bluuebunny/crossref_metadata_2025 huggingface dataset:
Hubungan antara latis distributif dan aljabar median
Authors: Dahoklory Novita , Patty Henry Willyam Michel
Published: October 2024

Let M be a non-empty set equipped by a ternary operation m:M×M×M→M. The set M is called a median algebra if (M,m) satisfies these properties (1) majority: m(a,a,b)=a, associativity: m(a,b,m(c,b,d) = m(m(a,b,c),b,d), and commutativity: m(a,b,c) = m(a,c,b) = m(b,a,c) for every a,b,c,d∈M. In this paper, we will relate a median algebra and a distributive lattice; every distributive lattice is a median algebra. Moreover, we will study an interval [a,b] in a median algebra (M,m) motivated by closed intervals in R. We will also investigate the basic properties of the interval [a,b] in a median algebra. Furthermore, using these properties, we will show that every interval in a median algebra is conversely a distributive lattice.
Keywords: median algebra, distributive lattices, interval.MSC2020: 06D99.
Escola e prevenção de suicídio de adolescentes
Authors: Gouvêa Elisa , Silva Edilaine de Jesus da
Published: October 2024

Este artigo traz um relato de experiência de um grupo de estudos realizado com estudantes participantes do grêmio estudantil, de uma escola pública do interior paulista, sobre a temática do suicídio. Por meio do aporte teórico-metodológico da Psicologia Histórico-Cultural, apresentamos os conceitos de suicídio, adolescência e a função social da escola, buscando, para este último, algumas vinculações com a Pedagogia Histórico-Crítica. Embasadas teoricamente de tal forma, realizamos quatro encontros com os adolescentes, que viram no espaço promovido uma oportunidade para se expressarem, serem acolhidos e também de darem saltos qualitativos sobre as temáticas estudadas no grupo, apreendendo-as em sua forma mais universal. Com isso, este trabalho tem o objetivo de pensar possibilidades de atuação da/do psicóloga/psicólogo escolar, de forma a fazer cumprir o papel social da escola de promover a socialização de conhecimentos universais e de construção de um espaço emancipatório e democrático de desenvolvimento, superando a lógica patologizante e medicalizante que usualmente opera nesses espaços.
Practical consciousness for avoiding elderly loneliness: Study in Surabaya City, East Java
Authors: Amalia Ayu Diah
Published: October 2024

Social change has an impact on changes within the family in terms of problems and needs. Modernization, industrialization, and urbanization create new problems for the elderly, such as reduced care and neglect due to the loss of the service provider role for the elderly. These conditions lead to elderly social degradation, and loneliness. This study aims to explore the experience of loneliness in the elderly and practical consciousness in managing loneliness. This qualitative research uses social phenomenology approach, and 19 elderly informants joined the research. The results showed that some elderly informants did not feel lonely despite living alone, but some elderly people also felt lonely although living with family. Practical consciousness of the elderly provides a good understanding as a strategy for how the elderly evaluate, and understand the social context around them and manage the loneliness experienced. Loneliness can reduce the well-being of the elderly, it takes the role of various parties such as family, community, and state to solve this problem. This study concludes that practical awareness in the elderly is one of the intervention strategies to avoid loneliness in the elderly.
Avaliação dos pacientes com mieloma múltiplo submetidos ao segundo transplante autólogo de células tronco hematopoéticas em um hospital de referência do estado do Ceará
Authors: Medeiros Anaxímenes Feitosa de , Duarte Fernando Barroso
Published: October 2024

Objetivo: Foi avaliado o impacto do segundo transplante autólogo de medula óssea nos pacientes com mieloma múltiplo redicivante. Metodologia: Estudo retrospectivo e descritivo, com a obtenção de dados por meio da análise de prontuários. Incluiu-se no estudo todos os pacientes portadores de mieloma múltiplo submetidos ao segundo transplante autólogo na unidade de transplante de medula óssea do Hospital Universitário Walter Cantídio/UFC de 2008 a 2022. Resultados: Quatorze pacientes preencheram os critérios de inclusão, sendo oito homens (57%) e seis mulheres (43%). A idade média dos pacientes foi de 58 anos (43-74). A sobrevida global média foi de 45 meses após o transplante (11 dias – 76 meses). A sobrevida livre de progressão média foi de 19 meses (5-43). Houve uma morte por complicações associadas ao transplante. Conclusão: Os resultados sugerem que o transplante de medula óssea autólogo é uma boa opção de consolidação para pacientes com mieloma múltiplo recidivado, principalmente em um ambiente com restrição de recursos, onde medicamentos modernos e dispendiosos não estão disponíveis. Além disso, o procedimento foi seguro nesta coorte de pacientes clinicamente elegíveis, com baixa mortalidade.
Electro-phytoremediation of polluted soil at pilot level using maize
Authors: Solís Sara , Acosta-Santoyo Gustavo , González-Jasso Eva , Bustos Erika
Published: October 2024

