956 research outputs found
Bird flu outbreak amidst COVID-19 pandemic in South Africa:Efforts and challenges at hand
Over the months of April and May 2021, South Africa has witnessed several outbreaks of highly infective avian influenza (H5N1) in different poultry farms. This came as a shock to a country that was already battling with the deadly COVIDâ19 pandemic. The emergence of the virus has spurred import bans and massive culls in the poultry business. Local experts have also called for a restriction on the movement of people and cars in and out of their chicken farms. Employees have also been encouraged to shower in the mornings when they arrive at the farms and wear fresh clothes, as the flu spreads very quickly. In a country that is already facing the economic implications of the COVIDâ19, this has the potential to cause a significant dent in the economy, as well as severely impact people's dayâtoâday life. Bird fluâalso called avian influenzaâis a viral infection that can infect not only birds but also humans and other animals. The threat of a new influenza pandemic has prompted countries to draft national strategic preparedness plans to prevent, contain and mitigate the next human influenza pandemic. This paper describes the South African burden, current efforts, and preparedness against the avian influenza virus
The Effect of Bevel on Fracture Resistance of GIC Restorations in Primary Molars: In Vitro Study RĂŽle du Biseau dans la RĂ©sistance Ă la Fracture des Restaurations aux Ciments Verres-IonomĂšres des Molaires Temporaires : Ătude In Vitro
Background: Glass ionomer cements (GICs) are commonly used for restorations in primary molars due to their adhesive, hydrophilic, and bioactive properties. However, their low mechanical resistance may limit their use in proximal cavities. Recent advancements in GICs, such as the high viscosity GIC EQUIA ForteÂź, have improved their mechanical properties. The effect of a Cavo superficial bevel on the mechanical strength of GIC restorations has been previously studied.
Objectives: To investigate the effect of a Cavo superficial bevel on fracture resistance and the type of fracture (adhesive, cohesive, or catastrophic) in EQUIA ForteÂź GIC restorations in primary molars.
Methods: 56 standardized proximal cavities were created on 51 temporary molars. The cavities were randomly divided into two groups: group I without a Cavo superficial bevel (n=28) and group II with a 45° Cavo superficial bevel (n=28). The cavities were restored with EQUIA ForteŸ. The samples were subjected to thermocycling and artificial aging, then, an axial speed loading of 1 mm/min was applied until fracture. Fracture toughness was recorded, and the type of fracture was observed under an optical microscope. A Mann-Whitney U test was used to compare the average fracture resistance between the groups. All tests were two-tailed and the level of significance was set at 5%.
Results: The average fracture resistance for group I was (237.57 ± 139.97 N) and for group II was (294.89 ± 171.07 N). There was no statistically significant difference in fracture resistance between the two groups (p\u3e0.05). Mixed fractures were observed in all samples, with adhesive fractures only present in group I and cohesive fractures only present in group II.
Conclusion: The Cavo superficial bevel does not significantly affect the fracture resistance of GIC restorations in primary molars. However, the bevel design may prevent adhesive and catastrophic fractures.
Contexte : Les ciments verres-IonomÚres (CVI) sont couramment utilisés pour les restaurations des molaires temporaires grùce à leurs propriétés adhésives, hydrophiles et bioactives. Cependant, leur faible résistance mécanique limite leur utilisation dans les cavités proximales. Avec les récents progrÚs de cette classe de matériaux, un CVI à haute viscosité a été introduit : EQUIA ForteŸ, visant à améliorer leurs propriétés mécaniques. Le rÎle du biseau cavo-superficiel sur la résistance mécanique des restaurations au CVI a déjà été étudié.
Objectifs : Tester le rĂŽle du biseau dans lâamĂ©lioration de la rĂ©sistance Ă la fracture et dâĂ©tudier la nature du trait de fracture adhĂ©sif, cohĂ©sif, ou catastrophique des restaurations aux CVI EQUIA ForteÂź des molaires temporaires.
