Follow-up Study Research Articles

Axillary Reactive Lymphoid Hyperplasia, Likely Due to Unicentric Castleman Disease, and the Concurrent Presence of Orbital Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma: A Six-Year Follow-Up Study

Axillary Reactive Lymphoid Hyperplasia, Likely Due to Unicentric Castleman Disease, and the Concurrent Presence of Orbital Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma: A Six-Year Follow-Up Study

Spatial and Temporal Visualization of Polymorphic Transformations in Pharmaceutical Tablets.

X-ray Diffraction Computed Tomography (XRD-CT) represents a cutting-edge method for non-destructive material analysis, offering the unique capability of providing molecular-level information with spatial resolution. In this study, we have applied XRD-CT to investigate pharmaceutically relevant tablets that have been subjected to a range of compression pressures typical in tablet manufacturing. By employing XRD-CT to pharmaceutical tablets, we reveal material changes without tablet destruction, thereby avoiding potential phase transformations during sample preparation that could lead to errors in the interpretation of the processes that have occurred. Utilizing a pressure-sensitive marker, glycolide, we have tracked changes within tablet structures induced by compression, pinpointing locations where glycolide undergoes pressure-induced transformation. Additionally, we conducted a follow-up study with analysis one month later, observing an in-situ hydrolysis reaction of glycolide within the tablets. Through the complementary use of electron diffraction, we have elucidated the structure of the hydrolysis product, further enhancing our understanding of temporal changes in the tablets.

Efficacy of electrical stimulation of the zygomaticus muscle in complete facial paralysis: evidence from facial grading and automated image analysis

Surface Functional Electrical Stimulation (FES) is a well-studied intervention for multiple muscular disorders. However, it is still controversially discussed as a complementary therapy for complete facial paralysis. The aim of this intervention is to test a daily home-based ES concept as a pilot study regarding safety, feasibility, and effects on facial functionality and symmetry. In a prospective single-centre pilot study, 10 patients (median 61 years, denervation 130 d) with complete peripheral facial paralysis performed home-based FES of the affected lateral mouth region Stimulation parameters, facial paralysis scores and standardised photographs were assessed in monthly follow-ups. No serious adverse events appeared. Stimulation parameters could be constantly increased indicating effective muscle training while subjectively perceived functionality of the face improved. Thus, smile angle of the paralysed side improved as well. FES is a safe therapy model for application in facial nerve paralysis patients. A feasible stimulation protocol could be applied, which improved the functionality and symmetry of the stimulated facial region. A future controlled, randomised and double-blind follow-up study is needed to investigate these initial results in a further evolved replicable setting.

Association of unemployment and increased depressive symptoms with all-cause mortality: follow-up study of a cardiovascular prevention programme.

Unemployment has been associated with increased risk of cardiovascular disease (CVD) and all-cause mortality. However, factors behind this association remain unsettled. A primary care CVD prevention programme was conducted in two Finnish towns in 2005-07. Of the participants (n = 4450), a cohort of apparently healthy CVD risk subjects belonging to the labour force (n = 1487) was identified. Baseline depressive symptoms were assessed by Beck's Depression Inventory. Data on employment status and mortality were obtained from official statistics. The effect of employment status and depressive symptoms on all-cause mortality after a median follow-up of 15 years was estimated in models adjusted for age, sex, body mass index, non-high-density lipoprotein cholesterol, physical activity, alcohol use, current smoking, glucose metabolism, and hypertension. In comparison to employed non-depressive subjects, fully adjusted hazard ratio (HR) for all-cause mortality was 3.53 (1.90-6.57) in unemployed subjects with increased depressive symptoms, 1.26 (0.68-2.34) in unemployed non-depressive subjects, and 1.09 (0.63-1.90) in employed depressive subjects. Factors independently associated with mortality were unemployment with increased depressive symptoms [HR 3.56 (95% CI 1.92-6.61)], screen-detected diabetes [HR 2.71 (95% CI 1.59-4.63)], current smoking [HR 1.77 (95% CI 1.19-2.65)], and higher age [HR 1.10 (95% CI 1.05-1.15)]. Unemployment in itself was not associated with all-cause mortality. If unemployment was accompanied with increased depressive symptoms, risk of death was significantly elevated.

