SD Values Research Articles

Neutrophil to lymphocytes ratio in deep infiltrating endometriosis as a new toll for clinical management.

Several mechanisms, including altered local and systemic immune system, apoptosis, and new angiogenesis, are responsible for the development and progression of endometriosis. Over the years many markers have been studied, like CA 125 and, recently, neutrophil-to-lymphocyte ratio (NLR). This tool is cost-effectiveness and non-invasiveness as a marker of systemic inflammatory diseases. The aim of this study is to assess the role of NLR in the real-life management of patients with endometriosis in order to evaluate the possible association between this value and symptoms. We performed a retrospective analysis of 199 premenopausal women affected by endometriosis, from January 2013 to December 2020, evaluating the characteristics of disease, the symptoms and the NLR. Analyzing the neutrophiles, the mean ± SD value was 6.1 ± 4.5 × 103/ul, while for lymphocytes mean ± SD value was 1.8 ± 0.7.NLR was categorized according to its median value (> 2.62 vs ≤ 2.62). The comparison between NLR values and CA 125, endometriosis stage, dysmenorrhea and presence of chronic pelvic pain, adjusting for previous therapy did not find a significant association. An interesting result, although not significant, was the association between NLR and chronic pelvic pain (OR = 1.9). In the sub-group of patients without previous therapy this association is even stronger (OR = 4.8, 95% CI 0.5-50.2, p = 0.190). The link between NLR and chronic pelvic pain can provide a further hint to the clinician even when taking symptoms into account to develop a particular therapeutic treatment related to the various expressions of NLR. Finally, NLR may enable the creation of customized follow-up protocols that divide patients into high- and low-risk categories for endometriosis recurrence.

The practical meaning of the classical optimizing method and Angular Detection Photometer (ADP) in coagulation tests of surface water

Because of the growing deficit of clean water, rational use of its supplies through adaptation of purification techniques to the needs is becoming vital. The commonly used coagulation process requires optimization tools and techniques. The following were used in this paper to optimize coagulation of natural water pollutants: the standard jar test method with direct filtration and the angular detection photometry (ADP) method. We tested two aluminium coagulants – PAC with different basicity – and an iron coagulant: PFS. A modified jar test method allowed to obtain results similar to those of the sedimentation method. At the optimum doses 1.3 mg Al/mg C org. and 2 mg Fe/mg Corg – colour (PtCo), A254, A436 – achieved reduction in the 84–96% range and DOC 60–67% after filtration. The titration method using an ADP successfully allows determine optimum coagulant doses. The SD and FI values were determined based on the recorded fluctuations of the signals measured by detectors placed at three angles relative to the IR beam. A variation in SD was observed, depending on the angle of detection and the coagulant and correlates well (R2 =0.6–0.86) with sedimentation time ST, which was twice as long in the case of fine suspension in the PFS.

IPN based hydrogels for in-vivo wound dressings; catalytic wound healing dynamics and isothermal adsorption models

Interpenetrating network (IPN) methacrylated chitosan or methacrylated flaxseed gum based hydrogels have been utilized to make outstanding in-vivo wound dressings. The photopolymerization process was accomplished in presence of Eosin-Y photoinitiator with average exposure time of 13–14 s for gelation. Spectroscopic structural investigations of 1H NMR. ATR-FTIR, TGA, and AFM techniques were used. In-vitro hemolysis test provided evidence of no cytotoxicity in both hydrogels observed. The in-vivo wound dressings were monitored for five mice coated with each hydrogel and another uncoated five mice for control (self-healing). All measurements were performed in quintuplicate (n = 5) and expressed as mean ± SD values. In wound healing dynamics, our data confirmed that wound healing pass through two stages; hemostasis and inflammation for stage 1, and proliferation and remodeling for stage 2. It also provided evidence of 1st order kinetics with descending rate of healing. Consequently, catalytic role of hydrogels in wound healing was checked via half-life (δ) and negative change of activation energy values (ΔEa). Various isothermal adsorption models demonstrated spontaneous and high binding affinities of hydrogels. It also confirmed the two-stage healing process in presence of hydrogels. Conclusively, the outstanding properties of the two hydrogels suggest their potential applications in treating venous ulcers and diabetic wound healing dressings.

