Grade Distribution Research Articles

Impact of diversion ileostomy on postoperative complications and recovery in the treatment of locally advanced upper-half rectal cancer.

The efficacy of diversion ileostomy followed by radical surgery for locally advanced upper-half rectal cancer remains uncertain. This study seeks to compare the effectiveness of treatment with and without diversion ileostomy in preventing anastomotic leakage (AL) and to identify a subset who may benefit from diversion ileostomy after AL occurs in Chinese patients with stage II and III upper-half rectal cancer. A retrospective study enrolled a total of 809 patients with locally advanced upper-half rectal cancer between 2017 and 2021, with 27.6% (n = 223) treated with diversion ileostomy and 72.4% (n = 586) treated without diversion ileostomy. The Diversion(+) group (n = 172) and Diversion(-) group (n = 172) were compared for perioperative outcomes through 1:1 propensity score matching (PSM). The selection of variables for multivariable logistic regression was determined through bivariate logistic regression analysis. Additionally, optimal cutoff values for risk factors were identified using ROC curve analysis. Within the entire cohort, patients in the Diversion(+) group exhibited a lower distance from the anal verge (DAV) and higher rates of chemoradiotherapy (CRT), diabetes, cN2 stage, mrCRM positivity, EMVI positivity, and CEA elevation compared to those in the Diversion(-) group. Following PSM, a satisfactory balance of baseline variables was achieved between the two groups. There were no statistically significant differences in AL rates (7.0% vs. 5.8%, p = 0.659) or AL grade distribution (Grade A: 0.6% vs. 0%, Grade B: 5.2% vs. 4.1%, Grade C: 1.2% vs. 1.7%, p = 0.691) between the two groups. However, the Diversion(+) group demonstrated a higher incidence of postoperative complications (30.8% vs. 17.4%, p = 0.004), Clavien‒Dindo III-IV complications (2.9% vs. 2.3%, p = 0.013), particularly wound infections (8.1% vs. 1.2%, p = 0.002), and early postoperative inflammatory small bowel obstruction (EPISBO) (8.7% vs. 1.2%, p = 0.001) compared to the Diversion(-) group. Results from multivariate logistic regression analysis revealed that male gender (OR = 2.354, p = 0.014) was the only independent risk factor associated with AL, while the presence of diversion ileostomy (with vs. without, OR = 1.144, p = 0.686) did not show significant associations. In patients with AL, the onset of the AL was observed to occur later in the Diversion(+) group compared to the Diversion(-) group (7.0 ± 3.3 vs. 3.4 ± 1.4 days, p < 0.001), while the recovery time was significantly shorter (11.3 ± 4.7 vs. 20.3 ± 7.2 days, p < 0.001). Similarly, in Grade C AL patients, the occurence time was delayed in the Diversion(+) group compared to the Diversion(-) group (8.7 ± 4.7 vs. 3.2 ± 1.5 days, p = 0.008), with a shorter recovery time (19.3 ± 2.1 vs. 25.7 ± 6.7 days, p = 0.031). A trend was observed indicating a longer interval before ileostomy restoration in the AL patients compared to the non-AL patients (7.6 ± 4.9 months vs. 5.5 ± 2.9 months, p = 0.079). In addition, DAV (OR = 0.078, p = 0.002) was identified as the only independent factor associated with potential-diversion-benefit in patients with AL, with an optimal cutoff point of 8.6cm. The utilization of diversion ileostomy as a preventative measure for AL in cases of locally advanced upper-half rectal cancer is not universally endorsed due to potential complications such as small bowel obstruction and wound infection. Nevertheless, in the occurrence of AL, diversion ileostomy may prove advantageous for patient recuperation. Particularly, male patients with a DAV ranging from 7 to 8.6cm may experience benefits from undergoing diversion ileostomy subsequent to AL in cases of locally advanced upper-half rectal cancer.

