Significant Intergroup Differences Research Articles

Effects of cognitive stimulation group programs in patients with mild Alzheimer’s disease

Objectives: This study examined the effects of a cognitive stimulation group program on cognitive functions, depression, activities of daily living (ADL), and quality of life in patients with mild Alzheimer’s disease (AD). Methods: Sixty patients with mild AD were randomized into the experimental or control groups (30 in each). Both groups underwent conventional occupational therapy for 30 minutes, followed by a 50-minute session of a cognitive stimulation group program for the experimental group and a cognitive workbook group program for the control group. Interventions for both groups were carried out for 4 weeks, five times a week, and once a day. Results: After the interventions, both groups showed significant differences in cognitive functions, depression, ADL, and quality of life ( p < 0.01, p < 0.001), with the experimental group demonstrating slightly higher scores in all assessment items. Significant intergroup differences were found in the scores for memory, the shortened Korean version of the Boston Naming Test, the Elderly Seoul Verbal Learning Test, the Korean version of the Trail Making Test Part A (depression), the Korean version of the Instrumental ADL scale, and quality of life ( p < 0.05, p < 0.01, p < 0.001). Conclusion: It has been shown that the cognitive simulation group program can be an effective intervention method to reduce the depression of mild AD patients and improve cognitive function, ADL, and quality of life. In addition, it is significant that various enjoyable activities were organized for each cognitive domain to induce active participation and motivation of the subjects. It is expected that this study can be usefully used as a guideline for the treatment of AD patients in the future.

Stage IIIA Non-Small Cell Lung Cancer Treatment and Outcomes: A Single Institution Retrospective Analysis.

Stage III non-small cell lung cancer (NSCLC) treatment remains challenging, with a multitude of treatment options available. We assessed Stage IIIA NSCLC outcomes by treatment received. We performed a single-institution retrospective review of NSCLC patients with Stage IIIA disease treated January 01, 2010-March 01, 2022. Demographics, treatments, outcomes, and failure patterns were collected. Progression-free survival (PFS) and overall survival (OS) were assessed using Kaplan-Meier analysis. Failure patterns were assessed for differences using chi-square analysis. Of 270 Stage III NSCLC patients, 134 had Stage IIIA disease with a median follow-up of 29.9 months and a median age of 66 years (IQR 60-75). 66 (49.3%) patients were male, and 105 (78.4%) were current/former smokers (with 30 median pack-years). Patients were treated with definitive radiation with/without chemotherapy (CRT; n = 77, 57.5%), surgery with neoadjuvant chemotherapy and/or radiation (Neoadj; n = 42, 31.3%), and surgery without neoadjuvant therapy (Surg; n = 15, 11.2%). Median PFS was 25.4 months (95% CI 12.5-42.6) for CRT, 22.6 months (95% CI 12.2-44.4) for Neoadj, and 22.8 months (95% CI 5.2-NA) for Surg with no significant intergroup difference (p = 0.99). Median OS was 57.0 months (95% CI 37.4-77.5) for CRT, 51.5 months (95% CI 36.7-65.5) for Neoadj, and 35.3 months (95% CI 16.8-NR) for Surg with no significant intergroup difference (p = 0.99). In this single institution retrospective study, we find no significant differences in PFS, OS, and failure patterns between patients with Stage IIIA NSCLC treated with definitive (chemo)radiation and surgery with or without neoadjuvant therapy. Further work in the immunotherapy era is needed.

Altered local spontaneous activity and functional connectivity density in major depressive disorder patients with anhedonia.

The purpose of this study was to investigate the alterations of intrinsic brain function in major depressive disorder (MDD) patients with and without anhedonia based on whole-brain level by using two novel measures, four-dimensional spatial-temporal consistency of local neural activity (FOCA) and local functional connectivity density (lFCD). A total of 26 MDD patients with anhedonia (MDD-WA), 29 MDD patients without anhedonia (MDD-WoA), and 30 healthy controls (HCs) were recruited and underwent resting-state functional magnetic resonance imaging (rs-fMRI) scanning and intrinsic brain function was explored by FOCA and lFCD. A two-sample t-test was conducted to explore FOCA and lFCD differences between MDD patients and HCs, then analysis of covariance (ANCOVA) and post hoc tests were performed to obtain brain regions with significant differences among three groups. Finally, the diagnostic performance of FOCA and lFCD values with significant inter-group difference was evaluated using receiver operating characteristic (ROC) curves. Compared to HCs, MDD patients showed decreased FOCA in the right cuneus (CUN) and left postcentral gyrus (PoCG), as well as diminished lFCD in the right CUN and left calcarine fissure and surrounding cortex (CAL). Interestingly, the MDD-WA group was more likely to exhibit decreased FOCA in the left PoCG and reduced lFCD in the left CAL after consideration for the effect of anhedonia in MDD patients. The MDD-WA group further showed increased FOCA in the bilateral caudate (CAU) and right ventral anterior nucleus (VA) when comparing to HCs. Additionally, as compared with MDD-WoA group, the MDD-WA group presented decreased FOCA in the right middle occipital gyrus (MOG), which was also negatively associated with the severity of anhedonia in MDD patients. Finally, FOCA values of the right MOG exhibited excellent discriminant validity in differentiating MDD-WA from MDD-WoA, and the other individual or combined indices of FOCA or lFCD values in the aforementioned distinct brain regions presented significant utility in distinguishing between MDD or MDD-WA and HCs. The present findings suggest that aberrant intrinsic brain function in the left CAL, left PoCG, bilateral CAU, right VA, and, especially the right MOG may be associated with anhedonia in patients with MDD. Altered FOCA in the right MOG may have the potential to be a diagnostic neuroimaging biomarker for MDD patients with anhedonia.

