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Background and objectiveDespite its acknowledged benefits, the selection of an optimal regional block for analgesia pediatric hernia surgery remains a subject of debate. This study endeavored to conduct a network meta-analysis and systematic review of randomized clinical trials, aiming to amalgamate insights from both direct and indirect comparisons concerning the analgesic effectiveness and safety of various regional blocks post-inguinal hernia repair in children.MethodA comprehensive literature search was performed across PubMed, EMBASE, Web of Science, and the Cochrane Library up to 12 November 2022 by two independent reviewers, employing a standardized protocol. The inclusion criteria encompassed randomized trials focusing on children undergoing inguinal hernia repair utilizing either local infiltration analgesia or regional analgesia. The primary outcomes assessed were pain scores at 2, 6, and 24 h post-operation.ResultsThe initial search yielded 281 records relating to 1,137 patients. The analysis of ranking probability indicated that Paravertebral Block (PVB) holds the highest likelihood (88% and 48%) of being the most effective in alleviating pain at 2 h and 6 h post-surgery. Trans vs. Abdominis Plane Block (TAPB) emerged as the superior choice for mitigating pain (83%) and decreasing morphine consumption (93%) at 24 h following the operation. Local Anesthetic Infiltration (LAI) was identified as the most effective in shortening the hospital stay, with a 90% probability.ConclusionsRegional anesthesia significantly enhances postoperative pain management in pediatric inguinal hernia repair surgery. For short-term postoperative pain relief, PVB emerges as the most effective technique. Meanwhile, TAPB provides more prolonged analgesia. Although TAPB does not exhibit a pronounced advantage in short-term analgesia, its simplicity and the absence of a need for a special position render it a viable option. However, the interpretation of these results should be approached with caution due to the presence of limited data and heterogeneity.Systematic Review RegistrationPROSPERO (CRD42022376435; www.crd.york.ac.uk/prospero).

Abstract Background Abnormalities in the 5-HT system and synaptic plasticity are hallmark features of schizophrenia. Previous studies suggest that the human endogenous retrovirus W family envelope (ERVWE1) is an influential risk factor for schizophrenia and inversely correlates with 5-HT4 receptor in schizophrenia. To our knowledge, no data describes the effect of ERVWE1 on 5-HT neuronal plasticity. N6-methyladenosine (m6A) regulates gene expression and impacts synaptic plasticity. Our research aims to systematically investigate the effects of ERVWE1 on 5-HT neuronal plasticity through m6A modification in schizophrenia. Results HTR1B, ALKBH5, and Arc exhibited higher levels in individuals with first-episode schizophrenia compared to the controls and showed a strong positive correlation with ERVWE1. Interestingly, HTR1B was also correlated with ALKBH5 and Arc. Further analyses confirmed that ALKBH5 may be an independent risk factor for schizophrenia. In vitro studies, we discovered that ERVWE1 enhanced HTR1B expression, thereby activating the ERK-ELK1-Arc pathway and reducing the complexity and spine density of 5-HT neurons. Furthermore, ERVWE1 reduced m6A levels through ALKBH5 demethylation. ERVWE1 induced HTR1B upregulation by improving its mRNA stability in ALKBH5-m6A-dependent epigenetic mechanisms. Importantly, ALKBH5 mediated the observed alterations in 5-HT neuronal plasticity induced by ERVWE1. Conclusions Overall, HTR1B, Arc, and ALKBH5 levels were increased in schizophrenia and positively associated with ERVWE1. Moreover, ALKBH5 was a novel risk gene for schizophrenia. ERVWE1 impaired 5-HT neuronal plasticity in ALKBH5-m6A dependent mechanism by the HTR1B-ERK-ELK1-Arc pathway, which may be an important contributor to aberrant synaptic plasticity in schizophrenia.

