Eighth Stage Research Articles

Development of ILeMBA to Improve Class V Student Learning Outcomes in Science and Technology Lesson Content in Tegal Regency Elementary Schools

In learning, to make it easier for students to understand the material, it is necessary to use media. This research aims to develop and test the feasibility, practicality, and effectiveness of ILeMBA in improving student learning outcomes in Natural and Social Sciences (IPAS) material on the structure of the earth's layers in class V elementary school. This type of research is Research & Development (R&D) with the Borg and Gall model which is limited to the eighth stage of this research. The research subjects involved 27 students (14 female students and 13 male students). The instruments used are expert validator sheets, needs questionnaires, responses, and test questions. The validation results from media experts reached 91% and 93% from material experts showed that the media was "very feasible". Teachers and students responded well, with a teacher response score of 100% and an average student score of 95%, entering the "very practical" criteria. The calculated t-test value is greater than the t-table on a small scale of 4.973 > 2.228 and on a large scale of 11.998 > 2.2021. The results of the N-Gain test scores on a small scale of 79% and a large scale of 91%, show a very high significant difference and improvement in student learning outcomes on the pretest and posttest. Thus, it can be concluded that ILeMBA is proven to be able to improve the learning outcomes of class V students in Natural and Social Sciences (IPAS) material on the structure of the earth's layers (natural and artificial features in waters and land).

Organization of outsourcing activity at Ukrainian enterprises

Introduction. Outsourcing is the best strategy to be ahead of the competition in today's market. Researches indicate that the activity of outsourcing companies is strongly affected by the war, which is relevant for Ukrainian companies. But, despite the fact that the topic of outsourcing activities is actively discussed in the scientific literature, not enough attention is paid to the issue of describing specific stages of the implementation of this activity at enterprises. The purpose of the paper is to determine the most optimal stages of the implementation of outsourcing activities at a Ukrainian enterprise in modern conditions. Results. Because of different problems exists a need to develop appropriate stages of outsourcing activities at Ukrainian enterprises. The first stage shows whether outsourcing is profitable. At the second stage, clear goals for outsourcing are expected to be established. The third stage describes the development of a description of the project, and the fourth stage is the selection of an appropriate outsourcing engagement model. At the fifth stage, the project budget and payment terms are established. The sixth and seventh stages involve planning and appointing an outsourcing manager, who in the eighth stage should send the project description to the relevant firms and review the proposals. The ninth stage is to choose an outsourcing company. At the tenth stage, risks associated with outsourcing are managed. The results and processes of outsourcing activities need to be monitored at the eleventh stage. The twelfth stage includes evaluating and adjusting the outsourcing, and the last stage is the outsourcing report. Conclusion. Outsourcing is a process that delegates some responsibilities and functions of the company to specific service providers. To create a successful outsourcing strategy at Ukrainian enterprises, it is advisable to implement thirteen stages of outsourcing activities. These stages should include the implementation of outsourcing opportunities and the management of related risks. Identifying risks with planned appropriate actions to mitigate them will set the company up for an active response. Understanding the implications of risk will help enterprise to have a control over the outsourcing process.

Analisis Implementasi Matriks dalam Estimasi Laju Pertumbuhan Populasi Wanita

Leslie matrix is a growth matrix used to estimate the growth rate of a population. Through the population growth rate, information can be obtained whether the growth tends to increase, decrease, or stabilize. The general form of the Leslie matrix is a square matrix in which the first-row entries contain values of female fertility rate , the subdiagonals contain values of female survival rate , and entries other than in the first row and sub diagonals are zero. This research is to determine the implementation of the Leslie matrix in estimating the female population growth rate in Situbondo Regency 2023 and its analysis. The stages of this research began with presenting the Leslie matrix population growth model for the next three years. The second stage is to determine the age class interval. Next, determine the initial age distribution vector. The fourth and fifth stages, respectively, are calculating the and the value. The next step is constructing the Leslie matrix. The seventh stage is to calculate the estimated female population. The eighth stage is determining the eigenvalue and ends with determining the dominant eigenvalue. Based on the results of the research that has been done, it is obtained that the estimated female population in Situbondo Regency 2023 tends to decrease with the acquisition of a dominant eigenvalue that is less than one. That information can be taken into consideration by the government in formulating population-related policies.

