Early Period Research Articles

Physical functional recovery in the early period after hospitalization for COVID-19: impact of hypertension and outcome prediction model

The aim – to study the influence of hypertension (HT) on the dynamics of natural recovery of physical functional status in the early period after hospitalization for COVID-19 and to develop a model for predicting recovery results at 1 month after discharge.Materials and methods. 221 hospitalized patients with COVID-19 (age 53.4±13.6 years, 53 % women) were included in the study, 176 of whom underwent the 6-minute walk test (6MWT) using an extended protocol within 1-2 days before discharge. A repeat visit to assess the dynamics of natural recovery was performed at 1 month after discharge.Results and discussion. Pre-discharge 6-minute walk distance was 378±57 m in patients with HT and 418±75 m without it, p=0.001, during the second visit – 440±52 versus 478±68, p=0.002; the achieved percentage of the individually predicted distance was 67.4±10.5 vs. 69.5±13.6 % and 81.6±9.9 vs. 81.9±15.7 %, respectively, p>0.05 for both visits. The increase in heart rate during the test at visit 1 was 18.5±8.3 versus 30.1±19.3 bpm, p<0.001, the percentage of chronotropic reserve utilizatoin was 21.3±9.6 % versus 29.2±11.4 %, p<0.001. During the second visit, residual manifestations of this trend were observed, with an increase in HR by 24.0±9.5 vs. 30.8±12.1, p=0.003 and the use of chronotropic reserve of 28.1±10.1 % vs. 33.4±12.4 %, respectively, p=0.029. The developed multivariate linear regression model explained 59 % of the variability in the achieved percentage of the individually predicted 6-minute walk distance at 1 month after discharge. The use of machine learning allowed to create an artificial neural network based regression model that used age, height, use of remdesivir in treatment, and SBP and DBP values at the time of discharge as predictors, and explained 90 % of observed variability.Conclusions. Hospitalized patients with COVID-19 were characterized by a decrease in the general physical functional status as assessed by 6MWT at the time of discharge and incomplete recovery after 1 month. Presence of hypertension was associated with more pronounced disturbances of the autonomic regulation of heart rate, but did not affect the reached percentage of the distance walked. The proposed artificial neural network based regression model allows for a high accuracy prediction of the 6MWT results at 1 month after discharge, which can be used in the selection of candidates for cardiopulmonary rehabilitation programs.

Evaluation of Analgesic Nociceptive Index in intraoperative and postoperative pain management in general anesthesia applied with two different methods

Aim: Effectiveness of analgesic nociceptive index (ANI) monitoring in predicting both intraoperative and postoperative early pain in neurosurgery patients undergoing lumbar spinal surgery. The patients were administered general anesthesia using different anesthesia management techniques.Method: The study included a total of 60 patients with American Society of Anesthesiologist (ASA) I-III. The patients were randomly divided into two groups of 30 each using the closed envelope method. Group T received total intravenous anesthesia (TIVA) with remifentanil-propofol, while Group D with desflurane-remifentanil. Non-invasive ANI monitoring was applied to patients undergoing lumbar spinal surgery, and ANI, heart rate, systolic/diastolic arterial pressure values were recorded before and after induction, skin incision, major muscle incision, laminectomy, right-left fasciectomy, screw fixation, after extubation and during the postoperative period. Post-operative heart rate, ANI value, mean arterial pressure values, and visual analog scale (VAS) values were measured.Results: No statistically significant difference was found in terms of the demographic data of the patients. According to the groups, no statistically significant difference was found between the ANI and VAS measurements of the cases at the postoperative 5th minute (P=0.261), postop 10th minute (P=0.379), postop 15th minute (P=0.673), postop 30th minute (P=0.784) and postop 60 minute (p =0.750).Conclusions: In our study on lumbar spine surgery, we could not detect any significant relationship between ANI monitoring and VAS values in the early postoperative period. There was no difference in ANI and VAS with either anaesthetic technique. In light of the results of our study, we believe that more studies are needed on the use of ANI monitoring in the early postoperative period.

