bluuebunny/crossref_metadata_2025 huggingface dataset:
Liberal or conservative oxygen therapy for ventilated patients in the ICU: a meta-analysis of randomized controlled trials
Authors: Liu Lu , Tian Yali
Published: September 2021

Background

The acknowledgment that conservative oxygen therapy (COT) was related to better prognosis in the intensive care unit (ICU) was challenged recently. We conducted an updated meta-analysis aimed to determine whether liberal oxygen therapy (LOT) or COT is associated with better improve clinical outcomes.

Methods

We systematically searched the electronic databases (PubMed, Web of Science and Embase) up to May 2021 for randomized controlled trials (RCTs). The primary outcome was the mortality of the final follow-up time and secondary outcomes were ICU mortality, the ICU length of stay and the number of ventilator-free days.

Results

A total of 7 RCTs were included, with 2166 patients admitted to the ICU. There was no significant difference in the primary outcome between the LOT and COT. Additionally, LOT could not significantly increase ICU mortality and the ICU length of stay compared with COT.

Conclusions

The present study showed that COT was not significantly superior to LOT in clinical outcomes. Therefore, additional high-quality studies with novel designs are required to further elucidate this controversy.
The consensus from The Chinese Society of Hematology on indications, conditioning regimens and donor selection for allogeneic hematopoietic stem cell transplantation: 2021 update
Authors: Zhang Xiao-hui , Chen Jing , Han Ming-Zhe , Huang He , Jiang Er-lie , Jiang Ming , Lai Yong-rong , Liu Dai-hong , Liu Qi-Fa , Liu Ting , Ren Han-yun , Song Yong-Ping , Sun Zi-min , Tang Xiao-wen , Wang Jian-min , Wu De-pei , Xu Lan-ping , Zhang Xi , Zhou Dao-bin , Huang Xiao-jun
Published: September 2021

The consensus recommendations in 2018 from The Chinese Society of Hematology (CSH) on indications, conditioning regimens and donor selection for allogeneic hematopoietic stem cell transplantation (allo-HSCT) facilitated the standardization of clinical practices of allo-HSCT in China and progressive integration with the world. There have been new developments since the initial publication. To integrate recent developments and further improve the consensus, a panel of experts from the CSH recently updated the consensus recommendations, which are summarized as follows: (1) there is a new algorithm for selecting appropriate donors for allo-HSCT candidates. Haploidentical donors (HIDs) are the preferred donor choice over matched sibling donors (MSDs) for patients with high-risk leukemia or elderly patients with young offspring donors in experienced centers. This replaces the previous algorithm for donor selection, which favored MSDs over HIDs. (2) Patients with refractory/relapsed lymphoblastic malignancies are now encouraged to undergo salvage treatment with novel immunotherapies prior to HSCT. (3) The consensus has been updated to reflect additional evidence for the application of allo-HSCT in specific groups of patients with hematological malignancies (intermediate-risk acute myeloid leukemia (AML), favorable-risk AML with positive minimal residual disease, and standard-risk acute lymphoblastic leukemia). (4) The consensus has been updated to reflect additional evidence for the application of HSCT in patients with nonmalignant diseases, such as severe aplastic anemia and inherited diseases. (5) The consensus has been updated to reflect additional evidence for the administration of anti-thymocyte globulin, granulocyte colony-stimulating factors and post-transplantation cyclophosphamide in HID-HSCT.
Ketamine versus propofol for rapid sequence induction in trauma patients: a retrospective study
Authors: Breindahl Niklas , Baekgaard Josefine , Christensen Rasmus Ejlersgaard , Jensen Alice Herrlin , Creutzburg Andreas , Steinmetz Jacob , Rasmussen Lars S.
Published: September 2021

Background

Rapid Sequence Induction (RSI) is used for emergency tracheal intubation to minimise the risk of pulmonary aspiration of stomach contents. Ketamine and propofol are two commonly used induction agents for RSI in trauma patients. Yet, no consensus exists on the optimal induction agent for RSI in the trauma population. The aim of this study was to compare 30-day mortality in trauma patients after emergency intubation prehospitally or within 30 min after arrival in the trauma centre using either ketamine or propofol for RSI.

Methods

In this investigator-initiated, retrospective study we included adult trauma patients emergently intubated with ketamine or propofol registered in the local trauma registry at Rigshospitalet, a tertiary university hospital that hosts a level-1 trauma centre. The primary outcome was 30-day mortality. Secondary outcomes included hospital and Intensive Care Unit length of stay as well as duration of mechanical ventilation. We analysed outcomes using multivariable logistic regression models adjusting for age, sex, injury severity score, shock (systolic blood pressure < 90 mmHg) and Glasgow Coma Scale score before intubation and present results as odds ratios (ORs) with 95% confidence intervals.

Results

From January 1st, 2015 through December 31st, 2019 we identified a total of 548 eligible patients. A total of 228 and 320 patients received ketamine and propofol, respectively. The 30-day mortality for patients receiving ketamine and propofol was 20.2% and 22.8% (P = 0.46), respectively. Adjusted OR for 30-day mortality was 0.98 [0.58–1.66],P = 0.93. We found no significant association between type of induction agent and hospital length of stay, Intensive Care Unit length of stay or duration of mechanical ventilation.

