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Antibiotic resistance can rapidly spread through bacterial populations via bacterial conjugation. The bacterial membrane has an important role in facilitating conjugation, thus investigating the effects on the bacterial membrane caused by conjugative plasmids, antibiotic resistance, and genes involved in conjugation is of interest. Analysis of bacterial membranes was conducted using gas cluster ion beam-secondary ion mass spectrometry (GCIB-SIMS). The complexity of the data means that data analysis is important for the identification of changes in the membrane composition. Preprocessing of data and several analytical methods for identification of changes in bacterial membranes have been investigated. GCIB-SIMS data from Escherichia coli samples were subjected to principal components analysis (PCA), principal components-canonical variate analysis (PC-CVA), and Random Forests (RF) data analysis with the aim of extracting the maximum biological information. The influence of increasing replicate data was assessed, and the effect of diminishing biological variation was studied. Optimized m/z region-specific scaling provided improved clustering, with an increase in biologically significant peaks contributing to the loadings. PC-CVA improved clustering, provided clearer loadings, and benefited from larger data sets collected over several months. RF required larger sample numbers and while showing overlap with the PC-CVA, produced additional peaks of interest. The combination of PC-CVA and RF allowed very subtle differences between bacterial strains and growth conditions to be elucidated for the first time. Specifically, comparative analysis of an E. coli strain with and without the F-plasmid revealed changes in cyclopropanation of fatty acids, where the addition of the F-plasmid led to a reduction in cyclopropanation.
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There is a growing demand for water treatment systems for which the quality of feedwater in and product water out are not necessarily fixed with "tunable" technologies essential in many instances to satisfy the unique requirements of particular end-users. For example, in household applications, the optimal water hardness differs for particular end uses of the supplied product (such as water for potable purposes, water for hydration, or water for coffee or tea brewing) with the inclusion of specific minerals enhancing the suitability of the product in each case. However, conventional softening technologies are not dynamically flexible or tunable and, typically, simply remove all hardness ions from the feedwater. Membrane capacitive deionization (MCDI) can potentially fill this gap with its process flexibility and tunability achieved by fine tuning different operational parameters. In this article, we demonstrate that constant-current MCDI can be operated flexibly by increasing or decreasing the current and flow rate simultaneously to achieve the same desalination performance but different productivity whilst maintaining high water recovery. This characteristic can be used to operate MCDI in an energy-efficient manner to produce treated water more slowly at times of normal demand but more rapidly at times of peak demand. We also highlight the "tunability" of MCDI enabling the control of effluent hardness over different desired ranges by correlating the rates of hardness and conductivity removal using a power function model. Using this model, it is possible to either i) soften water to the same hardness level regardless of the fluctuation in hardness of feed waters, or ii) precisely control the effluent hardness at different levels to avoid excessive or insufficient hardness removal.
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Membranas Artificiales , Purificación del Agua , Purificación del Agua/métodos , Ablandamiento del Agua , Agua/químicaRESUMEN
Most melanomas progress from radial to vertical growth phase before spreading locoregionally and distally. Much is still unknown about the metabolic changes in the tumor cells and their microenvironment during this metastatic progression. We aimed to gain new insight into the molecular characteristics of melanoma in regard to spatial lipidomics to deliver new knowledge regarding tumor metastatic progression. We included 10 fresh tumor samples from 10 patients including two in situ melanomas, two invasive primary melanomas, and six metastatic melanomas (four in-transit metastases and two distant metastases). In addition, we analyzed four healthy skin controls from the same patients. Time-of-flight imaging secondary ion mass spectrometry (ToF-SIMS) enabled detailed spatial-lipidomics that could be directly correlated with conventional histopathological analysis of consecutive H&E-stained tissue sections. Significant differences in the lipid profiles were found in primary compared to metastatic melanomas, notably an increase in phosphatidylethanolamine lipids relative to phosphatidylinositol lipids and an increase in GM3 gangliosides in the metastatic samples. Furthermore, analysis of the data from in transit versus distant metastases samples highlighted that specific phospholipids, and a difference in the long versus shorter chain GM3 gangliosides, discriminated the metastatic routes. Further studies are warranted to verify these preliminary findings. Lipidomic changes could serve as a novel biomarker for tumor progression and even serve as a target for novel treatments. Furthermore, analyzing the lipid profiles could help to differentiate between primary and metastatic melanomas in challenging cases.
