METHODS AND ANALYSIS: Currently, AsianNeo comprises nine neonatal networks from Indonesia, Japan, Malaysia, Philippines, Singapore, South Korea, Sri Lanka, Taiwan and Thailand. AsianNeo will undertake the following four studies: (1) institutional questionnaire surveys investigating neonatal intensive care unit resources and the clinical management of sick newborn infants, with a focus on VLBW infants (nine countries/regions); (2) a retrospective cohort study to describe and compare the outcomes of VLBW infants among Asian countries and regions (four countries/regions); (3) a prospective cohort study to develop the AsianNeo registry of VLBW infants (six countries/regions); and (4) implementation and evaluation of educational and quality improvement projects in AsianNeo countries and regions (nine countries/regions).
ETHICS AND DISSEMINATION: The study protocol was approved by the Research Ethics Board of the National Center for Child Health and Development, Tokyo, Japan (reference number 2020-244, 2022-156). The study findings will be disseminated through educational programmes, quality improvement activities, conference presentations and medical journal publications.
METHODS: Medical records of dogs with a histopathologic diagnosis of HGMCTs were reviewed from a single institution. Clinical factors, treatment-related variables, and adjuvant therapies were documented to evaluate their association with clinical outcomes. Comparative and survival analyses were conducted using Kaplan-Meier survival analysis, log-rank, and Fisher's exact tests.
RESULTS: The overall median survival time for the 77 dogs was 317 days (range 20-3,041 days) with 6-month, 1-year, and 2-year survival rates of 69, 50, and 30%, respectively. Surgically treated dogs had significantly prolonged survival and were 6.88 times more likely to survive beyond 5.5 months. The presence of metastasis at initial staging was strongly associated with poorer outcomes, as dogs without metastasis at initial staging had 6.94 times higher odds of surviving beyond 2 years. Surgical sites with incomplete margins had a higher local recurrence rate (58%) compared to those with clean margins (26%). Despite aggressive treatment, 75% of the dogs that received concurrent surgical and adjuvant therapy experienced disease progression. Lymph node extirpation, tumor localization, number of tumors, and local recurrence were not associated with the overall outcome.
CLINICAL RELEVANCE: The combination of aggressive local therapy and adjuvant systemic chemotherapy provides a notable survival benefit in dogs with HGMCTs. The limited therapeutic benefit of locoregional lymph node extirpation, combined with a persistently high metastatic rate despite systemic chemotherapy, highlights the critical need for more effective regional and systemic treatment approaches for HGMCT patients.
METHODS: Data were collected as part of the longitudinal, general Canadian population CHILD Study. LRTIs during the first 18 months of life were identified through parental symptom report at regular study visits. Systemic antibiotic use was defined as at least one dose of oral/intravenous antibiotics between birth and the 18-month visit and were further categorized by indication as either given for a respiratory indication (upper or lower respiratory symptoms) or non-respiratory indication. Asthma was diagnosed by in-study pediatricians at the 5-year study visit. Adjusted logistic regression models and mediation analyses via systemic antibiotics use were performed.
RESULTS: Among 2,073 participants included in our analysis, 72 (4.9%) had asthma age 5, and 609 (29.3%) used systemic antibiotics before the 18-month visit. Among children who had taken antibiotics, 61.6% also had an LRTI in that period compared to 49.7% among children without exposure to systemic antibiotics (p
MATERIALS AND METHODS: Additional analytical blocks on comparative and dynamic analysis of morbidity by the groups of nosologies were developed using the software meeting the general concept of the software complex (JavaScript, PHP, and others) and integrated into a new version of the Web application "Epidemiological Atlas of Russia. Territory of the Federal District". The initial data including information by the groups of diseases were converted into a set of interrelated tables with their further integration into the database of a new version of the Atlas under the control of a free relational MySQL database management system.
