uti

Steady-state VEPs, have been used to estimate visual acuity since the 1970s and allow responses to a range of stimulus sizes to be collected rapidly- with particular utility in infants. However, the assessment of children with cortical visual impairment is a bigger challenge that lead to the development of the Step VEP. Its initial evaluation revealed that accuracy and precision were poorer for pediatric patients than for optically degraded normal adults and that it was not necessarily successful in every child. Statistical models generated the equations: VAO = 0.56 VAStep (r2 = 0.75, F = 60.93, p = 0.000) and VAPL = 0.45 VAStep (r2 = 0.82, F = 156.85, p = 0.000), supported by a recent a systematic review of VA comparisons showing that recognition VA (optotypes) agrees more closely than discrimination VA (PL) with VEP VA. In combination, Step VEPS and subjective tests allowed complete assessment in 96% of patients, with incomplete Step VEPS much more likely to be partially successful than not, and more likely to be partially successful than incomplete subjective tests. This supports the rationale that Step VEPs maintain attention by limiting the time spent stimulating away from an individual’s threshold of spatial resolution. For the small number of patients in whom VA cannot be estimated, alternative stimuli and methods of presentation are proposed. 

The SARS-CoV-2 (COVID-19) pandemic outbreak has led to some lockdowns and changed human mobility and lifestyle in this country. Mashhad, one of the most polluted cities in Iran has experienced critical air pollution conditions in recent years. In the present study, the potential relationships between air quality conditions (such as popular index and criteria air pollutant concentration) and COVID-19 cases and deaths were investigated in Mashhad, Iran. To do that, the Long Short-Term Memory (LSTM) based hybrid deep learning architecture was implemented on AQI, meteorological data (such as temperature, sea level pressure, dew points, and wind speed), traffic index and impact number of death, and active cases COVID-19 from March 2019 to March 2022 in Mashhad. The results reveal the LSTM model could predict the AQI accurately. The lower error between the real and predicted AQI, including MSE, MSLE, and MAE is 0.0153, 0.0058, and 0.1043, respectively. Also, the cosine similarity between predicted AQI and real amounts of it is 1. Moreover, in the first peak of the pandemic (Aug 2021), we have the minimum amount of AQI. Meanwhile, by increasing the number of active cases and death and by starting lockdown, because the traffic is decreased, the air quality is good and the amount of AQI related to PM2.5 is 54.68. Furthermore, the decrease the active cases and death in pandemic causes a significant increase in AQI, which is 123.52 in Nov 2021, due to a decline in lockdowns, resumption of human activities, and probable temperature inversions. 

In this paper, the concentration of As, Cd, Cr, Cu, Pb, and Zn was investigated in soil and Ambrosia artemisiifolia L. sampling from polluted cite near the enterprises for the production and processing of batteries in the city of Dnipro in Ukraine. The obtained results of the study were provided to assess the plant species through bio-monitoring and phytoremediation. Though Ambrosia artemisiifolia L. is a weed that causes serious allergic reactions in humans, this plant species can also have a high bioaccumulative capacity regarding metals. The obtained results highlighted the metals’ significantly higher concentration in roots than in the inflorescence part in Ambrosia artemisiifolia L. Among all studied metals, Zn and Cu had the highest concentration in Ambrosia artemisiifolia L., while lead was characterized by the highest bioavailable content available to plant forms in the soil. The various distribution of As, Cd, Cr, Cu, Pb, and Zn was found in different parts of the plant. According to plant-up-taking indexes studied elements can be ranked in the following descending order: Cu > Zn > Cr > Cd > Pb. Ambrosia artemisiifolia L. could be proposed for phytoremediation in Zn, Cu, Cd, and Cr contaminated soils although this species is resistant to lead soil pollution.

