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Background: Recommendations within guidelines are developed by synthesising the best available evidence; when limited evidence is identified recommendations are generally based on informal consensus. However, there are potential biases in group decision making, and formal consensus methods may help reduce these., Methods: We conducted a case study using formal consensus, to develop one set of recommendations within the Neonatal Parenteral Nutrition guideline being produced for the National Institute for Health and Care Excellence. Statements were generated through identification of published guidelines on several topics relating to neonatal parenteral nutrition. Ten high quality guidelines were included, and 28 statements were generated; these statements were rated by the committee via two rounds of voting. The statements which resulted in agreement were then used to develop the recommendations., Results: The approach was systematic and provided transparency. Additionally, a number of lessons were learnt; including the value of selecting the appropriate topic, giving adequate time to the process, and ensuring methodologies are understood by the committee for their value and relevance., Conclusion: Formal consensus is a valuable option for use within guideline development when specific criteria are met. The approach provides transparent methodology, ensuring clarity on how recommendations are developed.

Background: In early 2020, COVID-19 pandemic has mobilized researchers in finding new remedies including repurposing of medicinal plant products focusing on direct-acting antiviral and host-directed therapies. In this study, we performed an in vitro investigation on the standardized Marantodes pumilum extract (SKF7®) focusing on anti-SARS-CoV-2 and anti-inflammatory activities. Methods: Anti-SARS-CoV-2 potential of the SKF7® was evaluated in SARS-CoV-2-infected Vero E6 cells and SARS-CoV-2-infected A549 cells by cytopathic effect-based assay and RT-qPCR, respectively. Target based assays were performed on the SKF7® against the S1-ACE2 interaction and 3CL protease activities. Anti-inflammatory activity of the SKF7® was evaluated by nitric oxide inhibitory and TLR2/TLR4 receptor blocker assays. Results: The SKF7® inhibited wild-type Wuhan (EC50 of 21.99 µg/mL) and omicron (EC50 of 16.29 µg/mL) SARS-CoV-2 infections in Vero-E6 cells. The SKF7® also inhibited the wild-type SARS-CoV-2 infection in A549 cells (EC50 value of 6.31 µg/mL). The SKF7® prominently inhibited 3CL protease activity. The SKF7® inhibited the LPS induced-TLR4 response with the EC50 of 16.19 µg/mL. Conclusions: In conclusion, our in vitro study highlighted anti-SARS-CoV-2 and anti-inflammatory potentials of the SKF7®. Future pre-clinical in vivo studies focusing on antiviral and immunomodulatory potentials of the SKF7® in affecting the COVID-19 pathogenesis are warranted. [ABSTRACT FROM AUTHOR]

Background: Pre-eclampsia is a syndrome that chiefly includes the development of new-onset hypertension and proteinuria after 20 weeks of pregnancy. Pre-eclampsia is one of the major causes of mortality and morbidity in Nepal. Hyperhomocysteinemia may be a cause of the endothelial dysfunction provoked by oxidative stress in pre-eclampsia. This study was designed to evaluate the association of homocysteine with Vitamin B12 and folate in patients with pre-eclampsia. Method: An observational cross sectional study was performed in the Gynecology and Obstetrics Department of TUTH involving seventy two subjects with pre-eclampsia. Blood pressure, urinary protein levels, serum homocysteine, Vitamin B12 and folate levels were compared in both mild and severe forms of pre-eclampsia. Concentration of Vitamin B12 and folate were measured using Vitros ECI and homocysteine was measured using CLIA. SPSS 23.0 was used to analyze the data. Tests were performed with Mann Whitney Test and Spearman's rank correlation test. A p-value < 0.05 was considered statistically significant. Results: This study showed no significant difference in age and weeks of gestation in both mild and severe forms of pre-eclampsia. Mean concentration of homocysteine was higher (13.1 ± 6.4 micromol/L) in severe Pre-eclampsia as compared to mild cases (7.6 ± 2.8 micromol/L). Mean concentration of folate was lower in severe cases (35.4 ± 24.1 micromol/L) when compared with mild cases of pre-eclampsia (57 ± 23.4 micromol/L). Conclusion: Homocysteine levels were increased in severe Pre-eclampsia when compared with mild pre-eclampsia and this finding can be used to predict and prevent complications in patients with pre-eclampsia. [ABSTRACT FROM AUTHOR]