Addressing unmet social needs of children with obesity: a pilot randomized controlled trial.

Childhood obesity is an ongoing public health crisis, and recent clinical practice guidelines identify addressing the role of social inequities in the disparity of health among children with obesity as an area to address. This study aimed to assess the feasibility of a community navigation intervention in a pediatric weight management clinic. A single-center pilot randomized controlled trial (RCT) recruiting families from a tertiary hospital pediatric weight management program to evaluate the feasibility of a community navigation intervention. The primary feasibility outcomes were recruitment rates (goal to recruit 80% of the sample in 6months), uptake of the intervention (goal > 80% of participants in the intervention group to have a visit with the navigator), and acceptability (goal > 90% of families in the intervention group complete all follow-up). Eighty participants completed the social needs screening, and 42 (52.5%) participants screened positive for an unmet social need. In the first 6months of recruitment, 18 participants were recruited out of a goal of 40 participants (the recruitment rate was 45% vs. the goal of 80% in 6months), and complete recruitment was achieved in 12months. Of the 21 participants randomized to the intervention arm, 20 completed the intervention (uptake of intervention was 95% vs. goal 80%). Ten participants in the intervention arm completed all four planned follow-up study visits (the acceptability of follow-up was 48% vs. the goal of 90%). We completed a pilot RCT of implementing a community navigator program in a pediatric weight management program. We found feasibility in the intervention's uptake but limited feasibility in recruiting participants and the acceptability of the follow-up. Clinicaltrials.gov, NCT04711707, https://clinicaltrials.gov/ct2/show/NCT04711707.

Understanding the transdiagnostic mechanisms underlying emerging psychopathology in adolescence: study protocol of a 1-year prospective epidemiological (EMERGE) study

IntroductionAdolescent mental health is a global public health challenge as most cases remain undetected and untreated, and consequently, have a high likelihood of persistence or recurrence. It is critical to...

Urinary Retention After GreenLight Laser Photoselective Vaporization of the Prostate (GLL.PVP) Surgery for Benign Prostatic Hyperplasia (BPH): A 3-6 Month Retrospective Follow-Up Study.

Objective Our study was designed to evaluate the postoperative urinary retention (UR) and success rate of the GreenLight Laser (Boston Scientific, Marlborough, MA, USA) photoselective vaporization of the prostate (GLL.PVP) procedure for Benign Prostatic Hyperplasia (BPH) patients, both with and without high-risk factors. Methodology We conducted a retrospective follow-up study of postoperative patients who underwent GLL.PVP for BPH. We collected data from clinical health records, including notes from the lower urinary tract symptoms (LUTS) clinic, trial without catheter (TWOC) clinic, and emergency department presentations with UR. The analysis examined several parameters, including the patient's age, high-risk factors, prostate volume, and both preoperative and postoperative objective voiding parameters. These voiding parameters included post-void residual (PVR) and maximum flow rate (Qmax). Additionally, the analysis looked into whether the patient had a catheter or experienced urinary retention prior to the surgery. Results A total of 50 GreenLight Laser PVP surgeries were performed over a 14-month period from May 2023 to July 2024 at West Middlesex University Hospital in London. Most of the patients were between the ages of 60 and 80. Prior to the surgery, data indicated that 17 patients (34%) were using long-term catheters, whereas 33 patients (66%) were not. Additionally, 25 patients (50%) were identified as having high-risk factors, which included being on anticoagulation therapy, a history of urinary retention, and a prostate volume exceeding 100 cc.Notably, the patient without h/o urinary retention had an average preoperative PVR of 150 mL and an averageQmaxof 7 mL/second In our 3-6 month retrospective postoperative follow-up study, we found that eight cases (16%) developed urinary retention, while 42 cases (84%) did not, with an average PVR volume of 105 mL and an average Qmax of 13.5 mL/second. In patients with preoperative urinary retention, 13 cases (76%) did not develop UR postoperatively whereas four cases (24%) developed. Conclusion Our study conclusively found that 42 cases (84%) of patients did not experience urinary retention (UR) in the follow-up after undergoing the GLL PVP operation, irrespective of any history of urinary retention or other high-risk factors. This unequivocally demonstrates the operation's efficacy. Furthermore, our findings revealed that three-quarters of patients with a preoperative history of urinary retention also did not develop UR post-surgery. The GLL.PVP procedure is safe and effective, leading to rapid improvements in voiding parameters.

