Establishing African genomics and bioinformatics programs through annual regional workshops.

The African BioGenome Project (AfricaBP) Open Institute for Genomics and Bioinformatics aims to overcome barriers to capacity building through its distributed African regional workshops and prioritizes the exchange of grassroots knowledge and innovation in biodiversity genomics and bioinformatics. In 2023, we implemented 28 workshops on biodiversity genomics and bioinformatics, covering 11 African countries across the 5 African geographical regions. These regional workshops trained 408 African scientists in hands-on molecular biology, genomics and bioinformatics techniques as well as the ethical, legal and social issues associated with acquiring genetic resources. Here, we discuss the implementation of transformative strategies, such as expanding the regional workshop model of AfricaBP to involve multiple countries, institutions and partners, including the proposed creation of an African digital database with sequence information relating to both biodiversity and agriculture. This will ultimately help create a critical mass of skilled genomics and bioinformatics scientists across Africa.

MLIP and Its Potential Influence on Key Oncogenic Pathways.

Muscle-enriched A-type lamin-interacting protein (MLIP) is an emerging protein involved in cellular homeostasis and stress adaptation. Eukaryotic cells regulate various cellular processes, including metabolism, DNA repair, and cell cycle progression, to maintain cellular homeostasis. Disruptions in this homeostasis can lead to diseases such as cancer, characterized by uncontrolled cell growth and division. This review aims to explore for the first time the unique role MLIP may play in cancer development and progression, given its interactions with the PI3K/Akt/mTOR pathway, p53, MAPK9, and FOXO transcription factors, all critical regulators of cellular homeostasis and tumor suppression. We discuss the current understanding of MLIP's involvement in pro-survival pathways and its potential implications in cancer cells' metabolic remodeling and dysregulated homeostasis. Additionally, we examine the potential of MLIP as a novel therapeutic target for cancer treatment. This review aims to shed light on MLIP's potential impact on cancer biology and contribute to developing innovative therapeutic strategies.

Lessons Learned from the COVID-19 Pandemic: Interpreting Vaccination Strategies in a Nationwide Demographic Study.

OBJECTIVE: Brazil was strongly affected by the COVID-19 pandemic. Its continental dimension and socio-demographic characteristics pose challenges to distribution and accessibility, making vaccination programs challenging. The objectives of the study were to describe the clinical and demographic characteristics of the general population vaccinated against COVID-19 by October 2021 and analyze the strategies implemented during the vaccination program. STUDY DESIGN AND SETTING: A retrospective nationwide study that analyzed data from the OpenDataSUS platform of the Informatics Department of the Brazilian Ministry of Health (DataSUS), which contains information from all individuals in Brazil who have received at least one dose of any vaccine against COVID-19 approved by the National Health Agency (ANVISA) from 17 January to 3 October 2021. RESULTS: Until 3 October, a total of 146,254,578 persons (68.6 per 100 inhabitants) received at least one dose of a vaccine in Brazil. The north and northeast regions had the lowest vaccination rates compared with the remaining regions (North: 56.8, Northeast: 62.0, South: 74.4, and Southeast: 73.2 per 100 inhabitants). Elderly individuals had the highest vaccination rates, particularly those above 70 years old. Heterologous dosing regimens were administered to 1,063,079 individuals (0.7% of those receiving the first dose). CONCLUSIONS: The COVID-19 vaccination program reached more than two-thirds of the population in Brazil by 9 months after its start, but the vaccination coverage was heterogeneous, reflecting the country's geographic and socio-demographic characteristics. Establishing priority groups for vaccination was a main characteristic of the vaccination strategy. In addition, technology transfer agreements have played an important role in increasing vaccine accessibility.

Monitoring of toxic cyanobacterial blooms in Lalla Takerkoust reservoir by satellite imagery and microcystin transfer to surrounding farms.

