Comprehensive Assessment Research Articles

Long-term Outcomes of Surgical Treatment for Pancreatic Neuroendocrine Neoplasm with Synchronous Hepatic Metastasis: A Multicenter Retrospective Cohort Study

Abstract Objectives: To evaluate surgical impact on the overall survival (OS) of pancreatic neuroendocrine neoplasm (pNEN) with synchronous hepatic metastases (sHM). Methods: A total of 163 pNEN-sHM patients were recruited from 3 institutions in China, who were categorized into 3 groups: no resection (NR), resection of the primary lesion (PR) and resection of both primary and hepatic lesions (PHR). Cox regression was employed to evaluate surgical impact on the OS. Results: In the overall cohort analysis, PHR demonstrated a significant protective effect on OS (HR 0.302, 95% CI: 0.127–0.721, p = 0.007). Nevertheless, subgroup analysis revealed PHR conferred a survival advantage in patients with pancreatic neuroendocrine tumor (pNET) located on the pancreatic body/tail (bt-pNET-sHM) (HR 0.287, 95% CI: 0.087–0.946, p = 0.040), whereas surgical treatment did not significantly impact survival in the subgroups of pancreatic neuroendocrine carcinoma (pNEC)-sHM or pancreatic head/neck pNET-sHM (hn-pNET-sHM). Conclusions: In this study, the survival benefit of surgery was only observed in the bt-pNET-sHM subgroup. Considering the multifactorial nature of decision-making, surgical intervention for pNEN-sHM management should be approached with a careful and comprehensive assessment, to prevent excessive surgery strategies.

Development of homemade oral nutrition supplements for individuals with kidney failure on hemodialysis: physicochemical properties, nutrient composition, and sensory evaluation

Purpose Protein-energy wasting is a common complication among patients with kidney failure undergoing dialysis. This study aims to develop a homemade oral nutrition supplement (ONS) to fulfill the energy and protein requirements of these patients. Design/methodology/approach Three formulations of homemade ONS were developed using soybean milk, whey protein isolates and canola oil. Two of these formulations were flavored with pineapple and honeydew juices, respectively. The energy and macronutrient contents were determined using proximate analyses, and mineral contents were determined using inductively coupled plasma optical emission spectroscopy. The acceptance of homemade ONS for five attributes, namely color, taste, odor, consistency and overall acceptability, was assessed using the nine-point hedonic scale. Findings The homemade ONS provided 198–212 kcal and 8.4–9.6 g protein per 100 mL, which were comparable to commercial products. Similarly, the sodium (45–65 mg/100 mL) and phosphorus (56–66 mg/100 mL) contents were on par with commercial products. However, the potassium content of homemade ONS was higher, ranging from 141 to 155 mg per 100 mL. The sensory evaluation indicated that the formulation added with honeydew juice had a similar degree of acceptance as the commercial ONS, while formulations containing pineapple juice and without added fruit juice were less favored. Originality/value A few studies have investigated the development of food products for individuals with kidney failure on dialysis. However, to the best of the authors’ knowledge, this is the first study to focus on developing a homemade ONS specifically tailored to meet the unique nutritional needs of hemodialysis patients. In addition, this research included a comprehensive assessment of the beverage’s nutritional content and sensory attributes.

India's flood risk assessment and mapping with multi-criteria decision analysis and GIS integration

ABSTRACT India's diverse geography poses significant flood risks, addressed in this study through the geographic information system and multi-criteria decision analysis. This comprehensive flood risk assessment considers seven parameters: mean annual precipitation, elevation, slope, drainage density (DD), land use and land cover, proximity to roads, and distance to rivers. The findings indicate that flood vulnerability is primarily influenced by rainfall, elevation, and slope, with DD, land use, and proximity to roads and rivers also playing crucial roles. Experts weighed these factors to create a thorough flood risk map using the normalized rank index and normalized weight index, categorizing areas into five risk levels: very high, high, moderate, low, and very low. The study reveals that 3.40% of the area is at very high risk, 32.65% at high risk, 39.72% at moderate risk, 20.97% at low risk, and 3.25% at very low risk. These results highlight how human and natural factors interact to influence flood risk, with vulnerable areas characterized by low elevations, steep slopes, high drainage densities, and proximity to rivers or roads. The findings provide valuable insights for policymakers, scientists, and local authorities to develop strategies to mitigate flood losses across India's varied landscapes.

