Abnormal Rate Research Articles

Influence of age and self-stigmatization on social eating and drinking issues in French outpatients living with and beyond head and neck cancer: a mixed-method study.

Social eating (SE) is a corner stone of daily living activities, quality of life (QoL), and aging well. In addition to feeding functional disorders, patients with head and neck cancer (HNC) face individual and social psychological distress. In this aging population, we intended to better assess the influence of age on these challenges, and the role of self-stigmatization limiting SE in patients with and beyond HNC. This was an exploratory multicenter cross-sectional mixed method study. Eligibility criteria were adults diagnosed with various non-metastatic HNC, before, during, or until 5years after treatment. SE disorders were explored with the Performance Status ScalePublic Eating rate(PSS-HN PE). In the quantitative part of the study, SE habits, Functional Assessment of Cancer Therapy Body Image Scale (FACT-MBIS) and specific to HNC (FACT-HN35) were also filled in by the patients. In the qualitative study, the semi-structured interview guide was drawn out to explore stigma, especially different dimensions of self-stigmatization. A total of 112 patients were included, mean age 64.7years, 23.2% of female. One-third (n = 35) of patients had an abnormal PSS-HN PE rate < 100. Younger patients had more often an impaired Normalcy of Diet mean (70.4 vs 82.7, p = .0498) and PE rates (76 vs 86.9, p = .0622), but there was no difference between age subgroups in MBIS nor FACT-HN scores. Seventy patients (72.2%) found SE and drinking « important» to « extremely important» in their daily life. The qualitative study reported self-stigmatization in two older patients and strategies they have developed to cope with in their behaviors of SE. This study confirms that SE remains of high concern in patients with and beyond HNC. Even in older patients experiencing less often functional feeding disorders, body image changes and SE issues are as impaired as in younger patients and need to be addressed.

A - 81 Gender Bias in Collateral Informant Ratings of the Lawton &amp; Brody Instrumental Activities of Daily Living Scale Varies by Ethnolinguistic Group

Abstract Objective Building on our prior work showing that sociocultural factors influence the nature of one’s daily activities and the degree of assistance rendered once cognitive difficulties emerge, the present study aimed to examine gender differences in the frequency of abnormal IADLS ratings [Not Applicable (N/A), Requires Assistance (R/A), Dependent] in cognitively healthy older adults from different ethnic (Hispanic vs. Non-Hispanic) and linguistic (English vs. Spanish) groups. Method Baseline data from 1060 healthy older adults [Non-Hispanic English-speakers (NE) = 597; Hispanic English-speakers (HE) = 249; Hispanic Spanish-speakers (HS) = 214] 50–90 years of age enrolled in the Texas Alzheimer’s Research and Care Consortium were analyzed using univariate analyses of variance and multivariate chi-squares within each ethnolinguistic group. Results Women obtained significantly (p &amp;lt; 0.001) higher IADLS total scores (indicative of greater impairment) than men in each ethnolinguistic group. A significant difference (p &amp;lt; 0.01) was found between gender across the sample for items related to Food Preparation, Housekeeping, and Laundry, wherein 7–25% of all men vs. &amp;lt; 1% of all women received “N/A” ratings. Significantly more HE men vs. women also received “N/A” ratings for Finances (4:1) and Medications (7:1), while a similar trend was observed in the NH and HS groups but did not reach statistical significance. No participants received an “N/A” rating and no significant gender differences were observed for remaining IADLs. Conclusion(s) Obtained findings highlight considerable gender bias on the Lawton &amp; Brody IADLS in healthy older adults, which clearly limits the utility of this instrument in the provision of patient-centered neuropsychological services and may confound the interpretation of clinical trial outcomes.

