Evaluation of Orexin-A Salivary Levels and its Correlation with Attention After Non-invasive Brain Stimulation in Female Volleyball Players

BACKGROUND

The capacity to change attention from one area to another depending on the many environmental circumstances present is a crucial aspect of selective attention and is strictly correlated to reaction time. The cholinergic system of the basal forebrain is crucial for attentive abilities. Several inputs, particularly orexin neurons, whose cell bodies are found in the postero-lateral hypothalamus, can activate the cholinergic system. The aim of this study was to investigate if high frequencies rTMS at dorsolateral prefrontal cortex (DLPFC) in highly trained volleyball players can change Orexin-A levels, attention and reaction time. This study was a double-blinded (participant and evaluator) matched-pair experimental design. Twenty right-handed female volleyball players were recruited for the study (age 24.6 ± 2.7 years; height 177.0 ± 5.5 cm; body mass 67.5 ± 6.5 kg; BMI 21.5 ± 1.2).

RESULTS

The main finding of this study was that 10 Hz rTMS to the DLPFC seems to increase Orexin-A salivary levels and the percentage of correct answers, while decreasing RT. After rTMS, the athletes show an increase in the percentage of correct answers immediately after the end of stimulation, and also after 15 and 30 min. Moreover, the athletes show decreases in reaction time after the end of stimulation and after 15 and 30 min to the end of stimulation, while no differences were found at the end of stimulation. Finally, the athletes show significant increases in Orexin-A salivary levels after stimulation with a peak after 30' of the end.

CONCLUSION

The results of our study seem to indicate that there is a relationship between salivary Orexin-A levels and RT. These results could provide useful tools for modulating sports training; in fact, if confirmed, they could lead coaches to offer their athletes rTMS sessions appropriately integrated with training. In fact, alternating attention is a mental flexibility that enables people to change their point of focus and switch between tasks requiring various levels of cognition.

A cross-sectional study on performance evaluation in Italian standardbred horses' real-time PCR-positive for Theileria equi

BACKGROUND

Inflammatory myopathy and perivasculitis have been recently described in horses with chronic equine piroplasmosis (EP). These alterations may be linked to poor performances. The aims of this study were to evaluate the prevalence for EP in clinically healthy Italian Standardbred (IS) racehorses and to compare laboratory parameters and performance metrics between positive and negative horses. Real-time PCR was applied for the detection of T. equi and B. caballi positivity. Haematology parameters, blood chemistry results, subjective muscle mass scores, and performance metrics were compared between PCR-positive and -negative horses.

RESULTS

This cross-sectional study included 120 well-trained IS racehorses and was performed over a two-years period. The prevalence of T. equi was 36.3%, whereas all samples were negative for B. caballi. Red blood cells count, haemoglobin concentration, aspartate aminotransferase, alkaline phosphatase, and gamma-glutamyl transferase activities were significantly higher in PCR-positive horses, whereas blood urea nitrogen, globulin concentration and globulin-to-albumin ratio were significantly lower in PCR-positive horses compared to PCR-negative ones. Nonetheless, all values fell within the physiological range. The best racing time, which was selected as the most representative of the performance metrics at the principal component analysis, was not affected by PCR positivity, the muscle mass score or the training yard. The best racing time was significantly better in horses with a mild or no signs of muscular atrophy, within the PCR-positive group. The muscle mass score was associated with the training yard in PCR-negative horses.

CONCLUSIONS

Prevalence of T. equi was high in IS racehorses in southern Italy. The absence of obvious changes in haematological and biochemical parameters, as well as performance metrics in positive horses, highlights the need for specific diagnostic tests to identify chronically infected horses.

Effects of Passive or Active Recovery Regimes Applied During Long-Term Interval Training on Physical Fitness in Healthy Trained and Untrained Individuals: A Systematic Review

BACKGROUND

Intermittent exercise programs characterized through intensive exercise bouts alternated with passive or active recovery (i.e., interval training), have been proven to enhance measures of cardiorespiratory fitness. However, it is unresolved which recovery type (active or passive) applied during interval training results in larger performance improvements.

OBJECTIVES

This systematic review aimed to summarize recent evidence on the effects of passive or active recovery following long-term interval exercise training on measures of physical fitness and physiological adaptations in healthy trained and untrained individuals. The study protocol was registered in the Open Science Framework (OSF) platform ( https://doi.org/10.17605/OSF.IO/9BUEY ).

METHODS

We searched nine databases including the grey literature (Academic Search Elite, CINAHL, ERIC, Open Access Theses and Dissertations, Open Dissertations, PsycINFO, PubMed/MEDLINE, Scopus, and SPORTDiscus) from inception until February 2023. Key terms as high-intensity interval training, recovery mode, passive or active recover were used. A systematic review rather than a meta-analysis was performed, as a large number of outcome parameters would have produced substantial heterogeneity.

