Count Score Research Articles

Risk factors and prognostic impact of new decompensated events in hospitalized patients with decompensated cirrhosis.

Decompensated cirrhosis (DC) is prone to recurrent episodes of decompensation following the initial event. This study aimed to identify the risk factors for subsequent decompensation and assess their impact on the outcomes of patients hospitalized for DC. Patients with DC were divided into two groups based on the occurrence of new decompensated events during hospitalization. Logistic regression analysis was employed to identify risk factors for new decompensation. The Cox proportional hazards model was used to evaluate the relationship between new decompensation and short-term mortality risk in these patients. The study cohort consisted of 339 patients with DC, with a median age of 57 years. During hospitalization, 83 patients (24.5%) experienced new decompensated events, with bacterial infections (BIs) being the most common (n = 46, 13.6%). Multivariate analysis revealed that the Model for End-Stage Liver Disease (MELD) score at admission (OR = 1.06, 95% CI: 1.02-1.11, P = 0.005) was the sole risk factor for new decompensation during hospitalization. Patients who experienced new decompensation had significantly higher 28-day (28.9% vs. 7.0%, P < 0.001) and 90-day (33.7% vs. 15.2%, P < 0.001) transplant-free mortality compared to those who did not. After adjusting for white cell count, C-reactive protein, and MELD score, new decompensation during hospitalization was identified as an independent risk factor for 28-day and 90-day mortality (HR = 2.63, 95% CI: 1.42-4.87, P = 0.002 and HR = 1.73, 95% CI: 1.04-2.88, P = 0.033, respectively). Patients with high MELD scores are susceptible to new decompensation during hospitalization, and the occurrence of new decompensation adversely affects short-term mortality in patients with DC.

Association between nutritional status, injury severity, and physiological responses in trauma patients

PurposeTo evaluate the predictive value of the Controlling Nutritional Status (CONUT) score and Injury Severity Score (ISS) in assessing physiological abnormalities and outcomes in trauma patients.MethodsA retrospective analysis was conducted on 354 trauma patients. Physiological parameters were assessed, including cardiovascular function, inflammatory response, liver and kidney function, and nutritional status. The CONUT score and ISS were calculated for each patient. Binary logistic regression was used to identify independent predictors of trauma severity. Receiver operating characteristic (ROC) curve analysis evaluated the predictive accuracy of the CONUT and ISS scores for adverse outcomes.ResultsSeverely injured patients exhibited more significant abnormalities in cardiovascular function, inflammatory response, liver and kidney function, and nutritional status compared to those with minor injuries. These patients had significantly higher CONUT scores. Logistic regression analysis identified white blood cell count, hemoglobin, and CONUT score as independent predictors of trauma severity. ROC analysis showed that both CONUT and ISS scores effectively predicted adverse outcomes, with ISS demonstrating better specificity.ConclusionThe CONUT and ISS scores are effective tools for predicting physiological abnormalities and adverse outcomes in trauma patients. Incorporating these scores into clinical practice may enhance prognostic assessments and improve management strategies for trauma patients.

Hemostatic effect of 3D-printed hip fixators in children with retinoblastoma after intra-arterial chemotherapy: a non-randomized controlled trial.

This study aimed to investigate the benefits of using three-dimensional (3D)-printed hip joint fixators after intra-arterial chemotherapy (IAC) by inguinal femoral artery puncture in children with retinoblastoma. Overall, 79 cases of retinoblastoma who had undergone IAC through the femoral artery were selected and divided into an observation group of 50 cases and an intervention group of 29 cases according to the hemostasis method employed. The patients in the observation group were treated with sandbags for hemostasis, while those in the intervention group were given 3D-printed hip joint fixators to help immobilize the hips and sandbags. We used the Face, Legs, Activity, Cry and Consolability scale (FLACC), the Wong-Baker Facial Expression Pain Scale, and self-made questionnaires to evaluate demographics, clinical characteristics, pain, complications, satisfaction, and other indicators of the two groups. There were no significant differences in general data, such as age, gender, height, weight, manual compression time, diseased eye, tumor stage, platelet count, puncture times, pain distribution, and total score, between the groups. There was a positive correlation between FLACC pain and the total Wong-Baker pain score (r = 0.599, p < 0.001). During the 2h of sandbag compression, sandbags were dislodged in the observation group as many as ten times, which was significantly higher than that in the intervention group (up to four times; p < 0.001). This was correlated with a very high score of satisfaction (92.34 ± 19.96 out of 100). The 3D-printed hip fixator is easy to operate, has a low incidence of complications, and saves time and effort. It effectively reduces the incidence of sandbags falling off after IAC in children with retinoblastoma and does not increase the patient's pain. It is a method that could improve hemostasis in young children undergoing IAC by inguinal femoral artery.

