Standard Rate Research Articles

Mobile health applications for individuals with psoriatic arthritis

Abstract Objectives Mobile health applications (Apps) hold promise as tools for symptom tracking and management of chronic rheumatic diseases, such as psoriatic arthritis (PsA). Apps for PsA have not been systematically evaluated. We conducted a comprehensive review of Apps designed for patients with PsA. Methods The iOS and Android App stores were searched for the term “arthritis”, and individual App descriptions were reviewed for “psoriatic arthritis”. Apps were downloaded and rated using the MARS standardized quality rating tool. Additionally, the Apps were evaluated to determine functionality, use of symptom scales, and potential for integration within clinical care. Results The search was conducted in Spring 2024 and 130 Apps were found that mentioned “arthritis”. Seven had specific mentions of psoriatic arthritis in their description. We found several other relevant Apps by following recommendations on the App stores. In total, 10 Apps for patients with PsA were identified. MARS scores suggest they were moderate to excellent in quality. The functionality of the 10 Apps differed: 7 allowed for symptom tracking; 3 allowed for data export to health records; 2 allowed for medication tracking; and 1 contained a patient community platform. The symptom tracking capabilities varied widely, and we could find only one published study of any of the Apps. Conclusions We analyzed Apps for PsA to identify potential unmet needs and found that there are few Apps publicly available, their functionality varies tremendously, and testing of these Apps is almost non-existent. There appears to be room for improvement of Apps for PsA.

Oxygen consumption measurements at ultra-high dose rate over a wide LET range.

The role of radiolytic oxygen consumption for the in-vitro "Ultra-High Dose Rate" (UHDR) sparing and in-vivo FLASH effect is subject to active debate, but data on key dependencies such as the radiation quality are lacking. The influence of "dose-averaged Linear Energy Transfer" (LETd) and dose rate on radiolytic oxygen consumption was investigated by monitoring the oxygen concentration during irradiation with electrons, protons, helium, carbon, and oxygen ions at UHDR and "Standard Dose Rates" (SDR). Sealed "Bovine Serum Albumin" (BSA) 5% samples were exposed to 15Gy of electrons and protons, and for the first time helium, carbon, and oxygen ions with LETd values of 1, 5.4, 14.4, 65, and 100.3keV/µm, respectively, delivered at mean dose rates of either 0.3-0.4Gy/s for SDR or approximately 100Gy/s for UHDR. The Oxylite (Oxford Optronics) system allowed measurements of the oxygen concentration before and after irradiation to calculate the oxygen consumption rate. The oxygen consumption rate was found to decrease with increasing LETd from 0.351mmHg/Gy for low LET electrons to 0.1796mmHg/Gy for high LET oxygen ions at SDR and for UHDR from 0.317 to 0.1556mmHg/Gy, respectively. A higher consumption rate for SDR irradiation compared to the corresponding UHDR irradiation persisted for all particle types. The measured consumption rates demonstrate a distinct LETd dependence. The obtained dataset, encompassing a wide range of LETd values, could serve as a benchmark for Monte Carlo simulations, which may aid in enhancing our comprehension of oxygen-related mechanisms after irradiations. Ultimately, they could help assess the viability of different hypotheses regarding UHDR sparing mechanisms and the FLASH effect. The found LETd dependence underscores the potential of heavy ion therapy, wherein elevated consumption rates in adjacent normal tissue offer protective benefits, while leaving tumor regions with generally higher "Linear Energy Transfer" (LET) vulnerable.

Optimizing Nitrogen Management in Maize (Zea mays L.) Using Urease and Nitrification Inhibitorss

ABSTRACT Nitrogen (N) is essential for plant growth, and in conventional agriculture, it is usually supplied through fertilization. However, N can be lost through various pathways, reducing its availability to plants and decreasing fertilizer efficiency. This study examined the effects of split urea application and fertilizers containing the nitrification inhibitor 3.4-dimethylpyrazole phosphate (DMPP) and the urease inhibitor N-(n-butyl) thiophosphoric triamide (NBPT). The fertilizers with inhibitors were applied at both full (100%) and reduced (75%) levels of the standard rate. Conducted over two years, the field trial aimed to assess the capacity of these treatments to mitigate N loss and meet the N requirements of maize effectively. The results of the study revealed that NBPT maintained the required N levels in the soil by meeting the N requirement of maize. On the other hand, DMPP caused N losses due to increasing ammonium levels in the soil during early plant growth stages. NBPT provided the best results in terms of plant yield and N content, whereas DMPP showed lower performance in these parameters. Reduced NBPT doses increased N use efficiency but were less effective in terms of yield compared to full doses. According to the result of the economic analysis, split urea treatment gave better results compared to all treatments. In conclusion, NBPT increased both yield and N use efficiency by regulating N release.

