Search Results (104,667)

Background: No consensus has been reached regarding the efficacy of indirect decompression through oblique lumbar interbody fusion (OLIF) in severe lumbar spinal stenosis (LSS). This study investigated the impact of preoperative magnetic resonance imaging (MRI)-based grading of central and foraminal stenosis on OLIF outcomes in LSS patients and identified risk factors for postoperative clinical dissatisfaction. Methods: We retrospectively reviewed LSS patients who underwent OLIF with a minimum 1-year follow-up. Clinical scores obtained preoperatively and at 3, 6, 12, and 24 months postoperatively were analyzed using the substantial clinical benefit (SCB) framework. The severity of central and foraminal stenosis in the initial MRI was assessed through qualitative grading systems. Results: Among the 145 patients, with a mean follow-up of 33.7 months, those with severe central stenosis showed a significantly higher proportion of patients achieving SCB in the visual analog scale for leg pain (94.5% versus 83.1%; p = 0.044) at one year postoperatively than those without. However, those with severe foraminal stenosis showed significantly higher Oswestry Disability Index (ODI) scores (p = 0.024), and lower walking ability scores in the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) (p = 0.004) at one year postoperatively than those without. The presence of a foraminal osteophyte of the superior articular process (SAP) was a significant risk factor responsible for not achieving SCB in ODI and walking ability in JOABPEQ at one year postoperatively (odds ratio: 0.20 and 0.22, respectively). Conclusions: After OLIF, patients with severe central stenosis showed clinical outcomes comparable to those without. The improvement in ODI and walking ability in JOABPEQ was limited in patients with severe foraminal stenosis. Surgeons should consider direct decompression in cases with the presence of foraminal osteophytes of SAP. Full article

Background/Objectives: Uvulopalatopharyngoplasty (UPPP) is a prevalent surgical procedure for treating obstructive sleep apnea. Effective postoperative pain management is crucial for patient comfort and recovery. This study aimed to compare the analgesic efficacies of parecoxib and ketorolac in patients undergoing UPPP. Methods: A prospective, randomized, double-blind study was conducted on 83 patients who received either parecoxib (40 mg intravenously every 12 h) or ketorolac (30 mg intravenously every 8 h) for 2 days following UPPP. Postoperative pain and swallowing discomfort were assessed using visual analog scales (VASs) at 4, 24, 48, and 72 h. The time to resume eating and adverse reactions were also recorded. Results: At 24 and 48 h postoperatively, the mean VAS score was significantly higher in the ketorolac group compared to the parecoxib group (5.0 ± 2.3 vs. 3.6 ± 2.2, p = 0.005 and 3.9 ± 2.2 vs. 2.5 ± 1.7, p < 0.001, respectively). However, no significant difference in the mean VAS scores was observed between the two groups at 72 h postoperatively. With regards to postoperative swallowing pain, the ketorolac group exhibited significantly higher mean VAS scores than the parecoxib group at 4, 24, 48, and 72 h postoperatively. Conclusions: Intravenous parecoxib may offer superior analgesic benefits in the early postoperative period, particularly in alleviating swallowing pain, compared to ketorolac in UPPP procedures. Full article

