Technological prospecting of patents related to monitoring accidents due to falls in hospitals / Prospección tecnológica de patentes relacionadas con el seguimiento de accidentes por caídas en hospitales / Prospecção tecnológica de patentes relacionadas ao monitoramento de acidentes por quedas em hospitais

ABSTRACT Objectives: to map the production of technologies aimed at monitoring falls in a hospital environment protected by registered patents. Methods: a technological prospecting of international patents, with a quantitative approach, with search carried out between February and March 2022 in the Derwent Innovations Index database with descriptors fall, hospital, monitoring. Results: 212 patents were found, with the majority filed and published since 2010, by Tran B (9) and Cerner Innovation Inc (9), focused on health technology. Universities were responsible for 13% of deposits. There was a predominance of records from the United States (43.4%), China (21.7%) and Japan (12.3%), in addition to technological strategies classified as devices for the environment (80.7%) and for preventing falls (66.5%) as well as trend towards resources with multiple functionalities in the same technology. Conclusions: the plurality of functions in the same device reflects the search for optimizing resources and the concern with comprehensive care.

RESUMEN Objetivos: mapear la producción de tecnologías destinadas al monitoreo de caídas en un ambiente hospitalario protegido por patentes registradas. Métodos: prospección tecnológica de patentes internacionales, con enfoque cuantitativo, con búsqueda realizada entre febrero y marzo de 2022 en la base de datos Derwent Innovations Index con los descriptores caída, hospital, monitoreo. Resultados: se encontraron 212 patentes, la mayoría presentadas y publicadas desde 2010, por Tran B (9) y Cerner Innovation Inc (9), enfocadas en tecnología de la salud. Las universidades fueron responsables del 13% de los depósitos. Hubo predominio de registros de Estados Unidos (43,4%), China (21,7%) y Japón (12,3%), además de estrategias tecnológicas catalogadas como dispositivos ambientales (80,7%) y para prevenir caídas (66,5%), así como la tendencia hacia recursos con múltiples funcionalidades en una misma tecnología. Conclusiones: la pluralidad de funciones en un mismo dispositivo refleja la búsqueda de optimización de recursos y la preocupación por la atención integral.

RESUMO Objetivos: mapear a produção de tecnologias voltadas para monitoramento de quedas em ambiente hospitalar protegidas por patentes registradas. Métodos: prospecção tecnológica de patentes internacionais, com abordagem quantitativa, com busca realizada entre fevereiro e março de 2022 na base Derwent Innovations Index com os descritores fall, hospital, monitoring. Resultados: foram encontradas 212 patentes, com maioria depositada e publicada a partir de 2010, por Tran B (9) e Cerner Innovation Inc (9), focadas em tecnologia em saúde. As universidades foram responsáveis por 13% dos depósitos. Houve predomínio de registros dos Estados Unidos (43,4%), da China (21,7%) e Japão (12,3%), além de estratégias tecnológicas classificadas como dispositivos para ambiente (80,7%) e para prevenção de quedas (66,5%), bem como a tendência de recursos com múltiplas funcionalidades em uma mesma tecnologia. Conclusões: a pluralidade de funções em um mesmo dispositivo reflete a busca pela otimização dos recursos e a preocupação com a integralidade do cuidado.

Establishment of Comprehensive Protection System for Intellectual Property of Single Herbs by Taking Callicarpa nudiflora of Jiuzhitang as An Example / 中国实验方剂学杂志

The development of single Chinese materia medica is an important direction of technological innovation in the field of Chinese materia medica at present， and the study of its comprehensive intellectual property protection system is of great significance to the intellectual property protection of the whole chain of innovative enterprises of single Chinese materia medica. Based on this， this paper takes the comprehensive protection system of intellectual property of Callicarpa nudiflora constructed by Jiuzhitang Pharmaceutical as a model to conduct empirical research， analyzes the protection forms applicable to intellectual property of Chinese materia medica， such as patents， administrative protection， trademarks， designs and intangible cultural heritages， and discusses the valuable and insufficient aspects of the protection system currently constructed by Jiuzhitang Pharmaceutical and puts forward the following suggestions：①paying attention to patent applications for planting/processing methods of raw medicinal materials， ②emphasizing the protection of geographical indications， authentic medicinal herbs， and new plant varieties， ③actively promoting product and technology upgrades， ④applying for data protection during product iteration， ⑤emphasizing the layout timing of patent and administrative protection， ⑥focusing on improving goodwill， ⑦enhancing awareness of intellectual property protection and promoting deep integration of industry， academia， and research. We hope that innovative enterprises engaged in the development of single Chinese materia medica can learn from the experience of the case， and optimize the strategy to better protect related products.

