Time Research Articles

Investigation of SARS-CoV-2 release in fecal specimens of discharge COVID-19 patients

Abstract Objectives The presence of live SARS-CoV-2 viruses in the fecal specimens and the positive results for SARS-CoV-2 RNA in gastrointestinal samples after respiratory specimens had become negative indicate that there may be a risk of transmission of the disease not only through the respiratory tract but also through the fecal-oral route. The study aim is to determine the time period that the SARS-CoV-2 virus remains in the fecal specimens of discharged COVID-19 patients to reveal the time interval in which the risk of transmission continues. Methods In 65 patients hospitalized with a COVID-19 diagnosis, the viral RNA was isolated from the supernatant of the stool sample using CVXTM viral RNA extraction kit. The extracted RNAs from the stool samples were detected using a commercial RT-PCR method. Results Positive results were obtained in the stool samples in eight of sixty-five patients and the presence of SARS-CoV-2 in these patients was detected for up to three weeks. Conclusions By determining the residence time of SARS-CoV-2 virus in stool samples of discharged COVID-19 patients, the time interval during which the possibility of transmission risk continues has been revealed. The findings of the study could prove beneficial in comprehending the risks of transmission and translating them into preventative measures.

Association of Time Since Diagnosis of Pediatric Ileocolic Intussusception With Success of Attempted Reduction: Analysis in 1065 Patients.

BACKGROUND: Radiologists generally treat pediatric ileocolic intussusceptions emergently given potential worse outcomes from delayed reduction attempts. However, relevant literature is conflicting. OBJECTIVE: To identify factors associated with successful image-guided ileocolic intussusception reduction in children, with attention to the time interval since diagnosis. METHODS: This retrospective study included patients <6 years old who underwent attempted image-guided enema reduction of ileocolic intussusception between May 2009 and July 2023. Patients were separated into two groups: those presenting directly to the institution (nontransferred patients, who all underwent attempted reduction <8 hours after ultrasound diagnosis), and those transferred from outside facilities. EHR data were extracted. Each patient's first image-guided reduction attempt was classified as successful or unsuccessful. Univariable and multivariable analyses were performed. RESULTS: The study included 1065 patients (649 male, 416 female; mean age, 18.1 months; age range, 2.2-71.0 months; 793 nontransferred and 272 transferred patients). In nontransferred patients, the mean interval between ultrasound diagnosis and reduction attempt was 150.8 minutes; in transferred patients, the mean interval between outside facility advanced imaging and reduction attempt was 460.1 minutes (p<.001). Successful reduction occurred in 84.6% and 81.6% of nontransferred and transferred patients, respectively (p=.25). In nontransferred patients, success occurred in 85.6% of attempts <2 hours after diagnosis versus 84.0% of attempts 2-<8 hours after diagnosis (p=.54); the mean interval from diagnosis to attempted reduction was 149.7 minutes and 156.8 minutes for successful and unsuccessful attempts, respectively (p=.53). In multivariable analysis, factors showing independent associations with success were proximal intussusception location (OR=3.63, p<.001) and absence of high-risk ultrasound findings (OR=2.57, p<.001); success was not independently associated with age, sex, bloody stools, reduction method, or time since diagnosis <2 hours (p>.05). In transferred patients, the mean interval from outside advanced imaging to attempted reduction was 463.1 minutes and 440.2 minutes for successful and unsuccessful attempts, respectively (p=.74). CONCLUSION: Intussusception reduction may not require completion emergently (within 2 hours after diagnosis), but potentially may be safely performed on an urgent basis (within 8 hours). CLINICAL IMPACT: The findings have implications for determining the standard of care, including criteria for oncall activation of radiologic resources, in pediatric intussusception management.

