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Objective. Quality of life (QoL) is a major concern in breast cancer (BC) patients. Despite efforts, no study has comprehensively addressed determinants of QoL in patients with BC. This study aimed to synthesize evidence on QoL correlations using the meta-analytic structural equation modeling (MASEM) approach. Methods. Our search in PubMed, Web of Science, Scopus, and Cochrane databases resulted in 5,238 initial relevant papers, 73 of which were eligible for final analysis with a total of 44,121 patients. We used a two-stage procedure of correlation-based MASEM to examine the relationship between QoL and body mass index (BMI), physical activity (PA), sleep, depression, fatigue, and stress. Results. Final MASEM model suggested that PA (path coefficient = 0.33, 95% CI = −0.0444; 0.6334), fatigue (path coefficient = −0.23, 95% CI = −0.6825; 0.0361), and stress (path coefficient = −0.22, 95% CI = −0.5143; 0.6875) were the most important factors related to QoL in patients with breast cancer. Final model identified variables responsible for 68% of the variation in QoL in BC. Conclusion. QoL is an important outcome in the treatment course of BC. Large-scale and meta-analysis studies could help patients to have a life with improved quality. [ABSTRACT FROM AUTHOR]

Anemia is a global public health problem, especially common among children in developing countries, which affects their physical and mental health development. However, there is currently a lack of research on the relationship between anemia and academic performance. The objective of this study was to explore the association between anemia and academic performance, and the possible factors mediating this association among Chinese children. The data for this study came from the baseline survey of the Chinese Education Panel Survey Elementary School Cohort. The cohort was conducted from September 2018 to June 2019 in 160 elementary schools, covering 20 provinces and 40 counties/districts throughout China. Paper-based questionnaires were used, completed by 4th grade students, parents, head teachers, main teachers, and principals. The data used included questionnaire responses, physical measurements, and academic performance of 17,695 students. Based on students' hemoglobin levels and school altitude data, we grouped them into anemia and nonanemia categories using WHO criteria. The anemia group had 1,154 individuals, while the nonanemia group had 16,541 individuals. An ordinary least squares regression and mediation effect analysis were conducted. Our findings found the prevalence of anemia was 6.52% among Chinese Grade 4 students. Students without anemia had a higher average test score for three academic subjects than students with anemia (P < 0.001); their test scores for Chinese, Mathematics, and English were also higher (P < 0.05). Multivariate regression analysis showed a negative association between anemia and average test scores as well as individual test scores for the three subjects. Mediation analysis found that anemia affected academic performance directly (P < 0.05), and indirectly by decreasing the cognition score (P < 0.05). The indirect effect was 19.9% of the total effect. Findings highlighted anemia affected academic performance both directly and indirectly. Nutrition-related interventions should be implemented to prevent a decrease in academic performance among students with anemia. [ABSTRACT FROM AUTHOR]

Social participation is positively related to mental health recovery and wellbeing, yet people with mental health problems are often socially isolated. This article investigates how social participation was incorporated into an Australian-integrated program that aimed to improve the wellbeing of people with chronic mental health needs. The data are from a longitudinal evaluation of the integrated program, including data linkage (5533 participants) and interviews (111). The paper uses concepts from the network perspective of social capital (bonding, bridging, linking, horizontal, and vertical) as lenses to re-examine the evaluation's findings about the consumers' social participation in life areas (social, leisure, and productive) facilitated by the program. This social capital perspective offers a lens to examine the breadth and intensity of participation experienced by the consumers taking part in the support program. The article adds to the literature about how service providers can improve social participation and therefore consumers' opportunities for recovery and wellbeing. The analyses found that the support increased people's social interaction and their capacity in the community. Their social interaction was mostly with other people in the service. Often their interactions in the community were only transactional. Few consumers participated in activities in productive life areas, and few of the activities promoted vertical social capital in social networks outside the service. The implications are that service providers need greater attention on facilitating a variety of social participation activities that can extend mental health consumers' horizontal and vertical social capital and so further contribute to their current and future recovery and wellbeing. [ABSTRACT FROM AUTHOR]

This paper proposed a control method of vehicle lateral stability control system. In order to obtain the best driving performance under the complicated friction conditions track, the direct yaw moment (DYC) and the engine torque regulation (ETC) value need to be adjusted to avoid penalisation of each other. Firstly, the intervention timing of direct yaw moment control and engine torque regulation control is studied, which is judged by the phase plane method and longitudinal speed threshold method, respectively. Then, a direct yaw moment control algorithm based on sliding mode control algorithm is designed, and its target value calculation depends on the linear two-degree-of-freedom model. The engine torque regulation is calculated by fuzzy algorithm. The input values are mainly the vehicle state parameters and the driver's input to the steering wheel. Matlab/Simulink, AMESim, and CarSim software programs are used to simulate sine with dwell maneuver. The simulation results show the effectiveness of the cooperation control algorithm proposed in this paper. [ABSTRACT FROM AUTHOR]

Background. Observational studies from China suggest that Kangbingdu oral liquid (KBD) may be effective in treating the common cold. Objective. Reevaluation of efficacy and safety of Kangbingdu oral liquid after marketing and expanding population. Design. Prospective, Pragmatic randomized controlled trial (Chictr.org.cn registration number: chiCTR-TRC-12002399). Setting. Eleven hospitals from 3 provinces in China. Patients were recruited through 11 centers, including 7 teaching hospitals, 2 University health services, one military clinic, and one community hospital. Patients. 2647 persons aged 18 to 75 years with Common cold. Intervention. Patients were randomly allocated to 2 groups: the treatment group Kangbingdu oral liquid (composed of 9 Chinese herbal medicines and honey) and the placebo group were divided into a standard-dose group of 10 ml every time, a middle dose group of 20 ml every time, high dose group of 30 ml every time, 3 times daily. Interventions and control were given for 5 days. Measurements. The primary outcome is the mean amount of total scores measured by the 11-primary symptoms: to observe the change of main symptoms from severe to disappear and to calculate and compare the mean amount of total scores after the periods of observation. Secondary outcomes are the disappearance rate of each symptom and the median time of body temperature returned to normal. Results. On day 5, the Kangbingdu liquid group had significant reductions in the mean amount of total scores measured by the 11-primary symptoms (7.39 [95% CI 7.26 to 7.51] compared to the placebo group (6.43 [95%: CI 6.24 to 6.62]). The Kangbingdu liquid can improve the remission rate of accompanying symptoms on day 5 including aversion to wind, aversion to cold, fever, cough, stuffy, runny nose, sore throat, muscular aches, headache, fatigue, and sweat (P < 0.0001). Significant reductions in time of body temperature to return to normal in the Kangbingdu liquid group (P50, 48.33 [95% CI 46.00 to 52.50] compared with the control group (P50, 64.59 [95% CI 51.08 to 70.50] (P = 0.0022). 13 (0.7%) participants in the Kangbingdu liquid group and 1(0.2%) participants in the placebo group (P > 0.05) had treatment-related AEs, which mainly include diarrhea and dyspepsia in the Kangbingdu liquid group and constipation in the placebo group. Conclusion. The study's conclusion in this paper was based on the placebo, Kangbingdu oral liquid two groups which clinically diagnosed the common cold and flu. (1) Kangbingdu oral liquid can effectively improve the comprehensive clinical symptoms of common adult cold, also improved main symptoms, including sore throat, muscle aches, headache, and so on. (2) Kangbingdu oral liquid effectively shortens the time of body temperature to return to normal. [ABSTRACT FROM AUTHOR]

Background. As the average life expectancy continues to increase, interest in cognitive impairment is increasing. Nowadays, as social media expands its reach, academic research is spreading through social media, changing the way and speed by which research is propagated and also who consumes this content. Therefore, using Altmetric, a new web-based set of metrics that analyzes the impact of content on social media platforms, we investigated the characteristics of influential research articles on the topic of cognitive impairment in social media. Methods. An Altmetric Explorer search was performed on May 25, 2018, to extract the following information: (i) journal name, (ii) journal impact factor (IF), (iii) year of publication, (iv) article topic, (v) article type, and (vi) cognitive impairment subtype. Results. The journal "Neurology" was the most cited journal for cognitive impairment articles shared on social media. Among the various types of cognitive impairment, most articles were related to dementia (all subtypes), Alzheimer's disease, and aging. The most common article type was original scientific paper, especially cohort study. The most popular topic was the identification of protective or risk factors for cognitive impairment. Conclusion. The characteristics of articles with a high Altmetric Attention Score were somewhat different from those of articles with a high number of traditional citations. Social media had the disadvantage that it was difficult to verify the authenticity of the primary source in question, but the advantage was that it could immediately determine the trends regarding how information about that source was being shared and consumed. Therefore, it may be advisable to use Altmetric analysis in combination with traditional methods of evaluating the research articles to understand the dissemination of scientific research and to direct future research. [ABSTRACT FROM AUTHOR]

