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Background: The objective of this systematic review was to identify pre-existing quality performance indicators (QPIs) for the surgical management of oesophageal cancer (OC). These QPIs can be used to objectively measure and compare the performance of individual units and capture key elements of patient care to improve patient outcomes. Methods: A systematic literature search of PubMed, MEDLINE, Scopus and Embase was conducted. Articles reporting on the quality of healthcare in relation to oesophageal neoplasm or cancer and the surgical treatment of OC available until the 1st of March 2022 were included. Results: The final list of articles included retrospective reviews (n = 13), prospective reviews (n = 8), expert guidelines (n = 1) and consensus (n = 1). The final list of QPIs was categorized as process, outcome or structural measures. Process measures included multidisciplinary involvement, availability of multimodality diagnostic and treatment pathways and surgical metrics. Outcome measures included reoperation and readmission rates, the achievement of RO resection and length of hospital stay. Structural measures include multidisciplinary meetings. Conclusions: This systematic review summarizes QPIs for the surgical treatment of OC. The data will serve as an introduction to establishing a quality initiative project for OC resections. [ABSTRACT FROM AUTHOR]

Background: Advanced‐staging radiography is used inconsistently for patients with early‐stage (stage I + II) breast cancer. However, accurate and appropriate staging of newly diagnosed breast cancer may significantly impact treatment decisions. Methods: Four hundred and ninety‐nine patients with stages II and III breast cancer were seen in the breast service at Waitemata DHB, New Zealand from 2013 to 2018 were enrolled in the study and audited for radiological staging. Results: One hundred and two stage II patients had computed tomography (CT) at baseline; 88 of 102 (86%) of stage II patients were node‐positive (≥N1) with six patients (6.8%) having distant metastatic disease, and were upstaged to stage IV. Fifty‐two stage III patients out of 72 (72%) had baseline staging CTs. Nine out of 52 patients (17%) of stage III patients were upstaged to stage IV. Despite guideline recommendations, baseline staging for T4 disease (stage IIIB) was poor, with only 7 out of 13 patients with stage IIIB disease radiologically staged. Conclusion: Consideration for baseline radiological staging should be given to stages II and III, cN1 breast cancer patients, in which diagnosis of distant metastatic disease would change the treatment plan. Regional guidelines for baseline radiological staging for breast cancer patients may have an impact on patient management in breast cancer patients. [ABSTRACT FROM AUTHOR]

Background: Quality performance indicators (QPI) are objective measurements of aspects of patient care that affect clinical outcome. This study investigates the compliance rate to published QPIs of gastric adenocarcinoma (GA) management, in a single institution, to determine areas of strong performance and those requiring improvement. Methods: All patients with GA treated from 2010 to 2015, and 2020 to 2021 were included. Electronic data in the form of clinic letters, operation notes, and histology and radiology reports were reviewed with ethics approval. QPI adherence was collected in binary form. Results: QPIs with high compliance rate include preoperative radiological staging and histological diagnosis, subspecialty surgeon training and pathology report documentation. QPIs with low compliance include perioperative chemotherapy (31.6%), postoperative radiological surveillance (32.5%) and minimally invasive approaches to surgical resection (12.5%). Conclusions: QPIs from the systematic review are variably implemented in clinical practice, thus informing on their relevance to real world clinical practice whilst also identifying the areas requiring focus for improvement. [ABSTRACT FROM AUTHOR]

