Score Analysis Research Articles

Haemodynamic Assessment and Outcomes of Aortic Valvuloplasty for Aortic Regurgitation in Patients with Bicuspid Aortic Valve

Background: Aortic valvuloplasty for bicuspid aortic valve carries a risk of postoperative stenosis. We evaluated the haemodynamic differences between aortic valvuloplasty for bicuspid aortic valve, tricuspid aortic valve, and aortic valve replacement by echocardiography. We also assessed whether a higher postoperative pressure gradient affects the outcomes of aortic valvuloplasty for bicuspid aortic valve. Methods: From 2014 to 2021, patients undergoing aortic valvuloplasty were classified into aortic valvuloplasty for bicuspid aortic valve (Group-PB) and aortic valvuloplasty for tricuspid aortic valve (Group-PT). We also enrolled patients undergoing aortic valve replacement (Group-R) between 2002 and 2021. Mid-term outcomes were compared within Group-PB based on peak pressure gradients of ≥20 mmHg (subgroup-H) and <20 mmHg (subgroup-L). Results: Group-PB included 42 patients and Group-PT included 70 patients. Both 7-day and 1-year echocardiography showed the highest peak/mean pressure gradients in Group-PB (n = 41) and the lowest values in Group-PT (n = 67). Propensity scoring analysis yielded similar results to an unadjusted analysis. The mid-term outcomes were not significantly different between subgroup-H (n = 20) and subgroup-L (n = 22), with rates of freedom from aortic regurgitation >II at 5 years of 94.4% vs. 94.4% (p = 0.749) and freedom from reoperation of 94.4% vs. 100.0% (p = 0.317), respectively. Conclusions: Aortic valvuloplasty for tricuspid aortic valve shows favourable valve function in the early postoperative period, whereas aortic valvuloplasty for bicuspid aortic valve has a risk of postoperative stenosis. However, a high pressure gradient (peak pressure gradient of ≥20 mmHg) after aortic valvuloplasty for bicuspid aortic valve does not impact mid-term outcomes.

The Academic Achievement of Undergraduate Students with Different TOEFL iBT Score Profiles: A Replication Study

ABSTRACT This replication study sought to compare the academic achievement of undergraduate students with different score profiles on the TOEFL iBT. Two-step cluster analysis of TOEFL iBT section scores identified six clusters among 2,347 undergraduate students who met the required cutscore on the TOEFL iBT for admission to a Canadian English-medium university but had different scores on different sections of the test. The largest cluster, comprising one-third of the students, had high scores on all sections of the test. The second largest cluster had lower scores on writing compared to other sections. The six clusters differed in terms of their demographic characteristics and academic achievement. Students with higher listening and reading scores or higher reading and writing scores and lower scores on other sections tended to have comparatively lower academic achievement. This trend was especially noticeable when contrasted with students with high scores on all sections of the test. However, cluster effects were moderated by study major. Finally, the strength and direction of the correlations between TOEFL iBT total scores and academic achievement varied across clusters. The findings suggest that universities should tailor admission criteria and English language support to meet the diverse linguistic needs of students with varying proficiency profiles pursuing different study majors.

Predicting independent walking ability using the Simplified Stroke Rehabilitation Assessment of Movement, Berg Balance Scale, and Barthel Index for Activities of Daily Living in individuals post-stroke: an observational preliminary study

IntroductionThe purpose of this study was to determine cut scores to predict independent ambulation for the Simplified Stroke Rehabilitation Assessment of Movement (S-STREAM), Berg Balance Scale (BBS), Barthel Index (BI) for Activities of Daily Living for patients with time after stroke up to 1 year. The study’s second goal was to establish statistical dependence between the tests the S-STREAM, BBS, BI, and the Functional Ambulation Category (FAC).MethodsCohort observational retrospective pilot study by design. Twenty-four people who suffered a stroke within the past year were enrolled in the study. The FAC was used to classify patients into independent walking and non-walking groups (scores 0–2 are non-walking patients, scores 4–5 are independent walking patients). Receiver operating characteristic (ROC) curve analysis was performed for the S-STREAM, BBS, BI selected according to the multiple logistic regression analysis with dichotomy on groups independent walking patients and not.ResultsROC analysis of scores at admission were used to determine cut scores for the independent waking ability for each of the listed measures. The cut score for S-STREAM was 19 points, for BBS was 27 points and for BI was 65 points. Based on this analysis it appears there is sufficient evidence to conclude a significant linear relationship between all tests the S-STREAM, BBS, BI, and FAC.ConclusionsIn patients who were ambulators, less than one year post stroke, this pilot study established a cut score for standardized assessment tools S-STREAM, BBS, BI for Activities of Daily Living.

