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The timing of physical activity has been associated with weight and moderate-to-vigorous physical activity (MVPA) in adults. However, few studies have tested associations in young adults, who are biologically and behaviorally different from adults. Young adults (18–35 yr) enrolled in a weight management program provided body mass index (BMI) and 4–7days of ActiGraph accelerometer wear time at baseline. Activity time of day was divided into the following quartiles: morning (06:00–11:59), afternoon (12:00–15:59), evening (16:00–18:59), and night (19:00–00:59). The proportion of weekly MVPA minutes occurring in each time category was used to predict BMI and total weekly MVPA using linear regression models. Marginal trends were estimated for the full sample and by sex. The analytic sample (N = 408, mAge = 23.8±4.5, mBMI = 31.1±4.4) was 79% female, 49% non-Hispanic White, with a mean weekly MVPA of 311±167minutes. MVPA timing was associated with total weekly MVPA but not BMI. Afternoon MVPA was inversely associated with total weekly MVPA in women (−1.72 [95% CI: −3.19, −0.26] min). When considering only bouted MVPA as a predictor, morning (all: 1.43 [95% CI: 0.86, 2.00] min) and night (women: 0.87 [95% CI: 0.15, 1.58] min) MVPA were positively associated with total weekly MVPA. Activity-based interventions designed to improve behavioral health may be improved by providing time-based recommendations tailored to the demographic characteristics of the target population. For example, morning may be an optimal time for both female and male young adults to engage in bouted physical activity to improve total weekly activity levels [ABSTRACT FROM AUTHOR]

Background: Early repair of the ruptured cerebral aneurysm (RRCA), preferably within 24 h of onset, is endorsed by clinical guideline as the preferred management strategy for patients with aneurysmal subarachnoid hemorrhage (aSAH). However, a comprehensive picture of this guideline-recommended usage in contemporary clinical practice is not available. Aims: This study aimed to characterize trends over time and practice variation in the implementation of an early RRCA strategy among patients with aSAH in a large, national representative data. Methods: Using data from the 2012–2019 National Inpatient Sample, we measured trends in the proportion of early RRCA, defined as within day 1 of admission, overall, and by demographic and geographical subgroups. In addition, we created multilevel regression models to quantify hospital-level variation in the early RRCA rates. Results: We identified 82,615 aSAH hospitalizations (mean age = 56.1 years; 68.9% women) undergoing RRCA and, among these, 84.0% (95% confidence interval (CI) = 83.4–84.7%) receiving early RRCA. The proportion of early RRCA increased steadily from 82.5% in 2012 to 85.8% in 2019 (p for trend <0.001). The proportion of patients receiving early RRCA across geographic regions ranged from 78.7% to 87.9%, with a median (interquartile range (IQR)) of 84.2% (83.0–86.1%). In contrast, the delivery of early RRCA varied widely among hospitals, with a median (IQR) rate of 86.1% (75.0–100.0%) and a range from 0% to 100.0%. The median odds ratio for the early use of RRCA treatment was 1.24 (95% CI = 1.21–1.27) in 2019, indicating 24% increased odds of implementing early RRCA if moving from a lower-use to a higher-use hospital. Conclusions: Most patients in the United States with aSAH received early RRCA treatment and exhibited an upward trend over the recent 8-year period. However, substantial variation in access to early RRCA was observed across population subgroups, particularly at the hospital level. Future efforts are necessary to identify further sources of this variation and to develop initiatives that could represent an opportunity to optimize guideline-based quality of care in aSAH management. Data access statement: The data are available from the corresponding author upon reasonable request following completion of onboarding and verification procedures as specified by the HCUP. [ABSTRACT FROM AUTHOR]

The efficiency of biological control agents can be influenced by several factors, such as the quality of their herbivore hosts and the nutritional status of the host plants. This study focused on the parasitism capacity of Habrobracon hebetor (Hymenoptera: Braconidae) on Helicoverpa armigera (Lepidoptera: Noctuidae) reared on different nitrogen fertilized tomato plant cultivars. Four cultivars, namely Kingston, Early Urbana, Super strain-B, and Primo Early, with four nitrogen levels (0, 2.1, 3.0, 3.9 g/pot Nitrogen as Urea 46%), were used. The results showed that the net parasitism rate (C0) of H. hebetor varied from 9.50 to 11.04 and 10.3 to 12.34 host/parasitoid on H. armigera reared on four host plant cultivars with the lowest and highest N levels, respectively. The transformation rate (Qp) on treatments was close to 1. The total parasitism capacity of a stable population (ψ) ranged from 0.224 to 0.358 host/parasitoid. Moreover, the highest recorded values of the finite parasitism rate (ω) included 0.281, 0.390, 0.329 and 0.431 day−1 on the hosts reared on Early Urbana, Super strain-B, Primo Early and Kingston at the highest N levels, respectively. Based on the estimated biological attributes in the current study, the optimum performance for H. hebetor belonged to the hosts fed on Kingston and Super strain-B cultivars. Moreover, the parasitism capacity of the parasitoid was positively influenced by nitrogen fertilized treatments as an effective bottom-up factor. [ABSTRACT FROM AUTHOR]

