Higher-order expansions of powered extremes of logarithmic general error distribution

In this paper,Let M_(n)denote the maximum of logarithmic general error distribution with parameter v≥1.Higher-order expansions for distributions of powered extremes M_(n)^(p)are derived under an optimal choice of normalizing constants.It is shown that M_(n)^(p),when v=1,converges to the Frechet extreme value distribution at the rate of 1/n,and if v>1 then M_(n)^(p)converges to the Gumbel extreme value distribution at the rate of(loglogn)^(2)=(log n)^(1-1/v).

Extended wet sieving method for determination of complete particle size distribution of general soils

The traditional standard wet sieving method uses steel sieves with aperture?0.063 mm and can only determine the particle size distribution(PSD)of gravel and sand in general soil.This paper extends the traditional method and presents an extended wet sieving method.The extended method uses both the steel sieves and the nylon filter cloth sieves.The apertures of the cloth sieves are smaller than 0.063 mm and equal 0.048 mm,0.038 mm,0.014 mm,0.012 mm,0.0063 mm,0.004 mm,0.003 mm,0.002 mm,and 0.001 mm,respectively.The extended method uses five steps to separate the general soil into many material sub-groups of gravel,sand,silt and clay with known particle size ranges.The complete PSD of the general soil is then calculated from the dry masses of the individual material sub-groups.The extended method is demonstrated with a general soil of completely decomposed granite(CDG)in Hong Kong,China.The silt and clay materials with different particle size ranges are further examined,checked and verified using stereomicroscopic observation,physical and chemical property tests.The results further confirm the correctness of the extended wet sieving method.

Epidemiological, Clinical Aspects and Factors Associated with Typical Gastroesophageal Reflux Disease in the General Population of Parakou, Republic of Benin

Introduction: Gastroesophageal reflux disease (GERD) is a benign and chronic disease that can impair the quality of life. Objective: To study the epidemiological, clinical aspects and factors associated with typical GERD in the general population of Parakou in the Republic of Benin. Methods: This was a descriptive and analytical cross-sectional study with prospective data collection which took place from May 1, 2019 to June 30, 2019. The study population consisted of any subject aged at least 15 years and living in Parakou. Subjects aged at least 15 years, present on the day of the survey and having given their free and informed verbal consent were included. The Short form of QRS®(Reflux-Qual Short form) questionnaire and the “Hospital Anxiety and Depression” score were used to assess the quality of life and anxiety/depression, respectively. The sampling was probabilistic through a 2-stage cluster sampling. The variable of interest was the presence of GERD. Results: Out of 390 subjects surveyed, 28 had symptoms of typical GERD, representing a prevalence of 7.18%. The average age of these subjects was 27.11 ± 7.88 years. Fifteen subjects (53.57%) were male, giving a sex ratio of 1.15. Fourteen (50%) had a secondary level of education, 12 (42.86%) were pupils/students, 18 (64.29%) were single. The monthly income of 22 subjects (78.57%) was lower than the guaranteed interprofessional minimum wage (40,000 FCFA). The average duration of progression of symptoms was 15.89 ± 4.97 months. Symptoms occurred less than twice a week in 22 subjects (78.57%). The clinical manifestations were both diurnal and nocturnal in 12 subjects (42.86%). None of the 28 subjects with GERD had clinical warning signs. Asthma, diabetes, consumption of high fat or spice foods, carbonated drinks, non-steroidal anti-inflammatory drugs, alcoholic beverages and tobacco were statistically associated with the occurrence of GERD. Each of the 28 subjects had at least one associated factor. A significant impair in quality of life was observed in 27 patients (96.43%). Conclusion: Typical GERD is relatively common in the general population of Parakou in the Republic of Benin. It often affects young males. Among the risk factors identified, the most common are carbonated drinks, spicy meals and diabetes. GERD significantly impairs quality of life. Raising awareness about the disease and its associated factors is necessary among the general population.