Background. Renal replacement therapy (RRT), as a cornerstone of supportive treatment, has long been performed in critically ill patients with acute kidney injury (AKI). However, the majority of studies may have neglected the effect of the duration of RRT on the outcome of AKI patients. This paper is aiming to explore the effect of the long duration of RRT on the outcome of critically ill patients with AKI. Methods. This retrospective study was conducted by using the Multiparameter Intelligent Monitoring in Intensive Care II (MIMIC-II) database. The primary outcome measure of this study was the mortality at 28 days, 60 days, and 90 days in the long-duration RRT group and the non-long-duration RRT group. The secondary outcomes assessed the difference in clinical outcome in these two groups. Lastly, the effect of the duration of RRT on mortality in AKI patients was determined as the third outcome. Results. We selected 1,020 patients in total who received RRT according to the MIMIC-II database. According to the inclusion and exclusion criteria, we finally selected 506 patients with AKI: 286 AKI patients in the non-long-duration RRT group and 220 in the long-duration RRT group. After 28 days, there was a significant difference in all-cause mortality between the long-duration RRT group and the non-long-duration RRT group (P = 0.001). However, the difference disappeared after 60 days and 90 days (P = 0.803 and P = 0.925 , respectively). The length of ICU stay, length of hospital stay, and duration of mechanical ventilation were significantly longer in the long-duration RRT group than those in the non-long-duration RRT group. Considering 28-day mortality, the longer duration of RRT was shown to be a protective factor (HR = 0.995, 95% CI 0.993–0.997, P < 0.0001), while 60-day and 90-day mortality were not correlated with improved protection. Conclusions. The long duration of RRT can improve the short-term prognosis of AKI patients, but it does not affect the long-term prognosis of these patients. Prognosis is determined by the severity of the illness itself. This suggests that RRT can protect AKI patients through the most critical time; however, the final outcome cannot be altered. [ABSTRACT FROM AUTHOR]

Purpose. According to the European Association of Urology bladder cancer is the seventh most commonly diagnosed malignancy in the world’s male population. Despite its high incidence, papers evaluating psychological state in those patients’ group are lacking. The purpose of the study was to evaluate pain management, disease acceptance, and adjustment to cancer in homogenous group of patients diagnosed with nonmuscle-invasive bladder cancer (NMIBC). Methods. Group of 252 male patients who were scheduled for NMIBC treatment were prospectively evaluated. Patients fulfilled Acceptance of Illness Scale (AIS), Mini-Mental Adjustment to Cancer (Mini-MAC) and Coping Strategies (CSQ) questionnaires before treatment introduction. Results. Highest CSQ score was achieved by the coping self-statements subscale (mean=18,37). The catastrophizing subscale score was the lowest (mean=11,24). Place of residence affected results of CSQ statement about pain control. Catastrophizing and coping self-statements strategies were associated with matrimonial status. In the Mini-MAC questionnaire the fighting spirit way of coping had the highest (21,73) and the helplessness-hopelessness subscale had the lowest mean value (13,3). Matrimonial status was strongly associated with anxious preoccupation, fighting spirit, and helplessness – hopelessness way of coping. The mean AIS test score was 28.8. AIS result was influenced by patient’s marital status, yet not by education, place of residence, nor any clinical factor. Conclusions. In the examined group, the level of acceptance of the disease reached values that were slightly higher than the average. It indicated a fairly good adaptation to cancer. Among the methods of coping with cancer, the constructive style is definitely dominant with a high intensity of the fighting spirit strategy. The destructive style of cancer coping reached low values with a low intensity of helplessness/hopelessness strategy. From pain coping strategies, self-statements and praying/hoping were the most commonly chosen ways, whereas catastrophizing was the rarest. Many associations between various questioners’ results were also observed. [ABSTRACT FROM AUTHOR]

Technological innovations can be assumed to have made the driving task more complex. It is, however, not yet clear to what extent this complexity leads to changes in longitudinal driving behavior. Furthermore, it remains to be seen how these adaptation effects can best be modeled mathematically. In order to determine the effect of complexity on empirical longitudinal driving behavior we performed a driving simulator experiment with a repeated measures design. Through this experiment we established that complexity of the driving task leads to substantial changes in speed and spacing. In order to provide insight into how complexity is actually related to changes in longitudinal driving behavior we introduce a new theoretical framework based on the Task-Capability-Interface model. Finally in this paper we take some first steps towards modeling of adaptation effects in longitudinal driving behavior in relation to complexity of the driving task through the introduction of a new neurofuzzy car-following model and based on the proposed theoretical framework. In this paper we show that this model yields a relatively good prediction of longitudinal driving behavior in case of driving conditions with differing complexity. The paper finishes with a discussion section and recommendations for future research. [ABSTRACT FROM AUTHOR]

In this paper, the longitudinal seismic response characteristics of utility tunnel subjected to strong earthquake was investigated based on a practical utility tunnel project and numerical method. Firstly, the generalized response displacement method (GRDM) that was used to conduct this study was reviewed briefly. Secondly, the information of the referenced engineering and the finite element model was introduced in detail, where a novel method to model the joints between utility tunnel segments was presented. Thirdly, a series of seismic response of the utility tunnel were provided, including inner force and intersegment opening width. The results showed that (i) the seismic response of the utility tunnel under far-field earthquake may be remarkable and even higher than that under near-field earthquake; (ii) sharp variation of response may occur at the interface between "soft" soil and "hard" soil, and the variation under far-field earthquake could be much more significant. This research provides a reference for the scientific study and design of relevant engineering. [ABSTRACT FROM AUTHOR]

Objective. The incidence of superficial organ diseases has increased rapidly in recent years. New methods such as computer-aided diagnosis (CAD) are widely used to improve diagnostic efficiency. Convolutional neural networks (CNNs) are one of the most popular methods, and further improvements of CNNs should be considered. This paper aims to develop a multiorgan CAD system based on CNNs for classifying both thyroid and breast nodules and investigate the impact of this system on the diagnostic efficiency of different preprocessing approaches. Methods. The training and validation sets comprised randomly selected thyroid and breast nodule images. The data were subgrouped into 4 models according to the different preprocessing methods (depending on segmentation and the classification method). A prospective data set was selected to verify the clinical value of the CNN model by comparison with ultrasound guidelines. Diagnostic efficiency was assessed based on receiver operating characteristic (ROC) curves. Results. Among the 4 models, the CNN model using segmented images for classification achieved the best result. For the validation set, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and area under the curve (AUC) of our CNN model were 84.9%, 69.0%, 62.5%, 88.2%, 75.0%, and 0.769, respectively. There was no statistically significant difference between the CNN model and the ultrasound guidelines. The combination of the two methods achieved superior diagnostic efficiency compared with their use individually. Conclusions. The study demonstrates the probability, feasibility, and clinical value of CAD in the ultrasound diagnosis of multiple organs. The use of segmented images and classification by the nature of the disease are the main factors responsible for the improvement of the CNN model. Moreover, the combination of the CNN model and ultrasound guidelines results in better diagnostic performance, which will contribute to the improved diagnostic efficiency of CAD systems. [ABSTRACT FROM AUTHOR]

Purpose. We evaluated the optic disc microvasculature in healthy subjects and patients with optic nerve head drusen (ONHD), active papilledema, and acute nonarteritic anterior ischemic optic neuropathy (NAION) using optical coherence tomography angiography (OCTA). Methods. This prospective, comparative case series included sixteen eyes with ONHD, thirty‐one eyes with active papilledema, sixteen eyes with acute NAION, and thirty‐two healthy eyes. The Optovue AngioVue OCT and OCTA Imaging System recorded peripapillary retinal nerve fiber layer (RNFL) thickness and vessel density maps from the radial peripapillary capillary (RPC) slab. Results. Average RNFL thicknesses were greater in eyes with ONHD, papilledema, and NAION compared to control eyes (all Ps < 0.001), but this parameter did not differ among patient groups. The mean peripapillary vessel density did not differ between the ONHD and control groups (P = 1.000), nor between the NAION and papilledema groups (P = 0.216). However, this value in the ONHD and control groups was significantly higher than in the NAION and papilledema groups (all Ps < 0.05). Conclusion. RPC density is influenced during the progression of conditions such as ONHD, papilledema, and NAION. Although a decrease in vessel density values has been observed in cases of true disc edema, further research is necessary to assess the potential of OCTA in differentiating between true and pseudo‐optic disc edema. [ABSTRACT FROM AUTHOR]

