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The industrial food applications of native starches are limited due to their limited resistance to shear, susceptibility to thermal decomposition, and high tendency for retrogradation. Cross-linking of starches adds intra and inter-molecular bonds at various locations in the starch molecule that result in the stability of the granule and enhance functional attributes. This process involves the use of various cross-linking agents such as sodium trimetaphosphate (STMP), sodium tripolyphosphate (STPP), epichlorohydrin (EPI), phosphorus chloride (POCl3), and citric acid, etc., to introduce covalent or non-covalent linkages between starch molecules. Cross-linked starch exhibits improved resistance to retrogradation, enhanced freeze-thaw stability, and increased stability during cooking, shearing, and processing, such as high or low temperatures and pH. This review paper offers an overview of cross-linking modifications, emphasizing their importance in addressing native starch limitations. It underscores the significance of selecting appropriate cross-linking agents to customize starch properties for specific applications. Furthermore, the paper discusses the properties and applications of cross-linked starches and delves into regulatory considerations regarding their use. Regulatory consideration for cross-linked starches has also been discussed. Cross-linking modifications offer a promising avenue to unlock the full potential of starch and expand its utility across a wide range of applications.

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.

Abstract Introduction Telepractice has the potential to align with the directive to reduce inequalities by United Nations Sustainable Development Goal 10. Telepractice additionally addresses a national digital health strategic plan for accessible digitally enabled models of care. To plan improvements, it is essential to understand the experience of telepractice for people with disability, which may be achieved through an approach such as journey mapping. The current article provides both a disability‐specific case study and a methodological guide for the inclusion of customers and clinicians in the meaningful redevelopment of services. The Perth, Australia‐based case study aimed to gain insights into the experience of telepractice for people with disability. The methodological aim describes using co‐design to produce a journey map in collaboration with customers and clinicians, for potential replication in a wide range of health and social care contexts. Method Interview transcripts gathered from a cohort of customer participants (n = 17) were used to inform the journey map. A group of customers (n = 5) and clinicians plus one manager (n = 5) distributed the findings onto a customer experience journey map during a co‐design workshop. The journey map describes the emotional experience and actions taken, along five phases of a timeline through telepractice service interactions: (1) before, (2) selecting telepractice, (3) telepractice preparation, (4) during telepractice sessions and (5) after. Results A journey map visualisation of customer experiences was produced that identified strengths of telepractice service delivery (flexibility) while noting challenges (with technology) as opportunities for improvement. The consensus of participants was the desire to have access to telepractice currently and in the future, in addition to in‐person delivery. Conclusion These findings are valuable in the context of advocating for the incorporation of customers and clinicians through co‐design workshops in the content analysis and creation of a journey map that is representative of the lived experience of accessing telepractice services. Patient or Public Contribution The paper forms part of a larger co‐design process that included customer participants throughout the design and planning of the project, inclusion of a peer researcher and the co‐designers in the workshops, journey map and this article production.

Music Real-time Communication applications (M-RTC) enable music making (musiking) for musicians simultaneously across geographic distance. When used for musiking, M-RTC such as Zoom and JackTrip, require satisfactorily received acoustical perception of the transmitted music to the end user; however, degradation of audio can be a deterrent to using M-RTC for the musician. Specific to the audio quality of M-RTC, we evaluate the quality of the audio, or the Quality of Experience (QoE), of five network music conferencing applications through quantitative perceptual analysis to determine if the results are commensurate with data analysis. The ITU-R BS.1534-3 MUlti Stimulus test with Hidden Reference and Anchor (MUSHRA) analysis is used to evaluate the perceived audio quality of the transmitted audio files in our study and to detect differences between the transmitted audio files and the hidden reference file. A comparison of the signal-to-noise ratio (SNR) and total harmonic distortion (THD) analysis to the MUSHRA analysis shows that the objective metrics may indicate that SNR and THD are factors in perceptual evaluation and may play a role in perceived audio quality; however, the SNR and THD scores do not directly correspond to the MUSHRA analysis and do not adequately represent the preferences of the individual listener. Since the benefits of improved M-RTC continue to be face-to-face communication, face-to-face musiking, reduction in travel costs, and depletion of travel time, further testing with statistical analysis of a larger sample size can provide the additional statistical power necessary to make conclusions to that end.

