bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors that sustain indigenous youth mentoring programs: a qualitative systematic review
Authors: Sanchez James , Maiden Jade , Barton Elsa , Walters Lucie , Quinn Donna , Jones Nathan , Doyle Aunty Kerrie , Lim David
Published: March 2023

Background

Indigenous youth worldwide continue to experience disproportional rates of poorer mental health and well-being compared to non-Indigenous youth. Mentoring has been known to establish favorable outcomes in many areas of health but is still in its early phases of research within Indigenous contexts. This paper explores the barriers and facilitators of Indigenous youth mentoring programs to improve mental health outcomes and provides evidence for governments’ response to the United Nations Declaration on the Rights of Indigenous Peoples.

Methods

A systematic search for published studies was conducted on PubMed, Embase, Scopus, CINAHL, and grey literature through Trove, OpenGrey, Indigenous HealthInfoNet, and Informit Indigenous Collection. All papers included in the search were peer-reviewed and published from 2007 to 2021. The Joanna Briggs Institute approaches to critical appraisal, data extraction, data synthesis, and confidence of findings were used.

Results

A total of eight papers describing six mentoring programs were included in this review; six papers were from Canada, and two originated from Australia. Studies included mentor perspectives (n = 4) (incorporating views of parents, carers, Aboriginal assistant teachers, Indigenous program facilitators, young adult health leaders, and community Elders), mentee perspectives (n = 1), and both mentor and mentee perspectives (n = 3). Programs were conducted nationally (n = 3) or within specific local Indigenous communities (n = 3) with varying mentor styles and program focus. Five synthesized findings were identified from the data extraction process, each consisting of four categories. These synthesized findings were: establishing cultural relevancy, facilitating environments, building relationships, facilitating community engagement, and leadership responsibilities, which were discussed in the context of extant mentoring theoretical frameworks.

Conclusion

Mentoring is an appropriate strategy for improving general well-being. However, more research is needed to explore program sustainability and maintaining outcomes in the long term.
Knowledge and nutrition-related practices among caregivers of adolescents with sickle cell disease in the Greater Accra region of Ghana
Authors: Ohemeng Agartha , Nartey Eunice Berko , Quaidoo Esi , Ansong Richard Stephen , Asiedu Matilda Steiner
Published: March 2023

Background

Due to its severe adverse effect on child mortality, sickle cell disease (SCD) has been identified as a set of diseases of public health concern. The high mortality rate among children with SCD in Africa has been attributed to several factors including sub-optimal management and care. This study documented the nutrition-related knowledge and practices of caregivers of teenagers who suffer from sickle cell disease (SCD) to inform decisions on integrated management of the disease.

Methods

The study included caregivers (n = 225) of adolescents with SCD who attended clinic at selected hospitals in Accra, Ghana. Pre-tested semi-structured questionnaire was employed in the gathering of information related to general and nutrition-related knowledge about SCD, as well as data on their nutrition-related practices with regards to their children who suffer from SCD. Pearson’s Chi-square test and binary logistic regression analyses were applied to explore the relationship between caregivers’ nutrition-related knowledge and practice.

Results

Nutrition-related knowledge among the caregivers studied was low, with less than a third of them (29.3%) of the sample being classified as having good knowledge. Caregivers who considered nutrition care when the child experienced crises were few (21.8%), and those with low nutrition-related knowledge were less likely to do this compared with caregivers having high knowledge (OR = 0.37, 95% CI = 0.18, 0.78). The common nutrition actions reported were the provision of more fruits/fruit juices (36.5%) and warm fluids such as soups and teas (31.7%). More than a third of the caregivers (38.7%) admitted that they faced challenges in caring for their adolescents with SCD, particularly in the area of finance for the needed health care.

Conclusion

Our study findings indicate that it is important to incorporate appropriate nutrition education messages for caregivers as part of a holistic management of SCD.
Osteoporotic vertebral compression fractures caused by Cushing’s syndrome in young women: case report and literature review
Authors: Cheng Jie , Ju Songli , Zhang Zihan
Published: March 2023

Background

Cushing’s syndrome is known as an important cause of secondary osteoporosis, characterized by reduction of bone mineral density and potential occurrence of fragility fractures before diagnosis in young population. Therefore, for young patients with fragility fractures, especially in young women, more attention should be paid on glucocorticoid excess caused by Cushing’s syndrome, due to relatively higher rate of misdiagnosis, distinct pathological characteristics and different treatment strategies compared with violent fractures and primary osteoporosis related fractures.

Case presentation

We presented an unusual case of a 26-year-old woman with multiple vertebral compression fractures and pelvis fractures, subsequently diagnosed as Cushing’s syndrome. On admission, the radiographic results showed fresh second lumbar vertebra fracture, and old fourth lumbar vertebra and pelvic fractures. The dual energy X-ray absorptiometry of lumbar spine revealed marked osteoporosis, and her plasm cortisol was extremely high. Then, Cushing’s syndrome, caused by left adrenal adenoma, was diagnosed by further endocrinological and radiographic examinations. After receiving left adrenalectomy, her plasma ACTH and cortisol values returned to normal level. In term of OVCF, we adopted conservative treatments, including pain management, brace treatment, and anti-osteoporosis measures. Three months after discharge, the patient’s low back pain was in complete remission without new onset of pain, and returned to normal life and work. Furthermore, we reviewed the literatures on advancements in the treatment of OVCF caused by Cushing’s syndrome, and based on our experiences, proposed some additional perspectives to guide treatment.

