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A Structured Method of Teaching Epidural Block reduces the incidence of accidental dural puncture in inexperienced trainees.

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Open Journal of Anesthesiology 2024年第4期14卷 131-135页

作者： marco Scorzoni Gianluigi Gonnella Emanuele Capogna Marina Campione Gaetano Draisci Matteo Velardo Giorgio Capogna Department of Anesthesiology Fondazione Policlinico Gemelli IRCCS Rome Italy Department of Economics and Law Enna Kore University Enna Italy European School of Obstetric Anesthesia Rome Italy

Background: The rate of accidental dural puncture is particularly high during the period of training, especially in novices. The structured epidural teaching model (SETM) includes three standardized video lessons, the construction of a 3D epidural module by trainees and practical training by using an epidural simulator with and without the CompuFlo™ Epidural instrument. In this study we report the retrospective analysis of the accidental dural puncture rate of inexperienced trainees during their 6 months clinical practice rotation in obstetrics before and after the introduction of the SETM in our Institution. Method: We evaluated the incidence of accidental dural puncture before the introduction of the SETM methodology and afterwards by analyzing our departmental database from February 2019 to January 2023. All epidural blocks were executed by trainees who had never previously performed an epidural block and were about to begin their obstetrics rotation. Results: We analyzed 7415 epidurals: 3703 were performed before the introduction of the SETM methodology (control group) and 3712 afterwards (study group). The incidence of accidental dural puncture was 0.37% for the control group and 0.13% for the study group (p<.05). The probability of making an accidental dural puncture was 64% (OR: 0.36) lower for trainees who had the training than for those who did not. Conclusions: After the introduction of the structured teaching method, we observed a significant reduction of accidental dural puncture during the training period. We hope that our observation will encourage a constructive discussion among experts about the need to use standardized and validated tools as a valuable aid in teaching epidural anesthesia.

关键词： teaching epidural Anesthesia obstetrical Anesthesia Anesthesia

Prognostic role of platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in patients with non-metastatic and metastatic prostate cancer:A meta-analysis and systematic review

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Asian Journal of Urology 2024年第2期11卷 191-207页

作者： Stefano Salciccia marco Frisenda Giulio Bevilacqua Pietro Viscuso Paolo Casale Ettore De Berardinis Giovanni Battista Di Pierro Susanna Cattarino Gloria Giorgino Davide Rosati Francesco Del Giudice Alessandro Sciarra Gianna Mariotti Alessandro Gentilucci Department of Urology Sapienza Rome UniversityPoliclinico Umberto I00161 RomeItaly Department of Urology Humanitas20089 RozzanoMIItaly

Objective: To analyze data available in the literature regarding a possible prognostic value of the platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) in prostate cancer (PCa) patients stratified in non-metastatic and metastatic ***: A literature search process was performed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. In our meta-analysis, the pooled event rate estimated and the pooled hazard ratio were calculated using a random effect ***: Forty-two articles were selected for our analysis. The pooled risk difference for non-organ confined PCa between high and low NLR cases was 0.06 (95% confidence interval [CI]: −0.03-0.15) and between high and low PLR cases increased to 0.30 (95% CI: 0.16-0.43). In non-metastatic PCa cases, the pooled hazard ratio for overall mortality between high and low NLR was 1.33 (95% CI: 0.78-1.88) and between high and low PLR was 1.47 (95% CI: 0.91-2.03), whereas in metastatic PCa cases, between high and low NLR was 1.79 (95% CI: 1.44-2.13) and between high and low PLR was 1.05 (95% CI: 0.87-1.24).Conclusion: The prognostic values of NLR and PLR in terms of PCa characteristics and responses after treatment show a high level of heterogeneity of results among studies. These two ratios can represent the inflammatory and immunity status of the patient related to several conditions. A higher predictive value is related to a high NLR in terms of risk for overall mortality in metastatic PCa cases under systemic treatments.

关键词： Prostatic neoplasm Neutrophil-to-lymphocyte ratio Platelet-to-lymphocyteratio Meta-analysis Radical prostatectomy Metastatic

Adherence to Pharmacotherapy in Post-Menopausal Women with Hypertension or Metabolic Syndrome: Real World Experience

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International Journal of Clinical Medicine 2024年第3期15卷 145-154页

作者： Maria Maiello Francesca Amati Vincenzo Ezio Santobuono Andrea Igoren Guaricci Cinzia Forleo marco Matteo Ciccone Pasquale Palmiero Department of Cardiology ASL BR SSN3 Brindisi Italy Cardiovascular Diseases Section Interdisciplinary Department of Medicine (DIM) University of Bari “Aldo Moro” Bari Italy

