Conservative Group Research Articles

From classrooms to global impact

In today's fast-changing environment, the need for quality education is more crucial than ever. Therefore, this article examines how quality education can transform society and contribute to a sustainable, interconnected world. It highlights the essential role of quality education in navigating global complexities, asserting that it can drive sustainable development and promote responsible global citizenship. The study redefined the scope of quality education by advocating for a holistic approach that goes beyond academic excellence, emphasizing the development of essential 21st-century competencies, critical thinking, and creativity. The article aligned educational practices with the United Nations Sustainable Development Goals (SDGs), highlighting the importance of environmental stewardship and social responsibility. It discussed how quality education nurtured intercultural understanding, empathy, and civic engagement, thereby cultivating a sense of global responsibility among students. Furthermore, the article identified quality education as a catalyst for sustainable development, preparing learners for the green economy and equipping them with future-ready skills to address complex global challenges through interdisciplinary problem-solving. The implementation of transformative quality education was examined, focusing on policy frameworks, inclusive curricula, and empowering educators as agents of change. The article concluded with a call to action, showcasing successful models and inspiring case studies, while mobilizing stakeholders to prioritize quality education as a means to empower global citizens and shape a better future.

Involving People in Conservation: Perceptions from Maine, USA

Abstract Environmental conservation groups involve people in diverse ways. These include participatory spaces where people can participate in decision-making and action and engagement processes, where groups communicate, educate, and conduct outreach to build environmental understanding and involve audiences in conservation activities. We explored the perceptions and experiences of conservation practitioners in Maine, USA, to understand their views of participation and engagement. We interviewed 21 practitioners and analysed the qualitative data using an interpretative phenomenological approach grounded in interviewees’ words and experiences. All interviewees recognised the interconnections between people, places, and the non-human world; however, individuals and the groups they work within thought about the role of people in conservation in diverse ways. Views of public stakeholders and rights holders, individual values, Indigenous knowledge, commitments to place and community, and personal experiences all influence who is involved, how people are involved, why people are involved, and what comes of people’s involvement. We conclude by discussing the implications for equitable conservation that seeks to incorporate diverse voices.

Abstract 4143258: Sex Differences in Health Status Outcomes: Analysis of the ISCHEMIA Randomized Clinical Trial

Background: Despite a lesser extent and severity of coronary artery disease (CAD), women had a higher burden of angina than men in the ISCHEMIA trial, suggesting that other factors may explain symptom severity in women. We aim to describe demographic and clinical characteristics, as well as differences in care patterns, associated with health status differences in women, as compared with men, in the conservative and invasive treatment groups of the ISCHEMIA trial. Methods: The ISCHEMIA trial randomized participants with moderate or severe ischemia to a routine invasive strategy of cardiac catheterization with complete revascularization plus guideline-directed medical therapy (GDMT), or an initial conservative strategy of GDMT alone with catheterization reserved for GDMT failure. Health status was a key secondary outcome. Using linear regression models we compared raw and adjusted Seattle Angina Questionnaire (SAQ) scores in women and men at baseline and at 1 year, stratified by randomized treatment strategy. Within the invasive strategy, sex differences were adjusted for completeness of revascularization among those with ≥1 coronary stenosis ≥70%. Results: Of 4,617 ISCHEMIA participants with valid SAQ data, women had lower (worse) baseline SAQ summary scores (SS) throughout follow up (Figure) after adjustment for demographics and clinical characteristics, including severity of CAD (difference 5.4 points, 95% CI 4.0-6.7). Women had lower SAQ SS after adjustment for post-randomization treatment (i.e., medical therapy, achievement of risk factor goals and, in the invasive strategy, complete revascularization), 2.4 points lower (95% CI 0.7-4.1) in the conservative group (Figure), and 1.9 points lower than in men (95% CI 0.1-3.7) in the invasive group. Findings were similar for all SAQ subscales. Conclusions: Women with chronic coronary disease in ISCHEMIA had worse health status than men at baseline and 1 year later, which was not explained by demographic or clinical characteristics, intensity of medical therapy, or completeness of revascularization.

