Molecular Characterization of Closely Related H6N2 Avian Influenza Viruses Isolated from Turkey,Egypt, and Uganda

Genetic analysis of circulating avian influenza viruses (AIVs) in wild birds at different geographical regions during the same period could improve our knowledge about virus transmission dynamics in natural hosts, virus evolution as well as zoonotic potential. Here, we report the genetic and molecular characterization of H6N2 influenza viruses isolated from migratory birds in Turkey, Egypt, and Uganda during 2017–2018. The Egyptian and Turkish isolates were genetically closer to each other than they were to the virus isolated from Uganda. Our results also suggest that multiple reassortment events were involved in the genesis of the isolated viruses. All viruses contained molecular markers previously associated with increased replication and/or pathogenicity in mammals. The results of this study indicate that H6N2 viruses carried by migratory birds on the West Asian/East African and Mediterranean/Black Sea flyways have the potential to transmit to mammals including humans. Additionally, adaptation markers in these viruses indicate the potential risk for poultry, which also increases the possibility of human exposure to these viruses.     

Laser Powder Bed Fusion of Polymers: Quantitative Research Direction Indices

Research on Laser Powder Bed Fusion (L-PBF) of polymer powder feedstocks has raised over the last decade due to the increased utilization of the fabricated parts in aerospace, automotive, electronics, and healthcare applications. A total of 600 Science Citation Indexed articles were published on the topic of L-PBF of polymer powder feedstocks in the last decade, being cited more than 10,000 times leading to an h-index of 46. This study statistically evaluates the 100 most cited articles to extract reported material, process, and as-built part properties to analyze the research trends. PA12, PEEK, and TPU are the most employed polymer powder feedstocks, while size, flowability, and thermal behavior are the standardly reported material properties. Likewise, process properties such as laser power, scanning speed, hatch spacing, powder layer thickness, volumetric energy density, and areal energy density are extracted and evaluated. In addition, material and process properties of the as-built parts such as tensile test, flexural test, and volumetric porosity contents are analyzed. The incorporation of additives is found to be an effective route to enhance mechanical and functional properties. Carbon-based additives are typically employed in applications where mechanical properties are essential. Carbon fibers, Ca-phosphates, and SiO₂ are the most reported additives in the evaluated SCI-expanded articles for L-PBF of polymer powder feedstocks. A comprehensive data matrix is extracted from the evaluated SCI-index publications, and a principal component analysis (PCA) is performed to explore correlations between reported material, process, and as-built parts.     

Shared decision making: A dual‐layer model to tackling multimorbidity in primary care

It is common for primary care providers (PCPs) to manage complex multimorbidity. When caring for patients with multimorbidity, PCPs face challenges to tackle several issues within a short consultation in order to address patients' complex needs. Furthermore, some PCPs may lack access to a multidisciplinary team and need to manage multimorbidity within the confine of a PCP‐patient partnership only. Instead of attempting to address multiple health issues within a single consultation, it would be more feasible and time effective for PCPs and patients to jointly prioritize the health issue to focus on. Using the Malaysian primary care setting as a case study, a dual‐layer‐shared decision‐making approach is proposed whereby PCPs and patients make decisions on which disease(s) (layer 1) and treatment(s) (layer 2) to prioritize. This dual‐layer model aims to address the challenges of short consultation time and limited healthcare resources by encouraging PCPs and patients to discuss, negotiate, and agree on the decision during the consultation to ensure patients' health needs are addressed.     

Pain mechanisms in chronic pancreatitis: of a master and his fire

Background  

Unraveling the mechanisms of pain in chronic pancreatitis (CP) remains a true challenge. The rapid development of pancreatic surgery in the twentieth century, usage of advanced molecular biological techniques, and emergence of clinician-scientists have enabled the elucidation of several mechanisms that lead to the chronic, complicated neuropathic pain syndrome in CP. However, the proper analysis of pain in CP should include three main arms of mechanisms: “peripheral nociception,” “peripheral/pancreatic neuropathy and neuroplasticity,” and “central neuropathy and neuroplasticity.”     

