Median Value Research Articles

Faith, Climate, and Energy Frugality: Unravelling the Nexus in European Perspectives

This study explores the relationship between religious beliefs, perceptions of climate change, and preferences for energy frugality in Europe using data from the November 2023 European Social Survey across 22 countries. The research reveals a predominant inclination toward median values in addressing climate change, with subtle variations based on levels of religiosity. Lower religiosity tends to be associated with a nuanced attribution of climate change to human activity. There is a complex interplay between religiosity and the perception of personal responsibility in mitigating climate change, indicating some polarisation but an overall increasing sense of accountability. Religious affiliations show distinct attitudes, with Protestants more inclined to attribute climate change to human causes. Roman Catholics are closer to some Protestants, while other Christian denominations exhibit flexibility and common ground with Islam and Judaism. However, it is concluded that demographics and political alignment play a more pivotal role compared to religiosity levels or religious denominations.

High-expression of FABP4 in Tubules is a Risk Factor for Poor Prognosis in DKD Patients.

Lipid metabolism imbalance is involved in the mechanism of renal tubular injury in diabetic kidney disease (DKD). Fatty acid binding protein 4 (FABP4) has been reported to participate in cellular lipid toxicity. However, the expression of FABP4 in renal tissues of DKD and its correlation with clinical/ pathological parameters and prognosis have not been studied. A retrospective cohort study was conducted in 108 hospitalized Type 2 diabetes (T2D) patients with renal injury, including 70 with DKD and 38 with NDKD (non-DKD). Clinical features, pathological findings, and follow-up parameters were collected. Serum and urine FABP4 were detected by ELISA. An immunohistochemistry stain was used to determine FABP4 in renal tubulointerstitium. A double immunofluorescence stain was employed to assess FABP4- and CD68-positive macrophages. Correlation analysis, logistic regression models, receiver operating characteristic (ROC), and Kaplan-Meier survival curve were performed for statistical analysis. DKD patients had increased expression of FABP4 and ectopic fat deposition in tubules. As shown by correlation analyses, FABP4 expression in renal tubules was positively correlated with UNAG (r=0.589, p=0.044) and ESRD (r=0.740, p=0.004). Multivariate regression analysis revealed that UNAG level was correlated with FABP4 expression level above median value (odds ratio:1.154, 95% confidence interval:1.009-1.321, p=0.037). High-expression of FABP4 in renal tubules of DKD was at an increased risk of ESRD. Increased FABP4 expression in inflammatory cells was also associated with ESRD in DKD. High-expression of FABP4 is involved in the pathogenesis of renal tubular lipid injury and is a risk factor for poor prognosis in DKD patients.

Diagnostic reference levels in spinal CT: Jordanian assessments and global benchmarks.

To reduce radiation dose and subsequent risks, several legislative documents in different countries describe the need for Diagnostic Reference Levels (DRLs). Spinal radiography is a common and high-dose examination. Therefore, the aim of this work was to establish the DRL for Computed Tomography (CT) examinations of the spine in healthcare institutions across Jordan. Data was retrieved from the picture archiving and communications system (PACS), which included the CT Dose Index (CTDI(vol)) and Dose Length Product (DLP). The median radiation dose values of the dosimetric indices were calculated for each site. DRL values were defined as the 75th percentile distribution of the median CTDI(vol) and DLP values. Data was collected from 659 CT examinations (316 cervical spine and 343 lumbar-sacral spine). Of the participants, 68% were males, and the patients' mean weight was 69.7 kg (minimum = 60; maximum = 80, SD = 8.9). The 75th percentile for the DLP of cervical and LS-spine CT scans in Jordan were 565.2 and 967.7 mGy.cm, respectively. This research demonstrates a wide range of variability in CTDI(vol) and DLP values for spinal CT examinations; these variations were associated with the acquisition protocol and highlight the need to optimize radiation dose in spinal CT examinations.

