bluuebunny/crossref_metadata_2025 huggingface dataset:
Live birth rates following individualized dosing algorithm of follitropin delta in a long GnRH agonist protocol
Authors: Sánchez Manuel Fernández , Larsson Per , Serrano Marcos Ferrando , Bosch Ernesto , Velasco Juan Antonio García , López Esther Santamaría , Mannaerts Bernadette
Published: May 2023

Purpose

To explore the efficacy and safety of individualized follitropin delta dosing, based on serum anti-Müllerian hormone (AMH) concentration and bodyweight, in a long gonadotropin-releasing hormone (GnRH) agonist protocol.

Methods

Clinical outcomes after one treatment cycle are reported in women with AMH: 5–35 pmol/L. Oocytes were inseminated by intracytoplasmic sperm injection, blastocyst transfer was on Day 5 and remaining blastocysts were cryopreserved. Data collection included live births and neonatal health follow-up for all fresh/frozen transfers performed within one year after treatment allocation.

Results

In total, 104 women started stimulation, of whom 101 had oocyte recovery and 92 had blastocyst transfer. The average daily dose of follitropin delta was 11.0 ± 1.6 µg and the duration of stimulation was 10.3 ± 1.6 days. The mean number of oocytes was 12.5 ± 6.4, the mean number of blastocysts was 5.1 ± 3.4, and 85% had at least one good-quality blastocyst. Following mostly single blastocyst transfer (95%), the ongoing pregnancy rate was 43%, the live-birth rate was 43%, and the cumulative live-birth rate was 58% per started stimulation. There were 6 cases of early OHSS (5.8%) graded as mild (n = 3) and moderate (n = 3) and 6 cases of late OHSS (5.8%) graded as moderate (n = 3) and severe (n = 3).

Conclusion

In this first evaluation of the individualized follitropin delta dosing in a long GnRH agonist protocol, the cumulative live-birth rate was high. A randomized trial comparing follitropin delta in a long GnRH agonist protocol versus in a GnRH antagonist protocol should provide further insight into the efficacy and safety of this treatment option.

Trial registration number

NCT03564509; June 21, 2018.
Sohlh1 and Lhx8 are prominent biomarkers to estimate the primordial follicle pool in mice
Authors: Liu Li , Liu Biting , Wang Lian , Li Caixia , Zhou Yang , Zhu Jihui , Ding Jinye , Liu Shupeng , Cheng Zhongping
Published: May 2023

Efficient evaluation of the primordial follicle pool (PFP) of mammalian models is an essential subject in biomedical research relating to ovarian physiology and pathogenesis. Our recent study has identified a gene signature including Sohlh1, Nobox, Lhx8, Tbpl2, Stk31, Padi6, and Vrtn strongly correlated with ovarian reserve by using bioinformatics analysis. Aimed to investigate the validity of these candidate biomarkers for evaluating the PFP, we utilized an OR comparison model to decode the relationship between the numbers of PFP and candidate biomarkers in the present study. Our results suggest that these biomarkers Sohlh1, Nobox, Lhx8, Tbpl2, Stk31, Padi6, and Vrtn possess independent potential to evaluate the number of the PFP. And the combination of Sohlh1 and Lhx8 can be used as the optimal biomarkers for rapid assessment of the PFP in the murine ovary. Our findings provide a new perspective for evaluating the PFP of the ovary in animal studies and the clinic.
The assessment and management of sesamoiditis: a focus group study of podiatrists in Aotearoa New Zealand
Authors: Kaur Preeti , Carroll Matthew R , Stewart Sarah
Published: May 2023

Background

Sesamoiditis is a common inflammatory condition affecting the sesamoid bones at the plantar aspect of the first metatarsophalangeal joint (1MTPJ). However, there are currently no recommendations or clinical guidelines to support podiatrists in their assessment or management of sesamoiditis. The aim of this study was to explore the views of podiatrists in Aotearoa New Zealand on their approaches to the assessment and management of patients with sesamoiditis.

Methods

This qualitative study included focus group discussions with registered podiatrists. Focus groups took place online via Zoom and were guided by a detailed focus group question schedule. The questions were designed to encourage discussion around assessment approaches used in the diagnosis of sesamoiditis and the treatment tools used to manage patients with sesamoiditis. Focus groups were audio‐recorded and transcribed verbatim. Reflexive thematic analysis was used to analyse the data.

Results

A total of 12 registered podiatrists participated in one of three focus groups. Four themes were constructed relating to the assessment of sesamoiditis: (1) obtaining a patient history; (2) recreating patient symptoms; (3) determining contributing biomechanical factors; and (4) ruling out differential diagnoses. Seven themes were constructed relating to the management of sesamoiditis: (1) consideration of patient factors; (2) patient education; (3) cushioning of the sesamoids to allow more comfortable weightbearing of the 1MTPJ; (4) pressure redistribution and offloading of the sesamoids; (5) immobilisation of the 1MTPJ and sesamoids; (6) facilitating efficient sagittal plane motion during gait; (7) referring to other health professionals to find different ways to treat or manage patient symptoms.

