Observed Time Period Research Articles

Reasons for milking system adoption: The case of Switzerland

This paper studies the importance which farm managers attach to the investment in the milking system in terms of their (management) objectives and expectations. According to a survey of 455 Swiss farm managers, the main reasons for investment decisions for all milking systems were to reduce labour and physical stress. For parlours, income objectives and animal welfare were more important than for other milking systems. In the case of automatic milking systems (AMS), the focus was on making working hours more flexible and increasing family time. According to farm managers, these objectives were largely achieved. The study shows, that higher income or production volume become less important reasons over the observed time period and that AMS are implemented by older farm managers.

How should one design and position straw feeders in group-housed horses? A case study on occupancy and agonistic interactions at straw feeders in a large group of horses

As group housing of horses can be associated with increased injury risk especially when there are limited resources, the aim of this study was to allow initial, scientifically based recommendations regarding the positioning and design of straw feeders. Data collection took place in a Hinrichs Innovation + Technik (HIT) active stable with 50–62 horses kept in one single group. Occupancy, feeding distances, prevalence of agonistic interactions (AIS) as well as the percentage of feeding disturbances at two different straw feeders were analysed. Equine behaviour was recorded for 6 h/day on 15 summer and 15 winter days. Using generalised linear mixed models, considering the fixed effects of feeder, a fresh straw supply and the interaction of observation day and time period delivered the best prediction for the number of feeding events/h and the prevalence of AIS/h. Here, both feeders differed (p < 0.05) with twice as many feeding events/h, but threefold more AIS/h respectively twice as many AIS/horse at the larger feeder, where conspecifics fed side by side. Sixty-five % of the AIS with low risk of injury and 92 % of the AIS with high risk of injury led to feeding disturbances. The latter made up 25 % of all AIS in total with no differences between both feeders. Feeding distances did not differ either. The horses tended to use only every third opening space when feeding simultaneously. This knowledge should be taken into account when making assumptions about the de facto animal:feeding place ratio and the design of straw feeders in the future. Moreover, regarding the smaller feeder, the horses preferred to feed simultaneously with the feeder edge between them, so that the actual animal distances were smaller. Additional research is needed to investigate, how feeding in rectangular position to each other influences threatening behaviour inside a feeder. In this study, a central positioning within a paddock was beneficial with respect to feeder usage, but disadvantageous regarding AIS and displacements. However, the investigation of further straw feeders and farms is essential to allow general statements, as the study also proves that many factors such as season and rank order stability potentially influence equine behaviour at straw feeders.

Two Decades of Fatal Workplace Accidents in Milan and Monza, Italy: Trends, Work Sectors, and Causes From Autoptic Data.

Work-related fatalities represent an important global public health threat, accounting for over 300,000 deaths annually. Despite preventive strategies, fatalities persist, necessitating comprehensive investigations. Autoptic investigations, when ordered, offer comprehensive data on fatal accidents, in particular with detailed information about the type of accident, lesions, and type of work, enabling a thorough analysis of various factors contributing to workplace deaths. This study investigates work-related fatalities in Milan and Monza Brianza, Lombardy, analyzing patterns, industries, and factors leading to death among workers. This retrospective study analyzed all fatal work accident data from the Autopsy Database of the Legal Medicine Institute of Milan from January 2000 to December 2022. We also estimated the risk of fatal accidents per 1.00.000 workers using ISTAT data for the different work sectors. Of the 17,841 violent deaths in Milan and Monza Brianza, 308 resulted from work-related accidents. The majority were male (95.1%). The secondary sector showed the higher estimated risk (27 /106 vs. 19/106 in primary and 2.3/106 in tertiary sector) accounted for 78.5% of fatalities, with specialized workers (35.1%) and construction workers (25%) being the most affected. Falls from above were the leading cause of death (36.7%). A decreasing trend in fatal accidents over the study period was observed, with July having the greatest frequency. The most common causes of death were polytrauma (36.4%) and head injuries (19.2%). Non-Italian workers constitute a noteworthy percentage of fatal cases (24%). The secondary sector has the most fatal accidents at work despite a decrease in accidents over the observed time period. There is a need for rigorous analysis and interventions, using forensic autopsy case data to help understand causes, and collaboration between institutions is encouraged to develop effective preventive policies.