Comparison of Orchid Conservation Between China and Other Countries

Global attention is highly focused on biodiversity conservation. Various countries are actively implementing relevant conservation measures. To advance these efforts in China, it is essential to understand global conservation actions. The orchid family, one of the most diverse groups of flowering plants, has become a “flagship” group for plant conservation. In this study, we summarized 3418 policies and regulations related to orchid conservation in 45 countries. We found that orchid conservation actions in various countries have focused on in situ conservation, with 1469 policies and regulations issued for nature reserves, while ex situ conservation has been seriously neglected, with only seven relevant regulations. Most developing countries have experienced an increase in orchid conservation actions, while developed countries have plateaued. We amassed 370 non-governmental organizations (NGOs) for orchid conservation. At present, the total number of policies and regulations for orchid protection in China is approximately 84, with 67 issued since 2000. Two non-governmental organizations have been established for orchid conservation. Although the benefit of orchid conservation in China is significant, it still requires continuous improvement compared to many other countries. We recommend that the Chinese government draws on the experiences of the United States, Canada, and Australia in areas such as policy and regulation formulation, optimization of non-governmental organizations, and implementation of related conservation projects. Through learning and collaboration, challenges can be transformed into opportunities for development.

Comparative efficacy of conservative, hyperbaric oxygen, and endovascular retinal surgery approaches in central retinal artery occlusion.

To assess and compare the efficacy of three treatment modalities for central retinal artery occlusion (CRAO): conservative therapy, hyperbaric oxygen therapy (HBOT), and endovascular retinal surgery (ERS). We retrospectively analyzed the cases of CRAO patients treated at the Toyama University Hospital. Their age range was 44-87years; a balanced gender distribution was observed. The conservative therapy group included 13 eyes (6 males, 7 females, average age 74years). HBOT group: 11 eyes from 10 patients (5 males, 5 females, average age 70years). ERS group: 10 eyes (7 males, 3 females, average age 74years). The treatments were as follows. Conservative group: ocular massage and sublingual nitroglycerin. HBOT: 60-min sessions at 2 atmospheres. ERS: vitrectomy followed by tissue plasminogen activator injection using a 47-ga. microneedle. Visual acuity was assessed using logMAR units, with statistical analyses by paired t-test, Kruskal-Wallis test, and Mann-Whitney U-test with Bonferroni correction. The conservative group showed a slight visual acuity change from 1.96 ± 0.53 to 1.88 ± 0.56 (p = 0.56). The HBOT group exhibited a significant improvement from 1.79 ± 0.80 to 1.28 ± 0.81 (p = 0.007). The ERS group displayed the most substantial improvement, with scores moving from 1.98 ± 0.36 to 0.68 ± 0.49 (p = 0.0000413). The ERS group's outcomes were significantly superior to those of the other groups. These results suggest that while conservative treatment may not be sufficient, both HBOT and endovascular retinal surgery show promise, with the latter demonstrating the most significant improvement.

An evaluation of 30 years’ experience in the use of botulinum toxin injections in the management of sixth nerve palsies