Anaerobic Adhesive Effect on the Counter-Torque of Zirconia Implant Abutment Screws: InVitro Study.

Implantology has become a primary solution for tooth loss due to excellent osseointegration and high long-term success rates. However, complications such as abutment screw loosening, especially in implant-supported single crowns, compromise prosthesis longevity. Anaerobic adhesives (AAs) have shown promise in mechanical fields for preventing screw loosening, but their effectiveness in dental implants, particularly zirconia, remains uncertain. This study evaluates the effect of medium-strength AA on the counter-torque and screw stability of zirconia implant abutments. Twenty neodent Zi zirconia implants were divided into two groups: control (n = 10) without adhesive and experimental (n = 10) using medium-strength AA (Loctite 242) on the prosthetic screw. Abutment screws were torqued to 32 Ncm and underwent mechanical cycling simulating mastication. Counter-torque was measured post-cycling. Structural damage and adhesive residues were inspected using a stereomicroscope. Data were analyzed using descriptive statistics including means and standard deviations (SDs). The Shapiro-Wilk test was performed to assess data normality. The counter-torque values after cycling were compared to the installation torque value using the one-sample t-test. Comparison between groups was performed using Student's t test. Statistical significance was established as p < 0.05. The presence of AA was detected on all screws, without causing damage and was easily removable. Both groups showed significantly lower counter-torque values than the installation torque, with no significant intergroup difference. Medium-strength AA did not significantly affect the counter-torque values of zirconia implant abutment screws, although it was easily removable and caused no damage.

Effects of motor imagery and action observation on pelvic floor and related structures in healthy women: A randomized controlled trial

The main aim was to assess the effects of motor imagery (MI) and action observation (AO) plus physical exercise (PE) on pelvic floor and related structures. Forty-four healthy women were randomized into three groups: MI, AO, or sham observation (SO) group. The outcome measures included the pelvic floor muscles (PFM) condition (including basal tone and strength), lumbo-pelvic motor control, and pain sensitivity. All women performed six sessions at the rate of 3 s/week (for 2 weeks). An initial assessment was carried out (T0), another one 1-week after starting the study (T1), and a third one at the end (T2). Results showed significant PFM strength gains in MI and AO groups, but not in the SO group. Regarding lumbo-pelvic motor control, both MI and AO groups obtained statistically significant changes between pre- and post-intervention Additionally, only the AO group showed significant improvements already at 1-week of intervention. Finally, all groups showed improved pain sensitivity in the likely area of referred menstrual pain post-intervention, with only the MI group showing changes 1 week after starting the intervention. In conclusion, results showed that adding MI and AO to PE program leads to an improvement of sensorimotor function of PFM and related structures in general. Despite finding no statistically significant inter-group differences, some findings such as strength gains or the lumbo-pelvic motor control improvements were only found in MI and AO groups, and this should be considered clinically.

Intranasal administration and intramuscular administration of medetomidine are effective for sedation and may increase cardiac size in cats.

This study aimed to compare the effects of intranasal (IN) and IM administration of medetomidine on cardiac size and sedation variables in cats. This study included 14 male tabby cats, aged 1 to 3 years, with American Society of Anesthesiologists status of 1 to 2. The cats were randomly assigned to 2 groups (IN and IM; n = 7 cats/group) and received 0.08 mg/kg of medetomidine. Radiographic and anesthesia parameters were recorded at multiple time points. No significant differences were observed between the groups in terms of cardiac size, except for the ventrodorsal cardiothoracic ratio, which showed a significant increase from baseline at several time points. Heart rate, respiratory rate, rectal temperature, and systolic and diastolic blood pressure showed no significant intergroup differences. Peripheral arterial oxygen saturation was significantly lower in the IM group (90 [85 to 93]) compared to the IN group (95 [92 to 100). The onset of clinical sedation was significantly faster in the IM group (3.85 ± 1.21 minutes) than in the IN group (9.85 ± 4.98 minutes). Lateral recumbency was achieved significantly earlier in the IM group (7.28 ± 1.79 minutes) compared to the IN group (12.42 ± 4.79 minutes). Both IN and IM administration of medetomidine in cats resulted in increased ventrodorsal cardiothoracic ratios compared to baseline, with no significant differences between groups for this parameter. Both IN and IM administration of medetomidine were well tolerated and effective for sedation in cats, with comparable safety profiles.

