Adequate Quality Research Articles

VULNERABILITY AND PROTECTION OF THE WATER BODY "MODRAC"

Hydroaccumulation Modrac was built in 1964 to provide technological water for the needs of industry, and today it also has a water supply role for the drinking water of Tuzla and Lukavac. Given that wastewater is discharged into waterways mostly without any remedial treatment, the water body "Modrac" is therefore continuously exposed to contamination by various harmful and dangerous pollutants. Due to the complex geological and hydrogeological conditions in which the waters of the Modrac reservoir exist, as well as the great influence of anthropogenic pollution factors, the degree of vulnerability of these waters is significantly high. By defining the pollution cadastre, analyzing the degree of vulnerability, and assessing risk based on hazard and vulnerability, adequate prerequisites are created for the application of methods to protect the quality of these waters. This would ensure the preconditions for adequate protection of water quality, and improve the conditions for the use of these waters, especially in the sphere of water supply, given that these waters, along with previous treatment at the water factory in Cerik, are remedied and brought to the condition of drinking water, which must meet the regulations on the use of drinking water. Key words: vulnerability of water, water body, pollutants, polluting substances

On the potential of Ukrainian higher educational establishments to satisfy the demand in personnel for renewable energy development

Green energy is a key factor for achieving global sustainable development goals. Energy safety is the basic condition for any state to function and for any economy to grow. Moreover, stable supply of energy resources is a pre-requisite for supporting adequate life quality level for the population, which is the main function of a state. In this context, the problem of training specialists in green energy has become an object of an increasing research interest in many countries, including Ukraine. Ukraine has not been experiencing any specific problems with energy security since gaining independence in 1991, except for minor issues with natural gas supply. However, in autumn and winter of 2022, the necessity to reconstruct the Ukrainian energy safety system became specifically acute. The factor having caused the problem is of a man-made nature and was brought forth by the neighboring state’s military aggression. Russian military forces have been purposefully and methodically devastating the Ukrainian energy infrastructure with missile strikes over the past several months. Thanks to the technical and technological aid offered by partner countries and introducing emergency power outage schedules across the country, Ukrainian energy companies have managed to sustain the energy system in a relatively operational condition for three months by now. Nevertheless, we should envisage the future challenges and build a strategy for the post-war reconstruction of the Ukrainian energy system. Renewable energy sources have a colossal potential and may become a powerful force in the future development of Ukraine’s energy industry. However, in practice, the energy industry must be supplied with a sufficient number of highly professional specialists to realize this opportunity. On the example of Ukrainian HEIs, this article offers an example and a methodology for analysing higher educational establishments’ potential and preparedness to satisfy the predicted demand in personnel and to ensure sustainable development of the renewable energy market. Another finding of this research is the system of markers to measure the success of an educational programme in green energy which can be applied by educational institutions to build the programme enhancement strategy. Also, the authors define directions for perspective development of energy education in Ukraine.

Guidelines for the purification and characterization of extracellular vesicles of parasites

AbstractParasites are responsible for the most neglected tropical diseases, affecting over a billion people worldwide (WHO, 2015) and accounting for billions of cases a year and responsible for several millions of deaths. Research on extracellular vesicles (EVs) has increased in recent years and demonstrated that EVs shed by pathogenic parasites interact with host cells playing an important role in the parasite's survival, such as facilitation of infection, immunomodulation, parasite adaptation to the host environment and the transfer of drug resistance factors. Thus, EVs released by parasites mediate parasite‐parasite and parasite‐host intercellular communication. In addition, they are being explored as biomarkers of asymptomatic infections and disease prognosis after drug treatment. However, most current protocols used for the isolation, size determination, quantification and characterization of molecular cargo of EVs lack greater rigor, standardization, and adequate quality controls to certify the enrichment or purity of the ensuing bioproducts. We are now initiating major guidelines based on the evolution of collective knowledge in recent years. The main points covered in this position paper are methods for the isolation and molecular characterization of EVs obtained from parasite‐infected cell cultures, experimental animals, and patients. The guideline also includes a discussion of suggested protocols and functional assays in host cells

In-Vitro Assessment of Platelets Survival in Stored Platelet Concentrates in Ile-Ife, Nigeria