Abstract Background Hepatocellular carcinoma (HCC) has high incidence and mortality worldwide. Local ablation using radiofrequency ablation (RFA) or microwave ablation (MWA) is potentially curative for early-stage HCC with outcomes comparable to surgical resection. We explored the influence of demographic, clinical, and laboratory factors on outcomes of HCC patients receiving ablation. Methods This retrospective cohort study included 221 HCC patients receiving local ablation at Mayo Clinic between January 2000 and October 2018, comprising 140 RFA and 81 MWA. Prognostic factors determining overall survival (OS) and disease-free survival (DFS) were identified using multivariate analysis. Results There was no clinically significant difference in OS or DFS between RFA and MWA. In multivariate analysis of OS, pre-ablation lymphocyte-monocyte ratio [Hazard ratio (HR) 0.7, 95% confidence interval (CI) 0.58–0.84, P = 0.0001], MELD score [HR 1.12, 95%CI 1.068–1.17, P

Primary sclerosing cholangitis (PSC) is associated with hepatobiliary and colorectal cancers, but it remains uncertain if PSC increases the risk for pancreatic cancer. While some European studies have suggested an increased risk of pancreatic cancer in PSC patients, other studies have not. And these studies did not well account for presence or absence of concomitant inflammatory bowel disease (IBD). The purpose of this study is to investigate the prevalence of pancreatic cancer in United States veterans with PSC both with and without IBD.MethodsThis retrospective study used International Classification of Diseases, Tenth Revision (ICD-10) codes to identify patients with PSC, IBD, and pancreatic cancer from the Veterans Affairs (VA) Corporate Data Warehouse. The prevalence of pancreatic cancer in patients with PSC only, IBD only, PSC with IBD, and neither PSC nor IBD were compared. Logistic regression was used to control for age, gender, chronic pancreatitis, diabetes mellitus, and tobacco and alcohol use.ResultsA total of 946 patients with PSC were identified from a population of over 9 million veterans. 486 (51.4%) of these had concurrent IBD. Additionally 112,653 patients with IBD without PSC were identified. When adjusted for confounding factors, patients with PSC had a significantly higher prevalence of pancreatic cancer compared to the general population and those with IBD without PSC (2.4% vs. 0.2% and 0.5%, respectively).ConclusionsVeterans with PSC, particularly those without concomitant IBD, have a high prevalence of pancreatic cancer compared to the general veteran population. Our findings support the need for multicenter prospective studies investigating the benefits of screening for pancreatic cancer in patients with PSC.

Litchi (Litchi chinensis) seeds are discerned as the primary waste by-products produced after processing of litchi fruit into beverages, jellies, wine, and squash. These seeds are a rich source of complex polysaccharides, out of with 40% are constituted by starch. This starch exhibits certain unique functional and structural properties which are ascribed to its low amylose and high amylopectin content. These distinct functional food properties include (swelling power, water holding capacity, solubility) and micromeritic properties (Hausner's ratio, Carr's index, and angle of repose). These properties ascertain their application both in food (thickener, edible packaging, functional ingredient) and non-food (excipient in pharmaceutical products, targeted drug delivery) products. Utilization of starch from litchi seed can improve the economic feasibility of litchi processing industry and also help in preventing the waste accumulation and environmental pollution. This review article explores the litchi seed starch isolation, its structure, functional properties and diversified novel applications.

Gait symmetry is commonly used as an informal measure to assess functional gait recovery. As other outcome measures used for the evaluation of clinical change over time, gait symmetry indices must be reliable. However, studies assessing the reliability of symmetry indices are scarce and focused on discrete and local indices (i.e., peak joint angle, step length), which fail to assess overall gait symmetry. On the other hand, the repeatability of global symmetry indices (using multiple continuous waveforms) based on joint angles may be hampered by the sensitivity of these variables to marker placement imprecision. The aim of this study is to evaluate the test–retest intra-rater reliability and measurement error of an alternative global symmetry index. Two 3D gait analyses were performed on separate days (a week interval) on twenty-three healthy adults. Reliability and measurement error were assessed by calculating the intraclass correlation coefficient and the 95% limits of agreement, standard error of measurement and smallest detectable change, respectively. The new symmetry index presented acceptable results in terms of reliability (ICC = 0.71, 95% CI 0.33–0.88) and measurement error (95% LOA between −30.2% and 29.1%, SEM = 10.7% and SDC = 29.7%), thus being a more promising tool to assess overall gait symmetry.

