Exploring the Relationship between Subcutaneous Fat Index and Neck Pain in Patients with Spinal Cervical Spondylosis: A Retrospective Cohort Study.

STUDY DESIGN: Retrospective Cohort Study. OBJECTIVES: This study measures the subcutaneous fat index (SFI) of the cervical spine in patients with spinal cervical spondylosis using cervical magnetic resonance imaging (MRI) and explores its relationship with neck pain in patients with spinal cervical spondylosis. METHODS: In this single-center retrospective study, 298 patients hospitalized for spinal cervical spondylosis between January and June 2021 were initially considered. After applying inclusion and exclusion criteria, 93 patients were enrolled. The cervical MRI data for these patients were analyzed using A-Site software. The SFI was measured at the median sagittal plane on T2-weighted images. Patients were categorized into two groups based on their admission complaints: those with cervical pain and those without it. Differences between these groups were then statistically analyzed. RESULTS: The mean SFIs with standard deviations for the neck and non-neck pain groups were 36.4%±7.7% and 27.0%±7.9%, respectively, with a significant difference (P<0.0001). The SFI was consistently higher across all neck segments in the neck pain group compared to the non-neck pain group (P<0.05). The two groups had no statistically significant difference in the body mass index (BMI). CONCLUSIONS: The SFI provides a more precise assessment of muscle and fat distribution in the posterior cervical region than BMI and is generally higher in patients with spinal cervical spondylosis who experience neck pain. These findings suggest the importance of early functional exercises post-surgery for potentially improving surgical outcomes in this patient population.

Low-dose, standard, and high-resolution cone beam computed tomography for alveolar bone measurements related to implant planning: An ex vivo study in human specimens.

AIM: To evaluate the performance of low-dose cone beam computed tomography (CBCT) protocols with regard to linear bone measurements in the posterior mandible for implant planning compared with higher dose protocols. MATERIALS AND METHODS: Forty-two edentulous posterior sites in human cadaveric mandibles were imaged in three CBCT scanners using three or four protocols with varying exposure parameters to achieve lower dose. Co-registration was performed to generate sagittal and cross-sectional image sections representative of the implant site. Three observers measured bone height, from the alveolar crest to the mandibular canal, and width, three mm from the top of the alveolar crest. Intra- and interobserver reproducibility were assessed for the cases rated as nonmeasurable as well as for completed measurements. The measurements were analyzed using paired t-tests for differences among the CBCT protocols and the frequency distribution of nonmeasurable cases with a Pearson Chi-square test. RESULTS: Reproducibility for registering nonmeasurable cases varied among observers; however, no consistent significant differences were found in the frequency distribution of these cases among observers, units, and protocols. Intraclass correlation coefficients (ICC) were >0.9 for all measurements of bone height and width. Mean differences of <0.5 mm were found regardless of protocol; however, one observer did in some cases produce larger differences. CONCLUSION: Linear bone measurements did not differ significantly and could be performed with excellent reliability, using low-dose CBCT protocols compared with standard and high-resolution ones. Varying approaches for rating nonmeasurable cases were found, indicating differences in diagnostic strategies related to implant planning among observers.

Influence of age, sex, bodyweight, and training on echocardiographic measurements in healthy mixed-breed donkeys.

The donkey has always been a notable working animal and its importance as a companion animal has been growing over the last few years. However, there are only a few studies about cardiology in this species. Therefore, this study aimed to evaluate the influence of age, sex, training, and bodyweight on cardiac dimension in mixed-breed donkeys. Forty-five clinically and para-clinically healthy mixed-breed donkeys were included, and B-mode and M-mode echocardiographic measurements were recorded. Multivariate linear regression analysis was performed to identify the effect of age, sex, bodyweight, and training on cardiac measurements. Most of the echocardiographic measurements showed a strong statistically significant correlation with bodyweight. Linear regression analysis between echocardiographic measurements and bodyweight was performed to obtain the values of the intercept and slope of the linear equation to calculate the echocardiographic measurements as a function of bodyweight. This is the first study reporting a strong linear correlation between echocardiographic measurements and bodyweight and reporting a correlation between training and echocardiographic parameters in donkeys, suggesting that this variable should be considered when assessing cardiac dimensions in these animals.

Exploring surface charge dynamics: implications for AFM height measurements in 2D materials.

