Monitoring Of Function Research Articles

Functional hemodynamic monitoring

Critically ill patients in the intensive care unit require intensified monitoring to control the treatment with volume and/or vasoactive substances. What role does functional hemodynamic monitoring play in controlling treatment and what techniques are used to manage this? Review of the current literature. Precise knowledge of the physiology of the cardiovascular system as well as the pathophysiology of individual clinical pictures and the possibilities of invasive and noninvasive monitoring are the prerequisites for the indications, implementation and interpretation of functional hemodynamic monitoring. An understanding of the heart-lung interaction and the influence of invasive ventilation on the volumetric target parameters, such as stroke volume variation, systolic pressure variation and pulse pressure variation as well as sonography of the inferior vena cava are indispensable prerequisites for the question of volume responsiveness. Other maneuvers, such as the passive leg raising test, can be very helpful when deciding on volume administration in everyday clinical practice. Static parameters such as central venous pressure generally play no role and if any only a subordinate one.

Effects of Ventricular Extrasystoles on Right Ventricle Functions (a Speckle Tracking Study). VES and RV Strain Imaging.

The adverse effects of ventricular extrasystoles (VES) on the heart, such as induced dyssynchrony, irregular heart rate, and atrioventricular dissociation, have been demonstrated. The aim of this study was to investigate the effects of VES on the right ventricle (RV) using strain imaging. Fifty patients with 5000 or more VES detected during 24hr Holterrhythm monitoring between April 2022 and September 2022 in the cardiology outpatient clinic were included in this study.A volunteer control group of 50 individuals matching the patients' age and demographic characteristics was selected. Right heart function parameters were compared echocardiographically between the two groups. In the VES group, both RV free wall strain (22.03±3.67, 29.52±3.01; p<0.001) and RV four-chamber strain (19.37±2.95, 22.34±2.11; p<0.001) were lower compared to the control groupIn the univariate regression analysis for decreased RV four-chamber strain, the presence of VES (p<0.001) was identified as a predictor, whereaas in the multivariate regression analysis, it was not considered to be an independent predictor. When evaluating the characteristics of the VES patients, the number of VES detected during Holter monitoring and delta QRS were observed as negative predictors of RV strain. This study demonstrated the adverse effects of VES on the right ventricle, as it is on the left ventricle.Therefore, regular monitoring of RV function with echocardiography is important in the follow-up of patients with VES.

The Movement: Reproductive Health and Rights in 2024

Women’s sexual and reproductive health (SRH) encompasses several topics, including but not limited to sexual expression, pregnancy, childbirth, contraception, and diseases of the reproductive system. The use of legal authority and power, as well as political influence, have long been factors used to regulate women’s SRH. In the United States (U.S.), examples of state and national legislation have been undertaken to impact SRH and medical treatment and decision-making related to SRH. Several national and international organizations engage in sexual and reproductive health rights (SRHR) activities. The activities of these national and international organizations in SRH often include policy formulation, data collection, monitoring, reporting, and other functions. While definitions of sexual and reproductive health rights vary, there are commonalities and core issues that can be identified. These include issues related to the LGBTQ population, immigration, and reproductive health rights among minoritized groups, which are leading topics wrapped around SRHR and of debate in recent history. This article aims to discuss sexual and reproductive health in promoting population health and societal well-being, recent policy decisions impacting SRH, and the role nurses play in shaping research, practice, and policies. For this paper, sexual and reproductive health rights (SRHR) are defined as an extension of human rights relating to an individual’s autonomy, sexuality, sexual expression, reproduction, and access to information and resources on SRH. SRHR also includes freedom from violence, discrimination, and mistreatment. While a comprehensive review of these areas is beyond this article's scope, historical and recent examples are illustrated.