Cyanobacterial harmful algal blooms (CyanoHABs) threaten public health and freshwater ecosystems worldwide. In this study, our main goal was to explore the dynamics of cyanobacterial blooms and how microcystins (MCs) move from the Lalla Takerkoust reservoir to the nearby farms. We used Landsat imagery, molecular analysis, collecting and analyzing physicochemical data, and assessing toxins using HPLC. Our investigation identified two cyanobacterial species responsible for the blooms: Microcystis sp. and Synechococcus sp. Our Microcystis strain produced three MC variants (MC-RR, MC-YR, and MC-LR), with MC-RR exhibiting the highest concentrations in dissolved and intracellular toxins. In contrast, our Synechococcus strain did not produce any detectable toxins. To validate our Normalized Difference Vegetation Index (NDVI) results, we utilized limnological data, including algal cell counts, and quantified MCs in freeze-dried Microcystis bloom samples collected from the reservoir. Our study revealed patterns and trends in cyanobacterial proliferation in the reservoir over 30 years and presented a historical map of the area of cyanobacterial infestation using the NDVI method. The study found that MC-LR accumulates near the water surface due to the buoyancy of Microcystis. The maximum concentration of MC-LR in the reservoir water was 160 µg L-1. In contrast, 4 km downstream of the reservoir, the concentration decreased by a factor of 5.39 to 29.63 µgL-1, indicating a decrease in MC-LR concentration with increasing distance from the bloom source. Similarly, the MC-YR concentration decreased by a factor of 2.98 for the same distance. Interestingly, the MC distribution varied with depth, with MC-LR dominating at the water surface and MC-YR at the reservoir outlet at a water depth of 10 m. Our findings highlight the impact of nutrient concentrations, environmental factors, and transfer processes on bloom dynamics and MC distribution. We emphasize the need for effective management strategies to minimize toxin transfer and ensure public health and safety.

Hemodialysis water reuse within a circular economy approach. What can we add to current knowledge? A point of view.

The ongoing climate change and the ecological challenges call for sustainable medicine and, in our field, sustainable kidney care. Dialysis is life-saving and resource-consuming, and high water consumption is one of the main concerns. Circular water economy, meaning reuse and recycling of water, and recovering resources can help reducing emissions and enhancing resilience to climate change. Several actions are possible including reusing reverse osmosis reject water, employable for gardening, aquaponics or even simply for toilet flushing, or in sterilization settings, reusing spent dialysate, at least for toilet flushing, but with wider use if microbiologically purified, recovering thermal energy from spent dialysate, that can probably be done with simple devices, or using phosphate-rich spent dialysate for producing fertilizers, namely struvite. All these options may be economically sound, and all help reducing the final dialysis carbon footprint. There is room for open-minded innovative approaches to improve water-related sustainability in hemodialysis, ultimately reducing ecological impact and increasing availability.

The effect of graphene oxide administration on the brains of male mice: Behavioral study and assessment of oxidative stress.

Graphene oxide (GO) nanoparticles are attracting growing interest in various fields, not least because of their distinct characteristics and possible uses. However, concerns about their impact on neurological health are emerging, underlining the need for in-depth studies to assess their neurotoxicity. This study examines GO exposure's neurobehavioral and biochemical effects on the central nervous system (CNS). To this end, we administered two doses of GO (2 and 5 mg/kg GO) to mice over a 46-day treatment period. We performed a battery of behavioral tests on the mice, including the open field to assess locomotor activity, the maze plus to measure anxiety, the pole test to assess balance and the rotarod to measure motor coordination. In parallel, we analyzed malondialdehyde (MDA) levels and catalase activity in the brains of mice exposed to GO nanoparticles. In addition, X-ray energy dispersive (EDX) analysis was performed to determine the molecular composition of the brain. Our observations reveal brain alterations in mice exposed to GO by intraperitoneal injection, demonstrating a dose-dependent relationship. We identified behavioral alterations in mice exposed to GO, such as increased anxiety, decreased motor coordination, reduced locomotor activity and balance disorders. These changes were dose-dependent, suggesting a correlation between the amount of GO administered and the extent of behavioral alterations. At the same time, a dose-dependent increase in malondialdehyde and catalase activity was observed, reinforcing the correlation between exposure intensity and associated biochemical responses.

Bio-based composite from chitosan waste and clay for effective removal of Congo red dye from contaminated water: Experimental studies and theoretical insights.