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BACKGROUND: Monkeypox (Mpox) is an important human pathogen without etiological treatment. A viral-host interactome study may advance our understanding of molecular pathogenesis and lead to the discovery of suitable therapeutic targets. METHODS: GEO Expression datasets characterizing mRNA profile changes in different host responses to poxviruses were analyzed for shared pathway identification, and then, the Protein-protein interaction (PPI) maps were built. The viral gene expression datasets of Monkeypox virus (MPXV) and Vaccinia virus (VACV) were used to identify the significant viral genes and further investigated for their binding to the library of targeting molecules. RESULTS: Infection with MPXV interferes with various cellular pathways, including interleukin and MAPK signaling. While most host differentially expressed genes (DEGs) are predominantly downregulated upon infection, marked enrichments in histone modifiers and immune-related genes were observed. PPI analysis revealed a set of novel virus-specific protein interactions for the genes in the above functional clusters. The viral DEGs exhibited variable expression patterns in three studied cell types: primary human monocytes, primary human fibroblast, and HeLa, resulting in 118 commonly deregulated proteins. Poxvirus proteins C6R derived protein K7 and K7R of MPXV and VACV were prioritized as targets for potential therapeutic interventions based on their histone-regulating and immunosuppressive properties. In the computational docking and Molecular Dynamics (MD) experiments, these proteins were shown to bind the candidate small molecule S3I-201, which was further prioritized for lead development. RESULTS: MPXV circumvents cellular antiviral defenses by engaging histone modification and immune evasion strategies. C6R-derived protein K7 binding candidate molecule S3I-201 is a priority promising candidate for treating Mpox.
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Interacciones Huésped-Patógeno , Monkeypox virus , Virus Vaccinia , Proteínas Virales , Humanos , Proteínas Virales/genética , Proteínas Virales/metabolismo , Virus Vaccinia/genética , Virus Vaccinia/metabolismo , Células HeLa , Monkeypox virus/genética , Mpox/virología , Mapas de Interacción de Proteínas , Perfilación de la Expresión Génica , Simulación del Acoplamiento Molecular , Poxviridae/genética , Poxviridae/metabolismo , Fibroblastos/virología , Fibroblastos/metabolismoRESUMEN
A long-term field trial of membrane capacitive deionization (MCDI) was conducted in a remote community in the Northern Territory of Australia, with the aim of producing safe palatable drinking water from groundwater that contains high concentrations of salt and hardness ions and other contaminants. This trial lasted for 1.5 years, which, to our knowledge, is one of the longest reported studies of pilot-scale MCDI field trials. The 8-module MCDI pilot unit reduced salt concentration to below the Australian Drinking Water Guideline value of 600 mg/L total dissolved solids (TDS) concentration with a relatively high water recovery of 71.6 ± 8.7 %. During continuous constant current operation and electrode discharging at near zero volts, a rapid performance deterioration occurred that was primarily attributed to insufficient desorption of multivalent ions from the porous carbon electrodes. Performance could be temporarily recovered using chemical cleaning and modified operating procedures however these approaches could not fundamentally resolve the issue of insufficient electrode performance regeneration. Constant current discharging of the electrodes to a negative cell cut-off voltage was hence employed to enhance the stability and overall performance of the MCDI unit during the continuous operation. An increase in selectivity of monovalent ions over divalent ions was also attained by implementing negative voltage discharging. The energy consumption of an MCDI system with a capacity of 1000 m3/day was projected to be 0.40â¼0.53 kWh/m3, which is comparable to the energy consumption of electrodialysis reversal (EDR) and brackish water reverse osmosis (BWRO) systems of the same capacity. The relatively low maintenance requirements of the MCDI system rendered it the most cost-efficient water treatment technology for deployment in remote locations. The LCOW of an MCDI system with a capacity of 1000 m3/day was projected to be AU$1.059/m3 and AU$1.146/m3 under two operational modes, respectively. Further investigation of particular water-energy trade-offs amongst MCDI performance metrics is required to facilitate broader application of this promising water treatment technology.
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Agua Potable , Purificación del Agua , Adsorción , Australia , Carbono , Cloruro de Sodio , Iones , Purificación del Agua/métodos , ElectrodosRESUMEN
Preventing avoidable venous-thrombo-embolism (VTE) is a priority to improve patient and service outcomes after total hip and total knee arthroplasty (THA, TKA), but compliance with relevant clinical guidelines varies. This study aims to determine the degree to which prophylaxis was compliant with Australian Orthopaedic Association (AOA) VTE prophylaxis guidelines and whether non-compliance is associated with increased risk of VTE. A prospective multi-centre cohort study of adults with osteoarthritis undergoing primary TKA/THA was completed at 19 high-volume public and private hospitals. Data were collected prior to surgery and for one-year post-surgery. Logistic regression was undertaken to explore associations between non-compliance with AOA VTE prophylaxis guidelines and symptomatic 90-day VTE outcomes. Data were analysed for 1838 participants from 19 sites. The rate of non-compliance with all clinical guideline recommendations was 20.1% (N = 369), with 14.1% (N = 259) non-compliance for risk-stratified prophylaxis, 35.8% (N = 658) for duration, and 67.8% (N = 1246) for other general recommendations. Symptomatic VTE was experienced up to 90-days post-surgery by 48 people (2.6%). Overall guideline non-compliance (AOR = 0.93, 95%CI = 0.4 to 1.3, p = 0.86) was not associated with a lower risk of symptomatic 90-day VTE. Results were consistent when people with high bleeding risk were excluded (AOR = 0.94, 95%CI = 0.44 to 2.34, p = 0.89). Non-compliance with the AOA VTE prophylaxis guidelines was not associated with risk of 90-day VTE after arthroplasty. This counterintuitive finding is concerning and necessitates a rigorous review of the AOA VTE prevention clinical guideline.