An often observed artifact in atomic force microscopy investigations of individual monolayer flakes of 2D materials is the inaccurate height derived from topography images, often attributed to capillary or electrostatic forces. Here, we show the existence of a Joule dissipative mechanism related to charge dynamics and supplementing the dissipation due to capillary forces. This particular mechanism arises from the surface conductivity and assumes significance specially in the context of 2D materials on insulating supports. In such scenarios, the oscillating tip induces in-plane charge currents that in many circumstances constitute the main dissipative contribution to amplitude reduction and, consequently, affect the measured height. To investigate this phenomenon, we conduct measurements on monolayer flakes of co-deposited graphene oxide and reduced graphene oxide. Subsequently, we introduce a general model that elucidates our observations. This approach offers valuable insights into the dynamics of surface charges and their intricate interaction with the tip.

Tomographic three-dimensional ultrasound imaging improves spatial visualization and management of varicose veins.

Tomographic three-dimensional ultrasound using handsfree electromagnetic tracking is an important adjunct to traditional two-dimensional duplex ultrasound examination. This technique allows vascular surgeons to better orientate and visualize the often complex anatomy along the entire length of the target vein. This paper reports a novel technique in preoperative and postoperative acquisition of superficial incompetent veins, thereby providing a comprehensive three-dimensional orientation of different pathological patterns of incompetence.

Effects of a physical exercise programme on bodyweight, body condition score and chest, abdominal and thigh circumferences in dogs.

BACKGROUND: Research on the effects of physical exercise on canine body composition is limited. The aim of this study was to investigate the effects of a physical exercise programme on bodyweight, body condition score (BCS) and chest, abdominal and thigh circumferences in dogs. Twenty-one healthy dogs of different breeds exercised together with their owners during an eight-week programme consisting of jogging and strength exercises. Standardised measurements were performed in triplicates with a measuring tape on standing dogs. Chest circumference was measured at three anatomical locations, abdomen at two and thigh at one. Data on bodyweight, BCS (9-point scale) and circumferences were analysed with mixed model repeated measures analyses to evaluate changes after the programme and effects of target distance. RESULTS: Seven dog owners choose a target distance of 2 km and 14 owners choose 5-10 km. Mean BCS decreased (P = 0.007) after the programme (5.1 ± 0.9 vs. 4.7 ± 0.6) but there was no effect of target distance. Almost all chest and abdominal circumference measurements decreased (P ≤ 0.007) with the 2 km group driving the reduction in chest circumference and the 5-10 km group driving the reduction in abdominal circumference. In contrast, thigh circumference (28.8 ± 0.4 vs. 30.2 ± 0.4) increased (P = 0.007) while bodyweight was maintained. There were positive correlations between BCS and abdominal/chest ratios before and after the programme (Pearson correlation; R square ≤ 0.43, P ≤ 0.0012) but the mean ratio remained constant. CONCLUSIONS: Results indicated a redistribution between total body fat and muscle mass in body composition of normal weight to slightly overweight dogs after the physical exercise programme. The use of bodyweight alone was not a reliable evaluation method to complement the BCS assessment. However, repeated measurements of chest, abdominal and thigh circumference might aid in the assessment of body composition in dogs performing physical exercise. Further research should include a control group and objective evaluations of total body fat and lean mass, in order to investigate the effectiveness of physical exercise as a freestanding method for decreasing BCS and increasing muscle mass in overweight dogs.

Therapeutic alliance in individual adult psychotherapy: a systematic review of conceptualizations and measures for face-to-face- and online-psychotherapy.

