Full Assessment Research Articles

NeRF-NQA: No-Reference Quality Assessment for Scenes Generated by NeRF and Neural View Synthesis Methods.

Neural View Synthesis (NVS) has demonstrated efficacy in generating high-fidelity dense viewpoint videos using a image set with sparse views. However, existing quality assessment methods like PSNR, SSIM, and LPIPS are not tailored for the scenes with dense viewpoints synthesized by NVS and NeRF variants, thus, they often fall short in capturing the perceptual quality, including spatial and angular aspects of NVS-synthesized scenes. Furthermore, the lack of dense ground truth views makes the full reference quality assessment on NVS-synthesized scenes challenging. For instance, datasets such as LLFF provide only sparse images, insufficient for complete full-reference assessments. To address the issues above, we propose NeRF-NQA, the first no-reference quality assessment method for densely-observed scenes synthesized from the NVS and NeRF variants. NeRF-NQA employs a joint quality assessment strategy, integrating both viewwise and pointwise approaches, to evaluate the quality of NVS-generated scenes. The viewwise approach assesses the spatial quality of each individual synthesized view and the overall inter-views consistency, while the pointwise approach focuses on the angular qualities of scene surface points and their compound inter-point quality. Extensive evaluations are conducted to compare NeRF-NQA with 23 mainstream visual quality assessment methods (from fields of image, video, and light-field assessment). The results demonstrate NeRF-NQA outperforms the existing assessment methods significantly and it shows substantial superiority on assessing NVS-synthesized scenes without references. An implementation of this paper are available at https://github.com/VincentQQu/NeRF-NQA.

Deep learning-based automatic segmentation of COVID-19 in chest X-ray images using ensemble neural net sentinel algorithm

IntroductionCOVID-19 has affected billions of people worldwide and has serious public health effects. Automatic image segmentation is crucial to improve clinical decision-making for full assessments of illness management as well as monitoring. It plays a crucial part in detecting, diagnosing, and tracking diseases by allowing for the exact or accurate segmentation of diseased regions. Automatic segmentation and classifying medical images remains the most difficult obstacle in medical diagnosis, however, because of the lack of annotated medical images. MethodsIn this article, we propose the Ensemble Neural Net Sentinel Algorithm (ENNSA), and unique deep learning (DL) method for the segmentation and classification of COVID-19. Chest X-ray dataset is first collected from Kaggle and preprocessed. The features in the processed image are retrieved using the Insistent Grey Level Co-occurrence Matrix (IGLCM). ResultsThe suggested ENNSA outperforms current techniques in terms of accuracy (99.25), precision (100), recall (43), and F1 score (61) regardless of unbalanced datasets, indicating its promise as a diagnostic tool for respiratory diseases. ConclusionIn addition, the segmentation approach is used to separate the chosen features for COVID-19 classification from the chest X-ray images. The investigational outcomes demonstrate that our proposed strategy outperforms currently used methods in classifying COVID-19.

Use of electrical stimulation for accelerated orthodontics in humans: a systematic review and meta-analysis.

The main objective of this systematic review is to comprehensively evaluate all the relevant studies to evaluate the effectiveness of electrical stimulation to accelerate orthodontic tooth movement in human patients. Using a suitable search strategy, various databases like PubMed, CENTRAL, Scopus and Google Scholar were surveyed for relevant randomized controlled trials (RCTs); after which a hand search of related orthodontic journals was completed. The risk of bias of studies was checked using Cochrane's ROB-2 tool. The quality of evidence of the included studies was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. Rate of orthodontic tooth movement was compared and thus efficiency of electrical stimulation to accelerate tooth movement was assessed. Meta-analysis was done on 2 studies out of the 4; rate of orthodontic tooth movement was compared at two time periods after start of treatment (3rd month and 5th month) with standardized mean difference (SMD) as summary estimate, with p < 0.05 denoting statistical significance. Publication bias was checked using a funnel plot. Via exploration of the online databases and hand searching,1080 studies were found after removing duplicates. After full text assessment, 13 studies in total were selected that used electrical stimulation, out of which 4 studies were included in the qualitative analysis as they met the inclusion criteria. The meta-analysis was done for 3rd month and 5th month with SMD as 0.69(-1.26-0.12) and 1.64(-3.44-0.16), respectively. The strength of evidence in the meta-analysis is moderate. There was no publication bias as shown by funnel plot. The studies included showed increased risk of selection and performance bias. Also due to the limited number of studies available, there was difficulty in reaching definitive conclusions. The meta-analysis showed a significant difference among the control and experimental group for the 3rd month. Even though a positive correlation is found between electrical stimulation and acceleration of orthodontic tooth movement, it is advised to conduct further studies, particularly with human participants, to establish a more conclusive outcome. This review has received no funding. The protocol for the study was registered in the Prospective Registration of Systematic Review (PROSPERO)(CRD42023495077).