Conclusions

In this study, trauma patients intubated with ketamine did not have a lower 30-day mortality as compared with propofol.
Incidence and predictors of mortality among neonates referred to comprehensive and specialized hospitals in Amhara regional state, North Ethiopia: a prospective follow-up study
Authors: Yeshaneh Alex , Tadele Bizuayehu , Dessalew Bogale , Alemayehu Mulunesh , Wolde Awraris , Adane Addisu , Shitu Solomon , Abebe Haimanot , Adane Daniel
Published: September 2021

Background

Neonatal mortality is a major global public health problem. Ethiopia is among seven countries that comprise 50 % of global neonatal mortality. Evidence on neonatal mortality in referred neonates is essential for intervention however, there is no enough information in the study area. Neonates who required referral frequently became unstable and were at a high risk of death. Therefore, this study aimed to assess the incidence and predictors of mortality among referred neonates.

Method

A prospective follow-up study was conducted among 436 referred neonates at comprehensive specialized hospitals in the Amhara regional state, North Ethiopia 2020. All neonates admitted to the selected hospitals that fulfilled the inclusion criteria were included. Face-to-face interviews, observations, and document reviews were used to collect data using a semi-structured questionnaire and checklists. Epi-data™ version 4.2 software for data entry and STATA™ 14 version for data cleaning and analysis were used. Variables with a p-value < 0.25 in the bi-variable logistic regression model were selected for multivariable analysis. Multivariable analyses with a 95% confidence level were performed. Variables with P < 0.05 were considered statistically significant.

Result

Over all incidence of death in this study was 30.6% with 95% confidence interval of (26.34–35.16) per 2 months observation. About 23 (17.83%) deaths were due to sepsis, 32 (24.80%) premature, 40 (31%) perinatal asphyxia, 3(2.33%) congenital malformation and 31(24.03%) deaths were due to other causes. Home delivery [AOR = 2.5, 95% CI (1.63–4.1)], admission weight < 1500 g [AOR =3.2, 95% CI (1.68–6.09)], travel distance ≥120 min [AOR = 3.8, 95% CI (1.65–9.14)], hypothermia [AOR = 2.7, 95% CI (1.44–5.13)], hypoglycemia [AOR = 1.8, 95% CI (1.11–3.00)], oxygen saturation < 90% [AOR = 1.9, 95% (1.34–3.53)] at admission time and neonate age ≤ 1 day at admission [AOR = 3.4, 95% CI (1.23–9.84) were predictors of neonatal death.

Conclusion

The incidence of death was high in this study. The acute complications arising during the transfer of referral neonates lead to an increased risk of deterioration of the newborn’s health and outcome. Preventing and managing complications during the transportation process is recommended to increase the survival of neonates.
High levels of unbound bilirubin are associated with acute bilirubin encephalopathy in post-exchange transfusion neonates
Authors: Ding Yiyi , Wang Shuo , Guo Rui , Zhang Aizhen , Zhu Yufang
Published: September 2021

Background

Although it is known that unbound bilirubin can enter the brain, there is little evidence of its association with the development of acute bilirubin encephalopathy. Here, we investigated this potential relationship in neonates who had undergone exchange transfusion.

Methods

Data from 46 newborns who underwent exchange transfusion between 2016 and 1-1 to 2018-12-31 at the First People’s Hospital of Changde City in China were analyzed. The unbound bilirubin level was taken as the independent variable and the development of the acute bilirubin encephalopathy as the dependent variable. The covariates were age, birth weight, sex, red blood cell count, blood glucose, hemolytic disease, and whether the infant had received phototherapy.

Results

The mean age and gestational age of the neonates were 146.5 ± 86.9 h and 38.6 ± 1.3 weeks [38.7(34.6–41.1) weeks] old, respectively; 52.17% were male. Binary logistic regression analysis after adjustment for covariates showed a positive association between the levels of unbound bilirubin and the development of acute bilirubin encephalopathy (odds ratio = 1.41, 95% confidence intervals 1.05–1.91, P = < 0.05).

Conclusion

There is a significant association between unbound bilirubin levels and the development of acute bilirubin encephalopathy in neonates. Further investigations are required to explore the mechanisms.
BiCyCLE NMES—neuromuscular electrical stimulation in the perioperative treatment of sarcopenia and myosteatosis in advanced rectal cancer patients: design and methodology of a phase II randomised controlled trial
Authors: Pring Edward T. , Gould Laura E. , Malietzis George , Lung Philip , Bharal Mina , Fadodun Tutu , Bassett Paul , Naghibi Mani , Taylor Claire , Drami Ioanna , Chauhan Deeptika , Street Tamsyn , Francis Nader K. , Athanasiou Thanos , Saxton John M. , Jenkins John T. ,   on behalf of the BiCyCLE Research Group
Published: September 2021

Background

Colorectal cancer is associated with secondary sarcopenia (muscle loss) and myosteatosis (fatty infiltration of muscle) and patients who exhibit these host characteristics have poorer outcomes following surgery. Furthermore, patients, who undergo curative advanced rectal cancer surgery such as pelvic exenteration, are at risk of skeletal muscle loss due to immobility, malnutrition and a post-surgical catabolic state. Neuromuscular electrical stimulation (NMES) may be a feasible adjunctive treatment to help ameliorate these adverse side-effects. Hence, the purpose of this study is to investigate NMES as an adjunctive pre- and post-operative treatment for rectal cancer patients in the radical pelvic surgery setting and to provide early indicative evidence of efficacy in relation to key health outcomes.

