Science Progress最新文献

Objectives: To investigate the characteristics of outpatients in the pediatric otolaryngology department of a tertiary Japanese hospital before and during the COVID-19 pandemic.

Methods: In this retrospective study conducted at a tertiary center in Japan, pediatric patients aged 0-15 years who visited the pediatric otolaryngology department between 2017 and 2022 were included. The number of outpatients in the department was compared between before and during the COVID-19 pandemic (January 2017-December 2022) by year, age, sex, and the disease for which the patient was examined. Additionally, the diseases that most substantially contributed to the change in outpatient visits were evaluated in detail regarding their severity.

Results: Among a total of 9219 outpatients, there were no significant differences between 2017-2019 and 2020-2022 (4650 vs. 4569). In contrast, the number of new outpatients decreased by 27.5% (from 1242 to 900) in each of the three years during the COVID-19 pandemic. In particular, the number of patients aged 1-6 years decreased as did that of male patients. Of eight disease categories, oral cavity- and pharyngeal- related diseases decreased the most significantly, by approximately 50%, and the decrease in the number of patients with obstructive sleep apnea (OSA) is thought to have had an impact on the decrease in the number of patients. Furthermore, in cases in which polysomnography testing was performed for OSA, the proportion of patients with moderate and severe categories showed a significant decrease.

Conclusions: The number of new pediatric ORL patients, particularly those with severe OSA, reduced during the COVID 19 pandemic. These results may provide indications about the characteristics of OSA incidence and exacerbations.

A voltage mode capacitance multiplier for ultra-low frequency physiological signal processing is designed with a circuit model. With the proposed multiplier, a filter can achieve a cutoff frequency of 12 mHz with a 1 pF basic capacitance and a 10 kΩ resistor. The corresponding multiplication factor will be 1.35 × 10⁹. By changing the controlling terminal, the multiplication factor can be widely tuned from 1950 to 1.35 × 10⁹ and the corresponding filter cutoff frequency will be from 12 mHz to 8.15 kHz. According to the circuit model, to further increase the multiplication factor to decrease the chip area, more multiplication stages can be added to the feedback loop.

Aims: Patients with epistaxis typically visit the emergency department for initial treatment. According to recent studies, tranexamic acid (TXA) is effective in the treatment of epistaxis. This study compared the therapeutic superiority of saline to that of 500 and 1000 mg doses of topical TXA for the treatment of anterior epistaxis. Materials and methods: This phase 4 clinical trial was a randomized, controlled, and double-blind trial. A total of 152 patients were divided into three groups. Group 1 was treated with 1000 mg TXA, Group 2 with 500 mg TXA, and Group 3 with saline. Results: Based on multinomial logistic regression analysis, the bleeding frequency at the 5th minute was 2.9 times and rebleeding status was 4.3 times less in Group 1 (1000 mg TXA) than in Group 3 (saline). There were no differences between the three groups in terms of side effects or salvage therapy. Conclusion: In addition to its superiority in treatment, 1000 mg of TXA is recommended because of the decreased rate of recurrent bleeding and low incidence of side effects.

Among the components of high-tech ships, the structural complexity of the propeller profile requires a high degree of flexibility in the CNC polishing machine. In addressing this requirement, the study formulates the flexible optimization problem pertaining to research on the propeller CNC polishing machine. A comprehensive analysis is undertaken to scrutinize the geometric features of the propeller and the phenomenon of polished contact. The propeller profile-polishing head dynamic contact mechanism is revealed, and the contact force characteristics of propeller polishing are obtained. It is suggested that the propeller configuration-process-polishing machine structure coupling mechanism be explored under the influence of polishing contact force. Subsequently, a dynamic model of the propeller CNC polishing process is formulated. Based on the above model, a simulation of the motion personification and structural flexibility of the propeller CNC polishing machine is proposed to obtain dynamic personification and flexibility rules. Integrating polishing contact force characteristics with dynamic personification and flexibility rules, the dynamic flexible collaborative optimization principle of the propeller CNC polishing machine is revealed. On this basis, multi-objective optimization modeling and solving are carried out, forming a new method for the flexible optimization design of propeller CNC polishing machines.

