Local System Research Articles

Co-freezing localized CRISPR-Cas12a system enables rapid and sensitive nucleic acid analysis.

Rapid and sensitive nucleic acid detection is vital in disease diagnosis and therapeutic assessment. Herein, we propose a co-freezing localized CRISPR-Cas12a (CL-Cas12a) strategy for sensitive nucleic acid detection. The CL-Cas12a was obtained through a 15-minute co-freezing process, allowing the Cas12a/crRNA complex and hairpin reporter confined on the AuNPs surface with high load efficiency, for rapid sensing of nucleic acid with superior performance to other localized Cas12a strategies. This CL-Cas12a based platform could quantitatively detect targets down to 98 aM in 30min with excellent specificity. Furthermore, the CL-Cas12a successful applied to detect human papillomavirus infection and human lung cancer-associated single-nucleotide mutations. We also achieved powerful signal amplification for imaging Survivin mRNA in living cells. These findings highlight the potential of CL-Cas12a as an effective tool for nucleic acid diagnostics and disease monitoring.

Trajectory mapping through channel state information by triangulation method and fine-tuning

AbstractTrajectory mapping techniques have widespread applications in diverse fields, including robotics, localization, smart environments, gaming, and tracking systems. However, existing free devices encounter challenges in representing trajectories, thereby limiting the effectiveness of applications such as robotics, localization, and tracking systems. The imprecise mappings generated by these methods lead to suboptimal performance and unreliable results. The proposed approach leverages WiFi sensing through channel state information (CSI), triangulation techniques, and a fine-tuning mechanism to enhance trajectory precision within indoor environment trajectory mapping. The proposed solution employs a domain adapter fine-tuning technique to enable location-independent tracking via CSI, minimizing errors. The use of CSI MIMO signals for trajectory mapping offers enhanced spatial resolution, robust multipath handling, and improved accuracy in tracking movement by leveraging multiple antenna channels and exploiting the rich information embedded in signal reflections and scattering, while triangulation aids in accurately determining the location of objects or targets. Furthermore, incorporating a fine-tuning mechanism refines the generated trajectories. The findings demonstrate substantial enhancements in mapping precision, with an accuracy of 95.5% in tracking 13 paths within the new domain. These results underscore the effectiveness of the proposed approach in overcoming the limitations of existing methods and achieving highly accurate trajectory mapping.

Atypical venous drainage system and distinct vascular characteristics in pediatric intracerebral hemorrhage caused by multiple micro arteriovenous malformations.

Hemorrhagic brain micro-arteriovenous malformations (micro-AVMs) are considered to constitute a relatively significant portion of pediatric AVMs, though they are often associated with a low bleeding rate, as seen in hereditary hemorrhagic telangiectasia, which frequently involves multiple micro-AVMs. We present a rare case of a 10-year-old girl with multiple hemorrhagic micro-AVMs. Intraoperative findings during the emergency operation for hematoma evacuation and post-operative superselective angiography highlighted the unique angioarchitecture of three micro-AVMs (two lesions in the superficial areas and one lesion in the deep-seated area) and the atypical bleeding source due to the complex congestive venous drainage system. One micro-AVM was successfully occluded by a transarterial emboliozation, and remaining two micro-AVMs underwent gamma knife irradiation as a salvage therapy. Superselective angiography is crucial for detecting micro-AVMs, offering detailed insights into small, localized abnormal vascular drainage systems, and guiding therapeutic strategy. Additionally, micro-AVM-associated unique vascular hypersensitivity, such as vasospasm, requires careful consideration, as invasive procedures may significantly alter the visibility of the entire micro-AVM network.

Thermosensitive multivesicular liposomal hydrogel: a potential platform for loco-regional drug delivery in the treatment of osteomyelitis caused by antibiotic-resistant biofilm-forming bacteria.

