrome (LCOS) is one of the most common complications in pediatric patients with congenital heart disease undergoing corrective surgery. LCOS requires high concentrations of inotropes to support cardiac contractility and improve cardiac output, allowing for a better systemic perfusion. To date, serum lactate concentrations and central venous oxygen saturation (ScVO2) are the most commonly used perfusion markers, but they are not completely reliable to identify a state of global tissue hypoxia. The study aims to evaluate whether the venoarterial carbon dioxide difference/arterial-venous oxygen difference ratio [P(v-a)CO2/C(a-v)O2] can be a good index to predict the development of LCOS in the aforemen-tioned patients, so as to treat it promptly. METHODSː This study followed a population of 98 children undergoing corrective cardiac surgery from June 2018 to October 2020 at the Department of Cardiac Surgery of University Hospital Inte-grated Trust and their subsequent admission at the Postoperative Cardiothoracic Surgery Intensive Care Unit. During the study, central arterial and venous blood gas analysis were carried out before and after cardiopulmonary bypass (CPB) (pre-CPB and post-CPB), at admission to intensive care unit, before and after extubation and at any time of instability or modification of the patient’s clinical and therapeutic conditions. RESULTSː The data analysis shows that 46.9% of the children developed a LCOS (in line with the current literature) but that there is no statistically significant association between the P(v-a)CO2/C(a-v)O2 ratio and LCOS onset. Despite the limits of statistical significance, however, a 31% increase in the ratio emerged from the pre-CPB phase to the post-CPB phase when LCOS is present. CONCLUSIONSː This study confirms a statistically significant association between the most used markers in adult patients (serum lactate concentration, ScVO2 and oxygen extraction ratio-ERO2) measured in the pre-CPB phase and the incidence of LCOS onset, especially in patients with he-modynamic instability before surgery.

Up to 56% of patients develop chronic postsurgical pain (CPSP) after coronary artery bypass grafting (CABG). CPSP can affect patients’ moods and decrease daily activities. The primary aim of this study was to investigate CPSP severity in patients following off-pump (OP)-CABG using the Neuropathic Pain Symptom Inventory (NPSI). This was a prospective cohort study conducted in a cardiac surgery department of a teaching hospital. Patients undergoing OP-CABG were enrolled in an erector spinae plane block (ESPB) group (n = 27) or a control (CON) group (n = 24). Before the induction of general anesthesia, ESPB was performed on both sides under ultrasound guidance using 0.375% ropivacaine. The secondary outcomes included cumulative oxycodone consumption, acute pain intensity, mechanical ventilation time, hospital length of stay, and postoperative complications. CPSP intensity was lower in the ESPB group than in the CON group 1, 3, and 6 months postsurgery (p < 0.001). Significant between-group differences were also observed in other outcomes, including postoperative pain severity, opioid consumption, mechanical ventilation time, and hospital length of stay in favor of the ESPB group. Preemptive ESPB appears to decrease the risk of CPSP development in patients undergoing OP-CABG. Reduced acute pain severity and shorter mechanical ventilation times and hospital stays should improve patients’ satisfaction and reduce perioperative complications.

Isokinetic testing of the knee joint is the “gold standard” in strength assessment in sport especially in soccer, where it is part of pre-season screening to establish norms in case of injuries. There are many devices on the market that make it difficult to use of normative data. Isokinetics literature in females’ soccer players is scarce in comparison to males. Furthermore, evaluation protocols strongly differ from each other, using different ranges of speeds, movement patterns and output data. Thus, it is difficult for the researcher and the clinician to choose a correct protocol for isokinetic evaluation in female soccer players. The indexes of isokinetic performance that are widely accepted are the hamstring/quadriceps (H/Q) ratio and dominant/non-dominant (D/ND) ratio as reference. In this review are highlighted some common features of isokinetic testing in female soccer players of different levels of qualification. From this study, it emerges that, for a reliable test, 3 reps at the speed of 60°/sec in knee flexion/extension is preferable due to the high reliability and that an optimal H/Q ratio in healthy female soccer players of different level of qualification and age is 50%, while the interlimb differences (D/ND) should be below 10%.

As in any other plant, in the grapevine roots play a vital role in terms of anchorage, uptake of water and nutrients, as well as storage and production of chemicals. Their behaviour and development depend on various factors, namely rootstock genetics, soil physical and chemical features, field agronomic practices. Canopy management, involving techniques such as defoliation and pruning, could greatly influence root growth. To date, most of the studies on grapevine winter pruning have focused on the effects on yield and quality of grapes, achievable by using different pruning systems and techniques, while the knowledge of root distribution, development, and growth in relation to winter pruning is still not well understood. In this contest, the purpose of this study was to investigate the effect of winter pruning on the root system of field-grown Vitis vinifera cv. Pinot Gris grafted onto rootstock SO4. We compared two pruning treatments (pruning-P and no pruning-NP) and analysed the effect on root distribution and density, root index and on the root sugar reserves. Root data were analysed in relation to canopy growth and yield, to elucidate the effect of winter pruning on the root/yield ratio. Our data indicated that winter pruning stimulated the root growth and distribution without compromising canopy development, while no-pruning treatment produced less growth of roots but a larger canopy. Information regarding root growth and root canopy ratio is important as it gives us an understanding of the relationship between the aerial and subterranean parts of the plant, how they compete, and finally, offers us the possibility to ponder on cultural practices.

African scientific research faces formidable challenges, particularly with limited access to state-of-the-art measurement instruments. The high cost associated with these devices presents a significant barrier for regional research laboratories, impeding their ability to conduct sophisticated experiments and gather precise data. This predicament not only hampers the individual laboratories but also has broader implications for the African scientific community and the advancement of knowledge in developing nations—the financial cost barrier considerably impacts the research quality of these laboratories. Reflection on technical and economical solutions needs to be quickly found to help these countries advance their research. In civil Engineering, the thermal conductivity property is the most important measurement for characterising heat transfer in construction materials. Existing devices (i.e., conductometers) in a laboratory are expensive (approximately 30,000 euros) and unavailable for some African laboratories. The study proposes a new and affordable device to evaluate thermal conductivity in construction materials. The method involves establishing a thermal flux between a heat source ( from the Joule effect provided by steel wool where a current is circulating) and a cold source (generated by ice cube) under steady-state conditions. The development of the cylindrical prototype is based on the comparative flux-meter method outlined in the measuring protocol of the ASTM E1225 standard document. Experiments were conducted on four distinct materials (polystyrene, wood, agglomerated wood, and rigid foam). The results indicate a correct correlation between the experimental values obtained from the newly developed prototype and the reference values found in the literature. For example, concerning the experimental polystyrene study, the detailed case analysis reveals a good correlation, with a deviation of only 4%. The percent error found falls within the acceptable range indicated by the standards recommendations of the ASTM E1225 standard, i.e., within 5% acceptable error.

