bluuebunny/crossref_metadata_2025 huggingface dataset:
The inter-prefectural regional disparity of healthcare resources and representative surgical procedures in orthopaedics and general surgery: a nationwide study in Japan during 2015–2019
Authors: Kido Masamitsu , Ikoma Kazuya , Kobayashi Yumiko , Maki Masahiro , Ohashi Suzuyo , Shoda Katsutoshi , Ichikawa Daisuke , Uehara Ritei , Takahashi Kenji
Published: September 2023

Background

Few reports have examined the localized regional disparity in representative surgical procedures in orthopaedics and general surgery globally. This study aimed to clarify the inter-prefectural regional disparity and relationships between healthcare resources and representative surgical procedures using a nationwide database in Japan.

Methods

The number of medical specialists in orthopaedics, general surgery, and anaesthesiology, as well as the number of hospitals, and the incidence of representative surgical procedures in orthopaedics and general surgery were evaluated annually per 100,000 inhabitants/people by prefecture in Japan during 2015–2019. Medium-sized regional disparities were evaluated using the Gini coefficient. Correlation coefficients were calculated for the defined variables and ageing rate. We also compared the urban and rural regional disparities in all study variables.

Results

The annual average number/incidence and Gini coefficients were 110.6 and 0.11 for femur fracture surgery, 106.3 and 0.09 for cholecystectomy, 14.2 and 0.11 for orthopaedic surgeon specialists, 17.6 and 0.09 for general surgeon specialists, 5.9 and 0.13 for anaesthesiology specialists, and 8.1 and 0.21 for hospitals, respectively. The correlation coefficients by the incidence of femur fracture surgery were 0.74 for orthopaedic surgeon specialists (p < 0.001), 0.63 for hospitals (p < 0.001), and 0.62 for the ageing rate (p < 0.001); those by the incidence of cholecystectomy were 0.60 for general surgeon specialists (p < 0.001) and 0.59 for hospitals (p < 0.001). The number/incidence of orthopaedic surgeon specialists, hospitals, femur fracture surgery, and cholecystectomy, as well as the ageing rate, were significantly higher in rural prefectures than in urban prefectures (p < 0.05).

Conclusions

Inter-prefectural regional disparity was small, although certain items were unevenly distributed in the rural prefectures, which is contrary to our expectations. Higher prevalence was recognised in rural prefectures due to the higher ageing rate; however, supply and demand are balanced. This study provides basic data for healthcare policy development in a medium-sized community.

Level of evidence

III.
GREM1, LRPPRC and SLC39A4 as potential biomarkers of intervertebral disc degeneration: a bioinformatics analysis based on multiple microarray and single-cell sequencing data
Authors: Zhang ZhaoLiang , Huo JianZhong , Ji XingHua , Wei LinDong , Zhang Jinfeng
Published: September 2023

Background

Low back pain (LBP) has drawn much widespread attention and is a major global health concern. In this field, intervertebral disc degeneration (IVDD) is frequently the focus of classic studies. However, the mechanistic foundation of IVDD is unclear and has led to conflicting outcomes.

Methods

Gene expression profiles (GSE34095, GSE147383) of IVDD patients alongside control groups were analyzed to identify differentially expressed genes (DEGs) in the GEO database. GSE23130 and GSE70362 were applied to validate the yielded key genes from DEGs by means of a best subset selection regression. Four machine-learning models were established to assess their predictive ability. Single-sample gene set enrichment analysis (ssGSEA) was used to profile the correlation between overall immune infiltration levels with Thompson grades and key genes. The upstream targeting miRNAs of key genes (GSE63492) were also analyzed. A single-cell transcriptome sequencing data (GSE160756) was used to define several cell clusters of nucleus pulposus (NP), annulus fibrosus (AF), and cartilaginous endplate (CEP) of human intervertebral discs and the distribution of key genes in different cell clusters was yielded.

Results

By developing appropriate p-values and logFC values, a total of 6 DEGs was obtained. 3 key genes (LRPPRC, GREM1, and SLC39A4) were validated by an externally validated predictive modeling method. The ssGSEA results indicated that key genes were correlated with the infiltration abundance of multiple immune cells, such as dendritic cells and macrophages. Accordingly, these 4 key miRNAs (miR-103a-3p, miR-484, miR-665, miR-107) were identified as upstream regulators targeting key genes using the miRNet database and external GEO datasets. Finally, the spatial distribution of key genes in AF, CEP, and NP was plotted. Pseudo-time series and GSEA analysis indicated that the expression level of GREM1 and the differentiation trajectory of NP chondrocytes are generally consistent. GREM1 may mainly exacerbate the degeneration of NP cells in IVDD.

Conclusions

Our study gives a novel perspective for identifying reliable and effective gene therapy targets in IVDD.
Prognostic value of APTT combined with fibrinogen and creatinine in predicting 28-Day mortality in patients with septic shock caused by acute enteric perforation
Authors: Fu Shuiqiao , Yu Wenqiao , Fu Qinghui , Xu Zhipeng , Zhang Shaoyang , Liang Ting-bo
Published: September 2023

Background

Septic shock is one of the leading causes of mortality in intensive care units. This retrospective study was carried out to evaluate the association of clinical available factors with 28-day mortality.

Patients and method

In this observational study, patients with perioperative septic shocks secondary to intra-abdominal infection caused by enteric perforation were included. A total of 328 sepsis patients were admitted to the surgical intensive care units from January 2012 to December 2016. A total of 138 patients met the enrolment criteria and were included in the study. The data of demographic, clinical and laboratory were all recorded.

