Clear Effect Research Articles

„Mal in Ruhe lesen“: Wirkungen von Lärm auf das Lesen – Ergebnisse einer Laborstudie mit Beschäftigten

“Reading in peace”: Effects of noise on reading – results from a laboratory study with employees Background: It is a regular day-to-day requirement in many occupations to retrieve information from written material by reading. Therefore, a proofreading task was applied as one of two tasks in this study, in which the effects of different realistic sounds on cognitive performance were investigated. Method: Seventy participants worked on a self-developed reading task, once in a silent condition and once in a condition with one of three background sounds. The sounds, which were kindly provided for this study by other institutions, were recordings from a checkout at a fashion retailer, a multi-space office and a construction site. Thus, the sample for this study consisted of three sound groups. In addition, all participants gave subjective assessments referring to the processing of the tasks with respect to four different aspects. Results: For the entire group, the analysis showed the tendency of a lower number of correctly finished items in the sound condition than in the silent condition. The results were different in the separate sound groups. The subjective assessments showed higher experienced effort and disturbance as well as lower self-assessed concentration in the sound condition than in the silent condition. Conclusions: Adverse effects of background sounds on reading performance were detectable, and they were different in the three sound groups. However, clearer effects were identified for the subjective assessments, i.e., when persons were questioned about their impressions. This underlines the importance of asking people affected by noise, in order to get an insight how the interfering effects are experienced. More detailed survey tools would be required to find out more about the sound characteristics which are responsible for particular effects. Keywords: noise – cognitive performance – proofreading – subjective assessments – workplace

Comparing ocrelizumab to interferon/glatiramer acetate in people with multiple sclerosis over age 60

BackgroundOngoing controversy exists regarding optimal management of disease modifying therapy (DMT) in older people with multiple sclerosis (pwMS). There is concern that the lower relapse rate, combined with a higher...

Impression of excessive digital media utilization on psychological well-being: A case of Pakistan’s metropolitan cities

Digital media utilization assumes an imperative part in changing millennials’ way of life. The rapid growth in the usage of digital media may have an impact on the mental prosperity of users. The primary focus of this research is to examine how excessive usage of digital media affects its consumers' psychological well-being in Pakistan's major cities. In January this year, there were 72 million digital media users in Pakistan, equal to 32% of the total population, of which 28% of Pakistan is between the ages of 26-41 (Kemp, 2022). This is the most probable age group to be used and influenced by digital media. Based on prior works, it delivers a more inclusive study of the spectacle by the view of independent variables (social capital, social isolation, and smartphone addiction), dependent variable (psychological well-being), and one mediator (excessive digital media utilization). This study sheds light on the best ways to mitigate the negative effects of using digital media, which claims to have a clear adverse effect on mental health through social capital creation and management. Overall, this research provides important insights for academics, scholars, and society at large. This paper consists of a quantitative approach of 236 users from metropolitan cities in Pakistan with the help of structural equation modeling to test the projected propositions. The research study could be additionally upgraded if we center around more factors and other various areas of Pakistan for exploring the effect of excessive digital media utilization on mental prosperity.

Cross-Education Effects of Hip Strengthening in Individuals with Chronic Ankle Instability

ABSTRACT Introduction/Purpose Chronic ankle instability (CAI) is associated with reduced balance, lumbopelvic stability, and hip strength. Accordingly, hip strengthening is an effective intervention for individuals with CAI. Cross-education through unilateral exercise is also beneficial to individuals with CAI, but cross-education effects of hip strengthening remain unknown. The purpose of this study was to determine cross-education effects of hip strengthening in individuals with CAI. Methods Thirty individuals with CAI were randomized into control (CON) and hip strengthening (HIP) groups. Baseline and postintervention tests of the uninvolved limb included lumbopelvic stability (unilateral hip bridge), handheld dynamometry (isometric hip extension, abduction, and external rotation strength), and balance (Star Excursion Balance Test (SEBT) in anterior, posterolateral (PL), and posteromedial directions). After baseline testing, HIP completed progressive hip strengthening of the involved limb three times per week for 8 wk, and CON did not. Repeated-measures analyses of variance assessed the effects of group and time on each outcome. Each group’s mean changes from baseline to postintervention were assessed via effect sizes. Statistical significance was set a priori at P < 0.05. Results Of the 30 participants enrolled, 10 did not complete the postintervention data collection. Multiple imputations estimated missing data, and an intention-to-treat analysis was conducted. There were no significant group-by-time interactions for hip strength, balance, or lumbopelvic stability. HIP exhibited moderate effect sizes for SEBT-PL and hip bridge. All other effect sizes were small or negligible. Conclusions We did not identify a clear cross-education effect following unilateral hip strengthening in a cohort with CAI. Examination of baseline to postintervention effect sizes indicate a potential trend toward improved balance and lumbopelvic stability of the HIP group.

