Minimum Duration Research Articles

Which intervention is optimal to control blood glucose and improve physical performance in the elderly living with type 2 diabetes mellitus? A network meta-analysis.

This study aimed to find the optimal intervention available to both control blood glucose and improve physical function in the geriatric population with T2DM. A systemic review and network meta-analysis (NMA) was conducted to assess and rank the comparative efficacy of different interventions on glycosylated hemoglobin A1c (HbAc1), fasting blood glucose (FBG), muscle mass, grip strength, gait speed, lower body muscle strength, and dynamic balance. A total of eight databases were searched for eligible randomized controlled trials (RCTs) that the elderly aged more than 60 years or with mean age ≥ 55 years, the minimal duration of the RCT intervention was 6 weeks, and those lacking data about glycemic level and at least one indicator of physical performance were excluded. The Cochrane risk of bias tool was used to assess the bias of each study included. Bayesian NMA was performed as the main results, the Bayesian meta regression and the frequentist NMA as sensitivity analysis. Of the 2266 literature retrieved, 27 RCTs with a total of 2289 older adults were included. Health management provided by health workers exerts beneficial effects that is superior to other interventions at achieving glycemic control, but less marked improvement in physical performance. Exercise combined with cognitive training showed more pronounced improvement in muscle strength, gait speed, and dynamic balance, but ranked behind in decreasing the HbAc1 and FBG. Personalized health management combined with physical and cognitive training might be the optimal intervention to both accomplish glycemic control and improvement of physical performance. Further RCTs are needed to validate and assess the confidence of our results from this NMA.

The Effect of Aerobic Exercise Frequency on Reducing Blood Glucose in Type 2 Diabetes Mellitus Sufferers in the Lingsar Health Center Working Area in 2024

One of the keys to a person suffering from diabetes mellitus being able to live a healthy life like other people without diabetes is to maintain balanced blood glucose levels within normal limits. One important way to reduce blood glucose levels, especially in type 2 DM sufferers, is exercise. This study aims to identify the effect of aerobic exercise, on changes in blood glucose levels. This research is a pre-experimental research with a one group pre-posttest approach. The research sample was 33 people suffering from type 2 DM at the Lingsar Community Health Center, selected using a simple random sampling technique. Each respondent was given aerobic exercise 3 times a week with a minimum duration of 20 minutes. Data on blood glucose levels before and after the intervention were collected using an observation sheet. The results of the study showed that the average blood glucose before the intervention was 162.2 mg/dL and after the intervention it fell to 156.14 mg/dL. The t-test with a=0.05 showed r=0.000. It can be concluded that there is an effect of aerobic exercise on the respondents' blood glucose levels. Aerobic exercise has been proven to reduce the average blood glucose level after this is done regularly. This study results can be an evidenced base for community nursing to promote regular aerobic exercise among people with DM, to help reduce or control their blood glucose.

Patient-perceived factors on treatment satisfaction in early onset scoliosis treated surgically with a minimum of ten years

BackgroundThe prognosis of surgically treated subjects with early onset scoliosis (EOS) into adulthood has been lacking. We aimed to investigate the patients’ perspectives on satisfaction with surgical treatment.MethodologyWe included all surgical candidates with EOS who had undergone index spinal surgery for scoliosis correction between 2009 and 2013. The minimum duration of postoperative follow-up was 10 years at the time of survey completion. Three questionnaires were used in this study, comprising the revised Scoliosis Research Society questionnaire (SRS-22r), the Patient-Reported Outcomes Measurement Information System (PROMIS-29), and the World Health Organization Quality of Life (WHOQOL-BREF). Measures of treatment satisfaction were retrieved from SRS-22r.ResultsThere were 29 participants who completed the survey, and thereby included in the study (i.e., a response rate of 43% and a dropout rate of 6%). Amongst them, 14, 11, and 4 individuals received posterior spinal fusion (PSF), magnetically controlled growing rods (MCGR), and traditional growing rods, respectively. The average duration after the index spinal surgery was 12.6 ± 2.2 years. Our findings revealed that self-image (across all treatment groups), sleep disruption (only in PSF), and social aspects (in both PSF and MCGR) were significantly worse when compared to the normative values. According to the multivariable linear regression model (R-square = 0.690, p < .001), an increase in SRS-22r mental health (p = .008) and PROMIS-29 social participation scores (p = .004) corresponded to 0.511 and 0.055 points increases in satisfaction. Every unit increase in PROMIS-29 fatigue (p = .043) and WHOQOL-BREF physical domain scores (p = .007) was in conjunction with 0.019 and 0.040 points decreases in satisfaction. SRS-22r self-image (p = .056) and WHOQOL-BREF environmental domain scores (p = .076) were included in the model but did not reach statistical significance.ConclusionsTo improve the long term quality of life in surgical candidates with EOS, we demonstrated that mental health, social participation, fatigue, and physical health were significant factors associated with treatment satisfaction. Interestingly, demographic and radiographic parameters did not have a significant effect in our cohort.