Result

All these 138 patients received abdominal surgery prior to surgical intensive care units caused by acute enteric perforation. These patients were all met the diagnostic criteria of septic shock according to Sepsis-3. Statistical analysis showed that lactic acid, blood platelet, fibrinogen, creatinine and activated partial thromboplastin time were found to be associated with 28-day mortality. A combination of serum activated partial thromboplastin time combined with fibrinogen and creatinine could predict in-hospital 28-day mortality. The area under the curve of serum activated partial thromboplastin time combined with fibrinogen and creatinine is 0.875 (0.806–0.944).

Conclusion

In conclusion, this pilot study demonstrated that these factors can predict the prognosis of septic shock caused by enteric perforation. In order to reduce the mortality, surgeons and intensive care units physician may consider these data in perioperative period.
Airway inflammatory changes in the lungs of patients with asthma-COPD overlap (ACO): a bronchoscopy endobronchial biopsy study
Authors: Dey Surajit , Lu Wenying , Haug Greg , Chia Collin , Larby Josie , Weber Heinrich C. , Gaikwad Archana Vijay , Bhattarai Prem , Shahzad Affan Mahmood , Pathinayake Prabuddha S. , Wark Peter A. B. , Eapen Mathew Suji , Sohal Sukhwinder Singh
Published: September 2023

Background

Although asthma and chronic obstructive pulmonary disease (COPD) are two distinct chronic airway inflammatory diseases, they often co-exist in a patient and the condition is referred to as asthma-COPD overlap (ACO). Lack of evidence regarding the inflammatory cells in ACO airways has led to their poor prognosis and treatment. The objective of this endobronchial biopsy (EBB) study was to enumerate inflammatory cellular changes in the airway wall of ACO compared with asthma, COPD current smokers (CS) and ex-smokers (ES), normal lung function smokers (NLFS), and non-smoker controls (HC).

Methods

EBB tissues from 74 patients were immunohistochemically stained for macrophages, mast cells, eosinophils, neutrophils, CD8+ T-cells and CD4+ T-cells. The microscopic images of stained tissues were evaluated in the epithelium, reticular basement membrane (RBM) cells/mm RBM length, and lamina propria (LP) cells/mm2 up to a depth of 120 µM using the image analysis software Image-Pro Plus 7.0. The observer was blinded to the images and disease diagnosis. Statistical analysis was performed using GraphPad Prism v9.

Results

The tissue macrophages in ACO were substantially higher in the epithelium and RBM than in HC (P < 0.001 for both), COPD-ES (P < 0.001 for both), and -CS (P < 0.05 and < 0.0001, respectively). The ACO LP macrophages were significantly higher in number than COPD-CS (P < 0.05). The mast cell numbers in ACO were lower than in NLFS (P < 0.05) in the epithelium, lower than COPD (P < 0.05) and NLFS (P < 0.001) in RBM; and lower than  HC (P < 0.05) in LP. We noted lower eosinophils in ACO LP than HC (P < 0.05) and the lowest neutrophils in both ACO and asthma. Furthermore, CD8+ T-cell numbers increased in the ACO RBM than HC (P < 0.05), COPD-ES (P < 0.05), and NLFS (P < 0.01); however, they were similar in number in epithelium and LP across groups. CD4+ T-cells remained lower in number across all regions and groups.

Conclusion

These results suggest that the ACO airway tissue inflammatory cellular profile differed from the contributing diseases of asthma and COPD with a predominance of macrophages.
Assessing the population’s correct knowledge of malaria in Malaysia: a vital component for malaria elimination certification
Authors: Abdul Rahim Faizul Akmal , Md Yatim Mohd Farihan , Abdul Mutalip Mohd Hatta , Mahmud Mohd Amierul Fikri
Published: September 2023

Background

Malaria remains a public health problem in Malaysia despite a decline in the number of cases in recent years. Public knowledge of malaria is essential to achieving and maintaining malaria elimination. Therefore, this survey assessed the prevalence of people who had ever heard of malaria, had correct knowledge of malaria transmission, symptoms, risk activities, and prevention measures in the Malaysian population, and identified the associated factors involved.

Methods

The data were obtained from the National Health and Morbidity Survey (NHMS) which was conducted from September to October 2020. A cross-sectional survey with five structured questionnaires using the method of computer-assisted telephone interviews (CATI) was used to collect data. The socio-demographic characteristics such as age, gender, ethnicity, nationality, marital status, educational level, and occupation were recorded. Data were analysed using STATA SE Version 16. Associations between variables were tested using chi-square and logistic regression, with the level of statistical significance set at p < 0.05.

Results

Out of 3085 respondents who participated in this survey, 2491 had ever heard of malaria with a prevalence of 76.1% (95% CI 70.5, 80.9). The prevalence of correct knowledge of malaria transmission was 53.9% (95% CI 50.2, 57.7), symptoms 24.1% (95% CI 21.2, 27.2), risk activities 34.0% (95% CI 29.3, 39.1) and prevention measures 59.7% (95% CI 55.5, 63.7). Multivariate analysis showed that age, ethnicity, and educational level were significantly associated with correct malaria transmission and risk activities. In addition, age and educational level were significantly associated with correct malaria symptoms. Subsequently, only the variable ethnicity showed a significant association with the correct malaria prevention measures.

Conclusion

In general, the prevalence of ever heard of malaria was considered high since the survey was performed based on a non-specific malaria population. However, the prevalence of correct knowledge of malaria symptoms and risk activities were considered low. It is concluded that educational level is one of the major factors associated with correct malaria knowledge, along with age and ethnicity. Therefore, based on these findings, targeted intervention and innovation should be planned by malaria programme managers to sustain malaria elimination in Malaysia.
Outcomes of patients aged ≥80 years with respiratory failure initially treated with non-invasive ventilation in European intensive care units before and during COVID-19 pandemic
Authors: Polok Kamil , Fronczek Jakub , Guidet Bertrand , Artigas Antonio , De Lange Dylan W. , Fjølner Jesper , Leaver Susannah , Beil Michael , Sviri Sigal , Bruno Raphael Romano , Wernly Bernhard , Pinto Bernardo Bollen , Schefold Joerg C. , Studzińska Dorota , Joannidis Michael , Oeyen Sandra , Marsh Brian , Andersen Finn H. , Moreno Rui , Cecconi Maurizio , Flaatten Hans , Jung Christian , Szczeklik Wojciech ,   COVIP & VIP2 study groups
Published: September 2023

Background

Non-invasive ventilation (NIV) has been commonly used to treat acute respiratory failure due to COVID-19. In this study we aimed to compare outcomes of older critically ill patients treated with NIV before and during the COVID-19 pandemic.