Towards various occupants with different thermal comfort requirements: A deep reinforcement learning approach combined with a dynamic PMV model for HVAC control in buildings

Reinforcement learning (RL) has great potential in achieving energy-efficient, comfortable and intelligent control of heating, ventilation and air conditioning (HVAC) systems. Although research on RL-based HVAC control has attracted increasing interest, current studies generally use simple building simulation as the environment to train agents, and the definition of thermal comfort is limited to a wide temperature range, which cannot meet the different thermal comfort requirements of various occupants. This study proposes a deep reinforcement learning (DRL) control framework based on the Dueling Deep Q-network (DQN) algorithm, combined with a self-designed environmental model and reward function, for HVAC control meeting different thermal comfort requirements. Specifically, based on the theory of building thermal dynamics, a nonlinear equation modified by experimental data is used for the environmental model that reflects the actual thermal change of building. Different thermal comfort requirements are considered and analysed through a dynamic predicted mean vote (PMV) model that focuses on the metabolic rate and clothing level of occupants. By systematically exploring different heating modes for occupants and control time intervals, the proposed framework demonstrates that heating energy consumption can be reduced by 4.8%-39.58% under various conditions compared to rule-based control. In addition, the study found that the HVAC control based on DRL has greater potential in saving energy when the heating demand of building is higher. Our study is helpful for researchers to make HVAC control more energy-efficient and user-friendly with the help of artificial intelligence.

Mechanically Induced Motor Tremors Disrupt the Perception of Time.

Contemporary research has begun to show a strong relationship between movements and the perception of time. More specifically, concurrent movements serve to both bias and enhance time estimates. To explain these effects, we recently proposed a mechanism by which movements provide a secondary channel for estimating duration that is combined optimally with sensory estimates, in accordance with Bayesian cue combination. However, a critical test of this framework is that by introducing "noise" into movements, sensory estimates of time should similarly become noisier in a manner predicted by cue combination equations. To accomplish this, we had human participants move a robotic arm while estimating intervals of time in either auditory or visual modalities (n=24, ea.). Crucially, we introduced an artificial "tremor" in the arm while subjects were moving, that varied across three levels of amplitude (1-3 N) or frequency (4-12 Hz). The results of both experiments revealed that increasing the frequency of the tremor led to noisier estimates of duration; however, the effect plateaued at higher frequencies, instead of increasing linearly, a finding consistent with optimal integration. Further, the effect of noise varied with the base precision of the interval, such that a naturally less precise timing (i.e. visual) was more influenced by the tremor than a naturally more precise modality (i.e. auditory). To explain these findings, we fit the data with a recently developed drift-diffusion model of perceptual decision making, in which the momentary, within-trial variance was allowed to vary across conditions. Here, we found that the model could recapitulate the observed findings, further supporting the theory that movements influence perception directly. Overall, our findings support the proposed framework, and demonstrate the utility of inducing motor noise via artificial tremors, thus providing clinical utility in their connection to movement disorders characterized by tremors.Significance Statement Our perception of time is naturally tied to movements of the body. Yet, how bodily movements bias or enhance estimates of time is still not well understood. We recently proposed that time estimates from body movements are combined with those from other sensory modalities via a Bayesian cue-combination mechanism. This suggests that, by adding noise into body movements, time estimates from other sensory modalities should also be noisier. Here, we find evidence for this effect across two experiments where human subjects judged intervals of time while moving a robotic arm at different levels of tremor. These findings support the connection between body movements and time and provide an additional avenue of research using noisy movements to impact sensory estimates.

Wavelet optical flow velocimetry of a scramjet combustor using high-speed frame-straddling focusing schlieren images

Scramjet combustors feature ultra-high-speed turbulent reacting flows with high temperatures and intense luminescence. Measurement of velocity fields under such extreme conditions presents great challenges. The present work demonstrated a seedless velocimetry approach using focusing schlieren images (FSIs) of high spatiotemporal resolution in a scramjet engine. Two fuel mass flow rates (Case1 and Case2) were investigated with corresponding global equivalence ratios of 0.27 and 0.13, respectively. The FSIs enabled by the employment of a high-speed pulsed LED light source are characterized by an effective exposure of 100 ns, and a 500-ns frame-straddling time interval with full resolution of 1280 × 800 pixels recorded at 76 kHz. The 100-ns exposure allows for capturing of transient high-speed flow motion without blurring, and the 500-ns time interval ensures an appropriate spatiotemporal correlation between subsequent schlieren images for high-speed reacting flows. A wavelet-based optical flow velocimetry (wOFV) algorithm was developed and applied to the FSIs. In contrast to the correlation-based algorithms widely employed in PIV for distinct particles, the wOFV algorithm suits better FSIs with continuous variation in brightness. The maximal velocities in the main duct of the scramjet combustor were measured to be approximately 550 m/s and 1100 m/s for Case 1 and Case2, suggestively corresponding to subsonic and supersonic combustion modes, respectively. The measured velocity inside the cavity is generally below 200 m/s for both cases. Recirculation regions and their dynamic motions inside the cavity were well resolved. In summary, the development of the novel velocimetry approach holds great potential for applications in extreme flow conditions.