Méthodes : 56 cavités proximales standardisées ont été réalisées sur 51 molaires temporaires. Ces cavités ont été divisées aléatoirement en deux groupes : groupe I sans biseau cavo-superficiel (n=28) et groupe II avec biseau cavo-superficiel de 45° (n=28). Les cavités ont été restaurées par EQUIA ForteŸ. Les échantillons ont été soumis à un thermocyclage et à un vieillissement artificiel, puis une vitesse axiale de chargement de 1 mm/min a été appliquée jusqu\u27à la fracture. La résistance à la fracture a été enregistrée et le type de fracture a été observé au microscope optique. Le test de Mann-Whitney U a été utilisé pour comparer la résistance moyenne à la fracture entre les groupes. Tous les tests étaient bilatéraux et le niveau de signification a été fixé à 5 %.
Résultats : La résistance moyenne à la fracture pour le groupe I était de (237,57 ± 139,97 N) et pour le groupe II était de (294,89 ± 171,07 N). Il n\u27y avait pas de différence statistiquement significative en termes de résistance à la fracture entre les deux groupes (p \u3e 0,05). Cependant, des fractures mixtes ont été observées dans tous les échantillons, les fractures adhésives étant uniquement présentes dans le groupe I et les fractures cohésives présentes uniquement dans le groupe II.
Conclusion : Le biseau cavo-superficiel n\u27influence pas de maniĂšre significative la rĂ©sistance Ă la fracture des restaurations CVI des molaires temporaires. Cependant, il sâest avĂ©rĂ© que la conception du biseau empĂȘche les fractures adhĂ©sives et catastrophiques dâavoir lieu.
Mots clés : Biseau, CVI, Classe II, Molaires Temporaires, Restauration, Type de fractur
C-Reactive Protein, Erythrocyte Sedimentation Rate and Orthopedic Implant Infection
BACKGROUND: C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) have been shown to be useful for diagnosis of prosthetic hip and knee infection. Little information is available on CRP and ESR in patients undergoing revision or resection of shoulder arthroplasties or spine implants. METHODS/RESULTS: We analyzed preoperative CRP and ESR in 636 subjects who underwent knee (n=297), hip (n=221) or shoulder (n=64) arthroplasty, or spine implant (n=54) removal. A standardized definition of orthopedic implant-associated infection was applied. Receiver operating curve analysis was used to determine ideal cutoff values for differentiating infected from non-infected cases. ESR was significantly different in subjects with aseptic failure infection of knee (median 11 and 53.5 mm/h, respectively, p=<0.0001) and hip (median 11 and 30 mm/h, respectively, p=<0.0001) arthroplasties and spine implants (median 10 and 48.5 mm/h, respectively, p=0.0033), but not shoulder arthroplasties (median 10 and 9 mm/h, respectively, p=0.9883). Optimized ESR cutoffs for knee, hip and shoulder arthroplasties and spine implants were 19, 13, 26, and 45 mm/h, respectively. Using these cutoffs, sensitivity and specificity to detect infection were 89 and 74% for knee, 82 and 60% for hip, and 32 and 93% for shoulder arthroplasties, and 57 and 90% for spine implants. CRP was significantly different in subjects with aseptic failure and infection of knee (median 4 and 51 mg/l, respectively, p<0.0001), hip (median 3 and 18 mg/l, respectively, p<0.0001), and shoulder (median 3 and 10 mg/l, respectively, p=0.01) arthroplasties, and spine implants (median 3 and 20 mg/l, respectively, p=0.0011). Optimized CRP cutoffs for knee, hip, and shoulder arthroplasties, and spine implants were 14.5, 10.3, 7, and 4.6 mg/l, respectively. Using these cutoffs, sensitivity and specificity to detect infection were 79 and 88% for knee, 74 and 79% for hip, and 63 and 73% for shoulder arthroplasties, and 79 and 68% for spine implants. CONCLUSION: CRP and ESR have poor sensitivity for the diagnosis of shoulder implant infection. A CRP of 4.6 mg/l had a sensitivity of 79 and a specificity of 68% to detect infection of spine implants
Current status of clinical outcome measures in inclusion body myositis: a systematised review
OBJECTIVES: Sporadic inclusion body myositis (IBM) is a debilitating idiopathic inflammatory myopathy (IIM) which affects hand function, ambulation, and swallowing. There is no approved pharmacological therapy for IBM, and there is a lack of suitable outcome measure to assess the effect of an intervention. The IBM scientific interest group under IMACS reviewed the previously used outcome measures in IBM clinical studies to lay the path for developing a core set of outcome measures in IBM. METHODS: In this systematised review, we have extracted all outcome measures reported in IBM clinical studies to determine what measures were being used and to assess the need for optimising outcome measures in IBM. RESULTS: We found 13 observational studies, 17 open-label clinical trials, and 15 randomised control trials (RCTs) in IBM. Six-minute walk distance, IBM-functional rating scale (IBM-FRS), quantitative muscle testing, manual muscle testing, maximal voluntary isometric contraction testing, and thigh muscle volume measured by MRI were used as primary outcome measures. Twelve different outcome measures of motor function were used in IBM clinical trials. IBM-FRS was the most used measure of functionality. Swallowing function was reported as a secondary outcome measure in only 3 RCTs. CONCLUSIONS: There are inconsistencies in using outcome measures in clinical studies in IBM. The core set measures developed by the IMACS group for other IIMs are not directly applicable to IBM. As a result, there is an unmet need for an IBM-specific core set of measures to facilitate the evaluation of new potential therapeutics for IBM