Methodology for the Development of Clinical Practice Guidelines for Chinese Patent Medicine （Part 8）： Quality Evaluation with AGREE Ⅱ and RIGHT / 中医杂志

ObjectiveTo evaluate the methodological and reporting quality of clinical practice guidelines for Chinese patent medicine （CPM） with internationally recognized tools the appraisal of guidelines for research and evaluation （AGEREE） Ⅱ and reporting items for practice guidelines in healthcare （RIGHT）， thereby providing refe-rence for the clinical application and future development of CPM guidelines. MethodsDatabases including CNKI， VIP， Wanfang and Sinomed were searched for CPM guidelines， as well as medlive.cn， websites of China Association of Chinese Medicine and Chinese Medical Association， and reference lists of the included papers. The quality of the guidelines was evaluated using the AGREE Ⅱand RIGHT tools， and consistency tests were performed using Interclass Correlation Coefficient， and descriptive analysis and chi-square test were used to analyze the reporting rate for each domain and the average score for each item. ResultsFinally， 140 CPM guidelines were included， of which 51 were disease-oriented and 89 were drug-oriented， all of which were issued by China. For 51 disease-oriented CPM guidelines， the highest average score of all six AGREE Ⅱ domains was 73.32% for clarity， and the lowest was 26.80% for application； for 89 drug-oriented CPM guidelines， the highest average score was 55.62% for scope and purpose， and the lowest was 31.32% for rigour of development. In terms of the seven domains of the RIGHT checklist， the highest reporting rate was 68.26% for background， and lowest was 27.45% for other areas regarding the disease-oriented CPM guidelines； the highest reporting rate was 61.31% for background， and the lowest was 4.49% for other areas regarding drug-oriented CPM guidelines. The average reporting rate was higher for disease-oriented than drug-oriented CPM guidelines in three domains of AGREE Ⅱ （rigour of development， clarity of presentation， editorial independence）， as well as four domains of RIGHT checklist （basic information， evidence， funding and declaration and management of interests， and other areas）. ConclusionThe overall methodology and reporting quality of the current CPM guidelines still need to be improved. It is recommended that future guideline development teams should strictly refer to the AGREE Ⅱ and RIGHT checklist， and take into account of the characteristics of CPM guidelines and relevant methodo-logical suggestions in the development and reporting of CPM guidelines， thereby guiding the clinical use of CPM in a better way.

Methodology for the Development of Clinical Practice Guidelines for Chinese Patent Medicine （Part 7）： Introduction and Interpretation of the Guideline Reporting Checklist / 中医杂志

The systematic and comprehensive introduction and interpretation of the Reporting Checklist of Clinical Practice Guidelines for Chinese Patent Medicines V1.0 is conducive to the presentation of high-quality clinical practice guidelines for Chinese patent medicines （CPMs）， thus improving their dissemination and use. The Reporting Checklist of Clinical Practice Guidelines for Chinese Patent Medicines V1.0 specifies the requirements for clear， complete and transparent reporting of the whole process of developing CPMs guidelines， containing 4 domains， 17 topics and 43 items， and involving the basic information， recommendations and methods of guideline development. Especially， it details the items related to the rules and regulations of the use of CPMs in the recommendations， which is helpful for improving the completeness， scientificity and practicality of the reporting of CPMs guideline.

Methodology for the Development of Clinical Practice Guidelines for Chinese Patent Medicine （Part 6）： Formation and Presentation of Recommendations / 中医杂志

Recommendation formation is a key component of clinical practice guidelines for Chinese patent medicine （CPM）， and should encompass the determination of the strength and direction of the recommendation， the rationale for the recommendation， and the methodology for implementing the recommendation. Recommendations can be formed through formal consensus and informal consensus. The strength and direction of recommendations for CPM guidelines should be determined by considering the quality of evidence for CPMs， the priority of the clinical questions， the pros and cons of efficacy and adverse effects， patient acceptance， the feasibility of the recommendation and the availability of resources， social fairness， economic benefits， and other influencing factors. In order to better guide guideline developers to consider these factors more rationally， this article provideed a detailed explanation of each factor in the context of the characteristics of TCM.