RESULTS

After screening titles, abstracts, and full texts, 24 studies were eligible for inclusion in our final analysis. Thirteen studies examined the effects of interval training interspersed with passive recovery regimes on physical fitness and physiological responses in trained (6 studies) and untrained (7 studies) individuals. Eleven out of 13 studies reported significant improvements in physical fitness (e.g., maximal aerobic velocity (MAV), Yo-Yo running test, jump performance) and physiological parameters (e.g., maximal oxygen uptake [VO2max], lactate threshold, blood pressure) in trained (effect sizes from single studies: 0.13 < Cohen's d < 3.27, small to very large) and untrained individuals (effect sizes: 0.17 < d < 4.19, small to very large) despite the type of interval training or exercise dosage (frequency, intensity, time, type). Two studies were identified that examined the effects of passive recovery applied during interval training in young female basketball (15.1 ± 1.1 years) and male soccer players (14.2 ± 0.5 years). Both studies showed positive effects of passive recovery on VO2max, countermovement jump performance, and the Yo-Yo running test. Eleven studies examined the effects of interval training interspersed with active recovery methods on physical fitness and physiological parameters in trained (6 studies) and untrained individuals (5 studies). Despite the type of interval training or exercise dosage, nine out of eleven studies reported significant increases in measures of physical fitness (e.g., MAV) and physiological parameters (e.g., VO2max, blood pressures) in trained (effect sizes from single studies: 0.13 < d < 1.29, small to very large) and untrained individuals (effect sizes: 0.19 < d < 3.29, small to very large). There was no study available that examined the effects of active recovery on physical fitness and physiological responses in youth.

CONCLUSIONS

The results of this systematic review show that interval training interspersed with active or passive recovery regimes have the potential to improve measures of physical fitness and physiology outcomes in trained and untrained adults and trained youth. That is, the applied recovery type seems not to affect the outcomes. Nonetheless, more research is needed on the effects of recovery type on measures of physical fitness and physiological adaptations in youth.

Lignin - A green material for antibacterial application - A review

Lignin's antibacterial properties have become increasingly relevant due to the rise of microbial infectious diseases and antibiotic resistance. Lignin is capable of interacting electrostatically with bacteria and contains polyphenols that cause damage to their cell walls. These features make lignin a desirable material to exhibit antibacterial behavior. Therefore, lignin in antibacterial applications offers a novel approach to address the growing need for sustainable and effective antibacterial materials. Recent research has explored the incorporation of lignin in various biomedical applications, such as wound dressings, implants, and drug delivery systems, highlighting their potential as a sustainable alternative to synthetic antibacterial agents. Furthermore, the development of lignin-based nanomaterials with enhanced antimicrobial activity is an active area of research that holds great promise for the future. In this review, we have provided a summary of how lignin can be incorporated into different forms, such as composite and non-composite synthesis of antibacterial agents and their performances. The challenges and future considerations are also discussed in this review article.

No benefit of vitamin D supplementation on muscle function and health-related quality of life in primary cardiovascular prevention patients with statin-associated muscle symptoms: A randomized controlled trial

BACKGROUND

Statins are the leading lipid-lowering drugs, reducing blood cholesterol by controlling its synthesis. Side effects are linked to the use of statins, in particular statin-associated muscle symptoms (SAMS). Some data suggest that vitamin D supplementation could reduce SAMS.

OBJECTIVE

The purpose of this study was to evaluate the potential benefits of vitamin D supplementation in a randomized controlled trial.

METHODS

Men (n = 23) and women (n = 15) (50.5 ± 7.7 years [mean ± SD]) in primary cardiovascular prevention, self-reporting or not SAMS, were recruited. Following 2 months of statin withdrawal, patients were randomized to supplementation (vitamin D or placebo). After 1 month of supplementation, statins were reintroduced. Before and 2 months after drug reintroduction, muscle damage (creatine kinase and myoglobin) was measured. Force (F), endurance (E) and power (P) of the leg extensors (ext) and flexors (fle) and handgrip strength (FHG) were also measured with isokinetic and handheld dynamometers, respectively. The Short Form 36 Health Survey (SF-36) questionnaire and a visual analog scale (VAS) were administrated to assess participants' self-reported health-related quality of life and SAMS intensity, respectively. Repeated-measures analysis was used to investigate the effects of time, supplementation, and their interaction, according to the presence of SAMS.

RESULTS

Despite no change for objective measures, subjective measures worsened after reintroduction of statins, independent of supplementation (VAS, SF-36 mental component score, all p < 0.05). However, no interaction between time and supplementation according to the presence of SAMS was observed for any variables.

CONCLUSIONS

Vitamin D supplementation does not appear to mitigate SAMS.

Use of additives to improve collective biogas plant performances: A comprehensive review

Nowadays, anaerobic digestion (AD) is being increasingly encouraged to increase the production of biogas and thus of biomethane. Due to the high diversity among feedstocks used, the variability of operating parameters and the size of collective biogas plants, different incidents and limitations may occur (e.g., inhibitions, foaming, complex rheology). To improve performance and overcome these limitations, several additives can be used. This literature review aims to summarize the effects of the addition of various additives in co-digestion continuous or semi-continuous reactors to fit as much as possible with collective biogas plant challenges. The addition of (i) microbial strains or consortia, (ii) enzymes and (iii) inorganic additives (trace elements, carbon-based materials) in digester is analyzed and discussed. Several challenges associated with the use of additives for AD process at collective biogas plant scale requiring further research work are highlighted: elucidation of mechanisms, dosage and combination of additives, environmental assessment, economic feasibility, etc.

