Relevant Indicators Research Articles

The Nomogram Model and Factors for the Postoperative Mortality of Elderly Patients with Femoral Neck Fracture Undergoing Artificial Hip Arthroplasty: A Single-Institution 6-Year Experience.

Artificial hip arthroplasty (AHA) is widely accepted in elderly patients with femoral neck fractures, but it is associated with high risk of death and various postoperative complications due to old age and accompanying chronic diseases. Therefore, this study aimed to explore the risk factors for death in elderly patients with femoral neck fractures after AHA and to establish a nomogram risk prediction model, which is expected to reveal high-risk patients and improve the postoperative quality of life and survival rate of patients. Elderly patients who underwent AHA for femoral neck fractures in our hospital from September 2014 to May 2021were retrospectively analyzed. These patients were divided into a survival group and a death group according to their clinical outcomes. The following clinical data were recorded for the patients in the two groups: sex, age, underlying diseases, smoking and drinking history, preoperative nutritional risk score (NRS) and American Society of Anesthesiologists (ASA) score, as well as relevant indicators about the operation. These data were subject to univariate analysis and then logistic analysis to determine the risk factors of death. Subsequently, a nomogram risk prediction model was established and further validated with the receiver operating characteristic curve (ROC) and the Hosmer-Lemeshow test. Finally, the effects of predictive risk factors were analyzed using the Kaplan-Meier survival curve. Follow-up was completed by 260 patients, including 206 patients in the survival group and 54 patients in the death group; the overall death rate was 20.77%, and the follow-up time, age, postoperative 1, 3 and 5-year death rates were 3.47 ± 1.93 years, 75.32 ± 9.12 years, 5.77%, 12.51%, and 25.61%, respectively. The top three causes of death in 54 patients were respiratory disease, cerebrocardiovascular disease, and digestive disease, respectively. The logistic analysis indicated that elderly patients with femoral neck fractures, the risk factors for death after AHA were age ≥ 80 years, preoperative NRS ≥ 4, HB ≤ 90 g/L, CR ≥ 110 umol/L, and ASA score ≥ 3, as well as postoperative albumin ≤ 35 g/L, the nomogram was established, and then its predictive performance was successfully validated using the ROC curve (AUC = 0.814, 95% confidence interval = 0.749-0.879) and the Hosmer-Lemeshow test (p = 0.840). Furthermore, Kaplan-Meier survival curve analysis revealed that the abovementioned six indicators were correlated with the post-AHA survival time of elderly patients with femoral neck fractures (pLog Rank < 0.05). Old age, preoperatively high NRS and ASA score, anemia, poor renal function, and postoperative hypoproteinemia are the major risk factors for death in elderly patients with femoral neck fractures after AHA; they are also associated with postoperative survival. Early identification and effective interventions for optimization of modifiable risk factors are recommended to improve the postoperative quality of life and survival rates.

Influence of Ultra-High-Voltage hybrid reactive power compensation on interruption performance of circuit breakers under different faults

For extremely large ultra-high-voltage (UHV) power transmission and distribution lines with typical project using hybrid reactive power compensation (HRPC), single-phase earth fault (1LG), three-phase ground fault (3LG), phase-to-phase fault (2LS), and two-phase grounding fault (2LG) often occurs. Circuit breaker is one of the most critical equipment of UHV transmission system. And the interruption performance is crucial to circuit breakers’ breaking capability. In this study, formal expressions of the indicators for the interruption performance of the circuit breaker are deduced in case of different faults based on the equivalent-valued parameter circuit based on the structure a UHV demonstration project. The simulations are used to validate the accuracy of formal expressions. Then, the influence of such factors as the location of the fault and the degree of HRPC on the interruption performance of the 1LG, 2LG, 3LG, and 2LS is analyzed. Finally, the interruption performance of circuit breakers under different faults are compared. A quantitative evaluation of the influence of changes in the relevant indicators on the interruption performance of circuit breakers can provide a technical basis for choosing the appropriate design of the circuit breaker in light of the application as well as equipment development and assessment.© 2017 Elsevier Inc. All rights reserved.

