The burden of upper motor neuron involvement is correlated with the bilateral limb involvement interval in patients with amyotrophic lateral sclerosis:a retrospective observational study

Amyotrophic lateral sclerosis is a rare neurodegenerative disease characterized by the involvement of both upper and lower motor neurons.Early bilateral limb involvement significantly affects patients'daily lives and may lead them to be confined to bed.However,the effect of upper and lower motor neuron impairment and other risk factors on bilateral limb involvement is unclear.To address this issue,we retrospectively collected data from 586 amyotrophic lateral sclerosis patients with limb onset diagnosed at Peking University Third Hospital between January 2020 and May 2022.A univariate analysis revealed no significant differences in the time intervals of spread in different directions between individuals with upper motor neuron-dominant amyotrophic lateral sclerosis and those with classic amyotrophic lateral sclerosis.We used causal directed acyclic graphs for risk factor determination and Cox proportional hazards models to investigate the association between the duration of bilateral limb involvement and clinical baseline characteristics in amyotrophic lateral sclerosis patients.Multiple factor analyses revealed that higher upper motor neuron scores(hazard ratio[HR]=1.05,95%confidence interval[CI]=1.01–1.09,P=0.018),onset in the left limb(HR=0.72,95%CI=0.58–0.89,P=0.002),and a horizontal pattern of progression(HR=0.46,95%CI=0.37–0.58,P<0.001)were risk factors for a shorter interval until bilateral limb involvement.The results demonstrated that a greater degree of upper motor neuron involvement might cause contralateral limb involvement to progress more quickly in limb-onset amyotrophic lateral sclerosis patients.These findings may improve the management of amyotrophic lateral sclerosis patients with limb onset and the prediction of patient prognosis.

Spousal Involvement in the Workplace of Doctors: What Is Defined as Appropriate or Inappropriate

Background: Workers spend a significant amount of time in the workspace. Involvement of a spouse in a doctor’s workplace can take different forms and come with different intentions. Objectives: The survey aimed to determine the prevalence and extent of spousal involvement in physicians’ workplaces as well as the outcome of such involvement on doctor’ swell-being, productivity, and relationship with colleagues. Methods: This cross-sectional online survey on spousal involvement in the workplace of doctors was conducted among 83 responding doctors from July to August 2023. Results: Among the respondents, 60 (72.3%) had witnessed a doctor’s spouse being involved in the workplace. The most common reason for spousal involvement in the workplace was to protect the spouse from what they perceived as a threat 34 (54.0%). Spouse’s ignorance of boundaries in the workplace (OR: 6.09 (95% CI: 1.70, 21.79) P: 0.003) and exertion of control by the spouse (OR: 11.2 (95% CI: 2.26, 56.41) P: 0.002) were significantly associated with higher odds of inappropriate spousal involvement in the workplace, while expression of love for spouse with acts of kindness was significantly associated with a lowered odd of inappropriate spousal involvement (OR: 0.11 (95% CI: 0.03, 0.36) P: 0.0001). Conclusion: Spousal involvement in the workplace is relatively common. Ignorance of the boundaries of the workplace and exertion of control by the spouse were significant enablers of inappropriate spousal involvement in the workplace of doctors. The establishment of workplace policies that define the limits of spousal involvement in the doctor’s workplace can foster a healthy workspace environment, enhance doctors’ well-being, and improve patient care.

Corrigendum:Sorl1 knockout inhibits expression of brain-derived neurotrophic factor:involvement in the development of late-onset Alzheimer’s disease

https://doi.org/10.4103/1673-5374.393108 In the article titled“Sorl1 knockout inhibits expression of brain-derived neurotrophic factor:involvement in the development of late-onset Alzheimer’s disease”,published on pages 1602-1607,Issue 7,Volume 19 of Neural Regeneration Research(Zhao et al.,2024),the first author’s affiliations were incorrectly tagged.

