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The neurological examination has remained key for the detection of worsening in neurocritical care patients, particularly after traumatic brain injury (TBI). New-onset, unreactive anisocoria frequently occurs in such situations, triggering aggressive diagnostic and therapeutic measures to address life-threatening elevations in intracranial pressure (ICP). As such, the field needs objective, unbiased, portable, and reliable methods for quickly assessing such pupillary changes. In this area, quantitative pupillometry (QP) proves promising, leveraging the analysis of different pupillary variables to indirectly estimate ICP. Thus, this scoping review seeks to describe the existing evidence for the use of QP in estimating ICP in adult patients with TBI as compared with invasive methods, which are considered the standard practice. This review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews, with a main search of PubMed and EMBASE. The search was limited to studies of adult patients with TBI published in any language between 2012 and 2022. Eight studies were included for analysis, with the vast majority being prospective studies conducted in high-income countries. Among QP variables, serial rather than isolated measurements of neurologic pupillary index, constriction velocity, and maximal constriction velocity demonstrated the best correlation with invasive ICP measurement values, particularly in predicting refractory intracranial hypertension. Neurologic pupillary index and ICP also showed an inverse relationship when trends were simultaneously compared. As such, QP, when used repetitively, seems to be a promising tool for noninvasive ICP monitoring in patients with TBI, especially when used in conjunction with other clinical and neuromonitoring data. [ABSTRACT FROM AUTHOR]

Introduction: Neuromonitoring represents a cornerstone in the comprehensive management of patients with traumatic brain injury (TBI), allowing for early detection of complications such as increased intracranial pressure (ICP) [1]. This has led to a search for noninvasive modalities that are reliable and deployable at bedside. Among these, ultrasonographic optic nerve sheath diameter (ONSD) measurement is a strong contender, estimating ICP by quantifying the distension of the optic nerve at higher ICP values. Thus, this scoping review seeks to describe the existing evidence for the use of ONSD in estimating ICP in adult TBI patients as compared to gold-standard invasive methods. Materials and Methods: This review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews, with a main search of PubMed and EMBASE. The search was limited to studies of adult patients with TBI published in any language between 2012 and 2022. Sixteen studies were included for analysis, with all studies conducted in high-income countries. Results: All of the studies reviewed measured ONSD using the same probe frequency. In most studies, the marker position for ONSD measurement was initially 3 mm behind the globe, retina, or papilla. A few studies utilized additional parameters such as the ONSD/ETD (eyeball transverse diameter) ratio or ODE (optic disc elevation), which also exhibit high sensitivity and reliability. Conclusion: Overall, ONSD exhibits great test accuracy and has a strong, almost linear correlation with invasive methods. Thus, ONSD should be considered one of the most effective noninvasive techniques for ICP estimation in TBI patients. [ABSTRACT FROM AUTHOR]

In this work we provide a characterization of distinct types of (linear and non-linear) maps between Banach spaces in terms of the differentiability of certain class of Lipschitz functions. Our results are stated in an abstract bornological and non-linear framework. Restricted to the linear case, we can apply our results to compact, weakly-compact, limited and completely continuous linear operators. Moreover, our results yield a characterization of Gelfand-Phillips spaces and recover some known results about Schur spaces and reflexive spaces concerning the differentiability of real-valued Lipschitz functions. [ABSTRACT FROM AUTHOR]

Purpose of Review: This paper summarizes the evolution of cardiac magnetic resonance for the diagnosis of myocarditis and the evidence supporting its use, and possible future directions for development. Recent Findings: The development of non-invasive imaging techniques, with the possibility of tissue characterization by magnetic resonance imaging, has revolutionized the diagnosis of myocarditis. Summary: Endomyocardial biopsy (EMB) remains the gold standard in the diagnosis of myocardial inflammation. Cardiac magnetic resonance has emerged as the non-invasive diagnostic technique of choice. Classic Lake Louise criteria, including evaluation of edema, hyperemia, and myocardial necrosis, have become obsolete due to their low negative predictive value, among other limitations. Emerging parametric mapping techniques have been incorporated into the new criteria. [ABSTRACT FROM AUTHOR]

