Among current state-of-the-art estimation methods for multilevel IRT models, the two-stage divide-and-conquer strategy has practical advantages, such as clearer definition of factors, convenience for secondary data analysis, convenience for model calibration and fit evaluation, and avoidance of improper solutions. However, various studies have shown that, under the two-stage framework, ignoring measurement error in the dependent variable in stage II leads to incorrect statistical inferences. To this end, we proposed a novel method to correct both measurement bias and measurement error of latent trait estimates from stage I in the stage II estimation. In this paper, the HO-IRT model is considered as the measurement model, and a linear mixed effects model on overall (i.e., higher-order) abilities is considered as the structural model. The performance of the proposed correction method is illustrated and compared via a simulation study and a real data example using the National Educational Longitudinal Survey data (NELS 88). Results indicate that structural parameters can be recovered better after correcting measurement biases and errors.

How people deal with ridicule and being laughed at plays a role in romantic life. We extend the research on the fear of being laughed at (gelotophobia), joy in being laughed at (gelotophilia), and joy in laughing at others (katagelasticism) by testing their associations with romantic jealousy and its consequences for relationship satisfaction (RS).

Our study is based on Actor-Partner Interdependence Model (APIM) analyses of self and partner ratings of the laughter-related dispositions using data from 228 opposite-sex couples. APIM mediation analyses estimated indirect effects of jealousy on the associations between the dispositions and RS.

As expected, gelotophobia-related positively to jealousy in actors, whereas gelotophilia and katagelasticism showed differential relationships. The analysis of partner effects showed that the actual expressions in the dispositions are unrelated to jealousy but perceived expressions account robustly for experiences of jealousy beyond self-ratings. Finally, jealousy had indirect effects on the associations between the dispositions and RS.

These findings contribute to our understanding of the role of dealing with ridicule and laughter in romantic life. We embed the findings into the literature, discuss practical implications, and derive future directions to expand the knowledge on gelotophobia, gelotophilia, and katagelasticism in romantic life.

These findings contribute to our understanding of the role of dealing with ridicule and laughter in romantic life. We embed the findings into the literature, discuss practical implications, and derive future directions to expand the knowledge on gelotophobia, gelotophilia, and katagelasticism in romantic life.

To gain insight into parents’ perspectives about their decision-making process concerning nusinersen treatment for their child, including perceived needs and concerns, and to explore factors that influence this process.

This was an exploratory qualitative interview study among parents of children with spinal muscular atrophy types 1 to 3. Data were analysed using inductive thematic analysis.

Nineteen parents of 16 children representing 13 families participated. A wide variety of perspectives was reported ranging from a biomedical approach, which focused on battling the disease, to a holistic approach, which aimed for a good quality of life for their child. The most important factors that helped parents to decide were honest and neutral communication with their physician and access to available information.