Outcome of Pediatric Inflammatory Bowel Disease in Asian Children: A Multinational One-year Follow-up Study.

Epidemiological data on pediatric inflammatory bowel disease (PIBD) have been reported in Asian countries. However, short-term follow-up data, especially in Southeast Asian countries, are limited. Analyze and compare the baseline and 1-year follow-up (1FU) data for PIBD in Asian children. The multinational network included patients with PIBD (aged <19 years) in five Asian countries (Malaysia, Philippines, Singapore, Sri Lanka, and Thailand). The diagnosis of PIBD requires gastrointestinal endoscopy. The patients' demographics, clinical information, disease-related outcomes, and treatment data at 1FU were collected. In 1995-2021, 368 patients were enrolled (CD, 56.8%; UC, 38%; and IBD-unclassified, 5.2%). At 1FU, symptoms including diarrhea, bloody stools, and nausea/vomiting subsided in <3%, while abdominal pain persisted in 10.5% of patients with CD and 7.1% of patients with UC. Assessment endoscopy was performed at 1FU in 38% of CD and 31% of UC cases, of which 21% and 23% showed mucosal healing, respectively. Oral prednisolone was administered to 55.3% of patients at diagnosis and 26.8% at 1FU, while infliximab was administered to 2.5% and 7.2% of patients at diagnosis and 1FU, respectively. Independent factors of 1-year clinical remission for CD were oral prednisolone (odds ratio [OR], 0.20; 95% confidence interval [CI], 0.06-0.68), antibiotic use (OR, 0.09; 95% CI, 0.01-0.54), and immunomodulator use (OR, 5.26; 95% CI, 1.52-18.22). A history of weight loss at diagnosis was the only independent risk factor of an IBD flare by 1FU (OR, 2.01; 95% CI, 1.12-3.63). The proportion of children with PIBD and abdominal pain at 1FU remained high. The rates of repeat endoscopy and infliximab use were suboptimal with high rates of systemic corticosteroid use. Quality improvement based on the aforementioned predictors may enhance PIBD care in this geographic region or similar settings.

Effectiveness of Fenestration and Discectomy among Patients Presenting with Lumbar Disc Herniation

Background:Research-StackExchange47, BackgroundLumbar disc herniation (LDH) is a frequent cause of back pain and neurological dysfunction that often requires surgical treatment. There writing was another popular technique fenestration the other favorite disceyotomy, to relieve symptoms by decompressing ✓ spinal nerve roots. The study is an investigation of these existing methods and their comparison with the aim of evaluating efficacy in symptom relief as well as patient outcome. Objective: aim to compare the clinical outcomes of fenestration and discectomy in lumbar disc herniation. Study design : Descriptive case series comparative study. Place and duration of study. 6th September 2023 to 6the March, 2024 at the Department of Neurosurgery, Qazi Hussain Ahmad Medical Complex Nowshera. Methods: The patients were included in this descriptive case series study that was conducted from 6th September 2023 to 6the March, 2024 at the Department of Neurosurgery, Qazi Hussain Ahmad Medical Complex Nowshera. A sample size was determined at 46% success rate with the help of WHO software, a confidence interval of 95% and margin of error was set at 9%. Assessment of the outcomes in patients including pain and functional improvement were calculated using p-values between groups by standard deviation. Results: This retrospective study included 118 patients (34 females and 84 males) with lumbar disc herniation. Overall, the proportion of males to females was 2.47:1 In a total of 88 patients (74.58%), efficacy was reported, and the mean score for effective relief from symptoms was 3.5 ± 1.2 (SD). Statistical analysis revealed significant differences between the techniques (p &lt; 0.05) with fenestration being marginally superior. Conclusion: Fenestration and discectomy for lumbar disc herniation: a follow-up study. As for symptomatic relief, fenestration seemed to be slightly better. Conclusions. This study provides evidence for both surgical methods as valid surgical options; however, choice of technique should be individualized based on patient characteristics. It is recommended that future studies with larger samples, to provide for more inclusive results.