Methodology for the Development of Clinical Practice Guidelines for Chinese Patent Medicine（Part 5）： Retrieval and Synthesis of Key Information on Rational Drug Use / 中医杂志

Recommendations for Chinese patent medicine （CPM） based on key information on rational drug use are one of the important conditions for enhancing guideline enforceability as well as facilitating guideline implementation. In this study， we discussed in detail of the key information on the rational use of CPM in five aspects， which are dosage， drug discontinuation， drug-drug and drug-food interactions， safety and economy. Following the process of multi-source search， synthesis and prioritization， it is suggested to collect key information on the rational use of CPM from a multi-source search of drug instructions， policy documents， literature， and clinical experts' experiences. Then the searched information should be summarized and prioritized with the principle that taking drug instructions as the basis and other-sources information for check and supplementation. Finally， methodological recommendations for the retrieval and synthesis of key information on rational drug use in guideline recommendations has been formed.

Methodology for the Development of Clinical Practice Guidelines for Chinese Patent Medicine（Part 4）： Evidence Retrieval and Evaluation / 中医杂志

The retrieval and evaluation of evidence is the basis for the development of clinical practice guidelines for Chinese patent medicine. As traditional Chinese medicine has a different development trajectory and utilization characteristics from modern medicine， there is certain differences in terms of evidence composition， retrieval and integration.This paper discussed multi-source body of evidence on Chinese patent medicine based on modern evidence-based medicine and ancient medical literature， and summarized the retrieval strategy as well as the possible problems and solving methods. For different types of evidence on Chinese patent medicine， the corresponding evaluation tools have been recommended， and the order to integrate the evidence based on the quality of the evidence from high to low is suggested. Finally， a multi-source based evidence retrieval-evaluation-integration scheme for Chinese patent medicine has been formed， which will provide a methodological reference for practitioners in the development of clinical practice guidelines for Chinese patent medicine.

Methodology for the Development of Clinical Practice Guidelines for Chinese Patent Medicine（Part 3）： Identification of Clinical Questions / 中医杂志

The identification of clinical questions for clinical practice guidelines of Chinese patent medicine （CPM） is important for subsequent evidence retrieval， evaluation of evidence quality， formation of recommendations. This paper described a methodological proposal for the identification of clinical questions for CPM guidelines to highlight the characteristics of Chinese patent medicine and reflect its effect in specific stage of the disease. Considering four aspects， namely， the drug of Chinese patent medicine （D）， the specific disease stage （S）， comparison （C）， and specific outcome （O）， DSCO framework has been proposed to formulate the clinical questions. Multi-source information through scientific research， policy or standard documents， and clinical data are suggested for collecting clinical questions， and clear selection criteria should be set to finalize the clinical questions to be addressed by the guideline. In addition， the above process needs to be transparently and publicly reported in order to ensure the clarity and completeness of the guidelines.

Methodology for the Development of Clinical Practice Guidelines for Chinese Patent Medicine： 2.Establishment of Guideline Working Group and Management of Conflict of Interests / 中医杂志

This paper summarized the key points and methods in terms of the establishment of the guideline working group and the management of conflict of interests， trying to provide reference for the development of clinical practice guidelines for Chinese patent medicine （CPM）. The establishment of the working group is the first important step for developing CPM guidelines. Considering the characteristics of the clinical practice guidelines for CPM， this study suggests that the three key elements of ‘multidisciplinarity’， ‘clinical relevance’ and ‘geographical representativeness’ should be put focus on when forming the working group. The guideline advisory committee， clinical expert group， evidence systematic evaluation group， secretary group and the external review group should be established. All group members should clarify the conflict of interest， and the process and management method of the conflict of interest should be clearly reported.

