Search

Objective: The objective of the study is to assess the characteristics of iron deficiency (ID) in Indian patients with chronic heart failure (CHF). Materials and Methods: This was a prospective observational study involving in patients visiting the outpatient department and admitted to hospitals with a clinical diagnosis of CHF falling within the New York Heart Association (NYHA) classification (I–IV). ID was diagnosed based on hemoglobin (Hb), serum ferritin levels, serum iron, total iron-binding capacity, and transferrin saturation (TSAT) percentage. Absolute ID was diagnosed as ferritin level 20%). Anemia was defined as Hb

The first reported case of Coronavirus Disease 2019 (COVID-19) in Rwanda occurred on March 14 2020. By the end of July 2024, a total of 133,518 individuals had tested positive for the infection, resulting in 1,468 deaths and 132,039 had fully recovered. The success of COVID-19 elimination in Rwanda hinges on the public's level of acceptance of the COVID-19 vaccination. Although COVID-19 is no longer a pandemic anymore, the World Health Organisation recommends countries vaccinate their populations to protect them from COVID-19 and its variants. Globally, COVID-19 has affected 704,753,890 people, caused 7,010,681 deaths and 675,619,811 have recovered. This study aimed to assess the acceptability of COVID-19 vaccines among adults aged 18 years and above in Rwanda. A cross-sectional study was conducted from January to March 2022 to determine the associations between COVID-19 vaccine acceptance (VA) with respondents' characteristics, using logistic regression analysis. This study enrolled 2,126 respondents with a mean age of 31 years, the majority of whom were females (82.2%), 51.4% had completed primary education, and 78.7% were married. Most respondents recognized the importance of COVID-19 vaccination for both personal health and community well-being. The study found a high rate of COVID-19 vaccine acceptance, with 91.6% of respondents expressing VA and an overall VA rate of 98.2%. Having a relationship with the child(ren) was the only characteristic associated with COVID-19 vaccine acceptance (p; 3.2 × 10− 3, OR; 2.9, 95% C.I; 1.4–5.9). In conclusion, the study found a high rate of COVID-19 vaccine acceptance among adults in Rwanda, with COVID-19 associated with having a relationship with the child(ren). The study recommends the need for mass educational campaigns and awareness-raising efforts to understand of COVID-19 vaccines. [ABSTRACT FROM AUTHOR]

Background: Positive parent-teen and peer relationships are crucial support resources for adolescents with type 1 diabetes mellitus (T1DM). There is quite a bit of research on parent-teen relationships in Western countries, less so with peer relationships. Additionally, information on these relationships and their influencing factors among adolescents from other regions with different family culture and peer cohesion is limited, which impedes the development of targeted interventions. Methods: This study analyzed baseline data from a randomized controlled trial in China involving 122 adolescents with T1DM aged 12– 18 years. Data were collected using established questionnaires on social-demographic and clinical characteristics, perceived stress, general self-efficacy, coping styles, diabetes self-management, and parent-teen and peer relationships. Multivariate linear regression analysis was conducted to determine the associating factors of parent-teen relationships and peer relationships respectively. Results: The total score of the parent-teen relationships subscale was 11.02 ± 2.77, within a theoretical range of 4– 16. The total score of the peer relationships subscale was 16.51 ± 2.42, within a theoretical range of 5– 20. Positive coping styles, less negative coping styles, and more collaboration with parents in diabetes self-management were associated with better parent-teen relationships. Younger age, positive coping styles, less negative coping styles, and higher goals for diabetes self-management were associated with better peer relationships. Conclusion: There is room to improve parent-teen relationships, maybe via encouraging more collaboration between parents and adolescents for diabetes management. The coping styles training is indicated to improve both relationships. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is leading globally in 2020, with mortality being a concern in developing countries. Cancer registration can help in studying systematically collected data about breast cancer. The aim of this study is (1) to describe demographic aspects, stage at diagnosis, histological types, and treatment availed by evaluating the 2016 Hospital-Based Cancer Registry (HBCR) of a Tertiary Cancer Centre (TCC), (2) to study the relationship between sociodemographic factors, the stage of the disease, the time between diagnosis and registration at TCC and the treatment status. Methodology: The data of all breast cancer patients who registered at the institution in 2016 was included in the study. The variables in the HBCR core form were used as a baseline for collecting data from hospital records. Results: The number of patients registered in 2016 was 534. The mean age was 53.8 (SD 53.8 ± 12.11). Majority (59.2%) presented in the early stages. Seventy-two percent were from rural areas, and 59.5% had a middle school education and above. Our study found a significant association between education status, the stage of disease, and treatment status. Conclusion: Education level plays an important role in early presentation and treatment completion. Registry data analysis can be used as a guideline for understanding patterns and for formulating cancer control activities in the state. [ABSTRACT FROM AUTHOR]

Fungi infection, especially derived from Plasmopara viticola, causes severe grapevine economic losses worldwide. Despite the availability of chemical treatments, looking for eco-friendly ways to control Vitis vinifera infection is gaining much more attention. When a plant is infected, multiple disease-control molecular mechanisms are activated. PRRs (Pattern Recognition Receptors) and particularly RLKs (receptor-like kinases) take part in the first barrier of the immune system, and, as a consequence, the kinase signaling cascade is activated, resulting in an immune response. In this context, discovering new lectin-RLK (LecRLK) membrane-bounded proteins has emerged as a promising strategy. The genome-wide localization of potential LecRLKs involved in disease defense was reported in two grapevine varieties of great economic impact: Chardonnay and Pinot Noir. A total of 23 potential amino acid sequences were identified, exhibiting high-sequence homology and evolution related to tandem events. Based on the domain architecture, a carbohydrate specificity ligand assay was conducted with docking, revealing two sequences as candidates for specific Vitis vinifera–Plasmopara viticola host–pathogen interaction. This study confers a starting point for designing new effective antifungal treatments directed at LecRLK targets in Vitis vinifera. [ABSTRACT FROM AUTHOR]

