Objective: To explore the application effect of a bimodal collaborative nursing model in patients undergoing gastric cancer surgery with concurrent inguinal hernia repair. Methods: Sixty patients with gastric cancer and concurrent inguinal hernia who were admitted to our hospital between August 2019 and August 2021 were selected as the study subjects. Based on the different nursing approaches, all patients were divided into a control group and an observation group, with 30 patients in each group. The control group received conventional nursing care, while the observation group received the bimodal collaborative nursing model in addition to conventional care. The postoperative recovery, psychological status, and quality of life of the two groups of patients were compared. Results: The postoperative recovery of the observation group was superior to that of the control group, and the difference was statistically significant (P < 0.05). The anxiety and depression scores of the observation group were lower than those of the control group, with statistically significant differences (P < 0.05). The quality of life score of the observation group was higher than that of the control group, with statistically significant differences (P < 0.05). Conclusion: The application of a bimodal collaborative nursing model in gastric cancer surgery with concurrent inguinal hernia repair is effective. It not only promotes postoperative physical recovery and improves the psychological well-being of patients but also enhances their quality of life. It is worthy of clinical promotion and application.

Introduction: This study aims to characterize changes in biogenic amines patterns in glioblasto-ma patients undergoing surgery and concurrent chemoradiation to illustrate how this class of metabolites changes during different stages of standard care treatment protocol. Methods: We examined 138 plasma specimens (before surgery, 2 days after surgical resection, before starting concurrent chemoradiation, immediately after chemoradiation, and after adju-vant chemotherapy treatment) from 36 patients with isocitrate dehydrogenase (IDH) wildtype glioblastoma. Untargeted GC-TOF mass spectrometry-based metabolomics of biogenic amines was used given its superiority for identifying and quantitating small metabolites; this yielded 340 structurally identified metabolites. Results: Comparing post-surgery to pre-surgery showed increased level of 12 metabolites: Gly-codeoxycholic acid (P=7.79E-05), Betonicine (P=9.23E-05), Glycocholic acid (P=3.18E-03), 3-Cysteinylaectaminophen (P=4.95E-03), S-Methyl-3-thioacetaminophen (P=5.77E-03), Tau-rocholic acid (P=9.97E-03), N-glycine (P=0.0013), p-acetamidophenyl.beta.-D-glucuronide (P=0.0048), 2-Hydroxy-5-sulfopyridine-3-carboxylic acid (P=0.0074), Acetaminophen sulfate (P=0.0095), 2-Amino-3-methoxybenzoic acid (P=0.02), and Dehydrofelodipine (P=0.024). There were 11 compounds that were downregulated, which included Mannitol (P=1.96E-19), Sorbitol (P=2.75E-019), Linoleic acid (P=1.51E-10), 1-Methylnicotinamide (P=1.78E-09), Nudifloramide (P=2.81E-08), Hexadecanedioic acid (P=5.49E-05), 3-Hydroxybutyric acid (P=0.0002), Riluzole (0.0036), Bupivacaine (P=0.0041), Lactitol (P=0.008), and 1-hydroxymidazolam.beta.-D-glucuronide (P=0.0414). After chemoradiation, significant de-crease was uncovered in Famotidine (P=0.0074), N-Isovalerylglycine (P=0.012), and 3-Methylcrotonylglycine (P=0.0131). While significant increase was detected in N-Methylisoleucine (P=0.0011), 4-Methyl-5-thiazoleethanol (P=0.042), and 6-Hydroxycaproic acid (P=0.049). Ensemble learning models, specifically random forest (RF) and AdaBoost (AB), accurately classified treatment phases with high accuracy (RF: 0.81 ± 0.04, AB: 0.78 ± 0.05). One significant insight gleamed from these models were that the metabolites Sorbitol and N-methylisoleucine were identified as important predictive features and confirmed by SHAP analysis. Conclusion: To our knowledge, this is the first study to describe plasma biogenic amines signa-tures during different treatment phases in patients with glioblastoma. A larger study is needed to confirm the results and the potential application of this algorithm for classification of treatment responses.