Previous studies in the horse highlight the potential benefit of prolonged in vitro maturation (IVM) (34 h) compared to short IVM (24 h) with or without prior oocyte holding, but little is known about the optimal IVM duration within this interval. To determine the effect of oocyte holding and duration of IVM ranged between 28 and 34 h on nuclear maturation, cleavage, blastocyst formation, and pregnancy rates, a retrospective study was performed in an equine clinical OPU-ICSI setting. The study included data of 2114 aspirated oocytes from 201 OPU-ICSI sessions. Duration of IVM was divided in three different time windows using quartiles, with 465 oocytes (22.0 %) between 28 and 30 h (first quartile), 1078 oocytes (51.0 %) >30 and 31.7 h (second and third quartiles), and 571 oocytes (27.0 %) >31.7 and 34 h (fourth quartile). Using logistic regression models, the effect of duration of IVM with and without holding was tested on nuclear maturation, cleavage, blastocyst, and pregnancy rates. The three IVM intervals did not show differences in nuclear maturation (respectively 64.5 ± 0.48 %, 65.7 ± 0.47 %, and 67.3 ± 0.47 %), cleavage (respectively 59.7 ± 0.49 %, 58.5 ± 0.49 %, and 64.8 ± 0.48 %), blastocyst (respectively 17.5 ± 0.38 %, 19.0 ± 0.39 %, and 20.8 ± 0.41 %) nor pregnancy rates (respectively 65.4 ± 0.49 %, 70.3 ± 0.46 %, and 74.2 % ± 0.44) (P ≥ 0.38). Oocyte holding prior to IVM did not affect the results either (P ≥ 0.15). In conclusion, oocyte holding and IVM duration between 28 and 34h do not significantly affect outcomes, allowing flexibility in the planning of clinical OPU-ICSI in horses. • Oocyte holding and in vitro maturation duration between 28 and 34 h do not affect equine OPU-ICSI outcomes. • Equine OPU-ICSI outcomes were determined for IVM intervals of 28–30h, 30–31.7h and 31.7–34h, with and without prior oocyte holding. • No differences in nuclear maturation, cleavage blastocyst or pregnancy rates were found between the three IVM time windows and prior oocyte holding did not affect these outcomes either. [ABSTRACT FROM AUTHOR]

Purpose: Our aim was to update evidence-based and consensus-based recommendations for the initial surgical management of spinal (cord) injuries in patients with multiple and/or severe injuries based on current evidence. This guideline topic is part of the 2022 update of the German Guideline on the Treatment of Patients with Multiple and/or Severe Injuries. Methods: MEDLINE and Embase were systematically searched to May 2021. Further literature reports were obtained from clinical experts. Randomised controlled trials, prospective cohort studies, and comparative registry studies were included if they compared interventions and the timing of interventions for the initial surgical management of spinal (cord) injuries in patients with polytrauma and/or severe injuries. We considered patient-relevant clinical outcomes such as mortality, complication rates, and lengths of stay. Risk of bias was assessed using NICE 2012 checklists. The evidence was synthesised narratively, and expert consensus was used to develop recommendations and determine their strength. Results: Seven new studies were identified. All studies compared different moments for the initial surgical management of spinal injuries. Three recommendations were modified, and three additional recommendations were developed. All achieved strong consensus. Conclusion: The following key recommendations are made. (1) Patients with spinal injuries or deformities with confirmed or assumed neurological deficits which can be treated operatively should undergo surgery as soon as possible (ideally on day 1) if their other medical conditions permit. (2) If suggested by fracture morphology with spinal canal compression or translational injury and if spinal neurological damage cannot be ruled out, assume the presence of spinal neurological damage until it can be ruled out. (3) In the absence of neurological signs and/or symptoms, unstable spinal injuries should be treated by early surgical stabilization based on the patient’s overall condition. (4) Depending on the injury, an anterior and/or posterior approach or, in exceptional cases, a halo fixation device can be used to stabilize the cervical spine. (5) Posterior internal fixation should be used as the primary surgical technique for stabilizing injuries to the thoracic and lumbar spine. [ABSTRACT FROM AUTHOR]