Anthracnose is a fungal disease caused by Colletotrichum spp. that affects the avocado (Persea americana Mill.) crop and causes significant economic losses in the farming sector. To focus control measures, it is important to understand the spatial distribution and the dynamics followed by the disease under field conditions. The use of methods derived from spatial statistics facilitates this task. The aim of this study was to determine the spatial behavior of anthracnose in Persea americana Mill. cv. Hass in Donato Guerra, a municipality in the State of Mexico, Mexico, using a geostatistical and spatial analysis by distance indices. Four hundred trees were selected and georeferenced in the municipal area. In order to measure the incidence, 48 fruits were selected from every tree. Using these data, the experimental semivariogram was estimated, and adjustments were made to models that explain the spatial arrangement. Maps were created using ordinary kriging, and the infection area was estimated. The maps generated show the presence of aggregation centers and a spatial distribution mostly fitting Gaussian and exponential models, with ranges fluctuating between 12 and 56 m, indicating spatial association between data. Likewise, the greatest percentage of infected areas was 98 %, while the lowest was 45 %. Geostatistics enables a precise understanding of the distribution patterns of diseases such as anthracnose in avocado-growing areas of the State of Mexico, which facilitates the implementation of integrated management programs with greater effectiveness. [ABSTRACT FROM AUTHOR]

Objectives: Grading of Recommendations Assessment, Development and Evaluation (GRADE) is a system for rating the confidence in estimates of effect and grading guideline recommendations. It promotes evaluation of the quality of the evidence for each outcome and an assessment of balance between desirable and undesirable outcomes leading to a judgment about the strength of the recommendation. In 2007, the National Institute for Health and Clinical Excellence began introducing GRADE across its clinical guideline program to enable separation of judgments about the evidence quality from judgments about the strength of the recommendation., Study Design and Setting: We describe the process of implementing GRADE across guidelines., Results: Use of GRADE has been positively received by both technical staff and guideline development group members., Conclusion: A shift in thinking about confidence in the evidence was required leading to a more structured and transparent approach to decision making. Practical problems were also encountered; these have largely been resolved, but some areas require further work, including the application of imprecision and presenting results from analyses considering more than two alternative interventions. The use of GRADE for nonrandomized and diagnostic accuracy studies needs to be refined., (Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.)

Aims/hypothesis: The cost-effectiveness of eight strategies for screening for gestational diabetes (including no screening) was estimated with respect to the level of individual patient risk., Methods: Cost-utility analysis using a decision analytic model populated with efficacy evidence pooled from recent randomised controlled trials, from the funding perspective of the National Health Service in England and Wales. Seven screening strategies using various combinations of screening and diagnostic tests were tested in addition to no screening. The primary outcome measure was the incremental cost per quality-adjusted life-year (QALY) over a lifetime., Results: The strategy that has the greatest likelihood of being cost-effective is dependent on the risk of gestational diabetes mellitus for each individual woman. When gestational diabetes mellitus risk is <1% then the no screening/treatment strategy is cost-effective; where risk is between 1.0% and 4.2% fasting plasma glucose followed by OGTT is most likely to be cost-effective; and where risk is >4.2%, universal OGTT is most likely to be cost-effective. However, acceptability of the test alters the most cost-effective strategy., Conclusions/interpretation: Screening for gestational diabetes can be cost-effective. The best strategy is dependent on the underlying risk of each individual and the acceptability of the tests used. The current study suggests that if a woman's individual risk of gestational diabetes could be accurately predicted, then healthcare resource allocation could be improved by providing an individualised screening strategy.

BACKGROUND: A sulphur dioxide (SO(2)) episode occurred in the United Kingdom in 1998. The worst affected area was the city of Nottingham. METHODS: Emergency hospital admissions in Nottingham in the episode week were compared with those in the previous week. RESULTS: A statistically significant increase in admissions for all respiratory diseases occurred in the episode week (odds ratio (OR) = 1.40, 95 per cent confidence interval (CI) = 1.00-1.94). Ten of the 25 excess admissions were for asthma, although the excess for asthma alone was not statistically significant (OR = 1.90, 95 per cent CI = 0.87-4.15). CONCLUSIONS: The excess admissions for respiratory diseases could have been caused by exposure to SO(2), to other pollutants present in increased concentrations during the pollution episode, or by seasonal variations in the frequency of asthma symptoms, or prevailing weather conditions. This study shows how simple analyses of routinely collected health data can be used to assess public health impacts of pollution episodes. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) recently produced draft guidelines for safe recreational water environments. The microbiological standards proposed in the guidelines are expected to overestimate the degree of water quality required to provide given levels of public health protection. The WHO standards were obtained by means of a risk assessment which featured a dose-response model derived from a series of randomised controlled trials. The trials have many strengths but biases and problems with statistical analysis are likely to have led to over-estimation of the risks from bathing in the dose-response model. In addition, the WHO risk assessment failed to consider the effects of uncertainty and variability in risk estimates and sensitivity to model assumptions. Improved standards could be obtained by extending the risk assessment to examine these effects and by incorporating a suitably revised dose-response model.

