bluuebunny/crossref_metadata_2025 huggingface dataset:
GUNC: detection of chimerism and contamination in prokaryotic genomes
Authors: Orakov Askarbek , Fullam Anthony , Coelho Luis Pedro , Khedkar Supriya , Szklarczyk Damian , Mende Daniel R. , Schmidt Thomas S. B. , Bork Peer
Published: June 2021

Genomes are critical units in microbiology, yet ascertaining quality in prokaryotic genome assemblies remains a formidable challenge. We present GUNC (the Genome UNClutterer), a tool that accurately detects and quantifies genome chimerism based on the lineage homogeneity of individual contigs using a genome’s full complement of genes. GUNC complements existing approaches by targeting previously underdetected types of contamination: we conservatively estimate that 5.7% of genomes in GenBank, 5.2% in RefSeq, and 15–30% of pre-filtered “high-quality” metagenome-assembled genomes in recent studies are undetected chimeras. GUNC provides a fast and robust tool to substantially improve prokaryotic genome quality.
Impact of a mobile phone-based interactive voice response software on tuberculosis treatment outcomes in Uganda (CFL-TB): a protocol for a randomized controlled trial
Authors: Byonanebye Dathan Mirembe , Mackline Hope , Sekaggya-Wiltshire Christine , Kiragga Agnes N. , Lamorde Mohammed , Oseku Elizabeth , King Rachel , Parkes-Ratanshi Rosalind
Published: June 2021

Background

Throughout the last decade, tuberculosis (TB) treatment success has not surpassed 90%, the global target. The impact of mobile health interventions (MHIs) on TB treatment outcomes is unknown, especially in low- and middle-income countries (LMICs). MHIs, including interactive voice response technology (IVRT), may enhance adherence and retention in the care of patients with tuberculosis and improve TB treatment outcomes. This study seeks to determine the impact of IVRT-based MHI on TB treatment success (treatment completion and cure rates) in patients with TB receiving care at five public health facilities in Uganda.

Methods

We used a theory-based and human-centered design (HCD) to adapt an already piloted software to design “Call for life-TB” (CFL-TB), an MHI that utilizes IVRT to deliver adherence and appointment reminders and allows remote symptom reporting. This open-label, multicenter, randomized controlled trial (RCT), with nested qualitative and economic evaluation studies, will determine the impact of CFL-TB on TB treatment success in patients with drug-susceptible TB in Uganda. Participants (n = 274) at the five study sites will be randomized (1:1 ratio) to either control (standard of care) or intervention (adherence and appointment reminders, and health tips) arms. Multivariable regression models will be used to compare treatment success, adherence to treatment and clinic appointments, and treatment completion at 6 months post-enrolment. Additionally, we will determine the cost-effectiveness, acceptability, and perceptions of stakeholders. The study received national ethical approval and was conducted in accordance with the international ethical guidelines.

Discussion

This randomized controlled trial aims to evaluate interactive voice response technology in the context of resource-limited settings with a high burden of TB and high illiteracy rates. The software to be evaluated was developed using HCD and the intervention was based on the IMB model. The software is tailored to the local context and is interoperable with the MHI ecosystem. The HCD approach ensures higher usability of the MHI by integrating human factors in the prototype development. This research will contribute towards the understanding of the implementation and impact of the MHI on TB treatment outcomes and the health system, especially in LMICs.

Trial registration

ClinicalTrials.govNCT04709159. Registered on January 14, 2021.
Excretion of Histomonas meleagridis following experimental co-infection of distinct chicken lines with Heterakis gallinarum and Ascaridia galli
Authors: Daş Gürbüz , Wachter Lukas , Stehr Manuel , Bilic Ivana , Grafl Beatrice , Wernsdorf Patricia , Metges Cornelia C. , Hess Michael , Liebhart Dieter
Published: June 2021

Background

Histomonosis is a severe re-emerging disease of poultry caused by Histomonas meleagridis, a protozoan parasite which survives in the environment via the cecal worm Heterakis gallinarum. Following infection, the parasites reside in the ceca and are excreted via host feces. In the present work, male birds of conventional broiler (Ross 308, R), layer (Lohmann Brown Plus, LB) and a dual-purpose (Lohmann Dual, LD) chicken line were infected with 250 embryonated eggs of Ascaridia galli and Heterakis gallinarum, respectively, with the latter nematode harboring Histomonas meleagridis, to investigate a co-infection of nematodes with the protozoan parasite in different host lines.

