General Conditions Research Articles

Excessive weight in pregnant women increases the chance of diagnosing periodontitis combined with tooth loss.

Excess weight (EW), especially in women of childbearing age, those who are pregnant, as well as postpartum, is a problem worldwide. Fat accumulation deregulates the inflammatory response, contributing to the development of health problems, such as periodontitis. This study investigated the association between EW and periodontitis during pregnancy. A cross-sectional, multicenter study involved 1745 postpartum women in Brazil. Socioeconomic-demographic data, gestational history, lifestyle behavior, and general and oral health conditions were obtained. Pre-pregnancy body mass index (BMI) was collected from medical records with EW being the exposure. Both tooth loss and clinical attachment level (CAL) were evaluated, and the presence of periodontitis was the outcome. Logistic regression, odds ratio (OR) and 95% confidence interval (95% CI), and quantile regression, beta coefficient and 95% CI, estimated the association between EW (BMI) and periodontitis and its combined effect with tooth loss ≥3, as dichotomous and continuous variables (CAL and tooth loss), with 5% significance level. The EW was 27.7% prevalent and periodontitis was 11.7%. There was a positive association between EW and periodontitis: ORadjusted:1.39; 95% CI:1.01;1.92 and between EW and periodontitis combined with tooth loss ≥3: ORadjusted:1.73; 95% CI:1.36;2.20. The adjusted association between EW and periodontitis as continuous variables was also positive, showing that for each unit of increased BMI, there was an elevation in the mean CAL (p=0.04) and tooth loss (p<0.01), with statistical significance. There was a moderate association between EW and periodontitis during pregnancy, with an even greater association of pregnant women with EW presenting periodontitis combined with tooth loss.

First transition dynamics of reaction–diffusion equations with higher order nonlinearity

AbstractIn this study, the dynamics of a reaction–diffusion equation on a bounded interval at the first dynamic transition point is investigated. The main difference of this study from the existing ones in the dynamic transition literature is that in this work, no specific form of the nonlinear operator is assumed except that it is an analytic function of and . The linear operator is also assumed to be a general operator with sinusoidal eigenvectors. Moreover, we assume that there is a first transition as a real simple eigenvalue changes sign. With this general framework, we make a rigorous analysis of the dependence of the first transition dynamics on the coefficients of the Taylor expansion of the nonlinear operator. The main tool we use in this study is the center manifold reduction combined with the classification of the dynamic transition theory. This study is a generalization of a recent work where the nonlinear operator contains only low‐order (quadratic and cubic) nonlinearities. The current generalization requires certain technical difficulties such as the validity of the genericity conditions on the Taylor coefficients of the nonlinear operator and a bootstrapping argument using these genericity conditions. The results of this work can be generalized in various directions, which are discussed in the conclusions section.

Lifetime cost analysis of concrete barriers and steel guardrails

This study investigates the lifetime costs associated with concrete barriers and steel guardrails. We introduce a cost analysis methodology that incorporates critical factors such as construction costs, maintenance costs, exposure risks during maintenance activities, and the costs imposed to traveling public through the increased traffic and the crash outcomes. We integrate various parameters including economic factors, road geometry, general weather condition, and traffic mix to estimate a location-dependent cost for each type of barrier accurately. A software tool, named CalBarrier, was developed during this study to carry out the calculations and the comparison of lifetime cost of aforementioned barriers. An inherent strength of this research is its reliance on recent real data extracted from various databases of California Department of Transportation (Caltrans), ensuring precision and relevance in accounting for various influential factors. Drawing insights from Caltrans practices and interviews with their personnel, this study emphasizes the intricate decision-making process involved in mitigating safety risks and reducing operational expenses. Although our data originates from California, the methodology for life cycle cost analysis, and our software are applicable for regions with different socio-economic conditions by deploying user input costs, making our findings a valuable resource for other areas facing comparable challenges.