Insights into the physics of gamma-ray bursts from the high-energy extension of their prompt emission spectra

The study of the high-energy part (MeV-GeV) of the spectrum of gamma-ray bursts (GRBs) can play a crucial role in investigating the physics of prompt emission, but it is often hampered by low statistics and the paucity of GeV observations. In this work, we analyze the prompt emission spectra of the 22 brightest GRBs which have been simultaneously observed by Fermi/GBM and Fermi/LAT, spanning six orders of magnitude in energy. The high-energy photon spectra can be modeled with a power-law N(E)∝E−β possibly featuring an exponential cutoff. We find that, with the inclusion of the LAT data, the spectral index β is softer than what is typically inferred from the analysis of Fermi/GBM data alone. Under the assumption that the emission is synchrotron, we derived a median value of the index p ∼ 2.79 of the power-law energy distribution of accelerated particles (N(γ)∝γ−p). In nine out of 22 GRB spectra, we find a significant presence of an exponential cutoff at high energy, ranging between 14 and 298 MeV. By interpreting the observed cutoff as a sign of pair-production opacity, we estimate the jet bulk Lorentz factor Γ, finding values in the range 130–330. These values are consistent with those inferred from the afterglow light curve onset time. Finally, by combining the information from the high-energy prompt emission spectrum with the afterglow light curve, we exploited a promising method to derive the distance R from the central engine where the prompt emission occurs. The distances (R > 1013 − 15 cm) inferred for the only two GRBs in our sample that are suitable for the application of this method, which have only lower limits on their cutoff energies, suggest large emitting regions, although they are still compatible with the standard model. Larger samples of GRBs with measured cutoff energies and afterglow deceleration time will allow for more informative values to be derived. These results highlight the importance of including high-energy data, when available, in the study of prompt spectra and their role in addressing the current challenges of the GRB standard model.

Prevalence and prognosis of anxiety, insomnia, and type D personality in patients with myocardial infarction: A Spanish cohort.

It has been suggested that patients with myocardial infarction and non-obstructive coronary arteries (MINOCA) have more psycho-emotional disorders than patients with obstructive coronary artery disease (MICAD). The aim of this study is to compare the prevalence of anxiety, insomnia, and type D personality between MINOCA and MICAD and their impact on prognosis. Patients with myocardial infarction undergoing coronary angiography were prospectively enrolled. Psychological questionnaires were completed by each patient during admission. Among a total of 533 patients, 56 had MINOCA and 477 had MICAD. There were no differences in the prevalence of anxiety and insomnia between both groups: trait anxiety median value (M) MINOCA = 18 (11-34) vs. MICAD M = 19 (12-27), p = 0.8; state anxiety MINOCA M = 19 (11-29) vs. MICAD M = 19 (12.2-26), p = 0.6; and insomnia MINOCA M = 7 (3-11) vs. MICAD M = 7 (3-12), p = 0.95. More MINOCA patients had type D personality (45.0% vs. 28.5%, p = 0.03). At 3-year follow-up, there were no differences in mortality between MINOCA and MICAD (hazard ratio [HR] 0.78, 95% confidence interval [CI] 0.28-2.17) in major adverse cerebral or cardiovascular events (MACCE) (HR 0.71, 95% CI 0.38-1.31). Scores of trait anxiety and negative affectivity were significantly associated with MACCE (HR 1.65, 95% CI [1.05-2.57]; HR 1.75, 95% CI [1.11-2.77], respectively). High insomnia levels were associated with greater mortality (HR 2.72, 95% CI [1.12-6.61]). Anxiety and insomnia levels were similar between patients with MINOCA and those with MICAD, whilst the prevalence of type D personality was higher in the MINOCA than in the MICAD group. Higher scores in trait anxiety, insomnia, and negative affectivity were related to a worse prognosis at 3-year follow-up.

Satellite-based atmospheric characterization for sites of interest in millimeter and sub-millimeter astronomy