RESULTS: The existing classifications of nosologic forms and the search for additional characteristics, potentially forming the groups of nosologies, have been analyzed and the current database of the Epidemiological Atlas has been optimized. The algorithms for obtaining and evaluating epidemiological indicators in the new analytical blocks for estimating cumulative morbidity by the nosologic groups were designed. There were created original analytical modules "Comparative analysis of morbidity by the groups of nosologies" and "Dynamic analysis of morbidity by the groups of nosologies" for the Web application "Epidemiological Atlas of Russia. Territory of Federal District" for the comparative and dynamic morbidity analysis based on the groups of nosologies in the administrative-territorial subject units, in the district subjects, and in the district as a whole, with the possibility of information detailing. The materials based on the database queries contain temporal (calendar month) and spatial detailing (administrative-territory unit of the Russian Federation subject). All materials may be exported as tables, graphs, or maps in various formats (.xls, .pdf, .csv, .png, .jpeg, .svg). Since the databases of the current epidemiological atlases of the Volga Federal District and Russia are universal, the mechanisms of processing tables and queries are identical providing the possibility of using the developed approaches employed in the Epidemiological Atlas of Russia or atlases of other federal districts in case of replicating a new Web application version. New analytical blocks may extend notions on the incidence of current infectious diseases and reveal characteristic regional features, facilitate more exact scientifically grounded proposals for decision-making by the executive authorities and timely taking preventive and anti-epidemic measures.
CONCLUSION: The developed analytical modules integrated into the new version of the "Epidemiological Atlas of Russia, Territory of the Federal District" were designed to extend the analytical capabilities of the geoinformation software complex. They are characterized by a high significance in optimization and quality improvement of epidemiological monitoring, operative and retrospective epidemiological analysis of current infectious and parasitic diseases in a separate subject, a federal district, and the Russian Federation as a whole, and represent an essential potential for further improvement of analytical methods and technologies.
DESIGN: Multicenter prospective before-and-after comparison design study.
SETTING: Twenty-one PICUs.
PATIENTS: Patients fulfilled the Pediatric Acute Lung Injury Consensus Conference 2015 definition of PARDS and were on invasive mechanical ventilation.
INTERVENTIONS: The LPMV protocol included a limit on peak inspiratory pressure (PIP), delta/driving pressure (DP), tidal volume, positive end-expiratory pressure (PEEP) to F io2 combinations of the low PEEP acute respiratory distress syndrome network table, permissive hypercarbia, and conservative oxygen targets.
MEASUREMENTS AND MAIN RESULTS: There were 285 of 693 (41·1%) and 408 of 693 (58·9%) patients treated with and without the LPMV protocol, respectively. Median age and oxygenation index was 1.5 years (0.4-5.3 yr) and 10.9 years (7.0-18.6 yr), respectively. There was no difference in 60-day mortality between LPMV and non-LPMV protocol groups (65/285 [22.8%] vs. 115/406 [28.3%]; p = 0.104). However, total adherence score did improve in the LPMV compared to non-LPMV group (57.1 [40.0-66.7] vs. 47.6 [31.0-58.3]; p < 0·001). After adjusting for confounders, adherence to LPMV strategies (adjusted hazard ratio, 0.98; 95% CI, 0.97-0.99; p = 0.004) but not the LPMV protocol itself was associated with a reduced risk of 60-day mortality. Adherence to PIP, DP, and PEEP/F io2 combinations were associated with reduced mortality.
CONCLUSIONS: Adherence to LPMV elements over the first week of PARDS was associated with reduced mortality. Future work is needed to improve implementation of LPMV in order to improve adherence.
METHODS: Post-hospitalised patients (n = 212) and age, sex and comorbidity-matched controls (n = 38) underwent CMR and 12‑lead ECG in a prospective multicenter follow-up study. Participants were screened for routinely reported ECG abnormalities, including arrhythmia, conduction and R wave abnormalities and ST-T changes (excluding repolarisation intervals). Quantitative repolarisation analyses included corrected QT (QTc), corrected QT dispersion (QTc disp), corrected JT (JTc) and corrected T peak-end (cTPe) intervals.
RESULTS: At a median of 5.6 months, patients had a higher burden of ECG abnormalities (72.2% vs controls 42.1%, p = 0.001) and lower LVEF but a comparable cumulative burden of CMR abnormalities than controls. Patients with CMR abnormalities had more ECG abnormalities and longer repolarisation intervals than those with normal CMR and controls (82% vs 69% vs 42%, p
METHODS AND MATERIALS: A cross-sectional study was conducted in selected hospitals in the Riyadh region in Saudi Arabia, over 6 months in 2022. All participants' records were reviewed for socio-demographic data including age, gender, residence, marital status, level of education, occupation, and special habits such as smoking or addiction. In addition to this main complaint and present history, history of chronic illnesses, drug intake, surgical interference, general examination findings including vital signs, state of consciousness, general condition at admission and discharge, and outcome of cases were recorded.
