Section Reviews Research Articles

Fragility Modeling of Power Grid Infrastructure for Addressing Climate Change Risks and Adaptation

ABSTRACTThe resilience of electric power grids is threatened by natural hazards. Climate‐related hazards are becoming more frequent and intense due to climate change. Statistical analyses clearly demonstrate a rise in the number of incidents (power failures) and their consequences in recent years. Therefore, it is of utmost importance to understand and quantify the resilience of the infrastructure to external stressors, which is essential for developing efficient climate change adaptation strategies. To accomplish this, robust fragility and other vulnerability models are necessary. These models are employed to assess the level of asset damage and to quantify losses for given hazard intensity measures. In this context, a comprehensive literature review is carried out to shed light on existing fragility models specific to the transmission network, distribution network, and substations. The review is organized into three main sections: damage assessment, fragility curves, and recommendations for climate change adaptation. The first section provides a comprehensive review of past incidents, their causes, and failure modes. The second section reviews analytical and empirical fragility models, emphasizing the need for further research on compound and non‐compound hazards, especially windstorms, floods, lightning, and wildfires. Finally, the third section examines risk mitigation and adaptation strategies in the context of climate change. This review aims to improve the understanding of approaches to enhance the resilience of power grid assets in the face of climate change. These insights are valuable to various stakeholders, including risk analysts and policymakers, who are involved in risk modeling and developing adaptation strategies.

CMOS Point-of-Care Diagnostics Technologies: Recent Advances and Future Prospects.

This review provides a comprehensive overview of point-of-care (PoC) devices across several key diagnostic applications, including blood analysis, infectious disease detection, neural interfaces, and commercialized integrated circuits (ICs). In the blood analysis section, the focus is on biomarkers such as glucose, dopamine, and aptamers, and their respective detection techniques. The infectious disease section explores PoC technologies for detecting pathogens, RNA, and DNA, highlighting innovations in molecular diagnostics. The neural interface section reviews advancements in neural recording and stimulation for therapeutic applications. Finally, a survey of commercialized ICs from companies such as Abbott and Medtronic is presented, showcasing existing PoC devices already in widespread clinical use. This review emphasizes the role of complementary metal-oxide-semiconductor (CMOS) technology in enabling compact, efficient diagnostic systems and offers insights into the current and future landscape of PoC devices.

A pragmatic approach to selecting a grading system for clinical practice recommendations in palliative care.

The limited palliative care evidence base is poorly amenable to existing grading schemes utilized in guidelines. Many recommendations are based on expert consensus or clinical practice standards, which are often considered 'low-quality' evidence. Reinforcing provider hesitancy in translating recommendations to practice has implications for patient care. To rationalize the selection of an appropriate grading system for rating evidence to support recommendations made in palliative care clinical practice guidelines. Review of the methodology sections of international palliative care guidelines published in English identified five grading systems comparison: Grading of Recommendations, Assessment, Development and Evaluations (GRADE); the Scottish Intercollegiate Guidelines Network (SIGN); Infectious Diseases Society of America-European Society for Medical Oncology (IDSA-ESMO); Confidence in the Evidence from Reviews of Qualitative research (CERQual) and the National Service Framework for Long Term Conditions (NSF-LTC). There is heterogeneity among grading systems used in published palliative care or terminal symptom management guidelines. GRADE has been increasingly adopted for its methodological rigour and inter-guideline consistency with other medical associations. CERQual has the potential to support recommendations informed by qualitative evidence, but its role in clinical guidelines is less defined. The IDSA-ESMO system has an intuitive typology with the ability to categorize tiers of lower-quality evidence. It is challenging to apply commonly used grading systems to the palliative care evidence base, which often lacks robust randomized controlled trials (RCTs). Adoption of IDSA-ESMO offers a feasible and practical alternative for lower-resourced guideline developers and palliative clinicians without a prerequisite for methodological expertise.