Biological and Physiological Changes in Spodoptera frugiperda Larvae Induced by Non-Consumptive Effects of the Predator Harmonia axyridis

The effects of predatory natural enemies on their prey or hosts involve both consumption and non-consumptive effects. This study investigated the non-consumptive effects of the predator, Harmonia axyridis (Coleoptera: Coccinellidae) on 1st, 2nd and 3rd instar larvae of Spodoptera frugiperda. We exposed larvae of different instars to the predator and assessed various parameters using a combination of biological and biochemical methods. Exposure to the predator significantly affected the growth and development of the S. frugiperda caterpillars. Firstly, the developmental duration of S. frugiperda larvae in the 1st–3rd instars and the pupal stage were notably prolonged. Moreover, we observed significant effects on pupal mass, pupal abnormality rate and emergence rate. These non-consumptive effects were gradually weakened with an increase in the larval stage exposed to the predator. Antioxidant enzyme activities including catalase (CAT) peroxidase (POD) and superoxide dismutase (SOD) activity increased significantly. Additionally, organismal triglyceride, trehalose and glycogen content were significantly altered by non-consumptive effects, while protein content showed no significant change. Spodoptera frugiperda larvae increased the activity of antioxidant enzymes in response to potential predators to mitigate oxidative stress and reduce cellular and tissue damage. This resources redistribution towards survival may inhibit growth and development of the species and further exacerbate these non-consumptive effects. These findings highlight the importance of considering non-consumptive effects in pest-management strategies to optimize control measures in agricultural systems.

Exploring the link between chromosomal polymorphisms and reproductive abnormalities

ObjectiveThis work aimed to investigate the potential correlation between chromosomal polymorphisms and various reproductive abnormalities.MethodsWe examined 21,916 patients affected by infertility who sought care at the Department of Reproductive Medicine, Affiliated Hospital of Shandong Second Medical University between January 2018 and December 2022. A total of 2227 individuals identified as chromosomal polymorphism carriers constituted the polymorphism group, and 2245 individuals with normal chromosome karyotypes were randomly selected to form a control group. Clinical manifestations, histories of spontaneous miscarriage, abnormal reproductive developments, fetal abnormalities, and male sperm quality anomalies were statistically compared between these two groups.ResultsOf the 21,916 patients analyzed, 2227 displayed chromosomal polymorphism, representing a 10.16% detection rate. Amongst the male patients, 1622 out of 10,827 exhibited polymorphisms (14.98%), whereas 605 out of 11,089 females showed polymorphisms (5.46%). Female carriers in the polymorphism group, showed statistically significant increased rates of spontaneous abortion (29.75% vs. 18.54%), fetal anomalies (1.32% vs. 0.81%), and uterine abnormalities compared with the control group (1.32% vs. 0.81%). Male carriers in the polymorphism group had higher rates of spontaneous abortion in partners (22.87% vs. 10.37%), fetal anomalies (1.97% vs. 0.25%), compromised sperm quality (41.74% vs. 7.18%), testicular underdevelopment (2.28% vs. 0.92%), and hypogonadotropic hypogonadism (0.62% vs. 0.37%) compared with the control group.ConclusionChromosomal polymorphisms may have a certain negative effect on reproductive irregularities, including spontaneous abortions, fetal anomalies, and reduced sperm quality in males. Their clinical effects deserve further investigation.

Impact of post-COVID-19 changes in outpatient chronic patients’ healthcare-seeking behaviors on medical utilization and health outcomes

IntroductionThis study comprehensively investigates the changes in healthcare utilization among chronic patients with regular outpatient visits to hospitals after the occurrence of Covid-19. The research examines whether patients altered their originally regular medical attendance frequencies due to the pandemic and explores potential negative impacts on the health conditions of those irregular attendees post-pandemic.MethodsData for this study were sourced from a database at a medical center in Taiwan. The subjects were chronic patients with regular hospital outpatient visits before the Covid-19 outbreak. The study tracked medical utilization patterns from 2017 to 2022 for different patient characteristics and outpatient behaviors, employing statistical methods such as Repeated Measures ANOVA and Generalized Estimating Equation to analyze changes in healthcare utilization and health status during the post-pandemic period.ResultsThe results reveal that, compared to the regular group, chronic patients with irregular outpatient visits during the post-pandemic period exhibited a decrease of 5.85 annual outpatient visits, a reduction of NT$20,290.1 in annual medical expenses, and a significantly higher abnormality rate in average biochemical test results by 0.9%.ConclusionsThe findings contribute to understanding the impact of the Covid-19 pandemic on healthcare utilization and health conditions among outpatient chronic disease populations. In response to the new medical landscape in the post-pandemic era, proactive suggestions are made, including providing telemedicine outpatient services and referral-based medical care to meet the needs of the target population, ensuring a continuous and reassuring healthcare model for chronic patients, and mitigating the operational impacts of public health emergencies on hospitals.

