BACKGROUND There has been an increasing focus in recent years on health-care disparities.Studies investigating return to work(RTW)or sports are often performed in large,urban areas.Relatively few studies have investig...BACKGROUND There has been an increasing focus in recent years on health-care disparities.Studies investigating return to work(RTW)or sports are often performed in large,urban areas.Relatively few studies have investigated rates of return to farming or other heavy labor that is of interest to patients in rural areas.AIM To evaluate the literature regarding RTW in farming or heavy labor after orthopedic hip,knee,or shoulder surgery.METHODS A search was performed in the PubMed and EMBASE databases using Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.Studies were included if they reported patients employed in farming or heavy labor,RTW rates after orthopedic surgery of the hip,knee,or shoulder,and had a minimum 6-month follow-up.A meta-analysis of proportions using a random-effects model was performed on three single-arm observational studies to estimate the pooled RTW rate following arthroscopic shoulder surgery.RESULTS Ten studies were included,and 101 farmers were identified among 440 total patients.One study involved hip surgery,two studies involved knee surgery,and seven studies involved shoulder surgery.RTW rates across studies varied by type of surgery and follow-up interval,ranging from 24%to 100%.The RTW rate was only 53.6%at 1 year following total hip arthroplasty.No studies investigated RTW in farmers following total knee arthroplasty.Among non-comparative studies,meta-analysis revealed a pooled RTW rate of 89%following arthroscopic shoulder surgery,with low heterogeneity(I^(2)=30.1%).Among comparative studies,one study reported significantly higher RTW odds for patients undergoing anatomic total shoulder arthroplasty compared to reverse shoulder arthroplasty(odds ratio=5.45).Overall,surgical intervention for shoulder pathology was associated with a high likelihood of RTW across multiple techniques,with particularly favorable outcomes for anatomic total shoulder arthroplasty.CONCLUSION This systematic review highlights the high rates of RTW in farmers and heavy laborers after shoulder surgery.However,our findings also underscore the need for more rural-specific research to guide patient counseling,rehabilitation expectations,and shared decision-making in this underserved population,particularly for orthopedic surgery of the hip and knee.展开更多
Long-term straw return with appropriate nitrogen(N)fertilization increases seedcotton yield and fiber quality,and the root system plays an important role in cotton production.However,under straw return and N fertiliza...Long-term straw return with appropriate nitrogen(N)fertilization increases seedcotton yield and fiber quality,and the root system plays an important role in cotton production.However,under straw return and N fertilization,the relationship between the cotton boll-loading capacity of the root system and seedcotton yield remains unclear.In this study,a ten years of long-term field experiment was conducted in a wheat-cotton rotation system.The effects of straw treatments(straw return and straw removal)and N rates(N0,N75,N150 and N300 representing 0,75,150 and 300 kg N ha^(-1),respectively)on cotton root activity,boll-loading capacity of the root system and their relationship to seedcotton yield from 2019 to 2022 were quantified.The results showed that straw return with an appropriate N fertilization of N150 increased root biomass,the rate and components of root-bleeding sap,as well as boll-loading capacity of the root system and seedcotton yield,but decreased the ratio of root to shoot biomass.Furthermore,the root-bleeding sap rate reached the maximum at 30 d post anthesis(DPA)during the peak boll setting stage.However,the contents of nitrate-N,free amino acids and soluble sugar in root-bleeding sap decreased from 10 DPA.Notably,in 2021 and at 30 DPA,the highest contents of nitrate-N(4.8μg mL^(-1))and free amino acids(8.3μg mL^(-1)),as well as soluble sugar(3.4μg mL^(-1))were observed at N150 under straw return.The increase in seedcotton yield is positively correlated to the soluble sugar content.Straw return significantly increased the boll-loading capacity of the root system,which first increased but then decreased with the increase in N fertilization.Under straw return with N150,the maximum seecotton yield(3455-4544 kg ha^(-1))was recorded,and the largest boll loading(49-54 boll 100 g^(-1))and boll capacity(242-292 g 100 g^(-1))of root system at the boll opening stage were observed.Therefore,straw return with appropriate N fertilization improved root activity and the boll-loading capacity of the root system,thereby increasing seedcotton yield.This study provides new insights into improving seedcotton yield from the perspective of coordinating cotton growth.展开更多
Straw return has demonstrated significant potential for enhancing carbon(C)sequestration and nitrogen(N)uptake while concurrently promoting plant productivity.However,the specific transport and distribution of C produ...Straw return has demonstrated significant potential for enhancing carbon(C)sequestration and nitrogen(N)uptake while concurrently promoting plant productivity.However,the specific transport and distribution of C produced by photosynthesis and exogenous N within the rice plant-soil system under straw return remains unclear.A long-term straw return pot trial experiment was conducted in a double cropping rice system,incorporating treatments of inorganic fertilizer application with straw removal(F),straw burning and ash return with reducing inorganic fertilizers(SBR),and straw return with reducing inorganic fertilizers(SR)to investigate C sequestration and exogenous N uptake using ^(13)C pulse and ^(15)N isotope tracer techniques.The SR treatment had significantly higher soil ^(13)C abundance,by 24.4 and 25.4%,respectively,^(13)C concentrations in aboveground plant parts,by 18.4 and 35.8%respectively,and ^(15)N concentrations in rice panicles,by 12.8 and 34.3%than the SBR and F treatments.This enhancement contributed to a higher total organic C concentration and increased rice grain yield in the SR treatment.Furthermore,the SR treatment had significantly higher photosynthetic C,by 9.8%,which was directly transferred to soil C.The SR treatment had a higher distribution of photosynthetic C in the leaves and stems,but a lower distribution in the panicle compared to the SBR treatment.This finding is advantageous for sequestering photosynthetic C into the soil through straw return;conversely,opposite trends were observed in ^(15)N distribution.In addition,rice plants in the SR treatment had increased N uptake from urea and soil N sources,enhancing N recovery by 9.2 and 12.5%,respectively,and reducing soil N residues.Correlation analysis showed that the SR treatment increased the concentrations of ^(13)C in leaves and roots while decreasing the ^(15)N abundance in all rice organs,thereby contributing to an increase in rice yield.The partial least square path model suggested that the increase in rice yield under the SR treatment was primarily linked to ^(13)C accumulation within the rice plant-soil system.The results suggest that straw return increases the sequestration of photosynthetic C and exogenous N in the rice plant-soil system and increases N utilization efficiency,which subsequently improves both rice and soil productivity.展开更多
Some patients with systemic lupus erythematosus experience neuropsychiatric symptoms.Although magnetic resonance imaging can detect abnormal signals in the white matter of the brain,conventional methods often struggle...Some patients with systemic lupus erythematosus experience neuropsychiatric symptoms.Although magnetic resonance imaging can detect abnormal signals in the white matter of the brain,conventional methods often struggle to accurately capture microstructural changes.Various diffusion models have been used to study white matter in systemic lupus erythematosus;however,comparative analyses of their sensitivity and specificity for detecting microstructural changes remain insufficient.To address this,our team designed a diagnostic trial that used multimodal diffusion imaging techniques to observe white matter microstructural changes in patients with systemic lupus erythematosus who had neuropsychiatric symptoms,with an aim to identify key diagnostic biomarkers for these patients.Patients with active lupus who received treatment at the Department of Rheumatology and Immunology,The First Affiliated Hospital of China Medical University,from September 2023 to March 2024 were recruited.According to the standards of the American College of Rheumatology,patients with systemic lupus erythematosus who had neuropsychiatric symptoms were assigned to the systemic lupus erythematosus group,whereas those without neuropsychiatric symptoms were assigned to the non-systemic lupus erythematosus group.Additionally,healthy volunteers matched by region,sex,and age were recruited as controls.All three groups underwent the same diffusion magnetic resonance imaging examination protocol to compare differences in diffusion parameters.Advanced diffusion imaging models were able to sensitively detect microstructural changes in the white matter fibers of patients with systemic lupus erythematosus who had neuropsychiatric symptoms,with specific diffusion parameters showing significant abnormalities in key brain regions.In the left superior longitudinal fasciculus subregion and the right thalamic radiations of patients with systemic lupus erythematosus who had neuropsychiatric symptoms,we also identified abnormal diffusion characteristics that were clearly correlated with disease activity,suggesting that microstructural changes in these areas may reflect the dynamic process of neuroinflammatory damage.The present study addresses critical challenges in the diagnosis of systemic lupus erythematosus by identifying specific white matter imaging biomarkers and elucidating the association between microstructural damage and clinical manifestations.The main contributions of our study include:1)establishing axial regression probability parameters from mean apparent propagator magnetic resonance imaging as sensitive biomarkers for systemic lupus erythematosus,particularly in the third subregion of the left superior longitudinal fasciculus;2)demonstrating that multimodal diffusion imaging may be superior to conventional diffusion tensor imaging for detecting white matter microstructural abnormalities in patients with systemic lupus erythematosus;and 3)integrating tract-based spatial statistics with clinically relevant analyses to link imaging findings to pathological mechanisms.展开更多