Development of Assessments to Measure Students' Science Literacy Ability: Rasch Modeling Analysis

Science literacy is a demand for education in the 21st century. The ability of science literacy in Indonesia is relatively low because the questions used are not based on scientific literacy. This research aims to produce assessment products that are suitable for use, then find out the responses of teachers and students, and find out the science literacy ability of students. The method in this research is Research and development (R&D) using the Borg & Gall development model to the eighth stage. The results obtained in this study are: (1) Product feasibility results based on material experts by 78% and declared feasible, then on media experts by 87.49% and declared possible. Then, the results of the validity of question items are displayed as suitable for use with a total of 20 valid questions, item reliability 0.90 (excellent). (2) The teacher's response result of 93.5% is excellent. Then, the response of students of 88.13% was excellent. (3) The lowest science literacy ability of students is in science as a way to conduct investigations, which is 34.50%, and the highest in science as a stem of science at 72.50%.

Dynamic Stress Test of Aero-engine Compressor Rotor Blade

To evaluate the effect of the compressor rotor blade on compressor blade fatigue, a non-contact dynamic stress measurement scheme of one aero-engine eighth stage compressor rotor blade was designed, and the dynamic stress test was carried out. Meanwhile, modal analysis of the eighth stage compressor rotor blade was done by finite element analysis software. Results show that between the range of the idle speed and the highest speed, there is no resonance for the eighth stage compressor rotor blade and the maximum vibration amplitude is less than 65 μm, which cannot result in high cycle fatigue failure.

Deep Einstein@Home All-sky Search for Continuous Gravitational Waves in LIGO O3 Public Data

We present the results of an all-sky search for continuous gravitational waves in the public LIGO O3 data. The search covers signal frequencies 20.0 Hz ≤ f ≤ 800.0 Hz and a spin-down range down to −2.6 × 10−9 Hz s−1, motivated by detectability studies on synthetic populations of Galactic neutron stars. This search is the most sensitive all-sky search to date in this frequency/spin-down region. The initial search was performed using the first half of the public LIGO O3 data (O3a), utilizing graphical processing units provided in equal parts by the volunteers of the Einstein@Home computing project and by the ATLAS cluster. After a hierarchical follow-up in seven stages, 12 candidates remain. Six are discarded at the eighth stage, by using the remaining O3 LIGO data (O3b). The surviving six can be ascribed to continuous-wave fake signals present in the LIGO data for validation purposes. We recover these fake signals with very high accuracy with our last stage search, which coherently combines all O3 data. Based on our results, we set upper limits on the gravitational-wave amplitude h 0 and translate these into upper limits on the neutron star ellipticity and on the r-mode amplitude. The most stringent upper limits are at 203 Hz, with h 0 = 8.1 × 10−26 at the 90% confidence level. Our results exclude isolated neutron stars rotating faster than 5 ms with ellipticities greater than within a distance d from Earth and r-mode amplitudes for neutron stars spinning faster than 150 Hz.

Development of Indonesian Language Teaching Materials Based on Local Wisdom on Historical Narrative Text Material for Grade V Students at SDN 5 Kebondalem Banyuwangi

This study aims to describe the development process, validity, and effectiveness of Indonesian language teaching materials based on local wisdom in historical narrative text material for fifth grade students at SDN 5 Kebondalem Banyuwangi. The type of research used is development research or better known as the Borg and Gall Research and Development (R&D) model. In this study, the steps for developing the Borg and Gall R&D model were only carried out up to the eighth stage, namely product trials. This is because at the eighth stage of development research it can be concluded the feasibility and effectiveness of the product being developed. Data collection techniques were carried out by observation, interviews, validation, questionnaires, and tests. Validity results by the three expert validators of media, language, and materials as well as practitioners show that the Indonesian language teaching materials based on local wisdom that have been developed get a score of 88.1 with very decent criteria. The product validity score of the student response questionnaire is 91% which is classified as very good. The effectiveness of teaching material products that have been developed in terms of the learning outcomes completeness score of 86,36 is classified as very good criteria. The level of product effectiveness when viewed from the student response questionnaire shows a final score 87 so that it belongs to the very effective category. Based on the test results, it shows that the developed Indonesian language teaching materials are very effective in the learning process of historical narrative text material in class V of elementary schools.