Association of diaphragmatic dysfunction with duration of mechanical ventilation in patients in the pediatric intensive care unit: a prospective cohort study

BackgroundMechanical ventilation (MV) can cause diaphragmatic injury and ventilator induced diaphragmatic dysfunction (VIDD). Diaphragm ultrasonography (DU) is increasingly used to assess diaphragmatic anatomy, function and pathology of patients receiving MV in the pediatric intensive care unit (PICU). We report the poor contractile ability of diaphragm during ventilation of critically ill patients in our PICU and the association to prolonged length of MV and PICU stay.MethodsPatients who received MV within 24 h of admission to the PICU, expected to undergo continuous MV for more than 48 h and succeeded to extubate were included in the study. DU monitoring was performed daily after the initiation of MV until extubation. Diaphragm thickening fraction (DTF) measured by DU was used as an indicator of diaphragmatic contractile activity. Patients with bilateral DTF = 0% during DU assessment were allocated into the severe VIDD group (n = 26) and the rest were into non-severe VIDD group (n = 29). The association of severe VIDD with individual length of MV, hospitalization and PICU stay were analyzed.ResultsWith daily DU assessment, severe VIDD occurred on 2.9 ± 1.2 days after the initiation of MV, and lasted for 1.9 ± 1.7 days. Values of DTF of all patients recovered to > 10% before extubation. The severe VIDD group had a significantly longer duration (days) of MV [12.0 (8.0-19.3) vs. 5.0 (3.5–7.5), p < 0.001] and PICU stay (days) [30.5 (14.9–44.5) vs. 13.0 (7.0-24.5), p < 0.001]. The occurrence of severe VIDD, first day of severe VIDD and length of severe VIDD were significantly positively associated with the duration of MV and PICU stay. The occurrence of severe VIDD on the second and third days after initiation of MV significantly associated to longer PICU stay (days) [43.0 (9.0–70.0) vs. 13.0 (3.0–40.0), p = 0.009; 36.0 (17.0-208.0) vs. 13.0 (3.0–40.0), p = 0.005, respectively], and the length of MV (days) was significantly longer in those with severe VIDD on the third day after initiation of MV [16.5 (7.0–29.0) vs. 5.0 (2.0–22.0), p = 0.003].ConclusionsDaily monitoring of diaphragmatic function with bedside ultrasonography after initiation of MV is necessary in critically ill patients in PICU and the influences and risk factors of severe VIDD need to be further studied. (355 words)

Research progress on key technologies of flexible wearable electronic devices

Flexible wearable device is an innovative technology product, using soft, lightweight material design, can fit the curve of the human body, providing a comfortable wearing experience. These devices typically integrate a variety of sensors, batteries, and connectivity technologies to enable biometric monitoring, motion tracking, communication, and other intelligent functions. Traditional electronic products tend to give a "stiff" impression that they cannot withstand bending, twisting and stretching. In recent years, under the background of the integration of electronic technology and modern material science technology, the emerging flexible electronic wearable device has become a research hotspot with its more flexible material, more sensitive and accurate signal transmission, and more extensive monitoring range. The development of flexible electronic technology has greatly improved the user's wearing experience and is more suitable for the free movement of the human body. This paper summarizes the basic principle and classification of key technologies of wearable electronic devices, and introduces the research progress and research trend.

A scoping review of remote and unsupervised digital cognitive assessments in preclinical Alzheimer's disease.

Subtle cognitive changes in preclinical Alzheimer's disease (AD) are difficult to detect using traditional pen-and-paper neuropsychological assessments. Remote and unsupervised digital assessments can improve scalability, measurement reliability, and ecological validity, enabling the detection and monitoring of subtle cognitive change. Here, we evaluate such tools deployed in preclinical AD samples, defined as cognitively unimpaired individuals with abnormal levels of amyloid-β (Aβ), or Aβ and tau. In this scoping review, we screened 1,680 unique reports for studies using remote and unsupervised cognitive assessment tools in preclinical AD samples; 23 tools were found. We describe each tool's usability, validity, and reported metrics of reliability. Construct and criterion validity according to associations with established neuropsychological assessments and measures of Aβ and tau are reported. With this review, we aim to present a necessary update to a rapidly evolving field, following a previous review by Öhman and colleagues (2021; Alzheimers Dement. Diagn. Assess. Dis. Monit ) and addressing the open questions of feasibility and reliability of remote testing in the target population. We discuss future directions for using remote and unsupervised digital cognitive assessments in preclinical AD and how such tools may be used for longitudinal monitoring of cognitive function, scalable case finding, and individualized prognostics in both clinical trials and healthcare contexts.