Awareness And Attitudes Of Pregnant Women Towards STI Prevention And Treatment In New Sociomedical Conditions Of COVID-19 Pandemic

Background — Restriction on in-person events during the pandemic constitutes a dangerous factor causing the reduced awareness of youth of the risks and measures to prevent sexually transmitted infections (STIs). Consequently, pregnancies ending in childbirth in 2022 occurred against the backdrop of the COVID-19 situation, characterized by a decrease in preventive activity. Information deficit in 2020-2021 and the emphasis on issues of maintaining health in connection with the psychological factors of the pandemic accounted for peculiarities of awareness of young women regarding the prevention of STIs. The objective of our study was to analyze the knowledge and attitude of women towards prevention, diagnosis and treatment of STIs during pregnancy and to highlight the differences that arose depending on their education profile/profession. Materials and Methods — In 2022, against the background of the cancelation of most anti-epidemic restrictions, we conducted a sociological survey of 518 pregnant women. The respondents were divided into two comparable subgroups (178 respondents with education in medicine/biology and 340 females with other education profiles). This sample size corresponded to a significance level of 95%. Data processing was based on the calculation of relevant indicators (the proportion of parents – women and their husbands – screened for STIs prior to the conception, readiness for systematic screening examinations, and intentions to seek medical help for STIs). The significance of the difference in values between the subgroups of respondents with education in medicine/biology and education in humanities or technology was assessed using the Student’s t-test. Results — We revealed that 66.8% of respondents were focused on productive contact with the health care system, 74.2% of women with education in medicine/biology were examined for STIs, which statistically significantly (p&lt;0.05) exceeded the proportion of women with other education profiles (62.9%). At the same time, the level of trust in the public venereological services vs. private clinics was significantly higher among all categories of pregnant women (p&lt;0.01). Conclusion — Our study exhibited a high level of awareness among pregnant women about the STIs and the beneficial importance of preparation for conception by STI prevention. Women with education in medicine/biology had a more conscious attitude towards screening examinations for STIs, but at the same time demonstrated a higher desire for self-medication. We established that during the pandemic, young people in general have shown a stronger intention to receive medical care in private clinics, but in case of pregnancy exhibited higher confidence in public medical facilities.

DEVELOPMENT AND IMPROVEMENT OF QUALITY CHARACTERISTICS OF MEDICAL CARE

The aim: to investigate changes in the interpretation of the content of the characteristics of the quality of medical care and medical service; to propose practical approaches to the formation of modern quality criteria and indicators in health care institutions.&#x0D; Materials and methods: sources of scientific literature from the databases PubMed, NICE, according to the selected research topic, were selected as research materials; methods: bibliosemantic; analysis and generalization of the obtained data.&#x0D; Results. Classic characteristics of quality – safety, quality of resources, quality of the medical care process, treatment outcome, patient satisfaction, timeliness, fairness, efficiency – are reviewed over time and acquire additional or radically changed content. The selection of relevant quality characteristics is important for health care managers to define quality criteria and indicators according to the requirements of the local context. In addition to the traditional components of infectious safety and the safety of medical interventions, the safety criterion is today complemented by the components of radiation, environmental, epidemic, physical, informational, and terrorist safety. Safety also refers to the ability of professionals to avoid, prevent and reduce harmful interventions or risks to themselves and the environment. Patient-centeredness must include respect for the relationship not only between physician and patient, but also between the patient and all providers of health care for that patient. Effective, safe health care is reflected in a culture of excellence that includes collaboration, communication, compassion, competence, advocacy, respect, accountability and reliability. The most relevant criteria and indicators of the quality of medical care must be developed in accordance with the structure of innovative organizational models of academic health care centers, where scientific, clinical and educational activities are integrated. This requires the formation of end-to-end quality criteria and indicators that cover all activities of academic centers.&#x0D; Conclusions: criteria and indicators of the quality of medical care and medical service are constantly supplemented with new components, in accordance with the achievements of medical science and practice. The transformation of the organizational structures of medical care into academic centers, where scientific and educational activities are added to traditional medical practice, requires the development and introduction of end-to-end criteria for the quality of medical care.

Assessing Stress Variability in Fractured Rock Masses with Frictional Properties and Power Law Fracture Size Distributions

AbstractThe presence of fractures in rock masses plays a major role in its stress state and its variability. Each fracture potentially induces a stress perturbation, which is correlated to its geometrical and mechanical properties. This work aims to understand and quantitatively predict the relationship between fractured systems and the associated stress fluctuations distribution, considering any regional stress conditions. The approach considers the rock mass as an elastic rock matrix into which a population of discrete fractures is embedded—known as a Discrete Fracture Network (DFN) modeling approach. We develop relevant indicators and analytical solutions to quantify stress perturbations at the fracture network scale, supported by 3D numerical simulations, using various fracture size distributions. We show that stress fluctuations increase with fracture density and decrease as a function of the so-called stiffness length, a characteristic length that can be defined as the ratio between Young’s modulus of the matrix and fracture stiffness. Based on these considerations we discuss, depending on DFN parameters, which range of fractures should be modeled explicitly to account for major stress perturbations in fractured rock masses.

