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Endoplasmic reticulum unfolded protein reaction modulates the adaptation of Trachemys scripta elegans inside salinity drinking water.
Age, year of arrest, cardiac rhythm, and the presence of a potentially reversible etiology including myocardial infarction and pulmonary embolism, were predictive of ECLS utilization. Among patients placed on ECLS, age, rhythm at arrest, and location of arrest were predictive of survival to discharge. CONCLUSIONS Mortality after cardiac arrest for those on ECLS has substantially decreased. Younger age, shockable rhythm, and out-of-hospital arrest location were predictive of survival or utilization. As ECLS use increases, it is critical to define selection criteria that maximize the benefits of ECLS. AIM In this study, we investigate the impact of bystander relation and medical training on survival to hospital discharge in out-of-hospital cardiac arrest (OHCA) patients receiving bystander cardiopulmonary resuscitation (CPR). METHODS A retrospective analysis was performed on non-traumatic OHCA patients receiving bystander CPR and Emergency Medical Service (EMS) attempted resuscitation from 2015 through 2017. Adjusted logistic regression was used to assess the association between related versus unrelated and layperson versus medically trained bystander CPR providers and survival to hospital discharge. RESULTS A total of 4464 OHCA were eligible for inclusion, of which 2385 (53.4%) received CPR from a relative, 468 (10.5%) from a work colleague or friend and 1611 (36.1%) from a stranger. Layperson's provided CPR in 3703 (83.0%) OHCA and medically trained professionals in 761 (17.0%). After adjustment for arrest characteristics, there was no difference in survival to hospital discharge between related versus unrelated CPR (adjusted odds ratio [AOR] 0.92, 95% confidence interval [CI] 0.68-1.23, p = 0.555). However, bystander CPR by a medically trained provider rather than a layperson, was associated with an increase in the odds of survival by 47% (AOR 1.47, 95% CI 1.09-2.00, p = 0.012) in the overall population and 73% (AOR 1.73, 95% CI 1.21-2.49; p = 0.003) in patients with an initial shockable arrest. Adjusting for public access defibrillation significantly attenuated the effect of medically trained bystander CPR in initial shockable arrests (AOR 1.42, 95% CI 0.97-2.07; p = 0.073). CONCLUSION This study supports ongoing efforts to crowdsource a larger number of first responders with medical training to OHCA patients to assist with the provision of CPR and early defibrillation. V.BACKGROUND The prognosis for cardiac arrest (CA) is associated with the degree of cerebral ischemia. We investigated the relationship between the wavelet coherence of cerebral oxyhemoglobin (HbO2) among different channels and outcomes after CA. Moreover, we aimed to develop a prognostication method after CA. METHODS Eighty-three post-resuscitation patients were included. The HbO2 data were collected during the post-resuscitation period (median day, 1) using functional near-infrared spectroscopy. The coherence between sections of prefrontal HbO2 oscillations in five frequency intervals (I, 0.6-2 Hz; II, 0.15-0.6 Hz; III, 0.05-0.15 Hz; IV, 0.02-0.05 Hz; and V, 0.0095-0.02 Hz) were analyzed. We evaluated the outcomes using cerebral performance category (CPC) scores (good outcome, CPC ≤ 2 and poor outcome, CPC ≥ 3) at 3 months after CA. Additionally, the predictive method was developed using the biomarker and coherence value after CA. RESULTS Among the included patients, 19 patients (22.9%) had a good outcome. Poor outcome group had significantly lower phase coherence in the myogenic frequency interval III compared to good outcome group (0.36 ± 0.14 vs. 0.54 ± 0.18, P  less then  0.001). The predictive method using neuron-specific enolase (NSE) and interval III value demonstrated good discrimination (area under the curve 0.919; 95% confidence interval, 0.850-0.989). CONCLUSIONS The predictive method using NSE and phase coherence of HbO2 in the interval III from the vascular smooth muscle cells could be a useful tool for prognosticating after CA. This suggests that evaluating cerebral ischemia using phase coherence of HbO2 might be a helpful outcome predictor following CA. AIM The Good Outcome Following Attempted Resuscitation (GO-FAR) score is useful for identifying patients post-arrest with very poor neurologic outcomes and may thus be utilized when counseling family members on do-not-attempt-resuscitation (DNAR) order. We validated the GO-FAR score for neurologically intact survival in patients with in-hospital cardiac arrest (IHCA) in an East Asian country in which DNAR order not common. METHODS Retrospective study about patients who experienced IHCA from 2013 to 2017 with a primary outcome of neurologically intact survival, defined as a CPC score 1 or 2 at discharge. GO-FAR score categorizes the patients into 4 groups a very low (15%) likelihood of neurologically intact survival. RESULTS Of the 1011 included patients, the rates of survival discharge and neurologically intact survival at discharge were 25.4% and 16.0%, respectively. The area under the receiver operating characteristics curve of GO-FAR score for good neurological outcome was 0.81 (95% CI, 0.78-0.84). Patients with low or very low probability of survival had a likelihood of 0.9% (95% CI, 0.0-2.0), but for those under 40 years old, it was increased to 4.2% (95% CI, 0.0-12.2). Patients with average or above-average probabilities had likelihoods of of 18.5% (95% CI, 15.3-21.6) and 50.5% (95% CI, 40.6-60.5), respectively. Delamanid CONCLUSIONS The GO-FAR score well-predicted the neurologically intact survival of East Asian patients with IHCA. This