Main versus segmental hepatic artery angioembolization in patients with traumatic liver injuries: A Western Trauma Association multicenter study

IntroductionHepatic angioembolization is highly effective for hemorrhage control in hemodynamically stable patients with traumatic liver injuries and contrast extravasation. However, there is a paucity of data regarding the specific location of angioembolization within the hepatic arterial vasculature and its implications on patient outcomes. MethodsA post-hoc analysis of a multicenter prospective observational study across 23 centers was performed. Adult patients undergoing main hepatic artery angioembolization or segmental hepatic artery angioembolization within 8 hours of arrival were included. The primary outcome was liver-related complications, defined as perihepatic fluid collection, bile leak/biloma, pseudoaneurysm, hepatic necrosis, and/or hepatic abscess. Secondary outcomes were liver-related complication interventions, length of stay, and mortality. ResultsA total of 55 patients underwent hepatic angioembolization, with 23 (41.8%) undergoing main hepatic artery angioembolization and 32 (58.2%) receiving segmental hepatic artery angioembolization. Both groups were comparable in age, vitals, mechanism of injury, liver injury grade distribution, and injury severity score (all P > .05). The main hepatic artery angioembolization group had greater rates of overall liver-related complications (65.2% vs 31.2%, P = .039), specifically perihepatic fluid collection (26.1% vs 6.3%, P = .040) and bile-leak/biloma (34.8% vs 12.5%, P = .048). Main hepatic artery angioembolization had greater rates of 2 or more liver-related complications (47.8% vs 9.4%, P = .001) and readmission within 30 days (30.4% vs 9.4%, P = .046). No significant differences were observed in hospital length of stay and mortality (all P > .05). ConclusionsMain hepatic artery angioembolization is associated with increased rates of liver-related complications, multiple liver-related complications, and readmission within 30 days compared with segmental hepatic artery angioembolization. Thus, main hepatic artery angioembolization should be reserved for use only when segmental hepatic artery angioembolization is not feasible, albeit with significantly increased morbidity.

Redesigning Building Thermal Science Education Through Inquiry-Based Experiential Learning

Mastering building thermal science is essential for architectural professionals, as it supports the design of energy-efficient and thermally optimized buildings, which are critical for addressing the growing demands of sustainable architecture. However, traditional teaching methods often disconnect theoretical instruction from practical application, limiting students’ ability to apply core concepts in real-world scenarios. This study introduces a pedagogical reform that integrates design-oriented and inquiry-based experiments, hands-on physical activities, and field-based testing into the teaching of building thermal science. The revised curriculum focuses on applying theoretical principles in real architectural contexts, allowing students to directly design and experience thermal phenomena such as heat transfer and thermal resistance in building envelope structures. To evaluate the effectiveness of this reform, a control group using traditional confirmatory experiments (following predetermined instructions to complete experiments and validate the results) was compared to a reform group engaged in inquiry-based experimental learning. Over the course of three cohorts (2019, 2020, 2021), the reform group consistently outperformed the control group, with statistically significant improvements in average course grades. Specifically, the reform group had mean grade differences of 7.21 points higher in 2019, 4.55 points higher in 2020, and 5.83 points higher in 2021, as demonstrated by t-test results (p &lt; 0.05). The reform group also exhibited more concentrated grade distributions, reflecting enhanced comprehension and retention of key thermal concepts. In addition to improved academic performance, students in the reform group demonstrated superior problem-solving abilities and a heightened awareness of energy conservation and sustainable design practices. This approach not only deepened their understanding of theoretical knowledge but also fostered a greater commitment to integrating sustainability into their architectural projects.

Emergency Medicine Clerkship Grading Scheme, Grade, and Rank-List Distribution as Reported on Standardized Letters of Evaluation

Background: The Standardized Letter of Evaluation (SLOE) is a crucial component of the emergency medicine (EM) application process. Given the critical role of the SLOE, we attempted to better understand the grading scales used, as well as the distribution of grades and rank-list positions.Objectives: Our primary objective in this study was to determine the distribution of grading formats, grades given, and rank-list positions across EM clerkships using the SLOE. Methods: We performed a cross-sectional study of the grading formats, grades given, and ranking distributions as reported on the SLOE during the 2022–23 application cycle. We obtained data on SLOEs from EM residency programs accredited by the Accreditation Council for Graduate Medical Education by reviewing all applicants who applied to either of two EM residency programs in geographically different regions. Trained abstractors recorded the following data: number of students rotating in the prior year; grading format used; and grade and rank distribution among students. Results: We included 264 programs in our final analysis, after 13 programs met exclusion criteria. The majority of programs (72.2%) use an Honors/High Pass/Pass/Fail grading scheme. We determined the mean percent of each grade: Honors/A 27.6%; High Pass/B 31.1%; Pass/C 40.8%; Low Pass/D 0.2%; and Fail/F 0.3%. Finally, we determined the mean percent for each rank-list position: top 10% was 17.6%; top third 36.5%; mid third 34.1%; and low third 11.8%. Conclusion: We determined the grading schemes and grade and rank-list distributions for EM programs during the 2022–2023 academic year. Most programs used a Honors/High Pass/Pass/Fail grading scheme, with the majority of students receiving Honors or High Pass, while 0.3% failed their rotation. Both grades and rank list demonstrated evidence of a skewed distribution toward higher grades and rank-list position.

