Short Term Research Articles

Impact effects of COVID-19 pandemic on chronic disease patients: A longitudinal prospective study.

To assess the effects of COVID-19 pandemic on clinical variables as part of the routine clinical monitoring of patients with chronic diseases in primary care. A prospective longitudinal study was conducted in primary care centres of the Andalusian Health Service. Data were recorded before the pandemic (T1), during the declaration of the state of emergency (T2) and in the transition phase (T3). The Barthel index and the Short Portable Mental Status Questionnaire (SPMSQ) were used to analyse functional and cognitive changes at the three time points. HbA1c, systolic and diastolic blood pressure, heart rate, BMI and lipid levels were assessed as clinical variables. Descriptive statistics and non-parametric chi-square test were used for analysis. STROBE checklist was used for the preparation of this paper. A total fo148 patients with chronic conditions were included in the analysis. Data analysis revealed in T2 only significant reductions in BMI, total levels of cholesterol and HDL during the onset of the pandemic. Barthel Index, SPMSQ, blood pressure and triglycerides and LDL levels worsened in T2, and the negative effects were maintained in T3. Compared to pre-pandemic values, HbA1c levels improved in T3, but HDL levels worsened. COVID-19 has drastically disrupted several functional, cognitive and biological variables. These results may be useful in identifying clinical parameters that deserve closer attention in the case of a new health crisis. Further studies are needed to assess the potential impacts of each specific chronic condition. Cognitive and functional status, blood pressure and triglycerides and LDL levels worsen in short term, maintaining the negative effects in medium-term.

Considering a Utility-Centric Framework Based on "Minimum Orthophosphate" Criteria for Mitigation of Elevated Cuprosolvency in Drinking Water.

Gaps in the United States Environmental Protection Agency (US EPA) Lead and Copper Rule (LCR) leave some consumers and their pets vulnerable to high cuprosolvency in drinking water. This study seeks to help proactive utilities who wish to mitigate cuprosolvency problems through the addition of orthophosphate corrosion inhibitors. The minimum doses of orthophosphate necessary to achieve acceptable cuprosolvency in relatively new copper pipe were estimated as a function of alkalinity via linear regressions for the 90th, 95th, and 100th percentile copper tube segments (R2 > 0.98, n = 4). Orthophosphate was very effective at reducing cuprosolvency in the short term but, in some cases, resulted in higher long-term copper concentrations than the corresponding condition without orthophosphate. Alternatives to predicting "long-term" results for copper tubes using simpler bench tests starting with fresh Cu(OH)2 solids showed promise but would require further vetting to overcome limitations such as maintaining water chemistry and orthophosphate residuals and to ensure comparability to results using copper tube.

Magnetic Resonance-Guided Focused Ultrasound for Treatment of Essential Tremor: Ventral Intermediate Nucleus Ablation Alone or Additional Posterior Subthalamic Area Lesioning?

Magnetic resonance-guided focused ultrasound (MRgFUS) for treatment of essential tremor (ET) traditionally targets the ventral intermediate (Vim) nucleus. Recent strategies include a secondary lesion to the posterior subthalamic area (PSA). The aim was to compare lesion characteristics, tremor improvement, and adverse events (AE) between patients in whom satisfactory tremor suppression was achieved with lesioning of the Vim alone and patients who required additional lesioning of the PSA. Retrospective analysis of data collected from ET patients treated with MRgFUS at St Vincent's Hospital Sydney was performed. Clinical Rating Scale for Tremor (CRST), hand tremor score (HTS), and Quality of Life in Essential Tremor Questionnaire (QUEST) were collected pre- and posttreatment in addition to the prevalence of AEs. The lesion coordinates and overlap with the dentatorubrothalamic tract (DRTT) were evaluated using magnetic resonance imaging. Twenty-one patients were treated in Vim only, and 14 were treated with dual Vim-PSA lesions. Clinical data were available for 29 of the 35 patients (19 single target and 10 dual target). At follow-up (mean: 18.80 months) HTS, CRST, and QUEST in single-target patients improved by 57.97% (P < 0.001), 36.71% (P < 0.001), and 58.26% (P < 0.001), whereas dual-target patients improved by 68.34% (P < 0.001), 35.37% (P < 0.003), and 46.97% (P < 0.005), respectively. The Vim lesion of dual-target patients was further anterior relative to the posterior commissure (PC) (7.84 mm), compared with single-target patients (6.92 mm), with less DRTT involvement (14.85% vs. 23.21%). Dual-target patients exhibited a greater proportion of patients with acute motor AEs (100% vs. 58%); however, motor AE prevalence was similar in both groups at long-term follow-up (33% vs. 38%). Posterior placement of lesions targeting the Vim may confer greater tremor suppression. The addition of a PSA lesion, in patients with inadequate tremor control despite Vim lesioning, had a trend toward better long-term tremor suppression; however, this approach was associated with greater prevalence of gait disturbance in the short term.

