Minimum Numbers Research Articles

Modeled Pathways and Fluxes of PCB Dechlorination by Redox Potentials.

Dechlorination is one of the main processes for the natural degradation of polychlorinated biphenyls (PCBs) in an anaerobic environment. However, PCB dechlorination pathways and products vary with PCB congeners, types of functional dechlorinating bacteria, and environmental conditions. The present study develops a novel model for determining dechlorination pathways and fluxes by tracking redox potential variability, transforming the complex dechlorination process into a stepwise sequence. The redox potential is calculated via the Gibbs free energy of formation, PCB concentrations in reactants and products, and environmental conditions. Thus, the continuous change in the PCB congener composition can be tracked during dechlorination processes. The new model is assessed against four measurements from several published studies on PCB dechlorination. The simulation errors in all four measurements are calculated between 2.67 and 35.1% under minimum (n = 0) and maximum (n = 34) numbers of co-eluters, respectively. The dechlorination fluxes for para-dechlorination pathways dominate PCB dechlorination in all measurements. Furthermore, the model also considers multiple-step dechlorination pathways containing intermediate PCB congeners absent in both the reactants and the products. The present study indicates that redox potential might be an appropriate indicator for predicting PCB dechlorination pathways and fluxes even without prior knowledge of the functional dechlorinating bacteria.

Learning curve of achieving competency in emergency endoscopy in upper gastrointestinal bleeding: how much experience is necessary?

ObjectivesThe management of upper gastrointestinal bleeding (UGIB) has seen rapid advancements with revolutionising innovations. However, insufficient data exist on the necessary number of emergency endoscopies needed to achieve competency in...

Infant and Young Child Feeding Practices among Mothers Attending a Government Hospital

Background: Appropriate young children (from birth to two years of life) feeding practice is very crucial to boost up children’s survival and optimum growth and development. Early initiation of breastfeeding (within an hour of childbirth), exclusive breastfeeding for six months and providing nutritionally adequate and appropriate complementary feeding for six months and continued breastfeeding up to two years of age or beyond are the major components of infant and young child feeding (IYCF) practices. The objective of the study was to find out the IYCF practices of mothers.
 Methods: Descriptive cross-sectional research was used and all 180 mothers attending government hospital of Biratnagar were the sample. Interview-based data collection was used by a self-developed, structured and semi-structured questionnaire. Data were analyzed using descriptive statistics using SPSS version 25.0.
 Result: Less than half (40%) mothers started breastfeeding within an hour after delivery, 90.6% fed colostrum, 73.3% practiced exclusive breast feeding and 89.4% continued to feed breastmilk along with complementary feed to under two years children. Among mothers, 68.3% started feeding complementary food at appropriate age, 70.6% of the mothers fed minimum numbers of time or more according to their child age, 80% mothers used to provide diverse food and 66.1% children were receiving minimum acceptable diet.
 Conclusion: The prevalence of timely initiation of complementary feeding at 6 months, minimum dietary diversity, minimum feeding frequency and minimum acceptable diet were satisfactory as almost two third and more children have met minimum acceptable diet. However, practice of early initiation of breast feeding is still low.

Effect of Irrigation Scheduling and Fertility Management on Growth and Yield Parameters of Basmati Rice

