bluuebunny/crossref_metadata_2025 huggingface dataset:
Prone positioning does not improve outcomes of intubated patients with pneumocystis pneumonia and moderate–severe acute respiratory distress syndrome: a single-center, retrospective, observational, cohort study
Authors: Wang Zhen , Zhou Yuyan , Zhu Min , Wang Faping , Zhou Yubei , Yu He , Luo Fengming
Published: May 2024

Background

Pneumocystis pneumonia is an uncommon precipitant of acute respiratory distress syndrome and is associated with high mortality. Prone positioning ventilation has been proven to reduce mortality in patients with moderate–severe acute respiratory distress syndrome. We investigated the effect of prone positioning on oxygenation and mortality in intubated patients with pneumocystis pneumonia comorbid with moderate–severe acute respiratory distress syndrome.

Methods

In this single-center, retrospective, observational, cohort study, eligible patients were enrolled at West China Hospital of Sichuan University from January 1, 2017, to December 31, 2021. Data on demographics, clinical features, ventilation parameters, arterial blood gas, and outcomes were collected. Patients were assigned to the prone cohort or supine cohort according to whether they received prone positioning ventilation. The main outcome was 28-day mortality.

Findings

A total of 79 patients were included in the study. Sixty-three patients were enrolled in the prone cohort, and 16 patients were enrolled in the supine cohort. The 28-day mortality was 61.9% in the prone cohort and 68.8% in the supine cohort (P = 0.26), and 90-day mortality was 66.7% in the prone cohort and 68.8% in the supine cohort (P = 0.55). Patients in the supine cohort had fewer invasive mechanical ventilation days and more ventilator-free days. The incidence of complications was higher in the prone cohort than in the supine cohort.

Conclusions

In patients with pneumocystis pneumonia and moderate–severe acute respiratory distress syndrome, prone positioning did not decrease 28-day or 90-day mortality.

Trial registration ClinicalTrials.gov number, ChiCTR2200063889. Registered on 20 September 2022, https://www.chictr.org.cn/showproj.html?proj=174886.
Mycotic pulmonary artery pseudoaneurysm following total arch replacement: a case report
Authors: Osada Hiroaki , Sakaguchi Hisashi , Yamazaki Kazuhiro , Minatoya Kenji
Published: May 2024

Background

Although the true prevalence and incidence are not clearly known, mycotic pulmonary artery aneurysm is a potentially devastating condition that leads to high mortality, over 60% if untreated. Among them, mycotic pulmonary artery pseudoaneurysm, which occurs in relatively central areas, has rarely been reported. We report an extremely rare case of a late complication with a mycotic pulmonary artery pseudoaneurysm, presumably due to infective endocarditis, in a 68-year-old woman 4 months after total arch replacement.

Case presentation

A 68-year-old woman was referred to our department for 2 weeks with fever of unknown origin. She had a history of emergency total arch replacement for an acute type A aortic dissection 4 months earlier and chronic rheumatoid arthritis on monthly subcutaneous tocilizumab treatment for several years. Blood culture was positive for Enterococcus faecalis. Transthoracic and transesophageal echocardiography revealed a left ventricular ejection fraction of 58%, severe mitral regurgitation with a 15-mm diameter vegetation on the anterior mitral leaflet, and severe aortic insufficiency with string-like structures. Contrast computed tomography showed a focal saccular outpouching from the right pulmonary artery. On 18F-fluorodeoxyglucose (FDG) positron emission tomography, focal uptake of FDGs was observed along the same lesion of the pulmonary artery and ascending-arch graft. The patient eventually recovered after the surgical intervention of mitral and aortic valve replacement, re-total arch replacement, pulmonary artery repair, application of omental flap, and antibiotics without any evidence of re-infection after 1 year.

Conclusions

We report a successful surgical repair of mycotic pulmonary artery pseudoaneurysm 4 months after total arch replacement for acute type A aortic dissection. This report describes an effective treatment for an extremely rare postoperative condition.
Using social media platform X to enhance student medical English learning: an attempt based on design-based research (DBR) in a medical English for specific purposes (ESP) course
Authors: Gaffas Zainab M.
Published: May 2024

This study aimed to (1) elaborate on microblogging-based instruction, which was built on social media platform X and designed based on the four phases of the design-based research (DBR) framework (Amiel and Reeves in J Educ Technol Soc 11(4):29–40, https://www.jstor.org/stable/jeductechsoci.11.4.29, 2008); (2) put microblogging-based instruction into practice in a medical English for Specific Purposes (ESP) course; (3) examine students’ perceptions of the pedagogical value of X platform usage on their learning experiences; and (4) investigate how well microblogging-based instruction enhances the students’ specialised-language performance. On the basis of the four phases of the DBR framework, a study was conducted with students studying a medical ESP course to identify the problems in the teaching practices used in ESP courses. To improve the identified problems, following the second phase, social media platform X was used to supplement ESP face-to-face instruction. Three tasks were designed for the students to do on X. These tasks were implemented and assessed on 19 EFL first-year premedical undergraduate students over 16 weeks at a university in the Kingdom of Saudi Arabia. Data collected from the students included a copy version of the ESP final test, a questionnaire, and semi- structured interviews. The results revealed that X-based instruction improved students’ ability to use medicine-specialised language, offered opportunities for students to become more familiar with medicine-specific terms, perceived ability in using writing and reading skills, collaborative learning, and generated thoughtful discussions outside the confines of the classroom. However, the students’ inadequate knowledge of the specialised subject, the stress of making X mandatory, and log- in overload remain key challenges against the effective appropriation of X use in an ESP context.
A model with multiple intracranial aneurysms: possible hemodynamic mechanisms of aneurysmal initiation, rupture and recurrence
Authors: Li Wenqiang , Wang Chao , Wang Yanmin , Zhao Yapeng , Yang Xinjian , Liu Xianzhi , Liu Jian
Published: May 2024

