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Crops of Vigna unguiculata L. “cowpea” and Zea mays L. “corn” require chemical fertilizers for proper growth and development; however, its inadequate application contaminates the environment, creating the need to search new alternatives that reduce its impact. Due to this, the objective of this research was to determine the effect of a biofertilizer from fish wastes on the yield of cowpea and corn, and its effect on their rhizospheric microbiota. The physicochemical and biological characteristics of the biofertilizer were determined, and then was applied on the field under a completely randomized block design with six treatments: absolute control, chemical control, biofertilizer at 1%, 1.25%, 1.5% and 1.25% plus chemical fertilizer. The application of biofertilizer at 1, 1.25 and 1.5% increased the height, root length and yield of cowpea; however, the increase percentages were lower than those obtained with chemical fertilizer and the biofertilizer at 1.25% plus chemical fertilizer. In the case of corn, all treatments with biofertilizer increased the growth and yield of aerial biomass compared to the control, and the percentages of increase exceeded the chemical fertilizer in terms of the number of leaves, length and root biomass. In addition, the biofertilizer increased the microbial fertility of the soil expressed as the number of colony-forming units of nitrogen-fixing and phosphate-solubilizing microorganisms per gram of soil in both crops. In conclusion, a positive effect of the biofertilizer from fish wastes was evidenced, which increased the yield of cowpea and corn, as well as an increase in soil microbial fertility.

The diagnostic process for psychiatric conditions is guided by the Diagnostic and Statistical Manual of Mental Disorders (DSM) in North America. Revisions of the DSM over the years have led to lowered diagnostic thresholds across the board, incurring increased rates of both misdiagnosis and over-diagnosis. Coupled with stigma, this ambiguity and lack of consistency exacerbates the challenges that clinicians and scientists face in the clinical assessment and research of mood disorders such as Major Depressive Disorder (MDD). While current efforts to characterize MDD have largely focused on qualitative approaches, the broad variations in physiological traits, such as those found in the gut, suggest the immense potential of using biomarkers to provide a quantitative and objective assessment. Here, we propose the development of a probiotic Escherichia coli (E. coli) multi-input ingestible biosensor for the characterization of key gut metabolites implicated in MDD. DNA writing with CRISPR based editors allows for the molecular recording of signals while riboflavin detection acts as a means to establish temporal and spatial specificity for the large intestine. We test the feasibility of this approach through kinetic modeling of the system which demonstrates targeted sensing and robust recording of metabolites within the large intestine in a time- and dose- dependent manner. Additionally, a post-hoc normalization model successfully controlled for confounding factors such as individual variation in riboflavin concentrations, producing a linear relationship between actual and predicted metabolite concentrations. We also highlight indole, butyrate, tetrahydrofolate, hydrogen peroxide, and tetrathionate as key gut metabolites that have the potential to direct our proposed biosensor specifically for MDD. Ultimately, our proposed biosensor has the potential to allow for a greater understanding of disease pathophysiology, assessment, and treatment response for many mood disorders.

40 años de Comunidades Imaginadas. Vidas y sobrevidas de un clásico

Summary: Given the importance of the kinin B1 receptor in insulin and leptin hormonal regulation, which in turn is crucial in maternal adaptations to ensure nutrient supply to the fetus, we investigated the role of this receptor in maternal metabolism and fetoplacental development. Wild-type and kinin B1 receptor-deficient (B1KO) female mice were mated with male mice of the opposite genotype. Consequently, the entire litter was heterozygous for kinin B1 receptor, ensuring that there would be no influence of offspring genotype on the maternal phenotype. Maternal kinin B1 receptor blockade reduces adiponectin secretion by adipose tissue ex vivo, consistent with lower adiponectin levels in pregnant B1KO mice. Furthermore, fasting insulinemia also increased, which was associated with placental insulin resistance, reduced placental glycogen accumulation, and heavier offspring. Therefore, we propose the combination of chronic hyperinsulinemia and reduced adiponectin secretion in B1KO female mice create a maternal obesogenic environment that results in heavier pups.

Climate change accelerates glacier retreat, leading to extensive exposure of sediment to light and ecological succession. Succession has traditionally been studied as a chronosequence, where vegetation development is directly correlated with time since glacier retreat or distance from the retreating glacier margin. More recent work has challenged this model, arguing that succession seems to be mainly influenced by heterogeneous conditions at the local scale. The aim of this study was to identify the factors influencing the local-scale establishment of plant communities following glacier recession. Vascular plants and their cover were inventoried in 100 plots (1 m2) for a thirty-year-old alluvial plain in front of the Otemma glacier (Swiss Alps). Depth to water table, distance to the glacial main river and to the nearest channel, sediment size, moss, lichen, and biological soil crust cover were measured. Results showed that proglacial margins develop hydrological heterogeneity over a small scale, reflected in the four observed plant communities. These range from the dry Sempervivum-dominated community, on gravel-rich sediments with a deep water table, to the Trifolium-dominated community, close to secondary channels, with the highest plant cover and species richness and incorporating grassland species. Heterogeneity in water availability exerted a critical control on vegetation development.

AbstractDifferent applications of the fertilizers were carried out to study their effect on tea plant productivity and phytochemicals in prepared black tea. Weight and dimensions of the bud, first and second leaf of each variety was taken for this purpose. Organic application (T1) 200 g vermicomposting per bush and inorganic application (T2) which is a combination of 2.5 g urea, 5 g Di-ammonium phosphate and 1 g potash was applied per bush. Weights of the bud was found higher in organic treated Ambari (0.061 g), Phubtsering 312 (0.056 g), Takda 78 (0.069 g) but in Banekbern 157 (0.046 g) and Gumti (0.07 g) inorganic fertilizer treatment increased the weight. The weight of first leaves ranged from 0.04 g to 0.115 g for the experimental samples. The weight of first leaves of PB 312, Banekbern 157 and Gumti varieties was observed to have greater for inorganic while for AV2 and Takda 78 weight of first leaf was observed to be greater for organic treatment. The weight of second leaf was found greater for inorganic treatment for all varieties which ranged from 0.115 g to 0.335 g in all samples of tea. In all varieties length was found to be increased in inorganic treatments. In all varieties, inorganic practice has positive effect in the growth and yield of the leaves. The fresh leaves and black tea prepared from the leaves of organic treatments had better tea quality in reference to TPC, TFC and DPPH radical scavenging activity. The caffeine content was not significantly different (p > 0.05) for the organic and inorganic treatment for both fresh leaves and prepared tea. Black tea prepared by organic treated leaves from Gumti and AV2 were superior to other samples regarding the phytochemical properties. Inorganic treatments increased the yield and growth but the quality of tea was increased by organic fertilizers.

Median arcuate ligament syndrome (MALS) is characterized by the constriction of the celiac trunk caused by fibrous connections originating from the median arcuate ligament (MAL) and diaphragmatic crura. It presents with symptoms often leading to misdiagnosis. In this study, we present three cases of MALS, with distinct manifestations. These cases were diagnosed through comprehensive investigations and managed successfully using laparoscopic decompression. The diagnosis of MALS poses challenges due to its variable presentations and overlap with other conditions. Diagnostic imaging techniques such as Doppler ultrasound, computed tomography (CT) scans and angiography play a role in confirming the diagnosis. Laparoscopic decompression has proven to be a treatment option that relieves symptoms and restores blood flow. This series highlights the importance of considering MALS as a cause for abdominal pain cases. Early detection and the use of diagnostic techniques can result in favorable outcomes.

