Large Effect Research Articles

Effects of Single-Joint Type Hybrid Assistive Limb in Knee Rehabilitation on Reduction of Pre-motor Time and Increased Rate of Fast Muscle Activation for Anterior Cruciate Regiment (ACL) Reconstruction.

Changes in muscle characteristics after post-anterior cruciate regiment (ACL) reconstruction are common. Knee robotic-assisted therapy using hybrid assistive limb (HAL) single-joint training for recovery from ACL injury has the potential to optimize muscle activity; however, its neurophysiological effects remain unclear. Thus, this study aimed to explore the electrophysiological parameters. This prospective, nonrandomized, controlled trial was conducted between December 2021 and January 2024. The patients were divided into two groups: the HAL group and the control group, each including five patients who underwent arthroscopic ACL reconstruction. Knee HAL single-joint training was conducted once weekly for three sessions. Three electrophysiological measures were examined related to knee neuromuscular responses pre-motor time, peak amplitude time, and neuromuscular rate of electromyography rise (RER) using surface electromyography (EMG). The pre-motor time and peak amplitude time were assessed in both groups at each session pre- and post-intervention.Bothgroups were evaluated for RERat postoperative weeks 17 and 21. Regarding the interaction of pre-motor time within each group, the interaction of pre-motor time within each group, the effect size of vastus medialis (VM) was larger in the HAL group. The peak amplitude time of EMG, the overall estimated marginal means, and the HAL group exhibited a significant difference in the VM (p=0.019), while vastus lateralis (VL) showed no significant difference but a larger effect size (d=0.61). The RERrevealed a significant difference in semitendinosus-RER30ms in the HAL group (p=0.044). Theknee HAL training for post-ACL reconstruction patients may influence neurophysiological outcomes.

Community representation and policing: Effects on Black civilians

AbstractDoes increased representation of Black individuals in the police force lead to less aggressive policing of Black individuals? The current study uses a Chicago panel data set with monthly police unit observations between 2013 and 2015 to understand 1) how police units’ representation of Black individuals affects the number of stops of Black residents and 2) how individual police officers patrol differently depending on the racial/ethnic background of co‐working officers. Using fixed‐effects negative binomial regression, we found that increasing racial congruence between police officers and the community being patrolled was associated over time with fewer stops of Black residents. Individual analyses showed that Black (vs. White) officers stopped fewer Black civilians, with larger effects in police units with higher percentages of Black officers, indicating a unit group effect. Furthermore, as the number of Black officer co‐workers in a shift increased, Black civilian stops declined for all officers, including White officers, which is consistent with active representation. These findings indicate that a more diverse and representative police force can reduce aggressive policing of minority communities by mitigating group threat and cultivating positive cross‐racial exchanges within police organizations and smaller peer groups.

A systematic review and Bayesian meta-analysis of 30 years of stress generation research: Clinical, psychological, and sociodemographic risk and protective factors for prospective negative life events.

Stress generation posits that (a) individuals at-risk for psychopathology may inadvertently experience higher rates of prospective dependent stress (i.e., stressors that are in part influenced by their thoughts and behaviors) but not independent stress (i.e., stressors occurring outside their influence), and (b) this elevated dependent stress, in some measure, is what places these individuals at-risk for future psychopathology. In recognition of 30 years of stress generation research, we conducted a systematic review and meta-analysis using frequentist and Bayesian approaches (102 articles with 104 eligible studies, N = 31,541). Generally strong support was found for psychopathology predicting dependent stress (e.g., dsOverall psychopathology = 0.36-0.52, BF₁₀ = 946.00 to 4.65 × 10¹⁸). Moderator analyses for dependent stress revealed larger effects for briefer assessments periods, shorter follow-ups, and self-report measures than for interviews. Among risk factors, depressogenic cognitive styles (ds = .26-.50, BF₁₀ = 47.50 to 1.00 × 10⁵) and general interpersonal vulnerability (ds = .26-.44, BF₁₀ = 2.72 to 2708.00) received the strongest support as stress generation mechanisms, and current evidence is modest for protective factors predicting dependent stress. Overall, larger effects were generally found for prospective prediction of dependent stress than independent stress. Evaluations of mediation in the research literature were relatively few, limiting the current review to qualitative analysis of the mediation component of stress generation. General support was found, however, for dependent stress as a mediator for psychopathology and associated risk factors in relation to subsequent psychopathology. The current review ends with recommendations for future research and integration of stress generation within minority stress frameworks. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

α-Synuclein strain propagation is independent of cellular prion protein expression in a transgenic synucleinopathy mouse model.

