Time Index Research Articles

Evaluation of the effect of intravitreal injections on corneal epithelial, scleral and limbal region changes in diabetic retinopathy by AS-OCT.

The aim of the study is to evaluate the effects of diabetic retinopathy and intravitreal injections on the corneal, limbal and scleral areas. Patients with diabetes mellitus at different diagnosis and treatment levels were compared among themselves and with the control group in terms of corneal, limbal and scleral aspects with the help of anterior segment optical coherence tomography. In addition, clinical tests such as tear break-up time, Schirmer test-I and ocular surface disease index questionnaire were applied to the patients and the difference between the groups was investigated. When the groups were examined in terms of BUT, SCH-I and OSDI, there was a statistically significant difference between control group and diabetic group(p < 0.05). In the limbal region, all measurements are higher than in patients with diabetic eye involvement. Thinning was detected in the scleral area with intravitreal injection (p < 0.05). It should be known that DM may cause undesirable changes in the limbal region, and the importance of non-invasive detection with AS-OCT should not be forgotten. Since intravitreal injections for DME cause thinning of the sclera, it can cause various complications, and it may be recommended to change the quadrant in repetitive injection applications.

Oral and Periodontal Manifestation of Smokeless Tobacco (SLT) Users in Khartoum Locality 2022-2023

Back ground: Smokeless Tobacco (SLT) can cause oral mucosal lesions such as keratosis, gingival inflammation, periodontal inflammation, alveolar bone damage, dental caries, tooth abrasion, staining of tooth structure, dysplasia, and oral cancer. Tobacco has been linked to severe consequences for overall health. Objective: To identify the oral and periodontal manifestation of smokeless tobacco (SLT) users in Khartoum locality. Methodology: A descriptive cross-sectional hospital based study was done among 80current smokeless tobacco patients attending the outpatients and periodontology clinic in ACTH (Academy Charity Teaching Hospita), KDTH(Khartoum Dental Teaching Hospital), and alhekmah health center from January to March 2023, patients undergo oral examination after obtaining an informed consent, data collected using online Google form, pretested questionnaire and interviews. Data collected using Microsoft Excel spreadsheets and analyzed by SPSS version 23. Results: The study included mostly male participants (97.5%), aged 18-29 years old (31.3%). With lower education levels (31.3%). and working as unskilled workers (47.5%). Most participants put the snuff at buccal mucosa (42.5%), used for less than 10 years (41.3%), for 1-5 minutes (52.5%), and 1 pack per day (56.3%). The majority had dental caries (66.3%) with class I predominance (53.8%), inflammation (97.5%), recession (67.5%), staining (78.8%), and halitosis (73.8%). Mucosal hypertrophy was the most common mucosal change (71.3%). There was a statistical association between start time and plaque index (P value = 0.008), and quantity in packs and pocket depth (P value = 0.013). Conclusions: The study revealed that SLT has sever and considerable adverse effects on oral health and periodontal tissues.

Evaluation of dry eye disease and corneal epithelial mapping in patients with lower eyelid ectropion.

To evaluate the corneal epithelial mapping, ocular surface parameters and their relationship with each other in lower eyelid ectropion patients according to severity. This retrospective study included 48 lower eyelid ectropion patients and 63 healthy individuals as control group. Ocular surface and tear functions were evaluated with ocular surface staining score, tear film break-up time (BUT), non-invasive tear break-up time (NIBUT) and ocular surface disease index (OSDI). Meibography scores and corneal epithelial thickness (CET) mapping were evaluated. The lower eyelid ectropion was classified and divided into subgroups as follows: mild, moderate and severe. There was no significant differences between the groups for age and gender. Compared to controls, CET was significantly thinner at inferior (p = 0.047) and inferior nasal quadrants (p = 0.023) in the ectropion patients. Lower BUT and NIBUT, higher OSDI scores and higher ocular surface staining were observed in the ectropion patients. In the subgroups determined according to the severity of ectropion, ocular surface damage was found to be significantly higher as the severity of ectropion increased (p < 0.05). Patients with lower eyelid ectropion had worse ocular surface findings and more ocular complaints. Furthermore, the inferior and inferior nasal CETs were thinner in patients with lower ectropion.