Extinction risk predictions for the world's flowering plants to support their conservation.

More than 70% of all vascular plants lack conservation status assessments. We aimed to address this shortfall in knowledge of species extinction risk by using the World Checklist of Vascular Plants to generate the first comprehensive set of predictions for a large clade: angiosperms (flowering plants, c. 330 000 species). We used Bayesian Additive Regression Trees (BART) to predict the extinction risk of all angiosperms using predictors relating to range size, human footprint, climate, and evolutionary history and applied a novel approach to estimate uncertainty of individual species-level predictions. From our model predictions, we estimate 45.1% of angiosperm species are potentially threatened with a lower bound of 44.5% and upper bound of 45.7%. Our species-level predictions, with associated uncertainty estimates, do not replace full global, or regional Red List assessments, but can be used to prioritise predicted threatened species for full Red List assessment and fast-track predicted non-threatened species for Least Concern assessments. Our predictions and uncertainty estimates can also guide fieldwork, inform systematic conservation planning and support global plant conservation efforts and targets.

Diagnosis and Prognosis Utility of Microrna-205 Expression in Prostate Carcinogenesis: Meta-Analysis and Bioinformatics Study

Background: Prostate cancer (PCa) is a common disease that affects millions of men worldwide. Precise and non-invasive markers for diagnosing and prognosing PCa are vital to enhance patient management. MicroRNAs have been proposed as non-invasive biomarkers. We performed a meta-analysis and a bioinformatics study of miR-205 to give a full assessment of its diagnostic and prognostic relevance. Materials and methods: We searched all published papers on miR-205 expression in PCa up to April 30, 2023 using PubMed, sciencedirect, Google Scolar, Web of Science. We used RevMan software to Meta-analyze the included literature. A bioinformatics investigation of genes and pathways that may be targets of the mature miR-205-5p impact was also performed. Results: The pooled standardized mean difference of miR-205 differential expression in PCa compared to normal tissue, in primary and progressed cancer and hazard ratio were -1.58; p˂0.001, -0.23; p=0.06 and 2.61; p=0.002 respectively. Bioinformatics analysis revealed that miR-205-5p may regulate YAP1 and the Hippo signaling pathway. Conclusion: The current study found that miRNA-205 is downregulated in PCa and have a significant prognostic value. MiRNA-205 may have a role in prostate carcinogenesis via regulating YAP1 through the Hippo signaling pathway.

Field evaluation of an automated mosquito surveillance system which classifies Aedes and Culex mosquitoes by genus and sex

BackgroundMosquito-borne diseases are a major concern for public and veterinary health authorities, highlighting the importance of effective vector surveillance and control programs. Traditional surveillance methods are labor-intensive and do not provide high temporal resolution, which may hinder a full assessment of the risk of mosquito-borne pathogen transmission. Emerging technologies for automated remote mosquito monitoring have the potential to address these limitations; however, few studies have tested the performance of such systems in the field.MethodsIn the present work, an optical sensor coupled to the entrance of a standard mosquito suction trap was used to record 14,067 mosquito flights of Aedes and Culex genera at four temperature regimes in the laboratory, and the resulting dataset was used to train a machine learning (ML) model. The trap, sensor, and ML model, which form the core of an automated mosquito surveillance system, were tested in the field for two classification purposes: to discriminate Aedes and Culex mosquitoes from other insects that enter the trap and to classify the target mosquitoes by genus and sex. The field performance of the system was assessed using balanced accuracy and regression metrics by comparing the classifications made by the system with those made by the manual inspection of the trap.ResultsThe field system discriminated the target mosquitoes (Aedes and Culex genera) with a balanced accuracy of 95.5% and classified the genus and sex of those mosquitoes with a balanced accuracy of 88.8%. An analysis of the daily and seasonal temporal dynamics of Aedes and Culex mosquito populations was also performed using the time-stamped classifications from the system.ConclusionsThis study reports results for automated mosquito genus and sex classification using an optical sensor coupled to a mosquito trap in the field with highly balanced accuracy. The compatibility of the sensor with commercial mosquito traps enables the sensor to be integrated into conventional mosquito surveillance methods to provide accurate automatic monitoring with high temporal resolution of Aedes and Culex mosquitoes, two of the most concerning genera in terms of arbovirus transmission.Graphical

