bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of Acute Malnutrition Treatment at Health Center and Community Level with a Simplified, Combined Protocol in Mali: An Observational Cohort Study
Authors: Kangas Suvi T. , Marron Bethany , Tausanovitch Zachary , Radin Elizabeth , Andrianarisoa Josiane , Dembele Salimou , Coulibaly Issa Niamanto , Ouedraogo Cesaire , Biotteau Marie , Ouologuem Bareye , Daou Soumaila , Traore Fatoumata , Traore Issiaka , Nene Marc , Bailey Jeanette
Published: September 2022

The simplified, combined protocol admits children with a mid-upper-arm circumference (MUAC) of <125 mm or edema to malnutrition treatment with ready-to-use therapeutic food (RUTF) prescribing 2 daily RUTF sachets to children with MUAC <115 mm or edema and 1 daily sachet to those with MUAC ≥115 mm but <125 mm. This treatment has previously been shown to result in non-inferior programmatic outcomes compared to standard treatment. We aimed at observing its effectiveness in a routine setting at scale, including via delivery by community health workers (CHW). A total of 27 601 children were admitted to the simplified, combined treatment. Treatment resulted in 96% overall recovery with a mean LOS of 40 days and a mean RUTF consumption of 63 sachets per child treated. Among children admitted with MUAC <115 mm or edema 94% recovered with a mean LOS of 55 days and consuming an average of 97 RUTF sachets. Recovery in all sub-groups studied exceeded 90%.Treatment by CHWs resulted in similar (96%) recovery as treatment by formal health care workers (96%). The simplified, combined protocol results in high recovery and low RUTF consumption per child treated, and can safely be adopted by CHWs to provide treatment in the community-level.
PDF Malware Detection Based on Optimizable Decision Trees
Authors: Abu Al-Haija Qasem , Odeh Ammar , Qattous Hazem
Published: September 2022

Portable Document Format (PDF) files are one of the most universally used file types. This has fascinated hackers to develop methods to use these normally innocent PDF files to create security threats via infection vectors PDF files. This is usually realized by hiding embedded malicious code in the victims’ PDF documents to infect their machines. This, of course, results in PDF Malware and requires techniques to identify benign files from malicious files. Research studies indicated that machine-learning methods provide efficient detection techniques against such malware. In this paper, we present a new detection system that can analyze PDF documents in order to identify benign PFD files from malware PFD files. The proposed system makes use of the AdaBoost decision tree with optimal hyperparameters, which is trained and evaluated on a modern-inclusive dataset, viz. Evasive-PDFMal2022. The investigational assessment demonstrates a lightweight-accurate PDF detection system, achieving a 98.84% prediction accuracy with a short prediction interval of 2.174 μSec. To this end, the proposed model outperforms other state-of-the-art models in the same study area. Hence, the proposed system can be effectively utilized to uncover PDF malware at high detection performance and low detection overhead.
Safety of handling of medical devices at all stages of their life cycle
Authors: Zinovyeva E. V. , Sapunova A. V. , Ivanov I. V.
Published: September 2022

The review describes the main points of the life cycle of a medical device, considers three stages of regulation of medical devices: pre-market, market and post-sale. The main attention is paid to post-sale supervision, as an activity for monitoring used medical devices, collecting information about the quality, safety and effectiveness of medical devices.
Development of a quality and safety management system for medical activities in the Primorsky Region
Authors: Khudchenko A. G. , Brodskaya T. A. , Goncharov K. V.
Published: September 2022

The article presents the experience of organizing a system for managing the quality and safety of medical activities in the Primorsky Region, its development in accordance with current trends in the national policy of protecting the health of citizens in the Russian Federation. In accordance with the regional healthcare development strategy, a pilot project has been implemented since 2018, which includes a number of reasonable interrelated activities. A regional Competence Center in the field of quality and safety of medical activity was organized, closely interacting with the National Institute of Quality, mechanisms for financing the quality management system were developed. As part of the implementation of the regional project, a system for recording undesirable events in the Primorsky Region was developed and implemented. A regional model of the system for managing the quality and safety of medical activities has been adopted, and the principles of organizing the healthcare system in Primorsky Region have been described. The successes and difficulties of the project implementation are analyzed, the prospects for the development of a quality and safety management system for medical activities in the Primorsky Region are presented, taking into account the specifics of the geopolitical situation and demographic trends in the region.
¿Es incorrecta la prevalencia de síntomas depresivos presentada en el informe de la Ensanut 2018-19?
Authors: Valencia Pablo D
Published: September 2022

No disponible
Aproximación a la distribución de los costos directos de la diabetes tipo 2 en Colombia
Authors: Echeverri Eduar D , Ruiz-Morales Alvaro J , Rondon Martin , Rosselli Diego
Published: September 2022

No disponible
Predicting the Solubility of Mercury in Hydrocarbons
Authors: Bryndzia L. Taras , Burgess Jamie M. , Bourdet Julien
Published: September 2022

Elemental mercury (Hg0) is a common trace contaminant associated with corrosion of infrastructure impacting exploration, production, and processing of commercial hydrocarbons. Presently lacking is a model for the quantitative prediction of Hg concentration in reservoir fluids, sufficiently reliable for process engineering applications and design of mitigation strategies to ameliorate the potential risk of Hg presence.