Applicability of Quality Management Tools for Evaluating Processes in Primary Health Care

Objective: The objective of the study was to understand the role of health managers in primary care, using validated quality tools, created and implemented within the Unified Health System (SUS). Method: This is a bibliographical review, of an exploratory and descriptive nature, developed using the qualitative method, through published scientific articles and literary works, without a time frame, in the Portuguese language. The Virtual Health Library (VHL) databases were used, specifically LILACS and MEDLINE, and BDTD, Google Scholar, SciELO and CAPES journals. Results and conclusion: The literature review identified that the quality tools validated in the SUS can be used by health managers to improve primary care, helping them to develop strategies to improve the provision of care to users. Among the tools identified, the PCATool-Brasil instrument was considered the most complete, as it evaluates primary care in several aspects, such as organization, access, care process, effectiveness and user satisfaction. Research implications: The research results indicate that quality tools validated in the SUS can be an important tool for health managers in improving primary care. However, it is important that managers adapt the tools to their local reality, taking into account the most relevant indicators for their population. Originality/value: The study is original because it presents a bibliographical review that addresses the role of health managers in primary care, using quality tools validated in the SUS. The study is also relevant for identifying that the PCATool-Brasil instrument is a complete tool that can be used by health managers to improve primary care.

Prognostic accuracy of SOFA, MEWS, and SIRS criteria in predicting the mortality rate of patients with sepsis: A meta-analysis.

In recent years, some studies classified patients with sepsis and predicted their mortality by using some evaluation scales. Several studies reported significant differences in the predictive values of several tools, and the non-uniformity of the cut-off value. To determine and compare the prognostic accuracy of Sequential Organ Failure Assessment (SOFA) score, Modified Early Warning Score (MEWS), and Systemic Inflammatory Response Syndrome (SIRS) criteria in predicting the mortality of patients with sepsis. This study comprised of systematic literature review and meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We searched PubMed, Embase, Web of Science and Cochrane Library databases from their establishment to July 31, 2022. The research articles published in the index journals provide sufficient data (true positive, false positive, true negative, and false negative results) for patients with sepsis. The combined sensitivity and specificity of the 95% confidence interval (CI) were calculated using the bivariate random effect model (BRM). The hierarchical overall subject working characteristics (HSROC) curve was drawn to evaluate the accuracy of the overall prognosis. Data of 55 088 patients from 32 studies were included in this meta-analysis. SOFA had an intermediate sensitivity of 0.73 (95% CI: 0.67-0.78) and a specificity of 0.70 (0.63-0.76). SIRS criteria had the highest sensitivity of 0.75 (0.66-0.82) and the lowest specificity of 0.40 (0.29-0.52). MEWS had the lowest sensitivity of 0.49 (0.40-0.59) and the highest specificity of 0.82 (0.78-0.86). Among SOFA, MEWS, and SIRS criteria, SOFA showed moderate sensitivity and specificity for predicting mortality in patients with sepsis, the highest sensitivity of SIRS and the strongest specificity of MEWS for predicting mortality in patients with sepsis. The future research direction is to combine the relevant indicators of MEWS and SIRS to develop a measurement tool with high reliability and validity. The review provides useful insights into the prognostic accuracy of different assessment tools in predicting mortality in sepsis patients, which will help clinicians choose the most appropriate tool for early identification and treatment of sepsis. The findings may also contribute to the development of more accurate and reliable prognostic models for sepsis.

REDUCING THE СО2 ATMOSPHERIC EMISSION BY NATURAL GAS “OXY-FUEL COMBUSTION”, AS A MEANS OF PREVENTION THE GREENHOUSE IMPACT

At present, the relation to the fuel-energy complex as the main source of climatic changes of a planetary scale (global warming) has been formed. In view of the corresponding forecasts related to the greenhouse effect, mostly associated with emissions of carbon-containing combustion products (carbonization of the environment), the following ways of countering the climate threat are considered the last time: a — rejection of use of the organic fuel with a gradual transfer to using (burning) of carbon-free fuels (primarily hydrogen and hydrogen-containing mixtures); b — increasing an efficiency of use the organic fuel, first of all is the natural gas, which can provide a 2-times (sometimes more) reduction of total CO2 emissions in the industry; c — reducing the consumption of C-containing technological substances in the treatment of thermal and chemical-thermal processing of metallic materials (steel); d — ferrous recycling and maximum scrap using by iron and steel production. In the paper under consideration the methodology, based upon application the specific greenhouse (CʺСO2) and harmful (CʺNOx) substances issue per unit of useful energy as the determinative parameters, has been advanced for the first time from the standpoint of environment’s decarbonization and pollution. The proper solution for lowering СО2 issue is especially suitable by provision the high temperature processes with utilization the systems of gently oxygen-enriched combustion air. In contrast to traditional assessment of harmful (primarily NOx) and greenhouse (СО2) emissions per unit of generated or supplied energy (the corresponding indicators are C'NOx and C'СO2), application of more adequate values have been proposed by performing the relevant calculations per unit of useful energy Quse. The proper values of relevant indicators CʺNOx and CʺСO2 are objective characteristics by option the most suitable composition of fuel-oxidant mixture. This is approach makes the decisive solution by conditions of mutual substitution the fuels with purpose of account the energy utilization of exhaust gases. Thermodynamic principles and a methodology for calculation the relevant indicators of pollution the exhaust gases CʺNOx and CʺСO2 have been developed. Numerical calculations have been performed and the values of specific emissions of CʺNOx and CʺСO2 have been and determined in dependence on degree of enrichment an oxidizing air-oxidant with oxygen [O2], % (vol.), by account the operating temperature of the process. The possibility of reducing the CʺСO2 emissions by 2 to 3 times or more compared to natural gas with atmospheric air burning has been established even by the cases of a slight (till 30 % vol.) enrichment of the air with oxygen. Bibl. 33, Fig. 11, Tab. 1.