If the Anthropocene marks a changed way of being in the world resulting from the integration of human activity and geological processes, a main question is how this situation may be aesthetically represented and with what implications. This article sketches an aesthetics of the Anthropocene by analyzing artistic engagements with advanced tools of visual calculation used in the context of the environment; it explores what I term *machinic landscapes*. Machinic landscapes are landscape works made by contemporary artists using forms of machine vision and involve a confrontation between two mediums, that of the logic and the representational mechanisms of its technology and that of the forms and processes found in nature and the environment and the multiple layers of representation that emerge and further generate through this. The bringing together of the terms *machinic* and *landscape* is meant to counter binaries between nature and technology and to foreground ways in which forms found in the natural environment are integrated into the functioning of a technical, aesthetic gesture by machine. Here I focus on the work of contemporary artists Mishka Henner, Daniel Lefcourt, and Davide Quayola, each of whom works with the digital visualizing programs often utilized in fields of landscape architecture and the geosciences including heightmapping, LiDAR, 3D scanning, and satellite imaging systems to produce artistic forms of landscape. Through their artworks, these artists experiment with parameters of technologies outside the contexts of scientific implementation, revealing multiplicities of machinic aesthetic output and their limitations. I argue that these machinic landscapes provide speculative outcomes and alternative imaginaries that directly address some of the aesthetic challenges of the Anthropocene---specifically, issues of latency, entanglement, and scale. Drawing on landscape theory, philosophy of technology, and concepts within geography to frame this study, this article revisits the art historical genre of landscape as a vehicle to explore contemporary aesthetic and political dimensions of our relationship to and in the environment.

The historical dominance of women working in occupational therapy, coupled with the underrepresentation of males in the field globally, creates a need to investigate the experiences of male students in occupational therapy programs. In the context of the Philippines, where women make up 74.72% of the occupational therapy workforce, this study aims to address the following scaffolding problem by exploring the experiences and motivations of male students in Philippine occupational therapy programs. This study seeks to shed light on the factors influencing their educational journey and contribute to a better understanding of gender dynamics within the field. A qualitative design was used. Nine male occupational therapy students from various universities across the Philippines completed a survey questionnaire developed by the authors and attended a focus group discussion. Qualitative data was recorded and analyzed using thematic analysis. Upon analysis, five themes emerged: (1) Means and Not the End, (2) Rapport and Communication, (3) Society and Stereotyping, (4) Introspection of Male Students, and (5) Furtherance of Gender Inclusivity. The findings suggest that there are roles and expectations specific to male occupational therapy students within the Philippines, which may differ to some extent from those of their female counterparts. The participants experienced particular challenges and opportunities due to their gender. These results may be used to understand the existing gender disparity still present in different occupational therapy workforces.

Electrical synapses are neuronal gap junction (GJ) channels associated with a macromolecular complex called the electrical synapse density (ESD), which regulates development and dynamically modifies electrical transmission. However, the proteomic makeup and molecular mechanisms utilized by the ESD that direct electrical synapse formation are not well understood. Using the Mauthner cell of zebrafish as a model, we previously found that the intracellular scaffolding protein ZO1b is a member of the ESD, localizing postsynaptically, where it is required for GJ channel localization, electrical communication, neural network function, and behavior. Here, we show that the complexity of the ESD is further diversified by the genomic structure of the ZO1b gene locus. The ZO1b gene is alternatively initiated at three transcriptional start sites resulting in isoforms with unique N-termini that we call ZO1b-Alpha, -Beta, and -Gamma. We demonstrate that ZO1b-Beta and ZO1b-Gamma are broadly expressed throughout the nervous system and localize to electrical synapses. By contrast, ZO1b-Alpha is expressed mainly non-neuronally and is not found at synapses. We generate mutants in all individual isoforms, as well as double mutant combinations in cis on individual chromosomes, and find that ZO1b-Beta is necessary and sufficient for robust GJ channel localization. ZO1b-Gamma, despite its localization to the synapse, plays an auxiliary role in channel localization. This study expands the notion of molecular complexity at the ESD, revealing that an individual genomic locus can contribute distinct isoforms to the macromolecular complex at electrical synapses. Further, independent scaffold isoforms have differential contributions to developmental assembly of the interneuronal GJ channels. We propose that ESD molecular complexity arises both from the diversity of unique genes and from distinct isoforms encoded by single genes. Overall, ESD proteomic diversity is expected to have critical impacts on the development, structure, function, and plasticity of electrical transmission.

Deploying hydrogen fuelling facilities plays a critical role in providing easy access to refuelling services for hydrogen fuel cell products. This study aims to uncover how people from different countries perceive accident risk from hydrogen fuelling stations (HFSs) and discern the gap between general cognition and reality. A cross-country investigation was simultaneously implemented in Japan, Spain, and Norway in December 2022 to observe the public’s risk attitude towards technical procedures of HFS operations, i.e., hydrogen production, transportation, storage, and dispensing. A total of 2,500 participants from the three countries completed the web-based questionnaires, evaluating their level of perceived risk towards HFSs in terms of risk probability and consequence. The investigation results demonstrated differentiated risk perception towards HFSs across countries, stimulating a reflection on the essential elements of societal risk perception. Moreover, this study emphasises the gap between cognitive and actual risk by employing event tree analysis of standard HFS equipment. The empirical frequencies of failure, e.g., the rupture and leakage occurring at the compressors, trailers, vessels, dispensers, and pipes, are summarised as a baseline. The comparative results indicate that the public tends to overestimate the risks of hydrogen transportation and underestimate the risks of production, identifying perceptual inaccuracies and suggesting directions for future hydrogen knowledge dissemination from a practical point of view.

Colorectal cancer (CRC) is the third leading cause of cancer-related deaths in the United States. Despite the availability of multiple screening options, CRC screening is underutilized. We conducted a survey of patients (n = 2973) who were prescribed the multi-target stool DNA (mt-sDNA) screening test (commercialized as Cologuard ® and manufactured by Exact Sciences Corporation) to understand attitudes and experiences that influence test completion and likelihood of future test completion. Using exploratory factor analyses, we developed three scales: Perceived Effectiveness, Perceived Ease of Use, and Perceived Comfort.

Abstract Obesity and depression, disorders associated with inflammation, have high incidences in women. Understanding the derangements present in the initial phase of obesity may point to factors that could help avoiding disease aggravation. The present study aimed at investigating the effects of a 6-months interdisciplinary therapy for weight loss in women with grade I obesity. Before and after the therapy, 37 middle-aged women donated blood and responded to questionnaires for depression and anxiety symptoms. Inflammatory parameters were evaluated in serum and a preliminary screening of the plasma proteome was performed. The therapy decreased anthropometric, psychological scores, and serum levels of inflammatory parameters. Depression and anxiety scores correlated positively with some inflammatory parameters. The proteomic analysis showed changes in proteins related to cholesterol metabolism and inflammatory response. Interdisciplinary therapy improves anthropometric and inflammatory statuses and ameliorating psychological symptoms. The decrease of MCP-1 levels after interdisciplinary therapy has not been reported so far, at the best of our knowledge. The present demonstration of positive associations of inflammatory markers and psychological scores indicate that these mediators may be useful to monitor psychological status in obesity. The present proteome data, although preliminary, pointed to plasma alterations indicative of improvement of inflammation after interdisciplinary therapy.

