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Connecting individual robots to form an inter-reconfigurable system with a flexible base size enhances the ability to access and cover areas for cleaning and maintenance tasks. Given that increased configuration complexity expands the search space dimension, an optimal routing solution ensuring efficiency is essential. In this paper, we present an inter-reconfigurable multi-robot system capable of adjusting the bases of its two units, along with an optimal path planning approach for confined spaces based on a modified informed rapidly-exploring random tree algorithm by a greedy set (RIRRT*). We validate the navigation of the proposed inter-reconfigurable platform using RIRRT* for four informed dimensional search spaces as a case study in both simulated and real-world environments. The proposed path planning method for the inter-reconfigurable system outperformed conventional strategies, achieving significant reduction in both execution time and energy utilization.
This article examines recent developments in English language education in Vietnam, contextualising them within contemporary sociopolitical and cultural discourses. It begins by tracing the historical emergence and evolution of English in Vietnam before examining its role in the education system. The article then critically discusses Project 2020, Vietnam's largest language education initiative, and its profound impact on the country's language education landscape. Finally, it presents three notable trends significantly shaped by Project 2020: the increasing prevalence of IELTS preparation, the rise of second-career language teachers, and the emergence of communities of practice for English teachers.
Although Vietnam’s current 2013 Constitution does not recognize a specific right to freedom of thought, it does recognize the constituent rights of freedom of thought, including freedom of religion and belief, freedom of speech, freedom of the press, freedom of association and freedom of peaceful assembly. Since Doi Moi (1986), the implementation of these freedoms has been much improved, but there are still many obstacles and limitations. These include strict control over media, restrictions on political dissent, and limitations on the activities of religious groups. The main reason for these limitations is the Communist Party’s concern that the exercise of these rights will lead to political instability and the changing of the socialist regime in Vietnam today. Vietnam is continuing to integrate more deeply into the world, and this is one of the main driving forces promoting freedom of thought in this country. However, in the short term, there will not be any significant changes because there have been no signs of the Communist Party of Vietnam relaxing civil liberties. Despite this, there is still room for freedom of thought, and it is crucial to advocate for its promotion. The journey towards promoting freedom of thought in Vietnam is undoubtedly a long-term one. It necessitates the active participation and coordination of numerous stakeholders, who must approach the task with patience, persistence, and flexibility.
The economic burden of migraine is substantial; determining the cost that migraine imposes on the Canadian healthcare system is needed.
Methods:
Administrative data were used to identify adults living with migraine, including chronic migraine (CM) and episodic migraine (EM), and matched controls in Alberta, Canada. One- and two-part generalized linear models with gamma distribution were used to estimate direct healthcare costs (hospitalization, emergency department, ambulatory care, physician visit, prescription medication; reported in 2022 Canadian dollars) of migraine during a 1-year observation period (2017/2018).
Results:
The fully adjusted total mean healthcare cost of migraine (n = 100,502) was 1.5 times (cost ratio: 1.53 [95% CI: 1.50, 1.55]) higher versus matched controls (n = 301,506), with a predicted annual incremental cost of $2,806 (95% CI: $2,664, $2,948) per person. The predicted annual incremental cost of CM and EM was $5,059 (95% CI: $4,836, $5,283) and $669 (95% CI: $512, $827) per person, respectively, compared with matched controls. All healthcare cost categories were greater for migraine (overall, CM and EM) compared with matched controls, with prescription medication the primary cost driver (incremental cost – overall: $1,381 [95% CI: $1,234, $1,529]; CM: $2,057 [95% CI: %1,891, $2,223]; EM: $414 [95% CI: $245, $583] per person per year).
Conclusion:
Persons living with migraine had greater direct healthcare costs than those without. With an estimated migraine prevalence of 8.3%–10.2%, this condition may account for an additional $1.05–1.29 billion in healthcare costs per year in Alberta. Strategies to prevent and effectively manage migraine and associated healthcare costs are needed.