It is important physicians understand that there are different perspectives influencing the decision-making process. Physicians should create an environment that allows parents to accept or reject tating honestly and openly with them and by discussing both options extensively. Clear information about pros and cons, recent developments in research, and the experiences of other parents should be made available to enable parents to make an informed decision. What this paper adds Parents perceived different needs and concerns about nusinersen treatment, which emphasized individual differences. Parents’ perspectives varied from battling the disease to preserving quality of life. Life expectancy, stopping deterioration, and improving quality of life were the perceived benefits of nusinersen treatment. Open communication about the pros and cons of treatment with clinicians facilitated decision-making. Clear and honest information facilitated the alignment of values and goals.Sexual segregation in foraging strategies has been little studied in marine species with slight sexual size dimorphism (SSD), particularly regarding the role of environmental conditions and fishery activities. Sexual differences in fishery attendance are of particular concern because uneven mortality associated with bycatch may exacerbate impacts in wildlife populations. Using a seabird species with slight SSD, the Scopoli’s shearwater Calonectris diomedea, we assessed sexual differences in foraging strategies and evaluated whether annual environmental conditions and fishery activity shaped such differences. We used a 4-year dataset combining bird GPS tracking, stable isotope analysis, the North Atlantic Oscillation index (NAO, as main proxy of the annual environmental conditions), and fishing vessel positioning data (Vessel Monitoring System, VMS) from the North Western Mediterranean, a region under intense fishery pressure. From 2012 to 2015, we tracked 635 foraging trips from 78 individuals. Females showedn foraging strategies can lead to an unbalanced exposure to relevant threats and have implications for the conservation of long-lived species.Type 1 diabetes (T1D) is a chronic autoimmune disease characterized by pancreatic islet β cell loss and dysfunction resulting in insulin deficiency and hyperglycemia. During a presymptomatic phase of established β cell autoimmunity, β cell loss may first be evident through assessment of β cell secretory capacity, a measure of functional β cell mass. Reduction in pancreatic islet β cell reserve eventually manifests as impaired first-phase insulin response to glucose and abnormal glucose tolerance, which progresses until the functional capacity for β cell secretion can no longer meet the demand for insulin to control glycemia. A functional β cell mass of ∼25% of normal may be required to avoid symptomatic T1D but is already associated with dysregulated glucagon secretion. With symptomatic T1D, stimulated C-peptide levels >0.60 ng/mL (0.200 pmol/mL) indicate the presence of clinically meaningful residual β cell function for contributing to glycemic control, although even higher residual C-peptide appears necessary for evidencing glucose-dependent islet β and α cell function that may contribute to maintaining (near)normal glycemia. β cell replacement by islet transplantation can restore a physiologic reserve capacity for insulin secretion, confirming thresholds for functional β cell mass required for independence from insulin therapy.There is an apparent reciprocal relationship between magnesium ammonium phosphate (MAP, struvite) and calcium oxalate (CaOx) urolithiasis incidence rate in cats. The number of struvite uroliths submitted for analysis over the past 35 years has been decreasing, with an increase in CaOx urolith submissions. Commercial diets aimed to dissolve struvite uroliths are typically acidified, and it has been suggested that dietary acidification increases urinary calcium excretion and the risk of CaOx crystallization. The objective of this study was to assess the effect of urine acidification on the relative supersaturation (RSS) of CaOx in cats, as a representation of crystallization risk. Four diets were extruded to contain identical nutrient contents, but with gradual acidification (0, 0.6, 1.3 and 1.9% sodium bisulphate substituted sodium chloride in diets A, B, C and D respectively). Thirteen adult cats were fed each diet sequentially for a minimum of 10 days. Average urine pH was 6.4, 6.2, 6.0 and 5.9 on diets A, B, C and D respectively (p less then 0.0001). Struvite RSS decreased on diets inducing more acidic urine pH (p less then 0.0001). Urinary calcium excretion and concentration increased with diets inducing lower urine pH (p less then 0.0001), but oxalate excretion and concentration decreased (p less then 0.001). CaOx RSS was not different between diets (p = 0.63). These results suggest that a lower diet base excess and resulting urine pH to support struvite dissolution do not increase the risk for CaOx crystallization in the range of urine pH representative of most commercial feline diets. Long-term studies are needed to confirm this.In clinical and experimental non-alcoholic steatohepatitis (NASH), the origin of the scar-forming myofibroblast is the hepatic stellate cell (HSC). We used foz/foz mice on a Western diet to characterize in detail the phenotypic changes of HSCs in a NASH model. We examined the single cell expression profiles (scRNA-Seq) of HSCs purified from the normal livers of foz/foz mice on a chow diet, in NASH with fibrosis of foz/foz mice on a Western diet, and in livers during regression of NASH after switching back to a chow diet. Selected genes were analyzed using immunohistochemistry, qRT-PCR, and shRNA-knockdown in primary mouse HSCs. Our analysis of the normal liver identified two distinct clusters of quiescent HSCs that correspond to their acinar position of either pericentral vein or periportal vein. The NASH livers had four distinct HSC clusters, including one representing the classic fibrogenic myofibroblast. The three other HSC clusters consisted of a proliferating cluster, an intermediate activated cluster, and an immune and inflammatory cluster. The livers with NASH regression had one cluster of inactivated HSCs, which was similar to, but distinct from, the quiescent HSCs. Conclusion Analysis of scRNA-Seq in combination with an interrogation of previous studies has revealed an unanticipated heterogeneity of HSC phenotypes under normal and injured states.Nearly 100 years ago, Charles Elton described lemming and vole population cycles as ecological models for understanding population regulation in nature. Yet, the mechanisms driving these cycles are still not fully understood. These rodent populations can continue to cycle in the absence of predation and with food supplementation, and represent a major unsolved problem in population ecology. It has been hypothesized that the social environment at high population density can drive selection for a low-reproduction phenotype, resulting in population self-regulation as an intrinsic mechanism driving the cycles. However, a physiological mechanism for this self-regulation has not been demonstrated. We manipulated population density in wild meadow voles Microtus pennsylvanicus using large-scale field enclosures over 3 years and examined reproductive performance and physiology. Within the field enclosures, we assessed the proportion of breeding animals, mass at sexual maturation, and faecal androgen and oestrogen metaial environment can fundamentally impact reproductive function in the brain. This, in turn, can drive population demography changes in wild animals.The trade-off between yield and quality, a major problem for the production of fleshy fruits, involves fruit expansive growth and sugar metabolism. Here we developed an integrative model by coupling a biophysical model of fleshy fruit growth processes, including water and carbon fluxes and organ expansion, with an enzyme-based kinetic model of sugar metabolism to better understand the interactions between these two processes. The integrative model was initially tested on tomato fruit, a model system for fleshy fruit. The integrative model closely simulated the biomass and major carbon metabolites of tomato fruit developing under optimal or stress conditions. The model also performed robustly when simulating the fruit size and sugar concentrations of different tomato genotypes including wild species. The validated model was used to explore ways of uncoupling the size-sweetness trade-off in fruit. Model-based virtual experiments suggested that larger sweeter tomatoes could be obtained by simultaneously manipulating certain biophysical factors and transmembrane transports. The integrative fleshy fruit model provides a promising tool to facilitate the targeted bioengineering and breeding of tomatoes and other fruits.In the study by Lamarca and colleagues, the authors recommended reclassification of ICC liver metastasis into an „M1a” category.(1) The study suffered from several shortcomings. As median follow-up was extremely short(11 months), the majority of survival data did not reflect „actual” events, but rather „actuarial” data. Model discrimination should have been assessed using Harrell’s c-index and area under curve(AUC) along with calibration plots to assess observed versus predicted outcomes.Warming-induced desiccation of the fertile topsoil layer could lead to decreased nutrient diffusion, mobility, mineralization and uptake by roots. Increased vertical decoupling between nutrients in topsoil and water availability in subsoil/bedrock layers under warming could thereby reduce cumulative nutrient uptake over the growing season. We used a Mediterranean semiarid shrubland as model system to assess the impacts of warming-induced topsoil desiccation on plant water- and nutrient-use patterns. A 6 yr manipulative field experiment examined the effects of warming (2.5°C), rainfall reduction (30%) and their combination on soil resource utilization by Helianthemum squamatum shrubs. A drier fertile topsoil (’growth pool’) under warming led to greater proportional utilization of water from deeper, wetter, but less fertile subsoil/bedrock layers (’maintenance pool’) by plants. This was linked to decreased cumulative nutrient uptake, increased nonstomatal (nutritional) limitation of photosynthesis and reduced water-use efficiency, above-ground biomass growth and drought survival. Whereas a shift to greater utilization of water stored in deep subsoil/bedrock may buffer the negative impact of warming-induced topsoil desiccation on transpiration, this plastic response cannot compensate for the associated reduction in cumulative nutrient uptake and carbon assimilation, which may compromise the capacity of plants to adjust to a warmer and drier climate.

