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Journal of the West African College of... 2023Mortality from peritonitis due to typhoid intestinal perforation (TIP) in sub-Saharan Africa is high.
BACKGROUND
Mortality from peritonitis due to typhoid intestinal perforation (TIP) in sub-Saharan Africa is high.
OBJECTIVES
This study aimed to determine the predictive factors of mortality, propose a prognostic score, and determine the appropriate surgical treatment for TIP in low-resource settings.
MATERIALS AND METHODS
This was a retrospective data collection of peritonitis due to TIP admitted at Zinder National Hospital from 2014 to 2021. To build a typhoid intestinal perforation prognostic score (TIPPS), patients were randomised into two groups: a score-building group and a validation group. Univariate and multivariate analyses were performed to identify risk factors of mortality. The value of <0.05 was assigned significant for all analyses.
RESULTS
TIP accounted for 52.4% ( = 1132) of all cases of peritonitis ( = 2159). The median age was 12 years. Rural provenance represented 72.2% ( = 817). Deaths accounted for 10.5% ( = 119). The factors influencing mortality were respiratory rate ≥24/min (odds ratio [OR] = 2.6, = 0.000), systolic blood pressure <90 mmHg (OR = 0.31, = 0.002), serum creatinine >20 mg/L (OR = 2.6, ≤ 0.009), haemoglobin (OR = 2.1, = 0.000), comorbidity (OR = 3.5, = 0.001), the American Society of Anesthesiologists score IV&V (OR = 3.3, = 0.000), admission and management delay > 72 h (OR = 3.2, = 0.001), and a number of perforations (OR = 2.4, = 0.0001). These factors were used to build a "TIPPS" score, which ranged from 8 to 20. The risk of mortality was associated with increased TIPPS. The performance of this score was good in the two groups (area under receiver operating characteristic > 0.83). According to the severity and mortality risk of TIP, we classified TIPS into four grades: grade I (low risk: 8-10), grade II (moderate risk: 11-13), grade III (high risk: 14-16) and grade IV (very high risk: 17-20).
CONCLUSION
The TIPPS is simple. It can describe the severity of the disease and can predict the risk of death. The study highlights the importance and impact of timely and adequate perioperative resuscitation in more complicated cases.
PubMed: 38449552
DOI: 10.4103/jwas.jwas_307_22 -
Heliyon Feb 2024Hochst. ex Endl. is an evergreen highland tree species reaching 30-40 m high and restricted to some mountainous areas. This tree is a species of great ecological and...
Hochst. ex Endl. is an evergreen highland tree species reaching 30-40 m high and restricted to some mountainous areas. This tree is a species of great ecological and economic significance in supporting biodiversity, preventing soil erosion, and providing valuable resources. The study aimed at comparing the provenances effect on growth and yield performance of a 16-years-old plantation. This long-term experiment included eleven provenances from different regions of Ethiopia. It was laid out in a randomized complete block design with four replicates. The plot size was 100 m with 2.5 m by 2.5 m spacing. Growth parameters such as height and diameter over a 1-m interval of standing trees were measured for sample trees. The results showed that the overall mean of basal area for 11 provenances was ranging from 4.4 ± 0.29 to 5.2 ± 0.33 m ha⁻. The biggest (11.3 ± 0.14 m) and smallest (9.8 ± 0.16 m) mean height was obtained in the provenances of Kolobo and Dikisis, respectively. The mean volume of the stem ranges from 12.3 ± 0.93 to 17.9 ± 1.1 m ha⁻. The highest and lowest form factor was obtained in the provenances of Gaynt (0.43 ± 0.02) and Hirna (0.32 ± 0.02), respectively. The generic form factor is 0.4 ± 0.01. Provenance Kolobo had the best growth rate in all growth stages with 1.4 m height greater than the poorest provenance Dikisis and 23% greater than the overall average volume (14.5 m ha⁻) at age of 16 years. The variations in growth and yield performance among the provenances could be attributed to genetic differences and adaptation to the local environment. Provenances originating from similar altitude such as Kolobo's provenances showed better growth and yield performance, possibly due to their adaptation to the cooler and wetter conditions prevailing in the study area. Choosing provenances that are well-adapted to the local site conditions can lead to improved productivity and economic returns.