The data revealed that the potential effect of irrigation scheduling and fertilizer management on plant height, number of tillers, dry matter accumulation (g plant-1), leaf area index, panicle length, number of panicle, number of grains per panicle and 1000- grains weight, and yields of Basmati rice. The maximum plant height and numbers of tillers were recorded in IW/CPE 1.0 up to panicle initiation stage and thereafter IW/CPE 1.2 up to dough stage and 150% RDN: 5 equal splits at 15, 25, 35, 45 & 60 DAT at all the stages of crop growth, while the minimum plant height and numbers of tillers were observed with the application of IW/CPE 0.8 throughout the growth stage and 100% RDN: 4 equal splits at 15, 30, 45 & 60 DAT at all the growth stages. Similarly, the maximum dry matter accumulation (g plant-1) and leaf area index were recorded in IW/CPE 1.0 up to panicle initiation stage and thereafter IW/CPE 1.2 up to dough stage and 150% RDN: 5 equal splits at 15, 25, 35, 45 & 60 DAT and significantly superior over rest of the treatments, while the minimum dry matter accumulation (g plant-1) and leaf area index were weighted with IW/CPE 0.8 throughout the growth stage and 100% RDN: 4 equal splits at 15, 30, 45 & 60 DAT. Yield attributing characters like panicle length, number of pancle, number of grains per panicle and 1000- grains weight exhibited variations due to different irrigation and fertilizer management. With the application of IW/CPE 1.0 up to panicle initiation stage and thereafter IW/CPE 1.2 up to dough stage and 150% RDN: 5 equal splits at 15, 25, 35, 45 & 60 DAT highest mean panicle length, number of pancle, number of grains per panicle and 1000- grains weight was recorded. The highest grain yield, straw yield and biological yield was recorded in IW/CPE 1.0 upto panicle initiation stage and thereafter IW/CPE 1.2 upto dough stage and 150% RDN: 5 equal splits at 15, 25, 35, 45 & 60 DAT and the lowest grain yield, straw yield and biological yield was recorded in IW/CPE 0.8 throughout the growth stage and 100% RDN: 4 equal splits at 15, 30, 45 & 60 DAT.

HPB P58 Laparoscopic cholecystectomy as a training case in the post-Covid world

Abstract Background Laparoscopic cholecystectomy is an index procedure for all higher surgical trainees, regardless of sub-specialty. Minimum numbers and evidenced ‘Level 4’ competency are necessary for successful completion of training. The Covid-19 pandemic led to falls in training opportunities, during the acute phase itself and in the current drive to reduce elective waiting lists. More cases are outsourced and those cases that are being performed in the NHS may be more complex due to longer waiting times. These twin pressures have led to concerns that training opportunities for laparoscopic cholecystectomy are being limited. This study evaluated the training opportunities for laparoscopic cholecystectomy. Methods All patients who had laparoscopic cholecystectomy over a four-month period, from January 2023 to April 2023 were identified from a prospectively maintained database of operations. Electronic patient records were interrogated to gather pre-operative data (symptomology, co-morbidities, acuity of presentation, pre-operative investigations), intra-operative findings and progress (grade of primary surgeon, nature of operation) and post-operative outcomes and complications. Factors which were associated with the case being performed by a trainee were assessed, as well as differences in outcomes between consultant and registrar procedures. Results There were 150 laparoscopic cholecystectomies performed during the study period. 79 (53%) of these cases were performed acutely ('hot' gallbladders). Registrars performed 36 elective laparoscopic cholecystectomies (51%) and 42 acute cases (53%). Operating time was comparable between registrars and consultants (median operating time [registrar vs. consultant], 72 vs. 78 minutes). There were no particular pre-operative factors that predicted a case being performed by a trainee. There were no differences in post-operative outcome or complication between grade of primary surgeon; there were no bile duct injuries. There were three patients who had a return-to-theatre (2 registrar, 1 consultant case). Conclusions The current case mix in our hospital has meant that just over half the laparoscopic cholecystectomies performed were completed by a trainee. Not a single case was performed by an 'SHO' level surgeon, suggesting that this operation is now the preserve of higher surgical trainees. Without a high-functioning acute gallbladder service, training opportunities for this operation would be severely limited. It is safe to train laparoscopic cholecystectomy, even in the acute setting, and more should be done to identify factors which could improve training opportunities.

Entropy generation minimization of hybrid nanofluid mixed convection flow in lid-driven square enclosure with heat-generating porous layer on inner walls

