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To assess all published studies which describe what happens to the delivery of pressure ulcer/injury (PI/PU) care pathways as a result of detecting raised sub‐epidermal moisture (SEM) delta (∆ ≥ 0.6). We undertook a systematic review of the literature, and included original research studies using either a prospective or retrospective study design that report the impact that assessment using SEM assessments have on healthcare practitioners' delivery of PI/PU care pathways in adults at risk of developing PI/PUs. The review protocol was registered on PROSPERO (CRD42023416975). A literature search was conducted in May 2023, using PubMed, CINAHL, Scopus, Cochrane, EMBASE, Web of Science and Science Direct databases. Data were extracted using a data extraction tool including elements such as country, setting, sample size, intervention, control and quality appraisal was undertaken using the Evidence‐based Librarianship. We identified nine papers published between 2017 and 2022. The majority of these studies were conducted in England (n = 6; 67%). The systematic review included studies conducted across multiple care settings including acute care, medical‐surgical units, and palliative care, highlighting the importance of PI/PU prevention and management across diverse patient populations. The PI/PU care pathways implemented in the studies varied, but commonly included elements such as the application or increased use of pressure‐redistributing mattresses/cushions, implementation of repositioning plans, management of incontinence and moisture, regular skin inspection, and assessment of patient mobility. Out of the nine studies identified, seven reported PI/PU incidence. A meta‐analysis of seven studies (N = 18 451) demonstrated a statistically significant reduction in visual PI/PU development in favour of SEM‐guided care pathways compared to usual care (the odds ratio = 0.36 [95% confidence interval: 0.24–0.53, p < 0.00001]). This systematic review provides evidence that implementing SEM assessments in patients at risk of developing PI/PUs prompts anatomy‐specific clinical actions. The subsequent implementation of enhanced and targeted skin care interventions leads to consistent and sustained reductions in hospital‐acquired PU incidence. The findings emphasise the importance of incorporating SEM assessments as part of comprehensive PI/PU prevention strategies in all care settings and patient populations. This systematic review is limited by the predominance of observational studies and variable study quality. Future research should focus on randomised trials in different care settings that monitor the efficacy of preventive interventions and their impact in reducing PI/PU incidence when implemented based on SEM assessments. [ABSTRACT FROM AUTHOR]

Introduction: Although Jordan has made significant progress toward expanding the utilization of facility‐based intrapartum care, prior research highlights that poor service quality is still persistent. This study aimed to identify quality gaps between women's expectations and perceptions of the actual intrapartum care received, while exploring the contributing factors. Methods: Utilizing a pre–post design, quality gaps in intrapartum care were assessed among 959 women pre‐ and postchildbirth at a prominent tertiary hospital in northern Jordan. Data were gathered using the SERVQUAL scale, measuring service quality across reliability, responsiveness, tangibles, assurance, and empathy dimensions. Results: The overall mean gap score between women's expectations and perceptions of the quality of intrapartum care was −0.60 (±0.56). The lowest and highest mean gap scores were found to be related to tangibles and assurance dimensions, −0.24 (±0.39) and −0.88 (±0.35), respectively. Significant negative quality gaps were identified in the dimensions of assurance, empathy, and responsiveness, as well as overall service quality (p < 0.001). The MLR analyses highlighted education (β = 0.61), mode of birth (β = −0.60), admission timing (β = −0.41), continuity of midwifery care (β = −0.43), physician's gender (β = −0.62), active labour duration (β = 0.37), and pain management (β = −0.33) to be the key determinants of the overall quality gap in intrapartum care. Conclusion: Our findings underscore the importance of fostering a labour environment that prioritizes enhancing caregivers' empathetic, reassuring, and responsive skills to minimize service quality gaps and enhance the overall childbirth experience for women in Jordan. Patient or Public Contribution: This paper is a collaborative effort involving women with lived experiences of childbirth, midwives, and obstetrics and gynaecologist physicians. The original idea, conceptualization, data generation, and coproduction, including manuscript editing, were shaped by the valuable contributions of stakeholders with unique perspectives on intrapartum care in Jordan. [ABSTRACT FROM AUTHOR]

Patients with familial adenomatous polyposis (FAP) develop early colorectal adenomas and if left untreated, progression to cancer is an inevitable event. Prophylactic surgery does not prevent further development of cancer in the rectal remnant, rectal cuff in patients with ileal pouch anal anastomosis (IPAA) and even on the ileal mucosa of the pouch body. The aim of this review is to assess long-term rates of cancer and adenoma development in patients with FAP after prophylactic surgery and to summarise current recommendations for endoscopic management and surveillance of these patients. A systematic literature search of studies from January 1946 through to June 2023 was conducted using the PRISMA checklist. The electronic database PubMed was searched. Fifty-four papers involving 5010 patients were reviewed. Cancer rate in the rectal remnant was 8.8–16.7% in the western population and 37% in the eastern population. The cumulative risk of cancer 30 years after surgery was 24%. Mortality due to cancer in the rectal remnant is 1.1–11.1% with a 5-year survival rate of 55%. The adenoma rate after primary IPAA was 9.4–85% with a cumulative risk of 85% 20 years after surgery and a cumulative risk of 12% for advanced adenomas 10 years after surgery. Cumulative risk for adenomas after ileorectal anastomosis (IRA) was 85% after 5 and 100% after 10 years. Adenomas developed more frequently after stapled (33.9–57%) compared to hand-sewn (0–33%) anastomosis. We identified reports of 45 cancers in patients after IPAA of which 30 were in the pouch body and 15 in the rectal cuff or at the anastomosis. There was a significant incidence of cancer and adenomas in the rectal remnant and ileal pouch of FAP patients during the long-term follow-up. Regular endoscopic surveillance is recommended, not only in IRA patients, but also in pouch patients after proctocolectomy. [ABSTRACT FROM AUTHOR]

The degradation of the cutting tool and its optimal replacement is a major problem in machining given the variability in this degradation even under constant cutting conditions. Therefore, monitoring the degradation of cutting tools is an important part of the process in order to replace the tool at the optimal time and thus reduce operating costs. In this paper, a cutting tool degradation monitoring technique is proposed using bootstrap-based artificial neural networks. Different indicators from the turning operation are used as input to the approach: the RMS value of the cutting force and torque, the machining duration, and the total machined length. They are used by the approach to estimate the size of the flank wear (VB). Different neural networks are tested but the best results are achieved with an architecture containing two hidden layers: the first one containing six neurons with a Tanh activation function and the second one containing six neurons with an ReLu activation function. The novelty of the approach makes it possible, by using the bootstrap approach, to determine a confidence interval around the prediction. The results show that the networks are able to accurately track the degradation and detect the end of life of the cutting tools in a timely manner, but also that the confidence interval allows an estimate of the possible variation of the prediction to be made, thus helping in the decision for optimal tool replacement policies. [ABSTRACT FROM AUTHOR]

Speckle reduction is a key preprocessing approach for the applications of Synthetic Aperture Radar (SAR) data. For many interpretation tasks, high-quality SAR images with a rich texture and structure information are useful. Therefore, a satisfactory SAR image filter should retain this information well after processing. Some quantitative assessment indicators have been presented to evaluate the edge-preservation capability of single-polarization SAR filters, among which the non-clean-reference-based (i.e., blind) ones are attractive. However, most of these indicators are derived based only on the basic fact that the speckle is a kind of multiplicative noise, and they do not take into account the detailed statistical distribution traits of SAR data, making the assessment not robust enough. Moreover, to our knowledge, there are no specific blind assessment indicators for fully Polarimetric SAR (PolSAR) filters up to now. In this paper, a blind assessment indicator based on an SAR Ratio Gradient Operator (RGO) and Confidence Interval Estimation (CIE) is proposed. The RGO is employed to quantify the edge gradient between two neighboring image patches in both the speckled and filtered data. A decision is then made as to whether the ratio gradient value in the filtered image is close to that in the unobserved clean image by considering the statistical traits of speckle and a CIE method. The proposed indicator is also extended to assess the PolSAR filters by transforming the polarimetric scattering matrix into a scalar which follows a Gamma distribution. Experiments on the simulated SAR dataset and three real-world SAR images acquired by ALOS-PALSAR, AirSAR, and TerraSAR-X validate the robustness and reliability of the proposed indicator. [ABSTRACT FROM AUTHOR]