Water pollution due to dyes in the textile industry is a serious environmental problem. During the finishing stage, Congo red (CR) dye, water-soluble, is released into wastewater, polluting the water body. This study explores the effectiveness of utilizing a composite composed of Safi raw clay and chitosan to remove an anionic dye from synthetic wastewater. The chitosan was extracted from crab shells. Its removal performance was compared to that of natural clay. Both the composite and raw clay were used to remove target pollutant. The effects of the chitosan load in the composite, size particles, initial dye concentration, contact time, pH, and temperature on the dye's elimination were tested in batch modes. The composite with 30% (w/w) of chitosan exhibited the highest dye removal. At pH 2, an adsorption capacity of 84.74 mg/g was achieved, indicating that the grafting of the polymer onto clay surface enhances its efficacity and stability in acidic environments. This finding was supported by characterization data obtained from X-ray diffraction (XRD), scanning electron microscopy (SEM), dispersive X-ray spectroscopy (EDX), and Fourier transform infrared (FT-IR) analyses. Under optimized conditions of 20 mg dose, pH 2, 30 min of reaction time, and 20 mg/L of dye concentration, about 92% of dye removal was achieved. The Langmuir isotherm model represents dye adsorption by the composite, while dye removal was controlled by pseudo-second-order model. Thermodynamic data of the adsorption (ΔH = +8.82 kJ/mol; ΔG <0) suggested that the dye adsorption was spontaneous and endothermic. The findings provide insights into the dye elimination by the adsorbent, indicating that the removal occurred via attractive colombic forces, as confirmed by density functional theory (DFT) analysis. Overall, the composite of natural clays and chitosan waste is a promising and innovative adsorbent for treating wastewater containing recalcitrant dyes.

Meta-Analysis of White Matter Hyperintensity Volume Differences Between APOE ε4 Carriers and Noncarriers.

Several studies have suggested that white matter hyperintensity volume (WMHV) is increased among apolipoprotein E (APOE) ε4 carriers while others have reported contradictory findings. Although APOE ε4 carriage is associated with greater AD pathology, it remains unclear whether cerebrovascular damage is also associated with APOE ε4 carriage. The aim of this meta-analysis was to determine whether WMHV is associated with APOE ε4 carrier status. 12 studies that were included yielded a total sample size of 16,738 adult subjects (ε4 carrier n = 4,721; ε4 noncarrier n = 12,017). There were no significant differences in WMHV between ε4 carriers and noncarriers (Hedge's g = 0.07; 95% CI (-0.01 to 0.15), P = 0.09). Subgroup analysis of community-based studies (n = 8) indicated a small effect size where ε4 carriers had greater WMHV relative to noncarriers (Hedge's g = 0.09 95% CI (0.02 to 0.16), P = 0.008). Among clinic-based studies (n = 3) there was no significant difference in WMHV by APOE ε4 carrier status (Hedge's g = -0.09, 95% CI (-0.60 to 0.41), P = 0.70). Observed APOE ε4-associated WMHV differences may be context-dependent and may also be confounded by a lack of standardization for WMHV segmentation.

3D printing feasibility of a controlled dynamization device for external circular fixation.

AIM: to assess the small-scale 3D printing feasibility and cost estimation of a device for controlled dynamization. MATERIALS AND METHOD: The two-part device previously developed by our research group was printed with a carbon fiber-reinforced nylon filament (Gen3 CarbonX™ PA6+CF, 3DXTECH Additive Manufacturing) by a professional 3D printer (FUNMAT HT, Intamsys). Electricity, material, and labor costs for production in a Brazilian city in the Santa Catarina state were calculated. RESULTS: The devices for controlled dynamization were successfully printed in accordance with the planned design and dimensions. Six out of 38 printed devices presented defects in the bolt hole and were discarded. The average printing time per device was 1.9 h. The average electricity, material, and labor costs per printed device were respectively US$0.71, US$13.55, and US$3.04. The total production cost per device reaches approximately US$20 by adding the average cost of defective devices (15 %). CONCLUSION: 3D printing of the controlled dynamization device is feasible and its cost seems affordable to most healthcare services, which could optimize the consolidation of diaphyseal fractures and reduce treatment time for patients.

Tumours of the foot: A 10 years retrospective analysis.