Seasonal dynamics of 25-hydroxyvitamin D and biogenic amines in the blood of apparently healthy women living in the city of Arkhangelsk

The aim of the study is to assess the seasonal supply of vitamin D and biogenic amines to practically healthy women of working age living in Arkhangelsk. Material and methods. The study sample included 20 practically healthy women aged 22–44 years, permanently residing in Arkhangelsk. The study was conducted over 4 seasons: during the period of increasing (March), maximum (June), decreasing (September) and minimum daylight hours (December). The concentration of 25-hydroxyvitamin D, serotonin, dopamine, adrenaline and noradrenaline in the blood were determined. Results. The annual dynamics of 25-hydroxyvitamin D level in the blood was established with its minimum content in the winter (December), followed by an increase in the vitamin concentration in the spring, the highest level during the period of maximum daylight hours (June) and a further decrease in the fall (September). During the period of minimum day length, the smallest proportion of people (15 %) with optimal 25-hydroxyvitamin D concentration is observed, while more than half of women have insufficient level, and a quarter have vitamin D deficiency. Serotonin level decreased from spring to winter. The peak of dopamine concentration was recorded in the summer; the minimum content was recorded in the autumn. The minimum concentration of adrenaline and noradrenaline is noted in the spring; the maximum levels are in the winter. Conclusions. The most critical season for 25-hydroxyvitamin D content in women blood is the minimum duration of daylight hours’ period (December), while the more favorable season can be attributed to the maximum duration period (June) and a decrease in the duration of daylight hours (September). The annual 25-hydroxyvitamin D dynamics and serotonin levels have similar features, and seasonal changes in the adrenaline and noradrenaline concentration are in the opposite direction.

High incidence of post-operative re-sprain following suture tape implantation for anterior talofibular ligament insufficiency and risk factors for post-operative re-sprain.

Anterior talofibular ligament (ATFL) insufficiency encompasses situations in which (i) frequent sprains cause ATFL loss, as evidenced by ATFL non-visualization on preoperative magnetic resonance imaging; or (ii) minimal healthy ATFL tissue for repair is left after the removal of the large os subfibulare. Suture tape implantation can be indicated for these cases rather than conventional ligament repair. This study was designed to investigate the incidence of post-operative re-sprain in patients who underwent suture tape implantation for ATFL insufficiency, and risk factors influencing the occurrence of post-operative re-sprain were identified. A total of 68 patients who underwent suture tape implantation for ATFL insufficiency from January 2016 to December 2021 were retrospectively evaluated. The minimum follow-up duration for inclusion was 2 years after surgery. All included patients were divided into two groups according to the presence of post-operative re-sprain during the follow-up period. Multiple clinico-radiographic parameters were measured, and binary logistic regression analysis was performed to determine the factors influencing post-operative re-sprain. Post-operative re-sprain occurred in 19 of the 68 patients (27.9%), and multiple re-sprains persisted in 7 patients (10.3%). Post-operative re-sprain was more likely to occur in patients who smoked after surgery (odds ratio [OR], 3.510), had generalized ligament laxity (OR, 4.364) and engaged in occupations requiring high physical activity levels (OR, 4.421), including soldiers, professional athletes, student-athletes and mailmen. The incidence of multiple post-operative re-sprains was high after suture tape implantation for ATFL insufficiency. Caution is particularly warranted in patients with risk factors, necessitating meticulous attention to their care. Careful consideration of strategies to mitigate risks when performing the surgery is also recommended. Level III.

