Between 2013 and 2018, the novel A/Anhui/1/2013 (AH/13)-lineage H7N9 virus caused at least five waves of outbreaks in humans, totaling 1,567 confirmed human cases in China. Surveillance data indicated a disproportionate distribution of poultry infected with this AH/13-lineage virus, and laboratory experiments demonstrated that this virus can efficiently spread among chickens but not among Pekin ducks. The underlying mechanism of this selective transmission remains unclear. In this study, we demonstrated the absence of Neu5Gc expression in chickens across all respiratory and gastrointestinal tissues. However, Neu5Gc expression varied among different duck species and even within the tissues of the same species. The AH/13-lineage viruses exclusively bind to acetylneuraminic acid (Neu5Ac), in contrast to wild waterbird H7 viruses that bind both Neu5Ac and N-glycolylneuraminic acid (Neu5Gc). The level of Neu5Gc expression influences H7 virus replication and facilitates adaptive mutations in these viruses. In summary, our findings highlight the critical role of Neu5Gc in affecting the host range and interspecies transmission dynamics of H7 viruses among avian species.IMPORTANCEMigratory waterfowl, gulls, and shorebirds are natural reservoirs for influenza A viruses (IAVs) that can occasionally spill over to domestic poultry, and ultimately humans. This study showed wild-type H7 IAVs from waterbirds initially bind to glycan receptors terminated with N-acetylneuraminic acid (Neu5Ac) or N-glycolylneuraminic acid (Neu5Gc). However, after enzootic transmission in chickens, the viruses exclusively bind to Neu5Ac. The absence of Neu5Gc expression in gallinaceous poultry, particularly chickens, exerts selective pressure, shaping IAV populations, and promoting the acquisition of adaptive amino acid substitutions in the hemagglutinin protein. This results in the loss of Neu5Gc binding and an increase in virus transmissibility in gallinaceous poultry, particularly chickens. Consequently, the transmission capability of these poultry-adapted H7 IAVs in wild water birds decreases. Timely intervention, such as stamping out, may help reduce virus adaptation to domestic chicken populations and lower the risk of enzootic outbreaks, including those caused by IAVs exhibiting high pathogenicity.

BACKGROUND: Patient-driven innovation in health care is an emerging phenomenon with benefits for patients with chronic conditions, such as cystic fibrosis (CF). However, previous research has not examined what may facilitate or hinder the implementation of such innovations from the provider perspective.
OBJECTIVE: The aim of this study was to explain variations in the adoption of a patient-driven innovation among CF clinics.
METHODS: A comparative multiple-case study was conducted on the adoption of a patient-controlled app to support self-management and collaboration with health care professionals (HCPs). Data collection and analysis were guided by the nonadoption, abandonment, spread, scale-up, and sustainability and complexity assessment tool (NASSS-CAT) framework. Data included user activity levels of patients and qualitative interviews with staff at 9 clinics (n=8, 88.9%, in Sweden; n=1, 11.1%, in the United States). We calculated the maximum and mean percentage of active users at each clinic and performed statistical process control (SPC) analysis to explore how the user activity level changed over time. Qualitative data were subjected to content analysis and complexity analysis and used to generate process maps. All data were then triangulated in a cross-case analysis.
RESULTS: We found no evidence of nonadoption or clear abandonment of the app. Distinct patterns of innovation adoption were discernable based on the maximum end-user activity for each clinic, which we labeled as low (16%-23%), middle (25%-47%), or high (58%-95%) adoption. SPC charts illustrated that the introduction of new app features and research-related activity had a positive influence on user activity levels. Variation in adoption was associated with providers\' perceptions of care process complexity. A higher perceived complexity of the value proposition, adopter system, and organization was associated with lower adoption. In clinics that adopted the innovation early or those that relied on champions, user activity tended to plateau or decline, suggesting a negative impact on sustainability.
CONCLUSIONS: For patient-driven innovations to be adopted and sustained in health care, understanding patient-provider interdependency and providers\' perspectives on what generates value is essential.

