Association of peripheral inflammatory indicators with osteoarthritis risk.

Objectives: Numerous studies have established the role of inflammation in osteoarthritis (OA) progression, yet limited research explores the association between systemic inflammatory indicators and pre-diagnosis OA risk. This study aimed to investigate the association between peripheral inflammatory indicators and the risk of OA using data from the UK Biobank. Methods: The study analyzed data from 417,507 participants in the UK Biobank, including neutrophil count, lymphocyte count, monocyte count, platelet count, and C-reactive protein meter. Additionally, derived ratios such as NLR(neutrophils-lymphocytes ratio), PLR(Platelets-lymphocytes ratio), SII(systemic immune-inflammation index), and LMR (lymphocytes-monocytes ratio) were examined. Cox proportional hazards models and restricted cubic spline models were used to assess both linear and nonlinear associations. Results: Over a mean follow-up period of 12.7 years, a total of 49,509 OA events were identified. The findings revealed that CRP (HR:1.06, 95%CI:1.05-1.07), NLR (HR:1.02, 95%CI:1.01-1.03), PLR (HR:1.02, 95%CI:1.01-1.03), and SII (HR:1.03, 95%CI:1.01-1.04) were associated with an increased risk of OA, while LMR (HR:0.97, 95%CI:0.96-0.99) showed a significant negative correlation with OA risk. Subgroup analyses further emphasized that these associations were significant across most of the population. Although neutrophils, lymphocytes, monocytes, and platelets showed a nominal association with the risk of OA, the results were unreliable, especially for specific joint OA. Conclusion: The study provides evidence of a significant association between elevated peripheral inflammatory indicators and OA risk. These findings underscore the importance of low-grade chronic inflammation in OA development. The potential clinical utility of these indicators as early predictors of OA is suggested, warranting further exploration.

Analysis of immune cells and risk factors related to lower limb deep vein thrombosis in patients with cerebral infarction.

To explore the characteristics of hematologic indicators and related risk factors of lower extremity deep vein thrombosis (LDVT) in patients with cerebral infarction. METHODS: This study retrospectively analyzed data from 174 patients with cerebral infarction admitted to The Rehabilitation Department of Shanghai Fifth Rehabilitation Hospital and Shanghai First People's Hospital from June 2022 to June 2023. Based on the results of lower limb venous color Doppler ultrasound examinations, patients were divided into two groups: the LDVT group (35 cases) and the non-LDVT group (139 cases). We compared the clinical data and hematologic indicators (D-dimer value, fibrinogen, white blood cells, platelets, uric acid, creatinine, etc.) of the two groups to identify the risk factors of cerebral infarction complicated with LDVT. RESULTS: Statistical analysis revealed that the D-dimer values of the LDVT group were significantly (P<0.05) higher than those of the non-LDVT group. The uric acid value of the LDVT group was significantly lower than that of the non-LDVT group, with statistical significance (P<0.05). The Brunnstrom staging in the LDVT group was significantly different from that in the non-LDVT group (P<0.05). Meanwhile, binary logistic regression analysis showed that LDVT complicated with cerebral infarction was associated with D-dimer level [OR=1.302, 95% CI (1.077, 1.575)], uric acid level [OR=0.995, 95% CI (0.990, 1.000)], and Brunnstrom staging [OR=3.005, 95% CI (1.312, 6.880)]. CONCLUSION: D-dimer value, uric acid value, and Brunnstrom stage I to II are closely related to the occurrence of LDVT in patients with cerebral infarction. High D-dimer value, low uric acid value, and Brunnstrom stage I to II are independent risk factors for LDVT in cerebral infarction. Early assessment of D-dimer value, uric acid value, and Brunnstrom stage of cerebral infarction should be considered in clinical practice.

[Microbiological and parasitological risk analysis of novel food sources obtained with the use of insects].