The genesis of the Baguamiao orogenic gold deposit linked to multistage ore-forming processes in Triassic tectonic transition of South Qinling, China

The Baguamiao gold deposit represents one of the largest Triassic orogenic gold deposits in the South Qinling metallogenic belt of central China. Here we investigate Ar-Ar dating of sericite and muscovite, fluid inclusion of quartz, the trace element and sulfur isotopic composition of pyrite from different mineralization stage in the Baguamiao gold deposit to gain insights into the ore genesis. The Ar-Ar dating results yield 40Ar/39Ar plateau ages of 217.5 ± 2.1 Ma, 209.2 ± 0.2 Ma and 208.8 ± 0.2 Ma, indicating a two-stage gold mineralization during the tectonic transition from the early metamorphic deformation (at ca. 218 Ma) to the late extension (ca. 209 Ma) in the post-collision environment. Fluid inclusion, trace element and sulfur isotopic analyses reveal that the two stages gold mineralization show different sources. The early mineralization period developed CO2-rich inclusions with medium temperature (317–413 °C) and medium–low salinity (4.62–18.81 wt% NaCleqv.), and is characterized by formation of Py1 and Py2 with depleted Au, Cu, Pb, Zn, Ag, Te and Bi. The sulfur isotope data of Py1 and Py2 are between 3.6 ∼ 10.5 ‰, suggesting that the sulfur source was mainly derived from the surrounding rock (Xinghongpu Group). The late mineralization period developed medium–high temperature (321–453 °C), medium–high salinity (3.3–19.62 wt% NaCleqv.) CO2-rich inclusions and high-temperature and high-salinity daughter crystal inclusions, and is characterized by formation of Py3 and Py4 with obviously higher arsenic and metal contents, such as Au, As, Cu, Pb, Zn, Ag, Cr, Ti, Mn, Sb. The δ34S values of Py3 and Py4 are 8.3 ∼ 18.8 ‰, suggesting a mixed fluid of the Xinghongpu Group and Gudaoling Group with deep magmatic-hydrothermal fluids. We propose that the two periods of gold mineralization in the Baguamiao deposit, in response to the collision assembly of Qinling Orogenic Belt, preserve evidence for diverse metal sources with the early mineralization period sourced from the metamorphism of the upper crust (Xinghongpu Group) in the compressional stage (ca. 218 Ma), and the late mineralization period characterized by the contribution of the Xinghongpu Group, Gudaoling Group and deep magmatic-hydrothermal fluids in a post-collisional extensional setting (ca. 209 Ma). The role of metamorphism and magmatic activity during the Triassic Qinling orogenic processes is considered to be important in the remobilization, transport and enrichment of sulfur, arsenic and gold (and potentially other trace elements) from the earlier formed seafloor exhalation sequence.

Patterns of engagement in care during clients' first 12 months after HIV treatment initiation in South Africa: A retrospective cohort analysis using routinely collected data.

Retention on antiretroviral therapy (ART) during the early treatment period is one of the most serious challenges facing HIV programs, but the timing and patterns of early disengagement from care remain poorly understood. We describe patterns of engagement in HIV care during the first year after treatment initiation. We analysed retrospective datasets of routinely collected electronic medical register (EMR) data for ≥18-year-old clients who initiated ART at public sector clinics in South Africa after 01/01/2018 and had ≥14 months of potential follow-up. Using scheduled visit dates, we characterized engagement in care as continuous (no treatment interruption), cyclical (at least one visit >28 days late with a return visit observed) or disengaged (visit not attended and no evidence of return). We report 6- and 12-month patterns of retention in care and viral suppression. Among 35,830 participants (65% female, median age 33), in months 0-6, 59% were continuously in care, 14% had engaged cyclically, 11% had transferred to another facility, 1% had died, and 16% had disengaged from care at the initiating facility. Among disengagers in the first 6 months, 58% did not return after their initiation visit. By 12 months after initiation, the overall proportion disengaged was 23%, 45% were classified as continuously engaged in months 7-12, and only 38% of the cohort had maintained continuous engagement at both the 6- and 12-month endpoints. Participants who were cyclically engaged in months 0-6 were nearly twice as likely to disengage in months 7-12 as were continuous engagers in months 0-6 (relative risk 1.76, 95% CI:1.61-1.91) and were more likely to have an unsuppressed viral load by 12 months on ART (RR = 1.28; 95% CI1.13-1.44). The needs of continuous and cyclical engagers and those disengaging at different timepoints may vary and require different interventions or models of care.