AIDS mortality in Brazil, 2012–2022: a time series study

BackgroundHuman immunodeficiency virus (HIV) infection is a health problem in Brazil and worldwide. Without treatment, the infection can progress to Acquired Immunodeficiency Syndrome (AIDS), with a high mortality potential. The objective of this study was to analyze the time trend of AIDS mortality in Brazil, macro-regions, federal units and their respective capitals, from 2012 to 2022.MethodsThis is a time-series study of all AIDS deaths in Brazil from 2012 to 2022. The study included the annual number of deaths and the crude and standardized mortality rates. The Joinpoint regression model was used for the time analysis of the standardized rates. Annual percentage change (APC) and average annual percentage change (AAPC) were calculated. A 95% confidence interval (CI) and a 5% significance level were used.ResultsDuring the period analyzed, 128,678 AIDS deaths were recorded in Brazil, with a crude mortality rate of 6.3/100,000 and a standardized mortality rate of 5.3/100,000. From 2012 to 2020, three regions showed a declining trend in AIDS mortality: Central-West (AAPC − 2.3%; 95%CI -4.3 to -0.21; p = 0.03), Southeast (AAPC − 5.6%; 95%CI -6.8 to -4.0; p < 0.001), and South (AAPC − 4.4%; 95%CI -5.27 to -3.6; p < 0.001). There was also a downward trend in 10 states and 10 capitals. There was an increase in the number of deaths from 2020 onwards in the North, Northeast and Southeast regions compared to 2019.ConclusionThere was a downward trend in AIDS mortality from 2012 to 2020 and an upward trend from 2020 to 2022. The regional differences observed could reflect the social disparities that exist in Brazil. In addition, the Covid-19 pandemic has had an impact on the process of dealing with HIV in Brazil.

Nurse Burnout and Patient Safety, Satisfaction, and Quality of Care: A Systematic Review and Meta-Analysis.

Occupational burnout syndrome is characterized by emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment and is prevalent among nurses. Although previous meta-analyses have explored the correlates of nurse burnout, none have estimated their association with health care quality and safety and patient morbidity and mortality. To evaluate the magnitude and moderators of the association between nurse burnout and patient safety, patient satisfaction, and quality of care. The Web of Science, Scopus, MEDLINE, Embase, PsycINFO, CINAHL, and ProQuest databases were searched from January 1, 1994, to February 29, 2024. Two reviewers independently identified studies that reported a quantifiable association between nurse burnout and any of the outcomes of patient safety, patient satisfaction, or quality of health care. The PRISMA 2020 guideline was followed. Two reviewers independently extracted the standardized mean difference (SMD) (Cohen d) estimates for a random-effects meta-analysis. Subgroup analyses and meta-regressions were conducted using prespecified variables. Any measure of patient safety, patient satisfaction, or quality of health care previously associated with nurse burnout. A total of 85 studies (81 cross-sectional and 4 longitudinal) involving 288 581 nurses from 32 countries (mean [SD] age, 33.9 (2.1) years; 82.7% female; mean [SD] burnout prevalence rate with study-specific ascertainments, 30.7% [9.7%]) were included. Nurse burnout was associated with a lower safety climate or culture (SMD, -0.68; 95% CI, -0.83 to -0.54), lower safety grade (SMD, -0.53; 95% CI, -0.72 to -0.34), and more frequent nosocomial infections (SMD, -0.20; 95% CI, -0.36 to -0.04), patient falls (SMD, -0.12; 95% CI, -0.22 to -0.03), medication errors (SMD, -0.30; 95% CI, -0.48 to -0.11), adverse events or patient safety incidents (SMD, -0.42; 95% CI, -0.76 to -0.07), and missed care or care left undone (SMD, -0.58; 95% CI, -0.91 to -0.26) but not with the frequency of pressure ulcers. Nurse burnout was also associated with lower patient satisfaction ratings (SMD, -0.51; 95% CI, -0.86 to -0.17) but not with the frequencies of patient complaints or patient abuse. Finally, nurse burnout was associated with lower nurse-assessed quality of care (SMD, -0.44; 95% CI, -0.57 to -0.30) but not with standardized mortality rate. The associations were consistent across nurses' age, sex, work experience, and geography and persistent over time. For patient safety outcomes, the association was smaller for the low personal accomplishment subcomponent of burnout than for emotional exhaustion or depersonalization, as well as for nurses with a college education. In this systematic review and meta-analysis, nurse burnout was found to be associated with lower health care quality and safety and lower patient satisfaction. This association was consistent across nurse and study characteristics.

