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Should healthcare professionals use the term ‘patient’? A patient is a social construct, in a biomedical model, in which each actor has their role to play. This model has been criticised as belonging to an era of medical hegemony and (mis)represents an individual seeking healthcare as one who is simply a passive participant and recipient of care. The ‘Language Matters’ campaign, for people living with diabetes, has sought to address the role of language in interactions between healthcare providers. A key point raised in the campaign is whether someone who feels well, but has ongoing healthcare input, should be referred to as a patient? In this article, we address the concept of a patient and how its use can belie a particular mindset (or ‘discourse’) in which power is established in a relationship and can lead to individuals being defined by their condition. However, for some linguistic communities (such as nurses and doctors), a patient may be considered less as one over whom they have dominion, but rather someone for whom they have specific responsibilities and duty of care. Drawing upon the philosophical theories of language—that the meaning and inference of a word is dependent on its use—we argue that the context in which use of the term patient occurs is crucial. Without more fundamental cultural disruption of the biomedical model, word substitution, in itself, will not change perception.

The presence of infective larvae (L3) of gastrointestinal nematode (GIN) parasites in pastures directly contributes to the constant recurrence of infections in ruminant herds. This study aimed to evaluate the nematophagous fungus Duddingtonia flagrans (AC001) (proteolytic crude extract and/or conidia) in the in vitro control of GIN L3 in coprocultures. To produce the proteolytic crude extract, a suspension (107 conidia/mL) of D. flagrans was inoculated into a liquid medium. After 6 days, the medium was filtered, centrifuged, and its proteolytic activity was measured. For the experimental assay, fecal samples were collected directly from the rectal ampulla of naturally infected sheep, and egg counts per gram of feces (EPG) were performed. Coprocultures were prepared using 10 g of fecal material with the groups defined as follows: control group G1 (1.0 mL of denatured proteolytic crude extract); treated group G2 (1.0 mL of active proteolytic crude extract); treated group G3 (1.0 mL of active proteolytic crude extract + 1.0 mL of AC001 conidia). The coprocultures were maintained at room temperature (25ºC), for 7 days, and then the L3 larvae were recovered. The results demonstrated that AC001 successfully produced protease (56.34 U/mL). The treatments with active proteolytic crude extract (G2) and active proteolytic crude extract + AC001 conidia (G3) were significantly different (p < 0.01) from the control group with denatured proteolytic crude extract (G1). AC001 and its proteolytic crude extract acted concomitantly on helminths directly in the fecal environment, suggesting potential future applications in the field. [ABSTRACT FROM AUTHOR]

Purpose: Spinal cord injury (SCI) is impairment of the spinal cord that adversely affects patients' health and quality of life (QoL). The aim of the study was to assess the quality of life (QoL) and related factors in patients with traumatic spinal cord injury in Middle Eastern countries. Methods: PubMed, Ovid Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EBSCOhost, psycINFO, and Google Scholar were systematically searched for eligible studies published in peer-reviewed journals up till October 2023. Results: Out of 1060 papers found in the literature, only 18 studies from Iran, Lebanon, and Turkey met the inclusion criteria. The majority of the studies employed the SF-36 scale to assess for QoL. In general, all SCI patients had reduced QoL scores when compared to the healthy population. Some of the factors such as age, education level, the level of injury, time since injury onset, marriage, and job opportunities were correlated with SCI subjects QoL. Our papers were assessed and found to be of both good and high quality. Conclusion: This review emphasizes the significant shortage of QoL studies among SCI patients in the Middle East countries and highlights the importance of improving the QoL of this marginalized population. This work should enhance the governments to establish rehabilitation centers, social and economic support systems, and mental health services to diminish complications arising from SCI. [ABSTRACT FROM AUTHOR]

It is well known that elite athletes of specific ethnicities and/or nationalities dominate certain sports disciplines (e.g., East Africans in marathon running). However, we do not know the nationalities of the fastest non-professional IRONMAN triathletes. Therefore, this study intended to identify the fastest athletes by country of origin competing in IRONMAN triathlon events, focusing on non-professional age group triathletes. Data from all IRONMAN age group athletes competing worldwide between 2002 and 2022 in all official IRONMAN races were collected. Sex, age group, country of origin of the athletes, location and year of the event, split times, overall race times, and transition times were obtained. Additionally, the dataset was augmented with specific data (i.e. event characteristics such as temperatures for water and air and course characteristics for all three split disciplines) related to the different race locations. We limited the analysis to the top 150 countries by participation (i.e. countries with at least 13 successful finishers records in the sample). A total of 677,320 records of IRONMAN age group triathletes originating from 150 different countries and participating in 443 races over 65 different locations were analyzed. European countries such as Germany, Austria, Denmark, Belgium, Switzerland, Norway, Czechia, Estonia, and Slovenia have the fastest IRONMAN age group athletes. IRONMAN Hawaii, IRONMAN Vitoria-Gasteiz and IRONMAN Hamburg are the fastest races. Hilly running and cycling race courses led to slower race times, while flat surfaces, rolling cycling and ocean swimming led to faster race times. Optimal water temperatures were found at 23–25 °C and optimal air temperature ranged between 19–21 and 25–28 °C. The fastest IRONMAN age group triathletes from European countries such as Germany, Austria, Denmark, Belgium, Switzerland, Norway, Czechia, Estonia, and Slovenia. With the presented results for optimal air and water temperatures and description of the optimal cycling and running course characteristics, IRONMAN age group athletes might be able to select an IRONMAN race with the best conditions in order to achieve a fast IRONMAN race time. [ABSTRACT FROM AUTHOR]

Haemosporidians, a group of vector-borne parasites that parasitize the blood cells and internal organs of various animal species, are reported to cause severe pathology in raptors. Species belonging to the genera Plasmodium, Haemoproteus and Leucocytozoon are the ones of greatest wildlife importance. The common buzzard (Buteo buteo) and the Eurasian sparrowhawk (Accipiter nisus) are the most numerous raptor species in Europe. Reliable data is lacking for many raptor species in Greece. The aim of this study was to assess, for the first time, the prevalence and geographical distribution of haemosporidian infection (mainly Leucocytozoon and Plasmodium) in these two avian species in Greece, in correlation with the risk factors of age and sex. In total, 62 common buzzards and 26 Eurasian sparrowhawks were included in this study, all being admitted for treatment at a Greek Wildlife Rehabilitation Center. Blood samples were collected and microscopical analysis was performed after staining blood smears with Giemsa. DNA was extracted from each sample and a fraction of the mitochondrial cytochrome b gene was amplified by a nested PCR protocol. All positive samples were subjected to sequencing. Total prevalence of haemosporidian infection by morphological and molecular examination was 59% and 73.9%, respectively. Binary logistic regression was carried out. The most prevalent infection was by Leucocytozoon spp. Most of the samples had mixed infections. The isolated genetic lineages of Leucocytozoon spp. were BUBT2, BUBT3, MILVUS01, ACNI1, BUBO01 and MILANS04. The detected genetic lineages of Plasmodium spp. were TURDUS1, BT7 and DONANA02. A new genetic lineage, BUTBUT17, was also identified. [ABSTRACT FROM AUTHOR]

