A Scoping Review of the Epidemiology, Management, and Outcomes of Golf-Related Fractures.

ABSTRACT: Golf is a popular sport; however, there is a paucity of data in relation to golf-associated fractures, and the rate and timing of returning to golf. The aim of this review is to describe golf-associated fractures, including epidemiology, management, and timing of returning to golf following treatment. A literature search was performed using MEDLINE/PubMed, Embase, and Web of Science. Data were extracted and summarized in a narrative synthesis. A total of 436 articles were identified with an initial search of which 58 met the inclusion criteria. Twelve anatomical sites of golf swing-related fractures were identified, of which 10 sites were specific for stress fractures. The most common sites of golf swing-related stress fractures were the ribs followed by the hook of hamate. There was a common theme of delay to diagnosis, being initially assigned to a soft tissue injury. Most golfers with swing-related stress fractures were able to return to golf with the exception of osteoporotic associated vertebral stress fractures. Timing of returning to golf was between 4 and 12 months for most of the golfers with stress fractures following conservative management. Operative intervention was an option of hook of hamate nonunion, following a stress fracture, and tibial shaft stress fractures. Golf equipment-related fractures were not rare and were associated with major trauma and in some cases associated with significant persistent morbidity. Golf-related stress fractures commonly involve the ribs and hook of hamate; knowledge of this may aid in early diagnosis and appropriate treatment when symptomatic golfers are encountered. Although golf is a noncontact sport, fractures associated with golf equipment can be life changing, and safety training guidelines should be established.

The health and welfare effects of environmental governance: Evidence from China.

Environmental regulations aim to reduce pollution and improve air quality and the health of residents. However, there is a lack of research focusing on the health and welfare effects of low-carbon city pilot policies. In this context, this study takes China's low-carbon city pilot policy as an entry point, focuses on the health effects of public environmental governance, and systematically investigates the effects and mechanisms of low-carbon city development on the health of middle-aged and elderly people by applying the difference-in-differences method. The study finds that low-carbon city (LCC) policy significantly improves the physical and mental health of middle-aged and elderly people, and the main transmission mechanism is the reduction in air pollution and improvement in social capital. These results hold following a series of robustness tests. Furthermore, low-carbon city construction can reduce hospitalization and outpatient costs for people over 45 years old by up to 3 % and 15.5 %, respectively. The findings of this study provide useful policy insights for ensuring sustainable improvement in environmental quality and public health.

Quantifying the direct and indirect impacts of urban waterlogging using input‒output analysis.

Increasingly frequent urban waterlogging disasters are having profound social and economic consequences. An appropriate and integrated evaluation of the total economic impacts of such disasters is crucial for achieving effective urban disaster risk management and sustainable development. However, existing metrics are inadequate for measuring the economic impacts of rainfall events of different intensities and their ripple effects across regions. Moreover, their ecological impacts have received insufficient attention. To address these gaps, we developed an integrated assessment framework for analyzing urban waterlogging losses and evaluating their various impacts. Taking Beijing as a case study, we used the InfoWorks ICM model to simulate urban waterlogging disaster risks, quantified direct economic losses, and assessed their environmental impacts. Additionally, we estimated indirect economic losses using input-output analysis and explored spillover effects. The results revealed increasing trends of direct economic losses and environmental losses corresponding to a longer return period. We observed synergies between these losses and their spatial heterogeneity. However, indirect impacts far outweighed direct impacts, with the former being 2.43 times larger than the latter. The cascading effect resulting from damage to infrastructure was also particularly pronounced. The industrial and spatial heterogeneity of interregional impacts was striking, with eastern provinces evidencing the most significant effects. By mapping the transmission paths of disaster losses along industrial chains and across regions, this study provides inputs that could assist policymakers in developing more effective measures for preventing and mitigating urban waterlogging disasters.

Country-specific net-zero strategies of the pulp and paper industry.