Significance of triggering receptor expressed on myeloid cells-2 prognostic evaluation in hepatitis B virus-related acute-on-chronic liver failure

Objective: To explore the significance of triggering receptor expressed on myeloid cells-2 (TREM-2) prognostic evaluation so as to provide novel biological markers in clinical practice for patients with hepatitis B virus-related acute-on-chronic liver failure ( HBV-ACLF). Methods: The research subjects of this study were divided into an experimental group and a control group. Fifty HBV-ACLF cases admitted to the Department of Infectious Diseases of the First Affiliated Hospital of Nanchang University from January 1, 2019 to December 31, 2019 were selected as the experimental group. Patients were divided into survival and death groups according to the actual prognosis at discharge (self-discharge and dead patients were considered death groups, and all enrolled patients were hospitalized for more than 28 days). Twenty-five healthy subjects were chosen as the control group. Peripheral venous blood was collected from the experimental group and the control group. Plasma and peripheral blood mononuclear cells (PBMC) were isolated. The concentrations of TREM-2, interleukin (IL)-6, and IL-8 were detected in the plasma. TREM-2 mRNA expression was detected in PBMC. A single blood sample was collected from the control group, whereas five blood samples were dynamically collected from the experimental group on the day of admittance and at 7, 14, 21, and 28 days after treatment commenced. Simultaneously, upon admission, the relevant clinical indicators of HBV-ACLF patients were monitored, including the liver function test: alanine aminotransferase, aspartate aminotransferase, total bilirubin, albumin, coagulation function test: international normalized ratio, prothrombin time, and other indicators. Measurement data were expressed as mean±standard deviation (x±s). Count data were compared and analyzed using the χ(2) test. The intra-group factor mean was compared using a repeated measures ANOVA. The means were analyzed by t-tests between the two groups. Bivariate correlation analysis was used to analyze the correlation between the two variables. The value of TREM-2 as a diagnostic marker was analyzed using the receiver operating characteristic (ROC) curve. Results: The mRNA expression of TREM-2 in the PBMC of HBV-ACLF patients showed a gradually increasing trend at various time points and was significantly higher in the survival group than that of the control group at 28 days (P < 0.01), while the death group showed a gradually weakening trend at various time points and was significantly lower than the control group at 28 days (P < 0.01). (1) The levels of TREM-2 in the plasma of HBV-ACLF patients generally showed a gradually increasing trend at various time points in the survival group. The levels on the day of admission and 7, 14, 21, and 28 days after the initiation of treatment were (1.49±0.85), (1.62±0.58), (1.95±0.69), (2.33±0.71), and (2.00±0.67) ng/ml, respectively. The expression of TREM-2 in the death group showed a gradually weakening trend at various time points. The levels on the day of admission and 7, 14, 21, and 28 days after initiation of treatment were (1.40±0.73), (1.59±0.79), (1.56±0.80), (1.05±0.49), and (0.81±0.21) ng/ml, respectively. The survival group's various detection time points were higher than those of the death group, and the difference was statistically significant. The plasma level of TREM-2 in the healthy control group was (1.25±0.35) ng/ml. (2) The concentrations of IL-6 and IL-8 in the plasma of HBV-ACLF patients showed a gradually decreasing trend at various time points in the survival group. The levels on the day of admission and 7, 14, 21, and 28 days after initiation of treatment were (46.70±26.31), (33.98±20.28), (19.07±10.24), (14.76±7.84), (9.12±7.65) and (108.29±47.07), (93.85±26.53), (79.27±34.63), (56.72 ±18.30), (37.81±13.88) pg/ml, respectively. However, its concentration in the death group fluctuated within a relatively high range. The levels on the day of admission and 7, 14, 21, and 28 days after the initiation of treatment were (41.94±24.19), (36.99±19.78), (34.30±20.62), (34.14±14.52), (36.64±23.61) and (104.65±50.16), (112.98±45.03), (118.43±45.00), (111.67±40.44), (109.55±27.54) pg/ml, respectively. (3) Bivariate correlation analysis results indicated that the plasma TREM-2 content was negatively correlated with the plasma levels of pro-inflammatory cytokines IL-6 and IL-8 (r = -0.224, P = 0.025; r = - 0.223, P = 0.026). ROC curve analysis showed that the mRNA levels of TREM-2 in PBMCs at various time points for prognostic evaluation of HBV-ACLF patients were 1d=0.667, 7d=0.757, 14d=0.979, 21d=0.986, and 28d= 0.993. The areas under the ROC curve of the TREM-2 content in the plasma at various time points were 1d=0.522, 7d=0.571, 14d=0.658, 21d=0.927, and 28d=0.994. Conclusion: TREM-2 mRNA expression in PBMC and TREM-2 content in plasma have a significant relationship to the prognosis of HBV-ACLF patients and may inhibit the liver inflammatory response by regulating the secretion of pro-inflammatory cytokines IL-6 and IL-8. Dynamic monitoring of TREM-2 expression in peripheral blood is favorable for evaluating the prognostic condition of HBV-ACLF patients.