Integrating Multi-Source Remote Sensing Data for Forest Fire Risk Assessment

Forest fires are a frequent and destructive phenomenon in Southwestern China, posing significant threats to ecological systems and human lives and property. In response to the growing need for effective forest fire prevention, this study introduces an innovative method for predicting and assessing forest fire risk. By integrating multi-source data, including optical and microwave remote sensing, meteorological, topographic, and human activity data, the approach enhances the sensitivity of risk models to vegetation water content and other critical factors. The vegetation water content is derived from both Vegetation Optical Depth and optical remote sensing data, allowing for a more accurate assessment of changes in vegetation moisture that influence fire risk. A time series prediction model, incorporating attention mechanisms, is used to assess the probability of fire occurrence. Additionally, the method includes fire spread simulations based on Cellular Automaton and Monte Carlo approaches to evaluate potential burn areas. This combined approach can provide a comprehensive fire risk assessment using the probability of both fire occurrence and potential fire spread. Experimental results show that the integration of microwave data and attention mechanisms improves prediction accuracy by 2.8%. This method offers valuable insights for forest fire management, aiding in targeted prevention strategies and resource allocation.

Coronary Computed Tomography Angiography in Heart Transplant Patients: Current Insights and Future Directions

Cardiac allograft vasculopathy (CAV) remains a significant challenge after heart transplantation, necessitating effective surveillance methods. This review centers around the role of coronary computed tomography angiography (CCTA) in CAV surveillance, given its unique capabilities to visualize and quantify CAV in comparison with other imaging modalities, including invasive coronary angiography and intravascular ultrasound. CCTA has shown good diagnostic performance for detecting and monitoring CAV, exemplified by a higher sensitivity and negative predictive value compared with invasive coronary angiography. Additionally, CCTA can provide valuable functional insights with fractional flow reserve integration. An additional, considerable benefit of CCTA is that it allows for the opportunity to assess other imaging markers of cardiometabolic and general health, including coronary artery calcium score, epicardial fat volume, liver fat, vertebral bone density, and lung density, which allows for a comprehensive assessment of the overall health of the patient.

Efficient DC–DC power converters for fuel‐cell electric vehicle: A qualitative assessment

AbstractThe general shift in vehicle propulsion systems from internal combustion engine (ICE) power‐train towards electric power‐train has led to the development of energy‐efficient and compact electric drivetrain for next‐generation automobiles such as fuel cell electric vehicles (FCEV). As opposed to ICE, fuel cell vehicles operate with higher powertrain efficiency and are combustion‐less since the only byproduct is water. In light of developmental and environmental goals, fuel cell technology is consequently seen as the evolutionary step in vehicle technology. The electric drivetrain for FCEV consists of power converters, motors, and associated control systems. Direct connection of the fuel cell stack to the DC bus and other system components is inefficient. As a result, it becomes essential to regulate the high‐voltage DC bus connecting the fuel cell stack to other system elements like the motor and energy storage devices. Therefore, DC–DC converters are designed for main power unit to provide the desired and regulated voltage to the DC bus making the system efficient and reliable. High‐voltage step‐up DC–DC converters have undergone extensive research in recent years, which has increased their functionality, performance, and efficiency for FCEV. A survey of these converters, and evaluation of their performance and index parameters, could be very helpful in designing efficient converters and for the development of vehicular electric power‐train. This paper reviews the literature on electric drive‐train, fuel cell systems, and different DC–DC converter topologies for fuel cell electric vehicles. This study aims to conduct a comprehensive assessment of the existing topologies, their applications, and comparative aspects, as well as works that haven't been covered in earlier reviews.