Methods

We analysed a merged cohort of older adults admitted to intensive care units (ICUs) due to respiratory failure. Patients were enrolled into one of two prospective observational studies: before COVID-19 (VIP2—2018 to 2019) and admitted due to COVID-19 (COVIP—March 2020 to January 2023). The outcomes included: 30-day mortality, intubation rate and NIV failure (death or intubation within 30 days).

Results

The final cohort included 1986 patients (1292 from VIP2, 694 from COVIP) with a median age of 83 years. NIV was used as a primary mode of respiratory support in 697 participants (35.1%). ICU admission due to COVID-19 was associated with an increased 30-day mortality (65.5% vs. 36.5%, HR 2.18, 95% CI 1.71 to 2.77), more frequent intubation (36.9% vs. 17.5%, OR 2.63, 95% CI 1.74 to 3.99) and NIV failure (76.2% vs. 45.3%, OR 4.21, 95% CI 2.84 to 6.34) compared to non-COVID causes of respiratory failure. Sensitivity analysis after exclusion of patients in whom life supporting treatment limitation was introduced during primary NIV confirmed higher 30-day mortality in patients with COVID-19 (52.5% vs. 23.4%, HR 2.64, 95% CI 1.83 to 3.80).

Conclusion

The outcomes of patients aged ≥80 years treated with NIV during COVID-19 pandemic were worse compared then those treated with NIV in the pre-pandemic era.
Acute-on-chronic liver failure alters linezolid pharmacokinetics in critically ill patients with continuous hemodialysis: an observational study
Authors: Tikiso Tjokosela , Fuhrmann Valentin , König Christina , Jarczak Dominik , Iwersen-Bergmann Stefanie , Kluge Stefan , Wicha Sebastian G. , Grensemann Jörn
Published: September 2023

Background

In acute-on-chronic liver failure (ACLF), adequate antibiotic dosing is challenging due to changes of drug distribution and elimination. We studied the pharmacokinetics of linezolid in critically ill patients with ACLF during continuous renal replacement therapy compared to patients without concomitant liver failure (NLF).

Methods

In this prospective cohort study, patients received linezolid 600 mg bid. Linezolid serum samples were analyzed by high-performance liquid chromatography. Population pharmacokinetic modelling was performed followed by Monte-Carlo simulations of 150 mg bid, 300 mg bid, 450 mg bid, 600 mg bid, and 900 mg bid to assess trough concentration target attainment of 2–7 mg/L.

Results

Eighteen patients were included in this study with nine suffering from ACLF. Linezolid body clearance was lower in the ACLF group with mean (standard deviation) 1.54 (0.52) L/h versus 6.26 (2.43) L/h for NLF, P < 0.001. A trough concentration of 2–7 mg/L was reached with the standard dose of 600 mg bid in the NLF group in 47%, with 42% being underexposed and 11% overexposed versus 20% in the ACLF group with 77% overexposed and 3% underexposed. The highest probability of target exposure was attained with 600 mg bid in the NLF group and 150 mg bid in the ACLF group with 53%.

Conclusion

Linezolid body clearance in ACLF was markedly lower than in NLF. Given the overall high variability, therapeutic drug monitoring (TDM) with dose adjustments seems required to optimize target attainment. Until TDM results are available, a dose reduction may be considered in ACLF patients to prevent overexposure.
Expanding citizen engagement in the secondary use of health data: an opportunity for national health data access bodies to realise the intentions of the European Health Data Space
Authors: Saelaert Marlies , Mathieu Louise , Van Hoof Wannes , Devleesschauwer Brecht
Published: September 2023

The European Health Data Space (EHDS) aims to make the primary use of health data for healthcare provision more continuous, effective, and (cost) efficient. Moreover, it pursues to facilitate the secondary use of health data for purposes such as research, innovation, and policy making. In the context of secondary use, the EHDS legislative proposal (published on 3 May 2022) argues that Member States should develop Health Data Access Bodies (HDABs) whose responsibilities include facilitating the secondary use of health data, issuing data permits, and implementing high levels of accountability and security. In Belgium, the setup in 2023 of a federal Health Data Agency (HDA) that is developing and implementing a policy strategy and framework for the secondary use of health data, aligns well with the responsibilities set out for HDABs. Even though the EHDS aspires the empowerment of citizens, for instance by giving them access to their health data and control over the healthcare professionals who can consult these data, this call for citizen empowerment resonates less loudly regarding secondary use. We think, however, that elaborating and implementing citizen engagement in the domain of secondary use is required to align secondary use with socio-ethical sensitivities, preferences, and values and to provide social legitimacy and ethical solidity to a health data governance system. When implementing the EHDS legislation on a national level, the Belgian HDA and the future HDABs in general might be excellent opportunities to realise this ambition of citizen involvement and empowerment. More specifically, we urge HDABs, firstly, to expand the field of citizen engagement towards the domain of secondary use and, secondly, to respect and facilitate the diversity of citizen engagement. This would offer citizens genuine, continuous and diversified possibilities of involvement and co-creation concerning the development of a solid ethical governance framework for health data.
Development and validation of a kidney renal clear cell carcinoma prognostic model relying on pyroptosis-related LncRNAs-A multidimensional comprehensive bioinformatics exploration
Authors: Liu Chang , Dai Shuxin , Geng Hao , Jiang Zhiwei , Teng Xiangyu , Liu Kun , Tuo Zhouting , Peng Longfei , Yang Chao , Bi Liangkuan
Published: September 2023

