Windbreaks Research Articles

Analysis of genes related to xylem cell wall development based on transcriptomics in Populus alba ‘Berolinensis’ tension wood

Populus alba ‘Berolinensis’ is a fast-growing, high-yielding species with strong biotic and abiotic stress resistance, and widely planted for timber, shelter belts and aesthetic purposes. In this study, molecular development is explored and the important genes regulating xylem formation in P. alba ‘Berolinensis’ under artificial bending treatments was identified. Anatomical investigation indicated that tension wood (TW) was characterized by eccentric growth of xylem and was enriched in cellulose; the degree of lignification was lower than for normal wood (NW) and opposite wood (OW). RNA-Seq-based transcriptome analysis was performed using developing xylem from three wood types (TW, OW and NW). A large number of differentially expressed genes (DEGs) were screened and 4889 counted. In GO and KEGG enrichment results, genes involved in plant hormone signal transduction, phenylpropanoid biosynthesis, and cell wall and secondary cell wall biogenesis play major roles in xylem development under artificial bending. Eight expansin (PalEXP) genes were identified from the RNA-seq data; four were differentially expressed during tension wood formation. Phylogenetic analysis indicated that PalEXLB1 belongs to the EXPB subfamily and that the other PalEXPs are members of the EXPA subfamily. A transcriptional regulatory network construction showed 10 transcription factors located in the first and second layers upstream of EXP, including WRKY, ERF and bHLH. RT‒qPCR analysis in leaves, stems and roots combined with transcriptome analysis suggests that PalEXPA2, PalEXPA4 and PalEXPA15 play significant regulatory roles in cell wall formation during tension wood development. The candidate genes involved in xylem cell wall development during tension wood formation marks an important step toward identifying the molecular regulatory mechanism of xylem development and wood property improvement in P. alba ‘Berolinensis’.

123 How Early Is Too Early for Cranioplasty Following Craniectomy? A Propensity-Matched Study

INTRODUCTION: Nearly 30% of patients experience complications following cranioplasty after decompressive craniectomy. However, the optimal timing for this procedure is not well established. METHODS: Using the TriNetX Research Network, we included patients who underwent either late cranioplasty (91 days to 1 year), or cranioplasty in the first (1-30 days), second (31-60 days), or third (61-90 days) month after craniectomy. Propensity score matching was used to match the late cranioplasty group separately with the other three cranioplasty groups based on demographics, comorbidities, anticoagulant/antiplatelet use, and laboratory values. Postoperative outcomes were assessed within six months after cranioplasty. RESULTS: We analyzed 2545 patients. After matching, 301 patients remained in the first-month, 314 in the second-month, and 406 in the third-month group. The prevalence of postoperative complications, including seizures/epilepsy, infections, wound disruption, intracranial/intraspinal abscess/granuloma, repeat craniectomy/craniotomy, removal/replacement of bone flap/prosthetic plate of skull, and dependence on wheelchair/care provider were similar across all groups. Compared to late cranioplasty, intracerebral hemorrhage was significantly more common in the first-month (p = 0.033) and second-month (p = 0.01) groups, but not in the third-month (p = 0.502) group. Epidural hemorrhage was significantly more common in the second-month (p = 0.0492) group, while subdural hemorrhage was significantly more common in all early cranioplasty groups. Meningitis/Encephalitis/myelitis/encephalomyelitis were significantly more common only in the first-month group (p = 0.009). Hydrocephalous was significantly more common only in the second-month group (p = 0.0046). The need for repeat cranioplasty was significantly higher in the first-month (p = 0.005) and second-month (p = 0.043) groups. Mortality rate was significantly higher in the first-month (p = 0.004) and second-month (p = 0.02) groups. CONCLUSIONS: Cranioplasty in the first 60 days following craniectomy is associated with increased postoperative morbidity and mortality. Prospective studies are needed to establish the best timing for cranioplasty.

Malnutrition in Head and Neck Free Flap Reconstruction as a Predictor of Adverse Outcomes.

