Significant Differences In Quality Research Articles

Do beta-blockers reduce negative intrusive thoughts and anxiety in cancer survivors? – An emulated trial

BackgroundHigh rates of negative intrusive thoughts have been reported among cancer patients. Prevalent users of beta-blocker therapy have reported lower levels of cancer related intrusive thoughts than non-user. The aim of this study is to investigate if initiation of beta-blocker therapy reduces the prevalence and severity of intrusive thoughts (co-primary endpoints) and the prevalence of anxiety, depressed mood, and low quality of life (secondary endpoints) in cancer survivors.MethodsData on patient-reported outcomes from three cohort studies of Swedish patients diagnosed with colon, prostate or rectal cancer were combined with data on beta-blocker prescriptions retrieved from the Swedish Prescribed Drug Register. Two randomized controlled trials were emulated. Trial 1 had follow-up 1 year after diagnosis, trial 2 had follow-up 2 years after diagnosis, baseline in both trials was 12 months before follow-up. Those who initiated beta-blocker therapy between baseline and follow-up was assigned Active group, those who did not was assigned Control group. All endpoints were analysed using Bayesian ordered logistic regression.ResultsTrial 1 consisted of Active group, n = 59, and Control group, n = 3936. Trial 2 consisted of Active group, n = 87, and Control group, n = 3132. The majority of participants were men, 83% in trial 1 and 94% in trial 2. The prevalence and severity of intrusive thoughts were lower in the Active group in trial 1, but no significant differences between groups were found in either trial. The prevalence of depressed mood, worse quality of life and periods of anxiety were higher in the Active group in both trials with significant differences for quality of life in trial 1 and anxiety in trial 2.ConclusionsThe emulated trials demonstrated no evidence of a protective effect of beta-blocker therapy against intrusive thoughts. The Active group had reduced quality of life and elevated anxiety compared to the Control group.Trial registrationThe three cohort studies were registered at isrctn.com/clinicaltrials.gov (ISRCTN06393679, NCT02530593 and NCT01477229).

Mitochondrial genome data provide insights into the phylogenetic relationships within Triplophysadalaica (Kessler, 1876) (Cypriniformes, Nemacheilidae).

Due to the detrimental effect of formaldehyde on DNA, ethanol has replaced formalin as the primary preservative for animal specimens. However, short-term formalin fixation of specimens might be applied during field collection. In an increasing number of studies, DNA extraction and sequencing have been successfully conducted from formalin-fixed specimens. Here the DNA from five specimens of Triplophysadalaica (Kessler, 1876) were extracted and performed high-throughput sequencing. Four of the specimens underwent short-term fixation with formalin and were subsequently transferred to ethanol. One was continuously stored in ethanol. No significant difference of DNA quality and amount were observed among these samples. Followed by assembly and annotation, five mitochondrial genomes ranging in length from 16,569 to 16,572 bp were obtained. Additionally, previously published data of other individuals or species were included to perform phylogenetic analyses. In the reconstructed trees, all eight individuals of T.dalaica form a monophyletic group within the Triplophysa branch. The group is divided into three clades: (1) samples from the Yellow River, (2) those from the Yangtze River, and (3) those from the Haihe River, and the Lake Dali Nur. This study sheds initial light on the phylogeographic relationships among different populations of T.dalaica, and will support the research about its evolutionary history in the future.

Distinct Changes in Metabolic Profile and Sensory Quality with Different Varieties of Chrysanthemum (Juhua) Tea Measured by LC-MS-Based Untargeted Metabolomics and Electronic Tongue.