Evolution of wind speed observed in Brazil between 1961 and 2020

AbstractThe study's main objective was to analyse daily wind speed data in Brazil collected on‐site from 1961 to 2020 and assess changes in two 30‐year climatological normals, denoted as P1 and P2. Data were sourced from 54 INMET‐managed meteorological stations, with missing data filled using the bootstrap expectation maximization algorithm. Imputation performance was evaluated, and results suggested that the 10% imputed level was most reliable, showing low RMSE values (below 0.5), SD values near 1, and r values exceeding 0.93. This method proved suitable for reconstructing historical wind speed data in Brazil. The analysis included the application of the Mann–Kendall test to detect linear trends and Sen's slope test to quantify trend intensity, both at a 5% significance level. Positive trends during P2 were observed in the Amazon basin and Brazil's semiarid region, while negative trends increased along the coast and in the Southeast region. Average wind speeds during P1 were higher than in P2. Comparing the two climatological normals revealed significant positive trends in some regions during P2, with an increase in average monthly variation of up to 0.85 m·s−1. The average slopes of significant trends were −1 and 1 m·s−1·decade−1 for all periods. The results indicated high wind magnitudes, with maximum power density of 778.08 W·m−2 for the NEB region, 170.90 W·m−2 for the SEB region and 401.67 W·m−2 for the SUB, making these regions promising for future wind power projects. These findings have the potential to enhance the optimization of renewable wind energy generation in Brazil.

Expression of concern: Natural copy number variation of tandemly repeated regulatory SNORD RNAs leads to individual phenotypic differences in mice.

Keshavarz, M., Savriama, Y., Refki, P., Reeves, R. G., & Tautz, D. (2021). Natural copy number variation of tandemly repeated regulatory SNORD RNAs leads to individual phenotypic differences in mice. Molecular Ecology, 30, 4708-4722. https://doi.org/10.1111/mec.16076 This expression of concern is for the above article, published online on 12 July 2021 in Wiley Online Library (wileyonlinelibrary.com), and has been published by agreement between the journal Editor-in-Chief, Loren Rieseberg and John Wiley & Sons Ltd. The expression of concern follows an internal investigation by the Max-Planck Society, which found a number of inconsistencies in the supporting information of the article, later also confirmed by the authors: Incorrect sex assignment for a set of mouse IDs (reported in TableS1, SNORD copy numbers) Inconsistencies in the ddPCR data that were used to determine SNORD copy number variation (reported in Tables S1, S4 and S6): Over-representation of certain values for SD, incorrect calculation of averages and SD values (TableS1, SNORD copy numbers). SNORD115 and SNORD116 copy numbers differed between columns C and I and columns D and J, respectively, despite having been determined only once (TableS4, other CNVs). Incorrect mouse IDs for family VI and VIII (TableS6, family study). Replicate three for SNORD115 and SNORD116 determination is often identical to the average (TableS6, family study). D.T. and M.K. could not retrieve the relevant raw data for the published ddPCR experiments that would have allowed to resolve the inconsistencies based on a re-analysis. Consequently, it cannot be excluded that these irregularities affect the reproducibility of the study and the conclusions that are based on these data. Therefore, the journal has decided to issue an expression of concern to inform and alert the readers. The transcriptome analyses and morphometric data presented in the article remain valid, including the corresponding original data depositions at ENA (accession number PRJEB29473) and Zenodo (record 4750371). The issues with the incorrect sex assignment (TableS1) and the erroneous mouse IDs (TableS6) were resolved, the corrected Tables S1 and S6 are provided in the updated Supporting Information.