Biofilm-mediated osteomyelitis presents significant therapeutic challenges. Given the limitations of existing osteomyelitis treatment approaches, there is a distinct need to develop a localized drug delivery system that is biocompatible, biodegradable, and capable of controlled antibiotic release. Multivesicular liposomes (MVLs), characterized by their non-concentric vesicular structure, distinct composition, and enhanced stability, serve as the system for a robust sustained-release drug delivery platform. In this study, various hydrogel formulations composed of poloxamer 407 and other hydrogels, incorporating vancomycin hydrochloride (VAN HL) -loaded MVLs (VAN HL-MVL), were prepared and evaluated. The optimized VAN HL-MVL sol-gel system, consisting of poloxamer 407 and hyaluronic acid, successfully maintained drug release for up to three weeks and exhibited shear-thinning behavior at 37°C. While complete drug release from MVLs alone took place in 312 hours, the hydrogel formulation extended this release to 504 hours. The released drug effectively inhibited the Staphylococcus aureus biofilms growth within 24 hours and methicillin-resistant Staphylococcus aureus biofilms within 72 hours. It also eradicated pre-formed biofilms of Staphylococcus aureus and methicillin-resistant Staphylococcus aureus in 96 and 120 hours, respectively. This injectable in situ gel system incorporating VAN HL-MVLs holds potential as an alternative to undergoing multiple surgeries for osteomyelitis treatment and warrants further studies.

Three-Dimensional Holographic-Guided Robotic Lung Segmentectomy for Deep Pulmonary Nodules: Technique and Initial Results.

Background: Diagnosis and treatment of small and isolated lung nodules remain challenging issues. Purpose: The aim of this article is to report the technique of real-time navigation using holographic reconstruction technology combined with a robot assisted thoracic surgery (RATS) platform for lung resection in patients withsmall deep nodules.Research Design: The pre-surgery 3D planning was based on the chest CT scan. The reconstruction was uploaded to a head-mounted display for real-time navigation during mini invasive robot assisted surgery performed with an open console platform. We evaluated this technique with the success rate of diagnosis, the operative time and the post-operative course.Study Sample: This technique was performed in 6 patients (4 female, mean age 65 years) to date.Results: The precision of the head-mounted display based localization system was effective in all cases without the need of open conversion. The mean diameter of the nodules was 8mm (6-9). The diagnosis was a lung cancer (n = 5) and tuberculoma (n = 1). The mean operative time was 125min (100-145). The mean hospital stay was 2.5days (1-3).Conclusions: In conclusion, the intraoperative navigation using the 3D holographic assistance was an helpful tool for mini invasive RATS lung segmentectomy without the need of preoperative localization.

Humanistic place leadership, cultural enhancement, and change in industrial districts

Drawing inspiration from the works of Fiorenza Belussi on multiple paths of development in local productive systems, the essay contributes to the ongoing debate on factors facilitating such transformations, focusing primarily on industrial districts (IDs) as open learning systems. With specific reference to the Italian context, this paper recalls the delicate balance between socio-cultural and economic elements within IDs transitioning towards new paths of development, crucial for facing the current technological and societal challenges. e essay proposes to look at the possible diffusion of humanistic management (HM) and cultural enhancement of economic strategies, as new triggering factors against lock-in conditions and tendencies toward degradation during phases of ID transformation. HM prioritizes the well-being of individuals and ethical decision-making, aligning with a broader societal purpose. Cultural enhancement, rooted in a common heritage, supports place identity, and suggests bases for multiple specializations. e convergence of HM and cultural enhancement within IDs may offer to renewed place-leaderships levers for strategies of transition pointing to sustainable paths that align with broader societal goals in an era of disrupting challenges.

