Miracle-dz/UniFAR-FTUs huggingface dataset:
The Vaginal Microbiome: II. Vaginal Dysbiotic Conditions

Objective This series of articles, titled The Vaginal Microbiome (VMB), written on behalf of the International Society for the Study of Vulvovaginal Disease, aims to summarize the recent findings and understanding of the vaginal bacterial microbiota, mainly regarding areas relevant to clinicians specializing in vulvovaginal disorders. Materials and Methods A search of PubMed database was performed, using the search terms “vaginal microbiome” with “dysbiosis,” “bacterial vaginosis,” “cytolytic vaginosis,” “desquamative inflammatory vaginitis,” and “aerobic vaginitis. ” Full article texts were reviewed. Reference lists were screened for additional articles. Results The second article in this series focuses on vaginal dysbiotic conditions. Dysbiosis is a term describing imbalances in bacterial communities. Given that lactobacillus-dominated microbiota are thought to be the most optimal, vaginal dysbiosis is usually considered as lactobacilli-depleted VMB. Bacterial vaginosis (BV), the most common vaginal dysbiotic condition, is a polymicrobial disorder, considered the leading cause for vaginal discharge in women worldwide. In addition, we review the VMB in other vaginal conditions associated with lactobacilli depletion: desquamative inflammatory vaginitis and aerobic vaginitis. We also discuss the controversial diagnosis of cytolytic vaginosis, related with lactobacilli overgrowth. Conclusions Bacterial vaginosis displays complex microbiology. The heterogeneity and diversity within the genus Gardnerella may impact the progression of BV. Bacterial biofilms may contribute to the etiology and persistence of BV, and various bacteria may affect its clinical presentation and pathogenicity. Lack of lactobacilli is not always accompanied by an overgrowth of anaerobes.
In vitro growth of the ovarian follicle: taking stock of advances in research

Several factors are necessary for the growth and survival of healthy follicles in the folliculogenesis process, including endocrine and paracrine glands, and a regulated ratio of granulosa cells to oocytes. One of the most powerful methods for studying folliculogenesis is the culture of ovarian follicles and oogenesis within a completely controlled environment. Follicle culture systems are highly developed and are rapidly evolving. However, the methods for separating the follicles, the cultivation techniques, the culture medium, and the dietary and hormonal supplements vary depending on the species studied. This study made a literature review of follicular culture techniques, and we investigated the heterogeneity among these key variables in follicular culture.
Intrusion Detection and light weight Firewall for the 6LoWPAN networks

IPv6 over Low power WPAN (6loWPAN) is an adaption layer introduced between the link layer and the network layer in the TCP/IP protocol stack to t the IPv6 datagrams over the IEEE 802.15. 4 link layer. 6loWPAN networks comprise of internet enabled resource-constrained smart objects which are interconnected with each other through the Internet Protocol (IPv6). In Internet of Things (IoT), smart devices of the 6loWPAN networks are connected to the unsecured public Internet. RPL (Routing Protocol for Low-Power and Lossy Networks) is the standardized routing protocol dened for routing IP datagrams over the lossy links in LLN (Low-Power and Lossy Networks). In IoT, all devices have a global identity and could be accessed from anywhere in the globe. Hence, security is an important factor in protecting the devices and their informational resources from adversaries. Security solutions must be highly e ective for smart objects considering their limited resources. Despite the state of the art crypto solutions providing information security, IPv6 enabled smart objects are vulnerable to attacks from outside and inside the 6LoWPAN networks.This thesis attempts to identify the intrusions aimed to disrupt 6LoWPAN networks and to prevent external adversaries taking advantage of the resource constrained 6LoWPAN environment. We review state of the art security attacks in conventional WSNs and the RPL-based LLNs. In order to improve the security within 6LoWPAN networks, we extend SVELTE (an IDS for the IoT) by adding ETX (Expected Transmissions) parameter in the 6Mapper. In RPL, ETX is a link reliability metric which indicates the number of successful IP datagram transmissions with respect to the Border Router. Monitoring the ETX value could prevent the Border Router and neighboring nodes to engage actively with the malicious intruder. We propose a geographic routing algorithm to identify the malicious node conducting attacks against ETX-based solutions. We also implement a lightweight rewall at the Border Router to prevent 6LoWPAN networks from external attackers. In this rewall we conduct a stateful deep packet inspection on the protocols adhering to the protocol stack for the 6LoWPAN networks. Our evaluation shows that the IDS module with ETX metric consumes negligible energy and very less CPU processing power. Our intrusion detection mechanisms improves the true positive rate of SVELTE.
A novel movement system screen for primary care providers: a multisite, observational study