The cellular prion protein, PrPC, has been postulated to function as a receptor for α-synuclein, potentially facilitating cell-to-cell spreading and/or toxicity of α-synuclein aggregates in neurodegenerative disorders such as Parkinson's disease. Previously, we generated the "Salt (S)" and "No Salt (NS)" strains of α-synuclein aggregates that cause distinct pathological phenotypes in M83 transgenic mice overexpressing A53T-mutant human α-synuclein. To test the hypothesis that PrPC facilitates the propagation of α-synuclein aggregates, we produced M83 mice that either express or do not express PrPC. Following intracerebral inoculation with the S or NS strain, the absence of PrPC in M83 mice did not prevent disease development and had minimal influence on α-synuclein strain-specified attributes such as the extent of cerebral α-synuclein deposition, selective targeting of specific brain regions and cell types, the morphology of induced α-synuclein deposits, and the structural fingerprints of protease-resistant α-synuclein aggregates. Likewise, there were no appreciable differences in disease manifestation between PrPC-expressing and PrPC-lacking M83 mice following intraperitoneal inoculation of the S strain. Interestingly, intraperitoneal inoculation with the NS strain resulted in two distinct disease phenotypes, indicative of α-synuclein strain evolution, but this was also independent of PrPC expression. Overall, these results suggest that PrPC plays at most a minor role in the propagation, neuroinvasion, and evolution of α-synuclein strains in mice that express A53T-mutant human α-synuclein. Thus, other putative receptors or cell-to-cell propagation mechanisms may have a larger effect on the spread of α-synuclein aggregates during disease.

Effects of forage feeding to calves on performance, rumen fermentation and nutrient digestibility: A meta-analysis

The literature on whether or not to feed forage is marked by inconsistencies, largely due to various factors associated with forage inclusion in calf diets. To elucidate these factors, we conducted a 3-level meta-analysis to comprehensively investigate the overall effects of forage provision in young calves. We searched for studies published between 2000 and 2023 in Google Scholar, ScienceDirect, and X-Mol. Moderator analyses were performed to evaluate the effects of different forage sources, forage provision methods, starter forms, milk levels and forage levels on the heterogeneity of growth performance, rumen fermentation and nutrient digestibility outcomes in studies feeding forage to calves. Mixed-effect model was used to predict the relationship between forage level and performance. Funnel plot and Egger's test were used to determine publication bias. A total of 86 treatment comparisons from 36 articles were included in the final data set. The weighted mean difference (WMD) was used to evaluate the effect size, and the statistical heterogeneity of the effect size was estimated using Cochrane's Q test. The results showed that forage supplementation improved growth performance, structural growth, and development of rumen fermentation in calves. However, moderator analyses revealed that several factors, including forage source, feeding method, physical form of starter, milk feeding level and forage feeding level might contribute considerably to variability, resulting in significant heterogeneity in the effects of forage provision in calves. Larger effect sizes were found for oat hay (OH) supplementation rather than alfalfa hay (AH) or straw, feeding forage as a free-choice (FC) compared with a total mixed ration (TMR; defined as a mixture of calf starter and forage), especially when forage was fed as a FC resulting in higher total dry matter intake (TDMI) and body barrel. Forage supplementation was more effective in boosting calf growth in calves provided ground starter than in calves fed pelleted and textured starter. Greater effects were shown for AH supplementation than OH or straw in improving rumen fermentation parameters. Furthermore, compared with the preweaning period, the effect of providing forage on calves was more noticeable in the postweaning period. The results of the mixed-effects model analysis indicated that calves can be efficiently fed 12% of dry matter as forage during the preweaning period to support their growth and development. Meanwhile, 9% of dry matter might be the optimal level for feeding OH and straw to preweaning calves. More studies are essential to explore how different levels of AH dietary supplementation affects calves during the preweaning period, to improve the consistency and accuracy of the dose-response curve predictions. Overall, growth performance and rumen fermentation of dairy calves were affected by forage inclusion. Moreover, forage source, feeding method, physical form of starter, milk feeding level, and forage level are essential factors that result in different degrees of effect on the calf's performance and rumen fermentation.

