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Background: Alcohol septal ablation (ASA) is recommended for moderate to severe symptomatic patients with hypertrophic obstructive cardiomyopathy. The current guidelines don not recommend particular alcohol doses and the amount of alcohol injected into the septal artery is based more on the interventionalist's decision rather than on systematic evidence. Our objective is to execute a comprehensive assessment of the efficacy and safety of low alcohol doses (1–2 ml)) in comparison to large ones (2–4 ml). Methods: Multiple databases, encompassing PubMed, WOS, Scopus, Embase, and Cochrane library were systemically assessed from inception to October 2023. Randomized controlled trials (RCTs) and observational studies comparing low-alcohol and high-alcohol dose in patients with HOCM was included. The main outcome was creatine kinase-MB (CK-MB). The secondary ones are septal thickness, left ventricular outflow pressure gradient, and atrioventricular (AV) block. Results: Eight studies, with a total of 1446 individuals, were finally involved in our investigation. low alcohol doses showed lower CK-MB levels relative to high ones (MD=-0.93, 95% CI [-1.15 to -0.72], P = 0.00001). Furthermore, in terms of septal thickness, left ventricular outflow pressure gradient, and AV block, neither of the two doses was preferred. Conclusion: We propose that the low alcohol dose is equally effective as the high dose. moreover, the low alcohol dose was associated with a lower CK-MB levels in comparison to the high one. PROSPERO registration: CRD42024511537 [ABSTRACT FROM AUTHOR]

Purpose: Necrotizing fasciitis (NF) is a rare, but rapidly progressing bacterial infection of the subcutaneous tissues and muscular fascia with high rates of morbidity and mortality. Our study aims to determine if socioeconomic status (SES) is a predictor of outcomes in NF. Methods: A retrospective review was conducted of patients diagnosed with NF at our institution. Demographic information, insurance status, medical and surgical history, vitals, ASA score, blood laboratory values, surgical procedure information, and outcomes prior to patient discharge were collected. Patient zip codes were utilized to obtain median household incomes at the time of the patient's surgical procedure to determine SES. Patients without complete data in their medical record were excluded. Initial descriptive statistics and logistic regression models were performed. Results: We identified 196 patients (mean age 50.13 ± 13.03 years, 31.6% female) for inclusion. Mortality rate was 15.3% (n = 30) and 33.7% (n = 66) underwent amputation. Mortality rate was not significantly different across income brackets. Lower income brackets had higher rates of amputation than higher income brackets (p < 0.05). A logistic regression models showed the rate of amputation decreases by 29% for every $10,000 increment in median household income and ASA score decreased by 0.15 units for every $10,000 increase in median household income. Conclusions: Amputation rates in cases of NF are significantly higher in lower SES groups than higher SES groups. Patients with perivascular disease in lower SES groups were more likely to experience serious complications of NF than their counterparts in higher SES groups. [ABSTRACT FROM AUTHOR]

The article presents the results of the study on the influence of FDM 3D printing parameters on the compressive behavior of test specimens made of ASA. In this context, 45 ASA test specimens, made by FDM on the Anycubic 4 Max Pro 2.0 printer, with height of the layer applied in one pass Lh equal to 0.10, 0.15, and 0.20 mm and filling percentage Id equal to 50, 75, and 100%, were compressive tested on a Barrus White 20 kN universal testing machine. The two considered variable parameters influence the compression resistance of the ASA parts, with the influence of Id being greater by 96.89% compared to the influence of Lh. It was measured that by increasing the filling percentage from 50% to 75%, the compressive strength increases by 38.10 - 39.31%, and by increasing the filling percentage from 75% to 100%, the compressive strength increases by 27.74 - 30.82%. [ABSTRACT FROM AUTHOR]

The role of acetylsalicylic acid in secondary cardiovascular prevention is established. However, its role in primary prevention is much more controversial. In this review, we analyzed meta-analyses and trials regarding aspirin in primary prevention and, consequently, hemorrhagic risk related to anti-platelet therapy. Several factors have been considered (e.g., sex, comorbidities, bleeding risk factors, concomitant drugs, weight, age), aspirin's pharmacokinetics included. In the end, we tried to individualize anti-aggregation therapy based on the risk/benefit ratio of every single subject. In conclusion, high-cardiovascular-risk subjects must be treated with acetylsalicylic acid in primary prevention according to their bleeding risk. For better cardiovascular stratification, other tools to detect risk modifier factors should be used (e.g., instrumental evaluations). [ABSTRACT FROM AUTHOR]

Abstract Background Alcohol septal ablation (ASA) is recommended for moderate to severe symptomatic patients with hypertrophic obstructive cardiomyopathy. The current guidelines don not recommend particular alcohol doses and the amount of alcohol injected into the septal artery is based more on the interventionalist’s decision rather than on systematic evidence. Our objective is to execute a comprehensive assessment of the efficacy and safety of low alcohol doses (1–2 ml)) in comparison to large ones (2–4 ml). Methods Multiple databases, encompassing PubMed, WOS, Scopus, Embase, and Cochrane library were systemically assessed from inception to October 2023. Randomized controlled trials (RCTs) and observational studies comparing low-alcohol and high-alcohol dose in patients with HOCM was included. The main outcome was creatine kinase-MB (CK-MB). The secondary ones are septal thickness, left ventricular outflow pressure gradient, and atrioventricular (AV) block. Results Eight studies, with a total of 1446 individuals, were finally involved in our investigation. low alcohol doses showed lower CK-MB levels relative to high ones (MD=-0.93, 95% CI [-1.15 to -0.72], P = 0.00001). Furthermore, in terms of septal thickness, left ventricular outflow pressure gradient, and AV block, neither of the two doses was preferred. Conclusion We propose that the low alcohol dose is equally effective as the high dose. moreover, the low alcohol dose was associated with a lower CK-MB levels in comparison to the high one. PROSPERO registration CRD42024511537

Royal illness and disability recur as motifs within the accounts of the Davidic monarchs provided in the books of Samuel and Kings. Recent work done on the intersection of disability studies and the Hebrew Bible provides a framework for tracing this motif throughout the history of the southern kingdom in 1 and 2 Kings. Under this framework, kings who are identified as acting righteously in the eyes of YHWH like their father David—Asa, Azariah, and Hezekiah—are kings who experience royal illness and disability. This paper considers how these instances of royal illness and disability informs the ideal for ancient Israel and Judah’s monarchs.

Background. As of today, there are no protocols for managing surgical patients with comorbidities. Therefore, the issue of perioperative management of high-risk surgical patients is very relevant, holds significant importance for practical medicine, and requires further study. One of the most popular tools for perioperative risk stratification remains the American Society of Anesthesiologists (ASA) classification. The purpose of the study was to assess the impact of the severity of surgical disease and the extent of surgery on the prognostic ability of the ASA assessment. Materials and methods. The retrospective study included 240 patients with ASA II, divided into 2 groups based on the extent of surgical intervention. Results. Correlation analysis revealed a strong positive linear relationship (r = 0.89, p < 0.001) between the duration of stay in the intensive care unit, the frequency of recurrent admissions to the intensive care unit within the same hospitalization, mortality, the total duration of hospitalization and the extent of surgical intervention. Furthermore, a strong positive correlation (r = 0.82, p < 0.001) was found between the severity of systemic disease spread and the extent of surgical intervention. A moderate positive correlation (r = 0.54, p < 0.001) was observed between the duration of surgical intervention and postoperative complications such as thromboembolism, anastomotic insufficiency, bronchopulmonary, urinary tract infection, as well as a strong positive linear relationship with postoperative wound infection. Conclusions. The frequency, nature of postoperative complications, and duration of hospitalization were significantly influenced by the severity of surgical pathology and the extent of surgical intervention. The ASA classification is a subjective tool for assessing mortality and has inadequate prognostic ability regarding the frequency of postoperative complications.

