Nevin Manimala

BMC Cardiovasc Disord. 2024 Dec 30;24(1):754. doi: 10.1186/s12872-024-04450-5.

ABSTRACT

BACKGROUND: Ischemic stroke is a major contributor to global morbidity and mortality, particularly in critically ill patients in intensive care units (ICUs). While advances in stroke management have improved outcomes, predicting mortality remains challenging due to the involvement of complex metabolic and cardiovascular factors. The triglyceride-glucose (TyG) index, a marker for insulin resistance, has gained attention for its potential to predict adverse outcomes in stroke patients. Furthermore, the TyG-BMI index, which combines TyG with body mass index (BMI), may offer a more comprehensive measure by accounting for obesity-related metabolic burden. However, the comparative impact of these indices on short- and long-term mortality among critically ill ischemic stroke patients remains unclear.

METHODS: This retrospective cohort study analyzed data from the Medical Information Mart for Intensive Care IV (MIMIC-IV 3.0) database, including 1,334 critically ill ischemic stroke patients. The patients were divided into four groups based on TyG and TyG-BMI quartiles, respectively. Cox proportional hazards models were employed to assess the association of these indices with 30-day, 90-day, 180-day, and 1-year all-cause mortality (ACM). Kaplan-Meier survival analysis was used to compare survival rates across different index levels. We utilized restricted cubic splines (RCS) to examine the association between the TyG, TyG-BMI index and the specified outcomes. Furthermore, TyG and TyG-BMI index were utilized to establish logistic regression models for mortality across different time periods, and corresponding Receiver Operating Characteristic (ROC) curves were generated.

RESULTS: Kaplan-Meier survival analysis show that Higher TyG levels were associated with significantly increased mortality risk at all time points, with patients in the highest TyG quartile exhibiting the greatest risk. Conversely, patients having a lower TyG-BMI level faced a heightened risk of long-term ACM. The RCS analysis results demonstrated that the TyG index did not exhibit a statistically significant nonlinear relationship with mortality across all time points. However, a significant nonlinear relationship was observed between the TyG index and long-term mortality. From the ROC curve, it can be observed that TyG performs better in predicting short-term mortality. Conversely, TyG-BMI demonstrates superior performance in predicting long-term mortality. The analysis revealed that while the TyG index alone is a strong predictor of mortality, the TyG-BMI index enhances the ability to predict long-term outcomes.

CONCLUSION: This finding suggests both the TyG and TyG-BMI indices serve as valuable predictors of mortality in critically ill ischemic stroke patients. However, significant differences were observed across the various follow-up periods. Based on the distinct characteristics of these two indicators, future research should focus on the selective integration of TyG and TyG-BMI indices into clinical risk assessment models, tailored to the metabolic profiles of ischemic stroke patients in the ICU. This approach could enhance the precision of mortality risk stratification and optimize patient management strategies.

PMID:39734194 | DOI:10.1186/s12872-024-04450-5

BMC Plant Biol. 2024 Dec 30;24(1):1275. doi: 10.1186/s12870-024-06012-5.

ABSTRACT

BACKGROUND: Subtropical forest plant diversity, characterized by a wide range of species adapted to seasonal variations, is vital for sustaining ecological balance, supporting diverse wildlife, and providing critical ecosystem services such as carbon sequestration and soil stabilization. The Changa Manga Forest, an ecologically rich area with varied vegetation, was analyzed to understand the intricate relationship between plant diversity and environmental factors. This study investigates the diversity patterns, vegetation structure, and environmental influences on forest biodiversity.

METHODS: A comprehensive survey was conducted across 127 stands within the Changa Manga Forest to document plant species and classify vegetation communities. Soil samples were collected and analyzed for key physicochemical parameters, while multivariate statistical methods, including hierarchical clustering and ordination, were applied to examine the relationships between vegetation structure and environmental factors. Diversity indices and beta diversity components were calculated to assess variations across plant communities.