Background: Adherence to medications is dependent upon a variety of factors, including individual characteristics of the patient, interactions with health care providers, and medication complexity. Even though several studies were conducted to test intervention strategies, results are uncertain. Aim: The aim of the study is to assess if a tailored combined intervention strategy improves medication adherence in a large population of post-menopausal women affected by hypertension or metabolic syndrome. Methods: We enrolled 6833 patients aged 50 to 69 years, 85.7% with hypertension, and 14.3% with metabolic syndrome. A network between patients, general practitioners, and cardiologists was established. Interventions included education, adequate information to patients, a simplified scheme of treatment, and periodic adherence assessment. These were either delivered as healthcare provider supports or using modern technology. Medication adherence was estimated by the proportion of days covered for all classes of drugs after the index date. Results: Non-adherent hypertensive women were 297 (5%), and those with metabolic syndrome were 73 (7.4%) (p Conclusions: The rate of non-adherence in both settings of postmenopausal women was 7.7%, much lower than that described in the literature. This rate was increased in patients with metabolic syndrome;probably it is related to the complexity of the therapeutic scheme or to a poor consciousness of the disease. Therefore, implementing a tailored combined intervention can improve significantly patients’ adherence to medical therapy.

关键词： Adherence Cardiovascular Prevention Postmenopausal Women Hypertensive Metabolic Syndrome

Minimally invasive surgical therapies(MISTs)for lower urinary tract symptoms(LUTS):promise or panacea?

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Asian Journal of Andrology 2024年第2期26卷 135-143页

作者： Gian Maria Busetto Andrea Checchia marco Recchia Edoardo Tocci Ugo G Falagario Gennaro Annunziata Pasquale Annese Nicola d'Altilia Vito Mancini Matteo Ferro Felice Crocetto Octavian Sabin Tataru Luca Di Gianfrancesco Angelo Porreca Francesco Del Giudice Ettore De Berardinis Carlo Bettocchi Luigi Cormio Giuseppe Carrieri University of Foggia Foggia 71122Italy Department of Urology and Renal Transplantation Policlinico of FoggiaFoggia 71122Italy Urology Unit "G.Tatarlla"HospitalCerignola 71042Italy Urology Unit European Institute of Oncology(IE0)IRCcSMilan 20141Italy University of Naples Federico Il Naples 80126Italy G.E.Palade University of Medicine PharmacyScienceand Technology of Targu MuresTargu Mures 540142Romania Department of Oncological Urology Veneto Institute of Oncology(IOv)IRccSPadua 35128Italy Department of Maternal-Infant and Urological Sciences Sapienza Rome UniversityRoma 00161Italy Urology Unit "L.Bonomo"HospitalAndria 76123Italy

The increasing importance of treatment of lower urinary tract symptoms(LUTS),while avoiding side effects and maintaining sexual function,has allowed for the development of minimally invasive surgical therapies(MiSTs).Recently,the European Association of Urology guidelines reported a paradigm shift from the management of benign prostatic hyperplasia(BPH)to the management of nonneurogenic male *** aim of the present review was to evaluate the efficacy and safety of the most commonly used MisTs:ablative techniques such as aquablation,prostatic artery embolization,water vapor energy,and transperineal prostate laser ablation,and nonablative techniques such as prostatic urethral lift and temporarily implanted nitinol device(iTIND).MiSTs are becoming a new promise,even if clinical trials with longer follow-up are still *** of them are still under investigation and,to date,only a few options have been given as a recommendation for *** cannot be considered as standard of care and are not suitable for all *** and disadvantages should be underlined,without forgetting our objective:treatment of LUTS and re-treatment avoidance.

关键词： aquablation iTIND prostatic artery embolization prostatic urethral lift transperineal prostate laser ablation water vapor energy

Herpes simplex keratitis:A brief clinical overview

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World Journal of Virology 2024年第1期13卷 5-32页

作者： Mutali Musa Ehimare Enaholo Gladness Aluyi-Osa George Nnamdi Atuanya Leopoldo Spadea Carlo Salati marco Zeppieri Department of Optometry University of BeninBenin 300283Nigeria Department of Ophthalmology Africa Eye Laser CentreKm 7Benin 300105Nigeria Department of Ophthalmology Centre for Sight AfricaNkpor 434101Nigeria Eye Clinic Policlinico Umberto I"Sapienza"University of RomeRome 00142Italy of Ophthalmology University Hospital of UdineUdine 33100Italy

