Longitudinally extensive transverse myelitis associated with scrub typhus:A case report

Rationale:Longitudinally extensive transverse myelitis(LETM)is a rare inflammatory demyelinating disease predominantly associated with autoimmune and inflammatory disorders.Scrub typhus can cause a variety of neurological complications,which may result in poor recovery and long-term disability.This report reveals a rare linkage between LETM and scrub typhus.Patient concerns:A 24-year-old female presented with a history of fever for 10 days associated with progressive quadriparesis.Physical examination revealed bilateral lower limb weakness(grade 0/5)and bilateral upper limb weakness(grade 2/5)with reduced sensation below the T3 dermatome.Diagnosis:Scrub typhus presenting with longitudinally extensive transverse myelitis.Interventions:Steroid pulse therapy with antibiotics supported by early intensive rehabilitation.Outcomes:Complete recovery was achieved.Lessons:This case report highlights the importance of considering scrub typhus as a potential cause of LETM in endemic regions,particularly in patients presenting with febrile illness and neurological symptoms.

Assessing the Environmental Impact of Extensive Beef Production in Grazing Lands of Argentina

Because of environmental constraints,beef cattle was for more than a century the only viable farming option in the extensive semiarid and subhumid lands of Argentina and the main source of nutrients for humans as well.However,a growing concern and criticism have risen today about its possible negative impact on the climate and the environment.These worries tend to affect current public opinions,national policies,and international trade.Based on 40 beef cattle farms scattered across different semiarid and subhumid regions of Argentina,here we evaluated the impact of extensive cattle production on carbon,water,and nutrient pollution.Life-Cycle Assessment(LCA)and Land-Based Assessment(LBA)were the two approaches we used here to compare the environmental impact of beef production.While the environmental footprint(EF)resulting from LCA expresses the impact per unit of food,the environmental balance(EB),derived from LBA,aims at quantifying the impact per unit of land.As such,the EB considers both negative and positive impacts on the farm as an integrated system.Following standardized procedures,we evaluated EF and EB up to the farm gate,leaving aside delocalized post-farm impacts such as those of processing,packaging,and transportation that occur beyond the farm gate.In agreement with previous evidence,our results show that the EF tends to decrease as per-head production increases.Correlation coefficients and statistical significance were the following for carbon(R=−0.574;p<0.01),water(R=−0.561;p<0.01),and N(R=−0.704;p<0.01)and Phosphorus(P)pollution(R=−0.802;p<0.01)footprints.On the contrary,the EB seems to be highly sensitive,and as per-hectare beef production increases.Correlations were the following for carbon emissions(CE:R=0.955;p<0.01),water consumption(WC:R=0.822;p<0.01),nitrogen excretion(NE:R=0.948;p<0.01)and phosphorus excretion(PE:R=0.945;p<0.01).What our results suggest is that the notion of EF is useful to evaluate the environmental impact in intensive beef production systems,and the EB is suitable to assess the impact of the extensive ones.In practice,both approaches provide different perspectives on the environmental-impact problem and they should be complementary used.We concluded that the methodological rigidity of EF does not allow proper discrimination among farms in the extensive systems.On the contrary,the EB approach tended to be highly sensitive to detecting differences between individual farms and farmers,thus allowing the identification of successful options for extensive beef production in terms of public image,policy-making,and commercial opportunities.

Origin of nucleation and growth of extension twins in grains unsuitably oriented for twinning during deformation of Mg-1%Al

A large number of anomalous extension twins,with low or even negative twinning Schmid factors,were found to nucleate and grow in a strongly textured Mg-1Al alloy during tensile deformation along the extruded direction.The deformation mechanisms responsible for this behaviour were investigated through in-situ electron back-scattered diffraction,grain reference orientation deviation,and slip trace-modified lattice rotation.It was found that anomalous extension twins nucleated mainly at the onset of plastic deformation at or near grain boundary triple junctions.They were associated with the severe strain incompatibility between neighbour grains as a result from the differentbasal slip-induced lattice rotations.Moreover,the anomalous twins were able to grow with the applied strain due to the continuous activation ofbasal slip in different neighbour grains,which enhanced the strain incompatibility.These results reveal the complexity of the deformation mechanisms in Mg alloys at the local level when deformed along hard orientations.

