Average Duration Research Articles

Concordance between the In Vivo Content of Neurospecific Proteins (BDNF, NSE, VILIP-1, S100B) in the Hippocampus and Blood in Patients with Epilepsy.

The identification of reliable brain-specific biomarkers in periphery contributes to better understanding of normal neurophysiology and neuropsychiatric diseases. The neurospecific proteins BDNF, NSE, VILIP-1, and S100B play an important role in the pathogenesis of neuropsychiatric disorders, including epilepsy. This study aimed to assess the correspondence of the expression of BDNF, NSE, VILIP-1, and S100B in the blood (serum and peripheral blood mononuclear cells (PBMCs)) to the in vivo hippocampal levels of subjects with drug-resistant epilepsy who underwent neurosurgery (N = 44) using multiplex solid-phase analysis, ELISA, and immunohistochemical methods, as well as to analyze the correlations and associations of the blood and hippocampal levels of these proteins with clinical parameters. We first studied the concordance between in vivo brain and blood levels of BDNF, NSE, VILIP-1, and S100B in epileptic patients. A positive correlation for NSE between hippocampal and PBMC levels was revealed. NSE levels in PBMCs were also significantly correlated with average seizure duration. BDNF levels in PBMCs were associated with seizure frequency and hippocampal sclerosis. Thus, NSE and BDNF levels in PBMCs may have potential as clinically significant biomarkers. Significant correlations between the levels of the neurospecific proteins studied herein suggest interactions between BDNF, NSE, VILIP-1, and S100B in the pathophysiology of epilepsy.

Beneficial impacts of residential greenness on sleep deprivation in adults aged 19 or older living in South Korea: A nationwide community health survey in 2011–2018

BackgroundEvidence of the relationship between greenness and sleep is limited, and, given the worsening sleep insufficiency worldwide, this relationship needs elucidation. In this study, we investigated the association of greenness with sleep deprivation using nationwide survey data. MethodsThis study included 1,727,273 participants in the Korea Community Health Survey who resided in all 229 districts of South Korea from 2011 to 2018. Sleep deprivation variables were defined as strong deprivation or mild deprivation, based on average daily sleep duration of <5 or 5–6 h, respectively. District-specific annual average of satellite-derived enhanced vegetation index (EVI) was used as a green space exposure. A logistic regression with complex survey weights was used to estimate the association between greenness and sleep deprivation, and it was further examined by sex, age group, educational status, income level, and population density. The regression analysis was performed annually, and the annual estimates were pooled by a combined data analysis. ResultsA higher level of greenness was associated (odds ratio [95 % confidence interval]) with strong and mild sleep deprivation (0.96 [0.93–0.99] and 0.96 [0.95–0.97]), respectively, and males and the younger age group (<65 years) showed a more prominent association with greenness than in females and the elderly group (65 years or older). In addition, only high-population-density areas showed evident associations of greenness with both strong and mild sleep deprivation. ConclusionsThis large population-based study provides important epidemiological evidence for improving sleep quantity through an increase in greenness exposure and supports policymakers in establishing strategies for urban planning.

Pengaruh Automatic Change Over Switch Terhadap Peningkatan Keandalan Gardu Distribusi T3-200A/1 Penyulang PLR-04

The process of distributing electrical energy has the potential to cause disturbances that can occur due to natural disturbances, disturbances to electrical equipment, disturbances at the generating center, transmission lines, and disturbances in the distribution network that can disrupt the reliability and service quality of the distribution of electrical energy. The quality of reliability can be rated by the length of outages, which can be determined using the System Average Interruption Duration Index (SAIDI), and how often blackouts occur in one unit of time, which can be determined using the System Average Interruption Frequency Index (SAIFI). In maintaining the reliability of electrical energy, additional equipment is needed that is capable of supplying backup energy to the load when a disturbance occurs, namely the Automatic Change Over Switch (ACOS). ACOS is a device that works automatically for the process of maneuvering the network from two voltage sources to maintain electricity availability without having to have long blackouts due to disturbances or loss of voltage at the main source. The use of the Automatic Change Over Switch (ACOS) is proven to be able to increase the reliability of electrical energy at distribution substation T3-200A/1 feeder PLR-04 by reducing the length of time outages (SAIDI) and reducing the frequency, because customers don't feel outages when the disturbance occurs. In addition, the use of Automatic Change Over Switch (ACOS) can also reduce the energy not supplied (ENS)

Identification of factors affecting the cases of under-age female marriage using geographically weighted panel regression approach in south kalimantan province.