Living with parents or attaining residential independence? A comparative study of young adults’ living arrangements in China and South Korea

This study examines the living arrangements of never-married urban young adults in China and South Korea from 2003 to 2018. Using data from the Chinese General Social Survey and the Korean General Social Survey, we investigate the relationship between socioeconomic status and young adults’ living arrangements. Our findings show that a majority of Korean young adults lived with their parents during the observed time period, while Chinese young adults experienced large shifts in their living arrangements. Findings from weighted logistic models demonstrate that employed or high-income young adults were more likely to leave the parental home than those who were not working, suggesting the important role of economic security in independent living. Highly educated young adults in China tended to have residential independence, while education was not significantly associated with Korean young adults’ living arrangements. Korean young adults with highly educated fathers were more likely to stay with parents. The interconnection between family socioeconomic characteristics at the micro level and variations in opportunity structures at the macro level results in country-specific patterns of living arrangements.

Treatment of bipolar depression: clinical practice vs. adherence to guidelines-data from a Bavarian drug surveillance project.

Pharmacotherapy of bipolar depression (BPD) is confronted with major clinical challenges, like limited evidence-based treatment options, regular cases of treatment resistance, and risk of treatment-emergent affective switches. Medical guidelines can support practitioners to make decisions based on current scientific evidence. The objective of this study is to evaluate to what extent recommendations of the 2019 German S3 guidelines "Diagnosis and Treatment of Bipolar Disorders" are reflected in clinical practice in inpatient treatment. We conducted a descriptive analysis of prescription numbers in 2,627 patients with BPD in a naturalistic inpatient setting analyzing data from the ongoing Bavarian multicenter drug safety project Pharmaco-Epidemiology and Vigilance (Pharmako-EpiVig) from the years 2014-2022. Of the patients, 38% were not administered any drug explicitly recommended for treatment of BPD, that is, quetiapine, lamotrigine, carbamazepine, or olanzapine. Only 6% of the patients received monotherapy with one of those drugs. Of the patients, 34% were administered ≥4 psychotropic drugs simultaneously. Patients received 912 different therapy regimens of mono or combination therapy with mood stabilizers (MS), atypical antipsychotics (AAP), and antidepressants. Of the patients, 72% received an antidepressant and 6% without concomitant prescription of an AAP or MS. Prescription rates of venlafaxine (21% to 14%) and tricyclic antidepressants (9% to 6%) decreased significantly from the first (2014-2016) to the last (2020-2022) observed time period. Of the patients, 60% received an MS. Prescription rate of valproate (22% to 14%) decreased significantly, while lithium prescription increased significantly (29% to 35%). Of the patients, 71% were administered an AAP. Quetiapine was the most prescribed drug overall (43%). Only two patients were administered a combination of olanzapine and fluoxetine. Our results demonstrate a substantial gap between guideline recommendations and current clinical practice. The remarkable heterogeneity in treatment regimens, with no discernible dominant treatment approach, is in part a reflection of the complexity of bipolar disorder but also substantiates the need of comprehensive recommendations regarding combination therapies. Increase in lithium prescription is an encouraging development due to its unique efficacy in maintenance treatment. To improve the quality of clinical practice guideline implementation, more randomized controlled trials shouldbeconducted in the future to prospectively investigate different implementation strategies.