Abstract Background With the advent of intensive combination regimens, an increasing number of patients with unresectable pancreatic cancer (UPC) have regained the opportunity for surgery. We investigated the clinical benefits and prognostic factors of conversion surgery (CS) in UPC patients. Methods We retrospectively enrolled patients with UPC who had received CS following first-line systemic treatment in our center between 2014 to 2022. Treatment response, safety of the surgical procedure and clinicopathological data were collected. We analyzed the prognostic factors for postoperative survival among UPC patients who had CS. Results Sixty-seven patients with UPC were enrolled (53 with locally advanced pancreatic cancer (LAPC) and 14 with metastatic pancreatic cancer (MPC)). The duration of preoperative systemic treatment was 4.17 months for LAPC patients and 6.52 months for MPC patients. All patients experienced a partial response (PR) or had stable disease (SD) preoperatively according to imaging. Tumor resection was unsuccessful in four patients and, finally, R0 resection was obtained in 81% of cases. Downstaging was determined pathologically in 87% of cases; four patients achieved a complete pathological response. Median postoperative-progression-free survival (PO-PFS) was 9.77 months and postoperative overall survival (PO-OS) was 31.2 months. Multivariate logistic regression analyses revealed that the resection margin and postoperative changes in levels of tumor markers were significant prognostic factors for PO-PFS. No factors were associated significantly with PO-OS according to multivariate analyses. Conclusions CS is a promising strategy for improving the prognosis of UPC patients. The resection margin and postoperative change in levels of tumor markers are the most important prognostic factors for prolonged PFS. Multidisciplinary treatment in high-volume centers is strongly recommended. Prospective studies must be undertaken to resolve the various problems regarding optimal regimens, the duration of treatment, and detailed criteria for CS.

Abstract Background Anastomosing hemangioma is an uncommon benign vascular tumor that may be mistaken for a malignancy. The imaging findings of anastomosing hemangioma are not well provided from the previous reports. Herein, in the study, we discuss the imaging findings for one case of retroperitoneal anastomosing hemangioma. Case presentation One 64-year-old female patient had a left retroperitoneal mass that was incidentally detected upon physical examination. A hypoechoic mass with abundant blood flow signals was found by US in the perirenal space. CT and MRI detected a large cystic and solid lesion in the left retroperitoneal space. Plain CT indicated that the internal density was uneven, and the pattern of enhancement was obvious and progressive. MRI-T2WI showed high intensity, DWI showed isointensity, and the mass also showed obvious progressive enhancement. Finally, anastomosing hemangioma was diagnosed via histopathological studies. Conclusion As a rare and benign tumour, anastomosing hemangioma is easily misinterpreted. We suggest that the observation of “genitourinary tract related, well defined, hyperintensity or isointensity on T2WI, isointensity on DWI, and obvious progressive enhancement patterns likely to the vascular enhancement” may consider the diagnosis of AH.

Cadmium (Cd) is one of the most toxic and widely distributed heavy metal pollutants, posing a huge threat to crop production, food security, and human health. Corn is an important food source and feed crop. Corn growth is subject to Cd stress; thus, reducing cadmium stress, absorption, and transportation is of great significance for achieving high yields, a high efficiency, and sustainable and safe corn production. The use of silicon or melatonin alone can reduce cadmium accumulation and toxicity in plants, but it is unclear whether the combination of silicon and melatonin can further reduce the damage caused by cadmium. Therefore, pot experiments were conducted to study the effects of melatonin and silicon on maize growth and cadmium accumulation. The results showed that cadmium stress significantly inhibited the growth of maize, disrupted its physiological processes, and led to cadmium accumulation in plants. Compared to the single treatment of silicon or melatonin, the combined application of melatonin and silicon significantly alleviated the inhibition of the growth of maize seedlings caused by cadmium stress. This was demonstrated by the increased plant heights, stem diameters, and characteristic root parameters and the bioaccumulation in maize seedlings. Under cadmium stress, the combined application of silicon and melatonin increased the plant height and stem diameter by 17.03% and 59.33%, respectively, and increased the total leaf area by 43.98%. The promotion of corn growth is related to the reduced oxidative damage under cadmium stress, manifested in decreases in the malondialdehyde content and relative conductivity and increases in antioxidant enzyme superoxide dismutase and guaiacol peroxidase activities, as well as in soluble protein and chlorophyll contents. In addition, cadmium accumulation in different parts of maize seedlings and the health risk index of cadmium were significantly reduced, reaching 48.44% (leaves), 19.15% (roots), and 20.86% (health risk index), respectively. Therefore, melatonin and silicon have a significant synergistic effect in inhibiting cadmium absorption and reducing the adverse effects of cadmium toxicity.