Fever can be viewed as an adaptive response to infection. Temperature control in sepsis is aimed at preventing potential harms associated with high temperature (tachycardia, vasodilation, electrolyte and water loss) and therapeutic hypothermia may be aimed at slowing metabolic activities and protecting organs from inflammation. Although high fever (>39.5°C) control is usually performed in critically ill patients, available cohorts and randomized controlled trials do not support its use to improve sepsis prognosis. Finally, both spontaneous and therapeutic hypothermia are associated with poor outcomes in sepsis.

Deep-sea methane seeps host highly diverse microbial communities whose biological diversity is distinct from other marine habitats. Coupled with microbial community analysis, untargeted metabolomics of environmental samples using high resolution tandem mass spectrometry provides unprecedented access to the unique specialized metabolisms of these chemosynthetic microorganisms. In addition, the diverse microbial natural products are of broad interest due to their potential applications for human and environmental health and well-being. In this exploratory study, sediment cores were collected from two methane seeps (-1000 m water depth) with very different gross geomorphologies, as well as a non-seep control site. Cores were subjected to parallel metabolomic and microbial community analyses to assess the feasibility of representative metabolite detection and identify congruent patterns between metabolites and microbes. Metabolomes generated using high resolution liquid chromatography tandem mass spectrometry were annotated with predicted structure classifications of the majority of mass features using SIRIUS and CANOPUS. The microbiome was characterized by analysis of 16S rRNA genes and analyzed both at the whole community level, as well as the small subgroup of Actinobacteria, which are known to produce societally useful compounds. Overall, the younger Dagorlad seep possessed a greater abundance of metabolites while there was more variation in abundance, number, and distribution of metabolites between samples at the older Emyn Muil seep. Lipid and lipid-like molecules displayed the greatest variation between sites and accounted for a larger proportion of metabolites found at the older seep. Overall, significant differences in composition of the microbial community mirrored the patterns of metabolite diversity within the samples; both varied greatly as a function of distance from methane seep, indicating a deterministic role of seepage. Interdisciplinary research to understand microbial and metabolic diversity is essential for understanding the processes and role of ubiquitous methane seeps in global systems and here we increase understanding of these systems by visualizing some of the chemical diversity that seeps add to marine systems.

الملخّص: تهدف نظرية و نقد مابعد الاستعمار الي رسم افضلية القوي المستعمرة الاوروبية في المجالات الثقافية و الاقتصادية و الاخلاقية و بيان هذه المسئلة أن سيطرة الاستعمار الاقتصادية و السياسية و الثقافية تنفي الهوية المستقلة و اصالة الاسيويين و الافريقيين. احد جوانب الادب الروائي هو نقد ما بعد الاستعمار. يسعي نقاد ما بعد الاستعمار بدراسة الآثار الظاهرة و الخفية للاستعمار كي يدرسوا تبعاته المباشرة و غير المباشرة في المجالات المختلفة. رواية «الفراشة الزرقاء» اثر «ربيع جابر» تمكنت بجودة أن تُري لقرائها اثر الاستعمار الفرنسي علي لبنان. و كذلك تبين كيف تستعمر فرنسا طاقات العمل في هذه البلدة باستخدام أياديها في لبنان و بتأسيس و صنع مصانع انتاج الحرير و النسيج. الدراسة هذه تسعي أن تدرس نماذج من رواية «الفراشة الزرقاء» ببحث مقومات مابعد الاستعمار مثل: دراسة الشرق، محورية اوروبا،العلاقة الثنائية، الطبقة الدانية و الهجرة ذلك باعتماد الطريقة الوصفية-التحليلية و كذلك التطرق لتأثير ذلك علي حياة الناس، الهوية و معتقداتهم في هذه الرواية. المتوقع في هذا البحث أن مقوم دراسة الشرق، محورية اوروبا و الهجرة يحتل التكرار الاكثر بنسبة سائر المقومات حيث يدل علي انفعال و عدم فاعلية الشعب اللبناني امام المستعمرين.

Despite clear evidence that regular screening reduces colorectal cancer (CRC) mortality and the availability of multiple effective screening options, CRC screening continues to be underutilized in the US.A systematic literature search of four databases – Ovid, Medline, EBSCHOhost, and Web of Science – was conducted to identify US studies published after 2017 that reported on barriers and facilitators to CRC screening adherence. Articles were extracted to categorize relevant CRC screening barriers or facilitators that were assessed against CRC screening outcomes using the 5As dimensions: Access, Affordability, Acceptance, Awareness, Activation.Sixty-one studies were included. Fifty determinants of screening within the 5As framework and two additional dimensions including Sociodemographics and Health Status were identified. The Sociodemographics, Access, and Affordability dimensions had the greatest number of studies included. The most common factor in the Access dimension was contact with healthcare systems, within the Affordability dimension was insurance, within the Awareness dimension was knowledge CRC screening, within the Acceptance dimension was health beliefs, within the Activation dimension was prompts and reminders, within the Sociodemographics dimension was race/ethnicity, and among the Health Status dimension was chronic disease history. Among all studies, contact with healthcare systems, insurance, race/ethnicity, age, and education were the most common factors identified.CRC screening barriers and facilitators were identified across individual, clinical, and sociocontextual levels. Interventions that consider multilevel strategies will most effectively increase CRC screening adherence.

Background and Aim: Parallel to the progress of services, organizational complexity levels in health care centers (HCCs) have increased. The influential factors in this regard include the variety of services, the non-uniformity of the centers’ management conditions, and the rising expectations from the health system. Therefore, considering many factors influenced and effective, improvement of health services requires development of a systematic approach to evaluate their efficiency and management system. The aim of this study was to develop a balanced scorecard (BSC) model suitable for HCCs using a hybrid approach that combines the Fuzzy Delphi and DNAP techniques. Materials and Methods: This research was a combined qualitative-quantitative study that was conducted with the aim of developing a BSC model suitable for HCCs. The statistical population consisted of 15 experts in health and medicine, who were selected based on the targeted snowball sampling. A researcher-made questionnaire and a 20×20 matrix questionnaire were used to collect the data. The questionnaire validity was calculated based on the experts’ opinions and the reliability was calculated using Cronbach’s alpha and consistency rate. The data was analyzed using Excel and MATLAB, and DNAP technique was used to determine the cause-and-effect relationship and the influence levels of the objectives. Results: According to the results of the Fuzzy Delphi technique in the panel of experts, 5 viewpoints with 20 objectives of the BSC suitable for HCCs were identified and replaced the traditional viewpoints of the BSC. In addition, these results showed that the views of growth and development, intra-organizational processes, and social responsibility are considered as the influential factors due to the positive D-R values, while the views of patients and society, financial status, and performance are considered as the factors that are effective due to the negative D-R values. Conclusion: The results of this study indicated that those points of view that are consistent with the goals of the HCCs should be used in the BSC in order to evaluate their performance. Also, prioritizing and determining the cause-and-effect relationship and considering the contribution of each point of view for achieving the goals of the HCCs can increase the performance.

Introduction: Cancer patients are known to experience sleep disturbances that differ between disease stages and treatments. Regarding lung cancer patients and immunotherapy, information on their sleep disturbances has been recently acquired, but no comparison has been made between different treatment modalities. Patients and Methods: We recruited 98 non-small cell lung cancer patients; 49 had programmed death-ligand 1 expression of ≥50% and received immunotherapy as first-line treatment and 49 had programmed death-ligand 1 expression in the range from 0–49 and received chemotherapy as first-line treatment. All patients were stage IV, but with no bone metastasis. Sleep disturbances were recorded through polysomnography and sleep questionnaires. Results: For immunotherapy patients with PD-L1 expression ≥ 50%, the disease response was rapid and the sleep disturbances decreased rapidly. On the other hand, for chemotherapy patients, the sleep disturbances remained for all those patients that had partial response and stable disease. It was noticed that chemotherapy drugs induce severe adverse effects. Discussion: In our study, it was observed that patients with complete response had reduced sleep disturbances in the case of immunotherapy patients. However, sleep disturbances continued for several patients in the chemotherapy group due to the adverse effects of chemotherapy drugs. In conclusion: Immunotherapy drugs on their own do not induce sleep disturbances and, through treatment response, alleviate sleep disturbances in lung cancer patients.

