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This study underscores the crucial role of seal impressions on Sino-Russian treaties, viewing the indifference of seal-created visual information as a significant defect in current treaty scholarship. This research proposes that the analysis of material seals holds equal importance to the textual examination of written articles in comprehending SinoRussian diplomatic culture. The mandatory use of official seals for signing bilateral treaties in both the Qing and Russian Empires is deeply rooted in their unique civilizations and traditions. From this background, the political culture of these empires guided the treaty negotiators to perceive the seal impressions on treaties not only as mutual commitments to fulfilling the treaty promises but also as a non-linguistic means to engage with their respective relationship positions. As a result, both written articles and visual sigillography are invaluable as primary sources in treaty research.

Agriculture contributes to 22 % of global anthropogenic greenhouse gas emissions, of which fertilizer represents 10.6 % of agricultural greenhouse gas emissions. While there is increasing concern about the impact of chemical fertilizers on climate change, the impact of biofertilizers, especially their manufacturing, has not been addressed extensively. This study quantifies the upstream emissions of a biofertilizer manufacturing plant in Malaysia using the Life Cycle Assessment (LCA) methodology, where electricity consumption (64.2 %) is the biggest source of carbon emissions. The emissions are compared with other fertilizers to determine the environmental advantages of biofertilizers. Compared to other chemical fertilizers, biofertilizer manufacturing emits 23.2 times less carbon emissions than nitrogen fertilizer manufacturing. Chemical fertilizer manufacturing emissions come from various factors, especially energy-intensive processes and direct carbon emissions from material reactions (e.g., carbonate dissolution and material decomposition). Organic fertilizers, such as manure, digestates, and compost, emit up to 10,666 times more carbon emissions due to organic decomposition, which releases carbon dioxide and methane.

Abstract Emotion recognition deficit is related to impaired community functioning. Loneliness is also associated with impaired social performance. However, the way in which emotion recognition and loneliness may contribute to social functioning remains unclear in euthymic patients with bipolar disorder. We aimed to examine emotion recognition ability in Han Chinese euBD patients relative to healthy controls (HCs) and to investigate the associations between emotion recognition, loneliness, and social functioning. Thirty‐nine HCs and 46 euthymic BD patients completed an emotion recognition task and nonsocial cognitive measures related to executive function and attention. The UCLA loneliness scale and Social Performance Scale were administered to evaluate psychological loneliness and social functioning, respectively. We observed lower emotion recognition accuracy, higher loneliness, and poorer social functioning in the BD patients after adjustment for demographic data. Loneliness was negatively associated with global social functioning in both the BD and HC groups. Higher loneliness and lower emotion recognition accuracy were associated with poorer social functioning in euthymic BD in different subdomains. Our study confirmed a subtle impairment of emotion recognition ability in euthymic BD. Loneliness impacts globally on social functioning, while emotion recognition ability may affect specific subdomains of social functioning in euthymic BD. Alleviation of loneliness and enhancement of social cognition might improve social functioning in BD patients.

IntroductionSpindle cell oncocytoma (SCO) of the pituitary gland is increasingly established with improvements in histological and immunohistochemical examination. However, the diagnosis was often mistaken based on imaging studies and nonspecific clinical manifestations.PurposeThis case is presented to provide an overview of the characteristics of the rare tumor as well as to demonstrate the difficulties in diagnosis and current treatments.Clinical discussionThe pathogenesis of SCO remains unclear, and a possible origin was described. Further research is needed to optimize pre-operative diagnosis and surgical strategy.ConclusionSCO should be considered when images indicate some features. Gross total resection (GTR) after surgery seems to have better long-term tumor control, and radiotherapy may help decrease tumor progression in patients with non-GTR. Regular follow-up is advised because of the higher recurrence rate.