Malnutrition is associated with increased mortality in patients with head and neck (H&N) cancer. Because albumin levels are used as a surrogate for nutritional status, the purpose of this study is to assess whether malnutrition is associated with adverse postoperative outcomes in H&N free flap reconstruction. The 2006-2018 National Surgical Quality Improvement Program Database was queried for patients undergoing flap procedures of the H&N based on Current Procedure Terminology codes. Patients were included if they were operated on by an otolaryngologist or when the primary surgical site was H&N. Nutritional status was categorized as malnourished (preoperative albumin level <3.5 g/dL) or normal (preoperative albumin level ≥3.5 g/dL). Major complications included pulmonary complications, cardiac complications, deep vein thrombosis/pulmonary embolism, and sepsis/septic shock. Minor complications included surgical infection, urinary tract infection, bleeding, and dehiscence. Data were analyzed via univariate chi-square and multivariate regression analyses. Of the patients, 2532 (83.3%) had normal albumin and 506 (16.7%) had hypoalbuminemia. Patients with hypoalbuminemia were more likely to have smoking history (P = 0.008), pulmonary comorbidity (P < 0.001), renal comorbidity (P = 0.018), disseminated cancer (P < 0.001), steroid use (P < 0.001), recent weight loss (P < 0.001), bleeding disorder (P = 0.023), and preoperative transfusion (P < 0.001). After adjustment for preoperative variance, malnourished patients were more likely to experience death (P < 0.001), return to operating room (P < 0.001), free flap failure (P = 0.008), pulmonary complication (P < 0.001), deep vein thrombosis/pulmonary embolism (P = 0.019), wound disruption (P = 0.042), intraoperative transfusion (P < 0.001), minor complication (P < 0.001), major complication (P < 0.001), and extended length of stay (P < 0.001). Of the patients with normal albumin, 2.1% experienced flap failure compared with 6.3% of patients with hypoalbuminemia. It should be noted that malnourished patients were 3.370 times more likely to experience flap failure (95% confidence interval, 1.383-8.212; P = 0.008) and 3.975 times more likely to experience death (95% confidence interval, 1.700-9.626; P = 0.001) than those with normal albumin. Malnutrition is associated with death, flap failure, minor complications, and other major complications following H&N free flap surgery, even after controlling for preoperative variance. Optimizing preoperative nutrition status before free flap procedures may ameliorate morbidity and mortality in H&N patients.

‘’Comparative outcome study between simple closure and flap technique in Pilonidal sinus disease’’

I have read the interesting article ‘’Comparative outcome study between simple closure and flap technique in Pilonidal sinus disease’’ by Dr. Ram Magar and Dr. Rupali Magar published in your journal on 15th March 2022. According to this valuable study; Limberg flap method has has been found to have better outcome with less wound infection, wound disruption, postoperative discharge and recurrence rate compared to simple closure group. And as stated, it is safe and easy procedure. So it is recommended that Limberg flap method should be used in the treatment of pilonidal sinus disease over other modalities.[1]&#x0D; In our 767 patients study group results, we had recommended Limberg Flap Repair Technique for surgical treatment of pilonidal sinus disease. This technique had an acceptable “short” ‘Return to Work Outcome’ when compared with open techniques. Also had the smallest postoperative infection rate and low recurrence rate.&#x0D; Still in our daily surgical practice, earlier healing, shorter return to work, lower rates of infection and recurrence are the major factors that make us to use Limberg Flap Repair Technique mostly. Moreover, it is easy, fast, and practical to apply.[2]

Association of Smokeless Tobacco and Complications Following Ankle and Hindfoot Arthrodesis.

The purpose of this study was to (1) evaluate the rates of postoperative complications following ankle or hindfoot arthrodesis among current smokeless tobacco users and people who smoke compared to matched controls, and (2) compare rates of postoperative complications in current smokeless tobacco users vs people who smoke tobacco cigarettes. A retrospective cohort study was conducted using a large national database. For patients who underwent ankle or hindfoot arthrodesis, smokeless tobacco users (n = 131) and people who smoke (n = 1948) were matched 1:4 with controls, and smokeless tobacco users (n = 131) were matched 1:4 with people who smoke tobacco cigarettes (n = 524). Orthopaedic complications within 90 days, 1 year, and 2 years were compared using multivariable logistic regressions. Within 90 days of ankle or hindfoot arthrodesis, smokeless tobacco users demonstrated significantly higher rates of hardware removal (odds ratio [OR] 5.01, 95% CI 1.65-15.20), wound disruption or dehiscence (OR 3.00, 95% CI 1.21-7.44), and pooled complications (16.0% vs 5.9%, OR 2.84, 95% CI 1.50-5.38) compared with tobacco-naïve controls. The rates of hardware removal, wound disruption and dehiscence, and pooled complications remained significant in the smokeless tobacco cohort at 1 and 2 years. At 2 years following ankle or hindfoot arthrodesis, smokeless tobacco users additionally demonstrated significantly higher rates of infection (OR 6.08, 95% CI 1.15-32.05) and nonunion (OR 2.35, 95% CI 1.31-4.20) compared with tobacco-naïve controls. Within 90 days of ankle or hindfoot arthrodesis, smokeless tobacco users demonstrated significantly lower rates of malunion or nonunion than patients who smoke tobacco cigarettes (OR 0.34, 95% CI 0.12-0.97), whereas all other complications were not significantly different. Smokeless tobacco use is associated with higher rates of complications following ankle or hindfoot arthrodesis compared with tobacco-naïve controls, and physicians should screen for smokeless tobacco use specifically and encourage cessation before operating electively. Level III, retrospective cohort study.

