Value Of Factor Research Articles

Functional analysis of TkWRKY33: A key regulator in drought-induced natural rubber synthesis in Taraxacum kok-saghyz

WRKY proteins, which form a transcription factor superfamily that responds to jasmonic acid (JA) signals, regulate various developmental processes and stress responses in plants, including Taraxacum kok-saghyz (TKS). TKS serves as an ideal model plant for studying rubber production and lays the foundation for a comprehensive understanding of JA-mediated regulation of natural rubber synthesis. In the present study, we screened and identified a valuable transcription factor, TkWRKY33, based on transcriptome data from TKS in response to JA. We investigated its role in the regulation of natural rubber synthesis within the JA signaling pathway and its function in response to drought stress. Through protein-protein interactions and transcriptional regulation analysis, we found that TkWRKY33 may regulate natural rubber synthesis through the JA-TkMPK3-TkWRKY33-(TkGGPS5/TkACAT8) cascade pathway, possibly by participating in JA-activated mitogen-activated protein kinase (MAPK) signaling. Overexpression of TkWRKY33 in tobacco, along with functional analysis of drought resistance and comparative analysis of natural rubber content after drought stress, revealed that TkWRKY33 not only enhances plant drought resistance by regulating the expression of genes related to reactive oxygen species (ROS) scavenging through the JA signaling pathway, but also has a close relationship with the signal transduction pathway mediated by the JA hormone in regulating natural rubber synthesis.The TkWRKY33 is recognized as a valuable transcription factor, which likely plays a role in regulating natural rubber biosynthesis through the JA-activated MAPK cascade signaling pathway JA-TkMPK3-TkWRKY33-(TkGGPS5/TkACAT8).

The effect of handedness and biological sex on fingermark ridge height and volume as examined by 3D imaging.

For decades, detectives and forensic scientists have relied on friction ridge skin comparisons to identify individuals in criminal investigations. This method involves examining (latent) fingermarks, typically captured as two-dimensional (2D) images, and comparing them with known inked impressions or scans. The comparisons focus on general patterns, the location and orientation of minutiae, and additional characteristics like scars or pores. However, this common process overlooks other potentially valuable factors, such as handedness, biological sex, and the time since deposition, which could provide crucial investigative leads, especially in cases with partial or unclear ridge patterns. This study explored the potential of three-dimensional (3D) optical profilometry (OP) to observe changes in fingermarks ridge height and volume over 7 days while considering hand dominance and biological sex. The results indicated that all the assessed 3D metrics were generally consistent in detecting the effects of sex and handedness, mostly noticeable on aged fingermarks. Specifically, females and impressions from their non-dominant hand exhibited higher values. Additionally, the influence of time was evident, with fresh fingermarks showing significantly larger ridges in terms of height and volume. These findings suggest that 3D OP can enhance the probative value of fingermarks by inferring additional characteristics such as sex, handedness, and the age of the impression. These activity-level propositions could provide useful information in cases where only partial or poor-quality fingermarks are recovered, providing new data dimensions that could lead to more comprehensive forensic examinations.

Invasive Fungal Rhinosinusitis: The First Histopathological Study in Vietnam.

Invasive fungal rhinosinusitis (IRFS) is a rare but highly fatal disease. The two primary groups of pathogens, Mucorales and Aspergillus, require different treatments and have distinct prognoses. This study aimed to analyze the histopathological features of IFRS. We conducted a retrospective study involving 57 IFRS cases. Demographic and comorbid characteristics were obtained from clinical records. Two pathologists independently examined the histopathological features using H&E, PAS, and GMS-stained slides. Fungal groups were identified with PCR under the guidance of histopathology. The mean age of IFRS was 58.9 ± 13.4. The male-to-female ratio was 1.4:1. 100% of cases had diabetes comorbidity. Mucorales, Aspergillus, and other fungi were found in 61.4%, 33.3%, and 5.3% of cases, respectively. No Aspergillus and Mucorales co-infections were detected. Histopathology and PCR results were strongly concordant in classifying pathogens (Cohen's kappa = 84.2%, 95% CI 60.1% - 100%, p < 0.001). Mucormycosis exhibited higher rates of extensive necrosis and vascular invasion, and lower rates of pigment and spore presence than the non-Mucormycosis group (p < 0.001, p = 0.01, p = 0.02, p = 0.03, respectively). Extensive necrosis and vascular invasion were statistically significantly correlative (OR = 13.03, 95% CI 2.62-64.75, p = 0.002). IFRS predominantly affects older adults and males. Histopathology is a reliable method for differentiating between Mucorales and Aspergillus. When extensive necrosis is detected, it is critical to investigate for vascular invasion carefully. The vascular invasion, degree of necrosis, pigments, and spores are valuable factors for distinguishing fungal agents of IFRS.

