Early Treatment Outcome of Humeral Shaft Fracture Non-Union in Adults: Comparative Study of Plating versus Interlocking Nailing

Background: Fractures of humeral shaft in adults are common injuries. Humeral shafts non-union either from late presentation after initial treatment by traditional bone setters or failed non-operative orthodox care is a major problem in this part of the world. This non-union is a major treatment challenge with increased cost of care and morbidity in this part of the world. Humeral shaft non-union can be treated with locked intra-medullary nailing (LIMN) or dynamic compression plating (DCP). Study on comparison of these methods of fixation in this part of the world is scarce in literature search, hence the reason for this study. Objective: The objectives of this study are: (1) to compare early clinical outcome following fixation of humeral shaft fracture nonunion with DCP versus LIMN;(2) to compare the time of radiologic fracture union of DCP with LIMN;(3) to compare complications following fixation of humeral shaft fracture nonunion with DCP versus LIMN. Patients and Methods: This was a randomized control study done for 2 years in which fifty adult patients with humeral shaft non-union were recruited. The patients were grouped into 2 (P = DCP & N = LIMN). Forty five of the patients completed the follow up periods of the study and then analyzed. The P group had ORIF with DCP while the N group had ORIF with LIMN. Both groups had grafting with cancellous bones. Each patient was followed up for a period of 6 months at the time which radiographic union is expected. Any patient without clinical and/or radiographic evidence of union after six months of surgery was diagnosed as having recurrent non-union. The data generated was analyzed using SPSS Version 23. The results were presented in charts and tables. The paired t-test was used while considering p value Result: Forty five patients completed follow up. There was a male preponderance (4:1), right humerus predominated (3:2). Motor vehicular accidents were the commonest cause of the fractures (62%). Most non-union fractures occurred at the level of the middle 3rd of the humeral shaft (60%). Failed TBS treatment was the commonest indication for the osteosynthesis (71%). More patients had plating (53%) compared to 47% who had LIMN. Most patients (93.4%) had union between 3 to 6 months irrespective of fixation type with no significant statistical difference between the union rate of DCP and LIMN (p value 0.06) with similar functional outcome and complication rates irrespective of the type of fixation. Conclusion: This study showed that the success rates in term of fracture union, outcome functional grades and complication rates were not directly dependent on the types of the fixation: plating or locked intra-medullary nailing.

Characteristics of early gastric tumors with different differentiation and predictors of long-term outcomes after endoscopic submucosal dissection

BACKGROUND Gastric cancer is a common malignant tumor of the digestive tract,and endosco-pic submucosal dissection(ESD)is the preferred treatment for early-stage gastric cancer.The analysis of the epidemiological characteristics of gastric mucosal tumors with different differentiation degrees and the influencing factors of long-term ESD efficacy may have certain significance for revealing the development of gastric cancer and ESD.AIM To analyze the features of gastric mucosal tumors at different differentiation levels,and to explore the prognostic factors of ESD.METHODS We retrospectively studied 301 lesions in 285 patients at The Second Affiliated Hospital of Xi'an Jiaotong University from 2014 to 2021,according to the latest Japanese guidelines(sixth edition),and divided them into low-grade intrae-pithelial neoplasia(LGIN),high-grade intraepithelial neoplasia(HGIN),and computed tomography at 3,6 and 12 months after ESD.We compared clinicopathologic characteristics,ESD efficacy,and complications with different degrees of differentiation,and analyzed the related factors associated with ESD.RESULTS HGIN and differentiated carcinoma patients were significantly older compared with LGIN patients(P<0.001)and accounted for more 0-IIc(P<0.001),atrophic gastritis was common(P<0.001),and irregular microvascular patterns(IMVPs)and demarcation lines(DLs)were more obvious(P<0.001).There was more infiltration in the undifferentiated carcinoma tissue(P<0.001),more abnormal folds and poorer mucosal peristalsis(P<0.001),and more obvious IMVPs,irregular microsurface patterns and DLs(P<0.05)than in the LGIN and HGIN tissues.The disease-free survival rates at 2,5,and 8 years after ESD were 95.0%,90.1%,and 86.9%,respectively.Undifferen-tiated lesions(HR 5.066),white moss(HR 7.187),incomplete resection(HR 3.658),and multiple primary cancers(HR 2.462)were significantly associated with poor prognosis.CONCLUSION Differentiations of gastric mucosal tumors have different epidemiological and endoscopic characteristics,which are closely related to the safety and efficacy of ESD.