Background: Craniofacial injuries are thought to be commonly associated with traumatic brain injury (TBI), but there is conflicting evidence in the literature. The objective of this retrospective cohort study is to evaluate the incidence of TBI in patients with craniofacial trauma. Methods: The study included 2982 consecutive patients with either solitary or concurrent diagnoses of TBI and facial fractures, seen and evaluated at a single level II trauma center between January 1, 2010 and December 31, 2020. Continuous variables were compared against whether the patient had one or both diagnoses.Results: Of the target population, 55.8% had a solitary diagnosis of TBI, 30.28% had a solitary diagnosis of facial fractures, and 13.92% had concurrent diagnoses of both TBI and facial fractures. Patients with concurrent diagnoses had a significantly longer mean length of stay (LOS) compared to those with solitary diagnoses (9.92 ± 16.33 days vs. 6.21 ± 10.96 days, p&lt;0.01), but age (p=0.68) and ICU LOS (p=0.09) did not differ significantly between the two groups. Conclusions: Trauma to the face should be given special attention due to the close relationship between facial bones and the brain. Patients with concurrent diagnoses of TBI and facial fractures had worse hospital outcomes than those with solitary diagnoses of either TBI or facial trauma.

Left atrial dysfunction is associated with exercise intolerance and poor prognosis in heart failure (HF). The effects of exercise training on atrial function in patients with HF with mid-range ejection fraction (HFmrEF) are unknown. The purpose of the present study was to assess the effects of a 12-weeks supervised concurrent, aerobic continuous plus resistance, exercise training (SCT) pro-gram on left atrial function of patients with HFmrEF. The study included 70 stable patients, who were randomly assigned into two groups: SCT with (three session/week) or a control (CON) group directed to follow contemporary exercise preventive guidelines at home. Before starting the training program and at 12-weeks, all patients performed: ergometric test, 6-minute walk test and echocardiography. At 12-weeks, exercise duration at ergometric test and distance walked at 6-minute walk test presented a significant greater increase in the SCT compared to control (be-tween-groups p 0.0001 and p 0.004 respectively). Peak atrial longitudinal strain and conduit strain presented an increase of 29% and 34% respectively in the SCT and were unchanged in the CON (between-groups p 0.008 and p 0.001 respectively). Peak atrial contraction strain increased of 21% in the SCT with no changes in the CON (between-groups p 0.002). Left ventricular global longi-tudinal strain increased significantly SCT compared to control (between-groups p 0.03). In con-clusions SCT improved left atrial and left ventricular function in HFmrEF

The effectiveness of combining strength-specific training with endurance training to enhance the performance of endurance runners remains uncertain. This study aimed to analyze effect of practising maximum-strength (MAX), explosive strength (EXP) or both combined (COMB) on seven runners’ performance-indicators: vertical jump (VJ), one-repetition-maximum-squat (1RM), peak-velocity/peak-running-speed (PV), lactate-threshold (over incremental-test-protocols, LT), middle-distance-time-trial (TT), maximum-oxygen-consumption (VO2max), running-economy (RE). Systematic-review (Scopus, Wed of Science, Sports Discuss, PubMed) with meta-analysis was conducted following PRISMA standards. Inclusion-criteria (PICOS) were: recreational or well-trained athletes aged 18-45 performing concurrent-training ≥five-week. Used search-terms were related to different types of strength/endurance, participants’ age, sport-modality. 20 manuscripts were selected, quality-assessed with PEDro. MAX training is more effective than EXP, COMB in improving VJ, 1RM, PV, while COMB is more effective than MAX, EXP to enhance TT. MAX is more effective than EXP in improving LT. Concurrent-workouts do not provide additional benefits to VO2max. It is unknown which strength-modality (MAX, EXP or COMB) is more effective in improving RE. Concurrent-training is more effective than single-mode-endurance-training for enhancing specific performance-variables in adult-endurance-runners. Middle-, long-distance-runners may consider incorporating MAX-training to target specific goals, e.g., improving VJ, 1RM, LT, PV while utilizing COMB-training to enhance TT. Certain variables may benefit from EXP. New randomized-controlled-trials are required to confirm these findings.

With the improvement in medical quality, cold mechanical rehabilitation equipment can no longer meet the psychological needs of the physically handicapped. Therefore, design for behaviour change should be viewed as a strategy for enabling lifestyle changes as soon as possible. Although how to use equipment to assist physically disabled people in hydrotherapy rehabilitation is the primary design goal, the psychological feelings of users are also one of the focuses of this study. Besides, coupled with the large-scale spread of the Coronavirus Disease (COVID-19) in the past two years. People's living habits are also forced to change, many activities that people are used to doing outdoors are being slowly completed at home. During the epidemic, it is very dangerous and inconvenient for users who need to go to institutional rehabilitation regularly. Hence, it is urgent to change past usage habits and places. In this study, a personal multi-functional hydrotherapy bucket is designed. In addition to not having to use a public spa with other people to reduce the risk of contracting the Coronavirus Disease, it can be easily placed at home by reducing its size. According to market research, it is known that the current domestic hydrotherapy buckets on the market usually only have a single function. The large medical hydrotherapy pools are not only rare in Taiwan, but this kind of equipment also takes up a lot of space. Various factors have resulted in a relatively low market share of hydrotherapy pools compared to other rehabilitation equipment. In order to take into account, the physical and psychological needs of the physically disabled, this research focus on the design of a multi-functional but small-sized hydrotherapy bucket. Taking the convenience of entering and leaving the bucket as the starting point to improve the shortcomings of the existing products, on the other hand, because most users are inconvenient to move, safety is also the focus of the design to reduce the occurrence of accidents and injuries. This study is based on the systematic design methodology of concurrent design to obtain product design results. Firstly, conduct market research and select products from different manufacturers for analysis and comparison. Through functional analysis and sorting out the problem points, the TRIZ theory and the morphological diagram method are used to find the solution to the problem. Finally, the best design scheme is obtained by the PUGH method. Besides, construct a 3D model to present the design concept that meets the design goals. The research results are hoped to be used as a reference for designing and developing related products, thereby increasing the home's multifunctional hydrotherapy buckets' market share.