Technoeconomic characterisation of low-carbon liquid hydrocarbons production

With growing attention on low-carbon fuels and chemicals to meet climate targets, careful cost and performance evaluations become critical. These hydrocarbons can be derived from biomass or hydrogen with captured CO2 via established pathways such as Fischer-Tropsch and methanol synthesis. Techno-economic studies are influential in identifying the economic viability of promising technologies in the absence of reliable industry data. A considerable number of techno-economic studies that represent same technologies exhibit substantial variability in their estimations, posing challenges in decision-making. This work aims to characterise, based on available data, the investment cost and plant performance for the Nth (i.e. mature) low-carbon liquid hydrocarbon plants. The extent of data variabilities across technologies are presented and the factors contributing to differences in data interpretation and normalisation are determined. Through a full assessment of existing values, central tendencies for prospective techno-economic evaluations are identified. Processes utilising biomass have the greatest ranges in the investment cost, with higher costs from studies with the highest level of detail and proximity to real-world plant cost estimations. Energy efficiency variabilities arise when tied to plants with multiple outputs. Demonstration scale hydrogen-to-hydrocarbons in relation to economies of scale should be carefully evaluated.

Passenger Air Taxi Services: An Assessment of the Current European Union Rules on Consumer Protection for Passengers

The Paris Olympics and Paralympics are scheduled to take place between 26 July and 8 September 2024, whereby electric vertical take-off and landing aircraft are anticipated to take to the skies to offer a new mobility solution to spectators of the Games. This will allow paying members of the public to move between different points within the Paris region akin to an on-demand taxi service, but through the air; passenger air taxi services (PATS). These passengers, as consumers, will have certain rights and duties under European Union law. To determine the level of protection afforded to these air passengers, a full assessment of Regulation (EC) No 261/2004 is required. As the revision of the Regulation is currently on the European Commission’s agenda, it is also important to consider its revision in light of PATS, whereby new technology, emerging business practices, changing customer behaviour and societal expectations for the level of legal protection of PATS users must be considered. This article will, therefore, assess the current version of the Regulation, in light of the interpretation from the European Court, to see whether it applies to PATS and, if so, whether it is suitable or if specific amendments need to be added to the planned revised Regulation.

Polyphenol exposure of mothers and infants assessed by LC–MS/MS based biomonitoring in breast milk

Exposure to polyphenols is relevant throughout critical windows of infant development, including the breastfeeding phase. However, the quantitative assessment of polyphenols in human breast milk has received limited attention so far, though polyphenols may positively influence infant health. Therefore, a targeted LC–MS/MS assay was developed to investigate 86 analytes representing different polyphenol classes in human breast milk. The sample preparation consisted of liquid extraction, salting out, freeze-out, and a dilution step. Overall, nearly 70% of the chemically diverse polyphenols fulfilled all strict validation criteria for full quantitative assessment. The remaining analytes did not fulfill all criteria at every concentration level, but can still provide useful semi-quantitative insights into nutritional and biomedical research questions. The limits of detection for all analyzed polyphenols were in the range of 0.0041–87 ng*mL−1, with a median of 0.17 ng*mL−1. Moreover, the mean recovery was determined to be 82% and the mean signal suppression and enhancement effect was 117%. The developed assay was applied in a proof-of-principle study to investigate polyphenols in breast milk samples provided by twelve Nigerian mothers at three distinct time points post-delivery. In total, 50 polyphenol analytes were detected with almost half being phenolic acids. Phase II metabolites, including genistein-7-β-D-glucuronide, genistein-7-sulfate, and daidzein-7-β-D-glucuronide, were also detected in several samples. In conclusion, the developed method was demonstrated to be fit-for-purpose to simultaneously (semi-) quantify a wide variety of polyphenols in breast milk. It also demonstrated that various polyphenols including their biotransformation products were present in breast milk and therefore likely transferred to infants where they might impact microbiome development and infant health.Graphical abstract

A scoping review and narrative synthesis of neonatal skin injury severity scales.