ABSTRACT Intrroduction Sixth nerve palsy is the most common type of extraocular muscle palsy. The therapy options in sixth nerve palsies include monitoring with or without conservative treatment, botulinum toxin injections or strabismus surgery. The aim of this retrospective study was to compare botulinum toxin (BT) injections into the medial rectus to conservative treatment in sixth nerve palsies. The rate of patients improved after intervention and treatment outcomes for the two treatment options were be evaluated at a German tertiary referral center. Methods A service evaluation was conducted on adult patients with sixth nerve palsy. Patient files were reviewed and data including abduction deficit and size of deviation were collected retrospectively. Patients which presented between January 1987 and April 2022 were considered. Patients were allocated into two treatment groups: BT injected into medial rectus or conservative treatment, which included observation, providing occlusion and Fresnel prisms. Inclusion criteria were attendance of two visits with orthoptic assessment. Exclusion criteria included presence of further oculomotor palsies, strabismus, strabismus surgery and suppression. Non-parametric statistical analysis was conducted using IBM® SPSS Statistics. Results A total of 606 adult patients with unilateral or bilateral sixth nerve palsy attended during the named period. A total of 137 adult patients met the inclusion criteria. Of which, 36 had a bilateral palsy, 101 had a unilateral palsy. 45.26% (n = 62) were treated with BT injections and 54.75% (n = 75) were treated conservatively. The median initial abduction deficit was greater in the BT group, (−4 to −5 after Scott and Kraft) than in the conservative treatment group (−1). The initial angle of deviation at distance was significantly larger in the BT group than in the conservative treatment group (p = <0.001). The rate of improvement in the BT group was 24.19% (n = 15) and 20% (n = 15) in the conservative treatment group. When excluding longstanding palsies rates of improvement in both groups increased to 28.85%. The improvement of the angle of deviation at distance in all patients was greater in the BT group (p = <.001). The improvement of abduction in bilateral palsies were greater in the BT group (p = .016), but in unilateral palsies, there was no significant difference in abduction improvement in the two treatment groups (OD p = .3, OS p = .406). Conclusion This service evaluation found that BT injection into medial rectus in unilateral and bilateral sixth nerve palsies did not increase the rate of improvement compared to conservative treatment. But BT injections reduced the angle of deviation to a greater extent than conservative treatment. Additionally, BT was able to improve abduction in bilateral palsies to a greater extent than conservative treatment. It is recommended a BT injection is considered in symptomatic bilateral sixth nerve palsies to enable fixation and improved ocular motility. More research is needed to verify reliable clinical guidelines for the use of BT in sixth nerve palsies.

Comparison of strategies based on DTI visualisation for stereotactic minimally invasive surgery in the treatment of moderate-volume thalamo-basal ganglia cerebral haemorrhage: a protocol for a multicenter prospective study

IntroductionHypertensive intracerebral hemorrhage (HICH) is a condition associated with significant morbidity, mortality, and disability, particularly among the elderly population. The management of moderate thalamic-basal ganglia cerebral hemorrhage primarily relies on conservative approaches. Nevertheless, the rate of long-term disability remains high. In recent years, there has been significant advancement in minimally invasive surgery and diffusion tensor imaging techniques. Consequently, the utilization of Diffusion Tensor Imaging (DTI) technology in patients with cerebral haemorrhage allows for the identification of the haematoma’s location in relation to the Corticospinal Tract (CST). This enables the development of precise puncture pathways that can be visualized, thereby avoiding any potential damage to the CST.Methods and analysisDiffusion Tensor Imaging (DTI) is a method used to assess the structural and physiological characteristics of biological tissue by examining the diffusion behavior of water molecules.In the central nervous system, limb paralysis will be inevitable if the corticospinal tract is damaged. By employing DTI imaging techniques on individuals, it becomes possible to visualize the spatial relationship between the hematoma and the CST. This approach allows avoidance of the CST during preoperative planning of the puncture path, thus reducing secondary injuries caused by the procedure. The primary objective of this study was to assess the ability of patients in the minimally invasive surgery group and the conservative group to perform activities of daily living after 6 months of treatment. In addition, secondary outcomes included assessment of hematoma resorption/clearance ratios, cytokine levels, complication rates, and therapeutic indexes at different treatment durations, as well as long-term safety and efficacy at 2–3 years of follow-up. Furthermore, subgroup analysis, and sensitivity analysis were conducted to further analyze the data. Logistic single-variate and multivariate regression analyses were applied to understand the adverse factors affecting prognosis.Ethics and disseminationThe clinical study was reviewed and approved by the Ethics Committee of the First People’s Hospital of Yibin. The ethical number is: 2023 Review (64).Registration numberThis protocol is registered in the Prospective Registry of Chinese Clinical Trial Registries (PROCCTR). The full date of first registration is 28/12/2023. The registration number for PROCCTR is ChiCTR2300079252.