Seeds rely on temperature to adjust their germination timing by modulating primary and secondary dormancy. The knowledge regarding an intraspecific variation in the germination responses to supra-optimal temperatures during imbibition within the Solanum lycopersicon species and its relation with pre- and post-harvest environments is limited. Here, we studied the impact of imbibition at 35°C in 17 genotypes selected from a multiparent advanced generation intercross (MAGIC) population. We discovered a high genetic variability in the germination responses to heat, leading to thermotolerance, thermoinhibition or thermodormancy with different depths. While thermodormancy appeared more profound than primary dormancy, there was no correlation between the deepness of primary and thermodormancy. Post-harvest treatments influenced considerably germination at supra-optimal temperatures. Dry storage beyond the apparent loss of primary dormancy led to an increased proportion of thermotolerant or thermoinhibited seeds at the expense of thermodormancy in a genotype-dependent manner, thereby revealing cryptic genetic variation. Prolonged cold imbibition also led to increased thermodormancy in genotypes that produced thermotolerant and thermoinhibited seeds. The thermal history before and after flowering influenced primary dormancy and the germination response to heat during imbibition in a genotype-dependent manner, with high temperatures leading to increased thermotolerance or thermoinhibition at the expense of thermodormancy, suggesting transgenerational plasticity despite the domestication of the species. The high potential of the MAGIC population for quantitative trait loci mapping and causal polymorphism identification will be helpful in deciphering the regulatory mechanisms that lead to the plasticity of thermoinhibition or thermodormancy, as well as their connection to the parental environment.
High takeoff of the right coronary artery suspected by echocardiography is widely considered a normal variant. However, in our experience, some patients initially thought to have a high takeoff of the coronary artery were later found to have an anomalous coronary origin with high-risk features. The aim of this study was to test the hypothesis that high takeoff of the right coronary artery suspected by echocardiography may indicate the presence of an anomalous coronary artery lesion with an intramural course requiring further investigation.
Methods:
A retrospective chart review was performed of patients evaluated at the University of Florida Congenital Heart Center from January 2010 through September 2015. Charts of all 62 patients who were noted to have an anomalous coronary artery or concern for an anomalous coronary artery were reviewed to identify those who were initially identified as having simply a high takeoff of the right coronary artery by initial echocardiogram. A total of 24 patients met these criteria.
Results:
Out of 24 patients identified as having high takeoff of the right coronary artery on their initial echocardiogram, 20 had confirmatory computerized tomographic angiography. On review of these patients, 9 had a right coronary origin from the left. This included 3 patients with an anomalous right coronary artery from the left coronary sinus and 6 with an anomalous right coronary artery origin just above the left coronary sinus. Six of these 9 patients had an intramural course. The remaining patients had high takeoff above the right coronary sinus or normal coronary origins.
Additionally, on review of all patients with computerized tomographic angiographic confirmation of high takeoff of the coronary artery, those with high takeoff above the left coronary sinus were more likely to have an intramural course (6 out of 9). Meanwhile, none of the 6 patients with high takeoff above the right coronary sinus confirmed by computerized tomographic angiography had an intramural course.
Conclusion:
Accurate identification of the coronary origin and course of the anomalous coronary artery is difficult by echocardiogram. Correct diagnosis of origin and course is important for appropriate risk stratification and treatment decisions. Therefore, patients with high takeoff of the right coronary artery suspected by echocardiography should undergo additional evaluation to assess for the presence of a potentially malignant course.
Focusing on the efforts to recover, repatriate, and rebury thousands of fallen soldiers from the China-Burma-India Theater, this chapter analyzes how the disparate treatment of American bodies and Chinese bodies defined the Sino-American relations in the immediate postwar period. The first part of this chapter examines how well-established institutions, ambulant resources, and cooperative regimes enabled US servicemen to salvage the bodies of American soldiers from distant theaters of war to reinter them in national and private cemeteries on American soil. The second part addresses the struggle of the Chinese government in Nanjing, the Chinese military command in India, and the Chinese communities in Burma to provide proper burials for the dead of the Nationalist expeditionary forces. China lacked the formal institutions and infrastructure to manage war graves in foreign territories, and failed to garner the support of local authorities. When the political chaos of the Chinese Civil War led to the cessation of funding from the Nationalist government, the graves of Chinese soldiers in India and Burma fell into oblivion.
