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Abstract Background Borderline Personality Disorder (BPD) is a prevalent and debilitating psychiatric condition often accompanied by Post-Traumatic Stress Disorder (PTSD), with a substantial prevalence of trauma history among affected individuals. The clinical, cognitive, and cerebral parallels shared with PTSD suggest a trauma-related etiology for BPD. Studies consistently demonstrate a reduction in hippocampal volume in individuals with BPD, echoing findings in PTSD. However, the interpretation of this shared neurobiological profile remains contentious, with ongoing debates regarding the independence of these pathologies or the potential exacerbation of diminished hippocampal volume in BPD due to concurrent PTSD. Differential impacts on hippocampal subfields across both disorders may further complicate interpretation, suggesting the volume of hippocampal subfields as a potential discriminant biomarker. This study aims to characterize the multidimensional specific and shared profiles of BPD and PTSD-related alterations, with a particular emphasis on hippocampal subfields during adolescence, a crucial period in BPD development. Methods This study focuses on female adolescents, who are more prevalent in the BPD population. Participants are categorized into three groups: BPD, BPD with comorbid PTSD, and a control group of matched healthy individuals. Data collection encompasses clinical, cognitive, and neuroimaging domains commonly affected in both disorders, utilizing various imaging markers (including gray matter macrostructure, white matter microstructural integrity, and regional functional connectivity). Discussion This study examines adolescent BPD with and without comorbid PTSD on clinical, neuroimaging, and cognitive levels. It is the first to use a comprehensive multi-modal approach within the same sample. Additionally, it uniquely explores hippocampal subfield volume differences in adolescents. Analysis of the relationship between the investigated domains and the effects of PTSD comorbidity will elucidate specific and shared alteration profiles in both disorders. Trial registration IDRCB number 2019-A00366-51 / clinicaltrials.gov ID: NCT0485274. Registered on 21/04/2021.

Abstract The European rabbit has invaded numerous ecosystems worldwide, but rarely steppes. Since its various introduction attempts into the ecosystems of the Magallanes/Fuegian region, the rabbit has become a key player, interacting with species at different trophic levels and generating impacts on ecosystems. To better understand the role of the rabbit in steppe and scrub ecosystems, we characterised the food web in the Magallanes/Fuegian region to understand the identity of their interacting species, the mechanisms and complexities of their interactions to demonstrate that rabbit management may become more complex than just controlling a single species. Based on a bibliographic review and wildlife specialists’ opinions, we built the Magellanic/Fuegian food web, evaluated their topological properties and performed a rabbit extinction simulation to assess the possible short-term ecological mechanisms operating in the community. We found that the network had 206 nodes (64% native, 13% exotic, and 22% mixed) and 535 links among nodes. The European rabbit was the most connected node of the food web, had the second largest dietary breadth, and ranked as the seventh prey item with more predators. A rabbit extinction simulation shows a possible release of herbivory pressure on plants, including that on several native plants (e.g., Gunnera tinctoria, Pratia repens, Gavilea lutea, Tetroncium magellanicus), and a possible release of competition for some herbivores that share resources with the rabbit (e.g., Ovis aries, Lama guanicoe, Bos taurus). Although rabbit predators have a broad and generalist diet, some such as the native Galicitis cuja, could face a 20% reduction in their trophic width and could intensify predation on alternative prey. These results show that the European rabbit is strongly embedded in the Magellanic/Fuegian ecosystem and linked to several native species. Therefore, rabbit management should consider ecosystem approaches accompanied by monitoring programs on native fauna and experimental pilot studies on native flora to conserve the Chilean Patagonia community.