INTRODUCTION: The foot is a complex structure composed of several tissues, each of which can be the origin of the proliferation and development of the tumour. Most lesions about the foot are reactive or inflammatory, but some are true neoplasms. METHOD: This is a retrospective analysis of 4997 patient records treated in the Orthopaedic Oncology Unit of University Malaya Medical Centre, Malaysia, between 1 January 2010 to 31 December 2020. Demographic data of 195 patients with foot tumours were analysed out of 4997 neoplasm patients. RESULTS: There were 195 cases of foot tumours: 148 were benign, and 47 were malignant. 47 were bone tumours, 4 were metastases, and 144 were soft tissue tumours. Six patients succumbed to the disease, two cases of giant cell tumour (GCT) and one patient with synovial sarcoma had a recurrence. Treatment of foot tumours was wide resection in general. However, in metastasis cases, amputation was done. The majority of tumours were in the toes and dorsum of the foot. Soft tissue tumours of the foot occur in the elderly population in contrast to bone tumours, mainly in the second decade of life. The gender distribution was almost equal for foot tumours. Ganglion and Giant Cell Tumour of the bone are the commonest benign soft tissue and bone tumours. The most common malignant soft tissue and bone tumours are malignant melanoma and chondrosarcoma. The amputation rate is 5.64% the recurrence rate is 1.54%. Mortality rate is 3.08%. The MSTS score is 79%, and the TESS score is 76.23%. CONCLUSION: Foot tumours are relatively rare, mostly originating from soft tissue and exhibiting a benign nature. Nonetheless, a noteworthy proportion-approximately a quarter of these tumours-demonstrate malignancy. The surgical interventions undertaken in managing these tumours and associated functional outcomes generally yield acceptable results.

Fixed-bed adsorption of pesticide agricultural waste using cross-linked adsorptive hydrogel composite beads.

Adsorption column blockage due to solid adsorbent material is prevalent in laboratory-scale applications. Creating composite materials with stable geometries offers a viable solution. By crafting hydrogel beads using sodium alginate (Alg) and a bio-source like activated carbon (RMCA-P), it becomes possible to effectively eliminate agricultural pollutants, including the pesticide 2,4-D, from aqueous solutions. To evaluate the performance of these beads, a range of structural and textural analyses such as DRX, FTIR, SEM/EDX, BET, Zeta potential, Boehm titration, and iodine number were employed. Moreover, the study found that optimizing certain parameters greatly enhanced adsorption column efficiency. Specifically, increasing the bed height while reducing the flow rate of the adsorbate and the initial concentration in the inlet proved beneficial. The column demonstrated peak performance at a flow rate of 0.5 mL/min, a bed height of 35 cm, and an inlet adsorbate concentration of 50 mg/L. Under these conditions, the highest recorded removal rate for 2,4-D was 95.49%, which was subsequently confirmed experimentally at 95.05%. Both the Thomas and Yoon-Nelson models exhibited a good fit with the breakthrough curves. After undergoing three cycles of reuse, the RMCA-P/Alg hydrogel composite maintained a 2,4-D removal percentage of 74.21%. Notably, the RMCA-P/Alg beads exhibited effective removal of 2,4-D from herbicidal field waters in a continuous operational mode.

Orthopedic postoperative infection profile and antibiotic sensitivity of 2038 patients across 24 countries - Call for region and institution specific surgical antimicrobial prophylaxis.

Purpose: Improper utilization of surgical antimicrobial prophylaxis frequently leads to increased risks of morbidity and mortality.This study aims to understand the common causative organism of postoperative orthopedic infection and document the surgical antimicrobial prophylaxis protocol across various institutions in to order to strengthen surgical antimicrobial prophylaxis practice and provide higher-quality surgical care. Methods: This multicentric multinational retrospective study, includes 24 countries from five different regions (Asia Pacific, South Eastern Africa, Western Africa, Latin America, and Middle East). Patients who developed orthopedic surgical site infection between January 2021 and December 2022 were included. Demographic details, bacterial profile of surgical site infection, and antibiotic sensitivity pattern were documented. Results: 2038 patients from 24 countries were included. Among them 69.7 % were male patients and 64.1 % were between 20 and 60 years. 70.3 % patients underwent trauma surgery and instrumentation was used in 93.5 %. Ceftriaxone was the most common preferred in 53.4 %. Early SSI was seen in 55.2 % and deep SSI in 59.7 %. Western Africa (76 %) and Asia-Pacific (52.8 %) reported a higher number of gram-negative infections whereas gram-positive organisms were predominant in other regions. Most common gram positive organism was Staphylococcus aureus (35 %) and gram-negative was Klebsiella (17.2 %). Majority of the organisms showed variable sensitivity to broad-spectrum antibiotics. Conclusion: Our study strongly proves that every institution has to analyse their surgical site infection microbiological profile and antibiotic sensitivity of the organisms and plan their surgical antimicrobial prophylaxis accordingly. This will help to decrease the rate of surgical site infection, prevent the emergence of multidrug resistance and reduce the economic burden of treatment.

