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The Priorat and Montsant Appellations of Origin are considered to produce some of the finest wines in the Mediterranean area of Spain. Located in the south of Catalonia (North-East Spain), they account for close to 4000 ha cultivated by more than 1300 vine growers under severe Mediterranean climatic conditions and hence threatened by global warming. In this context, sustainable practices are needed for the optimal use of natural resources in order to ensure the durability of high-quality wine production in the region. In addition, these practices allow this region to maintain high levels of biodiversity, a major characteristic of Priorat and Montsant's agricultural landscape, which represents an important touristic attraction. The Project LIFE Priorant+Montsant, funded by the European Union, proposed the implementation of sustainable practices at a regional scale, in order to achieve remarkable reductions of resource consumption in three axes: 1) Irrigation water management, 2) vine fertilization and 3) synthetic pesticide use. Reductions are achieved by providing the necessary technical support to growers to adopt practices, developing optimized strategies and evaluating the viticulture and winery production processes. After the two first seasons of the project, 2017 and 2018, the objectives of reduction of resources consumption have been successfully achieved. A total of 53 vineyard plots, representing the main grape varieties in the region (Grenache, Carignan, Cabernet Sauvignon and Syrah) were classified in eight sub-areas and monitored for water consumption. From pea-size to harvest (phenological stages), weekly measurements of phenology, water potential and meteorological data were collected. Irrigation recommendations were then given to growers, to avoid water potential below − 1.4 MPa. Overall, more than 50 irrigation recommendations were emitted to growers. The water consumption with the optimized irrigation strategy ranged from 10 to 63 litres per ha, the recommended dose saved 20 to 87% of the irrigation water per year, according to previous general recommendations in this region. Regarding fertilization, soil samples were provided by growers and leave samples were taken from vineyards to assess nutrient levels and develop the corresponding recommendation of fertilization, depending on the analysis results. The analyzed soil samples from the different sub-areas were grouped by the Principal Component Analysis, in which the first and second principal components accounted for 31.6% and 11.8% of the variability and were related to soil texture and nutrient content of soils, respectively. Overall, the recommended doses of organic fertilizers saved more than 20% of the usual chemical fertilizer application in the region. The reduction of pesticide use will be achieved through three actions related to three main pests and diseases of grapevine: optimized formulations against powdery mildew, alternative products to reduce copper use against downy mildew and, increase of surface under mating disruption strategy against grape berry moth Lobesia botrana. Before implementing these actions, no vineyards were managed under mating disruption in the Montsant area and 207 ha have been monitored in 2018 after two years. In the Priorat area, more than 200 ha have also adopted this strategy during the project. This action has saved more than 500 application doses of synthetic insecticides in those vineyards. Within the same scope, several formulations will be proved in the following years in order to assess their effectiveness against powdery and downy mildew in further specific field trials. Candidate products will be introduced in Integrated Pest Management strategies to achieve the desired pesticide reduction levels. The results will represent specific regional strategies for irrigation, fertilization and plant protection, and are extensible to most of the vineyards in Priorat and Montsant, as well as to other vitivinicultural regions which similar conditions. Keywords: Sustainable management, Irrigation, Fertilisation, Pesticides, Priorat-Montsant.

The reliability of two commonly used methods of seal-ability testing, dye leakage under normal atmospheric pressure and dye leakage in a partial vacuum, was tested using a repeated studies design. Forty extracted teeth were instrumented and obturated using lateral condensation of gutta-percha and Sealapex™ sealer. One-half of the teeth were placed in India ink under normal atmospheric pressure and the other half underwent air evacuation before immersion in the ink. After 24 h the teeth were removed from the ink and rendered transparent for linear leakage analysis. A second study, repeated within the exact parameters of the first, was performed approximately 1 month later. Mann-Whitney U tests indicated that there was no significant difference (P>0.05) between the air and vacuum groups or within each group (air or vacuum) between trials, indicating that the methodology is repeatable and that application of reduced air pressure did not enhance reliability. A large majority of the teeth placed under partial vacuum showed evidence of vacuum-induced artefacts that may negate the value of vacuum as a research tool. [ABSTRACT FROM AUTHOR]

