Low disease risk and penetrance in Leber hereditary optic neuropathy.

The risk of Leber hereditary optic neuropathy (LHON) has largely been extrapolated from disease cohorts, which underestimate the population prevalence of pathogenic primary LHON variants as a result of incomplete disease penetrance. Understanding the true population prevalence of primary LHON variants, alongside the rate of clinical disease, provides a better understanding of disease risk and variant penetrance. We identified pathogenic primary LHON variants in whole-genome sequencing data of a well-characterized population-based control cohort and found that the prevalence is far greater than previously estimated, as it occurs in approximately 1 in 800 individuals. Accordingly, we were able to more accurately estimate population risk and disease penetrance in LHON variant carriers, validating our findings by using other large control datasets. These findings will inform accurate counseling in relation to the risk of vision loss in LHON variant carriers and disease manifestation in their family. This Matters Arising paper is in response to Lopez Sanchez et al. (2021), published in The American Journal of Human Genetics. See also the response by Mackey et al. (2022), published in this issue.

Microbial Primer: Lipopolysaccharide - a remarkable component of the Gram-negative bacterial surface.

Lipopolysaccharide (LPS) is a fundamental tripartite glycolipid found on the surface of nearly all Gram-negative bacteria. It acts as a protective shield for the bacterial cell and is a potent agonist of the innate immune system. This primer serves to introduce the basic properties of LPS, its function in bacterial physiology and pathogenicity, and its use as a therapeutic target.

Review of hyperdispersal in wildlife translocations.

Species translocation is a common tool to reverse biodiversity loss, but it has a high failure rate. One factor that contributes to failure is postrelease hyperdispersal, which we define as the long-distance movement of individuals resulting in their failure to contribute to population establishment. We reviewed reported incidences of hyperdispersal and compared rates of hyperdispersal among taxa, population demographics, release cohorts, and success of mitigation techniques. Of 151 conservation translocations (reinforcements and reintroductions) in which animals were tracked, hyperdispersal was confirmed in 52.1% of programs. The prevalence of hyperdispersal (percentage of studies) was relatively consistent across taxa (42.9-60%), but hyperdispersal rates in birds were likely underestimated because 76.9% of bird translocations showed incidences in which birds could not be located after release, but hyperdispersal was unable to be confirmed. Eutherians exhibited a higher average incidence of hyperdispersal (percentage of hyperdispersing individuals in a cohort) of 20.2% than birds, reptiles, and marsupials (10.4%, 15.7%, and 10.3%, respectively). No significant trends were observed for sex, source population, or translocation type, but there were nonsignificant trends for males to hyperdisperse more than females and for higher incidences of hyperdispersal in reinforcements relative to reintroduction programs. Mitigation techniques included temporary confinement, supplementation of resources, and releasing animals in social groups, but only half of studies examining mitigation techniques found them useful. Hyperdispersal incidence was variable within taxa, and we advise against forming translocations strategies based on results from other species. Hyperdispersal is a significant welfare, economic, and conservation issue in translocations, and we suggest definitions, reporting, and experimental strategies to address it.

Revisión de la hiperdispersión en las reubicaciones de fauna Resumen La reubicación de especies se usa muy seguido como herramienta para revertir la pérdida de la biodiversidad a pesar de tener una tasa elevada de fracaso. Un factor que contribuye a este fracaso es la hiperdispersión posterior a la liberación, la cual definimos como el movimiento de larga distancia de los individuos que resulta en su fracaso para contribuir al establecimiento de la población. Revisamos las incidencias reportadas de la hiperdispersión y comparamos las tasas de hiperdispersión entre los taxones, las poblaciones, demografías, grupos de edad liberados y el éxito de las técnicas de mitigación. Confirmamos la hiperdispersión en 52.1% de 151 reubicaciones de conservación (reforzamiento y reintroducciones) en las cuales se rastreó a los animales. La prevalencia de la hiperdispersión (el porcentaje de estudios) tuvo una coherencia relativa en todos los taxones (42.9-60%), aunque probablemente se subestimaron las tasas de hiperdispersión de las aves porque el 76.9% de sus reubicaciones mostraron incidencias en las que no se pudieron ubicar a los individuos después de la liberación, pero tampoco se pudo confirmar la hiperdispersión. Los euterios exhibieron un promedio de incidencia de hiperdispersión (porcentaje de individuos con hiperdispersión dentro de un grupo de edad) del 20.2%, mayor que el de las aves, reptiles y marsupiales (10.4%, 15.7% y 10.3% respectivamente). No observamos tendencias significativas para el sexo, la población original o el tipo de reubicación, aunque sí hubo tendencias no significativas de mayor hiperdispersión en los machos que en las hembras y de mayor incidencia de hiperdispersión en los reforzamientos en relación con los programas de reintroducción. Las técnicas de mitigación incluyeron el confinamiento temporal, el suplemento de recursos y la liberación de animales en grupos sociales, pero sólo la mitad de los estudios que examinaban estas técnicas las encontraron útiles. La incidencia de la hiperdispersión varió en cada taxón, por lo que aconsejamos no estructurar las estrategias de reubicación con base en los resultados de otras especies. La hiperdispersión es un tema importante para el bienestar, la conservación y la economía de las reubicaciones y sugerimos estrategias de definición, reporte y experimentación para abordarla.