Effect of Gracilaria vermiculophylla Macroalga on Non-Alcoholic Fatty Liver Disease in Obese Rats.

Marine algae are valuable sources of bioactive compounds that have the potential to be used in the management of various pathologies. Despite the increasing prevalence of NAFLD, the absence of an approved effective pharmacological treatment with demonstrable effectiveness persists. In this context, the aim of the present study is to assess the effect of Gracilaria vermiculophylla red seaweed dietary supplementation on hepatic lipid accumulation, as well as on oxidative stress, inflammation and fibrosis- related markers on obese fa/fa Zucker rats fed with a standard diet, supplemented or not with 2.5% or 5% dehydrated Gracilaria vermiculophylla. After a six-week supplementation with the macroalga, no significant reduction in hepatic total lipid content or hepatic triglyceride content was observed. However, both doses were able to diminish hepatic NEFA concentration by reducing de novo lipogenesis and increasing mitochondrial biogenesis. Moreover, supplementation with the dose of 2.5% improved some oxidative stress and inflammation-related markers. Supplementation with the dose of 5% did not exert these clear beneficial effects. Thus, this study demonstrates that while Gracilaria vermiculophylla may not mitigate hepatic steatosis, it could exert protective effects on the liver by reducing NEFA content and enhancing oxidative stress and inflammation parameters.

Lower cognitive reserve is related to worse working memory performance in older adults after mTBI. An ERP study

ABSTRACT Objective Older adults (OA) after mild traumatic brain injury (mTBI) have a high risk of developing persistent post-injury cognitive impairments. Lower pre-morbid cognitive reserve (CR) is increasingly investigated as a risk factor for cognitive dysfunction in OA. However, how CR protects against effects of mTBI at the brain level remains largely understudied. Methods We examined 22 OA who sustained mTBI (mean 67.69 years, SD 5.11) in the sub-acute phase and 15 age- and CR-matched healthy OA (mean 68 years, SD 5.55) performing a three-level visual N-back task using electroencephalography. We calculated inverse efficiency scores of performance from accuracy and reaction times. Event-related potentials served as neurocognitive correlates of attentional (P2) and working memory (P3) processing. Results Overall, mTBI OA performed worse than healthy OA (p = 0.031). Lower CR generally decreased performance (p < 0.001). Furthermore, with increasing task difficulty, task performance was more affected by CR (p = 0.004). At the brain level, P2 amplitude was lower in mTBI OA than in healthy OA (p = 0.05). There was no clear effect of CR on P2 or P3 measures. Conclusion As mTBI OA with lower CR performed worse on a working-memory task, lower CR may be a risk factor for worse recovery after mTBI in this group.

Acute effects of static stretching and proprioceptive neuromuscular facilitation on non-local range of movement

ABSTRACT Acute effects of static stretching (SS) and proprioceptive neuromuscular facilitation (PNF) on local and non-local range of motion (ROM) were assessed in 29 participants. Three evaluations were performed one week apart: week-1 Control session (CS); weeks 2–3 either SS or PNF interventions (randomized). Dominant and non-dominant limbs, local (hamstring extensibility) and non-local ROMs (Shoulder extension-ShE) were collected at baseline (T0), immediately after (T1), and fifteen minutes post-intervention (T2). No differences were found between time-points during the CS. Local-ROM significantly increased (p=0.0002, ES=0.74 and 0.0079, 0.56, for dominant and non-dominant lower limbs, respectively) after both SS and PNF. No interaction between time and treatment was detected for ShE in both limbs. However, post-hoc analysis revealed a significant increase in dominant upper limb ShE between T0 and T1 only after SS (p=0.002; +6.5%). Acute bouts of SS and PNF can increase local-ROM, however, no clear effects were observed for non-local ROM.