Tracking myasthenia gravis severity over time: Insights from the French health insurance claims database.

Few data are available on the course of myasthenia gravis (MG) regarding disease severity and stability over time in real-world settings. This study used the French National Health Insurance Database (SNDS) to assess markers of disease severity in patients with MG longitudinally. All patients with MG-related claims in the SNDS between 2013 and 2020 were identified. Patients were followed for up to 8 years after the first claim. Intensive care unit (ICU) stays, treatment with intravenous immunoglobulin (IVIg) or plasma exchange (PE), and death were documented throughout the follow-up period. Standardized mortality rates were estimated, and mortality-related variables were identified using a Cox model. In all, 14,459 individuals constituted the full study population, including 6354 incident patients. In the incident population, 2199 (34.6%) were admitted to ICUs at least once, principally during the first year after the index date (N = 1477; 23.3%). This proportion decreased progressively to reach 3.0% in the seventh year. A total of 2817 patients received IVIg and 432 PE, again principally in the first year. In the full study population, the standardized mortality rate was 1.08 (95% confidence interval [CI] 1.03-1.13), being lower in men (0.95, 95% CI 0.89-1.02) than in women (1.15, 95% CI 1.07-1.23) and in patients aged >65 years (1.06, 95% CI 1.01-1.11) than in younger patients (1.50, 95% CI 1.24-1.76). Male gender, older age and higher comorbidity were independently associated with mortality. A subgroup of patients with MG require ICU admission and rescue therapy with IVIg or PE, indicative of poor disease control. New therapies are needed to improve disease control and reduce disease burden.

Analysis of the epidemiological trends of Tuberculosis in China from 2000 to 2021 based on the joinpoint regression model

BackgroundChina is ranked third globally in terms of burden and has a moderately high to high prevalence of tuberculosis (TB). This study meticulously investigated the notification rates of TB and assessed the epidemic in China from 2000 to 2021. The aim of the study was to provide robust supporting data that is crucial for enhancing TB prevention and control strategies.MethodsExtensive data regarding TB notification rates in China between 2000 and 2021 was collected. The joinpoint regression model was subsequently utilized to assess the temporal trends in the notification rates of TB, which were analyzed through the annual percentage change (APC) and the average annual percentage change (AAPC).ResultsDuring the study period (2000–2021), the standardized notification rates of TB in China ranged from 38.89/100,000 to 101.15/100,000, with a significant annual average decrease of 4.43% (P < 0.05). Before the COVID-19 pandemic, a marked acceleration in this decline was observed from 2006 to 2015, with an APC of 4.62% (P < 0.05). Stratified by age and sex, the age group with the most significant annual decline in overall standardized notification rates of TB among males in China was < 15 years old, followed by 55–64 years old, and the group with the least decrease was 25–44 years old. Similarly, the age group with the most significant annual decline in standardized notification rates of TB among females was < 15 years old.ConclusionsThe epidemic of TB in China exhibited a downward trajectory between 2000 and 2021. However, it is imperative to prioritize the attention given to males and older adults, and to promote specific and effective prevention and control strategies for these populations.

An evaluation of African animal trypanosomiasis control strategies in remote communities of Eastern Zambia.