Abstract Background Immune-mediated haemolytic anaemia (IMHA) has a high mortality rate within the first weeks to months of diagnosis. Identifying dogs at increased risk of death may help guide decision-making for owners and veterinarians. Prior studies have identified several but inconsistent prognostic factors. The objectives of the study were to describe the clinical presentation and outcome of canine immune-mediated haemolytic anaemia in Ireland and to assess for independent factors associated with survival including long-term survival. Medical records from a single centre were reviewed between 2002 and 2020 to identify dogs with immune-mediated haemolytic anaemia using the American College of Veterinary Internal Medicine (ACVIM) consensus statement algorithm. Survival analysis was performed using univariable Cox proportional hazards regression models with Breslow method for ties to identify prognostic factors. Results One hundred and four cases were included. The diagnosis of immune-mediated haemolytic anaemia was classified as definitive, supportive and suspicious in 42 (40%), 50 (48%), and 12 dogs (12%) respectively. Twenty-two dogs (21%) were diagnosed with associative IMHA and 82 dogs were diagnosed with non-associative IMHA (79%). 65% of the cases received more than one immunosuppressive medication during the course of treatment. The mortality rate at one and three months was 16% (95% confidence interval [CI] 9–26) and 31% (95% CI 21–43) respectively. Excluding dogs that died within three months, the median survival time was 2664 days. The relapse rate during the follow-up period was 7%. Survival did not improve over the course of the study period. Thrombocytopenia and hyperbilirubinaemia were identified as negative prognostic indicators (Hazard ratio 2.2 and 2.5, 95% CI 1.1–4.1 and 1.1–5.6, respectively). Conclusions Excluding dogs that died within three months, the outcome was good in dogs with non-associative immune-mediated haemolytic anaemia in Ireland. The relapse rate was low regardless of the presence of associative causes. Thrombocytopenia and hyperbilirubinaemia were the only independent negative prognostic factors. The one-month and three-month mortality rates were similar compared to prior studies and survival did not improve over time during the study period: the mortality rate of canine immune-mediated haemolytic anaemia remains high in the acute phase.

Abstract Background A previous study reported significant excess mortality among non-COVID-19 patients due to disrupted surgical care caused by resource prioritization for COVID-19 cases in France. The primary objective was to investigate if a similar impact occurred for medical conditions and determine the effect of hospital saturation on non-COVID-19 hospital mortality during the first year of the pandemic in France. Methods We conducted a nationwide population-based cohort study including all adult patients hospitalized for non-COVID-19 acute medical conditions in France between March 1, 2020 and 31 May, 2020 (1st wave) and September 1, 2020 and December 31, 2020 (2nd wave). Hospital saturation was categorized into four levels based on weekly bed occupancy for COVID-19: no saturation ( 5% and ≤ 15%), moderate saturation (> 15% and ≤ 30%), and high saturation (> 30%). Multivariate generalized linear model analyzed the association between hospital saturation and mortality with adjustment for age, sex, COVID-19 wave, Charlson Comorbidity Index, case-mix, source of hospital admission, ICU admission, category of hospital and region of residence. Results A total of 2,264,871 adult patients were hospitalized for acute medical conditions. In the multivariate analysis, the hospital mortality was significantly higher in low saturated hospitals (adjusted Odds Ratio/aOR = 1.05, 95% CI [1.34–1.07], P

Abstract Background Current guidelines recommend using antifungals for selected patients with health care-associated intra-abdominal infection (HC-IAI), but this recommendation is based on a weak evidence. This study aimed to assess the association between early empirical use of antifungals and outcomes in intensive care unit (ICU) adult patients requiring re-intervention after abdominal surgery. Methods A retrospective, multicentre cohort study with overlap propensity score weighting was conducted in three ICUs located in three medical institutions in France. Patients treated with early empirical antifungals for HC-IAI after abdominal surgery were compared with controls who did not receive such antifungals. The primary endpoint was the death rate at 90 days, and the secondary endpoints were the death rate at 1 year and composite criteria evaluated at 30 days following the HC-IAI diagnosis, including the need for re-intervention, inappropriate antimicrobial therapy and death, whichever occurred first. Results At 90 days, the death rate was significantly decreased in the patients treated with empirical antifungals compared with the control group (11.4% and 20.7%, respectively, p = 0.02). No differences were reported for the secondary outcomes. Conclusion The use of early empirical antifungal therapy was associated with a decreased death rate at 90 days, with no effect on the death rate at 1 year, the death rate at 30 days, the rate of re-intervention, the need for drainage, and empirical antibiotic and antifungal therapy failure at 30 days.

Objectives There is a lack of data on salivary sex hormones across the menstrual cycle (MC) or hormonal contraceptive (HC) cycle of elite athletes. We aimed to provide original data on salivary sex hormones (17β-estradiol, progesterone and free testosterone) in naturally menstruating female athletes with a regular cycle or irregular cycle and using combined HC. A secondary purpose was to compare these data with published data from the general population according to the menstrual status (MC or HC or irregularly menstruating).Methods 367 saliva tests were performed on 44 elite athletes during 6 months of follow-up to certify for cycle regularity. Athletes were grouped into regular MC, n=13; irregular MC, n=5; and HC, n=26. We compared salivary data of regular MC across six cycle phases (menses, mid-follicular, late follicular, early luteal, mid-luteal and late luteal phases) with published data from women with a similar MC or HC status from the general population.Results We provided salivary original data according to six sub-phases among elite athletes with regular MC. HC athletes showed lower salivary sex hormonal levels, markedly after the first week of active HC compared with regular MC. Athletes with irregular cycles do not show a progesterone rise from the first half to the second half of the cycle (Δirregular=0.38 (1.90), a rise detectable within regular MC group ΔregularMC=2.86 (2.88)).Conclusions We provided original data for salivary sex hormone levels in elite female athletes. These references may be valuable for research investigating MC or combined HC data, particularly in longitudinal follow-ups requiring repeated measurements.