Prediction of extracapsular extension (ECE) before radical prostatectomy in clinically localized prostate cancer (PCa) is very important for clinical practice. ECE affects our decision on treatment strategy. The aim of this study is to identify the predictors of ECE, determine cut-off values, and compare them with the accuracy of Partin Table parameters to improve tumor staging in clinical practice.

374 patients with clinically localized PCa who underwent open radical retropubic prostatectomy (RRP) were included in this study. Gleason Score (GS), age, digital rectal examination (DRE), prostate specific antigen (PSA), prostate specific antigen density (PSAD), free PSA, Free/Total PSA, prostate volume (PV), number of cores involved, tumor length, and tumor percentage in maximum involved core in biopsy were investigated.

PSAD, tumor percentage, and tumor length are predictive factors of ECE. The cut-off values of PSA, PSAD, maximum tumor length, and maximum tumor percentages in predicting ECE are > 8.90 ng/mL, > 0.26 ng/mL2, >5mm, and >50%, respectively. The cut-off values for Partin extraprostatic extension (EPE) and organ confined (OC) disease are >29% and ≤ 64%, respectively.

Partin tables could better predict extracapsular extension in clinically localized PCa if they include PSAD, tumor percentage, and tumor length. The cut-off values of these predictive factors can be beneficial in treatment strategies and in the decisions of lymphadenectomy and nerve-sparing surgery at radical prostatectomy.

Partin tables could better predict extracapsular extension in clinically localized PCa if they include PSAD, tumor percentage, and tumor length. The cut-off values of these predictive factors can be beneficial in treatment strategies and in the decisions of lymphadenectomy and nerve-sparing surgery at radical prostatectomy.

The aim of the presentstudyis to assess the effect of L-carnitine and Coenzyme Q10 (CoQ10) on human sperm motility, DNA fragmentation, chromatin structure, and reactive oxygen species (ROS) during, before and after freezing in oligospermia men.

Semen was collected from 30 oligospermic men, who referred to infertility clinic of Beasat Hospital in Sanandaj, Iran. The samples of each individual were divided into 8 equal parts 1. control group before freezing; 2. incubated with L-carnitine; 3. incubated with coenzyme Q10; 4. incubated with the combination of L-carnitine + CoQ10; 5. control freezing group; 6. the experimental freezing group with L-carnitine; 7. the experimental freezing group with coenzyme Q10 and 8. the experimental freezing with the combination of L-c + CoQ10. Sperm motility was assessed by WET MOUNT method. DNA fragmentation was evaluated by SCD (Sperm Chromatin Desperation), ROS, was evaluated by quantitative fluorescence reaction, and chromatin deficiency was determined by chromatin staining (CMA3).

Antioxidant treatments, significantly reduced the number of ROS + in the pre and post freezing groups. Significant improvement was seen in the sperm motility of class B in the pre freezing groups with L-carnitine. Antioxidants also reduced the percentage of DNA fragmentation and protamine deficiency in pre-and post-freezing.

Addition of Coq10 and L-carnitine to human sperm medium significantly reduced the number of ROS. This reduction in ROS reduced sperm damage during cryopreservation.

Addition of Coq10 and L-carnitine to human sperm medium significantly reduced the number of ROS. This reduction in ROS reduced sperm damage during cryopreservation.

Until recently, the urine of healthy individuals was assumed to be sterile. However, improvement of bacterial detection methods has debunked this assumption. Recent studies have shown that the bladder contains microbiomes, which are not detectable under standard conditions. In this review, we aimed to present an overview of the published literature regarding the relationship between urinary microbiota and functional disorders of the genitourinary system.

We searched Medline, PubMed, Embase, The Cochrane library and Scopus to identify RCTs published, with MeSH and free keywords including microbiota, bladder pain syndrome, prostatitis, kidney stone disease, and bladder cancer until September 2020. Randomized controlled trials investigating microbiome and lower urinary tract symptoms were included. Non-randomized trials, cross-over trials and pooled studies were excluded. The articles were critically appraised by two reviewers.

The urine microbiome is a newly introduced concept, which has attracted the attg the microbiota to a healthy composition and providing symptom relief. Modification of the urinary microbiome without antibiotic use can be a possible venue for future research.

 Most Hirschsprung’s disease (HD) are diagnosed in young children with increased risk („red flag”). Older children (>6 months) require open rectal biopsy (ORB) with its own impact on risk and resources. We investigated if „red flag”, age, and sex used in combination could exclude HD.