Challenges and opportunities in human dimensions behind cat-wildlife conflict.

Because global anthropogenic activities cause vast biodiversity loss, human dimensions research is essential to forming management plans applicable to biodiversity conservation outside wilderness areas. Engaging public participation is crucial in this context to achieve social and environmental benefits. However, knowledge gaps remain in understanding how a balance between conservation and public demands can be reached and how complicated sociocultural contexts in the Anthropocene can be incorporated in conservation planning. We examined China's nationwide conflict between free-ranging cats (owned cats that are allowed to go outdoors or homeless cats living outdoors) and wildlife to examine how a consensus between compassion and biodiversity conservation can help in decision-making. We surveyed a random sample of people in China online. Over 9000 questionnaires were completed (44.2% response). In aggregate, respondents reported approximately 29 million free-ranging owned cats and that over 5 million domestic cats per year become feral in mainland China. Respondents who were cat owners, female, and religious were more likely to deny the negative impacts of cats on wildlife and ongoing management strategies and more supportive of stray cat shelters, adoption, and community-based fund raising than nonowners, male, and nonreligious respondents (p < 0.05). Free-ranging cat ownership and abandonment occurred less with owners with more knowledge of biodiversity and invasive species than with respondents with less knowledge of these subjects (p < 0.05). We recommend that cat enthusiasts and wildlife conservationists participate in community-based initiatives, such as campaigns to keep cats indoors. Our study provides a substantially useful framework for other regions where free-ranging cats are undergoing rapid expansion.

Retos y oportunidades de las dimensiones humanas detrás del conflicto entre gatos y fauna Resumen Debido a que las actividades antropogénicas globales causan una enorme pérdida de la biodiversidad, la investigación sobre las dimensiones humanas es esencial para generar planes de manejo aplicables a la conservación de la biodiversidad fuera de las áreas silvestres. Es muy importante lograr que el público participe en este contexto para obtener los beneficios sociales y ambientales. Sin embargo, todavía existen vacíos en el conocimiento sobre cómo lograr el balance entre la conservación y las demandas públicas y cómo incorporar los contextos socioculturales complejos del Antropoceno a la planeación de la conservación. Analizamos el conflicto nacional entre los gatos libres (gatos callejeros o gatos domésticos que se les permite salir) y la fauna en China para estudiar cómo un consenso entre la compasión y la conservación de la biodiversidad puede ayudar en la toma de decisiones. Encuestamos en línea a una muestra aleatoria de personas en China. Se completaron más de 9000 cuestionarios (44.2% de respuesta). En total, los respondientes reportaron un aproximado de 29 millones de gatos libres y que más de cinco millones de gatos domésticos se vuelven ferales al año en China. Quienes respondieron y son dueños de gatos, mujeres y religiosos tuvieron la mayor probabilidad de negar los impactos negativos de los gatos sobre la fauna y de las estrategias actuales de manejo y de mostrar más apoyo por los refugios de gatos abandonados, la adopción y de la recaudación de fondos comunitaria que quienes no son dueños, no son religiosos y son hombres (p < 0.05). La propiedad de gatos libres y el abandono ocurrieron menos con los dueños con más conocimiento sobre la biodiversidad y las especies invasoras que con los respondientes con menos conocimiento sobre estos temas (p < 0.05). Recomendamos que los aficionados a los gatos y los conservacionistas de la fauna participen en las iniciativas comunitarias; por ejemplo, campañas para mantener a los gatos dentro de casa. Nuestro estudio proporciona un marco sustancialmente útil para otras regiones en donde los gatos libres se encuentran en rápida expansión.

Attributes of preemptive conservation efforts for species precluded from listing under the U.S. Endangered Species Act.

Preemptive conservation efforts to reduce threats have been credited with precluding the need to list some imperiled species under the U.S. Endangered Species Act (ESA). Such efforts can result in outcomes where species are conserved and regulatory costs associated with ESA listing are avoided. Yet, the extent and type of conservation effort involved in achieving preclusion from listing are not well understood. We quantified the attributes of conservation efforts identified as important for 43 species whose preclusion from listing was attributed to conservation efforts, as described in U.S. Federal Register documents that report the decisions not to list. We considered 2 features of preemptive conservation: effort applied (measured as the number of conservation initiatives) and number of conservation partners involved. We also quantified the type and location of conservation actions. We found a mean of 4.3 initiatives (range 1-22) and 8.2 partners (range 1-31) documented per precluded species; both measures of conservation effort were significantly and positively associated with the species' range area and the proportion of private land across its range. The number of initiatives was also positively related to the number of threats affecting a species. Locations of conservation actions varied; more species had actions on public land than on private land (p = 0.003). Numbers of species with restorative actions (e.g., invasive species control) were similar to numbers with prohibitive actions. Our findings highlight relationships between species' context and preemptive conservation activities, providing a first cross-species analysis of conservation efforts for species that were precluded from listing under the ESA due to conservation.