Sustainability of knotworking as a teacher professional development strategy

Teachers are faced with emerging and often complex constraints that can impact their ability to be pedagogically responsive to learners' different needs. These constraints or challenges were compounded by the COVID-19 pandemic. Thus, I extend scholarship in the field of teacher professional development by exploring the potential of implementing a nuanced form of collaborative intervention strategy called knotworking. There is a growing literature, some of which is discussed in this paper, on the utilisation of cultural historical activity theory-based constructs, which include Engeström's (2000a, 2001) knotworking heuristic, to manage the complex, value-based problems that teachers and school leaders are confronted with daily. This paper is a follow-up study that reported on a year-long knotworking intervention at a primary school in Johannesburg. The findings from the initial project (Andrews, 2024) showed that teachers were able to identify complex problems constraining their teaching and, through collaboration, generate new knowledge and teaching methods and deepen their understanding of how to be pedagogically responsive to the different learning needs of their children. In this follow-up paper, the participants in the initial knotworking intervention were interviewed to explore whether the new knowledge or practices they identified and implemented in the classroom had been sustained a year later. Findings from the qualitative data generated from the semi-structured interviews with the teachers show that much of the new knowledge, which included teaching practices, classroom management plans, or learner interventions that emanated from the knotworking interventions were still in use a year later and, in some instances, were integrated into internal operational policies.

Abstract 4134935: Impact of COVID-19 on Cardiology Fellows and Faculty in the United States: Two Years Later

Introduction: Recent data demonstrated that the COVID-19 pandemic adversely affected cardiovascular fellows in training (cFIT) and faculty in terms of educational disruption and search for job prospects, respectively. However, less is known about the pandemic's effect on cFIT and faculty in terms of general well-being, shifts in personal and professional priorities, quantitative measures of stress levels, and research productivity. Methods: A national survey targeting cFIT and faculty was developed to assess the effect of the pandemic two years later on these parameters. Fifty-four participants, including 21 cFIT and 33 faculty, responded to the survey. The survey was distributed between October 2021 and May 2022 to program directors of ACGME-accredited general cardiology fellowship programs in the United States. Results: 30% of cFITs perceived impaired clinical training during the pandemic; 36% of fellows experienced a decline in their clinical skills in the cardiac catheterization lab, while 27% experienced a decrease in their echocardiographic skills. Additionally, a significant percentage of cFIT reported negative interference in their competencies in nuclear cardiology (27%) and electrophysiology (12%). Most participants (76%), including faculty and fellows, reported several health issues such as sleep problems, low energy, changes in appetite, difficulty concentrating, and restlessness due to the pandemic. 43% of the faculty and 61% of cFIT reported high rates of impaired short-term productivity (Figure). Conclusion: In this national survey, we found that two years after the onset of the COVID-19 pandemic, cardiology fellows and faculty continued to experience significant concerns for decreased hands-on training and diminished research productivity. While faculty were not distressed regarding decreased clinical competencies, concerns about short-term and long-term research productivity persisted. Faculty and fellows all experienced increased stress levels and impaired productivity. Although limited by a small sample size, which can introduce bias, these results signal the importance of performing a follow-up study on the impact of COVID-19 on wellness as well as the impact on career.