 ”Red flags” are risk factors associated with HD, including neonatal bowel obstruction, genetic association, failure of passage of meconium in <48 hours, infantile constipation, distension with vomiting, or family history. All rectal biopsies (2015-2018) were reviewed for indications, methods, and histopathological findings. Logistic regression analysis was adopted to assess predictive value of „red flag,” age, and sex (

 < 0.05* was significant).

 A total of 187 children underwent 84 suction rectal biopsies and 113 ORBs (

 = 197 in total). Final histopathological diagnoses were non-HD (

 = 154) and HD (

 = 43). Total 78% of rectal biopsies were non-HD, of which 63% by ORB. Non-HD was associated with absence of „red flag” (49 vs. 16%*), increased age at biopsy (22 months vs. 28 days*), >6 months old (62 vs. 30%*), and female gender (54 vs. 16%*), compared with HD. In the absence of „red flag,” 7/82 (9%) had HD (negative predictive value = 91%). Logistic regression analysis found absent „red flag” predicted non-HD biopsy with odds ratio 4.77 (1.38, 16.47), corrected for age and sex.

 Negative rectal biopsy rate for HD is very high. The majority required ORB. Although „red flag” and gender, but not age, have strong predictive values, it is inadequate for excluding HD. This study supports the need for alternative strategies in excluding HD.

 Negative rectal biopsy rate for HD is very high. The majority required ORB. Although „red flag” and gender, but not age, have strong predictive values, it is inadequate for excluding HD. This study supports the need for alternative strategies in excluding HD.

 Acute appendicitis can be difficult to diagnose, especially in children < 4 years old. The aim of the present study was to assess the diagnostic value of Alvarado score (AS), appendicitis inflammatory response (AIR) score, and pediatric appendicitis score (PAS) in children younger than 4 years.

 All children younger than 4 years who underwent appendicectomy between 2005 and 2019 were included retrospectively. The diagnostic performance of the scores was analyzed using the area under the receiver-operating characteristic (ROC) curve and by calculating the diagnostic performances at optimal criterion value cutoff points.

 In this study, 100 children were included (58 boys and 42 girls) with a median age of 39.5 (12-47) months. Ninety children were diagnosed with pathologically proven acute appendicitis. The area under ROC curve of AS was 0.73, AIR score was 0.79, and PAS was 0.69 (

 > 0.05, respectively). In children with low risk of acute appendicitis, negative predictive values were 75.0% for AS, 50.0% for AIR score, and 66.7% for PAS (

 < 0.05, respectively). The positive predictive values in children with high risk of acute appendicitis were of 92.7% for AS, 92.6% for AIR score, and 93.6% for PAS (

 > 0.05, respectively). AS, AIR score, and PAS plus positive ultrasonography have 0.58, 0.49, and 0.88 area under ROC curve.

 The three scores can be of assistance in the suspicion of acute appendicitis. PAS markedly improved combined with positive ultrasonography, but none can be used in setting the diagnosis of acute appendicitis in young children.

 The three scores can be of assistance in the suspicion of acute appendicitis. PAS markedly improved combined with positive ultrasonography, but none can be used in setting the diagnosis of acute appendicitis in young children.

Obesity among adolescents is becoming increasingly prevalent and „food addiction” (addiction-like attraction to foods with high content of fat and refined carbohydrates) may be a potential contributor to this development. This study aimed to investigate the psychometric properties of the dimensional Yale Food Addiction Scale for Children version 2.0 (dYFAS-C 2.0) and to estimate the weighted mean score on the dYFAS-C 2.0 (as a measure of food addiction symptom load) among adolescents from the general Danish population.

A total of 3,750 adolescents aged 13-17 were randomly drawn from the general Danish population and invited to participate in a web-based survey. Data on health and socioeconomic factors from the Danish registers were linked to both respondents and non-respondents, which allowed for analysis of attrition. The total- and sex-stratified weighted mean dYFAS-C 2.0 scores were estimated using augmented inverse probability weighted estimation.

A total of n = 576 (15.4%) adolescents participated onal descriptive study combined with retrospective register data.

This study aimed to measure diaphragm thickness using ultrasound in adult patients with severe idiopathic scoliosis.

This prospective case-control study included patients with severe idiopathic scoliosis and a healthy control group. The control and patient groups’ demographic features, pulmonary function tests, diaphragm thickness, and thickening fraction measured using ultrasonography were compared.

End-expirium values were similar between the two groups (p = 0.902). However, end of inspirium, change level, and diaphragm thickening fraction were significantly lower in the scoliosis group (p < 0.001 for all). Cobb degree values were inversely correlated with forced expiratory volume in 1s (%) (r =  - 0.909, p < 0.001), forced vital capacity (%) (r =  - 0.887, p < 0.001), and end-inspirium thickness (r =  - 0.673 and p < 0.001) values. Furthermore, diaphragm thickness at the end of inspirium was positively correlated with forced expiratory volume in 1s (%) (r = 0.636, p = 0.001) and forced vital capacity (%) (r = 0.646, p = 0.001) values. No significant correlation was found between diaphragm thickening fraction and forced expiratory volume in 1s or forced vital capacity.

Ultrasound can provide valuable information about diaphragm morphology and quantify diaphragm contraction.