Three guenon species in Taï National Park frequently form and maintain stable polyspecific associations despite significant feeding competition. This dietary overlap provides an opportunity to examine how closely related and anatomically similar taxa process the same foods. Our research examines whether the oral-processing behaviors of these guenons differ when they consume the same foods. Methods: Data on oral-processing behavior were collected on one habituated group each of Cercopithecus campbelli, C. diana, and C. petaurista in Taï National Park, Côte d’Ivoire from January 2016 to December 2018. We recorded the frequency with which foods were introduced to the mouth (ingestive action) and the frequency with which foods were processed using incisors, canines, and postcanine teeth. Oral-processing profiles for species-specific plant foods, fungi, and invertebrates were compared using Monte Carlo resampling. We quantified oral-processing behavior during a total of 2316 five-minute focal periods. Diana monkeys use their incisors significantly more per ingestive action than Campbell’s monkeys or Lesser spot-nosed guenons. Lesser spot-nosed guenons use their incisors more than Campbell’s monkeys. Diana monkeys also use significantly more post-canine chews per ingestive action than Campbell’s monkeys and Lesser spot-nosed guenons. Lesser spot-nosed guenons generally use fewer post-canine chews than Diana monkeys but more than Campbell’s monkeys. Canine use during feeding was rare in all three taxa. The three study species use different oral-processing profiles when consuming the same foods. These results are intriguing given the overall similarity in dental and cranial anatomy in these taxa. The oral-processing profiles we report do not encompass the full dietary breadth of all species; however, the behavioral diversity demonstrated during consumption of the same foods suggests that insight into feeding behavior is more likely obtained by examining oral processing of individual foods rather than broad food categories. Furthermore, these results underscore that important variation in feeding behavior is not necessarily associated with morphological differences in dental or craniofacial anatomy.

Despite advances in deep learning methods for song recommendation, most existing methods do not take advantage of the sequential nature of song content. In addition, there is a lack of methods that can explain their predictions using the content of recommended songs and only a few approaches can handle the item cold start problem. In this work, we propose a hybrid deep learning model that uses collaborative filtering (CF) and deep learning sequence models on the Musical Instrument Digital Interface (MIDI) content of songs to provide accurate recommendations, while also being able to generate a relevant, personalized explanation for each recommended song. Compared to state-of-the-art methods, our validation experiments showed that in addition to generating explainable recommendations, our model stood out among the top performers in terms of recommendation accuracy and the ability to handle the item cold start problem. Moreover, validation shows that our personalized explanations capture properties that are in accordance with the user’s preferences.

In her early work on Modernist poetry and avant-garde poetics, Julia Kristeva proposed a bifurcated view of the poetic text as simultaneously constituted by both a “genotext” and a “phenotext.” Reading the “genotext” of any given poem might start by “pointing out the transfers of drive energy that can be detected in phonematic devices (such as the accumulation and repetition of phonemes or rhyme) and melodic devices (such as intonation or rhythm)”; and, in her words, it would also need to take into consideration “the way semantic and categorial fields are set out in syntactic and logical features.” This essay seeks to demonstrate how Harryette Mullen’s Muse & Drudge might be analyzed at the level of its genotext, taking (arbitrarily) as its primary example the first of the book’s eighty poems to illustrate how a straightforwardly genotextual analysis might proceed. The essay contends that, by closely observing the genotext of Mullen’s poetry in Muse & Drudge, one may eventually arrive at a more comprehensive understanding of the “polyvocal” and “polymorphous” nature of the language and poetic design of the poems in this enigmatic collection.

Background. Early-onset gastric cancer (EOGC, age≤60 years at diagnosis) now comprises >30% of new gastric cancers in the United States. It is hypothesized that chronic acid suppression with proton-pump inhibitors (PPIs) may promote tumorigenesis, while other medications including statins, nonsteroidal anti-inflammatory drugs (NSAIDs), metformin, and cyclooxygenase-2 (COX-2) inhibitors have been proposed as protective. We aimed to assess for an association between use of the aforementioned commonly prescribed medications and EOGC development. Methods. We used a population-based medical record linkage system, to identify cases of EOGC in Olmsted County, Minnesota, between January 1, 1995, and December 31, 2020. Patients were matched 1 : 1 with controls based on age at diagnosis, sex, smoking status, and body mass index (BMI). Conditional logistic regression was used to examine associations with the odds of EOGC development. Results. Ninety-six cases of EOGC were identified during the study period. On both univariate and multivariate regression analysis, there was no significant association between use of PPIs, statins, NSAIDs, or metformin and EOGC development. In a final multivariable model, there was a significant reduction in odds of EOGC with COX-2 inhibitor use for six months or more prior to cancer diagnosis (OR=0.39, 95% CI 0.16-0.94). Conclusion. In this retrospective, population-based study of individuals in Olmsted County, MN, we found significantly reduced odds of EOGC development associated with COX-2 inhibitor use for six months or more prior to diagnosis, but no association between EOGC development and use of PPIs and other commonly prescribed medications.