PurposeThis study aims to numerically scrutinize the entropy generation minimization and mixed convective heat transfer of multi-walled carbon nanotubes–Fe3O4/water hybrid nanofluid flow in a lid-driven square enclosure with heat generation in the presence of a porous layer on inner surfaces, considering local thermal non-equilibrium (LTNE) approach and the non-Darcy flow model.Design/methodology/approachThe dimensionless governing equations for hybrid nanofluid and solid phases are solved by applying the finite volume method and semi-implicit method for pressure-linked equations algorithm.FindingsThe roles of the internal heat generation in the porous layer, LTNE model and nanoparticles volume fraction on mixed convection phenomenon and entropy generation are introduced for lid-driven cavity hybrid nanofluid flow. Based on the investigation of entropy generation and heat transfer, the minimum total entropy generation and average Nusselt numbers are found at 1 ≤ Ri ≤ 10 where the effect of the forced and free convection flow directions being opposite each other is very significant. When considering various nanoparticle volume fractions, it becomes evident that the minimum entropy generation occurs in the case of φ = 0.1%. The outcomes of LTNE number reveal the operating parameters in which thermal equilibrium occurs between hybrid nanofluid and solid phases.Originality/valueThe analysis of entropy generation under various shear and buoyancy forces plays a significant role in the suitable thermal design and optimization of mixed convective heat transfer applications. This research significantly contributes to the optimization of design and the advancement of innovative solutions across diverse engineering disciplines, such as packed-bed thermal energy storage and thermal insulation.

Variations on Ramsey numbers and minimum numbers of monochromatic triangles in line $2$-colorings of configurations

Variations on Ramsey numbers and minimum numbers of monochromatic triangles in line $2$-colorings of configurations

Application of machine learning algorithms to model soil thermal diffusivity

Soil thermal diffusivity (k) is an important thermal property that significantly affects ground energy storage and heat transfer. Direct measurements of soil thermal diffusivity are challenging due to sensor limitations and variable soil physical properties, such as water content, bulk density, mineralogy and texture. Therefore, indirect estimations of k are commonly used. In this study, the abilities of six machine learning (ML) models, including k-nearest neighbours (KNN), multilayer perceptron (MLP), support vector regression (SVR), decision tree (DT), random forest (RF) and gradient boosting decision tree (GBDT), to estimate k values are evaluated based on a compiled database consisting of 999 samples. The ML model performances are evaluated by three model performance indicators (i.e., coefficient of determination-R2, mean absolute error-MAE and root mean square error-RMSE). The GDBT model best estimates soil thermal diffusivity, showing the highest fitness (R2 = 0.99). Model estimation accuracies are determined for varying numbers of available model inputs, and recommended minimum numbers of model inputs needed to accurately estimate thermal diffusivity are tabulated. This study demonstrates the ability of ML models to estimate values of soil thermal diffusivity, and it provides reference information for future thermo-related soil science and soil engineering applications.

Healthcare provision of transcatheter aortic valve implantation in Germany.

Transcatheter aortic valve implantation (TAVI) for aortic stenosis in older patients is the standard of care with awell-established supply density in Germany. In the near future, healthcare reform is planned that may affect TAVI capacities. Therefore, it is important to know how political regulations may interfere with access to services and what the need for TAVI will be in the future, based on demographic trends. The number of TAVI procedures (DRG F98A +F98) and the in-hospital main diagnoses of aortic stenosis (ICD I35) in 2021 were analyzed at the level of county or federal state based on anonymized data from hospital reports, according to §21 of the German hospital reimbursement law. The number of TAVI and aortic stenosis cases was projected for 2035 based on data from the German Federal Statistical Office on demographic developments. With quality assurance data from hospitals in 2019 and aroute planner, the travel time to the next hospital performing TAVI (OPS 5‑35a.0) was calculated, and the consequence of apolitically suggested minimum volume cut-off was analyzed. In 2021, atotal of 26,506 TAVI procedures were reported with amean number of TAVI per 100,000 inhabitants of32 (range between federal states from25 to42). Among the 66,045 diagnoses of aortic stenosis, there was avariation per 100,000 inhabitants from64 to 108 (mean79) between federal states. Compared to 2021, an additional 8748 (+13%) diagnoses of aortic stenosis and an increase of 4673 (+18%) TAVI procedures is to be expected in 2035. In 2019, 57% of German citizens could reach aTAVI hospital within 30 min and 91% within 60 min of driving time by car (mean time to hospital 31 min). Applying aminimum number of 150 TAVI/hospital per year would increase the driving time to hospital from 33to 52 min in Saxony-Anhalt and instantly remove six out of eight hospitals from service in Hesse. Regulation of TAVI services by minimum volume numbers would arbitrarily interfere with access to services, in contradiction to the medical service assurance tasks of federal state governments. These issues should be considered in the upcoming healthcare system reform.