Conclusion

Podiatrists in Aotearoa New Zealand demonstrate an analytical approach in the assessment and management of patients with sesamoiditis based on their clinical experience and knowledge of lower limb anatomy. A range of assessment and management techniques are selected based on the practitioners personal preferences, as well as the patient's social factors, symptomology, and lower limb biomechanics.
The future of intensive care: the study of the microcirculation will help to guide our therapies
Authors: Duranteau J. , De Backer D. , Donadello K. , Shapiro N. I. , Hutchings S. D. , Rovas A. , Legrand M. , Harrois A. , Ince C.
Published: May 2023

The goal of hemodynamic resuscitation is to optimize the microcirculation of organs to meet their oxygen and metabolic needs. Clinicians are currently blind to what is happening in the microcirculation of organs, which prevents them from achieving an additional degree of individualization of the hemodynamic resuscitation at tissue level. Indeed, clinicians never know whether optimization of the microcirculation and tissue oxygenation is actually achieved after macrovascular hemodynamic optimization. The challenge for the future is to have noninvasive, easy-to-use equipment that allows reliable assessment and immediate quantitative analysis of the microcirculation at the bedside. There are different methods for assessing the microcirculation at the bedside; all have strengths and challenges. The use of automated analysis and the future possibility of introducing artificial intelligence into analysis software could eliminate observer bias and provide guidance on microvascular-targeted treatment options. In addition, to gain caregiver confidence and support for the need to monitor the microcirculation, it is necessary to demonstrate that incorporating microcirculation analysis into the reasoning guiding hemodynamic resuscitation prevents organ dysfunction and improves the outcome of critically ill patients.
Sodium glucose co-transporter-2 inhibitors in intensive care unit patients with type 2 diabetes: a pilot case control study
Authors: Mårtensson Johan , Cutuli Salvatore Lucio , Osawa Eduardo A. , Yanase Fumitaka , Toh Lisa , Cioccari Luca , Luethi Nora , Maeda Akinori , Bellomo Rinaldo
Published: May 2023

Background

Sodium glucose co-transporter-2 (SGLT2) inhibitors improve long-term cardiovascular and renal outcomes in individuals with type 2 diabetes. However, the safety of SGLT2 inhibitors in ICU patients with type 2 diabetes is uncertain. We aimed to perform a pilot study to assess the relationship between empagliflozin therapy and biochemical, and clinical outcomes in such patients.

Methods

We included 18 ICU patients with type 2 diabetes receiving empagliflozin (10 mg daily) and insulin to target glucose range of 10–14 mmol/l according to our liberal glucose control protocol for patients with diabetes (treatment group). Treatment group patients were matched on age, glycated hemoglobin A1c, and ICU duration with 72 ICU patients with type 2 diabetes exposed to the same target glucose range but who did not receive empagliflozin (control group). We compared changes in electrolyte and acid–base parameters, hypoglycemia, ketoacidosis, worsening kidney function, urine culture findings, and hospital mortality between the groups.

Results

Median (IQR) maximum increase in sodium and chloride levels were 3 (1–10) mmol/l and 3 (2–8) mmol/l in the control group and 9 (3–12) mmol/l and 8 (3–10) mmol/l in the treatment group (P = 0.045 for sodium, P = 0.059 for chloride). We observed no differences in strong ion difference, pH or base excess. Overall, 6% developed hypoglycemia in each group. No patient in the treatment group and one patient in the control group developed ketoacidosis. Worsening kidney function occurred in 18% and 29% of treatment and control group patients, respectively (P = 0.54). Urine cultures were positive in 22% of treatment group patients and 13% of control group patients (P = 0.28). Overall, 17% of treatment group patients and 19% of control group patients died in hospital (P = 0.79).

Conclusions

In our pilot study of ICU patients with type 2 diabetes, empagliflozin therapy was associated with increases in sodium and chloride levels but was not significantly associated with acid–base changes, hypoglycemia, ketoacidosis, worsening kidney function, bacteriuria, or mortality.
Virtual family-centered hospital rounds in the neonatal intensive care unit: protocol for a cluster randomized controlled trial
Authors: Rosenthal Jennifer L. , Tancredi Daniel J. , Marcin James P. , Ketchersid Audriana , Horath Elva T. , Zerda Erika N. , Bushong Trevor R. , Merriott Daniel S. , Romano Patrick S. , Young Heather M. , Hoffman Kristin R.
Published: May 2023

Background

Family-centered rounds is recognized as a best practice for hospitalized children, but it has only been possible for children whose families can physically be at the bedside during hospital rounds. The use of telehealth to bring a family member virtually to the child’s bedside during hospital rounds is a promising solution. We aim to evaluate the impact of virtual family-centered hospital rounds in the neonatal intensive care unit on parental and neonatal outcomes.

Methods

This two-arm cluster randomized controlled trial will randomize families of hospitalized infants to have the option to use telehealth for virtual hospital rounds (intervention) or usual care (control). The intervention-arm families will also have the option to participate in hospital rounds in-person or to not participate in hospital rounds. All eligible infants who are admitted to this single-site neonatal intensive care unit during the study period will be included. Eligibility requires that there be an English-proficient adult parent or guardian. We will measure participant-level outcome data to test the impact on family-centered rounds attendance, parent experience, family-centered care, parent activation, parent health-related quality of life, length of stay, breastmilk feeding, and neonatal growth. Additionally, we will conduct a mixed methods implementation evaluation using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework.

Discussion

The findings from this trial will increase our understanding about virtual family-centered hospital rounds in the neonatal intensive care unit. The mixed methods implementation evaluation will enhance our understanding about the contextual factors that influence the implementation and rigorous evaluation of our intervention.

Trial registration

ClinicalTrials.gov Identifier: NCT05762835. Status: Not yet recruiting. First posted: March 10, 2023; last update posted: March 10, 2023.
Endocan in prediabetes, diabetes, and diabetes-related complications: a systematic review and meta-analysis
Authors: Khalaji Amirmohammad , Behnoush Amir Hossein , Saeedian Behrad , Khanmohammadi Shaghayegh , Shokri Varniab Zahra , Peiman Soheil
Published: May 2023

Background

Diabetes is one of the chronic conditions with a high burden all around the world. Macrovascular and microvascular involvement are among the common mechanisms by which diabetes can impact patients’ lives. Endocan as an inflammatory endothelial biomarker has been shown to increase in several communicable and non-communicable diseases. Herein, we aim to investigate the role of endocan as a biomarker in diabetes as a systematic review and meta-analysis.