Abstract Background Increasing attention has been paid to the effect of Epimedium on the nervous system, particularly anti-depression function. In the present study, we applied network pharmacology to introduce a testable hypothesis on the multi-target mechanisms of Epicedium against depression. Methods By reconstructing the network of protein–protein interaction and drug–component–target, we predicted the key protein targets of Epicedium for the treatment of depression. Then, through molecular docking, the interaction of the main active components of Epicedium and predicted candidate targets were verified. Results Nineteen active compounds were selected from Epicedium. There were 200 targets associated with Epicedium and 537 targets related to depression. The key targets of Epicedium for treating depression were IL6, VEGFA, AKT1, and EGF. According to gene ontology functional enrichment analysis, 22 items of biological process (BP), 13 items of cell composition (CC) and 9 items of molecular function (MF) were obtained. A total of 56 signaling pathways (P < 0.05) were identified by Kyoto Encyclopedia of Genes and Genomes analysis, mainly involving depression-related pathways such as dopaminergic synapse, TNF signaling pathway, and prolactin signaling pathway. The results of molecular docking showed that the most important activity components, including luteoklin, quercetin and kaempferol, were well combined with the key targets. Conclusions Luteoklin, quercetin, kaempferol and other active compounds in Epicedium can regulate multiple signaling pathways and targets such as IL6, AKT1, and EGF, therefore playing therapeutic roles in depression.

Schizophrenia, a mental disorder, afflicts 1% of the worldwide population. The dysregulation of homeostasis in the endoplasmic reticulum (ER) has been implicated in schizophrenia. Moreover, recent studies indicate that ER stress and the unfolded protein response (UPR) are linked to this mental disorder. Our previous research has verified that endogenous retrovirus group W member 1 envelope (ERVW-1), a risk factor for schizophrenia, is elevated in individuals with schizophrenia. Nevertheless, no literature is available regarding the underlying relationship between ER stress and ERVW-1 in schizophrenia. The aim of our research was to investigate the molecular mechanism connecting ER stress and ERVW-1 in schizophrenia. Here, we employed Gene Differential Expression Analysis to predict differentially expressed genes (DEGs) in the human prefrontal cortex of schizophrenic patients and identified aberrant expression of UPR-related genes. Subsequent research indicated that the UPR gene called XBP1 had a positive correlation with ATF6, BCL-2, and ERVW-1 in individuals with schizophrenia using Spearman correlation analysis. Furthermore, results from the enzyme-linked immunosorbent assay (ELISA) suggested increased serum protein levels of ATF6 and XBP1 in schizophrenic patients compared with healthy controls, exhibiting a strong correlation with ERVW-1 using median analysis and Mann–Whitney U analysis. However, serum GANAB levels were decreased in schizophrenic patients compared with controls and showed a significant negative correlation with ERVW-1, ATF6, and XBP1 in schizophrenic patients. Interestingly, in vitro experiments verified that ERVW-1 indeed increased ATF6 and XBP1 expression while decreasing GANAB expression. Additionally, the confocal microscope experiment suggested that ERVW-1 could impact the shape of the ER, leading to ER stress. GANAB was found to participate in ER stress regulated by ERVW-1. In conclusion, ERVW-1 induced ER stress by suppressing GANAB expression, thereby upregulating the expression of ATF6 and XBP1 and ultimately contributing to the development of schizophrenia.

Abstract Background and objectives The mechanisms by which local anesthetics cause neurotoxicity are very complicated. Apoptosis and autophagy are highly coordinated mechanisms that maintain cellular homeostasis against stress. Studies have shown that autophagy activation serves as a protective mechanism in vitro. However, whether it also plays the same role in vivo is unclear. The aim of this study was to explore the role of autophagy in local anesthetic-induced neurotoxicity and to elucidate the mechanism of neurotoxicity in an intrathecally injected rat model. Methods Eighteen healthy adult male Sprague-Dawley rats were randomly divided into three groups. Before receiving an intrathecal injection of 1% bupivacaine, each rat received an intraperitoneal injection of vehicle or rapamycin (1 mg.kg-1) once a day for 3 days. The pathological changes were examined by Haematoxylin and Eosin (HE) staining. Apoptosis was analysed by TdT-mediated dUTP Nick-End Labelling (TUNEL) staining. Caspase-3, Beclin1 and LC3 expression was examined by Immunohistochemical (IHC) staining. Beclin1 and LC3 expression and the LC3-II/LC3-I ratio were detected by western blot analysis. Results After bupivacaine was injected intrathecally, pathological damage occurred in spinal cord neurons, and the levels of apoptosis and caspase-3 increased. Enhancement of autophagy with rapamycin markedly alleviated the pathological changes and decreased the levels of apoptosis and caspase-3 while increasing the expression of LC3 and Beclin1 and the ratio of LC3-II to LC3-I. Conclusions Enhancement of autophagy decreases caspase-3-dependent apoptosis and improves neuronal survivalin vivo. Activation of autophagy may be a potential therapeutic strategy for local anaesthetic-induced neurotoxicity.

