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Junipers (Juniperus spp.) are important pharmaceutical plants, and they are commonly grown in the northern hemisphere because of the various medicinal properties attributed to the Juniperus genus. However, despite their pharmaceutical and also industrial importance, and despite plant diversity being a common topic of research among professional breeding programs, there is a relatively small body of work which focuses on diversity in juniper, and this is especially true of juniper species that are native to Iran. Thus, the present study set out to investigate juniper diversity via identifying any morphological, phytochemical, and genetic differences among and within three important species of Iranian junipers. The data revealed the terpenoid profiles of the investigated species to be distinct from one another, with α-pinene, β-pinene, myrcene, sabinene, and limonene being the predominant terpenoids detected. Intriguingly, high levels of myrtenyl acetate were detected in the J. sabina tissue collected from the Ramsar site, and this terpenoid was not found in either of the other studied species, nor has it been noted in any other studies that focus on juniper. The genetic variation of Juniperus was analyzed using five ISSR markers and the molecular variance was computed using the GenAlEx software. The results revealed there to be a high degree of genetic diversity both among and within the studied populations. A dendrogram of the genetic data using the UPGMA method with the Dice coefficient divided the genotypes into two main groups. J. communis and J. excelsa were grouped together, while J. sabina was separated into its own group. In general, morphologically speaking, the leaf and cone types were found to be chiefly influential vis-à-vis separating the populations into their respective groups. Ultimately, it is our hope that the biochemical, genetic, and morphological diversity data collected from these species will contribute to the success of future juniper breeding and restoration programs.

We conducted a scoping review to identify existing conceptual frameworks of postoperative recovery (PR) and assess their content.

PR is increasingly recognized by providers and third-party payers as a multidimensional phenomenon. Efforts to optimize PR and reduce complications and readmissions continue to evolve through changes in care (i.e., enhanced recovery protocols) and financial incentives. Delineating all factors affecting PR using a conceptual framework should aid in the design of effective interventions.

Web of Science and PubMed were queried to identify articles, between January 1980 and August of 2019, about conceptual frameworks of PR, using the search terms “concept,” “model,” “framework,” “recovery after surgery,” “conceptual framework” “postoperative,” “surgery,” and “children.” Articles considering PR as a concept rather than an outcome were included. Articles were examined in accordance with Walker and Avant’s method for the concept analysis. Lifirafenib in vivo Concepts identified across articles were claeptual frameworks of PR in adults, and the definitions of PR differ. No framework was specific to children. Consensus on a conceptual framework of PR in adults and development of a conceptual framework of PR specific to children are needed.

In the absence of ST-segment elevation (STE) in post-return of spontaneous circulation (ROSC) electrocardiogram (ECG), coronary angiography (CAG) is required in patients with suspected coronary artery disease (CAD). However, it is a challenge to identify patients with CAD after cardiac arrest (CA). Recent European Society of Cardiology guidelines recommends transthoracic echocardiography in patients presenting with cardiac arrest. We aimed to assess the diagnostic value of regional wall motion abnormalities (RWMAs) on transthoracic echocardiography (TTE) compared to ECG in diagnosing significant coronary artery stenosis in CA patients.

This is a retrospective, observational study of adult CA patients with presumed cardiac etiology who underwent CAG from a single tertiary care hospital. We compared the predictive value of RWMA on TTE and STE on ECG in significant stenosis of ≥70% of the coronary artery diameter. The primary outcome was significant stenosis on CAG.

There were 145 patients included in this study and CAG revealed significant stenosis in 76 (52.4%) patients. Among the 76 patients with significant stenosis, 68 (89.5%) had RWMA on TTE and 41 (54.0%) had STE. RWMA on TTE (OR 3.67; 95% CI 1.52-8.85) was independently associated with significant stenosis. Combining both RWMA on TTE and STE on ECG improved performance in the receiver operating characteristic curve analysis (area under the curve 0.722) for predicting significant stenosis compared to using only ECG alone (p=0.001).

RWMAs on TTE was independently associated with significant stenosis. The RWMA and STE combination had better predictive performance than using only STE on ECG to predict significant stenosis.

RWMAs on TTE was independently associated with significant stenosis. The RWMA and STE combination had better predictive performance than using only STE on ECG to predict significant stenosis.

In response to the COVID-19 pandemic in Detroit, an earlier termination of resuscitation protocol was initiated in March 2020. To characterize pre-hospital cardiac arrest careduring COVID-19 in Detroit, we analyzed out-of-hospital cardiac arrest (OHCA) rate of ROSC (return of spontaneous circulation) and patient characteristics before and during the COVID-19 pandemic.

OHCA data was analyzed between March 10th, 2020 – April 30th, 2020 and March 10th, 2019 – April 30th, 2019. ROSC, patient demographics, arrest location, initial rhythms, bystander CPR and field termination were compared before and during the pandemic. Descriptive statistics were utilized to compare arrest characteristics between years, and the odds of achieving vs. not achieving ROSC. 2020 vs. 2019 as a predictor for ROSC was assessed with logistic regression.

471 patients were included. Arrests increased to 291 during the pandemic vs. 180 in 2019 (62% increase). Age (mean difference+6; 95% CI +2.4 to +9.5), arrest location (nursing home OR=2.