Comparative efficacy of hyperbaric bupivacaine vs hyperbaric ropivacaine in spinal anesthesia for cesarean section:A metaanalysis

BACKGROUND Intrathecal bupivacaine is the traditional anesthetic drug used in spinal anesthesia for caesarean sections(CSs),but ropivacaine has emerged as a potential alter-native.This meta-analysis compares the efficacy and safety of intrathecal hyper-baric bupivacaine vs hyperbaric ropivacaine for cesarean sections.AIM To systematically evaluate and compare the efficacy and safety of intrathecal hyperbaric bupivacaine and hyperbaric ropivacaine for spinal anesthesia in CSs.METHODS A thorough search of electronic databases was carried out to find pertinent randomized controlled trials(RCTs)comparing intrathecal hyperbaric ropi-vacaine and hyperbaric bupivacaine during CSs.PubMed,Cochrane database,Google Scholar,and Scopus were searched,and papers from January 2000 to January 2024 were deemed eligible and filtered using predetermined inclusion and exclusion criteria.Studies were assessed for methodological quality,and data were extracted for time to adequate anesthesia(sensory and motor blockade),duration of sensory and motor block,hemodynamic changes and side effect profile.The standardized mean difference with 95%CI was used for continuous data.Dichotomous variables were assessed using the Mantel-Haenszel test and the random effect model to compute the odds ratio.RESULTS Total 8 RCTs were selected from a pool of 119 search results for meta-analysis.The meta-analysis evaluated pooled effect sizes and assessed heterogeneity among the studies.The primary objective was to compare key outcomes to identify any significant variances in efficacy and safety profiles between two local anesthetics.The analysis revealed that the difference in the onset of sensory blockade between the two local anesthetics was statistically insignificant(P=0.1586).However,the onset of motor blockade appeared to be faster with bupivacaine(P=0.03589).Additionally,the regression of sensory and motor blockade occurred earlier in the ropivacaine group.Furthermore,the duration of the first analgesic effect was shorter with a significance level of P<0.05.Regarding side effects profile,including hypotension,nausea,and shivering,the study did not observe any significant differences between the two groups.CONCLUSION This meta-analysis offers insights into the effectiveness and safety of hyperbaric bupivacaine vs ropivacaine for cesarean sections.Hyperbaric ropivacaine had a comparable safety profile and faster regression of sensory and motor blockade than hyperbaric bupivacaine,perhaps aiding early mobilization of parturient and facilitating mother-child bonding.Choosing ropivacaine may offer benefits beyond efficacy for cesarean section patients and short surgical procedures.

Barriers to Physical Activity among Children and Adolescents with Intellectual Disabilities: A Cross-sectional Study

Regular physical activity (PA) has numerous advantages in improving the physical and mental health of children and adolescents^([1]).However,the PA status quo for children and adolescents with intellectual disabilities (ID) is dismal.Children and adolescents with ID frequently exhibit sedentary behaviors because their physical,sensory,and/or cognitive impairments make it difficult to participate in sports and games with their peers^([2]).They have higher rates of mental illness,obesity,type 2diabetes,and other health problems than peers with typical development (TD).

Proper interpretation of sectional analysis results

Displacement control algorithms commonly used to evaluate axial force-bending moment(PM)diagrams may lead to incorrect interpretations of the strength envelopes for asymmetric sections.This paper aims to offer valuable insights by comparing existing displacement control algorithms with a newly proposed force control algorithm.The main focus is on the PM diagrams of three example sections that exhibit varying degrees of asymmetry.The comparative study indicates that conventional displacement control algorithms inevitably introduce non-zero out-of-plane bending moments.The reported PM diagram in such cases erroneously neglects the out-of-plane moment and fails to represent the strength envelope accurately.This oversight results in significant and unconservative errors when verifying the strength of asymmetric sections.

Associations of Perchlorate,Nitrate,and Thiocyanate with Sex Hormones among Children:A Nationally Representative Cross-sectional Study in U.S.

Nitrates,thiocyanates,and perchlorates are ubiquitous in the environment and can be introduced to the public through various dietary and environmental sources.Nitrates,thiocyanates,and perchlorates mainly affect health via the same mechanism.These toxins may act as endocrine disrupters and can result in decreased levels of thyroid hormones^([1]).