Background

Hemodynamic factors play an important role in aneurysm initiation, growth, rupture, and recurrence, while the mechanism of the hemodynamic characteristics is still controversial. A unique model of multiple aneurysms (initiation, growth, rupture, and recurrence) is helpful to avoids the confounders and further explore the possible hemodynamic mechanisms of aneurysm in different states.

Methods

We present a model with multiple aneurysms, and including the states of initiation, growth, rupture, and recurrence, discuss the proposed mechanisms, and describe computational fluid dynamic model that was used to evaluate the likely hemodynamic effect of different states of the aneurysms.

Results

The hemodynamic analysis suggests that high flow impingement and high WSS distribution at normal parent artery was found before aneurysmal initiation. The WSS distribution and flow velocity were decreased in the new sac after aneurysmal growth. Low WSS was the risk hemodynamic factor for aneurysmal rupture. High flow concentration region on the neck plane after coil embolization still marked in recanalized aneurysm.

Conclusions

Associations have been identified between high flow impingement and aneurysm recanalization, while low WSS is linked to the rupture of aneurysms. High flow concentration and high WSS distribution at normal artery associated with aneurysm initiation and growth, while after growth, the high-risk hemodynamics of aneurysm rupture was occurred, which is low WSS at aneurysm dome.
Bifunctional octadentate pseudopeptides as Zirconium-89 chelators for immuno-PET applications
Authors: Albanese Valentina , Roccatello Chiara , Pacifico Salvatore , Guerrini Remo , Preti Delia , Gentili Silvia , Tegoni Matteo , Remelli Maurizio , Bellotti Denise , Amico Jonathan , Gorgoni Giancarlo , Cazzola Emiliano
Published: May 2024

Background

Positron emission tomography (PET) is a highly sensitive method that provides fine resolution images, useful in the field of clinical diagnostics. In this context, Zirconium-89 (89Zr)-based imaging agents have represented a great challenge in molecular imaging with immuno-PET, which employs antibodies (mAbs) as biological vectors. Indeed, immuno-PET requires radionuclides that can be attached to the mAb to provide stable in vivo conjugates, and for this purpose, the radioactive element should have a decay half-life compatible with the time needed for the biodistribution of the immunoglobulin. In this regard, 89Zr is an ideal radioisotope for immuno-PET because its half-life perfectly matches the in vivo pharmacokinetics of mAbs.

Results

The main objective of this work was the design and synthesis of a series of bifunctional octadentate pseudopeptides able to generate stable 89Zr complexes. To achieve this, here we investigated hydroxamate, N-methylhydroxamate and catecholate chelating moieties in complexing radioactive zirconium. N-methylhydroxamate proved to be the most effective 89Zr-chelating group. Furthermore, the increased flexibility and hydrophilicity obtained by using polyoxyethylene groups spacing the hydroxamate units led to chelators capable of rapidly forming (15 min) stable and water-soluble complexes with 89Zr under mild reaction conditions (aqueous environment, room temperature, and physiological pH) that are mandatory for complexation reactions involving biomolecules. Additionally, we report challenge experiments with the competitor ligand EDTA and metal ions such as Fe3+, Zn2+ and Cu2+. In all examined conditions, the chelators demonstrated stability against transmetallation. Finally, a maleimide moiety was introduced to apply one of the most promising ligands in bioconjugation reactions through Thiol-Michael chemistry.

Conclusion

Combining solid phase and solution synthesis techniques, we identified novel 89Zr-chelating molecules with a peptide scaffold. The adopted chemical design allowed modulation of molecular flexibility, hydrophilicity, as well as the decoration with different zirconium chelating groups. Best results in terms of 89Zr-chelating properties were achieved with the N-methyl hydroxamate moiety. The Zirconium complexes obtained with the most effective compounds were water-soluble, stable to transmetallation, and resistant to peptidases for at least 6 days. Further studies are needed to assess the potential of this novel class of molecules as Zirconium-chelating agents for in vivo applications.
Bioimpedance based biomarker for the detection of precancerous and cancerous lesions of the pancreas: feasibility animal study
Authors: Dibennardo Federica , Fidaner Onur , Bogdanowicz Les , Gehrke Daniel S. , Ceres Donato , John Margaret C. , Bovalis Constantine H. , Kundro Erik M. , Grycuk Alexander , Castellanos Karla , Coleman Adonis , Sudhir Kavya , Heneche Jorge , Acebedo Jose , Jimenez Angel , Raijman Isaac , Grippo Paul , Guidetti Martina
Published: May 2024

Background

Pancreatic cancer (PC) remains a significant healthcare challenge due to its aggressive nature and poor prognosis. The current gold standard that combines imaging modalities, endoscopy, and biopsies has limited diagnostic efficacy due to various shortcomings.

