Time Index Research Articles

Diagnostic value of low dose dobutamine stress echocardiography in paradoxical low flow low gradient aortic stenosis

Abstract Background In aortic stenosis with low-gradient scenarios distinguishing between fixed and pseudo-severe stenosis becomes challenging. Low-dose dobutamine stress echocardiography (DSE) is recommended for classical low-flow low- gradient stenosis with reduced ejection fraction. Doubts of DSE's utility in paradoxical low-flow low-gradient (PLFLG) stenosis when ejection fraction is preserved are partially reasoned by proposed inefficiency in generating a contractile reserve 1. Guidelines advocate an integrated approach, combining various clinical and imaging aspects 2. Purpose This study aimed to investigate usefulness of DSE in PLFLG stenosis, identifying specific features to predict the possibility of generating significant stroke volume augmentation and distinguishing fixed aortic stenosis. Methods We identified patients with aortic stenosis who underwent DSE and multi-modality imaging at our centre between 2020 and 2023. Among them, those with PLFLG situations were used for detailed analysis. Multiple linear regression analysis was performed to identify parameters predictive of significant contractile reserve, defined as 20% stroke volume increase from baseline. For patients demonstrating contractile reserve we assessed predefined parameters by receiver operating characteristics (ROC) analysis to predict fixed stenosis defined as final aortic valve area < 1cm² and valve area change <0.2cm² or final mean pressure gradient >40mmHg. For predictive value of Agatston score we conducted post-hoc analysis. Results Among 256 DSE cases, 67 were conducted for PLFLG stenosis. Patients were 82 years of median age and mostly female (63%). Symptoms included dyspnea in 90% and angina in 40% of cases. Baseline echo showed median aortic valve area (indexed to body surface area) of 0.8cm² (0.44cm²/m²) with mean pressure gradient of 20mmHg. Contractile reserve was inducible in 70% of patients, of which 74% showed criteria of fixed stenosis. Higher left ventricular end-diastolic diameter (LVESD) and lower baseline systolic flow-rate were predictive for contractile reserve (p<0.05). Among patients with contractile reserve ROC for baseline mean pressure gradient, acceleration time (median 0.08s; range 0.04-0.11s) and acceleration time to ejection time index (0.28; range: 0.148-0.458) revealed good prediction of fixed stenosis in DSE meanwhile Agatston calcium score (median 1076; range: 301-8821) did not (figure 1). No correlation was found between Agatston score probability of severe stenosis and aortic valve pressure gradient behavior with increased stroke volume (figure 2). Conclusion DSE proves to be a useful a method in the differentiation between fixed and pseudo-severe stenosis in PLFLG situation. Our findings question the predictive value of Agatston score for aortic valve behavior with increase of stroke volume and warrant further investigations regarding value of acceleration time and acceleration time to ejection time index in those patients.Receiver operating characteristicsPost-hoc analysis of Agatston score

Stress-induced arterial hypertension: search for predictors

Background. Despite the existence of a clear cause-and-effect relationship between job strain and hypertension, there are still no clear criteria for defining stress-induced arterial hypertension (SIAH). Objective. Search for SIAH criteria, in particular predictors of hypertension in the workplace. Materials and methods. The study included volunteers experiencing stress in the workplace and not having hypertension. Before the start of the working day and at the end of the working day, the subject was surveyed, given questionnaires (Ch. D. Spielberg scale, Montgomery-Asberg MADRS scale, A. M. Vein scale, hospital anxiety and depression scale HADS), blood pressure and resting heart rate were measured, fasting blood was taken to determine the values of ACTH, TSH, T4, insulin, cortisol. All patients underwent ABPM on a working day and a day off. Results. According to ABPM (n=52), no signs of masked hypertension were detected, however, significant differences between workdays and weekends in the levels of maximum SBP and DBP during the daytime were noteworthy. In the group with maximum SBP>140 mm Hg during the daytime (SIAH, n = 34), on a workday there was an increase in the time index for SBP>30% (24 hours and day), characteristic of hypertension, and for DBP (24 hours and day), characteristic of borderline (possible) hypertension, the average DBP values during the day and at night were at the upper limit of the norm, which was significantly different from the Normotonic group (n = 19). On a weekday, the SIAH group also had significantly increased SBP (24 hours, day) and DBP (24 hours, day and night) indexes versus Normotonic. For all other indicators except ABPM, the groups were comparable. Conclusions. Taking into account the increase in the time index for SBP and DBP, it can be assumed that, against the background of stressful situations at the workplace, the subjects had short frequent increases in blood pressure, which have not yet led to a significant violation of self-regulation of blood pressure and the development of hypertension. An increase in the maximum values of systolic and/or diastolic blood pressure against the background of an increased time index on a working day are possible predictors of SIAH, in particular hypertension at the workplace.