The topic of this study was chosen because the percentage of underage female marriages in South Kalimantan Province was the highest in Indonesia over the last five years, from 2018 to 2022. This signifies that there are social issues in the local community that the government must address. One possible answer is to identify the factors that contribute to the creation of these conditions in each region. Using the Geographically Weighted Panel Regression (GWPR) method, this study attempts to determine the factors that influence the rise of underage female marriage instances in South Kalimantan Province. The number of poor individuals, population density, average duration of schooling, adjusted per capita expenditure, and total population were chosen as independent variables. Data acquired from South Kalimantan Province's Central Bureau of Statistics' periodic releases. Because there was high spatial heterogeneity between each location in this study, it was quite practical to employ the GWPR approach in developing a conjectural model. The results of evaluating the GWPR model with adaptive Gaussian kernel weights provide significant results and the model can explain the variance of data by 55 percent. Testing the parameters of the GWPR model reveals two (two) regional groupings with distinct influencing variables. The first group consists of ten (ten) regions that are considerably impacted by both the number of impoverished people and the average length of schooling, whereas the second group consists of three (three) regions that are impacted solely by the average length of schooling.

Technical aspects of performing laparoscopic hernioplasty in the treatment of large ventral hernias

Laparoscopic hernioplasty is a promising treatment option for ventral hernias. The technique of intraperitoneal mesh placement (IPOM) is the most extensively studied and widely used for the closure of a defect during laparoscopic hernia repair. The large size of the defect and its diameter exceeding 10 cm are limiting factors in the selection of minimally invasive techniques for hernioplasty. The process of suturing the hernia prior to the placement of the mesh, as well as the technique used to fix it, show controversial results in terms of postoperative quality of life and the risk of recurrence. Objective — to study the technical aspects of performing laparoscopic prosthetic hernioplasty using the IРOM technique for the surgical treatment of patients with large primary ventral hernias (PVH) and postoperative incisional ventral hernias (IVH). Materials and methods. The study included a total of 84 patients who were undergoing treatment at the clinical base of the Department of General Surgery No. 2 of Bogomolets National Medical University. There were 51 (60.7%) women and 33 (39.3%) men. The average age was 58.73±10.9 years. All patients were operated on for large ventral hernias. Of these, 52 (61.9%) patients had surgery for PVH (umbilical hernia, line alba hernia), while 32 (38.1%) — for IVH. In 56 (66.7) patients, the width of the hernia defect was &gt; 10 cm, of which 24 (28.6%) patients had PVH. In these patients, 4 weeks before surgery, 100 units of botulinum toxin type A (BTA) were injected intramuscularly into the muscles of the anterior abdominal wall in accordance with the methodology developed in the clinic. All patients underwent laparoscopic prosthetic hernioplasty with IPOM under general combined anesthesia. Control examinations of patients were carried out 2 weeks, 1 month, 6 months, and 1 year after the operation. Results. All patients underwent IPOM, while 38 (45.2%) patients underwent laparoscopic IPOM with suturing of the defect, 36 (42.9%) patients underwent IPOM with suturing the hernia defect before placing the mesh (IPOM+), and 10 (11.9%) patients underwent IPOM without suturing the defect. 32 (38.1%) patients were aged 65 years, including 10 patients who did not undergo suturing of the defect before the mesh placement. After the injection of BTA, the number of patients with a defect width of ≥10 cm decreased to 15 (17.8%). All of these patients had a defect smaller than 15 cm. The average duration of surgery for IPOM without hernia suturing was 60.00±11.30 min; for IPOM with laparoscopic suturing, it was 108.16±40.29 min; for IPOM+ with open suturing, it was152.08±40.64 min. The average length of stay in the hospital after surgery was higher in the group of patients who underwent hernioplasty using the IPOM+ technique compared to other techniques (p &lt;0.001). In the early postoperative period, the complication rate was 13.1%; all cases were classified as minor (Grade I, II, IIIa) according to the Clavien–Dindo classification. Conclusions. Laparoscopic hernioplasty using the IPOM is a safe and reliable method for large ventral hernia repair. Administering preoperative BTA injections enables the reduction of the defect and facilitates the execution of laparoscopic hernioplasty in patients with a primary hernia size of ≥10 cm.

