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Emergency general surgeons often provide care to severely ill patients requiring surgical interventions and intensive support. One of the primary drivers of morbidity and mortality is perioperative bleeding. In general, when addressing life threatening haemorrhage, blood transfusion can become an essential part of overall resuscitation. However, under all circumstances, indications for blood transfusion must be accurately evaluated. When patients decline blood transfusions, regardless of the reason, surgeons should aim to provide optimal care and respect and accommodate each patient's values and target the best outcome possible given the patient's desires and his/her clinical condition. The aim of this position paper was to perform a review of the existing literature and to provide comprehensive recommendations on organizational, surgical, anaesthetic, and haemostatic strategies that can be used to provide optimal peri-operative blood management, reduce, or avoid blood transfusions and ultimately improve patient outcomes. [ABSTRACT FROM AUTHOR]

Covid-19, the disease caused by severe acute respiratory syndrome coronavirus 2 is recognised as one of the most challenging global events of the twenty-first Century. The detrimental impact of the pandemic resulted in high rates of infection, morbidity, and mortality, with health-care workers firmly positioned on the frontline of this unparalleled international crisis. An emerging literature detailing the impact of COVID-19 on health-care practitioners identifies high levels of depression, anxiety, and distress. Accordingly, there are calls for the implementation of effective interventions to tackle the impending spectre of psychological morbidities and staff burnout. While it is important to explore new approaches, it is also valuable to examine how existing strategies, such as reflective practice, can be repurposed to specifically address practitioner well-being. This requires a reimagining of reflective practice and a reimagining of the reflective practice contexts in which reflective activity occurs. This paper presents The Reflective Practice Integrative Framework, which illustrates how reflective practice can be used to address the complex aims of supporting effective patient care, while also facilitating practitioner well-being. The Reflective Organisational Learning Framework is also presented which can be used to develop effective reflective practice environments through single, double, and/or triple loop learning. [ABSTRACT FROM AUTHOR]

Introduction: Osteoporosis is a major disease state associated with significant morbidity, mortality, and health care costs. Less than half of the individuals sustaining a low energy hip fracture are diagnosed and treated for the underlying osteoporosis. Objective: A multidisciplinary Canadian hip fracture working group has developed practical recommendations to meet Canadian quality indicators in post hip fracture care. Methods: A comprehensive narrative review was conducted to identify and synthesize key articles on post hip fracture orthogeriatric care for each of the individual sections and develop recommendations. These recommendations are based on the best evidence available today. Conclusion: Recommendations are anticipated to reduce recurrent fractures, improve mobility and healthcare outcomes post hip fracture, and reduce healthcare costs. Key messages to enhance postoperative care are also provided. [ABSTRACT FROM AUTHOR]

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive gastrointestinal malignancy with a poor 5-year survival rate. Accurate staging of PDAC is an important initial step in the development of a stage-specific treatment plan. Different staging systems/consensus statements convened by different societies and academic practices are currently used. The most recent version of the American Joint Committee on Cancer (AJCC) tumor/node/metastases (TNM) staging system for PDAC has shifted its focus from guiding management to assessing prognosis. In order to preoperatively define the resectability of PDAC and to guide management, additional classification systems have been developed. The National Comprehensive Cancer Network (NCCN) guidelines, one of the most commonly used systems, provide recommendations on the management and the determination of resectability for PDAC. The NCCN divides PDAC into three categories of resectability based on tumor-vessel relationship: 'resectable,' 'borderline resectable,' and 'unresectable'. Among these, the borderline disease category is of special interest given its evolution over time and the resulting variations in the definition and the associated recommendations for management between different societies. It is important to be familiar with the evolving criteria, and treatment and follow-up recommendations for PDAC. In this article, the most current AJCC staging (8th edition), NCCN guidelines (version 2.2019—April 9, 2019), and challenges and controversies in borderline resectable PDAC are reviewed. [ABSTRACT FROM AUTHOR]

Cerebellar reserve refers to the capacity of the cerebellum to compensate for tissue damage or loss of function resulting from many different etiologies. When the inciting event produces acute focal damage (e.g., stroke, trauma), impaired cerebellar function may be compensated for by other cerebellar areas or by extracerebellar structures (i.e., structural cerebellar reserve). In contrast, when pathological changes compromise cerebellar neuronal integrity gradually leading to cell death (e.g., metabolic and immune-mediated cerebellar ataxias, neurodegenerative ataxias), it is possible that the affected area itself can compensate for the slowly evolving cerebellar lesion (i.e., functional cerebellar reserve). Here, we examine cerebellar reserve from the perspective of the three cornerstones of clinical ataxiology: control of ocular movements, coordination of voluntary axial and appendicular movements, and cognitive functions. Current evidence indicates that cerebellar reserve is potentiated by environmental enrichment through the mechanisms of autophagy and synaptogenesis, suggesting that cerebellar reserve is not rigid or fixed, but exhibits plasticity potentiated by experience. These conclusions have therapeutic implications. During the period when cerebellar reserve is preserved, treatments should be directed at stopping disease progression and/or limiting the pathological process. Simultaneously, cerebellar reserve may be potentiated using multiple approaches. Potentiation of cerebellar reserve may lead to compensation and restoration of function in the setting of cerebellar diseases, and also in disorders primarily of the cerebral hemispheres by enhancing cerebellar mechanisms of action. It therefore appears that cerebellar reserve, and the underlying plasticity of cerebellar microcircuitry that enables it, may be of critical neurobiological importance to a wide range of neurological/neuropsychiatric conditions. [ABSTRACT FROM AUTHOR]

In July 2015, the Journal of the American Geriatrics Society published a manuscript titled, "Failing to Focus on Healthy Aging: A Frailty of Our Discipline?" In response, the American Geriatrics Society (AGS) Clinical Practice and Models of Care Committee and Public Education Committee developed a white paper calling on the AGS and its members to play a more active role in promoting healthy aging. The executive summary presented here summarizes the recommendations from that white paper. The full version is published online at GeriatricsCareOnline.org. Life expectancy has increased dramatically over the last century. Longer life provides opportunity for personal fulfillment and contributions to community but is often associated with illness, discomfort, disability, and dependency at the end of life. Geriatrics has focused on optimizing function and quality of life as we age and reducing morbidity and frailty, but there is evidence of earlier onset of chronic disease that is likely to affect the health of future generations of older adults. The AGS is committed to promoting the health, independence, and engagement of all older adults as they age. Geriatrics as an interprofessional specialty is well positioned to promote healthy aging. We draw from decades of accumulated knowledge, skills, and experience in areas that are central to geriatric medicine, including expertise in complexity and the biopsychosocial model; attention to function and quality of life; the ability to provide culturally competent, person‐centered care; the ability to assess people's preferences and values; and understanding the importance of systems in optimizing outcomes. J Am Geriatr Soc 67:17–20, 2019. [ABSTRACT FROM AUTHOR]