Abstract Context Movement of the human body is essential for the interaction of an individual within their environment and contributes to both physical and emotional quality of life. Movement system disorders (MSDs) are kinesiopathologic conditions that result from either altered movement patterns, trauma, or pathology. A screening tool may facilitate earlier diagnosis and treatment of acute MSDs. This tool could prevent progression to chronic conditions, leading to better patient outcomes and quality of life. Objectives Our study evaluated whether a screening tool would be able to accurately screen individuals for MSDs, explore comorbidities that may predict the prevalence of MSDs, and identify why people do not discuss these problems with their primary care provider (PCP). Methods A multisite, observational study in a primary care setting. Data were analyzed to determine the psychometric properties of the screening question. Logistic regression was performed to explore the relationship of comorbidities with MSDs. Thematic analysis was performed to explore why patients do not discuss these issues with their PCP. Results The point prevalence of MSDs was determined to be 78%. The sensitivity of the screening question was determined to be good (70%). Arthritis, obesity, sleep disorders, and gastroesophageal reflux disease (GERD) were significant predictors for an MSD. Thematic analysis regarding why patients do not discuss the MSD with their physician revealed: (1) the perceived lack of importance of the problem; (2) the lack of access to healthcare, and (3) the acuity of the problem. Conclusions Screening for an MSD and associated comorbidities could prevent the transition of acute conditions to chronic conditions. If PCPs can identify predictors and factors associated with an MSD, they may be able to screen for MSDs more effectively. Earlier identification of MSDs may facilitate earlier treatment and prevent costs associated with resulting chronic disorders and persistent pain and disability.
Correlation of ANA Characteristics with pANCA IFA Interference.

BACKGROUND Antineutrophil cytoplasmic antibody (ANCA) testing by the indirect immunofluorescence assay (IFA) is important for the diagnosis of autoimmune vasculitis. A common analytical interference for ANCA-IFA is the presence of an antinuclear antibody (ANA), which can cause an apparent perinuclear ANCA (pANCA) result on ethanol-fixed neutrophils. Here, the association of ANA patterns, titers, and concentrations with pANCA interference is investigated. METHODS Samples positive for ANA by IFA with homogeneous, speckled, dense fine speckled (DFS), and centromere patterns were tested for ANA by enzyme immunoassay (EIA)] and for ANCA by IFA on ethanol-fixed neutrophils. Titers and concentrations were determined for the ANA-IFA and EIA, respectively, and correlated with the frequency of pANCA interpretations. RESULTS For ANA-EIA positive samples (≥1.1U), 20.0% led to a pANCA interpretation compared to 5.1% for negative samples (≤1.0U). For samples positive by ANA-IFA, 12.9% resulted in a pANCA interpretation. Interference on pANCA correlated with ANA-IFA titer, with ANA titers ≥1:1280 identified as pANCA positive in 20.9% of samples compared to 9.7% for titers <1:1280. There was also a correlation with ANA pattern, as homogeneous samples were most likely to be called positive for pANCA (31.7%), followed by speckled (8.8%), DFS (6.8%), and centromere (3.6%). CONCLUSIONS Positivity for ANA by EIA is associated with increased prevalence of pANCA interpretation. Samples positive for ANA by IFA also demonstrated this association, particularly with higher-titer, homogeneous patterns. Laboratories can use this information to determine an optimal workflow for when investigating potential pANCA interferences.
Playfulness as a motivational tool : Using play to develop for an enhanced reception of swapping reusable goods