Ultrasound can provide valuable information about diaphragm morphology and quantify diaphragm contraction.This study aimed to investigate the distribution of virulence factor genes in Shigella strains isolated from children with diarrhea in the southwest, Iran. In this cross-sectional study, 1530 diarrheal stool specimens were collected from children aged under 15 years. The Shigella strains were identified by biochemical methods and polymerase chain reaction (PCR). Subsequently, all Shigella isolates were evaluated by PCR for the presence of nine virulence genes ipaH (responsible for dissemination from cell to cell), ial (responsible for epithelial cell penetration), sat (displays cytopathic activity in several intestinal cell lines), sigA (toxic to epithelial cells), pic (associated with colonization), pet (cytotoxic for epithelial cells), sepA (contribute to intestinal inflammation and colonization), virF and invE (regulatory proteins). A total of 91 isolates including 47 S. flexneri, 36 S. sonnei, and 8 S. boydii were identified. All isolates were positive for the ipaH gene. The other genes include ial, virF, invE, sigA, sat, sepA, pic and pet found in 84.6%, 72.5%, 68.1%, 62.6%, 51.6%, 39.5%, 37.3% and 28.5% of the isolates, respectively. The results showed a high distribution of virulence genes among Shigella strains in our region. It seems that for different Shigella spp. different virulence factors contribute to pathogenesis. The current study provided insights into some baseline information about the distribution of some virulence genes of Shigella isolates in Southwest Iran.Urbanization is a dominant component of social and economic development around the world, but this process creates tremendous pressure on the ecological environment. How to achieve coordination between urbanization and conservation of this environment has become a key issue, especially in developing countries. It is necessary to identify the driving factors that affect this coordination. To identify these factors, we chose 290 Chinese prefecture-level cities to analyze the driving factors behind urbanization using spatial regression analysis, and explored the spatial differences among regions in these factors. Our results show that industrial upgrading and technological progress were the main factors that promoted coordinated development, with industrialization having positive effects under government management, but with differences among regions in how the driving forces affected coordinated development. Using technological progress to promote industrial upgrading, creating new employment to absorb surplus rural labor, and providing workers with skills training so they can take advantage of new jobs can promote win-win solutions that coordinate urbanization with conservation of the ecological environment.The quality of water in many urban rivers in Latin America is increasingly degrading due to wastewater and runoff discharges from urban sprawl. Due to deficits in sanitary drainage systems, greywater is discharged to the stormwater drainage network generating a continuous dry-weather runoff that reaches rivers without treatment. One of the main challenges in the region is to achieve sustainable management of urban runoff for the recovery of rivers ecosystem integrity. However, retrofitting conventional centralized wastewater drainage networks into the existing urban grid represents important social, economic and technical challenges. This paper presents an alternative adaptive methodology for the design of Nature-based Solutions for decentralized urban runoff treatment. Through this study, technical solutions commonly used for stormwater management were adapted for dry-weather runoff treatment and co-designed for the particular conditions of a representative study area, considering space availability as the main constraining factor for retrofitting in urban areas. The application of a co-design process in a dense neighbourhood of the Great Metropolitan area of Costa Rica brought to light valuable insights about conditions that could be hindering the implementation of NBS infrastructures in Latin America.Various air and water pollution issues in the US were confronted in the last 60 years using national policy legislation, notably the Clean Water Act and the Clean Air Act. I examine changes in the concentrations of bacteria, oxygen, lead, and sulphate at the terminus of the Mississippi River before and after these pollution abatement efforts. Microbial concentrations increased or were stable from 1909 to 1980 but decreased about 3 orders of magnitude after the 1970s, while the average oxygen content increased. A large decline in lead concentration occurred after the 1960s, along with a less dramatic decline in sulphate concentrations. The pH of the river dropped to a low of 5.8 in 1965 as sulfur dioxide emissions peaked and averaged 8.2 in 2019 after emissions declined. Decades of efforts at a national scale created water quality improvements and are an example for addressing new and existing water quality challenges.Reliable catch information is scarce for most sharks and rays worldwide, with almost half of the stocks considered to be Data Deficient due to limited species-specific catch statistics. Western Australia (WA) hosts a diverse number of shark and ray species, some of which are considered to be threatened with extinction at a global level. Commercial catch statistics only account for shark and ray landings. The present study used the best available information to reconstruct unaccounted and unreported catches for 47 shark and ray taxa to better understand the impact of fishing. For some species, there was good agreement between reconstructed catches and reported landings, but overall reconstructed catches were 57% higher than those derived from official statistics alone, underestimating the actual extraction level for many species. The reconstructed catch time series provide the basis for the assessment of all species of sharks and rays captured in WA, including protected species that interact with commercial and recreational fisheries.

The aim of this study was to elaborate a consensus on treatment intensification strategies in patients with type 2 diabetes failing basal insulin supported oral therapy (BOT). The panel focused on glucagon-like peptide-1 receptor agonists (GLP-1RA) and basal insulin (BI) combinations.

The authors developed a Delphi questionnaire organized into ten statements and 77 items that focused on the definition of BOT and BOT failure, intensification strategies, fixed-dose combinations in general and the BI/GLP-1RA fixed combination. The survey was administered in two rounds to a panel of 80 Italian diabetes specialists, who rated their level of agreement with each item on a 5-point Likert scale. Consensus was predefined as > 66% of the panel agreeing/disagreeing on any given item.