The Bioaccumulation of Potentially Toxic Elements in the Organs of Phragmites australis and Their Application as Indicators of Pollution (Bug River, Poland)

The bioaccumulation of potentially toxic elements (PTEs) in aquatic plants is critical in assessing the quality of aquatic environments and the risks associated with anthropogenic activities. This research involved using Phragmites australis as a bioindicator in a comprehensive assessment of the spatial variation in pollution within the Bug River catchment, employing advanced statistical methods to identify pollution sources. The study aimed to investigate the bioaccumulation of PTEs in different parts of the P. australis plant and to evaluate their suitability as bioindicators of contamination. Plant samples were collected from 32 locations in the Bug River catchment, and the concentrations of metals such as Cd, Pb, Cr, Ni, Zn, Cu, Fe, and Mn were determined by atomic absorption spectrometry. The results indicated that PTE accumulation was highest in the roots, underscoring their crucial role in monitoring metal concentrations. Metal concentrations differed based on land use within the catchment area, with the highest levels observed in urbanized regions, highlighting the significant impact of human activities like wastewater discharge and transport emissions. The highest concentrations were observed for Fe, Mn, and Zn, while Cd concentrations were notably elevated in agricultural areas. The analyses confirmed that P. australis serves as an effective bioindicator of heavy metal contamination and can be employed in long-term biomonitoring programs.

A clustering-based survival comparison procedure designed to study the Caenorhabditis elegans model.

Caenorhabditis elegans is highly important in current research, serving as a pivotal model organism that has greatly advanced the understanding of fundamental biological processes such as development, cellular biology, and neurobiology, helping to promote major advances in various fields of science. In this context, the survival of a nematode under various conditions is commonly investigated via statistical survival analysis, which is typically based on hypothesis testing, providing valuable insights into the factors influencing its longevity and response to various environmental factors. The extensive reliance on hypothesis testing is acknowledged as a concern in the scientific analysis process, emphasizing the need for a comprehensive evaluation of alternative statistical approaches to ensure a rigorous and unbiased interpretation of research findings. In this work, we propose an alternative method to hypothesis testing for evaluating differences in nematode survival. Our approach relies on a clustering technique that takes into account the complete structure of survival curves, enabling a more comprehensive assessment of survival dynamics. The proposed methodology helps to identify complex effects on nematode survival and enables us to derive the probability that treatment induces a specific effect. To highlight the application and benefits of the proposed methodology, it is applied to two different datasets, one simple and one more complex.

Diskurser i kartläggning av nyanlända elever

The aim of this study is to shed light on discourses in national assessment material for recently arrived students and discourses about students' knowledge as they emerge from teachers’ use of the national assessment material for newly arrived students. The empirical material consists of assessment material for five students, two with little or no previous school background and three with long school background. The documentation in the mapping material is analyzed with Gee's discourse analysis. The result shows two different discourses in which information of different kinds is made significant: assessment discourse for newly arrived students and important knowledge at Language Introduction. Through the assessment material, the Swedish National Agency for Education supports a comprehensive assessment where information about students' previous knowledge and background regarding language and education is requested, with a particular focus on numeracy and literacy. What emerges from the study is that the documentation is inconsistent, often fragmentary and abbreviated. The results also show that the teachers consider personal matters, such as fleeing and arriving in Sweden, to be important knowledge at Language Introduction that they need to document. Additionally, the documentation regarding students who have experience studying in formal schools is more informative compared to the documentation for those students who have little or no experience of formal education. Thus, the information which is intended to be provided through assessment material appears only vaguely, and there is a discrepancy as some information is left out, particularly for students with short or no earlier schooling.

Generating and validating renewable affimer protein binding reagents targeting SH2 domains.

Despite SH2 domains, being pivotal in protein interactions linked to various diseases like cancer, we lack specific research tools for intracellular assays. Understanding SH2-mediated interactions and creating effective inhibitors requires tools which target individual protein domains. Affimer reagents exhibit promise, yet their potential against the extensive SH2 domain family remains largely unexplored. Our study aimed to bridge this gap by identifying Affimer reagents that selectively bind to 22 out of 41 SH2 domains. These reagents enabled a medium-throughput screening approach resembling siRNA studies, shedding light on their functionality. Notably, select Affimers demonstrated the ability to curtail the nuclear translocation of pERK, with Grb2 being a prominent target. Further analyses revealed that these Grb2-specific Affimer reagents displayed competitive inhibition with impressive metrics: IC50s ranging from 270.9 nM to 1.22 µM, together with low nanomolar binding affinities. Moreover, they exhibited the ability to pull down endogenous Grb2 from cell lysates, illustrating their efficacy in binding the Grb2 SH2 domain. This comprehensive assessment underscores the potential of Affimer reagents as domain-specific inhibitors. Their viability for medium/high-throughput phenotypic screening presents a promising avenue via which to identify and characterize potential drug targets within the SH2 domain family.