The Effect of Irrigation Techniques on Sustainable Water Management for Rice Cultivation System - A Review

Rice serves as a fundamental sustenance for approximately half of the global population, particularly in Asia. Nevertheless, the cultivation of rice demands a substantial water supply, and the challenges associated with water deficits have been exacerbated by irregular rainfall patterns induced by global warming. Consequently, there is a critical need to reassess irrigation techniques to effectively tackle these issues. In this comprehensive review, the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) method was employed to systematically explore literature on irrigation techniques aimed at fostering sustainable water management in rice cultivation systems. The primary components of the framework encompass water consumption and water-related characteristics, soil-related characteristics, and plant-related characteristics, encompassing relevant components and indicators. Two alternative irrigation methods, namely alternate wetting and drying (AWD) and saturated soil irrigation (SSI), have been proposed to enhance water use efficiency (WUE) in rice cultivation compared to traditional continuous flooding (CF). These alternative irrigation methods do not adversely affect rice yield, both quantitatively and qualitatively. Furthermore, these alternative irrigation approaches have the potential to mitigate greenhouse gas (GHG) emissions, particularly methane emissions, in rice production. This review underscores the significance of data on alternate irrigation systems, providing valuable insights for researchers and policymakers in formulating strategies that align at every level for practical implementation. This is crucial as it is relevant to multiple organizations and stakeholders. Moreover, in the face of inclement weather conditions resulting from climate change, the study's findings indicate that research on farmers' adaptation, plant stress, and resilience within the rice cultivation system is still in its nascent stages. This highlights the pressing need for further exploration and advancement in these areas to develop effective strategies for coping with the challenges posed by climate change.

Association between baseline intact parathyroid hormone levels, COVID-19 severity, and long-term outcomes in patients undergoing hemodialysis: A multicenter retrospective study

The COVID-19 pandemic poses unique challenges for vulnerable populations, including patients undergoing maintenance hemodialysis (HD). This study explores the relationship between baseline intact parathyroid hormone (iPTH) levels and COVID-19 severity, post-acute hospitalization, and mortality rates in HD patients.&#x0D; Methods. A multicenter retrospective cohort study was conducted across multiple centers, encompassing 142 patients undergoing HD treatment in three regions of Ukraine. The study spanned from March 2020 to May 2022. Baseline iPTH levels, demographic characteristics, and relevant clinical indicators were systematically recorded. Key endpoints included the severity of COVID-19, post-acute hospitalization, and mortality rates.&#x0D; Results. Of the initially eligible 165 patients, 23 were excluded, resulting in a final cohort of 142 patients. During the acute phase of COVID-19, distinct patterns emerged in terms of hospitalization rates, oxygen support requirements, and mortality. Lower iPTH levels were significantly associated with severe COVID-19-associated pneumonia (p &lt; 0.0001). A 20-month follow-up revealed a significant association between serum iPTH concentration &lt;174 pg/mL and increased rates of post-acute COVID-19 hospitalization [HR 6.3 (95% CI 2.9; 13.7)] and all-cause mortality [HR 34.3 (95% CI 6.9; 74.5)].&#x0D; Conclusion. This multicenter retrospective study suggests potential links between baseline iPTH levels and COVID-19 outcomes in patients undergoing HD. Serum iPTH concentration ≤174 pg/mL was significantly associated with increased post-acute hospitalization and mortality rate in our patient cohort. The findings emphasize the need for further research to elucidate underlying mechanisms and establish the prognostic value of iPTH in this specific patient population.