Method

In a phase II, double-blind, randomised controlled study, 58 patients will be recruited and randomised (1:1) to either a treatment (NMES plus standard care) or placebo (sham-NMES plus standard care) group. The intervention will begin 2 weeks pre-operatively and continue for 8 weeks after exenterative surgery. The primary outcome will be change in mean skeletal muscle attenuation, a surrogate marker of myosteatosis. Sarcopenia, quality of life, inflammatory status and cancer specific outcomes will also be assessed.

Discussion

This phase II randomised controlled trial will provide important preliminary evidence of the potential for this adjunctive treatment. It will provide guidance on subsequent development of phase 3 studies on the clinical benefit of NMES for rectal cancer patients in the radical pelvic surgery setting.

Trial registration

Protocol version 6.0; 05/06/20. ClinicalTrials.govNCT04065984. Registered on 22 August 2019; recruiting.
Comprehensive support for families with parental cancer (Family-SCOUT), evaluation of a complex intervention: study protocol for a non-randomized controlled trial
Authors: Dohmen Marc , Petermann-Meyer Andrea , Blei Daniel , Bremen Rebecca , Brock-Midding Evamarie , Brüne Manuela , Geiser Franziska , Haastert Burkhard , Halbach Sarah Maria , Heuser Christian , Holsteg Steffen , Heier Lina , Icks Andrea , Karger Andre , Montalbo Joseph , Nakata Hannah , Panse Jens , Rottmann Till-Philip , Sättler Kristina , Viehmann Anja , Vomhof Markus , Ernstmann Nicole , Brümmendorf Tim H.
Published: September 2021

Background

Families with minor children affected by parental cancer are at risk of considerable emotional and organizational stress that can severely burden all family members. So far, there has been a lack of comprehensive support services for affected families. The aim of this project is to implement and evaluate a complex psychosocial intervention for these families by providing advice, information, and care on an emotional, psycho-social, and communicative level during and after the cancer experience and across healthcare sectors.

Methods

Family-SCOUT is a project supported by the German Innovation Fund (https://innovationsfonds.g-ba.de/). The evaluation is based on a mixed-methods quasi-experimental design with the intervention and control groups. A standardized postal survey at three measurement points (T0: study enrollment; T1: 3 months of follow-up; T2: 9 months of follow-up), secondary data from the participating health insurance funds, and semi-structured qualitative interviews are used for summative and formative evaluation. The study aim is to includen=560 families. Data will be analyzed according to the intention-to-treat principle. The primary analysis is the comparison of the Hospital Anxiety and Depression Scale (HADS) response rates (minimal important difference (MID) ≥ 1.6 in at least one of the two parents) at T2 between the intervention and control group using Fisher’s exact test. The conduct of the study as well as the development and implementation of the intervention will be accompanied by comprehensive study monitoring following the principles of an effectiveness-implementation hybrid study.

Discussion

The results will allow to test the effectiveness and efficiency of the intervention for the target group. The first experience with the implementation of the intervention in model regions will be available. The evaluation results will serve as the basis to assess the need of including the intervention in the catalog of services of the statutory health insurance funds in Germany.

Trial registration

ClinicalTrials.gov, NCT04186923. Retrospectively registered on 4 December 2019.
Kabasura Kudineer (KSK), a poly-herbal Siddha medicine, reduced SARS-CoV-2 viral load in asymptomatic COVID-19 individuals as compared to vitamin C and zinc supplementation: findings from a prospective, exploratory, open-labeled, comparative, randomized controlled trial, Tamil Nadu, India
Authors: Natarajan S. , Anbarasi C. , Sathiyarajeswaran P. , Manickam P. , Geetha S. , Kathiravan R. , Prathiba P. , Pitchiahkumar M. , Parthiban P. , Kanakavalli K. , Balaji P.
Published: September 2021

Introduction

Despite several ongoing efforts in biomedicine and traditional medicine, there are no drugs or vaccines for coronavirus disease 2019 (COVID-19) as of May 2020; Kabasura Kudineer (KSK), a polyherbal formulation from India’s Siddha system of medicine, has been traditionally used for clinical presentations similar to that of COVID-19. We explored the efficacy of KSK in reducing viral load and preventing the disease progression in asymptomatic, COVID-19 cases.

Methods

A prospective, single-center, open-labeled, randomized, controlled trial was conducted in a COVID Care Centre in Chennai, India. We recruited reverse-transcription polymerase chain reaction (RT-PCR)-confirmed COVID-19 of 18 to 55 years of age, without clinical symptoms and co-morbidities. They were randomized (1:1 ratio) to KSK (60 mL twice daily for 7 days) or standard of care (7 days supplementation of vitamin C 60,000 IU morning daily and zinc 100 mg evening daily) groups. The primary outcomes were reduction in the SARS-CoV-2 load [as measured by cyclic threshold (CT) value of RT-PCR], prevention of progression of asymptomatic to symptomatic state, and changes in the immunity markers including interleukins (IL-6, IL-10, IL-2), interferon gamma (IFNγ), and tumor necrosis factor (TNF α). Siddha clinical assessment and the occurrence of adverse effects were documented as secondary outcomes. Paired t-test was used in statistical analysis.