Methodology for the Development of Clinical Practice Guideline for Chinese Patent Medicine（Part 1）： Development Status and Characteristics / 中医杂志

The irrational use of Chinese patent medicines （CPM） is becoming more and more prominent， which makes the demand for clinical practice guidelines of CPM gradually increase. In order to make domestic scholars understand the latest developments and existing problems of the CPM guidelines， and promote its development， this paper introduced the concept of CPM guidelines， summarized the characteristics of the two development modes， namely “taking CPM as the key” and “taking disease/syndrome as the key”， and analyzed the current methodological status of developing and reporting CPM guidelines. Based on the existed problems， three suggestions have been put forward to optimize the quality of CPM guidelines， which were clarifying the target users and scope of CPM guidelines， establishing an open and transparent mechanism of the personnel involvement and process steps， and formulating implementable and operable recommendations for the use of CPM.

Clinical outcomes and complications following percutaneous closure of patent foramen ovale

Introduction: patent foramen ovale (PFO) has been associated with systemic embolic events, and evidence in favor of its closure is increasing. Our objective is to describe the main clinical outcomes and complications of percutaneous closure of patent foramen ovale. Materials and methods: patients who underwent percutaneous PFO closure from January 1, 2016, through September 1, 2021, were recorded retrospectively. Immediate outcomes (<72 hours), and early and late-onset clinical outcomes were evaluated. In-hospital and follow-up mortality were evaluated through medical chart reviews or telephone calls. Results: forty patients who underwent percutaneous PFO closure were included. There was a mean follow up of 2.3 years, the mean age was 43 ± 13.6 years, 7% were over 60 years old, 72.5% were women, 25% were hypertensive, 20% had diabetes, and 10% had a history of migraines. The mean RoPE score was 6, and 50% had a score greater than 7. Out of all the cases, three (7.5%) had serious adverse events and four had immediate complications. During follow-up, 2.5% had early-onset events consisting of atrial fibrillation and 2.5% had late-onset events due to CVA recurrence. There were no deaths from neurological causes and we reported a 100% survival. Discussion: From our experience, we highlight a low percentage of serious adverse events, and a low number of immediate, early and late-onset events, with a 100% survival, showing excellent results for percutaneous PFO closure. (Acta Med Colomb 2022; 48. DOI:https://doi.org/10.36104/amc.2023.2585).

Cardiogenic shock due to pulmonary thromboembolism: the role of surgical thrombectomy / Shock cardiogénico debido a tromboembolismo pulmonar: el papel de trombectomía quirúrgica

Abstract A 53-year-old male patient with history of repaired hernia, who is admitted for 5 days of progressive dyspnea with diagnosis of abdominal sepsis, a computed tomography angiography was made, revealing pulmonary embolism in bilateral main pulmonary artery, and cardiac thrombectomy was performed.

Resumen Paciente masculino de 53 años de edad con historial de reparación de hernia, quien fue ingresado por presentar 5 días de disnea progresiva con diagnóstico de sepsis abdominal, se le realizó una angiografía por tomografía computada, revelando embolismo bilateral arteria pulmonar principal, se realizó una trombectomía cardíaca.

Trombocitopenia severa inducida por un oclusor para DAP: reporte de caso en tecnovigilancia

Introducción: El ductus arterioso persistente (DAP) es una cardiopatía congénita de especial interés. La oclusión intervencionista es el tratamiento de elección, no obstante, el dispositivo médico "oclusor para DAP", usado en este procedimiento, puede dar lugar a la aparición de eventos adversos de rara frecuencia como hemorragia, trombocitopenia, entre otros. Reporte de caso: Se presenta un caso de una paciente pediátrica con trombocitopenia severa posterior a la intervención. Durante su hospitalización, la paciente mantuvo niveles bajos de plaquetas hasta que logra su recuperación y sale de alta sin una nueva manifestación hematológica. El caso fue reportado como sospecha de incidente adverso asociada al oclusor para DAP. Conclusión: Al realizarse el análisis causa-raíz, se concluye que el tamaño del oclusor para DAP podría ser la principal causa de la trombocitopenia. El presente caso es una muestra que los dispositivos médicos pueden causar eventos adversos severos, por lo que, es necesaria la implementación de tecnovigilancia, principalmente a los dispositivos médicos de alto riesgo.