Background: The therapeutic alliance (TA) is a robust and pantheoretical predictor of treatment outcome in Face-to-Face- (F2F-) and Online-psychotherapy (Online-PT). Many authors have proposed several conceptualizations of TA, which are oftentimes operationalized. The resulting diversity of conceptualizations and measures is presented in this review. Methods: We performed a three-parted literature search for self-report-instruments of TA in individual, voluntary F2F-PT with adults (1. utilization of past reviews, 2. systematic literature search yielding 5,205 articles, 3. reference lists). Analogously, we conducted a systematic literature search for instruments of TA in the Online-setting (yielding 200 articles). Additionally, we analyzed the content of the instruments qualitatively. Results: A current overview of 48 instruments for measuring TA (46 for F2F-PT, 2 for Online-PT) including their conceptual backgrounds, characteristics and main content aspects is presented. Most instruments (n = 24) operationalize one or more theoretical conceptualizations of TA. Other instruments are adaptation/syntheses of existing measures (n = 14), based on literature searches (n = 3) or on an empirical survey (n = 3) and two instruments provide no conceptual background information. The content of the instruments mainly focused on the following aspects: 1. Self-disclosure and authenticity; 2. Agreement; 3. Active participation, motivation and compliance; 4. Trust and secure attachment; and 5. Considering needs/abilities/wishes of the patient. Additionally, a narrative review of various approaches to conceptualize TA is presented and linked to respective corresponding instruments. Discussion: The broad variety of conceptualizations and measures of TA makes coherent research on TA difficult. There are conceptual challenges such as the role of attachment style in TA that remain to be clarified. The current conceptualizations and measures do not incorporate the practical experience and expertise of psychotherapists and patients sufficiently. A metatheoretical conceptualization and measure of TA based on an empirical survey of psychotherapists and patients could address these issues.

Utility of block-matching and 3D filter for reproducibility of lung density and denoising in low-dose chest CT: A pilot study.

PURPOSE: This study aimed to acquire an image quality consistent with that of full-dose chest computed tomography (CT) when obtaining low-dose chest CT images and to analyze the effects of block-matching and 3D (BM3D) filters on lung density measurements and noise reduction in lung parenchyma. METHODS: Using full-dose chest CT images, we evaluated lung density measurements and noise reduction in lung parenchyma images for low-dose chest CT. Three filters (median, Wiener, and the proposed BM3D) were applied to low-dose chest CT images for comparison and analysis with images from full-dose chest CT. To evaluate lung density measurements, we measured CT attenuation at the 15th percentile of the lung CT histogram. The coefficient of variation (COV) and contrast-to-noise ratio (CNR) were used to evaluate the noise level. RESULTS: The 15th percentile of the lung CT histogram showed the smallest difference between full- and low-dose CT when applying the BM3D filter, and the highest difference between full- and low-dose CT without filters (full-dose =  - 926.28 ± 0.32, BM3D =  - 926.65 ± 0.32, and low-dose =  - 959.43 ± 0.95) (p < 0.05). The COV was smallest when applying the BM3D filter, whereas the CNR was the highest (p < 0.05). CONCLUSIONS: The results of the study prove that the BM3D filter can reduce image noise while increasing the reproducibility of the lung density, even for low-dose chest CT.

Distributed Consensus Estimation for Networked Multi-Sensor Systems under Hybrid Attacks and Missing Measurements.

Cyber-security research on networked multi-sensor systems is crucial due to the vulnerability to various types of cyberattacks. For the development of effective defense measures, attention is required to gain insight into the complex characteristics and behaviors of cyber attacks from the attacker's perspective. This paper aims to tackle the problem of distributed consensus estimation for networked multi-sensor systems subject to hybrid attacks and missing measurements. To account for both random denial of service (DoS) attacks and false data injection (FDI) attacks, a hybrid attack model on the estimator-to-estimator communication channel is presented. The characteristics of missing measurements are defined by random variables that satisfy the Bernoulli distribution. Then a modified consensus-based distributed estimator, integrated with the characteristics of hybrid attacks and missing measurements, is presented. For reducing the computational complexity of the optimal distributed estimation method, a scalable suboptimal distributed consensus estimator is designed. Sufficient conditions are further provided for guaranteeing the stability of the proposed suboptimal distributed estimator. Finally, a simulation experiment on aircraft tracking is executed to validate the effectiveness and feasibility of the proposed algorithm.

Power Grids and Instrument Transformers up to 150 kHz: A Review of Literature and Standards.

The phenomenon of high-frequency distortion (HFD) in the electric grids, at both low-voltage (LV) and medium-voltage (MV) levels, is gaining increasing interest within the scientific and technical community due to its growing occurrence and the associated impact. These disturbances are mainly injected into the grid by new installed devices, essential for achieving decentralized generation based on renewable sources. In fact, these generation systems are connected to the grid through power converters, whose switching frequencies are significantly increasing, leading to a corresponding rise in the frequency of the injected disturbances. HFD represents a quite recent issue, but numerous scientific papers have been published in recent years on this topic. Furthermore, various international standards have also covered it, to provide guidance on instrumentation and related algorithms and indices for the measurement of these phenomena. When measuring HFD in MV grids, it is necessary to use instrument transformers (ITs) to scale voltages and currents to levels fitting with the input stages of power quality (PQ) instruments. In this respect, the recently released Edition 2 of the IEC 61869-1 standard extends the concept of the IT accuracy class up to 500 kHz; however, the IEC 61869 standard family provides guidelines on how to test ITs only at power frequency. This paper provides an extensive review of literature, standards, and the main outputs of European research projects focusing on HFD and ITs. This preliminary study of the state-of-the-art represents an essential starting point for defining significant waveforms to test ITs and, more generally, to achieve a comprehensive understanding of HFD. In this framework, this paper provides a summary of the most common ranges of amplitude and frequency variations of actual HFD found in real grids, the currently adopted measurement methods, and the normative open challenges to be addressed.

