西双版纳黄瓜(Cucumis sativus var. xishuangbannanesis)是黄瓜的一个变种。云南省西双版纳及周边地区的少数民族长期以来栽培、管理和利用这种黄瓜,使它成为当地重要的作物农家品种,对其开展民族植物学研究,了解其传统知识十分必要。...西双版纳黄瓜(Cucumis sativus var. xishuangbannanesis)是黄瓜的一个变种。云南省西双版纳及周边地区的少数民族长期以来栽培、管理和利用这种黄瓜,使它成为当地重要的作物农家品种,对其开展民族植物学研究,了解其传统知识十分必要。我们于2017–2018年在西双版纳傣族自治州调查了西双版纳黄瓜农家品种及其相关的传统知识。结果表明,与现代品种相比,西双版纳黄瓜农家品种具有香味浓郁、耐贮藏等特异性;西双版纳的傣族、基诺族、彝族、瑶族等少数民族拥有丰富的关于西双版纳黄瓜农家品种的传统知识。西双版纳黄瓜种质资源在大部分村寨已经消失或濒临消失,与之相关的传统知识也随之消亡,目前仅在海拔较高、交通欠发达的边远山区还栽培和保留了少量的农家品种。建议开展西双版纳黄瓜农家品种的原生境保护,既保护其种质资源,也保护相关的传统知识。展开更多
Background: The rate of accidental dural puncture is particularly high during the period of training, especially in novices. The structured epidural teaching model (SETM) includes three standardized video lessons, the...Background: The rate of accidental dural puncture is particularly high during the period of training, especially in novices. The structured epidural teaching model (SETM) includes three standardized video lessons, the construction of a 3D epidural module by trainees and practical training by using an epidural simulator with and without the CompuFlo™ Epidural instrument. In this study we report the retrospective analysis of the accidental dural puncture rate of inexperienced trainees during their 6 months clinical practice rotation in obstetrics before and after the introduction of the SETM in our Institution. Method: We evaluated the incidence of accidental dural puncture before the introduction of the SETM methodology and afterwards by analyzing our departmental database from February 2019 to January 2023. All epidural blocks were executed by trainees who had never previously performed an epidural block and were about to begin their obstetrics rotation. Results: We analyzed 7415 epidurals: 3703 were performed before the introduction of the SETM methodology (control group) and 3712 afterwards (study group). The incidence of accidental dural puncture was 0.37% for the control group and 0.13% for the study group (p<.05). The probability of making an accidental dural puncture was 64% (OR: 0.36) lower for trainees who had the training than for those who did not. Conclusions: After the introduction of the structured teaching method, we observed a significant reduction of accidental dural puncture during the training period. We hope that our observation will encourage a constructive discussion among experts about the need to use standardized and validated tools as a valuable aid in teaching epidural anesthesia.展开更多
Objective: To study the genetic diversity of Culex theileri flavivirus and the spread of this virus among Spain, Portugal and Turkey.Methods: A database consisting of 55 sequences of the NS5/3'UTR region of Culex ...Objective: To study the genetic diversity of Culex theileri flavivirus and the spread of this virus among Spain, Portugal and Turkey.Methods: A database consisting of 55 sequences of the NS5/3'UTR region of Culex theileri flavivirus group downloaded from GenBank were aligned and manual edited with Bioedit.ModelT est v.3.7 was used to select the simplest evolutionary model that adequately fitted the sequence data.Maximum likelihood analysis was performed using MEGA7.The phylogenetic signal of the dataset was investigated by the likelihood mapping analysis.Results: The phylogenetic tree showed three clusters.Myanmar sequences clusterd together with Turkish sequences, Spain and Portugal strains grouped together and two Turkish sequences grouped separately.Selective pressure analysis showed a moderate percentage of sites(22.5%) under pervasive negative selection and only 1% under pervasive positive selection.The sites subject to selective pressure in CTFV RdRp NS5 fragments have been located onto the predicted three-dimensional structure.Conclusions: Phylogenetic and evolutionary analysis can be an important tool for understanding the evolutionary impact of the probable contemporary existence between nonpathogenic and pathogenic flaviviruses among these vectors.展开更多
This paper discusses some methodological aspects for the production of susceptibility maps of slope instability developed within the CARG Project (Geological Cartography of Italy at 1:50,000 scale). It describes an ex...This paper discusses some methodological aspects for the production of susceptibility maps of slope instability developed within the CARG Project (Geological Cartography of Italy at 1:50,000 scale). It describes an example of a susceptibility map in the presence of low susceptibility, using database having zero or negligible cost, with the aim to test some methodologies that can be easily reproducible to get a first estimate of the landslide susceptibility on a wide area. Two statistical approaches have been applied: the non-parametric conditional analysis and the logistic analysis for rare events. The predictive ability obtained from the two methodologies, was evaluated by the success-prediction curves for the conditional analysis, and by the Receiver Operating Characteristic curve (ROC), for the logistic model. The landslide susceptibility maps have been classified into four classes using both the Natural Breaks algorithm and the method proposed by Chung and Fabbri (2003). The paper considers the influence of these two classification methods on the quality of final results.展开更多
AIM： To determine the performance of novice readers （4^th year medical students） for detecting capsule endoscopy findings. METHODS： Ten capsule endoscopy cases of small bowel lesions were administered to the reade...AIM： To determine the performance of novice readers （4^th year medical students） for detecting capsule endoscopy findings. METHODS： Ten capsule endoscopy cases of small bowel lesions were administered to the readers. Gold standard findings were pre-defined by gastroenterologists. Ten gold standard ＂targets＂ were identified among the 10 cases. Readers were given a 30-min overview of Rapid Reader software and instructed to mark any potential areas of abnormalities. A software program was developed using SAS to analyze the thumbnailed findings. RESULTS： The overall sensitivity for detecting the gold standard findings was 80%. As a group, at least 5 out of 10 readers detected each gold standard finding per recording. All the gold standard targets were identified when the readers＇ results were combined. Incidental finding/false positive rate ranged between 8.2-59.8 per reader. CONCLUSION： A panel of medical students with minimal endoscopic experience can achieve high sensitivity in detecting lesions on capsule endoscopy. A group of novice readers can pre-screen recordings to thumbnail potential areas of small bowel lesions for further review. These thumbnails must be reviewed to determine the clinical relevance. Further studies are ongoing to assess other cohorts.展开更多