РИЗИКИ ТА ІНДИКАТОРИ СТІЙКОСТІ СІЛЬГОСПВИРОБНИЦТВА УКРАЇНИ В УМОВАХ ЗМІНИ КЛІМАТУ

Зміну клімату визнано однією з найсерйозніших сучасних загроз довгостроковим цілям суспільного розвитку. В сільському господарстві такі зміни провокують недоотримання агровиробниками гарантованих доходів і ризики продовольчої безпеки й здатні в цілому негативно вплинути на стійкість агросистеми. Забезпечення стійкості сільськогосподарського виробництва пов’язане з його екологізацією, кліматичною нейтральністю й високою опірністю негативним наслідкам різких кліматичних змін. Дослідження ризиків стійкості сільськогосподарського виробництва повинно мати системний характер і прив’язку до конкретних умов певної території.Ризики стійкості вітчизняного агровиробництва пропонується групувати за економічною, кліматичною, екологічною, соціальною сферами їх прояву. Для ефективної протидії негативним наслідкам кліматичних змін у сільгоспвиробництві й зменшення впливу на клімат з боку аграрного сектору необхідними є своєчасне прогнозування й управління відповідними ризиками, для чого має бути сформована система індикаторів стійкості. Це дозволить визначати вразливості й прогалини в спроможності забезпечення стійкості, а також оцінювати ефективність заходів з нівелювання негативного впливу несприятливих чинників на стійкість агрогосподарювання.Для умов України запропоновано комплексну систему індикаторів стійкості сільського господарства, яка включає чотири блоки: економічну, екологічну і кліматичну, соціальну стійкість, а також кліматичну нейтральність. Ключовими орієнтирами досягнення стійкості визнано: забезпечення національної продовольчої безпеки і доходів аграріїв; зниження волатильності врожайності сільгоспкультур; зменшення викидів вуглецю в результаті агрогосподарювання; забезпечення кадрового потенціалу агровиробництва. Розрахунки відповідних показників засвідчили, що в довоєнний період (зокрема, у 2021 р. порівняно з 2015 р.) ситуація не була загрозливою лише в економічній сфері. Водночас мали місце суттєві загрози у сферах екологічної і кліматичної стійкості, а також кліматичної нейтральності.

Multimodal Early Birth Weight Prediction Using Multiple Kernel Learning.

In this work, a novel multimodal learning approach for early prediction of birth weight is presented. Fetal weight is one of the most relevant indicators in the assessment of fetal health status. The aim is to predict early birth weight using multimodal maternal-fetal variables from the first trimester of gestation (Anthropometric data, as well as metrics obtained from Fetal Biometry, Doppler and Maternal Ultrasound). The proposed methodology starts with the optimal selection of a subset of multimodal features using an ensemble-based approach of feature selectors. Subsequently, the selected variables feed the nonparametric Multiple Kernel Learning regression algorithm. At this stage, a set of kernels is selected and weighted to maximize performance in birth weight prediction. The proposed methodology is validated and compared with other computational learning algorithms reported in the state of the art. The obtained results (absolute error of 234 g) suggest that the proposed methodology can be useful as a tool for the early evaluation and monitoring of fetal health status through indicators such as birth weight.

Relating the strategic role of technology orientation in organizational TQM performance

The importance of incorporating cutting-edge technological strategies to support business ecosystem development is growing across industries. By examining the relationship between organisational Total Quality Management (TQM) performance and the indicators of technology orientation, this study aims to fill the knowledge gap caused by insufficient empirical research on the characteristics of technology orientation. This study evaluates a unique conceptual framework using survey data from 254 IT manufacturing companies in India, utilising a two-staged structural equation modelling and artificial neural network methodology. The study developed hypotheses on TQM organisational performance through the literature on technology orientation to determine the correlations between these indicators. The findings highlight how enterprises that commit to adopting new technologies can enhance technological innovation to become more resourceful and creative and increase organisational TQM performance. The sensitivity analysis results showed that technology adoption significantly impacts organisational TQM performance. The novelty of this study contributes to the literature on organisation TQM performance by providing a deeper understanding of relevant technology orientation indicators and how organisations should use them to achieve superior performance. The results show that technology acceptance strategy, capability, infrastructure, innovation, and adoption benefit organisational TQM performance.