ASSESSMENT OF COMPLETE BLOOD COUNT AND LIVER ENZYMES IN CHRONIC KIDNEY DISEASE PATIENT

Chronic renal failure (CRF) poses a significant global health challenge, with chronic kidney disease (CKD) characterised by kidney damage or a glomerular filtration rate (GFR) persistently below 60 ml/min for over three months. This observational study, conducted in Faisalabad from January to July 2023, aimed to evaluate haematological variables and liver enzymes across different stages of CKD. Using non-probability purposive sampling, 144 CKD patient files and 48 healthy control files were collected, excluding specific conditions. CKD staging was determined using the Modification of Diet in Renal Disease (MDRD) algorithm, categorizing patients into mild (Group A), moderate (Group B), severe (Group C) CKD, and controls (Group D). Data analysis was performed using SPSS v23. Mean ± SD values were presented for each parameter across the four groups. Haemoglobin levels (Hb g/dl) exhibited a decreasing trend in CKD patients compared to the control group, with values of 13.7 ± 1.50 in controls, 11.7 ± 0.64 in Group 1, 9.7 ± 0.57 in Group 2, and 6.7 ± 1.5 in Group 3. Red blood cell count (RBCs per million/mm3) also decreased progressively in CKD patients compared to controls, with values of 5.48 ± 0.59, 4.62 ± 0.15, 3.57 ± 0.28, and 2.81 ± 0.23 in the respective groups. Conversely, white blood cell counts (WBC thousand/mm3) increased with CKD progression, showing values of 8406 ± 1383 in controls, 10674 ± 1006 in Group 1, 12028 ± 643.5 in Group 2, and 13564 ± 741.29 in Group 3. Similarly, platelet counts (lakh/ul) exhibited a decreasing trend in CKD patients compared to controls, with values of 324708 ± 112970, 235458 ± 63853, 144979 ± 6935.8, and 126333 ± 4768.3, respectively. Analysis of liver enzymes revealed a progressive decrease in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels as CKD advanced. AST levels (U/L) decreased from 29.104 ± 3.130 in controls to 7.5825 ± 1.543 in Group 3, while ALT levels (U/L) decreased from 48.145 ± 4.9679 in controls to 12.270 ± 3.3500 in Group 3. Our findings demonstrate that haemoglobin, red blood cell count, platelet count, and liver enzyme levels (AST and ALT) decrease as CKD progresses while white blood cell count increases. These insights into haematological and hepatic biomarkers underscore the dynamic nature of CKD pathology and may inform clinical management strategies.

Validation of the Meditech ABPM-06 24-hour blood pressure monitoring system in a pediatric population according to International Organization for Standardization Protocol 81060-2:2018.

Ambulatory blood pressure monitoring (ABPM) devices play a crucial role in diagnosing hypertension, not only in adults but also in pediatric patients. ABPM-06, the latest oscillometric device from Meditech Ltd. (Budapest, Hungary), is the focus of this study. The objective was to validate the ABPM-06 device using the International Organization for Standardization (ISO) 81060-2 : 2018 standard. A total of 86 healthy patients, consisting of 34 males and 52 females, aged between 3 and 17 years, were enrolled in this study. During the ambulatory phase, a total of 50 patients were enrolled, with 35 patients falling within the 3- to 12-year-old age range and 15 patients aged between 12 and 17 years. Additionally, for the dynamic test, 36 patients were selected, comprising of 10 individuals aged 3-12 years and 26 patients aged 12-17 years. These patients were recruited from the outpatient clinics of the Department of Pediatrics at Albert Szent-Györgyi University in Szeged, Hungary. The validation process involved utilizing the same-arm sequence protocol, both in resting positions and during stress testing. The ABPM-06 performed well in both clinical and ambulatory validations. In terms of validation criterion 1, the mean ± SD of the differences between the test device and reference blood pressure readings was -1.3 ± 3.5 mmHg for systolic and -0.1 ± 2.3 mmHg for diastolic, in children under the age of 12 years. For those over the age of 12 years, the mean ± SD of the differences was -2.8 ± 4.6 mmHg for systolic and -0.5 ± 2.7 mmHg for diastolic. Regarding the ambulatory validation, for children under 12 years old, the mean ± SD of the differences was -1.3 ± 3.5 mmHg for systolic and -0.1 ± 2.3 mmHg for diastolic. In the age group above 12 years, the mean ± SD of the differences was -2.8 ± 4.6 mmHg for systolic and -0.5 ± 2.7 mmHg for diastolic. Both tests successfully met the established criteria regarding the mean and SD values of the differences between the device readings and the observed SBP and DBP measurements. The ABPM-06 oscillometric device fully adheres to the ISO 81060-2 : 2018 standard requirements for ABPM determination in the pediatric population (ages 3-17 years). Consequently, this ABPM device proves to be suitable for effectively managing hypertension in children and adolescents.

TO EVALUATE THE RELATIONSHIP BETWEEN THYROID PROFILE AND IRON STATUS AMONG HYPOTHYROID PATIENTS

Objective: Iron deficiency is very commonly seen among hypothyroidism patients. The study aimed to find out the relationship between thyroid profile and iron status among hypothyroidism patients, whether it is interdependent or not. Methods: This retrospective study was conducted among hypothyroidism patients at the Department of Biochemistry, Government Medical College, Amritsar. One hundred study participants were included in this study. The study participants were divided into two groups. Fifty hypothyroidism patients served as cases and 50 normal healthy individuals as control. Serum thyroid-stimulating hormone (TSH), T3, and T4 levels and serum ferritin, iron, and TIBC levels were estimated and then compared between the two groups. Results: In our findings, 70% of the females were hypothyroidism patients. Hypothyroidism patients’ mean age±SD value was 37±15.1 whereas the healthy control group was 39±12.5. Most of the middle-aged people suffer from this disease, i.e., 52%. In this study, the levels of ferritin, and iron were found to decrease whereas that of TIBC increased in patients suffering from hypothyroidism as compared to healthy controls. Serum TSH levels were inversely correlated with ferritin. The levels of ferritin were found to be significantly decreased in patients as compared to controls. Conclusion: Thyroid hormone insufficiency may lead to a deficiency of iron and vice versa. Other factors such as oxidative stress may also play a role. Thus, iron the estimation using the above parameters may be useful during diagnosing and treating hypothyroid patients.