The effectiveness of a rehabilitation program with aqueous media on the egree of pain and balance for those suffering from sacroiliitis in football players

Abstract in English The aim of this study is to identify the effectiveness of rehabilitation exercises in conjunction with aquatic therapy for those suffering from sacroiliitis in football players. The researcher used the experimental approach, using the experimental design (pre-measurement, post-measurement). Similar to the objectives and procedures of the research, the researcher assumed the following: the existence of significant differences. Statistics between pre- and post-measurements in variables in favor of post-measurement for the following variables (degree of pain and level of balance).&#x0D; The experimental approach was used with a pre- and post-measurement design on one group of football players with sacroiliitis, numbering (8) players whose ages ranged from (20 - 25 years). The program was applied for (8) weeks with (5) sessions in The week, the program included rehabilitation exercises inside and outside the aquatic environment, and the results of the research were. - The rehabilitation program prepared with hydrotherapy helped improve the general condition of the body and gradually disappear the feeling of pain in the joint clearly.&#x0D; The use of hydrotherapy led to the disappearance of the feeling of pain and thus had a positive effect on performance&#x0D; Prepared rehabilitation exercises and making the injured feel comfortable and improving the psychological state of the injured.&#x0D; - The prepared rehabilitation program has a clear effect in improving the balance of the muscles working in the pelvic joint.&#x0D; The exercises carried out clearly helped in the injured person's return to playing football normally.&#x0D; - Using rehabilitative exercises accompanying hydrotherapy has good results, better than applying only rehabilitative exercises.&#x0D; Recommendations: - Paying attention to following the rehabilitation program with hydrotherapy when football players suffer from sacroiliitis in order to avoid deterioration of the patient’s condition. The researcher also recommended using rehabilitative exercises with hydrotherapy and employing it consistently within rehabilitation programs for all pelvic joint injuries. - The researcher recommended the importance of functional tests as a criterion for the player’s return to playing football. - She pointed to the diversification and expansion of special research into the prevention of pelvic joint injuries using modern means and devices.&#x0D; &#x0D; Keywords: sacroiliitis, hydrotherapy, degree of pain, and instability.

The backlash against free movement: Does EU‐internal migration fuel public concerns about immigration?

AbstractThe free movement of people is a fundamental principle of the European Union (EU) that has led to an increase in EU‐internal migration. This study investigates the impact of increased immigration to Germany resulting from the 2004 and 2007 eastern enlargement of the EU on concerns about immigration within the German population. By merging 20 years of annual migration statistics with panel data on individual attitudes and exploiting exogenous variation in the gradual enlargement of the free movement policy, we examine the causal effects of EU‐internal migration on immigration concerns. Our findings suggest that the influx of immigrants from new member states did not have a clear average effect on concerns about immigration, but increased concerns among German natives with materialist‐survival values. The study provides insights into the societal division caused by opposition to immigration as part of the European integration process.

Use of fermented malted barley by‐product as partial feed replacement and carbon source for rearing Nile tilapia (Oreochromis niloticus) juveniles

AbstractThe present research evaluates the performance of the Nile tilapia (Oreochromis niloticus) (initial weight 11.5 ± 0.07 g) with biofloc technology. For this purpose, spent grains (malted barley) from the brewing industry after aerobic fermentation were used, as both a carbon source (suspended solids) and partial substitute for the diets at 0, 10, 20, 30, and 40% levels (settleable solids). The partial 20% substitution of the diet did not have significant effects on the biological parameters: final body weight, weight gained, average body weight, specific growth rate, daily growth index, condition factor, feed conversion ratio, protein efficiency rate, and viscerosomatic and hepatosomatic indices. However, the dietary substitution showed a significant effect on the final biofloc chemical composition. Nitrogen compounds, NH4+, NO2−, and NO3−, were adequate for tilapia cultivation in all the treatments. No clear effect of partial dietary substitution was observed on meat quality parameters: pH, color, water holding capacity, and amino acid and fatty acid profile of fillet. The results suggest that a 20% substitution of the diet for malted barley is suitable for satisfactory biological parameters and Nile tilapia fillet quality.