Analysis of the Ongoing Effects of Disasters in Urbanization Process and Climate Change: China’s Floods and Droughts

Urban development and climate change have strengthened the possibility of floods and droughts in cities. In this study, we evaluated the influences of these disasters and related social damage in nine major basins during the past 50 years. Unusually, the following conclusions were drawn from the analysis of relevant indicators before and after urbanization: (1) agricultural loss area (flood), grain loss, and direct economic loss showed an upward trend, while other indicators showed the opposite. (2) Floods most often occur in the Yangtze River Basin (58, 26.2%), followed by the Liaohe River Basin (49, 22.2%), which is closely related to the topography and economic progress of the area. (3) The modified Mann–Kendall (MK) analysis results are consistent with the indicators trend. Finally, the regularity of the climate change and urbanization process is revealed by the migration of the standard deviation ellipse and the mean center of the four indicators. China needs to integrate urban water/drought policy development with sustainable urbanization policy development to cope with the changing natural and social environment and to minimize urban ecological risks.

Colonic stent as a bridge to surgery versus emergency rection for malignant left-sided colorectal obstruction: A systematic review and meta-analysis of randomized controlled trials.

The role of self-expanding metal stent (SEMS) implantation as a bridge to surgery in malignant left-sided colorectal obstruction (MLCO) remains controversial. To evaluate the safety of SEMS implantation versus emergency surgery (ER) in the treatment of MLCO. Four major literature databases (Cochrane Library, Embase, PubMed, and Web of Science) were searched to collect articles published before April 20, 2023. After determining random or fixed-effect models based on heterogeneity tests, odds ratios (RR) or standardized mean differences (SMD) with their respective 95% confidence intervals (CI) were calculated. Nineteen randomized controlled studies were included. The main outcomes included overall tumor recurrence rate, 30-day mortality rate, and overall incidence of complications. Secondary outcomes included mortality-related indicators, tumor recurrence-related indicators, surgery-related indicators, and other relevant indicators. The study found that there was no significant difference in the 30-day mortality rate between the SEMS group and the er group. However, the SEMS group had a lower overall incidence of complications (RR = 0.787, P = .004), lower incision infection rate (RR = 0.472, P = .003), shorter operation time (SMD = -0.591, P = .000), lower intraoperative blood loss (SMD = -1.046, P = .000), lower intraoperative transfusion rate (RR = 0.624, P = .021), lower permanent stoma rate (RR = 0.499, P = .000), lower overall stoma rate (RR = 0.520,P = .000), shorter hospital stay (SMD = -0.643, P = .014), and more lymph node dissections during surgery (SMD = 0.222, 95% CI: 0.021-0.423, P = .031), as well as a higher primary anastomosis rate (RR = 0.472, 95% CI: 0.286-0.7 77, P = .003), among other advantages. However, the SEMS group had a higher overall tumor recurrence rate (RR = 1.339, P = .048). SEMS has significant advantages over er in relieving clinical symptoms and facilitating postoperative recovery in MLCO, but does not reduce the tumor recurrence rate. Neoadjuvant chemotherapy combined with SEMS may provide a new approach to the treatment of MLCO.

The main interpretations of the process of democratization in modern political science

The article examines the interpretations of the political processes of democratization by authoritative Russian and foreign researchers, primarily by political scientists, as well as modern characteristics and trends of democratization based on both recognized established theories of the XX century and the most modern research and scientific publications. The article has a review-analytical character. The method of secondary analysis of scientific sources is applied. The author highlights structural and procedural/actor approaches to the study of democratic transits. Attention is paid to the global pace of democratization of political systems of states in the XX century and modern trends in democratization based on data from monitoring centers specializing in socio-political research. It is shown that the pace of democratization at the global level is currently declining, which may indicate a naturally expected decline in the "third wave" of democratization in S.Huntington's terminology. Based on the conducted analytical research, the main criteria that ensure the reproduction of the democratic system are identified: the formation and functioning of the party and electoral systems, the consolidation of the electorate based on the adoption of democratic values, the formation and development of civil society, on the basis of which in the future it is possible to conduct a comparative analysis after identifying the relevant indicators. The factors hindering democratization are considered. Attention is paid to the proposals of researchers aimed at improving the quality and sustainability of democracy. A remark is also made that for a number of states the expediency of fully adopting liberal democracy is currently a debatable topic due to the presence of at least two conceptually different paradigms of understanding and interpreting democracy: Western and eastern models of democracy with different roots. The relevance of the studied topic is explained by the fact that the variety and state of the political system of the state somehow affect every citizen; studies of the processes of development of political systems can contribute to the search for optimal ways of reform.