Evaluating high-throughput soil profile information is essential in safflower precision agriculture, as it facilitates efficient resource management and design of an experiment that promotes sustainable production. We collected soil from representative target environments (TE) of safflower cultivation and evaluated 14 soil physio-chemical features for constructing fine-resolution maps. The robustness, versatility, and predictive ability of two statistical learning models in correctly classifying the soil profile to clusters were tested. Calcium, sand, soil organic carbon, phosphorous, potassium, and sodium were found to be most influential in classifying the representative TE. Random Forest model was found to be the best performing with average prediction accuracy above 85% in all test settings which reached 100% in some. The optimal training population size for prediction was found to be 70–80%. The spatial distribution of sodium in Delhi was found to be aligned with the low yield of safflower emphasizing the importance of fine-resolution soil mapping to design a field experiment and optimize the nutrient supply. Fine-resolution mapping not only enhance soil management strategies but also support government initiatives such as soil health cards, delineation of cultivable land, and risk assessments in crop-growing areas. [ABSTRACT FROM AUTHOR]

In this paper, we deal with the task of identifying the probability of misstatements in the annual financial reports of public companies. In particular, we improve the state-of-the-art for financial misstatement detection by training a TabTransformer model with a gated multi-layer perceptron, which encodes and exploits relationships between financial features. We further calibrate a sample-dependent focal loss function to deal with the severe class imbalance in the data and to focus on positive examples that are hard to distinguish. We evaluate the proposed methodology in a realistic setting that preserves the essential characteristics of the task: (a) the imbalanced distribution of classes in the data, (b) the chronological order of data, and (c) the systematic noise in the labels, due to the delay in manually identifying misstatements. The proposed method achieves state-of-the-art results in this setting, compared to recent approaches in the literature. As an additional contribution, we release the dataset to facilitate further research in the field. [ABSTRACT FROM AUTHOR]

Objective: Patients are often observed overnight after ventricular shunt revision for hydrocephalus. We believe that a same-day discharge after a shunt revision is safe in the appropriate population. The purpose of this study was to determine the appropriate patient population and the safety profile for a same-day discharge following a ventricular shunt revision. Methods: We conducted a retrospective chart review of all shunt revisions at a single center from 2014 to 2021. We compared rates of emergency department visits, hospitalization, and revision at 30 and 90 days between same-day discharge and control patients following shunt revision. Non-parametric, logistic regression, and chi-squared testing were performed to measure statistical significance with and without propensity score matching. Results: A total of 996 patients were examined, with 56 (5.6%) patients being discharged on the same day as the surgery. Patients with a same-day discharge were older, more likely to have distal shunt failure, more likely to have undergone scheduled surgery, and less likely to have visited the emergency department in the prior 30 days. Propensity score matching compared 29 revisions in each group; all covariates were non-significant (p > 0.05), and 30-day and 90-day outcomes were not significantly different the between same-day and non-same day discharge. Conclusions: These findings validate the safety profile for the same-day discharge in post-operative shunt patients and describe our patient cohort’s preferred characteristics. Scheduled, distal shunt failure patients are preferred for early discharge post-operatively. When validated by further studies, this would provide improved patient comfort and decreased healthcare expenses for a shunt failure. [ABSTRACT FROM AUTHOR]

We compared chorioretinal microvascular of Slow Coronary Flow Phenomenon (SCFP) patients using Optical Coherence Tomography Angiography (OCTA) to healthy controls. We recruited 21 patients from September 2023 until January 2024 from two referral centers. We enrolled 21 age-sex-matched controls retrospectively. Patients were referred to obtain OCTA in our outpatient ophthalmology clinic. The OCTA and Enhanced Depth Imaging (EDI) OCT findings were measured. Whole image and perifoveal Vascular Density (VD) of superficial and deep capillary plexuses and Parafoveal VD of superficial layer were diminished in SCFP groups compared to controls (p < 0.05) while both superficial and deep foveal VD and deep parafoveal VD were spared. Sub-Foveal Choroidal Thickness (SFCT) was significantly thinned compared to controls (p < 0.05), while central macular thickness, choroidal vascularity index, and choriocapillaris flow were similar between groups. SFCT was the only independent predictor of SCFP on multivariable regression analysis. Parafoveal superficial VD and SFCT showed the strongest ability to distinguish between SCFP patients and healthy controls (AUC: 0.80, 0.79, respectively). Additionally, whole image and perifoveal VD in both superficial and deep capillary plexus demonstrated at least moderate discriminatory power. We found that decreased retinal microvascular density may serve as a potential biomarker for the diagnosis of SCFP. Additionally, SCFP patients had considerably thinner SFCTs than controls. Parafoveal superficial VD and SFCT showed the highest potential in distinguishing between individuals with SCFP and healthy individuals. SCFP is likely linked to anomalies in the small blood vessels of the retina and choroid. However, further studies are needed to confirm this association and to control for the potential confounding effects of diabetes and hypertension. [ABSTRACT FROM AUTHOR]

Immune checkpoint inhibitor (ICI) treatment has proven successful for advanced melanoma, but is associated with potentially severe toxicity and high costs. Accurate biomarkers for response are lacking. The present work is the first to investigate the value of deep learning on CT imaging of metastatic lesions for predicting ICI treatment outcomes in advanced melanoma. Adult patients that were treated with ICI for advanced melanoma were retrospectively identified from ten participating centers. A deep learning model (DLM) was trained on volumes of lesions on baseline CT to predict clinical benefit. The DLM was compared to and combined with a model of known clinical predictors (presence of liver and brain metastasis, level of lactate dehydrogenase, performance status and number of affected organs). A total of 730 eligible patients with 2722 lesions were included. The DLM reached an area under the receiver operating characteristic (AUROC) of 0.607 [95%CI 0.565–0.648]. In comparison, a model of clinical predictors reached an AUROC of 0.635 [95%CI 0.59 –0.678]. The combination model reached an AUROC of 0.635 [95% CI 0.595–0.676]. Differences in AUROC were not statistically significant. The output of the DLM was significantly correlated with four of the five input variables of the clinical model. The DLM reached a statistically significant discriminative value, but was unable to improve over known clinical predictors. The present work shows that the assessment over known clinical predictors is an essential step for imaging-based prediction and brings important nuance to the almost exclusively positive findings in this field. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) poses a significant global health challenge, necessitating advanced predictive models to support clinical decision-making. In this study, we explore multi-label classification as a novel approach to predict antibiotic resistance across four clinically relevant bacteria: E. coli, S. aureus, K. pneumoniae, and P. aeruginosa. Using multiple datasets from the DRIAMS repository, we evaluated the performance of four algorithms – Multi-Layer Perceptron, Support Vector Classifier, Random Forest, and Extreme Gradient Boosting – under both single-label and multi-label frameworks. Our results demonstrate that the multi-label approach delivers competitive performance compared to traditional single-label models, with no statistically significant differences in most cases. The multi-label framework naturally captures the complex, interconnected nature of AMR data, reflecting real-world scenarios more accurately. We further validated the models on external datasets (DRIAMS B and C), confirming their generalizability and robustness. Additionally, we investigated the impact of oversampling techniques and provided a reproducible methodology for handling MALDI-TOF data, ensuring scalability for future studies. These findings underscore the potential of multi-label classification to enhance predictive accuracy in AMR research, offering valuable insights for developing diagnostic tools and guiding clinical interventions. [ABSTRACT FROM AUTHOR]