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Artroplastia de Reemplazo de Cadera , Artroplastia de Reemplazo de Rodilla , Ortopedia , Tromboembolia Venosa , Adulto , Humanos , Tromboembolia Venosa/etiología , Tromboembolia Venosa/prevención & control , Tromboembolia Venosa/tratamiento farmacológico , Artroplastia de Reemplazo de Rodilla/efectos adversos , Estudios de Cohortes , Estudios Prospectivos , Australia , Artroplastia de Reemplazo de Cadera/efectos adversos , Anticoagulantes/uso terapéutico , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/prevención & control , Complicaciones Posoperatorias/tratamiento farmacológicoRESUMEN
resumen está disponible en el texto completo
ABSTRACT The CONSORT 2010 statement provides minimum guidelines for reporting randomized trials. Its widespread use has been instrumental in ensuring transparency in the evaluation of new interventions. More recently, there has been a growing recognition that interventions involving artificial intelligence (AI) need to undergo rigorous, prospective evaluation to demonstrate impact on health outcomes. The CONSORT-AI (Consolidated Standards of Reporting Trials-Artificial Intelligence) extension is a new reporting guideline for clinical trials evaluating interventions with an AI component. It was developed in parallel with its companion statement for clinical trial protocols: SPIRIT-AI (Standard Protocol Items: Recommendations for Interventional Trials-Artificial Intelligence). Both guidelines were developed through a staged consensus process involving literature review and expert consultation to generate 29 candidate items, which were assessed by an international multi-stakeholder group in a two-stage Delphi survey (103 stakeholders), agreed upon in a two-day consensus meeting (31 stakeholders) and refined through a checklist pilot (34 participants). The CONSORT-AI extension includes 14 new items that were considered sufficiently important for AI interventions that they should be routinely reported in addition to the core CONSORT 2010 items. CONSORT-AI recommends that investigators provide clear descriptions of the AI intervention, including instructions and skills required for use, the setting in which the AI intervention is integrated, the handling of inputs and outputs of the AI intervention, the human-AI interaction and provision of an analysis of error cases. CONSORT-AI will help promote transparency and completeness in reporting clinical trials for AI interventions. It will assist editors and peer reviewers, as well as the general readership, to understand, interpret and critically appraise the quality of clinical trial design and risk of bias in the reported outcomes.
RESUMO A declaração CONSORT 2010 apresenta diretrizes mínimas para relatórios de ensaios clínicos randomizados. Seu uso generalizado tem sido fundamental para garantir a transparência na avaliação de novas intervenções. Recentemente, tem-se reconhecido cada vez mais que intervenções que incluem inteligência artificial (IA) precisam ser submetidas a uma avaliação rigorosa e prospectiva para demonstrar seus impactos sobre os resultados de saúde. A extensão CONSORT-AI (Consolidated Standards of Reporting Trials - Artificial Intelligence) é uma nova diretriz para relatórios de ensaios clínicos que avaliam intervenções com um componente de IA. Ela foi desenvolvida em paralelo à sua declaração complementar para protocolos de ensaios clínicos, a SPIRIT-AI (Standard Protocol Items: Recommendations for Interventional Trials - Artificial Intelligence). Ambas as diretrizes foram desenvolvidas por meio de um processo de consenso em etapas que incluiu revisão da literatura e consultas a especialistas para gerar 29 itens candidatos. Foram feitas consultas sobre esses itens a um grupo internacional composto por 103 interessados diretos, que participaram de uma pesquisa Delphi em duas etapas. Chegou-se a um acordo sobre os itens em uma reunião de consenso que incluiu 31 interessados diretos, e os itens foram refinados por meio de uma lista de verificação piloto que envolveu 34 participantes. A extensão CONSORT-AI inclui 14 itens novos que, devido à sua importância para as intervenções de IA, devem ser informados rotineiramente juntamente com os itens básicos da CONSORT 2010. A CONSORT-AI preconiza que os pesquisadores descrevam claramente a intervenção de IA, incluindo instruções e as habilidades necessárias para seu uso, o contexto no qual a intervenção de IA está inserida, considerações sobre o manuseio dos dados de entrada e saída da intervenção de IA, a interação humano-IA e uma análise dos casos de erro. A CONSORT-AI ajudará a promover a transparência e a integralidade nos relatórios de ensaios clínicos com intervenções que utilizam IA. Seu uso ajudará editores e revisores, bem como leitores em geral, a entender, interpretar e avaliar criticamente a qualidade do desenho do ensaio clínico e o risco de viés nos resultados relatados.
