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4°, and an absolute error of 5.0°. Internal validation on patients with an age-adjusted alignment revealed similar accuracy across the entire age-adjusted TPA spectrum (ranges of LL errors ME = .2° to 1.7°, AE = 4.0° to 5.3°).

This study provides a simple guideline to identify the amount of LL needed to reach a given alignment (i.e., age-adjusted target) based on PI and associated TK. Implementation of this predictive formula during pre-operative surgical planning may help to reduce unexpected sub-optimal post-operative alignment outcomes.

This study provides a simple guideline to identify the amount of LL needed to reach a given alignment (i.e., age-adjusted target) based on PI and associated TK. Implementation of this predictive formula during pre-operative surgical planning may help to reduce unexpected sub-optimal post-operative alignment outcomes.Context Given that the composition of hospice patients' terminal diagnoses has become increasingly diverse, understanding whether hospices provide quality care to patients, regardless of disease, is important. However, data comparing diagnosis and caregiver-reported outcomes remain scarce. Objectives To analyze the association between the composition of patients' terminal diagnoses and caregiver-reported quality measures. Methods Using cross-sectional, publicly available data from the Centers for Medicare & Medicare Services (CMS), we analyzed data collected from 2015-2019. We conducted general linear model analyses to identify associations between hospice characteristics/practices and caregiver-reported outcomes. Results Of the 2810 hospices, those that cared for a greater percentage of dementia patients had fewer caregivers, on average, who rated hospice a 9 or 10 (where 0 = low, 10 = high; β = -.094; 95% CI = -.147, -.038), reported they always received help for pain and symptoms (β = -.106, CI = -.156, -.056), and reported definitely having received the training they needed (β = -.151, CI = -.207, -.095). Those caring for more stroke patients had fewer caregivers, on average, who rated hospice a 9 or 10 (β = -.184, CI = .252, -.115), reported they always received help for pain and symptoms (β = -.188, CI = -.251, -.126), reported definitely having received the training they needed (β = -.254, CI = -.324, -.184), and reported that the hospice offered the right amount of emotional/spiritual support (β = -.056, CI = -.093, -.019). Conclusion Hospices that cared for a greater proportion of dementia and stroke patients had poorer scores on caregiver-reported quality measures. These findings support efforts to identify mechanisms underlying these differences and to design strategies to ensure optimal outcomes for hospice patients regardless of diagnosis.

This study aims to investigate the anti-hypertensive effects of aqueous extract of

and their underlying mechanism using a two-kidney one-clip (2K1C) model of reno-vascular hypertension in rats.

The reno-vascular hypertensive rats were treated with

leaf extract (100 and 500 mg/kg; p.o.) and a reference drug, captopril (20 mg/kg; p.o.), for 4weeks. The blood pressure and heart rate were recorded using a tail-cuff. The heart weight, left ventricular wall thickness, and serum creatinine and urea levels were measured. A spectrophotometric assay was used to analyze the angiotensin-converting enzyme (ACE) inhibition activity of the extract and the reference drug. The total volume and the concentration of sodium, potassium, and chloride in urine samples were evaluated.

extract significantly reduced both systolic and diastolic blood pressures in the reno-vascular hypertensive rats. No significant difference in the heart rate was observed between each animal group.

extract reduced the 2K1C-induced increase in the heart and body weight ratio and the left ventricular wall thickness. Moreover, the extract also attenuated the increase in serum urea induced by the 2K1C treatment.

extract inhibited ACE activity in vitro with an IC

of 20.97±3.94µg/ml. The urine output and urinary electrolyte excretion significantly increased in C. fragrans extract-treated rats.

These findings demonstrated that

extract can mitigate hypertension and alleviate ventricular hypertrophy and renal dysfunction in reno-vascular hypertensive rats, at least in part via ACE activity inhibition and diuretic property.

These findings demonstrated that C. fragrans extract can mitigate hypertension and alleviate ventricular hypertrophy and renal dysfunction in reno-vascular hypertensive rats, at least in part via ACE activity inhibition and diuretic property.

To assess the different clinical findings and symptoms of patients with optic neuritis (ON) and uveitis, who were diagnosed with syphilis.

The medical records of patients, who had ocular involvement of syphilis, were retrospectively reviewed. Thirteen patients with syphilitic optic neuropathy (SON) were enrolled and underwent complete ophthalmological examinations and auxiliary laboratory testing.

Nine patients (69.2%) had comorbidities in addition to syphilis. One patient (with two eyes) presented with retrobulbar neuritis, and 12 patients (with 17 eyes) presented with anterior optic neuritis. Three patients (23.1%) had no uveitis, and 10 patients (76.9%) had uveitis in cases with SON. Four eyes (16.6%) had subretinal fluid, and three eyes (12.5%) had cystoid macular edema.

