Complex Regional Pain Syndrome: Outpatient Pain Management in the Chronic Setting: A Case Report

Background: Complex Regional Pain Syndrome (CRPS), previously known as reflex sympathetic dystrophy and causalgia, is a neuropathic pain condition that usually develops after an injury to an extremity. CRPS can be a debilitating condition with high levels of pain and reduced function. Aim: This case report aims to discuss the multimodal approach in the management of a patient who presented with ongoing poorly controlled pain secondary to CRPS from an injury that happened years prior. Case Presentation: A 45-year-old female was involved in a motor vehicle accident where her right leg was injured. She underwent several surgeries and developed CRPS that significantly reduced her mobility and quality of life. She presented to the pain clinic years after her initial injury and a multimodal regimen was started for her resulting in significantly improved function. Conclusion: CRPS can be a severely debilitating condition. While early diagnosis and management are important, ongoing management in the outpatient chronic pain setting is important in maintaining a good level of function.

Addressing inclusion,innovation,and sustainability challenges through the lens of economic geography:Introducing the hierarchical regional innovation system

The world is facing dramatic challenges related to environmental sustainability at an accelerating pace.In this context,the field of economic geography(EG)has been playing an important role in understanding both the socioeconomic and technological dimensions of these challenges,as it deals with a variety of complementary notions and perspectives.Departing from this lens,our aim is to explore a conceptual framework that can help us to understand environmental changes relating to multi-dimensional territorial development,notably in eco-nomic contexts where inequality is high,and stratification based on hierarchies regulate social and economic life.Based on the territory concept,we propose the original notion of a hierarchical regional innovation system(HRIS)that emphasises the pervasive role of hierarchies(powers)in regional innovation systems and illustrate its value with evidence and case studies from extant literature on sustainability transitions.The HRIS can help us understand and promote development paths considering the contribution of inclusive eco-innovations(another original conceptual amalgam).Through some empirical cases from other studies in low-carbon transitions,we show the application of the HRIS(and inclusive eco-innovation)framework.In conclusion,we provide incen-tives to explore new regional innovation systems,alongside the HRIS,adapted to different regions worldwide and centred on the inclusiveness of people and places.

Infectious ENT Emergencies: A One-Year Experience at the ENT Department of Mamou Regional Hospital

Introduction: ENT infectious emergencies encompass all infectious pathologies affecting the ear, nose, sinuses, throat, and neck. A good understanding of these emergencies is essential for organizing appropriate care. In Guinea, few studies have described ENT infectious pathologies in rural areas. Objective: To study ENT infectious emergencies in the Otorhinolaryngology department of the Mamou Regional Hospital. Materials and Methods: This is a retrospective and prospective descriptive study, conducted from August 1, 2021, to July 31, 2022. All patients admitted to the ENT department of the Mamou Regional Hospital for an infectious emergency were included. Results: Among the 1854 recorded consultations, 261 cases involved ENT infectious emergencies, representing a prevalence of 14.07%. The most represented age group was 0 to 10 years (31.03%), with a majority of female patients (59%) and a predominantly urban origin (81.61%). Students accounted for 32.18% of the cases. The main reasons for consultation were odynophagia/dysphagia (32.42%) and otalgia (22.94%). The primary etiologies were tonsillitis (28.73%) and otitis (27.20%). Treatments administered included probabilistic antibiotic therapy (38.80%), analgesics (32.03%), and corticosteroid therapy (10.47%). The outcome was favorable in 98.85% of cases, with only 0.38% lost to follow-up. Conclusion: The results of our study confirm the frequency of ENT infectious pathologies. Their management requires joint actions for population awareness, staff training, and services equipment, particularly in rural areas.

