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BACKGROUND: In the United States (US), 61% of all suicide cases may involve firearms, and some evidence suggests that mental disorders may play a role in suicide by firearm. We performed the first systematic review and meta-analyses to investigate: (i) whether mental disorders are associated with suicide by firearm, and (ii) whether the risk of using a firearm compared with alternative means is associated with higher levels of suicide in individuals with a mental disorder\ud \ud METHODS AND FINDINGS: We searched twelve databases from inception to the 24th of May 2020. We retrieved 22 observational studies conducted in the US. Random-effects meta-analyses showed individuals who had a diagnosis of a mental disorder had lower odds (odds ratios (OR)= 0.50, 95% CI: 0.36 to 0.69; I2=100 (95% CI: 87 to 100%), of dying by suicide with a firearm than those who did not have a diagnosis of a mental disorder. Secondary analysis showed that decedents who had a mental health diagnosis resulted in lower odds of dying by suicide by using firearms than using other means\ud \ud LIMITATIONS: Risk of bias revealed a heterogeneous and poor definition of mental disorders as well as lack of control for potential demographic confounding factors. In the meta-analyses, studies were combined in the same analytic sample as 77% of these studies did not specify the type of mental disorder\ud \ud CONCLUSION: While our results seem to suggest that having a mental disorder may not be consistently associated with the odds of dying by suicide using a firearm, the presence of substantial heterogeneity and high risk of bias precludes any firm conclusions.

Summary Objective This study examines the effects of passive vs. active recovery at different percentages of maximum aerobic speed (MAS) on performance in a repeated sprint test and testosterone/cortisol ratio in basketball. Methods Sixteen basketball players performed a 20 m shuttle run test and randomly 4 repeated 10 × 30 m shuttle sprint tests with different types of recovery: passive and active at 50%, 35% and 20% of the MAS. Heart rate, RPE, Cortisol (C), testosterone (T) and blood lactate concentrations were measured during the sprint tests. Results The results showed that the total time (TT) and best time (BT) for repeated sprints are significantly higher during the passive recovery than the active ones. The performance recorded during active recovery at 20% of the MAS is significantly higher than those obtained at 35 and 50% of the MAS. There was no significant difference in lactate concentrations and T/C ratio between passive and active recovery. Significant correlations (r2 > 50%) were recorded between total time and MAS for both types of recovery. Conclusion Passive recovery provides the best performance in repeated sprints. Also by comparing active recoveries, those of intensity below 35% of the MAS lead to a better performance in basketball players.

Aims: Progressive chronic kidney disease represents a dreadful complication of type 2 diabetes mellitus (T2DM). We tested the pattern of use and the renal effects of old glucose-lowering drugs in T2DM patients cared for by Italian general practitioners (GPs). Methods: Data of 2606 T2DM patients were extracted from the databases of GPs, who do not have access to the most recent glucose-lowering drugs in Italy. The rate of kidney function decline was calculated by CKD-EPIcr, based on two consecutive creatinine values. Results: Metformin was used in 55% of cases, either alone or with sulfonylureas/repaglinide, across the whole spectrum of CKD (from 66% in stage G1 to only 8% in G4). Sulfonylurea use peaked at 21–22% in stage G2–G3a, whereas repaglinide use significantly increased from 8% in G1 to 22% in G4. The median rate of CKD decline was − 1.64mL/min/1.73m2 per year; it was higher in G1 (− 3.22 per year) and progressively lower with CKD severity. 826 cases (31.7%) were classified as fast progressors (eGFR decline more negative than − 5mL/min/1.73m2 per year). The risk of fast progressing CKD was associated with increasing BMI, albuminuria, and sulfonylurea use, alone (OR, 1.47; 95% confidence interval, 1.16–1.85), or in association with metformin (OR, 1.40; 95% CI 1.04–1.88). No associations were demonstrated for metformin, cardiovascular and lipid lowering drug use. Conclusion: In the setting of Italian family practice, sulfonylurea use is associated with progressive CKD in patients with T2DM. Metformin, at doses progressively reduced according to CKD stages, as recommended by guidelines, is not associated with fast progression.

Background The human Adenovirus (HAdV) is a common agent of acute respiratory infections (ARIs). Its clinical impact in immunocompetent children and in the context of coinfections remains unclear in Tunisia. Material and methods HAdV‐ARIs were studied in hospitalized patients from birth to the age of 5 years from 2013 to 2014. Clinical and demographic characteristics, coinfections, and molecular characterization of HAdV were established. Results HAdV‐positivity was detected in 114/583 specimens (19.6%) including 6.1% single infections and 93.9% coinfections. Adenoviral coinfections mostly comprised human Rhinovirus (50.9%), Streptococcus pneumoniae (34.2%), human Respiratory Syncytial virus A/B (29.8%), and human Coronaviruses (21.9%). HAdV infection was predominant in the pediatric population (25.0% vs 10.0% in neonates, P

The objective of this study was to assess the effects of an additional small-sided games (SSGs) training program during Ramadan intermitting fasting (RIF) on technical performance depending on changes in body composition, sleep habits, and ratings of perceived exertion (RPE). Twenty-four professional male basketball players from the Tunisian first division participated in this study. The players were randomly assigned to an intervention group (INT, n = 12) or an active control group (CON, n = 12). Both groups completed a four-week SSG training program (three sessions per week). During the first and fourth weeks of the SSGs training, the two groups were evaluated to detect changes in technical performance, dietary intake, body composition, sleep quality index (PSQI) survey outcomes, RPE, heart rate (HR), and blood lactate concentration [La]. During the fourth week of the RIF period, body composition, dietary intake, sleep latency, sleep duration, and HR significantly decreased only for INT (p &lt, 0.001). However, RPE significantly increased (p &lt, 0.001), and technical performances were negatively affected (p &lt, 0.01). MANCOVA (adjusted for the percentage of change in sleep duration, body mass, and RPE) showed no significant differences in either group. In conclusion, our results showed that the technical performance of professional basketball male players was significantly affected at the end of RIF independently of changes in RPE, sleep habits, and body composition.