This paper introduces a new adaptive framework for fault detection and diagnosis using neural-based PCA. This framework addresses the limitations of traditional PCA in handling time-varying processes. The adaptive framework updates the correlation matrix recursively, allowing it to adapt to the natural time-varying behavior of processes. It also recursively determines the number of principal components and the confidence limits for three process monitoring statistics (T2, Q, and the combined index φ). To diagnose faults, four different types of contribution plots are used as follows: complete decomposition contributions (CDC), partial decomposition contributions (PDC), diagonal-based contributions (DBCs), and reconstruction-based contributions (RBCs). The evaluation through three simulation studies—including a numerical example, the continuous stirred tank reactor (CSTR) process, and water resource recovery facilities (WRRFs)—demonstrates that the combined statistics provided superior fault detection and diagnosis performance compared with individual statistics. Additionally, the study of the isolation method shows that no single method can definitively be claimed as superior. Overall, our study highlights the strength and versatility of neural-based PCA for detecting and diagnosing faults in dynamic processes. [ABSTRACT FROM AUTHOR]

This paper explores the inference for a constant-stress accelerated life test under a ranked set sampling scenario. When the lifetime of products follows the Fréchet distribution, and the failure times are collected under a maximum ranked set sampling with unequal samples, classical and Bayesian approaches are proposed, respectively. Maximum likelihood estimators along with the existence and uniqueness of model parameters are established, and the corresponding asymptotic confidence intervals are constructed based on asymptotic theory. Under squared error loss, Bayesian estimation and highest posterior density confidence intervals are provided, and an associated Monte-Carlo sampling algorithm is proposed for complex posterior computation. Finally, extensive simulation studies are conducted to demonstrate the performance of different methods, and a real-data example is also presented for applications. [ABSTRACT FROM AUTHOR]

This paper introduces a new four-parameter additive model, named xgamma-Burr XII distribution, by considering two competing risks: the former has the xgamma distribution and the latter has the Burr XII distribution. A graphical description of the xgamma-Burr XII distribution is presented, including plots of the probability density function, hazard rate and reversed hazard rate functions. The xgamma-Burr XII density has different shapes such as decreasing, unimodal, approximately symmetric and decreasing-unimodal. The main statistical properties of the proposed model are studied. The unknown model parameters, reliability, hazard rate and reversed hazard rate functions are estimated via the maximum likelihood method. The asymptotic confidence intervals of the parameters, reliability function, hazard rate function and reversed hazard rate function are also obtained. A simulation study is carried out to evaluate the performance of the maximum likelihood estimates. In addition, three real data are applied to show the superiority of the xgamma-Burr XII distribution over some known distributions in real-life applications. [ABSTRACT FROM AUTHOR]

Increasing yield is an important goal of barley breeding. In this study, 54 papers published from 2001–2022 on QTL mapping for yield and yield-related traits in barley were collected, which contained 1080 QTLs mapped to the barley high-density consensus map for QTL meta-analysis. These initial QTLs were integrated into 85 meta-QTLs (MQTL) with a mean confidence interval (CI) of 2.76 cM, which was 7.86-fold narrower than the CI of the initial QTL. Among these 85 MQTLs, 68 MQTLs were validated in GWAS studies, and 25 breeder's MQTLs were screened from them. Seventeen barley orthologs of yield-related genes in rice and maize were identified within the hcMQTL region based on comparative genomics strategy and were presumed to be reliable candidates for controlling yield-related traits. The results of this study provide useful information for molecular marker-assisted breeding and candidate gene mining of yield-related traits in barley. [ABSTRACT FROM AUTHOR]

Introduction/Objectives: Social determinants of health (SDoH) screening and intervention in pediatric primary care depends upon caregiver disclosure of adverse household or social conditions and thus may be influenced by perceived bias or stigma. This paper examines to what extent parents' experience of their child's medical home is associated with their perceptions of a practice-based social needs intervention. Methods: We conducted a cohort study of data reported by 73 parents of children obtaining care in a medical home with an embedded SDoH navigation program. Using survey data collected in October 2021 and October 2022, we calculated descriptive statistics and non-parametric bivariate analyses of the association between engagement with the SDoH navigation program and parent-reported social needs, stress, and perception of care quality as measured by the Person-Centered Primary Care Measure (PCPCM). Results: Initial ratings of care quality were high (mean baseline PCPCM score = 3.63) and remained high on second interview (mean change in PCPCM score = −0.04, 95%CI −0.16, 0.09, P =.58) despite significant reductions in parents' ratings of access to care over time. Parents reported substantial stress, unmet social needs, and unmet healthcare needs, with 41 families (56%) ever using the practice-based SDoH program, including 16 (22%) who were new users in 2022. There was no association observed between PCPCM score and parent stress, unmet social needs, or use of SDoH services. Conclusions: Parents' perceptions of care delivered in their child's medical home appears to be stable on repeat measurement, and independent of family context or interactions with social needs navigation services offered in the practice. [ABSTRACT FROM AUTHOR]

Increasing snow accumulation over the Antarctic Ice Sheet may mitigate future sea level rise. However, current estimates of mitigation potential are poorly constrained due to limited records of past variability. We present an annually resolved reconstruction of Antarctic snow accumulation from 1801 to 2000 CE, employing a paleoclimate data assimilation methodology to integrate ice core records with a multi‐model ensemble of climate simulations. Our reconstruction correlates well with instrumental reanalysis, and we find that Antarctic accumulation rates increased over the 20th‐century, resulting in a modest amount (∼1 mm) of sea level mitigation. Mitigation is primarily driven by an accelerating trend since around 1970. Our results contrast with previous mitigation estimates of ∼10–12 mm; this discrepancy is due to poorly constrained baseline estimates of 19th‐century accumulation in East Antarctica. Our reconstruction suggests that the uncertainty of future sea level mitigation from increasing Antarctic accumulation has been underestimated. Plain Language Summary: Ice loss from Antarctica causes sea level to rise, but Antarctica can also mitigate sea level rise if snowfall on the continent increases faster than the ice loss. There is not currently a consensus on whether Antarctica will contribute to or mitigate sea level rise in the coming century, due to a lack of Antarctic snowfall records. In this paper, we merge information from ice core records with climate models to reconstruct annual Antarctic snowfall from 1801 to 2000. We find that snowfall on Antarctica increased during the 20th‐century, but only had a modest counteracting effect of 1 mm on sea level rise in the 20th‐century, much less than a previous estimate of 10 mm. The large discrepancy is due to uncertainty in East Antarctic accumulation in the 19th‐century. The potential for Antarctica to mitigate sea level is uncertain, affecting projections for future sea level rise. Key Points: Antarctic accumulation reconstruction using paleoclimate data assimilation finds modest (∼1 mm) 20th‐century sea level mitigationWe find similar 20th‐century trends to previous work; lower sea level mitigation (1 vs. 10 mm) is due to the 19th‐century baselineUncertainty in past East Antarctic accumulation limits confidence in future projections of Antarctic sea level mitigation [ABSTRACT FROM AUTHOR]

Estimation of reliability and stress–strength parameters is important in the manufacturing industry. In this paper, we develop shrinkage-type estimators for the reliability and stress–strength parameters based on progressively censored data from a rich class of distributions. These new estimators improve the performance of the commonly used Maximum Likelihood Estimators (MLEs) by reducing their mean squared errors. We provide analytical asymptotic and bootstrap confidence intervals for the targeted parameters. Through a detailed simulation study, we demonstrate that the new estimators have better performance than the MLEs. Finally, we illustrate the application of the new methods to two industrial data sets, showcasing their practical relevance and effectiveness. [ABSTRACT FROM AUTHOR]