The treatment efficacy of 7.5% dapsone gel in papulopustular rosacea: a prospective study

Introduction Topical dapsone has a level A recommendation for the treatment of papulopustular rosacea; however, its treatment efficacy has not been studied previously. The aim of this study is to evaluate the safety and efficacy of topical 7.5% dapsone gel applied once daily at night in the treatment of papulopustular rosacea. Patients and methods This is a prospective study including female papulopustular rosacea patients with a minimum IGA score of 2. The patients were recruited at two different outpatient clinics by two independent dermatologists. The patients were prescribed 7.5% dapsone gel (same brand) for once-daily use at night. No other topical or systemic treatment modalities were allowed to be used during the study except for a sun protection factor 50 sunscreen and an emollient face cream. The patients were evaluated with the total lesion counts and IGA scores at weeks 0, 4 and 8 by two independent dermatologists. The side effects of burning, stinging, pain, erythema, and exfoliation were questioned during the follow-up visits. Results All 32 recruited patients (18–70) completed the study. The mean lesion counts of the patients were 22.10 ± 8.95 on the initial visit, 11.90 ± 6.49 on the 4th week follow-up and 3.87 ± 3.76 on the 8th week follow up. The mean IGA scores of the patients were 3.06 ± 0.81 on the initial visit, 2.10 ± 0.87 on week 4 and 0.74 ± 0.73 on week 8. The decrease in the mean lesion count and IGA score of the patients in weeks 4 and 8 were statistically significant (p = 0.000 for all). This decrease was independent of the patient’s age (p > 0.005). No side effects were reported. Conclusions The 7.5% topical formulation of dapsone is effective for papulopustular rosacea both on the first and second months of the treatment regardless of the age of the patient. Its safe side effect profile suits for a comfortable use in rosacea patients with a decreased skin tolerance.

The reliability and validity of superb microvascular imaging as a potential disease activity marker in rheumatoid arthritis.

Rheumatoid arthritis (RA) is a systemic autoimmune disease of unknown aetiology, that causes progressive and destructive inflammation in the joints. Superb microvascular imaging (SMI), a new ultrasound technique that allows visualizing slow blood flow in synovitis. This study aimed to report the clinical value and utility of the SMI technique and its grading for monitoring RA by determining the correlation with clinical disease activity scores (DAS 28) and power Doppler ultrasound (PDUS). All RA patients with clinically apparent synovitis were assessed using DAS 28. Synovitis were investigated with PDUS and SMI and each joint was graded semiquantitatively. All assessments were carried out at baseline and repeated at least 4-month follow-up. Correlations between scores were investigated using Spearman's correlation. Sixty RA patients with 552 affected joints were recruited. Clinical and sonographic scores were significantly improved at follow-up (p<0.001). SMI showed significantly more joint count and flow signal scores than clinical examination and PDUS. Moderate correlations were found between SMI score and clinical scores (p<0.001,0.586 for SMI score vs DAS 28-CRP, p=0.001,0.432 for SMI vs DAS 28-ESR). There were also stronger correlations between SMI score and PDUS score at both baseline and follow-up (p<0.001, r = 0.817, 0.842 respectively). SMI provides greater utility and ability to detect synovial vascularity and monitor disease activity than PDUS. A new activity scoring system based on SMI and clinical objective findings is required to improve reliability and validity.

Use of Injectable Progesterone as a Pre-Synchronisation Strategy in a Timed Artificial Insemination Protocol Based on Gonadotropin-Releasing Hormone and Progesterone in Bos indicus Beef Cows in Anoestrous.