As an important part of a modern economic system, a modern industrial system is the key to promoting high-quality economic development. China's modern industrial system construction focuses on industrial restructuring. At present, in order to strengthen the support and leading role of transportation in the modern economic system, China is actively promoting the construction of a competitive transportation power. Therefore, it is necessary to study whether large-scale investment in transportation infrastructure can promote industrial structure transformation and upgrade. This paper takes China as the research background. Firstly, a RAM model was employed to evaluate the unified economic and environmental efficiency of transportation infrastructure that measures the level of transportation infrastructure investment. Secondly, a PVAR model was built to evaluate the dynamic effects of transportation infrastructure investment on industrial structure transformation and upgrade. Finally, from the perspective of rational flow and optimal allocation of resource factors, the paper points out that transportation infrastructure investment can indirectly promote industrial structure transformation and upgrade through three paths, namely expanding market demand, reducing resource misallocation and increasing technological innovation, and the first half of these paths are positively regulated by policies. Then, an empirical test was done with the moderated mediation model. Research findings suggest that: first, improvements in the unified economic and environmental efficiency of transportation infrastructure can only promote industrial structure supererogation in a short time, but have no significant effect on promoting industrial structure rationalization in the short or long term. Second, in actual situation, transportation infrastructure investment can promote industrial structure transformation and upgrade only by expanding market demand and technological innovation, but not by reducing resource misallocation. Third, the first half of these paths through which transportation infrastructure investment promotes industrial structure transformation and upgrade are positively regulated by policies. This paper provided some theoretical reference for promoting industrial structure transformation and upgrade by virtue of the sustainable development of transportation. [ABSTRACT FROM AUTHOR]

The ethanol oxidation reaction (EOR) is an ideal alternative to the oxygen evolution reaction (OER) towards energy efficient hydrogen production. Here, the chrysanthemum-shaped B doped cobalt-nickel bimetallic phosphide with heterogeneous structure grown on nickel foam (B-Ni 2 P/CoP/NF) are synthesized and can act as a high activity bifunctional electrocatalysts for both the hydrogen evolution reaction (HER) and EOR. In 1.0 M KOH, the obtained catalyst shows good activity and excellent long-term stability (no decay after 108 h) for HER, with an overpotential of only 33 mV (vs. RHE) to reach a current density of 10 mA cm−2. The calculation of turnover frequency (TOF) and transfer coefficient (β) prove that the catalyst has good intrinsic catalytic activity, For EOR, in 1.0 M KOH+1.0 M C 2 H 5 OH solution, the B-Ni 2 P/CoP/NF catalyst requires only 1.45 V (vs. RHE) oxidation potential to reach the current density of 50 mA cm−2, which is 270 mV less than OER. Using B-Ni 2 P/CoP/NF as a bifunctional catalyst, the current density of 20 mA cm−2 can be achieved with only 1.48 V cell voltage in 1.0 M KOH+ 1.0 M C 2 H 5 OH solution, which is remarkably lower than the required cell voltage of water electrolysis (1.63 V) to achieve the same current density. This study demonstrates an efficient bimetallic phosphide as earth-abundant bifunctional electrocatalysts for green hydrogen production coupled with electrolysis of ethanol. [Display omitted] • The chrysanthemum-shaped B-CoP/Ni 2 P/NF catalyst with heterogeneous structure is prepared. • The B-CoP/Ni 2 P/NF catalyst has excellent bifunctional catalytic activity toward EOR and HER.in alkaline solution. • The doping of B regulates the electronic structure and further strengthens the synergistic effect of metal Ni and Co. [ABSTRACT FROM AUTHOR]

The development of renewable clean energy is imminent as global warming and environmental pollution become more serious issues today. Hydrogen energy has been widely studied as an ideal green energy source. Among several common hydrogen production methods, hydrogen production by electrolysis of water is considered an efficient, environmentally friendly, and sustainable hydrogen production strategy. Transition metal phosphates have outstanding electrocatalytic conductivity and high catalytic efficiency, thus exhibiting catalytic effects similar to noble metals. To further enhance the catalytic activity of the transition metal phosphates, in this paper, the cauliflower-like Co-W-P-O 4 /NF catalyst based on three-dimensional nickel foam was prepared by the method of element doping. The catalyst exhibited good bifunctional catalytic activity in alkaline solution. The prepared Co-W-P-O 4 /NF has a unique crystalline-amorphous phase structure with abundant active sites at the interface. In addition, W atoms can interact with Co atoms to co-optimise the electronic structure, enabling the Gibbs free energy of hydrogen adsorption (ΔG H*) to be close to 0, which is conducive to improving the performance of water electrolysis. To achieve a current density of 10 mA·cm−2, the Co-W-P-O 4 /NF required overpotentials of 42.1 mV for HER and 348.2 mV for OER in 1 M KOH solution, with the Tafel slopes being 48.0 and 83.6 mV·dec−1, respectively. When Co-W-P-O 4 /NF was used as both cathode and anode for water splitting, the two-electrode electrolyzer could achieve 10 mA·cm−2 with only 1.62 V, along with good stability. [Display omitted] • The cauliflower-like Co-W-P-O 4 /NF with crystalline-amorphous phase structure is prepared. • Co-W-P-O 4 /NF catalyst shows good bifunctional catalytic activity in alkaline solution. • The electron rearrangement and the rough surface structure can improve the performance of catalyst. [ABSTRACT FROM AUTHOR]