Context. Water vapor is the main source of atmospheric opacity for millimeter and sub-millimeter astronomy. Hence, several studies seek to effectively characterize it for site-testing purposes. In this task, reanalysis databases are quickly becoming a popular alternative to on-site measurements due to easy accessibility and the versatility of the data they provide. Aims. In the framework of validating the use of reanalysis data as a site-testing oriented tool, we perform a statistical comparison of atmospheric water vapor values obtainable from the MERRA-2 database with ground-based microwave radiometer measurements taken at two astronomical sites in Chile: Llano de Chajnantor, Atacama, and Cerro Paranal, Antofagasta. Methods. The MERRA-2 data were interpolated both vertically (across pressure levels) and geographically (latitude-longitude). For each site, different plots were generated: a direct temporal variation plot (to visually compare the data variation over time between both sources); a PWV versus PWV plot, fitting a linear fit through robust linear regression and calculating both the Pearson (r) and Spearman (ρ) correlation coefficients in order to look for correlations between both data sources; a histogram showing the distribution of the differences between the MERRA-2 data and the water vapor measurements (defined as APWV = PWVMERRA-2 − PWVsite), along with its standard deviation (σ), mean (µ), and median values, with the aim of better appreciating the similarities of the data sources over time; and a CDF plot to compare both data distributions disregarding time stamps. Finally, millimeter and sub-millimeter transmittance curves were created through the am atmospheric modeling software, which uses ozone and temperature data along with the verified water vapor data for the two studied sites as well as three other sites of interest for the next-generation Event Horizon Telescope: Las Campanas Observatory near La Serena, Chile; Valle Nevado, located near Santiago, Chile; and the General Bernardo O’Higgins base, located in Antarctica. Results. The interpolated MERRA-2 PWV values are highly correlated with the ground-based PWV values, with a Pearson coefficient greater than 0.9 and a Spearman coefficient higher than 0.85. However, their dependence is not linear, as PWVAPEX = m * PWV, with m being higher than 0.9 in both cases. The difference histograms show an almost zero-centered distribution for Llano de Chajnantor, with a µ value of −0.021 and a median value of −0.007. On the other hand, in Cerro Paranal, the difference histogram is slightly offset toward positive values, with µ value of 0.171 and a median value of 0.256. This offset is most likely due to the strong winds present in the site’s location, close to the Pacific Ocean. The transmittance curves show different performances depending on the site studied, with Cerro Chajnantor being the highest overall transmittance and Antarctica the lowest. Additionally, the transmittance profiles estimated for Cerro Chajnantor and Cerro Paranal were scaled using the PWV measurements, providing differences of less than 12% to the model data profiles. Results obtained at the Valle Nevado site suggest promising atmospheric conditions for stronomic observations in the millimeter and sub-millimeter range. Conclusions. The results we obtained show that the atmospheric water vapor estimation using MERRA-2 data can be used for site testing of new sites by evaluating the millimeter–sub-millimeter transmittance profile through vertical pressure correction and averaging the closest grid points to the site. This new method opens the door for future site-testing studies using MERRA-2 and potentially other reanalysis databases (e.g., ERA5) as reliable sources of information.

Exposure of Male Farmers and Nonfarmers to Neonicotinoid Pesticides in the South-West and Littoral Regions of Cameroon: A Comparative Study.

Pesticides, especially the newly developed neonicotinoids, are increasingly used in many countries around the world, including Cameroon, to control pests involved in crop destruction or disease transmission. Unfortunately, the pesticides also pose tremendous environmental problems because a predominant amount of their residues enter environmental matrices to affect other nontargeted species including humans. This therefore calls for continuous biomonitoring of these insecticides in human populations. The present study sought to assess the neonicotinoid insecticide exposures in two agrarian regions of Cameroon, the South-West region and Littoral region. The study involved 188 men, including 125 farmers and 63 nonfarmers. Spot urine samples were obtained from these subjects and subjected to liquid chromatographic-tandem mass spectrometric analysis for concentrations of neonicotinoid compounds, including acetamiprid, clothianidin, dinotefuran, imidacloprid, thiacloprid, nitenpyram, thiamethoxam, and N-dm-acetamiprid. Neonicotinoid compounds were detected in all study participants, and residues of all the screened pesticides were detected among participants. N-dm-Acetamiprid and imidacloprid were the most prevalent among the subjects (100.0% and 93.1%, respectively), whereas nitenpyram was less common (3.2%). The median values of imidacloprid and total urinary neonicotinoid concentrations were elevated among farmers (0.258 vs. 0.126 µg/L and 0.829 vs. 0.312 µg/L, respectively). Altogether the findings showed that both the farmer and nonfarmer study populations of Cameroon were exposed to multiple residues of neonicotinoids, with relatively higher levels of pesticides generally recorded among farmers. Although exposure levels of the neonicotinoids were generally lower than their respective reference doses, these results warrant further research on the health risk evaluation of multiple residues of the pesticides and reinforcement of control measures to minimize the exposure risks, especially among farmers. Environ Toxicol Chem 2024;43:952-964. © 2024 SETAC.

Clinical and Temporal Radiological Findings from Critical Patients with COVID-19 Pneumonia: A Descriptive Study.

