Increase In Life Expectancy Research Articles

Role of Magnetic Resonance Spectroscopy in Dementia

Abstract Background Dementia is becoming a significant public health problem of the century due to increasing life expectancy and aging populations around the world. The most common pathology underlying dementia in older adults is Alzheimer’s disease (AD). vascular dementia and Lewy body disease pathologies are other common causes of dementia in the elderly and in many instances AD is also present in patients with dementia with Lewy bodies (DLB) and vascular dementia (VaD). A relatively less common type of dementia is frontotemporal lobar degeneration (FTLD), which tends to affect younger individuals compared to other dementia pathologies. Aim of the Work Aim of the work is to identify the role of MRS in common dementia. Ethical considerations: Oral approval from the patients or responsible relatives were obtained after explaining the procedure to them, the study was conducted according to the stipulations of ASU ethical and scientific committee. Patients and Methods Our study included 36 patients diagnosed as dementia patients clinically, fulfilled the inclusion criteria. They were 22 females and 14 males; their ages ranged from 40-89 years with the mean age 68 years in addition to 13 healthy control cases in the same age group 7 females and 6 males, their ages ranged from 50 to 75 years. Results In our study, The most remarkable findings was reduction of cerebral volume in most of the patients in all types of dementia. NAA peak in dementia patients was reduced compared to the control groups with more reduction was noted in the Alzheimer’s group indicating demyelination with progressive neural and axonal damage. The Myoinositol increase is indicator for glial cell proliferation and gliosis. It’s peak was expected to be increased, however in our study it shows increased level in patients with advanced AD only, no significant change compared to the control group in other types of dementia or early diagnosed patients with Alzheimer’s disease. Conclusion Our study showed significant reduction of cerebral volume as well as some metabolic changes that proves that MRS is a non invasive imaging tool can be used to identify dementia after more researches to find disease specific changes.

Healthcare Professionals' Knowledge, Skills, and Information Needs Pertaining to Hearing Loss and Hearing Aids in Swedish Nursing Homes: A Cross-Sectional Study and Psychometric Evaluation.

Hearing loss increases with age and due to increased life expectancy there is an increase in the number of individuals living with hearing loss. Older people with hearing loss residing in nursing homes are often dependent on healthcare professionals to help them with their hearing aids. The aim of the study was to translate and test the psychometric properties of a Swedish version of a Norwegian questionnaire and to assess healthcare professionals' self-reported knowledge, experience, skills, competence, and information needs pertaining to residents' hearing loss and hearing aids in the Swedish context. A Norwegian questionnaire was translated and adapted, and thereafter distributed to healthcare professionals in nine nursing homes in mid Sweden between 2020 and 2021, and 313 questionnaires were returned. An exploratory factor analysis demonstrated adequate factorial structure in six factors, satisfying construct validity and internal consistency for the Swedish version. A confirmatory factor analysis showed a satisfactory model fit. Healthcare professionals reported having the skills required for handling hearing aids, but reported lower scores for having received information about hearing aids, taking initiatives to refer residents to hearing healthcare units, and checking for earwax. Registered nurses generally reported lower perceived knowledge and practical skills concerning hearing aids. Seventy-seven percent of the total group reported a need for information regarding hearing aid maintenance. Healthcare professionals reported that the majority of nursing home residents need help with their hearing aids, but only a minority of these professionals had received education on hearing loss and training in hearing aid maintenance. Enrolled nurses and care assistants demonstrated higher levels of competence in handling hearing aids compared to registered nurses. In order to ensure safe and effective care, as well as facilitate communication among older adults with hearing loss, healthcare professionals need appropriate education and training.

Comprehensive Assessment of Dermatologic and Dysmorphic Manifestations in Patients With Down Syndrome.