Arlenea delicata gen.et sp.nov.,a new ephedroid plant from the Early Cretaceous Crato Formation,Araripe Basin,Northeast Brazil

Ephedroid macrofossils have been widely documented in Cretaceous deposits,including numerous from the Lower Cretaceous Yixian Formation of NE China.However,few ephedroid macrofossils have been reported from South America.Herein,we describe a new plant of the family Ephedraceae,Arlenea delicata gen.et sp.nov.,from the Lower Cretaceous Crato Formation of the Araripe Basin,Northeast Brazil,based on the vegetative and reproductive structures.It has the typical morphological characteristics of ephedroid plants,including fertile reproductive branches,opposite phyllotaxy,terminal female cones,a sympodial branching system,longitudinally striated internodes,and swollen nodes.Our new finding is unusual in having inner chlamydosperms subtended by two pairs of bracts,reproductive units connected to branches through swollen receptacles and a smooth seed surface.This new ephedroid taxon from the Crato Formation increases our understanding of plant diversity of this group during the Early Cretaceous.Furthermore,the general morphology(fleshy bracts and enlarged receptacles)of this new fossil discovery indicates that seeds of this plant may have been dispersed by animals such as pterosaurs(mainly the Tapejaridae)and birds(Enantiornithes and Ornituromorpha).If true,this would explain the cosmopolitan distribution of Ephedraceae in the Lower Cretaceous.

Sedimentary Environment and Mineralization of the Black Shale Polymetallic Layer in the Early Cambrian,SW China:Constraints from in situ LA-ICP-MS Analysis of Pyrite

A polymetallic layer is usually developed at the bottom of the early Cambrian black shale in Guizhou Province.The mineral that makes up the polymetallic layer is related to the sedimentary facies.To analyze the differentiation mechanism between polymetallic deposits(Ni-Mo and V),the Zhijin Gezhongwu profile located in the outer shelf and the Sansui Haishan V deposit located in the lower slope are selected to study the in situ sulfur isotopes and trace elements of pyrite.The results show that δ^(34)S values of pyrite vary widely from−7.8‰to 28‰in the Gezhongwu profile,while the δ^(34)S values are relatively uniform(from 27.8‰to 38.4‰)in the Haishan profile.The isotopic S composition is consistent with the transition that occurs in the sedimentary phase from the shelf to the deep sea on the transgressive Yangtze platform;this indicates that the δ^(34)SO_(4)^(2−)values in seawater must be differently distributed in depositional environments.The sulfur in the Ni-Mo layer is produced after the mixing of seawater and hydrothermal fluid,while the V layer mainly originates from seawater.Overall,the Ni-Mo and V deposits have been differentiated primarily on the basis of the combined effect of continental weathering and hydrothermal fluid.

Early identification of stroke through deep learning with multi-modal human speech and movement data