Chrysanthemum tea, a typical health tea with the same origin as medicine and food, is famous for its unique health benefits and flavor. The taste and sensory quality of chrysanthemum (Juhua) tea are mainly determined by secondary metabolites. Therefore, the present research adopted untargeted metabolomics combined with an electronic tongue system to analyze the correlation between the metabolite profiles and taste characteristics of different varieties of chrysanthemum tea. The results of sensory evaluation showed that there were significant differences in the sensory qualities of five different varieties of chrysanthemum tea, especially bitterness and astringency. The results of principal component analysis (PCA) indicated that there were significant metabolic differences among the five chrysanthemum teas. A total of 1775 metabolites were identified by using untargeted metabolomics based on UPLC-Q-TOF/MS analysis. According to the variable importance in projection (VIP) values of the orthogonal projections to latent structures discriminant analysis (OPLS-DA), 143 VIP metabolites were found to be responsible for metabolic changes between Huangju and Jinsi Huangju tea; among them, 13 metabolites were identified as the key metabolites of the differences in sensory quality between them. Kaempferol, luteolin, genistein, and some quinic acid derivatives were correlated with the "astringency" attributes. In contrast, l-(-)-3 phenyllactic acid and L-malic acid were found to be responsible for the "bitterness" and "umami" attributes in chrysanthemum tea. Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis showed that the flavonoid and flavonol biosynthesis pathways had important effects on the sensory quality of chrysanthemum tea. These findings provide the theoretical basis for understanding the characteristic metabolites that contribute to the distinctive sensory qualities of chrysanthemum tea.

Assessing the Quality and Clarity of YouTube Videos as an Informational Source for Ankle Fractures: A Study of the Turkish Population.

Background and objective The significance of YouTube as a prominent source of healthcare-related information cannot be overstated. Its influence on patient education is substantial. However, despite its popularity, there has been little research into the quality and comprehensibility of videos related to ankle fractures, a condition with increasing incidence rates, particularly in the context of Turkey. To address this gap in the literature and the growing reliance on digital platforms for health information during the coronavirus disease 2019 (COVID-19) pandemic, this study aims to assess the quality, clarity, and pedagogical value of YouTube videos on ankle fractures for the Turkish population. Methodology A comprehensive examination of 150 YouTube videos concerning ankle fractures, employing exacting inclusion and exclusion criteria to identify 52 videos for in-depth analysis was undertaken. The investigation entailed an assessment of content quality, presentation style, and user interaction, utilizing the criteria established by the Journal of the American Medical Association (JAMA) and the Patient Education Materials Assessment Tool (PEMAT), as well as a novel measurement known as the Ankle Fracture Content Score (AFCS). A statistical analysis was executed to gauge the educational value and dependability of the information presented. Results The majority of ankle fracture management videos were found to be uploaded by medical professionals, covering various aspects such as rehabilitation and patient testimonials. However, the overall educational quality was suboptimal, with patient-shared videos lacking in depth and accuracy. Statistical analysis showed no significant differences in content quality across different uploader categories, except for notably lower educational quality in videos shared by patients. Conclusions The findings underscore a significant need for healthcare professionals and academic institutions in Turkey to produce and share high-quality, reliable, and comprehensible videos on ankle fractures. Leveraging YouTube's extensive reach can significantly improve health literacy among the Turkish public, ensuring access to accurate and trustworthy health information.

Virtual Reality and Transcranial Direct Current Stimulation for Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) is a common psychiatric disorder that is particularly difficult to treat in military veterans. Noninvasive brain stimulation has significant potential as a novel treatment to reduce PTSD symptoms. To test whether active transcranial direct current stimulation (tDCS) plus virtual reality (VR) is superior to sham tDCS plus VR for warzone-related PTSD. This double-blind randomized clinical trial was conducted among US military veterans enrolled from April 2018 to May 2023 at a secondary care Department of Veterans Affairs hospital and included 1- and 3-month follow-up visits. Participants included US military veterans with chronic PTSD and warzone-related exposure, recruited via referral and advertisement. Patients in psychiatric treatment had to be on a stable regimen for at least 6 weeks to be eligible for enrollment. Data were analyzed from May to September 2023. Participants were randomly assigned to receive 2-mA anodal tDCS or sham tDCS targeted to the ventromedial prefrontal cortex, during six 25-minute sessions of standardized warzone VR exposure, delivered over 2 to 3 weeks. The co-primary outcomes were self-reported PTSD symptoms, measured via the PTSD checklist for DSM-5 (PCL-5), alongside quality of life. Other outcomes included psychophysiological arousal, clinician-assessed PTSD, depression, and social/occupational function. A total of 54 participants (mean [SD] age, 45.7 [10.5] years; 51 [94%] males) were assessed, including 26 in the active tDCS group and 28 in the sham tDCS group. Participants in the active tDCS group reported a superior reduction in self-reported PTSD symptom severity at 1 month (t = -2.27, P = .02; Cohen d = -0.82). There were no significant differences in quality of life between active and sham tDCS groups. Active tDCS significantly accelerated psychophysiological habituation to VR events between sessions compared with sham tDCS (F5,7689.8 = 4.65; P < .001). Adverse effects were consistent with the known safety profile of the corresponding interventions. These findings suggest that combined tDCS plus VR may be a promising strategy for PTSD reduction and underscore the innovative potential of these combined technologies. ClinicalTrials.gov Identifier: NCT03372460.

