Normative Data of Liquid Gastric Emptying and Small-bowel Transit: A Prospective Cross-sectional Study.

Purpose of the Study: The primary objective was to establish the reference values for liquid gastric emptying and small bowel. The secondary objectives encompassed comparing the anterior view and geometric mean methods, assessing gender differences, and exploring potential correlations with age. Materials and Methods: Thirty-five consecutive healthy participants (28 females and 7 males) with a mean age of 42 ± 11 years (median, 42; range, 23-65) underwent liquid gastric emptying scintigraphy at five intervals (0, 0.5, 1, 2, and 4 h), with optional additional imaging at 24 h. Liquid gastric emptying was evaluated using percent retention and half-time (T1/2). Small-bowel transit was assessed using the index of small-bowel transit (ISBT), calculated as the ratio of terminal ileal reservoir counts to total abdominal counts at 4 h. Reference values were established based on percentiles or mean and standard deviation (SD). Rapid small-bowel transit was determined through visual inspection. Statistical analysis involved paired Samples t-test or Wilcoxon signed-rank test for comparing imaging methods, independent Samples t-test or Mann-Whitney U-test for gender comparison, and Spearman's rank correlation for assessing age-related associations. A 2-tailed P < 0.05 indicated significance. Results: Rapid liquid gastric emptying based on the geometric mean method was defined as percent retention <8% at 30 min, while delayed emptying as percent retention >33%, >20%, and >4% at 1, 2, and 4 h, respectively. The reference range of T1/2 of gastric emptying was 10-60 min. The reference value for small-bowel transit using the geometric mean method was established as ISBT >30% at 4 h, while rapid small-bowel transit was defined as the first visualization of activity in the cecum-ascending colon within 1 h. Parameters for liquid gastric emptying and small-bowel transit were notably higher in the anterior view method compared to the geometric mean method (P ≤ 0.019), except for percent retention at 2 h (P = 0.510). Nevertheless, the obtained reference values, whether based on percentiles or mean and SD, showed no notable variance between the two methods to warrant clinical significance. Gender did not display an impact on liquid gastric emptying or small-bowel transit in either method (P ≥ 0.173), and age demonstrated no significant moderate or strong correlations (Spearman's ρ ≤ 0.397). Conclusion: The study determined reference values for liquid gastric emptying and small-bowel transit through a standard gastric emptying scintigraphy protocol, avoiding additional complex procedures or extended imaging sessions. The established normative data can apply to individuals of both genders aged ≥18 years. While advocating the geometric mean method as the primary choice, the study acknowledges that in busy centers handling multiple studies with limited resources and a single-head gamma camera catering to multiple studies, the anterior view method remains a feasible alternative.

Clinical impact of novel CMR technology on patients with congenital heart disease. A scientific statement of the Association for European Pediatric and Congenital Cardiology (AEPC) and the European Association of Cardiovascular Imaging (EACVI) of the ESC.

Cardiovascular magnetic resonance (CMR) imaging is recommended in patients with congenital heart disease (CHD) in clinical practice guidelines as the imaging standard for a large variety of diseases. As CMR is evolving, novel techniques are becoming available. Some of them are already used clinically, whereas others still need further evaluation. In this statement the authors give an overview of relevant new CMR techniques for the assessment of CHD. Studies with reference values for these new techniques are listed in the supplement.

Preference for daily (1HP) vs. weekly (3HP) isoniazid-rifapentine among people living with HIV in Uganda.

BACKGROUND: Both 1 month of daily (1HP) and 3 months of weekly (3HP) isoniazid-rifapentine are recommended as short-course regimens for TB prevention among people living with HIV (PLHIV). We aimed to assess acceptability and preferences for 1HP vs. 3HP among PLHIV. METHODS: In a cross-sectional survey among PLHIV at an HIV clinic in Kampala, Uganda, participants were randomly assigned to a hypothetical scenario of receiving 1HP or 3HP. Participants rated their level of perceived intention and confidence to complete treatment using a 0-10 Likert scale, and chose between 1HP and 3HP. RESULTS: Among 429 respondents (median age: 43 years, 71% female, median time on ART: 10 years), intention and confidence were rated high for both regimens. Intention to complete treatment was rated at least 7/10 by 92% (189/206 randomized to 1HP) and 93% (207/223 randomized to 3HP). Respectively 86% (178/206) and 93% (208/223) expressed high confidence to complete treatment. Overall, 81% (348/429) preferred 3HP over 1HP. CONCLUSIONS: Both 1HP and 3HP were highly acceptable regimens, with 3HP preferred by most PLHIV. Weekly, rather than daily, dosing appears preferable to shorter duration of treatment, which should inform scale-up and further development of short-course regimens for TB prevention.