[Display omitted] • Fabrication of paper disc interfaced immunodevice for detecting diverse biomarker. • Highly sensitive and affordable disease detection tool. • Validated with range of spiked and real samples. • Universal sensing ability was accessed using C-reactive protein and potato viruses. The detection of specific biomarkers is used in various phases of the diagnosis of plant and human diseases, from prognosis to monitoring. Herein, we report a Prussian blue nanocube-modified immunodevice interfaced with a paper disc for the detection of plant biomarkers via streptavidin-biotin recognition. The detection ability of the immunodevice was assessed using Potato virus X as a model biomarker and analyzed using cyclic voltammetry, differential pulse voltammetry, and electrochemical impedance spectroscopy. The immunodevice displayed excellent performance for Potato virus X detection with a detection limit of 0.92 nM (3S/N). The selectivity of the fabricated Potato virus X immunodevice was investigated using closely associated antigens, such as potato aucuba mosaic virus, Potato virus Y, and Potato virus A. The Potato virus X immunodevice exhibited ∼ 90 % recovery in spiked complex plant samples with a relative error of ∼ 9 %. Furthermore, the immunodevice was used to screen for Potato virus X in 10 samples from potato tubers and leaves. The paper-disc-interfaced immunodevice was also evaluated by detecting other biomarkers, such as potato aucuba mosaic virus in plant diseases and C-reactive protein in human ones. This immunodevice may allow the on-site monitoring of diverse biomarkers by simplifying the current point of care diagnostic tools. [ABSTRACT FROM AUTHOR]

Restoration of damaged central nervous system structures, functional recovery, and prevention of neuronal loss during neurodegenerative diseases are major objectives in cerebellar research. The highly organized anatomical structure of the cerebellum with numerous inputs/outputs, the complexity of cerebellar functions, and the large spectrum of cerebellar ataxias render therapies of cerebellar disorders highly challenging. There are currently several therapeutic approaches including motor rehabilitation, neuroprotective drugs, non-invasive cerebellar stimulation, molecularly based therapy targeting pathogenesis of the disease, and neurotransplantation. We discuss the goals and possible beneficial mechanisms of transplantation therapy for cerebellar damage and its limitations and factors determining outcome. [ABSTRACT FROM AUTHOR]

This introduction to a special section brings together three papers first presented at a panel, 'Medical Professions in South Asia: Historical and Contemporary Analyses', at the 26th European Conference on South Asian Studies, held in Vienna, Austria and online, in July 2021. All three papers deal with aspects of the professionalisation of biomedical doctors in India since its independence in 1947. The authors bring together historical and sociological approaches to illuminate the growth of specialisms, patterns of practitioner–patient interactions and efforts to maintain occupational closure and maintain status in the face of growing challenges. The introduction concludes with a discussion of the relevance of these papers for the sociology of health and illness in India and beyond. [ABSTRACT FROM AUTHOR]

Introduction: Multiple Sclerosis (MS) is a disease of central nervous system that mainly causes lesions or plaques in the spinal cord and brain. The purpose of this study was to analyze the relation between c.-813C>T (rs2070744) and c.894G>T (rs1799983) polymorphisms of NOS3 gene and MS in Iranian patients. Methods: A total of 78 patients with MS and 80 healthy controls were screened for NOS3 (rs2070744 and rs1799983) Single Nucleotide Polymorphisms (SNPs) by tetra-primer multiplex ARMS-PCR and PCR-RFLP. Results: Genotype frequencies of the c.-813C>T polymorphism in patients compared to controls were as follows: 53.8% to 80.0% for TT genotype, 41.0% to 18.8% for TC genotype, and 5.1% versus 1.2% for CC genotype (P=0.001). The frequencies of GG genotype was 57.7% and 78.8% and for GT genotype of c.894G>T polymorphism in patients compared to control subjects was 42.3% and 21.2%, respectively (P=0.004). Conclusion: Our results indicate that the studied NOS3 polymorphisms may be associated with MS in Iranian patients. [ABSTRACT FROM AUTHOR]

The aim of this paper was to assess the validity and reliability of the touch-screen standard Portuguese version of the following patient-reported outcomes (PROs), compared with paper format, in patients with rheumatoid arthritis (RA) and spondyloarthritis: Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Ankylosing Spondylitis Quality of Life scale (ASQoL), Short-Form 36 (SF-36), Health Assessment Questionnaire (HAQ) and visual analogue scales (VAS) measuring pain and burden of disease. Adult patients with RA and spondyloarthritis attending the Portuguese Institute of Rheumatology were recruited from March 2013 to January 2014. Patients filled the paper and touch-screen formats of the standard Portuguese versions of the PROs. Two groups of VAS were used, RA and psoriatic arthritis (Global VAS) and another specific for spondyloarthrites (Spa-VAS). Paper questionnaires were filled 15 min before touch-screen formats. Agreement between formats (validity) was assessed by intraclass correlation coefficient (ICC), while internal consistency of scales (reliability) was assessed by Cronbach's alpha. Overall, 134 patients were included with a mean age of 51 years, 74.6 % female and 57.5 % presenting RA. BASDAI, BASFI, HAQ and ASQoL showed high ICC between paper and touch-screen formats (0.977, 0.958, 0.974 and 0.940, respectively). ICC for Global VAS ranged from 0.906 to 0.921, while Spa-VAS ranged from 0.867 to 0.943. The mean ICC for all SF-36 domains was 0.889 (ICC for each domain ranged from 0.781 to 0.944). Touch-screen standard Portuguese formats of these PROs may be valid and reliable tools for PRO measurement in rheumatology. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate and compare the executive functions of students with depression, anxiety, and stress symptoms with those functions in healthy ones. Methods: This study was a comparative and non-clinical analysis. The study population comprised all students of Shahid Beheshti University, Tehran, Iran. A total of 448 students were recruited using convenience sampling method. They were also screened using the Depression Anxiety Stress Scales (DASS) test comprising 21 items. Of study participants, 30 people were depressed, 27 had anxiety, and 15 suffered from stress. Then, 50 control people were matched with them. Next, both groups were compared using the Stroop test, Wisconsin card sorting, and cognitive ability test. Results: Using MANOVA test, data analysis revealed no significant differences among 4 groups with regard to selective attention and shifting attention. Depressed group reacted rapidly as opposed to the anxiety group with regard to measures of shifting attention and cognitive abilities; it was observed that the memory, inhibition control, planning, and flexibility of the healthy group were better than those of the 3 other groups. Conclusion: The findings of this research raised specific issues in relation to the role of depression, anxiety, and stress in the disruption of the executive functions of sufferers. Selective and shifting attention and cognitive abilities are specifically affected in this regard. Meanwhile, the role of stress in impairing decision making and the major role of anxiety in impairing sustained attention was shown to be considerable. [ABSTRACT FROM AUTHOR]

The International Union of Basic and Clinical Pharmacology (IUPHAR) Geriatric Committee aims to improve the use of drugs in older adults and develop new therapeutic approaches for the syndromes and diseases of old age through advocacy, education, and research. In the present paper, we propose strategies relevant to drug development and evaluation, spanning preclinical and the full range of clinical studies. Drugs for older adults need to consider not only age, but also other characteristics common in geriatric patients, such as multimorbidity, polypharmacy, falls, cognitive impairment, and frailty. The IUPHAR Geriatric Committee's position statement on 'Measurement of Frailty in Drug Development and Evaluation' is included, highlighting 12 key principles that cover the spectrum of translational research. We propose that where older adults are likely to be major users of a drug, that frailty is measured at baseline and as an outcome. Preclinical models that replicate the age, frailty, duration of exposure, comorbidities, and co‐medications of the proposed patients may improve translation. We highlight the potential application of recent technologies, such as physiologically based pharmacokinetic–pharmacodynamic modeling informed by frailty biology, and Artificial Intelligence, to inform personalized medicine for older patients. Considerations for the rapidly aging populations in low‐ and middle‐income countries related to health‐care and clinical trials are outlined. Involving older adults, their caregivers and health‐care providers in all phases of research should improve drug development, evaluation, and outcomes for older adults internationally. [ABSTRACT FROM AUTHOR]

