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Update in polycystic ovary syndrome.
Underwater noise pollution from shipping is globally pervasive and has a range of adverse impacts on species which depend on sound, including marine mammals, sea turtles, fish, and many invertebrates. International bodies including United Nations agencies, the Arctic Council, and the European Union are beginning to address the issue at the policy level, but better evidence is needed to map levels of underwater noise pollution and the potential benefits of management measures such as ship-quieting regulations. Crucially, corroboration of noise maps with field measurements is presently lacking, which undermines confidence in their application to policymaking. We construct a computational model of underwater noise levels in the Northeast Atlantic using Automatic Identification System (AIS) ship-tracking data, wind speed data, and other environmental parameters, and validate this model against field measurements at 4 sites in the North Sea. Overall, model predictions of the median sound level were within ±3 dB for 93% of the field measurements for one-third octave frequency bands in the range 125 Hz-5 kHz. Areas with median noise levels exceeding 120 dB re 1 μPa and 20 dB above modelled natural background sound were predicted to occur in the Dover Strait, the Norwegian trench, near to several major ports, and around offshore infrastructure sites in the North Sea. To our knowledge, this is the first study to quantitatively validate large-scale modelled noise maps with field measurements at multiple sites. Further validation will increase confidence in deeper waters and during winter months. Our results highlight areas where anthropogenic pressure from shipping noise is greatest and will inform the management of shipping noise in the Northeast Atlantic. The good agreement between measurements and model gives confidence that models of shipping noise can be used to inform future policy and management decisions to address shipping noise pollution.Background Guanxin V (GXV), a traditional herbal mixture, has been widely used in clinical practice for the treatment of coronary artery disease (CAD). This retrospective study was designed to assess the safety and effectiveness of GXV for CAD. Methods In our study, December 2006 to January 2009, 101 patients with CAD from Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine were enrolled, of whom 52 patients received GXV plus guideline-recommended medical therapy (GMT) (GXV group), 49 patients received GMT alone (GMT group). The general clinical information, traditional Chinese medicine syndrome score (TSS), the therapeutic effects, 6-minute walk test (6MWT), adverse events, echocardiography, and laboratory information were collected and analyzed pre-and post-treatment. Results We did not find differences in the information between the two groups before treatment. Patients in the GXV group had decreased TSS (P less then 0.0001) and increased therapeutic effects (P = 0.763) and 6MWT (P less then 0.0001) than those in the GMT group and there were no significant differences in safety between the two groups. Moreover, patients in the GXV group improved ejection fraction, cardiac output, and stroke volume (P = 0.2113, 0.0001, 0.0002, respectively), and dropped BNP (P = 0.3856) compared with those in the GMT group. Conclusions Superiority in the GXV group for patients with CAD was demonstrated over the GMT group for both the safety and effectiveness endpoints. This suggests that GXV is a potentially safe and effective treatment for CAD patients.Objective This article introduces SCALPEL3 (Scalable Pipeline for Health Data), a scalable open-source framework for studies involving Large Observational Databases (LODs). It focuses on scalable medical concept extraction, easy interactive analysis, and helpers for data flow analysis to accelerate studies performed on LODs. Materials and methods Inspired from web analytics, SCALPEL3 relies on distributed computing, data denormalization and columnar storage. It was compared to the existing SAS-Oracle SNDS infrastructure by performing several queries on a dataset containing a three years-long history of healthcare claims of 13.7 million patients. Results and discussion SCALPEL3 horizontal scalability allows handling large tasks quicker than the existing infrastructure while it has comparable performance when using only a few executors. SCALPEL3 provides a sharp interactive control of data processing through legible code, which helps to build studies with full reproducibility, leading to improved maintainability and audit of studies performed on LODs. Conclusion SCALPEL3 makes studies based on SNDS much easier and more scalable than the existing framework [1]. It is now used at the agency collecting SNDS data, at the French Ministry of Health and soon at the National Health Data Hub in France [2].Objective Radionuclide CSF study is a simple, effective, and low-radiation-dose procedure for the assessment of shunt patency. With the help of CT image of single-photon emission computed tomography/computed tomography (SPECT/CT), the interpretation becomes more accurate and easier.The aim of this study was to compare the classical methods and 2D planar scintigraphic images with radionuclide shuntography fused SPECT/CT. Methods Between 2015-2019 all hydrocephalic patients who underwent radionuclide shuntography and classical methods (cranial CT, USG and/or direct X-rays), for suspected VP shunt malfunction at our hospital were retrospectively enrolled in the study. Fusion with SPECT/CT is provided in all radionuclide shuntographies. Approximately 0.5-1 mCi diethylene-triaminepentaaceticacid (DTPA) was intrathecally injected. Images were collected as 5-second frames for the first minute, and 1-min frames for the second to the 30th min. Static whole body images were obtained as early (30 min) and delayed (120 min) images. SPECT/CT was performed in 120 min. Results When the classical methods were evaluated in the operated patients, according