ETDRS grading with CLARUS ultra-widefield images shows agreement with 7-fields colour fundus photography

BackgroundTo analyse and compare the grading of diabetic retinopathy (DR) severity level using standard 35° ETDRS 7-fields photography and CLARUS™ 500 ultra-widefield imaging system.MethodsA cross-sectional analysis of retinal images of patients with type 2 diabetes (n = 160 eyes) was performed for this study. All patients underwent 7-fields colour fundus photography (CFP) at 35° on a standard Topcon TRC-50DX® camera, and ultra-widefield (UWF) imaging at 200° on a CLARUS™ 500 (ZEISS, Dublin, CA, USA) by an automatic montage of two 133° images (nasal and temporal). 35° 7-fields photographs were graded by two graders, according to the Early Treatment Diabetic Retinopathy Study (ETDRS). For CLARUS UWF images, a prototype 7-fields grid was applied using the CLARUS review software, and the same ETDRS grading procedures were performed inside that area only. Grading of DR severity level was compared between these two methods to evaluate the agreement between both imaging techniques.ResultsImages of 160 eyes from 83 diabetic patients were considered for analysis. According to the 35° ETDRS 7-fields images, 22 eyes were evaluated as DR severity level 10–20, 64 eyes were evaluated as DR level 35, 41 eyes level 43, 21 eyes level 47, 7 eyes level 53, and 5 eyes level 61. The same DR severity level was achieved with CLARUS 500 UWF images in 92 eyes (57%), showing a perfect agreement (k > 0.80) with the 7-fields 35° technique. Fifty-seven eyes (36%) showed a higher DR level with CLARUS UWF images, mostly due to a better visualization of haemorrhages and a higher detection rate of intraretinal microvascular abnormalities (IRMA). Only 11 eyes (7%) showed a lower severity level with the CLARUS UWF system, due to the presence of artifacts or media opacities that precluded the correct evaluation of DR lesions.ConclusionsUWF CLARUS 500 device showed nearly perfect agreement with standard 35° 7-fields images in all ETDRS severity levels. Moreover, CLARUS images showed an increased ability to detect haemorrhages and IRMA helping with finer evaluation of lesions, thus demonstrating that a UWF photograph can be used to grade ETDRS severity level with a better visualization than the standard 7-fields images.Trial registrationApproved by the AIBILI - Association for Innovation and Biomedical Research on Light and Image Ethics Committee for Health with number CEC/009/17- EYEMARKER.

Update on Palmar Fasciitis and Polyarthritis Syndrome: A systematic review

ObjectivesThis systematic review aims to (1) summarize the clinical, laboratory, and imaging characteristics of Palmar Fasciitis and Polyarthritis Syndrome (PFPAS) patients and (2) evaluate the effectiveness of different treatments. MethodsWe conducted a systematic search of three electronic databases (Scopus, Embase, and PubMed) from inception to December 31, 2023. We presented demographic and clinical features, along with laboratory factors and imaging examinations of PFPAS patients. Additionally, we outline main treatments and evaluate therapeutic effectiveness. ResultsA total of 121 patients were included in the analysis, with a mean onset age of 61.4 years. Swelling or thickening (49.6%, n=60/121) and pain (41.3%, n=50/121) were characteristic musculoskeletal symptoms of the hands. The median time between onset of PFPAS symptoms and detection of malignancy was 4 months, with a median survival of 13.0 months (range=2 to 69). The abnormal rate of ultrasound, magnetic resonance imaging, and bone scan of the musculoskeletal system was more than 80%. Effective therapeutic responses were observed in 66.0% (n=33/50) of cases treated with chemotherapies and 79.2% (n=19/24) with operations. Two patients who received biologics achieved partial remission. ConclusionPFPAS is a rare paraneoplastic condition, and early recognition of its distinctive symptoms may lead to the detection of underlying malignancy and timely treatments, potentially saving lives.

Differentiating Definite and Probable Ménière Disease: A Comprehensive Evaluation of Audio-Vestibular Function Testing Combined with Inner Ear MRI.