Potential of simple and hybrid nanofluid enhancement in performances of a flat plate solar water heater under a typical North-African climate (Tunisia)

This work aims to quantify the long-term performance improvement of solar water heater system by using both simple and hybrid nanofluids. For this purpose, transient system simulations of a flat plate solar collector have been carried out and discussed using titanium oxide, magnesium oxide, and copper oxide/multiwalled oxide-carbon nanotube nanofluid-based nanoparticles. Tunisian climatic conditions with a typical household need has been considered, and the investigations have been established in terms of energy amounts, solar fractions, and harmful CO₂ emission avoidance. Results showed an increase in the collector performances using the considered nanofluids. In particular, using 0.2v% and 0.6v% TiO₂ homogeneously dispersed in water reduced the auxiliary energy up to 47.6 and 60.9%, respectively, compared to the reference case using water. The flat plate solar collector has an annual production of 1294 kWh for a need of 1998 kWh, which equates to an annual coverage rate of roughly 65%. Additionally, it was shown that when MgO with MWCNT were used instead of MgO nanofluid-based nanoparticles, the solar fraction increased by 5.14%. The use of 0.6 volume percent TiO₂ nanoparticles in water reduces hazardous CO₂ emissions by up to 0.829 tons annually.

Enhancement and mechanisms of iron-assisted anammox process

Anaerobic ammonium oxidation (anammox) is a sustainable biological nitrogen removal technology that has limited large-scale applications owing to the low cell yield and high sensitivity of anammox bacteria (AnAOB). Fortunately, iron-assisted anammox, being a highly practical method could be an effective solution. This review focused on the iron-assisted anammox process, especially on its performance and mechanisms. In this review, the effects of iron in three different forms (ionic iron, zero-valent iron and iron-containing minerals) on the performance of the anammox process were systematically reviewed and summarized, and the strengthening effects of Fe (II) seem to be more prominent. Moreover, the detailed mechanisms of iron-assisted anammox in previous researches were discussed from macro to micro perspectives. Additionally, applicable iron-assisted methods and unified strengthening mechanisms for improving the stability of nitrogen removal and shortening the start-up time of the system in anammox processes were suggested to explore in future studies. This review was intended to provide helpful information for scientific research and engineering applications of iron-assisted anammox.

The synergistic effect of heterogeneous nucleation and stress-induced crystallization on supramolecular structure and performances of poly(lactic acid) melt-spun fibers

As a kind of bio-based polymer, poly (lactic acid) has potential application in fibers fields. Due to the weak nucleation ability, PLA crystallizes slowly and forms large spherulites during the forming process, which deteriorates the properties of PLA fibers. In this work, melt-spun method is employed for the fabrication of PLA/T composite fibers using succinate diphenyl dihydrazide (TMC-306) as the nucleating agent, and then the hot-drawing and heat setting is performed to the as-spun fibers. Compared with pure PLA fibers, PLA/T fibers show faster crystallization rate and improved performance due to the synergistic effect of heterogeneous nucleation and stress-induced crystallization. The characterization of non-isothermal crystallization behavior indicates that the peak crystallization temperature as well as crystallinity of PLA composites is increased to 121.5 °C and 36.78 % respectively by blending 0.3 wt% TMC-306. Meanwhile, the obtained PLA/0.3T composite fibers are highly crystallized and oriented at hot-drawing ratio of 2.4 folds and heat setting temperature of 100 °C, and the conformational stability is noticeably enhanced. Further, the tensile strength and storage modulus of PLA/0.3T composite fiber are 3.46 cN/dtex and 46,953 MPa respectively, which are increased by 42 % and 41 % compared with neat PLA fibers.

Effects of Zinc Oxide Nanoparticles on the Performance of Broiler Chickens Under Hot Climatic Conditions

This study aimed to investigate the effects of different levels of zinc oxide nanoparticles on broilers' performance, nutrient digestibility, carcass criteria, and blood biochemistry. A total of 120 1-day-old unsexed broiler chickens (Ross 308) were fed zinc oxide nanoparticles at different levels (0, 20, 40, or 60 mg/kg) in their diets. Each treatment included 6 replicate pens with 5 birds each. The experiment lasted 42 days. The brooding temperatures were 37.8 °C, 35.8 °C, and 29.9 °C during 1-10 days, 11-21 days, and 22-42 days of age, respectively. The results revealed that dietary supplementation of nanoparticles of zinc oxide at 20, 40, and 60 mg/kg diet significantly improved body weight, body weight gain, and feed conversion ratio showing linear effects (P < 0.05) compared to the birds fed the control diet under hot climatic conditions. Dietary addition of zinc oxide nanoparticles at 20, 40, and 60 mg/kg linearly increased (P < 0.05) the nutrient digestibility of crude protein, crude fiber, and ether extract compared to the control group. Birds fed the supplemented diets had improved liver and kidney function without any negative effects on zinc, inorganic phosphorus, triiodothyronine (T₃), and thyroxine (T₄) levels in serum compared to the control. Diets supplemented with zinc oxide nanoparticles linearly (P < 0.05) improved the dressing percent and reduced abdominal fat percent compared to the control group. In view of the above findings, it can be concluded that dietary supplementations of zinc oxide nanoparticles at 20, 40, and 60 mg/kg resulted in improved growth performance, nutrient digestibility, carcass criteria, and liver and kidney functions of broiler chickens under hot environmental conditions.