Traditional handicraft apparel espouses ecological ethos and symbolises the harmonious coexistence between humans and nature. Owing to its distinct attribute of being handmade, it forms a characteristic branch of slow fashion and denotes a sustainable trend in the field of fashion design. However, slow fashion consumption research is relatively scarce. To gain further insights into the reasons, motivations and intentions of Chinese consumers related to the purchase of traditional handicraft fashion, the slow fashion consumption literature was referenced in this study, incorporating the theories of planned behaviour and self-concept. Moreover, structural equation modelling was used to scrutinise the consumption of traditional handicraft fashion. Results revealed that both self-concepts and perceived behaviour control (PBC) significantly impacted the consumption of conventional fashion. However, the internalised traditional cultural identity derived from the actual-self-aspect revealed a negligible relationship with traditional handicraft fashion consumption. In comparison, a significant impact was evinced by self-image enhancement from the ideal-self-aspect. Moreover, the reasons for PBC had the most significant influence on the consumption of traditional handicraft fashion compared to other considered factors. This study explores a specialised theoretical conventional handicraft model fashion consumption based on the mature theories of planned behaviour and self-concept, thus contributing to a sub-field in slow fashion consumption research. It also identifies and elucidates the factors that are pivotal to the revival of the traditional handicrafts sector in China and provides theoretical direction to improve the product planning and marketing of traditional fashion brands.

Background and objectives: The mechanisms by which local anesthetics cause neurotoxicity are very complicated. Apoptosis and autophagy are highly coordinated mechanisms that maintain cellular homeostasis against stress. Studies have shown that autophagy activation serves as a protective mechanism in vitro. However, whether it also plays the same role in vivo is unclear. The aim of this study was to explore the role of autophagy in local anesthetic-induced neurotoxicity and to elucidate the mechanism of neurotoxicity in an intrathecally injected rat model. Methods: Eighteen healthy adult male Sprague-Dawley rats were randomly divided into three groups. Before receiving an intrathecal injection of 1% bupivacaine, each rat received an intraperitoneal injection of vehicle or rapamycin (1 mg.kg-1) once a day for 3 days. The pathological changes were examined by Haematoxylin and Eosin (HE) staining. Apoptosis was analysed by TdT-mediated dUTP Nick-End Labelling (TUNEL) staining. Caspase-3, Beclin1 and LC3 expression was examined by Immunohistochemical (IHC) staining. Beclin1 and LC3 expression and the LC3-II/LC3-I ratio were detected by western blot analysis. Results: After bupivacaine was injected intrathecally, pathological damage occurred in spinal cord neurons, and the levels of apoptosis and caspase-3 increased. Enhancement of autophagy with rapamycin markedly alleviated the pathological changes and decreased the levels of apoptosis and caspase-3 while increasing the expression of LC3 and Beclin1 and the ratio of LC3-II to LC3-I. Conclusions: Enhancement of autophagy decreases caspase-3-dependent apoptosis and improves neuronal survivalin vivo. Activation of autophagy may be a potential therapeutic strategy for local anaesthetic-induced neurotoxicity. Resumo: Introdução e objetivos: Os mecanismos de neurotoxicidade dos anestésicos locais são complexos. A apoptose e a autofagia são mecanismos altamente organizados que mantêm a homeostase celular durante o estresse. Estudos revelam que a ativação da autofagia atua como mecanismo de proteção in vitro. Não está claro se a autofagia também desempenha essa função in vivo. O objetivo deste estudo foi analisar o papel da autofagia na neurotoxicidade induzida por anestésico local e esclarecer o mecanismo dessa neurotoxicidade utilizando um modelo de injeção intratecal em ratos. Métodos: Dezoito ratos Sprague-Dawley machos adultos saudáveis ​​foram divididos aleatoriamente em três grupos. Antes de receber a injeção intratecal de bupivacaína a 1%, cada rato recebeu injeção intraperitoneal de veículo ou rapamicina (1 mg.kg-1) uma vez ao dia durante 3 dias. As alterações patológicas foram examinadas por coloração com Hematoxilina e Eosina (HE). A apoptose foi analisada por coloração com o método dUTP Nick-End Labeling (TUNEL) mediado por TdT. A expressão de caspase-3, Beclin1 e LC3 foram examinadas por coloração Imunohistoquímica (IHQ). A expressão de Beclin1 e LC3 e a razão LC3-II/LC3-I foram detectadas por análise de western blot. Resultados: Após a injeção intratecal de bupivacaína, ocorreu lesão patológica nos neurônios da medula espinhal e os níveis de apoptose e caspase-3 aumentaram. A ativação da autofagia causada pela rapamicina mitigou de forma expressiva as alterações patológicas e diminuiu os níveis de apoptose e caspase-3, aumentando a expressão de LC3 e Beclin1 e a razão LC3-II/LC3-I. Conclusões: O aumento da autofagia diminui a apoptose dependente da caspase-3 e melhora a sobrevivência neuronal in vivo. A ativação da autofagia pode ser uma estratégia terapêutica potencial para a neurotoxicidade induzida por anestésicos locais.