Methods

International databases, including PubMed, Web of Science, Scopus, and Embase were searched for relevant studies assessing blood endocan in diabetic patients. Estimation of the standardized mean difference (SMD) and 95% confidence interval (CI) for comparison of circulating endocan levels between diabetic patients and non-diabetic controls were conducted through random-effect meta-analysis.

Results

Totally, 24 studies were included, assessing 3354 cases with a mean age of 57.4 ± 8.4 years. Meta-analysis indicated that serum endocan levels were significantly higher in diabetic patients in comparison with healthy controls (SMD 1.00, 95% CI 0.81 to 1.19, p-value < 0.01). Moreover, in the analysis of studies with only type-2 diabetes, the same result showing higher endocan was obtained (SMD 1.01, 95% CI 0.78 to 1.24, p-value < 0.01). Higher endocan levels were also reported in chronic diabetes complications such as diabetic retinopathy, diabetic kidney disease, and peripheral neuropathy.

Conclusion

Based on our study’s findings, endocan levels are increased in diabetes, however, further studies are needed for assessing this association. In addition, higher endocan levels were detected in chronic complications of diabetes. This can help researchers and clinicians in recognizing disease endothelial dysfunction and potential complications.
Cytomegalovirus reactivation with high viral load in a patient of coronavirus disease 2019 acute respiratory distress syndrome: a case report
Authors: Pal Sourav , Garg Atul , Agarwal Anupam , Ghoshal Ujjala , Singh Pooja , Chahar Jitendra S. , Gurjar Mohan
Published: May 2023

Introduction

Cytomegalovirus establishes life-long latency after primary infection in childhood. Cytomegalovirus reactivation has been well reported in immune-compromised patients; however, in the last few years it has been observed that cytomegalovirus reactivation also occurs in critically ill patients without exogenous immunosuppression, which increases length of intensive care unit stay and mortality rate.

Case report

A 63-year-old Indian male, without any known comorbidity, developed severe coronavirus disease 2019 and was admitted to the intensive care unit. He received remdesivir, tocilizumab, steroids, anticoagulants, and empiric antibiotics over the next 3 weeks. However, his clinical condition did not improve much, and during the 9th week of illness his condition started deteriorating and routine bacterial cultures, fungal cultures, and cytomegalovirus real-time polymerase chain reaction on blood were negative. His clinical condition worsened rapidly, which led to the need for invasive mechanical ventilation. Tracheal aspirate bacterial and fungal culture showed no growth, but cytomegalovirus real-time polymerase chain reaction showed 21,86,000 copies/mL in tracheal aspirates. After 4 weeks of ganciclovir treatment, the patient improved clinically and was discharged. Currently he is doing well and able to do his routine activity without the need of oxygen.

Conclusion

Timely management with ganciclovir is associated with favorable outcome in cytomegalovirus infection. Thus, it can be suggested that treatment should be initiated with ganciclovir if a patient with coronavirus disease 2019 has high cytomegalovirus load in tracheal aspirates, along with unexplained and prolonged clinical and/or radiological features.
Simultaneous inversion for source field and mantle electrical conductivity using the variable projection approach
Authors: Min Jingtao , Grayver Alexander
Published: May 2023

Time-varying electromagnetic field observed on the ground or at a spacecraft consists of contributions from (i) electric source currents, such as those in the ionosphere and magnetosphere, and (ii) corresponding fields induced by source currents within the conductive Earth’s interior by virtue of electromagnetic induction. Knowledge about the spatio-temporal structure of inducing currents is a key component in ionospheric and magnetospheric studies, and is also needed in space weather hazard evaluation, whereas the induced currents depend on the Earth’s subsurface electrical conductivity distribution and allow us to probe this physical property. In this study, we present an approach that reconstructs the inducing source and subsurface conductivity structures simultaneously, preserving consistency between the two models by exploiting the inherent physical link. To achieve this, we formulate the underlying inverse problem as a separable nonlinear least-squares (SNLS) problem, where inducing current and subsurface conductivity parameters enter as linear and nonlinear model unknowns, respectively. We solve the SNLS problem using the variable projection method and compare it with other conventional approaches. We study the properties of the method and demonstrate its feasibility by simultaneously reconstructing the ionospheric and magnetospheric currents along with a 1-D average mantle conductivity distribution from the ground magnetic observatory data.

Graphical Abstract
Development of chopper-stabilized ASIC preamplifier for improving noise equivalent magnetic induction of search coil magnetometer probing space plasma waves
Authors: Ozaki Mitsunori , Tokunaga Yuya , Koji Hiroki , Yagitani Satoshi
Published: May 2023

Space-based search coil (SC) magnetometers connected to preamplifiers have been used to investigate magnetic field vectors of plasma waves from 100 mHz to 10 kHz for understanding magnetospheric dynamics. However, flicker noise below several 100 Hz of typical preamplifiers degrades the noise equivalent magnetic induction (NEMI) of SCs and affects the probing of plasma waves from 100 mHz to 100 Hz. In this study, we developed a chopper-stabilized preamplifier using application-specific integrated circuit (ASIC) technology for improving the NEMI below 100 Hz while maintaining miniaturization and a low power consumption. The chopper ASIC preamplifier fits into a layout size of 2.3 × 3.4 mm in a bare chip. We used two SC sensors with different (20 cm and 5 cm) lengths to evaluate the NEMI with the prototype of the chopper ASIC preamplifier. At 100 mHz, the NEMI values of the 20-cm length and 5-cm length SCs were 0.1 nT/Hz1/2 and 1.9 nT/Hz1/2, respectively, which can detect typical electromagnetic ion cyclotron waves in the magnetosphere. The NEMI value at 100 mHz for the 5-cm-length SC was improved by approximately 19 dB compared with that for a previous ASIC preamplifier without chopping. We conducted temperature tests for the chopper ASIC preamplifier to evaluate the behavior for under a wide temperature range from − 40 to + 100 °C. The temperature coefficient of the gain was approximately − 0.02 dB/°C, which is a sufficiently low temperature-dependence. The use of ASIC technology achieved high stability under the wide temperature range and radiation tolerance. Thus, the chopper ASIC preamplifier with high robustness and ultra-low noise characteristics is suitable for plasma wave observations in harsh space environments for future missions.