Introduction: Platelets are fragments of megakaryocytes circulating in the blood and its concentrates are therapeutic in substantial bleeding disorders. Efforts to ensure adequate product quality are required due to their short lifespan and lack of robustness. A descriptive longitudinal laboratory-based study was adopted in this study. The study aimed at determining platelets survival in stored platelet concentrates and evaluating thromboxane A2 for platelets function. Materials and Methods: Platelet concentrates were prepared manually using buffy coat, where about 50ml of concentrates suspended in plasma were allowed to rotate and agitate continuously on platelet agitator at room temperature (20-240C). Aliquots of 4ml each was collected serially for 9 days (day 0 to day 8) from 10 different platelet concentrates collected from 7 male blood donors and 3 female blood donors with age (mean± SD: 36 ± 7.14 years), weight (mean± SD: 66.8 ± 6.01kg), height (mean± SD: 163 ± 4.57cm). The samples were analyzed for platelets count, platelet distribution width (PDW), mean platelet volume (MPV), platelet-large cell ratio (P-LCR), using Automated Haematology analyzer (Sysmex XP-300) and thromboxane A2 using standard ELISA technique. Data analysis was carried out using mean, standard deviation as descriptive statistics and logistic regression as inferential statistics; and p <0.05 was considered as evidence of statistical significance. Results: Socio-demographic characteristics had no effect on all parameters estimated. There is variation in platelet count and platelet indices values in stored platelet concentrates compared with the baseline values and the survival of platelets in stored platelet concentrates was relatively stable till day 4 after preparation but depreciation surfaced from day 5 to day 8 compared to baseline values. The study also showed that the degree of deterioration of thromboxane A2 was highly significant at day 3 (p<0.05) while the best duration of storage for platelet concentrates in the study area is the first 3 days, though storage up to day 5 is acceptable (p>0.05). Conclusion: This study confirms thromboxane A2 as a marker for platelet functionality. The best duration of storage for platelet concentrates in the study area is the first two (2) days when no significant deterioration was observed.

Optimization of Tissue Handling and Processing in the Era of Precision Medicine: A Practical Recommendation from a Multidisciplinary Panel of Indian Experts

AbstractMolecular analysis of biospecimens is the key to diagnostic and therapeutic decisions in clinical practice. However, there is a lack of consolidated guidelines for biospecimen collection, tissue handling, and storage in India. Therefore, this study aims to generate expert recommendations for the optimization of tissue handling and processing practices in India in the era of precision medicine. This study aimed to evaluate the clinical gaps related to tissue handling for molecular analysis and develop expert recommendations to mitigate preanalytical issues associated with biospecimen processing. These expert recommendations will help in increasing the diagnostic yield and accuracy of biomarker testing in clinical practice. A virtual advisory board meeting was convened with 19 experts, including pathologists, molecular biologists, medical oncologists, surgical oncologists, interventional radiologists, and a senior histology technician from 10 hospitals in India, along with an accreditation officer for testing and calibration of laboratory procedures. The scientific coordinators developed specific questions to address the salient issues associated with the preanalytic phase of tissue specimen preparation. The experts discussed each question until a complete set of recommendations was obtained. The expert panel provided recommendations for tissue collection, processing, fixation, and block preparation to ensure high-quality biospecimens. As per the expert panel recommendations, tissue sampling can be performed from any easily accessible site, regardless of the primary or metastatic locations. In addition, the cold ischemia time should be <1 hour, 10% neutral-buffered formalin should be used as the fixative, isopropyl alcohol should be used as the dehydrating agent, the volume of tissue to fixative ratio should be 1:10, and all the paraffin blocks should be archived in dry, pest-free conditions at room temperature. The experts suggested that the formalin used for fixation should be freshly prepared and its pH should be checked daily; moreover, the pH and date of formalin preparation should be mentioned on the containers. The experts highlighted the need to educate multidisciplinary teams on the optimization of tissue handling practices and emphasized that a pathologist should always check the tissue for adequate quality and quantity for biomarker testing. The existing routine clinical procedures for collecting and handling biospecimens adversely affect their quality. The expert recommendations for preanalytical quality control would ensure high-quality biospecimens for molecular analysis and precision medicine.

Authentic Pathology Specimen Reception: A Valuable Resource for Developing Biomedical Science Student Competencies and Employability.