Mechanical force skin injuries are common for critical care patients, especially neonates. Currently, identification and severity assessments of injuries are dependent on clinical experience and/or utilization of severity tools. Compared with adults, neonates sustain skin injuries in different anatomical locations and have decreased layers of healthy tissue (from 0.9 to 1.2 mm) creating questions around direct application of adult injury severity scales reliant on visual assessment. The aim of this scoping review (ScR) was to investigate severity scales used to report hospital acquired skin injuries for neonates. This study utilized the 2015 Joanna Briggs Institute methodology for scoping reviews and is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews extension. PubMed, CINAHL, COCHRANE Central, Scopus, and the reference lists of included studies were searched for studies published between 2001 and 2023, that included severity scales use within neonatal population. Two authors independently identified studies for full review, data extraction, and quality assessment. A systematic database search returned 1163 records. After full test review of 109 studies, 35 studies were included. A majority of studies included were cohort or action research and conducted in the United States of America. Most studies (57%, n = 20) reported skin injuries acquired throughout the body, 14 (40%) of the studies reported the nasal area alone and one study reported no anatomical location. A total of nine severity scales or combination of scales were utilized within studies (n = 31) and four studies did not report a scale. Various versions of scales from the National Pressure Ulcer Advisory Panel (n = 16), European Pressure Ulcer Advisory Panel (n = 8) or Neonatal Skin Condition Score (n = 4) were reported, compared with locally developed classifications/scales (n = 4). Scales were predominantly of ordinal grouping (74%, n = 26) or categorical assessment (14%, n = 5). Only one scale from 2004 was validated for neonates. Neonatal skin injuries will continue to be reported subjectively until severity scales are consistently applied or other measurements are identified to support assessment. Additionally, without skin injury assessment uniformity, critical examination of effectiveness of skin care treatment practices will have subjective comparison. This review suggests there is a need for consistent skin assessment and severity scales that are valid for the neonatal population and their unique skin considerations. In the context of neonatal skin, with its unique characteristics and heightened risk for injury, clinicians must stage, categorise, and describe injury locations to provide objective information on injury severity. Given the risk for injuries across the entire body, including mucous membranes, describing the depth of the injury is essential regardless of the anatomical site. Although not originally designed for this population, a modified version of the National Pressure Injury Advisory Panel (NPIAP) classification system, which incorporates additional classifications (e.g., skin tears), remains the most applicable severity assessment system currently available. This should be supplemented by clinical images or detailed descriptive language (e.g., subtle redness) until rigorously validated severity and assessment scales, based on neonatal data, are developed-particularly for infants born at less than 27 weeks gestation. [Correction added on 25 October 2024, after first online publication: The Relevance to Clinical Practice subsection in Abstract has been added on this version.].

Conservation status of the idle crayfish Austropotamobius bihariensis Pârvulescu, 2019

Knowledge about the conservation status of a species is crucial for its protection in the long run. It provides insights into the geographic range, population size and trend, which are useful in management activities towards safeguarding the future of a species. The idle crayfish, Austropotamobius bihariensis, is a recently described crayfish species that has not yet undergone a full conservation assessment. Here, we present our extensive 13-year study that aimed to fill this gap by investigating and monitoring the species' entire geographic occurrence range and quantifying its subpopulations. Although it is an endemic crayfish located in the Apuseni Mountains (Romania), its range and population is stable. The observed relative abundance is highly unbalanced within subpopulations, with 71% falling below ten individuals per 100 m river stretch. We documented four extinct subpopulations (ca. 16%), whereas more than half of the subpopulations being in a size-decreasing trend. Since no invasive crayfish were detected in (or very close to) its distribution area, the idle crayfish can still be considered safe against invasions. However, based on our findings and following the IUCN Red List Guidelines, we concluded that idle crayfish's most appropriate conservation status is Endangered. IUCN ratification is required for increased significance.