The return capsule of the Shenzhou-20 spaceship,carrying no astronauts,touched down at the Dongfeng landing site in north China’s Inner Mongolia Autonomous Region at 9:34 a.m.(Beijing Time)on January 19,according to ...The return capsule of the Shenzhou-20 spaceship,carrying no astronauts,touched down at the Dongfeng landing site in north China’s Inner Mongolia Autonomous Region at 9:34 a.m.(Beijing Time)on January 19,according to the China Manned Space Agency(CMSA).展开更多
Aimed at the remanufacturing system, the effect of the uncertainty of returns＇ quality on bottleneck shifting is investigated. A novel definition of bottleneck station is presented and the probability of a station be...Aimed at the remanufacturing system, the effect of the uncertainty of returns＇ quality on bottleneck shifting is investigated. A novel definition of bottleneck station is presented and the probability of a station becoming a bottleneck is also given. By calculating the effective output, the effective operation time （EOT） and the ratio of EOT of each station, the system＇s current bottleneck of effective output time is determined. By calculating the probability coefficient of variation and index of bottleneck shifting, the quantitative performance of bottleneck shifting is obtained. Discrete event simulation and the experiment design method are adopted to simulate the system, in which the proportion of quality grading, repair rates and process routes are considered. The case study shows that the uncertainty of returns＇ quality greatly increases the probability of bottleneck shifting, and with the increase of the discrete degree of the returns＇ repair rate, the bottleneck shifting phenomenon is more obvious. Furthermore, bottleneck shifting is closely related to the process route of the dominating returns＇ quality grade.展开更多
AIM To systemically review all studies reporting return to sport following tibial plateau fracture, in order to provide information on return rates and times to sport, and to assess variations in sporting outcome for ...AIM To systemically review all studies reporting return to sport following tibial plateau fracture, in order to provide information on return rates and times to sport, and to assess variations in sporting outcome for different treatment methods.METHODS A systematic search of CINAHAL, Cochrane, EMBASE, Google Scholar, MEDLINE, PEDro, Scopus, SPORTDiscus and Web of Science was performed in January 2017 using the keywords "tibial", "plateau", "fractures", "knee", "athletes", "sports", "non-operative", "conservative", "operative", "return to sport". All studies which recorded return rates and times to sport following tibial plateau fractures were included. RESULTS Twenty-seven studies were included: 1 was a randomised controlled trial, 7 were prospective cohort studies, 16 were retrospective cohort studies, 3 were case series. One study reported on the outcome of conservative management(n = 3); 27 reported on the outcome of surgical management(n = 917). Nine studies reported on Open Reduction Internal Fixation(ORIF)(n = 193), 11 on Arthroscopic-Assisted Reduction Internal Fixation(ARIF)(n = 253) and 7 on Frame-Assisted Fixation(FRAME)(n = 262). All studies recorded "return to sport"rates. Only one study recorded a "return to sport" time. The return rate to sport for the total cohort was 70%. For the conservatively-managed fractures, the return rate was 100%. For the surgically-managed fractures, the return rate was 70%. For fractures managed with ORIF, the return rate was 60%. For fractures managed with ARIF, the return rate was 83%. For fractures managed with FRAME was 52%. The return rate for ARIF was found to be significantly greater than that for ORIF(OR 3.22, 95%CI: 2.09-4.97, P < 0.001) and for FRAME(OR 4.33, 95%CI: 2.89-6.50, P < 0.001). No difference was found between the return rates for ORIF and FRAME(OR 1.35, 95%CI: 0.92-1.96, P = 0.122). The recorded return time was 6.9 mo(median), from a study reporting on ORIF.CONCLUSION Return rates to sport for tibial plateau fractures remain limited compared to other fractures. ARIF provides the best return rates. There is limited data regarding return times to sport. Further research is required to determine return times to sport, and to improve return rates to sport, through treatment and rehabilitation optimisation.展开更多
Straw return is an effective way to improve crop grain yield and potassium(K)use efficiency by increasing soil K content.However,the effects of straw return on soil K supplying capacity,replacement of K fertilizer,and...Straw return is an effective way to improve crop grain yield and potassium(K)use efficiency by increasing soil K content.However,the effects of straw return on soil K supplying capacity,replacement of K fertilizer,and K-use efficiency under maize(Zea mays L.)–rice(Oryza sativa L.)cropping systems are little studied.A two-year field experiment was conducted to determine the physiological determinants of K-use efficiency under straw return with four K fertilization rates.Sr33(straw returned plus 33%of K fertilizer applied)and Sr67(straw returned plus 67%of K fertilizer applied)increased annual crop yields by 1.5%and 3.2%and increased agronomic K-use efficiency by respectively 2.9 and 1.3-fold on average in the two years,compared with the conventional practice S0K100(no straw returned plus normal amounts of K fertilizer applied).The Sr33 and Sr67 treatments resulted in significantly greater equilibrium K concentration ratios(CR0 K)and specifically exchangeable K(KX)values according to quantity/intensity(Q/I)relationship analyses,indicating improvement of the potential soil K supply capacity.However,the Sr67 better maintained the soil exchangeable K level and K balance.The results suggested that K released from maize and rice straw can replace about half of chemical K fertilizer,depending on the available K content in maize–rice cropping system production.展开更多
Straw return is a promising strategy for managing soil organic carbon(SOC)and improving yield stability.However,the optimal straw return strategy for sustainable crop production in the wheat(Triticum aestivum L.)-cott...Straw return is a promising strategy for managing soil organic carbon(SOC)and improving yield stability.However,the optimal straw return strategy for sustainable crop production in the wheat(Triticum aestivum L.)-cotton(Gossypium hirsutum L.)cropping system remains uncertain.The objective of this study was to quantify the long-term(10 years)impact of carbon(C)input on SOC sequestration,soil aggregation and crop yields in a wheat-cotton cropping system in the Yangtze River Valley,China.Five treatments were arranged with a single-factor randomized design as follows:no straw return(Control),return of wheat straw only(Wt),return of cotton straw only(Ct),return of 50%wheat and 50%cotton straw(Wh-Ch)and return of 100%wheat and 100%cotton straw(Wt-Ct).In comparison to the Control,the SOC content increased by 8.4 to 20.2%under straw return.A significant linear positive correlation between SOC sequestration and C input(1.42-7.19 Mg ha^(−1)yr^(−1))(P<0.05)was detected.The percentages of aggregates of sizes>2 and 1-2 mm at the 0-20 cm soil depth were also significantly elevated under straw return,with the greatest increase of the aggregate stability in the Wt-Ct treatment(28.1%).The average wheat yields increased by 12.4-36.0%and cotton yields increased by 29.4-73.7%,and significantly linear positive correlations were also detected between C input and the yields of wheat and cotton.The average sustainable yield index(SYI)reached a maximum value of 0.69 when the C input was 7.08 Mg ha^(−1)yr^(−1),which was close to the maximum value(SYI of 0.69,C input of 7.19 Mg ha^(−1)yr^(-1))in the Wt-Ct treatment.Overall,the return of both wheat and cotton straw was the best strategy for improving SOC sequestration,soil aggregation,yields and their sustainability in the wheat-cotton rotation system.展开更多
With the increase of mining depth, more and deeper coal mines are limited by heat disaster. The cooling energy in deep mine cooling system comes from mine water inrush or ground cooling tower, but we cannot adopt the ...With the increase of mining depth, more and deeper coal mines are limited by heat disaster. The cooling energy in deep mine cooling system comes from mine water inrush or ground cooling tower, but we cannot adopt the two methods because mine water inrush in many old coal mines in China is limited. What is more, the cooling pipelines cannot be put in narrow pit-shaft. To settle the problem above, according to the characteristics of Zhangxiaolou Coal Mine, this paper adopts the deep mine return air as the cooling energy for deep mine cooling system. In addition, we carried out cite test to extract cold energy from return air. Through monitoring the water quantity, water temperature of cooling system and air temperature, we got the thermodynamic equilibrium parameters during the cooling energy acquisition analysis and the effect of cooling system that the temperature and humidity on working face are respectively reduced to 8-12 ℃ and 8-15% through cooling. This research offers experimental reference for deep mine cooling which lacks cooling energy.展开更多