The aim of this paper is to contribute technical arguments to the debate about the importance of health examination surveys and their continued use during the post-pandemic health financing crisis, and in the context of a technological innovation boom that offers new ways of collecting and analysing individual health data (e.g. artificial intelligence). Technical considerations demonstrate that health examination surveys make an irreplaceable contribution to the local availability of primary health data that can be used in a range of further studies (e.g. normative, burden-of-disease, care cascade, cost and policy impact studies) essential for informing several phases of the health planning cycle (e.g. surveillance, prioritization, resource mobilization and policy development). Examples of the use of health examination survey data in the World Health Organization (WHO) European Region (i.e. Finland, Italy, Malta and the United Kingdom of Great Britain and Northern Ireland) and the WHO Region of the Americas (i.e. Chile, Mexico, Peru and the United States of America) are presented, and reasons why health provider-led data cannot replace health examination survey data are discussed (e.g. underestimation of morbidity and susceptibility to bias). In addition, the importance of having nationally representative random samples of the general population is highlighted and we argue that health examination surveys make a critical contribution to external quality control for a country's health system by increasing the transparency and accountability of health spending. Finally, we consider future technological advances that can improve survey fieldwork and suggest ways of ensuring health examination surveys are sustainable in low-resource settings. [ABSTRACT FROM AUTHOR]

Background: The gaps in healthy life expectancy (HLE) between Indigenous and non-Indigenous Australians are significant. Detailed and accurate information is required to develop strategies that will close these health disparities. This paper aims to quantify and compare the causes and their relative contributions to the life expectancy (LE) gaps between the Indigenous and non-Indigenous population in the Northern Territory (NT), Australia. Methods: The age-cause decomposition was used to analyse the differences in HLE and unhealthy life expectancy (ULE), where LE = HLE + ULE. The data was sourced from the burden of disease and injury study in the NT between 2014 and 2018. Results: In 2014–2018, the HLE at birth in the NT Indigenous population was estimated at 43.3 years in males and 41.4 years in females, 26.5 and 33.5 years shorter than the non-Indigenous population. This gap approximately doubled the LE gap (14.0 years in males, 16.6 years in females) at birth. In contrast to LE and HLE, ULE at birth was longer in the Indigenous than non-Indigenous population. The leading causes of the ULE gap at birth were endocrine conditions (explaining 2.9–4.4 years, 23–26%), followed by mental conditions in males and musculoskeletal conditions in females (1.92 and 1.94 years, 15% and 12% respectively), markedly different from the causes of the LE gap (cardiovascular disease, cancers and unintentional injury). Conclusions: The ULE estimates offer valuable insights into the patterns of morbidity particularly useful in terms of primary and secondary prevention. [ABSTRACT FROM AUTHOR]

Diversity, flexibility, easy accessibility, broad continuing acceptance in developing countries and increasing popularity in developed countries, relative low cost, low levels of technological input, relative low side effects, and growing economic importance are some of the positive features of traditional medicine. In rural India, traditional medicine continues to be the only available form of care. Many communities continue to treat patients using their old methods, unaffected by contemporary medical advancements. Due to their accessibility, affordability, and ease of use, tribal tribes prefer to utilize and consult their own traditional healers. These are likewise thought to be highly effective and without any adverse effects. This paper aims to identify various traditional medicines used for treating illness and infirmities, by taking accounts from the residents of Chungtlang village, Mamit District, Mizoram. The objective here lies in discovering traditional knowledge of medicinal plants and their uses for various infirmities. [ABSTRACT FROM AUTHOR]

Background: Frailty has been associated with increased postoperative mortality and morbidity; however, the use of the modified frailty index (mFI-11) to assess patients undergoing surgery for diverticular disease has not been widely assessed. This paper aims to examine frailty, evaluated by mFI-11, to assess postoperative morbidity and mortality among patients undergoing operative intervention for colonic diverticular disease. Methods: We used data from the Healthcare Cost and Utilization Project National Inpatient Sample (October 1, 2015–December 31, 2019). ICD-10-CM codes were utilized to identify a cohort of adult patients with a primary admission diagnosis of diverticulitis. mFI-11 items were adapted to correspond with ICD-10-CM codes. Patients were stratified into robust (mFI < 0.27) and frail (mFI ≥ 0.27) groups. Primary outcomes were in-hospital postoperative morbidity and mortality. Secondary outcomes included system-specific postoperative complications, length of stay (LOS), total admission cost, and discharge disposition. Multivariable regression models were fit. Results: Of the 26,826 patients, there were 24,194 patients with mFI-11 < 0.27 (i.e., robust) and 2,632 patients with mFI-11 ≥ 0.27 (i.e., frail). Adjusted analysis showed significant increases in postoperative mortality (aOR 2.16, 95% CI 1.38–3.38, p = 0.001) and overall postoperative morbidity (aOR 1.84, 95% CI 1.65–2.06, p < 0.001). LOS was higher in the frail group (MD 1.78 days, 95% CI 1.46–2.11, p < 0.001) as well as total cost (MD $25,495.19, 95% CI $19,851.63-$31,138.75, p < 0.001). Conclusion: In the elective setting, a high mFI-11 (i.e., presence of the variables comprising the index) could alert clinicians to the possibility of implementing preoperative optimization strategies. In the emergent setting, a high mFI-11 may help guide prognostication for these vulnerable patients. [ABSTRACT FROM AUTHOR]

Simple Summary: This manuscript systematically reviewed the literature on the use of vascular shunts during advanced pancreatic surgery, analyzing intraoperative and postoperative outcomes, and enlightening excellent long-term patency, negligible additional operative time, and acceptable postoperative morbidity. The importance of the study was to underline feasibility of this technical artifice, which may help expert surgeons to achieve clear margins in borderline or locally advanced PDAC. Background: The rising diffusion of vascular resections during complex pancreatectomy for malignancy, for both oncological and technical matters, brought with it the use of vascular shunts, either temporary or definitive, to prevent bowel congestion and liver ischemia. This study aimed to systematically review the literature on the technical feasibility of vascular shunts during advanced pancreatic surgery, analyzing intraoperative and postoperative outcomes. Methods: A systematic literature search was performed on PubMed, Scopus, Web of Science, and the Cochrane Library Central, according to PRISMA guidelines. Studies published before 2006 were excluded, considering the lack of a standardized definition of locally advanced pancreatic cancer. The main outcomes evaluated were the overall complication rate and shunt patency. Results: Among 789 papers retrieved from the database search, only five fulfilled the inclusion criteria and were included in the review, amounting to a total of 145 patients undergoing a shunt creation at the time of pancreatectomy. Pancreatic adenocarcinoma (PDAC) was found to be the most common diagnosis and pancreaticoduodenectomy was the main surgical procedure, accounting for 88% and 83% of the overall cohort, respectively. The distal splenorenal shunt was the most performed. Overall, 44 out of 145 patients (30%) experienced postoperative complications; the long-term patency of definitive shunts was 83% (110 out of 120 patients). Conclusions: An increasing number of patients with borderline resectable or locally advanced PDAC are becoming amenable to resection and shunt creation may facilitate vascular resection with clear margins, becoming a valid tool of modern pancreatic surgery. [ABSTRACT FROM AUTHOR]