Graphical Abstract
Development of a high-performance seismic phase picker using deep learning in the Hakone volcanic area
Authors: Kim Ahyi , Nakamura Yuji , Yukutake Yohei , Uematsu Hiroki , Abe Yuki
Published: May 2023

In volcanic regions, active earthquake swarms often occur in association with volcanic activity, and their rapid detection and analysis are crucial for volcano disaster prevention. Currently, these processes are ultimately left to human judgment and require significant time and money, making detailed real-time verification impossible. To overcome this issue, we attempted to apply machine learning, which has been successfully applied to various seismological fields to date. For seismic phase pick, several models have already been trained using a large amount of training data (mainly crustal earthquakes). Although there are some cases in which these models can be applied without any problems, regional dependence on pre-trained models has been reported. Since this study targets earthquakes in a volcanic region, applying existing pre-trained models may be difficult. Therefore, in this study, we compared three models; the publicly available trained model (model 0), a model which was trained with approximately 220,000 P- and S-wave onset reading data recorded at the Hakone volcano from 1999 to 2020 with initialized parameters (model 1) using the same architecture, and a model fine-tuned with the aforementioned Hakone data using the parameters of model 0 as initial values (model 2), and evaluated their phase identification performance for the Hakone data. As a result, the seismic phase detection rates of models 1 and 2 were much higher than those of model 0. However, small-amplitude signals are often missed when multiple seismic events occur within a detection time window. Therefore, we created training data with two earthquakes in the same time window, retrained the model using the data, and successfully detected events that previously would have been missed. In addition, it was found that more events were detected by setting the threshold to a low probability value for detection, increasing the number of seismic phase detections, and filtering by phase association and hypocenter location.

Graphical Abstract
Fidelity to the ACT SMART Toolkit: an instrumental case study of implementation strategy fidelity
Authors: Tschida Jessica E. , Drahota Amy
Published: May 2023

Background

Evidence-based practices (EBPs) are shown to improve a variety of outcomes for autistic children. However, EBPs often are mis-implemented or not implemented in community-based settings where many autistic children receive usual care services. A blended implementation process and capacity-building implementation strategy, developed to facilitate the adoption and implementation of EBPs for autism spectrum disorder (ASD) in community-based settings, is the Autism Community Toolkit: Systems to Measure and Adopt Research-based Treatments (ACT SMART Toolkit). Based on an adapted Exploration, Adoption decision, Preparation, Implementation, Sustainment (EPIS) Framework, the multi-phased ACT SMART Toolkit is comprised of (a) implementation facilitation, (b) agency-based implementation teams, and (c) a web-based interface. In this instrumental case study, we developed and utilized a method to evaluate fidelity to the ACT SMART Toolkit. This study responds to the need for implementation strategy fidelity evaluation methods and may provide evidence supporting the use of the ACT SMART Toolkit.

Methods

We used an instrumental case study approach to assess fidelity to the ACT SMART Toolkit during its pilot study with six ASD community agencies located in southern California. We assessed adherence, dose, and implementation team responsiveness for each phase and activity of the toolkit at both an aggregate and individual agency level.

Results

Overall, we found that adherence, dose, and implementation team responsiveness to the ACT SMART Toolkit were high, with some variability by EPIS phase and specific activity as well as by ASD community agency. At the aggregate level, adherence and dose were rated notably lowest during the preparation phase of the toolkit, which is a more activity-intensive phase of the toolkit.

Conclusions

This evaluation of fidelity to the ACT SMART Toolkit, utilizing an instrumental case study design, demonstrated the potential for the strategy to be used with fidelity in ASD community-based agencies. Findings related to the variability of implementation strategy fidelity in the present study may also inform future adaptations to the toolkit and point to broader trends of how implementation strategy fidelity may vary by content and context.
Advancements in Systemic Therapy for Pancreatic Cancer
Authors: Brown Timothy J. , Reiss Kim A. , O'Hara Mark H.
Published: May 2023

Outcomes for patients with advanced pancreatic cancer have improved in the past 12 years, mainly because of progress made in systemic therapies. New treatment strategies for advanced pancreatic cancer include switch maintenance with cytotoxic therapies, induction maintenance, and the utilization of targeted agents for patients with actionable variants, as well as ongoing development of cytotoxic regimens, such as NALIRIFOX. The activity of immunotherapy has been disappointing to date, but novel combinations and identifying appropriate patient populations may further unlock its potential.
Sleep Fragmentation, Electroencephalographic Slowing, and Circadian Disarray in a Mouse Model for Intensive Care Unit Delirium
Authors: Dulko Elzbieta , Jedrusiak Michal , Osuru Hari P. , Atluri Navya , Illendula Meghana , Davis Eric M. , Beenhakker Mark P. , Lunardi Nadia
Published: May 2023

BACKGROUND:

We aimed to further validate our previously published animal model for delirium by testing the hypothesis that in aged mice, Anesthesia, Surgery and simulated ICU conditions (ASI) induce sleep fragmentation, electroencephalographic (EEG) slowing, and circadian disarray consistent with intensive care unit (ICU) patients with delirium.