Background: One of the most prevalent illnesses of the shoulder is rotator cuff tendinosis, which is also a major contributor to shoulder discomfort and shoulder joint dysfunction. According to statistics, rotator cuff tendinosis occurs in 0.3–5.5% of cases and affects 0.5–7.4% of people annually. It will be necessary to conduct a meta-analysis to evaluate the efficacy of hypertonic glucose proliferation therapy in the treatment of rotator cuff problems. Methods: The databases Cochrane PubMed, Library, Web of Science and EMbase, are retrieved by the computer. Individuals with rotator cuff lesions in the intervention group were treated with hypertonic dextrose proliferation therapy, whereas individuals in the control condition were treated with a placebo. Outcome markers for rotator cuff lesions patients; Pursuant to studies, the visual analogue scale (VAS) score, the shoulder pain & disability index (SPADI), & other metrics are used to evaluate the effects of hypertonic dextrose proliferation treatment on individuals with rotator cuff diseases. After carefully evaluating the calibre of the literature, data analysis was performed utilising the RevMan 5.3 programme. Results: Meta-analysis finally contained 6 papers. In six investigations, the test & control group's VAS scores improved, with the test team's score considerably outperforming the control team [standardized mean difference (SMD): 1.10; 95% Cl: 0.37,1.83; P < 0.01], shoulder pain and disability index (SPADI) score (SMD:8.13; 95% Cl: 5.34,10.91; P < 0.01), Flexion (SMD:5.73; 95% Cl: 0.99,10.47; P < 0.05), Abduction (SMD:6.49; 95% Cl: 0.66,12.31; P < 0.05), Internal rotation (SMD:-1.74; 95% Cl: -4.25,0.78; P = 0.176) and External rotation (SMD:2.78; 95% Cl: -0.13,5.69; P = 0.062). Conclusion: The findings of this study suggest that individuals with rotator cuff injuries may benefit from hypertonic dextrose proliferation treatment based on the visual analogue scale (VAS) score, the Shoulder Pain and Disability Index (SPADI) score, Flexion, & Abduction. These results must, nevertheless, be supported by high-caliber follow-up research. [ABSTRACT FROM AUTHOR]

In the context of optimization under uncertainty, we consider various combinations of distribution estimation and resampling (bootstrap and bagging) for obtaining samples used to estimate a confidence interval for an optimality gap. This paper makes three experimental contributions to on-going research in data driven stochastic programming: (a) most of the combinations of distribution estimation and resampling result in algorithms that have not been published before, (b) within the algorithms, we describe innovations that improve performance, and (c) we provide open-source software implementations of the algorithms. Among others, three important conclusions can be drawn: using a smoothed point estimate for the optimality gap for the center of the confidence interval is preferable to a purely empirical estimate, bagging often performs better than bootstrap, and smoothed bagging sometimes performs better than bagging based directly on the data. [ABSTRACT FROM AUTHOR]

The rising prevalence of obesity in children calls for new strategies for the provision of effective care by a multidisciplinary team. Telemedicine has overall proven to be an effective tool for promoting a healthy lifestyle. The main objective of the current paper is to present the protocol of our ongoing CardioMetabolic Prevention (CAMP) study and compare its design with published studies on telemedicine in paediatric obesity. Additionally, we analysed the preliminary anthropometric and laboratory data to test the efficacy of our 12-week intensive program that combines in-person and telemedicine support. The program demonstrated a positive impact on body mass index (BMI) and its z-scores in 21 adolescents, and BMI in 18 participating parents. However, we found no effect on body composition, waist circumference, cardiometabolic parameters, or fitness evaluated via a 6-min walk test in adolescents. In conclusion, the combination of in-person and telemedicine intensive support over 35 h delivered by a multidisciplinary team can be beneficial not only for adolescents with obesity but also for their parents. The ongoing CAMP study serves as a platform for precision medicine in future decisions regarding anti-obesity medication in adolescents with obesity. [ABSTRACT FROM AUTHOR]

In this paper, the empirical likelihood and estimations problems in varying coefficient models with right censored data are investigated by using a bias correction method. Naive and residual-adjusted empirical likelihood ratios and estimators of the coefficient functions are constructed, their asymptotic distributions are obtained, and a consistent estimator of the asymptotic variance is given. The obtained results can be directly used to construct the confidence regions of the coefficient functions. Furthermore, a new method for constructing pointwise confidence intervals and simultaneous confidence bands for each coefficient function is also proposed. The proposed method is to directly calibrate the empirical log-likelihood ratio so that the obtained ratio is asymptotically chi-squared. Undersmoothing of each coefficient function is avoided, and existing data-driven methods can also effectively select the optimal bandwidth. Simulation study is performed to compare the empirical likelihood with the normal approximation-based method. An example of real data is used to illustrate our approach. [ABSTRACT FROM AUTHOR]

Background Sexually transmissible infections are important causes of loss of health and lives in women and infants worldwide. This paper presents the methods and results of a systematic review that focuses on the impact of antibiotic treatment for syphilis, chlamydia, and gonorrhoea during pregnancy on birth outcomes for the Lives Saved Tool (LiST). Methods We searched PubMed, Embase, Cochrane Libraries, Global Health and Global Index Medicus for articles available until May 23rd, 2022. The search criteria focused on the impact of treatment for the three sexually transmitted infection among pregnant women. Nearly all the articles found were non-randomized studies. Results Treatment for pregnant women with active syphilis reduced the risk of preterm birth by 52% (95% CI=42%-61%; 11043 participants, 15 studies; low quality); stillbirth by 79% (95% CI=65%-88%; 14667 participants, eight studies; low quality); and low birth weight by 50% (95% CI=41%-58%; 9778 participants, seven studies; moderate quality). Treatment for pregnant women with chlamydia infection reduced the risk of preterm birth by 42% (95% CI=7%-64%; 5468 participants, seven studies; low quality) and might reduce the risk of low birth weight by 40% (95% CI =0%-64%; 4684 participants, four studies; low quality). No studies provided data on treatment of gonorrhoea therefore no meta-analysis was conducted. Conclusions Because few studies adjusted for potential confounding factors, the overall quality of evidence was considered low. However, given the consistent and large effects, we recommend updating the estimated effect of timely detection and treatment for syphilis on preterm birth and stillbirth in the LiST model. More research is required to ascertain the effect of antibiotic treatment for chlamydia and gonorrhoea infection in pregnancy. [ABSTRACT FROM AUTHOR]

This paper is concerned with the process of determining the material parameters of advanced constitutive models for clays. Provided results are applicable already in the early stages of geotechnical survey when no detailed data from laboratory tests of soils expected at construction site are known. A worldwide database of laboratory tests obtained during four year operation of web calibration application ExCalibre was used for this purpose. This application allows automatic calibration of three advanced constitutive soil models based on detailed data from triaxial and edometric tests. The paper describes the process of determining the confidence intervals of each material parameter of modified Cam-clay and hypoplastic clay models for low (CL) and high (CH) plasticity clay according to unified soil classification system (USCS) and tabulates their typical ranges. The purpose of presented work was to contribute to the use of advanced constitutive models among practical engineers. [ABSTRACT FROM AUTHOR]

This note contains instructions and an example concerning the use of a specially constructed graph paper that facilitates the graphical comparison of pairs of competing treatments. The graph paper helps a data analyst to construct simultaneous and nonsimultaneous confidence intervals for all pairwise differences of treatment means and to test for statistically significant differences between all such pairs of treatment means. Unlike analytical techniques, no specialized statistical knowledge and no special tables are required to use the paper. It is intended as a tool that a statistician can readily give to his clients. Step-by-step instructions are given for the preparation of the graphs. It is shown by example how thee graphs simplify and make more informative the statistical comparison of alternative treatments. [ABSTRACT FROM AUTHOR]