ANALYSIS OF THE DRAWING STAGES OF CHILDREN AGED 5-6 YEARS

This study aims to describe the stages of drawing work for children aged 5-6 years in the Bakti Ibu Begajah Playgroup, Sukoharjo District, Sukoharjo Regency. Based on the results of observations of children's drawing work put forward by Lowendfeld and Brittam, children aged 5-6 years are included in the pre-drawn period. Judging from the Observation instrument for the stages of drawing eight children aged 5-6 years, there is one child in the fifth stage, one child in the sixth stage, one child in the eighth stage and three children showing the ninth stage, one child in the tenth stage and the last one in the eleventh stage. Most of the children showed the results of the drawing in the nine stages of drawing observation. It was concluded that children's drawing results show different stages of the development of children's drawing with different characteristics and patterns of children aged 5-6 years because they are influenced by several factors such as interests, learning experiences, lifestyle and the environment around the child. By understanding the stages of drawing children, it can make it easier for educators to provide appropriate and directional stimulation to the next drawing stage.

Impact of Depth of Invasion Tumor Budding and Worst Pattern of Invasion on Clinical Outcome in Post-Operative Oral Cavity Squamous Cell Carcinoma

<h3>Purpose/Objective(s)</h3> Definitive treatment for oral cavity squamous cell carcinoma (OCSCC) is surgery followed by post-operative radiotherapy (PORT) with or without chemotherapy. Risk factors for PORT are T3/T4, node positive, lympho-vascular space invasion (LVI) or perineural invasion (PNI), close margin etc. Depth of invasion (DOI), tumor budding (TB) and worst pattern of invasion (WPOI) and tumor infiltrating lymphocytes (TILS) may have prognostic implications. We aim to report the incidence of these factors and its association with clinical outcome post-operative OCSCC patients treated at our institute. <h3>Materials/Methods</h3> 150 post-operative patients of OCSCC undergoing curative oncological resection were analyzed with median follow up time 18 months from year 2019 to 2021. WPOI (WPOI-5) was defined as tumor dispersion of ≥1mm between tumor satellites. High risk WPOI was defined as (WPOI 4/5). Tumor budding is defined as the presence of single cancer cell or cluster of <5 cancer cells at the invasive front. DOI and staging were used as per AJCC 8^th edition. Disease free survival (DFS) and overall survival (OS) were estimated with Kaplan- Meier method. <h3>Results</h3> Median age was 50 years with M:F ratio of 135:15. Tumor site was buccal mucosa: tongue:alveolus:others as 84 (56%):49 (32%):13 (8.6%):4 (2.6%). LVI:PNI: close/positive margin: extra nodal extension was seen in 57 (38%):52 (34%):35 (23%):33 (22%) patients respectively. DOI=>10, DOI<10, high risk WPOI, tumor budding and TILS were observed in 79(52.6%), 71(47.3%), 102(72.8%), 97(71.3%) and 30(21.5%) patients respectively. Association of these have been listed in Table 1. AJCC eighth stage was I:II:III:IV as 30 (20%):32 (21.3%):38 (25.3%):50 (33.3%). Median RT Dose was 60 Gray. Sixty-four patients received CTRT (Median 5 cycles). Median Overall Treatment Time (OTT) was 98 (95-120) days. 2-year OS and DFS for the entire cohort was 81% and 67% respectively. 2-year DFS for patient with TILS was 86% vs.64% without TILS (p=0.07). PNI (60% vs. 72%; p=0.06) and bone invasion (47% vs 84%; p=0.04) portended poorer DFS. TB, WPOI and DOI did not statistically impact DFS in our cohort. <h3>Conclusion</h3> TB, WPOI and DOI are often associated in post-operative OCSCC with other adverse risk features. Patients with TILS tend to have a better clinical outcome

Development and feasibility of culturally sensitive family-oriented dignity therapy for Chinese patients with lung cancer undergoing chemotherapy

ObjectiveIt is well-documented in the literature that dignity therapy is feasible and effectively improves the end-of-life experience of the terminally ill. In a similar vein, this study aimed to develop and investigate the feasibility of evidence-based and culturally sensitive family-oriented dignity therapy for Chinese patients with lung cancer undergoing chemotherapy. MethodsThree phases of the Medical Research Council framework were adopted to guide the development of the novel dignity therapy intervention. It was preliminarily designed based on a qualitative study and a systematic review, Erikson's eighth stage of psychosocial development, and the dignity model. The feasibility and acceptability of the intervention were examined in a pilot randomized controlled trial with 12 recruited dyads of patients and family caregivers. ResultsThe intervention consists of three face-to-face sessions that facilitate participants’ reminiscences and promote their communication. Recruitment and response rates for the feasibility study of the intervention were 92.3% and 75%, respectively. Both patients and family caregivers reported that the intervention alleviated their psychological distress and improved communication. ConclusionsThe Medical Research Council framework serves as a useful scientific basis for modifying dignity therapy with a culturally sensitive approach. The results of the feasibility study suggest that the family-oriented dignity therapy intervention is feasible, acceptable and has the potential to enhance the effects of dignity therapy.