Investigating nutritional strategies during a rest period to improve health, growth, and behavioral outcomes of transported surplus dairy calves

The objective of this study was to investigate the effects of feeding surplus dairy calves a milk replacer (MR) or one of 2 different oral rehydration solutions (ORS) during a mid-transportation rest period on metabolic and clinical health indicators, growth, and behavioral outcomes after arrival to a calf-raising facility. Surplus dairy calves (n = 128) were transported in 4 cohorts from February to July 2022 for 12 h to a holding facility, rested for 8 h, then transported for an additional 6 h to a calf-raising facility. Upon arrival to the holding facility, calves were randomly assigned to 1 of 3 treatments: MR (n = 43), a high sodium ORS developed for diarrhea (ORS-D; n = 43), or a high potassium ORS developed for transportation (ORS-T; n = 42). The exact age of calves at transportation was unknown, however all calves were under 14 d of age. Calf body weight at enrollment was 43.9 ± 5.9 kg, 43.7 ± 6.5 kg, and 45.0 ± 4.5 kg for calves fed MR, ORS-D, and ORS-T, respectively. Calves were fed 2.0 L of their treatment twice, once upon arrival and once before leaving the holding facility. At unloading and reloading at the holding facility, calves were weighed and blood sampled. Calves were also health scored at unloading at the holding facility. After arrival at the calf-raising facility, calves were weighed, health scored, and blood sampled. Blood samples were collected at 24 and 48 h and body weight (BW) was recorded at 24 h, 48 h, 72 h, 5 d, 7 d, 14 d, and at 8 wks after arrival to the calf-raising facility. Calves were also health scored daily for 14 d, which included fecal consistency scoring and evaluating the presence or absence of respiratory disease. Lying time, lying bouts, and activity index were measured during transportation and from 3 d relative to transportation using accelerometers. At arrival to the calf-raiser, calves fed ORS-D had higher concentrations of NEFA and BHB than calves fed MR. Furthermore, calves fed ORS-T had higher concentrations of BHB at arrival to the calf raiser compared with calves fed MR. In the 14 d after arrival to the calf-raiser, there was evidence that calves fed ORS-T had a higher proportion of days with diarrhea and respiratory disease compared with those fed MR. During transportation, calves fed ORS-T had a lower activity index than calves fed MR, suggesting that ORS-T calves had lower overall activity. Additionally, on the day of transportation (d 0), ORS-T and ORS-D calves had a lower activity index than calves fed MR. There were no treatment effects on growth outcomes. The results of this study suggest that feeding MR rather than an ORS during a mid-transportation rest period could minimize fat mobilization and can potentially improve diarrhea and respiratory disease but does not affect growth outcomes after arrival to calf-raisers.

Agreement of ultra-short-term heart rate variability measure after different repeated bouts of sprint ability tests.

This study aims to explore: (1) the validity of post-exercise ultra-short-term heart rate variability (HRVust) after two different bouts of repeated sprint ability test (RSA), and (2) the relationship between HRVust measure and RSA performance. Twenty adolescent male futsal players voluntarily participated in this study (age: 17.65 ± 1.81 years, body height: 170.88 ± 4.98 cm, body weight: 61.78 ± 4.67 kg). The participants performed a standard RSA test (RSAstandard) and an RSA test with a 10% decrement of the best sprint time test (RSA10%decrement) on two separate occasions within a week. On both occasions, a 5-min resting electrocardiography was administered pre- and post-RSA exercise protocols. The first 30-s (HRVust30s), 60-s (HRVust60s), and 60-120-s (HRVust1-2min) were extracted and used to compare with the standard of 5-min HRV recording (HRVcriterion). The natural logarithm (ln) of the standard deviation of normal-to-normal intervals (SDNN) and root mean square of successive normal-to-normal interval differences (RMSSD) HRV indices were utilised to establish intraclass correlation coefficient (ICC2,1), coefficient of variation (%CV), and Pearson product-moment correlation (r). Results revealed the ICC values of HRVust lnSDNN (RSAstandard = 0.77-0.88; RSA10%decrement = 0.41-0.71) and lnRMSSD (RSAstandard = 0.81-0.86; RSA10%decrement = 0.57-0.82). Furthermore, significantly positive correlations between best sprint time and post-exercise HRVust indices were found in lnSDNN (r = 0.47-0.62; p < 0.05) and lnRMSSD (r = 0.45; p < 0.05). Additionally, a large CV of lnSDNN (RSAstandard = 32%-45%; RSA10%decrement = 29%-39%), lnRMSSD (RSAstandard = 50%-66%; RSA10%decrement = 48%-52%), and ratio (RSAstandard = 45%-126%; RSA10%decrement = 27%-45%) was found after the RSA protocols. In conclusion, the number of bouts of RSA exercise potentially influences the agreement of post-exercise time-domain HRVust indices to standard HRV measure.

