Study Group Research Articles

Phylogeny of the Chinese species groups of the subgenus Homoneura Wulp, 1891 (Diptera, Lauxaniidae, Homoneurinae) based on morphological characters

The subgenus Homoneura Wulp, 1891 (Diptera, Lauxaniidae, Homoneurinae) is highly diverse with more than 220 species known from China, representing more than 80% of the Chinese genus Homoneura Wulp, 1891. These species were assigned into 21 species groups in studies mainly focusing on the classification and description of species. The phylogenetic relationships of each subgenus of Homoneura and the phylogenetic relationship of the species groups are still not well understood. We investigated the male morphology to provide the basis to further revise the species groups of this subgenus. In this survey, 230 species were examined and 117 morphological characters obtained, a phylogenetic analysis was conducted using the maximum parsimony analysis with TNT and WinClada. The analyses yielded 45 most parsimonious trees and one strict consensus tree. A phylogenetic hypothesis is proposed dividing the subgenus Homoneura into 12 species groups: H. (H.) nigrifacies, H. (H.) pallida, H. (H.) patella, H. (H.) beckeri, H. (H.) formosae, H. (H.) henanensis, H. (H.) nigra, H. (H.) notostigma, H. (H.) ornatifrons, and H. (H.) trispina, H. (H.) laticosta, and H. (H.) quinquenotata. This research provides valuable contributions towards a better understanding of the phylogenetic relationships within the subgenus Homoneura. However, the monophyly of the genus and subgenus was not supported.

EFFECT OF MANDIBULAR THIRD MOLARS ON INCISAL MANDIBULAR CROWDING IN PATIENTS WITHOUT PREVIOUS ORTHODONTIC TREATMENT

Third molars are characterized by variability in the presence or absence in the oral cavity, time of their formation and calcification. Mandibular incisal crowding is described as the discrepancy between the mesiodistal widths of the four permanent incisors and the available space in the alveolar process. The aim of this research is to assess the potential influence of mandibular third molars on the development of lower incisor crowding through determination of retromolar eruption space and eruption level of third molars. Examinations are performed on mandibular study plaster orthodontic models and orthopantomographic images of patients, aged between 12 and 22 years. Based on the Little’s index of irregularity: the sample is divided in two groups. Retromolar eruption space was determined by: determination of the Ganss Ratio. Evaluation of the eruption level of the mandibular third molars is determined according to Pell and Gregory. There was no significant difference between patients from the study and control groups in terms of Ganss ratio value(t-test (11)=-0.261 p=0.7989). A significant difference was determined between patients from the study and control groups in terms of dental crowding (t-test (11)=-4.679 p=0.0007). In patients with the index of irregularity > 3mm Level B eruption of mandibular third molars was present with higher frequency (75%) in the examination group and (40%) in the control group. There is no great correlation between the retromolar eruption space for the third molars, the level of eruption and the mandibular incisal crowding.

The use of composite endpoints in cardiovascular outcome trials for diabetes: A review of 22 randomized clinical trials published since 2008.

To describe the use of composite endpoints (CEs) in cardiovascular outcome trials (CVOTs) of type 2 diabetes and to evaluate the significance of the individual outcomes included within these CEs from the perspectives of both patients and clinicians. Secondary objectives were to estimate the gradient of treatment effects and events across outcomes. Eligible studies were randomized controlled trials assessing CV outcomes for patients with diabetes from 2008 and onwards. Trials were identified by searching the reports from the CVOT Summit of the Diabetes & CV Disease EASD (European Association for the Study of Diabetes) Study Group. The individual outcomes comprising the CE were compared for differences in importance for patients and clinicians, proportion of events, and effect size. We included 22 trials randomizing a mean of 8098 patients to an active intervention or a comparator group for an average of 33 months (standard deviation 16). All primary outcomes were CEs, and from a patient perspective there was no gradient of importance across outcomes in 22 of 22 (100%) CEs, while the gradient was small in 22 of 22 (100%) from a clinician perspective. The gradient of effect was moderate to large in 9 of 18 (50%) reporting studies, while assessment of events was available in 15 of 22 studies (68%), finding that three of 15 (20%) had a gradient of effect of more than 5% points between included outcomes. In 10 of 22 (45%) trial reports, the results were not clearly presented as based on a CE. To avoid misinterpretation, clinicians and regulatory authorities should be careful when interpreting the results of trials, of which the main outcomes are CEs.

Cost of medical care for malignant brain tumors at hospitals in the Japan Clinical Oncology Group brain-tumor study group.

