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The lack of publicly available, large, and unbiased datasets is a key bottleneck for the application of machine learning (ML) methods in synthetic chemistry. Data from electronic laboratory notebooks (ELNs) could provide less biased, large datasets, but no such datasets have been made publicly available. The first real-world dataset from the ELNs of a large pharmaceutical company is disclosed and its relationship to high-throughput experimentation (HTE) datasets is described. For chemical yield predictions, a key task in chemical synthesis, an attributed graph neural network (AGNN) performs as good or better than the best previous models on two HTE datasets for the Suzuki and Buchwald-Hartwig reactions. However, training of the AGNN on the ELN dataset does not lead to a predictive model. The implications of using ELN data for training ML-based models are discussed in the context of yield predictions.

Domino liver transplantation (DLT) utilizes a phenotypically normal explant from select recipients as a donor graft in another patient. The procedure is not widely employed and remains restricted to a small number of centers. The purpose of this study was to assess the national profile of DLT in the United States (US) and evaluate current survival outcomes.The United Network for Organ Sharing (UNOS) database was queried for all liver transplants (LT) between 1996 and 2020. Outcomes of interest were long-term graft and patient survival.Of 181,976 LTs performed nationally during the study period, 185 (0.1%) were DLTs. Amyloidosis and maple syrup urine disease (MSUD) accounted for 83% of dominoed allografts. Out of 210 explants with amyloidosis, 103 (49%) were dominoed into secondary recipients. Only 50 (22%) of all MSUD explants (n = 227) were dominoed. Graft survival was 79%, 73% and 53% at 3-, 5- and 10-years, respectively, for DLT recipients. Overall patient survival was 83%, 76% and 57% at 3-, 5- and 10-years.Despite excellent long-term survival outcomes, DLT allografts comprise a very small percentage of the liver donor pool. A large proportion of potential DLTs may be unconscionably excluded despite shortages in deceased donor organs.

Background Left atrial appendage closure (LAAC) during cardiac surgery in atrial fibrillation (AF) patients has been investigated in multiple studies with variable safety and efficacy results. Methods A comprehensive review was performed of all studies comparing LAAC and placebo arm during cardiac surgery in AF patients. A random-effect model was used to calculate risk ratios, mean differences, and 95% confidence intervals. Results Five randomized controlled trials and 22 observational studies were included with a total of 540,111 patients. The LAAC group had significantly decreased postoperative stroke/embolic events as compared to the no LAAC group with all cardiac surgeries (3.74% vs 4.88%, p = 0.0002), isolated valvular surgery (1.95% vs 4.48%, p = 0.002). However, CABG insignificantly favored the LAAC group for stroke/embolic events (6.72% vs 8.30%, p = 0.07). There was no difference between both groups in all-cause mortality in the perioperative period (p = 0.42), but was significantly lower in the LAAC arm after two years (14.1% vs 18.3%, p = 0.02). There was no difference in major bleeding, all-cause rehospitalizations, or cross-clamp time between both groups (p = 0.53 and p = 0.45). The bypass and the cross-clamp time were longer in the LAAC group (4 and 9 min, respectively). Conclusion In AF patients, LAAC during cardiac surgery had a decreased risk of stroke and long-term all-cause mortality. Additionally, there was no difference in major bleeding, all-cause rehospitalizations, or cross-clamp time.

Background Traditionally, curative resection was considered the cornerstone of treatment for perihilar cholangiocarcinoma. More recently, liver transplantation (LT) offered an alternative for patients with unresectable disease. The purpose of this study was to assess our experience with perihilar cholangiocarcinoma and LT. Methods A perihilar cholangiocarcinoma protocol was commenced in 2006 whereby diagnosed patients were enrolled onto an institutional registry for LT consideration. Data on patient progression and oncologic outcomes were assessed. Results Fifty-eight patients were initially enrolled onto the protocol and 38 proceeded to LT following neoadjuvant chemoradiation (mean age 55.6 ± 11.4 years). Mean time to LT was 3.7 ± 2 months and, among those transplanted, 14 (37%) had underlying primary sclerosing cholangitis (PSC). Thirteen (34%) patients developed malignant recurrence and there were no differences in disease recurrence between PSC (n = 3) and non-PSC (n = 10) patients (p = 0.32). Overall patient survival was 91%, 58% and 52% at 1-, 3- and 5-years corresponding with 81%, 52% and 46% graft survival, respectively. Conclusion Rigorous patient selection and chemoradiation treatment algorithms can be highly effective in treating perihilar cholangiocarcinoma. For appropriately selected candidates, LT can provide a 52% 5-year survival for patients who would otherwise have no surgical treatment option.

Cassava (Manihot esculenta) is among the most important crops in Brazil, not only due to its widespread cultivation and consumption, but also its history in the country. This root has been important both to the colonial project and the resistance to it, particularly in the quilombo-communities. Such sites of resistance have served as paradigmatic examples of ‘escape agriculture’ in the work of James Scott (2009), who highlights the role roots play in avoiding appropriation by the state. In this article, we experiment with the concept of ‘escape crops’ as we follow cassava from harvest to market in a contemporary quilombo-remnant community, Espirito Santo do Ita (Para). We combine Scott’s attention to the politics of crops with material semiotic sensibilities, thus exploring relationality and performativity. We argue that the cassava is central to the social life in the community, which is organized around the casas de farinha (flour mills). The processing practices also seem to foster a strong sense of collectivity and subjectivity, shaped by the materiality of the crop. Furthermore, the cassava which is performed in these spaces does not seem to allow for standardizations and abstractions, requiring processes of translation in order to be sold in the market, which is done through measuring operations. Through these operations, the cassava becomes an ambivalent and partial market entity, allowing for the cassava to travel in and out of the community, while at the same time precluding a co-option of this space by a capitalist logic. It seems, then, that by extending Scott’s concept, this root continues to be relevant for the community’s autonomy and freedom - not due to the crop’s biological traits alone, but due to the traits it gains and sheds relationally.

The purpose of this study was to investigate neurological disorder as a risk factor for dislocation following arthroplasty for acute hip fractures. We also analysed medical and surgical adverse events (AE), readmission, reoperation, revision, and mortality as secondary outcomes.A longitudinal cohort study using prospectively collected and aggregated data from the Swedish Hip Arthroplasty Register (SHAR) and the Swedish national patient register. All patients presenting with an acute hip fracture and treated with an arthroplasty in the period from 2005 to 2014 from the SHAR were identified. Patients in receipt of bilateral arthroplasties were excluded. Patients with a relevant pre-existing and diagnosed neurological disorder, as defined by ICD-10 codes, were identified (n = 9,702). All other cases (n = 29,411) were available for logistic regression propensity score matching. Patients were 1:1 matched on age, sex, Charlson comorbidity index, total versus hemiarthroplasty, head size, surgical approach, and year of surgery. Dislocations, adverse events, readmission, reoperation, revision, and mortality were studied using Kaplan-Meier analysis and Cox regression.The risk of dislocations was higher for patients with neurological disorder (HR=1.19, CI 1.03- 1.39, p0.05). Neurological disorder was associated with increased risk of encountering an adverse event (p0.001 at 90-days); these patients were at higher risk of dying (HR=1.51, CI 1.47-1.56, p0.001) however they were less likely to be readmitted (HR=0.73, CI 0.70- 0.76, p0.001). No excess risks of reoperation (HR=1.02, CI 0.90-1.17; p = 0.73) or revision (HR=1.00, CI 0.86-1.17; p = 0.99) were identified in the study group.Compared to matched controls, individuals with a preoperatively identified neurological diagnosis had higher rates of mortality, dislocations, and adverse events, but this cohort was not at increased risk of reoperation or revision. This study highlights an area of focus for future research to improve the long-term outcomes in patients with neurological disease undergoing arthroplasty for an acute hip fracture.