Outcomes of open reduction and internal fixation of calcaneus fractures: A database study comparing patients with and without diabetes.

Treatment of calcaneal fractures in patients with diabetes mellitus (DM) is challenging. The purpose of this study was to compare post-operative outcomes after open reduction and internal fixation (ORIF) for calcaneus fracture in patients with complicated DM, uncomplicated DM, and patients without DM. A commercially available de-identified database was queried for all calcaneus fracture diagnoses undergoing ORIF from 2010 to 2021. The patients were separated into three groups for analysis: patients without DM (10,951, 82.6%), uncomplicated DM (1,500, 11.3%) and complicated DM (802, 6.1%). At 1 year, post-operative adverse events were assessed among the three groups. The odds of adverse event(s) for each group were compared between the three groups with and without characteristic matching. In the unmatched cohorts, patients with complicated DM, when compared with patients without DM and patients with uncomplicated DM, had significantly higher rates of all adverse events with exception of DVT. Rates of CNA were significantly higher in patients with complicated DM compared with no DM (OR 107.7 (CI 24.83-467.6) p < 0.0001) and uncomplicated DM (OR 44.26 (CI 3.86-507.93) p = 0.0002). After matching, non-union, AKI, sepsis, surgical site infection, and wound disruption were higher in patients with complicated DM compared with patients without DM. There were no significant differences in the three groups with regard to reoperation, DVT, MI, pneumonia, or below the knee amputation. Patients with DM who underwent ORIF for calcaneus fracture experienced higher rates of post-operative adverse events compared with those patients without DM.

Abstract 1823: In vitro evaluation of novel pyrimidine nucleosides for the treatment of pancreatic cancer

Abstract The purpose of the study is to synthesize and characterize novel 5-FU analogs (AGY1 and AGY2) and investigate their anticancer activity against pancreatic cancer cell lines. Methods: 5-FU derivatives were synthesized and characterized using Nuclear magnetic resonance (NMR), high-performance liquid chromatography (HPLC), and elemental analysis to determine the presence of new bond formation and the purity of the derivatives or analogs. 2D cell viability, 3D models, cell migration, and cell cycle studies were performed on MiaPaCa-2 (MP-2) cells and PANC-1 cells. Apoptosis was performed on PANC-1 cells by staining with Acridine Orange and Ethidium Bromide. The metabolic stability of the analogs was determined by using human liver microsomes. PARP, p53, and BAX expressions in PANC-1 were determined by Western Blot. Results: NMR data showed the conjugation of alkyl and tetrahydrofuran groups to the 5-FU ring confirming the formation of AGY1 and AGY2. The elemental analysis of AGY1 and AGY2 showed 99.6% and 99.5 % purity respectively. The IC50 value of the AGY1 against 2D MP-2 was found to be 12.2 ± 1 µM, while the IC50 value of AGY2 was determined to be 2.9 ± 0.2 µM. Both AGY1 and AGY2 anticancer activities were significantly higher than 5-FU (18.5 ± 1.1 µM). However, AGY2 was more effective compared to AGY1. A similar trend was observed for AGY2 analog where the IC50 value for treated 2D PANC-1 was 3.1 ± 0.29 µM and demonstrated a higher anticancer activity compared to AGY1 (6.4 ± 0.38 µM) or 5-FU (7.5 ± 1.1 µM). For cell migration studies, AGY2 (43 ± 5.5) exposed MP-2 cells showed significant arrest towards the wound gap compared to AGY1 (74 ± 18.5) and 5-FU (86 ± 15.6). A similar result of cell migration arrests AGY2 was observed in PANC-1 treated-AGY1, AGY2, and 5-FU. Organoid and spheroid models demonstrated high and comparable anticancer activity of AGY1 and AGY2 compared to 5-FU treated organoid and spheroid models. The cell-cycle analysis showed that AGY2-treated MP-2 cells at 1μΜ concentration showed a higher G1 population arrest (64.25%) compared to AGY1 (54.2%) and 5-FU (55.75%). Similarly, in PANC-1 cells, AGY2 at 1μΜ concentration showed a higher S-phase arrest (53.86%) compared to AGY1 (50.76%) and 5-FU (36.14%). Metabolic stability data showed higher stability of AGY2 (95% intact) compared to AGY1 (85% intact) compared to 5-FU (55% intact) after 2 hour of human liver microsomal incubation. The expressions of p53 and BAX proteins in PANC-1 cells were significantly upregulated and PARP was downregulated at higher concentration when treated with AGY1 and AGY2 compared to 5-FU. Conclusion: We demonstrate that AGY2 showed more promising anticancer activity compared to AGY1 and 5-FU against pancreatic cancer cells. AGY2 has the potential to improve 5-FU’s metabolic stability and enhance its therapeutic efficacy. Citation Format: Raviteja Bulusu, Joy Okoro, Esther Frimpong, Bo Han, Sherise Rogers, Xue Zhu, Edward Agyare. In vitro evaluation of novel pyrimidine nucleosides for the treatment of pancreatic cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 1823.