The influence of weather conditions on the formation of the winter wheat harvest according to various precursors in the arid zone of Stavropol

Relevance. The identification of agro meteorological factors that have the greatest impact on the formation of grain yields and their consideration in the improvement of agricultural technologies is an urgent task of agriculture.Methods. The research was carried out in 1972–2023 in the fields of the Prikumsk experimental breeding station in a 6-pole grain-and-grass crop rotation. The purpose of the research is to study the influence of agro meteorological conditions on the formation of the winter wheat harvest according to various precursors for the correction and adaptation of applied agricultural technologies in the arid zone of the Stavropol Territory.Results. The yield of winter wheat significantly depended on precipitation in September — October, moisture reserves by spring, total moisture availability of crops, temperature in May and was determined by the density of plants and the weight of 1000 grains. The maximum yield was formed with precipitation in September — October &gt;117 mm, the highest density of standing (294–392 pcs/m2), spring moisture reserves in the meter soil layer and average total moisture supply for pure steam, respectively, 129–145 mm and 382 mm, occupied steam 115–135 mm and 378 mm and winter wheat 105–125 mm and 342 mm. The minimum duration of the sowing — germination period and the maximum density of standing accounted for a clean and occupied pair for the amount of precipitation for September — October (59–87), and a half-pair &gt;117 mm. Compared with pure steam, the density of standing decreased by an average of 12,2%, the yield by 19,2%, the duration of germination increased 1.4 times, and in repeated crops by 22,6%, 45,3% and 2,7 times, respectively. The mass of 1000 grains had a significant positive relationship with the density of standing by half-steam and a negative one with the average temperature for May — June by pure steam. For half-steam and pure steam, yield is more closely related to the mass of 1000 grains (r = 0.52–0.66) than to the density of standing (r = 0.45–0.50).

Effect of Tourniquet-Related Nerve Ischemia on Response to Handheld Nerve Stimulation in Ulnar Nerve Transposition.

Tourniquet-related nerve ischemia has been well studied in several reconstructive procedures, but the time-course of impaired response to intraoperative stimulation is unclear. The present study evaluated ischemic effects on conduction during ulnar nerve transposition and examined the relationship between intra- and pre- operative diagnostics. We hypothesized that intraoperative ischemia would have minimal impact on conduction. Thirty patients scheduled for anterior transposition were enrolled after preoperative examination, electrodiagnostic testing, and ultrasound. Demographic and symptom severity data were recorded. A handheld biphasic nerve stimulator was used intraoperatively to assess minimum amplitude and pulse duration needed for muscle response. Measurements were taken at 15-minute intervals after placement. Changes in threshold amplitude and pulse duration were calculated between each 15-minute interval; no significant difference was found in the change of either value (p = 0.70 and 0.178). A weak negative correlation existed between preoperative CMAP amplitudes and average intraoperative pulse duration, which increased to a moderate correlation when compared to 45-minute pulse duration (r=-0.62, p<0.01). Preoperative ulnar nerve cross-sectional area (CSA) demonstrated no significant correlation with average pulse duration but a moderate correlation with pulse duration at 45 minutes (r=0.63, p=0.01). Tourniquet use did not prevent effective intraoperative stimulation of the ulnar nerve for at least 45 minutes. The window for meaningful stimulation with tourniquet usage appears to be greater than previously thought. Preoperative nerve CMAP amplitude and CSA does appear to influence pulse duration required after 45 minutes of ischemia, suggesting that injured nerves are more susceptible to ischemia. 1.

Immediate Effects of Preconditioning Intermittent Theta Burst Stimulation on Lower Extremity Motor Cortex Excitability in Healthy Participants.

Previous studies have found that inhibitory priming with continuous theta burst stimulation (cTBS) can enhance the effect of subsequent excitatory conditioning stimuli with intermittent theta burst stimulation (iTBS) in the upper limbs. However, whether this combined stimulation approach elicits a comparable compensatory response in the lower extremities remains unclear. This study aimed to investigate how cTBS preconditioning modulated the effect of iTBS on motor cortex excitability related to the lower limb in healthy individuals. Using a randomised cross-over design, a total of 25 healthy participants (19 females, mean age = 24.80 yr) were recruited to undergo three different TBS protocols (cTBS + iTBS, sham cTBS + iTBS, sham cTBS + sham iTBS) in a random order. Each TBS intervention was administered with one-week intervals. cTBS and iTBS were administered at an intensity of 80% active motor threshold (AMT) delivering a total of 600 pulses. Before intervention (T0), immediately following intervention (T1), and 20 min after intervention (T2), the corticomotor excitability was measured for the tibialis anterior muscle of participants' non-dominant leg using a Magneuro100 stimulator and matched double-cone coil. The average amplitude of the motor-evoked potential (MEP) induced by applying 20 consecutive monopulse stimuli at an intensity of 130% resting motor threshold (RMT) was collected and analysed. Compare with T0 time, the MEP amplitude (raw and normalised) at T1 and T2 showed a statistically significant increase following the cTBS + iTBS protocol (p < 0.01), but no significant differences were observed in amplitude changes following other protocols (sham cTBS + iTBS and sham cTBS + sham iTBS) (p > 0.05). Furthermore, no statistically significant difference was found among the three protocols at any given time point (p > 0.05). Preconditioning the lower extremity motor cortex with cTBS prior to iTBS intervention can promptly enhance its excitability in healthy participants. This effect persists for a minimum duration of 20 min. No: ChiCTR2300069315. Registered 13 March, 2023, https://www.chictr.org.cn.