Down syndrome (DS), a common chromosomal anomaly caused by trisomy of chromosome 21, is characterized by a broad spectrum of phenotypic characteristics across multiple organ systems, including cardiac defects and leukemia. Dermatological findings are prevalent among individuals with DS; however, these issues are frequently underrecognized and inadequately researched, resulting in a significant gap in the provision of comprehensive healthcare strategies. Given the increased life expectancy of patients with DS and delayed manifestation of many dermatoses, physicians are increasingly encountering dermatological findings in this population. This study aimed to assess the prevalence and types of dermatological findings in individuals with DS, compare them with those in a control group, and emphasize the necessity of incorporating dermatological evaluations into routine health monitoring. This prospective cross-sectional study was conducted from June 2023 to June 2024 and involved 100 genetically confirmed individuals with DS and 100 age- and sex-matched controls. Comprehensive demographic, clinical, and karyotype data were collected for the DS group, and all the participants underwent detailed morphological evaluations. The DS group had a mean age of approximately 6.37 years, whereas the controls were around 7 years old, with no significant differences in age or sex distribution between the groups. Karyotype analysis showed that trisomy 21 was present in 92% of the cases, mosaicism in 6%, and translocation in 2%. Common dermatological findings in the DS group included xerosis cutis (49%), thin and sparse hair (48%), dental caries (34%), delayed tooth eruption (28%), nail dystrophy (25%), fissured tongue (23%), and cheilitis (18%). Significant differences were noted in the prevalence of scabies, bacterial infections, and café au lait macules between the DS and control groups (p < 0.01). Dysmorphic findings in the DS group included epicanthal folds (97%), upslanted palpebral fissures (97%), brachycephaly (91%), and single transverse palmar crease (89%). Significant gender differences were noted in the prevalence of brachycephaly and the sandal gap (p < 0.01). This study highlights the importance of regular dermatological care in enhancing the health management and quality of life of individuals with DS due to the prevalence and variability of dermatological conditions.

Screening Adherence for Second Primary Malignancies in Breast Cancer Survivors: Behaviors, Facilitators, and Barriers to Enhance Quality Care

Due to genetic, hormonal, and environmental factors, alongside increased life expectancy, breast cancer (BC) survivors have an increased risk of developing a second primary malignancy. Therefore, regular screening for other types of cancer is of utmost importance for their comprehensive care. This cross-sectional study evaluated BC survivors’ compliance with cervical, lung, and colorectal cancer screening, and identified facilitators and barriers influencing adherence. Fifty-two BC survivors answered the study's survey. A total of three (6%) cases of second primary malignancies were self-reported. Cervical cancer screening was performed within the past 3 years among 37/50 (74%) eligible participants. Only 7/24 (29%) eligible participants underwent colorectal cancer screening within the last 10 years, including six colonoscopies and 1 occult blood test. No participant had an indication for lung cancer screening. The primary reason for noncompliance with both cervical and colorectal cancer screening was lack of physician's recommendation, accounting for 79% and 88% of cases, respectively. Nearly all participants (98%) affirmed that BC survivors should undergo screening for other types of cancer. Most (96%) stated that, if recommended by a physician, they would agree to undergo screening for other neoplasms. Even though most BC survivors acknowledged its importance, screening particularly for colorectal cancer exhibited suboptimal rates. Oncologists could play a crucial role in increasing cancer screening uptake by reminding patients of their corresponding recommendations to detect other types of cancer.

Intramedullary Fixation vs Arthroplasty Management of Trochanteric Fractures in Elderly Patients a Systematic Review and Meta-Analysis