Multifactor evaluation method of smart meter

As an important terminal of smart grid, smart meter has the functions of equipment health monitoring and power metering. However, it is difficult to quantify the impact of factors such as ex-factory parameters, historical failure rates, electromagnetic interference when conducting an operational condition assessment. Therefore, in view of the large number of influencing factors and the difficulty in quantifying the degree of influence, an improved multifactor evaluation model for the operating status of smart meters is constructed. Firstly, a multifactor index system for evaluating the operating state of smart meters is constructed by analyzing the working mechanism and operating characteristics of smart meters. Then, an improved combinatorial weighting method is proposed by combining the subjective weight and the objective weight. The combinatorial weighting method is used to estimate the weight of factors in the health status evaluation of smart meters, and the improved multifactor evaluation method is presented to evaluate the health status of smart meters. Finally, an example is given to verify and analyze the proposed method. Compared with the other three methods, this method can provide effective evaluation results, and help guide targeted maintenance or replacement to improve the efficiency of smart meter detection.

Breast cancer and cardiovascular health.

Modern cancer therapies greatly improve clinical outcomes for both early and advanced breast cancer patients. However, these advances have raised concerns about potential short- and long-term toxicities, including cardiovascular toxicities. Therefore, understanding the common risk factors and underlying pathophysiological mechanisms contributing to cardiovascular toxicity is essential to ensure best breast cancer outcomes. While cardio-oncology has emerged as a sub-speciality to address these challenges, it is essential that all cardiologists recognize and understand the cardiovascular consequences of cancer therapy. This review aims to provide a comprehensive overview of the potential adverse cardiovascular effects associated with modern breast cancer therapies. A preventive, diagnostic, and therapeutic workflow to minimize the impact of cardiovascular toxicity on patient outcomes is presented. Key aspects of this workflow include regular monitoring of cardiovascular function, early detection and management of cancer therapy-related cardiovascular toxicities, and optimization of cardiovascular risk factor control. By highlighting the gaps in knowledge in some areas, this review aims to emphasize the critical role of cardio-oncology research in ensuring the holistic well-being of patients with breast cancer.

A uniformly convergent analysis for multiple scale parabolic singularly perturbed convection-diffusion coupled systems: Optimal accuracy with less computational time

This study addresses time-dependent multiple-scale reaction-convection-diffusion initial boundary value systems characterized by strong coupling in the reaction matrix and weak coupling in the convection terms for a locally optimal accurate solution. The discrete problem, which typically loses its tridiagonal structure, expands its bandwidth to four in such coupled systems, resulting in a substantial computational load. Our objective is to mitigate this computational burden through a splitting approach that transforms the non-tridiagonal matrix into a tridiagonal form while maintaining the consistency, local optimal accuracy in space, and stability of the numerical scheme. We employ equidistributed non-uniform grids, guided by a carefully chosen monitor function, to approximate the continuous space domain. The discretization strategy targets local optimal linear accuracy across space and time on the domain's interior points. In addition, we have also provided the global convergence analysis of the present splitting approach, mathematically. The mathematical evidence is also obtained from the numerical experiments by comparing the splitting approach (either diagonal or triangular forms) of the reaction matrix to its coupled form. The results strongly confirm the effectiveness of this approach in delivering uniform linear accuracy, based on the present problem discretizations while significantly reducing the computational costs.

Insights into renal and urological complications of inflammatory bowel disease.

Inflammatory bowel disease (IBD) is a chronic condition characterized by immune-mediated inflammation in the gastrointestinal tract, which follows a relapsing and remitting course. Apart from affecting the gastrointestinal tract, IBD also has extra-intestinal manifestations (EIMs). While the etiology of extraintestinal manifestation remains unclear, it is theorized to be based on immunological responses influenced by genetic factors. Renal involvement is one of the EIMs observed in ulcerative colitis and Crohn's disease. The renal manifestations in IBD patients encompass a range of conditions including nephrolithiasis, amyloidosis, tubulointerstitial nephritis, glomerulonephritis (GN), obstructive pathologies, and chronic kidney disease (CKD). The incidence of CKD in IBD patients varies from 5%-15%. The decline in renal function can stem from various factors such as direct inflammatory damage to the kidneys leading to glomerular or tubular injury, or from complications like recurrent stones, amyloidosis, or GN. Additionally, nephrotoxic medications used in treating IBD, such as TNF-α inhibitors, calcineurin inhibitors, and aminosalicylates, can exacerbate the decline in renal function. Currently, there is a lack of consensus regarding these patients' screening and renal function monitoring. This review aims to assess the existing literature on the different renal complications among individuals with IBD, shedding light on their pathophysiology and management.