Objective Utilities are values of health-related quality of life (HRQoL) based on patient preference for a health status. The purpose of this study was to compare indirect measures to a directly elicited utility. Design Cross-sectional study. Setting and Patients Emory Spine Center and the Emory Center for Chronic Pain at Crawford Long Hospital. Patients at least 18 years of age with chronic pain, defined as pain that persists beyond the normal time of healing, usually beyond 6 months. Measures Chronic pain subjects completed a paper-based, self-administered time trade-off ( TTO) survey, EQ-5 D survey, and a face-to-face ( FTF) TTO interview. Current pain severity was graded using the Numeric Rating Scale-11, subsequently stratified into no (0), mild (1-3), moderate (4-6), and severe (7-10) pain. Results Paired t test comparing FTF TTO and proxy utility measures stratified by severity revealed FTF TTO utility values significantly higher than EQ-5 D utility values for all pain severities (overall mean difference 0.18, standard deviation [ SD] 0.30, P < 0.001; Pearson's correlation 0.34, P < 0.0001); FTF TTO utility values were lower than paper TTO utility values, reaching statistical significance for mild and moderate pain (overall mean difference 0.09, SD 0.29, P = 0.0006; Pearson's correlation 0.38, P < 0.0001). Conclusions This study demonstrates that the EQ-5 D overestimates, whereas the paper version of TTO underestimates, the impact of pain on HRQoL compared with the directly elicited FTF TTO utility. Our findings provide preliminary evidence that utilities vary by method, and directly elicited utility values differ from indirectly elicited measures. [ABSTRACT FROM AUTHOR]

Introduction: Intrinsic capacity (IC) is a multidimensional indicator proposed by the World Health Organization that encompasses mental and physical capacities associated with functional ability. With the help of IC, different pathways of aging can be better understood, and heterogeneity can be captured more effectively. Before IC can be clinically incorporated, it requires valid and usable instruments alongside a comprehensive evaluation of psychometric evidence. Therefore, the present systematic review critically appraised, compared, and summarized the measurement properties of existing IC instruments used by older people. Methods: Published studies were searched in seven databases: EMBASE, MEDLINE, PsycINFO, PubMed, ScienceDirect, Scopus, and Web of Science, until August 2022. The measurement properties of the IC measures were evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). Results: Of the 582 papers initially identified, 10 studies were eligible for inclusion. Seven instruments were classified as five-domain measures, and three as more than five-domain measures. No instrument assessed all nine criteria in the psychometric properties evaluation outlined by COSMIN. The most reported psychometric properties were construct validity (n = 8), measurement invariance (n = 8), and structural validity (n = 7). There was underreporting of content validity, reliability, and measurement error. Conclusion: The present review indicated a general lack of psychometric assessments of existing IC instruments with independent studies as their evidence base. There is a need to explore further the associations of IC and its five domains of interaction, which express the ability of individuals to interact with the environment and affect their functional ability. [ABSTRACT FROM AUTHOR]

This paper focuses on autism spectrum disorder (ASD) and food selectivity, both of which are prevalent in the pediatric population. In this context, the authors paid attention to food selectivity and its possible correlation with the atypicality of sensory processes, outlining the useful rehabilitation treatments to draw on. This research included the parents or caregivers of pediatric patients diagnosed with autism spectrum disorder and placed within a therapeutic clinic. The sample is composed of 111 children, males and females, aged between 2 and 10 years, and includes 60 children diagnosed with autism and 51 children with normotypical development, similar in characteristics but without the disorder. The standardized questionnaire, "Brief Autism Mealtime Behavior Inventory", was developed to examine behavior during meals, especially in children with ASD. The "Brief Sensory Profile", and the "Child Oral and Motor Proficiency Scale", were also administered. The results obtained from the analysis lead to evidence of eating and food selectivity difficulty. Additionally, our study demonstrates that food selectivity can be caused by extreme sensory modulation and sensory problems related to the smell, texture, color, and temperature of food. In fact, the results obtained emphasize the correlation between food selectivity and the sensory domains of taste and smell. Furthermore, this research highlights a correlation between motor skills and eating skills, particularly regarding food selectivity, which is closely associated with atypical and disruptive behaviors during meals. [ABSTRACT FROM AUTHOR]

Background: Treatment for partners of patients diagnosed with sexually transmitted infections (STI), referred to as expedited partner therapy (EPT), is infrequently used in the emergency department (ED). This was a pilot program to initiate and evaluate EPT through medication-in-hand ("take-home") kits or paper prescriptions. In this study we aimed to assess the frequency of EPT prescribing, the efficacy of a randomized best practice advisory (BPA) on the uptake, perceptions of emergency clinicians regarding the EPT pilot, and factors associated with EPT prescribing. Methods: We conducted this pilot study at an academic ED in the midwestern US between August-October 2021. The primary outcome of EPT prescription uptake and the BPA impact was measured via chart abstraction and analyzed through summary statistics and the Fisher exact test. We analyzed the secondary outcome of barriers and facilitators to program implementation through ED staff interviews (physicians, physician assistants, and nurses). We used a rapid qualitative assessment method for the analysis of the interviews. Results: During the study period, 52 ED patients were treated for chlamydia/gonorrhea, and EPT was offered to 25% (95% CI 15%-39%) of them. Expedited partner therapy was prescribed significantly more often (42% vs 8%; P < 0.01) when the interruptive pop-up alert BPA was shown compared to not shown. Barriers identified in the interviews included workflow constraints and knowledge of EPT availability. The BPA was viewed positively by the majority of participants. Conclusion: In this pilot EPT program, expedited partner therapy was provided to 25% of ED patients who appeared eligible to receive it. The interruptive pop-up alert BPA significantly increased EPT prescribing. Barriers identified to EPT prescribing should be the subject of future interventions to improve provision of EPT from the emergency department. [ABSTRACT FROM AUTHOR]

Simple Summary: Downstaging therapies provides a viable alternative approach for expanding the MC limits and selecting a subgroup of patients whose LT candidacy would otherwise be disregarded. However, data on downstaging are still controversial due to a variety of reasons, such as differences in LRT, the wide variability in waiting time before LT and, particularly, the lack of intention-to-treat (ITT) analyses. This article is a systematic review and intends to synthesise the existing evidence about the effectiveness of downstaging therapies, aiming to: (a) assess outcomes from ITT analysis of patients with liver cirrhosis and HCC beyond the listing criteria and selected for downstaging protocol, in comparison with HCC within the listing criteria; (b) evaluate outcomes of patients with liver cirrhosis HCC beyond the listing criteria successfully downstaged and transplanted versus those not transplanted. Background: Locoregional therapies (LRTs) are commonly used to increase the number of potential candidates for liver transplantation (LT). The aim of this paper is to assess the outcomes of LRTs prior to LT in patients with hepatocellular carcinoma (HCC) beyond the listing criteria. Methods: In accordance with the PRISMA guidelines, we searched the Medline and Web of Science databases for reports published before May 2021. We included papers assessing adult patients with HCC considered for LT and reporting intention-to-treat (ITT) survival outcomes. Two reviewers independently identified and extracted the data and evaluated the papers. Outcomes analysed were drop-out rate; time on the waiting list; and 1, 3 and 5 year survival after LT and based on an ITT analysis. Results: The literature search yielded 3,106 records, of which 11 papers (1874 patients) met the inclusion criteria. Patients with HCC beyond the listing criteria and successfully downstaged presented a higher drop-out rate (OR 2.05, 95% CI 1.45–2.88, p < 0.001) and a longer time from the initial assessment to LT than those with HCC within the listing criteria (MD 1.93, 95% CI 0.91–2.94, p < 0.001). The 1, 3 and 5 year survival post-LT and based on an ITT analysis did not show significant differences between the two groups. Patients with HCC beyond the listing criteria, successfully downstaged and then transplanted, presented longer 3 year (OR 3.77, 95% CI 1.26–11.32, p = 0.02) and 5 year overall survival (OS) (OR 3.08, 95% CI 1.15–8.23, p = 0.02) in comparison with those that were not submitted to LT. Conclusions: Patients with HCC beyond the listing criteria undergoing downstaging presented a higher drop-out rate in comparison with those with HCC within the listing criteria. However, the two groups did not present significant differences in 1, 3 and 5 year survival rates based on an ITT analysis. Patients with HCC beyond the listing, when successfully downstaged and transplanted, presented longer 3 and 5-year OS in comparison with those who were not transplanted. [ABSTRACT FROM AUTHOR]