Although scholars and practitioners argue that organizations should provide justice information in the aftermath of a psychological contract breach (PC breach) to prevent or reduce violation feelings, it remains unclear whether that information should be provided within a few hours, days, or weeks following a PC breach. We estimated a 2-level time-lagged regression model on experience sampling data from 76 (226 observations), 70 (213 observations), and 70 (344 observations) employees with different intervals to test the durability of informational justice as a moderator on the PC breach-violation feelings relationship. We found that justice information should be provided in close temporal proximity (i.e., within the same day; Study 1) of PC breach to reduce violation feelings. In contrast, neither justice information provided the day (Study 2) or week (Study 3) after a PC breach successfully moderated the PC breach-violation feelings relationship. The current paper underscores the importance of being informationally just in close temporal proximity to a PC breach in line with resolution velocity as an indicator of the effectiveness of the recovery process. We discuss theoretical and practical implications of these findings. [ABSTRACT FROM AUTHOR]

Objectives: The relationship between sugar-sweetened beverage (SSB) intake and phenotypic age acceleration (PhenoAgeAccel) is unclear. The aim of this study was to explore the associations between the energy and timing of SSB intake and PhenoAgeAccel in adults. Methods: A cross-sectional analysis was conducted using data from the National Health and Nutrition Examination Survey (NHANES) 2007–2010, which involved U.S. adults aged 20 to 79 years. The assessment and estimation of SSB intake were conducted through 24-hour dietary recall interviews, categorizing participants into three groups: non-intake, low moderate-intake, and moderate–high-intake. Furthermore, SSB consumers were divided into three time intervals based on intake timing: dawn-to-forenoon (5:00 a.m. to 11:59 a.m.), noon-to-afternoon (12:00 p.m. to 17:59 p.m.), and dusk-to-night (18:00 p.m. to 4:59 a.m.). Multivariable linear regression models were employed to evaluate the associations between SSB intake (energy and timing) and PhenoAgeAccel. Additionally, stratified analyses and interaction analyses were conducted. Furthermore, obesity was assessed via two distinct metrics: the body roundness index (BRI) and the body mass index (BMI). Mediation analysis was conducted to investigate the mediating effect of obesity on the relationship between the energy of SSB intake and PhenoAgeAccel. Results: After controlling for covariates, SSB intake (per 100 kcal/day) was positively correlated with PhenoAgeAccel (β = 0.179, 95% confidence interval [CI]: 0.086–0.271). The moderate–high-intake group presented a significantly greater PhenoAgeAccel than the non-intake group (β = 1.023, 95% CI: 0.414–1.632). This relationship remained stable across stratified analyses. Compared with those who abstained from SSB, those who consumed SSB during the dusk-to-night period exhibited notably elevated PhenoAgeAccel (β = 0.915, 95% CI: 0.316–1.514). A significant interactive effect of smoking on the SSB intake timing–PhenoAgeAccel association was observed (P for interaction = 0.002). Mediation analysis revealed that both BRI and BMI significantly mediated the relationship between energy intake from SSB and PhenoAgeAccel, with mediation proportions of 16.29% and 16.21%, respectively. Conclusion: Our study revealed a positive correlation between SSB energy intake and PhenoAgeAccel, which may be partially mediated by obesity. Moreover, consuming SSB during the dusk-to-night period may increase PhenoAgeAccel. [ABSTRACT FROM AUTHOR]

Children with attention deficit hyperactivity disorder (ADHD) exhibit various degrees of motor and cognitive impairments in fine and gross motor skills. These impairments impact social functioning, while also hindering academic achievement, self-esteem, and participation. Specifically, motor impairments are not fully addressed by current therapies. For example, approximately 50% of children with ADHD exhibit significant motor impairments, as per clinical measures, while the other 50% experience more impairments in motor planning, execution and control than do typically developed (TD) children. Such findings indicate that ADHD-specific mechanisms may be underpinning motor impairments. In this paper, we outline ADHD impairments in motor planning, execution, and control, and the potential role of two such mechanisms: internal motor representation and timing perception. Next, we suggest mental imagery as an approach for treating ADHD motor impairments, potentially through addressing internal motor representation and timing perception. [ABSTRACT FROM AUTHOR]