Background

Renal cell carcinoma (RCC) is a malignant tumour that may develop in the kidney. RCC is one of the most common kinds of tumours of this sort, and its most common pathological subtype is kidney renal clear cell carcinoma (KIRC). However, the aetiology and pathogenesis of RCC still need to be clarified. Exploring the internal mechanism of RCC contributes to diagnosing and treating this disease. Pyroptosis is a critical process related to cell death. Recent research has shown that pyroptosis is a critical factor in the initiation and progression of tumour formation. Thus far, researchers have progressively uncovered evidence of the regulatory influence that long noncoding RNAs (lncRNAs) have on pyroptosis.

Methods

In this work, a comprehensive bioinformatics approach was used to produce a predictive model according to pyroptosis-interrelated lncRNAs for the purpose of predicting the overall survival and molecular immune specialties of patients diagnosed with KIRC. This model was verified from multiple perspectives.

Results

First, we discovered pyroptosis-associated lncRNAs in KIRC patients using the TCGA database and a Sankey diagram. Then, we developed and validated a KIRC patient risk model based on pyroptosis-related lncRNAs. We demonstrated the grouping power of PLnRM through PCA and used PLnRM to assess the tumour immune microenvironment and response to immunotherapy. Immunological and molecular traits of diverse PLnRM subgroups were evaluated, as were clinical KIRC patient characteristics and predictive risk models. On this basis, a predictive nomogram was developed and analyzed, and novel PLnRM candidate compounds were identified. Finally, we investigated possible medications used by KIRC patients.

Conclusions

The results demonstrate that the model generated has significant value for KIRC in clinical practice.
The effect of relative deprivation on aggressive behavior of college students: a moderated mediation model of belief in a just world and moral disengagement
Authors: Wang Mengyao , Chen Ming , Chen Zhiyan
Published: September 2023

Background

Previous research found that college students have exhibited a group of concern, and aggressive behavior occurs from time to time in daily life. In order to investigate the effect of relative deprivation on aggressive behavior of college students, this study conducted a moderated mediation model to examine the relationship between relative deprivation, aggressive behavior, belief in a just world, and moral disengagement.

Methods

1169 college students(71.7% female; mean age = 19.41, SD = 1.3, range = 17-30years) participated in and completed measures of Relative Deprivation Questionnaire, Belief in a Just World Scale, Moral disengagement Scale and Aggression Questionnaire. The data were analyzed by using a moderated mediation model with SPSS and Process 3.1 macro.

Results

The results revealed that: (1) Relative deprivation significantly positively predicted college students’ aggressive behavior controlling for gender, grade, and age (B = 0.45, p＜0.001). (2) Belief in a just world played mediating role in relative deprivation and aggressive behavior(indirect effect = 0.04, 95%CI = [0.002,0.007], accounting for 9% of the total effect). (3) The moderated mediator model test showed that moral disengagement regulates the first half of the mediator effect path (B = 0.71, p < 0.01).

Conclusion

The present study analyzed the moral disengagement mechanisms deeply and shed light on how to decrease the aggressive behavior of college students.
Analysis of the association between osteoporosis and muscle strength in Korean adults: a national cross-sectional study
Authors: Choi Ji-Young , Yang Young-Mo
Published: September 2023

Background

This study aimed to examine the associations between osteoporosis and hand grip strength (HGS), a surrogate marker of muscular strength, among Korean adults stratified by body mass index (BMI), age, and renal function.

Methods

This study was conducted using the data obtained from the Korea National Health and Nutrition Examination Survey 2015–2019, a cross-sectional and nationally representative survey performed by the Korea Centers for Diseases Control and Prevention.

Results

Of the 26,855 subjects included in this study, those with low muscle strength (LMS) and normal muscle strength were showed in 4,135 (15.4%) and 22,720 (84.6%) subjects, respectively. The osteoporotic subjects had a higher prevalence rate for LMS than those without osteoporosis after adjusting for age [odds ratio (OR), 1.684; 95% confidence interval (CI), 1.500–1.890). The subjects with osteoporosis and BMI < 18.5 kg/m2 also had a higher prevalence rate for LMS after adjusting for age compared to those with non-osteoporosis and BMI < 18.5 kg/m2 (OR, 1.872; 95% CI, 1.043–3.359). Compared to the non-osteoporotic subjects with estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2, those with osteoporosis and eGFR ≥ 60 mL/min/1.73 m2 had a higher prevalence rate for LMS after controlling for age and sex (OR, 1.630; 95% CI, 1.427–1.862).

Conclusions

The results showed that osteoporosis was likely to contribute to an increased prevalence rate of LMS in terms of HGS. Aging, BMI, and renal function also had significant effects on the association between osteoporosis and LMS. This association is likely to assist in developing better strategies to estimate bone health in clinical or public health practice.
Hybrid modeling techniques for 3D printed deep inferior epigastric perforator flap models
Authors: Jacobson Nicholas M. , Carerra Erik , Treat Aaron , McDonnell Megan , Mathes David , Kaoutzanis Christodoulous
Published: September 2023

Background

Deep Inferior Epigastric Perforator Flap (DIEP) surgical procedures have benefited in recent years from the introduction of 3D printed models, yet new technologies are expanding design opportunities which promise to improve patient specific care. Numerous studies, utilizing 3D printed models for DIEP, have shown a reduction of surgical time and complications when used in addition to the review of standard CT imaging. A DIEP free flap procedure requires locating the inferior epigastric perforator vessels traversing and perforating the rectus abdominis muscle, perfusing the abdominal skin and fatty tissue. The goal of dissecting the inferior epigastric perforator vessels is complicated by the opacity of the fatty tissue and muscle. Previous attempts to 3D print patient specific models for DIEP free flap cases from CT imaging has shown a wide range of designs which only show variations of perforator arteries, fatty tissue, and the abdominis rectus muscle.