Methods

We propose a feasibility study for the use of a bioimpedance biomarker to detect PC. The biomarker was evaluated in a double blind study on ex vivo pancreata of mice: 15 LSL-KrasG12D; LSL-p53R172H; Pdx1-Cre, 2 LSL-KrasG12D, and 9 wild type controls (Study 1). To determine if the biomarker can distinguish between PC and acute pancreatitis (AP), we challenged it with 18 cerulein-induced AP and 6 saline-injected controls (Study 2).

Results

The results from Study 1 showed 100% specificity and 94% sensitivity against histopathology outcomes; for Study 2 all AP and saline-injected pancreases were diagnosed as non-cancerous. Regression analysis revealed a positive correlation between biomarker and pathologically analyzed cancer-induced fibrosis (r(24)= 0.73 (p<0.001)).

Conclusion

These findings demonstrate the potential of this bioimpedance biomarker as a diagnostic tool for PC.
The effectiveness of natural indigo/kaolinite composite powder in the development of latent fingermarks
Authors: Leitzke Amanda Fonseca , Bueno Danielle Tapia , Poletti Tais , Maron Guilherme Kurz , Lopes Bruno Vasconcellos , Morais Eduarda Vitória , de Oliveira Lopes Inacio Ana Paula , Silveira Caroline Ieque , da Silva Juliana Porciuncula , Dias Daiane , Carreño Netftali Lenin Villarreal , Pereira Claudio Martin Pereira de
Published: May 2024

Background

Composites are materials that have multiple phases and have attracted much attention as they are able to improve physical and chemical properties of an isolated material. In this sense, these composites are commonly used as key components for two purposes: coloring and improving the operational properties; besides that, they have alternative synthesis routes that respect the principles of green chemistry. Thus, this reports the development of a new composite using natural products, indigo and kaolinite, for application in papilloscopy as a new nontoxic fingermark developer.

Results

The composite was obtained via green procedures and was characterized by spectroscopic and chromatographic techniques. Thus, to investigate the potential of the material as a fingermark developer, different techniques were applied such as depletion, aging, comparison with commercial powder, and development of latent fingermarks on different surfaces. Tests revealed that the composite presented good contrast and adhesion with the latent fingermarks, even after 15 days of deposition.

Conclusions

This study presents a natural indigo/kaolinite composite powder that showed similar or higher efficiency when compared to the commercial fingerprint powder and was able to develop identifiable natural and sebaceous fingermarks.

Key points

• A composite was formed from eco-friendly materials.

• The composite formation follows the concepts of green chemistry and low cost.

•The composite was applied as a latent fingermark developer.
Ultrasound-assisted resection of insular gliomas
Authors: Kaberia Patrick Murithi , Farhoud Ahmed Hafez , Abbassy Mahmoud , Heikal Anwar Hamed , Fayed Ahmed AbdelAziz
Published: May 2024

Background

Insular gliomas’ management challenges are attributed to their complex shape, proximity to critical vasculature, and organization. However, cytoreductive surgery's role in maximal extent of resection (EOR) improves survival. Intraoperative ultrasound (IOUS) aids in defining tumor border, detecting residual, and guiding access.

Aim

The aim of this study was to assess the impact of using intraoperative ultrasound on the extent of resection of insular gliomas, and the postoperative outcomes in a prospective cohort of 20 patients operated at Alexandria main university hospital and followed up for a period of at least 3 months.

Results

The Near total resection rate was 45% with 70% of patients having no neurological morbidity postoperatively. The median EOR was 81% with a range of 44 to 96%. The mean duration of IOUS setup was 19.6 ± 5.04 min, while the additional resection rate following IOUS assessment for residual tumor was 65% (n = 13). In addition, there was a significant increase in Karnofsky Performance Status (KPS) from the preoperative through to the 90-day follow-up period (p = 0.012). Finally, following multivariate linear regression analysis, the EOR was identified as having a statistically significant correlation with the postoperative KPS (p = 0.004).

Conclusion

Intraoperative ultrasonography is a valuable modality for strategizing the most efficient route to the tumor, promptly detecting any remaining tumor tissue, and optimizing the extent of resection for insular gliomas, while taking into consideration the phenomenon of brain shift.
ELECT: prospective, randomized trial comparing microvascular plug versus platinum-fibered microcoils for embolization of aneurysm sac side branches before endovascular aortic aneurysm repair
Authors: Konert Manuela , Schmidt Andrej , Branzan Daniela , Wittig Tim , Scheinert Dierk , Steiner Sabine
Published: May 2024

Background

Preemptive selective embolization of aneurysm sac side branches (ASSBs) has been proposed to prevent type II endoleak after endovascular aortic aneurysm repair (EVAR). This study aimed to explore if an embolization strategy using microvascular plugs (MVP) reduces intervention time and radiation dose compared to platinum-fibered microcoils. Furthermore, the effectiveness of the devices in occluding the treated artery was assessed.

Methods

Sixty patients scheduled for EVAR underwent percutaneous preemptive embolization of ASSBs using MVPs or coils after a 1:1 randomization. Follow-up imaging was performed during aortic stentgraft implantation.

Results

Overall, 170 ASSBs were successfully occluded (83 arteries by MVPs and 87 by coils) and no acute treatment failure occurred. The mean procedure time was significantly lower in the group treated with MVPs (55 ± 4 min) compared to coil occlusion (67 ± 3 min; p = 0.018), which was paralleled by a numerically lower radiation dose (119 Gy/cm2 vs. 140 Gy/cm2; p = 0.45). No difference was found for contrast agent use (34 ml MVP group vs 35 ml coil group; p = 0.87). At follow-up, reopening of lumbar arteries was seen in nine cases (four after coil embolization; five after MVPs).