CARDIOMIOPATIA INDUZIDA POR QUIMIOTERAPIA: UMA REVISÃO INTEGRATIVA SOBRE MECANISMOS, DIAGNÓSTICO E TRATAMENTO

Chemotherapy-induced cardiomyopathy is a significant complication associated with the use of chemotherapeutic agents, particularly anthracyclines such as doxorubicin. This condition adversely affects cardiac function and can limit cancer treatment due to the increased risk of cardiac side effects. Studies have shown that doxorubicin and other agents, such as paclitaxel, are effective in cancer treatment but also present a high risk of cardiac toxicity. Mechanisms of cardiotoxicity include oxidative stress, mitochondrial dysfunction, and cellular signaling alterations. Prevention and management of cardiotoxicity have evolved, with the use of cardiac protectors such as dexrazoxane and carvedilol, as well as ACE inhibitors like captopril and enalapril. Clinical guidelines recommend rigorous monitoring of cardiac function using echocardiography and magnetic resonance imaging for early detection of toxicity. This integrative review examines the mechanisms, diagnosis, and treatment options for chemotherapy-induced cardiomyopathy, highlighting the importance of preventive strategies and therapeutic interventions to improve the management of this condition.

Ownership structure, board composition and CEO dominance: what does really matters to corporate deleveraging policies?

Purpose The role played by corporate governance mechanisms on corporate deleveraging policies has not been clarified. Empirical evidence is confined to developed economies, even with conflicting and inconclusive results. This paper aims to examine the role of corporate governance mechanisms, such as ownership structure, board composition and CEO dominance, in explaining corporate deleveraging policies. Design/methodology/approach Using a sample of listed Pakistani firms between 2010 and 2022, this study resorts to binary response models to examine the effects of governance mechanisms on firms’ decision to go debt-free. Findings A greater ownership concentration, institutional ownership and family ownership increase the propensity for zero leverage. Board gender diversity decreases the propensity for deleveraging policies, which seems to indicate that the presence of females reinforces the monitoring function of the board. Finally, lower managerial ownership or CEO dominance decreases the propensity toward zero leverage (interest convergence hypothesis), but higher managerial ownership or CEO dominance increases the propensity toward zero leverage (managerial entrenchment hypothesis). Practical implications Risk-averse managers who prefer to control a firm using little or no debt will find it easier to implement these financing policies in firms with greater ownership concentration and where institutional holders have a substantial stake. For shareholders, this study suggests that investing in firms with females on board reduces the risk of corporate deleveraging policies being adopted for entrenched reasons. Social implications The presence of females on board seems to decrease the propensity of managers to adopt opportunistic actions and may also contribute to enhancing human welfare and society in developing countries. Originality/value To the best of the authors’ knowledge, this is the first study considering the effect of board diversity on zero leverage. Another singularity is that this study exhibits a nonlinear relationship between managerial ownership and corporate deleveraging policy.

Intracellularly manipulable aggregation of the aggregation-induced emission luminogens

Biophotonics has seen significant advancements with the development of optical imaging techniques facilitating the noninvasive detection of biologically relevant species. Aggregation-induced emission (AIE) materials have emerged as a novel class of luminogens exhibiting enhanced luminescence or photodynamic efficiency in the aggregated state, making them ideal for biomedical applications. The intracellularly controlled aggregation of aggregate-induced emission luminogens (AIEgens) enables high-resolution imaging of intracellular targets and diagnosis of related diseases, and enables disease therapy by exploiting the novel properties of aggregates. This review provides an in-depth analysis of the strategies employed to modulate the aggregation of AIEgens, focusing on the importance of molecular modifications to improve hydrophilicity and achieve precise control over the intercellular aggregation of AIEgens. Furthermore, the representative applications of AIEgens in bioimaging, such as enzyme activity monitoring, protein tracking, organelle function monitoring, and in vivo tumor-specific therapeutics, are reviewed. Additionally, we outline the challenges and future opportunities for AIE research, emphasizing the importance of the strategies for realizing the precisely controllable aggregation of AIEgens inside cells and the need for extending AIEgens’ absorption and emission wavelengths. This review aims to elucidate the rational development of responsive AIEgens for advanced biomedical applications.