The pulp and paper industry is an important contributor to global greenhouse gas emissions1,2. Country-specific strategies are essential for the industry to achieve net-zero emissions by 2050, given its vast heterogeneities across countries3,4. Here we develop a comprehensive bottom-up assessment of net greenhouse gas emissions of the domestic paper-related sectors for 30 major countries from 1961 to 2019-about 3.2% of global anthropogenic greenhouse gas emissions from the same period5-and explore mitigation strategies through 2,160 scenarios covering key factors. Our results show substantial differences across countries in terms of historical emissions evolution trends and structure. All countries can achieve net-zero emissions for their pulp and paper industry by 2050, with a single measure for most developed countries and several measures for most developing countries. Except for energy-efficiency improvement and energy-system decarbonization, tropical developing countries with abundant forest resources should give priority to sustainable forest management, whereas other developing countries should pay more attention to enhancing methane capture rate and reducing recycling. These insights are crucial for developing net-zero strategies tailored to each country and achieving net-zero emissions by 2050 for the pulp and paper industry.

Improved human greenspace exposure equality during 21st century urbanization.

Greenspace plays a crucial role in urban ecosystems and has been recognized as a key factor in promoting sustainable and healthy city development. Recent studies have revealed a growing concern about urban greenspace exposure inequality; however, the extent to which urbanization affects human exposure to greenspace and associated inequalities over time remains unclear. Here, we incorporate a Landsat-based 30-meter time-series greenspace mapping and a population-weighted exposure framework to quantify the changes in human exposure to greenspace and associated equality (rather than equity) for 1028 global cities from 2000 to 2018. Results show a substantial increase in physical greenspace coverage and an improvement in human exposure to urban greenspace, leading to a reduction in greenspace exposure inequality over the past two decades. Nevertheless, we observe a contrast in the rate of reduction in greenspace exposure inequality between cities in the Global South and North, with a faster rate of reduction in the Global South, nearly four times that of the Global North. These findings provide valuable insights into the impact of urbanization on urban nature and environmental inequality change and can help inform future city greening efforts.

A new statistical approach for China road freight transport at a subnational level.

Currently, there is a large deviation between official road freight data and real road freight performance at a subnational level in China. In order to deal with this deviation, the new concept of local freight tonnage and ton-kilometers is presented in this paper based on the territoriality principle, where either the origin or the destination of goods transported is local. Also, the statistic procedures and estimation models of the local freight tonnage and ton-kilometers are proposed based on five accessible basic datasets. Finally, an empirical study in Sichuan province of China is conducted. The statistical results show that there is a large amount of local freight transported by local non-commercial trucks and non-local trucks, which is ignored in the existing road freight statistics. Especially, the higher the level of local economic development, the greater the deviation between the official road freight data and the real road freight performance at a subnational level.

Direct Medical Expenses and Influencing Factors of MDR/RR-TB in Eastern China: Based on Data from Multi-Hospital Information Systems.

Background: Multidrug-resistant (MDR) and rifampicin-resistant (RR) tuberculosis (TB) is related to high healthcare costs. However, studies on direct healthcare expenditure in different settings remain inconclusive. Hence, we aimed to examine the direct medical expenses (DME) of patients with MDR/RR-TB and assessed which patient characteristics were associated with higher costs. Methods: DME was evaluated using records from the hospital information system in three cities with different economic levels in Zhejiang Province, Eastern China, matching with data (including socio-demographics, disease treatment status, etc.) collected in the Tuberculosis Management Information System. A logistic regression model was used to identify variables associated with higher costs. Results: Of 193 patients with MDR/RR-TB, the average DME was $10,491 (interquartile range (IQR) $4679-16,710), consisting of $2696 (IQR $1019-5100) out-of-pocket costs, medical reimbursement, and subsidies, accounting for 32%, 50.3% and 14%, respectively. A total of 74.2% and 56% of DME were for drugs and anti-TB drugs, respectively. Only 16.9% of the patients were treated with an all-oral regimen. Higher DME was significantly associated with local residents 7.29 (95% confidence interval (CI) [2.62-20.3]), hospitalization experience 7.63 (95% (CI) [2.54-22.95]), longer duration of treatment 6.63 (95% CI [2.27-19.35]), and lower health insurance reimbursement 5.65 (95% CI [1.90-16.79]). Conclusion: DME of patients with MDR/RR-TB was still significant, and domestic migrants, hospitalization, long treatment duration, and high health insurance rates increased the financial burden on MDR/RR-TB patients. Reasonable intervention programs should be developed to reduce the medical burden of patients with MDR/RR-TB, according to the DME and its component of MDR-TB patients, besides the economic status of their regions.