Background/Introduction: The pathology specimen reception is fundamental to the services provided by Biomedical Science laboratories worldwide. To ensure patient safety and that samples are of adequate quality to send for analysis, prospective Biomedical Scientists should have a robust knowledge of the processes involved and the acceptance criteria of the pathology specimen reception. This knowledge has been highlighted by employers as a current gap in Biomedical Science graduates and therefore needs to be addressed within higher education settings. To do this, this study aimed to 1) design a practical session to simulate the key processes of the pathology specimen reception and 2) to understand Biomedical Science students' opinions on these activities and the development of transferable skills required for post-graduate employment. Methods: The practical session was designed based on industrial requirements and academic knowledge of student skill sets to ensure suitability. Qualitative information regarding participant demographics and career interests was acquired through open-answer or multiple-choice questions. Quantitative student feedback was acquired via questionnaires utilising a 5-point Likert scale (n = 77). Results: The scenario-based practical session provided students with a positive learning experience with 98.7% of participants enjoying the session, with 87.0% stating they learned a lot by completing the session. It was also identified that participants preferred this style of learning to that of conventional higher education teaching modalities with 97.4% stating they would prefer simulated employment focussed scenarios embedded into the curriculum more often. The majority of participants also thought this session was helpful for the development of their key transferrable skills including teamworking, communication, and confidence. When stratified based on demographic data, there was minimal difference between cohorts and in the majority of cases, those participants from non-traditional university entry backgrounds had a more positive experience and better transferable skill development following the completion of this style of learning experience. Conclusion: This study highlights simulation-based learning as a tool to develop core Biomedical Science knowledge, build student graduate capital, and ensure the preparedness of students for post-graduation employment.

Association of Mediterranean Diet Adherence with Sociodemographic, Anthropometric, and Lifestyle Factors during the COVID-19 Pandemic: A Cross-Sectional Study in Greece.

The COVID-19 pandemic has negatively affected several aspects of people's lifestyle worldwide. Healthy dietary patterns and their bioactive components may improve or even co-treat the negative impacts of the COVID-19 pandemic in several aspects of people's lifestyle and mental health in daily life. The aim of this survey is to evaluate the potential effect of Mediterranean diet (MD) adherence against COVID-19-induced complications. This is a cross-sectional survey performed on 3721 adults aged between 18 and 65 years old, which aims to evaluate the potential association of MD adherence with multiple sociodemographic, anthropometric, and lifestyle factors during the COVID-19 pandemic period. This study has supported evidence that elevated MD compliance was independently related to female gender, better economic status, no smoking, increased risk of abdominal obesity, higher physical activity levels, greater prevalence of adequate sleep quality, better quality of life, and reduced probability of anxiety and depression during the COVID-19 pandemic by adjusting for multiple confounders. MD compliance may improve or even co-treat the negative impacts of the COVID-19 pandemic in several aspect of people's lifestyle in daily life. Further research is strongly recommended exploring the possible beneficial effects of the MD against COVID-19 lifestyle complications in daily life.

Medium-to-long term sustainability of a health systems intervention to improve service readiness and quality of non-communicable disease (NCD) patient care and experience at primary care settings in Uganda

BackgroundWith the double burden of rising chronic non-communicable diseases (NCDs) and persistent infectious diseases facing sub-Saharan Africa, integrated health service delivery strategies among resource-poor countries are needed.Our study explored the post-trial sustainability of a health system intervention to improve NCD care, introduced during a cluster randomised trial between 2013 and 2016 in Uganda, focusing on hypertension (HT) and type-2 diabetes mellitus (DM) services.In 2020, 19 of 38 primary care health facilities (HFs) that constituted the trial’s original intervention arm until 2016 and 3 of 6 referral HFs that also received the intervention then, were evaluated on i) their facility performance (FPS) through health worker knowledge, and service availability and readiness (SAR), and ii) the quality-of-patient-care-and-experience (QoCE) received.MethodsCross-sectional data from the original trial (2016) and our study (2020) were compared. FPS included a clinical knowledge test with 222 health workers: 131 (2016) and 91 (2020) and a five-element SAR assessment of all 22 HFs. QoCE assessment was performed among 420 patients: 88 (2016) and 332 (2020). Using a pair-matched approach, FPS and QoCE summary scores were compared. Linear and random effects Tobit regression models were also analysed.ResultsThe mean aggregate facility performance (FPS) in 2020 was lower than in 2016: 70.2 (95%CI = 66.0–74.5) vs. 74.8 (95%CI = 71.3–78.3) respectively, with no significant difference (p = 0.18). Mean scores declined in 4 of 5 SAR elements.Overall FPS was negatively affected by rural or urban HF location relative to peri-urban HFs (p < 0.01). FPS was not independently predicted but patient club functionality showed weak association (p = 0.09).QoCE declined slightly to 8.7 (95%CI = 8.4–91) in 2020 vs 9.5 (95%CI = 9.1–9.9) in 2016 (p = 0.02) while the proportion of patients receiving adequate quality care also declined slightly to 88.2% from 98.5% respectively, with no statistical difference (p = 0.20). Only the parent district weakly predicted QoCE (p = 0.05).ConclusionsFour years after the end of research-related support, overall facility performance had declined as expected because of the interrupted supplies and a decline in regular supervision. However, both service availability and readiness and quality of HT/DM care were surprisingly well preserved.Sustainability of an NCD intervention in similar settings may remain achievable despite the funding instability following a trial’s end but organisational measures to prepare for the post-trial phase should be taken early on in the intervention process.