Introduction: Patent ductus arteriosus (PDA) is a congenital heart condition of special interest. Interventional occlusion is the treatment of choice; however, a PDA occlude, used in this procedure, is a medical device that rarely could lead to adverse events such as hemorrhage, thrombocytopenia, etc. Case report: We present a case of a pediatric patient with severe thrombocytopenia after surgery. During her hospitalization, platelet levels remained lower and, finally, she was fully recovered without any hematological manifestation. The case was reported as a suspected adverse incident related to PDA occlude. Conclusion: After performing a cause-root analysis, we concluded that the size of the PDA occlude may be the main cause of thrombocytopenia. This case demonstrates that medical devices could lead to adverse events. Thus, it is important for clinicians to implement medical device surveillance, mainly for high-risk medical devices.

Papel do Ecocardiograma na Avaliação do Septo Interatrial e Pesquisa de Forame Oval Patente como Fonte Emboligênica / The Role of Echocardiography in the Assessment of the Interatrial Septum and Patent Foramen Ovale as an Emboligenic Source

Resumo A comunicação do septo atrial (CIA) representa, aproximadamente, de 6%-10% dos defeitos cardíacos congênitos, com incidência de 1 em 1.500 nascidos vivos.1 Forame oval patente (FOP) é mais comum e está presente em mais de 20%-25% dos adultos.2 Síndromes clínicas associadas a CIA e FOP são variáveis, com implicações abrangendo a medicina pediátrica e adulta, neurologia e cirurgia. O interesse adicional na anatomia do septo interatrial (SIA) aumentou substancialmente nas últimas duas décadas, com evolução simultânea dos procedimentos percutâneos envolvendo cardiopatia estrutural do lado esquerdo e procedimentos eletrofisiológicos. Idealmente, essas intervenções baseadas em cateter requerem rota direta para o átrio esquerdo (AE) através do SIA, necessitando completo entendimento de sua anatomia. Atualmente, tecnologias de imagem sofisticadas e não invasivas como ecocardiografia transesofágica bidimensional (ETE 2D) e tridimensional (ETE 3D), ressonância cardíaca (RMC) e tomografia computadorizada (TC) passaram por um extraordinário desenvolvimento tecnológico, fornecendo detalhes anatômicos das estruturas cardíacas visualizadas em formato 2D e 3D e são essenciais para diagnóstico e tratamento de pacientes com doenças cardíacas. A avaliação da anatomia e anormalidades do SIA, portanto, requer abordagem padronizada e sistemática, integrando modalidades diagnósticas e fornecendo avaliação adequada e uniforme para terapias cirúrgicas e transcateter.

Abstract Atrial septal defects (ASD) account for approximately 6%-10% of congenital heart defects, with an incidence of 1 in 1,500 live births.1 Patent foramen ovale (PFO) is more common and is present in more than 20%-25% of adults.2 Clinical syndromes associated with ASD and PFO are variable, and their implications are targeted by pediatric and adult medicine, neurology, and surgery. Additional interest in the anatomy of the interatrial septum (IAS) has increased substantially over the last two decades. Additionally, percutaneous procedures involving left-sided structural heart disease and electrophysiological procedures have evolved considerably. Ideally, these catheter-based interventions require a direct route to the left atrium (LA) through the IAS, with a full understanding of its anatomy. Also, sophisticated and noninvasive imaging technologies such as two-dimensional transesophageal echocardiography (2D-TEE) and three-dimensional transesophageal echocardiography (3D-TEE), cardiac magnetic resonance imaging (CMR), and computed tomography (CT) have evolved considerably, providing anatomical details of cardiac structures visualized in 2D and 3D format and being key for the diagnosis and treatment of patients with heart diseases. Therefore, assessing the anatomy of the IAS and any abnormalities requires a standardized and systematic approach, integrating diagnostic modalities and enabling adequate and consistent evaluation for both surgical and transcatheter therapies.

Pyroligneous extracts with therapeutic action: A technological prospect

Abstract The Pyroligneous extract is a product from the combustion of plant biomass with applications in the fields of health, industrial chemistry, and agriculture. The discovery of new molecules with therapeutic potential and of natural origin continues to be one of the great challenges for research centres around the world. The following work aims to analyze, through a technological prospection, the use of pyroligneous extracts for therapeutic purposes. To carry out the study, searches were carried out in documents deposited in Brazil, Europe, and the United States and searched on platforms specialized in patents. The number of inventions using pyroligneous extract with therapeutic applications is still quite small, however, innovations have been observed for the treatment of diseases of great clinical relevance such as cancer and hypertension. The systematic mapping of innovations is of great importance for the development of new technologies.