Background: The rate of suicide attempts by patients with bipolar disorder is high. In addition to patient and country specific factors, environmental factors may contribute to suicidal behavior. Sunlight has multiple diverse impacts on human physiology and behavior. Solar insolation is defined as the electromagnetic energy from the sun striking a surface area on earth. We previously found that a large change in solar insolation between the minimum and maximum monthly values was associated with an increased risk of suicide attempts in patients with bipolar I disorder. Methods: The association between solar insolation and a history of suicide attempts in bipolar disorder was again investigated using an international database with 15% more data and more sites at diverse locations and countries. Results: Data were available from 5641 patients with bipolar I disorder living at a wide range of latitudes in 41 countries in both hemispheres. A large change in solar insolation between the minimum and maximum monthly values was associated with a history of suicide attempts in patients with bipolar I disorder, a replication of our prior analysis. The estimated model also associated state sponsored religion in the onset country, female gender, a history of alcohol or substance abuse, and being part of a younger birth cohort with a history of suicide attempts. Conclusions: A large change between the minimum and maximum monthly values of solar insolation was associated with a history of suicide attempts in bipolar I disorder, replicating our prior research. Physicians should be aware that daylight has wide ranging physiological and psychiatric impacts, and that living with large changes in solar insolation may be associated with an increased suicide risk. [ABSTRACT FROM AUTHOR]

Climate change is one of the worst environmental issues, with a negative impact on most developing countries across the globe and in some regions, including Ethiopia. This study seeks to establish the temporal and spatial changes in rainfall for the period 1987–2021. In this study, ordinary statistical measures, such as the mean and coefficient of variation, precipitation concentration index (PCI), and standardized anomaly index (SAI), were applied to investigate the rainfall variation. Concerning the estimation of the spatiotemporal distribution and magnitude of changes in, non-parametric Mann-Kendall (MK) tests, Sen's slope estimator, and innovative trend analysis (ITA) were also conducted in ArcGIS 10.8 environment and XLSTAT/R. The study showed significant fluctuations in rainfall in the Wolaita zone, with minimum mean annual rainfall in 1997 and maximum rainfall in 2003. All but the Belg season had more negative seasonal anomalies than positive ones. The annual rainfall for each of the AEZs in different parts of the country ranged from one another; it was 969.03 mm in a southeast lowland AEZ and 1648.75 mm in the northwest highland AEZ. Rainfall was not uniformly distributed throughout the year and study area; the highland AEZs received more rainfall in the Belg and Kermit seasons than in the lowland seasons. In the ordinary kriging results, the extent of variability in the CV of the mean annual rainfall for each zone was identifiable. The southwest lowland AEZ produced a CV of 24.22% with a decrease in rainfall amounts, and the northeast highland AEZ produced a CV of 31.63% of the rainfall distribution amounts. This area includes lowland and highland AEZs of the northeastern part of the study area's rainfall, which is moderately distributed by PCI. This information is helpful when attempting to associate development and cropping systems with temporal and spatial climatic patterns with respect to rainfall for agro-climatological activities and projects or flood regulatory measures. [ABSTRACT FROM AUTHOR]

Background: In the field of medical and scientific research, radionuclides are used to investigate various physiological and pathological processes. PRISMAP - the European medical radionuclide programme was created to bring together production facilities including intense neutron sources, an isotope mass separation facility, high-power accelerators, biomedical research institutes, and hospitals to support medical research. The aim of this article is to introduce readers with the current status of innovative radionuclides in Europe. Main body: A survey was created targeting the latest trends mainly focused on the demand, the production and the distribution of non-routinely used medical radionuclides for use in research, and for pre-clinical and clinical trials. This survey has been disseminated through the PRISMAP community. 16 of 104 respondents were working in the field of radionuclide production. The data found common aspects from all producer-facility respondents: the biggest challenge for the producers is the availability of target materials, which goes hand-in-hand with their purity/enrichment grade. The results show that there are sufficient national or international distribution routes and methods established, although having reported challenges due to legislation constraints, especially for novel radionuclides. Conclusions: Thanks to a questionnaire distributed by the PRISMAP consortium, the current status in radionuclides production was identified. Understanding the current status of radionuclide production is essential for assessing the continent's capabilities and addressing the burgeoning demands for cutting-edge medical radionuclides. [ABSTRACT FROM AUTHOR]

Iron homoeostasis is tightly regulated, with hepcidin and soluble transferrin receptor (sTfR) playing significant roles. However, the genetic determinants of these traits and the biomedical consequences of iron homoeostasis variation are unclear. In a meta-analysis of 12 cohorts involving 91,675 participants, we found 43 genomic loci associated with either hepcidin or sTfR concentration, of which 15 previously unreported. Mapping to putative genes indicated involvement in iron-trait expression, erythropoiesis, immune response and cellular trafficking. Mendelian randomisation of 292 disease outcomes in 1,492,717 participants revealed associations of iron-related loci and iron status with selected health outcomes across multiple domains. These associations were largely driven by HFE, which was associated with the largest iron variation. Our findings enhance understanding of iron homoeostasis and its biomedical consequences, suggesting that lifelong exposure to higher iron levels is likely associated with lower risk of anaemia-related disorders and higher risk of genitourinary, musculoskeletal, infectious and neoplastic diseases. The largest meta-analysis of GWASs of hepcidin and sTfR identified 43 genomic loci, of which 15 new. Mendelian randomisation revealed associations of systemic iron status and iron-related loci with selected health outcomes across multiple domains. [ABSTRACT FROM AUTHOR]

Over the past decade and more, S-matrix-based calculational methods have experienced a resurgence, proving to be both an elegant and powerful tool for extracting physical quantities without the need for an underlying Lagrangian formulation. In this work, we critically review and further develop the formalism introduced by Dashen, Ma, and Bernstein, which connects the thermodynamics of relativistic systems to the information contained in their scattering amplitudes. As a demonstration, we revisit the computation of the QCD equation of state to leading order in the strong coupling, showcasing the advantages of this method over traditional Thermal Field Theory techniques. Additionally, we apply these tools to the effective theory of a long confining Flux Tube in D dimensions, analyzing thermal effects up to and including NNLO contributions. Our results are compared with those obtained using the Thermodynamic Bethe Ansatz method. We also discuss how these techniques enable the inclusion of non-universal effects in the study of Flux Tubes, while relying solely on the S-matrix as input. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate Chaldean American perspectives towards legalization and moral acceptability of recreational and medicinal marijuana in the state of Michigan. An online survey was created and distributed through various social media groups, churches, and Chaldean organizations which resulted in a total of 637 respondents following the removal of respondents who did not meet criteria. The survey was open from March 20th, 2022 to April 20th, 2022. The independent variable was level of religiosity. The dependent variables were moral acceptability, opinion towards legalization of recreational and medicinal marijuana, and risk of cannabis use disorder. Logistic regression was used to estimate the strength of the association between the independent and dependent variables. Approximately 64% of the sample was female and 54.6% were between the ages of 21 to 29. Almost 80% of respondents reported high religiosity and 83.4% strongly or somewhat supported the legalization of medicinal marijuana. In addition, 85.8% felt medicinal marijuana was morally acceptable and 58.9% believed recreational marijuana was morally wrong. In the fully adjusted models, individuals who reported high religiosity (compared to low/moderate) were more likely to oppose legalization of recreational marijuana (OR = 2.80; 95% CI = 1.46, 5.39) and believed that marijuana was morally wrong (OR = 2.36; 95% CI = 1.16, 4.78). This trend was not observed with medicinal marijuana. These findings have important implications in better understanding a traditionally conservative ethnic minority group in their attitudes towards marijuana and how religion influences their perspectives. Additional studies are needed to examine any changes in opinion overtime as this is the first study of its kind. [ABSTRACT FROM AUTHOR]