Forest Site and Stand Structure Affecting the Distribution of Emerald Ash Borer, Agrilus planipennis Fairmaire, 1888 (Coleoptera: Buprestidae), in Eastern Ukraine

The Emerald ash borer (EAB), Agrilus planipennis Fairmaire, 1888 (Coleoptera: Buprestidae), an invasive phloem-boring beetle, was first detected in the Luhansk Region of Ukraine in 2019. Subsequently, it rapidly expanded its presence to encompass a significant portion of the Kharkiv region and the parks of Kyiv. Previous research has established that the climatic conditions in Luhansk and its neighboring regions are conducive to the EAB, and the absence of a host plant (Fraxinus sp.) does not act as a deterrent to the pest’s expansion in Ukraine. Recognizing the urgency of identifying infested trees, our current research aimed to identify the most attractive EAB forest subcompartments based on forest site conditions and stand structure. Utilizing the MaxEnt model, we achieved an average performance in predicting the potential distribution of the EAB (AUC = 0.842). The six most impactful variables, contributing to 88.2% of the model, include “age of trees, years”, “area of forest subcompartment, ha”, “mean height of trees, m”, “proportion of Fraxinus excelsior in the stand composition, %”, “hygrotope index (humidity level), point”, and “number of neighboring-non-forest subcompartments”. Most likely, EAB occurrence is expected in the driest forest site conditions; the well-lit and warmed-up parts of stands, in particular; small subcompartments surrounded by non-forest landscapes; and forest shelter belts near roads and fields. However, the data obtained can be considered preliminary. To enhance the accuracy of our forecasting, it may be imperative to consider data on road localization, along which the pest can spread passively, as well as dominant wind speed.

(239) Postoperative Outcomes and Risk Factors in Patients Receiving Partial vs Total Penectomy for Penile Malignancy

Abstract Introduction Partial penectomies (PP) and total penectomies (TP) are both performed for penile cancer in the United States. Compared to TP, PP is performed more frequently to preserve functional urinary outcomes. To date TP and PP outcomes have not been compared, in this study we compared clinical characteristics and post-operative outcomes between TP and PP conducted between 2006–2016. Objective We conducted a retrospective review of penile cancer patients from National Surgical Quality Improvement Program (NSQIP) database for the years 2010–2016 using international classification of diseases clinical modification (ICD-CM) ninth revision codes. A total of 260 patients, 67 TP and 193 PP patients, were included. Methods We conducted a retrospective review of penile cancer patients from National Surgical Quality Improvement Program (NSQIP) database for the years 2010–2016 using international classification of diseases clinical modification (ICD-CM) ninth revision codes. A total of 260 patients, 67 TP and 193 PP patients, were included. Results Partial penectomy patients were less likely to be transferred patients (7.3% vs 20.9%, p=0.002), less likely to be suffering from diabetes (25.9% vs 40.3%, p=0.026), and were more likely to have preoperative laboratory values within normal limits. TP was associated with increased preoperative white blood cell count x109, preoperative white blood cell count &amp;gt; 7.5x109 (p&amp;lt;0.001), preoperative hematocrit (p&amp;lt;0.001). PP patients were, in contrast, shown to have higher pre-operative creatinine levels (p=.037) and lower platelet levels than TP patients (p=.045). PP patients had shorter operation times (78.8 vs 145.5 min, p&amp;lt;0.001). PP patients also had decreased levels of inpatient stay length (1.67 vs 4.31, p&amp;lt;0.001), any 30-day post-surgery complication (7% vs 31%, p&amp;lt;0.001), deep incisional surgical site infection (0.5% vs 6% p=0.017), wound disruption (0.5% vs 6.0%p=0.017), intraoperative or postoperative transfusion (1.6% vs 7.5%, p=0.029), and sepsis (0.5% vs 7.5%, p=0.005), when compared to patients who underwent TP. TP patients displayed a significantly greater number of concurrent surgical procedures (p&amp;lt;0.001), when compared to PP patients. There was no information on urinary, sexual, and erectile outcomes in the database. Conclusions PP is associated with fewer post-operative complications, shorter surgeries, shorter hospital stays, and fewer concurrent surgical procedures. Total penectomy is associated with a greater proportion of patients suffering from comorbid conditions, suggesting that TP patients are at higher risk for post-surgical complications and longer hospital stays. There is a gap in reported data pertaining to post-operative sexual function and erectile outcomes for PP at a national level. Disclosure No.