High anti-Müllerian hormone level as a predictor of poor pregnancy outcomes in women with polycystic ovary syndrome undergoing in vitro fertilization/intracytoplasmic sperm injection: a retrospective cohort study

ObjectiveTo study the correlation between anti-Müllerian hormone levels and pregnancy outcomes after in vitro fertilization/intracytoplasmic sperm injection in women with polycystic ovary syndrome, which remains controversial.MethodsThis retrospective cohort study recruited 4,719 women with infertility and polycystic ovary syndrome aged 20–40 years who underwent treatment at the Reproductive Center of Peking University Third Hospital between February 2017 and June 2023. We divided the participants into three groups according to the 25th and 75th percentile cutoffs of serum anti-Müllerian hormone: low (≤ 4.98 ng/mL, n = 1,198), average (4.98 − 10.65 ng/mL, n = 2,346), and high (≥ 10.65 ng/mL, n = 1,175). Pregnancy outcomes included live birth rate, miscarriage rate, clinical pregnancy rate, and cumulative live birth rate.ResultsThe live birth rate for fresh embryo transfer was 39.8%, 35.9%, and 30.4% in the low, average, and high anti-Müllerian hormone groups, respectively. The miscarriage rate was 11.3%, 17.1%, and 21.8% in the low, average, and high anti-Müllerian hormone groups, respectively. Significant intergroup differences were observed in the live birth rate (P = 0.017) and miscarriage rate (P = 0.018). No significant intergroup difference was observed in the clinical pregnancy rate (P = 0.204) or cumulative live birth rate (P = 0.423). After adjusting the confounders by multivariable logistic regression analysis, anti-Müllerian hormone was associated with decreased live birth rate in the high anti-Müllerian hormone group compared with that in the low anti-Müllerian hormone group (odds ratio: 0.629, 95% confidence interval: 0.460–0.860). Anti-Müllerian hormone was associated with increased miscarriage rate in the average and high anti-Müllerian hormone groups compared with that in the low anti-Müllerian hormone group (average vs. low: odds ratio: 1.592, 95% confidence interval: 1.017–2.490); high vs. low: odds ratio: 2.045, 95% confidence interval: 1.152–3.633).ConclusionHigh anti-Müllerian hormone is a prognostic factor for reduced live birth rate after fresh embryo transfer in women with polycystic ovary syndrome aged 20–40 years undergoing in vitro fertilization/intracytoplasmic sperm injection, and is associated with increased miscarriage rate in these patients.

Machine Learning-Based Clustering Using a 12-Lead Electrocardiogram in Patients With a Implantable Cardioverter Defibrillator to Identify Future Ventricular Arrhythmia

Implantable cardioverter defibrillators (ICDs) reduce mortality associated with ventricular arrhythmia in high-risk patients with cardiovascular disease. Machine learning (ML) approaches are promising tools in arrhythmia research; however, their application in predicting ventricular arrhythmias in patients with ICDs remains unexplored. We aimed to predict and stratify ventricular arrhythmias requiring ICD therapy using 12-lead electrocardiograms (ECGs) in patients with an ICD. This retrospective analysis included 200 adult patients who underwent ICD implantation at a single center. Patient demographics, clinical features, and 12-lead ECG data were collected. Unsupervised learning techniques, including K-means and hierarchical clustering, were used to stratify patients based on 12-lead ECG features. Dimensionality reduction methods were also used to optimize clustering accuracy. The silhouette coefficient was used to determine the optimal method and number of clusters. Of the 200 patients, 59 (29.5%) received appropriate therapy. The mean age of patients was 62.3 years, and 81.0% were male. The mean follow-up period was 2,953 days, with no significant intergroup differences. Hierarchical clustering into 3 clusters proved to be the most accurate (silhouette coefficient=0.585). Kaplan-Meier curves for these 3 clusters revealed significant differences (P=0.026). We highlight the potential of ML-based clustering using 12-lead ECGs to help in the risk stratification of ventricular arrhythmia. Future research in a larger multicenter setting may provide further insights and refine ICD indications.