Atributos de los esfuerzos preventivos de conservación para las especies excluidas del listado de la Ley de Especies en Peligro de Extinción de Estados Unidos Resumen A los esfuerzos preventivos de conservación para reducir las amenazas se les atribuye la exclusión de algunas especies en peligro de la lista de la Ley de Especies en Peligro de Extinción de los Estados Unidos (ESA, en inglés). Dichos esfuerzos pueden tener resultados en los que se protegen las especies y se evitan los costos regulatorios asociados con el listado de la ESA, pero no se sabe mucho sobre el alcance y el tipo de esfuerzo de conservación involucrados en la exclusión del listado. Cuantificamos los atributos de los esfuerzos de conservación identificados como importantes para 43 especies cuya exclusión del listado fue atribuida a los esfuerzos de conservación, descrito así en los documentos del Registro Federal de los EUA que reportan las razones para no incluirlas en la lista. Consideramos dos características de la conservación preventiva: el esfuerzo aplicado (medido como el número de iniciativas de conservación) y el número de socios de conservación involucrados. También cuantificamos el tipo y ubicación de las acciones de conservación. Obtuvimos una media de 4.3 iniciativas (rango 1­22) y 8.2 socios (rango 1­31) documentados por especie excluida; ambas medidas del esfuerzo de conservación tuvieron una asociación significativa y positiva con el área de distribución de la especie y la proporción de suelo privado en esta distribución. El número de iniciativas también tuvo una relación positiva con el número de amenazas para las especies. Las ubicaciones de las acciones de conservación variaron y más especies contaban con acciones en suelo público que en suelo privado (p = 0.003). El número de especies que contaban con acciones de restauración (p. ej.: control de especies invasoras) fue similar a aquellas con acciones prohibitivas. Nuestros hallazgos resaltan la relación entre el contexto de la especie y las actividades preventivas de conservación, lo que proporciona un primer análisis entre especies de los esfuerzos de conservación para especies excluidas de la ESA por cuestiones de conservación.

Development and performance evaluation of online monitors for near real-time measurement of total and water-soluble organic carbon in fine and coarse ambient PM.

In this study, we developed two online monitors for total organic carbon (TOC) and water-soluble organic carbon (WSOC) measurements in fine (dp < 2.5µm) and coarse (2.5µm < dp < 10µm) particulate matter (PM), respectively. Their performance has been evaluated in laboratory and field tests to demonstrate the feasibility of using these monitors to measure near real-time concentrations, with consideration of their potential for being employed in long-term measurements. The fine PM collection setup was equipped with a versatile aerosol concentration enrichment system (VACES) connected to an aerosol-into-liquid-sampler (AILS), whereas two virtual impactors (VIs) in tandem with a modified BioSampler were used to collect coarse PM. These particle collection setups were in tandem with a Sievers M9 TOC analyzer to read TOC and WSOC concentrations in aqueous samples hourly. The average hourly TOC concentration measured by our developed monitors in fine and coarse PM were 5.17 ± 2.41 and 0.92 ± 0.29 µg/m3, respectively. In addition, our TOC readings showed good agreement and were comparable with those quantified using Sunset Lab EC/OC analyzer operating in parallel as a reference. Furthermore, we conducted field tests to produce diurnal profiles of fine PM-bound WSOC, which can show the effects of ambient temperature on maximum values in the nighttime chemistry of the winter, as well as on increased photochemical activities in afternoon peaks during the summer. According to our experimental campaign, WSOC mean values during the study period (3.07 µg/m3 for the winter and 2.7 µg/m3 for the summer) were in a comparable range with those of earlier studies in Los Angeles. Overall, our results corroborate the performance of our developed monitors in near real-time measurements of TOC and WSOC, which can be employed for future source apportionment studies in Los Angeles and other areas, aiding in understanding the health impacts of different pollution sources.

Eosinophilic bronchiectasis increases length and cost of hospitalization: a retrospective analysis in a hospital of southern China from 2012 to 2020.