Results

Viral load in terms of the CT value (RdRp: 95% CI = 1.89 to 5.74) declined significantly on the seventh day in the KSK group and that of the control group, more pronounced in the study group. None progressed to the symptomatic state. There was no significant difference in the biochemical parameters. We did not observe any changes in the Siddha-based clinical examination and adverse events in both groups.

Conclusion

KSK significantly reduced SARS-CoV-2 viral load among asymptomatic COVID-19 cases and did not record any adverse effect, indicating the use of KSK in the strategy against COVID-19. Larger, multi-centric trials can strengthen the current findings.

Trial registration

Clinical Trial Registry of India CTRI2020/05/025215. Registered on 16 May 2020
Whole conversion of agro-industrial wastes rich in galactose-based carbohydrates into lipid using oleaginous yeast Aureobasidium namibiae
Authors: Wang Zhi-Peng , Zhang Xin-Yue , Ma Yan , Ye Jing-Run , Jiang Jing , Wang Hai-Ying , Chen Wei
Published: September 2021

Background

Raw materials composed of easily assimilated monosaccharides have been employed as carbon source for production of microbial lipids. Nevertheless, agro-industrial wastes rich in galactose-based carbohydrates have not been introduced as feedstocks for oleaginous yeasts.

Results

In this study, Aureobasidium namibiae A12 was found to efficiently accumulate lipid from soy molasses and whey powder containing galactose-based carbohydrates, with lipid productions of 5.30 g/L and 5.23 g/L, respectively. Over 80% of the fatty acids was C16:0, C18:0, C18:1, and C18:2. All kinds of single sugar components in the two byproducts were readily converted into lipids, with yields ranging between 0.116 g/g and 0.138 g/g. Three α-galactosidases and five β-galactosidases in the strain were cloned and analyzed. Changes of transcriptional levels indicated GalB and GalC were key α-galactosidases, and GalG was key β-galactosidase. In 10 L fermentor, lipid production from SM and WP achieved 6.45 g/L and 6.13 g/L, respectively. β-galactosidase was responsible for lactose hydrolysis; sucrase and α-galactosidase both contributed to the efficient hydrolysis of raffinose and stachyose in a cooperation manner.

Conclusions

This is a new way to produce lipids from raw materials containing galactose-based carbohydrates. This finding revealed the significance of sucrase in the direct hydrolysis of galactose-based carbohydrates in raw materials for the first time and facilitated the understanding of the efficient utilization of galactose-based carbohydrates to manufacture lipid or other chemicals in bioprocess.

Graphic abstract
Prevalence and risk factors associated with cat parasites in Italy: a multicenter study
Authors: Genchi Marco , Vismarra Alice , Zanet Stefania , Morelli Simone , Galuppi Roberta , Cringoli Giuseppe , Lia Riccardo , Diaferia Manuela , Frangipane di Regalbono Antonio , Venegoni Giulia , Solari Basano Fabrizio , Varcasia Antonio , Perrucci Stefania , Musella Vincenzo , Brianti Emanuele , Gazzonis Alessia , Drigo Michele , Colombo Liliana , Kramer Laura
Published: September 2021

Background

Parasites that infect cats include protozoa, helminths and arthropods, many of which are transmissible to humans. Effective control relies on a good knowledge of parasite distribution and the risk factors for infection. The present study was aimed at evaluating the prevalence of major feline parasites in Italy and the risk factors associated with their occurrence.

Methods

Over a 12-month study period, feces, hair and ectoparasites from naturally infected cats from feral colonies, shelters and private households were analyzed at 13 study centers across Italy. Samples from these cats (n = 987) were analyzed at all centers using the same diagnostic methods. Prevalence values and risk factors were evaluated statistically for the identification of predictors of risk.

Results

The overall prevalence of gastro-intestinal and broncho-pulmonary (BP) nematodes was 35.9% (354/987). Toxocara cati was the most prevalent species (253/987; 25.6%), followed by Ancylostomatidae (98/987; 9.9%). Among BP nematodes, Aelurostrongylus abstrusus was the most common (76/987; 7.7%). Approximately 35.7% (352/987) of the study population was infested by ectoparasites, of which the most common were fleas (29.4%, 290/987), followed by ear mites Otodectes cynotis (9.8%, 97/987). Predictors of risk for parasite infection included age, a predominantly or exclusively outdoor lifestyle, geographic area and lack of antiparasitic treatment.

Conclusions

Both ecto- and endoparasites are still common in cats throughout Italy, many of them being of zoonotic concern and vectors of pathogens to humans. Given the presence of parasites throughout the entire study period, year-round treatment should be considered. Furthermore, data confirm the need to protect the human–animal bond using proper endo- and ectoparasiticides to reduce the risk of human infection, in application of the One-Health concept.

Graphical abstract
Seasonal dynamics of Phlebotomus neglectus (Diptera: Psychodidae) in cave microhabitats in Romania and the rediscovery of Sergentomyia minuta (Rondani, 1843) after 50 years
Authors: Cazan Cristina Daniela , Horváth Cintia , Panait Luciana Cătălina , Porea Daniela , Marinov Mihai , Alexe Vasile , Mihalca Andrei Daniel
Published: September 2021

Background

In a countrywide study aiming to update the knowledge on diversity of sand fly species in Romania, a sand fly population was observed in an isolated system of cave microhabitats. The caves are located in the protected area of Canaraua Fetii, Dobrogea region, southeastern Romania. The highest sand fly diversity was recorded in this area between 1968 and 1970. This work presents a study conducted to estimate the seasonal variation of the sand fly species in correlation with the particular environmental factors of the isolated system of cave microhabitats.