Wind shadowing of a sonic anemometer in low Reynolds number flows

Computational Fluid Dynamics (CFD) simulations have been carried out to better understand the wind shadowing effects on a sonic anemometer system. The anemometer will measure wind speed on the surface of Mars and the stratosphere of Earth.The wind velocity vector is measured through the difference in acoustic time of flight in 3 directions. However, the structure itself disrupts the flow and creates an internal wake. To understand this and generate correction factors, CFD simulations were run under Mars surface conditions while varying incident angle and flow speed. Spalart-Allmaras turbulence models were employed in both steady and unsteady Reynolds Averaged Navier Stokes (RANS) frameworks and compared to a laminar model. Due to the low Reynold’s number (&amp;lt;150) we observe no shedding at speeds below 10 m/s. At speeds below 10 cm/s the flow diverts around the structure and sensitivity drops. At intermediate speeds near 5 m/s the wind shadow ratio (WSR) varies substantially with incident wind angle. Design changes to the structure allowed us to improve the worst WSR from 38% to 47%. We were also able to quantify correction factors. Validating comparisons to water tunnel and wind tunnel measurements will be presented.

Influence of wind barrier on aerodynamic characteristics of vehicle on railway–highway combined bridge

Wind barriers with different parameters will change the aerodynamic force of the car on the bridge as well as the stability of the vehicle–bridge system, affecting the vehicle’s safety and comfort. A numerical simulation test was conducted on the bridge-deck with three different air permeability wind barriers under three distinct vehicles of varying sizes and wind directions, with a large-span road–rail asymmetric cable-stayed bridge serving as the engineering foundation. The results show that the roll force of the bridge is proportional to the width of the body and inversely related to the height of the train. The roll force of a vehicle is inversely proportional to its height and width. The type of vehicle and the properties of the bridge deck exert minimal influence on the stability of the bridge when a single vehicle is positioned upstream. When a single vehicle is situated downstream, the tri-component force coefficient of the bridge undergoes significant changes, and the vehicle’s impact on the bridge’s stability becomes more pronounced. When the bridge deck’s ventilation rate is at 50%, the drag coefficient of the bridge deck doubles compared to that of a bare bridge deck, and the wind pressure coefficient of the vehicle surface on the bridge approaches zero. In scenarios involving two vehicles, the shielding effect caused by the vehicles positioned upstream and downstream results in a substantial shift in the aerodynamic forces acting on the two vehicles. This increases the wake width of the bridge and generates a visible vortex in the wake.

A Comparison of Adverse Short-Term Outcomes After Forefoot Amputation Based on Patient Height.

The objective of this investigation was to evaluate adverse short-term outcomes after partial forefoot amputation with a specific comparison performed based on patient height. The American College of Surgeons National Surgical Quality Improvement Program database was analyzed to select patients with a 28805 Current Procedural Terminology code (amputation, foot; transmetatarsal) who underwent the procedure with "all layers of incision (deep and superficial) fully closed." This resulted in 11 patients with a height of 60 inches or less, 202 with a height greater than 60 inches and less than 72 inches, and 55 with a height of 72 inches or greater. Results of the primary outcome measures found no significant differences among groups with respect to the development of a superficial surgical site infection (0% versus 6.4% versus 5.5%; P = .669), deep incisional infection (9.1% versus 3.5% versus 10.9%; P = .076), or wound disruption (0% versus 5.4% versus 5.5%; P = .730). In addition, no significant differences were observed among groups with respect to unplanned reoperations (9.1% versus 16.8% versus 12.7%; P = .630) or unplanned hospital readmissions (45.5% versus 23.3% versus 20.0%; P = .190). The results of this investigation demonstrate no differences in short-term adverse outcomes after partial forefoot amputation with primary closure based on patient height. Although height has previously been described as a potential risk factor in the development of lower-extremity pathogenesis, this finding was not observed in this study from a large US database.