Background Monkeypox is a zoonotic illness that can spread to humans through close contact with infected animals or other individuals. The symptoms are similar to smallpox, and the disease can be severe, particularly in people with weakened immune systems. In recent years, there have been monkeypox outbreaks in several countries, leading to increased concern about its spread and the need for effective management. Materials and methods The data will be collected from an online questionnaire, which will be given in the form of Google Forms. A cross-sectional study design will be used. The study sample will be 384. Results The result will reveal that the general population in the selected area improves their knowledge, attitudes, and perceptions regarding monkeypox. Conclusion This study will reflect on awareness regarding monkeypox in the general population.

Objective This study aims to investigate breast cancer lymph node involvement in a West Indian population while correlating it with various histological parameters and evaluating the role of the sentinel lymph node biopsy. Method This is a retrospective study where histology reports for all breast cancer-related biopsies from 2018 to 2021, totaling 813 samples, were obtained. Histological parameters from these reports were extracted into a spreadsheet and analyzed using Statistical Product and Service Solutions (SPSS, version 28.0; IBM SPSS Statistics for Windows, Armonk, NY) software for TNM staging and axillary and sentinel lymph node dissections, among other fields found in histology reports. Results In 44.8% of cases, patients present at the T2 stage with associated lymph node spread. Each T stage had more lymph nodes involved than uninvolved for tumors sized T2 and higher. Inversely, for tumors staged under T2, there were generally more uninvolved lymph nodes than involved ones. Larger tumors were found to have advanced N staging, especially in the T3 category, where a significantly higher proportion of cases were found to have N2 and N3 staging compared to the other T stages. This trend is also seen in M staging, where larger tumors metastasize more than smaller tumors (40% for T4a, 0% for T1). Despite significant lymph node involvement being observed, sentinel lymph node biopsies were usually negative. Conclusion More patients in this population present with lymph node involvement than without. Larger breast cancer tumors are associated with greater lymph node involvement, particularly at T2 and higher stages. Sentinel lymph node biopsies can be omitted in smaller breast cancer tumors up to 2 cm in size, and the local recurrence rate is low despite a false-negative rate of around 10% in upfront sentinel lymph node biopsy.

BACKGROUND: Introducing new liver transplantation (LT) practices, like unconventional donor use, incurs higher costs, making evaluation of their prognostic justification crucial. This study reexamines the spread pattern of new LT practices and its prognosis across the United States.
METHODS: The study investigated the spread pattern of new practices using the UNOS database (2014-2023). Practices included LT for hepatitis B/C (HBV/HCV) nonviremic recipients with viremic donors, LT for COVID-19-positive recipients, and LT using onsite machine perfusion (OMP). One year post-LT patient and graft survival were also evaluated.
RESULTS: LTs using HBV/HCV donors were common in the East, while LTs for COVID-19 recipients and those using OMP started predominantly in California, Arizona, Texas, and the Northeast. K-means cluster analysis identified three adoption groups: facilities with rapid, slow, and minimal adoption rates. Rapid adoption occurred mainly in high-volume centers, followed by a gradual increase in middle-volume centers, with little increase in low-volume centers. The current spread patterns did not significantly affect patient survival. Specifically, for LTs with HCV donors or COVID-19 recipients, patient and graft survivals in the rapid-increasing group was comparable to others. In LTs involving OMP, the rapid- or slow-increasing groups tended to have better patient survival (p = 0.05) and significantly improved graft survival rates (p = 0.02). Facilities adopting new practices often overlap across different practices.
CONCLUSIONS: Our analysis revealed three distinct adoption groups across all practices, correlating the adoption aggressiveness with LT volume in centers. Aggressive adoption of new practices did not compromise patient and graft survivals, supporting the current strategy. Understanding historical trends could predict the rise in future LT cases with new practices, aiding in resource distribution.