In this paper, we present a thermodynamic equilibrium mineral-based model for predicting the solubility of mercury in hydrocarbons, Hg0(org), at in-situ reservoir conditions. The model is based on literature experimental data on the solubility of Hg0 in a mixture of alkanes, in equilibrium with Hg0, H2S, O2, cinnabar (HgS), and water. As the model inputs are based on the chlorite-pyrite-H2S model, its application should primarily be limited to clastic hydrocarbon-bearing reservoirs. A global data set of Hg in hydrocarbons reveals a remarkably strong association with the presence of humic coal in subsurface formations.

Assuming that pure stoichiometric cinnabar (HgS) is stable at the reducing conditions typical of hydrocarbon reservoirs (i.e., aHgS = 1) results in an overestimation of Hg0(org) solubility by up to three orders of magnitude relative to globally reported concentrations of mercury in natural hydrocarbons. A statistically robust match between model and observed concentrations of Hg0(org) was achieved using an aHgS of 0.003, consistent with reported concentrations of Hg0 from pyrite (FeS2) in coals and hydrocarbon reservoirs. The model has been validated in a case study of reservoir Hg reported in the Gorgon North-1 well, North West Shelf (NWS), Australia.

The dominant process of cinnabar precipitation is by oxidation, particularly in the near-surface environment where reduced Hg0-bearing hydrocarbons mix with shallow oxygenated or acidic surface waters. Such processes are typical of the environments where most downhole fluid samples are collected during drilling, sampling, and cleanup of exploration and development wells. This leads to the invariable conclusion that much of the particulate mercury species, specifically HgS, collected with hydrocarbon fluid samples, are metastable with respect to the dissolved Hg0(org) in hydrocarbons at reservoir conditions and should not be included in the estimation of total Hg (i.e., THg) in hydrocarbons.

This hypothesis has been confirmed by an extended well test in the Minami-Nagaoka gas condensate field, where it was observed that Hg dissolved in produced water decreased to negligible levels over time, while the Hg0(org) in the condensate liquid reached a stable value like what the new Hg0(org) solubility model would predict for in-situ reservoir conditions.
Artificial Neural Network Model to Predict Production Rate of Electrical Submersible Pump Wells
Authors: Sabaa Ahmed , Abu El Ela Mahmoud , El-Banbi Ahmed H. , Sayyouh Mohamed H. M.
Published: September 2022

Production data are essential for designing and operating electrical submersible pump (ESP) systems. This study aims to develop artificial neural network (ANN) models to predict flow rates of ESP artificially lifted wells. The ANN models were developed using 31,652 data points randomly split into 80% (25,744 data points) for training and 20% (5,625 data points) for testing. Each data set included measurements for wellhead parameters, fluid properties, ESP downhole sensor measurements, and variable speed drive (VSD) sensors parameters. The models consisted of four separate neural networks to predict oil, water, gas, and liquid flow rates. Sensitivity analyses were performed to determine the optimum number of input parameters that can be used in the model. The best performance was achieved with ANN models of 16 input parameters that are readily available in ESP wells.

The results of the best ANN configuration indicate that the mean absolute percent error (MAPE) between the predicted flow rates and the actual measurements for the testing data points of the oil, water, gas, and liquid networks is 3.7, 5.2, 6.4, and 4.1%, respectively. In addition, the correlation coefficients (R2) are 0.991, 0.992, 0.983, and 0.979 for the estimated oil, water, gas, and liquid flow rates for the testing data points, respectively. The performance of the ANN models was compared against performance of published physics-based models and the results were comparable. Unlike the physics-based methods, the ANN models have the advantage that they do not require periodic calibration. The ANN models were used to predict the flow rate curves of an oilwell in the Western Desert of Egypt. The results were compared to the actual separator test data. It was clear that the model results matched the actual test data.

The ANN model is useful for predicting individual well production rates within wide variety of pumping conditions and completion configurations. This should allow for continuous monitoring, optimization, and performance analysis of ESP wells as well as quicker response to operational issues. In comparison to traditional separators and multiphase flowmeters (MPFMs), the use of the developed ANN models is simple, quick, and inexpensive.
Effects of dietary supplementation with prebiotics and Pediococcus acidilactici on gut health, transcriptome, microbiome, and metabolome in Atlantic salmon (Salmo salar L) after seawater transfer
Authors: Dhanasiri Anusha K. S. , Jaramillo-Torres Alexander , Chikwati Elvis M. , Forberg Torunn , Krogdahl Åshild , Kortner Trond M.
Published: September 2022