The cohort consisted of 9400 exposed children diagnosed with ventricular septal defect (VSD). The risk of community-acquired pneumonia (CAP) or asthma with VSD was assessed using the Cox proportional hazard model with an inverse probability of treatment weighting. During a mean follow-up of 6.67 years (starting from 12 months after birth), there were 2100 CAP admission cases among exposed patients (incidence rate: 33.2 per 1000 person-years) and 20,109 CAP admission cases among unexposed children (incidence rate: 29.6 per 1000 person-years), with hazard ration of 1.09 (95% CI 1.04–1.14). [ABSTRACT FROM AUTHOR]

Antifibrinolytic drugs are used extensively for on-demand treatment of severe acute bleeding. Controlling fibrinolysis may also be an effective strategy to prevent or lessen chronic recurring bleeding in bleeding disorders such as hemophilia A (HA), but current antifibrinolytics have unfavorable pharmacokinetic profiles. Here, we developed a long-lasting antifibrinolytic using small interfering RNA (siRNA) targeting plasminogen packaged in clinically used lipid nanoparticles (LNPs) and tested it to determine whether reducing plasmin activity in animal models of HA could decrease bleeding frequency and severity. Treatment with the siRNA-carrying LNPs reduced circulating plasminogen and suppressed fibrinolysis in wild-type and HA mice and dogs. In HA mice, hemostatic efficacy depended on the injury model; plasminogen knockdown improved hemostasis after a saphenous vein injury but not tail vein transection injury, suggesting that saphenous vein injury is a murine bleeding model sensitive to the contribution of fibrinolysis. In dogs with HA, LNPs carrying siRNA targeting plasminogen were as effective at stabilizing clots as tranexamic acid, a clinical antifibrinolytic, and in a pilot study of two dogs with HA, the incidence of spontaneous or excess bleeding was reduced during 4 months of prolonged knockdown. Collectively, these data demonstrate that long-acting antifibrinolytic therapy can be achieved and that it provides hemostatic benefit in animal models of HA. Editor's summary: Patients with hemophilia A suffer from spontaneous and excessive bleeding that can be treated with antifibrinolytics, but the short half-life of such drugs limits their use to on-demand treatment. Here, Strilchuk and colleagues packaged small interfering RNAs against plasminogen into lipid nanoparticles, showing that a single dose could reduce circulating plasminogen and suppress fibrinolysis for several weeks in mice. Prophylactic treatment led to improved hemostasis after saphenous vein injury in a mouse model of hemophila A, and 4 months of plasminogen knockdown decreased spontaneous and excess bleeding events in two dogs with hemophilia A without evidence of severe toxicity, suggesting that this approach should be further studied in the context of hemophilia A and other diseases characterized by high fibrinolysis. —Melissa L. Norton [ABSTRACT FROM AUTHOR]

Soil health encompasses the effects the uppermost part of the land have on human wellbeing in a broad sense, because soil is where most food ultimately comes from, and because it more inconspicuously fulfils other ecological functions, as important as feeding, for our planet's welfare, which is ours. Viticulture exploits the soil's resources from which wine, its most valuable produce, boasts to obtain some of its unique quality traits, which are wrapped within the terroir concept. However, using conventional methods, viticulture also has harsh impacts on the soil, thus jeopardizing its sustainability. How long will the terroir expression remain unchanged as vineyard soil degradation goes on? While this question is difficult to answer because of the complex nature of terroirs, it is undeniable that conventional soil management practices in viticulture leave, in general, ample room for improvement, in their impact on vineyards as much as on the environment. In response, viticulture must adopt practices that enable the long-lasting preservation of its grounds for both on-farm and off-farm benefits. In this regard, the increase in the soil's organic matter alongside the enhancement of the soil's biological community are key because they benefit many other soil properties of a physical, chemical, and biological nature, thus determining the soil's healthy functioning, where the vines may thrive for a long time, whereas its surroundings remain minimally disturbed. In the present review, the importance of soil health as it relates to vineyards is discussed, the soil degradation factors and processes that threaten winegrowing areas are presented, successful soil-health enhancement practices are shown, and future research trends are identified for the benefit of researchers and stakeholders in this special agricultural industry. [ABSTRACT FROM AUTHOR]

Plasmopara viticola is a destructive oomycete that affects grapevines, causing significant economic losses worldwide. This study highlights how the plant Glechoma hederacea might be at the basis for the development of biofungicides to control P. viticola. The aqueous extract obtained from G. hederacea aerial parts showed strong inhibition activity against P. viticola, comparable to that of copper hydroxide. The bioguided purification of the extract by chromatographic techniques led to the isolation of six pure metabolites, identified as the aromatic compounds carvacrol, caffeic acid and methyl caffeate, the flavonoids cirsimaritin and apigenin and the polyphenolic acid rosmarinic acid by spectroscopic methods. This is the first report about the isolation of methyl caffeate and cirsimaritin from G. hederacea. Caffeic acid and methyl caffeate showed the highest disease severity reduction, while carvacrol, cirsimaritin and apigenin also showed moderate activity against P. viticola. The inhibitory activity of the aqueous extract could suggest synergetic or additive action of caffeic acid and methyl caffeate together with other compounds contained in the extract. This study provides insights into the potential of G. hederacea as an allelopathic tool for developing control methods against P. viticola, revealing the combined action of different metabolites involved in the mechanism of action of the active compounds. [ABSTRACT FROM AUTHOR]