Objective: Sentinel lymph node mapping is an acceptable standard for lymph node evaluation in patients with endometrial cancer. The purpose of this study was to evaluate the adoption of this technique at two academic institutions, including which patient and disease features are associated with rates of successfully identifying sentinel lymph nodes with fluorescent mapping. In addition, we sought to characterize if and how surgeons experience the technique related to successful bilateral sentinel lymph node mapping. Methods: A retrospective chart review was performed of patients at two academic institutions who underwent sentinel lymph node mapping prior to a minimally invasive hysterectomy for endometrial cancer over the first 30 months during which the technique was adopted at each institution. A modified Poisson regression model was used to determine the relationships between patient, disease, and surgeon factors on outcomes of sentinel lymph node mapping. Results: A total of 460 charts were reviewed. The mean age was 64 and the median body mass index was 34.2. The most disease was stage I (83%), endometrioid (89%), and Grade I (64%). The bilateral sentinel lymph node mapping success rate was 65%, while unilateral or bilateral success occurred in 91% of cases. Sentinel lymph node mapping was significantly more likely to be successful in premenopausal women (RR 1.25; 95% CI 1.07 - 1.46; p = 0.005) and Asian women (RR 1.48; 95% CI 1.3-1.68; p < 0.001). BMI was not significantly predictive of mapping success (RR 1.03; 95% CI 1.00 - 1.07; p = 0.05). Increasing surgeon experience with the technique did predict successful bilateral sentinel lymph node mapping (RR 1.02; 95% CI 1.00 - 1.03; p = 0.02).Conclusion: Premenopausal status and surgeon experience with the technique increases the likelihood of bilateral sentinel lymph node detection for endometrial cancer.

Background: Control of increased athrogenic index of plasma and lipid parameters in the early stage of diabetes mellitus helps diabetic patients to improve their quality of life and treatment outcomes. Limited studies were conducted on the assessment of dyslipidemia and its correlation with clinical and anthropometric variables among diabetes patients but no study was conducted on the correlation of the athrogenic index of plasma with anthropometric measurements among diabetes patients in this study area. The objective of this study was to assess the correlation of dyslipidemia and athrogenic index of plasma with anthropometric measurements and clinical variables among diabetic patients in Dessie Compressive specialized hospital, Northeast Ethiopia.Methods: Institution-based comparative cross-sectional study was conducted from August 2020 to June 2021. A total of 250 diabetic and healthy control respondents were included in the study with convenience sampling. Semi-structured questionnaire of a modified WHO stepwise Approach to Surveillance for chronic disease was used to collect data. Finally, descriptive statistics and correlation analysis were conducted to assess the correlation between variables. A P-value of less than 0.05 was declared as the level of significance.Results: Athrogenic Index of Plasma, Triglyceride to High-density Lipoprotein Ratio, Very-Low-Density Lipoprotein, systolic blood pressure, diastolic blood pressure, triglyceride, waist circumference, WHtR and BMI were statistically significantly higher among type 2 DM groups. There was a significant positive linear correlation between triglycerides and waist circumference, between TG / HDL and WHtR, and between cholesterol and WHtR, but a significant negative linear correlation between HDL and waist circumference among the Type 2 DM group. Systolic blood pressure and pulse showed a significant positive linear correlation with WC, BMI, and WHtR among diabetics groups only. Our study showed that the pattern of lipid abnormalities observed among DM patients was high AIP in 68%, moderate AIP in 16% and all four groups of hyperlipidemia were found in 9% of diabetic patients. All lipid profiles showed a significant very strong positive linear correlation with AIP, but DHL has a significant very strong negative linear correlation with AIP among type 2 DM groups.Conclusion: The proportions of high athrogenic index of plasma and lipid profile disorders were higher in DM patients compared to healthy controls. Dyslipidemia and a high athrogenic index of plasma had a considerable correlation with anthropometric measurements and clinical outcomes of type II DM patients. DM patients who have a higher athrogenic index of plasma and higher lipid parameters should be strictly followed based on their anthropometric measurements.