to the direct radiographic findings, in only 17 patients had shunt dysfunction due to disconnection-kinking or laceration, was obtained.On the other hand,while67 shuntography were evaluated,65 of these patients (97%) whose intraoperative and shuntography findings were found to be compatible with each other. Conclusion The 3D SPECT images combined with the two-dimensional planar images added to the CT provide more accurate information and also provide detailed anatomical information. The patient's operation was performed successfully in one session in cooperation with the other surgical branches when needed.Objectives Many infants in the neonatal intensive care unit (NICU) require prolonged periods of respiratory support. Microlaryngoscopy and bronchoscopy (MLB) is performed to evaluate for airway pathology and facilitate decision-making regarding further airway interventions or tracheostomy. The objectives of this study are to describe the operative findings of MLB performed on infants in the NICU and determine which pre-operative characteristics or operative findings are predictive of the need for tracheostomy. Methods The medical records of preterm inpatients in the NICU at a single tertiary care hospital who underwent MLB between January 1, 2013 and January 7, 2016 were reviewed. Baseline and demographic characteristics and intra-operative findings were compared between patients who underwent tracheostomy and those who were successfully weaned from respiratory support. Results Seventy-three preterm patients underwent MLB for respiratory failure, of whom 41 (56.2%) underwent tracheostomy. Patients who underwent tracheostomy had lower mean gestational age (27.4 vs. 30.5 weeks), higher prevalence of bronchopulmonary dysplasia (73.2% vs. 37.5%), lower mean birth weight (1.1 kg vs. 1.6 kg), and a greater number of extubation events (5.2 vs. 3.0) than those who weaned from respiratory support. Abnormal MLB findings were common in both groups, though no single MLB finding differed significantly between groups. Conclusions Preterm infants in the NICU with gestational age ≤30 weeks, birth weight less then 1.5 kg, severe pulmonary disease, and who have failed more than 3 extubation attempts are more likely to require tracheostomy.The life-history theory suggests that parental experience of the environment is passed to offspring, which allows them to adapt to prevailing conditions. This idea is supported from the mother's side, but to a much less extent from the father's side. Here, we investigated the effect of immunising fathers on pre- and neonatal development and on immune and neuroendocrine phenotypes of their offspring in C57BL/6J mice. Nine days before mating, fathers were intraperitoneally injected with the immunogenic protein keyhole limpet hemocyanin (KLH). SB239063 Females mated with immunised males had less pre-weaning mortality of newborns compared to those mated with control males. Although the antibody response to KLH was similar for the male offspring of control and immunised fathers, the mass indexes of their main immune organs and their androgen response differed significantly. The mass indexes of the thymus and spleen in adult male offspring of immunised fathers were higher compared with the control offspring. The plasma testosterone levels were significantly decreased after KLH administration in the male offspring of control but not of immunised fathers. This was correlated with changes in sperm average path and straight-line velocities. Finally, excitatory neurotransmitters prevailed over inhibitory ones in the amygdala of the progeny of immunised fathers, while in control offspring, the opposite occurred. This is indicative of complex behavioural changes in the offspring of immunised fathers, including sexual ones. Therefore, the paternal experience of foreign antigens modulates the immune and neuroendocrine systems of their progeny, suggesting possible survival and reproductive adaptations to parasitic pressure.Losing a spouse can increase the risk for premature mortality, and declines in immune health are thought to play a role. Most of the supporting data have come from cross-sectional studies comparing already-bereaved individuals to matched controls, which provides valuable information about health disparities between groups but does not reveal health changes over time. Moreover, the health consequences of bereavement may be unique for dementia family caregivers, a large and growing segment of the population. The current study sought to evaluate the course of health around 52 dementia spousal caregivers' bereavement by capturing lymphocyte proliferation to Con A and PHA and self-rated health before and after spousal loss. To investigate the moderating role of the social environment, we examined associations between social ties and health trajectories before and after spousal loss. Using piecewise linear mixed models to allow for turning points in caregivers' trajectories, we found that, for the average caregiver, lymphocyte proliferation to both mitogens weakened as bereavement neared and continued to decline after the loss, but at a slower pace. In tandem, perceived health degraded as bereavement approached but rebounded thereafter. Further, we found that socially isolated caregivers showed marked declines in immune responses to Con A and PHA over time both before and after bereavement, whereas their socially connected counterparts had shallower declines to PHA and maintained a level immune response to Con A. In addition, socially isolated caregivers reported poorer health before and after bereavement compared to their counterparts, whose self-rated health declined as the loss neared but later recovered to exceed prior levels. These findings shed new light on the dynamics of immune function in response to spousal bereavement after dementia caregiving longitudinal data reveal a pattern of health recovery following caregivers' loss, particularly among those with more robust social networks prior to bereavement.
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