Prediction of grain shoal reservoirs via seismic forward modeling and waveform classification: Application to the northern slope of the central Sichuan Uplift, Sichuan Basin, SW China

Grain shoals are one of the principal reservoir facies of carbonate rocks in oil and gas exploration domains. With the discovery of oil and gas in the grain shoal reservoirs of the Longwangmiao Formation in the central Sichuan paleo-uplift, the characteristics and distribution of grain shoal reservoirs are still unclear in the northern slope of the central Sichuan paleo-uplift. Through integrated analysis of wireline logs and high-quality 3D seismic data, combined with seismic forward modeling and waveform classification, reservoir seismic facies, reservoir classification, and the reservoir distribution of different grades are investigated. The results show that (1) under the thin thickness (i.e., the thickness is around 80 m) of the Longwangmiao Formation (i) when reservoirs are not developed, the seismic waveform is manifested as a single peak, and the top interface of the Longwangmiao Formation corresponds to 1/8 [Formula: see text] above the single peak. (ii) When a single set of reservoirs is merely developed in the second member of the Longwangmiao Formation (SMLF), the waveform displays a single peak, and the top peak moves downward. In addition, when multiple sets of reservoirs are developed in the SMLF, the seismic reflections of multiple reservoirs are consistent with those of a single reservoir with the same cumulative thickness. (iii) When the reservoirs are developed in the first member of the Longwangmiao Formation (FMLF) and SMLF, the single peak moves downward, and either the reservoir thickness of the SMLF is greater than that of the FMLF or the reservoir velocity of the SMLF is lower than that of the FMLF. (2) Under the thick thickness (i.e., the thickness is approximately 110 m) of the Longwangmiao Formation, (i) when reservoirs are not developed, the waveform of the Longwangmiao Formation exhibits a double peak, and the top interface of the Longwangmiao Formation corresponds to the extreme value of the upper peak. (ii) When only a single set of reservoirs or multiple sets of reservoirs are developed in the SMLF, the Longwangmiao Formation exhibits a single peak, and the top interface of the Longwangmiao Formation corresponds to the trough. (iii) With the reservoir development in the first and second members of the Longwangmiao Formation, the waveform of the Longwangmiao Formation shows an asymmetric low-frequency peak, and either the reservoir thickness of the SMLF is greater than that of the FMLF or the reservoir velocity of the SMLF is lower than that of the FMLF. (3) Using the waveform classification method, seismic waveforms corresponding to the Longwangmiao Formation could be summarized into four types (i.e., two types of waveforms associated with reservoir development and two types of waveforms associated with reservoir un-development). Two reservoir waveforms are distributed as two strips oriented approximately east–west and spread in the central study area, according to the planar study results that combine seismic attributes and waveform classification. The reservoir stripes near well PS1 represent the better-developed reservoir zones in the study area.

Assessing the environmental benefits of passenger cars electrification in metropolises: A case study of Singapore

Land-based transportation is a significant contributor to global greenhouse gas (GHG) emissions, with internal combustion engine vehicles being the predominant mode of transport in this sector. As the world population grows and urbanization accelerates, transport demand in metropolitan areas is projected to double by 2050, underscoring the critical need for sustainable transportation strategies, forecasting, and planning within an urban context. One challenge in this endeavor is the insufficient attention given to the distribution of vehicle grades within the overall car population during GHG impact assessment, despite the recognized importance of car grade by researchers and policymakers. In this study, we incorporate both engine type and vehicle grade distribution, derived from data on over 30,000 passenger cars registered with the Land Transport Authority of Singapore between 2018 and 2022, into our life cycle assessment analysis. This approach ensures that our scenario-based studies on prediction and planning are more comprehensive than those that consider only the most popular models. Furthermore, while Singapore benefits from a relatively clean electricity supply, the current limitations in charging infrastructure negatively affect the GHG impact of electric vehicles. The insights from this research will inform the development of transportation policies for metropolises like Singapore, contributing to the advancement of a more sustainable transportation system.