Longevous ionogels with high strength, conductivity, adhesion and thermoplasticity

The longevity of flexible electronics substantially influences their viability for practical use. At present, the service life of pliable devices utilizing conductive gels is frequently compromised due to factors inclusive but not limited to solvent loss. Taking cues from the steadfast structure of human tissues, we hereby delineate a solvent-assisted strategy to fabricate ionogels, predicated on a supramolecular network of hydrogen bonds. Upon subjecting these ionogels to realistic operational environments, it has been empirically ascertained that they maintain a steadfast mechanical and electrical consistency for a minimum duration of 22 months. In terms of dynamic stretchability, they effortlessly endure one million stretch cycles, even when faced with a notch. The induction of a supramolecular structure within the ionogel not only confers exceptional mechanical attributes but also simultaneously enhances conductivity, a feat paralleled by few recent explorations. Furthermore, these ionogels boast of superior anti-freezing and adhesive characteristics, including a toughness extending up to 17.96 MJ/m3 at an ultra-low temperature of −50 °C, and an adhesive capacity permitting movement and bearing of items weighing over 10,000 times its own weight, the lap-shear strength can reach 30.2 kPa. Intriguingly, these gels demonstrate thermoplastic behavior, which facilitates their easy reshaping into diverse forms. Such compelling attributes amplify the potential of supramolecular ionogels, positioning them as formidable contenders for flexible electronics in stringent and challenging scenarios.

Acupuncture-related interventions improve chemotherapy-induced peripheral neuropathy: A systematic review and network meta-analysis

BackgroundThe previous effects of acupuncture-related interventions in improving chemotherapy-induced peripheral neuropathy (CIPN) symptoms and quality of life (QoL) remain unclear in terms of pairwise comparisons.AimsThis systematic review and network meta-analysis aimed to determine the hierarchical effects of acupuncture-related interventions on symptoms, pain, and QoL associated with CIPN in cancer patients undergoing chemotherapy.MethodsNine electronic databases were searched, including PubMed, Embase, Cochrane Library, EBSCO, Medline Ovid, Airiti Library, China National Knowledge Infrastructure (CNKI), China Journal full-text database (CJFD), and Wanfang. Medical subject heading terms and text words were used to search for eligible randomized controlled trials published from database inception to May 2023.ResultsA total of 33 studies involving 2,027 participants were included. Pairwise meta-analysis revealed that acupuncture-related interventions were superior to usual care, medication, or dietary supplements in improving CIPN symptoms, CIPN pain, and QoL. Furthermore, network meta-analysis indicated that acupuncture plus electrical stimulation (acupuncture-E) had the greatest overall effect among the various interventions. The surface under the cumulative ranking curve (SUCRA) revealed that acupuncture-E ranked the highest in improving CINP symptoms. Acupuncture alone was most effective in reducing CIPN pain, and acupuncture plus moxibustion (acupuncture-M) ranked highest in enhancing QoL.ConclusionThis finding suggests that acupuncture-related interventions can provide patients with benefits in improving CIPN symptoms, pain, and QoL. In particular, acupuncture-E could be the most effective approach in which the provided evidence offers diverse options for cancer patients and healthcare professionals.Implication for the profession and/or patient careThese findings provide valuable insights into the potential benefits of acupuncture-related interventions for managing symptoms, pain, and QoL associated with CIPN in patients undergoing chemotherapy. Among the various interventions studied, overall, acupuncture-E had the most significant impact and was effective for a minimum duration of 3 weeks. On the other hand, transcutaneous electrical acupoint/nerve stimulation (TEAS) was identified as a noninvasive and feasible alternative for patients who had concerns about needles or the risk of bleeding. It is recommended that TEAS interventions should be carried out for a longer period, preferably lasting 4 weeks, to achieve optimal outcomes.Trial registrationThe study protocol was registered in the International Prospective Register of Systematic Reviews. Registration Number: CRD42022319871.

