bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of Cat Allergy Using Controlled Methodology—A Review of the Literature and a Call to Action
Authors: Hossenbaccus Lubnaa , Linton Sophia , Ramchandani Rashi , Burrows Alyssa G. , Ellis Anne K.
Published: March 2022

The prevalence of cat allergen-induced AR is increasing worldwide, prompting its study using controlled methodology. Three general categories of allergen exposure models currently exist for the study of cat allergen-induced AR: natural exposure cat rooms, allergen exposure chambers (AEC), and nasal allergen challenges (NAC). We evaluated existing literature surrounding the use of these models to study cat allergen induced AR using online research databases, including OVID Medline, Embase, and Web of Science. We report that natural exposure cat rooms have been important in establishing the foundation for our understanding of cat allergen-induced AR. Major limitations, including variable allergen ranges and differing study designs highlight the need for a more standardized protocol. In comparison, AECs are an exceptional model to mimic real-world allergen exposure and study long-term implications of AR with large sample sizes. Existing AECs are limited by heterogeneous facility designs, differing methods of cat allergen distribution, and issues surrounding cost and accessibility. Conversely, NACs allow for smaller participant cohorts for easier biological sampling and are ideal for phase I, phase 2 or proof-of-concept studies. NACs generally have a standardized protocol and are less expensive compared to AECs. Nevertheless, NACs solely capture acute allergen exposure and have the further limitation of using allergen extracts rather than natural allergen. As the use of combined controlled methodologies is sparse, we recommend concurrent use of AECs and NACs to study short- and long-term effects of AR, thereby providing a more holistic representation of cat allergen-induced AR.
Hyperoxygenation During Mid-Neurogenesis Accelerates Cortical Development in the Fetal Mouse Brain
Authors: Markert Franz , Storch Alexander
Published: March 2022

Oxygen tension is well-known to affect cortical development. Fetal brain hyperoxygenation during mid-neurogenesis in mice (embryonic stage E14.5. to E16.5) increases brain size evoked through an increase of neuroprecursor cells. Nevertheless, it is unknown whether these effects can lead to persistent morphological changes within the highly orchestrated brain development. To shed light on this, we used our model of controlled fetal brain hyperoxygenation in time-pregnant C57BL/6J mice housed in a chamber with 75% atmospheric oxygen from E14.5 to E16.5 and analyzed the brains from E14.5, E16.5, P0.5, and P3.5 mouse embryos and pups via immunofluorescence staining. Mid-neurogenesis hyperoxygenation led to an acceleration of cortical development by temporal expansion of the cortical plate with increased NeuN+ neuron counts in hyperoxic brains only until birth. More specifically, the number of Ctip2+ cortical layer 5 (L5) neurons was increased at E16.5 and at birth in hyperoxic brains but normalized in the early postnatal stage (P3.5). The absence of cleaved caspase 3 within the extended Ctip2+ L5 cell population largely excluded apoptosis as a major compensatory mechanism. Timed BrdU/EdU analyses likewise rule out a feedback mechanism. The normalization was, on the contrary, accompanied by an increase of active microglia within L5 targeting Ctip2+ neurons without any signs of apoptosis. Together, hyperoxygenation during mid-neurogenesis phase of fetal brain development provoked a specific transient overshoot of cortical L5 neurons leading to an accelerated cortical development without detectable persistent changes. These observations provide insight into cortical and L5 brain development.
Effect of Borax On Sintering Kinetics, Microstructure and Mechanical Properties of Porous Glass-Ceramics From Coal Fly Ash by Direct Overfiring
Authors: Zeng Li , Sun Hongjuan , Peng Tongjiang
Published: March 2022

The direct sintering process of coal fly ash for the preparation of glass-ceramics is the liquid-phase sintering process, from non-densification to densification. When the temperature exceeds the densification temperature point, the porosity of glass-ceramics on the contrary increases and the pore diameter increases. This provides a basis to prepare porous glass-ceramics by direct overfiring. Adding borax to coal fly ash can reduce the temperature of liquid phase formation, reduce the preparing temperature of porous glass-ceramics, achieve the purpose of energy saving. The effects of borax on the structure, properties and sintering kinetics of porous glass-ceramics prepared from coal fly ash by overfiring were investigated. It is found that the introduction of B-O bond can change the network structure of non-crystalline vitreous in coal fly ash, reduce the melting temperature, promote the formation of liquid phase, and thus increase the porosity of porous glass-ceramics. This paper provides a certain experimental basis for the preparation of porous glass-ceramics by direct overfiring of coal fly ash at low temperature without adding pore-forming agent, and provides a new possibility for the high-value resource utilization of coal fly ash.
Sex Pheromones of the Potato Tuber Moth (Phthorimaea operculella)
Authors: Pan Huanhuan , Zhao Hongyi , Ai Likun , Huang Jian , Chen Yang
Published: March 2022

The potato tuber moth (Phthorimaea operculella) is a major potato pest. Its sex pheromones contain two chemical structures: 4E,7Z-tridecadiene-1-ol acetate (PTM1) and 4E,7Z,10Z-tridecatriene-1-ol acetate (PTM2). Increasing global consciousness of environmental protection is driving widespread attention to the possible use of these pheromones for sustainable pest management. This review summarizes research on the structure confirmation, field application, and chemical synthesis of the sex pheromones of the potato tuber moth. An efficient synthesis strategy of the two sex pheromones is proposed.
Patients With Symptomatic AAAs Are More Likely to Develop Lumen Partial-Thrombus After Endovascular Aortic Repair Than Asymptomatic Patients
Authors: Wang Enci , Xie Xinsheng , Xu Dandan , Shu Xiaolong , Zhao Yu fei , Zhang Yuchong , Lin Peng , Guo Daqiao , Fu Weiguo , Wang Lixin
Published: March 2022

Background

According to their symptoms, abdominal aortic aneurysms (AAAs) can be divided into symptomatic and asymptomatic types. This study aimed to explore the differences and correlations between postoperative lumen thrombosis in these two groups after endovascular aortic repair (EVAR).