Cranial operations are associated with a high risk of postoperative intracranial hemorrhage (pICH) and venous thromboembolic events, along with increased mortality and morbidity. With the use of acetylsalicylic acid (ASA) for prophylaxis becoming more prevalent, the risk of bleeding when ASA is administered preoperatively is unknown, as are the effects of discontinuation upon the occurrence of thromboembolic events, especially in societies with aging demographics. To address these questions, a retrospective analysis was performed using medical records and radiological images of 1862 patients subjected to brain tumor surgery over a decade in our department. The risk of pICH was compared in patients with metastases receiving ASA treatment versus patients not receiving ASA treatment. The occurrence of venous thromboembolic events after surgery was also evaluated. The study group consisted of 365 patients with different types of brain metastases. In total, 20 patients suffered pICH and 7 of these were associated with clinical neurological deterioration postoperatively. Of the 58 patients who took ASA preoperatively, 2 patients experienced pICH, compared with 5 patients in the non-ASA impact group (p = 0.120). Patients who took ASA were not at significantly higher risk of pICH and therefore a worse outcome compared to the group without ASA. Therefore, these data suggest that in patients at high cardiovascular risk, ASA can be safely continued during elective brain tumor surgery.

Abstract Background Salt is an important factor that affects crop productivity. Plant hexokinases (HXKs) are key enzymes in the glycolytic pathway and sugar signaling transduction pathways of plants. In previous studies, we identified and confirmed the roles of GmHXK2 in salt tolerance. Results In this study, we analyzed the tissue-specific expression of GmHXK2 at different growth stages throughout the plant’s life cycle. The results showed that GmHXK2 was expressed significantly in all tissues at vegetative stages, including germination and seedling. However, no expression was detected in the pods, and there was little expression in flowers during the later mature period. Arabidopsis plants overexpressing the GmHXK2 (OE) had more lateral roots. The OE seedlings also produced higher levels of auxin and ascorbic acid (AsA). Additionally, the expression levels of genes PMM, YUC4/YUC6/YUC8, and PIN/LAX1,LAX3, which are involved respectively in the synthesis of AsA and auxin, as well as polar auxin transport, were upregulated in OE plants. This upregulation occurred specifically under exogenous glucose treatment. AtHKT1, AtSOS1, and AtNHX1 were up-regulated in OE plants under salt stress, suggesting that GmHXK2 may modulate salt tolerance by maintaining ion balance within the cells and alleviating damage caused by salt stress. Additionally, we further confirmed the interaction between GmHXK2 and the protein GmPMM through yeast two-hybridization and bimolecular fluorescence complementation assays, respectively. Conclusion The expression of GmHXK2 gene in plants is organ-specific and developmental stage specific. GmHXK2 not only regulates the synthesis of AsA and the synthesis and distribution of auxin, but also promotes root elongation and induces lateral root formation, potentially enhancing soil water absorption. This study reveals the crosstalk between sugar signaling and hormone signaling in plants, where GmHXK2 acts as a glucose sensor through its interaction with GmPMM, and sheds light on the molecular mechanism by which GmHXK2 gene is involved in salt tolerance in plants.

The article presents the results of the technical–economical study regarding the optimization of fused deposition modeling (FDM) parameters (the height of the layer deposited in one pass—Lh and the filling percentage—Id) for the manufacture of Polyethylene Terephthalate Glycol (PETG) and Acrylonitrile Styrene Acrylate (ASA) parts. To carry out this technical–economical study, was used the fundamental principle of value analysis, which consists of maximizing the ratio between Vi and Cp, where Vi represents the mechanical characteristic, and Cp represents the production cost. The results of the study show that for tensile specimens made of PETG, the parameter that significantly influences the results of the Vi/Cp ratios is the height of the layer deposited in one pass, (Lh), and in the case of the compression specimens made of PETG, the parameter that significantly influences the results of the Vi/Cp ratios is filling percentage (Id). In the case of specimens manufactured via FDM from ASA, the parameter that decisively influences the results of the Vi/Cp ratios of the tensile and compression specimens is the filling percentage (Id). By performing optimization of the process parameters with multiple responses, we identified the optimal parameters for FDM manufacturing of parts from PETG and ASA: the height of the layer deposited in one pass, Lh = 0.20 mm, and the filling percentage, Id = 100%. [ABSTRACT FROM AUTHOR]

Background: In routine medical practice, patients are increasingly using ASA for primary and secondary prevention. Although many of these patients discontinue ASA prior to elective intracranial surgery, there are limited data to support whether perioperative ASA use raises the risk of postoperative hemorrhage. This study aimed to investigate the implications of continuing or stopping ASA around the time of surgery in patients with intracranial meningiomas, focusing on postoperative hemorrhage and thromboembolic events. Methods: For this purpose, medical records and radiological images of 1862 patients who underwent cranial neurosurgical procedures for brain tumors over a decade at our neurosurgical institute were retrospectively analyzed. The risk of postoperative hemorrhage was evaluated by comparing meningioma patients who received ASA treatment with those who did not. Furthermore, we investigated other factors that influence postoperative hemorrhage and thromboembolic events, particularly in patients receiving ASA treatment. Results: A total of 422 patients diagnosed with meningiomas underwent surgical intervention. Among the patients who received ASA preoperatively, 4 out of 46 (8.69%) experienced postoperative hemorrhage requiring surgical intervention, whereas the same complication occurred in only 4 out of 376 patients (1.06%) in the non-ASA group (p = 0.007). There was no significant difference in the incidence of thromboembolic events between the two groups. Conclusions: Our analysis revealed an increased risk of postoperative hemorrhage in patients using ASA. [ABSTRACT FROM AUTHOR]

The paper describes the type of changes in the structure and mechanical properties of 3D printed shapes under the influence of mineral oil. The effects of a room (23 °C) and elevated temperature (70 °C) on 3D prints manufactured by the FDM method and stored in oil for 15, 30, and 60 days on the change of properties and structure were investigated. The samples were produced from ABS (poly(acrylonitrile-co-butadiene-co-styrene)), ASA (poly(acrylonitrile-co-styrene-co-acrylate), PLA (poly(lactic acid)), and HIPS (high-impact polystyrene). Tests related to the strength of the materials, such as the static tensile test and Charpy impact test, were carried out. The structure was evaluated using a scanning electron microscope, and changes in chemical structure were determined by conducting FTIR (Fourier transform infrared spectroscopy) and TGA (thermogravimetric analysis) tests. The analysis of the results provided important information about the impact of mineral oil on specific materials. This is critical for designing and manufacturing components that can withstand mineral oil exposure in real-world environments. The materials underwent varying changes. Strength increased for PLA by about 28%, remained unchanged for ABS and HIPS during exposure for 30 days, and decreased for ASA with extended exposure up to 14%. [ABSTRACT FROM AUTHOR]