The problem of food safety being an important component of the country's food security, provides not only for continuous improvement of the methodology of hygienic standardization, but also for the formation of requirements for novel food, in particular, those obtained from non-traditional sources. The accumulated practical and theoretical competence in the food hygiene area, as well as knowledge of current trends of the food base broadening, allow us to analyze the risks associated with novel food obtained of insects. The purpose of the research was to analyze the microbiological and parasitological risk of novel food sources obtained with the use of insects, suggest the effective risk management measures. Material and methods. The analytical part of the work included literature search, collection of information and statistical materials published in domestic and foreign scientific editions. The search was carried out using the Google Academy retrieval system and electronic databases (PubMed, MEDLINE, EMBASE, Scopus, Web of Science, eLIBRARY), mainly in the last 25 years, using the keywords: Hermetia illucens, Tenebrio molitor, Acheta domesticus, insects, parasite, nematode, pathogen, cysts. Results. Based on the published materials' analysis, a systematization of microbiological and parasitological factors potentially capable of colonizing edible insects has been carried out. There were identified representatives of 24 groups of pathogenic and 18 opportunistic microorganisms and helminths related to microbial and parasitic pathogens, the spread of which is significantly influenced by inappropriate conditions of feeding and keeping insects. As there are currently no veterinary requirements for insect breeding and farming conditions, contamination of end products with infectious and parasitic pathogens can vary over a very wide range. Conclusion. The use of native insect biomass carries certain risks associated with its microbial and parasitic contamination, and the development of measures to prevent them requires significant resources. The possibility of deep processing of such raw materials can be considered as one of the solutions to mitigate these risks. For use in the food industry, insects should be subjected to processing similar to that currently used for soybean seeds, which includes separation of protein (entomoprotein), fat and chitin fractions, each of which would have an independent use. Thus, at present, insects should be considered as a source of novel food ingredients, first of all, complete protein of animal origin.

Key performance indicators for monitoring of anemia management and iron status in children attending a pediatric dialysis unit: the experience of Ain Shams University.

BACKGROUND: Anemia in children on maintenance hemodialysis (HD) leads to poor quality of life. Our study aimed to assess and monitor anemia and iron status management in children on maintenance HD over 18 months using key performance indicators. METHODS: Key performance indicators, formulated as the percentage of patients achieving the KDIGO (2012) guideline-recommended targets for hemoglobin (Hb) (11-12 g/dl), transferrin saturation (TSAT) (20-40%) and serum ferritin (200-500 ng/ml), were reported quarterly over the 18-month-period of this study. RESULTS: This study was carried out over an 18 month-period, from April 1st, 2020, till October 31st, 2021. A total of 78 patients (45 males and 33 females) were included; mean age 12.16 ± 3.3 years and HD duration range 3.0-140.88 months, median 16.51 months. The three most common primary causes of CKD were Congenital Anomalies of the Kidney and Urinary Tract (CAKUT) (29.5%), unknown cause (24.4%), and chronic glomerular diseases (20.5%). The quarterly reported percentages of patients achieving the recommended targets for Hb, TSAT, and serum ferritin ranges were 18.2-35.7%, 38.8-57.1%, and 11.9-26.6%, respectively. CONCLUSION: Although the mean Hb trend was nearing the KDIGO (2012) target, the key performance indicators showed that only a small percentage of our HD patients were achieving the targets for Hb, TSAT, & serum ferritin, thus alerting us to the need to revise our protocol for the management of anemia and iron status.

Retrospective evaluation of shock index and mortality in dogs with head trauma (2015-2020): 86 cases.