Mindfulness interventions have been implemented in many countries. This study aimed to examine the psychometric properties of English and Thai-version of the 15-item mindfulness attention awareness scale (MAAS) across five samples. A descriptive correlation research was conducted in the Philippines and Thailand, and five data sets were generated using self-reported and online questionnaires. Exploratory factor analyses were used to explore the factorial structure of the MAAS. Confirmatory factor analyses were performed to test measurement invariance across samples. Concurrent validity was tested by examining relationships between the MAAS and psychological well-being (PWB). A unidimensional structure of the MAAS was documented across the five samples. The MAAS demonstrated measurement invariance across samples for both English and Thai versions. Concurrent validity was displayed through significant correlations with PWB. This study produced evidence to support the construct validity, concurrent validity, and reliability of the English and Thai versions of MAAS. This study was not registered.

Studying concurrent systems is to sort the read/write and control events in the concurrent system according to the order, or in partial order, or in strict order. Because of the concurrency of events and the timeliness of writing events, there will be overlap between events, which requires interval order analysis. A single start and end sequence to represent the entire hierarchical order structure as well as all equivalent spaced order observations.a single sequence of beginnings and endings to represent the entire stratified order structures as well as all equivalent interval order observations. Mazurkiewicz traces and Comtracks are hierarchical traces, but they cannot describe interval traces. In a few sentences of this summary, we can tell the problems (petri interval traces with data), the previous work (Mazurkiewicz traces, Comtracks), the reasons that cannot be solved, and our own solutions (DPN: Petri nets with data, interval traces). This paper focuses on a BE (Beginnings and Endings) sequence representing an equivalent class of runs, or targets. Our goal is to have a BE sequence to represent the entire hierarchical order structure, that is, all equivalent observable interval orders.

Currently, data regarding optimal treatment modality, response, and outcome specifically for N3 head and neck cancer are lacking. This study aimed to compare the treatment outcomes between definitive concurrent chemoradiotherapy (CCRT) to the neck and upfront neck dissection followed by adjuvant CCRT. 93 N3 squamous cell carcinoma head and neck cancer patients were included. Primary tumor treatment was divided to definitive CCRT (CCRT group) or curative surgery followed by adjuvant CCRT (surgery group). Neck treatment was also classified into two treatment modalities: definitive CCRT to the neck (CCRT group) or curative neck dissection followed by adjuvant CCRT (neck dissection group). Overall, the 2-year overall survival (OS), local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS), and distant metastasis-free survival (DMFS) were 51.8%, 47.3%, 45.6%, and 43.6%, respectively. In both oropharyngeal cancer and nonoropharyngeal cancer patients, in terms of OS, LRFS, RRFS or DMFS no difference was noted regarding primary tumor treatment (CCRT vs. surgery) or neck treatment (CCRT vs. neck dissection). In summary, N3 neck patients treated with definitive CCRT can achieve similar outcomes to those treated with upfront neck dissection followed by adjuvant CCRT. Cautions should be made to avoid overtreatment for this group of patients.

The approach to the personal experience and previous ideas about Physical Education of future Primary Education teachers is a starting point of great interest for the teaching of the subject of Didactics of Physical Education. The study aims to investigate these prior beliefs and to verify to what extent this initial perception changes after taking the course on “Didactics of Physical Education”. A concurrent mixed-methods study was conducted, which included two data collection procedures: (1) a pre-experimental design with a single group featuring pre-test and post-test; (2) the analysis of students' autobiographical accounts of their school experience with physical education. The participants were students enrolled in the Bachelor’s degree program in Primary Education at the University of Santiago de Compostela (USC) who undertook the course last year. The results obtained reveal that after taking the subject of Didactics of Physical Education, students give greater value to more positive concepts of learning, socializing, participating, and playing, among others. Similarly, in the post-test, the assessment of concepts such as competitiveness and physical fatigue diminished. In their autobiographical memories, students associate good memories with relationships with classmates and the playful and socializing nature of the subject; and among the bad memories, they highlight the content related to physical performance, competitiveness, and lack of attention to the diversity of students and their individual characteristics.