Methods

A retrospective study using clinical data of 169 patients with AAA treated with EVAR collected in our hospital between January 2018 and January 2021 was conducted based on the inclusion and exclusion criteria for patient selection. Based on whether the patient had clinical symptoms at admission and the presence of a complete lumen thrombus during follow-up, the patients were divided into two sets of groups: a complete-thrombus group (n = 44) and a partial-thrombus group (n = 125), and a group with clinical symptoms (n = 32) and a group without clinical symptoms (n = 137). The clinical data of these groups were compared, and a further stratified analysis was performed.

Results

A total of 169 patients were included in the analysis. An abdominal aorta stent graft was successfully implanted in all patients. The complete-thrombus rate of the patients in this study was 73.96%. Univariate analysis showed that the maximal aortic diameter and preoperative peripheral blood neutrophil levels affected the clinical symptoms of patients with AAA (p < 0.05). The complete thrombus rate of the lumen of the AAA was lower in patients with clinical symptoms than in those without symptoms during the follow-up period (p < 0.05). Female sex, preoperative hyperuricemia, and symptoms at admission were independent risk factors for a partial thrombus in the lumen during follow-up. Based on these independent risk factors, we constructed a scoring system to differentiate patients into low- (0 points), middle- (1 point), and high-risk (2 points) groups. The scoring system could distinguish the complete lumen thrombosis rate after EVAR to a certain extent.

Conclusions

Patients with symptomatic AAAs were more likely to develop incomplete lumen thrombosis than asymptomatic patients during follow-up after EVAR.
Insulin Resistance and Vitamin D Deficiency: A Link Beyond the Appearances
Authors: Trimarco Valentina , Manzi Maria Virginia , Mancusi Costantino , Strisciuglio Teresa , Fucile Ilaria , Fiordelisi Antonella , Pilato Emanuele , Izzo Raffaele , Barbato Emanuele , Lembo Maria , Morisco Carmine
Published: March 2022

Vitamin D is a steroid hormone that plays a key role in the regulation of body homeostasis, including cardiovascular function. Although the chronic deficiency of vitamin D is associated with cardiovascular risk factors, as well as with an adverse prognosis, randomized controlled trials have failed in demonstrating that dietary vitamin D supplementation could ameliorate the prognosis of patients with cardiovascular diseases, and suggested that vitamin D deficiency is the expression of the effects of other determinants of cardiovascular risk. Thus, the supplementation of vitamin D is not sufficient to improve the cardiovascular risk profile and prognosis. Insulin resistance is a complex phenomenon that plays a key role in the pathogenesis of conventional cardiovascular risk factors. Interestingly, defects of vitamin D and insulin resistance have a superimposable epidemiological distribution. According to the common view, Insulin resistance is considered the direct or indirect consequence of vitamin D deficiency. However, it is also reasonable to speculate that the deficit or the impaired action of vitamin D, in some circumstances, could be the result of the same pathogenic mechanisms responsible of insulin resistance development. In this case, vitamin D deficiency could be considered an epiphenomenon of insulin resistance. Insulin resistance is a reversible condition, being possibly ameliorated by physical activity and hypocaloric diets. Notably, both physical exercise and energy-restricted dietary regimens are associated with an increase of vitamin D levels. These findings indicate that improving insulin resistance condition is a necessary step to ameliorate vitamin D supplementation-based strategies in cardiovascular prevention.
Pulmonary Arterial Hypertension and Consecutive Right Heart Failure Lead to Liver Fibrosis
Authors: Hamberger Florian , Legchenko Ekaterina , Chouvarine Philippe , Mederacke Young Seon , Taubert Richard , Meier Martin , Jonigk Danny , Hansmann Georg , Mederacke Ingmar
Published: March 2022

Hepatic congestion occurs in patients with right heart failure and can ultimately lead to liver fibrosis or cardiac cirrhosis. Elevated pulmonary arterial pressure is found in patients with hepatic congestion. However, whether pulmonary arterial hypertension (PAH) can be a cause of liver fibrosis is unknown. The aim of this study was to investigate whether rats in the SuHx model with severe PAH develop liver fibrosis and to explore the mechanisms of congestive hepatic fibrosis both in rats and humans. To achieve this, PAH was induced in six to eight-week old male Sprague Dawley rats by a single subcutaneous injection of the VEGFR 2 inhibitor SU5416 and subsequent hypoxia for 3 weeks, followed by a 6-week period in room air. SuHx-exposed rats developed severe PAH, right ventricular hypertrophy (RVH), and consecutive right ventricular failure. Cardiac magnetic resonance imaging (MRI) and histological analysis revealed that PAH rats developed both hepatic congestion and liver fibrosis. Gene set enrichment analysis (GSEA) of whole liver RNA sequencing data identified a hepatic stellate cell specific gene signature in PAH rats. Consistently, tissue microarray from liver of patients with histological evidence of hepatic congestion and underlying heart disease revealed similar fibrogenic gene expression patterns and signaling pathways. In conclusion, severe PAH with concomitant right heart failure leads to hepatic congestion and liver fibrosis in the SU5416/hypoxia rat PAH model. Patients with PAH should therefore be screened for unrecognized liver fibrosis.
Prognostic Factors and Models for Elderly (≥70 Years Old) Primary Operable Triple-Negative Breast Cancer: Analysis From the National Cancer Database
Authors: Tang Zhuowei , Ji Yuzhu , Min Yu , Zhang Xiaohong , Xu Weiyun , Zhao Lijuan , Zhang Jing , Long Li , Feng Jing , Wen Yixue
Published: March 2022