PubMed: 38434040
DOI: 10.1016/j.heliyon.2024.e26514 -
International Journal of Population... 2023We set out to assess the impact of Choosing Wisely Canada recommendations (2014) on reducing unnecessary health investigations and interventions in primary care across...
INTRODUCTION
We set out to assess the impact of Choosing Wisely Canada recommendations (2014) on reducing unnecessary health investigations and interventions in primary care across Southwestern Ontario.
METHODS
We used the Deliver Primary Healthcare Information (DELPHI) database, which stores deidentified electronic medical records (EMR) of nearly 65,000 primary care patients across Southwestern Ontario. When conducting research using EMR data, data provenance (i.e., how the data came to be) should first be established. We first considered DELPHI data provenance in relation to longitudinal analyses, flagging a change in EMR software that occurred during 2012 and 2013. We attempted to link records between EMR databases produced by different software using probabilistic linkage and inspected 10 years of data in the DELPHI database (2009 to 2019) for data quality issues, including comparability over time.
RESULTS
We encountered several issues resulting from this change in EMR software. These included limited linkage of records between software without a common identifier; data migration issues that distorted procedure dates; and unusual changes in laboratory test and medication prescription volumes.
CONCLUSION
This study reinforces the necessity of assessing data provenance and quality for new research projects. By understanding data provenance, we can anticipate related data quality issues such as changes in EMR data over time-which represent a growing concern as longitudinal data analyses increase in feasibility and popularity.
Topics: Humans; Electronic Health Records; Primary Health Care; Ontario; Software; Data Accuracy
PubMed: 38425492
DOI: 10.23889/ijpds.v8i5.2177 -
PloS One 2024Modern healthcare has a sharp focus on data aggregation and processing technologies. Consequently, from a data perspective, a patient may be regarded as a timestamped...
Modern healthcare has a sharp focus on data aggregation and processing technologies. Consequently, from a data perspective, a patient may be regarded as a timestamped list of medical conditions and their corresponding corrective interventions. Technologies to securely aggregate and access data for individual patients in the quest for precision medicine have led to the adoption of Digital Twins in healthcare. Digital Twins are used in manufacturing and engineering to produce digital models of physical objects that capture the essence of device operation to enable and drive optimization. Thus, a patient's Digital Twin can significantly improve health data sharing. However, creating the Digital Twin from multiple data sources, such as the patient's electronic medical records (EMR) and personal health records (PHR) from wearable devices, presents some risks to the security of the model and the patient. The constituent data for the Digital Twin should be accessible only with permission from relevant entities and thus requires authentication, privacy, and provable provenance. This paper proposes a blockchain-secure patient Digital Twin that relies on smart contracts to automate the updating and communication processes that maintain the Digital Twin. The smart contracts govern the response the Digital Twin provides when queried, based on policies created for each patient. We highlight four research points: access control, interaction, privacy, and security of the Digital Twin and we evaluate the Digital Twin in terms of latency in the network, smart contract execution times, and data storage costs.
Topics: Humans; Blockchain; Delivery of Health Care; Privacy; Electronic Health Records; Health Records, Personal
PubMed: 38422025
DOI: 10.1371/journal.pone.0286120 -
PNAS Nexus Feb 2024Storms can have devasting effects on shorelines, causing flooding and the destruction of property and infrastructure. As global warming and the frequency and magnitude...
Storms can have devasting effects on shorelines, causing flooding and the destruction of property and infrastructure. As global warming and the frequency and magnitude of tropical storms increase, barrier islands comprising 10% of the world's coast may undergo significant change caused by beach erosion, loss of dunes, and formation of washovers and tidal inlets. Understanding how storms affect sediment transport at tidal inlets is an understudied subject that directly influences barrier island erosional-depositional processes and long-term sediment budgets. This study models hydrodynamics and sediment transport at a conceptualized mixed-energy, mesotidal inlet system using 10 synthetic storm tracks. We investigate the provenance and the role of various storm characteristics and timing between the peak storm surge and high tide on sediment fluxes for different grain sizes. We find that most storms (38 of 40) cause a net import of sediment into the basin that is sourced primarily from the updrift and downdrift nearshore and secondly from the ebb-delta. Very little sediment comes from inlet channel scour. Cumulative (net) transport correlates well with peak significant wave height because wave height influences bottom shear stresses and sediment suspension on the ebb-tidal delta and in the nearshore. The duration of the storm surge also correlates with net transport because it controls the period of flood-directed currents. Our findings help explain the formation of flood deltas inside tidal inlets and the formation of sand shoals in backbarrier regions. Storm-induced enlargement of these deposits represents a permanent long-term loss of sand from barrier islands that will lead to erosion.