Impact of an Etoposide Chemotherapy Shortage on Patients With Extensive-Stage Small-Cell Lung Cancer: Results of a Natural Experiment.

A shortage of essential intravenous (IV) etoposide lasted from 2018 until 2020 in Ontario, Canada, allowing for a natural experiment in which external factors (IV etoposide availability) dictated patients' treatment assignment. The purpose of this study was to evaluate the impact of this IV etoposide shortage (IVES) on patient care outcomes. Individuals with extensive-stage small-cell lung cancer (ES-SCLC) treated during a pre-IVES (November 2017-October 2018) and IVES (November 2018-October 2019) time intervals were retrospectively reviewed at the Verspeeten Family Cancer Centre. We investigated the association of the shortage on health care utilization and survival using a time-to-event analysis, Cox proportional hazards and logistic regression modeling. A total of 119 patients with ES-SCLC were assessed, 49 in the pre-IVES interval and 70 in the IVES interval. The median age was 68 (IQR, 62-74) years, 48% (n = 57) were male, 33% (n = 39) had CNS metastases, and 69% (n = 82) received first-line systemic therapy. Alternate regimens used for IVES cohort included IV platinum-oral (PO) etoposide, IV platinum-IV irinotecan, and PO etoposide monotherapy. An adjusted multivariable model demonstrated a significant increase in hospitalization (odds ratio, 2.30 [95% CI, 1.01 to 5.24]; P = .047) and shorter progression-free survival (PFS; hazard ratio, 1.79 [95% CI, 1.19 to 2.68]; P = .005) during the IVES. This study demonstrated increased hospitalization, and decreased PFS, among patients with ES-SCLC treated with alternate chemotherapy regimens during an IVES. The impact of cancer drug shortages can be harmful, and optimizing a more secure drug supply with mitigation strategies is warranted.

Singular limit of a chemotaxis model with indirect signal production and phenotype switching

Abstract Convergence of solutions to a partially diffusive chemotaxis system with indirect signal production and phenotype switching is shown in a two-dimensional setting when the switching rate increases to infinity, thereby providing a rigorous justification of formal computations performed in the literature. The expected limit system being the classical parabolic–parabolic Keller–Segel system, the obtained convergence is restricted to a finite time interval for general initial conditions but valid for arbitrary bounded time intervals when the mass of the initial condition is appropriately small. Furthermore, if the solution to the limit system blows up in finite time, then neither of the two phenotypes in the partially diffusive system can be uniformly bounded with respect to the L 2-norm beyond that time.

Early clearance of BK polyomavirus-DNAemia among kidney transplant recipients may lead to better graft survival.

BK polyomavirus (BKPyV)-DNAemia is a common complication in kidney transplant recipients (KTRs). The significance of achieving viral clearance at different time intervals is not well understood. All adult KTRs transplanted between January 1, 2015 and December 31, 2017 who developed BKPyV-DNAemia were included. Outcomes were analyzed based on persistent clearance of BKPyV-DNAemia at 3-month intervals up to 2 years after initial detection, and for recipients with persistent BKPyV-DNAemia at last follow-up. Uncensored graft failure, death-censored graft failure (DCGF), and a composite outcome of DCGF or fall in estimated glomerular filtration rate (eGFR) by ≥50% from the time of initial BKPyV-DNAemia were outcomes of interest. Of 224 KTRs with BKPyV-DNAemia, 58 recipients (26%) achieved viral clearance by 3 months after initial detection, 105 (47%) by 6 months, 120 (54%) by 9 months, 141 (63%) by 12 months, 155 (69%) by 15 months, 167 (75%) by 18 months, 180 (80%) by 21 months, and 193 (86%) by 24 months. Nine recipients (4%) had persistent BKPyV-DNAemia at last follow-up. Compared to recipients who achieved viral clearance by 3 months, those who achieved clearance by 6 months (adjusted odds ratio [aOR]: 3.15; 95% confidence interval [CI]: 1.22-8.12; p=.02) and 9 months (aOR: 3.69; 95% CI: 1.02-13.43; p=.04) had significantly increased risk for uncensored graft failure. There was no significant association between time to viral clearance and DCGF or composite outcomes. We found a trend of increased risk for uncensored graft failure among those who cleared BKPyV-DNAemia more slowly. Aiming to clear viremia early, without risking rejection, may be beneficial for allograft function and patient morbidity and mortality.