The 5-factor modified frailty index (mFI-5) predicts adverse outcomes after elective anterior cervical discectomy and fusion (ACDF)

BackgroundAnterior cervical discectomy and fusion (ACDF) is a reliable procedure commonly performed in older patients with degenerative diseases of the cervical spine. Over 130,000 procedures are performed every year with an annual increase of 5%, and overall morbidity rates can reach as high as 19.3%, indicating a need for surgeons to gauge their patients’ risk for adverse outcomes. Frailty is an age-associated decline in functioning of multiple organ systems and has been shown to predict adverse outcomes following various spine procedures. There have been several proposed frailty indices of various factors including the 11-factor modified frailty index (mFI-11), which has been shown to be an effective tool for predicting complications in patients undergoing ACDF. However, there is a paucity of literature assessing the utility of the 5-factor modified frailty index (mFI-5) as a risk stratification tool for patients undergoing ACDF. The purpose of this study was to analyze the predictive capability of the mFI-5 score for 30-day postoperative adverse events following elective ACDF. MethodsA retrospective review was performed using the National Surgical Quality Improvement Program (NSQIP) database from 2010 through 2019. Patients older than 50 years of age who underwent elective ACDF were identified using Current Procedural Terminology ([CPT] codes 22554, 22551, 22552, and 63075). Exclusion criteria removed patients under the age of 51, as well as those with fractures, sepsis, disseminated cancer, a prior operation in the last 30 days, ascites, wound infection, or an emergency surgery. Patients were grouped using mFI scores of 1, 2, and 3+. Univariate analysis, using chi-squared and one-way analysis of variance (ANOVA) tests, was conducted to compare demographics, comorbidities, and postoperative complications across the varying cohorts based on mFI-5 scores. Multivariate logistic regression, including patient demographics and preoperative comorbidities as covariates, was performed to evaluate if mFI-5 scores were independent predictors of 30-day postoperative adverse events. Covariates including race, BMI, sex, ASA, and comorbidities were included in regression models. ResultsThe 45,991 patients were identified and allocated in cohorts based on mFI-5 score. Rates for superficial surgical site infection (SSI), organ/deep space SSI, pneumonia, progressive renal insufficiency, acute renal failure (ARF), urinary tract infection (UTI), stroke/cardiovascular accident (CVA), cardiac arrest requiring cardiopulmonary resuscitation (CPR), myocardial infarction, bleeding requiring transfusions, deep vein thrombosis/thrombophlebitis, sepsis, septic shock, readmissions, reoperation, and mortality incrementally increased with mFI-5 scores from 0 to 3+. Multivariate regression analysis revealed that mFI-5 scores 1 to 3+ increased the odds, in a stepwise manner, of total complications, cardiac arrest requiring CPR, pneumonia and mortality. MFI-5 scores of 2 and 3+ were independent predictors of readmission (2: OR=1.5, p<.001; 3+: OR=2.0, p<.001) and myocardial infarction (2: OR=3.4, p=.001; 3+: OR=6.9, p<.001). A score of 3+ increased the odds of ARF (OR=9.7, p=.022), septic shock (OR=3.6, p=.036), UTI (OR=2.1, p=.007), bleeding requiring transfusions (OR=2.1, p=.016), and reoperations (OR=1.7, p=.004). ConclusionmFI-5 score is a quick and viable option for surgeons to use as an assessment tool to stratify high risk patients undergoing elective ACDF, as increasing mFI-5 scores showed significantly higher rates of all adverse outcomes accounted for in this study, except for deep incisional SSI, wound disruption, and PE. Additionally, moderate to severe mFI-5 scores of 2 or 3+ were independent predictors for 30-day postoperative ARF, UTI, MI, bleeding requiring transfusions, septic shock, reoperation, and readmissions following elective ACDF surgery in adults over 50 years old.

Timber-framed exterior walls insulated with wood shavings: A field study in a nordic climate

Wood processing residues provide a possibility to produce thermal insulation material with low environmental impact. This paper deals with the hygrothermal performance of timber-framed exterior walls with wood shavings as insulation material. The presented study consisted of field measurements of five exterior wall structures with two different types of wood shavings insulation and three reference walls. The study was performed in cold Nordic climate, where hygrothermal conditions at outer parts of a wall structure are critical. Untreated wood shavings and wood shavings coated with pulverized clay were compared as insulation materials. Different wind barriers as well as a water vapour barrier and sheathing acting as vapour retarder were also used. Results indicated no suitable conditions for mould growth inside any wall. The thermal resistance of wind barriers as well as the clay-coating of wood shavings had positive effect on the hygrothermal performance of the test walls. Wood shavings proved to be suitable insulation materials for well-insulated structures from the hygrothermal point of view, when the overall design, construction and maintenance are carried out in a proper way.