Methods

Sand flies were collected between May and October 2020 from one trapping site of interest in Canaraua Fetii. The trapping site consisted of a cave entrance. CDC miniature light traps and sticky traps were used to collect insects from the exterior walls of the cave entrance. Species identification of collected sand flies was done using morphological keys. Statistical analysis of the trapping and climatic data was performed.

Results

From all collected sand flies, 99.7% (818/822) were Phlebotomus neglectus, 0.1% (1/822) Ph. balcanicus and 0.2% (2/822) Sergentomyia minuta. Sand fly activity was first observed on 2 July and last on 24 September. A monomodal abundance trend was present, with the peak activity between 16 and 17 July. The analysis of the climatic data showed correlations between the total number of captured sand flies and both average temperature and average relative humidity. The total number of collected specimens was statistically higher when CDC miniature light traps were used compared to sticky traps. The number of females on the sticky traps was significantly higher than the number of males on the same trap type. Compared with the sticky traps, significantly more males were collected by CDC miniature light traps. This is the first record of Se. minuta in Romania after 50 years of no records (despite the trapping effort of the last 5 years in the country). Also, Ph. sergenti, previously present in this location, was not found.

Conclusions

In the investigated natural habitat, the diversity of the sand fly species appears to have changed, with the predominance of Ph. neglectus instead of Ph. balcanicus and Se. minuta (recorded as the two predominant species in 1968–1970). A monomodal abundance trend was observed as in other regions of the country. The sand fly activity in this particular cave microhabitat appears to be longer than in other regions in Romania. Longer sand fly activity increases the zoonotic risk of various pathogenic species’ transmission, with an impact on public health, as sand flies are important insect vectors.

Graphical abstract
Elevated fecal calprotectin is linked to psychosocial complexity in pediatric functional abdominal pain disorders
Authors: Moorman Erin L. , Farrell Michael , Santucci Neha , Denson Lee , Le Christine , Cunningham Natoshia R.
Published: September 2021

Objective

Children with functional abdominal pain disorders (FAPD) and clinical elevations in three risk areas (anxiety, functional disability, and pain) have been found to be at increased risk for persistent disability. We evaluated if the presence of these three risk factors corresponded with greater gastrointestinal inflammation (measured via fecal calprotectin; FC) compared to those with no risk factors. FC concentration differences between children with three risk factors and those with one and two risk factors were explored.

Results

Fifty-six children with FAPD (Mage = 12.23) completed measures of anxiety (Screen for Child Anxiety Related Disorders), disability (Functional Disability Inventory), and pain intensity (Numeric Rating Scale). Participants were stratified into risk groups (range: 0–3). Fisher’s exact tests were conducted to determine if children with three versus fewer risk factors were more likely to have elevated FC (≥ 50 µg/g) versus normal levels. Children with three risk factors (MFC = 86.04) were more likely to have elevated FC compared to children with zero (MFC = 25.78), one (MFC = 38.59), and two risk factors (MFC = 45.06; p’s < 0.05). Those with three risk factors had borderline elevated FC concentrations whereas those with fewer had normal FC concentrations. Findings suggest the importance of a biopsychosocial approach to help elucidate a FAPD phenotype.
Mesenchymal stromal cells as a therapeutic intervention for COVID-19: a living systematic review and meta-analysis protocol
Authors: Kirkham Aidan M. , Monaghan Madeline , Bailey Adrian J. M. , Shorr Risa , Lalu Manoj M. , Fergusson Dean A. , Allan David S.
Published: September 2021

Background

Mesenchymal stromal cells (MSCs) have significant immunomodulatory and tissue repair capabilities, mediated partly by conditioned media or through secreted extracellular vesicles (MSC-EVs). Infection with SARS-CoV-2 can cause mild to life-threatening illness due to activated immune responses that may be dampened by MSCs or their secretome. Many clinical studies of MSCs have been launched since the beginning of the global pandemic, however, few have been completed and most lack power to assess efficacy. Repeated systematic searches and meta-analyses are needed to understand, in real time, the extent of potential benefit in different patient populations as the evidence emerges.

Methods

This living systematic review will be maintained to provide up-to-date information as the pandemic evolves. A systematic literature search of Embase, MEDLINE, and Cochrane Central Register of Controlled Trials databases will be performed. All clinical studies (e.g., randomized, pseudorandomized and non-randomized controlled trials, uncontrolled trials, and case series) employing MSCs or their secretome as a therapeutic intervention for COVID-19 will be included. Patients must have confirmed SARS-CoV-2 infection. Study screening and data extraction will be performed in duplicate. Information concerning interventions, patient populations, methods of MSC isolation and characterization, primary and secondary clinical and/or laboratory outcomes, and adverse events will be extracted. Key clinical outcomes will be pooled through random-effects meta-analysis to determine the efficacy of MSCs and their secreted products for COVID-19.

Discussion

Our systematic review and subsequent updates will inform the scientific, medical, and health policy communities as the pandemic evolves to guide decisions on the appropriate use of MSC-related products to treat COVID-19.