During the COVID-19 pandemic, the European Union (EU) observed a major centralisation of competence in public health policy – the EU Vaccines Strategy. Yet increased centralisation or integration is not always desirable because the EU lacks a layer of democratic control to ensure transparency and accountability. This feature highlights the need to better understand and assess the EU’s actions during the pandemic. This paper aims to assess the effectiveness of the EU Vaccines Strategy and contributes to the wider debate on the centralisation of power at Union level. The joint procurement of COVID-19 vaccines is considered a success, as it avoided a “vaccine scramble” by the EU Member States. However, the fact that the Member States were obliged to purchase more than they needed and the lack of transparency in the negotiations with companies on the procurement of vaccines have raised questions about the integrity of the Commission’s exercise of executive power.
When, how, and why did the Vietnam War begin? Although its end is dated with great precision to April 30, 1975, there is no agreement as to when it began. The Vietnam War was an enormously complex conflict and even though any comprehensive reckoning of its causes must include the role of the United States, it did not begin as an “American War.” This volume presents the scholarship that has flourished since the 1990s to situate the war and its origins within longer chronologies and wider interpretative perspectives. The Vietnam War was a war for national liberation and an episode of major importance in the Global Cold War. Yet it was also a civil war, and civil warfare was a defining feature of the conflict from the outset. Understanding the Vietnamese and Indochinese origins of the Vietnam War is a critical first step toward reckoning with the history of this violent, costly, and multilayered war.
This chapter offers an overview of developments in postwar Vietnam until the 2010s. After the war, the communist government sought to impose a socialist system in the South in the same way they had done in the North since 1954. This utopian march to socialism was draconian and produced an economic collapse and a looming famine in the mid 1980s. With leadership change and support from Soviet leader Mikhail Gorbachev, Vietnamese leaders embarked on market reform but refused political reform. For more than three decades, the communist party has overseen rapid economic growth that lifted millions out of poverty and raised national income many times. Despite impressive economic achievements, Vietnam’s political system is undergoing severe decay, with an aging leadership still pledging loyalty to communism while party and state bureaucracies are thoroughly penetrated by corrupt patronage networks that peddle offices and influences to serve officials and their cronies. The perverse outcome of a communist revolution that produced an oppressive and corrupt regime in Vietnam today has lately brought about the moment of reckoning for many Vietnamese about the true meaning of the Vietnam War.
Mylonchulus laocaiensis sp. n. recorded from Vietnam, is described and illustrated, and its phylogenetic relationship within the Mylonchulidae family and Mononchida order are analysed. The new species is characterized by medium body size (L = 1.0–1.5 mm); buccal cavity goblet shaped, 26–29 × 14–16.5 μm or 1.8 (1.7–1.9) times as long as wide; posterior position of dorsal tooth apex (79%–88% from the base of buccal cavity); a small subventral tooth present on subventral wall; pars refringens vaginae with faint and small (2.5 × 1.7 μm) teardrop-shaped pieces, short pars distalis vaginae; male with short spicules (54–57 μm) with rounded head. The molecular data (18S and 28S rDNA) are provided for the new species.
To assess the effectiveness of a 3-question decision-support tool to guide the diagnosis and treatment of urinary tract infections (UTIs) in acute care hospitalized patients as an antibiotic and diagnostic stewardship initiative.
Design:
Retrospective cohort study.
Setting:
Four acute care hospitals within the same health system in Miami, FL.
Patients:
124, admitted from the emergency department and hospitalized adult patients, treated with antibiotics for the indication of a UTI between March and April 2023.
Intervention:
We developed a 3-step clinical decision-support tool (CDST) to evaluate the appropriateness of urine cultures and antibiotic treatment. The tool’s recommendations when deciding to prescribe antibiotics were compared with the actual need for treatment throughout the hospitalization, up to the time of patient discharge.