METHODS:

A total of 41 mice were used. Mice were implanted with EEG electrodes and randomized to ASI or control groups. ASI mice received laparotomy, anesthesia, and simulated ICU conditions. Controls did not receive ASI. Sleep was recorded at the end of ICU conditions, and hippocampal tissue was collected on EEG recording. Arousals, EEG dynamics, and circadian gene expression were compared with t tests. Two-way repeated measures analysis of variance (RM ANOVA) was used to assess sleep according to light.

RESULTS:

ASI mice experienced frequent arousals (36.6 ± 3.2 vs 26.5 ± 3.4; P = .044; 95% confidence interval [CI], 0.29–19.79; difference in mean ± SEM, 10.04 ± 4.62) and EEG slowing (frontal theta ratio, 0.223 ± 0.010 vs 0.272 ± 0.019; P = .026; 95% CI, −0.091 to −0.007; difference in mean ± SEM, −0.05 ± 0.02) relative to controls. In ASI mice with low theta ratio, EEG slowing was associated with a higher percentage of quiet wakefulness (38.2 ± 3.6 vs 13.4 ± 3.8; P = .0002; 95% CI, −35.87 to −13.84; difference in mean ± SEM, −24.86 ± 5.19). ASI mice slept longer during the dark phases of the circadian cycle (nonrapid eye movement [NREM], dark phase 1 [D1]: 138.9 ± 8.1 minutes vs 79.6 ± 9.6 minutes, P = .0003, 95% CI, −95.87 to −22.69, predicted mean difference ± SE: −59.28 ± 13.89; NREM, dark phase 2 (D2): 159.3 ± 7.3 minutes vs 112.6 ± 15.5 minutes, P = .006, 95% CI, −83.25 to −10.07, mean difference ± SE, −46.66 ± 13.89; rapid eye movement (REM), D1: 20.5 ± 2.1 minutes vs 5.8 ± 0.8 minutes, P = .001, 95% CI, −24.60 to −4.71, mean difference ± SE, −14. 65 ± 3.77; REM, D2: 21.0 ± 2.2 minutes vs 10.3 ± 1.4 minutes, P = .029, 95% CI, −20.64 to −0.76, mean difference ± SE, −10.70 ± 3.77). The expression of essential circadian genes was also lower in ASI mice (basic helix-loop-helix ARNT like [BMAL1]: −1.3 fold change; circadian locomotor output cycles protein kaput [CLOCK]: −1.2).

CONCLUSIONS:

ASI mice experienced EEG and circadian changes mimicking those of delirious ICU patients. These findings support further exploration of this mouse approach to characterize the neurobiology of delirium.
Clinical Utility of the Cardiorespiratory Optimal Point in Patients with Heart Failure
Authors: KROESEN SOPHIE H. , BAKKER ESMÉE A. , SNOEK JOHAN A. , VAN KIMMENADE ROLAND R. J. , MOLINGER JEROEN , ARAÚJO CLAUDIO G. , HOPMAN MARIA T. E. , EIJSVOGELS THIJS M. H.
Published: May 2023

Introduction

We assessed the cardiorespiratory optimal point (COP)—the minimal V̇
E/V̇O2 in a given minute of an incremental cardiopulmonary exercise test—in patients with heart failure (HF) and aimed to determine 1) its association with patient and disease characteristics, 2) changes after an exercise-based cardiac rehabilitation program (CR), and 3) the association with clinical outcomes.

Methods

We studied 277 HF patients (67 (58–74) yr, 30% female, 72% HF with restricted ejection fraction) between 2009 and 2018. Patients participated in a 12- to 24-wk CR program, and COP was assessed pre- and post-CR. Patient and disease characteristics and clinical outcomes (mortality and cardiovascular-related hospitalization) were extracted from patient files. The incidence of clinical outcomes was compared across COP tertiles (low, <26.0; moderate, 26.0–30.7; high, >30.7).

Results

Median COP was 28.2 (24.9–32.1) and was reached at 51% ± 15% of V̇O2peak. Lower age, female sex, higher body mass index, the absence of a pacemaker or the absence of chronic obstructive pulmonary disease, and lower N-terminal prohormone brain natriuretic peptide concentrations were associated with a lower COP. Participation in CR reduced COP (−0.8; 95% confidence interval, −1.3 to −0.3). Low COP had a reduced risk (adjusted hazard ratio, 0.53; 95% confidence interval, 0.33–0.84) for adverse clinical outcomes as compared with high COP.

Conclusions

Classic cardiovascular risk factors are associated with a higher, more unfavorable, COP. CR-based exercise training reduces COP, whereas a lower COP is associated with a better clinical prognosis. As COP can be established during a submaximal exercise test, this may offer novel risk stratification possibilities for HF care programs.
Survival impact of fibrotic interstitial lung abnormalities in resected stage IA non-small cell lung cancer
Authors: Jeong Won Gi , Kim Yun-Hyeon
Published: May 2023

Objectives:

To assess the association between fibrotic interstitial lung abnormalities (ILAs) and long-term survival in patients with resected Stage IA non-small cell lung cancer (NSCLC).

Methods:

Data of patients who underwent curative resection of pathological Stage IA NSCLC between 2010 and 2015 were retrospectively analysed. ILAs were evaluated using pre-operative high-resolution CT scans. The association between ILAs and cause-specific mortality was assessed via Kaplan–Meier analysis and the log-rank test. Cox proportional hazards regression was performed to determine the risk factors for cause-specific death.