This study evaluated the effects of pre-synchronisation with injectable progesterone (P4) on the ovarian follicular dynamics of Bos taurus indicus cows in anoestrous treated with a timed artificial insemination (TAI) protocol. Multiparous Nelore females (n = 47) at 30-60 days postpartum were used in this study. 10 days before (D-10) the TAI protocol, antral follicle count (AFC; follicles ≥ 3 mm), ovarian condition and body condition score (BCS; 1-5) were assessed and were randomly allocated into two groups: Pre-sync (n = 25), which underwent pre-synchronisation with 150 mg of injectableP4 intramuscularly (i.m.), and control (n = 22), which received the same volume of NaCL 0.9%. On D0, the ovarian assessment was repeated, and TAI protocol was initiated in all animals, with the insertion of an intravaginal P4 device and administration of 10.5 μg of buserelin acetate (gonadotropin-releasing hormone-GnRH). On D7, the P4 device was removed, and 300 IU of equine chorionic gonadotropin, 150 μg of D-cloprostenol and 1 mg of estradiol cypionate were administered i.m. On the same day (D7), the presence of the corpus luteum (CL) was assessed, the dominant follicle was measured, and the tail was painted to evaluate estrous expression. On D9, the largest follicle was remeasured, and TAI was performed. Animals that were not detected in oestrous at the time of AI were administered 10.5 μg of GnRH i.m. Numerical data were analysed using the Mann-Whitney U test. Binary data were analysed using the Fisher's exact test (5%). BCS, both at the beginning of pre-synchronisation (p = 0.45) and TAI protocol initiation (p = 0.20), and AFC (p = 0.36) did not differ between control and Pre-sync groups. The diameter of the largest follicle was similar between the control and Pre-sync groups on D-10 (p = 0.32), D0 (p = 0.33), D7 (p = 0.29) and D9 (p = 0.22). On D7 of the protocol, the Pre-sync group had a higher percentage of CL visible on transrectal ultrasonography (84.0%; p = 0.02) than the control group (54.5%); however, the expression during oestrous did not differ between groups (p = 0.59). The pregnancy rate was similar (p = 0.64) between groups and was not influenced by the CL rate on D7 (p = 0.48), oestrous expression (p = 0.20) or their interaction (p > 0.1). Pre-synchronisation effectively increased the proportion of cows with CL on D7 without altering the diameter of the largest follicle, oestrous expression or pregnancy rate in anoestrous cows treated with a GnRH/P4-based TAI protocol.

Scoring model for the diagnosis of colorectal perforation and its differentiation from gastroduodenal perforation.

Distinguishing colorectal from gastroduodenal perforations is clinically important and challenging. We aimed to establish a scoring model based on objective findings (excluding computed tomography findings) for the diagnosis of colorectal perforation and its differentiation from gastroduodenal perforation. Patients diagnosed with colorectal or gastroduodenal perforations between January 2014 and December 2021 were retrospectively studied. Univariate and multivariate analyses were performed to identify independent variables, and a scoring model was developed based on these variables. Among 131 eligible patients, 64 (48.9%) were in the colorectal group and 67 (51.1%) were in the gastroduodenal group. White blood cell count, C-reactive protein, and quick Sequential Organ Failure Assessment score were identified as independent clinical variables associated with the diagnosis of colorectal perforation, which differentiated colorectal perforation from gastroduodenal perforation, and were used to develop a new scoring model. The scores ranged from 0 to 5, with an area under the receiver operating characteristic curve of 0.846. The probabilities of colorectal perforation with scores of 0, 1.5, 2, 3, 3.5, and 5 were 3.2, 20, 55.6, 81.8, 73.9, and 82.4%, respectively. The new scoring model may help in treatment selection and perioperative management of patients with gastrointestinal perforation.

Preservative effect of tea polyphenols and hydrogen peroxide on quality of chilled meat

The aim of this study was to research the effect of different preservatives on quality and shelf life of fresh chilled meat stored at 4 &amp;deg;C for 12 days. This study used tea polyphenols (0.2%) and hydrogen peroxide (1.27 g/L) to treat chilled pork and measured its pH, TVB-N, TBARS, the total viable bacteria count (TVC) and sensory score. The results showed that the treatments with tea polyphenols and hydrogen peroxide significantly (p &lt; 0.05) inhibited the growth of TVC on fresh chilled pork. The TVC of sample treated with tea polyphenols and hydrogen peroxide increased from initial value 3.2 to 6.0 log CFU/g after 10 and 12 days, respectively. It was also found in pH, TVB-N, TBARS and sensory measurement that the tea polyphenols and hydrogen peroxide treatment could extend the storage period of chilled meat as well as hydrogen peroxide was slightly better than tea polyphenols. It could be suggested that both tea polyphenols and hydrogen peroxide treatment has great potential to extend the shelf life of fresh chilled pork.

Nomograms for predicting short-term mortality in acute-on-chronic liver disease caused by the combination of hepatitis B virus and alcohol.