Long-term Follow-up Study for Fractured and Non-Fractured Hand Enchondromas Treated by Sole Curettage

Background: Enchondromas are the most common primary tumors in the small tubular bones of the hand and fractures are often the result of thinned cortical bone. The main question was whether fractured enchondromas influence the long-term clinical and radiological outcome. Methods: Between 2000 and 2019, 57 patients with previously treated fractured (group I) and non-fractured (group II) hand enchondromas (34 female, 23 male, mean age was 39.4 years, ± 13.7) were evaluated for clinical and radiological treatment outcomes. SF-36 and DASH questionnaires as well as patient reported experience measures were used to assess subjective health outcomes. Subsequently, 43 patients underwent clinical and radiological follow-ups. Comparative evaluation of objective treatment outcomes in both groups was conducted in terms of hand functionality, perioperative complications, recurrence rates, and osteogenesis. Results: Almost half the patients suffered enchondromas with fractures (49.1%, n=28). Two patients received additional k-wire-stabilization due to intraoperative instability. Defect resolution could be reached in 97.7% (n=42) of all cases. No recurrence of enchondroma was observed. Groups were equal regarding radiological and clinical outcomes. The patient reported experiences were predominantly positive (86%), both cohorts had good to very good results with a DASH mean score of 4 (±6.3). The SF-36 demonstrated a return to normal quality of life in both groups. Mean follow-up time was 7.78 years (±4.8). Conclusions: Sole curettage of enchondromas yields effective outcomes with good to excellent results regardless of the presence of a fracture. Long-term radiological follow-up is not required until symptomatic recurrence. .

Association of lower serum sclerostin levels with elevated risk for increased arterial stiffness: The JPOS Cohort Study.

Studies on the relationship between serum sclerostin, a Wnt/β-catenin pathway inhibitor, and atherosclerosis have yielded inconsistent results. We aim to longitudinally investigate the relationship between serum sclerostin levels and the risk of increased arterial stiffness in Japanese community-dwelling women. Of 1044 women aged ≥50 years whose brachial-ankle pulse wave velocity (baPWV) value was available in a baseline survey in 2011-2012, we excluded 374 whose baPWVs were ≥1800 cm/s, set as the cutoff for increased arterial stiffness, and eight with missing data. Of the remaining 662 women, we included in the analysis 556 followed in the 4- to 5-year follow-up study. The coefficient of variation of the sclerostin measurement was 3.45%. We obtained odds ratios (ORs) for sclerostin at baseline categorized by tertiles, with the high tertile as reference for increased arterial stiffness. Ninety-four women showed increased arterial stiffness during a mean follow-up of 4.0 years. The increased arterial stiffness rates in the low, medium, and high tertiles were 22.2%, 16.1%, and 12.4%, respectively (trend test p = 0.013). The ORs for the medium and low tertiles for increased arterial stiffness were 1.58 (p = 0.205) and 2.16 (p = 0.027), respectively, after adjusting for age and baseline baPWV. After further adjustment for baseline BMI, hypertension, hyperlipidemia, diabetes mellitus, eGFR, and BMC at whole body, the ORs for the medium and low tertiles were 1.65 (p = 0.181) and 2.50 (p = 0.014), respectively. Lower serum sclerostin levels were associated with elevated risks for increased arterial stiffness in Japanese community-dwelling women.

Evaluation of routine health monitoring for metabolic disorders in patients with serious mental illness on psychotropic medications: a study from Ethiopia.