Efficacy of an experimental toothpaste containing sodium bicarbonate, sodium hyaluronate and sodium fluoride on gingivitis

BackgroundGingivitis is driven by plaque accumulation and, if left untreated, can progress to irreversible periodontitis. For many, the mechanical action of toothbrushing does not achieve adequate plaque control. The aim of this study was to investigate whether twice-daily use of a toothpaste containing 0.2% high molecular weight (HMW) sodium hyaluronate with 67% sodium bicarbonate and 0.221% sodium fluoride (experimental toothpaste) could improve gingival health compared with a regular fluoride toothpaste (negative control). The study also assessed whether the experimental toothpaste could provide additive gingival health benefit over a toothpaste containing only 67% sodium bicarbonate and 0.221% sodium fluoride (positive control).MethodsThis was a single-center, examiner-blinded, randomized, clinical study in healthy adults with mild-to-moderate gingivitis. At baseline, after abstaining from toothbrushing for 12 h, prospective participants underwent oral soft tissue (OST) and oral hard tissue examination followed by assessments for gingival inflammation (Modified Gingival Index [MGI]), gingival bleeding (Bleeding Index [BI]), and supra-gingival plaque (Turesky Plaque Index [TPI]). Eligible participants were stratified by gender and baseline number of bleeding sites (low: <45; high: ≥45 bleeding sites). Following randomization, participants underwent prophylactic dental treatment. Participants received a full OST examination, MGI, BI and TPI assessments after 3 days, 1, 2 and 6 weeks of product use.ResultsIn total, 110 participants were screened for study entry and all were randomized to receive one of three toothpastes (experimental: sodium hyaluronate, sodium bicarbonate, sodium fluoride; positive control: sodium bicarbonate, sodium fluoride; negative control: regular fluoride toothpaste). For all measures, significant improvements were observed in participants receiving either sodium bicarbonate-containing toothpaste (experimental or positive control) compared with the regular fluoride toothpaste (negative control) at week 6. No significant difference was observed in any assessment or visit comparing the experimental toothpaste with the positive control.ConclusionsBoth the experimental and the positive control toothpastes demonstrated clinically relevant improvements in gingival health compared with a regular fluoride toothpaste (negative control). However, no additional gingival health improvement was observed for the experimental toothpaste compared with the positive control, therefore, no additional gingival health benefit can be attributed to the inclusion of sodium hyaluronate in this formulation.Trial registrationClinicalTrials.gov Identifier: NCT04737538 (04/02/2021).

Risk factors of multimorbidity among older adults in India: A systematic review and meta-analysis.

Multimorbidity among older adults is a growing concern in India. Multimorbidity is defined as the coexistence of two or more chronic health conditions in an individual. Primary studies have been conducted on risk factors of multimorbidity in India, but no systematic review has been conducted on this topic. This systematic review aimed to synthesize the existing evidence on risk factors of multimorbidity among older adults in India. The JBI and Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. Several databases were searched for published and unpublished studies until August 03, 2022. The screening of titles and abstracts and full texts, data extraction, and quality assessment were conducted by two independent reviewers. Any disagreements were resolved through discussion or by involving a third reviewer. Data synthesis was conducted using narrative synthesis and random effects meta-analysis, where appropriate. Out of 8781 records identified from the literature search, 16 and 15 studies were included in the systematic review and meta-analysis, respectively. All included studies were cross-sectional, and 10 met a critical appraisal score of more than 70%. Broadly, sociodemographic, lifestyle, and health conditions-related factors were explored in these studies. The pooled odds of multimorbidity were higher in people aged ≥70 years compared to 60-69 years (odds ratio (OR) 1.51; 95% confidence interval (CI) 1.20-1.91), females compared to males (1.38; 1.09-1.75), single, divorced, separated, and widowed compared to married (1.29; 1.11-1.49), economically dependent compared to economically independent (1.54; 1.21-1.97), and smokers compared to non-smokers (1.33; 1.16-1.52) and were lower in working compared to not working (0.51; 0.36-0.72). This systematic review and meta-analysis provided a comprehensive picture of the problem by synthesizing the existing evidence on risk factors of multimorbidity among older adults in India. These synthesized sociodemographic and lifestyle factors should be taken into consideration when developing health interventions for addressing multimorbidity among older adults in India.