Cranial operations are associated with a high risk of postoperative intracranial hemorrhage (pICH) and venous thromboembolic events, along with increased mortality and morbidity. With the use of acetylsalicylic acid (ASA) for prophylaxis becoming more prevalent, the risk of bleeding when ASA is administered preoperatively is unknown, as are the effects of discontinuation upon the occurrence of thromboembolic events, especially in societies with aging demographics. To address these questions, a retrospective analysis was performed using medical records and radiological images of 1862 patients subjected to brain tumor surgery over a decade in our department. The risk of pICH was compared in patients with metastases receiving ASA treatment versus patients not receiving ASA treatment. The occurrence of venous thromboembolic events after surgery was also evaluated. The study group consisted of 365 patients with different types of brain metastases. In total, 20 patients suffered pICH and 7 of these were associated with clinical neurological deterioration postoperatively. Of the 58 patients who took ASA preoperatively, 2 patients experienced pICH, compared with 5 patients in the non-ASA impact group (p = 0.120). Patients who took ASA were not at significantly higher risk of pICH and therefore a worse outcome compared to the group without ASA. Therefore, these data suggest that in patients at high cardiovascular risk, ASA can be safely continued during elective brain tumor surgery. [ABSTRACT FROM AUTHOR]

This study seeks to evaluate the relationship between American Society of Anesthesiologist (ASA) score and postoperative outcomes following TAA. The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database was queried from 2007 to 2020 to identify 2210 TAA patients. Patients were stratified into low (n = 1328; healthy/mild systemic disease) or high (n = 881; severe/life-threatening systemic disease) ASA score cohorts. There was no statistically significant difference in complications, readmission, or reoperation rate based on ASA score. Increased ASA score was significantly associated with longer length of stay (low = 1.69 days, high = 1.98 days; p <.001) and higher rate of adverse discharge (low = 95.3 %, high = 87.4 %; p <.001). Higher ASA scores (3 and 4) were statically significantly associated with increased length of stay and non-home discharge disposition. These findings are valuable for physicians and patients to consider prior to TAA given the increased utilization of resources and cost associated with higher ASA scores. Level III, Retrospective cohort study [ABSTRACT FROM AUTHOR]

This paper presents the results of the study on the influence of FDM printing parameters on the tensile behavior of samples made of ASA. To perform the study, 27 tensile samples were made of ASA on Anycubic 4 Max 2.0 3D printer using as the height of the single-pass layer Lh = 0.10/0.15/0.20 mm and as filling percentage Id = 50/75/100%. The results obtained from tensile testing of the samples on the universal testing machine demonstrate the way in which the FDM parameters influence the tensile strength, the percentage elongation at break, and the elastic modulus. The parameter that significantly influences the tensile characteristics of ASA samples made using FDM is the filling percentage (Id). [ABSTRACT FROM AUTHOR]

Background: Salt is an important factor that affects crop productivity. Plant hexokinases (HXKs) are key enzymes in the glycolytic pathway and sugar signaling transduction pathways of plants. In previous studies, we identified and confirmed the roles of GmHXK2 in salt tolerance. Results: In this study, we analyzed the tissue-specific expression of GmHXK2 at different growth stages throughout the plant's life cycle. The results showed that GmHXK2 was expressed significantly in all tissues at vegetative stages, including germination and seedling. However, no expression was detected in the pods, and there was little expression in flowers during the later mature period. Arabidopsis plants overexpressing the GmHXK2 (OE) had more lateral roots. The OE seedlings also produced higher levels of auxin and ascorbic acid (AsA). Additionally, the expression levels of genes PMM, YUC4/YUC6/YUC8, and PIN/LAX1,LAX3, which are involved respectively in the synthesis of AsA and auxin, as well as polar auxin transport, were upregulated in OE plants. This upregulation occurred specifically under exogenous glucose treatment. AtHKT1, AtSOS1, and AtNHX1 were up-regulated in OE plants under salt stress, suggesting that GmHXK2 may modulate salt tolerance by maintaining ion balance within the cells and alleviating damage caused by salt stress. Additionally, we further confirmed the interaction between GmHXK2 and the protein GmPMM through yeast two-hybridization and bimolecular fluorescence complementation assays, respectively. Conclusion: The expression of GmHXK2 gene in plants is organ-specific and developmental stage specific. GmHXK2 not only regulates the synthesis of AsA and the synthesis and distribution of auxin, but also promotes root elongation and induces lateral root formation, potentially enhancing soil water absorption. This study reveals the crosstalk between sugar signaling and hormone signaling in plants, where GmHXK2 acts as a glucose sensor through its interaction with GmPMM, and sheds light on the molecular mechanism by which GmHXK2 gene is involved in salt tolerance in plants. [ABSTRACT FROM AUTHOR]

Global warming has adversely affected Picea abies (L.) H. Karst. forests in Europe, prompting the need for innovative forest-breeding strategies. Somatic embryogenesis (SE) offers promise but requires protocol refinement. Understanding the molecular mechanisms governing somatic embryo development is essential, as oxidative stress plays a crucial role in SE regulation. Ascorbic acid (ASA), is a vital antioxidant that can potentially control oxidative stress. In the present study, we normalized ASA concentrations in induction and proliferation media to enhance embryogenic tissue (ET) regeneration and proliferation capacity of mature explants. The media were supplemented with ASA at 0 mg l-1, 25mg l-¹ 50mg l-¹100 mg l-1, and 200 mg l-1. The accumulation of hydrogen peroxide (H2O2) and endogenous phytohormones, including auxins, cytokinins, brassinosteroids, abscisic acid, and gibberellin, was measured in non-embryonic calli and ET. Subsequently, their impact on ET induction and multiplication was analyzed. Our results demonstrate that application of ASA at concentrations of 25 mg l-¹ and 200 mg l-¹ led to increased H2O2 levels, potentially inducing oxidative stress while simultaneously reducing the levels of all endohormone groups. Notably, the highest ET induction frequency (approximately 70%) was observed for ASA at 50 mg l-1. These findings will enhance SE induction procedures, particularly in more resistant explants, underscoring the significance of ASA application to culture media. [ABSTRACT FROM AUTHOR]

Background: Aspirin or acetylsalicylic acid (ASA) is among the most popular used drugs in the world. Gastric lesions are one of aspirin's often-occurring side effects. Silymarin is a natural compound that exhibits effects against inflammation, oxidation, and apoptosis. Aim of the work: This study was conducted to evaluate ASA-induced gastric mucosal damage and the potential ameliorative role of silymarin. Material and Methods: Thirty adult male albino rats were randomly divided into three equal groups: a control group (subdivided into a negative control group without any medication and a positive control group that received distilled water/day orally by gastric gavage for 2 weeks), ASA-treated group (received 200 mg ASA/kg b.w./day orally for 2 weeks), and ASA+silymarin-treated group (received 200 mg ASA/kg b.w./day in addition to 50 mg silymarin/kg b.w./day, orally for 2 weeks). At the end of the experiment, the rats were anaesthetized and sacrificed. The stomach was removed, opened, and processed for histological and iNOS immunohistochemical evaluation. Area % of collagen fibres and iNOS immune expression and gastric mucosal thickness of all animal groups were measured and compared. Results: The ASA induced gastric mucosal histological changes in the form of erosion, degeneration, vacuolization of cells, and dilatation of blood capillaries. The area % of collagen fibres and iNOS was significantly increased and gastric mucosal thickness was significantly decreased in ASA-treated groups in comparison to the control. These changes were improved in the ASA+silymarin-treated group. Conclusion: ASA induced gastric mucosal injuries and the concomitant administration of silymarin could ameliorate these effects. [ABSTRACT FROM AUTHOR]

