This study investigates the impact of segmental accuracy and nucleus placement on the comprehensibility of English as an International Language (EIL), with the aim of informing phonological norms and teaching models. Speech samples from 59 EIL speakers with varying levels of segmental accuracy were collected during a reading task, involving reading a passage in three different versions of speech, each version lasting approximately 30 to 40 s. To directly compare the impact of nuclear stress placement on comprehensibility, based on these samples, two versions of stimuli were created, each differing only in their placement of nuclear stress - either correct or incorrect. The correctness of placements was determined by seven native speakers of English. Eight native English speakers, aged 19-24, and eight EIL speakers, aged 20-24 with an upper-intermediate to advanced proficiency level, rated the comprehensibility of the two versions of speech. Results suggest that while correct nucleus placement enhances comprehensibility for native English listeners, it has little influence on EIL listeners. Segmental accuracy in EIL speech impacts comprehensibility substantially more than nucleus placement on both native and EIL listeners, indicating that English language teaching should focus on minimizing segmental errors to improve comprehensibility for EIL speakers, despite the benefits of correct nucleus placement.

We examined the remains of an individual who was unearthed from the Tuchengzi site and was believed to be from the Warring States period in China. The remains exhibited segmental femoral fracture. We aimed to deduce the cause of fracture, medical interventions, healing process, and motion behavior after fracture healing using several techniques, including macroscopic observation, computed tomography (CT), and finite element analysis. Based on the morphology of the long bones, it appeared that the individual was male. The fractures resulted in an adduction angle of 5.47° and an anterior flexion angle of 21.34° in the proximal femur, while the femoral neck anteversion angle had been replaced by a retroversion angle of 10.74°. Additionally, the distal femur formed an abnormal anterior convex angle of 144.60°. CT revealed mature callus formation and visible trabecular bundles. The finite element analysis indicated that the maximum von Mises stress in the femur was 17.44 MPa during standing and 96.46 MPa during walking. We suggest that medical practitioners in the Warring States period possessed a good knowledge of thigh anatomy, enabling them to perform fracture reduction and fixation. Reasonable medical intervention facilitated fracture healing and load recovery. Satisfactory fracture healing ensured that the individual could engage in normal standing and walking activities after rehabilitation.

UNASSIGNED: To describe the long-term effect of scleral buckling (SB) surgery for stage 4A retinopathy of prematurity (ROP).
UNASSIGNED: A retrospective chart review was conducted for patients with a diagnosis of stage 4A ROP who underwent SB between October 2010 and October 2021. Basic data were collected from patient charts, including gender, birth weight, gestational age at birth, disease stage, presence of plus disease, preoperative treatment [laser photocoagulation, intravitreal anti-vascular endothelial growth factor (VEGF) agent therapy, or a combination of both] and complications (vitreous hemorrhages), postmenstrual age at surgery, intraoperative combined treatment, and total length of follow-up. Retinal attachment status after surgery, postoperative complications (glaucoma, cataract), date and type of subsequent retinal surgeries (if performed), and refractive status 1 year after surgery were evaluated. The follow-up time after the first procedure was over 1 year.
UNASSIGNED: Six-two eyes from forty-eight patients met the inclusion criteria for this study. The initial reattachment rate was 93.5% (58/62 eyes), and the final reattachment rate was 100% after two procedures at the end of follow-up. The incidence of cataracts was 3.2% (2/62), with no eye subsequently needing lensectomy surgery. None of the patients developed glaucoma during the follow-up time. The average spherical equivalent refraction value for patients was -3.00 ± 2.51 D (-7.60 D to +2.75 D) 1 year after surgery.
UNASSIGNED: SB, especially segmental buckling, which induces less myopia and does not require buckle removal, has the potential to provide a significant positive impact in the treatment of stage 4A ROP.

UNASSIGNED: Breast-conserving surgery (BCS) is the preferred method for early breast cancer, and the accurate preoperative prediction of the feasibility of BCS can formulate the surgical plan and reduce the violation of the patient\'s will. The present study proposed to explore the preoperative magnetic resonance imaging (MRI) features associated with failed BCS and constructed an MRI-based model to predict BCS.
UNASSIGNED: This retrospective study included patients between March 2015 and July 2016, who planned to undergo BCS, had preoperative MRI examination, and had at least 2 years of follow-up. A total of 30 patients with failed BCS were identified and matched with 90 patients with successful BCS (ratio 1:3) according to age, neoadjuvant therapy, and hormone receptor expression. The patients were divided into the training group for model construction and the testing group for model validation. The MRI features, including the site of the tumor, the lesion type, and the lesion and breast volume, were compared between failure and successful BCS groups. A multivariate logistic model for predicting failed BCS was constructed using independent factors associated with failed BCS from the training group and was evaluated in the testing group. The performance of the model was evaluated using the receiver operating characteristic (ROC) curve.
UNASSIGNED: The mean age of the cohort was 45.7±10.3 years. A significantly more non-mass lesion and multifocality, the larger volume of lesion, and the ratio of lesion and breast volume were observed in failed BCS group compared to the successful BCS group. The ratio of lesion and breast volume and multifocality were independent factors associated with failed BCS, odds ratios were 1.044 (95% CI: 1.016-1.074) and 11.161 (95% CI: 1.739-71.652), respectively. An MRI-based model for predicting failed BCS was established, the area under the ROC curves in the training and testing group were 0.902 and 0.821, respectively.
UNASSIGNED: This model might help clinicians predict failed BCS preoperatively and make an accurate surgical strategy.