Although the early diagnosis and treatment for acute myocardial infarction have improved over the past decades, the morbidity and mortality from coronary artery disease (CAD) remain significant in Europe and worldwide. It is estimated that the majority of people in the developed countries who die suddenly from CAD, have no prior manifestation of disease, and the majority of these individuals are not considered to be at high risk. Accurate identification of individuals at risk of such events before the clinical manifestations is therefore required. This “State-of-Art” paper of the Italian Working Group on Atherosclerosis aims to i. provide an overview of both the traditional and emerging non-invasive imaging techniques used to detect early atherosclerosis in the general population with moderate cardiovascular risk; ii. identify the rationale for screening asymptomatic patients with preclinical atherosclerotic lesions and the optimal algorithm that should be used to detect them; iii. discuss the future directions of atherosclerosis research, with special focus on nanotechnology, aimed at early identification and treatment of low- and intermediate-risk patients. [ABSTRACT FROM AUTHOR]

Background: With the development of molecular high-throughput assays (i.e. next generation sequencing), the knowledge on the contribution of genetic and epigenetic alterations to the etiology of inherited endocrine disorders has massively expanded. However, the rapid implementation of these new molecular tools in the diagnostic settings makes the interpretation of diagnostic data increasingly complex.Main Body: This joint paper of the ENDO-ERN members aims to overview chances, challenges, limitations and relevance of comprehensive genetic diagnostic testing in rare endocrine conditions in order to achieve an early molecular diagnosis. This early diagnosis of a genetically based endocrine disorder contributes to a precise management and helps the patients and their families in their self-determined planning of life. Furthermore, the identification of a causative (epi)genetic alteration allows an accurate prognosis of recurrence risks for family planning as the basis of genetic counselling. Asymptomatic carriers of pathogenic variants can be identified, and prenatal testing might be offered, where appropriate.Conclusions: The decision on genetic testing in the diagnostic workup of endocrine disorders should be based on their appropriateness to reliably detect the disease-causing and -modifying mutation, their informational value, and cost-effectiveness. The future assessment of data from different omic approaches should be embedded in interdisciplinary discussions using all available clinical and molecular data. [ABSTRACT FROM AUTHOR]

Simple Summary: This review delves into key metabolic diseases affecting dairy cattle such as subacute ruminal acidosis (SARA), ketosis, and hypocalcemia. The aim of this review was to examine each disease in terms of its etiology, pathophysiology, clinical manifestations, diagnostic approaches, and treatment and prevention strategies. This review emphasizes early diagnosis and proactive management, so it can serve as a valuable resource for veterinarians, researchers, and dairy farmers, offering insights into the prevention and treatment of these prevalent metabolic diseases in dairy cattle. This review paper provides an in-depth analysis of three critical metabolic diseases affecting dairy cattle such as subacute ruminal acidosis (SARA), ketosis, and hypocalcemia. SARA represents a disorder of ruminal fermentation that is characterized by extended periods of depressed ruminal pH below 5.5–5.6. In the long term, dairy herds experiencing SARA usually exhibit secondary signs of the disease, such as episodes of laminitis, weight loss and poor body condition despite adequate energy intake, and unexplained abscesses usually 3–6 months after an episode of SARA. Depressed milk-fat content is commonly used as a diagnostic tool for SARA. A normal milk-fat test in Holstein dairy cows is >4%, so a milk-fat test of <3% can indicate SARA. However, bulk tank testing of milk fat is inappropriate to diagnose SARA at the herd level, so when >4 cows out of 12 and <60 days in milk are suspected to have SARA it can be considered that the herd has a problem. The rapid or abrupt introduction of fresh cows to high-concentrate diets is the most common cause of SARA. Changes in ruminal bacterial populations when exposed to higher concentrate rations require at least about 3 weeks, and it is recommended that concentrate levels increase by no more than 400 g/day during this period to avoid SARA. Ketosis, a prevalent metabolic disorder in dairy cattle, is scrutinized with a focus on its etiological factors and the physiological changes leading to elevated ketone bodies. In total mix ration-fed herds, an increased risk of mastitis and reduced fertility are usually the first clinical signs of ketosis. All dairy cows in early lactation are at risk of ketosis, with most cases occurring in the first 2–4 weeks of lactation. Cows with a body condition score ≥3.75 on a 5-point scale at calving are at a greater risk of ketosis than those with lower body condition scores. The determination of serum or whole blood acetone, acetoacetate, beta-hydroxybutyrate (BHB) concentration, non-esterified fatty acids (NEFA), and liver biopsies is considered the best way to detect and monitor subclinical ketosis, while urine or milk cowside tests can also be used in on-farm monitoring programs. Concentrations >1.0 mmol/L or 1.4 mmol/L blood or serum BHB are considered diagnostic of subclinical ketosis. The standard threshold used for blood is 1.2 mmol/L, which corresponds to thresholds of 100 mcmol/L for milk and 15 mg/dL for urine. Oral administration of propylene glycol (250–400 g, every 24 h for 3–5 days) is the standard and most efficacious treatment, as well as additional therapy with bolus glucose treatment. Hypocalcemia is a disease of adult dairy cows in which acute hypocalcemia causes acute to peracute, afebrile, flaccid paralysis that occurs most commonly at or soon after parturition. Dairy cows are at considerable risk for hypocalcemia at the onset of lactation, when daily calcium excretion suddenly increases from about 10 g to 30 g per day. Cows with hypocalcemia have a more profound decrease in blood calcium concentration—typically below 5.5 mg/dL. The prevention of parturient paresis has been historically approached by feeding cows low-calcium diets during the dry period. Negative calcium balance triggers calcium mobilization before calving and better equips the cow to respond to the massive calcium needs at the onset of lactation. Calcium intake must be limited to <20 g per day for calcium restriction to be effective. The most practical and proven method for monitoring hypocalcemia is by feeding cows an acidogenic diet for ~3 weeks before calving. Throughout the review, emphasis is placed on the importance of early diagnosis and proactive management strategies to mitigate the impact of these metabolic diseases on dairy cattle health and productivity. The comprehensive nature of this paper aims to serve as a valuable resource for veterinarians, researchers, and dairy farmers seeking a deeper understanding of these prevalent metabolic disorders in dairy cattle. [ABSTRACT FROM AUTHOR]

The article presents a review of current applications and capacities of artificial intelligence in identifying pests and diseases of common agricultural crops. The review is created based on the literature search, conducted using Google Scholar engine. In total, 42 recent scientific papers (22 published in journals and 20 conference proceedings), which were published within last five years, were analysed and included into this review. Scientific papers providing incomplete data, controversial and biased information were excluded from the review. Mainly open access sources were included into the review. As a result, it was established that current artificial intelligence applications in phytosanitary monitoring of crops allow a great decrease in the mistakes in pests and diseases identification, as well as a reduction in the expenses of labour and time for manual observations. Generally, most AI-based models for plants pests and diseases identification provided identification accuracy and specificity exceeding 85%-90%, some of them reaching the peak of 99%-100% accuracy. The best results are mainly recorded for convolutional neural networks and their combination with other machine learning techniques. However, no clear unified algorithm is recommended for this purpose. The best results are usually associated with neural network-based algorithms. Further deeper scientific research is necessary to clarify the advantages, drawbacks and pitfalls of artificial intelligence application in phytopathological surveys. [ABSTRACT FROM AUTHOR]