This study aimed to investigate what treatment are selected for malignant brain tumors, particularly glioblastoma (GBM) and primary central nervous system lymphoma (PCNSL), in real-world Japan and the costs involved. We conducted a questionnaire survey regarding treatment selections for newly diagnosed GBM and PCNSL treated between July 2021 and June 2022 among 47 institutions in the Japan Clinical Oncology Group-Brain Tumor Study Group. We calculated the total cost and cost per month of the initial therapy for newly diagnosed GBM or PCNSL. The most used regimen (46.8%) for GBM in patients aged ≤74years was 'Surgery + radiotherapy concomitant with temozolomide'. This regimen's total cost was 7.50 million JPY (Japanese yen). Adding carmustine wafer implantation (used in 15.0%), TTFields (used in 14.1%), and bevacizumab (BEV) (used in 14.5%) to the standard treatment of GBM increased the cost by 1.24 million JPY for initial treatment, and 1.44 and 0.22 million JPY per month, respectively. Regarding PCNSL, 'Surgery (biopsy) + rituximab, methotrexate, procarbazine, and vincristine (R-MPV) therapy' was the most used regimen (42.5%) for patients of all ages. This regimen incurred 1.07 million JPY per month. The three PCNSL regimens based on R-MPV therapy were in ultra-high-cost medical care (exceeding 1 million JPY per month). Treatment of malignant brain tumors is generally expensive, and cost-ineffective treatments such as BEV are frequently used. We believe that the results of this study can be used to design future economic health studies examining the cost-effectiveness of malignant brain tumors.

Can Faecal Zonulin and Calprotectin Levels Be Used in the Diagnosis and Follow-Up in Infants with Milk Protein-Induced Allergic Proctocolitis?

The aim of our study was to investigate whether a 1-month-long milk-free diet results in a reduction in faecal calprotectin (FC) and faecal-zonulin-related proteins (FZRP) in children with milk-protein-induced allergic proctocolitis (MPIAP). This is a single-centre, prospective, observational cohort study involving 86 infants with MPIAP, aged 1-3 months, and 30 healthy controls of the same age. The FC and FZRP were marked using the ELISA method (IDK® Calprotectin or Zonulin ELISA Kit, Immunodiagnostik AG, Bensheim, Germany). The diagnosis of MPIAP was confirmed with an open milk challenge test. FFC and FZRP proved useful in evaluating MPIAP treatment with a milk-free diet, and the resolution of allergic symptoms and a significant (p = 0.0000) decrease in the concentrations of both biomarkers were observed after 4 weeks on the diet. The FC and FZRP concentrations were still higher than in the control group. A high variability of FC concentrations was found in all the study groups. An important limitation is the phenomenon of FZRP not being produced in all individuals, affecting one in five infants. FC and FZRP can be used to monitor the resolution of colitis in infants with MPIAP treated with a milk-free diet, indicating a slower resolution of allergic inflammation than of allergic symptoms. The diagnosis of MPIAP on the basis of FC concentrations is subject to considerable error, due to the high individual variability of this indicator. FZRP is a better parameter, but this needs further research, as these are the first determinations in infants with MPIAP.

Effect of blue light emitting diode therapy on recurrent vulvovaginal candidiasis: A randomized assessor-blinded controlled trial.

Vulvovaginal Candidiasis (VVC) is a prevalent genital infection in women of reproductive age and requires effective non-drug therapies. Therefore, this study aimed to investigate the effect of blue light emitting diode (LED) therapy as an alternative treatment for recurrent VVC due to its proven antimicrobial properties. The safety and non-invasiveness of LED therapy make it a promising option for sensitive tissue applications. This randomized controlled trial recruited 60 women with culture-confirmed VVC. Participants were randomly allocated to two groups. Group A (control group) received standard antifungal treatment with Gynoconazol 0.8% vaginal cream for three consecutive nights (n=30). Group B (study group) received the same antifungal treatment plus two 60-min sessions of blue LED therapy directed at the vagina and vulva, with the sessions separated by two days (n=30). Candida count (via CHROMagar™ Candida) and vaginal pH (via AD110-AD111m) were assessed at baseline and one week after initiating treatment. Post-treatment, group (B) demonstrated a significantly greater reduction in Candida count compared to group (A) (mean difference (MD) 8.267; 95% Confidence Interval (CI) 6.723-9.811; p=0.0001). However, there was no statistically significant difference in vaginal pH between the groups (MD -0.03; 95% CI -0.244-0.178; p=0.749). Blue LED therapy effectively reduces Candida count in women with recurrent VVC without adversely affecting the vaginal pH, highlighting its safety and efficacy as a treatment modality.