Geostatistics is concerned with the estimation and prediction of spatially continuous phenomena using data obtained at a discrete set of locations. In geostatistics, preferential sampling occurs when these locations are not independent of the latent spatial field, and common modeling approaches that do not account for such a dependence structure might yield wrong inferences. To overcome this issue, some methods have been proposed to model data collected under preferential sampling. However, while these methods assume a constant degree of preferentiality, real data may present a degree of preferentiality that varies over space. For that reason, we propose a new model that accounts for preferential sampling by including a spatially varying coefficient that describes the dependence strength between the process that models the sampling locations and the latent field. To do so, we approximate the preferentiality component by a set of basis functions with the corresponding coefficients being estimated using the integrated nested Laplace approximation (INLA) method. By doing that, we allow the degree of preferentiality to vary over the domain with low computational burden. We assess our model performance by means of a simulation study and use it to analyze the average PM 2.5 levels in the USA in 2022. We conclude that, given enough observed events, our model, along with the implemented inference routine, retrieves well the latent field itself and the spatially varying preferentiality surface, even under misspecified scenarios. Also, we offer guidelines for the specification and size of the set of basis functions. Supplementary materials accompanying this paper appear online. [ABSTRACT FROM AUTHOR]

In this paper, we develop a nonparametric estimator of the regression function for a functional explanatory variable and a scalar response variable that is subject to left truncation and right censoring. The estimator is constructed by minimizing the mean squared relative error, which is a robust criterion that reduces the impact of outliers relatively to the Nadaraya Watson estimator. We prove the pointwise and uniform convergence of the estimator under some regular conditions and assess its performance by a numerical study. We also investigate the robustness of the estimator using the influence function as a measure of sensitivity to outliers and apply the estimator to a real dataset. [ABSTRACT FROM AUTHOR]

Although it requires simple computations, provides good performance on linear classification tasks and offers a suitable environment for active learning strategies, the Hebbian learning rule is very sensitive to how the training data relate to each other in the input space. Since this spatial arrangement is inherent to each set of samples, the practical application of this learning paradigm is limited. Thus, representation learning may play an important role in projecting the input data into a new space where linear separability is improved. Earlier methods based on orthogonal coding addressed this issue but presented many side effects, impoverishing the generalization of the model. Hence, this paper considers a recently proposed method based on kernel density estimators, which performs a likelihood-based projection where linear separability and generalization capacity are enhanced in an autonomous fashion. Results show that this novel method allows one to use linear classifiers to solve many binary classification problems and overcome the performance of well-established classifiers. [ABSTRACT FROM AUTHOR]

Monitoring the ecological status of rivers is essential for protecting freshwater biodiversity and ecosystem health. The main objective of this work was to predict the ecological quality of Greek rivers using a machine learning approach based on the Extreme Gradient Boosting (XGBoost) classifier. We used a dataset that comprises ecological, physicochemical, geomorphological, and sample-related parameters collected from the national monitoring network of Greek rivers as well as climate parameters from the ERA5-Land dataset. More specifically, we developed multiple models that predicted the ecological quality class derived by four quality elements (QEs) that are benthic macroinvertebrates, benthic diatoms, fish, and physicochemical quality. The Shapley Additive exPlanations (SHAP) approach was implemented for quantifying the contributions of the predictors on the quality class. We finally developed a web interface tool that can simulate what-if scenarios to predict the quality class under altered environmental conditions. Our findings showed that total phosphorus, nitrate, and ammonium were important predictors for benthic macroinvertebrates, benthic diatoms, and physicochemical quality, whereas for fish, predictors related with the geomorphology (e.g., altitude and slope) had a higher influence. The SHAP plots revealed the synergistic effect of predictors on the quality classes, highlighting a negative effect of increased nutrients on achieving the good quality class based on macroinvertebrates and diatoms and a positive relationship between altitude and slope with the good ecological quality class based on fish. Furthermore, the web interface could provide a useful tool for water managers to predict quality classes for water bodies under what-if scenarios. [ABSTRACT FROM AUTHOR]

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Background: International consensus on classifications of appendiceal mucinous neoplasms (AMNs) and associated pseudomyxoma peritonei (PMP) have been carefully made but clinicopathological associations supporting decision making remain scarce. Objective: This study aimed to assess interdependence between AMNs and PMP and provide directions for clinical management. Methods: This two-center retrospective cohort study reviewed patients with PMP treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy between 2005 and 2021. The primary objective was to reassess histopathologic grade of AMNs and PMP according to the Peritoneal Surface Oncology Group International classification and to establish its interdependence. Secondary outcomes were recurrence rate, PMP grade progression, ovarian involvement, and overall survival (OS). Results: Of 105 patients included, 78 (74.3%) had low-grade AMNs as the primary tumor, 8 (7.6%) had high-grade AMNs, 7 (6.7%) had mucinous adenocarcinoma (MAC), 1 (0.9%) had MAC with signet ring cells (SRC), and 11 (10.5%) had unidentified tumors. Overall, 11 patients (10.5%) had no PMP, 21 (20.0%) had acellular mucin, 56 (53.3%) had low-grade PMP, 12 (11.4%) had high-grade PMP, and 5 (4.8%) had PMP-SRC. In 11 cases (13.3%), AMNs and matching PMP grade differed. Over a 16-year follow-up, recurrence occurred in 31.8%, with three cases showing histopathologically changed PMP. Ovarian involvement was observed in 43/65 females (66.2%). Median OS was 13.8 years, and 5-year OS rates were 100%, 74.4%, 44.4%, and 20% for acellular mucin, low-grade PMP, high-grade PMP and PMP-SRC, respectively (p < 0.001). Conclusions: AMN histology does not always reflects its associated PMP grade, while PMP grade strongly influences survival. Ovarian involvement and recurrent PMP showing unchanged histopathological features are common. [ABSTRACT FROM AUTHOR]