Conclusion

Both microvascular plugs and coils can be effectively used for preemptive embolization of aneurysm sac side branches before EVAR. Use of plugs offers a benefit in terms of intervention time.

Trial registration

ClinicalTrials.gov Identifier: NCT03842930 Registered 15 February 2019.

Graphical Abstract
An emerging trend in Novel Psychoactive Substances (NPSs): designer THC
Authors: Caprari Cristian , Ferri Elena , Vandelli Maria Angela , Citti Cinzia , Cannazza Giuseppe
Published: May 2024

Since its discovery as one of the main components of cannabis and its affinity towards the cannabinoid receptor CB1, serving as a means to exert its psychoactivity, Δ9-tetrahydrocannabinol (Δ9-THC) has inspired medicinal chemists throughout history to create more potent derivatives. Initially, the goal was to synthesize chemical probes for investigating the molecular mechanisms behind the pharmacology of Δ9-THC and finding potential medical applications. The unintended consequence of this noble intent has been the proliferation of these compounds for recreational use. This review comprehensively covers the most exhaustive number of THC-like cannabinoids circulating on the recreational market. It provides information on the chemistry, synthesis, pharmacology, analytical assessment, and experiences related to the psychoactive effects reported by recreational users on online forums. Some of these compounds can be found in natural cannabis, albeit in trace amounts, while others are entirely artificial. Moreover, to circumvent legal issues, many manufacturers resort to semi-synthetic processes starting from legal products extracted from hemp, such as cannabidiol (CBD). Despite the aim to encompass all known THC-like molecules, new species emerge on the drug users’ pipeline each month. Beyond posing a significantly high public health risk due to unpredictable and unknown side effects, scientific research consistently lags behind the rapidly evolving recreational market.
Hyperuricemia and intravenous fat emulsion are risk factors for gout flares during active gastrointestinal bleeding: a case control study
Authors: Jiang Yujie , Hong Xuelian , Xia Bingtian , Du Hongwei
Published: May 2024

Objective

It is well-established that patients with a history of gout are more susceptible to experiencing gastrointestinal bleeding. Gout flare during active gastrointestinal bleeding poses a significant challenge due to the gastrointestinal side effects of anti-inflammatory therapy. This study sought to investigate the risk factors associated with gout flares during episodes of gastrointestinal bleeding.

Methods

We conducted a retrospective observational study involving 94 patients who experienced active gastrointestinal bleeding and had a history of gout. This study was conducted at Jinhua Municipal Central Hospital from January 2019 to October 2022. We collected and recorded demographic information and clinical characteristics.

Results

Among the gout flare patients, hyperuricemia and intravenous fat emulsion therapy were more prevalent compared to those who remained stable (81.6% vs. 57.8% and 46.9% vs. 24.4%, p < 0.05). Multivariate logistic regression analysis revealed that both hyperuricemia (odds ratio 2.741, 95% CI 1.014–7.413, p = 0.047) and intravenous fat emulsion therapy (odds ratio 2.645, 95% CI 1.046–6.686, p = 0.040) were independent predictors of gout flares. Furthermore, gout attacks occurred sooner in patients receiving intravenous fat emulsion therapy compared to those not receiving it (median: 4 days (interquartile range: 2) vs. median: 5 days (interquartile range: 2.25), p = 0.049).

Conclusion

Our study revealed a high incidence of gout flares during episodes of active gastrointestinal bleeding, with patients undergoing intravenous fat emulsion therapy and those with hyperuricemia being at increased risk.
Subclinical joint inflammation in rheumatoid arthritis: comparing thermal and ultrasound imaging at the metacarpophalangeal joint
Authors: Tan York Kiat , Lim Gek Hsiang
Published: May 2024

Background

While ultrasound and MRI are both superior to clinical examination in the detection of joint inflammation, there is presently a lack of data whether thermography may be similarly useful in the assessment of joint inflammation in patients with RA. Our study aims to evaluate the use of thermography in detecting subclinical joint inflammation at clinically quiescent (non-tender and non-swollen) metacarpophalangeal joints (MCPJs) in patients with rheumatoid arthritis (RA). The outcomes from thermography in our study will be compared with ultrasonography (which is a more established imaging tool used for joint inflammation assessment in RA).

Methods

The minimum (Tmin), average (Tavg) and maximum (Tmax) temperatures at the 10 MCPJs of each patient were summed to obtain the Total Tmin, Total Tavg and Total Tmax, respectively. Ultrasound grey-scale (GS) and power Doppler (PD) joint inflammation (scored semi-quantitatively, 0–3) at the 10 MCPJs were summed up to derive the respective TGS and TPD scores per patient. Pearson’s correlation and simple linear regression were respectively used to assess correlation and characterize relationships between thermographic parameters (Total Tmin, Total Tavg and Total Tmax) and ultrasound imaging parameters (TGS, TPD and the number of joint(s) with PD ≥ 1 or GS ≥ 2).