High fluoride level in drinking water is an endemic public health concern in East Africa. Unlike in Kenya where it is absent, the Nalgonda technique, a defluoridation method that uses two chemicals, alum, and CaO, has seen mixed results in its application and adoption in Ethiopia and Tanzania. This has been due to the low capacity of communities to manage the process and the breakdown in the supply chain of chemicals used in the technique. In the present study, we attempted to bridge the gap in the chemical deficit by investigating the possible substitution of CaO with leachate from wood ash, a by-product of wood combustion commonly found in Kenya. The leachate was prepared from one part of wood ash mixed with two parts of distilled water and stirred for 24 hours followed by decantation. The new technique, the Homa method, using alum and wood ash leachate was then tested on H2O samples from three areas in Kenya with high F- concentrations ranging from 5.1 mg L-1, 9.1 mg L-1 to 91.0 mg L-1. The determination of F- concentration by SPADNS Spectrophotometry was applied throughout the experiment. Four levels of alum i.e. 1%, 2%, 3%, and 4% were dosed on five volumes of water i.e. 100, 200, 300, 400, and 500 ml raw water at 5.1 and 9.1 mg L-1 F-. For water samples at 91.0 mg L-1 F-, the same volumes were treated with 5 higher alum levels i.e. 5%, 6%, 7%, 8%, and 9%. The final pH was then adjusted to 7 with ash leachate for defluoridation. The set-up was a factorial design experiment where the final F- concentration was the dependent variable and the volume of raw water, the percentages, and volume of alum and wood ash leachate constituted the different factors. A fitted multivariate regression model of the general form; where Y = Residual fluoride, X = wood Leachate volume, W = alum Concentration, X*W = Interaction α, β, γ were regression coefficients, ε = error term, showed that only in the Baringo area did we have an interaction between wood ash leachate and alum concentration significant (p < 0.05). Defluoridation occurred (p < 0.05) at as low as 10% and as high as 99%, depending on the initial F- content. Total coliform decreased from 310, 290 and 270 count/l respectively to zero. Unfortunately, high chemical and TDS (from 558 mg L-1 to more than 9,000 mg L-1) enrichment were recorded in addition to the mixed data on turbidity. The overall results show that wood ash can substitute CaO in the Nalgonda process. Further investigation is however required to make it applicable for potable water production.

Introduction: Dead Sea Salt, rich in minerals and ionic compositions and low in Sodium Chloride (NaCl) has many reported unique properties that set it apart from other salts. Objectives: To evaluate the composition of Dead Sea Salt and assess its in vitro cytotoxicity, and efficacy against oral bacterial leukotoxins, oral endotoxins and oral glucan sucrase. Methods: The cytotoxicity was evaluated in an established cell line (solution at 5000 µg/mL of culture medium) using positive and negative control groups. The effect on oral bacterial leukotoxin (LtxA) and different concentrations of lipopolysaccharide and glucan sucrase was established at 24, 36, 48, 60, 72, 84, and 96 hours using the HPLC method (high-performance liquid chromatography). Results: The most predominant elements detected were the water of crystallization (H2O, water that is found in the crystalline framework of salt and which is not directly bonded ), magnesium chloride (MgCl2), potassium chloride (KCl), sodium chloride (NaCl), calcium chloride (CaCl2), bromide (Br -) and sulfates (SO4). In vitro, Dead Sea Salt presented no cytotoxicity and was highly effective against leukotoxin, endotoxin, and glucan sucrase enzyme. Conclusion and clinical significance: We believe that rinsing with Dead Sea Salt has the potential to contribute to the prevention of periodontal, peri-implant and dental disease and merits clinical research.

Introduction: Even after surgical resection and adjuvant chemotherapy in pancreatic cancer the 5-year disease-free survival times (DFS), as well as overall survival rates (OS), are still low and median survival times are below 2 years. Here we retrospectively analyzed the outcome of immunotherapy in the additional adjuvant treatment of pancreatic cancer with long antigen exposition dendritic cell therapy (LANEX-DC®) in 28 patients who were treated at our institution. Patients: Data were available from 28 patients. Dendritic cells (LAEX-DC®) were produced according to a recently published protocol.Results: Therapy was well tolerated and no serious side effects were observed. The median disease-free survival times and the median survival times were 16,9 months and 29,4 months respectively. Five-year DFS and OS were 14,3% and 17,9%. Conclusion: We were able to show in a small cohort of patients that additional treatment with dendritic cells (LANEX-DC®) is highly effective and extends the median disease-free survival times as well as the median survival in the adjuvant treatment of pancreatic cancer, whereas the five-year overall survival still remains unsatisfactory.

