Identifying precondition configurations of mathematics anxiety among middle school students in China: using NCA and QCA approaches.

Introduction: Addressing mathematics anxiety is important to ensure that students achieve good academic performance and maintain their mental health during the critical middle school period. However, previous studies have focused on the separate effects of the preconditions for mathematics anxiety, ignoring the interaction of factors. Therefore, this study aims to identify the determinants of mathematics anxiety from the perspective of complex systems via necessary condition analysis (NCA) and qualitative comparative analysis (QCA). To the best of our knowledge, this is the first study to identify configurations of preconditions of mathematics anxiety among middle school students. Methods: A total of 183 middle school students aged 16 to 19 years (M age = 17.47, SD = 0.89) in China participated in this cross-sectional study. The outcome variable of the study is mathematics anxiety, and the condition variables include mathematics grade, parental support, learning motivation, learning planning, and learning interest. Results: The necessity condition analysis shows that not all the condition variables constitute the necessity condition of mathematics anxiety alone. Four paths for the influence of multiple condition variables on mathematics anxiety are identified via the configuration analysis. Notably, even students with high mathematics scores and learning interest still experience mathematics anxiety due to a lack of practical parental support and learning motivation. High levels of parental support can exacerbate the mathematics anxiety of students under two conditions: 1) a lack of learning motivation and learning plans, and 2) interest in learning but low mathematics scores and unclear learning plans. Discussion: This study highlights the need to consider the comprehensive impact of mathematics anxiety, and the findings will help educators and researchers identify the different characteristics of mathematics anxiety in student populations.

FOLLOW-UP OF PATIENTS WITH POST COVID-19 CONDITION AFTER A MULTIDISCIPLINARY TEAM ASSESSMENT: A PILOT STUDY.

Objective: To follow up patients with post-COVID-19 condition (PCC) 6 months after a multidisciplinary team assessment in specialist care regarding symptoms of pain, anxiety, depression, fatigue and cognition, level of activity, physical activity and sick leave. Methods: A prospective pilot study conducted in a clinical setting of patients (n = 22) with PCC referred from primary healthcare to a specialist clinic for a 2 day-multidisciplinary team assessment followed by a subsequent rehabilitation plan. Data were collected through questionnaires filled in prior to the team assessment and 6 months later. Results: Fifteen of the initial 22 patients participated in the follow-up. No statistically significant improvements were seen in any of the questionnaires after 6 months. However, 76.9% of the participants perceived the intervention as being helpful. This differed between the genders, where all the women 100% (n = 8) perceived it as being helpful, compared with 40% (n = 2) of the men (p = 0.012). Conclusions: Based on these findings, the benefit of a multidisciplinary team assessment of PCC is not fully convincing. However, since the participants themselves perceived the intervention as being helpful, the team assessment seems to be of some value. Further studies with larger populations would be of interest.

Most people who become ill with COVID-19 experience mild symptoms and recover within days or weeks. However, minor symptoms last from weeks to months and include fatigue, attention disorder, headache, dyspnea, anxiety, pain, anosmia, etc. This clinical state has been denoted as "post-COVID-19 condition" (PCC). It has been recommended that complex cases of PCC are to be assessed by a multidisciplinary team regarding treatment and rehabilitation. The efficiency of this recommendation has not yet been proven. This pilot study aimed to follow up patients with PCC six months after a multidisciplinary team assessment in specialist care regarding symptoms of pain, anxiety, depression, fatigue and cognition, level of activity, physical activity and sick leave through questionnaires. The results showed no statistically significant improvements in any of the questionnaires after six months. The majority of the participants perceived the team assessment as being helpful. Since the assessment seemed to be of some value, there is a need for further studies with larger populations.

Emaciated enigma: Decline in body conditions of common dolphins in the Celtic Seas ecoregion.

