Success Failure Research Articles

Long-term clinical and angiographic outcome of T-and protrusion technique with ultrathin strut drug eluting stents.

Data about coronary bifurcations treated with ultrathin strut drug-eluting stents (DES) using T-and-protrusion (TAP) technique is limited. In this study, a total of 84 consecutive patients, who underwent bifurcation percutaneous coronary intervention (PCI) with TAP technique using Orsiro® DES (Biotronik, Berlin, Germany), were included. All pre- and post-procedural data, as well as 1- and 2-year follow-up angiograms, were analyzed. Primary endpoints were procedural success and target lesion failure (TLF); secondary endpoints were all-cause mortality and major adverse cardiac and cerebrovascular events (MACCE) during follow-up. Procedural success was achieved in 100% of cases. TLF rate was higher in patients presented with acute coronary syndrome compared to the ones with chronic coronary syndrome (19% vs. 5% p = 0.09). All-cause mortality was 30% during follow-up, from which 26% was due to non-cardiovascular cause, and the MACCE rate was 46%. Coronary bifurcations treated with ultrathin strut DES showed good short-term results and were associated with acceptable cardiovascular mortality. However, in these long-term patients, the rate of MACCE and non-cardiovascular death were rather high.

Cellular and Humoral Response After Induction of Protection and After Finishing Hymenoptera Venom Immunotherapy

Hymenoptera venom allergy (HVA) is an IgE-mediated hypersensitivity reaction caused by Hymenoptera species stings (honeybee, vespid, or ant). The only effective treatment is Hymenoptera venom immunotherapy (VIT). Our study aimed to evaluate whether humoral and cellular biomarkers measured before, during, and after honeybee VIT are associated with the success of VIT, which was assessed by the response to a sting challenge one year after finishing VIT. In this prospective study, blood biomarkers of 25 patients undergoing honeybee VIT at the referral center in Slovenia were evaluated. A controlled honeybee sting challenge confirmed successful VIT in 20 of 25 (80%) patients. Honeybee venom (HBV) recombinant allergen profiles, evaluated before the treatment, were comparable between responders and non-responders. Longitudinal follow-up, up to 1 year after finishing VIT, showed that the immune responses do not differ significantly between patients with successful VIT and treatment failure. Those responses were characterized by decreased sIgE, tIgE, and BST, whereas sIgG4 levels increased. The basophil sensitivity also significantly decreases after VIT in both groups of patients. The analyzed biomarker which correlated considerably with treatment failure was higher basophil sensitivity to allergen stimulation before VIT. Similarly, systemic adverse events (SAEs) during the build-up phase of VIT correlated with treatment failure. Our study demonstrated similar sensitization profiles, and humoral and basophil immune responses to immunotherapy, in two different well-characterized groups of patients, one with successful VIT and the other with treatment failure. Notably, only high basophil sensitivity measured before VIT and SAEs during VIT were significantly associated with VIT failure, and both have the potential to be predictors of VIT failure.

Perspectives on Recent Developments and Directions in Tissue Engineering and Regenerative Medicine.

This perspective article draws on lessons learned at the 7th TERMIS World Congress held in Seattle, Washington in June 2024. This gathering of prominent researchers and translational scientists in tissue engineering and regenerative medicine (TERM) from around the world provided a forum to consider the impact of tissue engineering and its future directions. New frontiers are considered in the context of global challenges, including clinical translation and recent advances in pediatric tissue engineering, supercritical fluid technology for scaffold fabrication and sterilization, and learning from successful failures in tissue engineering and regenerative medicine. Bench-to-bedside translational strategies, inclusive research strategies, regulatory hurdles, and ethics linked to navigating responsibilities and innovations, are identified as important drivers in the field.