Biological mechanisms of microvessel formation in advanced atherosclerosis: The big Five

Advanced atherosclerotic lesions prone to rupture are characterized by a distinct histomorphology and pathobiology that became in recent years, increasingly related to the process of intraplaque neovascularization. Molecular mechanisms that regulate angiogenesis and that are active in the plaque region may destabilize advanced lesions by promoting microvessel growth and thus providing an entry route for inflammatory cells secondary to the luminal endothelium. In addition, angiogenic factors can also define intraplaque microvessel integrity and endothelial barrier function, determining the prevalence of intraplaque hemorrhaging. Here, we aim to compose a hypothetical model for angiogenic regulation of vulnerable plaque development, based on the evidence of clinical correlation and experimental functional studies that are provided for five of the most well-described angiogenic pathways in the current literature.     

Effect of balneotherapy on temporospatial gait characteristics of patients with osteoarthritis of the knee

Effects of balneotherapy on gait properties of patients with osteoarthritis of the knee were investigated prospectively. A total of 30 patients with knee osteoarthritis received balneotherapy consisting of two daily thermomineral water baths for 2 weeks. Patients were evaluated using gait analysis and clinical scores, both within 2 weeks, before and after spa treatment. Patients were walking faster in their control analyses (0.81 ± 0.21 to 0.89 ± 0.19 m/s; P = 0.017), with a shorter mean stance time (63.0 ± 3.3 to 61.8 ± 2.5% stride; P = 0.007), an increased cadence (96 ± 13.1 to 100 ± 11.9 steps/min; P = 0.094) and stride length (996 ± 174 to 1,058 ± 142 mm; P = 0.017). Balneotherapy also resulted in a significant decrease in Lequesne knee osteoarthritis index (12.1 ± 3.7 to 10.0 ± 3.3 points; P = 0.003), VAS for pain (58 ± 25 to 33 ± 15; P = 0.0001), VAS for patients’ (56 ± 24 to 29 ± 19; P < 0.001) and investigator’s global assessment (55 ± 20 to 26 ± 15; P < 0.0001) and WOMAC score (2.1 ± 0.7 to 1.6 ± 0.8; P = 0.0004). Balneotherapy has positive effects on gait properties and clinical health quality parameters of patients with knee osteoarthritis in short-term evaluations.     

National prevalence of underweight, overweight and obesity in Turkey: cross sectional study of a representative adult population

The aim of this study was to determine underweight, overweight, and obesity prevalence in representative sample of adult (≥ 18 years old) Turkish population living in urban and rural area of Turkey. Turkish citizens aged ≥ 18 who can represent adult population and permanently resident in Turkey were taken to this study in 1999–2000. The nationally representative sample population was selected from the target population using the census which was performed by national institute of statistics at 1997. Target population was 13.570 individuals living in these houses and 8674 people who aged ≥ 18 are chosen for the study. BMI was used as widely accepted diagnostic criteria of obesity. This study demonstrated that the prevalence of underweight was 10.7% in men, 5.9% in women and 8.1% for overall. The prevalence of overweight was 17.4% in men, 20.4% in women and 19% for overall. The prevalence of obesity was 7.8% in men, 22.1% in women and 15.6% for overall. The prevalence of overweight is higher (19.6%) in urban areas but prevalence of obesity is higher (17%) in rural areas of Turkey. Age, educational level and marital status seem to have association with obesity prevalence. The data we obtained showed us that while the underweight is still an issue for men, the overweight and obesity prevalence is high and needs to take early prevention steps for Turkish population.     

Thermal responses and heart rates of low-birth-weight premature babies during daily care on a heated, water-filled mattress

Body temperatures, heart rates and resting oxygen consumptions were examined during routine nursing care in 12 premature babies treated alternately in incubators or on a heated, water-filled mattress (HWM). The mean temperatures were significantly higher in the axilla (0.3 degree C; p less than or equal to 0.05) and the foot (1.4 degrees C; p less than 0.001) during HWM care. The degree of maximal fall in various body temperatures during routine nursing procedures was the same for both treatments, whereas the time taken for the foot temperature to fall was 13 min shorter during HWM care (p less than 0.001). The proportion of heart rates below 160 bpm when the babies were not disturbed was 7.4% greater during HWM treatment (p less than 0.01). The resting oxygen consumption in babies treated on HWM was slightly lower (6.2 +/- 0.4 vs 6.4 +/- 0.5 ml/kg/min; p less than 0.05). Treatment on the HWM seems to promote calm and comfort, since it reduces the amount of thermal stress and prolongs quiet resting periods.