Aerodynamics and surrounding flow patterns of a long-span bridge girder model with triple-separated boxes

The triple-box girder is finding broader applications in super long-span bridges for its excellent performance of flutter stability and traffic adaptability. In the present study, a bridge girder model with three separated boxes is experimentally investigated in detail via wind tunnel tests. In consideration of web modifications and accessory structures, the multi-point surface-pressure measurement and smoke-wire flow visualization are applied to investigate the aerostatic characteristics and flow structures. The “dual-frequency” phenomenon is found and explained for the bare girder with curved webs. For the present girder with linear webs, the global field is dominated by the separated-shear-layer instability. For the bare girder with curved webs, the upstream gap flow is dominated by the separated-shear-layer instability while the downstream gap flow is dominated by the double-shear-layer instability. The downstream gap flow exhibits obvious intermittent characteristics. In addition, non-Gaussian characteristic analysis of the surface wind pressures is introduced and improved for engineering practice. The distinguishing principle based on the skewness and kurtosis has high adaptability to both the bare girder and the completed bridge. In addition, semi-linear webs show better drag reduction. Combinations of accessory structures are also studied. The results show that during the construction process, prioritizing the installation of highway wind barriers can optimize the aerostatic performance of bridges. The present study embraces the booming era of long-span bridges with a triple-box girder and enriches the studies of bridge aerostatics.

Perspectives of rural farming households on home gardens as an agroforestry for food security: a qualitative study in Indonesia

In developing countries, rural farmers contribute significantly to food production, but their households are still vulnerable to poverty, food insecurity, and malnutrition. Food security is a concept that refers to the ability of a country or region to ensure the availability, accessibility, and utilization of sufficient and nutritious food for its entire population, both in normal situations and under crisis conditions such as natural disasters or political instability. Food security is critical as it is directly related to national security, public health, and sustainable development. To improve food security, governments and international agencies often focus on policies such as increased food production, diversification of food sources, sustainable management of natural resources, and food assistance programs for vulnerable populations. The practice of agroforestry in home gardens offers a variety of readily available, cost-effective, and nutritious food options, which plays a significant role in enhancing the food security of agricultural families. Agroforestry, an integrated land management system combining food crops, trees, and sometimes livestock, offers a potential solution to improve food security. By growing various crops, farmers are not solely dependent on a single source of food, which reduces the risk of crop failure. Agroforestry systems increase resilience to climate change by reducing the impact of natural disasters, such as floods and droughts. Trees can act as wind barriers, reduce soil erosion, and aid in water conservation. This qualitative research with a systematic exploratory approach and grounded analysis examines how agroforestry contributes to farmers' food security by conducting in-depth interviews with farmers in North Luwu, Indonesia. The study identified home garden categories of agroforestry and then evaluated the role of agroforestry food production in terms of securing the food needs of households. The study discovered that restructure food bolsters across various income brackets by promoting healthier eating habits. Additionally, food production enhances the sustainability of food supplies for households and the health and prosperity of agriculturalists. The primary obstacles to producing food at the household level were identified as secure access to appropriate land and the possession of adequate farming expertise. Key words: agroforestry, farmer, rural, food security, household, home garden, Indonesia

Thermal analysis of a bifacial vacuum-based solar thermal collector

In this study, thermal analysis of a vacuum-based bifacial solar thermal collector is conducted. This solar collector is expected to capture the solar radiation from both front and rear sides. One advantage of this collector is that it can work effectively in restricted positions where it should be installed in different positions such as vertically in narrow areas as road wind barriers. The effect of fluid inlet velocity and collector installation position, optimal tilted or vertical, on the performance of the proposed collector as one factor at a time is computationally evaluated. Further, response surface methodology is applied to evaluate the most significant factors affecting the operation of the collector and evaluating the interaction between different factors on the collector performance. The results showed that the proposed collector design still works effectively even for a vertical position of restricted areas. Further, the maximum absorber temperature is significantly increased by increasing the front radiation, water inlet temperature, and rear radiation ratio. Conversely, increasing the inlet velocity also significantly decreases the maximum absorber temperature. Furthermore, the effect of wind speed is statistically insignificant on the maximum absorber temperature. The heat loss from the proposed solar collector reduced by 78.5 % with increasing the coolant velocity from 5 mm/s to 30 mm/s.