The Effect Of Mergers And Acquisitions On The Financial Performance Of Companies Listed On The Indonesia Stock Exchange

Mergers and acquisitions (M&amp;A) have become a common strategy in business development in today's global market. This study aims to analyze the effect of M&amp;A on the financial performance of companies listed on the Indonesia Stock Exchange (IDX). Data is collected from companies that experienced M&amp;A during a certain period, focusing on financial variables such as profitability, liquidity, leverage, and sales growth. The panel regression analysis method was used to test the research hypothesis. The results show that M&amp;A has a significant influence on the financial performance of companies on the IDX. Specifically, the findings show an increase in profitability and sales growth after M&amp;A, while liquidity tends to decrease in the short term after the transaction. Leverage may also fluctuate depending on the capital structure and financial policies the company implements post-M&amp;A. This study provides valuable insights for stakeholders in the Indonesian capital market, including investors, fund managers, and regulators, to understand the implications of M&amp;A on firms' financial performance. The practical implications of this study can assist firms in planning and evaluating their M&amp;A decisions more carefully to increase firm value and reduce the risks associated with such transactions.

May Artificial Intelligence take health and sustainability on a honeymoon? Towards green technologies for multidimensional health and environmental justice

ABSTRACT The application of Artificial Intelligence (AI) in healthcare and epidemiology undoubtedly has many benefits for the population. However, due to its environmental impact, the use of AI can produce social inequalities and long-term environmental damages that may not be thoroughly contemplated. In this paper, we propose to consider the impacts of AI applications in medical care from the One Health paradigm and long-term global health. From health and environmental justice, rather than settling for a short and fleeting green honeymoon between health and sustainability caused by AI, it should aim for a lasting marriage. To this end, we conclude by proposing that, in the upcoming years, it could be valuable and necessary to promote more interconnected health, call for environmental cost transparency, and increase green responsibility. Highlights Using AI in medicine and epidemiology has some benefits in the short term. AI usage may cause social inequalities and environmental damage in the long term. Health justice should be rethought from the One Health perspective. Going beyond anthropocentric and myopic cost–benefit analysis would expand health justice to include an environmental dimension. Greening AI would help to reconcile public and global health measures.

Social foraging and the associated benefits of group‐living in Cliff Swallows decrease over 40 years

AbstractAnimals that feed socially can sometimes better locate prey, often by transferring information about food that is patchy, dense, and temporally and spatially unpredictable. Information transfer is a potential benefit of living in breeding colonies where unsuccessful foragers can more readily locate successful ones and thereby improve feeding efficiency. Most studies on social foraging have been short term, and how long‐term environmental change affects both foraging strategies and the associated benefits of coloniality is generally unknown. In the colonial Cliff Swallow (Petrochelidon pyrrhonota), we examined how social foraging, information transfer, and feeding ecology changed over a 40‐year period in western Nebraska. Relative to the 1980s, Cliff Swallows in 2016–2022 were more likely to forage solitarily or in smaller groups, spent less time foraging, were more successful as solitaries, fed in more variable locations, and engaged less in information transfer at the colony site. The total mass of insects brought back to nestlings per parental visit declined over the study. The diversity of insect families captured increased over time, and some insect taxa dropped out of the diet, although the three most common insect families remained the same over the decades. Nestling Cliff Swallow body mass at 10 days of age and the number of nestlings surviving per nest declined more sharply with colony size in 2015–2022 than in 1984–1991 at sites where the confounding effects of ectoparasites were removed. Adult body mass during the provisioning of nestlings was lower in more recent years, but the change did not vary with colony size. The reason(s) for the reduction in social foraging and information transfer over time is unclear, but the consequence is that colonial nesting may no longer offer the same fitness advantages for Cliff Swallows as in the 1980s. The results illustrate the flexibility of foraging behavior and dynamic shifts in the potential selective pressures for group living.