Long-Term Outcome After Resection of Hepatic and Pulmonary Metastases in Multivisceral Colorectal Cancer

Background/Objectives: Colorectal cancer (CRC) with hepatic (CRLM) and pulmonary metastases (CRLU) presents a significant clinical challenge, leading to poor prognosis. Surgical resection of these metastases remains controversial because of limited evidence supporting its long-term benefits. To evaluate the impact of surgical resection of both hepatic and pulmonary metastases on long-term survival in patients with multivisceral metastatic colorectal cancer, this retrospective cohort study included 192 patients with UICC stage IV CRC treated at a high-volume academic center. Methods: Patients were divided into two groups: those who underwent surgical resection of both hepatic and pulmonary metastases (n = 100) and those who received non-surgical treatment (n = 92). Propensity score matching was used to adjust for baseline differences. The primary outcome was overall survival (OS). Results: Unadjusted analysis showed a significant OS benefit in the surgical group (median OS: 6.97 years) compared with the conservative group (median OS: 2.17 years). After propensity score matching, this survival advantage persisted (median OS: 5.58 years vs. 2.35 years; HR: 0.3, 95% CI: 0.18–0.47, p &lt; 0.0001). Conclusions: Surgical resection of hepatic and pulmonary metastases in multivisceral metastatic CRC significantly improves long-term survival, supporting an aggressive surgical approach in selected patients.

Efficacy of Conservative Therapy versus Tamsulosin Added Therapy in Patients with Lower Ureteral Calculi and their Health Related Quality of Life

Background: Alpha-1 blockers reduce smooth muscle tension and alleviate spasms, thereby decreasing obstructions and relieving irritative symptoms in the lower urinary tract. This study aimed to assess the effectiveness of Tamsulosin and its impact on health-related quality of life in patients with distal ureteral calculi. Methods: A total of 120 patients with distal ureteral calculi were enrolled in this study and randomly assigned into two groups. Group 1 (n=60) received conservative therapy, while Group 2 (n=60) received Tamsulosin (0.4 mg daily) in addition to conservative therapy. All patients were monitored for pain, intensity of ureteric colic, and spontaneous stone expulsion. Health-related quality of life (HRQoL) was assessed for each patient using the RAND SF-36 Health Survey 1.0. Results: Spontaneous stone passage occurred in 52 patients (85%) in Group 1 and in all 60 patients (100%) in Group 2, with a statistically significant difference between the groups (P&lt;0.001). Analysis by stone diameter further indicated significant differences favoring Tamsulosin treatment for stones ≤6 mm (P=0.04) and &gt;6 mm (P=0.003). Health-related quality of life scores were significantly higher in the Tamsulosin group compared to the conservative therapy group. Conclusion: Tamsulosin, an alpha-1 blocker, is recommended for treating distal ureteral calculi, as it facilitates faster stone expulsion, increases expulsion rates, and enhances quality of life by reducing the frequency and severity of ureteric colic.

Post-Cataract Surgery Fungal Endophthalmitis: 6-Year Experience in Management and Outcomes at a Tertiary Eye Care Center.

This study aimed to describe the functional and anatomical outcomes of post-cataract surgery fungal endophthalmitis at King Khaled Eye Specialist Hospital (KKESH). A retrospective analysis of clinical data from a single institution was performed. This study included 29 patients with post-cataract surgery endophthalmitis with suspected or confirmed fungal etiology who presented between January 1, 2017, and December 31, 2022. We evaluated demographics, clinical features, microbiological assessments, and treatment strategies. The effects of various treatments on outcomes were analyzed. The need for additional treatment and functional and anatomical outcomes was also investigated. The mean time from surgery to the onset of ocular symptoms was 52.1 (SD ± 59.9; range, 3-210) days, and the mean time from surgery to the first visit to KKESH was 81.4 (SD ± 103.5; range, 2-510) days. Low culture positivity was noted in four samples, with two revealing Aspergillus sp. and two revealing Cladosporium sp. Of the 29 patients, 6 underwent pars plana vitrectomy (PPV) and received intravitreal antimicrobial/antibiotic injections. Two of the six patients also underwent simultaneous intraocular lens removal. The average number of additional treatments, regardless of visual acuity, was lower in the PPV group than in the conservative group (0.5 [SD ± 1.1; range, 0-3] and 1.48 [SD ± 1.47; range, 0-6], respectively). In the PPV group, 50% (n=3) of the eyes achieved functional success and 83.3% (n=5) of the eyes achieved anatomical success. In contrast, in the conservative group, 43.5% (n=10) of the eyes achieved functional success and 69.6% (n=16) of the eyes achieved anatomical success. For post-cataract surgery fungal endophthalmitis, a high index of suspicion and prompt PPV with empirical administration of intravitreal antifungal agents are required to achieve a favorable prognosis.