Balancing Non‐CO2 GHG Emissions and Soil Carbon Change in U.S. Rice Paddies: A Retrospective Meta‐Analysis and Agricultural Modeling Study

AbstractU.S. rice paddies, critical for food security, are increasingly contributing to non‐CO2 greenhouse gas (GHG) emissions like methane (CH4) and nitrous oxide (N2O). Yet, the full assessment of GHG balance, considering trade‐offs between soil organic carbon (SOC) change and non‐CO2 GHG emissions, is lacking. Integrating an improved agroecosystem model with a meta‐analysis of multiple field studies, we found that U.S. rice paddies were the rapidly growing net GHG emission sources, increased 138% from 3.7 ± 1.2 Tg CO2eq yr−1 in the 1960s to 8.9 ± 2.7 Tg CO2eq yr−1 in the 2010s. CH4, as the primary contributor, accounted for 10.1 ± 2.3 Tg CO2eq yr−1 in the 2010s, alongside a notable rise in N2O emissions by 0.21 ± 0.03 Tg CO2eq yr−1. SOC change could offset 14.0% (1.45 ± 0.46 Tg CO2eq yr−1) of the climate‐warming effects of soil non‐CO2 GHG emissions in the 2010s. This escalation in net GHG emissions is linked to intensified land use, increased atmospheric CO2, higher synthetic nitrogen fertilizer and manure application, and climate change. However, no/reduced tillage and non‐continuous irrigation could reduce net soil GHG emissions by approximately 10% and non‐CO2 GHG emissions by about 39%, respectively. Despite the rise in net GHG emissions, the cost of achieving higher rice yields has decreased over time, with an average of 0.84 ± 0.18 kg CO2eq ha−1 emitted per kilogram of rice produced in the 2010s. The study suggests the potential for significant GHG emission reductions to achieve climate‐friendly rice production in the U.S. through optimizing the ratio of synthetic N to manure fertilizer, reducing tillage, and implementing intermittent irrigation.

Effects of a Powered Ankle-Foot Prosthesis and Physical Therapy on Function for Individuals With Transfemoral Limb Loss: Rationale, Design, and Protocol for a Multisite Clinical Trial.

Powered ankle-foot prosthetic devices can generate net positive mechanical work during gait, which mimics the physiological ankle. However, gait deviations can persist in individuals with transfemoral limb loss because of habit or lack of rehabilitation. Prosthetic research efforts favor the design or evaluation of prosthetic componentry and rarely incorporate any type of rehabilitation, despite evidence suggesting that it is critical for minimizing gait imbalances. Given the accelerated rate of innovation in prosthetics, there is a fundamental knowledge gap concerning how individuals with transfemoral limb loss should learn to correctly use powered ankle-foot devices for maximum functional benefit. Because of the recent advances in prosthetic technology, there is also a critical unmet need to develop guidelines for the prescription of advanced prosthetic devices that incorporate both physical and psychological components to identify appropriate candidates for advanced technology. The primary goal of this investigation is to examine the roles of advanced prosthetic technology and a device-specific rehabilitative intervention on gait biomechanics, functional efficacy, and pain in individuals with transfemoral limb loss. The secondary goal is to develop preliminary rehabilitation guidelines for advanced lower limb prosthetic devices to minimize gait imbalances and maximize function and to establish preliminary guidelines for powered ankle-foot prosthetic prescription. This prospective, multisite study will enroll 30 individuals with unilateral transfemoral limb loss. At baseline, participants will undergo a full gait analysis and assessment of function, neurocognition, cognitive load, subjective preferences, and pain using their current passive prosthesis. The participants will then be fitted with a powered ankle-foot device and randomized into 2 equal groups: a powered device with a device-specific rehabilitation intervention (group A) or a powered device with the current standard of practice (group B). Group A will undergo 4 weeks of device-specific rehabilitation. Group B will receive the current standard of practice, which includes basic device education but no further device-specific rehabilitation. Data collection procedures will then be repeated after 4 weeks and 8 weeks of powered ankle use. This study was funded in September 2017. Enrollment began in September 2018. Data collection will conclude by March 2024. The initial dissemination of results is expected in August 2024. The projected trends indicate that the number of individuals with limb loss will dramatically increase in the United States. The absence of effective, evidence-based interventions may make individuals with transfemoral limb loss more susceptible to increased secondary physical conditions and degenerative changes. With this expected growth, considerable resources will be required for prosthetic and rehabilitation services. Identifying potential mechanisms for correcting gait asymmetries, either through advanced prosthetic technology or rehabilitative interventions, can provide a benchmark for understanding the optimal treatment strategies for individuals with transfemoral limb loss. ClinicalTrials.gov NCT03625921; https://clinicaltrials.gov/study/NCT03625921. DERR1-10.2196/53412.