Results

In this cross-sectional study, 420 clinically non-swollen and non-tender MCPJs from 42 RA patients were examined. All thermographic parameters (Total Tmin, Total Tavg and Total Tmax) correlated significantly (P-values ranging from 0.001 to 0.0012) with TGS score (correlation coefficient ranging from 0.421 to 0.430), TPD score (correlation coefficient ranging from 0.383 to 0.424), and the number of joint(s) with PD ≥ 1 or GS ≥ 2 (correlation coefficient ranging from 0.447 to 0.465). Similarly, simple linear regression demonstrated a statistically significant relationship (P-values ranging from 0.001 to 0.005) between all thermographic parameters (Total Tmin, Total Tavg and Total Tmax) and ultrasound imaging parameters (TPD and TGS).

Conclusion

For the first time, thermographic temperatures were shown to correlate with ultrasound-detected joint inflammation at clinically quiescent MCPJs. The use of thermography in the detection of subclinical joint inflammation in RA appears promising and warrants further investigation.
Climate and humans interact to shape the fire regime of a chir pine (Pinus roxburghii) forest in eastern Bhutan
Authors: Tenzin Karma , Nitschke Craig R. , Allen Kathryn J. , Krusic Paul J. , Cook Edward R. , Nguyen Thiet V. , Baker Patrick J.
Published: May 2024

Background

Chir pine (Pinus roxburghii Sarg.) forests are distributed in the dry valleys of Bhutan Himalaya. In the past, these forests have been heavily influenced by human activities such as grazing, burning, resin tapping, and collection of non-timber forest products. Bhutan’s Forest Act of 1969, which shifted forest management from local community control to centralized governmental control, greatly restricted these activities. To understand the implications of the Forest Act on the chir pine forests, we used tree-rings and fire scars to reconstruct the fire history of a chir pine forest in eastern Bhutan. This provided an opportunity to characterize the fire regime before and after the Forest Act of 1969 was implemented and assess the scale and magnitude of changes that have occurred.

Results

We developed a 120-year chir pine fire chronology from nine sites within a single forested landscape. Between 1900 and ~ 1970, fires were small and patchy. When fires occurred, they were limited to one to two sites within the larger study area. After 1970, there was a distinct shift in fire activity, with fires in 1985, 1989, 1996, 2000, and 2013 burning > 90% of sample plots. Fire activity was positively associated with La Niña conditions (wetter, cooler) in the preceding year. This is likely the result of increased accumulation and connectivity of fuels on the forest floor in wetter years.

Conclusions

Prior to 1970, the fire regime in the studied chir pine landscape in eastern Bhutan was dominated by patchy, low-intensity fires indicating that the fire regime was fuel limited. After 1970, fires became larger and more frequent. This shift was associated with the enactment of the Bhutan Forest Act in 1969, which regulated grazing and implemented a policy of strict fire exclusion in government-reserved forests. This likely led to a large buildup of fuels, particularly after La Niña years. Historical patterns of grazing and low-intensity fires prior to the Forest Act kept fuel loads low and disconnected. The cessation of most human activities in these forests after 1969 resulted in an increase in fuel loads and connectivity within the landscape. This has greatly reshaped fire regimes in the chir pine forests of eastern Bhutan over the past half century.
Exploring the complexities of poultry respiratory microbiota: colonization, composition, and impact on health
Authors: Oladokun Samson , Sharif Shayan
Published: May 2024

An accurate understanding of the ecology and complexity of the poultry respiratory microbiota is of utmost importance for elucidating the roles of commensal or pathogenic microorganisms in the respiratory tract, as well as their associations with health or disease outcomes in poultry. This comprehensive review delves into the intricate aspects of the poultry respiratory microbiota, focusing on its colonization patterns, composition, and impact on poultry health. Firstly, an updated overview of the current knowledge concerning the composition of the microbiota in the respiratory tract of poultry is provided, as well as the factors that influence the dynamics of community structure and diversity. Additionally, the significant role that the poultry respiratory microbiota plays in economically relevant respiratory pathobiologies that affect poultry is explored. In addition, the challenges encountered when studying the poultry respiratory microbiota are addressed, including the dynamic nature of microbial communities, site-specific variations, the need for standardized protocols, the appropriate sequencing technologies, and the limitations associated with sampling methodology. Furthermore, emerging evidence that suggests bidirectional communication between the gut and respiratory microbiota in poultry is described, where disturbances in one microbiota can impact the other. Understanding this intricate cross talk holds the potential to provide valuable insights for enhancing poultry health and disease control. It becomes evident that gaining a comprehensive understanding of the multifaceted roles of the poultry respiratory microbiota, as presented in this review, is crucial for optimizing poultry health management and improving overall outcomes in poultry production.
Effect of different starches in batter formulation on oil content and associated quality attributes of fried chicken nuggets
Authors: Faloye Opeyemi Rachel , Sobukola Olajide Philip , Shittu Taofeek Akinyemi , Bakare Hakeem Adegoke , Omidiran Adebukola Tolulope , Akinlade Florence Adeola , Bamidele Oluwaseun Peter
Published: May 2024

Persistent consumption of heavily fried and breaded foods over an extended period may have the potential to contribute to the development of cardiovascular, cerebrovascular diseases, and elevated blood pressure. The potential of coating using native starches (cassava, sweet potato, and corn) in batter formulation to reduce oil uptake as well as their effects on other quality attributes (moisture, colour and textural properties) were investigated. The chicken nuggets coated with batter from different starches were fried at 170 °C for 5 to 25 min. Scanning electron microscopy (SEM) was used to study changes in microstructural properties of fried chicken nuggets samples at different time intervals. The chicken nuggets coated with batter from sweet potato starch had lower oil (13.09%) and moisture (30.49%) contents compared with those coated with other starches. The SEM revealed that longer frying duration produced chicken nuggets with fewer gas cells and pores and subsequently lower oil content. There are changes in the colour and textural properties of the fried chicken nuggets irrespective of the starches used in batter formulation. Application of starches in batter formulation at different frying time affected some quality attributes of fried chicken nuggets with sweet potato starch having better attributes when compared with others.