Conclusion

In term of OVCF secondary to Cushing’s syndrome without neurological damage, we prefer systematic conservative treatments, including pain management, brace treatment, and anti-osteoporosis measures, to surgical treatment. Among them, anti-osteoporosis treatment has the highest priority because of the reversibility of osteoporosis caused by Cushing’s syndrome.
Senna occidentalis (L.) Link root extract inhibits Plasmodium growth in vitro and in mice
Authors: Mogaka Simeon , Molu Halkano , Kagasi Esther , Ogila Kenneth , Waihenya Rebeccah , Onditi Faith , Ozwara Hastings
Published: March 2023

Background

Senna occidentalis (L.) Link has been used worldwide in traditional treatment of many diseases and conditions including snakebite. In Kenya, a decoction from the plant roots taken orally, is used as a cure for malaria. Several studies have demonstrated that extracts from the plant possess antiplasmodial activity, in vitro. However, the safety and curative potency of the plant root against established malaria infection is yet to be scientifically validated, in vivo. On the other hand, there are reports on variation in bioactivity of extracts obtained from this plant species, depending on the plant part used and place of origin among other factors. In this study, we demonstrated the antiplasmodial activity of Senna occidentalis roots extract in vitro, and in mice.

Methods

Methanol, ethyl acetate, chloroform, hexane and water extracts of S. occidentalis root were tested for in vitro antiplasmodial activity against Plasmodium falciparum, strain 3D7. Cytotoxicity of the most active solvent extracts was determined using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and the curative potency in Plasmodium berghei infected mice evaluated by Rane’s test.

Results

All of the solvent extracts tested in this study inhibited the propagation of P. falciparum, strain 3D7, in vitro, with polar extracts being more active than non-polar ones. Methanolic extracts had the highest activity (IC50 = 1.76) while hexane extract displayed the lowest activity (IC50 = 18.47). At the tested concentrations, methanolic and aqueous extracts exhibited high selectivity index against P. falciparum strain 3D7 (SI > 10) in the cytotoxicity assay. Further, the extracts significantly suppressed the propagation of P. berghei parasites (P < 0.05) in vivo and increased the survival time of the infected mice (P < 0.0001).

Conclusions

Senna occidentalis (L.) Link root extract inhibits the propagation of malaria parasites in vitro and in BALB/c mice.
Biases in bioethics: a narrative review
Authors: Hofmann Bjørn
Published: March 2023

Given that biases can distort bioethics work, it has received surprisingly little and fragmented attention compared to in other fields of research. This article provides an overview of potentially relevant biases in bioethics, such as cognitive biases, affective biases, imperatives, and moral biases. Special attention is given to moral biases, which are discussed in terms of (1) Framings, (2) Moral theory bias, (3) Analysis bias, (4) Argumentation bias, and (5) Decision bias. While the overview is not exhaustive and the taxonomy by no means is absolute, it provides initial guidance with respect to assessing the relevance of various biases for specific kinds of bioethics work. One reason why we should identify and address biases in bioethics is that it can help us assess and improve the quality of bioethics work.
Novel, thalidomide-like, non-cereblon binding drug tetrafluorobornylphthalimide mitigates inflammation and brain injury
Authors: Lecca Daniela , Hsueh Shih-Chang , Luo Weiming , Tweedie David , Kim Dong Seok , Baig Abdul Mannan , Vargesson Neil , Kim Yu Kyung , Hwang Inho , Kim Sun , Hoffer Barry J. , Chiang Yung-Hsiao , Greig Nigel H.
Published: March 2023

Background

Quelling microglial-induced excessive neuroinflammation is a potential treatment strategy across neurological disorders, including traumatic brain injury (TBI), and can be achieved by thalidomide-like drugs albeit this approved drug class is compromised by potential teratogenicity. Tetrafluorobornylphthalimide (TFBP) and tetrafluoronorbornylphthalimide (TFNBP) were generated to retain the core phthalimide structure of thalidomide immunomodulatory imide drug (IMiD) class. However, the classical glutarimide ring was replaced by a bridged ring structure. TFBP/TFNBP were hence designed to retain beneficial anti-inflammatory properties of IMiDs but, importantly, hinder cereblon binding that underlies the adverse action of thalidomide-like drugs.

Methods

TFBP/TFNBP were synthesized and evaluated for cereblon binding and anti-inflammatory actions in human and rodent cell cultures. Teratogenic potential was assessed in chicken embryos, and in vivo anti-inflammatory actions in rodents challenged with either lipopolysaccharide (LPS) or controlled cortical impact (CCI) moderate traumatic brain injury (TBI). Molecular modeling was performed to provide insight into drug/cereblon binding interactions.

