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Nickel-based superalloys like Inconel 718 exhibit large machining challenges attributable to their poor thermal conductivity and pronounced work hardening behaviors. They normally contribute to quick tool wearing away and poor surface quality. In order to get around this problem, a hybrid deep learning system that fused a CNN and an LSTM was devised and successfully optimized through the JOA. The model was incorporated in MATLAB/Simulink, making it possible to predict surface roughness and flank wear in real-time while hard turning using a CBN tool under MQL conditions. The experimental data used for model training and validation were derived from 27 full-factorial machining trials that covered a range of cutting speeds, feed rates, and depths of cut. The data was preprocessed through normalization and outlier removal using the IQR and Z-score methods. The CNN–LSTM model that was optimized by JOA displayed remarkable prediction power with R  = 0.9991, RMSE = 0.0095, and MAPE = 2.21%, thus being far superior to the conventional models, like SVM, ANN, and ANFIS, etc. The findings indicate the model’s ability to precisely understand complex nonlinear interactions between the machining parameters and the corresponding responses, hence, the model’s strong generalization across different cutting conditions. The inclusion of the MATLAB/Simulink environment extends the model’s real-time deployment potential, digital-twin compatibility, and scalability, providing a low-cost and sensor-free solution that is perfect for smart and sustainable manufacturing. This study offers a scientifically interpretable and industrially deployable method for predictive modeling in the machining of hard-to-cut materials.

Purpose The influence of closing wedge high tibial osteotomy (CW-HTO) with high valgus correction on its survival is unclear. This study aimed to conduct a 15-year follow-up cohort study to estimate the long-term survival rate of CW-HTO. Factors related to poor outcomes were investigated. Methods A total of 159 knees in 123 patients were followed up, and 120 knees in 96 patients were enrolled for statistical analysis. Femorotibial angles were measured by standing anterior–posterior radiographs of the knee. Clinical objective evaluation was performed by the Japanese orthopaedic association (JOA) score of the knee, and scores lower than 70 points defined the poor result (PR) group. The survival rate of OW-HTO was estimated. Logistic regression analyses were performed to determine the risk factors for PR and conversion to total knee arthroplasty (TKA). Results A total of 16 knees in 15 patients (13.3%) underwent TKA 14.0 ± 4.8 (4-20) years after CW-HTO. The 5-year survival rate was 99.2%, 10-year was 96.7%, 15-year was 92.5%, and 86.7% at final follow-up (17.9 years). Based on the JOA score, 44 patients (35.8%) belonged to the PR group, and their risk factors were obesity ( p  = 0.018), low femorotibial angle ( p  = 0.019), low JOA score ( p  = 0.040), low knee extension angle ( p  = 0.045), and low knee flexion angle ( p  = 0.046). Conclusions The 15-year survival rate of CW-HTO was 92.5%. While higher scores of objective outcomes were kept over long-term follow-up, the risk factors for a worsening score or TKA conversion were obesity and severity of preoperative knee symptoms.

To explore whether the autophagy intensity of lumbar intervertebral discs or Charlson Comorbidity Index(CCI) can predict the postoperative curative effect of single-level lumbar disc herniation(LDH) in patients. According to age stratification, five patients with single-level LDH who underwent surgical treatment in our hospital were included in each age group, and the autophagy level of the resected lumbar disc was detected by immunohistochemistry. A total of 30 patients were included and followed up for 2 years. According to the JOA improvement rate at the last follow-up, the patients were divided into two groups. According to age stratification, we found that there were significant differences in autophagy intensity and Pfirrmann classification; that is, with older age, the degree of lumbar disc degeneration was more serious and the autophagy intensity was lower. According to the JOA improvement rate, we found that there were significant differences in age, Autophagy intensity, Pfirrmann classification and CCI classification between different groups ( P < 0.05). By binary logistic regression analysis, we found that only CCI classification was an independent risk factor for the difference in postoperative improvement in patients with single-level lumbar discectomy, and patients with a CCI ≥ 2 were more likely to have a poor postoperative improvement rate.

We study the competitive forces which shaped ideological diversity in the US press in the early twentieth century. We find that households preferred like-minded news and that newspapers used their political orientation to differentiate from competitors. We formulate a model of newspaper demand, entry, and political affiliation choice in which newspapers compete for both readers and advertisers. We use a combination of estimation and calibration to identify the model's parameters from novel data on newspaper circulation, costs, and revenues. The estimated model implies that competition enhances ideological diversity, that the market undersupplies diversity, and that optimal competition policy requires accounting for the two-sidedness of the news market.