Postoperative Analgesia and Cesarean Section under General Anesthesia: Multicenter Study

Background: Neuraxial anesthesia with intrathecal morphine is the reference technique in cesarean section anesthesia for the management of postoperative analgesia. If there is a contraindication to this, general anesthesia is required. The objective of the study was to evaluate the analgesic effectiveness of 4 analgesic techniques performed during cesarean section under general anesthesia in two centers with different anesthetic practices (North Franche Comté Hospital and Omar Bongo Ondimba Army Training Hospital). Method: This is a retrospective and descriptive study over 2 years, from January 1, 2019 to December 31, 2020. It involved evaluating the analgesic effectiveness and tolerance of morphine in the epidural catheter, wound infiltration, intravenous analgesia and Transversus Abdominous Plane block (TAP block) from the post-anesthesia care unit (PACU) until the 4th post-operative day. Results: Of the 354 cesarean sections performed, 84 (11.14%) received general anesthesia. The average age was 32.27 years. Acute fetal distress was the first indication for cesarean section (45.2%), followed by hemorrhagic placenta previa (10.7%) and prolapse of the cord (8.33%). Morphine in the epidural catheter was the most used (47.6%) followed by parietal infiltration (36.9%), intravenous analgesia (13.1%) and TAP block (2.38%). The analgesic effectiveness was comparable between the techniques from postoperative day 0 to day 4. No difference in side effects. Postoperative morphine consumption was significantly reduced (p = 0.011) in the infiltration (9 mg) and TAP block (9mg) groups compared to the epidural catheter (16 mg) and intravenous analgesia (17 mg). No difference in 02 rehabilitation criteria (ambulation, first bowel movement). No difference in the occurrence of chronic pain. Conclusion: In the event of a cesarean section under general anesthesia, there are effective and well-tolerated alternatives to neuraxial anesthesia, particularly regional anesthesia techniques (nerve blocks), particularly in countries with low availability of morphine.

New Approach to Synchronize General Relativity and Quantum Mechanics with Constant “K”-Resulting Dark Matter as a New Fundamental Force Particle

Planck scale plays a vital role in describing fundamental forces. Space time describes strength of fundamental force. In this paper, Einstein’s general relativity equation has been described in terms of contraction and expansion forces of space time. According to this, the space time with Planck diameter is a flat space time. This is the only diameter of space time that can be used as signal transformation in special relativity. This space time diameter defines the fundamental force which belongs to that space time. In quantum mechanics, this space time diameter is only the quantum of space which belongs to that particular fundamental force. Einstein’s general relativity equation and Planck parameters of quantum mechanics have been written in terms of equations containing a constant “K”, thus found a new equation for transformation of general relativity space time in to quantum space time. In this process of synchronization, there is a possibility of a new fundamental force between electromagnetic and gravitational forces with Planck length as its space time diameter. It is proposed that dark matter is that fundamental force carrying particle. By grand unification equation with space-time diameter, we found a coupling constant as per standard model “αs” for that fundamental force is 1.08 × 10-23. Its energy calculated as 113 MeV. A group of experimental scientists reported the energy of dark matter particle as 17 MeV. Thorough review may advance science further.

Analysis of the History and Current Situation of the Development of General Practice Teaching Clinics in China

A summary of the exploration of the teaching mode of the general practice teaching clinic, a summary of the deficiencies of the teaching clinic and a summary of the significance of the establishment of the general practice teaching clinic are presented with a view to promoting the development of general practice and cultivating more excellent successors in general practice.

Spherically Symmetric Problem of General Relativity for a Fluid Sphere

The paper is devoted to a spherically symmetric problem of General Relativity (GR) for a fluid sphere. The problem is solved within the framework of a special geometry of the Riemannian space induced by gravitation. According to this geometry, the four-dimensional Riemannian space is assumed to be Euclidean with respect to the space coordinates and Riemannian with respect to the time coordinate. Such interpretation of the Riemannian space allows us to obtain complete set of GR equations for the external empty space and the internal spaces for incompressible and compressible perfect fluids. The obtained analytical solution for an incompressible fluid is compared with the Schwarzchild solution. For a sphere consisting of compressible fluid or gas, a numerical solution is presented and discussed.