Monitoring the nutritional health of cetaceans has become increasingly important in a changing environment, where multiple stressors impact animals. Particularly for those species that require consumption of energy-dense prey, such as the common dolphin. Thus far, no uniform measure for monitoring body condition has been recommended across cetaceans, and species-specific measures may need to be developed if employed as a population condition indicator under Descriptor 1 of the Marine Strategy Framework Directive. Here, nine morphometric body condition indices were applied to long-term common dolphin stranding data sets originating from Ireland and the UK. We report a recent decline in the nutritional health of common dolphins in the Celtic Seas ecoregion comparing animals from 2017 to 2019 to animals from 1990 to 2006, with an increase in cases of animals dying due to starvation. Using ordinal regression trees, ventral blubber thickness (VBT) was identified as the most important index to predict nutritional status, defined at necropsy, followed by the scaled mass index (SMI). Using generalised linear models, both the VBT and SMI indices differentiated individuals that died from chronic and acute causes of death (i.e., bycatch), where animals in chronic conditions had significantly thinner VBT and lower SMI. Both significant temporal and seasonal patterns in VBT were identified, with poorer body conditions observed during the autumn and better body conditions observed during the spring, as well as an overall decline detected in VBT during the study period. While VBT was positively correlated with total body length, SMI showed the opposite trend. The VBT index is recommended for monitoring nutritional health within the species when total body length and season are considered. Further research is needed to understand the underlying causes for the observed decline, including shifts in prey availability and/or quality, to inform targeted conservation management strategies.

Effects of fluid therapy combined with a preoperative glucose load regimen on postoperative recovery in patients with rectal cancer.

BACKGROUND: Patients with rectal cancer undergoing radical resection often have poor postoperative recovery due to preoperative fasting and water deprivation and the removal of diseased tissue, and have a high risk of complications. Therefore, it is of great significance to apply appropriate rehydration regimens to patients undergoing radical resection of rectal cancer during the perioperative period to improve the postoperative outcomes of patients. AIM: To analyze the effects of goal-directed fluid therapy (GDFT) with a preoperative glucose load regimen on postoperative recovery and complications in patients undergoing radical resection for rectal cancer. METHODS: Patients with rectal cancer who underwent radical resection (n = 184) between January 2021 and December 2023 at our hospital were randomly divided into either a control group or an observation group (n = 92 in each group). Both groups received a preoperative glucose load regimen, and routine fluid replacement and GDFT were additionally implements in the control and observation groups, respectively. The operative conditions, blood levels of lactic acid and inflammatory markers, postoperative recovery, cognitive status, hemodynamic indicators, brain oxygen metabolism, and complication rates were compared between the groups. RESULTS: The colloidal fluid dosage, total infusion, and urine volume, as well as time to first exhaust, time to food intake, and postoperative length of hospital stay, were lower in the observation group (P < 0.05). No significant differences were observed between the two groups in terms of operation time, bleeding volume, crystalloid liquid consumption, time to tracheal extubation, complication rate, heart rate, or mean arterial pressure (P > 0.05). Compared with the control group, in the observation group the lactic acid level was lower immediately after the surgery (P < 0.05); the Mini-Mental State Examination score was higher on postoperative day 3 (P < 0.05); the pulse pressure variability (PPV) was lower at 30 min after pneumoperitoneum (P < 0.05), though the differences in the PPV of the two groups was not significant at the remaining time points (P > 0.05); tumor necrosis factor-α and interleukin-6 levels were lower on postoperative day 3 (P < 0.05); and the left and right regional cerebral oxygen saturation was higher immediately after the surgery and 30 min after pneumoperitoneum (P < 0.05). CONCLUSION: GDFT combined with the preoperative glucose load regimen is a safe and effective treatment strategy for improving postoperative recovery and risk of complications in patients with rectal cancer undergoing radical resection.

Consuming Beetroot Juice Improves Slalom Performance and Reduces Muscle Soreness in Alpine Skiers under Hypoxic Conditions.