Missed pertussis diagnosis during co-infection with Bordetella holmesii

The purpose of this study is to identify predictive factors associated with missed diagnosis of B. pertussis-B. holmesii co-infection by assessing the analytical performance of a commercially available multiplexed PCR assay and by building a prediction model based on clinical signs and symptoms for detecting co-infections. This is a retrospective study on the electronic health records of all clinical samples that tested positive to either B. pertussis or B. holmesii from January 2015 to January 2018 at Geneva University Hospitals. Multivariate logistic regression was used to build a model for co-infection prediction based on the electronic health record chart review. Limit of detection was determined for all targets of the commercial multiplexed PCR assay used on respiratory samples. A regression model, developed from clinical symptoms and signs, predicted B. pertussis and B. holmesii co-infection with an accuracy of 82.9% (95% CI 67.9-92.8%, p value = .012), for respiratory samples positive with any of the two tested Bordetella species. We found that the LOD of the PCR reaction targeting ptxS1 is higher than that reported by the manufacturer by a factor 10. The current testing strategy misses B. pertussis and B. holmesii co-infections by reporting only B. holmesii infections. Thus, we advocate to perform serological testing for detecting a response against pertussis toxin whenever a sample is found positive for B. holmesii. These findings are important, both from a clinical and epidemiological point of view, as the former impacts the choice of antimicrobial drugs and the latter biases surveillance data, by underestimating B. pertussis infections during co-infections.

Effects of different training intensities in high-intensity interval training (HIIT) on maximal aerobic velocity, hematological and muscle-damage markers in healthy young adults

This study aimed to examine the effects of two high-intensity interval training programs (HIIT) on maximal aerobic velocity (MAV), hematological variations and muscle damage markers in young healthy adults. Twenty-nine male physical education students, aged 20.3 ± 3.3 years, volunteered to participate in this study, and were randomly assigned to a control group (CG, n = 9) or two intervention groups (group 1 or 2). Intervention group 1 (n = 10) exercised at 100% of their MAV (EG₁₀₀) while group 2 (n = 10) exercised at 110% MAV (EG₁₁₀). Before and after the eight week training program, blood samples were drawn at rest, before, and after an intermittent exercise. Aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), C reactive protein (CRP), creatine kinase (CK) concentrations and hematological parameters (white blood cells [WBC], monocytes [MO], lymphocytes [LY], neutrophil [NE]) and lactate dehydrogenase (LDH) were measured. Post-hoc tests showed that MAV was significantly higher in EG₁₁₀ compared to EG₁₀₀ after HIIT (p < 0.01, η_p² = 0.05), whilst ALAT, ASAT, and CPR were significantly lower (p < 0.01; 0.02 < η_p² < 0.11) in EG₁₁₀ compared to EG₁₀₀. Moreover, post-hoc tests indicated that LY decreased significantly (p < 0.001, η_p² = 0.21) only for EG₁₁₀. Furthermore, there were significant positive correlations for both EG₁₀₀ and EG₁₁₀ between MAV and ALAT (r = 0.66, p = 0.044 and r = 0.64, p = 0.041 respectively), CK (r = 0.67, p = 0.031 and r = 0.86, p = 0.030, respectively), LDH (r = 0.74, p = 0.014, and r = 0.071, p = 0.021, respectively). In addition, there was a significant positive correlation for both, EG₁₀₀ and EG₁₁₀ between MAV and LY (r = 0.79, p < 0.01; r = 0.72, p < 0.05, respectively). Concerning the relationship between MAV and NE, there was a significant positive correlation (r = 0.66; p < 0.05) only for EG₁₁₀. Findings from this study revealed that HIIT at 110% MAV was more efficient to improve MAV and reduce muscle damage. In addition, we observed significant associations between performance improvements (MAV) and markers of muscle damage.

A literature review of emotional intelligence and nursing education

AIM

The purpose of this study is to investigate the current state of knowledge about emotional intelligence (EI) in nursing education BACKGROUND: Human relationships and emotions are an integral part of nursing care and contribute to care quality. This part of the profession must be addressed in nursing education to prepare students and deal with their emotions and the patients's. Research on emotional intelligence (EI) in nursing has been particularly developed recently. A broad understanding of many benefits of EI is crucial to include EI in this training program.

DESIGN

Systematic literature review METHODS: Undertaken using electronic database (Cairn; PubMed; Science Direct; Wiley online library) and specific search terms. This research covered articles published in English and French between 2007 and 2021. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines (PRISMA) directed the systematic review process.

RESULTS

57 articles are included in this systematic review. The literature focuses on EI and nursing education. The findings categorized into four themes: EI and performances; EI and Physical and mental health; EI and Social Relationship; and EI program.

CONCLUSIONS

This literature review reveals that EI has many benefits in nursing students. Several training programs aimed at developing this concept have proven to be effective in nursing education. We believe that a synthesis of this knowledge will then allow us to better understand the benefits of EI for a further implementation in nursing education. Perspectives and recommendations will also be formulated to enable the implementation of emotional skill development programs in such training.