CONTEXTE: L'association isoniazide-rifapentine est recommandée comme traitement de courte durée pour la prévention de la TB chez les personnes vivant avec le VIH (PVVIH), à raison d'un mois de traitement quotidien (1HP) et de 3 mois de traitement hebdomadaire (3HP). Nous avons cherché à évaluer l'acceptabilité et les préférences des PVVIH pour le traitement 1HP par rapport au traitement 3HP. MÉTHODES: Dans le cadre d'une enquête transversale menée auprès de PVVIH dans une clinique VIH de Kampala, en Ouganda, les participants ont été assignés de manière aléatoire à un scénario hypothétique de réception de 1HP ou de 3HP. Les participants ont évalué leur niveau d'intention perçue et de confiance pour terminer le traitement en utilisant une échelle de Likert de 0 à 10 et ont choisi entre 1HP et 3HP. RÉSULTATS: Parmi les 429 répondants (âge médian : 43 ans, 71% de femmes, durée médiane de la thérapie antirétrovirale : 10 ans), l'intention et la confiance ont été jugées élevées pour les deux schémas. L'intention de terminer le traitement a été évaluée à au moins 7/10 par 92% (189/206 randomisés pour 1HP) et 93% (207/223 randomisés pour 3HP). Respectivement 86% (178/206) et 93% (208/223) ont exprimé une grande confiance dans le fait de terminer le traitement. Dans l'ensemble, 81% (348/429) ont préféré la 3HP à la 1HP. CONCLUSION: Les schémas 1HP et 3HP étaient tous deux très acceptables, le schéma 3HP étant préféré par la plupart des PVVIH. L'administration hebdomadaire, plutôt que quotidienne, semble préférable à une durée de traitement plus courte, ce qui devrait inspirer l'extension et le développement de schémas thérapeutiques de courte durée pour la prévention de la TB.

Normal ovarian sizes on MRI in pediatric patients: a preliminary study.

BACKGROUND: Ovarian enlargement is one of several findings of pathology, including ovarian torsion. With increasing use of MRI for acute abdominal pain in children, data for normal ovary size and appearance are needed. OBJECTIVE: To provide preliminary data on normal sizes of ovaries on MRI in pediatric patients. MATERIALS AND METHODS: This retrospective IRB-approved study included girls (5 to 17 years of age) with MRI examinations performed for indications not related to the ovaries from 2018 to 2022. For each MRI, coronal T2-weighted single shot fast spin echo and axial T2-weighted fat-saturated images were independently reviewed by three pediatric radiologists who recorded ovary visualization and ovarian linear measurements (3 planes). Ovarian volumes were calculated from linear measurements. Agreement among observers was calculated using kappa statistics and intraclass correlation coefficients. RESULTS: A total of 181 MRIs were reviewed. The left ovary was visualized in 166-176 (92-97%) cases (R1-R3) and the right ovary was visualized in 165-174 (91-96%) cases with excellent agreement among reviewers (left: K = 0.89 [0.84-0.94], right: K = 0.85 [0.79-0.91]). Interrater class coefficient (ICC) for largest single dimension of the ovary was left: 0.83 (CI 0.79-0.87) and right: 0.85 (CI 0.81-0.89). There were significant moderate to strong correlations between ovarian volume and age (left: 0.67 [0.58-0.75], right: 0.66 [0.57-0.74]). CONCLUSION: The ovaries can be adequately visualized and measured on MRI with excellent inter-reader agreement. This study serves as the foundation for developing normative values for ovarian volumes by age on MRI.