There is considerable amount of data on arousal neurons whereas there is a paucity of knowledge regarding neurons that make us fall asleep. Indeed, current network models of sleep-wake regulation list many arousal neuronal populations compared to only one sleep group located in the preoptic area. There are neurons outside the preoptic area that are active during sleep, but they have never been selectively manipulated. Indeed, none of the sleep-active neurons have been selectively stimulated. To close this knowledge gap we used optogenetics to selectively manipulate neurons containing melanin concentrating hormone (MCH). The MCH neurons are located in the posterior hypothalamus intermingled with the orexin arousal neurons. Our data indicated that optogenetic stimulation of MCH neurons in wildtype mice (J Neuroscience, 2013) robustly increased both non-REM and REM sleep. MCH neuron stimulation increased sleep during the animal’s normal active period, which is compelling evidence that stimulation of MCH neurons has a powerful effect in counteracting the strong arousal signal from all of the arousal neurons. The MCH neurons represent the only group of sleep-active neurons that when selectively stimulated induce sleep. From a translational perspective this is potentially useful in sleep disorders, such as insomnia, where sleep needs to be triggered against a strong arousal drive. Our studies indicate that the MCH neurons belong within an overall model of sleep-wake regulation.

Arid soils present unique challenges and opportunities for studying microbial diversity and bioactive potential due to the extreme environmental conditions they bear. This review article investigates soil metagenomics as an emerging tool to explore complex microbial dynamics and unexplored bioactive potential in harsh environments. Utilizing advanced metagenomic techniques, diverse microbial populations that grow under extreme conditions such as high temperatures, salinity, high pH levels, and exposure to metals and radiation can be studied. The use of extremophiles to discover novel natural products and biocatalysts emphasizes the role of functional metagenomics in identifying enzymes and secondary metabolites for industrial and pharmaceutical purposes. Metagenomic sequencing uncovers a complex network of microbial diversity, offering significant potential for discovering new bioactive compounds. Functional metagenomics, connecting taxonomic diversity to genetic capabilities, provides a pathway to identify microbes' mechanisms to synthesize valuable secondary metabolites and other bioactive substances. Contrary to the common perception of desert soil as barren land, the metagenomic analysis reveals a rich diversity of life forms adept at extreme survival. It provides valuable findings into their resilience and potential applications in biotechnology. Moreover, the challenges associated with metagenomics in arid soils, such as low microbial biomass, high DNA degradation rates, and DNA extraction inhibitors and strategies to overcome these issues, outline the latest advancements in extraction methods, high-throughput sequencing, and bioinformatics. The importance of metagenomics for investigating diverse environments opens the way for future research to develop sustainable solutions in agriculture, industry, and medicine. Extensive studies are necessary to utilize the full potential of these powerful microbial communities. This research will significantly improve our understanding of microbial ecology and biotechnology in arid environments., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Paediatric cardiovascular diseases have been referred to as diseases of injustice as access to care is inequitable globally. For example, Africa only has 78 cardiac centres, with 22 located in Sub-Saharan Africa. Most of these centres rely on visiting surgical teams to provide clinical care. While visiting surgical teams provide essential care, building a sustainable and locally run cardiac workforce in Africa is critical to addressing these inequities in access to care. This paper considers the role of south-to-south partnerships in building sustainable surgical programmes using Rwanda's paediatric cardiac surgery programme as an example., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

In this paper, we explore the critical barriers that persons with disabilities face in accessing HIV services in the Eastern and Southern Africa (ESA) region, despite significant advancements in overall accessibility. We highlight the intersectional challenges experienced by individuals with disabilities, particularly women, and outline a comprehensive approach to bridge the existing gaps in policy and programmatic efforts. Specifically, we aim to address the exclusion of persons with disabilities from essential HIV prevention, treatment, and care services, a situation that has profound implications for their health, social inclusion, and economic productivity. In this discussion, we examine the current landscape, identify specific policy and programmatic hurdles, and propose targeted reforms, in an effort to contribute to the ongoing discourse on health equity and inclusivity., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)