Abstract This study aimed to semi-quantitatively evaluate the elastographic imaging color distribution of mediastinal and hilar lymph nodes (LNs), and explored its utility in helping define malignant and benign LNs for lung cancer patients. We prospectively collected patients who underwent preoperative mediastinal staging of suspected lung cancer by EBUS-TBNA. We analyzed the elastography color distribution of each LN and calculated the blue color proportion (BCP). The LN elastographic patterns were compared with the final EBUS-TBNA pathological results. A receiver operating characteristic (ROC) curve was constructed to evaluate the diagnostic value of BCP. We sampled and analyzed 79 LNs from 60 patients. The average BCP in malignant LNs was remarkably higher than that in benign LNs (57.1% versus 30.8%, P

This system is an Android mobile phone information service system for internet of vehicles. The information service system has four types of functions, including a login registration function, an information search function, a location function, and an information query function. The connection between cars and cars is gradually evolving into Internet of Vehicles from the traditional vehicle self-organizing network. The need for real-time service information for vehicles has also followed. Therefore, the research mainly designed an information service system for users of vehicles.

Using data from the 2014 Community College Survey of Student Engagement (CCSSE), we examined traditional and nontraditional students' perceived preparation for job skills in terms of the "three ways of knowing" from a career capital perspective. Results showed that traditional and nontraditional students shared commonalities as well as differences in terms of "three ways of knowing." Multinomial regression showed that different sets of predicators were significant in predicting students' perceived preparation for job skills, depending on the outcome being considered. However, variables that are directly aligned to the work or job preparation -- updating job skills as a goal, work-based learning, and using job placement assistance, each representing one way of knowing -- had the largest odds ratios in explaining the perceived preparation for job skills. Discussions of findings and implications are provided.

Data from the High School Longitudinal Study of 2009 were used to describe and compare postsecondary education enrollment patterns of first- and continuing-generation students. Social cognitive career theory was used to explain the processes of educational and career pursuit and attainment, as well as personal, behavioral, and contextual/environmental factors influencing these processes. Postsecondary educational self-efficacy (i.e., a belief or confidence in future educational success) had a significant positive influence on establishing higher postsecondary educational goals for all adolescents. Postsecondary educational self-efficacy and goals, together, also had a substantial positive influence on postsecondary enrollment patterns of both groups. Self-efficacy exerted a stronger total effect for first-generation students. Contextual supports and barriers directly influenced students' goals but played different roles depending on generational status.

This study examined students' participation in college and career preparation activities in high school, and the relationship between participation in these activities and students' education and work attainment within one year of high school graduation. This study used the High School Longitudinal Study of 2009 (HSLS:2009) dataset and participants included 12,217 public school students with 6,046 (49.49%) boys and 6,171 (50.51%) girls. Data analysis included descriptive statistics and multinomial logistic regression. Results indicate that socioeconomic status was the only significant predictor across all post-high school education and work outcomes. Significant predictors of post-high school education/work attainment were found but differed depending on which outcomes (i.e., education and/or work) were being considered.