Aboveground biomass (AGB) serves as a crucial indicator of the carbon sequestration capacity of coastal wetland ecosystems. Conducting extensive field surveys in coastal wetlands is both time-consuming and labor-intensive. Unmanned aerial vehicles (UAVs) and satellite remote sensing have been widely utilized to estimate regional AGB. However, the mixed pixel effects in satellite remote sensing hinder the precise estimation of AGB, while high-spatial resolution UAVs face challenges in estimating large-scale AGB. To fill this gap, this study proposed an integrated approach for estimating AGB using field sampling, a UAV, and Sentinel-2 satellite data. Firstly, based on multispectral data from the UAV, vegetation indices were computed and matched with field sampling data to develop the Field–UAV AGB estimation model, yielding AGB results at the UAV scale (1 m). Subsequently, these results were upscaled to the Sentinel-2 satellite scale (10 m). Vegetation indices from Sentinel-2 data were calculated and matched to establish the UAV–Satellite AGB model, enabling the estimation of AGB over large regional areas. Our findings revealed the AGB estimation model achieved an R² value of 0.58 at the UAV scale and 0.74 at the satellite scale, significantly outperforming direct modeling from field data to satellite (R² = −0.04). The AGB densities of the wetlands in Xieqian Bay, Meishan Bay, and Hangzhou Bay, Zhejiang Province, were 1440.27 g/m², 1508.65 g/m², and 1545.11 g/m², respectively. The total AGB quantities were estimated to be 30,526.08 t, 34,219.97 t, and 296,382.91 t, respectively. This study underscores the potential of integrating UAV and satellite remote sensing for accurately assessing AGB in large coastal wetland regions, providing valuable support for the conservation and management of coastal wetland ecosystems. Full article

Chronic wounds impose a substantial economic burden on healthcare systems and result in decreased productivity. Honey possesses diverse properties, rendering it a promising, cost-effective, and efficacious intervention strategy for the management of chronic wounds. However, the findings are controversial. We have presented an updated and comprehensive systematic review and meta-analysis to evaluate the efficacy and safety of honey dressings in the management of chronic wounds. Nine electronic databases were systematically searched to identify relevant studies published prior to 22 March 2024. A total of eight studies, including 906 individuals that met the inclusion criteria, were incorporated. The findings demonstrated a significant acceleration in wound healing time with honey dressings (MD = −17.13, 95% CI −26.37 to −7.89, p = 0.0003) and an increase in the percentage of wound healing (MD = 18.31, 95% CI 8.86 to 27.76, p = 0.0001). No statistically significant differences were observed in the healing rate (RR = 2.00, 95% CI 0.78 to 5.10, p = 0.15), clearance time of bacteria (MD = −11.36, 95% CI: −25.91 to 3.18, p = 0.13) and hospital stay duration. Honey may decrease the VAS score but may increase the incidence of painful discomfort during treatment. The topical application of honey is an effective therapeutic approach for managing chronic wounds, but the quality of the evidence was very low due to the quality of risk of bias, inconsistency, and publication bias, highlighting the necessity for larger-scale studies with adequately powered RCTs to ensure the safety and efficacy of honey dressings in chronic wound healing. Full article

External human–machine interfaces (eHMIs) may be useful for communicating the intention of an autonomous vehicle (AV) to road users, but it is questionable whether an eHMI is effective in guiding the actual behavior of road users, as intended by the eHMI. To address this question, we developed a Unity game in which the player drove a conventional car and the AVs were operating with eHMIs. We examined the effects of different eHMI designs—namely, textual, graphical, and anthropomorphic—on the driving behavior of a player in a gaming environment, and compared it to one with no eHMI. Participants (N = 18) had to follow a specified route, using the typical keys for PC games. They encountered AVs with an eHMI placed on the rear window. Five scenarios were simulated for the specified routes: school safety zone; traffic island; yellow traffic light; waiting for passengers; and an approaching e-scooter. All scenarios were repeated three times (a total of 15 sessions per participant), and the eHMI was randomly generated among the four options. The behavior was determined by observing the number of violations in combination with keystrokes, fixations, and saccades. Their subjective evaluations of the helpfulness of the eHMI and their feelings about future AVs revealed their attitudes. Results showed that a total of 45 violations occurred, the most frequent one being exceeding the speed limit in the school safety zones (37.8%) when the eHMI was textual, anthropomorphic, graphical, and when there was no eHMI, in decreasing order; the next was collisions (33.3%), when the eHMI was anthropomorphic, none, or graphical. The rest were ignoring the red light (13.3%), crossing the stop line (13.3%), and violation of the central line (2.2%). More violations occurred when the eHMI was set to anthropomorphic, followed by no eHMI, graphical, and textual eHMI. The helpfulness of the five scenarios scored high (5.611 to 6.389) on a seven-point Likert scale, and there was no significant difference for the scenarios. Participants felt more positive about the future of AVs after their gaming experience (p = 0.049). We conclude that gazing at unfamiliar and ambiguous information on eHMIs may cause a loss of driver attention and control. We propose an adaptive approach in terms of timing and distance depending on the behavior of other road users. Full article