individual participant data meta-analysis of randomised trials study protocol
Introduction Parenteral anticoagulants may improve outcomes in patients with
cancer by reducing risk of venous thromboembolic disease and through a direct
antitumour effect. Study-level systematic reviews indicate a reduction in
venous thromboembolism and provide moderate confidence that a small survival
benefit exists. It remains unclear if any patient subgroups experience
potential benefits. Methods and analysis First, we will perform a
comprehensive systematic search of MEDLINE, EMBASE and The Cochrane Library,
hand search scientific conference abstracts and check clinical trials
registries for randomised control trials of participants with solid cancers
who are administered parenteral anticoagulants. We anticipate identifying at
least 15 trials, exceeding 9000 participants. Second, we will perform an
individual participant data meta-analysis to explore the magnitude of survival
benefit and address whether subgroups of patients are more likely to benefit
from parenteral anticoagulants. All analyses will follow the intention-to-
treat principle. For our primary outcome, mortality, we will use multivariable
hierarchical models with patient-level variables as fixed effects and a
categorical trial variable as a random effect. We will adjust analysis for
important prognostic characteristics. To investigate whether intervention
effects vary by predefined subgroups of patients, we will test interaction
terms in the statistical model. Furthermore, we will develop a risk-prediction
model for venous thromboembolism, with a focus on control patients of
randomised trials. Ethics and dissemination Aside from maintaining participant
anonymity, there are no major ethical concerns. This will be the first
individual participant data meta-analysis addressing heparin use among
patients with cancer and will directly influence recommendations in clinical
practice guidelines. Major cancer guideline development organisations will use
eventual results to inform their guideline recommendations. Several knowledge
users will disseminate results through presentations at clinical rounds as
well as national and international conferences. We will prepare an evidence
brief and facilitate dialogue to engage policymakers and stakeholders in
acting on findings. Trial registration number PROSPERO CRD4201300352
AGREE-S: AGREE II extension for surgical interventions - United European Gastroenterology and European Association for Endoscopic Surgery methodological guide
The Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument has been developed to inform the methodology, reporting and appraisal of clinical practice guidelines. Evidence suggests that the quality of surgical guidelines can be improved, and the structure and content of AGREE II can be modified to help enhance the quality of guidelines of surgical interventions
Contrasting Expression of Canonical Wnt Signaling Reporters TOPGAL, BATGAL and Axin2LacZ during Murine Lung Development and Repair
Canonical Wnt signaling plays multiple roles in lung organogenesis and repair by regulating early progenitor cell fates: investigation has been enhanced by canonical Wnt reporter mice, TOPGAL, BATGAL and Axin2LacZ. Although widely used, it remains unclear whether these reporters convey the same information about canonical Wnt signaling. We therefore compared beta-galactosidase expression patterns in canonical Wnt signaling of these reporter mice in whole embryo versus isolated prenatal lungs. To determine if expression varied further during repair, we analyzed comparative pulmonary expression of beta-galactosidase after naphthalene injury. Our data show important differences between reporter mice. While TOPGAL and BATGAL lines demonstrate Wnt signaling well in early lung epithelium, BATGAL expression is markedly reduced in late embryonic and adult lungs. By contrast, Axin2LacZ expression is sustained in embryonic lung mesenchyme as well as epithelium. Three days into repair after naphthalene, BATGAL expression is induced in bronchial epithelium as well as TOPGAL expression (already strongly expressed without injury). Axin2LacZ expression is increased in bronchial epithelium of injured lungs. Interestingly, both TOPGAL and Axin2LacZ are up regulated in parabronchial smooth muscle cells during repair. Therefore the optimal choice of Wnt reporter line depends on whether up- or down-regulation of canonical Wnt signal reporting in either lung epithelium or mesenchyme is being compared
Thrombocytopenia and platelet transfusions in ICU patients: an international inception cohort study (PLOT-ICU)
Purpose
Thrombocytopenia (platelet countâ<â150âĂâ109/L) is common in intensive care unit (ICU) patients and is likely associated with worse outcomes. In this study we present international contemporary data on thrombocytopenia in ICU patients.