Reference intervals and percentiles for soluble transferrin receptor and sTfR/log ferritin index in healthy children and adolescents.

OBJECTIVES: Soluble transferrin receptor (sTfR) is a marker of both erythropoiesis and iron status and is considered useful for detecting iron deficiency, especially in inflammatory conditions, but reference intervals covering the entire pediatric age spectrum are lacking. METHODS: We studied 1,064 (48.5 % female) healthy children of the entire pediatric age spectrum to determine reference values and percentiles for sTfR and the ratio of sTfR to log-ferritin (sTfR-F index) using a standard immunoturbidimetric assay. RESULTS: Soluble TfR levels were highly age-specific, with a peak in infancy and a decline in adulthood, whereas the sTfR-F index was a rather constant parameter. There were positive linear relationships for sTfR with hemoglobin (Hb) (p=0.008) and transferrin (females p<0.001; males p=0.003). A negative association was observed between sTfR and ferritin in females (p<0.0001) and for transferrin saturation and mean corpuscular volume (MCV) in both sexes (both p<0.0001). We found a positive relationship between sTfR and body height, body mass index (BMI) and inflammatory markers (CrP p<0.0001; WBC p=0.0172), while sTfR-F index was not affected by inflammation. CONCLUSIONS: Soluble TfR values appear to reflect the activity of infant erythropoiesis and to be modulated by inflammation and iron deficiency even in a healthy cohort.

To be a midwife in Latvia - Midwives talking - Pilot study.

Introduction: For almost 20 years Latvia has been a member state of European Union. Accessible and constantly evolving information has led to a paradigm change in the woman - midwife relationship; nowadays, it should be horizontal - women's and her family orientated. The question is: how do the midwives perceive their professional identity, its core values, norms and beliefs in this new paradigm? Method and findings: Three interview rounds with 20 midwives were performed. Highlighted themes were asked to be explained in the next round of interview in order to compare them with authors' thematic analysis and formulated pre - understandings.The method of thematic analysis was used in frame of a pilot study to understand how practising midwives describe their professional identity.Eleven themes emerged and were categorised in three larger themes: integral part of midwife's professional identity - courage, patience, ability to provide intimacy, flexibility and creativity, the most beautiful profession; desirable part - the ability to evaluate yourself, the ability to draw boundaries, tolerance and acceptance of diversity, "go with the flow" - ability to allow physiological processes to take place, hindrances - struggle with bureaucratic norms and paperwork, struggle with the finances/salary. Conclusion: Within the present study midwives' voices have been conceptualised for the first time in Latvia. With the repeated reflection on their professional identity, midwives not only conceptualised it, but also let light shine on the shadowy side of its components.

Emerging priorities and concerns in the wake of the COVID-19 pandemic: qualitative and quantitative findings from a United States national survey.

Purpose: The present study examines how the coronavirus disease 2019 (COVID-19) experience affected values and priorities. Methods: This cross-sectional study collected data between January and April 2023, from 1,197 individuals who are chronically ill or part of a general population sample. Using open-ended prompts and closed-ended questions, we investigated individuals' perceptions about COVID-19-induced changes in what quality of life means to them, what and who are important, life focus, and changes in norms and stressors. Data analyses included content and psychometric analysis, leading to latent profile analysis (LPA) to characterize distinct groups, and analysis of variance and chi-squared to compare profile groups' demographic characteristics. Results: About 75% of the study sample noted changes in values and/or priorities, particularly in the greater prominence of family and friends. LPA yielded a four-profile model that fit the data well. Profile 1 (Index group; 64% of the sample) had relatively average scores on all indicators. Profile 2 (COVID-Specific Health & Resignation to Isolation Attributable to COVID-19; 5%) represented COVID-19-specific preventive health behaviors along with noting the requisite isolation and disengagement entailed in the social distancing necessary for COVID-19 prevention. Profile 3 (High Stress, Low Trust; 25%) represented high multi-domain stress, with the most elevated scores both on focusing on being true to themselves and perceiving people to be increasingly uncivil. Profile 4 (Active in the World, Low Trust; 6%) was focused on returning to work and finding greater meaning in their activities. These groups differed on race, marital status, difficulty paying bills, employment status, number of times they reported having had COVID-19, number of COVID-19 boosters received, whether they had Long COVID, age, BMI, and number of comorbidities. Conclusion: Three years after the beginning of the worldwide COVID-19 pandemic, its subjective impact is notable on most study participants' conceptualization of quality of life, priorities, perspectives on social norms, and perceived stressors. The four profile groups reflected distinct ways of dealing with the long-term effects of COVID-19.