Abstract Background Work stress is one of the leading causes of physical and mental problems among nurses and can affect patient safety. Nurses experiencing stress are more prone to make errors, which has consequences for the safety culture. This study aimed to describe the findings of studies that examined the relationship between job stress and patient safety culture among nurses. Methods A systematic review of published English-language articles from 2017 to 2021 was obtained through an electronic search of three large online databases (i.e., CINAHL through EBSCOhost, Medline through PubMed, and Embase). We used the Statement of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to guide the undertaking of this review. In addition, data extraction and quality assessment were performed for the final seven quantitative articles. Results This review showed a significant relationship between job-related stress in its different factors, patient safety culture, and patient safety. Three studies of the seven reviewed articles examined the relationship. The rest of the studies examined the relationship indirectly, discussing factors that impacted job stress and how they affected patient safety culture. However, differences in working conditions and study characteristics affected the results of these studies and the significance of this relationship. Conclusions This review suggests that nursing managers and administrators should consider actions to minimize nursing job stress to the minimum levels and improve their work environment to provide the best possible patient care. Future studies are needed to develop interventions to reduce workplace stress and improve nurses' safety. Furthermore, nurses’ managers and educators should train nurses on resilience and how to work in trauma-informed care.

Abstract South America, once an epicenter of COVID-19, has stayed on the road of continued management of the pandemic. The region initially struggled to cope with the pandemic as it experienced spiraling numbers of infections and overwhelmed public health systems. South America has risen in its pandemic response to be the region with the highest global vaccination rate. The region posed a strong vaccination drive, with over 76% of its population fully vaccinated with the initial protocol. South America leveraged its deeply rooted vaccination culture and public health confidence among its population. Herd immunity is an integral concept in population infectious disease management. Attaining herd immunity is presently not feasible with available vaccines, but the high vaccination rate in the region depicts the acceptance of vaccination as a strategy for population protection. The availability of effective transmission-blocking vaccines, the continuous implementation of strategies that will enable the undisrupted supply of the vaccines, equity in access to the vaccines, improved vaccine acceptance, and trust in the vaccination and public health systems will help shepherd the region towards herd immunity. Local vaccine production backed with investment in infrastructure and international collaboration for research and knowledge development will also drive population safety.

The oath is one of the evidence considered by the legislature for proving claims and is so addrecodified legal laws as if it has a purely positive place in the legal system, both civil and criminal, while the analysis of the jurisprudential and legal teachings shows that that it cannot be completely such a position was given to the oath. n order to check the validity of the oath in proving the claims, it is necessary to detail between the legal and criminal claims on the one hand, and the claims with a private plaintiff and the lack thereof on the other hand. Accordingly, this descriptive-analytical study investigates the validity of oath in hudud and ta’zir. According the findings of this study, based on the arguments such as the narration "there is no oath in hudud", the fact that hudud are due god and some of them lack private plaintiff, the denial nature of the oath (except in exceptional civil cases), the tendency of legislator to mitigation and tolerance in the issues related to hudud and strictness in proving them hudud, as well as insisting on repentance and not disclosing the crime by execution of hudud and preventing the spread of prostitution and retaining the indecency of crimes subject to hudud, the invalidity of the oath in hudud has been proven. Considering the above-mentioned arguments and the commonalities of hudud and ta'zir in the above aspects, the oath also has no positive place in ta'zir and cannot be considered as a valid reason in proving the crime subject to ta'zir. Obviously, in cases where hudud and ta'zir have a financial aspect in addition to public status, such as robbery, the attached oath can be valid and only prove the financial aspect of the crime.

The adoption of Electronic Health Record (EHR) and other e-health infrastructures over the years has been characterized by an increase in medical errors. This is primarily a result of the widespread usage of medical acronyms and abbreviations with multiple possible senses (i.e., ambiguous acronyms). The advent of Artificial Intelligence (AI) technology, specifically Natural Language Processing (NLP), has presented a promising avenue for tackling the intricate issue of automatic sense resolution of acronyms. Notably, the application of Machine Learning (ML) techniques has proven to be highly effective in the development of systems aimed at this objective, garnering significant attention and interest within the research and industry domains in recent years. The significance of automating the resolution of medical acronym senses cannot be overstated, especially in the context of modern healthcare delivery with the widespread use of EHR. However, it is disheartening to note that comprehensive studies examining the global adoption of EHR, assessing the impact of acronym usage on medical errors within EHR systems, and reporting on the latest trends and advancements in ML-based NLP solutions for disambiguating medical acronyms remain severely limited. In this current study, we present a detailed overview on medical error, its origins, unintended effects, and EHR-related errors as a subclass of clinical error. Furthermore, this paper investigates the adoption of EHR systems in developed and developing nations, as well as the review concludes with an examination of various artificial intelligence techniques, particularly machine learning algorithms for medical acronym and abbreviation disambiguation in EHRs.

Cardiac rehabilitation (CR) is a complex intervention that improves functional capacity and quality of life in patients with heart failure (HF). Besides exercise training (ET), CR includes aggressive risk factor management, education about medication adherence, stress management, and psychological support. Current guidelines strongly recommend CR as an integral part of chronic and stable HF patient care. However, CR programs are underused for multiple reasons, namely, low physician referral and patient adherence, high cost, and lack of awareness. In this review, we present existing evidence of the beneficial effects of ET and CR in HF with reduced and preserved ejection fraction, the underlying pathophysiologic mechanisms by which exercise might alleviate symptoms, and the different types of exercise that can be used in HF. Current guidelines supporting the use of CR, reasons for its underutilization, and home-based CR as an alternative or adjunct to traditional center-based programs are also described.

Abstract We previously described the hypotheses, outcomes, design, and analysis for E2C2, a pragmatic stepped-wedge trial to assess an intervention to improve symptom control in patients with cancer. Subsequent consideration of the design and cohort led to the addition of a second primary hypothesis. This article describes and presents the rationale for this second hypothesis. This addendum also details a revised analytic approach, necessitated by inconsistencies in the original analytic plan. The design, outcomes, and other aspects of the protocol remain unchanged.

In light of the rising evidence of the association between viral and bacterial infections and neurodegeneration, we aimed at revisiting the infectious hypothesis of Alzheimer’s disease and analyzing the possible implications of COVID-19 neurological sequelae in long-term neurodegeneration. We wondered how SARS-CoV-2 could be related to the amyloid-β cascade and how it could lead to the pathological hallmarks of the disease. We also predict a paradigm change in clinical medicine, which now has a great opportunity to conduct prospective surveillance of cognitive sequelae and progression to dementia in people who suffered severe infections together with other risk factors for Alzheimer’s disease.