Sinonasal Anatomic Variations in Headache Etiology

Abstract Purpose: Headache is a frequent clinical symptom with multiple etiologies. Our purpose is to investigate the correlation between variations in sinonasal anatomy and headaches. Methods: We retrospectively evaluated the paranasal computed tomography (CT) scans of patients with and without headaches. 118 patients presenting with headaches were included in the study group and 63 patients without headaches were included in the control group. Eight common anatomic variations were clarified and recorded in both groups regardless of whether unilateral or bilateral. Statistical analyses were performed with NCSS (Number Cruncher Statistical System) 2007 software. The results were evaluated at a significance level of p

Relationship of Non-Invasive Arterial Stiffness Parameters with 10-Year Atherosclerotic Cardiovascular Disease Risk Score in Post-COVID-19 Patients—The Results of a Cross-Sectional Study

This study evaluated the relationship of non-invasive arterial stiffness parameters with an individual 10-year risk of fatal and non-fatal atherosclerotic cardiovascular disease (ASCVD) events in the cohort post-coronavirus disease 2019 (COVID-19). The study group included 203 convalescents aged 60.0 (55.0–63.0) and 115 (56.7%) women. The ASCVD risk was assessed as low to moderate to very high based on medical history (for 62 participants with pre-existing ASCVD/diabetes/chronic kidney disease in the entire cohort) or calculated in percentages using the Systemic Coronary Risk Evaluation 2 (SCORE2) algorithm based on age, sex, smoking status, systolic blood pressure (BP), and non-high-density lipoprotein cholesterol (for 141 healthy participants). The stiffness index (SI) and reflection index (RI) measured by photoplethysmography, as well as pulse pressure (PP), calculated as the difference between systolic and diastolic BP, were markers of arterial stiffness. Stiffness parameters increased significantly with the increase in ASCVD risk in the entire cohort. In 30 (14.8%) patients in the low- to moderate-risk group, the median SI was 8.07 m/s (7.10–8.73), RI 51.40% (39.40–65.60), and PP 45.50 mmHg (40.00–57.00); in 111 (54.7%) patients in the high-risk group, the median SI was 8.70 m/s (7.40–10.03), RI 57.20% (43.65–68.40), and PP 54.00 mmHg (46.00–60.75); and in 62 (30.5%) patients in the very-high-risk group, the median was SI 9.27 m/s (7.57–10.44), RI 59.00% (50.40–72.40), and PP 60.00 mmHg (51.00–67.00). In healthy participants, the SI ≤ 9.0 m/s (sensitivity of 92.31%, area under the curve [AUC] 0.686, p < 0.001) based on the receiver operating characteristics was the most sensitive variable for discriminating low to moderate risk, and PP > 56.0 mmHg (sensitivity of 74.36%, AUC 0.736, p < 0.001) was used for discriminating very high risk. In multivariate logistic regression, younger age, female sex, PP ≤ 50 mmHg, SI ≤ 9.0 m/s, and triglycerides < 150 mg/dL had the best relationship with low to moderate SCORE2 risk. In turn, older age, currently smoking, PP > 56.0 mmHg, RI > 68.6%, and diastolic BP ≥ 90 mmHg were related to very high SCORE2 risk. In conclusion, arterial stiffness is significantly related to ASCVD risk in post-COVID-19 patients and can be helpful as a single risk marker in everyday practice. Cut-off points for arterial stiffness parameters determined based on SCORE2 may help make individual decisions about implementing lifestyle changes or pharmacological treatment of ASCVD risk factors

The Effect of Supportive Education About Gentle Birth with Audiovisual Media on Readiness to Childbirth in Third Trimester Primigravida

A third trimester primigravida mother's excessive anxiety indicates a lack of preparation that will negatively impact the mother's, the fetus's, and the delivery process's health. Making birth plans might help a mother feel more prepared for giving birth. The purpose of this study is to ascertain how preparedness for labor is affected by supportive education about gentle birth through the use of audiovisual media. Pre-experimental methodology with a single group pre-test–post-test design was employed in this study. Maternal preparation for labor and supportive education about gentle birth through audiovisual media were the research variables. In June 2023, the Pratama Anugrah Clinic in Surabaya recruited 30 participants for the study, of whom 30 were sampled using total sampling. The study group consisted of primigravida mothers in their third trimester. The questionnaire was the instrument, and the Wilcoxon test with α = 0.05 was utilized for analysis. The findings demonstrated that whereas most respondents (60%) felt well-prepared before receiving supportive education, nearly all respondents (93.3%) felt well-prepared for childbirth after receiving such information. The Pratama Anugrah Clinic Surabaya's mothers' preparedness for childbirth is impacted by supportive education, as indicated by the findings of the Wilcoxon test analysis, which yielded a P=0.003 result. The study concludes that maternal preparedness for childbirth can be positively impacted by supportive education about gentle birth through audiovisual media, leading to an increase in knowledge, information, and maternal readiness.