Dietary Practices of the Gauja Livs: Lipid Residue Analyses of the Turaida Hillfort and Pūteļi Cemetery Pottery Material

This study reports the first comprehensive data on the dietary aspects of Gauja Livs in the 11th–12th century CE. This region is presently lacking in bioarchaeological material (human bones and ancient plant remains), which is typically used for decoding the ancient diet. To tackle this problem pottery fragments from Turaida hillfort and Pūteļi cemetery were studied using Lipid Residue Analysis. Samples included both pottery clay matrix and burnt foodcrusts. The main goal of the study was to obtain direct information on the food substances consumed by the Gauja Livs, based on the pottery material from Turaida hillfort and from the local cemetery to reassess existing assumptions about their dietary practices both in mundane and ritual contexts. The lipid residue results revealed the main food groups consumed by the community contained terrestrial animal and aquatic products, but also provided insights into a potential mixing of different foodstuffs. Some of the expected foodstuffs were not found in or on the analysed pottery, leaving the possibility for a hypothetical use of cooking practices that might have excluded ceramic vessels. This research also gives preliminary indications of gender-based dietary patterns if assessed in context with other studies from the eastern Baltic Sea region in the pre-medieval and early medieval period.

Dynamics of Islamic Politics in the Early Period of the New Order

This article aims to review the relationship between proponents of Islamic politics and the New Order government. This article uses historical methods, namely heuristics, criticism, interpretation, and historiography. The research results show that the emergence of the New Order government cannot be separated from the support of military groups and Islamic political forces. The Islamic group's support for the New Order government was related to this group's desire to be involved in implementing state policies, especially in the field of government politics. This desire turned out not to be as expected, because the struggle of Islamic groups in political channels received restrictions and pressure from the government because it was considered to threaten national integration and development

Rest Grazing from the Critical Period of Soil Thawing in Alpine Meadow of Tibetan Plateau Is Conducive to the Sexual Reproduction of Polygonum viviparum

(1) Background: The most important management measure and utilization method for grassland is grazing. The suitable beginning period of spring rest grazing in the alpine meadow was selected to provide a theoretical basis for more scientific management and sustainable utilization. The experimental site is located in the cold-season pasture of an alpine meadow, which is located in the eastern part of the Qinghai Tibet Plateau. (2) Methods: We set up five treatments with the critical soil thawing period, the late soil thawing period, the grass reviving early period, the grass reviving late period with local traditional rest grazing period as the start time of rest grazing, and the grass withering period as the end time of rest grazing, recorded as P1, P2, P3, P4, and P5 (CK, control check). We studied the reproductive characteristics of the dominant plant, Polygonum viviparum, during different rest grazing periods. (3) Results: The results showed that, in general, P. viviparum was mainly involved in asexual reproduction and tended to have sexual reproduction with the rest of the grazing in advance. The biomass proportion of sexual reproduction organs and asexual reproduction organs in P1 were higher than those of other treatments, which were 704% and 20% higher than P5 (CK), respectively. The seed yields of P1 were 135%, 535%, 690%, and 1269% higher than P2–P5, respectively. The indices of P. viviparum seed quality in P5 were lower than those of the other treatments. The seed length, seed size, seed setting rate, and satiety grain weight ratio of P1 were higher than those of other treatments. We use the TOPSIS (Technique for Order Preference by Similarity to an Ideal Solution) analysis method to comprehensively evaluate the indicators of the five plots. (4) Conclusions: It was concluded that the rest of the grazing from the critical period of soil thawing was conducive to the growth and sexual (seed) reproduction of P. viviparum. Therefore, the resting grazing period of alpine meadows in spring should start with the critical period of soil thawing.