Compared to the overall population, patients with mental health problems are more likely to experience concurrent physical illnesses, poorer health outcomes, and mortality. Psychotropic medications, which are the pillars in the management of mental health conditions, are associated with adverse effects such as weight gain, an increased level of glucose, and elevated circulating lipid levels, all of which contribute to metabolic disorders. Inadequate health monitoring may led to suboptimal interventions and worsening of these conditions. However, there is a lack of studies assessing routine health monitoring practices for metabolic disorders and their determinants among patients with serious mental illnesses taking psychotropic medications in Ethiopia. This study aimed to evaluate routine health monitoring for metabolic disorders and its determinants in patients with serious mental illnesses on psychotropic medications in Ethiopia. A hospital based prospective follow-up study was conducted among patients with serious mental illness taking psychotropic medications who attended the outpatient psychiatry department at Debre Markos Comprehensive Specialized Hospital. Eligible participants were selected using a simple random sampling technique. Routine health monitoring was evaluated using guidelines and previous literature. Binary logistic regression was employed to identify the determinants of routine health monitoring, with statistical significance determined by a p-value of less than 0.05 and a 95% confidence interval (CI). The overall routine health monitoring practice for metabolic disorders was found to be sub-optimal. Vital signs were the most commonly assessed parameters. Key determinants of routine health monitoring included participants aged 45 and above (AOR (95% CI): 2.82 (1.34-5.92), having social insurance (AOR (95% CI): 2.94 (1.86-4.64), availability of laboratory tests at the hospital (AOR (95% CI): 3.46 (2.16-5.55), and reporting of medication-related side effects (AOR (95% CI): 1.96 (1.21-3.17)). Routine health monitoring for metabolic disorders in patients with serious mental illnesses attending the outpatient psychiatry department was inadequate. Health care providers should give more attention to younger patients, those without health insurance, and who are not reported side effects. These findings provide crucial insights for improving routine health monitoring and promoting better health outcomes.

Health-Related Quality of Life Among Discharged Patients With Hemophagocytic Lymphohistiocytosis: A Follow-Up Study.

Evaluating the post-discharge health-related quality of life (HRQoL) in hemophagocytic lymphohistiocytosis (HLH) and exploring its influencing factors. The study was conducted at a regional pediatric medical center and involved pediatric patients diagnosed with HLH between July 2017 and July 2022. Healthy children of the same age and sex were included as the control group. The HRQoL and its associated factors in pediatric patients were assessed using the PedsQL 4.0 Parent Proxy Report and a general information survey. In the first year following diagnosis, psychological health and overall score in HLH patients were worse than those of the control group. However, scores for emotional functioning, school functioning, physical health, psychosocial health, and overall scores in the HLH group increased over the years since diagnosis. By the 5-year post diagnosis, there were no significant differences between the HLH group and the control group in social functioning, school functioning, physical health, psychosocial health, and overall scores (p>0.05). Generalized linear model analysis revealed that HLH patients who underwent transplantation have worse social functioning, physical health, overall score, while HLH patients with HLH recurrence have worse social functioning, psychosocial health, overall score (p<0.05). The HRQoL of HLH patients is compromised after discharge; however, it progressively returns to levels comparable to those of healthy cohorts over time since diagnosis. Transplantation, and HLH recurrence are identified as factors affecting the HRQoL in HLH patients.