Career decision-making self-efficacy is a pivotal construct in understanding individuals' career behaviors (Betz, 2007). Family, as a primary source of social support, exerts a substantial influence on adolescents' career development and decision-making process (Whiston & Keller, 2004). This study examined the role of selected family variables in predicting 587 Chinese secondary vocational students' career decision-making self-efficacy. Family "structural" variables that reflected family members' socioeconomic status and family "process-oriented" variables, especially, parental career-related behaviors, were examined. Results showed that parental general psychosocial support was a statistically significant factor in predicting career decision-making self-efficacy, explaining 38.3% of the variance of this construct for Chinese secondary vocational students.

Meta-analytic studies are syntheses of literature in which researchers use statistical means to summarize the findings presented across primary studies. They are of great interest in the fields of medicine and social sciences with numerous examples published in peer-reviewed journals. However, it appears that career and technical education (CTE) researchers are either not performing these research syntheses, or are not publishing their findings. Thus, there are three purposes to this manuscript. The first is to present CTE researchers and practitioners with a rationale as to why meta-analyses should be performed. The second is to provide guidelines that researchers and practitioners use to perform their own meta-analyses. The third is to provide suggestions that researchers and practitioners can use to disseminate the results of their meta-analyses. The manuscript concludes with a listing of suggested areas for future research.

The purpose of this study was to examine quality indicators currently guiding the rigor of secondary career and technical education (CTE) programs of study in the United States. Quality indicators are desirable characteristics or expectations for a comprehensive and effective CTE program of study. As of May 2017, we were able to locate publicly accessible secondary CTE quality program standards/guidelines for 38 states. A majority (n=24) updated their secondary CTE quality program standards/guidelines within the last five years (i.e., 2012-2017). Deductive content analysis was conducted to examine the 38 state profiles using the Association of Career and Technical Education (ACTE) Quality CTE Program of Study Framework 4.0 for coding purposes. Common quality elements and key quality indicators were identified from those state documents, which supplements the ACTE Framework. Implications and examples for practice are also discussed.

The separation of actinides has a vital place in nuclear fuel reprocessing, recovery of radionuclides, and remediation of environmental contamination. Here we propose a new paradigm of nanocluster-based actinide separation, namely, nanoextraction, that can achieve efficient sequestration of uranium in an unprecedented form of giant coordination nanocages using a cone-shaped macrocyclic pyrogallol[4]arene as the extractant. The U24-based hexameric pyrogallol[4]arene nanocages with distinctive [U2(PG)2] binuclear units (PG = pyrogallol) that rapidly assembled in situ in monophasic solvent were identified by single-crystal X-ray diffraction, MALDI-TOF mass spectrometry, NMR spectroscopy, and small-angle X-ray and neutron scattering. Comprehensive biphasic extraction studies showed that this novel separation strategy has enticing advantages such as fast kinetics, high efficiency, and good selectivity over lanthanides, thereby demonstrating its potential for efficient separation of actinide ions.

Although prior studies have examined the influence of career and technical education (CTE) on high school completion in the United States, few studies provided direct empirical evidence on how it worked. Using the High School Longitudinal Study of 2009 (HSLS:2009), this study examined public high school students' CTE experience from three integral aspects (coursework, career and technical student organizations, and work-based learning) and investigated whether these experiences influenced high school on-time completion through school engagement. Results indicated that CTE coursework had the strongest positive influence on on-time completion. Mediating effects of selected school engagement variables existed for most CTE activities. Directions for future research are provided.

Career and technical education (CTE) has gone through major transformations in the United States with important benefits for all students seeking postsecondary and career success. Research analyzing students' CTE enrollment patterns is important to understand which students are taking CTE courses and why in order to inform future research and practice. Using the High School Longitudinal Study of 2009 (HSLS:2009), this study investigated CTE enrollment patterns using Aliaga, Kotamraju, and Stone's (2014) typology and literature-based individual and social factors. Results from descriptive and multinomial logistic regression indicated that the majority of students were enrolling in some level of CTE credits and that individual and social factors were influential but varied by specific enrollment patterns.