Factors Affecting Investment Decisions of Individuals: A Comparative Study Between Developed and Emerging Markets (The Case of Jordan)

This study aimed to analyze the factors influencing individuals' investment decisions in Jordan, comparing emerging markets (such as Jordan) and developed markets (such as Dubai). The sample included 100 individual investors (50 from Jordan and 50 from Dubai), and a 30-item questionnaire covering economic, psychological, social, and technical factors was used. The results showed that economic factors such as inflation and growth significantly influence investment decisions in both markets, but without significant statistical differences, as the T-statistic value for economic factors was 0.8665 and the P-value was 0.3883. On the other hand, psychological factors were more influential in developed markets, as the T-Statistic showed a value of -4.3778 and the P-value was 0.00003, indicating that Dubai investors bear more risks than Jordan. Technical factors significantly impacted developed markets, as the F-statistic value was 9.623 and the P-value was 0.0025. In contrast, the study showed that investors in emerging markets face more significant challenges compared to developed markets, with a T-Statistic of 6.6154 and a P-Value of 0.0000000019. The study recommends increasing government support to enhance political and economic stability in emerging markets to mitigate investor challenges. It also recommends enhancing the use of technology in investing in emerging markets, and improving financial education to encourage informed risk-taking. In addition, it is suggested that regulators in developed markets adopt strategies that support greater transparency and clarity of investment opportunities to facilitate decision-making.

Inter-Nation Equity And The Regulation of Tax Competition via the Global Minimum Tax Rule: A Case for Improvement

The Organization for Economic Co-operation and Development (OECD) is an institution that influences policymaking in international tax law, and it is changing the international tax architecture to deal with tax competition by encouraging countries to adopt a global minimum tax rule. This emerging rule – called Pillar Two in international tax circles – is inadequate for dealing with poverty and inequality in an asymmetrical global context. The rule is premised on the notion and argument that tax competition is a problem for international tax law. Notwithstanding, there is existing research and evidence to show that tax competition can also be a solution to the enormous challenge of poverty and inequality as it can have a redistributive effect. This is a valuable factor amid the inefficiently asymmetrical global society with extreme poverty in many countries and enormous wealth in a few others.This article submits that the Pillar Two minimum tax rule – the Global Anti-Base Erosion (GloBE) Rules encompassing the income inclusion rule (IIR), undertaxed payment/profit rule (UTPR), and qualified domestic minimum top-up tax (QDMTT) – should incorporate inter-nation equity to prevent exacerbating global inequality and poverty. Pillar Two intensifies these for at least two reasons: (1) it restricts the positive redistributive effects of tax competition on an inefficiently asymmetrical global society, and (2) it encourages tax competition more suited for high-income countries (HICs) and less suited for those that are low-income countries (LICs). There is latitude to incorporate a differentiated principle deriving from inter-nation equity into this new Pillar Two rule designed to regulate tax competition globally. This proposal requires that the emerging rule be disenabled in certain circumstances to enable LICs to choose whether to apply the rule without being worse off. The article’s proposal seeks to allow LICs room for effective tax competition needed to attain sustainable development goals.

Prediction the Occurrence of Thalassemia With Hematological Phenotype by Diagnosis of Abnormal HbA1c.