The Effect of an Exercise Program on the Quality of Life in Burn Patients

Background: Burn injuries are among the most significant causes of disability and death, having severe economic and social consequences in human societies. Objectives: This study aims to examine the effect of an exercise program on the quality of life of burn patients admitted to the burn department of Ali Ibne Abi Talib Hospital in Zahedan. Methods: In this quasi-experimental study, 30 patients with shoulder joint burns admitted to the burn department of Ali Ibne Abi Talib Hospital in Zahedan in 2021 participated. Patients meeting the inclusion criteria were selected via convenience sampling and then randomly assigned to intervention and control groups using permuted blocks. The intervention consisted of 4 individual training sessions and an exercise program. Patients in the intervention group performed exercises 3 times daily for 12 weeks, while those in the control group received only routine ward care. Data were collected using the Burn Specific Health Scale (BSHS), administered to groups 1- and 3-months post-intervention. Data analysis was conducted using SPSSv.21 software, employing the chi-square test, independent samples t-test, and repeated measures analysis of variance (ANOVA), with a significance level set at P &lt; 0.05. Results: One month post-intervention, the mean quality of life scores were 121.73 ± 7.52 in the intervention group and 122.93 ± 5.72 in the control group. After 3 months, these scores changed to 156.46 ± 9.53 in the intervention group and 122.82 ± 8.09 in the control group, indicating a significant increase in the intervention group (P = 0.001). Repeated measures ANOVA revealed no significant difference in quality of life between the 2 groups 1 month post-intervention (P = 0.37); however, a significant difference was observed at 3 months (P = 0.001). Conclusions: The study's findings suggest that exercise can improve the quality of life in patients with shoulder joint burns. Therefore, incorporating exercise and follow-up programs into the discharge plans of burn patients is recommended.

ChatGPT Generated Training Plans for Runners are not Rated Optimal by Coaching Experts, but Increase in Quality with Additional Input Information.

ChatGPT may be used by runners to generate training plans to enhance performance or health aspects. However, the quality of ChatGPT generated training plans based on different input information is unknown. The objective of the study was to evaluate ChatGPT-generated six-week training plans for runners based on different input information granularity. Three training plans were generated by ChatGPT using different input information granularity. 22 quality criteria for training plans were drawn from the literature and used to evaluate training plans by coaching experts on a 1-5 Likert Scale. A Friedmann test assessed significant differences in quality between training plans. For training plans 1, 2 and 3, a median rating of <3 was given 19, 11, and 1 times, a median rating of 3 was given 3, 5, and 8 times and a median rating of >3 was given 0, 6, 13 times, respectively. Training plan 1 received significantly lower ratings compared to training plan 2 for 3 criteria, and 15 times significantly lower ratings compared to training plan 3 (p < 0.05). Training plan 2 received significantly lower ratings (p < 0.05) compared to plan 3 for 9 criteria. ChatGPT generated plans are ranked sub-optimally by coaching experts, although the quality increases when more input information are provided. An understanding of aspects relevant to programming distance running training is important, and we advise avoiding the use of ChatGPT generated training plans without an expert coach's feedback.

Assessment of Changes in Body Composition After 3 Months of Dulaglutide Treatment.