A Day-to-Day Dynamical Approach to the Most Likely User Equilibrium Problem

The lack of a unique user equilibrium (UE) route flow in traffic assignment has posed a significant challenge to many transportation applications. The maximum-entropy principle, which advocates for the consistent selection of the most likely solution, is often used to address the challenge. Built on a recently proposed day-to-day discrete-time dynamical model called cumulative logit (CumLog), this study provides a new behavioral underpinning for the maximum-entropy user equilibrium (MEUE) route flow. It has been proven that CumLog can reach a UE state without presuming that travelers are perfectly rational. Here, we further establish that CumLog always converges to the MEUE route flow if (i) travelers have no prior information about routes and thus, are forced to give all routes an equal initial choice probability or if (ii) all travelers gather information from the same source such that the general proportionality condition is satisfied. Thus, CumLog may be used as a practical solution algorithm for the MEUE problem. To put this idea into practice, we propose to eliminate the route enumeration requirement of the original CumLog model through an iterative route discovery scheme. We also examine the discrete-time versions of four popular continuous-time dynamical models and compare them with CumLog. The analysis shows that the replicator dynamic is the only one that has the potential to reach the MEUE solution with some regularity. The analytical results are confirmed through numerical experiments. History: This paper has been accepted for the Transportation Science Special Issue on ISTTT25 Conference. Funding: This research was funded by the United States National Science Foundation’s Division of Civil, Mechanical and Manufacturing Innovation [Grant 2225087]. The work of J. Xie was funded by the National Natural Science Foundation of China [Grant 72371205]. Supplemental Material: The online appendix is available at https://doi.org/10.1287/trsc.2024.0525 .

Successful Electroconvulsive Therapy in a Patient With Catatonia and Maternal Duplication 15q11-13 Syndrome.

The 15q11-q13 chromosomal region contains genes encoding for GABA-A receptor subunits and is a known region of epigenetic modification associated with the development of neurodevelopmental disorders. The presence of at least one additional copy of the maternal 15q11-q13 results in a syndrome (maternal dup15q) characterized by intellectual disability, autism spectrum disorder, mood disorders, and epilepsy. Catatonia is a serious syndrome of behavioral and motor dysfunction, which occurs across a variety of psychiatric, neurologic, and general medical conditions, which has successfully been treated with benzodiazepines and electroconvulsive therapy. In this case report, we describe the treatment course of a patient with established maternal dup 15q with comorbid intellectual disability, autism spectrum disorder, bipolar mood disorder, and juvenile epilepsy who developed hypokinetic catatonia refractory to high-dose benzodiazepine therapy. In contrast with benzodiazepine treatment, electroconvulsive therapy resulted in rapid improvement in catatonic symptoms and return to premorbid baseline. This case suggests that electroconvulsive therapy can be safely delivered for some patients with maternal dup 15q and may be rapidly effective when benzodiazepine treatment results in inadequate symptom improvement.

Effective Application of Biocompatible Magnetite Nanoparticles in the Treatment of Multiple Sclerosis: Results of a Clinical Study