The purpose was to present a total description, distribution, and ranking of chronic pain conditions in the general population. This was based on structured clinical examinations of a random sample from a population-based survey (HUNT3) with a calculated oversampling of participants with chronic pain. Supplemented with access to hospital reports, the examination was performed by experienced physicians and psychologists using a consistent definition of chronic pain as well as ICD-10- and the new ICD-11-classification. The main findings were that a higher proportion of the 551 participants had chronic pain assessed by clinical examination (399) than by self-report in a survey the same day (337). Among those with examination-verified chronic pain estimated from HUNT3 to represent 27.9% of the general population, 63% had chronic primary pain, 81% musculoskeletal pain, and 77% more than one chronic pain condition. When separating chronic primary from chronic secondary pain according to ICD-11, the weighted prevalence was 17.7% for chronic pain conditions of unknown and 10.2% of known cause. When all the participants’ conditions were accounted for, the most prevalent were nonspecific low back (10.8%) and neck pain (7.6%). Participants with chronic primary pain did not have significantly more psychopathology than those with chronic secondary pain: 14.5% vs. 12.5%. Perspective: Since this study confirms the high prevalence in self-report surveys and indicates that two thirds of chronic pain conditions cannot be explained by underlying diseases, this huge health and societal problem should be solved primarily on a public health level directed towards prevention and rehabilitation.

The aim was to assess the validity of bioimpedance in the assessment of fat free mass (FFM) among women and to study if the validity differs between women with and without Rheumatoid Arthritis (RA).38 women with RA and 24 non-rheumatic controls were included. FFM was measured in the non-fasting state using DXA (Lunar Prodigy), multi-frequency bioelectrical impedance analysis (BIA) (MF-BIA [Tanita MC-180 MA]), single-frequency BIA (SF-BIA) and bioelectrical impedance spectroscopy (BIS) (both Impedimed SFB7). BIS raw data were also used to calculate FFM from equations by Matthie, Jaffrin and Moissl. Results were compared using correlation, Bland Altman analysis, Mann Whitney U test and Wilcoxon Signed Ranks Test.Women with RA had different body water distribution compared to women without RA (p 0.05). Median bias in FFM assessed by bioimpedance was 0.62-7.87 kg with wide limits of agreement for all methods. Median FFM differed significantly from DXA by all bioimpedance methods except for BIS by Jaffrin. Women with RA had significantly smaller biases compared to non-rheumatic controls using BIS equations by Matthie (p = 0.012) and Moissl (p = 0.025). Correlations between FFM measured by DXA and bioimpedance (r = 0.73-0.85, all p 0.001) did not differ between groups. The sensitivity of bioimpedance to detect low fat free mass index (FFMI) was 0-47%.The results of this study show that bioimpedance has similar validity in women with RA compared to non-rheumatic controls, despite differences in body water distribution. Agreement with DXA improved when applying specific equations, but the clinical utility of bioimpedance is questionable as all methods failed to identify low FFMI with acceptable precision.Clinicaltrials.org, NCT04247009.

Antioxidant defence mechanisms, such as the nuclear factor-erythroid 2-related-factor-2 (NRF2) axis, are integral to oxidative stress responses and ischemic injury. Hepatic antioxidant capacity is contingent on parenchymal quality, and there is a need to develop new insights into key molecular mechanisms in marginal liver allografts that might provide therapeutic targets. This study examines the clinical relevance of NRF2 in donor livers and its response to normothermic machine perfusion (NMP). Discarded donor livers (n = 40) were stratified into a high NRF2 and low NRF2 group by quantifying NRF2 expression. High NRF2 livers had significantly lower transaminase levels, hepatic vascular inflammation and peri-portal CD3+ T cell infiltration. Human liver allografts (n = 8) were then exposed to 6-h of NMP and high NRF2 livers had significantly reduced liver enzyme alterations and improved lactate clearance. To investigate these findings further, we used a rat fatty-liver model, treating livers with an NRF2 agonist during NMP. Treated livers had increased NRF2 expression and reduced transaminase derangements following NMP compared to vehicle control. These results support the association of elevated NRF2 expression with improved liver function. Targeting this axis could have a rationale in future studies and NRF2 agonists may represent a supplemental treatment strategy for rescuing marginal donor livers.

Introduction Although the molecular profile of the breast provides prognostic indicators, risk stratification in breast cancer continues to be a challenge. Therefore, it is mandatory to seek new prognostic markers that could aid the early diagnosis of potential metastases in biopsy samples from breast cancer; among these are increased Snail-1 and Claudin-4 expression. Objectives The aim of this study was to analyze the correlation between Snail-1 and Claudin-4 with other clinical-pathological parameters and distinct molecular subtypes. Methods This study included 110 patients with invasive ductal carcinoma from 2009 to January 2015. Snail-1 and Claudin-4 were assessed by immunohistochemistry in formalin-fixed paraffin-embedded tissue blocks and the data were correlated with clinical-pathological data and survival. Results A total of 65 patients (68.2%) were positive for Snail-1 and 85 patients (77.3%) were positive for Claudin-4. High Snail-1 and high Claudin-4 were detected in high-grade tumors and were associated with lymphovascular infiltration and lymph node metastases (p Conclusion High Snail-1 and Claudin-4 levels were associated with adverse outcomes in patients with breast cancer.

Gastrointestinal stromal tumors (GISTs) form commonly in the stomach, small intestine, colorectum, and esophagus. Metastatic GIST occurs in up to 50% of patients at presentation. The liver and peritoneal cavity are the most common (93%) metastatic sites; head and neck metastases are extremely rare. This report describes a unique case of a 77-year-old man who was diagnosed with a duodenal GIST that had been completely resected 15 years ago. Eleven years after complete resection, he presented with liver metastases and then received multiple lines of systemic therapy and ablative radiotherapy. In 2015, he presented to our oral and maxillofacial surgery department with a left exophytic maxillary mass that filled the left maxillary sinus. Incisional biopsy confirmed metastatic GIST. Further evaluation revealed extensive metastases in the patient's liver, lungs, spleen, abdominal wall, and lymph nodes. After adequate staging, the patient's condition was deemed palliative, and he was referred to the radiation oncology department for palliative treatment of the symptomatic maxillary lesion. To our knowledge, this is the first reported case of maxillary metastasis from a duodenal GIST. Inclusion of GIST in the differential diagnosis of jaw tumors in patients with nonoral malignancies is recommended. The literature on oral metastasis of GIST is reviewed and discussed in this case report.

The viability of wild Atlantic salmon populations is threatened by genetic introgression from escaped farmed salmon. Farmed Atlantic salmon are genetically improved for important commercial traits and a life in captivity but are poorly adapted to the natural environment. The rate of gene flow from escaped farmed to wild salmon depends on their spawning success and on offspring survival at various life stages. We here investigate relative survival of introgressed juvenile Atlantic salmon (parr) in a river in northern Norway. The studied population has experienced genetic introgression from farmed salmon for about four generations (20 years). We followed two cohorts of parr from the year of hatching (0+) to the age of 2 years (2+). Farmed genetic introgression was quantified at the individual level and on a continuous scale using diagnostic SNPs. Population-level genetic introgression decreased from 0+ to 2+ by 64% (2011 cohort) and 37% (2013 cohort). This change was driven by a 70% (2011 cohort) and 49% (2013 cohort) lower survival from age 0+ to 2+ in introgressed parr compared to parr of wild origin. Our observations show that there is natural selection against genetic introgression with a potential cost of lower productivity. aquaculture, Atlantic salmon, farmed salmon, genetic introgression, Salmo salar, survival

Background: Psoriasis is not merely an inflammatory skin disease but is commonly associated with systemic inflammation causing medical and psychiatric comorbidities. Objectives: Psoriasis is not merely an inflammatory skin disease but is commonly associated with systemic inflammation causing medical and psychiatric comorbidities. Methods: 100 psoriasis patients, age 80 and sex-matched controls were recruited, dermatological and psychiatric assessments were done, psoriasis severity was assessed using the Psoriasis Area and Severity Index (PASI) score. Montreal Cognitive Assessment-Basic (MoCA-B) was used to assess the different cognitive domains and to screen for any possible MCI. Results: Cognitive functions were significantly worse in patients than in the healthy controls for the total score of MOCA-B (p Conclusion: Psoriasis patients showed worse cognitive impairment when compared to the controls regardless of the psoriasis severity. Thus, the routine clinical examination of psoriasis patients should include the administration of a brief cognitive screening tool to reach the best management.