This article presents the imposition of a direct current electric field in the presence of seeds and plants of Zea mays L., to rehabilitate soils contaminated with hydrocarbons at a pilot level, and its influence on some physical and chemical properties of the soil, such as pH, electrical conductivity, organic matter content in the soil, enzymatic activity, bulk density, apparent density, porosity, cation exchange capacity, and soluble cations such as potassium, sodium, and calcium. For this reason, the edaphological characterization was carried out before and after an electro-phytoremediation process of soils contaminated with hydrocarbons, using an IrO2-Ta2O5|Ti anode and a titanium cathode, applying a constant electric field of 0.2 V/cm for 4 h to maize seeds and stimulating their germination. After one week, an electric field of 0.1 V/cm for 8 h was applied to the maize seeds every day for 42 days to stimulate the growth of maize plants. This study demonstrated the removal of hydrocarbons by electro-phytoremediation. The applied electric field increases seed germination and plant growth of Zea mays L. These results were obtained with the different transport phenomena that develop when using the electric field in the soil Vertisol pelic understudy at a pilot level.
Mural infectious endocarditis in a patient with tetralogy of Fallot: a clinical case
Authors: Kotlyar I. E. , Filchkova A. E. , Enenkov N. V. , Sidashova A. S. , Kondratyev D. O. , Dobrynina N. V. , Vasyushkina K. I. , Gorokhova T. A.
Published: October 2024

The article presents a clinical case of development of mural infective endocarditis (IE) with formation of vegetations in the region of the upper third of the interventricular septum in patient A., 51 years old, with uncorrected tetralogy of Fallot. The patient was admitted with complaints of increased heart rate, interruptions in the heart work, feet swelling, shins up to the upper third, dyspnea at rest, general weakness, fever up to 39 оC, sweating, headache. During transthoracic echocardiography on the upper third of the interventricular septum (IVS) from the side of the RV, an additional echo-positive linear mobile formation 0.9 cm long is visualized, similar to the chords of the tricuspid valve. Thus, based on the identification of 1 major Duke criterion (imaging criterion — the presence of parietal vegetation) and 3 minor criteria (predisposing factors — congenital heart disease of the blue type; fever >38 оC; positive blood culture not meeting the requirements for the major criterion), laboratory and instrumental diagnostic data and anamnesis, the following diagnosis was established: "Secondary infective endocarditis with damage to the upper third of the interventricular septum". Taking into account the sensitivity of the identified microflora, polymyxin and moxifloxacin were prescribed. During therapy, a dry cough and dry wheezing in the projection of the middle lobe on the right appeared. To exclude septic embologenic pneumonia, computed tomography of the chest organs was performed, on which no focal/infiltrative changes were detected. However, a shunt connecting the brachiocephalic trunk with the right pulmonary artery was visualized, which may explain the cause of compensation of hypoxemia that arose due to pathological hemodynamics as a result of high pulmonary stenosis. Given the incomplete effectiveness of therapy, as well as the sensitivity of the infectious agents isolated, a decision was made to change antibacterial therapy to vancomycin in combination with imipenem. Conservative treatment methods allowed not only to compensate for the existing clinical symptoms, but also to achieve reference values of laboratory parameters, despite the impossibility of surgical intervention.
Prevalence of chronic myocarditis in patients with atrial fibrillation according to the results of a single-center study
Authors: Archakov E. A. , Batalov R. E. , Khlynin M. S. , Dragunova M. A. , Sitkova E. S. , Eshmatov O. R. , Moskovskikh T. V. , Usenkov S. Yu. , Stepanov I. V. , Afanasyev S. A. , Popov S. V.
Published: October 2024

Aim. To assess the incidence of chronic myocarditis in patients with atrial fibrillation.

Material and methods. The study included 145 patients. The majority of patients were male — 118 (81.4%). The median age was 45 (38; 50) years. Most had paroxysmal AF — 60 (41.4%), slightly fewer had persistent AF — 55 (37.9%), 30 (20.7%) patients had long-term persistent AF. All patients underwent radiofrequency ablation of AF and endomyocardial biopsy (EMB) with subsequent histological and immunohistochemical studies (IHC). Morphological verification of myocarditis was performed in accordance with the Dallas criteria modified by the World Heart Federation.

Results. Signs of chronic myocarditis were identified in 64 patients (44.1%). The median age of patients with myocarditis was 44 (36.5;49) years, without myocarditis — 46 (38;51) years. In men, myocarditis was detected in 50 cases (42%), in women — in 14 (51.9%). In paroxysmal AF, myocarditis was detected in 25 patients (41.7%), in persistent AF — in 23 (41.8%), and in long-term persistent AF — in 16 (53.3%). The groups with and without chronic myocarditis were comparable when compared based on the main echocardiographic parameters. Regression analysis did not show a significant influence of these factors on the probability of detecting chronic myocarditis in patients with AF. In patients under 30 years of age, there were no signs of inflammation without the presence of myocardial fibrosis, while the maximum stage of fibrosis occurred in patients from 31 to 40 years of age. The stage of fibrosis did not depend on gender. More often than others, a combination of enterovirus and herpes virus type 6 was detected in biopsy specimens. In patients over 51 years of age, biopsies generally did not express any virus on immunohistochemical studies.

Conclusion. Chronic myocarditis in patients with AF was significantly more often detected in younger patients (up to 50 years inclusive), and was more common in women, as well as in the presence of a long-term persistent form of AF, regardless of gender. Detection of myocardial fibrosis signs is more typical for young patients with the maximum stage at the age of 31 to 40 years.
Nephroprotective and anticoagulant therapy in patients with atrial fibrillation and chronic kidney disease: real-world data
Authors: Listratov A. I. , Ivanov I. I. , Ziskina N. K. , Efimenko V. V. , Zhavoronkova A. V. , Milyakova E. S. , Kudrjavtseva A. A. , Napalkov D. A. , Sokolova A. A.
Published: October 2024

Aim. To assess the compliance of nephroprotective and anticoagulant therapy in patients with atrial fibrillation (AF) and chronic kidney disease (CKD) with modern clinical guidelines.