Risk factors and adverse outcomes of initial non-invasive ventilation failure in very low birth weight infants: a multicenter retrospective cohort study

Objective: To investigate the risk factors of initial non-invasive ventilation(NIV) failure and its association with adverse outcomes in very low birth weight infants(VLBWI). Methods: A retrospective cohort study was conducted, collecting clinical data of 2 102 VLBWI who received NIV within 30 minutes after birth, admitted to 18 NICU of Suxinyun Neonatal Perinatal Collaboration Network(SNPN) from January 1st, 2019 to December 31st, 2022. According to the outcome of NIV within the first 72 hours, the study cohort was divided into success group and failure group. Univariate analysis and multivariate Logistic regression analysis were performed to identify risk factors for NIV failure and its association with adverse outcome. Results: A total of 2 102 VLBWI were included, consisting of 1 078 males(51.3%). The gestational age was 29(28, 31) weeks, and the birth weight was 1 250(1 090, 1 380) g. The initial NIV failure rate was 15.3%(321/2 102). Multivariate Logistic regression analysis showed that smaller gestational age(OR=0.67, 95%CI 0.61-0.74, P<0.001), maternal hypertensive disorders during pregnancy(OR=10.31, 95%CI 7.48-14.21, P<0.001), Apgar score at the first ≤7(OR=1.40, 95%CI 1.01-1.93, P=0.042), grade 3-4 respiratory distress syndrome(RDS)(OR=2.85, 95%CI 1.69-4.81, P<0.001), ≥2 times pulmonary surfactant(PS) treatment(OR=3.78, 95%CI 2.09-6.83, P<0.001), fraction of inspired oxygen(FiO2)>0.30(OR=2.21, 95%CI 1.64-2.98, P<0.001) were all independent risk factors for initial NIV failure. The failure group had higher risks of mortality(OR=10.19, 95%CI 6.50-15.97, P<0.001), pneumothorax(OR=4.33, 95%CI 1.59-11.79, P=0.004), neonatal pulmonary hemorrhage(OR=8.48, 95%CI 4.08-17.64, P<0.001), moderate to severe bronchopulmonary dysplasia(BPD)(OR=1.75, 95%CI 1.19-2.56, P=0.004), and intraventricular hemorrhage(IVH)≥grade Ⅲ(OR=2.18, 95%CI 1.27-3.73, P=0.004) compared to the success group. Conclusions: Small gestational age, maternal hyertensive disorders during pregnancy, Apgar score at the first minute ≤7, grade 3-4 RDS, PS treatment ≥2 times and FiO2 >0.30 are risk factors for initial NIV failure in VLBWI. Initial NIV failure is associated with increased risk of mortality, pneumothorax, pulmonary hemorrhage, moderate to severe BPD, and IVH≥grade Ⅲ.

Modeling the successive failure of complex dams systems: A necessity in the light of climatic shifts in extreme storms

This study investigates the effect of extreme storms on the safety of flood protection dams within complex schemes. A modeling methodology is developed using HEC-RAS 2D and presented on an illustrative case, where nine scenarios are simulated. The impact of climatic shifts on extreme storms and dams’ safety is highlighted. The results showed that, despite multi-reservoir systems can be efficient in flood protection against their design storms, they can cause catastrophic damage when subjected to extreme events that have become evident nowadays due to climatic shifts. This is attributed to the successive failure of the water storage structures in a progressive (“domino-like”) manner. The consequences of such breaches can significantly multiply the hazards. These findings can be linked to storm Daniel that occurred at Wadi Derna in Libya and caused two successive dam breaches, leaving a tragedy. The proposed modeling methodology can be useful for designers in evaluating complex scenarios.