Short term power load forecasting system based on improved neural network deep learning model

AbstractThe electricity load prediction is closely related to production and daily life. The electricity load prediction is also a very important task. With the widespread application of smart grids, load data shows an exponential growth trend. The huge amount of data in the load makes power prediction even more difficult. On the basis of traditional prediction algorithms, a power load prediction model based on machine learning and neural networks is designed. Because the single model prediction has the unstable results, a combined model is obtained based on the ensemble learning idea and two single model prediction method. The prediction results are detected by the load data. From the experimental results, the mean absolute percentage error (MAPE) of the AdaBoost‐GRU data fusion model is 0.066%. Compared to the AdaBoost‐GRU data fusion model, the MAPE decreases by 1.59% and 1.12%, respectively. The relative mass scores of the two groups decrease by 132.57% and 89.14%, respectively. The prediction accuracy is improved, which has advantages compared to traditional combination models. It can effectively enhance the accuracy of short‐term power grid load forecasting. It is an important scientific and practical reference for power grid decision‐making.

Transcriptomic profiling of osteoarthritis synovial macrophages reveals a tolerized phenotype compounded by a weak corticosteroid response.

It is well-known that long-term osteoarthritis prognosis is not improved by corticosteroid treatments. Here we investigate what could underlie this phenomenon by measuring the short term corticosteroid response of OA-Mf. We determined the genome-wide transcriptomic response to corticosteroids of end-stage osteoarthritic joint synovial macrophages (OA-Mf). This was compared with LPS-tolerized and β-glucan-trained circulating blood monocyte-derived macrophage models. Upon corticosteroid stimulation, the trained and tolerized macrophages significantly alter the abundance of 201 and 257 RNA transcripts, respectively. By contrast, by the same criteria, OA-Mf have a very restricted corticosteroid response of only 12 RNA transcripts. Furthermore, while metalloproteinases 1, -2, -3 and -10 expression clearly distinguish OA-Mf from both the tolerized and trained macrophage models, OA-Mf Interleukin 1 (IL1), chemokine (CXCL) and cytokine (CCL) family member profiles resemble the tolerized macrophage model, with the exception that OA-Mf show high levels of CCL20. Terminal osteoarthritis joints therefore harbor macrophages with an inflammatory state that closely resembles the tolerized macrophage state and this is compounded by a weak corticosteroid response capacity that may explain the lack of positive long-term effects of corticosteroid treatment for osteoarthritis patients.

Effect of Continuous Positive Airway Pressure on Blood Pressure in Patients with Resistant Hypertension and Obstructive Sleep Apnea: An Updated Meta-analysis.

The effect of continuous positive airway pressure (CPAP) on resistant hypertension in patients at high risk with obstructive sleep apnea (OSA) needs further investigation. We aimed to determine the effect of CPAP on blood pressure in patients with resistant hypertension and OSA. Databases including PubMed, EMBASE, MEDLINE, the Cochrane Library, and CMB were searched. Data were pooled using a random-effects or fixed-effects model to derive weighted mean differences (WMDs) and 95% confidence intervals (CIs). A total of 12 trials and 718 participants were included. Compared with control, CPAP significantly reduced 24-h systolic blood pressure (SBP) (WMD: - 5.92 mmHg [ - 8.72, - 3.11]; P＜0.001), 24-h diastolic blood pressure (DBP) (WMD: - 4.44 mmHg [- 6.26 , - 2.62]; P ＜0.001), daytime SBP (WMD: - 5.76 mmHg [ - 9.16, - 2.36]; P ＜0.001), daytime DBP (WMD: - 3.92 mmHg [- 5.55, - 2.30];nighttime SBP (WMD: - 4.87 mmHg [ - 7.96 , - 1.78]; P = 0.002), and nighttime DBP (WMD: - 2.05 mmHg [- 2.99, - 1.11]; P＜0.001) in patients with resistant hypertension and OSA. CPAP improved theblood pressure bothin the short(＜3 months) and long term (≥ 3 months). No significant impact on mean heart rate was noted (WMD: -2.76 beats per min [- 7.50, 1.97]; P = 0.25). CPAP treatment was associated with BP reduction in patients with resistant hypertension and OSA.