Material and methods. The study included patients with CKD in combination with AF and in sinus rhythm. Clinical characteristics were retrospectively assessed, as were the use of renin-angiotensin system inhibitors (RASi), statins, sodium-glucose transporter type 2 inhibitors (SGLT-2i) and oral anticoagulants (OAC).

Results. A total of 464 patients (aged 66-80 years) were divided retrospectively in two subgroups — with and without AF. AF was detected in 210 (45.3%) patients. Patients from the subgroup with AF were significantly older (75 vs 72 years, p=0.001), more often had type 2 diabetes mellitus (T2DM) (28.6% vs 20.5%, p=0.042), coronary artery disease (CAD) (40.5% vs 30.7%, p=0.028) and chronic heart failure (CHF). (57.6% vs 22.8%, p<0.001). Mean estimated glomerular filtration rate (eGFR) according to Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was lower (46 vs 51 ml/min/1.73 m2, p<0.001) in patients with AF compared with the group without AF. ACE inhibitors (ACEi) were prescribed in 127 cases (27.4%), angiotensin II receptor blockers (ARBs) — in 227 (49%), angiotensin receptor neprilysin inhibitor (ARNI) — 33 (7.1%), statins — 362 (78%), SGLT2i — 63 (13.6%), direct oral anticoagulants (DOACs) — 203 (43.8%) and warfarin — in 10 cases (2.2%). In those patients in whom SGLT2i was prescribed, eGFR according to the CKD-EPI equation was significantly lower (47 vs 49 ml/min/1.73 m2, p=0.043). In patients with T2DM, SGLT-2i-2 was prescribed in 33.9% of cases, in patients with chronic heart failure with reduced ejection fraction (CHFrEF) — in 68.4% of cases. In 196 patients with AF, DOACs were prescribed, in 10 cases — warfarin.

Conclusion. Most patients with CKD receive nephroprotective therapy with RASi and statins according to current KDIGO guidelines. A significant proportion of patients with CHFrEF receive SGLT-2i, but only a third of patients with T2DM and CKD received SGLT-2i therapy.
Should a physician use the Beers criteria when prescribing direct oral anticoagulants to elderly patients?
Authors: Vorobyeva N. M. , Malaya I. P. , Zakiev V. D. , Tkacheva O. N.
Published: October 2024

The Beers Criteria are a tool for optimizing pharmacotherapy in elderly patients, containing information on potentially inappropriate drugs, which is only advisory in nature and is not mandatory for use in Russian Federation. In the updated version of the Beers Criteria from 2023, the expert opinion on rivaroxaban has changed — instead of "use with caution", as stated in the previous document from 2019, the experts now believe that "long-term treatment with rivaroxaban in non-valvular atrial fibrillation (AF) and venous thromboembolic complications (VTE) should be avoided in favor of safer alternative anticoagulants". This statement is based on moderate-quality evidence obtained from observational studies and network meta-analyses, which are significantly inferior to randomized controlled trials and have numerous limitations. The available evidence base for the use of rivaroxaban in elderly patients with AF and VTE and critical comments on the Beers criteria methodology, indicate the recommendations of the American Geriatrics Society experts regarding direct oral anticoagulants (DOAC) should be treated thoughtfully and carefully. When choosing a DOAC in elderly patients with AF or VTE, one should primarily focus on current clinical guidelines mandatory for use in Russian Federation, and on the data of studies that studied the efficacy and safety of specific DOACs in this category of patients. Rivaroxaban is a well-studied anticoagulant in elderly patients with AF and VTE, since its efficacy and safety have been established in RCTs and specially designed multicenter prospective observational studies with a fairly high quality of evidence. Based on this, rivaroxaban is a justified treatment option for elderly and senile patients with AF or VTE.
Association of Systemic Immune Inflammation Index and System Inflammation Response Index with Cardiovascular Disease among prediabetes and diabetes
Authors: Sun Jiayu , Liu Min , Zhang Andong , Dong Yutong , Shi Mengmeng
Published: October 2024

We aimed to explore the association of the systemic immune inflammation (SII) index and system inflammation response index (SIRI) with CVD among prediabetes and diabetes. The cross-sectional study included 4534 participants with prediabetes and diabetes from the National Health and Nutrition Examination Survey (NHANES) 2015–2018. Multivariate logistic regression analysis was used to assess the association of SII and SIRI with CVD. Restricted cubic spline (RCS) model was used to examine the dose-response relationships between SII, SIRI, and CVD. Among 4,534 individuals with prediabetes and diabetes, the prevalence of CVD was 16.6%, with 19.4% in males and 14.0% in females. SII (OR: 1.27, 95%CI: 1.04–1.56) and SIRI (OR: 1.38, 95%CI: 1.09–1.76) were positively associated with CVD among prediabetes and diabetes. Among prediabetes, SIRI was positively associated with CVD (OR: 1.32, 95%CI: 1.03–1.70). Among diabetes, there was a similar finding that SIRI was positively associated with CVD (OR: 1.43, 95%CI: 1.04–1.96). The dose-responses relationship of SIRI with CVD was significantly nonlinear (P for nonlinear < 0.001). SIRI index may be an important biomarker in people with diabetes and prediabetes. Therefore, we recommended long-term monitoring of the SII index and SIRI in these vulnerable individuals.
Association between lactate and 28-day mortality in elderly patients with sepsis among different BMI groups:a cohort study
Authors: Zhang Haofeng , Tang Li , Zhang Jun
Published: October 2024