The Influence of Sehat Jiwa Education on the First Active Phase of Labor in Community Health Centers across Makassar City

During pregnancy, women commonly experience both psychological and emotional changes, leading to concerns about childbirth and potential labor complications. Therefore, education programs became essential for preparing mothers mentally for delivery with the engagement of health workers and families. This study aimed to assess the effectiveness of Sehat Jiwa education on the length of the first active stage of labor. Using a Quasi-experimental design with a two-group control approach, the sample comprised 64 respondents (34 in the intervention group and 30 in the control group). The instruments adopted were the Sehat Jiwa (English: Soul Health) education module, questionnaires, and partograph sheets. The results showed that there was no significant difference in the length of the first active phase between the intervention and control groups, with a p-value of 0.061 &gt; 0.05. However, the average duration for the intervention group (5.88 hours) was slightly shorter than the control group (6.40 hours). Emphasizing Sehat Jiwa-based education for pregnant women was crucial, fostering smoother delivery processes and reducing the likelihood of increased labor complications.&#x0D;

Comparison of Efficacy of Botulinum Toxin Injection and Conventional Oral Drugs for Treatment of Refractory Migraine

Background: Background: Migraine, a debilitating neurological condition, significantly impacts quality of life. Despite various treatments, some cases remain refractory to conventional therapies. This study explores the efficacy of Botulinum Toxin Type A (BOTOX) injections compared to Conventional Oral Drugs (CODs) in treating refractory migraines, offering potential advancements in migraine management. Objectives: This single-center retrospective cohort study compared the efficacy and safety of Botulinum toxin (BOTOX) injection and Conventional Oral Drugs (COD) for treating the refractory migraine. Methods: Between May and August of 2023, 78 adults with refractory migraine were enrolled at tertiary care center in Islamabad. Their demographic data revealed the mean age of 46.5 years (SD=10.09), gender distribution of 28 males (35.90%) and 50 females (64.10%), and distribution of 27 employed (34.61%) and 51 unemployed (65.30%). Results: Average duration of refractory migraines was 9.72 years and average number of migraines per month was 22. The number of headache days per month decreased from 22 at baseline to 19 after two months and to 12 after three months (p=0.239) as the primary outcome measure (p&gt;0.05). The VAS scores decreased substantially from 7.6 to 5.5 (p=0.049), indicating decrease in headache severity (p&lt;0.05). Scores on Migraine-Specific Quality of Life (MSQ) increased from 43 to 73% (p&gt;0.05). The Migraine Disability Assessment (MIDAS) scores decreased from 66 to 48 (p=0.047) and Headache Impact Test (HIT-6) scores decreased from 69 to 40 (p=0.025), indicating an improvement in disability and quality of life (p&lt;0.05). Injection site pain (n=35), nausea (n=25), dizziness (n=15), fatigue (n=12), parched mouth (n=5), and muscle weakness (n=5) were reported as adverse effects. Conclusion: While BOTOX treatment significantly improved measures of headache severity, disability, and quality of life, patient tolerability and potential distress must be considered when selecting this treatment.

Endoscopic Management of Gastric Band Erosion: a Systematic Review and Meta-Analysis.

Gastric band erosion may be seen in up to 3% of patients. Endoscopic intervention has become increasingly utilized due to its minimally invasive nature. The purpose of this study was to perform a systematic review and meta-analysis to examine the role of endoscopic removal for eroded gastric bands. Individualized search strategies were developed for PubMed, EMBASE, Web of Science, and Cochrane Library databases in accordance with PRISMA and MOOSE guidelines. Outcomes included technical success, clinical success, procedure duration, adverse events, and surgical conversion. Pooled proportions were analyzed using random effects models. Heterogeneity and publication bias was assessed with I2 statistics and funnel plot asymmetry using Egger and Begg tests. Meta-regression was also performed comparing outcomes by endoscopic tools. Ten studies (n=282 patients) were included in this meta-analysis. Mean age was 40.68±7.25 years with average duration of band placement of 38.49±19.88 months. Pre-operative BMI was 42.76±1.06 kg/m2 with BMI of 33.06±3.81 kg/m2 at time of band erosion treatment. Endoscopic removal was attempted in 240/282 (85.11%) of cases. Pooled technical and clinical success of the endoscopic therapy was 86.08% (95% CI: 79.42-90.83; I2=28.62%) and 85.34% (95% CI: 88.70-90.62; I2=38.56%), respectively. Mean procedure time for endoscopic removal was 46.47±11.52 min with an intra-operative adverse event rate of 4.15% (95% CI: 1.98-8.51; I2=0.00%). Post-procedure-associated adverse events occurred in 7.24% (CI: 4.46-11.55; I2=0.00%) of patients. Conversion to laparotomy/laparoscopy occurred in 10.54% (95% CI: 6.12-17.54) of cases. Endoscopic intervention is a highly effective and safe modality for the treatment of gastric band erosion.

