Achievable Rate Research Articles

Live birth rate after oocyte donation in females diagnosed with turner syndrome: a systematic review and meta-analysis

BackgroundAn enduring challenge for women diagnosed with Turner syndrome (TS) is infertility. Oocyte donation (OD) offers a chance of pregnancy for these patients. However, current data on pregnancy outcomes are inadequate. Hence, this systematic review aims to explore the clinical outcomes of OD in patients with TS.MethodsA systematic search was conducted in PubMed, Web of Sciences, Scopus, and Embase for relevant papers from 1 January 1990 to 30 November 2023. Our primary research objective is to determine the live birth rate among women with TS who have undergone in vitro fertilization (IVF) using OD for fertility purposes. Specifically, we aim to calculate the pooled live birth rates per patient and per embryo transfer (ET) cycle. For secondary outcomes, we have analyzed the rates of clinical pregnancy achievement per ET cycle and the incidence of gestational hypertensive complications per clinical pregnancy. Prevalence meta-analyses were performed using STATA 18.0 by utilizing a random-effects model and calculating the pooled rates of each outcome using a 95% confidence interval (CI).ResultsA total of 14 studies encompassing 417 patients were systematically reviewed. Except for one prospective clinical trial and one prospective cohort study, all other 12 studies had a retrospective cohort design. Our meta-analysis has yielded a pooled live birth rate per patient of 40% (95% CI: 29-51%; 14 studies included) and a pooled live birth rate per ET cycle of 17% (95% CI: 13-20%; 13 studies included). Also, the pooled clinical pregnancy achievement rate per ET cycle was estimated at 31% (95% CI: 25-36%; 12 studies included). Moreover, the pooled rate of pregnancy-induced hypertensive disorders per clinical pregnancy was estimated at 12% (95% CI: 1-31%; 8 studies included). No publication bias was found across all analyses.ConclusionsThis study demonstrated promising pregnancy outcomes for OD in patients with TS. Further studies are essential to address not only the preferred techniques, but also the psychological, ethical, and societal implications of these complex procedures for these vulnerable populations.Trial registrationThis systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the registration code CRD42023494273.

Microwave vs radiofrequency ablation for small renal masses: perioperative and oncological outcomes.

To conduct a comprehensive comparison of microwave ablation (MWA) vs radiofrequency ablation (RFA) outcomes in the treatment of small renal masses (SRMs), specifically: TRIFECTA ([i] complete ablation, [ii] absence of Clavien-Dindo Grade ≥III complications, and [iii] absence of ≥30% decrease in estimated glomerular filtration rate) achievement, operative time (OT), and local recurrence rate (LRR). We retrospectively analysed 531 patients with SRMs (clinical T1a-b) treated with MWA or RFA at a single centre (2008-2022). First, multivariable logistic regression models were used for testing TRIFECTA achievement. Second, multivariable Poisson regression models were used to evaluate variables associated with longer OT. Finally, Kaplan-Meier plots depicted LRR over time. All analyses were repeated after 1:1 propensity score matching (PSM). Of 531 patients with SRMs, 373/531 (70.2%) underwent MWA and 158/531 (29.8%) RFA. MWA demonstrated superior TRIFECTA achievement (314/373 [84.2%]) compared to RFA (114/158 [72.2%], P = 0.001). These differences were driven by higher rates of complete ablation in MWA- vs RFA-treated patients (348/373 [93.3%] vs 137/158 [86.7%], P < 0.001). In multivariable logistic regression models, MWA was associated with higher TRIFECTA achievement, compared to RFA, before (odds ratio [OR] 1.92, P = 0.008) and after PSM (OR 1.99, P = 0.023). Finally, the median OT was shorter for MWA vs RFA (105 vs 115 min; P = 0.002). At Poisson regression analyses, MWA predicted shorter OT before (incidence rate ratio [IRR] 0.86, P < 0.001) and after PSM (IRR 0.85, P < 0.001). Local recurrence occurred in 17/373 (4.6%) MWA-treated patients and 21/158 (13.3%) RFA-treated patients (P = 0.29) after a median (interquartile range) follow-up of 24 (8-46) months. There were no differences in the LRR in Kaplan-Meier plots before (P = 0.29) and after PSM (P = 0.42). Microwave ablation provides higher TRIFECTA achievement, and shorter OT than RFA. No significant differences were found regarding the LRR.