Assessing the Impact of General Anesthesia and Bronchial Intubation in Conjunction with Thoracic Paravertebral Nerve Block on Cellular Immunity and Surgical Management in Tuberculous Pyothorax Patients

Objective:This study aims to investigate the impact of combining general anesthesia with bronchial intubation and thoracic paravertebral nerve block during surgery for patients with tuberculous pyothorax.Methods:Eighty patients diagnosed with tuberculous pyothorax,admitted to the hospital between January 2023 and September 2023,were randomly selected for this study.The patients were divided into control and study groups using a numerical table method.The control group underwent general anesthesia with bronchial intubation,while the study group received general anesthesia with bronchial intubation in conjunction with thoracic paravertebral nerve block.Subsequently,the patients were monitored to assess mean arterial pressure,heart rate variations,and adverse reactions to anesthesia.Results:The study group exhibited significantly lower mean arterial pressure and heart rate levels during the post-surgical incision,immediate end of surgery,and immediate extubation periods compared to the control group(P<0.05).Furthermore,the Ricker and Ramsay scores in the study group were significantly lower than those in the control group(P<0.05).Conclusion:The combined use of general anesthesia via bronchial intubation and thoracic paravertebral nerve block has been found to stabilize mean arterial pressure and heart rate while providing effective sedation for surgical treatment in patients with tuberculous septic thorax.

The Progenitors of Type Ia Supernovae with Asymptotic Giant Branch Donors

TypeⅠa supernovae(SNe Ia)are among the most energetic events in the universe.They are excellent cosmological distance indicators due to the remarkable homogeneity of their light curves.However,the nature of the progenitors of SNeⅠa is still not well understood.In the single-degenerate model,a carbon-oxygen white dwarf(CO WD)could grow its mass by accreting material from an asymptotic giant branch(AGB)star,leading to the formation of SNe Ia when the mass of the WD approaches to the Chandrasekhar-mass limit,known as the AGB donor channel.In this channel,previous studies mainly concentrate on the wind-accretion pathway for the mass-increase of the WDs.In the present work,we employed an integrated mass-transfer prescription for the semidetached WD+AGB systems,and evolved a number of WD+AGB systems for the formation of SNe Ia through the Roche-lobe overflow process or the wind-accretion process.We provided the initial and final parameter spaces of WD+AGB systems for producing SNe Ia.We also obtained the density distribution of circumstellar matter at the moment when the WD mass reaches the Chandrasekhar-mass limit.Moreover,we found that the massive WD+AGB sample AT 2019qyl can be covered by the final parameter space for producing SNe Ia,indicating that AT 2019qyl is a strong progenitor candidate of SNe Ia with AGB donors.

Predicting Gravitational Waves from Jittering-jets-driven Core Collapse Supernovae

I estimate the frequencies of gravitational waves from jittering jets that explode core collapse supernovae(CCSNe)to crudely be 5–30 Hz,and with strains that might allow detection of Galactic CCSNe.The jittering jets explosion mechanism(JJEM)asserts that most CCSNe are exploded by jittering jets that the newly born neutron star(NS)launches within a few seconds.According to the JJEM,instabilities in the accreted gas lead to the formation of intermittent accretion disks that launch the jittering jets.Earlier studies that did not include jets calculated the gravitational frequencies that instabilities around the NS emit to have a peak in the crude frequency range of 100–2000Hz.Based on a recent study,I take the source of the gravitational waves of jittering jets to be the turbulent bubbles(cocoons)that the jets inflate as they interact with the outer layers of the core of the star at thousands of kilometers from the NS.The lower frequencies and larger strains than those of gravitational waves from instabilities in CCSNe allow future,and maybe present,detectors to identify the gravitational wave signals of jittering jets.Detection of gravitational waves from local CCSNe might distinguish between the neutrino-driven explosion mechanism and the JJEM.

The Study of the Physical Properties and Energy Sources of Five Luminous Type Ibc Supernovae