Objective. To analyze and evaluate the effectiveness of traditional Chinese medicine decoction (TCMD) in the treatment of cardiac neurosis (CN) complicated with depression and anxiety. Methods. Relevant literature on TCMD in the treatment of CN complicated with depression and anxiety was retrieved from Chinese and English databases, and the retrieved literature was included and excluded. The quality of the retrieved literature was evaluated according to the Cochrane system, and the meta-analysis was undertaken with RevMan5.3 software. Results. A total of 10 papers were included, including 686 patients and 349 patients in the treatment group (131 males and 218 females), and there were 337 cases in the control group (131 males and 206 females). The results of the meta-analysis showed that compared with the control group, TCMD could significantly improve palpitation (MD = 0.78, 95% CI = 0.55–1.01, P < 0.00001), chest tightness/chest pain (MD = 0.53, 95% CI = 0.10–0.97, P < 0.05), shortness of breath (MD = 0.60, 95% CI = 0.26–0.93, P = 0.0005), and TCM syndrome score (MD = 5.91, 95% CI = 4.32–7.49, P < 0.00001), reduce resting heart rate (MD = 13.21, 95% CI = 9.01–17.40, P < 0.00001), and could reduce psychological scale scores, such as Zung's self-rating Depression Scale (MD = 7.90, 95% CI = 4.98–10.83, P < 0.00001), Zung's self-rating Anxiety Scale (MD = 6.55, 95% CI = 4.25–8.86, P < 0.00001), Hamilton Depression Scale (MD = 4.46, 95% CI = 3.00–5.92, P < 0.00001), and Hamilton Anxiety Scale (MD = 3.35, 95% CI = 1.85–4.85, P < 0.0001). The differences were statistically significant. Tonic drugs were commonly used; Angelica sinensis, Poria cocos, Polygala tenuifolia, Wild jujube kernel, and Bupleurum were the most frequently used traditional Chinese medicines. Conclusion. TCMD mainly composed of tonic and tranquilizing herbs could significantly improve the clinical symptoms of patients with CN and reduce heart rate, anxiety, and depression scores. However, the evidence grade of the clinical research was limited by the quality of the included literature, and more high-quality clinical trials are still needed for further verification. This trial was registered with PROSPERO: CRD42022312164 [ABSTRACT FROM AUTHOR]

Objective: To validate an ion exchange high-pressure liquid chromatography (HPLC) method for measuring glycated hemoglobin (HbA1c) in gingival crevicular blood (GCB) spotted on filter paper, for use in screening dental patients for diabetes. Methods: We collected the GCB specimens for this study from the oral cavities of patients during dental visits, using rigorous strategies to obtain GCB that was as free of debris as possible. The analytical performance of the HPLC method was determined by measuring the precision, linearity, carryover, stability of HbA1c in GCB, and correlation of HbA1c results in GCB specimens with finger-stick blood (FSB) specimens spotted on filter paper. Results: The coefficients of variation (CVs) for the inter- and intrarun precision of the method were less than 2.0%. Linearity ranged between 4.2% and 12.4%; carryover was less than 2.0%, and the stability of the specimen was 6 days at 4ºC and as many as 14 days at -70ºC. Linear regression analysis comparing the HbA1c results in GCB with FSB yielded a correlation coefficient of 0.993, a slope of 0.981, and an intercept of 0.13. The Bland-Altman plot showed no difference in the HbA1c results from the GCB and FSB specimens at normal, prediabetes, and diabetes HbA1c levels. Conclusion: We validated an HPLC method for measuring HbA1c in GCB; this method can be used to screen dental patients for diabetes. [ABSTRACT FROM AUTHOR]

Background: Socioeconomic, technological, and political developments have led to significant changes in the nursing profession in Israel. One major shift is the expansion of nurse authority. Aims: To explore the attitudes of physicians and nurses in Israel towards the expansion of nurses' authority to perform Peripheral Intra Venous cannulation. In addition, the study evaluated the influence of physicians' and nurses' collaboration and the nursing image on the decision for expansion of nurse authority to perform PIV cannulation. Methodology: Questionnaires were distributed to 100 Israeli physicians and 100 Israeli registered nurses using cross sectional correlation methods. Results: Nurses' and physicians' attitudes towards expansion of nurse authority to cannulate were generally positive. The attitudes towards physician-nurse collaboration, nursing image, and the advantages of performing Peripheral Intra Venous cannulation by nurses, were found to be related to the respondents' attitudes towards expansion of nurses' authority to perform Peripheral Intra Venous cannulation. Conclusion: Promotion of physician-nurse collaboration, a positive image of nursing, and advantages of performing Peripheral Intra Venous cannulation may improve the attitudes of both physicians and nurses towards the expansion of nurses' authority to perform Peripheral Intra Venous cannulation. [ABSTRACT FROM AUTHOR]

Increasing concentrations of dissolved inorganic carbon (DIC) in the interior ocean is expected as a direct consequence of increasing concentrations of CO2 in the atmosphere. This extra DIC is often referred to as anthropogenic carbon (Cant), and its inventory, or increase rate, in the interior ocean has previously been estimated by a multitude of observational approaches. Each of these methods are associated with hard to test assumptions since Cant cannot be directly observed. Results from a simpler concept with few assumptions applied to the Atlantic Ocean are reported on here using two large data collections of carbon relevant bottle data. The change in column inventory on decadal time scales, i.e. the storage rate, of DIC, respiration compensated DIC and oxygen is calculated for the Atlantic Ocean. The average storage rates for DIC and oxygen is calculated to 0.72±1.22 (95% confidence interval of the mean trend: 0.65-0.78) molm-2 yr-1 and -0.54±1.64 (95% confidence interval of the mean trend: -0.64-(-0.45)) molm-2 yr-1 , respectively, for the Atlantic Ocean, where the uncertainties reflect station-to-station variability and where the mean trends are non-zero at the 95% confidence level. The standard deviation mainly reflects uncertainty due to regional variations, whereas the confidence interval reflects the mean trend. The storage rates are similar to changes found by other studies, although with large uncertainty. For the subpolar North Atlantic the storage rates show significant temporal variation of all variables. This seems to be due to variations in the prevalence of subsurface water masses with different DIC concentrations leading to sometimes different signs of storage rates for DIC and Cant . This study suggest that accurate assessment of the uptake of CO2 by the oceans will require accounting not only for processes that influence Cant but also additional processes that modify CO2 storage. [ABSTRACT FROM AUTHOR]

Background: To determine the severity of dental fluorosis in selected populations in Chiang Mai, Thailand with different exposures to fluoride and to explore possible risk indicators for dental fluorosis. Methods: Subjects were male and female lifetime residents aged 8.13 years. For each child the fluoride content of drinking and cooking water samples were assessed. Digital images were taken of the maxillary central incisors for later blind scoring for TF index (10% repeat scores). Interview data explored previous cooking and drinking water use, exposure to fluoride, infant feeding patterns and oral hygiene practices. Results: Data from 560 subjects were available for analysis (298 M, 262 F). A weighted kappa of 0.80 was obtained for repeat photographic scores. The prevalence of fluorosis (TF 3+) for subjects consuming drinking and cooking water with a fluoride concentration of <0.9 ppm was 10.2%. For subjects consuming drinking and cooking water >0.9 ppm F the prevalence of fluorosis (TF 3+) rose to 37.3%. Drinking and cooking water at age 3, water used for infant formula and water used for preparing infant food all demonstrated an increase in fluorosis severity with increase in water fluoride level (p<0.001). The probability estimate for the presentation of aesthetically significant fluorosis was 0.53 for exposure to high fluoride drinking (.0.9 ppm) and cooking water (.1.6 ppm). Conclusions: The consumption of drinking water with fluoride content >0.9 ppm and use of cooking water with fluoride content >1.6 ppm were associated with an increased risk of aesthetically significant dental fluorosis. Fluoride levels in the current drinking and cooking water sources were strongly correlated with fluorosis severity. Further work is needed to explore fluorosis risk in relation to total fluoride intake from all sources including food preparation. [ABSTRACT FROM AUTHOR]