20 Years of triple-valve surgery in the UK: demographic and outcome trends.

To describe evolving demographic trends and early outcomes in patients undergoing triple-valve surgery in the UK between 2000 and 2019. We planned a retrospective analysis of national registry data including patients undergoing triple-valve surgery for all aetiologies of disease. We excluded patients in a critical preoperative state and those with missing admission dates. The study cohort was split into 5 consecutive 4-year cohorts (groups A, B, C, D and E). The primary outcome was in-hospital mortality, and secondary outcomes included prolonged admission, re-exploration for bleeding, postoperative stroke and postoperative dialysis. Binary logistic regression models were used to establish independent predictors of mortality, stroke, postoperative dialysis and re-exploration for bleeding in this high-risk cohort. We identified 1750 patients undergoing triple-valve surgery in the UK between 2000 and 2019. Triple valve surgery represents 3.1% of all patients in the dataset. Overall mean age of patients was 68.5 ± 12 years, having increased from 63 ±12 years in group A to 69 ± 12 years in group E (P < 0.001). Overall in-hospital mortality rate was 9%, dropping from 21% in group A to 7% in group E (P < 0.001). Overall rates of re-exploration for bleeding (11%, P = 0.308) and postoperative dialysis (11%, P = 0.066) remained high across the observed time period. Triple valve replacement, redo sternotomy and poor preoperative left ventricular ejection fraction emerged as strong independent predictors of mortality. Triple-valve surgery remains rare in the UK. Early postoperative outcomes for triple valve surgery have improved over time. Redo sternotomy is a significant predictor of mortality. Attempts should be made to repair the mitral and/or tricuspid valves where technically possible.

Occurrence and Outcome of Infective Endocarditis after Surgical Compared to Transcatheter Pulmonary Valve Implantation in Congenital Heart Disease.

Background: Conflicting data exist on the occurrence and outcome of infective endocarditis (IE) after pulmonary valve implantation. Objectives: This study sought to assess the differences between transcatheter pulmonary valve implantation (TPVI) and surgical pulmonary valve replacement (SPVR). Methods: All patients ≥ 4 years who underwent isolated pulmonary valve replacement between 2005 and 2018 were analyzed based on the data of a major German health insurer (≈9.2 million insured subjects representative of the German population). The primary endpoint was a composite of IE occurrence and all-cause death. Results: Of 461 interventions (cases) in 413 patients (58.4% male, median age 18.9 years [IQR 12.3-33.4]), 34.4% underwent TPVI and 65.5% SPVR. IE was diagnosed in 8.0% of cases during a median follow-up of 3.5 years. Risk for IE and all-cause death was increased in patients with prior IE (p < 0.001), but not associated with age (p = 0.50), sex (p = 0.67) or complexity of disease (p = 0.59). While there was no difference in events over the entire observational time period (p = 0.22), the time dynamics varied between TPVI and SPVR: Within the first year, the risk for IE and all-cause death was lower after TPVI (Hazard Ratio (HR) 95% CI 0.19 (0.06-0.63; p = 0.006) but increased over time and exceeded that of SPVR in the long term (HR 10.07 (95% CI 3.41-29.76; p < 0.001). Conclusions: Patients with TPVI appear to be at lower risk for early but higher risk for late IE, resulting in no significant difference in the overall event rate compared to SPVR. The results highlight the importance of long-term specialized care and preventive measures after both interventions.

Trends of the prevalence rate of central lymph node metastasis and multifocality in patients with low-risk papillary thyroid carcinoma after delayed thyroid surgery.

Active surveillance has been an option for patients with low-risk papillary thyroid carcinoma (PTC). However, whether delayed surgery leads to an increased risk of local tumor metastasis remain unclear. We sought to investigate the impact of observation time on central lymph node metastasis (CLNM) and multifocal disease in patients with low-risk PTC. Patients who were diagnosed with asymptomatic low-risk PTC, and with a pathological maximum tumor size ≤1.5 cm by were included. The patients were classified into observation group and immediate surgery group, and subgroup analyses were conducted by observation time period. The prevalence of CLNM, lymph node (LN) involved >5, multifocal PTC and bilateral multifocal PTC were considered as outcome variables. The changing trend and risk ratio of prevalence over observation time were evaluated by Mann-Kendall trend test and Logistics regression. Overall, 3,427 and 1,860 patients were classified to the observation group and immediate surgery group, respectively. Trend tests showed that decreasing trends both on the prevalence of CLNM and LN involved >5 over the observation time, but the difference was not statistically significant, and the prevalence of multifocal PTC and bilateral multifocal PTC showed the significant decreasing trends. After adjustment, multivariate analysis showed no statistically significant difference between observed and immediate surgery groups in the four outcome variables. In patients with subclinical asymptomatic low-risk PTC, observation did not result in an increased incidence of local metastatic disease, nor did the increased surgery extent in patients with delayed surgery compared to immediate surgery. These findings can strengthen the confidence in the active surveillance management for both doctors and patients.