Global traumatic brain injury intracranial pressure: from monitoring to surgical decision.

Traumatic brain injury (TBI) is a significant global public health issue, heavily impacting human health, especially in low-and middle-income areas. Despite numerous guidelines and consensus statements, TBI fatality rates remain high. The pathogenesis of severe TBI is closely linked to rising intracranial pressure (ICP). Elevated intracranial pressure can lead to cerebral herniation, resulting in respiratory and circulatory collapse, and ultimately, death. Managing intracranial pressure (ICP) is crucial in neuro-intensive care. Timely diagnosis and precise treatment of elevated ICP are essential. ICP monitoring provides real-time insights into a patient's condition, offering invaluable guidance for comprehensive management. ICP monitoring and standardization can effectively reduce secondary nerve damage, lowering morbidity and mortality rates. Accurately assessing and using true ICP values to manage TBI patients still depends on doctors' clinical experience. This review discusses: (a) Epidemiological disparities of traumatic brain injuries across countries with different income levels worldwide; (b) The significance and function of ICP monitoring; (c) Current status and challenges of ICP monitoring; (d) The impact of decompressive craniectomy on reducing intracranial pressure; and (e) Management of TBI in diverse income countries. We suggest a thorough evaluation of ICP monitoring, head CT findings, and GCS scores before deciding on decompressive craniectomy. Personalized treatment should be emphasized to assess the need for surgical decompression in TBI patients, offering crucial insights for clinical decision-making.

Time course of electrical activity of the diaphragm (EAdi) in the peri extubation period and its role as predictor of extubation failure in difficult to wean patients

IntroductionWeaning patients from mechanical ventilation is crucial in the management of acute respiratory failure (ARF). Spontaneous breathing trials (SBT) are used to assess readiness for extubation, but extubation failure remains a challenge. Diaphragmatic function, measured by electrical activity of the diaphragm (EAdi), may provide insights into weaning outcomes.Materials and methodsThis prospective, observational study included difficult-to-wean patients undergoing invasive mechanical ventilation. EAdi was recorded before, during, and after extubation. Patients were categorized into extubation success and failure groups based on reintubation within 48 h. Statistical analysis assessed EAdi patterns and predictive value.ResultsThirty-one patients were analyzed, with six experiencing extubation failure. Overall, EAdi increased significantly between the phases before the SBT, the SBT and post-extubation period, up to 24 h (p < 0.001). EAdi values were higher in the extubation failure group during SBT (p = 0.01). An EAdi > 30 μV during SBT predicted extubation failure with 92% sensitivity and 67% specificity. Multivariable analysis confirmed EAdi as an independent predictor of extubation failure.ConclusionsIn difficult-to-wean patients, EAdi increases significantly between the phases before the SBT, the SBT and post-extubation period and is significantly higher in patients experiencing extubation failure. An EAdi > 30 μV during SBT may enhance extubation failure prediction compared to conventional parameters. Advanced monitoring of diaphragmatic function could improve weaning outcomes in critical care settings.

Application of Echocardiography in Anaesthesia: From Preoperative Risk Assessment to Postoperative Care.