Treatment of peri-implant mucositis using an Er:YAG laser or an ultrasonic device: a randomized, controlled clinical trial

PurposeThe study assessed the clinical outcomes following treatment of peri-implant mucositis using Er:YAG laser or an ultrasonic device over six months. Patients' experience of pain, aesthetics, and Quality of life were further assessed.MethodsOne dental implant, per included patient, diagnosed with peri-implant mucositis underwent treatment with an Er:YAG laser (test) or an ultrasonic scaler (control) randomly. Treatments were performed at baseline and months three and six. At each session, oral hygiene was instructed after plaque registration, and the patient was guided in proper cleaning technique using a toothbrush and interproximal aids as needed. Full mouth bleeding on probing (FMBoP), full mouth plaque score (FMPS), implant bleeding on probing (BoP), implant mean graded bleeding (mBI), implant probing pocket depts (PPD), implant suppuration and bone levels were assessed. Oral health-related Quality of life (OHQoL) and visual analog scales (VAS), which reflect aesthetic satisfaction and pain of the treatment, were also evaluated.ResultsForty-six patients were included. FMBoP was significantly reduced from 30.1 to 21.5% (test) (p < 0.001) respectively from 35.0% to 30% (control) (p < 0.01). FMPS showed significant reduction from 61.5 to 32.7% (test) (p < 0.001) and from 58.7 to 39.1% (control) (p < 0.001). At the implant BoP reduced from 89.0 to 55.7% (test) (p < 0.001) respectively from 94.9 to 63.7% (control) (p < 0.001). mBI was reduced from 1.3 to 0.6 (test) (p < 0.01) and from 1.9 to 0.8 (control) (p < 0.001). Distribution of “no bleeding” increased from 13 to 61% (test) (p < 0.05) and from 0 to 35% (control) (p < 0.05). At month three, statistically significant intergroup differences were shown for PPD ≥ 4 mm with 43.5% (test) respectively 73.9% (control) (p < 0.05). At month six, statistically significant intergroup differences, were shown for FMBoP 21.5% (test) respectively 30% (control) (p < 0.05) and for plaque score at the implant 4.0% (test) respectively 26% (control) (p < 0.05). Less pain was reported in the laser group at three days 0.08 (test) respectively 0.2 (control) (p < 0.05).ConclusionsTreatment of peri-implant mucositis was effective regardless of whether the treatment was performed with an Er:YAG laser or an ultrasonic scaler. Fewer diseased sites were diagnosed at six months following laser treatment.Trial registration: Registered at www.clinicaltrials.gov: study no, NCT05772299.

P1327 Microbial signatures associated with Inflammatory Bowel Disease in Australia: baseline data from the Australian IBD Microbiome study

Abstract Background Microbial dysbiosis is associated with Crohn’s disease (CD) and ulcerative colitis (UC) onset and disease activity, however, large-scale data pertaining to Australian patients are limited1. This study aimed to describe the differences in gut microbiota composition between patients with IBD and healthy controls within the Australian IBD Microbiome (AIM) study2. Methods Paired faecal and oral samples alongside participant demographics and disease characteristics were collected at baseline from all healthy controls (HC) and IBD patients enrolled in the Australian IBD Microbiome (AIM) study from June 2019 to November 2023. Faecal and oral samples were self-collected in DNA stabilising buffer, aliquoted and stored at -80oC until extraction. Samples underwent 16S rRNA sequencing with annotation of DNA sequences to operational taxonomic units at the genus level. Differences in alpha diversity (Chao1) between groups were assessed using Mann-Whitney U tests. Beta diversity (weighted UniFrac dissimilarity) in bacterial communities were shown using Principal Coordinate Analysis (PCoA), and significance of variance was tested using ADONIS in R. Results 751 participants (305 HC, 232 CD, 214 UC) returned baseline faecal (n = 697) and/or oral samples (n = 737) and were included in the analysis, with patient group characteristics presented in Table 1. Most IBD patients were in clinical remission (Table 1). However, CD and UC patients had comparably lower faecal alpha diversity than the HC group (Figure 1A). Faecal beta diversity differed between CD, UC, and HC groups (Figure 1B). Five phyla were significantly different between the three groups in faecal samples (Figure 1C). No significant inter-group differences were seen with oral microbial analysis. Conclusion Compared to healthy adults, patients with IBD in Australia have distinct gut microbial profiles. Faecal rather than oral microbial sampling demonstrated a difference in community structure between IBD and healthy groups. Incorporating longitudinal microbial sampling and increasing sequencing resolution may elucidate a pathogenic relationship between gut microbiota and IBD.