OBJECTIVE: To examine the effect of ground cage use on Oncomelania hupensis spread, so as to provide insights into precision snail control.
METHODS: Twenty ground cages that were frequently used to capture rice field eels were purchased, including 11 packaging tape-made cages, 7 plastic cages and 2 nylon rope-made cages. The eel-capturing activity was mimicked, and 20 ground cages were assigned in settings with relatively high (1.00 snail/0.1 m2 and higher) and low snail densities (< 1.00 snail/0.1 m2) in Xindai Township, Pinghu City, Zhejiang Province during the period from 15 : 00 to 8 : 00 of the following day on April 13, 26 and 28. The numbers of snails carried by different types of ground cages were compared in settings with different types of snail densities using the rank-sum test.
RESULTS: A total of 11 cage-times were assigned in settings with a high snail density, and a total of 77 snails were captured, with a mean number of 7 snails in each cage-time and 2.15 snails in 0.1 m2 ground cage. The mean numbers of snails carried by packaging tape-made and plastic cages were 2.47 snails/0.1 m2 cage and 0.37 snails/0.1 m2 cage, respectively. A total of 24 cage-times were assigned in settings with a low snail density, and a total of 8 snails were captured, with a mean number of 0.33 snails in each cage-time and 0.09 snails in 0.1 m2 ground cage. The mean numbers of snails carried by packaging tape-made cages were 0.12 snails/0.1 m2 cage; however, no snails were carried by plastic or nylon rope-made cages. The number of snails carried by ground cages was higher in settings with a high snail density than in settings with a low snail density (Z = -4.019, P < 0.01), and the number of snails carried by packaging tape-made cages was higher in settings with a high snail density than in settings with a low snail density (Z = -4.086, P < 0.01). No significant differences were found in the numbers of snails carried by different types of ground cages.
CONCLUSIONS: The use of ground cage in snail habitats is a contributor to snail spread.
［摘要］ 目的 观察地笼使用对钉螺扩散的影响, 为制定钉螺精准防控措施提供参考。方法 购买捕鳝者常用地笼 20 只, 其中包装带编织地笼 11 只、塑料地笼 7 只、尼龙绳编织地笼 2 只。于适宜钉螺繁殖的 2024 年 4 月 13、26、28 日 15 : 00 至次日 8 : 00, 将 20 只地笼分别放置在浙江省平湖市新埭镇钉螺密度相对较高 (≥ 1.00只/0.1 m2) 和相对较低 (< 1.00只/0.1 m2) 环境中, 比较不同钉螺密度环境中不同材质地笼携带钉螺数量。结果 在钉螺密度相对较高环境中共放置地笼 11 笼·次, 检获钉螺 77 只, 平均 7 只/(笼·次)、2.15 只/0.1 m2 地笼, 其中包装带编织地笼和塑料地笼平均钉螺携带数量为 2.47 只/0.1 m2 地笼和 0.37只/0.1 m2 地笼; 在钉螺密度相对较低环境中共放置地笼24 笼·次, 检获钉螺 8 只, 平均 0.33 只/(笼·次) 和 0.09 只/0.1 m2 地笼; 其中包装带编织地笼平均钉螺携带数量为 0.12 只/0.1 m2 地笼, 塑料地笼和尼龙绳编织地 笼均未观察到携带钉螺。在钉螺密度较高环境中, 地笼钉螺携带数量多于钉螺密度相对较低环境 (Z = −4.019, P < 0.01), 包装带编织地笼在钉螺密度相对较高环境中的钉螺携带数量多于钉螺密度相对较低环境 (Z = −4.086, P < 0.01), 不同材质地笼钉螺携带数量差异无统计学意义 (Z = −1.873, P > 0.05)。结论 在有螺环境中使用地笼可导致钉螺扩散。.

Manure composting in traditional small-scale pig farms leads to the migration and diffusion of antibiotics and antibiotics resistance genes (ARGs) along the chain of transmission to the surrounding environment, increasing the risk of environmental resistance. Understanding the transmission patterns, driving factors, and health risks of ARGs on small-scale pig farms is important for effective control of ARGs transmission. This study was conducted on a small pig farm and its surrounding environment. The cross-media transmission of ARGs and their risks in the farming habitat were investigated using Metagenomic annotation and qPCR quantitative detection. The results indicate that ARGs in farms spread with manure pile-soil-channel sediment-mudflat sediment. Pig farm manure contributed 22.49 % of the mudflat sediment ARGs. Mobile genetic elements mediate the spread of ARGs across different media. Among them, tnpA and IS26 have the highest degree. Transmission of high-risk ARGs sul1 and tetM resulted in a 50 % and 116 % increase in host risk for sediment, respectively. This study provides a basis for farm manure management and control of the ARGs spread.