Background

Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer. In the elderly (≥70 years old) primary operable (T1-3N0-1M0) TNBC, individualized treatment modalities for this population are pivotal and important, but limited studies are explored.

Methods

The clinicopathological features of elderly primary operable TNBC patients were retrospectively selected from the Surveillance, Epidemiology, and End Results (SEER) database between January 2010 and December 2015. Kaplan–Meier curves were used to show the survival patterns in the different subgroups. Multivariate Cox analysis was used to identify independent risk factors in the 3-, 5-, and 7- year overall survival (OS) and cancer-specific survival (CSS) in this subpopulation. The predictive model was further developed and validated for clinical use.

Result

Between 2010 and 2015 years, a total of 4,761 elderly primary operable TNBC patients were enrolled for the study, with a mean age of 76 years and a median follow-up of 56 months. The multivariate Cox analysis showed that age (increased per year: hazard ratio (HR) = 1.05), race (Asian/Pacific Islander and American Indian/Alaska Native, HR = 0.73), differentiation grade (grade II: HR = 2.01; grade III/IV: HR = 2.67), larger tumor size (T1c: HR = 1.83; T2: HR = 2.78; T3: HR = 4.93), positive N stage (N1mi: HR = 1.60; N1: HR = 1.54), receiving radiation therapy (HR = 0.66), and receiving adjuvant chemotherapy (HR = 0.61) were the independent prognostic factors for OS, and a similar prognostic pattern was also determined in CSS. Besides, two nomograms for predicting the 3-, 5-, and 7-year OS and CSS in this population were developed with a favorable concordance index of 0.716 and 0.746, respectively.

Conclusion

The results highlight that both radiation and adjuvant chemotherapy are significantly associated with favorable long-term OS and CSS probability in elderly primary operable TNBC patients. Based on the determined independent prognostic factors, the novel nomograms could assist the oncologists to make individualized clinical decisions for the subpopulation at different risks.
An Artificial Intelligence Agent That Synthesises Visual Abstractions of Natural Forms to Support the Design of Human-Made Habitat Structures
Authors: Mirra Gabriele , Holland Alexander , Roudavski Stanislav , Wijnands Jasper S. , Pugnale Alberto
Published: March 2022

Biodiversity is in a state of global collapse. Among the main drivers of this crisis is habitat degradation that destroys living spaces for animals, birds, and other species. Design and provision of human-made replacements for natural habitat structures can alleviate this situation. Can emerging knowledge in ecology, design, and artificial intelligence (AI) help? Current strategies to resolve this issue include designing objects that reproduce known features of natural forms. For instance, conservation practitioners seek to mimic the function of rapidly disappearing large old trees by augmenting utility poles with perch structures. Other approaches to restoring degraded ecosystems employ computational tools to capture information about natural forms and use such data to monitor remediation activities. At present, human-made replacements of habitat structures cannot reproduce significant features of complex natural forms while supporting efficient construction at large scales. We propose an AI agent that can synthesise simplified but ecologically meaningful representations of 3D forms that we define as visual abstractions. Previous research used AI to synthesise visual abstractions of 2D images. However, current applications of such techniques neither extend to 3D data nor engage with biological conservation or ecocentric design. This article investigates the potential of AI to support the design of artificial habitat structures and expand the scope of computation in this domain from data analysis to design synthesis. Our case study considers possible replacements of natural trees. The application implements a novel AI agent that designs by placing three-dimensional cubes – or voxels – in the digital space. The AI agent autonomously assesses the quality of the resulting visual abstractions by comparing them with three-dimensional representations of natural trees. We evaluate the forms produced by the AI agent by measuring relative complexity and features that are meaningful for arboreal wildlife. In conclusion, our study demonstrates that AI can generate design suggestions that are aligned with the preferences of arboreal wildlife and can support the development of artificial habitat structures. The bio-informed approach presented in this article can be useful in many situations where incomplete knowledge about complex natural forms can constrain the design and performance of human-made artefacts.
Spatial and Vertical Benthic Foraminifera Diversity in the Oxygen Minimum Zone of Mejillones Bay, Northern Chile
Authors: Tavera Martínez Laura , Marchant Margarita , Muñoz Praxedes , Abdala Díaz Roberto T.
Published: March 2022