A-071 Macroprolactin Screening in Patients with Hyperprolactinemia: Comparison Between Different Criteria for Defining Macroprolactinemia

Abstract Background Prolactin (PRL) exists in different forms in human serum. The predominant form is monomeric PRL, the other forms include dimeric PRL and polymeric PRL, also known as macroprolactin, a biologically inactive form. Macroprolactin can be measured by almost all immunoassays for PRL. This may lead to misdiagnosis and mismanagement of patients. Polyethylene glycol (PEG) precipitation is the most widely used method for detecting macroprolactin, generally employing a cutoff of 40% to distinguish macroprolactinemia from true hyperprolactinemia. This approach lacks specificity, so the reported result may be misinterpreted in cases in which excess macroprolactin occurs simultaneously with supraphysiological concentrations of monomeric prolactin. Nowadays, it is recommended to report results as post-PEG PRL using method-specific post-PEG reference intervals, classifying as macroprolactinemia (false or pseudohyperprolactinemia) those individuals with post- PEG PRL within post-PEG reference intervals and true hyperprolactinemia above the upper limit of the post-PEG reference interval. The objective of this study was to evaluate the prevalence of macroprolactinemia in patients with hyperprolactinemia using two different criteria, a cutoff < 40% in PEG precipitation and a post- PEG PRL within post-PEG assay specific reference range. Methods We analyzed blood samples requesting serum macroprolactin from patients admitted to a private reference clinical laboratory in Rio de Janeiro, Brazil, from 01/01/2019 to 12/31/2023. Anonymized data on laboratory tests was available from a database of the local Laboratory Information System. All patients included had PRL levels above the reference range, males >15.2 ng/mL, females >23.3 ng/mL (ECLIA, Modular, Roche). Results 9423 patients, 80.1% women (W) were evaluated. Men (M) were statistically significantly older than women (p<0.001) (45.6; SD=15.0 vs. 38.9; SD=11.5). Prolactin median levels were significantly higher in women (p<0.001) than men (37.4ng/mL, IQR=26 vs. 23.8ng/mL, IQR=17.1). Macroprolactinemia detection was greater (p<0.001) by post-peg PRL concentration criteria (9.7% - 10.1%W vs. 8.4%M), than by < 40% PRL recovery criteria (5.5% - 5.7%W vs. 4.8%M). Dividing patients by prolactin levels (<50.0; 50.0 to <100.0; 100.0 to <150.0, >150.0 ng/mL, we found macroprolactinemia in 5.2% (5.2%W vs. 5.2%M), 7.7% (8.2%W vs. 2.4%M), 2.8% (2.8%W vs. 2.5%M) and 1.6% (1.3%W vs. 2.6%M) - <40% PRL recovery criteria; and 12.1% (12.8%W vs. 9.8%M), 4.4% (4.8%W vs. 0.6%M), 0.8% (0.8%W vs. 0%M), 0.0% (0%W vs. 0%M) - post-PEG PRL concentration criteria. By the last criteria, no patient with total PRL more than 150 ng/mL had macroprolactinemia. Conclusions The criterion for defining macroprolactinemia has a big impact on the study results and needs to be considered in data interpretation and comparison with other studies. PEG precipitation is an easy and fast screening method for macroprolactin. Its main purpose should be determining whether the bioactive monomeric prolactin concentration is increased which is why the post-PEG PRL with corresponding reference interval is the most suitable way of reporting results.

Healthcare Needs of Provincially Uninsured Migrant Families with Newborn Infants: A Qualitative Descriptive Study

Aim: This project aimed to explore the healthcare needs of provincially uninsured migrant families with newborns receiving care at a nurse practitioner (NP)-led clinic in Montreal, Quebec, Canada. The findings of this study are intended to guide primary healthcare professionals and administrators in understanding and addressing the specific needs of these families, enabling them to tailor their services appropriately. Background: Newborns of provincially uninsured migrant families in Quebec can experience delays in accessing provincial health insurance, preventing timely access to primary care services. In Montreal, a publicly funded NP-led clinic was created to enable newborns without provincial health insurance to access recommended well-baby visits in the first 4 months of life. There exists a paucity of literature on the specific healthcare needs of uninsured families with newborn infants, making tailored care difficult. Methods: A qualitative descriptive study was undertaken. Semi-structured interviews were conducted with the parents of provincially uninsured Quebec-born newborns being treated at a NP-led clinic. Ten interviews were conducted with a total of 13 participants between October 2023 and January 2024. Socio-demographic data were collected. Content analysis was undertaken to identify important themes. Findings: Two overarching themes were identified including (a) healthcare service needs related to newborn care, maternal postpartum care, and family healthcare; (b) healthcare access needs related to navigating the local healthcare system, transportation, and provincial health insurance. Conclusion: Provincially uninsured migrant families with newborns in Quebec face barriers to accessing healthcare. This study provides information on the healthcare services and access-related needs of these families and provides recommendations including how NP-led clinics can facilitate access to the healthcare services needed by these families.