In late December 2019, Wuhan, the capital of Hubei Province, China, became the center of an outbreak of pneumonia caused by severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). The radiological changes in the lungs of critical people with coronavirus disease 2019 (COVID-19) pneumonia at different times have not been fully characterized. We aim to describe the computed tomography findings of patients with critical COVID-19 pneumonia at different disease stages. Clinical and laboratory features of critical patients were assessed. CT scans were assigned to groups 1, 2, 3, or 4 based on the interval from symptom onset (within 2 weeks; ≥ 2-4 weeks; ≥ 4-6 weeks; or ≥ 6 weeks, respectively). Imaging features were analyzed and compared across the four groups. Total CT scores, corresponding periods of laboratory findings, and glucocorticoid dosages during the imaging intervals were longitudinally observed in five patients with complete data. All 11 critical patients (median age: 60 years [42-69]) underwent a total of 40 CT examinations, and the acquisition times ranged from 1-59 days after symptom onset. Median total CT scores were 18 (9-25.25); 44.5 (42.88-47.62); 43.75 (38.62-49.38); and 42 (32.25-53.25) in groups 1, 2, 3, and 4, respectively. The observed lesions were mainly bilateral (37 [92.5%]). The median values of involved lung segments were 10.5 (4.5-13.5); 17 (16-18.5); 18 (18-19.5); and 18 (18-19) in groups 1-4, respectively. The predominant patterns of observed abnormalities were ground-glass opacities (GGO) (9 [90%]); GGO with reticulation and mixed patterns (3 [37.5%] for both); GGO with consolidation (3 [30%]); and GGO with reticulation (8 [66.7%]) in groups 1-4, respectively. Patients developed fibrotic manifestations at later stages. Critical patients with COVID-19 infection generally presented with temporally changing abnormal CT features from focal unilateral to diffuse bilateral GGO and consolidation that progressed to or coexisted with reticulation in the long term after symptom onset. Low-dose glucocorticoids may be effective in patients with interstitial changes on CT findings.

Identifying characteristics of stroke patients benefiting from interprofessional collaboration

Introduction: This study identifies the patient population that may benefit from interprofessional collaboration in the support of patients with cerebrovascular diseases. Method: This study involved 170 patients who received treatment in Japan’s recovery rehabilitation wards in December 2019–June 2020. Participants were categorized into three groups based on their functional independence measure (FIM) scores at admission, distinguishing between complete dependence, modified dependence, and independence groups. They were classified into the group with higher collaborative practice (HCP) and the group with lower collaborative practice (LCP) based on the median value of the therapist collaborative practice scale (TCPS). The primary outcomes measured were FIM efficiency and FIM effectiveness. The main effects and interactions of the level of independence with activities of daily living (ADL) and collaboration were examined using a two-way analysis of variance and Bonferroni multiple comparison tests. Results: The level of independence with ADL and collaboration had an interaction effect related to FIM effectiveness ( F(2, 164) = 3.191, p = 0.044). Within the independence group, HCP and LCP differed significantly ( F(1, 164) = 15.562, p < 0.001). Conclusion: Interprofessional collaboration may improve ADL in patients with high ADL independence at admission. Furthermore, the interprofessional collaboration quality impacted patients’ ADL improvement.

Validity of Entrustable Professional Activities in a National Sample of General Surgery Residency Programs.

The American Board of Surgery has endorsed competency-based education as vital to the assessment of surgical training. From 2018 to 2020, a national pilot study was conducted at 28 general surgery programs to evaluate feasibility of implementing entrustable professional activities (EPAs) for 5 common general surgical conditions. ACGME core competency Milestones were also rated for each resident by program clinical competency committees. This study aimed to evaluate the validity of general surgery EPAs compared with Milestones. Prospectively collected, de-identified EPA Pilot Study data were analyzed. EPAs studied were EPA-1 (gallbladder), EPA-2 (inguinal hernia), EPA-3 (right lower quadrant pain), EPA-4 (trauma), and EPA-5 (consult). Variables abstracted included levels of EPA entrustment (1 to 5) and corresponding ACGME Milestone subcompetency ratings (1 to 5) for the same study cycle. Spearman's correlations were used to evaluate the relationship between summative EPA scores and corresponding Milestone ratings. A total of 493 unique residents received a summative entrustment decision. EPA summative entrustment scores had moderate-to-strong positive correlation with mapped Milestone subcompetencies, with median rho value of 0.703. Among operation-focused EPAs, median rho values were similar between EPA-1 (0.688) and EPA-2 (0.661), but higher for EPA-3 (0.833). EPA-4 showed a strong positive correlation with diagnosis and communication competencies (0.724), whereas EPA-5, mapped to the most Milestone subcompetencies, had the lowest median rho value (0.455). Moderate-to-strong positive correlation was noted between EPAs and patient care, medical knowledge, and communication Milestones. These findings support the validity of EPAs in general surgery and suggest that EPA assessments can be used to inform Milestone ratings by clinical competency committees.