This study aimed to identify predictive factors for the prognosis of acute-on-chronic liver disease (AoCLD) due to both hepatitis B virus (HBV) and alcohol and to develop prognostic models to improve treatment management. AoCLD patients with HBV and alcohol as etiological factors were selected from two multicenter prospective cohorts (NCT02457637,NCT03641872) and included in separate training and validation cohorts (n = 180 and n = 148). In the training cohort, the CATCH-LIFE A nomogram (based on age, bilirubin, international normalized ratio, serum sodium, and hepatic encephalopathy score) and CATCH-LIFE B nomogram (based on age, bilirubin, international normalized ratio, serum albumin, white blood cell, platelet count, and hepatic encephalopathy score) had discriminatory ability for predicting 28-day (c-indexes of 0.910 and 0.899) and 90-day mortality (c-indexes of 0.878 and 0.887, respectively). The area under the curve values for 28-day and 90-day mortality prediction by the CATCH-LIFE A nomogram were 0.922 (95% CI : 0.874, 0.971) and 0.905 (0.856, 0.956), respectively, while those for the CATCH-LIFE B nomogram were 0.916(0.861,0.972) and 0.915 (0.866,0.964), respectively. Similar performance results were observed in the validation cohort. Optimal cut-off scores for each nomogram could be used for patient stratification in high- and low-risk groups, and the high-risk groups showed shorter survival times than the low-risk groups in both the training and validation cohorts. Two nomograms constructed from the first short-term follow-up data from patients with AoCLD due to combined HBV infection and alcohol exposure showed good predictive performance for 28-day and 90-day mortality and might be used to guide clinical management.

Do all complain the same? Examining the role of luxury hotels reviewer attributes using text mining

Purpose Although extant studies found the determinants of customer complaints in luxury hotels, comparison of complaint severity using reviewer characteristics (nationality, reviewer type and expertise) is limited. This study aims to identify the variation in customers’ complaint attributes among different customer categories. Design/methodology/approach This study tried to address this gap by using structural topic modelling and text mining techniques to find the sentiment score, word count, complaints attributes and severity score. The research sample covers luxury hotels in India, and online review text and their associated data has been collected and analysed. Findings The authors found that leisure customers wrote lengthier reviews and complained about the facility-related aspects (valet parking, entertainment and amenities) and food-related aspects (food variety, service and menu) while the business customers’ complaint severity score is more on salient aspects (room size, bathroom and staff related services). The international customers wrote lengthier reviews and complained more about the facility-related aspects (amenities, pick-up and entertainment) and core service offerings (stay experience, bathroom, dirtiness and complaint resolution). Whereas domestic customers complained more about stay-related aspects (food variety, quality, services, staff behaviour and stay experience). Also, this study used correlation analysis to find the dependencies between topics and uncovered underlying patterns, trends and associations, aiding in a deeper understanding and interpretation of the complaints. This study can help service providers tailor their services based on customer attributes to ensure maximum customer satisfaction. Originality/value The findings of this study can enable hotel service providers to customise their services based on customer attributes to reduce dissatisfaction among customers and promote customer loyalty. The findings of this study can also be used to devise differential promotional strategies for different types of customers.

C-reactive protein/albumin ratio versus lactate/albumin ratio as an outcome predictor for patients with sepsis and septic shock in hospital stay

Background &amp; Objective: Pre-emptively identifying individuals at risk of developing sepsis and septic shock remains challenging. In septic patients, the Lactate/Albumin Ratio (LAR) and C-reactive protein (CRP)/Albumin ratio (CAR) have been suggested to be promising prognostic indicators for prediction of intensive care unit (ICU) mortality. We compared the prognostic values of CAR and LAR in patients with sepsis and septic shock. Methodology: Eighty adult patients diagnosed with sepsis and admitted to the ICUs of Ain Shams University Hospitals, were included in this observational prospective study. CRP levels, serum lactate, serum albumin, complete blood count (CBC), procalcitonin levels, and SOFA scores were assessed upon admission, with subsequently observing 28-day mortality among the selected patients. Results: CAR values were comparable between the mortality and survival groups (P = 0.807). However, LAR values were significantly elevated in the mortality group vs the survival group (P = 0.044). ROC analysis for mortality indicated that LAR had an AUC of 0.633 at a cutoff value &gt; 0.68, achieving sensitivity and specificity of 89.4% and 21.2%, respectively. In contrast, CAR had an AUC of 0.484 at a cutoff value ≥ 1.54, with sensitivity and specificity values of 63.8% and 57.6%, respectively. Length of ICU stay (P &lt; 0.001), duration of mechanical ventilation (P &lt; 0.001), cardiovascular support (P &lt; 0.001) and the need for renal replacement therapy (P &lt; 0. 039), were increased in the mortality group compared to the survival group. Conclusion: Lactate/albumin ratio is superior and more reliable bio-marker predictor compared to C-reactive protein (CRP)/albumin ratio for ICU mortality. Abbreviations: CAR - C-reactive protein/albumin ratio; CRP - C-reactive protein; ICU - intensive care unit; LAR - Lactate/Albumin Ratio; Keywords: Albumin; CRP To Albumin Ratio; Lactate; Lactate to Albumin Ratio; Mortality; Sepsis; Septic Shock; SOFA; Survival Citation: Abdou K, Mounir M, Abdelmohsen S, Salem S, Ali A. C-reactive protein/albumin ratio versus lactate/albumin ratio as an outcome predictor for patients with sepsis and septic shock in hospital stay. Anaesth. pain intensive care 2023;28(5):901−907; DOI: 10.35975/apic.v27i5.2571 Received: July 29, 2024; Reviewed: August 23, 2024; Accepted: August 28, 2024

