Transfusion-transmitted virus prevalence in subjects at high risk of sexually transmitted infection in Turkey

ObjectiveTo assess the possible sexual transmission of virus and to identify the prevalence of TTV viremia in Turkey and its association with other hepatotropic viruses.MethodsSerum samples were collected from 81 subjects (74 prostitutes and seven homosexual men) at high risk of sexually transmitted infection and from 81 healthy controls (74 females and seven males). Sera of patients and controls were tested for TTV, hepatitis A virus, hepatitis B virus, hepatitis C virus, and human immunodeficiency virus. Also, serum alanine and aspartate aminotransferases were measured.ResultsThe prevalence rates of TTV viremia in the risk group and control group were 86.4% and 82.7%, respectively. There was a statistical difference in mean age between TTV-infected and uninfected subjects (38.6 ± 9.9 versus 32.2 ± 6.1 years, respectively, P < 0.001). Prevalence rates of TTV infection in subjects with positive anti-HAV and positive anti-HBc were high when compared with subjects who were negative for these.ConclusionWe suggest that TTV infection has a diverse route of transmission, and its prevalence increases with age; also, the prevalence rate of TTV is high in certain risk groups. The prevalence rates of TTV in the group at risk for sexual transmission (86.4%) and in the control group (82.7%) were among the highest ever reported in the world. Also, we suggest that TTV generally does not cause clinical disease, in spite of this high prevalence

Too Big to Manage: US Megabanks’ Competition by Innovation and the Microfoundations of Financialization

Disagreements over the systemic implications—the future—of financialization can be traced in part to the absence of sustained attention to the role of banking firms in driving this secular shift forward. That is, the financialization literature lacks an adequate microfoundation. Accounting for the drivers of financialization processes solely at the macro level overlooks the problems of how these processes came about and whether they are sustainable. This paper addresses this explanatory gap, arguing that a key independent microeconomic driver of increasing financialization did exist: the incessant efforts by money-centre banks in the USA to break out of Depression-era restrictions on their size, activities, and markets. These banks’ growth strategies in turbulent times led to an institutional (meso) shift—the rise of a megabank-centred shadow banking system—that now shapes global financial architecture even while operating in ways that are unsustainable. In short, too-big-to-manage megabanks are at the heart of the fragility and instability of the economy today

Ultra-conformal drawn-on-skin electronics for multifunctional motion artifact-free sensing and point-of-care treatment

An accurate extraction of physiological and physical signals from human skin is crucial for health monitoring, disease prevention, and treatment. Recent advances in wearable bioelectronics directly embedded to the epidermal surface are a promising solution for future epidermal sensing. However, the existing wearable bioelectronics are susceptible to motion artifacts as they lack proper adhesion and conformal interfacing with the skin during motion. Here, we present ultra-conformal, customizable, and deformable drawn-on-skin electronics, which is robust to motion due to strong adhesion and ultra-conformality of the electronic inks drawn directly on skin. Electronic inks, including conductors, semiconductors, and dielectrics, are drawn on-demand in a freeform manner to develop devices, such as transistors, strain sensors, temperature sensors, heaters, skin hydration sensors, and electrophysiological sensors. Electrophysiological signal monitoring during motion shows drawn-on-skin electronics&apos; immunity to motion artifacts. Additionally, electrical stimulation based on drawn-on-skin electronics demonstrates accelerated healing of skin wounds. Designing efficient wearable bioelectronics for health monitoring, disease prevention, and treatment, remains a challenge. Here, the authors demonstrate an ultra-conformal, customizable and deformable drawn-on-skin electronics which is robust to motion artifacts and resistant to physical damage

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Palm vein authentication and verification system

In this work, both hardware and software of a palm vein capture system have been designed and a prototype is produced. By using this system, a genuine database was created with age and gender information of volunteered test subjects. Widely used pre-processing, acquisition of feature vectors, and classification methods were tested on the database and results are compared with speed versus accuracy. All the modules used in hardware and software were determined as open source. Python has been chosen as a software module programming on a single board computer with Linux kernel. As a result, an appropriately running system has been built with both secure software and hardware interfaces having maximum accuracy at 95.33% while specificity is at 100%

The relationship between pneumonia and gastric colonization in surgical intensive-care unit patients

Objective: To evaluate the correlation of intensive-care unit (ICU)-acquired pneumonia and gastric colonization, and the factors affecting gastric colonization in surgical ICU patients. Design: Prospective, clinical study. Setting: Surgical ICU of Gazi University, Faculty of Medicine, Department of General Surgery. Patients: Sixty-seven adult surgical ICU patients who did not have pneumonia on admission and would have nasogastric (NG) tubing at least for 48 hours were evaluated between October 1996 and April 1998. Method: Patients who were approved not to have pneumonia by physical examination, chest x-ray, white blood cell count, and sputum culture on admission were included in the study. NG tube aspirate and sputum samples for microbiologic studies, chest x-ray, and white blood cell count were obtained every other day and additionaly if there were symptoms or signs of infection. Results: Seventeen of the 67 patients (25.37%) had pneumonia in the period of ICU stay. In total, 122 NG tube aspirate and 122 sputum samples were obtained simultaneously. Of these 122 NG tube aspirate and sputum cultures, 85 couples of samples (69.67%) had NG tube aspirate culture (-)/sputum culture (-), 20 couples of samples (16.40%) NG tube aspirate culture (+)/sputum culture (+) (the same bacteria was isolated). Pneumonia in 13 of the 17 patients who had gastric colonization were the result of the same bacteria as isolated from the patient's gastric fluid. Conclusion: Based on the findings, gastric colonization is a serious predisposing factor for pneumonia. When both the dual-positive and the dual-negative culture results are taken into account, a strong positive correlation of the nasogastric tube aspirate and sputum cultures can be seen. Therefore, it is recommended to obtain the upper gastrointestinal (GI) fluid from indwelling gastric or enteric tubes periodically for microbiologic studies to predict the possible bacteria that could lead to pneumonia and moreover to take preventive or treatment measures

A technique developed by a morbidly obese patient to eat more despite an adjustable gastric band

A woman who had undergone gastric banding is described. In her non-compliance, she developed a subxiphoid pressure maneuver to empty her stomach and permit further intake