Mejillones Bay is located in northern Chile (23°S) and is influenced by an Oxygen Minimum Zone (OMZ), with oxygen levels below 0.5 ml l–1. This area presents particular ecological characteristics, such as circulation of currents, hotspot, high productivity and industrial activity. This extreme ecosystem generates the need to understand their dynamics and changes across time and space, as well as to identify the main differences with other OMZs. For this reason, we studied the benthic foraminifera to use them as environmental and oxygenation proxies. For this purpose, two sediment cores (ZA and Z1A) were collected, obtaining 14 samples of the first 8 cm (vertical distribution), and 18 samples with a mini boxcore (spatial distribution). When analyzing the foraminifera community, some similarities were found in environmental characteristics of other OMZs, such as the predominance of Bolivina seminuda, Bolivina costata, Epistominella exigua, Fursenkoina sp., and Nonioella stella (species typical of hypoxic conditions). In addition, a high abundance of angular-asymmetric morphologies was observed, indicating eutrophied silty substrates and low current circulation. However, the Mejillones Bay recorded a particular spatial and vertical dynamics respect to others OMZs, due to presence of other species of Bolivinids not reported for this area before, and a high abundance of Buliminella elegantissima, which is not recorded in most of OMZs. Foraminifera with rounded-symmetric morphologies were present and dominant in deeper layers, reflecting a turbulent and high-energy environment. On the basis of depth and conditions of microxia or dysoxia, no significative pattern of spatial and vertical distribution was observed. The latter can be explained by local factors such as cyclonic and anticyclonic whirlpools, wastewater from industrial activity and natural disaster such a Tsunami occurred in 1877. These factors contributed to the mixture of the benthic foraminifera and prevented the formation of spatial and vertical patterns. Finally, an intensification of hypoxia was identified, indicating microxia (0,01 ml l–1) in the superficial layers (0–3 cm from years 1996 to 2012), while the deeper layers (4–8 cm from years 1985 to 1877) presented foraminiferal species that indicated dysoxia conditions (0,07 ml l–1). The latter differs from other OMZs, which show greater oxygenation in the most superficial layers and microxia in deeper layers. This study represents the first ecological reconstruction using benthic foraminifera proxies for the Mejillones Bay, which results indicate an OMZ with ecological and environmental features that differ from other OMZs.
Food Safety Risk in Germany From Mislabeled Imported Fish: Ciguatera Outbreak Trace-Back, Toxin Elucidation, and Public Health Implications
Authors: Loeffler Christopher R. , Spielmeyer Astrid , Friedemann Miriam , Kapp Katrin , Schwank Ulrich , Kappenstein Oliver , Bodi Dorina
Published: March 2022

Ciguatera poisoning (CP) is a prevalent food related health risk, caused by the consumption of seafood contaminated with ciguatoxins (CTXs). Seafood is the most traded food commodity worldwide, and since 2012, imported snapper fish (Lutjanidae) were the leading cause of CP in Germany. Following a Germany wide CP outbreak in 2017, a product trace-back investigation was conducted for imported fish labeled as “Red Snapper” (Lutjanus malabaricus). Forty-five fish muscle-tissue portions from the implicated batch and two meal remnants were analyzed for CTXs. All samples were positive for “CTX-like toxicity” containing a range of 0.23–11.4 ng CTX3C equivalents per gram of wet tissue, determined by an in vitro cell assay [N2a-3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT)]. Liquid chromatography with tandem mass spectrometry (LC-MS/MS) chromatograms revealed the (potential) presence of several marine biotoxins of the class CTX in all batch samples. All samples exceeded current multi-national product legal requirements and recommended guidelines for CTXs. DNA barcoding confirmed the fish sold was mislabeled and was identified as L. bohar, a species frequently involved in CP. Consequently, the mislabeled food and contaminants risk focuses attention on the importance of correct food labeling. Processes for food authentication and CTX contaminant analysis exist and can be used to potentially prevent, stop, and remove foods from commerce for further evaluation to ensure consumer safety. This study further demonstrates their necessity.
Baseline Study of Microplastics in the Gastrointestinal Tract of Commercial Species Inhabiting in the Coastal Waters of Karachi, Sindh, Pakistan
Authors: Akhter Najeeb , Panhwar Sher Khan
Published: March 2022

A microplastics (MPs) emergence study in pelagic and mesopelagic species was carried out to delineate coastal degradation and ecosystem status around the Karachi metropolis. Species of high commercial and ecological worth were sampled using a gillnet of 1.5 cm knot-to-knot mesh size in November and December 2021. In total twenty-six individuals including Liza subviridis (15), Thryssa dussumieri (3), Rastrelliger kanagurta (2), and Portunus sanguinolentus (6) were used to perceive MPs. A strong linearity between body length and MPs (R2 = 0.937, SE 0.071 and R2 = 0.928, SE 0.104) were calculated for L. subviridis and P. sangiuilatus, respectively. However, the data of T. dussummeiri and R. Kanagurta showed minimization failure. The MPs in GIT were extracted using direct observation under a sophisticated binuclear microscope and chemical digestion (KOH) together with wet peroxide oxidation (H2O2+FeSO4) methods. The MP materials were categorized as foam, film, fiber, fragment, and beads of three different sizes 170, 120, 100 μm in the stomach, intestine, and esophagus. Film-type MPs appeared frequently, whereas beads were rarely seen. It is hoped that this baseline research would help to minimize industrial release, recognize critical knowledge gaps, and demonstrate MP flux being released into the aquatic environment. The results will support mitigation of this emerging threat to the living resources around the Karachi coastal area.
Diabetic Ketoacidosis With Acute Pancreatitis in Patients With Type 2 Diabetes in the Emergency Department: A Retrospective Study
Authors: Ma Li Ping , Liu Xue , Cui Bei Chen , Liu Yan , Wang Cong , Zhao Bin
Published: March 2022

Objective

This study aims to explore the incidence and clinical features of acute pancreatitis (AP) in patients with type 2 diabetes diabetic ketoacidosis (DKA) in the emergency department and discuss the predictive value of some pathological indicators for AP in DKA.