Introduction Home-based, virtually-supported care models may represent the most efficient and scalable approach to delivering prehabilitation services. However, virtual approaches to prehabilitation are understudied. This manuscript describes the protocol for an internal pilot randomised controlled trial of a virtually-delivered, multimodal prehabilitation intervention.Methods and analysis We will conduct a pragmatic, individual patient, internal pilot randomised controlled trial of home-based, virtually supported, multimodal prehabilitation compared with standard perioperative care in adults undergoing elective, inpatient thoracic, abdominal, pelvic and vascular surgery at five Canadian hospitals. Participants will be partially blinded; clinicians and outcome assessors will be fully blinded. The intervention consists of 3–12 weeks of a home-based, multimodal (exercise, nutrition and psychosocial support) prehabilitation programme supported through an online platform. The primary feasibility outcomes and their progression targets are (1) monthly recruitment of>6 participants at each centre, (2) intervention adherence of>75%, (3) retention of>90% of participants at the patient-reported primary outcome point of 30-days after surgery and (4) elicitation of patient, clinician and researcher-identified barriers to our pragmatic trial. A sample size of 144 participants will be adequate to estimate recruitment, adherence and retention rates with acceptable precision. All participants will be followed to either death or up to 1 year. As an internal pilot, if no substantive changes to the trial or intervention design are required, pilot participant outcome data will migrate, unanalysed by allocation, to the future full-scale trial.Ethics and dissemination Ethical approval has been granted by Clinical Trials Ontario (Project ID: 4479) and our ethics review board (Protocol Approval #20230399–01T). Results will be disseminated through presentations at scientific conferences, peer-reviewed publications, partner organisations and engagement of social and traditional media.Trial registration number ClinicalTrials.gov identifier NCT06042491. Protocol, V.1.2, dated 6 June 2024.

In immersive VR, a self-avatar that replicates the user’s movements and is viewed from a first-person perspective can substitute the real body. If the avatar’s movements are sufficiently synchronized with the user’s actual movements, the user can experience a sense of embodiment over the avatar. Recent studies have shown that discrepancies between the movements of the avatar and those of the user can be well tolerated while maintaining high levels of embodiment. The point at which a distortion is perceived (detection threshold) and its impact on the level of embodiment has not been studied in lower limb tasks such as gait. This study aimed to identify a detection threshold of gait asymmetry by unilaterally manipulating the step length of a self-avatar, and the effect of this detection on perceived embodiment. A real-time step length distortion model was developed, and a detection threshold between actual and avatar’s gait movement was assessed on thirty healthy participants. The step length was manipulated to introduce gait asymmetry (ascending condition) or start from a large asymmetry that was gradually decreased (descending). The results showed that, on average, the avatar’s step length could be increased by up to 12% before the participants detected the distortion. Furthermore, in the descending condition, they detected increases that were above 9%. The point of detection had no effect on the sense of embodiment as participants still reported being embodied in their avatars, even when they consciously detected the step length distortion. The sense of embodiment was closely correlated with the level of distortion; as distortion increased, embodiment decreased, and vice versa. For a given distortion level, embodiment was similar whether in the ascending or descending condition. This suggests that embodiment can be achieved even when the avatar’s spatial alignment initially differs from the participants’, provided that alignment is gradually restored. These results provide valuable insights into participants’ ability to tolerate movement discrepancies in embodied avatar experiences during gait in virtual environments, with potential applications in motor training and gait rehabilitation.

BackgroundAwareness of one's own states is a particularly important part of cognition and emotion regulation. Recently, the concept of alexisomia has been used to refer to lack of awareness and expression of somatic sensations. Developing self-reported questionnaires to evaluate alexisomia represents a challenge for clinical psychology and medicine. In this context, we suggested to adapt the Body Awareness Questionnaire in French to measure alexisomia and its relation to alexithymia. In fact, we carried out a backtranslation and studied the validity of the construct in relation to proximal constructs around emotional awareness.MethodsFor this study, 610 university students completed questionnaires measuring a three dimensions alexithymia concept [with The Toronto Alexithymia Scale (TAS-20)] or the five dimensions alexithymia concept [with The Bermond-Vorts Alexithymia Questionnaire (BVAQ-B)] and alexisomia (with the BAQ).ResultsConfirmatory factor analyses showed that the BAQ can be envisaged through 4 factors as well as a unidimensional model to refer to alexisomia. We also found that body awareness was negatively related to scores of alexithymia.ConclusionResults are discussed in light of the construct of alexisomia and its clinical implications in somatic as well as mental disorders. We suggest that the BAQ, which assesses interoception, can contribute, in part, to the assessment of alexisomia. Like alexithymia, this is a key concept to take into consideration when designing treatment and prevention programs.