Early identification and treatment of stroke can greatly improve patient outcomes and quality of life.Although clinical tests such as the Cincinnati Pre-hospital Stroke Scale(CPSS)and the Face Arm Speech Test(FAST)are commonly used for stroke screening,accurate administration is dependent on specialized training.In this study,we proposed a novel multimodal deep learning approach,based on the FAST,for assessing suspected stroke patients exhibiting symptoms such as limb weakness,facial paresis,and speech disorders in acute settings.We collected a dataset comprising videos and audio recordings of emergency room patients performing designated limb movements,facial expressions,and speech tests based on the FAST.We compared the constructed deep learning model,which was designed to process multi-modal datasets,with six prior models that achieved good action classification performance,including the I3D,SlowFast,X3D,TPN,TimeSformer,and MViT.We found that the findings of our deep learning model had a higher clinical value compared with the other approaches.Moreover,the multi-modal model outperformed its single-module variants,highlighting the benefit of utilizing multiple types of patient data,such as action videos and speech audio.These results indicate that a multi-modal deep learning model combined with the FAST could greatly improve the accuracy and sensitivity of early stroke identification of stroke,thus providing a practical and powerful tool for assessing stroke patients in an emergency clinical setting.

Determinants of Early Survival of Breast Cancer Patients in Yaoundé-Cameroon

Introduction: Breast cancer is one of the leading causes of death worldwide. We carried out this study with the aim of evaluating the determinants of early survival of women with breast cancer in two hospitals in the city of Yaoundé. Methodology: This was an analytical cross-sectional study with retrospective and prospective data collection of breast cancer patients during 6 years in two Hospitals of Yaoundé from January 2017 to December 2022. We consulted the files in search of epidemiological, clinical, paraclinical, therapeutic and survival variables. We completed the survival data directly from the patients or their relatives after their consent. We analyzed the data using SPSS version 23.0 software. Survival analysis was done using the Kaplan-Meier method and survival curves were compared using the Log Rank test. Factors influencing survival were evaluated using the Cox model. The significance threshold (P value) was set at 0.05 at 95% confidence interval. The study was approved by the ethics committees. Results: We included 500 patients whose ages varied between 22 and 83 years with a mean age of 47.19 ± 11.61 years. The most represented age group was 30 to 45 years old (45.8%). Less than half (41.6%) were postmenopausal. The most frequent reason for consultation was a breast lump (79.9%). The most common clinical stage at presentation was stage-3 (47.6%). Infiltrating ductal carcinoma was the most represented histological type (84.7%). The most represented histological grade was grade 2 (40.2%). Immunohistochemistry was performed in 34.20% of cases. The most represented molecular subtype was triple negative (41.8%) followed by Luminal A (30%). Concerning treatment, 17.2% did not receive any, 45% had surgery, 79.4% had chemotherapy, 34.2% hormone therapy, and 14.6% radiotherapy. The survival of patients with breast cancer at 1, 2, 3, 4 and 5 years was respectively 90.6%;83.1%;74.2%;69.8% and 59.2%. The median survival was not reached;however, the first quartile (Q1) was 36 months (3 years). Independent factors associated with reduced survival were breast ulceration (aHR = 3.23;p = 0.002), bilateral tumor location (aHR = 9.2;p < 0.001) and clinical stage 3 (aHR = 1.72;p = 0.010) while patients classified ACR3 on imaging (aHR = 0.19;p = 0.005) had improved survival. Conclusion: Breast cancer survival from 1 to 5 years decrease from 90 to 59%. Mortality was highest in the first 40 months. Independent factors associated with reduced survival were breast ulceration, bilateral tumor location and clinical stage 3 while patients classified ACR3 on imaging had improved survival.