The objective of this study was to investigate the construct validity and reliability of a new reactive multidirectional repeated sprinting test (RRSA5COD) in basketball players. Forty male basketball players were divided into two groups: Professional (PRO, n = 20) and Semi-professional (SEMI, n = 20). Participants completed the yo-yo intermittent recovery test level 1 (Yo-YoIR1), the squat jump (SJ), the counter movement jump (CMJ), the single leg drop jump (DJ), the 20-m sprint test, the planed multidirectional repeated sprinting test (PRSA5COD), and the RRSA5COD test. Reaction time (RT) and movement time (MT), total time (TT), best time (BT), and fatigue index (FI) were assessed. Heart rate (HR) was continuously recorded, while rating of perceived exertion (RPE) and blood lactate concentration (LA) were measured post-tests. The reliability of the RRSA5COD test was also assessed between two attempts with one week between them. The RRSA5COD results demonstrated to be reliable with most of the variables showing ICC &gt, 0.80. BA Bonferroni post hoc revealed a significant better TT in favor of RRSA5COD (p &lt, 0.001, ES = 0.15, small), and in favor of PRO (p &lt, ES = 0.006, small). The result showed a significant better performance in favor of PRO in all physical fitness tests. In conclusion, it was found that the RRSA5COD discriminates between professional and semi-professional male basketball players, and the results were demonstrated to be reliable.

Soil erosion is a severe and continuous environmental problem caused mainly by natural factors, which can be enhanced by anthropogenic activities. The morphological relief with relatively steep slopes, the dense drainage network, and the Mediterranean climate are some of the factors that render the Paleochora region (South Chania, Crete, Greece) particularly prone to soil erosion in cases of intense rainfall events. In this study, we aimed to assess the correlation between soil erosion rates estimated from the Revised Universal Soil Loss Equation (RUSLE) and the landscape patterns and to detect the most erosion-prone sub-basins based on an analysis of morphometric parameters, using geographic information system (GIS) and remote sensing technologies. The assessment of soil erosion rates was conducted using the RUSLE model. The landscape metrics analysis was carried out to correlate soil erosion and landscape patterns. The morphometric analysis helped us to prioritize erosion-prone areas at the sub-basin level. The estimated soil erosion rates were mapped, showing the spatial distribution of the soil loss for the study area in 2020. For instance, the landscape patterns seemed to highly impact the soil erosion rates. The morphometric parameter analysis is considered as a useful tool for delineating areas that are highly vulnerable to soil erosion. The integration of three approaches showed that there is are robust relationships between soil erosion modeling, landscape patterns, and morphometry.

One-class modelling is a useful approach in metabolomics for the untargeted detection of abnormal metabolite profiles, when information from a set of reference observations is available to model “normal” or baseline metabolite profiles. Such outlying profiles are typically identified by comparing the distance between an observation and the reference class to a critical limit. Often, multivariate distance measures such as the Mahalanobis distance (MD) or principal component-based measures are used. These approaches, however, are either not applicable to untargeted metabolomics data, or their results are unreliable. In this paper, five distance measures for one-class modeling in untargeted metabolites are proposed. They are based on a combination of the MD and five so-called eigenvalue-shrinkage estimators of the covariance matrix of the reference class. A simple cross-validation procedure is proposed to set the critical limit for outlier detection. Simulation studies are used to identify which distance measure provides the best performance for one-class modeling, in terms of type I error and power to identify abnormal metabolite profiles. Empirical evidence demonstrates that this method has better type I error (false positive rate) and improved outlier detection power than the standard (principal component-based) one-class models. The method is illustrated by its application to liquid chromatography coupled to mass spectrometry (LC-MS) and nuclear magnetic response spectroscopy (NMR) untargeted metabolomics data from two studies on food safety assessment and diagnosis of rare diseases, respectively.

Wheat is one of the most important crop grown worldwide, and especially in the Mediterranean basin, durum wheat is the most used for typical food industry. Due to the variable climate conditions, one of the most important targets for breeders in these areas is the identification of high yielding genotypes. The objective of the present study was to evaluate phenotypic variability in a set of Tunisian and Algerian durum wheat germplasm based on adaptive and yield related traits. Analysis of variance showed significant variation among genotypes, and high heritability for the analyzed agronomic traits. Tiller number per spike and spiked tiller per spike, which are an indication of the crop’s ability to maximize crop yield, ranged from 2.31 to 6.24 and 0.99 to 3.98 respectively. Heading date, one of the most important adaptive trait in cereal, also showed variability, ranging from 127 to 146 days after emergence. The 74 analyzed genotypes showed a high heritability value of thousand kernel weight (53.2%). Interestingly, genetic advance evaluated for thousand kernel weight was 13.77 g. The lowest but definitely moderate heritability value was recorded for tiller number per plant (42%), with a genetic advance of 0.51 tillers per plant. These data are an important starting point for the identification and future breeding of genotypes with higher genetic potential, important requirement for the production of high yielding wheat varieties.