7522 Effects of Trikafta On Bone Mineral Density And Body Composition In Patients With Cystic Fibrosis

Abstract Disclosure: N. Mon: None. S.S. Krishnasamy: None. G. Bakeerathan: None. L. Healy: None. E. Favier: None. S. Foushee: None. Background: Cystic fibrosis related bone disease (CFBD) is a common complication of adult Cystic fibrosis (CF) patients due to calcium, vitamin D and K malabsorption from exocrine pancreatic insufficiency, increased inflammatory cytokines, glucocorticoid therapy, delayed puberty, physical inactivity, and hypogonadism. Newer CF transmembrane conductance regulator (CFTR) modulator therapy elexacaftor/tezacaftor/ivacaftor (Trikafta) has proven benefit in pulmonary and nutritional outcomes. There is limited data on effects of Trikafta on bone health and body composition. The aim is to examine the effects of Trikafta on bone mineral density (BMD) at the lumbar spine (LS) and femoral neck (FN), and body composition in terms of fat free mass index (FFMI) and fat mass index (FMI) in our CF patients. Method: We conducted a cross sectional and retrospective review of 38 adults with CF (Ages 20-59, 28 males and 10 females) in our CF clinic. Body Mass Index (BMI), Body composition measured by bioelectric impedance analysis, BMD of LS and FN by Dual-energy X-ray absorptiometry, Vitamin D level, and forced expiratory volume in one second (FEV1 % predicted) in patients taking Trikafta were analyzed and compared with control CF group who were not on Trikafta. Results: 38 subjects on Trikafta, aged 33.29 ± 10.36 years with FEV1 % predicted 65.11± 28.14% were studied. Serum 25-hydroxyvitamin D level was 35.92 ± 18.52 ng/dL. Of the 38 study patients, 23 (60.53%) had a diagnosis of CF related diabetes (CFRD). Among the Trikafta cohort, 18 (50%) had low BMD with Z-scores ≤ -2.0 and 7 (19.44%) of them had Z score ≤ -1.0 and > -2.0. Compared with the control group, LS BMD 0.93 ± 0.16 g/cm2 and FN BMD 0.73± 0.13g/cm2 (p >0.05) were not improved significantly. BMI of study population 23.09 ± 4.21 kg/m2 (p <0.05) and FMI 6.11 ± 4.25 kg/m2 (p <0.05) increased significantly; however, there was a decrease in FFMI 9.60 ± 1.44 kg/m2 (p <0.05). Conclusion: Treatment with Trikafta in CF patients was associated with increases in BMI and fat mass index but decrease in fat free mass index. There was no statistically significant difference in BMD at LS and FN in our study cohort. This study has limitations in terms of gender differences within the study cohort, duration of Trikafta use in relation to bone mass, and also extent of glucocorticoid use among the study subjects. Larger prospective clinical trials are needed to study efficacy of Trikafta on CFBD. Presentation: 6/3/2024

Intraneural Topography and Branching Patterns of the Common Peroneal Nerve: Studying the Feasibility of Distal Nerve Transfers.

Common peroneal nerve (CPN) disruption is the most common lower extremity nerve injury and results in gait disturbances and sensory paresthesias. The goal of this study is to describe branching patterns and the intraneural topography of the CPN to facilitate operative planning in CPN reconstruction. The CPN and its distal motor and sensory branches were dissected in 6 lower leg cadavers. Branching patterns and distances were recorded with the fibular head as the landmark. Histological review of the nerve cross sections helped characterize the intraneural topography within the fibular tunnel. The CPN distal branching patterns were highly variable. The tibialis anterior motor branch was found on average 9.6 cm distal to the fibular head. Despite the variable branching patterns, the fascicular topography of the CPN within the fibular tunnel was consistent. Proximal to the tunnel, the nerve has 3 major fascicles, which include the superficial peroneal motor, common sensory, and deep peroneal motor (DPN) fascicles from lateral to medial. Within the tunnel, the topography consolidates into the superficial peroneal motor and DPN major divisions-motor axons anteriorly and sensory axons posteriorly. The data presented provide clinically relevant information for the peripheral nerve surgeon where fascicular reconstruction of the nerve and neurolysis should focus on the anterior half of the nerve to restore ankle dorsiflexion. The nerve proximally is divided into 3 major fascicles compared with 2 distally. Surgeons may consider distal nerve transfers from the tibial nerve motor branches to the DPN or tibialis anterior motor branch.

Heating Induced Nanoparticle Migration and Enhanced Delivery in Tumor Treatment Using Nanotechnology.