Ameliorative effect of Ononis natrix against chronic lead poisoning in mice: neurobehavioral, biochemical, and histological study.

Lead (Pb) is one of the most common heavy metals with toxicological effects on many tissues in humans as well as animals. In order to counteract the toxic effects of this metal, the administration of synthetic or natural antioxidants is thus required. The aim of this study was to examine the beneficial effect of the aqueous extract of Ononis natrix (AEON) against lead acetate-induced damage from a behavioral, biochemical, and histological point of view. Forty-eight male mice were divided into four equal groups: Ctr (control); Pb (lead acetate 1g/l); Pb + On 100 mg/kg (lead acetate 1 g/l + AEON 100 mg/kg); Pb + On 500 mg/kg (lead acetate 1 g/l + AEON 500 mg/kg). AEON was administered orally from day 21 after the start of lead exposure up to the end of the experiment. The results revealed that lead induced behavioral disorders, increased serum levels of liver markers (AST, ALT, and bilirubin), as well as kidney markers (urea and creatinine). At the same time, levels of thiobarbituric acid reactive substances (TBARS) and glutathione peroxidase (GPx) increased significantly. Moreover, Pb caused structural changes in the liver and kidneys of Pb-exposed mice. However, AEON administration significantly improved all lead-induced brain, liver, and kidney dysfunctions. Our results suggest that AEON could be a source of molecules with therapeutic potential against brain, liver, and kidney abnormalities caused by lead exposure.

Infratemporal abscess: a rare complication of a common procedure.

The infratemporal fossa (ITF) is an anatomically complex cavity that houses a variety of muscular and neurovascular structures at the base of the skull. Infections involving the ITF, though uncommon, can be fatal due to the difficulties of accessing this anatomical space and its proclivity to evolve into a cavernous venous thrombosis (CVT). As a result, a multi-disciplinary approach involving several surgical and medical subspecialists is often warranted. We present a case of an infratemporal fossa abscess (IFA) after wisdom teeth extraction with a very complicated clinical course and a distinct microbiologic profile.

Eco-friendly synthesis of clay-chitosan composite for efficient removal of alizarin red S dye from wastewater: A comprehensive experimental and theoretical investigation.

Alizarin Red S (ARS) is commonly utilized for dyeing in textile industry. The dye represents a refractory pollutant in the aquatic environment unless properly treated. To tackle this pollutant, the applicability of chitosan-clay composite (3C) for the ARS removal from textile wastewater was studied. Characterization studies were conducted on the synthesized adsorbent using Fourier transformation infrared (FT-IR), X-ray diffraction (XRD), and energy dispersive X-ray (EDX) techniques. Optimized parameters such as adsorbent's dosage, pH, reaction time, and initial concentrations were tested in a batch system. Additionally, density functional theory (DFT) was calculated to understand the adsorption mechanism and the role of benzene rings and oxygen atoms in the ARS as electron donors. At the same initial concentration of 30 mg/L and optimized conditions of 50 mg of dose, pH 2, and 10 min of reaction time, about 86% of ARS removal was achieved using the composite. The pseudo-second-order kinetic was applicable to model a reasonable fitness of the adsorption reaction, while the Temkin model was representative to simulate the reaction with a maximum adsorption capacity of 44.39 mg/g. This result was higher than magnetic chitosan (40.12 mg/g), or pure chitosan (42.48 mg/g). With ΔH = 27.22 kJ/mol and ΔG<0, the data implied the endothermic and spontaneous nature of the adsorption process. Overall, this implies that the clay-chitosan composite is promising to remove target dye from contaminated wastewater.

Meta-analysis of MTHFR C677T polymorphism and type 2 diabetes mellitus in MENA region.