Diagnostic Study of an Extreme Explosive Cyclone over the Kuroshio/Kuroshio Extension Region

Explosive cyclones(ECs)occur frequently over the Kuroshio/Kuroshio Extension region.The most rapidly intensified EC over the Kuroshio/Kuroshio Extension region during the 42 years(1979-2020)of cold seasons(October-April)was studied to reveal the variations of the key factors at different explosive-developing stages.This EC had weak low-level baroclinicity,mid-level cyclonic-vorticity advection,and strong low-level water vapor convergence at the initial explosive-developing stage.The low-level baroclinicity and mid-level cyclonic-vorticity advection increased substantially during the maximum-deepening-rate stage.The diagnostic analyses using the Zwack-Okossi equation showed that diabatic heating was the main contributor to the initial rapid intensification of this EC.The cyclonic-vorticity advection and warm-air advection enhanced rapidly in the middle and upper troposphere and contributed to the maximum rapid intensification,whereas the diabatic heating weakened slightly in the mid-low troposphere.The relative contribution of the diabatic heating decreased from the initial explosive-developing stage to the maximum-deepening-rate stage due to the enhancement of other factors(the cyclonic-vorticity advection and warm-air advection).Furthermore,the physical factors contributing to this EC varied with the explosive-developing stage.The non-key factors at the initial explosive-developing stage need attention to forecast the rapid intensification.

Establishment of extensively drug-resistant Pseudomonas aeruginosa pneumonia model in rat

Objective:To establish extensively drug-resistant Pseudomonas aeruginosa(XDR-PA)infection-induced pneumonia model in rats.Methods:Twenty-four male SD rats were randomly divided into blank group,low bacterial group,medium bacterial group,and high bacterial group.The low,medium and high bacterial groups were given intratracheal instillation of 0.1 mL of bacterial suspension(bacterial concentration in turn is 7.5×10^(9),3×10^(10),6×10^(10)CFU/mL),while the blank group were given the same volume of sterile normal saline.After modeling,the general conditions of rats in each group were observed,including mental state,hair,respiration,activity,eating,weight,and the survival curve was drawn.The pathological characteristics of lung tissue and the infiltration of inflammatory cells were observed.Pathogenic identification of each group was carried out by bacterial culture of lung tissue homogenate.Results:The general state of the blank group was normal,and the rats in other groups showed signs of mental depression,bristling,shortness of breath,even oral and nasal bleeding,decreased food intake and activity,and significant weight loss,and different degrees of death within 48 hours,the difference was statistically significant(P<0.05).Pathological results showed that the alveolar structure of rats in the blank group was complete,and the alveolar space was clear without exudation.The lung tissue of the low and medium bacterial groups showed obvious inflammatory cell infiltration,alveolar structure destruction,alveolar septum thickening,interstitial edema,but the pathological damage of the medium group was more severe,with a mortality rate of up to 50%,and the mortality rate of the low bacterial group was 17%.In the high bacterial group,red blood cells,inflammatory cells and a large amount of fibrin-like exudation can be seen in the alveolar space,which has the pathological characteristics of acute respiratory failure,and the mortality rate is as high as 67%.The results of bacterial culture of lung tissue homogenate showed that the blank group had no bacterial colonies,while PA colony growth can be seen in low,medium and high bacterial groups.Conclusion:9 Intratracheal instillation of low bacterial count(0.1 mL of 7.5×10^(9) CFU/mL)XDR-PA bacterial suspension can successfully construct a rat pneumonia model of XDR-PA infection.