Results:

Overall, 228 patients were identified (63.27 ± 8.54 years, 133 men [58.3%]). ILAs were detected in 24 patients (10.53%). Fibrotic ILAs were observed in 16 patients (7.02%), and there was a significantly higher cause-specific mortality rate among patients with fibrotic ILAs compared with patients with no ILAs (p < 0.001). Patients with fibrotic ILAs had a significantly higher cause-specific mortality rate than patients without ILAs at 5 post-operative years (survival rate: 61.88% vs 93.03%, p < 0.001). The presence of afibrotic ILA was an independent risk factor for cause-specific death (adjusted hazard ratio = 3.22; 95% confidence interval: 1.10, 9.44; p = 0.033).

Conclusion:

The presence of afibrotic ILA was a risk factor for cause-specific death in patients with resected Stage IA NSCLC. Radiologists and clinicians should be familiar with the relatively new concept of ILAs and understand the close association between ILA status and long-term survival in resected Stage IA NSCLC. Patients presenting fibrotic ILAs should receive appropriate surveillance and management to optimise prognosis.

Advances in knowledge:

Fibrotic ILAs are important findings implicated inthe long-term survival of patients with resected Stage IA NSCLC. Specific management is required for this group.
Performance of panoramic radiography compared with computed tomography in the evaluation of pathological changes in the maxillary sinuses: a systematic review and meta-analysis
Authors: Fischborn Amanda Regina , Andreis Jéssica Daniela , Wambier Leticia Maíra , Pedroso Caique Mariano , Claudino Marcela , Franco Gilson Cesar Nobre
Published: May 2023

Objective:

A systematic review was performed to evaluate the performance of panoramic radiography (PR) vs CT or cone beam CT (CBCT) in the diagnosis of pathological maxillary sinuses.

Methods:

This review was registered in the PROSPERO database under the number CRD42020211766. Observational studies that compared PR with CT/CBCT were used to evaluate pathological changes in the maxillary sinuses. A complete search of seven primary databases and gray literature was carried out. The risk of bias was assessed according to the Newcastle-Ottawa tool, and the GRADE tool was used to assess the quality of evidence. A binary meta-analysis was performed to assess the effectiveness of evaluating pathological alterations in the maxillary sinuses in PR and CT/CBCT.

Results:

Seven studies were included in our study, out of which four were included in a quantitative analysis. All studies were classified as low risk of bias. Five studies compared PR with CBCT and two studies compared PR to CT. The most common pathological alteration in maxillary sinuses reported was mucosal thickening. CT/CBCT was seen to be the most effective method for assessing pathological changes in the maxillary sinus when compared to PR (RR = 0.19, 95% confidence interval [CI] = 0.05 to 0.70, p = 0.01).

Conclusion:

CT/CBCT are the most appropriate imaging methods to evaluate pathological changes in the maxillary sinuses, while PR is still limited in the evaluation of these changes being considered only for initial diagnosis.
A Study on the Material Relationship between Whiteware and Material Soil of White Porcelain Kiln Site in Usan-ri
Authors: Kim Du Hyeon , Kim Gyeong Jung , Kim Hyun Suk , Han Min Su
Published: May 2023

This study identified the nature of objects through physical and chemical analysis of 28 whiteware pieces such as White porcelain, Gapbal, and Dochim excavated in Gwangju Usan-ri 4 and 9 and 14 material soil collected from Usan-ri 9, Gwangju. And confirmed material correlation between whiteware and whiteware-material soil. In the case of white porcelain, it was divided into four groups(W1∼4) according to the color and monochromaticity of the body, and two (M1-2) groups according to the Mullite peak intensity. Regardless of the kiln site, all of the high-middle-low quality white pocelain were identified, and and there was no significant difference in the overall composition. As a result of partic le size analysis, most of the material soil was c omposed of fine sand, silt, and clay. In particular, in the case of clay material soil, the main component and discriminant analysis results showed similar tendency to white porcelain pieces. Therefore, it was estimated that the white porcelain excavated in Usan-ri 9, Gwangju was manufactured using material soil collected from the adjacent klin site and the production techniques of Usan-ri No. 4 and No. 9 were similar, but there were some differences in materials.
Post-Cardiac arrest targeted temperature management in a parturient with severe COVID-19 disease
Authors: Eman Ali , Balaban Onur , Özmen Süner Kezban , Özgün Bora
Published: May 2023

Background and Objective: Targeted temperature management (TTM) may improve neurological outcomes and mortality after cardiac arrest. We present a targeted mild hypothermia treatment in a postpartum patient with COVID-19 after successful cardiopulmonary resuscitation (CPR).

Case presentation: A 23 year old, 26-week pregnant patient with the diagnosis of COVID-19. The patient developed respiratory arrest followed by cardiac arrest and underwent CPR for six minutes. The patient underwent an emergency cesarean section after CPR in intensive care unit. After the resuscitation, 72-hours hypothermia protocol was initiated. We extubated the patient 13 days after the hypothermia procedure. The patient was conscious and cooperative. Respiratory distress worsened in the following days; the patient was re-intubated 18 days after the TTM. The benefit of targeted hypothermia was improved neurologic outcome in our patient. However, severe infectious complications led to multi-organ failure and the patient died on the 45th ICU admission day.

doi: https://doi.org/10.12669/pjms.39.4.7193

How to cite this: Eman A, Balaban O, Süner KÖ, Özgün B. Post-Cardiac arrest targeted temperature management in a parturient with severe COVID-19 disease. Pak J Med Sci. 2023;39(4):---------. doi: https://doi.org/10.12669/pjms.39.4.7193