Economically, housing is a commodity with special characteristics that distinguish it from other commodities and complicate its market analysis (supply and demand). Housing price fluctuations have a very important effect on the national and regional economy. Fluctuations may potentially affect migration and capital mobility between regions. Investigating the long-term equilibrium relationship between housing prices in all regions of the country can answer the question of whether housing prices in all regions will converge or not. This research examines the convergence of housing prices from spatial econometric methods and dynamic panel data among Iranian cities. For this purpose, the housing prices of 31 Iranian cities from 1379 to 1397 are examined. This study is based on the theory that housing price shocks in one region can have a ripple effect on other regions due to migration, asset conversion and spatial arbitrage. If this hypothesis is acceptable, the relative price ratios of the regions should be stable. Although there may be a difference in the short term, it should converge in the long term. Therefore, when a housing price shock hits one of Iran's cities, due to the ripple effect of this shock, it affects the housing prices of other cities, and finally, the housing prices of all cities converge in the long term. In such a case, considering that regional planning policies have the same long-term effects for all regions, macroeconomic policy makers cannot independently control the housing prices of a region. However, planning policies are still effective on the short-term path of prices. The results show that there is a convergence of housing prices between cities in Iran. Moreover, the spatial effects are influential in the convergence of housing prices in cities, and the result confirms the hypothesis of a wave effect in the convergence of housing prices in regions. In such a case, regional planning policies will have the same long-term effects for all regions.

En los últimos años, la tendencia creciente de la deuda pública paraguaya se ha vuelto un tema recurrente y preocupante, en particular, en coincidencia con los últimos años del período del gobierno anterior y del actual, al constatarse que, a pesar de las críticas a dicha situación, se ha seguido aumentando el endeudamiento, sin que se establezcan nuevas estrategias para generar o ampliar fuentes o líneas de financiamiento de las políticas públicas. Además, la acumulación de deudas públicas será heredada a los gobiernos y generaciones futuras, pudiendo restringir las opciones de financiamiento público. En la actualidad, el país sobrevive a la crisis climática y económica iniciada en 2019 y agudizada con la pandemia del coronavirus en 2020 y el primer semestre de 2021, por la emergencia sanitaria y la crisis social, en la que la presión sobre los servicios hospitalarios deficitarios, la derivación de los pacientes al sector privado de la salud, la pérdida de vidas humanas, del empleo y del ingreso en las familias, llevó al gobierno a aumentar el gasto y la deuda pública de manera extraordinaria. En el presente trabajo, nos proponemos presentar los resultados del análisis de la deuda pública en el largo plazo 2004 – 2021, en el contexto de mayor estabilidad y crecimiento de la economía nacional (2004 – 2018); de la crisis (2019-2020), y los indicios de la recuperación actual. En dichos contextos buscamos identificar las características de la deuda pública, para reflexionar sobre los problemas persistentes y las alternativas de salida.

Abstract Background Neurological complications are associated with poor outcome in patients with infective endocarditis (IE). Although guidelines recommend systematic brain imaging in the evaluation of IE patients, the association between early brain imaging findings and outcomes has never been evaluated in critically ill patients. We aimed to assess the association of CT-defined neurological complications with functional outcomes of critically ill IE patients. Methods This retrospective cohort study included consecutive patients with severe, left-sided IE hospitalized in the medical ICU of a tertiary care hospital. Patients with no baseline brain CT were excluded. Baseline CT-scans were classified in five mutually exclusive categories (normal, moderate-to-severe ischemic stroke, minor ischemic stroke, intracranial hemorrhage, other abnormal CT). The primary endpoint was 1-year favorable outcome, defined by a modified Rankin Scale score of 0–3. Results Between 06/01/2011 and 07/31/2018, 156 patients were included. Among them, 87/156 (56%) had a CT-defined neurological complication, including moderate-to-severe ischemic stroke (n = 33/156, 21%), intracranial hemorrhage (n = 24/156, 15%), minor ischemic stroke (n = 29/156, 19%), other (n = 3/156, 2%). At one year, 69 (45%) patients had a favorable outcome. Factors negatively associated with favorable outcome in multivariable analysis were moderate-to-severe ischemic stroke (OR 0.37, 95%CI 0.14 − 0.95) and age (OR 0.94, 95%CI 0.91–0.97). By contrast, the score on the Glasgow Coma Scale was positively associated with favorable outcome (per 1-point increment, OR 1.23, 95%CI 1.08–1.42). Sensitivity analyses conducted in operated patients revealed similar findings. Compared to normal CT, only moderate-to-severe ischemic stroke was associated with more frequent post-operative neurological complications (n = 8/23 (35%) vs n = 1/46 (2%), p

Abstract Background Peritonitis is one of the major complications of peritoneal dialysis. The most common cause of peritonitis is infection at the catheter exit site. This study aimed to determine the effect of propolis on the incidence of catheter exit site infection and peritonitis in peritoneal dialysis patients. Method This study was a double-blind clinical trial (2019–2020) with peritoneal dialysis patients. Ninety peritoneal dialysis patients were allocated to three groups (placebo, control, intervention) using block randomization method. Catheter exit site was washed with 0.9% normal saline and dressing was done every other day after the morning peritoneal dialysis exchange by use of normal saline in placebo, mupirocin in control, and propolis in intervention group, for 6 months. Discussion 10% of the patients in the placebo and 6.7% in the control group developed catheter Exit Site Infection, but none patient in the intervention group developed this infection (P = 0.469). Whereas 6.7% in both the placebo and control groups developed peritonitis, but none patient in the intervention group contracted peritonitis (P = 0.997). No significant differences in the incidence of catheter exit site infection and peritonitis among the three groups were observed. Considering that mupirocin is of chemical origin and may lead to drug resistance whereas propolis is of plant origin and does not produce drug resistance, the use of propolis is recommended. Trial registration Iranian Registry of Clinical Trials [ IRCT20110427006318N10 ] (17/01/2019).

Abstract Viruses are the most abundant components of the human gut microbiome with a significant impact on health and disease. The effects of human immunodeficiency virus (HIV) infection on gut virome has been scarcely analysed. Several studies suggested that integrase strand transfers inhibitors (INSTIs) are associated with a healthier gut. Thus, the objective of this work was to evaluate the effects of HIV infection and INSTIs on gut virome composition. 26 non-HIV-infected volunteers, 15 naive HIV-infected patients and 15 INSTIs-treated HIV-infected patients were recruited and their gut virome composition was analysed using shotgun sequencing. Bacteriophages were the most abundant and diverse viruses present in gut. HIV infection was accompanied by a decrease in phage richness which was reverted after INSTIs-based treatment. β-diversity of phages revealed that samples from HIV-infected patients clustered separately from those belonging to the control group. Differential abundant analysis showed an increase in phages belonging to Caudoviricetes class in the naive group and a decrease of Malgrandaviricetes class phages in the INSTIs-treated group compared to the control group. Besides, it was observed that INSTIs-based treatment was not able to reverse the increase of lysogenic phages associated with HIV infection or to modify the decrease observed on the relative abundance of Proteobacteria-infecting phages. Our study describes for the first time the impact of HIV and INSTIs on gut virome and demonstrates that INSTIs-based treatments are able to partially restore gut dysbiosis at the viral level, which opens several opportunities for new studies focused on microbiota-based therapies.