RAPid SimPLE (RAPPLE) Targeted Radiation Treatment vs. Whole Brain Radiotherapy: A Retrospective Study of Matched Patients with Brain Metastases and Poor Prognosis

Patients with brain metastases and poor prognosis are often treated with whole brain radiotherapy (WBRT) which can cause a variety of side effects. Our institution devised a new brain-sparing radiotherapy technique to treat multiple brain metastasis for patients whose poor prognosis does not warrant SRS. This study compares the oncologic outcomes of matched patients treated with RAPPLE and WBRT. RAPPLE uses single-isocenter, coplanar volumetric modulated arc therapy and a non-stereotactic head-shell with IntegraBite™. Brain metastasis were contoured in a single gross tumor volume and expanded by 3 mm to create a planning target volume, of which 99.5% was covered with 95-110% of 20 Gy in 5 fractions. Patients treated with a first course of RAPPLE from January 2017 to December 2021 were identified in an institutional database. Using age, cancer diagnosis, and treatment date, we identified a matched cohort of patients receiving a first course of WBRT with 20 Gy in 5 fractions. Overall survival (OS) was calculated using the Kaplan-Meier method, and intracranial progression was calculated using cumulative incidence with a competing risk of death. Log-rank, Cox regression and Fine-Gray analyses were used for comparisons. Paired t-tests were used to compare patient-reported fatigue measured using 5-level Likert scales before and 2-6 weeks after radiotherapy. The RAPPLE and WBRT cohorts each had 137 patients. The matched median age was 69 years. Primary diagnoses were lung cancer (72%) and other cancers (28%). The minimum, median, and maximum numbers of metastases treated with RAPPLE were 1, 3, and 18, respectively. The median Karnofsky Performance Score (KPS) was 70 in both cohorts. The median survival was 4.1 months for RAPPLE and 4.2 months for WBRT, and the 18-month OS was 11% for RAPPLE and 12% for WBRT (log-rank p = 0.8). On multivariable analysis, KPS, diagnosis, extracranial disease, and use of systemic therapy before and after RT were predictive of OS, but use of RAPPLE vs. WBRT was not (HR = 0.97, 95% CI: 0.75-1.25, p = 0.8). The 18-month cumulative incidence of intracranial progression was 0.49 for RAPPLE and 0.37 for WBRT (p = 0.04). After RAPPLE, 17% required more focal RT and 4% required salvage WBRT, while after WBRT, 3% required focal RT and 4% required repeat WBRT. After RAPPLE, mean patient-reported fatigue remained stable from baseline to first follow-up (2.18 vs. 2.27, p = 0.9), but, after WBRT, it worsened from baseline to first follow-up (1.95 vs. 2.63, p = 0.002). As expected, after RAPPLE, more targeted radiotherapy was required for intracranial progression, but there was no difference in OS between the RAPPLE and WBRT cohorts. Patients reported significantly worse fatigue after WBRT. Almost all patients (96%) treated with RAPPLE avoided WBRT.

The Effects of COVID-19 on General Surgery Residency Programs in the United States.

The COVID-19 pandemic impacted multiple aspects of surgical education. This survey delineates steps taken by general surgery residency programs to meet changing patient-care needs while continuing to provide adequate education. A survey was administered to program directors and coordinators of all United States general surgery residency programs to assess the early effects of the pandemic on residents from March 1 through May 31, 2020. Of 303 programs contacted, 132 (43.6%) completed the survey. Residents were asked to work in areas outside of their specialty at 27.3% of programs. Residency curriculum was changed in 35.6% of programs, and 76.5% of programs changed their academic conferences. Resident schedules were altered at a majority of programs to limit resident-patient exposure, increase ICU coverage, or improve resident utilization. Surgical caseloads decreased at 93.8% of programs; 31.8% of those programs reported concerns regarding residents' achieving the minimum case numbers required to graduate. These results provided insight into the restructuring of general surgery residency programs during a pandemic and may be used to establish future pandemic response plans.