Cost-Effective Data Acquisition Systems for Advanced Structural Health Monitoring.

With the growing demand for infrastructure and transportation facilities, the need for advanced structural health monitoring (SHM) systems is critical. This study introduces two innovative, cost-effective, standalone, and open-source data acquisition devices designed to enhance SHM through the latest sensing technologies. The first device, termed CEDAS_acc, integrates the ADXL355 MEMS accelerometer with a RaspberryPi mini-computer, ideal for measuring strong ground motions and assessing structural modal properties during forced vibration tests and structural monitoring of mid-rise buildings. The second device, CEDAS_geo, incorporates the SM24 geophone sensor with a Raspberry Pi, designed for weak ground motion measurements, making it suitable for seismograph networks, seismological research, and early warning systems. Both devices function as acceleration/velocity Data Acquisition Systems (DAS) and standalone data loggers, featuring hardware components such as a single-board mini-computer, sensors, Analog-to-Digital Converters (ADCs), and micro-SD cards housed in protective casings. The CEDAS_acc includes a triaxial MEMS accelerometer with three ADCs, while the CEDAS_geo uses horizontal and vertical geophone elements with an ADC board. To validate these devices, rigorous tests were conducted. Offset Test, conducted by placing the sensor on a leveled flat surface in six orientations, demonstrating the accelerometer's ability to provide accurate measurements using gravity as a reference; Frequency Response Test, performed at the Gebze Technical University Earthquake and Structure Laboratory (GTU-ESL), comparing the devices' responses to the GURALP-5TDE reference sensor, with CEDAS_acc evaluated on a shaking table and CEDAS_geo's performance assessed using ambient vibration records; and Noise Test, executed in a low-noise rural area to determine the intrinsic noise of CEDAS_geo, showing its capability to capture vibrations lower than ambient noise levels. Further field tests were conducted on a 10-story reinforced concrete building in Gaziantep, Turkey, instrumented with 8 CEDAS_acc and 1 CEDAS_geo devices. The building's response to a magnitude 3.2 earthquake and ambient vibrations was analyzed, comparing results to the GURALP-5TDE reference sensors and demonstrating the devices' accuracy in capturing peak accelerations and modal frequencies with minimal deviations. The study also introduced the Record Analyzer (RECANA) web application for managing data analysis on CEDAS devices, supporting various data formats, and providing tools for filtering, calibrating, and exporting data. This comprehensive study presents valuable, practical solutions for SHM, enhancing accessibility, reliability, and efficiency in structural and seismic monitoring applications and offering robust alternatives to traditional, costlier systems.

Current Diagnostic Techniques for Pneumonia: A Scoping Review.

Community-acquired pneumonia is one of the most lethal infectious diseases, especially for infants and the elderly. Given the variety of causative agents, the accurate early detection of pneumonia is an active research area. To the best of our knowledge, scoping reviews on diagnostic techniques for pneumonia are lacking. In this scoping review, three major electronic databases were searched and the resulting research was screened. We categorized these diagnostic techniques into four classes (i.e., lab-based methods, imaging-based techniques, acoustic-based techniques, and physiological-measurement-based techniques) and summarized their recent applications. Major research has been skewed towards imaging-based techniques, especially after COVID-19. Currently, chest X-rays and blood tests are the most common tools in the clinical setting to establish a diagnosis; however, there is a need to look for safe, non-invasive, and more rapid techniques for diagnosis. Recently, some non-invasive techniques based on wearable sensors achieved reasonable diagnostic accuracy that could open a new chapter for future applications. Consequently, further research and technology development are still needed for pneumonia diagnosis using non-invasive physiological parameters to attain a better point of care for pneumonia patients.