The treatment of myopia and future development

Myopia is a relatively common disease at present, especially in the adolescent population is very high, and its prevalence increases with the passage of time, usually myopia will cause retinal detachment, glaucoma, etc., which may seriously lead to vision loss and blindness. Existing treatments include monocular lenses, contact lenses and refractive surgery, as well as the drugs atropine and pirrenzil. Studies have shown that most myopia treatments have little effect, are relatively short term, and have significant side effects. This article mainly summarizes the treatment methods of myopia, combined with the latest findings of clinical research, and put forward the possible future treatment methods.

Securing the Internet of Medical Things with ECG‐based PUF encryption

AbstractThe Internet of Things (IoT) is revolutionizing the healthcare industry by enhancing personalized patient care. However, the transmission of sensitive health data in IoT systems presents significant security and privacy challenges, further exacerbated by the difficulty of exploiting traditional protection means due to poor battery equipment and limited storage and computational capabilities of IoT devices. The authors analyze techniques applied in the medical context to encrypt sensible data and deal with the unique challenges of resource‐constrained devices. A technique that is facing increasing interest is the Physical Unclonable Function (PUF), where biometrics are implemented on integrated circuits' electric features. PUFs, however, demand special hardware, so in this work, instead of considering the physical device as a source of randomness, an ElectroCardioGram (ECG) can be taken into consideration to make a ‘virtual’ PUF. Such an mechanism leverages individual ECG signals to generate a cryptographic key for encrypting and decrypting data. Due to the poor stability of the ECG signal and the typical noise existing in the measurement process for such a signal, filtering and feature extraction techniques must be adopted. The proposed model considers the adoption of pre‐processing techniques in conjunction with a fuzzy extractor to add stability to the signal. Experiments were performed on a dataset containing ECG records gathered over 6 months, yielding good results in the short term and valuable outcomes in the long term, paving the way for adaptive PUF techniques in this context.

Behavior of soil reinforced with micropiles

Abstract Soil investigation is very important to check the bearing capacity before constructing any structure. There are different types of soils that cause many problems for the structure in short and long term, which are known as problematic soils. A lot of researchers dealt with improvement and reinforcement of the problematic soils by physical and chemical treatments. The objective of this study is reinforcing the problematic soil with micropiles with different depths and different configurations. In this study, two types of soils, soft clay and loose sand, were used to study the effect of adding micropiles of different depths and different configurations to investigate the best improvement of bearing capacity for shallow foundations on these soils. The results showed that reinforcing the natural soil with micropiles could improve the pressure carrying capacity of the problematic soils. When the design width is changed from under foundation alone to under foundation and 2B width, the soil reinforced with 2B depth of micropiles can raise the soil’s load carrying capacity by 45 to 65% when compared to untreated soil. Just 7% more bearing capacity may be achieved by increasing the depth of the micropiles from 2B to 3B (where B is the footing width); as a result, going deeper than 2B is not advantageous. Additionally, the bearing capacity of the micropiles increases by only 3% when the breadth of the configuration is increased from 1B to 2B; so, wider configurations than 1B are invalid.

Exercise-based cardiac rehabilitation for adults with heart failure.