Background The aim of this study was to evaluate the psychological distress pre-operatively, at 3, 6, and 12 months in patients who underwent lumbar spine fusion surgery. Methods A total of 440 patients received instrumented lumbar spine fusion were enrolled. Psychological distress was evaluated using the Modified Somatic Perception Questionnaire (MSPQ) and the Modified Zung Depressive Index (ZDI). The results of lumbar fusion surgery were evaluated using the Oswestry Disability Index (ODI), the Japanese Orthopedic Association (JOA-29), and the visual analog scale (VAS). Results Psychological distress was reported among 23% of patients and 7, 5.5, and 4.0% of the patients preoperatively, at 3, 6, and 12 months after lumbar surgery, respectively. The mean MSPQ score decreased from 8.78 (before surgery) to 4.30, 3.52, and 3.43 at 3, 6 and 12 months in after surgery, respectively, in patients with psychological distress patients ( p  < 0.001). The mean ZDI score decreased from 17.78 to 12.48, 10.35, and 9.61 ( p  < 0.001). The mean ODI score decreased from 22.91 to 11.78, 10.13, and 9.96 ( P  < 0.001). The mean JOA score increased from 13.65 to 22.30, 23.43, and 23.61 ( P  < 0.001). The mean low back pain (LBP) VAS score decreased from 4.48 to 1.96, 1.52, and 1.51 ( P  < 0.001); moreover, the mean leg pain (LP) VAS score decreased from 5.30 to 1.30, 1.04, and 1.03 ( P  < 0.001). Conclusions Patients with psychological distress may experience surgical intervention benefits equal to those of ordinary patients. Moreover, reduced pain and disability after surgical intervention may also alleviate psychological distress. Hence, we highly recommend that patients with psychological distress undergo surgical intervention as normal patients do, but appropriate screening measures and interventions are necessary.

Background/Objectives: Jwagwieum (or Joa-Gui Em; JGE) consists of six herbal medicines, Rehmannia glutinosa (Gaertn.) DC., Dioscorea japonica Thunb., Lycium chinense Mill., Cornus officinalis Siebold & Zucc., Poria cocos Wolf, and Glycyrrhiza uralensis Fisch., and has been widely used to treat kidney-yin deficiency syndrome. In the present study, a high-performance liquid chromatography with photodiode array detector (HPLC–PDA) method for the simultaneous quantification of the nine components, i.e., gallic acid, 5-(hydroxymethyl)furfural, morroniside, loganin, liquiritin apioside, liquiritin, ononin, glycyrrhizin, and allantoin, was developed. Methods: The developed HPLC–PDA assay for quality control of JGE was validated with respect to linearity, limit of detection (LOD), limit of quantification (LOQ), recovery, and precision. Results: In the regression equation of the calibration curve, the coefficient of determination was ≥0.9980, and LOD and LOQ were 0.003–0.071 μg/mL and 0.010–0.216 μg/mL, respectively. Recovery and precision (relative standard deviation) were 96.36–106.95% and <1.20%, respectively. In this analytical method, nine compounds were detected at concentrations of 0.15–3.69 mg/lyophilized gram. Conclusions: The developed and validated analytical method could be used to obtain basic data for the quality control of JGE and related herbal prescriptions.

Background With an aging population, the prevalence of lumbar spinal diseases necessitating surgical intervention is increasing. Handgrip strength (HGS) has emerged as a simple measure of muscle function that may correlate with surgical outcomes. However, the role of HGS concerning postoperative recovery following transforaminal lumbar interbody fusion (TLIF) is not well-studied, highlighting a gap in the literature regarding its potential as a prognostic tool. Methods This prospective observational study included 89 patients who underwent TLIF performed by a single surgeon. Patients were categorized into normal and low HGS groups based on preoperative HGS measurements. Demographics, baseline HGS, and surgical details were recorded, and outcomes were assessed using the JOA, EQ-5D-3L, and Barthel Index at 3, 6, and 12 months postoperatively. Generalized Estimating Equations were used to examine associations between baseline parameters and outcomes over time. Results All patients were followed for at least one year, except for 15 (15.6%) who were lost to follow-up before the one-year mark. Patients with lower preoperative HGS were associated with significantly poorer postoperative functional outcomes. Specifically, a one-unit decrease in HGS was associated with a 2.551-point decrease in the JOA score ( p  = 0.008), a 0.142-point decrease in the EQ-5D-3L score ( p  = 0.007), and a 5.784-point decrease in the Barthel Index ( p  = 0.036). Additionally, male sex, higher body mass index, and lower Charlson comorbidity index were associated with better postoperative outcomes. Conclusions Low preoperative handgrip strength is associated with poorer functional, quality of life, and independence outcomes up to 12 months after TLIF surgery. Assessing HGS preoperatively may provide clinicians with valuable information for identifying patients at risk of suboptimal recovery. Future research could explore intervention strategies to improve preoperative muscle function and potentially enhance recovery outcomes for patients undergoing TLIF.