Background
Given the importance of gut microbiota for health, growth and performance of the host, the aquaculture industry has taken measures to develop functional fish feeds aiming at modulating gut microbiota and inducing the anticipated beneficial effects. However, present understanding of the impact of such functional feeds on the fish is limited. The study reported herein was conducted to gain knowledge on performance and gut health characteristics in post-smolt Atlantic salmon fed diets varying in content of functional ingredients. Three experimental diets, a diet containing fructo-oligosaccharides (FOS), a diet with a combination of FOS and Pediococcus acidilactici (BC) and a diet containing galacto-oligosaccharides (GOS) and BC, were used in a 10-weeks feeding trial. A commercial diet without functional ingredients was also included as a control/reference. Samples of blood plasma, mucosa and digesta were subjected to microbiome, transcriptome and metabolome profiling for evaluation of the diet effects.
Results
No significant growth differences were observed between fish fed the supplemented diets, but FOS-BC fed fish showed significantly faster growth than the control fed fish. The microbiome results showed that the BC was present in both the digesta, and the mucosa samples of fish fed the FOS-BC and GOS-BC diets. Digesta-associated microbiota was altered, while mucosa-associated microbiota was relatively unaffected by diet. Replacing FOS with GOS increased the level of metabolites linked to phospholipid, fatty acid, carnitine and sphingolipid metabolism. Variation in metabolite levels between the treatments closely correlated with genera mainly belonging to Firmicutes and Actinobacteria phyla. The transcriptome analyses indicated diet effects of exchanging FOS with GOS on immune functions, oxidative defense and stress responses. No significant diet effect was observed on intestinal inflammation in the pyloric ceca or in the distal intestine, and no steatosis was observed in the pyloric ceaca.
Conclusions
Dietary supplementation with BC induced moderate effects on the microbiota of the digesta, while the effects of replacing FOS with GOS were more marked and was observed also for nutrient metabolism. Our data indicates therefore that the quality of a prebiotic may be of great importance for the effects of a probiotic on gut microbiota, function, and health.
Are nutrients or salinity the drivers of macroinvertebrate community composition in wetlands of the desert Southwest?
Authors: Piña Anna Elisa , Lougheed Vanessa
Published: September 2022

The relatively rare freshwater ecosystems in the arid southwestern United States serve as biodiversity hotspots, yet they remain among the most threatened systems in the world due to human impacts and climate change. Globally, arid region wetlands remain understudied with respect to their ecology, making assessments of quality or restoration efforts challenging. To address these needs, this project aims to better understand the factors that drive water quality and macroinvertebrate community composition of wetlands of the US desert Southwest. Water quality and macroinvertebrate data were collected over three years from 14 different wetland and riparian sites spanning across West Texas, New Mexico and Arizona. Principal Component Analysis (PCA) indicated that salinity related variables such as chloride, sulfate and conductivity were the greatest drivers of environmental variance (32%) among sampled desert wetlands. Nutrients such as nitrate and phosphate described a second axis, with 22% of variation in environmental data explained, where we found a clear distinction between wastewater and non-wastewater wetlands. Nutrients were shown to have the greatest impact on macroinvertebrate communities with wetlands receiving wastewater showing more uneven distribution of functional feeding groups and lower Simpson Index scores. These sites were dominated by filter feeders and had lower relative abundances of predator and collector-gatherer taxa. There was also a significant decrease in metrics related to diversity and environmental sensitivity such as % Ephemeroptera-Odonata-Tricoptera (EOT) within high nutrient sites. Increased salinity levels were also shown to correlate with lower Simpson Index scores indicating that increased salinity resulted in a decline in macroinvertebrate diversity and evenness. To enhance the water quality and diversity in their sites, we suggest that managers of these valuable created habitats that are fed with wastewater might try to find less nutrient-rich water sources, or dilute effluent with another water source such as groundwater. Overall, the nutrients within effluent water have shown to significantly alter community composition especially in desert wetlands where macroinvertebrates may be more adapted to salinity. Though macroinvertebrate communities in wastewater sites may not fully resemble those of natural wetlands over time, creation of these sites can still benefit landscape level diversity.
A post-market Cluster Randomized Controlled trial of the effect of the TENA SmartCare Change IndicatorTM on urinary continence care efficiency and skin health in older nursing home residents
Authors: Omotunde Muyibat , Agholme Fredrik , Böhling Arne , Huige Nicole , Schweigel Hardy , Hayder-Beichel Daniela , Reidy Robert , Wagg Adrian
Published: September 2022

Background

Urinary continence care for residents of nursing homes who are unable to communicate their toileting needs usually involves care aides manually checking continence products (pads) to determine the level of urine saturation prior to changing. The TENA SmartCare Change Indicator is a medical device which estimates urine saturation and notifies caregivers of the optimal time for pad changes. This study will seek to examine the effect of the TENA SmartCare Change Indicator on urinary continence care efficiency and skin health, in comparison to usual care.

Methods

This cluster randomized controlled trial (NCT05247047) involving older nursing home residents with urinary incontinence unable to consistently indicate their toileting needs, and their care aides, will compare technology-based and usual continence care over a period of eight weeks. Co primary endpoints of superiority in continence care efficiency and non-inferiority in maintenance of skin health will be assessed. Secondary outcomes will examine resident quality of life, sleep quality, responsive behaviors, changes in pad use and leakage episodes outside the pad. Change in care aide work engagement, job satisfaction and rushed tasks will be assessed. Benefits and challenges with the use of the device for continence care will be identified from the perspectives of the care staff.