Surgical management of first-time patellar dislocations in paediatric patients may lower rates of redislocation compared to conservative management: A systematic review and meta-analysis.

The purpose of this study is to assess whether early surgical intervention for first-time patellar dislocations in paediatric patients is superior to conservative management. We hypothesized that surgical intervention would lead to lower redislocation rates compared to conservative treatment. Three online databases (PubMed, MEDLINE and EMBASE) were searched from inception to 14 March 2024 to identify studies investigating the management options for acute first-time patellar dislocations in paediatric patients. Data pertaining to patient demographics, patient management, redislocation rates and Kujala scores, evaluating function, were abstracted. Weighted means and meta-analyses were conducted to compare rates of redislocation, as well as Kujala scores. The quality of included studies was assessed using the methodological index for non-randomized studies criteria for non-randomized studies and the ROB2 tool for randomized controlled trials (RCTs). A total of 11 studies and 761 patients were included in this review. The weighted mean post-operative combined rates of redislocation in the surgical group was 25.1%, compared to 46.4% in the conservative group at a mean follow-up of 53.2 months (12-168). The relative risk (RR) of redislocation was 0.82 (95% confidence interval [CI]: 0.65-1.04, I2 = 0%, p = 0.11), favouring surgery compared to conservative management. A subgroup meta-analysis of two recent RCTs with 110 patients demonstrated an RR of redislocation of 0.53 (95% CI: 0.31-0.91, I2 = 0%, p = 0.02), favouring surgery. Kujala scores among three comparative studies showed a mean difference of -2.7 (95% CI: -6.1 to 0.68, I2 = 0%, p = 0.12), favouring conservative treatment. The weighted mean redislocation rate in 131 patients undergoing medial patellofemoral ligament reconstruction (MPFLR) was 3.1%, compared to 39.4% in 203 patients undergoing other surgical procedures, such as lateral release and medial imbrication, Roux-Goldwaith and MPFL repair. Furthermore, the conservative groups experienced a complication rate of 0.9% compared to 2.9% across the surgical groups. Surgical management for first-time patellar dislocations in a paediatric population, particularly MPFLR, may be more beneficial in lowering redislocation rates than conservative management. No significant differences in Kujala scores were found. Level IV.

Comprehensive framework for data fusion in distributed ledger technologies to enhance supply chain sustainability

This review proposes a comprehensive framework that integrates data fusion with Distributed Ledger Technologies (DLT) to enhance sustainability in supply chain management. In today’s global supply chains, ensuring transparency, efficiency, and environmental responsibility is critical, yet the lack of real-time visibility and data fragmentation presents significant challenges. The framework addresses these issues by merging data from multiple sources, including IoT devices, operational databases, and external environmental factors, using advanced data fusion algorithms. DLT, with its decentralized, immutable, and transparent nature, ensures the integrity and security of the data, allowing all stakeholders to access accurate and tamper-proof information. The fusion of data within a DLT infrastructure not only improves traceability and accountability but also enables the automation of sustainability checks via smart contracts. These contracts can trigger actions based on predefined sustainability metrics such as carbon emissions, energy consumption, and resource efficiency. Furthermore, predictive analytics and machine learning algorithms integrated into the system provide real-time monitoring and optimization of sustainability performance throughout the supply chain. The proposed review offers numerous benefits, including enhanced transparency, reduced operational costs, improved sustainability outcomes, and risk mitigation. It also addresses challenges such as scalability, data privacy, and regulatory compliance, offering solutions to overcome these hurdles. By exploring case studies of successful implementations, this review demonstrates the practical applications and future potential of combining DLT and data fusion for sustainable supply chain management, positioning it as a critical tool for organizations aiming to meet environmental and regulatory demands in an increasingly digital and eco-conscious world.