Results

TFBP/TFNBP reduced markers of inflammation in mouse macrophage-like RAW264.7 cell cultures and in rodents challenged with LPS, lowering proinflammatory cytokines. Binding studies demonstrated minimal interaction with cereblon, with no resulting degradation of teratogenicity-associated transcription factor SALL4 or of teratogenicity in chicken embryo assays. To evaluate the biological relevance of its anti-inflammatory actions, two doses of TFBP were administered to mice at 1 and 24 h post-injury following CCI TBI. Compared to vehicle treatment, TFBP reduced TBI lesion size together with TBI-induction of an activated microglial phenotype, as evaluated by immunohistochemistry 2-weeks post-injury. Behavioral evaluations at 1- and 2-weeks post-injury demonstrated TFBP provided more rapid recovery of TBI-induced motor coordination and balance impairments, versus vehicle treated mice.

Conclusion

TFBP and TFNBP represent a new class of thalidomide-like IMiDs that lower proinflammatory cytokine generation but lack binding to cereblon, the main teratogenicity-associated mechanism. This aspect makes TFBP and TFNBP potentially safer than classic IMiDs for clinical use. TFBP provides a strategy to mitigate excessive neuroinflammation associated with moderate severity TBI to, thereby, improve behavioral outcome measures and warrants further investigation in neurological disorders involving a neuroinflammatory component.

Graphical Abstract
Integrated malaria prevention in low- and middle-income countries: a systematic review
Authors: Musoke David , Atusingwize Edwinah , Namata Carol , Ndejjo Rawlance , Wanyenze Rhoda K. , Kamya Moses R.
Published: March 2023

Background

As many countries aim to eliminate malaria, use of comprehensive approaches targeting the mosquito vector and environment are needed. Integrated malaria prevention advocates the use of several malaria prevention measures holistically at households and in the community. The aim of this systematic review was to collate and summarize the impact of integrated malaria prevention in low- and middle-income countries on malaria burden.

Methods

Literature on integrated malaria prevention, defined as the use of two or more malaria prevention methods holistically, was searched from 1st January 2001 to 31st July 2021. The primary outcome variables were malaria incidence and prevalence, while the secondary outcome measures were human biting and entomological inoculation rates, and mosquito mortality.

Results

A total of 10,931 studies were identified by the search strategy. After screening, 57 articles were included in the review. Studies included cluster randomized controlled trials, longitudinal studies, programme evaluations, experimental hut/houses, and field trials. Various interventions were used, mainly combinations of two or three malaria prevention methods including insecticide-treated nets (ITNs), indoor residual spraying (IRS), topical repellents, insecticide sprays, microbial larvicides, and house improvements including screening, insecticide-treated wall hangings, and screening of eaves. The most common methods used in integrated malaria prevention were ITNs and IRS, followed by ITNs and topical repellents. There was reduced incidence and prevalence of malaria when multiple malaria prevention methods were used compared to single methods. Mosquito human biting and entomological inoculation rates were significantly reduced, and mosquito mortality increased in use of multiple methods compared to single interventions. However, a few studies showed mixed results or no benefits of using multiple methods to prevent malaria.

Conclusion

Use of multiple malaria prevention methods was effective in reducing malaria infection and mosquito density in comparison with single methods. Results from this systematic review can be used to inform future research, practice, policy and programming for malaria control in endemic countries.
“It’s just another tool on my toolbelt”: New York state law enforcement officer experiences administering naloxone
Authors: Lloyd Danielle , Rowe Kirsten , Leung Shu-Yin John , Pourtaher Elham , Gelberg Kitty
Published: March 2023

Background

Although naloxone is widely acknowledged as a life-saving intervention and a critical tool for first responders, there remains a need to explore how law enforcement officers have adapted to a shifting scope of work. Past research has focused mainly on officer training, their abilities to administer naloxone, and to a lesser extent on their experiences and interactions working with people who use drugs (PWUD).

Methods

A qualitative approach was used to explore officer perspectives and behaviors surrounding responses to incidents of suspected opioid overdose. Between the months of March and September 2017, semi-structured interviews were conducted with 38 officers from 17 counties across New York state (NYS).

Results

Analysis of in-depth interviews revealed that officers generally considered the additional responsibility of administering naloxone to have become “part of the job”. Many officers reported feeling as though they are expected to wear multiple hats, functioning as both law enforcement and medical personnel and at times juggling contradictory roles. Evolving views on drugs and drug use defined many interviews, as well as the recognition that a punitive approach to working with PWUD is not the solution, emphasizing the need for cohesive, community-wide support strategies. Notable differences in attitudes toward PWUD appeared to be influenced by an officer’s connection to someone who uses drugs and/or due to a background in emergency medical services.

Conclusion

Law enforcement officers in NYS are emerging as an integral part of the continuum of care for PWUD. Our findings are capturing a time of transition as more traditional approaches to law enforcement appear to be shifting toward those prioritizing prevention and diversion. Widespread adoption of naloxone administration by law enforcement officers in NYS is a powerful example of the successful integration of a public health intervention into police work.
The MRI-guided two adaptive brachytherapy fractions versus one adaptive brachytherapy fraction in one application for the cervical cancer: a retrospective study
Authors: Song Shanshan , Han Dongmei , Zhang Ning , Mao Zhuang , Guo Xin , Cheng Guanghui
Published: March 2023

Purpose

This study retrospectively compared the clinical and toxicity outcomes for the cervical cancer of the MRI-guided two adaptive brachytherapy (IGABT) fractions versus one IGABT fraction in one application.