RESULTS: The species were classified into six distinct vegetation communities: Neltuma-Ziziphus-Malvestrum (NZM), Broussonetia-Lantana-Morus (BLM), Dalbergia-Lantana-Solanum (DLS), Morus-Abutilon-Ricinus (MAR), Eucalyptus-Vachellia-Sorghum (EVS), and Bombax-Leucaena-Croton (BLC). Analyses using hierarchical clustering and ordination methods revealed significant differences in species composition among these communities, with NZM and DLS exhibiting the highest dissimilarity. Canonical Correspondence Analysis (CCA) indicated that environmental factors such as soil pH, available phosphorus (AP), and organic matter percentage (OM%) are crucial in shaping plant distribution, though the total explained variation remained relatively low. Diversity indices varied significantly among communities, with the NZM community showing the highest Shannon and Simpson diversity, while EVS exhibited the lowest. The beta diversity analysis revealed a high species turnover between certain communities, indicating complex ecological interactions. Our results indicate significant variability in plant community composition and diversity patterns, influenced by edaphic factors and environmental gradients. We anticipate that future environmental changes, such as shifts in soil properties, precipitation patterns, and increased human activity, may exacerbate declines in local plant species richness and disrupt community structures. To preserve the invaluable biodiversity of the study area for future generations, it is essential to implement timely and effective conservation and management strategies.

PMID:39734183 | DOI:10.1186/s12870-024-06012-5

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Jan;39(1):71-76. doi: 10.13201/j.issn.2096-7993.2025.01.015.

ABSTRACT

Objective:This study aims to investigate the differences in hemostatic efficacy and patient comfort between an innovative domestically produced biodegradable nasal packing sponge and a traditional absorbent sponge following endoscopic nasal surgery. Methods:A prospective, randomized controlled trial design was utilized, including 30 patients who were divided into two groups according to random allocation, each receiving one of the two types of nasal packing. The study assessed the hemostatic efficacy, comfort, and safety of the materials by comparing the rates of no bleeding within 24 hours after packing, re-bleeding rates after 48 hours, pain ratings in the head and nasal areas, scores on a visual analog scale for nasal ocular symptoms, and safety indicators between the two groups. Results:The rates of no bleeding within 24 hours post-packing were 73.33% for both the experimental and control groups, with a no-bleeding rate of 100% after 48 hours in both groups. The pain rating in the head and nasal areas at various times post-packing was Grade Ⅰ（100%） in both groups, with no statistically significant difference（P=1.000）. The experimental groups sneezing score on the day of packing was（0.73±1.03）, lower than the control groups（2.27±1.67）, （P=0.007）; after 48 hours, the experimental groups sneezing score was（0.67±0.98）, also lower than the control groups（1.67±1.18）, （P=0.019）. There was no significant difference between the two groups in the Lund-Kennedy scoring during endoscopic examinations at the screening period, 7 days, 1 month, and 3 months post-packing（P>0.05）. Laboratory tests for other examination indicators were normal in both groups. Conclusion:The innovative domestically produced biodegradable nasal packing sponge not only provides hemostatic efficacy comparable to imported materials but also significantly improves patient comfort after surgery. It represents an economical and effective choice for nasal packing materials.

PMID:39734177 | DOI:10.13201/j.issn.2096-7993.2025.01.015

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Jan;39(1):66-70;76. doi: 10.13201/j.issn.2096-7993.2025.01.014.

ABSTRACT

Objective: To explore the efficacy of vonoprazan fumarate in the treatment of laryngopharyngeal reflux disease（LPRD） evaluated by the Chinese version of the RSS-12 scale. Methods:A total of 100 LPRD patients treated in the otolaryngology-head and neck surgery outpatient clinic of our hospital were randomly divided into two groups（50 cases each）. The observation group was treated with vonoprazan fumarate（20 mg, once daily）, and the control group was treated with esomeprazole enteric-coated capsules（20 mg, twice daily） for 12 weeks. The selected observation indicators in this study included RSI, the Chinese version of RSS-12, and RFS scores before and after treatment. Results:Prior to treatment, there was no statistically significant difference in the Chinese version of RSS-12, RSI, and RFS between the two groups（P>0.05）. After 8 and 12 weeks of antacid treatment, both the Chinese version of RSS-12 and RSI significantly decreased in both group （P<0.05）. The changes in symptoms were particularly noticeable between 0-8 weeks of treatment according to the Chinese version of RSS-12 and RSI. After 12 weeks of treatment, the RFS scores significantly decreased compared to pretreatment levels （P<0.05）. After 12 weeks of antacid treatment, according to the Chinese version of RSS-12, 80% of patients in the observation group showed a good therapeutic response, compared to 64% in the control group; according to RSI, 90% of patients in the observation group showed a good therapeutic response, compared to 84% in the control group. There was no statistically significant difference in the treatment effect between the two groups after 12 weeks of treatment（P>0.05）. Conclusion:Vonoprazan fumarate can significantly improve the symptoms and signs of laryngopharyngeal reflux, and their treatment effect is not inferior to proton pump inhibitors. Compared with RSI, the Chinese version of RSS-12 can serve as a new screening tool for clinical diagnosis of LPRD in China.