A coupled peridynamics–smoothed particle hydrodynamics model for fluid–structure interaction with large deformation

Fluid–structure interaction (FSI) is ubiquitous in various engineering disciplines, and effectively managing FSI often appears to be the key for successful failure analysis and safety-oriented design. Smoothed particle hydrodynamics (SPH) serves as a potent nonlocal meshfree method for fluid dynamics modeling, while peridynamics (PD) demonstrates exceptional capability in addressing structural dynamics involving large deformations and discontinuities. Thus, leveraging their respective strengths in a combined approach holds significant promise for tackling FSI challenges. In this work, we propose a new peridynamics–smoothed particle hydrodynamics (PD-SPH) coupling model for addressing FSI. A stable and efficient coupling algorithm for data transfer between PD and SPH is put forward. In this coupling strategy, a PD particle directly participates in solving the SPH governing equations when it is identified to be within the support domain of an SPH particle. This can be done since the SPH quantities including the density, velocity, and pressure of a PD particle are naturally attainable within the framework of non-ordinary state-based peridynamics theory. Concurrently, in solving PD governing equations, reaction forces from SPH particles act as external forces for PD particles, determined straightforwardly through Newton's third law. As such, the proposed PD-SPH coupling strategy is straightforward to implement and offers high computational efficiency. Validation examples demonstrate that the proposed PD-SPH coupling model is computationally robust and adept at capturing physical phenomena in diverse FSI scenarios involving breaking free surfaces of fluid and large structural deformations of solid. Moreover, the proposed PD-SPH coupling model is flexible introducing no constraint conditions for applications and can accommodate different particle resolutions for PD and SPH domains. These features enable a broad application range of the proposed PD-SPH coupling model including simulations of explosion-induced soil fragmentation, rock fracture, and concrete dam failure, which will be conducted by authors in the near future.

Higher protein intake may benefit in patients with prolonged mechanical ventilation.

Patients with prolonged mechanical ventilation (PMV) is usually associated with muscle wasting and diaphragm weakness, resulting in high medical costs and mortality. Adequate energy and protein intake were beneficial in sarcopenia patients. We aimed to investigate the impact of protein intake in weaning parameters in patients with PMV. We enrolled patients with PMV (mechanical ventilation ≥6 h/day for ≥21 days) from a respiratory care center (RCC) of a tertiary medical center from December 2020 to October 2022, and classified them into weaning success and weaning failure groups. The patients' characteristics, nutrition records, weaning parameters and outcomes were analyzed. A total of 289 patients were included (mean age 73.5 years). Of the 289 patients, 149 were weaned successfully and 140 were not. The average protein intake was higher in the weaning success group than in the weaning failure group (1.22 ± 0.320 versus 0.99 ± 0.332 g/kg/day, p < 0.001). No significant differences were noted in the average calorie intake and whey protein intake between the two groups. RSBI <90 breaths/min/L (OR = 2.38, p = 0.045), serum albumin at 4th week ≥3 g/dL (OR = 2.89, p = 0.027), daily protein intake ≥1.01 g/kg/day (OR = 8.10, p < 0.001), PaO2/FiO2 (PF) ratio ≥ 300 (OR = 2.56, p = 0.027) were independent predictors for weaning from ventilator. Weak positive correlations were found between average protein intake with PF ratio (r = 0.1576, p = 0.0227) and PaO2 (r = 0.13359, p = 0.0497). Daily protein intake had positively correlated with PF ratio and had independently benefit for weaning in patients with PMV.

Unraveling Magnet Structural Defects in Permanent Magnet Synchronous Machines—Harmonic Diagnosis and Performance Signatures

Rare-earth-based permanent magnets (PMs) have a vital role in numerous sustainable energy systems, such as electrical machines (EMs). However, their production can greatly harm the environment and their supply chain monopoly presents economic threats. Alternative materials are emerging, but the use of rare-earth PMs remains dominant due to their exceptional performance. Damage to magnet structure can cause loss of performance and efficiency, and propagation of cracks in PMs can result in breaking. In this context, prolonging the service life of PMs and ensuring that they remain damage-free and suitable for re-use is important both for sustainability reasons and cost management. This paper presents a new harmonic content diagnosis and motor performance analysis caused by various magnet structure defects or faults, such as cracked or broken magnets. The proposed method is used for modeling the successive physical failure of the magnet structure in the form of crack formation, crack growth, and magnet breakage. A surface-mounted permanent magnet synchronous motor (PMSM) is studied using simulation in Ansys Maxwell software (Version 2023), and different cracks and PM faults are modeled using the two-dimensional finite element method (FEM). The frequency domain simulation results demonstrate the influence of magnet cracks and their propagation on EM performance measures, such as stator current, distribution of magnetic flux density, back EMF, flux linkage, losses, and efficiency. The results show strong potential for application in health monitoring systems, which could be used to reduce the occurrence of in-service failures, thus reducing the usage of rare-earth magnet materials as well as cost.