Myocardial Remodeling Markers in Hypertensive and Overweight or Obese Patients

Pro-inflammatory and anti-inflammatory cytokines can be used as markers of the severity of the arterial hypertension (AH) and the risk of its complications. The objective: to analyze the significance of interleukin-10 (IL-10) and interleukin-1β (IL-1β) as markers of myocardial remodeling in patients with arterial hypertension (AH) and overweight or obesity. Materials and methods. 103 patients with AH (60 women and 43 men) took part in the study. The average age of the participants was 53.21±8.5 years, the average duration of AH – 8.2±6.3 years. The patients were divided into two groups according to the level of IL-10. The first group included 80 (78%) patients with AH and body mass index (BMI) ≥25 kg/m2 who had a normal level of IL-10 (up to 32 pg/ml), the second group included 23 (22%) individuals with increased anti-inflammatory cytokine. Also, the patients were divided into two groups according to cytokine levels. The first group included 74 (72%) patients with AH and overweight or obesity (the level of IL-1β was up to 11 pg/ml), the second group included 29 (28%) patients with an elevated level of IL-1β. All subjects underwent an anthropometric measurement, clinical and laboratory examination, and determination of the level of anti-inflammatory cytokine IL-10 and pro-inflammatory cytokine IL-1β by enzyme immunoassay method. Results. The results of pro-inflammatory and anti-inflammatory cytokine concentrations (IL-1β and IL-10, respectively) were different. It was found that the level of IL-10 does not depend on the age of patients and the duration of AH, but there is a direct relationship between the level of the anti-inflammatory cytokine and BMI (35.8±5.7 kg/m2 vs. 32.4±5.7 kg/m2; p&lt;0.05) with fasting glycemia level (r=0.3; p&lt;0.05). It is also indicated that patients AH and increased BMI have on average a significantly longer QT interval (0.40±0.07 s vs. 0.36±0.04 s; p&lt;0.05). It was determined that 13% of patients with elevated anti-inflammatory cytokine levels had QT prolongation. In 39% of cases, an increase in the mass index of the myocardium of the left ventricle was found (twice more among women). A direct correlation between the level of homocysteine and pro-inflammatory (r=0.31; p&lt;0.05) and anti-inflammatory cytokines (r=0.47; p&lt;0.05) was determined. At the same time, patients with elevated levels of IL-1β had a direct correlation with left ventricular myocardial mass index (r=0.42; p&lt;0.05) and average daily mean arterial pressure (r=0.85; p&lt;0.005). Conclusions. The anti-inflammatory cytokine IL-10 has greater prognostic significance than the pro-inflammatory cytokine IL-1β. An increased level of IL-10 in patients with AH and BMI ≥25 kg/m2 may indicate an adaptive reaction of the organism’s immune response. A high level of IL-10 in this cohort of patients is associated with worse control of blood pressure levels and can be considered as a predictor of the development of cardiac arrhythmias.

Predicting Phase 1 Lymphoma Clinical Trial Durations Using Machine Learning: An In-Depth Analysis and Broad Application Insights.

Lymphoma diagnoses in the US are substantial, with an estimated 89,380 new cases in 2023, necessitating innovative treatment approaches. Phase 1 clinical trials play a pivotal role in this context. We developed a binary predictive model to assess trial adherence to expected average durations, analyzing 1089 completed Phase 1 lymphoma trials from clinicaltrials.gov. Using machine learning, the Random Forest model demonstrated high efficacy with an accuracy of 0.7248 and an ROC-AUC of 0.7677 for lymphoma trials. The difference in the accuracy level of the Random Forest is statistically significant compared to the other alternative models, as determined by a 95% confidence interval on the testing set. Importantly, this model maintained an ROC-AUC of 0.7701 when applied to lung cancer trials, showcasing its versatility. A key insight is the correlation between higher predicted probabilities and extended trial durations, offering nuanced insights beyond binary predictions. Our research contributes to enhanced clinical research planning and potential improvements in patient outcomes in oncology.