An Evidential Reasoning Method of Comprehensive Evaluation of Water Quality Based on Gaussian Distribution

This study provides an evidential reasoning method for water quality evaluation based on Gaussian distribution to handle the problem of comprehensive water quality evaluation for a region across a period (multiple sections and multiple time points). The method turns the collection of observed water quality indicator values into a probability distribution of water quality grades by using the Gaussian distribution to compute the confidence assessment of water quality grades over one period. It eliminates the subjectivity involved in determining confidence levels and the problem of information loss during data fusion that arises with conventional approaches. The probability distribution of each assessment grade is then determined by repeatedly synthesizing evidence of the same water quality grade using the improved evidential reasoning synthesis rule. To avoid the subjectivity included in experience-based weight settings, principal component analysis (PCA) is utilized to calculate the weights of water quality indicators based on contribution rates and load coefficients. In the end, utility theory is presented to modify the discrete probability distribution of precise numerical expressions, offering thorough results for the evaluation of water quality and facilitating the comparison of various water quality grades. Using the Xiangjiang River Basin as a case study, the proposed evaluation method is contrasted with popular techniques for assessing water quality, including the Single-Factor Evaluation Method, the Fuzzy Comprehensive Evaluation Method, and the Evidential Reasoning Comprehensive Evaluation Method. The findings suggest that the evidence reasoning approach for evaluating water quality that is based on Gaussian distribution is more rational, accurate, and scientific. Additionally, empirical studies on the annual water quality trends in various regions, the upstream, midstream, and downstream trends, and the water quality trends during wet and dry periods are conducted using this method to assess and analyze changes in water quality in the Xiangjiang River Basin during the “11th Five-Year Plan” and “12th Five-Year Plan” periods. The analysis findings demonstrate that, even if the rate of progress has slowed, the Xiangjiang River Basin’s overall water quality has been steadily improving since management and protection measures were put in place. This shows that the preventive and control efforts implemented in the “11th Five-Year Plan” and “12th Five-Year Plan” periods were successful; nevertheless, carrying out the current tactics might only have a limited impact. As a result, more advanced and creative approaches are required to encourage the ongoing enhancement of the water quality in the Xiangjiang River Basin.

Cultivated Land Quality Assessment and Obstacle Factors Diagnosis in Changtu County, Northeast China

ABSTRACTEffective evaluation of cultivated land quality is crucial for sustainable agricultural management. Existing research often focuses on regional scales and lacks sufficient detailed analysis of spatial distribution and limiting factors at localized scales. This study aims to select the key indicators to evaluate cultivated land quality and analyze their influence on cultivated land quality at the county level. Taking Changtu County as the research area, principal component analysis (PCA) was employed to identify the most effective Minimum Data Set (MDS) for evaluation, including cultivated layer thickness, soil organic matter (SOM), pH, bulk density (BD), and cultivated layer texture. Additionally, an obstacle degree model was used to analyze restricting factors and their degrees of impact. Results showed that the constructed MDS could replace all indicators for cultivated land quality evaluation. Quality was higher in central areas and lower in eastern and western regions. SOM content decreases with the decrease of quality grade, significantly affecting the quality distribution, and pH in the medium category (Grades III and VI) cultivated lands were lower compared to other categories. Low organic matter content and low pH levels were the main obstacles affecting cultivated land quality, with average obstacle degrees of 43.5% and 29.3%, respectively. Low SOM content significantly affected land quality, particularly in the western region, whereas acidic soils in the eastern region influenced quality grade distribution. Thus, strategies for pH control and SOM enhancement are essential for improving cultivated land quality. This study provides valuable insights into sustainable agriculture.

Free vibration and buckling characteristics of temperature dependent FGCNT reinforced plates in finite element framework of a non-polynomial axiomatic approach

In the present work, a generalized finite element formulation is established and implemented for the free vibration and buckling characteristics for temperature dependent carbon nanotube (CNT) reinforced plate. The uniform and functionally graded distribution of CNT is assumed in the plate and the plate is modeled in non-polynomial axiomatic framework. The extended rule of mixture is employed for computing the equivalent material parameters which are temperature dependent. Further, an eight-noded C0 continuous element with seven degree of freedom is adopted for discretization of the plate domain. The convergence and comparison studies are carried out to ensure the accuracy and effectiveness of the proposed formulation. As temperature conditions significantly influence structures integrity, on that account, thorough parametric studies are performed to examine the influence of volume fraction (VCNT ), span to thickness ratio ( a / h ), CNT distribution and boundary conditions on the FG-CNTR plate for the different temperature conditions. The results demonstrate that the efficient use of CNT distribution and boundary conditions can consequently improve free vibration and buckling characteristics of the temperature dependent FG-CNTR plates.