Use of Digital Stethoscope to Measure Heart Rate in Birds: Comparison of Different Counting Methods Using Phonocardiograms.

The high cardiac contractility of birds poses a challenge to traditional cardiac auscultation, particularly for the accurate determination of heart rate (HR). The objectives of this study were to 1) evaluate the feasibility of using phonocardiograms of adequate length and quality to assess HR in different avian species with a commercially available digital stethoscope, 2) compare 5 counting methods, including 2 direct reading methods (manual counting and using a semiautomatic computerized algorithm as a reference method) and 3 listening methods (progressive mental counting, counting by 10s, and counting with a smartphone application tap counter), and 3) obtain the HR in selected birds and identify a correlation between body weight and HR in different avian species. An inverse correlation on a logarithmic scale was identified between the mean body weight and HR in 60 different bird species (n = 211; R = -0.72, P < 0.0001). Manual reading of phonocardiograms was the most reliable method and had the highest agreement with the reference method; this was followed by the counting by 10s method, the tapping method, and the progressive mental counting method, which was the least reliable. The agreement levels for the different methods were comparable for HRs <200 beats per minute (bpm) in birds weighing >1 kg. For HRs >500 bpm in birds weighing <150 g, only the reading method maintained a good agreement level. A digital stethoscope can be a useful tool for accurately determining the HR in birds, including very small species with high HRs.

Understanding the Knowledge, Attitudes, and Practices of Mothers/Caretakers Regarding Complementary Feeding in Children Aged 6 Months to 2 Years Attending the Pediatrics Outpatient Department at Ishaka Adventist Hospital

This research aimed to evaluate the knowledge, attitudes, and practices among mothers caring for children aged 6 months to 2 years regarding Complementary Feeding (CF). Conducted over a one-month period from October to November 2020, this descriptive cross-sectional study engaged 206 Mothers/caretakers attending Ishaka Adventist Hospital OPD for various child health concerns, including immunization and growth monitoring. Participants were selected randomly based on their arrival order at the hospital during the study period. Data collection involved researcher-administered questionnaires for illiterate participants and self-administered questionnaires for literate individuals after obtaining consent. Participants' comprehension and execution of complementary feeding practices were assessed through their responses. Data entry and analysis utilized EPI-DATA and STATA 17 software. Univariate analysis determined frequency, mean, mode, and percentage of participant responses, while bivariate analysis explored the relationship between knowledge and attitude, and between knowledge and practices among mothers/caretakers at Ishaka Adventist Hospital's pediatric OPD. Findings revealed that only 4% of participants were knowledgeable about the frequency of both Complementary Feeding (CF) and Breastfeeding (BF) for infants and the ideal diet composition. However, 63% were aware of the appropriate ages to initiate CF and stop BF, along with the consequences of delayed CF initiation. Although 85.5% commenced CF at the recommended age of six months, merely 4.3% provided adequate quantity and quality of complementary feeds to their infants. The study discovered statistically significant associations between proper/poor CF practices and respondents' age, education level, socio-economic status, and number of children in the household. Despite varied practices, participants generally exhibited positive and supportive attitudes toward CF. Keywords: Breast milk, Malnutrition, Immunization, Complementary Feeding, Babies.