Multiple sclerosis (MS) is a serious neurological disorder due to its widespread prevalence, chronic nature, frequent progression to disability, and tendency to affect young people. The pathogenesis of MS is based on the immunopathogenesis hypothesis. Biocompatible magnetite nanoparticles, which exhibit selective sorption activity towards cell membrane surface proteins, circulating immune com-plexes, lymphocytotoxic antibodies, and the complement system, as well as enhance phagocytic ac-tivity and the completion index of leukocyte phagocytosis, can be effectively used for immunocor-rection. The main goal of the study is to slow the progression of MS, improve the neurological status and overall condition of the patient, and reduce the dynamics of the spread of demyelinating lesions in the brain. Materials and methods: A patient diagnosed with multiple sclerosis, secondary progres-sive type, cerebrospinal form, at the clinical aggravation stage was included in the study. Neurologi-cal status and disability were assessed using the EDSS scale, and brain MRI with contrast enhance-ment was performed. The nanodevice Micromage-B was administered orally as an immunosorbent and immunomodulator. The regimen and dosage of Micromage-B were personalized. Assessments of general condition and neurological status were conducted every 7 days for 6 months, with contrast-enhanced brain MRI performed in the 5th month. Results: The use of Micromage-B in MS treatment led to an objective improvement in neurological status, with reduced stiffness and fatigue in the lower extremities. Gait and coordination improved, hand tremors decreased, depression and concen-tration disorders subsided, appetite was restored, and speech improved. Throughout the treatment period, positive dynamics in the normalization of neurological status were observed. After 6 months, the total score on the EDSS scale decreased from 210 to 45. The most significant improvements were observed in the evaluation of the pyramidal system and coordination, with the EDSS Disability Scale score decreasing from 6.0 to 5.0. For the first time, contrast-enhanced brain MRI showed a reduction in the number of new demyelination foci by the 4th month of Micromage-B administra-tion. The positive changes in neurological status correlated with the MRI results. The recovery of central nervous system activity in MS is likely not only due to the immunosuppressive properties of magnetite nanoparticles but also due to the activation of remyelination mechanisms and oligoden-drocyte differentiation through enzymatic methylation. Conclusion: The use of biocompatible nanodevices in the complex treatment of MS is promising. Further improvement and study of the regimen and method of using biocompatible magnetite nanoparticles to enhance MS treatment effec-tiveness are required.

Nutritional management of hyperlipaemia in a jenny: a brief report.

An adult jenny (5-years-old, non-pregnant) was presented to the Veterinary Teaching Hospital (VTH) of the University of Sassari, with a recent history of appetite loss, extreme underweight condition and reluctance to move. On physical inspection, emaciation [body condition score, BCS: 3/9], muscular waste [muscular condition score, MCS: 1/5], loose/running faeces [faecal score, FS: 2/8], and a general state of mild dehydration were found. Blood analyses outlined a general undernourishment condition [circulating albumins, ALB: 17.6g/L (21.6-31.6g/L)] with underlying systemic inflammatory profile and moderate increase in circulating enzymes to explore liver function [aspartate amino-transferase, AST: 657 u/L (279-430 u/L); alanine amino-transferase ALT: 60 u/L (5-14 u/L); gamma-glutamyl-transferase, γ-GT: 87 IU/L (14-69 IU/L); total bilirubin close to the upper limit, TB: 0.20mg/dL(0.07-0.21mg/dL)]and hyperlipaemia [TG: 8.70 mmol/L (0.60-2.87 mmol/L)], following fat depots mobilisation, with total cholesterol closed to the lower limit of the physiological range. Hyper-phosphataemia was linked to haemolytic anaemia [P:1.81 mmol/L (0.77-1.39 mmol/L) and red blood cells, RBC: 4.14 1012/L (4.40-7.10 1012)] aligned with the TB to the upper limit. On ultrasound abdominal imaging, enlarged and hyper-echogenic liver was observed. Based on the clinical evaluation, a condition of hepatic lipidosis was diagnosed, requiring dedicated nutritional treatment to solve the extreme emaciation along with the metabolic disorder in support of medical therapy. A two-step feeding protocol was planned to support treatments aiming at immediate re-hydration (Ringer lactate solution 2ml/kg/8h). The nutritional objectives were meant at first to restart the voluntary feed intake. Gradual increasing energy provision through a palatable hay-based diet was planned to cover one fourth of daily metabolizable energy requirement calculated on the expected metabolic weight, adjusted according to the daily intake of feed and clinical condition. At the conclusion of this first 7-day phase, circulating blood parameters were closer to the reference values and the BCS moved from 3 to 4 out of 9. Bowel motility was restored, and faecal score improved (4/8). In the second phase, allowance to pasture and a combination diet with compound mixed feed were designed. Within four weeks of starting the nutritional plan, blood parameters were re-established to reference values. The gradual feed provision calculated in this two-phase approach proved successful in support of the overall clinical improvement observed after four weeks of treatment, in a severely undernourished jenny with compromised liver functions.

