Anterior lamellar corneoscleral keratoplasty for the management of corneal thinning following treatment with mitomycin-C and interferon to treat highly suspected ocular surface squamous neoplasia: a case report

ABSTRACT A patient presented with corneoscleral thinning five months after the treatment of suspected ocular squamous surface neoplasia with mitomycin-C and interferon. For tectonic and aesthetic purposes, we decided to perform lamellar corneoscleral transplantation. The approach used established new tectonic support and corneal homeostasis. This technique might be an option in similar cases.

What influences interruption of continuous renal replacement therapy in intensive care unit patients: A review with meta-analysis on outcome variables.

BACKGROUND: Evidence suggests that 8%-10% of ICU patients receive renal replacement therapy. However, there is a high rate of unplanned CRRT interruption, ranging between 17% and 74%. Studies on unplanned interruption of CRRT mainly focused on the retrospective investigation of related risk factors and conclusions have been diverse. AIMS: This article aims to clarify the main influencing factors related to unplanned interruption of continuous renal replacement therapy (CRRT) in adult patients in intensive care units (ICUs). STUDY DESIGN: A literature review and meta-analysis were undertaken. Following the application of the Newcastle-Ottawa Scale (NOS), a total of 15 articles were included in a total of 2132 patients who underwent 3690 CRRT procedures and 2181 unplanned interruption times. The methodological guideline of a scoping review was applied for the evidence synthesis while applying the meta-analysis quantitative methodological guideline to identify and clarify main influencing factors related to unplanned interruption of CRRT. The reporting Prisma Protocol was followed. RESULTS: Longer filter life and prothrombin activation time, higher red blood cell count, greater transmembrane pressure, faster blood flow rate, intermittent saline irrigation, lower creatinine level, low prothrombin activity and pre-dilution are factors identified to potentially affect unplanned CRRT in ICU patients. CONCLUSIONS: Available evidence suggests four clinical challenges associated with unplanned CRRT interruption, namely: (a) effects of red blood cell count, filter life, cross-mode pressure, blood flow velocity, prothrombin activity and activated partial thrombin time on unplanned interruption; (b) influence of dilution mode on unplanned interruption; (c) influence of intermittent saline irrigation on unplanned interruption; (d) influence of Scr level on unplanned interruption. RELEVANCE TO CLINICAL PRACTICE: The potential to increase the ability to better manage unplanned CRRT in ICUs has been identified in this article and constitutes a relevant potential health care management contribution that can be implemented by nurses.

Agreement between the EWGSOP2 and SDOC consensuses for sarcopenia in patients receiving hemodialysis: Findings of a cross sectional analysis from the SARC-HD study.

BACKGROUND: Differences in definitions and operational diagnoses for sarcopenia create difficulties in understanding the epidemiology of the disease. We examined the prevalences of sarcopenia using the revised European Working Group on Sarcopenia in Older People (EWGSOP2) and the Sarcopenia Definitions and Outcomes Consortium (SDOC) consensuses and analyzed their level of agreement in patients receiving hemodialysis. METHODS: Data from the SARCopenia trajectories and associations with clinical outcomes in patients receiving hemodialysis (SARC-HD) multicenter study in Brazil were analyzed. Muscle strength was assessed using handgrip strength, muscle mass by calf circumference, and physical performance by the 4-m gait speed test. Sarcopenia was diagnosed according to both the EWGSOP2 (low muscle strength plus low muscle mass) and the SDOC (low muscle strength plus low physical performance). The Cohen kappa statistic was used to determine the level of agreement between the consensuses. RESULTS: 838 patients (57.8 ± 15.0 years; 61% men) from 19 dialysis units were included. We found similar prevalences of sarcopenia between the consensuses (EWGSOP2, n = 128, 15.3%; SDOC, n = 105, 12.5%) but with weak agreement (50 of 233 patients, 21.5%; κ = 0.34, 95% CI 0.25-0.43). Agreement was also weak within age categories (≥60 years, κ = 0.34; <60 years, κ = 0.15; both P < 0.001). Of the 51 patients diagnosed by the EWGSOP2 criterion as having severe sarcopenia, all but 1 (98.0%) met the SDOC criterion for sarcopenia (κ = 0.61, 95% CI 0.52-0.70). Low muscle strength was more frequently diagnosed using the SDOC than with the EWGSOP2 (52.3% vs 25.9%). CONCLUSION: We found a weak agreement between the EWGSOP2 and SDOC consensuses for the diagnosis of sarcopenia in patients receiving hemodialysis. Although still weak, agreement was marginally better for older patients. These findings highlight the importance of a global and standardized conceptual diagnosis of sarcopenia.