Erken Evre Karaciğer Fibrozisini Öngörmede Shear Wave Elastografinin Rolü

Aim: We examined the relationship between shear wave elastography (SWE) values and histopathological results in our study. Thus, we found the sensitivity of SWE in demonstrating early fibrosis. Materials and Methods: A total of consecutive 70 patients with chronic hepatitis B were prospectively evaluated. The patients included in fibrosis stages (F) 0, 1, 2, 3 and 4 according to Ishak scoring were examined with SWE. SWE measurements of F2, F3 and F4 patients who were found to have early stage fibrosis were compared with those of F0 and F1 patients. Results: The velocity+SD, and kPa+SD values in the group requiring treatment (F2, F3 and F4) were significantly higher than the group not requiring treatment (F0 and F1 )(p < 0.05). The sensitivity rate of the 1.85 cut-off value for velocity+SD was 53.8%, the positive prediction rate was 80.8%, the specificity rate was 83.3%, and the negative prediction rate was 58.1%. For kPa+SD, the cut-off value of 10.8 had a sensitivity rate of 51.3%, a positive prediction rate of 95.2%, a specificity of 96.7%, and a negative predictive rate of 60.4%. A significant correlation was observed between the fibrosis score and the kPa+SD distribution. Conclusion: SWE can differentiate the patients requiring treatment (F2, F3 and F4) from the patients not requiring treatment.

Embracing Inclusion: Private School Teachers' Perspective

Background: The concept of inclusive education, which integrates students with and without special needs, is pivotal for fostering equitable learning opportunities. Teacher attitudes are a significant determinant of the success of inclusive education policies. Objective: To ascertain the perspectives of private school teachers in Peshawar regarding the inclusion of children with disabilities in mainstream educational settings. Methods: A descriptive cross-sectional study was carried out over six months at seven private schools in Hayatabad, Peshawar, following IRB and ethical approval from KMU. The sample of 200 teachers was determined using a confidence level of 95% and a margin of error of 5%. Data were collected using the Attitudes Towards Mainstreaming Scale and analyzed using SPSS Version 25 to provide descriptive statistics, including frequencies and mean±SD values. Results: Teachers generally regarded inclusive education as a favorable practice (mean 2.03±0.89), with a significant number expressing strong agreement to the inclusion of learners in regular classrooms. The acceptance varied based on the type of disability, with physical disabilities (mean 2.40±1.12 for wheelchair-bound learners) receiving more agreement than behavioral issues (mean 2.36±0.95 for learners who stutter). Conclusion: Most private school teachers in Peshawar exhibit a supportive stance towards inclusive education. This positive attitude is crucial for fostering an inclusive environment that benefits all students.

The effect of irrigation and aspiration on the corneal endothelial cell density in patients undergoing Implantable Collamer Lens with a central hole implantation for myopia correction.