BACKGROUND Scaphoid fracture is the most commonly fractured carpal bone in the athletic patient,accounting for over 85%of all sport-related carpal bone fractures,and is particularly common in sports involving high imp...BACKGROUND Scaphoid fracture is the most commonly fractured carpal bone in the athletic patient,accounting for over 85%of all sport-related carpal bone fractures,and is particularly common in sports involving high impact injuries to the wrist.The management of such injuries comprises both conservative and surgical techniques,as guided by fracture location and type.Athletes demonstrate a unique challenge with regards to the management of scaphoid fractures due to their requirement to return to sport,as soon as able.AIM To review systemically all studies recording return to sport following scaphoid fractures,to collate information on return rates to sport(RRS)and mean return times(RTS)to sport and to determine differences in sporting outcome for the various treatment methods.METHODS A systematic search of MEDLINE,EMBASE,CINAHAL,Cochrane,Google Scholar,Physiotherapy Evidence Database,SPORTDiscus,Web of Science and Scopus was performed in August 2018 using the keywords"scaphoid","fracture","acute","carpal","athletes","sports","non-operative","conservative","operative"and"return to sport".All studies that recorded RRS and RTS following scaphoid fractures were included.RTS was recorded as the length of time from commencement of either primary conservative management or primary surgical procedure to return to sport.RESULTS Eleven studies were included:Two randomised controlled trials,six retrospective cohort studies and three case series.Seven studies reported on conservative management(n=77),and eight studies reported on surgical management(n=83).For conservative management,RRS was 90%(69/77),and the mean RTS was9.6 wk.Three studies allowed to return to sport in cast[RRS 89%(25/28);RTS 1.9 wk],and four studies required completion of cast treatment prior to returning to sport[RRS 90%(44/49);RTS 13.9 wk].Four studies recorded fracture union data:Union rate 85%(47/55);mean time to union 14.0 wk.For surgical management,RRS was 98%(81/83),and RTS was 7.3 wk.Three studies reported on Percutaneous Screw Fixation[RRS 97%(32/33);RTS 6.5 wk],and five studies reported on Open Reduction Internal Fixation[RRS 98%(49/50);RTS 7.9 wk].Six studies recorded fracture union data:Union rate 97%(69/71);mean time to union9.8 wk.On meta-analysis,RRS(RR=1.09;95%confidence interval(CI):1.00-1.18;P<0.045),RTS(MD 2.3 wk;95%CI:0.79-3.87;P<0.002),union rates(RR=1.14;95%CI:1.01-1.28;P<0.030)and mean times to union(MD 4.2 wk;95%CI:3.94-4.36;P<0.001)were all significantly better for the surgical cohort compared to the conservative cohort.CONCLUSION Surgical management of scaphoid fractures can provide significantly improved RRS and RTS to sport compared to conservative management.Both treatments,however,remain acceptable options,and athletes should be fully informed of the benefits and risks of both prior to deciding treatment plans.Immediate return to sport in a cast should be avoided due to the significant risk of non-union.展开更多
Background: Magnetic resonance image-guided radiation therapy (MR-IGRT) promises more precise and effective radiation treatments compared to conventional IGRT by using real-time on-board MR imaging. Under the influenc...Background: Magnetic resonance image-guided radiation therapy (MR-IGRT) promises more precise and effective radiation treatments compared to conventional IGRT by using real-time on-board MR imaging. Under the influence of a magnetic field, however, secondary electrons exiting a surface can be forced in a circular path and re-enter the medium, resulting in dose increase at a beam-exit surface, called the electron return effect (ERE). The purpose of the study is to compare the exit skin dose computed by Monte Carlo dose calculation with measurements using an adult anthropomorphic phantom and to measure the effect of skin dose reduction by adding 1 cm-thick bolus. Method: The plan was compared with measurements using an adult anthropomorphic phantom combined with radiochromic films and thermoluminescent dosimeters. We also measured the skin dose reduction by adding 1 cm-thick bolus on the frontal surface of the phantom. Results: We found that 1 cm-thick bolus reduced the skin dose by up to 20% both in measurements and calculations. The plan was found to overestimate the measured skin dose by about 10% and there was no significant difference in the bolus effect between the breast skin and the skin (without breast attachment) doses. Conclusion: In conclusion, we confirmed the ERE effect on the anthropomorphic phantom under the magnetic field and the exit skin dose reduction by adding a bolus. Skin dose measurements using anthropomorphic phantom may be helpful to evaluate more realistic skin dose and the bolus effect in the magnetic field.展开更多
Electric and magnetic fields in time and frequency domain due to return stroke-lateral corona (RS-LC) system and re- cently discovered red sprites have been calculated. It has been found that the electric and magnetic...Electric and magnetic fields in time and frequency domain due to return stroke-lateral corona (RS-LC) system and re- cently discovered red sprites have been calculated. It has been found that the electric and magnetic fields due to return stroke and lateral corona system radiate in the very low frequency (VLF) region while due to sprites radiate in the ex- tremely low frequency (ELF) range. A comparison has been made between the radiations emitted due to RS-LC system and sprites in ELF (0 - 200 Hz) region. It has been found that the electric field i.e. radiation power generated due to sprites dominates in the ELF range and thus it is concluded that the red sprites as compared to the RS-LC system are the prominent source for the excitation of Schumann resonances in the earth-ionosphere waveguide.展开更多
An ADS （automated dispensing system） was implemented in our hospital pharmacy in 2008 to optimize and secure the medication process. The main objective of this study was to compare the projected and the real ROI （r...An ADS （automated dispensing system） was implemented in our hospital pharmacy in 2008 to optimize and secure the medication process. The main objective of this study was to compare the projected and the real ROI （return on investment）, after seven years of use. ROI was calculated annually （from 2008 to 2015）, by deducting the cost of investment （ADS buying and implementation, maintenance, repairs and ADS upgrade） from the cost saving （drugs stock reduction and decrease of pharmacy staff dedicated to global dispensing）. In 2015, total costs saving （＋$1,141,987） were divided between decreasing drug stock value and reduction of pharmacy staff. Total costs of investment （-$978,656） were acquisition, maintenance, repairs and an unplanned upgrade costs. Finally, the real ROI was ＋$163,331 after seven years of use. In 2008, projected ROI was ＋$410,786. The real payback period has been increased by approximately two years （six years of use, instead of four years as expected）. Despite their cost, ADSs are a worthwhile investment, leading to a ROI within a few years. These economic considerations should be put into perspective with optimization of drugs stock management, greater efficiency of the global dispensing process, securitization of medication process and redeployment of pharmacy staff.展开更多
BACKGROUND Return to work(RTW)serves as an indication for young and middle-aged colorectal cancer(CRC)survivors to resume their normal social lives.However,these survivors encounter significant challenges during their...BACKGROUND Return to work(RTW)serves as an indication for young and middle-aged colorectal cancer(CRC)survivors to resume their normal social lives.However,these survivors encounter significant challenges during their RTW process.Hence,scientific research is necessary to explore the barriers and facilitating factors of returning to work for young and middle-aged CRC survivors.AIM To examine the current RTW status among young and middle-aged CRC survivors and to analyze the impact of RTW self-efficacy(RTW-SE),fear of progression(FoP),eHealth literacy(eHL),family resilience(FR),and financial toxicity(FT)on their RTW outcomes.METHODS A cross-sectional investigation was adopted in this study.From September 2022 to February 2023,a total of 209 participants were recruited through a convenience sampling method from the gastrointestinal surgery department of a class A tertiary hospital in Chongqing.The investigation utilized a general information questionnaire alongside scales assessing RTW-SE,FoP,eHL,FR,and FT.To analyze the factors that influence RTW outcomes among young and middle-aged CRC survivors,Cox regression modeling and Kaplan-Meier survival analysis were used.RESULTS A total of 43.54%of the participants successfully returned to work,with an average RTW time of 100 days.Cox regression univariate analysis revealed that RTW-SE,FoP,eHL,FR,and FT were significantly different between the non-RTW and RTW groups(P<0.05).Furthermore,Cox regression multivariate analysis identified per capita family monthly income,job type,RTW-SE,and FR as independent influencing factors for RTW(P<0.05).CONCLUSION The RTW rate requires further improvement.Elevated levels of RTW-SE and FR were found to significantly increase RTW among young and middle-aged CRC survivors.Health professionals should focus on modifiable factors,such as RTW-SE and FR,to design targeted RTW support programs,thereby facilitating their timely reintegration into mainstream society.展开更多