PubMed: 38415221
DOI: 10.1093/pnasnexus/pgae042 -
Antioxidants (Basel, Switzerland) Feb 2024International provenance trials are a hot topic in forestry, and in light of climate change, the search for more resilient beech provenances and their assisted migration...
International provenance trials are a hot topic in forestry, and in light of climate change, the search for more resilient beech provenances and their assisted migration is one of the challenges of climate-smart forestry. The main aim of the study was to determine intraspecific variability in European beech ( L.) among 11 beech provenances according to total antioxidant capacities estimated by various assays, such as DPPH (2,2-diphenyl-1-picrylhydrazyl), ABTS (2,2'-azino-bis-(3-ethylbenzothiazoline-6-sulfonic) acid), FRAP (ferric reducing antioxidant power) assay, and radical scavenging capacity against nitric oxide (RSC-NO assays), as well as osmolyte content, primarily individual polyamines (putrescine, spermidine, and spermine), and free proline content. Polyamine amounts were quantified by using HPLC coupled with fluorescent detection after dansylation pretreatment. The highest values for radical scavenger capacity assays (ABTS, DPPH, and FRAP) were measured in the German provenances DE47 and DE49. Also, the highest NO inhibition capacity was found in the provenance DE49, while the highest content of proline (PRO), total phenolic content (TPC), and total flavonoid content (TFC) was recorded in DE47. The Austrian AT56 and German provenance DE49 were most abundant in total polyamines. This research underlines the importance of the application of common antioxidant assays as well as osmolyte quantification as a criterion for the selection of climate-ready beech provenances for sustainable forest management.
PubMed: 38397825
DOI: 10.3390/antiox13020227 -
Scientific Reports Feb 2024The diffuse presence of small copper ore deposits in the Alpine area, mostly exploited since Late Medieval times, led most scholars to assume that these deposits may...
The diffuse presence of small copper ore deposits in the Alpine area, mostly exploited since Late Medieval times, led most scholars to assume that these deposits may actually be active much earlier and that many of the circulating prehistoric metal objects found in the area were produced with local copper sources. This assumption was recently validated for the Recent Bronze Age through the use of lead isotope tracers, and well supported by the archaeometallurgical evidences found in the South-Eastern Alps. However, the scarcity of available lead isotope data for pre-Bronze Age metals precluded to date the reconstruction of the metal flow through the Late Neolithic and Eneolithic (or Copper Age). Based on 49 new analyses of important archaeological objects from the Alpine region, the Po River Valley and Central Italy, mostly axes dated from the Late Neolithic to the Late Eneolithic, here we show that the diffusion of copper in Northern Italy (approximately 4500-2200 BC) includes three major periods of metal use and/or production, each related to specific ore sources. The South Alpine copper was massively used only starting from the middle of the 3rd millennium BC, in connection or slightly earlier than the Beaker event.
PubMed: 38383590
DOI: 10.1038/s41598-024-54825-z -
Virus Evolution 2024Autonomously replicating alphasatellites (family Alphasatellitidae) are frequently associated with plant single-stranded (ss)DNA viruses of the families Geminiviridae,...
Autonomously replicating alphasatellites (family Alphasatellitidae) are frequently associated with plant single-stranded (ss)DNA viruses of the families Geminiviridae, Metaxyviridae, and Nanoviridae. Alphasatellites encode a single replication-initiator protein (Rep) similar to Rep proteins of helper viruses and depend on helper viruses for encapsidation, movement, and transmission. Costs versus benefits of alphasatellite-helper virus association are poorly understood. Our surveys in Southeast Asia (SEA) for wild and cultivated banana plants infected with banana bunchy top virus (BBTV, Nanoviridae) and Illumina sequencing reconstruction of their viromes revealed, in addition to a six-component BBTV genome, one to three distinct alphasatellites present in sixteen of twenty-four BBTV-infected plants. Comparative nucleotide and Rep protein sequence analyses classified these alphasatellites into four distinct species: two known species falling into the genus (subfamily Petromoalphasatellitinae) previously identified in SEA and two novel species falling into the tentative genus (subfamily Nanoalphasatellitinae) so far containing a single species recently identified in Africa. The banaphisatellites were found to be most related to members of the genus of subfamily Nanoalphasatellitinae and the genus of subfamily Geminialphasatellitinae, both infecting dicots. This suggests a dicot origin of banaphisatellites that got independently associated with distinct strains of monocot-infecting BBTV in Africa and SEA. Analysis of conserved sequence motifs in the common regions driving replication and gene expression of alphasatellites and BBTV strains revealed both differences and similarities, pointing at their ongoing co-evolution. An impact of alphasatellites on BBTV infection and evasion of RNA interference-based antiviral defences was evaluated by measuring relative abundance of BBTV genome components and alphasatellites and by profiling BBTV- and alphasatellite-derived small interfering RNAs. Taken together, our findings shed new light on the provenance of alphasatellites, their co-evolution with helper viruses, and potential mutual benefits of their association.
