Living Independently Now Center

High mortality of pediatric acute respiratory distress syndrome (PARDS) demands new biomarkers. The study aims to clarify the clinical value of miR-192-5p in PARDS and its regulatory role in inflammatory responses. Baseline data and serum samples were collected from healthy children, sepsis children, and sepsis-induced PARDS subjects. The receiver operating characteristic curve (ROC), Kaplan-Meier curve and multivariate Cox regression were used to assess miR-192-5p’s diagnostic and prognostic value for PARDS. The relationship between miR-192-5p and each index was evaluated by correlation analysis. The expression of miR-192-5p, inflammatory factors and ZEB2 in the subjects’ serum and human pulmonary microvascular endothelial cells (HPMECs) were detected by RT-qPCR. The cell viability and secretion of inflammatory factors were evaluated by CCK-8 and ELISA kit. Bioinformatic prediction combined with dual-luciferase reporter assay was used to verify the target genes. miR-192-5p was significantly low-expressed in PARDS patients’ serum. MiR-192-5p was a prognostic protective factor for PARDS, and low miR-192-5p indicated poor prognosis. MiR-192-5p was negatively correlated with TNF-α, IL-6, IL-1β, and APACHE II score. LPS treatment led to reduced HPMECs viability, excessive inflammatory factor production, and down-regulated miR-192-5p expression. Overexpression of miR-192-5p mimic could partially reverse the above phenomena, while knockdown could aggravate the above phenomena. ZEB2 was a downstream target gene of miR-192-5p. miR-192-5p serves as a diagnostic biomarker for PARDS and links to poor prognosis. Downregulation of miR-192-5p may promote LPS-induced inflammatory response and induce HPMECs cell viability by targeting ZEB2, thereby involving in the progression of PARDS.

Viral pneumonia (VP) is a major cause of severe respiratory illness in children. lncRNAs are involved in disease progression by regulating immune regulation. This study investigates the clinical value and regulatory function of exosomal DLEU2 in pediatric VP. Include 247 pediatric VP cases, divided into 120 mild and 127 severe groups, and collected plasma exosomes samples. The abundance of DLEU2, miR-330-5p, and CEBPD were quantified using qRT-PCR. ROC curves and logistic regression were performed to determine the diagnostic and prognostic utility. The correlation was assessed between DLEU2 level and clinical indicators. A VP cell model was established by stimulating BEAS-2B with Poly(I: C). Cell transfection, ELISA, flow cytometry and dual-luciferase reporter assays were conducted to detect cytokines, apoptosis level and target gene regulation. Exosomal DLEU2 was elevated in severe VP and showed good diagnostic performance in distinguishing severe from mild disease. High DLEU2 was independently associated with increased disease severity and correlated with adverse status, including tachypnea, respiratory retractions, reduced SpO2, and elevated inflammatory markers. Poly(I: C) stimulation upregulated DLEU2 and promoted cytokine IL-6 and IL-8 secretion and apoptosis in BEAS-2B. Silencing DLEU2 markedly attenuated these effects. DLEU2 functioned as a ceRNA by sponging miR-330-5p, thereby relieving its inhibitory effect on CEBPD. Restoration of miR-330-5p reversed DLEU2-mediated inflammatory and apoptotic responses. DLEU2 is upregulated in pediatric VP and is associated with disease severity. Functional assays suggest that DLEU2 may aggravate inflammatory injury in bronchial epithelial cells via miR-330-5p.

ObjectiveThis study aimed to investigate, in an upper middle–income country context, the impact of maternal psychological status and prenatal psychological education on the cesarean delivery on maternal request among primiparous women.MethodsThis prospective longitudinal study included 948 primiparous women who delivered at five hospitals between June 2023 and June 2024. Women with medical indications for cesarean section, multiparity, or incomplete data were excluded. Maternal anxiety and depression were assessed in the first, second, and third trimesters using the Self-Rating Anxiety Scale and Self-Rating Depression Scale. Childbirth fear was evaluated in the third trimester using the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ). Multivariate logistic regression was used to examine factors associated with cesarean delivery on maternal request.ResultsAmong the 948 participants, 543 (57.3%) had vaginal deliveries, while 405 (42.7%) underwent cesarean delivery on maternal request. Third-trimester anxiety, depression, and W-DEQ scores were significantly higher in the cesarean group (P < 0.001 for all). Multivariate analysis revealed that conception via assisted reproductive technology (ART; OR = 2.12, 95% CI: 1.17–3.43), the presence of pregnancy-related illness (OR = 1.43, 95% CI: 1.09–2.08), and higher W-DEQ scores (OR = 1.08, 95% CI: 1.02–1.16) were independent risk factors for cesarean delivery on maternal request. Receipt of prenatal psychological education was associated with a 35% reduction in this risk (OR = 0.65, 95% CI: 0.38–0.91).ConclusionMaternal psychological distress and fear of childbirth are significant contributors to the decision for cesarean delivery on maternal request among primiparous women. In an upper middle–income country context, prenatal psychological education may serve as an effective intervention to reduce childbirth fear and promote informed, evidence-based delivery decisions. Integrating routine mental health screening and targeted education into antenatal care could help curb the rising trend of unnecessary cesarean deliveries.