External Otitis: Epidemiological, Clinical, Etiological, and Therapeutic Aspects at the Oto-Rhino-Laryngology Department of Mamou Regional Hospital

Introduction: External otitis (OE) is an acute or chronic inflammation or infection of the external ear resulting from an imbalance in the external auditory canal secondary to microtrauma, maceration, eczema, or a foreign body in the external auditory canal. Objective: To study cases of external otitis at the Mamou Regional Hospital. Materials and Methods: This was a prospective descriptive study conducted over a period of six (6) months from July 1st to December 31st, 2016. It included all patients admitted to the ENT department of the Mamou Regional Hospital. Results: During the study period, 712 patients were admitted to the department for various pathologies, of which 103 met our selection criteria, representing a frequency of 14.46%. The mean age of the patients was 33.74 years with a range of 1 to 90 years. Males predominated in the sample, accounting for 59.22%. The vast majority of patients resided in urban areas, constituting 61.17% of the sample. In our study, all patients consulted for otalgia (100%), and over half (53.39%) for hypoacusis. We formally identified rhinitis in 66.66% of cases, while diabetes was found in only 4 patients (11.11%). Otomycosis was the most commonly identified condition (53.39%), followed by furuncles (33.98%). Ear drops containing antibiotics were administered to all patients, although 66.60% received antibiotic therapy. Conclusion: External otitis is a relatively common condition, particularly among children and the elderly. Diagnosis can be made based on pain upon traction of the pinna and pressure on the tragus.

Normothermic regional perfusion mobile teams in controlled donation after circulatory death pathway: Evidence and peculiarities

To facilitate the implementation of controlled donation after circulatory death(cDCD)programs even in hospitals not equipped with a local Extracorporeal Membrane Oxygenation(ECMO)team(Spokes),some countries and Italian Regions have launched a local cDCD network with a ECMO mobile team who move from Hub hospitals to Spokes for normothermic regional perfusion(NRP)implantation in the setting of a cDCD pathway.While ECMO teams have been clearly defined by the Extracorporeal Life Support Organization,regarding composition,responsibilities and training programs,no clear,widely accepted indications are to date available for NRP teams.Although existing NRP mobile networks were developed due to the urgent need to increase the number of cDCDs,there is now the necessity for transplantation medicine to identify the peculiarities and responsibility of a NRP team for all those centers launching a cDCD pathway.Thus,in the present manuscript we summarized the character-istics of an ECMO mobile team,highlighting similarities and differences with the NRP mobile team.We also assessed existing evidence on NRP teams with the goal of identifying the characteristic and essential features of an NRP mobile team for a cDCD program,especially for those centers who are starting the program.Differences were identified between the mobile ECMO team and NRP mobile team.The common essential feature for both mobile teams is high skills and experience to reduce complications and,in the case of cDCD,to reduce the total warm ischemic time.Dedicated training programs should be developed for the launch of de novo NRP teams.

Study on the Promotion of Digital Trade to Northeast Asian Regional Economy

Society is currently transitioning from the era of informatization and digitization to the era of intelligence.Advanced technologies such as artificial intelligence,the Internet of Things,and big data are permeating every aspect of production and life.This penetration presents a rare opportunity for the development of digital trade and catalyzes innovation in traditional trade patterns.This paper first analyzes the inevitability of digital trade development in Northeast Asia.Secondly,it delves into the challenges faced by digital trade development and explores in-depth the promotion strategy for digital trade’s impact on the economic development of the Northeast Asia region,providing insights from various perspectives for reference.

The Impact of Human Resource Management on Regional Economic Development

A company that does a good job in human resource management will promote the process of regional economic development,and related enterprises will develop rapidly as a result.In future work,enterprises should carefully study the relationship between the two,and innovate their human resource management and development methods while fully considering the needs of talent development and regional economic development,in order to fundamentally optimize the regional economic development status.

Does digitalization mitigate regional inequalities?Evidence from China

Regional inequality significantly influences sustainable development and human well-being.In China,there exists pronounced regional disparities in economic and digital advancements;however,scant research delves into the interplay between them.By analyzing the economic development and digitalization gaps at regional and city levels in China,extending the original Cobb-Douglas production function,this study aims to evaluate the impact of digitalization on China's regional inequality using seemingly unrelated regression.The results indicate a greater emphasis on digital inequality compared to economic disparity,with variable coefficients of 0.59 for GDP per capita and 0.92 for the digitalization index over the past four years.However,GDP per capita demonstrates higher spatial concentration than digitalization.Notably,both disparities have shown a gradual reduction in recent years.The southeastern region of the Hu Huanyong Line exhibits superior levels and rates of economic and digital advancement in contrast to the northwestern region.While digitalization propels economic growth,it yields a nuanced impact on achieving balanced regional development,encompassing both positive and negative facets.Our study highlights that the marginal utility of advancing digitalization is more pronounced in less developed regions,but only if the government invests in the digital infrastructure and education in these areas.This study's methodology can be utilized for subsequent research,and our findings hold the potential to the government's regional investment and policy-making.