Background. Among the surgical methods for lumbar disc herniation, open lumbar microdiscectomy is considered the gold standard. Recently, percutaneous endoscopic lumbar discectomy is also commonly performed for lumbar disc herniation for its various strong points. Objectives. The present study aims to examine whether percutaneous endoscopic lumbar discectomy and open lumbar microdiscectomy show better results as surgical treatments for lumbar disc herniation in the Korean population. Methods. In the present meta-analysis, papers on Korean patients who underwent open lumbar microdiscectomy and percutaneous endoscopic lumbar discectomy were searched, both of which are surgical methods to treat lumbar disc herniation. The papers from 1973, when percutaneous endoscopic lumbar discectomy was first introduced, to March 2018 were searched at the databases of MEDLINE, EMBASE, PubMed, and Cochrane Library. Results. Seven papers with 1254 patients were selected. A comparison study revealed that percutaneous endoscopic lumbar discectomy had significantly better results than open lumbar microdiscectomy in the visual analogue pain scale at the final follow-up (leg: mean difference [MD]=-0.35; 95% confidence interval [CI]=-0.61, -0.09; p=0.009; back: MD=-0.79; 95% confidence interval [CI]=-1.42, -0.17; p=0.01), Oswestry Disability Index (MD=-2.12; 95% CI=-4.25, 0.01; p=0.05), operation time (MD=-23.06; 95% CI=-32.42, -13.70; p<0.00001), and hospital stay (MD=-4.64; 95% CI=-6.37, -2.90; p<0.00001). There were no statistical differences in the MacNab classification (odds ratio [OR]=1.02; 95% CI=0.71, 1.49; p=0.90), complication rate (OR=0.72; 95% CI=0.20, 2.62; p=0.62), recurrence rate (OR=0.83; 95% CI=0.50, 1.38; p=0.47), and reoperation rate (OR=1.45; 95% CI=0.89, 2.35; p=0.13). Limitations. All 7 papers used for the meta-analysis were non-RCTs. Some differences (type of surgery (primary or revisional), treatment options before the operation, follow-up period, etc.) existed depending on the selected paper, and the sample size was small as well. Conclusion. While percutaneous endoscopic lumbar discectomy showed better results than open lumbar microdiscectomy in some items, open lumbar microdiscectomy still showed good clinical results, and it is therefore reckoned that a randomized controlled trial with a large sample size would be required in the future to compare these two surgical methods. [ABSTRACT FROM AUTHOR]

Objective. This paper aims to systematically evaluate the intervention effect of mind-body exercise on cancer-related fatigue in breast cancer patients. Methods. Databases including PubMed, the Cochrane Library, Embase, Web of Science, CNKI, Wanfang Data, and SINOMED were retrieved to collect randomized controlled trials on the effects of mind-body exercise on relieving cancer-related fatigue in breast cancer patients. The retrieval period started from the founding date of each database to January 6, 2021. Cochrane bias risk assessment tools were used to evaluate the methodological quality assessment of the included literature, and RevMan 5.3 software was used for meta-analyses. Results. 17 pieces of researches in 16 papers were included with a total of 1133 patients. Compared with the control group, mind-body exercise can improve cancer-related fatigue in breast cancer patients. The combined effect size SMD = 0.59, 95% CI was [0.27, 0.92], p < 0.00001. Doing Tai Chi for over 40 minutes each time with an exercise cycle of ≤6 weeks can improve cancer-related fatigue in breast cancer patients more significantly. Sensitivity analysis shows that the combined effect results of the meta-analysis were relatively stable. Conclusion. Mind-body exercise can effectively improve cancer-related fatigue in breast cancer patients. [ABSTRACT FROM AUTHOR]

Applied macroeconomists often compute confidence intervals for impulse responses using local projections, that is, direct linear regressions of future outcomes on current covariates. This paper proves that local projection inference robustly handles two issues that commonly arise in applications: highly persistent data and the estimation of impulse responses at long horizons. We consider local projections that control for lags of the variables in the regression. We show that lag‐augmented local projections with normal critical values are asymptotically valid uniformly over (i) both stationary and non‐stationary data, and also over (ii) a wide range of response horizons. Moreover, lag augmentation obviates the need to correct standard errors for serial correlation in the regression residuals. Hence, local projection inference is arguably both simpler than previously thought and more robust than standard autoregressive inference, whose validity is known to depend sensitively on the persistence of the data and on the length of the horizon. [ABSTRACT FROM AUTHOR]

Objective. This study aims to explore the influences of Tai Chi on the balance function and exercise capacity among stroke patients. Methods. Databases including PubMed, Embase, WOS (Web of Science), the Cochrane Library, CNKI (China National Knowledge Infrastructure), Wanfang Data, VIP (VIP database), and CBM (China Biology Medicine disc) were retrieved to gather the figures of randomized controlled trials on the balance function and exercise capacity among stroke patients. Then relevant data were input and analyzed in Review Manager 5.3. Results. Nineteen papers were included and analyzed in this study. According to the combined effect size, the balance function of stroke patients improved significantly: the Berg Balance Function Scale score [MD = 7.67, 95% CI (3.44, 11.90)]; standing and walking test scores [MD = 3.42, 95% CI (4.22, −2.63)]; gravity swing area [MD = 0.79, 95% CI (1.48, 0.10)]; and gravity swing speed [MD = −5.43, 95% CI (−7.79, 3.08)]. In addition, the exercise capacity improved significantly as well: the FMA (Fugl-Meyer Assessment Scale) scale score [MD = 4.15, 95% CI (1.68, 6.63)]. There are no significant influences or changes of other related results. Conclusions. Stroke patients are able to improve their balance functions and exercise capacities prominently when they do Tai Chi exercise once or twice a week and ≥5 times/week and >30 ≤ 60 min/time. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to evaluate the association between hyperthyroidism and the risk of developing erectile dysfunction (ED). Methods: A comprehensive search of multiple databases, including PubMed, Embase, Cochrane, and Web of Science, was conducted to identify relevant studies investigating the relationship between hyperthyroidism and ED in men. The quality of the included studies was assessed using the Newcastle‒Ottawa Quality Rating Scale, and a meta-analysis was performed using Stata 16.0 and RevMan 5.3 software. Results: A total of four papers encompassing 25,519 study subjects were included in the analysis. Among these, 6,429 individuals had hyperthyroidism, while 19,090 served as controls. The overall prevalence of ED in patients with hyperthyroidism was determined to be 31.1% (95% CI 0.06–0.56). In patients with uncomplicated hyperthyroidism, the incidence of ED was 21.9% (95% CI 0.05–0.38). The combined odds ratio (OR) for the four studies was 1.73 (OR: 1.73; 95% CI [1.46–2.04]; p <.00001). Conclusion: Our findings demonstrate a higher incidence of ED in patients with hyperthyroidism. These results provide valuable information for healthcare professionals and can facilitate discussions surrounding appropriate treatment options for ED in patients with hyperthyroidism. [ABSTRACT FROM AUTHOR]