Nanoparticles have been developed as imaging contrast agents, heat absorbers to confine energy into targeted tumors, and drug carriers in advanced cancer treatment. It is crucial to achieve a minimal concentration of drug-carrying nanostructures or to induce an optimized nanoparticle distribution in tumors. This review is focused on understanding how local or whole-body heating alters transport properties in tumors, therefore leading to enhanced nanoparticle delivery or optimized nanoparticle distributions in tumors. First, an overview of cancer treatment and the development of nanotechnology in cancer therapy is introduced. Second, the importance of particle distribution in one of the hyperthermia approaches using nanoparticles in damaging tumors is discussed. How intensive heating during nanoparticle hyperthermia alters interstitial space structure to induce nanoparticle migration in tumors is evaluated. The next section reviews major obstacles in the systemic delivery of therapeutic agents to targeted tumors due to unique features of tumor microenvironments. Experimental observations on how mild local or whole-body heating boosts systemic nanoparticle delivery to tumors are presented, and possible physiological mechanisms are explored. The end of this review provides the current challenges facing clinicians and researchers in designing effective and safe heating strategies to maximize the delivery of therapeutic agents to tumors.

Editor's Choice – Sex Related Anatomical Differences in Patients With Aortic Arch Pathology and Their Impact on the Feasibility of Double and Triple Branched Endografts

To evaluate sex based differences in ascending aorta and arch anatomy in patients with underlying proximal aortic disease and to evaluate their impact on feasibility for total endovascular repair with custom made, branched arch devices. This was a retrospective cross sectional review of all patients undergoing open and or total endovascular arch repair due to distal ascending aorta and or aortic arch pathologies in a single high volume aortic centre between 2012 and 2022. Anatomical ascending aorta and aortic arch parameters were analysed on a flow centreline on a dedicated 3D workstation. Sex related differences of the ascending aorta, aortic arch, and supra-aortic vessels were evaluated. Subsequently, four endovascular devices were assessed for feasibility: double and triple branched devices both for the Zenith (Cook Medical) and Relay (Terumo Aortic) platforms, first in accordance with the instructions for use and then considering the possibility of adjunctive cervical debranching. The primary endpoints were sex specific differences in aortic anatomy, while secondary endpoints included sex based feasibility of branched endograft devices. During the study period, 395 patients underwent total aortic arch repair, of whom 152 (51 female, 33.5%) had high quality computed tomography angiograms available and were included in the study. Female patients had a shorter proximal landing zone than males (22 mm vs. 47 mm; p < .001). Left subclavian artery dissection was more frequent in men (24.8% vs. 3.9%; p < .001). Other anatomical parameters showed a similar distribution between sexes. Female patients presented a lower feasibility for double branched devices (35.3% vs. 58.4%; p= .015) as well as a tendency for lower feasibility rates for triple branched devices (31.4% vs. 47.5%; p= .081). Although most ascending aortic and arch parameters showed similar trends in both sexes, the availability of a suitable proximal landing zone was lower in female patients. Consequently, female patients had lower feasibility rates for double arch branched endografts and, to lesser extent, for triple arch branched endografts.

#2435 Calciphylaxis: patient demographics, risk factors and outcomes in a single regional centre in New Zealand