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Porównanie jakości sensorycznej świeżych oraz suszonych roślin przyprawowych
Authors: Bienia Bernadetta , Baran Jolanta
Published: May 2023

Celem pracy było porównanie jakości sensorycznej (intensywności i typowości zapachu, barwy, smaku) świeżych oraz suszonych roślin przyprawowych. Materiałem badawczym były przygotowane samodzielnie w pracowni oraz zakupione w sklepach internetowych i w sklepach detalicznych przyprawy roślinne: szczypiorek, koper, bazylia, natka pietruszki. Ocenę sensoryczną wykonano w pracowni, która spełnia warunki określone w normie PN-EN ISO 8589:2010. Do badań wytypowano dziesięcioosobowy zespół oceniający o sprawdzonej, odpowiednio wysokiej wrażliwości sensorycznej, zgodnie z wymogami normy PN-ISO 8586-2:1996. Dokonano ocenyw zakresie intensywności (aromatyczności) i typowości zapachu, intensywności zielonej barwy oraz aromatyczności (wyrazistości) smaku. Największą intensywnością i typowością zapachu, barwą i smakiem charakteryzowały się próbki świeżych roślin przyprawowych. Metody suszenia miały istotny wpływ na intensywność i typowość zapachu, intensywność barwy zielonej i intensywność smaku ocenianych suszy.
Rośliny wpływające na procesy krzepnięcia krwi
Authors: Sopata Katarzyna
Published: May 2023

Rośliny wpływające na procesy krzepnięcia krwi są używane jako preparaty ziołowe w leczeniu różnych schorzeń (choroba hemoroidalna, nadmierne krwawienia, miażdżyca, zakrzepica i wiele innych). Ważną grupę roślin stanowią rośliny działające przeciwpłytkowo i antykoagulacyjnie, które mogą stanowić bezpieczną alternatywę dla syntetycznych leków przeciwzakrzepowych stosowanych w prewencji i leczeniu zakrzepicy i schorzeń układu sercowo-naczyniowego. Związki czynne takie jak flawonoidy, kumaryny, alkaloidy, polifenole, konjugaty polifenolowo-polisacharydowe,związki terpenowe i inne są odpowiedzialne za efekt przeciwpłytkowy. Zahamowanie agregacji płytek przez preparaty roślinne może mieć różne mechanizmy. Jakkolwiek większość badań pozwalających określić działanie danego preparatu to eksperymenty in vitro, a badań in vivo wciąż jest niewiele. Bezpieczeństwo stosowania wielu wyciągów nie zostało potwierdzone. Pacjenci zażywający leki przeciwzakrzepowe powinni być świadomi możliwych interakcji między wyciągami roślinnymi a lekami syntetycznymi.
Zioła dla seniora. Upowszechnienie wiedzy o surowcach przeciwdziałających procesom neurodegeneracji
Authors: Wawer Iwona , Wilusz Magdalena
Published: May 2023

Choroby neurodegeneracyjne stanowią rosnący problem we wszystkich społeczeństwach, których profil demograficzny zmienia się w związku ze starzeniem się społeczeństwa. W celu zapobiegania chorobom neurodegeneracyjnym coraz bardziej jest doceniana możliwość wykorzystania leków roślinnych, ekstraktów, botanicznych suplementów diety i przypraw. W pracy prezentowane są wyniki ankiet przeprowadzonych z udziałem 80 osób w wieku 60+. Na podstawie wypowiedzi ankietowanych wynika, że większość seniorów nie stosuje leków roślinnych, jednak stosują innepreparaty roślinne, suplementy diety oraz przyprawy. Informacje na temat roślin leczniczych czerpią z gazet, książek i internetu, ale ich wiedza na temat roli składników roślinnych w profilaktyce chorób neurodegeneracyjnych jest niezadowalająca. Bardzo ważne jest, aby posiadać odpowiednią wiedzę na temat leków pochodzenia naturalnego, ponieważ są one coraz częściej stosowane w leczeniu różnych chorób. Dieta bogata w surowce roślinne (warzywa, przyprawy) może zmniejszyć ryzyko powstawania chorób wieku starczego, a także spowalniać ich rozwój.
Wspomnienia prof. Aleksandra Ożarowskiego z 1939 roku
Authors: Pietryja Marcelin Jan
Published: May 2023

Osobom interesującym się zielarstwem nie trzeba przedstawiać sylwetki Profesora Aleksandra Ożarowskiego. To jedna z najbardziej zasłużonych dlapolskiego ziołolecznictwa osób. Urodził się w 1916 roku w Prusakowie (obecnie Chmielnicki) na Ukrainie, zmarł w wieku 95 lat 23 czerwca 2011 roku.Profesor Ożarowski był przyjacielem utworzonego w 2007 roku Herbarium św. Franciszka. Mogliśmy korzystać z jego wiedzy i rad przy rozpoczynaniudziałalności. Była to dla nas ogromna i nieoceniona pomoc. Przekazał bezinteresownie do biblioteki Herbarium część swoich książek, dzięki czemumogliśmy pogłębiać fachową wiedzę.
Professional burnout syndrome in a group of nursing staff employed in a psychiatric hospital
Authors: Tomaszewska Katarzyna , Porczak Waldemar , Guty Edyta , Majchrowicz Bożena
Published: May 2023