Thick-wire GMAW for fusion welding of high-strength steels

The paper describes a high-current Gas Metal Arc Welding (GMAW) process using wire electrodes with diameters up to 4.0 mm for single-pass full penetration butt joint welding of 20 mm thick steel plates. Fundamental research aims to develop thick-wire GMAW into a high-efficiency method by identifying the limits of welding performance and achievable deposition rates. Current gaps in understanding include equipment requirements, process properties, application fields, and weld quality. The research project addresses these gaps through systematic investigations of basic technological analyses, application sample welding, and quality evaluations. The objective was to create a robust, cost-efficient gas-shielded high-performance welding technology with deposition rates comparable to Submerged Arc Welding. The fully mechanized, automatic welding setup included two parallel-connected welding power sources, one wire feeder and one high-power welding torch. Welding parameters and conditions were evaluated with the aim of achieving a high-quality weld. Optimal parameters were identified for one-sided single-pass welding on 20 mm thick plates. Validation of thick-wire GMAW for 20 mm thick high-strength steels was conducted via two-sided single-pass welding on S690Q grade plates. Testing of the weld joint included static tensile strength test (3x tensile specimen), a Charpy impact test at −40 °C (6x Charpy V-notch specimens respectively with notch position in weld metal, base material and heat-affected zone (HAZ)), microstructure examination and a hardness test. The lowest recorded impact energy was observed to be 50 J within the weld metal, in combination with hardness peaks in the HAZ reaching 415 HV1, and all tensile specimens failing outside the HAZ within the base material. The process achieved reliable, reproducible, and economical joint welding, meeting necessary mechanical-technological quality standards. The paper enhances the understanding of selected welding techniques tor thick plate joining and offers valuable industrial insights, demonstrating the technique's applicability and feasibility for high-strength applications.

Suggesting Priorities of Sustainable Development Goals Considering the Lingering Impacts of COVID-19

The Sustainable Development Goals (SDGs), aimed to be achieved by 2030, demand a more efficient approach for the remaining period due to the currently low achievement rate and the persisting impact of COVID-19. Consequently, this study analyzes United Nations statistics and previous studies to propose a global prioritization of SDGs. The arguments in each document were interpreted cross-sectionally with those of others. The analysis incorporates a simple system dynamics methodology and adds a national psychological and behavioral economic perspective. Among all SDGs, this study suggests that Goal 17 (Partnerships for the Goals) and ecosystem-related goals corresponding to Goals 13, 14, and 15 should be the foremost global priorities, given their capacity to establish the foundation for other goals. The general goals (Goals 1 to 9, 11, 12, and 16) and Goal 10 (Reduced Inequalities) follow as the subsequent priorities, fostering the most effective progression. The paper also suggests that among the targets of Goal 17, targets 17.2 (fully implement the commitment to Official Development Assistance), 17.18 (support available data to developing countries), and 17.11 (increase exports of developing countries) should be globally prioritized to focus on the economic recovery of developing countries in a short time. Furthermore, this study recommends that while each region maintains its local priorities, the international community should adhere to the global priorities presented. This alignment will lead to a worldwide virtuous circle—a structure where following each other's priorities helps resolve the next set of issues.