Effect of tranexamic acid dissolved in warm, cold, and room-temperature irrigation fluid on complications during and after TURP surgery: a double-blind, randomized clinical trial

BackgroundTransurethral resection of the prostate (TURP) surgery, as a common surgical technique for cases of benign prostatic hyperplasia, can often lead to various complications during and after the procedure. Among these, intraoperative bleeding and postoperative shivering are highly prevalent. Accordingly, the present study aimed to compare three combinations of tranexamic acid (TXA) dissolved in warm, cold, and room-temperature irrigation fluids to determine their greater effectiveness in reducing bleeding and postoperative complications, such as shivering, following TURP.MethodsThis prospective, double-blind clinical trial was conducted from April to November 2023 at Imam Khomeini Hospital in Alashtar, Iran. 100 patients scheduled for TURP were selected via convenience sampling and randomly assigned into four groups using a four-block and permutation design. The groups were as follows: Intervention Group A (TXA dissolved in cold irrigation fluid), Intervention Group B (TXA dissolved in room-temperature irrigation fluid), Intervention Group C (TXA dissolved in warm irrigation fluid), and the Control Group (room-temperature irrigation without TXA). Intraoperative bleeding was measured using a photometer, hemoglobin levels were assessed with the Cell-Dyn3200 hematology analyzer, and postoperative shivering was evaluated using the Crossley and Mahajan scale.ResultsPostoperative bleeding was significantly lower in Intervention Group A compared to the other groups (P < 0.05). Hemoglobin levels decreased significantly over time (P < 0.05), but no significant inter-group differences in hemoglobin changes were observed (P > 0.05). Postoperative shivering was lowest in Intervention Group C and highest in Intervention Group A (P < 0.05).ConclusionsCombining TXA in a cold irrigation fluid potentially reduces intraoperative bleeding, but is associated with a higher incidence of postoperative shivering than the other groups.

Efficacy of latissimus dorsi and teres major tendon transfer in anterosuperior irreparable rotator cuff tears and posterosuperior irreparable rotator cuff tears

BackgroundThere are various options of tendon transfer according to the different types of irreparable rotator cuff tears (IRCTs). However, there were no clear treatment options for the IRCTs involving the anterior, superior and posterior rotator cuff tears (global IRCTs). Latissimus dorsi and teres major (LDTM) could be transferred anteriorly or posteriorly in global IRCTs. The purpose of this study is to evaluate the efficacy of LDTM transfer in anterosuperior IRCTs (ASIRCTs) and posterosuperior IRCTs (PSIRCTs).MethodsThe patients who underwent anterior LDTM (aLDTM) transfer (aLDTM group, n = 35) for ASIRCTs or pLDTM transfer (aLDTM group, n = 33) for PSIRCTs between January 2017 and December 2020 were reviewed retrospectively. Clinical and functional outcomes were evaluated based on pain, patient-reported outcome scores, active range of motion (aROM) and strength of aROM. Radiological outcomes were evaluated using arthritic changes in the glenohumeral joint and transferred tendon integrity. Arthritic changes in the glenohumeral joint were evaluated using the acromiohumeral distance (AHD) and Hamada classification on the true anteroposterior radiograph.ResultsNo significant intergroup difference was confirmed in patient demographics except for preoperative fat infiltration grade of subscapularis and infraspinatus. The postoperative Constant score, and University of California and Los Angeles (UCLA) score of aLDTM group were significantly higher than that of pLDTM group (p < 0.001 and < 0.001, respectively). Moreover, the achievement of minimal clinically important difference (MCID) for American Shoulder and Elbow Surgeons score and UCLA score showed a significant difference between two groups (p = 0.021 and 0.042, respectively). The postoperative forward elevation (FE) was significantly higher in aLDTM group (p = 0.046). The postoperative FE strength and abduction strength were significantly higher in aLDTM group (p = 0.001 and 0.025, respectively). Moreover, the mean improvement of internal rotation strength in aLDTM group was significantly higher than mean improvement of external rotation strength in pLDTM group (p = 0.011). The progression of arthritic change was significantly higher in pLDTM group (p = 0.002).ConclusionAlthough LDTM transfer is an effective and safe treatment option for ASIRCTs and PSIRCTs, LDTM transfer is more effective for ASIRCTs than PSIRCTs due to its biomechanical advantage and tendon transfer principles.Level of studyLevel III.

Universal mental health training for frontline professionals (UMHT)’s feasibility analysis