Discussion

Urinary continence assessment and care in nursing homes is reported as suboptimal and threatening to dignity. Data on the utility and effect of technological solutions for improving urinary continence care are few and conflicting. If shown effective, this technological solution has the potential to improve the care for older residents and improve the working lives of caregiving staff who look after this most vulnerable section of the population.
Trial Registration: (NCT05247047)
Climatology and significant trends in maximum, minimum and average air temperatures in Alagoas, Northeast Brazil
Authors: Silva Josiel dos Santos , Júnior Jório Bezerra Cabral , Rodrigues Daniele Torres
Published: September 2022

The increase in air temperature can generate several environmental and socioeconomic impacts, so the main objective of this study was to characterize the monthly and annual profiles of maximum, minimum and average air temperatures and to identify whether there are significant trends in the time series of each, for the state of Alagoas, Brazil. For this, monthly data on maximum and minimum air temperatures (1980 to 2013) were used for 98 of the 102 municipalities in Alagoas. With the data in hand, the average air temperature was calculated and cluster analysis was applied to determine homogeneous sub-regions of the average air temperature. Trend analyzes were verified using nonparametric Mann-Kendall (sign of trend), Sen (magnitude of trend) and Pettitt (beginning of trend) tests. Analysis of variance (ANOVA) was used to verify differences between the decennial averages air temperatures. The statistical significance adopted was 5%. The results showed that the state of Alagoas has four sub-regions with homogeneous characteristics according to average air temperature. Sub-region 4 (S4), located in the Sertão (scrubland region) of Alagoas, had the highest average, maximum and minimum air temperatures, monthly and annually. Annually, significantly increasing trends were observed at 5% in the four sub-regions, with emphasis on S4, with increases above 1.0°C/décade in average, maximum and minimum temperatures. It is noteworthy that throughout the state of Alagoas, a significant trend of increase in the average air temperature was identified during the 34 years analyzed, highlighting the possible impacts of climate change.
Barriers and Facilitators of Managing Opioid Use Disorder in Primary Care and the Potential of Using a Software-based Measurement-Based Care Program: A Qualitative Study
Authors: Cruz Adriane M. dela , Karns-Wright Tara , Kahalnik Farra , Walker Robrina , Lanham Holly J. , Potter Jennifer Sharpe , Trivedi Madhukar H.
Published: September 2022

Background: Opioid use disorder (OUD) is a deadly disease that remains undertreated, despite effective pharmacological treatments. Barriers, such as stigma and affordability, and a lack of training and prescribing within medical practices result in low access to treatment. Software-delivered measurement-based care (MBC) is one way to increase treatment access. MBC uses systematic participant symptom assessments to inform an algorithm to provide support for physicians at critical decision points. Method: A qualitative study using focus groups of faculty clinicians (N = 33) from 3 clinics were conducted to understand perceptions of OUD diagnosis and treatment and whether a computerized MBC model might assist with diagnosis and treatment. Themes from the transcribed focus groups were identified in two phases: 1) content analysis focused on uncovering general themes; and 2) systematic coding and interpretation of the data. Results: Analysis revealed six major themes utilized to develop the coding terms: “perceptions of opioid use,” “current practices with patients using prescribed or illicit opioids or other drugs,” “attitudes and feelings about providing screening or treatment for OUD in your practice,” “perceived resources needed for treating OUD,” “primary care physician role in patient care not specific to OUD,” and “reactions to implementation of proposed clinical decision support tool.” Conclusion: Results revealed systemic and attitudinal barriers for screening, diagnosing, and treating OUD that could be alleviated with the implementation of a software-based MBC program. Providers tended to view the software-based MBC program favorably, indicating that it may be a solution to increasing accessibility to OUD treatment.
Development of laparoscopic skills in skills-naïve trainees using self-directed learning with take-home laparoscopic trainer boxes
Authors: Crihfield Eric , Uppalapati Pooja , Abittan Baruch , Laibangyang Anya , Brahmbhatt Sonam , Burlingame Madeleine , Goldberg Gary , Rabin Jill
Published: September 2022

Background
Simulation training is an essential part of laparoscopic skills development, but financial and time barriers limit their use. Take home laparoscopic trainer boxes with self-directed learning offer a potential solution. We evaluated the utility of this strategy in the development of laparoscopic skills in medical students and surgically naive postgraduate year 1 (PGY1) obstetrics and gynecology (OB/Gyn) residents.
Methods
74 medical students and beginning PGY1 OB/Gyn residents performed a laparoscopic peg transfer task. This was done with only task instructions and no additional training. Initial tasks were recorded and scored by task completion time with dropped peg time penalties. The participants took home a laparoscopic trainer box for 3 weeks to practice without guidance and returned to perform the same task for a second/final score. Initial and final scores were compared for improvement. This improvement was compared to practice and variables such as demographics, surgical interest, comfort with laparoscopy, and past experiences.
Results
Mean peg transfer task scores improved from 287 seconds to 193 seconds (p < 0.001). Score improvement showed a positive correlation with number of home practice sessions with a linear regression R2 of 0.134 (p = 0.001). More practice resulted in larger increases in comfort levels, and higher comfort levels correlated with better final task scores with a linear regression R2 of 0.152 (p < 0.001). Medical students interested in surgery had less practice sessions (p = 0.496), however interest in a surgical specialty had no impact on final scores or improvement. Playing a musical instrument and having two or more dexterity-based hobbies was associated with a better baseline score (p = 0.032 and p = 0.033 respectively), but no difference in the final scores or score improvement. No other past experiences impacted scores.
Conclusions
Our study demonstrates that the use of home laparoscopic box trainers can develop laparoscopic skills in surgical novices even without formal guidance or curriculum.
Myeloid mechano-metabolic programming restricts anti-tumor immunity
Authors: Tharp Kevin , Kersten Kelly , Maller Ori , Timblin Greg , Stashko Connor , Hayward Mary-Kate , Berestjuk Ilona , Hoeve-Scott Johanna ten , Samad Bushra , Combes Alexis , Weaver Valerie , Krummel Matthew
Published: September 2022