Background: Temporomandibular disorders (TMDs) are a frequent cause of orofacial pain, causing functional disability and a negative impact on quality of life. Botulinum toxin (BTX-A) injection in lateral pterygoid muscle (LPM) is one of the treatment modalities proposed, but the blind puncture guided by EMG carries a risk of vascular puncture or diffusion of the toxin to nearby muscles. We describe an ultrasound-guided approach and evaluate the spread of the injection in a fresh human cadaver., Methods: A fresh human cadaver was injected. An out-of-plane approach was performed using a convex probe, injecting 1.0 ml of 0.25% methylene blue dye into the LPM. After, a dissection was performed to isolate the lateral pterygoid muscle and assess the spread of the dye., Results: Ultrasound-guided injection allowed to visualize in real-time the spread of the dye within the LPM. The deep and superficial muscles nearby to LPM were not stained by the dye, but upper and lower head of LPM was heavily stained., Conclusion: Ultrasound-guided approach for the injection of BTX-A into the LPM could be considered a successful and safe treatment for myofascial pain related to TMD. Therefore, further clinical studies are needed to study the reproducibility of ultrasound guided LPM injection and to evaluate the clinical results., Competing Interests: Declaration of Competing Interest Authors disclose any financial and personal relationships with other people or organizations that could inappropriately influence the work., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Living in diverse environmentally harsh conditions, the plant exhibits a unique survival mechanism. As a result, the endophytes residing within the plant produce specific compounds that promote the plant's growth and defend it against pathogens. Plants and algae symbiotically harbor endophytes, i.e., microbes and microorganisms living within them. The objective of this study is to isolate endophytic fungi, specifically strains of Aspergillus terreus, from the leaves of the salt-tolerant plant Tetraena qatarensis and to explore the salt tolerance, antagonistic activity, and growth promotion properties. Strain C A. terreus (ON117337.1) was screened for salt tolerance and antagonistic effects. Regarding salt tolerance, the isolate demonstrated the ability to thrive in a concentration of up to 10% NaCl. A. terreus showed inhibitory activity against four fungal phytopathogens, namely Fusarium oxysporum, Alternaria alternata , Colletotrichum gloeosporioides, and Botrytis cinerea. The GC-MS investigation of the fungal (strain C Aspergillus terreus ) extract showed the presence of about 66 compounds (secondary metabolites). Secondary metabolites (SMs) are produced, like Hexadecanoic acid, which aids in controlling phytopathogens. Also produced is lovastatin, which is used to treat hypercholesterolemia. Strain C, which showed salinity tolerance and the highest inhibitory activity, was further analyzed for its effect on tomato seed germination under pathogen stress from Fusarium oxysporum . The greenhouse experiment indicated that the fungi increased the length of tomato seedlings and the plant biomass. Therefore, the selected endophytes derived from Tetraena qatarensis were scrutinized for their potential as biocontrol agents, aiming to thwart fungal pathogens and stimulate plant growth. The in vitro and in vivo assessments of strain C ( Aspergillus terreus ) against Fusarium oxysporum in this investigation indicate the promising role of endophytes as effective biological control agents. Investigating novel bio-products offers a sustainable approach to agriculture, gradually reducing dependence on chemical fungicides.

Background: Current literature and practice have demonstrated that pharmacists have an integral role in deprescribing. However, research regarding their impact on patients with chronic diseases is limited. Objective: To assess the impact of a pharmacist-led intervention on deprescribing inappropriate medication for patients with chronic diseases within a four-month study period compared to patients receiving usual care. Methods: This study was conducted at NYU Langone Health. Patients of the intervention group were referred by a provider and met the criteria of polypharmacy, required chronic disease states management, were nonadherent to medications, had poor health literacy, or required titration for heart failure (HF) guideline directed medical therapy. Results: A total of 142 patients were reviewed over a two-year period. At the end of the study period, the median number of medications for the two respective groups was similar (11 [4 - 30] vs 11 [2 - 23]). The pharmacist-led intervention had on average one medication deprescribed (m = -1.00, sd = 2.57), whereas the control group had on average .44 additional medications (m = 0.44, sd = 3.32) prescribed. Furthermore, the intervention group presented statistically significant differences (P = 0.046) regarding their diastolic blood pressure after the pharmacists' intervention (m = 72.69, sd = 11.64). Most importantly, patients with HF presented statistically significant improvement in their ejection fractions after the intervention (m = 41.46%, sd = 19.28%). Conclusion: The pharmacist-led intervention resulted in significant discontinuation of medications for patients in the intervention group compared to those in the usual care group within four-months.