A novel low-power MOS-only voltage reference is presented. The Enz-Krummenacher-Vittoz (EKV) model is adopted to provide a new perspective on the operating principle. The normalized charge density, introduced as a new variable, serves as an indicator when trimming the output temperature coefficient. The proposed voltage reference consists of a specific current generator and a 5-bit trimmable load. Thanks to the well-match between the current source stage and the output stage, the non-linear temperature dependence of carrier mobility is automatically canceled out. The circuit is designed in 55 nm COMS technology. The operating temperature ranges from -40 ∘C to 120 ∘C. The average temperature coefficient of the output voltage can be reduced to 21.7 ppm/∘C by trimming. The power consumption is only 23.2 nW with a supply voltage of 0.8 V. The line sensitivity and the power supply rejection ratio at 100 Hz are 0.011 %/V and -89 dB respectively.

In this study, in order to develop the composition ceramics for the application of ultrasonic transducer device for temporomandibular joint disorder pain relief and facial skin massage, Pb0.88(La0.6Sm 0.4)0.08(Mn 1/3 Sb 2/3)0.02 Ti 0.98 O3 ceramics were manufactured using CuO as sintering aids, and their piezoelectric ,and resonant properties were investigated. At the specimen sintered at 1200 [℃], the excellent values of piezoelectric properties appeared, respectively: the dielectric constant (εr) of 202, piezoelectric constant (d33) of 56[pC/N], first and third overtone electromechanical coupling factor kt of 0.548, kt3 of 0.219, and then first and third overtone mechanical quality factor Qmt1 of 345, Qmt3 of 292 were suitable for the device application such as ultrasonic transducer, respectively. When the length of one side was 7.7 mm, first and third overtone electromechanical coupling factor kt1 of 0.555, kt3 of, 0.196, and then first ,third overtone mechanical quality factor Qmt1 of 381, Qmt3 of 393 , and the first dynamic ratio(D.R) and third overtone dynamic ratio(D.R) of 63.7(dB),and 37.7(dB) were suitable for the device application such as ultrasonic transducer ,respectively .

Upper Blue Nile basin (UBNB) is the water tower of Ethiopia and downstream countries. It contributes significant moistures to the surrounding atmosphere. However, the contribution of the moisture from the basin to the precipitation in the area is not well documented. Therefore, this paper is aimed at seasonal variation of upper Blue Nile basin moisture budget and the global moistures in the role of temporal and spatial precipitation variability. To this end, we used European Centre for Medium-range Weather Forecast (ECMWF) data from 1979-2017. The UBNB moisture contributed precipitation in the central parts of the study area during the summer season, while in spring; it contributed in southern part of the study area. Northwest part of the study area got precipitation from the basin moistures during autumn season. The recycling ratios for four seasons (summer, autumn, spring and winter) were 9.70%, 16.33%, 19.01%, and 35.30% respectively. The maximum amount of precipitation is extracted from the local moistures during winter season. The annual average value of recycling ratio was found 20.11%. Hence, we concluded that UBNB moisture budget had lesser contribution of precipitation over the study area. It rather contributed a significant precipitation to the neighboring countries such as Egypt and Sudan. Further studies on moisture budget are required to explain this phenomenon in the context of Ethiopia.

This study aimed to evaluate the early-childhood comorbidities of cerebral palsy (CP) in children with low birth weight (LBW) and assess the impact of maternal bio-psychosocial factors on the risk of CP in preterm infants across varying birth weights. Data for 15,181 prematurely born infants from 2009 to 2013 and 151,810 matched controls from Taiwan's National Health Insurance Research Database were analyzed. Period prevalence of CP, and comorbidities of LBW were verified, and odds ratios (ORs) were calculated. Results confirmed that increasing prematurity and low birth weight (LBW) rates in Taiwan. LBW was associated with higher CP prevalence. Maternal age extremes (&lt;20 and &gt;40 years) were significant risk factors of CP in LBW infants. LBW infants showed higher risks of respiratory, circulatory, and nervous system and psycho-developmental comorbidities compared to controls. Infants with the lowest birth weights had even higher ORs for these comorbidities. However, gastrointestinal and nutritional comorbidities were less prevalent in premature infants. Maternal factors such as family income, number of hospital admissions, and length of hospital stay were significantly correlated with birth weight and subsequent complications. Each additional gestational week significantly reduced the risk of complications in premature infants. Additionally, maternal bio-psychosocial factors were associated with birth weight and related outcomes in premature infants, emphasizing the importance of addressing these factors in prenatal care and interventions.

(1) Background: Obesity and its comorbidities can cause burdens and limitations. Bariatric surgery (BS) is indicated as a safe procedure to reduce body mass and improve present comorbidities. Yet, several complications were reported, like vitamin D [25(OH)D] deficiency. We evaluated if 25(OH)D serum levels relate to clinical characteristics, symptoms, or habits in women after their BS and whether the vitamin D receptor (VDR) gene's TaqI and FokI polymorphisms affected 25(OH)D levels and the total body bone mineral density (TBBMD). (2) Methods: This cohort cross-sectional comparative analytical prospective study consisted of 27 women, 61.6 ± 5.0 years, submitted to BS one year prior at a public reference hospital, DF-Brazil. All participants were asked to follow the physical and dietary activity recommendations and received vitamin D3 supplements. Their anthropometric, biochemical, and immunological measurements and blood samples were obtained. (3) Results: 73.3% of participants had low 25(OH)D levels, and their levels correlated positively with TBBMD and negatively with systolic pressure. VDR TaqI did not affect 25(OH)D levels, whereas VDR FokI's allele f presence correlated to a median rise in 25(OH)D levels. Neither polymorphism correlated to TBBMD. (4) Conclusions: 25(OH)D levels were positively correlated with TBBMD, negatively with systolic blood pressure, and were higher in those with the VDR FokI allele f.