Objective: To estimate rates and identify factors associated with asymptomatic COVID-19 in the population of Olmsted County during the prevaccination era. Patients and Methods: We screened first responders (n=191) and Olmsted County employees (n=564) for antibodies to SARS-CoV-2 from November 1, 2020 to February 28, 2021 to estimate seroprevalence and asymptomatic infection. Second, we retrieved all polymerase chain reaction (PCR)-confirmed COVID-19 diagnoses in Olmsted County from March 2020 through January 2021, abstracted symptom information, estimated rates of asymptomatic infection and examined related factors. Results: Twenty (10.5%; 95% CI, 6.9%-15.6%) first responders and 38 (6.7%; 95% CI, 5.0%-9.1%) county employees had positive antibodies; an additional 5 (2.6%) and 10 (1.8%) had prior positive PCR tests per self-report or medical record, but no antibodies detected. Of persons with symptom information, 4 of 20 (20%; 95% CI, 3.0%-37.0%) first responders and 10 of 39 (26%; 95% CI, 12.6%-40.0%) county employees were asymptomatic. Of 6020 positive PCR tests in Olmsted County with symptom information between March 1, 2020, and January 31, 2021, 6% (n=385; 95% CI, 5.8%-7.1%) were asymptomatic. Factors associated with asymptomatic disease included age (0-18 years [odds ratio {OR}, 2.3; 95% CI, 1.7-3.1] and >65 years [OR, 1.40; 95% CI, 1.0-2.0] compared with ages 19-44 years), body mass index (overweight [OR, 0.58; 95% CI, 0.44-0.77] or obese [OR, 0.48; 95% CI, 0.57-0.62] compared with normal or underweight) and tests after November 20, 2020 ([OR, 1.35; 95% CI, 1.13-1.71] compared with prior dates). Conclusion: Asymptomatic rates in Olmsted County before COVID-19 vaccine rollout ranged from 6% to 25%, and younger age, normal weight, and later tests dates were associated with asymptomatic infection.

Moringa oleifera is a nutrient-rich plant, also referred to as a miracle tree, and is commonly used in the preparation of functional foods including herbal biscuits. Despite having a wide range of biomolecules, M. oleifera has not been studied for its nutritional benefits in Nepal. To fill this gap, five different formulations of flower and leaf powder ratios of 11:4, 11.75:3.25, 12.5:2.5, 13.25:1.75, 14:1 named as A, B, C, D, E, and control formulations were tested for their sensory and chemical characteristics. The results showed that calcium content (115.73 mg/100 g) was higher in biscuits with a higher percentage of the leaf (11:4) while TPC was minimum. Further, biscuits containing a higher percentage of flower powder contained fewer tannins. The sensory analysis concluded that D was deemed the best in overall attributes by panelists upon statistical analysis, however formulations A and B were superior to other samples regarding the chemical properties. These findings confirm that there is a huge potential for improving herbal biscuits.

Fruit leathers, which are also known as fruit rolls, are dehydrated fruit-based products. Despite the popularity of Lapsi fruit leather, its production is limited to home-scale industries, which lack uniformity in quality. Moreover, scientific research to address this issue is very limited. Therefore, in this study, Lapsi fruit leather was prepared and its nutritional, phytochemicals, and sensorial properties were studied. The fruit pulp and sugar were mixed at the proportion of 50:50, 80:20, 57.5:42.5, 72.5:27.5, and 65:35 to prepare leather and labeled as samples A, B, C, D, and E, respectively. The drying behavior was studied at 55°C in cabinet dryer. Among these samples, B had higher amount of crude fat (0.88 g/100 g sample), crude protein (3.87 g/100 g sample), crude fiber (10.95 g/100 g sample), and total ash (1.09 g/100 g sample); however, carbohydrate and energy value was significantly higher in sample A with the value of 83.21 g and 284 kcal per 100 g leather, respectively. Similarly, sample B was rich in phytochemicals containing 67 mg vitamin C/, total polyphenol of 88.33 mg GAE/g dry extract, total flavonoid of 37.57 mg QE/g dry extract and DPPH inhibition activity of 43.17%. Sample A was dried in 8.83 h, which had moisture diffusivity of 8.723 × 10−7 m2/sec, and sample B was dried in 7.33 h, which had moisture diffusivity of 10.0 × 10−7 m2/sec. Though there was significant effect (p

Abstract Background Acute kidney injury (AKI) requiring renal replacement therapy (RRT) is a serious complication in the ICU that results in increased mortality and risk of chronic kidney disease (CKD). Some studies suggest RRT modality may have an impact on long-term renal recovery after AKI. However, other predictive factors of severe long-term CKD in ICU patients with AKI requiring RRT are unknown. Methods We performed an ancillary study of the multicenter ELVIS trial in the population with AKI requiring RRT. Patients alive 3 months after RRT initiation were eligible. Serum creatinine levels available at 3, 6 and 12 months and 3 and 5 years were recorded. CKD stage was determined according to the glomerular filtration rate as estimated by the CKD-EPI formula. At each timepoint, two groups of patients were compared, a no/mild CKD group with normal or mildly to moderately decreased renal function (stages 1, 2 and 3 of the international classification) and a severe CKD group (stages 4 and 5). Our objective was to identify predictive factors of severe long-term CKD. Results Of the 287 eligible patients, 183 had follow-up at 3 months, 136 (74.3%) from the no/mild CKD group and 47 (25.7%) from the severe CKD group, and 122 patients at 5 years comprising 96 (78.7%) from the no/mild CKD group and 26 (21.3%) from the severe CKD group. Multivariate analysis showed that a long RRT period was associated with severe CKD up to 12 months (ORM12 = 1.03 95% CI [1.02–1.05] per day) and that a high SOFA score at the initiation of RRT was not associated with severe CKD up to 5 years (ORM60 = 0.85 95% CI [0.77–0.93] per point). Conclusion Severe long-term CKD was found in 21% of ICU survivors who underwent RRT for AKI. The duration of the RRT in AKI patients was identified as a new predictive factor for severe long-term CKD. This finding should be taken into consideration in future studies on the prognosis of ICU patients with AKI requiring RRT. Trial registration ELVIS trial was registered with ClinicalTrials.gov, number: NCT00875069 (June 16, 2014), and this ancillary study was registered with ClinicalTrials.gov, number: NCT03302624 (October 6, 2017).

Background: Evidence suggests that low family differentiation leads to anxiety throughout the family and affects children's social functioning and psychosomatic symptoms. Despite numerous studies examining system family therapy's efficacy on various pathological outcomes, including increased differentiation and psychological health, there are rare studies on psychosomatic disorders. Aims: This study aimed to evaluate the efficacy of Bowen Family System Therapy on chronic anxiety and differentiation in patients with psychosomatic disorders (migraine, gastrointestinal disorders, and cardiovascular disorders). Method: The present study was quasi-experimental with a pretest-posttest design and a control group. The statistical population of this study consisted of all patients with three types of psychosomatic disorders including migraine, gastrointestinal and cardiovascular disorders which were referred to Shariati Hospital and Tehran Heart Center in 2020. Thirty eligible people were selected by the available sampling method and randomly assigned to two groups. All of them completed the Beck Anxiety Inventory (BAI; 1988) and short-form of Differentiation of Self Inventory-Revised (DSI-R; Skowron & Friedlander, 1998) in the pretest and posttest stages. The experimental group received Bowen Family System Therapy. Finally, after data collection, a multivariate analysis of covariance was used to analyze the data using SPSS-version 19 software. Results: The results showed that there was a significant difference between the two groups in both variables of anxiety, differentiation, and all their components (P

