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World Journal of Emergency Medicine 2024年第3期15卷 220-222页

作者： Julie Cueva Duncan Grossman Vishnu Muppala Arlene Chung Mahlaqa Butt Jefferson Drapkin Antonios Likourezos Errel Khordipour department of Emergency Medicine Maimonides Medical CenterNew York 11219USA

The “door-to-doctor” time for patients to be seen by a physician is an increasingly studied metric.Hospitals may shorten this time by implementing a triage physician (TP).The exact role of a TP may vary across departments.TPs put in preliminary orders for lab work,imaging,and treatment,and decide treatment location for further evaluation.As the prevalence of TPs grows,its effect on resident education in academic emergency departments (EDs) remains unclear.We implemented a TP in the spring of 2016 and assessed resident physicians before and after implementation.

关键词： physician doctor treatment

Does topical vancomycin prevent fracture-related infections in closed fractures undergoing open reduction and internal fixation?A randomised controlled trial

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Chinese Journal of Traumatology 2024年第2期27卷 71-76页

作者： Mohit Gandhi Gopisankar Balaji Jagdish Menon Ruben Raj Thomas department of Orthopaedics Jawaharlal Institute of Postgraduate Medical Education and ResearchPondicherryIndia department of Preventive and Social Medicine Jawaharlal Institute of Postgraduate Medical Education and ResearchPondicherryIndia

Purpose:The role of topical vancomycin in fracture-related infection(FRI)is debatable.Very few studies have reported their efficacy in open and high-risk extremity fractures.This study aimed to assess topical vancomycin's role in reducing FRI in closed fractures undergoing open surgical intervention with an implant.Methods:This prospective randomized cohort study was carried out between February 2021 to January 2022.Patients with isolated closed fractures,who were planned for open reduction and internal fixation within 2 weeks from the time of injury were included for this study.The data collected included age,gender,socioeconomic status,mechanism of injury,diagnosis,Tscherne classification,and time interval to take up for surgery.Patients were randomized into the intervention and control groups using the block randomization technique.The control group received only systemic antibiotic prophylaxis,whereas the intervention group received topical application of vancomycin powder in the surgical wound alongside systemic antibiotic prophylaxis.The primary outcome measure was the incidence of FRI among these individuals.Clinical and radiological findings and culture reports(in cases with infection)were recorded during the post-operative period and at 6 weeks of follow-up.All relevant statistical calculations were done using STATA statistical/data analysis-parallel edition version 16.0(StataCorp LLC).The quantitative variables like age and duration of the surgery were assessed for normalcy by Shapiro-Wilk W test.An independent samples t-test with equal variances was applied to the age data.Fisher's exact test was used for the analysis of the primary outcome measure(presence of FRI following surgery),and"Risk of FRI"and"Risk difference"between the 2 groups was calculated.The strength of the association between qualitative variables was assessed using the Fisher's exact and Chi-square tests,respectively.Results:There were 88 patients included in this study.No statistical significance was found about FRI between both grou

关键词： Infections Antibiotics Vancomycin Fractures

Can we predict the incidence of high-grade Clavien-Dindo complications in patients with forgotten encrusted stents undergoing endourologic management?

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Asian Journal of Urology 2024年第1期11卷 99-104页

作者： Praanjal Gupta Ramanitharan Manikandan Lalgudi Narayanan Dorairajan Kodakattil Sreenivasan Sreerag Sidhartha Kalra Swapnil Singh Kushwaha department of Urology Jawaharlal Institute of Postgraduate Medical Education and ResearchPondicherryIndia

Objective:Ureteral stents are customarily inserted to facilitate urinary drainage,but they come with their own glitches of being forgotten and/or encrusted leading to serious consequences.The present study aimed to report the complications in patients with forgotten and encrusted stents according to the Clavien-Dindo system specific to urological procedures and identify the factors leading to high-grade(Clavien-Dindo Grade 4A or above)complications.Methods:The hospital records of patients with forgotten encrusted double-J stents over a period of 8 years were reviewed.The parameters recorded included patient demographics,indwelling time,need for percutaneous nephrostomy,hemodialysis,urine culture,blood culture,total blood counts,serum creatinine,radiologic findings,management techniques,number of surgical interventions,modified Clavien-Dindo complications,follow-up,and mortality,if any.Results:Forty patients were included in the study.The median age was 52(range 6-85)years.Of the total,25(62.5%)patients had a“significant”stent load;31(77.5%)had renal failure or acute kidney injury on presentation;19(47.5%)patients had sepsis at presentation.Among the patients presented with sepsis,11(57.9%)patients demonstrated a positive urine culture;and 7/11(63.6%)patients exhibited pan-resistant organisms.Twelve out of 40(30.0%)patients in our series developed high-grade Clavien-Dindo complications.On univariate analysis,sepsis at presentation(p=0.007),stent load(p=0.031),diabetes(p=0.023),positive urine culture(p=0.007),and stent indwelling time of more than 1 year(p=0.031)were found to be significant.On multivariate logistic regression analysis,sepsis at presentation(p=0.017)and positive urine culture(p=0.016)were significant predictors for high-grade complications.Conclusion:It is prudent to identify specific risk factors,namely sepsis at presentation and positive urine culture to triage and optimize these patients before surgical management.