Economic Growth Targets, Innovation Transformation, and Urban Carbon Emissions: An Empirical Study of the Yangtze River Delta

In the face of carbon emissions reduction efforts, which are a common but differentiated global responsibility, it is crucial to explore the potential synergistic path between economic growth and carbon emissions reduction. This study integrates economic growth management and carbon emissions into a theoretical framework, based on city-level panel data from 2005 to 2019 in the Yangtze River Delta and the fixed effects model. We explore the impact of economic growth targets on urban carbon emissions. Then, we explore the mechanism by which economic growth target affects carbon emissions with the mediation effect model and moderation effect model. The results reveal that economic growth targets are beneficial for carbon reduction, and innovation development from innovation transformation is an important mechanism driving carbon emissions reduction, but the effects of different innovation outputs exhibit notable variations. In addition, marketization and industrial structure affect the relationship between economic growth targets and carbon emissions. The heterogeneity analysis reveals substantial spatial and temporal differences. Based on the realities of developing countries’ ongoing economic targets, this study provides a new explanation for the relationship between government policies and carbon emissions, establishing a scientific basis for policymakers to formulate strategic green development policies.

Early Intervention in Patients With Asymptomatic Severe Aortic Stenosis and Myocardial Fibrosis

Development of myocardial fibrosis in patients with aortic stenosis precedes left ventricular decompensation and is associated with an adverse long-term prognosis. To investigate whether early valve intervention reduced the incidence of all-cause death or unplanned aortic stenosis-related hospitalization in asymptomatic patients with severe aortic stenosis and myocardial fibrosis. This prospective, randomized, open-label, masked end point trial was conducted between August 2017 and October 2022 at 24 cardiac centers across the UK and Australia. Asymptomatic patients with severe aortic stenosis and myocardial fibrosis were included. The final date of follow-up was July 26, 2024. Early valve intervention with transcatheter or surgical aortic valve replacement or guideline-directed conservative management. The primary outcome was a composite of all-cause death or unplanned aortic stenosis-related hospitalization in a time-to-first-event intention-to-treat analysis. There were 9 secondary outcomes, including the components of the primary outcome and symptom status at 12 months. The trial enrolled 224 eligible patients (mean [SD] age, 73 [9] years; 63 women [28%]; mean [SD] aortic valve peak velocity of 4.3 [0.5] m/s) of the originally planned sample size of 356 patients. The primary end point occurred in 20 of 113 patients (18%) in the early intervention group and 25 of 111 patients (23%) in the guideline-directed conservative management group (hazard ratio, 0.79 [95% CI, 0.44-1.43]; P = .44; between-group difference, -4.82% [95% CI, -15.31% to 5.66%]). Of 9 prespecified secondary end points, 7 showed no significant difference. All-cause death occurred in 16 of 113 patients (14%) in the early intervention group and 14 of 111 (13%) in the guideline-directed group (hazard ratio, 1.22 [95% CI, 0.59-2.51]) and unplanned aortic stenosis hospitalization occurred in 7 of 113 patients (6%) and 19 of 111 patients (17%), respectively (hazard ratio, 0.37 [95% CI, 0.16-0.88]). Early intervention was associated with a lower 12-month rate of New York Heart Association class II-IV symptoms than guideline-directed conservative management (21 [19.7%] vs 39 [37.9%]; odds ratio, 0.37 [95% CI, 0.20-0.70]). In asymptomatic patients with severe aortic stenosis and myocardial fibrosis, early aortic valve intervention had no demonstrable effect on all-cause death or unplanned aortic stenosis-related hospitalization. The trial had a wide 95% CI around the primary end point, with further research needed to confirm these findings. ClinicalTrials.gov Identifier: NCT03094143.