Women Approach Cute Objects but Avoid Cute Adult Female Faces: Verification of Correlation between Body Sway and Cuteness Rating

Perceived cuteness motivates people to approach cute objects, but no evidence exists of unconscious approach behavior toward objects. Given the unconscious responses associated with cuteness perception, an unconscious drive to physically approach cute objects is likely to occur. However, approach behavior may or may not occur depending on whether or not the perceived cute object is an adult, a baby, or a non-human. In this study, we recruited 24 participants and conducted a correlation study between cuteness ratings and body sway to examine whether or not the approach response is dependent on perceived cuteness. Results showed that the approach or avoidance response to cute objects was observed only in women. For babies, the approach response occurred regardless of the degree of cuteness, but for adult female faces, the cuter the face, the more the avoidance response occurred. For non-human images, the cuter the image, the more the approach response occurred only in early period of observation time. These results suggest that cuteness perception controls physical distance differently depending on the target of evaluation.

Successful pregnancy and delivery after HiPorfin photodynamic therapy for cervical high-grade squamous intraepithelial lesion

ObjectiveThe study analyzed HiPorfin-Photodynamic therapy (PDT) for young women with cervial high-grade squamous intraepithelial lesion (HSIL) and evaluated the impact of PDT on their pregnancy and delivery. MethodsRetrospective analysis of 4 patients (21–33 years old) were treated with HiPorfin® (2 mg/kg) PDT in 2019–2022. 1 patient suffered from cervical intraepithelial neoplasia (CIN)Ⅱ and 3 patients from CIN Ⅲ. 630 nm laser light irradiated the cervical surface and endocervical canal with light dose of 150 J/cm2 and 100–120 J/cm2 respectively. ResultsThe median observation time period was 40.5 months. Cure rate, HPV eradication rate and negative conversion rate of cytology were all 100.0 % at 3, 6 and 12 months. All cervical canal lesions completely turned negative. No recurrence occurred during the long-term follow-up period. None of patients suffered from infertility. Three patients delivered vaginally and one delivered by C-section to healthy infants at term. ConclusionHiPorfin® PDT for cervical HSIL was proved to be a safe method without adverse effects on female fertility and allowing these women to have healthy, full-term children.

ОЦЕНКА ИНВЕСТИЦИОННОЙ ЗАВИСИМОСТИ ОТРАСЛЕЙ ОБРАБАТЫВАЮЩЕЙ ПРОМЫШЛЕННОСТИ АЗЕРБАЙДЖАНА

In this article, branches of the manufacturing industry of Azerbaijan were studied in order to determine their dependence on investments based on annual statistical data. These are the textile industry, the production of building materials and the production of machinery and equipment and others. The time period of observation is 17 years from 2005 to 2022. The article presents the results of correlation analysis of dependencies, studies lag dependencies and others. Based on the studied literature and research results, the article considers options for attracting investments in the form of the development of new technologies, which also manifests itself in improving the existing management system with the available results. Based on the results obtained, the author presents conclusions and suggestions that can be used in the construction and monitoring of investment policy in manufacturing industries.