PMID:39734176 | DOI:10.13201/j.issn.2096-7993.2025.01.014

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Jan;39(1):61-65. doi: 10.13201/j.issn.2096-7993.2025.01.013.

ABSTRACT

Objective:To investigate optimal treatment strategy for pT3N0 laryngeal squamous cell carcinoma（SCC）. Methods:A retrospective study of 150 patients with pT3N0 laryngeal SCC treated in the First Affiliated Hospital of Chongqing Medical University was performed. The efficacies of partial laryngectomy and total laryngectomy, as well as surgery alone and postoperative radiotherapy were evaluated. The overall survival（OS）, disease specific survival（DSS） and disease-free survival（DFS） were analyzed with statistical package from SPSS. Results:Among the 108 patients with glottic laryngeal SCC, there were no significant differences in OS, DSS and DFS between the partial laryngectomy group and the total laryngectomy group（Log-rank=0.184, 0.010 and 0.051, P>0.05）. Similarly, there were no significant differences in OS, DSS and DFS between the surgery-alone group and postoperative radiotherapy group（Log-rank=0.214, 0.251 and 0.003, P>0.05）. Among the 38 patients with supraglottic laryngeal SCC, the OS in the total laryngectomy group was significantly higher than that in the partial laryngectomy group（Log-rank=7.338, P=0.007）. The DSS and DFS in the total laryngectomy group were higher than in the partial laryngectomy group, but the differences were not statistically significant（Log-rank=0.895 and 1.792; P>0.05）. The DFS in the postoperative radiotherapy group was significantly higher than in the surgery-alone group（Log-rank=7.172, P=0.007）, but there were no significant differences in OS and DSS between these two groups（Log-rank=0.010 and 0.876, P>0.05）. Conclusion:For pT3N0 glottic laryngeal cancer patients, the efficacy of partial laryngectomy is comparable to total laryngectomy, same as surgery alone and postoperative radiotherapy. For pT3N0 supraglottic laryngeal cancer patients, total laryngectomy could improve the overall survival, and postoperative radiotherapy could reduce the recurrence. Prospectively randomized study with large samples is still needed.

PMID:39734175 | DOI:10.13201/j.issn.2096-7993.2025.01.013

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Jan;39(1):24-28. doi: 10.13201/j.issn.2096-7993.2025.01.006.

ABSTRACT

Objective:This study aimed to compare the effects of cochlear implantation（CI） on vestibular function in patients with large vestibular aqueduct syndrome（LVAS） and in patients with extremely severe deafness with normal inner ear structure. Methods:A total of 28 LVAS patients and 28 patients with normal inner ear structure who suffered from extremely severe deafness were selected. The parameters of caloric tests, bone conduction evoked cervical vestibular-evoked myogenic potentials（cVEMP）, bone conduction evoked ocular vestibular-evoked myogenic potentials（oVEMP） and video head impulse tests（v-HIT） were compared between the two groups before and after CI. The data were analyzed using SPSS 26.0 software. Results:There was no significant difference in the results of the preoperative caloric test, v-HIT, and oVEMP（P1, N1） between the LVAS group and the control group（P>0.05）. Compared to the control group, the LVAS group exhibited a shorter cVEMP P1[（13.41±0.71）ms vs （16.28±0.89）ms, P<0.000 1], shorter N1[（19.83±0.54）ms vs （28.18±1.56）ms, P<0.000 1], higher amplitude[（123.60±83.80）μV vs （73.92±79.85）μV, P=0.049 4] and higher oVEMP amplitude[（16.60±13.87）μV vs （9.96±10.47）μV, P=0.028 5] before CI. The abnormal rate of caloric test increased in both groups after CI（25.00% vs 57.14%, P=0.028 8, 32.14% vs 82.14%, P=0.000 3, respectively）. There was no significant difference in the v-HIT parameters in both groups before and after the operation. As for the LVAS group, there was no statistically significant difference in cVEMP and oVEMP induction rates before and after operation. In the control group, there was a decrease in cVEMP induction rate（96.42% vs 64.28%, P=0.005 2） and oVEMP induction rate（96.42% vs 57.14%, P=0.000 9） after CI. LVAS group showed a shorter cVEMP P1[（13.41±0.71）ms vs （10.30±0.60）ms, P<0.000 1]; shorter cVEMP N1[（19.86±0.53）ms vs （18.97±1.33）ms, P=0.004 7]; decreased amplitude[（124.50±84.86）μV vs （64.35±61.57）μV, P=0.001 0] and shorter oVEMP amplitude[（15.92±13.03）μV vs （9.16±9.20）μV, P=0.009 9] after CI. The oVEMP N1 in the control group was longer than that before operation[（11.73 ± 0.91）ms vs （13.35 ± 2.60）ms, P=0.019 6], whereas there was no significant difference in other VEMP parameters after CI. Conclusion:Before CI, there was no significant difference in the results of the caloric test and v-HIT between the LVAS group and the control group, but the LVAS group exhibited increased sensitivity to acoustic stimulation-induced myogenic potentials. After CI, the function of the semicircular canal was impaired in both groups in the low-frequency area, and remained largely unaffected in the high-frequency area. Additionally, the function of the otolith in the LVAS group was less affected than that in the control group after CI, which may be related to the fact that the enlarged vestibular aqueduct of the LVAS patients acted as the third window of the inner ear.