1131 Could Colorectal Cancer Surgery in the England Benefit from Centralisation? a Retrospective Nationwide Correlative Study

Abstract Background Although centralisation has shown benefit for uncommon cancers and high-risk surgeries, there is controversy regarding its benefit for common malignancies. Minor improvements in colorectal surgical morbidity and mortality have the potential to save lives and conserve limited hospital resources. Aim To investigate the relationship between number of major resection cases per hospital and patient outcome measures. The proposed hypothesis was that number of major cases per hospital is inversely proportional to 90-day mortality, 30-day unplanned readmission, and 2-year mortality rates. Method A correlative study using National Bowel Cancer Audit data from 2016-18 in England was performed. The target population was colorectal cancer patients requiring major resection surgery in England. Bivariate analysis was used to investigate the relationship between number of major resections per hospital, and: 90-day mortality, 30-day unplanned readmission, and 2-year mortality rates. Results Combined patient outcome measures from 56,347 cases across 145 hospitals over 2016-18 were assessed. Correlation coefficients demonstrated no significant correlation between the three studied outcome measures (90-Day mortality [r = 0.100, -0.067-0.257, p = 0.240]; 30-day unplanned readmission rate [r = 0.093,-0.073-0.270, p = 0.284]; 2-year mortality [r = -0.069, -0.236-0.097, p = 0.411]). There is insufficient evidence to conclude a statistically significant relationship between number of major resections per hospital and the patient outcomes studied. Conclusions Centralising care by increasing hospital volume is unlikely a solution to improving colorectal patient outcomes in England. This may reflect the UK’s dedicated colorectal surgical training and minimum resection numbers for accreditation. Further studies will need to assess variables such as surgeon volume and case-mix, particularly with regard to rectal surgery.

Integrated Approach Improves Monitoring of Wintering Red Kites in Central Europe

ABSTRACT The Red Kite (Milvus milvus) is a common raptor in suitable areas of Austria, the Czech Republic, and Slovakia during the nonbreeding season. However, the exact number of birds wintering in these countries remains unknown. Through an integrated approach using satellite telemetry, direct field surveys at nocturnal roosts, and citizen science databases, we estimated the wintering population of Red Kites in this area during the winter of 2020/2021. Based on three surveys taking place at the beginning (28 November 2020), middle (9 January 2021), and end (5 February 2021) of winter, respectively, we counted 566, 558, and 536 Red Kites. The observations from online citizen science databases mostly appeared to correspond with the area of communal roost sites. Using our combined approach, the estimates of wintering Red Kites were determined as minimum numbers in the study area. A comparison of historical data (from the second half of the 20th and beginning of the 21st centuries, respectively) and our own results suggests that the wintering population of Red Kites in the study area has increased substantially. This dynamic could be caused by changes in climatic conditions, a shift of the birds' breeding range in Europe, changes in migration behavior and/or food availability, and/or conservation efforts.

An unsupervised dual contrastive learning framework for scatter correction in cone-beam CT image

Purpose:Cone-beam computed tomography (CBCT) is widely utilized in modern radiotherapy; however, CBCT images exhibit increased scatter artifacts compared to planning CT (pCT), compromising image quality and limiting further applications. Scatter correction is thus crucial for improving CBCT image quality. Methods:In this study, we proposed an unsupervised contrastive learning method for CBCT scatter correction. Initially, we transformed low-quality CBCT into high-quality synthetic pCT (spCT) and generated forward projections of CBCT and spCT. By computing the difference between these projections, we obtained a residual image containing image details and scatter artifacts. Image details primarily comprise high-frequency signals, while scatter artifacts consist mainly of low-frequency signals. We extracted the scatter projection signal by applying a low-pass filter to remove image details. The corrected CBCT (cCBCT) projection signal was obtained by subtracting the scatter artifacts projection signal from the original CBCT projection. Finally, we employed the FDK reconstruction algorithm to generate the cCBCT image. Results:To evaluate cCBCT image quality, we aligned the CBCT and pCT of six patients. In comparison to CBCT, cCBCT maintains anatomical consistency and significantly enhances CT number, spatial homogeneity, and artifact suppression. The mean absolute error (MAE) of the test data decreased from 88.0623 ± 26.6700 HU to 17.5086 ± 3.1785 HU. The MAE of fat regions of interest (ROIs) declined from 370.2980 ± 64.9730 HU to 8.5149 ± 1.8265 HU, and the error between their maximum and minimum CT numbers decreased from 572.7528 HU to 132.4648 HU. The MAE of muscle ROIs reduced from 354.7689 ± 25.0139 HU to 16.4475 ± 3.6812 HU. We also compared our proposed method with several conventional unsupervised synthetic image generation techniques, demonstrating superior performance. Conclusions:Our approach effectively enhances CBCT image quality and shows promising potential for future clinical adoption.