Methods

In weekly intervals, from 2 to 9 weeks post infection (wpi), individual fecal samples (n = 234) from the chickens were collected to quantify the excretion of H. meleagridis by real-time PCR and to determine the number of nematode eggs per gram (EPG) in order to elucidate excretion dynamics of the flagellate and the nematodes. This was further investigated by indirect detection using plasma samples of the birds to detect antibodies specific for H. meleagridis and worms by ELISA. The infection with H. meleagridis was confirmed by histopathology and immunohistochemistry to detect the flagellate in the cecum of representing birds.

Results

The excretion of H. meleagridis could already be observed from the 2nd wpi in some birds and increased to 100% in the last week of the experiment in all groups independent of the genetic line. This increase could be confirmed by ELISA, even though the number of excreted H. meleagridis per bird was generally low. Overall, histomonads were detected in 60% to 78% of birds with temporary differences between the different genetic lines, which also showed variations in the EPG and worm burden of both nematodes.

Conclusions

The infection with H. gallinarum eggs contaminated with H. meleagridis led to a permanent excretion of the flagellate in host feces. Differences in the excretion of H. meleagridis in the feces of genetically different host lines occurred intermittently. The excretion of the protozoan or its vector H. gallinarum was mostly exclusive, showing a negative interaction between the two parasites in the same host.

Graphic abstract
Peak week recommendations for bodybuilders: an evidence based approach
Authors: Escalante Guillermo , Stevenson Scott W. , Barakat Christopher , Aragon Alan A. , Schoenfeld Brad J.
Published: June 2021

Bodybuilding is a competitive endeavor where a combination of muscle size, symmetry, “conditioning” (low body fat levels), and stage presentation are judged. Success in bodybuilding requires that competitors achieve their peak physique during the day of competition. To this end, competitors have been reported to employ various peaking interventions during the final days leading to competition. Commonly reported peaking strategies include altering exercise and nutritional regimens, including manipulation of macronutrient, water, and electrolyte intake, as well as consumption of various dietary supplements. The primary goals for these interventions are to maximize muscle glycogen content, minimize subcutaneous water, and reduce the risk abdominal bloating to bring about a more aesthetically pleasing physique. Unfortunately, there is a dearth of evidence to support the commonly reported practices employed by bodybuilders during peak week. Hence, the purpose of this article is to critically review the current literature as to the scientific support for pre-contest peaking protocols most commonly employed by bodybuilders and provide evidence-based recommendations as safe and effective strategies on the topic.
Does the epigenetic clock GrimAge predict mortality independent of genetic influences: an 18 year follow-up study in older female twin pairs
Authors: Föhr Tiina , Waller Katja , Viljanen Anne , Sanchez Riikka , Ollikainen Miina , Rantanen Taina , Kaprio Jaakko , Sillanpää Elina
Published: June 2021

Background

Epigenetic clocks are based on DNA methylation (DNAm). It has been suggested that these clocks are useable markers of biological aging and premature mortality. Because genetic factors explain variations in both epigenetic aging and mortality, this association could also be explained by shared genetic factors. We investigated the influence of genetic and lifestyle factors (smoking, alcohol consumption, physical activity, chronic diseases, body mass index) and education on the association of accelerated epigenetic aging with mortality using a longitudinal twin design. Utilizing a publicly available online tool, we calculated the epigenetic age using two epigenetic clocks, Horvath DNAmAge and DNAm GrimAge, in 413 Finnish twin sisters, aged 63–76 years, at the beginning of the 18-year mortality follow-up. Epigenetic age acceleration was calculated as the residuals from a linear regression model of epigenetic age estimated on chronological age (AAHorvath, AAGrimAge, respectively). Cox proportional hazard models were conducted for individuals and twin pairs.

Results

The results of the individual-based analyses showed an increased mortality hazard ratio (HR) of 1.31 (CI95: 1.13–1.53) per one standard deviation (SD) increase in AAGrimAge. The results indicated no significant associations of AAHorvathwith mortality. Pairwise mortality analyses showed an HR of 1.50 (CI95: 1.02–2.20) per 1 SD increase in AAGrimAge. However, after adjusting for smoking, the HR attenuated substantially and was statistically non-significant (1.29; CI95: 0.84–1.99). Similarly, in multivariable adjusted models the HR (1.42–1.49) was non-significant. In AAHorvath, the non-significant HRs were lower among monozygotic pairs in comparison to dizygotic pairs, while in AAGrimAgethere were no systematic differences by zygosity. Further, the pairwise analysis in quartiles showed that the increased within pair difference in AAGrimAgewas associated with a higher all-cause mortality risk.