Background: Beetroot juice (BRJ) supplementation has been shown to increase sports performance under hypoxic conditions and to improve athletes' recovery. Objectives: In the present study, we aimed to investigate the effect of acute BRJ supplementation on slalom (SL) run performance and muscle soreness (MS) in Alpine skiers at moderate to high altitudes. Methods: Ten male Alpine skiers received 220 mL of BRJ (8.9 mmol/L nitrate) or placebo (PLA) in 2 sessions with a 7-d wash out interval in a randomized, crossover, PLA-controlled, double-blind study. The 90-s box jump (BJ90), agility hexagonal obstacle jump (Hex Jump), and wall-sit tests were measured before on-hill SL runs in both sessions. After the functional tests, SL run performance was measured by time to complete 2 runs on the SL course; immediately after each SL run, the rating of perceived exertion (RPE) was recorded. In addition, perceived MS was recorded using the visual analog scale at 12, 24, and 48 h after the SL runs. Results: The data were meticulously analyzed using 2-way repeated measures analysis of variance and paired t tests with significance set at P < 0.05. The findings were significant, indicating that compared with PLA, BRJ notably improved wall-sit and BJ90 performances (P < 0.05), while a substantial reduction was observed in RPE, Hex Jump, and MS (P < 0.05). A 1.74% shorter time to complete SL runs was observed in the BRJ group compared with the PLA group; however, there were no significant differences between the PLA and BRJ groups (P > 0.05). Conclusions: These results underscore the potential of BRJ supplementation to enhance sports performance and reduce MS in Alpine skiers under hypoxic conditions.

Barriers and Facilitators of Early Palliative Care in the Trajectory of People Living with Chronic Condition: A Mini Review Using Socio-ecological Framework to Inform Public Health Strategy.

The increasing incidence of chronic conditions on a global scale requires a comprehensive approach to palliative care, which is recognized as an essential element of the continuum of care for people with life-threatening conditions. It has been argued that the integration of early palliative care for people with chronic conditions is beneficial. Nevertheless, barriers to integrating early palliative care have been extensively not reviewed. This review aimed to explore the barriers and facilitators of integrating early palliative care for people living with chronic conditions, employing a socio-ecological framework to provide a critical understanding of the influencing factors at multiple levels. The method was a mini review. This review emphasizes the complex and diverse factors that either hinder or facilitate progress in four areas: individual (such as gaps in knowledge and emotional reactions), interpersonal (such as support from family caregiver), healthcare professionals and policy (such as barriers in education, guidelines, and collaboration among professionals), and community (such as societal knowledge and attitudes). Each level presents unique challenges and opportunities for enhancing early palliative care integration, from addressing misconceptions and fears at the individual level, to fostering supportive policies and community awareness. In conclusion, the effective management of early palliative care requires a comprehensive strategy that spans various dimensions, including educational initiatives, policy adjustments, and active involvements of the community. Healthcare systems are supposed to enhance the integration of early palliative care into the trajectory of chronic conditions and enhance the quality of life of affected persons and their families by recognizing and addressing the socio-ecological elements involved.

Damming of streams due to the construction of a highway in the Amazon rainforest favors individual trophic specialization in the fish (Bryconops giacopinii).

In Amazonian streams, damming caused by road construction changes the system's hydrological dynamics and biological communities. We tested whether the degree of specialization in fish (Bryconops giacopinii) individuals is higher in pristine stream environments with intact ecological conditions than in streams dammed due to the construction of a highway in the Amazon rainforest. To achieve this, stomach content data and stable isotopes (δ13C and δ15N) in tissues with varying isotopic incorporation rates (liver, muscle, and caudal fin) were used to assess the variation in consumption of different prey over time. The indices within-individual component (WIC)/total niche width (TNW) and individual specialization were employed to compare the degree of individual specialization between pristine and dammed streams. The condition factor and stomach repletion of sampled individuals were used to infer the intensity of intraspecific competition in the investigated streams. The species B. giacopinii, typically considered a trophic generalist, has been shown to be, in fact, a heterogeneous collection of specialist and generalist individuals. Contrary to our expectations, a higher degree of individual specialization was detected in streams dammed by the highway. In dammed streams, where intraspecific competition was more intense, individuals with narrower niches exhibited poorer body conditions than those with broader niches. This suggests that individuals adopting more restricted diets may have lower fitness, indicating that individual specialization may not necessarily be beneficial for individuals. Our results support the notion that intraspecific competition is an important mechanism underlying individual specialization in natural populations. Our results suggest that environmental characteristics (e.g., resource breadth and predictability) and competition for food resources interact in complex ways to determine the degree of individual specialization in natural populations.

A meta-analysis of factors influencing the inactivation of Shiga toxin-producing Escherichia coli O157:H7 in leafy greens.

