Objective: The 2023 ESH guidelines strongly emphasize the lack of data on women, both in randomized clinical trials and in real-world data. It is not known whether the considerable efforts to equalize the treatment of women and men have led to changes in routine practice, which was the main aim of our study. Design and method: The DISCOVERY study is a large real-world prospective observational study investigating the treatment of patients with hypertension and/or hypercholesterolemia in primary or secondary care in 10 countries in 2021 and 2022. Patients of both sexes over 18 years were included. Investigators (301 GPs, 127 internists, 271 cardiologists) treated the patients according to their usual routine. They collected data on admission and up to 12 weeks after admission so that treatment characteristics could be analyzed. The physicians were not informed about the aim (comparison of women vs. men) of the study to avoid information bias. Results: The study included 11,287 patients, 93.6% of whom had hypertension at baseline that was either newly diagnosed (N=2247) or previously treated (N=8280; 86.6% inadequately treated). Patients were recruited in consecutive order. Slightly more women (53.2%, mean age 62.2±11.3 years, 94% with hypertension) than men (46.8%, mean age 58.6±12.3 years, 93.2% with hypertension) were included. There were no significant differences in mean blood pressure (women 156/92mmHg, men 157/93mmHg) and in antihypertensive treatment (mainly monotherapy). There were several gender-specific differences such as age, body mass index, physical activity, smoking status and comorbidities that did not affect the results. At the second observation, blood pressure had decreased significantly (p<0.001) and consistently. Mean pressure in women was 130/80mmHg and in men 131/81mmHg. The blood pressure target < 140/90mmHg was achieved by 73.2% of women and 72.1% of men. The prescribed antihypertensive medications did not differ between women and men, being mainly single-pill combinations (71.6% for women, 71.5% for men). Conclusions: The study showed no differences in the treatment of hypertension between women and men under real-world conditions. The effectiveness was quite good, mainly achieved by single-pill combinations, although the treatment can still be improved.

This paper investigates the role of slip boundary conditions in computational fluid dynamics modeling of material extrusion and layer deposition during 3D concrete printing. The mortar flow governed by the Navier-Stokes equations was simulated for two different slip boundary conditions at the extrusion nozzle wall: no-slip and free-slip. The simulations were conducted with two constitutive models: a generalized Newtonian fluid model and an elasto-viscoplastic fluid model. The cross-sectional shapes of up to three printed layers were compared to the experimental results from literature for different geometrical-and speed-ratios. The results reveal that employing free-slip boundary conditions at the extrusion nozzle wall improves layer-mimicking quality for both constitutive models, indicating the presence and importance of a lubricating layer of fine particles at the concrete-solid wall interface. This enhanced performance is primarily due to the observed decrease in extrusion pressure that minimizes layer height-and width-deviations compared to the experimental prints. Furthermore, the free-slip boundary conditions play an important role in predicting the multilayer prints, its deformation and groove shapes.

Introduction Technical advances and the increasing role of interdisciplinary decision-making may warrant formal definitions of expertise in surgical neuro-oncology. Research question The EANS Neuro-oncology Section felt that a survey detailing the European neurosurgical perspective on the concept of expertise in surgical neuro-oncology might be helpful. Material and methods The EANS Neuro-oncology Section panel developed an online survey asking questions regarding criteria for expertise in neuro-oncological surgery and sent it to all individual EANS members. Results Our questionnaire was completed by 251 respondents (consultants: 80.1%) from 42 countries. 67.7% would accept a lifetime caseload of >200 cases and 86.7% an annual caseload of >50 as evidence of neuro-oncological surgical expertise. A majority felt that surgeons who do not treat children (56.2%), do not have experience with spinal fusion (78.1%) or peripheral nerve tumors (71.7%) may still be considered experts. Majorities believed that expertise requires the use of skull-base approaches (85.8%), intraoperative monitoring (83.4%), awake craniotomies (77.3%), and neuro-endoscopy (75.5%) as well as continuing education of at least 1/year (100.0%), a research background (80.0%) and teaching activities (78.7%), and formal interdisciplinary collaborations (e.g., tumor board: 93.0%). Academic vs. non-academic affiliation, career position, years of neurosurgical experience, country of practice, and primary clinical interest had a minor influence on the respondents’ opinions. Discussion and conclusion Opinions among neurosurgeons regarding the characteristics and features of expertise in neuro-oncology vary surprisingly little. Large majorities favoring certain thresholds and qualitative criteria suggest a consensus definition might be possible.