Nurses are one of the occupational groups most exposed to stress in the health care system. In their daily work, the staff of a psychiatric ward often encounters threats, aggression or unpredictability of patients' behavior. Employees, including nurses, often feel discomfort related to the treatment of patients admitted against their will, the need to use direct coercion. In psychiatry, it is also burdensome to participate in family matters of patients, to solve their problems. The group of factors recognized as stressful and causing psychological burden for nurses includes a large number of patients under their care, their serious condition as well as physical and verbal aggression of the patient and violence.
The aim of the study was to present the problem of occupational burnout in a group of nursing staff employed in a psychiatric hospital
Material and methods 203 nurses participated in the study. The research tool was a proprietary questionnaire and a standardized tool, the Ch. Maslach. The level of statistical significance in this study was p<0.05.
Results The average occupational burnout rate was 34.9% ± 20.9%. Emotional exhaustion was assessed at 32.5% ± 28.5%, the level of depersonalization at 23.1% ± 26.1%. The main motivators in the work of nurses are earnings (57.3%), willingness to help others (54.4%) and a good atmosphere at work (35%).
Conclusions: Mental burden in the work of a psychiatric nurse results in the development of occupational stress leading to occupational burnout. Actions are recommended to counteract the professional burnout syndrome
Sweet Syndrome - A Review of Pathogenesis, Clinical Features, Diagnosis and Treatment
Authors: Błaszczyk Agnieszka , Trojan Sara , Fussek-Styga Urszula , Kwieciński Jakub , Miszuda Sławomir , Basiaga Bartosz , Bednarz Krzysztof , Szwedkowicz Agata , Leśniak Marek , Heluszka Jakub
Published: May 2023

Sweet syndrome is a rare, inflammatory, non-infectious skin disorder characterized by an acute onset of skin leasions such as painful, erythematous plaques, nodules and papules, most frequently located on the upper extremities, trunk, neck and face. Generally, dermatological symptoms are accompanied by fever, headaches, arthralgia and leukocytosis. The syndrome belongs to the group of febrile neutrophilic dermatoses. Skin biopsy reveals a diffuse, neutrophilic infiltrate in the upper dermis. Sweet syndrome presents in three clinical subtypes: classical, malignancy-associated and drug-induced. The etiology of this disease still remains unclear, but it seems that can be associated with dysfunction of the immune system, genetic predispostion and neoplastic process. Sweet syndrome has been reported in relation to pregnancy, drug administration, vaccinaton and infection of the respiratory or digestive system. Systemic glucocorticosteroids still remain the first line treatment for most patients, nevertheless new therapeutic options against reccurent Sweet syndrome have been investigated.
use of adrenaline in cardiac arrest - impact on survival to discharge from the hospital
Authors: Zimnicki Patryk , Lato Marta , Iberszer Konrad , Litwiniuk Maria , Zaniuk Marcin , Hurkała Kamil , Antonik Dominika , Denys Barbara , Góra Karolina , Zdziennicki Wojciech
Published: May 2023

Introduction and objective: Epinephrine is the most important and primary drug that resuscitation team use to reverse cardiac arrest. The provision of epinephrine is currently suggested by both the American Heart Association and the European Resuscitation Council. It is vital to improving the return of spontaneous circulation (ROSC), however the evidence for the use of adrenaline in resuscitation is inconclusive.

Materials and methods: The literature was reviewed in the Pubmed database, in the Via Medica Journals database, and in the guidelines of the Polish Society of Anesthesiology, European Resuscitation Council and the American Heart Association with the use of keywords.

State of knowledge: There is a clear evidence of an association between epinephrine and increased return of spontaneous circulation (ROSC). Its action is based on stimulation of alpha- and beta-adrenergic receptors. Epinephrine have a role in resuscitation, during CPR it increases the probability of restoring cardiac activity with pulses, which is intermediate step toward long-term survival. However, there are conflicting results regarding long-term survival and functional recovery, particularly neurological outcome.

Conclusions: Research shows that epinephrine administration in patients with cardiac arrest increases the chance of restoring spontaneous circulation and patient survival to hospital admission and discharge. However, there are arguments questioning the validity of using epinephrine in resuscitation. Publications show that the compound contributes to post-resuscitation syndrome, which reduces a patient's chance of long-term survival. There are a number of conflicting studies that vary widely in the results presented. The current evidence is insufficient to either confirm or exclude the efficacy of epinephrine, which is why it is still recommended in the latest resuscitation guidelines by the European Resuscitation Council (ERC 2021) and the American Heart Association (AHA 2020).
The non-pharmacological treatment of primary dysmenorrhea - efficiency and safety
Authors: Zapała Brygida , Ząber Aldona , Gacoń Ewa , Zembala Julita , Siekierko Nikola , Kucharski Jakub , Żołnierek Maja , Kotusiewicz Wiktoria , Lewandowski Mateusz Mirosław
Published: May 2023

Primary dysmenorrhea  is the most common, though often underdiagnosed, gynecological disorder of women of reproductive age. The disease presents with painful abdominal cramps associated with menstrual bleeding in the absence of pelvic abnormalities. Symptoms are caused primarily by increased levels of prostaglandins produced by the endometrium, which provides hypercontraction of the uterine muscles, ischemia, and pain.  Dysmenorrhea is usually treated pharmacologically with non-steroidal anti-inflammatory drugs or hormonal contraception. In particularly severe cases, surgical treatment is also possible. Nonetheless, an increasing amount of studies on non-pharmacological treatments have been published recently. Methods like Transcutaneous Electrical Nerve Stimulation (TENS), acupuncture, continuous topical heat, or exercise and yoga seem to be effective in reducing the symptoms of primary dysmenorrhea. All have an anti-inflammatory effect by lowering prostaglandin levels, but they also contribute to reducing symptoms through other mechanisms. TENS elevates the pain threshold and, together with acupuncture, causes the release of endogenous opioids. Heat, yoga, and acupuncture also lead to increased blood flow in the uterus, reducing hypoxia. Their additional advantage is the low cost and ease of self-use, except for acupuncture, depending on the patient's needs. Side effects of non-pharmacological treatments are usually mild and rarely reported.