Abstract Objective structured clinical examination (OSCE) is a valid method to evaluate medical students’ competencies. The present cross-sectional study aimed at determining how students’ coping and health-related behaviors are associated with their psychological well-being and performance on the day of the OSCE. Fourth-year medical students answered a set of standardized questionnaires assessing their coping (BCI) and health-related behaviors before the examination (sleep PSQI, physical activity GPAQ). Immediately before the OSCE, they reported their level of instant psychological well-being on multi-dimensional visual analogue scales. OSCE performance was assessed by examiners blinded to the study. Associations were explored using multivariable linear regression models. A total of 482 students were included. Instant psychological well-being was positively associated with the level of positive thinking and of physical activity. It was negatively associated with the level of avoidance and of sleep disturbance. Furthermore, performance was negatively associated with the level of avoidance. Positive thinking, good sleep quality, and higher level of physical activity were all associated with improved well-being before the OSCE. Conversely, avoidance coping behaviors seem to be detrimental to both well-being and OSCE performance. The recommendation is to pay special attention to students who engage in avoidance and to consider implementing stress management programs. Clinical trial: The study protocol was registered on clinicaltrial.gov NCT05393206, date of registration: 11 June 2022.

Abstract Background Sedentary behaviour at work is a major cause of atherosclerosis, particularly in tertiary workers. However, no studies have ever assessed the effect of active workstation on lipoprotein subfraction profile. This study aimed to evaluate the effect of 12-week portable pedal machines (PPMs) on lipoprotein subfraction profile among healthy sedentary workers. Methods Healthy administrative workers were randomized into an intervention group using PPMs for 12 weeks or a control group using normal-desk. Lipoprotein subfractions were assessed using Lipoprint® electrophoresis. Main outcomes were explored using mixed models with sensitivity analyses (four models). Results We included 40 participants (43.7 ± 8.6 years old, 100% women, BMI 23.8 ± 3.4 kg/m2; sedentary time at work 7.7 ± 1.8 h/day). Groups did not differ at baseline in any outcomes. 32 participants finished the trial. Changes in lipoprotein subfractions were especially marked for LDL profile. There was an interaction time x group for all parameters related to LDL and their subfractions: total LDL-cholesterol (p = 0.012), LDL particle size (p = 0.027), large LDL subfractions 1 and 2 (p = 0.001), and small dense LDL subfractions 3 to 7 (p = 0.046), using the crude model. The interaction reflects difference in the direction of changes between groups. The LDL particle size significantly increased in the intervention group (from 271.9 ± 2.5 at t0 to 272.8 ± 1.9 Ångström at t1, p = 0.037) while it did not change in the control group (272.5 ± 1.7 at t0 to 271.8 ± 1.5Å at t1, p = 0.52). All interactions were constantly significant whatever the models. Influencing variables were mainly stress at work that was associated with an increase in total LDL-cholesterol (coefficient 3.15, 95CI 0.20 to 6.11 mg/dl, p = 0.038), and BMI that was associated with Large-LDL, Large-HDL, IDL-C and triglycerides. Conclusions Lipoprotein profile was improved after a 12-week PPMs intervention at work in healthy administrative workers. Changes were mainly showed for LDL and LDL subfractions. Lipoprotein profile was worsened by stress at work, BMI and age. Trial registration NCT04153214.