Background: Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death in the United States. Case-based learning using electronic delivery of the modules can educate clinicians and improve translation of evidence-based guidelines into practice for high-risk ASCVD patients., Objective: To develop and optimize module design, content, and usability of e-learning modules to teach clinicians evidence-based management in accordance with multi-society guidelines for high-risk ASCVD patients that will be implemented and evaluated in U.S. health systems in the TEACH-ASCVD study., Methods: Seven e-learning modules were created by a committee of lipid experts. Focus groups were conducted with lipid experts to elicit feedback on case content followed by interviews with a target audience of clinicians to assess usability of the online module platform. Responses from both groups were evaluated, and appropriate changes were made to improve the e-learning modules. Design of the TEACH-ASCVD study is presented., Results: Feedback regarding case content by lipid experts included providing more detailed patient histories, clarifying various diagnostic criteria, and emphasizing clinical best practices based on evidence-based guidelines. The target audience clinician group reported an agreeable experience with the e-learning modules but noted a discordance between the evidence-based guidelines and clinical decision-making in their own practices. Participants felt the modules would help educate clinicians in managing high-risk ASCVD patients., Conclusion: Clinicians must be informed of best practices as the field of lipidology continues to evolve. E-learning modules provide a concise, valuable, and accessible mechanism for educating clinicians regarding changes in the field to deliver the best patient care., (Copyright © 2023 National Lipid Association. Published by Elsevier Inc. All rights reserved.)

Background: Gender-based violence (GBV) has been shown to have significant and long-lasting impacts on women's physical and mental health. It is, therefore, important to study its occurrence in a population and its intersect with infectious diseases such as HIV to inform the wider health promotion agenda. This study aimed to determine the association between GBV and HIV status in women and adolescent girls in Zimbabwe., Methods: A secondary data analysis of data from a cross-sectional Zimbabwe Demographic and Health Survey (ZDHS) was conducted. Statistical analysis was employed to establish the association between GBV and HIV status. Geospatial mapping was conducted using a kernel smoothing method was employed to generate a continuous kernel density surface to illustrate the local spatial variations of female HIV and GBV prevalence., Results: Women and adolescent girls suffering emotional GBV, such as those subjected to humiliation by their husbands or partners, were 1.45 (1.14-1.84) [OR (95% CIs)] times more likely to be HIV positive than those who were never humiliated. The same was true for women and adolescent girls whose husbands or partners threatened to harm them or someone they love, 1.33 (1.04-1.68). There is a relationship between women's HIV status and intimate partner aggression, such as when their partners pushed, shook, or threw something at them or physically abused them. This was also the case for those who reported that partners kicked, dragged, or beat them, tried to choke or burn them on purpose, or threatened or attacked them with a knife, gun, or other weapons. Women who experienced forced sexual violence with threats were more likely 1.61 (1.08-2.41), to be HIV positive than those women who did not experience the same., Conclusion: GBV is widely spread in Zimbabwe. There is a need for the government to implement creative strategies to reach out to survivors, especially those that are forced to have unprotected sex and are at increased risk of HIV acquisition. This manuscript raises issues that can be addressed by robust health promotion strategies to reduce the impact of the syndemic of GBV and HIV acquisition in Zimbabwe., Competing Interests: All authors declare that they have no competing interests., (© 2023 The Author(s).)

This study investigates the effect of ions released from S-PRG fillers on host-derived enzymatic degradation of dentin collagen matrices. Dentin beams (n=80) were demineralized and distributed to eight groups following baseline dry mass and total MMP activity assessments. Each group treated with boron, fluoride, sodium, silicone, strontium, aluminium, or S-PRG eluate solutions for 5 min. Untreated beams served as control. After pre-treatment, MMP activity was reassessed, beams were incubated in complete medium for 1 week, dry mass was reassessed. Incubation media were analyzed for MMP and cathepsin-K-mediated degradation fragments. Data were analyzed with ANOVA and Tukey's test. All pretreatment groups showed significant reduction in total MMP activity (p<0.05) that was sustainable after incubation in all groups except for boron and silicone groups (p<0.05). Cathepsin-K activity did not differ between control or treatment groups. The results indicated that ions released from S-PRG fillers have the potential to partly inhibit MMP-mediated endogenous enzymatic activity.

Cariogenic biofilms produce strong acidic microenvironments, which is the primary cause of dental caries. Streptococcus mutans is a dominant species in cariogenic biofilms. Herein, we report a pH-responsive, charge-switching smart copolymer to selectively target and eradicate bacteria in cariogenic biofilms. To that end, the copolymer is designed to be activated in an acidic environment. The smart copolymer, Poly-1A, consists of ternary compositions of monomers with a cationic ethyl ammonium group, a carboxylic group, and a hydrophobic group in the side chains. The net charge of Poly-1A was charge neutral at neutral pH, but it switched to be cationic because the acidic carboxylate side chains were protonated and became neutral; however, the ammonium groups remained positive. Poly-1A with a net positive charge bound to the anionic surface of oral bacteria by electrostatic interactions and disrupted the bacterial membranes, causing bacterial death. Poly-1A reduced the cell viability of planktonic and biofilm S. mutans at pH 4.5, while it was not bactericidal at pH 7.4. Poly-1A did not reduce the cell viability of human gingival fibroblasts and periodontal ligament stem cells for a 1 h incubation.

