bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of postoperative delirium in paediatric patients undergoing surgery under general anaesthesia at Amhara Regional State Tertiary Hospitals: a multicenter prospective study
Authors: Yaregal Melesse Debas , Teshale Tesema Tadesse , Ayinie Mekonnen Zemenay , Chekol Wubie Birlie , Admass Biruk Adie , Mengie Workie Misganaw 
Published: March 2024

IntroductionPostoperative delirium in paediatric patients is a recognised issue. Nevertheless, in low- and middle-income nations, researchers have had luck in determining its extent and predictors. Identifying predictors of postoperative delirium in paediatric patients having general anaesthesia at Tertiary Hospitals in Ethiopia was the aim of this study.MethodsA multicenter, prospective follow up study was conducted from April 15 to June 15, 2023 at the study settings. During the study period a total of 424 paediatric surgical patients treated under general anaesthesia in all study locations, ranging in age from birth to sixteen were candidates for this study. Charts and direct observation of patient's with assessment tool [Cornell Assessment of Pediatric Delirium (CAPD)] were used from each available patient. Binary logistic regression analysis was performed to determine predictors of postoperative delirium in paediatric patients undergoing surgery under general anaesthesia.ResultsPostoperative delirium occurred in 160 of the 404 paediatric patients who underwent surgery under general anaesthesia. Ophthalmic surgery, corticosteroid use, anticholinergic use, severe postoperative pain, and preoperative anxiety were found to be predictors of postoperative delirium; whereas, sedative medication premedication and paracetamol used for analgesia were found to be protective against postoperative delirium.Inference and recommendationThe postoperative delirium in paediatric patients undergoing surgery under general anaesthesia was higher compared to developed countries. Ophthalmic surgery, corticosteroids, anticholinergic medications, postoperative pain, and preoperative anxiety were found to be predictors. The impact of postoperative delirium might be lessened by concentrating on its screening and factor control.
Efficacy and safety of levosimendan in patients with sepsis: a systematic review and network meta-analysis
Authors: Tan Ruimin , Guo He , Yang Zinan , Yang Huihui , Li Qinghao , Zhu Qiong , Du Quansheng 
Published: March 2024

Objective: We conducted a systematic review to assess the advantages and disadvantages of levosimendan in patients with sepsis compared with placebo, milrinone, and dobutamine and to explore the clinical efficacy of different concentrations of levosimendan.Methods: PubMed, Web of Science, Cochrane Library, Embase, CNKI, Wanfang data, VIP, and CBM databases were searched using such keywords as simendan, levosimendan, and sepsis. The search time was from the establishment of the database to July 2023. Two researchers were responsible for literature screening and data collection respectively. After the risk of bias in the included studies was evaluated, network meta-analysis was performed using R software gemtc and rjags package.Results: Thirty-two randomized controlled trials (RCTs) were included in the network meta-analysis. Meta-analysis results showed that while levosimendan significantly improved CI levels at either 0.1 µg/kg/min (mean difference [MD] [95%CrI] = 0.41 [−0.43, 1.4]) or 0.2 µg/kg/min (MD [95%CrI] =0.54 [0.12, 0.99]). Levosimendan, at either 0.075 µg/kg/min (MD [95% CrI] =0.033 [−0.75, 0.82]) or 0.2 µg/kg/min (MD [95% CrI] = −0.014 [−0.26, 0.23]), had no significant advantage in improving Lac levels. Levosimendan, at either 0.1 µg/kg/min (RR [95% CrI] = 0.99 [0.73, 1.3]) or 0.2 µg/kg/min (RR [95% CrI] = 1.0 [0.88, 1.2]), did not have a significant advantage in reducing mortality.Conclusion: The existing evidence suggests that levosimendan can significantly improve CI and lactate levels in patients with sepsis, and levosimendan at 0.1 µg/kg/min might be the optimal dose. Unfortunately, all interventions in this study failed to reduce the 28-day mortality.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023441220.
Grain yield and interspecific competition in an oat-common vetch intercropping system at varying sowing density
Authors: Wang Ying , Han Xue , Zhao Xingyao , Zhang Yanli , Qi Bingjie , Li Lijun 
Published: March 2024