We report a very rare case of successful intracardiac correction in a patient with heterotaxy syndrome.The cardiac malformations included dextrocardia,double outlet right ventricle,pulmonary stenosis,interrupted infer...We report a very rare case of successful intracardiac correction in a patient with heterotaxy syndrome.The cardiac malformations included dextrocardia,double outlet right ventricle,pulmonary stenosis,interrupted inferior vena cava,hemiazygos continuation and total anomalous pulmonary venous return.One-stage correction was performed.The atrial procedure consisted of intra-and extraatrial rerouting of the anomalous systemic and pulmonary venous return.The hepatic veins were detached and diverted to the left atrium via an extracardiac conduit.The correction of the double outlet right ventricle was accomplished by intraventricular redirection of the blood flow from the left ventricle to the aorta.The right ventricular outflow was ultimately remodeled using a valved conduit.For better perception of the complex morphology,a three-dimensional model was designed,using CT scan images.This proved to be very useful for surgical planning,especially with regard to the intraatrial reconstruction of the systemic and pulmonary venous rerouting.展开更多
BACKGROUND Many patients prioritize the ability to return to work(RTW)after shoulder replacement surgeries such as total shoulder arthroplasty(TSA),reverse TSA(rTSA),and shoulder hemiarthroplasty(HA).Due to satisfacto...BACKGROUND Many patients prioritize the ability to return to work(RTW)after shoulder replacement surgeries such as total shoulder arthroplasty(TSA),reverse TSA(rTSA),and shoulder hemiarthroplasty(HA).Due to satisfactory clinical and functional long-term outcomes,the number of shoulder replacements performed will continue to rise into this next decade.With younger individuals who compose a significant amount of the workforce receiving shoulder replacements,patients will begin to place a higher priority on their ability to RTW following shoulder arthroplasty.AIM To summarize RTW outcomes following TSA,rTSA,and HA,and analyze the effects of workers’compensation status on RTW rates and ability.METHODS This systematic review and analysis was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.A literature search regarding RTW following shoulder arthroplasty was performed using four databases(PubMed,Scopus,Embase,and Cochrane Library),and the Reference Citation Analysis(https://www.referencecitationanalysis.com/).All studies in English relevant to shoulder arthroplasty and RTW through January 2021 that had a level of evidence I to IV were included.Nonclinical studies,literature reviews,case reports,and those not reporting on RTW after shoulder arthroplasty were excluded.RESULTS The majority of patients undergoing TSA,rTSA,or HA were able to RTW betweenone to four months,depending on work demand stratification.While sedentary or light demand jobs generally have higher rates of RTW,moderate or heavy demand jobs tend to have poorer rates of return.The rates of RTW following TSA(71%-93%)were consistently higher than those reported for HA(69%-82%)and rTSA(56%-65%).Furthermore,workers’compensation status negatively influenced clinical outcomes following shoulder arthroplasty.Through a pooled means analysis,we proposed guidelines for the average time to RTW after TSA,rTSA,and HA.For TSA,rTSA,and HA,the average time to RTW regardless of work demand stratification was 1.93±3.74 mo,2.3±2.4 mo,and 2.29±3.66 mo,respectively.CONCLUSION The majority of patients are able to RTW following shoulder arthroplasty.Understanding outcomes for rates of RTW following shoulder arthroplasty would assist in managing expectations in clinical practice.展开更多
BACKGROUND Evidence-based guidance on return to sport following toe phalanx fractures is limited.AIM To systemically review all studies recording return to sport following toe phalanx fractures(both acute fractures an...BACKGROUND Evidence-based guidance on return to sport following toe phalanx fractures is limited.AIM To systemically review all studies recording return to sport following toe phalanx fractures(both acute fractures and stress fractures),and to collate information on return rates to sport(RRS)and mean return times(RTS)to the sport.METHODS A systematic search of PubMed,MEDLINE,EMBASE,CINAHL,Cochrane Library,Physiotherapy Evidence Database,and Google Scholar was performed in December 2022 using the keywords‘Toe’,‘Phalanx’,‘Fracture’,‘injury’,‘athletes’,‘sports’,‘non-operative’,‘conservative’,‘operative’,‘return to sport’.All studies which recorded RRS and RTS following toe phalanx fractures were included.RESULTS Thirteen studies were included:one retrospective cohort study and twelve case series.Seven studies reported on acute fractures.Six studies reported on stress fractures.For the acute fractures(n=156),63 were treated with primary conservative management(PCM),6 with primary surgical management(PSM)(all displaced intra-articular(physeal)fractures of the great toe base of the proximal phalanx),1 with secondary surgical management(SSM)and 87 did not specify treatment modality.For the stress fractures(n=26),23 were treated with PCM,3 with PSM,and 6 with SSM.For acute fractures,RRS with PCM ranged from 0 to 100%,and RTS with PCM ranged from 1.2 to 24 wk.For acute fractures,RRS with PSM were all 100%,and RTS with PSM ranged from 12 to 24 wk.One case of an undisplaced intra-articular(physeal)fracture treated conservatively required conversion to SSM on refracture with a return to sport.For stress fractures,RRS with PCM ranged from 0%to 100%,and RTS with PCM ranged from 5 to 10 wk.For stress fractures,RRS with PSM were all 100%,and RTS with surgical management ranged from 10 to 16 wk.Six cases of conservatively-managed stress fractures required conversion to SSM.Two of these cases were associated with a prolonged delay to diagnosis(1 year,2 years)and four cases with an underlying deformity[hallux valgus(n=3),claw toe(n=1)].All six cases returned to the sport after SSM.CONCLUSION The majority of sport-related toe phalanx fractures(acute and stress)are managed conservatively with overall satisfactory RRS and RTS.For acute fractures,surgical management is indicated for displaced,intra-articular(physeal)fractures,which offers satisfactory RRS and RTS.For stress fractures,surgical management is indicated for cases with delayed diagnosis and established nonunion at presentation,or with significant underlying deformity:both can expect satisfactory RRS and RTS.展开更多
BACKGROUND Lateral ankle sprains are the most common traumatic musculoskeletal injuries of the lower extremity,with an incidence rate of 15%-20%.The high incidence and prevalence highlights the economic impact of this...BACKGROUND Lateral ankle sprains are the most common traumatic musculoskeletal injuries of the lower extremity,with an incidence rate of 15%-20%.The high incidence and prevalence highlights the economic impact of this injury.Ankle sprains lead to a high socioeconomic burden due to the combination of the high injury incidence and high medical expenses.Up to 40%of patients who suffer from an ankle sprain develop chronic ankle instability.Chronic instability can lead to prolonged periods of pain,immobility and injury recurrence.Identification of factors that influence return to work(RTW)and return to sports(RTS)after a lateral ankle sprain(LAS)may help seriously reduce healthcare costs.AIM To explore which factors may potentially affect RTW and RTS after sustaining an LAS.METHODS EMBASE and PubMed were systematically searched for relevant studies published until June 2023.Inclusion criteria were as follows:(1)Injury including LAS or chronic ankle instability;(2)Described any form of treatment;(3)Assessment of RTW or RTS;(4)Studies published in English;and(5)Study designs including randomized controlled clinical trials,clinical trials or cohort studies.Exclusion criteria were:(1)Studies involving children(age<16 year);or(2)Patients with concomitant ankle injury besides lateral ankle ligament damage.A quality assessment was performed for each of the included studies using established risk of bias tools.Additionally quality of evidence was assessed using the GRADEpro tool in cases where outcomes were included in the quantitative analysis.A best evidence synthesis was performed in cases of qualitative outcome analysis.For all studied outcomes suitable for quantitative analysis a forest plot was created to calculate the effect on RTW and RTS.RESULTS A total of 8904 patients were included in 21 studies,10 randomized controlled trials,7 retrospective cohort studies and 4 prospective cohort studies.Fifteen studies were eligible for meta-analysis.The overall RTS rate ranged were 80%and 83%in the all treatments pool and surgical treatments pool,respectively.The pooled mean days to RTS ranged from 23-93 d.The overall RTW rate was 89%.The pooled mean time to RTW ranged from 5.8-8.1 d.For patients with chronic ankle instability,higher preoperative motivation was the sole factor significantly and independently(P=0.001)associated with the rate of and time to RTS following ligament repair or reconstruction.Higher body mass index was identified as a significant factor(P=0.04)linked to not resuming sports or returning at a lower level(median 24,range 20-37),compared to those who resumed at the same or higher level(median 23,range 17-38).Patients with a history of psychological illness or brain injury,experienced a delay in their rehabilitation process for sprains with fractures and unspecified sprains.The extent of the delayed rehabilitation was directly proportional to the increased likelihood of experiencing a recurrence of the ankle sprain and the number of ankle-related medical visits.We also observed that 10%of athletes who did return to sport after lateral ankle sprain without fractures described non-ankle-related reasons for not returning.CONCLUSION All treatments yielded comparable results,with each treatment potentially offering unique advantages or benefits.Preoperative motivation may influence rehabilitation after LAS.Grading which factor had a greater impact was not possible due to the lack of comparability among the included patients.展开更多