Introduction:The purpose of this study is to explore the association of baseline lactate level with 28-day mortality in elderly sepsis patients among different Body Mass Index (BMI) groups after ICU admission. Methods:In this retrospective cohort study,a total of 5699 patients with sepsis and age > 65 years were include from the Electronic Intensive Care Unit (eICU) Collaborative Research Database (eICU-CRD) from 208 distinct ICUs across the United States in 2014–2015.Lactate level and BMI at admission were obtained,and the outcome indicator was all-cause mortality within 28 days after ICU admission. A two-segment linear regression model was performed to verify the threshold effects of lactate on outcome and its differences among different BMI.Smooth curve fitting were also performed. Results:The ICU 28-day mortality of elderly sepsis patients in this study was 12.56%(n = 716). After adjustment for potential cofounders,for per 1mmol/L increase in lactate,the odds ratio(OR) of ICU 28-day mortality was 1.195(95%CI 1.136–1.257,P < 0.00001).Smooth fitting curves indicated a non-linear positive relationship between lactate and ICU 28-day mortality,with the turning point of lactate level was 5.5mmol/L.Below this threshold, each 1mmol/L increase in lactate increased the mortality risk by 37.5% (effect size 1.375, 95% CI 1.230–1.536, P < 0.0001).Results showed that the relationship between lactate and 28-day mortality exhibited different nonlinear patterns across BMI groups. Notably, in the group with BMI < 25, a significant increase in mortality risk was observed when lactate concentration was below 3.2mmol/L (1.630, 95% CI: 1.161, 2.287, P = 0.0047), while above this breakpoint, the increase in mortality risk was smaller (1.186, 95% CI: 1.024, 1.373, P = 0.0228). This pattern was also observed in the group with BMI ≥ 30, but the breakpoint effect was not significant in the group with BMI between 25 and 30. Conclusion: In critically ill patients with sepsis(age > 65 years) in ICU,a non linear positive relationship was discovered between lactate and ICU 28-day mortality.And the impact of lactate concentration on ICU 28-day mortality is not only related to lactate levels themselves but is also significantly influenced by BMI.This insight is crucial for clinicians in assessing patient mortality risk.
Bioinformatics Evidence of the Macrophage Inhibition In the Alleviation of Nonalcoholic Steatohepatitis Caused by Bariatric Surgery
Authors: Wang Ya Yun , ZHENG QIANWEN , Deng Shizhou , Chen Xiyu , Yang Yanling
Published: October 2024

The incidence of nonalcoholic steatohepatitis (NASH) is increasing worldwide, and effective treatment is urgently needed. To understand the molecular mechanisms behind the effectiveness of bariatric surgery in treating NASH, we integrated single-cell and bulk RNA sequencing data to identify the role of liver macrophage polarization in alleviating NASH and screen possible drugs for treatment. Analysis revealed that bariatric surgery alleviates NASH by inhibiting liver M1 macrophage polarization with 12 differentially expressed M1 macrophage-related genes. Additionally, 56 potentially effective drugs were predicted for NASH treatment. These findings shed light on the effectiveness of bariatric surgery in treating NASH and offer potential drug candidates for further exploration.
Can an authoritarianism-compatible argument lead to greater support for immigration?
Authors: Buchanan Tessa , Young David J. , Ackland James , Renwick Alan , de-Wit Lee
Published: October 2024

Immigration has been a major point of contention for voters in 2024, a record year for elections, yet politicians rarely speak up in favour of it. Here we test with three studies (n=6,107) whether British attitudes towards immigration become more positive when participants are exposed to a short text written to be compatible with moderate levels of what political psychologists call ‘authoritarianism’. In the first study (n=2,004), participants report feeling that they share more values with a fictitious immigrant but this is not sufficient to change overall immigration attitudes. The second study (n=1,006) shows that when factual arguments and an emotional appeal are added to this text, this shifts attitudes towards immigration overall. The third study (n=3,097) confirms these results with a nationally and politically representative sample sourced from YouGov. These findings demonstrate that persuasion is possible on contentious issues like immigration, that immigration attitudes are not fixed, and that arguments in favour of immigration can be effective in the right context.
Association between Serum Milk Fat Globule-EGF Factor 8 and Prognosis in Patients with Heart Failure
Authors: Lu Feng , Hou Jie , Huang Xueyun , Zhang Shuguang , Zhou Lei
Published: October 2024