Milk microfiltration process dataset annotated from a collection of scientific papers

Milk microfiltration process plays a key role in the dairy industry. Crossflow microfiltration of skimmed milk using a membrane with 0.1 µm mean pore size is widely used to fractionate the two main groups of dairy proteins: casein micelles (~150 nm) and serum proteins (~2-15 nm). Retentate, containing mainly casein micelles, is generally used to enrich vat milk for cheese making. Permeate, containing serum proteins, lactose and minerals, is usually ultrafiltered in order to produce protein-rich concentrate with a high nutritional value dedicated to specific populations such as infants and seniors. The great interest in these protein fractions explains the increasing number of microfiltration equipments in the dairy industry. This data article contains data associated with milk microfiltration process experiments and properties of the resulting dairy fractions annotated from a collection of scientific documents. These data are stored in INRAE public repository (see Data accessibility in the Specification Table for direct links to data). They have been structured using MILK MICROFILTRATION ontology and are replicated in @Web data warehouse providing additional querying tools (https://www6.inrae.fr/cati-icat-atweb/).

The interplay of roles and routines: situating, performances and patterning in the emergency department

PURPOSE

While previous research acknowledges the influence of roles on routine dynamics, roles are largely taken for granted. The purpose of this paper aims at examining how roles and routines interplay in accomplishing work in organizations.

DESIGN/METHODOLOGY/APPROACH

A four-year ethnography of an emergency department (ED) at a university hospital was conducted through observations, interviews and documents.

FINDINGS

Roles and routines are formed by scripted and unscripted patterns, which are brought into performances following a situational assessment. Performances trigger patterning processes prompting the co-construction of role and routine patterns.

PRACTICAL IMPLICATIONS

This study highlights the importance of designing flexible structures. Managers can benefit from identifying unscripted patterns critical to work performance and making them part of scripted patterns. Managers should contemplate the influence that individuals, their relations and context have on how work is done.

SOCIAL IMPLICATIONS

This study suggests that the existence of different patterns impacts the length of wait times in EDs, a societal issue worldwide because of the effects that waiting can have on the patient's health condition and the unnecessary costs it carries. This study can help design solutions to decrease wait times.

ORIGINALITY/VALUE

This paper contributes to research on routine dynamics by providing a more nuanced explanation of the sources of endogenous change and how these enable organizational stability and flexibility.

[External Quality Assessment of Thick and Thin Blood Smear Slides for the Diagnosis of Malaria in the Lomé and Gulf Health Districts of Togo]

Objective

In sub-Saharan Africa where 90% of malaria cases are concentrated, the control of this disease constitutes a major challenge whose diagnosis by thick and thin smear deserves to be exact and reproducible. The purpose of this study is to assess the performance of thick/thin blood smear in order to improve its implementation process.

Material and methods

This was a descriptive and analytical study that took place from May to June 2017 and involved participating laboratories (PL) coming from public, liberal and confessional sectors in Lomé. A set of 13 blood smear slides of variable parasite densities (PD) with assigned values (AV) of parasite densities and the Plasmodium species assigned was used. The criterion for establishing the parasite densities compliance interval was assigned values ± 25% and the performance rates were compared to the 80% recommended by the WHO for Africa region.

Results

41.9% (13/31) of the PLs had a compliance rate greater than 80% including four with a performance of 100% for the ability to identify the Plasmodium species. For the parasitaemia < 100/μl, 51.6% of participating laboratories had a performance rate less than 80% and for parasitaemia > 2000/μl, 100% of these laboratories had a performance rate greater than 80%.

Conclusion

The evaluated laboratories had insufficient ability for the identification of Plasmodium falciparum and the correct estimation of low parasitaemia. A need to strength the technical skills, adapted to the context of low parasitaemia are essential to improve the biological diagnosis of malaria in Togo.

Inventory management performance for laboratory commodities in public hospitals of Jimma zone, Southwest Ethiopia

Background

Maintaining an efficient and effective inventory management system ensures a reliable supply of laboratory commodities. The aim of this study was, therefore, to assess the performance of inventory management for laboratory commodities in public hospitals in the Jimma zone.

Methods

A facility-based cross-sectional descriptive study, accompanied by a qualitative method, was conducted in seven public hospitals between April 30 and May 29, 2019. We collected data through document reviews (225 bin-cards), physical observation, self-administered questionnaires, and in-depth interviews. The quantitative data were analyzed using Excel spreadsheets and SPSS version 24. Fifteen key informants of different backgrounds took part in the qualitative study. The data were then analyzed using thematic analysis techniques.

Results

All the public hospitals in the zone were included in the study, making a response rate of 100%. Of the total estimated bin-cards, 225 (69.9%) of them held along with the items, and only 30.4% of them filled accurately. In four of the hospitals, pharmacists determined how much to order. Five of the hospitals used average monthly consumption data to calculate purchase quantity. Over the past 6 months, four of the hospitals had placed at least one or two emergency orders. The wastage rate of the commodities in the hospitals was 27.2% and resulted in a loss of about 10,248.5 US dollars. The hospitals had met 70.6% of the criteria for proper storage conditions. Budget constraints, absence of prompt administrative support, lack of staff commitment, and frequent shortages of commodities on the part of suppliers were major bottlenecks of inventory management.

Conclusions

The hospitals had weak inventory management practices, showed by inaccurate records, stock-outs (frequent emergency orders), a high wastage rate compared to national baseline statistics, and the storage conditions below the standard.