PMID:39734168 | DOI:10.13201/j.issn.2096-7993.2025.01.006

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2025 Jan;39(1):14-18. doi: 10.13201/j.issn.2096-7993.2025.01.004.

ABSTRACT

Objective:To explore the feasibility of the multiple-choice auditory graphical interactive check（MAGIC） screening module in childhood hearing screening in children aged 3 to 6 years. Methods:A hearing screening was conducted on 366 children（732 ears） aged between 3 and 6 years. The screening methods included MAGIC, DPOAE, and acoustic immittance.The cooperation, screening time, pass rate, and correlation of the three screening methods were compared. Results:There was a statistically significant difference in the degree of cooperation among the three screeningmethods（P=0.004）.The MAGIC pure tone screening method was 98.6%, the screening DPOAE was 99.5%,and the acoustic immittance screening was 100%. For the screening duration, the MAGIC pure tone screening method was（116.3±59.1）s, the screening DPOAE was（27.2±19.7）s, and the acoustic impedance screening was（24.6±14.6）s. There was a significant statistical significance differences among the three or two groups（P<0.01）. The passing rates of MAGIC pure tone screening,screening DPOAE and acoustic immittance screening were 64.7%, 65.4%, and 69.3%, respectively, and there was no significant statistical difference among the three or two groups（P>0.05）. There was no significant difference between MAGIC pure tone screening method and screening DPOAE（P=0.827>0.05）, and acoustic impedance（P=0.653>0.05）, while the difference between screening DPOAE and acoustic impedance was statistically significant（P<0.01）. Conclusion:MAGIC pure sound screening method has good feasibility, can comprehensively reflect the hearing level of screened children, and can be promoted for hearing screening in children aged between 3 and 6 years.

PMID:39734166 | DOI:10.13201/j.issn.2096-7993.2025.01.004

Chin J Traumatol. 2024 Dec 22:S1008-1275(24)00175-5. doi: 10.1016/j.cjtee.2024.10.003. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the protective effect of sub-hypothermic mechanical perfusion combined with membrane lung oxygenation on ischemic hypoxic injury of yorkshire brain tissue caused by traumatic blood loss.

METHODS: This article performed a random controlled trial. Brain tissue of 7 yorkshire was selected and divided into the sub-low temperature anterograde machine perfusion group (n = 4) and the blank control group (n = 3) using the random number table method. A yorkshire model of brain tissue injury induced by traumatic blood loss was established. Firstly, the perfusion temperature and blood oxygen saturation were monitored in real-time during the perfusion process. The number of red blood cells, hemoglobin content, NA⁺, K⁺, and Ca²⁺ ions concentrations and pH of the perfusate were detected. Following perfusion, we specifically examined the parietal lobe to assess its water content. The prefrontal cortex and hippocampus were then dissected for histological evaluation, allowing us to investigate potential regional differences in tissue injury. The blank control group was sampled directly before perfusion. All statistical analyses and graphs were performed using GraphPad Prism 8.0 Student t-test. All tests were two-sided, and p value of less than 0.05 was considered to indicate statistical significance.