Construction and Application of a Regional Kilometer-Scale Carbon Source and Sink Assimilation Inversion System(CCMVS-R)

CO_(2)is one of the most important greenhouse gases(GHGs)in the earth’s atmosphere.Since the industrial era,anthropogenic activities have emitted excessive quantities of GHGs into the atmosphere,resulting in climate warming since the 1950s and leading to an increased frequency of extreme weather and climate events.In 2020,China committed to striving for carbon neutrality by 2060.This commitment and China’s consequent actions will result in significant changes in global and regional anthropogenic carbon emissions and therefore require timely,comprehensive,and objective monitoring and verification support(MVS)systems.The MVS approach relies on the top-down assimilation and inversion of atmospheric CO_(2)concentrations,as recommended by the Intergovernmental Panel on Climate Change(IPCC)Inventory Guidelines in 2019.However,the regional high-resolution assimilation and inversion method is still in its initial stage of development.Here,we have constructed an inverse system for carbon sources and sinks at the kilometer level by coupling proper orthogonal decomposition(POD)with four-dimensional variational(4DVar)data assimilation based on the weather research and forecasting-greenhouse gas(WRF-GHG)model.Our China Carbon Monito ring and Verification Support at the Regional level(CCMVS-R)system can continuously assimilate information on atmospheric CO_(2)and other related information and realize the inversion of regional and local anthropogenic carbon emissions and natural terrestrial ecosystem carbon exchange.Atmospheric CO_(2)data were collected from six ground-based monito ring sites in Shanxi Province,China to verify the inversion effect of regio nal anthropogenic carbon emissions by setting ideal and real experiments using a two-layer nesting method(at 27 and 9 km).The uncertainty of the simulated atmospheric CO_(2)decreased significantly,with a root-mean-square error of CO_(2)concentration values between the ideal value and the simulated after assimilation was close to 0.The total anthropogenic carbon emissions in Shanxi Province in 2019 from the assimilated inversions were approximately 28.6%(17%-38%)higher than the mean of five emission inventories using the bottomup method,showing that the top-down CCMVS-R system can obtain more comprehensive information on anthropogenic carbon emissions.

Enhancing Autonomy Capability in Regional Power Grids:A Strategic Planning Approach with Multiple Autonomous Evaluation Indexes

After the integration of large-scale DistributedGeneration(DG)into the distribution network,the randomness and volatility of its output result in a reduction of spatiotemporal alignment between power generation and demand in the distribution network,exacerbating the phenomenon of wind and solar power wastage.As a novel power system model,the fundamental concept of Regional Autonomous Power Grids(RAPGs)is to achieve localized management and energy autonomy,thereby facilitating the effective consumption of DGs.Therefore,this paper proposes a distributed resource planning strategy that enhances the autonomy capabilities of regional power grids by considering multiple evaluation indexes for autonomy.First,a regional Energy Storage(ES)configuration strategy is proposed.This strategy can select a suitable reference value for the upper limit of ES configuration based on the regional load andDGoutput to maximize the elimination of source load deviations in the region as the upper limit constraint of ES capacity.Then,a control strategy for regional ES is proposed,the charging and discharging reference line of ES is set,and multiple autonomy and economic indexes are used as objective functions to select different proportions of ES to control the distributed resources of the regional power grid and establish evaluation indexes of the internal regional generation and load power ratio,the proportion of power supply matching hours,new energy consumption rate and tie line power imbalance outside the region to evaluate changes in the regional autonomy capabilities.The final simulation results showthat in the real regional grid example,the planning method in the planning year in the region of the overall power supply matching hour ratio and new energy consumption rate increased by 3.9%and 4.8%on average,and the power imbalance of the tie line decreased by 7.8%on average.The proposed planning approach enables the maximization of regional autonomy while effectively smoothing the fluctuation of power exchange between the regional grid and the higher-level grid.This presents a rational and effective planning solution for the regional grid,facilitating the coordinated development between the region and the distribution network.