Introduction. Disease recurrence in patients with the early hormone receptor‐positive (HR+), human epidermal growth factor receptor 2‐negative (HER2−) breast tumor subtype is particularly challenging to manage due to its complex and very heterogeneous biological nature. Namely, due to primary and secondary resistance, one‐quarter of patients with early‐stage disease will experience disease recurrence. This variability in the timing of recurrence highlights the need to better identify key biomarkers that could predict therapeutic outcomes and guide personalized treatment strategies for these patients. Mutations in the phosphatidylinositol 4,5‐bisphosphate 3‐kinase catalytic subunit alpha (PIK3CA) gene are highly prevalent (30–40%) in HR+/HER2− advanced breast cancer. They lead to activation of the PI3K/AKT/mTOR pathway, promoting cell growth, and proliferation, and are associated with poor prognosis in advanced breast cancer. Our aim was to examine the association between and impact of PIK3CA mutation status on disease‐free survival (DFS) in HR+/HER2− early breast cancer patients. Methods. This cohort study was multicentric and retrospective in nature and was conducted at five Croatian institutions from July 2020 to December 2021. The study included initially early and locally advanced operable HR+/HER2− breast cancer patients who were diagnosed with disease recurrence during adjuvant hormonal treatment or within the first six years of follow‐up. Results. A total of 186 patients were included, 40.9% of whom tested positive for the PIK3CA mutation. Primary and adjuvant treatment, particularly adjuvant endocrine treatment, were similar between the two groups. After adjustment for 14 relevant covariates, we found that patients with a positive PIK3CA status and the H1047 PIK3CA mutation had a significantly lower hazard of disease recurrence than patients with no PIK3CA mutation (HR 0.65; 95% CI 0.45; 0.95; p = 0.024; false discovery rate, FDR <10%). Conclusions. This study highlights the potential impact of PIK3CA mutations on disease recurrence during or following adjuvant endocrine therapy and potentially opens the door for further investigation of possibly more personalized treatment strategies. [ABSTRACT FROM AUTHOR]

Study Objective: The present study is aimed at providing an assessment of the changes in burnout, job strain, isostrain, sleepiness, and fatigue levels over time and identifying factors associated with these symptoms among healthcare workers in French emergency departments (EDs). Method: We conducted a prospective, multicenter study in four EDs and an emergency medical service. Participants completed questionnaires at inclusion and at 90 days to assess burnout, job strain, isostrain, sleepiness, and fatigue. Results: A total of 211 respondents (43.5%) completed the questionnaires at inclusion. At the beginning of the study, 84 (40.8%) participants presented symptoms of burnout, 86 (43.2%) had symptoms of job strain, and 58 (29.4%) of isostrain. Forty‐two (20.1%) healthcare workers presented symptoms of sleepiness, and 8 (3.8%) had symptoms of fatigue. We found that symptoms of burnout were more frequent for healthcare workers with a previous psychiatric history (55.3% vs. 39.1%, p = 0.02) and were lower among participants who had at least one dependent child (33.1% vs. 48.3%, p = 0.013). Symptoms of job strain were higher among administrative staff compared to physicians (55.6% vs. 28.7%, p = 0.01) and among healthcare workers with managerial responsibilities compared to those without (45.6% vs. 28.8%, p = 0.015). Symptoms of isostrain were higher among administrative staff (42.3%) compared to paramedics (34.1%) and physicians (19.8%, p = 0.026). Conclusion: We identified that potential factors associated with the emergence of symptoms of burnout and job strain are suggested, underlining several areas of improvement for the prevention against mental health disorders in the specific population of ED healthcare workers. Trial Registration: ClinicalTrials.gov identifier: NCT04383886. [ABSTRACT FROM AUTHOR]

Background. Long-term application of antiresorptive and/or antiangiogenic agents may cause oral disorders, including medication-related osteonecrosis of the jaw (MRONJ), which remains an incurable disease. Surgical treatment can help alleviate infection of the jaw and block the progress of the disease, but postoperative recurrence is often caused by incomplete resection of necrotic bone during surgery. The traditional method for determining the boundary of necrotic bone resection is primarily based on the color, geology, and microcirculation-based bleeding state according to the bone tissue, which is easily affected by the surgeon's clinical experience and can cause insufficient resection of osteonecrosis bone. Recent studies have proposed using fluorescence technology-assisted necrotic bone resection. Objective. Systematic literature review was conducted to evaluate the therapeutic effectiveness of fluorescence-guided MRONJ surgery. Design. PubMed/MedLine, Scopus, and Web of Science databases were searched from inception to February 7, 2022. Randomized controlled trial (RCT) studies were evaluated according to the Cochrane risk of bias tool ROB 2, and non-RCT (N-RCT) studies were evaluated according to the ROBINS-I tool. Results. A total of 6 articles were included in the systematic review, including 4 N-RCT studies (1 retrospective study and 3 prospective studies) and 2 RCT studies, with 240 patients and 280 MRONJ lesions. The vast majority of studies were with moderate risk of bias, and the quality of the evidence was moderate. Conclusion. Evidence of moderate strength suggests that fluorescence-assisted techniques effectively determine the bone resection boundaries in MRONJ surgery. However, whether the prognosis of patients treated with fluorescence-guided surgery is significantly better than that of traditional surgery must be proved by randomized controlled studies with larger sample sizes and higher quality. [ABSTRACT FROM AUTHOR]

In any longitudinal study, a dropout before the final timepoint can rarely be avoided. The chosen dropout model is commonly one of these types: Missing Completely at Random (MCAR), Missing at Random (MAR), Missing Not at Random (MNAR), and Shared Parameter (SP). In this paper we estimate the parameters of the longitudinal model for simulated data and real data using the Linear Mixed Effect (LME) method. We investigate the consequences of misspecifying the missingness mechanism by deriving the so-called least false values. These are the values the parameter estimates converge to, when the assumptions may be wrong. The knowledge of the least false values allows us to conduct a sensitivity analysis, which is illustrated. This method provides an alternative to a local misspecification sensitivity procedure, which has been developed for likelihood-based analysis. We compare the results obtained by the method proposed with the results found by using the local misspecification method. We apply the local misspecification and least false methods to estimate the bias and sensitivity of parameter estimates for a clinical trial example. [ABSTRACT FROM AUTHOR]

Objectives. This papers aims to investigate the association between different levels of postpartum weight retention (PPWR) and cardiometabolic risk among the Saudi women 12 months postpartum. Methods. This study is a follow-up of subgroup of cohort from Riyadh mother and baby multicenter cohort study. Clinical data were collected from participants 12 months after delivery and included current Body Mass Index (BMI), waist circumference, hip circumference, and blood pressure. In addition the following blood tests done were fasting blood glucose (FBG), glycosylated haemoglobin (HbA1c) levels, and lipids profile to assess the participants' cardiometabolic risks. The participants were categorized into three groups based on the level of PPWR: weight retention < 3kg; weight retention 3 to < 7kg; and weight retention ≥ 7kg. Subsequently, the prevalence of cardiometabolic risk factors was compared in the three groups to assess the association between different levels of PPWR and cardiometabolic risk factors. Logistic regression was used to test the effect of PPWR in the development of metabolic syndrome and Adjusted Odds Ratio (AOR) was calculated. Results. A total of 115 women participated in this study. Around 35% of the study population retained ≥ 7 kg of weight. The prevalence of cardiometabolic risk factors, including metabolic syndrome (MetS), increases with the increase of PPWR (p<0.01). The prevalence of MetS is 13% with highest frequency in the group with the highest weight retention. The determinants developing MetS were prepregnancy weight; AOR (95% CI); 1.08 (1.02-1.14), P< 0.01, current BMI, AOR (95% CI); 1.30 (1.12-1.51), P< 0.01, and FBG during pregnancy, AOR (95% CI); and 4.82 (1.72-13.48), P < 0.01. Conclusion. Increased weight retention after delivery augments the rate of occurrence of cardiometabolic risk factors. Determinants of the development of MetS in postpartum Saudi women are increased prepregnancy weight, current BMI, and FBG during pregnancy. [ABSTRACT FROM AUTHOR]

Introduction. Malnutrition and obesity are a double burden on children in developing countries and could induce higher risks of noncommunicable diseases in the long term. In the big cities of Vietnam, both issues are present and share the issue of nutrition problems; the prevalence of malnutrition in children is gradually decreasing while the prevalence of obesity is increasing rapidly. The paper aims to identify the prevalence of stunting and overweight/obesity in apparently healthy young children in Ho Chi Minh City (HCMC). Methods. A prospective cross-sectional study recruited 12-24-month-old children receiving national vaccination in community health centers in HCMC from February 2016 to July 2017. Sixteen healthcare centers were randomly selected among 8 districts of HCMC. Stunting and overweight were defined by height-for-age z-score <-2 SD and BMI z-score ≥+2 SD. Results. A total of 768 children had mean age of 16.8±4.2 months old, 51.7% boys. The prevalence of stunting and overweight/obesity was 8.2% and 10.7%, respectively. Stunting was associated with older age, boys, and low birth weight of children and occupation of mothers (P <0.05). No associated risk factor was observed for overweight/ obesity status. Conclusion. The prevalence of overweight/obesity was higher than the prevalence of stunting in 12-24-month-old children in HCMC. Overweight/obesity would be a public health problem for children in big cities. [ABSTRACT FROM AUTHOR]

