Evaluation and Optimization of Cultural Perception of Coastal Greenway Landscape Based on Structural Equation Model.

The island-type greenway should emphasize the role of maintaining and promoting the island cultural landscape as it serves the function of a general greenway green infrastructure while also having a unique landscape appearance. The northern greenway of Pingtan is used as an example in the paper to illustrate how regional culture is perceived. The first part of the analysis looks at how demographic factors affect the quality of cultural perception. The study reveals that: from a gender perspective, women are more likely than men to perceive regional culture; from an age perspective, people between the ages of 18 and 40 are more likely to perceive regional culture; older people and children are less likely to perceive regional culture; and from a level of education perspective, the higher the education, the stronger the perception. The relationship between tourists' perceived quality, cognitive image, perceived value, satisfaction, and loyalty to the cultural expression of the greenway landscape is then analyzed by building a structural equation model. According to the findings, visitors' perceptions of the island's cultural quality have a positive impact on their cognitive images and perceptions of value, while their satisfaction with the cultural expressions along the coastal greenway has a positive impact on their loyalty.

The island-type pedicled TRAM flap: Improvement of the aesthetic outcomes of breast reconstruction.

BACKGROUND: The pedicled transverse rectus abdominis myocutaneous flap (TRAM) remains an effective and widely-used method for breast reconstruction despite well-documented donor-site morbidity. We present the island-type pedicled TRAM flap as a way to obtain better and more reliable outcomes in breast reconstruction. METHODS: A retrospective chart review of patients who underwent breast reconstruction with an island-type pedicled TRAM flap was performed. Patient demographics and complications were reviewed. In the island-type pedicled TRAM flap, we transversely resected the upper ipsilateral rectus muscle surrounding the origin of the superior epigastric vessels, preserving only a 1-cm muscle strip including the vascular pedicle to prevent epigastric bulging and inframammary fold (IMF) disruption. The flap was turned over into the ipsilateral breast pocket. The IMF was repaired except for the portion where the pedicle was placed. RESULTS: From January 2013 to November 2017, 88 patients underwent surgery using the island-type pedicled TRAM flap. The etiology of the defect was breast cancer with mastectomy in 86 cases, and paraffinoma in two cases. Seventy-seven patients underwent unilateral reconstruction, and 11 patients underwent bilateral reconstruction. Minor fat necrosis occurred in eight cases. Mild inframammary or epigastric bulging was observed in five cases, and neither partial nor total flap necrosis was observed. The aesthetic outcome of the IMF was evaluated in 55 cases, and 53 cases received good overall scores. CONCLUSION: Although the island-type pedicled TRAM flap is technically challenging because careful dissection and pedicle identification is required, it can provide more reliable and better aesthetic results without an increased risk of vascular compromise.

[Antibiotic resistance and virulence factors in clinical Salmonella enterica isolates]. / Resistencia a antibióticos y factores de virulencia en aislados clínicos de Salmonella enterica.

INTRODUCTION: The increase of Salmonella enterica isolates multi-resistant to different antibiotics, including ß-lactams and fluoroquinolones, is a problem of clinical importance. The dissemination of Salmonella Typhimurium resistant to ampicillin (AMP)-chloramphenicol (CHL)-streptomycin (STR)-sulphonamides and (SUL)-tetracycline (TET), that harbour the Salmonella Genomic Island type 1 (SGI1), and the acquisition of transferable genetic material have favoured the multi-resistance in this genus. METHODS: A total of 114 clinical S.enterica isolates were studied (period 2009-2010). The susceptibility to 20 antibiotics was determined by disc diffusion and microdilution. The antimicrobial resistance mechanisms and the integrons were analysed by PCR, and sequencing in the AMP(R) isolates. In all the blaPSE-1-positive isolates, the clonal relationship was determined by PFGE, as well as the presence of SGI1 and 29 virulence genes by PCR. RESULTS: Eighteen different serotypes were found among the 114 isolates studied, Typhimurium (61%) and Enteritidis (16%) being the most prevalent. High percentages of resistance to SUL (68%), TET (58%), AMP (55%) and STR (46%) were observed. The great majority (92%) of 63 AMP(R) isolates were multi-resistant, with the AMP-STR-TET-SUL phenotype (19 isolates) being the most frequent one and associated with the blaTEM-1b+strA-strB+tet(B)+sul2 genotype. Class 1 integrons (7 different structures) were observed in 48% AMP(R) isolates, highlighting the blaOXA-1+aadA1 structure (8 isolates), one empty integron and non-classical integrons (5 isolates). The blaPSE-1 gene was detected inside the classical SGI1 structure in 13 clonally-related isolates that showed the same virulence profile. CONCLUSIONS: The high percentage of multi-resistant S.enterica isolates, especially associated to S.Typhimurium, to the AMP, STR, TET and SUL phenotype, and to the blaTEM-1b+strA-strB+tet(B)+sul2 genotype, shows an important risk of possible failures in the treatment of serious infections caused by this serotype.

Thermodynamic modeling of ternary liquid-liquid systems with forming immiscibility islands

The aim of this work was to study the application of a stochastic algorithm to correlate the experimental data of island-type systems in ternary systems. Thermodynamic NRTL and UNIQUAC models were used to evaluate the activity coefficients. Results regarding the application of the stochastic algorithm were in good agreement with those presented in the current literature. However, generalization of the method proposed in the present work remained an intriguing and complex task so as to reach broad conclusions.