EuReCa_Srbija Subotica 2014-2021 - epidemiologija vanbolničkog srčanog zastoja

Aims and goals Continuous monitoring of epidemiology, treatment and outcome of out of hospital cardiac arrest on the territory of Subotica municipality. Methodology EuReCa Serbia is a part of international, prospective, multicentric, EuReCa_One project, which records survival of patients (epidemiology, treatment, outcome) with out of hospital cardiac arrest in Europe, who are registered on "clinicaltrials.gov (registration number: NCT02236819) by ERC. Data gathered by research center Subotica from October 1, 2014 to December 31, 2021. have been observed. Statistical software SPSS Statistics for Windows v27.0 was used for analysis. Variables are presented through incidence and percentage, and Chi-Square test was used for connection testing between categorical variables. Results During the observed time period, the incidence of EuReCa events was 171,67/100.000. Annual incidence of initiated cardiopulmonary resuscitation was 60.75/100000. Age Median for both sexes was 71 (IQR 62-81). Incidence of out of hospital cardiac arrest in patients" residences, per year, was 157.08 /100.000. Yearly Incidence of provided basic life support was 11.07. Return of spontaneous circulation (ROSC) was achieved in 164 patients of 516 cases (31.78%), which makes the incidence of achieved ROSC, per year, 19.31/100 000. Conclusion Incidence of initiated cardiopulmonary resuscitation and achieved return of spontaneous circulation can be compared with results of European countries. Further monitoring of OHCA is necessary so that the reasons for poor laymen involvement can be determined.

Turbidity effect derived from palm oil mill effluent altered predation period of siamese fighting fish (Betta splendens, Regan 1910)

Contamination of palm oil mill effluent (POME) into water bodies potentially increases turbidity, resulting in disrupting aquatic organisms behaviour, including predation period. However, the effect of increased turbidity due to POME contamination toward the fish predation is still unexplored. Siamese fighting fish (Betta splendens) is one of the ideal test fish to investigate this effect. This study aims to analyze the effect of increased turbidity due to POME contamination toward the fish predation period of Siamese fighting fish. The research design was completely randomized with six treatments (0, 20, 40, 60, 80 and 100 NTU) followed by five repetitions for each treatment. The experimental data parameters include the predation rate of Siamese fighting fish during foraging activity, which was calculated from the percentage of the number of mosquito larvae consumed per 2 min during 15 min. The significance level of predation between treatments in each observation time period was analyzed using a one-way Analysis of Variance (ANOVA) with the confidence interval set at the 95% level. The results showed that at a turbidity level of 100 NTU, the predation period of Siamese fighting fish had been altered. In the period of 0-2 min, the predation rate decreased significantly. Meanwhile, the predation rate increased significantly during the period of 2-4 and 8-10 min. This finding should be considered to support POME remediation management, especially turbidity parameters.Keywords:POMEFeeding periodForaging areaTurbidity

Momentum budget analysis of maintenance of Arabian Sea tropical cyclone Ockhi

In this study an effort is done to explain the maintenance of the Very Severe Cyclonic Storm(VSCS) Ockhi using the angular momentum(AM) budget technique . The AM budget equation for a region bounded by , to and to in (x,y,p,t) co-ordinate system is used from an earlier study. The different terms are explained with relative importance. This technique is used to the diagnosis of different small, medium and large weather systems by several authors. The Very Severe Cyclonic Storm(VSCS) Ockhi –a rare situation in Arabian Sea – is studied with a reanalyzed dataset in a fine mesh width. The values of different terms in the AM budget equation are calculated for pressure levels-1000,800,500,200,100hpa’s and for four day periods viz. 30 Nov ,01 Dec ,02 Dec and 03 Dec 2017 .The AM budget was prepared for the eight observation time periods of 00, 03,06,09,12,15,18,21 UTC for each day. The area selected is 5.04N - 19.2N, 60E- 77E where VSCS TC Ockhi formed.The sink and source terms are compared and the results are correlated with the help of charts . The NCMRWF IMDAA data set is used and the results are depicted in charts and results are compared with the observed synoptic behavior of the system .&#x0D; Keywords: - Angular Momentum Budget, Equation, Source/Sink terms,&#x0D; VSCS Ockhi-Diagnosis

Decreased Seasonal Influenza Rates Detected in a Crowdsourced Influenza-Like Illness Surveillance System During the COVID-19 Pandemic: Prospective Cohort Study.