Insights into uncovered public health risks. The case of asthma attacks among archival workers: a cross-sectional study.

Objective: To ascertain the prevalence of asthma attacks among archivists and identify the associated occupational factors in this understudied professional population. Methods: We conducted a cross-sectional, questionnaire-based study among 1,002 archival workers. A multiple logistic regression was conducted to identify the association between asthma attacks and occupational exposures. The Strobe Protocol was applied. Results: 999 workers were included in the final analysis with the asthma prevalence of 33.3%. Main factors associated with asthma attacks (OR [95% CI]) were the presence of chemically irritating odors (2.152 [1.532-3.024]), mold odors (1.747 [1.148-2.658]), and insects (1.409[1.041-1.907]). A significant synergistic effect was observed between chemical irritants and mold, the odds ratio was 7.098 (95% CI, 4.752-10.603). Conclusion: There was a high prevalence of asthma attacks among archival workers, an under-studied population. Chemical irritants, molds and insects were associated with their asthma attacks. Notably, this study's data analysis has revealed a strong synergy (OR = 7.098) between chemical odors and molds in the workplace. While the existing international literature on this specific interaction remains somewhat limited, previous studies have already demonstrated the potential for chemical irritants, such as sulfur dioxide and ozone, to synergistically interact with inhalable allergens, including fungi, molds and dust mites. Consequently, this interaction seems to exacerbate asthma symptoms and perpetuate untreated exposure. Furthermore, in damp and damaged buildings, the presence of microbial components, such as cellular debris or spores released during fungal growth can trigger an inflammatory response, potentially served as a shared pathway for the development of asthma among individuals exposed to these hazardous factors.

Anterior lamellar corneoscleral keratoplasty for the management of corneal thinning following treatment with mitomycin-C and interferon to treat highly suspected ocular surface squamous neoplasia: a case report.

A patient presented with corneoscleral thinning five months after the treatment of suspected ocular squamous surface neoplasia with mitomycin-C and interferon. For tectonic and aesthetic purposes, we decided to perform lamellar corneoscleral transplantation. The approach used established new tectonic support and corneal homeostasis. This technique might be an option in similar cases.

Unveiling the Enigmatic nature of six neglected Amazonian Leishmania (Viannia) species using the hamster model: Virulence, Histopathology and prospection of LRV1.