Recent advancements in modeling suggest that microbial inactivation in leafy greens follows a nonlinear pattern, rather than the simple first-order kinetics. In this study, we evaluated 17 inactivation models commonly used to describe microbial decline and established the conditions that govern microbial survival on leafy greens. Through a systematic review of 65 articles, we extracted 530 datasets to model the fate of Shiga toxin-producing Escherichia coli O157:H7 on leafy greens. Various factor analysis methods were employed to evaluate the impact of identified conditions on survival metrics. A two-parameter model (jm2) provided the best fit to most of both natural and antimicrobial-induced persistence datasets, whereas the one-parameter exponential model provided the best fit to less than 20% of the datasets. The jm2 model (adjusted R2 = .89) also outperformed the exponential model (adjusted R2 = .58) in fitting the pooled microbial survival data. In the context of survival metrics, the model averaging approach generated higher values than the exponential model for >4 log reduction times (LRTs), suggesting that the exponential model may be overpredicting inactivation at later time points. The random forest technique revealed that temperature and inoculum size were common factors determining inactivation in both natural and antimicrobial-induced die-offs.. The findings show the limitations of relying on the first-order survival metric of 1 LRT and considering nonlinear inactivation in produce safety decision-making.

Different impacts of physical activity on health in urban and rural older adults.

OBJECTIVE: This study aimed to explore the impact of physical activity on health among older adults in urban and rural areas in Taiwan. METHODS: This study employed a cross-sectional design and data were analyzed from 2015 to 2019 from the Hualien County Health Bureau. Participants were divided into urban (n = 4780) and rural groups (n = 4983), and logistic regression models were employed to examine how physical activity relates to their health condition in urban and rural older adults. RESULTS: Results indicated lower physical activity levels and higher unhealthy behavior rate in rural older adults compared to their urban counterparts. Rural older adults had higher rates of cardiovascular diseases and diabetes but lower rates of mental illness. Physical activity demonstrated greater physical health benefits for urban older adults than rural older people. Conversely, rural individuals who engaged in physical activity 150 min/week exhibited greater mental health benefits than their urban counterparts. CONCLUSIONS: Physical activity offers significant mental health benefits for both urban and rural older adults; however, notable improvements in physical health among urban older adults was found. If in the presence of unhealthy behaviors, regular physical activity may not effectively prevent chronic diseases. It is crucial to promote physical activity and healthy behaviors in rural areas.

Length-weight relationship and condition factor of Nile tilapia ( Oreochromis niloticus) fed diets supplemented with guava and star gooseberry leaf extract.

Background: Nile tilapia ( Oreochromis niloticus) is predominant cultured species in aquaculture. However, there is a scarcity of literature regarding relationship between guava and star gooseberry leaf extract and the condition factor. Thus, the present study aims to investigate the effect of guava and star gooseberry leaf extract-supplemented diets on the specific growth rate, length-weight relationship, and condition factor of Nile tilapia. Methods: Six hundred and thirty Nile tilapia (8.7±0.4 g) were randomly distributed among twenty-one tanks (30 fish per tank) within a recirculation system. Over a 60-day period, the fish were fed diets supplemented with 5g/Kg and 10g/Kg of guava leaf extract (GLE-5, GLE-10), star gooseberry leaf extract (SGLE-5, SGLE-10), and a mixture of both (MxLE-5, MXLE-10). Subsequently, specific growth rate, length-weight relationship, and condition factor were determined. Results: After 60 days, the specific growth rate was significantly higher in all the GLE, SGLE, and MxLE groups compared to the control group. The final lengths and weights differed significantly both in the control group and all the GLE, SGLE, and MxLE groups. The analysis of the regression equation indicated a positive correlation (r = 0.970, 0.977, 0.976, 0.974, 0.974, 0.974, and 0.969) between the length and weight of Nile tilapia in the control group and in all the GLE, SGLE, and MxLE groups. The regression exponent " b" values in all the GLE, SGLE, and MxLE groups were >3, indicating a positive allometric growth pattern in Nile tilapia compared to the control ( b=2.866), which exhibited a negative allometry. The final condition factor values did not differ significantly in either the control group or any of the plant extract groups. Conclusions: Nile tilapia exhibited positive allometric growth patterns and maintained good health when fed with GLE, SGLE, and MxLE groups. Therefore, these plant extracts demonstrate suitability for commercial Nile tilapia production.