Objectives: To study phytic acid (IP6) effect on collagen solubilization by assessing hydroxyproline (HYP) release, evaluate its binding to demineralized (DD) and mineralized dentin (MD) and determine the effect of different media on debinding of IP6., Methods: Demineralized dentin beams were incubated in 1%, 2% or 3% IP6 and HYP release was evaluated at 1 or 3 weeks and compared to those obtained in untreated control or phosphoric acid (PA)-treated beams. DD or MD powder was treated with 1%, 2% or 3% IP6 and the decrease in IP6 amount was quantitated by ultraviolet-visible spectroscopy. IP6-treated samples were re-suspended in distilled water, ethanol, urea or sodium chloride and the amount of IP6 displaced was determined., Results: At 1 week, the control group and IP6 showed lower HYP release when compared to PA (P < 0.05). There was no difference among PA, IP6 and control at 3 weeks (P = 0.22). IP6 binding was concentration dependent. 1% IP6 had higher binding potential with MD compared to DD while 2% IP6 showed the opposite result (P<0.05). 3% IP6 had similar binding values between DD and MD (P = 0.53). The highest debinding in MD occurred with urea for 2%, 3% and 1% IP6 in descending manner. Within each concentration of IP6 in DD, the highest debinding effect was reported with ethanol., Conclusions: IP6 bound to DD and MD in a concentration-dependent manner. IP6 was debound from DD mostly by the action of ethanol, while in MD, urea caused the most displacement. Collagen solubilization of IP6-treated DD was comparable to untreated DD., Clinical Significance: These findings add to the potential use of IP6 as an alternative to PA for dentin etching which possibly results in long-term stability of resin-dentin adhesion., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

This paper draws on research with a group of Zimbabwean orphaned young people. It explores their experiences of migrating to South Africa during the COVID-19 period when official borders were closed. It draws attention to the complexities of south-south migration in the era of COVID-19 in a way that situates the orphaned child migrants as having contradictory, fluid identities that are simultaneously victimised, agentic and infinitely more complex than the dominant binary representation of adult/child., (© 2022 The Authors. Children & Society published by National Children's Bureau and John Wiley & Sons Ltd.)

HIV and AIDS continue to be major public health concerns globally. Despite significant progress in addressing their impact on the general population and achieving epidemic control, there is a need to improve HIV testing, particularly among men who have sex with men (MSM). This study applied deep and machine learning algorithms such as recurrent neural networks (RNNs), the bagging classifier, gradient boosting classifier, support vector machines, and Naïve Bayes classifier to predict HIV status among MSM using the dataset from the Zimbabwe Ministry of Health and Child Care. RNNs performed better than the bagging classifier, gradient boosting classifier, support vector machines, and Gaussian Naïve Bayes classifier in predicting HIV status. RNNs recorded a high prediction accuracy of 0.98 as compared to the Gaussian Naïve Bayes classifier (0.84), bagging classifier (0.91), support vector machine (0.91), and gradient boosting classifier (0.91). In addition, RNNs achieved a high precision of 0.98 for predicting both HIV-positive and -negative cases, a recall of 1.00 for HIV-negative cases and 0.94 for HIV-positive cases, and an F1-score of 0.99 for HIV-negative cases and 0.96 for positive cases. HIV status prediction models can significantly improve early HIV screening and assist healthcare professionals in effectively providing healthcare services to the MSM community. The results show that integrating HIV status prediction models into clinical software systems can complement indicator condition-guided HIV testing strategies and identify individuals that may require healthcare services, particularly for hard-to-reach vulnerable populations like MSM. Future studies are necessary to optimize machine learning models further to integrate them into primary care. The significance of this manuscript is that it presents results from a study population where very little information is available in Zimbabwe due to the criminalization of MSM activities in the country. For this reason, MSM tends to be a hidden sector of the population, frequently harassed and arrested. In almost all communities in Zimbabwe, MSM issues have remained taboo, and stigma exists in all sectors of society.