Differentiating Ischemic Hepatitis from Acetaminophen Overdose in Acute Liver Failure: Role of Acetaminophen Adducts-Ischemic Hepatitis vs Acetaminophen Overdose.

Acetaminophen (APAP) hepatotoxicity and ischemic hepatic injury (IH) demonstrate remarkably similar biochemical patterns. Deciding between these two etiologies in the setting of acute liver failure (ALF) can be challenging. We reviewed all cases in the Acute Liver Failure Study Group (ALFSG) registry where these diagnoses were considered, to determine reasons for, and frequency of, difficulties making these diagnoses. We hypothesized that the newly developed APAP-CYS adduct assay could help in discerning the correct diagnosis. Among 3364 patients with ALF or acute liver injury (ALI: INR ≥ 2.0 but without encephalopathy) between 1998 and 2019, 1952 (58%) received a final diagnosis of either APAP (1681) or IH (271). We utilized a review committee of senior hepatologists as well as the APAP-CYS assay (where sera were available), measuring the presence of toxic by-products of APAP injury to optimize adjudication. With these methods, a total of 575 adduct positive APAP cases included 488 recognized APAP, as well as an additional 87 patients previously diagnosed as other etiologies. Nine cases initially attributed to IH were deemed combination APAP-IH injuries. Conversely, 215 of the 280 IH subjects tested for adducts disclosed 173 confirmed as IH with adduct testing below the toxicity threshold, while 9 cases were revised from APAP to the IH-APAP combination phenotype, where both hypotension and APAP likely played a role. Discerning APAP from IH can be difficult-in rare cases, combined injury is observed (18/1952). APAP-CYS testing resulted in revising the diagnosis in 14.6% of cases.

URINARY TRACT INFECTIONS AND TOTAL PROSTATE SPECIFIC ANTIGEN TPSA

Introduction: The urinary system consists of four main organs: the kidneys, ureters, bladder, and urethra, and these organs work to filter blood, remove waste, form urine, and eliminate urine from the body. In recent years there have been encouraging strides in understanding and studying the pathogenesis of urinary tract infections (UTIs) and total prostate specific antigen-TPSA. Purpose of the study: The purpose of the research will focus on biochemical markers such as: urea, creatinine, uric acid as urine degradation products and identification of parameters of diseases of the urogenital tract. Urinary status parameters will also be analyzed such as: proteinuria, hematuria, glycosuria, bilirubin, urobilinogen, pH, etc., parameters which are present during diseases and infections of the urogenital tract. The purpose of the paper will also analyze the bacteriological and virological parameters such as: ureoplasma, mycoplasma, chlamydia, toxoplasma and cytomegalovirus, which are identifying parameters for infections of the urogenital tract in different age groups and genders. This work will also consist in the measurement of total prostate specific antigen-TPSA as a main marker for the identification of prostate diseases. Material and method: In the research, a total of 50 male patients will be taken to analyze the urinary condition. Urine analyzes will be performed by collecting urine in sterile cups and using the urine microscopy method and the urine strip test using the chromatographic method, where these analyzes were performed according to the European guideline standards manual (2023). Vitek is an identification system that can identify bacteria and yeast. This test uses the biochemical reactions and nutrient utilization of the microorganism to make the identification of the bacteria and the antibiogram. The test requires that a sufficient amount of growth be obtained during a specified growth period of 18 – 70 hours. Patients of the study group for Total Prostate Specific Antigen (TPSA) were analyzed through the blood serum in ng/mL of the patients with the fluorescent immunoassay test method with Vidas Biomerie. Also 20 patients to analyze the total prostate specific antigen TPSA with serum and will be analyzed with fluorescent enzymatic immunoassay methods (Vidas). SPSS – Software package version 20.0 Numerical series were analyzed using central tendency measures (average, median, minimum values, maximum values), as well as distribution measures (standard deviation); To determine the regularity of the frequency distribution of the examined variables, the Shapiro-Wilk W Test was used; Non-parametric tests for two independent parameters were used to test the significance and difference between some numerical parameters with irregular frequency distribution (Mann Whitney U test); To determine statistical significance, a two-way analysis was used with a significance level (means) of p<0.05. Results: From the results, it was found that urinary infections are frequent and appear during the attack with bacteria and viruses such as ureoplasma, mycoplasma, chlamydia and cytomegaloviruses, which are identifying parameters for infections of the urogenital tract in different age groups of the male gender. Conclusion: From the analyzes performed on patients of different age groups, we came to the conclusion that: • The parameters of the urinary system will be able to give a real picture of infectious diseases of the urinary tract. • Biochemical markers can identify the functional state of the urinary tract. • Antibiogram and cytomegaloviruses - microbiological and virological status can give an insight into the type of urinary infections. • The prostate-specific antigen TPSA can be taken as the main marker for the identification of tumoral disease of the prostate gland.