Evaluation and Surgical Outcomes of Primary Closure for Breast Abscess- 3 Year Experience in Rangpur Zone

Background: Breast abscesses are a common medical concern, often associated with pain, cost implications, and dressing-related complications. Managing breast abscesses presents an opportunity to optimize patient outcomes while streamlining healthcare resource utilization. This study aimed to evaluate the effectiveness of primary closure as a surgical approach for breast abscess management in a private practice setting, focusing on reducing hospital stays and associated costs, particularly improving patient compliance. Methods: This prospective study was conducted in private practice settings over three years, from July 2020 to June 2023. A total of 119 patients, comprising both acute (n=72) and chronic (n=47) breast abscess cases, were included in the study. The surgical procedures included incision, drainage, curettage, and primary closure using 16 FR/18 FR drains. Special measures included iodine irrigation, keeping drains for at least 7 days, suture removal on 10th-14th postoperative days, and administering antibiotics for up to 14 days. Follow-up appointments occurred after 3 weeks. Results: Among the 119 patients, 72 (60.5%) presented with acute breast abscesses, while 47 (39.5%) had chronic abscesses. All patients were discharged on the 2nd postoperative day. In cases of chronic breast abscess, drains were removed between 5-7 postoperative days, while in acute cases, drains were removed at the 10th postoperative day or upon suture removal. No suction drains were used. Over 95% of patients resumed breastfeeding shortly after surgery. Suture removal on the 10-12th postoperative days showed healthy wounds in 88 patients, minor wound gaps in 13 patients (requiring no further intervention), and secondary stitching in 10 patients. Ten patients experienced delayed abscess formations under the scar, necessitating drainage under local anesthesia and oral antibiotics. The most frequently isolated causative organism from pus was Staphylococcus aureus. .........

Complications of periprosthetic fracture revision vs aseptic revision of total knee arthroplasty

BackgroundPeriprosthetic fractures after total knee arthroplasty (TKA) are a challenging problem due to complex fracture patterns, poor bone quality, and a high-risk patient population. Treatment of both periprosthetic fractures and aseptic complications can include revision TKA. In this study, we compared systemic and orthopaedic complications following periprosthetic fracture associated revision TKA to aseptic revision TKA. MethodsThis is a retrospective cohort study using data from the years 2010–2020 from a national administrative claims database. Billing codes were used to identify revision TKAs with a diagnosis of periprosthetic fracture or aseptic complications (loosening, dislocation, arthrofibrosis, osteolysis, or prosthetic wear) within one year prior to revision. Pertinent systemic complications and rates of repeat revision TKA, periprosthetic infection, and repeat fractures were compared between the two groups. ResultsWe identified 9891 periprosthetic fracture associated revision TKAs and 47,071 aseptic revision TKAs. Our study found higher rate of systemic complications including AKI, DVT, wound disruption, hematoma, and surgical site infections in periprosthetic fracture associated revision TKA compared to aseptic revision TKA. Furthermore, we found higher rates of repeat revision TKA, periprosthetic infections, and repeat periprosthetic fractures in fracture associated revision TKA group compared to aseptic revision group. ConclusionsOur work highlights the significant short- and long-term complications associated with periprosthetic fracture associated revision TKA. Future working comparing functional outcomes and optimal surgical techniques are needed.

Trends in prevalence and complications for smokers who underwent total hip arthroplasty from 2011 to 2019: an analysis of 243,163 patients.

Smoking is an established risk factor for postoperative complications after total hip arthroplasty (THA). It is unknown if the decreasing prevalence of adult smoking in the United States is reflected in the elective THA patient population. We aimed to investigate recent trends in: (1) the prevalence of smoking pre-THA, stratified by patient demographics; and (2) rates of 30-day complications and increased healthcare utilisation post-THA in smokers versus non-smokers. Patients who underwent primary elective THA (2011-2019) were identified using the National Surgical Quality Improvement Program database. A total of 243,163 cases (Smokers: n = 30,536; Non-smokers: n = 212,627) were included. Trends analyses were performed for smoking prevalence across the study period. Smokers were propensity score-matched (1:1) to a cohort of non-smokers (n = 29,628, each), and rates of 30-day complications, readmission, and non-home discharge were compared. The rate of preoperative smoking significantly decreased from 14.0% in 2011 to 11.6% in 2019 (p-trend = 0.0286). When stratified, a significant decreasing trend in smoking was found for males and all races; within races, American-Indian/Alaska-Native race had the sharpest decline (2011:36.3% vs. 2019:23.2%). No significant change in 30-day complication rates among smokers or non-smokers was observed (p-trend > 0.05), but non-home discharge significantly decreased for both smokers (p-trend = 0.001) and non-smokers (p-trend < 0.001). After matching, higher rates of superficial surgical site infections (SSI) (0.9% vs. 0.5%; p < 0.001), deep SSI (0.5% vs. 0.3%; p < 0.001), wound disruption (0.2% vs. 0.1%; p = 0.006), and readmission (4.2% vs. 3.1%; p = <0.001) were found in smokers versus non-smokers. The present study is encouraging that national efforts to reduce the prevalence of smoking may be successful within the THA population, but there is a persistently elevated risk of postoperative complications in smokers after THA.