Litigation claims in Urology in the UK National Health Service: an analysis of the trends, costs and causes over a 16-year period.

To analyse the litigation trends and the reasons for claims within the specialty of Urology, within the UK National Health Service (NHS), over a 16-year period. Data were requested from NHS Resolution under the Freedom of Information Act 2000. This included the total number of claims in Urology, the number of these that were successful (settled or closed), and the costs in damages paid out per financial year between 2006 and 2022. A breakdown of the successful claims by their primary cause was also collected. These were coded into the categories: 'non-operative', 'intraoperative', 'postoperative', and 'other'. A total of 4124 litigation claims were made between 2006 and 2022 and 60.9% (2511/4124) of these claims were successful. In all, £145 million (British pounds) was paid out in damages. The number of successful claims increased 2.9-fold from the start to end of this 16-year period, and the costs in damages paid out increased 10-fold. Regarding primary causes for the successful claims, failure or delay in treatment (20.9%, 525/2511), failure or delay in diagnosis (14.5%, 364/2511), and intraoperative problems (9.1%, 229/2511) accounted for the highest proportion. Overall, non-operative causes for successful claims accounted for 73.3% (1840/2511), intraoperative for 20.1% (504/2511), and postoperative for 3.9% (98/2511). The number of successful urological litigation claims, and their associated costs is rising. The majority are due to non-operative causes, which may be partially explained by NHS waiting lists alongside the effects of the coronavirus disease 2019 (COVID-19) pandemic.

Towards the Automation of Non-destructive Fault Recognition: Enhancement of Robustness and Accuracy Through AI Powered Acoustic and Thermal Signal Analysis in Time, Frequency- and Time-Frequency Domains

Non-destructive inspection and analysis techniques are crucial for quality assessment and defect analysis in various industries. They enable for screening and monitoring of parts and products without alteration or impact, facilitating the exploration of material interactions and defect formation. With increasing complexity in microelectronic technologies, high reliability, robustness and thus, successful failure analysis is essential. Machine learning (ML) approaches have been developed and evaluated for the analysis of acoustic echo signals and time-resolved thermal responses for assessing their ability for defect detection. In the present paper different ML architectures were evaluated, including 1D and 2D convolutional neural networks (CNNs) after transforming time domain data into the spectral- and wavelet domains. Results showed that 2D CNNs processing data in wavelet domain representation performed best, however at the expense of additional computational effort. Furthermore, ML-based analysis was explored for lock-in thermography to detect and locate defects in the axial dimension based on thermal emissions. While promising, further research is needed to fully realize its potential.

Initial Outcomes following Fresh Meniscus Allograft Transplantation in the Knee.