People with heart failure experience substantial disease burden that includes low exercise tolerance, poor health-related quality of life (HRQoL), increased risk of mortality and hospital admission, and high healthcare costs. The previous 2018 Cochrane review reported that exercise-based cardiac rehabilitation (ExCR) compared to no exercise control shows improvement in HRQoL and hospital admission amongst people with heart failure, as well as possible reduction in mortality over the longer term, and that these reductions appear to be consistent across patient and programme characteristics. Limitations noted by the authors of this previous Cochrane review include the following: (1) most trials were undertaken in patients with heart failure with reduced (< 45%) ejection fraction (HFrEF), and women, older people, and those with heart failure with preserved (≥ 45%) ejection fraction (HFpEF) were under-represented; and (2) most trials were undertaken in a hospital or centre-based setting. To assess the effects of ExCR on mortality, hospital admission, and health-related quality of life of adults with heart failure. We searched CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO and Web of Science without language restriction on 13 December 2021. We also checked the bibliographies of included studies, identified relevant systematic reviews, and two clinical trials registers. We included randomised controlled trials (RCTs) that compared ExCR interventions (either exercise only or exercise as part of a comprehensive cardiac rehabilitation) with a follow-up of six months or longer versus a no-exercise control (e.g. usual medical care). The study population comprised adults (≥ 18 years) with heart failure - either HFrEF or HFpEF. We used standard Cochrane methods. Our primary outcomes were all-cause mortality, mortality due to heart failure, all-cause hospital admissions, heart failure-related hospital admissions, and HRQoL. Secondary outcomes were costs and cost-effectiveness. We used GRADE to assess the certainty of the evidence. We included 60 trials (8728 participants) with a median of six months' follow-up. For this latest update, we identified 16 new trials (2945 new participants), in addition to the previously identified 44 trials (5783 existing participants). Although the existing evidence base predominantly includes patients with HFrEF, with New York Heart Association (NYHA) classes II and III receiving centre-based ExCR programmes, a growing body of trials includes patients with HFpEF with ExCR undertaken in a home-based setting. All included trials employed a usual care comparator with a formal no-exercise intervention as well as a wide range of active comparators, such as education, psychological intervention, or medical management. The overall risk of bias in the included trials was low or unclear, and we mostly downgraded the certainty of evidence of outcomes upon GRADE assessment. There was no evidence of a difference in the short term (up to 12 months' follow-up) in the pooled risk of all-cause mortality when comparing ExCR versus usual care (risk ratio (RR) 0.93, 95% confidence interval (CI) 0.71 to 1.21; absolute effects 5.0% versus 5.8%; 34 trials, 36 comparisons, 3941 participants; low-certainty evidence). Only a few trials reported information on whether participants died due to heart failure. Participation in ExCR versus usual care likely reduced the risk of all-cause hospital admissions (RR 0.69, 95% CI 0.56 to 0.86; absolute effects 15.9% versus 23.8%; 23 trials, 24 comparisons, 2283 participants; moderate-certainty evidence) and heart failure-related hospital admissions (RR 0.82, 95% CI 0.49 to 1.35; absolute effects 5.6% versus 6.4%; 10 trials; 10 comparisons, 911 participants; moderate-certainty evidence) in the short term. Participation in ExCR likely improved short-term HRQoL as measured by the Minnesota Living with Heart Failure (MLWHF) questionnaire (lower scores indicate better HRQoL and a difference of 5 points or more indicates clinical importance; mean difference (MD) -7.39 points, 95% CI -10.30 to -4.77; 21 trials, 22 comparisons, 2699 participants; moderate-certainty evidence). When pooling HRQoL data measured by any questionnaire/scale, we found that ExCR may improve HRQoL in the short term, but the evidence is very uncertain (33 trials, 37 comparisons, 4769 participants; standardised mean difference (SMD) -0.52, 95% CI -0.70 to -0.34; very-low certainty evidence). ExCR effects appeared to be consistent across different models of ExCR delivery: centre- versus home-based, exercise dose, exercise only versus comprehensive programmes, and aerobic training alone versus aerobic plus resistance programmes. This updated Cochrane review provides additional randomised evidence (16 trials) to support the conclusions of the previous 2018 version of the review. Compared to no exercise control, whilst there was no evidence of a difference in all-cause mortality in people with heart failure, ExCR participation likely reduces the risk of all-cause hospital admissions and heart failure-related hospital admissions, and may result in important improvements in HRQoL. Importantly, this updated review provides additional evidence supporting the use of alternative modes of ExCR delivery, including home-based and digitally-supported programmes. Future ExCR trials need to focus on the recruitment of traditionally less represented heart failure patient groups including older patients, women, and those with HFpEF.