Functional outcomes of repeat kidney resection in patients with cancer recurrence after nephron-sparing surgeries

Aim. To perform comparative analysis of functional outcomes of repeat kidney resection and radical nephrectomy in patients with local cancer recurrence after previous organ-sparing surgeries.Materials and methods. Data on 64 patients who underwent surgical treatment at the Oncourology Department of the N.N. Blokhin National Medical Research Center of Oncology between 2000 and 2022 due to local kidney cancer recurrence after previous nephron-sparing surgeries were retrospectively and prospectively included in the study. Among these, 37 (57.8 %) patients underwent repeat kidney resection (treatment group) and 27 (42.2 %) patients underwent radical nephrectomy (control group). The groups were matched in demographic and clinical characteristics (р >0.05). Median diameter of recurrent tumor in the treatment and control groups was 2.5 and 3.0 cm, respectively (95 % confidence interval 2.0–3.0 cm; Q1–Q3 2.4–4.0 cm). This difference was statistically significant (р = 0.012), but not clinically. Median follow-up duration was 35 (3–131) months (Q1–Q3 13–57 months).Results. Repeat nephron-sparing surgeries correlated with lower decrease in kidney function compared to organ-resecting surgical treatment. In the early postoperative period, decrease in calculated glomerular filtration rate per the CKD-EPI formula compared to baseline after re-resection and nephrectomy was 16 and 32 % (р = 0.010); long-term, it was 8 ± 41 and 45 ± 22 % (р <0.001), respectively. Complication rates in the groups were similar: 21.6 and 29.6 %, respectively (р = 0.563).Conclusion. For local kidney cancer recurrence, repeat resection promotes preservation of kidney function without increased complication rate.

Using Auschwitz Prisoner Numbers to Correct Deportation Lists

A list of the first Jews deported from Compiègne, France on 27 March 1942 to Auschwitz-Birkenau was never found. Similarly, there is no known arrival list for this convoy. All the 1112 men entered the camp, were assigned prisoner numbers, and were then tattooed. In 1978, Serge Klarsfeld created a list by assembling sub-lists from WWII and immediate post-war sources. Despite significant ongoing research by Klarsfeld and others, no definitive list was ever compiled. Material recorded and maintained by the Nazis (daily count book, death registers, entry cards) pertaining to this early period does exist. This paper demonstrates how systematic use of Auschwitz prisoner numbers combined with French censuses and metrical records enabled us to significantly revise our records of who was deported in this transport, by eliminating dozens of names, amending many more, and adding several others.

Three-dimensional simulation and characterization of airborne transient electromagnetic response in rough media

In fractal, porous, and cranny rough media, the diffusion of the electromagnetic (EM) field differs from that in piecewise smooth media. This phenomenon is known as anomalous diffusion. To study the influence of anomalous diffusion on EM signals, we use the fractional time derivative and derive a governing equation describing the subdiffusion process of electric fields in rough media. Three-dimensional forward modeling of the time-domain airborne EM is performed using the finite-difference method and frequency-time transformation. We verify the accuracy of our forward-modeling method by comparing it with semianalytical solutions for a layered earth model. The numerical results indicate that as the conductivity of rough media decreases with time, the amplitude of the EM field decreases during the early periods but increases during subsequent periods compared with nonrough media. The EM field does not diffuse in the classical mode of the “smoke ring,” but instead demonstrates a “trailing pattern,” meaning that it maintains its maximum value at positions close to the source and diffuses outward and attenuates until it vanishes.

Effect of Decentration, Rotation, and Tilt on Objective Optical Quality of Plate Haptic Toric Intraocular Lenses in the Early Postoperative Period.

This study aimed to determine the influence of decentration, rotation, and tilt on objective optical quality of plate haptic toric intraocular lenses (tIOLs). The area ratio of modulation transfer function (MTF), strehl ratio of point spread function (PSF), and higher order aberrations (HOAs) for 3 mm and 5 mm pupil diameter (PD) were evaluated at postoperative 1 month. The retroillumination images pictured by OPD-scan III were used to quantify the degree of decentration and rotation, whereas the tIOL tilt was directly obtained by the tilt aberration. Patients were separated into two subgroups based on tIOL misalignment cutoff values. There were 29 eyes (24 patients) in the study. The decentration of more than 0.25 mm did not substantially differ from those less than or equal to 0.25 mm. PSF of 3mm PD and MTF, intraocular HOAs, and trefoil aberration for 3 mm and 5 mm PD significantly deteriorated with a rotation of more than 3 degrees, whereas only intraocular HOAs for 5 mm PD and coma for 3 mm and 5 mm PD were significantly severe with a tilt of more than 0.1 µm and 0.25 µm in corresponding PD. Furthermore, tIOL rotation and tilt were highly correlated with intraocular trefoil aberration and coma, respectively. The decentration of the monofocal bitoric IOLs is more tolerant to optical quality degradation after 1 month of surgery but more sensitive to intraocular trefoil aberration caused by rotation and coma aberration induced by tilt. As far as we know, this is the first study to investigate the relationship between the plate haptic bitoric IOL misalignment and objective optical quality measured by OPD-scan III in the real world, which may provide reference information for IOL selection to improve surgical outcomes.