Ecological restoration amplifies riverine fish catch of Gudusia chapra (Hamilton, 1822): an impact study in the river Ganga using multivariate statistical tools and water quality indices.

Fish residing in the aquatic ecosystem are considered the best ecological indicator for monitoring environmental habitat. To evaluate the changes that occurred due to relative restoration in the ecological habitat, a study was conducted in the freshwater zone of the river Ganga between Buxar, Bihar, and Ballia, Uttar Pradesh, between July 2021 and July 2022. In the monitoring, the physico-chemical condition, as well as the food and feeding habits of the fish Gudusia chapra, were monitored with the help of various pollution evaluating indices, namely, the algal pollution index (API) for planktons, the comprehensive pollution index (CPI-WQI), and the National Sanitation Foundation Water Quality Indices (NSF-WQI) for water. The study showed that the relative restoration facilitated the amplification of the fish catch from 5.60 to 98.98% in two consecutive years. The reduction in the API (15 to 4) as well as CPI (0.80 to 0.72) during both years signified the reduction of the pollution status of the river in the region. The NSF-WQI also decreased from 88.27 to 79.27 from 2021 to 2022. The electivity index for the fish showed that fish preferred the groups Cyanobacteria, Rotifera, and Copepoda. The multivariate, as well as univariate analyses, revealed that the fish G. chapra is significantly influenced by multiple abiotic as well as biotic variables, among which the major contributors are riverine velocity, transparency, conductivity, pH, dissolved oxygen, total alkalinity, carbonate, bicarbonate, salinity, total hardness, calcium, silicate, and biochemical oxygen demand.

The role of condition on sexual selection in the seed bug Lygaeus simulans.

Organism condition plays an important role in sexual selection. Sexual ornaments and displays can be condition-dependent, reflecting either underlying genetic quality, experience of environmental stressors, or both. As such, the phenotypic expression of such traits, and the resulting patterns of mate choice acting on them, may be shaped by intrinsic genetic quality and the environment. Moreover, condition may also influence the choosing individual in mate choice, influencing their ability to invest in mate discrimination, or changing what traits of the chosen, including resources, are most preferred. Here we consider sexual selection and condition in the seed bug Lygaeus simulans, a species characterised by strong post-copulatory sexual selection, but rather limited pre-copulatory discrimination. We manipulated short-term condition in both males and females by restricting access to water for 24 h. Water is particularly important in these bugs, given their feeding ecology and physiology. We found that water-deprived males proved less likely to mate, while copulation duration with water-deprived females was significantly reduced. Given the importance of copulation duration for the successful transfer of sperm by males to females, the data suggest cryptic male choice acting against water-deprived females. These data add to those suggesting that cryptic male choice for fecund females plays an important role in sexual selection in this species. More generally, our results support the widespread importance of condition in terms of mating dynamics and sexual selection.

Designing a reliable machine learning system for accurately estimating the ultimate condition of FRP-confined concrete.

Precisely forecasting how concrete reinforced with fiber-reinforced polymers (FRP) responds under compression is essential for fine-tuning structural designs, ensuring constructions fulfill safety criteria, avoiding overdesigning, and consequently minimizing material expenses and environmental impact. Therefore, this study explores the viability of gradient boosting regression tree (GBRT), random forest (RF), artificial neural network-multilayer perceptron (ANNMLP) and artificial neural network-radial basis function (ANNRBF) in predicting the compressive behavior of fiber-reinforced polymer (FRP)-confined concrete at ultimate. The accuracy of the proposed machine learning approaches was evaluated by comparing them with several empirical models concerning three different measures, including root mean square errors (RMSE), mean absolute errors (MAE), and determination coefficient (R2). In this study, the evaluations were conducted using a substantial collection of axial compression test data involving 765 circular specimens of FRP-confined concrete assembled from published sources. The results indicate that the proposed GBRT algorithm considerably enhances the performance of machine learning models and empirical approaches for predicting strength ratio of confinement (f'cc/f'co) by an average improvement in RMSE as 17.3%, 0.65%, 66.81%, 46.12%, 46.31%, 46.87% and 69.94% compared to RF, ANNMLP, ANNRBF, and four applied empirical models, respectively. It is also found that the proposed ANNMLP algorithm exhibits notable superiority compared to other models in terms of reducing RMSE values as 9.67%, 11.29%, 75.11%, 68.83%, 73.64%, 69.49% and 83.74% compared to GBRT, RF, ANNRBF and four applied empirical models for predicting strain ratio of confinement (εcc/εco), respectively. The superior performance of the GBRT and ANNMLP compared to other methods in predicting the strength and strain ratio confinements is important in evaluating structural integrity, guaranteeing secure functionality, and streamlining engineering plans for effective utilization of FRP confinement in building projects.

