Search Results (218)

Ratoon rice is a planting system that efficiently utilizes temperature and light resources. However, multiple fertilization applications are typically required to maintain stable rice yields. Improper fertilization not only poses challenges to scarce labor resources but also increases carbon footprints (CFs). Research on the effects of different fertilization strategies on greenhouse gas (GHG) emissions, yield, CF, and ecosystem net economic benefits (NEEBs) in ratoon rice systems remains limited. A two-year field experiment was conducted to evaluate the effects of one conventional fertilization strategy and four optimized fertilization strategies on GHG emissions, yield, CF, and NEEBs in the ratoon rice system. The conventional fertilization strategy applied urea in five splits (FFP, 280 kg N·ha⁻¹). The optimized strategies included (1) one-time side deep application controlled-release fertilizer (CRF, 280 kg N·ha⁻¹); (2) CRF with 20% N replaced by organic fertilizer (OF + CRF1); (3) the same as (2) with a 10% N reduction (OF + CRF2, 252 kg N·ha⁻¹); and (4) the same as (2) with a 20% N reduction (OF + CRF3, 224 kg N·ha⁻¹). The results showed that compared with FFP, optimized fertilization treatments reduced CH₄ and N₂O emissions by 28.69% to 55.27% and 25.08% to 40.32%, respectively. They also increased the annual rice yields by 2.22% to 19.52% (except OF + CRF3). Optimizing fertilization treatments reduced annual CF, CF_Y, and CF_EC by 26.66% to 49.59%, 34.11% to 51.12%, and 25.35% to 41.47%, respectively. These treatments also increased NEEBs by 8.27% to 34.23%. Among them, OF + CRF1 and OF + CRF2 treatments achieved the highest NEEB. In summary, CRF treatments can balance ratoon rice yield and environmental benefits. Replacing part of the N with organic fertilizer further enhances annual yield and NEEBs. Full article

Fragility fractures of the pelvis (FFPs) are common in elderly patients, particularly those with osteoporosis. FFPs can be associated with high mortality, morbidity, and functional decline. Known risk factors include being over 80 years old and delays in surgical intervention when this is required. While the role of surgery in FFPs remains less defined than in proximal femoral fractures in the elderly, studies indicate that surgical fixation offers improved survival and functional outcomes. Similarly, the choice of fixation method, whether posterior or anterior, and their combinations, vary between clinicians. It depends on the fracture type and patient-specific factors, such as bone quality and comorbidities, as well as the surgeon’s experience and the availability of resources. Additionally, orthobiologic adjuncts such as cement augmentation and sacroplasty can enhance the stability of an osteoporotic fracture during surgical intervention. Furthermore, medical treatments for osteoporosis, especially the use of teriparatide, have demonstrated beneficial effects in reducing fractures and promoting healing of the FFPs. Return to pre-injury activities is often limited, with independence rates remaining low at mid-term follow-up. Factors that influence clinical outcomes include fracture type, with Type III and IV fractures generally leading to poorer outcomes, and patient age, functional reserve, and comorbidities. The present tutorial aims to summarise the relevant evidence on all aspects of FFPs, inform an updated management strategy, and provide a template of the reconstruction ladder referring to the most available surgical techniques and treatment methods. Further research, based on large-scale studies, is needed to address the open questions described in this manuscript and refine surgical techniques, as well as determine optimal treatment pathways for this vulnerable patient population. Full article

Background/Objectives: Liver transplantation (LT) is often complicated by severe bleeding and coagulopathy. Viscoelastic testing (VET) offers real-time, bedside assessment of coagulation and may improve transfusion management compared to standard tests. This study evaluates the clinical impact of VET implementation during liver transplantation on bleeding, transfusion requirements, complications, and mortality in a single Eastern European tertiary transplant center. Methods: We conducted a single-center before-and-after study comparing patients undergoing LT before and after the implementation of VET. All procedures were performed by the same surgical and anesthetic team using a standardized protocol. Data were collected retrospectively for the Before VET group and prospectively for the After VET group. We compared transfusion requirements, bleeding, complications, and mortality. Results: A total of 59 patients were included, 22 in the After VET group and 37 in the Before VET group. VET implementation was associated with lower intraoperative blood loss (median 4000 mL vs. 6000 mL, p = 0.017) and reduced red blood cell (RBC) transfusion volume (670 mL vs. 1000 mL, p = 0.008). FFP (0.23 vs. 1.59 units, p = 0.007) and platelet use (0.68 vs. 1.81 units, p = 0.035) were also significantly lower in the VET group, while fibrinogen use was higher (3.00 g vs. 2.00 g, p = 0.036). No differences were observed in complication rates or mortality at 30 days and 1 year in this small before-and-after study. Conclusions: VET improved transfusion precision and individualized coagulation management during LT, leading to reduced use of blood products. These findings support the adoption of VET as a standard of care in LT protocols, as it may enhance patient safety, even though no differences in postoperative complications or mortality were observed. Full article