BACKGROUND: The concept of eosinophilic bronchiectasis has received clinical attention recently, but the association between blood eosinophil count (BEC) and hospital characteristics has rarely been reported yet. We aim to investigate the clinical impact of BEC on patients with acute bronchiectasis exacerbation. METHODS: A total of 1332 adult patients diagnosed with acute exacerbation of bronchiectasis from January 2012 to December 2020 were included in this retrospective study. A propensity-matched analysis was performed by matching age, sex and comorbidities in patients with high eosinophil count (≥ 300 cell/µL) and low eosinophil count (< 300 cell/µL). Clinical characteristics, length of hospital stay (LOS), hospitalization cost and inflammatory markers were compared between the two groups. RESULTS: Eosinophilic bronchiectasis occurred in approximately 11.7% of all patients. 156 propensity score-matched pairs were identified with and without high eosinophil count. Eosinophilic bronchiectasis presented with a longer LOS [9.0 (6.0-12.5) vs. 5.0 (4.0-6.0) days, p < 0.0001] and more hospitalization cost [15,011(9,753-27,404) vs. 9,109(6,402-12,287) RMB, p < 0.0001] compared to those in non-eosinophilic bronchiectasis. The median white blood cell (WBC), lymphocyte, platelet (PLT) and C-reactive protein (CRP) levels in eosinophilic bronchiectasis were significantly increased. Multivariate logistic regression analysis confirmed that the high levels of eosinophil count (OR = 13.95, p < 0.0001), worse FEV1% predicted (OR = 7.80, p = 0.0003) and PLT (OR = 1.01, p = 0.035) were independent prognostic factors for length of hospital (LOS) greater than 7 days. CONCLUSION: Eosinophilic bronchiectasis patients had longer length of hospital stay and more hospitalization cost compared to those in non-eosinophilic bronchiectasis group, which might be associated with the stronger inflammatory reaction.

Development and external validation of a predictive model for prolonged length of hospital stay in elderly patients undergoing lumbar fusion surgery: comparison of three predictive models.

PURPOSE: This study aimed to develop a predictive model for prolonged length of hospital stay (pLOS) in elderly patients undergoing lumbar fusion surgery, utilizing multivariate logistic regression, single classification and regression tree (hereafter, "classification tree") and random forest machine-learning algorithms. METHODS: This study was a retrospective review of a prospective Geriatric Lumbar Disease Database. The primary outcome measure was pLOS, which was defined as the LOS greater than the 75th percentile. All patients were grouped as pLOS group and non-pLOS. Three models (including logistic regression, single-classification tree and random forest algorithms) for predicting pLOS were developed using training dataset and internal validation using testing dataset. Finally, online tool based on our model was developed to assess its validity in the clinical setting (external validation). RESULTS: The development set included 1025 patients (mean [SD] age, 72.8 [5.6] years; 632 [61.7%] female), and the external validation set included 175 patients (73.2 [5.9] years; 97[55.4%] female). Multivariate logistic analyses revealed that older age (odds ratio [OR] 1.06, p < 0.001), higher BMI (OR 1.08, p = 0.002), number of fused segments (OR 1.41, p < 0.001), longer operative time (OR 1.02, p < 0.001), and diabetes (OR 1.05, p = 0.046) were independent risk factors for pLOS in elderly patients undergoing lumbar fusion surgery. The single-classification tree revealed that operative time ≥ 232 min, delayed ambulation, and BMI ≥ 30 kg/m2 as particularly influential predictors for pLOS. A random forest model was developed using the remaining 14 variables. Intraoperative EBL, operative time, delayed ambulation, age, number of fused segments, BMI, and RBC count were the most significant variables in the final model. The predictive ability of our three models was comparable, with no significant differences in AUC (0.73 vs. 0.71 vs. 0.70, respectively). The logistic regression model had a higher net benefit for clinical intervention than the other models. The nomogram was developed, and the C-index of external validation for PLOS was 0.69 (95% CI, 0.65-0.76). CONCLUSION: This investigation produced three predictive models for pLOS in elderly patients undergoing lumbar fusion surgery. The predictive ability of our three models was comparable. Logistic regression model had a higher net benefit for clinical intervention than the other models. Our predictive model could inform physicians about elderly patients with a high risk of pLOS after surgery.

Motivation to Quit Smoking Among Black Adults Residing in Los Angeles County Communities With Menthol Cigarette Sales Restrictions.

Background: Research is needed to identify the determinants of motivation to quit smoking among non-Hispanic Black (NHB) adults who smoke menthol cigarettes and reside in communities covered by menthol cigarette bans. Objectives: This study examined the associations between motivation to quit smoking and a range of individual-level predictors, including measures of demographics, harm/risk perception of menthol cigarettes, and awareness of a ban on menthol cigarettes in Los Angeles County unincorporated communities. Self-identified NHB adults who currently smoke menthol cigarettes (N=50; M=47.2 years; SD=13.7; 46% female) were recruited in Los Angeles County unincorporated communities. Participants completed an interviewer-administered cross-sectional survey between January to September 2021. Results: Participants (74%) reported an annual household income of less than $25,000. Participants' mean age at cigarette initiation was 15.7 years old (SD=5.68). Most (88%) were aware of the ordinance banning menthol cigarette sales. Employing multivariable linear regression analysis, harm/risk perception of menthol cigarettes (B=14.69, p<0.01) and awareness of the local menthol ban (B=26.18, p<0.05) were found to be independently associated with motivation to quit smoking. Conclusions: Findings from this community-based sample suggest that among NHB adults who smoke menthol cigarettes, motivation to quit smoking is influenced by their perception of menthol cigarettes as harmful and awareness of local policy banning the sale of menthol cigarettes. Findings underscore the need for community-centered and culturally grounded interventions to facilitate quitting among NHB adults who smoke in order for communities covered by menthol bans to achieve health equity in reducing preventable racial inequities due to menthol cigarettes.

