Favorable Rate Research Articles

Feasibility, acceptability, and initial efficacy of empathic communication skills training to reduce lung cancer stigma in Nigeria: a pilot study.

Effective communication about cancer diagnosis and prognosis in sub-Saharan African oncology settings is often challenged by the cancer-related shame and stigma patients and families experience. Enhancing empathic communication between health care providers, including physicians and nurses, and oncology patients and their families can not only reduce cancer stigma but also improve patient engagement, treatment satisfaction, and quality of life. To reduce lung cancer stigma, we adapted an evidence-based empathic communication skills training intervention to reduce patients' experience of stigma in Nigeria and conducted a pilot study examining the feasibility and acceptability of the empathic communication skills training. Thirty health care providers, recruited from University College Hospital, Ibadan, and Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, participated in a 2.25-hour didactic and experiential training session. Participant surveys were completed before and after the training. Overall, participants reported highly favorable training evaluations, with at least 85% of health care providers agreeing or strongly agreeing to survey items assessing training relevance, novelty, clarity, and facilitator effectiveness. Self-efficacy to communicate empathically with patients increased significantly from before-training (Mean [SD] = 3.93 [0.28]) to after-training (Mean [SD] = 4.55 [0.15]; t29 = 3.51, P < .05). Significant improvements were observed in health care provider reports of empathy toward lung cancer survivors and attitude toward lung cancer care as well as significant reductions in lung cancer blame were noted. The empathic communication skills training was feasible, well received by oncology clinicians in Nigeria, and demonstrated improvements in health care provider-reported outcomes from before- to after-training.

Effect of Multiantibiotic-Loaded Bone Cement on the Treatment of Periprosthetic Joint Infections of Hip and Knee Arthroplasties-A Single-Center Retrospective Study.

Two-stage septic revision is the prevailing method for addressing late periprosthetic infections. Using at least dual-antibiotic-impregnated bone cement leads to synergistic effects with a more efficient elution of individual antibiotics. Recent data on the success rates of multiantibiotic cement spacers in two-stage revisions are rare. We conducted a retrospective follow-up single-center study involving 250 patients with late periprosthetic hip infections and 95 patients with prosthetic knee infections who underwent septic two-stage prosthesis revision surgery between 2017 and 2021. In accordance with the antibiotic susceptibility profile of the microorganisms, a specific mixture of antibiotics within the cement spacer was used, complemented by systemic antibiotic treatment. All patients underwent preoperative assessments and subsequent evaluations at 3, 6, 9, 12, 18, and 24 months post operation and at the most recent follow-up. During the observation period, the survival rate after two-step septic revision was 90.7%. Although survival rates tended to be slightly lower for difficult-to-treat (DTT) microorganism, there was no difference between the pathogen groups (easy-to-treat (ETT) pathogens, methicillin-resistant staphylococci (MRS), and difficult-to-treat (DTT) pathogens). Furthermore, there were no differences between monomicrobial and polymicrobial infections. No difference in the survival rate was observed between patients with dual-antibiotic-loaded bone cement without an additional admixture (Copal® G+C and Copal® G+V) and patients with an additional admixture of antibiotics to proprietary cement. Employing multiple antibiotics within spacer cement, tailored to pathogen susceptibility, appears to provide reproducibly favorable success rates, even in instances of infections with DTT pathogens and polymicrobial infections.

Oil saturation quantitative evaluation in lacustrine shale: Novel insights from NMR T1-T2 and displacement experiments