Abstract Introduction Intertrochanteric fractures of the femur are very common in elderly people. Their incidence has increased due to the increased life expectancy and osteoporosis; fall is the main cause of injuries. Most of the classification systems for intertrochanteric fractures have poor reliability and reproducibility. Intertrochanteric fractures are considered unstable in the presence of a comminuted posteromedial cortex, reverse obliquity, and subtrochanteric extension. Early operation within 12 hours to 48 hours is mandatory in the relatively fit patients. The surgical goal is to achieve a painless and stable lower limb with early return of function, with the lowest rates of mortality and morbidity. The mainstay of treatment of intertrochanteric hip fractures is internal fixation. Compare and contrast different clinical outcomes and provide a meta-analysis study of the data retrieved. This study was conducted aiming to help clinicians and surgeons to provide the best quality of health care to their patients in management of these fractures and help improve their quality of life. Methods We conducted a systematic search on four different databases: PubMed, Web of Science, Cochrane Central, and SCOPUS. The search was done by two independent researchers and differences was sorted out and solved by third independent researcher according to the PRISMA statement and the guidelines mentioned by the Cochrane’s handbook of systematic reviews. Eligibility criteria was predefined with clearly stated inclusion and exclusion criteria of studies. After clear screening of studies between two independent participants and solving contradictions by a third participant, our systematic research yielded 41 eligible studies. Data extraction was done including demographic data of subjects, outcomes to be measured, and data extracted for domains of risk of bias. Quality assessment of retrieved data was performed according to GRADE guidelines. This includes ROB2 bias tool for randomized control trials and ROBIN-1 tool for non-randomized control trials. Statistical analysis of analysis of outcomes were conducted using Review Manager Software. Outcomes to be measured were Operation time, Intraoperative blood loss, duration of hospital stay, time to weight bearing, Harris hip score at (1.5,3,6,12,18,24) month post surgery, General complications, Wound complications, Local major and minor complications, and mortality within (3,6,12,18,24) Month post-surgery, Reoperation rate. Results Study was conducted on 41 studies: 10 Randomized control studies and 31 Non- randomized control study. Collectively retrieving a total of 4782 patients: 2398 patient were allocated to the intramedullary fixation group and 2384 to the arthroplasty group; weighted mean age was 77.49 years and 79.18 years respectively. Our study yielded that arthroplasty and replacement procedures had favorable outcome regarding Harris hip score at 1 year after surgery, earlier time to weight bearing, and lower reoperation rate when compared to intramedullary fixation. However, arthroplasty had less favorable value regarding the operation time, blood loss and need for blood transfusion; while equal value in the length of hospital stays, complication rates, and incidence of mortality in the first year post surgery. Conclusion This study concluded a statistically significant favorable clinical outcome and equal complications of replacement procedures when compared to intramedullary fixation procedures at one year post surgery. However, several limitations were observed in our study which may affect this conclusion and urge the need for further research.

An insight into pharmacokinetics and dose optimization of antimicrobials agents in elderly patients.

The global elderly population is on the rise, and infections tend to have a higher mortality rate among older individuals. Aging is associated with the progressive impairment of multi-organ function, which can impact the pharmacokinetics of antimicrobials, potentially leading to the failure of anti-infective therapy. With the increasing life expectancy, a significant growth in the elderly demographic, and the escalating costs of healthcare, gaining a thorough understanding of pharmacokinetic changes in the elderly holds crucial clinical significance. This review compiles findings from published studies, offering a comprehensive overview of the pharmacokinetics of various antimicrobials in both adults and the elderly. Furthermore, it delves into advancements in pharmacokinetic methods specific to the elderly population.

A STUDY ON PIRFENIDONE VERSUS NINTEDANIB IN PATIENTS WITH IDIOPATHIC PULMONARY FIBROSIS IN A TERTIARY CARE HOSPITAL: A CROSS SECTIONAL STUDY