EARLY SUCCESSFUL PRIMARY PERCUTANEOUS CORONARY INTERVENTION ON LEFT VENTRICULAR EJECTION FRACTION IN PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION

Early intervention in patients with ST-elevation myocardial infarction (STEMI) is crucial for preserving left ventricular function and improving patient outcomes. Primary percutaneous coronary intervention (PPCI) has become the standard of care, and the timing of intervention significantly influences recovery and long-term prognosis. Objective: This study aimed to evaluate the impact of early successful primary percutaneous coronary intervention (PPCI) on left ventricular ejection fraction (LVEF) in patients presenting with STEMI. Methods: A prospective cohort study was conducted on 116 STEMI patients undergoing PPCI at a tertiary care hospital. The patients were categorized into two cohorts: early presenters (n=67) who received PPCI within 6 hours of symptom onset and late presenters (n=49) who received PPCI after 6 hours. Baseline characteristics, procedural outcomes, Thrombolysis in Myocardial Infarction (TIMI) flow grades, and LVEF measurements were assessed at presentation and two months post-PPCI using transthoracic echocardiography. The primary outcome was the change in LVEF from baseline to follow-up, and the secondary outcome was the distribution of TIMI flow grades achieved during PPCI. Statistical analysis was performed using appropriate tests to compare outcomes between the two groups. Results: Early presenters demonstrated significantly better outcomes compared to late presenters. At presentation, the mean LVEF in the early group was higher (45.67 ± 1.73%) compared to the late group (36.94 ± 1.25%) (p = 0.0001). At the two-month follow-up, the LVEF improved significantly in both groups, with early presenters achieving an LVEF of 56.24 ± 1.73%, which was notably higher than the LVEF of late presenters (45.12 ± 1.42%) (p = 0.0001). In terms of coronary reperfusion, 62.7% of early presenters achieved TIMI grade 3 flow compared to 26.5% of late presenters (p = 0.0001), indicating better coronary artery perfusion in the early intervention group. Conclusion: Early successful PPCI in STEMI patients is associated with superior recovery of left ventricular function and improved coronary reperfusion compared to delayed intervention. Patients who received PPCI within 6 hours of symptom onset demonstrated significantly higher LVEF at follow-up and achieved better TIMI flow grades, highlighting the critical importance of minimizing treatment delays in STEMI management.

Automatic Acne Severity Grading with a Small and Imbalanced Data Set of Low-Resolution Images.

Developing automatic acne vulgaris grading systems based on machine learning is an expensive endeavor in terms of data acquisition. A machine learning practitioner will need to gather high-resolution pictures from a considerable number of different patients, with a well-balanced distribution between acne severity grades and potentially very tedious labeling. We developed a deep learning model to grade acne severity with respect to the Investigator's Global Assessment (IGA) scale that can be trained on low-resolution images, with pictures from a small number of different patients, a strongly imbalanced severity grade distribution and minimal labeling. A total of 1374 triplets of images (frontal and lateral views) from 391 different patients suffering from acne labeled with the IGA severity grade by an expert dermatologist were used to train and validate a deep learning model that predicts the IGA severity grade. On the test set we obtained 66.67% accuracy with an equivalent performance for all grades despite the highly imbalanced severity grade distribution of our database. Importantly, we obtained performance on par with more tedious methods in terms of data acquisition which have the same simple labeling as ours but require either a more balanced severity grade distribution or large numbers of high-resolution images. Our deep learning model demonstrated promising accuracy despite the limited data set on which it was trained, indicating its potential for further development both as an assistance tool for medical practitioners and as a way to provide patients with an immediately available and standardized acne grading tool. chinadrugtrials.org.cn identifier CTR20211314.

Age-dependent prevalence of malocclusions requiring treatment according to the KIG classification : Amultipart cross-sectional study over a10-year period from the district of Viersen/North Rhine.