Self-perceived barriers to healthcare access for patients with post COVID-19 condition.

BACKGROUND: Many patients with post COVID-19 condition (PCC) require healthcare services. However, qualitative studies indicate that patients with PCC encounter many barriers to healthcare access. This cross-sectional study aimed to determine how many PCC patients report barriers to healthcare access and which barriers are reported, and to explore differences between subgroups. METHODS: Data were collected via an online survey from 10,462 adult patients with a confirmed or suspected COVID-19 infection in the Netherlands, who experienced persisting symptoms ≥ 3 months after the initial infection. To study self-perceived barriers, a list of eleven possible barriers was used, covering multiple aspects of healthcare access. Differences between subgroups based on sociodemographic characteristics, medical characteristics, PCC symptoms (fatigue, dyspnoea, cognitive problems, anxiety and depression), and healthcare use (general practitioner, paramedical professional, medical specialist, occupational physician and mental health professional) were studied through multivariable multinomial (0 vs. 1 vs. > 1 barrier) and binomial regression analyses (for each individual barrier). RESULTS: A total of 83.2% of respondents reported at least one barrier to healthcare access. Respondents reported a median of 2.0 (IQR = 3.0) barriers. The barriers "I didn't know who to turn to for help" (50.9%) and "No one with the right knowledge/skills was available" (36.8%) were most frequently reported. Respondents with younger age, higher educational level, not hospitalized during acute COVID-19 infection, longer disease duration, who had more severe PCC symptoms, and who did not consult an occupational physician or paramedical professional, were more likely to report barriers. Analyses per barrier showed that women were more likely to report financial and help-seeking barriers, while men were more likely to report barriers related to availability of care. Hospitalized respondents were less likely to report barriers related to availability of care, but not less likely to report financial or help-seeking barriers. CONCLUSIONS: This study shows that the majority of patients with PCC experiences barriers to healthcare access. Particular attention should be paid to younger, non-hospitalized patients with a long disease duration and severe PCC symptoms. Efforts to remove barriers should focus not only on improving availability of care, but also on helping patients navigate care pathways.

Some biological aspects of chacunda gizzard shad, Anodontostoma chacunda (Hamilton, 1822) from the Bay of Bengal, Bangladesh.

Anodontostoma chacunda is a commercial fish species in the market and is usually consumed in fresh, smoked, and dried forms. This study investigated the population structure, length-weight relationships (LWR), condition factor (K F ), size at sexual maturity (L m ), and breeding season of A. chacunda in the Bay of Bengal, Bangladesh, using the data collected from January to December 2020. A total of 1061 individuals were collected in the sampling period with the help of fishers. Total length (TL) and body weight (BW) were measured using a measuring board and an electronic balance. The TL ranged from 12.50 to 26.70 cm. The allometric coefficient (b) value was 3.34, indicating positive allometric growth in this species. The fish is in good condition, evidenced by its condition factor (K F ) ranging between 0.88 and 1.73. Maturity size ranged from 15.40 to 16.80 cm (TL) based on three distinguished models. Spawning time lasts from January to May and from September to December. The peak spawning time was December of A. chacunda in the Bay of Bengal. This information could prove valuable for fisheries researchers and biologists, facilitating efforts toward the conservation and sustainable management of this species.

Evaluating early intervention in smoldering myeloma clinical trials: a systematic review.