Aim: To investigate inflammation indices and erythropoietin (EPO) levels for their potential role in distinguishing polycythemia vera (PV) from secondary polycythemia (SP), and to compare different parameter combinations in terms of diagnostic accuracy. Methods: This retrospective cohort was created from patients assessed for polycythemia from January 2020 to December 2023. PV diagnosis was made according to the 2016 WHO criteria (n=145). Those who did not fulfill the criteria were defined as having SP (n=84). Results: NLR, PLR and SII were significantly higher in the PV group (p

The scale and accessibility of passive global surveillance have rapidly increased over time. This provides an opportunity to calibrate the performance of models, algorithms, and reflectance ratios between remote sensing devices. Here we test the sensitivity and specificity of Eucalypt chlorophyll-a reflectance ratio (ECARR) and Eucalypt chlorophyll-b reflectance ratio (ECBRR) to remotely identify eucalypt vegetation in Queensland, Australia. We compare reflectance ratio values from Sentinel-2 and Planet imagery across four sites of known vegetation composition. All imagery was transformed to reflectance values and Planet imagery was additionally scaled to harmonize across Planet Scenes. ECARR can identify eucalypt vegetation remotely with high sensitivity, but shows low specificity and is impacted by the density of the vegetation. ECBRR reflectance ratios show similar sensitivity and specificity when identifying eucalypt vegetation but with values an order of magnitude smaller than ECARR. We find that ECARR was better at identifying eucalypt vegetation in the Sentinel-2 imagery than Planet imagery. ECARR can serve as a general chlorophyll indicator but is not a specific index to identify Eucalyptus vegetation with certainty.

The study comprehensively evaluated the prognostic roles of PLR, NLR, MLR, BLR, and ELR in patients with acute exacerbation chronic obstructive pulmonary disease (AECOPD). 619 patients with AECOPD and 300 healthy volunteers were retrospectively included into the study. The clinical characteristics containing laboratory findings of the AECOPD patients and the blood cell counts (CBCs) of the healthy volunteers were collected. Compared with the healthy volunteers, PLR, NLR, and MLR were elevated in COPD patients in stable condition, and were further ele-vated during exacerbation. ELR showed the opposite trend. PLR, NLR, and MLR were all posi-tively correlated with hospital LOS as well as CRP. In contrast, ELR was negatively correlated with hospital LOS as well as CRP. Elevated PLR, NLR, and MLR were all associated with more serious airflow limitation in AECOPD. Elevated PLR, NLR, and MLR were all associated with increased in-hospital mortality while Elevated ELR was associated with decreased in-hospital mortality in AECOPD. A nomogram was construct to predict in-hospital mortality in AECOPD. The nomo-gram had a C-index of 0.850 (95% CI: 0.799 – 0.901) with good predictive value and clinical ap-plicability. In summary, PLR, NLR, MLR, and ELR served as predictors for clinical outcomes in patients with AECOPD.

Background. IgA nephropathy (IgAN) is associated with chronic inflammation. Platelet-related parameters, such as platelet (PLT) count, platelet-to-albumin ratio (PAR) and platelet-to-lymphocyte ratio (PLR), were examined as potential prognostic indicators for renal and cardiovascular (CV) outcomes in IgAN. Methods. 150 IgAN patients were devided into two groups based on the cut-off value of PAR. All-cause mortality, major CV events and end-stage renal disease were the primary combined endpoints. Secondary endpoints, such as CV or renal endpoints, were also analyzed separately. Results. The patient’s mean age was 43.7 ± 13.5 years, and the follow-up time was 124 ± 67 months. The K-M curve showed that PLR, PAR and PLT were strongly associated with primary combined (p = 0.002, p = 0.004, p = 0.001) and renal outcomes (p < 0.001, p < 0.001, p < 0.001), but not with CV outcomes in IgAN. However, when combined with left ventricular hypertrophy (LVH) or metabolic syndrome (MetS) PAR was found to be a significant predictor of both primary (p < 0.001, p < 0.001) and secondary outcomes (p = 0.001 and p = 0.038; p = 0.001 and p = 0.015). Additionally, PLR correlated with microalbuminuria (r = -0.165, p = 0.033) and LVH (r = -0.178, p = 0.025), while PLT correlated with eGFR (r = 0.158, p = 0.040). Conclusion. Elevated PAR and PLR may predict progression to end-stage kidney disease, but in combination with LVH and MetS, they showed CV events also in IgAN. The determination of PAR and PLR can be useful and cost-effective parameters for assessing both cardiovascular and renal risks in CKD.

Background: The aim of this study has been to investigate if inflammatory biomarkers such as the systemic immune-inflammation index (SII), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have any correlation with the recurrence of pleomorphic adenomas (PA) in patients afflicted by this disease. Methods: A retrospective multicentre study involving two Italian centres, the Maxillofacial Sur-gery at the Policlinico Federico II in Naples and the ENT and Maxillofacial Surgery at the IRCCS G. Pascale National Cancer Institute in Naples, has been performed. The study, involving 608 pa-tients who had received a diagnosis of PA, was conducted between January 2000 and January 2020. A Receiver Operating Characteristic (ROC) curve was used to calculate the optimal cut-off values for the SII, PLR and NLR. A linear regression model (LRM) and a non-linear logistic re-gression model (NLRM) were realized with respect to the NLR, PLR and SII. Results: The highest performance was achieved by the NLR (cut-off 2.960) with the AUC = 0.91, with an accuracy of 96.1%, sensitivity of 78.4% and specificity of 97.2%, PPV = 64.4% and NPV = 98.6%. The LRM and NLRM including all the haematological parameters did not increase the per-formance in terms of recurrence detection. Conclusion: The NLR is an excellent support tool in predicting the recurrence of PA with a cut-off of 2.960. It can be a good reference point for surgical decision-making and follow-up in clinical practice.