To evaluate the differences between audio-vestibular function testing and inner ear gadolinium magnetic resonance imaging (MRI) in distinguishing definite Ménière disease (DMD) and probable Ménière disease (PMD), and to provide a reference for early clinical diagnosis and intervention. A total of 116 patients diagnosed with DMD (n = 80) and PMD (n = 36) were enrolled. The differences in the results of pure tone audiometry, caloric test, and tympanic injection of gadolinium for contrast-enhanced MRI between the two groups were compared and analyzed. Parameters that could differentiate between the two conditions were identified, and the sensitivity and specificity and the area under the curve (AUC) of individual and combined indices in the differential diagnosis of DMD and PMD were evaluated. The hearing threshold and hearing asymmetry rate of the DMD group were significantly higher than those of the PMD group (p < 0.001), 98.8% and 30.6%, respectively. The abnormal rates of canal paresis (CP) and severity of endolymphatic hydrops in the DMD group were higher than those in the PMD group (p < 0.05). When combined with high-frequency hearing thresholds, hearing asymmetry, hearing curve type, endolymphatic hydrops, and abnormal CP, the diagnostic accuracy of DMD was improved compared to using high-frequency alone (p < 0.05). This study showed that PMD and DMD may represent two different stages in the development of MD disease. The comprehensive assessment of audio-vestibular function testing and inner ear MRI proves beneficial for early diagnosis, potentially contributing to the preservation of inner ear function.

Performance evaluation of noninvasive prenatal testing on 24 chromosomes in a cohort of 118,969 pregnant women in Sichuan, China.

This study aimed to comprehensively analyze the detection capacity of non-invasive prenatal testing (NIPT) for chromosomal abnormalities of all 24 chromosomes, as well as high-risk indications for pregnancy and the fetal fraction, in a large cohort. We retrospectively enrolled 118,969 pregnant women who underwent NIPT at Sichuan Provincial Maternity and Child Health Care Hospital from March 2019 to June 2022. The sensitivity, specificity, positive predictive value, negative predictive value, and positive chromosomal abnormality rate were calculated. The fetal fraction based on gestational age, maternal body mass index, and number was examined. NIPT demonstrated > 99% sensitivity and specificity for almost all of the common trisomies (T21, T18, and T13), sex chromosomal aneuploidies, rare autosomal trisomies, and microdeletion/microduplication syndromes. Positive predictive values varied from 12.0% to 89.6%. Advanced maternal age was associated with an increased risk of three major aneuploidies. The fetal fraction was positively correlated with gestational age and negatively correlated with the maternal body mass index. NIPT can be used to effectively screen for chromosomal abnormalities across all 24 chromosomes. Advanced maternal age is a risk factor for high-risk pregnancy, and careful consideration of the fetal fraction is essential during NIPT.

Role of minimal F-wave latency in the electrodiagnosis of polyneuropathy

Background and objective: Polyneuropathy is a debilitating condition that causes damage to more than two peripheral nerves in the body. The objective of this research was to detect the role of minimal F-wave latency as compared with other nerve conduction parameters for the electro-diagnosis of polyneuropathies. Methods: In this descriptive, prospective cross-sectional study, 80 consecutive patients with clinical diagnosis of polyneuropathy (both acute and chronic) between July and December 2023, presenting to the Neurology Department at King Edward Medical University were enrolled. Patients with clinical diagnosis of cervical/lumbar radiculopathies, plexopathies, compressive myelopathy , neuromuscular junction diseases, motor neuron disorders, or localized neuropathies were excluded from this research. NCS and EMG were carried out using conventional procedure. The results were recorded in the predesigned pro forma along with the history and demographic information. Statistical software SPSS 25.0 was used for the analysis of the recorded data. Results: F-wave abnormality was detected in 57 (71.3%) for median nerve, 57 (71.3%) for ulnar nerve, 79 (98.7%) for tibial nerve and in 79 (98.7%) patients for peroneal nerve. Nerve-specific motor nerve conduction study (MNCS) abnormality was found in 47 (58.8%) for median nerve, 43/80 (53.8%) for ulnar nerve, 59 (73.7%) for tibial nerve and in 57(71.3%) patients for peroneal nerve. Nerve-specific sensory nerve conduction study (SNCS) abnormality was present in 43 (53.3%) for median nerve, 43 (53.3%) for ulnar nerve, 50 (62.5%) for sural nerve, and in 49 (61.3%) patients for superficial peroneal nerve. Overall rate of abnormality was 85% for F-wave minimal latencies in comparison with 64% for MNCS and 56% for SNCS. Conclusion: Minimal F-wave latency can be an effective diagnostic parameter for detection of polyneuropathy. This can facilitate in early detection and management of polyneuropathy.