OBJECTIVE: To assess the relationship between shock index (SI) and mortality in dogs with head trauma (HT). A secondary objective was to compare SI with the animal trauma triage (ATT) score and Modified Glasgow Coma Scale (MCGS) score in HT cases. A tertiary aim was to assess if SI is predictive of survival to discharge or improvement in presenting neurologic signs. DESIGN: Retrospective study from January 2015 to December 2020. SETTING: Tertiary referral level II veterinary trauma center. ANIMALS: Eighty-six dogs with evidence of HT presenting through emergency for various traumas compared to 60 healthy control dogs. MEASUREMENTS AND MAIN RESULTS: SI was calculated using the quotient of heart rate over systolic blood pressure measured on presentation. SI was significantly higher in HT patients than healthy controls (P = 0.0019). SI was not significantly different between traumatic brain injury dogs that died or were euthanized and HT dogs that lived until the time of discharge (P = 0.98). SI was not significantly different between HT dogs that were neurologically normal at the time of discharge and HT dogs that were static or improved but not normal neurologically at the time of discharge (P = 0.84). In HT dogs, SI did not correlate with ATT score (P = 0.16) or MGCS score (P = 0.75). There was no significant difference in SI and length of hospitalization until death or discharge (P = 0.78). CONCLUSIONS: SI was significantly higher in HT patients compared to control patients. Interestingly, SI was not correlated with ATT score or MGCS score. The use of SI in HT patients warrants further investigation to assess the efficacy in predicting mortality.

Coastal erosion and flooding risk assessment based on grid scale: A case study of six coastal metropolitan areas.

Coastal areas, situated at the critical juncture of sea-land interaction, are confronted with significant challenges from coastal erosion and flooding. It is imperative to evaluate these risks and offer scientific guidance to foster regional sustainable development. This article developed a coastal risk assessment model based on grid scale, integrating both coastal exposure and socio-ecological environment. Fourteen indicators were selected, aiming to offer a systematic approach for estimating and comparing disaster risks in coastal areas. This risk assessment model was applied to Shanghai, New York, Sydney, San Francisco, Randstad, and Tokyo metropolitan areas. The results indicate: (1) Accounting for the protective role of habitat types like mangroves and the distance attenuation effect offered a more precise representation of hazard situation; (2) The integration of the Game Theory weighting method with both subjective Analytic Hierarchy Process and objective CRITIC weighting enhanced the scientific validity and rationality of the results by minimizing deviations between subjective and objective weights; (3) Shanghai exhibited the highest average hazard and vulnerability, San Francisco had the lowest average hazard and Sydney had the lowest average vulnerability; In terms of comprehensive risk, Shanghai possessed the highest average risk, while Sydney presented the lowest. The proposed model framework is designed to swiftly identify high-risk zones, providing detailed information references for local governments to devise efficacious risk management and prevention strategies.

Advancing groundwater quality predictions: Machine learning challenges and solutions.

Machine learning (ML) is revolutionizing groundwater quality research by enhancing predictive accuracy and management strategies for contamination. This comprehensive review explores the evolution of ML technologies and their integration into environmental science, assessing 230 papers to understand the advancements and challenges in groundwater quality research. It reveals that a substantial portion of the research neglects critical preprocessing steps, crucial for model accuracy, with 83 % of the studies overlooking this phase. Furthermore, while model optimization is more commonly addressed, being implemented in 65 % of the papers, there is a noticeable gap in model interpretability, with only 15 % of the research providing explanations for model outcomes. Comparative evaluation of ML algorithms and careful selection of evaluation metrics are deemed essential for determining model fitness and reliability. The review underscores the need for interdisciplinary collaboration, methodological rigor, and continuous innovation to advance ML in groundwater management. By addressing these challenges and implementing solutions, the full potential of ML can be harnessed to tackle complex environmental issues and ensure sustainable groundwater management. This comprehensive and critical review paper can serve as a guiding framework to establish minimum standards for developing ML in groundwater quality studies.

Assessing spatiotemporal change in coral reef social-ecological systems.

Coral reef resilience is eroding at multiple spatial scales globally, with broad implications for coastal communities, and is thus a critical challenge for managing marine social-ecological systems (SESs). Many researchers believe that external stressors will cause key coral reefs to die by the end of the 21st century, virtually eliminating essential ecological and societal benefits. Here, we propose the use of resilience-based approaches to understand the dynamics of coral reef SESs and subsequent drivers of coral reef decline. Previous research has demonstrated the effectiveness of these methods, not only for tracking environmental change, but also for providing warning in advance of transitions, possibly allowing time for management interventions. The flexibility and utility of these methods make them ideal for assessing complex systems; however, they have not been used to study aquatic ecosystem dynamics at the global scale. Here, we evaluate these methods for examining spatiotemporal change in coral reef SESs across the global seascape and assess the subsequent impacts on coral reef resilience. We found that while univariate indicators failed to provide clear signals, multivariate resilience-based approaches effectively captured coral reef SES dynamics, unveiling distinctive patterns of variation throughout the global coral reef seascape. Additionally, our findings highlight global spatiotemporal variation, indicating patterns of degraded resilience. This degradation was reflected regionally, particularly in the Pacific Ocean and Indian Ocean SESs. These results underscore the utility of resilience-based approaches in assessing environmental change in SESs, detecting spatiotemporal variation at the global and regional scales, and facilitating more effective monitoring and management of coral reef SESs.