Evidence Mapping and Quality Analysis of Systematic Reviews on Various Aspects Related to Cleft Lip and Palate.

Management of cleft lip and palate is interdisciplinary. An evidence-mapping approach was envisaged to highlight the existing gaps in this field, using only the highest level of evidence. To conduct evidence mapping and quality analysis of systematic reviews and meta-analyses related to any aspect of cleft lip and palate. The cleft lip and palate field was divided into 9 domains and 50 subdomains and a method of categorization of systematic reviews was established. A comprehensive search strategy was carried out in seven databases along with the search of gray literature and references of included articles. Systematic reviews related to any aspect of cleft lip and palate, conducted by a minimum of two reviewers, with a comprehensive search strategy and adequate quality analysis were included. A self-designed, pre-piloted data-extraction sheet was used to collect information that was analyzed through an expert group discussion. Quality analysis was performed using ROBIS-I, AMSTAR 2, and the PRISMA checklist. A total of 144 systematic reviews published between 2008 and 2022 were included. The largest number of these could be categorized in the therapeutic domain (n = 58). A total of 27% of the studies were categorized as inconclusive, 40% as partially conclusive, and 33% as conclusive. As per ROBIS-I, 77% of reviews had high risk of bias while 58% were graded as critically low in quality as per AMSTAR 2. The majority of systematic reviews showed low reporting errors. The majority of systematic reviews related to cleft lip and palate relate to therapeutic and prognostic domains and show high risk of bias and critically low quality regardless of the source journal. The results of this paper might serve as a starting point encouraging authors to carry out high-quality research where evidence is lacking. A multidisciplinary expert-group formulated an a priori protocol, registered in Open Science Framework (DOI 10.17605/OSF.IO/NQDV2).

Effectiveness of exercise on pain intensity and physical function in patients with knee and hip osteoarthritis: an umbrella and mapping review with meta-meta-analysis

Purpose The aim of this review was to provide a qualitative and quantitative overview of the effects of exercise on pain, physical function, and quality of life for patients with knee and hip osteoarthritis. Materials and methods This study was an umbrella and mapping review with meta-meta-analysis. Meta-analyses of randomized controlled trials were included. The methodological quality and risk of bias were evaluated using the Modified Quality Assessment Scale for Systematic Reviews and the Risk of Bias in Systematic Reviews tool. The quality of evidence was evaluated using the Physical Activity Guidelines Advisory Committee Grading Criteria. Results 41 meta-analyses were included, 43.9% of the studies had adequate methodological quality, and 56.1% of the studies had a low risk of bias. Moderate evidence was found that exercise decreases pain intensity (33 meta-analyses; SMD = −0.49; 95% CI −0.56 to −0.42), improves function (19 meta-analyses; SMD = −0.50; 95% CI −0.58 to −0.41), strength (6 meta-analyses; SMD = −0.57; 95% CI −0.70 to −0.44) and quality of life (SMD = −0.36; 95% CI −0.46 to −0.27) for patients with hip and knee osteoarthritis. Conclusion Exercise is an effective intervention to decrease pain intensity and improve function in patients with hip and knee osteoarthritis. (PROSPERO, CRD42020221987)

The Relationship Between Academic Performance and Physical Activity, Smart Phone Use and Sleep Quality in University Students

Objective: Our study was planned to examine the academic achievement, physical activity, smart phone use and sleep quality of university students. &#x0D; Methods: Young individuals between the ages of 18-25 studying at a vocational school were included in the study. While recording the demographic information of the participants, individuals were classified as "heavy users" and "light users", taking into account the duration of smartphone use during the day. In addition, the physical activity levels of the individuals were evaluated with the International Physical Activity Questionnaire-Short Form (IPAQ-SF), the smartphone usage level with the Smartphone Addiction Scale-Short Form (SAS-SF), and the sleep quality with the Pittsburg Sleep Quality Index (PSQI). &#x0D; Results: A total of 424 people, 326 of whom were women, with a mean age of 20.30±1.34 years, participated in the study. It was determined that 70.3% of the participants used smartphones for more than 4 hours a day. It was determined that there was a weak negative correlation between the academic success of the students and their physical activity levels, and that their academic success was not affected by smart phone use and sleep quality. However, it was determined that there was a weak positive correlation between the sleep quality of the students and their smartphone use. It was observed that the physical activity levels of male students were higher, while the academic success and sleep quality of normal education students were better. &#x0D; Conclusion: We think that active life, adequate and conscious smartphone use and quality sleep habits can affect academic success in university students.