Patterns of atrial fibrillation, relevant cardiac structural and functional changes predict functional and cognitive outcomes in patients with ischemic stroke and atrial fibrillation

BackgroundAtrial fibrillation (AF) pattern, relevant cardiac changes are important predictors of outcomes in AF, but their impact on patients with ischemic stroke and AF remained unclear. We aimed to explore the impact of AF patterns, cardiac structural and functional markers on long-term functional and cognitive outcomes in ischemic stroke patients with AF. MethodsIschemic stroke patients diagnosed with AF were enrolled in this retrospective cohort study. AF pattern was defined by both traditional and novel classification, in which patients were divided into AF diagnosed after stroke (AFDAS) and known before stroke (KAF). Left atrial (LA) diameter, left ventricular ejection fraction (LVEF), natriuretic peptide (BNP) and cardiac troponin (cTnI) were dichotomized according to the median value. Outcomes include poor functional outcome and cognitive impairment at the 1-year follow-up. Multivariable logistic regression was performed to validate the association between AF pattern, parameters of cardiac change and functional and cognitive outcome. ResultsA total of 377 patients were included. Non-paroxysmal AF patients had a higher risk of poor functional outcome (OR = 3.59, P < 0.0001) and cognitive impairment (OR = 2.38, P = 0.019) than paroxysmal AF patients, while there were no differences between AFDAS and KAF. Lower LVEF (OR = 1.83, P = 0.045) and higher BNP (OR = 2.66, P = 0.001) were associated with poor functional outcome. Lower LVEF (OR = 2.86, P = 0.004), higher LA diameter (OR = 2.72, P = 0.008) and BNP (OR = 2.31, P = 0.023) were associated with cognitive impairment. ConclusionsAF type and related cardiac markers can serve as predictors for poor functional and cognitive outcomes. Comprehensive cardiac assessment and monitoring should be strengthened after stroke.

Validation of ToucHb, a non-invasive haemoglobin estimation: Effective for normal ranges, needs improvement for anaemia detection.

Non-invasive methods for haemoglobin estimation hold enormous potential for early detection and treatment of anaemia, especially in limited resource settings. We sought to validate the diagnostic accuracy of ToucHb, a non-invasive haemoglobin estimation device available in the Indian market. We prospectively evaluated the diagnostic performance of the ToucHb device using the Automated complete blood count (CBC) method as the gold standard. Persons referred for haemoglobin estimation to the central laboratory of the government medical college hospital in Mysore, southern India were included in the study. Out Of 140 people approached, 127 gave consent; 65% (n = 82) were female with median age of 37 (IQR 28-45). ToucHB reported median haemoglobin value of 14 g/dL compared to 13.3 g/dL for CBC. Within 1 g/dL and 2 g/dL of CBC, 55.2% (70/127) and 74% (94/127) of ToucHb haemoglobin observations fell, respectively. The Bland-Altman plot showed a mean difference of 3 g/dL in haemoglobin between ToucHb and CBC among those with anaemia. The ToucHb device showed 22.2% sensitivity and 94.5% specificity for anaemia detection. In rural resource-limited settings, point of care non-invasive devices such as ToucHb can improve access and acceptance for anaemia screening. However, ToucHb has showed low sensitivity for anaemia detection and low accuracy at lower haemoglobin values. The utility of the instrument is especially limited in detecting anaemia, while it can estimate haemoglobin accurately among those with haemoglobin is in the normal range. Based on these findings, ToucHb and devices that work on the core technology deployed in ToucHb may be better suited to monitor known haemoglobin level rather than in anaemia screening or detection in primary/ secondary care and community settings.

An approach for improvement of the accuracy of cancer gene panel testing.