This study investigated the combined effect in rat lungs of simultaneous exposure to chrysotile asbestos and N-nitrosoheptamethyleneimine (NHMI), with the objective of determining the potential for chrysotile to promote or otherwise enhance the pathological responses to this potent rodent lung carcinogen. Groups of 15 or 20 male and female animals were treated with 0, 3, or 10 mg kg(-1) NHMI subcutaneously, once a week for 10 wk, plus either clean air (control) or 50 mg m(-3) chrysotile by nose-only inhalation for 4 wk. A broad range of pulmonary metaplastic, hyperplastic, and neoplastic lesions was observed. Effects were more marked in male than in female animals. NHMI treatment increased the incidence of hyperplastic lesions, with apparent augmentation by chrysotile exposure (not statistically significant). Similarly, a "promoting" effect of chrysotile in the induction of lung tumors was observed, with all but 2 of the 11 primary tumors detected being in animals treated with both NHMI and asbestos. However, this apparent interaction was again not confirmable statistically, probably because of the low number of observed tumors (stemming from premature termination of the experiment). The study results are in line with those of similar previous studies, which found a higher incidence of hyperplastic and neoplastic changes in animals treated with both nitrosamine and asbestos than in those given nitrosamine alone. It is proposed that the method described (with minor modification) could be used to investigate either (1) the ability of other inhaled particles to augment NHMI carcinogenicity, or (2) the propensity of other chemical carcinogens to interact with asbestos in the production of pulmonary neoplasms.

Background and Aims: Healthcare workers (HCWs), which include surgeons, anaesthesiologists, nurses, technicians, and other non-medical staff working in the operation theatre (OT), change to surgical scrubs for providing designated services. This study was intended to investigate the association of moving in and out of OT to other hospital areas without changing scrubs and its impact on bacterial infection. Methods: After PROSPERO registration, we performed a systematic review to compare the occurrence of surgical site infections (SSIs) with or without the movement of HCWs outside OT. We searched PubMed, Scopus, and Cochrane Library using relevant keywords. RoB-2 and ROBINS-E tools were used to assess the risk of bias in randomised controlled trials (RCTs) and observational studies, respectively. Results: We identified six articles that fulfilled the inclusion criteria: three RCTs and three observational studies. A risk of bias assessment revealed an overall low bias in the RCTs and an overall high bias in the observational studies. The analysis revealed a comparable incidence of bacterial infection in terms of colony-forming units when scrubs when HCWs moved in and out of OT with the same scrubs. A meta-analysis was not performed due to heterogeneity in participants and the OT set-up, as well as fewer studies and sample size. Conclusion: The evidence is insufficient to suggest that wearing scrubs outside the OT could increase the incidence of SSI in surgical patients or transmit the organisms to patients, causing infection. The present review neither supports nor is against wearing surgical scrubs outside OT premises. [ABSTRACT FROM AUTHOR]

Introduction: Multiple pregnancies are much more common today than they were in the past. Twin pregnancies occur in about 4% of pregnancies in Africa. Adverse pregnancy outcome was more common in twin pregnancy than in singleton pregnancy. There is no pooled evidence on the burden and adverse pregnancy outcome of twin pregnancy in eastern Africa. Thus, this systematic review and meta-analysis were conducted to assess the prevalence and adverse pregnancy outcomes of twin pregnancies. Methods: This systematic review and meta-analysis covers published and unpublished studies searched from different databases (PubMed, CINAHL (EBSCO), EMBASE, DOAJ, Web of Sciences, MEDLINE, Cochrane Library, SCOPUS, Google Scholar, and Google search). Finally, 34 studies were included in this systematic review and meta-analysis. JBI checklist was used to assess the quality of included papers. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Data synthesis and statistical analysis were conducted using STATA Version 14 software. Heterogeneity and publication bias were assessed. A forest plot was used to present the pooled prevalence using the random effect model. Results: The prevalence of twin pregnancy in eastern Africa was 3% [95% CI: 2, 3]. The adverse pregnancy outcomes like neonatal intensive care unit admission (78%), low birth weight (44%), low APGAR score (33%), prematurity (32%), stillbirth (30%), neonatal mortality (12%) and maternal complications like hypertensive disorder of pregnancy (25%), postpartum hemorrhage (7%), Cesarean section (37%), premature rupture of membrane (12%) and maternal mortality are more common among twin pregnancy than singleton pregnancy. Conclusion: One in every 33 children born a twin in east Africa; admission to neonatal intensive care unit, low birth weight, low APGAR score, prematurity, stillbirth, neonatal mortality and maternal complications are its associated adverse birth outcomes. Since twin pregnancy is a high-risk pregnancy, special care is needed during pregnancy, labor and delivery to reduce adverse pregnancy outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Hungarian Medical Journal / Orvosi Hetilap is the property of Akademiai Kiado 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.)