The digital documentation and analysis of cultural heritage increasingly rely on high-precision three-dimensional point cloud data, which often suffers from missing regions due to limitations in acquisition conditions, hindering subsequent analyses and applications. Point cloud completion techniques, by predicting and filling these missing regions, are vital for restoring the integrity of cultural heritage structures, enhancing restoration accuracy and efficiency. In this paper, for challenges in processing large-scale cultural heritage point clouds, particularly the slow processing speed and visualization impairments from uneven point density during completion, we propose a point cloud completion employing centroid-based voxel feature extraction, which significantly accelerates feature extraction for massive point clouds. Coupled with an efficient upsampling module, it achieves a uniform point distribution. Experimental results show that the proposed method matches SOTA performance in completion accuracy while surpassing in point density uniformity, demonstrating capability in handling larger-scale point cloud data, and accelerating the processing of voluminous point clouds. In general, the proposed method markedly enhances the efficiency and quality of large-scale point cloud completion, holding significant value for the digital preservation and restoration of cultural heritage. Full article

Short-term climate fluctuations can have a significant impact on the stability of food resource prices, thus threatening food security, even in cases where the crop production system shows good adaptation to climate change and/or increasing average yields over time. This paper illustrates, in detail, a statistical approach aimed at verifying whether the variation of the crop production system vulnerability to climate fluctuation exhibits a trend over time. These methods were applied to the case study of wheat grown in the Abruzzo region (Italy). The results show that, although the wheat crop yield still shows ongoing growth, the correlation between climate fluctuations and yield oscillations exhibits a systematic increase over the past sixty years. Such an increase in climate-related production fluctuations may represent a disturbing element for market equilibria and be potentially harmful for the various economic subjects involved at various scales, such as producers, distributors, investors/financial traders, and final consumers. The statistical approach illustrated provides a framework for monitoring climate impacts and also provides the basis for building up statistical forecasting models to support informed decision making in agricultural management and financial planning. Full article

Despite their significant impact, comprehensive screenings and detailed analyses of per- and polyfluoroalkyl substance (PFAS) binding strengths at the orthosteric and allosteric sites of NRs are currently lacking. This study addresses this gap by focusing on the binding interaction analysis of both common and uncommon PFAS with the nuclear receptors (NRs) vitamin D receptor (VDR), peroxisome proliferator-activated receptor gamma (PPARγ), pregnane X receptor (PXR), and estrogen receptor alpha (ERα). Advanced docking simulations were used to screen 9507 PFAS chemicals at the orthosteric and allosteric sites of PPARγ, PXR, VDR, and ERα. All receptors exhibited strong binding interactions at the orthosteric and allosteric site with a significant number of PFAS. We verified the accuracy of the docking protocol through multiple docking controls and validations. A mixture modeling analysis indicates that PFAS can bind in various combinations with themselves and endogenous ligands simultaneously, to disrupt the endocrine system and cause carcinogenic responses. These findings reveal that PFAS can interfere with nuclear receptor activity by displacing endogenous or native ligands by binding to the orthosteric and allosteric sites. The purpose of this study is to explore the mechanisms through which PFAS exert their endocrine-disrupting effects, potentially leading to more targeted therapeutic strategies. Importantly, this study is the first to explore the binding of PFAS at allosteric sites and to model PFAS mixtures at nuclear receptors. Given the high concentration and persistence of PFAS in humans, this study further emphasizes the urgent need for further research into the carcinogenic mechanisms of PFAS and the development of therapeutic strategies that target nuclear receptors. Full article