Evaluating the properties that affect the quality of the charcoal product, determining the limits of toxic emissions during combustion, and studying their impact on human health.

This research focuses on examining the potential impact of charcoal briquettes and lumps on human health due to the emissions they release, and verifying their quality standards. Quality assessment was conducted using a device capable of measuring toxic gases to identify contaminants from various sources such as biomass, synthetic resins, coal, metals, and mineral matter. Toxicity assessments were carried out on five types of briquettes and two varieties of lump charcoal. All charcoal samples were subjected to elemental analysis (SEM/EDAX), including the examination of Ca, Al, Cr, V, Cu, Fe, S, Sr, Si, Ba, Pb, P, Mn, Rb, K, Ti, and Zn. The results showed that burning lump charcoal had toxicity indexes ranging from 2.5 to 5, primarily due to NOx emissions. Briquettes, on the other hand, exhibited higher toxicity indices between 3.5 and 6.0, with CO2 being the main contributor to toxicity. The average 24-h CO content of all charcoal samples exceeded the World Health Organization's 24-h Air Quality Guideline of 6.34 ppm, with a measurement of 37 ppm. The data indicates that most of the products tested did not meet the prevailing quality standard (EN 1860-2:2005 (E) in Appliances, solid fuels and firelighters for barbecuing-Part 2: Barbecue charcoal and barbecue charcoal briquettes-Requirements and test method, 2005), which specifies a maximum of 1% contaminants, with some products containing as much as 21% impurities. The SEM analysis revealed irregularly shaped grains with an uneven distribution of particles, and the average particle size distribution is quite broad at 5 µm. Malaysia Charcoal had the highest calorific value at 32.80 MJ/Kg, with the value being influenced by the fixed carbon content-higher carbon content resulting in a higher calorific value.

A retrospective analysis of the influencing factors of nucleic acid CT value fluctuation in COVID-19 patients infected with Omicron variant virus in Changchun city.

Objective: This study aimed to determine the risk factors associated with fluctuations in nucleic acid CT values in patients infected with the Omicron variant during an outbreak at a hospital in Changchun city. Methods: A retrospective analysis was conducted on general information, medical history, vaccination history, and laboratory test data of COVID-19 patients infected with the Omicron variant and admitted to the hospital in Changchun from March 2022 to April 2022. The study aimed to explore the factors influencing nucleic acid CT value fluctuations in COVID-19 patients infected with the Omicron variant in Changchun city. Results: Fluctuations in nucleic acid CT values were significantly correlated with occupation composition (p = 0.030), hospital stay duration (p = 0.000), heart rate (p = 0.026), creatinine (p = 0.011), platelet count (p = 0.000), glutamic-pyruvic transaminase (p = 0.045), and glutamic oxaloacetic transaminase (p = 0.017). Binary logistic regression analysis revealed significant correlations between hospital stay duration (p = 0.000), platelet count (p = 0.019), heart rate (p = 0.036), and nucleic acid CT value fluctuations (p < 0.05), indicating that they were independent risk factors. Red blood cell count was identified as a factor influencing nucleic acid CT value fluctuations in Group A patients. Occupation composition, direct bilirubin, and platelet count were identified as factors influencing nucleic acid CT value fluctuations in Group B patients. Further binary logistic regression analysis indicated that occupational composition and direct bilirubin are significant independent factors for nucleic acid CT value fluctuations in Group B patients, positively correlated with occupational risk and negatively correlated with direct bilirubin. Conclusion: Therefore, enhancing patients' immunity, increasing physical exercise to improve myocardial oxygen consumption, reducing the length of hospital stays, and closely monitoring liver function at the onset of hospitalization to prevent liver function abnormalities are effective measures to control fluctuations in nucleic acid CT values.