PubMed: 38361826
DOI: 10.1093/ve/vead076 -
BMC Genomics Feb 2024Pecan scab is a devastating disease that causes damage to pecan (Carya illinoinensis (Wangenh.) K. Koch) fruit and leaves. The disease is caused by the fungus Venturia...
Pecan scab is a devastating disease that causes damage to pecan (Carya illinoinensis (Wangenh.) K. Koch) fruit and leaves. The disease is caused by the fungus Venturia effusa (G. Winter) and the main management practice for controlling the disease is by application of fungicides at 2-to-3-week intervals throughout the growing season. Besides disease-related yield loss, application of fungicides can result in considerable cost and increases the likelihood of fungicide resistance developing in the pathogen. Resistant cultivars are available for pecan growers; although, in several cases resistance has been overcome as the pathogen adapts to infect resistant hosts. Despite the importance of host resistance in scab management, there is little information regarding the molecular basis of genetic resistance to pecan scab.The purpose of this study was to elucidate mechanisms of natural pecan scab resistance by analyzing transcripts that are differentially expressed in pecan leaf samples from scab resistant and susceptible trees. The leaf samples were collected from trees in a provenance collection orchard that represents the natural range of pecan in the US and Mexico. Trees in the orchard have been exposed to natural scab infections since planting in 1989, and scab ratings were collected over three seasons. Based on this data, ten susceptible trees and ten resistant trees were selected for analysis. RNA-seq data was collected and analyzed for diseased and non-diseased parts of susceptible trees as well as for resistant trees. A total of 313 genes were found to be differentially expressed when comparing resistant and susceptible trees without disease. For susceptible samples showing scab symptoms, 1,454 genes were identified as differentially expressed compared to non-diseased susceptible samples. Many genes involved in pathogen recognition, defense responses, and signal transduction were up-regulated in diseased samples of susceptible trees, whereas differentially expressed genes in pecan scab resistant samples were generally down-regulated compared to non-diseased susceptible samples.Our results provide the first account of candidate genes involved in resistance/susceptibility to pecan scab under natural conditions in a pecan orchard. This information can be used to aid pecan breeding programs and development of biotechnology-based approaches for generating pecan cultivars with more durable scab resistance.
Topics: Fungicides, Industrial; Carya; Transcriptome; Trees; Ascomycota; Plant Diseases; Plant Breeding
PubMed: 38355402
DOI: 10.1186/s12864-024-10010-0 -
Scientific Reports Feb 2024In forensic investigations involving the identification of unknown deceased individuals, isotope analysis can provide valuable provenance information. This is especially...
In forensic investigations involving the identification of unknown deceased individuals, isotope analysis can provide valuable provenance information. This is especially pertinent when primary identifiers (i.e., DNA, dactyloscopy, etc.) fail to yield matches. The isotopic composition of human tissues is linked to that of the food consumed, potentially allowing the identification of regions of origin. However, the isotopic composition of deceased newborns and infants fed with milk formula may be influenced by that of the prepared milk. The findings contribute towards the possibility to isotopically identify bottle-fed infants. More importantly, the data convincingly show that the Sr isotope composition of the prepared milk is determined by that of the formula and not the (local) tap water, thereby limiting the potential of Sr isotope analysis for determining the geological or geographical origin in formula-fed babies in medico-legal cases.
Topics: Animals; Humans; Infant; Infant, Newborn; Isotopes; Milk
PubMed: 38351055
DOI: 10.1038/s41598-024-54173-y