Background Universal Mental Health Training for Frontline Professionals (UMHT) is an educational programme developed and piloted in Ukraine in 2021-2023. The UMHT trains frontline professionals (FLPs) to interact with, support, and refer individuals with mental health conditions for professional help. Methods To assess the UMHT feasibility in four focus areas (programme’s demand, acceptability, adaptability, and extendability), we used statistics on the actual use of the programme, as well as data from satisfaction and usability surveying of 144 programme deliverers and 714 trained frontline professionals. A combination of Kruskal-Wallis and Post Hoc Dunn tests was used to identify statistically significant intergroup differences in the UMHT usability. Results Programme’s demand increased through years of implementation (2021, 2022, 2023) in terms of the numbers of training events (27, 35, 90), trained frontline professionals (596, 779, 1548), involved donors and supporters (1, 4, 9) and implementers (2, 10, 18). The UMHT acceptability as satisfaction with the programme content and delivery, measured out of 5, is 4.81 (SD=0.291) for the UMHT trainers and 4.78(SD=0.434) for trained FLPs. The UMHT preparedness to use trained skills after participation in the training events, on the same scale, is 4.57 (SD=0.438) for the UMHT trainers and 4.46 (SD=0.650) for trained FLPs. The highest levels of usability of all UMHT skills on a scale from 0 to 1 were found for educators (0.68 [SD=0.118]), police officers (0.67 [SD=0.098]), and social workers (0.66 [SD=0.113]). Conclusions The UMHT offers a universal frame of interaction with people with mental health conditions for frontline professionals. Assessment of the UMHT feasibility shows the programme’s potential for further development and implementation. Programme trainers as its deliverers and frontline professionals as its recipients report high satisfaction with training content and delivery as well as preparedness to apply gained knowledge and skills in practice.

Comparison of Different Thromboprophylaxis Regimens in Elderly Patients Following Hip Arthroplasty.

Aims/Background Deep venous thrombosis (DVT) represents a significant postoperative complication after artificial femoral head replacement, with the incidence increasing proportionally with patient age. This study aimed to evaluate the effect of early postoperative use of intermittent pneumatic compression devices (IPC), followed by the combined use of low molecular weight heparin (LMWH) after 48 hours, for the prevention of postoperative lower limb DVT in elderly patients undergoing hip arthroplasty. Methods The retrospective study included 100 elderly patients who underwent unilateral femoral head replacement. The control group (n = 55) received combined LMWH initiated 12 hours postoperatively, while the observation group (n = 45) started combined LMWH 48 hours postoperatively. Changes in coagulation parameters, perioperative complications, and the incidence of postoperative lower limb DVT were compared between the two groups. Results Coagulation parameters showed significant changes post-intervention in both groups, with no statistically significant inter-group differences observed post-intervention (p > 0.05). The incidence of postoperative lower limb DVT did not differ significantly between the two groups (p > 0.05). However, the observation group demonstrated significantly lower postoperative blood loss, incidence of periwound hematoma, and transfusion rates compared to the control group (p < 0.05). Conclusion The sequential application of IPC in the early postoperative period, followed by combined LMWH administration after 48 hours, demonstrates comparable efficacy in preventing lower limb DVT formation in elderly patients undergoing hip arthroplasty when compared to the initiation of combined LMWH starting 12 hours postoperatively. In addition, this approach significantly reduces the risk of postoperative bleeding and exhibits a high safety profile.

Evaluation of Sorghum-Oat-Soybean Ready-To-Use Therapeutic Food (RUTF) on Nutritional Recovery and Biochemical Profiles in Rats

Mortality due to severe acute malnutrition is one of the leading causes of death especially among children in developing countries. Ready-to-use therapeutic foods (RUTFs) have become the beacon of hope in the new management scene of malnutrition. The study is aimed at the management and assessing the effectiveness of nutritional rehabilitation of malnourished rats. A 33-day study was conducted on 20 Wistar rats which were divided into five different cages randomly and were fed with varying ratios of Sorghum-Oat-Soybean (SOS) Ready-to-Use-Therapeutic Food (RUTF) formulations as well as two controls RUTFS. Results showed pre-starvation body weights of the experimental animals ranged from 104.76g (S1 group) to 106.37g (C0 group). Subsequent to 5 days of starvation, a significant reduction in body weight was observed, with values ranging from 75.05g (S1 group) to 76.11g (S3 group). Following 21 days of nutritional intervention with SOS-RUTF, significant inter-group differences (p &lt; 0.05) were detected in body and organ weights; hemoglobin, cholesterol, and triglyceride levels, ALT, AST, and ALP enzyme activities. The three SOS-RUTFs findings with of different ratios study revealed that SOS-RUTF enhanced formulations brought back the body weight, and organ weight was normal, balanced the biochemical parameters and corrected the hepatic and bone enzyme activities to near normal. These findings have important implications for the treatment of severe acute malnutrition. The study shows that the easily available, inexpensive, and nutritious SOS-RUTF can be used in clinical nutrition and is viable as an option for use in community interventions. This is especially so in developing countries where proper nutritious food is a luxury.