THE LOGARITHMIC SOBOLEV INEQUALITY FOR A SUBMANIFOLD IN MANIFOLDS WITH ASYMPTOTICALLY NONNEGATIVE SECTIONAL CURVATURE

In this note,we prove a logarithmic Sobolev inequality which holds for compact submanifolds without a boundary in manifolds with asymptotically nonnegative sectional curvature.Like the Michale-Simon Sobolev inequality,this inequality contains a term involving the mean curvature.

Biomechanical effects of posterior lumbar interbody fusion with vertical placement of pedicle screws compared to traditional placement

BACKGROUND The pedicle screw technique is widely employed for vertebral body fixation in the treatment of spinal disorders.However,traditional screw placement methods require the dissection of paraspinal muscles and the insertion of pedicle screws at specific transverse section angles(TSA).Larger TSA angles require more force to pull the muscle tissue,which can increase the risk of surgical trauma and ischemic injury to the lumbar muscles.AIM To study the feasibility of zero-degree TSA vertical pedicle screw technique in the lumbosacral segment.METHODS Finite element models of vertebral bodies and pedicle screw-rod systems were established for the L4-S1 spinal segments.A standard axial load of 500 N and a rotational torque of 10 N/m were applied.Simulated screw pull-out experiment was conducted to observe pedicle screw resistance to pull-out,maximum stress,load-displacement ratio,maximum stress in vertebral bodies,load-displacement ratio in vertebral bodies,and the stress distribution in pedicle screws and vertebral bodies.Differences between the 0-degree and 17-degree TSA were compared.RESULTS At 0-degree TSA,the screw pull-out force decreased by 11.35%compared to that at 17-degree TSA(P<0.05).At 0-degree and 17-degree TSA,the stress range in the screw-rod system was 335.1-657.5 MPa and 242.8-648.5 MPa,separately,which were below the fracture threshold for the screw-rod system(924 MPa).At 0-degree and 17-degree TSA,the stress range in the vertebral bodies was 68.45-78.91 MPa and 39.08-72.73 MPa,separately,which were below the typical bone yield stress range for vertebral bodies(110-125 MPa).At 0-degree TSA,the load-displacement ratio for the vertebral bodies and pedicle screws was slightly lower compared to that at 17-degree TSA,indicating slightly lower stability(P<0.05).CONCLUSION The safety and stability of 0-degree TSA are slightly lower,but the risks of screw-rod system fracture,vertebral body fracture,and rupture are within acceptable limits.

Correlation between psychological resilience and burnout among female employees in a shopping mall in Xi Xian new area,China:A cross-sectional survey-Retraction

In the article titled“Correlation between psychological resilience and burnout among female employees in a shopping mall in Xi Xian New Area,China:A cross-sectional survey”by Zhang Q and Liu L(J Integr Nurs 2021;3(3):117-121.doi:10.4103/jin.jin_14_21),[1]the content and results data of this article was questioned by International database(Web of Science)institution.This article was then investigated by the publisher and Journal of Integrative Nursing(JIN).

Effect of esketamine on reducing postpartum pain and depression

In this editorial,we comment on a recent article by Chen et al,that addressed the effect of intraoperative injection of esketamine on postoperative analgesia and postoperative rehabilitation after cesarean section.Poor management of postcesarean pain is associated with decreased maternal care for the baby,longer hospitalization,and higher risk of developing postpartum depression.Esketamine is a more potent S-enantiomer of ketamine which has shown promising analgesic and antidepressant properties for managing post-cesarean pain and depression in clinical studies.However,due to its potential adverse effects on the neurological and hemodynamic status of patients,it is recommended that its usage in low doses should be limited to cesarean candidates experiencing unbearable pain.Before any recommendation for routine perioperative use of esketamine,more standardized clinical trials are needed to strengthen our existing knowledge of its effectiveness in reducing postpartum pain and depression.