Communities living in African animal trypanosomiasis (AAT) endemic areas of Zambia use several control strategies to protect their livestock from the devastating effects of trypanosomiasis. Several studies have reported the effectiveness of trypanosomiasis control strategies based on retrospective data. In this study, we assessed incidence rates of AAT in cattle (n = 227) using a prospective cohort study comprising 4 treatment groups, i.e., Diminazene aceturate, Isometamidium chloride, Cyfluthrin pour-on and Cypermethrin treated targets. The study was conducted in Mambwe district in Eastern Zambia between February 2019 and March 2020. The endemic prevalence of AAT for each group was determined using ITS-PCR prior to application of treatments. High endemic trypanosome pre-treatment rates were found in all Groups (Diminazene aceturate (61%), Isometamidium chloride (48%), Cyfluthrin pour-on (87%) and Cypermethrin targets (72%)). The overall apparent prevalence for the Mambwe district was 67% (152/227) and true prevalence at 95%CI was 63–71%. Once treatments were implemented, 12 monthly follow-ups were conducted. The average monthly incidence rates without standardization recorded: Diminazene aceturate (67%) Isometamidium chloride (35%), Cyfluthrin pour-on (55%) and Cypermethrin targets (61%). Incidence rates were standardized considering the endemic level of disease for each Group and the average standardized monthly incidence rate in the Diminazene aceturate Group was 7%; the Isometamidium chloride Group −13%; the Cyfluthrin Group −26%; and the Cypermethrin target Group, −17%. All Groups showed a decrease in incidence of AAT over the period of the study with the Cyfluthrin group showing to be the most effective in reducing AAT incidence in cattle.

Analisis Peran Undewriter Dalam Menyeleksi Risiko pada Produk Asuransi Kesehatan:

This study aims at the role of the underwriter in selecting the risk of health insurance products, knowing the obstacles encountered by the underwriter in selecting the risk and the solutions applied to overcome these obstacles, and knowing the underwriting process of group health insurance at AJB Bumiputera Medan. The type of research used is descriptive research, with a qualitative approach. The conclusions of this study briefly are: (1) Underwriters have an important role in insurance companies because underwriters determine whether the insurance coverage can be accommodated by the company or not. (2) Obstacles encountered by underwriters in selecting risks are the availability of incomplete participant data, previous experience data of the insured and prospective insured not providing the desired budget and benefits, while the solution is to contact the agent concerned to obtain additional information needed by the underwriter, apply analysis to groups of prospective insurance participants as new participants, and provide standard premium rates and benefits. (3) The underwriting process begins when marketing applies for SPPA until the issuance of the policy. Keywords: Underwriting, Underwriter, Group Health Insurance

Evaluation of TNF-α and TNF-R1 immunomarkers in Renal Failure Patients in Karbala province

Renal failure is characterized by height level of pro-inflammatory cytokines, mainly Tumor necrosis factor-alpha (TNF-α) and its receptor TNF-R1. The aim was to investigate the association of TNF-α and TNF-R1 levels in Renal Failure.This study was carried out from February 2022 to March 2023 in the labs of Thi-Qar University's Col1ege of Education for Pure Sciences. In partnership with Al-Hussein Teaching Hospital, Nasiriyah General Hospital, and Thi-Qar Center for Nephrology and Dialysis in Thi-Qar Province .The study comprised (100) patients for both sex : (40 patients with diabetes mellitus), (40 patients without diabetes mellitus) whose serum urea level and serum creatinine level were examined, and (40 healthy).The level of biochemical indicators were measured, which included urea, creatinine, albumin and total protein where the study discovered a considerable rise in urea and creatinine levels compared to healthy subjects and standard rates, and this increase is related 'with a decrease GFR', while there is decrease in rate of albumin and total protein. The statistical analysis' findings revealed a considerable difference (p &lt;0.05) in patients with RF in concentration of the TNF-α and TNF-R1, where they were examined for 80 samples of RF patients, and 40 healthy samples in the control group. The number of RF patients in Thi-Qar province showed a marked increase in the yearly rate of hemodialysis. A third of all patients had a considerable prevalence of RF linked to hypertension. The study concluded that a significant effect of TNF-α is associated with markers of kidney disease severity and distant organ dysfunction among patients with RF. In addition, this study found a correlation between the effects of TNF- α on end-stage renal disease. Extensive studies are needed to confirm these relationships.