Nature exhibits rapid evolution in response to human activities. When using natural resources for their own profit, humans should account for such responses. Stackelberg evolutionary games (SEG) offer a method for modeling interactions between a rational leader (humans) and evolutionary followers (nature). The followers evolve according to the principles of natural selection, and the leader tries to steer these inevitable responses in a desired direction. While the separate elements of this method, Stackelberg and evolutionary game theory, are well established, their joint realization in SEG theory is underdeveloped. Thus far, simple examples and formalisms of SEGs have considered models where the manager and evolving species have a scalar-valued controller and scalar-valued trait, respectively. Here we provide examples from cancer therapy, fisheries management, and pest control to illustrate extensions of SEG theory, where managers are attempting to control a Darwinian system. The models we develop and present highlight extensions of SEG theory to include vector-valued management strategies and vector-valued traits in the evolving species, and traits influencing different life-history stages of the species under management. Throughout we highlight the mathematical challenges that lie ahead. [ABSTRACT FROM AUTHOR]

Background: This objective of this study was to diagnose Obstructive Sleep Apnoea (OSA) in pregnant women using Questionnaire-based methods and to determine any association of Sleep-Disordered Breathing (SDB) with Hypertensive Disorder of Pregnancy (HDP). Additionally, the study aimed to identify factors associated with OSA. Methods: This case–control study was conducted in department of Obstetrics in tertiary care hospital in Delhi. We Identified SDB using Berlin Questionnaire and Modified Stop-Bang Questionnaire in 100 pregnant women with Hypertension and 100 normotensive controls. We compared the groups using appropriate statistical analysis. Results: The mean age of women with HDP (25.46 ± 4.38) was found to be slightly higher than controls (24.13 ± 3.89) (p value-0.02). Sleep apnoea as depicted by the presence of either high-risk STOP Bang or Berlin score was seen more often in hypertensive women in 45% as compared to controls in 8% (p value < 0.001). Higher pre-pregnancy weight (58.58 ± 9.77 vs. 53.0 ± 6.59), higher BMI (24.03 ± 5.89 vs. 20.68 ± 1.49), higher mean neck circumference (14.97 vs. 14.27 inches) weight gain more than 11 kg during pregnancy (55.6% vs. 38.2%) were the high-risk factors more commonly associated with SDB as seen in women with OSA in hypertensive women. On logistic regression analysis, the presence of OSA was singularly responsible for development of Hypertension (Odds Ratio–13.014, 95% CI 5.237–32.337) (p value < 0.001). Conclusion: Gestational hypertension appears to be strongly associated with the presence of obstructive sleep apnoea. The recognition and treatment of OSA during pregnancy may lead to improved outcomes. [ABSTRACT FROM AUTHOR]

Magnesium sulfate is used as prophylaxis and treatment of severe preeclampsia/eclampsia, albeit its safety and toxicity are a concern. We designed this study to estimate the incidence of critical hypermagnesemia in severely preeclamptic women under a magnesium sulfate regimen at 8 h following its administration and to identify the associated risk factors as the primary outcomes. Also, secondary outcomes were to compare baseline characteristics, laboratory findings, and maternal-neonatal complications stratified by the baseline serum magnesium (Mg2+) in those women, and to assess the degree of agreement between patellar reflex and serum Mg2+ concentration 8 h following magnesium sulfate administration. We conducted a retrospective study including severely preeclamptic women receiving magnesium sulfate from June 2016 to May 2021. We enrolled 429 women in the study. Two-hundred sixty-one (60.8%) of the included women developed critical hypermagnesemia. Preeclamptic women with high baseline serum Mg2+ concentration demonstrated significantly affected renal functions, hepatic transaminase activities, and low platelet count as well as more reported maternal complications compared to those with low baseline serum Mg2. Multivariable logistic regression revealed that a lower gestational age, a higher uric acid concentration, and a higher baseline serum Mg2+ concentration were independently associated with an increased risk of critical hypermagnesemia. The agreement between deep tendon reflex assessment and serum Mg2+ concentration was slight although not significant. The maternal-neonatal outcomes were non-significant in women with critical hypermagnesemia. More vigilant monitoring through assessment of both serum Mg2+ concentration and deep tendon reflex should be considered especially in high-risk women. [ABSTRACT FROM AUTHOR]

Guidelines advise ongoing follow-up of patients after hypertensive disorders of pregnancy (HDP) to assess cardiovascular risk and manage future patient-specific pregnancy conditions. However, there are limited tools available to monitor patients, with those available tending to be simple risk assessments that lack personalization. A promising approach could be the emerging artificial intelligence (AI)-based techniques, developed from big patient datasets to provide personalized recommendations for preventive advice. In this narrative review, we discuss the impact of integrating AI and big data analysis for personalized cardiovascular care, focusing on the management of HDP. The pathophysiological response of women to pregnancy varies, and deeper insight into each response can be gained through a deeper analysis of the medical history of pregnant women based on clinical records and imaging data. Further research is required to be able to implement AI for clinical cases using multi-modality and multi-organ assessment, and this could expand both knowledge on pregnancy-related disorders and personalized treatment planning. [ABSTRACT FROM AUTHOR]