Direct evidence on the crossover from BCC to FCC stability: A lattice-based aggregation-volume-bias Monte Carlo approach to polymorphism.

A lattice-based version of the aggregation-volume-bias Monte Carlo method that was introduced recently has allowed for the extension of the calculation of the nucleation free energies from liquid clusters to solid clusters. Here, it was used to calculate the nucleation free energies of both bcc and fcc clusters formed by Lennard-Jones particles. Under the simulation conditions considered in this study, a cross-over of the thermodynamic stability from the bcc to the fcc structure was observed directly from the free energy results. In addition, the free energies obtained for both types of clusters were used to extrapolate bulk phase information, including chemical potential and surface tension, which revealed that bcc clusters are favored due to the lower surface tension. These results corroborate a recent classical density functional theory study. This work also demonstrates that this approach can be used to predict the entire thermodynamic landscape (i.e., free energies for clusters of different structures and sizes, including an infinitely large cluster, which is the bulk phase), which is important to answer fundamental questions related to crystallization such as the origin of polymorphism.

Neuroprotective Strategies for Stroke by Natural Products: Advances and Perspectives.

Cerebral ischemic stroke is a disease with high prevalence and incidence. Its management focuses on rapid reperfusion with intravenous thrombolysis and endovascular thrombectomy. Both therapeutic strategies reduce disability, but the therapy time window is short, and the risk of bleeding is high. Natural products (NPs) have played a key role in drug discovery, especially for cancer and infectious diseases. However, they have made little progress in clinical translation and pose challenges to the treatment of stroke. Recently, with the investigation of precise mechanisms in cerebral ischemic stroke and the technological development of NP-based drug discovery, NPs are addressing these challenges and opening up new opportunities in cerebral stroke. Thus, in this review, we first summarize the structure and function of diverse NPs, including flavonoids, phenols, terpenes, lactones, quinones, alkaloids, and glycosides. Then we propose the comprehensive neuroprotective mechanism of NPs in cerebral ischemic stroke, which involves complex cascade processes of oxidative stress, mitochondrial damage, apoptosis or ferroptosis-related cell death, inflammatory response, and disruption of the blood-brain barrier (BBB). Overall, we stress the neuroprotective effect of NPs and their mechanism on cerebral ischemic stroke for a better understanding of the advances and perspective in NPs application that may provide a rationale for the development of innovative therapeutic regimens in ischemic stroke.

The effect of diabetes mellitus on tuberculosis in eastern China: A decision-tree analysis based on a real-world study.

OBJECTIVES: The public health system faces major challenges due to the double burden of diabetes mellitus (DM) and tuberculosis (TB) in China. We aimed to investigate the prevalence and impact of diabetes on patients with TB. METHODS: Stratified cluster sampling was used to select 13 counties as study sites in the Zhejiang province. Patients who visited designated TB hospitals in these areas participated in this study between 1 January 2017 and 28 February 2019. Multiple logistic regression models were performed to investigate the association between DM and bacteriological and imaging results. A decision tree was used to predict the bacteriology and imaging results under the influence of DM. RESULTS: Of 5920 patients with newly diagnosed pulmonary tuberculosis, 643 (12.16%) had DM. Patients with pulmonary TB and DM were more likely to have pulmonary cavities (adjusted odds ratio [aOR], 2.81; 95% confidence intervals [95% CI]: 2.35-3.37) and higher rates of positive bacteriological tests (aOR, 2.32; 95% CI:1.87-2.87). Decision-tree analysis showed similar results. CONCLUSIONS: Concurrence of DM and pulmonary TB makes patients more likely to have positive bacteriological results and pulmonary cavities. Therefore, appropriate measures are necessary to promptly identify and manage patients with TB and DM.