COBIRAS: Offering a Continuous Bit Rate Slide to Maximize DASH Streaming Bandwidth Utilization

Reaching close-to-optimal bandwidth utilization in dynamic adaptive streaming over HTTP (DASH) systems can, in theory, be achieved with a small discrete set of bit rate representations. This includes typical bit rate ladders used in state-of-the-art DASH systems. In practice, however, we demonstrate that bandwidth utilization, and consequently the quality of experience (QoE), can be improved by offering a continuous set of bit rate representations, i.e., a continuous bit rate slide (COBIRAS). Moreover, we find that the buffer fill behavior of different standard adaptive bit rate (ABR) algorithms is sub-optimal in terms of bandwidth utilization. To overcome this issue, we leverage COBIRAS’ flexibility to request segments with any arbitrary bit rate and propose a novel ABR algorithm MinOff , which helps maximizing bandwidth utilization by minimizing download off-phases during streaming. To avoid extensive storage requirements with COBIRAS and to demonstrate the feasibility of our approach, we design and implement a proof-of-concept DASH system for video streaming that relies on just-in-time encoding ( JITE ), which reduces storage consumption on the DASH server. Finally, we conduct a performance evaluation on our testbed and compare a state-of-the-art DASH system with few bit rate representations and our JITE DASH system, which can offer a COBIRAS, in terms of bandwidth utilization and video QoE for different ABR algorithms.

Integrating mechanical and cultural methods for weed control in organic chickpea

Abstract The Northern Great Plains of the United States is a major production region for organic pulse crops that are prone to yield losses due to weeds. Weed management in organic systems relies on the integration of several tactics to stack additive effects and for redundancy to deal with variable efficacy of individual weed management practices. To address the need for effective, integrated weed management, we conducted a 2-yr trial that evaluated the effects of planting date, seeding rate, and preemergent weed control practices (shallow tillage and flame weeding) on weed biomass, crop density, and yield in organically managed chickpea (Cicer arietinum L.) in Montana. Stacking weed management practices increased yields. Early planting had the largest effects on yields, increasing them by 1.8- to 3.6-fold compared with planting 10 to 14 d later. Increasing the seeding rate from the standard rate (43 viable seeds m−2) by 50% increased yields by 47% from 889 to 1,304 kg ha−1. Both preemergent weed control practices increased yields by 40% to 50 % relative to the non-weeded controls. By integrating all three practices, yields of organic chickpea increased greater than 6-fold from 318 kg ha−1 in the controls to 2,006 kg ha−1. The effects of weed control treatments on midseason weed biomass were complex and variable. Although efficacy of the cultural (seeding rate and planting date) and physical (preemergent) treatments on weed biomass varied between years and when combined with other treatments, their full integration, that is, early planted, at higher seeding rate, and preemergent weed control, produced consistently lower weed biomass (84% reduction on average) compared with the standard grower practice (later planting, standard seeding rate, no preemergent weed control). The results lend support to the concept of integrating multiple weed management practices to achieve weed control and high yields in organically managed crops.

Metabolic rates of different demographics in the sand fiddler crab Leptuca pugilator.

Studies on animal energetics often focus on standardized metabolic rates to facilitate comparison across systems. Yet these standardized measurements often do not capture the realistic demographic and environmental variation that is common in natural settings. Rather, individuals included in these studies are often non-reproducing, uninjured, resting adults that have not recently eaten-far from a representative sample. We measured the respiratory rates of the sand fiddler crab Leptuca pugilator in air immediately after capture in the field, and compared rates between males, females of different reproductive states, and juveniles. As expected, we show that metabolic rates were influenced by body mass and activity level. We also show that being vitellogenic or gravid had only minor impacts on metabolic costs of females. Importantly, we demonstrate how considering demographics allows for the detection of phenomena that would otherwise go unnoticed. We found that field metabolic rates of L. pugilator in air are as much as an order of magnitude higher than previous standard metabolic rates measured on post-prandial, quiescent individuals. These higher rates may reflect a combination of high activity and active digestion, as fiddler crabs actively feed during low tide periods. Our results highlight the importance of considering differences in sex, life history stage, and reproductive state of organisms in fluctuating environments, such as intertidal habitats, when assessing energy expenditure.