Bipolar disorder presents significant challenges in clinical management, characterized by recurrent episodes of depression and mania often accompanied by impairment in functioning. This study investigates the efficacy...Bipolar disorder presents significant challenges in clinical management, characterized by recurrent episodes of depression and mania often accompanied by impairment in functioning. This study investigates the efficacy of pharmacological interventions and rehabilitation strategies to improve patient outcomes and quality of life. Utilizing a randomized controlled trial with multiple treatment arms, participants will receive pharmacotherapy, polypharmacotherapy, rehabilitation interventions, or combination treatments. Outcome measures will be assessed using standardized scales, including the Hamilton Depression Scale, Yale-Brown Obsessive Compulsive Scale (Y-BOCS), and Mania Scale. Preliminary data suggest improvements in symptom severity and functional outcomes with combination treatments. This research aims to inform clinical practice, guide treatment decisions, and ultimately enhance the quality of care for individuals living with bipolar disorder. Findings will be disseminated through peer-reviewed journals and scientific conferences to advance knowledge in this field.展开更多
The manuscript introduces an “ab initio” quantum model to deduce the Maxwell equations. After general considerations and laying out the model’s theoretical framework, these equations can be derived alongside a broa...The manuscript introduces an “ab initio” quantum model to deduce the Maxwell equations. After general considerations and laying out the model’s theoretical framework, these equations can be derived alongside a broad variety of other results. Specifically, a corollary of the present model proposes a possible mechanism underlying the formation of magnetic monopoles and allows estimating their formation energy in order of magnitude.展开更多
Objectives: Atlantoaxial dislocation remains a rare and serious condition with a high preoperative and postoperative morbidity and mortality. Its successful surgical management is still challenging and gratifying for ...Objectives: Atlantoaxial dislocation remains a rare and serious condition with a high preoperative and postoperative morbidity and mortality. Its successful surgical management is still challenging and gratifying for neurosurgeons. Several technics have been described such as wiring, trans articular screwing, C1C2 screwing with plate and screw introduced by Goel et al., and modified by insertion of polyaxially screw and rod many years later by Harms. Unavailability and expensiveness of upper cervical spine instrumentation device led us to C1C2 Wiring resulting in a good outcome. Finally, a quadriplegic patient with a more comfortable financial condition had ordered devices from abroad and benefit for Goel and Harms screwing technique and improved dramatically from ASIA A to ASIA E. Material and methods: This is a retrospective study of patients managed in our department by a same neurosurgeon from January 2019 to April 2024. Results: We defined 6 men and 1 woman with an average age of 33 years. Unrestrained driver in a rollover motor vehicle accident was most common. Only one patient was neurologically intact on admission. Neurovegetative disorders were noticed in one patient. Dislocation was associated to a fracture of the dens in two patients. Three patients have been successfully operated with remarkable outcome, mostly from ASIA A to E. Conclusion: C1C2 dislocation is a serious condition and C1C2 Wiring represents an effective and cheaper technic. Therefore, this technic should deserve consideration above all in low incomes countries when screwing devices are not available. Seatbelt should be demanded for motor vehicle drivers and passengers.展开更多
Shallots (Allium cepa ascalonicum L.) are an important crop primarily due to their likely culinary and economic value. However, its production comes with specific challenges. In addition, effective post-harvest manage...Shallots (Allium cepa ascalonicum L.) are an important crop primarily due to their likely culinary and economic value. However, its production comes with specific challenges. In addition, effective post-harvest management is critical to ensure the quality and availability of shallot bulbs for extended periods. This study assessed the yield performance and storability relevant traits of five shallot cultivars (Saboula Jaba, Espagne Jaba, Daou Jaba, Tata Jaba, and N’galamandjan Jaba) under controlled storage conditions. Field experiments were conducted in 2021 to evaluate growth and yield in terms of bulb quantity, size, and weight. Storability traits such as firmness, weight loss, and Total Soluble Solids (TSS) were also measured for each entry. The five ecotypes of shallots were evaluated on-station with a total rainfall of 810 mm in 2021. The results revealed statistically significant variations (p > 0.01) in storability traits and yield among the tested entries. Furthermore, the weight loss of stored bulbs varied, indicating genetic differences among the cultivars that can influence their moisture retention abilities, leading to differences in weight loss rates. Indeed, Daou jaba showed less weight loss and superior firmness. The top highest-ranking entry for yield was shown by N’galamandjan jaba with 40 T/ha, followed by Saboula jaba with 39 T/ha. These highest productivity entries also showed significantly higher bulb quantity and individual bulb size. While there was a significant correlation between weight loss and firmness, a correlation between weight loss and TSS was also observed. The weight loss and firmness of N’galamandjan jaba were significantly correlated (r = 0.52) on the one hand, and on the other hand, the weight loss and visual quality of Espagne Jaba were highly and significantly correlated (r = 0.69). N’galamandjan Jaba and Saboula Jaba can be used to improve the yield and the storability relevant traits and prevent post-harvest losses.展开更多