RESULTS: The mean age of the patient was 54.46 ± 15.85 (median of 53.67 years). In this study, the severity of COVID-19 was significantly associated with chronic diseases. For instance, 22.31% of the patients with diabetes reported mild symptoms, compared with 77.69% of the patients without diabetes. The current findings reported 2.18% of COVID-19 patients with respiratory diseases and 97.82% of the patients without respiratory diseases reported mild symptoms of COVID-19 infection. In comparison, 97.75% of COVID-19 patients without respiratory diseases and 2.25% of patients with respiratory diseases reported moderately severe COVID-19 infection.
CONCLUSION: The current findings revealed that 66.2% of the COVID-19 patients with chronic diseases were free of symptoms, 5.3% of them died and 0.9% of the patients were in a worse situation. The severity of COVID-19 was significantly associated with the presence of chronic diseases. Additionally, medical practitioners must be more knowledgeable about the long-term illnesses that put patients at risk for serious COVID-19 challenges and mortality.
MATERIALS AND METHODS: PC/Bi2O3 nanocomposites at concentrations of 0, 5, 20, 40, and 50 Bi2O3 wt% were fabricated via a solution method. Afterward, the samples were irradiated by gamma rays of cobalt-60 (60Co) related to Picker V-9, and Therarton-780 machines at 30-254 mGy/min. Dosimetric characteristics were carried out including linearity, angular dependency, energy, bias-polarity, field size, and repeatability.
RESULTS: Field emission scanning electron microscopy (FESEM) and transmission electron microscopy (TEM) analyses exhibited an appropriate dispersion state. The dosimeter response was linear at 30-254 mGy/min for the all samples. The 50 wt% sample exhibited the highest sensitivity at 4.61 nC/mGy. A maximum angular variation of approximately 15% was recorded in normal beam incidence. The energy dependence at two energies of 662 and 1250 keV was obtained as 0.7%. Bias-polarity for the 40, and 50 wt% samples at 400 V were measured as 15.9% and 9.0%, respectively. The dosimetry response was significantly dependent on the radiation field size. Also, the repeatability of the dosimeter response was measured as 0.4%.
CONCLUSIONS: Considering the dosimetry characteristics of PC-Bi2O3 nanocomposites, and appropriate correction factors, this material can be used as a real-time dosimeter for the photon fields at therapy level.
METHODS: To address the challenges of achieving low energy consumption and efficiency in path planning for plant protection robots operating in mountainous environments, a multi-objective path optimization approach was developed. This approach combines the improved A* algorithm with the Improved Whale Optimization Algorithm (A*-IWOA), utilizing a 2.5D elevation grid map. First, an energy consumption model was created to account for the robot's energy use on slopes, based on its kinematic and dynamic models. Then, an improved A* search method was established by expanding to an 8-domain diagonal distance search and introducing a cost function influenced by cross-product decision values. Using the robot's motion trajectory as a constraint, the IWOA algorithm was applied to optimize the vector cross-product factor (p) by dynamically adjusting population positions and inertia weights, to minimize both energy consumption and path curvature. Finally, in simulation and orchard scenarios, the application effects of the proposed algorithm were evaluated and compared against notable variants of the A* algorithm using the robot ROS 2 operating system.
RESULTS: The experimental results show that the proposed algorithm substantially reduces the travel distance and enhances both path planning and computational efficiency. The improved approach meets the driving accuracy and energy consumption requirements for plant protection robots operating in mountainous environments.
DISCUSSION: This algorithm offers significant advantages in terms of computational accuracy, convergence speed, and efficiency. Moreover, the resulting paths satisfy the stringent energy consumption and path planning requirements of robots in unstructured mountain terrain. This improved algorithm could also be replicated and applied to other fields, such as picking robots, factory inspection robots, and complex industrial environments, where robust and efficient path planning is required.