Mobilising tensions: transnational union network formation in the Asia-Pacific region

Trade unions are an important actor in the social regulation of the transnational corporation. How and why trade unions engage with the continued rise of global corporate social responsibility (CSR) initiatives remains largely under-researched, particularly in transnational arenas beyond Europe. Transnational trade union networks are a concerted development intended to advance collective worker voice and influence, especially in contexts without a history of strong social dialogue. Our qualitative fieldwork centres on a transnational trade union network comprised of global, national, and local union representatives from different countries in the Asia-Pacific representing workers from one Germany-headquartered multinational corporation in the chemical sector. We examine how labour actors involved in the network engage with global CSR initiatives to advance worker voice and influence in the Asia-Pacific region. Our micro-sociological and relational approach focused on the practices, relations, and affective dimensions of building and sustaining a transnational network. What emerged is the centrality of tensions and how actors creatively utilise and shape those tensions into resources for building the network. We analyse the nature of the tensions and their effects and discuss how key actors work generatively with tensions.

Hutan Nagari Simancuang: Pengelolaan Hutan Skema Perhutanan Sosial di Kabupaten Solok Selatan

The aim of this research is to describe and explain social forestry scheme forest management in Jorong Simancuang, South Solok Regency, West Sumatra Province. The research method uses a descriptive approach with data collection through interviews. The Infoman consists of the Nagari Forest Management Institute (LPHN), the Social Forestry Business Group (KUPS), community leaders, companions of the Indonesian Conservation Group (KKI) Warsi and the Farmers' Group. The results of this research show that social forestry is present in the Jorong Simancuang Village community, strengthening the legitimacy of the community's desire to protect their forests as a source of water for agriculture and forests as a source of farming economy.

Effects of immunosuppressive therapy on renal prognosis in primary membranous nephropathy

BackgroundImmunosuppressive therapy plays a crucial role in treating membranous nephropathy, with previous studies highlighting its benefits for patients with primary membranous nephropathy (PMN). Guidelines suggest that the management of membranous nephropathy should be tailored to individual risk levels. However, there is a lack of real-world studies examining the effects of immunosuppressive therapy on renal outcomes in PMN patients. This study aimed to investigate the relationship between immunosuppressive therapy and renal prognosis in PMN patients.MethodsThis was a real-world retrospective study including patients diagnosed with PMN in Shenzhen Second People’s Hospital and Hechi People’s Hospital. Univariate and multivariate Cox regression analysis and Kaplan-Meier survival analysis were used.ResultsAfter propensity score-matching, 464 PMN patients were included and they were assigned to conservative and immunosuppressive group in a 1:1 ratio. Immunosuppressive therapy was the protective factor of renal composite outcome (HR = 0.65, p < 0.01). Separately, the effect was significant in moderate- and high-risk but not in low-risk patients. Key influencing factors including age, blood pressure, albumin and total cholesterol levels, with slight differences among patients at different risk.ConclusionsThis study demonstrates the efficacy of immunosuppressive therapy in non-low-risk PMN patients. The key factors affecting renal prognosis in patients with different risk levels are emphasized to help provide individualized treatment.

Dural arteriovenous fistulas at the craniocervical junction: a systematic review and meta-analysis.