Direct current cardioversion and the impact of short-term exposure to air pollution: a report from the nationwide EP-PARTICLES study

Abstract Background Air pollution and atrial fibrillation (AF) represent significant public health challenges, impacting global health considerably. Numerous studies have focused on areas with high or very high air pollution concentrations, our study examines a unique area in Poland characterized by low to moderate air pollution levels. Our research also addresses a commonly overlooked in research type of pollution - Polish smog. Due to its composition rich in particulate matter and the conditions in which it is formed - is characterized by extremely adverse health effects. Aim To explore the correlation between short-term air pollution exposure and the incidence of acute direct current cardioversion (DCC) for AF treatment. Methods The study area encompassed three voivodeships from Eastern Poland at the NUTS-2 level, with a population of 5,429,378 individuals. Data on hospitalizations from 2011 to 2020 were obtained from the National Health Fund. We combined air pollution and weather condition data from both ground monitoring stations and satellite observations. Emergency visits for AF and DCC were identified using ICD-9 and ICD-10 codes. For a national perspective, we applied meta-analytical strategies to the municipality-specific outcomes. The results are presented as percentage increases in admissions (% IR) with 95% confidence intervals (95%CI). Results Over the decade, 190,454 hospitalizations for AF were reported with a standardized hospitalization rate (SHR) of 358 per 100,000/year (SD=113) and 30,291 DCC admissions (SHR=56.9 [SD]=26). The mean age for AF vs. DCC cohort was 69.6 (SD=11.2) vs. 68.7 (SD=10.4) years, with females representing 56.1% (N=106,822) of AF cases vs. 46.1% (N=13,953) of DCC admissions (P&amp;lt;0.001). Each 10 µg/m3 increase in PM2.5, PM10, and NO2 concentration on the exposure day led to 1.6% (1.1%–2.1%), 1% (0.8%–1.6%), and 1.8% (1.1%–2.6%) increases in acute AF admissions, respectively, with effects lasting up to 6 days. Women and older individuals were more vulnerable to AF episodes induced by air pollution (P&amp;lt;0.001). A 10 µg/m3 increase in PM2.5 on the day of admission increased DCC admissions by 1.5% (0.1%–2.9%, P=0.04), with effects persisting for up to 3 days. The impact of PM10 was time-delayed: 1.3% (0.2%–2.4%, P=0.02) for LAG1 (i.e. one day after exposure), and 1.1% (0.1%–2.2%, P=0.4) for LAG2. No significant effects of gaseous pollutants on DCC (SO2, NO2, and BaP) were observed, nor any differences in the effects by age or sex. Exposure-response functions show steeper slopes of the PM2.5 associations in the lower ranges of exposures, far below air quality norms set by the World Health Organization. Conclusions Air pollution acts as a triggering factor for acute AF hospitalizations and DCC. The differential impact of air pollution on AF events between groups highlights that women and older individuals are particularly vulnerable. Air pollution exposure should be considered into AF management and prevention strategies.Pooled exposure–response function: % inc

Cardiovascular Mortality Risk among Patients with Liver Cancer: A SEER Database Study.

Data sourced from the Surveillance, Epidemiology, and End Results (SEER) database encompassing liver cancer diagnoses from 2000 to 2017 were utilized. The standardized mortality rate (SMR) was computed using general population reference data, and multivariate competing risk models were employed for analysis. Analysis of 70,733 liver cancer patient records revealed 1,954 instances of CVM. The overall CVM SMR for liver cancer patients was 12.01 (95% CI: 11.48-12.55). Various demographic and clinical factors, including sex, race, age, year of diagnosis, pathological type, general stage, treatment modalities, and matrimonial status, emerged as liver cancer pa-tients` independent predictors of CVM. Liver cancer patients have a notably heightened susceptibility to cardiovascular mortality (CVM) in contrast to the general populace. It is imperative to promptly recognize high-risk subcategories and execute tailored cardiovascular interventions as crucial measures to bolster survival rates within this cohort of patients.

Growing Media pH and Nutrient Concentrations for Fostering the Propagation and Production of Lingonberry (Vaccinium vitis-idaea L.)

