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Abstract Background Fatty acid oxidation defects are rare autosomal recessive disorders with variable clinical manifestations and outcome. Early detection by systematic neonatal screening may improve their prognosis. Long-term outcome studies of these disorders in the Middle East and North Africa region are limited. The purpose of this study is to report the diagnostic challenges and outcome of fatty acid oxidation defects in a major tertiary care center in Lebanon, a resource-constrained country in the Middle East. Methods A retrospective review of charts of all fatty acid oxidation defects sequential patients diagnosed and followed at our center was conducted. Collected data included: parental consanguinity, age at diagnosis, clinical presentation, biochemical profile, confirmatory diagnosis, treatment and outcome. A genotype–phenotype correlation was also performed, when available. Results Seven types of fatty acid oxidation defects were identified in a total of 34 patients from 21 families. Most families (79%) were consanguineous (first-degree cousins). The majority were diagnosed when clinically symptomatic (78%), at various ages between 10 days and 19 years (average: 2 years). Follow-up duration spanned between 2 months and 15 years (average: 5 years). The remainder of the patients were detected while still asymptomatic by systematic neonatal screening (9%) or due to positive family history (9%). The most common defect was carnitine transporter deficiency (50%) with an exclusive cardiac presentation related to a founder variant c.981C > T, (p.Arg254*) in the SLC22A5 gene. Medium chain acyl-CoA dehydrogenase deficiency was found in 13% only, which could be explained by the absence of systematic neonatal screening. Rare gene variants were detected in very long chain and multiple acyl-CoA dehydrogenase deficiency. The worse prognosis was observed in very long chain acyl-CoA dehydrogenase deficiency. The overall survival at last follow-up reached 75% with a complete reversal of symptoms with treatment in most patients (63%), despite their late diagnosis. Conclusions Our experience highlights the diagnostic challenges and outcome of fatty acid oxidation defects in a resource-constrained country with high consanguinity rates. Physicians’ awareness and systematic neonatal screening are key for diagnosis. Larger genotype–phenotype studies are still needed to understand the natural history of these rare diseases and possibly improve their outcome.

The mechanical properties of fibre-managed Eucalyptus nitens (E. nitens) cross-laminated timber (CLT) have previously been extensively studied, proving the material to be structurally safe and reliable. However, the vibration performance of CLT manufactured from this relative new construction species is not yet fully understood, especially under different support conditions. In this study, three types of support conditions, including roller–roller, bearer–bearer and clamp–bearer support conditions, were examined under vibration impulse-response testing performed using a simple but effective and repeatable excitation method consisting of a basketball dropped from a known height and an accelerometer. Six three-ply E. nitens CLT panels considered to have different moduli of elasticity in different layers and one strength-class C24 spruce CLT as a controlled reference were included in this study. The results suggest that the fundamental frequency values can effectively reflect the inherent characteristics of CLT panels (bending stiffness and density); however, no obvious relationship was observed between damping ratios and these inherent properties. The values of frequency constant λ1 were determined to analyse the effect of different support conditions on the values of fundamental frequency. The average values of λ1 for the roller–roller (9.6) and bearer–bearer (10.1) supports align with the theoretical values (9.87) for simply support (S-S) conditions. However, when clamping loads were applied at one edge of the bearer support, the average values of λ1 increased up to 10.8 but remained far below the theoretical values for clamped–pinned (C-S) support (15.4).

The article in the journal "Colorectal Disease" discusses the use of robotic posterior pelvic exenteration for locally advanced rectal cancer. The authors present a case study of a 44-year-old woman with a middle-third adenocarcinoma and describe the surgical approach using a robotic platform. The postoperative outcome was favorable, with the patient recovering well after surgery. The study was approved by the institutional ethics review board, and informed consent was obtained from the patient. [Extracted from the article]

Introduction The management of mid and low rectal cancer is based on neoadjuvant chemoradiotherapy (CRT) followed by standardised surgery. There is no biomarker in rectal cancer to aid clinicians in foreseeing treatment response. The determination of factors associated with treatment response might allow the identification of patients who require tailored strategies (eg, therapeutic de-escalation or intensification). Colibactin-producing Escherichia coli (CoPEC) has been associated with aggressive colorectal cancer and could be a poor prognostic factor. Currently, no study has evaluated the potential association between intestinal microbiota composition and tumour response to CRT in mid and low rectal cancer. The aim of this study is to assess the association between response to neoadjuvant CRT and faecal intestinal microbiota composition and/or CoPEC prevalence in patients with mid or low rectal cancer.Methods and analysis This is a non-randomised bicentric prospective clinical study with a recruitment capacity of 200 patients. Three stool samples will be collected from participants with histological-proven adenocarcinome of mid or low rectum who meet eligibility criteria of the study protocol: one before neoadjuvant treatment start, one in the period between CRT end and surgery and one the day before surgery. In each sample, CoPEC will be detected by culture in special media and molecular (PCR) approaches. The global microbiota composition will be also assessed by the bacterial 16S rRNA gene sequencing. Neoadjuvant CRT response and tumour regression grade will be described using the Dworak system at pathological examination. Clinical data and survival outcomes will also be collected and investigated.Ethics and dissemination MICARE was approved by the local ethics committee (Comité de Protection des Personnes Sud-Est II, 18 December 2019. Reference number 2019-A02493-54 and the institutional review board. Patients will be required to provide written informed consent. Results will be published in a peer reviewed journal.Trial registration number NCT04103567.