Unveiling the heightened susceptibility: Exploring early hypophosphatemia in critically ill trauma patients.

BACKGROUND: Phosphorus is a vital mineral crucial for various physiological functions. Critically ill trauma patients frequently experience hypophosphatemia during the immediate post-traumatic phase, potentially impacting outcomes. This study aims to investigate the incidence of early hypophosphatemia in critically major trauma patients. METHODS: In this prospective observational study, trauma patients admitted to the intensive care unit (ICU) within one day were enrolled. These patients were categorized into Hypo-P groups and Non-hypo groups based on the development of new-onset hypophosphatemia within 72 h after feeding. The primary outcome assessed was the incidence of new-onset hypophosphatemia. The secondary outcomes included ICU and hospital stay, ventilation duration, and mortality. RESULTS: 76.1% of patients developed a new onset of hypophosphatemia within 72 h after feeding. The Hypo-P group had significantly longer ICU stays (8.1 days ± 5.5 vs. 4.4 days ± 3.1; p = 0.0251) and trends towards extended hospital stay, ventilation duration, and higher mortality. Additionally, they demonstrated significantly higher urine fractional excretion of phosphate (FEPO4) on the first ICU day (29.2% ± 14.23 vs. 19.5% ± 8.39; p = 0.0242). CONCLUSION: Critically ill trauma patients exhibited a significantly higher incidence of early hypophosphatemia than typical ICU rates, indicating their heightened vulnerability. The significantly high urine FEPO4 underscores the crucial role of renal loss in disrupting phosphate metabolism in this early acute phase after trauma. A significant correlation was observed between hypophosphatemia and longer ICU stays. Monitoring and managing phosphate levels may influence outcomes, warranting further investigation.

Inbreeding depression and runs of homozygosity islands in Asturiana de los Valles cattle breed after 30 years of selection.

Inbreeding depression results in a decrease in the average phenotypic values of affected traits. It has been traditionally estimated from pedigree-based inbreeding coefficients. However, with the development of single-nucleotide polymorphism arrays, novel methods were developed for calculating the inbreeding coefficient, and consequently, inbreeding depression. The aim of the study was to analyse inbreeding depression in 6 growth and 2 reproductive traits in the Asturiana de los Valles cattle breed using both genealogical and molecular information. The pedigree group comprised 225,848 records and an average equivalent number of complete generations of 2.3. The molecular data comprised genotypes of 2693 animals using the Affymetrix medium-density chip. Using the pedigree information, three different inbreeding coefficients were estimated for the genotyped animals: the full pedigree coefficient (FPED), and the recent and ancient inbreeding coefficients based on the information of the last three generations (FPED<3G) and until the last three generations (FPED>3G), respectively. Using the molecular data, seven inbreeding coefficients were calculated. Four of them were estimated based on runs of homozygosity (ROH), considering (1) the total length (FROH), (2) segments shorter than 4 megabases (FROH<4), (3) between 4 and 17 megabases (FROH4-17), and (4) longer than 17 Mb (FROH>17). Additionally, the three inbreeding coefficients implemented in the Plink software (FHAT1-3) were estimated. Inbreeding depression was estimated using linear mixed-effects model with inbreeding coefficients used as covariates. All analysed traits (birth weight, preweaning average daily gain, weaning weight adjusted at 180 days, carcass weight, calving ease, age at first calving, calving interval) showed a statistically significant non-zero effect of inbreeding depression estimated from the pedigree group, except for the Postweaning Average Daily Gain trait. When inbreeding coefficients were based on the genomic group, statistically significant inbreeding depression was observed for two traits, Preweaning Average Daily Gain and Weaning Weight based on FROH, FROH>17, and FHAT3 inbreeding coefficients. Nevertheless, similar to inbreeding depression estimated based on pedigree information, estimates of inbreeding depression based on genomic information had no relevant economic impact. Despite this, from a long-term perspective, genotyped data could be included to maximize genetic progress in genetic programs following an optimal genetic contribution strategy and to consider individual inbreeding load instead global inbreeding. ROH islands were identified on chromosomes 2, 3, 8, 10, and 16. Such regions contain several candidate genes for growth development, intramuscular fat, body weight and lipid metabolism that are related to production traits selected in Asturiana de los Valles breed.