Optimising desired gain indices to maximise selection response.

Introduction: In plant breeding, we often aim to improve multiple traits at once. However, without knowing the economic value of each trait, it is hard to decide which traits to focus on. This is where "desired gain selection indices" come in handy, which can yield optimal gains in each trait based on the breeder's prioritisation of desired improvements when economic weights are not available. However, they lack the ability to maximise the selection response and determine the correlation between the index and net genetic merit. Methods: Here, we report the development of an iterative desired gain selection index method that optimises the sampling of the desired gain values to achieve a targeted or a user-specified selection response for multiple traits. This targeted selection response can be constrained or unconstrained for either a subset or all the studied traits. Results: We tested the method using genomic estimated breeding values (GEBVs) for seven traits in a bread wheat (Triticum aestivum) reference breeding population comprising 3,331 lines and achieved prediction accuracies ranging between 0.29 and 0.47 across the seven traits. The indices were validated using 3,005 double haploid lines that were derived from crosses between parents selected from the reference population. We tested three user-specified response scenarios: a constrained equal weight (INDEX1), a constrained yield dominant weight (INDEX2), and an unconstrained weight (INDEX3). Our method achieved an equivalent response to the user-specified selection response when constraining a set of traits, and this response was much better than the response of the traditional desired gain selection indices method without iteration. Interestingly, when using unconstrained weight, our iterative method maximised the selection response and shifted the average GEBVs of the selection candidates towards the desired direction. Discussion: Our results show that the method is an optimal choice not only when economic weights are unavailable, but also when constraining the selection response is an unfavourable option.

How do emotions respond to outcome values and influence choice?

Emotions powerfully, predictably, and pervasively influence decision making. The risk-as-feelings hypothesis states that two kinds of emotions are important in decision-making, anticipatory emotions and anticipated emotions. We empirically investigated whether and how anticipatory and anticipated emotions may change as a function of outcome values and whether anticipatory or anticipated emotions may explain the influence of outcome values on risky choice. To study the effects of value on emotions and choice, we offered people hypothetical large amounts ($100, $200, $300, $400) and incentivized moderate amounts ($10, $20, $30, $40) as prospects in gambles over two consecutive studies. Using a representative sample from the US to ensure the generalizability of the findings, each participant in our two studies made choices in gain and loss domains. Overall, anticipatory and anticipated emotions responded very similarly to changes in value for the sure gains in both studies. The findings also indicated that both anticipatory and anticipated emotions explained the effects of the value on choice for the sure gain and sure losses, while both mediated the effect of framing on choice towards the sure and the gamble option. Although anticipatory emotions mediated a larger portion of the effect, anticipated emotions also show some mediation.

The biological variation of insulin resistance markers: data from the European Biological Variation Study (EuBIVAS).

OBJECTIVES: An insulin resistant state is characteristic of patients with type 2 diabetes, polycystic ovary syndrome, and metabolic syndrome. Identification of insulin resistance (IR) is most readily achievable using formulae combining plasma insulin and glucose results. In this study, we have used data from the European Biological Variation Study (EuBIVAS) to examine the biological variability (BV) of IR using the Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) and the Quantitative Insulin sensitivity Check Index (QUICKI). METHODS: Ninety EuBIVAS non-diabetic subjects (52F, 38M) from five countries had fasting HOMA-IR and QUICKI calculated from plasma glucose and insulin samples collected concurrently on 10 weekly occasions. The within-subject (CVI) and between-subject (CVG) BV estimates with 95 % CIs were obtained by CV-ANOVA after analysis of trends, variance homogeneity and outlier removal. RESULTS: The CVI of HOMA-IR was 26.7 % (95 % CI 25.5-28.3), driven largely by variability in plasma insulin and the CVI for QUICKI was 4.1 % (95 % CI 3.9-4.3), reflecting this formula's logarithmic transformation of glucose and insulin values. No differences in values or BV components were observed between subgroups of men or women below and above 50 years. CONCLUSIONS: The EuBIVAS, by utilising a rigorous experimental protocol, has produced robust BV estimates for two of the most commonly used markers of insulin resistance in non-diabetic subjects. This has shown that HOMA-IR, in particular, is highly variable in the same individual which limits the value of single measurements.