Experiments on image data augmentation techniques for geological rock type classification with convolutional neural networks

The integration of image analysis through deep learning(DL)into rock classification represents a significant leap forward in geological research.While traditional methods remain invaluable for their expertise and historical context,DL offers a powerful complement by enhancing the speed,objectivity,and precision of the classification process.This research explores the significance of image data augmentation techniques in optimizing the performance of convolutional neural networks(CNNs)for geological image analysis,particularly in the classification of igneous,metamorphic,and sedimentary rock types from rock thin section(RTS)images.This study primarily focuses on classic image augmentation techniques and evaluates their impact on model accuracy and precision.Results demonstrate that augmentation techniques like Equalize significantly enhance the model's classification capabilities,achieving an F1-Score of 0.9869 for igneous rocks,0.9884 for metamorphic rocks,and 0.9929 for sedimentary rocks,representing improvements compared to the baseline original results.Moreover,the weighted average F1-Score across all classes and techniques is 0.9886,indicating an enhancement.Conversely,methods like Distort lead to decreased accuracy and F1-Score,with an F1-Score of 0.949 for igneous rocks,0.954 for metamorphic rocks,and 0.9416 for sedimentary rocks,exacerbating the performance compared to the baseline.The study underscores the practicality of image data augmentation in geological image classification and advocates for the adoption of DL methods in this domain for automation and improved results.The findings of this study can benefit various fields,including remote sensing,mineral exploration,and environmental monitoring,by enhancing the accuracy of geological image analysis both for scientific research and industrial applications.

Dose-response study of spinal hyperbaric ropivacaine for cesarean section

Background： Spinal hyperbaric ropivacaine may produce more predictable and reliable anesthesia than plain ropivacaine for cesarean section. The dose-response relation for spinal hyperbaric ropivacaine is undetermined. This double-blind, randomized, dose-response study determined the ED50 （50% effective dose） and ED95 （95% effective dose） of spinal hyperbaric ropivacaine for cesarean section anesthesia. Methods： Sixty parturients undergoing elective cesarean section delivery with use of combined spinal-epidural anesthesia were enrolled in this study. An epidural catheter was placed at the L1-L2 vertebral interspace then lumbar puncture was performed at the L3-L4 vertebral interspace, and parturients were randomized to receive spinal hyperbaric ropivacaine in doses of 10.5 mg, 12 mg, 13.5 mg, or 15 mg in equal volumes of 3 ml. Sensory levels （pinprick） were assessed every 2.5 min until a T7 level was achieved and motor changes were assessed by modified Bromage Score. A dose was considered effective if an upper sensory level to pin prick of T7 or above was achieved and no intraoperative epidural supplement was required. ED50 and ED95 were determined with use of a logistic regression model. Results： ED50 （95% confidence interval） of spinal hyperbaric ropivacaine was determined to be 10.37 （5.23-11.59） mg and ED95 （95% confidence interval） to be 15.39 （13.81-23.59） mg. The maximum sensory block levels and the duration of motor block and the rate of hypotension, but not onset of anesthesia, were significantly related to the ropivacaine dose. Conclusion： The ED50 and ED95 of spinal hyperbaric ropivacaine for cesarean delivery under the conditions of this study were 10.37 mg and 15.39 mg, respectively. Ropivacaine is suitable for spinal anesthesia in cesarean delivery.

Psychological impact of the COVID-19 pandemic on healthcare workers:a cross-sectional study in China

Background Healthcare workers fighting against the coronavirus disease 2019(COVID-19)pandemic are under tremendous pressure,which puts them at an increased risk of developing psychological problems.Aims This study aimed to investigate the prevalence of psychological problems in different healthcare workers(ie,physicians,medical residents,nurses,technicians and public health professionals)during the COVID-19 pandemic in China and explore factors that are associated with the onset of psychological problems in this population during this public health crisis.Methods A cross-sectional,web-based survey was conducted in February 2020 among healthcare workers during the COVID-19 pandemic.Psychological problems were assessed using the Generalized Anxiety Disorder Scale,Patient Health Questionnaire and Insomnia Severity Index.Logistic regression analyses were used to explore the factors that were associated with psychological problems.Results The prevalence of symptoms of anxiety,depression,insomnia and the overall psychological problems in healthcare workers during the COVID-19 pandemic in China was 46.04%,44.37%,28.75%and 56.59%,respectively.The prevalence of the overall psychological problems in physicians,medical residents,nurses,technicians and public health professionals was 60.35%,50.82%,62.02%,57.54%and 62.40%,respectively.Compared with healthcare workers who did not participate in front-line work,front-line healthcare workers had a higher risk of anxiety,insomnia and overall psychological problems.In addition,attention to negative or neutral information about the pandemic,receiving negative feedback from families and friends who joined front-line work,and unwillingness to join front-line work if given a free choice were three major factors for these psychological problems.Conclusions Psychological problems are pervasive among healthcare workers during the COVID-19 pandemic.Receiving negative information and participating in front-line work appear to be.important risk factors for psychological problems.The psychological health of different healthcare workers should be protected during the COVID-19 pandemic with timely interventions and proper information feedback.