Postmarketing drug surveillance is a crucial aspect of the clinical research activities in pharmacovigilance and pharmacoepidemiology. Successful utilization of available Electronic Health Record (EHR) data can complement and strengthen postmarketing safety studies. In terms of the secondary use of EHRs, access and analysis of patient data across different domains are a critical factor; we address this data interoperability problem between EHR systems and clinical research systems in this paper. We demonstrate that this problem can be solved in an upper level with the use of common data elements in a standardized fashion so that clinical researchers can work with different EHR systems independently of the underlying information model. Postmarketing Safety Study Tool lets the clinical researchers extract data from different EHR systems by designing data collection set schemas through common data elements. The tool interacts with a semantic metadata registry through IHE data element exchange profile. Postmarketing Safety Study Tool and its supporting components have been implemented and deployed on the central data warehouse of the Lombardy region, Italy, which contains anonymized records of about 16 million patients with over 10-year longitudinal data on average. Clinical researchers in Roche validate the tool with real life use cases. [ABSTRACT FROM AUTHOR]

A lunar lander is exposed to extreme lunar thermal environments with a nighttime of 14.75 earth days. Thus, a proper thermal design is an important task to guarantee a successful lunar mission. This paper describes a preliminary thermal design and analysis results of a lunar lander to ensure its survivability during lunar night. The effectiveness of the thermal designs of a lunar lander with various thermal hardwares was numerically investigated according to the landing candidate areas to determine which design is the most feasible for night survival. In addition, we analyzed the mechanical safety of the solder joint of electronic components in accordance with the operating temperature range, because it is an important factor for reducing the system power budget during night survival. [ABSTRACT FROM AUTHOR]

This paper aims at investigating gravity load collapse behavior of extremely poor quality reinforced concrete columns under cyclic loading. Such columns were usually constructed by local people and may not be designed to meet any of the standards. It was found that their concrete strength may be as low as 5 MPa and the amount of longitudinal reinforcement may be lower than 1%. This type of column is deliberately defined as “nonengineered reinforced concrete column,” or NRCC. During earthquake, the gravity load collapse of the NRCC columns caused a large number of death tolls around the world. In this study, four columns as representative of existing NRCC were tested under cyclic loading. The compressive strength of concrete in order of 5 MPa was used to be representative of columns with poor quality concrete. Two axial load levels of 6 and 18 tons were used to study the influence of axial load level on maximum drift at gravity load collapse. To investigate the effect of bar types on drift capacity, 9 mm round bars were used in two specimens and 12 mm deformed bars were used for the rest of the specimens. The maximum drift before gravity load collapse was very dependent on the axial load level. The maximum drift of the specimens subjected to high axial load (18 tons) was extremely low at approximately 1.75% drifts. The use of deformed bars (associated with larger amount of longitudinal reinforcement) caused the damage to severely dissipate all over the height of the columns. Such damage caused columns to collapse at a lower drift compared to those using round bars. Finally, the plastic hinge model was used to predict the maximum drift of the low strength columns. It was found that the model overly underestimates the drift at gravity load collapse. [ABSTRACT FROM AUTHOR]

Background. Persistent severe serous choroidal detachment is a rare complication after glaucoma surgery. Surgical treatment with choroidal fluid drainage through a scleral incision is an option in these cases. Combining this procedure with pars plana vitrectomy and gas endotamponade has potential advantages. In the following, the perioperative course of this surgical option in a small cohort will be presented. Methods. This is a retrospective cohort study of the postoperative course of ab externo drainage of persistent serous choroidal detachment (≥4 weeks) in combination with pars plana vitrectomy and gas endotamponade in six eyes of six patients after exhausting all conservative treatment options. Inclusion criterion was persistent hypotony with severe serous choroidal detachment after intraocular pressure (IOP) lowering surgery due to medically uncontrolled glaucoma. Eyes were evaluated according to resolution of choroidal detachment, change in IOP and visual acuity (VA), postdrainage complications, and need for further surgeries. Results. Before surgery, all patients presented with flat anterior chamber, decreased vision, and persistent choroidal detachment. The surgery itself was uneventful, but due to the complexity of the cases, tailoring the procedure to each patient's needs was required. Complete resolution of choroidal effusion was achieved by one month in 5 eyes and in 1 eye by month 3. There was an increase in average IOP from 5 (±2.1) mmHg before surgery to 11.3 (±3.7) mmHg and in VA from 1.7 (±0.8) to 1.2 (±0.6) logMAR. Five out of six patients required additional surgery, mainly to further increase the IOP even though choroidal detachment had already resolved. Conclusion. Ab externo choroidal fluid drainage combined with pars plana vitrectomy and gas endotamponade seems to be an effective and safe treatment option in persistent ocular hypotony. Although repeated surgeries might be necessary, large‐scale prospective studies must be undertaken to provide corroborative evidence. [ABSTRACT FROM AUTHOR]

Background. Patients with β‐thalassemia major depend on lifelong transfusion, resulting in tissue iron overload. This longitudinal retrospective observational study aims to assess myocardial and liver iron overload using magnetic resonance imaging (MRI) and investigate the lag between myocardial and liver iron unloading in β‐thalassemia patients undergoing chelation therapy. Methods. Beta‐thalassemia major patients with at least two MRI studies between 2016 and 2020 were enrolled. Myocardial and liver iron overload were defined as T2∗ less than 20 and 2.1, respectively. Outcomes included mortality, myocardial and liver T2∗ changes, and systolic dysfunction assessed by cardiac MRI. Results. Fifty‐five patients with a mean age of 24.62 ± 7.94 years, a mean follow‐up duration of 24.3 ± 12.9 months, and a mean ferritin level of 1475.75 ± 771.12 ng/mL were enrolled. All of the abovementioned patients only took deferoxamine as the iron‐chelating medication. Mortality occurred in three patients (5.5%) during follow‐up. Liver T2∗ significantly increased (p value <0.05), while myocardial T2∗ showed a nonsignificant increase. Iron unloading of the myocardium was not significantly different from that of the liver and did not result in a significant lag (56% vs. 44%; p value = 0.419). Baseline myocardial T2∗ correlated with extramedullary hematopoiesis, weekly number of deferoxamine injections (p value <0.01), timing between the transfusions, and serum ferritin (p value <0.05). Conclusion. Liver T2∗ reduced during deferoxamine chelation therapy, while myocardial T2∗ remained unchanged. No significant lag was observed between myocardial and liver iron unloading. Further studies are required to elucidate these findings. [ABSTRACT FROM AUTHOR]

Social prescribing link workers are recently introduced roles in English primary care. One of their intended functions is to support patients with conditions influenced by the wider, social determinants of health. Their main purpose is to connect people to community resources to meet their nonmedical needs. However, our research reveals that link workers provide not only connections but also what we have described as "holding" for individuals with complex needs, who lack informal networks of support or who are waiting to access services. We explore the concept of holding, its meaning and significance in this context, and consider its consequences. As part of a realist evaluation, we observed seven link workers in GP practices in England during focussed ethnographies over a 3‐week period. We took field notes and interviewed 61 patients and 93 healthcare and voluntary sector professionals. Nine to twelve months later, we carried out follow‐up interviews with forty‐one patients, seven link workers, and a link worker manager. We identified four functions of holding: supporting patients waiting for services, sustaining patients as they prepare for change, reducing the emotional burden of primary healthcare professionals, and bearing witness to patients' distress. Holding appears to be a vital but often overlooked aspect of social prescribing. Patients benefit from having a reliable and consistent person to support their emotional needs. However, similar to the impact of holding on other primary care professionals, there are unintended consequences: some link workers exceed their capacity, become overburdened, experience burnout, and leave their job. Recognizing the importance of holding and understanding its role in link workers' primary care responsibilities are critical. If holding work is accepted as a role for link workers, providing training and support to them should be prioritised to ensure successful implementation and positive outcomes for patients, link workers, and primary healthcare staff. [ABSTRACT FROM AUTHOR]

Background and Objective. Research has shown that children's motor performance (MP) and body composition (BC) are positively related to health and influence physical activity across the lifespan. As an intervention for improving MP and BC in childhood, engagement in a sports club (SC) is an important key strategy. Therefore, the aim of the study is to examine the stability of MP and BC and their associations with SC participation. Methods. MP and BC of 295 children (161 girls) with a mean age of 8.42 ± 0.36 years were measured annually with the German Motor Test 6‐18. Based on self‐reports, children were divided into three groups according to consistent (CON), partial (PAR), and nonparticipation (NO) in SC. NO and PAR were then combined into NO‐PAR. The stability of MP and BC was determined using Pearson's correlation coefficient (r). Associations of SC participation, MP, and BC were examined using robust mixed‐model ANOVA (mmANOVA) additionally with first grade as covariate (ANCOVA). Results. More girls (39%) than boys (25%) were classified in PAR. The stability of MP (r =.755) and BMI (r =.889) was moderately high. Children in CON (r =.847) showed lower stability in BMI than NO‐PAR (r =.923). mmANOVA revealed better overall MP for both sexes in CON except for balance and BMI. Boys in CON showed better performance in flexibility, endurance, and speed than NO‐PAR. ANCOVA confirmed unadjusted results for boys. Conclusion. Lower stability of BMI due to CON indicates a greater variance in ranking and thus the chance to adjust weight management in childhood. Girls' MP benefited less from SC participation, which may be due to their more frequent rates in PAR. Therefore, interventions to increase engagement in SC should focus on a stepwise approach from none to partial and finally to long‐term participation. [ABSTRACT FROM AUTHOR]

