09/12/2024


This paper extends earlier on socioeconomic inequality in mental health, measured by the General Health Questionnaire, to include the second national lockdown up to March 2021.
Following trials of inhaled antibiotics in adults, this study investigates the efficacy of nebulised gentamicin to improve respiratory function in children with bronchiectasis.

This is a randomised, double-blind, placebo-controlled, crossover trial of 12-week nebulised placebo/gentamicin, 6-week washout, 12-week gentamicin/placebo. Participants were children (5-15 years) with bronchiectasis, chronic infection (any pathogen), and able to perform spirometry from a hospital bronchiectasis clinic. Primary outcomes were change in forced expiratory volume in 1 s (FEV
) and hospitalisation days. Secondary outcomes included sputum bacterial density, sputum inflammatory markers, additional antibiotics and symptom severity. Analyses were on an intention-to-treat basis.

Fifteen children (mean 11.7-years-old) completed the study. There was no significant change in mean FEV
(56%/55%, P= 0.38) or annual rate of hospital admissions (1.1/0, P= 0.12) between gentamicin and placebo, respectively. However, Haemophilus influenzae sputum growth (27% vs. 80%, P= 0.002) and bacterial density (2.4 log
cfu/mL lower P< 0.001) improved with gentamicin. Sputum inflammatory markers interleukin-1β (P< 0.001), interleukin-8 (P< 0.001) and tumour necrosis factor-α (P= 0.003) were lower with gentamicin. Poor recruitment limited study power and treatment adherence was challenging for this cohort.

In this crossover study of nebulised gentamicin in children with bronchiectasis, there was a reduction in sputum bacterial density and inflammation. However, there were no major improvements in clinical outcomes and adherence was a challenge.
In this crossover study of nebulised gentamicin in children with bronchiectasis, there was a reduction in sputum bacterial density and inflammation. However, there were no major improvements in clinical outcomes and adherence was a challenge.Brain networks exhibit signatures of modular structure, which maintains a fine trade-off between wiring cost and efficiency of information transmission. Alterations in modular structure have been found in patients with obsessive-compulsive disorder (OCD). However, previous studies were focused on a single scale (i.e., modularity or intra/intermodular connectivity) for investigation. Here, we recruited 92 OCD patients and 90 healthy controls. A comprehensive analysis was performed on modular architecture alterations in the voxelwise functional connectome at the "global" (modularity), "meso" (modular segregation and within- and between-module connections), and "local" (participation coefficients, PC) scales. We also examined the correlation between modular structure metrics and clinical symptoms. The findings revealed that (1) there was no significant group difference in global modularity; (2) both primary modules (visual network, sensorimotor network) and high-order modules (dorsal attention network, frontoparietal network) exhibited lower modular segregation in OCD patients, which was mainly driven by increased numbers of between-module connections; and (3) OCD patients showed higher PC in several connectors including the bilateral middle occipital gyri, left medial orbital frontal gyrus, left superior frontal gyrus, left posterior cingulate gyrus, right superior temporal gyrus and right middle frontal gyrus, and lower PC in the right lingual gyrus. Moreover, these alterations in modular structure were associated with clinical symptoms in patients. Our findings provide further insights into the involvement of different modules in functional network dysfunction in OCD from a connectomic perspective and suggest a synergetic mechanism of module interactions that may be related to the pathophysiology of OCD.
This review aimed to synthesise the available reviews on the effects of nursing interventions on sleep quality among patients hospitalised in intensive care and non-intensive care units.

Poor sleep quality is a common fact in hospitalised patients. Nurses can contribute to the improvement of patients' sleep quality and duration.

A review of intervention reviews was carried out and reported following the PRISMA guidelines and checklist.

We systematically searched for reviews published from January 2009 to December 2019 in PubMed, CINAHL Plus, Scopus, Institute for Scientific Information Web of Science, Joanna Briggs Database of Systematic Reviews and Cochrane Central Register of Controlled Trials databases. Searches were repeated at 24 November 2020 to include the most recent evidence. A narrative synthesis of the results was conducted.

Nine reviews (representing 109 original papers) met the selection criteria and were included for critical appraisal. Overall, nursing interventions and sleep quality were poorly defined. We grouped the interventions into 3 categories (environmental, barrier and internal interventions) to provide a more comprehensive overview and examine effects of nursing interventions on inpatients sleep quality. Inconsistent results were obtained and low quality of the original articles was reported, making it difficult to establish absolute conclusions.

The impact of environmental changes on patients' sleep was positive but inconclusive, while use of earplugs and eye masks, music and acupuncture generally showed positive results with moderate quality of evidence, and no harmful effects were reported.
The impact of environmental changes on patients' sleep was positive but inconclusive, while use of earplugs and eye masks, music and acupuncture generally showed positive results with moderate quality of evidence, and no harmful effects were reported.Genetic alterations in FGF/FGFR pathway are infrequent in gastrointestinal stromal tumors (GIST), with rare cases of quadruple wildtype GISTs harboring FGFR1 gene fusions and mutations. Additionally, FGF/FGFR overexpression was shown to promote drug resistance to kinase inhibitors in GISTs. However, FGFR gene fusions have not been directly implicated as a mechanism of drug resistance in GISTs. Herein, we report a patient presenting with a primary small bowel spindle cell GIST and concurrent peritoneal and liver metastases displaying an imatinib-sensitive KIT exon 11 in-frame deletion. After an initial 9-month benefit to imatinib, the patient experienced intraabdominal peritoneal recurrence owing to secondary KIT exon 13 missense mutation and FGFR4 amplification. Despite several additional rounds of tyrosine kinase inhibitors (TKI), the patient's disease progressed after 2 years and presented with multiple peritoneal and liver metastases, including one pericolonic mass harboring secondary KIT exon 18 missense from both KIT-dependent and KIT-independent off-target activation pathways.
The purpose of this study was to investigate the effect of hypothyroidism and thyroxine replacement therapy on the prognosis of nasopharyngeal carcinoma (NPC) patients.

