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IntroductionPragmatic trials in comparative effectiveness research assess the effects of different treatment, therapeutic, or healthcare options in clinical practice. They are characterized by broad eligibility criteria and large sample sizes, which can lead to an unmanageable number of participants, increasing the risk of bias and affecting the integrity of the trial. We describe the development of a sampling strategy tool and its use in the PREPARE trial to circumvent the challenge of unmanageable work flow.MethodsGiven the broad eligibility criteria and high fracture volume at participating clinical sites in the PREPARE trial, a pragmatic sampling strategy was needed. Using data from PREPARE, descriptive statistics were used to describe the use of the sampling strategy across clinical sites. A Chi-square test was performed to explore whether use of the sampling strategy was associated with a reduction in the number of missed eligible patients.Results7 of 20 clinical sites (35%) elected to adopt a sampling strategy. There were 1539 patients excluded due to the use of the sampling strategy, which represents 30% of all excluded patients and 20% of all patients screened for participation. Use of the sampling strategy was associated with lower odds of missed eligible patients (297/4545 (6.5%) versus 341/3200 (10.7%) p

Atrial fibrillation (AF) is the most common arrhythmia worldwide, and is associated with a significant risk of thromboembolic events. Left atrial appendage occlusion (LAAO) has emerged as a promising alternative for patients with contraindications or intolerance to anticoagulant therapy. This review summarises the current evidence, indications, and technical advancements in surgical and percutaneous LAAO. Preprocedural planning relies on various imaging techniques, each with unique advantages and limitations. The existing randomised clinical trials and meta-analyses demonstrate favourable results for both percutaneous and surgical LAAO. Postprocedural management emphasises personalised anticoagulation strategies and comprehensive imaging surveillance to ensure device stability and detect complications. Future focus should be put on antithrombotic regimens, investigating predictors of device-related complications, and simplifying procedural aspects to enhance patient outcomes. In summary, LAAO is presented as a valuable therapeutic option for preventing AF-related thromboembolic events, with ongoing research aimed at refining techniques and improving patient care.

The objective of this study is to determine the effect of two distinct cooking techniques, namely roasting and stewing, on the formation of volatile compounds in various beef muscles (Semimembranosus, Biceps femoris, and Rectus femoris) and how this relates to consumer acceptance. The research employs the concept of volatile “marker” compounds to discern the influence of cooking techniques on the flavor profile of beef. Eighteen “marker compounds” were selected to represent a number of the mechanisms of formation and quantified in beef subjected to two different cooking methods. While no statistically significant differences were observed in consumer evaluations between the two cooking methods, notable disparities emerged in the consumer assessments of specific muscle cuts. Notably, the Rectus femoris muscle received the highest ratings (p < 0.05) among other evaluated muscles. The utilization of Solid-Phase Microextraction (SPME) and gas chromatography–mass spectrometry (GC-MS) methods for the analysis of volatile “marker compounds” in beef proved effective in highlighting significant differences in flavor compound classes between cooking methods, and these differed between muscles. The main effect was of the cooking method with stewed beef aroma having approximately 39× more dimethyl trisulphide, 9× more dimethyl disulphide, 7× more pentanal, 3× more hexanal, and twice as much benzaldehyde and 2-methylthiophene. Dimethyldisulphide, dimethyltrisulphide, hexanal, and heptanal, therefore, emerged as characteristic volatile compounds associated with the stewing cooking technique, suggesting their potential as markers for lipid and other oxidation reactions. This work indicates that certain lipid oxidation compounds, Strecker aldehydes, and sulfur compounds can be markers for the undesirable and/or desirable flavors of cooked beef, but that this depends on the cooking method chosen. It shows that flavor differences may be understood through the analysis of volatile flavor compounds in association with palatability and other chemical measurements.

Long coherence times at room temperature make the NV center a promising candidate for quantum sensors and quantum computers. The necessary coherent control of the electron spin triplet in the ground state requires microwave π pulses in the nanosecond range, obtained from the Rabi oscillation of the mS spin states of the magnetic resonances of the NV centers. Laboratory equipment has a high temporal resolution for these measurements but is expensive and, therefore, uninteresting for fields such as education. In this work, we present measurement electronics for NV centers that are optimized for microcontrollers. It is shown that the Rabi frequency is linear to the output of the digital-to-analog converter (DAC) and is used to adapt the time length π of the electron spin flip, to the limited pulse width resolution of the microcontroller. This was achieved by breaking down the most relevant functions of conventional laboratory devices and replacing them with commercially available integrated components. The result is a cost-effective handheld setup for coherent control applications of NV centers.