With the process node further scaling down, the bit cell of magnetic random access memory (MRAM) device suffers from severe failure and reliability problems due to its process variation. In this article, we explored the variability of a promising toggle spin torques MRAM (TST-MRAM) in detail, which achieves ultrafast switching speed and high endurance and is expected to be applied as upper-level caches. Our research is conducted with a 14 nm FinFET design kit, the basic performance of TST-MRAM and different pulse conditions are explored, and then the variation effect of device parameters is discussed and compared in detail as well as the write error rate (WER) under different voltages. The results demonstrate that the variation of access transistors dominates the variability, where the transistor in the spin–orbit torque (SOT) branch has a greater negative impact than the transistor in the spin transfer torque (STT) branch. To further reduce WER, a better structure with diodes of bit cell is proposed. [ABSTRACT FROM AUTHOR]

The most common site of infection is the lung.[1] New Zealand is classified as a low TB incidence country with ~300 new cases diagnosed per year.[2] Intra-abdominal TB is notorious for non-specific presentation without the classic B-symptoms of fevers, night sweats and weight loss. We present a 59 years-old female patient with a 5 days history of generalized abdominal pain, nausea and vomiting, anorexia and fevers. Gastroduodenal TB is uncommon, accounting for ~1-6% of all abdominal TB.[[3]] Common presenting symptoms are abdominal pain, distension, nausea and vomiting and diarrhoea. [Extracted from the article]

Background A systematic review was undertaken to identify existing quality performance indicators (QPI) for the surgical treatment of oesophageal cancer (OC) with the aim of defining a set of QPIs that can be used in accreditation and allowing comparison of treatment and outcomes across jurisdictions, and provide a basis to develop quality improvement programs. These QPIs capture key components of patient care that are fundamental to the overall outcomes. Methods A systematic literature review was conducted by searching MEDLINE, PubMed, EMBASE, and SCOPUS with all literature available until the date of 1st March 2022 included. Search terms utilised were Quality of health care OR Quality improvement OR Quality control OR Quality indicators OR Benchmark, AND Oesophagectomy OR Esophagectomy OR Oesophageal neoplasm OR Esophageal Neoplasm OR Adenocarcinoma OR Squamous Cell Cancer OR Oesophageal resection OR Esophageal Resection OR Oesophageal cancer OR Esophageal Cancer OR Ivor Lewis OR Oesophageal Surgery OR Esophageal Surgery. Results Twenty-five articles were included in the final analysis. The selected studies included editorials, retrospective review, prospective review, expert guidelines and consensus. For OC QPIs, process measures included multi-disciplinary meetings, access to perioperative multimodal diagnostic pathways, and surgical metrics (margin negative resections and adequate lymphadenectomy). Outcome measures included the RO resection rate, reoperation, readmission rate, and length of hospital stay. Conclusions This systematic review summarises QPIs for the surgical management of OC. The data from this review will form the basis of a project to develop internationally agreed QPIs for OC resections. [ABSTRACT FROM AUTHOR]