Evaluation of nature-based climate solutions for agricultural landscapes in the Galapagos Islands

The Galápagos Islands are highly vulnerable to climate and environmental change, and nature-based solutions can help local communities adapt local agricultural systems. Through a comparative analysis, we evaluated the effects of three land management strategies on soil temperature, soil water availability and storage, and carbon stocks in Santa Cruz Island (Galapagos Archipelago). We installed six monitoring sites that consisted of two replicates per pathway: (i) the avoided loss of tropical forest, (ii) the conservation of scattered trees and living fences in at-risk agroforestry system, and (iii) the increase in biomass after a reduction of the grazing intensity. The monitoring sites were equipped with a dense network of rain gauges, air temperature and relative humidity sensors, and capacitance/frequency probes that registered volumetric water content and soil temperature. After pedological characterization of the soil profiles, the soil physico-chemical and hydrophysical properties were determined in laboratory. Over a period of 30 months (July 2019 to December 2021), hydrometeorological and soil environmental data were collected.We assessed differences in soil temperature, moisture availability and soil organic carbon content between native forests, sites under traditional agroforestry and under passive restoration. Forest soils were 12 % cooler;, and soil moisture under forest was 20 % higher than in parcels with silvopastural management. Forest soils had a lower dry bulk density, lower saturated hydraulic conductivity and higher water retention capacity in comparison with the other two management types. In silvopastural systems, a decrease of grazing intensity had a positive effect on soil carbon stocks, that were about 50 % higher than in soils under traditional management. This study shows that avoided loss of tropical forest within an agricultural landscape is a promising strategy to mitigate increasing soil temperatures, agricultural drought, and decline in soil organic carbon content. Continued monitoring of the experimental sites is necessary to corroborate the findings of this investigation at longer temporal scales.

Collecting Duct Pro(Renin) Receptor Contributes to Unilateral Ureteral Obstruction-Induced Kidney Injury via Activation of the Intrarenal RAS.

Although the concept of the intrarenal renin-angiotensin system (RAS) in renal disease is well-described in the literature, the precise pathogenic role and mechanism of this local system have not been directly assessed in the absence of confounding influence from the systemic RAS. The present study used novel mouse models of collecting duct (CD)-specific deletion of (pro)renin receptor (PRR) or renin together with pharmacological inhibition of soluble PRR production to unravel the precise contribution of the intrarenal RAS to renal injury induced by unilateral ureteral obstruction. We examined the impact of CD-specific deletion of PRR, CD-specific deletion of renin, and S1P (site-1 protease) inhibitor PF429242 treatment on renal fibrosis and inflammation and the indices of the intrarenal RAS in a mouse model of unilateral ureteral obstruction. After 3 days of unilateral ureteral obstruction, the indices of the intrarenal RAS including the renal medullary renin content, activity and mRNA expression, and Ang (angiotensin) II content in obstructed kidneys of floxed mice were all increased. That effect was reversed with CD-specific deletion of PRR, CD-specific deletion of renin, and PF429242 treatment, accompanied by consistent improvement in renal fibrosis and inflammation. On the other hand, renal cortical renin levels were unaffected by unilateral ureteral obstruction, irrespective of the genotype. Similar results were obtained via pharmacological inhibition of S1P, the key protease for the generation of soluble PRR. Our results reveal that PRR-dependent/soluble PRR-dependent activation of CD renin represents a key determinant of the intrarenal RAS and, thus, obstruction-induced renal inflammation and fibrosis.