Background: Hemorrhagic strokes constitute 10–15% of all strokes and have the worst mortality and morbidity of all subtypes. Mortality and morbidity of spontaneous intracerebral hemorrhage (sICH) are often secondary to the effects of inflammation, brain edema, and swelling. Studies have shown that celecoxib, a selective cyclooxygenase 2 (COX-2) inhibitor, reduces perihematomal edema formation and inflammation. This study aimed to examine the impact of celecoxib on sICH outcomes. Methods: TriNetX, a multi-institutional research database, was retrospectively queried to identify patients with sICH. Outcomes in patients who received celecoxib within 5 days (cohort 1) were analyzed and compared to those in patients who did not receive celecoxib (cohort 2). The primary end point was mortality within 1 year of sICH. Secondary end points included ventilator dependence, tracheostomy, percutaneous endoscopic gastrostomy tube placement, craniotomy, deep venous thrombosis, pulmonary embolism, ischemic stroke, transient ischemia attack, myocardial infarction, and seizures. Further analysis was performed to assess these outcomes for patients treated with ibuprofen, a nonselective COX inhibitor. Results: After propensity score matching, 833 patients were identified in each cohort based on celecoxib use. Mortality at 1 year was significantly reduced in patients with sICH receiving celecoxib compared to those who did not (13.33% vs. 17.77%; p = 0.0124). Risks of ventilator dependence, tracheostomy, percutaneous endoscopic gastrostomy tube placement, craniotomy, deep venous thrombosis, pulmonary embolism, ischemic stroke, transient ischemia attack, myocardial infarction, and seizures were not significantly increased in patients who received celecoxib within 5 days of sICH compared to those who did not receive celecoxib. There was no significant difference in mortality between patients based on ibuprofen administration. Conclusions: There exists a growing interest in using COX-2 as a potential target strategy for neuroprotection in patients with sICH, with some evidence of a mortality benefit in small cohort studies. This study shows that early celecoxib use is associated with decreased mortality in patients with sICH. [ABSTRACT FROM AUTHOR]

Magnetic Resonance Imaging (MRI) is an important diagnostic technique that uses powerful magnetic fields to generate detailed images of the human body. The aim of this study is to investigate to how static magnetic fields (SMF) affect the levels of trace elements and biochemical parameters in MRI staff' blood serum. This study examines the impacts of these exposures of 18 participants (9 males and 9 females) aged between 25 and 60.on the levels of trace elements in the blood serum and the biochemical parameters of the MRI staff at Azadi Teaching Hospital in Duhok and Zakho General Hospital-Bidari in Zakho City. Eighteen participants, consisting of nine males and nine females aged between 25 and 60, were selected from these hospitals. The researchers obtained blood samples and conducted analysis to determine the presence of trace elements (sodium, potassium, calcium, chloride) as well as numerous biochemical markers. The results showed that potassium and calcium levels increased with age, and older females had considerable deviations. Chloride levels exhibited a significant increase with age in both males and females. Glucose, creatinine, uric acid, and urea levels showed an increase with age, suggesting the possible damage to kidney function caused by continuous exposure to MRI. Increased levels of liver enzymes (GPT, GOT, ALP) and thyroid-stimulating hormone (TSH) were noticed, particularly in older females, indicating potential liver and thyroid dysfunction. These results highlight the importance of applying strict safety protocols and conducting regular health assessments for MRI personnel to minimize the possible hazards. [ABSTRACT FROM AUTHOR]

The weeds of the species Rottboellia cochinchinensis (Lour.) Clayton (camalote grass) are highly aggressive in bush competition for sugarcane crops, and these species are increasing their infestations in the state of Mato Grosso do Sul, generating impacts on the development of sugarcane plantations and reducing productivity and longevity. The objective of this study was to evaluate the efficacy of the herbicide imazapic in pre-emergence control of the species R. cochinchinensis when applied under conditions with and without sugarcane straw and in different simulations of rainfall. The experiment was conducted in a greenhouse in a completely randomized design. A 2 × 2 × 2 triple factorial design was used, consisting of 2 doses of the herbicide imazapic (105 and 147 g ai ha−1), 2 amounts of straw (0 and 10 t ha−1) and 2 rainfall simulations (10 and 30 mm). With 4 replicates and 4 controls, this factorial being isolated for two soil types (clayey and sandy) and in two germination flows (F1 and F2). The rainfall factor always resulted in higher control performances with the smallest simulated volume of 10 mm, and the amount of straw factor influenced the effectiveness of the control, both in sandy and clayey soils. The highest dose (147 g ai ha−1) showed better control efficacy in clayey soils. The herbicide imazapic showed excellent control until the end of the second flush, with an average dry mass reduction of 92% for R. cochinchinensis. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to report clinicopathologic and imaging features of odontogenic myxomas (OM), highlighting uncommon findings. Methods: Clinicopathologic and imaging data of OMs diagnosed in the five Brazilian diagnostic pathology centers were collected and analyzed. Results: The series comprised 42 females (68.9%) and 19 males (31.1%), with a 2.2:1 female-to-male ratio and a mean age of 34.5±15.4 years (range: 4-80). Clinically, most OMs presented as painless intraoral swelling (n = 36; 70.6%) in the mandible (n=37; 59.7%). Multilocular lesions (n=30; 83.3%) were more common than unilocular lesions (n=6; 16.7%). There was no statistically significant difference between the average size of unilocular and multilocular OMs (p=0.2431). The borders of OMs were mainly well-defined (n=24; 66.7%) with different degrees of cortication. Only seven tumors caused tooth resorption (15.9%), while 24 (54.5%) caused tooth displacement. Cortical bone perforation was observed in 12 (38.7%) cases. Morphologically, OMs were characterized mainly by stellate or spindle-shaped cells in a myxoid background (n=53; 85.5%). Surgical resection was the most common treatment modality (n=15; 65.2%), followed by conservative surgery (n=8; 34.8%). Outcomes were available in 20 cases (32.3%). Seven of these patients had local recurrence (35%). Enucleation was the treatment with the highest recurrence rate (4/7; 57.1%). Conclusions: OM has a predilection for the posterior region of the jaws of female adults. Despite their bland morphological appearance, they displayed diverse imaging features. Clinicians must include the OM in the differential diagnosis of osteolytic lesions of the jaws. A long follow-up is needed to monitor possible recurrences. [ABSTRACT FROM AUTHOR]

This work aims to enable distributed robot systems to follow time-varying paths safely. Artificial Vector Fields offer a viable alternative for addressing path-following challenges, yet collision avoidance among agents guided by such fields remains an open problem. To address this, we have designed a Model Predictive Control (MPC) setup that integrates an Artificial Vector Field reference with prominent collision avoidance methods, such as Optimal Reciprocal Collision Avoidance (ORCA) and Control Barrier Functions (CBF), to produce real-time, safe solutions. Our work involves a direct comparison between different MPC-based collision avoidance methods, and we have obtained results from various simulation scenarios as well as experiments on real robotic systems (Crazyflie 2.1). We aim to assess the applicability and limitations of these techniques through extracted metrics and insights. [ABSTRACT FROM AUTHOR]

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Allophycocyanins are phycobiliproteins that absorb red light and transfer the energy to the reaction centers of oxygenic photosynthesis in cyanobacteria and red algae. Recently, it was shown that some allophycocyanins absorb far-red light and that one subset of these allophycocyanins, comprising subunits from the ApcD4 and ApcB3 subfamilies (FRL-AP), form helical nanotubes. The lowest energy absorbance maximum of the oligomeric ApcD4-ApcB3 complexes occurs at 709 nm, which is unlike allophycocyanin (AP; ApcA-ApcB) and allophycocyanin B (AP-B; ApcD-ApcB) trimers that absorb maximally at ~ 650 nm and ~ 670 nm, respectively. The molecular bases of the different spectra of AP variants are presently unclear. To address this, we structurally compared FRL-AP with AP and AP-B, performed spectroscopic analyses on FRL-AP, and leveraged computational approaches. We show that among AP variants, the α-subunit constrains pyrrole ring A of its phycocyanobilin chromophore to different extents, and the coplanarity of ring A with rings B and C sets a baseline for the absorbance maximum of the chromophore. Upon oligomerization, the α-chromophores of all AP variants exhibit a red shift of the absorbance maximum of ~ 25 to 30 nm and band narrowing. We exclude excitonic coupling in FRL-AP as the basis for this red shift and extend the results to discuss AP and AP-B. Instead, we attribute these spectral changes to a conformational alteration of pyrrole ring D, which becomes more coplanar with rings B and C upon oligomerization. This study expands the molecular understanding of light-harvesting attributes of phycobiliproteins and will aid in designing phycobiliproteins for biotechnological applications. [ABSTRACT FROM AUTHOR]