Wound healing and postoperative management in paediatric patients following 27-Gauge Transconjunctival Sutureless Vitrectomy for vitreoretinal conditions.

The utilization of 27-G TSV, or 27-Gauge Transconjunctival Sutureless Vitrectomy, poses distinct difficulties in the context of paediatric patients, particularly those younger than 14 years old, on account of the dearth of exhaustive documentation concerning the efficacy and results of these operations. Therefore, this retrospective study was to evaluate the safety and efficacy of 27-G TSV in paediatric patients, with emphasis on management of intraoperative and postoperative complications and postoperative wound healing. A total of 54 eyes of 52 paediatric patients who underwent 27-G TSV at Sichuan Provincial People's Hospital were included in the study. The average duration of follow-up was 9.32 ± 3.35 months. The complication with the highest incidence rate was Rhegmatogenous Retinal Detachment (RRD), which was detected in 27.8% cases. Familial Exudative Vitreoretinopathy (FEVR) and Persistent Fetal Vasculature (PFV) each accounted for 16.7% of the cases. Retinopathy of Prematurity (ROP) and Vitreous Haemorrhage (VH) constituted 11.1% and 14.8%, respectively, of the reported cases. Lens injury (1.9%), cannula slippage (7.4%) and wound leakage (5.6%) were intraoperative complications. Iatrogenic retinal detachment occurred at 3.7%. Hypotony (10.8% of patients), vitreous haemorrhage (9.3%), cataract formation (9.3%), ocular hypertension (8.1%) and retinal detachment (5.6%) were postoperative complications. Effective management strategies were executed, such as performing in situ trocar puncture to address cannula slippage and promptly suturing to address wound leakage. 27-G TSV exhibited promise as the therapeutic alternative for range of vitreoretinal disorders in paediatric patients, accompanied by complications that were controllable during and after the procedure. Strict preoperative planning and precise surgical technique are indispensable in order to maximize patient outcomes and guarantee effective wound healing and recovery within this particular demographic.

Analysis of the transverse dental arch dimension stability and risk of gingival recessions associated with orthodontic treatment

Relevance. Orthodontic treatment may adversely affect the periodontal health. Therefore, a comprehensive diagnosis and treatment planning with a periodontist are crucial. Dentoalveolar expansion is one of the ways to provide the space for malocclusion correction. Nevertheless, the stability of the obtained transverse dimensions remains insufficiently studied and requires additional research.Material and methods. The comparative study included the clinical and paraclinical stages. The inclusion and exclusion criteria determined the study sample formation. Each patient had orthodontic treatment with the same standard arch-changing protocol recommended by the manufacturer; the average treatment duration was 18 ± 4 months. All patients underwent a clinical examination specifically focused on the gingival recession diagnosis. During the paraclinical stage, the study investigated medical records and measured study model parameters using Pont’s (1909) and Linder-Hart (1939) indices. Measurements were made four times during orthodontic treatment: before, immediately after, one and six years after treatment. All obtained data were statistically processed using the significance criteria.Results. Study models’ analysis during the active stage of treatment revealed expansion in each segment of the dentition. However, the result is prone to relapse within the first year after the bracket system removal. Clinical examination of the oral cavity revealed gingival recessions, which appeared during the active stage of the orthodontic treatment. Thus, every third case showed marginal tissue displacement. The comparison of the initial transverse dimensions in the study and control groups detected a discrepancy between the measured and reference values, which might be a prerequisite for determining new parameters.Conclusion. A periodontist should monitor orthodontic patients to protect periodontal health. The transverse dimensions appeared to increase to the utmost in the upper and lower premolar regions. However, the achieved result does not always remain stable. Most relapses occur during the first year after the orthodontic treatment; then, the outcome remains stable.