Summary Objectives The purpose of this study was to investigate the effect of acute moderate (MEx) and heavy (HEx) exercises on ghrelin, growth hormone (GH), insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) in untrained subjects. Methods A pre/post interventional study including seven overweight middle-aged males (mean ± SD: age = 36.4 ± 4.35 years) was designed. Participants performed two sessions of exercise at 7-day interval. Each session consisted in cycling exercise during 20 min at 60% (moderate exercise, MEx) or at 80% (heavy exercise, HEx) of peak aerobic power (PAP). Venous blood samples were obtained before, at the end (0 min) and after 30, 60, 90 and 120 min recovery in each session. Results After exercise and during recovery, ghrelin, IGF-1 and IGFBP-3 concentrations have been unchanged in both groups. However, GH concentration has significantly increased at the end of exercise (0.12 ± 0.09 vs. 1.08 ± 0.73 ng·mL−1; P = 0.004; ES = 1.99) and 30 min after (0.12 ± 0.09 vs. 0.60 ± 0.36 ng·mL−1; P = 0.035; ES = 1.98) in HEx session, only. No significant correlation was observed at baseline between ghrelin and the other markers (GH, IGF-1 and IGFBP-3). Conclusion Our results suggested that 20 min moderate or heavy sub-maximal exercises not stimulate the production and the release of ghrelin after 2 hours recovery. In our experimental conditions, it appears that: ghrelin does not participate in the regulation of the GH response to exercise in overweight males and; exercise intensity and duration may be determinant to affect ghrelin secretion.

Wolman disease is an ultrarare lysosomal storage disease caused by a mutation in the LIPA gene. The clinical features of Wolman disease include early onset of vomiting, diarrhea, failure to thrive, hepatosplenomegaly, and bilateral adrenal calcification. We report the case of a 3-month-old infant who presented clinical features of hemophagocytic lymphohistiocytosis. Genetic sequence analysis of the LIPA gene revealed homozygous mutation c.153 CA (p.Tyr51*). The parents were heterozygous for this mutation. Prenatal diagnosis has been carried out in the next pregnancy. To our knowledge, this mutation has never been reported before, and this is an unusual case of secondary hemophagocytic lymphohistiocytosis complicating Wolman disease.

This study established the correlation between respiratory syncytial virus (RSV) bronchiolitis and climate factors in the area of Sousse, Tunisia, during 13 years (2003–2015), from neonates and children

This paper suggests a new short-term planning strategy to maximize the benefits of simultaneous distribution network reconfiguration and distributed generation integration by considering the variations in DG outputs and the system load during the planning period. The objective functions to optimize are active power losses, green house emissions and operation costs, while satisfying all operational and topological constraints. A Pareto-optimality-based method is suggested to solve this combinatorial problem providing Pareto optimal solutions where utilities can select a final solution. The effectiveness of the proposed planning strategy is investigated through simulation tests performed on a standard distribution network test system. Fuzzy decision making is utilized to identify the best solutions among Pareto ones. These optimal solutions give significant economic, technical and environmental enhancements of the distribution network.

Background This study aimed to characterize the epidemiology of pathogenic respiratory agents in patients aged 0 to 12 months and hospitalized for acute respiratory infections in Tunisia between 2013 and 2014. Methods A total of 20 pathogens, including viruses, Mycoplasma pneumoniae, and Streptococcus pneumoniae, were detected using molecular sensitive assays, and their associations with the patient’s demographic data and season were analyzed. Results Viral infectious agents were found in 449 (87.2%) of 515 specimens. Dual and multiple infectious agents were detected in 31.4% and 18.6% of the samples, respectively. Viral infection was predominant in the pediatric environment (90.8%, P, This study provides a useful starting point for a better understanding about the circulation of respiratory infectious agents in the area of Sousse, Tunisia. It will participate to reduce the overuse of unnecessary antibiotics in public hospitals which will avoid bacterial resistance and contribute to the implementation of preventive strategies and control systems in Tunisia.

BACKGROUND Chimeric antigen receptor-modified T-cells targeting CD19 (CAR-T19) are licensed for treating relapsed/refractory diffuse large B-cell lymphoma and B-acute lymphoblastic leukemia. Predicting treatment responses and toxicity (e.g., cytokine release syndrome and neurotoxicity) remains a big challenge. CAR-T19 monitoring could increase our understanding of treatment responses and be of relevance to patient management. A robust method for accurate CAR-T19 detection is therefore extremely desirable. METHODS An assay that uses fluorochrome-conjugated human recombinant soluble CD19 was tested against two commercially available CAR-T19 therapies and a CAR-T19 cell line developed in-house. Precision, concordance, and analyte stability were tested using peripheral blood obtained from CAR-T19-treated patients and controls. RESULTS The assay showed good accuracy, and had a limit of blank for whole blood samples of 0.13%. Reproducibility and inter-operator concordance were satisfactory (CVs