This study used life cycle assessment to assess carbon emissions associated with the production of three novel bio-based food punnets and to compare them with an equivalent made from polypropylene (PP). Two of the punnet formats included empty fruit bunch fibre (EFB), an abundant source waste biomass originating from the palm oil industry. Two production technologies were assessed, with one of the punnets being pulp-moulded (100% EFB fibre) and the others being thermoformed blends. Primary data for pulp-moulding was collected at factory-scale in Malaysia, while a novel fibre pretreatment step, necessary as a precursor to pulp-moulding this form of fibre, was only available at small-scale. The results showed that both the thermoformed punnets have lower GWPs than the PP equivalent, the best being that containing 18% EFB fibre, which had a 21% lower carbon footprint by weight, at the factory gate. Results for the pulp-moulded format were less clear due to the small-scale of operation during pretreatment. Results for the pre-treatment step are therefore high as presented, however analysis suggests that where efficiencies-of-scale can achieve a 57% reduction in emissions associated with this step, then pulp-moulded punnets will have lower GWPs than the thermoformed samples. The key future question from this preliminary assessment is therefore the extent to which the EFB fibre pretreatment step can be optimised in the pulp-moulded production scenario. Further development and scaling-up of the novel pretreatment process would now be beneficial, however all three punnet formats have potential to reduce emissions relative to those of fossil-based plastic equivalents.Article Highlights: Life cycle assessment of Pulp moulded tray prepared oil palm Biomass anlayzed. Pulp-moulded food packaging tray display lower GWPs than the thermoformed tray. Developed biobased food packaging tray has potential to outperform fossil-based plastic alternatives. [ABSTRACT FROM AUTHOR]

BPV-2 infection can cause bladder infections in cattle that, when associated with bracken fern consumption, can progress to cancerous bladder tumors and also present as bovine enzootic hematuria (BEH). This study aimed to evaluate the prolonged natural BPV-2 infection in the blood and urine of cattle, excluding bracken fern consumption. Thirteen Girolando papillomatosis-affected cattle with no bracken fern contact history were monitored for 20 months. Blood, urine, and wart samples were collected for BPV-2 detection and clinical laboratory analyses. All animals showed the presence of BPV-2 in papillomas and blood, and 92.85% showed BPV-2 in urine, suggesting viral dissemination in the urinary tract. Despite all animals being infected with BPV-2, none showed BEH signs during the study. Thus, it was observed that BPV-2 infection alone didn't induce BEH over 20 months, implying a complex interaction with environmental factors or genetic predisposition. This underlines bracken fern consumption's critical role in urinary bladder carcinogenesis. The study underscores BEH's pathogenesis complexity, advocating longitudinal studies to comprehend BPV-2's role fully. [ABSTRACT FROM AUTHOR]

The Mouse Metabolic Phenotyping Center (MMPC)Live Program was established in 2023 by the National Institute for Diabetes, Digestive and Kidney Diseases (NIDDK) at the National Institutes of Health (NIH) to advance biomedical research by providing the scientific community with standardized, high quality phenotyping services for mouse models of diabetes and obesity. Emerging as the next iteration of the MMPC Program which served the biomedical research community for 20 years (2001–2021), MMPCLive is designed as an outwardly-facing consortium of service cores that collaborate to provide reduced-cost consultation and metabolic, physiologic, and behavioral phenotyping tests on live mice for U.S. biomedical researchers. Four MMPCLive Centers located at universities around the country perform complex and often unique procedures in vivo on a fee for service basis, typically on mice shipped from the client or directly from a repository or vendor. Current areas of expertise include energy balance and body composition, insulin action and secretion, whole body carbohydrate and lipid metabolism, cardiovascular and renal function, food intake and behavior, microbiome and xenometabolism, and metabolic pathway kinetics. Additionally, an opportunity arose to reduce barriers to access and expand the diversity of the biomedical research workforce by establishing the VIBRANT Program. Directed at researchers historically underrepresented in the biomedical sciences, VIBRANT-eligible investigators have access to testing services, travel and career development awards, expert advice and experimental design consultation, and short internships to learn test technologies. Data derived from experiments run by the Centers belongs to the researchers submitting mice for testing which can be made publicly available and accessible from the MMPCLive database following publication. In addition to services, MMPCLive staff provide expertise and advice to researchers, develop and refine test protocols, engage in outreach activities, publish scientific and technical papers, and conduct educational workshops and training sessions to aid researchers in unraveling the heterogeneity of diabetes and obesity. [ABSTRACT FROM AUTHOR]

Bacterial sexually transmitted infections (BSTIs) are largely preventable, yet their rates remain high across the U.S., particularly among sexual minority men (SMM) living with HIV (LWH). We explored longitudinal factors associated with BSTI acquisition in a national online sample of SMM LWH with recent suboptimal adherence to antiretroviral therapy (ART) or virologic non-suppression, such as spread within sexual networks, drug use in a sexual context (chemsex), and mental health issues. Participants completed online surveys over 12 months as part of an eHealth intervention. Over 12 months, 30% of participants self-reported at least one BSTI, with 28–45% reporting recurrent infections in consecutive surveys. Using generalized estimating equations with a binomial distribution and an exchangeable correlation structure, we found that BSTI accumulation was associated with chemsex, a higher number of anal sex partners, participation in exchange sex, and depressive symptoms. To reduce the burden of BSTIs among SMM LWH, public health initiatives and clinical settings should adopt a comprehensive sexual health approach, addressing chemsex, exchange sex, and associated mental health conditions. Addressing these factors can mitigate BSTI recurrence and improve overall sexual health among SMM LWH. [ABSTRACT FROM AUTHOR]

Land use and land cover (LULC) changes are recognized as drivers of environmental changes at the local, regional, and global levels. Detecting these changes is essential in developing land management plans and strategies. More particularly, the LULC changes constitute one of the sub-indicators used for setting the baseline for land degradation neutrality (LDN) planning and assessing the progress toward the sustainable development goal 15.3. This study aims to determine the implication of LULC dynamics on land cover degradation in Eastern DR Congo. This region has been subjected to uncontrolled LULC changes over the last three decades but the impact of these changes on land degradation has not been assessed yet at the territorial level. To fill this gap, the territory of Kalehe has been used as a case study to monitor the LULC changes during the 1987–2020 period based on the classification of Landsat images, to forecast the future LULC for the 2030–2070 period through the hybrid Markov-Support Vector Machine modeling, to determine the extent of land cover degradation associated with these changes and to assess the impact of biophysical and socio-economic factors on the occurrence of land cover degradation using the binary logistic regression model. The results reveal that the overall trends of LULC changes during the 1987–2020 period are the increasing of built-up area, shrubland, and cropland at the expense of forestland, wetland, and grassland. This situation is expected to continue in the future and contribute to the degradation of land cover within the study area. Under the current situation of LULC changes, 34.17% of the land has been subjected to potential degradation. Furthermore, under the business-as-usual scenario 28.28%, 27.28%, and 33.65% of the land will be degraded by 2030, 2050, and 2070 respectively. This land cover degradation is more likely to occur in the proximity of roads, localities, highly populated areas, mining concessions, and high-altitudinal zones. Since the current land use system is unsustainable, there is a necessity to implement sustainable land management strategies that take into account the biophysical and socio-economic specificities of this region to reverse the problem of land cover degradation. [ABSTRACT FROM AUTHOR]

