Systematic Review for Risks of Pressure Injury and Prediction Models Using Machine Learning Algorithms.

Pressure injuries are increasing worldwide, and there has been no significant improvement in preventing them. This study is aimed at reviewing and evaluating the studies related to the prediction model to identify the risks of pressure injuries in adult hospitalized patients using machine learning algorithms. In addition, it provides evidence that the prediction models identified the risks of pressure injuries earlier. The systematic review has been utilized to review the articles that discussed constructing a prediction model of pressure injuries using machine learning in hospitalized adult patients. The search was conducted in the databases Cumulative Index to Nursing and Allied Health Literature (CINAHIL), PubMed, Science Direct, the Institute of Electrical and Electronics Engineers (IEEE), Cochrane, and Google Scholar. The inclusion criteria included studies constructing a prediction model for adult hospitalized patients. Twenty-seven articles were included in the study. The defects in the current method of identifying risks of pressure injury led health scientists and nursing leaders to look for a new methodology that helps identify all risk factors and predict pressure injury earlier, before the skin changes or harms the patients. The paper critically analyzes the current prediction models and guides future directions and motivations.

Incomplete reproductive barriers and genomic differentiation impact the spread of resistance mutations between green- and red-colour morphs of a cosmopolitan mite pest.

Pesticide resistance represents a clear and trackable case of adaptive evolution with a strong societal impact. Understanding the factors associated with the evolution and spread of resistance is imperative to develop sustainable crop management strategies. The two-spotted spider mite Tetranychus urticae, a major crop pest with worldwide distribution and a polyphagous lifestyle, has evolved resistance to most classes of pesticides. Tetranychus urticae exists as either a green- or a red-coloured morph. However, the extent of genetic divergence and reproductive compatibility vary across populations of these colour morphs, complicating their taxonomic resolution at the species level. Here, we studied patterns of genetic differentiation and barriers to gene flow within and between morphs of T. urticae in order to understand the factors that influence the spread of resistance mutations across its populations. We derived multiple iso-female lines from Tetranychus populations collected from agricultural crops. We generated genomic and morphological data, characterized their bacterial communities and performed controlled crosses. Despite morphological similarities, we found large genomic differentiation between the morphs. This pattern was reflected in the incomplete, but strong postzygotic incompatibility in crosses between colour morphs, while crosses within morphs from different geographical locations were largely compatible. In addition, our results suggest recent/on-going gene flow between green-coloured T. urticae and T. turkestani. By screening the sequences of 10 resistance genes, we found evidence for multiple independent origins and for single evolutionary origins of target-site resistance mutations. Our results indicate that target-site mutations mostly evolve independently in populations on different geographical locations, and that these mutations can spread due to incomplete barriers to gene flow within and between populations.

Monkeypox outbreak 2022: What we know so far and its potential drug targets and management strategies.

Monkeypox is a rare zoonotic disease caused by infection with the monkeypox virus. The disease can result in flu-like symptoms, fever, and a persistent rash. The disease is currently spreading throughout the world and prevention and treatment efforts are being intensified. Although there is no treatment that has been specifically approved for monkeypox virus infection, infected patients may benefit from using certain antiviral medications that are typically prescribed for the treatment of smallpox. The drugs are tecovirimat, brincidofovir, and cidofovir, all of which are currently in short supply due to the spread of the monkeypox virus. Resistance is also a concern, as widespread replication of the monkeypox virus can lead to mutations that produce monkeypox viruses that are resistant to the currently available treatments. This article discusses monkeypox disease, potential drug targets, and management strategies to overcome monkeypox disease. With the discovery of new drugs, it is hoped that the problem of insufficient drugs will be resolved, and it is not anticipated that drug resistance will become a major issue in the near future.

Nutritional status and quality of life in diabetic patients on hemodialysis: a cross-sectional study from Palestine.