Team-based Learning (TBL) in Medical Education: Fostering Collaboration and Enhancing Learning Outcomes

ABSTRACT Background and Aim: Team-based learning (TBL) is an instructional strategy that has gained popularity in various educational settings, including anatomy courses. It is an active learning approach that encourages students to work collaboratively in small teams to solve problems, discuss concepts, and apply their knowledge. Therefore, the purpose of this study was to assess how well students engaged with and learned about anatomy through the medium of TBL. Materials and Methods: The current study was carried out for phase I MBBS students in the Department of Anatomy at KAHER’s J N Medical College, Belagavi. TBL sessions included 65 students. One week prior, students were provided pertinent reading materials for the gross anatomy topics that were chosen. The Pre-TBL test, which was composed of five MCQs based on case scenarios, was administered before the start of the session. Students completed the Individual Readiness Assurance Test (IRAT), which had ten multiple-choice questions (MCQs) at the start of the class. The students were then put into groups where they collaborated on the same MCQs, talked about the topics, and provided identical answers. This is called the Group Readiness Assurance Test (GRAT). A post-TBL test was given after the case scenario discussion to wrap up the session. This test’s questions were the same as those on the Pre-TBL. Results: The effect sizes provide insights into the magnitude of change observed between pre-TBL and post-TBL test scores. In this study, significant statistical differences were found between pre and post-TBL tests across all sessions [Table 1, P < 0.001], indicating larger effect sizes associated with more significant improvements in learning outcomes attributed to TBL. This aids in interpreting the statistical significance of the results. Conclusion: TBL can help students achieve academic success through teamwork. Study revealed that TBL is one of the most effective ways to teach anatomy and can complement traditional didactic lectures.

Intraocular Lens Power and Corneal Topographic Change After Pterygium Surgery

PurposeTo investigate the impact of pterygium excision on intraocular lens (IOL) power calculation and corneal astigmatism. DesignsProspective cohort study MethodsWe enrolled 30 eyes with primary pterygium that underwent pterygium excision with a conjunctival autograft. IOL power calculation and keratometry using the IOL Master 700, along with topographic parameters using the Pentacam Scheimpflug topography system, were performed preoperatively and at 1, 3, 6, and 12 months postoperatively. We analyzed correlations between pterygium length/area and IOL power, as well as corneal topographic changes. ResultsThe mean pterygium length was 2.08 ± 0.58 mm, and the mean area was 6.05 ± 2.41 mm2. One year after pterygium surgery, the calculated IOL power values using all formulas were lower than the preoperative values. Pterygia with a horizontal length of 1.73 mm and an area of 4.45 mm2, and those with a horizontal length of 2.25 mm and an area of 6.95 mm2 created 0.5 D and 1.0 D errors in calculated IOL power, respectively (p<0.001). The calculated IOL power values changed significantly from preoperative to six months postoperatively but did not change significantly from six to 12 months postoperatively. Pterygia with a horizontal length greater than 1.83 mm (p<0.001) and an area greater than 5.1 mm2 (p < 0.001) created a 2.0 D error in anterior corneal astigmatism. ConclusionsPterygium causes errors in IOL power calculation, with greater pterygium length/area exerting a larger effect. Cataract surgery with IOL implantation is recommended at least six months after pterygium surgery. In combined case, calculated IOL power should be decreased by 0.5-1.5 D based on the pterygium length/area.