Abstract Background and Aims Calciphylaxis, a condition associated with microvascular calcification and subsequent formation of non-healing tender skin lesions, has previously been estimated to affect only approximately 1% of patients with ESRD each year. However, clinicians practicing in a regional renal unit in the North Island of New Zealand have noted an increase in the frequency of clinical diagnoses of this condition over recent years. The aim of this review was to analyze patient demographics and risk factors and attempt to identify any correlation with subsequent outcomes. Method A cross sectional retrospective review of dialysis patients from Palmerston North Hospital's Renal Unit who were found to have diagnoses of calciphylaxis, was performed. The following factors were assessed: gender, ethnicity, smoking status, diabetes, obesity, hypertension, dialysis modality, prescription of phosphate binders, vitamin D analogues, and sodium thiosulphate (STS). We included patients with both histologically proven calciphylaxis and clinical diagnosis only. Levels of serum PTH, calcium and phosphate at the time of diagnosis were reviewed, though only PTH levels were included in the final analysis. Results A total of nineteen patients were identified having calciphylaxis as a diagnosis in the period studied. Findings were limited due to the small patient cohort size, but of those identified and reviewed some commonalities were found. Included were 9 NZ European people and 8 NZ Māori people. There were 8 females. One patient was a current smoker at time of diagnosis and five were documented as ex-smokers. Fourteen patients (74%) had type 2 diabetes mellitus and hypertension. Twelve patients (63%) were obese. Eighteen patients (95%) had hyperparathyroidism. Warfarin use was seen in 10 of the patients studied (52%) and twelve (63%) had used phosphate binders. Nine patients (47%) were diagnosed in the period between 2011 and 2021, with the remaining ten (53%) diagnoses occurring in 2022 or 2023. The majority (90%) were treated with STS, however 84% died. Dialysis modality at time of diagnosis and throughout disease span was also reviewed. Eight patients (42%) used only haemodialysis (HD), six patients (32%) used both modalities and five patients (26%) used only peritoneal dialysis. The majority (63%) of patients were on haemodialysis at time of diagnosis. Conclusion Calciphylaxis appears to be increasing dramatically in the single center studied in this review. Positive correlations were identified between high levels of PTH, obesity, hypertension, type 2 diabetes, and use of warfarin. Unfortunately, due to small case numbers, and poor historical documentation, further conclusions could not be drawn easily. A further RCT would be required to investigate the efficacy of STS as a treatment for calciphylaxis.

“FOR I DIPT INTO THE FUTURE …”: AN ANALYSIS OF MEDIA PREDICTIONS ABOUT THE FUTURE NORTH AMERICAN FOODSCAPE, 2000–2023

ABSTRACT This paper examines changing predictions made between 2000 and 2023 in a selection of newspapers and magazines concerning the future of the North American foodscape. The first section reviews existing literature, especially that by John Urry (2016) on the study of the future and explores Warren Belasco’s 2006 discussion about how reports of the future of food have changed over time. The second section, on methodology, describes how surveys of articles that included the keywords “future food” published in The New York Times, The Economist, Time Magazine, and The Utne Reader from 2000 to 2023 were assembled and classified according to theme to enable changes in content to be analyzed. As the paper’s subsequent analysis reports, while each media’s record is varied in detail, from around the year 2010 a broad consensus around the importance of environmental issues in the future of food begins to occur in all four sources. While such a finding is not in itself surprising, as the paper concludes, it does confirm the hypothesis advanced by Warren Belasco (2006) that predictions largely reflect present concerns and threaten to be overwhelmed by them. Keywords: future of food, forecasts, North America, newspapers.

Diagnostic discordance among histopathological reviewers of melanocytic lesions.

Histopathological examination is adequate for the diagnosis of most cutaneous melanocytic neoplasms. However, there is a subset that is either difficult to definitively diagnose or would have diagnostic disagreement upon review by multiple dermatopathologists if a more exhaustive review was performed. Melanocytic lesions underwent an independent, blinded diagnostic histopathological review of hematoxylin and eosin-stained sections. Each lesion was reviewed by three to six dermatopathologists and categorized as benign, malignant, or unknown malignant potential (UMP). Diagnoses were grouped as concordant (all the same designation); opposing (received benign and malignant designations); majority (single designation with the highest number of diagnoses, no benign/malignant opposing designations); and non-definitive (equal number of non-opposing designations [i.e., benign/UMP or malignant/UMP]). Lesions with equivocal designations (concordant or majority UMP, opposing, majority, and non-definitive) were utilized in a patient treatment model of projected surgical treatment discrepancies. In total, 3317 cases were reviewed, and 23.8% of lesions received equivocal diagnoses. Of these, 7.3% were majority benign, 4.8% were majority malignant, 2.7% were majority UMP, 0.5% were concordant UMP, 6.9% were opposing, and 1.6% were non-definitive. Patient treatment models of those with equivocal lesions (n = 788) revealed a potential of overall surgical treatment variations ranging from 18% to 72%, with the highest variation amongst lesions with opposing, non-definitive, or majority UMP (40%-72%) diagnoses. Histopathologic review in this large cohort demonstrated substantial diagnostic variation, with 23.8% of cases receiving equivocal diagnoses. We identified diagnostic ambiguity even in lesions where a definitive diagnosis was previously rendered by a single real-world dermatopathologist. The combined clinical impact of diagnostic discordance or a final diagnosis of UMP is highlighted by high diagnosis-dependent treatment variation in the patient treatment model, which could be underreported in a real-world setting, where review by more than one to two dermatopathologists is relatively rare.