BACKGROUND: Smoldering multiple myeloma (SMM), an asymptomatic precursor of multiple myeloma (MM), carries a variable risk of progression to MM. There is little consensus on the efficacy or optimal timing of treatment in SMM. We systematically reviewed the landscape of all clinical trials in SMM. We compared the efficacy of treatment regimens studied in SMM to results from these regimens when used in newly diagnosed multiple myeloma (NDMM), to determine whether the data suggest deeper responses in SMM versus NDMM. METHODS: All prospective interventional clinical trials for SMM, including published studies, meeting abstracts, and unpublished trials listed on ClinicalTrials.gov up to April 1, 2023, were identified. Trial-related variables were captured, including treatment strategy and efficacy results. Relevant clinical endpoints were defined as overall survival (OS) and quality of life. RESULTS: Among 45 SMM trials identified, 38 (84.4%) assessed active myeloma drugs, while 7 (15.6%) studied bone-modifying agents alone. Of 18 randomized trials in SMM, only one (5.6%) had a primary endpoint of OS; the most common primary endpoint was progression-free survival (n = 7, 38.9%). Among 32 SMM trials with available results, 9 (28.1%) met their prespecified primary endpoint, of which 5 were single-arm studies. Six treatment regimens were tested in both SMM and NDMM; 5 regimens yielded a lower rate of very good partial response rate or better (≥VGPR) in SMM compared to the corresponding NDMM trial (32% vs 63%, 43% vs 53%, 40% vs 63%, 86% vs 89%, 92% vs 95%, and 94% vs 87%, respectively). CONCLUSION: In this systematic review of all prospective interventional clinical trials in SMM, we found significant variability in trial design, including randomization status, primary endpoints, and types of intervention used. Despite the statistical limitations, comparison of treatment regimens revealed no compelling evidence that the treatment is more effective when introduced early in SMM compared to NDMM.

A two-dimensional four-quadrant assessment method to explore the spatiotemporal coupling and coordination relationship of human activities and ecological environment.

Human activities that involve diverse behaviors and feature a variety of participations and collaborations usually lead to varying and dynamic impacts on the ecological environment. Quantitative analysis of the dynamic changes and complex relationships between human activities and the ecological environment (eco-environment) can provide crucial insights for ecological protecting and balance maintaining. We proposed a two-dimensional four-quadrant assessment method based on the dynamic changes in Human Activity Index (HAI) - Environmental Ecological Condition Index (EECI) to analyze the dynamic trends and coupling coordination degree (CCD) between HAI and EECI. This approach was applied in an empirical study of Hainan Province. A comprehensive HAI at a resolution of 1 km × 1 km is established to measure human activities, while an EECI is developed to evaluate ecological environment quality. The eco-environment showed continuous improvement, with the HAI initially rising and then declining. Analysis of coupling coordination revealed a ratio of 6:1 between coordinated development regions and conflict regions, indicating a gradual improvement in overall coupling coordination. The interaction between the HAI and EECI is strengthening, though variations exist across different locations. Using the geodetector method, we identified Net Primary Productivity (NPP), Land use and land cover (LULC), and Particulate Matter (PM) as the primary factors influencing changes in coupling coordination between HAI and EECI. These factors indirectly affect the stability and carrying capacity of the ecological environment. This method facilitates a quantitative examination of the dynamic relationship between HAI and EECI in different regions, offering insights into ecosystem functionality, biodiversity maintenance, and the effect of HAI on the region.

Review of hydraulic conditions optimization for constructed wetlands.

Hydraulic conditions exert a comprehensive and vital influence on constructed wetlands (CWs). However, research on this subject is relatively limited. Hydraulic parameters can be categorized into design and operational parameters based on their properties. The design parameters are represented by the hydraulic gradient, substrate porosity, and aspect ratio, while operational parameters are represented by the hydraulic retention time, hydraulic loading rate, and water depth. These parameters directly or indirectly affect the operational lifespan and pollutant removal performance of CWs. Currently, the primary measures for optimizing the hydraulic conditions of CWs involve hydraulic structure and numerical simulation optimization methods. In this review, we aimed to elucidate the impact of hydraulic conditions on CW performance and summarize current optimization strategies. By highlighting the significance of hydraulic parameters in enhancing pollutant removal and extending operational lifespan, this review provides valuable insights for improving CW design and management. The findings will be useful for researchers and practitioners seeking to optimize CW systems and advance the application of nature-based solutions for wastewater treatment.

Assessing disparities in health and living conditions: a comparative study of Hungarian-speaking Roma and non-Roma women across Hungary, Romania, and Slovakia.