Since the development of the first instrument in the late 1960s, flow cytometry (FC) has become a powerful tool in both the clinical and research space. As one of the earliest single-cell analytical techniques, flow cytometry can measure thousands of cells in minutes, allowing researchers an unprecedented understanding of the biology of their system of interest. There are commercial systems available that can measure over 40 different parameters at the same time. The most common assay, immunophenotyping, involves labeling cells with fluorescently conjugated antibodies. The process of fluorescence occurs when a fluorescent molecule first absorbs a photon of light, which promotes an electron to a higher energy state. This energy is released by the emission of a photon of lower energy (thus a higher wavelength). The emitted photon will be within a range of visible wavelengths. When measured on a flow cytometer, this results in the fluorescent signal being measured not just in the primary detector but also in one or more secondary detectors. Termed \"spillover,\" this is when the fluorescent signal measured in a detector other than the intended one creates a problem in identifying the real signal. The process of compensation is used to address this spectral spillover. However, in correcting for the spillover by compensation, the spread of the data is revealed. This spread can be quantified, and, here, we discuss two methods that can be used to identify and measure this spectral spread for any combination of fluorochromes. The output of these methods is useful in experimental design and monitoring instrument quality control. Armed with this information, the researcher can better design polychromatic panels to minimize the impact of spread on their data.

Management of Dermanyssus gallinae, a cosmopolitan hematophagous mite responsible for damage in layer poultry farming, is hampered by a lack of knowledge of its spatio-temporal population dynamics. Previous studies have shown that the circulation of this pest between farms is of strictly anthropogenic origin, that a mitochondrial haplogroup has been expanding on European farms since the beginning of the 21st century and that its local population growth may be particularly rapid. To refine our understanding of how D. gallinae spreads within and among farms, we characterized the genetic structure of mite populations at different spatial scales and sought to identify the main factors interrupting gene flow between poultry houses and between mitochondrial haplogroups. To this end, we selected and validated the first set of nuclear microsatellite markers for D. gallinae and sequenced a region of the CO1-encoding mitochondrial gene in a subsample of microsatellite-genotyped mites. We also tested certain conditions required for effective contamination of a poultry house through field experimentation, and conducted a survey of practices during poultry transfers. Our results confirm the role of poultry transport in the dissemination of mite populations, but the frequency of effective contamination after the introduction of contaminated material into poultry houses seems lower than expected. The high persistence of mites on farms, even during periods when poultry houses are empty and cleaned, and the very large number of nodes in the logistic network (large number of companies supplying pullets or transporting animals) undoubtedly explain the very high prevalence on farms. Substantial genetic diversity was measured in farm populations, probably as a result of the mite\'s known haplodiploid mode of sexual reproduction, coupled with the dense logistic network. The possibility of the occasional occurrence of asexual reproduction in this sexually reproducing mite was also revealed in our analyses, which could explain the extreme aggressiveness of its demographic dynamics under certain conditions.

The aim of this study was to describe one-point (preiliac approach) and two-point (preiliac and retrocostal approach) blocks of the Transversus Abdominis Plane (TAP) on a cadaveric model. For this purpose, ultrasound-guided infiltration of the plane between the internal oblique and transversus abdominis muscles was performed and, after dissection of tissues, the areas and percentage of nerve fibers involved were analyzed. Injection into the TAP plexus of a 1 mL/kg solution of 2% lidocaine and 1% methylene blue (1:1) was performed in 30 rabbit cadavers. In fifteen rabbits (group S), the solution was inoculated at the preiliac level. In the other 15 rabbits (group D), the solution was divided into two inoculations (0.5 mL/kg at the retrocostal level and 0.5 mL/kg at the preiliac level). All cadavers were then dissected and stained spinal nerve branches were measured. Moreover, the percentage of length, height and the total area of the stained tissue were calculated. In the S group, T10, T11 and T12 nerve eminences were successfully stained in 18%, 52% and 75% of cases, respectively. Furthermore, L1, L2, L3 and L4 were stained in 95%, 100%, 60% and 40% of cases, respectively. In group D, the ventromedial eminence of T10, T11 and T12 were stained in 68.1%, 100% and 98% of cases, respectively, and L1, L2, L3 and L4 were stained in 88%, 100%, 62% and 31% of cases, respectively. In conclusion, a two-point TAP block is more effective in covering the nerve eminences of the cranial abdomen than the preiliac approach alone.