Cost-Effectiveness of a Direct-Aspiration First-Pass Technique versus Stent Retriever in Mechanical Thrombectomy

A direct-aspiration first-pass technique (ADAPT) in mechanical thrombectomy has been described in recent studies as an efficacious strategy compared with using a stent retriever (SR). We sought to evaluate for cost differences of ADAPT technique versus SR as an initial approach. We conducted a retrospective analysis of consecutive patients with mechanical thrombectomy at our institution between 2022 and 2023. Patients were grouped into ADAPT with/without SR as a rescue strategy and SR as an initial approach with allowance of concomitant aspiration. Direct cost data (consumables) were obtained. Baseline demographics, stroke metrics, procedure outcomes and cost, and last follow-up outcomes in modified Rankin Scale were compared between 2 groups. Fifty-six patients were included. Thirty-seven (66.1%) underwent ADAPT, with 11 (29.7%) eventually requiring an SR. Mean age was 64.8 years. The average National Institutes of Health Stroke Scale score was 13.2 in the ADAPT group and 14.0 in the SR group (P= 0.68), with a similar proportion of tissue plasminogen activator (P= 0.53), site of occlusion (P= 0.66), and tandem occlusion (P= 0.69) between the groups. Recanalization was achieved in 94.6% of all patients, with an average of 1.9 passes, 89.3% being TICI 2B or above, with no differences between the 2 groups. Significantly lower cost (P < 0.01) was observed in ADAPT ($14,243.4) compared with SR ($19,003.6). Average follow-up duration was 180.2 days, with mortality of 23.2%. At last follow-up, 55.4% remained functionally independent (modified Rankin Scale score <3) with no difference (P= 0.56) between the ADAPT (59.5%) and SR (47.4%) groups. Outcomes were comparable between the ADAPT and SR groups. ADAPT reduced procedural consumables cost by approximately $5000 (25%), even if stent retrievers were allowed to be used for rescue. Establishing ADPAT as initial approach may bring significant direct cost savings while obtaining similar outcomes.

Isolated substorms according to magnetic measurements at Tixie during minimum solar activity

A catalog of isolated substorms in 2016–2020 has been compiled from data on the H component of the geomagnetic field, obtained at Tixie. From the catalog data, it has been found that during this period changes in the number of substorms and the number of sunspots are well approximated by quadratic functions with minima at the end of 2017 and in the middle of 2019 respectively; during the year, disturbances more often occurred during solstice; within 24 hours, substorms more often occurred at local midnight. The intensity and duration of substorm disturbances, the duration of their expansion phase do not show a noticeable dependence on the time of occurrence; however, from average values of these parameters in hourly ranges, it has been found that the intensity takes lower values around 0–3 MLT; in the midnight sector, the duration of disturbances and the duration of their expansion phase are shorter than those in the dawn sector. Compared to the data from mid-latitude stations [Chu et al., 2015], the average duration of substorms and the duration of their expansion phase are longer.

Antibiotic exposure associated with nighttime sleep duration and daytime sleepiness in newlyweds.

Few studies have explored the relationship between antibiotic exposure and sleep in newlyweds. We applied the actor-partner interdependence moderation model to estimate the relationships of antibiotic exposure with nighttime sleep duration (weekday, weekend, and average sleep durations) and daytime sleepiness in newlyweds. We found that 99.0% of the 2698 enrolled individuals were exposed to at least one antibiotic. Among the newlyweds, exposure to florfenicol (β, - 0.077; 95% confidence interval [CI], - 0.143, - 0.011), exposure to chloramphenicols (- 0.086 [- 0.160, - 0.011]), and exposure to veterinary antibiotics (VAs) (- 0.106 [- 0.201, - 0.010]) were negatively associated with weekday sleep duration. Florfenicol, chloramphenicols, and VAs were also inversely related to average sleep duration in the newlyweds. Ciprofloxacin and cyadox exposure was significantly associated with an increase of 0.264 (0.030, 0.497) and (0.375 [0.088, 0.663]) Epworth Sleepiness Scale (ESS) scores in the newlyweds, respectively. Gender moderated the actor-partner effects of erythromycin and tetracyclines on the newlyweds' weekday sleep duration and ESS scores. Overall, exposure to florfenicol, chloramphenicols, and VAs shortened weekday and average sleep durations of newlyweds. Exposure to ciprofloxacin and cyadox promoted daytime sleepiness. Gender moderated the actor-partner effects of specific antibiotics on the weekday sleep duration and ESS scores of the newlyweds.

Radiation-induced ophthalmic risks of long duration spaceflight: Current investigations and interventions.