Feature discrimination learning transfers to noisy displays in complex stimuli

IntroductionPerception under noisy conditions requires not only feature identification but also a process whereby target features are selected and noise is filtered out (e.g., when identifying an animal hiding in the savannah). Interestingly, previous perceptual learning studies demonstrated the utility of training feature representation (without noise) for improving discrimination under noisy conditions. Furthermore, learning to filter out noise also appears to transfer to other perceptual task under similar noisy conditions. However, such learning transfer effects were thus far demonstrated predominantly in simple stimuli. Here we sought to explore whether similar learning transfer can be observed with complex real-world stimuli.MethodsWe assessed the feature-to-noise transfer effect by using complex stimuli of human faces. We first examined participants' performance on a face-noise task following either training in the same task, or in a different face-feature task. Second, we assessed the transfer effect across different noise tasks defined by stimulus complexity, simple stimuli (Gabor) and complex stimuli (faces).ResultsWe found a clear learning transfer effect in the face-noise task following learning of face features. In contrast, we did not find transfer effect across the different noise tasks (from Gabor-noise to face-noise).ConclusionThese results extend previous findings regarding transfer of feature learning to noisy conditions using real-life stimuli.

Modelling of patient journey in chronic spontaneous urticaria: Increasing awareness and education by shorten patients' disease journey in Germany.

Chronic spontaneous urticaria (CSU) is both physically and emotionally stressful, and guideline recommendations are often not optimally implemented in clinical practice. The objective of this study was to provide an overview on the patient journey in CSU and to develop a mathematical model based on solid data. The journey of CSU patients in Germany was traced through literature review and expert meetings that included medical experts, pharmacists and representatives of patient organizations. The current situation's main challenges in the patient journey (education, collaboration and disease management) were discussed in depth. Then, a probabilistic model was developed in a co-creation approach to simulate the impact of three potential improvement strategies: (1) patient education campaign, (2) medical professional education programme and (3) implementation of a disease management programme (DMP). Chronic spontaneous urticaria patients are severely burdened by delays in diagnosis and optimal medical care. Our simulation indicates that in Germany, it takes on average of 3.8 years for patients to achieve disease control in Germany. Modelling all three optimization strategies resulted in a reduction to 2.5 years until CSU symptom control. On a population level, the proportion of CSU patients with disease control increased from 44.2% to 58.1%. In principle, effective CSU medications and a disease-specific guideline are available. However, implementation of recommendations is lagging in practice. The approach of quantitative modelling of the patient journey validates obstacles and shows a clear effect of multiple interventions on the patient journey. The data generated by our simulation can be used to identify strategies for improving patient care. Our approach might helping in understanding and improving the management of patients beyond CSU.

Friends without benefits: Extensive cytotype sympatry and polyploid persistence in an African geophyte.

Polyploidy is a major factor in plant adaptation and speciation. Multiple mechanisms contribute to autopolyploid frequency within populations, but uncertainties remain regarding mechanisms that facilitate polyploid establishment and persistence. Here we aimed to document and predict cytotype distributions of Oxalis obliquifolia Steud. ex A. Rich. across Gauteng, South Africa, and test for evidence of possible mechanisms, including morphological, phenological, and reproductive traits, that may potentially facilitate polyploid persistence. Over 320 O. obliquifolia plants from 25 sites were cytotyped using flow cytometry, and DNA ploidy was confirmed using meiotic chromosome squashes. Cytotypes were mapped and correlations with abiotic variables assessed using ordinations. To assess morphological and phenological associations with cytotype, we grew multiple cytotypes in a common garden, measured phenotypic traits and compared them using linear models and discriminant analyses. Intercytotype reproductive isolation was assessed using crossing experiments, and AMOVAs based on ITS DNA sequences tested for cytogeographic structure. Six cytotypes were identified, and most sites had multiple cytotypes. Abiotic variables were not predictive of cytotype distribution. A clear gigas effect was present. Differences in flower size and phenology suggested pollinator interactions could play a role in polyploid persistence. Intercytotype crosses produced seed at low frequency. DNA data suggested diploids and polyploids were largely reproductively isolated in situ, and polyploidization events were not frequent enough to explain high cytotype sympatry. Diploids and polyploids are behaving as separate species, despite little observable niche differentiation and non-zero potential intercytotype seed set. Tests on biotic interactions and intercytotype F1 fitness may provide insights into diploid and polyploid coexistence.

