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Incidence and risk factors for anastomotic leakage after transanal total mesorectal excision in a retrospective cohort of 212 patients
Abstract Anastomotic leakage remains a major complication in colorectal surgery. Although several risk factors have been identified, the specific risks associated with TaTME procedures require further clarification. The aim of this study was to determine the frequency of anastomotic leakage after TaTME and to identify factors influencing leakage rates. Out of 237 patients who underwent TaTME, 229 received an anastomosis. Seventeen were excluded from further analysis—14 due to lack of leakage assessment before ileostomy closure and 3 due to missing follow-up data—resulting in a final cohort of 212 patients. Cases were analysed with respect to anastomotic technique and other variables potentially affecting the incidence of anastomotic leakage. Data were obtained from a prospectively maintained institutional database. The mean tumour distance from the anorectal junction (ARJ) was 2.92 cm (± 1.56). Anastomotic leakage occurred in 27 patients (12.74%). The only statistically significant risk factor for leakage was the type of anastomosis: leakage occurred in 18.28% of patients with hand-sewn anastomosis and in 8.47% of those with stapled anastomosis. Tumour height indirectly influenced the leakage rate, as hand-sewn anastomosis was used predominantly in lower tumours (1.78 cm vs. 3.82 cm from the ARJ). Anastomotic leakage rates after TaTME are comparable to those reported for other rectal cancer surgical techniques. Leakage risk is primarily determined by the type of anastomosis and, indirectly, by tumour height. TaTME appears to be a feasible option for selected patients in experienced centres, although further validation is required.
First molecular characterization and antimicrobial resistance profiles of Campylobacter jejuni isolated from poultry meat in Yemen
Understanding private landowner strategies for wild pig management using cluster analysis and structural equation modeling
Intertwining of the IGF system and animal welfare
Abstract To date, husbandry categories are defined based on the human concept of animal needs, however, to objectively assess animal welfare in defined husbandry systems, animal-related indicators must be evaluated. Here, we studied the impact of differential housing conditions on factors of the insulin-like growth factor system (IGF-system) in mother sows either housed in a conventional husbandry system corresponding to the regulations of the German husbandry form 1, or in the associated ecological facility, corresponding to the German husbandry form 4/5. Utilizing a proprietary bioassay that determines the activity of the IGF system at the level of intracellular signal transduction, we revealed altered serum IGF bioactivities in differentially housed sows. Moreover, we present a comprehensive analysis of the individual factors of the IGF system in serum of pregnant and lactating sows to elucidate which of these are modified depending on the housing conditions. An unsupervised principal component analysis suggests that IGF system factors might distinguish sows based on their housing environment. These results imply that the IGF system provides a solid basis for the documentation and objective assessment of animal health and welfare. However, a robust biomarker system for animal welfare assessment will likely require a multifactorial and integrative approach.
Explainable machine learning with routine biomarkers identifies culture-defined bacteremic urosepsis
Electrochemical characterisation of new textile electrodes based on a conductive silicon yarn for bioelectrical stimulation
Abstract Transcutaneous electrical stimulation for therapeutic applications relies on electrodes that interface with the human skin. Alongside hydrogel and rubber electrodes, textile electrodes are becoming increasingly important. We introduce a novel textile electrode based on conductive silicone yarn and analyse the electrochemical characteristics. We consider two realisations of the electrode, one with a snap lead button and one where the yarn itself is used for contacting to a cable. Characterisation was done in contact to 0.9% sodium chloride solution. Impedance spectroscopy was performed over 24 h in the frequency range from 0.1 Hz to 1 MHz. Open-circuit potential measurements were taken over 12 h. Voltage and current noise were analysed in the time domain for one hour, and the power spectral density was calculated for a frequency range from 0 to 500 Hz. Our new textile electrodes showed median impedances of 19.6 kΩ at 0.1 Hz and 98 Ω at 1 MHz, which are similar or lower compared to previously introduced stimulation electrodes. The conductive silicone yarn exhibited higher impedances. Noise characteristics and potential stability of the electrodes and the electrode material were comparable to conventional types. In addition to their electrochemical performance, the new textile electrodes offer the skin compatibility of rubber electrodes and the high comfort of textile electrodes, rendering them a promising, sustainable and user-friendly alternative for bioelectrical stimulation applications.