Patient-friendliness of ChatGPT responses: NSCLC targeted therapy.

231 Background: Non-small cell lung cancer (NSCLC) targeted therapies are complex, often requiring extensive patient education beyond what can be conveyed in a single provider visit. Given the average US reading level is at the 8th grade, and many patients seek additional information online, it is vital to evaluate the readability of online resources. This study aims to determine the patient friendliness of information provided by AI chatbots like ChatGPT in explaining NSCLC targeted therapies compared to other commonly accessed sources. Methods: This analysis included targeted therapies approved by the FDA for EGFR-mutated NSCLC: Afatinib, Erlotinib, Osimertinib, Dacomitinib, and Gefitinib. Information sources included ChatGPT 4, ChatGPT 3.5, the Patient Information section of the FDA label, and the Google featured snippet. Each version of ChatGPT was queried 10 times for each individual therapy – “My doctor is suggesting starting therapy with (Drug Name). What can I expect with this medication?”. All responses, labels, and snippets were examined by Microsoft Word for word count (WC) and Flesch Reading Ease Score (FRES), which considers average sentence length and number of syllables per word to assess readability. Data analysis was performed using ANOVA in SAS. Results: Across all therapies, Mean FRES for ChatGPT 4 was 31.21, ChatGPT 3.5 26.69, FDA labels 50.78, and Google snippets 33.1. Mean WC for ChatGPT 4 was 312.54, ChatGPT 3.5 355.78, FDA labels 1220, and Google snippets 42. Significant differences in FRES were found among sources for Afatinib (p-value &lt;0.0001), Erlotinib (p-value 0.0206), Osimertinib (p-value &lt;0.0001), Dacomitinib (p-value 0.0125), and Gefitinib (p-value &lt;0.0001). Significant differences in WC were also found among sources for Afatinib (p-value &lt;0.0001), Erlotinib (p-value &lt;0.0001), Osimertinib (p-value &lt;0.0001), and Gefitinib (p-value 0.0045). No significant difference in WC was found for Dacomitinib (p-value 0.2807). Conclusions: While the FDA label provided the most readable information, none of the sources aligned with the average 8th-grade reading level in the US, indicating a gap in accessible patient education for NSCLC targeted therapies. Notably, readability varies significantly between ChatGPT versions, affecting accessibility for users of the free version, ChatGPT 3.5. Although ChatGPT responses are more succinct compared to the verbose FDA labels, their higher education-level readability presents a barrier to comprehension. This study highlights the need for further research into optimizing AI-generated patient education materials to be both accurate and comprehensible at appropriate reading levels, thereby improving health communication strategies.

Evaluating the readability of online patient information for cholangiocarcinoma.