In this paper,we study five luminous supernovae(LSNe)Ibc(SN 2009ca,ASASSN-15mj,SN 2019omd,SN 2002ued,and SN 2021bmf)whose peak absolute magnitudes M_(peakare)≈-19.5 to-21 mag by fitting their multi-band light curves(LCs)with different energy source models.We find that SN 2009ca might be powered by the^(56)Ni model since the required^(56)Ni mass(0.56 M_(⊙))is comparable to those of energetic SNe Ic,while the rest four SNe cannot be accounted for the^(56)Ni model since their derived^(56)Ni masses are(?)1 M_(⊙)or the ratios of the^(56)Ni mass to the ejecta mass are larger than 0.2.This indicates that some LSNe might be powered by^(56)Ni decay,while most of them need additional energy sources.We then use the magnetar plus^(56)Ni model and the fallback plus^(56)Ni model to fit the LCs of the four LSNe that cannot be explained by the^(56)Ni model,finding that the two models can account for the four SNe,and the derived parameters are comparable to those of LSNe or superluminous SNe in the literature,if they were(mainly)powered by magnetars or fallback.We suggest that the magnetar plus^(56)Ni model is more reasonable than the fallback plus^(56)Ni model,since the validity of the fallback plus^(56)Ni model depends on the value of accretion efficiency(η)and favors a largeηvalue,and the magnetar plus^(56)Ni model yields smallerχ^(2)/dof values.It should be pointed out that,however,the fallback plus^(56)Ni model is still a promising model that can account for the four SNe in our sample as well as other LSNe.

Evaluation of Holstein cows with different tongue‑rolling frequencies:stress immunity,rumen environment and general behavioural activity

Background The tongue-rolling behaviour of cows is regarded as an outward sign of stressed animals in a low welfare status.The primary aim of this observational study was to evaluate the association between the frequency of tongue-rolling behaviour and its physiological function.The secondary aim was to explore the relationship between general activities and the frequency of tongue-rolling behaviour of cows.A total of 126 scan sampling behavioural observations were collected over 7 d on 348 Holstein cows with the same lactation stage in the same barn.The tongue-rolling frequency was defined as the number of tongue-rolling observations as a percentage to the total observations per individual cow.According to their tongue-rolling frequency,the cows were grouped into the CON(no tongue-rolling),LT(frequency 1%),MT(frequency 5%),and HT(frequency 10%)groups.Six cows from each group were randomly selected for sampling.Serum samples,rumen fluid,milk yield,and background infor-mation were collected.The general behaviour data during 72 continuous hours of dairy cows,including eating time,rumination time,food time(eating time+rumination time),and lying time,were recorded by the collar sensor.Results Cortisol(P=0.012),γ-hydroxybutyric acid(P=0.008),epinephrine(P=0.030),and dopamine(P=0.047)levels were significantly higher in tongue-rolling groups than in the CON group.Cortisol levels and tongue-rolling frequency had a moderate positive correlation(linearly r=0.363).With the increase in tongue-rolling frequency,the rumen pH decreased first and then increased(P=0.013),comparing to the CON group.HT cows had significantly less food time than CON cows(P=0.035).The frequency of tongue-rolling had a moderate negative relationship with rumination time(r=-0.384)and food time(r=-0.492).Conclusions The tongue-rolling behaviour is considered as a passive coping mechanism,as the stress response in cows with high tongue-rolling frequency increased.Food intake and rumination activities were all closely related to the occurrence of tongue-rolling behaviour.

Generalization of PhaseNet in Shandong and its application to the Changqing M4.1 earthquake sequence

Waveforms of seismic events,extracted from January 2019 to December 2021 were used to construct a test dataset to investigate the generalizability of PhaseNet in the Shandong region.The results show that errors in the picking of seismic phases(P-and Swaves)had a broadly normal distribution,mainly concentrated in the ranges of−0.4–0.3 s and−0.4–0.8 s,respectively.These results were compared with those published in the original PhaseNet article and were found to be approximately 0.2–0.4 s larger.PhaseNet had a strong generalizability for P-and S-wave picking for epicentral distances of less than 120 km and 110 km,respectively.However,the phase recall rate decreased rapidly when these distances were exceeded.Furthermore,the generalizability of PhaseNet was essentially unaffected by magnitude.The M4.1 earthquake sequence in Changqing,Shandong province,China,that occurred on February 18,2020,was adopted as a case study.PhaseNet detected more than twice the number of earthquakes in the manually obtained catalog.This further verified that PhaseNet has strong generalizability in the Shandong region,and a high-precision earthquake catalog was constructed.According to these precise positioning results,two earthquake sequences occurred in the study area,and the southern cluster may have been triggered by the northern cluster.The focal mechanism solution,regional stress field,and the location results of the northern earthquake sequence indicated that the seismic force of the earthquake was consistent with the regional stress field.