The Economic Production Quantity (EPQ) model is commonly used by practitioners in the fields of production and inventory management to assist them in making decision on production lot size. The common assumptions in t...The Economic Production Quantity (EPQ) model is commonly used by practitioners in the fields of production and inventory management to assist them in making decision on production lot size. The common assumptions in this model are that all units produced are perfect and shortages are not allowed. But, in real situation the defective items will be produced in each cycle of production and shortages and scrap are possible. These assumptions will underestimate the actual required quantity. Hence, the defective items can not be ignored in the production process. Rework process is necessary to convert those defective into finished goods. This study proposes EPQ model that incorporates both imperfect production quality and falsely not screening out a proportion of defects, thereby passing them on to customers, resulting in defect sales returns. To active this objective a suitable mathematical model is developed and the optimal production lot size which minimizes the total cost is derived. An illustrative example is provided and numerically verified. The validation of result in this model was coded in Microsoft Visual Basic 6.0.展开更多
文摘BACKGROUND There has been an increasing focus in recent years on health-care disparities.Studies investigating return to work(RTW)or sports are often performed in large,urban areas.Relatively few studies have investigated rates of return to farming or other heavy labor that is of interest to patients in rural areas.AIM To evaluate the literature regarding RTW in farming or heavy labor after orthopedic hip,knee,or shoulder surgery.METHODS A search was performed in the PubMed and EMBASE databases using Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.Studies were included if they reported patients employed in farming or heavy labor,RTW rates after orthopedic surgery of the hip,knee,or shoulder,and had a minimum 6-month follow-up.A meta-analysis of proportions using a random-effects model was performed on three single-arm observational studies to estimate the pooled RTW rate following arthroscopic shoulder surgery.RESULTS Ten studies were included,and 101 farmers were identified among 440 total patients.One study involved hip surgery,two studies involved knee surgery,and seven studies involved shoulder surgery.RTW rates across studies varied by type of surgery and follow-up interval,ranging from 24%to 100%.The RTW rate was only 53.6%at 1 year following total hip arthroplasty.No studies investigated RTW in farmers following total knee arthroplasty.Among non-comparative studies,meta-analysis revealed a pooled RTW rate of 89%following arthroscopic shoulder surgery,with low heterogeneity(I^(2)=30.1%).Among comparative studies,one study reported significantly higher RTW odds for patients undergoing anatomic total shoulder arthroplasty compared to reverse shoulder arthroplasty(odds ratio=5.45).Overall,surgical intervention for shoulder pathology was associated with a high likelihood of RTW across multiple techniques,with particularly favorable outcomes for anatomic total shoulder arthroplasty.CONCLUSION This systematic review highlights the high rates of RTW in farmers and heavy laborers after shoulder surgery.However,our findings also underscore the need for more rural-specific research to guide patient counseling,rehabilitation expectations,and shared decision-making in this underserved population,particularly for orthopedic surgery of the hip and knee.
基金supported by the Jiangsu Agricultural Science and Technology Innovation Fund(CX(22)2015)the Fundamental Research Funds for the Central Universities(XUEKEN2022008)+1 种基金the Innovation Center for Modern Crop Production Cosponsored by Province and Ministry(CIC-MCP)the Cotton Industry Technology Research System of Shandong Province(SDAIT-03).
文摘Long-term straw return with appropriate nitrogen(N)fertilization increases seedcotton yield and fiber quality,and the root system plays an important role in cotton production.However,under straw return and N fertilization,the relationship between the cotton boll-loading capacity of the root system and seedcotton yield remains unclear.In this study,a ten years of long-term field experiment was conducted in a wheat-cotton rotation system.The effects of straw treatments(straw return and straw removal)and N rates(N0,N75,N150 and N300 representing 0,75,150 and 300 kg N ha^(-1),respectively)on cotton root activity,boll-loading capacity of the root system and their relationship to seedcotton yield from 2019 to 2022 were quantified.The results showed that straw return with an appropriate N fertilization of N150 increased root biomass,the rate and components of root-bleeding sap,as well as boll-loading capacity of the root system and seedcotton yield,but decreased the ratio of root to shoot biomass.Furthermore,the root-bleeding sap rate reached the maximum at 30 d post anthesis(DPA)during the peak boll setting stage.However,the contents of nitrate-N,free amino acids and soluble sugar in root-bleeding sap decreased from 10 DPA.Notably,in 2021 and at 30 DPA,the highest contents of nitrate-N(4.8μg mL^(-1))and free amino acids(8.3μg mL^(-1)),as well as soluble sugar(3.4μg mL^(-1))were observed at N150 under straw return.The increase in seedcotton yield is positively correlated to the soluble sugar content.Straw return significantly increased the boll-loading capacity of the root system,which first increased but then decreased with the increase in N fertilization.Under straw return with N150,the maximum seecotton yield(3455-4544 kg ha^(-1))was recorded,and the largest boll loading(49-54 boll 100 g^(-1))and boll capacity(242-292 g 100 g^(-1))of root system at the boll opening stage were observed.Therefore,straw return with appropriate N fertilization improved root activity and the boll-loading capacity of the root system,thereby increasing seedcotton yield.This study provides new insights into improving seedcotton yield from the perspective of coordinating cotton growth.
基金supported by the National Natural Science Foundation of China(32160503)the Earmarked Fund for Jiangxi Agriculture Research System,China(JXARS-01)the National Key R&D Program of China(2023YFD2301303).
文摘Straw return has demonstrated significant potential for enhancing carbon(C)sequestration and nitrogen(N)uptake while concurrently promoting plant productivity.However,the specific transport and distribution of C produced by photosynthesis and exogenous N within the rice plant-soil system under straw return remains unclear.A long-term straw return pot trial experiment was conducted in a double cropping rice system,incorporating treatments of inorganic fertilizer application with straw removal(F),straw burning and ash return with reducing inorganic fertilizers(SBR),and straw return with reducing inorganic fertilizers(SR)to investigate C sequestration and exogenous N uptake using ^(13)C pulse and ^(15)N isotope tracer techniques.The SR treatment had significantly higher soil ^(13)C abundance,by 24.4 and 25.4%,respectively,^(13)C concentrations in aboveground plant parts,by 18.4 and 35.8%respectively,and ^(15)N concentrations in rice panicles,by 12.8 and 34.3%than the SBR and F treatments.This enhancement contributed to a higher total organic C concentration and increased rice grain yield in the SR treatment.Furthermore,the SR treatment had significantly higher photosynthetic C,by 9.8%,which was directly transferred to soil C.The SR treatment had a higher distribution of photosynthetic C in the leaves and stems,but a lower distribution in the panicle compared to the SBR treatment.This finding is advantageous for sequestering photosynthetic C into the soil through straw return;conversely,opposite trends were observed in ^(15)N distribution.In addition,rice plants in the SR treatment had increased N uptake from urea and soil N sources,enhancing N recovery by 9.2 and 12.5%,respectively,and reducing soil N residues.Correlation analysis showed that the SR treatment increased the concentrations of ^(13)C in leaves and roots while decreasing the ^(15)N abundance in all rice organs,thereby contributing to an increase in rice yield.The partial least square path model suggested that the increase in rice yield under the SR treatment was primarily linked to ^(13)C accumulation within the rice plant-soil system.The results suggest that straw return increases the sequestration of photosynthetic C and exogenous N in the rice plant-soil system and increases N utilization efficiency,which subsequently improves both rice and soil productivity.
基金supported by the National Natural Science Foundation Joint Fund,No.U22A20309(to PY)the Natural Science Foundation of LiaoningProvince,No.2023-MS-07(to HuL)the Unveiling Key Scientific and Technological Projects of Liaoning Province,No.2021JH1/10400051(to HuL).