Patients with statutory health insurance (SHI) in Germany must undergo an assessment of orthodontic treatment need using the "Kieferorthopädische Indikationsgruppen" (KIG; orthodontic indication groups) classification system since 2002. Atreatment need only exists if anomalies of acertain degree of severity are present. The aim of this study was to evaluate the age-dependent prevalence and percentage distribution of KIG grades requiring treatment in patients with SHI before the age of 18over a10-year period. Between 2012 and 2021, treatment indication existed for 1951 (1025female, 926male) out of 2288 patients with SHI in the cohort of this study before the age of 18according to current SHI guidelines. The KIG classification was based on the highest existing KIG grade. There were no multiple classifications. The patient cohort was divided into three patient groups (PG) according to chronological age for analysis: PG1 < 10years of age (early treatment), PG2 10 to < 13years of age (main treatment) and PG3 13 to < 18years of age (late treatment). In PG1 (454 patients), the KIG classificationsD(26.5%), K(25.5%), M(19.4%), and P(18.0%) dominated. In PG2 (998 patients), classifications D(33.2%), predominated, whereas K(7.5%) and M(5.9%) rarely occurred. The classifications E(12.6%) and P(13.3%) appeared quite frequently. Transverse deviations occurred only about half as often in PG2 as in PG1 and PG3. In PG3 (499patients), the classification E(17.6%) was particularly common, while P(2.6%) was rare. The proportion of KIG grades 5decreased depending on age: 19% in PG1, 13.5% in PG2, 10.4% in PG3. The prevalence of sagittal classifications was highest in all age groups (45.9% in PG1, 39.1% in PG2, 31.5% in PG3). The distribution of KIG classifications requiring treatment was not homogeneous, but age dependent. The differences were particularly evident in the early treatment group and may be due to the limited applicability of the KIG classification system in patients before late mixed dentition. With increasing age at initial examination, the prevalence of sagittal classifications decreased, while that of vertical classifications increased. Still, the sagittal classifications DandM occurred most frequently in all age groups. The KIG classification Dwas always the most common in all patients until the age of18.

Spatial distribution and topographic gradient effects of habitat quality in the Chang-Zhu-Tan Urban Agglomeration, China

This study aimed to analyze spatio-temporal changes in habitat quality in Chang-Zhu-Tan Urban Agglomeration during the 2000–2020 period and explore its topographic gradient effects. Using land use data from this period, the InVEST model was employed to assess the spatio-temporal variations in habitat quality. The bivariate spatial autocorrelation model was used to analyze the spatial correlation characteristics between habitat quality and various topographical factors. Additionally, terrain factor analysis was utilized to study the terrain gradient effects on habitat quality in the study area. The results reveal that: (1) The primary land use changes in the study area from 2000 to 2020 predominantly involve substantial arable land and forest conversions into urban development. (2) The average habitat quality indices for 2000, 2010, and 2020 in the Chang-Zhu-Tan Urban Agglomeration stand at 0.651, 0.622, and 0.606, respectively, indicating a consistent declining trend in habitat quality. The distribution of habitat quality grades demonstrates a spatial pattern of “lower in the central surroundings, higher in the surroundings.” (3) The Chang-Zhu-Tan Urban Agglomeration shows significant positive correlations between habitat quality and topographical gradients. Spatial aggregation tendencies between habitat quality and topographical gradients primarily exhibit “high-high” and “low-low” clustering. (4) The habitat quality of the Chang-Zhu-Tan urban agglomeration exhibits a significant topographic gradient effect, primarily characterized by an increase in habitat quality with the rise of the topographic gradient. The study outcomes contribute to unveiling the spatiotemporal variations in habitat quality within the Chang-Zhu-Tan Urban Agglomeration. Moreover, leveraging different habitat types’ distinctive terrain distribution characteristics, it proposes targeted habitat conservation measures, thereby offering theoretical support for biodiversity conservation and territorial spatial planning in the study area.