The aim of our minireview is to provide a brief overview of the diagnosis,clinical aspects,treatment options,management,and current literature available regarding herpes simplex keratitis(HSK).This type of corneal viral infection is caused by the herpes simplex virus(HSV),which can affect several tissues,including the *** significant aspect of HSK is its potential to cause recurrent episodes of inflammation and damage to the *** the initial infection,the HSV can establish a latent infection in the trigeminal ganglion,a nerve cluster near the *** virus may remain dormant for extended *** reactivation of the virus can occur,leading to recurrent episodes of *** triggering reactivation include stress,illness,immunosuppression,or *** episodes can manifest in different clinical patterns,ranging from mild epithelial involvement to more severe stromal or endothelial *** severity and frequency of recurrences vary among *** cases of HSK,especially those involving the stroma and leading to scarring,can result in vision impairment or even blindness in extreme *** cornea's clarity is crucial for good vision,and scarring can compromise this,potentially leading to visual *** management of HSK involves not only treating acute episodes but also implementing long-term strategies to prevent recurrences and attempt repairs of corneal nerve endings via *** medications,such as oral Acyclovir or topical Ganciclovir,may be prescribed for *** immune response to the virus can contribute to corneal ***,caused by the body's attempt to control the infection,may inadvertently harm the corneal *** should be informed about triggers and advised on measures to minimize the risk of *** summary,the recurrent nature of HSK underscores the importance of both acute and long-term management strategies to preserve corneal health and maintai

关键词： Herpes simplex virus Herpes simplex keratitis Acyclovir Neurotization Reactivation

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电能变革——卫生纸干燥中的能效提升

生活用纸 2024年第5期24卷 56-57页

作者： marco Cattani George Nowakowski 安德里茨Novimpianti 安德里茨加拿大Lachine工厂

安德里茨Novimpianti产品经理marco Cattani和安德里茨加拿大Lachine工厂卫生纸干燥业务副总裁George Nowakowski表示,随着卫生纸厂对能耗优化与出色可持续性的渴望愈发强烈,安德里茨电加热式气罩系统的出现可谓恰逢其时。

关键词：副总裁产品经理卫生纸能效提升可持续性能耗优化

意大利语版护理管理者胜任力测评工具的信效度检验

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International Journal of Nursing Sciences 2024年第3期11卷 338-348页

作者： Dhurata Ivziku Lucia Filomeno Daniela Forte Rosario Caruso Gianluca Conte Arianna Magon Raffaella Gualandi marco Di Muzio Daniela Tartaglini Department of Health Professions Fondazione Policlinico Universitario Campus Bio-MedicoRomeItaly Department of Biomedicine and Prevention University of Rome Tor VergataRomeItaly Health Professions Research and Development Unit IRCCS San Donato HospitalMilanItaly Department of Biomedical Sciences for Health University of MilanMilanItaly Department of Clinical and Molecular Medicine Sapienza UniversityRomeItaly Vice President Italian Society for the Direction and Management in Nursing(SIDMI) RomeItaly

目的旨在翻译Chase护理管理者胜任力测评工具(the Chase Nurse Manager Competency Instrument,CNMCI)为意大利语,并对其进行信度和效度检验。方法对英文版CNMCI进行翻译,并通过横断面研究验证其信效度。采用预翻译(建立等效)、初始翻... 详细信息

目的旨在翻译Chase护理管理者胜任力测评工具(the Chase Nurse Manager Competency Instrument,CNMCI)为意大利语,并对其进行信度和效度检验。方法对英文版CNMCI进行翻译,并通过横断面研究验证其信效度。采用预翻译(建立等效)、初始翻译、预测试、审查和管理5个步骤的问卷翻译方法,将英文版工具翻译为意大利语版。于2022年8月到2023年6月,选取意大利3个地区31所医疗机构349名护理管理者进行调查。采用内容效度、结构效度评估工具的效度;采用Cronbach'sα系数、重测信度评估工具的信度。结果意大利语版CNMCI,包括“知识理解”和“实施和/或使用能力”两个分量表,每个分量表包括53个条目。工具的条目内容效度指数(I-CVI)为0.83~1.00,两个分量表的内容效度指数(S-CVI)均为0.97。经验证性因子分析显示该工具各项拟合指数表现良好。工具中“知识理解”分量表的Cronbach'sα系数为0.978,“实施和/或使用能力”分量表的Cronbach'sα系数为0.976。各个维度之间的相关系数为0.494~0.908重测信度为0.820,表明工具的一致性较好。结论意大利语版CNMCI在测量护理管理者胜任力方面显示出良好的信度和效度,并支持该工具的多维度结构。此外,研究结果支持了这些因素的层次性质,进一步支持了该工具的有效性。