IntroductionOat (Avena nuda L.) and common vetch (Vicia sativa L.) intercropping in the northern regions of China has resulted in substantial production capabilities. However, there is currently a dearth of comprehensive research on whether this intercropping system can enhance productivity through increased sowing densities and underlying interspecies interaction mechanisms.MethodsA two-year field experiment was conducted in 2022 and 2023 to investigate the yield, biological efficiency, economic efficiency, and competition indicators of oats and common vetch in a high-density intercropping system. Two cropping patterns (monocropping and intercropping) and five sowing densities (D1: 4.5×106 plants ha-1; D2:5.4×106 plants ha-1; D3:6.3×106 plants ha-1; D4: 7.2×106 plants ha-1; and D5: 8.1×106 plants ha-1) were arranged in a randomized block design.ResultsAt the same sowing density, the intercropped oats exhibited greater grain yield than the monocultures. Increasing the oat sowing density significantly enhanced oat yield, with the D3 level in intercropping showing the highest yield increase, ranging from 30.98% to 31.85%, compared with the monoculture. The common vetch intercropping grain yield was maximized in the D2 treatment. The land equivalent ratio was maximized at the D2 level in both years and was significantly higher than D1, with the land equivalent coefficient, system productivity index, and percentage yield difference suggesting that increasing oat sowing densities improved the productivity of the intercropping system, with the best performance observed at the D2 level. For both years, the proportionate actual yield loss of oat was the highest at the D3 level; significantly surpassing D1, proportionate actual yield loss of common vetch and actual yield loss were the highest at level D2, both significantly surpassing D1. These indicates that appropriate densification contributes to the realization of the advantages of intercropping. With an increased oat sowing density, the economic benefits of the intercropping system were maximized at the D2 and D3 levels. Regarding intercropping competition, oat was the dominant crop under different sowing densities (Aggressivity for oat (AO)&gt;0, relative crowding coefficient for oat (KO)&gt;1, competition ratio for oat (CRO)&gt;1), whereas common vetch was the inferior crop. Compared with the D1 level, the D2 level harmonized the aggressivity, competitive ratio, and relative crowding coefficients of oat and common vetch, significantly increasing crowding coefficient for common vetch (KV) and competition ratio for common vetch by 19.76% to 21.94% and 4.80% to 7.51%, respectively, while reducing KO and CRO.DiscussionThis result suggests that in the intercropping of common vetch and oat in alpine regions, rational densification can harmonize interspecific competition and thus improve the biological efficiency and economic benefits of intercropping systems.
Efficacy and executive function of solution-focused brief therapy on adolescent depression
Authors: Chen Haisi , Zhou Mengmeng , Han Li , Manoharasetty Advaith , Yu Zhenghe , Luo Hong 
Published: March 2024

ObjectiveTo investigate the efficacy and impact on executive function of Solution-Focused Brief Therapy (SFBT) in treating Major Depressive Disorder (MDD) in adolescents.MethodsA total of 129 adolescents diagnosed with MDD were enrolled in the study. Out of these, 28 adolescents were assigned to the SFBT group, while 25 were part of the Active Control group (AC group), receiving psychodynamic psychotherapy. Executive function, depressive and anxiety symptoms were assessed at baseline, at the time of the third intervention, the sixth intervention, and the 10th intervention.ResultsAfter the third intervention, the scores of the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) of the participants in the SFBT group decreased significantly, which had the cumulative effect at the 6th and 10th interventions. The verbal fluency task (VFT) performances of the SFBT group participants yielded significantly higher scores after the third intervention and remained increasing at the 6th and 10th interventions. The AC group steadily decreased after the intervention. Analysis of functional near-infrared spectroscopy (fNIRS) data revealed a progressive and significant increase in the average oxyhemoglobin (oxy-Hb) levels in the dorsolateral prefrontal cortex (DLPFC) in the SFBT group compared to the AC group after the 10th intervention.ConclusionsSFBT might improve depressive and anxiety symptoms as well as executive function of adolescent depression.Clinical trial registrationhttps://www.chictr.org.cn, identifier ChiCTR2300067909.
Dissecting the causal relationship between neuroticism and osteoarthritis: a univariable and multivariable Mendelian randomization study
Authors: Zhang Shuren , Ji Junhui , Zhang Zexia , Cui Zhichao , Su MeiHua 
Published: March 2024