The management for craniocervical junction dural arteriovenous fistulas (CCJ-DAVFs) remains controversial and clinically challenging. We systemically summarized the clinical and angiographic outcomes of microsurgery, embolization, and conservative management. Relevant articles were retrieved from PubMed, Scopus, Web of Science, and Cochrane, following PRISMA guidelines. A systematic review and meta-analysis were conducted on the clinical characteristics, management approaches, and clinical and angiographic outcomes. We included 13 articles (166 patients). The weighted mean age was 58.9 years (95%CI: 53.2-64.5), 58.8 years (95%CI: 48.4-69.2), and 63.8 years (95%CI: 60.1-67.5), in microsurgery, embolization, and conservative groups respectively, with an overall male sex predominance (microsurgery [n = 51/77, 66.2%], embolization [n = 44/56, 78.6%], and conservative management [n = 6/8, 75.0%]). Patients were managed with microsurgery (n = 80/172, 46.5%), embolization (n = 79/172, 45.9%), and conservative treatment (n = 13/172, 7.6%). Foramen magnum was the most common location (microsurgery [n = 34/77, 44.2%], embolization [n = 31/56, 55.4%], and conservative treatment [n = 3/8, 37.5%]). Vertebral artery was the primary feeder (microsurgery [n = 58/84, 69.1%], embolization [n = 41/86, 47.6%], and conservative treatment [n = 4/7, 57.1%]). Complete fistula obliteration rates were 74.1% (95%CI:52.3-88.2%) in the microsurgery group and 54.9% (95%CI:30.7-77.0%) in the embolization group. Complications rates were 16.2% (95%CI:6.7-34.5%) in the embolization group, 11.6% (95%CI:3.8-30.4%) in the microsurgery group, and 7.7% (95%CI:1.1-39.1%) in the conservative group. Different rates of good clinical outcomes were observed [microsurgery: 66.4% (95%CI:48.1-80.8%), embolization: 51.9% (95%CI:30.8-72.4%), and conservative: 11.6% (95%CI:4.4-27.4%)]. In patients with CCJ-DAVFs, each management approach has its own merits based on the fistula and patient characteristics.

Trends and Developments in Engineering Education: A Bibliometric Analysis of Students' Competencies Research (2015-2024)

In this study, CiteSpace and VOSviewer bibliometrics software were used to analyze 257 papers on the topic of student competencies in engineering education included in the Core Collection of Web of Science databases from 2015 to 2024, revealing the research hotspots and development trends in this field. The study found that innovative research in engineering education mainly focuses on the areas of interdisciplinary integration, technology application and sustainable development, especially the application of project- based learning (PBL), augmented reality (AR) technology, and modeling tools have shown significant results in enhancing students' practical ability and innovative thinking. the extensive application of models such as BIM and LCSD further enhances students' professional skills in system analysis and engineering design. Meanwhile, the innovative curriculum design and the cultivation of innovative self-efficacy played an important role in the development of students' creativity. This study not only summarizes the hotspots of existing research, but also proposes future research directions in technology integration, global competency development and social responsibility education, providing a strong theoretical basis for the future development of engineering education.

Surgical intervention for distal radial fractures with concurrent ulnar styloid fractures may be beneficial for the elderly patients: a retrospective study

BackgroundDistal radius fractures are highly prevalent among older adults. Ulnar styloid fractures frequently accompany distal radius fractures, raising concerns about treatment outcomes due to the risk of distal radioulnar joint (DRUJ) instability. This study investigated the necessity of surgical intervention (open reduction internal fixation; ORIF) for distal radius fractures in very old patients with coexisting ulnar styloid fractures.Materials and methodsA retrospective analysis of 96 patients aged ≥ 80 years with AO classification 23-A2 to 23-B3 distal radius fractures with concomitant ulnar styloid fracture between 2019 and 2022 was performed. Patients were excluded if they were aged < 80 years, had a preinjury Barthel index of < 90, or had high-energy multiple trauma. The primary outcome was the Disabilities of the Arm, Shoulder, and Hand (DASH) score assessed at 3, 6, and 12 months. We compared the DASH score and their trajectories between the ORIF and conservative treatment groups.ResultsORIF group demonstrated significantly better DASH functional scores (25.31 ± 4.71) at the 12-month follow-up compared with the conservative group (34.42 ± 8.03; p < 0.001). Treatment choice was identified as a significant predictor of DASH scores at 12 months, with ORIF significantly improved patient’s wrist function and demonstrated a β coefficient of − 9.11 (95% confidence interval: −11.95 to − 6.27, p < 0.001). The other factors investigated, namely age, lowest T-score, and medical history of diabetes mellitus, hypertension, coronary artery disease, cerebrovascular accidents, cancer, and dementia, did not exhibit a significant association with the 12-month DASH scores in the adjusted model (p > 0.05).ConclusionsOur findings suggest that very old patients with distal radius fracture accompanied by ulnar styloid fractures may benefit from ORIF to achieve optimal long-term functional recovery.