Assessment of International Legal Protections for Displaced Children in Armed Conflicts

The protection of displaced children in the armed conflicts is an urgent and critical issue that demands comprehensive legal assessment and intervention. Armed conflicts often result in the displacement of vulnerable populations, with children being among the most affected. These children face heightened risks, including violence, exploitation, and the loss of family ties, which significantly impacts their physical and psychological well-being. International legal frameworks, including conventions and treaties, aim to safeguard the rights of children in such dire circumstances. However, the effectiveness of these protections often varies in practice, particularly in conflict zones where enforcement mechanisms are weak or absent.

Influence of oxygen partial pressure on the passivation and depassivation of super 13Cr stainless steel in high temperature and CO2 rich environment.

The passivation and depassivation characteristics of Super 13Cr stainless steel were examined under a range of oxygen partial pressures within a high-temperature (120 ℃) and high-pressure (3MPa) CO2 atmosphere. We performed comprehensive electrochemical assessments, encompassing open-circuit potential monitoring, electrochemical impedance spectroscopy, and linear polarization resistance analysis, to evaluate the corrosion resistance and passive film stability. The results demonstrate that the addition of low O2 partial pressures enhanced the stability of the passive film, while higher O2 levels led to the loss of the passivation properties of Super 13Cr stainless steel. The study elucidates the pivotal role of oxygen in the corrosion mechanisms affecting Super 13Cr stainless steel, presenting valuable data to enhance for integrity management in severe environmental conditions.

The Safety, Feasibility, and Efficacy of a Structured Individual Exercise Program for Community-Dwelling Stroke Patients

Introduction: Stroke is a leading cause of mortality and long-term disability worldwide, often resulting in low levels of physical activity post-discharge. A comprehensive exercise program could be a safe method to increase stroke patients’ physical activity and exercise volume. This pilot study examines the effectiveness, safety, and feasibility of a comprehensive exercise regimen for stroke patients residing in the community after discharge. Methods: This single-group pilot study included patients who received inpatient rehabilitation for motor impairment following a stroke. Community-dwelling participants engaged in a comprehensive exercise program, which was structured and individualized, consisting of stretching, aerobic exercise, strength training, and balance exercises, conducted under the supervision of a health exercise specialist in a dedicated living lab within the hospital. The program involved 20 sessions, each lasting 50 min, conducted three to five times weekly. The pre- and post-intervention evaluations were comprehensive, including safety and validity assessments, along with physical function tests such as cardiopulmonary exercise testing and various fitness tests (6 min walk test, timed up and go test, chair stand test, figure-of-8 walk test, grip strength test, and sit-and-reach test). Depression levels were assessed using the Geriatric Depression Scale (GDS). Results: A total of 22 subjects were recruited, with 21 completing the study after one dropout due to fatigue and visiting distance. Among the 21 completers, one subject experienced a mild adverse event (hypoglycemia), which was not serious, confirming the program’s safety. The exercise participation rate was 95.5%, and the adherence rate averaged 95.2%, with all completers achieving over 80% adherence. Significant improvements were observed in VO2 peak (p = 0.000), 6 min walk test (p = 0.000), timed up and go test (p = 0.000), chair stand test (p = 0.000), figure-of-8 walk test (p = 0.000), and grip strength (p = 0.001). However, changes in the peak respiratory exchange ratio (p = 0.078), sit-and-reach test (p = 0.228) and GDS scores (p = 0.275) were not significant. Conclusion: This study demonstrates that the comprehensive exercise program is sufficiently safe and valid for stroke rehabilitation patients. The program significantly enhances cardiopulmonary endurance, walking ability, balance, muscle strength, muscle endurance, and coordination. Further research with larger sample sizes and control groups is needed to confirm these findings and explore additional benefits.