This study examines the field of playful design as a tool to affect and enhance the reception of a mundane activity. The management of swapping reusable household goods between neighbors is explored by designing playful components to enhance the experience. A pilot field study was carried out to observe recycling areas, in conjunction to 20 interviews being conducted regarding their point of views on recycling habits and their perception on their own local recycling area.The results show a clear indifferent attitude towards recycling and the environment surrounding the recycling area. However the interviewees were predominantly optimistic to the idea of swapping reusable goods with neighbors for its well-known advantages. Concerns were expressed on the practical efficiency and organization of such an activity, as well as on the shameful label perceived by using pre-used goods.A hybrid mobile application prototype was developed as one suggestion on how to incorporate playful design in a way that takes into consideration the needs and concerns of the users for swapping goods.Future research includes carrying out case studies on such playful applications for the current intended uses to gather insight on how they are utilized by potential users. Relevant are also empirical studies on how playful design as a tool may be used and its impact on users to get rid of perceived negative labels.
Iron deficiency anaemia: pathophysiology, assessment, practical management

The WHO has recognised iron deficiency anaemia (IDA) as the most common nutritional deficiency in the world, with 30% of the population being affected with this condition. Although the most common causes of IDA are gastrointestinal bleeding and menstruation in women, decreased dietary iron and decreased iron absorption are also culpable causes. Patients with IDA should be treated with the aim of replenishing iron stores and returning the haemoglobin to a normal level. This has shown to improve quality of life, morbidity, prognosis in chronic disease and outcomes in pregnancy. Iron deficiency occurs in many chronic inflammatory conditions, including congestive cardiac failure, chronic kidney disease and inflammatory bowel disease. This article will provide an updated overview on diagnosis and management of IDA in patients with chronic conditions, preoperative and in pregnancy. We will discuss the benefits and limitations of oral versus intravenous iron replacement in each cohort, with an overview on cost analysis between the different iron formulations currently on the market.
Associations between nurse managers’ leadership styles, team culture and competence planning in Norwegian municipal in‐patient acute care services: A cross‐sectional study

Abstract Background Increased complexity in the primary healthcare services has followed in the wake of health reforms and reveals the need for competence enhancement in the nursing services. Effective and visionary leadership, sufficiently qualified staff and cooperation among professionals are considered as key measures to safeguard quality in the services. Aims To identify which leadership styles characterise first‐line nurse managers in Norwegian municipal in‐patient acute care (MipAC) units and to investigate how first‐line nurse managers’ leadership styles are associated with team culture and documented nursing competence planning. Methods A cross‐sectional survey was distributed to all the first‐line nurse managers in Norwegian MipAC units (n = 229). Data were collected between March and June 2019. The response rate was 80.5% (n = 182). First‐line managers’ background information and data about their focus on team culture and competence planning were recorded. Furthermore, we noted organisational structural characteristics, and managers’ transformational (relational) leadership and transactional (task‐oriented) leadership styles. Results The managers exhibited a high degree of transformational leadership behaviour, which was significantly associated with team culture. No significant associations between leadership behaviours and documented competence planning were found. Notably, we found a significant correlation between transformational and transactional leadership styles, indicating that the managers adapt their leadership behaviours to actual requirements and situations. Organisational structural factors: the share of registered nurses (RNs) on the staff and having a position for a professional development nurse were positively associated with competence planning. Conclusion A relational leadership style promotes team culture and both factors may empower the professional nursing environment. However, first‐line nurse managers need to acknowledge nursing competence planning as a central part of effective leadership. Having a professional development nurse position seems to complement leadership and ease the manager's responsibilities regarding team culture and competence planning.
ATM and TP53 polymorphisms modified susceptibility to radiation-induced lens opacity in natural high background radiation area, China