Background Oesophageal adenocarcinoma (OAC) is a lethal condition. The management is typically multifaceted with oesophagectomy being the cornerstone of treatment. Quality performance indicators (QPIs) are objective measurements of aspects of patient's care that affect clinical outcomes. We look to measure a set of clinically relevant QPIs that can be used to capture key aspects of patient management at our institution. Methods all patients with OAC treated from 2010 to 2015, and 2020 to 2021 at Te Whatu Ora Waitemata were included. Patients with secondary metastases to the oesophagus or gastric cancer with extension to the oesophagus were excluded. Electronic data in the form of clinic letters, operation notes, histology and radiology reports were reviewed. QPI adherence was collected in binary form. Results QPIs with consistently high compliance rates include radiological staging and histological diagnosis, perioperative dietitian involvement, explanations of disease and treatment intent, and pathology report documentation. QPIs demonstrating significant change and improvement across the two groups include endoscopic resection (60.0% of patients with T1 disease in 2010 to 88.9% in 2020 group), multimodality treatment (majority ECF and ECX perioperative chemotherapy in 2010 to majority FLOT chemotherapy in 2020 group) and minimally invasive approach (30.4% hybrid in 2010 compared to 72.4% hybrid in 2020). Conclusions QPIs from the systematic review were readily measurable and were variably implemented in clinical practice. Areas requiring improvement were identified however relevance to real-world clinical outcomes require further focus of investigation. [ABSTRACT FROM AUTHOR]

[Display omitted] • Grape cluster Cu-Co-P/NF was prepared by one-step potentiostatic electrodeposition. • Cu-Co-P/NF exhibit excellent catalytic activity and high stability for HER and OER. • The moderate amount of Cu doping could tune the electronic structure. The application of non-precious metal bifunctional electrode materials is relevant to solving the current serious energy and environmental problems. In this study, the Cu-Co-P/NF bifunctional electrocatalyst with grape-like clusters was successfully prepared for water splitting using nickel foam (NF) as a substrate by electrodeposition. In alkaline conditions, the catalysts showed good catalytic activity and stability in both the hydrogen evolution reaction (HER) and the oxygen evolution reaction (OER). At 10 mA cm-2, the overpotential required for HER was only 64 mV, whereas for OER it was 334 mV, with Tafel slopes of 40 mV dec-1 and 74 mVdec-1, respectively, and almost negligible potential fluctuations after 49 h and 52 h of testing under continuous electrolysis. Furthermore, the two-electrode electrolyzer required only 1.55 V to achieve 10 mA cm-2 in 1 M KOH solution when Cu-Co-P/NF was used as both cathode and anode for water splitting, which was superior to most previously reported electrocatalysts, and it also showed good durability in a 82 h test. Therefore, it has promising applications in industrial electrolytic systems. The unusual Cu-Co-P/NF with grape-like clusters, as well as the synergistic effect between Co and Cu atoms and the high electrochemically active surface area (ECSA), are responsible for the remarkable catalytic performance. [ABSTRACT FROM AUTHOR]

When soybean is replanted after wheat in parts of China, problems such as a short sowing period, large straw yield and poor mechanization technology emerge; these problems increase the difficulty of sowing subsequent soybeans and negatively affect soybean quality and yield. In addition, the ecological problems associated with straw burning and soil degradation become increasingly severe. Here, a straw clearing mulching no-tillage planter with integrated functions of lateral straw clearing anti-blocking, precision sowing, pesticide spraying, and straw mulching was developed. This planter could perform several functions, including surface straw clearing before sowing, herbicide spraying after sowing, and straw surface uniform mulching. A lateral straw clearing mulching device was designed, and the main parameters and values affecting the working performance of the device were determined. To verify the technical performance and working quality of straw clearing mulching no-tillage sowing, field experiments were conducted, testing the effects of straw clearing mulching no-tillage sowing (SCMNS) and stubble eliminating rotary-tillage sowing (SERS) on the sowing quality, seedling emergence rate, soil hydrothermal characteristics, soybean yield, and comprehensive economic benefits. The qualified indices of seed spacing and sowing depth of SCMNS were 87.2% and 76.5%, respectively, which were significantly higher than those of SERS. SCMNS could enhance the ground temperature, reduce water evaporation, improve water storage, and promote soil moisture conservation. The seedling emergence date of SCMNS was one day earlier than that of SERS. The seedling emergence rate of SCMNS was 89.8%, which was significantly higher than that of SERS. The soybean yields of SCMNS (2809.2 kg·hm−2) and SERS (2207.4 kg·hm−2) significantly differed. SCMNS improved the comprehensive economic benefits by increasing soybean yield and reducing production costs; the net income of 1147.82 €·hm−2 was 50.27% higher than that of SERS. • A straw clearing mulching no-tillage planter was developed. • A field test comparing no-tillage and rotary tillage was conducted. • The no-tillage sowing improved the sowing quality and yield of soybean. • The comprehensive economic benefit of soybean got remarkable promotion. [ABSTRACT FROM AUTHOR]