Mobile assessment of visual function helps to prevent Re-Injury in elderly patients with recent hip fractures

IntroductionPatients undergoing surgery due to hip fracture face an elevated risk of a subsequent fall during rehabilitation. An important contributing factor to this risk is deteriorated visual function, often responsive to intervention. This study aims to explore differences in visual acuity (VA) and stereovision (SV) between individuals with a history of fall-related hip injuries (study group) and age-matched controls, utilizing a mobile application (EuvisionTab, ET) to distinguish age-related visual decline from pathological vision. Materials & MethodsA total of 32 and 71 participants were enrolled in the study and control groups, respectively (mean age: 74.9 years, range: 60–96). Monocular logMAR VA was measured using a tablet by means of an adaptive threshold-search algorithm. SV was assessed using low-dot density static and dynamic random dot stereograms. An age-dependent reference limit for VA was established. For ET stereotests, the number of correctly identified optotypes out of 10 random presentations served as the measure for further comparisons. Visually impaired status in the study group was determined if patients failed either the VA threshold or the SV criteria. ResultsIn the control group, an apparent but statistically nonsignificant decline in VA was observed, while stereovision remained stable and did not exhibit significant age-related variations based on ET stereotests. Conversely, the study group demonstrated significantly worse results in monocular VA (p = 0.0032) and for both stereotests (p = 0.018 for static, p = 0.036 for dynamic) according to paired samples t-test and chi-square test, respectively. Hip injuries were significantly associated with visual impairment (OR = 4.88, p = 0.0012). DiscussionThis study focuses on one possible risk factor of elderly falls, namely, vision impairment. Patients with visual decay present a higher incidence of hip injuries compared to age-matched controls. This data suggest that vision screening and, when feasible, restoration of visual function may contribute to the prevention of secondary falls, refractures, or contralateral fractures. A mobile-based screening protocol, executable as part of a postoperative bedside examination and independent of specialized eye care, can be proposed.

School Corporate Social Responsibility Scale: A Validity and Reliability Study

The aim of this study is to develop a valid and reliable instrument to measure the performance of schools in relation to corporate social responsibility based on teachers’ perceptions. To this end, content and construct validity and reliability studies were conducted with the participation of 521 teachers from four different study groups. As part of the related studies, a comprehensive literature review on the phenomenon was conducted and the theoretical structure was revealed through open-ended questions to the first study group of thirty teachers. An item pool was then created in accordance with the existing scope and the type of scale was determined. Eight experts were consulted for the item pool and the item pool was finalised and a draft scale form consisting of thirty-one items was produced. The draft scale, with the addition of the administration instructions, was administered to the second study group, a group of forty teachers, and thus the pre- application was realised. The scale that emerged after the pre-test was applied to a total of 451 teachers from two different study groups for exploratory and confirmatory factor analyses, and validity and reliability analyses were conducted on the data obtained from the study groups. These analyses showed that the total variance explained by the nine-item, one-factor structure that emerged from EFA was 81.8%, and the construct validity of the scale was supported by confirming the emerging structure with CFA. Reliability analyses revealed that Cronbach’s α and McDonald’s ω values were 0.975 and 0.976 respectively, and these values, which were quite high, proved that the scale was a reliable scale. As a result, a valid and reliable scale capable of measuring teachers’ perceptions of the CSR performance of the schools where they work has been introduced to the literature.