Conclusions

In conclusion, the findings suggest that DNAm GrimAge is a strong predictor of mortality independent of genetic influences. Smoking, which is known to alter DNAm levels and is built into the DNAm GrimAge algorithm, attenuated the association between epigenetic aging and mortality risk.
ScrumOntoBDD: Agile software development based on scrum, ontologies and behaviour-driven development
Authors: Lopes de Souza Pedro , Lopes de Souza Wanderley , Ferreira Pires Luís
Published: June 2021

When developing a Learning Management System (LMS) using Scrum, we noticed that it was quite often necessary to redefine some system behaviour scenarios, due to ambiguities in the requirement specifications, or due to misinterpretations of stories reported by the Product Owners (POs). The definition of test suites was also cumbersome, resulting in test suites that were incomplete or did not at all comply with the system requirements. Based on this experience and to deal with these problems, in this paper, we propose the ScrumOntoBDD approach to agile software development, which combines Scrum, ontologies and Behaviour-Driven Development (BDD). This approach is centred on the concepts and techniques of Scrum and BDD and focuses on the planning and analysis phases of the software life cycle, since the BDD tools currently provide little support to these phases, while most of the problems during the LMS development were found exactly there. We claim that our approach improves the software development practices in this respect. Furthermore, ScrumOntoBDD employs ontologies in order to reduce ambiguities intrinsic to the use of a natural language as a BDD ubiquitous language. In this paper, we illustrate and systematically evaluate our approach, showing that it is beneficial since it improves the communication between members of an agile development team.
Network meta-analysis of short-term effects of different strategies in the conservative treatment of AIS
Authors: Li Kepeng , Miao Jun , Zhang Jingan
Published: June 2021

Purpose

To evaluate the short-term effects of different conservative treatments on in adolescent idiopathic scoliosis.

Methods

By searching the relevant literature of adolescent idiopathic scoliosis, the curative effects of the three regimens of bracing therapy combined with scoliosis-specific exercises, simple treatment with brace and simple scoliosis-specific exercises were compared. Review manager 5.3, Stata MP16 and Network software packages were used for Reticular Meta-analysis of Cobb’s angles before and after treatment.

Results

A total of 364 patients were included in four clinical studies. Reticular meta-analysis showed that the short-term effect of bracing treatment combined with scoliosis-specific exercises was better than that of treatment with brace and scoliosis-specific exercises, with effects of 2.71(95% CI 0.83–4.58) and 3.67(95% CI 1.21–6.14), respectively. There was no statistical difference between simple bracing therapy and scoliosis-specific exercises.

Conclusion

Among the three common conservative treatments of adolescent idiopathic scoliosis, the short-term effect of bracing treatment combined with scoliosis-specific exercises is better than that of bracing treatment or scoliosis-specific exercises.
Organizational forms and technical efficiency of the dairy processing industry in Southern Brazil
Authors: Beber Caetano Luiz , Lakner Sebastian , Skevas Ioannis
Published: June 2021

The objective of this article is to assess the determinants of the technical efficiency of dairy processing firms in Southern Brazil while accounting for their different organizational forms, namely cooperatives and investor-owned firms. The data from 243 milk processors in southern Brazil, including firm structure, management capacity, and organizational choice of dairies, were analyzed. A production frontier is specified to estimate technical efficiency and identify its potential driving sources. Bayesian techniques are used to estimate the model. An average efficiency of 77% indicates that the actual output is 23% below its potential, which implies that output could, on average, be increased by approximately 31.6%, under ceteris paribus conditions. Economies of scale were also detected. The analysis reveals that the management capacity within companies is the main determinant of efficiency. Idle capacities of processing plants are an important source of inefficiencies and cooperatives are more efficient than investor-owned firms, despite their transaction costs potentially being higher and the five vaguely defined property rights inherent to the traditional cooperatives which they must overcome. Knowledge about the cooperatives’ objectives other than profit maximization would provide a more realistic comparison against investor-owned firms. This study assessed the determinants of the efficiency levels of dairy processing companies in an emerging economy using a unique own dataset with data collected at a plant level. Based on the results, manifold managerial and political implications have been derived that can benefit the dairy industry of developing and emerging economies.
Whole exome sequencing reveals a novel LRBA mutation and clonal hematopoiesis in a common variable immunodeficiency patient presented with hemophagocytic lymphohistiocytosis
Authors: Ren Yanling , Xiao Feng , Cheng Fei , Huang Xin , Li Jianhu , Wang Xiaogang , Lang Wei , Zhou Xinping , Lan Jianping , Tong Hongyan
Published: June 2021