Language Crime Practices: Cyberbullying in the TikTok Comment Section (Review) – A Forensic Linguistics Analysis

Language Crime Practices: Cyberbullying in the TikTok Comment Section (Review) – A Forensic Linguistics Analysis

Islamic Jurisprudence's Penalties for Violation of Traffic Regulations and the Amended Jordanian Traffic Law

This study attempts to explain the ramifications of running red traffic lights and the public interests that result from the implementation of sanctions for such infractions. In addition, it aims to clarify the rulings on high-speed driving and driving without a licence in Islamic jurisprudence and Jordanian traffic legislation, Both inductive and analytical methods were used in the study, which involved a review of the relevant sections of the Jordanian Traffic Law as well as the writings of jurists. According to the results, if a driver of a vehicle causes an accident that results in the death of another person, they have a duty to compensate Allah for that loss, and blood money represents the victims' rights until they want to relinquish them. Infractions of traffic laws, such as speeding excessively, running red lights, and driving without a licence, can result in jail time, fines, and licence suspension. The study suggests using visual and audio mediums to make the requirements pertaining to infractions of traffic laws more clear.

A Rare Case of a Malignant Epithelioid Neoplasm With an Underlying Novel EWSR1::ZBT44 Fusion, Identified on Next-Generation Sequencing (NGS).

The clinicopathological spectrum of undifferentiated round cell sarcomas of bone and soft tissues is expanding after the 5th edition of the WHO classification. A 23-year-old male patient presented with a lump in his left thigh of 3 months' duration. Radiological examination revealed a well-defined, solid-cystic lobulated, soft tissue lesion in the proximal medial region of his left thigh, measuring 7.7 cm in the largest dimension. The referring diagnosis was an epithelioid sarcoma. Histopathological review of the tumor sections revealed a cellular tumor composed of malignant epithelioid to focally "rhabdoid-like" cells in a variable hyalinized and myxoid stroma with geographic areas of necrosis. In addition, there were areas reminiscent of hemangiopericytomatous vasculature. By immunohistochemistry, the tumor cells were diffusely positive for CD34, focally and distinctly for pan keratin (AE1/AE3). INI1/SMARCB1 and SMARCA4 (BRG1) were diffusely positive (normal). Next-generation sequencing with a wide sarcoma panel revealed EWSR1exon8::ZBT44exon4 fusion. The present example constitutes the first malignant epithelioid tumor with a hemangiopericytomatous growth pattern, exhibiting this rare fusion. The differential diagnoses of this tumor and their corresponding immunohistochemical profile are discussed. This example highlights the value of NGS in unraveling rare fusions and in differentiating these tumors from their several mimics.

Hepatic lipid accumulation is associated with multiple metabolic pathway alterations but not dyslipidemia and insulin resistance in central bearded dragons (Pogona vitticeps).

To investigate associations between hepatic fat accumulation, fibrosis, and plasma values of primary metabolites, biochemical measurands, insulin, and lipoproteins in bearded dragons. 48 adult central bearded dragons (Pogona vitticeps). Dragons were sedated with alfaxalone, and a blood sample was collected. Plasma was submitted for untargeted primary metabolomics using gas chromatography time-of-flight mass spectrometry, a biochemistry panel, and a lipoprotein panel determined by PAGE. Hepatic lipid content was quantified by liver attenuation measurements from CT images and digital image analysis of standardized histologic sections of the liver. Fibrosis was quantified by digital image analysis on Masson's trichrome-stained histologic sections. Severity was determined from pathologic review of liver sections according to a standardized grading system. Statistical associations were investigated using serial linear models adjusted for false discovery rate and multivariate statistics. Both hepatic fat and fibrosis had a significant effect on CT liver attenuation values. Several oligosaccharides (maltotriose, maltose, ribose, trehalose) and alkaline phosphatase were significantly and linearly increased with hepatic lipid content (all q < .05). On partial least square-discriminant analysis, β-hydroxybutyric acid was the most important discriminatory variable between fatty liver severity grades on histology. No significant associations were found with insulin, lipoproteins, and succinic acid. Bearded dragons with hepatic lipid accumulation experienced multiple metabolic pathway disruptions, some being compatible with mitochondrial dysfunction. No evidence of insulin resistance or dyslipidemia was found. Hepatic biopsy and histopathology remain recommended for reliably diagnosing and staging fatty liver disease in bearded dragons.