BackgroundAssistive technology and telecare have been promoted to manage the risks associated with independent living for people with dementia, but there is limited evidence of their effectiveness.ObjectivesThis trial aimed to establish whether or not assistive technology and telecare assessments and interventions extend the time that people with dementia can continue to live independently at home and whether or not they are cost-effective. Caregiver burden, the quality of life of caregivers and of people with dementia and whether or not assistive technology and telecare reduce safety risks were also investigated.DesignThis was a pragmatic, randomised controlled trial. Blinding was not undertaken as it was not feasible to do so. All consenting participants were included in an intention-to-treat analysis.SettingThis trial was set in 12 councils in England with adult social services responsibilities.ParticipantsParticipants were people with dementia living in the community who had an identified need that might benefit from assistive technology and telecare.InterventionsParticipants were randomly assigned to receive either assistive technology and telecare recommended by a health or social care professional to meet their assessed needs (a full assistive technology and telecare package) or a pendant alarm, non-monitored smoke and carbon monoxide detectors and a key safe (a basic assistive technology and telecare package).Main outcome measuresThe primary outcomes were time to admission to care and cost-effectiveness. Secondary outcomes assessed caregivers using the 10-item Center for Epidemiological Studies Depression Scale, the State–Trait Anxiety Inventory 6-item scale and the Zarit Burden Interview.ResultsOf 495 participants, 248 were randomised to receive full assistive technology and telecare and 247 received the limited control. Comparing the assistive technology and telecare group with the control group, the hazard ratio for institutionalisation was 0.76 (95% confidence interval 0.58 to 1.01;p = 0.054). After adjusting for an imbalance in the baseline activities of daily living score between trial arms, the hazard ratio was 0.84 (95% confidence interval 0.63 to 1.12;p = 0.20). At 104 weeks, there were no significant differences between groups in health and social care resource use costs (intervention group – control group difference: mean –£909, 95% confidence interval –£5336 to £3345) or in societal costs (intervention group – control group difference: mean –£3545; 95% confidence interval –£13,914 to £6581). At 104 weeks, based on quality-adjusted life-years derived from the participant-rated EuroQol-5 Dimensions questionnaire, the intervention group had 0.105 (95% confidence interval –0.204 to –0.007) fewer quality-adjusted life-years than the control group. The number of quality-adjusted life-years derived from the proxy-rated EuroQol-5 Dimensions questionnaire did not differ between groups. Caregiver outcomes did not differ between groups over 24 weeks.LimitationsCompliance with the assigned trial arm was variable, as was the quality of assistive technology and telecare needs assessments. Attrition from assessments led to data loss additional to that attributable to care home admission and censoring events.ConclusionsA full package of assistive technology and telecare did not increase the length of time that participants with dementia remained in the community, and nor did it decrease caregiver burden, depression or anxiety, relative to a basic package of assistive technology and telecare. Use of the full assistive technology and telecare package did not increase participants’ health and social care or societal costs. Quality-adjusted life-years based on participants’ EuroQol-5 Dimensions questionnaire responses were reduced in the intervention group compared with the control group; groups did not differ in the number of quality-adjusted life-years based on the proxy-rated EuroQol-5 Dimensions questionnaire.Future workFuture work could examine whether or not improved assessment that is more personalised to an individual is beneficial.Trial registrationCurrent Controlled Trials ISRCTN86537017.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 25, No. 19. See the NIHR Journals Library website for further project information.

Introduction\ud Caregivers who live with a person with dementia who receives care, compared with those who live elsewhere, are often considered to experience greater levels of psychological and affective burden. The evidence for this is, however, only limited to studies employing small sample sizes and that failed to examine caregivers’ psychological wellbeing. We address these issues in a large cohort of dementia caregivers.\ud \ud Methods\ud We conducted a cross-sectional study comparing caregivers living with a dementia care recipient (n = 240) to caregivers living elsewhere (n = 255) on caregivers’ burden, anxiety, and depression.\ud \ud Results\ud We found that caregivers living with the care recipient relative to those living elsewhere showed significantly greater burden and depression, but we found no group difference in anxiety.\ud \ud Conclusions\ud Our study adds to the evidence by showing that cohabiting with a care recipient with dementia is associated with greater burden and poorer psychological wellbeing. Strategies aiming to improve caregivers’ burden and psychological wellbeing should take account of caregivers’ living arrangements.

Background: Metabolic syndrome is a cluster of metabolic risk factors for type 2 diabetes mellitus and cardiovascular diseases. Physiological variations occurring in women during menopause are thought to be a predisposing factor for the metabolic syndrome. The aim of this study was to evaluate the prevalence of metabolic syndrome and its individual components according to menopausal status in a sample of Moroccan women. Methods: We analyzed data of 653 women aged 19 years and older. We used the recently published joint interim statement criteria to classify subjects as having metabolic syndrome. Results: Out of the total subjects, 262 (40.12%) were syndromic. The metabolic syndrome and abdominal obesity were more common in postmenopausal than in premenopausal women. The highest prevalence of metabolic syndrome was observed in menopausal transition especially among women aged 49-52 years (62.59%). During this period, half of women have at least three metabolic syndrome risk factors. Conclusion: Abdominal obesity associated with metabolic changes occurring in menopause was a risk factor for the development of metabolic syndrome in women. There is a need to adopt a healthy lifestyle to prevent weight gain in women. This can minimize the incidence of metabolic syndrome and its consequences as type 2 diabetes and cardiovascular diseases.

Multidirectional repeated sprints with quick changes-of-direction (CoD) are considered a key performance determinant in basketball. The objective of this study was to investigate the effects of a 12-week CoD sprint training program compared to regular basketball training on selected measures of physical fitness and physiological adaptations in male basketball players. Sixteen professional basketball players were randomly assigned to an intervention group (INT = 8) or an active control group (CON = 8). INT completed a 12-week CoD sprint training program with two sessions per week while CON continued their regular training. Training volume was similar between groups. Before and after the intervention, the two groups were evaluated for the repeated sprint ability test with CoD (IRSA5COD), the squat jump (SJ) and countermovement jump (CMJ) test, the five time-jump test (FJT) and change of direction T-test. Blood samples were taken before the beginning of the experimental protocol, after 4, 8 and 12 weeks to monitor the testosterone/cortisol ratio (T/C). For T-test, post-hoc tests revealed significant pre-to-post improvements for INT (3.4%, p = 0.001, ES = 0.91). For CMJ, post-hoc tests revealed a significant pre-to-post decrease for INT (&minus, 11.6%, p = 0.001, ES = 0.94), and a significant improvement for CON (4.96%, p = 0.014, ES = 0.60). For T/C ratio, post-hoc tests revealed a significant decrease after 12 weeks of training for INT (52.3%, p &lt, 0.001, ES = 0.63). In conclusion, twelve weeks of CoD sprint training enhanced CoD performance but negatively affected vertical jump capacity in male basketball players. T/C ratio indicated that the physiological demands associated with INT were well-balanced.