Oil saturation is important for shale reservior to identify favorable sections and determine the geological sweet spots. Current oil saturation evaluation methods, including experiments and empirical formulas, are not suitable for shale reservoir because of the complex mineral, fluid components and pore structure characteristics. A novel method was proposed to accurately calculate the shale oil saturation through the morphological dynamic variation characteristics of the 1D NMR T2 spectra and the signal intensity of the different hydrocarbon-bearing components of the 2D NMR T1-T2 map of shale samples with different oil and water saturation The results (1) indicated that the NMR T2 spectrum revealed that the pore structure of shale samples is complex and highly heterogeneous, and the primary factor that determines the volume of displaced oil in the displacement experiment with slight differences in wettability is the shale’s pore size distribution. (2) shown that the NMR T1-T2 map serves as a useful tool in distinguishing different hydrocarbon-bearing components of shale samples, including kerogen, adsorbed oil, free oil, structural, adsorbed water, and free water. Typically, kerogen is found in the top left region of the T1-T2 map with 10 < T1 < 100 ms & 0.02 < T2 < 0.2 ms. Based on this, T2 threshold for free oil and adsorbed oil are 2 and 0.2 ms, and the corresponding threshold of pore radius are 40 and 4 nm according to the NMR theory. (3) found that the morphological characteristics of 1D NMR T2 spectra vary with the variation of shale oil saturation. Specifically, T2 geometric mean (T2gm) and interval porosity corresponding to the first peak (Ap1) are positively and negatively correlated with oil saturation respectively. Then, oil saturation calculation method is established using the above two parameters and the Root Mean Square Error (RMSE) between the measured and calculated results is 5.85 %, which reflecting the accuracy and validity. In general, this method allows the shale oil saturation to be accurately calculated and provides basis for the determination of favorable sections and evaluation of resource of shale oil reservoir. Moreover, it also offers a new idea for the oil saturation prediction by NMR logging.

Real-world multi-target stool DNA adherence in an underserved and vulnerable prison patient population.

e15632 Background: In 2024, colorectal cancer (CRC) is estimated to be the fourth most diagnosed cancer, as well as the second leading cause of cancer death in the United States. While adherence to regular CRC screening has been suboptimal in the general population, this holds to be especially true in populations that are medically underserved. Non-invasive tests, such as the guideline recommended multi-target stool DNA (mt-sDNA) test, offer a more accessible option to increase screening participation in difficult to reach populations. Herein, we evaluated adherence to CRC screening in a cohort of prisoners who received the mt-sDNA test at a Nebraska Department of Corrections facility in Nebraska. Methods: This was a retrospective cohort study in a small prison population. Participants included both males and females between the ages of 45 and 75 years who underwent CRC screening evaluation at the prison’s medical center between June 1st – December 31st, 2023 and were offered multiple CRC screening options, including the mt-sDNA test. No inducements were provided for completion of the mt-sDNA test. Baseline demographics were collected for cohort description. The primary variable of interest was mt-sDNA test return rate (adherence), defined as completion of the mt-sDNA test within 60 days of kit receipt. We also evaluated mt-sDNA test results in secondary analyses. Results: Once inclusion criteria were applied, the resulting analysis cohort included 129 patients who were first time mt-sDNA screeners. The cohort was largely male (96.9%) and between the ages of 50-64 years (78.3%). Overall mt-sDNA test adherence was 95.3%, with the average time to test completion being 20 days. No significant difference was seen in test completion among males and females (95.2% vs 100%, respectively). Completion rates increased with patient age, at 90.9% (45-49 years), 95% (50-64 years), and 100% (65-75 years). The shortest time to completion in the population was observed amongst patients who were females (18.8 days), and those between the ages of 45-49 years (17.1 days). Negative and positive mt-sDNA test results were observed in 82.9% and 17.1% of the cohort, respectively. Conclusions: CRC screening with the mt-sDNA test in this single-center study of incarcerated participants yielded exceptionally high adherence rates within 60 days of kit receipt. Assessment of follow up colonoscopy rates for test-positive participants is ongoing. While based on a relatively small sample size in this initial study, the mt-sDNA test exhibited favorable completion rates in a difficult to reach population, supporting further efforts to characterize patient, provider, and system-level benefits that may be obtained through broader adoption of this highly accessible screening approach in this challenging healthcare setting.