The implementation of new surgical techniques offers chances but carries risks. Usually, several years pass before a critical appraisal and a balanced opinion of a new treatment method are available and rely on the evidence from the literature and expert's opinion. The frozen elephant trunk (FET) technique has been increasingly used to treat complex pathologies of the aortic arch and the descending aorta, but there still is an ongoing discussion within the surgical community about the optimal indications. This paper represents a common effort of the Vascular Domain of EACTS together with several surgeons with particular expertise in aortic surgery, and summarizes the current knowledge and the state of the art about the FET technique. The majority of the information about the FET technique has been extracted from 97 focused publications already available in the PubMed database (cohort studies, case reports, reviews, small series, meta-analyses and best evidence topics) published in English. [ABSTRACT FROM AUTHOR]

Background:Application of one or several paper patches on the tympanic membrane can improve autophony and other symptoms in some patients with a patulous eustachian tube.Method:The charts of 21 patients treated for patulous eustachian tube syndrome between 2006 and 2011 were studied for subjective improvement of symptoms following the application of paper patches.Results:Paper patching of the tympanic membrane provided symptomatic relief in 76.2 per cent of patients; relief was permanent in 50 per cent of these patients.Conclusion:Paper patching of the tympanic membrane is a simple and effective means of temporarily or permanently alleviating patulous eustachian tube syndrome symptoms. It is postulated that the patches decrease the admittance of low- to mid-frequency acoustic input at the tympanic membrane by increasing the stiffness of the tympanic membrane, thereby counteracting the middle-ear cushion effect caused by the open eustachian tube. [ABSTRACT FROM PUBLISHER]

Plant protection is increasingly problematic in a climate-challenged world where the need for food security is increasingly urgent. Plant Health Clinics (PHCs) are an effective way of improving the capability of extension services to assist farmers to manage plant problems, by delivering personalised advice. They are also recognised as an important element in the building of the region's plant health system, with links to biosecurity and research. Based on a medical model, the advice is provided by extension officers trained as 'plant health doctors', at a clinic accessible to farmers. Indications are that in the Pacific, farmers are very supportive of the PHC approach. In this paper, we consider the background and need for PHCs and the training of plant health doctors. We then discuss the important role of three of the region's universities – Fiji National University (FNU), Solomon Islands National University (SINU), and the University of Goroka (UoG) in PNG which now provide PHC education to students of agriculture and beyond to sustain the programme once donor funding ceases. Overall, the experience of including PHCs offers authentic learning for students, as well as opening a wide range of research opportunities to investigate and support the programme. [ABSTRACT FROM AUTHOR]

Background: Significant scientific research has been conducted concerning menopausal syndrome(MPS), yet few bibliometric analyses have been performed. Our aim was to recognise the 100 most highly cited published articles on MPS and to analytically evaluate their key features. Methods: To identify the 100 most frequently cited articles, a search was conducted on Web of Science using the term 'menopausal syndrome'. Articles that matched the predetermined criteria were scrutinised to obtain the following data: citation ranking, year of publication, publishing journal, journal impact factor, country of origin, academic institution, authors, study type, and keywords. Results: The publication period is from January 1, 2000, to August 31, 2022. The maximum number of citations was 406 and in 2012. The median citations per year was 39.70. Most of the articles focused on treatment and complications. These articles were published in 36 different journals, with the Journal of MENOPAUSE having published the greatest number (14%). Forty-eight articles (48%) were from the United States, with the University of Pittsburgh being the leading institute (9%). Joann E. Manson was the most frequent first author (n = 6). Observational studies were the most frequently conducted research type (n = 53), followed by experimental studies (n = 33). Keyword analysis identified classic research topics, including genitourinary syndrome of menopause, bone mineral density (BMD), and anti-mullerian hormone (AMH) loci. Conclusion: Using bibliometrics, we conducted an analysis to identify the inadequacies, traditional focal points, and potential prospects in the study of MPS across current scientific areas. Treatment and complications are at the core of MPS research, whereas prediction and biomarkers have less literature of high quality. There is a necessity for innovative analytical metrics to measure the real effect of these papers with a high level of citation on clinical application. [ABSTRACT FROM AUTHOR]

Eating disorders are historically underserved in healthcare, but are increasingly prevalent and recognised for their high costs regarding mortality, quality of life and the economy. Those with longstanding eating disorders are commonly labelled 'severe and enduring' (SEED), which has been challenged for its conceptual vagueness and potential to discourage patients. Attempts to define individuals from this cohort as having 'terminal' illness have also gained traction in recent years. This paper is grounded in lived/living experience and relevant research. It challenges the logical coherence and utility of SEED, arguing that the word 'enduring' unhelpfully situates intractability of longstanding illness within patients themselves and the nature of their illness. This risks a sense of inevitability and overlooks the important role of contextual factors such as lacking resources and insufficient evidence for withholding active treatment. Recommendations suggest approaches to dismantling unhelpful binaries between early intervention and intensive support, recovery and decline. [ABSTRACT FROM AUTHOR]

Nutrition has played a central role in the management and outcomes of people with cystic fibrosis (pwCF) since the 1970s. Advances in therapies and practices in recent decades have led to a significant change in the patient landscape with dramatic improvements in life expectancy, as well as quality of life, bringing with it new issues. Historically, cystic fibrosis was a condition associated with childhood and malnutrition; however, changes in patient demographics, nutritional assessment and fundamental nutritional management have evolved, and it has become an increasingly prevalent adult disease with new nutritional challenges, including obesity. This paper aims to describe these changes and the impact and challenges they bring for those working in this field. Nutritional professionals will need to evolve, adapt and remain agile to the wider range of situations and support required for a new generation of pwCF. Specialised nutrition support will continue to be required, and it will be additionally important to improve and optimise quality of life and long‐term health. Key points: Traditional cystic fibrosis dietary advice focused on a default high‐fat/high‐calorie intake with limited consideration for other important nutrients. The emerging new era approach should be individualised, flexible and with an emphasis on diversity and longevity.Historically, this population was predominantly undernourished or at risk of undernutrition, but with the success and impact of nutritional guidelines, multidisciplinary teams, screening and new therapies, overnutrition is becoming an increasing concern that requires attention.Significant improvements in life expectancy mean more people with cystic fibrosis are living into old age, bringing with it age‐related complications and new opportunities that require nutritional consideration from childhood. [ABSTRACT FROM AUTHOR]