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resumen está disponible en el texto completo
ABSTRACT The SPIRIT 2013 statement aims to improve the completeness of clinical trial protocol reporting by providing evidence-based recommendations for the minimum set of items to be addressed. This guidance has been instrumental in promoting transparent evaluation of new interventions. More recently, there has been a growing recognition that interventions involving artificial intelligence (AI) need to undergo rigorous, prospective evaluation to demonstrate their impact on health outcomes. The SPIRIT-AI (Standard Protocol Items: Recommendations for Interventional Trials-Artificial Intelligence) extension is a new reporting guideline for clinical trial protocols evaluating interventions with an AI component. It was developed in parallel with its companion statement for trial reports: CONSORT-AI (Consolidated Standards of Reporting Trials-Artificial Intelligence). Both guidelines were developed through a staged consensus process involving literature review and expert consultation to generate 26 candidate items, which were consulted upon by an international multi-stakeholder group in a two-stage Delphi survey (103 stakeholders), agreed upon in a consensus meeting (31 stakeholders) and refined through a checklist pilot (34 participants). The SPIRIT-AI extension includes 15 new items that were considered sufficiently important for clinical trial protocols of AI interventions. These new items should be routinely reported in addition to the core SPIRIT 2013 items. SPIRIT-AI recommends that investigators provide clear descriptions of the AI intervention, including instructions and skills required for use, the setting in which the AI intervention will be integrated, considerations for the handling of input and output data, the human-AI interaction and analysis of error cases. SPIRIT-AI will help promote transparency and completeness for clinical trial protocols for AI interventions. Its use will assist editors and peer reviewers, as well as the general readership, to understand, interpret and critically appraise the design and risk of bias for a planned clinical trial.
RESUMO A declaração SPIRIT 2013 tem como objetivo melhorar a integralidade dos relatórios dos protocolos de ensaios clínicos, fornecendo recomendações baseadas em evidências para o conjunto mínimo de itens que devem ser abordados. Essas orientações têm sido fundamentais para promover uma avaliação transparente de novas intervenções. Recentemente, tem-se reconhecido cada vez mais que intervenções que incluem inteligência artificial (IA) precisam ser submetidas a uma avaliação rigorosa e prospectiva para demonstrar seus impactos sobre os resultados de saúde. A extensão SPIRIT-AI (Standard Protocol Items: Recommendations for Interventional Trials - Artificial Intelligence) é uma nova diretriz de relatório para protocolos de ensaios clínicos que avaliam intervenções com um componente de IA. Essa diretriz foi desenvolvida em paralelo à sua declaração complementar para relatórios de ensaios clínicos, CONSORT-AI (Consolidated Standards of Reporting Trials - Artificial Intelligence). Ambas as diretrizes foram desenvolvidas por meio de um processo de consenso em etapas que incluiu revisão da literatura e consultas a especialistas para gerar 26 itens candidatos. Foram feitas consultas sobre esses itens a um grupo internacional composto por 103 interessados diretos, que participaram de uma pesquisa Delphi em duas etapas. Chegou-se a um acordo sobre os itens em uma reunião de consenso que incluiu 31 interessados diretos, e os itens foram refinados por meio de uma lista de verificação piloto que envolveu 34 participantes. A extensão SPIRIT-AI inclui 15 itens novos que foram considerados suficientemente importantes para os protocolos de ensaios clínicos com intervenções que utilizam IA. Esses itens novos devem constar dos relatórios de rotina, juntamente com os itens básicos da SPIRIT 2013. A SPIRIT-AI preconiza que os pesquisadores descrevam claramente a intervenção de IA, incluindo instruções e as habilidades necessárias para seu uso, o contexto no qual a intervenção de IA será integrada, considerações sobre o manuseio dos dados de entrada e saída, a interação humano-IA e a análise de casos de erro. A SPIRIT-AI ajudará a promover a transparência e a integralidade nos protocolos de ensaios clínicos com intervenções que utilizam IA. Seu uso ajudará editores e revisores, bem como leitores em geral, a entender, interpretar e avaliar criticamente o delineamento e o risco de viés de um futuro estudo clínico.