Off-camera gaze decreases evaluation scores in a simulated online job interview

During the pandemic, digital communication became paramount. Due to the discrepancy between the placement of the camera and the screen in typical smartphones, tablets and laptops, mutual eye contact cannot be made in standard video communication. Although the positive effect of eye contact in traditional communication has been well-documented, its role in virtual contexts remains less explored. In this study, we conducted experiments to gauge the impact of gaze direction during a simulated online job interview. Twelve university students were recruited as interviewees. The interview consisted of two recording sessions where they delivered the same prepared speech: in the first session, they faced the camera, and in the second, they directed their gaze towards the screen. Based on the recorded videos, we created three stimuli: one where the interviewee’s gaze was directed at the camera (CAM), one where the interviewee’s gaze was skewed downward (SKW), and a voice-only stimulus without camera recordings (VO). Thirty-eight full-time workers participated in the study and evaluated the stimuli. The results revealed that the SKW condition garnered significantly less favorable evaluations than the CAM condition and the VO condition. Moreover, a secondary analysis indicated a potential gender bias in evaluations: the female evaluators evaluated the interviewees of SKW condition more harshly than the male evaluators did, and the difference in some evaluation criteria between the CAM and SKW conditions was larger for the female interviewees than for the male interviewees. Our findings emphasize the significance of gaze direction and potential gender biases in online interactions.

Long-term Safety and Efficacy of the Derivo Embolization Device in aSingle-center Series.

This study analyzes the long-term clinical and angiographic outcomes of the Derivo Embolization Device (DED), an advanced flow diverter device with an electropolished surface, for the treatment of intracranial aneurysms. Aconsecutive series of 101 patients (mean age: 58years, 72% female) treated with the DED for 122 aneurysms at asingle center between 2017 and 2023 was retrospectively analyzed for major (change in National Institutes of Health Stroke Scale [NIHSS] score ≥ 4points) and minor (change in NIHSS score < 4points) neurological events, procedural morbidity (increase of at least one point on the modified Rankin Scale), and angiographic results. There were 14(11%) recurrent aneurysms, 15(12%) ruptured aneurysms, 26(21%) posterior circulation aneurysms and 16(13%) fusiform or dissecting aneurysms. Device deployment failed in 1case (1%). Procedure-related symptomatic procedural complications consisted of 2(2%) major events (1major stroke and 1vessel perforation with intracranial hemorrhage and infarction) and 6minor events (6minor strokes). Procedural morbidity was 5%. There were no late ischemic or hemorrhagic events during follow-up. Complete and favorable aneurysm occlusion was achieved in 54% (40/74) and 62% (46/74) at amean of 5months, 71% (27/38) and 87% (33/38) at amean of 12months, and 76% (25/33) and 97% (32/33) at amean of 35months, respectively. The results demonstrate progressive aneurysm occlusion beyond 12months after DED implantation with an almost 100% favorable occlusion rate. Procedural morbidity was low and there were no late complications.

Machine learning-derived immunosenescence index for predicting outcome and drug sensitivity in patients with skin cutaneous melanoma.

The functions of immunosenescence are closely related to skin cutaneous melanoma (SKCM). The aim of this study is to uncover the characteristics of immunosenescence index (ISI) to identify novel biomarkers and potential targets for treatment. Firstly, integrated bioinformatics analysis was carried out to identify risk prognostic genes, and their expression and prognostic value were evaluated. Then, we used the computational algorithm to estimate ISI. Finally, the distribution characteristics and clinical significance of ISI in SKCM by using multi-omics analysis. Patients with a lower ISI had a favorable survival rate, lower chromosomal instability, lower somatic copy-number alterations, lower somatic mutations, higher immune infiltration, and sensitive to immunotherapy. The ISI exhibited robust, which was validated in multiple datasets. Besides, the ISI is more effective than other published signatures in predicting survival outcomes for patients with SKCM. Single-cell analysis revealed higher ISI was specifically expressed in monocytes, and correlates with the differentiation fate of monocytes in SKCM. Besides, individuals exhibiting elevated ISI levels could potentially receive advantages from chemotherapy, and promising compounds with the potential to target high ISI were recognized. The ISI model is a valuable tool in categorizing SKCM patients based on their prognosis, gene mutation signatures, and response to immunotherapy.