BACKGROUND: End-stage renal disease (ESRD) is a leading cause of death and morbidity worldwide. Malnutrition is a common problem among hemodialysis (HD) patients that negatively impacts their prognosis and is linked to an increase in morbidity and mortality in these patients, as well as a decrease in their quality of life (QOL). In this study, we aimed to evaluate the QOL and to investigate factors that can influence it, including nutritional status, as well as socio-demographic factors, among Palestinian diabetic patients on HD therapy. METHODS: This was a cross-sectional study that occurred at a large hemodialysis center in Palestine. Malnutrition was assessed by the malnutrition-inflammation scale (MIS), and the quality of life was evaluated by using the EuroQoL five-dimensional instrument (EQ-5D). Multivariable linear regression analysis was carried out to look at the effect of multiple variables on QOL. RESULTS: A total of 118 diabetic patients on HD were included. Of these, 66.9% were male, and 60.2% were aged 60 years or higher. Having multiple comorbid diseases (p=0.004) and having been on HD for >4 years (p=0.003) were significantly associated with a higher MIS score, whereas living alone (p=0.037) and having been on HD for >4 years (p=0.002) was significantly associated with lower EQ-5D score. We also observed a significant association between the MIS score and the EQ-5D score(r=-0.616, p<0.001). Multiple linear regression analysis demonstrated that diabetic hemodialysis patients who lived within a family household were positively correlated with the QOL score (standardized coefficient, 0.178; 95% confidence interval (CI), 0.042 to 0.372; p = 0.015), and MIS score was significantly and negatively correlated with QOL scores (standardized coefficient, -0.587; 95% CI, -0.047 to -0.028; p < 0.001). CONCLUSIONS: We found that malnutrition was associated with a lower QOL score among diabetic patients on HD. We recommend general practitioners, dietitians, nephrologists, and nurses to make plans that pay more attention to this group of patients who show evidence of malnutrition. Patients on dialysis for ≥ 4 years, patients who live alone, and those suffering from multiple co-morbid diseases should receive special care due to their higher risk of being impacted by this problem.

Acaricide resistance status and identification of resistance mutations in populations of the two-spotted spider mite Tetranychus urticae from Ethiopia.

The intensive use of pesticides is a common practice for the management of the two-spotted spider mite, Tetranychus urticae, in greenhouses and field farms of Ethiopia. However, incidence of resistance and possible resistance mechanisms in T. urticae populations from Ethiopia have not yet been studied. Here, we assessed the toxicity of various acaricides-bifenazate, abamectin, emamectin benzoate, profenofos, fenbutatin oxide, fenpyroximate, amitraz and chlorfenapyr-on T. urticae populations sampled from six flower greenhouse farms, three strawberry greenhouse farms, one field-grown vegetable farm and two wild populations. In parallel, all populations were screened for known target-site mutations. All tested populations were fully susceptible to bifenazate, abamectin, emamectin benzoate and profenofos, but resistant against fenbutatin oxide and fenpyroximate. Four populations showed considerable levels of resistance against amitraz and one population was resistant to chlorfenapyr. Several target-site mutations were identified in the tested populations, including G119S, A201S, T280A, G328A and F331W/C/Y in acetylcholinesterase and the F1538I and L1024V mutation in the voltage-gated sodium channel. The F1538I mutation was found in eight out of 12 populations, whereas the L1024V mutation was only found in two populations. The H92R mutation in the PSST subunit of complex I and the I1017F mutation in chitin synthase 1 was detected in half of the tested populations. The G326E and I321T mutations in the glutamate-gated chloride channel 3 were also detected, but more rarely, whereas mitochondrial cytochrome b mutations were not detected. The current study revealed multiple resistance patterns in Ethiopian T. urticae populations and together with the wide presence of target-site mutations, calls for the wise use of acaricides in the management of T. urticae in Ethiopia.

Genome-wide gene expression profiling reveals that cuticle alterations and P450 detoxification are associated with deltamethrin and DDT resistance in Anopheles arabiensis populations from Ethiopia.

BACKGROUND: Vector control is the main intervention in malaria control and elimination strategies. However, the development of insecticide resistance is one of the major challenges for controlling malaria vectors. Anopheles arabiensis populations in Ethiopia showed resistance against both DDT and the pyrethroid deltamethrin. Although an L1014F target-site resistance mutation was present in the voltage gated sodium channel of investigated populations, the levels of resistance indicated the presence of additional resistance mechanisms. In this study, we used genome-wide transcriptome profiling by RNAseq to assess differentially expressed genes between three deltamethrin and DDT resistant An. arabiensis field populations - Asendabo, Chewaka and Tolay - and two susceptible strains - Sekoru and Mozambique. RESULTS: Both RNAseq analysis and RT-qPCR showed that a glutathione-S-transferase, gstd3, and a cytochrome P450 monooxygenase, cyp6p4, were significantly overexpressed in the group of resistant populations compared to the susceptible strains, suggesting that the enzymes they encode play a key role in metabolic resistance against deltamethrin or DDT. Furthermore, a gene ontology enrichment analysis showed that expression changes of cuticle related genes were strongly associated with insecticide resistance. Although this did not translate in increased thickness of the procuticle, a higher cuticular hydrocarbon content was observed in a resistant population. CONCLUSION: Our transcriptome sequencing of deltamethrin and DDT resistant An. arabiensis populations from Ethiopia suggests non-target site resistance mechanisms and paves the way for further investigation of the role of cuticle composition in insecticide resistance of malaria vectors. © 2019 Society of Chemical Industry.