Analysis of heat transfer and flow over a rotating cylinder at subcritical Reynolds numbers based on Taguchi method

The flow past the rotating circular cylinder and the effect of buoyancy on heat transfer char-acteristics are studied numerically for the Reynolds number of 20 and 40 and the Prandtl number of 0.7. The lift and drag coefficients, Strouhal number, and local Nusselt number on the cylinder are studied under the sway of combined buoyancy (at the Richardson num-ber varies from 0 to 2) and different rotational directions. Although the interaction between buoyancy and rotation is a puzzling heat transfer problem, the direction of rotation is found to have significant effects on the flow patterns and heat transfer rate. The main innovation of the present work is to determine the extreme points of Nusselt numbers when different conditions are applied. For a positive rotation, the maximum local Nusselt number is at θ=225o, and the minimum local Nusselt number is at θ=100o. In contrast, for a negative rotation, the maxi-mum and minimum local Nusselt numbers are at θ=140o and θ=270o, respectively. Applying Taguchi method, it is found that average Nusselt number is more dependent on Reynolds number than other factors. Additionally, it can be concluded that the direction of rotation can be used as a powerful tool to adjust the heat transfer rate and the required value of drag and lift. Consequently, without applying different rotation speeds, it would be difficult to stabilize the flow, and with the aid of Taguchi method, it is determined that rotation is deciding factor in stabilizing flow patterns. The results are in good agreement with the experimental results.

Guidance on breastfeeding in the prenatal period offered to pregnant women: A literature review

Introduction: Breastfeeding is the best way to provide the ideal food for the healthy growth and development of newborns. However, it is observed that there is a latent tendency to early weaning and mixed breastfeeding, making this a public health problem. Objective: The objective of this work is to clarify the importance of exclusive breastfeeding, as well as the role of the health professional to promote breastfeeding and present WHO data on this topic. Methodology: This is a descriptive bibliographic review work that had as theoretical basis articles published in the period from 2013 to 2023, where the most important ones were selected to be discussed here. Results: According to the information covered in the articles, exclusive breastfeeding is very important for the baby's health, there is also a lack of adequate transfer of information about this importance to mothers in the prenatal period. Conclusion: With the accomplishment of the present study it became evident the fact that despite the recommendations of the World Health Organization, especially with regard to exclusive breastfeeding, the reality in Brazil is far from reaching the minimum numbers of pregnant women who choose to breastfeed after the gestational period.

The occurrence and distribution of microplastic contamination in Qara-sou river, Iran: incidence, quantification, and qualification

ABSTRACT In the current study to investigate the characte – rization of Microplastic – released into the Qara-Sou river, Kermanshah, Iran, 12 sampling sites were surveyed along a 100 km stretch of the river. The maximum and minimum numbers of MPs were about 10,000 and 45,000 items per m3. The average concentration of MPs in the Qara-sou river was 23,666 ± 12147 items per m3. The dominant size and shape of MPs ranged from 0.025 to 1 mm (~44%) and fiber shapes (~78%). In addition, SEM-EDS analyses confirmed the presence of carbon-dominant peaks with O, Ca, Fe, Al, and Si. FTIR spectra have identified some MPs in the PVC, PU, PS, PE, and nylon polymer categories. A high level of MPs was discharged into the Qara-sou river, which should be attracting the attention of the community and decision-makers to reduce damage to the environment and human health.