264 Background: The digital age has facilitated the dissemination of free comprehensive information regarding the diagnosis and treatment of various cancers. Especially for rarer cancers, such as cholangiocarcinoma, patients heavily rely on online patient information (OPI) as a primary source of information. However, the usefulness of these websites is dependent on the readability of the information. The National Institute of Health (NIH) recommends OPI have a readability level of grade 8 or lower. We sought to assess the readability of OPI for cholangiocarcinoma. Methods: We utilized Google to identify the top ten websites utilizing the search query "cholangiocarcinoma". The readability score of each website was defined as the median of ten popular standardized readability scales - Flesch–Kincaid, Gunning Fog, Coleman–Liau, Simple Measure of Gobbledygook, Automated Readability Index, FORCAST, Raygor, Fry Graph, and New Dale Chall. These readability scales were obtained using www.readable.com. Group comparisons of readability score were performed for affiliation (i.e., academic, non-profit, or government) and website content (i.e., treatment modalities, complications, clinical trials, supportive care, and survivorship). Statistical analysis was done in RStudio. Pairwise comparisons were performed using the Wilcoxon rank sum test. Results: A total of 10 websites were analyzed with 4/10 (40%) affiliated with academic institutions, 3/10 (30%) affiliated with non-profit organization, and 3/10 (30%) affiliated with government websites. The median readability score for all 10 websites was 9.95 (IQR 9.15-10.75). The majority of the websites (9/10, 90%) websites had readability scores that did not satisfy the NIH recommendation for readability. Readability scores did not differ significantly between academic, government, and nonprofit websites (p=0.68). Readability also did not differ by website content. The correlation between word count and readability score was not statistically significant (r = 0.03, p = 0.92). Conclusions: We performed a first of its kind analysis to assess the readability of OPI for cholangiocarcinoma. The median readability of OPI for cholangiocarcinoma was at a 10th grade level and the majority of the websites did not satisfy the NIH guideline for readability. Surprisingly, government websites were not simpler to read than their academic and nonprofit counterparts. Our study underscores the need to develop OPI for cholangiocarcinoma that is easily readable for patients and their caregivers. Organizations publishing OPI may use readability scores to ensure their content is accessible for the general population.

Comparison of three objective nutritional screening tools for identifying GLIM-defined malnutrition in patients with gastric cancer.

This study aimed to compare three objective nutritional screening tools for identifying GLIM-defined malnutrition in patients with gastric cancer (GC). Objective nutritional screening tools including geriatric nutritional risk index (GNRI), prognostic nutritional index (PNI), and controlling nutritional status (CONUT) score, were evaluated in patients with GC at our institution. Malnutrition was diagnosed according to the GLIM criteria. The diagnostic value of GNRI, PNI, and COUNT scores in identifying GLIM-defined malnutrition was assessed by conducting Receiver Operating Characteristic (ROC) curves and calculating the area under the curve (AUC). Additionally, sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were determined. The Kappa coefficient (k) was used to assess agreement between three objective nutritional screening tools and GLIM criteria. A total of 316 patients were enrolled in this study, and malnutrition was diagnosed in 151 (47.8%) patients based on the GLIM criteria. The GNRI demonstrated good diagnostic accuracy (AUC = 0.805, 95% CI: 0.758-0.852) for detecting GLIM-defined malnutrition, while the PNI and COUNT score showed poor diagnostic accuracy with AUCs of 0.699 (95% CI: 0.641-0.757) and 0.665 (95% CI: 0.605-0.725) respectively. Among these objective nutritional screening tools, the GNRI-based malnutrition risk assessment demonstrated the highest specificity (80.0%), accuracy (72.8%), PPV (74.8%), NPV (71.4%), and consistency (k = 0.452) with GLIM-defined malnutrition. Compared to PNI and COUNT scores, GNRI demonstrated superior performance as an objective nutritional screening tool for identifying GLIM-defined malnutrition in GC patients.

The Protective Effect of Adipose-Derived Stromal Vascular Fraction on Ovarian Function in Rats with Cyclophosphamide-Induced Ovarian Damage

Objective: The aim of this study was to investigate if adipose-derived stromal vascular fraction (SVF) treatment has any protective effect on ovarian function in rats with cyclophosphamide (CP) induced ovarian damage. Design: This was an experimental animal study. Participants/Materials, Setting, Methods: 25 mature cycling Wistar-Albino rats were randomized into four groups (n = 5 per group). Rats in groups 1 and 2 received single dose of intraperitoneal (i.p.) 1 mL/kg sodium chloride 0.9% (NaCl). Groups 3 and 4 received single dose of 75 mg/kg i.p. CP. On seventh day, SVF was prepared from adipose tissues of 5 additional rats and groups 1 and 3 received 0.9% NaCl i.p. injections while groups 2 and 4 received 0.2 mL i.p. injections of SVF. On day 21 all rats were euthanized, and serum anti-mullerian hormone (AMH) levels, primordial, primary, secondary, antral, and atretic follicle counts, AMH positive staining follicle counts along with AMH staining intensity of the follicles were evaluated. Results: Among two CP induced ovarian damaged groups, SVF treated group showed significantly higher secondary and antral follicle and lower atretic follicle counts, significantly higher mean serum AMH levels, AMH positive antral follicle count and higher intensity of AMH positive follicle scores for primary, secondary, and antral follicles when compared to untreated group. Moreover, group 1 showed no significant difference for all parameters except antral follicle count and AMH positive staining intensity scores for antral follicles when compared to group 4. Limitations: This study was conducted on experimental rat model. Conclusion: Our study demonstrated a significant protective effect of SVF against CP-induced ovarian damage which reveals the apparent need for further investigation of its precise mechanisms of action as it may provide a new treatment approach for women with premature ovarian failure.