Background. Diabetic mellitus is a vision‐threatening disease because it causes diabetic retinopathy worldwide. The main focus of this research is to determine the prevalence and assess the visual outcome in diabetic retinopathy and macular edema patients by injecting Bevacizumab clinically. Methods. This hospital‐based trial case was conducted in Khulna BNSB Eye Hospital, Bangladesh. This study is based on a prospective cohort with a population of macular edema in 41 eyes of 25 diabetic patients, of whom 94 were diagnosed with diabetic retinopathy in 320 type 2 diabetes mellitus patients. The treating physician inserts 1.25 mg (0.05 ml) into the patient's eye. We have used optical coherence tomography (OCT) and colour fundus photography (CFP) for an eye check performed on all patients before and after the injection of Bevacizumab. The method results analyze the effects of the technique using IBM SPSS 25. Results. The study population selected 25 patients with 41 eyes for clinical investigation by injection of Bevacizumab. The net effects of this study on five eyes with macular edema were entirely resolved. It was BCVA from 6/6 to 6/9. The 29 eyes were partially resolved, which is called improved visual acuity, and BCVA was 6/12 to 6/60. In the case of seven eyes, we found that the vision did not change before or after the Avastin injection. No change was seen in seven eyes of macular edema due to the effects of the Avastin injection before and after. Conclusions. In clinical trial‐based research, Bevacizumab (Avastin) is best effective for diabetic retinopathy (DR) and diabetic macular edema (DME) patients. [ABSTRACT FROM AUTHOR]

Aims. This study aimed to analyze the effects of the surgery preparation time on patient outcomes. Background. Postoperative complications have a decisive effect on postoperative survival. The anesthesia time is a crucial determinant of such complications. Competent operating room nurses can shorten the surgery preparation time, which is the time from when anesthesia is first administered to the making of the surgical incision. The shortening of this preparation time can shorten the anesthesia time and may reduce postoperative complications. However, discussion of this preparation time is insufficient. Therefore, this study analyzed the effect of the surgery preparation time on patient outcomes. Methods. From electronic health records data, this retrospective cohort study used the data of 1,944 patients who had been immediately admitted to the ICU after their surgery between 2017 and 2020. The patients were divided into two groups: ≥30 minutes preparation time and <30 minutes preparation time groups. We performed chi-squared tests and t-tests to determine differences in preoperation, intraoperation, and postoperation characteristics of the patients and patient outcomes based on the surgery preparation time. Furthermore, we performed a multiple logistic regression by including 12 adjusted variables to determine the influence of the surgery preparation time on patient outcomes. Results. Among the 1,944 patients, 820 were in the ≥30 minutes preparation time group and 1,124 in the <30 minutes preparation time group. The multiple logistic regression analysis showed that the surgery preparation time affects alertness (OR = 1.44; 95% CI: [1.09, 1.90]), ventilator application (OR = 1.32; 95% CI: [1.03, 1.70]), and length of stay in the ICU (OR = 1.69; 95% CI [1.16, 2.47]). Conclusions. The surgery preparation time affects postoperative patient outcomes. The competence of operating room nurses is the most essential aspect of the surgery preparation time. Implications for Nursing Management. It is important to analyze operating room nurses' tasks, standardize the tasks, and educate nurses according to their experience level to reduce the surgery preparation time and improve patient outcomes. [ABSTRACT FROM AUTHOR]

The presence of positive bile culture during intraoperative procedures has been associated with elevated morbidity and mortality rates in hepatobiliopancreatic surgeries, contributing to increased healthcare expenditures. However, the precise impact of bactobilia on the development of postoperative complications remains uncertain due to existing disparities in the published literature. In this retrospective cohort study, we assessed 137 patients who underwent major hepatobiliopancreatic surgery to examine the relationship between intraoperative bile culture outcomes and subsequent postoperative infectious complications. Among patients with bactobilia, a significant 35.1% exhibited systemic or local infectious complications, whereas only 11.1% of those with negative culture results experienced any infectious complications (p = 0.002). Similarly, a notable difference was observed in the incidence of surgical site infections, with 24.3% in the bactobilia group compared to 7.9% in the negative culture group (p = 0.01). A total of 74 monomicrobial cultures with microbiological growth were isolated, predominantly featuring Gram-negative microorganisms, primarily Enterobacteriaceae in 49 cultures. Escherichia coli was identified in 37.8% of positive cultures, while Klebsiella pneumoniae was evident in 21.6%. Gram-positive microorganisms were present in 10 cultures, with Enterococcus emerging as the prevailing species. The logistic regression model identified a positive bile culture as an independent factor significantly associated with infection development (OR: 2.26; 95% confidence interval: 1.23-11; p = 0.02). Considering the limitations of the study, these findings underscore the critical importance of conducting bile cultures during the intraoperative phase to enable vigilant monitoring and prompt management of infectious complications. [ABSTRACT FROM AUTHOR]

Despite efforts to acknowledge diversity among unpaid caregivers, Canadian research, advocacy, practice, and policy tend to be based in and to reproduce dominant social and institutional expectations and assumptions about who provides unpaid support and why, and what this support looks like. The objective of thtudinal, qualitative research study. In that study, qualitative case study interviews were conducted with twelve home care clients, their identified family or friend caregiver, home care aide, case coordinator, and agency supervisor (129 interviews in total). Case study profiles compiled over time generated deeper information about the availability and capacity of informal sources of support for these clients, which prompted abductive analysis in relation to dominant assumptions typically made about caregivers in research, policy, and practice. Specifically, only one case (participant) had a caregiver whose profile closely matched dominant conceptualizations. In the remaining eleven cases, we found situations wherein: (a) caregivers grappled with physical or mental health challenges limiting their participation in care (sometimes meaning the client is themselves a caregiver, or the caregiver is also receiving home care services); (b) caregivers facing burnout sought to delimit their participation in care; (c) caregivers' participation was limited by older adults' reluctance to accept their help; (d) caregivers were largely unavailable, unreliable, or peripheral; or (e) client's unpaid support networks were diffuse without a clearly central or identifiable "caregiver." Findings are used to nuance and problematize widely held assumptions about caregivers, particularly their availability and capacity. Discussion highlights the need for research, policy, and programs related to unpaid caregiving to better reflect the lived realities of this support for older adults and often overlooked sources of diversity in caregiver circumstances and roles. [ABSTRACT FROM AUTHOR]

Purpose. The authors of this study proposed an innovative approach involving the use of Biodentine™ material as an intraorifice barrier in cracked teeth with root extension to promote internal crack sealing, preventing the possibility of microinfiltration and apical crack propagation. Materials and Methods. The dental records of 11 patients with 12 posterior cracked teeth with root extension were included with a precise protocol performed by a senior endodontist. The treatment protocol included pulp diagnosis, crack identification using a dental operating microscope (DOM), endodontic treatment, placing a Biodentine™ as an intraorifice barrier, and immediate full-coverage restoration. The effectiveness of the treatment was assessed at two intervals, 6 months, and 1−3 years posttreatment, evaluating clinical, radiographic, and tomographic aspects. The treatment was deemed successful if there were no indications of radiolucency, sinus tracts, edema, or periodontal pockets associated with the crack line. Results. The study observed remarkably positive outcomes during the follow-up period, which spanned from 1 to 3 years. All the cracked teeth (100%) remained asymptomatic, meaning they were free of pain or discomfort. Furthermore, these teeth were in occlusal function. Both radiographic and tomographic assessments revealed the absence of bone loss along the crack line. This outcome signifies that the treatment effectively prevented further deterioration of the surrounding bone. Conclusions. Integrating advanced biomaterials and conservative restorative techniques has paved the way for innovative approaches in dental care. This protocol suggests a proactive step for managing cracked teeth with root extension. It addresses both biological aspects by sealing internal cracks and mechanical aspects by preventing crack progression, thereby improving these teeth' prognosis and long-term survival. [ABSTRACT FROM AUTHOR]