Performance Evaluation of Non-Lambertian SLIPT for 6G Visible Light Communication Systems

Visible light communication (VLC) has emerged as one promising candidate technique to improve the throughput performance in future sixth-generation (6G) mobile communication networks. Due to the limited battery capacity of VLC systems, light energy harvesting has been proposed and incorporated for achieving the simultaneous lightwave information and power transfer (SLIPT) function and for improving the overall energy efficiency. Nevertheless, almost all reported works are limited to SLIPT scenarios adopting a basic and well-discussed Lambertian optical transmitter, which definitely cannot characterize the potential and essential scenarios employing distinctive non-Lambertian optical transmitters with various spatial beam characteristics. For addressing this issue, in this work, SLIPT based on a distinct non-Lambertian optical beam configuration is investigated, and for further enhancing the harvested energy and the achievable data rate, the relevant flexible optical beam configuration method is presented as well. The numerical results show that, for a typical receiver position, compared with about 1.14 mJ harvested energy and a 31.2 Mbps achievable data rate of the baseline Lambertian configuration, a harvested energy gain of up to 1.55 mJ and an achievable data rate gain of 21.1 Mbps can be achieved by the non-Lambertian SLIPT scheme explored here.

Engineering a vacuum-actuated peristaltic micropump with novel microchannel design to rapidly separate blood plasma with extremely low hemolysis

A need exists for scalable, automated lab-on-chip systems to separate blood plasma for medical diagnostics. In this study, a vacuum-actuated peristaltic micropump (VPM) was developed, incorporating with the inertial microfluidic technique for the separation and collection of blood plasma from diluted blood. The features of the micropump were investigated by varying parameters such as frequency, vacuum pressure, and the number of microchannels. The highest achievable flow rate was found to be 832 µL/min. Subsequently, to minimize the occurrence of red blood cell rupture during the separation process and significantly reduce hemolysis, the configuration of the vertical wall inside the microchannel was modified to an inclined wall. This improvement was validated through experiments using high-speed cameras and fluorescent particles. Blood plasma separation was achieved with high efficiency (98.5 %), rapidity (<1 min), automation, and minimal whole blood usage (5 µL). Importantly, the vacuum actuator with an inclined wall obstruction design demonstrated very low hemolysis (less than 2 %).

Analysis of Blood Lipids, Blood Glucose, Blood Uric Acid, and Blood Routine Test Results in Retired Employees of a Unit in the Civil Aviation System

Objective: To investigate and analyze the annual physical examination results of retired employees from a unit in the civil aviation system, focusing on blood lipids, blood glucose, blood uric acid, and blood routine results. The study aims to provide relevant references for formulating reasonable disease management measures for preventing and controlling hyperlipidemia, hyperuricemia, and other conditions in retired employees. Methods: The examination results of 231 participants were collected and analyzed. The participants were divided into four groups based on age: middle-aged group, young-old group, middle-old group, and old-old group. The blood test results were compared across these groups, and an assessment of atherosclerotic cardiovascular disease (ASCVD) risk levels was completed in conjunction with medical history. Blood test results were also compared by gender. Results: There were no significant statistical differences in blood test results when grouped by age. However, the prevalence of hyperuricemia was higher in males than in females, while the prevalence of hypercholesterolemia was higher in females than in males. The LDL-C target achievement rate was lower in the moderate-and-high-risk group as well as the very high-risk group as defined by ASCVD risk levels. Conclusion: Management of hyperuricemia and hyperlipidemia in retired employees (elderly patients) should be strengthened to reduce the risk of ASCVD events and alleviate the potential medical burden associated with disease progression.

"Volume" of Chinese Family Education: Analysis and Discussion of Formation Causes

The "volume" phenomenon of Chinese family education attention continues to rise in recent years, this paper for the Chinese family education "volume" phenomenon, through the relevant literature, different views, combined with social and cultural background and family education practice, to cause Chinese family education "volume" of multiple factors are analyzed. The study found that parents' educational anxiety, the intensification of social competition pressure, different economic advantages and resource access, the unbalanced distribution of educational resources, the bias of educational concepts and systems, and the intensification of psychological pressure are all important factors leading to the "coil" of family education in China. This paper further points out that family education should return to its essence and focus on the all-round development of children, rather than excessive pursuit of academic achievement and graduation rates. Finally, this paper puts forward countermeasures and suggestions to alleviate the trend of "roll" education, in order to promote the formation of healthier and balanced family education model and guide Chinese family education towards a more healthy and rational direction.