Treatment of diabetic foot with moxibustion: Clinical evidence from meta-analysis.

To assess the efficacy of moxibustion for diabetic foot, and compile the findings of randomised clinical trials. China National Knowledge Infrastructure Database, Medicine, WanFang Database, Embase, Chinese Scientific Journal Database and Web of Science were from the establishment to January, 2024 were searched. Randomised controlled trials, which evaluated the effects of moxibustion were included. A total of 12 randomised controlled trials involving 1196 patients were included. According to the pooled results of this meta-analysis, effective rate (relative risk 1.16, 95% confidence intervals, CI [1.11, 1.22]), healing time (mean difference [MD] -6.27, 95% CI [-8.68, -3.86]), wound area (MD 3.46, 95% CI [0.84, 6.09]), and ankle brachial index (MD 0.14, 95% CI [0.03, 0.24]) were statistically significant compared to the control group. This study suggests that moxibustion treatment has the potential for improving symptoms of diabetic foot. However, future in-depth research on the benefits and harms of moxibustion for the diabetic foot is needed before it can be accepted as an evidence-based treatment.

Nerve block reduces the incidence of 3-year postoperative mortality: a retrospective cohort study.

A retrospective cohort study was performed to determine the effect of nerve block on the incidence of postoperative mortality in patients with hip replacement. According to the inclusion and exclusion criteria, patients who were undergoing hip replacement for the first time under general or intraspinal anesthesia, classified as ASA class I-IV, and aged ≥65 years were selected. We collected the general data, past medical history, preoperative laboratory test results, perioperative fluid intake and outflow data, perioperative anesthesia and related drug data, postoperative laboratory results, and correlation time index. Patients with preoperative combined nerve block were included in the N group, and those without combined nerve block were included in the NN group. The patients were followed up via telephone call to assess survival outcomes at 3 years after surgery. Propensity score matching and uni- and multivariate analyses were performed to determine the influence of nerve block and other related factors on postoperative mortality. A total of 743 patients were included in this study, including 262 in the N group and 481 in the NN group. Two hundred five patients in both groups remained after propensity score matching. Main result: Preoperative nerve block was associated with reduced mortality three years after surgery. Nerve block reduces the incidence of 3-year postoperative mortality, and composite nerve block with general anesthesia and neuraxial anesthesia is worthy of promotion.

V4D: Voxel for 4D Novel View Synthesis.

Neural radiance fields have made a remarkable breakthrough in the novel view synthesis task at the 3D static scene. However, for the 4D circumstance (e.g., dynamic scene), the performance of the existing method is still limited by the capacity of the neural network, typically in a multilayer perceptron network (MLP). In this article, we utilize 3D Voxel to model the 4D neural radiance field, short as V4D, where the 3D voxel has two formats. The first one is to regularly model the 3D space and then use the sampled local 3D feature with the time index to model the density field and the texture field by a tiny MLP. The second one is in look-up tables (LUTs) format that is for the pixel-level refinement, where the pseudo-surface produced by the volume rendering is utilized as the guidance information to learn a 2D pixel-level refinement mapping. The proposed LUTs-based refinement module achieves the performance gain with little computational cost and could serve as the plug-and-play module in the novel view synthesis task. Moreover, we propose a more effective conditional positional encoding toward the 4D data that achieves performance gain with negligible computational burdens. Extensive experiments demonstrate that the proposed method achieves state-of-the-art performance at a low computational cost.