关键词： Forgotten Encrusted stent Outcome Predictor Clavien-Dindo complication

Relationship between physical activity and specific working memory indicators of depressive symptoms in university students

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World Journal of Psychiatry 2024年第1期14卷 148-158页

作者： Qun Zhao Xing Wang Shu-Fan Li Peng Wang Xiang Wang Xin Xin Suo-Wang Yin Zhao-Song Yin Li-Juan Mao School of Physical education Shanghai University of SportShanghai 200438China department of Physical education Donghua UniversityShanghai 201620China

BACKGROUND The detection rate of depression among university students has been increasing in recent years,becoming one of the main psychological diseases that endangers their physical and mental health.According to statistics,self-harm and suicide,for which there is no effective intervention,are the second leading causes of death.AIM To explore the relationship between different elements and levels of physical activity and college students’depression-symptom-specific working memory indicators.METHODS Of 143 college students were analyzed using the Beck Depression Self-Rating Scale,the Physical Activity Rating Scale,and the Working Memory Task.RESULTS There was a significant difference between college students with depressive symptoms and healthy college students in completing verbal and spatial working memory(SWM)tasks correctly(all P0.05).CONCLUSION An increase in physical exercise among college students,particularly medium-and high-intensity exercise and exercise of 30 min or more,can improve the correct rate of completing working memory tasks.

关键词： Physical activity Depression symptoms University students Working memory

Advancements in medical treatment for pancreatic neuroendocrine tumors:A beacon of hope

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World Journal of Gastroenterology 2024年第12期30卷 1670-1675页

作者： Somdatta Giri Jayaprakash Sahoo department of Endocrinology and Metabolism Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry605006India

This editorial highlights the remarkable advancements in medical treatment strategies for pancreatic neuroendocrine tumors(pan-NETs),emphasizing tailored approaches for specific subtypes.Cytoreductive surgery and somatostatin analogs(SSAs)play pivotal roles in managing tumors,while palliative options such as molecular targeted therapy,peptide receptor radionuclide therapy,and chemotherapy are reserved for SSA-refractory patients.Gastrinomas,insul-inomas,glucagonomas,carcinoid tumors and VIPomas necessitate distinct thera-peutic strategies.Understanding the genetic basis of pan-NETs and exploring immunotherapies could lead to promising avenues for future research.This review underscores the evolving landscape of pan-NET treatment,offering renewed hope and improved outcomes for patients facing this complex disease.

关键词： Pancreatic neuroendocrine tumor Medical management Somatostatin analog Immunotherapy Everolimus

Optimised hybrid classification approach for rice leaf disease prediction with proposed texture features

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Journal of Control and Decision 2024年第1期11卷 84-97页

作者： Sakhamuri Sridevi K.Kiran Kumar department of Computer Science and Engineering Koneru Lakshmaiah Education FoundationVaddeswaramIndia

This paper aims to frame a new rice disease prediction model that included three major phases.Initially,median filtering(MF)is deployed during pre-processing and then‘proposed Fuzzy Means Clustering(FCM)based segmentation’is done.Following that,‘Discrete Wavelet Transform(DWT),Scale-Invariant Feature Transform(SIFT)and low-level features(colour and shape),Proposed local Binary Pattern(LBP)based features’are extracted that are classified via‘MultiLayer Perceptron(MLP)and Long Short Term Memory(LSTM)’and predicted outcomes are obtained.For exact prediction,this work intends to optimise the weights of LSTM using Inertia Weighted Salp Swarm Optimisation(IW-SSO)model.Eventually,the development of IW-SSO method is established on varied metrics.

关键词： Rice disease improved fuzzy hybrid classifiers optimised LSTM IW-SSO algorithm

Stability analysis of a time-delayed Van der Pol–Helmholtz–Duffing oscillator in fractal space with a non-perturbative approach

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Communications in Theoretical Physics 2024年第4期76卷 22-31页

作者： Yusry O El-Dib department of Mathematics Faculty of EducationAin Shams UniversityRoxyCairoEgypt

The time-delayed fractal Van der Pol–Helmholtz–Duffing(VPHD)oscillator is the subject of this paper,which explores its mechanisms and highlights its stability analysis.While time-delayed technologies are currently garnering significant attention,the focus of this research remains crucially relevant.A non-perturbative approach is employed to refine and set the stage for the system under scrutiny.The innovative methodologies introduced yield an equivalent linear differential equation,mirroring the inherent nonlinearities of the system.Notably,the incorporation of quadratic nonlinearity into the frequency formula represents a cutting-edge advancement.The analytical solution's validity is corroborated using a numerical approach.Stability conditions are ascertained through the residual Galerkin method.Intriguingly,it is observed that the delay parameter,in the context of the fractal system,reverses its stabilizing influence,impacting both the amplitude of delayed velocity and the position.The analytical solution's precision is underscored by its close alignment with numerical results.Furthermore,the study reveals that fractal characteristics emulate damping behaviors.Given its applicability across diverse nonlinear dynamical systems,this non-perturbative approach emerges as a promising avenue for future research.