Contract Mechanism of Water Environment Regulation for Small and Medium Sized Enterprises Based on Optimal Control Theory

The small and scattered enterprise pattern in the county economy has formed numerous sporadic pollution sources, hindering the centralized treatment of the water environment, increasing the cost and difficulty of treatment. How enterprises can make reasonable decisions on their water environment behavior based on the external environment and their own factors is of great significance for scientifically and effectively designing water environment regulation mechanisms. Based on optimal control theory, this study investigates the design of contractual mechanisms for water environmental regulation for small and medium-sized enterprises. The enterprise is regarded as an independent economic entity that can adopt optimal control strategies to maximize its own interests. Based on the participation of multiple subjects including the government, enterprises, and the public, an optimal control strategy model for enterprises under contractual water environmental regulation is constructed using optimal control theory, and a method for calculating the amount of unit pollutant penalties is derived. The water pollutant treatment cost data of a paper company is selected to conduct empirical numerical analysis on the model. The results show that the increase in the probability of government regulation and public participation, as well as the decrease in local government protection for enterprises, can achieve the same regulatory effect while reducing the number of administrative penalties per unit. Finally, the implementation process of contractual water environmental regulation for small and medium-sized enterprises is designed.

Management of distal cholangiocarcinoma with arterial involvement: Systematic review and case series on the role of neoadjuvant therapy

BACKGROUND The use of neoadjuvant therapy(NAT)in distal cholangiocarcinoma(dCCA)with regional arterial or extensive venous involvement,is not widely accepted and evidence is sparse.AIM To synthesise evidence on NAT for dCCA and present the experience of a highvolume tertiary-centre managing dCCA with arterial involvement.METHODS A systematic review was performed according to PRISMA guidance to identify all studies reporting outcomes of patients with dCCA who received NAT.All patients from 2017 to 2022 who were referred for NAT for dCCA at our centre were retrospectively collected from a prospectively maintained database.Baseline characteristics,NAT type,progression to surgery and oncological outcomes were collected.RESULTS Twelve studies were included.The definition of“unresectable”locally advanced dCCA was heterogenous.Four studies reported outcomes for 9 patients who received NAT for dCCA with extensive vascular involvement.R0 resection rate ranged between 0 and 100%but without survival benefit in most cases.Remaining studies considered either NAT in resectable dCCA or inclusive with extrahepatic CCA.The presented case series includes 9 patients(median age 67,IQR 56-74 years,male:female 5:4)referred for NAT for borderline resectable or locally advanced disease.Three patients progressed to surgery and 2 were resected.One patient died at 14 months with evidence of recurrence at 6 months and the other died at 51 months following recurrence 6 months postoperatively.CONCLUSION Evidence for benefit of NAT is limited.Consensus on criteria for uniform definition of resectability for dCCA is required.We propose using the established National-Comprehensive-Cancer-Network®criteria for pancreatic ductal adenocarcinoma.

Shared decision making in rural general practices:a qualitative exploration of older rural South Australians'perceived involvement in clinical consultations with doctors

Background:Shared decision-making(SDM)implementation is a priority for Australian health systems,including general practices but it remains complex for specific groups like older rural Australians.We initiated a qualitative study with older rural Australians to explore barriers to and facilitators of SDM in local general practices.Methods:We conducted a patient-oriented research,partnering with older rural Australians,families,and health service providers in research design.Participants who visited general practices were purposively sampled from five small rural towns in South Australia.A semi-structured interview guide was used for interviews and reflexive thematic coding was conducted.Results:Telephone interviews were held with 27 participants.Four themes were identified around older rural adults’involvement in SDM:(1)Understanding of"patient involvement";(2)Positive and negative outcomes;(3)Barriers to SDM;and(4)Facilitators to SDM.Understanding of patient involvement in SDM considerably varied among participants,with some reporting their involvement was contingent on the“opportunity to ask questions”and the“treatment choices”offered to them.Alongside the opportunity for involvement,barriers such as avoidance of cultural care and a lack of continuity of care are new findings.Challenges encountered in SDM implementation also included resource constraints and time limitations in general practices.Rural knowledge of general practitioners and technology integration in consultations were viewed as potential enablers..Conclusion:Adequate resources and well-defined guidelines about the process should accompany the implementation of SDM in rural general practices of South Australia.Innovative strategies by general practitioners promoting health literacy and culturally-tailored communication approaches could increase older rural Australians'involvement in general.