Relationships between capnogram parameters by mainstream and sidestream techniques at different breathing frequencies

Capnography, routinely used in operating rooms and intensive care units, reveals essential information on lung ventilation and ventilation–perfusion matching. Mainstream capnography directly measures CO2 in the breathing circuit for accurate analysis and is considered a reference technique. Sidestream capnography, however, analyzes gas away from the patient leading to potentially less accurate measures. While these methodological differences impact the capnogram indices in mechanically ventilated patients, such assessments during spontaneous breathing are essentially lacking. Accordingly, we aimed to compare mainstream and sidestream capnography in spontaneously breathing subjects, focusing on differences in capnogram shape and dead space indices at various respiratory rates. Simultaneous mainstream and sidestream time and volumetric capnography were performed on spontaneously breathing adults (n = 35). Measurements were performed during controlled low (10/min), medium (12/min), and high (20/min) breathing rates as a challenge. Correlation and Bland–Altman analyses were used to assess trends and agreements between time and volumetric capnography indices obtained by the mainstream and sidestream techniques, including end-tidal CO2 (ETCO2), shape factors reflecting the slopes of phases 2 and 3, and anatomical and physiological dead space fractions. ETCO2 and physiological dead space measured by mainstream and sidestream techniques showed excellent correlations (r > 0.90, p < 0.001 for all breathing rates) and agreements. While strong correlations and moderate agreements were evidenced in the parameters reflecting the late phase of expiration (phase 3 slope and exhaled CO2 volume), these relationships were weaker for indices related to the early phase of expiration (phase 2 slope, anatomical dead space). Changing breathing frequency caused significant alterations in all capnography parameters, which were detectable by both mainstream and sidestream techniques. Sidestream capnography cannot substitute the more accurate mainstream technique for measuring the absolute values of shape factors and ventilation dead space fractions. However, sidestream capnography is also able to detect and track changes in uneven alveolar emptying, ventilation–perfusion matching and ventilation dead space fraction in spontaneously breathing subjects.

Impact of Ferulated Arabinoxylans from Maize Bran on Farinograph and Pasting Properties of Wheat Flour Blends

This research explores the extraction of ferulated arabinoxylans (FAXs) from maize bran and their incorporation into wheat flour to assess their impact on rheological and pasting properties. Flour blends were prepared with FAX concentrations of 0%, 2%, 4%, 6%, 8%, and 10%, and these blends were then evaluated using farinograph, mixograph, micro-extensibility, and viscosity analyses. The results indicated that farinograph water absorption increased significantly (p ≤ 0.05), ranging from 54.9% to 60.5%, as the FAX content rose, correlating with higher gel-forming potential. Notably, the 2% FAX treatment (FAX2) exhibited the longest dough development time at 24.7 min. Stability and mixing time index (MTI) values also varied significantly (p ≤ 0.05) among treatments, with FAX2 displaying a longer mixing time of 14.4 ± 3.3 min. A pasting analysis revealed a significant decrease in peak and hot paste viscosity (p &lt; 0.05) with increasing FAX concentrations, suggesting an association between lower hot paste viscosity and reduced breakdown. Micro-extensibility measures further indicated that blends with 0% and 2% FAX had greater extensibility, while the 4% FAX blend showed higher resistance. Overall, this research aims to advance the understanding of how these components can enhance flour functionality and contribute to the development of healthier, higher-quality baked products.