Efficacy and outcome of extensive intraoperative peritoneal lavage plus surgery vs surgery alone with advanced gastric cancer patients

BACKGROUND Gastric cancer(GC)is one of the most common malignant tumors.After resection,one of the major problems is its peritoneal dissemination and recurrence.Some free cancer cells may still exist after resection.In addition,the surgery itself may lead to the dissemination of tumor cells.Therefore,it is necessary to remove residual tumor cells.Recently,some researchers found that extensive intraoperative peritoneal lavage(EIPL)plus intraperitoneal chemotherapy can improve the prognosis of patients and eradicate peritoneal free cancer for GC patients.However,few studies explored the safety and long-term outcome of EIPL after curative gastrectomy.AIM To evaluate the efficacy and long-term outcome of advanced GC patients treated with EIPL.METHODS According to the inclusion and exclusion criteria,a total of 150 patients with advanced GC were enrolled in this study.The patients were randomly allocated to two groups.All patients received laparotomy.For the non-EIPL group,peritoneal lavage was washed using no more than 3 L of warm saline.In the EIPL group,patients received 10 L or more of saline(1 L at a time)before the closure of the abdomen.The surviving rate analysis was compared by the Kaplan-Meier method.The prognostic factors were carried out using the Cox appropriate hazard pattern.RESULTS The basic information in the EIPL group and the non-EIPL group had no significant difference.The median follow-up time was 30 mo(range:0-45 mo).The 1-and 3-year overall survival(OS)rates were 71.0%and 26.5%,respectively.The symptoms of ileus and abdominal abscess appeared more frequently in the non-EIPL group(P<0.05).For the OS of patients,the EIPL,Borrmann classification,tumor size,N stage,T stage and vascular invasion were significant indicators.Then multivariate analysis revealed that EIPL,tumor size,vascular invasion,N stage and T stage were independent prognostic factors.The prognosis of the EIPL group was better than the non-EIPL group(P<0.001).The 3-year survival rate of the EIPL group(38.4%)was higher than the non-EIPL group(21.7%).For the recurrence-free survival(RFS)of patients,the risk factor of RFS included EIPL,N stage,vascular invasion,type of surgery,tumor location,Borrmann classification,and tumor size.EIPL and tumor size were independent risk factors.The RFS curve of the EIPL group was better than the non-EIPL group(P=0.004),and the recurrence rate of the EIPL group(24.7%)was lower than the non-EIPL group(46.4%).The overall recurrence rate and peritoneum recurrence rate in the EIPL group was lower than the non-EIPL group(P<0.05).CONCLUSION EIPL can reduce the possibility of perioperative complications including ileus and abdominal abscess.In addition,the overall survival curve and RFS curve were better in the EIPL group.

Estimation of Displacement and Extension due to Reverse Drag of Normal Faults: Forward Method

In the case of reverse drag of normal faulting, the displacement and horizontal extension are determined based on the established equations for the three mechanisms: rigid body, vertical shear and inclined shear. There are three sub-cases of basal detachment for the rigid body model: horizontal detachment, antithetic detachment and synthetic detachment. For the rigid body model, the established equations indicate that the total displacement on the synthetic base (Dt2) is the largest, that on the horizontal base (Dt1) is moderate, and that on the antithetic base (Dt3) is the smallest. On the other hand, the value of (Dt1) is larger than the displacement for the vertical shear (Dt4). The value of (Dt1) is larger than or less than the displacement for the inclined shear (Dt5) depending on the original fault dip δ0, bedding angle θ, and the angle of shear direction β. For all original parameters, the value of Dt5 is less than the value of Dt4. Also, by comparing three rotation mechanisms, we find that the inclined shear produces largest extension, the rigid body model with horizontal detachment produces the smallest extension, and the vertical shear model produces moderate extension.

Analysis of the Digital Skill Gap of Agricultural Extension Personnel in South-East, Nigeria

The study analysed the digital skill gap of agricultural extension personnel on the use of digital technologies for extension services delivery in South-East, Nigeria. The specific objectives were to describe the socioeconomic characteristics of agricultural extension personnel in South-East Nigeria and identify the digital skill gaps among agricultural extension personnel in the area of study. Purposive sampling technique was used to select 364 Agricultural Extension personnel for the study. Data were collected through the use of structured questionnaire and were analysed using simple descriptive statistical tools such as percentages, mean score, and standard deviation. Findings indicated that most of the personnel were male (57.8%), within the age bracket of 38 - 47 years (62.9%), had B.Sc./HND as their highest educational qualification (74.7%), married (86.3%), and had a household size of 6 - 10 Persons (57.7%). It was further revealed that the majority (70.1%) were members of professional organization, earned a monthly income of N50,001.00 - N100,000.00 (65.7%), had a work experience of 11 - 15 years (51.1%), and owned a smartphone/ iPad/laptop (91.5%). Findings further indicated that they had moderate skill gap in Basic Computer skills (Mean = 4.32), and digital communication and collaboration skills (Mean = 4.26). Findings also showed that they had a high skill gap in digital technical skills (Mean = 2.46), digital data analysis skills (Mean = 2.09), digital content creation skills (Mean = 2.43), digital ethical skills (Mean = 2.79), multimedia production skills (Mean = 2.81), and video library management skills (Mean = 2.39). The study concluded that though there exists a high digital skill gap among agricultural extension personnel in South-East, Nigeria, their socioeconomic characteristics are capable of supporting the implementation of digital extension services in the area. The study recommended that the management of Agricultural Development Programs in South-East, Nigeria, should provide digital training for extension personnel to close the digital skill gap that currently exists among the personnel.