In this study, the preliminary serviceability performance of cross-laminated timber (CLT) panels constructed from fibre-managed Eucalyptus nitens (E. nitens) was investigated via bending and vibration tests. Linear four-point bending tests were performed to determine the stiffness and deflection of all CLT panels under serviceability loads. The dynamic response of CLT panels was tested using a basketball and an accelerometer. The fundamental natural frequencies of all tested panels were above the minimum frequency limit (8 Hz) when extrapolated to spans of up to 4.4 m. The configurations of E. nitens CLT panels were based on different modulus of elasticity (MOE) values for each board. Using higher MOE timber boards as the top and bottom layers can significantly increase the serviceability performance of both bending and vibration tests. The same experiments were carried out on two CLT panels made of strength class C24 Spruce-Pine-Fir to compare the serviceability performance of E. nitens CLT. The results demonstrated that E. nitens is a reliable resource for CLT manufacturing, and exhibits better serviceability performance compared to Spruce CLT. This provides more sustainable options for a species traditionally destined for pulp.

Fibre-managed E. nitens has the potential to be used as a feedstock for engineered wood products. This resource, however, has a number of strength-reducing features that need to be removed, and the board needs to be re-joint to be useful in greater lengths for timber construction. A common jointing practice is finger jointing. The suitability of the finger jointing technique for this species is crucial to the mechanical properties of the final product. This study was conducted to explore the influence of finger jointing on the stiffness of sawn boards. A strict manufacturing process of docking and re-joining timber boards in the same location without removing strength-reducing features was conducted to compare the stiffness parameters before and after finger jointing with bending tests. A statistical analysis was conducted. The results showed that the frequency of finger joints along the board did not significantly impact the edgewise stiffness; however, the average flatwise stiffness of the samples with more finger joints was improved slightly. A 10% increase in the end pressure reduced the tip gap significantly but did not influence the stiffness. The finger joint efficiency was 0.824 for the edgewise stiffness of the samples and 1.034 for flatwise stiffness of the jointed sections.

Hardness is commonly used to determine the suitability of a timber species for flooring applications. In this study, Janka hardness test is conducted on sawlog managed Eucalyptus nitens and regrowth forest Eucalyptus obliqua sourced from Tasmania, Australia. Plantation E. nitens timber is currently entering the Australian market and the feasibility of using this fast grown species in value added applications such as timber flooring is advantageous. Further to testing Janka hardness on solid timber samples, a regime of engineered timber flooring prototypes consisting of plantation E. nitens top layers, veneers and solid densified E. nitens boards were developed and subjected to Janka hardness test. The results were compared against solid E. obliqua flooring and a commercially available engineered flooring product with Tasmanian Oak top layer. The results showed that Janka hardness of plantation grown E. nitens, and E. obliqua currently available in the market are lower than the values published in the literature. This indicates that the material properties of fast grown plantation timber and regrowth forest material are different to the native forest timber properties published decades earlier. Furthermore, some of the tested engineered flooring prototypes showed similar behaviour to timber flooring products currently in market, suggesting that E. nitens engineered flooring would be suitable for domestic/light commercial flooring applications despite the general conception of unsuitability due to lower densities.

Continuous measurement of heart rate variability (HRV) in the short and ultra-short-term using wearable devices allows monitoring of physiological status and prevention of diseases. This study aims to evaluate the agreement of HRV features between a commercial device (Bora Band, Biosency) measuring photoplethysmography (PPG) and reference electrocardiography (ECG) and to assess the validity of ultra-short-term HRV as a surrogate for short-term HRV features. PPG and ECG recordings were acquired from 5 healthy subjects over 18 nights in total. HRV features include time-domain, frequency-domain, nonlinear, and visibility graph features and are extracted from 5 min 30 s and 1 min 30 s duration PPG recordings. The extracted features are compared with reference features of 5 min 30 s duration ECG recordings using repeated-measures correlation, Bland–Altman plots with 95% limits of agreements, Cliff’s delta, and an equivalence test. Results showed agreement between PPG recordings and ECG reference recordings for 37 out of 48 HRV features in short-term durations. Sixteen of the forty-eight HRV features were valid and retained very strong correlations, negligible to small bias, with statistical equivalence in the ultra-short recordings (1 min 30 s). The current study concludes that the Bora Band provides valid and reliable measurement of HRV features in short and ultra-short duration recordings.

The authors investigated the agreement between StepWatch3™ (SW3) and ActiGraph™ wGT3X+ monitors for measuring step-based metrics in patients with peripheral artery disease and older adults. In 23 patients with peripheral artery disease and 38 older participants, the authors compared the metrics obtained during an outdoor (400-m track) walking session (step count) and a 7-day free-living period (step count and 60/30/5/1-min maximal or peak step accumulation) using the SW3 (ankle) and the wGT3X+ (hip) with the low-frequency extension filter enabled (wGT3X+/LFE) or not (wGT3X+/N). During outdoor walking session, agreement was high, particularly for wGT3X+/LFE: correlations ≥.98, median absolute percentage errors <1%, and significant equivalence using a ± 15% equivalence zone or narrower. In free living, no wGT3X+ method was equivalent to SW3 for step count. The wGT3X+/LFE was equivalent to SW3 regarding all step accumulation metrics using a ± 20% equivalence zone or narrower, with median absolute percentage errors <11%. The wGT3X+/LFE method is the best option for comparisons with SW3 in peripheral artery disease and older adults. [ABSTRACT FROM AUTHOR]