Ultrasound in GCA: Halo Sign Quantification and Visual Symptoms, Systemic Inflammation and Relapse Risk.

A sonographic scoring system, termed Halo count and Halo score, of temporal and axillary arteries (TAXA) in suspected giant cell arteritis (GCA) has been proposed for outcome prognostication. We conducted a retrospective review into the relationship of Halo count and Halo score and clinical-laboratory parameters amongst patients diagnosed with GCA via our rapid-access pathway to determine whether these measures should form part of our local routine clinical practice. This review of TAXA ultrasound (US) images in patients with diagnosed GCA did not identify any correlation between Halo count/score and ocular symptoms, jaw claudication, 6-month relapse risk or inflammatory markers. This suggests that further prospective evaluation of Halo count and -score is required before adopting these measures into routine US scanning of TAXA for suspected GCA.

Gender Differences in Letters of Recommendations and Personal Statements for Neurotology Fellowship over 10 Years: A Deep Learning Linguistic Analysis.

Personal statements (PSs) and letters of recommendation (LORs) are critical components of the neurotology fellowship application process but can be subject to implicit biases. This study evaluated general and deep learning linguistic differences between the applicant genders over a 10-year span. Retrospective cohort. Two institutions. PSs and LORs were collected from 2014 to 2023 from two institutions. The Valence Aware Dictionary and Sentiment Reasoner (VADER) natural language processing (NLP) package was used to compare the positive or negative sentiment in LORs and PSs. Next, the deep learning tool, Empath, categorized the text into scores, and Wilcoxon rank sum tests were performed for comparisons between applicant gender. Among 177 applicants over 10 years, 120 were males and 57 were females. There were no differences in word count or VADER sentiment scores between genders for both LORs and PSs. However, among Empath sentiment categories, male applicants had more words of trust ( p = 0.03) and leadership ( p = 0.002) in LORs. Temporally, the trends show a consistently higher VADER sentiment and Empath "trust" and "leader" in male LORs from 2014 to 2019, after which there was no statistical significance in sentiment scores between genders, and females even have higher scores of trust and leadership in 2023. Linguistic content overall favored male applicants because they were more frequently described as trustworthy and leaders. However, the temporal analysis of linguistic differences between male and female applicants found an encouraging trend suggesting a reduction of gender bias in recent years, mirroring an increased composition of women in neurotology over time.

Neuroprotective Dietary Patterns and Longitudinal Changes in Cognitive Function in Older Adults

BackgroundNumerous studies have examined the association between neuroprotective diets and cognitive function during aging; however, these studies have produced divergent findings. Some studies find that greater adherence to these dietary patterns is associated with preserved cognition, whereas others find no effect. ObjectiveThe aim of this study was to examine the association of the Mediterranean, the Dietary Approach to Stop Hypertension (DASH), and Mediterranean-DASH Intervention for Neurodegeneration Delay (MIND) dietary patterns with global cognition over 4 waves of data from the Health and Retirement Study, a longitudinal panel study conducted at the University of Michigan. DesignThis is a longitudinal secondary data analysis using Health and Retirement Study data drawn from the Food Frequency Questionnaire completed as part of the Health Care and Nutrition Survey administered in 2013 to 2014, neuropsychological assessment data obtained from the Core questionnaire in 2014, 2016, 2018, and 2020, and demographic data from the Core questionnaire in 2014. Participants/settingParticipants with total daily energy intake below 600 or 800 kcal and above 6000 and 8000 kcal for women and men, respectively, were excluded based on criteria from a similar study using the same dataset. In addition, participants with a diagnosis of dementia, Alzheimer disease, or stroke as of 2014 were excluded. There were 6154 participants in the Mediterranean diet and DASH diet analyses and 5143 participants in the MIND diet analyses. Main outcome measureA global cognitive measure incorporating immediate and delayed recall, serial 7s, and backward counting scores was calculated for each participant at each wave. Statistical analysisThe primary analyses examined the association between each diet type and cognition over 4 waves using separate multilevel models that controlled for age, gender, self-rated health, years of education, total energy intake, weekly exercise, and body mass index. ResultsMediterranean and DASH diet adherence were positively and significantly associated with baseline cognition and were associated with slower cognitive decline over a 6-year period. MIND diet adherence was positively and significantly correlated with baseline cognition but was not significantly associated with slower cognitive decline over a 6-year period. Cross-level interactions for adherence to each dietary pattern and cognitive change over time, computed with standardized diet scores, were as follows: Mediterranean diet (β = .03; P = .002), DASH diet (β = .04; P = .004), and MIND diet (β = .02; P = .094). ConclusionsThe Mediterranean, DASH, and MIND dietary patterns are associated with better cognitive performance at baseline and the Mediterranean and DASH diets were associated with slower cognitive decline over time. Adherence to the DASH diet had the greatest magnitude of association with baseline cognition and rate of cognitive change.