Globally, there are over 1 billion people infected with soil-transmitted helminths (STHs), mostly living in marginalized settings with inadequate sanitation in sub-Saharan Africa and Southeast Asia. The World Health Organization recommends an integrated approach to STH morbidity control through improved access to sanitation and hygiene education and the delivery of preventive chemotherapy (PC) to school-age children delivered through schools. Progress of STH control programs is currently estimated using a baseline (pre-PC) school-based prevalence survey and then monitored using periodical school-based prevalence surveys, known as Impact Assessment Surveys (IAS). We investigated whether integrating geostatistical methods with a Markov model or a mechanistic transmission model for projecting prevalence forward in time from baseline can improve IAS design strategies. To do this, we applied these 2 methods to prevalence data collected in Kenya, before evaluating and comparing their performance in accurately informing optimal survey design for a range of IAS sampling designs. We found that, although both approaches performed well, the mechanistic method more accurately projected prevalence over time and provided more accurate information for guiding survey design. Both methods performed less well in areas with persistent STH hotspots where prevalence did not decrease despite multiple rounds of PC. Our findings show that these methods can be useful tools for more efficient and accurate targeting of PC. The general framework built in this paper can also be used for projecting prevalence and informing survey design for other neglected tropical diseases. [ABSTRACT FROM AUTHOR]

RNA transcripts play a crucial role as witnesses of gene expression health. Identifying disruptive short sequences in RNA transcription and regulation is essential for potentially treating diseases. Let us delve into the mathematical intricacies of these sequences. We have previously devised a mathematical approach for defining a "healthy" sequence. This sequence is characterized by having at most four distinct nucleotides (denoted as n t ≤ 4 ). It serves as the generator of a group denoted as f p . The desired properties of this sequence are as follows: f p should be close to a free group of rank n t − 1 , it must be aperiodic, and f p should not have isolated singularities within its S L 2 (C) character variety (specifically within the corresponding Groebner basis). Now, let us explore the concept of singularities. There are cubic surfaces associated with the character variety of a four-punctured sphere denoted as S 2 4 . When we encounter these singularities, we find ourselves dealing with some algebraic solutions of a dynamical second-order differential (and transcendental) equation known as the Painlevé VI Equation. In certain cases, S 2 4 degenerates, in the sense that two punctures collapse, resulting in a "wild" dynamics governed by the Painlevé equations of an index lower than VI. In our paper, we provide examples of these fascinating mathematical structures within the context of miRNAs. Specifically, we find a clear relationship between decorated character varieties of Painlevé equations and the character variety calculated from the seed of oncomirs. These findings should find many applications including cancer research and the investigation of neurodegenative diseases. [ABSTRACT FROM AUTHOR]

Introduction: Understanding the complex link between our gut health and general well-being has drawn more attention in recent years. Prebiotics can promote mineral absorption, influence metabolism, improve immune system regulation, and fight infections. Aim: This article focuses into the evolving paradigms in prebiotics research, highlighting their regulation, diverse applications, impact on diseases, and their growth on the global market. Discussion: Prebiotics are Generally Recognized as Safe (GRAS), novel foods and food additives by the Food and Drug Administration (FDA), EU and Japan, respectively. The multifaceted applications of prebiotics go across various sectors, ranging from functional foods and dietary supplements to cosmetics. A comprehensive review of prebiotics' effects on human health and illness prevention is a significant strength of the paper. Prebiotics support a healthy microbiome by feeding helpful gut flora, which may reduce the risk of a variety of illnesses and improve general health. In parallel, it covers an overview of the prebiotics industry in the world, considering aspects including consumer knowledge of gut health and growing prebiotic demand. Conclusion: Prebiotics are anticipated to have a significant role in determining the direction of nutrition and preventive healthcare as research advances and consumer demand for natural health solutions rises. [ABSTRACT FROM AUTHOR]

Background: Significant scientific research has been conducted concerning menopausal syndrome(MPS), yet few bibliometric analyses have been performed. Our aim was to recognise the 100 most highly cited published articles on MPS and to analytically evaluate their key features. Methods: To identify the 100 most frequently cited articles, a search was conducted on Web of Science using the term 'menopausal syndrome'. Articles that matched the predetermined criteria were scrutinised to obtain the following data: citation ranking, year of publication, publishing journal, journal impact factor, country of origin, academic institution, authors, study type, and keywords. Results: The publication period is from January 1, 2000, to August 31, 2022. The maximum number of citations was 406 and in 2012. The median citations per year was 39.70. Most of the articles focused on treatment and complications. These articles were published in 36 different journals, with the Journal of MENOPAUSE having published the greatest number (14%). Forty-eight articles (48%) were from the United States, with the University of Pittsburgh being the leading institute (9%). Joann E. Manson was the most frequent first author (n = 6). Observational studies were the most frequently conducted research type (n = 53), followed by experimental studies (n = 33). Keyword analysis identified classic research topics, including genitourinary syndrome of menopause, bone mineral density (BMD), and anti-mullerian hormone (AMH) loci. Conclusion: Using bibliometrics, we conducted an analysis to identify the inadequacies, traditional focal points, and potential prospects in the study of MPS across current scientific areas. Treatment and complications are at the core of MPS research, whereas prediction and biomarkers have less literature of high quality. There is a necessity for innovative analytical metrics to measure the real effect of these papers with a high level of citation on clinical application. [ABSTRACT FROM AUTHOR]

The outbreak of coronavirus disease in 2019 has become a serious threat to human health. Whether meteorological conditions could influence the transmission and virulence of COVID-19 remains controversial. In this study, we systematically reviewed the impact of temperature and humidity on the replication, morbidity, and mortality of COVID-19. We also discussed the main factors underlying the inconsistency across studies. Pubmed, Web of Science, Embase, and Scopus were used to identify papers published up to 7 December 2020. We initially identified 3515 papers, and 28 articles met the inclusion criteria after screening. Most studies showed high temperature and high humidity can partly reduce the reproduction, morbidity, and mortality of COVID-19. But the rest papers failed to identify a significant association. The discrepant results may be related to the difference in the climate context, study design, exposure assessment, policy intervention, socioeconomic status, and public health service. [ABSTRACT FROM AUTHOR]

E-readers are fast rivaling print as a dominant method for reading. Because they offer accessibility options that are impossible in print, they are potentially beneficial for those with impairments, such as dyslexia. Yet, little is known about how the use of these devices influences reading in those who struggle. Here, we observe reading comprehension and speed in 103 high school students with dyslexia. Reading on paper was compared with reading on a small handheld e-reader device, formatted to display few words per line. We found that use of the device significantly improved speed and comprehension, when compared with traditional presentations on paper for specific subsets of these individuals: Those who struggled most with phoneme decoding or efficient sight word reading read more rapidly using the device, and those with limited VA Spans gained in comprehension. Prior eye tracking studies demonstrated that short lines facilitate reading in dyslexia, suggesting that it is the use of short lines (and not the device per se) that leads to the observed benefits. We propose that these findings may be understood as a consequence of visual attention deficits, in some with dyslexia, that make it difficult to allocate attention to uncrowded text near fixation, as the gaze advances during reading. Short lines ameliorate this by guiding attention to the uncrowded span. [ABSTRACT FROM AUTHOR]

The article announces the winners of the 2016 Summer Biomechanics, Bioengineering, and Biotransport Conference Student Paper Competition including John P. Carruth, Sonia Kartha, and Jack A. Martin.