文摘Some patients with systemic lupus erythematosus experience neuropsychiatric symptoms.Although magnetic resonance imaging can detect abnormal signals in the white matter of the brain,conventional methods often struggle to accurately capture microstructural changes.Various diffusion models have been used to study white matter in systemic lupus erythematosus;however,comparative analyses of their sensitivity and specificity for detecting microstructural changes remain insufficient.To address this,our team designed a diagnostic trial that used multimodal diffusion imaging techniques to observe white matter microstructural changes in patients with systemic lupus erythematosus who had neuropsychiatric symptoms,with an aim to identify key diagnostic biomarkers for these patients.Patients with active lupus who received treatment at the Department of Rheumatology and Immunology,The First Affiliated Hospital of China Medical University,from September 2023 to March 2024 were recruited.According to the standards of the American College of Rheumatology,patients with systemic lupus erythematosus who had neuropsychiatric symptoms were assigned to the systemic lupus erythematosus group,whereas those without neuropsychiatric symptoms were assigned to the non-systemic lupus erythematosus group.Additionally,healthy volunteers matched by region,sex,and age were recruited as controls.All three groups underwent the same diffusion magnetic resonance imaging examination protocol to compare differences in diffusion parameters.Advanced diffusion imaging models were able to sensitively detect microstructural changes in the white matter fibers of patients with systemic lupus erythematosus who had neuropsychiatric symptoms,with specific diffusion parameters showing significant abnormalities in key brain regions.In the left superior longitudinal fasciculus subregion and the right thalamic radiations of patients with systemic lupus erythematosus who had neuropsychiatric symptoms,we also identified abnormal diffusion characteristics that were clearly correlated with disease activity,suggesting that microstructural changes in these areas may reflect the dynamic process of neuroinflammatory damage.The present study addresses critical challenges in the diagnosis of systemic lupus erythematosus by identifying specific white matter imaging biomarkers and elucidating the association between microstructural damage and clinical manifestations.The main contributions of our study include:1)establishing axial regression probability parameters from mean apparent propagator magnetic resonance imaging as sensitive biomarkers for systemic lupus erythematosus,particularly in the third subregion of the left superior longitudinal fasciculus;2)demonstrating that multimodal diffusion imaging may be superior to conventional diffusion tensor imaging for detecting white matter microstructural abnormalities in patients with systemic lupus erythematosus;and 3)integrating tract-based spatial statistics with clinically relevant analyses to link imaging findings to pathological mechanisms.
文摘The return capsule of the Shenzhou-20 spaceship,carrying no astronauts,touched down at the Dongfeng landing site in north China’s Inner Mongolia Autonomous Region at 9:34 a.m.(Beijing Time)on January 19,according to the China Manned Space Agency(CMSA).
基金The Program for Special Talent in Six Fields of Jiangsu Province(No.2013ZBZZ-046)the Program of Lanzhou Technology Development(No.2014-1-175)
文摘Aimed at the remanufacturing system, the effect of the uncertainty of returns＇ quality on bottleneck shifting is investigated. A novel definition of bottleneck station is presented and the probability of a station becoming a bottleneck is also given. By calculating the effective output, the effective operation time （EOT） and the ratio of EOT of each station, the system＇s current bottleneck of effective output time is determined. By calculating the probability coefficient of variation and index of bottleneck shifting, the quantitative performance of bottleneck shifting is obtained. Discrete event simulation and the experiment design method are adopted to simulate the system, in which the proportion of quality grading, repair rates and process routes are considered. The case study shows that the uncertainty of returns＇ quality greatly increases the probability of bottleneck shifting, and with the increase of the discrete degree of the returns＇ repair rate, the bottleneck shifting phenomenon is more obvious. Furthermore, bottleneck shifting is closely related to the process route of the dominating returns＇ quality grade.
文摘AIM To systemically review all studies reporting return to sport following tibial plateau fracture, in order to provide information on return rates and times to sport, and to assess variations in sporting outcome for different treatment methods.METHODS A systematic search of CINAHAL, Cochrane, EMBASE, Google Scholar, MEDLINE, PEDro, Scopus, SPORTDiscus and Web of Science was performed in January 2017 using the keywords "tibial", "plateau", "fractures", "knee", "athletes", "sports", "non-operative", "conservative", "operative", "return to sport". All studies which recorded return rates and times to sport following tibial plateau fractures were included. RESULTS Twenty-seven studies were included: 1 was a randomised controlled trial, 7 were prospective cohort studies, 16 were retrospective cohort studies, 3 were case series. One study reported on the outcome of conservative management(n = 3); 27 reported on the outcome of surgical management(n = 917). Nine studies reported on Open Reduction Internal Fixation(ORIF)(n = 193), 11 on Arthroscopic-Assisted Reduction Internal Fixation(ARIF)(n = 253) and 7 on Frame-Assisted Fixation(FRAME)(n = 262). All studies recorded "return to sport"rates. Only one study recorded a "return to sport" time. The return rate to sport for the total cohort was 70%. For the conservatively-managed fractures, the return rate was 100%. For the surgically-managed fractures, the return rate was 70%. For fractures managed with ORIF, the return rate was 60%. For fractures managed with ARIF, the return rate was 83%. For fractures managed with FRAME was 52%. The return rate for ARIF was found to be significantly greater than that for ORIF(OR 3.22, 95%CI: 2.09-4.97, P < 0.001) and for FRAME(OR 4.33, 95%CI: 2.89-6.50, P < 0.001). No difference was found between the return rates for ORIF and FRAME(OR 1.35, 95%CI: 0.92-1.96, P = 0.122). The recorded return time was 6.9 mo(median), from a study reporting on ORIF.CONCLUSION Return rates to sport for tibial plateau fractures remain limited compared to other fractures. ARIF provides the best return rates. There is limited data regarding return times to sport. Further research is required to determine return times to sport, and to improve return rates to sport, through treatment and rehabilitation optimisation.
基金supported by the Special Fund for Agroscientific Research in the Public Interest of China(201503122)the National Natural Science Foundation of China(31571622)。
文摘Straw return is an effective way to improve crop grain yield and potassium(K)use efficiency by increasing soil K content.However,the effects of straw return on soil K supplying capacity,replacement of K fertilizer,and K-use efficiency under maize(Zea mays L.)–rice(Oryza sativa L.)cropping systems are little studied.A two-year field experiment was conducted to determine the physiological determinants of K-use efficiency under straw return with four K fertilization rates.Sr33(straw returned plus 33%of K fertilizer applied)and Sr67(straw returned plus 67%of K fertilizer applied)increased annual crop yields by 1.5%and 3.2%and increased agronomic K-use efficiency by respectively 2.9 and 1.3-fold on average in the two years,compared with the conventional practice S0K100(no straw returned plus normal amounts of K fertilizer applied).The Sr33 and Sr67 treatments resulted in significantly greater equilibrium K concentration ratios(CR0 K)and specifically exchangeable K(KX)values according to quantity/intensity(Q/I)relationship analyses,indicating improvement of the potential soil K supply capacity.However,the Sr67 better maintained the soil exchangeable K level and K balance.The results suggested that K released from maize and rice straw can replace about half of chemical K fertilizer,depending on the available K content in maize–rice cropping system production.
基金supported by the National Natural Science Foundation of China(32071968)the Jiangsu Agricultural Science and Technology Innovation Fund,China(CX(22)2015))the Jiangsu Collaborative Innovation Center for Modern Crop Production,China。
文摘Straw return is a promising strategy for managing soil organic carbon(SOC)and improving yield stability.However,the optimal straw return strategy for sustainable crop production in the wheat(Triticum aestivum L.)-cotton(Gossypium hirsutum L.)cropping system remains uncertain.The objective of this study was to quantify the long-term(10 years)impact of carbon(C)input on SOC sequestration,soil aggregation and crop yields in a wheat-cotton cropping system in the Yangtze River Valley,China.Five treatments were arranged with a single-factor randomized design as follows:no straw return(Control),return of wheat straw only(Wt),return of cotton straw only(Ct),return of 50%wheat and 50%cotton straw(Wh-Ch)and return of 100%wheat and 100%cotton straw(Wt-Ct).In comparison to the Control,the SOC content increased by 8.4 to 20.2%under straw return.A significant linear positive correlation between SOC sequestration and C input(1.42-7.19 Mg ha^(−1)yr^(−1))(P<0.05)was detected.The percentages of aggregates of sizes>2 and 1-2 mm at the 0-20 cm soil depth were also significantly elevated under straw return,with the greatest increase of the aggregate stability in the Wt-Ct treatment(28.1%).The average wheat yields increased by 12.4-36.0%and cotton yields increased by 29.4-73.7%,and significantly linear positive correlations were also detected between C input and the yields of wheat and cotton.The average sustainable yield index(SYI)reached a maximum value of 0.69 when the C input was 7.08 Mg ha^(−1)yr^(−1),which was close to the maximum value(SYI of 0.69,C input of 7.19 Mg ha^(−1)yr^(-1))in the Wt-Ct treatment.Overall,the return of both wheat and cotton straw was the best strategy for improving SOC sequestration,soil aggregation,yields and their sustainability in the wheat-cotton rotation system.
基金Financial supports for this project, provided by the key program supported by the National Natural Science Foundation of China(No. 51134005)the Doctoral Scientific Fund Project of the Ministry of Education of China (No. 20120023120004), are gratefully acknowledged
文摘With the increase of mining depth, more and deeper coal mines are limited by heat disaster. The cooling energy in deep mine cooling system comes from mine water inrush or ground cooling tower, but we cannot adopt the two methods because mine water inrush in many old coal mines in China is limited. What is more, the cooling pipelines cannot be put in narrow pit-shaft. To settle the problem above, according to the characteristics of Zhangxiaolou Coal Mine, this paper adopts the deep mine return air as the cooling energy for deep mine cooling system. In addition, we carried out cite test to extract cold energy from return air. Through monitoring the water quantity, water temperature of cooling system and air temperature, we got the thermodynamic equilibrium parameters during the cooling energy acquisition analysis and the effect of cooling system that the temperature and humidity on working face are respectively reduced to 8-12 ℃ and 8-15% through cooling. This research offers experimental reference for deep mine cooling which lacks cooling energy.