Methods

One hundred and twenty patients with cervical cancer received external beam radiotherapy combined with or without concurrent chemotherapy, which was followed by the IGABT. The IGABT in 63 patients had one IGABT in each application (Arm 1), while in the other 57 patients, at least one treatment was two continuous IGABT every other day in one application (Arm 2). Clinical outcomes including overall survival (OS), cancer specific survival (CSS), progression free survival (PFS), local control (LC) were analyzed. Brachytherapy-related toxicities were evaluated, which included pain, dizziness, nausea/vomiting, fever/infection, blood loss during the removal of applicator and needles, the deep venous thrombosis, and other acute toxicities. The Common Terminology Criteria for Adverse Events (CTC-AE 5.0) was used to evaluate the incidence and severity of toxicities of the urinary system, lower digestive system, and reproduction system. Kaplan–Meier and the Log-rank test were used to analyze the clinical outcomes.

Results

The median follow-up time of the patients in Arm 1 and Arm 2 was 23.5 and 12.0 months, respectively. The overall treatment time was significantly shorter in Arm 2 than Arm 1 (60 vs. 64 d; P = 0.017). The OS, CSS, PFS, and LC in Arm1 and Arm 2 was 77.8% vs. 86.0% (P = 0.632), 77.8% vs. 87.7% (P = 0.821), 68.3% vs. 70.2% (P = 0.207), and 92.1% vs. 94.7% (P = 0.583), respectively. The highest NRS of the pain during brachytherapy waiting period (2.22 ± 1.84 vs. 3.02 ± 1.65; P < 0.001) and at the time of the removal of the applicator (4.69 ± 1.49 vs. 5.30 ± 1.18; P < 0.001) in the patients who received one hybrid intracavitary and interstitial brachytherapy (IC/ISBT) in one application and two continuous IC/ISBT every other day in one application were significantly different. So far four patients with grade 3 late toxicities have been reported.

Conclusions

The findings of this study demonstrated that the two continuous IGABT every other day in one application is a logistically applicable, safe, and effective treatment strategy that could shorten the overall treatment time and reduce the medical cost, comparing with the one IGABT in one application.
Sexual dimorphism in reactive oxygen species production and a role for integrin α1β1 in estrogen receptor α and β expression in articular cartilage
Authors: Black Alicia L. , Haskins James , Pozzi Ambra , Clark Andrea L.
Published: March 2023

Background

Osteoarthritis (OA) is a debilitating disease involving cartilage degradation. A need remains for the discovery of new molecular targets in cartilage for pharmaceutical intervention of OA. One potential target is integrin α1β1 that protects against OA when it is upregulated by chondrocytes early in the disease process. Integrin α1β1 offers this protection by dampening epidermal growth factor receptor (EGFR) signaling, and its effects are more robust in females compared to males. The aim of this study, therefore, was to measure the impact of itga1 on chondrocyte EGFR activity and downstream reactive oxygen species (ROS) production in male and female mice. Furthermore, chondrocyte expression of estrogen receptor (ER) α and ERβ was measured to investigate the mechanism for sexual dimorphism in the EGFR/integrin α1β1 signaling axis. We hypothesized that integrin α1β1 would decrease ROS production and pEGFR and 3-nitrotyrosine expression, with this effect being greater in females. We further hypothesized that chondrocyte expression of ERα and ERβ would be greater in females compared to males, with a greater effect seen in itga1-null compared to wild-type mice.

Materials and methods

Femoral and tibial cartilage of male and female, wild-type and itga1-null mice were processed for ex vivo confocal imaging of ROS, immunohistochemical analysis of 3-nitrotyrosine, or immunofluorescence of pEGFR and ERα and ERβ.

Results

We show that ROS-producing chondrocytes are more abundant in female itga1-null compared to wild-type mice ex vivo; however, itga1 had limited influence on the percent of chondrocytes stained positively for 3-nitrotyrosine or pEGFR in situ. In addition, we found that itga1 influenced ERα and ERβ expression in femoral cartilage from female mice, and that ERα and ERβ were coexpressed as well as colocalized in chondrocytes. Finally, we show sexual dimorphism in ROS and 3-nitrotyrosine production, but surprisingly not in pEGFR expression.

Conclusions

Together these data highlight sexual dimorphism in the EGFR/integrin α1β1 signaling axis and underline the need for further investigation into the role of ERs in this biological paradigm. Understanding the molecular mechanisms underlying the development of OA is essential for the development of individualized, sex-specific treatments in this age of personalized medicine.
Customized biofilm device for antibiofilm and antibacterial screening of newly developed nanostructured silver and zinc coatings
Authors: Ghezzi Daniele , Boi Marco , Sassoni Enrico , Valle Francesco , Giusto Elena , Boanini Elisa , Baldini Nicola , Cappelletti Martina , Graziani Gabriela
Published: March 2023

Background

Bacterial colonisation on implantable device surfaces is estimated to cause more than half of healthcare-associated infections. The application of inorganic coatings onto implantable devices limits/prevents microbial contaminations. However, reliable and high-throughput deposition technologies and experimental trials of metal coatings for biomedical applications are missing. Here, we propose the combination of the Ionized Jet Deposition (IJD) technology for metal-coating application, with the Calgary Biofilm Device (CBD) for high-throughput antibacterial and antibiofilm screening, to develop and screen novel metal-based coatings.