Surgical Treatment of Patients with Endometriosis in the Certified Endometriosis Centers of the DACH Region - A Subanalysis of the Quality Assurance Study QS ENDO pilot.

Introduction After puberty, at least 10% of all women and girls suffer from endometriosis. Surgery is useful for both the diagnosis and therapy. To date, quality indicators for the surgical treatment of endometriosis are lacking. QS ENDO aims to record the quality of care provided in the DACH region and to introduce quality indicators for the diagnosis and treatment of endometriosis. In the first phase of the study, QS ENDO real, the reality of care was recorded using a questionnaire. The second phase, QS ENDO pilot, investigated the treatment of patients who underwent surgery in certified endometriosis centers in a defined time-period. Material and Methods The surgical data of 10 patients from each of the 44 endometriosis centers in the DACH region was recorded using an online tool. Collected data included the approach used, the endometriosis phenotype, a description of the surgical site, resection status, histological confirmation, the use of a classification, and any complications. All operations were carried out in October 2016 as the defined time-period. The surgical approaches used were compared with the recommendations in the current guidelines. Results The data of 435 patients with a median age of 34 years were evaluated. 315 (72.4%) were nulliparous. 120 patients had given birth to at least one child and 42.5% (51) of them had delivered their child by caesarean section. About 50% of all patients also had deep infiltrating endometriosis in addition to ovarian endometriosis, and the median NAS score was 7.5. With regards to the surgical treatment, endometriomas were completely resected in 81% (94) of patients. 87.3% of patients underwent resection of peritoneal endometriosis. Forty-one patients had a hysterectomy, with a total hysterectomy carried out in 26 (63.4%) and a supracervical hysterectomy in 15 (36.6%) patients. Of the 59 patients with bowel endometriosis, half had segmental resection and half had shaving of the anterior rectal wall. Complications requiring revision occurred in 0.9% of cases. Conclusion The surgical procedures carried out in the certified endometriosis centers of the DACH region are largely in line with the recommendations for appropriate surgical approaches in the current standard guidelines.

A systematic benchmarking framework for future assessments of soil health: An example from Denmark.

Based on current evidence and established critical thresholds for soil degradation indicators, it is concerning that over 60-70% of European soils are unhealthy due to unsustainable management and the impact of climate change. Despite European and national efforts to improve soil health, significant gaps remain. The proposal for a Soil Monitoring and Resilience Law, to be implemented by the European Union, seeks to establish a framework for soil monitoring and promote sustainable management practices to achieve healthy soils by 2050. This requires extensive data collection and soil monitoring systems to accurately estimate soil health across Europe, considering the diversity of soil types, climates, and land uses. To establish a framework for soil monitoring, we must understand the site-specific status of soil and the ranges of soil health indicators across specific pedoclimatic regions. In our study, we evaluated the soil status in agricultural areas in Denmark using soil health indicators and a site-specific benchmarking approach. We compiled nationally representative datasets, combining point and model-informed data of soil parameters such as organic carbon content, bulk density, pH, electrical conductivity, clay-to-soil organiccarbon ratio, water erosion, and nitrogen leaching. By categorizing Danish agricultural soils into monitoring units based on textural classes, landscape elements, and wetland types, we calculated benchmarks for these indicators, considering different cropping systems. Our approach provided detailed point-based results and a spatially explicit overview of the status of soil health indicators in Denmark. We identified areas where soil deviates from the benchmarks of different indicators. Such deviations might indicate soil functions operating outside the normal range, posing potential threats to soil health. This proposed framework could support the establishment of a baseline for assessing the directionality of future changes in soil health. Moreover, it is adaptable for implementation by other countries to support assessments of soil health.