The current investigation aims to analyze the occurrence of thalassemia in patients who participated in hemoglobin A1c (HbA1c) testing in clinical laboratory showing high hemoglobin F (HbF) level (≥ 1.5%) or abnormal Hb peak and predict the main influence factors by using different statistical models. The current investigation is a single-center retrospective cohort study. HbA1c concentration was detected by using TOSOH HLC-723G8 glycated hemoglobin analyzer. SNaPshot SNP (Single Nucleotide Polymorphism) typing and AccuCopy technology were employed to detect mutations in thalassemia-related pathogenic genes. A total of 126 patients endured high HbF levels or abnormal Hb peak during HbA1c detection, and 66.7% of subjects (n = 84) showed thalassemia mutations. Three heterozygosity mutations, including c.52A>T (p.K18*), c.-78A>G, and c.126_129delCTTT(p.F42Lfs*19) present in HBB gene, were also identified. --SEA/αα mutation demonstrated the youngest ages (p < 0.001). 17 M (p < 0.001) and 41/42 M (p < 0.01) mutations with β-thalassemia showed higher HbF levels compared with patients without thalassemia mutations. Except for -α3.7, mutations in thalassemia showed lower levels of mean corpuscular hemoglobin (MCH) and mean corpuscular volume (MCV) compared with patients without thalassemia mutations. Patients with thalassemia mutations showed younger age (p < 0.001), lower Hb (p < 0.001), MCV and MCH levels (p < 0.001), higher red blood cell (RBC)count (p < 0.001), and platelet distribution width (PDW) level (p = 0.007) than patients without thalassemia mutations. Three statistical models indicate MCV is the most valuable independent factor for predicting thalassemia and ROC (receiver operating characteristic) curves analysis of AUC (Area Under the Curve) of 0.855 (95% CI [0.787-0.923], p < 0.001) with MCV. High HbF level (≥ 1.5%) or abnormal Hb peak present in HbA1c testing indicated high incident rate of thalassemia. MCV is the most valuable independent predicting factor for subjects having thalassemia.

Association of triglyceride-glucose-body mass index with all-cause and cardiovascular mortality among individuals with chronic kidney disease

There is still a paucity of research on the relationship between triglyceride-glucose-body mass index (TyG-BMI) and long-term all-cause and cardiovascular disease (CVD) mortality in patients with chronic kidney disease (CKD). The objective of this study was to explore the relationship between the TyG-BMI index and mortality rate and to determine valuable predictive factors for the survival status of this population. Data were obtained from the National Health and Nutrition Examination Survey (NHANES 2001–2018) and the National Death Index (NDI). We used multivariate Cox regression and restricted cubic spline (RCS) to analyze the link between the TyG-BMI index and all-cause and CVD mortality. Subgroup analysis was conducted according to age, gender, race, education and poverty. In addition, receiver operating characteristic (ROC) curves were utilized to assess the differentiation of the TyG-BMI index in predicting mortality. A total of 3089 individuals were enrolled. Over a median follow-up period of 81 months, 1097 individuals passed away. The RCS analysis revealed a U-shaped link between the TyG-BMI index and all-cause and CVD mortality. The ROC curve indicated that the TyG-BMI index has a stronger diagnostic effect than the TyG index. Subgroup analysis results demonstrated that the TyG-BMI index was more significantly correlated with all-cause and CVD mortality rates in elderly patients. In the American population, a U-shaped association was discovered between the baseline TyG-BMI index and all-cause and cardiovascular mortality rates in CKD patients. The thresholds for all-cause and CVD mortality were found to be 299.31 and 294.85, respectively.

BOARD ATTRIBUTES AND SUSTAINABILITY REPORTING OF LISTED FIRMS IN NIGERIA

This study investigates the impact of board attributes on sustainability reporting among listed firms in Nigeria from 2013 to 2022, using a correlational research design. The research population encompasses all Nigerian listed firms, with a stratified sampling technique deemed appropriate for the study. Secondary data were sourced from the audited annual reports and accounts of sampled firms available on the Nigerian Exchange Group (NGX) website. The analysis of the extracted panel data was conducted using multiple regression techniques with STATA version 13. The findings of the study reveal that board size, gender diversity, and independence positively influence sustainability reporting, while board commitment has a negative impact on sustainability reporting. Consequently, the study recommends that the management of Nigerian listed firms should view large and diverse boards as an asset for promoting sustainability reporting. Such boards, comprising experienced and knowledgeable members, are more likely to make effective decisions on sustainability-related issues. Additionally, the presence of women on boards should be considered a valuable factor in encouraging comprehensive financial reporting, which includes qualitative and quantitative information on the social, environmental, and economic activities of the business for stakeholders.