Background: Development of accurate pest monitoring systems is essential for the establishment of integrated pest management strategies. Information about the pest behavior during the colonization process, as well as the sex and reproductive status of the colonizing population often are lacking and hinder their development. The cabbage stem flea beetle (CSFB, Psylliodes chrysocephala) can cause the complete destruction of oilseed rape crops (OSR, Brassica napus). In the present study, the colonization process of OSR fields by the CSFB was studied., Results: More individuals were caught on the outward facing side of the traps than the side of the trap facing towards the crop at the field border and catches were higher on the trapping units at the center of the field than at its border, suggesting that more beetles were entering than leaving the crop. Catches were higher on lower traps placed near to the crop than on those positioned further from the ground and also were higher during the day than late afternoon and night. The sex-ratio of individuals caught was skewed towards males and sexual maturity was acquired for females during the experiment. Integration of sampling data with local meteorological data showed that the catches correlated mostly with air temperature and relative humidity., Conclusion: This study provides new information about the dispersion of the CSFB in OSR fields during the colonization process, and highlights correlations between local meteorological factors and activity of the CSFB, and represent a new step towards implementing monitoring strategies against this pest. © 2023 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry., (© 2023 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.)

Background: Understanding the dynamics of pest immigration into an agroecosystem enables effective and timely management strategies. The pollen beetle (Brassicogethes aeneus) is a primary pest of the inflorescence stages of oilseed rape (Brassica napus). This study investigated the spatial and temporal dynamics of pollen beetle immigration into oilseed rape fields in Denmark and the UK using multiple methods, including optical sensors., Results: In all fields, pollen beetles were found to be aggregated and beetle density was related to plant growth stage, with more beetles occurring on plants after the budding stage than before inflorescence development. Optical sensors were the most efficient monitoring method, recording pollen beetles 2 and 4 days ahead of water traps and counts from plant scouting, respectively., Conclusion: Optical sensors are a promising tool for early warning of insect pest immigration. The aggregation pattern of pollen beetles post immigration could be used to precisely target control in oilseed rape crops. © 2023 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry., (© 2023 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.)

Background: Insect pest resistance to insecticides and societal pressure to reduce pesticide load has increased oilseed rape (OSR) farmers' motivation to protect and exploit parasitoids for pest control. However, parasitoid presence and parasitism must be made visible to influence farmers' spraying decisions. Parasitism of cabbage seed weevil (CSW) (Ceutorhynchus obstrictus (Marsham)) reduces damage to OSR immediately, making them a good case for demonstrating conservation biocontrol to farmers. We assessed the occurrence and activity of CSW parasitoids in 84 OSR fields over 2 years and identified the impact of associated local landscape factors., Results: Mean cabbage seed weevil infestation rates were 11% and 10% in 2020 and 2021, and parasitism rates were high in both years (75% and 74%, respectively). Temporal and spatial dynamics of OSR in the landscape surrounding the focal fields were important for both CSW and parasitoid numbers, suggesting a dilution effect for increasing OSR area since the previous year. A multimodel inference analysis showed that OSR-related factors were important predictors for both the infestation rate of CSW and the number of parasitoids. For parasitoids, protected nature areas and hedgerows were important. Parasitism rates were high and largely unaffected by landscape factors., Conclusion: CSW and its parasitoids respond similarly to interannual changes in the OSR resource; in addition, parasitoids benefit from uncropped areas in the surrounding landscape. The complexity of the pest and parasitoid response to landscape factors limits the prospect of designing landscapes for improved pest control by the parasitoids. Parasitoids of CSW may be present as local populations in agricultural landscapes with the potential for consistent and substantial parasitism. © 2023 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry., (© 2023 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.)

Copyright of Ecoscience (Ecoscience) is the property of Taylor & Francis Ltd 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.)

We studied the species diversity of mites in five blackberry orchards [Rubus ulmifolius Schott (Rosales:Rosaceae)], three using organic production techniques and two conventional. Samples (n = 40 per orchard) were taken monthly over a period of eight months and each sample was comprised of leaves, flowers and fruits. We collected 16,667 mites in total; 1,391 specimens were mounted for identification. We analysed the population dynamics of the most abundant species and determined their spatial distribution using Spatial Analysis by Distance Indices (SADIE). We recorded 11 species from seven taxonomic families. The most abundant species throughout the study were Tetranychus urticae Koch (Acari: Tetranychidae) and Diptacus rubuscolum Trinidad, Duarte & Navia (Acari: Diptilomiopidae). Two predatory mite species were present in both production systems: Typhlodromalus peregrinus Muma and Neoseiulus californicus McGregor (Acari: Phytoseiidae). There was no significant relationship between the population dynamics of D. rubuscolum or T. urticae and either precipitation or temperature. The distribution of both these phytophagous species was generally aggregated and uniform. Overall, species diversity was significantly greater in conventional compared with organic production orchards, whereas mite abundance was greater in organic orchards compared with conventional orchards. [ABSTRACT FROM AUTHOR]