Abstract  Web-based questionnaires are increasingly employed for clinical research. To investigate whether web-based and paper versions of the Pelvic Floor Distress Inventory 20 (PFDI-20) and Pelvic Floor Impact Questionnaire 7 (PFIQ-7) yield similar results, we compared results obtained with these two modes of administration. Women with pelvic floor disorders completed both versions of these questionnaires. Scores between modes of administration were compared using the paired t test and the intraclass correlation coefficient (ICC). Among the 52 participants, there were no significant differences in scores or scale scores between the web-based and paper questionnaires. The ICC was 0.91 for the PFDI-20 score and 0.81 for the PFIQ-7 score (p  [ABSTRACT FROM AUTHOR]

Cigarette smoke is a complex chemical mixture that causes a variety of diseases, such as lung cancer. With the electrically heated cigarette smoking system (EHCSS), temperatures are applied to the tobacco below those found in conventional cigarettes, resulting in less combustion, reduced yields of some smoke constituents, and decreased activity in some standard toxicological tests. The first generation of electrically heated cigarettes (EHC) also resulted in increased formaldehyde yields; therefore, a second generation of EHC was developed with ammonium magnesium phosphate (AMP) in the cigarette paper in part to address this increase. The toxicological activity of mainstream smoke from these two generations of EHC and of a conventional reference cigarette was investigated in two studies in rats: a standard 90-day inhalation toxicity study and a 35-day inhalation study focusing on lung inflammation. Many of the typical smoke exposure-related changes were found to be less pronounced after exposure to smoke from the second-generation EHC with AMP than to smoke from the first-generation EHC or the conventional reference cigarette, when compared on a particulate matter or nicotine basis. Differences between the EHC without AMP and the conventional reference cigarette were not as prominent. Overall, AMP incorporated in the EHC cigarette paper reduced the inhalation toxicity of the EHCSS more than expected based on the observed reduction in aldehyde yields. [ABSTRACT FROM AUTHOR]

In a recent study published in the Bulletin of the World Health Organization, Mathers et al. (2005) discussed the current status of global reporting of mortality data, and several indicators of quality and completeness of coded data were examined. Unfortunately, no recognition was attributed to the capacity, knowledge and skills of individual coders to impact upon the quality of the data (Walker 2006). This paper explores some of the quality issues relating to coders, as identified in an international needs assessment study conducted through a joint collaboration between the Education Committee of the World Health Organization Family of International Classifications (WHO-FIC) and the International Federation of Health Records Organizations (IFHRO) (Walker & McKenzie 2004). The study provides the first comprehensive view of coders of mortality and morbidity data internationally. This paper reports selected results from that survey, highlighting the need for recognised standards of uniform education for coders internationally. [ABSTRACT FROM AUTHOR]

Abstract: Spirituality is often explained in the nursing literature as the patient''s quest to find meaning in life and in their experiences. This is most often described in an unlimited and unconditional way defined by whatever interpretations the person places upon it. This opens it to a variety of understandings, some of which may be negative and unhelpful in terms of what we usually consider to be spiritual well being. This discussion paper attempts to look beyond the generality of this idea to examine whether our concept of having meaning, if used in terms of spirituality, should be conditional on meanings which are actually to do with the depth of our being and not meanings which only give pleasure and satisfaction. The paper attempts to do this in two ways. First it explores the beliefs of Victor Frankl to ask the question whether having meaning alone is sufficient to provide spiritual comfort or whether the content of the particular beliefs associated with meaning, may matter. Frankl is often used as a source for the idea of spirituality being to do with meaning and in this paper Frankl''s thought is explored in detail to see his own underlying beliefs which helped in his life experiences. Secondly, an understanding of ‘meaning’ as being conditioned by something “ultimate” described by Paul Tillich is explored. This would give nursing a more structured and purposeful approach to using the term ‘meaning’ in relation to spiritual care and in addition it would open up a way forward in terms of researching which particular meanings might be most helpful in illness and adversity. [Copyright &y& Elsevier]

Summary: To assist in the early detection of critical illness, many hospitals now use a “track and trigger” system that allocates points to routine vital signs measurements on the basis of their derangement from an arbitrarily agreed “normal” range. These points are summed to provide an early warning score (EWS). Little is known about the accuracy with which EWS are calculated and charted. We compared the speed and accuracy of charting the weighted value attributed to each vital sign, and of calculating the EWS, using the traditional pen and paper method with that using a specially programmed, personal digital assistant (VitalPAC™). Incorrect entries or omissions occurred in 24 (29%) of 84 EWS computed using pen/paper compared to 8 (10%) computed using the VitalPAC™ method. Fewer incorrect clinical actions were indicated using EWS derived via the VitalPAC™ method (4/84, 5%) than from those calculated using pen/paper (12/84, 14%). The mean time (±S.D.) taken for participants to calculate and chart a set of weighted values and EWS using the pen/paper method was 67.6±35.3s (n =84). The corresponding time taken to enter a set of physiological data using the VitalPAC™ was 43.0±23.5s (n =84). By comparison with the conventional pen/paper method, the use of VitalPAC™ was on average 1.6-times faster. The use of a device such as VitalPAC™ offers significant advantages both in speed and accuracy of recording of EWS. [Copyright &y& Elsevier]

The optimal approach to desmoid-type fibromatosis has not been established as of today.Considering the unpredictable behaviour and the heterogeneity of this disease, we propose a treatment algorithm, based on a front-line wait and see (WS) approach and subsequent therapy in case of progression.A careful counseling at a referral center is mandatory and should be offered to all patients affected by sporadic DF from the time of their diagnosis.Desmoid-type fibromatosis (DF) is a rare locally aggressive monoclonal proliferation of myofibroblasts lacking metastatic capacity. It may be observed in nearly every part of the body. Considering the variable clinical presentations, anatomic locations, and biologic behaviors, an individualized treatment approach is required. The pathogenesis of DF is not completely understood even if a high prevalence (∼85%) of CTNNB1 mutations discovered in sporadic DF underlies the importance of the Wnt/β-catenin pathway. No established and evidence-based approach for the treatment of this neoplasm is available as of today. Considering the unpredictable behavior and the heterogeneity of this disease, we propose a treatment algorithm approved by the French and the Italian Sarcoma Group, based on a front-line wait and see approach and subsequent therapy in the case of progression. A careful counseling at a referral center is mandatory and should be offered to all patients affected by sporadic DF from the time of their diagnosis. [ABSTRACT FROM PUBLISHER]

Vibrational spectroscopy techniques have demonstrated potential to provide non-destructive, rapid, clinically relevant diagnostic information. Early detection is the most important factor in the prevention of cancer. Raman and infrared spectroscopy enable the biochemical signatures from biological tissues to be extracted and analysed. In conjunction with advanced chemometrics such measurements can contribute to the diagnostic assessment of biological material. This paper also illustrates the complementary advantage of using Raman and FTIR spectroscopy technologies together. Clinical requirements are increasingly met by technological developments which show promise to become a clinical reality. This review summarises recent advances in vibrational spectroscopy and their impact on the diagnosis of cancer. [ABSTRACT FROM AUTHOR]

Peripartum cardiomyopathy is an idiopathic cardiomyopathy presenting with heart failure secondary to left ventricular systolic dysfunction towards the end of pregnancy or in the months following delivery, where no other cause for heart failure is identified. Outcome varies from full recovery to residual left ventricular systolic dysfunction and even death. Many women return to their physician to acquire information on their long-term prognosis, to seek medical advice regarding contraception, or when planning a subsequent pregnancy. This position paper summarizes current evidence for long-term outcome, risk stratification of further pregnancies and overall management. Based on the best available evidence, as well as the clinical experience of the European Society of Cardiology Study Group on Peripartum Cardiomyopathy members, a consensus on pre- and postpartum management algorithms for women undergoing a subsequent pregnancy is presented. [ABSTRACT FROM AUTHOR]