RESULTS: The contents of red blood cells and hemoglobin during perfusion were maintained at normal levels but more red blood cells were destroyed 3 h after the perfusion. The blood oxygen saturation of the perfusion group was maintained at 95% – 98%. NA⁺ and K⁺ concentrations were normal most of the time during perfusion but increased significantly at about 4 h. The Ca²⁺ concentration remained within the normal range at each period. Glucose levels were slightly higher than the baseline level. The pH of the perfusion solution was slightly lower at the beginning of perfusion, and then gradually increased to the normal level. The water content of brain tissue in the sub-low and docile perfusion group was 78.95% ± 0.39%, which was significantly higher than that in the control group (75.27% ± 0.55%, t = 10.49, p < 0.001), and the difference was statistically significant. Compared with the blank control group, the structure and morphology of pyramidal neurons in the Prefrontal cortex and CA1 region of the hippocampal gyrus were similar, and their integrity was better. The structural integrity of granulosa neurons was destroyed and cell edema increased in the perfusion group compared with the blank control group. Immunofluorescence staining for glail fibrillary acidic protein and Iba1, markers of glial cells, revealed well-preserved cell structures in the perfusion group. While there were indications of abnormal cellular activity, the analysis showed no significant difference in axon thickness or integrity compared to the 1-h blank control group.

CONCLUSIONS: Mild hypothermic machine perfusion can improve ischemia and hypoxia injury of yorkshire brain tissue caused by traumatic blood loss and delay the necrosis and apoptosis of yorkshire brain tissue by continuous oxygen supply, maintaining ion homeostasis and reducing tissue metabolism level.

PMID:39734147 | DOI:10.1016/j.cjtee.2024.10.003

Dent Mater. 2024 Dec 28:S0109-5641(24)00364-6. doi: 10.1016/j.dental.2024.12.011. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the self-etch bonding potential of universal adhesive systems with varying acidic compositions by analyzing the wettability properties, topographical change, and microshear bond strength (µSBS) to enamel.

METHODS: Eight universal adhesives were tested: All-Bond Universal (Bisco), Ambar Universal (FGM), Gluma Bond Universal (Kulzer), OptiBond Universal (Kerr), Peak Universal Bond (Ultradent), Prime&Bond Universal (Dentsply), Singlebond Universal (3 M ESPE), and Tetric N-Bond Universal (Ivoclar). Bovine incisors were prepared and treated with each adhesive according to the manufacturer’s instructions. The following tests were carried out: contact angle to measure the adhesives’ wetting ability; optical profilometry to evaluate the topographical changes obtained with adhesives’ application; energy dispersive X-ray spectroscopy (EDX) to quantify the removal of inorganic elements from enamel; and µSBS to verify the bonding potential of adhesives to enamel. Statistical analyzes included ANOVA, Kruskal-Wallis, Weibull analysis, Pearson correlation, and chi square test (α=0.05).

RESULTS: Significant differences were found in contact angles immediately after adhesive application and after 30 s, with Gluma Bond Universal and Tetric N-Bond Universal showing the lowest (the best wetting ability) and the highest values (the lowest wetting ability), respectively. EDX revealed varying degrees of Ca and P reduction, with Gluma Bond Universal resulting in the greatest Ca and P reduction from enamel (∼65 % and ∼62 % reduction, respectively. Topographical analysis indicated significant changes in roughness, mainly for Gluma Bond Universal. The µSBS mean values ranged from 14.7 MPa (Ambar Universal) to 26.8 MPa (Tetric N-Bond Universal). OptiBond Universal and Tetric N-Bond Universal exhibited the highest resin-enamel bonds. Weibull analysis was performed to better understand the bonding reliability of the tested adhesives, with OptiBond Universal demonstrating increased modulus and characteristic strength, performing as one of the most interesting compositions for enamel bonding. Adhesives based on carboxylic acids were more acidic than adhesives containing phosphate-based monomers (p = 0.033), and the removal of Ca and P elements from enamel was more intense with the use of adhesives based on carboxylic acids (p = 0.029). There was a strong relationship between the Sz values of adhesively treated enamel and the baseline contact angle (wettability) of adhesives (R² = -0.771; p = 0.025).

SIGNIFICANCE: The study highlights significant variability among universal adhesives in terms of their interaction with enamel. Adhesives based on GPDM (OptiBond Universal) and 10-MDP (Tetric N-Bond Universal) demonstrated the best bonding performance, suggesting they may be preferable in clinical settings where strong and reliable enamel bonds are critical. The presence of 10-MDP was not significantly associated with improved dental bonds. The present findings provide valuable information for dentists in selecting adhesives that optimize clinical outcomes in enamel substrate using the self-etching adhesive approach.

PMID:39734140 | DOI:10.1016/j.dental.2024.12.011

Vaccine. 2024 Dec 28;46:126676. doi: 10.1016/j.vaccine.2024.126676. Online ahead of print.

NO ABSTRACT

PMID:39733480 | DOI:10.1016/j.vaccine.2024.126676