In the conventional technique, viscoelastic agents are typically rinsed away with balanced salt solution (BSS), but it may lead to a series of complications such as viscoelastic residue, anterior chamber instability and intraoperative TICL rotation. The utilization of irrigation and aspiration (I/A) has been shown to be effective in maintaining anterior chamber stability, reducing the incidence of postoperative high intraocular pressure, and minimizing postoperative fundus complications. However, there is a lack of previous studies investigating the impact of I/A on corneal endothelial cells during ICL implantation. The objective of this study was to examine the effect of I/A on corneal endothelial cells in patients undergoing myopia correction through implantation of Implantable Collamer Lens with a central hole (V4c ICL). A retrospective selection was made of 344 eyes from 172 patients who underwent V4c ICL implantation and I/A to remove viscoelastic agent from the anterior chamber between 2021 and 2022. The intraocular pressure (IOP) was measured at 1h, 2h and 3h after surgery. Corneal endothelial cell density (ECD), coefficient of variation in cell size (CV), standard deviation of cell area (SD), and percentage of hexagonal cells (HEX) were evaluated at 1week postoperatively to assess corneal endothelial cells. The first two represent polymegethism or morphological variation, while the third parameter represents the degree of polymorphism of the corneal endothelial cells. Electronic medical records were utilized for data collection purpose. All surgeries proceeded without complications. The IOP was 16.50 ± 3.42mmHg (range: 11.5-22.3mmHg) prior to surgery and increased to 21.25 ± 5.61mmHg (range: 9.5-34.8mmHg), 19.85 ± 5.18mmHg (range: 11.4-36.2mmHg) and finally settled at an average of 18.81 ± 4.57mmHg (range: 10.1-38.8mmHg) at the respective time points of 1h, 2h and 3h after surgery. The preoperative ECD was recorded as being approximately 3004 ± 295 cell/mm2, which exhibited a marginal decreased of 1.17% postoperatively, resulting in an average ECD value of 2969 ± 303 cell/mm2 one week after surgery (P = 0.12). Similarly, the preoperative CV was determined as 31.10 ± 3.78%, and it experienced a slight reduction with an average CV value of 30.74 ± 3.77% at week after surgery (P = 0.21). And, the preoperative SD was reported as 104.76 ± 17.26, and it remained virtually unchanged with an average SD value of 104.85 ± 18.75 at one week after surgery (P = 0.95). The preoperative HEX was calculated as 55.38 ± 8.94%, and it remained its stability with an average HEX value of 55.45 ± 8.73% one week after surgery (P = 0.92). The utilization of I/A led to a slight decrease in postoperative ECD when compared to conventional surgical techniques. Nevertheless, the reduction in ECD remained within acceptable limits, taking into accout the avervantaged it offered, such as stabilization of the anterior chamber and decreased occurrence of viscoelastic residue after surgery. It is challenging to anticipate the long-term safety of corneal endothelial cells based on current short-term studies. However, this study provides a valuable reference indicating that neither anterior chamber irrigation nor I/A aspiration have an adverse impact on the safety of corneal endothelial cells in the short term. Further research is imperative to enhance our understanding of their effects over an extended period.

Adipokines and adiposity among postmenopausal women of the Multi-Ethnic Study of Atherosclerosis.

We investigated whether the associations of serum adiponectin, leptin, and resistin with adiposity differ with menopausal age. In this cross-sectional study, we included 751 postmenopausal women from the Multi-Ethnic Study of Atherosclerosis (MESA) who reported their menopausal age (<45, 45-49, 50-54 and ≥55 y) and had anthropometrics, serum adipokines, and abdominal computed tomography measures of visceral and subcutaneous adipose tissue (VAT and SAT) obtained at MESA exam 2 or 3. Linear regression models were used for analysis. The mean ± SD age was 65.1 ± 9.0 years for all participants. The median (interquartile range) values for serum adiponectin, leptin and resistin, VAT, and SAT were 21.9 (14.8-31.7) ng/L, 24.3 (12.5-42.4) pg/L, 15.3 (11.8-19.5) pg/L, 183.9 (130.8-251.1) cm2, and 103.7 (65.6-151.5) cm2, respectively. The mean ± SD values for body mass index, waist circumference, and waist-to-hip ratio were 28.3 ± 5.81 kg/m2, 96.6 ± 15.9 cm, and 0.91 ± 0.078, respectively. Adiponectin was inversely associated with all adiposity measures, with similar patterns across menopausal age categories. Leptin was positively associated with all adiposity measures, and the strength of associations varied across menopausal age categories for body mass index, waist circumference, and SAT (Pinteraction ≤ 0.01 for all). The associations of resistin with adiposity measures were mostly nonsignificant except in the 45- to 49-year menopausal age category. Menopausal age category had no influence on the association of serum adiponectin with adiposity. The association of serum leptin and resistin differed according to menopausal age category for generalized adiposity but was inconsistent for measures of abdominal adiposity.