BackgroundDigital interventions integrating gamification features hold promise to promote daily steps. However, results regarding the effectiveness of this type of intervention are heterogeneous and not yet confirmed in real-life contexts. ObjectiveThis study aims to examine the effectiveness of a gamified intervention and its potential moderators in a large sample using real-world data. Specifically, we tested (1) whether a gamified intervention enhanced daily steps during the intervention and follow-up periods compared to baseline, (2) whether this enhancement was higher in participants in the intervention than in nonparticipants, and (3) what participant characteristics or intervention parameters moderated the effect of the program. MethodsData from 4819 individuals who registered for a mobile health Kiplin program between 2019 and 2022 were retrospectively analyzed. In this intervention, participants could take part in one or several games in which their daily step count was tracked, allowing individuals to play with their overall activity. Nonparticipants were people who registered for the program but did not take part in the intervention and were considered as a control group. Daily step counts were measured via accelerometers embedded in either commercial wearables or smartphones of the participants. Exposure to the intervention, the intervention content, and participants’ characteristics were included in multilevel models to test the study objectives. ResultsParticipants in the intervention group demonstrated a significantly greater increase in mean daily steps from baseline than nonparticipants (P

Microphysiological systems (MPSs) have attracted increasing attention as a method for simulating in vitro drug efficiency. In particular, the interaction between liver and intestine tissues is one of the primary targets since they are closely involved in drug absorption and metabolism. However, most of the intestine-liver MPSs reported previously require pumps, electrodes, and porous membranes for co-culture of cells and evaluation of intestinal permeability (i.e., Trans-Epithelial Electrical Resistance, TEER), requiring complex manufacturing processes and operations. In this study, we report an all-polydimethylsiloxane (PDMS) co-culture microfluidic device, connecting microchamber-based paracellular transport assay on gut microtissues to liver tissues matured on the same device. On one side of the device, HepaRG cells are confined within thin parallel grooves that induce their differentiation into hepatocytes. The other side of the device is connected with microchannels to the liver side and includes the gut tissues, organized above microchambers. Such microchambers allow the evaluation of paracellular permeability by fluorescence imaging. Thanks to the microfluidic device we investigated changes in intestinal permeability induced by differentiated hepatocyte excretion and found that Caco-2 permeability was decreased when co-culture with HepaRG. Due to its simplicity and straightforward implementation, this method is anticipated as an innovative and efficient approach to assess tissue barrier function in multi-organ on-chip experiments.

Introduction Therapeutic interventions for disorders of consciousness lack consistency; evidence supports non-invasive brain stimulation, but few studies assess neuromodulation in acute-to-subacute brain-injured patients. This study aims to validate the feasibility and assess the effect of a multi-session transcranial alternating current stimulation (tACS) intervention in subacute brain-injured patients on recovery of consciousness, related brain oscillations and brain network dynamics.Methods and analyses The study is comprised of two phases: a validation phase (n=12) and a randomised controlled trial (n=138). Both phases will be conducted in medically stable brain-injured adult patients (traumatic brain injury and hypoxic-ischaemic encephalopathy), with a Glasgow Coma Scale score ≤12 after continuous sedation withdrawal. Recruitment will occur at the intensive care unit of a Level 1 Trauma Centre in Montreal, Quebec, Canada. The intervention includes a 20 min 10 Hz tACS at 1 mA intensity or a sham session over parieto-occipital cortical sites, repeated over five consecutive days. The current’s frequency targets alpha brain oscillations (8–13 Hz), known to be associated with consciousness. Resting-state electroencephalogram (EEG) will be recorded four times daily for five consecutive days: pre and post-intervention, at 60 and 120 min post-tACS. Two additional recordings will be included: 24 hours and 1-week post-protocol. Multimodal measures (blood samples, pupillometry, behavioural consciousness assessments (Coma Recovery Scale-revised), actigraphy measures) will be acquired from baseline up to 1 week after the stimulation. EEG signal analysis will focus on the alpha bandwidth (8–13 Hz) using spectral and functional network analyses. Phone assessments at 3, 6 and 12 months post-tACS, will measure long-term functional recovery, quality of life and caregivers’ burden.Ethics and dissemination Ethical approval for this study has been granted by the Research Ethics Board of the CIUSSS du Nord-de-l’Île-de-Montréal (Project ID 2021–2279). The findings of this two-phase study will be submitted for publication in a peer-reviewed academic journal and submitted for presentation at conferences. The trial’s results will be published on a public trial registry database (ClinicalTrials.gov).Trial registration number NCT05833568.