Abstract Background The composition of the digestive microbiota may be associated with outcome and infections in patients admitted to the intensive care unit (ICU). The dominance by opportunistic pathogens (such as Enterococcus) has been associated with death. However, whether this association remains all throughout the hospitalization are lacking. Methods We performed a single-center observational prospective cohort study in critically ill patients admitted with severe SARS-CoV-2 infection. Oropharyngeal and rectal swabs were collected at admission and then twice weekly until discharge or death. Quantitative cultures for opportunistic pathogens were performed on oropharyngeal and rectal swabs. The composition of the intestinal microbiota was assessed by 16S rDNA sequencing. Oropharyngeal and intestinal concentrations of opportunistic pathogens, intestinal richness and diversity were entered into a multivariable Cox model as time-dependent covariates. The primary outcome was death at day 90. Results From March to September 2020, 95 patients (765 samples) were included. The Simplified Acute Physiology Score 2 (SAPS 2) at admission was 33 [24; 50] and a Sequential Organ Failure Assessment score (SOFA score) at 6 [4; 8]. Day 90 all-cause mortality was 44.2% (42/95). We observed that the oropharyngeal and rectal concentrations of Enterococcus spp., Staphylococcus aureus and Candida spp. were associated with a higher risk of death. This association remained significant after adjustment for prognostic covariates (age, chronic disease, daily antimicrobial agent use and daily SOFA score). A one-log increase in Enterococcus spp., S. aureus and Candida spp. in oropharyngeal or rectal swabs was associated with a 17% or greater increase in the risk of death. Conclusion We found that elevated oropharyngeal/intestinal Enterococcus spp. S. aureus and Candida spp. concentrations, assessed by culture, are associated with mortality, independent of age, organ failure, and antibiotic therapy, opening prospects for simple and inexpensive microbiota-based markers for the prognosis of critically ill SARS-CoV-2 patients.

Abstract The recommended fixed dosage of betamethasone for pregnancies at risk of preterm birth was determined in the 1970s, regardless of gestational age (GA), number of fetuses, and maternal weight. We aimed to examine the association between maternal and neonatal betamethasone serum levels and neonatal respiratory distress syndrome (RDS) and to examine whether levels correlate with maternal weight, GA, or number of fetuses. A prospective study was conducted at a single academic medical center between August 2016 and February 2019. Women received betamethasone and delivered between 28+0 and 34+6 weeks were included. Maternal serum levels (MSLs), and neonatal serum levels (NSLs) of betamethasone at delivery were analyzed using Corticosteroid enzyme‐linked immunosorbent assay kit. RDS was diagnosed according to clinical and radiographic findings. We assumed that the sensitivity of NSLs to detect RDS is 95%; hence, 150 neonates were needed (power 80%, alpha 0.05). Overall, 124 women were included; including 96 (77.4%) singletons, 26 (21.0%) twins, and 2 (1.6%) triplets, corresponding to 154 neonates. RDS was diagnosed in 35 neonates (22.7%). After adjusting for GA, time elapsed from the last dose, and number of doses, NSLs were associated with RDS (relative risk: 0.97, 95% confidence interval: 0.94–0.99, p = 0.011). A level of 6.00 ng/ml predicted RDS with a sensitivity of 80.0% and specificity of 64.7%. Adjusted MSLs were not associated with RDS. Both maternal and neonatal serum levels were not associated with the number of fetuses and maternal weight. In conclusion, NSLs are associated with RDS whereas MSLs are not.

This article examines the principles of hygiene that were integrated into the design of the Beaujon hospital, opened in 1935 at Clichy in what is today the Hauts-de-Seine department, bordering Paris. The hospital was built for the city’s public health authority (Assistance Publique) by a team of architects including Jean Walter, Urbain Cassan and Louis Plousey. The principles involved were aimed at combatting the main sanitary afflictions of the day, tuberculosis, cancer, syphilis and alcoholism. They were also concerned by the damage resulting from the First World War, at a time when society understood that an unhealthy environment or inappropriate hygiene, along with poor sanitary habits, could contribute to the development of illnesses. The healthcare establishment, was designed to offer the sick the best possible conditions for recovery.The article looks at the architectural arrangements used during the interwar period and designed to improve conditions of hygiene for users – staff included – in this building which was the first multi-storey hospital in France. These arrangements have been much altered since the hospital was built, but today form what we call the site’s ‘health values’.The article addresses the present-day issues of the building’s urban and landscape heritage status, with regards to the original design and considering the future of the hospital, due to be closed in 2030.

Key Clinical Message It is of utmost importance to be aware of acute calcific periarthritis, as it may confuse the clinicians leading to misdiagnosis. Furthermore, patients may be subjected to various diagnostic and invasive procedures due to a lack of familiarity with this condition. Abstract Deposition of hydroxyapatite crystals in the para‐articular soft tissues is a well‐known condition, often involving the shoulder joint. However, the deposition of calcium salts in the para‐articular soft tissue of acromioclavicular joint has rarely been described. We report a case of a 55‐year‐old otherwise healthy man, presented with acute onset of pain and restriction of movement of left shoulder, who was diagnosed based on radiographic findings with calcific periarthritis of the acromioclavicular joint. As suggested by the literatures, he was managed conservatively, and no reoccurrence was reported after the episode.

BackgroundThe increase in the prevalence of obesity is associated with the increase in the consumption of ultra-processed foods and may be related to the increase in the disorders involving metabolism and the transport and storage of fatty acids.ObjectiveTo evaluate the effect of processed food consumption according to the degree of processing on the serum fatty acid levels and lipid profile of women with severe obesity.MethodsThis was a cross-sectional study. Data were collected from anthropometric assessments, the food frequency questionnaire (FFQ), and blood tests for lipidogram studies and serum fatty acid measurements. The foods consumed were identified through the FFQ and classified according to the degree of processing based on the NOVA rating, and the frequencies of consumption were transformed into scores, as proposed by Fornés methodology. Data were analyzed using IBM SPSS Statistics, version 21. The significance level for the analysis was set at 5%.ResultsThis study included 44 women with a mean age of 40.59 years and mean body mass index of 48.61 kg/m2. An inverse association was observed between the consumption of unprocessed and the occurrence of hypertriglyceridemia (p = 0.021) and levels of triglycerides (p = 0.047), total cholesterol (p = 0.030), and very low-density lipoprotein-cholesterol (p = 0.039). The consumption of processed foods was positively associated with the presence of hypertriglyceridemia (p = 0.044) and omega 6/3 ratio (p = 0.001) and negatively associated with total omega 3 levels (p = 0.011). The consumption of processed foods was positively associated with total cholesterol (p = 0.041) and negatively associated with the omega 3/6 ratio (p = 0.001). A negative correlation was found between the average consumption of ultra-processed foods (at least once a week) and serum level of high-density lipoprotein (p = 0.035).ConclusionThe consumption of processed and ultra-processed foods was associated with unfavorable lipid profiles and fatty acid levels in women with severe obesity. These results emphasize the importance of promoting the consumption of unprocessed food to mitigate metabolic disorders linked to processed food intake.

Gray platelet syndrome (GPS) is a rare hereditary hemorrhagic disorder characterized by macrothrombocytopenia and the absence of alpha-granules in platelets. Clinically, mild-to-moderate bleeding is the main manifestation, often accompanied by thrombocytopenia, splenomegaly, and myelofibrosis. Here, we present a case of a 15-year-old male patient with a history of hepatosplenomegaly, and thrombocytopenia for 8 years, who presented with sudden generalized abdominal pain. Despite initial suspicion of gastroenteritis, diagnostic imaging revealed an extensive hemoperitoneum. Subsequent genetic testing confirmed the diagnosis of GPS, which had not been previously identified. This case highlights the importance of considering inherited platelet disorders should be considered in adolescents with long-standing thrombocytopenia, and emphasizes the need for thorough evaluation in patients with suggestive symptoms.