Coronavirus Disease-19 (COVID-19) is a highly contagious infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The development of rapid antigen tests has contributed to easing the burden on healthcare and lifting restrictions by detecting infected individuals to help prevent further transmission of the virus. We developed a state-of-art rapid antigen testing system, named DIAGNOVIR, based on immune-fluorescence analysis, which can process and give the results in a minute. In our study, we assessed the performance of the DIAGNOVIR and compared the results with those of the qRT-PCR test. Our results demonstrated that the sensitivity and specificity of the DIAGNOVIR were 94% and 99.2%, respectively, with a 100% sensitivity and 96.97% specificity, among asymptomatic patients. In addition, DIAGNOVIR can detect SARS‑CoV‑2 with 100% sensitivity up to 5 days after symptom onset. We observed that the DIAGNOVIR Rapid Antigen Test's limit of detection (LoD) was not significantly affected by the SARS‑CoV‑2 variants including Wuhan, alpha (B1.1.7), beta (B.1.351), delta (B.1.617.2) and omicron (B.1.1.529) variants, and LoD was calculated as 8 × 102, 6.81 × 101.5, 3.2 × 101.5, 1 × 103, and 1 × 103.5 TCID50/mL, respectively. Our results indicated that DIAGNOVIR can detect all SARS-CoV-2 variants in just seconds with higher sensitivity and specificity lower testing costs and decreased turnover time. [ABSTRACT FROM AUTHOR]

Aims: Study in adults with T1D showed that delivery of insulin for pure-protein meals may not be obligatory. The aim of this study was to assess the effects of whey isolate protein drink consisting of 50 g/200 kcal from pure protein on postprandial glycemia (PPG) following with square-wave insulin bolus in comparison with no insulin strategy in T1D children on insulin pumps. Methods: This was a randomized, double-blind, cross-over study including 58 children with mean: age 14.62 ± 3.64 years. Participants were randomly assigned into two treatment orders: NB-SQ (no bolus on the first day) and SQ-NB (square-bolus on the first day). The primary outcome was PPG during a 5-h follow-up. The secondary outcome was the frequency of hypoglycemia and glycemic variability parameters. Results: PPG [mg/dl] since 150 min of the follow-up was significantly lower when square-wave bolus was delivered (group SQ vs NB); at 150, 180, 210, 240, 270, 300 min: 130.6 versus 154.5 (p = 0.009), 153.4 versus 124.9 (p = 0.004), 151.0 versus 118.7 (p = 0.003), 146.4 versus 114.2 (p = 0.002), 141.2 versus 107.7 (p = 0.001), 131.0 versus 105.1 (p = 0.005). We observed statistically significant difference in overall rate of hypoglycemia < 70 mg/dl between groups SQ versus NB: 6.8% versus 2.5% (p = 0.001). The overall rate of hypoglycemia below 54 mg/dl was < 1% (p = 0.452). Conclusions: A meal containing 50 g of pure protein may be consumed without additional insulin dose. An additional square-wave bolus may be beneficial in reducing PPG. To avoid hypoglycemia, lower insulin dose should be calculated for 100 kcal from protein than for individual insulin-to-carb ratio. [ABSTRACT FROM AUTHOR]

Purpose: To study the effect of increasing grades of hypertensive retinopathy (HTR) on neonatal outcomes among preeclamptic women and assess the various maternal risk factors for HTR. Methods: A prospective cohort study was conducted on 258 preeclamptic women. The systolic and diastolic blood pressure (SBP and DBP), liver, and renal function parameters were collected besides basic demographic details. Dilated fundus examination with the Keith–Wagner–Barker classification was used to grade HTR. Following delivery, neonatal outcomes were evaluated. Results: Of the 258 preeclamptic women recruited, 53.1% had preeclampsia (PE), and 46.9% had severe preeclampsia. With increasing grades of HTR, a significant association with low birth weight (LBW) (p = 0.012) and preterm gestational age (p = 0.002) was noted but not with the Appearance, Pulse, Grimace, Activity and Respiration (APGAR) score (p = 0.062). Also, it did not increase the risk of retinopathy of prematurity (ROP), with most babies, even those born to mothers with high grades of HTR, showing no evidence of ROP (p = 0.025). Among the maternal factors, increasing age (p = 0.016), SBP (p < 0.001), DBP (p < 0.001), serum creatinine (p = 0.035), alanine aminotransferase (p = 0.008), lower hemoglobin (Hb) (p = 0.009), lower platelet (p < 0.001), and severe PE (p < 0.001) have been found to significantly affect the grade of HTR. Conclusion: Higher grades of HTR in the preeclamptic mother are associated with preterm delivery and LBW of the neonates but neither affect the APGAR score nor pose the risk of developing ROP. [ABSTRACT FROM AUTHOR]