Early Nursing Intervention in Children with Viral Meningitis

Aim: To explore the effect of a WeChat peer education program in children with severe viral meningitis combined with respiratory failure. Design: Retrospective cohort study. Methods: Patients who had severe viral meningitis combined with respiratory failure, were admitted to the hospital from March 2017 to June 2018, and who received the WeChat-based nursing intervention were included. Patients who received routine nursing were used as controls. The family’s emotional state, self-care ability, and rehabilitation were analyzed. Results: There were 37 patients in the WeChat group (19 boys (51.3%) and 18 girls (48.7%);mean of 5.1 ± 2.4 years of age) and 37 controls (20 boys (54.1%) and 17 girls (45.9%);mean of 5.9 ± 2.4 years of age) (all P > 0.05). After nursing, improvements in the self-assessed anxiety score and self-assessed depression score were better in the WeChat group (anxiety: -29.2% vs. -20.3%, P = 0.015;depression: -25.2% vs. -15.4%, P = 0.009). After nursing, the improvements in the condition management ability scale and condition management difficulty scale scores were better in the WeChat group (ability: +80.5% vs. +44.4%. P = 0.001;difficulty: +58.4% vs. +37.8%, P = 0.003). After nursing, the improvement in the Fugl-Meyer score was better in the WeChat group (+138.0% vs. +53.0%, P Conclusion: Early nursing intervention combined with WeChat peer education can improve the emotional state of children with severe viral meningitis combined with respiratory failure and their caregivers. Impact: Viral meningitis is associated with a good prognosis, but central nervous system complications can be observed. Early intervention is the key to a good prognosis. Internet-based nursing and coaching can improve self-efficacy and care ability in patients with various conditions, as well as improve the emotional state of the children and their caregivers. The research might have an impact on any children’s hospital that deals with viral meningitis.

Early monitoring values of oncogenic signalling molecules for hepatocellular carcinoma

The prevention and early diagnosis of liver cancer remains a global medical challenge.During the malignant transformation of hepatocytes,a variety of oncogenic cellular signalling molecules,such as novel high mobility group-Box 3,angiopoietin-2,Golgi protein 73,glypican-3,Wnt3a(a signalling molecule in the Wnt/β-catenin pathway),and secretory clusterin,can be expressed and secreted into the blood.These signalling molecules are derived from different signalling pathways and may not only participate in the malignant transformation of hepatocytes but also become early diagnostic indicators of hepatocarcinogenesis or specific targeted molecules for hepatocellular carcinoma therapy.This article reviews recent progress in the study of several signalling molecules as sensitive biomarkers for monitoring hepatocarcinogenesis.

Effect of preload forces on multidimensional signal dynamic behaviours for battery early safety warning

Providing early safety warning for batteries in real-world applications is challenging.In this study,comprehensive thermal abuse experiments are conducted to clarify the multidimensional signal evolution of battery failure under various preload forces.The time-sequence relationship among expansion force,voltage,and temperature during thermal abuse under five categorised stages is revealed.Three characteristic peaks are identified for the expansion force,which correspond to venting,internal short-circuiting,and thermal runaway.In particular,an abnormal expansion force signal can be detected at temperatures as low as 42.4°C,followed by battery thermal runaway in approximately 6.5 min.Moreover,reducing the preload force can improve the effectiveness of the early-warning method via the expansion force.Specifically,reducing the preload force from 6000 to 1000 N prolongs the warning time(i.e.,227 to 398 s)before thermal runaway is triggered.Based on the results,a notable expansion force early-warning method is proposed that can successfully enable early safety warning approximately 375 s ahead of battery thermal runaway and effectively prevent failure propagation with module validation.This study provides a practical reference for the development of timely and accurate early-warning strategies as well as guidance for the design of safer battery systems.

Women Breast Cancer: Knowledge, Attitudes, Practices and Factors Associated with Early Screening in the Municipality of Abomey-Calavi in Benin in 2018