FireSonic: Design and Implementation of an Ultrasound Sensing-Based Fire Type Identification System.

Accurate and prompt determination of fire types is essential for effective firefighting and reducing damage. However, traditional methods such as smoke detection, visual analysis, and wireless signals are not able to identify fire types. This paper introduces FireSonic, an acoustic sensing system that leverages commercial speakers and microphones to actively probe the fire using acoustic signals, effectively identifying fire types. By incorporating beamforming technology, FireSonic first enhances signal clarity and reliability, thus mitigating signal attenuation and distortion. To establish a reliable correlation between fire type and sound propagation, FireSonic quantifies the heat release rate (HRR) of flames by analyzing the relationship between fire-heated areas and sound wave propagation delays. Furthermore, the system extracts spatiotemporal features related to fire from channel measurements. The experimental results demonstrate that FireSonic attains an average fire type classification accuracy of 95.5% and a detection latency of less than 400 ms, satisfying the requirements for real-time monitoring. This system significantly enhances the formulation of targeted firefighting strategies, boosting fire response effectiveness and public safety.

The Characteristics of Long-Wave Irregularities in High-Speed Railway Vertical Curves and Method for Mitigation.

Track geometry measurements (TGMs) are a critical methodology for assessing the quality of track regularities and, thus, are essential for ensuring the safety and comfort of high-speed railway (HSR) operations. TGMs also serve as foundational datasets for engineering departments to devise daily maintenance and repair strategies. During routine maintenance, S-shaped long-wave irregularities (SLIs) were found to be present in the vertical direction from track geometry cars (TGCs) at the beginning and end of a vertical curve (VC). In this paper, we conduct a comprehensive analysis and comparison of the characteristics of these SLIs and design a long-wave filter for simulating inertial measurement systems (IMSs). This simulation experiment conclusively demonstrates that SLIs are not attributed to track geometric deformation from the design reference. Instead, imperfections in the longitudinal profile's design are what cause abrupt changes in the vehicle's acceleration, resulting in the measurement output of SLIs. Expanding upon this foundation, an additional investigation concerning the quantitative relationship between SLIs and longitudinal profiles is pursued. Finally, a method that involves the addition of a third-degree parabolic transition curve (TDPTC) or a full-wave sinusoidal transition curve (FSTC) is proposed for a smooth transition between the slope and the circular curve, designed to eliminate the abrupt changes in vertical acceleration and to mitigate SLIs. The correctness and effectiveness of this method are validated through filtering simulation experiments. These experiments indicate that the proposed method not only eliminates abrupt changes in vertical acceleration, but also significantly mitigates SLIs.

Open-fitting hearing aids: a comparative analysis between open behind-the-ear and open completely-in-the-canal instant-fit devices.

PURPOSE: Our study aims to assess the open-fitting capabilities and vent properties of traditional open-fitting behind-the-ear (open BTE) hearing aids to instant-fit open-fitting completely-in-the-canal (open CIC) systems. METHODS: The study analysed data from 40 patients grouped in two groups based on the used hearing aids. Free field pure tone and speech audiometry were performed to obtain the free-field pure tone average and free-field word recognition score (WRS). The matrix sentence test was employed to evaluate the auditory performance and functional outcomes of patients. The Satisfaction with Amplification in Daily Life (SADL) and the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire were used to assess the personal satisfaction and benefit provided by the hearing aid. Real ear measurements were conducted to objectively evaluate the Real-Ear Unaided Gain (REUG) and Real-Ear Occluded Gain (REOG) of the two groups. For this purpose, six frequency bands (band 1 from 125 to 200 Hz, band 2 from 250 to 400 Hz, band 3 from 500 to 800 Hz, band 4 from 1000 to 1600 Hz, band 5 from 2000 to 3150 Hz, and band 6 from 4000 to 6300 Hz) were defined and compared. RESULTS: Free-field WRS exhibited a significant difference (p-value = 0.004) between open BTE and open CIC, with better results for the open BTE. Matrix test speech reception threshold scores did not differ significantly between groups. No statistical significant difference were observed between APHAB and SADL total scores. Correlation tests revealed a negative correlation between SRT and APHAB scores in the open BTE group, not seen in the open CIC. No statistically significant difference was observed for all bands of REUG values, demonstrating comparability in terms of acoustic resonance of the external auditory canal. Comparing the REOG recorded in the two groups a significant difference was observed for bands 2 through 6. While the average REOG values for bands 5 and 6 were higher in patients with traditional open BTE aids, in contrast, for bands 2, 3, and 4, the REOG values for the open CIC group were higher and statistically significant compared to patients wearing traditional open-fitting BTE hearing aids. CONCLUSION: Patients with open CIC seem to perform worse in quiet environments compared to noisy ones, as indicated by the free field WRS score. However, the absence of differences in functional performance assessed with the matrix sentence test, and in the psychosocial aspects, makes these devices a good solution for individuals who reject hearing aids due to aesthetic concerns. The differences in terms of real ear measurements, while statistically significant, do not negatively impact overall performance.