Uncertainties of ENSO-related Regional Hadley Circulation Anomalies within Eight Reanalysis Datasets

El Nino-Southern Oscillation(ENSO),the leading mode of global interannual variability,usually intensifies the Hadley Circulation(HC),and meanwhile constrains its meridional extension,leading to an equatorward movement of the jet system.Previous studies have investigated the response of HC to ENSO events using different reanalysis datasets and evaluated their capability in capturing the main features of ENSO-associated HC anomalies.However,these studies mainly focused on the global HC,represented by a zonal-mean mass stream function(MSF).Comparatively fewer studies have evaluated HC responses from a regional perspective,partly due to the prerequisite of the Stokes MSF,which prevents us from integrating a regional HC.In this study,we adopt a recently developed technique to construct the three-dimensional structure of HC and evaluate the capability of eight state-of-the-art reanalyses in reproducing the regional HC response to ENSO events.Results show that all eight reanalyses reproduce the spatial structure of HC responses well,with an intensified HC around the central-eastern Pacific but weakened circulations around the Indo-Pacific warm pool and tropical Atlantic.The spatial correlation coefficient of the three-dimensional HC anomalies among the different datasets is always larger than 0.93.However,these datasets may not capture the amplitudes of the HC responses well.This uncertainty is especially large for ENSO-associated equatorially asymmetric HC anomalies,with the maximum amplitude in Climate Forecast System Reanalysis(CFSR)being about 2.7 times the minimum value in the Twentieth Century Reanalysis(20CR).One should be careful when using reanalysis data to evaluate the intensity of ENSO-associated HC anomalies.

Individual alcohol consumption by the population of Russia versus regional living conditions

Background:There are substantial regional differences in drinking alcohol in Russia,both at the population and individual levels.However,the causes of these differences have not been studied yet.Objective:The goal of our study was to examine the effect of regional living conditions on individual alcohol consumption by the population of Russia.Methods:For the analysis,we used data from a cross-sectional epidemiological study conducted in 2013-2014.The final analytical sample included 18,130 people aged 25-64 years.We conducted the interviews face to face,based on which any drinking in the last year,as well as alcohol abuse,were considered as a response.Alcohol abuse was recorded when the respondent consumed 5.75 or more grams of pure ethanol per day(75th percentile of average daily alcohol consumption among alcohol drinkers).The assessment of the regional living conditions was accomplished via integral indexing,which was previously performed based on publicly available data for 2010-2014.Associations were assessed using generalized scoring equations with unchanging standard errors.The associations were expressed by odds ratios(OR)and 95%confidence intervals(C).Results:Deterioration of social conditions and increase in demographic depression in the region of residence increased the odds of any drinking(OR 1.51,95%CI:1.33 to 1.72,P<0.001 and OR 1.22,95%CI:1.05 to 1.41,P=0.oo9,respectively).The odds of alcohol abuse increased with the deterioration of social living conditions and the growth of the industrial development in the region:OR 1.35,95%CI:1.14 to 1.59,P<0.001 and OR 1.16,95%CI:1.05 to 1.28,P=0.002,respectively.Conclusion:Our analysis allowed assessing the impact of the regional living conditions on individual drinking alcohol in the population of Russia.

Online identification and extraction method of regional large-scale adjustable load-aggregation characteristics

This article introduces the concept of load aggregation,which involves a comprehensive analysis of loads to acquire their external characteristics for the purpose of modeling and analyzing power systems.The online identification method is a computer-involved approach for data collection,processing,and system identification,commonly used for adaptive control and prediction.This paper proposes a method for dynamically aggregating large-scale adjustable loads to support high proportions of new energy integration,aiming to study the aggregation characteristics of regional large-scale adjustable loads using online identification techniques and feature extraction methods.The experiment selected 300 central air conditioners as the research subject and analyzed their regulation characteristics,economic efficiency,and comfort.The experimental results show that as the adjustment time of the air conditioner increases from 5 minutes to 35 minutes,the stable adjustment quantity during the adjustment period decreases from 28.46 to 3.57,indicating that air conditioning loads can be controlled over a long period and have better adjustment effects in the short term.Overall,the experimental results of this paper demonstrate that analyzing the aggregation characteristics of regional large-scale adjustable loads using online identification techniques and feature extraction algorithms is effective.