The present study aims at investigating and describing the pragmatic functions of the discourse marker i:h in the Algerian Spoken Arabic, specifically in the eastern south, in the city of Ouargla. This piece of work is unique of its type in the Algerian context because it is the first to be conducted from a pragmatic perspective. Twelve different situations were included in the questionnaire which consists of one hundred items to collect data. The study adapted the pragmatic approach by Fraser (1990), which accounts upon a differentiation between content and pragmatic meaning. The findings revealed that, based on context, the discourse marker i:h is multifunctional in Algerian Spoken Arabic, and it conveys at least 12 meanings. Other functions were suggested by the participants. The distinction between the two groups at the level of both variables age and gender was not significantly marked. [ABSTRACT FROM AUTHOR]

ObjectiveThis study aimed to analyze factors associated with recent complications after colorectal cancer surgery, constructing a nomogram to aid gastrointestinal surgeons in preoperative decision-making for patients at risk of such complications.MethodsIn this retrospective study, clinical data were collected from patients undergoing radical colorectal cancer surgery at the Department of Gastrointestinal Surgery of the Affiliated Cancer Hospital of Guizhou Medical University and the Second People’s Hospital of Chengdu from November 1, 2021, to January 26, 2024. Univariable and multivariable logistic regression analyses were conducted to assess risk factors for recent postoperative complications and develop a prediction model. External validation was performed using data from 48 postoperative colorectal cancer patients in the Second People’s Hospital of Chengdu City from January 1, 2023, to May 30, 2023. Evaluation included receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis using R4.2.2 statistical software.ResultsA total of 324 patients who underwent radical colorectal cancer surgery were enrolled. The training cohort (n=176) identified four independent risk factors for recent complications: PNI ≥45 (OR=4.17, P

Chunsheng Duan, Yuan Li, Jiansu Ma, Yanglin Song, Lixia Zhou Department of Pediatric Surgery, Xingtai People’s Hospital, Xingtai, Hebei, 054000, People’s Republic of ChinaCorrespondence: Lixia Zhou, Department of Pediatric Surgery, Xingtai People’s Hospital, 16 Hongxing Street, Xingtai, Hebei, 054000, People’s Republic of China, Tel/Fax +86-0319-3286096, Email zhoulx_xt@163.comPurpose: Surgery impairs immune function and increases postoperative complications. B7H3, a co-stimulatory molecule, plays a crucial role in immune regulation. The present study examined the impact of B7H3 on the postoperative immune response in children with acute suppurative appendicitis (ASA) by comparing preoperative and postoperative B7H3 levels in laparoscopic surgery (LA) and open appendectomy (OA).Patients and Methods: 198 pediatric ASA patients were enrolled. The researcher group performed LA, while the control group performed OA. Perioperative time, recovery time of gastrointestinal function, time to pass gas, length of incision, and length of hospitalization were compared in the perioperative period. Additionally, an ELISA assay was conducted to examine the levels of inflammatory factors and B7H3 and CD28. Short-term postoperative complications were also evaluated.Results: Compared with the control group, the research group had a short operative time, gastrointestinal function recovery time, gas time, and hospitalization time. The short-term complication rate was significantly lower in the research group. More importantly, B7H3 and CD28 were insignificantly different preoperatively, but they were all reduced postoperatively. Moreover, the reduction was more pronounced in the research group. The same results were noted in inflammatory factors and immune markers, which were non-significant different preoperatively and were typically reduced postoperatively, particularly in the research group. Finally, postoperative B7H3 was positively correlated with both inflammatory factors and immune cell levels.Conclusion: B7H3 was reduced in both postoperative periods, and the reduction was more pronounced in the LA group. B7H3 may be involved in postoperative recovery by modulating postoperative inflammation and immune responses.Keywords: ASA, laparoscopic surgery, open appendectomy, B7H3, CD298

Colorectal cancer (CRC) is one of the most prevalent cancers worldwide, ranking as the third most malignant. The incidence of CRC has been increasing with time, and it is reported that Westernized diet and lifestyle play a significant role in its higher incidence and rapid progression. The intake of high amounts of omega-6 (n − 6) PUFAs and low levels of omega-3 (n − 3) PUFAs has an important role in chronic inflammation and cancer progression, which could be associated with the increase in CRC prevalence. Oxylipins generated from PUFAs are bioactive lipid mediators and have various functions, especially in inflammation and proliferation. Carcinogenesis is often a consequence of chronic inflammation, and evidence has shown the particular involvement of n − 6 PUFA arachidonic acid-derived oxylipins in CRC, which is further described in this review. A deeper understanding of the role and metabolism of PUFAs by their modifying enzymes, their pathways, and the corresponding oxylipins may allow us to identify new approaches to employ oxylipin-associated immunomodulation to enhance immunotherapy in cancer. This paper summarizes oxylipins identified in the context of the initiation, development, and metastasis of CRC. We further explore CRC chemo-prevention strategies that involve oxylipins as potential therapeutics. [ABSTRACT FROM AUTHOR]

Modern civilization increasingly relies on sustainable and eco-friendly data centers as the core hubs of intelligent computing. However, these data centers, while vital, also face heightened vulnerability to hacking due to their role as the convergence points of numerous network connection nodes. Recognizing and addressing this vulnerability, particularly within the confines of green data centers, is a pressing concern. This paper proposes a novel approach to mitigate this threat by leveraging swarm intelligence techniques to detect prospective and hidden compromised devices within the data center environment. The core objective is to ensure sustainable intelligent computing through a colony strategy. The research primarily focusses on the applying sigmoid fish swarm optimization (SiFSO) for early compromised device detection and subsequently alerting other network nodes. Additionally, our data center implements an innovative ant skyscape architecture (ASA) cooling mechanism, departing from traditional, unsustainable cooling strategies that harm the environment. To validate the effectiveness of these approaches, extensive simulations were conducted. The evaluations primarily revolved around the fish colony's ability to detect compromised devices, focusing on source tracing, realistic modelling, and an impressive 98% detection accuracy rate under ASA cooling solution with 0.16 ºC within 1,300 second. Compromised devices pose a substantial risk to green data centers, as attackers could manipulate and disrupt network equipment. Therefore, incorporating cyber enhancements into the green data center concept is imperative to foster more adaptable and efficient smart networks. [ABSTRACT FROM AUTHOR]

The role of acetylsalicylic acid in secondary cardiovascular prevention is established. However, its role in primary prevention is much more controversial. In this review, we analyzed meta-analyses and trials regarding aspirin in primary prevention and, consequently, hemorrhagic risk related to anti-platelet therapy. Several factors have been considered (e.g., sex, comorbidities, bleeding risk factors, concomitant drugs, weight, age), aspirin’s pharmacokinetics included. In the end, we tried to individualize anti-aggregation therapy based on the risk/benefit ratio of every single subject. In conclusion, high-cardiovascular-risk subjects must be treated with acetylsalicylic acid in primary prevention according to their bleeding risk. For better cardiovascular stratification, other tools to detect risk modifier factors should be used (e.g., instrumental evaluations).

Global warming has adversely affected Picea abies (L.) H. Karst. forests in Europe, prompting the need for innovative forest-breeding strategies. Somatic embryogenesis (SE) offers promise but requires protocol refinement. Understanding the molecular mechanisms governing somatic embryo development is essential, as oxidative stress plays a crucial role in SE regulation. Ascorbic acid (ASA), is a vital antioxidant that can potentially control oxidative stress. In the present study, we normalized ASA concentrations in induction and proliferation media to enhance embryogenic tissue (ET) regeneration and proliferation capacity of mature explants. The media were supplemented with ASA at 0 mg l−1, 25 mg l−1, 50 mg l−1, 100 mg l−1, and 200 mg l−1. The accumulation of hydrogen peroxide (H2O2) and endogenous phytohormones, including auxins, cytokinins, brassinosteroids, abscisic acid, and gibberellin, was measured in non-embryonic calli and ET. Subsequently, their impact on ET induction and multiplication was analyzed. Our results demonstrate that application of ASA at concentrations of 25 mg l−1 and 200 mg l−1 led to increased H2O2 levels, potentially inducing oxidative stress while simultaneously reducing the levels of all endohormone groups. Notably, the highest ET induction frequency (approximately 70%) was observed for ASA at 50 mg l−1. These findings will enhance SE induction procedures, particularly in more resistant explants, underscoring the significance of ASA application to culture media.