Background: Clinical exoskeletal-assisted walking (EAW) programs for individuals with spinal cord injury (SCI) have been established, but many unknown variables remain. These include addressing staffing needs, determining the number of sessions needed to achieve a successful walking velocity milestone for ambulation, distinguishing potential achievement goals according to level of injury, and deciding the number of sessions participants need to perform in order to meet the Food and Drug Administration (FDA) criteria for personal use prescription in the home and community. The primary aim of this study was to determine the number of sessions necessary to achieve adequate EAW skills and velocity milestones, and the percentage of participants able to achieve these skills by 12 sessions and to determine the skill progression over the course of 36 sessions.Methods: A randomized clinical trial (RCT) was conducted across three sites, in persons with chronic (≥6 months) non-ambulatory SCI. Eligible participants were randomized (within site) to either the EAW arm first (Group 1), three times per week for 36 sessions, striving to be completed in 12 weeks or the usual activity arm (UA) first (Group 2), followed by a crossover to the other arm for both groups. The 10-meter walk test seconds (s) (10MWT), 6-min walk test meters (m) (6MWT), and the Timed-Up-and-Go (s) (TUG) were performed at 12, 24, and 36 sessions. To test walking performance in the exoskeletal devices, nominal velocities and distance milestones were chosen prior to study initiation, and were used for the 10MWT (≤ 40s), 6MWT (≥80m), and TUG (≤ 90s). All walking tests were performed with the exoskeletons.Results: A total of 50 participants completed 36 sessions of EAW training. At 12 sessions, 31 (62%), 35 (70%), and 36 (72%) participants achieved the 10MWT, 6MWT, and TUG milestones, respectively. By 36 sessions, 40 (80%), 41 (82%), and 42 (84%) achieved the 10MWT, 6MWT, and TUG criteria, respectively.Conclusions: It is feasible to train chronic non-ambulatory individuals with SCI in performance of EAW sufficiently to achieve reasonable mobility skill outcome milestones.

Singularities in the polarization state of non-uniform electromagnetic beams have been a topic of both theoretical and practical interest for many years, as have singularities in the correlation functions of random scalar wavefields. However, there has been relatively little work done to explore the intersection of these phenomena, namely singularities in the polarization state of partially coherent wavefields. In this paper, we use a simple model of a partially coherent electromagnetic vortex beam to highlight three different ways that one can define polarization singularities in scalar wavefields, one of which has been previously undiscussed.

Biofilms are community structures of bacteria enmeshed in a self-produced matrix of exopolysaccharides. The biofilm matrix serves numerous roles, including resilience and persistence, making biofilms a subject of research interest among persistent clinical pathogens of global health importance. Our current understanding of the underlying biochemical pathways responsible for biosynthesis of these exopolysaccharides is largely limited to Gram-negative bacteria. Clostridia are a class of Gram-positive, anaerobic and spore-forming bacteria and include the important human pathogens Clostridium perfringens, Clostridium botulinum and Clostridioides difficile, among numerous others. Several species of Clostridia have been reported to produce a biofilm matrix that contains an acetylated glucan linked to a series of hypothetical genes. Here, we propose a model for the function of these hypothetical genes, which, using homology modelling, we show plausibly encode a synthase complex responsible for polymerization, modification and export of an O-acetylated cellulose exopolysaccharide. Specifically, the cellulose synthase is homologous to that of the known exopolysaccharide synthases in Gram-negative bacteria. The remaining proteins represent a mosaic of evolutionary lineages that differ from the described Gram-negative cellulose exopolysaccharide synthases, but their predicted functions satisfy all criteria required for a functional cellulose synthase operon. Accordingly, we named these hypothetical genes ccsZABHI, for the Clostridial cellulose synthase (Ccs), in keeping with naming conventions for exopolysaccharide synthase subunits and to distinguish it from the Gram-negative Bcs locus with which it shares only a single one-to-one ortholog. To test our model and assess the identity of the exopolysaccharide, we subcloned the putative glycoside hydrolase encoded by ccsZ and solved the X-ray crystal structure of both apo- and product-bound CcsZ, which belongs to glycoside hydrolase family 5 (GH-5). Although not homologous to the Gram-negative cellulose synthase, which instead encodes the structurally distinct BcsZ belonging to GH-8, we show CcsZ displays specificity for cellulosic materials. This specificity of the synthase-associated glycosyl hydrolase validates our proposal that these hypothetical genes are responsible for biosynthesis of a cellulose exopolysaccharide. The data we present here allowed us to propose a model for Clostridial cellulose synthesis and serves as an entry point to an understanding of cellulose biofilm formation among class Clostridia.