Environment and Digitalization: The New Paradigms in the European Stock Markets

In a European context in which the objectives of climate neutrality and digitalization appear fundamental, the work analyzes the relationships between the price of the main stock market indices and the most representative variables such as carbon emissions, digitalization, use of renewable energy, research and development expenses, environmental taxes, and all economic and management activities aimed at reducing or eliminating any form of pollution. The analysis was developed through three different regressions involving the long period 1995–2020 and the short period 2017–2020. The results show how increasing carbon emissions and environmental taxes positively impact stock indices. The former is linked to an increase in production and, therefore, economic growth, and the latter encourages sustainability. Taxes on transport and energy in the long term generate higher costs, which damage profitability and negatively impact the performance of stock indices. Finally, in the short term, implementing environmental protection measures or the sustainable management of resources may lead to higher operating costs for the companies involved. These cost increases can negatively impact profit margins and reduce the value of companies. These results, therefore, show us how environmental sustainability has a significant impact on European stock markets; consequently, the relevant regulations and policies should also consider the economic and managerial impacts that companies implement to achieve their objectives of the Green Deal.

Ensuring useful adoption of generative artificial intelligence in healthcare.

This article aims to examine how generative artificial intelligence (AI) can be adopted with the most value in health systems, in response to the Executive Order on AI. We reviewed how technology has historically been deployed in healthcare, and evaluated recent examples of deployments of both traditional AI and generative AI (GenAI) with a lens on value. Traditional AI and GenAI are different technologies in terms of their capability and modes of current deployment, which have implications on value in health systems. Traditional AI when applied with a framework top-down can realize value in healthcare. GenAI in the short term when applied top-down has unclear value, but encouraging more bottom-up adoption has the potential to provide more benefit to health systems and patients. GenAI in healthcare can provide the most value for patients when health systems adapt culturally to grow with this new technology and its adoption patterns.

Frequency prediction of a post-disturbance power system using a hybrid ARIMA and DBN model

The online prediction of power system dynamic frequency helps to guide the choice of control measures quickly and accurately after a disturbance, and this then ensures the reliable and stable operations of a power system. However, the prediction performance of the traditional single model is not accurate enough, and the prediction method cannot reflect the dynamic mechanism of the power system. To address these challenges, based on the analysis of the mechanism of the dynamic operation of a power system, a dynamic frequency online prediction method using the autoregressive integrated moving average (ARIMA) model and the deep belief network (DBN) is proposed in this paper. First, according to the mechanism of the dynamic operation of a power system, the dynamic frequency can be regarded as having two stages after the disturbance occurs. In the first stage, the frequency changes monotonously in the short term, which is predicted by the ARIMA model. Furthermore, the second stage is an oscillation phase with changing amplitude, which is predicted by the DBN. The calibration process is used to combine the two predicted results. Second, the three metrics including the frequency nadir (fnadir), the quasi-steady state frequency (fss), and the frequency curve obtained through the prediction are analyzed to measure the accuracy of the prediction results. Finally, to verify the accuracy of the proposed model, the IEEE 10-generator 39-bus benchmark system is used for verification.

Does Alternative Data Improve Financial Forecasting? The Horizon Effect

ABSTRACTExisting research suggests that alternative data are mainly informative about short‐term future outcomes. We show theoretically that the availability of short‐term‐oriented data can induce forecasters to optimally shift their attention from the long term to the short term because it reduces the cost of obtaining short‐term information. Consequently, the informativeness of their long‐term forecasts decreases, even though the informativeness of their short‐term forecasts increases. We test and confirm this prediction by considering how the informativeness of equity analysts' forecasts at various horizons varies over the long run and with their exposure to social media data.

Predischarge oxygen uptake efficiency slope has short and long-term value in the prognosis of patients after acute myocardial infarction.