This brief report aims to compare the performance of motor reproduction and timeline estimation tasks in two groups of children aged 5–6 and 7–8 years old. The study included 80 children and used a computer-based experiment with two sessions for each method. The findings suggest that motor reproduction and timeline estimation tasks differ in accuracy and variability, with timeline estimation yielding more accurate and less variable estimates. These differences between the two tasks are even more pronounced in younger children. The discussion highlights the importance of using the timeline estimation task for future research on children's time perception. [ABSTRACT FROM AUTHOR]

Temporal processing can be divided into explicit timing and implicit timing. Explicit timing tasks require participants to attend to the temporal aspects of the task, whereas in implicit timing tasks, temporal information affects performance without explicit instruction to process time. Compared to younger adults, older adults have been shown to exhibit greater variability in explicit timing, while in implicit timing, they have been shown to rely more on temporal predictions formed by the hazard function. However, the relationship between explicit and implicit timing and its age-related changes have yet to be explored. To address this issue, we collected data in which younger and older adults performed a time bisection task (i.e., explicit timing task) and a foreperiod task (i.e., implicit timing task) in a within-subjects design. Based on a Bayesian optimization framework, we hypothesized that individuals with higher variability in explicit timing would show a stronger foreperiod effect, which is an index of the degree of reliance on temporal predictions. Results showed a different relation between explicit and implicit timing in younger and older adults. In older adults, results were consistent with the hypothesis that increased variability in explicit timing was associated with a stronger foreperiod effect. In contrast, bias in the temporal representation but not variability was associated with the foreperiod effect in younger adults. Implications for the age-related difference in the relation between explicit and implicit timing are discussed. [ABSTRACT FROM AUTHOR]

This paper inductively distinguishes six types of European Parliament (EP) involvement in the negotiation of international agreements. Since 2009, the EP has veto power on international agreements and has leveraged it through various activities such as resolutions. However, there exists no cross-case characterization of the EP's involvement. Therefore, this paper asks: what are the types of EP involvement during the negotiation of international agreements? To systematically compare the nature, frequency and timing of EP activities, sequence analysis is applied to a dataset of EP activities relative to the 344 agreements concluded since 2009. For a majority of agreements, the EP acts as a 'bystander' and does not conduct any activities. When it does conduct activities, the EP most frequently acts as a 'loud late riser' and is active only during the ratification stage. For other agreements, EP involvement is very diverse regarding the timing and frequency of activities. [ABSTRACT FROM AUTHOR]

Background: Coronary artery disease (CAD) and depression often coexist, complicating disease management and worsening prognoses. Depression significantly increases mortality risk in CAD patients, but the impact of depression onset timing on long-term mortality in 2-year survival CAD patients remains unclear. Methods: This retrospective cohort study used data from Taiwan’s National Health Insurance Research Database from January 1, 2007, to December 31, 2014, including 1,254,084 individuals in the “no depression” group, 14,554 individuals in the “before CAD” group, 1,839 individuals in the “within one month” group, and 17,427 individuals in the “after one month” group between 2008 and 2010, with excluding mortal individuals within 2 years of CAD. It assessed all-cause mortality, CAD-specific mortality, all-cause hospitalization, and CAD-specific hospitalization over a two-year follow-up period. Results: Hazard ratios (HRs) for all-cause mortality were lower in the “before CAD” (HR 0.93, 95% CI 0.89–0.97), “within one month” (HR 0.76, 95% CI 0.67–0.87), and “after one month” (HR 0.52, 95% CI 0.49–0.54) groups compared to the “no depression” group. Women had significantly lower HRs for all-cause and CAD-specific mortality. The “after one month” group showed a higher risk for all-cause hospitalization. Socioeconomic status, comorbidities, and age significantly influenced outcomes. Conclusion: Depression in CAD patients who survived beyond two years appeared to confer a protective effect on mortality. These findings suggest that there may be other confounding factors that influence the prognosis of 2-year survival CAD patients. Further research may explore the mechanisms underlying these protective effects to improve clinical practices. [ABSTRACT FROM AUTHOR]