[Performance of magnetic resonance imaging ang genourob laximetry in anterior cruciate ligament rupture in 30 cases]

INTRODUCTION

The aim of this work was to evaluate the diagnostic contribution of magnetic resonance imaging and genourob compared to intraoperative arthroscopy. The objective was to implement a protocol based on magnetic resonance imaging and / or genourob.

MATERIALS AND METHODS

We did a cross-sectional study from July 18, 2016 to July 19, 2017 at the Maltese hospital comparing the results of MRI and GNRB from 30 patients compared to intraoperative arthroscopy data.

RESULTS

Complete break.

- In MRI, we obtained a sensitivity (Se) of 95.7%, a specificity (Sp) of 85.7%.

- At the GNRB, we found a Se of 87%, a Sp of 42.9%.

Partially broken.

- In MRI we obtained a Se of 85.7%, a Sp of 95.7%.

- At the GNRB, we found a Se of 42.9%, a Sp of 87%.

CONCLUSION

MRI is better than GNRB. The GNRB does not improve the results of the MRI. It has no diagnostic contribution in the rupture of the ACL knee. It is a device used by the orthopedists to evaluate knee laxity that does not depend on the ACL alone.

Kalman Filter-Based Novel Methodology to Assess Insulin Pump Accuracy

Background: Insulin pump or continuous subcutaneous insulin infusion (CSII) system is a widely adopted contemporary treatment for type 1 diabetes and is a major component of an artificial pancreas (AP). CSII accuracy is essential for glycemic control and to-date such metric has not been given sufficient study, especially at the range of the lowest basal rate. The gold-standard assessment method IEC (International Electrotechnical Commission) 60601-2-24 has some limitations. Our study presents a new accurate and reactive method for CSII system evaluation based on direct flow measurement. Materials and Methods: A leading-edge assessment method based on a double measurement approach utilizing a direct mass flow meter and a time-stamped microgravimetric bench test was combined with a Bayesian-based mathematical filter (Kalman). The performance of this new method was evaluated while assessing the delivery precision of an off-the-shelf insulin pump at several basal rates. The proposed methodology offers a double reading-volume and flow rate-which provides direct instantaneous flow rate. CSII dose errors were evaluated using mean absolute relative dispersion (MARD) at different time intervals windows over the whole test. Results: The metrological aspect of the measurements and filtering performance were consistent. CSII precision is shown to be different in terms of the flow rate value: MARD_15min (2 UI/h) = 12.7%, MARD_15min (0.5 UI/h) = 20.4%, and MARD_15min (0.1 UI/h) = 65.0%. MARD_240min (2 UI/h) = 8.1%, (0.5 UI/h), MARD_240min (0.5 UI/h) = 18.8%, and MARD_240min (0.1 UI/h) = 18.4%. Instantaneous flow rate results highlight an irregular stroke-based delivery. Conclusion: This new method to assess insulin pump administration has been validated and highlights the current imprecision in insulin delivery, especially for the lowest basal rate, which is mainly used in pediatric cases and AP system delivery. This leading-edge method should be used to precisely compare several CSII performances in those contexts.

Effect of dietary supplementation with insect fats on growth performance, digestive efficiency and health of rabbits

BACKGROUND

The present work aimed at evaluating the effect of the dietary replacement of soybean oil (S) by two types of insect fats extracted from black soldier fly larvae (H, Hermetia illucens L.) and yellow mealworm larvae (T, Tenebrio molitor L.) on growth performance, nutrient digestibility, blood parameters, intestinal morphology and health of growing rabbits.

METHODS

At weaning, 200 crossbred rabbits (36 days old) were allotted to five dietary treatments (40 rabbits/group): a control diet (C) containing 1.5% of soybean oil and four experimental diets where soybean oil was partially (50%) or totally (100%) substituted by H (H50 and H100) or T (T50 and T100) fats. Total tract digestibility was evaluated on 12 rabbits per treatment. The growth trial lasted 41 d and, at slaughtering (78 days old), blood samples were collected from 15 rabbits per treatment, morphometric analyses were performed on duodenum, jejunum and ileum mucosa, and samples of liver, spleen and kidney were submitted to histological evaluation.

RESULTS

No difference was observed between the control and the experimental groups fed insect fats in terms of performance, morbidity, mortality and blood variables. The addition of H and T fats did not influence apparent digestibility coefficients of dry matter, protein, ether extract, fibre fractions and gross energy. Gut morphometric indices and organ histopathology were not affected by dietary inclusion of H and T fats.

CONCLUSIONS

H and T fats are suitable sources of lipid in rabbit diets to replace soybean oil without any detrimental effect on growth performance, apparent digestibility, gut mucosa traits and health.

Diagnostic accuracy in field conditions of the sickle SCAN® rapid test for sickle cell disease among children and adults in two West African settings: the DREPATEST study

Background

Sickle cell disease (SCD) accounts for 5% of mortality in African children aged < 5 years. Improving the care management and quality of life of patients with SCD requires a reliable diagnosis in resource-limited settings. We assessed the diagnostic accuracy of the rapid Sickle SCAN® point-of-care (POC) test for SCD used in field conditions in two West-African countries.