Conducto arterioso permeable: mecanismos moleculares del cierre y su relacion con el tratamiento

El conducto arterioso establece una conexión esencial entre la arteria aorta descendente proximal y la arteria pulmonar principal cerca del origen de la rama pulmonar izquierda, siendo vital durante la vida fetal y generalmente cerrándose poco después del nacimiento en la mayoría de los recién nacidos a término; no obstante, en recien nacidos pretermino, es común la persistencia del conducto arterioso debido a estímulos vasodilatadores que mantienen su permeabilidad y flujo sanguíneo constante, requiriendo enfoques de tratamiento que involucran la inhibición de la prostaglandina E2 y antiinflamatorios no esteroides, aunque la comparación de su eficacia con métodos conservadores sigue siendo poco clara, especialmente en recién nacidos prematuros extremos. La presente revisión tiene como objetivo proporcionar una comprensión de los mecanismos moleculares clave detrás de la fisiopatología del conducto arterioso persistente y su abordaje terapéutico.

The ductus arteriosus establishes an essential connection between the proximal descending aorta and the main pulmonary artery near the origin of he left pulmonary branch, being vital during fetal life and generally closing shortly after birth in most term newborns; However, in preterm infants, persistence of the ductus arteriosus is common due to vasodilator stimuli that maintain its patency and constant blood flow, requiring treatment approaches involving prostaglandin E2 inhibition and nonsteroidal anti-inflammatory drugs, although the comparison of their efficacy with conservative methods remains unclear, especially in extremely preterm infants. The present review aims to provide an understanding of the key molecular mechanisms behind the pathophysiology of patent ductus arteriosus and its therapeutic approach.

Proporção de Largura de Distribuição de Hemoglobina/Glóbulos Vermelhos (HRR): Um Novo e Promissor Parâmetro de Glóbulos Vermelhos no Fechamento Ductal / Hemoglobin/Red Cell Distribution width Ratio (HRR): A Novel and Promising Red Cell Parameter in Ductal Closure

Resumo Fundamento Ainda não está clara a eficácia dos parâmetros hematológicos no fechamento da persistência do canal arterial (PCA). Objetivos O objetivo principal do nosso estudo é investigar o efeito da proporção (HRR) de largura de distribuição de hemoglobina (HB) para glóbulos vermelhos (RDW) no fechamento do PCA. Métodos Bebês prematuros com muito baixo peso ao nascer (MBPN: <1.500 g) e <32 semanas gestacionais foram incluídos no estudo, e todos os dados foram registrados retrospectivamente. Características demográficas, resultados clínicos, parâmetros de hemácias e HRR e suas proporções foram comparados entre grupos de PCA hemodinamicamente significativa (hsPDA) e não-hsPDA. Todos os resultados foram analisados estatisticamente, e p<0,05 foi considerado estatisticamente significativo. Resultados Um total de 677 bebês prematuros, 269 no grupo hsPDA e 408 no grupo não-hsPDA, foram incluídos no estudo. Hemoglobina (HB), hematócrito (HCT), volume celular médio (VCM), glóbulos vermelhos (RBC), largura de distribuição dos glóbulos vermelhos (RDW), volume plaquetário médio (VPM), relação VCM/RBC, relação HB/RBC, RDW A razão /RBC e a razão RDW/VPM foram semelhantes entre os grupos hsPDA e não hsPDA, (p>0,05). HRR foi significativamente menor no grupo hsPDA [mediana (Quartil 1 (Q1) - Q3) (Q1 - Q3): 0,93 (0,8-1,0)] em comparação com não-hsPDA [mediana (Q1 - Q3): 1,07 ( 1,0-1,2)] (p<0,001). A AUC para o valor diagnóstico de HRR em hsPDA foi de 0,816 e o valor de corte foi ≤0,98 (p<0,001, 95% [IC]: 0,785-0,845, sensibilidade: 90%, especificidade: 92%). Conclusões O valor de HRR foi considerado um parâmetro eficaz e poderoso no diagnóstico de hsPDA.