Precise cell wall modification of bamboo through two-step furfurylation via solution quantitative adsorption

Improving the dimensional stability of bamboo for construction and engineering use through furfurylation is crucial. Traditional methods like impregnation and soaking furfurylation are hindered by high modifier consumption and waste disposal issues. In this study, we propose a novel technique called solution quantitative adsorption furfurylation (SQAF) to enhance bamboo's dimensional stability and overcome these challenges. Our findings indicate that SQAF achieves enhanced dimensional stability (anti-swelling efficiency (ASE) up to 53.02 %) and reduced hygroscopicity (EMC down to 4.11 %) with approximately 12.50 % weight percentage gain (WPG), and a high furfuryl alcohol (FA) utilization efficiency (SR > 85 %). Analysis using SEM and nanoindentation reveals precise modification of the cell walls without FA resin accumulating in cell cavities. Additionally, SQAF allows for a graded distribution of FA resin, thereby improving the physical properties of bamboo while maintaining its mechanical integrity, especially as the decline in toughness of bamboo is reduced by more than 40 % compared to traditional methods.

Repurposing chemotherapy-induced peripheral neuropathy grading.

Chemotherapy-induced peripheral neuropathy (CIPN) is perceived differently by patients and physicians, complicating its assessment. Current recommendations advocate combining clinical and patient-reported outcomes measures, but this approach can be challenging in patient care. This multicenter European study aims to bridge the gap between patients' perceptions and neurological impairments by aligning both perspectives to improve treatment decision-making. Data were pooled from two prospective studies of subjects (n = 372) with established CIPN. Patient and physician views regarding CIPN were assessed using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), Total Neuropathy Scale-clinical version (TNSc) items, and the disease-specific quality of life - Chemotherapy-Induced Peripheral Neuropathy questionnaire (QLQ-CIPN20) from the European Organization for Research and Treatment of Cancer (EORTC). To identify inherent neurotoxic severity patterns, we employed hierarchical cluster analysis optimized with k-means clustering and internally validated by discriminant functional analysis. Both NCI-CTCAE and TNSc demonstrated a significant difference in the distribution of severity grades in relation to QLQ-CIPN20 scores. However, a proportion of subjects with different neurotoxic severity grades exhibited overlapping QLQ-CIPN20 scores. We identified three distinct clusters classifying subjects as having severely impaired, intermediately impaired, and mildly impaired CIPN based on TNSc and QLQ-CIPN20 scores. No differences in demographics, cancer type distribution, or class of drug received were observed. Our results confirm the heterogeneity in CIPN perception between patients and physicians and identify three well-differentiated subgroups of patients delineated by degree of CIPN impairment based on scores derived from TNSc and QLQ-CIPN20. A more refined assessment of CIPN could potentially be achieved using the calculator tool derived from the cluster equations in this study. This tool, which facilitates individual patient classification, requires prospective validation.

A Graded Redox Interfacial Modifier for High-Performance Perovskite Solar Cells.

Perovskite solar cells have emerged as a potential competitor to the silicon photovoltaic technology. The most representative perovskite cells employ SnO2 and spiro-OMeTAD as the charge-transport materials. Despite their high efficiencies, perovskite cells with such a configuration show unsatisfactory lifespan, normally attributed to the instability of perovskites and spiro-OMeTAD. Limited attention was paid to the influence of SnO2, an inorganic material, on device stability. Here we show that improving SnO2 with a redox interfacial modifier, cobalt hexammine sulfamate, simultaneously enhances the power-conversion efficiency (PCE) and stability of the perovskite solar cells. Redox reactions between the bivalent cobalt complexes and oxygen lead to the formation of a graded distribution of trivalent and bivalent cobalt complexes across the surface and bulk regions of the SnO2. The trivalent cobalt complex at the top surface of SnO2 raises the concentration of (SO3NH2)- which passivates uncoordinated Pb2+ and relieves tensile stress, facilitating the formation of perovskite with improved crystallinity. Our approach enables perovskite cells with PCEs of up to 24.91%. The devices retained 93.8% of their initial PCEs after 1000 hours of continuous operation under maximum power point tracking. These findings showcase the potential of cobalt complexes as redox interfacial modifiers for high-performance perovskite photovoltaics.