Based on recent evidence-based advances in meniscus allograft transplantation (MAT), fresh (viable) meniscus allografts have a potential for mitigating key risk factors associated with MAT failure, and preclinical and clinical data have verified the safety of fresh meniscus allografts as well as possible efficacy advantages compared to fresh-frozen meniscus allografts. The objective of this study was to prospectively assess clinical outcomes for the initial cohort of patients undergoing MAT using fresh meniscus allografts at our center. Patients who were prospectively enrolled in a dedicated registry were included for analyses when they had undergone primary MAT using a fresh meniscus allograft for treatment of medial and/or lateral meniscus deficiency with at least 1-year follow-up data recorded. Forty-five patients with a mean final follow-up of 47.8 months (range = 12-90) were analyzed. Mean patient age was 30.7 years (range = 15-60), mean BMI was 29.7 kg/m2 (range = 19-48), and 14 patients (31%) were female. In total, 28 medial, 13 lateral, and 4 combined medial and lateral MATs with 23 concurrent ligament reconstructions and 2 concurrent osteotomies were included. No local or systemic adverse events or complications related to MAT were reported for any patient in the study. Treatment success rate for all patients combined was 91.1% with 3 patients requiring MAT revision and 1 patient requiring arthroplasty. Treatment failures occurred 8 to 34 months after MAT and all involved the medial meniscus. None of the variables assessed were significantly different between treatment success versus treatment failure cohorts. Taken together, the data suggest that the use of fresh (viable) meniscus allografts can be considered a safe and effective option for medial and lateral meniscus allograft transplantation. When transplanted using double bone plug suspensory fixation with meniscotibial ligament reconstruction, fresh MATs were associated with a 91% success rate, absence of local or systemic adverse events or complications, and statistically significant and clinically meaningful improvements in patient-reported measures of pain and function at a mean of 4 years postoperatively.

Prevalence of middle mesial canal in mandibular molars: A cross-sectional cone-beam computed tomography study.

The first tooth to erupt is the first mandibular molar, which is the tooth with the highest number of retreatments. Several factors are responsible for the failure of the endodontic success and one of the most important being the particular pulp anatomy of each tooth. To aim was determine the prevalence of the middle mesial (MM) canal in first mandibular molars and to study if there are predisposing factors to the presence of this canal by retrospectively analyzing cone-beam computed tomography (CBCT) images in vivo. CBCT images of 100 patients were selected. A total of 206 first mandibular molars were examined. The CBCTs were analysed using Careastream CS 3D imaging software. Findings of MM canals were recorded along the variables sex and left/right side. Prevalence was compared using the Chi-square test (P< 0.05) and Cramer's V was used to indicate the effect size between the variables. Of the 206 teeth analysed, the prevalence of MM canals was 33.11% (49 teeth). There was no statistically significant difference between sex and prevalence of the MM canal. There was a significant difference between sex and the distance between the mesial canals was found, being the most common range in women was 1-2 mm (35.8%) and 2-3 mm (51%) in men. The most common range of distance between the mesial canals where the MM canal was localized was 3-4 mm (50%), being statistically significant (p<0,05). This cross-sectional study showed a high prevalence of MM canals (33.11%) in first mandibular molars. The prevalence of the MM canal was significantly higher when the distance between mesiobucal and mesiolingual canals was 3-4mm. This knowledge let direct the clinicians in locating MM canal for improving endodontic prognosis. Key words:Cone-beam computed tomography, middle mesial canal, prevalence.

484. DELTA-IRP AS A NEW HIGH-RESOLUTION MANOMETRY METRIC TO PREDICT THE POSITIVE OUTCOME OF LAPAROSCOPIC HELLER-DOR IN PATIENTS WITH ACHALASIA

Abstract Background There is no consensus on the definition of failure after treatment in patients with esophageal achalasia. The Eckardt score (ES) is commonly used to define clinical outcome, but objective metrics based on high-resolution manometry (HRM) or other tools are lacking. Aim of this study was to identify any HRM objective parameters useful to predict a positive outcome after surgical treatment with laparoscopic Heller-Dor (LHD). Methods Patients who had undergone LHD between 2012 and 2022, with pre- and postoperative HRM at our Center, were enrolled. Patients were divided according to the outcome of treatment between success group (SG, symptom relief or resolution) and failure group (FG, ES&amp;gt;3 or the need for additional treatment). Further to the traditional HRM metrics commonly evaluated, we also measured the difference between median values of pre- and postoperative Integrated Relaxation Pressure (∆-IRP). A ROC curve analysis was applied to assess the accuracy of each HRM parameter identified. Data are reported in Table 1. Results We enrolled 358 patients (F:M=177:187): 331 in the SG and 27 in the FG. The ∆-IRP was higher in SG [22mmHg (IQR:15-31)] than in FG [14.3mmHg (IQR:9.9-18.3), p=0.04]. The univariate analysis is showed in Table 1. At multivariate analysis, the ∆-IRP was the only parameter independently related to clinical success (p&amp;lt;0.01). The ROC curve for the ∆-IRP showed an area under the curve of 0.71, with a threshold value set at 16.55 mmHg (sensibility 71%, specificity 70%). Conclusions Our data showed that the ∆-IRP with a threshold of 16.5 mmHg could represent a new objective tool to predict the positive outcome of LHD in patients with esophageal achalasia.