Background: The principal objective of this study was to gain a better understanding of the mechanisms of type 2 diabetes mellitus (T2DM) patients with fatigue (D-T2DM) through exome and transcriptome sequencing. Methods: After whole-exome sequencing on peripheral blood of 6 D-T2DM patients, the consensus mutations were screen out and analyzed by a series of bioinformatics analyses. Then, we combined whole-exome sequencing and transcriptome sequencing results to find the important genes that changed at both the DNA and RNA levels. Results: The results showed that a total of 265,393 mutation sites were found in D-T2DM patients compared with normal individuals, 235 of which were consensus mutations shared with D-T2DM patients. These genes significantly enriched in HIF-1 signaling pathway and sphingolipid signaling pathway. At the RNA level, a total of 375 genes were identified to be differentially expressed. After the DNA-RNA joint analysis, eight genes were screened that changed at both DNA and RNA levels. Among these genes, FUS and LMNA were related to carbohydrate metabolism, energy metabolism, and mitochondrial function. Subsequently, we predicted the herbs, including Qin Pi and Hei Zhi Ma, that might play a therapeutic role in D-T2DM through the SymMap database. Conclusion: These findings have significant implications for understanding the mechanisms of D-T2DM and provide potential targets for D-T2DM diagnosis and treatment. [ABSTRACT FROM AUTHOR]

A magnetic tunneling junction (MTJ) with very low energy barrier, which shows controllable stochastic property, is recently proposed to constitute the probability bit (P-Bit). With the P-Bit, Ising computation, which is a general and powerful computing platform for both conventional and non-conventional problems, is implemented. However, such hardware emulation suffers from the severe intrinsic variations of a stochastic MTJ device. The nonuniform probability switching curves of different stochastic MTJs hinder straightforward expansion of Ising computer to a large P-Bits array for solving more complicated problems. In this work, we propose a novel Ising computer using a single stochastic MTJ device. With the utilization of the time-division multiplexing (TDM) technology, a “Compute–Read–Switch” scheme is proposed, so that the single stochastic MTJ can act as multiple P-Bits during Ising computation. A design guide for the current magnitude and time duration of the “Compute–Read–Switch” scheme is investigated and provided. Furthermore, NOT and XOR logic gates are implemented with our proposal. An accuracy rate as high as 69% for the integer factorization is also achieved, which is comparable with conventional Ising computer. Meanwhile, the TDM Ising computer avoids the calibration process, which is mandatory in the conventional Ising computer. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the usefulness of Contrast-enhanced ultrasound (CEUS) in the diagnosis and differential diagnosis of Polypoid lesions of gallbladder (PLGs) ≥ 1 cm.Methods: A prospective analysis was performed on 180 patients with PLGs ≥ 1 cm. 175 cases were confirmed by pathological diagnosis and the remaining were confirmed by other imaging findings. The characteristics of lesions on conventional Ultrasonography (US) and CEUS were recorded.Results: Significant differences were observed in enhancement patterns between benign and malignant PLGs during both arterial (P < 0.001) and venous phases (P < 0.001). The malignant lesions typically yielded a "fast-in and fast-out" enhancement pattern. There was no significant difference in Arrival time (AT) between malignant and benign PLGs. If we consider wash-out time ≤ 40 s as a diagnostic standard for malignant lesions, the sensitivity, specificity, and accuracy were 88.24%, 85.62%, and 86.11%, respectively. Destruction of the Gallbladder (GB) wall was a particularly important indication of malignant PLGs, and the sensitivity, specificity, and accuracy were 93.33%, 92.12%, and 92.22%, respectively. The accuracy of CEUS in the diagnosis of PLGs, as well as malignant and benign lesions, was 92.22%, 92.47%, and 91.17%, respectively.Conclusions: The "fast-in and fast-out" enhancement pattern, hyper-enhancement in comparison to the GB wall in the arterial phase, wash-out time ≤ 40 s, GB wall destruction, and hepatic parenchymal infiltration are the characteristic findings of malignant PLGs. Besides, CEUS provides a valuable reference to classify some of the benign lesions. [ABSTRACT FROM AUTHOR]