The lingonberry (Vaccinium vitis-idaea L.), recognized for its nutritional value and adaptability to cold climates, faces cultivation challenges, particularly in soil pH and fertility optimization. In a greenhouse study, lingonberry transplants were grown in media with pH levels of 6.5 (3:1:1 PRO-MIX BX/peat moss/perlite) and 5.2 (2:1 peat moss/perlite). Seven months post-exposure to different media pH, various fertility treatments (NPK) were tested, including a control (0–0–0), a balanced 5–5–5 kg ha−1 rate, a standard 36–24–48 kg ha−1 rate, and both higher (up to 54–36–72 kg ha−1) and lower (down to 9–6–12 kg ha−1) rates, applied every three weeks for fifteen weeks across six replications with a standard micronutrient rate. Results showed that media pH significantly affected plant height and volume, with plants at pH 6.5 growing 27% taller and larger than plants at pH 5.2. Fertility levels influenced plant volume, peaking at a moderate fertility rate (18–12–24 kg ha−1) before declining at higher rates. Interactions between pH and fertility significantly impacted shoot biomass, where higher fertility rates (above 36–24–48 kg ha−1) had a more pronounced negative effect on shoot biomass at pH 6.5 compared to pH 5.2. Root dry biomass was consistently 1.2–2.3 times greater than shoot dry biomass and less influenced by the treatments. Shoot death rates increased sharply at fertility rates above 18–12–24 kg ha−1, peaking at 21–35%. Nitrogen concentration in shoots and roots increased with higher fertilizer rates, peaking at 1.74% in the 45–30–60 kg ha−1 treatment. Fertility treatments raised growing media’s electrical conductivity (EC, 1:20 ratio), with a maximum of 1.41 dS m−1 in the 54–36–72 kg ha−1 treatment, though pH remained unchanged. Growing media nitrate levels increased with higher N rates, while ammonium levels were unaffected. Shoot death rates rose significantly with higher nitrate concentrations, particularly above 17.5 mg L−1, but showed no link to ammonium levels. Lingonberries can survive and thrive across a wide range of pH levels. These results indicate that lingonberries are resilient and low maintenance, requiring modest nutrient levels, and excessive fertilization hampers their growth.

Bias in Evaluating Trends of Thyroid Cancer Incidence between Rural and Urban Populations

Abstract Background Diagnosis of thyroid cancer is based on fine needle aspiration cytology of thyroid nodules, based on nodules’ sonographic appearance and size. The American Thyroid Association published new guidelines for management of thyroid nodules in 2009 and 2015, where in some cases, only follow-up of thyroid nodules without any other procedure is recommended. This may lead to a decrease in diagnosed thyroid cancer cases. We studied thyroid cancer trends in Israel between the Arab population who are more likely to be living in rural areas, and the Jewish population who predominantly living in urban areas, and assesses whether these guidelines were reflected in the trends. Methods Data on new thyroid cancer cases were retrieved for Jews and Arabs separately from the Israel National Cancer Registry. Trends in age standardized incidence rates between 1996-2019 were evaluated for the two population groups using joinpoint regression model. Population group was included in the regression models to compare the trends between the two groups. We also studied trends in treatment of thyroid cancer at Rambam Health Care Campus. Results In both populations, age standardized thyroid cancer incidence rate increased between 1996 and 2013. However, between 2013-2019, Annual Percentage Change continuously increased in Arabs, but decreased in Jews. In the hospital study, we found that the Arab patients were 30% more likely to have surgery for small tumors. Conclusions The decrease in thyroid cancer incidence in the Jewish population compared with the Arab population may be related to differences in implementing the 2009 guidelines, which do not recommend fine needle aspiration cytology for very small tumors. We have found evidence that these guidelines were not followed to the same extent among Arab community clinics. This may explain the persisting increasing trend among Arabs, and could be one of the possible explanations for the differences in trends between the two groups. Key messages • Updated Guidelines regarding thyroid cancer diagnosis may be differently implemented by rural and urban populations. • Trends assessment may be biased due to differences in guidelines implementation.