Seasonal respiratory viruses had lower incidence during their 2019-2020 and 2020-2021 seasons, which overlapped with the COVID-19 pandemic. The widespread implementation of precautionary measures to prevent transmission of SARS-CoV-2 has been seen to also mitigate transmission of seasonal influenza. The COVID-19 pandemic also led to changes in care seeking and access. Participatory surveillance systems have historically captured mild illnesses that are often missed by surveillance systems that rely on encounters with a health care provider for detection. This study aimed to assess if a crowdsourced syndromic surveillance system capable of detecting mild influenza-like illness (ILI) also captured the globally observed decrease in ILI in the 2019-2020 and 2020-2021 influenza seasons, concurrent with the COVID-19 pandemic. Flu Near You (FNY) is a web-based participatory syndromic surveillance system that allows participants in the United States to report their health information using a brief weekly survey. Reminder emails are sent to registered FNY participants to report on their symptoms and the symptoms of household members. Guest participants may also report. ILI was defined as fever and sore throat or fever and cough. ILI rates were determined as the number of ILI reports over the total number of reports and assessed for the 2016-2017, 2017-2018, 2018-2019, 2019-2020, and 2020-2021 influenza seasons. Baseline season (2016-2017, 2017-2018, and 2018-2019) rates were compared to the 2019-2020 and 2020-2021 influenza seasons. Self-reported influenza diagnosis and vaccination status were captured and assessed as the total number of reported events over the total number of reports submitted. CIs for all proportions were calculated via a 1-sample test of proportions. ILI was detected in 3.8% (32,239/848,878) of participants in the baseline seasons (2016-2019), 2.58% (7418/287,909) in the 2019-2020 season, and 0.27% (546/201,079) in the 2020-2021 season. Both influenza seasons that overlapped with the COVID-19 pandemic had lower ILI rates than the baseline seasons. ILI decline was observed during the months with widespread implementation of COVID-19 precautions, starting in February 2020. Self-reported influenza diagnoses decreased from early 2020 through the influenza season. Self-reported influenza positivity among ILI cases varied over the observed time period. Self-reported influenza vaccination rates in FNY were high across all observed seasons. A decrease in ILI was detected in the crowdsourced FNY surveillance system during the 2019-2020 and 2020-2021 influenza seasons, mirroring trends observed in other influenza surveillance systems. Specifically, the months within seasons that overlapped with widespread pandemic precautions showed decreases in ILI and confirmed influenza. Concerns persist regarding respiratory pathogens re-emerging with changes to COVID-19 guidelines. Traditional surveillance is subject to changes in health care behaviors. Systems like FNY are uniquely situated to detect disease across disease severity and care seeking, providing key insights during public health emergencies.

Post-Transplant Cyclophosphamide-Based Prophylaxis and Its Impact on the Immune Reconstitution and the Incidence of Infectious Complications