Objective: Investigating the relationship between serum milk fat globule-EGF factor 8 (MFGE8) and prognosis in patients with heart failure (HF).
Methods:This research conducted a prospective observational analysis on patients with HF at Huai’an TCM Hospital, which is affiliated with Nanjing University of Chinese Medicine between September 2021 and September 2022. The main focus was determined as combined result of being readmitted to the hospital for HF or all-cause death within a year. Various methods were utilized to evaluate the relationship between MFGE8 and prognosis, such as least absolute shrinkage and selection operator regression (LASSO), logistic regression, generalized additive model (GAM), multivariate adaptive regression splines (MARS), and random forest.
Results:A total of 153 patients were enrolled, and 44 patients had outcome events (28.76%). The MFGE8 at hospital release were significantly lower in patients with primary the main outcome (398 [258, 762] vs. 600 [36, 892], P = 0.002), as was the fold change of MFGE8 at discharge and admission (ΔMFGE8) (4.37 [-73.34, 69.1] vs. 58.6 [30.2, 88.2], P < 0.001). Four variables were chosen using by LASSO regression: hypertension, body mass index, MFGE8 at discharge, and ΔMFGE8. Multivariate logistic regression was implemented using the chosen variables. The results showed that MFGE8 at discharge (beta = -0.001, OR = 1.000, P = 0.039) and ΔMFGE8 (beta = -3.786, OR = 0.022, P = 0.003) were independently associated with primary outcome. The random forest model determined that the ΔMFGE8 is the variable with the highest level of significance (GINI coefficient: 10.64).
Conclusion: The presence of Serum MFGE8 is inversely associated with the likelihood of clinical outcome in HF patients, suggesting that it might be a valuable indicator of the prognosis for HF patients.
Impact of Testicular Cancer on Socio- Economic Health, Sexual Health and Fertility of Survivors – A Questionnaire based Survey
Authors: Khan M Raheel , Sheehan Patrice Kearney , Bazin Ashley , Leonard Christine , Aleem Umair , Farooq Abdul R , Corrigan Lynda , McDermott Ray
Published: October 2024

Purpose
Testicular cancer (TC) is diagnosed at a young age and carries a remarkably high cure rate even with advanced stage at diagnosis. Hence, there is a sizeable population living in the survivorship phase. Many studies have highlighted the plight of TC survivors as a result of late side effects of different therapeutic modalities used for treatment of TC. Although, a number of co-morbidities are known to cause chronic diseases and mortality in TC survivors, in this study we focus on the impact of TC on socio-economic health, sexual health and fertility.
Methods
We performed a questionnaire based survey on TC survivors in one of the cancer centres of Ireland. Questionnaires were designed to measure the impact on social, sexual and economic health on a five point Likert scale. Any effect on the fertility was investigated with questions regarding biological children before and after cancer with or without medical assistance.
Results
A total of 83 TC survivors participated in the study. Of all participants, 17% reported issues with fertility and the same proportion reported seeking medical help to conceive. The percentage of survivors who experienced fertility issues persisting for more than 1 year was 14%. Almost half of our respondents revealed some effect on their performance at work and personal finances. Around one third, had an impact on career choice, job security and relationship with their partner. Regarding sexual health, worst repercussions were noted on the sex drive and body image perception, where close to half of the respondents reported at least some deterioration. Ejaculation and erectile function was affected in 30% of the participants.
Conclusions
High cure rates in TC are coupled with long term side effects, consequently affecting the socio-economic and sexual health of survivors. A comprehensive and holistic survivorship program is needed to improve the quality of life and health of TC survivors.
Association between BMI and outcomes in critically ill patients: An analysis of the MIMIC-III database
Authors: Yu Wenbo , Jiang Weiwei , Yuan Jihong , Fan Tao , Xiao Huiyan , Sun Lizhu , Zhu Yan , Li Wenfang , Wu Shaoshuai
Published: October 2024

Background: Obesity is a significant public health challenge, yet the link between BMI and mortality in critical illness remains unclear.
Methods: This study analyzed 19,311 patients from the MIMIC-III database, categorized into underweight, healthy, overweight, and obese groups. Using Cox models and restricted cubic splines, we explored the complex relationship between BMI and mortality. Finally, multiple sensitivity analyses were performed to test the robustness of the results.
Results: The proportion of underweight patients (2.3%) was the lowest, while overweight (34.8%) and obese (34.5%) patients constituted a large proportion. Being underweight portended a greater risk, while being overweight or obese was associated with a lower risk of mortality, which is consistent with the sensitivity analysis. Moreover, we observed a typical L-shaped relationship between BMI and the risk of mortality with and without adjustment, with the lowest mortality occurring at approximately 32 kg/m². The overall pattern of the nonlinear association between BMI and mortality was similar for most subgroup analyses.
Conclusions: Underweight was associated with a greater risk of mortality, while obesity and overweight were both associated with a lower risk of mortality in critically ill patients. BMI had a typical L-shaped association with the risk of mortality.
A new combined reduction anatomical plate for the treatment of acetabular anterior column and posterior hemi-transverse fractures: a finite element analysis study
Authors: Chen Lin , Bao Chongshuai , Jun Ao , Wang Ansu
Published: October 2024