Tumor progression is accompanied by fibrosis, which is associated with diminished anti-tumor immune infiltrate. Here, we demonstrate that tumor infiltrating myeloid cells respond to the stiffened fibrotic tumor microenvironment (TME) by initiating a TGF-beta (TGFβ)-directed, collagen biosynthesis program. A collateral effect of this programming is an untenable metabolic milieu for productive CD8 T cell anti-tumor responses, as collagen-synthesizing macrophages consume environmental arginine, synthesize proline, and secrete ornithine that compromises CD8+ T cell function. Thus, a stiff and fibrotic TME may impede anti-tumor immunity not only by direct physical exclusion of CD8+ T cells, but also via secondary effects of a myeloid mechano-metabolic programming we identified that creates an inhospitable metabolic milieu for CD8+ T cells.
P- element Induced Wimpy Testis (PIWI), a Potential Candidate Marker for Hepatocellular Carcinoma
Authors: Hammad Gehan , Mamdouh Samah , Seoudi Dina Mohamed , Seleem Mohamed Ismail , Safwat Gehan , Mohamed Rania Hassan
Published: September 2022

P-Element-induced wimpy testis (PIWI) proteins are engaged in epigenetic regulation of gene expression in germline cells when they are in combination with PIWI-interacting RNA (piRNA). Different types of tumour cells have been found to exhibit abnormal expression of piRNA and PIWI proteins. HCC is majorly associated with lower survival rates. Thus, there is an urgent need for improve less invasive diagnostic methods. Purpose: The aim of this study was to assess the diagnostic potential by determining the expression profiles of PIWI-like protein-1, -2, -3, & -4 (PIWIL1, PIWIL2, PIWIL3, & PIWIL4) in hepatocellular carcinoma, and determine its association with clinicopathological features. Methods: Samples from patients comprising serum and frozen fragments of paired tissue specimens (tumour and adjacent non-malignant liver tissue) were employed for molecular analyses. Real-time polymerase chain reaction was performed on 50 tissue and serum samples from HCC patients and 25 serum samples from healthy controls. Results: Expression levels were significantly higher in both HCC tissue and serum samples than in the controls (p<0.001). Additionally, the diagnostic performance was assessed by ROC curves, the PIWIL1-4 levels in serum showed better potential and sensitivity to screen HCC patients than their levels in tissues. Moreover, some PIWIL elements were found here to be significantly correlated with the HCC profile. Conclusion: PIWI expression could be considered to be associated with HCC progression, and could be a tool for the diagnosis and prognosis of HCC, additionally, it could represent a possible therapeutic target.
Investigation of trace element accumulation in Cockscomb (Celosia argentea Linn) grown in soil amended with chicken manure via some pollution indices
Authors: Oguntade Oladele Abdulahi , Yisa Nosiru Monday , Olagunju Solomon Oladimeji , Joda Abiodun Oladipupo , Adewusi Kayode Matthew , Olayiwola Richard Oluseyi
Published: September 2022

Trace elements such as Cadmium (Cd), Copper (Cu) and Manganese (Mn) in chicken manure can contaminate soil and bioaccumulate in edible tissues of plant resulting in food chain contamination. This study investigated the influence of chicken manure on trace element load of soil and accumulation in tissues ofCelosia argentea. Potted soil, 5kg each was amended with either conventional chicken manure (CCM) or local chicken manure (LCM) at rates of 4, 6, 8, and 10 t ha− 1and compared with control soil (no amendment). Treatments were replicated trice in a Completely Randomized Design. Results showed that soil trace element pollution increased with rates of amendments. Pollution indices; contamination factor, degree of contamination, elemental pollution index, pollution load index and total contamination factor were significantly (p ≤ 0.001) higher in soil amended with CCM than LCM. Bioaccumulation coefficients (BAC), bioaccumulation factor (BAF) and transfer factor (TF) of trace elements were higher in tissues of celosia grown with CCM than LCM. Contamination factor and PLI contributed most (92.7%) to soil’s effective CEC. Above 4 t ha− 1, growth and yield were not significantly influenced by amendments. Root to shoot translocation of trace element was restricted by amendments. Potential risks of Cu and Mn accumulation in edible shoot of celosia are eminent above 6 t ha− 1of the amendments.
Quality of Recovery after day care surgery with app controlled Remote Monitoring: study protocol for a randomized controlled trial
Authors: Thiel Bram , Godfried Marc , Emst Maaike van , Vernooij Lisette , Vliet Liesbeth van , Rumke Eva , Gerrits Will , Dongen Robert van , Koopman Seppe , Kalkman Cor
Published: September 2022