The management of benign prostatic obstruction (BPO) should involve a treatment algorithm that takes into account prostate size, and patient's symptoms and preference with the aim of helping with urinary symptoms and enhance quality of life. The diagnostic assessment for men with lower urinary tract symptoms (LUTS) should be comprehensive to help choose the best management strategy. Strategies from lifestyle modifications to medical treatment with alpha blockers and/or 5-alpha-reductase inhibitors to surgical procedures can all be used in the management algorithm. Surgical management ranges from transurethral resection of prostate (TURP) to minimally invasive surgical therapies (MIST) including laser therapies such as Holmium laser enucleation (HoLEP) and photoselective vaporisation (PVP), aquablation, Rezūm system, prostate artery embolisation (PAE), prostatic urethral lift (PUL), temporary implantable nitinol device (iTind) and Optilume BPH catheter system. BPO is a common urological condition that has a significant impact on quality of life and economic burden globally and is likely to become increasingly prevalent with an ageing population. Selecting the most appropriate treatment modality will depend on the individual patient preferences, availability of resources, cost, anatomical factors and the goals of treatment. [ABSTRACT FROM AUTHOR]

Introduction: High HbA1c levels in type 1 diabetes (T1D) are associated with increased risk of micro- and macrovascular complications and severe diabetes distress. A more comprehensive understanding of the adult perspective of living with T1D can improve the quality of care. We aimed to describe experiences of living with T1D as an adult with prolonged elevated HbA1c. Methods: Thirteen adults with T1D and HbA1c > 60 mmol/mol (7.6%) for at least 1 year were individually interviewed via a digital platform. The interviews were transcribed verbatim and analyzed using qualitative content analysis. Results: The analysis identified an overarching theme, "a lifelong follower", and generated two main categories describing study participants' experience: constraining and manageable. Constraining experiences were explained in obligated control, loss of control, environmental impact, and consequences of diabetes. Manageable experiences were described in everyday life, approach to diabetes, and support in life. Diabetes knowledge in health care and in the general public, and individualized care were important factors in feeling understood, safe, and supported. Conclusions: The findings revealed the diverse experiences of adults with prolonged elevated HbA1c. Living with T1D, a lifelong non-chosen follower, could be perceived as constraining but manageable in different degrees. A person-centered care approach addressing both dimensions may be beneficial. Experiences of living with and managing diabetes are multifaceted and intertwined with life context and medical prerequisites. [ABSTRACT FROM AUTHOR]

Background: Breast aesthetics is becoming increasingly important in breast cancer surgery due to changes in patient expectations and greater emphasis been placed on the psychosocial outcomes. Studies have shown no difference in local recurrence risk between mastectomy and breast conserving surgery (BCS) and also a higher overall survival rate after BCS. Breast preservation improves the quality of life substantially compared to mastectomy. Oncoplastic breast-conserving surgery (O-BCS) involves tumour excision whilst overcoming the limitations of standard breast conserving surgery (S-BCS) by allowing larger resection volumes, avoiding deformities with better aesthetic results. Our study aims to compare the oncosurgical and aesthetic outcomes of O-BCS versus S-BCS among women in Sri Lanka. Methods: We conducted a retrospective study over a 4-year period including patients who underwent breast conservation surgery for primary non-metastatic breast cancer in two tertiary care units. We assessed outcomes in terms of re-excision rates, resection margin, complications and aesthetic outcomes using a Likert scale questionnaire to grade specific outcomes such as symmetry, volume, nipple position, scar visibility. Non-parametric tests were used for statistical analyses. Results: Fifty-four and seventy-three patients underwent S-BCS and O-BCS respectively. The median specimen volume and the maximum tumour diameter were significantly higher in O-BCS [160(range:65–220); 4.2(range: 1.2–5.2)] compared to S-BCS [65(range:45–86); 2.4(range: 1.0-2.6)]. The median closest tumour margin was 16 mm (range:4-25 mm) in O-BCS while 6 mm (range:<1 – 12 mm) in S-BCS (p = 0.01). Close (< 1 mm) and positive margins needing re-excision were seen mostly in S-BCS. Superior aesthetic outcomes with statistical significant difference were reported in the O-BCS compared to S-BCS group with better symmetry, volume, nipple position and scar visibility. The re-excision rates were significantly lower in O-BCS group. There was no significant difference in the operative time and complications while the aesthetic outcomes were significantly superior in OBCS. Conclusions: Overall, Level 2 perforator flap based reconstruction had superior aesthetic outcomes. O-BCS is safe and more aesthetically acceptable with no difference in oncological outcome and operative time. More consideration should be given to aesthetic parameters such as scar visibility, nipple position, breast volume and shape when considering the best surgical option for the patients. [ABSTRACT FROM AUTHOR]