Metagenomic profiling uncovers microbiota and antibiotic resistance patterns across human, chicken, pig fecal, and soil environments.

The ongoing and progressive evolution of antibiotic resistance presents escalating challenges for the clinical management and prevention of bacterial infections. Understanding the makeup of resistance genomes and accurately quantifying the current abundance of antibiotic resistance genes (ARGs) are crucial for assessing the threat of antimicrobial resistance (AMR) to public health. This comprehensive study investigated the distribution and diversity of bacterial community composition, ARGs, and virulence factors (VFs) across human, chicken, pig fecal, and soil microbiomes in various provinces of China. As a result, multidrug resistance was identified across all samples. Core ARGs primarily related to multidrug, MLS (Macrolides-Lincosamide-Streptogramins), and tetracycline resistance were characterized. A significant correlation between ARGs and bacterial taxa was observed, especially in soil samples. Probiotic strains such as Lactobacillus harbored ARGs, potentially contributing to the dissemination of antibiotic resistance. We screened subsets of ARGs from samples from different sources as indicators to assess the level of ARGs contamination in samples, with high accuracy. These results underline the complex relationship between microbial communities, resistance mechanisms, and environmental factors, emphasizing the importance of continued research and monitoring to better understand these dynamics.

Outcome clusters and their stability over 1 year in patients with SLE: self-reported and performance-based cognitive function, disease activity, mood and health-related quality of life.

OBJECTIVE: To determine if self-reported fatigue, anxiety, depression, cognitive difficulties, health-related quality of life, disease activity scores and neuropsychological battery (NB) cluster into distinct groups in patients with SLE based on symptom intensity and if they change at 1-year follow-up. METHODS: This is a retrospective analysis of consecutive consenting patients, followed at a single centre. Patients completed a comprehensive NB, the Beck Anxiety Inventory, Beck Depression Inventory, Fatigue Severity Scale, Short-Form Health Survey Physical Component Summary and Mental Component Summary scores and the Perceived Deficits Questionnaire. Disease activity was assessed by Systemic Lupus Erythematosus Disease Activity Index 2000. Ward's method was used for clustering and principal component analysis was used to visualise the number of clusters. Stability at 1 year was assessed with kappa statistic. RESULTS: Among 142 patients, three clusters were found: cluster 1 had mild symptom intensity, cluster 2 had moderate symptom intensity and cluster 3 had severe symptom intensity. At 1-year follow-up, 49% of patients remained in their baseline cluster. The mild cluster had the highest stability (77% of patients stayed in the same cluster), followed by the severe cluster (51%), and moderate cluster had the lowest stability (3%). A minority of patients from mild cluster moved to severe cluster (19%). In severe cluster, a larger number moved to moderate cluster (40%) and fewer to mild cluster (9%). CONCLUSION: Three distinct clusters of symptom intensity were documented in patients with SLE in association with cognitive function. There was a lower tendency for patients in the mild and severe clusters to move but not moderate cluster over the course of a year. This may demonstrate an opportunity for intervention to have moderate cluster patients move to mild cluster instead of moving to severe cluster. Further studies are necessary to assess factors that affect movement into moderate cluster.

The potential presence of infection may be indicated through non-invasive prediction of procalcitonin and C-reactive protein levels within the initial three days after cervical cerclage: a retrospective case-control study.