American tegumentary leishmaniasis (ATL) is highly endemic in the Amazon basin and occurs in all South American countries, except Chile and Uruguay. Most Brazilian ATL cases are due to Leishmania (Viannia) braziliensis, however other neglected Amazonian species are being increasingly reported. They belong to the subgenus L. (Viannia) and information on suitable models to understand immunopathology are scarce. Here, we explored the use of the golden hamster Mesocricetus auratus and its macrophages as a model for L. (Viannia) species. We also studied the interaction of parasite glycoconjugates (LPGs and GIPLs) in murine macrophages. The following strains were used: L. (V.) braziliensis (MHOM/BR/2001/BA788), L. (V.) guyanensis (MHOM/BR/85/M9945), L. (V.) shawi (MHOM/BR/96/M15789), L. (V.) lindenbergi (MHOM/BR/98/M15733) and L. (V.) naiffi (MDAS/BR/79/M5533). In vivo infections were initiated by injecting parasites into the footpad and were followed up at 20- and 40-days PI. Parasites were mixed with salivary gland extract (SGE) from wild-captured Nyssomyia neivai prior to in vivo infections. Animals were euthanized for histopathological evaluation of the footpads, spleen, and liver. The parasite burden was evaluated in the skin and draining lymph nodes. In vitro infections used resident peritoneal macrophages and THP-1 monocytes infected with all species using a MOI (1:10). For biochemical studies, glycoconjugates (LPGs and GIPLs) were extracted, purified, and biochemically characterized using fluorophore-assisted carbohydrate electrophoresis (FACE). They were functionally evaluated after incubation with macrophages from C57BL/6 mice and knockouts (TLR2-/- and TLR4-/-) for nitric oxide (NO) and cytokine/chemokine production. All species, except L. (V.) guyanensis, failed to generate evident macroscopic lesions 40 days PI. The L. (V.) guyanensis lesions were swollen but did not ulcerate and microscopically were characterized by an intense inflammatory exudate. Despite the fact the other species did not produce visible skin lesions there was no or mild pro-inflammatory infiltration at the inoculation site and parasites survived in the hamster skin/lymph nodes and even visceralized. Although none of the species caused severe disease in the hamster, they differentially infected peritoneal macrophages in vitro. LPGs and GIPLs were able to differentially trigger NO and cytokine production via TLR2/TLR4 and TLR4, respectively. The presence of a sidechain in L. (V.) lainsoni LPG (type II) may be responsible for its higher proinflammatory activity. After Principal Component analyses using all phenotypic features, the clustering of L. (V.) lainsoni was separated from all the other L. (Viannia) species. We conclude that M. auratus was a suitable in vivo model for at least four dermotropic L. (Viannia) species. However, in vitro studies using peritoneal cells are a suitable alternative for understanding interactions of the six L. (Viannia) species used here. LRV1 presence was found in L. (V.) guyanensis and L. (V.) shawi with no apparent correlation with virulence in vitro and in vivo. Finally, parasite glycoconjugates were able to functionally trigger various innate immune responses in murine macrophages via TLRs consistent with their inflammatory profile in vivo.

Effect of hydrofluoric acid and self-etch ceramic primers on the flexural strength and fatigue resistance of glass ceramics: A systematic review and meta-analysis of in vitro studies.

This systematic review evaluated the effect of different hydrofluoric acid (HF) etching regimens and a self-etch ceramic primer (SECP) on the flexural strength (FS) and fatigue failure load (FFL) of glass-ceramic materials.The identification of relevant studies was conducted by two authors in five databases: PubMED, Scopus, Web Of Science, LILACS and Virtual Health Library (BVS) until July 2022 with no year limit. The analysis was conducted in RevMan 5.4.1 Software (Cochrane Collaboration) using Random effect model at 5 %. The risk of bias of the included studies were assessed. From the 5349 articles identified, 34 were included for quantitative analysis. Meta-analysis showed that for predominantly glassy ceramics, etching with HF 5 % had no significant impact on FS, however, HF acid etching with concentrations greater than 5 % negatively impacted FS. For lithium disilicate glass-ceramics (LDGC) HF acid etching, negatively influenced FS, while increasing the FFL. HF etching negatively affected FS of hybrid ceramics. The self-etch ceramic primer and HF acid etching showed a similar impact on FFL and FS. This meta-analysis indicates that the impact of SECP and HF acid etching on the mechanical behavior of glass ceramics is material-dependent.

Case report: persistent double dorsal aorta.

Persistent double dorsal aorta is an extremely rare congenital anomaly, with only 13 cases published to date. The objective of this study is to present this embryological variant as observed in the abdominal aorta of a patient. The anatomical description was written up on the basis of a review of electronic medical records and imaging exams. The patient in this case was an elderly 79-year-old man who presented at emergency with pain at rest in the left lower limb. He was admitted and laboratory tests and imaging exams were ordered. The variation was an imaging finding observed on angiotomography, consisting of complete separation of the abdominal aorta into two portions - a ventral and a dorsal, with different calibers - at the level of the third lumbar vertebra. There was also an anomalous origin of the inferior mesenteric artery.

Is the facial bone wall critical to achieving esthetic outcomes in immediate implant placement with immediate restoration? A systematic review.

