Value of segmental myocardial strain by 2-dimensional strain echocardiography for assessment of scar area induced in a rat model of myocardial infarction

<p>Abstract</p> <p>Objectives</p> <p>Two-dimensional strain echocardiography (2DSE) technique has enabled accurate quantification of regional myocardial function. This experimental study was aimed to investigate the value of 2DSE in detection of segmental regional myocardial dysfunction induced by fibrosis following myocardial infarction in a small animal (rat) model.</p> <p>Methods</p> <p>A rat model of myocardial infarction was established by ligation of the proximal left anterior descending coronary artery in 17 SD rats. Regional myocardial function was detected by 2DSE at baseline and 4-weeks post-infarction, including end-systolic radial strain and strain rate (SR and SrR) and end-systolic circumferential strain and strain rate (SC and SrC) of each of six segments at papillary level. According to the size of scar found by histologic Masson staining, the optimal cutoff points of parameters for detecting scar area were analyzed and the sensitivity and specificity of every parameter to detect myocardial scar were obtained using ROC.</p> <p>Results</p> <p>(1) Comparing with parameters measured at baseline, there were significant decreases in SR, SrR, SC and SrC of each segment at 4 weeks post-infarction, with the worst in the infarct area (32.90 ± 8.79 vs 11.18 ± 3.89, 6.28 ± 1.35 vs 3.18 ± 0.47, -14.46 ± 2.21 vs <it>-</it>6.30 ± 2.17 and 4.93 ± 0.95 vs 2.59 ± 1.16, respectively) (all <it>P </it>< 0.05). (2)By 4 weeks, the myocardium of infarct area (anteroseptum, anterior and anterolateral) had fibrosis (31.33 ± 9.89, 73.42 ± 13.21 and 13.99 ± 3.24%, respectively) with minimal fibrosis in inferoseptal segment (0.32 ± 0.19%), no fibrosis was found in the inferior and inferolateral segments. (3)Significant negative correlations were found between the size of segmental scar and 2DSE parameters (r-value -0.61 ~ -0.80, all <it>P </it>< 0.01) with the strongest correlation in SR. SR less than 10% has 84% sensitivity and 98% specificity for detecting segments of scar area greater than 30% with AUC = 0.97.</p> <p>Conclusions</p> <p>2DSE is able to assess regional myocardial dysfunction in a rat model of myocardial infarction and has high accuracy in detecting infarct segments with scar area greater than 30%.</p

Uniportal video-assisted thoracoscopic segmentectomy for fetal adenocarcinoma lung cancer with severe pulmonary emphysema: a case report

BackgroundFetal adenocarcinoma is a very rare subtype of lung adenocarcinoma. Its incidence ranges from 0.1 to 0.87% among all primary lung neoplasms. Low-grade types tend to appear in the younger generation, and the age ranges from 20 to 50 years with a mean age of around 35 years. Surgical resection is currently the best way to treat fetal adenocarcinoma lung cancer without distant metastasis.Case reportThis is a 56-year-old female who underwent low-dose computer tomography (LDCT) screening during the health examination. She used to be a heavy smoker for more than 30 years, and the CT images revealed severe bronchiectasis and emphysema. There is a solitary nodule with a diameter of 18.9 x 17.8mm in the central area of the left upper lobe. We decided to conduct left upper lobe S1~S3 segmentectomy under uniportal VATS. The surgery was successful, and the patient was discharged within one week and recovered well. The final diagnosis was fetal adenocarcinoma, low-grade (pT1cN0Mx, stage IA3).ConclusionThe first case reported as fetal adenocarcinoma lung cancer who underwent uniportal video-assisted thoracoscopic segmentectomy. We believe it is a safe and feasible procedure for low-grade types fetal adenocarcinoma patient with poor pulmonary function

PBL teaching model on cultivating students' clinical thinking in clinical practice teaching of ophthalmology