Methods
We conducted a prospective cohort study in adult ICU patients in 52 ICUs across 10 countries. We assessed frequencies of thrombocytopenia, use of platelet transfusions and clinical outcomes including mortality. We evaluated pre-selected potential risk factors for the development of thrombocytopenia during ICU stay and associations between thrombocytopenia at ICU admission and 90-day mortality using pre-specified logistic regression analyses.
Results
We analysed 1166 ICU patients; the median age was 63 years and 39.5% were female. Overall, 43.2% (95% confidence interval (CI) 40.4â46.1) had thrombocytopenia; 23.4% (20â26) had thrombocytopenia at ICU admission, and 19.8% (17.6â22.2) developed thrombocytopenia during their ICU stay. Non-AIDS-, non-cancer-related immune deficiency, liver failure, male sex, septic shock, and bleeding at ICU admission were associated with the development of thrombocytopenia during ICU stay. Among patients with thrombocytopenia, 22.6% received platelet transfusion(s), and 64.3% of in-ICU transfusions were prophylactic. Patients with thrombocytopenia had higher occurrences of bleeding and death, fewer days alive without the use of life-support, and fewer days alive and out of hospital. Thrombocytopenia at ICU admission was associated with 90-day mortality (adjusted odds ratio 1.7; 95% CI 1.19â2.42).
Conclusion
Thrombocytopenia occurred in 43% of critically ill patients and was associated with worse outcomes including increased mortality. Platelet transfusions were given to 23% of patients with thrombocytopenia and most were prophylactic.publishedVersio
The Science Performance of JWST as Characterized in Commissioning
This paper characterizes the actual science performance of the James Webb
Space Telescope (JWST), as determined from the six month commissioning period.
We summarize the performance of the spacecraft, telescope, science instruments,
and ground system, with an emphasis on differences from pre-launch
expectations. Commissioning has made clear that JWST is fully capable of
achieving the discoveries for which it was built. Moreover, almost across the
board, the science performance of JWST is better than expected; in most cases,
JWST will go deeper faster than expected. The telescope and instrument suite
have demonstrated the sensitivity, stability, image quality, and spectral range
that are necessary to transform our understanding of the cosmos through
observations spanning from near-earth asteroids to the most distant galaxies.Comment: 5th version as accepted to PASP; 31 pages, 18 figures;
https://iopscience.iop.org/article/10.1088/1538-3873/acb29
Les droits disciplinaires des fonctions publiques : « unification », « harmonisation » ou « distanciation ». A propos de la loi du 26 avril 2016 relative à la déontologie et aux droits et obligations des fonctionnaires
The production of tt⟠, W+bb⟠and W+cc⟠is studied in the forward region of protonâproton collisions collected at a centre-of-mass energy of 8 TeV by the LHCb experiment, corresponding to an integrated luminosity of 1.98±0.02 fbâ1 . The W bosons are reconstructed in the decays WââÎœ , where â denotes muon or electron, while the b and c quarks are reconstructed as jets. All measured cross-sections are in agreement with next-to-leading-order Standard Model predictions.The production of , and is studied in the forward region of proton-proton collisions collected at a centre-of-mass energy of 8 TeV by the LHCb experiment, corresponding to an integrated luminosity of 1.98 0.02 \mbox{fb}^{-1}. The bosons are reconstructed in the decays , where denotes muon or electron, while the and quarks are reconstructed as jets. All measured cross-sections are in agreement with next-to-leading-order Standard Model predictions
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