BACKGROUND: Rehabilitation in the anterior region requires specific conditions for success, such as the presence of papilla, emergence profile, and balance between pink and white esthetic. OBJECTIVES: This systematic review aimed to evaluate the esthetic risk associated with immediate implant placement with immediate restoration in the anterior superior area, where the facial bone plate may be absent or deficient. MATERIAL AND METHODS: The search was done in PubMed, Embase, Cochrane, Lilacs, Scopus, Scielo, and Google Scholar databases. The investigation involved clinical studies and observational studies published between January 2012 and July 2023. Studies were excluded if there was less than 12-month follow-up, no immediate restoration or facial defect, heavy smokers, or systemic disease. The risk of bias was assessed using the ROBINS-I and Modified-Cochrane RoB tools. RESULTS: Twelve studies were included in this systematic review. The thinner the facial plate, the higher the alveolus's risk of gingival recession or shrinkage. There was an increased interproximal recession when the thin phenotype was associated with flap surgery. An increase in pink esthetic score (PES) was reached when immediate implant placement (IIP) and immediate restoration were done. Soft tissue augmentation achieved more gingival-level stability. Regardless of the initial phenotype, an esthetic outcome was delivered. The risk of bias was high in 1 study and moderate in 3 studies. CONCLUSION: It is possible to conclude that esthetic results and increased final PES or patient satisfaction index in IIP treatments associated with immediate restoration could be obtained even in buccal bone wall defects or gingival recession, regardless of their extension.

The Dimensionality of the Moral Foundations: Contributions from the Moral Foundations Sacredness Scale in Four Societies.

Moral Foundations Theory proposes that five innate modules offer an intuitive response that drives our moral judgments. Various instruments were developed to measure the five moral foundations, including the MFV and the MFQ-30 which focus on deliberative moral reasoning. This approach is limited because intuitions are more basic and affect-laden. The Moral Foundations Sacredness Scale (MFSS) was designed to elicit responses that more closely resemble these phenomena. However, studies have not converged on a factorial structure for the MFSS, and measurement invariance has never been assessed. Our study sought to evaluate these properties across four adult samples, via Exploratory Structural Equation Modeling, and the associations between the MFSS's scales and relevant constructs. We found that a two-factor solution, reflecting the individualizing and binding foundations, had a reasonable fit, and had invariance (configural, metric, and scalar) across gender, age groups, and (configural) four international samples. The scales were reliable, had construct validity with the MFQ-30, and criterion-related validity with the binding moderately predicting belief in God/spirit and religious behaviors. The convergence we found regarding the MFSS's factorial structure across groups has important implications for the dimensionality of these constructs, and - ultimately - for the development of Moral Foundations Theory.

Relato de caso: aorta dorsal dupla persistente / Case report: persistent double dorsal aorta

Resumo A aorta dorsal dupla persistente é uma anomalia congênita extremamente rara, com apenas 13 casos publicados até o presente momento. Este estudo tem como objetivo apresentar a variação embriológica observada em aorta abdominal do paciente. A descrição anatômica foi realizada a partir da revisão de prontuário eletrônico e exames de imagem. Desta forma, o presente caso refere-se a um paciente idoso de 79 anos admitido em atendimento hospitalar por queixa de dor em membro inferior esquerdo ao repouso. Foi solicitada a internação do mesmo, assim como exames laboratoriais e de imagem. Obtida como um achado de imagem a partir de angiotomografia, a variação consiste na completa separação em duas porções: uma ventral e outra dorsal, de calibres diferentes, da aorta abdominal, ao nível da terceira vértebra lombar. Isso ocorre em conjunto com a origem anômala da artéria mesentérica inferior.

Abstract Persistent double dorsal aorta is an extremely rare congenital anomaly, with only 13 cases published to date. The objective of this study is to present this embryological variant as observed in the abdominal aorta of a patient. The anatomical description was written up on the basis of a review of electronic medical records and imaging exams. The patient in this case was an elderly 79-year-old man who presented at emergency with pain at rest in the left lower limb. He was admitted and laboratory tests and imaging exams were ordered. The variation was an imaging finding observed on angiotomography, consisting of complete separation of the abdominal aorta into two portions - a ventral and a dorsal, with different calibers - at the level of the third lumbar vertebra. There was also an anomalous origin of the inferior mesenteric artery.