Abstract Background The police and others in occupations where they come into close contact with people experiencing/with mental ill health, often have to manage difficult and complex situations. Training is needed to equip them to recognise and assist when someone has a mental health issue or learning/intellectual disability. We undertook a systematic review of the effectiveness of training programmes aimed at increasing knowledge, changing behaviour and/or attitudes of the trainees with regard to mental ill health, mental vulnerability, and learning disabilities. Methods Databases searched from 1995 onwards included: ASSIA, Cochrane Central Register of Controlled Clinical Trials (CENTRAL), Criminal Justice Abstracts, Embase, ERIC, MEDLINE, PsycINFO, Social Science Citation Index. Courses, training, or learning packages aimed at helping police officers and others who interact with the public in a similar way to deal with people with mental health problems were included. Primary outcomes were change in practice and change in outcomes for the groups of people the trainees come into contact with. Systematic reviews, randomised controlled trials (RCTs) and non- randomised controlled trials (non-RCTs) were included and quality assessed. In addition non-comparative evaluations of training for police in England were included. Results From 8578 search results, 19 studies met the inclusion criteria: one systematic review, 12 RCTs, three prospective non-RCTs, and three non-comparative studies. The training interventions identified included broad mental health awareness training and packages addressing a variety of specific mental health issues or conditions. Trainees included police officers, teachers and other public sector workers. Some short term positive changes in behaviour were identified for trainees, but for the people the trainees came into contact with there was little or no evidence of benefit. Conclusions A variety of training programmes exist for non-mental health professionals who come into contact with people who have mental health issues. There may be some short term change in behaviour for the trainees, but longer term follow up is needed. Research evaluating training for UK police officers is needed in which a number of methodological issues need to be addressed. Trial registration Protocol registration number: PROSPERO: CRD42015015981 .

While multiple types of remote sensing instruments have been used to investigate wind profiles associated with thunderstorms, the use of profiling Lidars (LIght Detection And Ranging) has been mostly limited to the wind energy sector. Using data from a wind energy company, this study explores the feasibility of profiling lidar data to obtain low-level (

Evolutionary algorithms such as the basin-hopping (BH) algorithm have proven to be useful for difficult non-linear optimization problems with multiple modalities and variables. Applications of these algorithms range from characterization of molecular states in statistical physics and molecular biology to geometric packing problems. A key feature of BH is the fact that one can generate a coarse-grained mapping of a potential energy surface (PES) in terms of local minima. These results can then be utilized to gain insights into molecular dynamics and thermodynamic properties. Here we describe how one can employ concepts from unsupervised machine learning to augment BH PES searches to more efficiently identify local minima and the transition states connecting them. Specifically, we introduce the concepts of similarity indices, hierarchical clustering, and multidimensional scaling to the BH methodology. These same machine learning techniques can be used as tools for interpreting and rationalizing experimental results from spectroscopic and ion mobility investigations (e.g., spectral assignment, dynamic collision cross sections). We exemplify this in two case studies: (1) assigning the infrared multiple photon dissociation spectrum of the protonated serine dimer and (2) determining the temperature-dependent collision cross-section of protonated alanine tripeptide.