On local power of likelihood-based tests in von Mises regressions

The von Mises distribution has played a central role as a distribution on the circle. Its associated circular regression model has been applied in a number of areas. In this paper, we consider the von Mises regression model and, under a sequence of Pitman alternatives, derive the nonnull asymptotic expansions of the cumulative distribution functions of the likelihood ratio, Wald, Rao score, and gradient test statistics for testing a subset of the von Mises regression parameters, as well as for testing the concentration parameter. We then compare analytically the local power of these likelihood-based tests on the basis of the asymptotic expansions and provide conditions where one test can be more locally powerful than the other one in this class of regression models. Consequently, on the basis of the general conditions established, the user can choose the most powerful test to make inferences on the model parameters. We also provide a numerical example to illustrate the usefulness and applicability of the general result.

Long-term survival analysis of robotic esophagectomy for esophageal cancer.

Robotic esophagectomy has improved early outcomes and enhanced the quality of lymphadenectomy for esophageal cancer surgery. This study aimed to determine risk factors for long-term survival following robotic esophagectomy and the causes of long-term mortality. We included patients who underwent robotic esophagectomy at our institute between 2010 and 2022. Robotic esophagectomy was defined as a surgical procedure performed robotically in both the abdomen and thorax. Robotic esophagectomy was performed in patients at all stages, including advanced stages, even in patients with stage IV and supraclavicular lymph node metastasis. A total of 340 patients underwent robotic esophagectomy during the study period. Ivor-Lewis operation and McKeown operation were performed on 153 (45.0%) and 187 (55.0%) patients, respectively. The five-year survival rates based on clinical stages were as follows: 85.2% in stage I, 62.0% in stage II, 54.5% in stage III, and 40.3% in stage IV. Risk factors for long-term survival included body mass index, Charlson comorbidity index, clinical stages, and postoperative complications of grade 4 or higher. Among the cases of long-term mortality, recurrence accounted for 42 patients (61.7%), while non-cancer-related death occurred in 26 patients (38.2%). The most common cause of non-cancer-related death was malnutrition and poor general condition, observed in 11 patients (16.2%). Robotic esophagectomy has demonstrated the ability to achieve acceptable long-term survival rates, even in patients with cervical lymph node metastasis. However, addressing high-grade postoperative complications and long-term malnutrition remains crucial for further improving the long-term survival outcomes of patients with esophageal cancer.

Unbacked Cryptomoney, Fiscal Evasion and Environment Tax: Some Policy Recommendations in Europe

In a 2019 New York Times article, Paul Krugman declared himself a “crypto skeptic” and shared his pessimistic predictions for cryptocurrencies. Nevertheless, unbacked cryptomoney is now very important in our societies and has revolutionized the monetary and financial landscape as exemplified by the increased pressure from competent regulators to monitor and regulate it. Cryptocurrencies are described by their high volatility that permits regulators to define them as non-safe financial assets when it comes to energy consumption. The anonymous property of cryptocurrencies opens the door to tax evasion, making it especially susceptible to avoiding environment-related taxes aimed at tackling negative impact of climate change. Against this background, the paper sets a twofold aim: to demonstrate that unbacked cryptomoney is volatile and it may pose a threat to financial and fiscal stability; and to develop the idea that, given their different degrees of anonymity and their decentralisation nature, cryptocurrencies could actively participate in the process of tax evasion and therefore incur high costs for countries. Given the general ecological condition and ensuing concerns, it is clear that avoiding eco-taxes represents a serious issue since money from eco-taxation could have been invested in environmental social and governance projects. Therefore, a clear and compelling legal framework should be implemented worldwide to reduce the tax evasion phenomena via cryptomoney channels.