The 36-Item Yoni Task: Normative Data for the Clinical Assessment of Theory of Mind

Background: The evaluation of Theory of Mind (ToM) in the clinical setting remains limited due to the lack of valid instruments for a quick and reliable assessment. In this study, the psychometric properties of the Yoni-36 task were tested, and correction grids, equivalence scores, and normative data were computed. Methods: In total, 318 healthy subjects (169 females; mean age = 42.22 ± 18.11 years; mean education = 15.01 ± 3.43 years) were enrolled and administered the Yoni-36 task. Results: Statistical analysis showed good-to-high internal consistency, split-half reliability, and discrimination ability (especially for the second-order items) of the Yoni-36 task. Regression models highlighted the predictive role of age and education on second-order, affective, cognitive accuracy, and response time scores. Education influenced the first-order ToM response time score as well. Based on β values of the regressions, raw scores of the Yoni task were adjusted for sex, age, and education, and correction grids were computed. The equivalent scores indicated an accuracy index score &lt; 0.69 and a response time index score &lt; 0.83 as cut-off points for ToM competence. Normative data reported a mean accuracy and response time index score of 0.90 ± 0.11 and 0.91 ± 0.05 in the Italian population, respectively. Conclusions: The Yoni-36 proved to be a valid instrument for a quick and reliable ToM assessment, suitable to be included in neuropsychological batteries and to be used in routine clinical practice.

Smart Grid Forecasting with MIMO Models: A Comparative Study of Machine Learning Techniques for Day-Ahead Residual Load Prediction

With the fast expansion of intermittent renewable energy sources in the upcoming smart grids, simple and accurate day-ahead systems for residual load forecasts are urgently needed. Machine learning strategies can facilitate towards drastic cost minimizations in terms of operating-reserves avoidance to compensate the mismatches between the actual and forecasted values. In this study, a multi-input/multi-output model is developed based on artificial neural networks to map the relationship between different predictor inputs, including time indices, weather variables, human activity parameters, and energy price indicators, and target outputs such as wind and photovoltaic generation. While the information flows in only one direction (from the predictor nodes through the hidden layers to the target node), benchmark training algorithms are employed and assessed under different case studies. The model is evaluated under both parametric and non-parametric formulations, namely neural networks and Gaussian process regression. Essential improvements are achieved by enhancing the number of embedded predictors, while superior performance is observed by using Bayesian regularization mechanisms. In terms of mean-error indices and determination coefficient, this opens the pathway towards minimization via Bayesian inference-based approaches in the presence of increased and highly stochastic renewable inputs.

Sequential Task Allocation of More Scalable Artificial Dragonfly Swarms Considering Dubins Trajectory

With the rapid advancement of UAV technology and the increasing complexity of tasks, multi-UAV systems face growing challenges in task execution. Traditional task allocation algorithms often perform poorly when dealing with issues such as local optima, slow convergence speed, and low convergence accuracy, making it difficult to meet the demands for efficiency and practicality in real-world applications. To address these problems, this paper focuses on collaborative task allocation technology for multi-UAV. It proposes a collaborative task allocation strategy for multi-UAV in a multi-target environment, which comprehensively considers various complex constraints in practical application scenarios. The strategy utilizes Dubins curves for trajectory planning and constructs a multi-UAV collaborative task allocation model, with targets including the shortest total distance index, the minimum time index, and the trajectory coordination index. Each UAV is set as an artificial dragonfly by modifying the traditional dragonfly algorithm, incorporating differential evolution algorithms and their crossover, mutation, and selection operations to bring UAV swarms closer to the characteristics of biological dragonflies. The modifications can enhance the global scalability of artificial dragonfly swarms (ADSs), including wider search capacity, wider speed range, and more diverse search accuracy. Meanwhile, potential solutions with global convergence properties are stored to better support real-time adjustments to task allocation. The simulation results show that the proposed strategy can generate a conflict-free task execution scheme and plan the trajectory, which has advantages in changing the data scale of the UAV and the target and improves the reliability of the system to a certain extent.

The Relationship Between Physical Activity Environment, Mental Wellbeing, Flourishing and Thriving: A Mixed Method Study.