BackgroundMental health has been found to be associated with risk of osteoarthritis (OA), but the causal relationship was not fully clarified.MethodsTwo-sample Mendelian randomization (MR) study was conducted to investigate the causal relationship between neuroticism (n = 329,821) and the two most frequently affected parts of osteoarthritis (OA) (knee OA: case/control =24,955/378,169; hip OA: case/control = 15,704/378,169) using large scale summary genome-wide association study (GWAS) data. Inverse variance weighted (IVW), weighted median, and MR-Egger were used to estimate the causal effects. Multiple sensitivity analyses were conducted to examine the robustness of the causal estimates. Multivariable MR analysis was used to estimate the direct effects of neuroticism on OA after accounting for the other OA risk factors. Two-step MR approach was employed to explore the potential mediators of the causal relationship.ResultsUnivariable MR analysis indicated that 1-SD increase in genetically predicted neuroticism score was associated with an increased risk of knee OA (IVW: OR, 1.17; 95% CI, 1.087–1.26; p = 2.72E−05) but not with hip OA. The causal effects remained significant after accounting for the effects of BMI, alcohol drinking, and vigorous physical activity but were attenuated with adjustment of smoking. Further mediation analysis revealed that smoking initiation mediated a significant proportion of the causal effects of neuroticism on knee OA (proportion of mediation effects in total effects: 22.3%; 95% CI, 5.9%–38.6%; p = 7.60E−03).ConclusionsNeuroticism has significant causal effects on knee OA risk. Smoking might partly mediate the causal relationship. Further studies were warranted to explore the underlying mechanisms and potential use of neuroticism management for OA treatment.
A proposed analytical approach to estimate excess daily mortality rates in Ecuador
Authors: Fernandez-Naranjo Raul Patricio , Vasconez-Gonzalez Jorge , Izquierdo-Condoy Juan S. , Landazuri Samanta , Castillo Diana , Ortiz-Prado Esteban 
Published: March 2024

BackgroundThe COVID-19 pandemic has proved deadly all over the globe; however, one of the most lethal outbreaks occurred in Ecuador.AimsThis study aims to highlight the pandemic’s impact on the most affected countries worldwide in terms of excess deaths per capita and per day.MethodsAn ecological study of all-cause mortality recorded in Ecuador was performed. To calculate the excess deaths relative to the historical average for the same dates in 2017, 2018, and 2019, we developed a bootstrap method based on the central tendency measure of mean. A Poisson fitting analysis was used to identify trends on officially recorded all-cause deaths and COVID-19 deaths. A bootstrapping technique was used to emulate the sampling distribution of our expected deaths estimator μ⌢deaths by simulating the data generation and model fitting processes daily since the first confirmed case.ResultsIn Ecuador, during 2020, 115,070 deaths were reported and 42,453 were cataloged as excess mortality when compared to 2017–2019 period. Ecuador is the country with the highest recorded excess mortality in the world within the shortest timespan. In one single day, Ecuador recorded 1,120 deaths (6/100,000), which represents an additional 408% of the expected fatalities.ConclusionAdjusting for population size and time, the hardest-hit country due to the COVID-19 pandemic was Ecuador. The mortality excess rate shows that the SARS-CoV-2 virus spread rapidly in Ecuador, especially in the coastal region. Our results and the proposed new methodology could help to address the real situation of the number of deaths during the initial phase of pandemics.
Forgone healthcare for medically vulnerable groups during the pandemic era: experiences of family caregivers of young adults with substance use disorders in Zambia
Authors: Kabembo Ireen Manase 
Published: March 2024