Fermion Disorder Operator at Gross-Neveu and Deconfined Quantum Criticalities.

The fermion disorder operator has been shown to reveal the entanglement information in 1D Luttinger liquids and 2D free and interacting Fermi and non-Fermi liquids emerging at quantum critical points (QCPs) [W. Jiang et al., arXiv:2209.07103]. Here we study, by means of large-scale quantum Monte Carlo simulation, the scaling behavior of the disorder operator in correlated Dirac systems. We first demonstrate the logarithmic scaling behavior of the disorder operator at the Gross-Neveu (GN) chiral Ising and Heisenberg QCPs, where consistent conformal field theory (CFT) content of the GN-QCP in its coefficient is found. Then we study a 2D monopole-free deconfined quantum critical point (DQCP) realized between a quantum-spin Hall insulator and a superconductor. Our data point to negative values of the logarithmic coefficients such that the DQCP does not correspond to a unitary CFT. Density matrix renormalization group calculations of the disorder operator on a 1D DQCP model also detect emergent continuous symmetries.

Genome-Wide Assessment of Runs of Homozygosity by Whole-Genome Sequencing in Diverse Horse Breeds Worldwide.

In the genomes of diploid organisms, runs of homozygosity (ROH), consecutive segments of homozygosity, are extended. ROH can be applied to evaluate the inbreeding situation of individuals without pedigree data and to detect selective signatures via ROH islands. We sequenced and analyzed data derived from the whole-genome sequencing of 97 horses, investigated the distribution of genome-wide ROH patterns, and calculated ROH-based inbreeding coefficients for 16 representative horse varieties from around the world. Our findings indicated that both ancient and recent inbreeding occurrences had varying degrees of impact on various horse breeds. However, recent inbreeding events were uncommon, particularly among indigenous horse breeds. Consequently, the ROH-based genomic inbreeding coefficient could aid in monitoring the level of inbreeding. Using the Thoroughbred population as a case study, we discovered 24 ROH islands containing 72 candidate genes associated with artificial selection traits. We found that the candidate genes in Thoroughbreds were involved in neurotransmission (CHRNA6, PRKN, and GRM1), muscle development (ADAMTS15 and QKI), positive regulation of heart rate and heart contraction (HEY2 and TRDN), regulation of insulin secretion (CACNA1S, KCNMB2, and KCNMB3), and spermatogenesis (JAM3, PACRG, and SPATA6L). Our findings provide insight into horse breed characteristics and future breeding strategies.

Tracing metal footprints via global renewable power value chains.

The globally booming renewable power industry has stimulated an unprecedented interest in metals as key infrastructure components. Many economies with different endowments and levels of technology participate in various production stages and cultivate value in global renewable power industry production networks, known as global renewable power value chains (RPVCs), complicating the identification of metal supply for the subsequent low-carbon power generation and demand. Here, we use a multi-regional input-output model (MRIO) combined with a value chain decomposition model to trace the metal footprints (MFs) and value-added of major global economies' renewable power sectors. We find that the MFs of the global renewable power demand increased by 97% during 2005-2015. Developed economies occupy the high-end segments of RPVCs while allocating metal-intensive (but low value-added) production activities to developing economies. The fast-growing demand for renewable power in developed economies or developing economies with upper middle income, particularly China, is a major contributor to the embodied metal transfer increment within RPVCs, which is partly offset by the declining metal intensities in developing economies. Therefore, it is urgent to establish a metal-efficient and green supply chain for upstream suppliers as well as downstream renewable power installers for just transition in the power sector across the globe.