Five-year oncological outcomes after enhanced recovery after surgery (ERAS) compared to conventional care for colorectal cancer: a retrospective cohort of 981 patients.

The enhanced recovery after surgery (ERAS) protocol has been introduced over the past three decades for patients undergoing colorectal surgery. However, the effect of this program on long-term survival is poorly studied. We evaluated the effect of ERAS on 5-year overall survival (OS) and recurrence-free survival (RFS) after colorectal cancer surgery, and identified risk factors. This retrospective study used data from the comparison of oncological outcomes at 3years after ERAS or conventional care (pre-ERAS), conducted in our department between 2005 and 2017, and published in 2022. A total of 981 patients were included (ERAS, n = 486; pre-ERAS, n = 495). The 5-year OS and RFS rates were similar in the ERAS and pre-ERAS groups, respectively (63.3% [58.9;67.4] vs 57.7% [53.2;61.9]; p = 0.055) and (69.5% [65.2;73.4] vs 70.9% [66.6;74.8]; p = 0.365). The 5-year OS result was confirmed by a propensity score analysis (HR0.98 [0.71; 1.37], p = 0.911). Analysis of 5-year survival by a multivariate Cox model identified age (HR1.28 [1.15; 1.43]), BMI < 18.5 (HR1.62 [1.08;2.45]), smoking (HR1.68 [1.26;2.24]), ASA score > 2 (HR1.56 [1.22;1.98]), and laparotomy interventions (HR2.06 [1.61;2.63]) as risk factors for death. Regarding RFS, multivariate analysis adjusted on the ERAS group identified age as a protective factor with a reduction of 10% in the risk of recurrence (HR0.90 [0.81-0.99]). In contrast patients treated with neoadjuvant chemotherapy had a higher risk of recurrence (HR1.41 [1.07-1.85]). This study failed to demonstrate any advantage of the ERAS program in improving 5-year OS and RFS after colorectal cancer surgery. Age, undernutrition, smoking, ASA score > 2, and laparotomy interventions are independently associated with early mortality.

Feature Engineering for the Prediction of Scoliosis in 5q-Spinal Muscular Atrophy.

5q-Spinal muscular atrophy (SMA) is now one of the 5% treatable rare diseases worldwide. As disease-modifying therapies alter disease progression and patient phenotypes, paediatricians and consulting disciplines face new unknowns in their treatment decisions. Conclusions made from historical patient data sets are now mostly limited, and new approaches are needed to ensure our continued best standard-of-care practices for this exceptional patient group. Here, we present a data-driven machine learning approach to a rare disease data set to predict spinal muscular atrophy (SMA)-associated scoliosis. We collected data from 84 genetically confirmed 5q-SMA patients who have received novel SMA therapies. We performed expert domain knowledge-directed feature engineering, correlation and predictive power score (PPS) analyses for feature selection. To test the predictive performance of the selected features, we trained a Random Forest Classifier and evaluated model performance using standard metrics. The SMA data set consisted of 1304 visits and over 360 variables. We performed feature engineering for variables related to 'interventions', 'devices', 'orthosis', 'ventilation', 'muscle contractures' and 'motor milestones'. Through correlation and PPS analysis paired with expert domain knowledge feature selection, we identified relevant features for scoliosis prediction in SMA that included disease progression markers: Hammersmith Functional Motor Scale Expanded 'HFMSE' (PPS = 0.27) and 6-Minute Walk Test '6MWT' scores (PPS = 0.44), 'age' (PPS = 0.41) and 'weight' (PPS = 0.49), 'contractures' (PPS = 0.17), the use of 'assistive devices' (PPS = 0.39, 'ventilation' (PPS = 0.16) and the presence of 'gastric tubes' (PPS = 0.35) in SMA patients. These features were validated using expert domain knowledge and used to train a Random Forest Classifier with an observed accuracy of 0.82 and an average receiver operating characteristic (ROC) area of 0.87. The introduction of disease-modifying SMA therapies, followed by the implementation of SMA in newborn screenings, has presented physicians with never-seen patients. We used feature engineering tools to overcome one of the main challenges when using data-driven approaches in rare disease data sets. Through predictive modelling of this data, we defined disease progression markers, which are easily assessed during patient visits and can help anticipate scoliosis onset. This highlights the importance of progressive features in the drug-induced revolution of this rare disease and further supports the ongoing efforts to update the SMA classification. We advocate for the consistent documentation of relevant progression markers, which will serve as a basis for data-driven models that physicians can use to update their best standard-of-care practices.