As a result of global efforts to combat the rise in global climate change and carbon dioxide emissions, there has been a substantial increase in renewable energy investment for both residential and utility power generation. Solar power facilities are estimated to be among the major contributors to global decarbonization in terms of capacity by 2050. Consequently, the majority of economically significant countries are progressively implementing utility-scale photovoltaic (U-PV) systems. Nevertheless, a major obstacle to the expansion of U-PV generation is the identification and assessment of direct current (DC) faults in the extensive array of PV panels. In order to address this obstacle, it is imperative to provide an evaluation method that can accurately and cost-effectively identify and locate potential DC faults in PV arrays. Therefore, many studies attempted to utilize thermal cameras, voltage and current sensors, power databases, and other detecting elements; however, some of these technologies provide extra hurdles in terms of the quantity and expense of the utilized hardware equipment. This work presents a sophisticated system that aims to diagnose and locate various types of PV faults, such as line-to-ground, line-to-line, inter-string, open-circuit, and partial shading events, within a PV array strings down to a module level. This study primarily depends on three crucial indicators: precise calculation of the PV array output power and current, optimal placement of a limited number of voltage sensors, and execution of specifically specified tests. The estimation of PV array power, along with selectively placed voltage sensors, minimizes the time and equipment required for fault detection and diagnosis. The feasibility of the proposed method is investigated with real field data and the PSCAD simulation platform during all possible weather conditions and array faults. The results demonstrate that the proposed approach can accurately diagnose and localize faults with only N_S/2 voltage sensors, where N_S is the number of PV array parallel strings. Full article

The direct enzymatic conversion of untreated waste shrimp and crab shells has been a key problem that plagues the large-scale utilization of chitin biological resources. The microorganisms in soil samples were enriched in two stages with powdered chitin (CP) and shrimp shell powder (SSP) as substrates. The enrichment microbiota XHQ10 with SSP degradation ability was obtained. The activities of chitinase and lytic polysaccharide monooxygenase of XHQ10 were 1.46 and 54.62 U/mL. Metagenomic analysis showed that Chitinolyticbacter meiyuanensis, Chitiniphilus shinanonensis, and Chitinimonas koreensis, with excellent chitin degradation performance, were highly enriched in XHQ10. Chitin oligosaccharides (CHOSs) are produced by XHQ10 through enzyme induction and two-stage temperature control technology, which contains CHOSs with a degree of polymerization (DP) more significant than ten and has excellent antioxidant activity. This work is the first study on the direct enzymatic preparation of CHOSs from SSP using enrichment microbiota, which provides a new path for the large-scale utilization of chitin bioresources. Full article

Soft condensed matter is challenging to study due to the vast time and length scales that are necessary to accurately represent complex systems and capture their underlying physics. Multiscale simulations are necessary to study processes that have disparate time and/or length scales, which abound throughout biology and other complex systems. Herein we present ezAlign, an open-source software for converting coarse-grained molecular dynamics structures to atomistic representation, allowing multiscale modeling of biomolecular systems. The ezAlign v1.1 software package is publicly available for download at github.com/LLNL/ezAlign. Its underlying methodology is based on a simple alignment of an atomistic template molecule, followed by position-restraint energy minimization, which forces the atomistic molecule to adopt a conformation consistent with the coarse-grained molecule. The molecules are then combined, solvated, minimized, and equilibrated with position restraints. Validation of the process was conducted on a pure POPC membrane and compared with other popular methods to construct atomistic membranes. Additional examples, including surfactant self-assembly, membrane proteins, and more complex bacterial and human plasma membrane models, are also presented. By providing these examples, parameter files, code, and an easy-to-follow recipe to add new molecules, this work will aid future multiscale modeling efforts. Full article