Echocardiography has carved out a fundamental niche in anaesthesiology, revolutionizing the monitoring and management of cardiac function during surgery. Clinical practice has changed from simple 2D and 3D echocardiography to more sophisticated applications such as incorporating artificial intelligence. Echocardiography provides detailed real-time information about cardiac anatomy and function, helping anaesthesiologists make better decisions regarding tailoring anesthetic interventions and optimizing patient outcomes. From optimizing hemodynamic management in patients with severe aortic stenosis to fine-tuning fluid and vasopressor therapy in patients with right heart dysfunction, echocardiography has improved the care provided in the perioperative period. These applications permit the demonstration of not only technical advantages that could accrue from echocardiography but are also a part of individualized care to improve the outcomes of patients. The challenges in integrating echocardiography with anaesthesia include operator dependency, a steep learning curve in acquiring echocardiographic skills, and limitations due to patient factors and technological limitations, which lead to poor echocardiographic performance. Additionally, transoesophageal echocardiography (TEE) is an invasive procedure with several potential risks that must be considered cautiously. Continuing education, certification recommendations, and skill development are prerequisites for this echocardiography tool to remain robust and reliable in anaesthesiology. Technological innovation, especially in improving 3D imaging and integration with artificial intelligence, is where a very bright future lies ahead for echocardiography. It would further accelerate the process of echocardiographic evaluation and improve diagnostic accuracy. All these would turn out to be more person-centered for each patient. Anaesthesiologists must, therefore, pace themselves with such developments so these can be appropriately applied in the clinics. In summary, echocardiography became so integrally ingrained into anaesthesia that it propelled the specialty with essential tools anaesthesiologists use to manage patients for optimum outcomes. Its application has difficulties and limitations, but continued professional development and development of echocardiographic technology will make sure that its benefits are maximized. Quickly, echocardiography is becoming central to anaesthesiology's role in optimizing patient care and surgical success as we move into the application of evermore sophisticated echocardiographic techniques.

Material Composition and Implantation Site Affect in vivo Device Degradation Rate.

Successful tissue engineering requires biomedical devices that initially stabilize wounds, then degrade as tissue is regenerated. However, the material degradation rates reported in literature are often conflicting. Incorporation of in situ monitoring functionality into implanted devices would allow real time assessment of degradation and potential failure. This necessitates introduction of contrast agent as most biomedical devices are composed of polymeric materials with no inherent contrast in medical imaging modalities. In the present study, computed tomography (CT)-visible radiopaque composites were created by adding 5-20wt% tantalum oxide (TaO x ) nanoparticles into polymers with distinct degradation profiles: polycaprolactone (PCL), poly(lactide-co-glycolide) (PLGA) 85:15 and PLGA 50:50, representing slow, medium and fast degrading materials respectively. Radiopaque phantoms, mimicking porous tissue engineering devices, were implanted into mice intramuscularly or intraperitoneally, and monitored via CT over 20 weeks. Changes in phantom volume, including collapse and swelling, were visualized over time. Phantom degradation profile was determined by polymer matrix, regardless of nanoparticle addition and foreign body response was dictated by the implant site. In addition, degradation kinetics were significantly affected in mid-degrading materials, transitioning from linear degradation intramuscularly to exponential degradation intraperitoneally, due to differences in inflammatory responses and fluid flow. Nanoparticle excretion from degraded phantoms lagged behind polymer, and future studies will modulate nanoparticle clearance. Utilizing in situ monitoring, this study seeks to unify literature and facilitate better tissue engineering devices, by highlighting the relative effect of composition and implant site on important materials properties.

Ownership concentration and SME IPO underpricing in India – moderating impact of board monitoring and resource provision role

PurposeThe study aims to explore how the monitoring and resource provision function of board of directors impact the association between ownership concentration and small- and medium-sized enterprise (SME) initial public offering (IPO) underpricing in the context of an emerging economy like India.Design/methodology/approachThe sample comprises 390 SME IPOs listed on Bombay Stock Exchange SME platform and National Stock Exchange EMERGE (EMERGE is the NSE new initiative for SMEs to raise the funds from investors) in India. To test the moderating impact of the board monitoring role and resource provision role, the study employs hierarchical moderated regression subject to the fulfillment of assumptions.FindingsThe findings divulge that ownership concentration significantly reduces underpricing, hinting towards the operationalization of alignment of interest hypothesis. With regards to moderating relationship, the study found that while board resource providing role negatively moderates the relationship between ownership concentration and SME IPO underpricing, board monitoring function fails to cast any significant impact on the relationship between ownership concentration and SME IPO underpricing.Research limitations/implicationsThe present study ignores larger firms listed on the main platform which have complex decision-making than smaller firms. Besides, it is confined to only a single country, i.e. India. Extending the study to other countries with similar institutional characteristics would have validated the findings. Furthermore, the moderating impact of other organizational factors like firm age, lifecycle of firm and change in technology would form an interesting avenue for future research.Practical implicationsThe findings of the study have practical implications for managers in designing the adequate board structure that significantly reduces underpricing. It thus further advices the issuers on focusing more on strengthening the resource provision role of board of directors for achieving higher rewards. The findings are helpful to policymakers in framing such policies that enhance the resource-oriented role of board of directors and resource accessibility for SMEs. Furthermore, the results advise the investors to be relatively assured about the SMEs whose board exercises its resource provision role emphatically. Accordingly, findings are helpful to investors in making investment decisions in alternative market settings characterized by the concentrated ownership structure.Originality/valueThe study furthers the debate on the importance of two prominent roles played by board as a moderating variable in the underexplored context of IPO underpricing of small and medium-sized firms in India.