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Importance: Transparent reporting of randomized trials is essential to facilitate critical appraisal and interpretation of results. Factorial trials, in which 2 or more interventions are assessed in the same set of participants, have unique methodological considerations. However, reporting of factorial trials is suboptimal. Objective: To develop a consensus-based extension to the Consolidated Standards of Reporting Trials (CONSORT) 2010 Statement for factorial trials. Design: Using the Enhancing the Quality and Transparency of Health Research (EQUATOR) methodological framework, the CONSORT extension for factorial trials was developed by (1) generating a list of reporting recommendations for factorial trials using a scoping review of methodological articles identified using a MEDLINE search (from inception to May 2019) and supplemented with relevant articles from the personal collections of the authors; (2) a 3-round Delphi survey between January and June 2022 to identify additional items and assess the importance of each item, completed by 104 panelists from 14 countries; and (3) a hybrid consensus meeting attended by 15 panelists to finalize the selection and wording of items for the checklist. Findings: This CONSORT extension for factorial trials modifies 16 of the 37 items in the CONSORT 2010 checklist and adds 1 new item. The rationale for the importance of each item is provided. Key recommendations are (1) the reason for using a factorial design should be reported, including whether an interaction is hypothesized, (2) the treatment groups that form the main comparisons should be clearly identified, and (3) for each main comparison, the estimated interaction effect and its precision should be reported. Conclusions and Relevance: This extension of the CONSORT 2010 Statement provides guidance on the reporting of factorial randomized trials and should facilitate greater understanding of and transparency in their reporting.
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Revelación , Ensayos Clínicos Controlados Aleatorios como Asunto , Proyectos de Investigación , Humanos , Lista de Verificación , Consenso , Revelación/normas , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto/normas , Estándares de Referencia , Proyectos de Investigación/normasRESUMEN
Importance: Trial protocols outline a trial's objectives as well as the methods (design, conduct, and analysis) that will be used to meet those objectives, and transparent reporting of trial protocols ensures objectives are clear and facilitates appraisal regarding the suitability of study methods. Factorial trials, in which 2 or more interventions are assessed in the same set of participants, have unique methodological considerations. However, no extension of the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013 Statement, which provides guidance on reporting of trial protocols, for factorial trials is available. Objective: To develop a consensus-based extension to the SPIRIT 2013 Statement for factorial trials. Evidence Review: The SPIRIT extension for factorial trials was developed using the Enhancing the Quality and Transparency of Health Research (EQUATOR) methodological framework. First, a list of reporting recommendations was generated using a scoping review of methodological articles identified using a MEDLINE search (inception to May 2019), which was supplemented with relevant articles from the personal collections of the authors. Second, a 3-round Delphi survey (January to June 2022, completed by 104 panelists from 14 countries) was conducted to assess the importance of items and identify additional recommendations. Third, a hybrid consensus meeting was held, attended by 15 panelists to finalize selection and wording of the checklist. Findings: This SPIRIT extension for factorial trials modified 9 of the 33 items in the SPIRIT 2013 checklist. Key reporting recommendations were that the rationale for using a factorial design should be provided, including whether an interaction is hypothesized; the treatment groups that will form the main comparisons should be identified; and statistical methods for each main comparison should be provided, including how interactions will be assessed. Conclusions and Relevance: In this consensus statement, 9 factorial-specific items were provided that should be addressed in all protocols of factorial trials to increase the trial's utility and transparency.
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Lista de Verificación , Proyectos de Investigación , Humanos , Consenso , Ensayos Clínicos Controlados Aleatorios como Asunto , Literatura de Revisión como AsuntoRESUMEN
This Tutorial focuses on the use of secondary ion mass spectrometry for the analysis of cellular and tissue samples. The Tutorial aims to cover the considerations in sample preparation analytical set up and some specific aspects of data interpretation associated with such analysis.
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Espectrometría de Masa de Ion SecundarioRESUMEN
Physiotherapists are increasingly using psychological treatments for musculoskeletal conditions. We assessed the effects of physiotherapist-delivered psychological interventions on pain, disability, and quality of life in neck pain. We evaluated quality of intervention reporting. We searched databases for randomized controlled trials (RCTs) comprising individuals with acute or chronic whiplash-associated disorder (WAD) or nontraumatic neck pain (NTNP), comparing physiotherapist-delivered psychological interventions to standard care or no treatment. Data were extracted regarding study characteristics and outcomes. Standardised mean difference (SMD) was calculated by random-effects meta-analysis. We evaluated certainty of evidence using Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) and intervention reporting using TIDieR. Fourteen RCTs (18 articles-4 detail additional outcome/follow-up data) were included comprising 2028 patients, examining acute WAD (n = 4), subacute/mixed NTNP (n = 3), chronic WAD (n = 2), and chronic NTNP (n = 5). Treatment effects on pain favoured psychological interventions in chronic NTNP at short-term (SMD -0.40 [95% CI -0.73, -0.07]), medium-term (SMD -0.29 [95% CI -0.57, 0.00]), and long-term (SMD -0.32 [95% CI -0.60, -0.05]) follow-up. For disability, effects favoured psychological interventions in acute WAD at short-term follow-up (SMD -0.39 [95% CI -0.72, -0.07]) and chronic NTNP at short-term (SMD -0.53 [95% CI -0.91, -0.15]), medium-term (SMD -0.49 [95% CI -0.77, -0.21]), and long-term (SMD -0.60 [95% CI -0.94, -0.26]) follow-up. GRADE ratings were typically moderate, and intervention reporting often lacked provision of trial materials and procedural descriptions. Psychological interventions delivered by physiotherapists were more effective than standard physiotherapy for chronic NTNP (small-to-medium effects) and, in the short term, acute WAD.