Abstract Background It is still unclear how effective hematological parameters are in the closure of patent ductus arteriosus (PDA). Objectives The primary aim of our study is to investigate the effect of hemoglobin (HB)-to-red cell distribution width (RDW) ratio (HRR) on the closure of PDA. Methods Premature babies with very low birth weight (VLBW: <1500 g) and <32 gestational weeks were included in the study, and all data were recorded retrospectively. Demographic characteristics, clinical results, red cell parameters, and HRR and their ratios were compared between hemodynamically significant PDA (hsPDA) and non-hsPDA groups. All results were statically analyzed, and P<0.05 was considered statistically significant. Results A total of 677 premature babies, 269 in the hsPDA group and 408 in the non-hsPDA group, were included in the study. Hemoglobin (HB), hematocrit (HCT), mean cell volume (MCV), red blood cell (RBC), red cell distribution width (RDW), mean platelet volume (MPV), MCV/RBC ratio, HB/RBC ratio, RDW/RBC ratio, and RDW/MPV ratio were found to be similar between hsPDA and non-hsPDA groups, (p>0.05). HRR was found to be significantly lower in the hsPDA group [median (Quartile 1 (Q1) - Q3) (Q1 - Q3): 0.93 (0.8-1.0)] compared to non-hsPDA [median ( Q1 - Q3): 1.07 (1.0-1.2)] (p<0.001). The AUC for the diagnostic value of HRR in hsPDA was 0.816, and the cutoff value was ≤0.98 (p<0.001, 95% [CI]: 0.785-0.845, sensitivity: 90%, specificity: 92%). Conclusions HRR value was found to be both an effective and powerful parameter in diagnosing hsPDA.

Analysis of patent records related to the prevention and signaling of falls in Brazil / Análisis de registros de patentes relacionados con la prevención y señalización de caídas en Brasil / Análise dos registros de patentes relacionadas à prevenção e sinalização de quedas no Brasil

ABSTRACT Objective: To analyze patent records aimed at preventing and signaling falls in a Brazilian database. Method: Electronic documentary research carried out in the database of the Instituto Nacional da Propriedade Industrial using the word "fall" in the search resource. Patent records related to the prevention and signaling of falls at home and in care environment applied from 2000 to 2021 were included. Tabulated data were evaluated using absolute/relative frequencies. Results: From the 45 patents, 91% were published starting from 2011, with an average of 1214 days between application and publication, 11% of applicants were from public universities and 9% of the inventors were nurses, physician or physical therapists. Conclusion: There was a delay in the publication of the patents and small participation of researchers linked to the academic area and health professionals, revealing the need to equip universities and health services in order to guarantee the development of innovations.

RESUMEN Objetivo: Analizar los registros de patentes destinados a la prevención y señalización de caídas en una base de datos brasileña. Método: Búsqueda documental electrónica realizada en la base de datos del Instituto Nacional de Propiedade Industrial utilizando la palabra "caída" en el buscador. Se incluyeron registros de patentes relacionadas con la prevención y señalización de caídas en el hogar y en el ambiente asistencial presentadas desde 2000 hasta 2021. Los datos tabulados se evaluaron mediante frecuencias absolutas/relativas. Resultados: De las 45 patentes, el 91% fueron publicadas a partir de 2011, con un promedio de 1214 días entre presentación y publicación, el 11% de los solicitantes estaban vinculados a universidades públicas y el 9% de los inventores eran enfermeros, médicos o fisioterapeutas. Conclusión: Hubo retraso en la publicación de patentes y poca participación de investigadores vinculados al área académica y profesionales de la salud, revelando la necesidad de equipar universidades y servicios de salud para garantizar el desarrollo de innovaciones.

RESUMO Objetivo: Analisar os registros de patentes voltados para prevenção e sinalização de queda em base de dados brasileira. Método: Pesquisa documental eletrônica realizada na base de dados do Instituto Nacional da Propriedade Industrial utilizando-se a palavra "queda" no recurso de busca. Foram incluídos registros de patentes relacionados à prevenção e sinalização de quedas em domicílio e ambiente de cuidado, depositados no período de 2000 a 2021. Os dados tabulados foram avaliados por meio de frequências absolutas/relativas. Resultados: Das 45 patentes, 91% foram publicadas a partir de 2011, com média de 1214 dias entre depósito e publicação, 11% dos depositantes eram vinculados a universidades públicas e 9% dos inventores eram enfermeiros, médico ou fisioterapeuta. Conclusão: Observou-se morosidade na publicação das patentes e pequena participação de pesquisadores vinculados à área acadêmica e profissionais da saúde, revelando necessidade de instrumentalizar universidades e serviços de saúde a fim de garantir o desenvolvimento de inovações.