Background: Among the most commonly known causes of hematospermia are infections in the genitourinary tract, but no study exists that has comprehensively investigated hematospermia in patients with acute epididymitis., Objectives: To assess the impact of hematospermia in patients with acute epididymitis and its association with clinical, microbiological, and semen parameters., Materials and Methods: Since May 2007, a total of 324 sexually active patients with acute epididymitis were recruited in a prospective cohort study. Patients received a comprehensive medical and sexual history, and clinical, sonographic, laboratory, and microbiological diagnostics. Antibiotic therapy was given according to European Association of Urology guidelines. Semen analysis was offered 14 days after the first presentation and initiation of therapy. Since 2013, a separate control group of 56 patients presenting with isolated hematospermia (= no other urogenital symptoms) was prospectively recruited, and differences between the groups were statistically evaluated., Results: Of 324 patients with acute epididymitis, 50 patients (15%) had self-reported hematospermia. This occurred with a median of 24 h before the onset of scrotal symptoms and was associated with significantly elevated prostate-specific antigen levels compared to 274 patients without hematospermia (3.1 vs. 1.8 ng/ml, p < 0.01). The two most common etiological pathogens were Escherichia coli and Chlamydia trachomatis, and the bacterial spectrum was comparable in both epididymitis subgroups (p = 0.859). Semen analysis at 14 days still showed hematospermia in 24% of patients associated with massive leukocytospermia. Compared to the hematospermia control group, the two epididymitis subgroups showed significantly increased inflammation markers (pH, leukocytes, and elastase), reduced sperm concentration, and reduced levels of alpha-glucosidase and zinc (always p < 0.01)., Discussion and Conclusion: In sexually active patients who develop acute epididymitis, self-reported hematospermia is evident in 15% of patients as early as one day before the onset of scrotal symptoms. Conversely, none of the 56 patients presenting with isolated hematospermia developed epididymitis within the next 4 weeks., (© 2023 The Authors. Andrology published by Wiley Periodicals LLC on behalf of American Society of Andrology and European Academy of Andrology.)

New tranexamic acid (TXA) complexes of ferric(III), cobalt(II), nickel(II), copper(II) and zirconium(IV) were synthesized and characterized by elemental analysis (CHN), conductimetric (Λ), magnetic susceptibility investigations (μeff), Fourier transform infrared (FT-IR), proton nuclear magnetic resonance ( 1 H-NMR), ultraviolet visible (UV-vis.), optical band gap energy (E g ) and thermal studies (TG/DTG and DTA). TXA complexes were established in 1 : 2 (metal: ligand) stoichiometric ratio according to CHN data. Based on FT-IR and 1 H-NMR data the disappeared of the carboxylic proton supported the deprotonating of TXA and linked to metal ions via the carboxylate group's oxygen atom as a bidentate ligand. UV-visible spectra and magnetic moment demonstrated that all chelates have geometric octahedral structures. E g values indicated that our complexes are more electro conductive. DTA revealed presence of water molecules in inner and outer spheres of the complexes. DTA results showed that endothermic and exothermic peaks were identified in the degradation mechanisms. The ligand and metal complexes were investigated for their antimicrobial and herbicidal efficacy. The Co(II) and Ni(II) complexes showed antimicrobial activity against some tested species. The obtained results showed a promising herbicidal effect of TXA ligand and its metal complexes particularly copper and zirconium against the three tested plants., (© 2024 Wiley-VHCA AG, Zurich, Switzerland.)

This study summarizes progress made in rolling out COVID-19 vaccinations in the African region in 2022, and analyzes factors associated with vaccination coverage. Data on vaccine uptake reported to the World Health Organization (WHO) Regional Office for Africa by Member States between January 2021 and December 2022, as well as publicly available health and socio-economic data, were used. A negative binomial regression was performed to analyze factors associated with vaccination coverage in 2022. As of the end of 2022, 308.1 million people had completed the primary vaccination series, representing 26.4% of the region's population, compared to 6.3% at the end of 2021. The percentage of health workers with complete primary series was 40.9%. Having carried out at least one high volume mass vaccination campaign in 2022 was associated with high vaccination coverage (β = 0.91, p < 0.0001), while higher WHO funding spent per person vaccinated in 2022 was correlated with lower vaccination coverage (β = −0.26, p < 0.03). All countries should expand efforts to integrate COVID-19 vaccinations into routine immunization and primary health care, and increase investment in vaccine demand generation during the transition period that follows the acute phase of the pandemic. [ABSTRACT FROM AUTHOR]