Results:
Overall, 31% of antibiotics prescribed for UTIs were inappropriate and met the criteria for asymptomatic bacteriuria (ASB) based on the CDST. Prospective implementation of the decision-support tool could potentially reduce antibiotic use by 33.6%, corresponding to 265 days of unnecessary therapy. The sensitivity and specificity of the tool were calculated to be 98.6% and 100%, respectively, indicating high accuracy in identifying the need for antibiotic treatment. Urinalysis alone was insufficient to differentiate between symptomatic UTIs and ASB, with leukocyturia present in 95.3% of UTI cases and 94.6% of ASB cases (P = 0.87).
Conclusions:
Implementing a 3-question CDST may reduce unnecessary laboratory work-up and treatment for ASB improving the diagnostic and antimicrobial stewardship of UTIs.
The increasing contamination of water by organic dyes causes water pollution in the enviroment. Factories discharge untreated effluents into nearby water courses adding to the existing water pollution; this poses a significant environmental challenge. Hence there is a pressing demand to develop efficient technology for wastewater treatment, and photocatalysis has emerged as an advanced oxidation process with a green chemical approach for such treatment. This study aims to synthesize montmorillonite/TiO2 (Mnt/TiO2) photocatalysts and clarify the effect of montmorillonite content on the photodegradation of the organic dye rhodamine B (RhB). Mnt/TiO2 was prepared by a chemical method with various mass ratios of mMnt:mTiO2 based on the cation exchange capacity (CEC) of Mnt. The physicochemical properties of the samples prepared were determined by the following methods: energy-dispersive X-ray spectroscopy (EDX), scanning electron microscopy (SEM), Brunauer–Emmett–Teller (BET), X-ray diffraction (XRD), and Fourier transform infrared spectroscopy (FTIR). The photocatalytic degradation efficiency of the RhB solution of Mnt/TiO2 was investigated by UV-Vis spectroscopy under UVC irradiation. Liquid chromatography-mass spectrometry (LCMS) was used to identify the photocatalytic by-products. The results showed that the structure of the nanocomposites has a ‘house-of-cards’ form with TiO2 nanoparticles randomly distributed on the surface and sheets of clay minerals. The best mass ratio of mMnt:mTiO2 is 10:1, corresponding to a 10 ppm RhB solution decolorization efficiency of 91.5% in 210 min. In this study, Mnt/TiO2 successfully cleaved the dye chromophore structure and broke the RhB rings into small and broken-ring compounds.
Understanding post-stroke spasticity (PSS) treatment in everyday clinical practice may guide improvements in patient care.
Methods:
This was a retrospective cohort study that used population-level administrative data. Adults (aged ≥18 years) who initiated PSS treatment (defined by the first PSS clinic visit, focal botulinum toxin injection, or anti-spasticity medication dispensation [baclofen, dantrolene and tizanidine] with none of these treatments occurring during the 2 years before the stroke) were identified between 2012 and 2019 in Alberta, Canada. Spasticity treatment use, time to treatment start and type of prescribing/treating physician were measured. Descriptive statistics were performed.
Results:
Within the cohort (n = 1,079), the most common PSS treatment was oral baclofen (initial treatment: 60.9%; received on/after the initial treatment date up to March 31, 2020: 69.0%), largely prescribed by primary care physicians (77.6%) and started a median of 348 (IQR 741) days after the stroke. Focal botulinum toxin (23.3%; 37.7%) was largely prescribed by physiatrists (72.2%) and started 311 (IQR 446) days after the stroke; spasticity clinic visits (18.6%; 23.8%) were also common.
Conclusions:
We found evidence of gaps in provision of spasticity management in persons with PSS including overuse of systemic oral baclofen (that has common adverse side effects and lacks evidence of effectiveness in PSS) and potential underuse of focal botulinum toxin injections. Further investigation and strategies should be pursued to improve alignment of PSS treatment with guideline recommendations that in turn will support better outcomes for those with PSS.