Mastering the Sequential Organ Failure Assessment Score: Critical Choices of Score Statistic, Timing, Imputations, and Competing Risk Handling in Major Trials-A Systematic Review.

The Sequential Organ Failure Assessment (SOFA) score originated as a tool for assessing organ dysfunction in critical illness but has expanded to become an outcome measure in clinical trials. We aimed to assess how the SOFA score was used as the primary or secondary endpoint of major randomized controlled trials (RCTs). Independent reviewers searched MEDLINE/PubMed, Scopus, and Embase databases. Articles were selected when they fulfilled: 1) RCT; 2) SOFA score was primary or secondary endpoint; and 3) published in the Lancet, New England Journal of Medicine, or Journal of the American Medical Association. Data collection included study details, outcomes, statistical differences in SOFA score, choice of score statistics, timepoints of SOFA reporting, and how missing data and competing risks analysis were managed. Twenty-three RCTs had SOFA score as outcome measure, eight used it as primary endpoint. Daily maximum SOFA was the key statistic in 11 RCTs, delta SOFA was used in eight, and mean SOFA in four. Mean SOFA was most frequently chosen as primary endpoint (4/8, 50%). There were 18 different outcome assessment timepoints, ranging from 1 to 28 days. Three RCTs reported statistically significant difference in SOFA between groups. Handling of missing SOFA scores was not described in ten of 23 RCTs. When described, it varied from study to study with variable imputation methods and variable accounting for the competing risk of mortality and ICU discharge. There is major variability in the choice of summary statistic for SOFA score analysis and assessment timepoints, when using it as outcome measure in RCTs. There was either no information or great variability in the handling of missing values, use of imputation, and accounting for competing risk. The current use of SOFA scores in RCTs lacks sufficient reproducibility and statistical and methodological robustness.

Are large language models qualified reviewers in originality evaluation?

Large language models (LLMs) are a new generation of conversational language model with impressive semantic comprehension, text generation, and knowledge inference capabilities. LLMs are significantly influencing the development of science by assisting researchers in analyzing, understanding, and grasping original knowledge in scientific papers. This study investigates LLMs’ potential as qualified reviewers in originality evaluation in zero-shot learning, utilizing a unique, manually crafted prompt. Using biomedical papers as the data source, we constructed two evaluation datasets based on Nobel Prize papers and disruptive index. The evaluation performance of multiple LLMs of different types and scales on the datasets was scrutinized through the analysis of originality score (OS), originality type (OT), and originality description (OD), all of which were generated by the LLM. Our results show that LLMs can to some extent discern papers with distinct originality level via OS; however, they appear to be overly lenient reviewers. In LLMs’ evaluation mechanism, five distinct OTs reflecting varied research contributions do not manifest independently, but together they positively influence OS. Of all the LLMs analyzed, GPT-4 stood out as able to produce the most readable ODs, effectively explaining the inference process for both OS and OT from the perspectives of completeness, logicality, and regularity.

Imaging-genomic spatial-modality attentive fusion for studying neuropsychiatric disorders.