Graphical Abstract
An unusual presentation of subacute Haemophilus parainfluenzae endocarditis in a low-risk woman treated by minimally invasive mitral valve repair: a case report
Authors: Qamar Younus , Shazly Ahmed , Qamar Amna , Islam Heraa , Yonis Hannah , Sabry Haytham
Published: May 2024

Background

HACEK endocarditis is usually insidious and can often be difficult to diagnose due to the slow-growing nature of the organisms. This report presents our experience in treating a patient with Haemophilus parainfluenzae endocarditis.

Case presentation

We describe the case of a previously fit and well 23 year-old woman who presented to her local emergency department with a four-week history of persistent febrile illness. She had associated nausea, vomiting, and lethargy. This was preceded by an episode of mucopurulent rhinorrhoea. She was treated empirically with oral amoxicillin for a putative diagnosis of rhinosinusitis. Initially, her symptoms abated, however, she was readmitted with high fevers and a new pansystolic murmur. Transthoracic echocardiography revealed a large, mobile, echogenic mass, tethered to the posterior mitral valve leaflet (PMVL) and mild mitral regurgitation (MR). On examination, she had multiple non-tender, erythematous macules on the plantar surface of her feet, consistent with Janeway lesions. Two separate blood cultures grew H. parainfluenzae. Infectious diseases recommended a four-week course of intravenous ceftriaxone. Transesophageal echocardiography demonstrated a perforation within the P3 segment of the PMVL. Subsequently, the patient underwent mitral valve repair surgery with an uneventful recovery.

Conclusions

Our case highlights the importance of promptly diagnosing HACEK endocarditis. A prolonged course of antibiotic therapy can be lifesaving, and surgery is often necessary to address complications such as perforation within the mitral valve leaflets. In our patient, we were able to perform a sliding P2 leaflet plasty for good quality repair of the mitral valve, through a minimally invasive right anterior thoracotomy.
Evaluating the efficacy and safety of nivolumab and ipilimumab combination therapy compared to nivolumab monotherapy in advanced cancers (excluding melanoma): a systemic review and meta-analysis
Authors: Rangwala Hussain Sohail , Fatima Hareer , Ali Mirha , Sunder Sailesh , Devi Sonia , Rangwala Burhanuddin Sohail , Abbas Syed Raza
Published: May 2024

Background

Nivolumab (Nivo) and ipilimumab (Ipi) have revolutionized cancer treatment by targeting different pathways. Their combination shows promising results in various cancers, including melanoma, but not all studies have demonstrated significant benefits. A meta-analysis was performed to assess the effectiveness and safety of Nivo-Ipi compared to Nivo alone in advanced cancer types (excluding melanoma).

Methods

Following PRISMA guidelines, we conducted a meta-analysis up to September 30, 2023, searching databases for randomized controlled trials (RCTs). We focused on advanced solid malignancies (excluding melanoma) with specific Nivo and Ipi dosing. Primary outcomes were overall survival (OS), progression-free survival (PFS), grades 3–4 adverse events (AEs), and treatment-related discontinuations. Secondary outcomes included specific adverse events. Statistical analysis in Review Manager included hazard ratio (HR) and risk ratio (RR), assessing heterogeneity (Higgins I2).

Results

Nine RCTs, involving 2152 patients covering various malignancies, were analyzed. The Nivo plus Ipi group exhibited a median OS of 12.3 months and a median PFS of 3.73 months, compared to monotherapy with 11.67 months and 3.98 months, respectively. OS showed no significant difference between Nivo and Ipi combination and Nivo alone (HR = 0.97, 95% CI: 0.88 to 1.08, p = 0.61). PFS had a slight improvement with combination therapy (HR = 0.91, 95% CI: 0.82 to 1.00, p = 0.04). Treatment-related cumulative grades 3–4 adverse events were higher with Nivo and Ipi (RR = 1.52, 95% CI: 1.30 to 1.78, p < 0.00001), as were treatment-related discontinuations (RR = 1.99, 95% CI: 1.46 to 2.70, p < 0.0001). Hepatotoxicity (RR = 2.42, 95% CI: 1.39 to 4.24, p = 0.002), GI toxicity (RR = 2.84, 95% CI: 1.44 to 5.59, p = 0.002), pneumonitis (RR = 2.29, 95% CI: 1.24 to 2.23, p = 0.008), dermatitis (RR = 2.96, 95% CI: 1.08 to 8.14, p = 0.04), and endocrine dysfunction (RR = 6.22, 95% CI: 2.31 to 16.71, p = 0.0003) were more frequent with Nivo and Ipi.