Abstract Objective Patients with head and neck cancer often undergo extensive ablative and reconstructive surgery. Many risk factors are unalterable, but some operative variables are possible to adjust. The goal of this study was to estimate the association between operative variables and the incidence of perioperative complications in a contemporary tertiary care university‐based head and neck patient population and a Veteran Administration hospital head and neck patient population from an earlier time period. Methods We retrospectively reviewed all patients who underwent major head and neck surgery. Results Two‐hundred‐two university patients and 122 veteran patients were reviewed. On multivariable analysis, the total amount of intravenous (IV) fluid received during the procedure was associated with postoperative complications as were patients’ weight, American Society of Anesthesiologists (ASA) score, and adult comorbidity evaluation‐27 (ACE‐27) score. These associations did not depend on whether the patient was treated at the university or veteran hospital. Conclusion Our study suggests that the odds of a postoperative complication increase as the total amount of IV fluid increases.

Introduction: Postoperative shivering is an involuntary, oscillatory muscular activity during early recovery after anaesthesia. Postoperative shivering is a frequent complication of anaesthesia; it has been reported to range from 20 to 70% in general anaesthesia. Shivering is believed to increase oxygen consumption and increase the risk of hypoxemia; it might also increase postoperative complications. dexmedetomidine might provide a simple pharmacological intervention to suppress shivering and improve comfort without producing respiratory compromise in patients. Methods: The study was conducted in department of anaesthesiology at Pt. B. D. Sharma PGIMS, Rohtak. Total one hundred thirty-two patients of either sex between 18-60 years of age having physical status of grade I and II according to American Society of Anaesthesiologists (ASA) scheduled for elective laproscopic cholecystectomy under general anaesthesia were included in this study. It was a prospective, randomized and double blinded study. All the patients were randomly divided into four groups of 33 each. Group-I(DN)(n=33) Administration of 20 ml of normal saline over 10 min. Group-II(D0.5)(n=33) Administration of 0.5 mcg kg-1 dexmedetomidine over 10 min. Group-III(D0.75)(n=33) Administration of 0.75 mcg kg-1dexmedetomidine over 10 min. Group-IV(D1.0)(n=33) Administration of 1.0 mcg kg-1 dexmedetomidine over 10 min. Results: After studying various factors, we found from our study that i.v dexmedetomidine in the dose range of 0.5 mcgkg-1, 0.75 mcgkg-1 and 1.0 mcgkg-1reduces the rise in heart rate, systolic blood pressure, diastolic blood pressure during general anaesthesia. Thus, dexmedetomidine provides better perioperative haemodynamic stability in ASA I and II grade patients during general anaesthesia as dexmedetomidine has sedative, anxiolytic and sympatholytic properties. The decrease in pain and shivering was greater in dexmedetomidine dose 0.75 mcgkg-1 and 1.0 mcgkg-1 than dexmedetomidine dose 0.5 mcgkg-1 and placebo and time of first rescue analgesic was more in dexmedetomidine dose 0.75 mcgkg-1 and 1.0 mcgkg-1 than dexmedetomidine dose 0.5 mcgkg-1 and placebo. Conclusion: we recommend dexmedetomidinedose 0.75mcgkg-1 as an anaesthetic adjuvant can be used during general anaesthesia as an optimal dose to reduce post operative shivering in patients undergoing laproscopic cholecystectomy, because it significantly attenuates heart rate and blood pressures, it decreases pain and shivering and it facilitates smooth emergence from anaesthesia and the sedation and complication rate of dexmedetomidinedose 0.75mcgkg-1 is lower than other doses. [ABSTRACT FROM AUTHOR]

The experiment was conducted during the Autumn season (2021-2022) in Yaremjah and AlZanazel locations in the governorate of Nineveh, Iraq. The experiment included three factors: the first included two species of broad beans, namely Luz de otono and Aquadlge. The second factor involved soaking the seeds and splashing the plants with antioxidants with the following levels (without treatment, treatment with ascorbic acid 250 mg.l-1, pyridoxine 250 mg.l-1, AsA 250 mg+ B1 250 mg + B6 250 mg.l-1.) The seeds were soaked in water for 6 hours and splashing was performed until complete wetting of the plants after 30 and 45 days after planting. The third factor is fertilizing using Di Ammonium phosphate (0 and 120 kg.h-1). The yield of the seeds, TFC and TPC were studied. It was observed that the species Aquadlge was significantly superior over the species Luz de otono in terms of all the characteristics studies. Adding (AsA+B1+B6) gave the highest significant increase in all the characteristics followed by AsA. From the other hand, adding no antioxidants gave the lowest significant average for all the characteristics studied. The DAP fertilizer gave a significant increase in all the characteristics compared to the treatment without addition of fertilizer. [ABSTRACT FROM AUTHOR]

A series of 5-FU-ASA hybrids were synthesized with good yields using click chemistry as the key step. The structures of these compounds were elucidated by spectroscopic analysis. Finally, an optimal pharmacokinetic profile was also estimated for each synthetized hybrid. Taken together, hybrids 4a–h could be used as starting points for further pharmacological studies concerning therapeutic cancer intervention. [ABSTRACT FROM AUTHOR]

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BACKGROUND: Recent studies showed that aspirin for preeclampsia prevention is underused despite its effectiveness in preventing preeclampsia among patients with moderate and high risk factors. Little is known about this issue in the Sub-Saharan setting, including Ethiopia. OBJECTIVE: This study aimed to determine the missed opportunity for aspirin prophylaxis among candidates for this preeclampsia preventive intervention at a national tertiary referral hospital in Ethiopia. STUDY DESIGN: This was a cross-sectional study on pregnant women who had preeclampsia and who were managed at the St. Paul's Hospital Millennium Medical College (Ethiopia) over a 6-month period (April 1–September 30, 2023). Data were collected prospectively using a structured questionnaire. The primary outcome was the proportion of women who had an indication for aspirin prophylaxis for preeclampsia prevention but were not given the opportunity (missed opportunity for aspirin) among all pregnant preeclampsia patients presenting to our hospital. Secondary outcomes were adverse maternal and perinatal outcomes. Data were analyzed using SPSS version 23. Descriptive statistics were employed to analyze the data. Proportions and percentages were used to present the results. RESULTS: A total of 427 pregnant women with preeclampsia were screened for inclusion and 32 of them were excluded based on the study criteria. Among the 395 pregnant women with preeclampsia who were included in the final analysis, 195 (49.4%) had an indication for aspirin prophylaxis for the prevention of preeclampsia. The mean systolic and diastolic blood pressure measurements at presentation were 153.8±12.8 and 100.6±8.5 mm Hg, respectively. Most patients had proteinuria (51.7% of the participants had a urine test-strip protein level of +2, whereas 18.5% [74/395] had a urine test-strip protein level of +1 and 10.9% had 24-hour urine protein levels in the preeclampsia range). Among the women who had an indication for aspirin prophylaxis, only 1.1% received aspirin (the missed opportunity for aspirin prophylaxis for preeclampsia prevention was 98.9%). The perinatal morality rate was 11.9%, whereas the neonatal intensive care unit admission rate was 20.5%. The rate of a low Apgar score at 5 minutes was 8.9%. Eight mothers (2.1%) developed hemolysis, elevated liver enzymes, and low platelet count syndrome, whereas another 3 (0.8%) mothers developed a pulmonary edema. CONCLUSION: In this study, the missed opportunity for administration of aspirin prophylaxis for the prevention of preeclampsia was high although half of the study subjects were candidates for this preventive intervention. Preeclampsia was also associated with higher rates of adverse perinatal outcomes and serious maternal morbidity.