Tangent Space Approach for Thermal Tensor Network Simulations of the 2D Hubbard Model.

Accurate simulations of the two-dimensional (2D) Hubbard model constitute one of the most challenging problems in condensed matter and quantum physics. Here we develop a tangent space tensor renormalization group (tanTRG) approach for the calculations of the 2D Hubbard model at finite temperature. An optimal evolution of the density operator is achieved in tanTRG with a mild O(D^{3}) complexity, where the bond dimension D controls the accuracy. With the tanTRG approach we boost the low-temperature calculations of large-scale 2D Hubbard systems on up to a width-8 cylinder and 10×10 square lattice. For the half-filled Hubbard model, the obtained results are in excellent agreement with those of determinant quantum Monte Carlo (DQMC). Moreover, tanTRG can be used to explore the low-temperature, finite-doping regime inaccessible for DQMC. The calculated charge compressibility and Matsubara Green's function are found to reflect the strange metal and pseudogap behaviors, respectively. The superconductive pairing susceptibility is computed down to a low temperature of approximately 1/24 of the hopping energy, where we find d-wave pairing responses are most significant near the optimal doping. Equipped with the tangent-space technique, tanTRG constitutes a well-controlled, highly efficient and accurate tensor network method for strongly correlated 2D lattice models at finite temperature.

The burden of skin and subcutaneous diseases: findings from the global burden of disease study 2019.

Background: The small number of existing integrative studies on the global distribution and burden of all types of skin and subcutaneous diseases hinders relevant comparisons. Objective: This study aimed to determine the latest distribution, epidemiological differences, and factors potentially influencing each skin and subcutaneous disease and the policy implications. Methods: Data on the skin and subcutaneous diseases were obtained from the Global Burden of Disease Study 2019. The incidence, disability-adjusted life years (DALYs), and deaths due to skin and subcutaneous diseases in 204 countries and regions from 1990 to 2019 were analyzed and stratified by sex, age, geographical location, and sociodemographic index (SDI). The annual age-standardized rate of change in the incidence was obtained to evaluate temporal trends. Results: Of 4,859,267,654 (95% uncertainty interval [UI], 4,680,693,440-5,060,498,767) new skin and subcutaneous disease cases that were identified, most were fungal (34.0%) and bacterial (23.0%) skin diseases, which accounted for 98,522 (95% UI 75,116-123,949) deaths. The burden of skin and subcutaneous diseases measured in DALYs was 42,883,695.48 (95%UI, 28,626,691.71-63,438,210.22) in 2019, 5.26% of which were years of life lost, and 94.74% of which were years lived with disability. The highest number of new cases and deaths from skin and subcutaneous diseases was in South Asia. Globally, most new cases were in the 0-4-year age group, with skin and subcutaneous disease incidence slightly higher in men than in women. Conclusion: Fungal infections are major contributors to skin and subcutaneous diseases worldwide. Low-middle SDI states had the highest burden of skin and subcutaneous diseases, and this burden has increased globally. Targeted and effective management strategies based on the distribution characteristics of each country are, thus, required to reduce the burden of skin and subcutaneous diseases.

How has China's industrial eco-efficiency been improved? Evidence from multi-scale countrywide study.

The process of industrialization often causes resource depletion and environmental pollution. To shed light on China's resource use and pollution trends in the context of the country's rapid industrial growth, this study analyzes the eco-efficiency of China's industry from 2000 to 2015. We quantify industrial eco-efficiency (IEE) for China and its provinces using data envelopment analysis (DEA) and analyze potential influencing factors at national and regional levels using Tobit regression. IEE in China and in most provinces shows a clear upward trend with some fluctuations, with national scores increasing from 0.394 to 0.704. There is strong regional disparity, with average IEE scores in eastern provinces (0.840) higher than those in central provinces (0.625), which are in turn higher than those in the northeast (0.537) and west (0.438). We next consider potential drivers. Economic development and foreign direct investment (FDI) are positively associated with IEE but appear to show diminishing returns. Environmental enforcement and market for technology are also positively associated with IEE, as expected. The impact of economic development, industrial sector structure, and investment in research and development (R&D) are modified by the stage of industrialization in each region. Targeted measures that can adjust industry structure, enhance environmental enforcement, attract FDI, and increase R&D investment may help further improve IEE in China.