Multimodal learning has emerged as a powerful technique that leverages diverse data sources to enhance learning and decision-making processes. Adapting this approach to analyzing data collected from different biological domains is intuitive, especially for studying neuropsychiatric disorders. A complex neuropsychiatric disorder like schizophrenia (SZ) can affect multiple aspects of the brain and biologies. These biological sources each present distinct yet correlated expressions of subjects' underlying physiological processes. Joint learning from these data sources can improve our understanding of the disorder. However, combining these biological sources is challenging for several reasons: (i) observations are domain specific, leading to data being represented in dissimilar subspaces, and (ii) fused data are often noisy and high-dimensional, making it challenging to identify relevant information. To address these challenges, we propose a multimodal artificial intelligence model with a novel fusion module inspired by a bottleneck attention module. We use deep neural networks to learn latent space representations of the input streams. Next, we introduce a two-dimensional (spatio-modality) attention module to regulate the intermediate fusion for SZ classification. We implement spatial attention via a dilated convolutional neural network that creates large receptive fields for extracting significant contextual patterns. The resulting joint learning framework maximizes complementarity allowing us to explore the correspondence among the modalities. We test our model on a multimodal imaging-genetic dataset and achieve an SZ prediction accuracy of 94.10% (p < .0001), outperforming state-of-the-art unimodal and multimodal models for the task. Moreover, the model provides inherent interpretability that helps identify concepts significant for the neural network's decision and explains the underlying physiopathology of the disorder. Results also show that functional connectivity among subcortical, sensorimotor, and cognitive control domains plays an important role in characterizing SZ. Analysis of the spatio-modality attention scores suggests that structural components like the supplementary motor area, caudate, and insula play a significant role in SZ. Biclustering the attention scores discover a multimodal cluster that includes genes CSMD1, ATK3, MOB4, and HSPE1, all of which have been identified as relevant to SZ. In summary, feature attribution appears to be especially useful for probing the transient and confined but decisive patterns of complex disorders, and it shows promise for extensive applicability in future studies.

Bactogram: Spatial Analysis of Bacterial Colonisation in Epidermal Wounds.

Skin barrier damage and subsequent development of harmful microbiota contribute to conditions such as wound infections, atopic dermatitis and chronic wounds, which impact millions of people globally and pose a significant economic burden on healthcare systems. Established microbial sampling methods, such as swabs and tissue biopsies, provide limited information on the spatial distribution of bacteria. We here describe a new method that produces a visual map of the distribution of cultivable bacteria, denoted 'Bactogram', across the whole wound and surrounding skin, suitable for image-based quantification. As part of an exploratory endpoint in a clinical trial we applied the Bactogram method to 48 suction blister wounds in 24 healthy volunteers. Bacteria developed in all wounds, predominantly on the skin under the dressing and near wound edges. Two quantification methods, based on visual scoring and image analysis, demonstrated high inter-, and intra-rater agreement and were used to characterise bacterial re-colonisation during epidermal wound healing. We also demonstrated proof of concept that the method can be used with chromogenic agar to enable spatial identification of pathogenic bacterial species, such as Staphylococcus aureus. In conclusion, this study introduces a simple method for sampling bacteria over large areas and generating a bacterial map that can identify spatial variations in bacterial composition and abundance in skin and wound conditions. Trial Registration: ClinicalTrials.gov identifier: NCT05378997.

Yohimbine treatment improves pulmonary fibrosis by attenuating the inflammation and oxidative stress via modulating the MAPK pathway

Idiopathic pulmonary fibrosis (IPF) is a devastating interstitial lung disorder characterized by the accumulation of extracellular matrix and collagen, resulting in significant parenchymal scarring and respiratory failure that leads to mortality. Yohimbine (YBH) is an α-2 adrenergic receptor antagonist with anti-oxidant and anti-inflammatory properties. In the current study, we aimed to investigate the anti-inflammatory, anti-oxidant and anti-fibrotic activity of YBH against LPS/TGF-β-induced differentiation in BEAS-2B/LL29 cells and bleomycin (BLMN) induced pulmonary fibrosis model in rats. Network pharmacology, gene expression, Western-blot analysis, immune-cytochemistry/immunohistochemistry, lung function and histology techniques were used to assess the fibrotic marker expression/levels in cells or rat lung tissues. YBH treatment significantly attenuated the LPS-induced pro-inflammatory (identified through a network-pharmacology approach) and oxidative stress markers expression in lung epithelial cells. TGF-β stimulation significantly elevated the fibrotic cascade of markers and treatment with YBH attenuated these markers’ expression/levels. Intra-tracheal administration of BLMN caused a significant elevation of various inflammatory/oxidative stress and fibrotic markers expression in lung tissues and treatment with YBH significantly mitigated the same. Ashcroft score analysis revealed that BLMN exhibited severe distortion of the lungs, elevation of thickness of the alveolar walls and accumulation of collagen in tissues, further treatment with YBH significantly suppressed these events and improved the lung architecture. Lung functional parameters demonstrated that BLMN-induced stiffness and resistance were reduced considerably upon YBH treatment and restored lung function dose-dependently. Overall, this study reveals that YBH treatment significantly attenuated the BLMN-induced fibrosis by regulating the MAPK pathway and provided insightful information for progressing towards translational outcomes.