The effects of a retrieval cue on renewal of conditioned responses in human appetitive conditioning

Contextual renewal of reward anticipation may be one potential mechanism underlying relapse in eating and substance use disorders. We therefore tested retrieval cues, a method derived from an inhibitory retrieval-based model of extinction learning to attenuate contextual renewal using an appetitive conditioning paradigm. A pilot study was carried out in Experiment 1 to validate a differential chocolate conditioning paradigm, in which a specific tray was set up as a conditioned stimulus (CS) for eating chocolate (unconditioned stimulus, US). Using an ABA renewal design in Experiment 2, half of the participants were presented with a retrieval cue in the acquisition phase (group AC) and the other half in the extinction phase (group EC). Presentation of the retrieval cue in the EC was associated with reduced renewal of US-expectancy, while there was a clear renewal effect for US-expectancy in the AC. One limitation was the difference in cue presentations between both groups due to the number of trials in acquisition and extinction. Experiment 3 therefore aimed at replicating the results of Experiment 2, but with fewer cue presentations for the EC to match the AC. No significant group differences were observed indicating no effect of the retrieval cue. Theoretical and clinical implications in light of the differing results are discussed.

Second-line immunotherapy in new onset refractory status epilepticus.

Several pieces of evidence suggest immune dysregulation could trigger the onset and modulate sequelae of new onset refractory status epilepticus (NORSE), including its subtype with prior fever known as febrile infection-related epilepsy syndrome (FIRES). Consensus-driven recommendations have been established to guide the initiation of first- and second-line immunotherapies in these patients. Here, we review the literature to date on second-line immunotherapy for NORSE/FIRES, presenting results from 28 case reports and series describing the use of anakinra, tocilizumab, or intrathecal dexamethasone in 75 patients with NORSE. Among them, 52 patients were managed with anakinra, 21 with tocilizumab, and eight with intrathecal dexamethasone. Most had elevated serum or cerebrospinal fluid cytokine levels at treatment initiation. Treatments were predominantly initiated during the acute phase of the disease (92%) and resulted, within the first 2 weeks, in seizure control for up to 73% of patients with anakinra, 70% with tocilizumab, and 50% with intrathecal dexamethasone. Cytokine levels decreased after treatment for most patients. Anakinra and intrathecal dexamethasone were mainly initiated in children with FIRES, whereas tocilizumab was more frequently prescribed for adults, with or without a prior febrile infection. There was no clear correlation between the response to treatment and the time to initiate the treatment. Most patients experienced long-term disability and drug-resistant post-NORSE epilepsy. Initiation of second-line immunotherapies during status epilepticus (SE) had no clear effect on the emergence of post-NORSE epilepsy or long-term functional outcomes. In a small number of cases, the initiation of anakinra or tocilizumab several years after SE onset resulted in a reduction of seizure frequency for 67% of patients. These data highlight the potential utility of anakinra, tocilizumab, and intrathecal dexamethasone in patients with NORSE. There continues to be interest in the utilization of early cytokine measurements to guide treatment selection and response. Prospective studies are necessary to understand the role of early immunomodulation and its associations with epilepsy and functional outcomes.