Objective: To compare the estimation of time spent on 4 categories of physical activity intensity (sedentary behaviour, light physical activity, moderate physical activity, and vigorous physical activity) between a motion sensor and a heart rate monitor during a stroke outpatient rehabilitation session. Design: A multicentre cross-sectional observational study. Subjects/Patients: Participants with stroke (> 6 months) undergoing outpatient rehabilitation sessions. Methods: Participants wore the SenseWear Armband motion sensor and the Polar H10 heart rate monitor during 2 rehabilitation sessions. The times estimated by each device were compared using a generalized linear mixed model and post-hoc tests. Results: Ninety-nine participants from 29 clinics were recruited and data from 146 sessions were included in the analysis. The estimated times depended on the devices and the physical activity intensity category (F = 135, p

TRIM33 is a member of the tripartite motif (TRIM) family of proteins, some of which possess E3 ligase activity and are involved in the ubiquitin-dependent degradation of proteins. Four of the TRIM family proteins, TRIM24 (TIF1α), TRIM28 (TIF1β), TRIM33 (TIF1γ) and TRIM66, contain C-terminal plant homeodomain (PHD) and bromodomain (BRD) modules, which bind to methylated lysine (KMen) and acetylated lysine (KAc), respectively. Here we investigate the differences between the two isoforms of TRIM33, TRIM33α and TRIM33β, using structural and biophysical approaches. We show that the N1039 residue, which is equivalent to N140 in BRD4(1) and which is conserved in most BRDs, has a different orientation in each isoform. In TRIM33β, this residue coordinates KAc, but this is not the case in TRIM33α. Despite these differences, both isoforms show similar affinities for H31-27K18Ac, and bind preferentially to H31-27K9Me3K18Ac. We used this information to develop an AlphaScreen assay, with which we have identified four new ligands for the TRIM33 PHD-BRD cassette. These findings provide fundamental new information regarding which histone marks are recognized by both isoforms of TRIM33 and suggest starting points for the development of chemical probes to investigate the cellular function of TRIM33.

Abstract Background Virulent systemic feline calicivirus (VS-FCV) infection is an emerging disease. It is distinct from classic oronasal calicivirus infection as it manifests with unique systemic signs including severe cutaneous ulcerations, limb oedema, and high mortality, even in adequately vaccinated cats. Devastating epizootic outbreaks with hospital-acquired infections have been described in the United States, the United Kingdom, continental Europe and Australia with up to 54 cats affected in one outbreak and a mortality rate of up to 86%. This highly contagious and potentially fatal disease has not yet been reported in Ireland. Case presentation An 11-month-old male neutered vaccinated domestic shorthair cat was presented with a 10-day history of lethargy, decreased appetite and progressively worsening pitting oedema in all four limbs. The signs were first noted after another kitten from a high-density cat shelter was introduced in to the household. Additional physical examination findings included marked pyrexia, and lingual and cutaneous ulcers. Virulent systemic feline calicivirus was diagnosed based on compatible history and clinical signs, exclusion of other causes, and calicivirus isolation by RT-PCR both in blood and oropharyngeal samples. Negative calicivirus RT-PCR in blood following resolution of the clinical signs further supported the diagnosis. Conclusion This case represents the first known case of VS-FCV infection in Ireland. Given the severity of the clinical signs, and the high risk for epizootic outbreaks, Irish veterinarians should be aware of the disease to ensure prompt diagnosis and implementation of adequate preventive measures, in order to limit the threat that this disease represents for the wider cat population and particularly given the risk of hospital-acquired VS-FCV infection. Virulent systemic calicivirus should be suspected in cats with pyrexia of unknown origin, oedema or ulceration affecting the limbs or the face, and exposure to rescue cats from high-density households.

Abstract Background Organizational factors may influence surgical outcomes, regardless of extensively studied factors such as patient preoperative risk and surgical complexity. This study was designed to explore how operating room organization determines surgical performance and to identify gaps in the literature that necessitate further investigation. Methods We conducted a systematic review according to PRISMA guidelines to identify original studies in Pubmed and Scopus from January 1, 2000 to December 31, 2019. Studies evaluating the association between five determinants (team composition, stability, teamwork, work scheduling, disturbing elements) and three outcomes (operative time, patient safety, costs) were included. Methodology was assessed based on criteria such as multicentric investigation, accurate population description, and study design. Results Out of 2625 studies, 76 met inclusion criteria. Of these, 34 (44.7%) investigated surgical team composition, 15 (19.7%) team stability, 11 (14.5%) teamwork, 9 (11.8%) scheduling, and 7 (9.2%) examined the occurrence of disturbing elements in the operating room. The participation of surgical residents appeared to impact patient outcomes. Employing specialized and stable teams in dedicated operating rooms showed improvements in outcomes. Optimization of teamwork reduced operative time, while poor teamwork increased morbidity and costs. Disturbances and communication failures in the operating room negatively affected operative time and surgical safety. Conclusion While limited, existing scientific evidence suggests that operating room staffing and environment significantly influences patient outcomes. Prioritizing further research on these organizational drivers is key to enhancing surgical performance.