Comparative Study of the Socioeconomic Characteristics and Digital Literacy Level of Agricultural Extension Personnel in Imo and Ebonyi States, South-East, Nigeria

The study comparatively analysed the socioeconomic characteristics and digital literacy level of Agricultural Extension personnel (AEP) in Ebonyi and Imo States, South-East, Nigeria. The specific objectives were to describe the socioeconomic characteristics of agricultural extension personnel in Ebonyi and Imo States, and to ascertain the digital literacy level of AEP in the studied states. Purposive sampling technique was used to select 312 Agricultural Extension personnel (132 from Ebonyi State Agricultural Development Program and 180 from Imo State Agricultural Development Program) for the study. Data were collected through the use of validated and structured questionnaire, and administered through the help of well-trained enumerators. Data were analysed using simple descriptive statistical tools such as percentages mean score, standard deviation and weighted mean. Findings indicated that they were more male in the both States (55.3% and 57.8%) for Ebonyi and Imo State respectively and that the average age of AEP in Ebonyi and Imo States were 44.7 years and 49.2 years respectively. It was further revealed that the majority (77.3% and 82.8%) had B.Sc./HND as their highest academic qualifications, belonged to professional organisations (62.1% and 75%), and were earning an average monthly income of N58,798 and N62,648 for Ebonyi and Imo State respectively. Also, it was revealed that their mean years of service were 12.4 years and 13.4 years for Ebonyi and Imo State respectively. Almost all of them (87.9% and 95.0%) own a smartphone, had access to the internet (80.3% and 90.0%), but do not own a laptop/ipad (82.6% and 72.8%) for Ebon-yi and Imo State respectively. Results further revealed that Agricultural extension personnel in both Ebonyi and Imo State respectively had low digital literacy level ( = 2.41 and 2.32). The study concluded that AEP in Ebonyi and Imo State respectively had similar socioeconomic characteristics and low level of digital literacy. The study recommended that the management of ADPs in both Ebonyi and Imo State should ensure the training of AEP in digital skills to enhance their digital literacy level to enable them use digital technologies in their work.

Wellbore Cleaning Degree and Hydraulic Extension in Shale Oil Horizontal Wells

The efficient development and exploitation of shale oil depends on long-distance horizontal wells. As the degreeof cleaning of the wellbore plays a key role in these processes, in this study, this problem is investigated experimentallyby focusing on the dimensionless cuttings bed height. A method is proposed to calculate the horizontalwellhydraulic extension taking into account the influence of the wellbore cleaning degree on the wellborepressure distribution and assess the effect of a variety of factors such as the bottom hole pressure, the circulatingpressure drop, the drilling pump performance and the formation properties. The analysis shows that the hydraulicextension of horizontal wells decreases with an increase in the cuttings bed height, and the higher the displacementof drilling fluid, the faster the hydraulic extension declines. The annular pressure drop of the horizontalsection increases with the increase of the cuttings bed height, resulting in a higher bottom-hole pressure. Severalarguments are provided to guide the safe drilling of shale oil horizontal wells and overcome the limits of currenttechnological approaches.