COVID-19 has overloaded national health services worldwide. Thus, early identification of patients at risk of poor outcomes is critical. Our objective was to analyse SARS-CoV-2 RNA detection in serum as a severity biomarker in COVID-19. Retrospective observational study including 193 patients admitted for COVID-19. Detection of SARS-CoV-2 RNA in serum (viremia) was performed with samples collected at 48–72 h of admission by two techniques from Roche and Thermo Fischer Scientific (TFS). Main outcome variables were mortality and need for ICU admission during hospitalization for COVID-19. Viremia was detected in 50–60% of patients depending on technique. The correlation of Ct in serum between both techniques was good (intraclass correlation coefficient: 0.612; p < 0.001). Patients with viremia were older (p = 0.006), had poorer baseline oxygenation (PaO2/FiO2; p < 0.001), more severe lymphopenia (p < 0.001) and higher LDH (p < 0.001), IL-6 (p = 0.021), C-reactive protein (CRP; p = 0.022) and procalcitonin (p = 0.002) serum levels. We defined "relevant viremia" when detection Ct was < 34 with Roche and < 31 for TFS. These thresholds had 95% sensitivity and 35% specificity. Relevant viremia predicted death during hospitalization (OR 9.2 [3.8–22.6] for Roche, OR 10.3 [3.6–29.3] for TFS; p < 0.001). Cox regression models, adjusted by age, sex and Charlson index, identified increased LDH serum levels and relevant viremia (HR = 9.87 [4.13–23.57] for TFS viremia and HR = 7.09 [3.3–14.82] for Roche viremia) as the best markers to predict mortality. Viremia assessment at admission is the most useful biomarker for predicting mortality in COVID-19 patients. Viremia is highly reproducible with two different techniques (TFS and Roche), has a good consistency with other severity biomarkers for COVID-19 and better predictive accuracy. [ABSTRACT FROM AUTHOR]

We determined stunting, wasting, and obesity frequencies in a total 1092 2-to-12 year old Baka Pygmy children from anthropometric and health data gathered in 34 villages in the Djoum-Mintom region in southeastern Cameroon in four health campaigns in 2010 and 2017–9. We compare these to the WHO Child Growth Standards, Amazonian Tsiname growth references for inter-population comparisons and the study population itself. Population-specific growth charts were constructed using GAMLSS modelling. Our results show that Baka children have one of the highest global rates of stunting relative to the WHO child growth standard with 57.8% for 2-to-12 year olds and 64% and 73% for 2-to-4 year old girls and boys, respectively. Frequencies of wasting, overweight, and low BMI were low at 3.4%, 4.6% and 4.3%, respectively, for 2-to-12 year olds. Underweight was at 25.5%, in the upper range for sub-Saharan Africa. Edemas indicated rare severe malnutrition (0.3%). Uncertainties in age estimation had dramatic effects on the reliability of estimated individual z-scores but distributions of z-scores were robust at a population level. In the context of the recent evidence for genetic adaptation of the Pygmies' small stature to the tropical forest environment we argue that WHO child standards for weight and BMI are applicable. However, standards for height are clearly not adequate for Pygmy people. To achieve UN Sustainable Development Goals, we recommend that Pygmy specific growth standards are developed for the various, genetically differing Pygmy tribes. [ABSTRACT FROM AUTHOR]

Purpose: DLG7 (disc large homolog 7) is a microtubule-associated protein encoded by DLGAP5 (DLG associated protein 5) gene and has an important role during spindle assembly. Spindle assembly deregulation is a well-known cause of genomic instability. The aim of this study was to investigate the influence of DLGAP5 expression on survival and to evaluate its potential use as a biomarker in colorectal cancer (CRC). Methods: DLGAP5 expression was measured in the primary tumor and corresponding normal mucosa samples from 109 patients with CRC and correlated to clinical and pathological data. The results were validated in a second, publically available patient cohort. Molecular effects of DLG7/DLGAP5 in CRC were analyzed via functional assays in knockdown cell lines. Results: DLGAP5 downregulation led to a significant reduction of the invasion and migration potential in CRC. In addition, DLGAP5 expression correlates with nodal status and advanced UICC stage (III–IV).Subgroup analyses revealed a correlation between DLGAP5 overexpression and poor survival in patients with non-metastatic disease (M0). Furthermore, overexpression of DLGAP5 is associated with worse overall survival in distinct molecular CRC subtypes. Conclusions: The results of this study suggest the importance of DLGAP5 in defining a more aggressive CRC phenotype. DLG7/DLGAP5 represents a potential biomarker for CRC in molecular subgroups of CRC. [ABSTRACT FROM AUTHOR]