Background: Idiopathic pulmonary fibrosis (IPF) is a chronic condition with a poor prognosis and have an average life expectancy of 3-4 years. Two antifibrotic treatments have been approved to treat IPF: nintedanib and pirfenidone. These medications lower the decline in lung function and lower the risk of acute respiratory deterioration, which is linked with a high morbidity and death.Individual clinical trials have not been powered to demonstrate mortality decreases, however analysis of pooled data from clinical trials and observational research imply that anti-fibrotic drugs increase life expectancy. This study describes the utility of anti-fibrotic drugs and compare their efficacy. Methods and Materials: This 6 month cross-sectional study conducted at Santhiram Medical College and General Hospital in Nandyal.In patients with IPF , Clinical, functional and radiological data were gathered at baseline and during the follow-up, as per our Center procedure.This study compares and evaluates the efficacy of nintedanib and pirfenidone. A total of 40 patients over the age of 18 with IPF diagnosis were included. Patients under 18 years , those with known fibrosing lung diseases, bronchial asthma, COPD, HIV, Tuberculosis, or other organ failures were excluded. Results: At baseline, IPF patients treated with Pirfenidone had Forced vital capacity(FVC) and Forced expiratory volume at 1 second(FEV1) predicted percentages of 63.57 ± 8.34% and 72.31 ± 4.91%, respectively. In IPF patients treated with Nintedanib, at baseline(time 0), FVC and FEV1 percentages were 60.15±8.82% and 72.31±4.91% respectively. There were no significant variations in FVC and FEV1 percentages at time 0 between patients treated with the two medications (p=0.23,p=0.7,respectively). At 3-month follow-up, patients treated with Pirfenidone had predicted FVC and FEV1 values of 65.73 ± 7.84% and 72.94 ± 4.45%, respectively, whereas patients treated with Nintedanib had predicted valuesof 65.75 ± 7.67% and 72.42 ± 4.45%. At 6-month follow-up, patients on Pirfenidone had predicted FVC and FEV1 values of 66.9 ± 8.72% and 73.5 ± 4.50%, respectively. Nintedanib treatment resulted in 67.7±8.46% and 72.94±4.51% outcomes. Conclusion: our study shown that pirfenidone and nintedanib are equally effective at reducing FVC decline over a 6-month time frame.While nintedanib was slightly more beneficial in lowering FVC decline during the 6-month period. Both drugs were well tolerated, while nintedanib showing good tolerance in the majority of IPF patients.

Equality and justice as the basis for unification of the right of citizens for an insurance labor pension

The differentiation of the right of citizens of the Russian Federation for an insurance labor pension by gender provided for by the current legislation raises questions in civil society due to the discrepancy between the norms fixing different retirement ages for men and women, the principle of equality guaranteed by the Constitution of the Russian Federation, and ensuring social justice in society. One of the reasons is that a significant proportion of men do not live to the 65-year retirement age fixed by law. Analyzing the current legal norms and comparing them with statistical data and the results of law enforcement indicating a clearly unfair standardization of these relations, the authors offer their own vision of solving the existing problems. The authors substantiate the conclusion on the necessity to unify the right of citizens for an insurance pension by establishing a common retirement age of 60 years for men and women for the period of solving the main demographic problems in the state and creating conditions for increasing life expectancy. At the same time, emphasizing the special role of women, the authors propose to include legislatively the time associated with the birth and upbringing of children in a woman’s insurance experience, regardless of whether a woman had previous employment relationships and insurance experience. It should be done to create a favorable regime for the formation of women’s insurance experience and ensure formal equality with men.

Effects of agricultural carbon footprints and malnutrition on life expectancy in China.

This study explored the impact of carbon footprints and malnutrition on life expectancy in China over the periods of 2000 and 2021. Data from the World Bank Indicators database was utilized, and Dynamic Ordinary Least Squares (DOLS) was employed to analyse the extracted data. The results show that over the periods of 2000 and 2021, agricultural carbon footprints in China experienced a first sharp decline in 2015. In contrast, per capita food production in China rose from 88.29% in 2011 to over 108% in 2021. Within a space of a decade, the undernourished population in China was reduced by 78.8%. Moreover, per capita food production had a positive impact on life expectancy in China. Conversely, malnutrition exerted a negative and significant influence on life expectancy. Agricultural carbon footprints contributed a positive but insignificant impact on life expectancy, and GDP per capita growth increased life expectancy significantly in the country. We conclude that policymakers in China are should ensure that all citizens have access to food necessary to improve life span of the country`s population.