E-BOOK EKONOMI BERBASIS KOMIK DIGITAL SEBAGAI MEDIA UNTUK MENINGKATKAN HASIL BELAJAR

The aim of economic e-book development based digital comics is as a medium to improve learning outcomes. The development stage employed Borg and Gall’s model consisting of 10 stages and this development is limited to the eighth stage: large-scale tryout. The e-book tryout stage was conducted through expert validation and tryout with students. The instruments used in this research were questionnaire and test. The method used was pretest posttest control group design. Considering the result of t-test, it could be found that the posttest value of experiment class was better (84.29), while that of control class was only 79.80. Furthermore, in the effectiveness test on digital comic-based economy e-book using t-test withy IBM SPSS 20 software help, it could be seen that the significance value was 0.000 and this value was less than 0.05, meaning that H1 was supported. This value was confirmed with tstatistic of 3.804 &gt; ttable of 2.021. It suggested that the mean score of learning outcomes for experiment class students was better that that for control ones and it could be concluded that the digital comic-based economy e-book effectively improved the students’ learning outcome.

Stage migration and treatment outcome in carcinoma tongue - A comparison of seventh and eighth AJCC pathological staging systems.

The eighth edition of the American Joint Committee on Cancer (AJCC) for oral cancer has incorporated additional pathological features like depth of invasion (DOI) and extranodal extension (ENE) into T and N staging. The incorporation of these two factors will impact the staging and, hence, the treatment decisions. The aim of the study was to clinically validate the new staging system in predicting the outcome in patients treated for carcinoma oral tongue. The study also examined the correlation of pathological risk factors with survival. We studied 70 patients with squamous cell carcinoma of the oral tongue who underwent primary surgical treatment at a tertiary care center in the year 2012. All these patients were restaged pathologically according to the new AJCC eighth staging system. The 5-year overall survival (OS) and disease-free survival (DFS) were calculated using the Kaplan-Meier method. Akaike information criterion and concordance index were calculated between both staging systems to identify a better predictive model. Log-rank test and univariate Cox regression analysis were conducted to find out the significance of different pathological factors on outcome. Incorporation of DOI and ENE resulted in 47.2% and 12.8% stage migration, respectively. DOI less than 5 mm was associated with a 5-year OS and DFS of 100% and 92.9%, respectively, compared to 88.7% and 85.1%, respectively, when the DOI was more than 5 mm. Presence of lymph node involvement, ENE, and perineural invasion (PNI) were associated with inferior survival. The eighth edition had lower Akaike information criterion and improved concordance index values compared with the seventh edition. The eighth edition of AJCC allows better risk stratification. Restaging of cases based on the eighth edition AJCC staging manual resulted in significant upstaging with difference in survival.

Layanan Bimbingan Dan Konseling Terhadap Anak Terlantar Di Rehabilitasi Sosial UPTD PSBS Dinas Sosial Provinsi Kepulauan Bangka Belitung

Abstract Guidance and Counseling Services for Abandoned Children and Abandoned Persons/Elderly in Social Rehabilitation UPTD PSBS Social Service of the Archipelago Province. This research is a descriptive qualitative research that aims to find out how the guidance and counseling services provided to neglected children and the elderly in social rehabilitation UPTD PSBS Social Service of the Bangka Belitung Islands Province. The data sources used are primary data, namely the Head of the Social Apocation Program, the Head of Subdivision of TU, ​​and the Head of Guidance and the secondary data are books, journals, theses, archives, and official documents at the Office of Social Institutions for Bina Serumpun Province of the Bangka Belitung Islands Province. Collecting data using the method of observation, interviews and documentation. The results showed that: Guidance and counseling services for abandoned children and abandoned people in the UPTD PSBS of the Archipelago Province Social Service can be classified into eight stages, namely the first stage: Initial Approach, second stage: acceptance, third stage: care, fourth stage: maintenance, and Social Protection Care, Fifth Stage: Assessment Stage, Sixth Stage: Coaching Stage, Seventh Stage: Distribution Stage, Eighth Stage: Termination Stage.