Is More Always Better? - A Randomized Comparative Clinical Trial About the Impact of Polidyoxanone Threads Quantity for Facial Lifting

Abstract Background Minimally invasive aesthetic procedures, such as the use of polydioxanone (PDO) threads, are increasingly popular for facial rejuvenation. Objectives This study investigates the impact of the number of PDO threads on tissue displacement, volume changes, and patient satisfaction. Methods This randomized controlled trial involved 22 subjects seeking facial lifting using PDO threads. Participants were divided into two groups: G1 with 3 threads per hemiface and G2 with 6 threads per hemiface. 3D stereophotogrammetry was used to evaluate volumetric changes and tissue displacement at baseline, 20-, and 60-days post-treatment. Patient satisfaction was assessed using the Global Aesthetic Improvement Scale (GAIS). Results Significant volumetric changes were observed over time in both midface and lower face regions (p&amp;lt;0.05), but no significant intergroup differences were found (p&amp;gt;0.6). Tissue displacement showed statistical significance over time (p=0.039) but not between groups (p=0.821). GAIS scores did not differ significantly between groups or between patients and specialists. Adverse events were minor and transient, primarily involving pain. Conclusions The number of PDO threads used did not significantly influence sustained lifting outcomes or patient satisfaction. Initial improvements in volume and tissue displacement diminished by 60 days, suggesting that additional threads do not enhance long-term efficacy. Further studies with longer follow-up are needed to better understand collagen stimulation's potential role in lasting effects.

Effect of Probiotics on the Symptomatology of Autism Spectrum Disorder and/or Attention Deficit/Hyperactivity Disorder in Children and Adolescents: Pilot Study.

The aim of this study is to investigate the impact of using probiotics with strains related to dopamine and gamma-aminobutyric acid production on clinical features of autism spectrum disorder (ASD) and/or attention deficit/hyperactivity disorder (ADHD). This randomized, controlled trial involved 38 children with ADHD and 42 children with ASD, aged 5-16years, who received probiotics (Lactiplantibacillus plantarum and Levilactobacillus brevis 109/cfu/daily) or placebo for 12weeks. Parent-reported symptoms were assessed using Conners' 3rd-Ed and the Social Responsiveness Scale Test, 2nd-Ed (SRS-2), and children completed the Conners Continuous Performance Test, 3rd-Ed (CPT 3) or Conners Kiddie CPT, 2nd-Ed (K-CPT 2). Executive functions, quality of life and sleep patterns were also parent-assessed. Intention-to-treat analyses, controlling for sociodemographic and nutritional covariates, revealed no significant inter-group differences in parent-reported or neuropsychological data after the probiotic intervention. However, age-stratified analyses showed improved hyperactivity-impulsivity symptoms in younger children with ASD (Cohen's d = 1.245) and ADHD (Cohen's d = 0.692). Intra-group analyses supported these findings in the aforementioned age and intervention group for both diagnoses. An improvement in impulsivity for children with ASD was also observed in the intra-group analysis of the CPT commissions scores (probiotic: p = 0.001, Cohen's d = -1.216; placebo: p = 0.013, Cohen's d = -0.721). A better comfort score (quality of life) was shown in children with ASD (probiotic: p = 0.010, Cohen's d = 0.722; placebo: p = 0.099, Cohen's d = 0.456). The probiotics used, may improve hyperactivity-impulsivity in children with ASD or/and ADHD and quality of life in children with ASD. Further research is warranted to explore probiotics as an adjunctive therapeutic intervention for NDs.Trial registration: clinicaltrials.gov Identifier: NCT05167110.

Morphological Study on Lenticulostriate Arteries in Patients With Middle Cerebral Artery Stenosis at 7 T MRI.

Middle cerebral artery (MCA) stenosis affects lenticulostriate arteries (LSAs) that supply the basal ganglia. Increased spatial resolution and signal-to-noise ratio of 7 T could facilitate morphological imaging of very-small-diameter LSAs. To evaluate differences in morphological characteristics of LSA among different MCA stenoses. Prospective. We enrolled 161 patients (age: 26-83 years, 115 males) with MCA-M1-segment stenosis, and assigned them to the symptomatic (ischemic stroke on imaging, or transient ischemic attack diagnosed clinically within 90 days) and asymptomatic (mild-to-moderate stenosis, ≤70% diameter reduction and severe stenosis, >70% and ≤99% diameter reductions) groups and further subdivided them into the proximal and distal stenosis subgroups. 7 T, three-dimensional time-of-flight magnetic resonance angiography (3D TOF-MRA). The number of LSA stems, branches, length, and tortuosity (LSA length/linear distance between LSA start- and endpoints) were evaluated independently in both hemispheres by 3 radiologists with 2-, 10-, and 12-years' experience, and inter-group and inter-subgroup comparisons were undertaken. Independent t tests, paired t tests, chi-square test, and multiple linear regression analysis (P < 0.05 indicated statistical significance). Compared with the asymptomatic group (N = 76), the symptomatic group (N = 85) had significantly fewer LSA branches (7.58 ± 2.31 vs. 9.29 ± 2.37) and shorter length (4.32 ± 0.84 vs. 4.59 ± 0.72 cm). There were no significant intergroup differences in LSA morphological characteristics between the mild-to-moderate and severe-stenosis subgroups (LSA stems: P = 0.457, LSA branches: P = 0.433, LSA length: P = 0.150, and LSA tortuosity: P = 0.613). The proximal stenosis subgroup had significantly fewer (8.08 ± 1.80 vs. 10.64 ± 2.21) and shorter LSA branches (4.43 ± 0.69 vs. 4.76 ± 0.71 cm) than in the distal stenosis subgroup. Multiple linear regression, after false discovery rate correction, showed that symptoms and the MCA-M1-segment-stenosis site (proximal/distal) were significantly associated with LSA and length. Having symptoms and a proximal MCA-M1 segment stenosis were associated with fewer LSA branches, whereas stenosis severity did not significantly affect LSA morphological characteristics. Lenticulostriate arteries mainly originate from the middle cerebral artery, which 7 T magnetic resonance imaging (MRI) can help visualize effectively. We mainly focused on evaluating lenticulostriate artery stems, branches, length, and tortuosity (length/linear distance between start- and endpoints) among 3 types of middle cerebral artery stenoses (symptomatic and asymptomatic, mild-to-moderate and severe stenosis, and proximal and distal stenosis). Symptomatic patients with proximal MCA stenosis had fewer lenticulostriate artery branches (7.58 ± 2.31 vs. 9.29 ± 2.37 and 8.08 ± 1.80 vs. 10.64 ± 2.21). This research based on the morphological perspective clearly depicted the lenticulostriate artery using 7 T MRI to provide more intuitive results. 2 TECHNICAL EFFICACY: Stage 3.