Multimodal Imaging of Structural Damage and Inflammation in Psoriatic Arthritis: A comparison of DMARD-Naive and DMARD-Failure Patients.

To compare inflammatory and structural differences in active Psoriatic Arthritis (PsA) between disease-modifying antirheumatic drug (DMARD)-naive and DMARD-failure patients using diverse imaging approaches for future analyses. Additionally, to explore the influence of patient characteristics (clinical and demographic variables) on imaging findings. Of the 80 patients included from the first cohort of the ongoing multicentre TOFA-PREDICT trial, 40 were DMARD-naive and 40 were DMARD-failure (csDMARD failure; 1 prior bDMARD excluding etanercept was allowed), all meeting classification criteria for PsA with a minimum disease duration of eight weeks. Baseline conventional radiographs of hands and feet, MRIs of both ankles, and whole-body 18F-FDG PET/CT were evaluated for inflammatory and structural imaging parameters, including Sharp-van der Heijde (SHS), Heel Enthesitis Magnetic Resonance Imaging Scoring System (HEMRIS) and Deauville synovitis scoring. Differences between groups and the influence of patient characteristics were examined with multiple linear regression. At baseline, patient characteristics were similar between groups. Imaging parameters showed limited inflammation and structural damage. Inflammatory imaging parameters were not significantly different (p> 0.200). Among structural parameters, only HEMRIS Achilles tendon structural damage was significantly different (p= 0.024, R2=0.071) and, SHS Joint Space Narrowing was not statistically significant (p= 0.050, R2=0.048) with higher values for both in DMARD-failures. After correction of patient characteristics, these differences in imaging disappeared (both p> 0.600). At baseline, PsA patient groups were comparable concerning structural and inflammatory imaging parameters, especially after correcting for patient characteristics. Thus, DMARD-naive and DMARD-failure patient groups may be combined in future PsA progression and treatment decision studies. EudraCT: 2017-003900-28.

PsySuite: An android application designed to perform multimodal psychophysical testing.

In behavioral sciences, there is growing concern about the inflation of false-positive rates due to the amount of under-powered studies that have been shared in the past years. While problematic, having the possibility to recruit (lots of) participants (for a lot of time) is realistically not achievable for many research facilities. Factors that hinder the reaching of optimal sample sizes are, to name but a few, research costs, participants' availability and commitment, and logistics. We challenge these issues by introducing PsySuite, an Android app designed to foster a remote approach to multimodal behavioral testing. To validate PsySuite, we first evaluated its ability to generate stimuli appropriate to rigorous psychophysical testing, measuring both the app's accuracy (i.e., stimuli's onset, offset, and multimodal simultaneity) and precision (i.e., the stability of a given pattern across trials), using two different smartphone models. We then evaluated PsySuite's ability to replicate perceptual performances obtained using a classic psychophysical paradigm, comparing sample data collected with the app against those measured via a PC-based setup. Our results showed that PsySuite could accurately reproduce stimuli with a minimum duration of 7ms, 17ms, and 30ms for the auditory, visual, and tactile modalities, respectively, and that perceptual performances obtained with PsySuite were consistent with the perceptual behavior observed using the classical setup. Combined with the high accessibility inherently supported by PsySuite, here we ought to share the app to further boost psychophysical research, aiming at setting it to a cheap, user-friendly, and portable level.