Outcomes of Femoral Popliteal Bypass in Octogenarians.

Femoral-popliteal bypass (FPB) surgery is a common lower extremity revascularization procedure. As the population continues to age, this procedure is being performed increasingly on older patients. This study investigated whether outcomes differ in this population. Patients over and less than 80 years old who underwent FPB between 2009-2013 were queried using an existing hospital registry. Demographics, comorbidities, intraoperative complications, perioperative outcomes, and two-year patencies were compared. Twenty-four patients in the octogenarian cohort (OC) and 72 patients in the non-octogenarian cohort (NOC) were identified. There was a lower prevalence of smoking (p=0.018) and higher prevalence of hypertension (p=0.021) among octogenarians. Other medical characteristics were similar (p<0.05). There were no differences in use of vein versus PTFE (p=0.002) as a conduit, or above (OC 20.0% vs. NOC 36.7%), versus below knee (OC 80.0% vs. NOC 63.3%) distal anastomosis (p>0.05) between the groups. There was a difference (p<0.01) in indication for procedure (OC/NOC): claudication (0%/44%), limb salvage (71%/31%), and rest pain (29%/25%). There were no differences in 30-day readmissions (17% vs. 21%; p=0.59) or incidence of postoperative (25% vs. 19%; p=0.56) or intraoperative complications (8.3% vs. 4.2%; p=0.52). Length of stay (LOS) was longer and statistically significant in octogenarians (12 days vs. 7 days; p=0.032) and remained significant after multivariate linear regression (p=0.015). Patencies in OC were lower and dropped faster after six months; however, there were no statistically significant differences in patencies at any time interval (p>0.05). The position of the distal anastomosis relative to the knee, conduit type, and indication were not independently predictive of patency outcomes (p>0.05). The safety and efficacy of FPB in octogenarians is similar to the general population despite LOS in octogenarians being 5.98 days longer. While the difference in indication suggests that vascular surgeons are more conservative in treating octogenarians, our analysis did not reveal significant differences between populations and suggests that lower extremity bypass can be performed safely with comparable results in this cohort. A larger cohort is needed to validate these results.

Impact of lung adenocarcinoma subtypes on survival and timing of brain metastases

PurposeLung cancer is a devastating disease, with brain metastasis being one of the most common distant metastases of lung adenocarcinoma. This study aimed to investigate the prognostic characteristics of individuals with brain metastases originating from invasive lung adenocarcinoma of distinct pathological subtypes, providing a reference for the management of these patients.MethodsClinical data from 156 patients with lung adenocarcinoma-derived brain metastases were collected, including age, sex, smoking status, Karnofsky Performance Status scores, pathological subtype, lymph node metastasis, tumor site, treatment mode, T stage, and N stage. Patients were classified into two groups (highly differentiated and poorly differentiated) based on their pathological subtypes. Propensity score matching was used to control for confounding factors. The prognostic value of pathological subtypes was assessed using Kaplan-Meier analysis and Cox proportional hazards regression modeling.ResultsKaplan-Meier analysis indicated that patients in the moderately to highly differentiated group had better prognoses. Multivariate analysis revealed that being in the poorly differentiated group was a risk factor for poorer prognosis. Thoracic tumor radiation therapy, chemotherapy, and surgery positively influenced the time interval between lung cancer diagnosis and brain metastasis.ConclusionsThe pathological subtypes of lung adenocarcinoma-derived brain metastases are associated with patient prognosis. Patients in the poorly differentiated group have worse prognoses compared to those in the moderately to highly differentiated group. Therefore, patients in the poorly differentiated group may require more frequent follow-ups and aggressive treatment.