Conclusions

Combining nivolumab and ipilimumab did not significantly improve overall survival compared to nivolumab alone in advanced cancers (except melanoma). However, it did show slightly better PFS at the cost of increased toxicity, particularly grades 3–4 adverse events. Specific AEs occurred more frequently in the combination group. Further trials are needed to fully assess this combination in treating advanced cancers.
Hepatocellular carcinoma in hepatitis C virus patients treated with direct acting antivirals (DAAs) and patients not exposed to DAAs: a large center comparative study
Authors: Elgazzar Mohamed , Salman Tary , Abdelsameea Eman , Akl Mohamed , Omar Nabil , Abdel-Samiee Mohamed , Abas Shrif , Elsakhawy Mohmoud , Elsherif Ahmed , Abdelkader Ibrahim , Elazab Dina , Ehsan Nermine , Mohamady Mohamed , El-Kassas Mohamed , Omar Hazem Metwaly
Published: May 2024

Background

Hepatocellular carcinoma (HCC) is the first cause of cancer in Egypt. Recently, HCC developed post direct-acting antivirals (DAAs) differ in some characteristics from those developed without DAAs exposure regarding the biological features and behavior of HCC. We aimed to assess the epidemiological, clinical, laboratory, and radiological findings besides the biological behavior of HCC patients post DAAs in comparison to HCC not exposed to DAAs. An analytic cross-sectional research was performed at the National Liver Institute which is a tertiary multidisciplinary HCC center. Subjects included hepatitis C virus patients and were allocated into two groups: group I included 2036 HCC cases post-DAA treatment and group II included 6338 HCC cases who did not receive DAAs. Subjects were examined to evaluate clinical, laboratory, and radiological findings. Tumor staging was done using the BCLC staging system.

Results

Group II showed a more advanced Child–Pugh score, FIB-4 index, and MELD score than Group I (P = 0.001). The multiplicity of hepatic focal lesions was elevated in group I than in group II (P = 0.033). AFP level was significantly elevated in group I than in group II (p = 0.012). Portal vein invasion was significantly elevated in group I than in group II patients (P = 0.001). Extrahepatic spread of HCC was significantly elevated in group I than in group II (P = 0.001). Infiltrative lesions were significantly elevated in group I than in group II (P = 0.002).

Conclusion

Our study detected that the behavior in HCC post DAAs treatment is more aggressive in respect of the number of lesions, PV invasion; local and distant metastasis, and serum AFP level than in patients unexposed to DAAs. Strict surveillance in cirrhotic patients treated with DAA should be followed according to the international guidelines for early diagnosis and treatment of HCC.
The influence of preoperative or intraoperative methadone on postcardiac surgery pain and opioid administration: a systematic review and meta-analysis
Authors: Goldblatt Joshua , Crawford Lachlan , Ross Jordan , Edelman James , Pavey Warren
Published: May 2024

Background

Opioid analgesia remains a cornerstone of the management of perioperative pain in cardiac surgical patients. Emerging evidence suggests that intermediate and long-term postoperative opioid dependence is underappreciated and associated with adverse patient outcomes. Methadone has emerged in the cardiothoracic and non-cardiothoracic anesthesia literature as an option that may provide lasting analgesic benefit and may be associated with a reduction in overall perioperative opioid requirements.

Main body

This study was a systematic literature review and meta-analysis that aimed to provide evidence supporting the use of perioperative or intraoperative methadone in adult cardiac surgical patients, particularly with respect to objective measures of postoperative pain and opioid requirements prior to and at discharge from the hospital. Electronic searches of three research databases were performed: PubMed (1972 to October 2023), Ovid MEDLINE (1946 to October 2023), and EMBASE (1978 to October 2023). This search yielded a total of 190 articles, 7 of which met the relevant inclusion and exclusion criteria. This included five randomized controlled trials and two large retrospective cohort studies.

Conclusion

Preoperative or intraoperative methadone led to reduced pain scores at 24 h postoperatively and reduced opioid requirements at discharge. Methadone may be effective at reducing perioperative pain scores and opioid requirements postoperatively, including at discharge. The literature on this subject has important limitations, and further research in larger randomized controlled trials is needed.
Assessment of single and combined administration of ubiquinone and lactoferrin on histopathology, ultrastructure, oxidative stress, and WNT4 expression gene induced by thioacetamide on hepatorenal system of adult male rats
Authors: El-Hameed Sohaila Abd , Ibrahim Iman , Awadin Walaa , El-Shaieb Ahmed
Published: May 2024

Background

Hepatorenal syndrome is a life-threatening medical complication of liver cirrhosis. Hepatic cirrhosis is commonly accompanied by rapid failure of renal functions. Thioacetamide (TAA) is a potent hepatotoxin and a class 2-type carcinogen. Ubiquinone (Coq10) and lactoferrin (LF) are potent antioxidants with antifibrotic and antiinflammatory effects. However, whether Coq10 and LF reduce the hepatorenal injury induced by TAA remains unclear. Here, we investigated the potential protective effect of both/or Coq10 and LF in ameliorating TAA-induced hepatorenal injury and the role of WNT4 gene expression in detecting TAA-induced renal injury in rats. Seventy healthy and mature male Sprague Dawley rats, weighting (200 g ± 20 g) and aging (4–6) weeks were randomly divided into seven groups (n = 10): control, Coq10, LF, TAA, TAA + Coq10, TAA + LF, and TAA + Coq10 + LF. The hepatorenal injury was induced through intraperitoneal (i.p.) injection of TAA (150 mg/kg/twice/weekly) for nine weeks. Coq10 (10 mg/kg/day) and LF (200 mg/kg/day) were orally administered for nine weeks.