Consensus was achieved for 71 of the 77 items. The panel agreed that the use of sulfonylureas in the BOT regimen is inappropriate. BOT failure was defined as individualized targets not being met for glycated hemoglobin, fasting plasbinations may increase compliance and optimize the advantages of each of these molecules.Tinnitus, the perception of sound in the absence of a physical sound in the environment, is highly heterogeneous. It varies in its etiology, characteristics, and impact on an individual’s life. The sound is commonly described as „ringing,” „buzzing,” „crickets,” „hissing,” „humming.” Tinnitus can be acute or chronic, mild or disabling. It can be perceived unilaterally or, more commonly, bilaterally. The sound and its location differ from person to person and fluctuate in the same individual over a certain period of time. This heterogeneity in characterization has important implications for research and clinical practice. Identifying patterns in how tinnitus sounds and its relationship to hearing may aid in identifying different forms of tinnitus and revealing their underlying mechanisms. However, the subjective nature of characterizing tinnitus makes it difficult to reliably define and measure. This chapter will focus on reviewing the psychoacoustic assessment of tinnitus, its relationship to cognitive and behavioral aspects of tinnitus, and its neuropathophysiology. In particular, it will describe the heterogeneity of tinnitus and tinnitus matching, and how individual variability in measures may be used to guide treatment and as a prognostic factor.It becomes increasingly clear that (non-)invasive neurostimulation is an effective treatment for obsessive-compulsive disorder (OCD). In this chapter we review the available evidence on techniques and targets, clinical results including a meta-analysis, mechanisms of action, and animal research. We focus on deep brain stimulation (DBS), but also cover non-invasive neurostimulation including transcranial magnetic stimulation (TMS). Data shows that most DBS studies target the ventral capsule/ventral striatum (VC/VS), with an overall 76% response rate in treatment-refractory OCD. Also TMS holds clinical promise. Increased insight in the normalizing effects of neurostimulation on cortico-striatal-thalamic-cortical (CSTC) loops – through neuroimaging and animal research – provides novel opportunities to further optimize treatment strategies. Advancing clinical implementation of neurostimulation techniques is essential to ameliorate the lives of the many treatment-refractory OCD patients.Obsessive-compulsive disorder (OCD) sits at the epicenter of a spectrum of related conditions (often referred to as obsessive-compulsive related disorders (OCRD) or obsessive-compulsive spectrum disorders (OCSD)) that can be as disabling as they are varied in presentation. Research in the field now encompasses diverse disciplines ranging from inflammatory mechanisms to computational psychiatry, to neurocognitive endophenotypes to functional imaging to pharmacogenomics to brain stimulation approaches. As these disorders become more clearly elucidated, there is a need to continually re-evaluate the implications of research findings and to incorporate these findings into new treatment approaches that benefit both patients and clinicians. Even the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) is intended to be flexible and to incorporate validated and reliable biomarkers and neuroscience findings as they become available. This concluding chapter highlights just a few areas of study that promise to influence our understanding of the pathophysiology and clinical practice of OCRD. These include patient-centered outcomes research, the study of developmental brain trajectories in spectrum conditions, robot models of OCRDs, goal-directed versus habit-based behaviors, pharmacogenomics, problematic use of the Internet, and digital interventions. For example, digital medicine may become increasingly useful by identifying patients early on in the course of their illness; providing biomarkers to subtype patients; predicting treatment response; serving as a more proximal outcome measure of treatment response; or providing easily accessible and less costly forms of care. In order to address unmet clinical needs in OCRD, it is helpful to take an interdisciplinary perspective, and the work described in this collection of articles is likely to be invaluable in shaping the future of the field.Pharmacogenetics has become increasingly important in the treatment of psychiatric disorders because approximately 50% of individuals who take psychotropic medications do not typically respond to them. Obsessive-compulsive disorder (OCD) is one such chronic and often debilitating mental illness with significant non-response to even the first-line medication, serotonin reuptake inhibitors. Precision medicine utilizing genetic testing panels has received significant attention based on the evidence that the variability of antidepressant response and adverse effects is partly due to the variability in an individual’s genome. Thus, extensive research has investigated the role of genetic factors on antidepressant response in major depressive disorder (MDD) and their utility for guiding antidepressant treatment to significantly improving outcomes in individuals with MDD. However, limited progress remains in the pharmacogenetics of OCD. This chapter will provide an overview of the recent findings in the pharmacogenetics of OCD. Promising results with limited replications have been reported for the cytochrome P450 liver metabolism genes in addition to several serotonergic and glutamatergic system genes, which may play an important role in antidepressant response in the treatment of OCD.The high incidence of obesity has increased the need to discover new therapeutic targets to combat obesity and obesity-related metabolic diseases. Obesity is defined as an abnormal accumulation of adipose tissue, which is one of the major metabolic organs that regulate energy homeostasis. However, there are currently no approved anti-obesity therapeutics that directly target adipose tissue metabolism. With recent advances in the understanding of adipose tissue biology, molecular mechanisms involved in brown adipose tissue expansion and metabolic activation have been investigated as potential therapeutic targets to increase energy expenditure. This review focuses on G-protein coupled receptors (GPCRs) as they are the most successful class of druggable targets in human diseases and have an important role in regulating adipose tissue metabolism. We summarize recent findings on the major GPCR classes that regulate thermogenesis and mitochondrial metabolism in adipose tissue. Improved understanding of GPCR signaling pathways that regulate these processes could facilitate the development of novel pharmacological approaches to treat obesity and related metabolic disorders.

