Community farms and gardens have shown positive impacts on enhancing sustainable agriculture and food security, especially for disadvantaged citizens. The benefits of community gardens/farms for ...immigrants have been extensive, and the potential for spreading this model is considerable. However, minimal data sets exist on the number, as well as the success, of these gardens/farms operating in Iowa. Through personal interviews with farmers and organizations, participatory action research, and observations, this study analyzed the impacts of community gardens/farms on Iowa immigrant communities regarding food security and safety, income stability, and educational gain. In examining the complex roles of community gardens/farms, not only on immigrant families, but also on the community, concerning primary farming motivations and background, market understanding, obstacles, and short- and long-term benefits. Findings from 35 interviews with community farm organizers (CFOs) and community gardeners/farmers (FMRs) showed that “food security” and “reconnecting with nature, culture, and tradition” were considered the most important benefits of community gardens/farms. Economic benefits (“income”) derived from community gardens/farms tended to be cited by the more experienced farmers. Farmers’ length of time in the U.S was positively correlated to their focus on economic benefits of the gardens/farms. For the five CFOs interviewed, “land access” and “financial support” were the two most cited barriers preventing long-term success of the community garden/farm. “Language barriers” were cited as potential constraints, but varied between organizations and farmer participants. Organic practices were the norm on most community gardens/farms, although organic certification was not obtained, due to consumers first-hand knowledge of growers and the perceived lack of need for third-party verification. Food safety (FS) practices varied among gardens/farms, with the most rigorously adopted practices on farms where CFOs had obtained FS training and provided trainings to their participants. This study helped fill information gaps regarding impacts of community gardens/farms in Iowa, particularly those established to assist immigrant and refugee gardeners/farmers. In addition, organizations were provided recommendations to improve their programs, which included seeking additional government and donor support to increase the size and security of land tenure for the gardens/farms, and to expand FS and business planning educational opportunities to meet participants’ needs.
The objective of this study was to investigate the incidence and predictors of first-pass effect (FPE) and to compare the clinical outcomes among FPE, multiple-pass effect, and incomplete reperfusion ...(ICR) in acute anterior circulation large vessel occlusion.
Patients from the ANGEL-ACT (Endovascular Treatment Key Technique and Emergency Workflow Improvement of Acute Ischemic Stroke) registry were included. FPE was defined as complete reperfusion after a single pass of the thrombectomy device without rescue treatment. MPE was defined as complete reperfusion after ≥ 2 passes of the thrombectomy device. ICR was defined as a modified Thrombolysis in Cerebral Infarction score of 2b independent of the number of passes. Multivariable analyses were used to determine predictors of FPE and to compare the following outcomes: functional independence, mortality within 90 days, intraprocedural complications, and intracranial hemorrhage (ICH) among FPE, MPE, and ICR.
There were 1139 patients, of whom 307 (27.0%) achieved FPE. FPE was related to occlusion location (M1 vs internal carotid artery ICA, adjusted OR aOR 1.57, 95% CI 1.15-2.15, p = 0.004; M2/anterior cerebral artery vs ICA, aOR 2.06, 95% CI 1.32-3.22, p = 0.002) and negatively associated with underlying intracranial atherosclerosis disease (ICAD) (aOR 0.33, 95% CI 0.23-0.49, p < 0.001). Patients with FPE had a higher rate of functional independence (52.7% of FPE patients vs 45.6% of MPE patients and 37.1% of ICR patients, p = 0.002; MPE vs FPE, aOR 0.69, 95% CI 0.51-0.95, p = 0.023; ICR vs FPE, aOR 0.45, 95% CI 0.31-0.66, p < 0.001), lower rate of intraprocedural complications (4.2% vs 18.1% and 21.2%, p < 0.001; MPE vs FPE, aOR 6.23, 95% CI 3.36-11.54, p < 0.001; ICR vs FPE, aOR 7.70, 95% CI 3.97-14.94, p < 0.001), and lower rate of ICH within 24 hours (18.3% vs 27.9% and 26.9%, p = 0.009; MPE vs FPE, aOR 1.97, 95% CI 1.35-2.86, p < 0.001; ICR vs FPE, aOR 2.03, 95% CI 1.30-3.16, p = 0.002) than those with MPE and ICR.
FPE was achieved at a rate of 27.0% and associated with functional independence, decreased intraprocedural complications, and ICH. Non-ICA occlusion and underlying ICAD were predictors of FPE.
Background and Purpose
Two early basilar artery occlusion (BAO) randomized controlled trials did not establish the superiority of endovascular thrombectomy (EVT) over medical management. While many ...providers continue to recommend EVT for acute BAO, perceptions of equipoise in randomizing patients with BAO to EVT versus medical management may differ between clinician specialties.
