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Broadband shock-associated sounds modelling regarding high-area-ratio under-expanded water jets.
67, SE=0.07, p<0.001), insulin intravenous drip (B=-0.10, SE=0.05, p<0.05), and increased proportion days endocrine system involved (B=-0.25, SE=0.06, p<0.001) were each significantly associated with decreased HLOS.

Glucose dysregulation adversely affects mortality and HLOS in COVID-19. These data can help clinicians to guide patient treatment and management in COVID-19 patients.
Glucose dysregulation adversely affects mortality and HLOS in COVID-19. These data can help clinicians to guide patient treatment and management in COVID-19 patients.
This study aimed to assess the effects of vildagliptin on the prevention of cardiovascular diseases in Thai patients with type 2 diabetes mellitus using the Thai Cardiovascular Risk Score.

All patients with type 2 diabetes mellitus who used vildagliptin at a secondary hospital in Thailand were screened and recruited. The relevant variables were obtained from patient medication charts at the first visit on which the patients were prescribed vildagliptin and from the 6-month, 12-month, and 18-month post-treatment visits. The Thai Cardiovascular Risk Score was calculated and monitored as a primary outcome, whereas changes in separate cardiometabolic parameters were assessed as secondary outcomes.

Of the 321 patients screened, only 95 were recruited for the analysis. The average 10-year cardiovascular risks of patients increased from 19.65% at baseline to 20.74%, 20.69%, and 23.78% at 6, 12, and 18 months post treatment, respectively. However, a better trend of reduction in cardiovascular risk was observed in patients with a high baseline cardiovascular risk. The glucose-lowering effects of vildagliptin were significantly observed 12 months of treatment onwards, but non-significant changes were found in lipid and blood pressure levels as well as body mass index.

Vildagliptin provided a promising glucose-lowering effect in Thai patients with type 2 diabetes mellitus. However, the mean 10-year cardiovascular risk did not significantly decrease. However, a negative correlation between cardiovascular risk reduction and baseline cardiovascular risk was observed in this study. Low sample size was a major limitation of this study.
Vildagliptin provided a promising glucose-lowering effect in Thai patients with type 2 diabetes mellitus. However, the mean 10-year cardiovascular risk did not significantly decrease. However, a negative correlation between cardiovascular risk reduction and baseline cardiovascular risk was observed in this study. Low sample size was a major limitation of this study.
Witnessing the death and dying of patients is a strong, often overwhelming experience during clinical practice. It is necessary to explore how nursing students experience care for dying patients and to understand their perceptions of death and dying.

This study aimed to explore the experiences of nursing students who witness dying patients and terminal care in their clinical practice.

A qualitative study using focus group discussion methodology.

A university in Seoul, South Korea.

A total of 16 nursing students with more than 1year of clinical practice experience participated. Their median age was 21.9years (range 21-24), and all were women.

A qualitative study using three focus groups (10 juniors in two focus groups and 6 seniors in one focus group) was conducted from December 2018 to January 2019. Data were analyzed using the Colaizzi analysis method.

The analysis resulted in 26 themes, 9 theme clusters, and 3 categories. Three categories emerged 1) Experience the distance death up close; 2) Dilemma at the end of life; and 3) Strategy on a better end to life.

For nursing students, it is necessary to develop and apply internal and external reinforcement programs on providing person-centered care so that they can accept the death of others with equanimity. Nursing students, who are future nurses, should receive education covering various aspects of clinical scenarios involving dying patients and their family members.
For nursing students, it is necessary to develop and apply internal and external reinforcement programs on providing person-centered care so that they can accept the death of others with equanimity. Nursing students, who are future nurses, should receive education covering various aspects of clinical scenarios involving dying patients and their family members.ATLAS (Antimicrobial Testing Leadership and Surveillance) detects trends in multi-drug resistance longitudinally over time. In the present study, the in vitro activity of ceftazidime-avibactam and comparators was analyzed against Escherichia coli (n = 458) and Klebsiella pneumoniae (n = 455) isolates obtained from 9 centers across India. The overall susceptibility to ceftazidime-avibactam was observed to be 72% among K. pneumoniae isolates and 87% among E. coli isolates. Among the tested carbapenem resistant isolates, 51% of CR-K. pneumoniae and 24% of CR-E. coli were susceptible to ceftazidime- avibactam. OXA-48 like was identified in 52% of the K. pneumoniae isolates followed by co-production of NDM with OXA-48 like in 27%. NDM was predominantly identified in 68% of the E. coli isolates followed by OXA-48 like in 24% isolates. The findings suggest that ceftazidime- avibactam is a reasonable alternative to standard therapy for management of carbapenem resistant Enterobacterales infections particularly with K. pneumoniae and E. coli with the OXA-48 like genotype.
In a previous study, a mushroom was shown to digest milk protein to a mixture of oligopeptides and free amino acids. The aim of this study was to examine effects of this mixture, i.e., mushroom-fermented milk, on blood pressure and stroke susceptibility in the stroke-prone spontaneously hypertensive rats (SHRSP).