In response to the current needs of patients with limb dysfunction, with the goal of safety, real-time, non-invasive, and intelligent rehabilitation assessment, and with limb dysfunction patients as the research object, the author uses intelligent perception technology to obtain rehabilitation data of patients, fully utilizing the advantages of the data itself, and is committed to achieving rehabilitation training and muscle fatigue assessment for limb dysfunction patients. The author developed an assessment model for limb function evaluation using the Dynamic Time Warping K-Nearest Neighbor (DTW-KNN) algorithm and a Long Short-Term Memory (LSTM) neural network-based evaluation model. Based on the experimental findings, it was demonstrated that DTW-KNN effectively categorizes and assesses the rehabilitation motions of upper limbs during elbow flexion under various completion scenarios. Patients have the flexibility to conduct independent and effective upper limb rehabilitation training at home using the upper limb functional rehabilitation system, without any constraints of time or space. By enabling physicians to promptly modify the rehabilitation plan, the system significantly addresses the limitations of conventional upper limb rehabilitation approaches, lowers the medical expenses associated with stroke upper limb rehabilitation, and helps mitigate the shortage of rehabilitation specialists. Utilizing the developed upper limb functional rehabilitation system, the author gathered a set of inertial sensing data on upper limb rehabilitation movements, showcasing prominent temporal features. Consequently, to address this issue, the author proposes the use of Long Short-Term Memory (LSTM) neural network - a recurrent neural network (RNN) with superior temporal data processing capabilities. Based on the multi-dimensional inertial sensing data collected by the upper limb rehabilitation system, the author constructs a recurrent neural network classification model. The model can accurately classify and evaluate different types of upper limb rehabilitation movements under varying completion scenarios. The experimental results indicate that: The overall classification accuracy of DTW-KNN for elbow flexion, elbow flexion&forearm abduction, and shoulder flexion in upper limb rehabilitation movements is 71.8%, 47.9%, and 68.8%, respectively. It was observed that the classification accuracies of LSTM neural network model were 98.2%, 93.3%, and 95.1%, respectively. This marks a notable improvement in the classification accuracy of LSTM neural network model compared to DTW-KNN, with an increase of 26.4%, 45.4%, and 26.3%, respectively. LSTM has a significant advantage over DTW-KNN in terms of classification time, with less classification time. [ABSTRACT FROM AUTHOR]

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Objective: Sentinel Lymph Node Biopsy (SLNB) is an important management tool for early-stage melanoma. Different radiopharmaceuticals are used internationally to localise the sentinel node using lymphoscintigraphy (LSG) before surgery. Recent reports have suggested that a delayed interval between LSG and SLNB using 99mTc-labelled nanocolloid tracer has an adverse survival impact, but not with 99mTc-labelled antimony sulphide colloid. This study aims to analyse survival outcome in a prospective cohort of melanoma patients undergoing same day or next day SLNB after LSG using 99mTc-labelled nanocolloid. Methods: Outcome data were reviewed for patients undergoing SLNB, stratified by time interval between LSG and SLNB at a single UK academic centre. Kaplan–Meier survival analysis was used to assess overall survival (OS), melanoma-specific survival (MSS) and progression-free survival (PFS). Cox multivariable regression analysis identified independent risk factors. Results: 925 patients had LSG using the 99mTc-nanocolloid tracer between 2009 and 2019, with a median follow-up of 6.36 years. No difference was seen on univariate analysis in OS, MSS, PFS, or nodal recurrence between patients undergoing same day or next day SLNB (Log-rank P = 0.437, 0.293, 0.587, 0.342 respectively). In addition, nodal recurrence as first site or anytime site of recurrence in SLNB negative patients was similar between the groups (Log-rank P = 0.093 and 0.457 respectively). Stratified analysis of time did not demonstrate an outcome difference (MSS Log-rank P = 0.938). Cox multivariable regression did not show time interval to independently influence OS, MSS or PFS. Conclusions: We do not find a significant effect on long-term outcomes when SLNB is performed the day after LSG with 99mTc-labelled nanocolloid tracer. We infer that tracer migration is not clinically significant within 24 h of injection based on long term clinical outcome data. [ABSTRACT FROM AUTHOR]