Background: The majority of surgical interventions are performed in day care and patients are discharged after the first critical postoperative period. At home, patients have limited options to contact healthcare providers in the hospital in case of severe pain and nausea. A smartphone application for patients to self-record pain and nausea when at home after day care surgery might improve patient’s recovery. Currently patient experiences with smartphone applications are promising; however, we do not know whether remote monitoring with such an application also improves the patient’s recovery. This study aims to evaluate the experienced quality of recovery after day care surgery between patients provided with the smartphone application for remote monitoring and patients receiving standard care without remote monitoring.Methods: This non-blinded randomized controlled trial with mixed methods design will include 310 adult patients scheduled for day care surgery. The intervention group receives the smartphone application with text message function for remote monitoring that enables patients to record pain and nausea. An anesthesia professional trained in empathetic communication, who will contact the patient in case of severe pain or nausea, performs daily monitoring. The control group receives standard care, with post-discharge verbal and paper instructions. The main study endpoint is the difference in perceived quality of recovery, measured with the QoR-15 questionnaire on the 7th day after day care surgery. Secondary endpoints are the overall score on the Quality of Recovery-15 at day 1, 4 and 7-post discharge, the perceived quality of hospital aftercare and experienced psychological effects of remote monitoring during postoperative recovery from day care surgery. Discussion: This study will investigate if facilitating patients and healthcare professionals with a tool for accessible and empathetic communication might lead to an improved quality of the postoperative recovery period. Trial registration: The ‘Quality of Recovery after day care surgery with app controlled Remote Monitoring: a randomized controlled trial’ is approved and registered on 23-2-2022 by Research Ethics Committees United with registration number R21.076 / NL78144.100.21. The protocol NL78144.100.21, Quality of Recovery after Day Care Surgery with App Controlled Remote Monitoring: a Randomized Controlled Trial is registered at ClinicalTrials.gov public website (registration date 16-2-2022; NCT05244772)
Hydrothermal transformation of glycerol to lactic acid in alkaline medium using Cu catalysts obtained from hydrotalcite-like precursors.
Authors: Moreira Arthur B.F. , Nogueira Daniel S. , Freitas Isabelle C. , Júnior Ricardo L. Souza , Chagas Carlos Alberto , Souza Mariana M.V.M. , Manfro Robinson Luciano
Published: September 2022

The conversion of glycerol into lactic acid in alkaline medium using heterogeneous catalysts has been highlighted and has proved to be an efficient alternative to the conventional fermentative route. This work investigated the production of lactic acid from glycerol in alkaline medium using copper catalysts obtained from hydrotalcite-like precursors in a continuous flow reaction system and the effect of different copper loading on catalytic behaviors in terms of yield and selectivity to lactic acid. The catalysts were synthesized by the coprecipitation method and characterized by XRF, XRD, N2 adsorption-desorption, H2-TPR, CO2-TPD, and the copper dispersion was determined by N2O oxidation. The reaction was performed for 30 h at 240°C, 35 atm, using space velocity (WHSV) of 2 h− 1, solution of 10 vol% glycerol, and NaOH/glycerol molar ratio of 0.75. Although the 30CuHT catalyst presented higher BET surface areas, Cu dispersion, and basicity than the 20CuHT catalyst, the best results in terms of glycerol conversion (96.5%) and yield (64%) to lactic acid were obtained in the catalytic test performed with the 20CuHT catalyst. This result may be related to the reaction steps that occur in the liquid phase in the presence of the hydroxyl group (OH-). Furthermore, the high content of Cu may favor the hydrogenation of the reaction intermediates (2-hydroxypropenal and pyruvaldehyde), increasing the formation of 1,2-propanediol and consequently reducing the yield of lactic acid. Finally, the catalytic activity of the reduced and non-reduced catalysts was investigated, and the results showed that copper oxide also has catalytic activity. However, the reduction of copper oxide provides better results.
Vermiremediation of paper mill sludge with cow dung and tea waste amendments using epigeic earthworm Eisenia fetida (Savigny)
Authors: Badhwar Vinay Kumar , Singh Sukhwinderpal , Singh Balihar
Published: September 2022

Vermiremediation of paper mill sludge (PMS) was done by Eisenia fetida after adding cow dung (CD) and tea waste (TW). In all, six reactors were prepared: R1 [CD (100%)], R2 [PMS: CD (1:2)], R3 [PMS: CD (1:1)], R4 [PMS: TW: CD (1:1:1)], R5 [PMS: TW: CD (1:2:1)] & R6 [PMS: TW: CD (2:1:1)]. A significant decrease in heavy metals was observed: Cd (37.2–58.2%), Cr (57.0-74.3%), Cu (67.3–79.8%), Ni (74.7–81.9%), Pb (78.8–83.4%) & Zn (71.2–77.4%); while heavy metal concentrations in earthworm tissues (mg.kg− 1) were recorded as: Cd (2.79–3.24), Cr (23.54–28.76), Cu (9.53–11.56), Ni (3.52–3.99), Pb (8.76–9.43) & Zn (23.12–29.72), after 60 days of study period. The Bioaccumulation factors (BAFs) of E.fetida was in the order: Ni > Cd > Cr > Pb > Zn > Cu. R3 obtained the maximum heavy metal removal (74.45%) while that in R4 (72.93%) also emphasized the use of tea waste in the bioremediation process. It was finally observed that cow dung and tea waste amendments favored the vermiremoval of heavy metals from paper mill sludge using Eisenia fetida.
Comparison of re-excision rates in patients undergoing breast conserving therapy with wire localization vs. RFID localization for non-palpable early-stage breast cancer and DCIS in a community hospital
Authors: Fernow Amy , Roche Faith Anne , Winter Allyson , Corbett Julie , Shaffer Lynn , Arp Irina , Padia Shilpa , Slam Kristine
Published: September 2022