The dynamics of fishing villages along the South Atlantic Coast of North America (ca. 5000–3000 years BP)

We present new chronologies that inform the timing and tempo of shell ring and shell mound construction on the South Atlantic Bight. Our project combines recently acquired dates with legacy radiocarbon dates from over 25 rings and mounds to provide a higher-resolution chronology regarding the occupation and formation of this larger landscape of the earliest fishing villages along the East Coast of the United States. We resolve the ordering and timing of occupation of these rings and mounds through Bayesian statistical modeling. These new models historicize and contextualize these shell rings in ways previously impossible. Specifically, our new chronologies of these villages indicate that the earliest villages were established prior to the invention of pottery. The early period of village establishment evidences isolated village rings, whereas later periods seem to have more villages, but these appear to have been relocated to other areas and/or islands over time. Shell mounds are fewer in number, are spread throughout the time period, and may represent special purpose sites compared to shell-rings. Once villages spread, they quickly adopted new technologies (i.e., pottery) and created new institutions and practiced village relocation, which allowed this way of life to persist for more than a thousand years.

The War on the North American Left-Wing Labor Movement From World War I Through the Post-World War II Period

Repression of the North American trade union movement dates to the late nineteenth century. Much of this repression has occurred in response to union militancy during strikes, some of which were directed against political radicals of various orientations. Peaks of repression against radical trade unionism occurred during World War I and in the immediate postwar years as well as in the early Cold War period, after World War II’s conclusion into the early 1950s. Through the analysis of three recently published volumes, I argue that the repression of North American left-wing unions was intentionally severe because of the strength of these labor organizations and the threat they were perceived to pose to employers and the government. Given that these left-wing unions were much more militant than the American Federation of Labor unions, this governmental repression (as well as that of other forces) can be viewed as a conscious set of tactics invoked that were meant to break, or at a minimum tame, these radical unions in the service of capital. Such behavior also acted as a warning to nonradical unions that repression could be directed against them as well.

‘De pestiferis libris, cuiusmodi sunt in Hispania Amadisus, Splandianus … ’. Production, Materiality, and Readers of the Dutch ‘Amadijs’

ABSTRACT In the 16th century at the latest there were strong political, cultural and literary ties between the Iberian Peninsula and the Dutch speaking regions in north western Europe. Literature in general and especially romances from the ‘south’ were printed, translated and adapted in Dutch. After an introduction in which the contribution presents a short overview of the translation and adaptation of Iberian romances in Dutch the focus will be on the ‘Amadijs’ tradition especially. For the first time the Spanish source and the ‘Amadijs’ are compared, including an analysis of the paratextual elements of the first Dutch edition of ‘Amadijs’ (1546), which clearly shows that Nuyts did not follow his source as an inspiration for the design of his edition, but copied the design of earlier Dutch editions of narratives as a marketing strategy. Part four shows that the Dutch ‘Amadijs’ was obviously read by everyone in the early modern period.

Clinical outcomes of endodontic microsurgery in complicated cases with large or through-and-through lesions: a retrospective longitudinal study.