In the midst of the COVID-19 pandemic, Remote Patient Monitoring technologies are highly important for clinicians and researchers. These connected-health technologies enable monitoring of patients and facilitate remote clinical trial research while reducing the potential for the spread of the novel coronavirus. There is a growing requirement for monitoring of the full 24 h spectrum of behaviours with a single research-grade sensor. This research describes a free-living and supervised protocol comparison study of the Verisense inertial measurement unit to assess physical activity and sleep parameters and compares it with the Actiwatch 2 actigraph. Fifteen adults (11 males, 23.4 ± 3.4 years and 4 females, 29 ± 12.6 years) wore both monitors for 2 consecutive days and nights in the free-living study while twelve adults (11 males, 23.4 ± 3.4 years and 1 female, 22 ± 0 years) wore both monitors for the duration of a gym-based supervised protocol study. Agreement of physical activity epoch-by-epoch data with activity classification of sedentary, light and moderate-to-vigorous activity and sleep metrics were evaluated using Spearman’s rank-order correlation coefficients and Bland–Altman plots. For all activity, Verisense showed high agreement for both free-living and supervised protocol of r = 0.85 and r = 0.78, respectively. For physical activity classification, Verisense showed high agreement of sedentary activity of r = 0.72 for free-living but low agreement of r = 0.36 for supervised protocol; low agreement of light activity of r = 0.42 for free-living and negligible agreement of r = −0.04 for supervised protocol; and moderate agreement of moderate-to-vigorous activity of r = 0.52 for free-living with low agreement of r = 0.49 for supervised protocol. For sleep metrics, Verisense showed moderate agreement for sleep time and total sleep time of r = 0.66 and 0.54, respectively, but demonstrated high agreement for determination of wake time of r = 0.83. Overall, our results showed moderate-high agreement of Verisense with Actiwatch 2 for assessing epoch-by-epoch physical activity and sleep, but a lack of agreement for activity classifications. Future validation work of Verisense for activity cut-point potentially holds promise for 24 h continuous remote patient monitoring.

L’homme est sensible à des parasites qui trouvent des réservoirs naturels chez les singes. En Côte d’Ivoire, les risques de zoonoses auxquels sont exposées les populations rurales constituent un enjeu majeur de santé publique. Le Parc National de Taï (PNT) abrite plusieurs espèces de primates arboricoles qui bénéficient d’un suivi depuis 1991. Afin de mieux comprendre les interactions entre les communautés d’hôtes, humains et simiens, et d’évaluer les risques sanitaires liés à la transmission des parasites intestinaux, nous avons recueilli les selles de sept espèces de singes, de 385 personnes dans 3 villages situés à 1 km du PNT et des assistants de recherche. Un examen coprologique a été réalisé afin de dresser un inventaire faunistique des parasites intestinaux. La technique PCR nichée a été retenue pour amplifier et séquencer les gènes de la TPI et de la Gdh à partir d’extraits d’ADN d’origine humaine et simienne de Giardia duodenalis. De même, la technique PCR-RFLP a été appliquée à l’amplification d’un fragment d’ADN ribosomique ITS2 destiné à différencier deux espèces d’Oesophagostomum : O. bifurcum et O. stephanostomum. L’examen microscopique des selles a permis de mettre en évidence des kystes de Giardia sp. dans 9 % des échantillons humains et dans 16 % des prélèvements de singes. Parallèlement, le gène de la TPI a été identifié dans 63 % des selles humaines et 43 % des selles de singes et le gène de la Gdh détecté dans 37 % des selles humaines et 87 % de celles des singes. Par ailleurs, des œufs d’Oesophagostomum ont été observés au microscope dans 10 % des selles humaines et 32 % des prélèvements simiens. La différenciation moléculaire a permis de détecter 7 % de selles humaines positives à la fois à O. bifurcum età O. stephanostomum, 13 % à O. stephanostomum et 33 % à O. bifurcum. Chez les singes, 20 % étaient positifs à O. stephanostomum, 73 % à O. bifurcum et 13 % à la fois à O. bifurcum et O. stephanostomum. Ces résultats mettent en évidence une prévalence relativement élevée de ces parasites connus pour leur potentiel zoonotique et posent la question des modalités et du risque de transmission interspécifique dans cette réserve protégée. Les analyses phylogénétiques en cours nous permettront d’évaluer le risque zoonotique réel lié à la cohabitation entre les populations humaines locales et les populations simiennes dans cette région tropicale.Travail soutenu par le Programme d’Appui Stratégique à la Recherche Scientifique (PASRES, Project No. 48) et US National Science Foundation (NSF) 0921770 and 0922429.

The electronic MEdical Records & GEnomics (eMERGE) network was established in 2007 by the National Human Genome Research Institute (NHGRI) of the National Institutes of Health (NIH) in part to explore the utility of electronic medical records (EMRs) in genome science. The initial focus was on discovery primarily using the genome-wide association paradigm, but more recently, the network has begun evaluating mechanisms to implement new genomic information couple to clinical decision support into EMRs. Herein, we describe this evolution including the development of the individual and merged eMERGE genomic datasets, the contribution the network has made towards genomic discovery and human health, and the steps taken towards the next generation genotype-phenotype association studies and clinical implementation.