UAV trajectory planning in NOMA-aided UAV-mounted RIS networks: A budgeted Multi-armed bandit approach

Abstract Reconfigurable Intelligent Surface (RIS) and Non-Orthogonal Multiple Access (NOMA) can be used as supporting technologies for driving the effective development of Unmanned Aerial Vehicles (UAV) communication systems. Herein, both technologies are combined to widen the millimeter-wave Base Stations (mmWave-BS) coverage range. In this work, we consider UAV Trajectory Planning (UTP) problem to enhance the performance of a NOMA-based UAV-mounted RIS communication network. The problem is formulated using two Budgeted Multi-Armed Bandits (BMAB) schemes. BMAB is a variant of the classical MAB algorithm that considers the random cost of selecting an arm. The UAV performs as a bandit player attempting to maximize its achievable rate (i.e., reward) via accessing different grids in its trajectory. This reward is accomplished simultaneously while minimizing the energy/cost of flying the UAV from one grid to another to preserve its battery lifetime. Hence, two variants of the Budgeted upper confidence bound (BUCB), namely the BUCB1 and BUCB2, are investigated, where the simulations show that both algorithms outperform other benchmarks.

Mental Health Literacy Among Urban and Rural Residents of Guangdong Province, China.

The study aims to understanding the mental health literacy level of urban and rural residents in Guangdong Province, the first major province in China, and its influencing factors is crucial. A multi-stage stratified equal-volume random sampling method was adopted in October-December 2022 to select permanent residents aged 18 years and above in Guangdong Province for the questionnaire survey, which consisted of a general demographic information questionnaire and a national mental health literacy questionnaire. Rao-Scott χ²-test with correction based on sampling design, independent samples t-test and binary multivariate logistic regression analysis were performed. A total of 51744 individuals completed the questionnaire, including 31822 urban residents and 19200 rural residents. The rate of achievement of mental health literacy was 13.6% among urban residents, which was significantly higher compared to the rate of 8.6% among rural residents. Logistic regression analysis showed that female, higher education, being mental worker, being a retiree, having a higher monthly household income, maintaining a regular diet, and using electronic products for 2-6hours per day were protective factors for mental health literacy attainment in urban residents, while having chronic diseases, being a smoker and having a history of drinking were identified as risk factors in urban residents. Among in rural residents, married, younger, higher education, being mental worker and using electronic products for 2-6hours per day, maintaining a regular diet, and engaging in regular exercise were protective factors for achieving mental health literacy, while previous smoking was a risk factor. The study revealed a low level of mental health literacy among urban and rural residents of Guangdong Province, with a significant disparity between the two areas. These findings highlight the need for continuing efforts to increase the dissemination of mental health knowledge in rural communities and improve levels of mental health literacy.

Do class III obese patients achieve similar outcomes and satisfaction to nonobese patients following surgery for cervical myelopathy? A QOD study.

The aim of this study was to compare the rate of achievement of the minimal clinically important difference (MCID) in patient-reported outcomes (PROs) and satisfaction between cervical spondylotic myelopathy (CSM) patients with and without class III obesity who underwent surgery. The authors analyzed patients from the 14 highest-enrolling sites in the prospective Quality Outcomes Database CSM cohort. Patients were dichotomized based on whether or not they were obese (class III, BMI ≥ 35 kg/m2). PROs including visual analog scale (VAS) neck and arm pain, Neck Disability Index (NDI), modified Japanese Orthopaedic Association (mJOA), EQ-5D, and North American Spine Society patient satisfaction scores were collected at baseline and 24 months after cervical spine surgery. Of the 1141 patients with CSM who underwent surgery, 230 (20.2%) were obese and 911 (79.8%) were not. The 24-month follow-up rate was 87.4% for PROs. Patients who were obese were younger (58.1 ± 12.1 years vs 61.2 ± 11.6 years, p = 0.001), more frequently female (57.4% vs 44.9%, p = 0.001), and African American (22.6% vs 13.4%, p = 0.002) and had a lower education level (high school or less: 49.1% vs 40.8%, p = 0.002) and a higher American Society of Anesthesiologists grade (2.7 ± 0.5 vs 2.5 ± 0.6, p < 0.001). Clinically at baseline, the obese group had worse neck pain (VAS score: 5.7 ± 3.2 vs 5.1 ± 3.3), arm pain (VAS score: 5.4 ± 3.5 vs 4.8 ± 3.5), disability (NDI score: 42.7 ± 20.4 vs 37.4 ± 20.7), quality of life (EQ-5D score: 0.54 ± 0.22 vs 0.56 ± 0.22), and function (mJOA score: 11.6 ± 2.8 vs 12.2 ± 2.8) (all p < 0.05). At the 24-month follow-up, however, there was no difference in the change in PROs between the two groups. Even after accounting for relevant covariates, no significant difference in achievement of MCID and satisfaction was observed between the two groups at 24 months. Despite the class III obese group having worse baseline clinical presentations, the two cohorts achieved similar rates of satisfaction and MCID in PROs. Class III obesity should not preclude and/or delay surgical management for patients who would otherwise benefit from surgery for CSM.