Case report: Ultrasound-guided percutaneous drainage combined with lavage using urokinase: An economical and effective treatment for muscular hematomas in hemophiliacs.

This was an initial effort to treat hemophiliac hematoma by ultrasound-guided intratumoral drainage and lavage with urokinase after adequate supplementation of coagulation factors. Two patients with severe hemophilia underwent ultrasound-guided percutaneous drainage in combination with lavage using urokinase. After 5-day and 3-day treatments, respectively, intramuscular hematomas in both patients disappeared, compression symptom was relieved, and no obvious adverse reactions or serious complications were observed during the treatment or follow-up. These findings suggest that ultrasound-guided drainage combined with lavage using urokinase is an immediate, safe, effective, and minimally invasive treatment for intramuscular hematomas in hemophiliacs, avoiding potential complications by surgical resection with relatively low treatment cost.

Quality assessment of Telenomus remus successively reared on Spodoptera litura eggs for 30 generations.

BACKGROUND: Telenomus remus (Nixon) is a dominant natural enemy controlling the invasive pest Spodoptera frugiperda (J. E. Smith). Continuous rearing of egg parasitoids on alternative hosts is crucial for mass production and cost reduction. However, to ensure the effectiveness of natural enemy products against target pests in the field, it is necessary to evaluate the parasitoid quality during the mass-rearing process. Despite the successful rearing of this parasitoid on the alternative host Spodoptera litura (Fabricius) eggs, less attention has been paid to the quality of parasitoids continuously reared for multiple generations. Therefore, we evaluated the performance of T. remus reared on S. litura eggs for 30 generations via morphological characteristics, flight ability, and life table analysis. RESULTS: Wing length, wing width, body length, and right hind tibia length of T. remus did not differ among the different generations. However, the body length of female parasitoids was significantly longer than that of males for any generation. Although the proportion of 'flyers' and 'deformed' T. remus varied among generations, the flight ability did not decline significantly after rearing on S. litura eggs. Moreover, T. remus continuously reared on S. litura eggs maintained stable parasitism performance and life table parameters on the target host S. frugiperda eggs. CONCLUSION: S. litura eggs are suitable hosts for the mass-rearing of T. remus. This study can be subsequently used to guide the production and facilitate the application of T. remus in the control of S. frugiperda. © 2023 Society of Chemical Industry.

Thermodynamic Characteristic for a Correlated Flat-Band System with a Quantum Anomalous Hall Ground State.

While the ground-state phase diagram of the correlated flat-band systems has been intensively investigated, the dynamic and thermodynamic properties of such lattice models are less explored, but it is the latter which is most relevant to the experimental probes (transport, quantum capacitance, and spectroscopy) of the quantum moiré materials such as twisted bilayer graphene. Here we show, by means of momentum-space quantum Monte Carlo and exact diagonalization, in chiral limit there exists a unique thermodynamic characteristic for the correlated flat-band model with interaction-driven quantum anomalous Hall (QAH) ground state, namely, the transition from the QAH insulator to the metallic state takes place at a much lower temperature compared with the zero-temperature single-particle gap generated by the long-range Coulomb interaction. Such low transition temperature comes from the proliferation of excitonic particle-hole excitations, which transfers the electrons across the gap between different topological bands to restore the broken time-reversal symmetry and gives rise to a pronounced enhancement in the charge compressibility. Future experiments, to verify such generic thermodynamic characteristics, are proposed.