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Membrane capacitive deionization (MCDI) is a water desalination technology that involves the removal of charged ions from water under an electric field. While constant-current MCDI coupled with stopped-flow during ion discharge is expected to exhibit high water recovery and good performance stability, previous studies have typically been undertaken using NaCl solutions only with limited investigation of MCDI performance using multi-electrolyte solutions. In the present work, the desalination performance of MCDI was evaluated using feed solutions with different levels of hardness. The increase of hardness resulted in the degradation of desalination performance with the desalination time (Δtd), total removed charge, water recovery (WR) and productivity decreasing by 20.5%, 21.8%, 3.8% and 3.2%, respectively. A more serious degradation of WR and productivity would be caused if Δtd decreases further. Analysis of the voltage profiles and effluent ion concentrations reveal that the insufficient desorption of divalent ions at constant-current discharge to 0 V was the principal reason for the degradation of performance. The Δtd and WR can be improved by discharging the cell using a lower current but the productivity decreased by 15.7% on decreasing the discharging current from 161 to 107 mA. Discharging the cell to a negative potential was shown to be a better option with the Δtd, total removed charge, WR and productivity increasing by 27.4%, 23.9%, 3.6% and 5.3%, respectively, when the cell was discharged to a minimum voltage of - 0.3 V. Use of such a method should be feasible for operation of full scale MCDI plants and would be expected to lead to better regeneration of the electrode, improved desalination performance and, potentially, a significant reduction in the need for use of clean-in-place procedures.
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Purificación del Agua , Purificación del Agua/métodos , Adsorción , Iones , Cloruro de Sodio , Electrodos , AguaRESUMEN
OBJECTIVE: To determine the accuracy of high-risk human papillomavirus (HPV) DNA samples on filter paper in comparison to specimen transport medium (STM). METHODS: This was a cross-sectional diagnostic study of 42 consecutive women who were prospectively recruited. Each had self-collected vaginal samples on filter paper, physician-collected cervical samples on filter paper, and physician-collected cervical samples in STM. HPV DNA testing was performed with a Hybrid Capture 2 system (Qiagen). Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and agreement of filter paper methods with the standard procedure were calculated. RESULTS: The overall prevalence of HPV in STM was 67.5%. Detection of HPV DNA in the physician-collected cervical samples on filter paper had a sensitivity of 77.8%, a specificity of 100%, a PPV of 100%, and an NPV of 68.4%. The patient's self-sampling on filter paper had a sensitivity of 66.7%, a specificity of 100%, a PPV of 100%, and an NPV of 59.1%. The agreement between STM method and physician-collected sample on filter paper was substantial, (κ = 0.695, P < 0.001), while the agreement between STM and self-collected samples on filter paper was moderate (κ = 0.565, P < 0.001). Most patients reported that self-collection was acceptable (100%), painless (95%), and not embarrassing (95%). CONCLUSION: Filter paper, with dried self-collected vaginal samples, can be used to detect high-risk HPV with acceptable accuracy.