Abstract. Objectives:. Patient engagement in the design and implementation of clinical trials is necessary to ensure that the research is relevant and responsive to patients. The PREP-IT trials, which include 2 pragmatic trials that evaluate different surgical preparation solutions in orthopaedic trauma patients, followed the patient-centered outcomes research (PCOR) methodology throughout the design, implementation, and conduct. We conducted a substudy within the PREP-IT trials to explore participants' experiences with trial participation. Methods:. At the final follow-up visit (12 months after their fracture), patients participating in the PREP-IT trials were invited to participate in the substudy. After providing informed consent, participants completed a questionnaire that asked about their experience and satisfaction with participating in the PREP-IT trials. Descriptive statistics are used to report the findings. Results:. Four hundred two participants participated in the substudy. Most participants (394 [98%]) reported a positive experience, and 376 (94%) participants felt their contributions were appreciated. The primary reasons for participation were helping future patients with fracture (279 [69%]) and to contribute to science (223 [56%]). Two hundred seventeen (46%) participants indicated that their decision to participate was influenced by the minimal time commitment. Conclusions:. Most participants reported a positive experience with participating in the PREP-IT trials. Altruism was the largest motivator for participating in this research. Approximately half of the participants indicated that the pragmatic, low-participant burden design of the trial influenced their decision to participate. Meaningful patient engagement, a pragmatic, and low-burden protocol led to high levels of participant satisfaction.

The study aimed to determine photosynthetic signatures, i.e. photosynthetic energy storage (ES) efficiency and photoacoustic spectra of pigment-containing biofilm communities attached to submerged solid substrates in relation to the temporal variability of the trophic state of natural water. Biofouling phenomenon signatures on artificial solid surfaces, deployed in the shallow Baltic Sea waters (Gulf of Gdańsk, Poland) for a specific period of time, were determined over a three-year period using improved photoacoustic spectroscopy apparatus based on closed cell geometry. Selected chemical parameters (oxygen, nitrogen and phosphorus concentrations) and biological productivity (primary production and Chlorophyll a; hereinafter abbreviated as Chl a) of the water body were obtained from the SatBałtyk System platform (http://satbaltyk.iopan.gda.pl) and used as comprehensive data. As a result, close cross-correlations between photosynthetic energy storage and PAS amplitude spectra and the seawater chemical parameters were demonstrated. As found, ES was negatively correlated with concentrations of biogenic elements (correlation coefficient R given in brackets): O (–0.67), P (–0.81), N (–0.76), and positively correlated with concentrations of Chl a (0.82) and primary production (0.39). As periphyton is believed to respond dynamically to water quality and environmental stresses, its photosynthetic system features can be used as novel, modern and robust indicators in marine bioassessment, in addition to traditional trophic state indices based on chemical analysis.

Abstract Background Rotator cuff tears among patients under 50 years either result from an adequate trauma or are considered non-traumatic due to work-related or athletic overuse. The impact of these different mechanisms on postoperative functional outcomes and tendon healing has not yet been fully understood. Therefore, it was the purpose of this study to investigate the influence of etiology of (antero-)superior rotator cuff tears on postoperative outcomes and the healing rates after arthroscopic rotator cuff repair in a young patient population. Methods Patients under 50 years who underwent arthroscopic rotator cuff repair between 2006–2017 for an anterosuperior rotator cuff tear with a minimum follow up of 24 months were included in this study. Revision surgeries or reconstructive concomitant procedures other than long head of the biceps tenodesis were excluded. Patients were divided into two groups according to the etiology of their rotator cuff tear (traumatic vs. non-traumatic). Demographic and outcome scores including the American Shoulder and Elbow Surgeons (ASES) score, the Constant Score (CS), bilateral strength measurements and postoperative tendon integrity evaluated on magnetic resonance imaging (MRI) were assessed and compared between both groups. Results The mean follow up for this study was 55.6 months (24 – 158). Twenty-one patients (50.0%) had a traumatic RCT and 21 patients (50.0%) had a non-traumatic tear. Outcome scores did not differ significantly between groups. Strength measurements of the supraspinatus revealed significantly decreased force of the affected side as opposed to the contralateral side (p = 0.001), regardless of etiology. Retear rates were similar in both groups (37.5% and 33.3%, p = n.s.). Cuff integrity at follow-up was not predictive of superior scores or strength. Conclusion Surgical treatment of traumatic and non-traumatic RCT yields good clinical results in patients under the age of 50. The etiology of the rotator cuff tear did not significantly affect postoperative outcomes or healing rates. About one third of the patients suffered from a retear postoperatively, however retears were not predictive of inferior outcomes at midterm follow-up. Study design Level III. Trial registration Retrospectively registered.

