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Left ventricular (LV) myocardial work (LVMW) indexes have shown incremental value over LV ejection fraction and were found to have prognostic significance in patients with secondary mitral regurgitation. We therefore aimed to investigate the association between LVMW indexes and forward flow reserve in patients with secondary mitral regurgitation, treated with transcatheter edge-to-edge repair (TEER). LVMW indexes were evaluated at baseline and forward stroke volume index (FSVI) was evaluated at baseline and 6-month follow-up after TEER. Patients were divided in 2 groups improvers (improvement in FSVI ≥20%) and nonimprovers (improvement in FSVI <20%). A total of 70 patients (median age 76 years, 59% men) were included. FSVI was the only echocardiographic parameter that improved after TEER. There was a significant decrease in LV global longitudinal strain in the nonimprovers (p = 0.002) but not in the improvers (p = 0.177). Global work index and global constructive work worsened in nonimprovers (p = 0.005 and p = 0.004, respectively), whereas no difference was seen in these indexes in improvers (p = 0.093 and p = 0.112, respectively). Global work efficiency remained independently associated with forward flow reserve after adjusting for a variety of potential confounders. In conclusion, FSVI nonimprovers demonstrated worsening of LV systolic function after TEER compared with improvers, in whom LV systolic function remained stable. Global work efficiency was associated with FSVI improvement after TEER, independent of LV systolic function.Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiac disease explaining about 4% of sudden cardiac death (SCD) cases in the young in Sweden. This study aimed to describe the circumstances preceding SCD in all victims <35 years of age who received an autopsy-confirmed diagnosis of ARVC from January 1, 2000, to December 31, 2010, in Sweden (n = 22). Data on demographics, medical and family history, circumstances of death, and anatomopathological findings were collected from several compulsory national health registries, clinical records, family interviews, and autopsy reports. this website Registry-based data were compared with age-matched, gender-matched, and geographically-matched population controls. During the 6 months preceding SCD, 15 cases (68%) had experienced symptoms of cardiac origin, mainly syncope or presyncope (54%) and chest discomfort (27%). A total of 8 cases (36%) had sought medical care because of cardiac symptoms. The occurrence of hospital visits was significantly increased in cases compared with controls (odds ratio 4.62 [1.35 to 15.8]). A total of 10 cases (45%) had a family history of SCD. The most common activity at the time of death was exercise (41%). A complete cardiac investigation was seldom performed; only 1 case was diagnosed with ARVC before death. In conclusion, in this nationwide study, we observed a high prevalence of symptoms of cardiac origin, healthcare use, and family history of SCD preceding SCD in the young caused by ARVC. Increased awareness of these warning signals in younger patients is critical to improving risk stratification and early disease detection.

To compare the cumulative live birth rates (CLBRs) and cost effectiveness of intracytoplasmic sperm injection (ICSI) and conventional invitro fertilization (cIVF) for non-male factor infertility.

A retrospective cohort study.

Society for Assisted Reproductive Technology clinics.

A total of 46,967 patients with non-male factor infertility with the first autologous oocyte retrieval cycle between January 2014 and December2015.

None.

The primary outcomes were CLBR, defined as up to 1 live birth from an autologous retrieval cycle between 2014 and 2015, and linked fresh and frozen embryo transfers through 2016. The secondary outcomes included miscarriage rate, 2 pronuclei per oocyte retrieved, and the total number of transferred and frozen embryos. Analyses were performed on subsamples with and without preimplantation genetic testing for aneuploidy (PGT-A). A cost analysis was performed to determine the costs accrued by ICSI.

Among cycles without PGT-A in patients with non-male factor infertility, thee of ICSI in patients with non-male factor infertility is not warranted.

The changes in hormones, diet, and hygiene associated with pregnancy are associated with oral diseases. There is insufficient awareness of the importance of oral health during pregnancy. This study investigated the oral health status and knowledge amongst pregnant women in Shanghai.

This cross-sectional study enrolled pregnant women at the Shanghai Red House Obstetrics & Gynecology Hospital in December 2020. The Fourth National Oral Health Questionnaire was used to evaluate the oral health status. Decayed/missing/filled teeth (DMFT) were the sum of the number of decayed, missing due to caries, and filled teeth. The chi-square test and Kruskal-Wallis test were used to compare the groups.

A total of 224 pregnant women were enrolled. The rates of dental caries were 69.8%, periodontal health was 1.8%, calculus detection was 95.6%, shallow periodontal pocket was 51.1%, deep periodontal pocket was 4.9%, regular oral examination was 22.8%, correct brushing was 49.6%, and prepregnancy oral examination was 20.1%. DMFT was 2.27, and the caries filling ratio was 45.4%. The number of missing teeth increased with age (P < .001). Only 26.3% used dental floss more than once a day, 47.3% rinsed the mouth more than twice a day, and 46.9% cleaned their tongue coating every week. In addition, 99% of the pregnant women agreed that "oral health was vital to their lives" and 97.7% agreed that "regular oral examination was necessary."