Low volatility ETFs have become popular in recent year because investors are starting to understand the advantages involved in investing in those ETFs compared to traditional index investment. In this research I have examined the performance of six popular low volatility ETFs, four of them invest in U.S stocks and the other two invest in other developed and emerging markets. Results have pointed out that not only five of the low volatility ETFs have exposed their investors to lower risk, four of them have also produced higher returns. The advantage of investing in low volatility ETFs is prominent in the U.S stock market. All three sizes of stocks categories (Large, Mid and Small Capitalization) low volatility ETFs have outperformed their indexes bench marks in terms of risk and returns. For the non U.S stock investing, while no advantage have been found for investing in low volatility ETFs for developed countries, significant lower risk was found for emerging markets.

Extreme-mass-ratio inspirals (EMRIs) are significant observational targets for spaceborne gravitational wave detectors, namely, LISA, Taiji, and Tianqin, which involve the inspiral of stellar-mass compact objects into massive black holes with a mass range of approximately 104∼107M⊙. EMRIs are estimated to produce long lived gravitational wave signals with more than 105 cycles before plunge, making them an ideal laboratory for exploring the strong-gravity properties of the spacetimes around the MBHs, stellar dynamics in galactic nuclei, and properties of the MBHs itself. However, the complexity of the waveform model, which involves the superposition of multiple harmonics, as well as the high-dimensional and large-volume parameter space, make the fully coherent search challenging. In our previous work, we proposed a 10-dimensional search using Particle Swarm Optimization (PSO) with local maximization over the three initial angles. In this study, we extend the search to an 8-dimensional PSO with local maximization over both the three initial angles and the angles of spin direction of the MBH where the latter contribute a time independent amplitude to the waveforms. Additionally we propose a 7-dimensional PSO search by using a fiducial value for the initial orbital frequency and shifting the corresponding 8-dimensional Time Delay Interferometry responses until a certain lag returns the corresponding 8-dimensional log-likelihood ratio maximum. The reduced dimensionality likelihoods enable us to successfully search for EMRI signals with duration of 0.5 years and signal-to-noise ratio of 50 within a wider search range than our previous study. We discuss further developments, such as using a hierarchical search to narrow down the search ranges of certain parameters, and applying Graphics Processing Units to speed up the code. These advances aim to improve the efficiency and accuracy of the EMRI search algorithm.

Polycyclic aromatic hydrocarbons (PAHs) and polychlorinated biphenyls (PCBs) exist in the atmosphere in the vapor and particulate phases, as well as in the solubilized form in fog/rain/cloud waters. They are abundant pollutants and are known for their acute and chronic toxicity. In the current paper, fogwater samples are collected during 42 events between 2015 and 2021 at four sites (Strasbourg, Geispolsheim, Erstein, Cronenbourg) in the Alsace region with different topological characteristics. PAHs and PCBs are extracted using the liquid-liquid extraction (LLE) supported on a solid cartridge (XTR Chromabond), and then analyzed by gas-chromatography tandem mass spectrometry (GC-MS/MS). Total PAHs and PCBs concentration in fog samples varied between 0.58 and 6.7 µg L-1 (average of 2.70 µg L-1), and 0.14 and 15.5 µg L-1 (average of 2.75 µg L-1). Low molecular weight (LMW) predominant and highly detectable over high molecular weight PAHs by at least 1.6 times, while pentachloro-biphenyls are the dominant PCB congener accounting for at least 50% of the total fraction. PAHs and PCBs concentrations have increased over sampling years at all sites, except a slight decrease in PCBs level at Geispolsheim. Diagnostic ratio analysis suggested that diesel and fossil fuel combustion are the dominant contributors to PAHs in Alsace

Swarm intelligence (SI) methods are nature-inspired metaheuristics for global optimization that exploit a coordinated stochastic search strategy by a group of agents. Particle Swarm Optimization (PSO) is an established SI method that has been applied successfully to the optimization of rugged high-dimensional likelihood functions, a problem that presents the main bottleneck across a variety of gravitational wave (GW) data analysis challenges. We present results from a first application of PSO to one of the most difficult of these challenges, namely, the search for Extreme Mass Ratio Inspiral (EMRI) in data from future spaceborne GW detectors such as LISA, Taiji, or Tianqin. We use the standard Generalized Likelihood Ratio Test formalism, with minimal use of restrictive approximations, to search 6 months of simulated LISA data and quantify the search depth, in signal-to-noise ratio (SNR), and breadth, in the ranges of the EMRI parameters, that PSO can handle. Our results demonstrate that a PSO-based EMRI search is successful over a search region that is in the ballpark of the one that current hierarchical schemes can identify. Directions for future improvements, including computational bottlenecks to be overcome, are identified.

This paper discusses the theoretical and experimental correlations between fatigue and static strength statistical distributions. We use a two-parameter residual strength model that obeys the qualitative Strenght-Life Equal-Rank (SLERA) assumption for guidance. The modeling approach consists of recovering the model's parameters by best fitting the constant amplitude (CA) fatigue data at a given stress ratio, R, and the experimental Weibull parameters of the static strength distribution function. Once the model's parameters are fixed, its capabilities, potential, and limits are discussed by comparing its predictions with residual strength and fatigue data obtained at different stress ratios, R. Moreover, from a preliminary analysis, the theoretical extension of the model's capabilities to variable amplitude loadings is conceptualized. The application of Miner's rule is also discussed and compared with a new damage rule to analyze the fatigue responses under variable amplitude loadings.