Methods

Inpatient medical data of DKA patients hospitalized to our hospital's emergency department between January 2017 and January 2021 were evaluated retrospectively. These DKA patients were split into two groups based on whether they had AP or not. We examined the two groups' epidemiologic features, baseline laboratory results, and clinical outcomes. The Bedside Index for Sequential Organ Failure Assessment (SOFA), Acute Physiology and Chronic Health Evaluation II (APACHE II), and Logistic Organ Failure System (LODS) scores were computed and compared across groups.

Results

The prevalence of AP in DKA patients was 15.53%. The difference in Abdominal pain between the two groups of patients was statistically significant (p < 0.001), and there was no statistical difference in age, gender, and BMI. The DKA and AP group LOS (P < 0.001), ICU admission rate (P = 0.046), anion gap (P < 0.001), red blood cell (P = 0.002), hemoglobin (P < 0.001), hematocrit (P = 0.002), serum triglyceride (P < 0.001), serum cholesterol (P < 0.001), serum amylase (P = 0.004), random glucose (P = 0.028), plasma fibrinogen (P < 0.001), glycosylated hemoglobin [HbA1c (%); P = 0.008] higher than the DKA group, pH (P < 0.001), carbon dioxide combining power (CO2CP; P < 0.001), ionized calcium (Ca2+; P = 0.022), ionized sodium (Na+; P = 0.001), and correction Na (P = 0.034) lower than the DKA group. Multivariate analysis showed that low pH (P < 0.05), hypertriglyceridemia (P = 0.001), and hypercholesterolemia (P = 0.01) were risk factors for DKA combined with AP. ROC curve analysis showed that the three cut-off value: serum triglycerides of 10.52 mmol/L, serum cholesterol of 9.03 mmol/L, and pH of 7.214. Serum triglyceride has the largest area under the curve (0.93). Under this cut-off value, the sensitivity (80%) and specificity of serum triglyceride, the degree (93.7%) is the highest, while the positive predictive value (62.0%) and negative predictive value (94.7%) of serum cholesterol are the highest.

Conclusions

A severe episode of DKA with significant acidosis and hyperlipidemia is more likely to be linked with AP. The frequently used critical illness score is ineffective in determining the severity of the condition. When the serum triglyceride cut-off value is 10.52mmol/L, it has a higher predicted value for AP in DKA.
Case Report: Familial Pseudohyperkalemia Due to Red Blood Cell Membrane Leak in a Chinese Patient
Authors: Xiong Weijue , Song Junxian , Yue Zhihong , Pei Lin , Liu Yang , Chen Jiangtian , Chen Hong
Published: March 2022

Hyperkalemia is a critical condition requiring careful evaluation and timely intervention. Many conditions could manifest as pseudohyperkalemia and it's important to differentiate them as inappropriate potassium-lowering therapy might lead to detrimental outcomes. A 56-year-old female was admitted for hyperkalemia (5.62–8.55 mmol/L). She had no symptoms or signs of hyperkalemia. A comprehensive work-up of hyperkalemia retrieved no valuable findings. Her blood samples underwent incubation tests at different temperatures and revealed temperature-dependent potassium leaks from red blood cells. Based on all test results, a diagnosis of hyperkalemia caused by red blood cell membrane defects was suspected. Whole-genome sequencing revealed a heterozygous c.1123C>T (p. R375W) mutation in the ABCB6 gene and confirmed the diagnosis of familial pseudohyperkalemia (FP). FP is an inherited benign condition in which red blood cells have increased cold-induced permeability to potassium. The patient was discharged with no additional treatment and she was suggested avoiding blood donation.
Efficacy and Safety of Remimazolam Tosilate Combined With Esketamine for Analgesic Sedation in Mechanically Ventilated ICU Patients: A Single-Arm Clinical Study Protocol
Authors: Song Xuan , Wang Feng , Dong Ranran , Zhu Kehan , Wang Chunting
Published: March 2022

Introduction

Patients in the intensive care unit (ICU) frequently experience increased heart rate, blood pressure, and respiration rate as a product of anxiety and restlessness about their condition and treatments. Analgesia and sedation commonly involve benzodiazepines or opioids that lead to respiratory suppression and other adverse reactions. Remimazolam tosilate is a short-acting GABAA receptor agonist with reduced cardiovascular and respiratory inhibition compared to other commonly used benzodiazepines. Esketamine is a non-competitive N-methyl-D-aspartic acid (NMDA) receptor inhibitor that inhibits hyperalgesia and prolongs postoperative analgesia. It also reduces postoperative pain, delirium, and the use and acute tolerance of opioids. This study aims to assess the efficacy and safety of remimazolam tosilate combined with esketamine and sufentanil for sedation and analgesia in mechanically ventilated ICU patients.