Linked shrinkage to improve estimation of interaction effects in regression models.

Objectives: The addition of two-way interactions is a classic problem in statistics, and comes with the challenge of quadratically increasing dimension. We aim to a) devise an estimation method that can handle this challenge and b) to aid interpretation of the resulting model by developing computational tools for quantifying variable importance. Methods: Existing strategies typically overcome the dimensionality problem by only allowing interactions between relevant main effects. Building on this philosophy, and aiming for settings with moderate n to p ratio, we develop a local shrinkage model that links the shrinkage of interaction effects to the shrinkage of their corresponding main effects. In addition, we derive a new analytical formula for the Shapley value, which allows rapid assessment of individual-specific variable importance scores and their uncertainties. Results: We empirically demonstrate that our approach provides accurate estimates of the model parameters and very competitive predictive accuracy. In our Bayesian framework, estimation inherently comes with inference, which facilitates variable selection. Comparisons with key competitors are provided. Large-scale cohort data are used to provide realistic illustrations and evaluations. The implementation of our method in RStan is relatively straightforward and flexible, allowing for adaptation to specific needs. Conclusions: Our method is an attractive alternative for existing strategies to handle interactions in epidemiological and/or clinical studies, as its linked local shrinkage can improve parameter accuracy, prediction and variable selection. Moreover, it provides appropriate inference and interpretation, and may compete well with less interpretable machine learners in terms of prediction.

Comparison of synthesized and acquired high b-value diffusion-weighted MRI for detection of prostate cancer.

BACKGROUND: High b-value diffusion-weighted images (DWI) are used for detection of clinically significant prostate cancer (csPCa). This study qualitatively and quantitatively compares synthesized DWI (sDWI) to acquired (aDWI) for detection of csPCa. METHODS: One hundred fifty-one consecutive patients who underwent prostate MRI and biopsy were included in the study. Axial DWI with b = 0, 500, 1000, and 2000 s/mm2 using a 3T clinical scanner using a 32-channel phased-array body coil were acquired. We retrospectively synthesized DWI for b = 2000 s/mm2 via extrapolation based on mono-exponential decay, using b = 0 and b = 500 s/mm2 (sDWI500) and b = 0, b = 500 s/mm2, and b = 1000 s/mm2 (sDWI1000). Differences in signal intensity between sDWI and aDWI were evaluated within different regions of interest (prostate alone, prostate plus 5 mm, 30 mm and 70 mm margin and full field of view). The maximum DWI value within each ROI was evaluated for prediction of csPCa. Classification accuracy was compared to Restriction Spectrum Imaging restriction score (RSIrs), a previously validated biomarker based on multi-exponential DWI. Discrimination of csPCa was evaluated via area under the receiver operating characteristic curve (AUC). RESULTS: Within the prostate, mean ± standard deviation of percent mean differences between sDWI and aDWI signal were -46 ± 35% for sDWI1000 and -67 ± 24% for sDWI500. AUC for aDWI, sDWI500, sDWI1000, and RSIrs within the prostate 0.62[95% confidence interval: 0.53, 0.71], 0.63[0.54, 0.72], 0.65[0.56, 0.73] and 0.78[0.71, 0.86], respectively. CONCLUSION: sDWI is qualitatively comparable to aDWI within the prostate. However, hyperintense artifacts are introduced with sDWI in the surrounding pelvic tissue that interfere with quantitative cancer detection and might mask metastases. In the prostate, RSIrs yields superior quantitative csPCa detection than sDWI or aDWI.

Comparative macroanatomical and scanning electron microscopy study of the eyeball in brachycephalic and mesocephalic dog breeds.