Methods

We conducted a case-control study in Bamako (Mali) and Lomé (Togo). Known cases of sickle cell disease (HbSS, HbSC), trait (HbAS), HbC heterozygotes (HbAC) and homozygous (HbCC), aged ≥6 months were compared to Controls (HbAA), recruited by convenience. All subjects received both an index rapid POC test and a gold standard (high-performance liquid chromatography in Bamako; capillary electrophoresis in Lomé). Personnel conducting tests were blinded from subjects' SCD status. Sensitivity and specificity were calculated for each phenotype. Practicality was assessed by local healthcare professionals familiar with national diagnostic methods and their associated constraints.

Results

In Togo, 209 Cases (45 HbAS, 39 HbAC, 41 HbSS, 44 HbSC and 40 HbCC phenotypes) were compared to 86 Controls (HbAA). 100% sensitivity and specificity were observed for AA Controls and HbCC cases. Estimated sensitivity was 97.7% [95% confidence interval: 88.0-99.9], 97.6% [87.1-99.9%], 95.6% [84.8-99.5%], and 94.9% [82.7-99.4], for HbSC, HbSS, HbAS, and HbAC, respectively. Specificity exceeded 99.2% for all phenotypes. Among 160 cases and 80 controls in Mali, rapid testing was 100% sensitive and specific. Rapid testing was well accepted by local healthcare professionals.

Conclusion

Rapid POC testing is 100% accurate for homozygote healthy people and excellent (Togo) or perfect (Mali) for sickle cell trait and disease patients. In addition to its comparable diagnostic performance, this test is cheaper, easier to implement, and logistically more convenient than the current standard diagnostic methods in use. Its predictive value indicators and diagnostic accuracy in newborns should be further evaluated prior to implementation in large-scale screening programs in resource-limited settings where SCD is prevalent.

Modelling the resilience of rail passenger transport networks affected by large-scale disruptive events: the case of HSR (high speed rail)

This paper deals with modelling the dynamic resilience of rail passenger transport networks affected by large-scale disruptive events whose impacts deteriorate the networks' planned infrastructural, operational, economic, and social-economic performances represented by the selected indicators. The indicators of infrastructural performances refer to the physical and operational conditions of the networks' lines and stations, and supportive facilities and equipment. Those of the operational performances include transport services scheduled along particular routes, their seating capacity, and corresponding transport work/capacity. The indicators of economic performances include the costs of cancelled and long-delayed transport services imposed on the main actors/stakeholder involved-the rail operator(s) and users/passengers. The indicators of social-economic performances reflect the compromised accessibility and consequent prevention of the user/passenger trips and their contribution to the local/regional/national Gross Domestic Product. Modeling resulted in developing a methodology including two sets of analytical models for: (1) assessing the dynamic resilience of a given rail network, i.e., before, during, and after the impacts of disruptive event(s); and (2) estimation of the indicators of particular performances as the figures-of-merit for assessing the network's resilience under the given conditions. As such, the methodology could be used for estimating the resilience of different topologies of rail passenger networks affected by past, current, and future disruptive events, the latest according to the "what-if" scenario approach and after introducing the appropriate assumptions. The methodology has been applied to a past case-the Japanese Shinkansen HSR network affected by a large-scale disruptive event-the Great East Japan Earthquake on 11 March 2011.

Performance and self-perceived competencies of enrolled nurse/midwives: a mixed methods study from rural Tanzania

BACKGROUND

Tanzania is experiencing a severe shortage of human resources for health, which poses a serious threat to the quality of health care services particularly in rural areas. Task shifting has been considered a way to address this problem. However, since a large percentage of health care providers in rural setting is comprised of Enrolled Nurse/Midwives (ENMs), most of the health care tasks are shifted to them. This article analyzes the performance and self-perceived competencies of ENMs at the dispensary level; the lowest health facility in Tanzania. Performance refers to routine duties performed by ENMs, and self-perceived competence means self-perceived proficiency in performing nursing/midwifery and medical duties.

METHODS

This was a mixed methods study conducted in rural Tanzania. A purposeful sample of twelve (12) informants (six ENMs; two Community Leaders [CLs] and four Dispensary In-charges [DIs]) was recruited for semi-structured interviews. The interviews were supplemented with quantitative data from 59 ENMs. Both thematic and descriptive analysis approaches were used.

RESULTS

Three themes emerged: (1) 'Approval of the performances of ENMs in meeting community health needs' underscores important services the community members got from ENMs at dispensaries. (2) 'Experienced difficulties of meeting community health needs' indicate the problems ENMs encountered while providing services to the community. In striving to serve a large number of demanding clients without adequate medical equipment and supplies, sometimes the ENMs ended up with prescription errors (3) 'Appreciating the performances and competencies of ENMs' shows the acknowledgement of community members towards ENMs' performance and competencies within and beyond their scope of practice. The community members as well as ENMs and their supervisors knew that ENMs must sometimes provide care that is outside their scope of training and competency. Overall, the performance among ENMs above 38 years of age (P < 0.05) and participants of professional development courses (P < 0.01) was high.

CONCLUSIONS

The results highlight performance and self-perceived competencies of ENMs in struggling to meet community health needs. Additionally, these results highlight the health care system shortfalls in supporting and developing an adequate number of qualified health care professionals so that health care needs of all citizens, including those in rural areas, are met.