Common variable immunodeficiency (CVID) was a kind of primary immunodeficiency disorders with heterogeneous phenotype and genotype. Lipopolysaccharide-responsive and beige-like anchor (LRBA) mutation was identified as disease associated in CVID, advanced genetic method will help to detect atypical cases. We report a case of adult patient manifested as hemophagocytic lymphohistiocytosis (HLH), bone marrow examination suggested prosperity to MDS, manifested as increased immature myeloid cells and dysplastic hematopoiesis. Whole exome sequencing (WES) identified a novel heterogeneous c.1876T > C (p.W626R) mutation in LRBA and four somatic mutations: ASXL1 (c.1967dupA); PTPN11 (c.226G > A), U2AF1 (c.101C > T and c.470A > G), among which ASXL1 was a high-risk marker of clonal hematopoiesis. Combined with her recurrent severe infections and immune abnormalities such as hypoimmunoglobulinemia, the patient was diagnosed with CVID. Subsequent hematopoietic stem cell transplantation saved her from severe cytopenia and immune deficiency. This case report highlights the great promise of utilization of WES for diagnosing rare disease with atypical manifestations and guiding further treatment.
Assessment of safety and tolerability of remogliflozin etabonate (GSK189075) when administered with total daily dose of 2000 mg of metformin
Authors: Dobbins Robert , Hussey Elizabeth K. , O’Connor-Semmes Robin , Andrews Susan , Tao Wenli , Wilkison William O. , Cheatham Bentley , Sagar Katare , Hanmant Barkate
Published: June 2021

Background

Patients with type 2 diabetes mellitus (T2DM) are characterized by an elevated glycemic index and are at a higher risk for complications such as cardiovascular disease, nephropathy, retinopathy and peripheral neuropathy. Normalization of glycemic index can be achieved by dosing combinations of metformin with other anti-diabetic drugs. The present study (Clintrials number NCT00519480) was conducted to evaluate the safety, tolerability, pharmacokinetics and pharmacodynamics of remogliflozinetabonate, an SGLT2 inhibitor, withdoses (500 mg and 750 mg BID) greater than the commercial dose (100 mg BID)in combination with metformin with minimum daily dose of 2000 mg given in two divided doses.

Methods

This was a randomized, double-blinded, repeat dose study in 50 subjects with T2DM. The study was conducted in three phases; run-in, randomization, and treatment. All subjects were on a stable metformin dosing regimen. Cohort 1 subjects were randomly allocated to receive either remogliflozin etabonate 500 mg BID or placebo BID (2:1) in addition to metformin. Cohort 2 subjects were administered with either remogliflozin etabonate 750 mg BID or placebo BID (2:1) in addition to metformin for 13 days. All the subjects were assessed for safety (adverse events, lactic acid levels, vital signs, electrocardiogram [ECG]), pharmacokinetic evaluation, and pharmacodynamics (Oral Glucose Tolerance Testing) parameters.

Results

Co-administration of remogliflozin etabonate and metformin was well tolerated in all subjects during the observation period. There were no severe or serious adverse events (SAEs) and no increase in lactic acid concentration was reported during the study. The statistical results showed that concomitant administration of remogliflozin etabonate, either 500 mg or 750 mg BID, with metformin had no effect on the pharmacokinetics of metformin. The accumulation ratios, Day 13 vs. Day 1, for AUC values of remogliflozin etabonate and its metabolites were all very close to 1, indicating no accumulation in plasma concentrations of remogliflozin etabonate and its metabolites. Mean glucose values from baseline and glucose and insulin values following oral glucose tolerance test (OGTT) were decreased in all treatment groups.