Background: Percutaneous screw fixation has increasingly been used for pelvic ring fracture fixation. In older adult patients, especially in patients with a fragility fracture of the pelvis (FFP), minimally invasive techniques followed by early ambulation have been promoted in order to regain pre-injury levels of mobility and independence. The purpose of this study was to evaluate patient-centered outcomes, including post-operative pain relief, functional performance, and satisfaction, in older adults with pelvic ring fractures treated with percutaneous screw fixation and to assess injury characteristics, complications, and return-to-home rates. Methods: In this retrospective cohort study, patients 50 years and older who had their pelvic fracture treated in the Amsterdam UMC location AMC between January 2019 and December 2022 were identified. After a minimum follow-up period of 6 months, a questionnaire was conducted by phone to evaluate the pain, current living situation, and mobility of the patients. Results: A total of 51 patients were included in this study with a median age of 74 years (IQR 62–82), and the vast majority were female (n = 40, 78%). Over half of the pelvic fractures were caused by low-energy trauma (n = 29, 57%). Unilateral or bilateral sacral fractures with unilateral anterior ring fractures were the most common fracture pattern. The interoperative complication rate was 4%, and the in-hospital complication rate was 23%. Forty-five patients were reached to complete the questionnaire. Forty patients (91%) returned to an acceptable level of mobility after treatment, and almost all (n = 44, 98%) were pleased with the results of the surgery. Conclusions: Percutaneous screw fixation of pelvic fractures in older adult patients is a safe and effective operating technique. Most patients preserve their pre-morbid functionality and are able to return to their previous place of residence after admission. Furthermore, patients are almost unanimously very pleased with the results of the surgery despite some residual pain complaints. Full article

Objectives: This study evaluated the effectiveness of three-dimensional (3D) navigated transsacral screw fixation in patients with sacral insufficiency fractures (SIF) who experienced inadequate mobilization after conservative management. Methods: We conducted a retrospective analysis of 53 patients (mean [±standard deviation] age 78.7 [±10.8] years; range 43.7–92.4; 81.1% female) with sacral insufficiency fractures confirmed by computed tomography or magnetic resonance imaging. Documented osteoporosis was present in 28 (52.8%) of these patients. All had failed conservative management due to persistent sacral pain or inability to mobilize. Therefore, they underwent 3D-navigated transsacral screw fixation. We collected data on demographics, fracture classification (FFP system), pain levels (Visual Analog Scale [VAS]), opioid consumption, time to mobilization, and length of hospital stay. Clinical outcomes were recorded at discharge, 1 month, and 3 months post-op; telephone interviews were conducted between 1 January and 28 February 2024 to assess longer-term pain relief and functional status. Results: Using the fragility fractures of the pelvis (FFP) classification, 60.8% of patients had FFP IIa fractures, 11.8% had FFP IIc, and 21.6% had FFP IVb. Two transsacral screws were placed in 34.0% of cases and three in 38.0%. We observed significant postoperative pain reduction—median (interquartile range [IQR]) VAS-at-rest decreased from 5 (4) preoperatively to 2 (2) at discharge and 0 (1) at 3 months (p < 0.001)—along with reduced opioid use (from 92.5% of patients on the immediate postoperative day to 45.0% at 3 months, p = 0.003). Early mobilization was achieved in 96.2% of patients. The mean hospital stay was 11.7 ± 5.1 days (95% confidence interval [CI]: 10.3–13.2; range 3–25 days), with the few outlier cases (>21 days) attributable to medical complications or delayed rehabilitation placement. The overall complication rate was low (7.5%, predominantly minor wound issues), and the 3-month reoperation rate was 7.7%. Conclusions: The 3D-navigated transsacral screw fixation is a minimally invasive and effective approach for managing sacral insufficiency fractures. It provides substantial pain relief, enables early mobilization, and demonstrates a low complication rate at 3 months. This technique shows promise in improving short-term outcomes for patients who do not respond to conservative care, regardless of osteoporosis status, although further research is needed to evaluate long-term fracture healing and functional recovery. Full article