Bacteria from Patagonian Merino wool were isolated to assess their wool-keratinolytic activity and potential for felt-resist treatments. Strains from Bacillus, Exiguobacterium, Deinococcus, and Micrococcus produced wool-degrading enzymes. Bacillus sp. G51 showed the highest wool-keratinolytic activity. LC-MS/MS analysis revealed that G51 secreted two serine proteases belonging to the peptidase family S8 (MEROPS) and a metalloprotease associated with Bacillolysin, along with other enzymes (γ-glutamyltranspeptidase and dihydrolipoyl dehydrogenases) that could be involved in reduction of keratin disulfide bonds. Optimum pH and temperature of G51 proteolytic activity were 9 and 60 °C, respectively. More than 80% of activity was retained in HO, Triton X-100, Tween 20, Lipocol OXO650, Teridol B, and β-mercaptoethanol. Treatment of wool top with G51 enzyme extract caused a decrease in wool felting tendency without significant weight loss (<1.5%). Sparse work has so far been performed to investigate suitable keratinases for the organic wool sector. This eco-friendly treatment based on a new enzyme combination produced by a wild bacterium has potential for meeting the demands of organic wool processing which bans the use of hazardous chemicals and genetic engineering. [ABSTRACT FROM AUTHOR]

The cybercrime industry is characterised by work specialisation to the point that it has become a volume industry with various “as-a-service” offerings. One well-established “as-a-service” business model is blackmarket pay-per-install (PPI) services, which outsource the spread of malicious programmes to affiliates. Such a business model represents the archetype of specialisation in the cybercrime industry: a mass of individuals, known as affiliates, specialise in spreading malware on behalf of a service. Extant literature has focused on understanding the scope of such a service and its functioning. However, despite the large number and aggregate effect of affiliates on cybercrime, little research has been done on understanding why and how affiliates participate in such models. This study depicts the motivations and challenges of affiliates spreading Android banking Trojan applications through a blackmarket PPI service. We conducted a thematic analysis of over 6,000 of their private chat messages. The findings highlight affiliates’ labour-intensive work and precarious working conditions along with their limited income, especially compared to their expectations. Affiliates’ participation in cybercrime was found to be entangled between legal and blackmarket programmes, as affiliates did not care about programmes’ legal status as long as they yielded money. This study contributes to the literature by providing additional evidence on the downsides of work specialisation emerging from the cybercrime industry. [ABSTRACT FROM AUTHOR]

Introduction: The pathogenesis of prosthesis loosening is not well understood. The aim of our study was to sonicate components of joint prostheses removed due to aseptic loosening, culture the sonicate fluid, and to correlate these results with the degree of radiological osteolysis. Methods: From January 2008 to June 2009 all consecutive patients who underwent a revision of hip or knee prosthesis due to aseptic loosening were included in the study. Aseptic loosening was established when the patient had radiological signs of loosening without symptoms or signs of infection. The diagnosis was confirmed when histology was negative, and ≥5 out of 6 standard cultures of periprosthetic tissue were negative. Bone lysis was measured according to the Paprosky or Engh classifications without knowing the result of sonication cultures. Removed components were placed in sterile bags and immediately transported to the microbiology laboratory and sonicated. Sonicate fluid was cultured and the results were correlated with the degree of bone lysis. The proportion of components with positive sonication culture according to the bone lysis classification was compared using χ test. Results: A total of 52 patients were included and 123 components were sonicated. In 30 patients at least 1 sonicated component was positive (57.7%) and 44 out of 123 (35.8%) components were positive. The proportion of positive sonication cultures was significantly higher in the group of components with a higher degree of bone lysis of 3 (76.5%) than in those with lower degrees (33.9% for 1 and 24% for 2) (χ test, p = 0.0004). Conclusions: Sonication cultures were positive in 57% of patients who underwent revision arthroplasty for aseptic loosening. The percentage of positive sonication cultures was significantly higher in patients with severe osteolysis. Level of evidence: level I of Prognostic Studies-Investigating the Effect of a Patient Characteristic on the Outcome of Disease. [ABSTRACT FROM AUTHOR]