The Moderating Role of Government Effectiveness on the Relationship between Selected Macroeconomic Variables and Horticultural Export Performance in Kenya

The horticultural sector in Kenya plays a crucial role in driving the country’s economy, making up approximately 1.6% of the country’s GDP in 2019. Despite generating a significant Ksh152.3 billion in 2022, the value of these exports exhibited a decline compared to Ksh157.7 billion in 2021. These decreases in horticultural exports performance warrant further investigation into the underlying factors impacting this important sector. This study examines the role of government effectiveness in the relationship between different macroeconomic factors and Kenya’s horticultural exports performance using time series data from 1990 to 2021. The study’s key findings highlight the significant influence of government effectiveness on the relationship between exchange rates, inflation rates, interest rates, and horticultural export performance. This implies that well-designed government policies have the potential to enhance the positive impacts of these macroeconomic factors. The findings highlight the crucial role of government effectiveness in shaping the impact of macroeconomic factors on Kenya’s horticultural export performance. Considering these findings, the study provides a few policy recommendations. Investments in strengthening government institutions and policies can amplify the benefits of favourable exchange rates, controlled inflation, and stable interest rates on horticultural exports. Additionally, taking steps to enhance market access, decrease trade barriers, and negotiate more favourable trade agreements can amplify the advantages of favourable terms of trade for horticultural exports. Lastly, it is important to consider policies that can help address the negative effects of unfavourable terms of trade. This includes strategies like export diversification and risk management, which can be particularly effective with strong government backing.

Influence of Water Quality and Phytoplankton Community on the Growth of Litopenaeus vannamei in Low-Salinity Semi-Mass Circular Ponds

This study examines the dynamics of vannamei shrimp (Litopenaeus vannamei) cultivation in low salinity aquaculture systems, focusing on water quality parameters, plankton diversity, and shrimp growth rates. Vannamei shrimp are favored in aquaculture due to their disease resistance, rapid growth, and high survival rates. Key water quality parameters, including dissolved oxygen (DO), temperature, light intensity, pH, and salinity, were monitored over a 30-day period in low salinity ponds. The results showed significant fluctuations in these parameters, influencing shrimp health and growth. DO levels varied from 5.8 to 8.39 ppm in the morning and from 5.14 to 7.8 ppm in the afternoon. Water temperature ranged from 27.3°C to 32.3°C, light intensity from 3,170 to 66,300 lux, pH from 7.72 to 8.73, and salinity from 5 to 6 ppt. Plankton diversity and density, including species like Microcystis, Cyclotella, and Rhizosolenia, were also assessed, highlighting their role in the aquatic ecosystem. The specific growth rate (SGR) of the shrimp was calculated, showing a favorable growth rate of 2.32% per day. These findings indicate that maintaining stable water quality and diverse plankton populations is crucial for optimizing shrimp growth in low salinity aquaculture systems. This research provides valuable insights into the environmental conditions necessary for successful vannamei shrimp cultivation, emphasizing the importance of regular monitoring and management to ensure sustainable aquaculture

Frameless LINAC Stereotactic Radiosurgery for Brain Metastasis using VMAT: A Review of 20 Cases and Institutional Experience

Background/Objectives: Brain metastases can be treated with Stereotactic Radiosurgery (SRS), a precise radiation therapy approach. This study aimed to review the feasibility and efficacy of frameless LINAC-based SRS using Volumetric Modulated Arc Therapy (VMAT) in a group of 20 patients. Methods: Twenty patients diagnosed with brain metastases received VMAT SRS. Clinical characteristics such as demographics, gender, performance status, number of brain metastases, neurological symptoms, neurosurgical procedures, systemic status, prior treatments, lesion size, SRS dose, local control after SRS and toxicity profile were assessed. Results: The median age of patients was 49.5 years (range 32-63), with 80% being female. Most patients (85%) had ECOG scores of 0-1. The median lesion size treated was 16 mm, with a median dose of 20 Gy for the first SRS (SRS1). After SRS1, 75% of patients achieved Local Control (LC), with a median duration of LC of 7.65 months. Six patients received a second SRS (SRS2) with a median dose of 20 Gy to a different location. Two out of six patients achieved LC after SRS2. Radiation necrosis occurred in 2 cases (10%). The median follow-up time from brain metastasis to the last follow-up was 20.31 months (range 0-50.43 months). Conclusion: Frameless LINAC-based VMAT SRS appears to be a promising treatment option for brain metastases. Initial findings suggest favorable local control rates and further research is needed to optimize treatment strategies.