Research shows that mental wellbeing contributes to a greater quality of life and longevity, superior overall health, life success, and fulfillment. High mental wellbeing, such as flourishing and thriving, is associated with a sense of meaning and purpose, mastery and accomplishment, social connectedness, optimism, and contribution to society. Nature-based physical activity participation has been linked with mental wellbeing enhancement over and above the impact of physical activity alone. The present study sought to address a gap in the research by exploring whether the environment in which physical activity takes place and one's gender moderate the relationship between activity time and various indices of mental wellbeing. Using a mixed methods design, participants (N = 235) aged 18 to 76 (M = 33.41, SD = 13.41) completed an online survey. We divided participants into three groups based on their preferred type of physical activity: indoor, outdoor non-nature-based, and outdoor nature-based physical activity. The moderation analyses highlight the importance of the environment in physical activity, with outdoor nature-based settings consistently showing positive associations with flourishing and thriving. These findings suggest that engaging in physical activities in natural environments can significantly predict an individual's mental wellbeing, for both males and females. Qualitative data supported the findings and also revealed that nature-based physical activity achieves these benefits through developing positive affect, social closeness and engagement, purpose, enhanced experiences, and interests beyond oneself. Findings from this study demonstrate the importance of nature-based physical activity for mental wellbeing promotion and protection, indicating that opportunities for nature-based physical activity should be more effectively provided, perhaps across multiple domains of life such as education, sport, public health, and urban planning.

GC–MS-based metabolite fingerprinting reveals the presence of novel anticancer compounds in the microcolonial fungus Aureobasidium sp. TD-062 from the under-explored Thar Desert

Aureobasidium sp., strain TD-062, a micro colonial black yeast, was obtained as part of a screening program from the Thar Desert of India, which has been inadequately explored for novel microorganisms/bioactive metabolites. The anticancer activity of aqueous and organic solvent extracts of culture supernatant of TD-062 was investigated against A-375 myeloma and MCF-7 breast cancer cell lines. Following column chromatography, bioactive fractions were subjected to GC–MS analysis in two cycles. The GC–MS metabolite fingerprinting revealed 20 compounds belonging to various chemical groups. Further, based on observed and calculated mass ion spectra, retention time, and retention indices, many compounds could be considered novel. The second purification cycle resulted in three compounds- ATD-1, ATD-2 and ATD-3 with different calculated retention indices from that of the nearest matching compounds, squalene and tocopherol. In silico prediction study of their ADMET profiles, suggests that these new compounds have a suitable contour for use as safe anticancer drugs, without the toxicity normally associated with anticancer compounds.

A Multiple Mediator Model of Depression, Dysfunctional Beliefs about Sleep, and Sleep Effort in the Relationship between Psychological Inflexibility and Insomnia in Shift Working Nurses.

The aims of this study were to explore the influence of shift working nursing professionals' psychological inflexibility on their level of insomnia. Additionally, we investigated the mediation effect of depression and sleep-related cognitions on this association. An online survey was conducted among 202 nursing professionals at Asan Medical Center from July to August, 2023. Participants responded to questionnaires including the Insomnia Severity Index (ISI), Acceptance and Action Questionnaire-II (AAQ-II), Dysfunctional Beliefs and Attitudes about Sleep - 16 (DBAS-16), Glasgow Sleep Effort Scale (GSES), Patient Health Questionnaire-9 items (PHQ-9), and the Discrepancy between desired time in bed and desired total sleep time index (DBST index). Pearson's correlation and linear regression were performed to explore the factors predicting ISI scores. Mediation analysis was implemented. Linear regression revealed that insomnia severity was predicted by DBAS-16 (β = 0.15, p = 0.008), GSES (β = 0.48, p < 0.001), and PHQ-9 (β = 0.26, p < 0.001). Mediation analysis showed that the relationship between the psychological inflexibility of shift-working nursing professionals' and insomnia severity was fully mediated by depression, dysfunctional beliefs about sleep, and sleep effort. Psychological inflexibility does not directly influence insomnia severity, but depression, dysfunctional beliefs about sleep, and sleep effort fully mediate the relationship.