The whole is lesser than the sum of its parts? Dissecting layer-enriched samples of rodent placenta is worth the effort

Gene expression in the placenta, assessed by bulk RNA-seq, is a common method to explore placental function. Many rodent studies homogenize the entire placenta, and yet doing so may obscure differences within specific functional regions such as the labyrinth, junctional zone and decidua. Conversely, analysis of the whole placenta could generate apparent differences due to changes in composition (e.g., relative amounts of labyrinth vs junctional zone) rather than differential gene expression. We assess the value of dissecting and separately analysing the labyrinth and junctional zone/decidua by comparing RNA-seq results from the labyrinth, junctional zone/decidua combined, and whole placenta from an experiment examining effects of maternal food restriction and fetal sex in C57BL6/J mice at gestational day 17.5. The number of genes identified as differentially expressed in response to maternal food restriction was substantially higher in the labyrinth (910 genes), than in the junctional zone/ decidua (50 genes), which in turn was slightly higher than in the whole placenta (3 genes). Only one gene was differentially expressed in all 3 tissue types, and 20 genes were differentially expressed in both the labyrinth and junctional zone/decidua. The larger number of differentially expressed genes in the labyrinth was due to both larger effect sizes and estimates of effect sizes having smaller standard errors. While dissection to obtain layer-enriched samples is slightly more time-consuming than collection of whole placenta and requires some practice, our results show that layer-enrichment is clearly worth the effort.

Quantification choices for individual differences: An example of mapping self-report to psychophysiological responses

A popular focus in affective neuroscience research has been to map the relationships between individual differences (e.g. personality and environmental experiences) and psychophysiological responses, in order to further understand the effect of individual differences upon neurobehavioral systems that support affect and arousal. Despite this trend, there have been a lack of practical examples demonstrating how the quantification of individual differences (e.g. categorical or continuous) impacts the observed relationships between different units of analysis (e.g. self-report > psychophysiological responses). To address this gap, we conducted a two-stage aggregated meta-analysis of self-reported intolerance of uncertainty (IU) and skin conductance responses during threat extinction (k = 18, n = 1006) using different quantification choices for individual differences in self-reported intolerance of uncertainty (continuous, categorical via median split, and categorical via extremes – one standard deviation above/below). Results from the meta-analyses revealed that the different quantification techniques produced some consistent (e.g. higher IU was significantly associated with skin conductance responding during late extinction training) and inconsistent IU-related effects. Furthermore, the number of statistically significant effects and effect sizes varied based on the quantification of individual differences in IU (e.g. categorical, compared to continuous was associated with more statistically significant effects, and larger effect sizes). The current study highlights how conducting different quantification methods for individual differences may help researchers understand the individual difference construct of interest (e.g. characterisation, measurement), as well as examine the stability and reliability of individual difference-based effects and correspondence between various units of analysis.

Impact of trade on industry-level output

This study examines whether a country's trade significantly increases industry-level output and whether this impact is greater for industries with higher levels of differentiation. To empirically answer these questions, the Frankel and Romer [(1999). “Does Trade Cause Growth?” American Economic Review 89 (3): 379–399] method, which uses the geographical component of trade as an instrument, is extended in two ways. First, the study examines the impacts on industry-level output instead of country-level output. Second, an index of industry differentiation based on Rauch [(1999). Networks Versus Markets in International Trade.” Journal of International Economics 48 (1): 7–35] is introduced. Using a two-stage least squares estimation and data for 20 manufacturing industries and 99 countries in 2015, it is found that the impact of a country’s trade on industry-level output and output per worker is heterogeneous across industries. A one-percentage-point increase in the trade/GDP ratio results in a larger effect for industries with higher degrees of differentiation, ranging from 0.340% to 1.736% for industrial output and from 0.754% to 1.566% for industrial output per worker. This heterogeneity with respect to industry differentiation is robust even when controlling for latitude and institutional variables. These results suggest that a country’s trade affects industry-level output differently depending on the industry’s level of differentiation.

Exercise and Acute Cognitive Enhancement.