Methods and Analysis

This prospective, single-arm, single-center, open-label clinical trial will be conducted from January 2022 to December 2023. The study will include 200 adult patients (≥ 18 years) from Shandong Provincial Hospital (affiliated with Shandong First Medical University) who are mechanically ventilated and admitted to the ICU between 24 and 72 h from the time of ventilation and who are administered analgesia and sedatives. Patients will undergo arterial blood gas analysis before administration. Remimazolam tosilate (0.2 mg/kg) will be injected intravenously within 30 s, followed by continuous infusion at a rate of 0.1 to 0.3 mg/kg/h via micropump. Esketamine (0.25 mg/kg) will be injected intravenously and maintained at 0.15 mg/kg/h, while sufentanil will be maintained at the rate of 0.1 to 0.2 μg/kg/h. The primary study outcome is the overall time required to maintain sedation. Secondary outcomes will include the total dosage used to reach the target sedation level, total mechanical ventilation time, awakening time, length of hospital stay, and incidence of cardiorespiratory-related adverse events and delirium. Adverse events (AEs) will be reported regardless of their relationship to the experimental drugs. AEs associated with adverse drug reactions will be classified as “affirmative correlation,” “possible relevance,” and “unable to determine.” A paired t-test or Wilcoxon signed-rank test will be used to compare the changes of observed indexes before and after treatment. A P < 0.05 will be considered statistically significant.

Ethics and Dissemination

This study was approved by the local ethics committee at Shandong Provincial Hospital affiliatied to Shandong First Medical University. The results of this trial will be disseminated in peer-reviewed journals and at scientific conferences.

Trial Registration

The trial is registered at the Chinese Clinical Trial Registry: ChiCTR2100053106; date of registration: 2021-11-10.
Adaptation to an Intracellular Lifestyle by a Nitrogen-Fixing, Heterocyst-Forming Cyanobacterial Endosymbiont of a Diatom
Authors: Flores Enrique , Romanovicz Dwight K. , Nieves-Morión Mercedes , Foster Rachel A. , Villareal Tracy A.
Published: March 2022

The symbiosis between the diatom Hemiaulus hauckii and the heterocyst-forming cyanobacterium Richelia intracellularis makes an important contribution to new production in the world’s oceans, but its study is limited by short-term survival in the laboratory. In this symbiosis, R. intracellularis fixes atmospheric dinitrogen in the heterocyst and provides H. hauckii with fixed nitrogen. Here, we conducted an electron microscopy study of H. hauckii and found that the filaments of the R. intracellularis symbiont, typically composed of one terminal heterocyst and three or four vegetative cells, are located in the diatom’s cytoplasm not enclosed by a host membrane. A second prokaryotic cell was also detected in the cytoplasm of H. hauckii, but observations were infrequent. The heterocysts of R. intracellularis differ from those of free-living heterocyst-forming cyanobacteria in that the specific components of the heterocyst envelope seem to be located in the periplasmic space instead of outside the outer membrane. This specialized arrangement of the heterocyst envelope and a possible association of the cyanobacterium with oxygen-respiring mitochondria may be important for protection of the nitrogen-fixing enzyme, nitrogenase, from photosynthetically produced oxygen. The cell envelope of the vegetative cells of R. intracellularis contained numerous membrane vesicles that resemble the outer-inner membrane vesicles of Gram-negative bacteria. These vesicles can export cytoplasmic material from the bacterial cell and, therefore, may represent a vehicle for transfer of fixed nitrogen from R. intracellularis to the diatom’s cytoplasm. The specific morphological features of R. intracellularis described here, together with its known streamlined genome, likely represent specific adaptations of this cyanobacterium to an intracellular lifestyle.
Emergence of an ST1326 (CG258) Multi-Drug Resistant Klebsiella pneumoniae Co-harboring mcr-8.2, ESBL Genes, and the Resistance-Nodulation-Division Efflux Pump Gene Cluster tmexCD1-toprJ1 in China
Authors: Liu Congcong , Wu Yuchen , Fang Yinfei , Sang Zi , Huang Ling , Dong Ning , Zeng Yu , Lu Jiayue , Zhang Rong , Chen Gongxiang
Published: March 2022

CG258 is the dominant carbapenemase-producing Klebsiella pneumoniae clone worldwide and treatment of infections caused by this clone relies largely on the last-line antibiotics, colistin, and tigecycline. However, the emergence and global dissemination of mcr and tmexCD1-toprJ1 genes have significantly compromised their clinical applications. CG258 K. pneumoniae carrying both mcr and tmexCD1-toprJ1 have not been reported. A colistin-resistant strain T698-1 belonging to ST1326, a member of CG258, was isolated from the intestinal sample of a patient and characterized by the antimicrobial susceptibility testing, conjugation assay, WGS and bioinformatics analysis. It was resistant to colistin, tetracycline, aminoglycoside, fluoroqinolone, phenicols, sulfonamide, and some β-lactams, and positive for mcr-8.2, tmexCD1-toprJ1, and ESBL genes (blaDHA–1 and blaCTX–M–15). The tmexCD1-toprJ1 gene cluster was located in an multi-drug resistant (MDR) region flanked by TnAs1 elements on an IncHI1B/FIB plasmid. The genetic context of tmexCD1-toprJ1 was slightly distinct from previously reported Tn5393-like structures, with an IS26 element disrupting the upstream Tn5393 and its adjacent genetic elements. The mcr-8.2 gene was inserted into the backbone of an IncFII/FIA plasmid with the genetic context of ISEcl1-mcr-8.2-orf-ISKpn26. To our knowledge, this is the first report of co-occurrence of mcr-8.2 and tmexCD1-toprJ1 in a CG258 K. pneumoniae strain. Though this strain is tigecycline sensitive, the acquisition of colistin and tigecycline resistance determinants by the endemic CG258 K. pneumoniae clone still poses a serious public health concern. CG258, which became resistant to multiple last resort antibiotics, would be the next emerging superbug.
Consequences of Implementing Neutralizing Buffered Peptone Water in Commercial Poultry Processing on the Microbiota of Whole Bird Carcass Rinses and the Subsequent Microbiological Analyses
Authors: Wages Jennifer A. , Dittoe Dana K. , Feye Kristina M. , Ricke Steven C.
Published: March 2022