PURPOSE: To identify which non-invasive infection indicators could better predict post-cervical cerclage (CC) infections, and on which days after CC infection indicators should be closely monitored. METHODS: The retrospective, single-center study included 619 single-pregnancy patients from January 2021 to December 2022. Patients were categorized into infected and uninfected groups based on physicians' judgments of post-CC infections. Registered information included patient characteristics, cervical insufficiency history, gestational age at CC, surgical method (McDonald/Shirodkar), purpose of CC, mid-pregnancy miscarriage/preterm birth, infection history or risk factors, and infection indices on days 1, 3, 5, and 7 after CC. Propensity score matching (PSM) was applied to reduce patient characteristic bias. Statistical analysis of C-reactive protein (CRP), white blood cell (WBC), neutrophil count (NEU), percentage of neutrophil count (NEU_P), interleukin-6 (IL-6), and procalcitonin (PCT) in the infected group compared with the uninfected group was performed using chi-square tests and t-tests. Receiver operating characteristic (ROC) curves were used to further assess the diagnostic value of CRP, PCT, and CRP-PCT in combination. RESULTS: Among the 619 included patients, 206 patients were matched using PSM and subsequently assessed. PCT values on day 1 and day 3 after CC exhibited significant differences between the two groups in two statistical ways (P < 0.01, P < 0.05). The CRP levels on day 1 were significantly higher in the infected group compared to the uninfected group in two statistical ways (P < 0.05). On day 3, the mean CRP value was significantly elevated in the infected group compared to the uninfected group (P < 0.05). Analyses of IL-6, WBC, NEU, and NEU_P did not yield clinically significant results. The area under the ROC curves for CRP, PCT, and CRP-PCT on day 1 and day 3 were all below 0.7. In the preventive CC group, the AUC values of CRP and CRP-PCT obtained on d1 were found to be higher than 0.7, indicating moderate diagnostic accuracy. CONCLUSION: For women after CC surgery, especially of preventive aim, increased serum CRP and PCT levels from post-CC day 1 to day 3 may signal a potential postoperative infection, warranting close monitoring.

Benchmarking circularity in supply chains: A systematic literature review.

The challenges posed by unsustainable practices in today's economy underscore the urgent need for a transition toward a circular economy (CE) and a holistic supply chain (SC) perspective. Benchmarking plays a pivotal role in managing circular SCs, offering a metric to gauge progress. However, the lack of consensus on the optimal benchmarking approach hampers effective implementation of circular business practices. To address this gap, we conducted a systematic review of the literature, identifying 29 pertinent publications. The analysis revealed 30 unique attributes and sub-attributes for benchmarking circularity, which were clustered into five main attributes. The main attributes are goals, subjects, key performance indicators (KPIs), data sources, and evaluation methods, while the sub-attributes are organised as features of the main attributes and depicted as a feature model. Drawing from selected publications, we illustrated each feature with examples. Our model offers a comprehensive benchmarking reference for circularity and will be a valuable tool for managers in the transition toward circularity. Supply chains seeking to benchmark their transition to circularity can apply the reference model to ensure that their benchmarking strategy is consistent with state-of-the-art knowledge. By providing a generic circularity benchmarking approach that is valid for diverse economic sectors, our findings contribute to theoretical efforts to address the lack of generic frameworks for CE.

Effects of nanoselenium on the performance, blood indices, and milk metabolites of dairy cows during the peak lactation period.

To compare the impact of nanoselenium and sodium selenite on the performance, blood indices, and milk metabolites of dairy cows during the peak lactation period, two groups of dairy cows under the same conditions were selected as the control group (CON group) and treatment group (NSe group) for a 38-day (10 days for adaptation and 28 days for sampling) experiment. The control group (CON) was provided a basal diet +3.3 g/d of sodium selenite (purity1%), whereas the nanoselenium group (NSe) was offered the same diet +10 mL/d of nanoselenium (selenium concentration 1,500 mg/L). The results showed that NSe significantly increased the milk yield, milk selenium content, and feed efficiency (p < 0.05), but had no significant effect on other milk components (p > 0.05). NSe significantly increased blood urea nitrogen (BUN) and alkaline phosphatase (ALP) (p < 0.05), but had no significant effects on malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), blood total antioxidant capacity (T-AOC), or blood selenium (p > 0.05). In addition, the nontargeted metabolomics of the milk was determined by LC-MS technology, and the differentially abundant metabolites and their enrichment pathways were screened. According to these findings, NSe considerably increased the contents of cetylmannoside, undecylenoic acid, 3-hydroxypentadecanoic acid, 16-hydroxypentadecanoic acid, threonic acid, etc., but decreased the contents of galactaric acid, mesaconic acid, CDP-glucose etc. Furthermore, the enriched metabolic pathways that were screened with an impact value greater than 0.1 included metabolism of niacin and niacinamide, pyruvate, citrate cycle, riboflavin, glycerophospholipid, butanoate and tyrosine. Pearson correlation analysis also revealed a relationship between different milk metabolites and blood selenium, as well as between milk selenium and blood biochemical indices. In conclusion, compared with sodium selenite, nanoselenium improves the milk yield, feed efficiency, and milk selenium content of dairy cows and regulates milk metabolites and related metabolic pathways in Holstein dairy cows during the peak lactation period, which has certain application prospects in dairy production.