Background: Acetabularanterior column and posterior hemi-transverse fractures pose a significant challenge for orthopaedic surgeons. Traditional treatment methods are associated with high rates of post-operative complications and lengthy surgical procedures. To enhance treatment efficacy, this study developed a novel internal fixation device called the Combined Reduction Anatomical Plate (CRAP) and conducted a finite element analysis to compare its biomechanical properties to those of traditional internal fixation methods.
Methods: A standard finite element model of an anterior column and posterior hemi-transverse fracture of the acetabulum was established using finite element software. Subsequently, four different internal fixation devices were applied: CRAP, double-column locking plates (DLP), supra-pectineal quadrilateral anatomical plate (SQAP), and iliositus + anterior column plate (LACP). After determining the boundary conditions and material properties, the model was simulated in three different body positions (standing, sitting, and lying on the affected side) and subjected to vertical downward forces of 200 N, 400 N, and 600 N. Subsequently, the stress distribution and peak values among the four fixation methods were analyzed, and the maximum pelvic displacement and fracture fragment displacement were evaluated.
Results: In this study, the CRAP maximum stress on the steel plate and screws was 159.540 N, 160.540 N, 157.050 N, 177.330 N, 64.756 N, and 30.003 N, which was less than that of the SQAP and LACP and greater than that of the DLP. The maximum tangential micromotion of the CRAP was only 0.016 mm, and the maximum displacement of the pelvis was 0.855 mm. The results showed that the new type of plate developed and designed in this study exhibited a relatively uniform stress distribution and high stiffness, providing sufficient strength. However, the four groups showed no obvious difference in tangential fretting.
Conclusion: Compared with the other three fixation methods, the newly designed sectional anatomical reduction plate and screws showed a uniform stress distribution, greater rigidity, sufficient strength, and improved mechanical stability. The CRAP can therefore provide sufficient biomechanical stability and help fracture healing.
Effect of electro-acupuncture on postpartum urinary retention —— A protocol for multicenter, randomized and placebo-controlled trial
Authors: Dou Zhen , Zhang Yunzhi , Cui Hongyan , Zhao Xiaoli , Dai Lijing , wang Baojuan , Fu Yu , Xia Tian , Chang Ying
Published: October 2024

Background
Postpartum urinary retention (PUR) is one of the serious and common clinical complications after delivery. Although urinary catheterization can provide temporary relief from voiding disorders, it may cause discomfort, pain, and even urethral injury to the mother, thereby increasing the risk of urinary system infection. Acupuncture was shown it has unique advantages in relieving the clinical symptoms of PUR, promoting bladder recovery. However, there is not sufficient high-quality evidence to strongly support the effectiveness of electroacupuncture in the prevention and treatment of PUR. Therefore, we have designed a multi-center, large-sample, randomized controlled clinical trial to assess the impact of electroacupuncture intervention on the incidence of PUR and the recovery of bladder function.
Methods
This is a multicenter, randomized, parallel-group clinical trial conducted in China to investigate the impact of electroacupuncture intervention on the incidence of PUR. Patient screening and enrollment will take place at four hospitals in China: the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin Central Hospital of Gynecology Obstetrics, Tianjin Shuige Hospital and Second People's Hospital of Fengrun District, Tangshan City. Patients will be randomly assigned to either the electroacupuncture group or the sham acupuncture group, with 330 patients in each group. Each acupuncture treatment will comprise three 30-minute sessions over 2 days (the first hour, the first day, and the second day after delivery). The primary outcome measure is the incidence of PUR. Adverse events will be recorded, and their impact will be analyzed at the end of the trial.
Discussion
This study will provide high-quality evidence support for the effectiveness of electroacupuncture in preventing and treating PUR, and provide scientific basis for the application of non-drug therapy in postpartum rehabilitation.
Trial registration
ClinicalTrials.gov: ChiCTR2300078039.Registered on 27 November 2023.
Comparing the effects of treadmill training versus Baduanjin on prefrontal cortical activity during dual-task walking in Parkinson’s disease: Study protocol using a fNIRS device
Authors: Hui Juan , Li Zhenlan , Xu Shanshan , Yu Junwu , Tang Min , Zhou Lifeng
Published: October 2024

Background:
Patients with Parkinson’s disease (PD) have shown impaired gait rhythmicity and increased prefrontal activation during complex tasks, presumably to compensate for decreased automaticity. Exercise can reduce cortical excitability and enhance automaticity, thereby improving walking function. However, the effectiveness of treadmill training and Baduanjin on prefrontal activity has received little attention when patients with PD walk under different dual-task conditions. This randomized control trial (RCT) will investigate the comparative effects of treadmill training and Baduanjin on prefrontal activation and gait function during both single and dual tasks in PD.
Methods:
This RCT will be designed as a single-center, three-arm, single-blind study. One hundred and forty-four participants will be allocated into treadmill training, Baduanjin, or waitlist control groups. Participants in both the treadmill training and Baduanjin groups will receive 45 min of specific exercise three times weekly for 12 weeks. Participants in the control groups will maintain routine care and lifestyle. The primary and secondary outcomes will be assessed at baseline, after a 12-week intervention, and at the end of a12-week follow-up. The primary outcomes will be prefrontal activation (oxygenated hemoglobin concentration, HbO2) measured by functional near-infrared spectroscopy (fNIRS), and gait parameters (gait speed, stride length, double-phase time, stride variability, and step width) assessed by an electronic walkway with pressure sensors. The secondary outcomes will be motor function, balance, mobility, and quality of life.
Discussion:
This study will determine whether treadmill training or Baduanjin is more effective in reducing prefrontal activation and improving gait function. If the findings are consistent with our expectations, they may help clinicians and physical therapists to manage gait impairments in patients with PD and to select targeted interventions for them.
Trial registration
http//www.chictr.org.cn. Trial number ChiCTR2300075048. Registered on 23 Aug 2023.
Critical sustainability events and perceived roles of academic leaders at a leading university in sustainability: CIT case study
Authors: Veidemane Anete , Crăciun Daniela , Meulen Barend van der
Published: October 2024