Changes in body composition accompanied by glucagon-like peptide 1 receptor agonist (GLP-1RA) induced weight loss have drawn much attention. However, fewer studies have reported body composition changes in patients receiving dulaglutide therapy in Chinese population. A total of 70 overweight/obese type 2 diabetes mellitus (T2DM) patients who received dulaglutide therapy were included. Clinical data were collected. Visceral fat area (VFA) and body composition were also measured. Changes in clinical indicators and body composition of patients before and after intervention were also analyzed. Correlation analysis and multiple linear regression model were used to evaluate the association between hemoglobin A1C (HbA1c) and body composition. The results showed that body weight (BW), VFA, body fat (BF), lean body mass (LBM), skeletal muscle mass (SMM) and water content were reduced after 3 months dulaglutide intervention. The lean body mass percentage (LBMP) and skeletal muscle mass percentage (SMMP) significantly increased. Moreover, there was no significant difference in bone mineral quality (BMQ) after the intervention. The multiple linear regression model revealed that the % change in BF was independently associated with % change in HbA1c (β = 0.449, t = 3.148, p=0.002). These results indicate that dulaglutide intervention does not cause muscle and bone mass loss while inducing weight loss, and % change in BF was independently associated with improved glucose control during dulaglutide therapy. This study offers some positive results to support the clinical application of dulaglutide.

Psychological profile of Chinese peritoneal dialysis patients during the Omicron pandemic in 2022

ObjectiveThe aim of this study was to determine the psychological status of peritoneal dialysis (PD) patients who were blocked during the 2022 Omic Pandemic in Shanghai.MethodsThis was an observational and cross-sectional study. We selected 172 PD patients from the peritoneal dialysis center of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, during the quarantine of the Omicron pandemic in Shanghai from April to May 2022. General data and biochemical indices were collected. The Kidney Disease Quality of Life (SF-36) questionnaire was used to evaluate the psychological state of the patients during the quarantine.ResultsAccording to the assessment of the SF-36 scale, the physiological and psychological health status of PD patients was better than that before quarantine (P < 0.05). According to the comparison of biochemical indices, the high-density lipoprotein, total cholesterol and body mass index (BMI) levels were lower in patients after quarantine than before quarantine, while the blood phosphorus, blood calcium and haemoglobin levels were greater after quarantine (P < 0.05). Logistic regression analysis revealed that health changes were positively correlated with age of penetration (years) (OR = 1.031, 95% CI = 1.005–1.058); however, physiological function was negatively correlated with sex (OR = 0.198, 95% CI = 0.044–0.899). Energy was significantly positively correlated with closed-loop time (OR = 1.063, 95% CI = 1.001–1.128) (P < 0.05). There were no significant differences in biochemical indices or quality of life between APD patients and non-APD patients (P > 0.05). According to the results of the abstract independent sample T test, when comparing the various dimensions of the SF-36 scale, for the dimensions of physiological function, pain and energy, the PD patients were better than the HD patients were (P < 0.05). Similarly, for the dimension of physiological function, the HD patients were better than the PD patients were (P < 0.05). During the quarantine period from April to May in Shanghai, the infection rate of PD patients was lower than usual (P < 0.05).ConclusionsDuring the Omicron pandemic in Shanghai in 2022, PD patients exhibited relatively stable psychological and physiological states and a low infection rate. Compared with HD patients, PD patients had better adaptability. Especially in the context of the COVID-19 pandemic, peritoneal dialysis has more advantages.

The efficacy of short acquisition time using 18F-FDG total-body PET/CT for the identification of pediatric epileptic foci

Background18F-FDG positron emission tomography (PET) plays a crucial part in the evaluation for pediatric epileptic patients prior to therapy. Short-term scanning holds significant importance, especially for pediatrics epileptic individuals who exhibited involuntary movements. The aim was to evaluate the effects of short acquisition time on image quality and lesion detectability in pediatric epileptic patients using total-body (TB) PET/CT. A total of 25 pediatric patients who underwent TB PET/CT using uEXPLORER scanner with an 18F-FDG administered dose of 3.7 MBq/kg and an acquisition time of 600 s were retrospectively enrolled. Short acquisition times (60 s, 150 and 300 s) were simulated by truncating PET data in list mode to reduce count density. Subjective image quality was scored on a 5-point scale. Regions of interest analysis of suspected epileptogenic zones (EZs), corresponding locations contralateral to EZs, and healthy cerebellar cortex were used to compare the semi-quantitative uptake indices of short-time images and then were compared with 600 s images. The comparison of EZs detectability based on time-dependent PET images was performed.ResultsOur study demonstrated that a short acquisition time of 150 s is sufficient to maintain subjective image quality and lesion significance. Statistical analysis revealed no significant difference in subjective PET image quality between imaging at 300 s and 150 s (P > 0.05). The overall impression scores of image quality and lesion conspicuity in G60s were both greater than 3 (overall quality, 3.21 ± 0.46; lesion conspicuity, 4.08 ± 0.74). As acquisition time decreased, the changes of SUVmax and SD in the cerebellar cortex gradually increased (P < 0.01). There was no significant difference in asymmetry index (AI) difference between the groups and the AIs of EZs were > 15% in all groups. In 26 EZs of 25 patients, the lesion detection rate was still 100% when the time was reduced to 60 s.ConclusionsThis study proposed that TB PET/CT acquisition time could be reduced to 60 s with acceptable lesion detectability. Furthermore, it was suggested that a 150 s acquisition time would be sufficient to achieve diagnostic performance and image quality for children with epilepsy.