Patients who survive an acute myocardial infarction (AMI) have a higher risk of having a major cardiovascular event (MACE). Cardiopulmonary exercise testing (CPET) could develop prognostic stratification and prescribing exercise prescription. Patients after AMI frequently terminate CPET early with submaximal testing results. We aimed to look at the characteristics of patients' predischarge CPET variables after AMI intervention and find potential CPET variables with prognostic value. Between July 2012 and August 2017, we recruited patients who survived first AMI after primary percutaneous coronary intervention and received predischarge CPET retrospectively in a tertiary medical center of Taiwan. Patients were followed-up on a MACE or administrative censoring occurred (up to 5 years). To identify significant predictors of a MACE, a Cox regression model was used. One hundred thirteen patients (103 men and 10 women) were studied, with an average age of 58.32 ± 12.49. MACE over 3 months, 2-years, and 5-years was 17.70%, 53.10%, and 62.83%, respectively. The oxygen uptake efficiency slope during the whole during of CPET (OUES 100) divided by body surface area (OUES 100/BSA) was found to be a significant event predictor for MACE at 3-month, 2- and 5-years. Cox regression analysis revealed that those with OUES 100/BSA <0.722 ( p = 0.004), OUES 100/BSA <0.859 ( p = 0.002), and OUES 100/BSA <0.829 ( p = 0.002) had a 7.14-fold, 3.47-fold, and 2.72-fold increased risk of 3-month, 2-year, and 5-year MACE, respectively. It is critical to identify a submaximal predictor during CPET for patients who survive AMI. Our findings suggested that OUES could be a significant prognostic indicator in patients after first AMI in both the short and long term.

Andrographolide Improves ApoE4-Mediated Blood-Brain Barrier Injury by Alleviating Inflammation.

The pathological and physiological studies of Alzheimer's disease (AD) have been in-depth, and apolipoprotein E4 (ApoE4) has been proven to be highly correlated with AD, and clinical and experimental data show that ApoE4 can cause blood-brain barrier (BBB) injury, and the change of BBB permeability is an important factor affecting the development of AD. Andrographolide (Andro), as the active component of the natural plant Andrographis paniculata, has been proven to have anti-inflammatory and antioxidant effects, which have potential neuroprotective effects. To verify the protective effect of Andro on BBB in a short term, our research group used atorvastatin (Atorva)-mediated zebrafish brain injury model and the ApoE4-mediated cell co-culture model of BBB injury to explore the protective effects and mechanisms of Andro on BBB injury. Studies have shown that Andro can inhibit the activation of CypA/NF-κB/MMP-9 signaling pathway and has achieved the effect of antagonizing the inhibition of ApoE4 on intercellular tight junction proteins (occludin, claudin-5, and ZO-1). At the same time, Andro can inhibit the secretion of cell adhesion molecules (VCAM-1 and ICAM-1) in cells, thereby delaying the occurrence and progression of neuroinflammation and playing a protective role in BBB. In conclusion, Andro is a potent natural product which can protect the blood-brain barrier.

Short and long term effect of anti-reflux mucosectomy with cap-assisted endoscopic mucosal resection for refractory gastroesophageal disease.

Anti-reflux mucosectomy with cap-assisted endoscopic mucosal resection (ARMS-C) is a safe and effective treatment for managing refractory gastroesophageal reflux disease (GERD). This study aimed to investigate the short and long-term outcomes of ARMS-C. This study was conducted from 2018 to 2022, during which 115 eligible patients underwent ARMS-C. The primary endpoints of this study were to evaluate the GERD-Q questionnaire score and determine the number of patients who reduced their proton pump inhibitor (PPI) dosage or discontinued PPI usage. The secondary endpoints included the evaluation of the DeMeester score, acid exposure time (AET), gastroesophageal flap valve grade (GEFV), lower esophageal sphincter pressure, the rate of successful esophageal peristalsis, and GERD-Q questionnaires. Additionally, we analyzed the long-term efficacy of ARMS-C. Out of the 120 patients, 115 underwent ARMS-C, 96 were followed up for at least six months after the procedure, and 22 were followed up for at least two years. The primary outcome showed a significant improvement in GERD-Q scores, decreasing from 10.67 to 7.55 (p < 0.001). Out of the 96 patients, 36 were able to reduce or completely stop using PPIs. The DeMeester score, GEFV, AET, and the proportion of intact peristalsis also demonstrated improvement. As for the long-term efficacy of ARMS-C, 86% of patients showed improvement in symptoms, and no serious adverse effects were reported after the procedure. ARMS-C is a safe and effective endoscopic technique to treat refractory GERD patients.