To analyze the effect of the COVID-19 pandemic on the provision of fragility hip fracture care, comparing patients treated before cohorting and in separate COVID-19 and non-COVID-19 circuits with the corresponding months in 2018 and 2019.

Retrospective single-center cohort study including 64 patients with fragility hip fractures treated during the COVID-19 pandemic (March 1st-May 1st, 2020), compared to 172 patients treated in 2018 and 2019. Dedicated COVID-19 and non-COVID-19 circuits were established on March 14th. Patients treated before cohorting (17 patients), in COVID-19 (14 patients) and non-COVID-19 circuits (33 patients) were included.

Baseline characteristics were similar for 2018-19 and 2020. Patients in 2020 had a lower median surgical delay (50.5 vs. 91.3h) and length of stay (9.0 vs. 14.0days), while those with COVID-19, had longer surgical delays and length of stay (87.7h and 15.0days, respectively). Thirty-days mortality was higher among patients before cohorting, but similar in Covid-19d to negative cases and 2018-19. Delaying surgery among patients with severe respiratory illness until a favourable trend could be observed did not lead to increased mortality.

To determine the prevalence of sleep-related disorders, poor sleeping, and factors associated with poor sleep quality among inhabitants of Parakou, Benin.

This was a cross-sectional study conducted from April-August 2018on 930 randomly selected adults (age ≥ 18 years). Using the Pittsburg Sleep Quality Index, the Insomnia Severity Index, and the EpworthSleepiness Scale, subjects were questioned on their sleep, on parasomnias, and onmovement-related sleep disorders.

Overall, the prevalence of insomnia was 22% (95% CI, 19.1-24.4) and severe insomnia was 0.8%. The prevalence of excessive daytime sleepiness was 15% (95% CI, 12.5-17.0). Daily nightmares (2%) and rhythmic movements (6%) were those most commonly reported among parasomnias and movement-related sleep disorders. No major differences were found between men and women. The prevalence of poor sleeping (PSQI > 5) was 39% (95%CI, 36.3-42.5). Adjusted analyses showed a higher risk of poor sleeping in those aged 45-54 years (aOR = 1.78, p = 0.032) or ≥ 55 years (aOR = 3.61, p < 0.001), those overweight or obese (aOR = 1.53, p = 0.007), those underweight (aOR = 2.90, p = 0.030), and among females (aOR = 1.84, p < 0.001). Being divorced was associated with a lower risk of poor sleeping (aOR = 0.18, p = 0.036). Poor sleepers were more commonly found among those who had excessive daytime sleepiness (65% versus 36%, p < 0.001) and insomnia (86% versus 27%, p < 0.001).

Sleep-related disorders were common in Parakou city, Benin, with four out of ten persons having poor sleep quality. There is a need to improve the management of sleep-related disorders and promote better sleep practices for the community.

Sleep-related disorders were common in Parakou city, Benin, with four out of ten persons having poor sleep quality. There is a need to improve the management of sleep-related disorders and promote better sleep practices for the community.

Difficult mask ventilation (DMV) is a potentially life-threatening situation that can arise during anesthesia. However, most clinical predictors of DMV are based on European and US populations. On the other hand, most predictive models consist of multiple factors and complicated assessments. Since obstructive sleep apnea (OSA) is among the most important risk factors associated with DMV, the apnea-hypopnea index (AHI) may play an important role in determining patient risk.The purpose of this study was to investigate the relationship between DMV and AHI, and to determine preoperative risk factors for DMV in Chinese patients.

A prospective cohort trial enrolled patients scheduled for elective surgery. After obtaining informed consent, patient demographic information was collected, and patients were tested with pre-operative polysomnography. The anesthesiologist who managed the airway graded the mask ventilation. The difficult mask ventilation was defined as the mask ventilation provided by an unassisted anesthesiologist without oral airway or other adjuvant. A logistic regression model was used to analyze the association between AHI and DMV.

A total of 159 patients were analyzed. For both primary and secondary outcomes, the unadjusted and adjusted odds ratio for DMV showed significant increases by 5 AHI units. AHI, age, and the Mallampati classification were found to be independent predictive factors for DMV.

AHI is associated with DMV as a novel independent risk factor in Chinese patients. Along with age and Mallampati classification, AHI should be included in establishing a superior predictive strategy for DMV screening.

Chinese Clinical Trial Registry ChiCTR-DDD-17013076.

Chinese Clinical Trial Registry ChiCTR-DDD-17013076.

Gestational disorders including preeclampsia, growth restriction and diabetes are characterized, in part, by altered metabolic interactions between mother and fetus. Understanding their functional relevance requires metabolic characterization under normotypic conditions.

We performed untargeted metabolomics on livers of pregnant, late-term C57Bl/6J mice (N = 9 dams) and their fetuses (pooling 4 fetuses/litter), using UPLC-MS/MS.