The clinical data of 284 NPC patients, who received intensity-modulated radiation therapy (IMRT) between January 2011 and December 2016, were retrospectively analyzed.

Hypothyroidism occurred in 38% of patients. Patients with hypothyroidism had significantly better disease-free survival (DFS) (p=0.002) and relapse-free survival (RFS) (p=0.008). Multivariate analysis showed that hypothyroidism was a positive independent prognostic factor (DFS and RFS). Among the patients with hypothyroidism, thyroxine replacement therapy did not yield inferior survival (DFS, RFS, all p > 0.05).

The NPC patients with complete response are at risk of hypothyroidism, which is attributable to escalating dose. https://www.selleckchem.com/peptide/lypressin-acetate.html These patients experienced clinical hypothyroidism could be adequately treated with thyroid hormone replacement. Further investigation of the underlying biological mechanism and potential therapeutic implications are required.
The NPC patients with complete response are at risk of hypothyroidism, which is attributable to escalating dose. These patients experienced clinical hypothyroidism could be adequately treated with thyroid hormone replacement. Further investigation of the underlying biological mechanism and potential therapeutic implications are required.Gene editing in mammalian zygotes enables us to generate genetically modified animals rapidly and efficiently. In this study, we compare multiple gene targeting strategies in rat zygotes by generating a novel knock-in reporter rat line to visualize the expression pattern of transcription factor AP-2 gamma (Tfap2c). The targeting vector is designed to replace the stop codon of Tfap2c with T2A-tdTomato sequence. We show that the combination of electroporation-mediated transduction of CRISPR/Cas9 components with adeno-associated virus-mediated transduction of the targeting vector is the most efficient in generating the targeted rat line. The Tfap2c-T2A-tdTomato fluorescence reflects the endogenous expression pattern of Tfap2c in preimplantation embryo, germline, placenta, and forebrain during rat embryo development. The reporter line generated here will be a reliable resource for identifying and purifying Tfap2c expressing cells in rats, and the gene targeting strategy we used can be widely applied for generating desired animals.
It remains unclear why some patients with the same heart rate during an atrial fibrillation (AF) have subjective symptoms, whereas others do not. We assessed the hypothesis that different responses of arterial and left atrial blood pressures to rapid stimulation may be associated with the symptoms of AF.

A total of 110 patients who underwent catheter ablation for paroxysmal AF were retrospectively studied. Asymptomatic AF was defined as a European Heart Rhythm Association score of Ⅰ for AF-related symptoms. The left atrial pressure (LAP) was measured during sinus rhythm (SR), in 10 pacing per minute (ppm) increments from 100 ppm to the Wenckebach block rate in high right atrial pacing.

Asymptomatic AF was observed in 19/110 patients (17%). Patients with symptomatic AF showed higher E/e' ratio and gradual LAP increase that was dependent on the pacing rate. Patients with asymptomatic AF had decreased LAP at 100 ppm compared that at SR, and thereafter, LAP gradually increased depending on the pacing rate. The rate of LAP change compared to that at SR was significantly lower in patients with asymptomatic AF than that in patients with symptomatic AF. The rate of LAP change was independently associated with AF symptoms.

Patients with asymptomatic AF showed lower E/e' ratio and decreased LAP at 100 ppm to rapid stimulation, followed by a steady increase in LAP afterwards. Factors other than left ventricular diastolic dysfunction may be involved in AF symptoms.
Patients with asymptomatic AF showed lower E/e' ratio and decreased LAP at 100 ppm to rapid stimulation, followed by a steady increase in LAP afterwards. Factors other than left ventricular diastolic dysfunction may be involved in AF symptoms.Glaucoma disease in humans can lead to blindness if it progresses to the point where it affects the oculus' optic nerve head. It is not easily detected since there are no symptoms, but it can be detected using tonometry, ophthalmoscopy, and perimeter. However, advances in artificial intelligence approaches have permitted machine learning techniques to diagnose at an early stage. Numerous methods have been proposed using Machine Learning to diagnose glaucoma with different data sets and techniques but these are complex methods. Although, medical imaging instruments are used as glaucoma screening methods, fundus imaging specifically is the most used screening technique for glaucoma detection. This study presents a novel DenseNet and DarkNet combination to classify normal and glaucoma affected fundus image. These frameworks have been trained and tested on three data sets of high-resolution fundus (HRF), RIM 1, and ACRIMA. A total of 658 images have been used for healthy eyes and 612 images for glaucoma-affected eyes classification.