Purpose: Patients with early-stage breast cancer or ductal carcinoma in situ (DCIS) are typically offered breast conserving therapy (BCT). Various techniques are available to localize the breast lesion. The objective of this study was to ensure that use of radiofrequency identification tags (RFID) for localization of nonpalpable early-stage breast cancer and DCIS is not inferior to the previously utilized method of wire localization.Methods: This is a retrospective cohort study to compare re-excision rates for breast cancer and DCIS patients who underwent BCT with wire vs RFID localization. Data on demographics, cancer pathology and surgery details for patients treated during 2019 to 2020 was collected from Mount Carmel Health System charts and an associated outpatient surgery center. The primary outcomes were margin status and re-excision rate. The estimated sample size was 316. Wire and RFID groups were compared using Fisher’s exact and Wilcoxon rank sum tests.Results: Three-hundred sixty patients were evaluated (139 wire, 221 RFID). The positive margin rates were low in both groups, and non-inferior for RFID compared to wire localization patients (4.5% vs. 2.2%, p=0.1392). The re-excision rates were equivalent for patients in the RFID and wire groups (0.5% vs. 0.7%, p=1.0). Conclusions: In this large study directly comparing patients with wire vs. RFID, the localization methods had equivalent positive margin and re-excision rates. RFID can provide a more convenient option for patients without jeopardizing surgical management.
Association between Pre-Hospital Antibiotic Exposure and Level of Bacterial Resistance (PHAE Study): A Matched Case Control Study at the Medical and Paediatric wards of Mbarara Regional Referral Hospital-South Western Uganda
Authors: Buzaare Peter , Tusiimire Jonans , Namugambe Juliet , Muzoora Conrad
Published: September 2022

Background
This study aimed to determine the association between pre-hospital antibiotic exposure and level of bacterial resistance among adult and paediatric patients.
Methods:
In the study, 79 antibiotic pre-exposed patients (cases) were compared with 79 non-pre-exposed patients (controls) hospitalized at medical and paediatric wards at Mbarara Regional Referral Hospital (MRRH) for various bacterial diagnoses. Data collected included participant demographics, previous medications and bacterial culture and sensitivity results. Data was analysed to determine the odds ratios for the occurrence of bacterial resistance between the cases and controls.
Results:
Results from the study showed that there was no statistically significant difference in terms of antibiotic resistance between pre-exposed and non-pre-exposed participants (OR: 0.5, 95%CI: 0.045 - 5.51, P = 0.571), whereby “no resistance” was defined as zero antibiotics resisted and “resistance” defined as 1 or more antibiotics resisted. However, when we adjusted the definition of “no resistance” and “resistance” to mean “one or less antibiotics resisted” and “two or more antibiotics resisted” respectively, there was a statistically significant more resistance in pre-exposed participants (cases) compared to non-pre-exposed participants (OR: 7, 95% CI: 1.59 - 30.8; p = 0.010). When the definition of resistance was further adjusted upwards to “three or more antibiotics resisted”, the resistance in cases was still significantly higher compared to controls (OR: 5.4, 95%CI: 2.42 - 12.2, p = 0.000) and when the definition of resistance was further adjusted to “four or more antibiotics resisted”, the OR increased even further (OR: 7.14, 95%CI: 3.24 - 15.8, p = 0.000). Ceftriaxone (17.6%) and amoxicillin (14.1%) were the commonest antibiotics to which participants were pre-exposed.
Conclusion:
The study showed that pre-hospital antibiotic exposure is strongly associated with resistance to one or more antibiotics. Strategies should be sought to reduce the level of such exposures and to enforce proper screening of patients during admission to facilitate rational prescription of antibiotics, improve quality of care, and slow the emergence of antimicrobial resistance in the management of infections.
Registration: This study was approved and registered by Mbarara University Research Ethics Committee (MUREC) and its number is 53/03-20
Underwater endoscopic mucosal resection for 10-20 mm pedunculated colorectal polyps: a prospective pilot study
Authors: Gao Hui , Zheng Shuhao , Liu Cenqin , Yuan Xin , Xie Jiarong , Xu Lei , Chen Xueqin
Published: September 2022

Background: The prophylactic application of clips for large pedunculated colorectal polyp resection may prevent postpolypectomy bleeding (PPB) but carries the risk of tumor remnants. This study assessed the effectiveness and safety of underwater endoscopic mucosal resection (UEMR) without clips before resecting large pedunculated polyps.Methods: Pedunculated polyps with a head diameter of 10-20 mm, a stalk diameter of ≥ 5 mm and a stalk length of ≥ 10 mm were eligible for inclusion and removed by UEMR without prophylactically clipping stem. The primary outcome was the rate of PPB, which included immediate PPB (IPPB) and delayed PPB (DPPB). The secondary outcomes included the rate of en bloc resection, complete resection, R0 resection and other adverse events.Results: Totally, 28 patients with 32 polyps were included in this study. The head diameter was 14.6 ± 3.5 mm. After polypectomy, two cases (6.3%) of nonactive spurting IPPB were observed, and no DPPB occurred during the follow-up period. All pedunculated polyps were successfully resected and achieved en bloc resection, complete resection and R0 resection. None of the polyps showed evidence of other severe adverse events.Conclusion: UEMR without the application of prophylactic clips has a low postpolypectomy bleeding rate and low risk of residual tumor and other severe adverse events. Therefore, it might be suitable and safe for resection of 10-20 mm pedunculated polyps.Trial registration: The study was registered on 08/04/2021 at ClinicalTrials.gov (NCT04837690).
Crop mobilization of retained phosphorus and changes in phosphorus compounds in soils amended with compost
Authors: Li Xue , Romanyà Joan
Published: September 2022