Current evidence on artificial intelligence in regional anesthesia

The recent advancement in regional anesthesia(RA)has been largely attributed to ultrasound technology.However,the safety and efficiency of ultrasound-guided nerve blocks depend upon the skill and experience of the performer.Even with adequate training,experience,and knowledge,human-related limitations such as fatigue,failure to recognize the correct anatomical structure,and unintentional needle or probe movement can hinder the overall effectiveness of RA.The amalgamation of artificial intelligence(AI)to RA practice has promised to override these human limitations.Machine learning,an integral part of AI can improve its performance through continuous learning and experience,like the human brain.It enables computers to recognize images and patterns specifically useful in anatomic structure identification during the performance of RA.AI can provide real-time guidance to clinicians by highlighting important anatomical structures on ultrasound images,and it can also assist in needle tracking and accurate deposition of local anesthetics.The future of RA with AI integration appears promising,yet obstacles such as device malfunction,data privacy,regulatory barriers,and cost concerns can deter its clinical implementation.The current mini review deliberates the current application,future direction,and barrier to the application of AI in RA practice.

Analysis of Regional Difference of Agricultural Land Productivity in Heilongjiang Province

The sustenance of humanity is contingent upon the production of food.The foundation of this production is agriculture,which in turn is dependent upon the cultivation of the land.As a fundamental element of agricultural advancement,the rational development and utilization of land play a pivotal role in the process of rural revitalization.Agricultural land productivity serves as a principal indicator of the efficacy of land utilization and the extent of agricultural advancement.Nevertheless,there is a paucity of research examining the productivity of agricultural land,particularly a lack of specialized research on large agricultural provinces.In light of the aforementioned considerations,this paper presents a comprehensive examination of agricultural land productivity and its regional variations in Heilongjiang Province in 2022,with the aid of pertinent statistical data.The findings of the analysis indicate that among the prefecture-level cities,Daqing and Suihua exhibit the highest levels of agricultural land productivity.Additionally,Zhaodong City,Zhaozhou,Qinggang,Wangkui,and Lanxi counties exhibit high levels of agricultural land productivity within their respective prefecture-level cities.There are notable disparities in agricultural land productivity across various regions,including Yichun,Heihe,Harbin,Daqing,Hegang,and Suihua.In contrast,other regions demonstrate a more balanced spatial distribution.In order to facilitate the prosperous development of the agricultural industry in Heilongjiang Province,it is essential to optimize the spatial planning of the land,to investigate the potential for agricultural development in each region,to establish effective collaboration between resources and industries,and to create a development synergy that will collectively advance rural revitalization.

Resilience-Oriented Load Restoration Method and Repair Strategies for Regional Integrated Electricity-Natural Gas System

The rising frequency of extreme disaster events seriously threatens the safe and secure operation of the regional integrated electricity-natural gas system(RIENGS).With the growing level of coupling between electric and natural gas systems,it is critical to enhance the load restoration capability of both systems.This paper proposes a coordinated optimization strategy for resilience-enhanced RIENGS load restoration and repair scheduling and transforms it into a mixed integer second-order cone programming(MISOCP)model.The proposed model considers the distribution network reconfiguration and the coordinated repair strategy between the two systems,minimizing the total system load loss cost and repair time.In addition,a bi-directional gas flow model is used to describe the natural gas system,which can provide the RIENGS with more flexibility for load restoration during natural gas system failure.Finally,the effectiveness of the proposed approach is verified by conducting case studies on the test systems RIENGS E13-G7 and RIENGS E123-G20.

Specialization and Coordination: New Paradigm, Theory, and Path for Regional Development

In its new development stage,China seeks to derive new dynamism from reform and opening up at a higher level to boost consumption and services.This process coincides with a further differentiation of comparative advantages across regions.Economic activity and population will continue to concentrate in clusters in coastal and central cities amid a continuous outflow of population from remote areas.Development expansion from coastal to interior regions and from central cities to the periphery will promote a new regional development paradigm of“dual centers and periphery”.Therefore,China’s regional development strategy should follow the new theory of seeking relative equilibrium amid development,identify regions of population inflow and outflow,and explore a new development path of regional specialization and coordination.By deepening market reforms and increasing central government coordination,the country is poised to improve the spatial allocation of resources and unleash institutional dividends in the process of developing a unified national market.