Substantial research has explored the effects of a single session of exercise on cognitive performance. Meta-analytic reviews provide summary statistics relative to these effects when the cognitive task is performed while exercising and when performed after exercise. When performed concomitantly the effects of exercise are typically small or negative with the exception of moderate effects for speed of cognitive performance during moderate intensity exercise. When cognitive performance is assessed following the cessation of exercise, the effects are typically positive. When considering the effects following exercise, most studies have focused on executive function and episodic memory as the cognitive outcomes of interest with meta-analyses supporting small-to-moderate benefits. When potential moderators related to exercise parameters or participants characteristics are examined, results suggest that 20 minutes of moderate to vigorous intensity exercise consistently benefits performance with larger effects evident for executive function tasks with higher cognitive demands, for long-term memory tasks when exercise is performed prior to information encoding, and when considering individuals with lower initial cognitive performance levels. These observed benefits are likely due to the impacts acute exercise can have on physiological arousal, brain function, and brain neurotrophic factors. Advancements in our understanding of the potential of a single session of exercise to benefit cognitive performance are important for exercise prescription and to inform chronic exercise programs designed to benefit cognition.

Heart Rate Variability Biofeedback as a Treatment for Military PTSD: A Meta-Analysis.

Emerging research has provided tentative support for the use of heart rate variability biofeedback (HRVB) as a treatment for several psychological disorders, with meta-analyses providing compelling evidence for HRVB as a promising treatment for anxiety, depression, and PTSD. Given the prevalence of PTSD in military veterans and the comparatively lower benefit and higher attrition rate of traditional psychological treatment for PTSD relative to civilian counterparts, it is important to examine complementary and alternative treatment approaches such as HRVB in this population. Although studies of HRVB for PTSD have been conducted with military veterans, they have involved relatively small sample sizes, limiting interpretation. To address this, the current article presents a comprehensive meta-analysis, consolidating existing literature to more accurately evaluate the efficacy of HRVB in reducing PTSD symptoms within military populations. This meta-analysis was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, and our protocol was registered with PROSPERO to increase review transparency. A literature search of HRVB interventions was conducted using PubMed, PsycINFO, Military Database, PTSDPubs, and EBSCO's Psychological and Behavioral Sciences Collection. Five studies met eligibility criteria, providing a combined sample size of 95 military services members. For all studies, effect sizes were negative, indicating a reduction in PTSD symptoms. Effect sizes ranged from -1.614 to -0.414, resulting in an overall moderate to large mean effect for HRVB (Hedges's g = -0.557; 95% confidence interval = -0.818 to -0.296; P < .001). Additionally, cumulative attrition was 5.8%, significantly lower than commonly reported rates for evidence-based treatments (16%-36%). The present study is the first meta-analysis to examine HRVB as a treatment for military service members with PTSD. Results indicate that HRVB may be a viable treatment approach to reduce PTSD symptomatology. Low attrition rates, ease of accessibility, and favorable participant outlook serve as additional benefits for the use of HRVB.

Immorality backward, morality forward? Metaphorical morality in Chinese-English bilinguals.

This study explored whether instructing participants to make forward or backward joystick movements in response to morality words is consistent with the conceptual metaphor MORAL IS MOVING FORWARD/IMMORAL IS MOVING BACKWARD in Chinese-English bilinguals' first and second languages. Chinese-English bilinguals were instructed to categorize words as moral or immoral while moving a joystick in a compatible block (moral-forward, immoral-backward) and an incompatible block (moral-backward, immoral-forward). The results revealed three main conclusions: First, participants showed faster categorization of immoral words when their responses involved backward joystick movements compared to forward joystick movements. Second, participants also demonstrated a slightly faster categorization of moral words when their responses involved backward joystick movements compared to forward joystick movements. Third, Chinese morality words were categorized faster overall than English morality words. However, despite a slightly larger effect size observed in L1, the action compatibility effects for morality words exhibited a similar pattern across both languages. In sum, bilinguals showed shared access to the IMMORAL IS MOVING BACKWARD conceptual metaphor across both L1 and L2, but they did not access the MORAL IS MOVING FORWARD conceptual metaphor in either L1 or L2. This study provides new evidence supporting the conceptual metaphor theory.

Nurse understaffing associated with adverse outcomes for surgical admissions.