Impact of the carbon market on investment benefits of power-grid enterprises in China: a system dynamics analysis

The power grid,as the hub connecting the power supply and consumption sides,plays an important role in achieving carbon neutrality in China.In emerging carbon markets,assessing the investment benefits of power-grid enterprises is essential.Thus,studying the impact of the carbon market on the investment and operation of powergrid enterprises is key to ensuring their efficient operation.Notably,few studies have examined the interaction between the carbon and electricity markets using system dynamics models,highlighting a research gap in this area.This study investigates the impact of the carbon market on the investment of power-grid enterprises using a novel evaluation system based on a system dynamics model that considers carbon-emissions from an established carbon-emission accounting model.First,an index system for benefit evaluation was constructed from six aspects:financing ability,economic benefit,reliability,social responsibility,user satisfaction,and carbon-emissions.A system dynamics model was then developed to reflect the causal feedback relationship between the impact of the carbon market on the investment and operation of power-grid enterprises.The simulation results of a provincial power-grid enterprise analyze comprehensive investment evaluation benefits over a 10-year period and the impact of carbon emissions on the investment and operation of power-grid enterprises.This study provides guidelines for the benign development of power-grid enterprises within the context of the carbon market.

Evolutionary analysis of green credit and automobile enterprises under the mechanism of dynamic reward and punishment based on government regulation

To explore the green development of automobile enterprises and promote the achievement of the“dual carbon”target,based on the bounded rationality assumptions,this study constructed a tripartite evolutionary game model of gov-ernment,commercial banks,and automobile enterprises;introduced a dynamic reward and punishment mechanism;and analyzed the development process of the three parties’strategic behavior under the static and dynamic reward and punish-ment mechanism.Vensim PLE was used for numerical simulation analysis.Our results indicate that the system could not reach a stable state under the static reward and punishment mechanism.A dynamic reward and punishment mechanism can effectively improve the system stability and better fit real situations.Under the dynamic reward and punishment mechan-ism,an increase in the initial probabilities of the three parties can promote the system stability,and the government can im-plement effective supervision by adjusting the upper limit of the reward and punishment intensity.Finally,the implementa-tion of green credit by commercial banks plays a significant role in promoting the green development of automobile enter-prises.

Demography and Socio-Economic Aspects on Irrigated Smallholder Agricultural Enterprises and Their Association with the Cultivation of Maize (Zea mays L.) as a Selected Field Crop

The purpose of this study is to correlate demography and socio-economic aspects at Irrigated Smallholder Agricultural Enterprises and their association with the Cultivation of Maize in order to determine its positive impacts at irrigated smallholders’ agricultural entrepreneurs’ household. Chi-square test was used as descriptive analysis method. The Fischer Exact tests were employed to test demography (gender, age, education, and income) in winter and summer production season of irrigated smallholder agricultural enterprises and their association with the cultivation of selected field crop (i.e. maize). The results show that gender results were not being statistically significant, as measured by the Phi measure of effect size, φ = 0.149, p = 0.011, and φ = 0.05, p = 0.392 in summer. As far as age is concern, it appears to be a statistically significant association between cultivating maize and age in winter, φ = 0.046, p = 0.730 in winter and φ = 0.172, p = 0.013. Education winter result not being statistically significant, the effect size showed a weak association, as measured by the Phi measure of effect size, φ = 0.112, p = 0.305 and φ = 0.035, p = 0.948 in summer. Income result not being statistically significant, as measured by the Phi measure of effect size, φ = 0.049, p = 0.399 and φ = 0.081, p = 0.166 in summer. In conclusion, the study shows that the development of best management practices must be based on a comprehensive analysis of the livelihoods and irrigated smallholder agricultural enterprise farming styles of participating irrigated smallholder agricultural entrepreneurs.

Research on Pathways of How Digital Transformation Affects the Business Performance of MEEC Enterprises in Chengdu

This paper aims to examine the impact of digital transformations on the business performance of the meetings,expositions,events,and conventions(MEEC)industry in Chengdu by conducting an empirical analysis of 68 MEEC enterprises in the city.The study employed the fuzzy-set qualitative comparative analysis(fsQCA)method to explore the pathways and factors involved.Drawing on the theory of synergetics,nine condition variables were carefully selected from four dimensions:digital technologies,digital strategy,digital infrastructure,and digital innovation.The findings revealed that digital transformations were an intricate systematic process,whereby a single factor alone did not serve as a necessary condition for MEEC enterprises to achieve high business performance.The analysis identified five distinct pathways that would lead to high performance,which can be categorized into three distinct models:the“organization-human resources”dominated model,the“human resources-infrastructure”driven model,and the multi-factor coordination model.The analysis also identified two pathways that would result in low performance,categorized as the“basic condition absent”model.Notably,there was substantial heterogeneity observed in the configurational pathways in terms of the magnitude of the impact of digital transformation on business performance across MEEC enterprises of different sizes.This paper suggests that the government should assume the role of a platform,providing policy and financial support to MEEC enterprises to help guide them through the process of digital transformation and that MEEC enterprises themselves should seize the opportunities arising from digital transformation to strengthen their digital infrastructure construction,human resources development,and innovation in brand building.This study presents empirical evidence that contributes to the understanding of the transformation process of MEEC enterprises within the digital economy era,as well as valuable insights into understanding the channels and internal conditions involved in digital transformations.