Objective Treatment of pain associated with osteoarthritis (OA) is unsatisfactory and innovative approaches are needed. The secretome from human adipose-derived mesenchymal stem cells (hASC-Conditioned Medium, CM) has been successfully used to relieve painful symptoms in models of chronic pain. The aim of this study was to explore the efficacy of the hASC-CM to control pain and neuroinflammation in an animal model of OA. Methods OA was induced in mice by intra-articular monosodium-iodoacetate (MIA) injection. Thermal hyperalgesia and mechanical allodynia were assessed. Once hypersensitivity was established (7 days after MIA), hASC-CM was injected by IA, IPL and IV route and its effect monitored over time. Neuroinflammation in nerve, dorsal root ganglia and spinal cord was evaluated measuring proinflammatory markers and mediators by RT-qPCR. Protein content analysis of secretome by Mass Spectrometry was performed. Results A single injection with hASC-CM induced a fast and long lasting antihyperalgesic and antiallodynic effect. The IV route of administration appeared to be the most efficacious although all the treatments were effective. The effect on pain correlated with the ability of hASC-CM to reduce the neuroinflammatory condition in both the peripheral and central nervous system. Furthermore, the secretome analysis revealed 101 factors associated with immune regulation. Conclusion We suggest that hASC-CM is a valid treatment option for controlling OA-related hypersensitivity, exerting a rapid and long lasting pain relief. The mechanisms underpinning its effects are likely linked to the positive modulation of neuroinflammation in peripheral and central nervous system that sustains peripheral and central sensitization.

Introduction The coinciding of month of Ramadan with international basketball competitions could affect players’ performance. Objective This field investigation examined the impacts of a basic training program in small-sided games and repeated sprint ability during intermittent fasting for Ramadan (R) and one month after Ramadan (AR) [control month] on body composition, agility and lower limb power. Methods Sixteen basketball players (age, 23.4±2.3 years) performed two training programs [small-sided games (SSG) and repeated sprint ability (RSA)] during R and AR, interrupted by fifteen days of total recovery. The players were randomly allocated to two groups (GSSG, n=8 and GRSA, n=8). Body composition, agility T test, squat jump (SJ) test, countermovement jump (CMJ) test and five-jump (FJT) test performances were measured on four occasions: before R (P1) and at the end of R (P2),as well as before AR (P3) and at the end of AR (P4). Results The results showed that body mass (BM), body mass index (BMI) and body fat (BF %) decreased significantly at the end of R for both groups (all p < 0.001). Moreover, the performances in the agility T test, SJ test, CMJ test and FJT test improved significantly at the end of R for both groups (p

The coronavirus disease 19 (COVID-19) is a viral infection caused by a new coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is considered as a public health emergency of international concern. The only available way, apparently effective, to control this pandemic is the social distancing. However, other possible aspects of infection control may be mentioned. In this review, we highlight certain peculiarities linked to the nature of the virus and its angiotensin converting enzyme 2 receptor, the host defense and the final clinical manifestation of the infection that could be essential elements in strengthening the effectiveness of COVID-19 pandemic control efforts.

Over the years, several studies have shown that many factors are likely to affect the results of forensic hair analyses and complicate their interpretation. Among these factors, one of the major drawbacks in hair analysis is the affectability of deposited xenobiotics by cosmetic treatments, which could be eventually used to adulterate the sample. It is well known that some cosmetic treatments containing hydrogen peroxide, such as permanent dyeing or bleaching, lead to the formation of 1-H-pyrrole-2,3,5-tricarboxylic acid (PTCA), a melanin degradation product. Considering that PTCA is also an endogenous compound, spontaneously formed by natural oxidation of melanin, its only detection in hair is not enough to confirm a cosmetic oxidative treatment. For this reason, the aim of the present work was to develop and validate a reliable liquid–liquid extraction method in ultra-high-performance liquid chromatographic–tandem mass spectrometry for the determination of endogenous PTCA in hair from a wide multi-ethnic population (African, Arab, Asian-Pacific, Caucasian, Hispanic and Indian). According to previous studies, untreated hair samples showed a PTCA content of 8.54 ± 5.72 ng/mg (mean ± standard deviation [SD]), ranging between 0.44 and 23.7 ng/mg; after in vitro cosmetic bleaching, PTCA increased to 16.8 ± 6.95 ng/mg (range: 4.16–32.3 ng/mg). Comparing baseline PTCA levels of each subgroup with the others, we could not observe any statistically significant difference, except for Caucasians (P

We introduce an extension for TPC benchmarks addressing the requirements of big data processing in cloud environments. We characterize it as the Elasticity Test and evaluate under TPCx-BB (BigBench). First, the Elasticity Test incorporates an approach to generate real-world query submissions patterns with distinct data scale factors based on major industrial cluster logs. Second, a new metric is introduced based on Service Level Agreements (SLAs) that takes the quality of service requirements of each query under consideration.