The rapid development of self-driving vehicles requires integrating a sophisticated sensing system to address the various obstacles posed by road traffic efficiently. While several datasets are available to support object detection in autonomous vehicles, it is crucial to carefully evaluate the suitability of these datasets for different weather conditions across the globe. In response to this requirement, we present a novel dataset named the Canadian Vehicle Datasets (CVD). Subsequently, we present deep learning models that use this dataset. The CVD comprises street-level videos which were recorded by Thales, Canada. These videos were collected with high-quality cameras mounted on a vehicle in the Canadian province of Quebec. The recordings were made during daytime and nighttime, capturing weather conditions such as hazy, snowy, rainy, gloomy, nighttime and sunny days. A total of 10000 images of vehicles and other road assets are extracted from the collected videos. A total of 8388 images were annotated with corresponding generated labels 27766 with their respective 11 different classes. We analyzed the performance of the YOLOv8 model trained using the existing RoboFlow dataset. Then, we compared it with the model trained on the expanded version of RoboFlow using the proposed weather-specific dataset, CVD. Final values of improved accuracy of 73.26 %, 72.84 %, and 73.47 % (Precision/Recall/mAP) were reported upon adding the proposed dataset. Finally, the model trained on this diverse dataset exhibits heightened robustness and proves highly beneficial for both autonomous and conventional vehicle operations, making it applicable not only in Canada but also in other countries with comparable weather conditions.

Abstract Background Severe diabetes complications impact the quality of life of patients and may lead to premature deaths. However, these complications are preventable through proper glycemic control and management of risk factors. Understanding the risk factors of complications is important in guiding efforts to manage diabetes and reduce risks of its complications. Therefore, the objective of this study was to identify risk factors of severe diabetes complications among adult hospitalized patients with diabetes in Florida. Methods Hospital discharge data from 2016 to 2019 were obtained from the Florida Agency for Health Care Administration through a Data Use Agreement with the Florida Department of Health. Adapted Diabetes Complications Severity Index (aDCSI) scores were computed for 1,061,140 unique adult patients with a diagnosis of diabetes. Severe complications were defined as those with an aDCSI ≥ 4. Population average models, estimated using generalized estimating equations, were used to identify individual- and area-level predictors of severe diabetes complications. Results Non-Hispanic Black patients had the highest odds of severe diabetes complications compared to non-Hispanic White patients among both males (Odds Ratio [OR] = 1.20, 95% Confidence Interval [CI]: 1.17, 1.23) and females (OR = 1.27, 95% CI: 1.23, 1.31). Comorbidities associated with higher odds of severe complications included hypertension (OR = 2.30, 95% CI: 2.23, 2.37), hyperlipidemia (OR = 1.29, 95% CI: 1.27, 1.31), obesity (OR = 1.24, 95% CI: 1.21, 1.26) and depression (OR = 1.09, 95% CI: 1.07, 1.11), while the odds were lower for patients with a diagnosis of arthritis (OR = 0.81, 95% CI: 0.79, 0.82). Type of health insurance coverage was associated with the severity of diabetes complications, with significantly higher odds of severe complications among Medicare (OR = 1.85, 95% CI: 1.80, 1.90) and Medicaid (OR = 1.83, 95% CI: 1.77, 1.90) patients compared to those with private insurance. Residing within the least socioeconomically deprived ZIP code tabulation areas (ZCTAs) in the state had a protective effect compared to residing outside of these areas. Conclusions Racial, ethnic, and socioeconomic disparities in the severity of diabetes complications exist among hospitalized patients in Florida. The observed disparities likely reflect challenges to maintaining glycemic control and managing cardiovascular risk factors, particularly for patients with multiple chronic conditions. Interventions to improve diabetes management should focus on populations with disproportionately high burdens of severe complications to improve quality of life and decrease premature mortality among adult patients with diabetes in Florida.