STUDY OF PREFRONTAL OXYGENATION DURING EMOTIONAL THINKING USING FUNCTIONAL NEAR-INFRARED SPECTROSCOPY (FNIRS)

Introduction: This section provides an overview of the project and introduces the topic. It should include the background, objectives, and scope of the research. Literature Review: This section reviews relevant literature related to the topic to provide a better understanding of the existing research and technology available. It should include sources such as books, academic journals, and online articles. Methodology: This section outlines the methodology used to design and develop the project, including the hardware and software components, programming languages and tools used, and testing procedures. System Design: This section describes the architecture and design of the system, including the hardware and software components, communication protocols, and interfaces. It should provide a detailed explanation of how the system is structured. Implementation: This section details the process of implementing the system, including the setup of the hardware and software components, programming of the microcontroller and sensors, and integration of any external platforms. Results and Evaluation: This section presents the results of the testing and evaluation of the system, including the performance, efficiency, and effectiveness of the system in achieving its objectives. It should also discuss any limitations or challenges encountered during testing. Conclusion and Future Work: This section summarizes the research findings and provides recommendations for future work. It should discuss any potential for further development and improvement of the system.

127 Advance RI-K Scholar Career Development Program: A one-year intensive program for developing early career faculty in an IDeA state

OBJECTIVES/GOALS: We developed a state-wide program to support early career faculty in preparing mentored career development awards, and connect them to resources, mentorship, and career development opportunities. We aimed to build self-efficacy along multiple axes, including research design and grantsmanship, and to facilitate networking with mentors and peers. METHODS/STUDY POPULATION: The program recruited four cohorts of faculty over the course of four years, for a total of 32 faculty participants (63% physician scientists). Participants were selected by a Steering Committee, and represented a variety of specialties from 19 departments across Brown University, University of Rhode Island, and affiliated hospitals. Participation required an institutional commitment of 20% minimum protected time to engage in research and a year-long curriculum that included biweekly didactic sessions, project development support, individual consultations, feedback on drafts, and internal study section review. Participants completed pre-, interim-, and final-assessments, which collected measures of self-efficacy, professional development needs, program satisfaction, and formative feedback. RESULTS/ANTICIPATED RESULTS: Over the first 3 years, 21 participants completed the program, 43% have received NIH or VA K/CDA awards so far, and 48% received other federal or non-federal awards. Over 25 faculty from across institutions participated in leadership and didactics, with even greater participation on mentorship teams, panels, and grant review. All cohorts showed improvements in measures of self-efficacy in grantsmanship and research and reported high satisfaction with program activities. Participants found individualized proposal feedback and internal study sections to be most valuable, and frequently cited the value of peer-learning opportunities. Challenges for scholars include mentorship challenges, competing priorities/protected time, and various external factors that impacted individual research progress. DISCUSSION/SIGNIFICANCE: The program has successfully supported cohorts of junior clinical and translational faculty from across the state in launching their independent research careers. The program may serve as a model for IDeA state inter-institutional collaboration in developing diverse faculty cohorts in the early stages of preparing their career development award.