Family Business and Its Problems; A Failure of Entrepreneurial Succession in Nigeria

Family Business and Its Problems; A Failure of Entrepreneurial Succession in Nigeria

Fueling Alzheimer's Disease: Where Does Immunometabolism Stand?

More than a century after the first description of Alzheimer's disease (AD), the road to a cure for this complex and heterogeneous neurodegenerative disorder has been paved by countless descriptive hypotheses and successive clinical trial failures. Auspiciously, the era of genome-wide association studies revolutionized the classical "neurocentric" view of AD by providing clues that brain-resident immune cells (i.e., microglia and astrocytes) are also key players in the pathological and clinical trajectory of this neurodegenerative disorder. Considering that the intercommunication among neurons, astrocytes, and microglia is fundamental for the functional organization of the brain, it is evident that the disruption of the proper functioning of this "triad" could contribute to the neuroinflammatory and neurodegenerative events that occur in the AD brain. Importantly, recent scientific progress in the burgeoning field of immunometabolism, a crossroad between metabolism and immune response, shed light on the importance of metabolic reprogramming of brain-resident immune cells in AD pathology. In this sense, the present review is aimed to summarize and discuss the current knowledge on the metabolic patterns of brain-resident immune cells during the AD continuum, putting a special focus on glucose, amino acids, and lipid metabolism. Changing the "old" picture of AD pathological basis by integrating the role of brain-resident immune cells it is imperative to establish new and feasible therapeutic interventions able to curb neuroinflammatory and neurodegenerative processes, and consequently cognitive deterioration.

Lessons from history for successful disinflation

Why are some attempts at disinflation successful and others failures? We investigate this question in the context of the Federal Reserve's attempts at disinflation since World War II. Our central finding is that a fundamental determinant of success was the strength of the Federal Reserve's commitment to disinflation at the start of its attempts. In episodes where its commitment was high, there were significant declines in inflation that were often long-lasting, while in ones where its commitment was low, falls in inflation were small and short-lived. We find that although the extent of the Federal Reserve's commitment was often clear to the public, there is no evidence that stronger commitment to disinflation directly affected expected inflation. Rather, the main channel through which weak commitment led to unsuccessful disinflation was premature abandonment of the disinflationary policy. We conclude by discussing the implications for the Federal Reserve's current effort at disinflation.

Evaluation of the Results of Intracytoplasmic Sperm Injection and Microdissection Testicular Sperm Extraction Treatments in Patients with Nonobstructive Azoospermia According to Etiological Factors: A Retrospective Analysis

Objective: This study aimed to retrospectively compare the results of microdissection testicular sperm extraction (microTESE) and Intracytoplasmic sperm injection (ICSI) treatments in nonobstructive azoospermia (NOA) patients with different aetiologies. Determinants (clinical characteristics) for microTESE outcomes were compared between patients with successful sperm retrieval (SSR) and sperm retrieval failure (SRF). Methods: A total of 510 NOA patients who underwent microTESE between January 2015 and January 2024 were included in this study. Patients were classified according to the cause of NOA and SSR, fertilisation rate, clinical pregnancy, and overall live birth rate were evaluated. Results: The SSR rate was 44.1% in the whole population. The idiopathic patient group had the lowest SSR rate (X2: 34.81; p&lt;0.01). There was no difference between the groups in terms of fertilisation rate, clinical pregnancy and overall live birth rate. There was a negative correlation between age and SSR rates in patients with idiopathic NOA (t:-0.27; p&lt;0.01). SSR rates were higher in patients with cryptorchidism (right: t:0.8; P:0.003; left: t:0.72; p:0.002) and mumps orchitis (right: t:0.76; P&lt;0.01; left: t:0.76; p=0.003). Conclusion: Etiology has a significant role in terms of SSR in patients with NOA. SSR was found to be significantly less in patients with idiopathic NOA compared to other causes. In addition, age and testicular volume were significant predictive factors for SSR in patients with idiopathic and acquired NOA.