IntroductionScholars worldwide have defined the COVID-19 pandemic as a mass-disabling event of our time. The situation is grave for families experiencing financial hurdles while caring for young adults in recovery from addiction problems.MethodsUsing semi-structured interviews with 30 purposively selected family caregivers (FCGs) of young adults with substance use disorders (SUDs) in Lusaka, Zambia, this study reveals several factors influencing forgone healthcare for this medically vulnerable group.ResultsFinancial challenges and huge out-of-pocket bills; caregivers’ perceived far-fetched recovery of the young adult; the cost of medication and transportation; the young adult’s little perceived need for healthcare service use, their runaway and treatment elusive tendencies; caregiver concerns about contracting the virus, and the stigma associated with it; and a fragmented child and adolescent mental health system influenced forgone healthcare. The young adults were often unavailable for days and months, posing challenges to the continuity of care. Despite caregivers’ acknowledgment of the availability of healthcare professionals, young adults with problematic substance use had limited access to SUD recovery services, resulting in adverse health outcomes. Results also show that most family caregivers encountered challenges in accessing and purchasing psychotropic medications, which were difficult to find during the lockdowns. Some family caregivers lost their sources of income by being laid off from work due to the pandemic and skipping work to attend to caregiving responsibilities. Most of those in self-employment had to close their business and stay home to look after their youth. Several caregivers kept their youth at home because they failed to access private residential SUD recovery services. Family caregivers mostly relied on outpatient public health services, alternative medicine from traditional healers, and faith-based healing, all of which some young adults rarely accessed because of their problematic behaviors of escaping healthcare.ConclusionThese identifiable risk factors, and their detrimental consequences highlight the need for interventions to improve healthcare access for this vulnerable population. Supporting FCGs of addicted young adults is crucial in ensuring the well-being of both the caregivers and care recipients. Further research is warranted to explore potential solutions, such as peer support programs, policy changes, and education initiatives for carers and recipients in the (post) pandemic era.
Urinary microbiome and urological cancers: a mini review
Authors: Randazzo Gianmarco , Bovolenta Eleonora , Ceccato Tommaso , Reitano Giuseppe , Betto Giovanni , Novara Giacomo , Iafrate Massimo , Morlacco Alessandro , Dal Moro Fabrizio , Zattoni Fabio 
Published: March 2024

IntroductionThe urinary microbiome (UMB) includes living bacteria, their genomes, and their products from interactions with the host environment. A “core” UMB could potentially exist, with variations between age and sex groups. Changes in UMB composition have been associated with benign urological disorders, but also with urologic cancers. Mechanisms through which UMB can trigger and maintain cancer can be local inflammation and interaction with immune system.Aim of the studyTo describe the association between UMB and development of urologic cancers.MethodsA non-systematic literature review identified recently published studies (last 5 years), involving human patients, dealing with UMB. The database used for this review was PubMed, and the identified studies served as the base for a narrative analysis of the literature that explored the potential associations between UMB and urological cancers.ResultsIn bladder cancer (BC), UMB may play a role in epithelial-mesenchymal transition (and thus to progression to metastasis), as well as in effectiveness of BCG response rate. BC is also associated with changes in UMB, with bacterial richness indices increased in cancer groups compared to non-neoplastic groups and being different between NMIBC vs MIBC patients. In prostate cancer (PCa), there is an abundance in proinflammatory bacteria and uropathogens. In regard to renal cell carcinoma (RCC), penile cancer and testicular cancer there are still too few studies to draw significant conclusions about its relationship with the UMB.ConclusionsGaining a deeper understanding of UMB role in urologic tumors could aid in the development of new therapies and improve classification of patients’ risk.
Prioritizing patients for hip fracture surgery: the role of frailty and cardiac risk
Authors: Forssten Maximilian Peter , Mohammad Ismail Ahmad , Ioannidis Ioannis , Ribeiro Marcelo A. F. , Cao Yang , Sarani Babak , Mohseni Shahin 
Published: March 2024