The Effects of Infrastructure Projects on House Prices and Rents:Evidence from the HS2 Extension Cancellation in the UK

This paper uses the HS2 extension cancellation in November 2021 as a quasi-experiment to study its impact on house prices and rents in Leeds.Using a DiD approach on repeat sales and monthly rents,I compare property values near the HS2 station and proposed construction site before and after the announcement.Results show a 3.6%decrease in house prices and a 3.9%decline in rents near the station,while properties near the construction site experienced a 2.4%increase in prices and a 2.1%rise in rents.This is the first paper to analyse the HS2 cancellation effect using panel data methods.

The Role of Extensive Reading in Foreign Language Learning

Researches on foreign language extensive reading program indicate that students can improve their foreign language reading ability,and develop positive attitudes toward reading and increased motivation to read.Comparing to the other types of reading.(skimming,scanning,and intensive reading.),reading extensively can result in gains in vocabulary and other aspects of foreign language learning.Teachers should provide various experience and make students have the chance to enjoy reading.and give them more guidance on developing certain reading skills.

Systemic-Functional Grammar and English Extensive Reading

Systemic Functional Linguistics is known to people by its special functionalism and social meaning. The study of Systemic Functional Linguistics is also accepted by more and more people. In addition, it means a lot to the learning of lexis, English writing and extensive reading.

Extensively drug-resistant bacteria are an independent predictive factor of mortality in 130 patients with spontaneous bacterial peritonitis or spontaneous bacteremia

AIM: To evaluate the epidemiology and outcomes of culture-positive spontaneous bacterial peritonitis (SBP) and spontaneous bacteremia (SB) in decompensated cirrhosis.METHODS: We prospectively collected clinical, laboratory characteristics, type of administered antibiotic, susceptibility and resistance of bacteria to antibiotics in one hundred thirty cases (68.5% males) with positive ascitic fluid and/or blood cultures during the period from January 1, 2012 to May 30, 2014. All patients with SBP had polymorphonuclear cell count in ascitic fluid > 250/mm3. In patients with SB a thorough study did not reveal any other cause of bacteremia. The patients were followed-up for a 30-d period following diagnosis of the infection. The final outcome of the patients was recorded in the end of follow-up and comparison among 3 groups of patients according to the pattern of drug resistance was performed.RESULTS: Gram-positive-cocci (GPC) were found in half of the cases. The most prevalent organisms in a descending order were Escherichia coli (33), Enterococcus spp (30), Streptococcus spp (25), Klebsiella pneumonia (16), S. aureus (8), Pseudomanas aeruginosa (5), other Gram-negative-bacteria (GNB) (11) and anaerobes (2). Overall, 20.8% of isolates were multidrug-resistant (MDR) and 10% extensively drug-resistant (XDR). Health-care-associated (HCA) and/or nosocomial infections were present in 100% of MDR/XDR and in 65.5% of non-DR cases. Meropenem was the empirically prescribed antibiotic in HCA/nosocomial infections showing a drug-resistance rate of 30.7% while third generation cephalosporins of 43.8%. Meropenem was ineffective on both XDR bacteria and Enterococcus faecium (E. faecium). All but one XDR were susceptible to colistin while all GPC (including E. faecium) and the 86% of GNB to tigecycline. Overall 30-d mortality was 37.7% (69.2% for XDR and 34.2% for the rest of the patients) (log rank, P = 0.015). In multivariate analysis, factors adversely affecting outcome included XDR infection (HR = 2.263, 95%CI: 1.005-5.095, P = 0.049), creatinine (HR = 1.125, 95%CI: 1.024-1.236, P = 0.015) and INR (HR =1.553, 95%CI: 1.106-2.180, P = 0.011).CONCLUSION: XDR bacteria are an independent life-threatening factor in SBP/SB. Strategies aiming at restricting antibiotic overuse and rapid identification of the responsible bacteria could help improve survival.

Associating liver partition and portal vein ligation for staged hepatectomy for extensive alveolar echinococcosis:First case report in the literature

Alveolar echinococcosis(AE) is a zoonotic disease that is caused by Echinococcus multilocularis that affects liver and a variety of organs and tissues. It differs from other echinococcal disease because it shows tumor like behavior in the affected organ and tissues. The treatment of choice is concomitant medical therapy and resection with negative margins. Nevertheless, resection with the intent of negative margins(R0) may lead to serious complications such as liver failure. In the present case report, we used Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy(ALPPS) procedure, which was defined in 2012 by Schnitzbauer et al, in a 28-year-old male patient to avoid complications of major liver resection in order to treat alveolar echinococcosis. Until now, we have not encountered any study using ALPPS procedure for the treatment of alveolar echinococcosis. In the present case report we aimed to show that ALPPS procedure can be safely performed for marginnegative resection of primary or recurrent AE that shows a tumor like behavior. It is our opinion that this procedure should be performed in centers that have expertise and sufficient technical capacity to perform liver transplantation and advanced liver surgery.