322. IMPACT OF POSTOPERATIVE NUTRITIONAL SUPPORT MODES ON CLINICAL AND PATIENT-REPORTED OUTCOMES IN ENHANCED RECOVERY AFTER ESOPHAGECTOMY FOR CANCER

Abstract Background Enhanced Recovery After Surgery (ERAS) for esophagectomy has been demonstrated to be safe and effective. However, there is significant variation in the nutritional support treatment modes during the perioperative period. We have recently developed a novel ERAS nutritional support mode. In this study, we compared this new mode with the previous ERAS nutritional support treatment mode to assess their impact on clinical and Patient-Reported Outcomes (PROs), aiming to develop an optimal approach. Methods We enrolled 357 patients who underwent esophagectomy for esophageal thoracic cancer or esophagogastric junction cancer from June 2021 to August 2023. Two different ERAS nutritional support treatment protocols were used postoperatively: the control group previously received enteral nutrition by nasojejunal tube + parenteral nutrition + early oral diet after surgery, while the study group currently received parenteral nutrition + early oral diet. We compared the two groups in terms of clinical observation indicators, hematological analysis, serum protein changes and clinical outcomes. The comparison of quality of life on PROs was assessed using the MD Anderson Symptom Inventory. Symptom changes were analyzed using a mixed-effects model. Results A total of 324 patients successfully completed the ERAS nutritional support protocols. The success rates were 91% in the control group and 90.2% in the study group, with no statistically significant difference (p>0.05). The incidence of complications did not significantly differ between the two groups (p>0.05). Compared to the control group (n=223), the study group (n=101) significantly shortened the chest drain time (6.2±2.6 days vs. 6.6±1.5 days, p<0.05) and elevated the levels of serum total protein and albumin on the 4th postoperative day (53±5 g/L vs. 51±4 g/L, 30±2 g/L vs. 28±2 g/L, p<0.05). There were no statistically significant differences in the first flatus time, first defecation time, infusion time and postoperative hospital stay between the two groups (p>0.05). The comparison of hematological analysis, serum protein changes, changes in body weight during the perioperative period and 30-day readmission rate showed no statistically significant differences (p>0.05). In the MD Anderson Symptom Inventory, the study group had significantly better scores in sadness, dry mouth, enjoyment of life, and general activity dimensions compared to the control group (p=0.013, p<0.001, p=0.045, p=0.008). Conclusion Based on the similar rehabilitation outcomes, the simplified ERAS nutritional support treatment mode without postoperative enteral nutrition by nasojejunal tube is more optimized because it is physiological sound and significantly improves quality of life on PROs.

Effect of Lavender Oil Leg Massage on Physical, Cognitive, and Psychological Variables of Patients with Hypertension: A Randomized Controlled Trial.

Hypertension (HTN) is one of the most important non-communicable risk factors that cause cardiovascular diseases. Complementary therapies including massage and aromatherapy are widely used in the management of HTN. However, studies on aromatherapy massage in HTN are limited. Thus, this study was conducted to evaluate the effect of lavender oil leg massage on physical (cardiopulmonary function), cognitive, and psychological variables of patients with HTN. A parallel-group randomized controlled trial, comprising 100 HTN patients aged 44.99 ± 5.39 years who were recruited and randomly divided into the study group (SG) and control group (CG), was conducted. The SG received lavender oil leg massage, while the CG received supine rest for 20 min. Outcome variables like blood pressure (BP), pulse rate (PR), random blood sugar (RBS) level, oxygen saturation, pulmonary function, oral temperature, trail making test (TMT) A and B, and state anxiety and mindfulness were assessed before and after the intervention. The within-group analysis showed a significant improvement in systolic blood pressure, diastolic blood pressure, PR, RBS, TMT-A, TMT-B, and state mindfulness both in the SG and CG. However, a significant reduction in state anxiety was observed only in the SG unlike the CG. Moreover, the between-group analysis showed a significant improvement in state mindfulness and state anxiety in the SG compared to the CG. The results of this study suggest that lavender oil leg massage is effective in reducing BP and RBS, and improving cognitive function in hypertensive patients. In addition, it is more effective in reducing anxiety and improving mindfulness than rest in supine position in patients with HTN.

Individualized responses to acupuncture in premature ovarian insufficiency: A study protocol for a nested case-control trial with transcriptome analysis