Aim of the study: To evaluate the effect of the nursing instructions on reducing the selected functional gastrointestinal disorders among elderly patients. Research design: Quasi-experimental (Pre–posttest). A consecutive sample of one hundred elderly patients was included in this study. Setting: The current study was carried out at a Geriatric home, Geriatric club, and Gastrointestinal clinic at Qena two tools were utilized to collect data, First Tool: A Structured interviewing questionnaire sheet, personal data (age, gender, marital status level, etc.)Second Tool: The Patient Assessment of Constipation-Symptoms questionnaire. Results: there was a highly statistically significant difference in total mean average score and SD (20.4 ±8.3, 10.8 ±8.3) of constipation symptoms severity during pre and post-nursing instructions implementation p value≤0.05. Conclusion implementing the nursing instructions regarding selected functional gastrointestinal disorders among elderly patients reflected a significant impact on patient's outcomes of constipation this significant difference justified the research hypothesis. Recommendations: A continuous education and training are offered on regular basis for elderly patients regarding gastrointestinal disorders, in addition to educational classes for elderly people about age-related changes that affect their gastrointestinal tract and elimination pattern without a feeling of shame or embarrassment to prevent complications. Encouraging to improve the elderly home foods menu to contain high fiber foods such as vegetables and fruits to over com constipation problems

Background: Depression among female undergraduates is associated with hormonal changes and other stressful events around the menstrual cycle. Aim: This study assessed the relationship between premenstrual syndrome and depression among female undergraduates in a private Nigerian university. Methodology: The study was conducted at the Afe Babalola University, Ado Ekiti. A stratified sampling technique was used in this study. A semi-structured questionnaire with sections on sociodemographic schedule proforma and the Becks Depression Inventory were used to collect information from respondents. Data were analyzed using Statistical Package for Social Sciences (SPSS version 21). Result: A total number of 440 students were recruited. Three hundred and sixty-two (82.3%) of the respondents had depression, with prominent mild mood disturbance (43.9%). The odds of depression were higher among respondents older than 20 years as compared with those who were 20 years old or younger (AOR=91.194 CI;9.326,891.774) ). Also, the odds of depression were higher among respondents who did have not close relationships with their mother compared to those who did (AOR= 10.5, CI; 3.525, 31.33). Besides, the odds of depression were higher among those with premenstrual syndrome than respondents without a history of premenstrual syndrome (AOR=70.06 CI; 12.018, 48.406). Finally, the odds of depression were higher among respondents with a family history of premenstrual (AOR=0.637 CI; 0.257, 1.574). Conclusion: There is a need to provide services aimed at preventing and managing premenstrual syndrome among undergraduates and screen for depression to prevent and detect mental health problems in this vulnerable population.

Toward the goal of using more livers for transplantation, transplant centers are looking to increase the use of organs from "marginal" donors. Livers from these donors, however, have been shown to be more susceptible to preservation and reperfusion injury.Using a porcine model of donation after circulatory death, we studied the use of antibody-mediated CD47 blockade to further improve liver graft function undergoing normothermic machine perfusion. Livers from 20 pigs (5 per group) were brought under either 30 or 60 min of warm ischemia time followed by the administration of CD47 monoclonal antibody (CD47mAb) treatment or immunoglobulin G control antibodies and 6 h of normothermic extracorporeal liver perfusion.After 6 h of normothermic extracorporeal liver perfusion, CD47mAb-treated livers with 30 or 60 min warm ischemia time had significantly lower alanine transaminase levels and higher bile production compared with their respective control groups. Blockade of the CD47 signaling pathway resulted in significantly lower thrombospondin-1 protein levels, lower expression of caspase-3, and higher expression of phosphorylated extracellular signal-regulated kinase.These findings suggested that CD47mAb treatment decreases ischemia/reperfusion injury through CD47/thrombospondin-1 signaling downregulation and the presence of necrosis/apoptosis after reperfusion and could increase liver regeneration during normothermic perfusion of the liver.

High-dose radiation exposures of humans occur every year around the world, and may lead to harmful tissue reactions. This review aims to look at the available information sources that can help answering the question of how often these events occur yearly on a global scale. In the absence of comprehensive databases of global occurrence, publications on radiation accidents in all uses of radiation and on rates of high-dose events in different medical uses of radiation have been reviewed. Most high-dose radiation exposures seem to occur in the medical uses of radiation, reflecting the high number of medical exposures performed. In therapeutic medical uses, radiation doses are purposely often given at levels known to cause deterministic effects, and there is a very narrow range in which the medical practitioner can operate without causing severe unacceptable outcomes. In interventional medical uses, there are scenarios in which the radiation dose given to a patient may reach or exceed a threshold for skin effects, where this radiation dose may be unavoidable, considering all benefits and risks as well as benefits and risks of any alternative procedures. Regardless of if the delivered dose is unintended, unnecessary or unavoidable, there are estimates published of the rates of high-dose events and of radiation-induced tissue injuries occurring in medical uses. If this information is extrapolated to a global scenario, noting the inherent limitations in doing so, it does not seem unreasonable to expect that the global number of radiation-induced injuries every year may be in the order of hundreds, likely mainly arising from medical uses of radiation, and in particular from interventional fluoroscopy procedures and external beam radiotherapy procedures. These procedures are so frequently employed throughout the world that even a very small rate of radiation-induced injuries becomes a substantial number when scaled up to a global level.

Background: The COVID-19 pandemic has had a huge impact on people’s lives and may influence mental health in the general population. In a unique representative Danish longitudinal study, we examined mental well-being measured just before and during the COVID-19 pandemic. Methods: The Danish Health and Wellbeing Survey is the Danish contribution to the European Health Interview Survey. In this study, we included the wave from autumn 2019, which we re-invited in the autumn 2020. The study population consisted of 4,234 persons. The main outcome was the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS). Linear and logistic regression models were conducted to evaluate change in SWEMWBS between 2019 and 2020. Outcomes: The SWEMWBS distribution was similar in 2019 and 2020, although the distribution moved to lower scores in 2020 compared to 2019. Mean SWEMWBS decreased significantly from 25·5 in 2019 to 24·6 in 2020 corresponding to a mean change of -1·0 (95%CI, -1·1. to -0·8). The proportion with low SWEMWBS increased from 16·5% in 2019 to 20·1% in 2020 (p

Introduction : Symptoms of irritable bowel syndrome (IBS) are common reasons for endoscopic procedures. We examined the yield of colonoscopy and upper endoscopy in IBS for several organic diseases. Methods : Matched population-based prevalence study in Sweden. We identified 21,944 participants diagnosed with IBS from 1987 to 2016 undergoing colonoscopy with a biopsy from all of Sweden's 28 pathology departments within 6 months of diagnosis. We compared prevalence of histopathology-proven diagnoses of inflammatory bowel disease (IBD), colorectal cancer, precancerous polyps, and microscopic colitis between patients recently diagnosed with IBS and matched controls without IBS (n = 81,101) undergoing colonoscopy. We also compared prevalence of celiac disease between patients diagnosed with IBS (n = 9,965) and matched controls (n = 45,584) undergoing upper endoscopy with biopsy. IBS patients were also compared to their siblings. Conditioned logistic regression estimated adjusted odds ratios (aORs). Results : Biopsy-proven IBD was seen in 1.6% of IBS and in 5.9% of controls (aOR=0.21; 95%CI=0.19–0.24). The prevalence of precancerous polyps was 4.1% vs. 13.0% (aOR=0.28; 95%CI=0.26–0.30), colorectal cancer 0.8% vs. 6.3% (aOR=0.17; 95%CI=0.14–0.20) and celiac disease 1.9% vs. 3.4% (aOR=0.54; 95%CI=0.47–0.63). Conversely, the prevalence of microscopic colitis was 2.9% vs. 1.7% (aOR=1.77; 95%CI=1.61–1.95), with higher prevalence in older patients and patients with IBS with diarrhea. Yield of colonoscopy for precancerous polyps, colorectal cancer, and microscopic colitis increased by age. Our findings were consistent using unaffected siblings as the comparator group. Discussion : The diagnostic yield of upper endoscopy and colonoscopy for organic disease is low in patients with a first-time diagnosis of IBS, though increases with age.