Effect of using MgO coating with multiple coatings on the optical properties of a five-layer stack

تم استخدام المادة العازلة MgO ذات معامل الانكسار العالي (H) 1.737 مع أربعة مواد عازلة BaF2 (فلوريد الباريوم) و Al2O3 (الألومينا) و GdF3 (فلوريد الجادولينيوم) و LaF3 اللانثانوم فلورايد ذوات معامل انكسار واطيء (L) 1.4825 و 1.5322 و 1.59 و 1.6056 على التوالي كطلاءات بصرية لخمس طبقات وللتصميمين الأول هو ((Glass/H/L/H/L/H والثاني (Glass/L/H/L/H/L) ، باستخدام برنامج MATLAB. تم حساب الخصائص البصرية (M، Rvis.، Rsol.، Tsol.) للطلاءات البصرية الأربعة المتكونة ، وذلك لمعرفة أي طلاء منها كفوء لتلوين زجاج الأنظمة الشمسية المستخدمة كواجهات للأبنية وأيها غير كفوء. تظهر النتائج أنه في التصميم الأول (Glass/H/L/H/L/H) للطبقات الخمس ، يوجد طلاءان فقط لهما كفاءة للتلوين ، وهما الطلاءان (MgO + BaF2) و (MgO + Al2O3) ، لأنهما يحققان القيم المطلوبة من عامل الجدارة (M) والانعكاسية المرئية Rvis. حيث ان القيم المطلوبة لقيم عامل الجدارة (M) و.Rvis والتي تجعل الطلاء كفوءاً للتلوين هي 6% و12% على التوالي ، ولهما قمة انعكاس منتظمة وحادة للتلوين في المنطقة المرئية. في التصميم الأول ، يتناسب معامل الانكسار عكسياً مع الخصائص البصرية للطلاء وبالتالي كفاءة تلوين الطلاء ، مما يعني أن طلاء (MgO + BaF2) أكثر كفاءة من طلاء (MgO + Al2O3) للتلوين. يعتبر التصميم الثاني (Glass/L/H/L/H/L) للطبقات الخمس غير كفوء للتلوين للطلاءات الأربعة ( (MgO + BaF2 ، (MgO+ Al2O3) ، (MgO + GdF3) ، MgO + LaF3)) لأنها لا تمتلك القيم المطلوبة من (M) و . Rvis

Cervical facet joint degeneration, facet joint angle and paraspinal muscle degeneration are correlated with degenerative cervical spondylolisthesis at C4/5: a propensity score-matched study

BACKGROUND CONTEXTPrior studies have hypothesized that degenerative cervical spondylolisthesis (DCS) may be influenced by loss of stability due to disc, facet joint or cervical alignment. Meanwhile, it is commonly believed that the facet joints and paraspinal muscles participate in maintaining cervical spine stability. However, the impact of paraspinal muscle morphology and detailed facet joint features on DCS requires further investigation. PURPOSETo compare facet joint characteristics, disc degeneration and muscle morphology between patients with DCS and those without DCS. STUDY DESIGN/SETTINGRetrospective cohort study. PATIENT SAMPLEConsecutive surgical patients with degenerative cervical spondylosis from June 2016 to August 2023 were recruited. OUTCOME MEASURESDCS was assessed on X-ray based on the translation distance. Cervical facet joint degeneration (CFD), the facet joint angle on the axial plane (FA-A) and the facet joint angle on the sagittal plane (FA-S), and facet joint tropism (FT) were measured on computerized tomography (CT). Paraspinal muscle degeneration was assessed on magnetic resonance imaging (MRI) including by the adjusted cross-sectional area (aCSA), the functional aCSA, the fat infiltration ratio (FI%). The Pfirrmann grade of the cervical disc was also evaluated. METHODSDemographic and clinical data were compared in matched and unmatched cohorts. Disc degeneration, muscle degeneration and facet joint characteristics, including FA, FT and CFD, were compared between patients with and without DCS. Furthermore, the degree of CFD was compared with that of adjacent segments in both groups. Additionally, logistic regression was performed to determine independent risk factors for DCS. Finally, the receiver operating characteristic (ROC) curve, area under the curve (AUC) and cutoff value for the risk factors were calculated. RESULTSA total of 431 surgical patients were propensity score matched for age, sex and BMI, and 146 patients were included in the final analysis, with 73 patients in the DCS group and 73 patients in the non-DCS group. DCS patients exhibited more severe CFD at C4/5 (segment with spondylolisthesis). Additionally, DCS was generally associated with more severe CFD, a more horizontal FA-S, more FT and worse paraspinal muscle health but similar disc degeneration. In addition, anterior spondylolisthesis was related to more severe CFD and decreased functional aCSA of the flexors and extensors. Finally, more severe CFD, a more horizontal FA-S and a higher FI% on deep extensor were revealed to be risk factors for DCS, with cutoff values of 1.5, 44.5̊, and 37.1%, respectively. CONCLUSIONSThis study demonstrated that CFD, the FA and FT and parasipnal muscle degeneration were associated with DCS. And may provide novel insight into the pathogenesis and nature history of DCS and suggest the evolution of degeneration in the cervical spine.