Due to the global pandemic spread of COVID-19, the medical field has experienced many changes [1]. One of the main changes is the attention to Telemedicine (Digital Medicine), which is a part of Digital Health. The combination of ‘Digital’ and ‘Dentistry’ can be awkward because dental treatment is often conducted face-to-face with clinical treatment, but it is planned to proceed with the inevitable flow of the times [2,3]. In addition, Digital therapeutics (DTx), a part of digital dentistry, is a narrower concept and has an evidence-based effect on diseases. This article contains opinions on the concept and current status of Teledentistry and the application of DTx [4].

Background: Intracerebral hemorrhage (ICH) is one of the most feared complications after brain tumor surgery. Despite several factors being considered to influence bleeding, an increasing number of clinical studies emphasize that hemostatic disorders, developed during surgical aggression and tumor status, could explain unexpected ICH. The objective of this prospective study was to evaluate the influence of perioperative D-dimer levels on ICH after brain tumor surgery. Methods: This prospective, observational, 18-month study, at a single third-level hospital, included all consecutive adults operated on brain tumors and postoperative stay in an intensive care unit. Three blood samples evaluated D-dimer levels (A-baseline, B-postoperative and C-24 hours after surgery). The normal range considered was 0-500ng/ml. ICH, as a primary outcome, was defined as bleeding that generates radiological signs of intracranial hypertension either by volume or by mass effect on the routine CT scan 24 hours after surgery. Other tumor features and hemostasis variables were analyzed. Chi-squared and Fisher’s exact test were used in the inferential analysis for qualitative variables and Wilcoxon and T-Test for quantitative ones. P-value < 0.05 was considered significant for a confidence interval of 95%. Results: A total of 109 patients operated on brain tumor surgery were finally included, 69 male (63,30%) and 40 female (36,70%), with a mean age of 54,60 ± 14,75 years. ICH was confirmed in 39 patients (35,78%). Their average of DDimer was A-1.526,70 ng/dl, B-1.061,88 ng/dl, and C-1.330,91 ng/dl (A p0.039, B p0,223 C p0.042, W-Wilcoxon test). The male group was also associated with ICH (p0,030 X2 test). Of those 39 patients with ICH, 30 in sample A (76,9%), 20 in sample B (51,28%) and 35 in sample C (89,74%) had a D-dimer > 500 ng/dl (p0,092, p1, p0,761 X2 test) and the relative risk of developing a postoperative hematoma in this patients was increased 0,36-fold presurgery, 0,25-fold postsurgery and 0,40-fold 24hours after surgery. D-dimer variation, had no statistical significance (p0,118, p0,195, p0,756 T-test). Platelets and prothrombin activity were associated with D-dimer levels only in sample A (p 0,02 and p 0,20, W Wilson). Conclusion: High levels of perioperative D-dimer could be considered a risk marker of ICH after brain tumor surgery. However, more studies would be worthwhile to confirm this association and develop primary prevention strategies for stroke. 

The epidemics of heart failure and an aging population resulted in an exponential rise in the use of cardiac implantable devices (CIEDs) in developed countries. This is paralleled by the increased rate of complications such as system infection or malfunction. The higher number of complications, and longer patient life expectancies, are followed by an increase in the need for lead extractions. 