Tissue biofabrication mimicking organ-specific architecture and function requires physiologically-relevant cell densities. Bioprinting using spheroids can achieve this, but is limited due to the lack of practical, scalable techniques. This study presents HITS-Bio (High-throughput Integrated Tissue Fabrication System for Bioprinting), a multiarray bioprinting technique for rapidly positioning multiple spheroids simultaneously using a digitally-controlled nozzle array (DCNA). HITS-Bio achieves an unprecedented speed, ten times faster compared to existing techniques while maintaining high cell viability (> 90%). The utility of HITS-Bio was exemplified in multiple applications, including intraoperative bioprinting with microRNA transfected human adipose-derived stem cell spheroids for calvarial bone regeneration (~ 30 mm3) in a rat model achieving a near-complete defect closure (bone coverage area of ~ 91% in 3 weeks and ~96% in 6 weeks). Additionally, the successful fabrication of scalable cartilage constructs (1 cm3) containing ~600 chondrogenic spheroids highlights its high-throughput efficiency (under 40 min per construct) and potential for repairing volumetric defects.HITS-Bio, a high-throughput bioprinting platform, rapidly assembles spheroids to mimic native tissue architecture. Its intraoperative application in bone shows near-complete calvarial defect repair in rats and fabrication of scalable cartilage. [ABSTRACT FROM AUTHOR]

Current understanding of soil carbon dynamics suggests that plant litter quality and soil mineralogy control the formation of mineral-associated soil organic carbon (SOC). Due to more efficient microbial anabolism, high-quality litter may produce more microbial residues for stabilisation on mineral surfaces. To test these fundamental concepts, we manipulate soil mineralogy using pristine minerals, characterise microbial communities and use stable isotopes to measure decomposition of low- and high-quality litter and mineral stabilisation of litter-C. We find that high-quality litter leads to less (not more) efficient formation of mineral-associated SOC due to soil microbial community shifts which lower carbon use efficiency. Low-quality litter enhances loss of pre-existing SOC resulting in no effect of litter quality on total mineral-associated SOC. However, mineral-associated SOC formation is primarily controlled by soil mineralogy. These findings refute the hypothesis that high-quality plant litters form mineral-associated SOC most efficiently and advance our understanding of how mineralogy and litter-microbial interactions regulate SOC formation. This study challenges the hypothesis that high-quality plant litters form stable, mineral-associated soil organic carbon most efficiently, providing evidence that litter-microbial interactions and soil mineralogy regulate soil organic carbon formation. [ABSTRACT FROM AUTHOR]

This narrative review seeks to summarize chemotherapeutic regimens commonly used for patients with newly diagnosed Philadelphia (Ph) chromosome–negative B-cell precursor acute lymphoblastic leukemia (BCP-ALL) in the frontline setting and to describe the latest clinical research using the bispecific T-cell–engaging immunotherapy blinatumomab in the first-line treatment setting. Current standard-of-care chemotherapeutic backbones for newly diagnosed Ph-negative BCP-ALL are based on the same overarching treatment principle: to reduce disease burden to undetectable levels and maintain lasting remission. The adult treatment landscape has progressively evolved following the adoption of pediatric-inspired regimens. However, these intense regimens are not tolerated by all, and high-risk patients still have inferior outcomes. Therefore, designing more effective and less toxic strategies remains key to further improving efficacy and safety outcomes. Overall, the treatment landscape is evolving in the frontline, and integration of blinatumomab into different standard frontline regimens may improve overall outcomes with a favorable safety profile. [ABSTRACT FROM AUTHOR]

Ultramarathon running is of increasing popularity, where the time-limited 24-hour run is one of the most popular events. Although we have a high scientific knowledge about different topics for this specific race format, we do not know where the best 24-hour runners originate from and where the fastest races are held. The purpose of the present study was to investigate the origin of these runners and the fastest race locations. A machine learning model based on the XG Boost algorithm was built to predict running speed based on the athlete´s age, gender, country of origin and the country where the race takes place. Model explainability tools were used to investigate how each independent variable would influence the predicted running speed. A sample of 171,358 race records from 63,514 unique runners from 73 countries participating in 24-hour races held in 57 countries between 1807 and 2022 was analyzed. Most of the athletes originated from the USA, France, Germany, Great Britain, Italy, Japan, Russia, Australia, Austria, and Canada. Tunisian athletes achieved the fastest average running speed, followed by runners from Russia, Latvia, Lithuania, Island, Croatia, Slovenia, and Israel. Regarding the country of the event, the ranking looks quite similar to the participation by the athlete, suggesting a high correlation between the country of origin and the country of the event. The fastest 24-hour races are recorded in Israel, Romania, Korea, the Netherlands, Russia, and Taiwan. On average, men were 0.4 km/h faster than women, and the fastest runners belonged to age groups 35–39, 40–44, and 45–49 years. In summary, the 24-hour race format is spread over the world, and the fastest athletes mainly originate from Eastern Europe, while the fastest races were organized in European and Asian countries. [ABSTRACT FROM AUTHOR]

This study explores the complex interconnections among global population growth, energy consumption, CO2 production, and disparities in service access through the lens of a single case study. Rapid population growth in many major cities has created significant challenges related to equitable access to services and socio-economic development, thereby impacting both their energy consumption patterns and environmental impacts. The case investigated in this study, like many other cases in developing countries, exhibits differences in service provision, infrastructure development, and energy usage, particularly between the northern and southern regions, which significantly affect the quality of life, environmental sustainability, and economic development. Previous efforts to narrow these geographic disparities have yielded limited success and exhibited several shortcomings. By employing a GIS Analytical Network Process method, this study examines service accessibility patterns in a single-case city, with a particular emphasis on green spaces, food services, and educational facilities and services. This GIS-based approach seeks to achieve sustainable levels of access to multiple land uses by evaluating their accessibility and identifying areas of overlap between them. The study endeavors to increase access and density of service standards when planning the placement of new facilities based on these standards in new locations. The method developed in this study represents a critical stride toward achieving these key objectives. The findings reveal that only 47% of city population blocks enjoy high service accessibility, while 40% have moderate accessibility, and 2.6% experience poor accessibility. These insights are of significant value to urban planners, researchers, and policymakers striving to reduce energy shortages and promote sustainable energy and transportation strategies to mitigate environmental impact in urban areas. [ABSTRACT FROM AUTHOR]