Evaluation of Sleep Behaviors in Male Football Players Participating in Youth Football Leagues

This article addresses a research study aimed at evaluating the sleep behaviors of young football players in Turkey. The research was conducted using a correlational survey design. The population consisted of male football players participating in the Turkey Football U 19 Elite A, U 17 Elite A, U 17 Elite B, U 19 Regional Development, U 17 Regional Development, and U 16 Development leagues, with a sample size of 203 players. Statistical methods such as normality analysis, Mann-Whitney U test, and Kruskal-Wallis H test were used for analysis. The study found no statistically significant differences in the variables of football year, position status, training day, regular medication use status, education level, and sleep duration among young football players. The data revealed that young players who stayed with friends at home or alone had higher sleep quality compared to those staying with their families at home. When analyzed according to the computer and phone usage variable, except for the sleep disorder factor, all sub-dimensions favored those using computers and phones. Regarding the playing status in development leagues, significant results were found in the sports factor sub-dimension for U 19 Elite A and U 19 Regional Development league players in relation to sleep quality factors. According to ASBQ Total Score averages, the values of U 19 Elite A league players were more significant compared to U 17 Elite A league players and U 16 Development league players. Regarding the sleep problem status variable, players indicating sleep problems had statistically higher values in sleep quality factors, Habitual sleep efficiency factors, and ASBQ Total Scores. In conclusion, it can be stated that there is a direct relationship between sleep and performance among U 19 Elite A young football players, and they act with this awareness.

Comparative analysis of macular characteristics in mCNV and contralateral eyes.

To illustrate the characteristics of perforating scleral vessels in macular regions between mCNV eyes and contralateral eyes in unilateral mCNV patients. This was a retrospective study that included patients with unilateral naive mCNV. The study aimed to identify and analyze the distribution of perforating scleral vessels (PSVs) in the macular region of mCNV eyes and contralateral eyes. The central macular choroidal thicknesses (mChT) were measured using optical coherence tomography angiography (OCTA). The grades of myopic atrophic maculopathy (MAM) and macular myopic diffuse chorioretinal atrophy (DCA) were evaluated within groups. The number of PSVs and mChT were compared between contralateral and mCNV eyes based on the grade of DCA. The ROC curves were utilized to explore the diagnostic indexes for mCNV. A total of 102 eyes from 51 patients with unilateral mCNV were included. There was no significance in the severity of MAM or the grade of DCA between mCNV eyes and contralateral eyes (p = 0.074, p = 0.054, respectively). The mean number of PSVs in mCNV eyes was fewer than the contralateral eyes [1.00 (1.00-2.00) vs. 2.00 (0.75-3.00), p = 0.030]. The mChT in mCNV eyes was thinner than the contralateral eyes [36.00 (25.00-53.75) μm vs. 46.00 (31.00-75.25) μm, p = 0.001]. The mean grade of DCA in mCNV eyes was higher than that in contralateral eyes [3.00 (3.00-3.00) vs. 3.00 (2.00-3.00), p = 0.004]. When DCA involved the macular region, there were more PSVs in contralateral eyes than in mCNV eyes [1.50 (1.00-2.00) vs. 2.00 (1.00-3.00), p = 0.042]. Similarly, when DCA involved the foveal region, there were more PSVs in contralateral eyes than in mCNV eyes [1.50 (1.00-2.00) vs. 3.00 (2.00-4.00), p = 0.004]. The grade of DCA and mChT were valuable factors for predicting mCNV eyes (AUC = 0.6566, p = 0.021; AUC = 0.6304, p = 0.029; respectively). When the extent of DCA exceeded the foveal region, the count of PSVs was a good diagnostic factor for predicting mCNV (AUC = 0.7430, p = 0.003). The mean amount of PSVs was significantly lower in the mCNV eyes compared to the contralateral eyes. When the extent of DCA exceeded the foveal region, the count of PSVs was a good diagnostic factor for predicting mCNV. Myopic eyes with a higher grade of DCA and a thinner mChT were more likely to develop mCNV.