Background and aim: The albumin-globulin ratio (AGR) is one of the indicators of inflammation and immunity and it has a prognostic significance in many malignant diseases. Previous studies have shown the relationship between inflammatory mediators and POPF. This study aimed to evaluate the relation of AGR, which is a relatively new indicator, with postoperative pancreatic fistula (POPF). Methods: Pancreaticoduodenectomy (PD) patients between 2017 and 2020 were retrospectively analyzed and divided into two groups as those with and without clinically relevant POPF (CR-POPF). They were compared in terms of preoperative-postoperative AGR and clinicodemographic characteristics. AGR was calculated as Albumin / (Total protein-albumin) and the cutoff point for AGR was determined according to Youden’s index. Results: CR-POPF developed in 21% of 121 patients who underwent PD. There was no difference between the groups in terms of age, gender, comorbid disease status, pancreatic duct width, and anastomosis technique. Preoperative and postoperative day-3 (POD3) albumin levels and AGR were found to be significantly lower in the CR-POPF group. Multivariate analysis showed that AGR and pancreatic tissue stiffness are independent risk factors for the development of POPF. Conclusions: Low AGR is an independent risk factor for the development of CR-POPF. To reduce the incidence of POPF, this ratio should be tried to be kept at an optimal level.

The article deals with auxetic structures made on the basis of suitably connected rigid rotating squares (from Grima and Evans), with axes of rotation on the squares’ surface. The geometric model and the resulting relationships that allow for the determination of Poisson’s ratio are considered in detail. It is demonstrated that changing the rotation axis position does not affect the negative Poisson’s ratio, equal to -1. The models built confirm the initial considerations and can offer new application possibilities.

Recent studies indicate that the Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) aboard the Cloud-Aerosol Lidar and Infrared Pathfinder Satellite Observations (CALIPSO) satellite provides valuable information about ocean phytoplankton distributions. CALIOP’s attenuated backscatter coefficients, measured at 532 nm in receiver channels oriented parallel and perpendicular to the laser’s linear polarization plane, are significantly improved in the Version 4 data product. However, due to non-ideal instrument effects, a small fraction of the backscattered optical power polarized parallel to the receiver polarization reference plane is misdirected into the perpendicular channel, and vice versa. This effect, known as polarization crosstalk, typically causes the measured perpendicular signal to be higher than its true value and the measured parallel signal to be lower than its true value. Therefore, the ocean optical properties derived directly from CALIOP’s measured signals will be biased if the polarization crosstalk effect is not taken into account. This paper presents methods that can be used to estimate the CALIOP crosstalk effects from on-orbit measurements. The global ocean depolarization ratios calculated both before and after removing the crosstalk effects are compared. Using CALIOP crosstalk-corrected signals is highly recommended for all ocean subsurface studies.

While sex ratios at birth (SRB) have been shown to vary within and across populations, after over a century of research, explanations have remained elusive. A variety of ecological, demographic, economic, and social variables have been evaluated, yet their association with SRB has been equivocal. Here, in an attempt to shed light on this unresolved topic within the literature, we approach the question of what drives variation in SRB using detailed longitudinal data spanning the frontier-era to the early 20th century in a US population. Using several measures of environmental harshness, we find that fewer boys are born during challenging times. However, these results hold only for the frontier-era and not into a period of rapid industrialization. We argue that the mixed state of the literature may result from the impact and frequency of exogenous stressors being dampened in post-industrial societies.

The goal of this paper is to explore the relationship between the specific non-performing loan ratio (NPL ratio) and the corresponding impact on the bank’s profitability and lending behavior. It also seeks to investigate the macroeconomic impacts of economies with excessively high NPL ratios as well as the efficacy and impact of alleviation measures used by banks and governments around the world to help facilitate a decrease in high NPL ratios. The possible implications and effects of the COVID-19 pandemic on NPL ratios is also addressed in this paper. It is found that when excessively high NPL ratios go unaddressed, the economy tends to suffer. On the other hand, this study shows that when measures are taken to reduce or eliminate the high NPL ratios, economic performance improves, and the reduction has a clear positive impact on the economy.

Logistics industry has been found to be among the key sources of carbon emission. In Vietnam logistics industry, there is a considerable difference between the number of foreign and Vietnamese firms as well as the proportion of markets that they are taking. This study is to research the low-carbon emission measures conducted by domestic and foreign invested logistics service providers (LSPs) and compare the results of the two groups. Both qualitative and quantitative approaches are applied. Literatures in relevant fields are reviewed and expert opinions are taken for structuring a questionnaire which was later distributed to 279 LSPs, with 166 returned and 159 being valid for data calculation. The results imply that there are differences in extension of applications of low-carbon practices between foreign and domestic firms. Except for transport mode switch and energy-saving lighting, the other practices witness that adoption levels of foreign LSPs are higher than their counterparts, which is possibly thanks to their global operation, more comfortable capital resources and awareness level of green initiative necessity. In conclusion, a comparison between the application conducted by foreign-invested firms and domestic ones, which has not been investigated before, was made.

Abstract: A two-year study of pearl millet-groundnut cropping systems across two fertilizer levels was conducted at the INRAN/TARNA research station in Maradi, Niger in the Sahelian zone of West Africa. The objective of this study was to identify the best cropping system with and without fertilizer application to optimize pearl millet and groundnut yields, land use efficiency, and economics as measured by value-to-cost ratio. The experiment was conducted with three replications, and ten treatments combination of five pearl millet and groundnut cropping systems (pearl millet and groundnut sole crops, and three pearl millet – groundnut intercrops), and two fertilizer levels. Sole cropping produced the highest pearl millet grain by over 300 kg ha-1 and groundnut pod yields by over 500 kg ha-1, but all the intercropping systems had a LER above 1.0 with land use efficiency increased by 19 to 41%, also intercropping increased diversity, and reduced risk. Fertilizer application increased yields in all cropping systems by 200 to 600 kg ha-1. Government subsidy increased the value-to-cost ratio by 0.5 to 2, 5 units, and was required for economic response for pearl millet sole and intercrops in 2022. The groundnut sole cropping system had the greatest economic response to fertilizer application. Based on the risky environment and multiple end uses needed by producers, the intercrop system M-G: 1:3:1 with fertilizer application is usually the best option to optimize pearl millet and groundnut production.

