In low-flow anesthesia, automated monitoring of end-tidal oxygen (etO2) and end-tidal anesthetic agents (etAA) has been favored to reduce clinicians’ cognitive workload during anesthesia maintenance. This systematic review, therefore, aimed to determine the comparative efficacy and safety of automated end-tidal controlled anesthesia (etCA) versus manually controlled anesthesia (MCA). An electronic search was conducted across four databases: PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and Scopus. The retrieved references were then analyzed against the studies’ screening and eligibility criteria before the full articles were included in the study. The Review Manager (RevMan 5.4.1) was then used to conduct the statistical analysis of the reported outcomes. The electronic search retrieved 965 articles, among which 10 were included in this review. The studies included a pooled sample size of 1269 who underwent surgical procedures under low-flow anesthesia. The analyzed evidence suggests with low certainty that the type of anesthesia control may not have any significant effect on both the anesthesia duration (SMD − 0.00 min; 95
We study degenerate controlled diffusions and Hamilton–Jacobi–Bellman equations posed on genuine continuum percolation clusters. The diffusion is constrained to evolve inside the infinite cluster and degenerates according to the distance to the irregular random boundary. Under suitable regularity and degeneracy assumptions on the diffusion matrix, we prove that the corresponding controlled diffusion never reaches the boundary and therefore admits a unique global strong solution. Using this result, we establish a stochastic control representation formula for viscosity solutions of degenerate Hamilton–Jacobi–Bellman equations posed on the random cluster, without imposing boundary conditions. We further verify that the structural assumptions introduced in this work, including quantitative integrability properties of the distance-to-the-boundary function and the associated degeneracy, hold for concrete continuum percolation models such as the Boolean model. In particular, although the diffusion never reaches the boundary, the boundary geometry remains a fundamental ingredient of the theory through the admissible degeneracy regime. The results establish a quenched framework for stochastic control and degenerate partial differential equations on genuine continuum percolation geometries, and identify a link between the analytic structure of the diffusion and the stochastic geometry of the underlying cluster. They also provide the foundational framework for the homogenization theory developed in the companion article [BMM26].
Abstract Background Type 1 diabetes (T1D) in children and adolescents is increasingly recognized as a multisystem disorder, with a substantial burden of autoimmune, cardiometabolic, microvascular, and psychosocial comorbidities. While individual complications are well described, integrated registry-based summaries using harmonized definitions remain limited. Objective To summarize the point-prevalence of major comorbidities in children and adolescents with T1D over the past two decades using large international registries and validated population-based studies. Methods A structured synthesis of PubMed-indexed literature (≈2005-2025) was conducted, prioritizing international registries (SWEET, SEARCH for Diabetes in Youth, DPV, T1D Exchange, NPDA/ADDN) and systematic reviews. Harmonized thresholds were applied where possible: overweight/obesity (BMI ≥85th percentile, WHO/CDC), LDL-hypercholesterolemia (LDL-C ≥100 mg/dL), hypertension (blood pressure ≥95th percentile), and screen-detected microvascular or psychological outcomes. Estimates are reported as point-prevalence. Results Celiac disease is the most frequent autoimmune comorbidity, with a global prevalence of approximately 3-5%, ranging from ~2% in parts of Asia and the Middle East to ~7-8% in Australia and Europe. Thyroid autoimmunity is also common but variably reported. Approximately 30% of youth with T1D are overweight or obese. LDL-hypercholesterolemia affects 9-20%, and hypertension is present in 6-10%. Overall, 30-40% exhibit at least one major cardiovascular risk factor, with a smaller subset showing clustering of two or more factors. Microalbuminuria is detected in approximately 5-12%, increasing with age, diabetes duration, and glycemic exposure. Retinopathy remains uncommon in early childhood but increases in adolescents with longer disease duration. Peripheral or autonomic neuropathy is identified in roughly 7-12% by objective testing. Psychological morbidity is substantial, with 25-35% screening positive for depressive or anxiety symptoms. At diagnosis, diabetic ketoacidosis occurs in approximately 25-35%, with wide inter-country variability. Conclusions Children and adolescents with T1D carry a significant, multidimensional comorbidity burden. Consistent findings across international registries highlight the need for integrated screening and early preventive strategies extending beyond glycemic control.
Introduction: Lead exposure is an important occupational and environmental health problem, especially in the industrial environment. This study determined blood lead levels, associated clinical manifestations and protective measures among petrol refinery workers and population in nearby areas in Kirkuk City, Iraq. Methods: A cross-sectional study was done with 357 workers in petrol refinery and people who live in the nearby city and suburbs. Data were obtained using structured interviews, physical examination and laboratory measurement of blood lead levels. Information regarding occupational history and clinical symptoms and the protection measures was collected. Binary and multivariable logistic regression analyses were performed to determine factors associated with elevated blood lead levels (eBLLs). Results: Longer time of employment and increased time outdoors were significantly associated elevated of BLLs (p<0.05). The workers who use of masks and gloves, machine guards, and consumption of milk in the workplaces were found having lower BLLs (all p<0.05). Workers who had high lead concentrations were positively associated with reporting a metallic taste in the mouth (OR=2.52, p=0.024). Conclusion: Lead occupational and non-occupational exposures in Kirkuk are associated with the negative clinical outcomes. Implementation of the relevant measures of protection strategies have been correlated to reduced BLLs, therefore, pointing at the significance of the enhanced occupational safety practices and preventive actions to decrease the adverse health outcomes on the workers and the community overall.