This article reports a 110.2 MHz ultra-low-power phase-locked loop (PLL) for MEMS timing/frequency reference oscillator applications. It utilizes a 6.89 MHz MEMS-based oscillator as an input reference. An ultra-low-power, high-resolution phase-frequency detector (PFD) is utilized to achieve low-noise performance. Eliminating the reset feedback path used in conventional PFDs leads to dead/blind zone-free phase characteristics, which are crucial for low-noise applications within a wide operating frequency range. The PFD operates up to 2.5 GHz and achieves a linear resolution of 100 ps input time difference ( Δ t i n ), without the need for any additional calibration circuits. The linearity of the proposed PFD is tested over a phase difference corresponding to aa Δ t i n ranging from 100 ps to 50 ns. At a 1 V supply voltage, it shows an error of <±1.6% with a resolution of 100 ps and a frequency-normalized power consumption ( P n ) of 0.106 pW/Hz. The PLL is designed and fabricated using a TSMC 65 nm CMOS process instrument and interfaced with the MEMS-based oscillator. The system reports phase noises of −106.21 dBc/Hz and −135.36 dBc/Hz at 1 kHz and 1 MHz offsets, respectively. It consumes 6.709 μ W at a 1 V supply and occupies an active CMOS area of 0.1095 mm2. [ABSTRACT FROM AUTHOR]

Background: Recent randomized clinical trials (RCTs) of STEMI patients with multi-vessel disease (MVD) reported potential superiority of immediate (ICR) vs. staged complete revascularization (SCR). Inherently, the risk of procedural MI is less likely to be detected in ICR patients, and this may have influenced the results. Recently published meta-analyses encompassed observational studies without including STEMI data from the BioVasc trial. The aim of this meta-analysis was to perform an updated comparison of the two strategies in STEMI patients with MVD. Methods: Electronic databases were searched from their inception till August 2024 to identify RCTs assessing CR timing in STEMI patients with MVD. Only studies with an endpoint involving major adverse cardiovascular events (MACE) were included. Results: Six RCTs totaling 2023 patients were included in the analysis. The median time to staged PCI was 19 days. The incidence of MACE (as defined by each study's protocol) was comparable between the two strategies [RR 0.86, 95% CI (0.58 to 1.27)]. There was also no difference in the risk of non-procedural MI [RR 0.91, 95% CI (0.49–1.67)], death [RR 1.47, 95% CI (0.89–2.44)] and cardiovascular death [RR 1.53, 95% CI (0.79–2.98)]. There was a significant 40% reduction in unplanned revascularization in patients undergoing ICR versus SCR [RR 0.60 (0.40 to 0.89), p = 0.01]. Conclusions: ICR reduced the risk of unplanned revascularization compared to SCR but had a comparable effect on MACE, death, cardiovascular death and non-procedural MI. Both strategies are safe in managing patients with acute MI and MVD. [ABSTRACT FROM AUTHOR]

Despite extensive research on task planning in L2 writing contexts, the optimal length of pre-task planning time remains uncertain due to varying lengths used in TBLT studies. This study aimed to address this gap by investigating the effects of different pre-task planning times (nil, 5, 10, and 15 minutes) on the argumentative writing task performance of 80 L2 learners. Additionally, the study explored L2 learners' perceptions of pre-task planning time lengths through semi-structured interviews, given the lack of evidence on this topic. The quantitative analyses indicated that pre-task planning supported Kellogg's Overload Hypothesis and facilitated the quantity and quality of written outputs. In particular, a 10-minute planning time showed the most significant improvement in complexity, accuracy, and fluency. However, longer planning times (15 minutes) led to greater complexity, and shorter planning times (5 minutes) resulted in greater accuracy. The qualitative analyses revealed that while L2 learners had different perceptions of pre-task planning time lengths, the majority found a 10-minute planning time to be the most effective. This study has theoretical and pedagogical implications for TBLT researchers and L2 writing practitioners. [ABSTRACT FROM AUTHOR]

Background: We investigated the proper timing, efficacy and safety of tacrolimus for juvenile myasthenia gravis (JMG). Methods: We conducted a retrospective cohort study for JMG patients treated with tacrolimus at Xiangya Hospital, Central South University, Changsha, China from 2010 to 2023. The clinical information of patients with a follow‐up of more than 1 year was collected. Comparisons of clinical features between groups of patients who achieved therapeutic goal and those who did not achieve therapeutic goal as well as between groups of patients treated with tacrolimus within or after 1 year from JMG onset was carried out. Results: Forty‐three patients were enrolled, of whom 28 achieved therapeutic goal. Tacrolimus reduced glucocorticoids (GC) dosages for the 28 cases and 15 cases discontinued GC completely. Generalized myasthenia gravis (GMG) subtype had an association with a group of patients who achieved therapeutic goal (p = 0.001). Median duration from JMG onset to tacrolimus use was 10.50 months for those who achieved therapeutic goal and 36.00 months for those who did not achieve therapeutic goal (p = 0.010). The median Myasthenia Gravis Activities of Daily Living (MG‐ADL) score improved significantly (p = 0.003). The initiation of tacrolimus within 1 year of JMG onset showed an association with achievement of therapeutic goal (p = 0.026). GMG subtype showed an association with a group of patients who received tacrolimus within 1 year (p = <0.001). Tacrolimus side effects were tolerable. Conclusion: The provision of tacrolimus within 1 year of JMG onset is effective and safe. [ABSTRACT FROM AUTHOR]