Tropical Cyclone Wind Shear-Relative Asymmetry in Reanalyses

Abstract While tropical cyclones (TCs) are axisymmetric vortices to the first order, they often exhibit noteworthy structural asymmetries. These often result from environmental vertical wind shear, which tilts the vortex and induces a wavenumber 1 pattern in the circulation and precipitation fields. Reanalyses and climate models have improved in representing the TC structure and climatology, but their relatively coarse resolution and dependence on parameterized physics cast doubt on their ability to capture the asymmetric TC structure. We perform the most comprehensive process-oriented assessment of TC asymmetry to date in reanalyses. Specifically, we analyze the composite shear-relative TC structure in ERA5 and Climate Forecast System Reanalysis (CFSR), which vary in their resolutions, physical parameterization suites, and data assimilation techniques. These structures are compared with aircraft reconnaissance radar observations. In agreement with the observations, the strongest tangential winds are usually found left-of-shear, while inner core rainfall, ascent, vortex tilt, and low-level inflow are favored directly downshear or in the downshear-left quadrant. Outer rainband convection generally peaks in the downshear-right quadrant. Thermodynamic asymmetries are also apparent, with anomalous low-level moisture right-of-shear, midlevel warmth in the upshear-right quadrant (uptilt), and cloud properties suggestive of a realistic precipitation life cycle from growth to fallout. We also decompose rainfall contributions from the convective parameterization and large-scale cloud schemes and highlight the roles of vorticity advection, buoyancy advection, and diabatic processes in driving asymmetric vertical motions in the inner core and outer rainband regions. Our results suggest that process-level studies of TC asymmetry and TC–wind shear interaction under future warming are viable using climate models. Significance Statement Asymmetries are common in tropical cyclones (TCs), influencing their intensity, track, and hazards. Vertical wind shear often plays a leading-order role in causing these asymmetries. It is uncertain how well asymmetric structures and processes are captured in reanalyses and global climate models (GCMs) with grid spacings of 0.25° and coarser. In this study, we first evaluate TC asymmetry in reanalyses, which have the benefit of being forced by observations. This helps to assess whether the resolutions associated with GCMs sufficiently capture asymmetric structures and processes and motivates upcoming work with free-running GCMs to study how TC asymmetry may change in a warming climate.

How can manufacturers identify the conditions for financially viable product-as-a-service?

IntroductionWith the much-needed transformation from linear to more circular resource flows, it is imperative for enterprises to understand their financial prospects. Transforming towards Product-as-a-Service (PaaS) with circular elements introduces new considerations that must be addressed to ensure profitability and sustainability. However, there is a lack of comprehensive financial assessments based on empirical cases to guide companies in assessing the lucrativeness of their transformations. This paper addresses this gap by proposing a simple-to-use and flexible financial assessment model for PaaS, helping practitioners identify the conditions necessary for financial viability from both provider and user perspectives.MethodsGrounded in transdisciplinary research, this study focuses on a construction machine manufacturer's transformation from a traditional one-off sales business model to PaaS. The transformation is analysed through the development of a life cycle costing financial assessment model that addresses relevant cost drivers.ResultsUsing discounting methods, the model can help practitioners generate scenarios to identify feasible solutions for profitable PaaS setups. Additionally, the paper presents an analytical procedure to identify conditions for a financially viable PaaS. The procedure includes scenario-based analysis that accounts for systemic changes often necessary for successfully realising PaaS.DiscussionBy following the proposed procedure, along with the financial assessment model, manufacturers can streamline their financial assessments to identify necessary changes. For the analysed case company, the modelling results indicate that it must redesign its products for PaaS to outperform its previous business model.

One ring does not fit all: Evaluation of banding‐related injuries in tricolored bats

AbstractThe potential harm inflicted by forearm bands on bats has been debated for decades. To aid in decision‐making regarding bat marking, we conducted a comprehensive assessment of banding injuries using recapture data from a long‐term overwintering study in Georgia, USA, involving 776 banded tricolored bats (Perimyotis subflavus) with 284 recaptures. Most recaptured bats showed no visible injuries (77.8%); however, 22.2% of bats presented varying degrees of band‐related injuries. Although <25% of tricolored bats exhibited banding‐related injuries, sublethal effects of injuries are unknown and could add additional stressors to bat populations already facing multiple threats, including mortality from white‐nose syndrome. Thus, we recommend that banding bats, especially species that have experienced white‐nose syndrome‐related population declines, be appropriately justified and their use carefully considered. Our study contributes valuable knowledge to aid in informed decision‐making on the use of capture‐mark‐recapture methods in the research and management of bat communities.