Tissue-based comprehensive genomic profiling (CGP) is increasingly being employed for genotype-directed therapies in patients with advanced cancer. However, tissue availability may limit their potential applications. In Japan, the cost of cancer gene panel tests is covered by public insurance for patients diagnosed with advanced solid tumors once in their lifetime. Therefore, it is essential to improve the success rate (reportability) and accuracy of CGP tests. The purpose of this study was to identify the factors associated with efficient and accurate CGP testing using relevant information obtained from real-world data. This study included 159 samples analyzed using tumor-only panel FoundationOne® CDx cancer genome profiling (F1CDx) and 85 samples analyzed using matched-pair panel OncoGuide™ NCC Oncopanel system (NCCOP) at St. Marianna University Hospital. Sample characteristics (fixation conditions, storage period, histology, tumor cell ratio, and genomic tumor cell content), CGP performance, and quality control status were evaluated across all 244 tested samples. In 237/244 samples (97.1%), CGP testing results were successfully obtained [F1CDx, 99.4% (158/159) and NCCOP, 92.9% (79/85)]. An increased number of fibroblasts, inflammatory cells, and necrotic tumor cells, long-term storage, and/or prolonged fixation of tissue sections were involved in the unreported results and/or qualified CGP results. In addition, a negative correlation between median insert size values and ΔΔCq was observed in the NCCOP system. We identified various factors associated with efficient and accurate CGP testing using relevant information obtained from real-world data, suggesting that thorough selection and preparation of tissue sections could optimize CGP and maximize useful information.

Morphological and optical properties of carbonaceous aerosol particles from ship emissions and biomass burning during a summer cruise measurement in the South China Sea

Abstract. Carbonaceous aerosols constitute a crucial component of atmospheric marine aerosols among which black carbon (BC) and brown carbon (BrC) are important contributors to light absorption and hence the positive climatic radiative forcing in the marine atmosphere. We conducted month-long (5 May–9 June 2021) onboard sample collections and online measurements of carbonaceous aerosols to characterize their morphological and optical properties during a ship cruise in the South China Sea (SCS), covering a marine region of 11.9–24.5° N, 111.1–118.2° E. Single particles were collected by a single-particle sampler, and offline analyses were performed using a transmission electron microscope (TEM) coupled with energy-dispersive X-ray spectroscopy (EDS). Online measurements of BC in PM2.5 were made by a seven-wavelength aethalometer, and organic carbon (OC) and elemental carbon (EC) mass concentrations were measured by a semi-online OC/EC analyzer. Feret diameters of the single particles during navigation and stop showed size distributions with the lognormal fitting peaks at 307 and 325 nm, respectively. The fresh (without coating) and aged BC particles (after removal of coating by the electron beams in the TEM) showed same median fractal dimensions (1.61), in contrast to their different median lacunarities (0.53 vs. 0.59). The aged BC particles showed narrower Feret diameters (229–2557 nm) during navigation than those (78–2926 nm) of freshly emitted BC from the ship's own exhaust during stop. Moreover, tar balls, as one important component of single particles from ship emissions and as the tracer of biomass burning, were identified with geometrical diameters of 160–420 nm in the TEM images. The EDS analyses showed those tar balls are mainly mixed with sea salt, organics, BC, and sulfate. We also found a significant fraction of aged BC in various mixing states (core–shell, embedded) with other components of the aerosol particles after long-range transport. The campaign was further divided into several periods (the before-monsoon period, BMP; transition monsoon period, TMP; after-monsoon period, AMP; and ship pollution period, SPP) according to the wind direction during monsoon and the ship's own pollution. The median absorption Ångström exponent (AAE) values derived from all wavelengths were 1.14, 1.02, 1.08, and 1.06 for BMP, TMP, AMP, and SPP, respectively. Particularly, a median AAE value of 1.93 was obtained during two significant biomass burning events. These results showed that biomass burning (BB) and fossil fuel (FF) combustion contributed to 18 %–22 % and 78 %–82 % of all the BC light absorption without the two intense biomass burning events, during which BB and FF accounted for 42 % and 58 %, respectively. The two BB events originated from the Philippines and Southeast Asia before and after the summer monsoon. Our results demonstrated that BC can serve as the core of aged particles, but the fractal dimensions of BC aggregates were subject to little variation; moreover, such BC particles become much more aggregated after aging in the marine atmosphere, which further affects the light absorption of the BC particles in the SCS.