Numerical integration method for two-parameter singularly perturbed time delay parabolic problem

This study presents an (ε, μ)−uniform numerical method for a two-parameter singularly perturbed time-delayed parabolic problems. The proposed approach is based on a fitted operator finite difference method. The Crank–Nicolson method is used on a uniform mesh to discretize the time variables initially. Subsequently, the resulting semi-discrete scheme is further discretized in space using Simpson's 1/3rd rule. Finally, the finite difference approximation of the first derivatives is applied. The method is unique in that it is not dependent on delay terms, asymptotic expansions, or fitted meshes. The fitting factor's value, which is used to account for abrupt changes in the solution, is calculated using the theory of singular perturbations. The developed scheme is demonstrated to be second-order accurate and uniformly convergent. The proposed method's applicability is validated by three model examples, which yielded more accurate results than some other methods found in the literature.

The Effect of a Vegan Diet on the Health Indicators and Outcomes of P atients with Type 2 Diabetes Mellitus.

Recently, there has been a notable increase in interest in various forms of vegetarianism, which may be due to the growing prevalence of health issues, such as Type 2 Diabetes Mellitus (T2DM). Adhering to a vegan diet may have positive health outcomes. As a result, we conducted a review article to gather data from previous research studies on the effects of a vegan diet on different aspects of managing patients with T2DM. We searched the PubMed website for research studies on how a vegan diet affects the outcomes of patients with T2DM. The research studies were categorized according to the type of data collected, such as prevalence, incidence, body weight, insulin resistance, glycemic control, and lipid profile. It was found that following a vegetarian diet can significantly reduce the risk of mortality from heart disease. Additionally, studies have demonstrated that a vegetarian diet is linked to several improvements in T2DM. However, long-term weight loss plans and managing T2DM is a comprehensive intervention that includes caloric restriction, exercise, and behavioral modification. Incorporating a vegan diet can be a valuable factor to consider in managing T2DM, as it can offer numerous benefits, such as increased insulin sensitivity, weight loss, and reduced blood sugar levels. It helps to reduce cholesterol levels, LDL, and triglyceride levels, which are all risk factors associated with T2DM. By reducing these risk factors, the vegan diet can improve the overall health of T2DM patients. </p>.

دراسة توصيلية وحسابية للكلورامفينيكول في مذيبات ودرجات حرارية مختلفة

في العمل الحالي ، تم قياس الموصلية الكهربائية للكلورامفينيكول في الماء والميثانول عند درجات حرارة مختلفة 293-313 كلفن . تم تسجيل كل من المواصلة المكافئة عند درجة التخفيف اللانهائي (Λ0) وثابت التجمع الايوني (KA) والمسافة بين الايونات (R) باستخدام معادلة لي ويتون وتم حساب المعلمات الديناميكية الحرارية (متغير المحتوى الحراري، طاقة جيبس الحرة، متغير العشوائية) وبالمثل ، هناك معلومات نظرية وفيرة حول سلوك المركب مع المذيبات المختلفة (الماء والميثانول) من خلال حساب طاقات أعلى مدار جزيئي مشغول وادنى مدار جزيئي مشغول من المركب 2،2-ثنائي كلورو – N- (1R,2S)]- 1،3- ثنائي هيدروكسي-1- (4- نيتروفينيل) بروبان-2- يل] أسيتاميد عن طريق الحسابات الكومبيوترية (AM1, PM3, HF) وكانت إمكانات المركب مختلفة عند تغيير المذيب نتيجة لتباين قيمة الطاقة والعوامل النظرية الأخرى مثل الحجم الجزيئي ، معلمات كونولي.