Resistance of glaze application on indirect restorative CAD/CAM materials against abrasive toothbrushing wear.

PURPOSE: The aim of this study was to evaluate the effect of toothbrushing on the surface roughness (Sa), roughness profile (Rv), gloss units (GU) and surface morphology of three glazed ceramics. MATERIALS AND METHODS: Specimens (n=7) from different CAD/CAM materials 1- Lithium disilicate-based glass ceramic (IPS e.max CAD); 2- Zirconia-reinforced lithium silicate glass ceramic (Celtra Duo) and 3- 6 mol% yttria partially-stabilized zirconia (InCoris) were evaluated. IPS e.max CAD and InCoris specimens were sintered and all the groups were pre-polished and glazed according to the manufacturer's recommendations: IPS Ivocolor Glaze Paste (Ivoclar Vivadent) or Universal Overglaze High Flu (Dentsply/Sirona). Sa, Rv, GU and morphology were analyzed before and after brushing at 30.000, 120.000 and 180.000 cycles. The data of Sa and GU were analyzed by ANOVA two-way and post-hoc Tukey's test (α=0.05). Rv was analyzed by Kruskal-Wallis and Student-Newman-Keuls. The surface morphology was analyzed qualitatively. RESULTS: The Sa decreased significantly after 180.000 toothbrushing cycles for all materials tested. CE showed higher Rv than EM and IN, and IN showed the highest GU after 180.000 toothbrushing cycles, which promoted a polishing effect for all materials. CONCLUSION: Long-term toothbrushing was not able to jeopardize the glazed-surface of all tested materials compared to unbrushed.

Evidence on the need for early identification of asymptomatic true abdominal aortic aneurysm in pregnancy: A case report.

Pregnant women are more likely to face cardiovascular disease than non-pregnant women. However, abdominal aortic aneurysm is an extremely rare complication of pregnancy. Abdominal aortic aneurysms in pregnancy are difficult to identify in the early stage and are often diagnosed only when the symptoms have manifested. We report the case of a multiparous 35-year-old patient with a history of abnormal ascending aorta and ruled-out Marfan syndrome by genetic testing. After a multidisciplinary medical team evaluation, she delivered a live baby by cesarean section at 37 weeks of gestation, and the abdominal aortic aneurysm was repaired simultaneously. This case offers evidence-based recommendations for obstetricians to carry out preventive imaging examination for pregnant women with similar risk factors and provide successful experience in prenatal examination for similar diseases.

Three joint temperament-character configurations account for learning, personality and well-being: normative demographic findings in a representative national population.

Introduction: A common practice in research and clinical practice is to use data considered representative of a target population to compare and understand the personality characteristics of specific groups or specific individuals. To this end, numerous studies have presented normative data for the temperament and character traits outlined in Cloninger's psychobiological model of personality. However, recent genomic evidence demonstrates that human personality is organized as a complex hierarchy that ascends beyond the individual traits to multi-trait profiles that regulate emotional reactivity (temperament profiles) or goals and values (character profiles), and then to three phenotypic networks, which integrate temperament profiles and character profiles, that regulate learning. Given this recent understanding, our aim was to provide a novel and more comprehensive description of personality features at a societal level (using a stratified sample representative of the Portuguese population) by considering personality at its higher levels of complexity. Methods: Toward this goal, a stratified sample of 2,443 Portuguese adults responded to the Revised Temperament and Character Inventory (TCI-R). Results: We summarize the prevalence of (a) temperament profiles, (b) character profiles, and (c) integrated temperament-character networks within the whole sample, as well as for men vs. women and different age groups separately. Independent of age and education, women were more likely to be capable of resourceful productivity and helpful cooperation combined with being more intuitive, meditative and creative than men. Independent of age and gender, individuals with a degree were also more likely to present these biopsychosocial features. We also found that the organized character profile was most typical of adults in their 40s. Finally, the distribution of personality profiles across age differed as a function of gender: for men the oldest individuals had the most coherent personalities while high personality integration was most prevalent for women in their 30s. Discussion: These results have strong implications for research and intervention. In particular, these results are relevant for understanding the epidemiology of interactions between personality, mental health and well-being, including their expressions in a national population as a function of demographic characteristics.