Long-Term Quality of Life after COVID-19 Infection: Cross-Sectional Study of Health Care Workers.

(1) Background: Post-COVID syndrome is defined as symptoms that occur simultaneously with or after a COVID-19 infection, last for 12 weeks, and are not due to another diagnosis. Limited data are available on people's long-term quality of life following a COVID-19 infection. The aim of this cross-sectional study was to investigate the long-term quality of life after COVID-19 among employees of a hospital in Germany and to identify risk factors. (2) Methods: A monocentric, cross-sectional study was conducted using the validated and digitized WHOQOL-BREF questionnaire via Netigate® between 10/2022 and 02/2023. Data on the quality of life and global health status were collected in the following four domains: physical health, mental health, social relationships, and the environment. (3) Results: The response rate was 73.8 % (923/1250). Furthermore, 63.4 % of the hospital staff respondents reported at least one persistent symptom after a COVID-19 infection, leading to significant differences in quality of life. Pre-existing conditions, persistent symptoms, and disabilities after a COVID-19 infection as well as a high BMI, no partnership, and a low educational level were found to significantly contribute to a low long-term quality of life. (4) Conclusions: Obesity, a lack of partnership, and a low level of education were independent risk factors for a lower quality of life post-COVID-19 infection in this cohort of hospital staff. Further multicenter studies are required to validate the incidence and their suitability as independent risk factors for post-COVID syndrome.

Biochemical composition of the beans of local coffee cultivars from southwestern Saudi Arabia

Coffee (Coffea arabica L.) is an economically and culturally important crop for the communities of the southwest mountain regions of Saudi Arabia. The objective of the study was to characterize the biochemical composition of the dry green beans of the coffee cultivars grown there. The analysis of variance revealed significant differences among the 66 accessions studied for all eight biochemical compounds analyzed especially, caffeine, trigonelline and chlorogenic acid. Remarkably, caffeine concentrations varied from 0.75 g 100 g−1 in accession KSA-38–1.51 g 100 g−1 in KSA-47 and trigonelline concentrations varied from 0.81 g 100 g−1 in KSA-69–1.64 g 100 g−1 in KSA-6R. However, 55% and 64% of the accessions had low to moderate caffeine and trigonelline concentrations, respectively. Chlorogenic acid concentration varied from 2.35 g 100 g−1 in KSA-3R to 4.33 g 100 g−1 in KSA-32. Because these compounds are the most important bitterness attributes contributing to coffee quality, significant differences in beverage quality are expected between the accessions. Furthermore, the results of the multivariate analysis indicated the presence of considerable diversity among the 66 accessions. The hierarchical cluster analysis grouped the genotypes into fourteen clusters. The observed divergence suggests that genetic gains for biochemical features are possible. Therefore, we recommend accessions KSA-1, KSA-9R, KSA-10, KSA-29, KSA34, KSA37, KSA-38, KSA-39 and KSA-60 for further evaluation.