Summary: Background: Lack of specific definitions of clinical characteristics, disease severity, and risk and preventive factors of post-COVID-19 syndrome (PCS) severely impacts research and discovery of new preventive and therapeutics drugs. Methods: This prospective multicenter cohort study was conducted from February 2020 to June 2022 in 5 countries, enrolling SARS-CoV-2 out- and in-patients followed at 3-, 6-, and 12-month from diagnosis, with assessment of clinical and biochemical features, antibody (Ab) response, Variant of Concern (VoC), and physical and mental quality of life (QoL). Outcome of interest was identification of risk and protective factors of PCS by clinical phenotype, setting, severity of disease, treatment, and vaccination status. We used SF-36 questionnaire to assess evolution in QoL index during follow-up and unsupervised machine learning algorithms (principal component analysis, PCA) to explore symptom clusters. Severity of PCS was defined by clinical phenotype and QoL. We also used generalized linear models to analyse the impact of PCS on QoL and associated risk and preventive factors. CT registration number: NCT05097677. Findings: Among 1796 patients enrolled, 1030 (57%) suffered from at least one symptom at 12-month. PCA identified 4 clinical phenotypes: chronic fatigue-like syndrome (CFs: fatigue, headache and memory loss, 757 patients, 42%), respiratory syndrome (REs: cough and dyspnoea, 502, 23%); chronic pain syndrome (CPs: arthralgia and myalgia, 399, 22%); and neurosensorial syndrome (NSs: alteration in taste and smell, 197, 11%). Determinants of clinical phenotypes were different (all comparisons p

Background: Gut microbiota (GM) modulation has been considered a nutritional approach to manage obesity. Reduced Firmicutes/Bacteroidetes ratio (F/B) is associated with reduced energy harvesting capacity from the diet, ameliorates endotoxemia and inflammation, and restores gut hormone signaling related to hypothalamic control of energy homeostasis. As anti-obesogenic and anti-inflammatory properties have been attributed to Ginkgo biloba extract (GbE), the present study investigated whether GbE supplementation for two weeks modulates the GM composition of obese rats. Method: Fifty-six 2-month-old male Wistar rats were submitted to a lard-rich diet-induced obesity protocol for 60 days (high-fat diet, HFD). Following the obesity-inducing period, rats were gavaged daily with GbE at 500 mg/kg (HFD+G group), or saline (HFD group), for 14 days. A 3rd group (pair-fed group, PF) was performed by mimicking the HFD group (saline administration) but with its food intake matched to the HFD+G group. Rats were euthanized on the 14th supplementation day. Stool DNA was extracted and amplified with V3–V4 region primers of the 16S rRNA gene. Results: In comparison to both HFD and PF groups, GbE supplementation increased the number of Bacteroidetes colon community and concomitantly reduced the abundance of Firmicutes, reducing the F/B ratio. Hierarchical clustering showed that communities of the HFD+G group were less likely related to HFD and PF groups. Conclusion: As GbE modulated the GM structure and diversity in GbE-supplemented obese rats, our results show that GbE possesses phytotherapeutic potential to modulate obesity by improving GM and lessening the consequences of obesity-related GM dysbiosis.

This article aims to analyze the development communication model of the Religious Harmony Forum (FKUB) in increasing the intensity of religious moderation in Medan City. Intolerance is a vital problem that damages the social order, especially in Medan City, one of the most intolerant cities in Indonesia. The urgency of this research is to find alternative solutions for a heterogeneous society to degrade intolerance. The Religious Harmony Forum has a vital role in accommodating the interests of heterogeneous communities in order to create a harmonious social space. This research uses a qualitative method with a sociological-communicative approach. The data techniques used in this research are interviews, observation, and documentation that rely on two source types, namely primary data and secondary data. This article uses analytical interpretation and content analysis techniques to process raw data and create constructive solutions. The results show that the Religious Harmony Forum of Medan City is working on various programs with three periodizations. This program is implemented through linear communication and participatory communication models. The dynamics of intolerance in Medan City have not been fully degraded, considering that there are still several programs that still need to be implemented. This program aims to encourage harmonious social intensity according to the guidance of the Qur'an, a society that puts aside religious subjectivity and is oriented toward humanity.

Introduction Delirium is a severe complication that is associated with short-term adverse events, prolonged hospital stay and neurological sequelae in survivors. Automated pupillometry is an easy-to-use device that allows for accurate objective assessment of the pupillary light responses in comatose patients in the intensive care unit (ICU). Whether automated pupillometry might predict delirium in critically ill patients is not known. We hypothesise that automated pupillometry could predict the occurrence of delirium in critically ill patients without primary brain injury, requiring more than 48 hours of invasive mechanical ventilation in the ICU.Methods and analysis The PupillOmetry for preDIction of DeliriUM in ICU (PODIUM) study is a prospective cohort study, which will be conducted in eight French ICUs in the Paris area. We aim to recruit 213 adult patients requiring invasive mechanical ventilation for more than 48 hours. Automated pupillometry (Neurological Pupil Index; NPi-200, Neuroptics) will be assessed two times per day for 7 days. Delirium will be assessed using the Confusion Assessment Method in ICU two times per day over 14 days in non-comatose patients (Richmond Agitation and Sedation Scale ≥−3).The predictive performances of the seven automated pupillometry parameters (ie, pupillary diameter, variation of the pupillary diameter, pupillary constriction speed, pupillary dilatation speed, photomotor reflex latency, NPi and symmetry of pupillary responses) measured to detect the delirium occurrence within 14 days will be the main outcomes. Secondary outcomes will be the predictive performances of the seven automated pupillometry parameters to detect complications related to delirium, ICU length of stay, mortality, functional and cognitive outcomes at 90 days.Ethics and dissemination The PODIUM study has been approved by an independent ethics committee, the Comité de Protection des Personnes (CPP) OUEST IV—NANTES (CPP21.02.15.45239 32/21_3) on 06 April 2021). Participant recruitment started on 15 April 2022. Results will be published in international peer-reviewed medical journals and presented at conferences.Trial registration number NCT05248035; clinicaltrials.gov.

IntroductionZinner syndrome (ZS) is a rare condition characterized by a triad of seminal vesicle cyst (SVC), ipsilateral ejaculatory duct obstruction, and ipsilateral renal agenesis. The diagnosis is often delayed due to non-specific symptoms, such as lower urinary tract symptoms and infertility, typically appearing in the second and third decades of life.Case presentationWe present the first published case of ZS in Palestine, involving a 53-year-old male patient who sought medical attention for right-sided hernia repair. Pre-operative imaging revealed a combination of findings, including a solitary left kidney with cysts, mild hydronephrosis, an enlarged prostate, suspicious soft tissue density, and abnormal lymph nodes. The diagnosis of ZS was confirmed through an abdominal ultrasound, identifying a dilated seminal vesicle and completing the criteria of ZS.DiscussionThe typical for ZS is to present in late second decade of life with nonspecific urogenital symptoms and infertility, However, our patient’s incidental diagnosis during the preoperative evaluation of incisional hernia in a relatively old age with no previous complaints, the identification of a high aortic bifurcation at the level of the left kidney and a double Inferior Vena Cava (IVC) in this case of ZS represents novel and distinctive findings not commonly reported in previous cases.ConclusionOur patient’s presentation and findings expand our understanding of the anatomical variations associated with ZS. This case report contributes to the advancement of knowledge in the field of ZS and provides valuable insights for future clinical management and research investigations.