Achieving high yields in the large-scale agricultural systems that dominate the US landscape requires critical machine-enabled field operations to be executed in narrow windows of time. Novel cropping systems hold great promise to increase ecosystem services from these large-scale systems, but researchers and end-users need effective methods of representing the timing requirements of such systems. This gap prompted our exploration of approaches to visualize the timing of critical machine-enabled field operations. We refer to the resulting graphic as a field operations visualizer (FOV). We iterated multiple versions of the FOV through a user-centered process involving extensive stakeholder feedback. The resulting FOV version offers a straightforward method of visualizing operation sequences and identifying potential conflicts. Survey results suggest that the FOV provides significant operational insights to users about the timing challenges (or benefits) of novel cropping systems. The FOV may therefore be useful in guiding efforts to improve novel cropping systems and to thereby ultimately increase their deployment to deliver ecosystem services. [ABSTRACT FROM AUTHOR]

Purpose: In humans, 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) tumour-to-background contrast continues to increase long after a typical uptake period of 45 – 60 min. Similar studies have not been performed in mice and the static imaging time point for most studies is arbitrarily set at 30 – 60 min post-injection of [18F]FDG. Ideally, static PET imaging should be performed after the initial period of rapid uptake but this period has not been defined in mice, with previous dynamic studies in mice being limited to 60 min. This study aimed to define the kinetics of [18F]FDG biodistribution over periods of 3 – 4 h in different murine tumour models, both subcutaneous and autochthonous, and to further refine fasting and warming protocols used prior to imaging. Procedures: Dynamic [18F]FDG PET-CT scans lasting 3 or 4 h were performed with C57BL/6 J and Balb/c nude mice bearing subcutaneous EL4 murine T-cell lymphoma and Colo205 human colorectal tumours, respectively, and with transgenic Eμ-Myc lymphoma mice. Prior to [18F]FDG injection, four combinations of different animal handling conditions were used: warming for 1 h at 31 °C; maintenance at room temperature (20 – 24 °C), fasting for 6 – 10 h and a fed state. Results: Tumour mean standardised uptake value (SUVmean) peaked at 147 ± 48 min post injection in subcutaneous tumours and 74 ± 31 min in autochthonous Eμ-Myc lymphomas. The tumour-to-blood ratio (TBR) peaked at 171 ± 57 and 83 ± 33 min in subcutaneous and autochthonous Eμ-Myc tumours, respectively. Fasting increased tumour [18F]FDG uptake and suppressed myocardial uptake in EL4 tumour-bearing mice. There was a good correlation between tumour SUVmean and Ki calculated using an input function (IDIF) derived from the inferior vena cava. Conclusions: Delayed static [18F]FDG-PET imaging (> 60 min) in both autochthonous and subcutaneous tumours in improved tumour-to-background contrast and increased reproducibility. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the associations of outdoor playtime, screen time, and sleep duration with ball bouncing skills in a sample of 3- to 5-year-old children. Participants were young children (N = 11,121; 48.8% female) whose parent/guardian completed the 2022 National Survey of Children's Health. The dependent variable was one item that asked about the child's ability to bounce a ball repeatedly. The primary independent variables were the National Survey of Children's Health items asking about hours of weekday and weekend outdoor play, screen time, and sleep duration. The primary analysis consisted of robust Poisson regression models to calculate adjusted prevalence ratios by regressing competent (high) ball bouncing skills with reported hours of weekday and weekend outdoor play, screen time, and sleep. After covariate adjustment, two or more hours spent in weekday outdoor play was associated with a 15%–41% higher prevalence of competent ball bouncing skills (p <.01), and three or more hours of weekend outdoor play was associated with a 14%–28% higher prevalence of competent ball bouncing skills (p <.05). More hours of outdoor play were associated with competency in ball bouncing skills in young children. Mechanisms for this association are unclear and warrant further investigation. [ABSTRACT FROM AUTHOR]