Tracking the Role of Faults on Mudstone Caprock Seals: A Case Study from Beier Depression, Hailar Basin, NE China

To study the oil and gas enrichment characteristics of the reservoir rocks in the second Member of the Nantun Formation (N2) of the F1 fault in the Beier Depression, this research focuses on the mechanism of shortening the sealing time of the regional mudstone cap due to faults and the factors influencing the sealing duration. The period during which the regional mudstone cap seal began is determined by analyzing the relationship between the diagenetic index of the regional mudstone cap and its underlying reservoir rocks and time. This relationship between the rock-formation index and time helps establish the onset of regional mudstone cap seal, and from this, the index of shortening time due to faults is derived. A research framework to study the sealing time shortening of regional mudstone cap seal caused by a fault was developed, which was further applied to analyze the relationship between the fault-induced shortening time of the seal in the lower of the first Member of the Damoguaihe Formation section (D1x) of the Beier Depression and hydrocarbon concentrations in the N2 Formation. The results show that the F1 fault at measurement points 1–4, 6, and 9–11 reduced the blocking time of the regional mudstone cap in D1x to 100%, hindering hydrocarbon accumulation and preservation in the N2. Conversely, the F1 fault at measurement points 5, 7, 8, and 12–15 reduces the blocking time of the regional mudstone cap in the D1x by 37–99%, which is more conducive to hydrocarbon accumulation and preservation in N2, resulting in positive oil and gas shows. Based on the test results, a discussion on the feasibility, applicability, and limitations of the new method is conducted, yielding the following conclusions: (1) The relationship between oil and gas indications in the reservoir rocks of the Nan’er Member confirms the feasibility of the new method. The research findings of the new method on the F1 fault align with current oil and gas exploration realities, indicating its potential use in studying the degree to which faults shorten the sealing time of regional mudstone caprocks. (2) The new method is primarily applicable to the study of the modification effects of tensile normal faults on regional mudstone caprocks and their impact on oil and gas sealing capacities. However, its application to other types of faults may have limitations. (3) The new method is mainly suitable for caprocks dominated by mudstone. When studying other types of caprocks, such as carbonate rocks, evaporites, igneous rocks, and metamorphic rocks, different research methods and technical means are required. These findings provide valuable insights for oil and gas exploration efforts near fault zones.

The efficacy of ciprofol versus propofol on anesthesia in patients undergoing endoscopy: a systematic review and meta-analysis of randomized controlled trials.

Ciprofol is a new intravenous anesthetic with a similar chemical structure to propofol. We aimed to compare the incidence of adverse actions like injection pain and time indexes of ciprofol versus propofol on anesthesia in patients undergoing endoscopy. We also compared anesthetists' satisfaction during the procedure. Two independent researchers (Liu and Zeng) searched the Cochrane Library, Embase databases, and PubMed for controlled clinical trials. This meta-analysis of randomized controlled trials (RCTs) was performed with the Review Manager, Stata and the Cochrane Risk-of-Bias 2 tool to evaluate methodological quality. Relative risks with 95% confidence interval (CI) were calculated for outcomes. Ten trials, including 1545 patients, were examined in the current meta-analysis. During anesthesia in patients undergoing endoscopy, the incidence of injection pain was significantly reduced in the research group. Compared with propofol, the pooled risk difference (RD) with the use of ciprofol for injection pain for all the procedures was - 0.34 (95% confidence interval [CI], -0.48 to 0.19), and RR for hypotension was 0.73(95% CI:0.58 to 0.92). GRADE showed this meta-analysis has moderate or low confidence. Trial sequential analysis for mortality indicated insufficient sample size for a definitive judgment for lower incidence of hypotension. In painless endoscopy, compared with propofol, ciprofol exhibited non-inferiority anesthesia/sedation in patients, and had a good safety profile with a lower incidence of pain on injection and may reduce the chance of hypotension. Trial sequential analysis suggested the need for more cases, and GRADE highlighted moderate certainty, emphasizing the necessity for further targeted RCTs. PROSPERO, CRD42023433627.

Objective and subjective assessment of PET felt recycled panels as an acoustic treatment in the meeting rooms

This study presents the performance of the PET-felt recycled panels for the room acoustic treatment. As the objective parameters, Reverberation Time (RT) and Speech Transmission Index (STI) were measured with B&amp;K DIRAC, an omnidirectional loudspeaker, and power amplifier in the meeting room at the Department of Interior Design, Bilkent University, Ankara, Turkey, before the acoustic treatment. Following ISO 12913-2 Method A, Perceived Affective Quality (PQA), Appropriateness, and Assessment of the Acoustic Environment were measured. Fifteen participants who were occupants of the meeting room were selected for the questionnaire survey to be conducted using the snowball method. The findings showed that the reverberation time was five seconds at 1 kHz, which is insufficient, and the acoustic quality could have been better for the speech-purpose room. PET-felt recycled acoustic panels were applied to the ceiling and walls as a solution. After the acoustic treatments, all procedures were repeated with the same. The results showed that significant improvements have been provided in both objective and subjective assessments. RT was in the optimum range. The participants found the meeting room with PET-felt recycled panels more pleasant and eventful after the acoustic treatment.