Methods

To remedy this limitation, we have leveraged a voxel-based modeling environment to composite complex modeling elements and incorporate a ruled grid upon the muscle providing effortless ‘booleaning’ and measured guidance.

Results

A limitation of digital surface-based modeling tools has led to existing models lacking the ability to composite critical anatomical features, such as differentiation of vessels through different tissues, coherently into one model, providing information more akin to the surgical challenge.

Conclusion

With new technology, highly detailed multi-material 3D printed models are allowing more of the information from medical imaging to be expressed in 3D printed models. This additional data, coupled with advanced digital modeling tools harnessing both voxel- and mesh-based modeling environments, is allowing for an expanded library of modeling techniques which create a wealth of concepts surgeons can use to assemble a presurgical planning model tailored to their setting, equipment, and needs.

Trial registration

COMIRB 21–3135, ClinicalTrials.gov ID: NCT05144620.
Specific pathway abundances in the neonatal calf faecal microbiome are associated with susceptibility to Cryptosporidium parvum infection: a metagenomic analysis
Authors: Hares M. F. , Griffiths B. E. , Johnson F. , Nelson C. , Haldenby S. , Stewart C. J. , Duncan J. S. , Oikonomou G. , Coombes J. L.
Published: September 2023

Background

Cryptosporidium parvum is the main cause of calf scour worldwide. With limited therapeutic options and research compared to other Apicomplexa, it is important to understand the parasites’ biology and interactions with the host and microbiome in order to develop novel strategies against this infection. The age-dependent nature of symptomatic cryptosporidiosis suggests a link to the undeveloped immune response, the immature intestinal epithelium, and its associated microbiota. This led us to hypothesise that specific features of the early life microbiome could predict calf susceptibility to C. parvum infection.

Results

In this study, a single faecal swab sample was collected from each calf within the first week of life in a cohort of 346 animals. All 346 calves were subsequently monitored for clinical signs of cryptosporidiosis, and calves that developed diarrhoea were tested for Rotavirus, Coronavirus, E. coli F5 (K99) and C. parvum by lateral flow test (LFT). A retrospective case–control approach was taken whereby a subset of healthy calves (Control group; n = 33) and calves that went on to develop clinical signs of infectious diarrhoea and test positive for C. parvum infection via LFT (Cryptosporidium-positive group; n = 32) were selected from this cohort, five of which were excluded due to low DNA quality. A metagenomic analysis was conducted on the faecal microbiomes of the control group (n = 30) and the Cryptosporidium-positive group (n = 30) prior to infection, to determine features predictive of cryptosporidiosis. Taxonomic analysis showed no significant differences in alpha diversity, beta diversity, and taxa relative abundance between controls and Cryptosporidium-positive groups. Analysis of functional potential showed pathways related to isoprenoid precursor, haem and purine biosynthesis were significantly higher in abundance in calves that later tested positive for C. parvum (q ≤ 0.25). These pathways are either absent or streamlined in the C. parvum parasites. Though the de novo production of isoprenoid precursors, haem and purines are absent, C. parvum has been shown to encode enzymes that catalyse the downstream reactions of these pathway metabolites, indicating that C. parvum may scavenge those products from an external source.

Conclusions

The host has previously been put forward as the source of essential metabolites, but our study suggests that C. parvum may also be able to harness specific metabolic pathways of the microbiota in order to survive and replicate. This finding is important as components of these microbial pathways could be exploited as potential therapeutic targets for the prevention or mitigation of cryptosporidiosis in bovine neonates.
Rectus femoris and vastus intermedius thickness measurement by ultrasound before and after anterior cruciate ligament reconstruction in athletes
Authors: Kandil Nour Mohamed , El Toukhy Marwan Mohamed , Al-Feeshawy Ahmed Saeed Hussein , Hashem Aya Mohamed Bassam
Published: September 2023

Background

Most anterior cruciate ligament (ACL) injuries which are common in violent sports require anterior cruciate ligament reconstruction (ACLR) to restore knee joint stabilization. Rectus femoris (RF) and vastus intermedius (VI) weakness are among the notable changes after ACLR. This weakness can be hazardous to the patient as it could decrease functional activity and thus increases the chances of re-injury. The objectives of the current study were to measure the (RF) thickness, (VI) thickness and the total (RF + VI) thickness on (ACL) reconstructed limb and the non-reconstructed limb of athletes using ultrasound and to compare the results pre-operatively and 6–8 months post-operative.

Results

The reconstructed limb showed a significant decrease in (RF), (VI) and the total thickness in the 1st, 2nd and 3rd measurements compared to that of non- reconstructed limb post-operatively. In both limbs, the decrease of (VI) thickness was significantly higher than (RF) thickness in the 1st, 2nd and 3rd measurements (p < 0.001, p < 0.001 and p < 0.001 respectively).