Sperm morphology by strict criteria does not predict clinical pregnancy rate following intra-uterine insemination

ABSTRACT Objective To determine the impact of abnormal sperm morphology of the pre-washed semen sample on the day of intrauterine insemination (IUI) on clinical pregnancy rates (CPR) Design Cross sectional retrospective chart review. Setting Academic fertility center Patient(s) Couples undergoing (IUI) from May 2014 to March 2022. Intervention(s) Sperm morphology, by strict criteria, on the pre-washed IUI sample. Main outcomes Measure(s) To determine the association of sperm morphology with CPR. Result(s) Semen analysis reports, including Kruger strict criteria for morphology from the pre-washed IUI sample, were reviewed for 1,059 cycles, comprising 825 total treated couples. Of the total 1,059 cycles,15.1% resulted in clinical pregnancy. When categorized by strict morphology ≥4% (normal morphology), (3%–2%) [mild-moderate teratozoospermia (TZS)], and ≤1% (severe TZS), the CPR was 16%, 13%, and 10%, respectively (p value 0.30). Early spontaneous miscarriage rate was 4% and when stratified by morphology ≥4% (3%–2%), and ≤1%, was 3%, 1%, and 0%, respectively (p value 0.20). In couples with isolated TZS, the pregnancy rate was 16% in the normal morphology group, 14% in the mild–moderate group, and 8% in the severe group. (p value 0.30). In the multivariate logistic regression, sperm morphology, mild/moderate TZS vs normal forms (OR = 0.99, 95% CI [0.94–1.1]), severe TZS vs normal forms (OR = 0.98, 95% CI [0.0.83–1.1]), was not a predictor of CPR. The Pre-wash TMSC (OR = 1.0, 95% CI [0.996–1.00]) was also not predictive of CPR. The only predictive factor of CPR in IUI was the PWTMSC (OR = 1.03, 95%CI [1.00–1.06). Conclusion(s) The morphology of the pre-washed sample on the day of IUI did not find a difference in CPR, neither in miscarriage rate following IUI, in couples with normal or abnormal sperm morphology, including severe TZS. Mild, moderate, or severe TZS in the semen sample should not exclude couples to attempt an IUI procedure.

Current Knowledge of Enterococcal Endocarditis: A Disease Lurking in Plain Sight of Health Providers.

Enterococcus faecalis is a bacterial pathogen that can cause opportunistic infections. Studies indicate that initial biofilm formation plays a crucial regulatory role in these infections, as well as in colonising and maintaining the gastrointestinal tract as a commensal member of the microbiome of most land animals. It has long been thought that vegetation of endocarditis resulting from bacterial attachment to the endocardial endothelium requires some pre-existing tissue damage, and in animal models of experimental endocarditis, mechanical valve damage is typically induced by cardiac catheterisation preceding infection. This section reviews historical and contemporary animal model studies that demonstrate the ability of E. faecalis to colonise the undamaged endovascular endothelial surface directly and produce robust microcolony biofilms encapsulated within a bacterially derived extracellular matrix. This report reviews both previous and current animal model studies demonstrating the resilient capacity of E. faecalis to colonise the undamaged endovascular endothelial surface directly and produce robust microcolony biofilms encapsulated in a bacterially derived extracellular matrix. The article also considers the morphological similarities when these biofilms develop on different host sites, such as when E. faecalis colonises the gastrointestinal epithelium as a commensal member of the common vertebrate microbiome, lurking in plain sight and transmitting systemic infection. These phenotypes may enable the organism to survive as an unrecognised infection in asymptomatic subjects, providing an infectious resource for subsequent clinical process of endocarditis.

Demystifying Corporate Bonds in Malawi-cross Section Review of the Public Listing and Private Placements

Demystifying Corporate Bonds in Malawi-cross Section Review of the Public Listing and Private Placements

The Role of Gut and Oral Microbiota in the Formation and Rupture of Intracranial Aneurysms: A Literature Review.

In recent years, there has been a growing interest in the role of the microbiome in cardiovascular and cerebrovascular diseases. Emerging research highlights the potential role of the microbiome in intracranial aneurysm (IA) formation and rupture, particularly in relation to inflammation. In this review, we aim to explore the existing literature regarding the influence of the gut and oral microbiome on IA formation and rupture. In the first section, we provide background information, elucidating the connection between inflammation and aneurysm formation and presenting potential mechanisms of gut-brain interaction. Additionally, we explain the methods for microbiome analysis. The second section reviews existing studies that investigate the relationship between the gut and oral microbiome and IAs. We conclude with a prospective overview, highlighting the extent to which the microbiome is already therapeutically utilized in other fields. Furthermore, we address the challenges associated with the context of IAs that still need to be overcome.