Results

The films are composed of nanosized spherical aggregates of metallic silver or zinc oxide with a homogeneous and highly rough surface topography. The antibacterial and antibiofilm activity of the coatings is related with the Gram staining, being Ag and Zn coatings more effective against gram-negative and gram-positive bacteria, respectively. The antibacterial/antibiofilm effect is proportional to the amount of metal deposited that influences the amount of metal ions released. The roughness also impacts the activity, mostly for Zn coatings. Antibiofilm properties are stronger on biofilms developing on the coating than on biofilms formed on uncoated substrates. This suggests a higher antibiofilm effect arising from the direct contact bacteria-coating than that associated with the metal ions release. Proof-of-concept of application to titanium alloys, representative of orthopaedic prostheses, confirmed the antibiofilm results, validating the approach. In addition, MTT tests show that the coatings are non-cytotoxic and ICP demonstrates that they have suitable release duration (> 7 days), suggesting the applicability of these new generation metal-based coatings for the functionalization of biomedical devices.

Conclusions

The combination of the Calgary Biofilm Device with the Ionized Jet Deposition technology proved to be an innovative and powerful tool that allows to monitor both the metal ions release and the surface topography of the films, which makes it suitable for the study of the antibacterial and antibiofilm activity of nanostructured materials. The results obtained with the CBD were validated with coatings on titanium alloys and extended by also considering the anti-adhesion properties and biocompatibility. In view of upcoming application in orthopaedics, these evaluations would be useful for the development of materials with pleiotropic antimicrobial mechanisms.

Graphical Abstract
DEPROMP Trial: the additive value of PSMA-PET/CT-guided biopsy for prostate cancer management in biopsy naïve men—study protocol for a randomized trial
Authors: Krausewitz P. , Bundschuh R. A. , Gaertner F. C. , Essler M. , Attenberger U. , Luetkens J. , Kristiansen G. , Muders M. , Ohlmann C-H. , Hauser S. , Ellinger J. , Ritter M.
Published: March 2023

Background

The primary objective is to determine the proportion of men with suspected prostate cancer (PCA) in whom the management plans are changed by additive gallium-68 prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA-PET/CT) guided prostate biopsy (PET-TB) in combination with standard of care (SOC) using systematic (SB) and multiparametric magnetic resonance imaging-guided biopsy (MR-TB) compared with SOC alone. The major secondary objectives are to determine the additive value of the combined approach of SB + MR-TB + PET-TB (PET/MR-TB) for detecting clinically significant PCA (csPCA) compared to SOC; to determine sensitivity, specificity, positive and negative predictive value and diagnostic accuracy of imaging techniques, respective imaging classification systems, and each biopsy method; and to compare preoperatively defined tumor burden and biomarker expression and pathological tumor extent in prostate specimens.

Methods

The DEPROMP study is a prospective, open-label, interventional investigator-initiated trial. Risk stratification and management plans after PET/MR-TB are conducted randomized and blinded by different evaluation teams of experienced urologists based on histopathological analysis and imaging information: one including all results of the PET/MR-TB and one excluding the additional information gained by PSMA-PET/CT guided biopsy. The power calculation was centered on pilot data, and we will recruit up to 230 biopsy-naïve men who will undergo PET/MR-TB for suspected PCA. Conduct and reporting of MRI and PSMA-PET/CT will be performed in a blinded fashion.

Discussion

The DEPROMP Trial will be the first to evaluate the clinically relevant effects of the use of PSMA-PET/CT in patients with suspected PCA compared to current SOC. The study will provide prospective data to determine the diagnostic yields of additional PET-TB in men with suspected PCA and the impact on treatment plans in terms of intra- and intermodal changes. The results will allow a comparative analysis of risk stratification by each biopsy method, including a performance analysis of the corresponding rating systems. This will reveal potential intermethod and pre- and postoperative discordances of tumor stage and grading, providing the opportunity to critically assess the need for multiple biopsies.

Trial registration

German Clinical Study Register DRKS 00024134. Registered on 26 January 2021.
Efficacy of lotilaner against myiasis caused by Cochliomyia hominivorax (Diptera: Calliphoridae) in naturally infested dogs
Authors: do Vale Tássia Lopes , Costa Alcyjara Rego , Miranda Leandro Macedo , Silva Geovane Ferreira , Silva Naylene Carvalho Sales , Lima Tiago Barbalho , Chaves Daniel Praseres , Sager Heinz , Lasmar Pedro Veloso Facury , Costa–Junior Livio Martins
Published: March 2023

Background

The New World screwworm fly, Cochliomyia hominivorax, is widely distributed across South America. This parasitic insect is a significant cause of primary myiasis in animals, including dogs. There is an urgent need for a rapid and efficient treatment to improve the recovery of affected animals. In the present study we evaluated the potential of lotilaner for the treatment of myiasis caused by C. hominivorax larvae in naturally infested dogs. Lotilaner belongs to the isoxazoline class of chemical compounds and is marketed as Credelio™ for use against ticks and fleas in dogs and cats.