Effect of Cyclic Loading Treatment on the Compression Energy and Creep Properties of Machine-Harvested Seed Cotton

Machine-harvested seed cotton was taken as the research object to further clarify its creep performance, minimize its power consumption during the loading process, and obtain a better loading method. The uniaxial compression creep test was carried out using the Instron universal material test bench to apply cyclic loading treatment. The test factors included cyclic loading times, cyclic stress peak, and cyclic loading frequency. The energy consumption curve of the machine-harvested seed cotton during cyclic loading was obtained through OriginPro 2019b software, and its energy change law was analyzed. Creep strain was divided into two parts, namely, initial creep strain and creep strain increment, to elucidate the creep mechanism. The Burgers model was chosen to describe the creep strain increment. Results show that machine-harvested seed cotton exhibits energy consumption hysteresis during cyclic loading. The compression energy rapidly decreases with increasing cyclic loading times and then stabilizes. Meanwhile, the compression energy increases with increasing cyclic stress peak and cyclic loading frequency. The creep strain mechanism is also the same, which first rapidly increases and then levels off. Cyclic loading times, cyclic stress peak, and cyclic loading frequency have different effects on creep strain increment, instantaneous elastic modulus, hysteresis elastic modulus, viscosity coefficient, delay time, and relative deformation index. Finally, disregarding power consumption and interaction, extending the cyclic loading time, and increasing the cyclic stress peak while simultaneously minimizing the cyclic loading frequency can reduce the relative deformation index in the creeping stage. Accordingly, the deformation retention ability in the creep is improved, but the compression energy in the cyclic loading increases. The results can provide theoretical and data support for studying the theoretical basis of the rheological properties of machine-harvested seed cotton, the design of seed cotton baling devices, and the study of bale (mold) forming quality.

Nonlinear and nonstationary detection and quantification of multi-scale measured signals for bridge structure

The assessment of nonlinear and nonstationary levels in measured bridge signals is a vital step in system identification and long-term health monitoring for the bridge structure. The field-measured signals from the bridge structure are inherently weak and multiscale, so a specific adaptive variational mode decomposition (AVMD) is proposed to decompose them and extract their included multi-scale features. Combination the adaptability of empirical mode decomposition with the dimensionality reduction of principal component analysis, the number of inherent mode functions (IMFs) that need to be given in the conventional variational mode decomposition is adaptively determined in the proposed AVMD. The original measured signals from the bridge structure multiscale are subsequently decomposed by AVMD into the multiscale IMFs with the lowest cross-correlation. Then, the recurrence plot and recurrence quantification analysis are introduced into the detection and quantification of the measured signals, and the nonlinear and nonstationary quantification indexes are constructed to describe quantitatively the nonlinear and nonstationary levels. The stabilities and accuracies of three nonlinear and three nonstationary quantification indexes are comparatively discussed by the nonlinear and nonstationary detection and quantification of three well-defined simulated signals. The Shannon entropy and trapping time indexes are subsequently determined to quantify the nonlinear and nonstationary levels of the measured signals, respectively. Finally, the proposed algorithm and quantification indexes are applied to the nonlinear and nonstationary detection and quantification of the measured signals from the real-world bridge structures. It is shown from the validation and discussion that the proposed algorithm is available to detect and quantify the nonlinear and nonstationary levels of the measured multiscale signal from the real-world bridge structure.

Parameter extraction of photovoltaic model based on butterfly optimization algorithm with chaos learning strategy