EPCO-29. PATHOMICS ANALYSIS IDENTIFIES POTENTIAL SUBTYPES OF DIFFUSE GLIOMAS IN H&amp;E-STAINED WHOLE-SLIDE IMAGES

Abstract IDH status is the first criteria of diagnostic definition for diffuse gliomas in the 2021 WHO classification. While sufficient number of molecular tools are available to identify IDH1 and/or IDH2 mutations, they impose a time and cost burden on patients. We previously trained deep learning models visually differentiate IDH wild-type (IDHwt) and IDH mutant (IDHmut) gliomas in a small set of H&amp;E-stained whole image slides (WSIs) from TCGA using an Uncertainty-Aware Convolutional Neural Network (CNN) at 10x magnification. In this follow-up study, we aimed to improve our models by expanding our annotations of a more representative subset of the TCGA public data, increasing the sampling magnification to 20x, redesigning the preprocessing filters, adjusting the training pipeline to reduce overfitting, and assessing the confidence in model prediction via uncertainty metrics. METHODS By modifying the pre-processing methods from our pilot study, we increased the number of expert-annotated WSIs. Using a 2:1:2 train/validation/test split, we fine-tuned a ResNet18 deep learning model with a pre-trained feature extractor and Monte Carlo dropouts. To identify image features critical for separating by IDH status, we extracted the learned embeddings and performed post-hoc analyses (PCA, t-SNE, and UMAP). RESULTS The new set of annotations resulted in ~15-fold increase in the number of WSIs (i.e.,&amp;gt;2.5 million tiles), without any data augmentation. Our prototype model demonstrated clear separation of cases according to IDH status (sensitivity = 0.63, specificity = 0.91, weighted F1 = 0.81). CONCLUSION We successfully improved the prediction of IDH status in H&amp;E-stained WSIs and identified potential subtypes of IDHwt and IDHmut diffuse gliomas after significantly increasing the dataset size with appropriate expert annotations. We are currently addressing the data imbalance by annotating additional IDHmut glioma WSIs. Furthermore, we will integrate other biomarkers (1p19q, EGFR etc.) to increase the robustness of histo-pathomics as a surrogate for molecular tests.

Incidence of acute kidney injury and its predictors among neonates admitted at neonatal intensive care unit of, Northwest Ethiopia comprehensive specialized hospitals, 2023.

Acute kidney injury is an acute and reversible increment in serum creatinine (SCr) levels with a reduction in urine output oliguria, or anuria. Acute kidney injury is a major cause of neonatal morbidity and mortality worldwide; it is a serious problem in low and middle-income countries, particularly in sub-Saharan Africa such as Ethiopia. Moreover, there are few studies in developing countries. This study aimed to investigate the incidence and predictors of acute kidney injury in neonates admitted to the neonatal intensive care unit of some specialized hospitals in the Amhara region of northwestern Ethiopia. A facility-based retrospective follow-up study was conducted in the Northwest Amhara Region's comprehensive specialized hospitals with 634 neonates from January 2020 to December 2022. Data were collected by reviewing patient charts using simple random sampling with a pretested checklist, entered using Epi-data 4.6, and analyzed using STATA 14. Median survival time, Kaplan-Meier survival curve, and log-rank test were calculated. Bivariable and multivariable Cox hazard models were used to determine the determinants of acute kidney injury. A hazard ratio with a 95% confidence interval was calculated. Variables with p-values less than 0.05 were considered statistically significant. The incidence of Acute Kidney Injury among Neonates admitted to Neonatal IntensiveCare Unit was 14.9 per 1000 (95% CI: 12.5-17.7) with the proportion of acute kidney injury (20.19%) (95% CI: 17.23-23.50) neonates with sepsis (AHR: 2.59; 95%CI: 1.21-5.56), neonates with perinatal asphyxia [(AHR: 2.70; 95%CI: 1.29-5.65) were taking gentamicin drugs [(AHR = 1.74; 95%CI: 1.03-2.94], neonates were preterm [(AHR; 1.77: 95%CI: 1.05 -2.98], and neonatal-hyponatremia [(AHR: 2.14; 95%CI: (1.00 -4.9)] and hyperkalemia [(AHR: 2.64; 95 CI: (1.11- 6.2)] were statistically found to be significant predictors of acute kidney injury. The incidence of acute kidney injury in neonates was high. Premature infants, neonates with sepsis, who suffered perinatal asphyxia, who received gentamicin drugs, whose sodium levels decreased and potassium levels increased were at higher risk of developing acute kidney injury. All concerned agencies should work to prevent acute kidney injury and pay special attention to multifactorial causes. Therefore, strategies need to be developed and/or strengthened to prevent the occurrence of acute kidney injury in infants with sepsis, neonates who suffered perinatal asphyxia, and preterm infants whose sodium levels decreased and potassium levels increased.