关键词：胜任力护理管理者信度调查及问卷效度

Effect of drug therapies on self-reported chemosensory outcomes after COVID-19

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2024年第2期10卷 88-96页

作者： marco A.Fornazieri Bruno M.Cunha Samuel P.Nicácio Lucas K.Anzolin JoséL.B.da Silva Aristides Fernandes Neto Deusdedit Brandão Neto Richard L.Voegels Fábio D.R.Pinna Department of Surgery Londrina State UniversityLondrinaBrazil Department of Medicine Pontifical Catholic University of ParanáLondrinaBrazil Department of Otorhinolaryngology University of São PauloSao PauloBrazil Department of Otorhinolaryngology:Head and Neck Surgery Perelman School of MedicineSmell and Taste CenterUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA

Objective:The aim of this study was to assess the relative efficacy of medications used following severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)infection on self-reported alterations in taste and/or smell ***:Seven hundred and fourteen persons with self-reported postcoronavirus disease 2019(post-COVID-19)chemosensory disorders were personally interviewed regarding specific medications they were administered following the acute phase of the *** dependent measure—self-reported total recovery of chemosensory symptoms—was subjected to stepwise logistic *** predictors included demographic and clinical variables,in addition to specific medications used to mitigate disease symptoms(i.e.,systemic corticosteroids,oseltamivir,vitamin C,ibuprofen,hydroxychloroquine,azithromycin,ivermectin,nitazoxanide,anticoagulants,and zinc).Results:The median time between COVID-19 symptom onset and the interviews was 81 days(interquartile range:60-104).Of the 714 subjects,249(34.9%)reported total recovery of their chemosensory function;437(61.2%)had at least one treatment since the beginning of the *** and those with more comorbidities had undergone more *** recovery rates of the treated and nontreated groups did not differ ***,respondents who had used nitazoxanide tended to have a higher rate of self-reported taste or smell *** who took oral zinc were less likely to ***:No medication employed during the first months after SARS-CoV-2 infection had a clear positive effect on returning self-reported smell or taste function to normal,although nitrazoxide trended in a positive *** zinc had a negative effect on the reported recovery of these senses.

关键词： chemosensory disorder coronavirus infections COVID-19 drug therapy SARS-CoV-2 smell loss taste loss

Optimizing laser coupling,matter heating,and particle acceleration from solids using multiplexed ultraintense lasers

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Matter and Radiation at Extremes 2024年第4期9卷 16-28页

作者： Weipeng Yao Motoaki Nakatsutsumi Sébastien Buffechoux Patrizio Antici marco Borghesi Andrea Ciardi Sophia N.Chen Emmanuel d’Humières Laurent Gremillet Robert Heathcote Vojtech Horny Paul McKenna Mark N.Quinn Lorenzo Romagnani Ryan Royle Gianluca Sarri Yasuhiko Sentoku Hans-Peter Schlenvoigt Toma Toncian Olivier Tresca Laura Vassura Oswald Willi Julien Fuchs LULI-CNRS CEASorbonne UniversitéEcole PolytechniqueInstitut Polytechnique de ParisF-91128 Palaiseau CedexFrance Sorbonne Université Observatoire de ParisUniversité PSLCNRSLERMAF-75005 ParisFrance INRS-EMT 1650 BoulLionel-BouletVarennesQuebec J3X 1S2Canada Center for Plasma Physics School of Mathematics and PhysicsQueen’s University BelfastBelfast BT71NNUnited Kingdom “Horia Hulubei”National Institute for Physics and Nuclear Engineering 30 Reactorului StreetRO-077125 Bucharest-MagureleRomania University of Bordeaux Centre Lasers Intenses et ApplicationsCNRSCEAUMR 5107F-33405 TalenceFrance CEA DAMDIFF-91297 ArpajonFrance Université Paris-Saclay CEALMCE91680 Bruyères-le-ChatelFrance Central Laser Facility STFC Rutherford Appleton LaboratoryDidcotUnited Kingdom SUPA Department of PhysicsUniversity of StrathclydeGlasgow G40NGUnited Kingdom Department of Physics University of NevadaRenoNevada 89557USA Institute of Laser Engineering Osaka University2-6 YamadaokaSuitaOsaka 565-0871Japan Institut fur Laser und Plasmaphysik Heinrich Heine Universitat DusseldorfDusseldorfGermany

Realizing the full potential of ultrahigh-intensity lasers for particle and radiation generation will require multi-beam arrangements due to technology ***,we investigate how to optimize their coupling with solid ***,we show that overlapping two intense lasers in a mirror-like configuration onto a solid with a large preplasma can greatly improve the generation of hot electrons at the target front and ion acceleration at the target *** underlying mechanisms are analyzed through multidimensional particle-in-cell simulations,revealing that the self-induced magnetic fields driven by the two laser beams at the target front are susceptible to reconnection,which is one possible mechanism to boost electron *** addition,the resistive magnetic field generated during the transport of the hot electrons in the target bulk tends to improve their *** simulations also indicate that such effects can be further enhanced by overlapping more than two laser beams.

关键词： laser acceleration particle