Combining Multiple Spectroscopic Techniques to Reveal the Effects of Staphylococcus aureus Infection on Human Bone Tissues.

Osteomyelitis (OM) and periprosthetic joint infections (PJIs) are major public health concerns in Western countries due to increased life expectancy. Infections usually occur due to bacterial spread through fractures, implants, or blood-borne transmission. The pathogens trigger an inflammatory response that hinders bone tissue regeneration. Treatment requires surgical intervention, which involves the precise removal of infected tissue, wound cleansing, and local and systemic antibiotic administration. Staphylococcus aureus (SA) is one of the most common pathogens causing infection-induced OM and PJIs. It forms antimicrobial-resistant biofilms and is frequently found in healthcare settings. In this proof-of-concept, we present an approach based on multiple spectroscopic techniques aimed at investigating the effects of SA infection on bone tissue, as well as identifying specific markers useful to detect early bacterial colonization on the tissue surface. A cross-section of a human femoral diaphysis, with negative-culture results, was divided into three parts, and the cortical and trabecular regions were separated from each other. Two portions of each bone tissue type were infected with SA for one and seven days, respectively. Multiple techniques were used to investigate the impact of the infection on bone tissue, Brillouin-Raman microspectroscopy and attenuated total reflection Fourier transform infrared spectroscopy were employed to assess and develop a new noninvasive diagnostic method to detect SA by targeting the bone of the host. The results indicate that exposure to SA infection significantly alters the bone structure, especially in the case of the trabecular type, even after just one day. Moreover, Raman spectral markers of the tissue damage were identified, indicating that this technique can detect the effect of the pathogens' presence in bone biopsies and pave the way for potential application during surgery, due to its nondestructive and contactless nature.

Epidemiology of complications in anesthesiology and possible ways of their prevention

Increase in life expectancy in the world leads to an increase in the number of patients with multimorbidity who will require surgical intervention and anesthesia in the future. The desire of specialists to meet the high standards of clinical guidelines when performing medical interventions is often associated with the risk of complications, especially when providing emergency medical care. Complications during surgical interventions and anesthesia can be observed in institutions of any level and when providing care by any specialists.The aim. To assess the main risk factors that can cause complications when providing anesthesia.Materials and methods. The study was conducted in accordance with international reporting requirements for reviews (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The search was performed in PubMed and Cochrane Controlled Clinical Trials Register. The method of searching by references was used to select the articles. The search strategy did not include limitations of the language, type and date of the article. Inclusion criteria: full-text publications devoted to the influence of risk factors on the incidence of complications when providing anesthesia care. Exclusion criteria: brief summaries; abstracts without a full-text version; publications without key words.Results. The review assessed the most common risk factors causing complications during anesthesia and ways to reduce them.

Strategy for optimizing outpatient access for chronic patients in a health insurance company

ABSTRACT The last decades have been marked by significant population transformations in several nations. The demographic transition, resulting from the significant reduction in birth rates and the increase in life expectancy, has resulted in a further ageing population. Knowing how to prioritize and optimize the allocation of resources becomes, therefore, a prerequisite for managers decision-making. Strategies that reduce hospital costs while improving the quality of care are essential for the sector, mainly because they allow integrated processes and greater accessibility to users. Proximity and ease of access to health services are essential to ensure continuity of care and improve patient engagement with suggested treatment. The objective of this article is to demonstrate a viable solution for the allocation of chronic patients in the outpatient units of a Brazilian health insurance company in a regionalized manner and based on a set of criteria and restrictions. The study used Integer Programming, an optimization technique of Operations Research, to determine the outpatient units. As a result, it was possible to identify and suggest practical improvements in the care coordination process, offering a concrete contribution to the effectiveness and operational efficiency of the decision-making process.