Context Plant populations in agricultural landscapes are mostly fragmented and their functional connectivity often depends on seed and pollen dispersal by animals. However, little is known about how the interactions of seed and pollen dispersers with the agricultural matrix translate into gene flow among plant populations. Objectives We aimed to identify effects of the landscape structure on the genetic diversity within, and the genetic differentiation among, spatially isolated populations of three temperate forest herbs. We asked, whether different arable crops have different effects, and whether the orientation of linear landscape elements relative to the gene dispersal direction matters. Methods We analysed the species’ population genetic structures in seven agricultural landscapes across temperate Europe using microsatellite markers. These were modelled as a function of landscape composition and configuration, which we quantified in buffer zones around, and in rectangular landscape strips between, plant populations. Results Landscape effects were diverse and often contrasting between species, reflecting their association with different pollen- or seed dispersal vectors. Differentiating crop types rather than lumping them together yielded higher proportions of explained variation. Some linear landscape elements had both a channelling and hampering effect on gene flow, depending on their orientation. Conclusions Landscape structure is a more important determinant of the species’ population genetic structure than habitat loss and fragmentation per se. Landscape planning with the aim to enhance the functional connectivity among spatially isolated plant populations should consider that even species of the same ecological guild might show distinct responses to the landscape structure.

Aims The aim of this study was to assess the prognostic value of the modified three-group Stulberg classification, which is based on the sphericity of the femoral head, in patients with Perthes’ disease. Methods A total of 88 patients were followed from the time of diagnosis until a mean follow-up of 21 years. Anteroposterior pelvic and frog-leg lateral radiographs were obtained at diagnosis and at follow-up of one, five, and 21 years. At the five- and 21-year follow-up, the femoral heads were classified using a modified three-group Stulberg classification (round, ovoid, or flat femoral head). Further radiological endpoints at long-term follow-up were osteoarthritis (OA) of the hip and the requirement for total hip arthroplasty (THA). Results There were 71 males (81%) and 17 females. A total of 13 patients had bilateral Perthes’ disease; thus 101 hips were analyzed. At five-year follow-up, 37 hips were round, 38 ovoid, and 26 flat. At that time, 66 hips (65%) were healed and 91 (90%) were skeletally immature. At long-term follow-up, when the mean age of the patients was 28 years (24 to 34), 20 hips had an unsatisfactory outcome (seven had OA and 13 had required THA). There was a strongly significant association between the modified Stulberg classification applied atfive-year follow-up and an unsatisfactory outcome at long-term follow-up (p < 0.001). Between the five- and 21-year follow-up, 67 hips (76%) stayed in their respective modified Stulberg group, indicating a strongly significant association between the Stulberg classifications at these follow-ups (p < 0.001). Conclusion The modified Stulberg classification is a strong predictor of long-term radiological outcome in patients with Perthes’ disease. It can be applied at the healing stage, which is usually reached five years after the diagnosis is made and before skeletal maturity. Cite this article: Bone Joint J 2021;103-B(12):1815–1820.

Background: Rheumatoid Arthritis (RA) is a systemic, autoimmune and inflammatory disease that is associated with progressive joint degeneration, limitation of physical activity and disability. Aim: the study aimed to assess factors affecting self-management of patients with rheumatoid arthritis. Design: A descriptive exploratory research design was utilized. Setting: This study was carried out at the National Medical Institute of Damanhur –affiliated to the General Organization for teaching hospitals and Institutes at the Medical clinics in the out- patient department. Study subjects: A purposive sample of 100 adult patients of both genders with rheumatoid arthritis. Tools: Patient interviewing questionnaire, Rheumatoid Arthritis Disease Activity Scale, Rheumatoid Arthritis Self-Efficacy and Rheumatoid Arthritis Self-Management practices Questionnaire. Results: About 58% of the studied patients had unsatisfactory level of knowledge about the self-management of RA. Also, 32% of them had low disease activity. Moreover, 52% of them had moderate level of self-efficacy and 50% of them had moderate level of total self-management. Conclusion: More than half of the studied patients had unsatisfactory level of knowledge about rheumatoid arthritis. Also, one third of them had low level of disease activity. Moreover, more than half of the studied patients had moderate level of self-efficacy and half of them had moderate level of total self-management. There was highly significant positive correlation between total knowledge of the studied patients and self-efficacy with self- management. While, there was highly significant negative correlation between total disease activity of the studied patients and self- management. Recommendation: Self-management educational program should become an integrated part of the total management of patients with rheumatoid arthritis.

Background: Sex determination of the individual plays a vital role in establishing the identity of remains by anthropologist. The characterization of hyoid bone is made possible by analysing sexually dimorphic features, enabling it to occasionally be utilized in the sex determination part of establishing the parameters of biological profile in skeletal remains. Hyoid bone is basically the key bone in forensic investigation of neck trauma (as strangulation). This study aims at evaluating the application of the hyoid bone metric measurements and hyoid bone density to identify sex in Egyptian population using two-dimensional computed tomography (CT) images methodology. Patients and methods: This is a cross-sectional study that was done on thoracic Computed Tomography (CT) of 103 general Egyptian population constituting of 54 males and 49 females. The statistics against following parameters were noted from each patient: Bone density in Hounsfield unite by CT (HU), the distance between bilateral greater horns (GH), the distance between bilateral lesser horns (LH), Distance from most anterior end of hyoid arch to great horns (AP) . Results: As per the statistics, it is evident that the hyoid bone density (HU) among males was significantly higher than females. This fact stood among all age groups of males and females. Another important observation is that this difference was statistically significant among children and young adults of both genders. Also, GH was significantly higher in males of young adult age group and middle age group. But in the case of AP, it was significantly higher in female child compared with male child age group. The calculated accuracy (AUC) of HU (bone density) appeared to be 0.70 which was remarkably the most accurate hyoid bone parameter for sex detection (P value 0.001) as compared with the accuracy of other metric parameters (GH 0.60, LH 0.51 and AP 0.55). Conclusion: These results stipulate that the hyoid bone density (HU) own a high degree of accuracy and can use well established characteristics to determine the sex. KEY WORDS: Bone density, , Forensic investigation, Hyoid bone, Sex estimation.

This paper presents a novel DSO support tool with visualisation capability for forecasting network congestion in distribution systems with a high level of renewables. To incorporate the uncertainties in the distribution systems, the probabilistic power flow framework has been utilised. An advanced photovoltaic production forecast based on sky images and a load forecast using an artificial neural network is used as the input to the tool. In addition, advanced load models and operating modes of photovoltaic inverters have been incorporated into the tool. The tool has been applied in case studies to perform congestion forecasts for two real distribution systems to validate its usability and scalability. The results from case studies demonstrated that the tool performs satisfactorily for both small and large networks and is able to visualise the cumulative probabilities of nodes voltage deviation and network components (branches and transformers) congestion for a variety of forecast horizons as desired by the DSO. The results have also shown that explicit inclusion of load‐voltage dependency models would improve the accuracy of the congestion forecast. For demonstrating the applicability of the tool, it has been integrated into an existing distribution management system via the IoT platform of a DMS vendor, Atos Worldgrid.