Treatment of contagious bovine pleuropneumonia as a potential driver for antimicrobial resistance in pastoral production systems of Kenya
Abstract The control of contagious bovine pleuropneumonia (CBPP) remains constrained by institutional, financial and technical barriers in many livestock-keeping regions of sub-Saharan Africa, despite its detrimental impact on trade, pastoral livelihoods and food security. Therefore, livestock keepers are relying on suboptimal use of antimicrobials to manage CBPP outbreaks. We conducted an outbreak investigation to understand epidemiological and management practices in 95 herds with ongoing or recent cases of CBPP in five counties of Kenya. A wide range of antimicrobials including tetracycline, penicillin-streptomycin (pen & strep), tylosin, and diminazen were used in majority of herds (90/95; 94.7%), with half of these herds receiving sequential administration of two or more types of drugs to address failure of the first use. Only 33/95 (34.7%) of farmers reported to have vaccinated their animals and most of them vaccinated in response to outbreaks in their herds rather than the expected routine preventive program (28/33, 84.8%). The average case fatality rate (CFR) for CBPP was estimated at 36%, with only treatment with tylosin resulting in a significant reduction in mortalities due to CBPP ( p = 0.035). Majority of livestock keepers (83.3%) continued to consume milk from their animals during and after the treatment period, without observing the stipulated withdrawal periods. Policy emphasis should shift toward prudent use of antimicrobials and preventive vaccination as the cornerstone of CBPP control, while using multifaceted One Health strategy that bridges veterinary, public health, and environmental sectors.
Perioperative treatments and endophthalmitis after cataract surgery in France: the national population-based ICCARE study
A mixed methods study of multidisciplinary team assessment and therapeutic decision making for intestinal strictures in Crohn’s disease
Silicon wafers outperform batteries: efficiency heterogeneity and policy effects in China’s photovoltaic industry
Ambimodal (2 + 1)/(4 + 1) Pseudopericyclic Transition States in Reactions between Dihalocarbenes and Olefins
Enhancing chicken manure with bread waste and black soldier fly associated bacteria to increase larval biomass
Abstract Black soldier fly larvae (BSFL) represent a promising and sustainable source of protein and essential nutrients for poultry feed. This study aimed to improve BSFL growth and organic waste bioconversion by utilizing chicken manure (CM), a widely available but environmentally problematic byproduct of poultry production due to its unpleasant odor, greenhouse gas emissions, and pathogen risks. In the first trial, CM was combined with bread waste (BW) at different ratios to overcome the poor larval growth observed when reared on CM alone. The 1:1 BW: CM mixture yielded the highest larval biomass, feed conversion efficiency, and nutritional value. In the second trial, beneficial bacteria were isolated from BSF egg surfaces and larval guts (3.5 × 10⁶ and 2.4 × 10⁶ CFU/ml, respectively). Thirteen isolates were screened for urease and protease activity, and five were selected and identified using phenotypic traits and 16 S rRNA sequencing: Microbacterium paraoxydans , Bacillus proteolyticus , Priestia megaterium , Bacillus subtilis , and Morganella morganii . Supplementation of CM-based diets with these strains significantly improved BSFL dry weight and feed conversion efficiency, with the most notable enhancements achieved using M. paraoxydans and M. morganii . Amino acid analysis of larvae fed a 3CM:1BW diet supplemented with M. paraoxydans revealed elevated levels of essential (Isoleucine, leucine, Phenylalanine, valine) and non-essential (alanine, Glycine) amino acids. Overall, this study demonstrates a cost-effective and eco-friendly strategy for optimizing BSFL production while recycling organic waste in sustainable livestock systems.