In environmental science, where information from sensor devices are sparse, data fusion for mapping purposes is often based on geostatistical approaches. We propose a methodology called adaptive distance attention that enables us to fuse sparse, heterogeneous, and mobile sensor devices and predict values at locations with no previous measurement. The approach allows for automatically weighting the measurements according to a priori quality information about the sensor device without using complex and resource-demanding data assimilation techniques. Both ordinary kriging and the general regression neural network (GRNN) are integrated into this attention with their learnable parameters based on deep learning architectures. We evaluate this method using three static phenomena with different complexities: a case related to a simplistic phenomenon, topography over an area of 196 $ {km}^2 $ and to the annual hourly $ {NO}_2 $ concentration in 2019 over the Oslo metropolitan region (1026 $ {km}^2 $). We simulate networks of 100 synthetic sensor devices with six characteristics related to measurement quality and measurement spatial resolution. Generally, outcomes are promising: we significantly improve the metrics from baseline geostatistical models. Besides, distance attention using the Nadaraya–Watson kernel provides as good metrics as the attention based on the kriging system enabling the possibility to alleviate the processing cost for fusion of sparse data. The encouraging results motivate us in keeping adapting distance attention to space-time phenomena evolving in complex and isolated areas.
We aimed to (1) report updated estimates of direct healthcare costs for people living with MS (pwMS), (2) contrast costs to a control population and (3) explore differences between disability levels among pwMS.
Methods:
Administrative data were used to identify adult pwMS (MS cohort) and without (control cohort) in Alberta, Canada; disability level (based on the Expanded Disability Status Scale) among pwMS was estimated. One- and two-part generalized linear models with gamma distribution were used to estimate the incremental direct healthcare cost (2021 $CDN) of MS during a 1-year observation period.
Results:
Adjusting for confounders, the total healthcare cost ratio was higher in the MS cohort (n = 13,089) versus control (n = 150,080) (5.24 [95% CI: 5.08, 5.41]) with a predicted incremental cost of $15,016 (95% CI: $14,497, $15,535) per person-year. Among the MS cohort, total predicted direct healthcare costs were higher with greater disability, $14,430 (95% CI: $13,980, $14,880) to $58,697 ($51,514, $65,879) per person-year in mild and severe disability, respectively. The primary health resource cost component shifted from disease-modifying therapies in mild disability to supportive care in moderate and severe disability.
Conclusion:
Adult pwMS had greater direct healthcare costs than those without. Extrapolating to the population level (where 14,485 adult pwMS were identified in the study), it is estimated that $218 million per year in healthcare costs may be attributable to MS in Alberta. The significantly larger economic impact associated with greater disability underscores the importance of preventing or delaying disease progression and functional impairment in MS.
Adopting a healthy dietary pattern may be an initial step in combating inflammation-related chronic diseases; however, a comprehensive synthesis evaluating current evidence is lacking. This umbrella review aimed to summarise the current evidence on the effects of dietary patterns on circulating C-reactive protein (CRP) levels in adults. We conducted an exhaustive search of the Pubmed, Scopus and Epistemonikos databases, spanning from their inception to November 2023, to identify systematic reviews and meta-analyses across all study designs. Subsequently, we employed a random-effects model to recompute the pooled mean difference. Methodological quality was assessed using the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) checklist, and evidence certainty was categorised as non-significant, weak, suggestive, highly suggestive or convincing (PROSPERO: CRD42023484917). We included twenty-seven articles with thirty meta-analyses of seven dietary patterns, fifteen of which (50 %) exhibited high methodological quality. The summary effects of randomised controlled trials (RCT) found that the Mediterranean diet was the most effective in reducing circulating CRP levels, followed by Vegetarian/Vegan and Energy-restricted diets, though the evidence was of weak quality. In contrast, Intermittent Fasting, Ketogenic, Nordic and Paleolithic diets did not show an inverse correlation with circulating CRP levels. Some results from combined interventional and observational studies, as well as solely observational studies, also agreed with these findings. These dietary patterns show the potential in reducing CRP levels in adults, yet the lack of high-quality evidence suggests future studies may alter the summary estimates. Therefore, further well-conducted studies are warranted.
We showed images of classic Blalock–Taussig–Thomas shunt in a 35-year-old male patient with tetralogy of Fallot who underwent palliative surgery in 1992. It is a rare image echocardiography in our modern life.