Despite the development of new therapies to lower cardiovascular disease (CVD) risk in recent decades, the trend of reductions in CVD mortality has reversed. New therapies are essential for the prevention of first and recurrent CVD. The importance of lowering low-density lipoprotein cholesterol (LDL-C) in the management and prevention of atherosclerotic CVD (ASCVD) is widely reflected in clinical treatment guidelines; however, most patients with established ASCVD do not achieve guideline-recommended LDL-C targets. Common reasons include adherence challenges, public disinformation, statin tolerability issues, access barriers, and clinical inertia. Inclisiran is a novel small interfering ribonucleic acid (RNA) that lowers circulating LDL-C by ∼50% when added to maximally tolerated statins by mimicking the body's natural pathway of RNA interference to specifically prevent proprotein convertase subtilisin/kexin type 9 synthesis. The unique dosing regimen of inclisiran (initial, at 3 months, and then every 6 months) has the advantage of allowing for healthcare provider administration during recommended routine visits for patients with established ASCVD, which can circumvent adherence issues associated with currently available LDL-C-lowering therapies. Inclisiran has demonstrated favorable tolerability and safety for up to 3 years, and evidence from longer-term use is accumulating in ongoing studies. This review discusses the novel mechanism of action of inclisiran and its potential position in the clinical armamentarium., Competing Interests: Declaration of Competing Interest R.S. is an employee of Novartis Pharmaceuticals Corporation. D.S. is a consultant for Akcea Therapeutics and Novartis Pharmaceuticals Corporation, and a clinical trial investigator for Ionis, Amgen, AstraZeneca, Novartis, Regeneron, and REGENXBIO. R.P. has nothing to disclose., (Copyright © 2022. Published by Elsevier Inc.)

Health care workers (HCWs) are more than ten times more likely to be infected with coronavirus infectious disease 2019 (COVID-19) than the general population, thus demonstrating the burden of COVID-19 among HCWs. Factors that expose HCWs to a differentially high-risk of COVID-19 acquisition are important to elucidate, enable appropriate public health interventions to mitigate against high risk and reduce adverse outcomes from the infection. We conducted a systematic review and meta-analysis to summarize and critically analyze the existing evidence on SARS-CoV-2 risk factors among HCWs. With no geographical limitation, we included studies, in any country, that reported (i) the PCR laboratory diagnosis of COVID-19 as an independent variable (ii) one or more COVID-19 risk factors among HCWs with risk estimates (relative risk, odds ratio, or hazard ratio) (iii) original, quantitative study design, and published in English or Mandarian. Our initial search resulted in 470 articles overall, however, only 10 studies met the inclusion criteria for this review. Out of the 10 studies included in the review, inadequate/lack of protective personal equipment, performing tracheal intubation, and gender were the most common risk factors of COVID-19. Based on the random effects adjusted pooled relative risk, HCWs who reported the use of protective personal equipment were 29% (95% CI: 16% to 41%) less likely to test positive for COVID-19. The study also revealed that HCWs who performed tracheal intubations were 34% (95% CI: 14% to 57%) more likely to test positive for COVID-19. Interestingly, this study showed that female HCWs are at 11% higher risk (RR 1.11 95% CI 1.01-1.21) of COVID-19 than their male counterparts. This article presents initial findings from a living systematic review and meta-analysis, therefore, did not yield many studies; however, it revealed a significant insight into better understanding COVID-19 risk factors among HCWs; insights important for devising preventive strategies that protect them from this infection., Prospero Registration Number: CRD42020193508 available for public comments via the link below https://www.crd.york.ac.uk/prospero/display&#95;record.php?ID=CRD42020193508)., Competing Interests: All authors have no conflict of interest to declare., (© 2022 Occupational Safety and Health Research Institute.)