Research on the Collaborative Governance of Social Responsibility in Online Audiovisual Enterprises

This paper aims to analyze the present conditions of the social responsibility ecosystem in online audiovisual enterprises in the digital age. It focuses on the governance of social responsibility in these enterprises and conducts an in-depth analysis of the problems and influencing factors related to the social responsibility aberrations of online audiovisual enterprises. Drawing upon social responsibility theory and collaborative governance theory, this research constructs a social responsibility guidance and governance system guided by the public, supported by the voluntary fulfillment of responsibilities by online audiovisual enterprises, and based on the collaborative participation of diverse stakeholders. It explores and optimizes the implementation pathways of this system, providing theoretical support and practical guidance for promoting the sustainable development of online audiovisual enterprises. Furthermore, it aims to contribute to the creation of a harmonious Internet ecosystem.

Assessing Factors Influencing Solar Energy Adoption among Small and Medium Enterprises in Mzuzu City, Malawi

One of the many renewable energy sources that offer advantages is solar energy, which also lowers energy prices and promotes environmental sustainability and energy security. Despite these advantages, various barriers, such as installation costs, have prevented small and medium-sized enterprises from investigating this invention. Malawi has a significant energy shortfall such that most businesses have been hindered from their profit maximization goals. The “Photovoltaic systems” (PV) that transform sunlight into electricity are the subject of this study. This type of solar energy system is situated on the building’s roof and generally produces electricity for businesses and even homes. Solar energy offers a great impact to small and medium enterprises in Mzuzu city with a cost-effective and dependable alternative to energy that has the potential to change the game. Therefore the aim of the study was to identify factors that encourage the adoption of solar energy among small medium enterprises in the city of Mzuzu city. And to identify some of barriers faced when adopting solar energy among small and medium enterprises in the city of Mzuzu. The research approach employed in the study was a survey. A survey is a type of research methodology in which primary data is gathered from a sample using a questionnaire. When information is to be gathered from a wider sample, a survey is employed. A bigger sample size was needed in this study in order to facilitate hypothesis testing. It is advised to apply a logical approach while using the survey. The survey utilized a five-point Likert scale. The study used convenience sampling to select study participants. The sample size in this study was determined using Cochran’s sample size formula. Statistical Package for Social Sciences (SPSS) and Microsoft Excel were used for statistical analysis. About 97.2% of the participants were aware of solar as a source of energy compared to 2.8 % who were unaware. The majority of participants use solar energy for lighting only, seconded by those who use electricity. The least number of participants use solar energy for cooling only. The majority of participants 21.5% indicated partnership and collaboration as the most motivating factor for the adoption of solar energy. This was followed by technical expertise 19.1 % the least number of participants 10.8% expressed that policy and regulatory frameworks were associated with the adoption of solar energy. This study found that there are no statistically significant factors influencing barriers to the adoption of solar energy. The price of solar energy adoption was identified as the least factor associated with the acceptance or rejection of solar energy. Nonetheless, the reasons given by the homes that had embraced solar technology aligned with the findings of other studies. This survey also found that although the public was aware of solar energy, and technology, there were still a number of factors that mattered, especially for non-adopters.

Chinese Enterprises’ Investment in Southeast Asia Continues Unabated

As we all know,Southeast Asia has become a hot destination for Chinese enterprises to invest in.The latest report shows that Southeast Asia continues to attract China’s capital,within which the medical industry has become an important area for Chinese enterprises to invest in,and the investment activity has gradually warmed up despite fluctuations.