Systematic review registration

PROSPERO CRD 42021225431
Multiple solutions for singular semipositone boundary value problems of fourth-order differential systems with parameters
Authors: Lin Longfei , Liu Yansheng , Zhao Daliang
Published: September 2021

The aim of this paper is to establish some results about the existence of multiple solutions for the following singular semipositone boundary value problem of fourth-order differential systems with parameters: $$ \textstyle\begin{cases} u^{(4)}(t)+\beta _{1}u''(t)-\alpha _{1}u(t)=f_{1}(t,u(t),v(t)),\quad 0< t< 1; \\ v^{(4)}(t)+\beta _{2}v''(t)-\alpha _{2}v(t)=f_{2}(t,u(t),v(t)),\quad 0< t< 1; \\ u(0)=u(1)=u''(0)=u''(1)=0; \\ v(0)=v(1)=v''(0)=v''(1)=0, \end{cases} $$

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On pairs of fuzzy dominated mappings and applications
Authors: Rasham Tahair , Asif Awais , Aydi Hassen , De La Sen Manuel
Published: September 2021

The main purpose of this paper is to present some fixed-point results for a pair of fuzzy dominated mappings which are generalized V-contractions in modular-like metric spaces. Some theorems using a partial order are discussed and also some useful results to graphic contractions for fuzzy-graph dominated mappings are developed. To explain the validity of our results, 2D and 3D graphs have been constructed. Also, applications are provided to show the novelty of our obtained results and their usage in engineering and computer science.
Simulation experiment to test strategies of geomagnetic navigation during long-distance bird migration
Authors: Zein Beate , Long Jed A. , Safi Kamran , Kölzsch Andrea , Wikelski Martin , Kruckenberg Helmut , Demšar Urška
Published: September 2021

Background

Different theories suggest birds may use compass or map navigational systems associated with Earth’s magnetic intensity or inclination, especially during migratory flights. These theories have only been tested by considering properties of the Earth’s magnetic field at coarse temporal scales, typically ignoring the temporal dynamics of geomagnetic values that may affect migratory navigational capacity.

Methods

We designed a simulation experiment to study if and how birds use the geomagnetic field during migration by using both high resolution GPS tracking data and geomagnetic data at relatively fine spatial and temporal resolutions in comparison to previous studies. Our simulations use correlated random walks (CRW) and correlated random bridge (CRB) models to model different navigational strategies based on underlying dynamic geomagnetic data. We translated navigational strategies associated with geomagnetic cues into probability surfaces that are included in the random walk models. Simulated trajectories from these models were compared to the actual GPS trajectories of migratory birds using 3 different similarity measurements to evaluate which of the strategies was most likely to have occurred.

Results and conclusion

We designed a simulation experiment which can be applied to different wildlife species under varying conditions worldwide. In the case of our example species, we found that a compass-type strategy based on taxis, defined as movement towards an extreme value, produced the closest and most similar trajectories when compared to original GPS tracking data in CRW models. Our results indicate less evidence for map navigation (constant heading and bi-gradient taxis navigation). Additionally, our results indicate a multifactorial navigational mechanism necessitating more than one cue for successful navigation to the target. This is apparent from our simulations because the modelled endpoints of the trajectories of the CRW models do not reach close proximity to the target location of the GPS trajectory when simulated with geomagnetic navigational strategies alone. Additionally, the magnitude of the effect of the geomagnetic cues during navigation in our models was low in our CRB models. More research on the scale effects of the geomagnetic field on navigation, along with temporally varying geomagnetic data could be useful for further improving future models.
Birds of three worlds: moult migration to high Arctic expands a boreal-temperate flyway to a third biome
Authors: Piironen Antti , Paasivaara Antti , Laaksonen Toni
Published: September 2021

Background

Knowledge on migration patterns and flyways is a key for understanding the dynamics of migratory populations and evolution of migratory behaviour. Bird migration is usually considered to be movements between breeding and wintering areas, while less attention has been paid to other long-distance movements such as moult migration.

Methods

We use high-resolution satellite-tracking data from 58 taiga bean geeseAnser fabalis fabalisfrom the years 2019–2020, to study their moult migration during breeding season. We show the moulting sites, estimate the migratory connectivity between the breeding and the moulting sites, and estimate the utilization distributions during moult. We reveal migration routes and compare the length and timing of migration between moult migrants and successful breeders.

Results

All satellite-tracked non-breeding and unsuccessfully breeding taiga bean geese migrated annually to the island of Novaya Zemlya in the high Arctic for wing moult, meaning that a large part of the population gathers at the moulting sites outside the breeding range annually for approximately three months. Migratory connectivity between breeding and moulting sites was very low (rm =  − 0.001, 95% CI − 0.1562–0.2897), indicating that individuals from different breeding grounds mix with each other on the moulting sites. Moult migrants began fall migration later in autumn than successful breeders, and their overall annual migration distance was over twofold compared to the successful breeders.