Effect of “Tell Show Do” Method on Dental Anxiety in Pediatrics Dentistry: A Meta Analysis

Background: Anxiety in children will make it difficult for dentists to perform dental treatment. In dentistry, especially pediatric dentistry, children who are very anxious will avoid examinations and refuse dental treatment. This study aims to analyze the influence of the "tell show do" method in reducing dental anxiety in pediatric patients. Subjects and Method: This was a systematic review and meta-analysis conducted using PRISMA flow diagrams. Search articles through journal databases including: Google Scholar, PubMed, and Springer Link by selecting articles published in 2016 and 2022. The keywords used are (“tell show do” OR “TSD”AND “dental anxiety” OR “anxiety” ) AND (“pediatric dentistry” OR “children”) AND (“RCT” OR “randomized control trial”). The inclusion criteria were full paper articles using the Randomized Controlled Trial (RCT) research method, the results of the analysis used the Mean SD value, the intervention provided was a tell show do, the study subjects were pediatric dental patients at the first visit, with dental anxiety as an outcome. Articles that met the requirements were analyzed using the Revman 5.3 application. Results: The meta-analysis of 12 articles shows that there is an increasing effect using the tell show do method on reducing dental anxiety. Children who received the tell show do intervention had a dental anxiety level 0.54 units lower than those who did not receive the tell show do, and the effect was statistically significant (SMD 0.54; 95% CI= 0.23 to 0.85; p=0.0007). Conclusion: The tell show do method has an effect on reducing anxiety in pediatric dental patients. Keywords: tell show do, dental anxiety, meta-analysis

Neutrophil/Lymphocytes Ratio and Haemoglobin Electrophoretic Pattern in an Undergraduate Student’s Population Rivers State University, Port Harcourt, Nigeria

Neutrophil/lymphocyte ratio (NLR) is a very cheap and accurate method of accessing inflammation and is fast emerging as a prognostic biomarker in many diseases. This study determines the Neutrophil/lymphocyte ratio and haemoglobin electrophoretic patterns in an undergraduate student’s population at Rivers State University, Port Harcourt, Nigeria. One hundred and fifty (150) undergraduate students aged between 17 and 30 years old were recruited for the study. Five millimeters (5ml) of venous blood was collected from each participants into ethylene diamine tetraacetic acid (EDTA) vacutainer bottle for the determination of haemoglobin genotype using cellulose acetate electrophoresis method while the neutrophil/lymphocyte ratio was calculated from neutrophil and lymphocyte values obtained from BC 5000 Mindray Hematology Auto-Analyzer. The results obtained showed that the mean±SD value of Neutrophil/Lymphocyte ratio was 1.21 ± 0.07 for male and 1.14 ± 0.06 for female participants with both within normal reference ranges and with no significant difference (p=0.4692). 100 (66.7%) subjects had haemoglobin genotype AA (HbAA) out of which 48 (32%) male, 52 (34.7%) female while 50 (33.3%) participants had haemoglobin genotype AS (HbAS) of which 24 (16%) male, 26 (17.3%) female. No haemoglobin genotype SS/SC (HbSS/HbSC) traits were seen in the study population. Furthermore, results also showed that haemoglobin genotype and sex had no effects on the neutrophil/lymphocyte ratio (p=0.05). This study shows a 66.7%, 33.3%, and 0% expression for HbAA, HbAS, and HbSS/HbSC, respectively, and that the Neutrophil/Lymphocyte ratio is within the normal reference range. Further studies to include other haemoglobin variants such as haemoglobin SS (HbSS) and haemoglobin SC (HbSC) is recommended.

A New Method to Evaluate Lower Esophageal Distension Capacity in Eosinophilic Esophagitis by Using Functional Lumen Imaging Probe (EndoFLIP™).

Endoluminal functional lumen impedance planimetry (EndoFLIPTM) has become the gold standard to evaluate esophageal distensibility, although the study itself and its analysis present challenges. We propose here a new method to assess lower esophageal distension capacity that overcomes several limitations of prior approaches, including incomplete and corrupted EndoFLIPTM recordings. Esophageal distension capacity was evaluated with a 16-channel EndoFLIPTM in 10 controls and 14 patients with eosinophilic esophagitis (EoE). Controls were evaluated once. EoE patients were evaluated at baseline and after at least six weeks of treatment with orodispersible budesonide tablets, 1 mg bd. Balloon volumes were increased by 5 mL stepwise, either reaching a maximum volume of 60 mL or a maximum balloon pressure of 60 mmHg. Recordings were analyzed with a homemade R script. The mean esophageal diameter at 60 mL, D (60 mL), was calculated or extrapolated depending on whether the 60 mL volume was reached. By fitting a Michaelis-Menten curve across all measured diameters throughout all constant volume steps, the mean D (60 mL) was estimated. For control subjects, the mean ± SD value of D (60 mL) was 17.08 ± 1.69 mm, and for EoE patients at baseline, D (60 mL) was 14.51 ± 2.68 mm. After six weeks of treatment of EoE patients, D (60 mL) significantly increased to 16.22 ± 1.86 mm (paired Wilcoxon signed test: p = 0.0052), although the values for control subjects were not reached. The estimated mean esophageal diameter at 60 mL is a good proxy for esophageal distension capacity, which correlates with clinical outcomes in EoE. The method presented in this study overcomes difficulties encountered during the standard measurement protocol, allowing the analysis of recordings from incomplete and corrupted registries.