BACKGROUND AND AIMS: The association of the C677T polymorphism of the Methylenetetrahydrofolate Reductase (MTHFR) gene with susceptibility to type 2 diabetes mellitus (T2DM) has been widely debated. Therefore, our aim is to conclusively resolve this controversy in the Middle East and North Africa region population through a meta-analysis. MATERIEL AND METHODS: We identified relevant articles by searching literature databases, such as PubMed, Web of Science, and Science Direct, to retrieve studies that examined the association between the MTHFR C677T polymorphism and the risk of developing T2DM. Using meta-analysis, we calculated the odds ratio (OR) and confidence interval (CI) values of these studies to assess the susceptibility to T2DM related to the C677T polymorphism of MTHFR gene. RESULTS: In this meta-analysis, we included a total of 13 publications comprising 2072 T2DM patients and 2164 control subjects. The results of the meta-analysis suggested that there is a significant association between the C677T polymorphism and T2DM risk in overall comparisons for allele contrasts (T vs C): OR = 1.25, 95% CI = 1.04-1.50, p = 0.015 and homozygous (TT vs CC): OR = 1.44, 95% CI = 1.01-2.05, p = 0.038). Subgroup analysis revealed that the C677T polymorphism is associated with a risk of T2DM in Asian populations, while there is no significant association between this polymorphism and T2DM in Caucasian and African populations. Furthermore, there was no evidence of publication bias. CONCLUSION: Our study's results suggest that the allele contrast of the C677T polymorphism of the MTHFR gene is associated with an increased risk of T2DM in the overall population, particularly among Asians.

The parallax effect and magnification on daily orthopedic trauma radiographs / O efeito paralaxe e magnificação sobre radiografias do cotidiano do trauma ortopédico

Objective: To identify the parallax effect on radiographs of upper and lower limbs in everyday orthopedics. Methods: This was an experimental, descriptive-theoretical study, with data analysis of digital radiographs from a tertiary trauma hospital in southern Brazil. Results: The parallax effect and magnification recorded different degrees of deformation, in the analysis of radiographs of the upper limbs, the AP radiograph of the shoulder showed greater degrees of distortion at a predetermined point (4.00%), in lower limbs the pelvis showed a greater degree of magnification (7.85%). Conclusions: There was a positive association between image magnification and the size of the film or structure to be analyzed. The parallax effect has a significant impact on image distortion in the context of orthopedic trauma. Level of Evidence III.

Objetivo: Identificar o efeito paralaxe sobre radiografias de membros superiores e inferiores do cotidiano ortopédico. Métodos: Este foi um estudo experimental, descritivo-teórico, com análise de dados de radiografias digitais de um hospital de trauma terciário sul-brasileiro. Resultados: O efeito paralaxe e magnificação registrou diferentes graus de deformação, em análise de radiografias de membros superiores a radiografia em AP do ombro apresentou maior graus de distorção em um ponto pré-determinado (4,00%), em membros inferiores a pelve apresentou maior grau de magnificação (7,85%). Conclusões: Houve uma associação positiva entre a magnificação de imagem e o tamanho do filme ou estrutura a ser analisada. O efeito paralaxe tem impacto significativo sobre a distorção de imagens no contexto de trauma ortopédico. Nível de evidência III. Estudo diagnóstico ­ investigação de um exame para diagnóstico, - estudo com pacientes não consecutivos, sem padrão de referência ouro.

The Accuracy of Readily Available Consumer-Grade Oxygen Saturation Monitors in Pediatric Patients.

BACKGROUND: Pulse oximetry measurement is ubiquitous in acute health care settings in high-income countries and is familiar to any parent whose child has been treated in such a setting. Oximeters for home use are readily available online and are incorporated in several smartphones and smartwatches. METHODS: We wished to determine how accurate are oximeters available online that are designated for adult and pediatric use, and the saturation monitor integrated in a smartphone, when used in children, compared to reference, hospital-grade oximeters. We evaluated a fingertip oximeter marketed for children purchased online; an adult fingertip oximeter purchased online; the oximeter integrated in a smartphone; and reference, hospital-grade oximeters. Participants were < 18 y of age. Bland-Altman charts were generated, and the estimated root mean square error (EARMS) was calculated. Rates of failure to obtain a measurement, relationship between device and time to successful measurement, relationship between age and time to successful measurement, and relationship between error (vs the reference device) and age were evaluated for each consumer-grade device. RESULTS: We measured SpO2 in 74 children between 0.1-17.0 y of age. Subjects weighing < 30 kg had a median (interquartile range [IQR]) age of 2 (1.0 month-1.4 y) months, and subjects weighing ≥ 30 kg had a median (IQR) age of 14.3 (11.9-16.2) y. Readings could not be obtained in 7.5, 0, and 38.8% of subjects using the pediatric, adult, and smartphone oximeters, respectively. The time to successful reading had a modest negative correlation with age with the inexpensive adult and pediatric oximeters. The inexpensive pediatric oximeter had an overall negative bias, with a mean difference from the reference device of -4.5% (SD 7.9%) and an error that ranged from > 8% to < 33% the reference device. The EARMS was 7.92%. The inexpensive adult oximeter demonstrated no obvious trend in error in the limited saturation range evaluated of 87-99%. The overall mean difference was -0.7% (SD 2.5%). EARMS was 2.5%. The smartphone oximeter underestimated SpO2 at saturations < 94% and overestimated SpO2 for saturations > 94%. Saturations could read as much as > 4%, or < 17%, than the reference oximeter. The mean difference was -2.9% (SD 5.2%). EARMS was 5.1%. CONCLUSIONS: Our findings suggest that the performance of consumer-grade devices varies considerably by both subject age and device. The pediatric fingertip device and smartphone application we tested are poorly suited for use in infants. The adult fingertip device we tested performed quite well in larger children with relatively normal oxygen saturations, and the pediatric fingertip device performed moderately well in subjects > 1 y of age who weighed < 30 kg. Given the vast number of devices available online and ever-changing technology, research to evaluate nonclinical oximeters will continue to be required.