A Quality Review of EIA: A Comparative Study of State-Funded and International Aid Agency-funded Development Projects in Sri Lanka

A development project's environmental impact assessment (EIA) is a tool for mitigating the effects on the environment and promoting sustainable development. EIA is an expensive and professionally engaged process that involves the public. Many countries around the world have long-standing laws in place connected to this topic, as well as solid knowledge and experience. One persistent argument against the efficacy of EIA in developing nations is that the procedure and quality differ from country to country. The International Aid Agencies (IAA) have their guidelines for protecting the environment while following local environmental assessment standards for any financing requirements. IAA involvement in the EIA process might significantly affect how well- written EIA reports are. To evaluate the assessment quality, six EIA reports from state-financed development projects (SL-EIAs) and another six development projects EIAs funded by the IAA (IAA-EIAs) in Sri Lanka were randomly chosen. LeeCooley review package (1990) was used to evaluate the Environmental Impact Statements (EIS) of each EIA. In this investigation, it was discovered that IAA-EIAs and SL-EIAs had a significant difference in overall quality. IAA-EIAs show values that range from highly satisfactory to satisfactory and each share 50 percent, whereas SL-EIAs indicate 83 percent satisfactory and 17 percent of borderline quality. In comparison to the SL-EIAs, all four review areas of the IAA-EIAs performed notably well. While the SL-EIA shows good to borderline quality (0.66-0.72), all evaluated IAA-EIA reports reveal highly satisfactory to satisfactory (0.81-0.93) quality. The engagement of IAA in the environmental assessment has a considerable impact to improve assessment quality in comparison to the only domestic assessment. Finding the weak area in the SL-EIA process and adhering to the IAA standards would elevate the standard of the report.&#x0D; Keywords: EIA quality, Review, International Aid Agency, Development projects

The application value of LAVA-flex sequences in enhanced MRI scans of nasopharyngeal carcinoma: comparison with T1WI-IDEAL.

Magnetic resonance imaging (MRI) staging scans are critical for the diagnosis and treatment of patients with nasopharyngeal cancer (NPC). We aimed to evaluate the application value of LAVA-Flex and T1WI-IDEAL sequences in MRI staging scans. Eighty-four newly diagnosed NPC patients underwent both LAVA-Flex and T1WI-IDEAL sequences during MRI examinations. Two radiologists independently scored the acquisitions of image quality, fat suppression quality, artifacts, vascular and nerve display. The obtained scores were compared using the Wilcoxon signed rank test. According to the signal intensity (SI) measurements, the uniformity of fat suppression, contrast between tumor lesions and subcutaneous fat tissue, and signal-to-noise ratio (SNR) were compared by the paired t-test. Compared to the T1WI-IDEAL sequence, LAVA-Flex exhibited fewer artifacts (P<0.05), better visualization of nerves and vessels (P<0.05), and performed superior in the fat contrast ratio of the primary lesion and metastatic lymph nodes (0.80 vs. 0.52, 0.81 vs. 0.56, separately, P<0.001). There was no statistically significant difference in overall image quality, tumor signal-to-noise ratio (SNR), muscle SNR, and the detection rate of lesions between the two sequences (P>0.05). T1WI-IDEAL was superior to LAVA-Flex in the evaluation of fat suppression uniformity (P<0.05). LAVA-Flex sequence provides satisfactory image quality and better visualization of nerves and vessels for NPC with shorter scanning times.

Hyperbaric Oxygen Therapy and Late Local Toxic Effects in Patients With Irradiated Breast Cancer