Background: Several reviews have examined the health benefits of participation in specific sports, such as baseball, cricket, cross-country skiing, cycling, downhill skiing, football, golf, judo, rugby, running and swimming. However, new primary studies on the topic have recently been published, and the respective meta-analytic evidence needs to be updated. Objectives: To systematically review, summarise and appraise evidence on physical health benefits of participation in different recreational sports. Methods: Searches for journal articles were conducted in PubMed/MEDLINE, Scopus, SpoLit, SPORTDiscus, Sports Medicine & Education Index and Web of Science. We included longitudinal and intervention studies investigating physical health outcomes associated with participation in a given sport among generally healthy adults without disability. Results: A total of 136 papers from 76 studies conducted among 2.6 million participants were included in the review. Our meta-analyses of available evidence found that: (1) cycling reduces the risk of coronary heart disease by 16% (pooled hazard ratio [HR] = 0.84; 95% confidence interval [CI]: 0.80, 0.89), all-cause mortality by 21% (HR = 0.79; 95% CI: 0.73, 0.84), cancer mortality by 10% (HR = 0.90; 95% CI: 0.85, 0.96) and cardiovascular mortality by 20% (HR = 0.80; 95% CI: 0.74, 0.86); (2) football has favourable effects on body composition, blood lipids, fasting blood glucose, blood pressure, cardiovascular function at rest, cardiorespiratory fitness and bone strength (p < 0.050); (3) handball has favourable effects on body composition and cardiorespiratory fitness (p < 0.050); (4) running reduces the risk of all-cause mortality by 23% (HR = 0.77; 95% CI: 0.70, 0.85), cancer mortality by 20% (HR = 0.80; 95% CI: 0.72, 0.89) and cardiovascular mortality by 27% (HR = 0.73; 95% CI: 0.57, 0.94) and improves body composition, cardiovascular function at rest and cardiorespiratory fitness (p < 0.010); and (5) swimming reduces the risk of all-cause mortality by 24% (HR = 0.76; 95% CI: 0.63, 0.92) and improves body composition and blood lipids (p < 0.010). Conclusions: A range of physical health benefits are associated with participation in recreational cycling, football, handball, running and swimming. More studies are needed to enable meta-analyses of health benefits of participation in other sports. PROSPERO registration number CRD42021234839. Key Points: We found a reduced risk of all-cause mortality associated with cycling (–21%), running (–23%) and swimming (–24%). Running also improves body composition, cardiovascular function at rest and cardiorespiratory fitness, while swimming also improves body composition and blood lipids. Football improves body composition, blood lipids, fasting blood glucose, blood pressure, cardiovascular function at rest, cardiorespiratory fitness and bone strength, while handball improves body composition and cardiorespiratory fitness. [ABSTRACT FROM AUTHOR]

Simple Summary: Completion lobectomy (CL) entails the resection of the remaining pulmonary lobe subsequent to wedge resection or segmentectomy. Indications for CL include reoperations for multiple or relapsed lung cancers and metastatic lung tumors, and the prognostic advantage of these procedures has been widely reported. However, ipsilateral surgical treatments, particularly within the same lobe, present challenges due to the development of intrapleural adhesions, rendering reoperation more difficult and time-consuming. VATS has emerged as the gold standard in the surgical treatment of early-stage NSCLC, offering superior postoperative outcomes when compared to thoracotomy. Its efficacy has been well established, even during complex procedures. However, its application in ipsilateral reoperations remains anecdotal, and to the best of our knowledge, no studies have analyzed the safety and efficacy of uniportal-VATS in this setting. This paper aims to evaluate the role of iniportal-VATS in CL long after wedge resection or anatomical segmentectomy in the same lobe. Background: Completion lobectomy (CL) following a prior resection in the same lobe may be complicated by severe pleural or hilar adhesions. The role of uniportal video-assisted thoracoscopic surgery (U-VATS) has never been evaluated in this setting. Methods: Data were collected from two Italian centers. Between 2015 and 2022, 122 patients (60 men and 62 women, median age 67.7 ± 8.913) underwent U-VATS CL at least 4 weeks after previous lung surgery. Results: Twenty-eight (22.9%) patients were affected by chronic obstructive pulmonary disease (COPD) and twenty-five (20.4%) were active smokers. Among the cohort, the initial surgery was performed using U-VATS in 103 (84.4%) patients, triportal-VATS in 8 (6.6%), and thoracotomy in 11 (9.0%). Anatomical segmentectomy was the initial surgery in 46 (37.7%) patients, while hilar lymphadenectomy was performed in 16 (13.1%) cases. CL was performed on 110 (90.2%) patients, segmentectomy on 10 (8.2%), and completion pneumonectomy on 2 (1.6%). Upon reoperation, moderate pleural adhesions were observed in 38 (31.1%) patients, with 2 (1.6%) exhibiting strong adhesions. Moderate hilar adhesions were found in 18 (14.8%) patients and strong adhesions in 11 (9.0%). The median operative time was 203.93 ± 74.4 min. In four (3.3%) patients, PA taping was performed. One patient experienced intraoperative bleeding that did not require conversion to thoracotomy. Conversion to thoracotomy was necessary in three (2.5%) patients. The median postoperative drainage stay and postoperative hospital stay were 5.67 ± 4.44 and 5.52 ± 2.66 days, respectively. Postoperative complications occurred in 34 (27.9%) patients. Thirty-day mortality was null. Histology was the only factor found to negatively influence intraoperative outcomes (p = 0.000). Factors identified as negatively impacting postoperative outcomes at univariate analyses were male sex (p = 0.003), age > 60 years (p = 0.003), COPD (p = 0.014), previous thoracotomy (p = 0.000), previous S2 segmentectomy (p = 0.001), previous S8 segmentectomy (p = 0.008), and interval between operations > 5 weeks (p= 0.005). In multivariate analysis, only COPD confirmed its role as an independent risk factor for postoperative complications (HR: 5.12, 95% CI (1.07–24.50), p = 0.04). Conclusions: U-VATS CL seems feasible and safe after wedge resection and anatomical segmentectomy. [ABSTRACT FROM AUTHOR]

Satellite communication is proposed to fulfill the ubiquitous coverage for next-generation wireless networks. Considering the propagation delay and path loss, low-earth orbit (LEO) satellites are widely adopted. However, since the beam boresight directions become close in quasi-earth-fixed cells (QEFC) scenarios at low elevation angles, the interference increases and causes low communication quality. This paper introduces the optimal beamwidth maximizing uplink coverage probability scheme for quasi-earth-fixed cells in LEO satellite communication systems. The proposed scheme dynamically adjusts the beamwidth to achieve max uplink coverage probability at different elevation angles. The simulation results show that the proposed scheme matches the exhaustive search method in different scenarios and target signal-to-interference-plus-noise ratios. Furthermore, the proposed scheme significantly mitigates interference and improves the uplink coverage probability. Compared with the 3GPP setting, the proposed scheme improves the uplink coverage probability by 0.93 at time 100 s, and compared with the three-color frequency reuse, the proposed scheme improves the uplink coverage probability by 0.195 at time 100 s. The dynamic beamwidth and boresight direction adjustments enable the satellite to maintain seamless and reliable communication services across a wide range of operating conditions, ultimately realizing the goal of ubiquitous communications in the QEFC LEO satellite system. [ABSTRACT FROM AUTHOR]

Peritoneal dialysis(PD) is one of the most efficient methods in end‐stage kidney disease, and it is very important for PD to perform well. No research has been conducted to evaluate the effect of various types of PD catheters on the prognosis of post‐operative wound complications. While recent meta‐analyses are in favour of straight tubing, there is still uncertainty as to whether direct or coiled PD is beneficial. The purpose of this meta‐analysis was to compare the efficacy of direct and coiled PD catheters on the incidence of post‐operative wound infection, bleeding and peritonitis. A comprehensive search was carried out on three databases, including PubMed and Embase, and a manual search was carried out on the links in the paper. The results showed that the incidence rate of bleeding after operation and the degree of infection among the straight and coiled pipes were compared. The results showed that there were no statistically significant differences in the incidence of post‐operative wound infection among straight PD patients with coiled PD (OR, 0.79; 95% CI, 0.58–1.08 p = 0.13). No statistical significance was found in the case of PD with coiled tubing compared with that of straight PD group in wound leakage (OR, 1.17; 95% CI, 0.71–1.93 p = 0.55). No statistically significantly different rates of post‐operative peritonitis were observed for coiled tubing compared with straight ones in PD patients (OR, 1.06; 95% CI, 0.78–1.45 p = 0.7). There is no statistical significance on the rate of wound infection, wound leakage and peritonitis among coiled and straight tube in PD. [ABSTRACT FROM AUTHOR]