Methods

Eleven dogs with naturally acquired myiasis were enrolled in this study based on the severity of lesions and the number of identified larvae. All animals received a single oral administration of lotilaner at a minimum dose of 20.5 mg/kg body weight. After treatment, the number of expelled larvae, live or dead, was determined at 2, 6 and 24 h, and the larval expulsion rate, larvicidal effect and overall efficacy were calculated. After 24 h, the remaining larvae were removed, counted and identified. The lesions were cleaned, and palliative treatment was administered when necessary, according to the animal's health status.

Results

All larvae were identified as C. hominivorax. The larval expulsion rate was 80.5% and 93.0% at 2 and 6 h post-treatment, respectively. Lotilaner showed an overall efficacy of 100% at 24 h post-treatment.

Conclusions

Lotilaner demonstrated a rapid onset of action and a high efficacy against C. hominivorax. We therefore recommend lotilaner for the effective treatment of myiasis in dogs.

Graphical Abstract
Eight-and-a-half syndrome as the first presentation of multiple sclerosis in an Asian male: a case report
Authors: Lim Xin Ying , Wai Yong Zheng , Yong Yun Xiu , Lim Lik Thai
Published: March 2023

Background

Multiple sclerosis is a diffuse chronic demyelinating disease of the central nervous system. It is relatively uncommon in the Asian population and even more so in males. Despite the usual involvement of the brainstem, eight-and-a-half syndrome remains a rare first presentation in multiple sclerosis. Only a few cases have been reported previously, but none involving the Asian population. Eight-and-a-half syndrome, a neuro-ophthalmological condition, is characterized by one-and-a-half syndrome with ipsilateral lower facial nerve palsy, which localizes lesions to the pontine tegmentum. This case report demonstrates the first case of eight-and-a-half syndrome as the first presentation of multiple sclerosis in an Asian male.

Case presentation

A healthy 23-year-old Asian man presented with sudden onset of diplopia followed by left-sided facial asymmetry for 3 days. Assessment of extraocular movement revealed left conjugate horizontal gaze palsy. On right gaze, there was limited left eye adduction and horizontal nystagmus of the right eye. These findings were consistent with a left-sided one-and-a-half syndrome. Prism cover test revealed left esotropia of 30 prism diopters. Cranial nerve examination showed left lower motor neuron facial nerve palsy, while other neurological examination was normal. Magnetic resonance imaging brain showed multifocal T2 fluid attenuated inversion recovery hyperintense lesions, involving bilateral periventricular, juxtacortical, and infratentorial regions. A focal gadolinium contrast-enhanced lesion with open ring sign on T1 sequence was seen at the left frontal juxtacortical region. Multiple sclerosis was diagnosed on the basis of the clinical and radiological evidence, which fulfilled the 2017 McDonald criteria. Positive oligoclonal bands in cerebrospinal fluid analysis further confirmed our diagnosis. He had a complete resolution of symptoms 1 month after a course of pulsed corticosteroid therapy, and was subsequently placed on maintenance therapy with interferon beta-1a.

Conclusion

This case illustrates eight-and-a-half syndrome as the first presentation of a diffuse central nervous system pathology. A wide range of differential diagnoses needs to be considered in such a presentation as based on the patient’s demographics and risk factors.
Vasculitis presenting as carpal tunnel syndrome: a case report
Authors: Rahbar Mohammad , Dolatkhah Neda
Published: March 2023

Background

Carpal tunnel syndrome is the most common focal mononeuropathy which presents with pain in the wrist and hand, paresthesia, loss of sensation in the distribution of the median nerve, and in more severe cases, weakness and atrophy of the thenar muscles. Meanwhile, carpal tunnel syndrome can present as an initial manifestation of underlying systemic vasculitis disorder and result in severe physical disabilities.

Case presentation

A 27-year-old Iranian man was referred to our electrodiagnosis center with a clinical diagnosis of carpal tunnel syndrome in April 2020. Surgical intervention had been taken into account for him because of unsuccessful conservative therapies. On admission, thenar eminence was reduced. Electrodiagnostic findings were not compatible with median nerve entrapment at the wrist. All sensory modalities in the distribution of the right median nerve were decreased. Additionally, a mild increase in erythrocyte sedimentation rate was noted in laboratory tests. Because of the high vasculitis suspicion, we recommended the nerve biopsy and/or starting a high-dose corticosteroid. However, the surgery release was performed. After 6 months, the patient was referred for progressive weakness and numbness in the upper and lower limbs. After documentation of vasculitis neuropathy by biopsy, a diagnosis of non-systemic vasculitic neuropathy was confirmed. A rehabilitation program started immediately. Rehabilitation led to gradual improvement and recovery of function and muscle strength, and no complications remained, except mild leg paralysis.

Conclusions

Physicians should be suspicious of the median nerve vasculitis mononeuropathy in a patient with carpal tunnel syndrome-like symptoms. Median nerve vasculitis mononeuropathy as an initial presenting feature of vasculitis neuropathy can further result in severe physical impairments and disabilities.
Prevalence of pineal gland calcification: systematic review and meta-analysis
Authors: Belay Daniel Gashaneh , Worku Misganaw Gebrie
Published: March 2023

Background

Pineal gland calcification is the formation of corpora arenacea predominantly composed of calcium and phosphorus. It plays an important role in regulating the light/dark circadian changes to synchronize their daily physiological activities like feeding, metabolism, reproduction, and sleep through the secretion of melatonin. Therefore, this study aimed to assess the pooled prevalence of pineal gland calcification.