User Orientation Detection in Relation to Antenna Geometry in Ultra-Wideband Wireless Body Area Networks Using Deep Learning.

In this paper, the issue of detecting a user's position in relation to the antenna geometry in ultra-wideband (UWB) off-body wireless body area network (WBAN) communication using deep learning methods is presented. To measure the impulse response of the channel, a measurement stand consisting of EVB1000 devices and DW1000 radio modules was developed and indoor static measurement scenarios were performed. It was proven that for the binary classification of user orientation, neural networks achieved accuracy that was more than 9% higher than that for the well-known threshold method. In addition, the classification of user position angles relative to the reference node was analyzed. It was proven that, using the proposed deep learning approach and the channel impulse response, it was possible to estimate the angle of the user's position in relation to the antenna geometry. Absolute user orientation angle errors of about 4-7° for convolutional neural networks and of about 14-15° for multilayer perceptrons were achieved in approximately 85% of the cases in both tested scenarios.

Estimating the minimal clinically important difference of shoulder functional scores after arthroscopic rotator cuff repair: a prospective study.

INTRODUCTION: The minimal clinically important difference (MCID) is a valuable tool for patient-based outcome analysis, for which limited data is available in the literature, especially after arthroscopic rotator cuff repair (ARCR). Although several studies have reported MCID after ARCR, few have studied the impact of various clinical factors such as Diabetes, pseudoparalysis, type of cuff repair, and retear over MCID. This study attempts to determine the MCID in shoulder functional scores after ARCR and the impact of various factors on MCID. METHODS: 144 patients undergoing ARCR were prospectively evaluated at six and 12 months by ASES and UCLA scores. MCID for American Shoulder and Elbow Surgeons (ASES) and the University of California and Los Angeles (UCLA) scores were calculated using an anchor-based and distribution-based approach. MCID was also calculated for diabetic and non-diabetic patients, smokers vs. non-smokers, presence or absence of pseudoparalysis, type of cuff repair (single row vs. suture bridge), and presence of retears. Uni- and multivariate analysis was performed to identify factors affecting the MCID of both scores. RESULTS: Mean MCID for ASES score was 13.3 and 16.6 using an anchor-based and distribution-based approach, respectively. For the UCLA score, the mean MCID was 10.0 and 12.6 by anchor-based and 12.6 by distribution-based approach, respectively. Patients with higher pre-operative ASES scores demonstrated lower MCID values. No significant difference was observed in MCID scores of diabetic vs. non-diabetic patients, smoker vs. non-smoker, patients with or without pseudoparalysis, and type of cuff repair. The age, gender, and presence of retear did not affect MCID values. CONCLUSION: This study establishes the MCID values of ASES and UCLA scores for rotator cuff repair by anchor and distribution methods. No patient or surgical factors appear to affect the MCID except pre-operative ASES scores. STUDY DESIGN: Prospective cohort, Level II.

Comparison of the monitoring of surface deformations in open-pit mines with Sentinel-1A and TerraSAR-X satellite radar data.

In case necessary precautions are not taken in surface mines, serious accidents and loss of life may occur, particularly due to large mass displacements. It is extremely important to identify the early warning signs of these displacements and take the necessary precautions. In this study, free medium-resolution satellite radar images from the European Space Agency's (ESA) C-band Sentinel-1A satellite and commercial high-resolution satellite radar images (SAR, Synthetic Aperture Radar) from the Deutsches Zentrum für Luft- und Raumfahrt's (DLR) X-band TerraSAR-X satellite were obtained, and it was attempted to reveal the traceability and adequacy of monitoring of deformations and possible mass displacements in the dump site of an open-pit coal mine. The compatibility of the results obtained from the satellite radar data with two devices of Global Positioning System (GPS) which were installed in the field was evaluated. Furthermore, the velocity results in the Line Of Sight (LOS) direction and vertical deformation velocity results obtained with all three approaches (GPS/Sentinel-1A, GPS/TerraSAR-X, and Sentinel-1A/TerraSAR-X) were compared. It was observed that the results were statistically equal and the directions of movement were similar/compatible. The result of this study showed that deformations at mine sites can be monitored with sufficient accuracy for early warning with free Sentinel-1A satellite data, although the TerraSAR-X satellite offers a higher resolution.

[Barriers and facilitators in accessing and using primary health care centers for people experiencing homelessness]. / Barreras y facilitadores en el acceso y la utilización de los centros de atención primaria para las personas en situación de sinhogarismo.