Risk predictive score and cord morphology classification for intraoperative neuromonitoring alerts in kyphosis surgery

BACKGROUNDIntraoperative neuromonitoring (IONM) alert is one of the worrying events of kyphosis corrective surgery, which can result in a postoperative neurological deficit. To our knowledge, there is no risk prediction score to predict such events in patients undergoing kyphosis surgery. PURPOSETo develop a new preoperative MRI-based cord morphology classification (CMC) and risk prediction score for predicting IONM alerts in patients with kyphotic deformity. STUDY DESIGNRetrospective analysis of prospectively collected data. PATIENT SAMPLEAbout 114 patients undergoing surgical correction for kyphotic deformity. OUTCOME MEASURESIntraoperative neuromonitoring alerts and postoperative neurological status using AIS grading. METHODSKyphotic deformity patients undergoing posterior spinal fusion were retrospectively reviewed. Based on the morphology of the spinal cord and surrounding CSF in MRI, there are 5 types of cord. Type 1 (normal cord): circular cord with surrounding visible CSF between the cord and the apex, Type 2 (flattened cord): cord with <50% distortion at the apex with obliteration of the anterior CSF; Type 3 (deformed cord): cord with >50% distortion at the apex with complete obliteration of the surrounding CSF; Type 4 (stretched cord): the cord is stretched and atrophied over the apex of the curve. Type 5 (translated cord): horizontal translation of the cord at the apex with buckling collapse of the vertebral column. Preoperative radiographs were used to measure the preoperative sagittal cobbs angle, sagittal deformity angular ratio (S-DAR), sagittal vertical axis (SVA), apex of the curve, and type of kyphosis. Clinical data like the duration of symptoms, clinical signs of myelopathy, neurological status (AIS grade), grade of myelopathy using the mJOA score, and type of osteotomy were documented. Multivariate logistic regression was used to determine the risk factors for IONM alerts and the risk prediction score was developed which was validated with new cohort of 30 patients. RESULTSA total of 114 patients met the inclusion criteria. IONM alerts were documented in 33 patients (28.9%), with full recovery of the signal in 25 patients and a postoperative deficit in 8 patients. Rate of IONM alerts was significantly higher in Type 5 (66%), followed by Type 4 (50%), Type 3 (21.1%), Type 2 (11.1%), and Type 1 (11.1%) (p-value<.001). Based on multiple logistic regression, 7 factors, namely preoperative neurological status, mJOA score≤6, presence of signs of myelopathy, apex of the curve above T5, preoperative sagittal cobbs, S-DAR, and MRI-based CMC, were identified as risk predictors. The value for the risk factors varies from 0 to 4, and the maximum total risk score was 13. The cut-off value of 6 had good sensitivity (84.9%) and specificity (77.8%) indicating a high risk for IONM alerts. The AUC of the predictive model was 0.92, indicating excellent discriminative ability. CONCLUSIONWe developed and validated a risk predictive score that identifies patients at risk of IONM alerts during kyphosis surgery. Identification of such high-risk patients (risk score≥6) helps in proper evaluation and preoperative counselling and helps in providing a proper evidence-based reference for treatment strategies.

Confidence-Aware Paced-Curriculum Learning by Label Smoothing for Surgical Scene Understanding

Curriculum learning and self-paced learning are the training strategies that gradually feed the samples from easy to more complex. They have captivated increasing attention due to their excellent performance in robotic vision. Most recent works focus on designing curricula based on difficulty levels in input samples or smoothing the feature maps. However, smoothing labels to control the learning utility in a curriculum manner is still unexplored. In this work, we design a paced curriculum by label smoothing (P-CBLS) using paced learning with uniform label smoothing (ULS) for classification tasks and fuse uniform and spatially varying label smoothing (SVLS) for semantic segmentation tasks in a curriculum manner. In ULS and SVLS, a bigger smoothing factor value enforces a heavy smoothing penalty in the true label and limits learning less information. Therefore, we design the curriculum by label smoothing (CBLS). We set a bigger smoothing value at the beginning of training and gradually decreased it to zero to control the model learning utility from lower to higher. We also designed a confidence-aware pacing function and combined it with our CBLS to investigate the benefits of various curricula. The proposed techniques are validated on four robotic surgery datasets of multi-class, multi-label classification, captioning, and segmentation tasks. We also investigate the robustness of our method by corrupting validation data into different severity levels. Our extensive analysis shows that the proposed method improves prediction accuracy and robustness. The code is publicly available at https://github.com/XuMengyaAmy/P-CBLS. <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Note to Practitioners</i> —The motivation of this article is to improve the performance and robustness of deep neural networks in safety-critical applications such as robotic surgery by controlling the learning ability of the model in a curriculum learning manner and allowing the model to imitate the cognitive process of humans and animals. The designed approaches do not add parameters that require additional computational resources.