Predicting Ego Integrity Using Prior Ego Development Stages for Older Adults in the Community.

Background: Erikson’s ego development theory is the most accepted theory that involves eight stages of psychosocial development over an individual`s all lifespan. The result of development in prior stages will influence the later stages. The elderly were mainly characterized by the central developmental tasks: achieving ego integrity vs. despair. The harvest in the last stage will be related to the attitude of facing death in the elderly. Methods: A cross-sectional study of elderly age from 65 to 90 years old (n = 292) was carried out and investigated via the Inventory of Psychosocial Balance. Pearson correlation and path analysis were performed in order to analyze the direct and indirect effect among the first seven stages with the eighth stage. Results: We found that all the eight stages were significantly related to each other, and comparing to the previous seven stages, “the generativity stage” (r = 0.77) was the most relevant stage with “ego integrity”. In all indirect and direct effects, the seventh stage had the greatest impact on the “ego integrity stage”; the direct effect was 0.89. Conclusions: Compared to the whole lifespan, adulthood possessed a higher influence on the elderly stage. We found that all the eight stages were significantly related to each other, and comparing the first seven stages, the “generativity stage” (r = 0.77) was the most relevant stage to “ego integrity”. Conclusions: Compared to the whole lifespan, adulthood possessed a higher influence on the elderly stage.

Radiomic Features Associated With HPV Status on Pretreatment Computed Tomography in Oropharyngeal Squamous Cell Carcinoma Inform Clinical Prognosis.

PurposeThere is a lack of biomarkers for accurately prognosticating outcome in both human papillomavirus-related (HPV+) and tobacco- and alcohol-related (HPV−) oropharyngeal squamous cell carcinoma (OPSCC). The aims of this study were to i) develop and evaluate radiomic features within (intratumoral) and around tumor (peritumoral) on CT scans to predict HPV status; ii) investigate the prognostic value of the radiomic features for both HPV− and HPV+ patients, including within individual AJCC eighth edition-defined stage groups; and iii) develop and evaluate a clinicopathologic imaging nomogram involving radiomic, clinical, and pathologic factors for disease-free survival (DFS) prediction for HPV+ patients.Experimental DesignThis retrospective study included 582 OPSCC patients, of which 462 were obtained from The Cancer Imaging Archive (TCIA) with available tumor segmentation and 120 were from Cleveland Clinic Foundation (CCF, denoted as SCCF) with HPV+ OPSCC. We subdivided the TCIA cohort into training (ST, 180 patients) and validation (SV, 282 patients) based on an approximately 3:5 ratio for HPV status prediction. The top 15 radiomic features that were associated with HPV status were selected by the minimum redundancy–maximum relevance (MRMR) using ST and evaluated on SV. Using 3 of these 15 top HPV status-associated features, we created radiomic risk scores for both HPV+ (RRSHPV+) and HPV− patients (RRSHPV−) through a Cox regression model to predict DFS. RRSHPV+ was further externally validated on SCCF. Nomograms for the HPV+ population (Mp+RRS) were constructed. Both RRSHPV+ and Mp+RRS were used to prognosticate DFS for the AJCC eighth edition-defined stage I, stage II, and stage III patients separately.ResultsRRSHPV+ was prognostic for DFS for i) the whole HPV+ population [hazard ratio (HR) = 1.97, 95% confidence interval (CI): 1.35–2.88, p < 0.001], ii) the AJCC eighth stage I population (HR = 1.99, 95% CI: 1.04–3.83, p = 0.039), and iii) the AJCC eighth stage II population (HR = 3.61, 95% CI: 1.71–7.62, p < 0.001). HPV+ nomogram Mp+RRS (C-index, 0.59; 95% CI: 0.54–0.65) was also prognostic of DFS (HR = 1.86, 95% CI: 1.27–2.71, p = 0.001).ConclusionCT-based radiomic signatures are associated with both HPV status and DFS in OPSCC patients. With additional validation, the radiomic signature and its corresponding nomogram could potentially be used for identifying HPV+ OPSCC patients who might be candidates for therapy deintensification.