Frameless LINAC Stereotactic Radiosurgery for Brain Metastasis using VMAT: A Review of 20 Cases and Institutional Experience

Background/Objectives: Brain metastases can be treated with Stereotactic Radiosurgery (SRS), a precise radiation therapy approach. This study aimed to review the feasibility and efficacy of frameless LINAC-based SRS using Volumetric Modulated Arc Therapy (VMAT) in a group of 20 patients. Methods: Twenty patients diagnosed with brain metastases received VMAT SRS. Clinical characteristics such as demographics, gender, performance status, number of brain metastases, neurological symptoms, neurosurgical procedures, systemic status, prior treatments, lesion size, SRS dose, local control after SRS and toxicity profile were assessed. Results: The median age of patients was 49.5 years (range 32-63), with 80% being female. Most patients (85%) had ECOG scores of 0-1. The median lesion size treated was 16 mm, with a median dose of 20 Gy for the first SRS (SRS1). After SRS1, 75% of patients achieved Local Control (LC), with a median duration of LC of 7.65 months. Six patients received a second SRS (SRS2) with a median dose of 20 Gy to a different location. Two out of six patients achieved LC after SRS2. Radiation necrosis occurred in 2 cases (10%). The median follow-up time from brain metastasis to the last follow-up was 20.31 months (range 0-50.43 months). Conclusion: Frameless LINAC-based VMAT SRS appears to be a promising treatment option for brain metastases. Initial findings suggest favorable local control rates and further research is needed to optimize treatment strategies.

Li (200) with in-situ generated high entropy alloy/oxide fillers and Li2O enabling desirable Li metal anode

The development of Li metal batteries (LMBs) with high-energy density is impeded by the uncontrollable growth of Li dendrites. In this work, the Li foil is cold-pressed with ball-milled high entropy Mg/Ni/Co/Cu/Zn-based oxides (HEO), which can in-situ generate high entropy alloy/oxide and Li2O in the bulk phase and surface of composited Li anode (denoted as HEA/O@Li). During the cold-pressing process, the Li foil with polycrystalline nature transform into (200) textured Li. The in-situ generated Li2O can provide more lithiophilic sites and enrich the inorganic components of solid state interface (SEI), while the HEA/O fillers dispersed in the composited Li anode can strength corresponding mechanical stability and tune the Li+ stripping/plating process. As a result, the HEA/O@Li exhibits outstanding cycle stability for almost 1000 h at 1 mA cm−2 with fixed area capacity of 1 mAh cm−2. Moreover, the full batteries matched with LiFePO4 cathode demonstrate favorable cycling stability (110 mAh g−1 at 0.5C after 700 cycles) and rate capability.

Comparative analysis of clinical outcomes in repeat ablation for recurrent atrial tachyarrhythmia following initial pulmonary vein isolation with pulsed-field ablation and cryoballoon ablation

Abstract Background While pulsed-field ablation (PFA) holds promise for the initial catheter ablation performing pulmonary vein (PV) isolation (PVI) in patients with atrial fibrillation (AF), a repeat procedure remains necessary for those experiencing recurrent atrial tachyarrhythmia (ATA). This study aimed to evaluate the clinical outcomes of repeat procedures following the initial PFA in patients with recurrent ATA by comparing that following the initial CBA. Methods Patients who underwent a second ablation for recurrent ATA following initial PVI with pentaspline PFA or cryoballoon ablation (CBA) were included. Repeat ablation utilized radiofrequency current ablation with three-dimensional mapping guidance, involving repeat PVI combined with linear ablations when necessary. Acute data, such as documented arrhythmia before the repeat procedure, the number of reconnected PVs, procedural characteristics, and clinical follow-up, were analyzed. Results In total, 110 patients underwent initially successful PVI with PFA (N = 51) and CBA (N = 59), followed by a repeat procedure for recurrent ATA with a mean time interval of 365±299 days between the two procedures. The primary indication at the repeat procedure was atrial tachycardia (AT) in the PFA group (N = 27, 53%) and AF in the CBA group (N = 47, 80%). The overall PV reconnection rate per vein was 22.1%, with no significant difference between the two groups (19.1% in PFA vs. 24.7% in CBA, P = 0.16). Repeat PVI was successfully performed in all patients with PV reconnection (41.2% in PFA vs. 55.9% in CBA, P = 0.12). PV reconnection was most commonly found at the right inferior PV in both groups (25.5% vs. CBA; 32.2%, P = 0.44). Additional substrate modification was conducted in 76.5% of the PFA group and 74.6% in the CBA group, respectively (P = 0.82). The mean follow-up period was 349±280 days. The Kaplan-Meier curve indicated no statistical significance in the 1-year arrhythmia-free survival after the repeat procedure (62.4% in PFA vs. and 73.0% in CBA group, P = 0.54, Figure). Conclusion Comparable lesion durability between the initial PVI with PFA and CBA was unveiled during the repeat ablation. The second ablation for recurrent arrhythmia following initial PFA demonstrated a favorable clinical success rate at one year after the subsequent procedure, showing no significant difference compared to repeat ablation subsequent to CBA.arrhythmia-free survival after the repe