Abstract Purpose: A population-based case-control study was conducted in Yangjiang and Enping areas in South China to assess whether the risk of lens opacity induced by natural high background radiation exposure is modulated by polymorphisms of ATM and TP53. Materials and methods: A total of 133 cases who were diagnosed with cortical and posterior subcapsular (PSC) opacity were recruited, and 419 healthy controls were selected through counter-matching in terms of radiation status. Genomic DNA from all the participants was genotyped with the Illumina platform for four single nucleotide polymorphisms of ATM (rs189037, rs373759, and rs4585) and TP53 (rs1042522). The cumulative lens dose received during the entire life was estimated based on annual indoor and outdoor radiation doses and gender- and age-specific occupancy factors. Non-conditional logistic regression was performed to calculate odds ratio (OR) and 95% confidence intervals (95% CI). Results: ATM rs189037 and TP53 rs1042522 were significantly related to cortical and PSC opacity. The risk of opacity was higher when individuals carried the A allele of ATM rs189037 and C allele of TP53 rs1042522, compared with GG genotype. ATM rs189037 A allele carriers (AG/AA) and TP53 rs1042522 C allele carriers (CG/CC) combined with a cumulative lens dose of 100 mGy or higher showed statistically significant opacity risks (OR = 5.51, 95% CI: 1.47–20.66; OR = 2.69, 95% CI: 1.10–6.60). Conclusion: The A allele of ATM rs189037 and C allele of TP53 rs1042522 increased the risk of lens opacity induced by radiation. These polymorphisms in ATM and TP53 might modify the risk of cortical and PSC opacity induced by chronic and prolonged low-dose radiation.
Proximal hamstring tendon avulsions: comparable clinical outcomes of operative and non-operative treatment at 1-year follow-up using a shared decision-making model

Objective To prospectively evaluate 1-year clinical and radiological outcomes after operative and non-operative treatment of proximal hamstring tendon avulsions. Methods Patients with an MRI-confirmed proximal hamstring tendon avulsion were included. Operative or non-operative treatment was selected by a shared decision-making process. The primary outcome was the Perth Hamstring Assessment Tool (PHAT) score. Secondary outcome scores were Proximal Hamstring Injury Questionnaire, EQ-5D-3L, Tegner Activity Scale, return to sports, hamstring flexibility, isometric hamstring strength and MRI findings including proximal continuity. Results Twenty-six operative and 33 non-operative patients with a median age of 51 (IQR: 37–57) and 49 (IQR: 45–56) years were included. Median time between injury and initial visit was 12 (IQR 6–19) days for operative and 21 (IQR 12–48) days for non-operative patients (p=0.004). Baseline PHAT scores were significantly lower in the operative group (32±16 vs 45±17, p=0.003). There was no difference in mean PHAT score between groups at 1 year follow-up (80±19 vs 80±17, p=0.97). Mean PHAT score improved by 47 (95% CI 39 to 55, p<0.001) after operative and 34 (95% CI 27 to 41, p<0.001) after non-operative treatment. There were no relevant differences in secondary clinical outcome measures. Proximal continuity on MRI was present in 20 (95%, 1 recurrence) operative and 14 (52%, no recurrences) non-operative patients (p=0.008). Conclusion In a shared decision-making model of care, both operative and non-operative treatment of proximal hamstring tendon avulsions resulted in comparable clinical outcome at 1-year follow-up. Operative patients had lower pretreatment PHAT scores but improved substantially to reach comparable PHAT scores as non-operative patients. We recommend using this shared decision model of care until evidence-based indications in favour of either treatment option are available from high-level clinical trials.
On the Use of Ultrasound-Based Technology for Cargo Inspection