Neuraxial anesthesia versus general anesthesia in patients undergoing three-dimensional laparoscopic radical prostatectomy:Preliminary results of a prospective comparative study

Objective:Neuraxial anesthesia(NA)showed to reduce both morbidity and mortality in patients undergoing laparoscopic surgery.We aimed to investigate the use of NA in patients undergoing transperitoneal three-dimensional laparoscopic radical prostatectomy(t-3DLRP)and compare the intraoperative and postoperative outcomes with a control group of patients undergoing t-3DLRP under general anesthesia(GA).Methods:A prospective,double-center,double-surgeon study cohort of 84 consecutive patients undergoing t-3DLRP between June 2019 and June 2021 was analyzed.A study group of 42 patients undergoing t-3DLRP under NA was compared with a control group of 42 patients undergoing t-3DLRP under GA.Results:The two group were similar in all demographic,clinical,and pathological variables.Postoperative blood gas parameters were within physiologic limits in both groups.Muscle relaxation was adequate for surgery during both NA and GA.Median length of stay was 1 day shorter for NA group than GA group(5 days vs.6 days,p=0.05).t-3DLRP under NA had a statistically lower rate of minor complications(4.8%vs.19.0%,p=0.03)and less postoperative pain(median numeric rating scale 3 vs.4,p=0.01)compared to GA.No major complications were observed in both groups.Significantly more patients were willing to undergo a similar intervention under NA than GA(p=0.04).Conclusion:t-3DLRP under NA is a feasible and safe procedure,with less postoperative pain and fewer minor complications than the same procedure under GA.NA allows the maintenance of muscle relaxation and respiratory excursions without interfering with surgery.

Breeding design in wheat by combining the QTL information in a GWAS panel with a general genetic map and computer simulation

A large amount of genome-wide association study(GWAS)panels together with quantitative-trait locus(QTL)information associated with breeding-targeted traits have been described in wheat(Triticum aestivum L.).However,the application of mapping results from a GWAS panel to conventional wheat breeding remains a challenge.In this study,we first report a general genetic map which was constructed from 44 published linkage maps.It permits the estimation of genetic distances between any two genetic loci with physical map positions,thereby unifying the linkage relationships between QTL,genes,and genomic markers from multiple genetic populations.Second,we describe QTL mapping in a wheat GWAS panel of 688 accessions,identifying 77 QTL associated with 12 yield and grain-quality traits.Because these QTL have known physical map positions,they could be mapped onto the general map.Finally,we present a design approach to wheat breeding by using known QTL information and computer simulation.Potential crosses between parents in the GWAS panel may be evaluated by the relative frequency of the target genotype,trait correlations in simulated progeny populations,and genetic gain of selected progenies.It is possible to simultaneously improve yield and grain quality by suitable parental selection,progeny population size,and progeny selection scheme.Applying the design approach will allow identifying the most promising crosses and selection schemes in advance of the field experiment,increasing predictability and efficiency in wheat breeding.

Effects of General Anesthesia on the Results of Cardiac Catheterization in Pediatric Patients with Ventricular Septal Defect

Background:There is no gold standard sedation method for pediatric cardiac catheterization.In congenital heart diseases with intracardiac shunts,hemodynamic parameters are prone to change depending on the ventilation conditions and anesthetics,although few studies have examined these effects.The purpose of this study was to investigate the effects of two different sedation methods on the hemodynamic parameters.Methods:This study retrospectively evaluated consecutive patients with ventricular septal defect(VSD)below 1 year of age who underwent cardiac catheterization at Aichi Children’s Health and Medical Center,who were divided into age-and VSD diameter-matched general anesthesia(GA)and monitored anesthesia care(MAC)under the natural airway groups(n=40 each),for comparison of hemodynamic parameters.Results:In the GA group,arterial blood pH and arterial partial pressure of oxygen were significantly higher(p<0.01),whereas arterial partial pressure of carbon dioxide was significantly lower than in the MAC group(p<0.01).Mean pulmonary artery pressure(p<0.05)and systemic blood pressure(p<0.01)were lower in the GA group.Pulmonary vascular resistance index(p<0.01)and systemic vascular resistance index(p<0.01)were also significantly lower in the GA group than the MAC group.There were no significant differences in pulmonary blood flow index,systemic blood flow index,and pulmonary/systemic blood flow ratio between the two groups.Conclusions:Cardiac catheterization under GA in VSD patients results in different hemodynamic parameters compared to that under MAC.In particular,when using pulmonary artery pressure and pulmonary vascular resistance measured under GA for judgment regarding the surgical indications or perioperative management,consideration should be given to the fact that these parameters might be lower compared to those measured under MAC.