Conclusions

Ultrasound can be used to assess quadriceps atrophy (including the individual muscles) found after ACLR. Ultrasound is an affordable and easily available modality as compared to MRI and CT scans for the assessment of RF and VI muscle weakness in athletes with ACLR during the rehabilitation period and can guide selective rehabilitation protocols if wasting is identified early.
Μελέτη των κλινικών, μικροβιολογικών και μοριακών παραγόντων για την εμφάνιση εμμένουσας μικροβιαιμίας από πηκτάση-αρνητικούς σταφυλόκοκκους σε νεογνά
Authors: Μπέλλου Βενετία
Published: September 2023

Οι πηκτάση αρνητικοί σταφυλόκοκκοι (Coagulase-Νegative Staphylococci, CNS) είχαν παραδοσιακά θεωρηθεί βακτήρια με χαμηλή λοιμογόνο δύναμη. Η άποψη αυτή την τελευταία δεκαετία έχει αλλάξει, και οι CNS σχετίζονται με ενδονοσοκομειακές κυρίως λοιμώξεις σε ειδικές κατηγορίες ασθενών, όπως τα πρόωρα νεογνά, οι ανοσοκατεσταλμένοι, και οι ασθενείς που φέρουν προσθετικά υλικά. Οι CNS είναι το κυριότερο αίτιο εμφάνισης όψιμης νεογνικής σήψης στις Μονάδες Εντατικής Νοσηλείας Νεογνών (Μ.Ε.Ν.Ν.). Μελέτες έχουν καταλήξει στο συμπέρασμα πως βασικοί παράγοντες εμφάνισης σήψης από CNS στη Μ.Ε.Ν.Ν. είναι η παρουσία κεντρικών γραμμών, η ενδοτραχειακή διασωλήνωση, καθώς και η χορήγηση παρεντερικής διατροφής. Σκοπός: Εμμένουσες μικροβιαιμίες από CNS, που ορίζονται ως τρεις ή περισσότερες διαδοχικές θετικές καλλιέργειες αίματος με το ίδιο στέλεχος CNS, με διαφορά τουλάχιστον 48 ωρών μεταξύ των καλλιεργειών, έχουν αναφερθεί σε Μ.Ε.Ν.Ν. Σκοπός της παρούσας διατριβής ήταν η περιγραφή των κλινικών και μικροβιακών χαρακτηριστικών των περιπτώσεων αυτών στη Μ.Ε.Ν.Ν. του Π.Γ.Ν.Π. σε μια περίοδο δύο ετών και στη συνέχεια η σύγκριση των αποτελεσμάτων αυτών με παρόμοια μελέτη που είχε πραγματοποιηθεί στην ίδια Μ.Ε.Ν.Ν. με στόχο την αξιολόγηση πιθανών αλλαγών μέσα σε μια δεκαετία. Υλικά και μέθοδος: Δημογραφικά, κλινικά και μικροβιολογικά δεδομένα καταγράφηκαν για όλες τις περιπτώσεις μικροβιαιμίας από CNS στην τριτοβάθμια Μ.Ε.Ν.Ν. του Π.Γ.Ν.Π. κατά την περίοδο 2016-2017 και συγκρίθηκαν με τα αποτελέσματα ίδιας μελέτης που πραγματοποιήθηκε στην ίδια Μ.Ε.Ν.Ν. το 2006-2007. Αποτελέσματα: Καταγράφηκαν 56 περιπτώσεις νεογνικής σήψης από CNS. Δεκατέσσερις από τις περιπτώσεις αυτές εμφάνισαν εμμένουσα μικροβιαιμία (25%). Δεν υπήρχαν σημαντικές διαφορές στα δημογραφικά και κλινικά χαρακτηριστικά μεταξύ των περιπτώσεων με εμμένουσα και με μη εμμένουσα μικροβιαιμία. Ο S. epidermidis ήταν το πιο κοινό είδος. Στη λογαριθμική παλινδρόμηση, η παραγωγή βιομεμβράνης (β=2,464, p=0,04) ήταν ο πιο σημαντικός παράγοντας για την ανάπτυξη εμμένουσας μικροβιαιμίας από CNS. Τα στελέχη που προκάλεσαν εμμένουσα μικροβιαιμία το 2016-2017 ήταν λιγότερο πιθανό να παράγουν βιομεμβράνη, και να φέρουν οπερόνιο ica σε σύγκριση με εκείνα του 2006-2007.Συμπέρασμα: H επίπτωση της εμμένουσας μικροβιαιμίας από CNS μειώθηκε μέσα σε μια δεκαετία, γεγονός που θα μπορούσε να αποδοθεί στην εφαρμογή εντατικών πρακτικών ελέγχου των λοιμώξεων. Η παραγωγή βιομεμβράνης παραμένει ο πιο σημαντικός παράγοντας κινδύνου.
Preferences for services in a patient’s first six months on antiretroviral therapy for HIV in South Africa and Zambia (PREFER): research protocol for a prospective observational cohort study
Authors: Maskew Mhairi , Ntjikelane Vinolia , Juntunen Allison , Scott Nancy , Benade Mariet , Sande Linda , Hasweeka Pamfred , Haimbe Prudence , Lumano-Mulenga Priscilla , Shakewelele Hilda , Mukumbwa-Mwenechanya Mpande , Rosen Sydney
Published: September 2023

Background

For patients on HIV treatment in sub-Saharan Africa (SSA), the highest risk for loss from care consistently remains the first six months after antiretroviral (ART) initiation, when patients are not yet eligible for most existing differentiated service delivery (DSD) models. To reduce disengagement from care during this period, we must gain a comprehensive understanding of patients’ needs, concerns, resources, and preferences for service delivery during this period. The PREFER study will use a sequential mixed-methods approach to survey a sample of patients in South Africa and Zambia 0-6 months after ART initiation to develop a detailed profile of patient characteristics and needs.

Protocol

PREFER is an observational, prospective cohort study of adult patients on ART for ≤6 months at 12 public sector healthcare facilities in Zambia and 18 in South Africa that aims to inform the design of DSD models for the early HIV treatment period. It has four components: 1) survey of clients 0-6 months after ART initiation; 2) follow up through routinely collected medical records for <12 or <24 months after enrollment; 3) focus group discussions to explore specific issues raised in the survey; and 4) in South Africa only, collection of blood samples self-reported naïve participants to assess the prevalence of ARV metabolites indicating prior ART use. Results will include demographic and clinical characteristics of patients, self-reported HIV care histories, preferences for treatment delivery, and predictors of disengagement.