Background: Many nurses perceive that the Electronic Medical Record (EMR) reduces the workload, improves the quality of documentation, and improves safety and patient care. However, other nurses reported that the system and environment of healthcare might impede EMR documentation at the bedside. Objective: The study aimed to describe the nurses' views of the use, quality, and satisfaction with EMR in daily practice in outpatient settings. Furthermore, the relationships among the use, quality, and user’s satisfaction of EMR were assessed in the study. Methods: The proposed study employed a cross-sectional, descriptive correlational design. Inclusion criteria were nurses willing to participate in the study, fluent in the English language, and have been working in the Outpatient Department for more than three months until the time of study implementation. A self-reported questionnaire with strong validity and reliability was used to assess nurses’ views of use, quality and satisfaction of EMR. Results: The response rate was 77.2% (170 out of 220), 91.2% of the participants were females. Results about the use of EMR have shown positive views ranging from 51.2% to 84.7%, with the lowest scores reported when to write nurse care worksheets (Kardex). For the quality of EMR, the results have shown positive views ranging from 70% to 87.6% with the lowest scores reported related to the EMR system problems and crashes, and for the user’s satisfaction, the results have shown positive views ranging from 76.5% to 87.1%. There were significant positive correlations between the three elements use, quality, and user’s satisfaction of EMR. Conclusion: Participants reported positive views in the domain of use, quality, and satisfaction with EMR. Furthermore, positive correlations were reported between the use, quality, and satisfaction domains of EMR.

Purpose This paper aims to describe a hybrid academic library system and to draw up a model of this system suggesting strategies and scenarios for achieving optimum performance of the system in a technology changing world. Design/methodology/approach The mixture of traditional or manual ways of carrying out library operations with new, modern, automated systems often brings about several problems. The problems are ones that can be tackled within the framework of having appropriate systems dynamics routines applied and also making use of personnel skilled in strategic management of hybrid library systems. Findings A system dynamics model for the management of the system is developed around the issues of personnel management, collection management, capacity building and provision of access to research materials, information technology infrastructure, forming of consortia and security in the system. Originality/value Recommendations are made as to which strategy/scenario or combinations of scenarios will provide lasting solutions to the problems recurring or likely to reoccur in a hybrid academic library system.

Background Restorative surgery after colectomy due to ulcerative colitis (UC) may be performed simultaneously with colectomy (primary) or as a staged procedure. Risk factors for failure after restorative surgery are not fully explored. This study aimed to compare the risk of failure after primary and staged reconstruction. Methods This is a national register-based cohort study of all patients 15 to 69 years old in Sweden treated with colectomy due to UC and who received an ileorectal anastomosis (IRA) or ileal pouch-anal anastomosis (IPAA) between 1997 and 2017. Failure was defined as a reoperation with new ileostomy after restorative surgery or a remaining defunctioning ileostomy after 2 years. Risk of failure was calculated using the Kaplan-Meier method and Cox regression adjusted for sex, age, calendar period, primary sclerosing cholangitis, and duration of UC. Results Of 2172 included patients, 843 (38.8%) underwent primary reconstruction, and 1329 (61.2%) staged reconstruction. Staged reconstruction was associated with a decreased risk of failure compared with primary reconstruction (hazard ratio, 0.73; 95% CI, 0.58–0.91). The 10-year cumulative risk of failure was 15% vs 20% after staged and primary reconstruction, respectively. In all, 1141 patients (52.5%) received an IPAA and 1031 (47.5%) an IRA. In stratified multivariable models, staged reconstruction was more successful than primary reconstruction in both IRA (hazard ratio, 0.75; 95% CI, 0.54–1.04) and IPAA (hazard ratio, 0.73; 95% CI, 0.52–1.01), although risk estimates failed to attain statistical significance. Conclusions In UC patients undergoing colectomy, postponing restorative surgery may decrease the risk of failure.

There is some emerging evidence that suggests certain supplements help lower blood sugar levels. One of these is cinnamon, which exhibits characteristics that mimic insulin, such as the activity of biologically active substances to activate insulin receptor kinase, increasing glucose uptake, autophosphorylation of the insulin receptor, and glycogen synthase activity. To assess the effect of the cinnamon substance on lowering fasting blood sugar, modifying body weight, body mass index (B.M.I.), and waist circumference in type two diabetics. A randomized controlled intervention clinical trial. The study was conducted on 60 patients with type II diabetes mellitus; the study followed both gender patients for four weeks. The contributors were allocated randomly into a group that receives 2 g/d cinnamon substance (intervention group), and a group without cinnamon substance is given (control group). Fasting plasma glucose (F.P.G.) and anthropometrics measurement at the beginning (beforehand cinnamon supplementation and 4week at the end of the study duration). After 4 weeks of cinnamon taken, serum F.P.G. levels significantly improved (P≤0.0001). Anthropometric measurements (weight, height, B.M.I.) were reduced significantly (change mean ≤ P=0.001) for all. The Present study disclosed that supplementation of 2 gm cinnamon improves F.P.G. and has a good role in anthropometric indices (weight, waist circumference, B.M.I.).

Government funding supports industry-academia research and innovation projects in Norway, sharing the risk of the research component in innovation. However, funding alone may not be sufficient to overcome potential differences in collaborative agendas and ways of working. As a result, positive research outcomes often get stuck in the valley of death, instead of ending up as successful innovations that create value. To contribute to bridging the valley of death, we investigated the importance of six agile principles for collaborative industry-academia research and innovation projects, abbreviated IPN in Norway. The study was limited to the manufacturing sector. We surveyed 124 IPN project leaders (70 from industry; 54 from academia) to evaluate the importance of the knowledge management practices associated with the six agile principles across the three project stages. The statistical analyses indicate the consistency of the agile principles throughout the project stages. This means that agile principles are relevant for IPN projects and can be used as guidelines for improvement of the knowledge management practices. Moreover, the study identifies the agile principles that are perceived as most important to use in different stages of a project. It also identifies the different perceptions of the importance of agile principles of the project leaders from industry and academia. These findings can support project leaders who are implementing agile principles to industry-academia research and innovation projects. The results from the study can also support national and federal research/innovation councils in decision-making when assessing industrial research applications.

Objective: To evaluate the prehospital obstetric population that utilizes emergency medical services (EMS) and their association with hypertensive disorders of pregnancy. Methods: We conducted a retrospective evaluation of one year of all medical calls from a large, municipal, midwestern fire department. Inclusion criteria included all pregnant patients transported to a hospital by EMS. Descriptive statistics were calculated to evaluate prehospital event information (e.g., zip code, time, and duration of call), patient characteristics, and clinical management data regarding blood pressure. Census data were used to compare neighborhood information with poverty rates. Results: Of the 1,575 identified patients, 64.4% (1015/1575) presented with obstetric complaints, 57.4% (700/1220) were in their third trimester and 72.7% (686/944) were multiparous. The median call duration was 17 (interquartile range 12–22) minutes. In the areas where EMS usage was highest, one quarter of individuals lived below the poverty level. Of the studied population, 32.0% (504/1575) were found to be hypertensive; 14.9% (75/504) of hypertensive patients were found to have severe hypertension. Only one patient (1/1575, 0.06%) presented with a chief complaint of hypertension; the rest were discovered by EMS. The highest rates of hypertension were noted in wealthier areas of the city. Patients with severe hypertension were more likely to present with seizures, consistent with eclampsia. Conclusion: Hypertension is common in the obstetric population using EMS. Prehospital management of hypertensive disorders of pregnancy may focus on identification and treatment of severe pre-eclampsia or eclampsia. Areas with longer call times may consider treatment of severe hypertension. Prehospital treatment of hypertensive disorders of pregnancy could be optimized.

In this research, a solar cooker was manufacture from the scrap of an elliptical satellite dish, the dish was covered with reflective layer of aluminum that reflects up to up to 85% of solar radiation. This solar cooker has the ability to move horizontally in 360 degrees and vertically in 90 degrees, which makes it easier to follow the movement of the sun. Experimental investigation was carried out on this solar cooker in January, March, June, September between the hours of 9:00 AM. to 3:00 PM local time in Baghdad city in year 2020, by heating 1 L of water at every experiment, the results showed the best month for testing is June, due to the increase in the intensity of solar radiation and the reduced influence of weather factors, wind speed and cloud cover. this changing environmental conditions led to an instability in energy efficiency. The results also showed that the thermal efficiency is correlated inversely with solar radiation. This means that whenever the quantity of solar radiation was high we needed less energy to raise the temperature of the water, because the thermal efficiency is the ratio of the sensible energy required to heat the mass of water in the pot when the solar energy falls on the dish at the same time, and is correlated inversely with temperature and wind speed.