OBJECTIVE: To identify barriers and facilitators for the access and use of primary care centers for people experiencing homelessness. DESIGN: Qualitative study, phenomenological theoretical-methodological approach. Between May 19 and July 27, 2023. LOCATION: Besòs Primary Health Care Center and Gregal social dining (Besòs and Maresme neighborhood, Barcelona). PARTICIPANTS: People experiencing homelessness attending the Gregal social dining and professionals from the Besòs Primary Health Care Center. METHOD: Theoretical purposive sampling. Individual and group interviews and open non-participant observation. Thematic content analysis, triangulation by independent analysis of three members of the research team and triangulation of methods. Discourse saturation was achieved through variability of discourse and techniques. RESULTS: Eleven individual interviews, three group interviews and two observations. Different barriers and facilitators were identified. These were classified into five categories: (1)concept and identification of people experiencing homelessness; (2)personal factors of people experiencing homelessness; (3)behaviors and attitudes of professionals; (4)structural factors related to health system regulation, anf (5)internal organizational factors of primary health care centers. CONCLUSIONS: People experiencing homelessness face multiple barriers to access primary health care, although there are also facilitators such as trusting relationships and multidisciplinary and intersectoral work that can be enhanced from primary health care centers to contribute to health equity.

Guardians of health under fire: Understanding and combating violence against doctors.

Violence against physicians is not a newly emerged but an increasingly serious problem. Various studies have reported a prevalence of up to 90%. If not prevented, it not only causes physical and mental harm to physicians who are dedicated to serving humanity but also affects the entire healthcare system and, consequently, the whole community with its direct and indirect effects. Some interventions have a positive outcome when effectively managed. However, for these interventions to be permanent and effective, they need to be multidisciplinary, legally backed and adopted as public policy. In this article, the prevalence of violence against physicians in the literature, its causes, practices worldwide, and suggestions for solving this problem are compiled.

[Health consequences of violence against women by the couple]. / Consecuencias para la salud de la violencia contra la mujer por la pareja.

Intimate partner violence against women (IPV) has devastating effects on the healthcare and well-being of women and their children. Physical, psychological, and social consequences, a worse perception of their own health, and loss of quality of life are well-documented, while aftereffects persist in time even after the end of abuse. Psychological consequences of abuse last longer and are more serious. IPV also affects sons and daughters, disabled people, family, and the attacker himself. Many health problems, both physical and mental, that lead women to go to healthcare services in search of help have an origin in the violence they experience. Treatment of the symptoms without awareness of its relation to such violence favours medicalization, iatrogenesis, and chronification. Psychological violence poses a threat that is invisible, subtle, cumulative, and difficult to detect; it is, however, the most destructive.

The impact of asymptomatic human immunodeficiency virus (HIV)-positive disease status on inpatient complications following total joint arthroplasty: a propensity score-matched analysis.

PURPOSE: The number of patients with asymptomatic human immunodeficiency virus (AHIV) is increasing as the efficacy of antiretroviral therapy improves. While there is research on operative risks associated with having HIV, there is a lack of literature describing the impact of well-controlled HIV on postoperative complications. This study seeks to elucidate the impact of AHIV on postoperative outcomes after total hip (THA) and knee (TKA) arthroplasty. METHODS: The Nationwide Inpatient Sample was retrospectively reviewed for patients undergoing TKA and THA from 2005 to 2013. Subjects were subdivided into those with AHIV and those without HIV (non-HIV). Patient demographics, hospital-related parameters, and postoperative complications were all collected. One-to-one propensity score-matching, Chi-square analysis, and multivariate logistical regressions were performed to compare both cohorts. RESULTS: There were no significant differences between AHIV and non-HIV patients undergoing TKA or THA in terms of sex, age, insurance status, or total costs (all, p ≥ 0.081). AHIV patients had longer lengths of stay (4.0 days) than non-HIV patients after both TKA (3.3 days) and THA (3.1 days) (p ≤ 0.011). Both TKA groups had similar postoperative complication rates (p > 0.081). AHIV patients undergoing THA exhibited an increased rate of overall surgical complications compared non-HIV patients (0 vs. 4.5%, p = 0.043). AHIV was not associated with increased complications following both procedures. CONCLUSION: Despite lengthier hospital stays among AHIV patients, baseline AHIV was not associated with adverse outcomes following TKA and THA. This adds to the literature and warrants further research into the impact of asymptomatic, well-controlled HIV infection on postoperative outcomes following total joint arthroplasty.

Internalized HIV-related stigma in women of color obtaining care at an HIV specialty center in Los Angeles County, California.

The current study examined the role of internalized HIV-related stigma in antiretroviral therapy adherence, viral load, and retention in care among women of color living with HIV in Los Angeles County, California. African American and Hispanic/Latino women 18 years of age and older completed a one-time brief survey between September 2017 and February 2018. Descriptive statistics, and univariable and multivariable logistic regressions were used to analyze the data. Seventy-six participants enrolled in the study and 74 completed the entire survey. Seventy-six percent of respondents were Hispanic/Latino, 24% were African American, 71% were unemployed, and 54% had less than a high school education. Thirty-five percent were defined as having "high" stigma with a score in the upper quartile of the scale. Being unemployed, having a high school education or less, and not meeting the Health Resources and Services Administration's annual retention in care measure were associated with "high" stigma. When controlling for education and employment status, those reporting "high" stigma vs. "low" stigma were 18.8 times more likely to not meet the criteria for annual retention in care (OR = 18.8, 95% CI = 1.9-189.2, p = 0.013). Stigma-reduction interventions targeting healthcare settings may be necessary to improve patient retention and engagement in care.