Comparison and Optimization of Water Conservation Function in Natural Forests and Tea Plantations in a Headwater Catchment, Taihu Lake Basin

The rapid expansion of tea plantations (Camellia sinensis), which replace local natural forests, decreases the water conservation function in the headwater region and threatens regional water security. However, studies focusing on the comprehensive evaluation and improvement of the water conservation function of natural forests and tea plantations are lacking. In this study, we developed a comprehensive evaluation method for the water conservation function by investigating, monitoring, and conducting process model simulations of 221 tea plantation and natural forest (bamboo forest) samples obtained in the field. We also quantified the trade-off between water conservation and carbon sequestration. The results showed that the tea plantations had lower annual water conservation than the bamboo forests. Slope was the most critical influential variable affecting water conservation in tea plantations. Strict control should be exercised in the development of steep slopes above 20° for tea plantations, to enhance the regional water conservation capacity. Water conservation in bamboo forests increased to the maximum level at a planting density (SD) of approximately 2500–2700 tree/ha and then decreased quickly. The optimal SD values of bamboo forests were 2500, 2600, and 2650 trees/ha at slopes of 10°, 15°, and 20°, respectively, which can maintain higher water conservation and adequate carbon sequestration. Overall, water conservation and carbon sequestration increased by approximately 22.6% and 13.7%, respectively, compared with the average values for bamboo forests. However, at slopes &gt;20°, a strong trade-off was observed between water conservation and carbon sequestration, and competing ecosystem services accompanied those, which were hard to balance and which resulted here in disproportionate water conservation at the cost of carbon sequestration loss.

An Evaluation Analysis for Computed Tomography Image Quality of Primary Liver Cancer Lesions Based on Deep Learning Image Reconstruction.

Abdominal multi-slice helical computed tomography (CT) and contrast-enhanced scanning have been widely recognized clinically. The impact of the deep learning image reconstruction (DLIR) on the quality of dynamic contrast-enhanced CT imaging of primary liver cancer lesions was evaluated through comparison with the filtered back projection (FBP) and the new generation of adaptive statistical iterative reconstruction-V (ASIR-V). We evaluated the image noise of the lesion, fine structures inside the lesion, and diagnostic confidence in 48 liver cancer subjects. The CT values of the solid part of the lesion and the adjacent normal liver tissue and the systolic and diastolic blood pressure (SD) values of the right paravertebral muscle were measured. The muscle SD value was considered as the background noise of the image, and the signal noise ratio (SNR) and contrast signal-to-noise ratio (CNR) of the lesion and normal liver parenchyma were calculated. High consistency in the evaluation of image noise (Kappa = 0.717). The Kappa values for margin/pseudocapsule, fine structure within the lesion, and diagnostic confidence were 0.463, 0.527, and 0.625, respectively. Besides, the differences in SD, SNR and CNR data of reconstructed lesion images among the six groups were statistically significant. The contrast-enhanced CT image noise of DLIR-H in the portal venous phase is much lower than that of ASIR-V and FBP in primary liver cancer patients. In terms of the lesion structure display, the new reconstruction algorithm DLIR is superior.

Endocyclophotocoagulation Combined with Phacoemulsification in Glaucoma Treatment: Five-Year Results.