Background/Objectives: The National Cancer Institute introduced the intensified R-da-EPOCH regimen in primary mediastinal large B-cell lymphoma (PMLBCL) to improve outcomes while minimizing radiotherapy use. However, there is no randomized comparison of R-da-EPOCH vs. R-CHOP-21. The objective of this study was to compare R-da-EPOCH with R-CHOP-21 in consecutive patients with PMLBCL of a single, large referral center, where the R-da-EPOCH escalation schedule was strictly followed. Methods: We retrospectively analyzed all 35 consecutive patients who received R-da-EPOCH (2017–2022) compared to 35 consecutive patients treated with R-CHOP-21 arm at the same Department, starting from the most recent patient and going backwards (2005–2017). Results: R-da-EPOCH was given strictly in 33/35 (94%) patients. The 5-year freedom from progression (FFP) was 91% vs. 69% (p = 0.027). The 5-year event-free survival (EFS) was 84% vs. 69% (p = 0.124). The 5-year overall survival (OS) was 97% vs. 80% (p = 0.063). Among R-CHOP-21-responders, 20/29 (69%) received RT compared to 2/34 (6%) R-da-EPOCH-responders. In multivariate analysis, R-da-EPOCH remained better than R-CHOP-21 in terms of FFP [hazard ratios (HRs) 0.21–0.26, all p < 0.05] and was associated with very favorable HR for EFS and OS. Conclusions: Optimally delivered R-da-EPOCH minimized the use of RT in a real-life setting and provided superior outcomes than R-CHOP-21. Full article

Background: This institutional, register-based analysis aimed to evaluate the feasibility of using CT-based sacral Hounsfield units (HUs) for assessing bone density in pelvic fragility fractures and to explore their potential correlation with DEXA measurements and osteological laboratory diagnostics. Methods: Patients aged > 80 years, admitted between 2003 and 2019 with pelvic ring fractures, were analyzed in this retrospective single-center study. CT scans were evaluated according to the classification of fragility fractures of the pelvis (FFPs), which guided treatment decisions (conservative or surgical). The diagnosis of a fragility fracture was based on both fracture morphology and patient history, including the presence of low-energy trauma. Bone health was assessed using standardized laboratory diagnostics including serum calcium, phosphate, alkaline phosphatase, and 25(OH)-vitamin D, in addition to DEXA scans and CT-derived Hounsfield units. Vitamin D levels and bone density evaluations were analyzed to identify possible correlations among these factors and with fracture patterns. Results: A total of 456 patients (mean age 87.3 years, 79.6% female) were included. The CT-based FFP classification identified Type II as the most common fracture type (66.7%). Conservative treatment was the predominant approach (84.9%). Serum 25(OH)-vitamin D deficiency was observed in 62.7% of the patients, while osteopenia and osteoporosis were found in 34.3% and 46.5% of cases, respectively. HU values at S1 showed significant correlation with femoral neck T-scores, highlighting the utility of CT scans for bone density assessment. Conclusions: This study emphasizes the complementary roles of CT-derived HU values and DEXA T-scores in evaluating bone quality and fracture severity in geriatric patients with FFP. While DEXA remains the gold standard, CT imaging offers valuable early insights, supporting the timely initiation of osteoporosis therapy. Given the high prevalence of fragility fractures in this age group, early CT-based screening may facilitate earlier initiation of osteoporosis-specific therapy, including anabolic agents where indicated. Further research is needed to explore the relationships between vitamin D levels, bone density assessments, and fracture types. Full article

Background: Fragility fractures of the pelvic ring (FFPs) represent a fast-growing entity in geriatric traumatology with increasing incidence worldwide. This study aimed to analyze the epidemiology, treatment concepts, and surgical strategies for FFPs based on data collected by the German Pelvic Multicenter Study Group documented in the German Pelvic Fracture Registry. It is the largest cohort study of its kind. Methods: This retrospective cohort study included patients aged 65 years or older after FFPs, as classified according to the Rommens and Hofmann classification. Data were collected from July 2018 onward and analyzed for demographics; fracture classifications; treatment modalities (operative vs. non-operative); and details of surgery, including timing and choice of implants. Patients after high-energy trauma were excluded. Statistical analyses included descriptive metrics and subgroup comparisons. Results: Among 1242 patients (84% female; median age 83.4 years), FFP Type II was the most common fracture type (50.8%), followed by Type IV (21.1%). Non-operative management was employed in 68.8% of cases, while 30.9% underwent surgery. Surgical intervention was more frequent in higher-grade FFPs (e.g., 72.1% in Type IV). The most common surgical technique for the posterior pelvic ring was percutaneous screw fixation (61.3%), with navigation used in 47.4% of cases. Conclusions: This study highlights the variability in treatment strategies for FFPs, with conservative management predominating in lower-grade fractures and surgical approaches increasingly utilized for more complex cases. The findings underscore the need for standardized, evidence-based guidelines and further research to optimize treatment and long-term outcomes for geriatric patients with FFPs. Full article