Neutrophil to lymphocyte ratio (NLR) is a promising predictive and prognostic factor in breast cancer. We investigated its ability to predict disease-free survival (DFS) and overall survival (OS) in patients with luminal A or luminal B-HER2-negative breast cancer who received neoadjuvant chemotherapy (NACT). Pre-treatment complete blood cell counts from 168 consecutive patients with luminal breast cancer were evaluated to assess NLR. The study population was stratified into NLRlow or NLRhigh according to a cut-off value established by receiving operator curve (ROC) analysis. Data on additional pre- and post-treatment clinical-pathological characteristics were also collected. Kaplan-Meier curves, log-rank tests, and Cox proportional hazards models were used for statistical analyses. Patients with pre-treatment NLRlow showed a significantly shorter DFS (HR 6.97, 95% CI 1.65-10.55, p= 0.002) and OS (HR 7.79, 95% CI 1.25-15.07, p= 0.021) compared to those with NLRhigh. Non-ductal histology, luminal B subtype, and post-treatment Ki67≥ 14% were also associated with worse DFS (p= 0.016, p= 0.002, and p= 0.001, respectively). In multivariate analysis, luminal B subtype, post-treatment Ki67≥ 14%, and NLRlow remained independent prognostic factors for DFS, while only post-treatment Ki67≥ 14% and NLRlow affected OS. The present study provides evidence that pre-treatment NLRlow helps identify women at higher risk of recurrence and death among patients affected by luminal breast cancer treated with NACT.

Digital-based differential amplifiers (DDA) are particularly suitable to low voltage digital integrated circuit technologies. This paper presents an exhaustive analysis of the digital-based analog amplifiers to take advantage of today's high-performance digital technologies and of computer-aided design (CAD) commonly employed to design integrated circuits. The operating principle and the main mathematical relations of the digital-based differential amplifiers are discussed along with an exhaustive explanation of its operating regions and of the corresponding power consumption. Finally, a detailed description of the design procedure of in UMC 180nm standard CMOS technology is shown.

HER2-low and ultra-low breast cancer (BC) have been recently proposed as new subcategories of HER2 BC, re-considering the immunohistochemical negative score of 0, 1+ or score of 2+/in situ hybridization (ISH) negative phenotype. In the present review we have outlined the needed criteria to exactly distinguish HER2 low and ultra-low BC. Recent clinical trials have demonstrated significant clinical benefits of novel HER2 directing antibody-drug conjugates (ADCs) in treating these group sof tumors. In particular, Trastuzumab-deruxtecan (T-Dxd), a HER2-directing ADC has been recently approved by the U.S. Food and Drug Administration as the first targeted therapy to treat HER2-low BC. Furthermore, ongoing trials, such as the DESTINY-Breast06, are currently evaluating ADCs in patients with HER2-ultra low BC. Finally we hope that new guidelines may help to codify HER2 low and ultra-low BC, increasing our knowledge of tumor biology and improving a targetable new therapeutical treatment.

Multidisciplinary Design Optimization (MDO) is the most active field in the design of current complex system engineering, which is possessed with such two difficulties as subsystem information exchange and analytical and computational complexity of systems. Therefore, an improved collaborative optimization algorithm based on ANN (artificial neural network) response surface was proposed dependent on the consistency constraint algorithm and concurrent subspace algorithm. As an optimization method with secondary structure, it satisfied only local constraints in discipline layer, but provided a coordinated mechanism for interdisciplinary conflict in system layer. Finally, it was applied in the multidisciplinary design optimization of autonomous underwater vehicle (AUV). As shown from the result, the MDO convergence stability and reliability of low resistance, low noise and high maneuvering performance of the AUV shape can be ensured by the improved collaborative optimization algorithm, thus verifying the effectiveness of the algorithm.

Waterbomb structures are origami-inspired deformable structural components used in new types of robots. They have a unique radially deployable ability that enables robots to better adapt to their environment. In this paper, we propose a series of new waterbomb structures with square, rectangle, and parallelogram base units. Through quasi-static axial and radial compression experiments and numerical simulations, we prove that the parallelogram waterbomb structure has a twist displacement mode along the axial direction. Compared with the square waterbomb structure, the proposed optimal design of the parallelogram waterbomb structure reduces the critical axial buckling load-to-weight ratio by 55.4% and increases the radial stiffness-to-weight ratio by 67.6%. The significant increase in the radial stiffness-to-weight ratio of the waterbomb structure and decrease in the critical axial buckling load-to-weight ratio make the proposed origami pattern attractive for practical robotics applications.

Background Telomere shortening is related to aging and unfavourable health outcomes. Obesity and metabolic diseases are important factors for accelerating aging. This study aimed to find out the association between obesity, metabolic disease, and telomere length in metabolically healthy adults. Methods 237 adults were enrolled with written consents at a health promotion centre of a tertiary hospital from February 2014 to March 2015. After excluding 99 subjects who met the exclusion criterion, a total of 130 metabolically healthy subjects were selected for final analysis. The subjects were divided into quartile groups according to the telomere lengths of their oral mucosal cells. Results The subjects consisted of 66 (50.8%) males with a mean age of 58.59 years. The body mass index (BMI, kg/m2) increased significantly along with the quartile groups (Q1, 23.00; Q2, 23.96; Q3, 23.70; Q4, 25.20; P-for trend=0.008). Waist circumference (WC, P-for trend=0.022), waist-to-hip ratio (WHR, P-for trend=0.005), and waist-to-height ratio (WHtR, P=0.001) also increased along with the quartile groups. Obesity prevalence (BMI ≥25 kg/m2), abdominal obesity (WC ≥90 cm for men, ≥85 cm for women), WHR 〉1.0 for men or 〉0.85 for women, and WHtR ≥0.5 increased significantly as the telomere length increased (P-for trend <0.05). After adjusting for covariates, the ORs for each obesity markers increased as the telomere length increased (P-for trend <0.05); and the ORs of WHtR were especially meaningful (Q1, 1.00; Q2, 2.53; Q3, 2.97; Q4, 7.81; P-for trend = 0.001). There were no significant trends for metabolic syndrome and its components along with the prevalence of fatty liver disease. Conclusion Obesity markers and telomere length had significant positive correlation despite the established theory. The obesity paradox may exist in metabolically healthy adults with regard to telomere length, However, further studies with larger sample sizes for the association between obesity and telomere length are needed.