Methods

A systematic review was done using published research articles from different electronic databases. Cross-sectional studies were included for systematic review and only studies conducted on the human population were included for quantitative analysis. Published articles were selected by assessing the title and abstract for relevance to the review objectives. Finally, the full text was retrieved for further assessment.

Results

The pooled prevalence of pineal gland calcification was 61.65% [95% CI: 52.81, 70.49], with a heterogeneity of I2 = 97.7%, P ≤ 0.001. According to the qualitative analysis, an increase in age, male sex, and white ethnicity are the major socio-demographic characteristics that increase the prevalence of pineal gland calcification.

Conclusion

The pooled prevalence of pineal gland calcification was higher compared with reports from previous studies. Different studies reported pineal gland calcification was most prevalent in the adult population compared with the pediatric age groups. According to the qualitative analysis, an increase in age, male sex, and white ethnicity are the major socio-demographic characteristics that increase the prevalence of pineal gland calcification.
Experimental Study of the Shear Behavior of RC Beams Strengthened with High-Performance Fiber-Reinforced Concrete
Authors: Gerges Najib , Issa Camille A. , Sleiman Elias , Najjar Melissa , Kattouf Ali
Published: March 2023

In this study, the efficacy of strengthening of reinforced concrete (RC) beams in shear by utilizing high-performance fiber-reinforced concrete (HPFRC) was explored. The shear strengthening was achieved by epoxy bonding of prefabricated HPFRC strips or plates onto the beams. The beams were strengthened utilizing two different strengthening schemes: (i) plates side strengthening (ii) vertical strips applied at shear critical sections. The behavior of the two configurations was compared to the behavior of non-shear reinforced and shear-reinforced RC beams. The high-performance concrete (HPC) utilized contains 1.5% of steel fibers per volume of HPC mortar and is known as HPFRC. Parameters determined were the flexural strength and compressive strength of HPFRC mortar. The obtained results revealed that HPFRC realized a 28-day flexural strength of 20 MPa and a compressive strength of 108 MPa. Moreover, HPFRC strengthened RC beams experienced an increased in strength capacity of about 50% for plates and 36% for vertical strips compared to the RC beams with no stirrups. The results for HPFRC strengthened beams with plates were superior compared to those of the stirrup-reinforced beams, whereas the results of HPFRC strips strengthened beams were almost identical to the stirrup-reinforced beams. Also observed, was an improvement in the ductility of the beams with the best results achieved when employing HPFRC plates and strips.
Age-related accumulation of B-1 cell progenitors in mice reflects changes in miR15a/16-1 expression and radioresistance capacity
Authors: Souza Olívia F , de Oliveira Vivian C , Rodrigues Gabriel J. F. , Costa Lucas V. S. , Corado Fernanda , Popi Ana F.
Published: March 2023

Hyperproliferative diseases such as Chronic Lymphocytic Leukemia (CLL) and Systemic Lupus Erythematosus (SLE) are potentially related to some disturbance in the apoptosis pathway, specifically in B-1a cells (CD5+). Accumulation of B-1a cells in lymphoid organs, bone marrow or periphery is observed in some leukemia experimental murine models along aging. It is known that aging also increases the healthy B-1 cell population. However, it is not yet clear if it happens due to self-renewal of mature cells or proliferation of progenitor cells. Herein we demonstrated that the B-1 cell precursor population (B-1p) from bone marrow of middle-aged mice is higher than from young mice. Also, these aged cells are more resistant to irradiation and have downregulation of microRNA15a/16. Alterations in these microRNAs expression and in Bcl-2 regulation were already described in human hematological malignancies and new therapeutically approaches focus on that axis. This finding could explain the early events related to cell transformation during aging and correlate with beginning of symptoms in hyperproliferative diseases. Moreover, studies have already reported these pro-B-1 as a contributor to the origin of other leukemia (Acute Myeloid Leukemia - AML). Our results point to a possible relation between B-1 cell precursors and hyperproliferation during aging. We hypothesized that this population could be maintained until the mature status of the cell or reveal changes that result in re-activation of precursor in adult bone marrow, culminating in accumulation of B-1 cells later. Based on this, B-1 cell progenitor could represent an origin for B cell malignancies and a new candidate target to diagnose and treatments in the future.
Double-chambered left ventricle: diagnosis by CMR and review of the literature
Authors: Saadia Sheema , Nasir Aiysha , Sultan Fateh Ali Tipoo
Published: March 2023

Background

A double-chambered left ventricle (DCLV) is an extremely rare congenital malformation. The exact prevalence of DCLV is not known, although studies have reported prevalence of 0.04–0.42%. This abnormality is characterized by the sub-division of left ventricle into two chambers, the main left ventricular chamber (MLVC) and the accessory chamber (AC) by a septum or muscle band.