Objective: To determine whether smear layer management, via conservative etching protocols, and the hydrophobic-rich content of hybrid layers would affect the fatigue strength of resin-dentin interfaces., Methods: Bar-shaped dentin beams obtained from sound third molars were wet-polished for 30 s. Dentin was etched with 32 % ortho-phosphoric acid for 3 or 15 s, 10 % meta-phosphoric acid for 15 s or by a prime-and-rinse application using a mild universal adhesive (Scotchbond Universal, 3M ESPE). Self-etch application served as control. Coating was performed with a solvent-free bisGMA-based resin. Composite buildups were made with a nanofilled composite. Resin-dentin beams with twin-bonded interfaces were sectioned and stored in deionized water for 24 h at 37 ℃ before 4-point flexural quasi-static monotonic testing (n = 16). Stress-life fatigue behavior was evaluated under cyclic loading (n = 35) by the staircase method at 4 Hz. The tension side of cyclic-loaded unfractured beams were evaluated under SEM, along with the micro-morphology of etched dentin surfaces. Monotonic data was analyzed by two-way ANOVA followed by the Tukey Test and cyclic-loaded data by Kruskal-Wallis on Ranks (α = 0.05)., Results: Etching protocols and higher hydrophobic-rich content produced significantly higher fatigue life distributions (p < 0.05). Dentin demineralization was ranked as OPA 15 s > MPA 15 s > OPA 3 s > P + R > SE. Less aggressive etching and coating reduced crack formation at hybrid layers., Significance: Current oversimplification trends in resin-dentin bonding constitute a trade-off between hybridization quality and easier adhesive handling. Controlled dentin etching and increasing the hydrophobic-rich content of hybrid layers may be necessary to extend the longevity of mild universal adhesives., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Combination of insulin and GLP-1RAs have shown reductions in the HbA1c, body weight, and the risk of hypoglycemia. To date, there are conflicting data regarding the effect of GLP-1RAs on insulin dosage(s)., Objective: The objective of this study was to evaluate adjustments of insulin doses upon initiation of GLP-1RAs., Methods: This was a retrospective chart review of patients on insulin therapy initiated on GLP-1RAs at NYU Langone Health. Patients were included in the study if they were at least 18 years of age, history of type 2 diabetes, and were on concurrent basal or mixed insulin therapy. 45 patients met inclusion criteria and were included in the study analysis. The primary endpoint was the median change in overall basal insulin doses. Secondary endpoints included median changes in total basal, mixed, and bolus insulin doses, oral antidiabetic medications and GLP-1RA doses, HbA1c, body weight, fasting glucose, and creatinine clearance. Safety results included any adverse reactions to insulin and/or GLP-1RA., Results: In the per-protocol analysis, there was a significant reduction in overall total basal insulin doses from baseline to week 24 (50 units vs. 44 units, p < 0.05). There was a median reduction in patients receiving glargine (50 units vs. 44 units) and detemir (29 units vs. 21.5 units)., Conclusions: Use of GLP-1RAs after 24 weeks resulted in a statistically significant reduction in overall total basal insulin dosages from baseline. The median HbA1C in our patient population was >8%. Consider a ≥10% reduction in the overall basal insulin dose upon initiation of GLP-1RA in patients with a HbA1C >8%.

Fungal infections in cereals lead to huge economic losses in the food and agriculture industries. This study was designed to investigate the occurrence of toxigenic fungi and their mycotoxins in marketed cereals and explore the effect of the antagonistic yeast Cyberlindnera jadinii volatiles against key toxigenic fungal strains. Aspergillus spp. were the most frequent contaminating fungi in the cereals, with an isolation frequency (Fr) of 100% in maize, followed by wheat (88.23%), rice (78.57%) and oats (14.28%). Morphological and molecular identification confirmed the presence of key toxigenic fungal strains in cereal samples, including A. carbonarius , A. flavus , A. niger , A. ochraceus and A. parasiticus . Aflatoxins (AFs) were detected in all types of tested cereal samples, with a significantly higher level in maize compared to wheat, rice, oats and breakfast cereals. Ochratoxin A (OTA) was only detected in wheat, rice and maize samples. Levels of mycotoxins in cereals were within EU permissible limits. The volatiles of Cyberlindnera jadinii significantly inhibited the growth of A. parasiticus , A. niger and P. verrucosum . The findings of this study confirm the presence of toxigenic fungi and mycotoxins in cereals within the EU permissible limits and the significant biocontrol ability of Cyberlindnera jadinii against these toxigenic fungi.

In this article, the authors discuss the problem of high prevalences of active syphilis amongst key populations (KPs) in Zimbabwe, in combination with low testing rates, partly because of a difficult legal and social environment for these populations. The article highlights the need to develop strategies to address the high prevalence of syphilis amongst KPs. The authors discuss requirements for addressing deficits in existing clinical services, predominantly primary care settings, in providing primary healthcare, including sexually transmitted infection (STI) management, to Zimbabwe's KP communities and utility of point-of-care testing and self-testing and other innovations to improve testing uptake., Competing Interests: The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article., (© 2022. The Authors.)