Background: The Roma minority, Europe's largest ethnic minority, experiences significant disparities in living conditions and health outcomes compared to the non-Roma populations across the continent. Despite extensive documentation of the socio-economic challenges faced by the Roma, there is a notable lack of comparative research. Methods: This study aims to fill this gap by examining the differences in socio-economic characteristics, living conditions, and self-reported health status between Roma (R) and non-Roma (nR) women in in Hungary (HU), Romania (RO), and Slovakia (SK), providing a cross-country comparative analysis. Utilizing simple and multiple binary logistic models, our research analysed data collected from September 2020 to March 2022, involving 322 Roma and 294 non-Roma women in Hungary, 258 Roma and 183 non-Roma women in Romania, and 146 Roma and 163 non-Roma women in Slovakia. Results: Findings indicate significant associations between increased age (R:OR = 1.04[1.02,1.06], p < 0.001), (nR:OR = 1.04[1.02,1.05], p < 0.001) lower financial situation (R:OR = 2.05[1.01,4.18], p = 0.048) (nR:OR = 1.67[1.01,2.77], p = 0.047), and basic education level (R:OR = 3.60[1.29,10.08], p = 0.015) (nR:OR = 3.64[1.77,7.51], p < 0.001) with the likelihood of poor health status across both groups in Hungary. In Romania, increased age (OR = 1.04[1.02,1.06], p < 0.001) and basic education level (OR = 5.24[2.29,11.99], p < 0.001) were particularly predictive of poor health among non-Roma, while in Slovakia, age (OR = 1.05[1.02,1.07], p < 0.001) was a significant factor for Roma, and intermediate education level (OR = 2.68[1.16,6.20], p = 0.021) was for non-Roma. The study also found that a higher number of children (HU:OR = 1.35[1.12,1.63], p = 0.002), (RO:OR = 1.57[1.25,1.96], p < 0.001) and problems with housing comfort (RO:OR = 4.83[2.19,10.62], p = 0.015) and wall conditions (RO:OR = 2.81[1.22,6.46], p < 0.001) significantly impacted the health status of non-Roma women in Hungary and Romania. Conversely, an increase in household size was associated with a better health status among Roma women in Hungary (OR = 0.88[0.79,0.99]) and Slovakia (OR = 0.78[0.61,0.99]). Conclusion: By offering a novel comparative analysis, this study highlights the critical need for focused attention on the health disparities faced by Roma women, particularly those in a multiply disadvantaged situation due to their ethnic and socio-economic status.

Fiber quality and fertility in male alpacas in the Cusco region of Peru.

Introduction: High testosterone levels might be associated with coarser fiber in alpacas, affecting fiber quality. In the husbandry systems employed in the Andes, males with higher libido might have an increased frequency of successful matings than males with lower libido. This study aimed to determine some of the factors affecting fiber quality in Peruvian alpacas and to evaluate the association between fiber quality and male mating behavior. Methods: The study population consisted of 189 adult male alpacas at La Raya, Cusco, Peru, at 4,400 m above sea level, belonging to the National University of San Marcos, Lima, and the National University of San Antonio Abad of Cusco. Fiber samples were collected from male alpacas in September 2015; body condition score (BCS) was evaluated. After washing and drying, the fiber samples were analyzed using an Optical Fiber Diameter Analyser 2000; linear regression analysis between predictor variables (location of alpacas, age, BCS, and fiber color) and fiber quality outcomes was conducted. Fertility data were available only for some males belonging to San Marcos University, consisting of hand-written records from the breeding season January to April 2015; individual fertility quotients were calculated for each male. Results: Age was associated with fiber quality, young alpacas having the finest fibers (p < 0.05). An increased BCS was associated with increased fiber length, fiber diameter and spinning fineness, but decreased comfort factor (p < 0.05). White fibers were thinner (p = 0.05) than colored fibers, with lower comfort factor and spinning fineness. A significant association between the fertility quotient and fiber curvature was observed (p = 0.018). Discussion: These results suggest that careful selection of breeding individuals and attention to husbandry could result in improved fiber quality among alpaca herds in Peru. However, it would be advisable to increase the number of males studied, using more reliable methods for evaluating male fertility and pregnancy diagnosis than were available for this study.