The article presents comparative results from 5 categories of animals (4 samples originating from pigs, 2 from cows, 1 from chicken, 1 from ostriches, 1 from horses, samples quantified with A, B, C, D, E, F, G, H, I). These samples were collected from large, medium and small (family) farms. The results were validated by the biogas production generated by the respective samples, using the Automatic Methane Potential Test System (AMPTS II) bio-processor. The largest amounts of biogas (2,464.5 Nml, 2,262.0 Nml) were recorded for the samples from pig farms (Sample B and Sample D), whereas the lowest values were obtained in the case of Sample A (414.1 Nml) and Sample C (558.3 Nml). The heavy metals analyzed in the article are Zn, Cu, Fe, Mn, Ca, K, As. The results corroborate that the C/N ratio can also vary to values lower than 20-30, without affecting the biogas production process, and the heavy metal content must be known especially for the full management of the wastes. All final data presented in the article are based on repeated, triplicate experiments, with less as 2% deviation between data.

Ethiopia is one of the countries with the highest level of malnourishment of lactating mothers in sub-Saharan Africa. However, different communities produced different foods solely for lactating mothers. "Shameta" is one of the cereal-based fermented cultural foods exclusively produced for lactating mothers with the perception that it would support the health, strength, and recovery of mothers. This study investigated the effects of fermentation time and blending ratio on the nutritional quality of "Shameta." Three levels of blending ratio of ingredients (Maize-Barley-Fava bean) and three levels of fermentation times were laid down in a completely randomized design (CRD). The study showed that lactic acid bacteria were the dominant group, followed by yeasts. Notably, the ingredient formulation ratio of Maize-Barley-Fava bean (81:5:5) in all fermentation times (8, 10, and 12 days) results in the highest LAB dominance with the highest crude fat (13.23 g/100g) content. However, the highest crude protein (16.56 g/100g) and mineral contents were observed in a ratio mix of 66:10:15 fermented for 12 days. The nutritional quality of culturally prepared Shameta can be improved by optimizing fermentation time and ingredient compositions for better recovery, strength, and health of lactating mothers.

The purpose of this study was to determine the income, costs and revenue of the Gontor Putri 3 bakery. Want to know the efficiency of the bakery business in Karangbanyu Regency. The method used in this research is analytical descriptive by conducting a survey. The data used in this research is primary data. Data collection techniques use observation, interviews and documentation, while the process of analysis is quantitative descriptive. Using the R/C ratio, a value of 1.72 per month is obtained. This value indicates that the bakery factory in Karangbanyu is efficient because the value is more than one.

On the basis of the golden ratio and the compasseses, every angle was divided into three equal parts. In general, it has been proven that the problem of triangulation of an angle cannot be solved on the basis of the golden ratio and the expanding of the angle. The relationship of golden relativity with Pi number and Euler's number has not been investigated to solve impossible problems. According to the investigation of events in six-dimensional space-time, with the simultaneous movement of two arms of the compasses based on the golden ratio, every angle was divided into three equal parts. The growth rate based on the golden ratio is the key to solving the most intractable mathematical and physical problems.

Frontotemporal dementia (FTD) is the second most common form of presenile dementia; however, its diagnosis has been poorly investigated. Previous attempts to diagnose FTD using quantitative electroencephalography (qEEG) have yielded inconsistent results in both spectral and functional connectivity analyses. This study aimed to introduce an accurate qEEG marker that could be used to diagnose FTD and other neurological abnormalities. We used open-access electroencephalography data from OpenNeuro to investigate the power ratio between the frontal and temporal lobes in the resting state of 23 patients with FTD and 29 healthy controls. Spectral data were extracted using a Fast Fourier Transform in the delta (1–4 Hz), theta (4–8 Hz), alpha (8–13 Hz), beta (13–32 Hz), and gamma (32–45 Hz) bands. We found that the spectral power ratio between the frontal and temporal lobes is a promising qEEG marker of FTD. Frontal/temporal (F/T) theta/alpha, alpha/theta, al-pha/gamma, and gamma/alpha showed a consistently high discrimination score for the diagnosis of FTD for different parameters and referencing methods. The study findings can serve as reference for future research focused on diagnosing FTD and other neurological anomalies.

Retention mechanisms in HILIC have been investigated and reported in literature. However, the current understanding of the retention mechanisms is qualitative and lacks quantitative details. Previously, mechanism elucidation was based on indirect evidence, and unambiguous assignment of retention mechanisms has not been reported based on direct data. This study aims to quantitatively determine the contributions of two major retention mechanisms in HILIC, hydrophilic partitioning and surface adsorption to the overall retention of neutral compounds. Using the methodologies we developed previously, the phase ratio for adsorbed water layer and distribution coefficients were measured and used to calculate the retention factors attributed to hydrophilic partitioning. The methodology allows the determination of the contribution of surface adsorption simultaneously. The evaluation of five test compounds demonstrates that the retention may be controlled by hydrophilic partitioning, surface adsorption or both depending on compound characteristics. Quantitative assessment of retention mechanisms also makes it possible to better understand the effect of acetonitrile on retention in HILIC.

At present, aeroponic control is mainly regulated according to the environmental factors of aeroponics, such as the temperature, humidity, light intensity, carbon dioxide concentration, pH, and electrical conductivity (EC) of the nutrient solution. There is a lack of knowledge available in the literature for an aeroponic control system for plant growth information as the primary feedback signal. Therefore, a fuzzy logic-controlled aeroponics system was developed for the growth of lettuce as a feedback signal. After designing, the effectiveness test of system was performed with experiment having three treatments T1 (180C), T2 (220C) and without control (CK). The results show an increasing trend in shoot length, root length, and shoot area over time in all treatments. In terms of shoot area, the maximum of 345 cm² was observed in the T1 treatment, while the CK treatment had a minimum of 241.8 cm². Statistical analysis indicated that the T1 and T2 treatments were not significantly different, but both were significantly different from the CK treatment. The study demonstrates the effectiveness of the fuzzy logic control system and an 18°C nutrient solution temperature, resulting in improved lettuce growth and reduced root-to-shoot ratio. The findings suggest the potential of using fuzzy logic control in aeroponics for optimized cultivation outcomes.