Defining plant development timing through seasonal growth and dormancy phases is a valuable proxy for studying climate change and serves as an annual bioindicator. However, current methods for determining the growing season vary due to species‐specific interpretations and differing understandings of its main drivers. Körner et al. (2023) introduced four non‐interchangeable definitions of growing seasons to clarify this complex issue. While some studies have paired different methods, none have simultaneously applied a full set of methods at the individual tree or species level. Here, I aim to present a new perspective to understanding growing season timing by focusing on all facets of above‐ground tree growth and measurable biological and phenological markers. This approach calls for simultaneous, continuous monitoring during active and dormancy periods on the same trees and across different species at a large spatial scale. The goal is to comprehensively understand each method's errors, temporal lags, and the factors determining each growing season, as defined by Körner et al. (2023, Ecology Letters, 26, 1277). Accurate estimation of growing season timing can reshape our understanding of its environmental drivers, improve terrestrial ecosystem models, assess the impact of climate change on tree growth, determine the biological zero for various species, verify remote sensing indices and forecast species distribution. [ABSTRACT FROM AUTHOR]

Vasopressor administration at an appropriate time is crucial, but the optimal timing remains controversial. Does early vs late norepinephrine administration impact the prognosis of septic shock? Searches were conducted in PubMed, EMBASE, the Cochrane Library, and KMbase databases. We included studies of adults with sepsis and categorized patients into an early and late norepinephrine group according to specific time points or differences in norepinephrine use protocols. The primary outcome was overall mortality. The secondary outcomes included length of stay in the ICU, days free from ventilator use, days free from renal replacement therapy, days free from vasopressor use, adverse events, and total fluid volume. Twelve studies (four randomized controlled trials [RCTs] and eight observational studies) comprising 7,281 patients were analyzed. For overall mortality, no significant difference was found between the early norepinephrine group and late norepinephrine group in RCTs (OR, 0.70; 95% CI, 0.41-1.19) or observational studies (OR, 0.83; 95% CI, 0.54-1.29). In the two RCTs without a restrictive fluid strategy that prioritized vasopressors and lower IV fluid volumes, the early norepinephrine group showed significantly lower mortality than the late norepinephrine group (OR, 0.49; 95%, CI, 0.25-0.96). The early norepinephrine group demonstrated more mechanical ventilator-free days in observational studies (mean difference, 4.06; 95% CI, 2.82-5.30). The incidence of pulmonary edema was lower in the early norepinephrine group in the three RCTs that reported this outcome (OR, 0.43; 95% CI, 0.25-0.74). No differences were found in the other secondary outcomes. Overall mortality did not differ significantly between early and late norepinephrine administration for septic shock. However, early norepinephrine administration seemed to reduce pulmonary edema incidence, and mortality improvement was observed in studies without fluid restriction interventions, favoring early norepinephrine use. [Display omitted] [ABSTRACT FROM AUTHOR]

The process of placing a patient on venoarterial extracorporeal membrane oxygenation (VA-ECMO) is complex and requires the activation and coordination of numerous personnel from a variety of disciplines to achieve procedural success, initiate flow, and subsequently monitor the patient's condition. The literature suggests that nighttime cannulation for extracorporeal cardiopulmonary resuscitation (ECPR) is associated with adverse outcomes compared to daytime cannulation. Given the strain on personnel that this process can create, it is plausible that patients who are initiated on VA-ECMO for non-ECPR indications during the nighttime and on weekends, which are generally periods with reduced staffing compared to weekday daytime hours, also may experience worse outcomes, including decreased survival. This study aimed to determine whether nighttime/weekend VA-ECMO cannulation is associated with worse outcomes, including decreased survival. Retrospective cohort study Large quaternary academic medical center Patients VA-ECMO cannulation during the day versus night/weekends We performed a retrospective review of patients at a single center who underwent VA-ECMO cannulation between 2011 and 2021. The 468 patients included 158 patients (33.8%) in the daytime cannulation cohort and 310 (66.2%) in the nighttime/weekend cannulation cohort. Nighttime and weekend VA-ECMO cannulations were not associated with increased 1-year mortality (64.2% vs 60.1%; p = 0.42) or with increased use of renal replacement therapy (25.4% vs 22.2%; p = 0.49). We conclude that nighttime and weekend VA-ECMO cannulations can be performed safely at a large academic medical center. [ABSTRACT FROM AUTHOR]