Learning from perpetrator replacement to remove crime opportunities and prevent poaching of the Sundarbans tiger.

Illegal wildlife trade (IWT) is one of the leading causes of the decline in high-value species. Crime-reduction strategies to counter IWT can have unintended effects, with crime displacement occurring when offenders react to such interventions. Despite the value of understanding how and why displacement occurs for informing conservation strategies, few examples are published. We explored a case of perpetrator replacement following an intervention and drew lessons for conservation strategies for high-value species. Poaching and subsequent trade threaten the Sundarbans tiger (Panthera tigris). Pirate gangs were the dominant poachers from 1980 to 2017, but following an extensive campaign, the Sundarbans was declared pirate free in 2018. We interviewed 280 individuals, including 100 tiger poachers, from 26 administrative unions bordering the Sundarbans and used interviewee responses to compare the poaching situation during and after the pirate era. We analyzed the spatial distribution of tiger poachers among the unions and used crime script analysis of the dominant poacher type to identify intervention. Because pirates opportunistically poached tigers, the government's successful counter-pirate campaign inadvertently removed the dominant tiger poaching type. However, a temporary reduction in poaching was rapidly cancelled out by the emergence of at least 32 specialist tiger-poaching teams. With the risk of extortion and robbery from pirates gone, other groups increased the frequency of opportunistic and targeted tiger poaching. Based on expert interviews, we estimated that 341 tiger poachers of all types are active throughout the unions, with 79% of specialists concentrated in 27% of unions. The highly focused counter-pirate campaign reduced motivations and opportunities for piracy but left intact the opportunity structure and trade connections for tiger poaching, and with insufficient enforcement officers trading has flourished. Interventions targeting opportunities for poaching by specialist tiger poachers include heightened surveillance and reporting mechanisms and alternative livelihood provision to disincentivize poaching.

Aprendizaje a partir de la sustitución del infractor para eliminar las oportunidades de crimen y prevenir la caza furtiva del tigre de Sundarbans Resumen El mercado ilegal de fauna (MIF) es una de las principales causas de la declinación de especies importantes. Las estrategias de reducción de crímenes para contrarrestar el MIF pueden tener efectos no deseados, como el desplazamiento del crimen que ocurre cuando los infractores reaccionan a dichas intervenciones. A pesar de lo valioso que es para las estrategias de conservación entender cómo y por qué ocurre este desplazamiento, se publican pocos ejemplos. Exploramos un caso de sustitución del infractor después de una intervención sacamos lecciones para las estrategias de conservación de especies importantes. La caza furtiva y el mercado subsecuente son una amenaza para el tigre de Sundarbans (Panthera tigris). Los piratas fueron los cazadores dominantes entre 1980 y 2017, pero después de una campaña exhaustiva, el Sundarbans fue declarado libre de piratas en 2018. Entrevistamos a 280 individuos, incluidos 100 cazadores furtivos, de 26 uniones administrativas que rodean al Sundarbans y usamos sus respuestas para comparar la situación de la caza furtiva durante y después de los piratas. Analizamos la distribución espacial de los cazadores furtivos entre las uniones y usamos el análisis de escritura criminal del tipo dominante de cazador para identificar las intervenciones. Ya que los piratas eran cazadores furtivos oportunistas, la campaña exitosa del gobierno para contrarrestarlos eliminó sin saberlo el tipo dominante de caza furtiva. Sin embargo, una reducción temporal de la caza se canceló rápidamente con la emergencia de al menos 32 equipos especialistas en la cacería furtiva de los tigres. Sin el riesgo de la extorsión o robo por parte de los piratas, otros grupos incrementaron la frecuencia de la cacería oportunista y focalizada. Con base en las entrevistas a expertos, estimamos que 341 cazadores de tigres de todos los tipos están activos en las uniones, con 79% de los especialistas concentrados en 27% de las uniones. La campaña focalizada anti-piratas redujo las motivaciones y oportunidades de piratería, pero no afectó la estructura de oportunidades y conexiones mercantiles de la cacería furtiva de tigres, lo cual, sumado a la falta de suficientes agentes policiales, ha aumentado el mercado. Las intervenciones enfocadas en las oportunidades de cacería de los cazadores especialistas incluyen una mayor vigilancia y mecanismos de reporte y el suministro de sustentos alternativos para desalentar la cacería furtiva.