Hyperbaric oxygen therapy (HBOT) is proposed as treatment for late local toxic effects after breast irradiation. Strong evidence of effectiveness is lacking. To assess effectiveness of HBOT for late local toxic effects in women who received adjuvant radiotherapy for breast cancer. This was a hospital-based, pragmatic, 2-arm, randomized clinical trial nested within the prospective UMBRELLA cohort following the trials within cohorts design in the Netherlands. Participants included 189 women with patient-reported moderate or severe breast, chest wall, and/or shoulder pain in combination with mild, moderate, or severe edema, fibrosis, or movement restriction 12 months or longer after breast irradiation. Data analysis was performed from May to September 2023. Receipt of 30 to 40 HBOT sessions over a period of 6 to 8 consecutive weeks. Breast, chest wall, and/or shoulder pain 6 months postrandomization measured by the European Organization for Research and Treatment of Cancer QLQ-BR23 questionnaire. Secondary end points were patient-reported fibrosis, edema, movement restriction, and overall quality of life. Data were analyzed according to intention-to-treat (ITT) and complier average causal effect (CACE) principles. Between November 2019 and August 2022, 125 women (median [range] age at randomization, 56 [37-85] years) with late local toxic effects were offered to undergo HBOT (intervention arm), and 61 women (median [range] age at randomization, 60 [36-80] years) were randomized to the control arm. Of those offered HBOT, 31 (25%) accepted and completed treatment. The most common reason for not accepting HBOT was high treatment intensity. In ITT, moderate or severe pain at follow-up was reported by 58 of 115 women (50%) in the intervention arm and 32 of 52 women (62%) in the control arm (odds ratio [OR], 0.63; 95% CI, 0.32-1.23; P = .18). In CACE, the proportion of women reporting moderate or severe pain at follow-up was 32% (10 of 31) among those completing HBOT and 75% (9.7 of 12.9) among control participants expected to complete HBOT if offered (adjusted OR, 0.34; 95% CI, 0.15-0.80; P = .01). In ITT, moderate or severe fibrosis was reported by 35 of 107 (33%) in the intervention arm and 25 of 49 (51%) in the control arm (OR, 0.36; 95% CI, 0.15-0.81; P = .02). There were no significant differences in breast edema, movement restriction, and quality of life between groups in ITT and CACE. In this randomized clinical trial, offering HBOT to women with late local toxic effects was not effective for reducing pain, but was effective for reducing fibrosis. In the subgroup of women who completed HBOT, a significant reduction in pain and fibrosis was observed. A smaller than anticipated proportion of women with late local toxic effects was prepared to undergo HBOT. ClinicalTrials.gov Identifier: NCT04193722.

DNA quality and quantity in adipose tissue: a comparison of the effects of bomb explosion

BACKGROUND Adipose tissue is often overlooked in DNA testing due to misconceptions about its DNA content. However, its shock-absorbing qualities may be useful for high-pressure scenarios like bomb blasts. This study aimed to evaluate DNA quality and quantity in adipose tissue affected by blasts compared to that in unaffected tissue.&#x0D; METHODS 10 adipose tissue samples were taken from regions near and far from the blast, representing the blast-exposed and non-blast-exposed groups. The adipose tissue was stored at a low temperature for 5 days, after which an organic extraction method was applied. The purity of the DNA extract was assessed using a NanoDrop spectrophotometer, and its integrity was evaluated using 0.8% concentration gel electrophoresis at 60 V for 90 min. DNA typing was conducted using the GlobalFiler™ kit, and DNA quantity was determined with the Quantifiler™ Trio DNA Quantification kit.&#x0D; RESULTS Of 20 DNA extracts from adipose tissue, all samples demonstrated purity, integrity, and complete typing results. Adequate integrity was found in 90% of samples in both groups. A 50% incidence of allele shifting was observed at the D7S820 locus within the blast-exposed group.&#x0D; CONCLUSIONS DNA from blast-exposed adipose tissue exhibited no significant quality or quantity differences from non-blast-exposed tissue. This suggested adipose tissue’s potential as an alternative DNA source in a bomb explosion.

Comparative evaluation of double- and single-armed two-suture longitudinal intussusception techniques in microsurgical vasoepididymostomy: An updated systematic review and meta-analysis.

This study aimed to compare the outcomes of double-armed two-suture longitudinal intussusception microsurgical vasoepididymostomy (LIVE) and single-armed two-suture LIVE techniques in patients with epididymal obstructive azoospermia (EOA). The main outcomes assessed were patency rates, patency time, semen quality and natural pregnancy rates. Data from patients with EOA who underwent two-suture LIVE were obtained from databases including PubMed, EMBASE, and Web of Science. Weighted data were analyzed using a random-effects model, and weighted mean differences were reported. A total of 1574 patients with EOA from 24 studies were included. The overall patency rate was approximately 68% (95% confidence interval [CI]: 63-72%), with a patency time of approximately 4.63 months (95% CI: 4.15-5.12). The sperm concentration reached 26.90 million/ml and the sperm motility was 23.74%. The natural pregnancy rate was 38% (95% CI: 31-46%). The different definitions of patency do not seem to have any meaningful impact when comparing patency rates. There was no significant difference in patency rates, patency time, semen quality and natural pregnancy rates between the double-armed and single-armed LIVE techniques. The single-armed LIVE is a potential alternative surgical option when high quality double-needle sutures are not easily accessible.