Conclusion

Co-administration of doses of remogliflozin etabonate (500 mg BID or 750 mg BID) greater than the commercial dose (100 mg BID) with metformin (2000 mg BID) was shown to be safe and effective during the observation period.

Trial registration

ClinicalTrials.gov, NCT00519480. Registered:22 August 2007.
Far eastern curlew and whimbrel prefer flying low - wind support and good visibility appear only secondary factors in determining migratory flight altitude
Authors: Galtbalt Batbayar , Lilleyman Amanda , Coleman Jonathan T. , Cheng Chuyu , Ma Zhijun , Rogers Danny I. , Woodworth Bradley K. , Fuller Richard A. , Garnett Stephen T. , Klaassen Marcel
Published: June 2021

Background

In-flight conditions are hypothesized to influence the timing and success of long-distance migration. Wind assistance and thermal uplift are thought to reduce the energetic costs of flight, humidity, air pressure and temperature may affect the migrants’ water balance, and clouds may impede navigation. Recent advances in animal-borne long-distance tracking enable evaluating the importance of these factors in determining animals’ flight altitude.

Methods

Here we determine the effects of wind, humidity, temperature, cloud cover, and altitude (as proxy for climbing costs and air pressure) on flight altitude selection of two long-distance migratory shorebirds, far eastern curlew (Numenius madagascariensis) and whimbrel (Numenius phaeopus). To reveal the predominant drivers of flight altitude selection during migration we compared the atmospheric conditions at the altitude the birds were found flying with conditions elsewhere in the air column using conditional logistic mixed effect models.

Results

Our results demonstrate that despite occasional high-altitude migrations (up to 5550 m above ground level), our study species typically forego flying at high altitudes, limiting climbing costs and potentially alleviating water loss and facilitating navigation. While mainly preferring migrating at low altitude, notably in combination with low air temperature, the birds also preferred flying with wind support to likely reduce flight costs. They avoided clouds, perhaps to help navigation or to reduce the risks from adverse weather.

Conclusions

We conclude that the primary determinant of avian migrant’s flight altitude selection is a preference for low altitude, with wind support as an important secondary factor. Our approach and findings can assist in predicting climate change effects on migration and in mitigating bird strikes with air traffic, wind farms, power lines, and other human-made structures.
The time is now: why we must identify and address health disparities in sport and recreation injury
Authors: Baker Charlotte , Chinaka Oziomachukwu , Stewart Elizabeth C.
Published: June 2021

Background

Social and structural determinants of health (SDOH) are the conditions in which individuals are born, live, learn, work, play, worship, and age. These drivers of health are integral in contextualizing the understanding and prevention of sport and recreation injury (SRI), and recognizing their impact is necessary to provide a complete and accurate picture of health and health outcomes related to injury.

Main

Reducing disparities and achieving equity in sports and recreation is possible in part by improving data collection methodologies and utilization. Often, many SDOH have considerable effect on SRI. Although SRI epidemiology frequently examines differences by sex, there is limited inclusion of factors such as socioeconomic status, housing, gender, and food security, in sport specific data sources or in analysis of sport recreation and injury using other sources (e.g. administrative data). The ongoing dual epidemics in the United States – racism and COVID-19 – have emphasized the importance of having and utilizing SDOH data to reduce the burden of injury and disproportionate effects on our diverse population.

Conclusion

Moving forward, to address disparities in SRI, SDOH must be included as a part of research priorities, health related goals, and policies. This difference can be made in developing consistency in data collection and utilization. This will provide an accurate picture of the intersections and interdisciplinary changes required to design the best approach to problems to develop solutions. Future data collection and utilization should prioritize SDOH.
Recognition and management of rapid-onset gluten ataxias: case series
Authors: Newrick Laurence , Hoggard Nigel , Hadjivassiliou Marios
Published: June 2021

Background

Most immune-mediated cerebellar ataxias, including those associated with gluten sensitivity (Gluten Ataxia), tend to present subacutely and usually progress gradually. Acute presentations with rapid progression outside the context of paraneoplastic cerebellar degeneration require prompt diagnosis and early access to disease-modifying immunotherapy in order to avert severe and permanent neurological disability.

Case presentations

We describe three cases of rapid-onset Gluten Ataxia, an immune-mediated cerebellar ataxia due to gluten sensitivity. We detail their presentation, clinical and neuroimaging findings, and our treatment strategy with immunotherapy.