Visual function can be preserved with early diagnosis and proper treatment. Accordingly, newly diagnosed patients with ON and uveitis should undergo syphilitic investigation in routine practice.

Visual function can be preserved with early diagnosis and proper treatment. Accordingly, newly diagnosed patients with ON and uveitis should undergo syphilitic investigation in routine practice.Astilbin is a dihydroflavanol found in many plants and processed foods. Astilbin possesses multiple health-beneficial bioactivities and has received great attention. Hence, the natural source, physicochemical properties, biological activities and metabolism of astilbin are summarized in the present article. Engelhardia roxburghiana Wall. and Smilax glabra Roxb. are the main resource for astilbin purification because of high content. Because of chemical instability, astilbin amount in foods is dependent on the processing and storage conditions. The degradation of astilbin includes isomerization and decomposition. The interconversion of astilbin and its isomers occurs through a chalcone intermediates, which significantly affects the taste of wine during storage. Many factors such as temperature, pH, metal ions and food additives could affect the chemical stability of astilbin. Astilbin exhibits very novel selective immunosuppressive activity, which is not found in other compounds. The rhamnose moiety of astilbin is essential for this bioactivity. After digestion, astilbin was mainly absorbed and transported in circulatory blood in its intact form, and only one metabolite, 3'-O-methylastilbin, was found. Although having many bioactivities, astilbin faces the challenge of poor bioavailability. Some promising strategies were developed for improving its bioavailability, particularly through fabrication the zein nanoparticles.

Management of the airway in the perioperative period for patients requiring major head and neck ablative surgery has commonly included the performance of elective surgical tracheostomy. This has been standard practice in most maxillofacial units across the UK, including ours. However, the COVID-19 pandemic and emerging guidelines on aerosol-generating procedures required us to revisit the need for a perioperative tracheostomy.

We present our series of 29 consecutive cases, cared for during the first wave of the COVID-19 pandemic, that were managed either using surgical tracheostomy or overnight tracheal intubation.

Out of 29 patients 3 received a surgical tracheostomy. The average duration of tracheostomy use was 8 days. Twenty patients were managed using a period of overnight tracheal intubation. Average duration of tracheal intubation was 1.2 days, with an average intensive care unit stay of 1.7 days. The average duration of hospital stay was 15.8 days for patients managed with overnight tracheal intubation and 30.1 days for patients who received a surgical tracheostomy. The return to theatre rate was 13.8% for reasons including flap failure and neck space infection. There were no airway issues reported in this series of patients.

Our findings suggest that overnight tracheal intubation can be a safe alternative to surgical tracheostomy in the majority of cases.

Our findings suggest that overnight tracheal intubation can be a safe alternative to surgical tracheostomy in the majority of cases.

Decisional conflict (DC) is a psychological construct that an individual experiences in making a decision that involves risk, loss, regret, or challenges to one's values. This study assessed DC in a cohort of South African men undergoing curative treatment for localised prostate cancer (LPC). The objectives were to (1) to examine the association between DC and prostate cancer knowledge (PCK), demographics, state anxiety, prostate cancer anxiety and time to treatment and (2) to compare levels of DC between treatment groups [prostatectomy (RP) and external beam radiation (RT)].

Data, comprising the Decisional Conflict Scale (DCS), Prostate Cancer Knowledge (PCK), State-Trait Anxiety Inventory (STAI-S), the Memorial Anxiety Scale for Prostate Cancer (MAX-PC) and demographic data from 83 participants of a larger prospective longitudinal observational study examining depression, anxiety and health related quality of life (DAHCaP) were analysed.

The mean age of participants was 63 years (RP 61yrs and RT 65yrstime treatment was received from diagnosis. No correlation was observed between DC and PCK. Pre-surgical management of DC should include shared decision making (SDM) which is cognisant of patients' values facilitated by a customised decision aid.Cereals provide humans with essential nutrients, and its quality assessment has attracted widespread attention. Infrared (IR) spectroscopy (IRS) and hyperspectral imaging (HSI), as powerful nondestructive testing technologies, are widely used in the quality monitoring of food and agricultural products. Artificial intelligence (AI) plays a crucial role in data mining, especially in recent years, a new generation of AI represented by deep learning (DL) has made breakthroughs in analyzing spectral data of food and agricultural products. The combination of IRS/HSI and AI further promotes the development of quality evaluation of cereals. This paper comprehensively reviews the advances of IRS and HSI combined with AI in the detection of cereals quality. The aim is to present a complete review topic as it touches the background knowledge, instrumentation, spectral data processing (including preprocessing, feature extraction and modeling), spectral interpretation, etc. To suit this goal, principles of IRS and HSI, as well as basic concepts related to AI are first introduced, followed by a critical evaluation of representative reports integrating IRS and HSI with AI. Finally, the advantages, challenges and future trends of IRS and HSI combined with AI are further discussed, so as to provide constructive suggestions and guidance for researchers.