BackgroundPremature ovarian insufficiency (POI), a modifiable cause of infertility with substantial implications for women's well-being, prompts the exploration of efficacious adjunctive treatments. Acupuncture emerges as a promising therapeutic avenue; however, the nuanced effects of acupuncture in POI warrant more comprehensive investigation. The intricate mechanisms dictating individualized responses remain elusive. This trial seeks to assess the effectiveness of acupuncture as an adjunctive treatment for POI, concurrently delving into the impact of transcriptome analysis on peripheral blood to unravel the underpinnings of these individual variations. The overarching objective is to enrich our comprehension of acupuncture's therapeutic potential in the context of POI, with a view to advancing holistic patient care. Methods/designConstituting an open-label, nested case-control study, this research endeavors to enroll 108 women diagnosed with POI. Participants will be randomly assigned in a 1:1 ratio to either the study group or the control group, each comprising 54 subjects. Ten patients from each group meeting specific criteria will partake in transcriptome analysis. An additional 10 subjects meeting the study criteria will form a healthy control group. The study group will exclusively undergo acupuncture treatment, while the control group will solely receive Fenmutong. Acupuncture sessions, administered thrice weekly across three menstrual cycles from the fifth day of menstruation, constitute the intervention. Primary outcome measurement rests on Follicle-Stimulating Hormone (FSH) levels, supplemented by secondary assessments encompassing biometric features, hormone biomarkers, anxiety and depression scores, and transcriptome analysis. Baseline measurements precede intervention, with post-intervention evaluations following. The study endeavors to discern specific genes linked to individualized responses to acupuncture. Data analysis, employing SPSS 25.0 software, incorporates a meticulous examination of peripheral blood samples for transcriptome analysis. The investigation aspires to shed light on genetic determinants influencing the effects of acupuncture on women with POI, thereby fostering elevated standards in patient care and management. DiscussionThis study pivots on the principal objective of scrutinizing the efficacy of acupuncture as an adjunctive treatment for POI. Beyond effectiveness, it undertakes an exploration of the intricate mechanisms underlying the diverse responses exhibited by individuals in the context of acupuncture, augmenting the depth of understanding in this therapeutic domain.

Traumatic native hip dislocation in the absence of acetabular or femoral fracture in adults: a retrospective study reporting clinical and radiological outcomes from a major trauma centre in the United Kingdom.

Posterior native hip dislocations (NHD) are high-energy injuries. Thompson-Epstein Type I dislocations describe those without significant associated femoral or acetabular fracture. The aim of this study was to compare the clinical and radiological outcomes of patients with Type I NHDs. We also evaluate the association between radiological indicators of femoroacetabular impingement (FAI) and NHD. A retrospective study from January 2012 to May 2021 compared skeletally mature patients (⩾16 years) with Type I posterior NHD to age and gender-matched controls with Type II-V posterior NHD. Patient demographics, mechanism of injury, complications and patient-reported outcome measures (PROMs) are presented. Post reduction radiographs and computed tomography were used to assess for FAI. Univariate analyses were performed to evaluate radiological outcomes. 13 patients (77% male) with Type I posterior NHD were compared to a control group of 40 patients (80% male) with Type II-V posterior NHD. 11 patients in the study group and 14 in the control group experienced isolated injuries (p = 0.01). Post-reduction complications were similar. The study group had significantly lower post-injury osteoarthritis incidence (n = 0) compared to controls (n = 18, p = 0.0083). Patients reported a mean Oxford Hip Score of 43.5 ± 2.2 and EQ-5D-VAS score of 87.1 ± 7.4, with 6 patients indicating minimal symptoms across all EQ-5D-5L domains. Radiological femoroacetabular impingement (FAI) was prevalent in both groups, especially among males. Patients who underwent emergent closed reduction of Type I NHD demonstrated good short to medium term outcomes. Our radiological findings suggest a high prevalence of FAI. Future work should aim to quantify longer term outcomes following this injury. We call for further comparative studies of patients who suffer NHD with and without fractures to aid our understanding of risk factors. Given the rarity of this injury, multicentre efforts will be required to capture large numbers of patients.

Glycoprotein IIb/IIIa Inhibitors in Acute Myocardial Infarction and Angiographic Microvascular Obstruction: The REVERSE-FLOW Trial.

Glycoprotein (GP) IIb/IIIa inhibitors are recommended in acute myocardial infarction (AMI) for bailout treatment in case of angiographic microvascular obstruction (MVO), also termed no-reflow phenomenon, after percutaneous coronary intervention (PCI) with, however, lacking evidence (class IIa, level C). The investigator-initiated, international, multicenter REVERSE-FLOW trial randomized 120 patients with AMI and Thrombolysis In Myocardial Infarction flow grade ≤2 after primary PCI to optimal medical therapy with or without GP IIb/IIIa inhibitor. The primary endpoint was infarct size (%LV) assessed by cardiac magnetic resonance (CMR). Secondary endpoints included CMR-derived MVO and 30-day adverse clinical events. The trial is registered with ClinicalTrials.gov: NCT02739711. The population was predominantly male (76.7%) with a median age of 66 years and ST-elevation myocardial infarction in 73.3% of patients. Clinical and angiographic characteristics were well balanced between the cohorts. Patients in the treatment group (n=62) received eptifibatide (n=41) or tirofiban (n=21). Infarct size assessed by CMR imaging was similar in both study groups (25.4% of left ventricular mass [LV] vs. 25.2%LV; p=0.386). However, the number of patients with evidence of CMR-derived MVO (74.5% vs. 92.2%; p=0.017) and the extent of MVO (2.1%LV vs. 3.4%LV; p=0.025) were significantly reduced in the GP IIb/IIIa inhibitor group compared to controls. Thirty-day outcome showed an increased bleeding risk after GP IIb/IIIa inhibitor administration restricted to non-life-threatening bleedings (22.6% vs. 6.9%; p=0.016) without differences in all-cause mortality (4.8% vs. 3.4%; p=0.703). Bailout GP IIb/IIIa inhibition in AMI patients with angiographic MVO failed to reduce the primary endpoint infarct size but decreased CMR-derived MVO and led to an increase in non-fatal bleeding events.