Single-Pill Combination Therapy of Amlodipine, Telmisartan, and Chlorthalidone in the Management of Hypertension: A Systematic Review of Randomized Controlled Trials.

Hypertension is a major cause of cardiovascular disease and death worldwide. Low-dose combination therapy is a promising approach for managing hypertension due to its safety and efficacy. This systematic review evaluates the safety and efficacy of a single-pill, low-dose combination of amlodipine, telmisartan, and chlorthalidone for essential hypertension based on evidence from randomized controlled trials (RCTs). We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and searched the Cochrane, Scopus, PubMed, and Web of Science databases until July 01, 2024, using the following search string: (telmisartan) AND (amlodipine) AND (chlorthalidone) AND (randomized OR randomly). The quality of the RCTs was assessed using the revised Cochrane risk of bias tool. The primary endpoint was the mean change in sitting systolic blood pressure (BP), with secondary endpoints including BP target achievement rates, BP response rates, and serious treatment-related adverse events. Overall, three RCTs met the inclusion criteria and exhibited a low risk of bias. The doses in the combination pill ranged from 2.5 to 5 mg of amlodipine, 20 to 80 mg of telmisartan, and 4.167 to 25 mg of chlorthalidone. Control groups varied, including usual care, amlodipine 10 mg, and dual therapy of telmisartan and amlodipine. Results showed significant reductions in mean sitting systolic and diastolic BP, improved BP control and response rates, and a generally safe profile with no significant differences in serious adverse events. Despite encouraging data, results should be interpreted with caution due to heterogeneity in doses and control groups. Further research should address the long-term effects and explore predictors of response to this therapy.

HAC-SAGIN: High-altitude computing enabled space–air–ground integrated networks for 6G

The space–air–ground integrated networks (SAGINs) provide a new paradigm for the development of the Internet of Things (IoT) networks by enhancing coverage and deploying computing resources near IoT devices, especially in emergency situations and disaster-hit regions. In the context of the IoT networks, aerial platforms such as unmanned aerial vehicles (UAVs) and high-altitude platforms (HAPs) present in the air layer of SAGINs with access and aerial computing (AC) capabilities have the potential to significantly expand coverage, enhance performance, reduce delay and handle complex computation tasks for IoT devices. Seeking the stated prospect, we propose a high-altitude computing (HAC)-enabled SAGIN leveraging millimeter waves (mmWave) frequency range in which the IoT devices are provided access services by low-earth orbit satellites (LEO-SATs) and HAPs while the HAPs offer AC facility as well. Non-orthogonal multiple access (NOMA) is used as a multiple-access technique with different clustering mechanisms in uplink (UL) and downlink (DL) communication. We aim to establish high-rate data transmission in DL along with minimizing the execution time of IoT devices offloading their data to the HAPs in UL communication. The mmWaves range is targeted to have high-rate data transmissions and NOMA implementation further enhances the bandwidth available for an individual IoT device. For efficient offloading in UL communication, we formulate an optimization problem aiming to minimize the execution time by using the Lagrangian function-based approach. Execution time is minimized by reducing the transmission and computation time, which is attained by the optimization of allocated power and computation resources. Simulation results demonstrate that the proposed HAC-SAGIN is able to establish high-rate transmissions in DL and exhibits a significant decrease in execution time in UL in contrast to the no optimization case. Optimum power assignment improves the achievable rate, leading to reduced transmission times, while optimum core assignment efficiently reduces the computation time. In addition, the offloaded data size-driven NOMA implementation in UL prominently improves the system effective throughput.