Exploring sound diffusion in learning environments through experimental and wave-based analysis

Acoustic design guidelines in learning environments generally involve specific requirements of reverberation time (T20), speech clarity (C50), and speech transmission index (STI) to ensure adequate quality for spoken communication. Predictive formulas recommended by international standards rely on ideal diffuse field theory as a crucial factor for meeting adequate room acoustics criteria. However, such theoretical assumptions are barely encountered in real-world rooms, undermining the predictions' accuracy. The present work explores the main factors influencing sound diffusion in classrooms by means of in-field acoustic measurements and numerical models. In detail, different desk configurations and the installation of materials with varying acoustic impedances at the suspended ceiling have been studied to evaluate the associated increase in sound diffusion. Among the several metrics to quantify sound diffusion, the standard deviation of measured reverberation time values has been selected in the present study. Experimental and simulated data findings reveal that the furniture layout with a single desk arrangement and the suspended ceiling's treatment with porous and perforated ceiling tiles increase sound diffusion by exploiting edge diffraction and material discontinuities, respectively.

Correction for reverberation time in acoustic measurements from service and equipment - Comparison between different methods

The measured values of the sound pressure level in ordinary rooms in dwellings vary depending on the combined effect of the absorption and the scattering of the furniture, or to the presence of absorbent surfaces on walls and ceilings. Regarding the measurement of noise from building services, ISO 16032 and ISO 10052 methods allow to normalize the sound pressure levels to a reference reverberation time of 0,5s. Several European countries incorporate this reverberation time correction into their regulations. However, Spanish regulations, specifically RD 1367/2007, and the majority of regional decrees and ordinances concerning the evaluation of noise from activities or equipment within buildings, do not incorporate this correction, even when measurements are performed in two scenarios: before the building's occupation when rooms are empty, or when the building is fully furnished, as may occur in the case of complaints. For that reason, this study compares the values of the reverberation time index obtained in 180 residential rooms using various methods while also evaluating the benefits and drawbacks of their application.

Impact of the COVID-19 pandemic on health-care use among patients with cancer in England, UK: a comprehensive phase-by-phase time-series analysis across attendance types for 38 cancers