Comparison of Embolization Coils and Patent Ductus Arteriosus Occluders for Coronary Artery Fistula Transcatheter Closure: A Single Centre Experience.

There is no dedicated occlusive device for closing coronary artery fistulas (CAFs), and specific efficacy and safety data of various off-label occlusive devices for CAFs closure are scarce. Patients undergoing transcatheter closure of CAFs from January 2011 to December 2022 were included in the single-center retrospective study. The study population was divided into 2 groups: coils group (n=35) and patent ductus arteriosus (PDA) occluders group (n=66). No significant intergroup differences were observed in demographic characteristics except age. The presence of multiple CAF origins (54.3% vs. 4.5%, p<0.001) and multiple draining sites (51.4% vs. 3.0%, p<0.001) were more common in the coils group. In contrast, the presence of aneurysm (72.7% vs. 14.3%, p<0.001), and large fistula (75.8% vs. 37.1%, p<0.001) were more prevalent in the PDA occluders group. The acute procedural success rate of the PDA occluders group was higher compared to that of the coils group (87.9% vs. 62.9%, adjusted odds ratio [OR], 7.20; 95% confidence interval, 1.59-32.64; p=0.01). In addition, no significant intergroup differences were noted in both the recanalization rate (7.8% vs. 20%, p=0.107) and the reintervention rate (3.1% vs. 8.6%, p=0.342). Transcatheter closure of CAFs using PDA occluders was associated with significantly higher acute procedural success rates compared to coil embolization with comparable late outcomes.

Sex-Specific Analysis of the Relationship Between Ventricular Premature Contractions Frequency Distribution and Heart Rate: A Cross-Sectional Study in Chinese Adults.

To investigate the correlation between premature ventricular contraction (PVC) frequency and heart rate (HR) in Chinese adults, with an emphasis on sex-specific differences in clinical characteristics. This retrospective study analyzed 24-hour Holter monitoring data from 478 inpatients at the First People's Hospital of Yibin between January 2021 and December 2022. The inclusion criteria were age ≥18 years, ≥20hours of Holter recording, frequent PVCs (≥ 500 PVCs), and complete clinical profiles. Patients were stratified into three groups on the basis of the hourly correlation between PVC counts and HR: fast heart rate-related PVC (F-HR-PVC), slow heart rate-related PVC (S-HR-PVC), and independent heart rate-related PVC (I-HR-PVC). Heart rate variability (HRV) indices were assessed to evaluate autonomic nervous system activity. Among the 478 patients, 267 were males and 211 were females with a mean age of 65.7±13.0 years. The mean PVC burden was 5.7±7.0%, and the mean left ventricular ejection fraction (LVEF) was 59.1±8.7%. In males, the F-HR-PVC group was most common (45.3%), while in females, the I-HR-PVC group was most prevalent (50.2%). Despite these observed differences, a chi-square test did not reveal statistically significant differences in the distribution of VPC profiles between sexes (P=0.167). Analysis of clinical characteristics and Holter indices across sex groups showed significant differences in males, particularly in age, maximum heart rate, and minimum heart rate (P < 0.05). In females, significant intergroup differences were observed in VPC burden (P < 0.05). Although no significant sex differences were observed in the correlation between PVC frequency and HR, the study suggests a potential gender influence on VPC characteristics. These findings may inform future research and have implications for the development of sex-specific diagnostic and therapeutic strategies for PVCs.