Influences of dexmedetomidine on stress responses and postoperative cognitive and coagulation functions in patients undergoing radical gastrectomy under general anesthesia

BACKGROUND Radical gastrectomy(RG)is commonly used in the treatment of patients with gastric cancer(GC),but this procedure may lead to stress responses,postoperative cognitive dysfunction,and blood coagulation abnormalities in patients.AIM To investigate the influences of dexmedetomidine(DEX)on stress responses and postoperative cognitive and coagulation functions in patients undergoing RG under general anesthesia(GA).METHODS One hundred and two patients undergoing RG for GC under GA from February 2020 to February 2022 were retrospectively reviewed.Of these,50 patients had received conventional anesthesia intervention[control group(CG)]and 52 patients had received DEX in addition to routine anesthesia intervention[observation group(OG)].Inflammatory factor(IFs;tumor necrosis factor-α,TNF-α;interleukin-6,IL-6),stress responses(cortisol,Cor;adrenocorticotropic hormone,ACTH),cognitive function(CF;Mini-Mental State Examination,MMSE),neurological function(neuron-specific enolase,NSE;S100 calciumbinding protein B,S100B),and coagulation function(prothrombin time,PT;thromboxane B2,TXB2;fibrinogen,FIB)were compared between the two groups before surgery(T0),as well as at 6 h(T1)and 24 h(T2)after surgery.RESULTS Compared with T0,TNF-α,IL-6,Cor,ACTH,NSE,S100B,PT,TXB2,and FIB showed a significant increase in both groups at T1 and T2,but with even lower levels in OG vs CG.Both groups showed a significant reduction in the MMSE score at T1 and T2 compared with T0,but the MMSE score was notably higher in OG compared with CG.CONCLUSION In addition to a potent inhibitory effect on postoperative IFs and stress responses in GC patients undergoing RG under GA,DEX may also alleviate the coagulation dysfunction and improve the postoperative CF of these patients.

The Evolving Absolute Magnitude of Type 1a Supernovae and Its Critical Impact on the Cosmological Parameters

In this work, a computer optimization model has been developed that allows one to load the initial data of observations of supernovae 1a into a table and, in simple steps, by searching for the best fit between observations and theory, obtain the values of the parameters of cosmological models. The optimization is carried out assuming that the absolute magnitude of supernovae is not constant, but evolves with time. It is assumed that the dependence of the absolute magnitude on the redshift is linear: M = M( z = 0) + εc z, where εc is the evolution coefficient of the absolute magnitude of type 1a supernovae. In the case of a flat universe ( ΩM + ΩΛ = 1 ), the best fit between theory and observation is εc = 0.304. In this case, for the cosmological parameters we obtain ΩΛ = 0.000, ΩM =1.000. Naturally, this result exactly coincides with the simulation result for the model with zero cosmological constant ( εc = 0.304, q0 = 0.500 ). Within the framework of the ΛCDM model, without restriction on space curvature ( ΩM + ΩΛ+ ΩK = 1 ), we obtain the following values: εc = 0.304, ΩΛ = 0.000, ΩM = 1.000, ΩK =0.000. Those, this case also leads to a flat model of the Universe ( ΩK =0.000 ). In this work, the critical influence of the absolute magnitude M of type 1a supernovae on the cosmological parameters is also shown. In particular, it was found that a change in this value by only 0.4m (from -19.11 to -18.71) leads to a change in the parameters from ΩΛ = 0.7 and ΩM = 0.3 to ΩΛ = 0 and ΩM =1.