Root patterns and exact surface energy of the spin-1 Heisenberg model with generic open boundaries

Abstract We investigate the thermodynamic limit and exact surface energy of the isotropic spin-1 Heisenberg chain with integrable generic open boundary conditions by a novel Bethe ansatz method. We obtain the homogeneous (or two-term) Bethe ansatz like equations for the zero roots of the transfer matrix. Based on the patterns of the zero roots, we analytical calculate the densities of zero roots and the surface energies of the model in all regimes of the boundary parameters.&amp;#xD;

Abdominoplasty Combined with the Anterior Component Separation Technique for Reconstruction of Midline Large Ventral Hernias: Functional and Aesthetic Outcome Clinical Study

Abstract Background Large midline ventral hernias, diastasis of recti and the associated laxity and abdominal shape deformity, represent aesthetic and functional problems for the patients. So, the surgical treatment of both pathologies at the same time is highly recommended if the patient’s general condition permits. This can be achieved by a comprehensive technique incorporating abdominoplasty performed by a transverse lower abdominal incision into any of the hernia repair techniques. Objective The aim of this study is to evaluate the functional and aesthetic outcome of the combined abdominoplasty and anterior component separation technique in the management of midline ventral abdominal hernias. Patients and Methods This study is a prospective case control study that evaluates both functional and aesthetic outcome of performing abdominoplasty on patients with large midline ventral hernias. This study was conducted between December 2020 to March 2022 at the Plastic Surgery Department, Demerdash University Hospital, Cairo, Egypt. Study consisted of fifteen patients with different presentations of abdominal wall laxity and ventral hernias. Patients were evaluated regarding their age, BMI, degree of rectus diastasis, Pre-operative radiological findings, post Operative complication and hernia reoccurrence, patients’ satisfaction, and the pre-operative and post-operative umbilical measurements were compared. Results and Conclusion The current study showed that Abdomioplasty can be combined with complex hernia repair by anterior component separation technique within the same setting in high-risk patients safely with an excellent functional outcome and acceptable satisfactory aesthetic results. Although, this can be associated with an increased risk of postoperative surgical site complications such as; skin necrosis and wound infection. Patient characteristics associated with the development of complications following anterior component separation combined with abdominoplasty include obesity, previous abdominal procedures and previous pregnancies.

Economic Evaluation of Using Ultracapacitors in Electric Vehicles

The main challenge of hybridizing ultracapacitors (UCs) with batteries in electric vehicles is their uncertain economic viability, besides their complexity and weight, which should be fully addressed. Therefore, this article determines the general condition for achieving a justified economic system, which is held when the average annual cost (AAC) of a battery‐UC system over a vehicle's useful life is lower than the annual cost of a sole‐battery for a specific system design, energy management strategy, vehicle type, and driving style. As such, the energy storage system is designed in a case study vehicle, and the optimal current distribution is found by dynamic programming (DP) under UDDS, HWFET, and US06 driving cycles. Then, by economic analysis, it is indicated that although adding an UC incurs additional costs, it saves the AAC by improving the battery health and prolonging its lifespan up to a maximum of 15‐year calendar life, which proves its economic justification. Investing in UCs is more economically viable for vehicles with severe driving cycles and high current stress. Finally, the DP optimal trajectory is implemented into an experimental setup under the US06 driving cycle to verify the evaluated strategy.

Global dynamics of a diffusive competitive Lotka–Volterra model with advection term and more general nonlinear boundary condition

We investigate a competitive diffusion–advection Lotka–Volterra model with more general nonlinear boundary condition. Based on some new ideas, techniques, and the theory of the principal spectral and monotone dynamical systems, we establish the influence of the following parameters on the dynamical behavior of system (1.2): advection rates αu\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$\\alpha _{u}$\\end{document} and αv\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$\\alpha _{v}$\\end{document}, interspecific competition intensities cu\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$c_{u}$\\end{document} and cv\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$c_{v}$\\end{document}, the resources functions ru\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$r_{u}$\\end{document} and rv\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$r_{v}$\\end{document} of the two competitive species, and nonlinear boundary functions g1\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$g_{1}$\\end{document} and g2\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$g_{2}$\\end{document}. The models of (Tang and Chen in J. Differ. Equ. 269(2):1465–1483, 2020; Zhou and Zhao in J. Differ. Equ. 264:4176–4198, 2018) are particular cases of our results when gi≡const\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$g_{i}\\equiv const$\\end{document} for i=1,2\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$i=1,2$\\end{document}, and hence this paper extends some of the conclusions from (Tang and Chen in J. Differ. Equ. 269(2):1465–1483, 2020; Zhou and Zhao in J. Differ. Equ. 264:4176–4198, 2018).