Accurate extraction of photovoltaic (PV) model parameter is significant for the evaluation of PV system. Most of existing methods for extracting the PV parameters suffer from low extraction accuracy and are prone to fall into local optima. To solve these shortcomings, a chaos learning butterfly optimization algorithm (CLBOA) is proposed. First, the introduced Cauchy mutation increases the perturbation to butterflies and helps the algorithm to jump out of local optima. Second, a chaos learning strategy is proposed to lead the butterflies within the population to learn from the optimal individual using the improved Tent chaos mapping, which strengthens the learning exchange of the population, enhances the ability of global exploration and local exploitation, and optimizes the convergence speed and accuracy. Third, the three worst individual positions were randomly initialized using a terminal elimination mechanism to increase population diversity. After evaluating CLBOA through the CEC2022 benchmark suite, it was used to extract parameters for a total of 12 PV cell and module models for 5 materials. Compared with 9 well-known algorithms, CLBOA performs excellent in terms of convergence performance, parameters extraction accuracy, running time and improvement index. Finally, CLBOA was applied on YL PV power station model of Guizhou Power Grid in China under different irradiations and temperatures. The I-V and P-V curves reconstructed by CLBOA are highly fit to the synthesized curves, and the individual absolute error (IAE) and relative error (RE) also confirm the satisfactory accuracy of parameters extraction. Comprehensive analysis shows that CLBOA can extract parameters better than the comparison algorithms, demonstrating its strong potential for PV parameters extraction.

Associations between Nocturnal Hypoxemia and Retinal Nerve Fiber Layer Thinning: The Nagahama Study.

Rationale: There have been meta-analyses that showed reduced retinal nerve fiber layer (RNFL) thickness, which is a surrogate marker of glaucoma, in patients with obstructive sleep apnea (OSA). However, the sample sizes in these reports were small (<300), and the mechanism of RNFL thinning in patients with OSA was not revealed.Objectives: To investigate the relationship of RNFL thickness with nocturnal hypoxemia or hypoxemic burden in a large-scale study.Methods: In this epidemiological study, 8,309 community residents were enrolled. The actigraphy-modified 3% oxygen desaturation index (acti-ODI3%) and cumulative percentage of sleep time with oxygen saturation <90% (acti-CT90) modified by objective sleep duration using actigraphy were measured. The hypoxemic burden is shown as acti-CT90. Circumpapillary RNFL thickness was determined using optical coherence tomography.Results: Multivariable logistic analysis models revealed that an increase in acti-CT90 was significantly associated with mean RNFL thinning after adjusting for several factors in participants without glaucoma diagnosed or treated previously (β = -0.037; P = 0.009). There were significant differences in mean RNFL thickness among participants stratified according to acti-CT90 (>1.5 vs. ⩽1.5; P = 0.04). Although acti-ODI3% was significantly associated with acti-CT90 (β = 0.72; P < 0.0001), acti-ODI3% was not significantly associated with mean RNFL thickness in the multivariable logistic analysis (β = -0.011; P = 0.48). In addition, acti-CT90 was significantly associated with mean RNFL thickness both in the elderly (⩾60 yr; β = -0.058; P = 0.002) and nonelderly (<60 yr; β = -0.054; P = 0.007).Conclusions: Acti-CT90, but not acti-ODI3%, was associated with mean RNFL thinning in participants irrespective of age in the elderly or nonelderly. Further prospective studies are required to investigate whether the prevention of hypoxic burden, which was shown as acti-CT90 in this study, is favorable for RNFL thinning.

Validity and reliability of a repeated multi-changes of direction agility test in senior soccer players.

This study aimed to evaluate the validity, reliability, and sensitivity of repeated multi-changes of direction agility test (rMCOD) compared to a soccer-specific field test of repeated sprint ability (S-RSA) and repeated sprint ability test (RSA). Thirty-five healthy male soccer players (age: 18.4 ± 1.3 years) from Tunisan national soccer league (elite and sub-elite) took part in this study. They performed the tests in a randomized order over five sessions interspaced by at least 72 h. The construct, predictive and discriminant validity, relative and absolute reliability, and sensitivity of the tests were analyzed. The total and best time of the test (the sum for all trials and the trial with the lowest duration on nine, six, and seven attempts for rMCOD, RSA, and S-RSA, respectively), fatigue index, rating of perceived exertion (RPE), and lactate concentration were recorded. rMCOD correlated with both, S-RSA and RSA in total time (r = 0.85 and r = 0.52, respectively) and fatigue index (r = 0.74 and r = 0.83, respectively). Receiver operator characteristics were not able to discriminate between group levels (elite and sub-elite). When comparing training levels, only the fatigue index in S-RSA showed a difference between groups. Fatigue index, total time, and the best time in rMCOD showed excellent reliability, as well as the minimal change detectable (MCD = 0.89, MCD = 0.63, and MCD = 0.11, respectively) was higher than the standard error of the mean (SEM = 0.32, SEM = 0.23, and 0.04, respectively). rMCOD showed large to very large predictive validity compared with the S-RSA and RSA, being a reliable test for the following parameters: the best time and total time to perform the test. Nevertheless, this study design cannot ensure whether or not this test is able to detect real changes in performance in response to training since it did not include a training intervention; besides, rMCOD could not distinguish between elite and sub-elite players, which is a limitation.