Advancing Gene Discovery for Substance Use Disorders Using Additional Traits Related to Behavioral Disinhibition.

Substance use disorders (SUDs) frequently co-occur with each other and with other traits related to behavioral disinhibition, a spectrum of outcomes referred to as externalizing. Nevertheless, genome-wide association studies (GWAS) typically study individual SUDs separately. This single-disorder approach ignores genetic covariance between SUDs and other traits and may contribute to the relatively limited genetic discoveries to date. To identify the most effective model for capturing genetic relationships between SUDs and externalizing phenotypes, optimizing the detection of genetic influences on SUDs while maintaining specificity. We used Genomic SEM to estimate SNP effects on a broad factor representing liability to externalizing and SUDs, on factors representing liability to behavioral disinhibition and SUDs separately, and on residualized SUDs. Subsequent gene-based, tissue expression, and polygenic score (PGS) analyses were used to compare the ability of these alternative approaches to identify genetic influences on SUDs. This study was carried out from May 2023 - September 2024. We used GWAS summary statistics based on samples of European ancestry from previous studies of externalizing and SUD phenotypes in the main multivariate GWAS ( N > 2.2 million). We used two independent samples to estimate polygenic associations, a family-based sample enriched for substance use problems (COGA; N = 7,530) and a population-based sample representative of the United States, (All of Us; N = 77,442). N/A. Across the three factors (Externalizing; SUDs; Behavioral Disinhibition) and four residualized SUDs (alcohol, tobacco, opioid, and cannabis), we compared the number, putative function, previous associations of significant genomic risk loci and genes, and variance explained by polygenic scores in substance use outcomes. We identified genomic risk loci and genes uniquely associated with Externalizing that are relevant to the neurobiology of substance use. Genes identified for residual SUDs were involved in substance-specific processes (e.g., metabolism). The Externalizing PGS accounted for the most variance in substance outcomes relative to the PGS for the other factors and residual PGS appeared to capture substance specific signals. Our findings suggest that modeling both a broad genetic liability to externalizing behaviors and substance-specific liabilities enhances the detection of genetic effects related to SUDs and explains more variance in substance use outcomes. Question: Can we advance gene discovery for substance use disorders (SUDs) by incorporating information about correlated outcomes related to behavioral disinhibition?Findings: Combining genetic effects common to SUDs and behavioral disinhibition in a multivariate genome-wide association study of > 2.2 million individuals identified 708 genomic risk loci and accounted for more variance in SUD phenotypes compared with modeling each set of phenotypes separately.Meaning: SUDs and behavioral dysregulation are influenced by a common set of common variants; modeling their joint contributions improves power for genetic discovery and polygenic prediction.

Cognitive Diagnostic Assessment in Educational Testing: A Score Strategy-Based Evaluation