Risk prediction models are frequently used to identify high‐risk patients undergoing emergency laparotomy. The National Emergency Laparotomy Audit (NELA) developed a risk prediction model specifically for emergency laparotomy patients, which was recently updated. In this study, we validated the updated NELA model in an external population. Furthermore, we compared it with three other risk prediction models: the original NELA model, the Portsmouth Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (P‐POSSUM) model, and the American Society of Anesthesiologists Physical Status (ASA‐PS). We included adult patients undergoing emergency laparotomy at Zealand University Hospital, from March 2017 to January 2019, and Herlev Hospital, from November 2017 to January 2020. Variables included in the risk prediction models were collected retrospectively from the electronic patient records. Discrimination of the risk prediction models was evaluated with area under the curve (AUC) statistics, and calibration was assessed with Cox calibration regression. The primary outcome was 30‐day mortality. Out of 1226 included patients, 146 patients (11.9%) died within 30 days. AUC (95% confidence interval) for 30‐day mortality was 0.85 (0.82–0.88) for the updated NELA model, 0.84 (0.81–0.87) for the original NELA model, 0.81 (0.77–0.84) for the P‐POSSUM model, and 0.76 (0.72–0.79) for the ASA‐PS model. Calibration showed underestimation of mortality risk for both the updated NELA, original NELA and P‐POSSUM models. The updated NELA risk prediction model performs well in this external validation study and may be used in similar settings. However, the model should only be used to discriminate between low‐ and high‐risk patients, and not for prediction of individual risk due to underestimation of mortality. [ABSTRACT FROM AUTHOR]

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Colorectal cancer (CRC) is one of the most prevalent cancers worldwide, ranking as the third most malignant. The incidence of CRC has been increasing with time, and it is reported that Westernized diet and lifestyle play a significant role in its higher incidence and rapid progression. The intake of high amounts of omega-6 (n − 6) PUFAs and low levels of omega-3 (n − 3) PUFAs has an important role in chronic inflammation and cancer progression, which could be associated with the increase in CRC prevalence. Oxylipins generated from PUFAs are bioactive lipid mediators and have various functions, especially in inflammation and proliferation. Carcinogenesis is often a consequence of chronic inflammation, and evidence has shown the particular involvement of n − 6 PUFA arachidonic acid-derived oxylipins in CRC, which is further described in this review. A deeper understanding of the role and metabolism of PUFAs by their modifying enzymes, their pathways, and the corresponding oxylipins may allow us to identify new approaches to employ oxylipin-associated immunomodulation to enhance immunotherapy in cancer. This paper summarizes oxylipins identified in the context of the initiation, development, and metastasis of CRC. We further explore CRC chemo-prevention strategies that involve oxylipins as potential therapeutics.

A series of 5-FU-ASA hybrids were synthesized with good yields using click chemistry as the key step. The structures of these compounds were elucidated by spectroscopic analysis. Finally, an optimal pharmacokinetic profile was also estimated for each synthetized hybrid. Taken together, hybrids 4a–h could be used as starting points for further pharmacological studies concerning therapeutic cancer intervention.

OBJECTIVE: We aimed to determine the role of American Society of Anesthesiologists (ASA) score and Charlson Comorbidity Index (CCI) in determining in-hospital mortality and other factors associated with mortality in patients over 65 years of age who underwent surgery for hip fracture during our study, including the COVID-19 process. PATIENTS AND METHODS: Between January 1st, 2020, and December 31st, 2021, 200 patients over 65 years of age who underwent hemiarthroplasty or internal fixation for hip fracture after low-energy trauma were retrospectively evaluated. RESULTS: Of the 200 patients included in the study, 130 were female and 70 were male. The median ASA score was 3 (IQR: 2-3), and the median CCI was 3 (IQR: 5-7). Forty-two of 137 (68.5%) patients with intertrochanteric fractures and 22 of 63 (31.5%) patients with femoral neck fractures (34.4%) died. The median time to surgery was 4 days (IQR: 3-6). Among chronic diseases, cardiac pathologies were the most common (57%, n=114). There were statistically significant differences in ASA scores (p=0.0001 [z=-5.472]), CCI scores (0.0001 [z=-6.156]), presence of cardiac disease [p=0.0001 (X²=32.155)] and presence of neurological disease [p=0.045 (X²=4.007)] compared to mortality. ASA and CCI scores were significantly higher in people with mortality. As a result of the multivariate model established with these factors, which were found to be significant in univariate analyses, only the presence of cardiac disease (p=0.0001) and the increase in CCI scores (p=0.0001) were found to have a statistically significant increasing effect on mortality. CONCLUSIONS: CCI and cardiac pathology were associated with mortality. The type of hip fracture, surgical method, and anesthesia method were not associated with mortality. [ABSTRACT FROM AUTHOR]

Background: In a clinical setting assessment of airway needs to be simple and convenient3. There is no single test with absolute accuracy to predict difficult airway2. In our study we assessed airway difficulty in elective surgeries for adults by comparing ULBT and MMS individually as well as in combination to that of Cormack-Lehane grading. Method: The single blinded prospective, comparative and observational study was conducted at SDMCMS& Hospital Dharwad. A total of 150 patients aged 18-60 years of either sex with ASA physical status 1,2&3 who underwent elective surgery under general anaesthesia were included. CL grade 3&4 deemed as difficult laryngoscopy. Diagnostic testing was carried out to compare MMS and ULBT with CL grade in predicting difficult intubation. McNemar test was used to compare difference between diagnostic parameters. P-value less than or equal to 0.05 was considered statistically significant. Results: Demographic data and ASA grades were same for participants. We observed that at 95% Confidence Interval (CI) for ULBT sensitivity (92%), specificity (68%), positive predictive value (93.5%) and negative predictive value (62.96%) was better compared to that of MMS whose sensitivity was 64.8 %, specificity 24%. Also, ULBT had a better accuracy 88% than that of MMS with 58%. Conclusion: Our study and analysis concluded that the upper lip bite test is good option for predicting difficult intubation than Modified Mallampati Score. [ABSTRACT FROM AUTHOR]