Exploration of the effects of anisotropy and rotation on Rayleigh–Bénard convection of nanoliquid-saturated porous medium using general boundary conditions

This paper presents an analysis of Rayleigh–Bénard convection (RBC) of a Newtonian-nanoliquid-saturated anisotropic porous medium in the presence of rotation (Rayleigh–Bénard–Taylor convection). The investigation is performed using non-classical boundary conditions. The effect of various parameters on the onset of convection is presented graphically. The system sees stabilisation due to an increase in the rotation rate and thermal anisotropy parameter whereas the system destabilises due to an increase in the mechanical anisotropy parameter. The results of 82 limiting cases can be extracted from the current work. The results of free-free, rigid-free and rigid-rigid isothermal/adiabatic boundaries are obtained from the present study by considering appropriate limits. The results of the limiting cases of the present study are in excellent agreement with those observed in earlier investigations.

General Conditions of Evaluation of Evidence on Internal Conviction Through the Prism of Regulatory Realization of Principles in the Republic of Kazakhstan

General Conditions of Evaluation of Evidence on Internal Conviction Through the Prism of Regulatory Realization of Principles in the Republic of Kazakhstan

The evaluation of feasibility of ambulatory laparoscopic cholecystectomy using intraoperative instillation of bupivacaine: a retrospective observational study.

This study aimed to compare outcomes of opioid patients-controlled anesthesia (PCA) and intraoperative local anesthesia in terms of postoperative pain, lab results, patient surveys, and discharge scores to evaluate the feasibility of ambulatory laparoscopic cholecystectomy (LC). Patients who underwent LC for acute cholecystitis were assigned to the outpatient surgery (OPS) group or inpatient surgery (IPS) group according to the surgeon. In the OPS group, a mixture of bupivacaine and epinephrine was injected into trocar sites and sprayed on the surgical dissection field. Oral opioid and analgesics were given twice a day. In the IPS group, patients received opioid PCA. Numeric rating scale (NRS) for walking, erythrocyte sedimentation rate (ESR), CRP, self-assessed survey on general physical condition and discharge, and discharge score of ambulatory surgery were assessed postoperatively. NRS was significantly lower in the OPS group. There were no significant differences in ESR and CRP between the groups. Self-assessed survey on general conditions and the possibility of discharge were significantly better in the OPS group. The discharge scores at 3, 6, and 9 hours were significantly higher in the OPS group. Intraoperative instillation of bupivacaine at port sites and dissection fields had a better effect on short-term postoperative pain, patient surveys, and discharge criteria of ambulatory surgery than opioid PCA.

Crease instability in Gent-Gent hyperelastic materials

We study the crease instability of an incompressible Gent-Gent elastomer under general loading conditions. The Gent-Gent model has two distinct characteristics: the logarithmic nonlinearity triggered by I2 energy term and the strain hardening due to limiting chain extensibility. By performing finite element analysis combined with an evaluation of surface tension, we investigate the effects of the two characteristics on the critical creasing onset and the creasing onset delayed by surface tension. The results show that uniaxial compression induces logarithmic nonlinearity that accelerates the critical creasing onset, whereas equibiaxial compression hastens the initiation of strain hardening that delays the critical creasing onset. In addition, logarithmic nonlinearity mitigates the delay in creasing onset caused by surface tension under the uniaxial condition, and strain hardening suppresses creasing in cooperation with surface tension under the equibiaxial condition. Conversely, under the plane strain condition, two characteristics have little effect on the creasing onset delayed by surface tension.