tool may be used as part of a shared decision regarding DNAR orders. AIM Flow disruptions (FDs) are deviations from the progression of care that compromise safety and efficiency of a specific process. The study aim was to identify the impact of FDs during neonatal resuscitation and determine their association with key process and outcome measures. METHODS Prospective observational study of video recorded delivery room resuscitations of neonates less then 32 weeks gestational age. FDs were classified using an adaptation of Wiegmann's FD tool. The primary outcome was target oxygenation saturation achievement at 5 min. Secondary outcomes included achieving target saturation at 10 min, time to positive pressure ventilation for initially apnoeic/bradycardic neonates, time to electrocardiogram signal, time to pulse oximetry signal, and time to stable airway. Multivariable logistic regression assessed association between FDs and achieving target saturations adjusting for gestational age and leader. Associations between FDs and time to event outcomes were assessed using Cox proportional hazards models. RESULTS Between 10/2017-7/2018, 32 videos were included. A mean of 52.6 FDs (standard deviation 17.9) occurred per resuscitation. Extraneous FDs were the most common FDs. FDs were associated with an adjusted odds ratio of 0.92 (95% confidence interval [CI] 0.80-1.05) of achieving target saturation at 5 min and 0.94 (95% CI 0.84-1.05) at 10 min. There was no significant evidence to show FDs were associated with time to event outcomes. CONCLUSIONS FDs occurred frequently during neonatal resuscitation. Measuring FDs is a feasible method to assess the impact of human factors in the delivery room and identify modifiable factors and practices to improve patient care. OBJECTIVES To investigate the prevalence of various electrocardiographic (ECG) abnormalities among HIV-positive and HIV-negative individuals. METHODS This cross-sectional evaluation included 1412 HIV-positive and 2824 HIV-negative participants aged 18-75 years and frequency-matched by age and sex, derived from the baseline survey of Comparative HIV and Aging Research in Taizhou (CHART), China between February and December 2017. RESULTS HIV-positive individuals had higher prevalence of sinus tachycardia (5.6% [79/1412] vs 1.3% [36/2824], p1.00 mm aOR 2.18, 95%CI 1.39-3.42), whereas being in higher blood pressure categories were significantly associated with both sinus tachycardia (prehypertension aOR 5.61, 95%CI 1.76-17.91; hypertension aOR 12.62, 95%CI 3.60-44.27) and ST/T abnormalities (hypertension aOR 2.04, 95%CI 1.41-2.95) in HIV-negative individuals only. Longer duration of known HIV infection was the only HIV-specific factor of ST/T abnormalities (aOR 1.61, 95%CI 1.17-2.22), none was for sinus tachycardia. CONCLUSIONS HIV infection is independently associated with sinus tachycardia and ST/T abnormalities. Further research is needed to investigate specific mechanisms by which HIV infection leads to ECG abnormalities and evaluate whether inclusion of ECG parameters improve CVD prediction. Integrating ECG screening into routine HIV care is recommended in China. The sodium-glucose cotransporter 2 (SGLT2) inhibitors are a new class of effective drugs managing patients, who suffer from type 2 diabetes (T2D) Landmark clinical trials including EMPA-REG, CANVAS and Declare-TIMI have demonstrated that SGLT2 inhibitors reduce cardiovascular mortality and re-hospitalization for heart failure (HF) in patients with T2D. It is well established that there is a strong independent relationship among infarct size measured within 1 month after reperfusion and all-cause death and hospitalization for HF The fact that cardiovascular mortality was significantly reduced with the SGLT2 inhibitors, fuels the assumption that this class of therapies may attenuate myocardial infarct size. Experimental evidence demonstrates that SGLT2 inhibitors exert cardioprotective effects in animal models of acute myocardial infarction through improved function during the ischemic episode, reduction of infarct size and a subsequent attenuation of heart failure development. The aim of the present review is to outline the current state of preclinical research in terms of myocardial ischemia/reperfusion injury (I/R) and infarct size for clinically available SGLT2 inhibitors and summarize some of the proposed mechanisms of action (lowering intracellular Na+ and Ca2+, NHE inhibition, STAT3 and AMPK activation, CamKII inhibition, reduced inflammation and oxidative stress) that may contribute to the unexpected beneficial cardiovascular effects of this class of compounds. OBJECTIVES To evaluate the influence of boric acid (BA) on various aspects of the human periodontal ligament stem cells (hPDLSCs), including proliferation, migration, and adhesion. METHODS BA was prepared at increasing concentrations of 0.5%, 0.75%, 1%, 1.5%, 3%, and 6%, and an [3-(4,5-dimethylthiazol-2-YL)-2,5-diphenyl] (MTT) assay was used to determine the non-toxic concentrations of BA on hPDLSCs. The appropriate concentrations of BA were applied in subsequent experiments to evaluate its effect on three particular aspects of hPDLSCs proliferation, migration, and adhesion. The proliferation of hPDLSCs was determined with a hemocytometer. The migration of hPDLSCs was evaluated using a scratch assay, followed by analysis of the recorded digital images using the Image-Analysis J 1.51j8 software. The adhesion of hPDLSCs to sterilized root surfaces that retained or lacked a cementum was assessed using the MTT assay. RESULTS Non-toxic concentrations of BA against hPDLSCs were 0.5% and 0.75%, allowing a relative growth rate of greater than 75%.
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