Borrelial lymphocytoma (BL) is a rare manifestation of Lyme disease characterized by pathological lymphoproliferation on the skin (a type of cutaneous pseudolymphoma) in reaction to a Borrelia infection. It usually manifests itself as red plaques or swollen nodules, most commonly located on the ear lobes, genitals, or around the nipples. We describe a case of a 5-year-old girl with a painful erythematous nodule of the right auricle. The initial symptomatic treatment (with antihistamines and topical anti-inflammatory agents) resulted in temporary partial relief. There was a history of tick bites 3 and 5 months prior to the first manifestation of the disease. A positive serology test result for Borrelia burgdorferi (both chemiluminescent immunoassay and Western-Blot) led to the diagnosis of BL. The administration of an oral antibiotic therapy resulted in the quick disappearance of the lesion.

Invasive meningococcal disease is a dangerous bacterial infection that often leads to death or permanent disability. Immunization is the best strategy to protect individuals against invasive infections caused by Neisseria meningitidis. The effectiveness of vaccines has been demonstrated in many countries where they have been introduced into national vaccination programs. Meningococcal vaccinations in Poland are recommended in the framework of the National Immunization Program. However, they are not reimbursed, meaning the patient or parent covers vaccination costs. In addition, insufficient public awareness of the disease course and risks associated with meningococcal infection, the need for immunization in the first year of a child’s life, the number of doses administered, and the price of the vaccines are barriers to the acceptance and implementation of meningococcal immunization, especially in the youngest children. Recommendations for physicians implementing meningococcal vaccination in children and adults are the result of the work of an expert group.

We investigate the magnetic field-dependent fluorescence lifetime of microdiamond powder containing a high density of nitrogen-vacancy centers. This constitutes a non-intensity quantity for robust, all-optical magnetic field sensing. We propose a fiber-based setup in which the excitation intensity is modulated in a frequency range up to 100MHz. The change in magnitude and phase of the fluorescence relative to B=0 is recorded where the phase shows a maximum in magnetic contrast of 5.8∘ at 13MHz. A lock-in amplifier-based setup utilizing the change in phase at this frequency shows a 100 times higher immunity to fluctuations in the optical path compared to the intensity-based approach. A noise floor of 20μT/Hz and a shot-noise-limited sensitivity of 0.95μT/Hz were determined.

Children with Developmental Language Disorder (DLD) commonly present with oral language weaknesses which disrupt the development of literacy and impede related academic progress. While there is evidence to support the delivery of manualised Tier 2 interventions with this population, little is known about the effects of Tier 1 interventions. A retrospective cohort comparison was used to evaluate whether there was an observable effect of a manualised Tier 1 intervention compared to 'business-as-usual' on early literacy skills for children with DLD. Participants were 140 children attending a specialised education program with equivalent oral language skills and alphabetic knowledge at baseline. After 18 months formal literacy intervention, both groups were assessed on measures of early literacy skills. The differences between group means on all measures favoured the manualised intervention group, and they performed significantly better on a measure of nonword reading fluency. The findings indicate that a manualised Tier 1 intervention may be advantageous for children with DLD in developing proficiency in phonological recoding. This research contributes to the sparse evidence-base supporting the implementation of Tier 1 interventions for at risk populations, and findings warrant future research using experimental designs with tighter controls.

The European Academy of Paediatrics (EAP) and the European Confederation of Primary Care Paediatricians (ECPCP) emphasize the importance of promoting healthy lifestyles within the pediatric population. Many health professionals have questions concerning adequate levels of physical activity for both the healthy pediatric population and for those who may have specific complications. Unfortunately, the academic literature that provides recommendations for participation in sport activities within the pediatric population that have been published during the last decade in Europe is limited and is mainly dedicated to specific illnesses or advanced athletes and not toward the general population. The aim of part 1 of the EAP and ECPCP position statement is to assist healthcare professionals in implementing the best management strategies for a pre-participation evaluation (PPE) for participation in sports for individual children and adolescents. In the absence of a uniform protocol, it is necessary to respect physician autonomy for choosing and implementing the most appropriate and familiar PPE screening strategy and to discuss the decisions made with young athletes and their families. This first part of the Position Statement concerning Sport Activities for Children and Adolescents is dedicated to healthy young athletes.

Multisystem inflammatory syndrome in children (MIS-C) is a late complication of SARS-CoV-2 infection, either symptomatic or asymptomatic. The underlying cause is immunological dysregulation, leading to severe inflammatory processes. Children with MIS-C require hospital treatment, the use of immunomodulating drugs, and often intensive care. COVID-19 vaccination is safe and highly effective in preventing not only severe COVID-19, but also MIS-C in adolescents. However, there are no explicit vaccination recommendations for children who underwent MIS-C. We present a summary of current knowledge on vaccinations against COVID-19 in the context of MIS-C. Moreover, we propose guidance concerning vaccinations for children following MIS-C.