Background/Introduction: WHO recommended ‘ready to use therapeutic food’ (RUTF) for community-based management (CMAM) of severely malnourished children (SMC). This is often rejected by children. The objective is to identify and map the locally produced and socio-culturally acceptable food items to treat SMC. Methods: Through community participation, eight varieties of MAHAN Local therapeutic foods (LTFs) were prepared by tribal females at our center as per WHO norms with a shelf life of 4 weeks. LTFs with micronutrients were given at the feeding centers in the villages under supervision 3 - 4 times a day. Results: Multiple, palatable, culturally acceptable, safe, feasible with local womanpower, and cost-effective recipes were developed. Hence, our LTFs are qualitatively superior to other therapeutic foods. This mapping exercise provides a ready reference to other government or non-government organizations for CMAM. Conclusion: MAHAN-LTF is a multiple, palatable, generalizable, and sustainable therapeutic food and are being used in other tribal blocks of India.

The mental health impact caused by COVID-19 on adolescents was reviewed, and due to limited data, adult results were included, to support our assertion that additional mental health resources are needed for both adult and young people. Positive gains would include improved socio-emotional skills, a decrease in maladaptive behaviors contributing to the disruption in interpersonal relationships and lifetime achievements, suicide attempts and psychopathology, persistent mental health concerns found in the juvenile justice and foster care systems and substance use addiction later in adulthood (The American Psychological Association, 2019; Garber & Weersing, 2010; Office of Juvenile Justice and Delinquency Prevention, n.d.; Tomasello, 2018;). Geiger & Davis, 2019, found that 13% or 3.2 million United States (U.S.) teenagers aged 12 - 17 years old experienced at least one major depressive episode with the depression rate increasing 59% from 2007 to 2017. Therefore, we assert that developing programs to overcome barriers to mental health aid can reduce instances experienced in adolescence and adulthood.

The COVID-19 pandemic resulted in public health measures and fewer viral infections, which trigger the nephrotic syndrome. Our objectives were to characterize the effect of the COVID-19 pandemic on children with nephrotic syndrome. This single-center retrospective chart review compared children with nephrotic syndrome one year before the pandemic with the first wave of the pandemic. Epidemiologic events, clinical characteristics, and health care utilization were compared using paired t-tests, Fisher’s exact tests and Wilcoxon Rank Sum tests. Among 96 children the mean age was 10.7 ± 5.28 years. The distribution was minimal change disease (16.7%), focal segmental glomerulosclerosis (12.5%), membranous nephropathy (1%) and not biopsied (69.8%). Medication responsiveness was steroid-sensitive (25%), frequently relapsed (54%) and steroid-resistant (20.8%). There were 14 new diagnoses of nephrotic syndrome pre-pandemic and 18 during the pandemic. Fewer relapses during the pandemic were likely due to fewer viral illnesses from public health measures during the pandemic.

Monilinia laxa is a fungus that causes brown rot in stone fruit. Immature green fruits in the first stage of fruit development (stage I) are generally susceptible. To investigate the relationship between the physical characteristics of immature fruit and susceptibility to M. laxa, we characterized the progeny, derived from a clone of wild peach (Prunus davidiana) crossed with two commercial nectarines (Prunus persica) varieties, through laboratory infection, transpiration monitoring and stomata counting. Two types of fruit infections were observed - ‘classic’ brown rot and ‘clear spot’ symptoms - which have not previously been described in the literature. The number and density of stomata did not explain the observed variability of infection in the progeny. However, surface conductance was positively correlated with infection level. This study provides experimental evidence partially linking physical fruit characteristics to brown rot infection at the immature fruit stage. The role of delayed cuticle deposition in susceptibility to brown rot of immature fruit is discussed.

The depletion of non-renewable resources is followed by severe ecological and social impacts, and the heavy usage of raw, virgin resources leaves significant, long-lasting footprints. The transition to a more circular economy, where the value of products, materials and resources is maintained and circulated (by recycling activities) in the economy for as long as possible, is an essential contribution to the EU’s efforts to develop a sustainable, low carbon, resource efficient and competitive economy. In this context, ecological solutions consisting of materials that help carbon sequestration and necessitate small amounts of energy for production are becoming increasingly popular from a building construction point of view, namely: The raw material is cheap and in large quantities; has low thermal conductivity; are from a renewable source. The paper presents an analysis of IZOMIN an innovative thermal insulating product made from renewable or recycled resources and their main technical properties, the purpose being to inform the market in order to increase the present level of technical knowledge and technologies used to facilitate the implementation of buildings with high energy efficiency.