Objective: High blood pressure and proteinuria play major roles in chronic kidney disease (CKD), a high-mortality condition that affects millions of people. Reactive oxygen species (ROS) produced by NADPH oxidases are implicated in many pathophysiological processes including hypertension and CKD. Apocynin (APO) shows the anti-oxidative activity by inhibiting the assembly of NADPH oxidase and overproduction of ROS. The aim of this study was to investigate the effects of apocynin on oxidative stress, blood pressure and kidney function in normotensive rats with CKD induced by 5/6 nephrectomy through ligation of renal poles (Nx-L). Design and method: Male Wistar rats were divided into three groups. One group was control (sham surgery) and two other groups underwent two-step surgical procedure of 5/6 nephrectomy induced by ligation of renal poles. Unlike conventional Nx which leads to high mortality due to hemorrhage in or after surgery, here we induced Nx by ligation of the upper and lower poles (leads to necrosis of these poles) of left kidney after removal the right kidney one week later. After 4 weeks from this procedure, control and model group (Nx-L) received vehicle, while Nx-L+APO received apocynin 20 mg/kg/day (i.p.) for 4-week-period. Mean blood pressure (MAP), proteinuria, and oxidative stress marker (thiobarbituric acid reactive species-TBARS) in plasma and urine were measured. Results: In model group we observed significantly increased MAP (121,13±2,01vs.94,88±4,13mmHg, p<0.001), plasma creatinine (55,4±1,3vs. 41,3±2,3μmol/l, p<0.001), and proteinuria (0,036±0,006vs.0,017±0,001mg/min/kg, p<0.01) levels compared to those in control. Furthermore, significant increase of plasma TBARS level (5,47±0,77vs.2,75±0,52nmol/ml, p<0.01) and urine TBARS excretion (1,10±0,06vs.0,86±0,04nmol/min/kg, p<0.01) were detected in model compared to control. Interestingly, APO treatment significantly reduced blood pressure to the level of control (83,88±5,14vs.94,88±4,13mmHg). APO significantly reduced urine protein loss (0,024±0,002vs.0,036±0,006mg/min/kg, p<0.05) and plasma creatinine level (49,9±1,5vs.55,4±1,3μmol/l, p<0.05) as well as reduced plasma lipid peroxidation (2,19±0,26vs.5,47±0,77nmol/ml, p<0.001) in comparison to model group. Conclusions: Our results show that APO treatment prevents blood pressure rising and ameliorates kidney function in rats with 5/6 nephrectomy trough improvement of systemic oxidative status. Therefore, NADPH oxidase presents a potential therapeutic target in this form of kidney disease.

This study aimed to investigate the impact of an 8-week aerobic dance intervention on postural balance in children. Forty-one children, aged 9 to 11, were randomly assigned to either an aerobic dance group (ADG) or a control group (CG) from a primary school. Postural balance was assessed using center of pressure (CoP) excursions before and after the 8-week intervention period. Evaluations were conducted on both firm and foam surfaces in bipedal and unipedal stances under open-eyes (OE) and closed-eyes (CE) conditions, as well as on both medial–lateral (ML) and anterior–posterior (AP) surfaces in a bipedal stance under OE conditions. The ADG exhibited significantly decreased CoPVm values during firm bipedal CE, unipedal OE, foam bipedal OE and CE, and foam unipedal OE (p < 0.005). This study suggests that aerobic dance intervention improved postural balance in children, showcasing adaptability and improved stability under various conditions.

Bradycardia is a commonly occurring condition in premature infants, often causing serious consequences and cardiovascular complications. Reliable and accurate detection of bradycardia events is pivotal for timely intervention and effective treatment. Excessive false alarms pose a critical problem in bradycardia event detection, eroding trust in machine learning (ML)-based clinical decision support tools designed for such detection. This could result in disregarding the algorithm's accurate recommendations and disrupting workflows, potentially compromising the quality of patient care. This article introduces an ML-based approach incorporating an output correction element, designed to minimise false alarms. The approach has been applied to bradycardia detection in preterm infants. We applied five ML-based autoencoder techniques, using recurrent neural network (RNN), long-short-term memory (LSTM), gated recurrent unit (GRU), 1D convolutional neural network (1D CNN), and a combination of 1D CNN and LSTM. The analysis is performed on ∼440 hours of real-time preterm infant data. The proposed approach achieved 0.978, 0.73, 0.992, 0.671 and 0.007 in AUC-ROC, AUC-PRC, recall, F1 score, and false positive rate (FPR) respectively and a false alarms reduction of 36% when compared with methods without the correction approach. This study underscores the imperative of cultivating solutions that alleviate alarm fatigue and encourage active engagement among healthcare professionals.