As the average duration of space missions increases, astronauts will experience longer periods of exposure to risks of long duration space flight including microgravity and radiation. The risks from long-term exposure to space radiation remains ill-defined. We review the current literature on the possible and known risks of radiation on the eye (including radiation retinopathy) after long duration spaceflight. A PubMed and Google Scholar search of the English language ophthalmic literature was performed from inception to July 11, 2022. The following search terms were utilized independently or in conjunction to build this manuscript: "Radiation Retinopathy", "Spaceflight", "Space Radiation", "Spaceflight Associated Neuro-Ocular Syndrome", "Microgravity", "Hypercapnia", "Radiation Shield", "Cataract", and "SANS". A concise and selective approach of references was conducted in including relevant original studies and reviews. A total of 65 papers were reviewed and 47 papers were included in our review. We discuss the potential and developing countermeasures to mitigate these radiation risks in preparation for future space exploration. Given the complex nature of space radiation, no single approach will fully reduce the risks of developing radiation maculopathy in long-duration spaceflight. Understanding and appropriately overcoming the risks of space radiation is key to becoming a multi-planetary species.

MMF as Immunosuppressive Therapy in IgA Nephropathy

Introduction: IgA Nephropathy (IgAN) is the most common cause of primary glomerulonephritis in developed countries. Treatment with ACEI/ARB has strong evidence in managing IgAN. If there is evidence of progression, immunosuppression is recommended. KDIGO guidelines do not advise Mycophenolate Mofetil’s (MMF) use in non-Chinese population currently. Methods: In this study, we reviewed immunosuppression with MMF retrospectively in IgAN patients managed at the Sussex Kidney Unit (SKU) – Brighton – United Kingdom. This was assessed using the primary measures of renal survival without requiring renal replacement therapy (RRT) and proteinuria reduction to &gt;50% of the diagnosis baseline. Twenty-five patients diagnosed with IgAN between 2011 and 2020 and had been treated with MMF were retrospectively reviewed. Data was collected until January 2023, including laboratory results, histopathology, clinic letters, and medication. For those on RRT, data was collected up until the start of RRT. Results: Twenty- Five patients were reviewed; 24 were white Caucasians, and 1 was ethnically Asian. MMF was used in all 25 patients. Three patients were treated with MMF alone and 17 in combination with steroids. Five patients had prednisolone and cyclophosphamide for three months, followed by MMF maintenance. The average treatment duration was 2 years, and the average dose was 1g BD. Five patients progressed to end-stage renal disease (ESRD), and 3 had renal transplants. Twenty patients maintained renal survival; the mean eGFR at diagnosis was 45.6+/-34.1 and, at the time of review, was 56.1+/-26.6. Of the 17 patients who presented with AKI, 5 recovered to normal renal function, 5 had end-stage renal disease (ESRD), 4 had improvements, and 3 showed a decrease in eGFR. Overall, 70.6% of AKI patients recovered to normal or CKD levels. Eighty % of the patients had renal survival without RRT during the review. Twenty patients achieved more than 50% reduction of proteinuria, with five patients having proteinuria less than 0.3 g/24 hours and nine patients less than 0.5 g/24 hours. Comparison between the proteinuria at diagnosis and at the assessment time was significant (P&lt;0.001). Conclusions: Mycophenolate mofetil effectively maintained renal survival and improved proteinuria in IgA nephropathy patients indicated for immunosuppression. The treatment was well tolerated by all patients.

Autologous platelet-rich plasma for the treatment of interstitial cystitis/bladder pain syndrome in women: evaluation of clinical efficacy