Clinical Comprehensive Evaluation of Biantong Capsules and Biantong Tablets in Treatment of Constipation / 中国实验方剂学杂志

ObjectiveTo carry out the clinical comprehensive evaluation of Biantong capsules and Biantong tablets in the treatment of constipation guided by the clinical value of drugs， and to provide a scientific basis for the rational pricing， rational use， and cataloging of Biantong capsules/tablets. MethodThe available evidence and survey data were used for the clinical comprehensive evaluation of Biantong capsules/tablets and three control drugs in the treatment of constipation in terms of the six dimensions including effectiveness， safety， economics， innovation， suitability， and accessibility. ResultIn terms of effectiveness， Biantong capsules/tablets can improve the response rate， with clear pharmacological mechanism. In terms of safety， the absence of toxic reaction， the mild adverse reactions， and the favorable prognosis indicate high safety. In terms of economics， the average daily cost of Biantong capsules/tablets is the lowest among the tested drugs， which indicates a cost-effectiveness advantage. In terms of innovation， Biantong capsules/tablets have been authorized patents in China and listed as members in the third category of new drugs of traditional Chinese medicine/ninth new drugs of traditional Chinese medicine. In terms of suitability， Biantong capsules/tablets are convenient to store and take and have good suitability in terms of drug technical characteristics and drug usage. In terms of accessibility， Biantong capsules/tablets have a wide coverage in hospitals， sufficient capacity， low patient burden， extensive drug catalogue coverage， and no major environmental risk for long-term application. The comprehensive values of the tested drugs follow a descending order of control drug B （84.27 score）， Biantong capsules/tablets （82.47 score）， control drug A （70.47 score）， and control drug C （59.46 score）. The recommendations of the expert panel are Class A （18/18）， which can be directly converted into decision-making. ConclusionBiantong capsules/tablets demonstrate a high clinical comprehensive value in the treatment of constipation， providing a reference for the rational pricing， rational use， and cataloging of drugs.

Diagnostic analysis of cTTE for patent foramen ovale and the value of combined NLR monitoring in predicting cryptogenic stroke / 中国医师杂志

Objective:To investigate the diagnostic value of transthoracic echocardiographic contrast-enhanced ultrasound (cTTE) in patent foramen ovale (PFO) and the value of combined neutrophil to lymphocyte ratio (NLR) in predicting cryptogenic stroke.Methods:A total of 120 suspected PFO patients admitted to the Affiliated Hospital of Jining Medical College from January 2021 to December 2021 were selected and examined by cTTE and transesophageal echocardiography (TEE) to analyze the diagnostic value of cTTE in PFO. The clinical data and cTTE parameters of PFO patients with and without cryptogenic stroke were analyzed.Results:A total of 69 patients with PFO were confirmed. Among the 69 patients, 23 patients with cryptogenic stroke and 46 patients without cryptogenic stroke were confirmed by magnetic resonance imaging (MRI). The value of cTTE in the diagnosis of PFO was high: the sensitivity, accuracy and negative predictive value of cTTE under Valsalva motion in the diagnosis of PFO were 95.65%, 91.67% and 93.62%, respectively, which were significantly higher than that of cTTE at rest (all P<0.05). The NLR, the proportion of large shunt of PFO right to left shunt (PFO-RLS), the inlet width of patent foramen ovale (PFO) and the outlet width of PFO in patients with PFO complicated with cryptogenic stroke were (3.01±0.89), 43.48%(10/23), (2.54±0.65)mm and (1.51±0.35)mm, respectively, which were significantly higher than those in patients without cryptogenic stroke (all P<0.05). Logistic regression analysis showed that NLR and the degree of PFO-RLS shunt were the influencing factors of patients with PFO complicated with cryptogenic stroke (both P<0.05). The area under the Receiver operating characteristic (ROC) curve predicted by NLR combined with PFO-RLS shunt was 0.905, which was significantly higher than that predicted by NLR and PFO-RLS shunt alone (all P<0.05). Conclusions:cTTE has a good value in the diagnosis of PFO, and cTTE combined with NLR has a certain application value in predicting PFO complicated with cryptogenic stroke.