Conclusions

PREFER aims to understand why the early treatment period is so challenging and how service delivery can be amended to address the obstacles that lead to early disengagement from care and to distinguish the barriers encountered by naïve patients to those facing re-initiators. The information collected by PREFER will help respond to patients’ needs and design better strategies for service delivery and improve resource allocation going forward.
Gender, hierarchy and implicit bias: An interdisciplinary pilot simulation study
Authors: Ahmedli Nigar N. , Ngo Michelle , Yang Greenberg Catherina , Schiff Elliot , Chambers Terry-Ann , Patel Roshan , Vivek Kumar , Straker Tracey , Yang Christina J.
Published: September 2023

Background: Interdisciplinary collaboration and team dynamics play critical roles in patient safety, especially in the management of airway emergencies. However, these interactions can be influenced by implicit biases, which are often heightened in emergency scenarios in which Type 1 thinking predominates. This study aimed to understand the complex relationships of gender bias and hierarchy in a simulated airway emergency.

Methods: Using the validated modified Advocacy-Inquiry Score (mAIS), we designed a simulation focused on the interaction between otolaryngology residents and anesthesiology attendings when deviation from the emergency airway management algorithm was introduced. A total of 15 otolaryngology residents were recruited. mAIS values were compared between female and male residents (self-identified gender) and by PGY-level.

Results: The mean mAIS in female versus male participants was 4.11 (SD 0.44) versus 4.41 (SD 0.51) (p=0.12), respectively. There were no statistically significant differences in mean scores based on either gender or PGY-level. Twelve participants demonstrated male association with career and female association with family on the Implicit Association Test while three were neutral. Results from our debriefing sessions indicated that females were challenged more and spoke up less than their male counterparts, even when they were clinically more experienced.

Conclusions: This pilot study prompted conversation within our institution’s departments of otolaryngology and anesthesia about training and empowering residents to employ cognitive and interpersonal skills to challenge a superior when appropriate. Our simulation design fosters recognition and discussion of implicit biases related to gender and hierarchy and is adaptable to numerous other specialties and fields in healthcare.
Leksykograficzny obraz pojęcia „cenzura” w słownikach oraz encyklopediach powszechnych wydanych w Polskiej Rzeczypospolitej Ludowej oraz Związku Socjalistycznych Republik Radzieckich
Authors: Dzienisiewicz Daniel , Nowak Piotr
Published: September 2023

Dotychczas wiele uwagi poświęcono zagadnieniu języka oficjalnej propagandy epoki socjalizmu, brak jednak publikacji o charakterze lingwistycznym dotyczących zakresu semantycznego pojęcia „cenzura” w kontekście ustroju socjalistycznego. W celu wypełnienia tej luki przeanalizowano definicje wyrazu „cenzura” zaczerpnięte z wybranych słowników oraz encyklopedii o treści ogólnej wydanych w Związku Socjalistycznych Republik Radzieckich (od roku 1940 do 1991) oraz Polskiej Rzeczypospolitej Ludowej (w latach 1959–1988). Badanie ma na celu rekonstrukcję i porównanie obrazów cenzury utrwalonych w definicjach leksykograficznych oraz ustalenie, czy obraz tego pojęcia uległ zmianie pod wpływem poszerzania ram wolności słowa w obu państwach. W toku badania wykazano, że w definicjach hasła „cenzura” widoczny jest znaczący wpływ oficjalnej ideologii na język w postaci wyraźnego zunifikowania definicji cenzury w obu państwach.
Analiza użyteczności i funkcjonalności aplikacji mobilnej e-podróżnik.pl w świetle badań własnych
Authors: Pietrusiak Oliwia
Published: September 2023

Artykuł jest poświęcony aplikacji mobilnej e-podróżnik.pl i ma na celu analizę jej użyteczności i funkcjonalności. W opracowaniu dokonano charakterystyki tej aplikacji, przedstawiono jej działania oraz zdefiniowano jej użyteczność i funkcjonalność. Opisano całą metodologię badania, w tym cel i zakres badania, problemy badawcze oraz organizację i przebieg badania, a także narzędzie badawcze – kwestionariusz badania. Opisano, zanalizowano oraz zinterpretowano wyniki. Opracowano wnioski, które mogą poprawić użyteczność i funkcjonalność aplikacji oraz polepszyć wrażenia użytkownika związane z korzystaniem z niej, takie jak dłuższe wyświetlanie niektórych komunikatów i informacji oraz zmiana umiejscowienia pewnych elementów.
Challenges of Distillery Effluent Treatment and its Bioremediation Using Microorganism: A Review.
Authors: Patel Ajad , Gaur Rajeeva , Verma Tuhina , Singh Ranjan
Published: September 2023

Waste management is a global issue with which the entire globe is currently grappling. The composition and characteristics of the pollutants in effluents are unknown, which poses the greatest worry. The Industrial Revolution has captured the attention of environmentalists worldwide. Their concern regarding the lethal effects of untreated industrial effluent wastewater is growing daily. Dealing with a range of hazardous compounds is costly and complicated, which hinders wastewater treatment. Recent years have paved the way for microorganisms to act as a low-cost source for detoxifying such a complex effluent mixture. Their simple availability and moderate cost make them the preferred technique. Bioremediation is the method of utilising the high and diversified metabolic activity of microorganisms to breakdown contaminants in industrial wastewater, particularly distillery effluent. Their readily available nature and affordable price make them the preferred option. Bioremediation is the process of using bacteria and other organisms with strong metabolic activity to breakdown contaminants in industrial effluents, particularly distillery effluents. Microorganisms like Bacteria fungi etc.,alone or in conjunction with other organisms, create an environment conducive to not only the breakdown of toxicants but also the production of some useful byproducts. This review focuses on distillery effluents, particularly melanoidins, and the reported microorganisms utilised for decolorization. The study combines a vast array of microorganisms that are utilised alone or in conjunction with other organisms in the decolorization process.
Seasonal Reptilian Diversity at Gautala Reserve Forest, Aurangabad (Maharashtra), India.
Authors: Mirza Amrin Naimoddin , Patil Satish S.
Published: September 2023