There is a growing consensus that transportation construction projects have an influence beyond the provision of reliable infrastructure and significantly impact socioeconomic advancements. This is reflected in recent global infrastructure development initiatives, which encompass diverse objectives related not only to technical aspects but also nontechnical ones. However, it is challenging to synthesize diverse and sometimes competing objectives in program development. Well-established frameworks or formulas supporting the synthesis and delivery of objectives do not always exist. Ex post empirical analysis of program development outcomes, rather than planning documents, is scarce. In this study, the authors applied an explainable machine learning method, specifically, a zero-inflated negative binomial model with two classification parts, supported by a genetic algorithm, the extreme gradient boosting algorithm, and SHapley Addictive explanation values, on the project inventory supported by discretionary transportation programs of Canadian federal governments over an eight-year period. The project records were mapped to the three categories of community attributes corresponding to the three objectives of the Canadian infrastructure initiative: resilient infrastructure; economic growth; and equity promotion. The results reveal a dichotomous reality: Although transportation equity could be a significant factor in rural areas, the communities where most Canadians live host major transportation construction projects because of factors related to transportation assets and local economics. Bridge improvement is a focal theme, and a vibrant local economy is generally favored. Percentages of senior citizens and children might adjust the level of development. It is anticipated that the findings will provide policy decision-makers, transportation asset owners, and community leaders with a realistic understanding of the realities of discretionary transportation program development, thereby informing evidence-based decision-making in the future.

This paper addresses the anytime sorting problem, aiming to develop algorithms providing tentative estimates of the sorted list at each execution step. Comparisons are treated as steps, and the Spearman's footrule metric evaluates estimation accuracy. We propose a general approach for making any sorting algorithm anytime and introduce two new algorithms: multizip sort and Corsort. Simulations showcase the superior performance of both algorithms compared to existing methods. Multizip sort keeps a low global complexity, while Corsort produces intermediate estimates surpassing previous algorithms.

Objective: To explore the distribution characteristics of peripheral retinal defocus in children and adolescents. Methods: This cross-sectional study included 500 individuals aged 3 to 18 years, who visited the People's Hospital of Lincang, the First Affiliated Hospital of Dali University and Dali Ophthalmology Hospital between January and December 2021. Data of the right eye of each participant was analyzed. There were 226 males (45.20%) and 274 females (54.80%), with an average age of (10.79±3.79) years. All participants underwent post-cycloplegic refraction, optical biometry, and intraocular pressure measurement to obtain spherical equivalent, average corneal curvature, axial length, and intraocular pressure. Multispectral refraction topography was performed to obtain topographic maps and values at various field angles and orientations of peripheral retinal defocus. Based on multispectral refraction topography, peripheral retinal defocus values were categorized as crater type, hemilateral upturn type, saddle type, and relatively flat type. The distribution of different refractive states was analyzed. Results: The spherical equivalent of the 500 participants was(-1.51±2.61) D, axial length was (24.10±1.28) mm, and average corneal curvature was (43.20±1.22) D. Among the 500 eyes, 382 exhibited hyperopic peripheral retinal defocus values, with 316 eyes (82.72%) being myopic. Myopic peripheral retinal defocus values were observed in 118 eyes, with 15 eyes (12.72%) being myopic. Among different types of peripheral retinal defocus values, 112 eyes (22.4%) exhibited a crater type, 153 eyes (30.6%) exhibited a hemilateral upturn type, 107 eyes (21.4%) exhibited a saddle type, and 128 eyes (25.6%) exhibited a flat type. The proportion of myopia was 82.14% (92 eyes), 69.28% (106 eyes), 60.75% (65 eyes), and 3.90% (5 eyes), respectively. The peripheral retinal defocus values at 15°, 30°, and 45° were (0.01±0.08) D, (0.06±0.21) D, and (0.20±0.37) D, respectively. The peripheral retinal defocus values at temporal, inferior, nasal, and superior locations were (0.58±0.69) D, (0.52±0.63) D, (0.21±0.64) D, and (-0.26±0.67) D, respectively. Notably, the superior primarily manifested as myopic, while the others were predominantly hyperopic. Conclusions: Approximately three-fourths of children and adolescents exhibit hyperopic peripheral retinal defocus values, with a higher prevalence of myopia in this subgroup. The hyperopia peripheral retinal defocus value increases with the distance from the retina to the macula. The peripheral retinal defocus values between superior and inferior, nasal and temporal locations are asymmetrical, with the temporal hyperopic peripheral retinal defocus value being most prominent and the superior myopic peripheral retinal defocus value being most evident.