#2868 Clinical outcomes of octogenarians starting haemodialysis: a single center experience

Abstract Background and Aims Simultaneously with the aging of the general population, the number of patients with ESRD is also increasing. The question of the most favorable dialysis treatment arises, but the most frequently used method is still haemodialysis (HD). Method Retrospective data from patients aged 80 years or older treated with chronic HD treatments in our Dialysis Center and followed between 2009 and 2023. were studied. Results This study included 33 octogenarians (83.5 ± 5.4 years, 25M, 8F) Underlying renal diseases were hypertensive/ischaemic nephropathy (76%), diabetic nephropathy (10%), obstructive nephropathy (4%) and UN in 3 (10%). Vascular access was AV fistula in 72%, AV graft in 4%, long-term HD catheter in 17%, temporary catheter in 7%. Over half of them (i.e., 55%) were mobile, 35% mobile with assistance and 10% were immobile. Out of thirty-three, 3 died during the first 90 days of HD therapy and they were excluded from further analysis. During the observation period, 19 of 30 have died (63%). There was no statistically significant difference between those who were still alive and who died regarding their vascular access status, though all four of our patients with temporary catheters died (21% of all died, p 0.26). Also, their age (82.8±2.5 vs. 83.5±3.3 y), Charlson score (8.4±1.7 vs. 8.4±1.2), their Kt/V (1.45±0.24 vs. 1.43±0.31), Hb (104.4±6.2 vs 106.1±7.9 g/L) or albumin level (37.8±5.3 vs. 36.9±4.6 g/L) and other of blood analysis did not differ significantly between live and died patients. The only 2 parameters that were statistically significantly different were their HD vintage (34.3±21.0 vs. 57.1±39.2 p 0.05) and the last obtained lean tissue index (LTI, assessed by “Body Composition monitor” bioimpedance apparatus). Namely, their LTI was less than 10 kg/m2 BSA (present in 6 of 19, i.e. 32% of died patients and in none of the survivors, p&amp;lt;0.05) The 1-year, 2-year, 5-year survival has a favorable rate, i.e. 86%, 77%, 42% respectively (Figure:). The main causes of death were cardiovascular disease (47%), COVID (26.3%), sepsis, gastrointestinal bleeding, disseminated malignancy, stroke (1 case each) and 1 patient decided not to continue his HD treatments. Conclusion With careful clinical assessment and timely created vascular access, HD is a good choice for the treatment of very old ESKD patients. The outcomes in observed population would probably be better without pandemic COVID scenario.

Bi2S3 Confined by Covalent Organic Frameworks Enables High‐Rate High‐Capacity Potassium Storage

AbstractPotassium‐ion hybrid capacitors (PIHCs) are highly promising as an energy‐storage system. However, the rate performance and cycling performance of most materials with high capacity cannot simultaneously meet the requirements of PIHCs. In this work, a composite material of Bi2S3 nanoparticles in situ confined within a sulfur‐doped covalent organic framework (COF) and combined with graphene (Bi2S3@SCOF/G) is synthesized. Due to the synergistic effect of the stability of COF to buffer large mechanical stresses and the high electronic conductivity of graphene, the Bi2S3@SCOF/G anode reveals a high reversible capacity (503.8 mAh g−1 at 100 mA g−1 after 100 cycles) and favorable rate performance (223.9 mAh g−1 even at 5000 mA g−1). Furthermore, the PIHCs assembled with activated carbon show excellent energy density and cycling performance, indicating their potential for practical applications.