Quantitative diffusion-weighted MRI response assessment in rhabdomyosarcoma: an international retrospective study on behalf of the European paediatric Soft tissue sarcoma Study Group Imaging Committee

ObjectiveTo investigate the feasibility of diffusion-weighted magnetic resonance imaging (DW-MRI) as a predictive imaging marker after neoadjuvant chemotherapy in patients with rhabdomyosarcoma.Material and methodsWe performed a multicenter retrospective study including pediatric, adolescent and young adult patients with rhabdomyosarcoma, Intergroup Rhabdomyosarcoma Study group III/IV, treated according to the European paediatric Soft tissue sarcoma Study Group (EpSSG) RMS2005 or MTS2008 studies. DW-MRI was performed according to institutional protocols. We performed two-dimensional single-slice tumor delineation. Areas of necrosis or hemorrhage were delineated to be excluded in the primary analysis. Mean, median and 5th and 95th apparent diffusion coefficient (ADC) were extracted.ResultsOf 134 included patients, 82 had measurable tumor at diagnosis and response and DW-MRI scans of adequate quality and were included in the analysis. Technical heterogeneity in scan acquisition protocols and scanners was observed. Mean ADC at diagnosis was 1.1 (95% confidence interval [CI]: 1.1–1.2) (all ADC expressed in * 10−3 mm2/s), versus 1.6 (1.5–1.6) at response assessment. The 5th percentile ADC was 0.8 (0.7–0.9) at diagnosis and 1.1 (1.0–1.2) at response. Absolute change in mean ADC after neoadjuvant chemotherapy was 0.4 (0.3–0.5). Exploratory analyses for association between ADC and clinical parameters showed a significant difference in mean ADC at diagnosis for alveolar versus embryonal histology. Landmark analysis at nine weeks after the date of diagnosis showed no significant association (hazard ratio 1.3 [0.6–3.2]) between the mean ADC change and event-free survival.ConclusionA significant change in the 5th percentile and the mean ADC after chemotherapy was observed. Strong heterogeneity was identified in DW-MRI acquisition protocols between centers and in individual patients.Graphical

Numerical investigation of indoor thermal comfort and air quality for an office equipped with corner impinging jet ventilation

ABSTRACT This study investigates the feasibility of using only corner impinging jet ventilation (CIJV) for heating and cooling a medium-sized office space with two occupants while maintaining adequate indoor thermal comfort and air quality compared to traditional mixing ventilation systems. This study examines what impact various outdoor temperatures, ranging from −15°C to 25°C, have on an office environment in terms of indoor thermal comfort and air quality. Three different workspace positions were evaluated. The results show that the CIJV system meets the ASHRAE thermal comfort standards for all three positions. In terms of indoor air quality, CIJV performs better than traditional mixing systems, with improved mean age of air and ACE values. This study concludes that CIJV can be used both close and far away from the supply inlets and still provide adequate indoor thermal comfort and air quality during both cooling and heating season.

Chlormethiazole as a hypnotic in elderly patients: A systematic review and meta-analysis.

The study objective was to estimate the efficacy and safety of chlormethiazole in older adults experiencing insomnia (sleep disorder). We therefore systematically searched Medline, Scopus, the Cochrane Library, PsycINFO, Ovid, ZB MED and PMC through December 2021 for randomized-controlled trials including patients > 60 years old with insomnia treated with chlormethiazole. Standardized mean differences or odds ratios with 95% confidence intervals were calculated for the main outcome parameters: sleep duration, onset of sleep, quality of sleep, adverse events or drop-out rates compared with placebo and other drugs. Risk of bias was assessed using the Cochrane tool. Eight randomized-controlled trials with 424 patients were included. Chlormethiazole significantly increased the duration of sleep when compared with placebo (standardized mean difference = 0.61; 95% confidence interval = 0.11-1.11; p = 0.02). More patients receiving chlormethiazole had adequate quality of sleep than those receiving other drugs (odds ratio = 1.44; 95% confidence interval = 1.04-1.98; p = 0.03). No differences were found regarding the onset of sleep (standardized mean difference = 1.07; 95% confidence interval = 0.79-1.46; p = 0.65). Drop-out rates were significantly lower under chlormethiazole treatment when compared with other drugs (odds ratio = 0.51; 95% confidence interval = 0.26-0.99; p = 0.05) and did not differ from placebo treatment (odds ratio = 1.37; 95% confidence interval = 0.23-8.21; p = 0.73). Side-effects such as "hangover" and daytime drowsiness occurred less frequently during chlormethiazole treatment compared with other drugs in three out of four studies, but differences were not significant (odds ratio = 0.24; 95% confidence interval = 0.04-1.48; p = 0.12). In conclusion, chlormethiazole showed significant effects on the duration and the quality of sleep with better tolerability if compared with other drugs in older adults with insomnia.