文摘BACKGROUND Scaphoid fracture is the most commonly fractured carpal bone in the athletic patient,accounting for over 85%of all sport-related carpal bone fractures,and is particularly common in sports involving high impact injuries to the wrist.The management of such injuries comprises both conservative and surgical techniques,as guided by fracture location and type.Athletes demonstrate a unique challenge with regards to the management of scaphoid fractures due to their requirement to return to sport,as soon as able.AIM To review systemically all studies recording return to sport following scaphoid fractures,to collate information on return rates to sport(RRS)and mean return times(RTS)to sport and to determine differences in sporting outcome for the various treatment methods.METHODS A systematic search of MEDLINE,EMBASE,CINAHAL,Cochrane,Google Scholar,Physiotherapy Evidence Database,SPORTDiscus,Web of Science and Scopus was performed in August 2018 using the keywords"scaphoid","fracture","acute","carpal","athletes","sports","non-operative","conservative","operative"and"return to sport".All studies that recorded RRS and RTS following scaphoid fractures were included.RTS was recorded as the length of time from commencement of either primary conservative management or primary surgical procedure to return to sport.RESULTS Eleven studies were included:Two randomised controlled trials,six retrospective cohort studies and three case series.Seven studies reported on conservative management(n=77),and eight studies reported on surgical management(n=83).For conservative management,RRS was 90%(69/77),and the mean RTS was9.6 wk.Three studies allowed to return to sport in cast[RRS 89%(25/28);RTS 1.9 wk],and four studies required completion of cast treatment prior to returning to sport[RRS 90%(44/49);RTS 13.9 wk].Four studies recorded fracture union data:Union rate 85%(47/55);mean time to union 14.0 wk.For surgical management,RRS was 98%(81/83),and RTS was 7.3 wk.Three studies reported on Percutaneous Screw Fixation[RRS 97%(32/33);RTS 6.5 wk],and five studies reported on Open Reduction Internal Fixation[RRS 98%(49/50);RTS 7.9 wk].Six studies recorded fracture union data:Union rate 97%(69/71);mean time to union9.8 wk.On meta-analysis,RRS(RR=1.09;95%confidence interval(CI):1.00-1.18;P<0.045),RTS(MD 2.3 wk;95%CI:0.79-3.87;P<0.002),union rates(RR=1.14;95%CI:1.01-1.28;P<0.030)and mean times to union(MD 4.2 wk;95%CI:3.94-4.36;P<0.001)were all significantly better for the surgical cohort compared to the conservative cohort.CONCLUSION Surgical management of scaphoid fractures can provide significantly improved RRS and RTS to sport compared to conservative management.Both treatments,however,remain acceptable options,and athletes should be fully informed of the benefits and risks of both prior to deciding treatment plans.Immediate return to sport in a cast should be avoided due to the significant risk of non-union.
文摘Background: Magnetic resonance image-guided radiation therapy (MR-IGRT) promises more precise and effective radiation treatments compared to conventional IGRT by using real-time on-board MR imaging. Under the influence of a magnetic field, however, secondary electrons exiting a surface can be forced in a circular path and re-enter the medium, resulting in dose increase at a beam-exit surface, called the electron return effect (ERE). The purpose of the study is to compare the exit skin dose computed by Monte Carlo dose calculation with measurements using an adult anthropomorphic phantom and to measure the effect of skin dose reduction by adding 1 cm-thick bolus. Method: The plan was compared with measurements using an adult anthropomorphic phantom combined with radiochromic films and thermoluminescent dosimeters. We also measured the skin dose reduction by adding 1 cm-thick bolus on the frontal surface of the phantom. Results: We found that 1 cm-thick bolus reduced the skin dose by up to 20% both in measurements and calculations. The plan was found to overestimate the measured skin dose by about 10% and there was no significant difference in the bolus effect between the breast skin and the skin (without breast attachment) doses. Conclusion: In conclusion, we confirmed the ERE effect on the anthropomorphic phantom under the magnetic field and the exit skin dose reduction by adding a bolus. Skin dose measurements using anthropomorphic phantom may be helpful to evaluate more realistic skin dose and the bolus effect in the magnetic field.
文摘Electric and magnetic fields in time and frequency domain due to return stroke-lateral corona (RS-LC) system and re- cently discovered red sprites have been calculated. It has been found that the electric and magnetic fields due to return stroke and lateral corona system radiate in the very low frequency (VLF) region while due to sprites radiate in the ex- tremely low frequency (ELF) range. A comparison has been made between the radiations emitted due to RS-LC system and sprites in ELF (0 - 200 Hz) region. It has been found that the electric field i.e. radiation power generated due to sprites dominates in the ELF range and thus it is concluded that the red sprites as compared to the RS-LC system are the prominent source for the excitation of Schumann resonances in the earth-ionosphere waveguide.
文摘An ADS （automated dispensing system） was implemented in our hospital pharmacy in 2008 to optimize and secure the medication process. The main objective of this study was to compare the projected and the real ROI （return on investment）, after seven years of use. ROI was calculated annually （from 2008 to 2015）, by deducting the cost of investment （ADS buying and implementation, maintenance, repairs and ADS upgrade） from the cost saving （drugs stock reduction and decrease of pharmacy staff dedicated to global dispensing）. In 2015, total costs saving （＋$1,141,987） were divided between decreasing drug stock value and reduction of pharmacy staff. Total costs of investment （-$978,656） were acquisition, maintenance, repairs and an unplanned upgrade costs. Finally, the real ROI was ＋$163,331 after seven years of use. In 2008, projected ROI was ＋$410,786. The real payback period has been increased by approximately two years （six years of use, instead of four years as expected）. Despite their cost, ADSs are a worthwhile investment, leading to a ROI within a few years. These economic considerations should be put into perspective with optimization of drugs stock management, greater efficiency of the global dispensing process, securitization of medication process and redeployment of pharmacy staff.
基金Supported by the Chongqing Medical University Program for Youth Innovation in Future Medicine,No.W0019Chongqing Municipal Education Commission’s 14th Five-Year Key Discipline Support Project,No.20240101 and No.20240102。
文摘BACKGROUND Return to work(RTW)serves as an indication for young and middle-aged colorectal cancer(CRC)survivors to resume their normal social lives.However,these survivors encounter significant challenges during their RTW process.Hence,scientific research is necessary to explore the barriers and facilitating factors of returning to work for young and middle-aged CRC survivors.AIM To examine the current RTW status among young and middle-aged CRC survivors and to analyze the impact of RTW self-efficacy(RTW-SE),fear of progression(FoP),eHealth literacy(eHL),family resilience(FR),and financial toxicity(FT)on their RTW outcomes.METHODS A cross-sectional investigation was adopted in this study.From September 2022 to February 2023,a total of 209 participants were recruited through a convenience sampling method from the gastrointestinal surgery department of a class A tertiary hospital in Chongqing.The investigation utilized a general information questionnaire alongside scales assessing RTW-SE,FoP,eHL,FR,and FT.To analyze the factors that influence RTW outcomes among young and middle-aged CRC survivors,Cox regression modeling and Kaplan-Meier survival analysis were used.RESULTS A total of 43.54%of the participants successfully returned to work,with an average RTW time of 100 days.Cox regression univariate analysis revealed that RTW-SE,FoP,eHL,FR,and FT were significantly different between the non-RTW and RTW groups(P<0.05).Furthermore,Cox regression multivariate analysis identified per capita family monthly income,job type,RTW-SE,and FR as independent influencing factors for RTW(P<0.05).CONCLUSION The RTW rate requires further improvement.Elevated levels of RTW-SE and FR were found to significantly increase RTW among young and middle-aged CRC survivors.Health professionals should focus on modifiable factors,such as RTW-SE and FR,to design targeted RTW support programs,thereby facilitating their timely reintegration into mainstream society.