Solution of rectangular bar forging with bulging of sides by strain rate vector inner-product

Abstract：ools. The effective strain rate for for determining the total pressure developed during forging of a rectangular bar forging with bulging was expressed in terms of four-dimensional strain rate vector. The inner-product of the vector was termwise integrated and summed. The integral mean value theorem was applied to determining the ratio of the strain rate components and the values of direction cosine of the vector and then an analytical solution of stress effective factor was obtained. The compression experiments of pure lead bar were performed to test the accuracy of the solution. The optimized results of total pressure by golden section search were compared with those of the indicator readings of the testing machine. It indicates that the optimized total pressures are 2.60%-10.14% higher than those measured. The solution is available and still an upper-bound solution.

Influence of Cross-Sectional Flow Area of Annular Volute Casing on Transient Characteristics of Ceramic Centrifugal Pump

The annular volute is typically used in a slurry pump to reduce the collisions between solid particles and the volute tongue and to achieve a better resistance to blocking. However, only limited studies regarding annular volutes are available, and there is no systematic design method for annular volutes. In this study, the influence of volute casing cross-sectional flow area on the hydraulic loss, pressure pulsations, and radial force under varying working conditions in a centrifugal ceramic pump are discussed in detail. Experimental tests were conducted to validate the numerical results. The results indicated that, when the volute casing flow area increases, the hydraulic performance decreases marginally under the rated working conditions, but increases at the o-design points, specifically under large flow condition. However, the volute casing with a larger flow area has a wider high-e ciency region. In addition, the increase in the volute casing flow area will decrease the pressure pulsations in the volute, regardless of the working condition, and decrease the radial force on the shaft, therefore, providing an improved pump operational stability. It is anticipated that this study will be of benefit during the design of annular volutes.

Analysis of Factors Influencing Insomnia and Construction of a Prediction Model:A Cross-sectional Survey on Rescuers

Objective To determine the factors influencing insomnia and construct early insomnia warning tools for rescuers to informbest practices for early screening and intervention.Methods Cluster sampling was used to conduct a cross-sectional survey of 1,133 rescuers from one unit in Beijing,China.Logistic regression modeling and R software were used to analyze insomniarelated factors and construct a PRISM model,respectively.Results The positive rate of insomnia among rescuers was 2.74%.Accounting for participants’age,education,systolic pressure,smoking,per capita family monthly income,psychological resilience,and cognitive emotion regulation,logistic regression analysis revealed that,compared with families with an average monthly income less than 3,000 yuan,the odds ratio(OR)values and the[95%confidence interval(CI)]for participants of the following categories were as follows:average monthly family income greater than 5,000 yuan:2.998(1.307–6.879),smoking:4.124(1.954–8.706),and psychological resilience:0.960(0.933–0.988).The ROC curve area of the PRISM model(AUC)=0.7650,specificity=0.7169,and sensitivity=0.7419.Conclusion Insomnia was related to the participants’per capita family monthly income,smoking habits,and psychological resilience on rescue workers.The PRISM model’s good diagnostic value advises its use to screen rescuer early sleep quality.Further,advisable interventions to optimize sleep quality and battle effectiveness include psychological resilience training and smoking cessation.