Cognitive diagnostic assessment (CDA) represents an innovative approach in educational testing, utilizing cognitive diagnosis models (CDMs) to uncover specific cognitive attributes that influence students' responses to assessment items. Unlike traditional assessments, CDA offers detailed, actionable insights into individual learning processes, enabling more targeted and personalized educational interventions. However, the implementation of CDA is still underexplored compared to other psychometric theories, especially in Malaysia. Therefore, this study seeks to describe the application of CDA in Malaysia through the SCORE analysis model method. The SCORE model of CDA is evaluated across five key elements: Strengths (S), Challenges (C), Options (O), Responses (R), and Effectiveness (E) by analyzing past literature sourced from reputable databases such as Google Scholar, SCOPUS, and Web of Science. The findings indicate that CDA offers strengths like granular feedback, enhanced validity, and data-driven decisions, but faces challenges in complex implementation and resource demands. Its effectiveness hinges on efficient implementation and appropriacy, while exploring opportunities, managing risks, and considering stakeholders' responses help optimize its transformational and commercial value. The findings provide educators with a framework for utilizing CDA to enhance instructional strategies and tailor interventions to meet individual student needs. For policymakers, the implications of the strengths, challenges, and opportunities of CDA emphasize the importance of supporting its implementation through professional development, infrastructure investment, and policy alignment. Future studies are recommended to explore the long-term impacts of CDA on student achievement and educational equity, scalability across educational levels, and development of user-friendly tools to enhance accessibility for educators.

Comparative Analysis of qSOFA, PRIEST, PAINT, and ISARIC4C Scores in Predicting Severe COVID-19 Outcomes Among Patients Aged over 75 Years

Comparative Analysis of qSOFA, PRIEST, PAINT, and ISARIC4C Scores in Predicting Severe COVID-19 Outcomes Among Patients Aged over 75 Years

Cross-sectional study: can endogenous procalcitonin differentiate between healthy and bovine respiratory disease-affected preweaned dairy calves?

Bovine respiratory disease (BRD) represents a significant challenge in cattle management due to its multifactorial nature and lack of a gold standard diagnostic method. Procalcitonin (PCT) has emerged as a potential biomarker for bacterial infections in various species, including cattle. This study aimed to investigate plasma PCT concentration variations in pre-weaned dairy calves categorized as BRD-positive using clinical scores (WRSC; BRD-positive ≥5), thoracic ultrasonography with two cut-off (TUS; BRD-positive ≥1 or ≥3), or a combination of both methods (WRSC/TUS1cm or WRSC/TUS3cm). Additionally, the accuracy of PCT in diagnosing BRD was evaluated. A cross-sectional study was conducted on a convenience sample of 226 pre-weaned Italian-Friesian female calves. Clinical scoring, TUS, and plasma PCT analysis were performed. Calves were categorized based on TUS findings, clinical scores, or a combination of both methods. Statistical analyses were conducted to assess the differences in PCT concentrations among different groups and to determine the diagnostic accuracy of PCT. Results showed a significant increase in PCT levels in calves with lung consolidation detected by TUS using a 1 cm cutoff. However, the diagnostic accuracy of PCT in discriminating BRD-positive cases was poor (area under the curve 0.62). The optimal cutoff value for PCT was determined to be 86.63 pg/mL, with sensitivity of 49.7%, specificity of 71.8%, positive predictive value of 79.4% and negative predictive value of 39.5%. In conclusion, while PCT showed potential as a biomarker for BRD, its diagnostic accuracy was limited in this study. Future research should focus on integrating PCT measurements with other diagnostic methods and conducting longitudinal cohort studies to better understand its role in BRD diagnosis and management.

Challenges to sustainable transport infrastructure integration in Johannesburg, South Africa

Purpose. This study assesses the challenges of incorporating sustainability into South Africa's transport infrastructure, focusing on Johannesburg. Methodology. A quantitative approach was employed, using closed-ended questionnaires distributed to professionals involved in road infrastructure delivery and construction in South Africa. Data were analyzed using Mean Item Score (MIS) and factor analysis. Results. Key challenges identified include lack of political commitment to sustainable transportation, insufficient investment in energy-efficient vehicles, and resource constraints. The study also highlighted the need to expand and modernize transport infrastructure to accommodate population growth and increased economic activities. Theoretical contribution. This research provides insights into the specific barriers to sustainable transport infrastructure development in an urban South African context. Practical implications. The findings underscore the importance of improved coordination among government entities, private sector participants, and communities to address challenges and achieve sustainable transport infrastructure development. Sustainable Development Goals (SDGs): SDG 11: Sustainable Cities and Communities; SDG 9: Industry, Innovation and Infrastructure; SDG 13: Climate Action; SDG 7: Affordable and Clean Energy; SDG 3: Good Health and Well-being

Efficacy of Nortriptyline-Topiramate and Verapamil-Paroxetine in Tinnitus Management: A Randomized Placebo-Controlled Trial.