Objectives Health literacy encompasses a broad skill set linked to patients' self-management ability and the complexity of their health care environments. Self-management in the context of multimorbidity is particularly challenging, placing patients at risk of poor clinical outcomes. This study aimed to explore the prognostic associations between health literacy domains, depression, and 12-month health care utilization and mortality in patients with diabetes and end-stage renal disease (DM-ESRD). Design Observational study. Methods Patients with DM-ESRD undergoing haemodialysis were recruited. Information on all-cause hospitalization/admission and mortality of participants was recorded. Negative binomial and Cox regressions were used to model risk factors for hospitalization and mortality. Results A total 221 participants [median age: 59 years, 61.6% men, 54.8% Chinese] were recruited. Differences in health literacy were found as a function of age, ethnicity, relationship status, and education. After adjusting for demographic and clinical factors, the HLQ domain Actively Managing My Health remained independently associated with lower rates of hospitalization (incidence rate ratio (IRR) = 0.674, 95% CI [0.490, 0.925], p = .02) and mortality (hazard ratio = 0.382, 95% CI [0.160, 0.848], p = .02). Cumulative hospitalization days were associated with employment status (IRR = 2.242, 95% CI [1.223, 4.113], p = .009), albumin (IRR = 0.918, 95% CI [0.854, 0.988], p = .02), HbA1c (IRR = 1.183, 95% CI [1.028, 1.360], p = .02), comorbidity burden (IRR = 1.137, 95% CI [1.003, 1.289], p = .04), and depression (IRR = 1.059, 95% CI [1.003, 1.118], p = .04) but no health literacy domains. Conclusions Health literacy skills related to Actively Managing My Health predict hospitalization and mortality independently of other risk factors. The HLQ provides an assessement of novel health literacy parameters which offer new insights into patients' status and behaviours and may strengthen interventions to improve clinical services, and patient outcomes in DM-ESRD. Statement of contribution What is already known on this subject? Patients with diabetes (DM) comprise the fastest growing segment of patients with end-stage renal disease (ESRD). Health literacy (HL) is pivotal for managing the complex treatment guidelines for DM-ESRD. Most prior work on HL focused on functional HL and shown significant associations with mortality and hospitalization. Limited research has investigated wider HL skills in relation to clinical outcomes. What does this study add? Supporting patients in Actively Managing my health liteacy skills is critical in decreasing probability of hospitalization and morbidity. The presence of symptoms of depression is associated with longer hospitalization period. This work was supported by grant from the National Kidney Foundation Singapore toKonstadina Griva (NKFRC/2013/01/20). Dr RH Osborne was funded in part through aNational Health and Medical Research Council of Australia Senior Research Fellowship #1059122.

Rice (Oryza sativa L.) is the main source of staple food for human population. Salinity is the major problem for agricultural production, and it affects rice production globally. Salinity induces the production of reactive oxygen species (ROS) in plant cells. ROS can act as signaling molecules, mediating many key physiological processes. Osmotic adjustment has been shown to be an effective component of stress tolerance, and accumulation of osmoprotectants is a common response observed in different plant systems. Information on the metabolic pathways of these compatible solutes for their regulation, enzymes involved, and compartmentalization are well characterized in most important plant species. Different approaches have been developed and exploited to ameliorate the harmful effects of salinity on rice production. Genomics approaches have the potential to accelerate breeding process for the development of salt-tolerant crop cultivars. Identified genomic regions associated with salinity tolerance accelerated molecular breeding efforts to develop salt-tolerant rice cultivars. Development of genetically engineered plants with enhanced tolerance to salinity is an important challenge in rice biotechnology research. Genetic engineering has been used as a prominent tool for rice improvement. In this chapter, a detailed description of molecular mapping techniques, and major findings made by these techniques, is presented. We discuss the mechanisms by which rice perceive environmental signals and transmit them to cellular machinery to activate adaptive responses and to impart stress tolerance. Finally, we provide an overview of recent developments on the production of various transgenic lines in rice that are highly promising for stress tolerance.

A recently developed software application, eCTG, extracts cardiotocographic (CTG) signals from digital CTG images, possibly obtained by scanning paper CTG reports. The aim of this study was to evaluate eCTG robustness across varying image formats, resolution and screw. Using 552 digital CTG signals from the &ldquo, CTU-UHB Intrapartum Cardiotocography Database&rdquo, of Physionet, seven sets of digital CTG images were created, differing in format (.TIFF, .PNG and .JPEG), resolution (96 dpi, 300 dpi and 600 dpi) and screw (0.0&deg, 0.5&deg, and 1.0&deg, ). All created images were submitted to eCTG for CTG signals extraction. Quality of extracted signals was statistically evaluated based 1) on signal morphology, by computation of the correlation coefficient (&rho, ) and of the mean signal error percent (MSE%), and 2) on signal clinical content, by assessment of 18 standard CTG variables. For all sets of images, &rho, was high (&rho, &ge, 0.81) and MSE% was small (MSE% &le, 2%). However, significant changes occurred in median values of four, four and five standard CTG variables in image sets with 96 dpi resolution, 0.5&deg, screw and 1.0&deg, screw, respectively. In conclusion, for an optimal eCTG performance, digital images should be saved in lossless formats, have a resolution of at least 300 dpi and not be affected by screw.

Several studies of distribution network enhancement focused only on the optimization of either the integration of distributed generations (DG) or network reconfiguration. However, very few researches have been done for distribution network reconfiguration simultaneously with the DG location and sizing. This paper presents a multi-objective management operations based on network reconfiguration in parallel with renewable DGs allocation and sizing for minimizing active power loss, annual operation costs (installation, maintenance, and active power loss costs) and pollutant gas emissions. The time sequence variation in wind speed, solar irradiation and load are taken into consideration. An efficient evolutionary technique based on the Pareto optimality is adopted to solve the problem. A fuzzy set theory is used to select the best compromise solution among obtained Pareto set. The obtained results prove the efficiency and the accuracy of the suggested method for the network manager to find the optimal network configuration simultaneously with DG location and sizing considering multiple criteria.