Asia Pacific Regional Young Professional Campaign held in Shenzhen

Jointly supported by the Secretariat of IEC and SAC,the 2024 Asia Pacific Regional Young Professional(APRE YP)Campaign was successfully held in Shenzhen from June 25 to 30.The event was hosted by the Quality and Standards Academy,Shenzhen Technology University(SZTU),guided by the IEC Asia-Pacific Regional Center and the IEC Academy&Capacity Building.The 6-day event included roundtable discussion,theme discussion,expert lectures,business practice,and other activities,which were participated by 27 young experts from Singapore,Malaysia,Thailand,Vietnam,Laos,Myanmar,Cambodia,Russia,and China.

Training Mode of Design Talents under the Concept of Regional Revitalization and Industrial Upgrading

Based on the background of the revitalization of Northeast China and industrial transformation,with the goal of serving society with design,leading the future with design,and revitalizing the economy with design,we adhere to the innovative,comprehensive and cultural design talent cultivation concept,fully practice the“student-centered,output-oriented,continuously-improving”educational philosophy taking quality as the first priority,and continuously improve the theoretical system and implementation path for cultivation of postgraduate talents in design science,hoping to optimize the entire process of talent cultivation.Meanwhile,on the basis of“fostering character and civic virtue,cultivating people in a three-all manner,and cultivating people from five aspects simultaneously”,we cultivate high-quality design talents with brand-new models and ideas,through a series of educational reform measures,such as strategic cooperation,resource integration,systematic sorting,quality improvement,standard formulation,strengthening characteristics,platform construction,so that the quality of talents and social development can be perfectly integrated and mutually assist each other to achieve a win-win effect,and the training of design talents can be implemented and serve the society.

Prostate cancer temporal and regional trends in Brazil

Objectives:The Brazilian Unified Health System(SistemaÚnico de Saúde−SUS)is the universal public healthcare system of Brazil that maintains a nationwide database of its patients.Our primary objective was to analyze regional and temporal trends,while our secondary goal was to establish correlations between states’health economy status and their prostate cancer(PCa)epidemiology.Methods:We analyzed Brazil’s nationwide data on prostate cancer(PCa)incidence,mortality,and care gathered between 2013 and 2021 by the Information Technology Department of SUS(DATA-SUS),updated monthly using the International Classification of Diseases(ICD-10)code.Results:In the period,273,933 new cases of PCa and 135,336 PCa deaths were reported in men aged 50 years or over in Brazil.The median annual PCa-specific incidence rate(PCSIR)ranged from 14.7 in the Southeast to 6.9 in the North region and the median annual PCa-specific mortality rate(PCSMR)ranged from 7.7 in the Northeast to 6.0 in the South region(per 10,000 men>50).The median annual mortality to incidence ratio(MIR)was highest in the North(0.88)and lowest in the Southeast region(0.44).There were significant regional differences in PCa treatment rates(per new cases);the Midwest region had the highest median annual surgery rate(0.63)while the North region had the highest median annual systemic therapy rate(0.75)and the lowest radiation therapy rate(0.06).Temporal analysis of the data showed significant change in annual rate trends after the year 2018 for PCSIR(coefficient[β]=+3.66,p<0.001),any treatment(β=−0.06,p=0.016),surgery([SR]β=+0.05,p=0.017)radiation therapy([RTR]β=−0.06,p=0.005)and systemic therapy([STR]β=−0.10,p=0.002).After the 2020 pandemic,annual PCSIR decreased(β=−2.15,p=0.002)but annual PCSMR,MIR,and treatment rates remained stable.Correlation studies showed that the PCSIR was strongly negatively correlated with STR(p<0.001)and positively correlated with RTR(p=0.004).MIR was positively correlated with STR(p<0.001)and negatively correlated with the number of robotic surgical systems per million population(p=0.003).Conclusion:Our data shows that PCa care is dependent on the region and is likely influenced by access to treatment options.Furthermore,changes after the year 2018 underscore the influence of international guidelines on Brazilian clinicians’decision-making especially concerning population screening which in turn affected incidence and treatment rates.Limitation of our study includes limited patientrelated information and data on private practices as well as an unknown impact of traveling patients.