Modelling the nicotine pharmacokinetic profile for e-cigarettes using real time monitoring of consumers' physiological measurements and mouth level exposure.

Pharmacokinetic (PK) studies can provide essential information on abuse liability of nicotine and tobacco products but are intrusive and must be conducted in a clinical environment. The objective of the study was to explore whether changes in plasma nicotine levels following use of an e-cigarette can be predicted from real time monitoring of physiological parameters and mouth level exposure (MLE) to nicotine before, during, and after e-cigarette vaping, using wearable devices. Such an approach would allow an -effective pre-screening process, reducing the number of clinical studies, reducing the number of products to be tested and the number of blood draws required in a clinical PK study Establishing such a prediction model might facilitate the longitudinal collection of data on product use and nicotine expression among consumers using nicotine products in their normal environments, thereby reducing the need for intrusive clinical studies while generating PK data related to product use in the real world.An exploratory machine learning model was developed to predict changes in plasma nicotine levels following the use of an e-cigarette; from real time monitoring of physiological parameters and MLE to nicotine before, during, and after e-cigarette vaping. This preliminary study identified key parameters, such as heart rate (HR), heart rate variability (HRV), and physiological stress (PS) that may act as predictors for an individual's plasma nicotine response (PK curve). Relative to baseline measurements (per participant), HR showed a significant increase for nicotine containing e-liquids and was consistent across sessions (intra-participant). Imputing missing values and training the model on all data resulted in 57% improvement from the original'learning' data and achieved a median validation R2 of 0.70.The study is in its exploratory phase, with limitations including a small and non-diverse sample size and reliance on data from a single e-cigarette product. These findings necessitate further research for validation and to enhance the model's generalisability and applicability in real-world settings. This study serves as a foundational step towards developing non-intrusive PK models for nicotine product use.

Validation of a new sampler for radon gas measurements in surface water.

Radon gas (Rn-222) in water poses health risks due to radiation exposure, yet it's also an important tracer for studying natural systems. Sampling procedures for Rn-222 analysis are very sensitive to potential losses of the gas to the atmosphere. It requires a well-defined and properly validated protocol to ensure accuracy and reliability. A novel sampler was developed to collect surface water from a distance (e.g. from bridges), addressing logistic challenges posed by topography. The sampler, manually operated, ensures precise depth-specific sampling throughout the water column. A three-stage validation process (technical performance test, uncertainty estimations and preliminary test) was followed to validate the protocol.•The comparison of the technical procedure for analysis and measurement through Liquid Scintillation Counting is statistically robust (one-way ANOVA p-value = 0.96).•For the protocol proposed for Rn-222 determination, the estimated sampling and measurement uncertainties (k = 2) are respectively 5% and 15%. These are compatible with the literature and the laboratory's precision.•Preliminary tests, with meaningful patterns identified and possibly related to the river's hydrodynamics, revealed a very reliable protocol, even in low Rn-222 concentrations.Therefore, the sampler has demonstrated a good analytical reproducibility and was considered validated for Rn-222 determination in surface waters.

[Inter-arm blood pressure difference: Consecutive versus simultaneous measurements in treated and controlled hypertense patients]. / Diferencia de presión arterial entre brazos: mediciones consecutivas versus simultáneas en pacientes hipertensos tratados y controlados.