Introduction: It is important to appropriately risk stratify bariatric surgery patients, as these patients often have obesity-related comorbidities which can increase postoperative complication risk but also benefit the most from bariatric surgery. We aimed to evaluate the utility of risk stratification using ASA class for bariatric surgery patients and assessed predictive factors of postoperative complications. Methods: The 2020 MBSAQIP database was analyzed, and an ASA-deemed high-risk cohort (class IV) and normal-risk (ASA class II and III) cohort were compared. Univariate analysis was performed to characterize differences between cohorts and to compare complication rates. Multivariate logistic regression analysis was performed to determine factors associated with increased odds of postoperative complications. Results: We evaluated 138 612 patients with 5380 (3.9%) considered high-risk and 133 232 (96.1%) normal-risk. High-risk patients were more likely to be older (46.2 ± 12.0vs.43.4 ± 11.9, p < 0.001), male (30.9%vs.18.4%, p < 0.001), have higher BMI (51.4 ± 10.2vs.44.9 ± 7.4, p < 0.001), and have more comorbidities. High-risk patients were more likely to have increased 30-day serious complications (4.5%vs.2.8%, p < 0.001) and death (0.2%vs.0.1%, p = 0.001) but not anastomotic leak (0.2%vs.0.2%, p = 0.983). Multivariate models showed ASA class IV patients were at higher odds for any serious complication by 30 days (aOR 1.36, 95%CI 1.18–1.56, p < 0.001) but not for death (aOR 1.04, 95%CI 0.49–2.21, p = 0.921). The factor independently associated with the highest odds of complication in both models was functional status preoperatively (partially dependent aOR 2.06, 95%CI 1.56–2.72, p < 0.001; fully dependent aOR 3.19, 95%CI 1.10–9.28, p = 0.033 for any serious complication; partially dependent aOR 5.08, 95%CI 2.16–12.00, p < 0.001 for death). Conclusions: While elevated ASA class correlates with increased serious complications, pre-operative functional status appears to have a much greater contribution to odds of serious complications and mortality. These findings question the utility of using ASA to risk stratify patients peri-operatively and provides evidence for using a simpler and more practical functional status approach. [ABSTRACT FROM AUTHOR]

Background/Aim: Current evidence regarding the optimal management of older colorectal cancer patients, is conflicting. Functional deficits impact long-term survival prognosis, while frailty often results to optimal treatment postponement. Thus, the characteristics of this subgroup combined with treatment deviations further perplex optimal oncological management. The study aim was to compare survival and optimal surgery rates between older and younger colorectal cancer patients. Patients and Methods: This study was designed as a prospective cohort. All adult (318 years) colorectal cancer patients operated, during the 2016-2020 period, in the Department of Surgery, University Hospital of Larissa, were considered as eligible. The primary endpoint of the study was the difference in terms of the overall survival between older (>70 year) and younger (<70 years) colorectal cancer patients. Results: Overall, 166 patients (60 younger and 106 older) were enrolled. Although the older subgroup displayed a higher rate (p=0.007) of ASA II and ASA III patients, mean CCI scores were comparable (p=0.384). The two subgroups were similar in terms of performed operations (p=0.140). No delay in surgery was noted. Most operations were performed using an open approach (open: 57.8% vs. laparoscopic: 42.2%), under an elective status (elective: 91% vs. emergency: 1.8%). There was no difference in terms of overall complications rate (p=0.859). Overall survival was similar (p=0.227) between the older and younger subgroups (25.68 vs. 28.48 months). Conclusion: Older operated patients did not differ from their younger counterparts with regard to their overall survival. Due to several study limitations, further trials are required to confirm these findings. [ABSTRACT FROM AUTHOR]

Background: In patients undergoing surgical procedures, preoperative period is one of the most worrying periods. There are only few studies which revealed that increased preoperative anxiety is associated with increased requirements of doses of anesthetic agents. Aim: The aim of this study is to assess the prevalence of preoperative anxiety in patients posted for surgical procedures and its relation to the doses of anesthetic drugs. Materials and Methods: This is a cross-sectional, analytical study done between January 2021 and April 2021. A total of 100 patients undergoing surgery have given consent to participate in the study by filling self-designed questionnaire, Amsterdam Preoperative Anxiety and Information Scale (APAIS). Data analysis was done by SPSS version 24 using appropriate statistical tests. Results: Preoperative anxiety was noted in 21% of the patients who were undergoing surgery. The association between preoperative anxiety and need for increase in the doses of anesthetic agents during intraoperative period was found to be statistically significant (P < 0.004). Conclusion: A significant number of patients required increased amounts of anesthetic drugs to reduce anxiety during intraoperative period. Therefore, appropriate methods have to be introduced to address the concerns of patients undergoing surgery and thereby reducing anxiety. [ABSTRACT FROM AUTHOR]

Summary: Detailed contemporary knowledge of the characteristics of the surgical population, national anaesthetic workload, anaesthetic techniques and behaviours are essential to monitor productivity, inform policy and direct research themes. Every 3–4 years, the Royal College of Anaesthetists, as part of its National Audit Projects (NAP), performs a snapshot activity survey in all UK hospitals delivering anaesthesia, collecting patient‐level encounter data from all cases under the care of an anaesthetist. During November 2021, as part of NAP7, anaesthetists recorded details of all cases undertaken over 4 days at their site through an online survey capturing anonymous patient characteristics and anaesthetic details. Of 416 hospital sites invited to participate, 352 (85%) completed the activity survey. From these, 24,177 reports were returned, of which 24,172 (99%) were included in the final dataset. The work patterns by day of the week, time of day and surgical specialty were similar to previous NAP activity surveys. However, in non‐obstetric patients, between NAP5 (2013) and NAP7 (2021) activity surveys, the estimated median age of patients increased by 2.3 years from median (IQR) of 50.5 (28.4–69.1) to 52.8 (32.1–69.2) years. The median (IQR) BMI increased from 24.9 (21.5–29.5) to 26.7 (22.3–31.7) kg.m–2. The proportion of patients who scored as ASA physical status 1 decreased from 37% in NAP5 to 24% in NAP7. The use of total intravenous anaesthesia increased from 8% of general anaesthesia cases to 26% between NAP5 and NAP7. Some changes may reflect the impact of the COVID‐19 pandemic on the anaesthetic population, though patients with confirmed COVID‐19 accounted for only 149 (1%) cases. These data show a rising burden of age, obesity and comorbidity in patients requiring anaesthesia care, likely to impact UK peri‐operative services significantly. [ABSTRACT FROM AUTHOR]

Background: Dementia is associated with a greater burden of cardiovascular risk factors. There is a significant vascular contribution to dementia, and aspirin may play a role in targeting this vascular dysregulation via its anti-inflammatory and antiplatelet effects. We provide an overview of the effects of aspirin therapy on the prevention of dementia and cognitive decline in patients with or without dementia and/or cognitive impairment. Methods: We performed a search for studies enrolling adults with or without dementia or MCI and comparing aspirin with placebo, usual care, or active control with respect to cognitive outcomes. Results: We describe aspirin’s effects on the primary prevention of cognitive impairment and various subtypes of dementia, as well as its role in cognitive decline in certain subsets of patients, including those with cerebral small vessel disease (CVSD), coronary heart disease (CHD), and gender differences. Overall, the benefits of aspirin in preventing dementia and cognitive decline remain inconclusive. The majority of cohort studies investigating aspirin’s role in preventing cognitive decline or dementia looked promising, but this was not supported in most randomised controlled trials. However, aspirin may still be beneficial in certain subgroups of patients (such as CHD, VD, and CSVD) and warrants further investigation.

