Performance of non-invasive bedside vascular testing in the prediction of wound healing or amputation among people with foot ulcers in diabetes: A systematic review.

INTRODUCTION: The presence of peripheral artery disease (PAD) confers a significantly increased risk of failure to heal and major lower limb amputation for people with diabetes-related foot ulcer (DFU). Determining performance of non-invasive bedside tests for predicting likely DFU outcomes is therefore key to effective risk stratification of patients with DFU and PAD to guide management decisions. The aim of this systematic review was to determine the performance of non-invasive bedside tests for PAD to predict DFU healing, healing post-minor amputation, or need for minor or major amputation in people with diabetes and DFU or gangrene. METHODS: A database search of Medline and Embase was conducted from 1980 to 30 November 2022. Prospective studies that evaluated non-invasive bedside tests in patients with diabetes, with and without PAD and foot ulceration or gangrene to predict the outcomes of DFU healing, minor amputation, and major amputation with or without revascularisation, were eligible. Included studies were required to have a minimum 6-month follow-up period and report adequate data to calculate the positive likelihood ratio (PLR) and negative likelihood ratio for the outcomes of DFU healing, and minor and major amputation. Methodological quality was assessed using the Quality in Prognosis Studies tool. RESULTS: From 14,820 abstracts screened 28 prognostic studies met the inclusion criteria. The prognostic tests evaluated by the studies included: ankle-brachial index (ABI) in 9 studies; ankle pressures in 10 studies, toe-brachial index in 4 studies, toe pressure in 9 studies, transcutaneous oxygen pressure (TcPO2 ) in 7 studies, skin perfusion pressure in 5 studies, continuous wave Doppler (pedal waveforms) in 2 studies, pedal pulses in 3 studies, and ankle peak systolic velocity in 1 study. Study quality was variable. Common reasons for studies having a moderate or high risk of bias were poorly described study participation, attrition rates, and inadequate adjustment for confounders. In people with DFU, toe pressure ≥30 mmHg, TcPO2 ≥25 mmHg, and skin perfusion pressure of ≥40 mmHg were associated with a moderate to large increase in pretest probability of healing in people with DFU. Toe pressure ≥30 mmHg was associated with a moderate increase in healing post-minor amputation. An ABI using a threshold of ≥0.9 did not increase the pretest probability of DFU healing, whereas an ABI <0.5 was associated with a moderate increase in pretest probability of non-healing. Few studies investigated amputation outcomes. An ABI <0.4 demonstrated the largest increase in pretest probability of a major amputation (PLR ≥10). CONCLUSIONS: Prognostic capacity of bedside testing for DFU healing and amputation is variable. A toe pressure ≥30 mmHg, TcPO2 ≥25 mmHg, and skin perfusion pressure of ≥40 mmHg are associated with a moderate to large increase in pretest probability of healing in people with DFU. There are little data available evaluating the prognostic capacity of bedside testing for healing after minor amputation or for major amputation in people with DFU. Current evidence suggests that an ABI <0.4 may be associated with a large increase in risk of major amputation. The findings of this systematic review need to be interpreted in the context of limitations of available evidence, including varying rates of revascularisation, lack of post-revascularisation bedside testing, and heterogenous subpopulations.

Association of single nucleotide polymorphism in NLRC3, NLRC5, HIP1, and LRP8 genes with fecal egg counts in goats naturally infected with Haemonchus contortus.

Haemonchus contortus is a common, intractably pathogenic and economically important gastrointestinal nematode for goat producers worldwide, especially in tropical and subtropical regions. The objective of this study is to identify single nucleotide polymorphisms (SNPs) of 12 candidate goat genes mainly related to the innate immune response associated with fecal egg counts (FECs) of Haemonchus contortus in goat as an indicator of the level of parasite infection. Phenotypic data including FEC and blood traits were recorded in 189 native goats from China and 191 ones from Bangladesh, respectively. Bangladeshi goats had significantly (P < 0.01) lower FEC compared to that of Chinese goats, suggesting higher susceptible and infection rates in Chinese goat populations. FEC was significantly positive correlated with body weight (r = 0.64, P < 0.01) and hemoglobin (r = 0.49, P < 0.01) value, but negative with pack cell volume (r = - 0.63, P < 0.05) in goats. Genotyping of SNPs was performed using a matrix-assisted laser desorption ionization time of flight mass spectrometry assay and a generalized linear model was used to evaluate the association between each SNP and goat FEC trait. Eleven novel SNPs in the NLRC3, NLRC5, HIP1, and LRP8, out of 46 variants from these 12 genes, were significantly associated with FEC of goats with a nominal significance level of P < 0.05. Of these 11 SNPs, linkage disequilibrium were revealed among SNPs in LRP8 (r2 = 0.87 to 1), between SNPs in NLRC3, NLRC5, and HIP1 (r2 = 0.96 to 0.99), respectively. Further, haplotypes within NLRC3, NLRC5, and HIP1 were significantly associated (P < 0.001) with FEC. In artificial challenge trail, quantitative real-time PCR exposed that the relative expression of mRNA was higher in the resistant group for NLRC3 (P < 0.01), LRP8 and HIP1 (P < 0.001) but lower in the resistant group for NLRC5 (P < 0.0001), compared to the susceptible group. The possible SNP markers and genes identified in this study could be potentially used in marker-assisted selection for breeding local goats breeds resistant to gastrointestinal nematode parasite particularly for Haemonchus contortus, and then for improving health and productivity of goat.