To investigate the clinical outcomes of endodontic microsurgery in complicated cases presenting with large or through-and-through lesions. We retrospectively collected and analyzed preoperative, intraoperative, and follow-up data from 143 complicated cases that underwent endodontic microsurgery. Clinical outcomes were assessed in terms of tooth survival and surgery success. Cox regression analysis was used to evaluate the survival rate and identify associated risk factors. Additionally, the success rate was compared across different postoperative periods, and potential factors contributing to surgical failure were identified through binary logistic regression. The overall survival and success rates were 93.0% and 91.7%, respectively. The Cox regression model identified four risk factors affecting tooth survival, including apicoectomy of four teeth (HR = 35.488; P = 0.0002), an open apex observed on preoperative radiographs (HR = 6.300; P = 0.025), the performance of guided tissue regeneration technique (HR = 8.846; P = 0.028), and a palatal surgical approach (HR = 8.685; P = 0.030). The success rate demonstrated an initial increase in the early postoperative period (from 0.5 to 2 years; P = 5.8124e-30), followed by stabilization (from 2 to 9 years; P = 0.298). Surgery success rate significantly declined when apicoectomy involved four teeth (OR = 109.412; P = 0.002). Endodontic microsurgery demonstrates satisfactory outcomes in complicated cases, maintaining a stable success rate after two years. However, tooth survival and surgery success are significantly compromised when apicoectomy involves four teeth. Factors such as guided tissue regeneration, an open apex, and the palatal surgical approach are associated with an increased risk of tooth extraction. Despite achieving acceptable outcomes in complicated cases, endodontic microsurgery is adversely affected by the apicoectomy of four teeth.

Settlement, Climate Crisis and Lordship in Early Medieval Scandinavia

This article examines and describes the nature of lordship in Scandinavia during the Early Medieval period (c.400–1000 CE). It counters the assertions of earlier research, which claim that lordship with estates had already developed at the beginning of the period. Earlier arguments have built on assumptions that the development of estates was propelled by the ‘Dust Veil’ and the subsequent climate crisis of the mid-sixth century. Scholars have argued that a more hierarchical society followed, reflected through the emergence of more lavish burial customs. Through a broad comparison with other north-western European regions and peoples, this article demonstrates that these burial customs can be understood differently, and further, that a more hierarchal society was not necessarily the outcome of the crises of the sixth century. The resulting analysis of Scandinavian lordship is then anchored in a detailed case study of the well-preserved settlements, houses, farms and field-systems on the Baltic Island of Öland. It concludes that incentives to create estates in Scandinavia were not present before the Christianization process.

Mineralization processes of the Mount Garnet Zinc deposit, NE Queensland (Australia): Insights from garnet geochemistry and U-Pb geochronology

The Mount Garnet Zinc deposit in NE Queensland, Australia, is located in the region of voluminous magmatism associated with the formation of Palaeozoic continental arcs of Gondwana. Ore-forming events of this deposit are related to the intrusion of the Kennedy Igneous Association (KIA) – a large suite of igneous rocks spanning Late Carboniferous to Early Permian in age – into the Silurian limestone (Chillagoe Formation) in the Hodgkinson Province (Mossman Orogen). Petrographic observations and in situ major and trace element analysis reveal the sequence of garnet growth and fluid-rock interaction during skarn formation. Three types of garnets are identified, Grt I (including IA and IB) and Grt II. Grt IB is related to Zn-Pb mineralization. All garnets have elevated Sn and W and the highest levels of W and Sn are observed in Grt II. Garnet U-Pb ages of Grt IB provide the first direct geochronological result of hydrothermal minerals in the Mount Garnet region. New data argues that the base metal mineralization may take place during early Permian period and be sourced from the Claret Creek Supersuite. Sn-W mineralization may be associated with the O’Briens Creek Supersuite.

Nutritional, Textural, and Sensory Attributes of Protein Bars Formulated with Mycoproteins.