Establishment of a Prognostic Nomogram for Patients With Locoregionally Advanced Nasopharyngeal Carcinoma Incorporating TNM Stage, Post-Induction Chemotherapy Tumor Volume and Epstein-Barr Virus DNA Load

ObjectivesTo establish and validate an effective nomogram to predict clinical outcomes for patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC).Materials and MethodsThe clinicopathological parameters and follow-up information of 402 locoregionally advanced NPC patients (training cohort, n = 302; validation cohort, n = 100) were retrospectively enrolled. The nomogram was built with the important prognostic variables identified by Cox regression analysis. Overall survival (OS) and progression-free survival (PFS) were the primary and secondary endpoints, respectively. The predictive power and clinical utility of the nomogram were assessed using the Harrell concordance index (C-index), calibration curve, and decision curve analysis. We compared the eighth staging system model with the nomogram to analyze whether the model could improve the accuracy of prognosisResultsEpstein–Barr virus (EBV) DNA load, the gross tumor volume (GTVnx), and cervical lymph node tumor volume (GTVnd) after induction chemotherapy were the independent predictors of OS and PFS. The calibration curves indicated superb agreement between the nomogram-predicted probabilities and observed actual probabilities of survival. The C-index and area under the receiver operator characteristic curve (AUC) of the nomogram integrating these significant factors and N stage, and TNM stage were higher than those of the eighth TNM system alone. In addition, the decision curve analyses demonstrated the clinical value and higher overall net benefit of the nomogram. High-risk groups identified by the nomogram had significantly poorer OS and PFS than the low-risk group (p < 0.05).ConclusionsThe multidimensional nomogram incorporating TNM stage, EBV DNA load, and tumor volume after induction chemotherapy led to a more precise prognostic prediction and could be helpful for stratifying risk and guiding treatment decisions in locoregionally advanced NPC patients who have undergone induction chemotherapy and concurrent chemoradiation.

Comparative assessment of the eighth and seventh AJCC staging edition prognostic performance of patients with p16 positive oropharynx cancer.

6067 Background: The American Joint Committee on Cancer (AJCC) TNM staging system defines the anatomical extent of disease and serves as a guide for treatment and prognosis. The favorable prognosis of p16+ oropharyngeal squamous cell carcinoma (OPSCC) compared to p16 negative counterpart led to major updates in the AJCC 8th edition. Its prognostic performance, however, warrants further validation. Methods: We included patients diagnosed with p16+ OPSCC enrolled in a prospective registry ( Stiefel) at The University of Texas MD Anderson Cancer Center between March 2015 and December 2018. Patients’ stage at diagnosis was classified according to the AJCC 7th (AJCC-7) and 8th (AJCC-8) editions. Overall survival (OS) and progression-free survival (PFS) was defined as time from diagnosis to death or to progression or death, respectively. The Kaplan-Meier method was used to calculate 1- and 3-year survival probabilities. Differences between groups were compared using the log-rank test. Prognostic discriminative performance of each staging system was evaluated using Harrel’s C-statistic. Survival differences between heavy (&gt; 10 pack-years [PY]) vs. light/never smokers (≤ 10 PY) by AJCC-8 staging groups was assessed with the log-rank test. Results: Of 463 patients, the median follow-up was 34.7 months (2.3-169.74). Nearly 90% (N=413) of patients were down-staged from AJCC-7 to AJCC-8 with 69% of patients with IVA disease based on AJCC-7 (N=319) re-staged as stage I (N=196 [42%]), II (N=79 [17%]) or III (44 [10%]) according to AJCC-8. Over 60% (N=279) of patients were staged as I with AJCC-8. Compared to AJCC-7, AJCC-8 had improved prognostic ability (C-statistic, 0.58 for AJCC-7 vs. 0.63 for AJCC-8) and provided better discriminative survival probabilities at 1 and 3-year follow-up (Table). Similar results were observed for PFS. Smoking status did not impact OS when stratified by AJCC-8 staging groups: I, p=0.347; II, p=0.310; and III, p=0.532 for &gt; 10 vs. ≤ 10 PY. Conclusions: Our cohort validates that the AJCC-8 provides better prognostic discriminative performance when compared to AJCC-7, however, a disproportionate number of patients were classified as stage I. Smoking was not associated with survival within each staging group.[Table: see text]