Self-management Behaviours among Nurses and Midwives during Pregnancy and Associated Factors: A Cross-sectional Study

The high rate of perinatal abnormality among pregnant nurses and midwives attributable to their working environment is a serious international occupational health concern. Self-management behaviours can prevent abnormalities, but nurses and midwives have difficulty carrying out these behaviours during pregnancy. This cross-sectional study aimed to examine self-management behaviours and associated factors during pregnancy among nurses and midwives. The partic­ipants were 232 pregnant or postpartum registered nurses and midwives from four Japanese general hospitals. Participant recruitment and questionnaire distribution were undertaken through hospital management. Data were collected from July to November 2022. Instruments included the Personal Demographic and Obstetric Conditions Questionnaire, the Self-Management Behaviours Questionnaire, the Working Conditions during Pregnancy Questionnaire, the Social and Workplace Support Scale, the Sense of Coherence Scale, and Self-Management Difficulties Scale. Data analysis used univariate and multiple classification analysis. Results indicated that participants demonstrated good compliance with contraindications among self-management behaviours but scored lower in knowledge and self-monitoring, abnormalities prevention, and avoiding burden movements. Multiple classification analyses revealed that parity, profession, overtime, acquisition of maternity protection provisions, managers support, family support, and prioritising the foetus were significantly associated with self-management behaviors. Nursing administrators must provide adequate information and adjust the work of pregnant staff. Policymakers need to propose measures to reinforce maternity protection provisions for pregnant nurses and midwives. Pregnant nurses and midwives need to be proactively educated on occupational health and safety. Learning the importance of acquiring maternity protection provisions, receiving support and prioritising the foetus will contribute to effective self-management practices in them. Further research is needed to promote self-management behaviours among pregnant nurses and midwives.

In Silico Approach to Model Heat Distribution of Magnetic Hyperthermia in the Tumoral and Healthy Vascular Network Using Tumor-on-a-Chip to Evaluate Effective Therapy.

Glioblastoma multiforme (GBM) is the most severe form of brain cancer in adults, characterized by its complex vascular network that contributes to resistance to conventional therapies. Thermal therapies, such as magnetic hyperthermia (MHT), emerge as promising alternatives, using heat to selectively target tumor cells while minimizing damage to healthy tissues. The organ-on-a-chip can replicate this complex vascular network of GBM, allowing for detailed investigations of heat dissipation in MHT, while computational simulations refine treatment parameters. In this in silico study, tumor-on-a-chip models were used to optimize MHT therapy by comparing heat dissipation in normal and abnormal vascular networks, considering geometries, flow rates, and concentrations of magnetic nanoparticles (MNPs). In the high vascular complexity model, the maximum velocity was 19 times lower than in the normal vasculature model and 4 times lower than in the low-complexity tumor model, highlighting the influence of vascular complexity on velocity and temperature distribution. The MHT simulation showed greater heat intensity in the central region, with a flow rate of 1 µL/min and 0.5 mg/mL of MNPs being the best conditions to achieve the therapeutic temperature. The complex vasculature model had the lowest heat dissipation, reaching 44.15 °C, compared to 42.01 °C in the low-complexity model and 37.80 °C in the normal model. These results show that greater vascular complexity improves heat retention, making it essential to consider this heterogeneity to optimize MHT treatment. Therefore, for an efficient MHT process, it is necessary to simulate ideal blood flow and MNP conditions to ensure heat retention at the tumor site, considering its irregular vascularization and heat dissipation for effective destruction.

Ischemic stroke associated with amyloid-related imaging abnormalities in a patient treated with lecanemab.