Species energy theory suggests that, because of limitations on reproduction efficiency, a minimum density of plant individuals per viable species exists and that this minimum correlates the total number of plant individuals N with the number of species S. The simplest assumption is that the mean energy input per individual plant is independent of the number of individuals, making N, and thus S as well, proportional to the total energy input into the system. The primary energy input to a plant-dominated ecosystem is estimated as its Net Primary Productivity (NPP). Thus, species energy theory draws a direct correspondence from NPP to S. Although investigations have verified a strong connection between S and NPP, strong influences of other factors, such as topography, ecological processes such as competition, and historical contingencies, are also at play. The lack of a simple model of NPP expressed in terms of the principal climate variables, precipitation P, and potential evapotranspiration, PET, introduces unnecessary uncertainty to the understanding of species richness across scales. Recent research combines percolation theory with the principle of ecological optimality to derive an expression for NPP(P, PET). Consistent with assuming S is proportional to NPP, we show here that the new expression for NPP(P, PET) predicts the number of plant species S in an ecosystem as a function of P and PET. As already demonstrated elsewhere, the results are consistent with some additional variation due to non-climatic inputs. We suggest that it may be easier to infer specific deviations from species energy predictions with increased accuracy and generality of the prediction of NPP(P, PET). Full article

A transition to clean fuels and technology for cooking is increasingly recognised as a cornerstone of sustainable development. However, sufficient, appropriate, affordable finance to support the transition is lacking. Grounded in primary data collection via expert interviews, this study’s research objective was to critically assess development finance institutions’ (DFIs) delivery of climate and development finance to address cooking poverty. Interview findings underscore DFIs’ important role in the transition, including to create the ecosystem conditions conducive to sustained investment. However, as a group they are not demonstrating the risk appetite and financial solutions that clean cooking markets need. Nor are they operating with the agility and flexibility required for rapid scale-up. Consequently, DFIs are not optimally fulfilling their mandates to create additionality and mobilise private capital in these markets. Interviewees call for DFIs to reconsider their approach, and we rely on these findings to posit a theory of change for clean cooking finance. Full article

In this paper, we present a vision-based leader–follower strategy for formation control of multiple quadrotors. The leaders use a decoupled visual control scheme based on invariant features. The followers use a control scheme based only on bearing measurements, and a robust control is introduced to deal with perturbations generated by the unknown movement of the leaders. Using this formulation, we study a geometrical pattern formation that can use the distance between the leaders to scale the formation and cross constrained spaces, such as a window. A condition is defined for which a formation has rigidity properties considering the constrained field of view of the cameras, such that invariance to translation and scaling is achieved. This condition allows us to specify a desired formation where the followers do not need to share information between them. Results obtained in a dynamic simulator and real experiments show the effectiveness of the approach. Full article

A global gravity field model (GGM) is essential to be validated with ground-based or airborne observational data for the accurate application of the GGM at a regional scale. Furthermore, accurately understanding the commission errors between the GGM and observational data are crucial for improving regional gravity fields. Taking the North China region as an example, to circumvent the omission errors, it is necessary to unify the spatial resolutions of the EIGEN-6C4 model and terrestrial gravity observational data to 110 km (determined by the distribution of gravity stations) by employing the spherical harmonic function for the EIGEN-6C4 model and the Slepian basis function for the gravity data, respectively. However, the application of spherical harmonic function expansions in the gravity model results in the Gibbs phenomenon, which may be a primary factor contributing to commission errors and impedes the accurate validation of the EIGEN-6C4 model with terrestrial gravity data. To effectively mitigate this issue, this study proposes a combination approach of window function filtering and regional eigenvalue constraint (based on the Slepian basis). Utilizing the EIGEN-6C4 gravity model to derive the gravity disturbance field at a resolution of 110 km (with spherical harmonic expansion up to the 180th degree and order), the combination approach effectively suppresses over 90% of high-degree (above the 120th degree) Gibbs phenomena. This approach also reduces signal leakage outside the region, thus enhancing the spatial accuracy of the regional gravity disturbance field. A subsequent comparison of the regional gravity disturbance field derived from the true model and terrestrial gravity data in North China indicates excellent consistency, with a root mean squared error (RMSE) of 0.80 mGal. This validation confirms that the combined approach of window function filtering and regional eigenvalue constraints effectively mitigates the Gibbs phenomenon and yields precise regional gravity fields. This approach is anticipated to significantly benefit scientific applications such as improving the accuracy of regional elevation benchmarks and accurately inverting the Earth’s internal structure. Full article