Defining optimal thresholds for digital Brix refractometry to determine IgG concentration in ewe colostrum and lamb serum in Scottish lowland sheep flocks.

This research aimed to define thresholds for ewe colostrum and lamb serum Brix refractometer measurements in lowland Scottish sheep. This would facilitate the use of this convenient, sheep-side test, enabling quick and accurate identification of poor quality colostrum and prevention of failure of transfer of passive immunity (FTPI) in lambs. Secondary aims were to identify risk factors for poor colostrum quality and FTPI in lambs. Serum samples (n=233) were collected from lambs between 24 and 48hrs after birth, from four lowland Scottish meat sheep farms. Pre-suckle colostrum samples (n=112) were also collected from ewes on two of these farms. Farmers provided information on litter size, ewe body condition score, ewe breed and dystocia. Duplicate digital Brix refractometer measurements were compared with immunoglobulin G (IgG) radial immunodiffusion (RID) testing for all colostrum and serum samples. Receiver operating characteristic (ROC) curves were used to redefine thresholds for Brix testing in colostrum and serum. Linear regression models were constructed with colostrum and serum IgG concentration as the outcomes of interest. Colostrum and serum IgG concentrations were highly variable. The prevalence of inadequate colostrum quality (using <50g/L IgG on RID) was 4.5% (95% CI = 1.5 - 10.1) and the prevalence of FTPI (using <15g/L IgG in serum on RID) was 7.73% (95% CI = 4.64-11.93). A ewe's colostrum IgG concentration was significantly and positively associated with the serum IgG concentration of her lamb(s) (p=0.02). ROC analysis defined a Brix threshold for adequate colostrum quality of >22.10% (sensitivity 80% (95%CI=28.4-99.5), specificity 90% (95%CI=82.3-94.8)). ROC analysis defined a Brix threshold for serum of >8.65% for adequate passive transfer of immunity in Scottish lambs (sensitivity 94% (95%CI=72.7-99.8), specificity 82% (95%CI=76.6-87.2)). To optimise passive transfer of immunity in lambs, we suggest that ewe colostrum Brix measurements be defined as 'poor' (<22%); 'fair' (22-26%) and 'good' (>26%); and lamb serum as 'poor' (<8%); 'fair' (8-9%) and 'good' (>9%). It is recommended that these tests are used as for flock screening, using samples from multiple animals.

Long-term field evaluation of Pera sweet orange selections under the Brazilian humid subtropical climate