Since the emergence of the Coronavirus disease (COVID-19) pandemic, the disease has affected more than 675 million people worldwide, including more than 6.87 million deaths. To mitigate the effects of this pandemic, many countries established control measures to contain its spread. Their riposte was based on a combination of pharmaceutical (vaccination) and non-pharmaceutical (such as facemask wearing, social distancing, and quarantine) measures. In this way, cross-sectional research was conducted in Algeria from 23 December 2021 to 12 March 2022 to investigate the effectiveness of preventative interventions in lowering COVID-19 infection and severity. More specifically, we investigated the link between mask-wearing and infection on one side, and the relationship between vaccination and the risk of hospitalization on the other. For this purpose, we used binary logistic regression modeling that allows learning the role of mask-wearing and vaccination in a heterogeneous society with respect to compliance with barrier measures. This study determined that wearing a mask is equally important for people of all ages. Further, findings revealed that the risk of infection was 0.79 times lower among those who were using masks (odds ratio (OR) = 0.79; confidence interval (CI) 95% = 0.668–0.936; p-value = 0.006). At the same time, vaccination is a necessary preventive measure as the risk of hospitalization increases with age. Compared with those who did not get vaccinated, those who got vaccinated were 0.429 times less likely to end up in the hospital (OR = 0.429; CI95% = 0.273–0.676; p < 0.0001). The model performance demonstrates significant relationships between the dependent and independent variables, with the absence of over-dispersion in both studied models, such as the Akaike Information Criterion (AIC) scores. These findings emphasize the significance of preventative measures and immunization in the battle against the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Paediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS-TS) is a new disease in children and adolescents that occurs after often asymptomatic or mild COVID-19. It can be manifested by different clinical symptomatology and varying severity of disease based on multisystemic inflammation. The aim of this retrospective cohort trial was to describe the initial clinical presentation, diagnostics, therapy and clinical outcome of paediatric patients with a diagnosis of PIMS-TS admitted to one of the 3 PICUs. All paediatric patients who were admitted to the hospital with a diagnosis of paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) during the study period were enrolled in the study. A total of 180 patients were analysed. The most common symptoms upon admission were fever (81.6%, n = 147), rash (70.6%, n = 127), conjunctivitis (68.9%, n = 124) and abdominal pain (51.1%, n = 92). Acute respiratory failure occurred in 21.1% of patients (n = 38). Vasopressor support was used in 20.6% (n = 37) of cases. Overall, 96.7% of patients (n = 174) initially tested positive for SARS-CoV-2 IgG antibodies. Almost all patients received antibiotics during in-hospital stays. No patient died during the hospital stay or after 28 days of follow-up. Initial clinical presentation and organ system involvement of PIMS-TS including laboratory manifestations and treatment were identified in this trial. Early identification of PIMS-TS manifestation is essential for early treatment and proper management of patients. [ABSTRACT FROM AUTHOR]

Breast cancer is the most diagnosed cancer and the second leading cause of cancer death among women in the world. Compared to some other regions in the world, amount of information available about breast cancer epidemiology in the Kurdistan Region of Iraq is scarce. This study is an attempt to enrich our knowledge about different epidemiological aspects of breast cancer in the region since epidemiological studies contribute quite significantly to the current knowledge of environmental and genetic risk factors and to the current treatment strategies for breast cancer. In addition, studies has shown that the past and ongoing research has a massive implication in improving the outcome of this common disease. This work takes all women diagnosed with breast cancer at Nanakaly Hospital in Erbil, Iraq as sample of the study. Patient characteristics were captured then statistical analysis was performed on these data sets. The majority of patients were found to be city dwellers and about 46% were diagnosed at stage II and 40% at stage III. The vast majority of cases tested positive for hormone receptors but negative for HER2. [ABSTRACT FROM AUTHOR]

Background: Corticosteroids play a significant role in managing the vast majority of inflammatory and immunologic conditions. To date, population-based studies on knowledge and attitudes concerning corticosteroids are scarce. This study aims to comprehensively assess knowledge, perception, experience and phobia toward corticosteroid use among the general population in the era of COVID-19. Methods: A cross-sectional self-administrated questionnaire was used to collect the data from 6 countries. Knowledge and corticophobia scores, descriptive statistics and logistic regression were computed. Results: A total of 2354 participants were enrolled in this study; the majority were females (61.6%) with an average age of 30. Around 61.9% had been infected previously with COVID-19, and about one-third of the participants had experience with corticosteroid use. The mean knowledge score was relatively satisfactory (8.7 ± 4.5 out of 14), and Corticophobia ranked a high score in all countries. Age, female gender, and history of COVID-19 were positively correlated with developing corticophobia. Conclusion: Our study highlights that the general knowledge about steroids was satisfactory. However, the phobia toward its use upon indication is high. Therefore, enhancing awareness and providing essential counseling regarding the rational use of corticosteroids may reduce corticophobia. [ABSTRACT FROM AUTHOR]

Background and Aims. Grapevine is susceptible to several diseases and requires a large use of fungicides. Sustainable alternatives must be safe for humans and the environment and also should not interfere with must fermentation. The aim of this study was to implement the use of a rare sugar, tagatose, against powdery mildew and downy mildew and to assess possible side effects on Saccharomyces cerevisiae fermentation. Methods and Results. Tagatose was evaluated for the suppression of powdery mildew and downy mildew under controlled and field conditions and for its impact on S. cerevisiae fermentation of synthetic and grape musts. Tagatose applied at 8 kg/hareduced powdery mildew and downy mildew severity and incidence on grapevine leaves and bunches under field conditions. Tagatose caused a limited and transient slowdown of the fermentation with no negative impact on yeast viability and wine chemical composition at the end of the fermentation. Conclusions. Tagatose is a promising alternative for sustainable grapevine protection against powdery mildew and downy mildew with no negative impacts on the must fermentation. Significance of the Study. These findings pave the way for grapevine protection strategies based on the use of rare sugars as sustainable fungicides in integration with other plant protection products. [ABSTRACT FROM AUTHOR]