Predators of the sea urchin Diadema mexicanum (Diadematoida: Diadematidae) at the Eastern Tropical Pacific coral reefs

Introduction: The coral reefs of Isla del Coco National Park are some of the most pristine ecosystems on Earth. The sea urchin Diadema mexicanum (Diadematoida: Diadematidae) is a common inhabitant with a pivotal role in the ecology of this unique ecosystem.&#x0D; Objective: In this study, we identified the predominant predators of D. mexicanum and estimated the predatory consumption rates. We also determined predation rates at different sea urchin sizes and at sites with contrasting refuge availability.&#x0D; Methods: We use field video recording observations and tethering experiments.&#x0D; Results: The balistid Sufflamen verres and the labrid Bodianus diplotaenia were identified as predators of small and medium size D. mexicanum; the labrids Thalassoma grammaticum and B. diplotaenia (juvenile) and the tetraodontid Arothron meleagris were attempted predators; and Canthigaster punctatissima and Holacanthus passer were scavengers. Larger sea urchins (&gt; 30 mm) were also preyed upon during the tethering experiments. Furthermore, a clear effect of the site on survival of the different sea urchins’ sizes was noted. No difference in the sea urchin predator biomass was found among sites, which highlights the importance of site complexity on survival. At high and medium complexity sites, large individuals had better survival, while at the low complexity site, there was almost no differences in survival rates among the three size classes. Our results also show that a high abundance of these predatory fishes, above 0.04 ind m-2, guarantees a low sea urchin density. Below this threshold, a higher variability in sea urchin density is observed Despite not being registered with the video recordings, lobsters were observed once preying upon a large sea urchin individual.&#x0D; Conclusions: This study identifies a keystone fish guild with high predation rate for Diadema in the National Park, which suggests that protective actions have positively benefited predatory fish and lobster populations.

Assessing mismatch negativity (MMN) and P3b within-individual sensitivity - A comparison between the local-global paradigm and two specialized oddball sequences.

Mismatch negativity (MMN) and P3b are well known for their clinical utility. There exists no gold standard, however, for acquiring them as EEG markers of consciousness in clinical settings. This may explain why the within-individual sensitivity of MMN/P3b paradigms is often quite poor and why seemingly identical EEG markers can behave differently across Disorders of consciousness (DoC) studies. Here, we compare two traditional paradigms for MMN or P3b assessment with the recently more popular local-global paradigm that promises to assess MMN and P3b orthogonally within one oddball sequence. All three paradigms were administered to healthy participants (N = 15) with concurrent EEG. A clear MMN and local effect were found for 15/15 participants. The P3b and global effect were found for 14/15 and 13/15 participants, respectively. There were no systematic differences between the global effect and P3b. Indeed, P3b amplitude was highly correlated across paradigms. The local effect differed clearly from the MMN, however. It occurred earlier than MMN and was followed by a much more prominent P3a. The peak latencies and amplitudes were also not correlated across paradigms. Caution should therefore be exercised when comparing the local effect and MMN across studies. We conclude that the within-individual MMN sensitivity is adequate for both the local-global and a dedicated MMN paradigm. The within-individual sensitivity of P3b was lower than expected for both the local-global and a dedicated P3b paradigm, which may explain the often-low sensitivity of P3b paradigms in patients with DoC.

Effect of Coffee and Chocolate Ingestion on Clozapine Dose and on Plasma Clozapine and Norclozapine Concentrations in Clinical Practice.

Some reports point to dietary caffeine intake as a cause of increased plasma clozapine concentrations in certain patients. We compared clozapine dose and plasma clozapine and N-desmethylclozapine (norclozapine) concentrations in male and female smokers and nonsmokers in relation to reported (i) coffee (caffeine) and (ii) chocolate (caffeine and theobromine) intake in samples submitted for clozapine therapeutic drug monitoring, 1993-2017. There was information on coffee ingestion for 16,558 samples (8833 patients) from males and 5886 samples (3433 patients) from females and on chocolate ingestion for 12,616 samples (7568 patients) from males and 4677 samples (2939 patients) from females. When smoking was considered, there was no discernible effect of either coffee or chocolate ingestion either on the median dose of clozapine or on the median plasma clozapine and norclozapine concentrations in men and in women. However, cigarette smoking was associated with higher coffee and chocolate consumption. Although male nonsmokers who reported drinking 3 or more cups of coffee daily had significantly higher median plasma clozapine and norclozapine concentrations than those who drank less coffee, they were also prescribed a significantly higher clozapine dose. There was no clear effect of coffee ingestion on plasma clozapine and norclozapine in female nonsmokers. Inhibition of clozapine metabolism by caffeine at the doses of caffeine normally encountered in those treated with clozapine is unlikely even in male nonsmokers. Measurement of plasma caffeine in an appropriate sample should be considered in any future investigation into a presumed clozapine-caffeine interaction.