A new guided wave imaging application for fast, low-cost ultrasound-based cargo scanning system is proposed. The ultimate goal is the detection of high-atomic-number, shielding containers used to diminish the radiological signature of nuclear threats. This ultrasonic technology has the potential to complement currently deployed X-ray-based radiographic systems, thus enhancing the probability of detecting nuclear threats. An array of ultrasonic transceivers can be attached to the metallic structure of the cargo to create a guided Lamb wave. Guided medium thickness and composition variation creates reflections whose placement can be revealed by means of an imaging algorithm. The knowledge of the reflection position provides information about the shielding metallic container location inside the cargo. Moreover, due to the low coupling between metallic and nonmetallic surfaces, only the footprint of metallic containers shows up in the imaging results, thus avoiding false positives from plastic or wooden assets. As imaging capabilities are degraded if working with dispersive Lamb wave modes, the operating frequency is tuned to provide a tradeoff between low dispersion and real-time image resolution. Reflected waves in the guided domain bounds may limit the performance of imaging methods for guided media. This contribution proposes a solution based on realtime Fourier domain analysis, where plane wave components can be filtered out, thus removing nondesired contributions from bounds. Several realistic examples, scaled due to limited calculation capabilities of the available computational resources, are presented in this work, showing the feasibility of the proposed method. [DOI: 10.1115/1.4032724]
Economic implications of FDA platelet bacterial guidance compliance options: Comparison of single‐step strategies

Bloodborne pathogens pose a major safety risk in transfusion medicine. To mitigate the risk of bacterial contamination in platelet units, FDA issues updated guidance materials on various bacterial risk control strategies (BRCS). This analysis presents results of a budget impact model updated to include 5‐ and 7‐day pathogen reduced (PR) and large volumed delayed sampling (LVDS) BRCS.
Genetic polymorphisms of ACE1, ACE2, and TMPRSS2 associated with COVID‐19 severity: A systematic review with meta‐analysis

Novel coronavirus disease 2019 (COVID‐19) poses a global threat, due to its fluctuating frequency and lethality. Published data revealed associations of COVID‐19 susceptibility and severity with host genetic polymorphisms in renin‐angiotensin‐aldosterone system (RAAS)‐related genes including angiotensin‐converting enzyme (ACE)1, ACE2, and transmembrane protease (TMPRSS)2. However, the findings remain inconclusive. Accordingly, we aimed to clarify associations of genetic variants in those genes with COVID‐19 susceptibility and severity using a systematic review with meta‐analysis. From inception through 1 July 2021, a literature search was performed using PubMed, Scopus, Web of Science, and Cochrane Library databases. Allelic distributions for each polymorphism were calculated as pooled odds ratios (OR) with 95% confidence intervals (CI) to assess the strength of association. A total of 3333 COVID‐19 patients and 5547 controls from 11 eligible studies were included. From a systematic review, ACE1 rs1799752, ACE1 rs4646994, ACE2 rs2285666, and TMPRSS2 rs12329760 were identified as common polymorphisms of RAAS‐related genes. Meta‐analysis showed a significant association between TMPRSS2 rs12329760 C‐allele and an increased risk of developing severe COVID‐19 (OR = 1.32, 95% CI: 1.01, 1.73). Likewise, additional meta‐analyses uncovered that both ACE1 rs4646994 DD‐genotype and ACE2 rs2285666 GG‐genotype carriers had a significantly increased risk of developing severe COVID‐19 (OR = 2.06, 95% CI: 1.45, 2.93; OR = 2.14, 95% CI: 1.26, 3.66; respectively). Genetic polymorphisms of ACE1 rs4646994 DD‐genotype, ACE2 rs2285666 GG‐genotype, and TMPRSS2 rs12329760 CC‐genotype and C‐allele may serve as predictive models of COVID‐19 severity.
Editorial commentary: Cutting the Gordian knot of right‐sided prosthetic valve thrombosis

With limited data available for the tricuspid valve, there are no stringent recommendations in the current guidelines (ESC 2021). Valve replacement for the right‐sided heart is inherently problematic and bears the potential for complications — including prosthetic valve thrombosis (PVT). The purpose of this editorial is to review the key features of this clinical scenario and to outline the essential aspects for optimized patient management and improved outcome. Depending on the clinical presentation of PVT, either immediate surgery, thrombolysis, or anticoagulation may be considered — with the sole intensification of anticoagulation likely being the most inferior. Given the high risk of re‐thrombosis, a dedicated follow‐up program is essential to identify complications early and offer adequate treatment.