Outcomes associated with isoniazid preventive therapy for tuberculosis prevention among human immunodeficiency virus positive patients attending antiretroviral therapy clinics in Mangalore

Background The World Health Organization recommends that Isoniazid Preventive Therapy (IPT) should be administered to all People living with Human immunodeficiency virus (PLHIV) not currently suffering from tuberculosis (TB) to reduce the incidence of the same. The objectives of this study were to determine the incidence of PLHIV who contracted TB after receiving 6 months of IPT (followed up for ≥ 2 years), the incidence of PLHIV who developed tuberculosis when not on IPT, and the occurrence of adverse drug reactions due to IPT. Methods A Retrospective Cohort study was conducted in two ART centers in Mangalore, which included PLHIV who had completed 6 months of IPT from January 2017 to May 2018 and were followed up until May 2020; patients in the comparison group consisted of those attending ART centers during the same period who did not receive IPT. These data were retrieved from the case files of these patients from June to November 2020, entered into MS Excel, and analyzed using statistical package for social science (SPSS) version 25. Results The study included 1014 patients: 525 (51.8%) received IPT and 489 (48.2%) did not. Eight (1.5%) patients developed TB after IPT completion compared to 32 (6.5%) patients who developed TB from the non-IPT group. There was a 77% reduction in the incidence of developing TB in those patients who received IPT as compared to those who haven’t receive IPT (RR of 0.23, p value &lt;0.0001). The reason for stopping IPT were due to side effects of IPT, experienced by 77 (14.6%) patients. Conclusions This study indicated that the completion of IPT significantly reduced the TB burden, showing significant protection against TB for a minimum duration of 2 years. Thus, implementation of IPT should be strengthened, and strict compliance should be ensured to reduce TB infection among PLHIV.

Outpatient selected lobar lavage: A novel approach to managing pulmonary alveolar proteinosis

BACKGROUND Pulmonary alveolar proteinosis (PAP) is a rare disease characterized by the accumulation of surfactant components in alveoli, impairing gas exchange. The mainstay of treatment remains whole lung lavage (WLL); however, selected lobar lavage (SLL) using smaller volumes of normal saline has also been described. Due to the marked variability in the severity and natural history of PAP, there is a need for more tailored treatment approaches. METHODS Repeated outpatient SLL were performed using conscious sedation and fiberoptic bronchoscopy at intervals between 1 and 6 weeks. Each procedure targeted a single lobe, with the order of lavages based on degree of radiographic involvement. The bronchoscope was modified with a flushing pump to deliver warm normal saline in 100 mL aliquots up to a maximum of 3000 mL. Computed tomography scans and pulmonary function testing were performed at baseline and repeated after completion of all lavages. RESULTS Radiographic and symptomatic improvement was noted in all cases and physiologic improvement was noted in three of four cases. The only complication was transient procedural hypoxemia. All patients were able to be discharged home on the same day of their procedure. INTERPRETATION Our experience suggests outpatient SLL is a safe and effective alternative to WLL in mild-moderate cases of PAP with the benefits of avoiding admission to hospital, general anesthesia, and endotracheal intubation with single-lung ventilation. All patients remained relapse free for a minimum follow-up duration of 11 months.

Endoscopic Submucosal Resection Turbinoplasty and Partial Inferior Turbinectomy for Management of Inferior Turbinate Hypertrophy: A Randomized Clinical Trial.

This study aims to compare outcomes of endoscopic submucosal resection Turbinoplasty and partial inferior turbinectomy in the treatment of Chronic inferior turbinate hypertrophy. A randomized prospective comparative study was conducted on 40 patients who complained of a minimum 3-month duration of nasal obstruction combined with clinical findings of moderate to severe inferior turbinate hypertrophy. Patients were divided into two groups: Group A (Endoscopic submucosal resection Turbinoplasty), and Group B (partial inferior turbinectomy) Which included 20 patients in each group. The outcomes of both techniques were analyzed and compared. A total of 40 patients were randomized with 20 patients assigned to each group. Within each group, there were 12 (60%) females and 8 (40%) males. The median age in Group A was 22.7 (IQR, 7.50), and 26.5 (IQR, 15.5) in Group B. There were statistically significant differences between the two groups regarding nasal obstruction, nasal discharge, and crustations favoring Group A (p < 0.001, 0.003, 0.013 respectively). Additionally, there was a statistically significant increase in anterior nasal space postoperatively in Group A over Group B (p < 0.001) while a statistically significant increase in posterior nasal space was detected in Group B over Group A (p < 0.001). Also, there was a statistically significant reduction in turbinate size anteriorly and posteriorly in Group B over Group A (p < 0.001). submucosal resection Turbinoplasty is a safe and reliable technique of high efficacy and minimal complications that allows precise excision of hypertrophied stromal tissue in a submucosal plane which protects the physiological function of overlying respiratory precious mucosa and has minimal complications. the trial was retrospectively registered at Clinical Trail.Gov identifier: NCT06310083.