Enhancement of W Nanoparticles Synthesis by Injecting H2 in a Magnetron Sputtering Gas Aggregation Cluster Source Operated in Ar

AbstractSynthesis of W nanoparticles by magnetron sputtering combined with gas aggregation operated in Ar suffers from a continuous decrease of the synthesis rate, ceasing in a finite time interval, in the range of minutes to tens of minutes. Experimentally, we noticed that adding small amounts of H2 to Ar (5–20%) increases the synthesis rate, which remains constant over time, at a value dependent on the amount of injected hydrogen. Mass spectrometry investigations revealed, in the hydrogen presence, a dominance of the ArH+ ions over the Ar+ ones, associated also with an increased number of W+ and WH+ species in plasma, sustaining a substantial increase in the nucleation rate.

Temperature Field Measurements in Swirl Spray Flames Using Two-Line Planar Laser Induced Fluorescence Thermometry

Abstract This paper investigates the temperature fields in a centrally staged swirl spray combustor using two-line OH planar laser induced fluorescence (PLIF) thermometry at elevated inlet pressures and temperatures up to 0.62 MPa and 650 K. The pilot and main stages of the combustor were supplied with RP-3 kerosene. OH radicals were excited using the Q1(5) and Q1(14) transitions within the A2Σ←X2Π (1,0) band. Two laser excitation systems were operated simultaneously, where the two beams were spatially combined and separated by a small interval in time. The PLIF signals excited at the two wavelengths were captured by two identical sets of imaging system. The calibration coefficient needed for quantitative conversion from fluorescence ratio to temperature was determined based on results from independent coherent anti-Stokes Raman scattering (CARS) measurements. A joint threshold mask was developed to remove the noise and weak signals in the raw PLIF images. The high temperature zones in the temperature field were then obtained, and the pilot and main stage flames were identified. In addition, the radial position of the pilot flame showed marked variations at a nominally fixed condition. By extracting the radial profiles, a consistency between the peaks of PLIF intensity and temperature was found, suggesting that PLIF images could be a qualitative substitute for the high temperature zones in the temperature fields of these swirl spray flames. This study demonstrates the feasibility of temperature field measurements using two-line OH PLIF in aero-engine model combustors.

Enhancements of Wave Power Absorption with Arrays and a Vertical Breakwater

The capability of the in-house transient wave-multibody computational tool, ITU-WAVE, is extended to predict the wave power absorption with Wave Energy Converters (WECs) arrays placed in front of a vertical breakwater. The hydrodynamic forces are approximated by solving boundary integral equation at each time interval. The reflection of incoming waves due to a vertical wall is predicted with method of images. The constructive or destructive performance of WECs arrays with different array configurations is measured with mean interaction factor. The behaviour of the hydrodynamic forces of each WEC due to a vertical wall effect shows considerable differences than those of WECs arrays without a vertical wall. When the wave power absorption with WECs arrays with and without a vertical wall effect are compared, the numerical results show that WECs placed in front of a vertical wall have much greater effects on wave power absorption. This can be attributed to the hydrodynamic interaction, standing waves, and nearly trapped waves in the gap between a vertical wall and WECs arrays. The analytical and other numerical results are used for the validation of present ITU-WAVE computational results for exciting and radiation forces, and mean interaction factor of WECs arrays which show satisfactory agreements.

Predictive models, as an idea, to advance the secondary to tertiary transition in science courses

Investigating the transition between the secondary and the tertiary levels is a main theme in mathematics and science education. More so, this paper considers the transition that intersects with the after-effects of COVID-19, or the transition together with an educational context dominated by sociocultural differences and educational disadvantages. With this knowledge in mind, we investigated the effects of predictive mathematical models (multiple regression, logistic regression, and decision trees) to predict &lt;i&gt;at-risk&lt;/i&gt; students at three time intervals (weeks one, three, and seven) in the semester. The idea was implemented with a first-year life science class of 130 students. Variables from an academic readiness questionnaire along with early assessment grades were used to build these models. Through a Monte Carlo cross validation method, the performance of the executed predictive models was assessed, and limitations were reported. We argue that the results obtained from predictive models can support both lecturers and students in the transition phase. The idea can be expanded to other courses in STEM fields and other educational contexts.