Anti-amyloid antibody therapies such as lecanemab are increasingly being used to treat Alzheimer's disease (AD). These therapies are associated with a high rate of amyloid-related imaging abnormalities (ARIA). We review the case history of a patient who developed ARIA associated with lecanemab treatment. In addition to microhemorrhages and cerebral edema that are recognized features of ARIA, the patient developed several ischemic strokes. The patient also experienced frequent electrographic seizures without overt clinical seizures. The patient demonstrated clinical and radiographic improvement after steroid treatment. Our case suggests that ischemic strokes may be a feature of ARIA and highlights the importance of having a high clinical suspicion for seizures in ARIA. As anti-amyloid therapies are likely going to be increasingly used to treat AD, it is important to appreciate the spectrum of clinical and radiographic findings that can result as side effects from this class of therapies. We report a patient who developed severe amyloid-related imaging abnormalities (ARIA) after treatment with lecanemab. Our report suggests that ischemic strokes may be a novel imaging feature of ARIA. Our report highlights the need for high clinical suspicion for seizures in ARIA.

Acute indomethacin exposure impairs cardiac development by affecting cardiac muscle contraction and inducing myocardial apoptosis in zebrafish (Danio rerio)

The accumulation of the active pharmaceutical chemical in the environment usually results in environmental pollution to increase the risk to human health. Indomethacin is a non-steroidal anti-inflammatory drug that potentially causes systemic and developmental toxicity in various tissues. However, there have been few studies for its potential effects on cardiac development. In this study, we systematically determined the cardiotoxicity of acute indomethacin exposure in zebrafish at different concentrations with morphological, histological, and molecular levels. Specifically, the malformation and dysfunction of cardiac development, including pericardial oedema, abnormal heart rate, the larger distance between the venous sinus and bulbus arteriosus (SV-BA), enlargement of the pericardial area, and aberrant motor capability, were determined after indomethacin exposure. In addition, further investigation indicated that indomethacin exposure results in myocardial apoptosis in a dose-dependent manner in zebrafish at early developmental stage. Mechanistically, our results revealed that indomethacin exposure mainly regulates key cardiac development-related genes, especially genes related to the cardiac muscle contraction-related signaling pathway, in zebrafish embryos. Thus, our findings suggested that acute indomethacin exposure might cause cardiotoxicity by disturbing the cardiac muscle contraction-related signaling pathway and inducing myocardial apoptosis in zebrafish embryos.

Effect of resveratrol on spermatogenesis in breeding boars and the proteomic analysis for testes

Effect of resveratrol (RSV) on spermatogenesis and the mechanism of resveratrol in promoting spermatogenesis of breeding boars was explored by feeding sexually mature Duroc boars with normal diet and 20 mg/kg resveratrol diet for 14 days to the control group and experimental group, respectively. Semen volume, sperm density, motility, viability and abnormality rate were analyzed on day 0, 7, and 14. Blood samples were collected, and levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone (T) in serum were analyzed. On day 14, the testis tissue was collected for antioxidant and proteomics analysis etc. The semen volume, sperm density, motility, and viability of the experimental group and the contents of serum FSH, LH, T and plasma SOD activity were significantly higher than those in the control group. However, the serum IL-6, TNF-α and plasma MDA were remarkably lower in experimental group. The above results showed that resveratrol can simulate spermatogenesis in breeding boars. Proteomic results demonstrated that three differentially expressed proteins (DEPs) were up-regulated and 12 DEPs were down-regulated; ODF1, calmodulin, Cabs1, and Hp were involved in spermatogenesis; and the main enriched metabolic pathway is steroid hormone synthesis pathway. Therefore, the improvement in sperm quality by resveratrol may be achieved by regulating the changes in outer dense fiber 1, calmodulin, spermatid specific 1, and haptoglobin expression and steroid synthesis pathway.

Evaluation of myocardial work and exercise capacity in patients recovered from the severe form of COVID-19