Preoperative Symptom Duration and the Effect on Clinical Outcomes and PROMIS-PF in Patients Undergoing Lumbar Fusion Surgery.

Retrospective Review. The purpose of this study is to examine the effect of preoperative symptom duration on postoperative clinical outcomes for patients undergoing lumbar fusion surgery. Lumbar fusion surgery can be significantly beneficial for lumbar spondylolisthesis and spinal stenosis. Surgical treatment is typically preceded by some amount of non-operative intervention and there isn't a consensus on the optimal timing between symptom onset and surgical intervention. A retrospective review of 144 patients undergoing a 1-3 level lumbar fusion from June 2020 to December 2023 was performed. Demographics, preoperative symptom onset, primary diagnosis, and surgical procedure were compared between patients with less than or greater than 2 years of symptoms. Postoperative outcomes and PROMIS-PF were compared between groups. Univariate and multivariate analyses were performed. 52 (36.1%) had symptoms for 2 years or longer while 92 (63.9%) had symptoms for less than 2 years. There was no difference in demographics, procedure type, primary diagnosis, or preoperative symptoms between those who had symptoms for greater than or less than 2 years. Those who had symptoms for 2+ years had a significantly lower change in PF (4.7±7.1 vs. 7.7±9.0; P=0.029) and lower rate of MCID achievement (44.2% vs. 65.2%; P=0.023). There was no difference in outcomes by symptom duration. On multivariate analysis those with symptoms of 2 years or more were 2.4 times less likely to achieve an MCID (OR: 0.42, 95% CI: 0.19 to 0.92; P=0.031). Patients undergoing lumbar fusion with greater than 2 years of symptoms prior to surgery have a smaller increase in PROMIS-PF and are less likely to achieve MCID on PROMIS-PF. Further study is needed in order to determine the optimal timing for lumbar fusion surgery following symptom onset.

Achieving normoglycaemia with tirzepatide: Post hoc exploratory analysis of the SURPASS J-mono and J-combo studies.

Normoglycaemia was achieved in a significant proportion of Japanese participants with type 2 diabetes in two phase 3 studies of tirzepatide. This post hoc exploratory analysis aimed to identify predictive factors associated with normoglycaemia achievement. SURPASS J-mono and SURPASS J-combo study data were pooled for this analysis. Characteristics of participants in whom normoglycaemia [glycated haemoglobin (HbA1c) <5.7%] was achieved were summarized. Logistic regression analyses were performed with HbA1c <5.7% achievement as the target variable. Of 912 participants, normoglycaemia was achieved in 553 (60.6%) following 52 weeks of tirzepatide treatment. Overall, the mean (SD) age was 56.7 (10.6) years and mean diabetes duration was 7.7 (6.0) years, and 76% of participants were men. Mean (SD) change from baseline in HbA1c and bodyweight was -2.87% (0.95) versus -2.47% (1.1) and -10.30 (5.8) kg versus -3.75 (4.3) kg for participants in whom normoglycaemia was and was not reached, respectively. Multivariate regression analyses showed that lower baseline body mass index, shorter disease duration and lower baseline HbA1c were significantly associated with higher rates of normoglycaemia achievement (p = 0.009, p = 0.008, p < 0.001, respectively) as was a tirzepatide dose of 10 or 15 mg compared with 5 mg (p < 0.001). The highest percentage of participants in whom normoglycaemia (94%) was achieved were those with lower baseline HbA1c (<8%) and the greatest weight reduction (≥15%). Baseline HbA1c and body mass index, disease duration and the tirzepatide treatment group were shown to be predictive factors for achieving normoglycaemia. A lower baseline HbA1c was most strongly associated with normoglycaemia achievement.