Purpose of Review: There is a notable lack of consistency in the measurement of psychosocial factors affecting youth with type 1 diabetes, resulting in a need for increased measurement standardization and establishment of measures tailored to capture unique experiences faced by youth. This review sought to assess 10 years of extant literature (2011 to 2020) to identify which established measurement tools are commonly used and to evaluate new measurement tools that were introduced during this period. Recent Findings: There are a variety of psychosocial factors affecting youth, and assessment of these measures has shown substantial variability. Our review found that most frequently cited scales were those pertaining to self-efficacy, diabetes distress, family conflict, autonomy, and fear of hypoglycemia. During our review period, experts developed and validated 21 new scales, the majority of which sought to evaluate areas pertaining to diabetes distress. Summary: Of the common scales and newly developed scales identified in this review, psychometric properties showcase high reliability and validity, and items are becoming increasingly specific to youth but still lack assessment of how youth perceive technology's impact on diabetes management. The field would benefit from measures employing more nuanced age specificity and addressing technology usage. [ABSTRACT FROM AUTHOR]

Simple Summary: Nearly all breast cancer patients survive for more than five years when the tumor is found early and in the localized stage. Regular clinical breast examinations, mammograms, and monthly self-exams of the breasts all contribute to early detection. However, late-stage breast cancers are common in many Asian countries. Low-income countries suffer from a lack of resources for breast cancer screening. High-income countries, on the other hand, are not benefiting fully from national breast screening programs due to an underutilization of the preventive healthcare services available. Existing reviews on Asian breast cancers are heavily focused on risk factors. The question of whether we should adopt or adapt the knowledge generated from non-Asian breast cancers would benefit from an extension into screening guidelines. In addition, several Asian countries are piloting studies that move away from the age-based screening paradigm. Close to half (45.4%) of the 2.3 million breast cancers (BC) diagnosed in 2020 were from Asia. While the burden of breast cancer has been examined at the level of broad geographic regions, literature on more in-depth coverage of the individual countries and subregions of the Asian continent is lacking. This narrative review examines the breast cancer burden in 47 Asian countries. Breast cancer screening guidelines and risk-based screening initiatives are discussed. [ABSTRACT FROM AUTHOR]

Wang et al. assessed the epidemiological impact of vaccination on COVID-19 in Hong Kong for the ancestral, Delta, and Omicron strains [[20]]. Our research mainly focuses on COVID-19, an urgent problem to solve in 2022 with the emergence of multiple SARS-CoV-2 variants that can escape human immunity elicited by previous infection or vaccination [[16]]. Infectious diseases, such as COVID-19 [[1]], influenza [[2]], dengue [[3]], and monkeypox [[4]], have caused significant burdens to population health and socioeconomic development in the world. 2022; 378: 90-94. 10.1126/science.add4507 16 Du Z., Hong H., Wang S., Ma L., Liu C., Bai Y., Adam D.C., Tian L., Wang L., Lau E.H.Y. Reproduction Number of the Omicron Variant Triples That of the Delta Variant. [Extracted from the article]

Copyright of Journal of Academic Research in Nursing (JAREN) is the property of Hemsirelikte Egitim ve Arastirma Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Mortality, morbidity, and organ failure are important and common serious harms after surgery. However, there are many candidate measures to describe these outcome domains. Definitions of these measures are highly variable, and validity is often unclear. As part of the International Standardised Endpoints in Perioperative Medicine (StEP) initiative, this study aimed to derive a set of standardised and valid measures of mortality, morbidity, and organ failure for use in perioperative clinical trials., Methods: Three domains of endpoints (mortality, morbidity, and organ failure) were explored through systematic literature review and a three-stage Delphi consensus process using methods consistently applied across the StEP initiative. Reliability, feasibility, and patient-centredness were assessed in round 3 of the consensus process., Results: A high level of consensus was achieved for two mortality time points, 30-day and 1-yr mortality, and these two measures are recommended. No organ failure endpoints achieved threshold criteria for consensus recommendation. The Clavien-Dindo classification of complications achieved threshold criteria for consensus in round 2 of the Delphi process but did not achieve the threshold criteria in round 3 where it scored equivalently to the Post Operative Morbidity Survey. Clavien-Dindo therefore received conditional endorsement as the most widely used measure. No composite measures of organ failure achieved an acceptable level of consensus., Conclusions: Both 30-day and 1-yr mortality measures are recommended. No measure is recommended for organ failure. One measure (Clavien-Dindo) is conditionally endorsed for postoperative morbidity, but our findings suggest that no single endpoint offers a reliable and valid measure to describe perioperative morbidity that is not dependent on the quality of deli-vered care. Further refinement of current measures, or development of novel measures, of postoperative morbidity might improve consensus in this area., (Copyright © 2023 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.)

This literature review considers the personal and practice implications of managing type 1 diabetes in adolescence. The review is part of a wider postgraduate study and critically considers 25 largely qualitative articles. It identifies two themes: 'social and emotional transition' and 'service-related transition'. Social and emotional transition relates to the experiences of adolescents diagnosed with type 1 diabetes, including increased risk of anxiety, depression and eating disorders. The service-related transition refers to this vulnerable group not fitting well into child or adult services and the added pressures of managing the move from one service to another. This includes the expectation of increased autonomy and problems of poor self-management. The review includes examples of positive practice largely grounded in improved personal and service transition. It considers the problems encountered and informs professionals about gaps in practice, encompassing the distinct difficulties adolescents with type 1 diabetes may experience. [ABSTRACT FROM AUTHOR]