Methods
We conducted an international survey (January 18, 2022 to March 31, 2022) regarding management strategies in acute BAO prior to the announcement of two trials indicating the superiority of EVT, and compared responses between interventionalists (INTs) and non‐interventionalists (nINTs). Selection practices for routine EVT and perceptions of equipoise regarding randomizing to medical management based on neuroimaging and clinical features were compared between the two groups using descriptive statistics.
Results
Among the 1245 respondents (nINTs = 702), INTs more commonly believed that EVT was superior to medical management in acute BAO (98.5% vs. 95.1%, p < .01). A similar proportion of INTs and nINTs responded that they would not randomize a patient with BAO to EVT (29.4% vs. 26.7%), or that they would only under specific clinical circumstances (p = .45). Among respondents who would recommend EVT for BAO, there was no difference in the maximum prestroke disability, minimum stroke severity, or infarct burden on computed tomography between the two groups (p > .05), although nINTs more commonly preferred perfusion imaging (24.2% vs. 19.7%, p = .04). Among respondents who indicated they would randomize to medical management, INTs were more likely to randomize when the National Institutes of Health Stroke Scale was ≥10 (15.9% vs. 6.9%, p < .01).
Conclusions
Following the publication of two neutral clinical trials in BAO EVT, most stroke providers believed EVT to be superior to medical management in carefully selected patients, with most indicating they would not randomize a BAO patient to medical treatment. There were small differences in preference for advanced neuroimaging for patient selection, although these preferences were unsupported by clinical trial data at the time of the survey.
Exchange-biased CrMn/Co bilayers with various thicknesses of Co sputtered onto Si(1
0
0) substrates by the RF sputtering system have been studied. Double-shifted loops have been observed with the ...thickness of Co layer in a narrow range and become single-shifted loops after some cycles of measurement. Those results are interpreted as the association of positive and negative exchange bias.
Image inpainting is a process of filling missing and damaged parts of image. By using the Mumford-Shah image model, the image inpainting can be formulated as a constrained optimization problem. The ...Mumford-Shah model is a famous and effective model to solve the image inpainting problem. In this paper, we propose an adaptive image inpainting method based on multiscale parameter estimation for the modified Mumford-Shah model. In the experiments, we will handle the comparison with other similar inpainting methods to prove that the combination of classic model such the modified Mumford-Shah model and the multiscale parameter estimation is an effective method to solve the inpainting problem.
Background: An association between heart rate variability (HRV) and cardiac events in certain diseases has been demonstrated. However, the association with new-onset atrial fibrillation (AF) after ...coronary artery bypass grafting (CABG) is still controversial. This study aimed to investigate the association between HRV and new-onset AF in patients undergoing CABG during a 6-month follow-up. Methods: This prospective study included 119 consecutive patients who underwent off-pump CABG. All patients were assessed using 24-hour Holter recordings 2 days before CABG and 1 week, 3 months, and 6 months postoperatively. HRV was analyzed, and AF was detected from its recordings. Main results: In patients undergoing CABG, NYHA III increased the AF rate 7 days postoperatively, and advanced age and diabetes were associated with AF 6 months postoperatively. A reduction in time-domain measurements before surgery was significantly associated with a higher risk of developing AF seven days postoperatively; no association between preoperative HRV and AF was found at six months. Reduced preoperative HRV (SDNN (standard deviation of all normal-to-normal intervals ) < 50 ms) was an independent predictor of AF at 3 (AUC = 0.65) and 6 months (AUC = 0.62) following surgery. Conclusion: A reduction in the time domain measurements before CABG was associated with a higher risk of new-onset AF at 7 days postoperatively but not at 6 months. An SDNN <50 ms was a weak independent predictor of a higher incidence of AF at 3 and 6 months post-surgery. Keywords: heart rate variability, coronary artery bypass graft, atrial fibrillation, standard deviation of all normal-to-normal intervals
Melanoma skin cancer is one of the most dangerous forms of skin cancer because it grows fast and causes most of the skin cancer deaths. Hence, early detection is a very important task to treat ...melanoma. In this article, we propose a skin lesion segmentation method for dermoscopic images based on the U-Net architecture with VGG-16 encoder and the semantic segmentation. Base on the segmented skin lesion, diagnostic imaging systems can evaluate skin lesion features to classify them. The proposed method requires fewer resources for training, and it is suitable for computing systems without powerful GPUs, but the training accuracy is still high enough (above 95 %). In the experiments, we train the model on the ISIC dataset – a common dermoscopic image dataset. To assess the performance of the proposed skin lesion segmentation method, we evaluate the Sorensen-Dice and the Jaccard scores and compare to other deep learning-based skin lesion segmentation methods. Experimental results showed that skin lesion segmentation quality of the proposed method are better than ones of the compared methods.
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