Objective: This retrospective study aimed to investigate the correlation between neutrophil gelatinase-associated lipocalin (NGAL) levels and the clinical progression and severity of diabetes-related acute kidney injury (AKI). The quantitative determination of NGAL in plasma on the Beckman Coulter AU480 analyzer was measured using the Bioporto NGAL Test^TM, a particle-enhanced turbidimetric immunoassay with hospitalized patients at an East Central Georgia Medical Center.

Methods: The clinical determination of plasma NGAL included a retrospective cohort study where 45 adult patients were selectively recruited. The selective criteria were patients with and without diabetes mellitus (DM) at risk for developing AKI admitted to the Medical Center between January and November 2023. All patients included in the study had pNGAL levels measured upon admission and up to 96 h post-admission. Receiver operating characteristics and likelihood ratio methods were used to determine optimal sensitivity, specificity, and cutoff value of pNGAL in AKI patients associated with and without DM.

Results: The intra-assay and interassay imprecision percent relative standard deviation was between 2.7% and 4.2%. pNGAL levels were higher for patients with AKI compared to non-AKI patients, regardless of DM status. The optimal cutoff value for pNGAL to predict AKI for patients with DM was 293 ng/mL, with a sensitivity of 80% and specificity of 87%. In a multivariate logistic regression model, pNGAL levels at 48 h post-admission were determined to be associated with diabetes-related AKI patients.

Conclusion: Plasma NGAL levels at 48 h are associated with patients with diabetes-related AKI. The specific cutoff values for AKI for early diagnosis and risk stratification and its association with comorbidities must be determined to improve patient outcomes.

Objectives: Basilar artery atherosclerotic plaque is the predominant cause of stroke in the posterior circulation. İscheamic stroke caused basilar artery atherosclerosis faces a high risk of recurrence despite optimal medical treatment, which might lie in the less than ideal recognition of underlying stroke mechanism and lack of individualized treatment for strokes of different mechanisms. We aim in this study to investigate the effect on stroke mechanism, stroke recurrence and clinical outcome in stroke patients with basilar artery atherosclerosis.

Methods: In this study, 107 ischaemic stroke patients with atherosclerotic stenosis in the BA who were followed up in Uludag University Faculty of Medicine between 1 January 2019 and 1 January 2022. The study was conducted retrospectively and observationally.

Results: According to the results of our study, the degree of stenosis in atherosclerotic stenosis of the symptomatic basilar artery was found to be an independent risk factor for stroke recurrence. Independent risk factors for unfavourable clinical outcomes in these patients were determined as female gender, stenosis being in the proximal segment, stroke mechanism being from artery to artery embolism, and congestive heart failure.

Conclusion: The most striking result of our study is that clinical outcome was found to be closely related to the female gender, the stroke mechanism being artery-to-artery embolism, and the stenosis is in the proximal segment. If stroke mechanisms were evaluated more clearly, it would likely help provide individualised treatments.

Melatonin, N-acetyl-5-methoxytryptamine, is a neuroendocrine hormone secreted by the pineal gland. This pleiotropic indoleamine possesses amphiphilic properties, allowing it to penetrate most biological barriers and exert its effects at the subcellular level. Importantly, melatonin also plays a crucial role in regulating the body's response to circadian rhythms, adapting to internal and external environmental cues. Melatonin functions as a powerful antioxidant and free radical scavenger, protecting cells from oxidative damage. Its diverse physiological roles include maintaining the functional integrity of endothelial cells, thereby preventing atherosclerosis, a major contributor to cardiovascular disease. Additionally, melatonin exhibits antioxidant and free radical scavenging properties, potentially improving metabolic disorders. These combined effects suggest a unique adjunctive therapeutic potential for melatonin in treating cardiovascular diseases. This review aims to explore the mechanisms by which melatonin interacts with the cardiovascular system and investigates its potential use as an adjunctive therapeutic agent in managing cardiovascular disease.