The Impact of Effective Mass on the Strength of Side and Turning Kick in Taekwon-Do Male Practitioners

Background: One of the elements of improving the striking power of combat sports athletes is the ability to use their body mass in an efficient manner; this can improve movement technique and thus increase combat effectiveness. Therefore, the aim of this study was to gain knowledge about the influence of the effective mass obtained on the strength of turning and side kicks in the context of lateralization. Material and methods: The study involved four adult taekwon-do ITF (International Taekwon-do Federation) competitors. Acceleration and force data were obtained by mounting a wireless IMU sensor manufactured by Noraxon, which was synchronized with a force plate. Results: The median force pressure values amounted to 2661.53 N for the turning kick and 4596.15 N for the side kick, with foot acceleration of 150.56 m/s2 and 74.34 m/s2, respectively. The calculated median effective mass for the turning kick was 20.12%, and for the side kick, it was 73.09% of the total body mass. The conducted analysis indicates a lack of statistically significant differences between the right and left leg in the obtained kinetic variable values (p &gt; 0.05). Conclusions: Our research suggests that the side kick achieves, on average, higher force values than the turning kick. The noted correlation between the three variables informs us that the greater the effective mass, the greater the force pressure and the smaller the foot acceleration, which is consistent with other studies. The lack of lateralization in the limbs performing the kicks is consistent with another study.

Improved Short-Term Prognosis of Pediatric Partial-Thickness Burns: Emergency Conservative Debridement Under Topical Anesthesia.

Early wound management for pediatric patients with partial-thickness burns in the emergency department remains debatable. This study aims to evaluate the value of emergency conservative debridement under topical anesthesia in improving short-term prognosis of pediatric partial-thickness burns. This retrospective cohort study enrolled children with partial-thickness thermal burns presenting to the emergency department within 6 hours postburn. All the enrolled patients were divided into 2 groups: the debridement group and the dressing group. The associations between emergency conservative debridement and time to reepithelialization was analyzed by using Kaplan-Meier curves with log rank test and multivariate Cox regression analysis. Moreover, the associations between emergency conservative debridement and in-hospital cost and length of stay were also evaluated. All baseline characteristics between groups were comparable (all P > 0.05). Emergency conservative debridement under topical anesthesia significantly decreased the median value of time to reepithelialization (13 vs 14 days, P = 0.02). Cox regression analysis showed that emergency conservative debridement significantly improved wound reepithelialization after adjusting for burn size (odds ratio, 4.07; 95% confidence interval, 1.64-10.11; P < 0.01). The mean length of stay of patients receiving conservative wound debridement was lower than that of patients in the wound dressing group (14.3 ± 7.3 vs 18.8 ± 10.4 days, P < 0.01), but not in terms of mean in-hospital cost per 1% total body surface area (2.8 ± 1.9 vs 3.0 ± 2.1 × 103 RMB per 1% total body surface area, P = 0.58). Emergency conservative debridement of pediatric partial-thickness burns under topical anesthesia significantly improves the wound healing outcomes without increasing health care burden.

The relation between plasma apelin 36 and insulin resistance in obese type 2 diabetic Egyptian population

ABSTRACT Background Obesity causes changes in the production of adipose tissue secreted factors, which are responsible for metabolism modulation. One of these factors is Apelin, a small peptide that interacts with a specific cell-surface receptor to modulate various cells signaling processes. Apelin is regarded as a new player because of its powerful role in energy metabolism and improvement of insulin sensitivity. Aim of the Work This study investigates the plasma apelin 36 role and to what extent it can impact the insulin resistance in obese Egyptians diagnosed with type 2 diabetes (T2DM). Subjects and Methods The study involved 90 participants, with 30 assigned to each of the three study involved categories: obese individuals with diabetes, obese individuals without diabetes, and healthy controls (n = 30 for each group). Measurements of skin fold thickness, body mass index (BMI), waist/hip ratio, and body fat % were obtained along with a comprehensive clinical examination and history. The following were investigated: plasma insulin, Hb A1c, lipid profile, plasma apelin (ELISA), plasma leptin (ELISA), and plasma adiponectin (ELISA). Results The median value of serum leptin in obese subjects (groups I and II) was higher significantly than healthy control group (group III) (p = <0.001). A significant decrease in serum adiponectin could be detected in obese subjects (groups I and II) compared to control subjects (Group III) (p = 0.004). When compared to the healthy control group (group III), the mean serum apelin level was significantly higher in the obese participants (groups I and II) and much higher among obese diabetic group (p = <0.001). A statistically significant correlation (p = 0.001) was observed between fasting serum insulin and both HOMA-IR and serum apelin among the non-diabetic obese participants involved in the study. Conclusions Obese people have raised serum apelin levels; those with T2DM have significantly greater serum apelin levels. While it showed a positive correlation with insulin level and HOMA-IR among the obese non-diabetic individuals.

Predictive role of the prognostic nutritional index in patients with pancreatic ductal adenocarcinoma who underwent neoadjuvant chemoradiotherapy followed by curative pancreatic resection: A retrospective study using prospectively collected data.