Community-scale changes to landfast ice along the coast of Alaska over 2000-2022

Landfast sea ice that forms along the Arctic coastline is of great importance to coastal Alaskan communities. It provides a stable platform for transportation and traditional activities, protects the coastline from erosion, and serves as a critical habitat for marine mammals. Here we present a full assessment of landfast ice conditions across a continuous 7885 km length of the Alaska coastline over 2000–2022 using satellite imagery. We find that the maximum landfast ice extent, usually occurring in March, averaged 67 002 km2 during our study period: equivalent to 4% of the state’s land area. The maximum extent of landfast ice, however, exhibits considerable interannual variability, from a minimum of 29 871 km2 in 2019 to a maximum of 87 571 km2 in 2010. Likewise, the landfast ice edge position averages 22.9 km from the coastline but, at the community-scale, can range from 2.8 km (in Gambell) to 71.1 km (in Deering). Landfast ice breakup date averages 2 June but also varies considerably both between communities (3 May in Quinhagak to 24 July in Nuiqsut) and interannually. We identify a strong control of air temperature on breakup timing and use this relationship to project future losses of ice associated with Paris Climate Agreement targets. Under 2 °C of global air temperature warming, we estimate the average Alaskan coastal community will lose 19 days of ice, with the northernmost communities projected to lose 50 days or more. Overall, our results emphasize the highly localized nature of landfast ice processes and the vulnerability of coastal Arctic communities in a warming climate.

The impact of corona virus disease-2019 (COVID-19) vaccination on patients with systemic rheumatic diseases attending a tertiary care university-based hospital

BackgroundSafety and efficacy of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccine among systemic rheumatic diseases (SRDs) remain a serious concern. Aim of the workTo explore different corona virus disease-2019 (COVID-19) vaccine adverse reactions, post-vaccination COVID-19 infection, disease flare and acceptability of vaccine among patients with SRDs. Patients and methodsThis study was conducted on 750 patients with SRDs attending the Rheumatology Department, Cairo University Hospitals (December 2022 – February 2023). All patients were subjected to full clinical history, COVID-19 infection, vaccine history, adverse events, disease flare and assessment of their acceptability to the vaccine. ResultsThe mean age of the patients was 41.6 ± 11.7 years with a female:male 8.4:1 and 52.5 % were educated. 414 (55.2 %) received COVID-19 vaccine. Only 26 (6.3 %) suffered from post-vaccination COVID- 19 infection (one mild attack). The causes for not receiving the vaccine were either due to unacceptability (78.9 %) or doctors’ advice (21.1 %). 64.8 % received inactivated virus vaccines (64.8 %) and 87.9 % received two doses. The commonest local and systemic side effects were pain (73.9 %) and headache (30.2 %). Only four (0.96 %) patients reported disease flare. There was a significant difference between the diagnosis, type of vaccines and some of the adverse effects of the vaccines such as pain (p = 0.019) and fever (p = 0.021), redness (p = 0.007) and swelling (p = 0.013). ConclusionThe efficacy and safety of SARS-CoV-2 vaccine among Egyptian patients with SRDs is confirmed. There were significant differences in certain vaccine side effects especially pain, fever, redness and swelling. Most patients well tolerated the COVID-19 vaccine providing reassurance.