Conclusions

Regular moult migration makes the Arctic an equally relevant habitat for the taiga bean goose population as their boreal breeding and temperate wintering grounds, and links ecological communities in these biomes. Moult migration plays an important role in the movement patterns and spatio-temporal distribution of the population. Low migratory connectivity between breeding and moulting sites can potentially contribute to the gene flow within the population. Moult migration to the high Arctic exposes the population to the rapid impacts of global warming to Arctic ecosystems. Additionally, Novaya Zemlya holds radioactive contaminants from various sources, which might still pose a threat to moult migrants. Generally, these results show that moult migration may essentially contribute to the way we should consider bird migration and migratory flyways.
Response to commentary
Authors: Hirasawa Yasutaka , Nakada Taka-aki , Terada Jiro
Published: September 2021

This is a response to the issues raised in the commentary by Dr. Yifu Si et al.
Component gap control during posterior-stabilised total knee arthroplasty using the posterior condylar pre-cut technique
Authors: Kawasaki Makoto , Kaneyama Ryutaku , Suzuki Hitoshi , Fujitani Teruaki , Tsukamoto Manabu , Sabanai Ken , Yoshioka Toru , Okimoto Nobukazu , Nagamine Ryuji , Sakai Akinori
Published: September 2021

Purpose

Adjusting the gap lengths to ensure equal lengths in both extension and flexion during total knee arthroplasty (TKA) is important for achieving successful outcomes. We designed a new pre-cut trial component (PCT) for posterior-stabilised (PS) TKA and aimed to determine whether the pre-cut technique is useful for component gap (CG) control in PS TKA.

Methods

A total of 70 knees were included. The PS PCT for PS TKA is composed of a 9-mm-thick distal part and 5-mm-thick posterior part with a cam structure. First, the distal femur and proximal tibia were cut to create an extension gap. Next, a 4-mm pre-cut was made from the posterior femoral condylar line; then, the PS PCT was attached, and the CGs were checked and compared at 0° and 90° knee flexion. Final CGs with the trial femoral components were compared with gaps in PS PCT at 0° and 90° knee flexion.

Results

CGs using PS PCTs were 10.2 mm at 0° and 13.6 mm at 90° knee flexion. According to the release of the posterior capsule at intercondylar notch and the adjustment of the cutting level of posterior femoral condyle, the final CG on knee extension was 11.3 mm; it did not significantly differ from CGs with PS PCT. The final CG at 90° knee flexion was 12.7 mm; it did not significantly differ from the estimated gap (12.4 mm) in PS PCT after flexion gap control.

Conclusion

CG control using PS PCT is a useful technique during PS TKA.

Level of evidence

Level IV: Case series.
Ultrasound-based evaluation revealed reliable postoperative knee stability after combined acute ACL and MCL injuries
Authors: Lutz Patricia M. , Höher Louisa S. , Feucht Matthias J. , Neumann Jan , Junker Daniela , Wörtler Klaus , Imhoff Andreas B. , Achtnich Andrea
Published: September 2021

Purpose

Anterior cruciate ligament (ACL) injuries are often combined with lesions of the medial collateral ligament (MCL). The aim of this study was to evaluate treatment outcome of combined acute ACL and MCL lesions using functional US and clinical examination.

Methods

Patients aged > 18 years undergoing primary ACL reconstruction with concomitant operative (group 1) or non-operative treatment of the MCL (group 2) between 2014 and 2019 were included after a minimum follow-up of 12 months. Grade II MCL injuries with dislocated tibial or femoral avulsions and grade III MCL ruptures underwent ligament repair whereas grade II injuries without dislocated avulsions were treated non-operatively. Radiological outcome was assessed with functional US examinations. Medial knee joint width was determined in a supine position at 0° and 30° of knee flexion in unloaded and standardized loaded (= 15 Dekanewton) conditions using a fixation device. Clinical examination was performed and patient-reported outcomes were assessed by the use of the subjective knee form (IKDC), Lysholm score, and the Tegner activity scale.

Results

A total of 40 patients (20 per group) met inclusion criteria. Mean age of group 1 was 40 ± 12 years (60% female) with a mean follow-up of 33 ± 17 months. Group 2 showed a mean age of 33 ± 8 years (20% female) with a mean follow-up of 34 ± 15 months. Side-to-side differences in US examinations were 0.4 ± 1.5 mm (mm) in 0° and 0.4 ± 1.5 mm in 30° knee flexion in group 1, and 0.9 ± 1.1 mm in 0° and 0.5 ± 1.4 mm in 30° knee flexion in group 2, with no statistically significant differences between both groups. MCL repair resulted in lower Lysholm scores (75 ± 19 versus 86 ± 15;p < 0.05). No significant differences could be found for subjective IKDC or Tegner activity scores among the two groups.

Conclusion

A differentiated treatment concept in combined ACL and MCL injuries based on injury patterns leads to reliable postoperative ligamentous knee stability in US-based and clinical examinations. However, grade II and III MCL lesions with subsequent operative MCL repair (group 1) result in slightly poorer subjective outcome scores.