Atrial standstill associated with lamin A/C mutation: A case report.

The case report shares evidence for a better understanding of atrial standstill. This being a rare arrhythmogenic condition. This is a 46-year-old woman presented with multiple sites of arterial embolism, including lower extremity arteries, coronary artery, and cerebral artery. Unexpectedly, multiple arterial embolization in the patient was due to atrial standstill by transthoracic echocardiography and cardiac electrophysiological study. An additional family investigation revealed that the patient's brother and sister also suffered from this disease. In search of further understanding the case, we carried out the genetic testing of the family and a frame shift double-G insertion mutation at c.1567 in the LMNA gene was found in all the three individuals. The patient recovered well after anticoagulation therapy and left bundle branch area pacing. This report remarks on the importance of multiple sites of arterial embolism which should be wary of family atrial standstill.

Review on Geopolymers as Wellbore Sealants: State of the Art Optimization for CO2 Exposure and Perspectives.

Wellbores used in underground production and storage activities, including carbon capture and storage (CCS), are typically sealed using sealants based on Ordinary Portland Cement (OPC). However, leakage along these seals or through them during CCS operations can pose a significant threat to long-term storage integrity. In this review paper, we explore the potential of geopolymer (GP) systems as alternative sealants in wells exposed to CO2 during CCS. First, we discuss how key parameters control the mechanical properties, permeability, and chemical durability of GPs based on different starting materials as well as their optimum values. These parameters include the chemical and mineralogical composition, particle size, and particle shape of the precursor materials; the composition of the hardener; the chemistry of the full system (particularly the Si/Al, Si/(Na+K), Si/Ca, Si/Mg, and Si/Fe ratios); the water content of the mix; and the conditions under which curing occurs. Next, we review existing knowledge on the use of GPs as wellbore sealants to identify key knowledge gaps and challenges and the research needed to address these challenges. Our review shows the great potential of GPs as alternative wellbore sealant materials in CCS (as well as other applications) due to their high corrosion durability, low matrix permeability, and good mechanical properties. However, important challenges are identified that require further research, such as mix optimization, taking into account curing and exposure conditions and available starting materials; the development of optimalization workflows, along with building larger data sets on how the identified parameters affect GP properties, can streamline this optimization for future applications.

Update of dialysis initiation timing in end stage kidney disease patients: is it a resolved question? A systematic literature review.

BACKGROUND: The exact optimal timing of dialysis for ESKD patients remains unknown. This study systematically reviewed the available evidence with regard to the optimal initiation of maintenance dialysis in ESKD patients. METHODS: An electronic search was performed in Embase, PubMed and the Cochrane Library in order to find studies investigating associations between variables reference to "start of dialysis" and outcomes. Quality assessment and bias assessment were performed by the Newcastle-Ottawa scale and the ROBINSI tool. Due to the heterogeneity of studies, a meta-analysis could not be performed. RESULTS: Thirteen studies were included; four studies included only haemodialysis patients, three peritoneal dialysis, six both; study outcomes included mortality, cardiovascular events, technique failure, quality of life and others. Nine studies mainly focused on the optimal GFR of maintenance dialysis initiation; five studies showed none association between GFR and mortality or other adverse outcomes, two studies showed dialysis initiation at higher GFR levels were with poor prognosis, and 2 studies showed higher GFR levels with better prognosis. Three studies paid attention to comprehensive assessment of uremic signs and/or symptoms for optimal dialysis initiation; uremic burden based on 7 uremic indicators (hemoglobin, serum albumin, blood urea nitrogen, serum creatinine, potassium, phosphorus, and bicarbonate) were not associated with mortality; another equation (combination of sex, age, serum creatinine, blood urea nitrogen, serum albumin, haemoglobin, serum phosphorus, diabetes mellitus, and heart failure) based on fuzzy mathematics to assess the timing of haemodialysis initiation was accuracy to prognose 3-year survival; the third study found that volume overload or hypertension was associated with the highest risk for subsequent mortality. Two studies compared urgent or optimal start in dialysis, a study reported increased survival in optimal start patients, another reported no differences between Urgent-Start-PD and Early-Start-PD regarding 6-month outcomes. LIMITATIONS: Heterogeneity among the studies was quite high, with differences in sample size, variable and group characteristics; no RCT studies were included, which weakened the strength of evidences. CONCLUSIONS: The criteria for dialysis initiation were varied. Most studies proved that GFR at dialysis initiation was not associated with mortality, timing of dialysis initiation should not be based on GFR, assessments of volume load and patient's tolerance to volume overload are prospective approaches.