Trabeculectomy is the main surgical treatment for glaucoma, but scar formation during wound healing may lead to surgical failure. In this study, we evaluated the efficacy of anti‐vascular endothelial growth factor (anti‐VEGF) and mitomycin C (MMC) on wound healing after glaucoma surgery. We have been looking for Pubmed, Embase and other databases. The last time we looked at an electronic database was August 2023. A case control study was conducted to compare the use of anti‐VEGF and mitomycin C for the treatment of glaucoma. We used the Cochrane standard methodology for collecting and analysing the data. Based on the criteria of inclusion, we have determined 369 related papers and selected seven eligible trials for data analysis. Three hundred and twenty‐six cases were treated with trabeculectomy, of which 166 were injected with anti‐VEGF and 160 were given MMC for trabeculectomy. In six trials, anti‐VEGF and MMC were not found to have any statistical significance on postoperative wound leakage after surgery (OR, 1.55; 95% CI, 0.71, 3.35 p = 0.27). The three trials showed that anti‐VEGF and MMC did not differ in terms of reducing postoperative wound hypotony after surgery (OR, 0.78; 95% CI, 0.20, 3.11 p = 0.73). Five trials demonstrated that anti‐VEGF and MMC were not associated with a lower incidence of shallow anterior chamber (OR, 1.17; 95% CI, 0.5, 2.76 p = 0.71). There is no significant difference in the effect of anti‐VEGF and MMC on wound healing after glaucoma surgery. A multicentre randomized controlled trial with a larger sample size is needed to confirm this study. [ABSTRACT FROM AUTHOR]

Hypertensive disorders of pregnancy (HDPs) represent a significant source of severe maternal and fetal morbidity. Screening strategies relying on traditional medical history and clinical risk factors have traditionally shown relatively modest performance, mainly in the prediction of preeclampsia, displaying a sensitivity of 37% for the early-onset form and 29% for the late-onset form. The development of more accurate predictive and diagnostic models of preeclampsia in the early stages of pregnancy represents a matter of high priority. The aim of the present paper is to create an effective second trimester prediction algorithm of early-onset HDP occurrence and severity, by combining the following two biochemical markers: a soluble fms-like tyrosine kinase 1 (sFlt-1)/placental growth factor (PlGF) ratio and uterine artery Doppler ultrasound parameters, namely the pulsatility index (PI) and the resistivity index (RI), in a population of high-risk pregnant women, initially assessed through traditional risk factors. A prospective single-center observational longitudinal study was conducted, in which 100 women with singleton pregnancy and traditional clinical and medical history risk factors for preeclampsia were enrolled at 24 weeks of gestation. Shortly after study enrollment, all women had their sFlt-1 and PlGF levels and mean uterine artery PI and RI determined. All pregnancies were followed up until delivery. Receiver operating characteristic (ROC) analysis established algorithms based on cutoffs for the prediction of the later development of preeclampsia: PI 1.25 (96.15% sensitivity, 86.49% specificity), RI 0.62 (84.6% sensitivity, 89.2% specificity) and sFlt-1/PlGF ratio 59.55 (100% sensitivity, 89.2% specificity). The sFlt-1/PlGF ratio was the best predictor for preeclampsia, as it displayed the highest area under the curve (AUC) of 0.973. The prediction algorithm for the severe form of preeclampsia, complicated by fetal growth restriction leading to preterm birth, antepartum fetal demise or acute fetal distress with a cerebro-placental ratio of

SARS-CoV-2 serology may be helpful to retrospectively understand infection dynamics in specific settings including kindergartens. We assessed SARS-CoV-2 seroprevalence in individuals connected to kindergartens in Berlin, Germany in September 2021. Children, staff, and household members from 12 randomly selected kindergartens were interviewed on COVID-19 history and sociodemographic parameters. Blood samples were collected on filter paper. SARS-CoV-2 anti-S and anti-N antibodies were assessed using Roche Elecsys. We assessed seroprevalence and the proportion of so far unrecognized SARS-CoV-2 infections. We included 277 participants, comprising 48 (17.3%) kindergarten children, 37 (13.4%) staff, and 192 (69.3%) household members. SARS-CoV-2 antibodies were present in 65.0%, and 52.7% of all participants were vaccinated. Evidence of previous infection was observed in 16.7% of kindergarten children, 16.2% of staff, and 10.4% of household members. Undiagnosed infections were observed in 12.5%, 5.4%, and 3.6%, respectively. Preceding infections were associated with facemask neglect. In conclusion, two-thirds of our cohort were SARS-CoV-2 seroreactive in September 2021, largely as a result of vaccination in adults. Kindergarten children showed the highest proportion of non-vaccine-induced seropositivity and an increased proportion of previously unrecognized SARS-CoV-2 infection. Silent infections in pre-school children need to be considered when interpreting SARS-CoV-2 infections in the kindergarten context. [ABSTRACT FROM AUTHOR]

Background: Shortages of mechanical ventilation have become a constant problem in Emergency Departments (EDs), thereby affecting the timely deployment of medical interventions that counteract the severe health complications experienced during respiratory disease seasons. It is then necessary to count on agile and robust methodological approaches predicting the expected demand loads to EDs while supporting the timely allocation of ventilators. In this paper, we propose an integration of Artificial Intelligence (AI) and Discrete-event Simulation (DES) to design effective interventions ensuring the high availability of ventilators for patients needing these devices. Methods: First, we applied Random Forest (RF) to estimate the mechanical ventilation probability of respiratory-affected patients entering the emergency wards. Second, we introduced the RF predictions into a DES model to diagnose the response of EDs in terms of mechanical ventilator availability. Lately, we pretested two different interventions suggested by decision-makers to address the scarcity of this resource. A case study in a European hospital group was used to validate the proposed methodology. Results: The number of patients in the training cohort was 734, while the test group comprised 315. The sensitivity of the AI model was 93.08% (95% confidence interval, [88.46 − 96.26%]), whilst the specificity was 85.45% [77.45 − 91.45%]. On the other hand, the positive and negative predictive values were 91.62% (86.75 − 95.13%) and 87.85% (80.12 − 93.36%). Also, the Receiver Operator Characteristic (ROC) curve plot was 95.00% (89.25 − 100%). Finally, the median waiting time for mechanical ventilation was decreased by 17.48% after implementing a new resource capacity strategy. Conclusions: Combining AI and DES helps healthcare decision-makers to elucidate interventions shortening the waiting times for mechanical ventilators in EDs during respiratory disease epidemics and pandemics. [ABSTRACT FROM AUTHOR]

Relationships between students and external partners in work-integrated learning can vary and power dynamics, hierarchies and student agency have been under explored in research to date. Integrated research involving workintegrated learning, students as partners and transdisciplinarity presents an opportunity to enrich each of these fields. This paper presents the results of a case study of transdisciplinary project-based work-integrated learning in Australia. Our results highlight that reciprocity and the valuing of student knowledge are key elements in breaking down traditional power dynamics and enabling student agency, in line with the transdisciplinary principle of mutual learning. Participants who valued these elements in their relationship were less likely to frame the relationship in hierarchical terms and were more open to learning from one another. By empowering students to draw on their expertise and reframe challenges while also preparing partners for this kind of relationship, all parties can be positioned as learners within work-integrated learning. [ABSTRACT FROM AUTHOR]