Background Microbiota can favour crop access to phosphorus (P) pools retained in soil. Microbial activity and P mobilization can be enhanced by soil carbon and root exudates.Aims We aimed to study the changes in organic and inorganic P (Po; Pi) forms and compounds in organically fertilised soils growing crops for two years.Methods Crops were grown in pots with compost added at the soil surface. We measured changes in microbial carbon, soluble carbon, total Po and Pi forms, the less labile EDTA-NaOH-Pi (-Po), and labile NaHCO3-Pi (-Po) in surface and subsurface soils from crop-free pots amended with compost and unamended, and from amended pots growing crops. P compounds in the EDTA-NaOH extract were measured by 31P-NMR.Results Compost addition increased the levels of Pi and although it had no effect on Po it increased inositol hexakisphosphate and other-monoesters. After the application of compost, the amount of total organic carbon, soluble carbon and P forms increased in surface soil, while in the subsurface soil there was a reduction in organic carbon and an increase in soluble carbon, total Pi, EDTA-NaOH-Pi and NaHCO3-Pi and the less labile EDTA-NaOH-Po and labile NaHCO3-Po. Growing crops reduced all measured Pi forms and had no observable impact on total Po in either organic C-enriched or organic C-depleted soils.Conclusions Crops mostly used Pi from the low P availability C-depleted layer. Large reductions in NaHCO3-Po and increased levels of other-monoesters in crop growing organic C-enriched layers may suggest microbial mobilization and crop use of this pool.
CTCF loss induces giant lamellar bodies in Purkinje cell dendrites
Authors: Hirayama Teruyoshi , Yuuki Kadooka , Tarusawa Etsuko , Saito Sei , Nakayama Hisako , Hoshino Natsumi , Nakama Soichiro , Fukuishi Takahiro , Kawanishi Yudai , Umeshima Hiroki , Tomita Koichi , Yoshimura Yumiko , Galjart Niels , Hashimoto Kouichi , Ohno Nobuhiko , Yagi Takeshi
Published: September 2022

Loss of Purkinje cells (PCs) in the cerebellum causes severe motor deficits. The peculiar lamellar structures known as “giant lamellar bodies” (GLBs) have been reported in PCs of patients with Werdnig-Hoffman disease, 13q deletion syndrome, and Krabbe’s disease. GLBs are localized to PC dendrites and are associated with neurodegeneration. They have been noted, however, only in case reports following autopsy, and reports of their existence have been very limited. Here we show that GLBs were reproducibly formed in PC dendrites of a mouse model, in which the CCCTC-binding factor (CTCF) was deleted. CTCF orchestrates gene expression by organizing the three-dimensional chromatin structure. The mouse model showed progressive motor dysfunction and abnormal dendritic morphology in PCs, including dendritic self-avoidance defects and proximal shift in the climbing fibre innervation territory on PC dendrites. GLBs were not clearly found in PC dendrites at infancy but instead developed with age. In conjunction with GLB development, the endoplasmic reticulum was almost absent around the nuclei, the mitochondria were markedly swollen and their cristae had decreased drastically, and almost all PCs eventually disappeared as severe motor deficits manifested. Thus, our results are the first experimental demonstration that GLBs represent a pathological alteration of PCs and suggest different genetic backgrounds involved in the induction of GLBs.
Low Incidence of Alcohol Relapse following Living Donor Liver Transplantation
Authors: Falari Sanyam Santosh , Mohapatra Nihar , Patil Nilesh Sadashiv , Pattnaik Bramhadatta , Varshney Mohit , Choudhury Ashok , Sarin Shiv Kumar , Pamecha Viniyendra
Published: September 2022

Background
Alcohol relapse after liver transplantation has a negative impact on outcomes. There is limited data on its burden, the predictors, and the impact following live donor liver transplantation (LDLT).
Methods
A single-center observational study was carried out between July 2011 and March 2021 for patients undergoing LDLT for Alcohol associated liver disease (ALD). The incidence, predictors of alcohol relapse, and post-transplant outcomes were assessed.
Results
Altogether 720 LDLT were performed during the study period, 203 (28.19%) for ALD. The overall relapse rate was 9.85% (n = 20) with a median follow-up of 52 months (range, 12-140 months). Sustained harmful alcohol use was seen in 4 (1.97%). On multivariate analysis, pre-LT relapse (p=0.001), duration of abstinence less than 3 months (p=0.007), daily intake of alcohol (p=0.001), absence of life partner (p=0.021), concurrent tobacco abuse before transplant (p=0.001), the donation from second-degree relative (p=0.003) and poor compliance with medications (p=0.001) were identified as predictors for relapse. Alcohol relapse was associated with the risk of graft rejection (HR 4.54,95% CI 1.751–11.80, p = 0.002).
Conclusion
Our results show that the overall incidence of relapse and rate of harmful drinking following LDLT is low. Donation from spouse and first degree relative was protective. History of daily intake, prior relapse, pre-transplant abstinence of less than three-months duration and lack of family support significantly predicted relapse.