Reptiles are playing a vital role in ecology. These reptiles show a diverse range of habitat adaptations. They are dispersed in extreme desert conditions as well as in low-temperature areas and they are broadly dispersed across the world. The occurrence of reptiles is a sign of rich biodiversity and ecology. To assess the distribution of the reptile species in a given area, a reptilian species survey was carried out in the Gautala Reserve Forest, where 15 different spots were selected during the rainy, winter, and summer seasons. A checklist was created for the period of 2017-2018. During the investigation, a total of 28 species of reptiles from 6 families were found. The transect method was used to sample direct and indirect evidence of reptilian species. This paper discusses seasonal variations in reptilian diversity and statistical analysis methods. The Boidae family has fewer species than various other families, compared to the huge number of species of the Colubridae family reported in the current study. According to the IUCN, Three species of reptiles, the Common Sand Boa (Gongylophis Conicus), India Rock Python (Python molurus molurus), and John's Sand Boa (Eryx johnii), are Near Threatened (NT- Decreasing), and one species of reptile, the Gunther's Racer (Coluber gracilis), is Data Deficient (DD-Unknown). The remaining 24 species of reptiles are considered Least Concerned. Baseline information on the resilience of these reptile species was collected for the current investigation. These details will be useful for future planning on the preservation of reptile diversity.
Getting to Grips with RF Design
Authors: Patrick Mark
Published: September 2023

An introductory guide to RF design and terminology.
Fruit Picking Robot Arm Training Solution Based on Reinforcement Learning in Digital Twin
Authors: Tian Xinyuan , Pan Bingqin , Bai Liping , Wang Guangbin , Mo Deyun
Published: September 2023

In the era of Industry 4.0, digital agriculture is developing very rapidly and has achieved considerable results. Nowadays, digital agriculture-based research is more focused on the use of robotic fruit picking technology, and the main research direction of such topics is algorithms for computer vision. However, when computer vision algorithms successfully locate the target object, it is still necessary to use robotic arm movement to reach the object at the physical level, but such path planning has received minimal attention. Based on this research deficiency, we propose to use Unity software as a digital twin platform to plan the robotic arm path and use ML-Agent plug-in as a reinforcement learning means to train the robotic arm path, to improve the accuracy of the robotic arm to reach the fruit, and happily the effect of this method is much improved than the traditional method.
ENTREVISTA
Authors: Raimunda Bedasee
Published: September 2023

Alix Renaud é presidente da Associação Haitiana em Québec. Além de especialista em linguística, é tradutor, crítico literário e declamador de poemas. Poeta, dramaturgo, romancista. Com 45 anos, parece um menino bem-comportado & estudioso. Esta entrevista trata principalmente do seu romance A Corps joie, editado em Québec pela Nouvelle Optique.
AS FAMÍLIAS MULLIDAE, PEMPHERIDIDAE, EPHIPPIDIDAE, CHAETODONTIDAE, POMACANTHIDAE, SPHYRAENIDAE E POLYNEMIDAE ( PIS- CES, PERCIFORMES) NA COLEÇÃO DO LABORATÓRIO DE ICTIOLOGIA DA UNIVERSIDADE FEDERAL DO RIO DE JANEIRO
Authors: Duarte Lopes Paulo Roberto
Published: September 2023

É apresentado o material pertencente às famílias Muliidae, Pempherididae, Ephippididae, Chaetodontidae, Pomacanthidae, Sphyraenidae e Polynemidae (totalizando 13 espécies e 51 exemplares) que se encontra depositado no Laboratório de Ictiologia (Departamento de Zoologia) da Universidade Federal do Rio de Janeiro. A maioria dos exemplares aqui apresentados provém do litoral do Estado do Rio de Janeiro (região sudeste do Brasil), em especial da Baía de Guanabara. Alguns indivíduos Foram coletados nos litorais dos Estados da Bahia (região nordeste do Brasil) e do Espírito Santo (litoral sudeste do Brasil). Para cada espécie considerada são citados o nome vulgar (no litoral sudeste do Brasil), a distribuição geográfica (no Oceano Atlântico ocidental) e os dados relativos ao material estudado (procedência, total de exemplares depositados e respectivo número de registro na coleção). Nenhuma ampliação dos limites de distribuição geográfica foi assinalada Para as espécies aqui consideradas.
A ORIGEM DOS SERES VIVOS, À LUZ DA EVOLUÇÃO DO PENSAMENTO HUMANO
Authors: Bastos de Menezes Orlando
Published: September 2023

O Autor pretende bosquejar a evolução do pensamento humano a respeito da origem dos seres vivos, a partir dos primórdios da invocada Civilização, até o alvorecer da Ciência Moderna. Nesta Parte 1, são reproduzidas as palavras da Bíblia sobre o tema, bem como as apreciações que fizeram os renomados sábios gregos instituidores da cognominada “Filosofia da Natureza”, chegando-se até Aristóteles, com excertos de sua teoria da “Geração Espontânea”.
AMOR E HUMOR NA POESIA DE BENJAMIN PÉRET
Authors: Lourenço de Abreu Maria Leonor
Published: September 2023

Neste trabalho focalizam-se os aspectos mais significativos referentes ao amor e ão humor na poesia surrealista de Benjamin Péret. Amor sublime e humor negro são considerados como o silex norteador da aventura poética proposta pelo surrealismo, cuja finalidade consistia na busca da expressão humana sob todas as Formas.