Introduction: Studies conducted in real-life scenarios on vaccine protection against COVID-19 constitute an important global priority, but one that is currently mostly neglected in low- and middle-income countries such as Angola. Here, we analyze for the first-time vaccine protection against COVID-19 in a real-life scenario after 6 months of implementing a multi-vaccination plan in Angola, providing estimation of odds ratios in vaccinated individuals and vaccine efficacy against infection by SARS-CoV-2 in a period that coincided with the identification of the Omicron variant in the country. Methods: We used a negative test case-control design to assess the effectiveness of vaccination against confirmed SARS-CoV-2 infection. A total of 4.232 vaccinated and unvaccinated individuals with the result of a rapid antigen diagnostic test against SARS-CoV-2 performed from December 27 to 28, 2021 were included in the study. Data were extracted from the Digital Vaccination Record Platform (Rediv) of the Ministry of Health of Angola. All ethical procedures related to the authorization necessary to carry out the study were followed. Statistical analyzes were performed using version 7.5.2.0 of CDC's Epi Info. Frequency distributions and measures of central tendency were used to characterize the study universe. The general and sex-adjusted and age-adjusted odds ratios, were evaluated by comparing the chances of vaccination between cases and controls, and their associated 95% CI, which were calculated using the Mantel-Haenszel stratification method. The risk classification of Axel Kroeger, Piscoya and Alarcon was used to interpret the odds ratio. The Breslow-Day statistic was used to assess the homogeneity of the odds ratios. Vaccine efficacy was calculated using the odds ratio applying the accepted statistical vaccine efficacy formula:(1 − odds ratio) × 100. For all estimates, a P value < 0.05 was considered statistically significant. Results: The population consisted of 63.63% male and 36.37% female. The mean age was 36 years with a standard deviation of 13. 83. Regarding vaccination status, 83.27% of individuals were vaccinated and 16.73% were unvaccinated, with 21.81% positive and 78.19% negative for SARS -CoV-2. The odds of SARS-CoV-2 infection were 0.85 (95% CI 0.70 – 1.03) times lower in vaccinated compared to unvaccinated individuals, with P=0.09. The overall vaccine efficacy (VE) was 15% (95% CI -3 – 30). Conclusion: There was no statistically significant decrease in the chances of SARS-CoV-2 infection in vaccinated versus unvaccinated individuals. However, the overall vaccine efficacy was 15%.

(1) Background: The CEO message of hospital homepage contain various contents such as the hospital's future vision, promises with customers, upgraded services and public activities. The CEO’s message of the homepage includes non-financial information as well as financial information of corporates. Also, it provides useful information for not only company's goals and vision but also firm performance and strategies for the future. This study aims to investigate associations between CEO’s message of hospitals homepages and financial status. We used the balanced scorecard frame to analyze what content on the hospital's homepage is related to the hospital's various financial ratios. (2) Methods: We adopt a text mining method to extract significantly repeated keywords from the CEO’s message of hospital website. And we classify these keywords by a balanced scorecard frame. To examine the relationship between keywords of CEO’s message of the hospital homepage and hospital’s financial ratio, T-test is conducted for the difference in the TF-IDF (Term Frequency is Divided by Inverse Document Frequency) mean of the home page contents and its relationship with the views of the balanced scorecard framework. (3) Results: According to empirical results on 65 samples collected from local hospitals, there are some significant relationship between the qualitative content of the hospital's homepage and the quantitative financial ratio that indicates profitability, activity, leverage, liquidity, and transfer to essential business fund (EBF) income. (4) Conclusions: The introduction section of a homepage is most accessible to customers, containing the aims and ideals of hospitals and reflecting their values and visions [1]. In addition, in view of financial status, they can either emphasize financial strength or focus on other areas to mask weakness of financial information. This study reminds us of the importance of hospital website’s disclosure, and it can be inferred from the financial status of the hospital. It also highlights the need for harmonization between quantitative data, financial statements, and qualitative data, CEO’s messages. (5) Implications: To our best knowledge, this paper is the first research attempting to investigate the relation between text of hospital homepage and financial ratio of hospital through text mining technique and balanced scorecard frame. Hospitals take a crucial part in a country’s welfare and healthcare backbone industry. Nevertheless, in many countries, hospital organization sectors tend to remain a source of critical fiscal deficits due to its ineffective and sloppy management. We expect that the result of this paper can provide hospital managers to useful information.

In attempting to predict the further course of the novel coronavirus (COVID-19) pandemic caused by SARS-CoV-2, mathematical models of different types are frequently employed and calibrated to reported case numbers. Among the major challenges in interpreting these data is the uncertainty about the amount of undetected infections, or conversely: the detection ratio. As a result, some models include assumptions about the percentage of detected cases among total infections while others completely neglect undetected cases. Here, we illustrate how model projections about case and fatality numbers vary significantly under varying assumptions on the detection ratio. Uncertainties in model predictions can be significantly reduced by representative testing, both for antibodies and active virus RNA, to uncover past and current infections that have gone undetected thus far.

There is high prevalence of hypertension and is rapidly increasing around the world, despite the intervention programme implemented, this study aimed at estimating the prevalence rate, test of association between hypertension and risk factors and model hypertension rate. Data used was obtained from the health record of Federal Medical Centre, Keffi from January 2016 – January 2019. Ordinal logistic regression model was used; Model Fitting Information, Goodness-of-Fit, Pseudo R-Square and Test of Parallel Lines are fitted to the data sets to test the accuracy and correctness of the model. The results indicated that the overall prevalence of hypertension rate is high at 36.4%, among the adult population, body mass index and gender are statistically significant, and Age is not significant in the study. Individuals that are overweight are more likely to be hypertensive compare to other weights. At age 40 – 49 years which have the highest rate of 26.5% and the odd ratio is 0.75 compared to others. One year increase in age 30 – 39, the cumulative odd of being hypertensive is 0.91 while other independent variables are held constant. The odd ratio of female being hypertensive is 0.85, therefore the females are more likely to be hypertensive with 54.4% compared to the males at 45.6% . There is no presence of multicolinearity among the variables and Logit models were formulated to calculate probabilities of the various possible outcomes.