Relationship between Volitional and Non-Volitional Quadriceps Muscle Endurance in Patients with Chronic Obstructive Pulmonary Disease.

Volitional assessment of quadriceps muscle endurance is clinically relevant in patients with chronic obstructive pulmonary disease (COPD). However, studies that determine the construct validity of volitional tests by comparing them to non-volitional measures are lacking. Therefore, the aim of the current study is to evaluate the correlation between volitional and non-volitional quadriceps muscle endurance in patients with COPD. Quadriceps muscle endurance was evaluated in twenty-six patients with COPD. A volitional isometric and a volitional isokinetic protocol were performed on a computerised dynamometer to determine the isometric time and isokinetic work fatigue index, respectively. Non-volitional assessment of quadriceps muscle endurance was evaluated using repetitive electrical stimulations to establish the isometric muscle force decline. Sixteen patients (61 ± 8 years, 63% male, FEV1 47 (32-53)%) performed all three quadriceps endurance tests conforming to pre-defined test criteria. Both volitional isometric time and isokinetic work fatigue index did not significantly correlate with non-volitional muscle force decline (both p > 0.05). There was a strong correlation between volitional isometric time and isokinetic work fatigue index (rho = -0.716, p = 0.002). To conclude, this study suggests that volitional measures evaluate partly different aspects of quadriceps muscle endurance compared to non-volitional measures. Accordingly, these outcome measures cannot be used interchangeably.

Reducing the unwanted deflagration enhancement of C3HF7 on fuel-lean hydrogen-air mixture by diluting CO2: An experimental and numerical research

To prevent the explosion hazards of hydrogen energy, in this work, the deflagration behaviors of H2-air mixtures at equivalence ratios from 0.6 to 1.4 under the effects of C3HF7 and CO2 are experimentally investigated. Deflagration pressure and time indexes at ambient pressure and temperature are obtained. The characteristic parameters of chemical kinetics are analyzed according to a detailed mechanism. The results suggest that C3HF7 has dual effects of pressure enhancement and suppression with the rising volume ratio in fuel-lean H2-air mixtures. It is the F-involved reactions that govern the exothermic process, facilitate the comprehensive conversion of crucial free radicals, and augment the exothermicity of the principal reaction, leading to the elevation in peak pressure. Dilution of CO2 would decrease the heat release rate of the F-involved reactions and reduce the explosion enhancement effect of C3HF7. The results of this work are beneficial to the formulation of mitigation measures for hydrogen explosions.

Early bone loss in patients with obstructive sleep apnea: a cross-sectional study

BackgroundObstructive sleep apnea (OSA) and osteoporosis are both prevalent diseases with shared pathophysiological mechanisms and risk factors. However, the association between the two diseases is seldom studied. This study aimed to identify the link between OSA and bone metabolism.MethodsMale participants aged 30–59-years who visited the sleep clinic were continuously recruited. Polysomnography was used to evaluate sleep and respiratory conditions. Blood samples were collected to detect metabolic, inflammatory and bone turnover indicators. High-resolution peripheral quantitative computer tomography was used to measure the non-dominant lateral radius and tibia.ResultsNinety subjects were recruited. The cortical area (Ct.Ar) of tibia of the severe OSA group was significantly higher than that of the mild and moderate OSA groups (P = 0.06 and P = 0.048). There were significant differences between the four groups in terms of total volumetric bone mineral density (vBMD) (F = 2.990, P = 0.035), meta trabecular vBMD (F = 3.696, P = 0.015), trabecular thickness (Tb.Th) (F = 7.060, P = 0.000) and cortical thickness (Ct.Th) (F = 4.959, P = 0.003). The mean values of the OSA groups were lower than control group. Hypopnea index and percentage of total sleep time with SpO2 < 90% were both positively correlated with alkaline phosphatase (R = 0.213, P = 0.044; R = 0.212, P = 0.045). Sleep efficiency was correlated with multiple indicators of the radius.ConclusionsIn non-elderly male populations, OSA patients tended to have lower vBMD, Tb.Th and Ct.Th than non-OSA patients. The negative effect of OSA may mainly affect the osteogenesis process, and is presumed to be related to sleep-related hypoxemia and sleep efficiency.

