METHODS AND RESULTS: We present a 50-year-old patient in whom a Medtronic EV ICD system was successfully removed without specialist extraction tools, 186 weeks after implantation, by an operator experienced in transvenous lead extraction but without formal training in EVICD implantation.
CONCLUSION: The successful extraction of an EV ICD system is possible without specialised tools at least 3.6 years post-implant.
METHODS: 200 patients with heart failure and reduced ejection fraction (HFrEF) admitted into two hospitals in Malaysia due to worsening of HF were surveyed using the EQ-5D-5 L questionnaire. The primary outcomes were utility values at admission, discharge and 1-month post-discharge (1MPD). Secondary outcomes included the visual analogue scores (VAS) and the proportion of patients reporting each EQ-5D-5 L dimension levels. Missing data were imputed using multiple imputation, and generalised linear mixed models were fitted.
RESULTS: At admission, the unadjusted mean utility values and VAS scores for HFrEF patients in Malaysia were as low as 0.150 ± 0.393 and 38.2 ± 20.8, respectively. After a median hospital stay of 4 days, there was a significant improvement in utility values and VAS scores by 0.510 (95% CI: 0.455-0.564) and 28.8 (95% CI: 25.5-32.1), respectively. The utility value and VAS score at 1-month post-discharge were not significantly different from discharge. The proportion of HFrEF patients reporting problems and severe problems in mobility, self-care, usual activities, and anxiety/depression, pain/discomfort reduced at varying degree from admission to discharge and 1MPD.
CONCLUSION: HF is a progressive condition with substantial variation in HRQoL during the disease trajectory. During hospitalisation due to worsening of HF, HFrEF population has unfavourable HRQoL. Rapid and significant HRQoL improvement was observed at discharge, which sustained over one month. The study findings can inform future cost-effectiveness analyses and policies.
METHODS: A mandibular complete denture was scanned by a desktop scanner to create a digital STL reference file (control). Fifteen identical scans were created by using an intraoral scanner and exported as STL files (test group). These 15 files were saved at 100% of the original scan resolution then reduced to 75%, 50%, 25%, and 10% of their original quality. These 75 scans were statistically analyzed by calculating The Hausdorff Distance (HD) and Dice Similarity Coefficients (DSC) to assess the variation between the mean reduced intraoral scanner files test and the control desktop scanner file and eventual inconsistencies. The volumes of the reduced mesh files were also compared with the 100% resolution intraoral mesh files to evaluate precision and trueness of the intraoral scanner.
RESULTS: Reduced mesh files of 10%, 25%, 50%, 75% of the original scan yielded a percentage similarity average of 99.7%, indicating a very high precision value for the intraoral scanner. Also, the volumes of each associated mesh reduction slightly decreased with non-statistically significant results.
CONCLUSIONS: This study concluded that the chosen intraoral scanner for this study provided very high trueness (98.34%) and precision (99.7%), and also the volumes of reduced mesh files slightly decreased but were not statistically significant.
METHODS: This study included 965 Chinese community-dwelling older adults. Pearson correlation coefficient was conducted to assess the relationship between readiness toward ACP, death anxiety, and family cohesion. Structural equation model was used to examine the study hypothetical model.
RESULTS: 965 valid questionnaires were collected. Death anxiety is significantly related to the readiness toward ACP (r = -0.437, P < 0.01) and family cohesion (r = -0.444, P < 0.01), and family cohesion exhibited a positive correlation with readiness toward ACP (r = 0.499, P < 0.01). Family cohesion partially mediated the effect of death anxiety on readiness toward ACP, accounting for 35.94 % of the total effect.
CONCLUSIONS: Family cohesion mediates the relationship between death anxiety and readiness toward ACP. Healthcare professionals should implement measures to alleviate death anxiety and promote family cohesion in older adults, thereby enhancing their readiness toward ACP.
METHODS: Electronic databases were searched for studies investigating IL-37 and SLE. Data on IL-37 levels, SLE Disease Activity Index (SLEDAI) score, genetic polymorphisms, and its therapeutic effects from pre-clinical studies were extracted.
RESULTS: Previous studies presented conflicting findings on IL-37 levels in SLE patients. Some reported positive correlations with disease activity, while others observed associations between lower IL-37 and increased activity. Genetic variations in the IL-37 gene linked to SLE susceptibility have been reported. Pre-clinical studies using engineered mesenchymal stem cells or direct IL-37 treatment showed promise in reducing disease severity in mouse models and cell cultures of SLE. The analysis of multiple studies reveals that IL-37 expression varies significantly across different SLE subtypes.
CONCLUSIONS: While a potential link exists between IL and 37 and disease activity, genetic predisposition, and therapeutic benefit, further research is needed. Future studies with standardized designs, larger and more diverse populations, and mechanistic investigations are crucial to determine the therapeutic potential of IL-37 for SLE. This review highlights the need for well-designed clinical trials to evaluate the safety and efficacy of IL-37 therapy in patients with SLE.