Customised weight-based volume contrast media protocol for multiphase abdominal computed tomography.

Multiphase computed tomography (CT) using fixed volume contrast media may lead to high radiation exposure and toxicity in patients with low body weight. We evaluated a customised weight-based protocol for multiphase CT in terms of radiation exposure, image quality and cost savings. A total of 224 patients were recruited. An optimised CT protocol was applied using 100 kV and 1 mL/kg of contrast media dosing. The image quality and radiation dose exposure of this CT protocol were compared to those of a standard 120 kV, 80 mL fixed volume protocol. The radiation dose information and CT Hounsfield units were recorded. The signal-to-noise ratio, contrast-to-noise ratio (CNR) and figure of merit (FOM) were used as comparison metrics. The images were assessed for contrast opacification and visual quality by two radiologists. The renal function, contrast media volume and cost were also evaluated. The median effective dose was lowered by 16% in the optimised protocol, while the arterial phase images achieved significantly higher CNR and FOM. The radiologists' evaluation showed more than 97% absolute agreement with no significant differences in image quality. No significant differences were found in the pre- and post-CT estimated glomerular filtration rate. However, contrast media usage was significantly reduced by 1,680 mL, with an overall cost savings of USD 421 in the optimised protocol. The optimised weight-based protocol is cost-efficient and lowers radiation dose while maintaining overall contrast enhancement and image quality.

Development and outcomes of surgical and urological kidney transplantation programs in Germany: a total population analysis from 2006 to 2021

PurposeKidney transplantation (KT) is the most frequently performed organ transplantation. In Germany, KT is performed in urology and surgery departments with unknown consequences of this parallel structure. The aim of the study was to compare the development and outcome of KT in urology and surgery departments.MethodsOn an institutional level, we analyzed the annual caseload from 2006 to 2021 with the reimbursement. INFO tool based on hospitals’ quality reports (Reimbursement Institute, Hürth, Germany). For outcome comparison we extracted raw data from the transplantation centers' quality reports (Deutsche Stiftung Organtransplantation, DSO).ResultsA total of 23,599 cases (17,781 deceased donor and 5,818 living donor KTs) were included. The total number of KTs decreased from 1851 in 2006 to 1701 in 2021 (− 8%; p = 0.12). The total number of urological KTs decreased from 592 cases in 2006 to 395 cases in 2021 (− 33.3%; p = 0.01). Further analysis revealed no significant differences between intra- and postoperative complications and graft quality at one year for deceased donor KTs (DDKT) although differences in immediate renal function and graft quality at discharge could be observed. There were no significant differences in immediate renal function and graft quality at discharge for living donor KTs (LDKT) between the specialties.ConclusionKTs performed in urology departments declined between 2006 and 2021. Nevertheless, intra- and postoperative complications as well as long-term function did not differ between surgical and urological KT programs. Hence, an interdisciplinary approach, especially considering the upcoming challenges in KT as, e.g., robot-assisted surgery seems reasonable.

Effects of Land Use Changes on Water Quality and Flooding in Upper Nan River, Thailand

Land use change is a crucial issue when considering global dynamics and their interactions with the hydrologic properties of the soil and water management in catchment areas. Between 2017 to 2018, research was conducted on the effects of land use changes on water quality and flooding in the upper Nan River Basin. In Nan Province, land use is distributed as follows: natural forest protection covers 61.77 percent, agricultural purposes account for 35.23 percent, residential areas constitute 1.95 percent, and water usage represents 0.7 percent. The results indicate that the expansion of urban and agricultural regions has impacted the water quality of the river basin. A significant positive correlation was observed between agricultural land use and total phosphate content, while a strong negative correlation was found between forest land and total phosphate content. Residential occupancy and water quality demonstrated a strong correlation with total coliform contents. There were significant differences in water quality between the wet and dry seasons, particularly temperature, turbidity, total solids, total dissolved solids, and conductivity. Moreover, increases in annual and seasonal stream flow amounts were noted in relation to water levels and residential and construction projects.