A Study on the Rational Decision-Making Process of Vessel Organization—Focusing on Cases of Vessel Accidents

Vessel organizations are exposed to the risk of accidents due to the limited experience and intuition of the top decision makers in the organization in the special environment of the sea. This study aims to provide a direction for sustainable and rational decision-making in vessel organization through decision making process theory and case studies of actual vessel accidents. The results obtained from the actual case studies show that all three vessel accidents were caused by the arbitrary decision of the decision maker based on the Garbage Can model. This can be attributed to the closed nature of the vessel’s organization, which requires a decision-making process that is a hybrid of the Carnegie Decision model and Management Science model. Implications include the introduction of a ‘My Ship’ system, the de-subjectivization of top decision makers, situational awareness, and the need to provide top decision makers with the context and information relevant to their decisions. Limitations of this study include the fact that the case study was conducted only on Korean-flagged vessels and the study was limited to vessel accidents that occurred in the waters off Korea, China, and Japan, which limits the generalizability of the findings. In order to overcome these limitations, it would be interesting to conduct a follow-up study to include vessel accidents of different nationalities or to further investigate the characteristics of the decision-making process in vessel accidents by country.

Computational investigation of the social function of domestic cat facial signals.

There is growing interest in the facial signals of domestic cats. Domestication may have shifted feline social dynamics towards a greater emphasis on facial signals that promote affiliative bonding. Most studies have focused on cat facial signals during human interactions or in response to pain. Research on intraspecific facial communication in cats has predominantly examined non-affiliative social interactions. A recent study by Scott and Florkiewicz1 demonstrated significant differences between cats' facial signals during affiliative and non-affiliative intraspecific interactions. This follow-up study applies computational approaches to make two main contributions. First, we develop a machine learning classifier for affiliative/non-affiliative interactions based on manual CatFACS codings and automatically detected facial landmarks, reaching above 77% in CatFACS codings and 68% in landmarks by integrating a temporal dimension. Secondly, we introduce novel measures for rapid facial mimicry based on CatFACS coding. Our analysis suggests that domestic cats exhibit more rapid facial mimicry in affiliative contexts than non-affiliative ones, which is consistent with the proposed function of mimicry. Moreover, we found that ear movements (such as EAD103 and EAD104) are highly prone to rapid facial mimicry. Our research introduces new possibilities for analyzing cat facial signals and exploring shared moods with innovative AI-based approaches.

Estimation of joint kinetics during manual material handling using inertial motion capture: a follow-up study.

Musculoskeletal models based on inertial motion capture and ground reaction force (GRF) prediction hold great potential for field-based risk assessment of manual material handling. However, previous evaluations have identified inaccuracies in the methodology?s estimation of spinal forces, while the accuracy of other key outcome variables is currently unclear. This study evaluated knee, shoulder, and L5-S1 joint reaction forces (JRFs) derived from a musculoskeletal model based on inertial motion capture and GRF prediction against a model based on simultaneously collected optical motion capture and force plate measurements. Data from 19 healthy subjects performing lifts with various horizontal locations, deposit heights and asymmetry angles were analyzed, and the consistency and absolute agreement of the model estimates statistically compared. Despite varying levels of agreement across tasks and variables, considerable absolute differences were identified for the L5-S1 axial compression (RMSE = 63.0-94.2%BW) and anteroposterior shear forces (RMSE = 40.9-80.6%BW) as well as the bilateral knee JRFs (RMSE = 78.9-117%BW). Glenohumeral JRFs and vertical GRFs exhibited the highest overall consistency (r = 0.33-0.91, median 0.78) and absolute agreement (RMSE = 7.63-34.9%BW), while the L5-S1 axial compression forces also showed decent consistency (r = 0.04-0.89, median 0.80). The findings generally align with prior evaluations, indicating persistent challenges with the accuracy of key outcome variables. While the modelling framework shows promise, further development of the methodology is encouraged to enhance its applicability in ergonomic evaluations.