The clinical significance of carbon-ion radiotherapy (CIRT) for adenocarcinoma (AC) of the uterine cervix has been assessed in several single-institutional studies. To validate the significance, we conducted a multi-institutional survey of CIRT for locally advanced AC (LAAC) of the uterine cervix. We retrospectively analyzed the clinical outcomes of patients with stage IIB–IVA LAAC of the uterine cervix who underwent chemo-CIRT or CIRT alone between April 2010 and April 2016. Patients received 74.4 Gy (relative biological effectiveness [RBE]) in 20 fractions of CIRT or 55.2 Gy (RBE) in 16 fractions of CIRT plus 3 sessions of brachytherapy. Patients aged ≤70 years with adequate bone marrow and organ function were administered cisplatin weekly (40 mg/m2 per week for up to 5 weeks). Fifty-five patients were enrolled in this study. The median follow-up period was 67.5 months. The 5-year overall survival (OS) and local control (LC) rates were 68.6% and 65.2%, respectively. Multivariate analysis showed that the initial tumor response within 6 months was significantly associated with LC and OS. The present study represents promising outcomes of CIRT or chemo-CIRT for LAAC of the uterine cervix, especially in the cases showing initial rapid regression of the tumor.

All departments in a business work separately, but for the same purpose.In this article, a system that allows not only the mechanical design department but also the manufacturing, storage, process planning, quality control, electrical design, purchasing departments, etc. to have access to the required information has been developed. Initially, current manufacturng result informations is collected from the project attandees. Secondly, a workflow is designed dependent on the current data flow. All the project stakeholders are introduced to join and use product data management system. In the absence of this kind of system, loss of time, scraps and loss of engineering time would be investigated. This allowed the company owners to be sure that no faulty revision of design will be produced after the system started. On the other hand automation of bill of materials generation provided the purchasing department correct and up to date information about outsourced parts. Allowing different engineering disciplines to work together provided more suitable environment. Gradually this conditions allowed all the departments work faster and market the new product much faster than before the system. Tracing the workflows for management purposes would be handled by the system. A ‘Validation of Design’ process is modelled for the company.

State-of-the-art augmented-reality (AR) glasses record their position and orientation in space, enabling measurements and analyses of clinical gait-and-balance tests. This study’s objective was to evaluate concurrent validity and test-retest reliability for common clinical gait-and-balance tests in people with Parkinson’s disease: the Five Times Sit-To-Stand (FTSTS) and Timed Up-and-Go (TUG) tests. Position and orientation data was collected in 22 participants with Parkinson's disease using HoloLens 2 and Magic Leap 2 AR glasses, from which test-completion durations and durations of distinct sub-parts (e.g., sit-to-stand, turning) were derived and compared to reference systems and over test repetitions. Regarding concurrent validity, for both tests an excellent between-systems agreement was found for position and orientation time series and test-completion durations. Between-systems agreement for FTSTS (sub-)durations were all excellent, while TUG turning sub-durations were excellent (turn 1) and moderate (turn 2). Regarding test-retest reliability, the within-system test-retest variation in test-completion times and sub-durations was always much greater than the between-systems variation, implying that these (sub-)durations may be derived interchangeably from AR and reference-system data. In conclusion, AR data are of sufficient quality to evaluate gait and balance in people with Parkinson's disease, with valid quantification of test-completion durations and sub-durations of distinct FTSTS and TUG sub-parts.

Human papillomavirus (HPV) infections, primarily transmitted through sexual contact, have been linked to various cancers, including cervical, penile, anal, oropharynx, breast, and prostate cancers. This study presents a unique case of concurrent high-risk HPV35, HPV45, and HPV59 infections in both prostate and bladder cancer tissues from a single patient, representing the first documented instance worldwide with identical HPV types detected in two adjacent organs of the same individual. Employing a multiplex-PCR approach, gel electrophoresis, and Sanger sequencing, we confirmed the presence of these high-risk HPV types. Additionally, Western blot analysis using an HPV E7 antibody demonstrated the active expression of HPV oncoproteins in both cancer types. This discovery underscores the potential for HPV intra-organ transmission and necessitates further exploration of alternative transmission routes. The implications of our results offer new insights into the complex dynamics of HPV transmission in cancer pathogenesis.