this study aimed to assess the effectiveness and safety of phaco-endocyclophotocoagulation (phaco-ECP) in patients with glaucoma over five consecutive years. Thirty-eight patients (38 eyes) with primary and secondary glaucoma were enrolled to undergo phaco-ECP (Endo Optiks URAM E2, Beaver-Visitec International, Waltham, MA, USA). The primary outcome measures were intraocular pressure (IOP) reduction, success rates, glaucoma medication use, and visual acuity after phaco-ECP. An IOP reduction of 20% compared to the baseline value without re-intervention was considered a successful treatment. Complete success was defined as a cessation of antiglaucoma medications. Secondary outcome measures included intraoperative and postoperative complications. Measurements were performed preoperatively and in the first week and 1, 3, 6, 12, 18, 24, 30, 36, 42, 48, 54, and 60 months postoperatively. The mean ± SD values of IOP preoperatively, at 12, 24, 36, 48, and 60 months postoperatively were 22.6 ± 6.7 mmHg, 15.9 ± 3.9 mmHg (p < 0.001), 15.9 ± 2.9 mmHg (p < 0.001), 15.6 ± 2.7 mmHg (p < 0.001), 15.5 ± 3.8 mmHg (p < 0.001), and 15.2 ± 2.6 mmHg (p < 0.001), respectively. The mean IOP at the last follow-up was reduced by 32.7%. The decrease in the number of antiglaucoma medications was statistically significant at each follow-up visit compared to the baseline. The qualified success rate was 40.6%. All patients at the 60-month follow-up visit required the use of antiglaucoma medications-none of the patients achieved complete success. During the follow-up period, nine patients (28.3%) that required retreatment due to nonachievement of the target IOP were considered failures. Six patients (15.8%) were lost from the follow-up. A total of 23 patients were evaluated 60 months after their phaco-ECP. Complications directly associated with the procedure, such as corneal edema (25.6%), IOP spikes (20.5%), IOL dislocation (2.6%), and uveitis (12.8%), were observed in our patients. Hypotony was not observed in any of our patients. The phaco-ECP procedure was effective, well-tolerated, and safe for reducing IOP in glaucoma patients with cataracts over a long-term follow-up. Randomized, larger-scale studies are required to validate the results obtained.

More Variability in Tibialis Anterior Function during the Adduction of the Foot than Dorsiflexion of the Ankle.

The aim of the study was to compare maximal force, force steadiness, and the discharge characteristics of motor units in the tibialis anterior (TA) muscle during submaximal isometric contractions for ankle dorsiflexion and adduction of the foot. Nineteen active young adults performed maximal and submaximal isometric dorsiflexion and adduction contractions at five target forces (5%, 10%, 20%, 40%, and 60% maximal voluntary contraction [MVC]). The activity of motor units in TA was recorded by high-density EMG. The maximal force was similar between dorsiflexion and adduction, despite EMG amplitude for TA being greater ( P < 0.05) during dorsiflexion than adduction. Τhe coefficient of variation (CV) for force (force steadiness) during dorsiflexion was always less ( P < 0.05) than during adduction, except of 5% MVC force. No differences were observed for mean discharge rate; however, the regression between the changes in discharge rate relative to the change of force was significant for dorsiflexion ( R2 = 0.25, P < 0.05) but not for adduction. Discharge variability, however, was usually less during dorsiflexion. The CV for interspike interval was less ( P < 0.05) at 10%, 20%, and 40% MVC but greater at 60% MVC during dorsiflexion than adduction. Similarly, the SD values of the filtered cumulative spike train of the motor units in TA were less ( P < 0.05) at 5%, 10%, 20%, and 40% MVC during dorsiflexion than adduction. Although the mean discharge rate of motor units in TA was similar during foot adduction and ankle dorsiflexion, discharge variability was less during dorsiflexion resulting in less accurate performance of the steady adduction contractions. The neural drive to bifunctional muscles differs during their accessory function, which must be considered for training and rehabilitation interventions.

Limited angular remodelling after in-situ fixation for slipped capital femoral epiphysis

BackgroundIn Sweden, most children with slipped capital femoral epiphysis (SCFE) are operated on with a single smooth pin or a short-threaded screw, allowing further growth of the femoral neck. Using the Swedish Pediatric Orthopaedic Quality registry, SPOQ, we investigated whether angular remodelling occurs adjacent to the proximal femoral epiphysis after fixation of SCFE using implants, allowing continued growth of the femoral neck.MethodsDuring 2008–2010 a total national population of 155 children were reported to the SPOQ registry. Following our strict inclusion criteria, radiographs of 51 hips were further assessed. The lateral Head Shaft Angle (HSA), the Nötzli 3-point α-angle, the anatomic α-angle, and the Anterior Offset Ratio (AOR) on the first postoperative radiographs and at follow-up were measured to describe the occurrence of remodelling. Slip severity was categorised as mild, moderate or severe according to postoperative HSA.ResultsMean and SD values for the change in HSA were 3,7° (5,0°), for 3-point α-angle 6,8° (8,9°), and anatomic α-angle 13,0° (16,3°). The overall increase in AOR was 0,038 (0.069). There were no significant differences between the slip severity groups.ConclusionsWe found limited angular remodelling after in situ fixation with smooth pins or short threaded screws for SCFE. The angular remodelling and the reduction of the CAM deformity was less than previously described after fixation of SCFE with similar implants. Results about the same magnitude with non-growth sparing techniques suggest that factors other than longitudinal growth of the femoral neck are important for angular remodelling.