Ensuring communication redundancy and establishing a telementoring system for robotic telesurgery using multiple communication lines

Assuring communication redundancy during the interruption and establishing appropriate teaching environments for local surgeons are essential to making robotic telesurgery mainstream. This study analyzes robotic telesurgery with telementoring using standard domestic telecommunication carriers. Can multiple carriers guarantee redundancy with interruptions? Three commercial optical fiber lines connected Hirosaki University and Mutsu General Hospitals, 150 km apart. Using Riverfield, Inc. equipment, Hirosaki had a cockpit, while both Mutsu used both a cockpit and a surgeon’s console. Experts provided telementoring evaluating 14 trainees, using objective indices for operation time and errors. Subjective questionnaires addressed image quality and surgical operability. Eighteen participants performed telesurgery using combined lines from two/three telecommunication carriers. Manipulation: over 30 min, lines were cut and restored every three minutes per task. Subjects were to press a switch when noticing image quality or operability changes. Mean time to task completion was 1510 (1186–1960) seconds: local surgeons alone and 1600 (1152–2296) seconds for those under remote instructor supervision, including expert intervention time. There was no significant difference (p = 0.86). The mean error count was 0.92 (0–3) for local surgeons and 0.42 (0–2) with remote instructors. Image quality and operability questionnaires found no significant differences. Results communication companies A, B, and C: the A/B combination incurred 0.17 (0–1) presses of the environment change switch, B/C had 0, and C/A received 0.67 (0–3), showing no significant difference among provider combinations. Combining multiple communication lines guarantees communication redundancy and enables robotic telementoring with enhanced communication security.

Intra-Day and Inter-Day Reliability and Usefulness of Performance, Kinetic and Kinematic Variables during Drop Jumping in Hurling Players

The aim of this study was to estimate the intra-day and inter-day reliability and usefulness of performance (Jump height (JH), ground contact time (GCT) and reactive strength index (RSI)), kinetic (force, power, eccentric rate of force development [E-RFD] and leg stiffness [LS]) and kinematic (velocity) variables during drop jumping (DJ) in hurling players. Seventeen (n = 17; mean ± SD; age = 23.35 ± 5.78 years, height = 178.35 ± 6.30 cm, body mass = 78.62 ± 8.06 kg) male club-level hurling players completed two maximal DJs from 0.20, 0.30, 0.40, 0.50 and 0.60 m drop heights on three testing days separated by 5–9 days of rest. Reliability was assessed using the coefficient of variation percentage (CV% ≤ 15%) and intraclass correlation coefficient (ICC &gt; 0.70). For intra-day reliability, GCT (0.40 m, 0.50 m and 0.60 m), peak force (absolute and relative) (0.40 m and 0.50 m) and leg stiffness (0.40 m and 0.50 m) were found to be unreliable (ICC = 0.32–0.68 and CV% = 3.67–11.83%) from those specific drop heights. All other variables were found to be reliable (ICC = 0.72–0.98 and CV% = 1.07–14.02%) intra-day. All variables were found to be reliable (ICC = 0.72–0.96 and CV% = 2.57–14.68%) inter-day except for relative peak force and absolute and relative eccentric RFD (0.30 m and 0.40 m) (ICC = 0.68–0.90 and CV% = 7.76–16.47%). Practitioners have multiple reliable DJ performance, kinetic and kinematic variables for performance testing and training purposes.