The use of former foodstuff and by-products in cow diets could improve the environmental sustainability of livestock. However, knowledge about the effects of these feeds in ruminant diets on the quality of dairy products is lacking. This study investigated the effects of integrating wheat distillers’ grain with solubles (WDGS) and a former foodstuff product (FFP) into the diet of dairy cows on milk and cheese quality. The environmental impact of the two feeding systems has been evaluated by LCA. A double crossover design was set up with 84 Holstein cows, alternating a control diet and a circular one. In the circular diet, traditional feeds were partially replaced with 4 kg/d WDGS and 3 kg/d FFP. The results showed no effects on dry matter intake and milk yield, while fiber digestibility improved. A reduction in the milk fat content and a modification of the fatty acid profile of milk and cheese were observed. Conversely, cheese yield, composition, and sensory attributes were not affected. The environmental impact of the diet was significantly reduced in terms of land occupation, net fresh water, and global warming potential. These findings suggest that these feeds can be safely included in dairy cow diets. This approach could significantly contribute to reducing greenhouse gas emissions, enhancing the sustainability of the dairy system. Full article

To effectively determine the influences of fuzzy uncertainties on structural systems in engineering, according to the fuzzy failure probability (FFP) model, which is based on the probabilistic perspective, the importance measure (IM) technique is extended to fuzzy uncertain structural systems. A novel IM framework, i.e., the fuzzy-failure-probability-based IM (FFP-IM), is established. By transforming the fuzzy failure probability into the expected value of the function for the failure domain, the proposed FFP-IM index can be represented as the variance-based IM of that index function. Then, an efficient solution algorithm for the proposed FFP-IM index is established based on the state-dependent parameter method. Ultimately, the Ishigami function, alongside three practical engineering examples, validates the proposed FFP-IM’s rationality and applicability. Furthermore, these examples illustrate the solution algorithm’s superior computational efficiency and accuracy. Full article

This study assesses the environmental impacts of producing 1000 tinplate aerosol cans at a Portuguese packaging company using the life cycle assessment (LCA) methodology. The inventory analysis is based on real industrial data collected from the company for foreground processes, complemented with the literature data for background processes. Two energy scenarios are compared: the current production setup, which relies on electricity from the Portuguese grid and 100% natural gas, and an optimized renewable energy scenario powered entirely by photovoltaic electricity, with thermal energy supplied by a mix of 20% green hydrogen and 80% natural gas. The ReCiPe 2016 Midpoint (E) method was applied to assess 18 environmental impact categories. For the production of 1000 cans, the associated impacts are as follows: 287.11 kg CO₂ eq for GWP, 1.01 × 10⁻⁴ kg CFC-11 eq for ODP, 16.52 kBq Co-60 eq for IRP, 51.59 kg 1,4-DCB for FETP, 0.69 kg PM_2.5 eq for PMFP, 77.20 kg oil eq for FFP, and 2.57 m³ for WCP. Tinplate exhibits the highest environmental burden across most impact categories, particularly in HTPc (96%) and SOP (98%). Offset aluminum printing plates have the greatest impact on FETP (33%), while wood pallets significantly contribute to LOP (81%). The renewable energy scenario resulted in significant reductions in IRP (60.9%), LOP (50.3%), ODP (39.8%), FFP (26.1%), and GWP (24.4%). However, it also led to notable increases in other impact categories, including FETP (135.3%), METP (130.8%), FEP (128.8%), MEP (114.3%), HTPnc (112.0%), SOP (107.8%), TETP (103.4%), and WCP (75.2%), primarily due to green hydrogen production and photovoltaic systems. Among the renewable options, wind electricity stands out as the most environmentally favorable choice for hydrogen production, outperforming both photovoltaic and hydroelectricity. Full article