Newly self-administered two-step tool for screening cognitive function in an ageing Chinese population:an exploratory cross-sectional study

Background Early screening of cognitive function is critical to dementia treatment and care.However,traditional tests require face-to-face administration and are often limited by implementation costs and biases.Aims This study aimed to assess whether the Thoven Cognitive Self-Assessment(TCSA),a novel,innovative two-step touchscreen-based cognition assessment tool,could identify early cognitive impairment due to dementia in older adults.Methods The TCSA was administered to 61 healthy controls(HCs),46 participants with mild cognitive impairment(MCI)and 44 participants diagnosed with dementia recruited from Shanghai.Two outcome measures were generated from the TCSA test:the TCSA_(primary task)score and the TCSA_(secondary task)score.Results The total average scores in the control group for the TCSA_(primary task)and TCSA_(secondary task)were significantly higher than those in the MCI and dementia groups(TCSA_(primary task):HCs vs MCI group vs dementia group,8.58±1.76 vs 5.40±2.67 vs 2.74±2.11,F=75.40,p<0.001;TCSA_(secondary task):HCs vs MCI group vs dementia group,23.02±3.31 vs 17.95±4.93 vs 11.93±5.50,F=76.46,p<0.001).Moreover,receiver operating characteristic analysis showed that a score below 7.5 for the TCSA_(primary task)and a score below 22.5 for the TCSA_(secondary task)were indicators of MCI.Conclusions The TCSA appears to be efficacious for the detection of cognitive impairment in older adults.It demonstrates the potential for large-scale cognition screening in community service settings.

Sectional distribution of salinity and its indication of Kuroshio'sintrusion in the southern Taiwan Strait and northeastern South China Sea late summer, 1994

Using the CTD data investigated at about 330 stations in the southern Taiwan Strait, the northeastern South China Sea and their adjacent seas in August and September of 1994, this paper anayses the sectional distributions of salinity in 10 selected sections and discusses the possibility of the Kuroshio's intrusion into the northeastern South China Sea and the southern Taiwan Strait. The results show that: as the main stream of Kuroshio passes by the northern Luzon Strait during the survey period, the 'Kuroshio-influenced water' with some hydrological features of the Kuroshio may extend through the Luzon Strait to the sea areas near both the Dongsha Islands and the Taiwan Shoal of the southern Taiwan Strait.

The KLL dielectronic recombination processes for highly charged krypton,iodine and barium ions

The KLL dielectronic recombination （DR） processes of ions from highly charged helium-like to oxygen-like krypton, iodine and barium ions are studied systematically in the relativistic distorted-wave approximation with configuration interaction. The KLL DR resonant energies, the corresponding resonant strengths and the theoretical spectra for each highly charged ion species are obtained. The results accord well with other available values. The behaviour of KLL resonant strengths for He-like ions with atomic number Z is analysed.

Association between clustering of cardiovascular risk factors and resting heart rate in Chinese population:a cross-sectional study

BACKGROUND Epidemiologic studies have explored the association between a single cardiovascular risk factor(CVRF)and resting heart rate(RHR),but the research on the relation of multiple risk factors with RHR remains scarce.This study aimed to explore the associations between CVRFs clustering and the risk of elevated RHR.METHODS In this cross-sectional study,adults aged 35-75 years from 31 provinces were recruited by the China PEACE Million Persons Projects from September 2015 to August 2020.We focused on seven risk factors:hypertension,diabetes mellitus,dyslipidemia,obesity,smoking,alcohol use,and low physical activity.Multivariate logistic regression was used to calculate odds ratios(OR)for elevated RHR(>80 beats/min).RESULTS Among 1,045,405 participants,the mean age was 55.67±9.86 years,and 60.4%of participants were women.The OR(95%CI)for elevated RHR for the groups with 1,2,3,4 and≥5 risk factor were 1.11(1.08-1.13),1.36(1.33-1.39),1.68(1.64-1.72),2.01(1.96-2.07)and 2.58(2.50-2.67),respectively(Ptrend<0.001).The association between the CVRFs clustering number and elevated RHR was much more pronounced in young males than in other age-sex subgroups.Clusters comprising more metabolic risk factors were associated with a higher risk of elevated RHR than those comprising more behavioral risk factors.CONCLUSIONS There was a significant positive association between the CVRFs clustering number and the risk of elevated RHR,particularly in young males.Compared clusters comprising more behavioral risk factors,clusters comprising more metabolic risk factors were associated with a higher risk of elevated RHR.RHR may serve as an indicator of the cumulative effect of multiple risk factors.