One versus 2years of alendronate following denosumab: the CARD extension.

When denosumab is discontinued, antiresorptive therapy is critical to attenuate high-turnover bone loss. The ideal choice and duration of antiresorptive therapy are not yet defined, however. In the Comparison of Alendronate or Raloxifene following Denosumab (CARD) study, we demonstrated that 12months of alendronate was better able to maintain the bone mineral density (BMD) gains achieved with 12months of denosumab versus 12months of raloxifene. In this extension, we wished to determine if 12months of alendronate would be sufficient in maintaining these denosumab-induced BMD gains. In the CARD study, postmenopausal osteoporotic women aged 60-79 at high fracture risk received 12months of denosumab 60-mg SC every 6months followed by 12months of either alendronate 70mg weekly (N = 26) or raloxifene (N = 25). All subjects in the alendronate arm were then offered participation in a 1-year extension in which they were randomized to continue alendronate for an additional 12months (N = 10) or to receive calcium and vitamin D alone (N = 8). The primary outcome was change in spine BMD between months 24 and 36. Exploratory endpoints included changes in areal BMD (aBMD) at other anatomic sites as well as changes in serum bone turnover markers. The CARD study demonstrated the effectiveness of 12months alendronate in preserving denosumab-induced BMD gains. In the extension, aBMD was maintained at the spine, total hip, and femoral neck in both those randomized to an additional year of alendronate and those randomized to calcium/vitamin D alone. We did, however, observe a transient comparative decrease between months 24-30 in the calcium/vitamin D group at the total hip (P = 0.008) and femoral neck (P = 0.040). At the end of 24months of the CARD study, bone turnover markers serum c-telopeptide (CTX) and procollagen N-propeptide of type I collagen (PINP) were suppressed in both groups and then increased more between months 24-36 in the calcium/vitamin D group than the alendronate group (P = 0.051 for CTX, P = 0.030 for P1NP). Both CTX and PINP remained below the month 0 baseline in both groups (P < 0.05 for all comparisons). With the limitations of our small sample size, these data suggest that both 1 and 2years of alendronate effectively maintain BMD gains achieved with 1year of denosumab and prevented any rebound in bone turnover marker levels above pre-denosumab baseline. This is the first randomized trial to assess minimum duration of bisphosphonate after short-term denosumab and may be helpful to guide clinical care. Similar studies performed after longer durations of denosumab would be helpful to further define optimal management. ClinicalTrials.gov registration number: NCT03623633.

Outcomes Using the Optimized Pitch and Language Strategy Versus the Advanced Combination Encoder Strategy in Mandarin-Speaking Cochlear Implant Recipients.

The experimental Optimized Pitch and Language (OPAL) strategy enhances coding of fundamental frequency (F0) information in the temporal envelope of electrical signals delivered to channels of a cochlear implant (CI). Previous studies with OPAL have explored performance on speech and lexical tone perception in Mandarin- and English-speaking CI recipients. However, it was not clear which cues to lexical tone (primary and/or secondary) were used by the Mandarin CI listeners. The primary aim of the present study was to investigate whether OPAL provides improved recognition of Mandarin lexical tones in both quiet and noisy environments compared with the Advanced Combination Encoder (ACE) strategy. A secondary aim was to investigate whether, and to what extent, removal of secondary (duration and intensity envelope) cues to lexical tone affected Mandarin tone perception. Thirty-two CI recipients with an average age of 24 (range 7 to 57) years were enrolled in the study. All recipients had at least 1 year of experience using ACE. Each subject attended two testing sessions, the first to measure baseline performance, and the second to evaluate the effect of strategy after provision of some take-home experience using OPAL. A minimum take-home duration of approximately 4 weeks was prescribed in which subjects were requested to use OPAL as much as possible but were allowed to also use ACE when needed. The evaluation tests included recognition of Mandarin lexical tones in quiet and in noise (signal to noise ratio [SNR] +5 dB) using naturally produced tones and duration/intensity envelope normalized versions of the tones; Mandarin sentence in adaptive noise; Mandarin monosyllabic and disyllabic word in quiet; a subset of Speech, Spatial, and Qualities of hearing questionnaire (SSQ, speech hearing scale); and subjective preference for strategy in quiet and noise. For both the natural and normalized lexical tone tests, mean scores for OPAL were significantly higher than ACE in quiet by 2.7 and 2.9%-points, respectively, and in noise by 7.4 and 7.2%-points, respectively. Monosyllabic word recognition in quiet using OPAL was significantly higher than ACE by approximately 7.5% points. Average SSQ ratings for OPAL were significantly higher than ACE by approximately 0.5 points on a 10-point scale. In quiet conditions, 14 subjects preferred OPAL, 7 expressed a preference for ACE, and 9 reported no preference. Compared with quiet, in noisy situations, there was a stronger preference for OPAL (19 recipients), a similar preference for ACE (7 recipients), while fewer expressed no preference. Average daily take-home use of ACE and OPAL was 4.9 and 7.1 hr, respectively. For Mandarin-speaking CI recipients, OPAL provided significant improvements to lexical tone perception for natural and normalized tones in quiet and noise, monosyllabic word recognition in quiet, and subjective ratings of speech intelligibility. Subjects accessed both primary and secondary cues to lexical tone for perception in quiet and noise conditions. The benefits of lexical tone recognition were attributed to enhanced F0 rate cues encoded by OPAL, especially in a noisy environment. The OPAL strategy was well accepted by many of the Mandarin-speaking CI recipients.