Use of Semi-Indirect Evaporative Cooling in HVAC systems: experimental study

This study investigates the application of a Semi-Indirect Evaporative Cooler (SIEC) to develop a Decarbonised Evaporative-Based Air Conditioning System (DEBACS). The research aims to show the benefit of using the SIEC in combination with a traditional Air Conditioning Unit to enhance the energy efficiency of an HVAC system. The SIEC, constructed from ceramic material, operates in both dry and wet modes. By spraying water on the inner side, it functions as an efficient air-to-air recuperator, with the ceramic material improving water distribution and device performance. The SIEC device has been experimentally tested. Tests were conducted in both dry and wet modes across three airflow rates and three temperature levels. Moreover, a simple model that describes the SIEC behaviour in general operative conditions has been derived. Results indicated that under optimal conditions (lowest supply airflow), the SIEC achieved an efficiency ratio between 50 % and 70 % in dry mode, and nearly 100 % in wet mode, with the wet mode improving efficiency ratio by 30-50 %. These findings underscore the potential of the ceramic SIEC device as an effective technology for air conditioning systems, promoting energy efficiency, compliance with EPBD standards, and significant decarbonisation in the HVAC sector.

The predictive value of CHA2DS2-VASc score on the prognosis of patients with atrial fibrillation based on a prospective cohort study.

Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia encountered in clinical practice, and it is associated with an increased risk of mortality, stroke, and peripheral embolism. The risk of stroke in AF is heterogeneous and dependent on underlying clinical conditions included in current risk stratification schemes. Recently, the CHA2DS2-VASc score has been incorporated into guidelines to encompass common stroke risk factors observed in routine clinical practice. The aim of this study was to study the predictive value of CHA2DS2-VASc score on the prognosis of patients with AF to determine the correlation of major complications including cerebral infarction and intracranial hemorrhage in patients with AF with oral anticoagulant and antiplatelet aggregation drugs and to identify the risk factors for all-cause mortality. A prospective study was conducted on 181 patients with AF who underwent physical examinations at Hai'an Qutang Central Hospital from January 2020 to December 2020. The patient's general condition, chronic disease history, CHA2DS2-VASc [congestive heart failure, hypertension, age ≥75 years (doubled), diabetes, stroke (doubled), vascular disease, age 65 to 74 years, and sex category (female)] score, left ventricular ejection fraction (LVEF), lipid metabolism, and oral anticoagulant and antiplatelet aggregation medication during physical examination were recorded. By using telephone meetings to complete the follow-up, we tracked the patient's cerebral infarction, intracranial hemorrhage, and survival status within 2 years of follow-up, statistically analyzed the relationship between AF complications and medication, and grouped patients with AF based on the CHA2DS2-VASc score to evaluate its predictive ability for mortality outcomes in these patients. The patients were divided into four groups according to the medication situation, and the incidence of cerebral infarction in the combination group was significantly lower than that in the non-medication group (0.0% vs. 19.2%; P<0.01). The incidence of intracranial hemorrhage in the combination group was significantly higher than that in the non-drug group (13.8% vs. 0.0%; P<0.01). The logistic regression model indicated that patients with a history of cerebral infarction had an increased risk of death compared to those without a history of cerebral infarction [odds ratio (OR) =7.404; 95% confidence interval (CI): 2.255-24.309]. After grouping according to the CHA2DS2-VASc score, we found that there was a significant difference in the 2-year survival rate between patients with CHA2DS2-VASc score <5 and those with a score ≥5 (P<0.01). The characteristic curve analysis of the participants showed that the CHA2DS2-VASc score had good predictive ability for all-cause mortality in patients with AF (area under the curve =0.754), with a cutoff value of 4, a sensitivity of 62.50%, a specificity of 86.06%, and a 95% CI of 0.684-0.815. The CHA2DS2-VASc score demonstrated high predictive value for all-cause mortality in patients with AF.