Nurses play a crucial role in maintaining the safety of surgical patients. Few nurse staffing studies have looked specifically at surgical patients to examine the impact of exposure to low staffing on patient outcomes. A longitudinal patient analysis was conducted in four organizations in England using routine data from 213 910 admissions to all surgical specialties. Patients' staffing exposures were modelled as counts of understaffed registered nurse and nurse assistant days in the first 5 inpatient days. Understaffing was identified when staffing per patient-day was below the mean for the ward. Cox models were used to examine mortality within 30 days of admission and readmission within 30 days of discharge. Generalized linear models were used to investigate duration of hospital stay and occurrence of hospital-acquired conditions. Increased exposure to registered nurse understaffing was associated with longer hospital stay and increased risk of deep vein thrombosis, pneumonia, and pressure ulcers. This was also true for nurse assistant understaffing, but the effect sizes tended to be smaller. In the Cox models, there were similarly increased hazards of death for registered nurse understaffing (HR 1.09, 95% c.i. 1.07 to 1.12) and nurse assistant understaffing (HR 1.10, 1.08 to 1.13), whereas the effect size of registered nurse understaffing for readmission (HR 1.02, 1.02 to 1.03) was greater than that seen with nurse assistants (HR 1.01, 1.01 to 1.02). Understaffing by both registered nurses and nursing assistants is associated with increased risks of a range of adverse events, and generally larger effects are seen with registered nurse understaffing.

Field-induced slow magnetic relaxation in a mononuclear Dy(III) complex with octahedral geometry

We have synthesized a mononuclear Dy(III)-based complex, [Dy(CyPh2PO)3Cl3)] (1) (CyPh2PO = cyclohexylbisphenylphosphine oxide), constructed from a phosphine oxide ligand and a light halogen Cl donor. The Dy(III) ion presents an octahedral geometry where two O atoms from two phosphine ligands locate at two vertexes, while the equatorial positions are completed by three Cl anions and a O atom from another phosphine ligand. Magnetism results reveal that slow relaxation of the magnetizations exists in 1 under an extra dc field because of the significant quantum tunnelling of magnetization (QTM) at 0 Oe dc field. The lighter Cl ions in equatorial plane result in a larger effect to QTM, and thus smaller contribution to slow magnetic relaxation.

A meta-analysis of performance advantages on athletes in multiple object tracking tasks

This study compared the multiple object tracking (MOT) performance of athletes vs. non-athletes and expert athletes vs. novice athletes by systematically reviewing and meta-analyzing the literature. A systematic literature search was conducted using five databases for articles published until July 2024. Healthy people were included, specifically classified as athletes and non-athletes, or experts and novices. Potential sources of heterogeneity were selected using a random-effects model. Moderator analyses were also performed. A total of 23 studies were included in this review. Regarding the overall effect, athletes were significantly better at MOT tasks than non-athletes, and experts performed better than novices. Subgroup analyses showed that expert athletes had a significantly larger effect than novices, and that the type of sport significantly moderated the difference in MOT performance between the two groups. Meta-regression revealed that the number of targets and duration of tracking moderated the differences in performance between experts and novices, but did not affect the differences between athletes and non-athletes. This meta-analysis provides evidence of performance advantages for athletes compared with nonathletes, and experts compared with novices in MOT tasks. Moreover, the two effects were moderated by different factors; therefore, future studies should classify participants more specifically according to sports levels.

Genetic architecture of telomere length in 462,666 UK Biobank whole-genome sequences

Telomeres protect chromosome ends from damage and their length is linked with human disease and aging. We developed a joint telomere length metric, combining quantitative PCR and whole-genome sequencing measurements from 462,666 UK Biobank participants. This metric increased SNP heritability, suggesting that it better captures genetic regulation of telomere length. Exome-wide rare-variant and gene-level collapsing association studies identified 64 variants and 30 genes significantly associated with telomere length, including allelic series in ACD and RTEL1. Notably, 16% of these genes are known drivers of clonal hematopoiesis—an age-related somatic mosaicism associated with myeloid cancers and several nonmalignant diseases. Somatic variant analyses revealed gene-specific associations with telomere length, including lengthened telomeres in individuals with large SRSF2-mutant clones, compared with shortened telomeres in individuals with clonal expansions driven by other genes. Collectively, our findings demonstrate the impact of rare variants on telomere length, with larger effects observed among genes also associated with clonal hematopoiesis.