The oral health status amongst pregnant women in Shanghai was poor, but oral health awareness and attitudes were relatively high.

The oral health status amongst pregnant women in Shanghai was poor, but oral health awareness and attitudes were relatively high.European health insurance systems have become increasingly fragmented due to neoliberal health care reforms and the privatization of health care. Attempts to enable transnational access to public health care services throughout the European Union (EU) have contributed to this process by spreading ideas of EU citizens as consumers having to make informed choices about health insurance. However, marginalized populations such as EU migrant sex workers are presented with only limited choices within these systems. This article highlights how these limitations in access to health insurance are not only related to financial precarities, but are also caused by underlying racialized, classist, and sexualized assumptions about citizenship and belonging which influence the legal framework of both national and EU-wide health insurance provision. Based on ethnographic research with migrants from eastern EU countries involved in sex work in Berlin, the article discusses their attempts to gain access to health insurance as a salient example of the moral economy of health insurance provision in a supposedly universal health care system. Following how migrant sex workers from eastern European countries experience and negotiate exclusions from health insurance systems, the article addresses how meanings and interpretations of health insurance change towards an understanding of health insurance not as a right, but as a privilege for those conforming to narrow ideas of European citizenship. This indicates that current restructurings of health insurance systems are not only characterized by increasing privatization. Equally, the (re-)emergence of links between access to health insurance and restrictive ideas of belonging and citizenship rights are undermining aspirations for transnationally available universal health care.Radiographic evidence of scapho-lunate diastasis associated with a displaced distal radius fracture has been well recognized yet the clinical significance remains in question. If left untreated, will this progress to both radiographic and clinical changes consistent with intercarpal arthritis? Using the accumulated data of over 400 surgically treated distal radius fractures in the ICUC database, 16 cases of untreated scapho-lunate diastasis were followed on an average of 8 years without evidence of progressive functional or radiographic deterioration. In 50% of these cases, incidental findings of similar scapho-lunate diastasis was noted in the opposite uninjured wrist.The enthusiasm for environmental energy harvesting has triggered a boom in research on photo-thermoelectric generators (PTEGs), and the relevant applications are mainly focused on self-energy supply sensors owing to the limitations of their output performances. For this purpose, high-output hierarchical heterogeneous PTEGs were constructed by assembling separately optimized thermoelectric (TE) and photothermal (PT) layers. The pressure and temperature conditions of Ag2Se films during the pressing process were first explored, and the sample with the optimal performance and least defects was selected as the TE layer. At the same time, different morphologies of polypyrrole (PPy) PT layers were electrochemically synthesized. It is found that the three-dimensional structure of Bushy-PPy could effectively improve the light absorption and thus enhance the PT conversion performance. The final assembled PTEG can produce an output voltage of -9.03 mV and an output power of 3.53 μW under the irradiation of a near-infrared light source of 300 mW cm-2 without a cooling source, and it can also achieve considerable output power under visible light irradiation of different intensities. Combining its high retentions of electrical conductivity (99%) and output performance (97%) after 1000 bending-tension cycles, it is proven to be a promising next-generation wearable flexible energy harvesting device.

Differentiating recurrence from benign posttreatment changes has clinical importance in the imaging follow-up of head and neck cancer. This study aimed to investigate the utility of normalized dynamic contrast-enhanced MR imaging and ADC for their differentiation.

This study included 51 patients with a history of head and neck cancer who underwent follow-up dynamic contrast-enhanced MR imaging with DWI-ADC, of whom 25 had recurrences and 26 had benign posttreatment changes. Quantitative and semiquantitative dynamic contrast-enhanced MR imaging parameters and ADC of the ROI and reference region were analyzed. Normalized dynamic contrast-enhanced MR imaging parameters and normalized DWI-ADC parameters were calculated by dividing the ROI by the reference region.

Normalized plasma volume, volume transfer constant between extravascular extracellular space and blood plasma per minute (



), area under the curve, and wash-in were significantly higher in patients with recurrence than in those with benign posttreatment change (

= .003 to <.001). The normalized mean ADC was significantly lower in patients with recurrence than in those with benign posttreatment change (

< .001). The area under the receiver operating characteristic curve of the combination of normalized dynamic contrast-enhanced MR imaging parameters with significance (normalized plasma volume, normalized extravascular extracellular space volume per unit tissue volume, normalized



, normalized area under the curve, and normalized wash-in) and normalized mean ADC was 0.97 (95% CI, 0.93-1).

Normalized dynamic contrast-enhanced MR imaging parameters, normalized mean ADC, and their combination were effective in differentiating recurrence and benign posttreatment changes in head and neck cancer.

Normalized dynamic contrast-enhanced MR imaging parameters, normalized mean ADC, and their combination were effective in differentiating recurrence and benign posttreatment changes in head and neck cancer.