Climbing dunes are a form of topographic barrier dunes that feature in the aeolian landforms on the Qinghai-Tibetan Plateau. Topography fundamentally influences the spatial distribution and morphological characteristics of climbing dunes by modifying the near-surface airflow and creating space for sediment deposition. Previous studies have considered several aspects of the influence of topography on aeolian landforms. However, morphological differences between climbing dunes in different geomorphic contexts and dynamic changes in the area have received little attention. Therefore, topographic measurements, near-surface flow field measurements, dune morphology analysis, and remote sensing image analysis were combined to explore relationships between dune morphology and topography. Topographic obstacles can accelerate the near-surface airflow, particularly with a 25–35° slope gradient, which is beneficial for sand transport and deposition. Suitable accommodation space (concave slope morphology) and abundant sediment comprise the primary factors that control the scale and morphological diversity of climbing dunes, which are also influenced by a variable wind direction. In general, the morphology of the climbing dunes becomes progressively more complicated from the bottom to the middle of the windward slope, and the sand ridge lines of the dunes are perpendicular to the prevailing wind direction. Based on the influence of climate and human activities, the total area of climbing dunes in this region has decreased over the past 30 years. Despite general evidence of enhanced human-induced desertification in semi-arid and sub-humid regions, warming has not led to the rapid expansion of climbing dunes in these arid locations. This research offers new insights into the relationship between the terrain and dune morphology, enriching the theoretical basis for the plateau aeolian geomorphology. Furthermore, it allows us to consider the dynamic changes in climbing dunes area in the context of global warming. • Clarify the relationship between terrain, near-surface airflow and dune morphology • Sand sources and slope morphology are controlling the scale of climbing dune. • Analysis of the dynamic changes of climbing dune under climate warming [ABSTRACT FROM AUTHOR]

Wear-resistant films, which are widely applied to extend the service life of the gears and bearings, usually surfer from dynamic bonding fatigue failure induced by the Hertz-like contact. However, there is still lack of research on the influence of the main mechanical parameters of films on the dynamic bonding fatigue failure mechanism. In this work, graphite-like carbon (GLC) films with a low friction coefficient and different Ti doping ratios were deposited on the surface of stainless steel via direct current magnetron sputtering (DCMS) technology. The microstructure and mechanical properties of the films before and after vacuum annealing were investigated by SEM, Raman, and nanoindentation, and the dynamic bonding failure life of the films were evaluated by the ball-bearing-disc method with dynamic contact fatigue loads. The results revealed that the critical dynamic bonding strength exhibited a significant function dependence on the values of hardness-to-elastic modulus (H3/E2) parameters of the GLC films. The film failure mechanism showed a transition from the film/substrate interface spalling mode to the near-surface cohesion shear spalling mode with the increase of H3/E2. [Display omitted] • GLC films with low friction coefficient and different Ti doping ratios were deposited on stainless steel. • Vacuum annealing treatment leads to changes in the mechanical properties and carbon phase. • The increase of H3/E2 ratio can significantly enhance fatigue life and change the failure behaviours of the GLC films. • The reasons for the difference in failure mechanisms of films at dynamic bonding fatigue strength test were analysed. [ABSTRACT FROM AUTHOR]