Background: Outcome selection underpins clinical trial interpretation. Inconsistency in outcome selection and reporting hinders comparison of different trials' results, reducing the utility of research findings., Methods: We conducted an iterative consensus process to develop a set of Core Outcome Measures for Perioperative and Anaesthetic Care (COMPAC), following the established Core Outcome Measures for Effectiveness Trials (COMET) methodology. First, we undertook a systematic review of RCTs in high-impact journals to describe current outcome reporting trends. We then surveyed patients, carers, researchers, and perioperative clinicians about important outcomes after surgery. Finally, a purposive stakeholder sample participated in a modified Delphi process to develop a core outcome set for perioperative and anaesthesia trials., Results: Our systematic review revealed widespread inconsistency in outcome reporting, with variable or absent definitions, levels of detail, and temporal criteria. In the survey, almost all patients, carers, and clinicians rated clinical outcome measures critically important, but clinicians rated patient-centred outcomes less highly than patients and carers. The final core outcome set was: (i) mortality/survival (postoperative mortality, long-term survival); (ii) perioperative complications (major postoperative complications/adverse events; complications/adverse events causing permanent harm); (iii) resource use (length of hospital stay, unplanned readmission within 30 days); (iv) short-term recovery (discharge destination, level of dependence, or both); and (v) longer-term recovery (overall health-related quality of life)., Conclusions: This core set, incorporating important outcomes for both clinicians and patients, should guide outcome selection in future perioperative medicine or anaesthesia trials. Mapping these alongside standardised endpoint definitions will yield a comprehensive perioperative outcome framework., (Copyright © 2021 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.)

This literature review explores the perceptions and experiences of adolescents living with type 1 diabetes. The number of adolescents living with this condition is growing in Western societies. It is important to understand their views and experiences to ensure they receive optimum support. A systematic database search identified studies conducted between 2004 and 2014 undertaken in five countries. Most participants were aged 13-17 years, although some studies included participants aged 11-18 years. Key findings identified were: striving for autonomy; parental conflict; yearning for social acceptance; and concerns about diabetes education. Thematic analysis identified psychosocial, management, and knowledge of type 1 diabetes as the main themes. The review also identified that the psychosocial effects of living with type 1 diabetes were significant. Adolescents would benefit from more in-depth research on this subject and more innovative ways to help them cope better with their condition. [ABSTRACT FROM AUTHOR]

Background: Adverse cardiovascular events are a leading cause of perioperative morbidity and mortality. The definitions of perioperative cardiovascular adverse events are heterogeneous. As part of the international Standardized Endpoints in Perioperative Medicine initiative, this study aimed to find consensus amongst clinical trialists on a set of standardised and valid cardiovascular outcomes for use in future perioperative clinical trials., Methods: We identified currently used perioperative cardiovascular outcomes by a systematic review of the anaesthesia and perioperative medicine literature (PubMed/Ovid, Embase, and Cochrane Library). We performed a three-stage Delphi consensus-gaining process that involved 55 clinician researchers worldwide. Cardiovascular outcomes were first shortlisted and the most suitable definitions determined. These cardiovascular outcomes were then assessed for validity, reliability, feasibility, and clarity., Results: We identified 18 cardiovascular outcomes. Participation in the three Delphi rounds was 100% (n=19), 71% (n=55), and 89% (n=17), respectively. A final list of nine cardiovascular outcomes was elicited from the consensus: myocardial infarction, myocardial injury, cardiovascular death, non-fatal cardiac arrest, coronary revascularisation, major adverse cardiac events, pulmonary embolism, deep vein thrombosis, and atrial fibrillation. These nine cardiovascular outcomes were rated by the majority of experts as valid, reliable, feasible, and clearly defined., Conclusions: These nine consensus cardiovascular outcomes can be confidently used as endpoints in clinical trials designed to evaluate perioperative interventions with the goal of improving perioperative outcomes., (Copyright © 2020 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.)

Background: Perioperative infection and sepsis are of fundamental concern to perioperative clinicians. However, standardised endpoints are either poorly defined or not routinely implemented. The Standardised Endpoints in Perioperative Medicine (StEP) initiative was established to derive a set of standardised endpoints for use in perioperative clinical trials., Methods: We undertook a systematic review to identify measures of infection and sepsis used in the perioperative literature. A multi-round Delphi consensus process that included more than 60 clinician researchers was then used to refine a recommended list of outcome measures., Results: A literature search yielded 1857 titles of which 255 met inclusion criteria for endpoint extraction. A long list of endpoints, with definitions and timescales, was generated and those potentially relevant to infection and sepsis circulated to the theme subgroup and then the wider StEP-COMPAC working group, undergoing a three-stage Delphi process. The response rates for Delphi rounds 1, 3, and 3 were 89% (n=8), 67% (n=62), and 80% (n=8), respectively. A set of 13 endpoints including fever, surgical site, and organ-specific infections as defined by the US Centres for Disease Control and Sepsis-3 are proposed for future use., Conclusions: We defined a consensus list of standardised endpoints related to infection and sepsis for perioperative trials using an established and rigorous approach. Each endpoint was evaluated with respect to validity, reliability, feasibility, and patient centredness. One or more of these should be considered for inclusion in future perioperative clinical trials assessing infection, sepsis, or both, thereby permitting synthesis and comparison of future results., (Copyright © 2019 British Journal of Anaesthesia. All rights reserved.)