Rats were fed mushroom-fermented milk with or without 1 % salt water. Blood pressure was monitored either by the tail-cuff method or the telemetry system. Symptoms of stroke were examined every day to determine the stroke latency.

Mushroom-fermented milk at 120mg/Kg BW/day (estimated as a peptides/amino acids content) did not ameliorate hypertension in SHRSP. In contrast, mushroom-fermented milk significantly improved stroke susceptibility under salt-loading. The effects were replicated using milk fermented with three different mushrooms. To elucidate the effective components in mushroom-fermented milk, spermidine (3mM), one of major components of mushroom-fermented milk, and a mixture of amino acids (0.8g/L) was examined, both of which showed no significant effects on stroke susceptibility. Intake of mushroom-fermented milk did not affect sodium content significantly either in feces or in urine of the rats given 1% salt water. This observation indicated sodium absorption by the digestive system was not inhibited by intake of mushroom-fermented milk.

Despite that the mechanisms were not elucidated, intake of mushroom-fermented milk effectively prevented stroke in SHRSP. Mushroom-fermented milk would be a new candidate for a supplemental nutrient supporting the cardiovascular health.
Despite that the mechanisms were not elucidated, intake of mushroom-fermented milk effectively prevented stroke in SHRSP. Mushroom-fermented milk would be a new candidate for a supplemental nutrient supporting the cardiovascular health.
Aneurysmal subarachnoid hemorrhage (aSAH) accounts for 5% of strokes but results in significant morbidity and mortality. In addition to systemic inflammation, up to half of patients develop cardiac injury; however, the relationship between systemic inflammation and cardiac injury after aSAH is unknown. We investigated changes in leukocyte counts in relation to cardiac dysfunction MATERIALS AND METHODS We reviewed the records of consecutive patients with SAH at our large academic medical referral center. The inclusion criteria were aSAH and available cardiac troponin I (cTnI) levels within 48h of admission. The primary outcome was cardiac injury, defined as cTnI ≥0.04ng/mL (lab reference range 0.01-0.03ng/mL). We compared baseline characteristics, including serum leukocyte counts and performed univariable and multivariable logistic regression analysis to determine whether changes in leukocyte subpopulations predict cardiac injury.

Of 288 SAH patients, 250 met inclusion criteria. Of these, 116 (46.4%) had eac inflammation after aSAH drives subsequent morbidity and mortality.
Kinesio taping (KT) and proprioceptive neuromuscular facilitation (PNF) are interventions mainly used in clinical settings to improve gait after stroke. Lower-leg KT using the concept of PNF (PNF-KT) has been shown to enhance the recovery of gait speed in patients with stroke. But, the effect of PNF-KT on the ankle movement and gait parameters in stroke patients is unclear. We aimed to investigate the immediate effects of PNF-KT on ankle dorsiflexion range of motion (DF-ROM) and gait parameters in patients with stroke with foot drop.

For the A-KT condition, tape was attached to the gastrocnemius and tibialis anterior muscles, and tape for eversion was attached. In the PNF-KT condition, tape was attached to the tibialis anterior, extensor hallucis and digitorum muscles. Ankle movement was measured as the ankle DF-ROM using an iSEN system. Gait ability was assessed using the GAITRite system. The measured gait variables were gait velocity, cadence, and step length (both sides).

A-KT and PNF-KT significantly improved the ankle DF-ROM, gait velocity, cadence, and the affected- and unaffected-side step length compared to that with no taping. Moreover, PNF-KT significantly increased the ankle DF-ROM, gait velocity, cadence, and the affected- and unaffected-side step length compared to that with A-KT.

PNF-KT applied to the affect side improved ankle DF-ROM and gait parameters in hemiplegic stroke patients than no taping, A-KT. Lower-leg PNF-KT may be a useful intervention in a rehabilitation program to improve ankle DF-ROM and gait parameters in chronic stroke patients with foot drop in clinical settings.
PNF-KT applied to the affect side improved ankle DF-ROM and gait parameters in hemiplegic stroke patients than no taping, A-KT. Lower-leg PNF-KT may be a useful intervention in a rehabilitation program to improve ankle DF-ROM and gait parameters in chronic stroke patients with foot drop in clinical settings.
Although studies have demonstrated that inflammatory and lipid/ lipoproteins-related biomarkers, genetic mutations, and epigenetic mechanisms could be candidates for diagnosis and prognosis of ischemic stroke, there is still no consensus on how to identify vulnerable plaques based on circulating biomarkers.

Histological and immunohistochemical staining were performed in the aorta sections of ApoE
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and WT mice. Eighty-nine patients who underwent CTA were included in this study. The degree of carotid stenosis and the wall features of plaque components were quantitatively analyzed. And the serum concentration of FKN and PDGF-BB were measured.

(1) The type V vulnerable atherosclerotic plaques deposited on the aortas of ApoE
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mice after feeding with western diet for 16 weeks. And the expression of CX3CR1 and PDGFR-β increased in the areas of atherosclerotic plaques, especially inside the fibrous cap of plaque. (2) Patients with symptomatic carotid stenosis showed larger LNRC, smaller calcified plaques and more plaque ulceration detected by CTA than asymptomatic stenosis patients.
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