The cabbage seedpod weevil, Ceutorhynchus obstrictus (Marsham) (Coleoptera: Curculionidae), is an invasive pest infesting canola (Brassica napus L. and B. rapa L. (Brassicales: Brassicaceae)) crops in North America. Larval feeding causes significant damage leading to yield losses of 5–30%. Native to the Palearctic region, the species was accidentally introduced to North America over 90 yr ago, and now occupies most temperate regions of Canada and the United States. Currently, the species has been projected to continue its range expansion to potentially infest most canola producing regions in North America. Here, we review the taxonomic nomenclature, distribution, biology, pest status, and management of the cabbage seedpod weevil in North America with an emphasis on spring-planted canola crops in the Great Plains and highlight areas for future research to develop a comprehensive integrated pest management program against this debilitating pest. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore the association of maternal preconceptional folic acid (FA) supplementation with gestational age and preterm birth in twin pregnancies, and whether the association varies by chorionicity or conception mode., Methods: From November 2018 to December 2021, the information of FA supplementation and pregnancy outcomes were collected in twin pregnant women. The linear regression models and the logistic regression were used to test the association of preconceptional FA supplementation with gestational age at delivery and preterm birth and premature rupture of membranes (PROM)., Results: A total of 416 twin pregnancies were included. Compared with no use in twins, maternal preconceptional FA use was associated with a 0.385-week longer gestational age (95% CI 0.019-0.751) and lower risk of preterm birth < 36 weeks (adjusted OR 0.519; 95% CI 0.301-0.895) and PROM (adjusted OR 0.426; 95% CI 0.215-0.845). The protective effect on preterm birth < 36 weeks and PROM is similar whether taking FA supplements alone or multivitamins. However, the associations varied by chorionicity and conception mode of twins or compliance with supplementation. The positive associations between preconceptional FA use and gestational age only remained significant among twins via assisted reproductive technology or dichorionic diamniotic twins. Significant protective effects on preterm birth < 36 weeks and PROM were only found among women who took FA at least 4 times a week before conception., Conclusion: Maternal preconceptional FA supplementation was associated with longer gestation duration and lower risk of preterm birth < 36 weeks and PROM in twin pregnancies. To improve the success of their pregnancies, reproductive women should start taking FA supplements well before conception and with good compliance., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Background: Successful management of canine atopic dermatitis (cAD) is challenging and effective pet owner education is crucial to successful outcomes. However, there are limited proven educational strategies in this area. Our goal was to create an effective and engaging educational tool for owners of dogs with cAD., Hypothesis: Video-based education efficacy would be comparable to traditional verbal delivery. Secondary objectives included assessing client perception of the intervention, and determining if there were clinical benefits for the dogs and improved client adherence to treatment., Subjects: Twenty-nine dogs with cAD and their owners were recruited from a teaching hospital of a European veterinary medicine faculty., Materials and Methods: In this 8 week, prospective, randomised controlled study, clients in the control group (CG, n = 13) received verbal education and those in the intervention group (IG, n = 16) watched a video. Client knowledge was assessed at Day (D)0 and D56. Treatment adherence and perceived utility and appeal ratings were measured at D56. Clinical progress was assessed at D0 and D56 using CADESI-04 and PVAS10., Results: The differences found in the means of cAD knowledge score, clinical outcomes, utility and appeal ratings and owners' adherence score between groups were not statistically significant. A significant association between the outcome and the intervention group concerning education success [CG, six of 13 (46.15%); IG, 15 of 16 (93.75%)] was found (p = 0.01)., Conclusions and Clinical Relevance: Video-based instructions positively impacted owners' education and demonstrated their potential as a valuable tool. The authors believe that video-based education could be a time-efficient alternative for initial cAD education in veterinary clinics., (© 2023 ESVD and ACVD.)

Antibody-mediated central nervous system (CNS) disorders including those associated with aquaporin-4 or myelin oligodendrocyte glycoprotein IgG and autoimmune encephalitis often affect women of childbearing age. Pathogenic antibodies of these diseases can potentially alter reproductive functions and influence fetal development. Hormonal changes occurring during pregnancy may modify the course of autoimmune diseases by influencing relapse risk, attack severity, and affect the delivery and postpartum period. Moreover, balancing treatment related safety issues with the risk of potentially disabling relapses during pregnancy and breastfeeding are major challenges. Intentional prenatal, gestational, and post-partum counseling is paramount to address these issues and mitigate these risks. Fortunately, new insights on risk factors for adverse pregnancy outcomes and possible preventive strategies are emerging. This review aims to summarize the interplay between antibody-mediated CNS disorders and pregnancy during the prenatal, gestational, and postpartum periods, highlight current treatment recommendations, and discuss future areas of research. [ABSTRACT FROM AUTHOR]