文摘We report a very rare case of successful intracardiac correction in a patient with heterotaxy syndrome.The cardiac malformations included dextrocardia,double outlet right ventricle,pulmonary stenosis,interrupted inferior vena cava,hemiazygos continuation and total anomalous pulmonary venous return.One-stage correction was performed.The atrial procedure consisted of intra-and extraatrial rerouting of the anomalous systemic and pulmonary venous return.The hepatic veins were detached and diverted to the left atrium via an extracardiac conduit.The correction of the double outlet right ventricle was accomplished by intraventricular redirection of the blood flow from the left ventricle to the aorta.The right ventricular outflow was ultimately remodeled using a valved conduit.For better perception of the complex morphology,a three-dimensional model was designed,using CT scan images.This proved to be very useful for surgical planning,especially with regard to the intraatrial reconstruction of the systemic and pulmonary venous rerouting.
文摘BACKGROUND Many patients prioritize the ability to return to work(RTW)after shoulder replacement surgeries such as total shoulder arthroplasty(TSA),reverse TSA(rTSA),and shoulder hemiarthroplasty(HA).Due to satisfactory clinical and functional long-term outcomes,the number of shoulder replacements performed will continue to rise into this next decade.With younger individuals who compose a significant amount of the workforce receiving shoulder replacements,patients will begin to place a higher priority on their ability to RTW following shoulder arthroplasty.AIM To summarize RTW outcomes following TSA,rTSA,and HA,and analyze the effects of workers’compensation status on RTW rates and ability.METHODS This systematic review and analysis was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.A literature search regarding RTW following shoulder arthroplasty was performed using four databases(PubMed,Scopus,Embase,and Cochrane Library),and the Reference Citation Analysis(https://www.referencecitationanalysis.com/).All studies in English relevant to shoulder arthroplasty and RTW through January 2021 that had a level of evidence I to IV were included.Nonclinical studies,literature reviews,case reports,and those not reporting on RTW after shoulder arthroplasty were excluded.RESULTS The majority of patients undergoing TSA,rTSA,or HA were able to RTW betweenone to four months,depending on work demand stratification.While sedentary or light demand jobs generally have higher rates of RTW,moderate or heavy demand jobs tend to have poorer rates of return.The rates of RTW following TSA(71%-93%)were consistently higher than those reported for HA(69%-82%)and rTSA(56%-65%).Furthermore,workers’compensation status negatively influenced clinical outcomes following shoulder arthroplasty.Through a pooled means analysis,we proposed guidelines for the average time to RTW after TSA,rTSA,and HA.For TSA,rTSA,and HA,the average time to RTW regardless of work demand stratification was 1.93±3.74 mo,2.3±2.4 mo,and 2.29±3.66 mo,respectively.CONCLUSION The majority of patients are able to RTW following shoulder arthroplasty.Understanding outcomes for rates of RTW following shoulder arthroplasty would assist in managing expectations in clinical practice.
文摘BACKGROUND Evidence-based guidance on return to sport following toe phalanx fractures is limited.AIM To systemically review all studies recording return to sport following toe phalanx fractures(both acute fractures and stress fractures),and to collate information on return rates to sport(RRS)and mean return times(RTS)to the sport.METHODS A systematic search of PubMed,MEDLINE,EMBASE,CINAHL,Cochrane Library,Physiotherapy Evidence Database,and Google Scholar was performed in December 2022 using the keywords‘Toe’,‘Phalanx’,‘Fracture’,‘injury’,‘athletes’,‘sports’,‘non-operative’,‘conservative’,‘operative’,‘return to sport’.All studies which recorded RRS and RTS following toe phalanx fractures were included.RESULTS Thirteen studies were included:one retrospective cohort study and twelve case series.Seven studies reported on acute fractures.Six studies reported on stress fractures.For the acute fractures(n=156),63 were treated with primary conservative management(PCM),6 with primary surgical management(PSM)(all displaced intra-articular(physeal)fractures of the great toe base of the proximal phalanx),1 with secondary surgical management(SSM)and 87 did not specify treatment modality.For the stress fractures(n=26),23 were treated with PCM,3 with PSM,and 6 with SSM.For acute fractures,RRS with PCM ranged from 0 to 100%,and RTS with PCM ranged from 1.2 to 24 wk.For acute fractures,RRS with PSM were all 100%,and RTS with PSM ranged from 12 to 24 wk.One case of an undisplaced intra-articular(physeal)fracture treated conservatively required conversion to SSM on refracture with a return to sport.For stress fractures,RRS with PCM ranged from 0%to 100%,and RTS with PCM ranged from 5 to 10 wk.For stress fractures,RRS with PSM were all 100%,and RTS with surgical management ranged from 10 to 16 wk.Six cases of conservatively-managed stress fractures required conversion to SSM.Two of these cases were associated with a prolonged delay to diagnosis(1 year,2 years)and four cases with an underlying deformity[hallux valgus(n=3),claw toe(n=1)].All six cases returned to the sport after SSM.CONCLUSION The majority of sport-related toe phalanx fractures(acute and stress)are managed conservatively with overall satisfactory RRS and RTS.For acute fractures,surgical management is indicated for displaced,intra-articular(physeal)fractures,which offers satisfactory RRS and RTS.For stress fractures,surgical management is indicated for cases with delayed diagnosis and established nonunion at presentation,or with significant underlying deformity:both can expect satisfactory RRS and RTS.
文摘BACKGROUND Lateral ankle sprains are the most common traumatic musculoskeletal injuries of the lower extremity,with an incidence rate of 15%-20%.The high incidence and prevalence highlights the economic impact of this injury.Ankle sprains lead to a high socioeconomic burden due to the combination of the high injury incidence and high medical expenses.Up to 40%of patients who suffer from an ankle sprain develop chronic ankle instability.Chronic instability can lead to prolonged periods of pain,immobility and injury recurrence.Identification of factors that influence return to work(RTW)and return to sports(RTS)after a lateral ankle sprain(LAS)may help seriously reduce healthcare costs.AIM To explore which factors may potentially affect RTW and RTS after sustaining an LAS.METHODS EMBASE and PubMed were systematically searched for relevant studies published until June 2023.Inclusion criteria were as follows:(1)Injury including LAS or chronic ankle instability;(2)Described any form of treatment;(3)Assessment of RTW or RTS;(4)Studies published in English;and(5)Study designs including randomized controlled clinical trials,clinical trials or cohort studies.Exclusion criteria were:(1)Studies involving children(age<16 year);or(2)Patients with concomitant ankle injury besides lateral ankle ligament damage.A quality assessment was performed for each of the included studies using established risk of bias tools.Additionally quality of evidence was assessed using the GRADEpro tool in cases where outcomes were included in the quantitative analysis.A best evidence synthesis was performed in cases of qualitative outcome analysis.For all studied outcomes suitable for quantitative analysis a forest plot was created to calculate the effect on RTW and RTS.RESULTS A total of 8904 patients were included in 21 studies,10 randomized controlled trials,7 retrospective cohort studies and 4 prospective cohort studies.Fifteen studies were eligible for meta-analysis.The overall RTS rate ranged were 80%and 83%in the all treatments pool and surgical treatments pool,respectively.The pooled mean days to RTS ranged from 23-93 d.The overall RTW rate was 89%.The pooled mean time to RTW ranged from 5.8-8.1 d.For patients with chronic ankle instability,higher preoperative motivation was the sole factor significantly and independently(P=0.001)associated with the rate of and time to RTS following ligament repair or reconstruction.Higher body mass index was identified as a significant factor(P=0.04)linked to not resuming sports or returning at a lower level(median 24,range 20-37),compared to those who resumed at the same or higher level(median 23,range 17-38).Patients with a history of psychological illness or brain injury,experienced a delay in their rehabilitation process for sprains with fractures and unspecified sprains.The extent of the delayed rehabilitation was directly proportional to the increased likelihood of experiencing a recurrence of the ankle sprain and the number of ankle-related medical visits.We also observed that 10%of athletes who did return to sport after lateral ankle sprain without fractures described non-ankle-related reasons for not returning.CONCLUSION All treatments yielded comparable results,with each treatment potentially offering unique advantages or benefits.Preoperative motivation may influence rehabilitation after LAS.Grading which factor had a greater impact was not possible due to the lack of comparability among the included patients.
文摘The Economic Production Quantity (EPQ) model is commonly used by practitioners in the fields of production and inventory management to assist them in making decision on production lot size. The common assumptions in this model are that all units produced are perfect and shortages are not allowed. But, in real situation the defective items will be produced in each cycle of production and shortages and scrap are possible. These assumptions will underestimate the actual required quantity. Hence, the defective items can not be ignored in the production process. Rework process is necessary to convert those defective into finished goods. This study proposes EPQ model that incorporates both imperfect production quality and falsely not screening out a proportion of defects, thereby passing them on to customers, resulting in defect sales returns. To active this objective a suitable mathematical model is developed and the optimal production lot size which minimizes the total cost is derived. An illustrative example is provided and numerically verified. The validation of result in this model was coded in Microsoft Visual Basic 6.0.