Introduction PTCY-based prophylaxis is becoming increasingly prevalent across allogeneic hematopoietic cell transplantation (allo-HCT) due to its efficacy on GVHD prevention. However, using PTCY has been associated with delayed engraftment, immune reconstitution, and high infectious complications. Although different studies have investigated how PTCY interacts with infectious risk after allo-HCT, whether the incidences of these complications differ depending on donor type has not been widely investigated. At our institution, PTCY-based prophylaxis has become our institutional prophylaxis irrespectively of the selected donor type. This study explores the incidences of infectious complications and immune cell reconstitution dynamics in patients undergoing allo-HCT with PTCY and according to the donor type selected. Methods This study included the 253 consecutive adults who underwent peripheral blood allo-HCT with PTCY at our institution between 2013 and 2021. Retrospective data was updated in June 2023. All patients received levofloxacin 500mg daily from day +1 until neutrophil engraftment. No patient received letermovir. Cumulative incidences (CI) analyses have been estimated considering death as competing event and reported at day +30, +100, +180, and 1-year. Infection density was calculated by dividing the number of infections of a patient by the observed time period after allo-HCT. Immune reconstitution was evaluated by the measurement of lmmunoglobulin (IgG), CD4+T-cell (CD4) and CD8+T-cells (CD8) levels in alive patients without relapse history. Results The median age was 53 years (range, 18-70 years), with 44 (17.6%) patients older than 65. Acute myeloid leukemia was the most common underlying diagnosis (38%), and 103 (41%) patients received myeloablative conditioning regimens. As reported in Table 1, 120 (47.4%) patients received grafts from HLA-matched donors, 84 (33.2%) from 9/10 HLA mismatched unrelated donors (MMUD) and 49 (19.4%) from haploidentical donors (haplo-HCT). To perform the statistical analysis, the study cohort was divided into 3 groups according to donor type. Baseline characteristics were balanced between these 3 groups, except for the proportion of patients with HCT-CI&amp;gt;3, higher in HLA-matched donor group (p=0.028). As shown in Table 1, 244 (96%) patients engrafted. The median of days to neutrophil and platelet engraftment, and the CIs of clinically relevant acute and chronic GVHD did not differ according to the donor type. Moreover, the duration of the immunosuppression and post-transplant outcomes were similar in all groups. Bacterial bloodstream infections (BSI) were predominantly diagnosed within the first 30 days post allo-HCT, and with a tend to higher incidence in allo-HCT performed from HLA-matched donors (p=0.07). CMV reactivation was the most frequent viral infection in all groups, occurring mostly between days +30 and +100, and with a higher CI in the MMUD group (p=0.033). CMV disease, grade 2-4 BK hemorrhagic cystitis, VHH6 reactivation/disease and fungal infection CIs were not prevalent post-transplant complications generally occurring during the first 100 days after allo-HCT, with comparable CI differences among the 3 groups. The CI of respiratory viral infections increased steadily during the first year after allo-HCT, with similar incidences among the 3 study groups. Infection density analysis showed comparable volume of infections complications in the 3 study groups. As shown in Figure 1, a higher infection density was observed during the first 100 days after allo-HCT (with approximately 1 or 2 number of infections occurring during that time period in most of the patients). After day +100, the number of infections progressively decreased during the post-transplant follow-up. Immune reconstitution was measured in 139 (55%) alive patients. IgG, CD4, and CD8 levels tended to normalize in most patients from day 180 onwards, with median days to normalization of 208, 216, and 203 days, respectively, and with no differences according to donor type. Conclusions Patients undergoing allo-HCT with PTCY-based prophylaxis have a relevant infectious density rate during the peri-engraftment phase with no differences according to donor type. Infectious complications decreased 6 months after allo-HCT, and in parallel with discontinuation of immunosuppression and immune reconstitution with no differences according to donor type.

Jumping Trends In Trampoline-Related Craniofacial Injuries.

In 1990, the American Academy of Pediatrics recommended the sale of trampolines cease in the United States. The risk of traumatic injury is well-documented, yet trampolines remain a growing source of recreation. Trampoline parks, in particular, are becoming a common entertainment attraction that can result in serious injury. There is currently a paucity of literature characterizing craniofacial injuries from trampoline use and plans to prevent these injuries. A retrospective review of the National Electronic Injury Surveillance System was conducted to analyze emergency department visits for trampoline-related craniofacial injuries in 1 to 20 year olds between 2013 and 2022. An estimated 206,866 trampoline-related craniofacial injuries occurred. Males suffered injuries 1.67 times more frequently than females. Injured sites included the head (41.0%), face (23.2%), neck (20.4%), mouth (11.9%), eyeball (2.0%), and ear (1.4%). The most common diagnoses were lacerations (28.9%), internal injuries (23.2%), strain/sprains (14.8%), contusions/abrasions (13.0%), and concussions (8.7%). Head internal injuries and facial lacerations significantly increased over the observed time period. Trampolines are a rising source of craniofacial trauma for America's youth. Children between 3 and 11 years old were disproportionately affected. Regulation over trampoline safety features remains limited in the United States. Future studies should aim to characterize the mechanisms of these injuries for the development of targeted safety measures.