Inflammation and dyslipidemia are often present in polycystic ovary syndrome (PCOS). We determined the effect of saturated fat ingestion on circulating heat shock protein-70 (HSP-70) and mononuclear cell (MNC) toll-like receptor-2 (TLR2) gene expression, activator protein-1 (AP-1) activation, and matrix matalloproteinase-2 (MMP-2) protein in women with PCOS. Twenty reproductive-age women with PCOS (10 lean, 10 with obesity) and 20 ovulatory controls (10 lean, 10 with obesity) participated in the study. HSP-70 was measured in serum and TLR2 mRNA and protein, AP-1 activation, and MMP-2 protein were quantified in MNC from blood drawn while fasting and 2, 3, and 5 h after saturated fat ingestion. Insulin sensitivity was derived from an oral glucose tolerance test (IS(OGTT)). Androgen secretion was assessed from blood drawn while fasting and 24, 48, and 72 h after human chorionic gonadotropin (HCG) administration. In response to saturated fat ingestion, serum HSP-70, TLR2 gene expression, activated AP-1, and MMP-2 protein were greater in lean women with PCOS compared with lean controls and in women with PCOS and obesity compared with controls with obesity. Both PCOS groups exhibited lower IS(OGTT) and greater HCG-stimulated androgen secretion compared with control subjects of their respective weight classes. Lipid-stimulated proatherogenic inflammation marker responses were negatively correlated with IS(OGTT) and positively correlated with abdominal adiposity and HCG-stimulated androgen secretion. In PCOS, saturated fat ingestion stimulates proatherogenic inflammation independent of obesity. This effect is greater when PCOS is combined with obesity compared with obesity alone. Abdominal adiposity and hyperandrogenism may perpetuate proatherogenic inflammation. NEW & NOTEWORTHY This paper demonstrates that in polycystic ovary syndrome (PCOS), ingestion of saturated fat triggers a molecular pathway of inflammation known to drive atherogenesis. This effect is independent of obesity as it occurs in lean women with PCOS and not in lean ovulatory control subjects. Furthermore, the combined effects of PCOS and obesity are greater compared with obesity alone.

Background Atopic dermatitis is characterized by impaired skin barrier and altered cutaneous innate immunity. The estimated prevalence among Egyptian children was 10–12%. Several studies suggest that it may be associated with systemic comorbidities other than the spectrum of atopy, such as metabolic syndrome and other inflammatory conditions. The aim of this study is to compare the profile of systemic conditions of diabetes, dyslipidemia, and multiple inflammatory markers in children with and without diagnosed atopic dermatitis. Methods One hundred atopic dermatitis patients and 101 normal controls were collected from outpatient clinic based on their clinical condition, both had measurement of body mass index, blood sugar, serum insulin, lipid profile, C reactive protein, and gamma-glutamyl transferase. Results Children diagnosed with atopic dermatitis had significantly higher levels of body mass index (34.7 ± 5.7 vs 26.1 ± 4.9), fasting glucose (143.2 ± 30.3 vs 100.8 ± 16.0), serum insulin (11.3 ± 4.4 vs. 4.6 ± 3.0), serum triglycerides (194.1 ± 38.1 vs 156.2 ± 31.6), total cholesterol (198.4 ± 27.7 vs 163.7 ± 27.7), alkaline phosphatase (229.4 ± 89.8 vs. 189.4 ± 46.8), and gamma-glutamyl transferase (54.7 ± 19.9 vs 34.3 ± 9.5), C-reactive protein level was approximately four times higher (19.9 ± 13.2 vs 5.1 ± 3.4) and the immunoglobulin E level was approximately 10 times higher (2050.3 ± 843.8 vs 252.7 ± 103.1) than in controls Conclusion We found a positive relationship of atopic dermatitis with both diabetes and hyperlipidemia among children, and positive dose-response relationship of several non-traditional biomarkers of C-reactive protein, gamma-glutamyl transferase, and alkaline phosphatase with the presence and severity of atopic dermatitis.

Background and aims Teeth extracted are usually disposed as bio-waste whereas they could serve as an autologous tissue for culturing multipotent dental pulp cells which have application potential in regenerative medicine. This study aimed to examine the feasibility of cryopreserving dental pulp tissue at teeth extraction for later culturing of cells. Methods The pulp tissue from each of a total of 10 teeth was cut into small fragments which were then divided into two portions. One portion was directly used for culturing pulp cells using the explant method. The other portion was cryopreserved with 10% DMSO in liquid nitrogen for at least one month and then thawed for culturing pulp cells. Results Vital cells were obtained from all the 10 pulp fragment suspensions which went through cryopreservation. The cell outgrowth from the explants of cryopreserved pulp fragments was two days later than that of corresponding fresh pulp tissue. Otherwise, no difference was observed in proliferation, expression of stem cell markers and differentiation into adipose cells and osteoblasts between the two groups of cells cultured from the fresh or the cryopreserved pulp fragments. Conclusions Cryopreserving fragmented dental pulp tissue provides a feasible option for saving pulp tissues as autologous cell sources for possible later application.

Liver transplantation (LT) is a complex operation that most transplant surgeons learn in fellowship. Training varies as there is lack of objective data that can be used to standardize teaching. We performed a retrospective review of our adult LT database with aim of looking at fellow's experience. Using American Society of Transplant Surgery cutoff of, at least 45 LT during fellowship, data for first 45 LT were compared to LT 45-90. Fellow's cases were also clustered in sequential groups of 15 LT and analyzed to estimate the learning curve (LC). Comparison of LT 1-45 with LT 46-90 showed significantly lower total operative times (TOT) (324 vs. 344 min) and warm ischemia times (WIT) (28 vs. 31 min) in the 45-90 group. Rates of biliary complications (23.8% vs. 16.4%) and bile leaks alone (10.3% vs. 5.5%) were significantly higher for first 45 LT. Analysis of fellows experience in sequential clusters of 15 LT showed decreasing TOT, WIT, biliary complications and rates of unplanned return to the OR with progression of fellowship. This study validates the current ASTS requirement of at least 45 LT. LC generated using these data can help individualize training and optimize outcomes through identification of areas in need of improvement.

BackgroundIncreasing evidence recognizes the harm of excess oxygen to lungs, eyes, and brain of preterm infants, but not yet to the intestine. We assessed changes in splanchnic oxygenation during reoxygenation with 21% compared to 100% O-2 in a newborn piglet model of perinatal asphyxia.MethodsWe randomized 25 piglets to control or intervention. Intervention groups underwent global hypoxia until acidosis and hypotension occurred. Piglets were reoxygenated for 30 min with 21% or 100% O-2 and observed for 9 h. We continuously measured regional splanchnic oxygen saturation (r(s)SO(2)) using near-infrared spectroscopy (NIRS). We calculated mean r(s)SO(2) and r(s)CoVar (as SD/mean). We measured PaO2 and SaO(2), sampled from the right carotid artery. ResultsReoxygenation after global hypoxia restored r(s)SO(2). Reoxygenation with 100% O-2 increased r(s)SO(2) to values significantly higher than baseline. In intervention groups, r(s)CoVar decreased during observation compared to baseline. We found a correlation between r(s)SO(2) and PaO2 (r = 0.420, P < 0.001) and between r(s)SO(2) and SaO(2) (r = 0.648, P < 0.001) in pooled data from the entire experiment.ConclusionReoxygenation after global hypoxia improves splanchnic oxygenation, but is associated with reduced variability of r(s)SO(2). Reoxygenation with 100% O-2 exposes the intestine to hyperoxia. Splanchnic NIRS is able to detect intestinal hypoxia and hyperoxia.ImpactSplanchnic oxygenation improves during reoxygenation after global hypoxia, though reoxygenation with 100% O2 exposes the intestine to hyperoxia. Decreased variability of splanchnic oxygenation several hours after hypoxia and reoxygenation seems to be independent of the resuscitation strategy, and may indicate intestinal injury. Splanchnic NIRS monitoring was able to detect intestinal hypoxia and exposure to hyperoxia, as evidenced by a strong correlation between splanchnic oxygenation and arterial oxygen content.