Developing a 15-minute city: Evaluating urban quality using configurational analysis. The case study of Terni and Matera, Italy

the pandemic and the post-pandemic scenarios pose the question of a radical transformation of cities based on criteria of diversity, density, and proximity to foster inclusion, sustainability, participation, and quality of life. The 15-minute city emerges as a robust concept to inform the adaptation of the urban environment to the post-pandemic scenario. The 15-minute city concept combines the components of density, proximity, diversity, and digitalization to increase residents' access to basic services, favour sustainable modes of transportation, and transform public urban spaces into multifunctional places. The proposed study focuses on the dimensions of density, proximity, and diversity. It develops a set of indicators derived from the configurational analysis to evaluate urban quality in terms of the potential to actualize the 15-minute city concept. The selected areas of study are the cities of Terni and Matera in Italy. The study addresses three issues: i) defining a set of relevant, reproducible, and comparable indicators for measuring density, proximity, diversity, and imageability at the district scale; ii) investigating the influence of distinct urban planning concepts, manifested and reproduced by the configuration of public spaces, on density, proximity, diversity, and imageability; and iii) defining urban scale metrics to measure levels of spatial injustice in terms of unequal conditions of access to basic services. The analysis underlines the gap in terms of access to basic services and imageability among central compact districts and dispersed outer areas. As a result, the case study underlines that the proposed set of indicators is instrumental to understanding the urban environment's potential to meet the needs of urban populations. Moreover, by enabling the identification of inequalities in the distribution of spatial capital, the proposed set of indicators facilitates informed decisions in the context of urban planning.

The role of the acmeological approach in future teachers’ professional development

This study aimed to identify the impact role of providing training to future teachers with acmeological approach on leading to the personal and professional growth, which is relevant and valuable for providers and clients of educational services. The study was experimental in nature, the sample consisted of 325 respondents who had undergone special trainings with acmeological approach and who had participated in psycho-diagnostic research carried out before and after the training, as well as three months after the start of the experiment. The methods embraced testing by the questionnaires for studying meaningful life orientations, self-relationship, testing for “assessment of self-fulfillment” and “readiness to self-development”, and the indicator of self-change potential. The findings were compared with relevant indicators and their accuracy was confirmed via the students’ t-test. In the control group, participants expressed a desire to understand themselves but felt unable to facilitate self-improvement. Conversely, students in the experimental group expressed a desire to understand themselves and possessed the ability to promote self-improvement. The majority of students favored the acmeological approach for enhancing motivation and cultivating a highly professional persona. Three months post-experiment, students in the experimental group exhibited a greater tendency towards self-change. The results of the experiment have shown the effectiveness of acmeological approach for developing future teachers professionally, and the experimental verification of its impact on students' self-awareness, meaningful life orientations, ability to self-change, and their potential for high levels of teacher professionalism.

Persistent use of nitrous oxide for anaesthesia in European hospitals despite its harmfulness to the climate – how emission taxation can achieve the coupling of cost-effectiveness and climate protection: observational study

BackgroundHealth care has the intrinsic obligation to preserve health. This concept is also applicable to planetary health. Nitrous oxide (N2O) lacks clinical indications in modern anaesthesia, while it is a high-potential greenhouse gas. Its seemingly low cost contrasts with the consequential externalised socio-economic costs due to its contribution to the climate crisis, which is approximately €698 per emitted ton of CO2 equivalent. This difference can be internalised through emission taxation. In this study, we aim to evaluate how much N2O – total amount and converted to CO2 equivalent – is used at a German university hospital and compare this amount to that used at European hospitals. Furthermore, how the cost of N2O usage changes under different emission taxation scenarios is calculated.MethodsThis trial was a retrospective observational study at a German university hospital with approximately 1,250 beds between 2016 and 2020. Additionally, five European hospitals from the Health Care Without Harm Network were used for comparison from a European perspective. The main outcome parameters were the amount of N2O used, in total and converted to CO2 equivalent, and the total cost at emission taxation of €0, €25, €55 and €698 per ton CO2 equivalent.ResultsAt the peak, 2,104 tCO2 equivalent in N2O was emitted in 2019. The actual cost was €14,040 in this year, while the corresponding socio-economic damage due to the climate crisis was almost €1.5 million. Other European hospitals showed comparable amounts of emissions.ConclusionsThe annual peak amount of emitted N2O corresponded to the total annual greenhouse gas emission of 188 people in Germany. To achieve a drastic reduction in use, the abandonment of recommendations by anaesthesiologic societies appears necessary, in addition to an internalisation of future costs via emission taxation, which will cause inadequate cost for a medication without relevant benefit or indication. To that end, the inclusion of health sector emissions within national or international greenhouse gas taxation, for example, the European Union Emissions Trading System, appears necessary and expedient in view of the urgent need to address the ecological transformation.Trial registrationThe trial was registered with the German Clinical Trials Register, identifier DRKS00024973 on 12/04/2021.