Development of a Batting Tool for Learning Physical Education Sports and Health for Students in Elementary School

Research objectives: (1) to generate products for the development of baseball games targeting elementary school students (SD), (2) to assess the viability of developing a baseball game bat for Physical Education learning (PE learning) in elementary students, and (3) to evaluate the effectiveness of a baseball game bat for Physical Education learning (PE) in enhancing the hitting skills of elementary school students. This study was categorized as Research and Development (R&amp;D) or development research, consisted of the following stages: 1) identification of potential and problems; 2) collection of information; 3) design of the product; 4) validation of the product; 5) revision of the product; 6) conducting product trials; 7) further revision of the product; 8) conducting broader trials; and 9) finalizing the model through revision. The trial participants consisted of third grade students from SD Negeri Dalangan 1 (Dalangan 1 Elementary School) in Minggir District. The trials were conducted on a weekly basis. For small-scale trials, there were 6 students involved, and for large-scale trials, there were 12 students. The sample was determined by using purposive sampling. The selected instruments included a questionnaire for material experts and media experts to assess the eligibility of a batting tool as a medium for learning baseball games, as well as questionnaires to gather student assessment responses. The acquired data would thereafter be quantitatively examined by using descriptive statistics, through the calculation of percentages. The acquired results indicate the following: (1) the development of baseball game batting products goes through nine stages of development, and (2) The assessment of the development tool's viability is based on a) the trial validity conducted by material experts shows that the mean value at 4.89 levels of achievement 97.78% are in the "very feasible" category. b) Media specialists undergo validity testing, resulting in an average value of 4.83. The achievement rates for this testing are at 96.67%, placing it in the "very feasible" category. c) A smallscale feasibility trial is conducted. Students receive an average score of 4.62, which corresponds to 87.23% in the "very feasible" category. The large-scale feasibility trials, conducted through a questionnaire, show an average score of 4.95, which corresponds to 99.10% in the "very feasible" category. Additionally, the t-test results indicate that the mean post-test score of 85.42 is significantly higher than the mean pre-test score of 41.67. The rise can be deemed significant based on the statistical significance (2-tailed) with a p-value of 0.000 (less than 0.05). Therefore, the creation of a castle game bat product is highly viable and efficient for teaching Physical Education for elementary school students.

Channel Characteristics of Hybrid Power Line Communication and Visible Light Communication Based on Distinct Optical Beam Configurations for 6G IoT Network

In the envisioned 6G internet of things (IoT), visible light communication (VLC) has emerged as one promising candidate to mitigate the frequency spectrum crisis. However, when working as the access point, VLC has to be connected with the backbone network via other wire communication solutions. Typically, power line communication (PLC) is viewed as an excellent match to VLC, which is capable of providing both a power supply and backbone network connection. Generally, the integration of PLC and VLC is taken into consideration for the above hybrid system for channel characteristics analysis. However, almost all current works focus on hybrid PLC and VLC, based on a conventional Lambertian optical beam configuration, and fail to address the applications of hybrid PLC and VLC based on distinct optical beam configurations. To address this issue, in this paper, the channel characteristics of hybrid PLC and VLC, based on distinct optical beam configurations, are explored and illustrated. Numerical results show that, for a central position of the receiver, compared with an achievable rate of about 194 Mbps for hybrid PLC and VLC with a baseline Lambertian optical beam configuration, the counterparts of a hybrid channel based on Rebel and NSPW optical beams are about 173.4 Mbps and 222.4 Mbps. Moreover, the effect of azimuth rotation is constructed and estimated for hybrid PLC and VLC, adopting a typical rotating asymmetric beam configuration.