Across the globe, kidney cancer and other cancerous diseases has been a threat to human lives. The incidence and mortality rate represent a significant and growing threat to both developed and developing countries especially in Africa, where most cancers are diagnosed at an advanced stage. This typically contributes to its complications and high rate of mortality, and has been attributed to limited awareness of early signs and symptoms of the disease, lack of detective mechanism and inaccessible cancer care in our health care centres. To preclude the harm and mortality caused by the disease, an intelligent mechanism for early prediction and prognosis of the syndrome is vital. However, early detection and prognosis requires an accurate information and analytic procedure that will assist and equip the health-care providers/public with the skills to identify early the indicators of the disease. Efforts in this work, produced a model for early prediction of kidney cancer using data analytic approach. Dataset and reports pertaining to the disease were acquired from selected private and public hospitals in fifty-two (52) selected LGA in Nigeria. A two-layered classifier system consisting of Artificial Neural Networks (ANN) and Decision Tree (DT) designed for the work was successfully employed in the model building. Waikato Environment for Knowledge Analysis (WEKA) platform was used for the experiment. The performance of the classifiers considered was compared using standard metrics of accuracy and time taken as benchmark. Experimental results show that the J48 decision tree algorithm outperform all other algorithms in the classifier family with correctly classified instances of 74.7%, F-Measure of 0.614, TP rate of 0.747, FP rate of 0.135, precision and recall of 0.687 and 0.714 respectively. It took the algorithm, 0.03 seconds to build the model. The performance of this algorithm proved its suitability as a valuable tool for the research purpose. The model will in no small measure support the efforts of the national health scheme in preventing the disease mortality rate.

For successful evaluation of the overall effects of salmon louse infestation on brown trout population dynamics, it is crucial to have a realistic understanding of how lice infestation distributions are generated and how they should be interpreted. Here, we simulated the potential effects of spatio-temporal variance in lice larvae densities, temporal variance in sea trout marine migration timing and spatial variance in marine habitat use on lice infestation distributions. We show that, when sampling populations with individual variation in marine behaviour, e.g. from post-smolts to veteran migrants, we must expect multi-modal mixture lice infestation distributions. Applying standard statistical distributions, such as the Poisson, negative binomial or zeroinflated distributions, can be too simplistic and give biased results. Temporary increases in salmon lice load in a given area may have inconsistent effects among individuals of a population and may be critical for vulnerable groups such as post-smolts, dependent on timing. For many analyses, it will be necessary to resolve the contributions from groups of fish with different lice infestation expectations due to spatio-temporal differences in habitat use within the overall mixture distribution. Another consequence is that different data sources, obtained by different methods or sampled at different locations and periods, must be expected to give different lice infestation distributions, even when sampling the same population. We also discuss additional factors that may complicate the interpretation of salmon lice infestation distributions on sea trout, such as lice-induced mortality, and behavioural changes, such as premature return to less saline water for delousing. Salmo trutta · Lepeophtheirus salmonis · Anadromy · Marine migration · Aquaculture · Negative binomial distribution · Zero-inflated models © The authors 2020. Open Access under Creative Commons by Attribution Licence. Use, distribution and reproduction are un - restricted. Authors and original publication must be credited.

Networks are important systems that impact multiple aspects of economic activities such as investments, businesses, innovation, and entrepreneurship skills. However, there is scant literature examining the crucial networks needed to inform diasporas’ decisions and oversee businesses/investments in their countries of origin. Using social network theory, the primary data for this article were gathered using in-depth interviews from 2019 to 2020. This is in addition to the authors’ primary insights over more than three decades into migration trajectories, diaspora existentialities, and investment domains in Nigeria. Findings suggest that some diasporas involve their networks such as family members and friends in their investment decision-making processes and eventual investments, while others have mistrust for their networks with implications for real investment choices and eventual outcomes. This article clearly shows that the diaspora networks within their investments’ thresholds, the roles of significant others, and the challenges of the diaspora are highly dynamic and ambivalent, as demonstrated through the Nigerian experience.

The development of a large-scale professional development project for Swedish mathematics teachers is retrospectively examined. By referring to documentation produced by stakeholders in the development process, the stakeholder’s design recommendations and underlying assumptions on teacher development are described. Seeing the development as a co-determination process explains how research-based principles appearing early in the process gradually change to become something different in the end, without the reasons for this shift ever being explicitly discussed in stakeholders’ documentations. It is discussed whether the distributed way of constructing the program might cause difficulties in sticking to an explicit theory of change. The impact sheet to this article can be accessed at 10.6084/m9.figshare.16610113.

Objectives Polypharmacy is usually associated with duplication of therapy, unnecessary medications and adverse drug reactions. Therefore, it is crucial to study the factors that increase the risk of polypharmacy. The objective of this study was to assess the risk factors for polypharmacy (i.e. the concomitant use of at least five medications) with a special focus on comorbidity in Jordan. Methods Using a retrospective cross-sectional study design, medical records of patients (age ≥55 years), which covered slightly over one-fourth of the population, found in a national electronic healthcare database from 2018 to 2019 were retrieved. Polypharmacy, the main outcome, was defined as the current use of at least five medications (the patient should have at least one chronic condition, one medication refill and continuous use of the medication for at least 30 days). Comorbidity, the main exposure, was summarized using the Charlson Comorbidity Index (CCI). Potential predictors of polypharmacy were examined using a multivariable logistic regression analysis. Key findings An eligible sample of 113 834 individuals (mean age 68 years, 51.5% female) were included in the analysis, of whom 38% met the polypharmacy definition (28% were categorized as having major [5–9 medications] and 10.2% exhibited excessive polypharmacy [≥10 medications]). Approximately, 20% of the patients had a CCI of ≥1. The most significant predictors of polypharmacy were a CCI score between 3 and 4 (adjusted odds ratio [AOR] = 5.89; 95% CI, 5.10 to 6.80; P < 0.001), gender (AOR = 0.86; 95% CI, 0.82 to 0.86; P < 0.001), and age ≥75 years (AOR = 1.62; 95% CI, 1.57 to 1.67; P < 0.001). Conclusions Polypharmacy is common among patients in Jordan. Comorbidity is positively, independently and strongly related to polypharmacy. Identifying groups who are at the greatest risk for polypharmacy can help optimize patients’ treatment, which can lead to better outcomes and improved quality of life.

Purpose The need for sustainable development (SD) of higher education (HE) is recognized in the UN 2030 Agenda for SD. Central to the SD of HE is information literacy and information use. This study aims to investigate information literacy, information use and SD of HE in Nigeria. Design/methodology/approach A descriptive survey research design was used for the study. The population for the study was the staff of public higher educational institutions in Southern Nigeria. A self-structured online questionnaire was sent to the respondents via social media. The data generated were analysed using mean, frequency count and percentages. Findings It was reflected that information literacy played a significant role in the SD of HE and that the extent of information use was high. It was revealed that the areas of HE that require SD include economic/finance and investment priorities; administration, mission and planning; and research and scholarship. Originality/value The study emphasizes that SD of HE in the current educational enterprise requires that people are information literate and information is extensively used.