Functional pain syndromes are very common diseases that negatively impact the quality of life of patients with important socio-economic repercussions. The clinical alterations associated with these pathologies are mul...Functional pain syndromes are very common diseases that negatively impact the quality of life of patients with important socio-economic repercussions. The clinical alterations associated with these pathologies are multiple and have a complex psycho-organic character that moves along the micorobiome-gut-brain-axis. For the present study, 45 patients of both sexes (19 male, 26 female) aged 30 - 59 years were enrolled because of a diagnosis of Functional pain syndromes (FPS) that lasted for more than 6 months. All patients underwent pre-treatment clinical assessments (T0) for anxiety disorder, multidimensional assessment of pain, monitoring of baseline values of Alpha-Theta cerebral rhythm in occipital region and monitoring of salivary cortisol levels. All the patients underwent a clinical treatment combined with central neuromodulation with neurofeedback—Alpha Theta increase protocols (once a week for three months), administration of multispecies probiotic (one dose per day for 3 months) and clinical psychological interviews (once a week for three months). At the end of treatment (T1), patients were re-evaluated. Results show statistically relevant improvements of each feature considered: the Relief from Pain provided by the medication increases on average from 36.6% to 87.3%, the salivary Cortisol level at 11 pm decreases from 6.4 ng/ml to a physiological value of 1.2 ng/ml, and the anxiety rating score is reduced from 28 to 12. Moreover, the 23.9% increase in α-θ relative power shows the positive outcome of the brain autoregulation. This study highlights that the combined approach of Neurofeedback with drugs and multispecies probiotic results in great improvements in the patients’ life.展开更多
The main aim of the paper is to present (and at the same time offer) a differ-ent perspective for the analysis of the accelerated expansion of the Universe. A perspective that can surely be considered as being “in pa...The main aim of the paper is to present (and at the same time offer) a differ-ent perspective for the analysis of the accelerated expansion of the Universe. A perspective that can surely be considered as being “in parallel” to the tradition-al ones, such as those based, for example, on the hypotheses of “Dark Matter” and “Dark Energy”, or better as a “com-possible” perspective, because it is not understood as being “exclusive”. In fact, it is an approach that, when con-firmed by experimental results, always keeps its validity from an “operative” point of view. This is because, in analogy to the traditional perspectives, on the basis of Popper’s Falsification Principle the corresponding “Generative” Logic on which it is based has not the property of the perfect induction. The basic difference then only consists in the fact that the Evolution of the Universe is now modeled by considering the Universe as a Self-Organizing System, which is thus analyzed in the light of the Maximum Ordinality Principle.展开更多
Background: Emerging evidence has recognized that anemia and iron deficiency are recurrent comorbidities in chronic heart failure (HF) and several trials have established that iron administration improves myocardial a...Background: Emerging evidence has recognized that anemia and iron deficiency are recurrent comorbidities in chronic heart failure (HF) and several trials have established that iron administration improves myocardial asset and clinical scenario in HF. Purpose: Recent acquisitions suggest that iron deficiency represents a concrete bias in the pathogenetic mechanism of chronic HF, so we have investigated the putative role of the hepcidin/ferroportin axis in the cardiovascular setting to advocate novel pharmacological and clinical approaches. Methods: Here, after an excursus on iron metabolism, we first reviewed the ongoing studies on novel iron targeted compounds. Then, we summarize large clinical interventional studies conducted on patient suffering from iron deficiency and HF which have tested the effects of drugging iron regard QoL, hospitalizations and cardiovascular death. Results: Novel compounds such as hepcidin agonist (PTG 300), synthetic human hepcidin (LJPC-401) and anti FPN (Vamifeport) are ongoing in iron overloaded patients, while the hepcidin blocker (PRS-080) is under investigation in anemic patients. Noteworthy, novel insights could arise from the results of a Phase IV interventional study regarding the modification of hepcidin pathway in a large cohort of HF patients (n = 1992) by sodium glucose cotransporter 2 inhibitors. To date, several studies highlight the beneficial effect of iron administration in cardiovascular setting and latest evidences consider hepcidin level as a novel biomarker of cardiac injury and atherosclerosis. Conclusions: We advocate that data from ongoing studies will suggest novel iron targeted therapies for diagnosis, prognosis and therapy transferable in selected heart failed patients.展开更多
Postural problems are very common, which is why plenty of Techniques have been created to solve them: Mezieres Technique (including muscle chains), RPG (Global Postural Re-Education, including pelvic diaphragm), Pilat...Postural problems are very common, which is why plenty of Techniques have been created to solve them: Mezieres Technique (including muscle chains), RPG (Global Postural Re-Education, including pelvic diaphragm), Pilates Method (including core muscles), Bobath Concept (including COG, center of gravity) and Yoga. In this work, I show a new way of treating and solving postural problems. I am basing this physiotherapy approach on a new Image I created. Every patient can use it for every correction and change in posture. I called the new Image: “OMINO (little man)”. “Postural Card” could be a good work to make “OMINO” possible. “OMINO” is immediately understandable and, using “OMINO POCKET INSTRUCTIONS”, it can be easily done. Contribution of paper: • Trunk is a vital element for any kind of rehabilitation;• “Core stability” is the key to activating the trunk. • Doing “OMINO” means working on “core stability”;• “OMINO” makes rehabilitation simple for the patient.展开更多