Long COVID is a chronic condition characterized by symptoms such as fatigue, dyspnea, and cognitive impairment that persist or relapse months after an acute infection with the SARS-CoV-2 virus. Many distinct symptoms have been attributed to Long COVID; however, little is known about the potential clustering of these symptoms and risk factors that may predispose patients to certain clusters. In this study, an electronic survey was sent to patients in the UC San Diego Health (UCSDH) system who tested positive for COVID-19, querying if patients were experiencing symptoms consistent with Long COVID. Based on survey results, along with patient demographics reported in the electronic health record (EHR), linear and logistic regression models were used to examine putative risk factors, and exploratory factor analysis was performed to determine symptom clusters. Among 999 survey respondents, increased odds of Long COVID (n = 421; 42%) and greater Long COVID symptom burden were associated with female sex (OR = 1.73, 99% CI: 1.16-2.58; β = 0.48, 0.22-0.75), COVID-19 hospitalization (OR = 4.51, 2.50-8.43; β = 0.48, 0.17-0.78), and poorer pre-COVID self-rated health (OR = 0.75, 0.57-0.97; β = -0.19, -0.32--0.07). Over one-fifth of Long COVID patients screened positive for depression and/or anxiety, the latter of which was associated with younger age (OR = 0.96, 0.94-0.99). Factor analysis of 16 self-reported symptoms suggested five symptom clusters-gastrointestinal (GI), musculoskeletal (MSK), neurocognitive (NC), airway (AW), and cardiopulmonary (CP), with older age (β = 0.21, 0.11-0.30) and mixed race (β = 0.27, 0.04-0.51) being associated with greater MSK symptom burden. Greater NC symptom burden was associated with increased odds of depression (OR = 5.86, 2.71-13.8) and anxiety (OR = 2.83, 1.36-6.14). These results can inform clinicians in identifying patients at increased risk for Long COVID-related medical issues, particularly neurocognitive symptoms and symptom clusters, as well as informing health systems to manage operational expectations on a population-health level.

Aim: To evaluate the effect of a novel, co‐designed, digital AF educational program, 'INFORM‐AF', to reduce re‐hospitalisation of people with AF. The secondary aims are to examine the effect of the intervention on: (a) reducing cardiovascular‐related hospitalisation, (b) increasing medication adherence, AF‐related knowledge, and Atrial fibrillation (AF)‐related quality of life and (c) determining the cost‐effectiveness of the intervention. Background: AF is an increasingly prevalent cardiac arrythmia that involves complex clinical management. Comprehensive education is essential for successful self‐management of AF and is associated with positive health‐related outcomes. There has been an increase in technology‐based education for AF. However, its effects on hospitalisation, medication adherence and patient‐reported outcomes are unclear. Design: A prospective, randomised (1:1), open‐label, blinded‐endpoint, multicentre clinical trial. Methods: Eligible participants are aged 18 years or above, diagnosed with AF, and own a smartphone. The study will be conducted at two metropolitan hospitals. In the intervention group, participants will receive the AF educational program delivered via Qstream®. In the control group, participants will receive the Stroke Foundation 'Living with AF' booklet. The primary outcome is re‐hospitalisation within 12 months from an indexed presentation or hospital admission. Conclusion: This clinical trial is part of a developing program of work that will examine mHealth educational‐behavioural interventions on cardiovascular outcomes. Findings from this pilot study will inform the development of a digital educational framework for patients living with AF. Implications for the Profession and/or Patient Care: There remain many gaps in providing high‐quality patient education for patients with AF. This trial will test a new theory‐driven, smartphone‐based education program on important clinical outcomes, including rehospitalisation. Impact: This study evaluates a novel, co‐designed, digital AF educational program, 'INFORM‐AF', to reduce the re‐hospitalisation of people with AF.Study results are expected to be reported in 2025.Findings are expected to inform practice recommendations for AF patient education that may be included in future clinical practice guideline recommendations. Reporting Method: SPIRIT Checklist. Patient or Publication Contribution: JL is a consumer co‐researcher on the project and provided critical input into intervention design, and feedback and input across the study duration. [ABSTRACT FROM AUTHOR]