This case study explores the perceived roles of academic leaders in critical sustainability events at a leading university in sustainability - the University of Auckland (UoA). UoA was selected due to its high position in the Times Higher Education (THE) Impact Ranking (1st in 2019 and 2020) based on its contribution to Sustainable Development Goals (SDGs). Employing the critical incident technique (CIT) through semi-structured interviews, university staff were asked to reflect on the meaning of a sustainable university, critical sustainability events, and the roles of academic leaders in these events. Both central-level and faculty-level leadership were considered. The interviews revealed that while a multi-dimensional and holistic vision of a sustainable university is beneficial for engaging diverse stakeholders, three transformation tensions emerge as the discussion moves from a vision to implementation: priorities (competing sustainability dimensions), pace (desired speed of transformation), and process (desired consultation for transformation). These tensions are displayed in the Triangle of Transformation Tensions. In total, 16 critical events (CEs) were identified by staff predominantly (81%) occurring within the last five years (2019–2023). The majority were internal CEs, initiated by the university (75%) while the two most frequent CEs were external– COVID-19 and THE Impact Ranking. Central-level strategies and policies (e.g., sustainability strategy, flight policy) represented the most common type of CE (25%). Yet these CEs should not be viewed in isolation. Often most recalled CEs, highly visible and centralised, were underpinned by less prominent CEs (e.g., data monitoring). Moreover, the recent change in the central-level leadership, though less frequently recalled as a CE (10%), was mentioned by the majority of interviewees (> 60%). The perceived roles of academic leaders were conceptualised into five categories: no role, support, drive, divert and block, ranging from passive to active leadership roles. The study hypothesizes that staff associate visible leadership roles with invisible leadership stances, which depend on competing priorities, including intrinsic values, external opportunities & pressures, and resource & authority constraints. No single role is optimal in every situation. Rather each role can be utilised to address the transformation tensions (priorities, pace, process) in various ways.
Modified anterior rectopexy – clinical and radiological outcomes in patients with combined defects in the posterior pelvic compartment
Authors: Melvas Bjarne , Kurlberg Goran , Borjesson Lars
Published: October 2024

Background
Different types of posterior pelvic organ prolapse (PPOP; rectal prolapse, rectocele or enterocele) often coexist and can be associated with overlapping symptoms. This study introduces a modified laparoscopic anterior rectopexy, laparoscopic vaginorectopexy (LVRP), for the correction of multiple PPOP in a single procedure. The focus is on bowel function, recurrence rates and complications.
Methods
Twenty-five women with symptoms of obstructed defecation (OD) and more than one PPOP were prospectively included and assessed with clinical examination, defecography and a questionnaire for bowel function and quality of life (QoL). During LVRP, a t-shaped mesh was sutured to the pelvic muscles, vagina and sacrouterine ligaments and then stapled to the promontory; the mesorectum was stapled to the mesh. Follow up was scheduled twelve months after the procedure and long term (minimum ten years).
Results
One patient suffered from mesh erosion and another from postoperative bleeding. Outcomes after twelve months were: no recurrence of internal or external rectal prolapse; three rectoceles and one enterocele recurred; bowel function and QoL improved for around half of patients; few patients deteriorated. At long term follow up, the effects on OD and QoL were unchanged, but an increase in incontinence was recorded.
Conclusions
LVRP is a technique for the correction of multiple PPOP in a single procedure. The procedure is safe with low recurrence and complication rates. Bowel function and QoL improve over the short term, while the effect on faecal incontinence deteriorates over the long term.
Trial registration no.:
NCT06330857
The expression of TRPM4 protein is increased in the hippocampus of aged PND rats, and ulinastatin affects TRPM4 and apoptosis to enhance cognition dysfunction
Authors: Xia Xiaohui , li Jiayi , Zhang Mengmeng , Zhang Chunyan , Lu Keliang , Han Huirong
Published: October 2024

Background
Transient receptor potential melastatin 4(TRPM4)is a non-selective cation channel that is mainly permeable to Na+, activated by intracellular calcium, and modulated by ATP; Dysregulation of TRPM4 contributes to many pathological processes, including stroke, cerebral edema after traumatic, spinal cord injury and neurodegenerative diseases。TRPM4 plays an important role in neuronal apoptosis and mitochondrial function protection, and we assume that it plays a role in PND. Ulinastatin has been shown to have a protective effect on perioperative neurocognitive function, and we used the group with Ulinastatin as a protective agent for comparison.
Methods
Forty18-month-old male Sprague-Dawley rats were divided into four groups: group C (sham-operated); surgery group (internal fixation of tibial fracture); UTI group (Ulinastatin + surgery), and 9- phenanthrol group (TRPM4 channel inhibitor + surgery). Western blotting, qPC,and IF were used to detect the expression levels of TRPM4 in different groups of rats. The neurocognitive function of rats was detected by the Y-maze and NOR test. The expression of apoptosis-related proteins in rat hippocampal cells was detected, and the apoptosis level of rat hippocampal cells was detected by the TUNEL method. Mitochondrial morphology was observed by transmission electron microscopy.
Results
TRPM4 expression was significantly higher in the hippocampus of rats in the surgery group compared with the sham surgery group. Behavioral assays in the 9-phenanthrol group showed better results than those in the surgery group, with decreased expression of BAX, an apoptosis-related protein, elevated expression of BCL-2, and decreased tunel Apoptosis Index in the hippocampus of rats. The Ulinastatin group and the inhibitor group had similar results.
Conclusion
TRPM4 expression is elevated in the hippocampus of aged PND rats, and inhibition of its expression attenuates hippocampal apoptosis and protects perioperative neurocognitive function in rats, with a similar effect to that of Ulinastatin protection.
Association between microcephaly and hearing disorders in children exposed or suspected of exposure to the Zika virus during the intrauterine period
Authors: Amaral Andrea de Oliveira Campos , de Faria Armanda de Oliveira Pache , Carvalho Fabiana Rabe , Dalcastel Luis Antonio Bataglin , Almeida Simone Saraiva de Abreu , Fernandes Alexandre Ribeiro , Velarde Luis Guillermo Coca , Oliveira Solange Artimos , Cardoso Claudete Aparecida Araújo , Miterhof Maria Elisa Vieira da Cunha Ramos , Vianna Renata Artimos de Oliveira
Published: October 2024