Bevaikystė ir požiūris į rūpinimąsi vyresnio amžiaus tėvais Lietuvoje

In rapidly ageing societies, caring and responsibilities for parents in old age is a widely discussed topic. This is particularly relevant in societies with low fertility and high rates of childlessness. Lithuania is one of the countries where demographic ageing rates have risen sharply in a short period of time. This process has been driven not only by low fertility but also by emigration of middle-aged and young people and increasing life expectancy. There is no lack of research on demographic changes in ageing societies in the country, but very little is known about the attitudes of childless men and women towards caring for their parents in old age. The aim of the study is to determine the attitudes of childless and child-bearing individuals towards parental responsibilities in Lithuania. Our analysis is based on the 2018-2019 ‘Families and Inequality Survey’ dataset collected in Lithuania. The data covers 3,005 individuals aged 34-48 at the time of the survey. The representative sample was obtained by using a stratified sampling method. Face-to-face interviews were carried out with respondents in their homes by using a standardized questionnaire. The data were analysed using descriptive statistics and chi-square methods. We found that the proportion of men (12.0%) who do not want to have children is statistically significantly higher (p=0.003) than the proportion of women (7.6%). We found that childless people were less likely than those with children to agree with the statement that children should look after their parents. In addition, women were more likely than men to agree with these statements. Our findings are important from a practical point of view – when considering social care and pronatalist policy measures. Research project is financially supported by the Research Council of Lithuania (LMTLT), agreement No. P-MIP-22-24.

Стоимость лекарственного лечения пациентов с онкологическими заболеваниями в амбулаторных условиях, рассчитанная на основании стандартов медицинской помощи.

Modern oncology has achieved impressive results in terms of increasing life expectancy and reducing mortality of patients with malignant neoplasms. This has led to many patients requiring long-term outpatient treatment. The purpose of the study is to calculate the cost of treatment of patients with malignant neoplasms in the Russian Federation in an outpatient setting based on standards of medical care. Materials and methods. Based on the standards of medical care, the cost of drug treatment for patients with cancer in an outpatient setting was calculated. A comparison was made of the estimated amount with the actual costs of purchasing drugs for outpatient use. Results. Current regulations do not determine the place of use of drugs under the conditions of medical care. Criteria for classifying drugs as drugs for outpatient use are proposed. The highest drug costs for outpatient cancer patients are for the treatment of breast cancer, melanoma, kidney cancer and ovarian cancer. Conclusions. Calculating the cost of drug treatment for patients with cancer in an outpatient setting based on standards of care does not reflect the true need for treatment based on clinical guidelines.

Glioblastoma Multiforme: Sensitivity to Antimicrobial Peptides LL-37 and PG-1, and Their Combination with Chemotherapy for Predicting the Overall Survival of Patients.

Background/Objectives: Glioblastomas (GBMs) are the most malignant and intractable of all cancers, with an unfavorable clinical prognosis for affected patients. The objective was to analyze the sensitivity of GBM cells to the antimicrobial peptides (AMPs) cathelicidin (LL-37) and protegrin-1 (PG-1), both alone and in combination with chemotherapy, to predict overall survival (OS) in the patients. Methods: The study was conducted on 27 GBM patients treated in the neurosurgical department of the Almazov Medical Research Centre (Saint Petersburg, Russia) from 2021 to 2024. The cytotoxic effects of chemotherapy, AMPs, and their combinations on brain tumor cells were assessed by an MTT assay using a 50% inhibitory concentration (IC50). Results: In GBM cells from the patients, LL-37 and PG-1 exhibited strong anticancer effects, surpassing those of chemotherapy drugs. These LL-37 and PG-1 anticancer effects were associated with a statistically significant increase in life expectancy and OS in GBM patients. These findings were confirmed by experiments on rats with C6 glioma, where the intranasal administration of LL-37 (300 μM) and PG-1 (600 μM) increased the life expectancy of the animals to 69 and 55 days, respectively, compared to 24 days in the control group (HR = 4.139, p = 0.0005; HR = 2.542, p = 0.0759). Conclusions: Additionally, the combination of LL-37 and PG-1 with chemotherapy drugs showed that a high IC50 of LL-37 with cisplatin (cutoff > 800 μM) in GBM cells was associated with increased life expectancy (19 vs. 5 months, HR = 4.708, p = 0.0101) and OS in GBM patients. These combinations could be used in future GBM treatments.