MECHANICAL PRODUCT EXTENSIVE INTELLIGENT CONCEPTUAL DESIGN

Based on extenics, an extensive functional information model(function-behavioral action-structure-environmental constraint) of the mechanical productintelligent conceptual design is developed, and the mechanism of theoretic structure solutions isproduced, the mapping relations between function-behavior and behavior-structure are analyzed. Themodel is applied to the filling material system's conceptual design to verify validity.

THE EXTENSIVENESS AND SPECIFICITY OF EFFECT OF ELECTROACUPUNCTURE AT DIFFERENT ACUPOINTS ON NOCICEPTIVE RESPONSE OF CONVERGENT NEURONS IN TRIGEMINAL NUCLEUS CAUDALIS

Experiments were carried out on rats anaesthetized with uraethane. The sponta-neous discharges and nociceptive responses of convergent neurons in the right trigerninal nucleus cau-dalis(TNC) to noxious stimuli at receptive field (cheek) were recorded extracellularly with glass mi-cro-electrode. Electroacupuncture (EA ) was applied at bilateral " Xiaguan" (ST 7 on face ) or "Zusanli" (ST 36 on shank) acupoint with Iow (2V) and high (18V) intensity. The noclceptive re-sponse of convergent neurons in TNC could be inhihited by low intensity EA applied at "Xiaguan" butnot "Zusanlil", showing the specificity of acupoints. High intensity EA at either "Xiaguan" or "Zusan-li" also reduced the nociceptive responses, showing the analgesic extensiveness of acupoints. We sug-gest that "the gate of control" mechanism plays a main role in low intensity EA and "diffuse noxiousinhibitory controls" (DNIC) rnechanism does so in high intensity EA.The results suggest that we should pay attention to the location of acupoints,

Problems in EFL Extensive Reading Teaching and Possible Solutions

This paper examines the problems existing in Extensive Reading Teaching for Vocational Business English Majors and analyses the contributing factors for the time-consuming and inefficient Extensive Reading Teaching.Based on the analysis,the author points out some solutions from the following several aspects:the teachers’ roles,the choice of textbooks and the organization of the class as well as the integrated design of the class activities,be carried out in the student-centered class to be practical and helpful in the Extensive Reading Teaching.

Large-Scale Circulation Features Typical of Wintertime Extensive and Persistent Low Temperature Events in China

A pair of northeast-southwest-tilted mid-tropospheric ridges and troughs on the continental scale was observed to be the key circulation feature common among wintertime extensive and persistent low tempera-ture events (EPLTE) in China.During the persistence of such anomalous circulations,the split flow over the inner Asian continent and the influent flow over the southeast-ern coast of China correspond well to the expanded and amplified Siberian high with tightened sea level pressure gradients and hence,a strong,cold advection over south-eastern China.The western Pacific subtropical high tends to expand northward during the early stages of most EPLTEs.

Precursory Signals of Extensive and Persistent Extreme Cold Events in China

The distinct precursory signals of countrywide extensive and persistent extreme cold events (CECs) were investigated and contrasted with those of countrywide cold wave events (CCWs). It is shown that most CECs were accompanied by a CCW in the initial stages. From the comparison between the CECs and the CCWs that were independent of any CEC, it is found that a south- west-northeast-oriented tilted ridge at 500 hPa was present around the Europe-Barents Sea regions approximately 10 days prior to the start of the CEC. Consistent with this feature, a high sea level pressure and strong cold air accumulation occurred over a broad extent of northern Eurasia one week prior to the start of the CEC. The tilted ridge and the strong cold air accumulation were the precursory signals that were absent for the CCW, and they provide important clues for the early prediction of whether a CCW event might evolve into a CEC.