A micro bacteriological culture assessment of the histopathological alterations in liver and bile in gallstone disease

Background: The present investigation aims to evaluate both the intensity and occurrence of hepatic impairment in patients afflicted with gallstone disease, examining the involvement of bacteria in the progression of these alterations. Methods: This prospective observational investigation was carried out on 189 patients scheduled for open or laparoscopic cholecystectomy at IGIMS in Patna, Bihar, India. In all the patients, laboratory and radiological investigations were performed. A healthy section of the liver border near the gallbladder fossa was chosen and grasped with non-traumatic forceps. Approximately 1 cm of the liver edge was excised using scissors and forwarded for histopathological analysis. Results: An examination of 189 liver biopsy specimens revealed that 87 (46%) patients showed no abnormalities, while 102 patients (54%) exhibited one or more changes. Upon analysing the liver biopsy samples from the control cohort (41 patients) during autopsy, 37% of the cases were identified to display hepatic lipidosis, while 48% of the cases showed lymphocytic invasion. Importantly, no cases of acute inflammatory changes were detected in the control cohort. Microbiological analysis was conducted on 96 patients, of which 33 (34%) showed positive cultures, with one or more microorganisms isolated from either the biliary tract or liver. Among these, 74% (24 cases) originated from the bile or gallbladder, while 26% (9 cases) were isolated from the liver. Conclusions: Gallstone disease induces significant liver histological changes, notably more prevalent in patients with prolonged symptoms. The present study clearly identifies this and underscores the importance of timely diagnosis and intervention for the effective management of this disease

Collabs: A Flexible and Performant CRDT Collaboration Framework

A collaboration framework is a distributed system that serves as the data layer for a collaborative app. Conflict-free Replicated Data Types (CRDTs) are a promising theoretical technique for implementing collaboration frameworks. However, existing frameworks are inflexible: they are often one-off implementations of research papers or only permit a restricted set of CRDT semantics, and they do not allow app-specific optimizations. Until now, there was no general framework that lets programmers mix, match, and modify CRDTs. We solve this with Collabs, a CRDT-based collaboration framework that lets programmers implement their own CRDTs, either from-scratch or by composing existing building blocks. Collabs prioritizes both semantic flexibility and performance flexibility: it allows arbitrary app-specific CRDT behaviors and optimizations, while still providing strong eventual consistency. We demonstrate Collabs's capabilities and programming model with example apps and CRDT implementations. We then show that a collaborative rich-text editor using Collabs's built-in CRDTs can scale to over 100 simultaneous users, unlike existing CRDT frameworks and Google Docs. Collabs also has lower end-to-end latency and server CPU usage than a popular Operational Transformation framework, with acceptable CRDT metadata overhead.Comment: 18 pages, 19 figure

Safety evaluation of the single-dose Ad26. COV2.S vaccine among healthcare workers in the Sisonke study in South Africa : a phase 3b implementation trial

Real-world evaluation of the safety profile of vaccines after licensure is crucial to accurately characterise safety beyond clinical trials, support continued use, and thereby improve public confidence. The Sisonke study aimed to assess the safety and effectiveness of the Janssen Ad26.COV2.S vaccine among healthcare workers (HCWs) in South Africa. Here, we present the safety data.Funding for the Sisonke Study was provided by: The National Department of Health through baseline funding to the South African Medical Research Council; the Solidarity Response Fund NPC; The Michael & Susan Dell Foundation; the ELMA Vaccines and Immunization Foundation; the ELMA Vaccines and Immunization Foundation; and the Bill & Melinda Gates Foundation.https://journals.plos.org/plosmedicinedm2022Paediatrics and Child HealthSchool of Health Systems and Public Health (SHSPH

MOESM1 of Segmentation of 3D images of plant tissues at multiple scales using the level set method

Additional file 1. Supplementary Methods. Section 1. Mathematical details of the level set method; Section 2. Parameters and initialization; Figure S1. Parameter effects and sensitivity to initialization