Effects of dietary methionine on productivity, reproductive performance, antioxidant capacity, ovalbumin and antioxidant-related gene expression in laying duck breeders

The study investigated whether dietary methionine (Met) affects egg weight and antioxidant status through regulating gene expression of ovalbumin (OVAL), nuclear factor erythroid 2 like 2 (Nrf2) and haem oxygenase 1 (HO-1) in laying duck breeders. Longyan duck breeders (n 540, 19 weeks) were randomly assigned to six treatments with six replicates of fifteen birds each. Breeders were fed diets with six Met levels (2·00, 2·75, 3·50, 4·25, 5·00 and 5·75 g/kg) for 24 weeks. The egg weight (g), egg mass (g/d), feed conversion ratio, hatchability, 1-d duckling weight, albumen weight, albumen proportion and OVAL mRNA level improved with dietary Met levels, whereas yolk proportion decreased (P<0·05). The weight of total large yellow follicles increased linearly (P<0·001) and quadratically (P<0·05) with dietary Met concentration, and their weight relative to ovarian weight showed a linear (P<0·05) effect. Dietary Met level had a linear (P<0·05) and quadratic (P<0·001) effect on the gene expression of glutathione peroxidase (GPX1), HO-1 and Nrf2, and quadratically (P<0·05) increased contents of GPX and total antioxidant capacity (T-AOC) in liver of duck breeders. In addition, maternal dietary Met enhanced gene expression of GPX1, HO-1 and Nrf2, increased contents of GPX and T-AOC and reduced carbonylated protein in the brains of hatchlings. Overall, dietary Met concentration affected egg weight and albumen weight in laying duck breeders, which was partly due to gene expression of OVAL in oviduct magnum. A diet containing 4·0 g Met/kg would achieve optimal hepatic GPX1 and Nrf2 expression, maximise the activity of GPX and minimise lipid peroxidation.

Comparison of plasma exchange performances between Spectra Optia and COBE Spectra apheresis systems in repeated procedures considering variability and using specific statistical models

Repeated therapeutic plasma exchange (TPE) procedures using centrifugation techniques became a standard therapy in some diseases. As the new device Spectra Optia (SPO; Terumo BCT) was available, we studied its performances in repeated procedures in 20 patients in three apheresis units. First we analysed the performance results obtained by SPO. Second we compared the performances of the SPO device to a standard device, COBE Spectra (CSP; Terumo BCT) in the same patients using statistical method of mixed effects linear regression that considers variability between patients, centres and apheresis procedures. The performances analysed were classified according to plasma removal performances and their consequences on patients whose blood disturbances were assessed. Primary outcome was plasma removal efficiency (PRE) and PRE-anticoagulant corrected which was a more accurate parameter. Secondary outcomes corresponded to the volume of ACD-A consumed, platelets content in waste bag, procedure duration and status of coagulation system observed after TPE sessions. Before comparing the performances of both devices we compared the plasma volumes (PVs) processed in both techniques which showed that the PVs processed in SPO procedures were lower than in CSP procedures. In these conditions the statistical analysis revealed similar performances in both apheresis devices in PRE (p = ns) but better performances with SPO when considering higher PRE corrected by anticoagulant volume used (p < 0.05). Comparison of secondary outcomes showed no difference after SPO and CSP. After verifying that pre-apheresis patients' coagulation blood levels were identical before SPO and CSP, we showed identical haemostasis disturbances after SPO and CSP but lower platelet losses and higher fibrinogen post-apheresis blood levels after SPO (p < 0.05). No side effects or technical complications occurred during and after SPO and CSP. This study demonstrated that the Spectra Optia device is an alternative device to today's standard, the COBE Spectra device.

Analysis of 10 km swimming performance of elite male and female open-water swimmers

This study investigated trends in performance and sex difference in swimming speed of elite open-water swimmers at FINA 10 km competitions (i.e. World Cup races, European Championships, World Championships and Olympic Games). Swimming speed and sex difference in swimming speed of the fastest and the top ten women and men per event competing at 10 km open-water races between 2008 and 2012 were analysed using single and multi-level regression analyses. A total of 2,591 swimmers (i.e. 1,120 women and 1,471 men) finished 47 races. Swimming speed of the fastest women (1.35 ± 0.9 m/s) and men (1.45 ± 0.10 m/s) showed no changes across years. The mean sex difference in swimming speed for the fastest swimmers was 6.8 ± 2.5%. Swimming speed of the top ten female swimmers per event was 1.34 ± 0.09 m/s and remained stable across the years. The top ten male swimmers per event showed a significant decrease in swimming speed over time, even though swimming speed in the first race (i.e. January 2008, 1.40 ± 0.0 m/s) was slower than the swimming speed in the last race (i.e. October 2012, 1.50 ± 0.0 m/s) (P < 0.05). To summarize, swimming performances remained stable for the fastest elite open-water swimmers at 10 km FINA competitions between 2008 and 2012, while performances of the top ten men tended to decrease. The sex difference in swimming speed in elite ultra-swimmers (~7%) appeared smaller compared to other ultra-distance disciplines such as running. Further studies should examine how body shape and physiology of elite open-water ultra-distance swimmers influence performances.