关键词： Van der Pol-Helmholtz-Duffing oscillator fractal space time-delay non-perturbative approach stability analysis El-Dib's frequency formula

Embodying Deeply Held Values in education:Seeking a More Equitable World for Both Humans and Non-Humans

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ECNU Review of education 2024年第2期7卷 241-251页

作者：林静 Shue-kei Joanna Mok Virginia Gomes department of Counseling Higher Education and Special EducationCollege of Education3214 Benjamin BuildingUniversity of MarylandCollege ParkMD20742USA

Highlights In this article,we contend that the bedrock of an equitable world lies in the profound recognition of love as the fundamental force permeating the cosmos.We believe that love is built into the essence of who we are.We posit that genuine progress toward an equitable world is elusive unless we place love,both for one another and for the natural world,at the core of our educational endeavors.

关键词： Embodied practices heart and spirit love and equity love as a cosmic force

Digital psychiatry in low-and-middle-income countries:New developments and the way forward

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World Journal of Psychiatry 2024年第3期14卷 350-361页

作者： Subho Chakrabarti department of Psychiatry Postgraduate Institute of Medical Education and ResearchChandigarh 160012UTIndia

Low-and middle-income countries(LMICs)bear the greater share of the global mental health burden but are ill-equipped to deal with it because of severe resource constraints leading to a large treatment gap.The remote provision of mental health services by digital means can effectively augment conventional services in LMICs to reduce the treatment gap.Digital psychiatry in LMICs has always lagged behind high-income countries,but there have been encouraging developments in the last decade.There is increasing research on the efficacy of digital psychiatric interventions.However,the evidence is not adequate to conclude that digital psychiatric interventions are invariably effective in LMICs.A striking development has been the rise in mobile and smartphone ownership in LMICs,which has driven the increasing use of mobile technologies to deliver mental health services.An innovative use of mobile technologies has been to optimize task-shifting,which involves delivering mental healthcare services in community settings using non-specialist health professionals.Emerging evidence from LMICs shows that it is possible to use digital tools to train non-specialist workers effectively and ensure that the psychosocial interventions they deliver are efficacious.Despite these promising developments,many barriers such as service costs,underdeveloped infrastructure,lack of trained professionals,and significant disparities in access to digital services impede the progress of digital psychiatry in LMICs.To overcome these barriers,digital psychiatric services in LMICs should address contextual factors influencing the delivery of digital services,ensure collaboration between different stakeholders,and focus on reducing the digital divide.

关键词： Digital psychiatry Low-and middle-income countries Developments Mental health

Actuality and underlying mechanisms of systemic immuneinflammation index and geriatric nutritional risk index prognostic value in hepatocellular carcinoma

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World Journal of Gastrointestinal Surgery 2024年第2期16卷 260-265页

作者： Konstantin Y Tchilikidi department of Surgery with Postgraduate education Altai State Medical UniversityBarnaul 656031Russia

This editorial contains comments on the article“Correlation between preoperative systemic immune inflammation index,nutritional risk index,and prognosis of radical resection of liver cancer”in a recent issue of the World Journal of Gastrointestinal Surgery.It pointed out the actuality and importance of the article and focused primarily on the underlying mechanisms making the systemic immuneinflammation index(SII)and geriatric nutritional risk index(GNRI)prediction features valuable.There are few publications on both SII and GNRI together in hepatocellular carcinoma(HCC)and patient prognosis after radical surgery.Neutrophils release cytokines,chemokines,and enzymes,degrade extracellular matrix,reduce cell adhesion,and create conditions for tumor cell invasion.Neutrophils promote the adhesion of tumor cells to endothelial cells,through physical anchoring.That results in the migration of tumor cells.Pro-angiogenic factors from platelets enhance tumor angiogenesis to meet tumor cell supply needs.Platelets can form a protective film on the surface of tumor cells.This allows avoiding blood flow damage as well as immune system attack.It also induces the epithelial-mesenchymal transformation of tumor cells that is critical for invasiveness.High SII is also associated with macro-and microvascular invasion and increased numbers of circulating tumor cells.A high GNRI was associated with significantly better progression-free and overall survival.HCC patients are a very special population that requires increased attention.SII and GNRI have significant survival prediction value in both palliative treatment and radical surgery settings.The underlying mechanisms of their possible predictive properties lie in the field of essential cancer features.Those features provide tumor nutrition,growth,and distribution throughout the body,such as vascular invasion.On the other hand,they are tied to the possibility of patients to resist tumor progression and development of complications in both postoperative and cancer-related settings.The

关键词： Systemic immune-inflammation index Geriatric nutritional risk index Radical surgery Transarterial chemoembolization Hepatocellular carcinoma Prognosis