Neuromuscular diseases present profound challenges to individuals and healthcare systems worldwide, profoundly impacting motor functions. This research provides a comprehensive exploration of how artificial intelligen...Neuromuscular diseases present profound challenges to individuals and healthcare systems worldwide, profoundly impacting motor functions. This research provides a comprehensive exploration of how artificial intelligence (AI) technology is revolutionizing rehabilitation for individuals with neuromuscular disorders. Through an extensive review, this paper elucidates a wide array of AI-driven interventions spanning robotic-assisted therapy, virtual reality rehabilitation, and intricately tailored machine learning algorithms. The aim is to delve into the nuanced applications of AI, unlocking its transformative potential in optimizing personalized treatment plans for those grappling with the complexities of neuromuscular diseases. By examining the multifaceted intersection of AI and rehabilitation, this paper not only contributes to our understanding of cutting-edge advancements but also envisions a future where technological innovations play a pivotal role in alleviating the challenges posed by neuromuscular diseases. From employing neural-fuzzy adaptive controllers for precise trajectory tracking amidst uncertainties to utilizing machine learning algorithms for recognizing patient motor intentions and adapting training accordingly, this research encompasses a holistic approach towards harnessing AI for enhanced rehabilitation outcomes. By embracing the synergy between AI and rehabilitation, we pave the way for a future where individuals with neuromuscular disorders can access tailored, effective, and technologically-driven interventions to improve their quality of life and functional independence.展开更多
This study used Topological Weighted Centroid (TWC) to analyze the Coronavirus outbreak in Brazil. This analysis only uses latitude and longitude in formation of the capitals with the confirmed cases on May 24, 2020 t...This study used Topological Weighted Centroid (TWC) to analyze the Coronavirus outbreak in Brazil. This analysis only uses latitude and longitude in formation of the capitals with the confirmed cases on May 24, 2020 to illustrate the usefulness of TWC though any date could have been used. There are three types of TWC analyses, each type having five associated algorithms that produce fifteen maps, TWC-Original, TWC-Frequency and TWC-Windowing. We focus on TWC-Original to illustrate our approach. The TWC method without using the transportation information predicts the network for COVID-19 outbreak that matches very well with the main radial transportation routes network in Brazil.展开更多
In the present study, we analysed the results from the use of serological tests for the evaluation of the antibody response to SARS-CoV-2 virus, with the aim of verifying the seroprevalence for SARS-CoV-2 virus infect...In the present study, we analysed the results from the use of serological tests for the evaluation of the antibody response to SARS-CoV-2 virus, with the aim of verifying the seroprevalence for SARS-CoV-2 virus infection in Rome. Evaluations related to the seroprevalence are important for defining the epidemiological parameters of this disease. We therefore analysed the data deriving from 1586 subjects, residing in the geographical area of Rome, subjected to a rapid test, capable of detecting the presence of specific IgM and IgG class antibodies directed against the SARS-CoV-2 virus. Among the 1586 cases, 83 had positive conversion of IgM antibody and/or IgG antibody and 1503 tested negative. Out of 83 positive cases, 48% (40/83) samples resulted positively for both IgM and IgG, while 45% (37/83) were positive for IgG only, and 7% (6/83) for IgM only. The prevalence of anti-SARS-CoV-2 antibodies in the considered geographical area was 5% (83/1586), and 54% (45/83) of our population was an asymptomatic carrier. The study was performed to better evaluate the population prevalence in the studied geographic area. To our knowledge, this is the first study carried out in the Lazio region reporting data related to the asymptomatic carriers.展开更多
Ebola virus disease is a complex zoonosis that is highly virulent in humans. Despite its sorely pathogenic and lethal nature, survivors of this infection and even asymptomatic cases are able to develop both humoral an...Ebola virus disease is a complex zoonosis that is highly virulent in humans. Despite its sorely pathogenic and lethal nature, survivors of this infection and even asymptomatic cases are able to develop both humoral and cellular immunity against several Ebola virus (EBOV) proteins. We aimed at determining immunoglobulin G (IgG) antibodies level against two Ebola viral antigens, the glycoprotein and the nucleoprotein in Ebola survivors and their relatives. Anti-EBOV glycoprotein (GP) and nucleoprotein (NP) IgG antibodies were quantified using ELISA. We enrolled 199 participants in two different sites as follow: 91 survivors at the Loreto clinic and 70 survivors with 38 relatives of Sierra Leone Association of Ebola Survivors Bombali Branch (SLAESB) tested for anti-EBOV NP and anti-EBOV GP IgG antibodies. Our findings revealed that the median anti-EBOV IgG level among survivors was 5.7128 U/ml [IQR: 2.793 - 7.783] for anti-EBOV GP IgG and 4.431 U/ml [IQR: 2.083 - 7.696] for anti-EBOV NP IgG. Survivors relatives had a median anti-EBOV GP IgG level of ?0.7128 U/ml [IQR: -0.903 to -0.04327] and -2.711 U/ml [IQR: -4.01 to -1.918] for anti-EBOV NP IgG. We observed that IgG levels in survivors were higher than in relatives with a significant difference of about 0.0001. The median value of anti-EBOV IgG level among seropositive relatives was 0.7043 U/ml [IQR: 0.5686 to 3.716] for anti-EBOV GP IgG and 4.05 U/ml [IQR: 0.2765 to 7.759] for anti-EBOV NP IgG respectively. Interestingly, we observed that 3.30% of Loreto clinic survivors did not developed anti-EBOV NP IgG antibodies;also about 10% survivors of the SLAESB were not reactive to anti-EBOV NP IgG and 1.43% of these survivors did not express antibodies against the Ebola viral glycoprotein. Our work is consistent with previous published studies showing heterogeneity in both survivors and asymptomatic cases of Ebola infection developing adaptive immunity against EBOV proteins.展开更多