Public Policy Interests and Algorithm for Determining the Law Applicable to Private Law Relations Complicated by a Foreign Element

The study contains a step-by-step algorithm for determining the law applicable to private cross-border legal relations. The algorithm is developed based on legislation, law enforcement practice and doctrine. The initial rule of the sequential execution of the stages (steps) of the algorithm is a mechanism in which the determination of the law applicable to the legal relationship at one of the stages excludes the subsequent stages of the algorithm. Public policy interests dictate the rules for determining the law to be applied to private law relations complicated by a foreign element. The establishment by the legislator and law enforcement officer of the closest connection between the interests of conflicting public orders (legal orders) with elements of cross-border legal relations is the basis for the process regulation in the Russian Federation. At the first, second and third stages of the algorithm, the interests of the domestic public order (law and order) dominate. At the fourth stage of the algorithm, public interests in the part not regulated by super imperative norms are correlated with the agreement of the parties on the choice of the applicable law. At the fifth — eighth stages of the algorithm, the law enforcement officer is guided by the rules established by the legislator taking into account the interests of public orders that are conflicting in cross-border legal relations. At the last, ninth stage of the algorithm, the applicable law is established by the judge based on the closest connection between the interests of public order (law and order) with elements of crossborder legal relations.

Numerical Study on the Cavitation Flow and Its Effect on the Structural Integrity of Multi-Stage Orifice

Flow leakage due to cavitation erosion occurred at the socket welding part downstream of the multi-stage orifice installed in the auxiliary feedwater (AFW) pump recirculation line of the domestic nuclear power plant (NPP). To assess the adequacy of the changed operating flow rate proposed by a domestic NPP operator as the corrective measure concerning the flow leakage in the AFW pump recirculation line, the pattern of the cavitation flow in the eight-stage orifice and the connecting pipe depending on the magnitude of the operating flow rate was predicted by using ANSYS CFX R19.1. Additionally, using ANSYS Mechanical, the structural analysis was conducted under the same operating flow rate condition used for the flow analysis, and the structural integrity was evaluated for the allowable stress. Based on the flow analysis results, it was found that the operating flow rate was the main factor to influence the cavitation behavior inside the multi-stage orifice, and cavitation flow still happened even in the vicinity of the corrected operating flow rate, so it should be necessary to fundamentally review the adequacy of the multi-stage orifice design. On the other hand, the geometric dimensions and arrangement of orifice hole position at the individual stage of the multi-stage orifice may have a significant influence on the characteristics of pressure drop and flow patterns (including cavitation). Therefore, these effects were examined by simulating an analysis model in which the hole diameter of the eighth-stage orifice was changed under the design flow rate condition. As a result of flow analysis, it was found that reducing the hole diameter in the eighth stage orifice resulted in increasing the pressure drop. In relation to the structural integrity of the eight-stage orifice and the connecting pipe, it was found that its integrity could be maintained under the design and operating flow rate conditions.

Changes to Biceps and Supraspinatus Tendons in Response to a Progressive Maximal Treadmill-Based Propulsion Aerobic Fitness Test in Manual Wheelchair Users: A Quantitative Musculoskeletal Ultrasound Study.

Objective To investigate if the completion of a recently developed treadmill-based wheelchair propulsion maximal progressive workload incremental test alters the integrity of the long head of the biceps and supraspinatus tendons using musculoskeletal ultrasound imaging biomarkers. Method Fifteen manual wheelchair users completed the incremental test. Ultrasound images of the long head of the biceps and supraspinatus tendons were recorded before, immediately after, and 48 hours after the completion of the test using a standardized protocol. Geometric, composition, and texture-related ultrasound biomarkers characterized tendon integrity. Results Participants propelled during 10.2 ± 2.9 minutes with the majority (N = 13/15) having reached at least the eighth stage of the test (speed = 0.8 m/s; slope = 3.6°). All ultrasound biomarkers characterizing tendon integrity, measured in the longitudinal and transversal planes for both tendons, were similar (p = 0.063 to 1.000) across measurement times. Conclusion The performance of the motorized treadmill wheelchair propulsion test to assess aerobic fitness produced no changes to ultrasound biomarkers of the biceps or supraspinatus tendons. Hence, there was no ultrasound imaging evidence of a maladaptive response due to overstimulation in these tendons immediately after and 48 hours after the performance of the test.