Research accumulated over the past decades has shown that mycoprotein could serve as a healthy and safe alternative protein source, offering a viable substitute for animal- and plant-derived proteins. This study evaluated the impact of substituting whey protein with fungal-derived mycoprotein at different levels (10%, 20%, and 30%) on the quality of high-protein nutrition bars (HPNBs). It focused on nutritional content, textural changes over storage, and sensory properties. Initially, all bars displayed similar hardness, but storage time significantly affected textural properties. In the early storage period (0-5 days), hardness increased at a modest rate of 0.206 N/day to 0.403 N/day. This rate dramatically escalated from 1.13 N/day to 1.36 N/day after 5 days, indicating a substantial textural deterioration over time. Bars with lower mycoprotein levels (10%) exhibited slower hardening rates compared with those with higher substitution levels (20% and 30%), pointing to a correlation between mycoprotein content and increased bar hardness during storage. Protein digestibility was assessed through in vitro gastric and intestinal phases. Bars with no or low-to-medium levels of mycoprotein substitution (PB00, PB10, and PB20) showed significantly higher digestibility (40.3~43.8%) compared with those with the highest mycoprotein content (PB30, 32.9%). However, digestibility rates for all mycoprotein-enriched bars were lower than those observed for whey-protein-only bars (PB00, 84.5%), especially by the end of the intestinal digestion phase. The introduction of mycoprotein enriched the bars' dietary fiber content and improved their odor, attributing a fresh mushroom-like smell. These findings suggest that modest levels of mycoprotein can enhance nutritional value and maintain sensory quality, although higher substitution levels adversely affect texture and protein digestibility. This study underscores the potential of mycoprotein as a functional ingredient in HPNBs, balancing nutritional enhancement with sensory acceptability, while also highlighting the challenges of textural deterioration and reduced protein digestibility at higher substitution levels.

Impact of deceased organ donor marijuana use on donor culture positivity and solid organ transplant recipient outcomes

With the increasing prevalence of marijuana use in the US, many deceased organ donors have a history of marijuana use, raising concerns about infectious risks to transplant recipients. We performed a multicenter retrospective cohort study in which exposed donors were those with recent marijuana use (in the prior 12 months) and unexposed donors were those with no recent marijuana use. Primary outcomes included the following: (1) positive donor cultures for bacteria or fungi, (2) recipient infection due to bacteria or fungi within 3 months posttransplant, and (3) recipient graft failure or death within 12 months posttransplant. Multivariable regression was used to evaluate the relationship between donor marijuana use and each outcome. A total of 658 recipients who received organs from 394 donors were included. Recent marijuana use was not associated with donor culture positivity (aOR: 0.84, 95% CI: 0.39-1.81, P = .65), recipient infection (aHR: 1.02, 95% CI: 0.76-1.38, P = .90), or recipient graft failure or death (aHR: 1.65, 95% CI: 0.90-3.02, P = .11). Our data suggest that organs from donors with a history of recent marijuana use do not pose significant infectious risks in the early posttransplant period.

Fukuchi-Manabe Score for Infection Control Measures During the Very Early COVID-19 Pandemic Period When Access to Reverse Transcription-Polymerase Chain Reaction Testing Was Poor in Japan: A Single-Center Observational Prospective Cohort Study.

During the early stages of the COVID-19 pandemic in Japan, access to reverse transcription-polymerase chain reaction (RT-PCR) testing was limited. All patients with COVID-19 required hospitalization, and isolation of suspected COVID-19 patients had not yet been implemented. With the recently acquired evidence on COVID-19, it is important to develop a risk stratification system for isolation rooms in the context of limited resources for better resource management. This study aimed to develop and validate a COVID-19 risk-scoring strategy, the Fukuchi-Manabe score, to safely stratify and manage isolation rooms, personal protective equipment (PPE), and RT-PCR testing in the context of limited RT-PCR testing and a short supply of PPE. This single-center prospective study consecutively enrolled suspected COVID-19 adult inpatients between March 1 and August 31, 2020. The primary and secondary outcomes were a positive RT-PCR test and the occurrence of nosocomial infections during the study period, respectively. Factors related to patient history, symptoms, chest computed tomography findings, and laboratory data suggestive of COVID-19 were scored, totaled, and divided into four categories ("probable," "possible," "less likely," and "non-suspicious") based on the likelihood of COVID-19. Sensitivity, specificity, and positive and negative predictive values were evaluated for each probability category. Twenty of 224 inpatients were positive on the RT-PCR test, including 18 "probable" patients (90.0%), one "possible" patient, and one "less likely" patient. The area under the curve (AUC) (95% confidence interval: 0.841-0.977), sensitivity, and specificity were 0.909, 90.0%, and 80.4%, respectively. The positive and negative predictive values and accuracy for the "probable" category were 0.90, 0.80, and 0.82, respectively. The mean and standard deviation of AUCs, validated by bootstrap analysis, were 0.910±0.034. No nosocomial infections were observed. The Fukuchi-Manabe score will be helpful when other novel pathogens emerge in the future before the availability of genetic testing methods.