The global coronavirus (COVID-19) pandemic in early 2020 caused the amount of medical waste, especially plastic waste, to increase. The pandemic exacerbated the plastic waste management problem, including the need to find more sustainable treatment methods. This study investigated the sustainable conversion of plastic waste (FFP2-type face masks) to syngas via pure CO₂ plasma gasification to recover energy and reduce environmental pollution. A direct current (DC) thermal arc plasma torch of 40.6–68.4 kW power generated the plasma stream. Carbon dioxide (CO₂), as a greenhouse gas (GHG), was used as the main plasma-forming gas and gasifying agent. The 140_thermal feedstock input plasma gasification system was used in the study. The effect of the CO₂-to-C ratio on the gasification performance efficiency was investigated. The best CO₂ plasma gasification process performance was obtained at a CO₂-to-C ratio of 2.34. In these conditions, the main syngas components (H₂ + CO) comprised 80.46 vol.% (H₂: 24.62 vol.% and CO: 55.84 vol.%) and the following values were seen for the heating value of the syngas (LHV_syngas: 13.88 MJ/Nm³), the syngas yield (3.13 Nm³/kg_FFP2), the tar content in the syngas (23.0 g/Nm³), the carbon conversion efficiency (CCE: 70.6%), and the cold gas efficiency (CGE: 47.8%). Additionally, the plasma gasification process mass and energy balance were evaluated. It was demonstrated that CO₂ plasma gasification could be a promising thermochemical treatment technology for sustainable plastic waste disposal and the simultaneous utilization of greenhouse gases, such as carbon dioxide. Full article

This work evaluated red kiwifruit plants’ spray treatment with cis-3-hexenyl butyrate (HB) as an inductor of some metabolic mechanisms related to fruit ripening, including an increase in anthocyanin content and the red hue color parameter. Considering their key role as ripening parameters for postharvest fruit quality and sorting assessment, the soluble solid content (SSC) and the flesh firmness penetrometer (FFP) were also measured. Treated plants received an application of 50 mM HB, administered exactly 2 and 4 weeks before the commercial harvest. At harvest time and during postharvest fruit ripening, near-infrared (NIR) spectral acquisitions were performed in order to check the feasibility of a rapid and non-destructive prediction of fruit anthocyanin content and SSC, coupled to destructive measurements and chemometric modelling. Regarding technological and chemical results, HB treatment indicates an optimum overall qualitative storage at 30 days. The fruit from treated plants is characterized by good quality parameters, including higher SSC, enhanced red hue (a* value) and increased anthocyanin content, despite similar weight loss to the untreated fruit. The obtained chemometric results underscore the promise and feasibility of NIRs in terms of detecting and estimating anthocyanin content and SSC in red kiwifruit, in order to pursue an evident perspective of improvement. Full article

Active drug delivery systems for cancer therapy are gaining attention for their biocompatibility and enhanced efficacy compared to conventional chemotherapy and surgery. To improve precision in targeted drug delivery (TDD), actuating devices using external magnetic fields are employed. However, a key challenge is the inability to visually track magnetic drug carriers in blood vessels, complicating navigation to the target. Magnetic particle imaging (MPI) systems can localize magnetic carriers (MCs) but rely on bulky electromagnetic coils to generate a static magnetic field gradient, creating a field-free point (FFP) within the field of view (FOV). Also, additional coils are required to move the FFP across the FOV, limiting flexibility and increasing the system size. To address these issues, we propose a non-FFP-based, open-type RF coil system with a simplified structure composed of a Tx/Rx coil and a permanent magnet at the coil center, eliminating the need for an FFP. Furthermore, integrating a robotic arm for coil assembly enables easy adjustment of the FOV size and location. Finally, imaging tests with magnetic nanoparticles (MNPs) confirmed the system’s ability to detect and localize a minimum mass of 0.3 mg (Fe) in 80 × 80 mm². Full article

One of the most widely used processes in ship hull plate manufacturing is the flame forming process (FFP). In this work, the fabrication of saddle-shaped specimens with FFP using a spiral irradiating pattern is studied experimentally. The deformation of the deformed plates by FFP based on the spiral irradiating pattern is affected by process parameters such as the pitch of spiral passes (PSP), the radius of the starting circle (RSC), and the number of irradiation passes (NIP). However, in this work, the effects of process parameters on the deformation of SSS are statistically examined by the design of experiment (DOE) method based on response surface methodology (RSM). The experimental and statistical results show that the deformation of flame-formed SSS increases with the increase in RSC and NIP and the decrease in PSP. In addition, the results of the optimization procedure demonstrate that the maximum value of deformations of flame-formed saddle-shaped specimens is achieved by adjusting the process parameters as follows: PSP = 10 mm, RSC = 75 mm, and five NIPs. Full article