Immunohematological evaluation of red cell alloimmunization and statistical assessment of various adsorption techniques in warm autoimmune hemolytic anemia

Adsorption techniques are widely applied to detect underlying masked alloantibodies in warm autoimmune hemolytic anemia (WAIHA). We established various adsorption techniques with an aim to detect alloimmunization in WAIHA This study conducted over a period of nine years included 298 patients of WAIHA. Complete immunohematological evaluation was performed on these 298 samples following departmental protocols. Clinical and laboratory details of patients were obtained from patient files. Various adsorption methods were performed and statistically evaluated in the study. Out of 479 cases of autoimmune hemolytic anemia, WAIHA comprised of 62.2 % (N = 298). A total of 139 (46.6 %) serum samples revealed autoantibodies. Adsorption study was performed in 101 (72.7 %) indicated samples and 24 (23.8 %) of these showed 26 alloantibodies. Among the patients subjected to adsorption study hemolytic marker were significantly deranged in the alloimmunization group (p < 0.01). Polyethylene glycol (PEG) adsorption was the quickest (52.2–54.6 min) of all adsorption techniques with minimum (1.3–1.5) numbers of adsorptions needing for complete removal of serum antibodies. The LISS-papain (LP) technique was found to be more sensitive and specific compared to the other two techniques. The agreement between PEG adsorption and LP adsorption was found to be ‘perfect’ (96.4 %) with a Cohen’s kappa (k) value of 0.9. We conclude that identification of alloantibody specificities underlying a warm autoantibody is critical for a safe and effective transfusion. All WAIHA patients with history of blood transfusion, pregnancy or both should be subjected to adsorption study. Selection of a suitable adsorption technique depends on multiple important factors.

Modeling-based prediction tools for preimplantation genetic testing of mitochondrial DNA diseases: estimating symptomatic thresholds, risk, and chance of success.

Preimplantation genetic testing (PGT) has become a reliable tool for preventing the germline transmission of mitochondrial DNA (mtDNA) variants. However, procedures are not standardized across mtDNA variants. In this study, we aim to estimate symptomatic thresholds, risk, and chance of success for PGT for mtDNA pathogenic variant carriers. We performed a systematic analysis of heteroplasmy data including 455 individuals from 187 familial pedigrees with the common m.3243A>G, m.8344A>G, or m.8993T>G pathogenic variants. We applied binary logistic regression for estimating symptomatic thresholds of heteroplasmy, simplified Sewell-Wright formula and Kimura equations for predicting the risk of disease transmission, and binomial distribution for predicting minimum oocyte numbers. We estimated the symptomatic thresholds of m.8993T>G and m.8344A>G as 29.86% and 16.15%, respectively. We could not determine a threshold for m.3243A>G. We established models for mothers harboring common and rare mtDNA pathogenic variants to predict the risk of disease transmission and the number of oocytes required to produce an embryo with sufficiently low variant load. In addition, we provide a table allowing the prediction of transmission risk and the minimum required oocytes for PGT patients with different variant levels. We have established models that can determine the symptomatic thresholds of common mtDNA pathogenic variants. We also constructed universal models applicable to nearly all mtDNA pathogenic variants which can predict risk and minimum numbers for PGT patients. These models have advanced our understanding of mtDNA disease pathogenesis and will enable more effective prevention of disease transmission using PGT.

Effects of a hydropower project on a high-value Asian elephant population.

Habitat loss and fragmentation are leading contributors to the endangered status of species. In 2006, the Nakai Plateau contained the largest known Asian elephant (Elephas maximus) population in the Lao People's Democratic Republic (Lao PDR), and the population was among those with the highest genetic diversity reported for Asian elephants. In 2008, completion of the Nam Theun 2 hydroelectric dam inundated much of the Plateau, resulting in the loss of 40% of elephant habitat. We studied elephant presence, movements, and the incidence of human-elephant conflict (HEC) on the Nakai Plateau and surrounding areas from 2004 to 2020, before and for 12 years after dam completion. To examine contemporary population dynamics in the Nakai elephants, we used genetic sampling to compare minimum population numbers, demography, and levels of genetic diversity from the wet and dry seasons in 2018/2019, 10 years after dam completion, with those reported in a pre-dam-completion genetic survey. After dam completion, we found a major increase in HEC locally and the creation of new, serious, and persistent HEC problems as far as 100 km away. While we were unable to compare estimated population sizes before and after dam completion, our data revealed a decrease in genetic diversity, a male-biased sex ratio, and evidence of dispersal from the Plateau by breeding-age females. Our results raise concerns about the long-term viability of this important population as well as that of other species in this region. Given that hydropower projects are of economic importance throughout Laos and elsewhere in southeast Asia, this study has important implications for understanding and mitigating their impact.