Since late 2021, we have observed a significant increase in the proportion of children infected with SARS-CoV-2. The course of the disease in children is usually sparsely symptomatic or asymptomatic. However, the predominance of new virus variants makes children more likely to become symptomatically ill and require hospitalisation. This paper aims to update recommendations for managing a child with COVID-19 in out- and inpatient settings. Current options for prevention and antiviral treatment are discussed, noting the limited availability of therapy for children. In most children with COVID-19, the basis for treatment remains symptomatic and supportive therapy and measures to reduce SARS-CoV-2 infection spread.

Background/Objectives: Sudden cardiac death (SCD) remains a major global health concern and represents one of the most common causes of mortality due to cardiovascular diseases. The wearable cardioverter–defibrillator (WCD) is an innovative, non-invasive medical device designed to provide continuous heart monitoring and immediate defibrillation in patients at risk for SCD. The study aimed to assess the efficacy of WCD usage in patients awaiting decision on therapy with implantable cardioverter–defibrillators (ICDs). Methods: We explored the clinical applications, benefits, and limitations of WCD usage within the BIA-VEST registry in Poland over the years 2021–2023. The study included 10 patients with a mean age of 49.1 ± 12.02 years. Results: All patients demonstrated good tolerance and compliance with the LifeVest WCD, wearing it for an average of 93.1 days, about 22.8 h per day (95.7% of the time). No interventions from LifeVests were recorded, and there were no effective, ineffective, or inadequate discharges. After the first follow-up echocardiography, five patients still required ICDs. Due to improved LVEF and overall condition in six out of ten patients undergoing WCD bridge therapy, ICD implantation was finally waived. Conclusions: The WCD acts as a bridge to therapy, such as ICD implantation or cardiac surgery, and may be particularly beneficial for patients with transient or evolving conditions, such as structural heart diseases and life-threatening ventricular arrhythmias. [ABSTRACT FROM AUTHOR]

Cardiac transthyretin amyloidosis is an underdiagnosed disorder with significant diagnostic difficulties due to its non-specific clinical manifestations. It is caused by the deposition of protein aggregates with an abnormal tertiary structure in the extracellular matrix. Their accumulation leads to the development of hypertrophic and restrictive cardiomyopathy and, at a later stage, heart failure with preserved ejection fraction syndrome. Depending on the pathogenesis, there are different types of the disease—hereditary and age-related wild-type transthyretin amyloidosis. We present the case of an 85-year-old woman who was referred to the department with a two-month history of exertional dyspnea in New York Heart Association functional class II. After reviewing the initial findings, several red flags for cardiac amyloidosis (CA) were identified. Following the diagnostic algorithm, scintigraphy was performed and showed significant radioisotope accumulation in the myocardium, confirming the suspected disease. In this manuscript, we present the current recommendations and diagnostic pathway, discussing in detail both available and emerging treatment options. As early diagnosis is essential to prevent the development of serious complications, we would like to highlight the pitfalls in diagnosing CA and emphasize the need to be aware of its variable clinical presentation and red flags. [ABSTRACT FROM AUTHOR]

Background/Objectives. Iron deficiency is one of the most common nutritional deficiencies worldwide and is the leading cause of anemia in the pediatric population (microcytic, hypochromic anemia due to iron deficiency). Moreover, untreated iron deficiency can lead to various systemic consequences and can disrupt the child's development. Methods/Results. Therefore, a team of experts from the Polish Pediatric Society, the Polish Society of Pediatric Oncology and Hematology, the Polish Neonatology Society, and the Polish Society of Family Medicine, based on a review of the current literature, their own clinical experience, and critical discussion, has developed updated guidelines for the diagnosis, prevention, and treatment of iron deficiency in children from birth to 18 years of age. These recommendations apply to the general population and do not take into account the specifics of individual conditions and diseases. [ABSTRACT FROM AUTHOR]

Information about effective interventions for students with early reading difficulties is essential when deciding about how best to provide support. MiniLit, a small-group intervention for young struggling readers, was released in 2011 after several years of development and trials. This paper provides a rationale for MiniLit, a brief history of its development and implementation, and a summary of evidence collected from various efficacy studies. Pre- and post-test group data from program trials and experimental research indicate that MiniLit has produced large gains in students' phonemic awareness, phonic decoding, word reading, and spelling. Experimental studies yielded lower effect sizes than program trials for phonic decoding and word reading skills, with effect sizes for these dimensions in the medium or large range. Program revisions in response to evidence from studies, feedback from practitioners, and findings from recent research about early reading have been undertaken, resulting in the development of MiniLit Sage.