In the last decades, narrative theory has collaborated with sociology and anthropology of health to account for the importance that illness narratives hold for those who are or have been sick, for those who live with them, for the organizations where they work – if they do, and for public administration. The reason for the link between the two disciplines is that the way in which one explains one's illness to him or herself, as well as to others, has a crucial impact on one's experience of being ill as well as on others' reactions. This paper focuses on the work of one the most influential sociologists who has combined both disciplines: Frank's The Wounded Storyteller. To our mind, Frank's lucid account misses the importance of the biocapitalistic forces in his otherwise compelling reflection on illness narratives and proposal of three narrative types. In this paper, we suggest how the logic of the messianic narratives of Benjamin and Derrida can help identify the biocapitalistic forces that inform one of the illness narratives Frank studies and criticizes – the restitution narrative- and can help complement the narrative type Frank most praises – the quest narrative. [ABSTRACT FROM AUTHOR]

The SARS-CoV-2 pandemic has affected almost every aspect of how we care for patients, including the evaluation of patients with new neurological symptoms. For all physicians, the patient with the new onset of dizziness is particularly difficult, given that dizziness is a common symptom [[1]] with a broad differential diagnosis that includes both benign and serious causes. For example, the currently recruiting AVERT (Acute Video-oculography for Vertigo in Emergency Rooms for Rapid Triage) trial is a multicenter, phase II clinical trial comparing standard emergency department care for AVS patients with an algorithm-determined diagnosis based on an automated video-oculographic recording interpretation [[15]]. Even with these caveats, we share the enthusiasm for the increasing role of telemedicine in managing the acutely dizzy patient and recognize that even when the pandemic is over, there will be no going back to the old model of always seeing the patient in the hospital or office. [Extracted from the article]

Purpose: Trabecular bone score (TBS) is a grey-level textural measurement acquired from dual-energy X-ray absorptiometry lumbar spine images and is a validated index of bone microarchitecture. In 2015, a Working Group of the European Society on Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) published a review of the TBS literature, concluding that TBS predicts hip and major osteoporotic fracture, at least partly independent of bone mineral density (BMD) and clinical risk factors. It was also concluded that TBS is potentially amenable to change as a result of pharmacological therapy. Further evidence on the utility of TBS has since accumulated in both primary and secondary osteoporosis, and the introduction of FRAX and BMD T-score adjustment for TBS has accelerated adoption. This position paper therefore presents a review of the updated scientific literature and provides expert consensus statements and corresponding operational guidelines for the use of TBS. Methods: An Expert Working Group was convened by the ESCEO and a systematic review of the evidence undertaken, with defined search strategies for four key topics with respect to the potential use of TBS: (1) fracture prediction in men and women; (2) initiating and monitoring treatment in postmenopausal osteoporosis; (3) fracture prediction in secondary osteoporosis; and (4) treatment monitoring in secondary osteoporosis. Statements to guide the clinical use of TBS were derived from the review and graded by consensus using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Results: A total of 96 articles were reviewed and included data on the use of TBS for fracture prediction in men and women, from over 20 countries. The updated evidence shows that TBS enhances fracture risk prediction in both primary and secondary osteoporosis, and can, when taken with BMD and clinical risk factors, inform treatment initiation and the choice of antiosteoporosis treatment. Evidence also indicates that TBS provides useful adjunctive information in monitoring treatment with long-term denosumab and anabolic agents. All expert consensus statements were voted as strongly recommended. Conclusion: The addition of TBS assessment to FRAX and/or BMD enhances fracture risk prediction in primary and secondary osteoporosis, adding useful information for treatment decision-making and monitoring. The expert consensus statements provided in this paper can be used to guide the integration of TBS in clinical practice for the assessment and management of osteoporosis. An example of an operational approach is provided in the appendix. Summary: This position paper presents an up-to-date review of the evidence base, synthesised through expert consensus statements, which informs the implementation of Trabecular Bone Score in clinical practice. [ABSTRACT FROM AUTHOR]

Purpose - to ensure the food security of Kazakhstan, domestic sugar industry should aim at a significant reduction in import dependence and transition to self-sufficiency. The share of domestic sugar from sugar beet in Kazakhstan is 7%. Design/methodology/approach - review indicating the main problems in the sugar beet production in Kazakhstan for the purpose of reimagining the domestic sugar beet industry to reduce dependence on sugar import. We analyzed the dynamics of sugar beet cultivation in Kazakhstan over the past 20 years and detected a sharp reduction in the sugar beet production. Findings - we have identified 10 problems in sugar beet production in Kazakhstan and determined the necessary targeted solutions. We consider the main direction to be the development of scientific methodology for sugar beet production (breeding of new highly productive disease-resistant cultivars, improvement of sugar beet protection system, efficient crop rotation). The most notable problems included in this paper are small-scale marketability of sugar beet farms, infectious diseases of sugar beet, water supply shortages, use of outdated agricultural technologies, high cost of imported sugar beet seeds. Originality/value - The present paper includes a full analysis of current problems in sugar beet production in Kazakhstan. [ABSTRACT FROM AUTHOR]

The α and β thalassaemias are the commonest genetic disorders worldwide. The homozygous state is associated with high morbidity and mortality, thus screening of at-risk pregnancies and prenatal testing are strongly advocated. A thalassaemia (thal) array has been designed using allele-specific arrayed primer extension (AS-APEX) for the simultaneous analysis of 15 non-deletion α-gene defects and 23 β-gene mutations commonly found in southeast Asian countries, where thalassaemias are highly prevalent. This overcomes the problem of using multiple reverse dot blot analysis. The array showed 100% sensitivity and specificity in the detection of 120 β-thal mutants and 35 non-deletion α-thal mutants. It is robust enough to be produced in a single place and shipped to other laboratories for use. The production cost of the array is low, each slide can be used for three different test samples and is therefore amenable to large scale antenatal screening in southeast Asian countries. [ABSTRACT FROM AUTHOR]

Declares that the striking similarities in the leukemias in both atomic bomb survivors and in therapy patients indicate that a significant portion of the atomic bomb survivor leukemias described by M. Nakanishi et al. were indeed induced. Microsatellite and genetic instability in acute myeloid leukemias; Need for mathematical models and statistical analyses to test experimental data.

The endoplasmic reticulum (ER) is the largest membrane system in eukaryotic cells and is the primary site for the biosynthesis of lipids and carbohydrates, as well as for the folding, assembly, modification, and transport of secreted and integrated membrane proteins. The ER membrane complex (EMC) on the ER membrane is an ER multiprotein complex that affects the quality control of membrane proteins, which is abundant and widely preserved. Its disruption has been found to affect a wide range of processes, including protein and lipid synthesis, organelle communication, endoplasmic reticulum stress, and viral maturation, and may lead to neurodevelopmental disorders and cancer. Therefore, EMC has attracted the attention of many scholars and become a hot field. In this paper, we summarized the main contributions of the research of EMC in the past nearly 15 years, and reviewed the structure and function of EMC as well as its related diseases. We hope this review will promote further progress of research on EMC. [ABSTRACT FROM AUTHOR]