This paper contributes to the small but growing literature on the linkages between renewable energy consumption, international trade, oil price and economic growth. It aims to investigate such dynamic relationships using the bounds testing approach to cointegration and the ARDL methodology for Tunisia over the period 1980–2011. The main empirical findings reveal the presence of a bidirectional relationship between renewable energy consumption and international trade in the short-run. Indeed, an increase in oil price may imply an increase of renewable energy consumption. Furthermore, a unidirectional relationship between renewable energy and oil price is proven in the short-run.

Introduction Malignant pleural mesothelioma (MPM) is a rare fatal asbestos-related malignancy originating in the mesothelial cells of the pleura. A platinum-based doublet containing a third-generation antifolate is the front-line standard of care whilst there are no approved second-line treatments for MPM which remains a disease setting to test the efficacy of new therapeutic agents. Methods Bone marrow mesenchymal stromal cells (BM-MSCs) were loaded with pemetrexed (PMX) and paclitaxel (PTX) according to a standardized procedure. Drug release by both PMX- and PTX-primed BM-MSCs (BM-MSCs/PMX and BM-MSCs/PTX) was tested on the in vitro proliferation of a panel of tumor cell lines including NCI-H28 mesothelioma. Results The in vitro anticancer activity of pure PTX was significantly higher than that of PMX against all the cell lines tested (14.7 times higher than that of PMX against NCI-H28). Whereas BM-MSCs did not take up and release PMX in amounts effective on mesothelioma, PTX-loaded BM-MSCs dramatically inhibited mesothelioma proliferation. Conclusions PTX-primed mesenchymal stromal cells successfully inhibit the in vitro proliferation of human mesothelioma cells. Further studies and in vivo testing are required to confirm our preliminary in vitro results as a potential new mesothelioma therapy based on cell drug delivery.

Localization of chemotherapy at the tumor site can improve therapeutic efficacy and reduce systemic toxicity. In previous studies we have shown that mesenchymal stromal cells (MSCs) isolated from bone marrow or adipose tissue can be loaded with the anti-cancer drug Paclitaxel (PTX) and kill cancer cells when localized nearby. We here investigated the capacity of human micro-fragmented adipose tissue (MFAT), used as a natural scaffold of MSCs, to deliver PTX with the idea to improve local drug concentration and to prolong the therapeutic activity. Surprisingly, we found that both fresh but also devitalized MFAT (DMFAT) (by freezing/thawing procedure) were able to deliver and release significant amount of PTX, killing several human cancer cell lines in vitro with a long lasting activity. In an orthotopic mice model of Neuroblastoma (NB) transplant, DMFAT loaded with PTX prevents or delays NB relapse when placed in the surgical area of tumor resection, without any collateral toxicity. We concluded that MFAT, but also DMFAT, may represent very innovative natural biomaterials able to localize and release anti-cancer molecules at the tumor site, helping to fight cancer in human.

In this work, phenolic composition, antioxidant and antibacterial activities of selected Tunisian barley varieties were studied. Swihli barley exhibited the highest total phenolic content and the strongest antioxidant and antibacterial activities. Liquid chromatography/mass spectrometry analysis revealed significant qualitative and quantitative differences in phenolic composition among the different varieties. Procyanidin B3 and catechin were the most abundant. Pearson’s correlation test revealed significant correlations between the antioxidant activities of barley extracts and both hydroferuloyl glucose and catechin-3-glucose.

Tissue healing is a complex process involving several players such as cells and growth factors released from platelets upon activation. Today, platelet concentrates (PCs) are used in many different medical fields including oral, orthopaedic, and reconstructive surgery since they allow growth factors delivery to the injured site, aiming at enhancing tissue regeneration. The purpose of this in vitro study was to evaluate the effect of the acellular plasma of an activated platelet concentrate obtained using a manual protocol, on the proliferation, and biological activity of differentiated cells involved in tissue healing. Human osteoblasts and dermal fibroblasts were grown in serum-free medium supplemented with PC derived from several donors. Human osteoblast and human dermal fibroblast proliferation was assessed by MTT test after 7 days and cells were count up to 12-day incubation. Human osteoblast osteo-differentiation was tested after 7 and 14-day incubation by alkaline phosphatase assay. The addition of PC to the culture medium caused an increased proliferation with respect to cells grown in standard condition. The results of the present study suggest that PC supports the proliferation of terminally differentiated cells involved in wound healing and tissue regeneration, confirming its beneficial clinical application in regenerative therapies.

Il s’agit d’un enfant âge de 6 ans hospitalise pour une alteration de l’etat general avec une pâleur intense et une hepatosplenomegalie. Il n’a pas d’antecedents personnels ou familiaux et il n’existe pas de consanguinite. L’hemogramme montre une anemie, une thrombopenie et une hyperleucocytose moderee. L’examen du frottis sanguin revele une erythromyelemie et la presence de blastes faisant suspecter fortement une leucemie aigue erythroblastique. Le myelogramme est massivement envahi par une population erythroblastique immature presentant des anomalies morphologiques et des signes de dyserythropoiese. De nombreuses images d’hemophagocytose sont egalement notees. Le diagnostic retenu est celui de leucemie erythroblastique pure associee a un syndrome d’activation macrophagique. Compte tenu de l’aggravation de l’hyperleucocytose, un second myelogramme est realise. Il montre une moelle infiltree par une composante monocytaire et la persistance d’images d’hemophagocytose. L’immunophenotypage a confirme la filiation monocytaire de la proliferation. Devant ces resultats, il a ete conclu a une transformation en leucemie aigue monoblastique et le patient decede au bout de deux jours. Nous rapportons un cas de leucemie aigue erythroblastique avec un syndrome d’activation macrophagique et qui se singularise par sa transformation rapide en une leucemie aigue monoblastique.