BackgroundThe impact of COVID-19 goes beyond its acute form and can lead to the persistence of symptoms and the emergence of systemic disorders, defined as long-term COVID. MethodsWe performed a cross-sectional study that included patients over 18 years of age who recovered from the severe form of COVID-19 at least 60 days after their discharge. Patients and controls were enrolled to undergo transthoracic echocardiography (TTE) using a more sensitive tool, myocardial work, in combination with cardiopulmonary exercise testing (CPET). ResultsA total of 52 patients and 31 controls were enrolled. Significant differences were observed in ejection fraction (LVEF; 62 ± 7 vs. 66 ± 6 %; p = 0.007), global longitudinal strain (LVGLS; −18.7 ± 2.6 vs. −20.4 ± 1.4 %; p = 0.001), myocardial wasted work (GWW; 152 ± 81 vs. 101 ± 54 mmHg; p = 0.003), and myocardial work efficiency (GWE; 93 ± 3 vs. 95 ± 2 %; p = 0.002). We found a significant difference in peak VO2 (24.4 ± 5.4 vs. 33.4 ± 8.8 mL/kg/min; p < 0.001), heart rate (160 ± 14 vs. 176 ± 11 bpm; p < 0.001), ventilation (84.6 ± 22.6 vs. 104.9 ± 27.0 L/min; p < 0.001), OUES% (89 ± 16 vs. 102 ± 22 %; p = 0.002), T ½ (120.3 ± 32 vs. 97.6 ± 27 s; p = 0.002) and HRR at 2 min (−36 ± 11 vs. −43 ± 13 bpm; p = 0.010). ConclusionOur findings revealed an increased wasted work, with lower myocardial efficiency, significantly reduced aerobic exercise capacity, and abnormal heart rate response during recovery, which may be related to previously described late symptoms. The reduction in functional capacity during physical exercise is partly associated with a decrease in resting myocardial work efficiency. These findings strongly indicate the need to determine whether these manifestations persist in the long term and their impact on cardiovascular health and quality of life in COVID-19 survivors.

Amplitude-integrated electroencephalography monitoring results of hospitalized neonates in plateau areas

To investigate the amplitude-integrated electroencephalography (aEEG) monitoring results of hospitalized neonates in plateau areas. A retrospective analysis was conducted on 5 945 neonates who were admitted to the Department of Neonatology, Kunming Children's Hospital, and received aEEG monitoring from January 2020 to December 2022. According to the aEEG monitoring results, they were divided into a normal aEEG group and an abnormal aEEG group. The incidence rate of aEEG abnormalities was analyzed in neonates with various systemic diseases, as well as the manifestations of aEEG abnormalities and the consistency between aEEG abnormalities and clinical abnormalities. Among the 5 945 neonates, the aEEG abnormality rate was 19.28% (1 146/5 945), with an abnormality rate of 29.58% (906/3 063) in critically ill neonates and 8.33% (240/2 882) in non-critically ill neonates (P<0.05). The children with inherited metabolic diseases showed the highest aEEG abnormality rate of 60.77% (79/130), followed by those with central nervous system disorders [42.22% (76/180)] and preterm infants [35.53% (108/304)]. Compared with the normal aEEG group, the abnormal aEEG group had significantly lower age and gestational age, as well as a significantly lower birth weight of preterm infants (P<0.05). Among the 1 146 neonates with aEEG abnormalities, the main types of aEEG abnormalities were sleep cycle disorders in 597 neonates (52.09%), background activity abnormalities in 294 neonates (25.65%), and epileptiform activity in 255 neonates (22.25%), and there were 902 neonates (78.71%) with abnormal clinical manifestations. The sensitivity and specificity of aEEG monitoring for brain function abnormalities were 33.51% and 92.50%, respectively. In plateau areas, there is a relatively high rate of aEEG abnormalities among hospitalized neonates, particularly in critically ill neonates and those with smaller gestational ages and younger ages, suggesting a high risk of brain injury. Therefore, routine aEEG monitoring for the hospitalized neonates can help with the early detection of brain function abnormalities, the decision-making in treatment, and the formulation of brain protection strategies.

Efficacy of therapeutic hypothermia on mild neonatal hypoxic-ischemic encephalopathy: a prospective randomized controlled study