Level of evidence

Retrospective cohort study; Level III
Sugarcane bagasse: a biomass sufficiently applied for improving global energy, environment and economic sustainability
Authors: Ajala E. O. , Ighalo J. O. , Ajala M. A. , Adeniyi A. G. , Ayanshola A. M.
Published: September 2021

Sugarcane (Saccharum officinarum) bagasse (SCB) is a biomass of agricultural waste obtained from sugarcane processing that has been found in abundance globally. Due to its abundance in nature, researchers have been harnessing this biomass for numerous applications such as in energy and environmental sustainability. However, before it could be optimally utilised, it has to be pre-treated using available methods. Different pre-treatment methods were reviewed for SCB, both alkaline and alkali–acid process reveal efficient and successful approaches for obtaining higher glucose production from hydrolysis. Procedures for hydrolysis were evaluated, and results indicate that pre-treated SCB was susceptible to acid and enzymatic hydrolysis as > 80% glucose yield was obtained in both cases. The SCB could achieve a bio-ethanol (a biofuel) yield of > 0.2 g/g at optimal conditions and xylitol (a bio-product) yield at > 0.4 g/g in most cases. Thermochemical processing of SCB also gave excellent biofuel yields. The plethora of products obtained in this regard have been catalogued and elucidated extensively. As found in this study, the SCB could be used in diverse applications such as adsorbent, ion exchange resin, briquettes, ceramics, concrete, cement and polymer composites. Consequently, the SCB is a biomass with great potential to meet global energy demand and encourage environmental sustainability.
Building youth and family resilience for better mental health: developing and testing a hybrid model of intervention in low- and middle-income countries
Authors: Basu Debasish , Nagpal Sugandha , Pillai Renjith R. , Mutiso Victoria , Ndetei David , Bhui Kamaldeep
Published: September 2021

Resilience is a dynamic, multi-level, multi-systemic process of positive adaptation at the individual, family and community levels. Promoting resilience can be a cost-effective form of preventive and early intervention, offering significant health advantages for young people throughout their lives. Developing resiliency interventions for youth and their families in low- and middle-income countries (LMICs), particularly in the context of the ongoing pandemic, is especially important given a lack of services and trained specialists, and poor levels of public spend on mental health, alongside marked and clustered psychosocial disadvantages and adverse childhood experiences. We propose a ‘hybrid’ model targeting 10- to 17 year-old children and their families, and options to engage through communities, schools and the family unit. These options will enhance individual and family resilience, and possibly buffer against adversity. The adaptations respect cultural and health beliefs, take account of structural drivers of inequalities and are suitable for LMICs.
Willingness to Travel for Cellular Therapy: The Influence of Follow-Up Care Location, Oncologist Continuity, and Race
Authors: Frosch Zachary A. K. , Namoglu Esin C. , Mitra Nandita , Landsburg Daniel J. , Nasta Sunita D. , Bekelman Justin E. , Iyengar Raghuram , Guerra Carmen E. , Schapira Marilyn M.
Published: September 2021

PURPOSE:

Patients weigh competing priorities when deciding whether to travel to a cellular therapy center for treatment. We conducted a choice-based conjoint analysis to determine the relative value they place on clinical factors, oncologist continuity, and travel time under different post-treatment follow-up arrangements. We also evaluated for differences in preferences by sociodemographic factors.

METHODS:

We administered a survey in which patients with diffuse large B-cell lymphoma selected treatment plans between pairs of hypothetical options that varied in travel time, follow-up arrangement, oncologist continuity, 2-year overall survival, and intensive care unit admission rate. We determined importance weights (which represent attributes' value to participants) using generalized estimating equations.

RESULTS:

Three hundred and two patients (62%) responded. When all follow-up care was at the center providing treatment, plans requiring longer travel times were less attractive ( v 30 minutes, importance weights [95% CI] of –0.54 [–0.80 to –0.27], –0.57 [–0.84 to –0.29], and –0.17 [–0.49 to 0.14] for 60, 90, and 120 minutes). However, the negative impact of travel on treatment plan choice was mitigated by offering shared follow-up (importance weights [95% CI] of 0.63 [0.33 to 0.93], 0.32 [0.08 to 0.57], and 0.26 [0.04 to 0.47] at 60, 90, and 120 minutes). Black participants were less likely to choose plans requiring longer travel, regardless of follow-up arrangement, as indicated by lower value importance weights for longer travel times.

CONCLUSION:

Reducing travel burden through shared follow-up may increase patients' willingness to travel to receive cellular therapies, but additional measures are required to facilitate equitable access.
Cripping the Welfare Queen
Authors: Kim Jina B.
Published: September 2021

Drawing together feminist- and queer-of-color critique with disability theory, this essay offers a literary-cultural reframing of the welfare queen in light of critical discourses of disability. It does so by taking up the discourse of dependency that casts racialized, low-income, and disabled populations as drains on the state, reframing this discourse as a potential site of coalition among antiracist, anticapitalist, and feminist disability politics. Whereas antiwelfare policy cast independence as a national ideal, this analysis of the welfare mother elaborates a version of disability and women-of-color feminism that not only takes dependency as a given but also mines the figure of the welfare mother for its transformative potential. To imagine the welfare mother as a site for reenvisioning dependency, this essay draws on the “ruptural possibilities” of minority literary texts, to use Roderick A. Ferguson’s coinage, and places Sapphire's 1996 novel Push in conversation with Jesmyn Ward's 2011 novel Salvage the Bones. Both novels depict young Black mothers grappling with the disabling context of public infrastructural abandonment, in which the basic support systems for maintaining life—schools, hospitals, social services—have become increasingly compromised. As such, these novels enable an elaboration of a critical disability politic centered on welfare queen mythology and its attendant structures of state neglect, one that overwrites the punitive logics of public resource distribution. This disability politic, which the author terms crip-of-color critique, foregrounds the utility of disability studies for feminist-of-color theories of gendered and sexual state regulation and ushers racialized reproduction and state violence to the forefront of disability analysis.