Impact of Organizational Justice on Employee Productivity in Millat Tractors Limited

Employee Productivity has a significant effect on the wellbeing of employees and it is a valuable factor in an organization’s functions. The main intention of current research is to explore the connection of organizational Justice with employee productivity and this has impact on employee productivity. In Industrial sector of Lahore (Pakistan) so Millat Tractor Company has been considered as target population. We are selected randomly for conducting the research. Overall, 220 questionnaires were distributed. 190 complete questionnaires were returned back and used for analysis. Results demonstrated the direct positive influence of organizational justice on employee productivity. Moreover, results showed that the positive relationship between organizational justice and employee productivity. These results will be very helpful in fostering the efforts of HR specialists towards formulating and embedding the employee’s voice mechanism in industrial sector.

Association between trunk extensor strength and gait-induced back pain in the elderly with adult spinal deformity: a cross-sectional study.

The purpose of the present study was to investigate the association between quantitatively assessed trunk extensor strength and gait-induced back pain (GIBP) in patients with adult spinal deformity (ASD). Ninety-five patients with ASD aged ≥ 50 years who were admitted to our hospital between April 2018 and March 2023 were included in the study. GIBP was evaluated through a 6-minute walking test (6MWT), with GIBP being defined as the occurrence of back pain during the evaluation and inability to complete the test. The patients were divided into three groups: difficulty completing the 6MWT (Group 1), ability to complete the 6MWT with breaks (Group 2), and ability to complete the 6MWT without taking a break (Group 3). The main independent variable was trunk extensor strength, which was measured using a hand-held dynamometer. Ordered logistic regression analysis was conducted to assess the association between GIBP and trunk extensor strength while adjusting for basic characteristics and radiographic parameters as covariates. The numbers of patients with ASD included in each group were; 27 in Group 1 (28.4%), 31 in Group 2 (32.6%), and 37 in Group 3 (39.0%). An ordered logistic regression analysis adjusted for basic characteristics and radiographic parameters, trunk extensor strength was significantly associated with GIBP (odds ratios, 1.128; 95% confidence intervals, 1.025-1.242). The results of the present study strongly indicate that trunk extensor strength is a valuable factor associated with GIBP in patients with ASD.

Left atrial strain in neonates with congenital diaphragmatic hernia and length of stay in pediatric intensive care unit.

The role of cardiac left ventricle (LV) dysfunction in children with congenital diaphragmatic hernia (CDH) has gained increasing attention. The hernia allows abdominal mass to enter thorax and subsequently both dislocating and compressing the heart. The pressure on vessels and myocardium alters blood flow and may interfere with normal development of the LV. A dysfunctional LV is concerning and impacts the complex pathophysiology of CDH. Hence, assessing both the systolic and diastolic LV function in the newborn with CDH is important, and it may add value for medical treatment and prognostic factors as length of stay (LOS) in pediatric intensive care unit (PICU). LV strain is considered an early marker of systolic dysfunction used in the pediatric population. Left atrial (LA) strain is an echocardiographic marker of LV diastolic dysfunction used in the adult population. When filling pressure of the LV increases, the strain of the atrial wall is decreased. We hypothesized that reduced LA strain and LV strain are correlated with the LOS in the PICU of newborns with CDH. This retrospective observational cohort study included data of 55 children born with CDH between 2018 and 2020 and treated at Karolinska University Hospital, Sweden. Overall, 46 parents provided consent. Echocardiograms were performed in 35 children <72 h after birth. The LA reservoir strain (LASr), LV global longitudinal strain, LV dimensions, and direction of blood flow through the patent foramen ovale (PFO) were retrospectively assessed using the echocardiograms. Children with LASr <33% (n = 27) had longer stays in the PICU than children with LA strain ≥33% (n = 8) (mean: 20.8 vs. 8.6 days; p < 0.002). The LASr was correlated with the LOS in the PICU (correlation coefficient: -0.378; p = 0.025). The LV dimension was correlated with the LOS (correlation coefficient: -0.546; p = 0.01). However, LV strain was not correlated to LOS. Newborns with CDH and a lower LASr (<33%) had longer stays in the PICU than children with LASr ≥33%. LASr is a feasible echocardiographic marker of diastolic LV dysfunction in newborns with CDH and may indicate the severity of the condition.