Objective: Posterior fossa decompression for Chiari malformation type I (Chiari 1) is effective and associated with a low risk of complication. However, up to 20% of patients may experience continued deficits or recurring symptoms after surgical intervention. For pediatric patients, there are no established tools to predict outcomes, and the risk factors for unfavorable postoperative outcomes are poorly understood. Hence, our aim was to investigate baseline data and early postoperative predictors of poor outcomes as determined by the Chicago Chiari outcome scale (CCOS). Methods: All pediatric patients (< 18 years) receiving a posterior fossa decompression for Chiari 1 between the years of 2005 and 2020 at the study center were eligible for inclusion. Patients with congenital anomalies were excluded. Results: Seventy-one pediatric patients with a median age of 9 years were included. Most patients (58%) were females. Chiari 1 was associated with syringomyelia (51%), scoliosis (37%), and hydrocephalus (7%). Perioperative complications occurred in 13 patients (18%) of which two required additional procedures under general anesthesia. On multivariable proportional odds logistic regression, motor deficits (OR: 0.09; CI95%: [0.01–0.62]; p = 0.015), and surgical complications (OR: 0.16; CI95%: [0.41–0.66]; p = 0.011) were significant predictors of worse outcomes. The presence of syringomyelia was identified as a predictor of better outcomes (OR: 4.42 CI95% [1.02–19.35]; p = 0.048). A persistent hydrocephalus during the early postoperative period after posterior fossa decompression was a strong predictor of worse long-term CCOS (OR: 0.026; CI95%: [0.002–0.328]; p = 0.005). Conclusion: Results from this study indicate that the existence of motor deficits and syringomyelia prior to surgery, and surgical complications and persistent hydrocephalus despite posterior fossa decompression, were useful predictors of long-term outcome. [ABSTRACT FROM AUTHOR]

Aim: Sufficient liver function is crucial in extracellular matrix growth, hemostasis, and wound healing. Repeated abdominal surgery is a known risk factor for the development of wound complications. This study aimed to evaluate this high-risk constellation in patients undergoing associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) and repeated liver resections (RLR) in comparison to single liver resection (SLR). Method: Forty patients who underwent ALPPS between 2011 and 2020 were evenly matched with patients undergoing RLR or SLR (n = 40 per group) using propensity scores. Postoperative outcomes were compared and factors associated with wound complications were analyzed. Results: Postoperative wound complications were significantly more frequent in ALPPS group (p = 0.001). The reoperation rate was not significantly different between the three groups (p = 0.143). However, surgical reintervention due to wound complications occurred more frequently in the ALPPS group in relation to RLR and SLR (17.5% vs. 7.5% and 5% respectively). Length of stay was significantly longer in the ALPPS group (p = 0.033). ALPPS was an independent risk factor for postoperative wound complication (OR = 8.55, 95% CI:1.07–68.44, p = 0.043). Risk factor analysis identified age ≥ 60 years (OR = 27.64, 95% CI:3.09-246.75, p = 0.003), BMI ≥ 30 kg/m2 (OR = 30.21, 95% CI:3.35-271.83, p = 0.002), and low postoperative albumin levels (OR = 168.41, 95% CI:7.76-3651.18, p = 0.001) as independent predictors of postoperative wound complications after major liver resection. Conclusion: Patients undergoing ALPPS and RLR are faced with a high risk of developing wound complications. Older age, obesity, a history of previous abdominal surgery, and a decreased postoperative albumin level were independent risk factors for wound complications. [ABSTRACT FROM AUTHOR]

Objective: The optimal timing of surgical intervention for chronic subdural hematomas (CSDH), specifically night-time versus daytime, remains a subject of debate, with concerns about the potential impact of circadian timing on surgical outcomes. This study evaluated the association between the timing of burr-hole drainage for CSDH and postoperative outcomes, comparing night-time and daytime surgeries. Methods: In a post-hoc analysis of the FINISH trial, we included adult patients with symptomatic unilateral or bilateral CSDH who underwent burr-hole drainage between January 2020 and August 2022. Night-time surgery was defined as procedures starting between 23:00 and 06:00, with daytime surgeries occurring between 06:01 and 22:59. The primary outcome was functional outcome at six months post-surgery, assessed using the modified Rankin Scale (mRS), with favorable outcomes defined as an mRS of 0–3. Secondary outcomes included mortality, reoperation rates, and adverse events within six months. Results: Our analysis of 589 patients (83% daytime surgery, 17% night-time surgery) revealed no significant differences in baseline characteristics. The unadjusted analysis suggested a higher rate of favorable functional outcomes in the night-time surgery group than in the daytime group (94% vs. 86%, p = 0.037). Mortality, adverse events, and reoperation rates were similar in the groups. Adjusted logistic regression analyses, accounting for potential confounders, indicated that night-time surgery was not associated with a higher risk of unfavorable functional outcomes compared to daytime surgery. Conclusions: Our findings suggest that night-time surgery versus daytime surgery is not associated with worse postoperative outcomes. These findings challenges the traditional preference for daytime CSDH surgery and emphasizes the potential for flexibility in surgical scheduling to optimize patient care in CSDH management. [ABSTRACT FROM AUTHOR]

Hematological changes is one of the most common complications occurred in cancer patients. Therefore, the current study aimed to assess the hematological toxicity of cervical cancer patients before and after the initiation of treatment. The retrospective cohort study was conducted from 2015 to 2022 at the University of Gondar Comprehensive Specialized Hospital. The hematological profile and sociodemographic and clinical data of the cervical cancer patients were collected using data extraction sheets. The Epidata version 3.1 and SPSS version 25 were used for data entry and analysis, respectively. Descriptive statistics were employed to summarize the data. To compare the median differences in hematological parameters before and after treatment, the Wilcoxon rank test was used. In addition, to assess the presence of an independent association between hematological abnormalities and the independent variables, logistic regression models were used. A p value less than 0.05 was considered to indicate statistical significance for all tests. In current study, the median (Interquartile range) of hemoglobin levels, white blood cell counts, and platelet counts, before treatment were 13.2 (12.1, 15) g/dl, 7.5 (5.8, 11.8) *109/L, and 330 (252, 383) *109/L, respectively. However, after treatment the median (Interquartile range) value of hemoglobin levels, white blood cell counts, and platelet counts were significantly lowered. On the other hand, red cell distribution width was significantly greater after treatment. At baseline, the magnitude of leucocytosis, anemia, and thrombocytosis were 27.9%, 24.6%, and 18.7%, respectively. After the treatment, anemia increased to 44.3%, but leucocytosis and thrombocytosis were replaced by leucopenia 18.3% and thrombocytopenia 17.8%, respectively. Hematological abnormalities such as anemia, leucopenia and thrombocytopenia were high after chemo-radiotherapy, and surgery. As the stage of cancer advances, the risk of developing anemia, leucocytosis, and thrombocytosis increased in 7.6, 6.9 and 9 times, respectively. Furthermore, being HIV patients and rural resident increased the risk of developing anemia about twofold. In conclusion hematological abnormalities were observed before and after cervical cancer treatment, with significance increment after chemo-radiotherapy and surgery. As the stage of cancer advances, the risk of developing hematological abnormalities increases. Therefore, routine monitoring of hematological changes before and after treatment and screening for major risk factors are important for improved patients' management. [ABSTRACT FROM AUTHOR]