The anatomical structures forming the eyeball differ among dog breeds, both morphologically and morphometrically. This study was aimed at determining the morphometric values of the eyeball layers of different dog breeds and the morphological structures of these layers using scanning electron microscopy. Thirty-two eyeballs of 17 dogs belonging to 9 different breeds that died from traffic accidents, falling from a height, and naturally were used. These dog breeds were grouped according to their brachycephalic and mesocephalic skull structures, and morphometric measurements of the eyeballs of each group were obtained. Scanning electron microscopy was used to examine the morphological structure of the eyeball layers. The studied dogs' eyeballs comprised three layers: outer, middle, and inner. Thickness measurements obtained from three different regions of the eyeball indicated that the equatorial region was the thinnest among all dog breeds. Moreover, the cornea, which is covered by the sclera along its edges, was thicker at the corneal limbus than at the corneal vertex. A positive correlation was observed between lens thickness and the number of ciliary processes, which varied according to the dogs' head structures. Notably, depression was observed in the posterior surface of the lens in brachycephalic dogs. The morphometric values of the eyeball layers in the brachycephalic and mesocephalic dog breeds were also determined. These values will help researchers study this subject, and the determined morphometric and morphological values will contribute to the anatomy literature. RESEARCH HIGHLIGHTS: This comprehensive study investigates the morphometric and morphological variations in the eyeball layers of different dog breeds, utilizing scanning electron microscopy to analyze eyeballs. It reveals significant breed-specific differences, particularly between brachycephalic and mesocephalic dogs, regarding eyeball layer thickness, corneal structure, lens thickness, and the number of ciliary processes.

Evaluation of a Pharmacist-Led Personal Continuous Glucose Monitor Workflow to Improve Glycemic Management in an Internal Medicine Clinic.

The use of personal continuous glucose monitors (CGMs) in patients with diabetes has increased significantly and is expected to continue to increase as CGMs become more affordable and insurance plans improve coverage. The utilization of CGMs has improved diabetes management and reduced hypoglycemic events. A pharmacist-led personal CGM workflow was created to evaluate the impact on glycemic management in patients with diabetes. This was a prospective, investigator-initiated pilot study conducted at an Atrium Health Internal Medicine clinic over 28 weeks. In this pilot, 42 patients were qualifying candidates with diabetes and personal CGM use. Additionally, 30 patients were followed until study completion and included into final analysis. The average baseline A1c was reduced from 8.3% to 7.1% over a 3 - 6 month period. The pharmacist-led CGM workflow revealed a statistically significant reduction in A1c from baseline by an average of 1.2% (95% CI, -0.6 - -1.8; P = 0.0006). On average, patients were enrolled for 19.9 weeks and had an average of 5 visits during this time. During the study duration, 100 medications changes were implemented under the existing Clinical Pharmacist Practitioner (CPP) agreement between the pharmacists and the provider. The implementation of the CGM workflow led to one less diabetes related hospitalization. Overall, 58 CPT 95251 codes were billed yielding $7,052.00 in billed CGM services for the clinic. This project generated 40.6 provider relative value units (RVUs). The utilization of a pharmacist-led personal CGM workflow can improve diabetes outcomes.

Health state utility values in patients with Ankylosing Spondylitis: a systematic review and meta-analysis.

INTRODUCTION: Ankylosing spondylitis (AS) is a chronic condition that requires lifelong treatment and results in a serious disease burden. Health state utility values (HSUVs) are a valuable tool for quantifying this burden and conducting cost-utility analysis. OBJECTIVE: We conducted a systematic review and meta-analysis to obtain estimates of HSUVs in patients with AS, explored potential sources of heterogeneity, and compared pooled patient HSUVs with population norms. METHOD: We searched PubMed, Embase, Web of science, Cochrane database and Scopus until July, 2023 to obtain eligible studies. The methodological quality of the included studies was assessed using the ROBINS-I checklist. RESULTS: Forty-two publications involving 11,354 participants were included in this systematic review. The most commonly used instrument is the EQ-5D (38 studies). The estimated HSUVs for patients with AS from all available studies was pooled as 0.62 (95% CI 0.59 to 0.65). The pooled mean utility estimates from the random effects meta-analysis for SF-6D, EQ-5D-3L, EQ-5D-5L, and HUI3 were 0.65 (95% CI 0.62,0.68), 0.63 (95% CI 0.59,0.66), 0.60 (95% CI 0.42,0.79), and 0.48 (95% CI 0.43,0.53), respectively. For the EQ-5D-3L we conducted stratified meta-analyses and meta-regression based on key subgroups. The pooled estimates of EQ-5D-3L were lower for patients published before 2010, with high disease activity, long duration of disease, and in developed countries. CONCLUSION: Pooled estimates of HSUVs for people with AS were substantially lower than population norms. These estimates provide robust evidence that can inform the economic evaluation of new therapies for individuals with AS.