The quality of older adults'involvement in clinical communication with general practitioners:evidence from rural towns in Australia

Objective:A study was conducted about the putative links of older rural Australians'health knowledge and preparation with their quality of involvement in patient-general practitioner(GP)communication during health intake visits.Methods:It was a cross-sectional study between January 2021 and April 2022.The 32-item quality of involvement in communication scale was designed and incorporated into the SurveyGizmo software.This online survey was administered by sending an email request to the Renmark Rotary Club,which actively promoted this study across five rural towns in South Australia.121 participants completed the surveys.Mean-sum scores were calculated based on the questionnaire responses to evaluate outcomes,specifically initiation of information,active participation,and emotional expression.We employed different methods including t-tests,ANOVA,and leaner regressions to analyse data.Results:The demographic profile of participants characterised by a female predominance(58.7%,71/121),a majority falling within the 65-<70 age bracket(47.1%,57/121),and a high level of educational attainment(58.7%had completed high school or higher,71/121).Additionally,35%of the participants predominantly spoke a language other than English at home.Regarding the initiation of information with GPs,the mean sum-score was(20.5+3.7),indicating a marginally above-average level of engagement.Contrarily,the active participation was suboptimal,as suggested by a mean sum score of(35.9±6.3).Furthermore,the emotional expression was relatively low,with a mean score of(13.9±1.8).Substantial variations were discerned in the quality of patient-GP communication,contingent upon factors such as educational background,language spoken at home,health literacy,and preparatory measures for clinical visits.Participants who predominantly spoke a language other than English at home demonstrated significantly lower levels of information initiation with their GPs(P<0.o01).Higher educational attainment was positively correlated with increased active participation(P<0.001).Enhanced health literacy and thorough visit preparation were significantly associated with increased levels of active participation(P<0.001).Conclusion:Meaningful engagement through recognition,empowerment,and support(health literacy programs)for older rural adults is suggested for improving their quality of involvement in communication with GPs.

Stomach perforation-induced general occlusion/occlusion-like syndrome and stable gastric pentadecapeptide BPC 157 therapy effect

BACKGROUND Using rat stomach perforation as a prototypic direct lesion applied in cytoprotection research,we focused on the first demonstration of the severe occlusion/occlusion-like syndrome induced by stomach perforation.The revealed stomachinduced occlusion/occlusion-like syndrome corresponds to the previously described occlusion/occlusion-like syndromes in rats suffering multicausal pathology and shared severe vascular and multiorgan failure.This general point was particularly reviewed.As in all the described occlusion/occlusion-like syndromes with permanent occlusion of major vessels,peripheral and central,and other similar noxious procedures that severely affect endothelium function,the stable gastric pentadecapeptide BPC 157 was resolving therapy.AIM To reveal the stomach perforation-induced general occlusion/occlusion-like syndrome and BPC 157 therapy effect.METHODS The procedure included deeply anesthetized rats,complete calvariectomy,laparotomy at 15 min thereafter,and stomach perforation to rapidly induce vascular and multiorgan failure occlusion/occlusion-like syndrome.At 5 min post-perforation time,rats received therapy[BPC 157(10μg or 10 ng/kg)or saline(5 mL/kg,1 mL/rat)(controls)]into the perforated defect in the stomach).Sacrifice was at 15 min or 60 min post-perforation time.Assessment(gross and microscopy;volume)included:Brain swelling,peripheral vessels(azygos vein,superior mesenteric vein,portal vein,inferior caval vein)and heart,other organs lesions(i.e.,stomach,defect closing or widening);superior sagittal sinus,and peripherally the portal vein,inferior caval vein,and abdominal aorta blood pressures and clots;electrocardiograms;and bleeding time from the perforation(s).RESULTS BPC 157 beneficial effects accord with those noted before in the healing of the perforated defect(raised vessel presentation;less bleeding,defect contraction)and occlusion/occlusion-like syndromes counteraction.BPC 157 therapy(into the perforated defect),induced immediate shrinking and contraction of the whole stomach(unlike considerable enlargement by saline application).Accordingly,BPC 157 therapy induced direct blood delivery via the azygos vein,and attenuated/eliminated the intracranial(superior sagittal sinus),portal and caval hypertension,and aortal hypotension.Thrombosis,peripherally(inferior caval vein,portal vein,abdominal aorta)and centrally(superior sagittal sinus)BPC 157 therapy markedly reduced/annihilated.Severe lesions in the brain(swelling,hemorrhage),heart(congestion and arrhythmias),lung(hemorrhage and congestion),and marked congestion in the liver,kidney,and gastrointestinal tract were markedly reduced.CONCLUSION We revealed stomach perforation as a severe occlusion/occlusion-like syndrome,peripherally and centrally,and rapid counteraction by BPC 157 therapy.Thereby,further BPC 157 therapy may be warranted.