Ferulic Acid-Loaded Nanostructure Maintains Brain Levels of ACh, Glutamate, and GABA and Ameliorates Anxiety and Memory Impairments Induced by the D-Galactose Aging Process in Rats.

Population aging is a global reality driven by increased life expectancy. This demographic phenomenon is intrinsically linked to the epidemic of cognitive disorders such as dementia and Alzheimer's disease, posing challenges for elderly and their families. In this context, the search for new therapeutic strategies to prevent or minimize cognitive impairments becomes urgent, as these deficits are primarily associated with oxidative damage and increased neuroinflammation. Ferulic acid (FA), a natural and potent antioxidant compound, is proposed to be nanoencapsulated to target the central nervous system effectively with lower doses and an extended duration of action. Here, we evaluated the effects of the nanoencapsulated FA on d-galactose (d-Gal)- induced memory impairments. Male Wistar adult rats were treated with ferulic acid-loaded nanocapsules (FA-Nc) or non-encapsulated ferulic acid (D-FA) for 8weeks concurrently with d-Gal (150mg/kg s.c.) injection. As expected, our findings showed that d-Gal injection impaired memory processes and increased anxiety behavior, whereas FA-Nc treatment ameliorated these behavioral impairments associated with the aging process induced by d-Gal. At the molecular level, nanoencapsulated ferulic acid (FA-Nc) ameliorated the decrease in ACh and glutamate induced by d-galactose (d-Gal), and also increased GABA levels in the dorsal hippocampus, indicating its therapeutic superiority. Additional studies are needed to elucidate the mechanisms underlying our current promising outcomes. Nanoscience applied to pharmacology can reduce drug dosage, thereby minimizing adverse effects while enhancing therapeutic response, particularly in neurodegenerative diseases associated with aging. Therefore, the strategy of brain-targeted drug delivery through nanoencapsulation can be effective in mitigating aging-related factors that may lead to cognitive deficits.

Antimicrobial susceptibility testing of bone and joint pathogens using isothermal microcalorimetry.

The rise in osteomyelitis and periprosthetic joint infections, in combination with increasing life expectancy and the prevalence of diabetes, underscores the urgent need for rapid and accurate diagnostic tools. Conventional culture-based methods are often time-consuming and prone to false-negatives, leading to prolonged and inappropriate antibiotic treatments. This study aims to improve osteomyelitis diagnostics by decreasing the time to detection and the time to an antibiotic susceptibility result to enable a targeted treatment using isothermal microcalorimetry (IMC). IMC measures heat flow in real-time, providing insights into bacterial metabolism without the need for labeling. Using clinical isolates from bone infections, assessing their response to antibiotics through IMC, we demonstrated that IMC could detect bacteria within 4 h and determine antimicrobial susceptibility profiles within 2-22 h (median 4.85, range 1.28-21.78). This is significantly faster than traditional methods. A decision tree, based on antibiotic susceptibility, accurately categorized pathogens, achieving high accuracy (74-100%), sensitivity (100%), and specificity (65-100%). These findings suggest that IMC could redefine diagnostics of bone and joint infections and potentially infections in general, offering timely and precise treatment guidance, thereby improving patient outcomes and reducing health care burdens. Further optimization and clinical validation are needed to fully integrate IMC into routine diagnostics.