Association between specific social activities and depressive symptoms among older adults: A study of urban-rural differences in China.

Background: Engaging in social activities can help older persons with their depressed symptoms. Few studies, however, have looked into the connection between social interactions and depressed symptoms in Chinese older persons. The aim of this study was to investigate differences in older Chinese individuals' social activity involvement and depressive symptoms across urban and rural settings. Methods: A cross-sectional investigation using information from the 2018 China Health and Retirement Longitudinal Study (CHARLS), which was limited to older individuals aged 60 and over. Generalized linear models were constructed to assess the effects of participants' characteristics and specific social activities on CES-D scores. The association between specific social activities and depressed symptoms was investigated using multivariate logistic regression analysis. Results: In this study, it was discovered that older individuals had a prevalence of depressed symptoms of 36.2%, with rural older adults having a greater prevalence of depressive symptoms (39.7%) than urban older adults (30.9%). Our results showed that for urban respondents, providing help to others (not regularly. OR = 0.753, 95% CI: 0.579-0.980, P = 0.035), going to a sport (not regularly. OR = 0.685, 95% CI: 0.508-0.924, P = 0.013), and using the Internet (not regular. OR = 0.613, 95% CI: 0.477-0.789, P < 0.001; almost weekly. OR = 0.196, 95% CI: 0.060-0.645, P = 0.007) were all significantly and negatively associated with depressive symptoms, while for rural respondents, interacting with friends (not regularly. OR = 1.205, 95% CI: 1.028-01.412, P = 0.021) and using the Internet (not regularly. OR = 0.441, 95% CI: 0.278-0.698, P < 0.001) were significantly and negatively associated with depressive symptoms. Conclusions: According to our research, there is a cross-sectional relationship between participating in a specific social activity and depressed symptoms in Chinese older adults, and this relationship varies across urban and rural older adults. This suggests that taking part in specific social activities may be crucial for reducing depression symptoms in older persons, developing more focused interventions that might support healthy aging, and offering a guide for policymakers and activists working to improve the mental health of seniors.

Effect of Educational Intervention on Knowledge and Level of Adherence among Hemodialysis Patients: A Randomized Controlled Trial.

Purpose: The purpose of the study was to assess the impact of an educational intervention on the level of knowledge and adherence to the treatment regimen among hemodialysis (HD) patients as well as to describe the association between these variables. Methods: In this randomized controlled trial, 160 HD patients at an HD centre of a 2030-bed tertiary teaching hospital in Southern India were randomly assigned into intervention (N = 80, received education and a booklet) and control (N = 80, received standard care) groups. Knowledge and adherence were measured preintervention and postintervention using a validated questionnaire for knowledge and the ESRD-AQ (End-Stage Renal Disease Questionnaire) for the level of adherence. The statistical analysis of the data was performed with the help of the Statistical Program SPSS version 19.0. The statistical significance level was set at 0.05. Results: The increase in knowledge on disease management, fluid adherence, and dietary adherence in the intervention group was significantly higher compared to the control group. There was no significant correlation between knowledge and adherence. Adherence improved for all the domains, i.e., dialysis attendance, episodes of shortening, adherence to medication, fluid restriction, and dietary restriction. Adherence to fluid and dietary restriction was statistically significant. This trail is registered with https://clinicaltrials.gov/ct2/show/CTRI/2018/05/014166.