Abstract Background Lettuce (Lactuca sativa L.) cultivated in facilities display low vitamin C (L-ascorbic acid (AsA)) contents which require augmentation. Although UV-B irradiation increases the accumulation of AsA in crops, processes underlying the biosynthesis as well as metabolism of AsA induced by UV-B in lettuce remain unclear. Results UV-B treatment increased the AsA content in lettuce, compared with that in the untreated control. UV-B treatment significantly increased AsA accumulation in a dose-dependent manner up until a certain dose.. Based on optimization experiments, three UV-B dose treatments, no UV-B (C), medium dose 7.2 KJ·m− 2·d− 1 (U1), and high dose 12.96 KJ·m− 2·d− 1 (U2), were selected for transcriptome sequencing (RNA-Seq) in this study. The results showed that C and U1 clustered in one category while U2 clustered in another, suggesting that the effect exerted on AsA by UV-B was dose dependent. MIOX gene in the myo-inositol pathway and APX gene in the recycling pathway in U2 were significantly different from the other two treatments, which was consistent with AsA changes seen in the three treatments, indicating that AsA accumulation caused by UV-B may be associated with these two genes in lettuce. UVR8 and HY5 were not significantly different expressed under UV-B irradiation, however, the genes involved in plant growth hormones and defence hormones significantly decreased and increased in U2, respectively, suggesting that high UV-B dose may regulate photomorphogenesis and response to stress via hormone regulatory pathways, although such regulation was independent of the UVR8 pathway. Conclusions Our results demonstrated that studying the application of UV-B irradiation may enhance our understanding of the response of plant growth and AsA metabolism-related genes to UV-B stress, with particular reference to lettuce.

Eucalyptus/polyvinyl chloride (PVC) composites were prepared by extrusion molding with eucalyptus as filler, PVC as matrix, and different contents of acrylonitrile styrene acrylate copolymer (ASA). The effects of different ASA content on the mechanical properties, water absorption properties, and thermal stability of eucalyptus/PVC composites were studied. The morphology of the tensile section of the composites was observed by scanning electron microscopy (SEM). The results showed that the addition of ASA could improve the mechanical properties, heat resistance, and interfacial compatibility of eucalyptus/PVC composites. It also could reduce the water absorption of the composites. When ASA content was 10 wt%, the mechanical properties and heat resistance of eucalyptus/PVC composite were the best, and the water absorption in 24 h was the lowest.

Background: In patients undergoing surgical procedures, preoperative period is one of the most worrying periods. There are only few studies which revealed that increased preoperative anxiety is associated with increased requirements of doses of anesthetic agents. Aim: The aim of this study is to assess the prevalence of preoperative anxiety in patients posted for surgical procedures and its relation to the doses of anesthetic drugs. Materials and Methods: This is a cross-sectional, analytical study done between January 2021 and April 2021. A total of 100 patients undergoing surgery have given consent to participate in the study by filling self-designed questionnaire, Amsterdam Preoperative Anxiety and Information Scale (APAIS). Data analysis was done by SPSS version 24 using appropriate statistical tests. Results: Preoperative anxiety was noted in 21% of the patients who were undergoing surgery. The association between preoperative anxiety and need for increase in the doses of anesthetic agents during intraoperative period was found to be statistically significant (P < 0.004). Conclusion: A significant number of patients required increased amounts of anesthetic drugs to reduce anxiety during intraoperative period. Therefore, appropriate methods have to be introduced to address the concerns of patients undergoing surgery and thereby reducing anxiety.

Objective: to assess the clinical and economic feasibility of ticagrelor in combination with acetylsalicylic acid (ASA) in comparison with clopidogrel in combination with ASA in patients with acute coronary syndrome (ACS), including both those who underwent, and those who did not undergo percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG); and new oral anticoagulants (NOACs) in combination with clopidogrel in comparison with warfarin in combination with clopidogrel and ASA in patients with atrial fibrillation (AF) who underwent PCI; to identify the impact of the above strategies of antithrombotic therapy on the targets of the State Health Care Program of the Russian Federation (RF) “Development of Health Care” and the Federal Project “Cardiovascular Diseases Control”.Material and methods. The clinical and economic study (CES) of ticagrelor in combination with ASA in ACS patients was based on a costbenefit analysis. A combined model, including a decision tree and Markov model was developed. The horizon period of the analysis was 5 years. Quality-adjusted life year (QALY) was used as an efficiency criterion and only the direct medical costs associated with the conditions identified in the modeling were taken into account. A discount rate of 5% was taken into account during the CES. The application of NOACs in combination with clopidogrel was studied in the CES using a cost minimization analysis considering the costs per patient characterized by the presence of AF regardless of the presence of ACS and a history of PCI.Results. We used a decision tree and Markov modeling in adult patients with ACS, who had or had not undergone PCI or CABG, in the horizon period of 5 years considering the discount rate of the added quality-adjusted life year (incremental cost-effectiveness ratio (ICER) per QALY). The result for ticagrelor in combination with ASA compared to clopidogrel in combination with ASA was 605,199 rubles, which was significantly lower than the willingness-to-pay threshold (2,235,201 rubles). Assessment of the impact of the therapy regimen including ticagrelor in combination with ASA on the target indicators of the State Health Care Program of the RF “Development of Healthcare” and the Federal Project “Cardiovascular Diseases Control” showed that the use of this therapy regimen will reduce mortality from myocardial infarction (MI) and cardiovascular causes by 2.45 cases per 100 thousand population provided that 100% of patients with MI and unstable angina in the RF are transferred from clopidogrel + ASA scheme to ticagrelor + ASA. The potential contribution of ticagrelor in combination with ASA compared to clopidogrel in combination with ASA in patients with ACS in achieving the target reduction of mortality from circulatory diseases will be 6.48% by 2023. In all simulated scenarios, in the group of patients with AF who had undergone PCI, pharmacotherapy regimens containing NOACs (dabigatran etexilate, rivaroxaban, apixaban) were more costly than therapy regimens containing warfarin (with not significantly different effectiveness).Conclusion. The results of the evaluation of clinical and economic feasibility of antiplatelet therapy strategies demonstrated the costeffectiveness of ticagrelor in combination with ASA compared to clopidogrel in combination with ASA in patients with ACS, including those who had undergone PCI or CABG and those who had not. The strategy of ticagrelor + ASA showed a favorable effect on the rates of mortality from MI, as well as from circulatory diseases. The results of the clinical and economic evaluation of the four strategies of antithrombotic drug therapy in patients with AF who had undergone PCI showed higher costs of the regimens containing NOACs with a presumed zero effect on the mortality from circulatory diseases.

Objective: We aimed to evaluate the effectiveness of predicting postoperative pulmonary complications (PPCs) following spine surgery, comparing American Society of Anesthesiologist (ASA) and Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) risk scoring systems. Material and methods: We reviewed 377 patients aged≥18 years who had undergone vertebral surgery. Demographic data, comorbidities, ASA classification, body mass index, ARISCAT risk score, pulmonary complications developing with in the postoperative 1st month were assessed. Results: A total of 377 patients, 221 (58.6%) women and 156 (41.4%) men, mean age of 59±11.8 years were evaluated. Out of the 377 patients, 73 (19.4%) patients were ASA I, 235 (62.3%) patients were ASA II, 69 (18.3%) patients were ASA III, and the mean ARISCAT score was 22.51±8.38. In the postoperative period, PPC was identified in 30 (8%) patients, with atelectasis in 15 (4%), pneumothorax in 4 (1.1%), pneumonia in 4 (1.1%), respiratory failure in 4 (1.1%), bronchospasm in 2 (0.5%) patients, and pulmonary embolism in 1 (0.3%) patient. There was a statistically significant correlation between the presence of PPC and ASA score, and between the presence of PPC and the ARISCAT levels (p=0.000, p=0.000). The incidence of PPC increased with increasing ASA scores. The ARISCAT scores were higher in patients who developed PPC. The hospital stay of patients with PPCs were longer than other patients (p=0.000). Conclusion: In our study, in which ASA classification and ARISCAT risk index were compared as a means to predict PPC, both scores were found to be effective.