Viral hepatitis B and C infections are among the leading cause of death in Sub-Saharan Africa. Lack of knowledge and awareness in the general population as in health care settings may enhance the propagation of these ...Viral hepatitis B and C infections are among the leading cause of death in Sub-Saharan Africa. Lack of knowledge and awareness in the general population as in health care settings may enhance the propagation of these diseases. We aimed at determining the prevalence of HBV and HCV in Ebola survivors and health care workers (HCWs) of the Makeni town in Sierra Leone. We conducted a cross-sectional study during the last 2013-2016 Ebola outbreak in Makeni among Ebola survivors (N = 68) and 81 Health care workers from Holy Spirit hospital and Loreto clinic, two health care facilities in Makeni district. Serological markers of HBV (HBs Ag, anti-HBs Ab and anti-HBc Ab) and anti-HCV antibodies detection were done using ELISA techniques. The positive detection rates for HBs Ag, anti-HBs Ab and anti-HBc antibodies in Ebola survivors were 23.53% (16/68), 32.35% (22/68) and 88.89% (16/18) respectively. Survivors with a current HBV infection had a positive rate of 38.89% (7/18) and 16.66% (3/18) of them were considered immune due to past HBV infection. HCV prevalence was 26.47% (18/68) and about 10.29% (7/68) were HBV/HCV co-infected. The positive detection rates of HBsAg, anti-HBs Ab and anti-HBc Ab were 37.07% (30/81), 33.33% (27/81) and 30.86% (25/81) respectively in health care workers. We observed that 4.94% (4/81) of the HCWs were currently infected with HBV. Participants considered as immune due to past infection represented 23.47% (19/81) and those immune due to vaccination represented 2.47% (2/81). The prevalence of HCV infection among health staff was 2.47% (2/81) with 1.23% (1/81) being HBV/HCV co-infection. Our findings showed that viral hepatitis infection is a burden for Sierra Leone government. There is an urgent need to develop and implement strategies that could improve population immunization against HBV and vulgarization of HCV treatment programs.展开更多
文摘西双版纳黄瓜(Cucumis sativus var. xishuangbannanesis)是黄瓜的一个变种。云南省西双版纳及周边地区的少数民族长期以来栽培、管理和利用这种黄瓜,使它成为当地重要的作物农家品种,对其开展民族植物学研究,了解其传统知识十分必要。我们于2017–2018年在西双版纳傣族自治州调查了西双版纳黄瓜农家品种及其相关的传统知识。结果表明,与现代品种相比,西双版纳黄瓜农家品种具有香味浓郁、耐贮藏等特异性;西双版纳的傣族、基诺族、彝族、瑶族等少数民族拥有丰富的关于西双版纳黄瓜农家品种的传统知识。西双版纳黄瓜种质资源在大部分村寨已经消失或濒临消失,与之相关的传统知识也随之消亡,目前仅在海拔较高、交通欠发达的边远山区还栽培和保留了少量的农家品种。建议开展西双版纳黄瓜农家品种的原生境保护,既保护其种质资源,也保护相关的传统知识。
文摘Background: The rate of accidental dural puncture is particularly high during the period of training, especially in novices. The structured epidural teaching model (SETM) includes three standardized video lessons, the construction of a 3D epidural module by trainees and practical training by using an epidural simulator with and without the CompuFlo™ Epidural instrument. In this study we report the retrospective analysis of the accidental dural puncture rate of inexperienced trainees during their 6 months clinical practice rotation in obstetrics before and after the introduction of the SETM in our Institution. Method: We evaluated the incidence of accidental dural puncture before the introduction of the SETM methodology and afterwards by analyzing our departmental database from February 2019 to January 2023. All epidural blocks were executed by trainees who had never previously performed an epidural block and were about to begin their obstetrics rotation. Results: We analyzed 7415 epidurals: 3703 were performed before the introduction of the SETM methodology (control group) and 3712 afterwards (study group). The incidence of accidental dural puncture was 0.37% for the control group and 0.13% for the study group (p<.05). The probability of making an accidental dural puncture was 64% (OR: 0.36) lower for trainees who had the training than for those who did not. Conclusions: After the introduction of the structured teaching method, we observed a significant reduction of accidental dural puncture during the training period. We hope that our observation will encourage a constructive discussion among experts about the need to use standardized and validated tools as a valuable aid in teaching epidural anesthesia.
文摘Objective: To study the genetic diversity of Culex theileri flavivirus and the spread of this virus among Spain, Portugal and Turkey.Methods: A database consisting of 55 sequences of the NS5/3'UTR region of Culex theileri flavivirus group downloaded from GenBank were aligned and manual edited with Bioedit.ModelT est v.3.7 was used to select the simplest evolutionary model that adequately fitted the sequence data.Maximum likelihood analysis was performed using MEGA7.The phylogenetic signal of the dataset was investigated by the likelihood mapping analysis.Results: The phylogenetic tree showed three clusters.Myanmar sequences clusterd together with Turkish sequences, Spain and Portugal strains grouped together and two Turkish sequences grouped separately.Selective pressure analysis showed a moderate percentage of sites(22.5%) under pervasive negative selection and only 1% under pervasive positive selection.The sites subject to selective pressure in CTFV RdRp NS5 fragments have been located onto the predicted three-dimensional structure.Conclusions: Phylogenetic and evolutionary analysis can be an important tool for understanding the evolutionary impact of the probable contemporary existence between nonpathogenic and pathogenic flaviviruses among these vectors.
文摘This paper discusses some methodological aspects for the production of susceptibility maps of slope instability developed within the CARG Project (Geological Cartography of Italy at 1:50,000 scale). It describes an example of a susceptibility map in the presence of low susceptibility, using database having zero or negligible cost, with the aim to test some methodologies that can be easily reproducible to get a first estimate of the landslide susceptibility on a wide area. Two statistical approaches have been applied: the non-parametric conditional analysis and the logistic analysis for rare events. The predictive ability obtained from the two methodologies, was evaluated by the success-prediction curves for the conditional analysis, and by the Receiver Operating Characteristic curve (ROC), for the logistic model. The landslide susceptibility maps have been classified into four classes using both the Natural Breaks algorithm and the method proposed by Chung and Fabbri (2003). The paper considers the influence of these two classification methods on the quality of final results.