Objective: Polyvascular disease (polyVD) often coexists with coronary artery disease (CAD). We aim to investigate the prevalence of polyVD using the method of ultrasound and find its association with adverse outcomes in coronary artery bypass grafting (CABG) patients. Methods: This retrospective and cross-sectional study included 1344 patients with a mean age of 61.4 years. Presence of peripheral artery atherosclerotic plaque and stenosis was assessed using the method of ultrasound. Receiver operating characteristic (ROC) analysis and multivariate logistic regression analysis were performed to investigate the association of polyVD with in-hospital all-cause death. Results: 52.1% of the patients had polyVD and among which 31.9% had one additional arterial bed involvement and 20.2% had two or three additional arterial beds involvement. Patients with two or three involved arterial beds had worse baseline characteristics. In-hospital all-cause death rate increased with the number of involved arterial beds (1.1% in patients with only CAD vs 3.7% in patients with two or three involved arterial beds), and this trend was more prominent in elderly patients. Multivariate logistic regression analysis confirmed that polyVD patients with two or three involved arterial beds had about three times the risk for all-cause death. Conclusions: Prevalence of polyVD assessed by ultrasound was high in CABG patients and it was significantly associated with in-hospital all-cause death. Our study may provide additive information for preoperative risk stratification in CABG patients.

Objectives: Marine biodiversity and ecosystem services in the high seas are threatened by numerous stress factors caused by human activities, including global shipping, high-sea fishing, marine plastic pollution, and anthropogenic climate change. Socioeconomic factors are one of the criteria for the establishment of area-based management tools in the high seas for marine biodiversity conservation beyond national jurisdiction. The aim of the work is to propose a spatiotemporal approach to identify risks from marine human activities and recommendations for high seas governance. Methods: Data related to human activities from 2014 to 2022 were used to calculate the distribution and changes of human-related stressors, and the risk to marine biodiversity in the high seas caused by human activities. Results: The North Atlantic, Philippine Sea, Arabian Sea, Bay of Bengal, and East Central Atlantic show high and increasing intensities of human-related stressors, and are therefore particularly at need for the protection and conservation of marine biodiversity. Risks from human activities vary within the marine areas that are prioritized for biodiversity protection. The study recommends that the designation of high seas protected areas should take into account the types of risks to which the different marine areas are exposed, and that the high seas protected areas should be established gradually. At the same time, appropriate management measures should be formulated according to the intensity of human activities in the different marine areas. Conclusions: Quantifying and classifying the risk from human-related stressors could help identify solution for the protection and conservation and facilitate the marine spatial planning, establishment area based management tools, including marine protected areas in the high seas.

Introduction: Antitussive and expectorant drugs such as aminophylline (APL), doxofylline (DXL), bromhexine hydrochloride (BXH), and ambroxol hydrochloride (AXH), either individually or in combination, are widely used in the prevention and treatment of respiratory diseases. The study aimed to establish a high-performance liquid chromatography (HPLC) method for the simultaneous determination of these four drugs and to investigate their stability in 0.9% sodium chloride injection or 5% glucose injection over 48 hours. Methods: An InertSustain C₁₈ column (150 mm × 4.6 mm, 5 μm) was used. The mobile phase consisted of acetonitrile and 50 mmol·L^-1 potassium dihydrogen phosphate solution (pH 4.0) with gradient elution. The flow rate was 0.8 mL·min^-1, and the column temperature was maintained at 30°C. The stability of APL, DXL, BXH, and AXH in 0.9% sodium chloride and 5% glucose injections over 48 h was determined using HPLC. Results: APL, DXL, BXH, and AXH showed good linearity within the ranges of 0.01 to 0.20, 0.003-0.06, 0.015-0.30, and 0.016-0.16 mg·mL^-1, respectively (r > 0.999). The intraday and interday relative standard deviations were <2%, with recovery rates between 98.4% and 102.2%. The four drugs remained colorless and clear in infusion mixtures. The pH value fluctuated within ±0.3 over 48 hours, and the relative percentage content of the drugs ranged from 95.0% to 105.0%. Conclusion: The established HPLC method is simple, reliable, and stable, allowing for the simultaneous determination of the four antitussive and expectorant drugs. APL, DXL, BXH, and AXH were stable within 48 hours when mixed with 0.9% sodium chloride and 5% glucose injections.