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Objective: Probable sarcopenia is a predictor of functional limitation in older adults. However, whether standard thresholds recommended by guides, or population-specific thresholds better predict impairment in functionality is an issue that needs to be enlightened. We aimed to study the associations of probable sarcopenia identified by the use of EWGSOP2 and population-specific thresholds with deterioration in functionality at follow-up and give prevalences of probable sarcopenia with different thresholds in older outpatients admitted to a tertiary health center. Methods: In this retrospective, longitudinal follow-up study, we assessed handgrip strength (HGS) at the admission with a Jamar hand-dynamometer and diagnosed probable sarcopenia with standard and population-specific thresholds, i.e., 27 kg/16 kg, and 35 kg/20 kg in males/females, respectively. We evaluated activities of daily living (ADL) and instrumental ADL (IADL), with Katz and Lawton scales, at the admission and follow-up. To study whether probable sarcopenia was a predictor of impaired functionality, we defined two models for Cox regression analysis. We performed adjustments for age, sex, and nutritional status (assessed by Mini-Nutritional Assessment-Short Form) in Model 1 and defined Model 2 by adding low gait speed and frailty to the variables in Model 1. Results: Among a total of 1970 patients, 195 had follow-up of median 560 days. The mean age was 75.5 ± 5.5, and 142 (72.8%) were female. In the basal evaluation, the prevalences of probable sarcopenia defined by the standard cut-offs and by population-specific cut-offs were 8.7% and 35.4%, respectively. In univariate analyses (Kaplan–Meier log-rank test), probable sarcopenia by population-specific cut-offs, but not EWGSOP2-cut-offs, was associated with deteriorations in both ADL (p = 0.04) and IADL (p < 0.001). In multivariate analyses, only the probable sarcopenia identified by population-specific cut-offs was independently associated with impairment in IADL in both models [HR (95%CI) = 1.88 (1.07–3.30), and 1.9 (1.04–3.6); for Model 1 and Model 2, respectively)]. Conclusion: Our findings suggested that the definition of probable sarcopenia identified by not standard, but population-specific thresholds more reliably predicted longitudinal deterioration of functionality in older outpatients. This finding might be considered as evidence supporting the use of population-specific cut-offs when the concern is sarcopenia diagnosis. [ABSTRACT FROM AUTHOR]

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(1) Background: The diagnosis of invasive aspergillosis (IA) in an intensive care unit (ICU)remains a challenge and the COVID-19 epidemic makes it even harder. Here, we evaluated AspergillusPCR input to help classifying IA in SARS-CoV-2-infected patients. (2) Methods: 45 COVID-19 patients were prospectively monitored twice weekly for Aspergillus markers and anti-Aspergillus serology. We evaluated the concordance between (I) Aspergillus PCR and culture in respiratory samples, and (II)blood PCR and serum galactomannan. Patients were classified as putative/proven/colonized using AspICU algorithm and two other methods. (3) Results: The concordance of techniques applied on respiratory and blood samples was moderate (kappa=0.58 and kappa=0.63, respectively), with ahigher sensitivity of PCR. According to AspICU, 9/45 patients were classified as putative IA. When incorporating PCR results, 15 were putative IA because they met all criteria, probably with a lack of specificity in the context of COVID-19. Using a modified AspICU algorithm, eight patients were classified as colonized and seven as putative IA. (4) Conclusion: An appreciation of the fungal burden using PCR and Aspergillus serology was added to propose a modified AspICU algorithm. This proof of concept seemed relevant, as it was in agreement with the outcome of patients, but will need validation in larger cohorts. [ABSTRACT FROM AUTHOR]

Background: Cefoperazone/sulbactam is a broad-spectrum antibacterial agent. Drug-induced immune hemolytic anemia is a rare but serious condition, and reactive thrombocytosis is caused by processes extrinsic to the megakaryocyte. Limited data are available for cefoperazone/sulbactam-associated hemolytic anemia and reactive thrombocytosis. Case presentation: We report the case of a 60-year-old woman undergoing surgical excision of the left atrial myxoma, who presented with hemolytic anemia and thrombocytosis following cefoperazone/sulbactam administration for lung infection. The duration of cefoperazone/sulbactam therapy was 8 days. Blood analysis showed markedly decreased hemoglobin, hematocrit, and red blood cell levels, with elevated lactate dehydrogenase, indirect bilirubin, platelets, and reticulocytes. Furthermore, the direct antiglobulin test was positive for anti-C3 and a diagnosis of hemolytic anemia and reactive thrombocytosis was made. Then, cefoperazone/sulbactam was discontinued and red blood cell transfusion was performed for 3 days. After 1 week, the patient's condition improved, and she was discharged. Conclusion: This is the first suspected case report of immune hemolytic anemia and reactive thrombocytosis related to cefoperazone/sulbactam. Caution should be taken for this reaction in patients undergoing cefoperazone/sulbactam therapy. [ABSTRACT FROM AUTHOR]