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Infecciones por Papillomavirus , Displasia del Cuello del Útero , Neoplasias del Cuello Uterino , Humanos , Femenino , Virus del Papiloma Humano , Neoplasias del Cuello Uterino/diagnóstico , Infecciones por Papillomavirus/diagnóstico , Estudios Transversales , Papillomaviridae/genética , ADN Viral/genética , Manejo de Especímenes/métodos , Frotis Vaginal/métodos , Sensibilidad y Especificidad , Detección Precoz del Cáncer/métodos , Displasia del Cuello del Útero/diagnósticoRESUMEN
BACKGROUND: The wars in Afghanistan and Iraq produced thousands of pediatric casualties, using substantial military medical resources. We sought to describe characteristics of pediatric casualties who underwent operative intervention in Iraq and Afghanistan. METHODS: This is a retrospective analysis of pediatric casualties treated by US Forces in the Department of Defense Trauma Registry with at least one operative intervention during their course. We report descriptive, inferential statistics, and multivariable modeling to assess associations for receiving an operative intervention and survival. We excluded casualties who died on arrival to the emergency department. RESULTS: During the study period, there were a total of 3,439 children in the Department of Defense Trauma Registry, of which 3,388 met inclusion criteria. Of those, 2,538 (75%) required at least 1 operative intervention totaling 13,824 (median, 4; interquartile range, 2-7; range, 1-57). Compared with nonoperative casualties, operative casualties were older and male and had a higher proportion of explosive and firearm injuries, higher median composite injury severity scores, higher overall blood product administration, and longer intensive care hospitalizations. The most common operative procedures were related to abdominal, musculoskeletal, and neurosurgical trauma; burn management; and head and neck. When adjusting for confounders, older age (unit odds ratio, 1.04; 1.02-1.06), receiving a massive transfusion during their initial 24 hours (6.86, 4.43-10.62), explosive injuries (1.43, 1.17-1.81), firearm injuries (1.94, 1.47-2.55), and age-adjusted tachycardia (1.45, 1.20-1.75) were all associated with going to the operating room. Survival to discharge on initial hospitalization was higher in the operative cohort (95% vs. 82%, p < 0.001). When adjusting for confounders, operative intervention was associated with improved mortality (odds ratio, 7.43; 5.15-10.72). CONCLUSION: Most children treated in US military/coalition treatment facilities required at least one operative intervention. Several preoperative descriptors were associated with casualties' likelihood of operative interventions. Operative management was associated with improved mortality. LEVEL OF EVIDENCE: Prognostic and Epidemiological; Level III.
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Armas de Fuego , Personal Militar , Heridas y Lesiones , Heridas por Arma de Fuego , Humanos , Niño , Masculino , Estudios Retrospectivos , Quirófanos , Afganistán/epidemiología , Irak/epidemiología , Guerra de Irak 2003-2011 , Campaña Afgana 2001- , Sistema de Registros , Heridas y Lesiones/cirugíaRESUMEN
It is believed that human papilloma virus infection (HPV), which is caused by the DNA virus, is the most prominent factor contributing to sexually transmitted disease (STD) in the world, with males having a prevalence rate of 3.5%-45% while that women are 2%-44%. Infertility is a rising problem on a global basis, affecting anywhere from 10% to 30% of couples who have reached reproductive age. This study aims to investigate the existing research on HPV, its connection to male infertility, and how it could be a helpful tool for medical professionals managing HPV in the context of reproductive health care. Infection with HPV has been identified as a risk factor for several spontaneous abortions; however, there is a lack of evidence on how HPV influences individuals undergoing assisted reproductive technology (ART) in terms of live births. The significance of the immune response to HPV-infected male reproductive system cells and its effect on embryos, as well as the oxidative stress generated by high-risk HPV DNA damage and genomic instability, is discussed in this review. Further, the association between male individuals infected with HPV and asthenozoospermia should provide a compelling case for vaccinating young people against HPV.
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Infertilidad Masculina , Infecciones por Papillomavirus , Embarazo , Humanos , Masculino , Femenino , Adolescente , Infecciones por Papillomavirus/complicaciones , Infecciones por Papillomavirus/epidemiología , Virus del Papiloma Humano , Salud Reproductiva , Papillomaviridae/genéticaRESUMEN
BACKGROUND: Over the past few decades the benefits of assessing Quality of Life (QoL) and mental health in patients with Type 2 Diabetes Mellitus (T2DM) have steadily increased with limited studies relating to the most useful method to assess these patients. This study aims to identify, review, summarise, and evaluate the methodological quality for the most validated commonly used health-related QoL and mental health assessment measurements in diabetic patients. METHODS: All original articles published on PubMed, MedLine, OVID, The Cochrane Register, Web of Science Conference Proceedings and Scopus databases were systematically reviewed between 2011 and 2022. A search strategy was developed for each database using all possible combinations of the following keywords: "type 2 diabetes mellitus", "quality of life", mental health", and "questionnaires". Studies conducted on patients with T2DM of ≥ 18 years with or without other clinical illnesses were included. Articles designed as a literature or systematic review conducted on either children or adolescents, healthy adults and/or with a small sample size were excluded. RESULTS: A total of 489 articles were identified in all of the electronic medical databases. Of these articles, 40 were shown to meet our eligibility criteria to be included in this systematic review. Approximately, 60% of these studies were cross-sectional, 22.5% were clinical trials, and 17.5% of cohort studies. The top commonly used QoL measurements are the SF-12 identified in 19 studies, the SF-36, included in 16 studies, and the EuroQoL EQ-5D, found in 8 studies. Fifteen (37.5%) studies used only one questionnaire, while the remaining reviewed (62.5%) used more than one questionnaire. Finally, the majority (90%) of studies reported using self-administered questionnaires and only 4 used interviewer mode of administration. CONCLUSION: Our evidence highlights that the commonly used questionnaire to evaluate the QoL and mental health is the SF-12 followed by SF-36. Both of these questionnaires are validated, reliable and supported in different languages. Moreover, using single or combined questionnaires as well as the mode of administration depends on the clinical research question and aim of the study.