Impacts of River Network Connectivity on Flood Signatures and Severity Regulated by Flood Control Projects

The operation of hydraulic projects within plain river networks to mitigate floods can alter river network connectivity patterns, subsequently affecting flood processes. This study employed the MIKE 11 model to simulate flood processes under three different river network connectivity scenarios. Based on the simulations, we propose a method to evaluate flood intensity severity by integrating three flood characteristic indices: Slope of the Flow Duration Curve (SFDC), Rising Climb Index (RCI), and Flashiness Index (FI). These indices assess the overall magnitude of change, the rate of rise, and process fluctuations, respectively. Results indicate that changes in river network connectivity significantly impact RCI and SFDC, more than FI. Compared to the natural river network connectivity mode, changes in urban or watershed river network connectivity resulted in a significant decrease in RCI values by 3–37% or 18–38% across various return periods, with the rate of change in RCI values increasing as the return period lengthened. The impact of urban river network connectivity changes on SFDC within the Changzhou urban area was more pronounced under high-magnitude storm conditions, causing a 61% reduction. Furthermore, changes in watershed river network connectivity had a larger effect on SFDC under low-magnitude storm conditions than under high-intensity storms. Over 80% of the rivers under natural connectivity conditions exhibited flood intensity severity of Level III or higher, particularly in the Chenshu–Qingyang area. The alterations in connectivity significantly decreased flood intensity severity, with 85% to 91% of rivers showing the lowest flood intensity severity of Level I. Under a 100-year rainstorm scenario, flood risk shifted from within the flood protection envelope to outside it in the Changzhou urban area. The results will provide an important scientific basis for regional flood management in plains with dense rivers.

Evaluation of a Digital Decision Aid for Knee Replacement Surgery.

We studied whether an individualized digital decision aid can improve decision-making quality for or against knee arthroplasty. An app-based decision aid (EKIT tool) was developed and studied in a stepped-wedge, cluster-randomized trial. Consecutive patients with knee osteoarthritis who were candidates for knee replacement were included in 10 centers in Germany. All subjects were asked via app on a tablet about their symptoms, prior treatments, and preferences and goals for treatment. For the subjects in the intervention group, the EKIT tool was used in the doctor-patient discussion to visualize the individual disease burden and degree of fulfillment of the indication criteria, and structured information on knee arthroplasty was provided. In the control group, the discussion was conducted without the EKIT tool in accordance with the local standard in each participating center. The primary endpoint was the quality of the patient's decision on the basis of the discussion of indications, as measured with the Hip and Knee Quality Decision Instrument (HK-DQI). (Registration number: ClinicalTrials.gov:NCT04837053). 1092 patients were included, and data from 1055 patients were analyzed (616 in the intervention group and 439 in the control group). Good decision quality, as rated by the HKDQI, was achieved by 86.0% of patients in the intervention group and 67.4% of patients in the control group (relative risk, 1.24; 95 % confidence interval, [1.15; 1.33]). A digital decision aid significantly improved the quality of decision-making for or against knee replacement surgery. The widespread use of this instrument may have an even larger effect, as this trial was conducted mainly in hospitals with high case numbers.

Optimization of rotor profile design and analysis of transient flow fields in an asymmetric singular double claw vacuum pump

The claw vacuum pump is widely used in vacuum industries due to its high-performance, compact structure, and oil-free operation. This study delves into the rotor profile and internal flow field characteristics of an asymmetric singular double claw vacuum pump. Theoretical profile equations for the male-female rotor of claw vacuum pumps were given, and a three-dimensional transient simulation of the internal flow field was carried out using the dynamic mesh reconstruction method. The simulation result was also verified by experiments. Analysis shows that: the radial clearance significantly affects the volumetric efficiency of the claw vacuum pump, with a larger effect than the axial clearance; the maximum instantaneous temperature corresponds to radial clearance, leading to maximum thermal deformation concentrated at the claw tip; thermal deformation is the predominant factor contributing to maximum deformation; the smaller the coefficient of thermal expansion, the less the rotor material affects the claw vacuum pump clearance. Based on these insights, we have innovatively optimized two elements of the theoretical claw vacuum pump rotor profile, i.e., the curvature of the cusp B and three optimized configurations of the complex EH section. The optimization results provide a solid theoretical basis for advancing the design and practical application of this pump type.