Background: Breast cancer is the dominant cancer in women in both developed and developing countries. The objective of this study was to assess the knowledge, attitudes, practices and factors associated with early breast cancer screening among women in the Municipality of Abomey-Calavi in Benin. Methods: This was a cross-sectional, descriptive, analytical study with prospective data collection from October 1 to 8, 2018, involving 1740 women in the Municipality of Abomey-Calavi, aged 18 years or older and selected by WHO four-stage random cluster sampling. Consenting women who were mentally competent, 18 years of age or older at the time of the survey, and residing continuously in the Municipality of Abomey-Calavi for the last six months prior to the survey were included. On the other hand, women who belonged to a breast cancer prevention service, women in whom secondary screening was noted, or non-consenting women were not included. The initial minimum size was estimated by the Schwartz formula with a cluster effect of k = 2. Information was collected by questionnaire survey, entered with Epidata 3.1. Fr and analyzed with R Studio 3.5.1. software. Results: The mean age of the women surveyed was 32.0 ± 11.5 years with a range of 18 and 71 years. Regarding knowledge, the clinical manifestation known by the majority of women was the presence of a nodule (68.50%). In the series, 1308 (75.17%) declared having heard about breast cancer once before, either on the radio, television or from friends and 726 (55.50%) had heard about breast cancer screening. Five hundred and twelve (70.52%) of the 726 who had heard of breast cancer said they knew that breast cancer could be screened earlier. Breast self-examination was the most cited screening method (67.58%). The disease is of natural origin according to 37.84% of them. Regarding attitudes and practices, the prevalence of early breast cancer screening was 12.93%, of which 11.67% declared that they had checked themselves to know whether they were carriers of the disease or not. The main means of the early screening used was breast self-examination (85.78%). Factors associated with early breast cancer screening found in multivariate analysis were age (≤50 years), education level (increasingly higher), marital status (married/coupled), place of residence (downtown), and socioeconomic level (average/high). Conclusion: The frequency of early breast cancer screening among women is still low in the municipality of Abomey-Calavi, although they have a good knowledge of the disease. This raises the need to strengthen awareness of early breast cancer screening.

Comparative Study of Early Neonatal Complications between the First and Second Twin during Twin Vaginal Deliveries at the Yaounde Gynaeco-Obstetric and Pediatric Hospital, and the Yaounde Central Hospital

Introduction: Twin birth is the expulsion of two fetuses and their appendages out of the woman’s reproductive tract. It’s a high-risk delivery because of the high frequency of maternal, fetal and neonatal complications. Few studies exist on the comparative prognoses of twins. Our objective was to compare early neonatal complications in first and second twins. Methods: We carried out a cross-sectional prospective study from January 2 to April 30, 2020 (4 months) at the Yaounde Gynaeco-Obstetric and Pediatric Hospital, and the Yaounde Central Hospital. Data collected were analyzed using IBM SPSS version 23. Descriptive statistics were done in frequencies and percentages, means and standard deviations. Paired-sample student's t-test were used to compare means. McNemar’s Chi-square and Ficher’s exact tests were used to compare proportions. Statistical significance was set at p-values less than 0.05. Results: Of a total of 2183 deliveries during the study period, 43 (1.96%) were twin vaginal deliveries. Among the 43 women, 41 consented to have their newborns participate in the study. Overall, APGAR scores were better for the first twins at the first (p = 0.004) and fifth (p = 0.031) minutes than for the second twins. Although both twins had complications and that there were 4 neonatal deads of the second twin, there was no relationship between studied complications and the rank of the twin (p = 0.310). Conclusion: As the APGAR score seemed to be better for first twins, clinicians should pay more attention during twin births, in order to improve the prognosis of the second twin.

Present and future of new systemic therapies for early and intermediate stages of hepatocellular carcinoma

Hepatocellular carcinoma(HCC)is a high mortality neoplasm which usually appears on a cirrhotic liver.The therapeutic arsenal and subsequent prognostic outlook are intrinsically linked to the HCC stage at diagnosis.Notwithstanding the current deployment of treatments with curative intent(liver resection/local ablation and liver transplantation)in early and intermediate stages,a high rate of HCC recurrence persists,underscoring a pivotal clinical challenge.Emergent systemic therapies(ST),particularly immunotherapy,have demonstrate promising outcomes in terms of increase overall survival,but they are currently bound to the advanced stage of HCC.This review provides a comprehensive analysis of the literature,encompassing studies up to March 10,2024,evaluating the impact of novel ST in the early and intermediate HCC stages,specially focusing on the findings of neoadjuvant and adjuvant regimens,aimed at increasing significantly overall survival and recurrence-free survival after a treatment with curative intent.We also investigate the potential role of ST in enhancing the downstaging rate for the intermediate-stage HCC initially deemed ineligible for treatment with curative intent.Finally,we critically discuss about the current relevance of the results of these studies and the encouraging future implications of ST in the treatment schedules of early and intermediate HCC stages.