Increasing animal protein, especially from beef, is necessary to satisfy the requirements of the growing global population. However, this is becoming increasingly challenging due to stakeholders prioritizing sustainable systems with low environmental impacts. To answer these challenges, the use of feed additives such as yeast probiotics seems to be an effective route for improvements in feed efficiency and growth performance. The current study was performed to quantify the environmental impacts of the production and use of a yeast probiotic (Actisaf® Sc 47) through an LCA method in four trials performed during the fattening period: France (French trial), Spain (Spanish trial), and Italy (Italian trials A and B). During each trial, two groups of animals with the same characteristics were compared during the fattening period: the control group without Actisaf® Sc 47 supplementation used as a baseline, and the experimental group with Actisaf® Sc 47 supplementation. The calves started the trial at the ages of 224, 92, and 186 days during the French, Spanish, and Italian trials A and B, respectively. Of the sixteen impact category indicators, nine were analyzed. In Italian trials A and B, the Spanish trial, and the French trial, the use of Actisaf® Sc 47 reduced CC by 4.8, 3.8, 6.6, and 5.4%; FE by 4.8, 3.9, 8.2, and 6.3%; ME by 4.9, 4.0, 6, and 6.4%; and TE by 5.3, 4.1, and 6.2%, respectively. Moreover, during the same trials, Actisaf® Sc 47 reduced AC by 6.0, 4.1, 6.3, and 7.1%; LU by 4.7, 3.9, 5.8, and 6.1%; WU by 4.5, 3.4, 5.2, and 5.9%; RU (fossils) by 4.8, 3.7, 7.3, and 4.8%; and PM by 5.2, 4.1, 6.3, and 7.1%, respectively. The use of Actisaf® Sc 47 has beneficial effects on the environment. Regarding Actisaf® Sc 47 production, the results showed that the production of 1 kg of Actisaf® Sc 47 emitted 2.1 kg of CO2 eq, 60% of which came from the fermentation process and 39% from drying. The results demonstrate the interest in using Actisaf® Sc during the fattening period for its multiple positive outcomes: improving performance and efficiency, while reducing the global carbon footprint.

This study evaluated the influence of acute fatigue on heart rate variability (HRV) and muscle oxygen saturation (SmO2) at rest, as well as the reliability of SmO2 data measured using near-infrared spectroscopy (NIRS) during a vascular occlusion test (VOT). Twelve physically active subjects participated. Measurements included perceived muscle soreness using the visual analog scale (VAS pain), HRV parameters, variables of resting SmO2 (desaturation and resaturation), and reoxygenation kinetics (mean response time, MRT) through a VOT-NIRS located in the vastus lateralis (VL). Measurements were taken at three points: 24 h before, before exhaustive exercise, and 30 min after exhaustive exercise. The results indicated that acute fatigue increased resting muscle oxygen consumption in desaturation (+22 SmO2) and resaturation (+18 SmO2), improved MRT (−15 s), and elevated sympathetic nervous system (SNS) activity, as observed in the R-R interval (−262 ms) and SNS index (+0.5). HRV significantly influenced desaturation (r2 = 0.69), resaturation (r2 = 0.60), and MRT (r2 = 0.54). Reliability was established with an ICC of 0.49 and 0.63 for desaturation and resaturation, respectively. Real changes in desaturation and resaturation should be considered ≥ 7% SmO2 at rest and ≥ 11% SmO2 to avoid daily fatigue interference. In conclusion, acute fatigue increases resting SmO2 consumption and is associated with higher SNS activity and increased VAS pain.

Active nematic liquid crystals have the remarkable ability to spontaneously deform and flow in the absence of any external driving force. While living materials with orientational order, such as the mitotic spindle, can self-assemble in quiescent active phases, reconstituted active systems often display chaotic, periodic, or circulating flows under confinement. Quiescent in vitro active nematics are, therefore, quite rare, despite the prediction from active hydrodynamic theory that confinement between two parallel plates can suppress flows. This spontaneous flow transition—named the active Fréedericksz transition by analogy with the conventional Fréedericksz transition in passive nematic liquid crystals under a magnetic field—has been a cornerstone of the field of active matter. Here, we report experimental evidence that confinement in spherical droplets can stabilize the otherwise chaotic dynamics of a 3D extensile active nematics, giving rise to a quiescent—yet still out-of-equilibrium—nematic liquid crystal. The active nematics spontaneously flow when confined in larger droplets. The composite nature of our model system composed of extensile bundles of microtubules and molecular motors dispersed in a passive colloidal liquid crystal allows us to demonstrate how the interplay of activity, nematic elasticity, and confinement impacts the spontaneous flow transition. The critical diameter increases when motor concentration decreases or nematic elasticity increases. Experiments and simulations also demonstrate that the critical confinement depends on the confining geometry, with the critical diameter in droplets being larger than the critical width in channels. Biochemical assays reveal that neither confinement nor nematic elasticity impacts the energy-consumption rate, confirming that the quiescent active phase is the stable out-of-equilibrium phase predicted theoretically. Further experiments in dense arrays of monodisperse droplets show that fluctuations in the droplet composition can smooth the flow transition close to the critical diameter. In conclusion, our work provides experimental validation of the active Fréedericksz transition in 3D active nematics, with potential applications in human health, ecology, and soft robotics.