Currently, a low number of citrus varieties are commercially planted to supply the Brazilian citrus industry demand. The diversification of citrus scion and rootstock varieties is an important strategy to prevent disease outbreaks and to obtain higher off-season profits, as well as to extend fruit supply for the citrus processing industry. The aim of this study was to evaluate 16 Pera sweet orange selections (Citrus ×sinensis Osbeck) under a humid subtropical climate in the northwest region of the state of Paraná, Brazil regarding tree development, production, and disease incidence. The experimental orchard was planted in December 2012 in a randomized block design with three replications and five trees per plot. All scions were grafted on Rangpur lime rootstock (C. ×limonia Osbeck). The evaluations were performed from 2016 through 2022, and included vegetative growth, yield, fruit quality, estimated tree density and productivity for new plantings, and incidence of diseases as citrus canker, huanglongbing (HLB), and citrus tristeza virus (CTV). All data was submitted to ANOVA and means grouped by the Scott Knott’s test (p ≤ 0.05). Pera Perão was the most vigorous variety, with the heaviest and largest fruit, and was among the selections with the highest content of soluble solids (SS), titratable acidity (TA) and juice. However, this variety showed a light-yellow juice color, and one of the lowest SS·TA−1 ratio. This selection had the lowest percentage of fruits with citrus canker but was among the selections with the highest HLB incidence. The selections Ovale, Clone 9, and Clone 42 also showed higher vegetative growth and fruit length, but lower SS content, juice yield and technological indices. All other Pera selections had lower tree height and canopy volume than Ovale, Clone 9, and Clone 42, and adequate overall fruit quality. Conversely, Pera Comprida, Dibbern, Morretes, and Seleç ão 12 scored lower cumulative fruit yield. Pera Pirangi and Comprida had the highest citrus canker incidence on fruits, while Morretes, Ovo, Pirangi, Seleç ão 12, and Seleç ão 27 had the highest HLB incidence alongside Perão. Low severity level of stem pitting was observed within the evaluated selections. The scores ranged from one (absence of stem pitting) to two (sparse surface stem pitting). IAC, Olímpia, Mel, Bianchi, and IPR 159 revealed to be the most suitable for new plantings under humid subtropical edaphoclimatic conditions, as trees had small vegetative growth, high yield performance and fruit quality, in addition to showing lower incidences of citrus canker, HLB and CTV.

Nocturnal Polysomnography without Technical Supervision in the Diagnosis of Respiratory Sleep Disorders, Diagnostic Performance of Home and Sleep Laboratory Studies.

Introduction Unattended Polysomnography (type 2 PSG) is a procedure for the diagnosis of sleep-disordered breathing (SDB). Published evidence on its performance and efficacy is limited. Available studies reveal a high rate of lost records that could limit its application. Objective To assess the efficacy of type 2 PSG and the rate of studies that must be repeated due to critical loss of signals. Methods prospective, descriptive study. Adult patients with suspected SDB were included. Unattended PSG was performed using portable equipment. 75 patients were connected at home and another 75 in the laboratory, without subsequent monitoring. Records were evaluated to determine the percentage of the night with adequate quality for each of the signals, considered as an evaluable signal for = 70% of the total recording time (TRT). The need to repeat the studies was also estimated. Results: 150 patients were recruited; 44% women; age 57.3 ± 15.4 years; BMI 29.4 ± 6.5. EEG and EOG signals were adequate in 149 records. Flow signal by pressure cannula was adequate in 146 and by thermistor in 67.8%. In only one study the signal of both effort bands were inadequate. Oximetry was lost in 4 cases. Ten tracings (6%) met the criteria for repetition; 8 hospital and 2 home. Conclusions Acceptable records were obtained in most unattended PSG studies, both at home and in the sleep laboratory. The rate of repetition of studies due to loss of signal was 6%, with failure in SaO2 or in flow signals being the main cause of the indication.

Advantages of Dynamic Navigation in Prosthetic Implant Treatment in Terms of the Clinical Evaluation and Salivary Pro-Inflammatory Biomarkers: A Clinical Study

Successful implantation in augmented areas relies on adequate bone density and quality, along with thorough planning. The minimisation of the risks involved in the surgery and recovery phases is also of tremendous relevance. The aims of the present research were to clinically and biochemically evaluate the healing process after implant surgery (dental implants) using dynamic surgical navigation following prior bone augmentation. Thirty healthy patients who had implant treatment were analysed. The study participants (30 patients) were randomised between two groups. The 15 patients in the study group were treated with Navident dynamic navigation by using a flapless technique. The control group included 15 subjects in whom the implantation procedure was performed classically using the elevation flap full-thickness method. In all cases, the patient’s clinical condition, the patient’s subjective visual assessment of post-operative pain using the Visual Analogue Scale (VAS), and the levels of the salivary biomarkers interleukin 6 (IL 6) and C-reactive protein (CRP) immediately before surgery on the first post-operative day and on the seventh post-operative day were assessed. The healing process was shown to be faster in patients in the study group due to the low invasiveness of the treatment, which was confirmed by lower levels of pro-inflammatory cytokines in the study group versus the control group. The statistical analysis used Student’s t-test and Mann–Whitney test. The implementation of dynamic navigation and the application of the flapless technique reduced post-operative trauma, leading to a reduced risk of infection, reduced patient discomfort, and faster recovery.