Provenance of Conglomerate and Sandstone from Early Permian Shoushangou Formation in Xi Ujimqin,Inner Mongolia:Implications for Understanding Paleo-Asian Ocean Subduction

During the Late Carboniferous to Early Permian,a rift was formed by post-collisional extension after ocean closure or an island arc-related basin formed by Paleo-Asian Ocean(PAO)subduction in the Xi Ujimqin area.Nevertheless,the closure time of the PAO is still under debate.Thus,to identify the origin of the PAO,the geochemistry and U-Pb age of zircons were analyzed for the extra-large deep marine,polymict clastic boulders and sandstones in the Shoushangou Formation within the basin.The analyses revealed magmatic activity and tectonic evolution.The conglomerates include megaclasts of granite(298.8±9.1 Ma)and granodiorite porphyry(297.1±3.1 Ma),which were deposited by muddy debris flow.Results of this study demonstrated that the boulders of granitoids have the geochemistry of typical I-type granite,characterized by low Zr+Nb+Ce+Y and low Ga/Al values.The granitoid boulders were formed in island arc setting,indicating the presence of arc magmatism in the area that is composed of the Late Carboniferous to Early Permian subduction-related granitoid in southern Xi Ujimqin.Multiple diagrams for determining sedimentary provenance using major and trace elements indicate that Shoushangou sediments originated from continental island arc-related felsic rocks.Detrital zircon U-Pb age cluster of 330–280 Ma was obtained,indicating input from granite,ophiolite,Xilin Gol complex,and Carboniferous sources to the south.The basin was geographically developed behind the arc during the Early Permian period because the outcropped intrusive rocks in the Late Carboniferous to Early Permian form a volcanic arc.The comprehensive analyses of source areas suggest that Shoushangou sediments developed in a backarc basin in response to the northward subduction of the PAO.The backarc basin and intrusive rocks,in addition to previously published Late Carboniferous to Early Permian magmatic rocks of arc unit in Xilin Gol,confirm the presence of an Early Permian trencharc-basin system in the region,represented by the Baolidao arc and Xi Ujimqin backarc basin.This study highlights the importance and potential of combined geochemical and geochronological studies of conglomerates and sandstone for reconstructing the geodynamic setting of a basin.

Early Triassic Volcanic Rocks in the Western Yarlung Zangbo Suture Zone:Implications for the Opening of the Neo-Tethys Ocean

In this study,zircon U-Pb dating of volcanic rocks from the Zhongba ophiolite of the Yarlung Zangbo Suture Zone(YZSZ)in southern Xizang(Tibet)yielded an age of 247±3 Ma.According to whole rock geochemical and Sr-NdPb isotopic data,the Early Triassic samples could be divided into two groups:Group 1 with P-MORB affinity,showing initial^(87)Sr/^(86)Sr ratios of 0.70253–0.70602,ε_(Nd)(t)values of 4.2–5.3,(^(206)Pb/^(204)Pb)_(t)ratios of 16.353–18.222,(^(207)Pb/^(204)Pb)_(t)ratios of 15.454–15.564,and(^(208)Pb/^(204)Pb)_(t)ratios of 35.665–38.136;Group 2 with OIB affinity,showing initial^(87)Sr/^(86)Sr ratios of 0.70249–0.70513,ε_(Nd)(t)values of 4.4–4.9,(^(206)Pb/^(204)Pb)_(t)ratios of 17.140–18.328,(^(207)Pb/^(204)Pb)_(t)ratios of 15.491–15.575,and(^(208)Pb/^(204)Pb)_(t)ratios of 36.051–38.247.Group 2 rocks formed by partial melting of the mantle source enriched by a former plume,and assimilated continental crustal material during melt ascension.The formation of Group 1 rocks corresponds to the mixing of OIB melts,with the same components as Group 2 and N-MORBs.The Zhongba Early Triassic rocks belong to the continental margin type ophiolite and formed in the continental–oceanic transition zone during the initial opening of the Neo-Tethys in southern Xizang(Tibet).