Arterio-occlusive events among patients with chronic myeloid leukemia on tyrosine kinase inhibitors

AbstractTyrosine kinase inhibitors (TKIs) are standard therapy for patients with chronic myeloid leukemia. Each of these drugs has a specific profile of tyrosine kinases that they inhibit and, although all are clinically effective, they each have unique toxicity profiles. With the introduction of ponatinib, arterio-occlusive events were first noted and later found to occur with all TKIs to various extents. The recognition of this “class effect” was delayed considering ponatinib was introduced 10 years after the introduction of imatinib. The reasons for the delay in identification of this class effect are likely multifaceted. Importantly, there is an inconsistency in adverse event reporting criteria among the major clinical trials of the various TKIs, likely resulting in mixed reporting of arterio-occlusive events. Reporting events based on a frequency threshold, lack of sufficient follow-up, attempts at causality attribution, and the primary focus on molecular response may all have played an additional role. Considering the increasing rate of arterio-occlusive events over time, the termination of many trials after only 5 years prevents full assessment of the impact of these events. A comprehensive evaluation of TKI adverse effects using uniform Medical Dictionary for Regulatory Activities terms and comprehensive adjudication of these events may be helpful in better assessing the real risk for patients with each TKI. Future clinical trials should use a uniform and comprehensive approach to reporting adverse events without attempting to assign causality to the study drug.

Nutritional status of hospitalized elderly patients in Ethiopia: a cross-sectional study of an important yet neglected problem in clinical practice.

Malnutrition is a common geriatric syndrome affecting approximately half of the older population with a more pronounced occurrence rate in those hospitalized. It affects the physiology, and results in poor humanistic and clinical outcomes. In Africa, particularly in Ethiopia, albeit multiple studies are available on malnutrition in non-hospitalized older population, similar studies in inpatient settings are scarce. Therefore, this study was conducted with the intention to quantify the prevalence of malnutrition in older patients on inpatient admission and determine its associated factors. A total of 157 older inpatients aged 60 years and above were included in the present study. The data collection format was developed after an in-depth review of relevant literatures. The full Mini-Nutritional Assessment (MNA) tool was employed to assess the nutritional status on admission. Data completeness was checked thoroughly. Descriptive statistics and logistic regression analysis were conducted using STATA 15.0. The area under the receiver operating characteristic curve (ROC), Hosmer-Lemeshow test, and classification table were computed to evaluate the final model goodness-of-fit. Of the total study subjects, 81% were malnourished (MNA score <17) and 17% were at risk for malnutrition (MNA score of 17.5-23.5). However, upon review of the patients' medical charts, malnutrition diagnosis was recorded in only two patients. Rural residence (AOR = 2.823, 95%CI: 1.088, 7.324), self-reported financial dependence for expenses (AOR = 4.733, 95%CI: 1.011, 22.162), and partial dependence in functional autonomy on admission (AOR = 3.689, 95%CI: 1.190, 11.433) significantly increased the risk of malnutrition. The area under the ROC curve (0.754) and the Hosmer-Lemeshow test (p = 0.7564) indicated that the final model reasonably fits the data. The model`s sensitivity is 96.85%. In the present study, an alarmingly high prevalence of malnutrition was identified older inpatients. The problem went undiagnosed in a similar percentage of patients. Several available literatures indicate the presence of an association between nutritional status and patient outcomes, thus strict nutritional screening at inpatient admission and intervention are recommended with special emphasis for those from rural areas, with financial dependence, and with functional impairment on admission.

Factors associated with self-perceived treatment-resistance in bipolar disorder.

Patients with bipolar disorder often report self-perceived treatment resistance. However, it is not known to what extent it is due to actual treatment resistance. The Juntendo University provides "Bipolar Disorder Treatment Rebuilding Program," in which patients with self-reported treatment resistant bipolar disorder are hospitalized for 2 weeks and undergo detailed examinations. In this study, we report our experience with the initial 43 patients hospitalized during the one and half years after the launch of the program. Among the patients who underwent full assessment, only one was regarded as having genuine treatment-resistant bipolar disorder without comorbidity. In other cases, ten were not diagnosed with bipolar disorder, 3 had organic brain diseases, 12 had comorbid mental disorders and its symptoms were regarded as treatment-resistant bipolar symptoms by the patients, and 18 did not receive adequate treatment because attendant physicians did not adhere to the treatment guidelines or patients did not adhere to the treatment because of lack of insight. The number of participants was not large, and selection bias hampered the generalization of the findings. Insight and adherence were assessed without the use of validated tools. We could not verify recovery after adequate treatment because of the limited hospitalization period. The findings suggest that most patients with self-perceived treatment-resistant bipolar disorder may not have genuine treatment-resistant bipolar disorder. These results shed light on the difficulties of public education of bipolar disorder and importance of providing appropriate services for diagnosis and treatment of bipolar disorder in the community.