Practices and Reflections of CNOOC on Building World-Class Enterprises

At present,China is facing new strategic opportunities as well as risks and challenges in its development.Faced with the challenges brought by current global major risks,China urgently needs to build a group of world-class enterprises as ballast stones.Accelerating the development of a number of world-class enterprises is an important support for China to enhance its comprehensive strength and international competitiveness,and is crucial for the realization of the strategic blueprint for socialist modernization.After more than forty years of reform and opening up,Chinese enterprises have rapidly developed and grown stronger,with their position rising and their influence in the global market increasing continuously.However,Chinese enterprises are“large in size but not yet strong enough”.In this context,this paper systematically analyzes the practical significance and theoretical connotation of building world-class enterprises and the status quo of building world-class enterprises in China and takes CNOOC as an example to deeply analyze the practices of large central enterprises to build world-class enterprises at the levels of group and subsidiaries,providing a reference for Chinese enterprises to accelerate their progress towards world-class enterprises.

Hainan's Policy and High Tech Attract Foreign Enterprises' Attention

The"Hainan Tour"event for foreignfunded enterprises,which was jointly hosted by the CCPIT and the government of Hainan Province,has recently been closed.Over 30 foreign-funded enterprises have reached cooperation intentions with relevant institutions from Hainan Province.

Nurturing a Thriving Business Hub Zhongshan’s support system has earned the trust of enterprises

Abusiness environment is the soil on which companies depend for survival and growth,and it represents the soft power and competitiveness of a region.In recent years,the Zhongshan Municipal Party Committee and Zhongshan Municipal People’s Government have placed great emphasis on improving the business environment,striving to create a world-class,market-oriented,and law-based international business environment.

Determinants of Occipital Involvement in Males and Females with Pattern Hair Loss: A Retrospective Study

Background: Pattern hair loss (PHL) is the most common form of hair loss affecting both men and women. The occipital region, located at the back of the scalp, has been considered resistant to hair loss in PHL. It is often used as a donor site for hair transplantation procedures. However, evidence suggests that the occipital region may also be affected by PHL, although to a lesser extent compared to the frontal and vertex regions. Objective: To assess the levels and determinants of occipital involvement in PHL, focusing on gender and disease severity. Such data would enhance the comprehensive understanding of PHL progression and inform development of improved treatment strategies. Methods: This retrospective study involved 1993 adults (1000 males, 993 females) following for PHL at a specialized hair clinic in Jeddah, Saudi Arabia. Any patient who had hair transplantation in the past and any male who had balding areas (Hamilton-Norwood scales 4 to 7) at the initial consultation was excluded. The primary outcome was occipital involvement, defined as >10% thin hairs in the trichometry assessments of the occipital region. Additional data included patients age, treatment status, disease severity, and other trichometry parameters. Results: The prevalence of occipital involvement was found to be 23.8% overall, significantly more frequent in females (35.6%) than males with early PHL (Hamilton-Norwood scales 2 and 3) (12.1%) (p Conclusion: This study underscored the relevance of gender and disease severity in occipital involvement in PHL. Females had significantly higher rates of occipital involvement, suggesting that gender differences are critical in understanding PHL progression. Future research should aim to validate these findings, with an aim to refine therapeutic and surgical approaches to improve patient outcomes.

Bringing Opportunities Job fair connects Chinese-invested enterprises in South Africa with local job seekers

Simphiwe Zondi in Johannesburg,South Africa,was especially happy on 16 April.At the 2024 Job Fair of the Chinese-Invested Enterprises in South Africa held in the Gallagher Convention Centre on that day,he presented his CV and immediately secured a job as a technical director at the South Africa subsidiary of PowerChina,which ranked 105th on the Fortune Global 500 list in 2023.He was one of the few applicants who signed employment contracts at the job fair.

Energy Saving Analysis of Coal Gas Resource Utilization in Iron and Steel Enterprises

The article discusses the preparation of a gas balance sheet,as well as the recovery,storage,transporta-tion,and use of gas.An analysis was conducted on the occurrence and consumption quotas of various gas media,and specific energy-saving measures were elaborated for each process.This provides a theoretical reference for saving gas and reducing energy consumption in steel enterprises.

Research on the Impact of Digital Transformation on the Performance of Manufacturing Enterprises

To address the challenges faced by manufacturing enterprises in digital transformation,this paper analyzes the relationship between digital transformation and enterprise performance.Using panel data from domestic A-share-listed manufacturing enterprises from 2012 to 2022,two hypotheses were proposed.The analysis and verification revealed that digital transformation in manufacturing enterprises can enhance performance and reduce costs.Based on the impact of digital transformation on manufacturing enterprise performance,optimization suggestions are proposed to guide future digital transformation and performance improvement efforts in these enterprises.