On a B-field transform of generalized complex structures over complex tori

Let (Xn,Xˇn) be a mirror pair of an n-dimensional complex torus Xn and its mirror partner Xˇn. Then, by SYZ transform, we can construct a holomorphic line bundle with an integrable connection from each pair of a Lagrangian section of Xˇn→Rn/Zn and a unitary local system along it, and those holomorphic line bundles with integrable connections forms a dg-category DGXn. In this paper, we focus on a certain B-field transform of the generalized complex structure induced from the complex structure on Xn, and interpret it as the deformation XGn of Xn by a flat gerbe G. Moreover, we construct the deformation of DGXn associated to the deformation from Xn to XGn, and also discuss the homological mirror symmetry between XGn and its mirror partner on the object level.

Women’s Knowledge of Local Plants and Their Gastronomic Heritage in Chitral, NW Pakistan

Women are the “guardians of the kitchen” and central to household food security, yet their role has never been studied across the Hindukush region or Pamiri Knot. This study explores the women’s knowledge (specifically from the Khowar (Kho) and Wakhi linguistic groups) of local food systems and determines their role in ensuring household food security and sustainability in the mountain regions of northern Pakistan. Based on in-depth semi-structured interviews with female informants in the Rech and Broghil valleys of upper Chitral, 91 different types of food products were recorded, including wild and cultivated species. Eremurus stenophyllus and Allium barsczewskii were the commonly utilized plant species, though distinct preferences between the Kho and Wakhi groups were noted. Prominent differences were perceived in using certain cultivated plants among the two ethnic groups. For instance, Kho preferred plants like Beta vulgaris, Zea mays, and Brassica napus as indicated by the use reports, while Wakhi concentrated on Thymus serpyllum, Zygophyllum obliquum and Papaver involucratum. Both groups had shared dairy practices, but cottage cheese and curd were highly cited among Kho, while double-fermented curd and Qurut for Wakhi. The study recorded some new food uses for specific plants, such as Atriplex hortensis, Carthamus tinctorius, Hylotelephium spp., and Saxifraga sibirica. Cross-culture analyses revealed a mosaic pattern of homogenous and heterogenous trends based on reported food species of plants/animals and their use reports. Our findings emphasize the significant role of women in sustaining local food diversity, food sustainability, and the preservation and security of the local food systems, cultural legacy, and household food management. Therefore, inclusive research addressing their social, economic, and environmental issues must be conducted. Furthermore, policies must incorporate women’s traditional knowledge to build resilient food systems.

Post-growth agrifood systems: Towards an emancipatory politics

Abstract A world without hunger demands a post-growth rewiring of the global agrifood system predicated on emancipatory politics that enables reform of actors and institutions outside agriculture. This is necessary to shift out of the prevalent growth-hegemonic framing of agriculture and its contributions to economic growth, where the structural injustice of hunger is rendered invisible. Recent International Relations (IR) scholarship highlights the institutional arrangements underpinning global agrifood problems. This paper uses critical IR theory to understand the structural mechanisms and relations of power through which the growth-hegemonic theorisation of agriculture is produced and reproduced, sustaining hunger within an exceedingly financialised agro-industrial complex. The structural power of knowledge shaping the interlocking structures of finance, production, and security is evident in the extremely high multilevel concentration in modern agrifood systems. This structural power evident in local decentralised agroecological systems and in transnational agrarian movements reflects post-growth principles of sufficiency, shared prosperity, care, ecological and social justice.Together, they are the counter-hegemonic voices, cooperative social systems, and class interests championed by post-growth politics.

Demographic and food frequency survey of a marginalized community in Almora, Uttarakhand, India

The demography and eating behaviour of the marginalized communities residing in the Almora district of Uttarakhand, India, was investigated. It was observed that agriculture was the main income source along with other work such as labourer, black-smith, etc. Food consumption was mainly dependent upon either the Government Public Distribution System or on traditional coarse grains which were being produced only for their own consumption. Traditional food crops were being neglected in the Himalayan region due to the deterioration of local food systems, changing food habits, and lack of awareness of the uses and nutritional value of traditional crops.