Background and objectives: This paper is aimed at excavating the factors responsible for RHD events and vis-à-vis establishing severity levels of RHD patients referred to Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) in Thimphu’s capital city of Bhutan. Methods: By taking notorious advantage of the data gathered over the past five years (2016-2020) from RHD patients across 20 districts of Bhutan, about 232 RHD patients are involved in this study recorded in JDWNRH by the Cardiology Department. Besides descriptive methods, multivariate linear regression models augmented by the multinomial logistic regression models had been applied to establish the causual links. Results: The findings revealed that RHD prevailed amongst the young populace of Bhutan, especially females. Variables like age, frequency of visits, number of diagnostics, levels of education and region had been found as predictors of RHD prevalence. Other socio-demographic factors like occupation and status of employment did not affect the RHD prevalence. The multinomial logistic regression results indicated that higher levels of education as an important factor for not making the patient fall into the category of ‘severe.’ Age has been constantly found to be a highly significant variable contributing to RHD events and a quadratic relationship is revealed between age and the severity of RHD. Conclusion and implications for translation: This study pigeonholed the significant factors responsible for RHD events and entailed severity levels by gender and age. The findings of this study also provide additional important insights into developing public health policies and programs. 

The use of complementary and alternative medicine (CAM) applications increased by 39.3% of individuals with chronic diseases during the pandemic process in Turkey. For this reason, this descriptive study was conducted to determine the use of integrative and integrated medicine practices in hemodialysis patients during the COVID-19 pandemic. The population of the study consisted of individuals who were treated in a hemodialysis unit in the city center (n = 235). It was planned to include whole of the population by using the whole number method, but patients, who did not agree to participate in the study and did not meet the inclusion criteria of the study, were excluded from the sample and the study was conducted with 160 patients between 1 June and 1 September 2021. As a data collection tool, a questionnaire consisting of 30 questions including socio-demographic and disease characteristics of the patients was prepared by the researcher upon review of related literature. Considering the distribution of phytotherapy method (herbal treatment) usage frequency of integrative and integrated medicine applications of individuals before the COVID-19 pandemic and during the COVID-19 pandemic period, the most vitamins (21.8%), prebiotics (12.5%), and honey (%) 10.6), their use was found to be high. During the COVID-19 pandemic, the use of massage (40%), breathing exercises (30.0%) and spiritual therapy (28.7%) applications increased. As a result, it is seen that integrative and integrated applications are considered in the process of dealing with hemodialysis patients. Physicians need to be aware of and ask patients about their use of integrated and integrated health practices.

“Manna” is the product obtained from the solidification of the elaborate sap that comes out of the incisions made during the summer season on the stem and on the main branches of some species of the genus Fraxinus (Oleaceae). The cultivation of manna ash trees dates back to ancient times in Sicily and elsewhere ash trees – known as sacred trees, a symbol of abundance and therefore auspicious – was increasingly widespread until the middle of the last century. Subsequently, however, the crop underwent a progressive decline, remaining relegated to restricted areas of Sicily, in particular in the Madonie district (Palermo, Italy). In this brief review, the essential characteristics of the manna and the ash trees from which it is extracted are summarized. The aspects of the current productivity of manna in the Sicilian territory and the implications of a potential recovery and increase of an ancient craft, ash tree cultivation, are also reported in a perspective of sustainable development and green economy for the Mediterranean area and beyond. Finally, the authors remember what has been done to ensure the conservation not only of the active cultivation of manna ash but also of all the relative agro-biodiversity. The conservation of the living germplasm of the ancient cultivars recovered in the Madonie area (Palermo, Sicily) represents one of the most qualifying results.

According to the Food and Agriculture Organization [1], it’s possible to conceptualize food security from four dimensions: physical availability of food, economic and physical access to  food, food utilization and stability of the other three dimensions over time. A situation of food security is found in  these four dimensions are fulfilled simultaneously.