The reduction of copper-based plant-protection products with the final aim of phasing out has a high priority in European policy, as well as in organic agriculture. Our survey aims at providing an overview of the current use of these products in European organic agriculture and the need for alternatives to allow policymakers to develop strategies for a complete phasing out. Due to a lack of centralized databases on pesticide use, our survey combines expert knowledge on permitted and real copper use per crop and country, with statistics on organic area. In the 12 surveyed countries (Belgium, Bulgaria, Denmark, Estonia, France, Germany, Hungary, Italy, Norway, Spain, Switzerland, and the UK), we calculated that approximately 3258 t copper metal per year is consumed by organic agriculture, equaling to 52% of the permitted annual dosage. This amount is split between olives (1263 t y−1, 39%), grapevine (990 t y−1, 30%), and almonds (317 t y−1, 10%), followed by other crops with much smaller annual uses (<80 t y−1). In 56% of the allowed cases (countries × crops), farmers use less than half of the allowed amount, and in 27%, they use less than a quarter. At the time being, completely abandoning copper fungicides would lead to high yield losses in many crops. To successfully reduce or avoid copper use, all preventive strategies have to be fully implemented, breeding programs need to be intensified, and several affordable alternative products need to be brought to the market. [ABSTRACT FROM AUTHOR]

In organic viticulture, copper-based fungicides are commonly used to suppress Downy Mildew infection, caused by the oomycete Plasmopara viticola. However, the frequent and intensive use of such fungicides leads to accumulation of the heavy metal in soil and nearby waters with adverse effects on the ecosystem. Therefore, alternative, organic fungicides against Downy Mildew are urgently needed to reduce the copper load in vineyards. In this study, the use of Warburgia ugandensis Sprague (Family Canellacea) leaf and bark extracts as potential fungicides against Downy Mildew were evaluated. In vitro (microtiter) and in vivo (leaf discs, seedlings) tests were conducted, as well as field trials to determine the efficacy of the extracts against Downy Mildew. The results revealed an MIC100 of 500 µg/mL for the leaf extract and 5 µg/mL for the bark extract. Furthermore, experiments with leaf discs and seedlings demonstrated a strong protective effect of the extracts for up to 48 h under (semi-) controlled conditions. However, in field trials the efficacy of the extracts distinctly declined, regardless of the extracts' origin and concentration. [ABSTRACT FROM AUTHOR]

Background: Tranexamic acid reduces the risk of bleeding among patients undergoing cardiac surgery, but it is unclear whether this leads to improved outcomes. Furthermore, there are concerns that tranexamic acid may have prothrombotic and proconvulsant effects., Methods: In a trial with a 2-by-2 factorial design, we randomly assigned patients who were scheduled to undergo coronary-artery surgery and were at risk for perioperative complications to receive aspirin or placebo and tranexamic acid or placebo. The results of the tranexamic acid comparison are reported here. The primary outcome was a composite of death and thrombotic complications (nonfatal myocardial infarction, stroke, pulmonary embolism, renal failure, or bowel infarction) within 30 days after surgery., Results: Of the 4662 patients who were enrolled and provided consent, 4631 underwent surgery and had available outcomes data; 2311 were assigned to the tranexamic acid group and 2320 to the placebo group. A primary outcome event occurred in 386 patients (16.7%) in the tranexamic acid group and in 420 patients (18.1%) in the placebo group (relative risk, 0.92; 95% confidence interval, 0.81 to 1.05; P=0.22). The total number of units of blood products that were transfused during hospitalization was 4331 in the tranexamic acid group and 7994 in the placebo group (P<0.001). Major hemorrhage or cardiac tamponade leading to reoperation occurred in 1.4% of the patients in the tranexamic acid group and in 2.8% of the patients in the placebo group (P=0.001), and seizures occurred in 0.7% and 0.1%, respectively (P=0.002 by Fisher's exact test)., Conclusions: Among patients undergoing coronary-artery surgery, tranexamic acid was associated with a lower risk of bleeding than was placebo, without a higher risk of death or thrombotic complications within 30 days after surgery. Tranexamic acid was associated with a higher risk of postoperative seizures. (Funded by the Australian National Health and Medical Research Council and others; ATACAS Australia New Zealand Clinical Trials Registry number, ACTRN12605000557639 .).

Background: Most patients with coronary artery disease receive aspirin for primary or secondary prevention of myocardial infarction, stroke, and death. Aspirin poses a risk of bleeding in patients undergoing surgery, but it is unclear whether aspirin should be stopped before coronary artery surgery., Methods: We used a 2-by-2 factorial trial design to randomly assign patients who were scheduled to undergo coronary artery surgery and were at risk for perioperative complications to receive aspirin or placebo and tranexamic acid or placebo. The results of the aspirin trial are reported here. Patients were randomly assigned to receive 100 mg of aspirin or matched placebo preoperatively. The primary outcome was a composite of death and thrombotic complications (nonfatal myocardial infarction, stroke, pulmonary embolism, renal failure, or bowel infarction) within 30 days after surgery., Results: Among 5784 eligible patients, 2100 were enrolled; 1047 were randomly assigned to receive aspirin and 1053 to receive placebo. A primary outcome event occurred in 202 patients in the aspirin group (19.3%) and in 215 patients in the placebo group (20.4%) (relative risk, 0.94; 95% confidence interval, 0.80 to 1.12; P=0.55). Major hemorrhage leading to reoperation occurred in 1.8% of patients in the aspirin group and in 2.1% of patients in the placebo group (P=0.75), and cardiac tamponade occurred at rates of 1.1% and 0.4%, respectively (P=0.08)., Conclusions: Among patients undergoing coronary artery surgery, the administration of preoperative aspirin resulted in neither a lower risk of death or thrombotic complications nor a higher risk of bleeding than that with placebo. (Funded by the Australian National Health and Medical Research Council and others; Australia New Zealand Clinical Trials Registry number, ACTRN12605000557639.).