IntroductionThe number of patients with hip fractures continues to rise as the average age of the population increases. Optimizing outcomes in this cohort is predicated on timely operative repair. The aim of this study was to determine if patients with hip fractures who are frail or have a higher cardiac risk suffer from an increased risk of in-hospital mortality when surgery is postponed &gt;24 h.MethodsAll patients registered in the 2013–2021 TQIP dataset who were ≥65 years old and underwent surgical fixation of an isolated hip fracture caused by a ground-level fall were included. Adjustment for confounding was performed using inverse probability weighting (IPW) while stratifying for frailty with the Orthopedic Frailty Score (OFS) and cardiac risk using the Revised Cardiac Risk Index (RCRI). The outcome was presented as the absolute risk difference in in-hospital mortality.ResultsA total of 254,400 patients were included. After IPW, all confounders were balanced. A delay in surgery was associated with an increased risk of in-hospital mortality across all strata, and, as the degree of frailty and cardiac risk increased, so too did the risk of mortality. In patients with OFS ≥4, delaying surgery &gt;24 h was associated with a 2.33 percentage point increase in the absolute mortality rate (95% CI: 0.57–4.09, p = 0.010), resulting in a number needed to harm (NNH) of 43. Furthermore, the absolute risk of mortality increased by 4.65 percentage points in patients with RCRI ≥4 who had their surgery delayed &gt;24 h (95% CI: 0.90–8.40, p = 0.015), resulting in a NNH of 22. For patients with OFS 0 and RCRI 0, the corresponding NNHs when delaying surgery &gt;24 h were 345 and 333, respectively.ConclusionDelaying surgery beyond 24 h from admission increases the risk of mortality for all geriatric hip fracture patients. The magnitude of the negative impact increases with the patient's level of cardiac risk and frailty. Operative intervention should not be delayed based on frailty or cardiac risk.
Effects of the Construction of Granadilla Industrial Port in Seagrass and Seaweed Habitats Using Very-High-Resolution Multispectral Satellite Imagery
Authors: Mederos-Barrera Antonio , Sevilla José , Marcello Javier , Espinosa José María , Eugenio Francisco 
Published: March 2024

Seagrass and seaweed meadows hold a very important role in coastal and marine ecosystems. However, anthropogenic impacts pose risks to these delicate habitats. This paper analyses the multitemporal impact of the construction of the largest industrial port in the Canary Islands, near the Special Area of Conservation Natura 2000, on Cymodocea nodosa seagrass meadows (sebadales) of the South of Tenerife, in the locality of Granadilla (Canary Islands, Spain). Very-high-resolution WorldView-2 multispectral satellite data were used for the analysis. Specifically, three images were selected before, during, and after the construction of the port (2011, 2014, and 2022, correspondingly). Initially, advanced pre-processing of the images was performed, and then seabed maps were obtained using the machine learning K-Nearest Neighbors (KNN) supervised classification model, discriminating 12 different bottom types in Case-2 complex waters. The maps achieved high-quality metrics with Precision values of 85%, 81%, and 80%, recall of 76%, 77%, and 77%, and F1 scores of 80%, 79%, and 77% for 2011, 2014, and 2022, respectively. The results mainly show that the construction directly affected the seagrass and seaweed habitats. In particular, the impact of the port on the meadows of Cymodocea nodosa, Caulerpa prolifera, and maërl was assessed. The total maërl population was reduced by 1.9 km2 throughout the study area. However, the Cymodocea nodosa population was maintained at the cost of colonizing maërl areas. Furthermore, the port sedimented a total of 0.98 km2 of seabed, especially Cymodocea nodosa and maërl. In addition, it was observed that Caulerpa prolifera was established as a meadow at the entrance of the port, replacing part of the Cymodocea nodosa and maërl areas. As additional results, bathymetric maps were generated from satellite imagery with the Sigmoid model, and the presence of a submarine outfall was, as well, presented.
Qui était Salomé ?
Authors: Dalaison Julie 
Published: March 2024

Des monnaies émises par la cité de Nicopolis en Arménie Mineure montrent les portraits du souverain Aristobule et de sa femme Salomé. Cette émission amène à s’interroger sur l’identité réelle de cette dernière, afin de savoir s’il s’agit de la « fameuse » Salomé – la « danseuse aux voiles » – qui, sur les ordres de sa mère Hérodias, aurait charmé Antipas pour obtenir la tête de Jean-Baptiste. En reprenant les témoignages de Flavius Josèphe et des Évangiles et en réexaminant certains aspects de la généalogie fort complexe des Hérodiens, cet
article tente de montrer qu’il s’agit en fait de deux personnes distinctes.