METHODS: Antimicrobial activity was determined with disc diffusion and broth microdilution assays against eight skin colonising microorganisms including Staphylococcus aureus, Staphylococcus epidermidis, Salmonella enterica, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumonia followed by further fractionation of the pods ethyl acetate fraction by column chromatography along with preparative thin-layer chromatography. Quantification of bacterial death mechanism was elucidated by the measurement of hole size in cell wall that has been induced by extract constituents via field-emission scanning electron microscopy (FESEM).
RESULTS: Four fractions showed significant antimicrobial activity against the six microorganisms tested (p
OBJECTIVES: By leveraging the power of advanced machine learning schemes and experimental approaches, this research aims to provide valuable insights into CO2 flux prediction in coal fire areas and inform environmental monitoring and management strategies.
METHODS: The study involves the collection of an experimental dataset specific to underground coal fire areas, encompassing various parameters related to CO2 flux and underground coal fire characteristics. Innovative feature engineering techniques are applied to capture the unique characteristics of underground coal fire areas and their impact on CO2 flux. Different machine learning algorithms, including Natural gradient boosting regression (NGRB), Extreme gradient boosting (XGboost), Light gradient boosting (LGRB), and random forest (RF), are evaluated and compared for their predictive capabilities. The models are trained, optimized, and assessed using appropriate performance metrics.
RESULTS: The NGRB model yields the best predictive performances with R2 of 0.967 and MAE of 0.234. The novel contributions of this study include the development of accurate prediction models tailored to underground coal fire areas, shedding light on the underlying factors driving CO2 flux. The findings have practical implications for delineating the spontaneous combustion zone and mitigating CO2 emissions from underground coal fires, contributing to global efforts in combating climate change.
METHODS: A retrospective analysis of prospectively collected data was conducted. Skeletal maturity was determined using Risser, SSMS, TOCI and CVM for each patient. Crosstabulations of axial vs. appendicular markers were formed to analyze their concordance and discordance. Logistic and logarithmic regression models were run to assess longitudinal growth (postoperative height gain and leg-length growth) and curve modulation (follow-up instrumented Cobb correction after index operation), respectively. Models were compared using Akaike information criterion (AIC).
RESULTS: 34 patients (32 F/2 M, mean age: 12.8 ± 1.5 years, mean follow-up: 47.7 (24-80) months) were included. The median preoperative maturity stages were: Risser: 1 (-1-4), SSMS: 4 (1-7), TOCI: 6 (1-8) and CVM: 4 (1-6). At latest follow-up, all patients reached skeletal maturity. Concordance and discordance were observed between axial vs. appendicular systems that demonstrated a range of possible distributions of CVM, where trunk peak height velocity occurred before, simultaneously with or after the standing height peak height velocity. R-squared values for Risser, SSMS, TOCI and CVM were 0.701, 0.783, 0.810 and 0.811, respectively, for prediction of final height; 0.759, 0.821, 0.831 and 0.775 for final leg-length, and 0.507, 0.588, 0.668 and 0.673 for curve modulation. Delta AIC values demonstrated that different skeletal maturity assessment methods provided distinctive information regarding follow-up height gain, leg-length growth and curve behavior.
CONCLUSIONS: Risser score provided considerably less information for all three outcome variables. TOCI and SSMS provided substantial information regarding remaining leg-length assessments, while in terms of assessment of total height gain and curve modulation after surgery, CVM and TOCI offered substantial information and SSMS offered strong information. Mutual use of axial and appendicular markers may provide valuable insight concerning timing of surgery and magnitude of surgical correction.
METHODS: This study involved a modified electronic Delphi technique involving 27 specialists working in primary care recruited via convenient and snowball sampling. The Delphi survey was conducted online between August 2022 and April 2023, utilizing the Google Forms platform. Descriptive statistics were employed to analyse consensus across Delphi rounds.
RESULTS: Twenty-six international experts participated in the survey. The retention rate through the second and third Delphi rounds was 96.2% (n = 25). The broader consensus definition emphasizes person-centred care, collaborative patient-physician partnerships, and a holistic approach to health, including managing acute and chronic conditions through in-person or remote access based on patient preferences, medical needs, and local health system organization.
CONCLUSION: The study highlights the importance of continuity of care, prevention, and coordination with other healthcare professionals as core values of primary care. It also reflects the role of GP/FM in addressing new challenges post-pandemic, such as healthcare delivery beyond standard face-to-face care (e.g. remote consultations) and an increasingly important role in the prevention of infectious diseases. This underscores the need for ongoing research and patient involvement to continually refine and improve primary healthcare delivery in response to changing healthcare landscapes.