The COVID-19 pandemic resulted in the widespread disruption of cancer health provision services across the entirety of the cancer care pathway in the UK, from screening to treatment. The potential long-term health implications, including increased mortality for individuals who missed diagnoses or appointments, are concerning. However, the precise impact of lockdown policies on national cancer health service provision across diagnostic groups is understudied. We aimed to systematically evaluate changes in patterns of attendance for groups of individuals diagnosed with cancer, including the changes in attendance volume and consultation rates, stratified by both time-based exposures and by patient-based exposures and to better understand the impact of such changes on cancer-specific mortality. In this retrospective, cross-sectional, phase-by-phase time-series analysis, by using primary care records linked to hospitals and the death registry from Jan 1, 1998, to June 17, 2021, we conducted descriptive analyses to quantify attendance changes for groups stratified by patient-based exposures (Index of Multiple Deprivation, ethnicity, age, comorbidity count, practice region, diagnosis time, and cancer subtype) across different phases of the COVID-19 pandemic in England, UK. In this study, we defined the phases of the COVID-19 pandemic as: pre-pandemic period (Jan 1, 2018, to March 22, 2020), lockdown 1 (March 23 to June 21, 2020), minimal restrictions (June 22 to Sept 20, 2020), lockdown 2 (Sept 21, 2020, to Jan 3, 2021), lockdown 3 (Jan 4 to March 21, 2021), and lockdown restrictions lifted (March 22 to March 31, 2021). In the analyses we examined changes in both attendance volume and consultation rate. We further compared changes in attendance trends to cancer-specific mortality trends. Finally, we conducted an interrupted time-series analysis with the lockdown on March 23, 2020, as the intervention point using an autoregressive integrated moving average model. From 561 611 eligible individuals, 7 964 685 attendances were recorded. During the first lockdown, the median attendance volume decreased (-35·30% [IQR -36·10 to -34·25]) compared with the preceding pre-pandemic period, followed by a median change of 4·38% (2·66 to 5·15) during minimal restrictions. More drastic reductions in attendance volume were seen in the second (-48·71% [-49·54 to -48·26]) and third (-71·62% [-72·23 to -70·97]) lockdowns. These reductions were followed by a 4·48% (3·45 to 7·10) increase in attendance when lockdown restrictions were lifted. The median consultation rate change during the first lockdown was 31·32% (25·10 to 33·60), followed by a median change of -0·25% (-1·38 to 1·68) during minimal restrictions. The median consultation rate decreased in the second (-33·89% [-34·64 to -33·18]) and third (-4·98% [-5·71 to -4·00]) lockdowns, followed by a 416·16% increase (409·77 to 429·77) upon lifting of lockdown restrictions. Notably, across many weeks, a year-over-year decrease in weekly attendances corresponded with a year-over-year increase in cancer-specific mortality. Overall, the pandemic period revealed a statistically significant reduction in attendances for patients with cancer (lockdown 1 -24 070·19 attendances, p<0·0001; minimal restrictions -19 194·89 attendances, p<0·0001; lockdown 2 -31 311·28 attendances, p<0·0001; lockdown 3 -43 843·38 attendances, p<0·0001; and lockdown restrictions lifted -56 260·50 attendances, p<0·0001) compared with before the pandemic. The UK's COVID-19 pandemic lockdown affected cancer health service access negatively. Many groups of individuals with cancer had declines in attendance volume and consultation rate across the phases of the pandemic. A decrease in attendances might lead to delays in cancer diagnoses, treatment, and follow-up, putting such groups of individuals at higher risk of negative health outcomes, such as cancer-specific mortality. We discuss the factors potentially responsible for explaining changes in service provision trends and provide insight to help inform clinical follow-up for groups of individuals at risk, alongside potential future policy changes in the care of such patients. Wellcome Trust, National Institute for Health Research University College London Hospitals Biomedical Research Centre, National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre, Academy of Medical Sciences, and the University College London Overseas Research Scholarship.

Assessing the therapeutic role of trehalose and hyaluronic acid: implications for patient care.

This Systematic review aims to assess the efficacy of trehalose and hyaluronic acid in enhancing ocular recovery post-cataract surgery, focusing on their impact on tear film stability, ocular surface integrity, and patient-reported outcomes. A comprehensive search was conducted across MEDLINE, PubMed, and Cochrane Library databases to identify randomized controlled trials investigating the efficacy of trehalose, hyaluronic acid, or their combination in post-cataract surgery care. The inclusion criteria focused on peer-reviewed studies in English, detailing outcomes relevant to ocular recovery such as tear film stability, ocular surface integrity, patient-reported discomfort, or visual acuity (VA). The quality of the included studies was assessed using the Cochrane Risk of Bias Tool and synthesized the data qualitatively. Four qualitative investigations met the inclusion criteria. The studies collectively assessed the efficacy of a 3% trehalose and 0.15% hyaluronic acid eye drop solution in reducing postoperative eye symptoms compared to various control solutions. Parameters measured included tear break-up time (TBUT), Fluorescein staining, tear production (Schirmer test), and Ocular Surface Disease Index (OSDI) scores. The results indicated significant improvements in tear film stability and ocular surface health for the treatment groups compared to controls, with a notable decrease in patient-reported discomfort. The study showed an improvement of - 18 (± 14.6) in the treatment group compared to - 7 (± 8.0) in the control group for OSDI. For TBUT, the treatment group improved by 3 (± 1.2) s, whereas the control group improved by 0.3 (± 0.71) s. VA, measured on a scale of 0-100, increased to 17 (± 0.7) in the treatment group compared to 15 (± 1.1) in the control group. Trehalose and hyaluronic acid may be beneficial in the postoperative period by enhancing tear film stability and ocular surface health. While the results are promising, further research is needed to confirm these findings, understand the mechanisms of action, and explore broader applications.