Asunto(s)
Diabetes Mellitus Tipo 2 , Adulto , Niño , Adolescente , Humanos , Calidad de Vida , Salud Mental , Encuestas y CuestionariosRESUMEN
Aberrant functioning of the proteasome has been associated with crucial pathologic conditions including neurodegeneration. Yet, the complex underlying causes at the cellular level remain unclear and there are conflicting reports of neuroprotective to neurodegenerative effects of proteasomal inhibitors such as lactacystin that are utilised as models for neurodegenerative diseases. The conflicting results may be associated with different dose regimes of lactacystin and hence we have performed a dose dependent study of the effects of lactacystin to identify concurrent changes in the cell membrane lipid profile and the dynamics of exocytosis using a combination of surface sensitive mass spectrometry and single cell amperometry. Significant changes of negatively charged lipids were associated with different lactacystin doses that showed a weak correlation with exocytosis while changes in PE and PE-O lipids showed dose dependent changes correlated with initial pore formation and total release of vesicle content respectively.
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Lípidos de la Membrana , Inhibidores de Proteasoma , Inhibidores de Proteasoma/farmacología , Espectrometría de Masas , ExocitosisRESUMEN
Epidemiological link between HPV and SLE is evolving. The possibility of HPV infection-induced molecular mimicry and systemic lupus erythematosus (SLE) was elucidated through detailed in silico analyses. Conserved regions in the structural protein sequences of high-risk HPV types were inferred, and sequence homologies between viral and human peptides were identified to delineate proteins implicated in SLE. B-cell epitopes and MHC-class II binding were compiled using Immune Epitope Database and ProPred II analysis tool. Molecular modeling and molecular dynamics/simulation (MDS) were performed using AutoDock Vina and GROMACS, respectively. Sequence alignment revealed 32 conserved regions, and 27/32 viral peptides showed varying similarities to human peptides, rich in B-cell epitopes with superior accessibility, high hydrophilicity, antigenicity and disposition to bind many class-II HLA alleles. Molecular docking of 13 viral peptides homologous (100%) to human peptides implicated in SLE showed that VIR-PEP1 (QLFNKPYWL) and VIR-PEP2 (DTYRFVTS) exhibited higher binding affinities than corresponding human peptides to SLE predisposing HLA-DRB1 allele. MDS of these peptides showed that the viral peptides had superior folding, compactness, and a higher number of hydrogen bonds than human peptides throughout the simulation period. SASA analysis revealed that the VIR-PEP1&2 fluctuated less frequently than corresponding human peptides. MM-PBSA revealed that the VIR-PEP2 complex exhibited higher binding energy than the human peptide complex. This suggests that highly conserved structural peptides of high-risk HPV types homologous to human peptides could compete and bind avidly to the HLA allele associated with SLE and predispose HPV-infected individuals to SLE through molecular mimicry.Communicated by Ramaswamy H. Sarma.
Asunto(s)
Lupus Eritematoso Sistémico , Infecciones por Papillomavirus , Humanos , Epítopos de Linfocito B , Imitación Molecular , Simulación del Acoplamiento Molecular , Péptidos/química , Epítopos de Linfocito TRESUMEN
OBJECTIVES: To investigate the digital literacy of staff in London, UK, community pharmacies and to explore their perceptions about the use of eHealth tools. METHODS: The study population was community pharmacy staff (N = 21,346) in Greater London. A survey tool was divided into six sections: Use of the internet; Use of social media; Use of mobile health applications (MHAs); Perception of and practical use of digital health tools; Scenario-based questions and demographics. Responses were analysed in SPSS. Following data collection, Health Education England's (HEE's) Digital Capabilities Framework (DCF) was published. The authors mapped the survey tool retrospectively to the framework. KEY FINDINGS: Almost all respondents (98.0%, n = 551/562) used eHealth tools at work, mainly to access medicine information (89.8%, n = 495/551). Almost one-third (31.7%, N = 178/562) used social media regularly, while many (79.4%, N = 446/562) were aware of MHAs. Self-perceived digital literacy indicated that 63.3% (n = 356/562) deemed themselves to be above average. Under 35s rated their digital literacy more highly than over 35s (P < 0.001). HEE's DCF indicated that actual digital literacy was lower than that of self-perceived. Despite the high use of eHealth tools, respondents were reluctant to recommend these to the public for health advice. CONCLUSIONS: Community pharmacy staff self-report their digital literacy to be high yet do not use these skills for public health purposes. Furthermore, these self-reported skills appear to be over-estimated. Despite high levels of use of digital tools at work, staff do not use them for public health, therefore, further training to build confidence to better utilise them is recommended.