Cet ouvrage a pour ambition de montrer, de manière nuancée et précise, les effets de la désindustrialisation sur un territoire de l’est de la France. Celle-ci peut changer les comportements électoraux d’une population dont les habitus ont été bouleversés par la fermeture des entreprises et la dislocation de la communauté qu’elles avaient contribué à forger. Une autre évolution participe à ces évolutions : le vieillissement de la population et le départ des jeunes, qui s’accélère après les années 2000. L’ancien monde commence aussi à se disloquer sous l’effet de facteurs comme l’entrée dans la société de consommation et l’étiolement des pratiques religieuses.

Konjac glucomannan is rich in polysaccharides, able to reduce the incidence of blood vessel blockages. The aim of this study was to assess lipid metabolic activity on the effectiveness of konjac glucomannan for reducing total cholesterol levels in the blood. This study implemented a pretest and posttest randomized controlled group. The research samples were male Rattus novergicus Wistar aged approximately 3 months with a body weight of 120-200 g which were divided randomly into 2 treatment groups. All samples were given a high-fat diet. The positive control group (P1) was given 1.26 mg simvastatin intervention; while the treatment group was given konjac glucomannan intervention at a dose of 20 mg/kg BW. Blood cholesterol levels are checked using UV-Vis Spectophotometry. The data obtained was analyzed descriptively. The results of the study showed that blood cholesterol levels in Rattus novergicus Wistar could decrease at a dose of 25 mg/kg BW. Treatment with a dose of 20 mg/kg konjac glucomannan dose-dependently restored all changes towards normal values as well as lipid accumulation in the liver and adipose tissue. These findings indicate d that konjac glucomannan is able to reduce body weight gain and IR in hypercholesterolemia in Wistar Rattus Novergicus through adipocytokine modulation. It was concluded that konjac glucomannan has the ability to reduce cholesterol levels in the blood. Keywords : konjac glucomannan; LDL-C; blood cholesterol level; Uv-Vis spectophotometry; Rattus novergicus wistar ABSTRAK Konjak glukomanan kaya akan polisakarida, mampu mengurangi kejadian penyumbatan pembuluh darah. Tujuan penelitian ini adalah menilai aktivitas metabolisme lipid terhadap efektivitas konjak glukomanan untuk penurunan kadar kolesterol total dalam darah. Penelitian ini menerapkan pretest and post test randomized controlled group . Sampel penelitian adalah Rattus novergicus Wistar jantan berumur kurang lebih 3 bulan dengan berat badan 120-200 g yang dibagi secara acak menjadi 2 kelompok perlakuan. Semua sampel tersebut diberi diet tinggi lemak. Kelompok kontrol positif (P1) diberikan intervensi simvastatin 1,26 mg; sedangkan kelompok perlakuan diberikan intervensi konjak glukomanan dengan dosis 20 mg/kg BB. Kadar kolesterol darah diperiksa menggunakan Spektofotometri UV-Vis. Data yang diperoleh dianalisis secara deskriptif. Hasil penelitian menunjukkan bahwa kadar kolesterol darah Rattus novergicus Wistar dapat menurun pada dosis 25mg/kg BB. Pengobatan dengan dosis 20 mg/kg konjak glukomanan secara dependen memulihkan semua perubahan menuju nilai normal serta akumulasi lipid di hati dan jaringan adiposa. Temuan ini menunjukkan bahwa konjak glukomanan mampu menurunkan pertambahan berat badan dan IR pada hiperkolesterolemia pada Rattus Novergicus Wistar melalui modulasi adipositokin. Disimpulkan bahwa konjak glukomanan memiliki kemampuan menurunkan kadar kolesterol dalam darah. Kata kunci : konjac glucomannan; LDL-C; blood cholesterol level; spectofotometri Uv-Vis; Rattus novergicus wistar

Many decision problems cannot be solved exactly and use several estimation algorithms that assign scores to the different available options. The estimation errors can have various correlations, from low (e.g. between two very different approaches) to high (e.g. when using a given algorithm with different hyperparameters). Most aggregation rules would suffer from this diversity of correlations. In this article, we propose different aggregation rules that take correlations into account, and we compare them to naive rules in various experiments based on synthetic data. Our results show that when sufficient information is known about the correlations between errors, a maximum likelihood aggregation should be preferred. Otherwise, typically with limited training data, we recommend a method that we call Embedded Voting (EV).

In this article we study the allocation of a budget to promote an opinion in a group of agents. We assume that their opinion dynamics are based on the well-known voter model. We are interested in finding the most efficient use of a budget over time in order to manipulate a social network. We address the problem using the theory of discounted Markov decision processes. Our contributions can be summarized as follows: (i) we introduce the discounted Markov decision process in our cases, (ii) we present the corresponding Bellman equations, and, (iii) we solve the Bellman equations via backward programming. This work is a step towards providing a solid formulation of the budget allocation in social networks.