Introduction. The pathogenetic theory of interstitial cystitis/bladder pain syndrome (IC / BPS) development declares that due to vascular changes and trophic disorders in the bladder wall, a complex of dystrophic, necrobiotic and sclerotic processes develops, involving all layers of the bladder wall with the subsequent development of fibrosis. Therapy of moderate-to-severe symptoms of IC/BPS that recommended in EAU guidelines is not so effective.Objective. To evaluate the results of intradetrusor autologous platelet-rich plasma (PRP) injections in female IC / BPS-patients.Matherials &amp; methods. A single-centre controlled randomized prospective trial that includes 85 women from 20 to 79 years old and with average disease duration of 4.8 ± 2.1 years. They were divided into two groups: group 1 — 35 patients were treated with total of five cystoscopies and hydrodistension, each once in two weeks for 10 weeks; group 2 — 50 patients were treated with total of 5 intradetrusor PRP-injection (mean platelet concentration was 982 х 103/l) into 20 – 22 points, each once in two weeks. We assessed pain (VAS-scale), urgency and frequency (PUF-scale, IUS-scale), bladder urinary, Global Response Assessment (GRA), bladder diary and bladder capacity before treatment, after one and 12 months.Results. Conventional IC/BPS therapy leads to a significant reduction in symptoms one month after its completion, and a similar pattern of symptoms and signs is observed in the PRP-treatment group. However, in group 1, negative dynamics is further determined up to 12 months, but the indicators do not reach the initial values. In contrast, in group 2, we found stabilisation of pain severity and improvement of all other symptoms and signs by 12 months compared to baseline and one month after the completion of PRP-therapy.Conclusion. The developed method of PRP-therapy of IC/BPS has high efficacy not only at the treatment completion, but also at monitoring of patients for 24 months. PRP-therapy combined with classical treatment will probably have a higher level of efficacy both in terms of symptoms and signs of the disease over a long-term monitoring.

Comparison of Partial Versus Superficial or Total Parotidectomy for Superficial T1-2 Primary Parotid Cancers.

This study aimed to compare the oncological outcomes of partial versus superficial or total parotidectomy for superficial T1 or T2 primary parotid cancers and investigate their prognostic factors and recurrence patterns. The medical records of 77 patients with T1-2 primary parotid malignancies between May 2003 and March 2022 were retrospectively reviewed. Univariate and multivariate analyses were performed to evaluate the prognostic factors associated with overall survival, disease-free survival, and local and distant recurrence. The average follow-up duration was 70.2 months (range, 12-202 months). The 5-year overall and disease-free survival rates were 88.7% and 77.1%, respectively. Twenty-two patients underwent partial parotidectomy, and 55 underwent superficial or total parotidectomy. There were no significant differences in the disease recurrence (P=0.320) and mortality rates (P=0.884) of the partial and superficial or total parotidectomy groups. The mean duration of surgery was shorter and the overall complication rates were significantly lower in the partial group than in the superficial or total parotidectomy group (P=0.049). Sixteen cases of recurrence occurred during the study period (20.8%). Univariate analyses showed that high-grade tumors (P=0.006), lymphovascular invasion (P=0.046), and regional lymph node metastasis (P=0.010) were significant risk factors for disease recurrence. Multivariate analysis identified regional lymph node metastasis as an independent prognostic factor for disease recurrence (P=0.027), and lymphovascular invasion as an independent prognostic factor for overall survival (P=0.033). The conservative surgical approach of partial parotidectomy can yield oncological outcomes comparable to those of superficial or total parotidectomy with careful patient selection in T1-2 parotid cancers.

Single-Center Comparison of Chronic Subdural Hematoma Evacuation Outcomes Under Local Versus General Anesthesia

Chronic subdural hematoma (CSDH) is a neurosurgical pathology of an aged populace. Pathogenetic risk factors include traumatic brain injury, prolonged use of antiplatelet drugs, hypertension, and some inflammatory processes. The incidence increases as patients age. Burr-hole evacuation is the most common approach in management of symptomatic cases. We compared evacuation of chronic subdural hematomas with general or local anesthesia (GA and LA, respectively) and evaluated the safety, economic benefits, effects of comorbidity, benefits, and shortcomings of both techniques. We conducted a retrospective study of 67 consecutive patients who had 74 procedures for CSDH in a single neurosurgical center, the Regional Clinic, Centre of Neurosurgery and Neurology, over a 3-year period. They were grouped into the GA group (n= 44) and LA group (n= 23). Mean duration of procedure, length of hospital stay, complications, and preoperative and postoperative neurologic statuses were compared. The distribution of nominal variables between groups was compared using the Fisher exact test. The average duration of operation and length of hospital stay were compared using the Mann-Whitney U-test due to violation of the normality assumption. LA proved to be as effective as GA in CSDH evacuation. Seventy-four surgical procedures were performed on 67 patients due to recurrence in less than 30 days in 7 patients. Fifteen patients had tension pneumocephalus managed with fluid therapy to full recovery. LA was economical and required shorter hospital stays and surgical time. In our studies, LA proved to be noninferior to GA, time conserving, and less prone to some of the adverse effects of GA on elderly patients with comorbidity, although some patients who are hyperactive or contraindicated to LA will require GA.