OBJECTIVE: To identify studies of behavioural activation designed for people with cancer and examine the effects on psychological distress, including depression and anxiety.
DESIGN: Systematic review and meta-analysis.
METHODS: A systematic search of PubMed/MEDLINE, CINAHL, EMBASE, PsycINFO, and the Cochrane Library was performed from the inception to 6 April 2024. Randomised controlled trials reporting on the effects of behavioural activation on psychological distress among cancer patients were included. Two authors independently screened the eligible studies, assessed the quality of studies, and extracted data. The risk of bias was assessed using version 2 of the Cochrane risk-of-bias tool for randomised trials (RoB 2). The meta-analysis was performed by Review Manager 5.4, and narrative synthesis was employed when the meta-analysis was inappropriate. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system was used to assess the certainty of the evidence.
RESULTS: A total of nine studies were included in this systematic review, with 1811 participants. The pooled analysis showed that behavioural activation could improve depression (SMD = -0.24, 95 % CI -0.44 - -0.03, p = 0.020; moderate quality of evidence), and anxiety (SMD = -0.56, 95 % CI -1.01 - -0.10, p = 0.020; low quality of evidence) among people with cancer. The effects were robust in sensitivity analysis and yielded consistent results in studies that were not pooled due to insufficient data. Subgroup analyses suggested that face-to-face and group administration were more effective, whereas the effects of different dosages were uncertain. Besides, the effects of behavioural activation at different follow-up periods were not identified There was no consensus on the optimal components of intervention.
CONCLUSIONS: The evidence for behavioural activation as an effective treatment of psychological distress among people with cancer is promising. However, it should be noted that the quality of evidence was moderate and low, thus emphasising the need for caution when applying these findings. In order to explore which components may be most effective in improving psychological outcomes, more rigorous study designs and more detailed descriptions of interventions are necessary.
REGISTRATION: The protocol was registered on PROSPERO (Registration number: CRD42024533171).
METHODS: A mixed methods systematic review informed by JBI methodology. Researchers conducted a comprehensive search of databases in both English and Chinese, covering the years 2005 to 2023. The initial search took place in January 2024 and was updated in March 2024. This study includes all studies results available up to December 31, 2023. The protocol has been registered on PROSPERO (CRD42023384078) and includes 14 studies in the review.
RESULTS: The activity categories included group psychological activities, individual family activities and multiple formats services. Three barriers to implementation emerged: social workers, activities and parents. The facilitators were parents and activity design.
CONCLUSION: This review revealed that some studies suffered from poor data collection methods and data quality. Studies on services for mental health in urban left-behind children requires methodologically robust study designs for broader dissemination and rigorous evaluation.
SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42023384078, available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023384078.
METHODS: A systematic review was conducted on MEDLINE, Embase, Google Scholar, Scopus, and Web of Science. The terminologies "IOTA-SR", "adnexal, mass", and "ovarian tumors scoring" were employed. Twenty-seven research articles conducted from 2008 to 2022 were included in the meta-analysis; the publication outcome indicates that performance quality tests were extracted directly or indirectly, including true positive (TP), false positive (FP), true negative (TN), and false negative (FN). The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) was used to evaluate the study quality and estimate the risk of bias. After estimating the pooled effect of the sensitivity, specificity, and diagnostic odds ratio (DOR), the summary receiver operating characteristic (SROC) curve was estimated using the bivariate random effects model. Utilizing Cochran's Q statistics and Higgins's inconsistency test through the I2 index for pooled analysis, the heterogeneity of studies was quantitatively evaluated. The funnel plot and Egger's test were utilized to visually and quantitatively evaluate potential publication bias.
RESULTS: Among 27 studies, including 7,841 adnexal masses, the results of this meta-analysis showed excellent diagnostic performance with a pooled sensitivity of 92% [95% confidence interval (CI), 0.89-0.94] and a pooled specificity of 92% (95% CI, 0.89-0.94). The IOTA-SR was applicable in 85.7% of adnexal masses.
CONCLUSION: The IOTA-SR is highly effective in the presurgical differentiation of malignant versus benign adnexal masses when applied by an expert ultrasonography operator.