Effectiveness of indirect revascularization for adult hemorrhagic moyamoya disease: a 10-year follow-up study.

The optimal surgical approach for hemorrhagic moyamoya disease (hMMD) continues to be a topic of debate. The authors' prior research demonstrated that both combined and indirect revascularization were efficacious. However, questions remain regarding the long-term prognosis consistency between these two treatments. Therefore, the objective of this study was to evaluate and compare the enduring effects of these surgical modalities on adult hMMD, extending the findings of the authors' previous studies. The authors recruited patients diagnosed with hMMD between 2010 and 2015. The patients were categorized into two groups: those who underwent combined revascularization (superficial temporal artery-middle cerebral artery bypass alongside dural reverse application) and those who underwent indirect revascularization (encephaloduroarteriosynangiosis [EDAS]). The primary and secondary endpoints of this study were instances of rebleeding, confirmed with CT scan, and death resulting from rebleeding, respectively. The authors estimated rebleeding-free and death-free survival rates by utilizing the Kaplan-Meier survival method. They used Cox regression to adjust for confounders and to evaluate the effects of the varying surgical modalities on the endpoints. After an average follow-up period of 114 months, 35 patients (28.6%) experienced 40 rebleeding events, yielding an average annual incidence of 3.5%. Of the 79 patients who received combined revascularization, 17 (21.5%) experienced rebleeding events. Similarly, of 43 patients who underwent EDAS, 18 (41.9%) experienced rebleeding events (p = 0.018). Most rebleeding instances occurred 61-120 months after surgery (21 patients [60%]), followed by 12-60 months (11 patients [31.4%]). Multivariate survival analysis highlighted significant differences in surgical outcomes (HR 0.33, 95% CI 0.15-0.74, p = 0.007). The authors observed that 8 patients (10.1%) died of rebleeding events in the combined group, as well as 10 patients (23.3%) in the EDAS group. Despite the lack of a statistically significant difference in mortality (p = 0.051), multivariable survival analysis found a significant difference (HR 0.31, 95% CI 0.10-0.97, p = 0.044). High rebleeding rates persist in adult hMMD patients, even after revascularization. Combined revascularization proved superior to EDAS in preventing long-term rebleeding. In contrast, EDAS alone did not display a clear effect on reducing long-term rebleeding rates.

The Influence of New Energy Industry Agglomeration on Regional Green Innovation Performance—Evidence from China

The advance of the new energy industry and the promotion of green innovation are both important ways to solve environmental pollution and achieve economic green transformation, and there may be a non-negligible intrinsic connection between the two. Utilizing panel data covering the period from 2011 to 2021, encompassing 30 provinces and cities in China, this study measures agglomeration levels of the new energy sector and green innovation performance in each region. Via the application of the fixed-effect model and spatial Durbin model, this study empirically examines the impact mechanism of green innovation performance resulting from the agglomeration of the new energy industry. This investigation discloses that there is regional heterogeneity in China’s new energy industry agglomeration level, with the highest level observed in the western region. The distribution of green innovation performance forms an “East–Middle–West” ladder pattern, with both the central and western regions falling below the national average. Agglomeration of the new energy sector exerts a non-linear, “U-shaped” influence on green innovation performance, demonstrating conspicuous regional heterogeneity; opening up positively moderates the “positive U-shaped” correlation between new energy agglomeration and green innovation performance. A clear spatial spillover effect characterizes the agglomeration of the new energy industry, demonstrating a non-linear “inverted U-shaped” influence on the green innovation performance of surrounding regions. This paper aims to offer policy insights into the establishment of developmental layouts for the new energy industry in China while simultaneously providing practical references for enhancing regional green innovation performance.