Multivariate analysis of 730 hepatic metabolites revealed that maternal and fetal metabolite profiles were highly compartmentalized, and were significantly more similar within fetuses (ρ

 = 0.81), or within dams (ρ

 = 0.79), than within each maternal-fetal dyad (ρ

= – 0.76), suggesting that fetal hepatic metabolism is under distinct and equally tight metabolic control compared with its respective dam. The metabolite profiles were consistent with known differences in maternal-fetal metabolism. The reduced fetal glucose reflected its limited capacity for gluconeogenesis and deble model for mechanistic investigation into how maternal-fetal metabolism adapts (or not) to gestational stressors.This study deals with the development of alumina-supported cobalt (Co/Al2O3) catalysts with remarkable performance in dry reforming of methane (DRM) and least carbon deposition. The influence of Co content, calcination, and reduction temperatures on the physicochemical attributes and catalyst activity of the developed catalysts was extensively studied. For this purpose, several characterization techniques including ICP-MS, H2 pulse chemisorption, HRTEM, H2-TPR, N2 adsorption desorption, and TGA were implemented, and the properties of the developed catalysts were carefully analyzed. The impact of reaction temperature, feed gas ratio, and gas hourly space velocity (GHSV) on the reactants conversion and products yield was investigated. Use of 10%Co/Al2O3 catalyst, calcined at 500°C and reduced under H2 at 900°C in DRM reaction at 850°C, CH4/CO2 ratio of 11, and GHSV of 6 L.g-1.h-1 resulted in a remarkable catalytic activity and sustainable performance in long-term operation where great CO2 (96%) and CH4 (98%) conversions and high H2 (83%) and CO (91%) yields with a negligible carbon deposition (3 wt%) were attained in 100-h on-stream reaction. The good performance of the developed catalyst in DRM reaction was attributed to the small Co particle size with well-dispersion on the alumina support which increased the catalytic activity and also the strong metal-support interaction which inhibited any serious metal sintering and enhanced the catalyst stability.Sewage sludge (SS) production in China has increased rapidly, accompanying the fast expansion of its sewage treatment capacity. Heavy metals (HMs) in SS have been a great concern, hampering the utilization and disposal of SS. In this study, heavy metal (HM) contents in SS from throughout China were determined. The median values of HMs in SS decreased in the order Zn > Cu > Cr > Pb > Ni > As > Hg > Cd. The general attainment rates of HMs in SS are satisfying (> 90%). Combining the present data with those obtained from references, spatial distributions and temporal trends of HMs in SS were analyzed. Depending on the specific HM element, the spatial variation trend might be decreasing trends from south to north and from east to west of China. The element-specific hot spots of SS with relatively high HM contents were identified. Analysis of the historical data in different time intervals reviewed obvious decreasing trends in HM contents of SS in China, indicating the well implementation of more and more stringent environmental regulations.The instant endeavor was undertaken to monitor copper (Cu) contents in water, soil, forage, and cow’s blood impacted by heavy automobiles in Sahiwal town of district Sargodha, Pakistan. The samples were collected in triplicates with a total of 120 soil and water samples with corresponding forage samples. For the analysis of metal concentration in cows, 60 blood samples were collected from the cows feeding on these forages on selected sites. Metal contents were analyzed by atomic absorption spectrophotometry. The results showed that water samples contained mean values of Cu concentration ranged from 1.01 to 0.444 mg/kg at all sites. It was maximum at site 3 and minimum at site 6. The soil samples of all the forage fields showed Cu mean values concentration ranged from 1.94 to 0.286 mg/kg at all sites. It was maximum in Trifolium alexandrinum grown field at site 2, and minimum in Avena sativa at site 2. All the forage samples showed the mean value of Cu concentration ranged from 0.151 to 1.86 mg/kg at all sites. The concentration of Cu was maximum in Zea mays grown at site 5 and minimum in Trifolium alexandrinum at site 4. The cow blood samples showed the mean concentration of Cu ranged from 1.368 to 0.53 mg/kg at all sites. It was maximum at site 2 and minimum at site 6. Owing to the results of pollution index and transfer factors, metal content was found to be in permissible range in forages as well as animal samples.To make full use of unlabeled data for soft-sensor modelling and to address the coexistence of a large number of hard-to-measure variable issues, this study proposed a novel two-step adaptive heterogeneous co-training multioutput model. First, unlabeled data with the highest confidence were selected to optimize the model. Then, the proposed model co-trained Gaussian process regression (GPR) and least squares support vector machine (LSSVM) algorithms with two sets of independent labeled data. Second, at each step of the model update, the Kalman filter (KF) worked together with a moving window (MW) to strengthen the model to address process dynamics. Finally, the proposed model was demonstrated by a simulated wastewater treatment platform, BSM1, and a real sewage treatment plant. The root-mean-square error (RMSE) and root-mean sum of squares of the diagonal (RMSSD) were obviously reduced, and the correlation coefficient (R) and correlation coefficient (RR) reached 0.8 in both case studies. The results suggest that the proposed model can significantly improve prediction performance.Ex situ aqueous mineral carbonation of ultramafic mining waste is an evolving technology for the CO2 sequestration from small- to medium-scale emitters. The mineral ores or mine wastes of associated ultramafic mineralogy are a suitable feedstock for mineral carbonation. The aqueous mineral carbonation at ambient temperature is motivating and attractive from an energy-saving perspective. This study has investigated the CO2 sequestration potential of a locally available ultramafic material generated from a nickel ore mine with a futuristic scope of integrating the method into an ongoing mineral extraction and/or tailing management operation. The mineral characterization and experimental results indicate that the tested material has CO2 sequestration potential and underwent carbonation at ambient temperature. The carbonate conversion efficiencies obtained for Ca and Mg from the dissolved ionic forms at optimum conditions are 60% and 25%, respectively. The material was able to sequestrate about 0.12 gCO2 per g solid at this efficiency.