Despite a strong association between nutritional indices and disease prognosis, evidence regarding the evaluation of nutritional indices after preoperative treatment for pancreatic ductal adenocarcinoma (PDAC) is insufficient. We evaluated the clinical significance of the prognostic nutritional index (PNI) in patients with resectable (R-) and borderline resectable (BR-) PDAC who received neoadjuvant chemoradiotherapy (NACRT) followed by pancreatic resection. We assessed 153 patients with R- and BR-PDAC who underwent NACRT followed by curative resection between 2009 and 2022. We evaluated the association between preoperative PNI after NACRT and short- and long-term outcomes. The median preoperative PNI value after NACRT was 42.1, and the optimal cutoff value from the time-dependent receiver operating characteristic curve was 38.6. The low PNI group (PNI < 38.6, n = 44) exhibited significantly worse inflammatory parameters, surgical outcomes, and prognoses than the high PNI group (PNI ≥ 38.6, n = 109). Multivariate analysis identified preoperative PNI ≤ 38.6 (hazard ratio [HR]: 2.32, 95% confidence interval [CI]: 1.00-5.38, p = .049), blood loss ≥1642 mL (HR: 3.05, 95% CI: 1.65-5.64, p < .001), node positive pathology (HR: 2.10, 95% CI: 1.32-3.34, p = .002), and lack of postoperative adjuvant chemotherapy (HR: 3.55, 95% CI: 2.05-6.15, p < .001) as significant predictors of overall survival. For patients with R- and BR-PDAC receiving preoperative treatment, it is imperative to closely monitor their nutritional status when determining the optimal surgical procedure timing.

Effects of health claims on demand structure and market power: The case of the yogurt market in Japan

AbstractThis study aims to clarify the effects of health claims on consumer purchasing behavior and market power, using the Japanese yogurt market as a case study. For the analysis, the Berry, Levinsohn, and Pakes model was applied for estimations using product‐level purchasing data. The main analysis results are as follows. First, consumers prefer brands with lower prices, higher protein, lower fat, lower carbohydrates, and foods for specified health uses (FOSHU). Second, from the value of own‐price elasticity of market shares, the higher the price of a brand, the more sensitively consumers respond to price. From the value of the cross‐price elasticity of market shares, strong competition exists among FOSHU brands, and the price of R‐1 drink types tends to significantly impact the market shares of brands other than FOSHU brands. Third, the market power of each brand tends to be higher for lower‐priced brands and lower for higher‐priced brands. In terms of market power by manufacturer, Meiji has the highest both the weighted average and median values. However, both the weighted average and median values of Danone Japan are relatively lower than those of other manufacturers. Fourth, in terms of each brand's market power, brands with low prices and FOSHU labeling have high market power. These findings suggest that the acquisition of FOSHU brands in the Japanese yogurt market does not lead to a decline in market power (increase in price) and has positive effects for manufacturers, such as an increased market share.

Intelligent diagnosis of lung nodule images based on machine learning in the context of lung teaching.

The vast majority of intelligent diagnosis models have widespread problems, which seriously affect the medical staff judgment of patients' injuries. So depending on the situation, you need to use different algorithms, The study suggests a model for intelligent diagnosis of lung nodule images based on machine learning, and a support vector machine-based machine learning algorithm is selected. In order to improve the diagnostic accuracy of intelligent diagnosis of lung nodule images as well as the diagnostic model of lung nodule images. The objectives are broken down into algorithm determination and model construction, and the proposed optimized model is solved using machine learning techniques in order to achieve the original algorithm selected for intelligent diagnosis of lung nodule photos. The validation findings demonstrated that dimensionality reduction of the features produced 17 × 1120 and 17 × 2980 non-node matrices with 1216 nodes and 3407 non-nodes in 17 features. The support vector machine classification method has more benefits in terms of accuracy, sensitivity, and specificity when compared to other classification methods. Since there were some anomalies among both benign and malignant tumors and no discernible difference between them, the distribution of median values revealed that the data was symmetrical in terms of texture and gray scale. Non-small nodules can be identified from benign nodules, but more training is needed to separate them from the other 2 types. Pulmonary nodules are a common disease. MN are distinct from the other 2 types, non-small nodules and benign small nodules, which require further training to differentiate. This has great practical value in teaching practice. Therefore, building a machine learning-based intelligent diagnostic model for pulmonary nodules is of significant importance in helping to solve medical imaging diagnostic problems.