A Multi-Method Study Examining the Role of Swiping on Dating Apps: Mate Value Preferences, Sexual Satisfaction, and Need Satisfaction with Matches in Emerging Adults.

Intrinsic (i.e., personality traits) and extrinsic mate value (i.e., resources, physical attractiveness) preferences play a crucial role in (online) relationship formation. The role of mate values in dating applications was unclear and was addressed in a multi-method study. A first content analytical study examined the prevalence of mate values (MVs) on Tinder profiles (Study 1) and two subsequent cross-sectional studies explored the relationships between dating app use, various swiping behaviors, sexual satisfaction (Studies 2-3), need satisfaction with matches (Study 3), having a committed relationship versus casual sex motivation for using dating apps and users' gender. The content analysis of 307 Tinder profiles indicated that resources and physical attractiveness were most salient in biographies and pictures, respectively. The first cross-sectional study (nfullsample = 325, ndating app users = 133) revealed no significant relationships between dating app frequency/swiping frequency, intrinsic and extrinsic MV preferences, and sexual satisfaction. The second cross-sectional study (n = 323) showed no significant relationships between picture-based or biography-based swiping, intrinsic and extrinsic MV preferences, and need satisfaction with matches. Gender differences emerged in the presentation of MVs on Tinder (Study 1) and general MV preferences (Study 2-3), but not in the relationships between different types of dating app use/swiping and MV preferences (Study 2-3). A committed relationship and a casual sex motivation played a role in the relationships between different types of swiping behaviors and MV preferences, and between MV preferences, and sexual satisfaction/need satisfaction with matches.

African swine fever virus DNA is present in non-biting flies collected from outbreak farms in Romania.

BACKGROUND: African swine fever (ASF) is a highly contagious and severe haemorrhagic disease of Suidae, with mortalities that approach 100 percent. Several studies suggested the potential implication of non-biting dipterans in the spread of ASFV in pig farms due to the identification of the ASFV DNA. However, to our knowledge, no study has evaluated the viral DNA load in non-biting dipterans collected in outbreak farms and no risk factors have been analysed. In this context, our study aimed to analyse the risk factors associated with the presence of non-biting dipterans collected from ASF outbreaks in relation to the presence and load of viral DNA. METHODS: Backyard farms (BF), type A farms (TAF), and commercial farms (CF), were targeted for sampling in 2020. In 2021, no BF were sampled. Each farm was sampled only once. The identification of the collected flies to family, genus, or species level was performed based on morphological characteristics using specific keys and descriptions. Pools were made prior to DNA extraction. All extracted DNA was tested for the presence of the ASFV using a real-time PCR protocol. For this study, we considered every sample with a CT value of 40 as positive. The statistical analysis was performed using Epi Info 7 software (CDC, USA). RESULTS: All collected non-biting flies belonged to five families: Calliphoridae, Sarcophagidae, Fanniidae, Drosophilidae, and Muscidae. Of the 361 pools, 201 were positive for the presence of ASFV DNA. The obtained CT values of the positive samples ranged from 21.54 to 39.63, with a median value of 33.59 and a mean value of 33.56. Significantly lower CT values (corresponding to higher viral DNA load) were obtained in Sarcophagidae, with a mean value of 32.56; a significantly higher number of positive pools were noticed in August, mean value = 33.12. CONCLUSIONS: Our study brings compelling evidence of the presence of the most common synanthropic flies near domestic pig farms carrying ASFV DNA, highlighting the importance of strengthening the biosecurity measures and protocols for prevention of the insect life cycle and distribution.