A High-Precision Inverse Finite Element Method for Shape Sensing and Structural Health Monitoring

In the contemporary era, the further exploitation of deep-sea resources has led to a significant expansion of the role of ships in numerous domains, such as in oil and gas extraction. However, the harsh marine environments to which ships are frequently subjected can result in structural failures. In order to ensure the safety of the crew and the ship, and to reduce the costs associated with such failures, it is imperative to utilise a structural health monitoring (SHM) system to monitor the ship in real time. Displacement reconstruction is one of the main objectives of SHM, and the inverse finite element method (iFEM) is a powerful SHM method for the full-field displacement reconstruction of plate and shell structures. However, existing inverse shell elements applied to curved shell structures with irregular geometry or large curvature may result in element distortion. This paper proposes a high-precision iFEM for curved shell structures that does not alter the displacement mode of the element or increase the mesh and node quantities. In reality, it just modifies the methods of calculation. This method is based on the establishment of a local coordinate system on the Gaussian integration point and the subsequent alteration of the stiffness integration. The results of numerical examples demonstrate that the high-precision iFEM is capable of effectively reducing the displacement difference resulting from inverse finite element method reconstruction. Furthermore, it performs well in practical engineering applications.

Деятельность Н.И. Буланова на посту городского Головы Ставропольской городской Думы

In 1873, the City Duma was established in Stavropol (now Tolyatti) as the highest body of local government. It was in charge of various issues: the formation of the external appearance of the city, the organization of cultural events, the development of education and healthcare. The functioning of the local government system remains one of the main issues today. Having studied this problem, it can be noted that, based on the accumulated experience, there is a transformation of the relationship between the government and the heads of local government. The authors made an attempt to address the history of the Stavropol City Duma of the 19th century and analyze one of the key figures in the system of self-government – the city Mayor, who occupied a fairly high status due to the concentration of both legislative and executive power in his hands. The focus of the study is on the activities of the City Head of the Stavropol Duma, Nikolai Ivanovich Bulanov, who was born into a merchant family and was able to receive a higher education, which made him very different from his fellow officers. Nikolai Bulanov worked for more than 30 years in the Stavropol city government and during this time made a significant contribution to the development of city infrastructure. The source base is includes materials from the Tolyatti archive: journals of City Duma meetings on issues of city improvement, formal lists, ballot papers for city mayor election, reports of city councils.

Assessing the Relationship between Urban Heat Islands and Local Climate Zones during a Winter Period in the Coastal City of Balneário Camboriú/SC, Brazil

This research seeks to understand the link between urban heat island and urban cool island, which are the Local Climatic Zones (LCZ) and atmospheric systems during the winter season in the city of Balneário Camboriú, Southern Brazil. First, meteorological data on the urban environment was collected at 11 permanent points in the Balneário Camboriú metropolitan region. Next, a synoptic analysis of the dates was performed to understand the atmospheric systems operating in the region. Finally, the LCZs map created for the city in the World Urban Database and Access Portal Tools was used to correlate the magnitudes of the heat and cool islands found in Balneário Camboriú in the winter period. The results indicate that the increasing verticalization as a result of the construction of skyscrapers in Balneário Camboriú has a significant influence on local conditions for the occurrence of heat and cold islands. The findings indicate that LCZs with sparsely distributed buildings (LCZs 6, 8 and 9) and LCZs with dense vegetation (LCZ A) have lower intensity magnitudes of heat and cool conditions. The biggest magnitudes of heat and cool islands were reported in LCZs 1 and 3 during the timeframe. The synoptic analysis supports earlier research that points to atmospheric stability (Anticyclonic domain) as a favorable atmospheric setting for the emergence of urban heat and coolness islands.