Adverse childhood experiences from family and society contribute to increased risk of depressive symptoms and cognitive impairment:a cross-sectional study

Background Family environments can shape children’s personalities and social networks,rendering distinguishing adverse childhood experiences(ACEs)from family and society essential,but related evidence remains limited.Aims This cross-sectional study aimed to investigate the correlations between intrafamilial and social ACEs,their associations with depressive symptoms and cognitive impairment and the(education-moderated)mediating role of social ACEs.Methods Data for this cross-sectional study were from the China Health and Retirement Longitudinal Study.Nine intrafamilial(0,1,2,3,and 4 or more)and three social(0,1,and 2 or more)ACEs were identified.Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale.Global cognition,including episodic memory and mental intactness,was calculated as z scores.Binary and ordered logistic regressions,generalised linear models with Gaussian family and identity link,and mediation analysis were used.Results 13435 participants aged 59.0(51.0–66.0)were included.Compared with participants with no intrafamilial ACEs,those with 1,2,3,and 4 or more intrafamilial ACEs tended to develop more social ACEs,with odds ratios(ORs)of 1.55(95%confidence interval(CI):1.36 to 1.76),2.36(95%CI:2.08 to 2.68),3.46(95%CI:3.02 to 3.96)and 6.10(95%CI:5.30 to 7.02),respectively.Both intrafamilial and social ACEs were associated with depressive symptoms(OR>3 for four or more intrafamilial ACEs and two or more social ACEs)and global cognition(β=−0.26 for four or more intrafamilial ACEs andβ=−0.29 for two or more social ACEs).Social ACEs mediated the associations of intrafamilial ACEs with depressive symptoms and global cognition by 12.3%and 13.1%,respectively.Furthermore,as education levels increased,the impact of intrafamilial ACEs on depressive symptoms was increasingly mediated through social ACEs,while the mediating role of social ACEs between intrafamilial ACEs and cognitive impairment gradually diminished.Conclusions Improving children’s social environments and elevating general education can prevent later-life depressive symptoms and cognitive impairment attributed to ACEs in China.

Arterial stiffness expressed as brachial–ankle pulse wave velocity and gait assessment independent of lower extremity strength:a cross-sectional study in the older men population

BACKGROUND Older men are more vulnerable to fatal falls than women,and gait disturbances contribute to the risk of falls.Studies have assessed the association between arterial stiffness and gait dysfunction,but the results have been inconclusive.This study aimed to conduct a cross-sectional analysis to evaluate the association between brachial–ankle pulse wave velocity(baPWV)and gait assessment in older men.METHODS Data from the 2014–2015 Korea Institute of Sport Science Fitness Standards project were used for the analysis.The inclusion criteria were men aged>65 years with gait assessment[the 30-s chair stand test(30s-CST),the timed up and go(TUG)test,the figure-of-8 walk(F8W)test,the 2-min step test(2MST),and the 6-min walk test(6MWT)]and baPWV measurement data.Generalized linear regression analysis was conducted with multiple confounding factor adjustments,including lower extremity isometric strength.RESULTS A total of 291 participants were included in the analysis.The mean age was 71.38±4.40 years.The mean values were as follows:(1)30s-CST,17.48±5.00;(2)TUG test,6.01±1.10 s;(3)F8W test,25.65±4.71 s;(4)2MST,102.40±18.83 per 2 min;and(5)6MWT,500.02±85.65 m.After multivariable adjustment,baPWV was associated with the 6MWT(β=−0.037,95%CI:−0.072–−0.002),TUG test(β=0,95%CI:0.000–0.001),and F8W test(β=0.002,95%CI:0.000–0.004).baPWV was not associated with the 30s-CST and 2MST.CONCLUSIONS The current study showed a statistically significant association between gait assessments and arterial stiffness,independent of lower extremity strength.However,this association was modest.Future prospective studies are needed to elucidate the complex relationship between arterial stiffness and gait dysfunction.