Investigation of the Usefulness of HALP Score in Predicting Short-Term Mortality in Patients with Acute Decompensated Heart Failure in a Coronary Care Unit.

Background/Objectives: Acute decompensated heart failure (ADHF) presents a significant clinical challenge characterized by frequent hospitalizations, high mortality rates, and substantial healthcare costs. The united index of hemoglobin, albumin, lymphocytes and platelets (HALP) is a new indicator that reflects systemic inflammation and nutritional status. This study aimed to investigate the prognostic utility of the HALP score and hematological parameters in predicting short-term mortality among ADHF patients admitted to the coronary care unit (CCU). Methods: This investigation adopts a retrospective observational design, encompassing a cohort of patients with ADHF who were followed in the CCU at our medical institution between January 2019 and April 2024. Results: The cohort of 227 individuals was dichotomized into two subsets based on the presence or absence of short-term mortality in the hospital, resulting in 163 (71.8%) and 64 (28.2%) individuals in the survivor and exitus groups, respectively. Age was significantly higher in the exitus group (p-value = 0.004). Hemoglobin, lymphocyte count, platelet count, albumin, and HALP score were significantly higher in the survivor group (all p-values < 0.001). No significant difference was observed between the groups in terms of gender, diabetes mellitus (DM), coronary artery disease (CAD), or ejection fraction (EF), although hypertension (HT) prevalence was significantly higher in the exitus group (p-value = 0.038). ROC analysis demonstrated that hemoglobin, lymphocyte, albumin, and HALP score had significant discriminative power, with albumin showing the highest AUC (0.814). Conclusions: In conclusion, the HALP score and hematological parameters represent valuable prognostic feature for short-term mortality prediction in ADHF patients admitted to the CCU. These findings underscore the importance of early risk stratification and targeted interventions guided by comprehensive biomarker assessments in optimizing patient outcomes.

Translational evaluation of Gelsectan® effects on gut barrier dysfunction and visceral pain in animal models and irritable bowel syndrome with diarrhoea.

Gelsectan® is a formulation of xyloglucan (XG), pea protein, grape seed extract (PPGS) and xylo-oligosaccharides (XOS). Our aim was to examine the effect of Gelsectan® on rectal sensitivity in an animal model, abdominal pain in irritable bowel syndrome with diarrhoea (IBS-D) subjects and intestinal permeability in both conditions. Animals: Wistar rats received gavage with XOS, XG+PPGS or XG+PPGS+XOS, as a single dose or for 7days before a partial restraint stress (PRS). Visceromotor response to rectal distension and total gut paracellular permeability to 51Cr-EDTA were assessed. Humans: IBS-D and control patients were involved. After initial colonoscopy with biopsy sampling Gelsectan® was administered to IBS-D patients for 12weeks. Stool count and pain scores were documented. After treatment, colonoscopy was repeated. The permeability of biopsy samples was measured in Ussing-chambers. Adherent mucus layer, Muc-2 expression as well as TNFα, Interferon IFNγ were evaluated by histology/immunohistochemistry and ELISA assays, respectively. Animal studies: In control rats, PRS significantly increased visceromotor response as well as gut paracellular permeability. Single dose administration of XG+PPGS+XOS failed to reverse PRS, but 7days of oral treatment reversed PRS-induced rectal hypersensitivity and gut hyperpermeability. Human studies: Gelsectan® treatment significantly reduced and abdominal pain. Intestinal permeability in IBS-D patients was elevated compared with controls, Gelsectan® restored permeability in the ascendent colon. Periodic acid-Schiff-stained mucus layer was significantly thinner in IBS-D patients compared with controls, In both segments, mucus thickness and the proportion of Muc-2 positive cells were not affected by Gelsectan® treatment. IFNγ tissue level in the sigmoid colon shows modest mucosal inflammation in IBS-D. Gelsectan® prevented rectal hypersensitivity in rats, abdominal pain in human and intestinal hyperpermeability in rat and human studies respectively. These effects involve restoration of gut permeability. Based on this translational study, Gelsectan® can be considered as an effective therapy for IBS-D symptoms.