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Owing to the deep concave mining in Bayan Obo stope, the slope angle is steep, the terrain is high, the outcrop width of the crushing belt is large, the stability of many slopes is poor, and there are potential sliding surfaces. In this paper, through on-site investigation and sampling, the main factors affecting the landslide of the high and steep slopes of Bayan Obo are analyzed. Uniaxial compression tests were carried out to obtain the mechanical parameters of dolomite and slate. With the help of the three-dimensional digital speckle system, the whole process of slope landslide under rainfall conditions was studied through similar simulation and numerical simulation experiments. The influence of rainfall on the slope of Bayan Obo and the induced pattern of landslide were revealed. The experimental results show that rainfall is the key to inducing instability, the slippage at the edge of the slope is obvious, and there is seepage in the depths but the effect is not significant. The landslide can be roughly divided into the damage accumulation stage; the deformation development and expansion stage; and the unstable slip stage. [ABSTRACT FROM AUTHOR]

Experimental findings on rotational grazing (RG) trials have generally differed from producer observations of RG outcomes on commercial scale ranches. Factors such as small plot size, short duration trials and relatively rigid grazing management that lacks responsiveness to the dynamic and complex social-ecological systems in grazing trials could all contribute to this disparity in outcomes. These differences call for a better understanding of producer perceptions of RG benefits. To fill this knowledge gap, we surveyed 4500 producers from the Northern and Southern Great Plains of the USA. Among the 875 respondents, 40.5% reported that they used continuous grazing (CG), 52.7% implemented RG management in an extensive manner, while 6.8% adopted management intensive grazing. Compared with CG users, adopters of RG in its extensive and intensive form reported an average annual increase of grazing season by 7.6 and 39.3 days, respectively. When controlling for producer demographics, ranch management goals and other rancher characteristics, we found soil and climate heterogeneity significantly affected the perceived relative benefits of RG vs CG strategies. Therefore, instead of focusing on whether RG outperforms CG per se, future research could focus on comparison of RG benefits under different management intensity levels and identifying soil and climate conditions where RG benefits are more noticeable. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the feasibility of the combination of point-shear wave elastography (p-SWE) and estimated glomerular filtration rate (eGFR) for assessing different stages of interstitial fibrosis and tubular atrophy (IF/TA) in patients with chronic renal allograft dysfunction (CAD). From September 2020 to August 2021, 47 patients who underwent renal biopsy and p-SWE examinations were consecutively enrolled in this study. The areas under the receiver operating characteristic curves (AUCs) were calculated to evaluate overall accuracy and to identify the optimal cutoff values for different IF/TA stages. A total of 43 patients were enrolled in this study. The renal cortical stiffness and eGFR showed a significant difference between IF/TA Grade 0–1 and Grade 2–3 (p < 0.001). Additionally, renal stiffness and eGFR were independent predictors for moderate-to-severe IF/TA (Grade ≥ 2) according to multiple logistic regression analysis. The combination of p-SWE and eGFR, with an optimal cutoff value of −1.63, was superior to eGFR alone in assessing moderate-to-severe interstitial fibrosis (AUC, 0.86 vs. 0.72, p = 0.02) or tubular atrophy (AUC, 0.88 vs. 0.74, p = 0.02). There was no difference between p-SWE and eGFR in assessing moderate-to-severe IF/TA (AUC, 0.85 vs. 0.79, p = 0.61). Therefore, combining p-SWE and eGFR is worthy of clinical popularization and application. [ABSTRACT FROM AUTHOR]

Introduction: Parkinson's disease is one of the most common neurodegenerative diseases. Deep brain stimulation (DBS) can improve motor symptoms in patients with middle and late Parkinson's disease, reduce the use of levodopa, and thus reduce drug-related side effects. Postoperative delirium can significantly reduce the short-term and long-term quality of life in elderly patients, which can be alleviated by dexmedetomidine (DEX). However, whether prophylactic DEX could reduce the incidence of postoperative delirium in patients with Parkinson's disease was still unknown., Methods and Analysis: This is a single-centre, randomised, double-blinded, placebo-controlled group trial. A total of 292 patients aged 60 years and above elected for DBS will be stratified according to DBS procedure, subthalamic nucleus or globus pallidus interna, then randomly allocated to the DEX group or the placebo control group with a 1:1 ratio, respectively. In the DEX group, patients will be injected with the DEX continuously with an electronic pump at a rate of 0.1 µg/kg/hour for 48 hours at the beginning of general anaesthesia induction. In the control group, normal saline will be administered at the same rate for patients as in the DEX group. The primary endpoint is the incidence of postoperative delirium within 5 days after surgery. Postoperative delirium is assessed by the combination of the Richmond Anxiety Scale and the Confusion Assessment Method (CAM) for the intensive care unit or the 3-minute diagnostic interview for CAM as applicable. The secondary endpoints include the incidence of adverse events and non-delirium complications, the length of stay in the intensive care unit and hospital and all-cause 30-day mortality after the operation., Ethics and Dissemination: The protocol has been approved by the Ethics Committee of Beijing Tiantan Hospital of Capital Medical University (KY2022-003-03). The results of this study will be disseminated through presentation at scientific conferences and publication in scientific journals., Trial Registration Number: NCT05197439., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Serum fibroblast growth factor 23 (FGF23) is associated with acute kidney injury (AKI) and mortality in patients with critical illnesses. However, the accurate predictive performance of FGF23 on AKI remains inconclusive., Methods: Meta-analysis was performed using data sources including PubMed, Web of Science, EMBASE, and Cochrane (until June 1, 2021). Cohort or observational studies including patients with AKI and serum FGF23 level as the index test were included. The primary outcome was the AKI detective accuracy. This study has been registered in PROSPERO (CRD42021249930)., Results: Eleven studies with 1946 patients in seven countries were included. Across all settings, the sensitivity and specificity for serum FGF23 levels to predict AKI were 82% (95% CI, 66-91%) and 77% (95% CI, 67-85%), respectively. The diagnostic odds ratio of FGF23 was 15.51 (95% CI, 4.89-49.19), with the pooled positive likelihood ratio of 3.62 (95% CI, 2.25-5.83) and a negative likelihood ratio of 0.23 (95% CI, 0.11-0.50). The area under the receiver operating characteristic curve to detect AKI was 0.86 (95% CI, 0.82-0.88). C-terminal FGF23 had a better performance than intact FGF23., Conclusions: Plasma FGF23 is a valuable biomarker for incident AKI in critically ill patients. Comparisons of FGF23 with other biomarkers in AKI still need more studies to prove., Competing Interests: None., (AJTR Copyright © 2021.)