Single nucleotide polymorphisms in candidate genes are significantly associated with resistance to Haemonchus contortus infection in goats.

BACKGROUND: Haemonchosis is a major economic problem in goat production in humid, tropical and subtropical regions. The disease is caused by an abomasal nematode, Haemonchus contortus, which is highly pathogenic in small ruminants. The aim of this study was to identifying single-nucleotide polymorphisms (SNP) that were associated with fecal egg counts (FEC) and could be used as markers to identify resistance to H. contortus in goats. RESULTS: Ten novel variants in the CIITA, ATP2A3, HSPA8, STAT5B, ESYT1, and SERPING1 genes were associated with FEC in goats with a nominal significance level of P < 0.05. Two missense mutation in the exon region of the caprine CIITA gene resulted in replacement of arginine with cysteine at position 9473550 (R9473550C) and aspartic acid with glutamic acid at position 9473870 (D9473870E). Chinese goat breeds had significantly higher FEC than Bangladeshi goat breeds within their respective genotypes. Polymorphism information content (PIC), effective allele number (Ne), and heterozygosity (He) were greatest for the STAT5B_197_A > G SNP locus in all goat breeds. Pairwise coefficients of linkage disequilibrium (D´, r 2) revealed complete LD (r 2 = 1) between significant SNP polymorphisms in CIITA and SERPING1 and strong LD (r 2 = 0.93 and 0.98) between polymorphisms in HSPA8 and ATP2A3, respectively. Correlation coefficient (r) between FEC and body weight (BW) was significantly positive (r = 0.56***, P < 0.001) but that between FEC and packed cell volume (PCV) was negatively significant (r = - 0.47**, P < 0.01) in the total population of goats. On the other hand, correlation coefficient (r) between BW and PCV was not significant in total population of goats. Association analysis revealed that haplotypes within ATP2A3, HSPA8, and SERPING1 were significantly associated with FEC. Quantitative real-time PCR revealed that the relative expression of mRNA was higher (P < 0.001) for resistant, compared to susceptible, groups of goats for all candidate genes except CIITA. CONCLUSIONS: This study identified SNP markers that can potentially be used in marker-assisted selection programs to develop goat breeds that are resistant to H. contortus.

Relative resistance of Menz and Washera sheep breeds to artificial infection with Haemonchus contortus in the highlands of Ethiopia.

The aim of this study was to evaluate the relative resistance of Menz and Washera sheep breeds to artificial infection with Haemonchus contortus. The challenge trial was conducted at the Debre Berhan Agricultural Research Center in Ethiopia. A total of 39 (Menz = 21, Washera = 18) lambs of about 6 months old were used for the trial. All lambs were initially treated against internal parasite using albendazole and Fasinex to free them from internal parasites and kept indoors. H. contortus third-stage larvae (L3) were prepared according to standard procedure from adult female parasite collected from abattoirs and recovered using the Baerman technique. Approximately 5000 infective larvae were inoculated to the experimental lambs at about 5 weeks after deworming. Fecal egg count (FEC), packed cell volume (PCV), FAffa MAlan CHArt (FAMACHA) score, lamb body weight, and survival of lambs were recorded at 28, 35, and 42 days after challenge. Breed effect was not significant (P > 0.05), whereas time of measurement and the interaction of breed and time had significant (P < 0.05) effects on FEC and PCV. At 28 days after challenge, Menz sheep had lower FEC than Washera sheep, whereas at days 35 and 42, the Washera sheep had lower FEC than Menz lambs. The PCV decreased significantly throughout the post-challenge period. Despite their parasite burden, Menz sheep were able to maintain live weight during the 42 days of challenge. Chi-square tests for breed differences in lamb survival were not significant at any time (28, 35, and 42 days after challenge). Lower FEC at 28 days and delayed rise in FEC after infection in Menz lamb would allow in delaying anthelmintic treatment. In addition to maintain body weights during the infection period, sheep of both breeds exhibited substantial variability in PCV and FEC, suggesting opportunity to consider parasite resistance in selection program.

Effects of load on good morning kinematics and EMG activity.