To investigate the efficacy of therapeutic hypothermia on mild neonatal hypoxic-ischemic encephalopathy (HIE). A prospective study was performed on 153 neonates with mild HIE who were born from September 2019 to September 2023. These neonates were randomly divided into two groups: therapeutic hypothermia (n=77) and non-therapeutic hypothermia group (n=76). The short-term clinical efficacy of the two groups were compared. Barkovich scoring system was used to analyze the severity of brain injury shown on magnetic resonance imaging (MRI) between the two groups. There were no significant differences in gestational age, gender, birth weight, mode of birth, and Apgar score between the therapeutic hypothermia and non-therapeutic hypothermia groups (P>0.05). There were no significant differences in the incidence rates of sepsis, arrhythmia, persistent pulmonary hypertension and pulmonary hemorrhage and the duration of mechanical ventilation within the first 72 hours after birth between the two groups. The therapeutic hypothermia group had longer prothrombin time within the first 72 hours after birth and a longer hospital stay (P<0.05). Compared with the non-therapeutic hypothermia group, the therapeutic hypothermia group had lower incidence rates of MRI abnormalities (30% vs 57%), moderate to severe brain injury on MRI (5% vs 28%), and watershed injury (27% vs 51%) (P<0.05), as well as lower medium watershed injury score (0 vs 1) (P<0.05). Therapeutic hypothermia can reduce the incidence rates of MRI abnormalities and watershed injury, without obvious adverse effects, in neonates with mild HIE, suggesting that therapeutic hypothermia may be beneficial in neuroprotection in these neonates.

Genomic insights into prenatal diagnosis of congenital heart defects: value of CNV-seq and WES in clinical practice.

This study aimed to assess the efficiency of CNV-seq and WES in detecting genetic cause of congenital heart disease (CHDs) in prenatal diagnoses and to compare CNV detection rate between isolated and non-isolated CHD cases. We conducted a retrospective study of 118 Chinese fetuses diagnosed with CHD by prenatal ultrasound. Participants underwent CNV-seq and, if necessary, WES to detect chromosomal and single nucleotide variations. The overall detection rate for pathogenic or likely pathogenic chromosomal abnormalities was 16.9%, including 7.6% aneuploidies and 9.3% pathogenic/likely pathogenic copy number variations (CNVs), predominantly 22q11.2 deletion syndrome (54.4%). The sensitivity and specificity of CNV-Seq for detecting P/Lp CNVs were 95% and 100%, respectively. CNV-Seq offered a 6.7% improvement in detecting chromosomal abnormalities over karyotyping. WES further identified significant single nucleotide and small indel variations contributing to CHD in genes such as TMEM67, PLD1, ANKRD11, and PNKP, enhancing diagnostic yield by 14.8% in cases negative for CNVs. Non-isolated CHD cases exhibited higher rates of detectable chromosomal abnormalities compared to isolated cases (32.4% vs. 9.9%, p = 0.005), underlining the genetic complexity of these conditions. The combined use of CNV-seq and WES provides a comprehensive approach to prenatal genetic testing for CHDs, unveiling significant genetic cause that could impact clinical management and parental decision-making. This study supports the integration of these advanced genomic technologies in routine prenatal diagnostics to increase detection diagnostic yields of causal genetic variants associated with CHDs.

Is galvanic VEMP a prediction of the nerve origin and damage in patients of vestibular schwannoma

Background Recent studies proved that certain proportions of vestibular schwannoma (VS) originated other than vestibular nerve of the eighth cranial nerve. Aims/objectives Unlike air-conducted sounds (ACS) and bone-conducted vibration (BCV), galvanic vestibular stimulation (GVS) evokes vestibular evoked myogenic potentials (VEMPs) from the vestibular nerve. Materials and methods Case-control study was conducted in unilateral VS patients pre-operatively. Healthy ears were controls. Patients examined ACS, BCV and GVS ocular VEMP (oVEMP) and cervical VEMP (cVEMP), caloric test, video head impulse test (vHIT), suppression head impulse paradigm (SHIMP) and pure tone audiometry (PTA). Results Seven (26.9%) tumors affected left ear and 19 (73.1%) on the right(p < .05). Response rates in VS group were statistically lower than control except for ACS-cVEMP (p < .05). Response rates of VEMPs in VS patients decreased with the tumor size grows. But not all BCV and GVS VEMPs disappeared in the largest tumor group. Abnormal rates of caloric test, vHIT gains and SHIMP were found. Conclusions and significance Response rates of GVS VEMPs decreased with the residual functional nerve fibers. GVS VEMPs help to differentiating labyrinthine and retro-labyrinthine lesions. GVS combined with BCV VEMPs probably reflex the tumor origin from the eighth cranial nerve and/or the remaining vestibular function.