Purpose
This study aimed to evaluate the association between microcephaly and hearing disorders in children with exposed or suspected of exposure to Zika virus (ZIKV) during the intrauterine period.
Methods
This cross-sectional study, we enrolled children exposed or suspected of being exposed to ZIKV and born to mothers with confirmed or suspected ZIKV infection during pregnancy, admitted to the hospital between April 2016 and July 2018, and followed up until September 2021. All children underwent at least one automated auditory brainstem response (AABR) test. For analysis, the patients were divided into four groups: those with microcephaly, without microcephaly, suspected ZIKV infection, and controls. Other causes of microcephaly were excluded. Hearing impairment was assessed using the AABR to determine associations with microcephaly or central nervous system (CNS) abnormalities.
Results
Of the 134 children included, 34 (25.4%) were diagnosed with congenital Zika syndrome (CZS), of whom 28 (82.4%) had microcephaly, and the remaining six (17.6%) without microcephaly. Among the 28 children with microcephaly, 3 (10.7%) had abnormal AABR. Among children without microcephaly (n = 106), 3 (2.8%) had abnormal AABR (p = 0.09).
Conclusion
In our study population, children with and without microcephaly had abnormal AABR.
Infants with bronchiolitis with high-flow nasal cannula in the paediatric ward. Is there a role for the ROXi (Respiratory rate–Oxygenation index) to predict transfer requirement to the PICU?
Authors: Pallec Catline Le , Cerasuolo Damiano , Cauvin Jean Charles , Agossah Cédric , Milesi Christophe , Savy Nadia , Brossier David W.
Published: October 2024

Introduction: The respiratory rate–oxygenation index (ROXi) has been shown to be a reliable tool to predict the risk for HFNC failure in adult patients with lower respiratory tract infections. In paediatrics, the reliability of this index to predict HFNC failure appeared mitigated. In specific population, such as infants with moderate to severe bronchiolitis hospitalized in paediatric ward with HFNC, its ability to predict transfer requirement to the PICU needs to be further evaluated. The main objective of this study was to evaluate the ability of the ROXI collected at initiation of HFNC in the paediatric ward to predict the need for PICU transfer and/or HNFC failure in cases of moderate to severe bronchiolitis.
Methods: A retrospective review of patients aged 0 to 6 months with bronchiolitis who received HFNC within seven tertiary paediatric hospital over the last 5 epidemic seasons from 2018 to 2023 was conducted. Demographic, clinical, and biochemical variables were collected at admission and at the beginning of HFNC therapy support. Initial management and its evolution were described. Patients were compared depending on their transfer to the PICU during hospital stay. HFNC failure was defined as the need for Non-Invasive Ventilation. Multivariable regression analysis was used to determine parameters associated with transfer to the PICU and HFNC failure.
Results: We included 383 infants in this multicentric study (median age 63 days [7; 192]). 76 patients (20%) requiring HNFC were finally transferred to the PICU with a median of 2 days after the hospitalization. Only 40 children (10%) benefited from ventilatory escalation and for children transferred to a PICU, only one patient was intubated. In our population, the optimal ROX index for prediction of PICU requirement and HNFC failure of 6.9 (sensibility 53.1% and specificity 79.8%) and 7.6 (sensibility 62.5% and specificity 66.8%), respectively. In the multivariate analysis, explanatory variables for both transfer to the PICU and HFNC failure were preterm birth, younger age (under 3-month-old), and mWCAS ≥ 3. Besides, SpO2 ≤ 92% at admission and hypotonia were considered as risks factor for transfer and HFNC failure, respectively
Conclusion: HFNC appeared to be a safe tool for the management of moderate to severe bronchiolitis in the paediatric ward. However, it is necessary to identify patients for whom management remains safe in the paediatric ward, and in this context ROXi appears to be an interesting marker.
Predictive Analysis and Data-Driven Approaches for Developing Sustainable Municipal Solid Waste Management Strategies in Smart Cities: A Case Study of Madurai
Authors: Ganesh S. Valai , Suresh V. , Barnabas S. Godwin
Published: October 2024

This study predicts the handling of trash in Madurai Smart City and proposes rules to improve the environment and health. A mixed-methods analysis was conducted using qualitative and quantitative data, including interviews with stakeholders, policy reviews, garbage pickup, processing metrics, and population growth estimates. Predictive analytics tools such as time series forecasting and machine learning models have been used to determine the long-term effectiveness of waste management strategies. Key findings include the placement of trash trucks, encouraging recycling through community involvement programs, and the utilization of creative waste-to-energy systems. This study emphasizes the need for government, people, and technology support for effective waste management. Predictive analysis can aid in strategic planning and dynamic policy decisions, enhance living conditions and make Madurai Smart City more environmentally friendly. This study highlights the importance of the government, people, and technology in implementing effective waste management strategies.