基金Supported by NIH Clinical Associate Physician(CAP)Award(Dr.Jutabha),American Society for Gastrointestinal Endoscopy Research Award(Dr.Jutabha),American College of Gastroenterology Capsule Endoscopy Research Award(Dr.Jutabha),NIH General Clinical Research
文摘AIM： To determine the performance of novice readers （4^th year medical students） for detecting capsule endoscopy findings. METHODS： Ten capsule endoscopy cases of small bowel lesions were administered to the readers. Gold standard findings were pre-defined by gastroenterologists. Ten gold standard ＂targets＂ were identified among the 10 cases. Readers were given a 30-min overview of Rapid Reader software and instructed to mark any potential areas of abnormalities. A software program was developed using SAS to analyze the thumbnailed findings. RESULTS： The overall sensitivity for detecting the gold standard findings was 80%. As a group, at least 5 out of 10 readers detected each gold standard finding per recording. All the gold standard targets were identified when the readers＇ results were combined. Incidental finding/false positive rate ranged between 8.2-59.8 per reader. CONCLUSION： A panel of medical students with minimal endoscopic experience can achieve high sensitivity in detecting lesions on capsule endoscopy. A group of novice readers can pre-screen recordings to thumbnail potential areas of small bowel lesions for further review. These thumbnails must be reviewed to determine the clinical relevance. Further studies are ongoing to assess other cohorts.
文摘Bipolar disorder presents significant challenges in clinical management, characterized by recurrent episodes of depression and mania often accompanied by impairment in functioning. This study investigates the efficacy of pharmacological interventions and rehabilitation strategies to improve patient outcomes and quality of life. Utilizing a randomized controlled trial with multiple treatment arms, participants will receive pharmacotherapy, polypharmacotherapy, rehabilitation interventions, or combination treatments. Outcome measures will be assessed using standardized scales, including the Hamilton Depression Scale, Yale-Brown Obsessive Compulsive Scale (Y-BOCS), and Mania Scale. Preliminary data suggest improvements in symptom severity and functional outcomes with combination treatments. This research aims to inform clinical practice, guide treatment decisions, and ultimately enhance the quality of care for individuals living with bipolar disorder. Findings will be disseminated through peer-reviewed journals and scientific conferences to advance knowledge in this field.
文摘The manuscript introduces an “ab initio” quantum model to deduce the Maxwell equations. After general considerations and laying out the model’s theoretical framework, these equations can be derived alongside a broad variety of other results. Specifically, a corollary of the present model proposes a possible mechanism underlying the formation of magnetic monopoles and allows estimating their formation energy in order of magnitude.
文摘Objectives: Atlantoaxial dislocation remains a rare and serious condition with a high preoperative and postoperative morbidity and mortality. Its successful surgical management is still challenging and gratifying for neurosurgeons. Several technics have been described such as wiring, trans articular screwing, C1C2 screwing with plate and screw introduced by Goel et al., and modified by insertion of polyaxially screw and rod many years later by Harms. Unavailability and expensiveness of upper cervical spine instrumentation device led us to C1C2 Wiring resulting in a good outcome. Finally, a quadriplegic patient with a more comfortable financial condition had ordered devices from abroad and benefit for Goel and Harms screwing technique and improved dramatically from ASIA A to ASIA E. Material and methods: This is a retrospective study of patients managed in our department by a same neurosurgeon from January 2019 to April 2024. Results: We defined 6 men and 1 woman with an average age of 33 years. Unrestrained driver in a rollover motor vehicle accident was most common. Only one patient was neurologically intact on admission. Neurovegetative disorders were noticed in one patient. Dislocation was associated to a fracture of the dens in two patients. Three patients have been successfully operated with remarkable outcome, mostly from ASIA A to E. Conclusion: C1C2 dislocation is a serious condition and C1C2 Wiring represents an effective and cheaper technic. Therefore, this technic should deserve consideration above all in low incomes countries when screwing devices are not available. Seatbelt should be demanded for motor vehicle drivers and passengers.
文摘Shallots (Allium cepa ascalonicum L.) are an important crop primarily due to their likely culinary and economic value. However, its production comes with specific challenges. In addition, effective post-harvest management is critical to ensure the quality and availability of shallot bulbs for extended periods. This study assessed the yield performance and storability relevant traits of five shallot cultivars (Saboula Jaba, Espagne Jaba, Daou Jaba, Tata Jaba, and N’galamandjan Jaba) under controlled storage conditions. Field experiments were conducted in 2021 to evaluate growth and yield in terms of bulb quantity, size, and weight. Storability traits such as firmness, weight loss, and Total Soluble Solids (TSS) were also measured for each entry. The five ecotypes of shallots were evaluated on-station with a total rainfall of 810 mm in 2021. The results revealed statistically significant variations (p > 0.01) in storability traits and yield among the tested entries. Furthermore, the weight loss of stored bulbs varied, indicating genetic differences among the cultivars that can influence their moisture retention abilities, leading to differences in weight loss rates. Indeed, Daou jaba showed less weight loss and superior firmness. The top highest-ranking entry for yield was shown by N’galamandjan jaba with 40 T/ha, followed by Saboula jaba with 39 T/ha. These highest productivity entries also showed significantly higher bulb quantity and individual bulb size. While there was a significant correlation between weight loss and firmness, a correlation between weight loss and TSS was also observed. The weight loss and firmness of N’galamandjan jaba were significantly correlated (r = 0.52) on the one hand, and on the other hand, the weight loss and visual quality of Espagne Jaba were highly and significantly correlated (r = 0.69). N’galamandjan Jaba and Saboula Jaba can be used to improve the yield and the storability relevant traits and prevent post-harvest losses.