Highlights • Stridor due to impacted esophageal foreign body in infants is a well known entity. but often forgotten. • Persistent stridor and upper −airway obstruction with no obvious cause should arouse the suspicion of the esophageal foreign body in infants. • Impacted oesophageal foreign bodies are usually treated endoscopically. When this approach is either unfeasible or unsuccessful, as in the case presented here, open surgical removal may be mandatory. • In children, prevention of foreign body ingestion is better than cure., Introduction Foreign body (FB) ingestion, a common and serious problem in children, can present with a wide variety of symptoms. This paper describes and discusses the case of an esophageal foreign body (EFB), in which the patient presented with primarily respiratory clinical signs causing delayed diagnosis. Presentation of case A six month old boy presented with three months history of harsh cough, stridor and pulmonary congestion. He was repeatedly treated with steroids and antibiotics. His symptoms worsened progressively. On examination, he was tachypneic with suprasternal recession, scattered crepitations, diffuse wheeze and a continuous stridor. Chest X-ray was normal. The flexible bronchoscopy showed a posterior external compression on the middle wall of the trachea. The CT scan was normal. The contrast X-ray study of the esophagus revealed an endoluminal filling defect. The esophagoscopy revealed narrowing at 12 cm of dental arch, and a bourgeoning yellow mass easily bleeding on contact. Esophageal biopsies were obtained, and histology was inconclusive. A surgical exploration was planned, but the infant forced out a pistachio shell after a chest physiotherapy session. Discussion Ingestion of FB by small children is a common problem. The majority of EFBs pass harmlessly through the gastrointestinal tract; however, some EFBs can cause significant morbidities. The diagnosis may be delayed leading to several complications especially if the ingestion of the FB is unwitnessed and when the clinician does not think of FB ingestion as part of the differential diagnosis of chronic respiratory signs. Conclusion This case highlights, the importance of recognizing, the rare and often forgotten respiratory symptoms of EFB body to avoid diagnostic delay especially in unwitnessed FB ingestion.

Chimeric antigen receptor T-cells (CAR-T) have emerged as an extremely promising therapy for hematological malignancies. The immunophenotype of apheresis material and the CAR-T cell product is known to be predictive of the likelihood of response to treatment of certain malignancies. Central memory and stem cell-like memory T cell phenotypes are associated with a more sustained proliferative response and long-term CAR-T persistence (Fraietta et al, Nature Medicine, 2018). There is an unmet need for standardized methods and reagents to reliably profile the memory phenotype of CAR-Ts to better evaluate product quality, and support improvements in CAR-T manufacturing. The BD Biosciences dried memory T-cell panel contains a pre-validated mixture of 7 antibodies for the identification of naïve, stem cell memory, central memory and effector memory CD4+ and CD8+ T cell subsets. The pre-mixed dried antibody tube offers consistency in staining profiles over time and reduces the risk of operator errors. Additional drop-in antibodies can complement the panel and enable more in-depth evaluation of the T cell phenotype. Here we demonstrate the use of this panel with drop-in markers to monitor changes in expression of PD-1, TIM-3, LAG-3, HLA-DR, CD45RO, and CXCR3 on T cells transduced to express our novel anti-CD37 CAR. Cells were stained at day 0 prior to transduction, day 7, and following resting and re-stimulation, and acquired on a 12 color BD FACS Lyric. The use of a standardized memory T-cell panel will allow us to more accurately evaluate how T-cell phenotype impacts on the efficacy and longevity of response in patients receiving CAR-T therapies. Disclosures Maus: INFO PENDING: Other: INFO PENDING. Bornheimer:BD Biosciences: Employment. Hanley:BD Biosciences: Employment. Frigault:Novartis: Patents & Royalties: Royalty; Arcellx, Celgene, Foundation Medicine, Kite/Gilead, Nkarta, Novartis, and Xenetic: Consultancy.

This paper presents a model-based approach for the design of ultra-low power wireless sensor nodes along with a high-level of abstraction modeling framework based on Simulink/StateFlow. This leads to a fast and effective method of designing low-power wireless sensing systems by serving as a guideline for choosing the right commercial off-the-shelf (COTS) components and node configuration. Through simulations, the impact of using different configurations on energy and power consumption metrics is determined, and the models capture the energy consumption contributions of each of the studied components.

All over the causes of intractable diarrhea of infancy, microvillous inclusion disease is a rare congenital defect of intestinal brush border of unknown aetiology. An autosomal recessive inheritance is suggested by cases occurring in siblings and high incidence of consanguinity. The prognosis of the disease is extremely poor, as life can be sustained only by total parenteral nutrition. The authors report a preterm male newborn of 35 weeks gestation presenting severe hypernatremic dehydration on day 4 after birth caused by a secretory profuse diarrhea and discuss the tools allowing the light microscopic and genetic diagnosis. The final diagnosis of microvillus intestinal disease (MVID) was made on the third month after extensive investigations using electron microscopic examination of intestinal biopsy and genetic confirmation, finding a mutation at the homozygous status of MYO5B gene. The infant died on the fourth month in spite of optimal electrolytic support and parenteral prolonged nutrition. Although MVID is extremely rare, it remains a possible cause of intractable secretory diarrhea leading to severe hypernatremic dehydration and metabolic acidosis in neonates.

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Geographic and climate parameters influence the epidemiology of Respiratory Syncytial Virus (RSV). In Tunisia, information about the impact of environment factors on RSV infection is not well established. The objective is to predict the onset of RSV season based on meteorological parameters by investigating the association between RSV bronchiolitis and climate factors.