The multifaceted factors affecting the publication times of pediatric ophthalmology and strabismus articles: what has changed in two decades

AbstractExpeditious publication is an important factor when considering publishing ophthalmic research. We investigated the factors associated with shorter publication times in pediatric ophthalmology and strabismus (POS). We analyzed 2487 POS articles from 8 ophthalmology journals publishing POS articles. Time from submission to acceptance, from acceptance to publication, and from submission to publication were calculated for each article. We compared trends over time of factors affecting the publication times from 2002 to 2007 and those from 2014 to 2018. Median peer review durations were 156 days from submission to acceptance; 79 days from acceptance to publication, and 244 days from submission to publication. The American Journal of Ophthalmology, JAMA Ophthalmology, and Strabismus had the shortest submission to publication time. Authors from Africa, East Europe, Central and South America received the fastest processing time in all time categories, although most authors were based in North America and UK. All-time intervals decreased annually, significantly more during the first decade. In the study's second period, more co-authors and affiliated departments correlated with shorter review times. Manuscripts in higher Impact Factor (IF) journals had faster publication times in the first decade. Female senior authors faced longer submission-to-acceptance times in the first decade. This gender gap disappeared in the second period. A general improvement occurred with most journals, specifically those journals with a higher number of co-authors and affiliated departments, indicating an efficient collaborative authorship. Low-income regions benefited from comparatively shorter time intervals. The gender gap in senior authorship diminished over time.

A Scoping Review: Unveiling the Benefits of ACF on Tuberculosis Control

Background: Tuberculosis (TB) ranks among the top ten infectious diseases and causes of death worldwide. The implementation of active case-finding TV is crucial in achieving the objectives of the World Health Organization’s End TB strategy. Aims: This review aims to determine the role of active case finding in TB control in a community with high-burden TB. Methods: This review used databases Pubmed, Research Gate, Ebscohost, Science Direct, and Scopus. The search for articles used the main keywords community, active case finding, AND tuberculosis. The articles were selected in English, with a five-year time interval between 2019 to 2023. The type of article subject area included medicine, health, health care, environmental science, and social science. The documents were from journals and articles. The text availability was free full text. Results: This review was done on 3.561 articles that were screened and analyzed out of 6 articles. The articles were originated from Cambodia, China, India, and Africa. This scoping review describes the effect of ACF in the community on TB control (cohorts and cross-sectional) in high-burden TB. Results from 5 articles including 6 studies indicated that ACF in the community was significantly associated with TB control. One of the studies revealed that studies in which ACF reported a non-significant association. Conclusion: This review summarized that ACF provides greater benefits than the PCF strategy, especially in high-risk populations and those with limited access to healthcare facilities. It promotes prompt diagnosis and treatment improves treatment outcomes, minimizes health complications, and reduces the social and economic impact of TB.

Groundwater Flow Controlled Migration of Dissolved Microbial Gas in the Eastern Hungarian Pannonian Basin

Formation of commercial microbial gas accumulations requires specific migration and accumulation conditions which can be effectively provided by groundwater flow systems. Namely, if microbial methane can be gathered and transported in aqueous solution over large lateral distances, great amount of free gas can be exsolved where flows turn upward causing a decrease in solubility. Based on this concept and the flow pattern of regional scale topography-driven groundwater flow systems, the present study built a simplistic 2D model in MS Excel including a methane solubility database with 32000 data. The model can calculate the required flow pathway length to saturate groundwater with methane, the amount of free gas that can be released in a potential accumulation zone, and the necessary time interval for the whole process. Application of the model was demonstrated based on the geological and hydrogeological conditions of a study area in the Central Pannonian Basin (Hungary) focusing on the Hajdúszoboszló gas field. In light of the upscaled results of the 2D model, the known microbial gas accumulations of the study area could be charged according to the model. In addition, parameter sensitivity analysis also provided valuable insights into the complex mechanisms of microbial gas migration.