Background. Stroke incidence and mortality have drastically decreased in high-income countries in the past twenty years. In this study, we provide updated estimates on mortality, recurrent stroke, and functional dependency among patients with first-ever ischemic stroke and assess predictors associated with poor outcomes with a focus on age, vascular factors, stroke severity, function, and comorbidity burden. Methods. MIDNOR STROKE is a multicenter prospective longitudinal study including patients with first-ever ischemic stroke admitted to stroke units in Central Norway during 2015-2017. Data on survival, stroke recurrence, and functional dependency were collected during hospital stay and follow-up. Multivariable Cox proportional hazard models and logistic regression models were used to analyze predictors of mortality, stroke recurrence, and functional dependency. Results. A total of 794 participants were included in the study. After a year, 7.6% of the participants had died, 5.8% had a recurrent stroke, and 13.6% experienced functional deterioration to dependency. Multivariable analysis revealed that age (HR: 1.07, 96% CI: 1.03, 1.10), stroke severity (HR: 1.10, 95% CI: 1.07, 1.13), comorbidity burden (low: HR: 4.05, 95% CI: 1.48, 11.10; moderate: HR: 5.44, 95% CI: 2.06, 14.40; and high: 7.72, 95% CI: 2.85, 21.00), and coronary artery disease (HR: 2.40, 95% CI: 1.32, 4.38) predicted all-cause death. Statin therapy predicted improved survival (HR: 0.39, 95% CI: 0.21, 0.75). High age (HR: 1.09, 95% CI: 1.05, 1.14) and increased stroke severity (OR: 1.26, 95% CI: 1.17, 1.38) predicted elevated risk of functional dependency at one year. Conclusions. In this study, we have demonstrated that 1-year survival following first-ever ischemic stroke was high compared to previous reports and that statin therapy predicted improved survival. The risk of recurrent stroke after one year was found to be low compared to previous studies. Approximately 14% of stroke survivors who were initially functionally independent experienced deterioration to functional dependency. In addition to older age and stroke severity, increased comorbidity burden and a history of coronary artery disease predicted poor stroke prognosis. Interventions aimed at reducing stroke severity may improve patient outcomes. Furthermore, prevention efforts targeting conditions such as CAD and reducing overall comorbidity burden in stroke patients may favorably improve survival. This trial is registered with NCT03962127. [ABSTRACT FROM AUTHOR]

Cholesterol is a core component of the central nervous system, essential for the cellmembrane stability and the correct functioning of neurotransmission. It has been observed that cholesterol may be somewhat associated with suicidal behaviours. Therefore, the aim of this paper was to elucidate current facts and views about the role of cholesterol levels in mood disorders. The majority of the studies reviewed in the present paper suggest an interesting relationship between cholesterol (especially lower levels) and suicidality. On the other hand, particularly during the last years, relationships between serum cholesterol and suicidality were doubted on the basis of some recent studies that have not found any correlation. However, the debate on relationships between cholesterol and suicide is open and longitudinal studies on a larger sample of patients are needed to further clarify this important issue. [ABSTRACT FROM AUTHOR]

Purpose. Exercise training is an essential treatment option for patients with chronic heart failure (CHF). However, it remains controversial, which surrogate measures of functional work capacity are most reliable. The purpose of this paper was to compare functional capacity work measured as capillary lactate concentrations area under the curve (AUC) with standard cardiopulmonary exercise testing (CPET) with VO2peak and the 6-minute walk test (6 MWT). Methods. Twenty-three patients in New York Heart Association (NYHA) class II/III with left ventricular ejection fraction (LVEF) <35% were randomised to home-based recommendation of regular exercise (RRE) (controls), moderate continuous training (MCT) or aerobic interval training (AIT). The MCT and AIT groups underwent 12 weeks of supervised exercise training. Exercise testing was performed as standard CPET treadmill test with analysis of VO2peak, the 6 MWT and a novel 30-minute submaximal treadmill test with capillary lactate AUC. Results. All patients had statistically significant improvements in VO2peak, 6 MWT and lactate AUC after 12 weeks of exercise training: 6 MWT (p =0.035), VO2peak (p =0.049) and lactate AUC (p =0.002). Lactate AUC (p =0.046) and 6MWT (p =0.035), but not VO2peak revealed difference between the exercise modalities regarding functional work capacity. Conclusion. 6-MWT and lactate AUC, but not VO2peak, were able to reveal a statistically significant improvement in functional capacity between different exercise modalities. [ABSTRACT FROM AUTHOR]

Aims. To develop an evidence-based practice (EBP) facilitating strategy informed by the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework and evaluates the strategy's effectiveness on promoting EBP. Background. Nurses are increasingly expected to use research evidence in practice to improve patients' outcomes, but the application of such evidence is still unsatisfactory. The facilitation of EBP in nursing needs the organization and the individual levels. Methods. Based on an analysis of EBP-promoting strategies and expert consultation, the core team of the nursing department developed an EBP group-based and project-oriented strategy under the guidance of the i-PARIHS framework. The strategy was implemented for six years and evaluated by a longitudinal design. The validated Chinese version of the self-reported Evidence Based Practice Questionnaire (EBPQ) was used to assess the attitudes, knowledge, and practice of the nurses. Results. The mean score of the total EBPQ was 4.46 (SD = 0.92) after one year of the EBP strategy, and the scores for knowledge, attitudes, and practice of EBP members were higher than those of general nurses p < 0.05 . After four years, EBP members' scores continued to increase. EBP groups conducted 51 EBP projects in the areas of emergency nursing, surgical and medical nursing, critical care, and so forth. Of these, 33 projects improved nursing practice by changing nursing procedures, upgrading nursing tools, and developing nursing standards, resulting in improved patient outcomes. Conclusion. The EBP group-based and project-oriented strategy can promote EBP. The composition of the EBP group, the annual audit of EBP projects, and the roles of internal and external facilitators were key components of this EBP-facilitating strategy. Implications for Nursing Management. The strategy is an organizational-level EBP-facilitation approach which can improve nurses' academic preparation for EBP through ongoing training and sustained EBP behavior that involves annual projects. [ABSTRACT FROM AUTHOR]

Background. In recent years, the attention paid to colorectal cancer (CRC) surgery and postoperative analgesia has increased. Objective. The objective of the current study was to compare the impact of ultrasound-guided erector spinae plane block (ESPB) and transmuscular quadratus lumborum block (TQLB) upon providing relief to patients with postoperative pain who underwent laparoscopic resection for CRC. Methods. In this prospective, comparative, and randomized study, the authors considered a total of 60 patients who chose to undergo laparoscopic resection for colorectal cancer. The total number of patients was randomly divided into two groups (such as ESPB and TQLB) so that each group had a total of 30 patients. For the former group, i.e., the ESPB group, 20 ml of 0.25% bupivacaine was administered at each side for bilateral ultrasound-guided erector spinae plane block, while the latter group received the same dose of medicine for bilateral ultrasound-guided transmuscular quadratus lumborum block (TQLB). The researchers recorded the first time to rescue an analgesic, the whole amount of rescue analgesia under consumption in the first 24 hours after the surgical procedure, and associated adverse events. Results. Among the groups considered, the ESPB group took a significantly lengthy time to raise a first request for rescue analgesic (280 ± 15.5 min) in comparison with the TQLB group (260 ± 13.8 min). Likewise, the consumption of overall nalbuphine was remarkably lesser in the ESPB group during the first 24 hours (24 ± 2.5 mg) compared to the TQLB group (30.5 ± 1.55 mg). Conclusion. The analgesic efficacy of ESPB was better when compared to TQLB in terms of time to rescue analgesia and overall opioid consumption during the first 24 hours. This study was registered at ClinicalTrials.gov on 10/10/2022 (registration number: NCT05574283). [ABSTRACT FROM AUTHOR]

Background. The association between atherogenic index of plasma (AIP) and hyperuricemia remains indistinct. This study was aimed to examine the relationship between AIP and hyperuricemia among the middle-aged and the elderly Chinese population. Methods. Datasets were retrieved from the China Health and Retirement Longitudinal Study (CHARLS) survey conducted in 2011 and 2015. 13,021 participants in the CHARLS in 2011 and 7,017 participants involved both in 2011 and 2015 were included, respectively. The measurement of AIP and hyperuricemia was based on the test of fasting blood. Association between AIP and hyperuricemia was assessed by logistic regression, and the nonlinear association was examined by restricted cubic splines (RCS). The cutoff point of AIP was calculated using receiver operator curve (ROC). 1 : 1 propensity score matching (PSM) was adopted to further explore the relationship between AIP and hyperuricemia. Results. In the section of a cross-sectional study, a positive association between AIP and hyperuricemia was found. The odds ratios (ORs) of hyperuricemia were 1.00 (reference), 1.52 (1.10–2.10), 1.80 (1.31–2.47), and 3.81 (2.84–5.11). Nonlinear association was not detected using RCS analysis. There were 664 hyperuricemia cases during the four years follow-up. The hyperuricemia prevalence was 9.5%. In the fully adjusted longitudinal analysis, the ORs for hyperuricemia across the quartiles of AIP were 1.00 (reference), 1.00 (0.74–1.37), 1.59 (1.20–2.11), and 2.55 (1.94–3.35), respectively. In the longitudinal analysis after PSM, the OR of hyperuricemia were 1.91 (1.45, 2.51) and 1.92 (1.45, 2.54) in the univariate and multivariate model, respectively. Conclusion. AIP can predict the prevalence of hyperuricemia in the Chinese middle-aged and elderly population. [ABSTRACT FROM AUTHOR]