Operative treatment of periprosthetic fractures of the proximal femur with a contralateral, upside-down LISS plate in elderly patients

BackgroundIncreasing expectancy of life and levels of activity in the growing geriatric population lead to a rising number of prosthetic implants of the hip and consequently the incidence of periprosthetic fractures of the femur increase. The fracture pattern and the possible instability of the stem are a challenge to the orthopaedic surgeon. Treatment options are complete replacement of the implant or a solitary osteosynthesis. The goal of this study was to analyse the feasibility of the operative intervention using a contralateral reversed anatomic distal femoral LISS® locking plate and the radiological and functional outcome in a geriatric cohort.MethodsWe included all patients older than 75 years of age with a Vancouver type B fracture, which have been treated by osteosynthesis using a LISS® (contralateral reversed) plate in our institution in an interdisciplinary ortho-geriatric setting between 7/2013 and 12/2021. Perioperative morbidities, clinical and radiological outcome during follow-up were retrospectively analysed.ResultsDuring the observed time period, 83 patients (mean age: 88 years (range: 76–103), male/female: 26/57) were treated. Most fractures were Vancouver type B2 (n = 45, 54%) followed by B1 (n = 20, 24%) and B3 (n = 18, 22%). The most prevalent postoperative surgical complication was anaemia (n = 73, 88%) followed by infections (n = 12, 14%, urinary infections, pneumonia) and cardiovascular decompensation (n = 8, 10%). Clinical and radiological follow up 6–8 weeks postoperative was possible for 59 patients (70%). The majority of them did not describe pain (n = 50, 85%) and had a good or excellent radiological outcome. Three cases needed revision surgery due to infection and another three due to non-union, loosening of the stem or an additional fracture. 1-year mortality was 30%.ConclusionWe are convinced that the reversed contralateral LISS-plate is an easy-to-use implant with a small complication rate but a very successful and high healing rate in a geriatric, polymorbid cohort.

Imaging the Spatiotemporal Evolution of Plate Coupling With Interferometric Radar (InSAR) in the Hikurangi Subduction Zone

AbstractThe coupling at the interface between tectonic plates is a key geophysical parameter to capture the frictional locking across plate boundaries and provides a means to estimate where tectonic strain is accumulating through time. Here, we use both interferometric radar (InSAR) and Global Navigation Satellite System (GNSS) data to investigate the plate coupling of the Hikurangi subduction zone beneath the North Island of New Zealand, where multiple slow slip cycles are superimposed on the long‐term loading. We estimate the plate coupling across the subduction zone over three multi‐year observational periods targeting different stages of the slow slip cycle. Our results highlight the importance of the observational time period when interpreting coupling maps, emphasizing the temporal variability of plate coupling. Leveraging multiple geodetic data sets, we demonstrate how InSAR provides powerful constraints on the spatial resolution of both plate coupling and slow fault slip, even in a region where a dense GNSS network exists.

New Benchmarks on Demographic Disparities in Pivotal Trials Supporting FDA-Approved Drugs and Biologics.

A lack of diversity and representation in clinical trials is an established issue in drug development, and the COVID-19 pandemic increased awareness of the problem among the general public. This awareness has led to increased pressure on drug development sponsors, as well as additional attention and regulation from federal bodies, to improve the diversity of clinical trials. This study updates existing baselines regarding demographic disparities, as well as detecting early signs that the situation may be starting to improve. Building on an existing dataset, this study collected and analyzed pivotal trial demographic data for drugs and biologics approved by the FDA between 2007 and 2021. Demographic data were collected from applications on the FDA website and clinicaltrials.gov, and compared to indication-specific demographic data when available, or US census estimates when they were not. Regression analyses were used to test for significant trends in reporting of demographic data and representation in pivotal trials, as well as the effect of representation on clinical trial duration and FDA review. Reporting of demographic data has improved significantly for all three demographic categories (sex, racial identity, and ethnic identity) over the observed time period (p < 0.0001). During this time period, overrepresentation of white participants has decreased significantly (p < 0.0001), and representation of Black participants has increased (p = 0.0003). Other racial and ethnic identities did not show significant trends. Representation of demographic subgroups was not significant predictors of trial duration except for the representation of Black participants, which was a negative correlation, indicating that as representation of Black participants increases, trial duration decreases (p = 0.0350).