Return to athletics after total knee arthroplasty: a survey study of 784 recreational athletes across 12 sports.

Postoperative return to recreational activity is a common concern among the increasingly active total knee arthroplasty (TKA) patient population, though there is a paucity of research characterizing sport-specific return and function. This study aimed to assess participation level, postoperative return to activity, sport function, and limitations for recreational athletes undergoing TKA. A survey of recreational sports participation among primary, elective TKA patients from a single academic center between June 2011 and January 2022 was conducted. Of the 10,777 surveys administered, responses were received from 1,063 (9.9%) patients, among whom 784 indicated being active in cycling (273 [34.8%]), running (33 [4.2%]), jogging (68 [8.7%]), swimming (228 [29.1%]), tennis (63 [8.0%]), skiing (55 [7.0%]), or high-impact team sports (64 [8.2%]) between two years preoperatively and time of survey administration, and were included for analyses. Cycling (62.3% at two years preoperatively vs. 59.0% at latest follow-up) and swimming (62.7% at two years preoperatively vs. 63.6% at latest follow-up) demonstrated the most favorable participation rate changes, while running (84.0% at two years preoperatively vs. 48.5% at latest follow-up) and skiing (72.7% at two years preoperatively vs. 45.5% at latest follow-up) demonstrated the least favorable participation rate changes. The majority of respondents were "satisfied" or "very satisfied" with their return across all sports, though dissatisfaction was highest among runners and joggers. For cycling, running, jogging, and swimming, respondents most commonly reported no change in speed or distance capacity, though among these cyclists reported the highest rates of improved speed and distance. The majority of returning skiers reported improved balance, form, and ability to put on skis. Return to sport is feasible following TKA with high satisfaction. Swimming and cycling represent manageable postoperative activities with high return-rates, while runners and joggers face increased difficulty returning to equal or better activity levels. Patients should receive individualized, sports-specific counseling regarding their expected postoperative course based on their goals of treatment.

Intermediate-term impact on corneal endothelial cells and efficacy of Preserflo MicroShunt implantation in patients with open-angle glaucoma - a prospective study over two years.

Preserflo MicroShunt is a novel microinvasive bleb forming device for the treatment of primary open-angle glaucoma. The intermediate- and long-term success and the impact of this procedure on corneal endothelial cell density remain to be investigated. In this prospective observational study, 62 eyes of 55 glaucoma patients (mean age ± SD: 67.0 ± 15.0years) receiving a Preserflo MicroShunt were included. Corneal endothelial cell density, intraocular pressure and best corrected visual acuity were assessed preoperatively and at 3, 6, 9, 12, 18 and 24months postoperatively. Success rates, bleb revision rates and complications were analysed. Complete success was defined as an intraocular pressure reduction of ≥ 20% and achieving a target pressure of ≤ 18, ≤ 15 or ≤ 12mmHg without antiglaucoma medication. Qualified success indicated that the criteria were reached with or without medication. Corneal endothelial cells showed no significant decline over 24months (p > 0.05). Intraocular pressure showed a substantial reduction postoperatively (p < 0.001), decreasing from 29.6 ± 8,3mmHg to 13.0 ± 4.3mmHg after 24months (p < 0.001). Complete and qualified success with a target pressure ≤ 15mmHg was achieved in 52.9% and 54.6% of cases after 24months, respectively. Best corrected visual acuity did not change after 24months. Preserflo MicroShunt had no negative side effects on corneal endothelial cells and showed favourable success rates after 2years in patients with open-angle glaucoma.

The Great Debate: Mesh or No Mesh in Contaminated Hernia Repairs?