Results

TAA induced marked hepatorenal damage, evident by the significant increase in the alanine aminotransferase (ALT), aspartate transaminase (AST), serum creatinine (SCr) activities, and the blood urea nitrogen (BUN) level. Besides, the significant increases in concentrations of malondialdehyde (MDA) and nitric oxide (NOx) together with significant decreases in the activities of catalase (CAT) and superoxide dismutase (SOD). The histopathological analysis of the TAA group showed obvious fibrosis, steatosis, and inflammation of the hepatic parenchyma as well as severe glomerular and tubular damage of the renal parenchyma. In addition, TAA induced marked ultrastructural alterations and up-regulation in the expression of the WNT4 gene in the kidney. Meanwhile, the biochemical, histopathological, and ultrastructural alterations were significantly decreased with significant down-regulation in the expression of WNT4 in the groups exposed to TAA and treated with Coq10 and LF.

Conclusion

Our data suggested that Coq10 and LF could have protective effects on TAA hepatorenal damage, through improving the hepatic and renal functions, reduction of oxidative stress, structural and ultrastructural alterations, besides down-regulation in the expression of WNT4.
Comorbidities and final outcome of post COVID-19 associated oral mucormycosis patients: a cross-sectional study
Authors: Ghalwash Dalia , Abou-Bakr Asmaa , Hussein Radwa R. , El-Gawish Ayman A.
Published: May 2024

Background

Mucormycosis is an invasive and possibly fatal fungal infection that frequently affects the mouth. Co-infection in post COVID-19 patients is an emerging concern, owing to their complex nature and higher mortality. Therefore, this study aimed to report the underlying risk factors, clinical characteristics, presentation, and final outcome of COVID-19 associated oral mucormycosis cases.

Results

This study included 51 patients with oral mucormycosis 28 (55%) males and 23 (45%) females. Twenty-three patients (45%) presented with deep necrotic ulcer, 16 patients (31%) presented with superficial ulcer, and 12 patients (23%) of them presented with fistula. The overall survival rate was 51% (26 patients recovered). On the other hand, mortality rate was 49% (25 patients), of which 68% suffered from uncontrolled diabetes mellitus.

Conclusions

The mortality rate of COVID-19 associated mucormycosis cases with oral manifestations was found to be quite high mostly due to delayed diagnosis and lack of timely treatment. Thus, increasing the awareness of dentists and maxillofacial surgeons is crucial for the early diagnosis of oral mucormycosis which is vital to improve prognosis of this serious infection. This is of high importance in view of the escalating numbers of mucormycosis cases being recorded worldwide.
Design for community happiness—an approach and framework
Authors: Badawy Ramy Kamaleldin , Ettouney Sayed M. , Abdel Kader Nasamat M. A.
Published: May 2024

The paper addresses the emerging notion of “happiness” and “community happiness” as means and an objective in site planning and community design highlighting its complexities and illusive nature in terms of scope, aspects, and components to formulate a conceptual “framework” and a design tool for monitoring, enhancing, and developing community happiness, in limited scale urban settings. The research presents and follows the proposition that “happiness” is inherently addressed in site planning and design processes and the closely related notions and drives of “sustainable development” and “quality of life”. The design for the “community happiness” framework is formulated through a sequence of relational matrices, for “happiness”, “sustainable development”, and “quality of life”, each comprising selected international approaches and agendas, related indicators, and key aspects, physical, and non-physical, emphasizing similarities and overlapping. The proposed “framework” and underlying propositions were validated through a pilot questionnaire, targeting a sample of specialists, and practicing academics. The participants generally accepted the research key propositions, adopted the method and the proposed “framework”, and interacted with them, emphasizing the relative weights of the selected “happiness” key indicators and relations to site planning elements, and criteria. The relative importance of the design criteria, the related “happiness” indicators, and the likely products, as well as the cost of achieving “happiness” deserve to be further addressed, in future research.
Network analysis of DSM-5 criteria for gambling disorder: considering sex differences in a large clinical sample
Authors: Lucas Ignacio , Mora-Maltas Bernat , Granero Roser , Demetrovics Zsolt , Ciudad-Fernández Víctor , Nigro Giovanna , Cosenza Marina , Rosinska Magda , Tapia Javier , Fernández-Aranda Fernando , Jiménez-Murcia Susana
Published: May 2024

Background

The fifth version of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) and its revised version (DSM-5-TR) propose severity levels for gambling disorder (GD) based on the number of criteria met. However, this taxonomy has some limitations. We aimed to assess the centrality of each criterion and its relationship by conducting a network analysis while considering sex differences.

Methods

We performed a network analysis with the DSM-5 criteria for GD with data from 4,203 treatment-seeking patients (3,836 men and 367 women) diagnosed with GD who sought for treatment in a general tertiary hospital which has a unit specialized in behavioral addictions.

Results

The withdrawal criterion (“Restless or irritable when attempting to cut down or stop gambling”) showed the highest centrality values in both sexes. In men, the second most central criterion was the tolerance criterion (“Needs to gamble with increasing amounts of money in order to achieve the desired excitement”); while among women, the second was the chasing losses criterion (“After losing money gambling, often returns another day to get even”).

Conclusions

The most central criteria identified are associated with compulsivity-driven behaviors of the addictive process. Taking into account the high relevance and transitive capacity of withdrawal in both men and women, as well as tolerance in men, and chasing losses in women, the recognition and understanding of these symptoms are fundamental for the accurate diagnosis and severity assessment of GD.