Comparative analysis of an epoxy resin-based and a premixed calcium silicate-based sealer’s push-out bond strength with and without incorporation of chitosan nanoparticles: An in vitro investigation

Aim and Objectives: The aim of the study was to compare and evaluate the push-out bond strength (POBS) of epoxy resin-based and calcium silicate-based sealers with and without incorporating chitosan nanoparticles (CSNPs). Methodology: Eighty human mandibular premolars with a single canal were taken. A standard root length of 15 mm was established. Canals were instrumented with Neoendo files up to size 30, 4% and were irrigated with 5 ml of 2.5% NaOCl, and 5 ml of ethylenediaminetetraacetic acid 17%. Then, samples were obturated using the size 30, 4% gutta-percha, single-cone technique using respective sealers. For POBS, it was grouped as Group 1 Adseal, Group 2 CeraSeal, Group 3 Adseal + 2% wt/vol CSNP, and Group 4 CeraSeal + 2% wt/vol CSNP. Samples embedded in acrylic resin were sectioned transversely at 11 and 7 mm from the apex. Dislodgment resistance was calculated using a universal testing machine. The data were analyzed using a one-way ANOVA test, followed by Tukey’s post hoc analysis. The level of significance (P value) was set at P < 0.05. Results: At 7 mm from the apex, Group 4 (CeraSeal + 2% wt/vol CSNP) demonstrated significantly higher mean POBS. However, no significant difference was observed between Groups 1 (Adseal), Group 2 (CeraSeal), and Group 3 (Adseal + 2% wt/vol CSNP). At 11 mm from the apex, Group 2 (CeraSeal) and Group 4 (CeraSeal + 2% wt/vol CSNP) demonstrated significantly higher mean POBS. On comparison between POBS at 7 mm and 11 mm from the apex, the mean POBS at the 11 mm region from the apex was significantly higher in all study groups, which was statistically significant. Conclusion: Within the limitations of the study, it has been concluded that Group 4 (CeraSeal + 2% wt/vol CSNP) has better bond strength compared to the other groups.

Analysis of Th1/Th2 Balance and Related Cytokine Changes in the Peripheral Blood of Patients with Multiple Myeloma.

This study aimed to explore the changes in Th cells and cytokines in the peripheral blood of patients with multiple myeloma before and after treatment and at the time of the bacterial infection. In total, 23 newly diagnosed MM patients admitted to the Hospital and 23 healthy individuals were selected as the study group and the control group, respectively. Flow cytometry was used to detect the Th1 and Th2 lymphocytes and cytokines, such as IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, INF-γ, IL-17A, IL-1b, TNF-α, TNF-β, and IL-12P70, in the peripheral blood of the patients at initial diagnosis, before and after treatment, and at the time of the bacterial infection. The Th1% and Th1/Th2 ratio at the time of the initial diagnosis were lower in the MM patients than in the control group, whereas the Th2% at initial diagnosis was higher in the MM patients than in the control group. The levels of IL-6, IL-8, IL-10, and IL-17A at initial diagnosis were higher in the MM patients than in the control group. After 4 cycles of treatment, the Th2% in the patients was lower than before the treatment and the Th1/Th2 ratio in the patients was higher than before the treatment. The Th1% and the levels of IL-6, IL-8, IL-10, and INF-γ increased, while the level of IL-12P70 decreased, when MM patients got a bacterial infection. The abovementioned differences were statistically significant (p < 0.05). The Th1/Th2 deviation affects the immune function of the MM patients. There were significant changes in the Th1 and Th2 lymphocytes and cytokines in newly diagnosed MM patients after the treatment. The changes in the Th lymphocytes and cytokines may be an indicator of bacterial infection.