Multidisciplinary management of immunotherapy-related adverse events in solid tumors: An inter-institutional and telemedicine-based working team.

BACKGROUND: Although immune checkpoint inhibitors (ICIs) show a more favorable toxicity profile than classical cytotoxic drugs, their mechanism of action is responsible for peculiar new toxicities. There is an urgent need for a multidisciplinary approach to advice on how to manage organ-specific toxicities. METHODS: Our project aims to integrate the practices of two different hospitals into a single Italian regional collaborative model to treat immune-related adverse events (irAEs). The team structure is a multi-professional and multidisciplinary cooperative network that consists of different medical specialists. The team referrer is the medical oncologist and an existing telematic platform is used for specialists' cooperation. The leading oncologist first evaluates patients' clinical condition, therefore team intervention and teleconsultation are planned to activate proper management. After a first phase structured for general setting, outcomes analysis, data collection, and identification of critical issues, it is planned to define appropriate key performance indicators (KPIs) in quality, structure, process, and outcome settings. Therefore, a second phase would serve to implement KPIs. In the third phase, the proposal for the enlargement of the network with the extension to more centers in the context of the Regional Health Service will be performed. DISCUSSION: The multidisciplinary management of irAEs based on telemedicine fits into the debate on the renewal of healthcare systems and the push for change toward multidisciplinary with the rising use of telemedicine. To our knowledge, this is the first project reporting a multi-institutional experience for change of service in irAEs management.

Perceptible landscape patterns reveal invisible socioeconomic profiles of cities.

Urban landscape is directly perceived by residents and is a significant symbol of urbanization development. A comprehensive assessment of urban landscapes is crucial for guiding the development of inclusive, resilient, and sustainable cities and human settlements. Previous studies have primarily analyzed two-dimensional landscape indicators derived from satellite remote sensing, potentially overlooking the valuable insights provided by the three-dimensional configuration of landscapes. This limitation arises from the high cost of acquiring large-area three-dimensional data and the lack of effective assessment indicators. Here, we propose four urban landscapes indicators in three dimensions (UL3D): greenness, grayness, openness, and crowding. We construct the UL3D using 4.03 million street view images from 303 major cities in China, employing a deep learning approach. We combine urban background and two-dimensional urban landscape indicators with UL3D to predict the socioeconomic profiles of cities. The results show that UL3D indicators differs from two-dimensional landscape indicators, with a low average correlation coefficient of 0.31 between them. Urban landscapes had a changing point in 2018-2019 due to new urbanization initiatives, with grayness and crowding rates slowing, while openness increased. The incorporation of UL3D indicators significantly enhances the explanatory power of the regression model for predicting socioeconomic profiles. Specifically, GDP per capita, urban population rate, built-up area per capita, and hospital count correspond to improvements of 25.0%, 19.8%, 35.5%, and 19.2%, respectively. These findings indicate that UL3D indicators have the potential to reflect the socioeconomic profiles of cities.

Effect of haemodialysis practice guideline on dialysis indicators and haemodynamic complications among patients undergoing haemodialysis.