Undernutrition, and overweight and obesity: the two faces of malnutrition in Brazil, 1990-2019

Abstract Background The double burden of malnutrition consists of the coexistence of nutritional deficiencies (malnutrition and overweight/obesity. Approximately 2.28 billion children and adults are overweight, and more than 150 million children are malnourished. The Decade of Action on UN Nutrition and SDGs that broaden the focus to both sides of malnutrition: overweight/obesity and nutritional deficiencies. Objectives To analyze the global burden of disease attributable to undernutrition and high body mass index (BMI) in Brazil and its 27 states, as well as its association with the socio-demographic index (SDI) from 1990 to 2019. Methods: Study design This is an epidemiological time-series study. This study analyzed the undernutrition and high BMI estimated by the Global Burden of Disease study conducted from 1990 to 2019 for Brazil and its states, using the following metrics: absolute number of deaths, standardized mortality rate, and disability-adjusted life years (DALYs). This study also analyzed the correlation between the percentage variation of mortality rates and SDI. Results A decrease in the number of deaths (75%), mortality rate (75.1%), and DALYS (72%) attributable to undernutrition was found in Brazil and in all regions. As regarding the high BMI, an increase in the number of deaths was found (139.6%); however, the mortality rate (9.7) and DALYs (6.4 %) declined in all regions, except in the North and Northeast regions, which showed an increase. A strong correlation was identified between undernutrition and high BMI with SDI. Conclusions Our study observed a double burden of malnutrition in Brazil, with a reduction in the burden of diseases due to malnutrition in Brazil and variation in the burden due to high BMI according to the socioeconomic status of the region. Public policies are necessary in order to guarantee the human right to a healthy and sustainable diet, together with food and nutrition security and a diminishing of social inequality. Key messages • Overcome the malnutrition public policies are necessary to guarantee the human right to healthy and sustainable food, such as encouraging the production and commercialization of fruits &amp; vegetables. • Overcoming undernutrition and excess weight requires public policies aimed at reducing social inequality and providing access to healthy food for all, and taxation of ultra-processed foods.

Social and metabolic mediation of growth performance in a temperate estuarine fish

Despite the importance of juvenile growth to lifetime fitness, high variability exists within many fish species where some individuals grow markedly faster than others. Here, we explored whether social context mediated growth performance in n = 35 Galaxias maculatus by manipulating the social environment after identifying different growth phenotypes. We found that initially fast-growing fish slowed their growth rate when pooled with similarly fast-growing individuals, whereas none of the initially slow-growing fish markedly improved their growth when pooled with other slow-growers. We examined for any metabolic underpinnings to the findings by measuring standard, routine, and maximum metabolic rates (SMR, RMR, and MMR) at two time points separated by ~4 months. SMR and RMR positively correlated with growth rates when the fish were pooled into growth phenotypes, but not when they were returned to their original (mixed) social groups. We highlight research directions to further elucidate how social context and metabolism interact to govern growth phenotype.

The effects of SGLT2 inhibitors on right ventricle functions in heart failure patients: update meta-analysis of the current literature

Abstract Background There is some discrepancy in the present studies concerning the effect of sodium-glucose cotransporter type 2 (SGLT2) inhibitors on right ventricular (RV) functions in heart failure (HF) patients. The current meta-analysis was focused on determining the impact of SGLT2 inhibitors on RV functions in such individuals. Methods Two independent investigators searched PubMed, Google Scholar, and the Cochrane Library for articles of interest. To analyze heterogeneity, Higgins' I2 as well as prediction intervals and Egger's test were utilized to assess heterogeneity. The Newcastle-Ottawa standard ratings approach was used to assess the quality of observational studies. The Robin-I risk of bias algorithm was used to assess the bias risks of randomized studies. Results This meta-analysis evaluated 8 studies in total. Over the follow-up time frame, patients who used SGLT-2 inhibitors had substantially lower systolic pulmonary artery pressure (sPAP) and higher TAPSE values (mean difference (MD) = 1.30 [0.78;1.82], p =0.002 and MD =-5.39 [-7.88; -2.89], p=0.003, respectively). There was no significant difference in RVS’ values between follow-up and baseline (MD=1.38 [-1.35;3.80], p=0.169). However, as compared to the baseline period, fractional area contraction (FAC) values were substantially larger at the end of the follow-up period (MD=5.40 [3.74;7.07], p=0.015). Conclusion To the best of our knowledge, this is the first meta-analysis assessing the impact of SGLT2 inhibitors on RV function in HF patients. Our findings suggest that SGLT2 inhibitors may improve RV performance in HF patients.