Many strength and conditioning coaches utilize the good morning (GM) to strengthen the hamstrings and spinal erectors. However, little research exists on its electromyography (EMG) activity and kinematics, and how these variables change as a function of load. The purpose of this investigation was to examine how estimated hamstring length, integrated EMG (IEMG) activity of the hamstrings and spinal erectors, and kinematics of the lumbar spine, hip, knee, and ankle are affected by changes in load. Fifteen trained male participants (age = 24.6 ± 5.3 years; body mass = 84.7 ± 11.3 kg; height = 180.9 ± 6.8 cm) were recruited for this study. Participants performed five sets of the GM, utilizing 50, 60, 70, 80, and 90% of one-repetition maximum (1RM) in a randomized fashion. IEMG activity of hamstrings and spinal erectors tended to increase with load. Knee flexion increased with load on all trials. Estimated hamstring length decreased with load. However, lumbar flexion, hip flexion, and plantar flexion experienced no remarkable changes between trials. These data provide insight as to how changing the load of the GM affects EMG activity, kinematic variables, and estimated hamstring length. Implications for hamstring injury prevention are discussed. More research is needed for further insight as to how load affects EMG activity and kinematics of other exercises.

Identification of fungi on diseased soybean seeds harvested during a high rainfall period in Mato Grosso do Sul, Brazil / Identificação de fungos em sementes doentes de soja colhidas durante um período de intensa precipitação pluviométrica em Mato Grosso do Sul, Brasil

The aim of this work was to evaluate the incidence of several genera of fungi on soybean seeds harvested duringa period of high rainfall in Mato Grosso do Sul, Brazil. Agronomic trait means from 110 plants were determined from data obtained at the time of harvest. From the seeds obtained, 800 were selected that showed discoloration of the tegument, with or without visible fungal colonies. Half of the seeds were superficially disinfected by immersion in a 1% sodium hypochlorite solution for 3 minutes, and all 800 seeds were then incubated to stimulate fungal growth. A modified blotter-test method was used in which 25 seeds were deposited on filter paper placed in a germination box, and a saturated NaCl solution (-1,0MPa) was used to inhibit germination of the seeds. After incubation for 7 days at 25ºC, fungal growth was inspected using optical and stereoscopic microscopes to identify the genera of the fungi present on the basis of their morphologies. On average, there were 50,3 pods per plant, 2,0 seeds per pod, and 31,7 visibly diseased seeds per soybean plant. The mean weight of 100 seeds was 14,72 g and there were 15,30 g of seed per plant, of which 4,58 g were visibly diseased on average. Among the fungi observed were Fusarium spp. (80-90%), Phomopsis spp. (39-45 %), Cercospora spp. (22-30 %), Colletotrichumspp. (5-10 %), Rhizoctoniaspp. (< 2%) and Penicilliumspp. These results showed that there is a need to breed new soybean genotypes with resistance to the most common seed diseases.

O objetivo deste trabalho foi avaliar a incidência de gêneros de fungos em sementes de soja colhidas durante um período de intensa pluviosidade em Mato Grosso do Sul, Brasil. Foram determinadas algumas características agronômicas em 110 plantas, no momento da colheita. A partir das sementes colhidas, foram selecionadas 800 com descoloração do tegumento, com ou sem colônias de fungos visíveis. Metade das sementes foram desinfestadas superficialmente por imersão em uma solução de hipoclorito de sódio a 1% por 3 minutos e todas os 800 sementes foram incubadas para estimular o crescimento de fungos. Foi utilizado o método 'blotter-teste' modificado, em que 25 sementes foram depositadas em papel de filtro colocado em uma caixa de germinação. Foi empregada uma solução saturada de NaCl (-1,0 MPa) para inibir a germinação das sementes. Após a incubação por sete dias a 25 ºC, o crescimento de fungos foi avaliado utilizando microscópios ópticos e estereoscópicos para identificar morfologicamente os gêneros. Em média, houve 50,3 vagens por planta, 2,0 sementes por vagem, e 31,7 sementes visivelmente doentes por planta soja. O peso médio de 100 sementes foi 14,72 g e houve 15,30 g de sementes por planta, dos quais 4,58 g estavam visivelmente doente. Entre os fungos observados, detectou-se Fusarium spp. (80-90%), Phomopsis spp. (39-45%), Cercospora spp. (22-30%), Colletotrichum spp. (5-10%), Rhizoctonia spp. (<2%) e Penicillium spp. Estes resultados mostraram que há necessidade de serem desenvolvidos genótipos de soja resistentes às doenças mais comuns que incidem nas sementes.

Cavernous hemangioma arising from the gastro-splenic ligament: a case report.

We present a rare case of a 45-year-old woman who presented with epigastric pain associated with early satiety and weight loss. Imaging revealed a large intra-abdominal mass in the epigastrium. Despite intensive investigations, including ultrasound scanning, computed tomography, upper gastrointestinal endoscopy, and percutaneous biopsy, a diagnosis could not be obtained. A histological diagnosis of cavernous hemangioma arising from the gastro-splenic ligament was confirmed after laparoscopic excision and histological examination of the intra-abdominal epigastric mass.