Correlation between NRT measurement level and behavioral levels in pediatrics cochlear implant patients.

OBJECTIVE: To determine the relationship between the electrically evoked nerve action potential (Neural Response Telemetry [NRT]) and behavioral levels (T- and C-level) for pediatric patients using the Nucleus 24 cochlear implant system. METHOD: A hospital based study of pediatric cochlear implant patients in the period between June 2000 and December 2008. At King Abdul-Aziz University Hospital (KAUH) Saudi Arabia the Neural Response Telemetry was administered to 47 children (mean age at implantation: 4 years) with the Nucleus 24 cochlear implants. Four intra cochlear electrodes (numbers 5, 10, 15, and 20) were tested one-month post-implantation, the neural response threshold compared with the behavioral threshold and the maximum comfort level estimated at the same time. RESULTS: At all the electrode numbers, the mean for NRT level measurements was significantly higher than that for the T-level measurements and the mean for the C-level measurements was significantly higher than that for NRT level measurements The correlation analyses showed positive correlation between C-level and NRT level measurements and T-level and NRT level measurements. CONCLUSION: There was a positive correlation between NRT value measurements and both T and C value measurements. Therefore, it is useful to use the NRT values to predict the behavioral T and C values in prelingual children.

[Cardiovascular emergencies in Subsaharan Africa]. / Urgences cardiovasculaires en Afrique subsaharienne.

BACKGROUND: The increasing prevalence of cardiovascular diseases in subsaharan Africa and their related mortality and morbidity have been established. A large number of them present as emergencies. The purpose of this first multicentric study was to assess the causes, management and outcome of cardiovascular emergencies in savannah and forest environments. METHODS: A total of 665 patients were included from seven participating centers in seven countries: 417 were classified as belonging to the savannah zone (Dakar, Nouakchott, Ouagadougou, N'djamena) whereas 248 patients were from the forest zone (Abidjan, Libreville, Yaounde). Patients were examinated by one or several cardiologists. Statistical analysis was performed by the Medical Statistic Unit of the Hopital Nord, Marseille (France). RESULTS: There were more men (53.4%) than women (46.6%). 77.7% of the patients lived in urban areas. Most of them had low or very low incomes. Patients reached the hospitals in ambulances only in 6.2% of cases. The remaining others were transported by routine urban vehicle or bicycle or ambulation. The mean delay between the onset of symptoms and the arrival to the emergency unit was 6.8 days. Three immediate situations were preponderant: severe hypertension (32.2%), heart failures NYHA IV (27.5%), stroke (20.3%). Underlying conditions were: mainly chronic hypertension (52.3%), cardiomyopathies (20.6%), valvular heart diseases (11.1%). Coronary heart diseases were rare (6.1%). The observed mortality was 21.2% without any differences in age groups. The most common emergencies resulting in death included: stroke (31.9%), vascular collapses (18.4%), pulmonary embolism (9.2%). The patients from the savannah zone were younger, more often classified in the low or average socioeconomic level. Hypertension was more frequent in forest zones. Valvular heart diseases were more frequent in savannah. Cardiomyopathies were comparable in both zones. Coronary heart disease was slightly more common in the savannah area. DISCUSSION: Compared with patients from western countries, the African patients are younger because some diseases affect young people like rheumatic heart disease or postpartum and infectious cardiomyopathies. The difficulties to reach health care facilities made the outcome more severe. Hypertension and valvular heart disease deserve priority in preventive strategy. Cardiomyopathies have to be studied to precise their causes. Finally, the management of cardiovascular emergencies needs a special care in the hospitals owing to their increasing frequency and their severity.