BACKGROUND: Contact allergy to oxidized (ox.) linalool and ox. limonene has been reported to have a high prevalence, raising the question of inclusion into the baseline series. However, several important issues should be clarified and further investigated before inclusion can be warranted.OBJECTIVES: To report the trends of ox. terpenes allergy in patients with dermatitis, features of the patch test reactions, and clinical characteristics of the patients.METHODS: A retrospective analysis of 5773 patients was performed. All patients were patch tested with baseline series, individual ingredients of fragrance mix I and II, ox. linalool, and ox. limonene from 2013 to 2020.RESULTS: The prevalence rates of contact allergy to ox. linalool and ox. limonene were 7.0% and 5.1%, respectively. Significantly increasing trends of contact allergy were observed. More than 95% of contact allergy cases were identified on Day 3/4. Patients with contact allergy to ox. linalool and ox. limonene were significantly younger than those with contact allergy to other fragrances and were predominantly female. Strong reactions were associated with older age and multiple fragrance allergies.CONCLUSIONS: Contact allergy to ox. linalool and ox. limonene is becoming increasingly important, and findings show intriguing features. More studies concerning the clinical relevance before recommending these substances for screening are required. (Less)

Breast cancer is the most common causing death in women. Tamoxifen, 1-[4-(2-dimethyl-aminoethoxy) phenyl]-1,2-diphenyl-1-butene), is a nonsteroidal antiestrogen breast cancer prevention drug causing liver toxicity. This study was carried out to elucidate the efficacy of Moringa oleifera aqueous extract against carcinogenic effect of Tamoxifen in male rats. 50 male albino rats were divided equally into five groups: control group (I); Moringa oleifera aqueous group (II) of dose (300mg/Kg/day for 6 weeks); group (III) received Tamoxifen (3mg/Kg/3 days for 6 weeks); rats received orally Tamoxifen and Moringa oleifera aqueous extract together for 6 weeks group (IV) and rats pretreated with Moringa oleifera aqueous extract then Tamoxifen with the same dose and period group (V). In group (III) there were elevate in serum activities of ALT, AST, LDH, and serum levels of TNF-α, IL-1β, Il-10, cholesterol, TG, LDL, HDL, Urea, Creatinine also liver MDA; NO; ATPase. There were decrease in serum Total protein, Albumin and liver antioxidants markers (TAC and GSH) compared to control. In conclusion, oral administration of Moringa oleifera aqueous extract improved the biochemical markers and provided antioxidant activity against the toxicity of Tamoxifen in liver tissues.

Background Preventive health measures reduce treatment and disease-related complications including infections, osteoporosis, and malignancies in patients with inflammatory bowel disease (IBD). Although guidelines and quality measures for IBD care highlight the importance of preventive care, their uptake remains variable. This systematic review evaluates interventions aimed at improving the rates of provision and uptake of preventive health measures, including vaccinations, bone density assessment, skin cancer screening, cervical cancer screening, and smoking cessation counseling. Methods We searched PubMed, MEDLINE, EMBASE, and CENTRAL for full text articles published until March 2021. Studies were included if they evaluated interventions to improve the provision or uptake of 1 or more preventive health measures in adult IBD patients and if they reported pre- and postintervention outcomes. Results In all, 4655 studies were screened, and a total of 17 studies were included, including 1 randomized controlled trial, 1 cluster-controlled trial, and 15 prospective interventional studies. A variety of interventions were effective in improving the rates of adherence to preventive health measures. The most common interventions targeted gastroenterologists, including education, electronic medical records tools, and audit feedback. Other interventions targeted patients, such as education, questionnaires, and offering vaccine administration at clinic visits. Few interventions involved IBD nurses or primary care physicians. Conclusions A range of interventions—targeted at gastroenterologists, patients, or both—were effective in improving the provision and uptake of preventive care. Future studies should involve randomized controlled trials evaluating multifaceted interventions that target barriers to adherence and involve IBD nurses and primary care physicians.

Food borne illnesses are prevalent in all parts of the world. Contaminated food Contributes to 1.5 billion cases of diarrhea in children each year, resulting in more than three million premature deaths (WHO). This study was conducted in August 2016 in Bahri locality, Khartoum state, to evaluate the knowledge, attitudes and practices of the consumers regard food safety. A total of questionnaire guided face to face interview with 120 respondents were carried out. Major food safety knowledge concepts include clean and hygiene, general sanitation, safe storage of food, proper cooking of food, use of thermometer in cooking. In general, the respondents had good knowledge about some food safety related issues and not enough knowledge about other issues. The results of the questionnaire showed that most of the respondents know the importance of washing hands before handling food 63% and wash the instruments and cleaning of the counter just after the preparation of the meal 83%. The results of the questionnaire revealed that 50% of the respondents know the importance of covering hands with a bandage and gloves when preparing food with cuts on their hands. Also, its reveal that 80% of the respondents didn`t know the proper way of thawing, and 84.2% of the respondents didn`t know food thermometer which use to ensuring proper cooking. This study recommend for Consumers should know and apply the five keys to safer food and implementing more training programs to the consumers to improve knowledge, attitudes and practices towards food safety.

 Objectives: The purpose of this survey is to investigate the knowledge, attitudes and practices related to antibiotic prescription patterns in a group of dentists in Egypt.  Materials and Methods: A cross-sectional survey was conducted electronically using online google forms. It included inquiries in the form of close-ended questions to be answered in tick-box format, the questions mainly uncovered, the participants’ “Knowledge” about the problem of antibiotic resistance and its association with professional mal practices, and also their “Attitudes and practices” concerning antibiotic prescriptions in different clinical conditions. 500 participants answered the questionnaire over a period of three months.  Results: Most of the participants prescribed Amoxicillin or Amoxicillin + clavulanic acid in conditions that warrant antibiotics usage. A comparable proportion preferred a treatment duration of 5-7 days. Although, 96% of the responses came in favor of antibiotic prescription in serious clinical conditions as facial cellulitis, still variable proportions of the sample chose to prescribe antibiotics for conditions that do not necessitate their usage as “localized intra-oral abscesses”, “sinus tracts and fistulas”, “luxation injuries” and “managing viral infections”.  Conclusions: Although the participants showed considerably adequate knowledge of the bacterial resistance problem, their practices showed varying degrees of deviation from the guidelines of antibiotic prescriptions set by the AAPD.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the etiological agent of coronavirus disease 2019 (COVID-19). This virus has become a global pandemic with unprecedented mortality and morbidity along with attendant financial and economic crises. Furthermore, COVID-19 can easily be transmitted regardless of religion, race, sex, or status. Globally, high hospitalization rates of COVID-19 patients have been reported, and billions of dollars have been spent to contain the pandemic. Angiotensin-converting enzyme (ACE) 2 is a receptor of SARS-CoV-2, which has a significant role in the entry of the virus into the host cell. ACE2 is highly expressed in the type II alveolar cells of the lungs, upper esophagus, stratified epithelial cells, and other tissues in the body. The diminished expressions of ACE2 have been associated with hypertension, arteriosclerosis, heart failure, chronic kidney disease, and immune system dysregulation. Overall, the potential drug candidates that could serve as ACE2 activators or enhance the expression of ACE2 in a disease state, such as COVID-19, hold considerable promise in mitigating the COVID-19 pandemic. This study reviews the therapeutic potential and pharmacological benefits of the novel ACE2 in the management of COVID-19 using search engines, such as Google, Scopus, PubMed, and PubMed Central.

Background Attention deficit hyperactivity disorder (ADHD) is an early-onset neurodevelopmental disorder that can extend into adulthood with multiple reported neuroimaging abnormalities. The focus of this research was to assess white matter impairments in ADHD children’s fathers with and without potential adult ADHD to see if these differences are connected with the persistence of ADHD into adulthood. Results The occurrence rate of the potential adult ADHD diagnosis among fathers of children with ADHD was 60%. There were statistically significant differences between fathers with ADHD and the non-ADHD population, due to the fact that the mean FA of the left superior corona radiata and the right posterior corona radiata were lower in the ADHD group than in the non-ADHD group, while the FA of the ADHD group was significantly greater than that of the non-ADHD group in terms of the left and right anterior thalamic radiations, the right superior longitudinal fasciculus and the left anterior corona radiata. Conclusions We observed an increased prevalence of ADHD in fathers of children diagnosed with ADHD. Fathers with potential adult ADHD have a variety of white matter abnormalities that reflect the neurobiological basis of ADHD, even in sub-threshold cases. This may provide insight into the neuroanatomical locations associated with the maintenance of ADHD throughout adulthood.

This paper presents an overview of the general idea and history of cloud computing in theory. The objective of this review is to draw attention to preceding studies about cloud computing that have common characteristics with the theme of this paper. There were some points discussed in general, including the advantages of this technology, its subjects, security, and the effects of adopting cloud computing in an organization.