Considerable controversies exist regarding whether elderly patients with early-stage breast cancer receiving breast-conserving surgery (BCS) should forgo radiotherapy. We utilized the National Cancer Database to analyze data of 115 516 women aged ≥70 years, treated with BCS for T1-2N0-1M0 breast cancer between 2004 and 2014. Multivariable Cox proportional hazards model was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for mortality 3, 5 and 10 years after 90 days of BCS associated with radiotherapy. Patients who received no radiotherapy had a higher mortality rate than those who received radiotherapy (5-year survival rate: 71.2% vs 83.8%), with multivariable-adjusted HRs of 1.65 (95% CI: 1.57-1.72) for 3-year mortality, 1.53 (1.47-1.58) for 5-year mortality and 1.43 (1.39-1.48) for 10-year mortality. The association held even for patients ≥90 years. This association was observed in all strata by reasons for radiotherapy omission, receipt of endocrine therapy or chemotherapy, calendar period and other clinical characteristics, with 40% to 65% increased 5-year mortality for patients without radiotherapy. This positive association persisted when analyses were restricted to patients with T1N0 and estrogen-receptor-positive disease who had received endocrine therapy (5-year mortality: HR 1.47 [1.39-1.57]) and in propensity score weighted analyses. Our study shows, in routine practice, elderly patients who received no post-BCS radiotherapy had higher total mortality than those who received radiotherapy. These findings suggest that the current recommendation of omission of post-BCS radiotherapy for elderly women with early-stage breast cancer may need to be reconsidered, particularly for those without contraindication.

Clinical practice of retrieval of segmental (station 13) and subsegmental (station 14) lymph nodes for pathologic examination varies during lung cancer surgery. This study aimed to evaluate whether omitting retrieval of nodes from stations 13 and 14 could affect outcome evaluation for patients with pN0 non-small-cell lung cancer (NSCLC).
This retrospective study analyzed 442 patients with NSCLC who were treated with both R0 resection and systematic mediastinal lymphadenectomy with pathologically confirmed stage pN0 NSCLC. The study group included patients in whom N1 nodes including stations 10 to 14 were investigated, and the control group included patients in whom stations 10 to 12 only were investigated. Clinical and pathologic parameters of the groups were balanced by propensity score matching, and oncologic outcomes were assessed by the log-rank test.
A total of 435 cases were included in the final analysis (170 in the study group and 265 in the control group). In the study group, a mean ± SD of 5.0 ± 3.0 nodes per case were collected from nodes 13 and 14. After propensity score matching, 143 cases were included in each group. Overall and disease-free survival improved in the study group compared to the control group (P = .027 and P = .021, respectively). T staging and intrapulmonary node collection were prognostic factors for pN0 cases.
Inferior oncologic outcomes of pN0 cases without intrapulmonary node retrieval suggest that the procedure of intrapulmonary lymph node retrieval may play a role in outcome evaluation for pN0 NSCLC patients.

The incidence of segmental testicular infarction is extremely low. The condition usually presents with acute scrotal pain and may be confused clinically and radiologically with a testicular tumor or torsion. To the best of our knowledge, only a few cases have been reported in the English literature. In this study, we present a case of segmental testis infarction in a 23-year-old male with an acute onset of testicular pain. The diagnosis of testicular infarction was considered following sonography examination. Hemorrhagic infarction of the testis was confirmed by surgical exploration and pathological examination. Partial orchiectomy was performed. Although it is uncommon, segmental testicular infarction should be taken into consideration when acute scrotal pain is encountered, since the therapeutic strategy could be conservative.

Using a multiple-deviant oddball paradigm, this study examined second graders\' brain responses to Cantonese speech. We aimed to address the question of whether a change in a consonant or lexical tone could be automatically detected by children. We measured auditory mismatch responses to place of articulation and voice onset time (VOT), reflecting segmental perception, as well as Cantonese lexical tones including level tone and contour tone, reflecting suprasegmental perception. The data showed that robust mismatch negativities (MMNs) were elicited by all deviants in the time window of 300-500 ms in second graders. Moreover, relative to the standard stimuli, the VOT deviant elicited a robust positive mismatch response, and the level tone deviant elicited a significant MMN in the time window of 150-300 ms. The findings suggest that Hong Kong second graders were sensitive to neural discriminations of speech sounds both at the segmental and suprasegmental levels.