This paper examined the possible breading space of tsetse flies in Ikom Local Governement Area and it's environs in Cross River State, Nigeria, using remote sensing and geographic information system techniques. The study used supervised classification techniques with maximum likelihood algorithms to classify the satellite imagery in to four categories as vegetation-agriculture, water bodies, built-up lands, and other land uses and digitized all the rivers on the imagery as polylines. A buffer operation of 1km away from the digitized area was done; an overlaid analysis was carried out on the buffered operation and the classified image, so as to analyze the probability of breeding of the tsetse flies on each parcel of land. The study grouped the possible breeding sites of the tsetse flies into three; most probable, moderately probable and less probable breeding space. Result of the findings reveals that 48.496 Hectares (24.64 %) is most probable for tsetse flies to breed on, 107.54 hectares (54.24 %) is moderately probable, and 42.231 Hectares (21.3 %) is less probable. Based on the findings of the study it's apparent that Ikom Local Governement Area and it's environs provide a good breeding space and habitat for tsetse flies, it becomes imperative for all stakeholders in the control and eradication of tsetse flies, to work towards its total eradication in the area. [ABSTRACT FROM AUTHOR]

This paper tries to investigate the policy tools supporting New Technology-Based Firms (NTBFs). Given this aim, after reviewing background research regarding policy tools in Iran and other countries, the policy tools applied in other countries are compared with those applied in Iran and the gap between probable and preferred future situations was investigated in the framework of financial, administrative, information and regulatory policy tools by using paired T-Test and descriptive survey. The components of preferred policy tools are ranked by Freedman test. Research findings indicate that the widest and the narrowest gaps are in financial and information policy tools. The most preferred policy tools include joint ventures, joint R&D, issuing or buying stocks, companies' guarantees to receive aids, networking, grants, loans, incubators' development, creating a proper legal environment, training (managerial/technical) for companies, HR development, awards and bonuses, tax incentives, tax exemptions and consultancy service provision for the companies. [ABSTRACT FROM AUTHOR]

The present pilot study compared the effects of cognitive and non-cognitive approaches on the development of Japanese learners' knowledge about the different degrees of sureness attached to certain, probable, and possible items. The results showed that the cognitive approach group outperformed the non-cognitive approach and control groups in writing and comparison judgment tests, and that both the cognitive and non-cognitive approach groups performed better than the control group in the categorization judgment test. These results suggest that the cognitive approach with 3D image content through computers can promote L2 language learning because it may have made the target structures more salient and also enabled the participants to connect spatial concepts with different degrees of sureness attached to the certain, probable, and possible items, thereby facilitating deep processing of form-meaning pairings. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to determine the characteristics and significance of a probable diagnostic entity for primary headache disorder (PHD). Background A diagnosis of probable primary headache disorder (PPHD) is given when a patient's headache fulfills all but one criteria of the third beta edition of the international classification of headache disorder (ICHD-3β). Despite the uncertainty regarding this diagnosis, the inclusion of a probable diagnosis entity in this manual may aid in the accurate classification of headache disorders and allow effective treatment strategies to be started at the patient's initial visit. Methods This cross-sectional multicenter registry study assessed first-visit patients with complaints of headaches who presented at the outpatient clinics of 11 neurologists in Korea. The classification of a headache disorder was made according to the criteria of the ICHD-3 β by each investigator based on the initial evaluation of the patient or by a consensus meeting for uncertain cases. The rates of a probable diagnosis among PPHD patients were assessed and the clinical characteristics of these patients were compared with those of patients with a diagnosis of definite primary headache disorder (DPHD). Results A total of 1429 patients were diagnosed with PHD, and 305 (21.3%) of these patients had PPHD. The proportions of PPHD differed among the subtypes of DPHD as follows: migraines (16.1%), tension-type headaches (TTH; 33%), trigeminal autonomic cephalalgia (TAC; 40.9%), and other PHD (14%, P < .001). Patients with PPHD had less severe headache intensity than patients with DPHD (5.8 ± 2.2 vs 6.5 ± 2.1, respectively, P < .001) as well as a shorter duration of headache from onset (median: 1 vs 4 months, respectively, P < .001). The most common criteria missing for a definite diagnosis in the PPHD patients were total frequency (52.1%), duration of attack (14.4%), and accompanying symptoms (13.1%). Conclusions A probable diagnosis was given to 21.3% of the first-visit PHD patients due to incomplete or atypical presentations of the headaches. The incorporation of a probable diagnosis into the ICHD-3 β may be useful for reducing the diagnoses of unspecified headaches. [ABSTRACT FROM AUTHOR]

An adverse drug reaction is a causal relationship between a drug and an event. Alcohol consumption remains a huge threat to the global health. A seizure is an event accompanied with loss of motor activity and alterations in the patients EEG. Phenytoin is one of the most commonly employed anti-seizure medications. Manifestations of chronic phenytoin use may induce phenytoin toxicity and psychosis. Here we report a case of a 45 year old male patient with probable phenytoin induced psychosis while being treated for seizures in the in-patient ward. The long term use of phenytoin may manifest psychotic symptoms in certain population. There is a definite need of more evidence in this field and proper diagnostic and management approaches. [ABSTRACT FROM AUTHOR]