A Comprehensive Assessment of Water Loss and Driving Forces for the Middle Route of the South-to-North Water Diversion Project from Humanistic Perspective

A Comprehensive Assessment of Water Loss and Driving Forces for the Middle Route of the South-to-North Water Diversion Project from Humanistic Perspective

Longitudinal Predictors of Adaptive Functioning in Emerging Adults with and without Autism Spectrum Disorder.

Individuals with autism spectrum disorder (ASD) display heterogeneity in adaptive functioning, underscoring the need to identify predictors to inform clinical and scientific interventions. We investigated the longitudinal associations between an autism diagnosis, co-occurring psychopathology symptoms, executive functions (EF) and subsequent adaptive functioning in individuals with and without ASD (IQ > 70). Sixty-six individuals (26 with ASD, 40 without ASD) were assessed at baseline (mean age = 11.8 years, SD = 2.1) and at 10-year follow-up (mean age 21.4, SD = 2.3). The diagnostic evaluation comprised a comprehensive assessment of autism symptoms and emotional and cognitive functioning. Co-occurring psychopathology symptoms were assessed with two measures: self-reported depressive symptoms with the Short Mood and Feelings Questionnaire and parent-reported total problems with the Child Behavior Checklist 6-18. Participants completed neuropsychological tests to evaluate EF. We investigated adaptive functioning by using the Weiss Functional Impairment Rating Scale (WFIRS) which is a self-report measure of impairment in the following domains: family, work, school, life skills, self-concept, social and risk-taking. Among the emerging adults previously diagnosed with ASD, 46% reported living independently, 75% had at least one friend, and 71% were employed or in education. Individuals with ASD reported significantly lower adaptive functioning compared to individuals without ASD (WFIRS Total, Hedges' g = 0.92). Greater EF difficulties in childhood/adolescence predicted lower adaptive functioning in emerging adulthood, surpassing the influence of autism diagnosis and co-occurring symptoms. The findings highlight the influential role of EF, implying that interventions targeting EF difficulties could improve long-term outcomes for individuals with ASD.

A Ni4O4-cubane-squarate coordination framework for molecular recognition.

Molecular recognition is a fundamental function of natural systems that ensures biological activity. This is achieved through the sieving effect, host-guest interactions, or both in biological environments. Recent advancements in multifunctional proteins reveal a new dimension of functional organization that goes beyond single-function molecular recognition, emphasizing the need for artificial multifunctional materials in industrial applications. Herein, we have designed a porous Ni4O4-cubane squarate coordination polymer as an artificial molecular recognition host, drawing inspiration from the structural and functional features of natural enzymes. A comprehensive assessment of the material's ability to distinguish target species under different operating conditions was carried out. The results confirm its sieving function through hexane isomers separation, host-guest interaction function via xenon/krypton separation, and dual presence of sieving and interaction through carbon dioxide/nitrogen separation. Additionally, the material demonstrates good stability and feasibility for large-scale production, indicating its practical potential. Our findings provide a bio-inspired multifunctional recognition material for chemical separations as proof-of-concept while offering solutions to advance artificial multifunctional materials adaptable to other applications beyond chemical separations.

Volumetric Imaging From Raman Perspective: Review and Prospect

AbstractVolumetric imaging, which supports quantitative and comprehensive assessment of a 3D sample from an entire volume, has attracted tremendous attention in biomedical research. Fluorescence imaging techniques, such as optical sectioning and light sheet microscopy, enable to reconstruct the 3D distribution of chemicals within a sample. However, current methods rely on exogenous labels, from which considerable perturbation may be introduced in living systems. Raman imaging offers a feasible solution to visualize components in biological samples in a label‐free manner. Besides, the integration of Raman microscopy with 3D approaches will benefit the research of biomedical samples on novel devices, which is dominated by the strongly enhanced spatial resolution, imaging speed, and overall field of view as well as complemented more details of samples. In this overview, recent achievements in 3D visualization of biological samples from the Raman perspective, are explored including scanning mechanism, light sheet, tomography strategy, compressive sensing, holography, and tissue clearing. Importantly, these platforms are compatible with biomedical research, thus allowing the imaging of chemical constituents and the distribution of samples in a whole volume. As a unique volumetric imaging tool for biological discovery, these methods may provide a strategy to accelerate new discoveries across diverse fields of research.