Background. Altered maternal serum lipid metabolism is associated with hypertensive disorders in pregnancy (HDP). However, its range in pregnancy and characteristic among different subgroups of HDPs are unclear. Methods. Pregnant women with HDP who underwent antenatal care and delivered in Obstetrics and Gynecology Hospital of Fudan University during January 2018 to August 2022 were enrolled. The levels of total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDLC), low-density lipoprotein cholesterol (LDLC), apolipoprotein (Apo)-A, B, and E, free fatty acids (FFA), and small and dense low-density lipoprotein cholesterol (sdLDL) were measured during 4–16 weeks and 28–42 weeks of pregnancy. Results. A total of 2648 pregnant women were diagnosed with HDP, 1,880 of whom were enrolled for final analysis, including 983 (52.3%) preeclampsia (PE), 676 (36.0%) gestational hypertension (GH), and 221 (11.7%) chronic hypertension (CH). For all HDPs, serum TC, TG, LDLC, HDLC, Apo-A, Apo-B, Apo-E, and sdLDL increased significantly during pregnancy, while FFA decreased significantly. Notably, the levels of TC, LDLC, Apo-B, and sdLDL in PE group were equal to or lower than those in CH group at 4–16 weeks of pregnancy, but increased greatly during pregnancy (P < 0.05). Conclusions. Maternal serum lipid levels changed through pregnancy among women with HDPs. Women complicated with PE seem to have undergone a more significant serum lipid change compared to those with GH or CH. [ABSTRACT FROM AUTHOR]

Background. There are many different haematological malignancy subtypes. Most follow chronic pathways that are uncertain and unpredictable, which may lead to feelings of anxiety and distress. The provision of information can ameliorate such difficulties, but patients are known to have unmet needs in this regard. The aim of this study is to explore experiences of information sharing among patients with chronic blood cancers and the factors impacting this process. Methods. The study is set within a UK cohort of blood cancer patients, where care is provided across 14 hospitals according to national clinical guidelines. Purposive sampling was used to identify expert participants (based on experience), and in-depth qualitative interviews were conducted with 35 patients, 10 with a relative present. The study was intended to inform practice and utilised qualitative description, with thematic content analysis and systematic data coding. Results. Experiences of information sharing varied. Most patients described this positively, but not all. Several barriers and facilitators were identified, which are discussed within five themes: (1) shock affects ability to process information, (2) the importance of time to facilitate information exchange, (3) personal relationships have an impact on meeting information needs, (4) HCP interpersonal skills are central to good information sharing, and (5) communication skills and terminology. Conclusions. Patients with chronic blood cancers prefer to engage in information sharing when they are not in a state of shock, and when they have adequate time to process material that is effectively and sensitively delivered, by HCPs they know and trust. [ABSTRACT FROM AUTHOR]

Background. To control the malaria mortality, the global and national communities have worked together and produced impressive results in the world. Some of the Asian counties’ malaria mortality rate is more compared to countries with high health facilities around the world. This paper’s main aim is to describe trend of malaria cases and mortality in 10 Asian countries using the World Health Organization data. Methods. Malaria mortality data was collected systematically from WHO and UN database for the period 2006–2011. We estimated malaria mortality by age and countries. We also explored the dynamic relationships among malaria death rate, total populations, and geographical region using a map. During 2006–2011, the average malaria death per 10,000 population of all ages was 0.239 (95% CI 0.104 to 0.373), of children aged less than 5 year 1.143 (0.598 to 1.687), and of age greater than 5 years 0.089 (0.043 to 0.137) in Asian countries. Malaria prevalence per 10,000 populations steadily decreased from 486.7 in 2006 to 298.9 in 2011. Conclusion. The findings show that malaria mortality is higher for children aged less than 5 years compared with with adults selected in Asian countries except Sri Lanka. [ABSTRACT FROM AUTHOR]

Due to material multiplicity, rigid-flexible hybrid and environmental variations, and so forth, the properties of the tracks will be inevitably changed due to the cyclic loads temporally and spatially. In this paper, a theoretical study is conducted to clarify the influence of the longitudinal inhomogeneity of track stiffness on system responses and then a general state estimation method is proposed to inversely predict the parametric distribution of the tracks. To achieve these purposes, a 3D nonlinear vehicle-track coupled model is firstly constructed, where track systems are established by the finite element method with random parameters. Based on this dynamic model, the distribution characteristics of system responses due to random parametric excitations are properly revealed. The numerical studies show that the longitudinal inhomogeneity of track supporting stiffness has significant effects on system responses; besides, the response distributions are varied against different parametric distributions. Finally, a representative example is demonstrated to show the effectiveness of the proposed track state estimation method. [ABSTRACT FROM AUTHOR]

Introduction. The unique demands of firefighting results in acute, recurrent, or chronic pain complications. We aimed to describe the percentage distribution of number and location of painful sites among FFs and determine whether work limitations differed based on the number or location of painful sites, age, and/or sex. Methods. About 325 firefighters completed a work limitation questionnaire (WLQ-26) and a checklist to indicate painful regions of the body using either a paper format or an online survey. A one-way ANOVA was employed to analyze the transformed work limitation scores; this was a two-sided test with a significance level of <0.05, to determine if work limitations differed among firefighters based on the number or location of painful sites, age, and/or sex. Results. The data analyzed consisted of 325 (men = 216 , women = 109) FFs in total. The percentage distribution of the number of painful sites in our study cohort was 43% no pain, 17% one painful site, 19% two painful sites, and 21% three or more painful sites. The percentage distribution of the locations of painful sites was 43% no pain, 41% spine, 9% lower extremity, and 7% upper extremity. An estimated 31% of FFs (n = 102) reported non-MSK comorbidities with 23% (n = 76) reporting at least one non-MSK comorbidity and 8% (n = 26) reported having two or more comorbidities. FFs > 45 years of age experienced more physical work limitations than FFs ≤ 45 years (mean difference: 0.74/10; 95% CI.19-1.29; p = 0.008). Conclusions. The majority of firefighters reported having at least one painful site and indicated the spine as the most common painful location. Age, the number of painful sites, and location of pain were identified as a potential contributor to physical/mental and work output limitations. [ABSTRACT FROM AUTHOR]

The aim of the present paper is to review the scientific literature concerning the usefulness of 18F-FDG PET/CT in the evaluation of response to chemotherapy in patients affected by liver metastases from colorectal cancer. Material and Methods. Studies were identified by searching PubMed electronic databases. Both prospective and retrospective studies were included. Information regarding the figure of merit of PET for the evaluation of therapy response was extracted and analyzed. Results. Existing data suggests that 18F-FDG PET/CT may have an outstanding role in evaluating the response. The sensitivity of PET in detecting therapy response seems to be greater than conventional imaging (CT and MRI). PET/CT response is strictly related to better overall survival and progression-free survival. Conclusions. PET/CT is more than a promising technique to assess the response to chemotherapy in colorectal and liver metastases. However, to be fully validated, this examination needs further studies by recruiting more patients. [ABSTRACT FROM AUTHOR]

Bladder cancer occurs in the epithelial lining of the urinary bladder and is amongst the most common types of cancer in humans, killing thousands of people a year. This paper is based on the hypothesis that the use of clinical and histopathological data together with information about the concentration of various molecular markers in patients is useful for the prediction of outcomes and the design of treatments of nonmuscle invasive bladder carcinoma (NMIBC). A population of 45 patients with a new diagnosis of NMIBC was selected. Patients with benign prostatic hyperplasia (BPH), muscle invasive bladder carcinoma (MIBC), carcinoma in situ (CIS), and NMIBC recurrent tumors were not included due to their different clinical behavior. Clinical history was obtained by means of anamnesis and physical examination, and preoperative imaging and urine cytology were carried out for all patients. Then, patients underwent conventional transurethral resection (TURBT) and some proteomic analyses quantified the biomarkers (p53, neu, and EGFR). A postoperative follow-up was performed to detect relapse and progression. Clusterings were performed to find groups with clinical, molecular markers, histopathological prognostic factors, and statistics about recurrence, progression, and overall survival of patients with NMIBC. Four groups were found according to tumor sizes, risk of relapse or progression, and biological behavior. Outlier patients were also detected and categorized according to their clinical characters and biological behavior. [ABSTRACT FROM AUTHOR]

This paper aimed to study the longitudinal vibration characteristics of the 5000 m mining pipe in the ocean under different working wind conditions, offset angle, damping, and ore bin weight. Based on the finite element method, the mining pipe is simplified into beam element and discretized, and the physical and mathematical models of the mining pipe system are established. The Wilson-θ direct integral method is adopted for numerical calculation. The results show that the longitudinal vibration of the mining pipe is irregular, which presents the phenomenon of oscillation. The vibration amplitude decreases first and then increases from top to bottom, the minimum vibration amplitude appears at 1000 m, and the maximum vibration amplitude appears at the top of the mining pipe. Under the same working wind condition, the overall longitudinal vibration amplitude of the mining pipe can be increased by increasing the ore bin weight and the offset angle, but neither of them can change the frequency of the longitudinal vibration. The closer the excitation frequency generated by different working wind conditions is to the natural frequency, the larger the mining pipe longitudinal vibration amplitude is. The closer the vibration frequency generated by the same excitation frequency is to the natural frequency, the stronger the vibration intensity is, and when damping is added, the vibration intensity decreases faster. [ABSTRACT FROM AUTHOR]

