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Impact of FloTrac/EV1000-guided intraoperative hemodynamic optimization on postoperative outcomes in cardiac valve surgery: a randomized controlled trial
Abstract Cardiac valve surgery is associated with significant postoperative morbidity and mortality. This study evaluated the impact of intraoperative hemodynamic optimization using FloTrac/EV1000 on postoperative outcomes in patients undergoing cardiac valve surgery. In this single-center, prospective, randomized controlled trial, 82 patients undergoing elective cardiac valve surgery were randomly allocated to either FloTrac/EV1000 management (EV1000 group, n = 42) or conventional management (Control group, n = 40). The primary outcome was ICU length of stay. Secondary outcomes included mechanical ventilation duration, hospital length of stay, vasoactive drug requirements, fluid balance, and postoperative complications. The EV1000 group had significantly shorter ICU (30.2%) and hospital (13.6%) stay ( p = 0.007 and 0.047, respectively) compared to the Control group. The EV1000 group required more vasoactive drugs during pre-bypass ( p = 0.018) but fewer before ICU transfer ( p = 0.003) and during their ICU stay ( p < 0.05). The incidence of postoperative ventricular fibrillation (0 vs. 15.0%, p = 0.011), bradycardia (11.9 vs. 35.0%, p = 0.016), atrial fibrillation with rapid ventricular response (14.3 vs. 25.0%, p = 0.032), acute respiratory distress syndrome (0 vs. 5.0%, p = 0.045), and acute kidney injury (0 vs. 5.0%, p = 0.045) was lower in the EV1000 group. Goal-directed hemodynamic management using FloTrac/EV1000 monitoring in cardiac valve surgery was associated with shorter ICU and hospital length of stay, reduced postoperative vasoactive drug requirements, and fewer postoperative complications compared with conventional management. Whether this benefit derives from the monitoring technology, the structured hemodynamic algorithm, or their combination warrants confirmation in future multicenter trials. Trial registration: NCT04292951 (The full date of first registration on https://ClinicalTrials.gov : March 1, 2020).
Hybrid evolutionary-gradient training improves long-term time series forecasting
A brain-inspired computational framework for image-based risk assessment
Hot corrosion and cyclic oxidation behavior of CoMoCrSi + Cr₃C₂ composite coatings on MDN 420 steel by HVOF spray process
An ensemble of vision and swin transformers with LLM-based explanations for sugarcane leaf disease diagnosis
Alkali metal-induced modifications in the electronic and NLO properties of triselenasumanene complexes through DFT study
A latent profile analysis of physical activity participation patterns and mental health among university students: the mediating role of emotion regulation
Prevalence and risk factors of child morbidity with spatial analysis among under five children in Bangladesh
Green silver nanoparticles of Khaya senegalensis as dual inhibitors of viral thymidine kinase and 3 C protease: metabolomics, and computational insights
Abstract To the best of our knowledge, this is the first study to evaluate green synthesized silver nanoparticles loaded Khaya senegalensis (Desr.) A. Juss. against HSV-1 and Coxsackie B4, while providing mechanistic insights through enzyme inhibition and in silico analyses. FTIR, HRTEM, UV–visible spectroscopy, particle size, and zeta potential analyses further characterized the nanoparticles, which exhibited colloidal stability (− 20.7 ± 5.26 mV), predominantly spherical morphology, and a core size of 8–38 nm by HRTEM. The larger hydrodynamic diameter observed by DLS (~ 463 nm) reflects the core plus capping biomolecules and solvation layer, consistent with effective nanoparticle stabilization. KS-AgNPs leaves showed the strongest antiviral effect against HSV-1 and Coxsackie B4, with an IC₅₀ of 99.65 ± 1.84 µg/mL. This was better than the crude leaf extract (116.26 ± 1.28 µg/mL) but less potent than the standard drug acyclovir (79.25 ± 0.14 µg/mL). Metabolomic profiling identified thirty secondary metabolites, with molecular docking and dynamics highlighting myricetin as a key antiviral compound (binding energies: −10.98 kcal/mol for thymidine kinase, − 9.42 kcal/mol for 3 C protease). Furthermore, pharmacokinetics, and ADME studies for myricetin was performed. In vitro enzyme inhibition assays confirmed suppression of thymidine kinase (IC₅₀ = 0.249 ± 0.007 µg/mL) and 3 C protease (IC₅₀ = 0.732 ± 0.028 µg/mL). The results indicate that biogenic KS-AgNPs have notable antiviral effects, and that metabolites from Khaya senegalensis may serve as potential candidates for future antiviral therapies.
CXCL12 and eotaxin are independent prognostic serum biomarkers in gastric cancer
Abstract Gastric cancer is the fifth most common cancer and the fifth leading cause of cancer-related death worldwide. Its poor prognosis primarily results from a late diagnosis and the lack of effective treatments for advanced disease. Thus, we aimed to identify new prognostic serum biomarkers to aid clinical decision-making. Our patient cohort consisted of 240 individuals who underwent surgery for histologically verified gastric adenocarcinoma in the Department of Surgery at Helsinki University Hospital between 2000 and 2009. To determine the serum protein concentrations of cytokines and growth factors, we utilized Bio-Rad’s premixed Bio-Plex Pro Human Cytokine 27- and 21-plex assay kits. Among the 48 biomarkers we analyzed, three emerged as statistically significant prognostic markers for disease-specific survival using the Cox proportional hazards univariate analysis: C-X-C motif chemokine ligand 12 (CXCL12) (hazard ratio [HR] 0.39, 95% confidence interval [CI] 0.23–0.63, p < 0.001), stem cell factor (HR 0.38, 95% CI 0.19–0.77, p = 0.007), and eotaxin (HR 0.57, 95% CI 0.37–0.89, p = 0.013). Our multivariate survival analysis revealed that, among the 48 biomarkers analyzed, CXCL12 and eotaxin served as independent prognostic markers among gastric cancer patients. The prognostic effect of inflammatory serum biomarkers in gastric cancer may provide new insights into the immunological microenvironment of disease.
Touch and manual action in chemotherapy-induced peripheral neuropathy: a mixed-methods study
Abstract Chemotherapy induced peripheral neuropathy (CIPN) is a frequent side effect of a number of chemotherapeutic agents which are widely used in the treatment of common cancers. Sensory symptoms primarily affect the fingers and toes and include numbness, tingling and pain. However, there is limited understanding of how these touch impairments may impact manipulation skills. Questionnaire and focus group methods were used to describe the experience of CIPN side effects impacting manual activities in 25 self-selected participants recruited from a cancer charity web site advertisement. Participants’ responses demonstrated varying degrees of impact of touch impairment associated with CIPN on the performance of manual activities involving bimanual, unimanual and directed touch. Examination of the components of the affected activities, together with participants’ reports of alterations in their experience of touch, were used to generate theory-informed hypotheses about why some manual tasks are more affected than others. In future research it is proposed that quantitative objective measures should be used to complement patient reported outcome measures in evaluating the mechanisms underlying issues in sensory motor control of manual activities caused by the effects of CIPN.