A Graded Redox Interfacial Modifier for High‐Performance Perovskite Solar Cells

Perovskite solar cells have emerged as a potential competitor to the silicon photovoltaic technology. The most representative perovskite cells employ SnO2 and spiro‐OMeTAD as the charge‐transport materials. Despite their high efficiencies, perovskite cells with such a configuration show unsatisfactory lifespan, normally attributed to the instability of perovskites and spiro‐OMeTAD. Limited attention was paid to the influence of SnO2, an inorganic material, on device stability. Here we show that improving SnO2 with a redox interfacial modifier, cobalt hexammine sulfamate, simultaneously enhances the power‐conversion efficiency (PCE) and stability of the perovskite solar cells. Redox reactions between the bivalent cobalt complexes and oxygen lead to the formation of a graded distribution of trivalent and bivalent cobalt complexes across the surface and bulk regions of the SnO2. The trivalent cobalt complex at the top surface of SnO2 raises the concentration of (SO3NH2)‐ which passivates uncoordinated Pb2+ and relieves tensile stress, facilitating the formation of perovskite with improved crystallinity. Our approach enables perovskite cells with PCEs of up to 24.91%. The devices retained 93.8% of their initial PCEs after 1000 hours of continuous operation under maximum power point tracking. These findings showcase the potential of cobalt complexes as redox interfacial modifiers for high‐performance perovskite photovoltaics.

Experimental and theoretical analysis on the thermomechanical properties of functionally graded graphene nanoplatelet reinforced cement composites

Graphene reinforced cement composites (GRCCs) have attracted great attention due to their excellent mechanical and physical properties. Instead of uniform distribution, the functionally graded distribution of graphene fillers can effectively utilize the mechanical and physical properties of the reinforcements while reducing cost. This paper is the first attempt to combine experimental analysis and theoretical modelling to investigate the thermomechanical properties of functionally graded graphene nanoplatelet (GNP) reinforced cement composites (FG-GNPRCCs). Samples with uniform (profile H) and functionally graded (profiles X, O and A) distribution of GNPs were prepared and tested. Among all the FG distribution patterns as involved, profile X exhibited the most pronounced enhancement. Compared to the uniform distribution at room temperature, the loss factor and storage modulus of profile X increased by 19.3 % and 19.5 %, respectively. Based on the effective medium theory (EMT) and Mori-Tanaka (MT) model, a parallel triple-inclusion model was developed to predict the thermal conductivity of GNPRCCs. The effects of coated GNP, agglomeration and the attributes of pores (i.e., size, shape and porosity) on the thermomechanical properties of the composites were considered. Dynamic mechanical analysis revealed that profile X had the best energy dissipation and the extent of inelastic deformation within the temperature range from −50 °C to 70 °C. In contrast, profile A is beneficial for scenarios that desire a gradual transition and controlled stress along a certain direction.

Teaching a New Obturation Technique in Preclinical Endodontic Training: Assessment of Student Learning Experience, Performance, and Self-Evaluation

IntroductionThis study investigated the impact of implementing hydraulic condensation (HC) as a second obturation technique in the Endodontic Preclinical course for dental students trained in warm vertical compaction (WVC). MethodsA total of 70 students performed root canal treatment of 2 extracted molars; they performed the HC technique for the first time after a demonstration. The combination of the obturation technique (WVC or HC) and the type of molar (maxillary or mandibular) was randomly assigned, resulting in 4 groups (n = 35). The students answered a questionnaire appraising their learning experience and completed a self-evaluation rubric. Masked instructors graded projects. Data were statistically analyzed (significance set at 5%). ResultsMost of the students (91%) considered learning 2 obturation techniques relevant and considered it difficult to perform the downpack in molars (P < .05). About half of the students (45.7%) responded that HC resulted in fewer errors and disagreed that WVC derives in a more homogeneous obturation; accordingly, 52.9% of the students selected the highest self-grading for HC obturations, while only 38.6% for WVC. No significant difference was found in the distribution of grades attributed by students and instructors (P > .05). Students reported significantly higher levels of confidence for HC and difficulty for WVC (P < .05). No difference was found between the techniques regarding the presence of voids. The presence of multiple errors was more frequent for WVC (P < .05). ConclusionThe findings indicate a positive learning experience and comparable performance among preclinical dental students in implementing HC as an alternative obturation technique.

Does supportive feedback on class rank improve scores for intermediate-level microeconomics?

Instructors may use low-cost, light-touch strategies to help students achieve optimal effort in demanding upper-level courses. The authors of this study exploit an intervention that provides a series of personalized feedback emails to students about their relative performance, which is tied to approving messages or tips that encourage improvement. The authors analyze the efficacy of this supportive rank feedback in an intermediate-level microeconomics theory course, given the challenges it poses to students. Evidence shows gains from feedback across the grade distribution, but they are short-lived and decline toward zero as the course progresses.