Leveraging machine learning for early recurrence prediction in hepatocellular carcinoma:A step towards precision medicine

The high rate of early recurrence in hepatocellular carcinoma(HCC)post curative surgical intervention poses a substantial clinical hurdle,impacting patient outcomes and complicating postoperative management.The advent of machine learning provides a unique opportunity to harness vast datasets,identifying subtle patterns and factors that elude conventional prognostic methods.Machine learning models,equipped with the ability to analyse intricate relationships within datasets,have shown promise in predicting outcomes in various medical disciplines.In the context of HCC,the application of machine learning to predict early recurrence holds potential for personalized postoperative care strategies.This editorial comments on the study carried out exploring the merits and efficacy of random survival forests(RSF)in identifying significant risk factors for recurrence,stratifying patients at low and high risk of HCC recurrence and comparing this to traditional COX proportional hazard models(CPH).In doing so,the study demonstrated that the RSF models are superior to traditional CPH models in predicting recurrence of HCC and represent a giant leap towards precision medicine.

Early warning method for thermal runaway of lithium-ion batteries under thermal abuse condition based on online electrochemical impedance monitoring

Early warning of thermal runaway(TR)of lithium-ion batteries(LIBs)is a significant challenge in current application scenarios.Timely and effective TR early warning technology is urgently required considering the current fire safety situation of LIBs.In this work,we report an early warning method of TR with online electrochemical impedance spectroscopy(EIS)monitoring,which overcomes the shortcomings of warning methods based on traditional signals such as temperature,gas,and pressure with obvious delay and high cost.With in-situ data acquisition through accelerating rate calorimeter(ARC)-EIS test,the crucial features of TR were extracted using the RReliefF algorithm.TR mechanisms corresponding to the features at specific frequencies were analyzed.Finally,a three-level warning strategy for single battery,series module,and parallel module was formulated,which can successfully send out an early warning signal ahead of the self-heating temperature of battery under thermal abuse condition.The technology can provide a reliable basis for the timely intervention of battery thermal management and fire protection systems and is expected to be applied to electric vehicles and energy storage devices to realize early warning and improve battery safety.

Early gastric cancer recurrence after endoscopic submucosal dissection:Not to be ignored!

This editorial comments on the article“Efficacy of multi-slice spiral computed tomography in evaluating gastric cancer recurrence after endoscopic submucosal dissection”.We focus on the importance of paying more attention to postendoscopic submucosal dissection(ESD)gastric cancer recurrence in patients with early gastric cancer(EGC)and how to manage it effectively.ESD has been a wellknown treatment and the mainstay for EGC,with the advantages of less invasion and fewer complications when compared with traditional surgical procedures.Despite a lower local recurrence rate after ESD,the problem of postoperative recurrence in patients with EGC has become increasingly non-ignorable with the global popularization of ESD technology and the increasing number of post-ESD patients.

ARHCS (Automatic Rainfall Half-Life Cluster System): A Landslides Early Warning System (LEWS) Using Cluster Analysis and Automatic Threshold Definition