A robust OFDM IM-QAM NOMA scheme for URLLC and eMBB downlink service coexistence

This work introduces a non-orthogonal multiple access (NOMA) scheme suitable for low-rate ultra-reliable low-latency communication (URLLC) and enhanced mobile broadband (eMBB) services multiplexing in downlink communication. Tailored to minimize mutual interference, URLLC information is conveyed via a modified index modulation (IM) scheme on top of quadrature amplitude modulation (QAM) transferring eMBB traffic. Aiming at providing a proof of concept of the proposed scheme, we calculate the bit error rate of both services over Rayleigh fading with diversity, as well as the eMBB service achievable rate with typical multi-input multi-output (MIMO) configuration when the URLLC service utilizes space–time coding or diversity. The proposed scheme achieves a low bit error rate for the URLLC IM signal, at the cost of a lower information rate, while affecting the performance of the eMBB user mainly due to power sharing among the IM and QAM signals. To further investigate the feasibility of the proposed scheme, we calculate the transmission energy required by the base station to support both services over a typical cellular channel model, for various service requirements and user distances, in comparison to an orthogonal multiple access (OMA) puncturing scheme utilizing time-multiplexing of QAM for the eMBB traffic and BPSK for the URLLC traffic. Overall, our results show that the proposed scheme attains better performance compared to the puncturing scheme and offers a robust solution with easy user pairing for low-rate URLLC and typical eMBB downlink service multiplexing for 5G communications and beyond.

On-clamp vs off-clamp robot-assisted partial nephrectomy for achieving modified trifecta: inverse probability of treatment weighting analysis from a high-volume tertiary robotic center.

On-clamp partial nephrectomy for the surgical treatment of renal masses poses the risk of ischemia and greater post-operative renal function loss. Conversely, the off-clamp technique might enhance renal function preservation by avoiding any ischemia time. Nevertheless, the debate persists regarding the efficacy of the on- versus off-clamp partial nephrectomy in achieving better surgical, functional, and oncological outcomes. We retrospectively assessed the data from patients undergoing Robot-Assisted Partial Nephrectomy (RAPN) from 2016 and 2023 in a tertiary robotic center. Inverse probability of treatment weighting (IPTW) was used to account for selection bias in treatment allocation. The main objective of the study was assessing the achievement rates of a modified trifecta within the two groups. Multivariable logistic regression analysis (MLRA) was employed to assess the predictors of trifecta achievement. 532 patients were included in the analysis, of whom 74.1% vs. 25.9% underwent on- and off-clamp, respectively. Balancing the two groups for the main predictors of on-clamp surgery, there were no significant differences between on- and off-clamp in terms of estimated blood loss, transfusion rate, intra- and post-operative complications, positive surgical margins, and post-operative mean reduction of eGFR. Finally, no differences were found in the rate of "trifecta" achievement between on-clamp and off-clamp RAPN (24.6% vs. 21%, p = 0.82). At MLRA, off-clamp technique was not a predictor of trifecta achievement compared to the on-clamp technique (off-clamp vs. on-clamp, aOR 1.24, 95% CIs [0.65-2.36], p = 0.58). Our study revealed that clamping technique does not imply clinically relevant differences in reaching trifecta outcomes.

Pengaruh Fasilitas Terhadap Kepuasan Tamu di Legen Villa Lubuk Minturun

This research was motivated by the discovery of problems related to facilities to guest satisfaction. The research aims to obtain information and describe the influence of facilities on knowledge satisfaction at Legen Villa Lubuk Minturun. The method used in this study is quantitative. Using primary data and secondary data. Guests who have stayed and who are staying are the population of this study. The sample used in this study amounted to 85 guests with a non-probability sampling technique. Data collection was carried out by using a questionnaire based on a likert scale that has been tested for validity and reliability. The tool used for data processing is SPSS 25. The results obtained from the study were that the facility variable was classified as sufficient based on statistical calculations with an average respondent achievement rate (TCR) of 72% and guest satisfaction was classified as a good category based on statistical calculations with an average respondent achievement rate (TCR) of 79.35%. In this study, the Beta or Satandardized Coefficient value of the facility variable (X) was 0.408 with a Thical value (3.225) with a significance of 0.002 &lt; 0.05, which showed that the facility variable had a positive influence on guest satisfaction (Y). The Adjusted R Square value was 0.334, which showed the contribution of the influence of the facility variable by 33.4%, and the remaining 66.6% was influenced by other variables that were not studied