文摘Functional pain syndromes are very common diseases that negatively impact the quality of life of patients with important socio-economic repercussions. The clinical alterations associated with these pathologies are multiple and have a complex psycho-organic character that moves along the micorobiome-gut-brain-axis. For the present study, 45 patients of both sexes (19 male, 26 female) aged 30 - 59 years were enrolled because of a diagnosis of Functional pain syndromes (FPS) that lasted for more than 6 months. All patients underwent pre-treatment clinical assessments (T0) for anxiety disorder, multidimensional assessment of pain, monitoring of baseline values of Alpha-Theta cerebral rhythm in occipital region and monitoring of salivary cortisol levels. All the patients underwent a clinical treatment combined with central neuromodulation with neurofeedback—Alpha Theta increase protocols (once a week for three months), administration of multispecies probiotic (one dose per day for 3 months) and clinical psychological interviews (once a week for three months). At the end of treatment (T1), patients were re-evaluated. Results show statistically relevant improvements of each feature considered: the Relief from Pain provided by the medication increases on average from 36.6% to 87.3%, the salivary Cortisol level at 11 pm decreases from 6.4 ng/ml to a physiological value of 1.2 ng/ml, and the anxiety rating score is reduced from 28 to 12. Moreover, the 23.9% increase in α-θ relative power shows the positive outcome of the brain autoregulation. This study highlights that the combined approach of Neurofeedback with drugs and multispecies probiotic results in great improvements in the patients’ life.
文摘The main aim of the paper is to present (and at the same time offer) a differ-ent perspective for the analysis of the accelerated expansion of the Universe. A perspective that can surely be considered as being “in parallel” to the tradition-al ones, such as those based, for example, on the hypotheses of “Dark Matter” and “Dark Energy”, or better as a “com-possible” perspective, because it is not understood as being “exclusive”. In fact, it is an approach that, when con-firmed by experimental results, always keeps its validity from an “operative” point of view. This is because, in analogy to the traditional perspectives, on the basis of Popper’s Falsification Principle the corresponding “Generative” Logic on which it is based has not the property of the perfect induction. The basic difference then only consists in the fact that the Evolution of the Universe is now modeled by considering the Universe as a Self-Organizing System, which is thus analyzed in the light of the Maximum Ordinality Principle.
文摘Background: Emerging evidence has recognized that anemia and iron deficiency are recurrent comorbidities in chronic heart failure (HF) and several trials have established that iron administration improves myocardial asset and clinical scenario in HF. Purpose: Recent acquisitions suggest that iron deficiency represents a concrete bias in the pathogenetic mechanism of chronic HF, so we have investigated the putative role of the hepcidin/ferroportin axis in the cardiovascular setting to advocate novel pharmacological and clinical approaches. Methods: Here, after an excursus on iron metabolism, we first reviewed the ongoing studies on novel iron targeted compounds. Then, we summarize large clinical interventional studies conducted on patient suffering from iron deficiency and HF which have tested the effects of drugging iron regard QoL, hospitalizations and cardiovascular death. Results: Novel compounds such as hepcidin agonist (PTG 300), synthetic human hepcidin (LJPC-401) and anti FPN (Vamifeport) are ongoing in iron overloaded patients, while the hepcidin blocker (PRS-080) is under investigation in anemic patients. Noteworthy, novel insights could arise from the results of a Phase IV interventional study regarding the modification of hepcidin pathway in a large cohort of HF patients (n = 1992) by sodium glucose cotransporter 2 inhibitors. To date, several studies highlight the beneficial effect of iron administration in cardiovascular setting and latest evidences consider hepcidin level as a novel biomarker of cardiac injury and atherosclerosis. Conclusions: We advocate that data from ongoing studies will suggest novel iron targeted therapies for diagnosis, prognosis and therapy transferable in selected heart failed patients.
文摘Postural problems are very common, which is why plenty of Techniques have been created to solve them: Mezieres Technique (including muscle chains), RPG (Global Postural Re-Education, including pelvic diaphragm), Pilates Method (including core muscles), Bobath Concept (including COG, center of gravity) and Yoga. In this work, I show a new way of treating and solving postural problems. I am basing this physiotherapy approach on a new Image I created. Every patient can use it for every correction and change in posture. I called the new Image: “OMINO (little man)”. “Postural Card” could be a good work to make “OMINO” possible. “OMINO” is immediately understandable and, using “OMINO POCKET INSTRUCTIONS”, it can be easily done. Contribution of paper: • Trunk is a vital element for any kind of rehabilitation;• “Core stability” is the key to activating the trunk. • Doing “OMINO” means working on “core stability”;• “OMINO” makes rehabilitation simple for the patient.
文摘Neuromuscular diseases present profound challenges to individuals and healthcare systems worldwide, profoundly impacting motor functions. This research provides a comprehensive exploration of how artificial intelligence (AI) technology is revolutionizing rehabilitation for individuals with neuromuscular disorders. Through an extensive review, this paper elucidates a wide array of AI-driven interventions spanning robotic-assisted therapy, virtual reality rehabilitation, and intricately tailored machine learning algorithms. The aim is to delve into the nuanced applications of AI, unlocking its transformative potential in optimizing personalized treatment plans for those grappling with the complexities of neuromuscular diseases. By examining the multifaceted intersection of AI and rehabilitation, this paper not only contributes to our understanding of cutting-edge advancements but also envisions a future where technological innovations play a pivotal role in alleviating the challenges posed by neuromuscular diseases. From employing neural-fuzzy adaptive controllers for precise trajectory tracking amidst uncertainties to utilizing machine learning algorithms for recognizing patient motor intentions and adapting training accordingly, this research encompasses a holistic approach towards harnessing AI for enhanced rehabilitation outcomes. By embracing the synergy between AI and rehabilitation, we pave the way for a future where individuals with neuromuscular disorders can access tailored, effective, and technologically-driven interventions to improve their quality of life and functional independence.