To assess the effect of haemodialysis practice guidelines on dialysis indicators and haemodynamic complications, the comparative study was conducted at the dialysis unit of Sheikh Zayed Hospital, Lahore, Pakistan, and comprised patients undergoing haemodialysis who were divided into intervention group A in which updated haemodialysis practice guidelines were used, and control group B in which routine base dialysis was given. Data was collected using a self-structured tool. Data was analysed using McNemar test and Mann-Whitney U-test with p<0.05. Compared to baseline, there was a significant improvement in post-intervention ratio of effective removal of clearance (K) resulting from the treatment characterised by time (t) in the patient with a specific volume of distribution (V), or Kt/V, median & IQR 0.83(0.355) vs 1.21(0.11) and percentage of urea reduction ratio with median & IQR 49(12) vs. 66.5(18.65) (p<0.05). Intradialytic hypotension was found in 17(56.6%) subjects in group B and in 4(13.4%) in group A (p=0.002). Intradialytic hypertension was found in 8(25.6%) patients in group B and 1(3.4%) in group A (p=0.039). It is recommended that dialysis be performed in accordance with the most recent clinical guidelines in order to improve practices and to increase haemodialysis effectiveness.

Identifying quality indicators for home care services: a modified Delphi and Analytic Hierarchy Process study.

BACKGROUND: As the recipients of home care services, patients have the most direct and profound experience of service quality. There is limited knowledge as to quality indicators for home care services from patients' perspective. This study aimed to identify quality indicators for home care services based on the Service Quality model and determine the weights of these indicators. METHODS: A two-round Delphi survey and Analytic Hierarchy Process consultation were conducted to gather opinions from national experts on quality indicators for home care services developed on the basis of the Service Quality model. Consensus was defined as at least 80% agreement on the importance (important and very important) of indicators among experts. The Analytic Hierarchy Process was used to calculate the weight coefficients of the identified indicators. RESULTS: The response rate was 95.0% and 97.4% in the first and second round, respectively. After two rounds, five first-level (tangibility, reliability, responsiveness, assurance and empathy) and 23 second-level indicators were identified. The Kendall's W values were 0.54 and 0.40 for the first-level and second-level indicators (p < 0.001). The weight coefficients for the first-level and second-level indicators were 0.110-0.298 and 0.019-0.088, respectively. CONCLUSION: Quality indicators for home care services were identified based on the Service Quality model. These indicators can be used to evaluate the service quality of home care from patients' perspective and facilitate to determine work priorities and improve the quality of home care.

Data on the temporal changes in soil properties at the emergency crash site of the launch vehicle 'Soyuz-FG' in Kazakhstan.

On October 11, 2018, in the Ulytau region of the Republic of Kazakhstan, the Soyuz-FG launch vehicle carrying a crewed MS-10 spacecraft failed, creating two areas where rocket propellants spilled and soil condition was monitored in 2018, 2019, 2022 and 2023. This article presents data on the content of pollutants, namely unsymmetrical dimethylhydrazine (UDMH), nitrosodimethylamine (NDMA) and total petroleum hydrocarbons (TPH), total N, organic carbon, exchangeable Ca and Mg, water-soluble NO3-, NO2-, HCO3-, CO3 2-, SO4 2-, Cl-, K +, Na+, pH values, cation exchange capacity and electrical conductivity of the water extract in disturbed and background Aridisols (more than 200 samples in total). This data set contains information on interseasonal (autumn 2022 and spring 2023) differences in the content and vertical differentiation of some soil properties in Aridisols in Central Kazakhstan. In autumn, the content of TPH, water-soluble Cl- and SO4 2- and alkalinity from CO3 2- is 1.4, 235, 201, and 2 times higher, respectively, and the content of total N and water-soluble NO3 - and NO2 -, alkalinity from HCO3 - is 2.4, 1.4, 6.4 and 1.9 times lower, respectively (p < 0.05). In spring and autumn, the content of exchangeable Ca and Mg, cation exchange capacity did not differ significantly. The presented materials can be used to optimize restoration of disturbed arid ecosystems and future monitoring work at sites of regular landing of the first stages and emergency crash sites of launch vehicles.