[...]Hussman merrily reviewed a long career of defying the odds, from buying an also-ran afternoon paper in Little Rock for $3.7 million in 1974 to eventually winning a brutal 12-year newspaper war over the revered and Pulitzer-honored Arkansas Gazette. After winning the Arkansas market, which once boasted a combined 300,000 subscribers, Hussman prospered for the next two decades before free news on the internet undermined the daily newspaper business model. Sensing business community support for the new ownership, he quickly built circulation and advertising sales, but the bottom line kept getting worse. [...]from 1975 to 1977, a series of National Labor Relations Board elections decertified all of the paper's labor unions.

Joint problems impair performance during exercise and daily activities and influence quality of life. The present study aimed to examine the effects of a combination of six non-essential amino acids (6AA) on joint conditions in an adult population. A total of 50 participants aged between 20 and 64 years with joint discomfort but no diagnosed joint disorder were randomly and blindly assigned to a control or 6AA group. The 6AA group took 12 g of the non-essential amino acid formulation orally (4 g three times a day) and the control group took equivalent doses of a placebo. Each group maintained the daily dose for 12 weeks. Primary outcome measures were evaluated with the visual analogue scale (VAS), the Japanese Knee Osteoarthritis Measure (JKOM), and the Japanese Orthopaedic Association score (JOA). These tests were taken before the experiment began at 4 weeks and 12 weeks after the intervention. The results of the VAS indicated that 6AA improved joint pain, discomfort, and stiffness both during a resting state and during normal activity. Participants’ scores on the JKOM and JOA also showed significant improvements in the group that had taken the 6AA supplement. These results demonstrate that 6AA improves symptoms of joint problems, such as pain, discomfort, stiffness, and difficulty in performing daily activities after 4 weeks of daily consumption.

The aim of the study is to investigate the clinical and radiologic factors represented by the increasing of spinal cord area associated with the prognosis of the patients at long-term follow-up by multivariate analysis after single-door cervical laminoplasty (SDCL). A total of 115 patients who underwent cervical laminoplasty with miniplate fixation were included from November 2008 to June 2018. The average postoperative follow-up period was 17.3 months (range, 12–105 months). The prognosis of the patients following cervical laminoplasty was evaluated by the recovery rate of Japanese Orthopedic Association (JOA) at the final follow-up. The recovery rate of JOA ≤ 50% were classified as poor prognosis group (PP group) whose prognosis is relatively poor, and those> 50% were classified as good prognosis group (GP group) whose have a better prognosis. The clinical factors including gender, age, duration of symptoms, diagnosis type, blood loss, operative time, pre- and post-JOA score, etc. were recorded. The radiologic factors including sagittal canal diameter (SCD), the cervical curvature index (CCI), the range of motion (ROM), the spinal canal area and the increasing of cervical spinal cord area, etc. were collected before and after operation and measured by X-ray plain and computed tomography (CT) scan images. The univariate analysis and multivariate logistic regression analysis were performed. There were 62 patients in PP group and 53 patients in GP group. The multivariate analysis showed that the preoperative (OR=6.875, P = 0.001) and postoperative JOA scores (OR=24.000, P = 0.001), preoperative spinal canal area (OR=2.464, P = 0.023) and the increasing of cervical spinal cord area (OR=5.438, P = 0.001) maybe related factors to the recovery rate of JOA at the final follow-up. The preoperative spinal canal area, the increasing of cervical spinal cord area, preoperative and postoperative JOA scores play important roles in long-term prognosis after SDCL. •The preoperative and postoperative JOA scores are associated with the recovery rate of JOA at the final follow-up.•The preoperative spinal canal area and the increasing of cervical spinal cord area may be predictors of prognosis outcome.•The surgeon should not pursue the overexpansion of the spinal canal during the operation.•Patients who are predicted with a poor prognosis should be prepared for long-term follow-up after surgery.