文摘This study used Topological Weighted Centroid (TWC) to analyze the Coronavirus outbreak in Brazil. This analysis only uses latitude and longitude in formation of the capitals with the confirmed cases on May 24, 2020 to illustrate the usefulness of TWC though any date could have been used. There are three types of TWC analyses, each type having five associated algorithms that produce fifteen maps, TWC-Original, TWC-Frequency and TWC-Windowing. We focus on TWC-Original to illustrate our approach. The TWC method without using the transportation information predicts the network for COVID-19 outbreak that matches very well with the main radial transportation routes network in Brazil.
文摘In the present study, we analysed the results from the use of serological tests for the evaluation of the antibody response to SARS-CoV-2 virus, with the aim of verifying the seroprevalence for SARS-CoV-2 virus infection in Rome. Evaluations related to the seroprevalence are important for defining the epidemiological parameters of this disease. We therefore analysed the data deriving from 1586 subjects, residing in the geographical area of Rome, subjected to a rapid test, capable of detecting the presence of specific IgM and IgG class antibodies directed against the SARS-CoV-2 virus. Among the 1586 cases, 83 had positive conversion of IgM antibody and/or IgG antibody and 1503 tested negative. Out of 83 positive cases, 48% (40/83) samples resulted positively for both IgM and IgG, while 45% (37/83) were positive for IgG only, and 7% (6/83) for IgM only. The prevalence of anti-SARS-CoV-2 antibodies in the considered geographical area was 5% (83/1586), and 54% (45/83) of our population was an asymptomatic carrier. The study was performed to better evaluate the population prevalence in the studied geographic area. To our knowledge, this is the first study carried out in the Lazio region reporting data related to the asymptomatic carriers.
文摘Ebola virus disease is a complex zoonosis that is highly virulent in humans. Despite its sorely pathogenic and lethal nature, survivors of this infection and even asymptomatic cases are able to develop both humoral and cellular immunity against several Ebola virus (EBOV) proteins. We aimed at determining immunoglobulin G (IgG) antibodies level against two Ebola viral antigens, the glycoprotein and the nucleoprotein in Ebola survivors and their relatives. Anti-EBOV glycoprotein (GP) and nucleoprotein (NP) IgG antibodies were quantified using ELISA. We enrolled 199 participants in two different sites as follow: 91 survivors at the Loreto clinic and 70 survivors with 38 relatives of Sierra Leone Association of Ebola Survivors Bombali Branch (SLAESB) tested for anti-EBOV NP and anti-EBOV GP IgG antibodies. Our findings revealed that the median anti-EBOV IgG level among survivors was 5.7128 U/ml [IQR: 2.793 - 7.783] for anti-EBOV GP IgG and 4.431 U/ml [IQR: 2.083 - 7.696] for anti-EBOV NP IgG. Survivors relatives had a median anti-EBOV GP IgG level of ?0.7128 U/ml [IQR: -0.903 to -0.04327] and -2.711 U/ml [IQR: -4.01 to -1.918] for anti-EBOV NP IgG. We observed that IgG levels in survivors were higher than in relatives with a significant difference of about 0.0001. The median value of anti-EBOV IgG level among seropositive relatives was 0.7043 U/ml [IQR: 0.5686 to 3.716] for anti-EBOV GP IgG and 4.05 U/ml [IQR: 0.2765 to 7.759] for anti-EBOV NP IgG respectively. Interestingly, we observed that 3.30% of Loreto clinic survivors did not developed anti-EBOV NP IgG antibodies;also about 10% survivors of the SLAESB were not reactive to anti-EBOV NP IgG and 1.43% of these survivors did not express antibodies against the Ebola viral glycoprotein. Our work is consistent with previous published studies showing heterogeneity in both survivors and asymptomatic cases of Ebola infection developing adaptive immunity against EBOV proteins.
文摘Viral hepatitis B and C infections are among the leading cause of death in Sub-Saharan Africa. Lack of knowledge and awareness in the general population as in health care settings may enhance the propagation of these diseases. We aimed at determining the prevalence of HBV and HCV in Ebola survivors and health care workers (HCWs) of the Makeni town in Sierra Leone. We conducted a cross-sectional study during the last 2013-2016 Ebola outbreak in Makeni among Ebola survivors (N = 68) and 81 Health care workers from Holy Spirit hospital and Loreto clinic, two health care facilities in Makeni district. Serological markers of HBV (HBs Ag, anti-HBs Ab and anti-HBc Ab) and anti-HCV antibodies detection were done using ELISA techniques. The positive detection rates for HBs Ag, anti-HBs Ab and anti-HBc antibodies in Ebola survivors were 23.53% (16/68), 32.35% (22/68) and 88.89% (16/18) respectively. Survivors with a current HBV infection had a positive rate of 38.89% (7/18) and 16.66% (3/18) of them were considered immune due to past HBV infection. HCV prevalence was 26.47% (18/68) and about 10.29% (7/68) were HBV/HCV co-infected. The positive detection rates of HBsAg, anti-HBs Ab and anti-HBc Ab were 37.07% (30/81), 33.33% (27/81) and 30.86% (25/81) respectively in health care workers. We observed that 4.94% (4/81) of the HCWs were currently infected with HBV. Participants considered as immune due to past infection represented 23.47% (19/81) and those immune due to vaccination represented 2.47% (2/81). The prevalence of HCV infection among health staff was 2.47% (2/81) with 1.23% (1/81) being HBV/HCV co-infection. Our findings showed that viral hepatitis infection is a burden for Sierra Leone government. There is an urgent need to develop and implement strategies that could improve population immunization against HBV and vulgarization of HCV treatment programs.