The inter-arm difference (IAD) of systolic blood pressure (SBP) is associated with higher cardiovascular risk. We compared simultaneous and consecutive recordings in measuring IAD of SBP, and evaluated reproducibility between visits. 143 hypertensive patients (63.8±9.5 years, 51.7% women) treated and controlled with stable antihypertensive medication for a period of ≥3 months were included. Blood pressure (BP) in both arms was measured simultaneously and consecutively with an automatic oscillometric device, in two visits. The IAD of the simultaneous SBP was significantly lower compared to the consecutive one, both in the first (3.51±4.1 vs. 4.40±3.7mmHg; P<.01) and in the second visit (3.62±3.5 vs. 5.69±5.1mmHg; P<.001). When the IAD of SBP was categorized as ≥10 or <10mmHg, the reproducibility between visits was insignificant in both simultaneous measurements and consecutive measurements. The frequency of initial dominance was similar between the left and right arm in simultaneous ones (46.2 vs. 43.3%), and greater in the right arm in consecutive ones (55.2 vs. 38.5). The persistence of dominance between both visits was significantly higher when SBP was measured simultaneously (54.4% vs. 45.5%; P<.01). Our study shows that to define the arm with the highest BP, simultaneous measurements are preferable. In treated and controlled hypertensive patients, the poor persistence of initial dominance between visits requires us to review the recommendation of recording, during follow-up, the BP in the arm where it was highest on the first visit.

Early predictive value of ultrasound measurements of rectus femoris cross-sectional area to diagnose ICU-acquired weakness in patients undergoing invasive mechanical ventilation: a prospective cohort study.

BACKGROUND: The diagnosis of ICU-acquired weakness (ICUAW) may be delayed due to the complexity of critically ill patients. This study aimed to investigate the value of ultrasound measurements of rectus femoris cross-sectional area (RFCSA) in predicting ICUAW in patients undergoing invasive mechanical ventilation. METHODS: This was a prospective cohort study of patients undergoing mechanical ventilation for at least 48 h. RFCSA was measured using ultrasound in patients upon ICU admission and followed until discharge. Using the Medical Research Council score as the gold standard, we evaluated the diagnostic value of ultrasound measurements in predicting ICUAW. Kaplan-Meier curves were constructed to evaluate and compare the length of ICU stay and duration of invasive mechanical ventilation between patients with and without ICUAW. RESULTS: Among the 76 patients, 34 (44.7%) were diagnosed with ICUAW using the Medical Research Council score as the gold standard. The RFCSA atrophy rate between day 1 and day 3 was significantly higher in the ICUAW group (7.9 ± 2.8% vs. 4.3 ± 2.1%, p < 0.001). By utilizing a cutoff point of 6.9%, we discovered that the RFCSA atrophy rate exhibited excellent diagnostic accuracy in predicting ICUAW, with a sensitivity of 76.5% and specificity of 92.9%. In ICUAW patients diagnosed based on an RFCSA atrophy rate, the proportion of patients with an ICU stay longer than 14 days was 42.9%, which was significantly higher compared to 22.9% in the non-ICUAW group (HR: 1.768; 95% CI 1.128-2.772; p = 0.006). Similarly, the proportion of patients continuing mechanical ventilation at 14 days was 28.6% versus 4.2% between the two groups (HR: 1.988; 95% CI 1.266-3.120; p < 0.001). CONCLUSION: Ultrasound measurements of RFCSA provide a reliable method for diagnosing ICUAW and indicating prognosis in patients undergoing invasive mechanical ventilation.

Phenotypic Characterization of the Martina Franca Donkey: An Endangered Italian Donkey Breed.

The Martina Franca (MF) donkey breed (Equus asinus) primarily inhabits the rural areas surrounding the homonymous municipality, as well as neighboring municipalities in the provinces of Bari and Brindisi, all located in the Apulia region of Italy. The objective of this study was to assess the current phenotype through the evaluation of 27 morphologic measurements. The study was conducted on 73 female and 18 male breeding animals from eight different herds located in central and southern Italy. Statistical analysis was performed in order to demonstrate statistical differences between males and females, as well as sexual dimorphism and uniformity of all measurements in both genders. The results demonstrated that the mean of three parameters used for the evaluation of an MF donkey (height at withers, circumference of thorax, and shin circumference) are highly representative of the population, with minimal dispersion Cv^ = 0.05-0.06 up to a maximum of 10%, as evidenced by relatively low standard deviations across observed measurements in both genders. Regarding sexual dimorphism, a statistically significant difference was found between males and females. This dimorphism is linked to reproductive activity and is useful during gestation. Overall, our findings suggest that the MF donkey phenotype has been largely preserved over time with high uniformity in males, slight inhomogeneity in the female population, and less variability in both genders.