AIM: To explore the teaching effect of problem-based learning(PBL)on cultivating students' clinical thinking in clinical practice teaching of ophthalmology. METHODS: A total of 141 clinical undergraduate students were selected to attend the ophthalmology course in the first semester of the 2017-2018 academic year, students were randomly assigned to the traditional lecture based learning(LBL)teaching group of 69 and the PBL model teaching group of 72 in the clinical practice class. The two groups of students studied the same courses at the early stage, and there was no statistically significant difference in college entrance examination scores, gender, age, and practice time of ophthalmology(P>0.05). At the end of the internship, the teaching effects of the two teaching methods were compared and analyzed by means of students' curriculum assessment questionnaire survey and the clinical examination results. RESULTS: The evaluation of students' satisfaction with the training of various abilities of the course showed that the satisfaction of each ability of the PBL teaching group was higher than that of the traditional teaching group(LBL). Among these abilities, there were statistically significant differences in learning interest improvement, knowledge expansion ability, problem-solving ability and doctor-patient communication ability(PPCONCLUSION: PBL teaching method is more effective in clinical practice teaching of ophthalmology, which is beneficial to train clinical thinking and improve teaching quality

Exploring the challenges of taiwanese nurses in the COVID-19 post-pandemic era

In the wake of the COVID-19 pandemic, the fluctuating nurse resignation rates highlighted an understudied area in healthcare: post-pandemic challenges in clinical settings. This study, conducted from May to November 2023, employed a qualitative inquiry using focus groups to delve into these challenges. Six focus group sessions, involving 33 nurse participants recruited through snowball sampling from various hospital settings were conducted to explore their clinical experiences during and after the pandemic. Thematic analysis revealed two primary themes: the 'Invisibility of Nurses' within the healthcare system and the 'Moral Duty of Nursing Practice'. These findings illuminate a tension between the overlooked role of nurses and their ethical obligations, underscoring a critical need for policy reassessment. The study advocates for systemic changes, particularly in the undervaluation of the nursing profession and the National Health Insurance system, to address the poor working environment and mitigate long-term nursing shortages. This research deepens understanding of post-pandemic nursing workforce challenges in Taiwan, highlighting the need for policy evolution to enhance recognition and support for the nursing industry. It is suggested to provide tangible compensation to acknowledge nurses' daily care and health education for patients. A healthier working environment can be enhanced by collaborative efforts between healthcare institutions and nurses

Ample Pairs

We show that the ample degree of a stable theory with trivial forking is preserved when we consider the corresponding theory of belles paires, if it exists. This result also applies to the theory of $H$-structures of a trivial theory of rank $1$.Comment: Research partially supported by the program MTM2014-59178-P. The second author conducted research with support of the programme ANR-13-BS01-0006 Valcomo. The third author would like to thank the European Research Council grant 33882

Mediating role of resilience in the relationships of physical activity and mindful self-awareness with peace of mind among college students

Abstract Peace of mind (PoM) is an index of mental health in Asian culture and emphasizes low arousal, happiness, harmony, and an internal state of peacefulness. While previous studies have found that mindful self-awareness can contribute to PoM, regular physical activity (PA) is also an important factor contributing to one’s PoM due to its function in promoting one's resilience. The study aims to investigate a hypothetical model that assumes PA is associated with resilience while controlling for mindful self-awareness, contributing to PoM. The PoM scale, Connor-Davidson Resilience Scale, Chinese translation of Mindful Attention Awareness Scale, and PA self-report questionnaire were used. A path analysis was applied to test the association between these variables and the mediating role of resilience. A total of 436 students from a university in Taiwan were recruited; the mean age was 20.87, with 46.3% female and 73.6% engaging in over 150 min/week of moderate PA. Gender and age negatively correlated with PA. After controlling for age and gender, there was no direct effect of physical activity on PoM; both mindful self-awareness and PA predict resilience, which in turn predicts PoM, suggesting that both cognitive (i.e., mindful self-awareness) and PA are important to cultivate resilience and thus PoM

High-speed measurement-device-independent quantum key distribution with integrated silicon photonics

Measurement-device-independent quantum key distribution (MDI-QKD) removes all detector side channels and enables secure QKD with an untrusted relay. It is suitable for building a star-type quantum access network, where the complicated and expensive measurement devices are placed in the central untrusted relay and each user requires only a low-cost transmitter, such as an integrated photonic chip. Here, we experimentally demonstrate a 1.25 GHz silicon photonic chip-based MDI-QKD system using polarization encoding. The photonic chip transmitters integrate the necessary encoding components for a standard QKD source. We implement random modulations of polarization states and decoy intensities, and demonstrate a finite-key secret rate of 31 bps over 36 dB channel loss (or 180 km standard fiber). This key rate is higher than state-of-the-art MDI-QKD experiments. The results show that silicon photonic chip-based MDI-QKD, benefiting from miniaturization, low-cost manufacture and compatibility with CMOS microelectronics, is a promising solution for future quantum secure networks.Comment: 30 pages, 12 figure