Assessment of Pollution of the Waters in the South Kuril Fishing Zone of Russia by Radioactive Waters from the Fukushima-1 NPP Based on Lagrangian Modeling

The study investigates the potential hazard arising from the actions taken by the Japanese government regarding the discharge of technical radioactive water from the Fukushima-1 nuclear power plant storage facilities. The contamination of the South Kuril Fishing Zone (SKFZ), which is one of the most promising fishing areas for the Russian Federation, with radioactive particles, is considered. Based on the modeling of passive markers simulating radioactive contamination, the study analyzes the pathways and mechanisms of pollution transfer into the SKFZ. The research is conducted using altimetric data on geostrophic currents for the period from August 24, 2022, to August 24, 2023. The pollution transfer into the SKFZ is determined by a set of conditions related to the current development regime of the First Kuril Meander and the local vortex system with varying characteristics, both near the discharge site and at the SKFZ border. A seasonal dependence of the speed and quantity of polluted water infiltration toward the Russian Federation’s shores is established. The possibility of rapid pollution advection into the SKFZ within 13 days has been discovered. This speed is due to the entrainment of contamination by the Kuril Meander and its further transport by the mesoscale vortex system to the SKFZ border. The study reveals periodicity in the influx of pollution into the SKFZ. Graphs depicting the distribution of the quantity of “dirty” markers over their release times and the arrival of polluted water at the SKFZ border have been created.

Piezoelectric Ultrasonic Local Resonant Ultra-Precision Grinding for Hard–Brittle Materials

Hard–brittle materials are widely used in the optics, electronics, and aviation industries, but their high hardness and brittleness make it challenging for traditional processing methods to achieve high efficiency and superior surface quality. This study aims to investigate the application of ultrasonic local resonant grinding to sapphire to improve the efficiency and meet the requirements for the optical window in the surface roughness of the material. The resonant frequency of a piezoelectric ultrasonic vibration system and the vibration amplitude of a grinding head’s working face were simulated and tested, respectively. The results of ultrasonic grinding experiments showed that the local resonant system reduced the surface roughness parameter (Ra) of sapphire to 14 nm and improved its surface flatness to 44.2 nm, thus meeting the requirements for the ultra-precision grinding of sapphire. Compared with a conventional resonant system, the surface roughness of the sapphire ground with the local resonant system was reduced by 90.79%, its surface flatness was improved by 81.58%, and the material removal rate was increased by 31.35%. These experimental results showed that ultrasonic local resonant grinding has better effects than those of conventional ultrasonic grinding in improving surface quality and increasing the material removal rate.

Losing the Postcode Lottery: An Observational Study Examining the Association Between Patient Address and Delayed Discharge in a Rehabilitation Centre

Abstract Background Quality and Fairness: A Health System for You published by the HSE in 2001 stated, as one of its core principles “Access to healthcare should be fair. The system must respond to people’s needs rather than have access dependent on geographic location or ability to pay.”1 Twenty years on, experience at our rehab unit suggests that inequality exists in accessing care in the community for older persons based on their residential address. The aim of our study was to examine and quantify this inequity of access. Methods A retrospective study was designed. Using the local patient information management system, all discharges in 2023 were identified. Baseline demographics, admission and discharge date and residential address were recorded. Delayed discharges were defined as patients for whom their rehabilitation programme is complete as agreed at the multi-disciplinary team meeting. Delayed discharge data was obtained from medical social work department who input this data to the HSE weekly. Patients were assigned a community healthcare organisation (CHO) based on address. CHO ‘A’ included two CHOs with predominantly rural areas whilst CHO ‘B’ comprised of one predominantly urban CHO. Results 167 patients were included. 24 discharges were delayed (14.4%). Median age was 84. Total bed days lost: 935 (mean 40.6, range 3 – 232). All nine CHOs were represented. Patients living in CHO A had increased likelihood of having discharge delayed (OR: 4.82, CI 2.86 – 8.13). Conversely, those living in CHO B were less likely to have had a discharge delayed (OR: 0.39, CI 0.15 – 0.96) Conclusion Our study demonstrates that health inequity does exist. Patients residing in rural communities are 4 times more likely to have their discharge delayed awaiting community supports compared to urban dwellers. Ending of the discrimination of patients based on their postcode and ensuring access based on need is the very essence of Sláintecare.