The surface-based degree centrality of patients with lifelong premature ejaculation: A resting-state fMRI study

The aim of this study was to investigate alterations in the resting-state brain functional network characteristics of lifelong premature ejaculation (PE) patients using surface-based degree centrality (DC), and to analyze the correlation between these alterations and clinical symptoms in PE patients. The study included individuals with lifelong PE (patient group, n = 36) and a control group matched by age and education level (control group, n = 22). Resting-state functional magnetic resonance imaging (fMRI) scans were performed on all participants. Surface-based degree centrality analysis was conducted and the differences between the two groups were compared using t-tests. Further, the DC values of brain regions showing significant differences were correlated with clinical symptoms. Compared to the control group, the patient group exhibited significantly reduced degree centrality (DC) values in the left precuneus and significantly increased DC values in the right supplementary motor area (SMA). Furthermore, intravaginal ejaculatory latency time (IELT) and Chinese Index of Premature Ejaculation (CIPE) values were positively correlated with left precuneus DC values and negatively correlated with right SMA DC values. Patients with primary lifelong ejaculation demonstrate abnormalities in key brain network nodes and their connections with relevant brain regions, which are strongly associate with clinical symptoms. These findings enhance our understanding of the neuronal pathological changes in PE patients.

Correlation Analysis of Activity Levels and Risk Factors in Patients with Stroke: Variations in Cardiac Function According to the Longshi Scale.

This study examined the link between physical activity levels, as measured by the Longshi Scale, and cardiac function and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels in stroke patients, aiming to find correlations with stroke risk factors. The study involved 123 apoplexy patients divided into four groups based on the Longshi Scale: bedridden (31), domestic (32), community (30), and health (30). Clinical data was collected, and hemodynamic assessments were performed using impedance cardiography. Cardiac output time index (CTI) and estimated ejection fraction (EF est) were significantly reduced in both the domestic and community groups compared to the health group (P < 0.05), while diastolic arterial blood pressure (DABP) and systemic vascular resistance index (SVRi) were increased. In the bedridden group, stroke volume (SV), cardiac output (CO), CTI, left cardiac work index (LCWi), and EF est were all lower compared to the health group (P < 0.05), with SVRI and NT-proBNP levels being higher. Additionally, the bedridden group exhibited lower SV, CO, DABP, LCWi, CTI, and EF est when compared to the domestic and community groups (P < 0.05), but higher end-diastolic filling rate (EDFR) and NT-proBNP levels. The Longshi Scale grading positively correlated with SV (r = 0.536, P < 0.01), and NT-proBNP, EF, and cognitive dysfunction were found to be associated with activity levels in stroke patients. The Longshi Scale correlates with cardiac function indicators like NT-proBNP and EF, and can help identify stroke patients at risk of cardiac dysfunction. Moreover, cognitive dysfunction was identified as a significant factor influencing the range of activity in patients with stroke.

A comparative Analytical Investigation of Different Geomagnetic Storms During Solar Cycles 23 and 24

Abstract In this work, the geomagnetic storms that occurred during solar cycles 23 and 24 were classified based on the value of the Disturbance Storm Time index (Dst), which was considered an indicator of the strength of geomagnetic conditions. The special criterion of Dst &gt;-50 nT was adopted in the classification process of the geomagnetic storms based on the minimum daily value of the Dst-index. The number of geomagnetic storms that occurred during the study period was counted according to the adopted criteria, including moderate storms with (Dst &gt;-50 nT), strong storms with (Dst &gt;-100 nT), severe storms with (Dst &gt;-200 nT), and great storms with (Dst &gt;-350 nT). The statistical results showed that the total number of geomagnetic storms identified during solar cycle 23 was 571 storms, while during solar cycle 24, the number of storms decreased to 282 storms. Depending on the minimum value of Dst-index, the geomagnetic storms identified during Cycle 23 were classified into: 446 moderate, 101 strong, 19 severe, and 5 great storms. During Cycle 24, it was classified into: 247 moderate, 34 strong, and 1 severe storm. Also, the results of the study indicated that no storm of either a severe or great type was recorded during the solar cycle 24, given that this cycle witnessed low solar activity. This indicates that solar activity associated with sunspot number (SSN) corresponds to the rate of occurrence and strength of geomagnetic storms of all categories.