SESAM Q-switched Dy-doped fluoride fiber laser at 3.1 µm.

We report on a passive Q-switching laser operation of an in-band pumped Dy-doped zirconium fluoride fiber using a commercially available semiconductor saturable absorber mirror (SESAM). Stable Q-switching pulse trains with minimum pulse duration of 460 ns, highest repetition frequency of 206 kHz, and pulse energy up to 1.7 µJ are demonstrated.

Exploring the versatility of carbohydrate-capped green silver nanoparticles as multi-dimensional reagents for targeted applications

The present work describes the impact of the structural diversity of different carbohydrate molecules on the morphology and sensing ability of silver nanoparticles synthesized by a green protocol using Ocimum sanctum leaf extract, used as the reducing agent. Seven different monosaccharides were utilized as capping and stabilizing agents during the green synthesis of silver nanoparticles. The carbohydrate-capped nanoparticles were more stable in solution than the uncapped counterpart for at least three months. The formation and stability of the silver nanoparticles were analyzed using UV-visible, fluorescence spectroscopy, and X-ray diffraction studies, whereas the morphological characteristics were studied using scanning electron microscopic analysis. The different types of interaction of sugar molecules with silver atoms were studied using DFT calculation. Silver nanoparticles synthesized using d-galactose and l-arabinose, having an axial-OH group at the C-4 position, were found to have the smallest size with maximum efficacy as chemosensors for toxic mercury (II) ions in aqueous medium. The green silver nanoparticles were successfully employed as antimicrobial agents against different gram-positive and gram-negative bacteria. The catalytic activity of silver nanoparticles in the degradation of organic dyes was also evaluated for Congo red, methyl orange and reactive blue in the presence of sodium borohydride. The nanoparticles showed excellent dye degradation activity with a minimum time duration.

High-power idler-resonant intracavity KTA OPO driven by a dual-loss-modulated Q-switched mode-locked laser with AOM and Sb2Te3 nanosheets.

By using Sb2Te3 nanosheets as saturable absorbers (SA) and an acousto-optic modulator (AOM), a laser-diode (LD) end-pumped idler-resonant KTiOAsO4 (KTA)-based intracavity optical parametric oscillator (IOPO) pumped by a dual-loss-modulated Q-switched mode-locked (QML) laser has been realized. The experimental results show that the pulse widths of the Q-switched envelope and the mode-locking pulse numbers underneath the Q-switched envelope decrease as the pump power increases. When the pump power reaches a certain value, only one mode-locking pulse underneath a Q-switched envelope exists, resulting in the generation of the subnanosecond mode-locking pulses of OPO with the repetition rate of AOM. The minimum mode-locking pulse durations of the signal and idler waves were measured to be 545 and 936 ps at an AOM frequency of 1 kHz and a diode pump power of 22.45 W, corresponding to the maximum peak powers of 648 and 185 kW, respectively. Furthermore, a set of coupled rate equations for the dual-loss-modulated QML laser-pumped intracavity idler-resonant OPO was formulated according to the Gauss distribution of intracavity photon density. The numerical simulations of these equations agree with the experimental results. These results collectively suggest the potential application of Sb2Te3 as a promising nanomaterial in the realm of optoelectronics.