To evaluate the efficacy of 2 drug combinations on tinnitus severity and associated stress, depression, sleep, and anxiety. A randomized, double-blind, placebo-controlled clinical trial conducted between 2019 and 2023 for an 8-week duration. Single institution tertiary care center. The study recruited adult patients with moderate to severe tinnitus for 6 months or more. In total, 81 patients were assessed for eligibility, 78 were enrolled and randomized, and 67 were included in the per-protocol analysis. Patients were randomized into 3 groups (1:1:1). Group NT received nortriptyline-topiramate, group VP received verapamil-paroxetine, and group P received placebo. A total of 19 patients in group NT, 22 in group VP, and 26 patients in group P were included in the per-protocol analysis. In group NT, the Tinnitus Functional Index (TFI) score decreased from 58.4 ± 13.9 (baseline) to 46.3 ± 17.5 (end-of-trial) (P < .001). Similarly, in group VP, the TFI score decreased from 54.6 ± 17.5 to 42.2 ± 16.1 (P = .004). However, group P did not demonstrate any significant decrease in the TFI score from 51.2 ± 18.6 to 45.2 ± 20.1 (P = .086). The between-arm analysis did not yield any statistical significance decrease in the TFI score (analysis of variance, P = .265). Both combinations of drugs were promising in improving tinnitus severity. However, larger-scale trials with longer follow-up periods are warranted to validate our findings between groups.

Gossypetin Alleviates DSS-induced Colitis by Regulating COX2 and ROS-JNK Signaling.

Inflammatory Bowel Disease (IBD) represents a chronic and recurrent inflammatory condition affecting the gastrointestinal tract, with a rising global incidence. Current treatment approaches include surgery and drugs. However, surgeries are invasive procedures, while drug treatments often present with various side effects. Gossypetin, a flavonoid found abundantly in plants such as hibiscus, exhibits anti-oxidant and anti-cancer properties. However, its potential impact on IBD remains unexplored. This study aimed to investigate the therapeutic potential of gossypetin on colitis. We employed the DSS-induced colitis model to evaluate the therapeutic potential of gossypetin on colitis. The efficacy of gossypetin was assessed within this model using the Disease Activity Index (DAI) score and histological analysis. Additionally, we utilized qRT-PCR to measure the levels of inflammatory cytokines and Superoxide Dismutase (SOD). Immunohistochemistry confirmed the expression of tight junction markers, COX-2, and phosphorylated JNK protein, normally associated with disease progression. Furthermore, Western blot analysis was conducted to examine the SOD levels and anti-apoptotic effects of gossypetin. In DSS-induced colitis mice, gossypetin treatment ameliorated weight loss and reduced colon length caused by DSS treatment. Additionally, gossypetin-treated groups exhibited DAI scores and reduced histological damage. Moreover, gossypetin treatment increased tight junction expression, decreased inflammatory responses, reduced ROS levels, attenuated JNK signaling, and decreased apoptosis. Gossypetin shows therapeutic potential for mitigating the symptoms and progression of colitis by targeting ROS-JNK signaling involved in inflammation and tissue damage. This highlights the potential of natural compounds such as gossypetin for targeted therapies with reduced side effects and improved efficacy.

HISTORICAL AND CULTURAL ASPECTS OF THE EVOLUTION OF TWO-PIANO MUSIC IN CHINA

Objective: This study aims to analyze the historical development and theoretical foundations of music for two pianos in China and to establish a periodization of its key stages. Special attention is devoted to the methodological issues related to performance techniques in this genre, as well as to the influence of Western musical traditions on the formation of Chinese two-piano music. The research seeks to identify the specific features of this genre as an important element of Chinese musical culture and to analyze its interaction with contemporary trends in musical art. Methodology: To achieve the research objectives, a historical-musicological approach has been applied, which allows for tracing the development of two-piano music in the context of cultural and social changes in China. A comparative method is also employed to analyze the interplay between Chinese and Western musical elements in two-piano compositions. The research is based on the analysis of musical scores, monographs, and academic works dedicated to Chinese musical traditions. Scientific novelty: For the first time, this study systematically examines the historical development of two-piano music in China, emphasizing the key stages of its formation and the influence of both national and Western musical traditions. It explores how Chinese composers have utilized this genre to express national identity, blending traditional Chinese elements with Western musical forms. Particular attention is given to analyzing the technical and performance innovations that have shaped the development of this genre in China. Conclusions: Music for two pianos in China reflects a unique synthesis of Chinese folk musical traditions and Western technical and harmonic approaches. It not only enriches the concert repertoire but also plays a significant role in shaping contemporary Chinese musical identity. Although this genre is still evolving, notable achievements in its development can already be observed, especially due to support from educational and performance initiatives. However, further expansion of the repertoire and improvement in performance standards require enhancing the system of musical education and actively incorporating new pedagogical approaches to two-piano ensemble training.