Distal versus traditional radial access in patients undergoing emergency coronary angiography or percutaneous coronary intervention: a systematic review and meta-analysis.

Distal radial access (DRA) is a well-tolerated and effective alternative to traditional radial access (TRA) for coronary procedures. However, the comparative value of these modalities remains unknown in the emergency setting, particularly in patients with ST-elevation myocardial infarction (STEMI). To compare DRA versus TRA for emergency coronary procedures through a meta-analysis. We systematically searched PubMed, Embase, and Cochrane databases to identify studies comparing DRA versus TRA in patients undergoing emergency coronary angiography (CAG) or percutaneous coronary intervention (PCI). All statistical analyses were performed using R software version 4.3.1 with a random-effects model. We included four studies comprising 543 patients undergoing emergency CAG or PCI, of whom 447 (82.3%) had STEMI. As compared with TRA, DRA was associated with lower radial artery occlusion rates (RR, 0.21; 95% CI, 0.06-0.72) and shorter hemostasis time (MD, -4.23 h; 95% CI, -6.23 to 2.13). There was no significant difference between modalities in terms of puncture failure (RR, 1.38; 95% CI, 0.31-6.19), crossover access (RR, 1.37; 95% CI, 0.42-4.44), puncture time (SMD, 0.33; 95% CI, -0.16 to 0.81), procedure time (MD, 0.97 min; 95% CI, -5.19 to 7.13), or rates of cannulation success (RR, 0.94; 95% CI, 0.83-1.06). In terms of other periprocedural complications, there were no differences between both groups. These findings remained consistent in a subgroup analysis of patients with STEMI. In this meta-analysis, DRA was superior to TRA in terms of radial artery occlusion and hemostasis time, with similar rates of periprocedural complications.

Influence of Comprehensive Nursing Care on Heart Failure Patient Management: A Systematic Review and Meta-Analysis.

Heart failure is a common chronic illness associated with high readmission rates and death. Comprehensive nursing care, management of symptoms, and psychological support are increasingly seen as critical components of successful heart failure therapy. This systematic review and meta-analysis aimed to determine the effect of comprehensive nursing care on clinical outcomes and quality of life in heart failure patients. We searched electronic databases (PubMed, PROSPERO, and Web of Science) for randomised controlled trials and observational studies on comprehensive nursing care treatments for heart failure patients. Data on readmission rates, mortality rates, and quality of life were obtained and examined. A total of 693 studies satisfied the inclusion criteria. A meta-analysis found that comprehensive nursing care reduced heart failure-related readmissions considerably when compared to conventional therapy (odds ratio [OR]: 0.77; 95% CI: 0.66-0.88, p = 0.0002). There was a significant difference in all-cause mortality (OR: 0.76; 95% CI: 0.60-0.97, p = 0.03), but comprehensive treatment enhanced quality of life and functional status (standardised mean difference -0.05, 95% CI: -0.21 to 0.10, p = 0.49). Comprehensive nursing care improves clinical outcomes and quality of life for heart failure patients. This study stresses the need to add comprehensive nurse interventions in normal heart failure treatment programmes.

Investigation of the Relationship between Family Business Success and Marital Failure in Tanzania.

Investigation of the Relationship between Family Business Success and Marital Failure in Tanzania.