In 2016, the United States Department of Agriculture (USDA) Food Safety and Inspection Service (FSIS) established guidelines which modified the Buffered Peptone Water (BPW) rinsate material to include additional compounds that would better neutralize residual processing aids and allow for better recovery of sublethal injured Salmonella spp. cells. While the added compounds improved the recovery of Salmonella spp., specific data to understand how the new rinse agent, neutralizing Buffered Peptone Water (nBPW), impacts the recovery of other microorganisms such as Campylobacter spp. and indicator microorganisms are lacking. Therefore, this study evaluated the impact of rinse solutions (BPW or nBPW) used in Whole Bird Carcass rinsate (WBCR) collections on the subsequent microbiome and downstream culturing methodologies. Carcasses exiting a finishing chiller were rinsed in 400 ml of BPW or nBPW. Resulting rinsates were analyzed for Enterobacteriaceae (EB), Salmonella, and Campylobacter spp. prevalence and total aerobic bacteria (APC) and EB load. The 16S rDNA of the rinsates and the matrices collected from applied microbiological analyses were sequenced on an Illumina MiSeq®. Log10-transformed counts were analyzed in JMP 15 using ANOVA with means separated using Tukey’s HSD, and prevalence data were analyzed using Pearson’s χ2 (P ≤ 0.05). Diversity and microbiota compositions (ANCOM) were analyzed in QIIME 2.2019.7 (P ≤ 0.05; Q ≤ 0.05). There was an effect of rinsate type on the APC load and Campylobacter spp. prevalence (P < 0.05), but not the quantity or prevalence of EB or Salmonella spp. prevalence. There were differences between the microbial diversity of the two rinsate types and downstream analyses (P < 0.05). Additionally, several taxa, including Streptococcus, Lactobacillus, Aeromonas, Acinetobacter, Clostridium, Enterococcaceae, Burkholderiaceae, and Staphylococcaceae, were differentially abundant in paired populations. Therefore, the rinse buffer used in a WBCR collection causes proportional shifts in the microbiota, which can lead to differences in results obtained from cultured microbial populations.
The Development of a Real-Time Recombinase-Aid Amplification Assay for Rapid Detection of African Swine Fever Virus
Authors: Wu Yongshu , Yang Yang , Ru Yi , Qin Xiaodong , Li Miaomiao , Zhang Zhixiong , Zhang Rui , Li Yijing , Zhang Zhidong , Li Yanmin
Published: March 2022

African swine fever (ASF), caused by the African swine fever virus (ASFV), is an acute, deadly, infectious disease of domestic pigs and wild boars and has a tremendous negative socioeconomic impact on the swine industry. ASF is a notifiable disease to the World Organization for Animal Health (OIE). Currently, no effective vaccine or treatment against ASF is available. Early detection and rapid diagnosis are potentially significant to control ASF spread with the emerging ASFV mutant strains and non-classical symptoms. In this study, we developed a real-time recombinase-aid amplification (RAA) assay to detect the ASFV genome rapidly. Thirty samples were detected using commercial lysis buffer for DNA extraction and equipped with a portable testing instrument. The results showed that the sensitivity of RAA was 103 copies per reaction at 95% probability in 9 min at 39°C. The method was universally specific for three strains of ASFV, and there was no cross-reaction with other pathogens, including foot-and-mouth disease virus (FMDV), classical swine fever virus (CSFV), porcine reproductive and respiratory syndrome virus (PRRSV), porcine circovirus 2 (PCV2), pseudorabies virus (PRV), and porcine parvovirus (PPV). The coefficient of variation (C.V) of repetitive experiments was 0%, and the coincidence rate was 100% compared to the real-time qPCR. 123 field samples were detected by the real-time RAA assay, and the results showed that the clinical coincidence rate of the real-time RAA assay was 98% compared to the real-time qPCR assay. The advantages of this method were as follows: the extraction of DNA can be performed on site, the DNA template is directly used, a small battery-powered instrument is easily available, and the on-site diagnostic process is finished within an hour. These suggest that this assay could be used to detect different genotypes of ASFV and play a vital role in the control of ASF.
COVCOG 2: Cognitive and Memory Deficits in Long COVID: A Second Publication From the COVID and Cognition Study
Authors: Guo Panyuan , Benito Ballesteros Alvaro , Yeung Sabine P. , Liu Ruby , Saha Arka , Curtis Lyn , Kaser Muzaffer , Haggard Mark P. , Cheke Lucy G.
Published: March 2022

COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been often characterized as a respiratory disease. However, it is increasingly being understood as an infection that impacts multiple systems, and many patients report neurological symptoms. Indeed, there is accumulating evidence for neural damage in some individuals, with recent studies suggesting loss of gray matter in multiple regions, particularly in the left hemisphere. There are several mechanisms by which the COVID-19 infection may lead to neurological symptoms and structural and functional changes in the brain, and cognitive problems are one of the most commonly reported symptoms in those experiencing Long COVID – the chronic illness following the COVID-19 infection that affects between 10 and 25% of patients. However, there is yet little research testing cognition in Long COVID. The COVID and Cognition Study is a cross-sectional/longitudinal study aiming to understand cognitive problems in Long COVID. The first paper from the study explored the characteristics of our sample of 181 individuals who had experienced the COVID-19 infection, and 185 who had not, and the factors that predicted ongoing symptoms and self-reported cognitive deficits. In this second paper from the study, we assess this sample on tests of memory, language, and executive function. We hypothesize that performance on “objective” cognitive tests will reflect self-reported cognitive symptoms. We further hypothesize that some symptom profiles may be more predictive of cognitive performance than others, perhaps giving some information about the mechanism. We found a consistent pattern of memory deficits in those that had experienced the COVID-19 infection, with deficits increasing with the severity of self-reported ongoing symptoms. Fatigue/Mixed symptoms during the initial illness and ongoing neurological symptoms were predictive of cognitive performance.
Adherence to the United States Department of Agriculture Dietary Recommendations Pre- and During the Coronavirus Disease-19 Pandemic Among Pregnant Women in Arab Countries
Authors: Hoteit Maha , Hoteit Reem , Al-Jawaldeh Ayoub , Abou Nasr Mariane , Obeid Sara , Fakih Chadi , El Hajj Mohamad , Qasrawi Radwan , Abu Seir Rania , Allehdan Sabika , Ismail Mahmoud Samy , Bookari Khlood , Arrish Jamila , Al-Bayyari Nahla , Tayyem Reema
Published: March 2022

During pregnancy, woman’s diet is one of the most preeminent factors affecting mother and child’s health. Prior to the coronavirus disease-19 (COVID-19) pandemic, inadequate maternal diet and low adherence to dietary guidelines was reported among pregnant women in the Arab countries. Nowadays, COVID-19 infection during pregnancy is widely discussed among literature. However, there is limited data on the health impacts of the COVID-19 pandemic on non-infected pregnant women. This substantially larger group also suffered significant lifestyle changes during the lockdown period. The aim of the study is to characterize dietary patterns, intake and adherence to the United States Department of Agriculture (USDA) pregnancy guidelines before and during the COVID-19 pandemic in Arab pregnant women. Using a specially designed questionnaire and using the snowball sampling method, the survey was carried out among a convenient sample of 1,939 pregnant women from five Arab countries. Our study found an increment in the consumption of cereals, fruits, vegetables, dairy products, meats, and nuts that occurred during the pandemic compared to the preceding period. Despite this noticeable increase during the pandemic, the Arab pregnant women in this study had significantly lower adherence to the USDA pregnancy guidelines. The daily consumption of almost all food groups was lower than the USDA’s daily recommendations, except for fruits intake, which was higher than the daily standard. Demonstrated poor adherence to prenatal USDA dietary guidelines by Arab pregnant women can lead to numerous deficiencies and health risks among their offspring. In conclusion, our study showed that before and during the COVID-19 pandemic, poor adherence to dietary recommendations occurred in a considerable number of Arab pregnant women. The findings emphasize the need for nutritional education and intervention during prenatal visits.
Dietary Phosphorus Reduced Hepatic Lipid Deposition by Activating Ampk Pathway and Beclin1 Phosphorylation Levels to Activate Lipophagy in Tilapia Oreochromis niloticus
Authors: Liu Xiangyuan , Zhao Tao , Wei Xiaolei , Zhang Dianguang , Lv Wuhong , Luo Zhi
Published: March 2022

High-phosphorus diet (HPD) reduces lipid deposition and significantly influences lipid metabolism. However, the relevant mechanism is unknown. Herein, using widely-cultured teleost tilapia Oreochromis niloticus as the experimental animals, we found that HPD and Pi incubation reduced triglyceride (TG) content (P ≤ 0.05), suppressed lipogenesis, activated AMP-activated protein kinase (AMPK) pathway and autophagy (P ≤ 0.05), and increased fatty acid β-oxidation and lipolysis in tilapia liver and hepatocytes (P ≤ 0.05). Our further investigation indicated that Pi treatments activated the lipophagy and facilitated mitochondrial fatty acid β-oxidation, and according reduced TG deposition (P ≤ 0.05). Mechanistically, phosphorus increased the AMPKα1 phosphorylation level at S496 and Beclin1 phosphorylation at S90, and Beclin1 phosphorylation by AMPKα1 was required for phosphorus-induced lipophagy and lipolysis. Our study revealed a mechanism for Beclin1 regulation and autophagy induction in response to high-phosphorus diet, and provided novel evidences for the link between dietary phosphorus addition and lipolytic metabolism via the AMPK/Beclin1 pathway. Our results also suggested that AMPK should be the potential target for the prevention and control of lipid metabolic disorders. Overall, these results suggested that HPD reduced hepatic lipid deposition by activating AMPK pathway and Beclin1 phosphorylation levels to activate lipophagy, which provided potential targets for the prevention and control of fatty liver in fish.