Abdominal hernia surgeries are commonly performed with many different approaches, and mesh utilization has become a cornerstone in hernia repair, ensuring durable outcomes with minimal recurrence risk. However, managing contaminated hernia repairs presents unique challenges due to the heightened risks of mesh infection. Recent advancements in lightweight macroporous polypropylene meshes offer promising solutions. Studies have highlighted the superiority of macroporous polypropylene meshes compared to primary suture repair and other mesh types in terms of reduced surgical site infection rates and lower hernia recurrence rates. Moreover, utilizing macroporous polypropylene mesh in the retrorectus plane is associated with a favorable salvage rate, underscoring its efficacy in contaminated hernia repairs. At the same time, contrary evidence suggests higher postoperative complications with mesh use in settings of clean-contaminated or contaminated fields. Most significant complications are increased infection rates and similar recurrence rates compared to mesh-free repairs. New synthetic mesh that is being marketed as having better outcomes than other types of mesh and potentially primary repair need to be carefully assessed as biologic mesh once used to also be touted as the mesh to use in such fields, but more research is showing higher complication rates. The risk of infection and consequent morbidity might outweigh the benefit of less recurrence risk with mesh use. Further research, including prospective studies with long-term follow-up, is warranted to elucidate optimal hernia repair strategies in contaminated fields and inform evidence-based practice guidelines.

Endometrial Elasticity is an Ultrasound Marker for Predicting Clinical Pregnancy Outcomes after Embryo Transfer.

Endometrial elasticity is a potential new marker for assessing endometrial receptivity and pregnancy outcomes based on endometrial thickness and type. Currently, little research has been conducted on the elasticity of the endometrium using shear wave elasticity imaging (SWEI). This study aimed to explore whether endometrial elasticity is an ultrasound marker for predicting clinical pregnancy outcomes after embryo transfer. A total of 245 infertile women underwent ultrasonography before embryo transfer at the Peking University Third Hospital. We compared the endometrial elasticity and sub-endometrial blood flow rate using SWEI in the groups with different pregnancy outcomes. Trends in clinical pregnancy outcomes across the quartiles of endometrial elasticity in the fundus of the uterus (E1) were assessed. Logistic regression analysis was performed to obtain odds ratios for clinical pregnancy outcomes based on the quartiles of E1, with or without adjusting for potential confounding variables. Women in the clinical pregnancy group had higher E1 values and sub-endometrial blood flow rates in the uterine fundus than those in the non-pregnancy group. Women in the highest quartile of E1 had the most favorable clinical pregnancy rates. Endometrial elasticity measured using SWEI is a promising ultrasound marker for predicting clinical pregnancy outcomes after embryo transfer.

Endovascular treatment of embolism-related acute basilar artery occlusion stroke: ADAPT versus stent retriever thrombectomy.

This study aimed to compare the efficacy and safety of a direct aspiration first-pass technique (ADAPT) and stent retriever thrombectomy (SRT) technique in embolism-related acute basilar artery occlusion (EMB-ABAO). We collected data from patients with EMB-ABAO in multiple stroke centers from January 2017 to February 2024. We defined two groups of enrolled patients, the ADAPT group and the SRT group. The primary outcome was the first attempt recanalization (FAR) rate. Secondary outcomes were the puncture to recanalization (PTR) time and the 90-day favorable functional outcome. The safety outcome was 90-day all-cause mortality rate. A total of 406 patients were screened for endovascular treatment (EVT) of ABAO ischemic stroke, and 108 patients were identified with EMB-ABAO stroke. Among these, 96 patients were included in the final analysis. Among them, 58 (60.42%) were in the ADAPT group, and 38 (39.58%) were in the SRT group. Compared with the SRT group, the ADAPT group achieved FAR more frequently (60.34% versus 39.47%; p = 0.045) and a higher 90-day favorable functional outcome rate (44.83% versus 36.84%; p = 0.438). The median PTR time of the ADAPT group was significantly shorter than that of the SRT group (42 versus 105 min; p < 0.001). In cases where EMB-ABAO is suspected, ADAPT was superior to SRT in terms of FAR rate and PTR time, but the 90-day mRS scores had no statistical significance. Given the reduced time to recanalization with ADAPT, an initial attempt at recanalization with ADAPT may be necessary before stent retriever. However, due to the study limitations, these findings should be interpreted as preliminary and require further study.