Introduction: This review explores the literature and presents institutional cases of concurrent robotic multisite surgery—in particular, robot-assisted radical prostatectomy (RARP) and robot-assisted partial nephrectomy (RAPN) for synchronous prostate and kidney cancers. We highlight dual-console synchronous robotic procedures, emphasizing the unique docking tech-nique developed. Aim: The aims of the study were to evaluate the feasibility, safety, and clinical outcomes of concurrent RARP and RAPN for synchronous prostate cancer and small renal tumors, as well as other concurrent robotic multisite surgeries, and to compare institutional findings with the existing literature. Materials and Methods: We describe the unique docking technique used in our procedures, which facilitates atraumatic transitions between surgeries using the same port sites. Additionally, eligible studies on concurrent robotic multisite surgery that were published in English were retrieved from the MEDLINE, Embase, and Cochrane Library databases. Data on operative time, blood loss, complications, and postoperative outcomes were extracted. Results: Eight cases from our institution demonstrated the feasibility and safety of the proposed approach, which is consistent with previous reports. The unique docking technique and dual-console setup enhance surgical precision, offering significant benefits in patient outcomes. As part of the litera-ture review, nine retrospective studies involving 40 cases of concurrent RARP and RAPN were reviewed. Additionally, eleven retrospective studies involving 392 cases of concomitant RARP and robotic transabdominal preperitoneal inguinal hernia repair (RTAPPIHR) were analyzed. Conclusions: Concurrent RARP and RAPN for synchronous prostate and kidney tumors is a viable and effective approach. Our early experience suggests that this and other combined procedures can optimize patient care and reduce costs. Prospective trials are needed to validate these findings and further refine the techniques.

The incidence and mortality of cervical cancer are high in Romania compared to other European countries, particularly for locally advanced cervical cancer cases, which are predominant at the time of diagnosis. Widely accepted therapeutic guidelines indicate that the treatment for locally advanced cervical cancer consists of concurrent chemoradiotherapy (total dose 85-90Gy at point A), with surgery not being necessary as it does not lead to improved survival and results in significant additional morbidity. In Romania, the treatment for locally advanced cervical cancer differs, involving lower-dose chemotherapy (total dose 60-65Gy at point A), followed by surgery which, under these circumstances, ensures better local control. In this regard, we attempted to evaluate the role and necessity of surgery in Romania, considering that in our study, residual lesions were found in 55.84% of cases on resected specimens, especially in cases with unfavorable histology (adenocarcinoma and adenosquamous carcinoma). This type of surgery was associated with significant morbidity (28.22%) in our study. The recurrence rate was 24.21% for operated patients compared to 62% for non-operated patients receiving suboptimal concurrent chemotherapy alone. In conclusion, In Romania, surgery will continue to play a predominant role until radiotherapy achieves the desired effectiveness for local control.

Recent studies have indicated that terahertz time-domain spectroscopy (THz-TDS) can stably and efficiently acquire output spectra using an affordable and compact multimode laser diode (MMLD) with delayed optical feedback as the light source. This research focused on a numerical analysis of the optimal conditions for employing an MMLD with delayed optical feedback (chaotic oscillating laser diode) in THz-TDS, utilizing multimode rate equations. The findings revealed that the intermittent chaotic output generated by the MMLD, characterized by concurrent picosecond pulse oscillations lasting several tens of picoseconds, proves to be highly effective for THz-TDS. By appropriately setting the amounts of injection current and optical feedback, and the delay time of optical feedback, intermittent chaotic oscillation can be attained within a considerably broad parameter range. Moreover, both the MMLD output spectrum and the THz-TDS output spectrum exhibit a consistently stable shape at the microsecond scale, demonstrating the attractor properties inherent in an MMLD with delayed optical feedback.

Biological control, a well-established plant protection method, has garnered substantial attention in recent decades. Various approaches, including biological control agents (BCA), catch crops, biofumigation, sticky traps, and pheromones, have been extensively explored. While the effectiveness of these methods varies depending on specific circumstances, their collective significance has grown amid mounting pressures to curtail or eliminate conventional synthetic plant protection products. Previous review articles have highlighted the synergistic benefits of using two or more BCAs simultaneously, yet limited information exists regarding the concurrent use of diverse biological control methods. This comprehensive review incorporates a thorough literature search to assess the synergistic potential of concurrently employing two or more of these methods, followed by a discussion on perspectives of holistic management and mimicking of complex natural systems, shedding light on the vast potential and need for further research in this domain.