The histology of periprosthetic tissue is a gold standard for the diagnosis of periprosthetic joint infection. However, the specificity and sensitivity of histology has never been 100%. In the present study we hypothesized that the type of microorganism could be related to the effectiveness of histology in the detection of infection. Frozen sections and cultures from periprosthetic tissue of 38 revision arthroplasties taken at the time of resection arthroplasty for the treatment of infection were retrospectively reviewed. Frozen sections were evaluated following Feldman’s criteria. A culture was considered positive when the same microorganism was isolated in at least two samples or when pus was present around the prosthesis. The literature providing information on histology and microbiology of arthroplasty-associated infection was reviewed. Coagulase-negative staphylococcus (CNS) was the etiology in 13 cases, Gram-negative bacilli in 8, Staphylococcus aureus in 7 , Candida sp in 2, Peptococcus sp in 2, Enterococcus sp in 1 and S. pneumoniae in 1. No microorganism was isolated in four cases. Almost all the frozen sections in the 38 cases were positive except in 2 of the 13 that were caused by CNS (15.3%). The articles reviewed supported our findings. Frozen section is a useful test to intraoperatively confirm an infection when preoperative septic loosening is suspected. However, histology has false-negative results when the infection is due to low-virulence microorganisms. [ABSTRACT FROM AUTHOR]

Tuberculous arthritis of the elbow joint is not commonly seen by orthopaedic physicians. In the past 20 years, with the pandemic of the human immunodeficiency virus and the increase in immunocompromised people, we have observed a resurgence of tuberculosis. Osteoarticular involvement has increased, too. Spinal and monoarthritis of weight-bearing joints such as the hip or knee are most frequently involved. The elbow joint is an uncommon location of osteoarticular tuberculosis. The aim of this case report is to describe a case of tuberculous arthritis of the elbow and the diagnostic problems that may arise and lead to a delay in treatment. [ABSTRACT FROM AUTHOR]

We studied the effect of the procurement team on the risk of contamination in 270 large bone allografts retrieved from 53 non-living donors under strictly aseptic conditions. The overall contamination rate was 8.1%. When the procurement team was constituted by three or less members the contamination rate was 5.6%, while if there were four or more members the rate was 12.9%; this difference was significant in the statistical analysis. We conclude that a procurement team constituted by three or less trained members is a determinant factor in decreasing the bacterial contamination rate of bone allografts. [ABSTRACT FROM AUTHOR]

A classical result of variational analysis, known as Attouch theorem, establishes an equivalence between epigraphical convergence of a sequence of proper convex lower semicontinuous functions and graphical convergence of the corresponding subdifferential maps up to a normalization condition which fixes the integration constant. In this work, we show that in finite dimensions and under a mild boundedness assumption, we can replace subdifferentials (sets of vectors) by slopes (scalars, corresponding to the distance of the subdifferentials to zero) and still obtain the same characterization: namely, the epigraphical convergence of functions is equivalent to the epigraphical convergence of their slopes. This surprising result goes in line with recent developments on slope determination (Boulmezaoud et al. in SIAM J Optim 28(3):2049–2066, 2018; Pérez-Aros et al. in Math Program 190(1–2):561-583, 2021) and slope sensitivity (Daniilidis and Drusvyatskiy in Proc Am Math Soc 151(11):4751-4756, 2023) for convex functions. [ABSTRACT FROM AUTHOR]