Purpose. To compare corneal higher-order aberrations (HOAs), refractive error, and ocular biological parameters before and after phacoemulsification combined with goniosynechialysis (Phaco-GSL) in primary angle closure/glaucoma (PAC/PACG) patients with different axial lengths (ALs). Methods. In this prospective study, cataract patients diagnosed with PAC/PACG were categorized into two groups based on their ALs: the short AL group (AL ≤ 22.5 mm) and the normal AL group (22.5 < AL ≤ 24.5 mm). The pre- and postsurgery measurements of intraocular pressure (IOP) and best-corrected visual acuity (BCVA) were conducted at 1 day, 1 week, 1 month, 3 months, 6 months, and 12 months. Additionally, the assessments included corneal HOAs, the number of antiglaucoma medications, visual field parameters, manifest refraction, and other ocular biological parameters before surgery and at the final follow-up. Results. Prior to surgery, the two groups exhibited no significant differences, except for AL, curvature value, and Z (4, 0) of the posterior corneal surface (all P < 0.01). Following surgery, BCVA improved, and IOP decreased significantly in both groups (P < 0.01). Both anterior and total corneal HOAs, along with Z (3, −3), increased in the two groups (all P < 0.05), with the normal AL group exhibiting a significantly greater increase in total cornea Z (3, −3) than the short AL group (P = 0.047). The normal AL group also exhibited a slight tendency towards hyperopia (P < 0.01). Significant changes were observed in the visual field index and mean deviation in both groups (P < 0.05). Conclusions. Phaco-GSL resulted in an increased corneal HOAs, particularly trefoil, with variations based on the patient's AL. Patients with normal ALs tended to shift towards hyperopia after surgery. [ABSTRACT FROM AUTHOR]

Objective. To analyze the impact of clinical supervision on the improvement of positivity rates and quality indicators of nursing practice for medical-surgical patients in a private healthcare unit. Methodology. Prospective interventional cohort study with a quantitative approach, to study the effect of supervision on indicators and indices of quality of care. Materials and Method. A quantitative approach through an interventional prospective cohort study and simple random sampling. Results. Of the n = 764 records of audits conducted on the quality of nursing practice that were analyzed, there were higher scores and positivity indices in both services after the implementation of clinical supervision. Conclusion. The practice of clinical supervision allows for the strategic monitoring of teams according to the results of audits on nursing care practices, thus raising the indices of positivity and quality indicators of nursing care practices with a direct impact on the patient. [ABSTRACT FROM AUTHOR]

Background. Acute generalised peritonitis (AGP) is a common and serious digestive surgery pathology. Undernutrition exacerbates patient condition and compromises their postoperative prognosis. Early enteral nutrition is recommended to reduce postoperative complications, but its availability and cost are problematic in low-income countries. The objective of this study was to evaluate the impact of providing early enteral feeding (EEF) to postoperative patients with intestinal perforation AGP using a locally prepared protein-energy food ration in two hospitals in Bukavu, a city of South Kivu, in the eastern part of the Democratic Republic of Congo. Methods. A prospective, randomised controlled trial with two groups of patients was conducted to investigate the effects of EEF with a local mixture versus enteral feeding after peristalsis had returned (control group) in patients who underwent laparotomy for AGP caused by ileal perforation. The local mixture consisted of soybean, maize, white rice, and pineapple. The trial included 66 patients with ileal perforation peritonitis. Results. The results comparing early enteral fed and nonfed patients showed significant differences in peristalsis recovery time (2.1 (0.6) days vs. 3.8 (1.2) days, p < 0.0001) and length of hospital stay (25.5 (14.9) days vs. 39.4 (25.3) days, p = 0.0046). Bivariate analyses indicated a significant early enteral feeding (EEF) reduced of 9.1% (vs. 36.4%, p = 0.0082) in parietal infections and 3.4% (28.1%, p = 0.009) in fistulas (p = 0.009) when EEF was included. In addition, EEF significantly reduced reintervention rates by 9.1% (p = 0.0003) and eliminated evisceration rates. EEF was also shown to reduce the incidence of malnutrition by 63.6% (p < 0.0001). Multivariate analysis showed that enteral nutrition significantly reduced the time to recovery of peristalsis (p = 0.0278) with an ORa of 0.3 and a 95% CI of 0.1-0.9. Moreover, EEF reduced malnutrition (p = 0.0039) with an ORa of 0.1 and a 95% CI of 0-0.4. Conclusion. EEF with locally sourced protein-energy rations can enhance a patient's nutritional status and facilitate postoperative recovery. This procedure is advantageous and involved early enteral nutrition using locally manufactured rations, especially for those operated on for acute generalised peritonitis in the Democratic Republic of Congo. [ABSTRACT FROM AUTHOR]

NADC34-like porcine reproductive and respiratory virus (PRRSV) has had a significant impact on the pig industry, particularly in China. However, the evolutionary characteristics and pathogenicity of NADC34-like PRRSV strains within intensive farming systems are not well understood, particularly regarding the biological characteristic variation of successive outbreaks on a farm. In this study, we conducted continuous surveillance in an intensive farm that experienced a PRRSV outbreak. Two PRRSV strains, GDHZ109/2020 and GDYS162/2022, were isolated and fully sequenced from the same swine farm in Guangdong Province in 2020 and 2022, respectively. Evolutionary analysis based on the ORF5 gene revealed that both strains clustered with NADC34-like strains and shared 96.5% homology. Analysis of the full-length genome and NSP2 gene classified the strains into lineage 1.8, represented by the NADC30 strain. Recombination analysis suggested complex recombination patterns for both strains, involving NADC30-like, NADC34-like, and JXA1-like strains. Although many recombinant regions were nearly identical, there were differences observed in the NSP5–NSP7 region. Pathogenicity experiments conducted on piglets demonstrated that GDHZ109/2020 exhibited higher pathogenicity compared to GDYS162/2022. Piglets in the GDHZ109/2020 infected group had more severe clinical signs and higher mortality. Moreover, analysis of respiratory microbial diversity indicated a significant increase in the abundance of potentially pathogenic microbiota, such as Klebsiella and Erysipelothrix contributing to the respiratory tract of PRRSV-infected piglets, suggesting secondary infections due to differences in immune defense. These findings highlight the importance of NADC34-like recombinant strains' evolution during the farm's epidemic period, which may have contributed to changes in pathogenicity. This study improves our understanding of the current prevalence of PRRSV and provides novel insights into the prevention and control of PRRSV. [ABSTRACT FROM AUTHOR]

Background. Crohn's disease (CD) is a chronic inflammatory disease, and its incidence is gradually increasing. Thus, the use of a simple and convenient examination method to detect CD in the natural population as early as possible is crucial. This study is aimed at using the colloidal gold semiquantitative assay to detect fecal calprotectin (FCP) and determine whether it is helpful in screening or diagnosing CD. Methods. Using a prospectively maintained database, 59 patients with CD were analyzed using FCP measurement. Subsequently, 76 patients and 89 healthy individuals were assigned to the gastrointestinal dysfunction and control groups, respectively. To aid in the screening or diagnosis of CD, the receiver operating characteristic curve was used to determine the diagnostic efficacy of FCP thresholds. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were presented with 95% confidence intervals (CIs). Results. Patients with CD showed significantly higher FCP levels. Compared with the healthy population, when the FCP level cut-off was 15 μg/g and 60 μg/g, the sensitivity, specificity, PPV, and NPV for CD diagnosis were 98.3% (CI, 95.0%–100%) and 78.0% (CI, 67.4–88.6%), 84.3% (CI, 76.7%–91.8%) and 98.9% (CI, 96.7%–100%), 80.6% (CI, 71.5%–89.7%) and 97.9% (CI, 93.7%–100%), and 98.7% (CI, 96.2%–100%) and 87.1% (CI, 80.6%–93.6%), respectively. The AUCs were 0.969 (CI, 0.941–0.997). Compared with the gastrointestinal dysfunction group, using the same FCP level cut-off, the sensitivity, specificity, PPV, and NPV for CD diagnosis were 98.3% (CI, 95.0%–100%) and 78.0% (CI, 67.4%–88.6%), 71.1% (CI, 60.9%–81.3%) and 89.5% (CI, 82.3%–96.7%), 72.5% (CI, 62.7%–82.3%) and 85.2% (CI, 75.7%–94.7%), and 98.1% (CI, 94.5%–100%) and 84.0% (CI, 76.0%–92.0%), respectively. The AUCs were 0.908 (CI, 0.856–0.960). Conclusion. Detecting FCP by using the colloidal gold semiquantitative assay can be effective in screening and adjunct diagnosing of CD. [ABSTRACT FROM AUTHOR]

Drill string vibration is a widely studied topic. his paper developed a real-time measurement system near the drilling bit and extracted the lateral vibration, longitudinal vibration time series of bottom rotating drill string. In order to reconstruct the phase space, we estimated the delay time with mutual information and calculated the embedding dimension through Cao's method. Finally, the chaotic characterization of the system is analyzed by calculating the correlation dimension and the largest Lyapunov exponent. The results show that such system can exhibit positive infinite-time Lyapunov exponents and a clear convergence toward the correlation dimension, which is a strong indicator for the chaotic behavior of the system. It is expected that the new dynamics found in this paper could be of potential implication to the control methods of the drill string vibration. [ABSTRACT FROM AUTHOR]