Surgical treatment of peri-implant fracture with plate-on-plate technique: a case report

Due to the increased life expectancy and exposure to high-energy traumas, there has been a rise in the demand for surgical treatment using internal fixation, and consequently, an increase in refractures. Despite the growing discussion around peri-implant fractures, there is still little discussion addressing periplate fractures. This report presents a case using the plate-on-plate technique where the fracture is addressed while maintaining the previous fixation material by placing a locked plate above the previously existing material. This case involves a 54-year-old man with a peri-implant diaphyseal fracture of the distal third of the left femur after a motorcycle versus car collision. The patient underwent surgical treatment with a steel locking condylar plate, maintaining the previous fixation material through the plate-on-plate technique. Subsequently, fracture consolidation and functional range of motion were evidenced. Thus, in line with studies, the plate-on-plate technique proved to be an effective alternative for peri-implant fractures, allowing an approach with lower morbidity and mortality and reducing the risks of surgical complications; however, it requires studies with a higher level of epidemiological evidence.

Application of the Foresight Method in the Educational Process of Higher Education

In conditions of increasing life expectancy, declining fertility, increased migration and other demographic changes, the Foresight method can help families and society prepare for new challenges and opportunities. For example, anticipating an increase in the number of elderly people may prompt the state to develop a support program for this category of the population, and forecasting an increase in migration may contribute to the development of integration programs for new immigrants. The Foresight method is relevant in the context of demographic changes, as it allows you to predict possible scenarios for the future development of the family and society based on the analysis of current data and trends. This will make it possible to make more informed decisions and develop new tools for the state to improve the demographic situation in the country. The Foresight method is also of great relevance in education, especially in the context of technological innovations. Thus, the purpose of the article is to study the demographic situation of the Russian Federation by the Foresight method in sociology classes. The authors believe that the interest in the Foresight method lies in the fact that it allows the students of the Faculty of Economics and Management of VSTU to develope strategic thinking and planning skills, to apply those in the field of demography as well as in their future professional activity. The article presents the results of a survey of first-year students of Volgograd State Technical University (VSTU) in relation to the demographic situation in the country. The positive and negative factors affecting the demographic situation are considered. Some measures to improve the demography of the Russian Federation are proposed. The proposed Foresight method in the educational process may be of interest to teachers and methodologists of higher education engaged in the development of new approaches to training students.

Text mining of verbal autopsy narratives to extract mortality causes and most prevalent diseases using natural language processing

Verbal autopsy (VA) narratives play a crucial role in understanding and documenting the causes of mortality, especially in regions lacking robust medical infrastructure. In this study, we propose a comprehensive approach to extract mortality causes and identify prevalent diseases from VA narratives utilizing advanced text mining techniques, so as to better understand the underlying health issues leading to mortality. Our methodology integrates n-gram-based language processing, Latent Dirichlet Allocation (LDA), and BERTopic, offering a multi-faceted analysis to enhance the accuracy and depth of information extraction. This is a retrospective study that uses secondary data analysis. We used data from the Agincourt Health and Demographic Surveillance Site (HDSS), which had 16338 observations collected between 1993 and 2015. Our text mining steps entailed data acquisition, pre-processing, feature extraction, topic segmentation, and discovered knowledge. The results suggest that the HDSS population may have died from mortality causes such as vomiting, chest/stomach pain, fever, coughing, loss of weight, low energy, headache. Additionally, we discovered that the most prevalent diseases entailed human immunodeficiency virus (HIV), tuberculosis (TB), diarrhoea, cancer, neurological disorders, malaria, diabetes, high blood pressure, chronic ailments (kidney, heart, lung, liver), maternal and accident related deaths. This study is relevant in that it avails valuable insights regarding mortality causes and most prevalent diseases using novel text mining approaches. These results can be integrated in the diagnosis pipeline for ease of human annotation and interpretation. As such, this will help with effective informed intervention programmes that can improve primary health care systems and chronic based delivery, thus increasing life expectancy.