Case presentation

We are reporting two cases of DCLV, one in an adult male and an infant, who were referred for undergoing cardiac magnetic resonance (CMR) imaging. The adult patient was asymptomatic, whereas the infant had the diagnosis of left ventricular aneurysm on fetal echocardiography. On CMR, we confirmed the diagnosis of DCLV in both patients, as well as moderate aortic insufficiency in the adult patient. Both patients were lost to follow-up.

Conclusions

The double-chambered left ventricle (DCLV) is commonly detected in infancy or childhood. Although echocardiography can help detect double-chambered ventricles, MRI provides a better knowledge of this problem and can also be used to diagnose other related heart disorders.
Echocardiography-directed management of hemodynamically unstable neonates in tertiary care hospitals
Authors: Shokr Ahmed Abd-Elaziz Salem , Tomerak Rania Hosny , Agha Hala Mounir , ElKaffas Rania Mohamad Helmy , Ali Samia Bekhtte Ibrahem
Published: March 2023

Background

Hemodynamic instability and inadequate cardiac performance are common in critically ill children. The clinical assessment of hemodynamic status is reliant upon physical examination supported by clinical signs such as heart rate, blood pressure, capillary refill time, and measurement of urine output and serum lactate. Unfortunately, all of these parameters are surrogate markers of cardiovascular well-being, and they provide limited direct information regarding the adequacy of blood flow and tissue perfusion. A bedside point-of-care echocardiography can provide real-time hemodynamic information by assessing cardiac function, loading conditions (preload and afterload), and cardiac output, which makes it an ideal tool for monitoring hemodynamic assessment in neonates and children.

Methods

A prospective cross-section study was carried out on all neonates admitted to the NICU of Cairo University Children’s Hospital (CUCH) during the period from September 2017 through August 2018 in whom manifestations of hemodynamic instability were elected regardless of gestational age, weight, gender, or type of disease.

Results

There is a positive correlation between EF, FS, LVOT, RVOT, LVTI, RVTI, MAPSE, and TAPSE with birth weight. There is a negative correlation between birth weight and either LVO or RVO. In neonates weighted > 1500 g, there is a significant correlation between decreases in longitudinal systolic function of the heart (TAPSE and MAPSE) and either hemodynamic instability or need for echo-directed management, but there is no significant correlation between both in neonates weighted ≤ 1500 g. There is a significant relationship between birth weight and survival “the more the births weight the better survival chance and between complete compliance with ECDM protocol and achieving normal hemodynamic state.”

Conclusions

Decreases in EF, FS, TAPSE, and MAPSE in low birth weight neonates’ ≤ 1500 g are late signs of hemodynamic instability. TAPSE and MAPSE are the earliest parameters noticed to be decreased in hemodynamically unstable neonates > 1500 g even before EF and FS but return to normal values latterly. There is a significant relationship between complete compliance with ECDM protocol and achieving normal hemodynamics. Birth weight of ≤ 1500 g was an independent predictor of mortality regardless of the degree of compliance with the protocol.
Magnetic resonance imaging in the workup of patients with perianal fistulas
Authors: Madany Asmaa Hagagy , Murad Amr Farouk , Kabbash Mansour Mohammed , Ahmed Hala Maher
Published: March 2023

Background

Perianal sepsis and fistulas are common lesions. Fistula-in-ano is a tedious problem because of high recurrence rates and severe unexpected complications postoperatively. Many imaging modalities are used to evaluate this area. Magnetic resonance imaging (MRI) has been considered the gold standard procedure for perianal fistula assessment, i.e., it provides the surgeon with an accurate roadmap to select the best surgical approach, determines the extent of sphincter division, and estimates the risk of postoperative incontinence. We carried out a prospective diagnostic accuracy study involving 50 patients (mean age, 42.44 years) with perianal fistulas who underwent pelvic MRI with a 1.5 Tesla scanner using multiple sequences, including diffusion and post-contrast series that were either local or systemic. This study aimed to evaluate the diagnostic validity of pelvic MRI/MR fistulogram in perianal fistula assessment, identify perianal fistula-associated findings by MRI, and optimize the MRI technique with maximum technical safety.

Results

Intersphincteric fistulas were the most common type of perianal fistula observed based on Parks’ classification. Intersphincteric, trans-sphincteric, extrasphincteric, and suprasphincteric fistulas were found in 30 (60%), 12 (24%), 4 (8%), and 4 (8%) patients, respectively. According to St. James’ classification, 21 (42%), 9 (18%), 8 (16%), 4 (8%), and 8 (16%) patients had perianal fistula grades I, II, III, IV, and V, respectively. The combination of variable MR sequences and MR fistulogram increased the diagnostic validity of MRI examinations. Our results correlated with surgical results (reference standard) with perfect interobserver reliability.

Conclusions

Of all imaging modalities, MRI has become a prerequisite for a successful surgery of a perianal fistula. MRI can identify: (a) fistula morphological details, (b) the relationship between the fistulous tract and the anal sphincter, (c) fistula wound healing, (d) an active versus chronic scarred fistula, (e) postoperative stigmata, and (f) a perianal fistula from its mimics. MRI with variable sequences and MRI fistulogram are successful combinations that increase diagnostic efficiency with technical safety by avoiding both ionizing radiation and systemic gadolinium.