Hypoperfusion states could increase the risk of non-arteritic anterior ischemic optic neuropathy.

Non-arteritic anterior ischemic optic neuropathy (NAION) is a leading cause of acute optic nerve damage. While cardiovascular risk factors such as hypertension, diabetes mellitus, and obstructive sleep apnea are well-established, the association between NAION and states of hypoperfusion is underexplored. This study investigated this potential association. This retrospective case-control study analyzed all electronic medical records of Clalit Health Services' patients from 2001 to 2022. Patients diagnosed with NAION were matched in a 1:4 ratio by year of birth and sex, using propensity score analysis to adjust for various comorbidities. Events of hypoperfusion occurring in the month prior to the diagnosis of NAION were categorized into two physiological mechanisms: a decrease in SVR and a decrease in cardiac output due to cardiac dysfunction or diminished preload (attributed to hypovolemia). Conditional logistic regression was used to explore differences between the groups. A total of 1,374 patients diagnosed with NAION and 5,496 matched controls were included in the study. We found a nearly 6.5-fold increase in the likelihood of NAION in association with events of hypoperfusion that occurred in the month period preceding the diagnosis of NAION (odds ratio [OR] 6.48; 95% confidence interval [CI]: 5.05-8.32). In particular, the group of patients with cardiac dysfunction (OR 6.47; 95% CI: 4.63-9.04) and the group with hypovolemia (OR 6.1; 95% CI: 4.08-9.13) emerged as having the most substantial risk factors. The group with decreased Systemic Vascular Resistance (SVR) (OR 4.64; 95% CI: 2.84-7.59) was also strongly related with NAION. Cerebrovascular accident emerged as an independent significant risk factor for NAION (OR 16.1; 95% CI: 10.8-24). Hypoperfusion states are significant, independent risk factors for NAION.

INDEKS MASA TUBUH DENGAN KADAR GULA DARAH PADA PENDERITA DIABETES MELLITUS TIPE 2

High blood glucose levels are caused by insufficient insulin produced by the pancreas, causing hyperglycemia. The purpose of this study was to analyze the relationship between body mass index and blood sugar levels during type 2 diabetes mellitus. This type of research was correlational analysis with a cross-sectional approach. The population of this study was all type 2 diabetes mellitus patients at the Melati Elderly Posyandu, Mlaras Village, Sumobito as many as 54 respondents. The sample of this study was 48 respondents with type 2 diabetes mellitus at the Melati Elderly Posyandu, Mlaras Village, Sumobito using the Slovin formula. The sampling technique is simple random sampling. Body mass index variable data was collected by measuring body weight and height and calculated using the formula BMI = BB/TB2(m) while blood sugar levels were variable using a 5010 V5+ photometer. Data processing by editing, coding, scoring, tabulating and data analysis using the Pearson correlation statistical test with an error rate (alpha) of 0.05. Before the Pearson correlation test was carried out, the data normality test was carried out with the Kolmogorov-Smirnov test because it uses a ratio data scale. The results showed that the average body mass index was 19.18 with a standard deviation of 4.14 while the blood glucose level at the time was 197.25 with a standard deviation of 60.62. The data normality test is fulfilled. The results of the Pearson correlation test showed that the value of p = 0.025 was smaller than alpha 0.05, so H1 was accepted. The conclusion of this study is that there is a relationship between body mass index and blood glucose levels in patients with type 2 diabetes mellitus. It is hoped that health workers will always provide information related to risk factors for type 2 diabetes mellitus.