406. EXPLORING THE OPTIMAL TIMING OF MINIMALLY INVASIVE SURGERY FOR ESOPHAGEAL SQUAMOUS CELL CARCINOMA AFTER NEOADJUVANT CHEMORADIOTHERAPY

Abstract Background Neoadjuvant chemoradiotherapy has gradually become a first-line treatment for esophageal squamous cell carcinoma patients. After the completion of neoadjuvant chemoradiotherapy, patients usually undergo minimally invasive surgery to ensure complete removal of the tumor and lymphatic tissue. However, the optimal interval between neoadjuvant chemoradiotherapy and minimally invasive surgery is still an unknown factor, and whether it affects postoperative disease-free survival (DFS) and overall survival (OS) of patients remains unknown. Therefore, the main purpose of this study is to explore the specific impact of the interval between neoadjuvant chemoradiotherapy and minimally invasive surgery on patients, and to find the optimal interval time. Methods Patients who underwent neoadjuvant chemoradiotherapy and minimally invasive surgery from two institutions between October 2012 and September 2022 were included in this study. The time interval is defined as the days between the last time a patient receives neoadjuvant chemoradiotherapy and the execution of surgery. Determine the optimal interval truncation point using the surv_cutpoint function in the survminer package. The main research result is the OS and DFS of different interval groups. A multivariate Cox regression model was established to determine the main factors affecting Patient's OS. Construct a nomogram based on selected factors to meet clinical needs. Results 252 patients were included in the study. The average interval between patients undergoing neoadjuvant chemoradiotherapy and minimally invasive surgery is 59 days. The earliest interval for patients to undergo surgery is 28 days. Determine the optimal interval of 46 days based on the survminer package and divide the patients into two groups. The five-year OS rates for the short interval group and the long interval group were 82.6% and 61.0% (P = 0.023). The five-year DFS rates for the two groups were 67.6% and 48.2% (P=0.068). Multivariate Cox regression shows that the time interval, patient's sex, tumor differentiation, ypT, and ypN are the main factors affecting overall survival. Conclusions The interval between neoadjuvant chemoradiotherapy and minimally invasive surgery has a certain impact on patient survival, and it is recommended to undergo surgery between 28 and 46 days to improve patient prognosis and survival.

A typical meteorological day database of solar terms for simplified simulation of outdoor thermal environment on a long-term

The simulation of the outdoor thermal environment long-term, represented by the annual conditions, can describe outdoor thermal environment characteristics more completely. To simplify the simulation, Typical Meteorological Year (TMY) or Principal Component Analysis (PCA) methods are often used to generate a Typical Meteorological Day (TMD) as input conditions for a simplified simulation of the outdoor thermal environment in the long term. However, the results of these typical days are accidental, the time interval between the typical days is heterogeneous, and these typical days cannot be linked together to represent a data sequence used to describe meteorological features in the long term. By combining knowledge of Solar Terms in the traditional Chinese calendar with the CSWD (the Chinese standard year) method, a meteorological element data sequence of a typical weather day (Solar Terms Typical Meteorological Day, STTMD) can be generated. There are 24 typical days obtained by the STTMD method. In the traditional Chinese calendar, they have a definite time order, and the time interval between the typical days is about 15 days. Connecting these typical days can form a hypothetical meteorological year, which is used to simplify the description of the annual meteorological characteristics with the maximum probability of occurrence. Based on meteorological observation data from 1981 to 2010, the STTMD data series of 61 stations in China were generated. These data were used to form a simple national climate division, and then the meteorological representation of different divisions was analyzed. Meteorological representativeness analysis for these subtions indicated the good accuracy of STTMD data. The method can simplify the numerical simulation process for those studied on long-term and can be extended to applications such as outdoor comfort evaluation and urban building energy consumption.

Osteopathische herzfokussierte Palpation und Herzfrequenzvariabilität: Teil 1 – Ziele, Material und Methoden der randomisierten, kontrollierten Pilotstudie

Does osteopathic heart-focused palpation change heart rate variability in people with musculoskeletal pain who are under stress? Part 1 of this two-part article describes the aims, material, methods and participants of the randomized, controlled pilot study; part 2 in the following issue will present the results.Heart rate variability (HRV) describes fluctuations in time intervals between heartbeats and reflects autonomic activity. HRV is reduced in stressed patients with musculoskeletal pain and improved after osteopathic manipulative treatment and mind–body interventions. Heart-focused palpation (HFP) combines manual and mind–body approaches to facilitate relaxation. This randomised controlled pilot study investigated the feasibility and sample size for a future randomised controlled trial and the effect of a single treatment with HFP or sham HFP (SHAM) on short-term HRV. A total of 33 adults with stress and musculoskeletal pain completed the trial.