Background and purpose: The aim of this study was to examine non‐motor symptoms in different Parkinson's disease (PD) motor subtypes and their associations with quality of life (QoL). Methods: A total of 132 patients with early PD with comprehensive motor examinations and non‐motor symptom assessments were included. Motor subtypes were classified based on Stebbins' method. Non‐motor symptoms were assessed by the Non‐Motor Symptom Scale (NMSS) and validated by more comprehensive instruments, including the Pittsburgh Sleep Quality Index (PSQI) and Fatigue Severity Scale (FSS). QoL was measured by the Parkinson's Disease Questionnaire‐8. Results: We identified 66 patients (50%) with tremor‐dominant (TD) subtype, 47 (35.6%) with postural instability and gait disorder (PIGD) subtype and 19 (14.4%) with Intermediate subtype. By comparing NMSS scores, patients with the PIGD subtype had more severe sleep impairment and fatigue (domain 2 score: 5.64 vs. 2.52, P < 0.001), urinary symptoms (domain 7 score: 6.96 vs. 3.48, P = 0.005) and overall more severe non‐motor symptoms (NMSS total score: 25.89 vs. 17.27, P = 0.031), compared with patients with the TD subtype. Validation using the PSQI and FSS again suggested that patients with the PIGD subtype had independently and significantly more severe sleep impairment (PSQI score: 5.57 vs. 4.29, P = 0.020) and fatigue (FSS score: 34.81 vs. 25.85, P = 0.003) compared with patients with the TD subtype. Several non‐motor symptoms had significant associations with QoL, among which sleep impairment and fatigue (P < 0.0001, partial r2 = 0.273) explained the largest proportion of QoL variability in patients with PD. Conclusions: Patients with the PIGD subtype had more severe sleep impairment, fatigue and urinary disturbance compared with patients with the TD subtype. Sleep impairment and fatigue were the most important factors affecting QoL independent of motor subtypes. Prompt identification and treatment of these non‐motor symptoms may improve patients' QoL. [ABSTRACT FROM AUTHOR]

Surface states of topological semimetals may give rise to unusual transport properties and topological superconductivity. Here, the H-T phase diagram of AuSn4 is experimentally established, displaying 2D superconductivity, Bose metal behavior, and normal-state magnetotransport driven by surface states.

This study aimed to assess the availability of clinical protocols and their effect on compliance to the Surviving Sepsis Campaign bundles and on mortality in severe sepsis in ten Singaporean adult teaching intensive care units (ICU). The presence of 11 protocols in the ICUs, steps taken based on the Johns Hopkins University Quality and Safety Research Group's model to translate protocols into practice, and organisational characteristics were assessed. Clinical and research personnel recorded characteristics of patients with severe sepsis who were admitted in July 2009, the achievement of sepsis bundle targets and outcomes. Hospital mortality was 39% for 128 patients. Fewer than half of the ICUs had protocols for early goal-directed therapy, blood cultures, antibiotics, steroids, lung-protective ventilation and weaning. Compliance rates with the resuscitation and management bundles were 18 and 3% respectively. Units with protocols were generally not more likely to achieve associated bundle targets. Steps from the Johns Hopkins model to measure performance, engage teams and sustain and extend interventions were taken in fewer than half of the available protocols. However, on logistic regression analysis, the number of protocols available per ICU was independently and inversely associated with mortality. In conclusion, clinical protocols are infrequently available in Singapore's ICUs and when present do not generally improve compliance to the sepsis bundles. These protocols may, however, be a surrogate marker of the quality of care as they are independently associated with decreased mortality. The use of an integrated and multifaceted approach to translate protocols into practice should be considered. [ABSTRACT FROM AUTHOR]

The incidence of pharyngolaryngeal adverse events associated with laryngeal mask airways can be reduced by the use of manometry to limit the laryngeal mask airway intracuff pressures. We conducted a prospective, observational study in 80 patients undergoing general anaesthesia with the ProSeal™ laryngeal mask airway to determine the accuracy of a finger palpation technique compared to actual readings obtained from a hand-held manometer by different anaesthesia personnel. The strength of association of estimated versus actual intracuff pressures, R, for nurse anaesthesia assistants, junior anaesthetists and senior anaesthetists were 0.21 (weak), 0.35 (moderate) and 0.78 (strong) respectively. Subgroup analysis showed that anaesthetists with more than three years of experience were more accurate than those with less than three years of experience. The actual versus estimated intracuff pressures were 4±17 vs 19±27 cmH2O (P value <0.001) respectively. In all groups, the palpation technique tended to underestimate the actual intracuff pressure by a mean of 10.3 cmH2O. Palpation accuracy decreased when actual intracuff pressures were >80 cmH2O. These findings suggest that cuff pressure manometry should be recommended as standard of care with the use of laryngeal mask airways. [ABSTRACT FROM AUTHOR]