Prevalence of radiographic findings in chronic osteomyelitis.

BACKGROUND: Simple radiography in conjunction with pertinent medical history and a comprehensive physical examination is typically adequate for diagnosing chronic osteomyelitis (CO). However, radiographic manifestations of CO lack specificity; therefore, the concordance among specialists in this regard has not been systematically assessed. This study aimed to compare and evaluate the proficiency of orthopedic surgeons and radiologists in identifying radiographic indicators present in simple radiographs for diagnosing CO. METHODS: This cross-sectional study was a correlational investigation utilizing plain radiographs obtained from a cohort of 60 patients diagnosed with CO. Comprehensive assessments of the demographic and clinical characteristics, comorbidities, and microbiological parameters were conducted. Additional variables included the anatomical location of the CO, existence of fistulas, disease duration, and presence of pseudoarthrosis. This study meticulously documented the presence or absence of six specific findings: bone destruction, which incorporates erosion and radiolucencies around implants; bone sclerosis; cortical thinning concomitant with erosion; cortical thickening; sequestrum formation; and soft-tissue swelling. RESULTS: Most patients were men (75%), with a mean age of 45.1 years. Hematogenous etiology of CO represented 23%. Bone sclerosis (71.3%) and cortical thickening (67.7%) were the most common radiographic findings, followed by soft-tissue swelling (51.3%), sequestration (47.3%), bone destruction (33.3%), and cortical erosion (30.3%). The mean agreement was 74.2%, showing a marked disagreement rate of 25.8% among all radiographic findings. The presence or absence of soft tissue edema, a prominent radiographic finding that was more important than the other findings, showed the greatest disagreement. CONCLUSIONS: Radiographic findings in CO were universally observed in all patients, demonstrating a high degree of concordance among specialists, with the exception of soft tissue swelling.

Digitalization and innovation in green ports: A review of current issues, contributions and the way forward in promoting sustainable ports and maritime logistics.

As a fundamental transportation mode, maritime logistics has become an indispensable component on a global scale. However, there are multiple drawbacks associated with ports operating in traditional ways, such as higher cost, lower efficiency and generating more environmental pollution. Digital technologies have been researched and implemented gradually in green ports, especially in data collection and real-time monitoring, and these advances help to promote higher work efficiency and reduce detrimental environmental impacts. It was found that green ports (e.g. ports of Raffina, Los Angeles, and Long Beach) generally perform better in energy conservation and pollutant emission reduction. However, considering the variability in the level of digitalization, there are challenges in achieving effective communications between individual ports. Therefore, to optimize and update green port practices, a systematic review is necessary to comprehensively analyze the beneficial contributions of green ports. This review adopted bibliometric analysis to examine the shipping framework focusing on green ports digitalization and innovation. After that, with regards to the bibliometric results, five aspects were analyzed, including environment, performance, policy, technology, and management. Besides, intelligent life-cycle management was systematically discussed to improve green ports and maritime logistics performance and sustainability in three aspects, namely waste discharge, shipping management system and green ports management. The findings revealed that green ports and maritime logistics require digital cooperation, transformation, and management to achieve sustainable development goals, including route selection and control of ships' numbers, weather prediction, and navigational effluent monitoring, albeit with some obstacles.