A significant portion of Landslide Early Warning Systems (LEWS) relies on the definition of operational thresholds and the monitoring of cumulative rainfall for alert issuance. These thresholds can be obtained in various ways, but most often they are based on previous landslide data. This approach introduces several limitations. For instance, there is a requirement for the location to have been previously monitored in some way to have this type of information recorded. Another significant limitation is the need for information regarding the location and timing of incidents. Despite the current ease of obtaining location information (GPS, drone images, etc.), the timing of the event remains challenging to ascertain for a considerable portion of landslide data. Concerning rainfall monitoring, there are multiple ways to consider it, for instance, examining accumulations over various intervals (1 h, 6 h, 24 h, 72 h), as well as in the calculation of effective rainfall, which represents the precipitation that actually infiltrates the soil. However, in the vast majority of cases, both the thresholds and the rain monitoring approach are defined manually and subjectively, relying on the operators’ experience. This makes the process labor-intensive and time-consuming, hindering the establishment of a truly standardized and rapidly scalable methodology on a large scale. In this work, we propose a Landslides Early Warning System (LEWS) based on the concept of rainfall half-life and the determination of thresholds using Cluster Analysis and data inversion. The system is designed to be applied in extensive monitoring networks, such as the one utilized by Cemaden, Brazil’s National Center for Monitoring and Early Warning of Natural Disasters.

Usefulness of the Surgical Apgar Score to Predict the Occurrence of Major Complications in the Early Post-Operative Period of Major Surgeries: Experience of Two Second-Category Hospitals in Cameroon

Objective: The Surgical Apgar Score (SAS) is a tool for intraoperative stratification of the risk of serious complications in the early postoperative period. It varies from 0 to 10 points divided into three risk categories (0 to 4 high, 5 to 7 moderate, 8 to 10 low). The aim of the study was to evaluate its relevance in predicting the appearance of these complications. Material and methods: This descriptive and analytical study was carried out at the “Laquintinie” Hospital in Douala and at the Central Hospital in Yaounde, Cameroon. The main data were collected on a population of patients over 18 years old and recorded on a survey form. They consisted of variables of main interest and exposure variables. Univariate and multivariate statistical analysis using top-down logistic regression models made it possible to evaluate the association of each variable of main interest and each exposure variable. The association was significant at P Results: Of the 88 patients studied, the SAS was 3 hours. In multivariate, this link persisted only and strongly for the SAS OR (IC) 0.1 (0.1 - 0.2) and p = 000. Conclusion: The study found a specific and powerful link between the SAS score < 4 and the occurrence of complications in the early postoperative period, in favor of its relevance in predicting them.

A Comparison between Late Preterm and Term Infants with Respiratory Distress Syndrome, Early-Onset Sepsis, and Neonatal Jaundice in Ecuadorian Newborns

Background: To examine the differences in prevalence of respiratory distress syndrome, early-onset sepsis and jaundice, between late preterm infants versus term infants in Ecuadorian newborns. Methods: Study design: Epidemiological, observational, and cross-sectional, with two cohorts of patients. Settings: IESS Quito Sur Hospital at Quito, Ecuador, from February to April of 2020. Participants: This study included 204 newborns, 102 preterm infants, 102 term infants. Results: There are significant differences between late preterm infants and term infants, with a p-value of 0.000 in the prevalence of early sepsis, 70.59% vs. 35.29%. In respiratory distress syndrome between late and term premature infants, significant differences were observed with a p-value of 0.000, the proportion being 55.58% vs. 24.51% respectively. The prevalence of jaundice is higher in term infants with a p value of 0.002, 72.55%, versus 51.96% in late preterm infants, and the mean value of bilirubins in mg/dL was higher in term infants 14.32 versus 12.33 in late preterm infants;this difference is statistically significant with a p value of 0.004. Admission to the NICU is more frequent in late preterm infants with a p-value of 0.000, being 42.16% for late preterm infants vs. 7.84% in term infants;the mean of the hospital days with p-value 0.005, was higher in late preterm infants 4.97 days vs. 3.55 days for term newborns. Conclusion: Due to the conditions of their immaturity, late preterm infants are 2.86 times more likely to present early sepsis than full-term newborns. It is shown that late preterm infants are 2.69 times more likely to have respiratory distress syndrome compared to term infants, therefore, late preterm infants have a longer hospital stay of 4.97 days versus 3.55 days in term infants. Jaundice and mean bilirubin levels are higher in term infants due to blood group incompatibility and insufficient breastfeeding.