Purpose of Review: The "fourth trimester" concept, defined as the first 12 weeks after delivery (and beyond), is a critical window of time for clinicians to intervene to optimize women's cardiovascular health after pregnancy. A timely and comprehensive postpartum cardiovascular assessment should be performed in all women following delivery in order to (1) follow up medical conditions present prior to conception, (2) evaluate symptoms and signs of common postpartum complications, and (3) identify risk factors and prevent future adverse cardiovascular outcomes. In this review, we aim to discuss major maternal cardiovascular risk factors such as hypertensive disorders of pregnancy, gestational diabetes mellitus, postpartum weight retention, and postpartum depression, as well as lactation as a potential protective risk modifying factor. Additionally, we will review effectiveness of outpatient interventions to enhance transitions in cardiovascular care during the fourth trimester. Recent Findings: A seamless hand-off from obstetric to primary care, and potentially cardiology, is needed for early detection and management of hypertension, weight, glycemic control, stress and mood, and long-term cardiovascular risk. Additionally, the use of telemedicine, blood pressure self-monitoring, remote activity monitoring, and behavioral health coaches are potentially feasible modalities to augment clinic-based care for cardiovascular risk factors and weight management, but additional studies are needed to study their long-term effectiveness. Summary: Development of a comprehensive postpartum care plan with careful consideration of each patient's risk profile and access to resources is critical to improve maternal morbidity and mortality, reduce health disparities, and achieve long-term cardiovascular health for women. Supporting postpartum well-being of women during this transition period requires a multidisciplinary approach, especially primary care engagement, and planning should start before delivery. [ABSTRACT FROM AUTHOR]

Low birth weight is one of the leading factors for infant morbidity and mortality. To a large extent affect, various maternal risk factors are associated with pregnancy outcomes by increasing odds of delivering an infant with low birth weight. Despite this association, understanding the maternal risk factors affecting term low birth weight has been a challenging task. To date, limited studies have been conducted in India that exert independent magnitude of these effects on term low birth weight. The aim of this review is to examine the current knowledge of maternal risk factors that contribute to term low birth weight in the Indian population. In order to identify the potentially relevant articles, an extensive literature search was conducted using PubMed, Goggle Scholar and IndMed databases (1993 - Dec 2020). Our results indicate that maternal age, educational status, socio-economic status, ethnicity, parity, pre-pregnancy weight, maternal stature, maternal body mass index, obstetric history, maternal anaemia, gestational weight gain, short pregnancy outcome, hypertension during pregnancy, infection, antepartum haemorrhage, tobacco consumption, maternal occupation, maternal psychological stress, alcohol consumption, antenatal care and mid-upper arm circumference have all independent effects on term low birth weight in the Indian population. Further, we argue that exploration for various other dimensions of maternal factors and underlying pathways can be useful for a better understanding of how it exerts independent association on term low birth weight in the Indian sub-continent. [ABSTRACT FROM AUTHOR]

Purpose of Review: We reviewed the effects of hypertension and the means to prevent and treat it across the spectrum of a woman's lifespan and identified gaps in sex-specific mechanisms contributing to hypertension in women that need to be addressed. Recent Findings: Hypertension continues to be an important public health problem for women across all life stages from adolescence through pregnancy, menopause, and older age. There remain racial, ethnic, and socioeconomic differences in hypertension rates not only overall but also between the sexes. Blood pressure cutoffs during pregnancy have not been updated to reflect the 2017 ACC/AHA changes due to a lack of data. Additionally, the mechanisms behind hypertension development in menopause, including sex hormones and genetic factors, are not well understood. Summary: In the setting of increasing inactivity and obesity, along with an aging population, hypertension rates are increasing in women. Screening and management of hypertension throughout a women's lifespan are necessary to reduce the burden of cardiovascular disease, and further research to understand sex-specific hypertension mechanisms is needed. [ABSTRACT FROM AUTHOR]

Appropriate paper-based technology (APT) is used to provide postural support for children with cerebral palsy (CP) in low-resourced settings. This pilot study aimed to evaluate the impact of APT on the children's and families' lives. A convenience sample of children with CP and their families participated. Inclusion was based on the Gross Motor Function Classification System levels IV and V. APT seating or standing frames were provided for six months. A mixed methods impact of APT devices on the children and families included the Family Impact Assistive Technology Scale for Adaptive Seating (FIATS-AS); the Child Engagement in Daily Life (CEDL) questionnaire; and a qualitative assessment from diary/log and semi-structured interviews. Ten children (median 3 years, range 9 months to 7 years). Baseline to follow-up median (IQR) FIATS-AS were: 22.7 (9.3) and 30.3 (10.2), respectively (p=.002). Similarly mean (SD) CEDL scores for "frequency" changed from 30.5 (13.2) to 42.08 (5.96) (p=.021) and children's enjoyment scores from 2.23 (0.93) to 2.91 (0.79) (p=.019). CEDL questionnaire for self-care was not discriminatory; seven families scored zero at both baseline and 6 months. Qualitative interviews revealed three key findings; that APT improved functional ability, involvement/interaction in daily-life situations, and a reduced family burden of care. APT devices used in Kenyan children with non-ambulant CP had a meaningful positive effect on both the children's and their families' lives. Assistive devices are often unobtainable for children with cerebral palsy (CP) in low-income countries. APT is a low cost and sustainable solution to make seating and standing devices for disabled children in Kenya. The regular use of a postural support device enhanced the children's motor skills, ability to function and participate in everyday activities, reduced the burden of care for the families and promoted the children's social interaction. The postural support devices were highly valued and utilised by the children and families in this study. [ABSTRACT FROM AUTHOR]