Factors influencing same-day discharge after minimally invasive hysterectomy for malignant and non-malignant gynecological diseases: a systematic review and meta-analysis.

To explore the factors influencing the successful implementation of same-day discharge in patients undergoing minimally invasive hysterectomy for malignant and non-malignant gynecological diseases. We searched PubMed, Embase, Cochrane Central Register of Controlled Trials, International Clinical Trials Registry Platform, and Clinical Trials.gov from inception to May 23, 2023. We included case-control and cohort studies published in English reporting same-day discharge factors in patients undergoing minimally invasive hysterectomy for malignant and non-malignant gynecological diseases. STATA 16.0 was used for the meta-analysis. Risk factors were assessed using odds ratios (OR) (relative risk (RR)/hazard ratios (HR)) with 95% confidence intervals (CI), and logistic regression determined the same-day discharge rate (%). We analyzed 29 studies with 218192 patients scheduled for or meeting same-day discharge criteria. The pooled rates were 50% (95% CI 0.46-0.55), and were similar for malignant and non-malignant gynecological diseases (48% and 47%, respectively). In terms of basic characteristics, an increase in age (OR: 1.03; 95% CI: 1.01-1.05), BMI (OR: 1.02; 95% CI: 1.01-1.03), and comorbidities including diabetes and lung disease were risk factors affecting SDD, while previous abdominal surgery history (OR: 1.54; 95% CI: 0.93-2.55) and hypertension (OR: 1.53; 95% CI: 0.80-2.93) appeared not to affect SDD. In terms of surgical characteristics, radical hysterectomy (OR: 3.46; 95% CI: 1.90-6.29), surgery starting after 14:00 (OR: 4.07; 95% CI: 1.36-12.17), longer surgical time (OR: 1.03; 95% CI: 1.01-1.06), intraoperative complications (OR: 4.68; 95% CI: 1.78-12.27), postoperative complications (OR: 3.97; 95% CI: 1.68-9.39), and surgeon preference (OR: 4.47; 95% CI: 2.08-9.60) were identified as risk factors. However, robotic surgery (OR: 0.44; 95% CI: 0.14-1.42) and intraoperative blood loss (OR: 1.16; 95% CI: 0.98-1.38) did not affect same-day discharge. An increase in age, body mass index, and distance to home; certain comorbidities (e.g., diabetes, lung disease), radical hysterectomy, surgery starting after 14:00, longer surgical time, operative complications, and surgeon preference were risk factors preventing same-day discharge. Same-day discharge rates were similar between malignant and non-malignant gynecological diseases. The surgery start time and body mass index have a greater impact on same-day discharge for malignant diseases than non-malignant diseases.

Analysing Risk &amp; Return Profiles: A Comparative Study of the Indonesian Stock Market against International Benchmarks

The Indonesian stock market, also known as IDX, has emerged as a prominent player in the financial landscape of Southeast Asia. It has attracted the interest of investors who regard it as a potential source of massive returns. Nevertheless, empirical research has consistently demonstrated that developing nations’ stock markets tend to exhibit a notable degree of volatility. This volatility is well recognised for its propensity to amplify risk levels for domestic investors, potentially leading to a decrease in the demand for stock market investments. The observed phenomenon in Indonesia reveals a very low degree of stock market engagement when compared to benchmark nations. This suggests that the high volatility in the market may be a contributing factor. Understanding the risk-return characteristics of the IDX in comparison to recognised benchmark indexes is crucial for making educated investment decisions. This study will conduct a comparative analysis of the risk-return attributes of the IDX in comparison to six well recognised benchmark indexes, specifically the S&amp;P 500 Index, the Straits Times Index, the FTSE 100 Index, the Shanghai Stock Exchange Composite, the BSE Sensex, and the BOVESPA Index. The study employs several risk and return measures, such as standard deviation, coefficient of variation, and the Sharpe ratio, to assess the relative performance of the IDX. The objective of this study is to evaluate the comparative appeal of the Indonesian stock market when compared to international benchmarks, with a specific focus on risk and return. The aim is to determine the optimal level of stock market involvement and the inclination towards risk aversion or risk-seeking behaviour among retail investors in Indonesia.