Evaluation of Left Ventricular Remodeling and Prognosis after PCI in Acute Myocardial Infarction Using Real-Time, Three-Dimensional Echocardiography Combined with Layer-Specific Strain Imaging

Aim: This study aimed to evaluate left atrial and left ventricular volumes, strains, and strain rates in patients with acute ST-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI) using real-time three-dimensional echocardiography and layer-specific strain techniques. The relationships between these parameters and left ventricular remodeling (LVR) and prognosis were also explored. Methods: The study included 217 patients with first-episode STEMI who underwent emergency PCI. Echocardiography and myocardial strain analyses were performed within 24 h post-PCI. Patients were categorized into early and non-early LVR groups based on the increase in left ventricular end-diastolic volume (LVEDV). The occurrence of major cardiovascular adverse events (MACE) was followed up for one-year post-PCI. Differences in clinical data and ultrasound parameters between the groups were compared, and the predictive value of myocardial strain indicators for late LVR was analyzed using a multivariate logistic regression model and receiver operating characteristic (ROC) curves. Results: Early LVR occurred in 54.8% of patients and was characterized by decreased left ventricular systolic function, more segments with abnormal movement, and reduced absolute strain values in the three layers of the left ventricular wall myocardium, with a compensatory increase in left atrial strain rate during the contraction phase. The early LVR group showed a higher incidence of MACE at the one-year follow-up. At 6 months post-PCI, 29.9% of patients developed late LVR, which was not completely related to early LVR. Late LVR was associated with a higher incidence of MACE. The longitudinal strain value of each layer of left ventricular myocardium obtained from layer-specific strain imaging showed predictive value for advanced LVR. Conclusions: More than half of patients with STEMI develop early LVR post-PCI, with a higher incidence of MACE during one-year of follow-up, necessitating attention to early LVR in clinical practice. Late LVR, which develops in some patients after 6 months, is also linked to a higher incidence of MACE. Accurate monitoring of the myocardial deformation function using layer-specific strain imaging is expected to become a reference indicator for clinical diagnosis and treatment. Monitoring the structure and function of the left atrium and mitral valve alongside the LVR is important for prognostic assessment and for formulating diagnostic and treatment plans.

Incidence, characteristics, and risk factors of hypofibrinogenemia induced by generic tigecycline: a retrospective study.

The objective of this study was to evaluate the incidence, clinical features, and risk factors of generic tigecycline-associated hypofibrinogenemia. A single-center retrospective study was conducted in adult patients treated with generic tigecycline. Clinical data were extracted from the electronic medical records. The endpoint was tigecycline-related hypofibrinogenemia, defined as a condition with no abnormality in fibrinogen before tigecycline application, but developing hypofibrinogenemia upon prescription. The risk factors were determined by logistic regression analysis, and the ROC curve was subsequently established. A total of 240 adults prescribed generic tigecycline from May 1st to November 30th 2023 were included. It was shown that hypofibrinogenemia is a frequent side effect of generic tigecycline, with an adverse reaction rate of 42.9% (103/240). However, the incidence of adverse reactions to generic drugs was lower than in previous studies. The cumulative dose of tigecycline (OR:1.002, 95%CI 1.001-1.002, P < 0.001), baseline FIB (OR:0.995, 95%CI 0.992-0.997, P < 0.001), baseline PT (OR:1.247, 95%CI 1.071-1.452, P = 0.004) and baseline ALB (OR:0.931, 95%CI 0.879-0.986, P = 0.025) were identified as independent prognostic factors of tigecycline-related hypofibrinogenemia. We recommend intensive monitoring of coagulation function in patients exhibiting the aforementioned risk factors for generic tigecycline-associated hypofibrinogenemia to ensure patients safety.