Conclusions

Our cases highlight the potential for immune-mediated cerebellar ataxias to present acutely, with rapid-onset symptoms and devastating neurological consequences. We caution against the diagnosis of ‘post-infective cerebellitis’ in adults, and advocate early consideration of an immune-mediated cerebellar ataxia and initiation of immunotherapy to prevent irreversible cerebellar damage.
Immediate implant-retained prosthetic obturation after maxillectomy based on zygomatic implant placement by 3D-guided surgery: a cadaver study
Authors: Vosselman N. , Glas H. H. , de Visscher S. A. H. J. , Kraeima J. , Merema B. J. , Reintsema H. , Raghoebar G. M. , Witjes M. J. H.
Published: June 2021

Background

The aim of this study was to introduce a complete 3D workflow for immediate implant retained prosthetic rehabilitation following maxillectomy in cancer surgery. The workflow consists of a 3D virtual surgical planning for tumor resection, zygomatic implant placement, and for an implant-retained prosthetic-obturator to fit the planned outcome situation for immediate loading.

Materials and methods

In this study, 3D virtual surgical planning and resection of the maxilla, followed by guided placement of 10 zygomatic implants, using custom cutting and drill/placement-guides, was performed on 5 fresh frozen human cadavers. A preoperatively digitally designed and printed obturator prosthesis was placed and connected to the zygomatic implants. The accuracy of the implant positioning was obtained using 3D deviation analysis by merging the pre- and post-operative CT scan datasets.

Results

The preoperatively designed and manufactured obturator prostheses matched accurately the per-operative implant positions. All five obturators could be placed and fixated for immediate loading. The mean prosthetic point deviation on the cadavers was 1.03 ± 0.85 mm; the mean entry point deviation was 1.20 ± 0.62 mm; and the 3D angle deviation was 2.97 ± 1.44°.

Conclusions

It is possible to 3D plan and accurately execute the ablative surgery, placement of zygomatic implants, and immediate placement of an implant-retained obturator prosthesis with 3D virtual surgical planning.The next step is to apply the workflow in the operating room in patients planned for maxillectomy.
Method comparison of Particle Enhanced Immunoturbidimetry (PEIT) with High Performance Liquid Chromatography (HPLC) for glycated hemoglobin (HbA1c) analysis
Authors: Dildar Shabnam , Imran Sheharbano , Naz Farah
Published: June 2021

Background and objective

High Performance Liquid Chromatography (HPLC) technique is considered as a gold standard for HbA1c analysis however all laboratories cannot adopt it due to certain limitations. Our aim was to compare Particle Enhanced Immunoturbidimetry (PEIT) method with High Performance Liquid Chromatography (HPLC) for HbA1c analysis.

Method

All blood samples were analyzed by HPLC assay on a Bio-Rad D-10 analyzer and PEIT on an Erba XL-200 analyzer. Precision studies were undertaken and Coefficient of Variation (%CV) calculated. Systemic Error (SE), Random Error (RE) and Total Error (TEcalc) were obtained. The Total Allowable Error (TEa) set by the National Glycohemoglobin Standardization Program (NGSP) for HbA1c is 6%.The acceptable evaluation method is where TEcalc is less than TEa.

Results

The Precision studies were satisfactory with Coefficient of Variation (%CV) being less than 4% for both techniques. Mean HbA1c levels were slightly higher from HPLC than PEIT 9.07 ± 2.23% and 8.93 ± 2.10% respectively, although the difference was minimal. RE was 1.41%, TEcalc was 1.55%, which was less than TEa set by the NGSP. Both methods strongly correlated with the correlation coefficient (r) 0.9716, p < 0.0001.

Conclusion

Our study showed HbA1c analysis by PEIT technique is precise, accurate, rapid and convenient and can be employed as an alternative to HPLC technique in countries where cost is a major problem for diagnosis and treatment.
Quantum dash multi-wavelength lasers for Tbit/s coherent communications and 5G wireless networks
Authors: Lu Zhenguo , Liu Jiaren , Mao Youxin , Zeb Khan , Liu Guocheng , Poole Philip J. , Weber John , Rahim Mohamed , Pakulski Grzegorz , Song Chunying , Vachon Martin , Barrios Pedro , Poitras Daniel , Wang Shurui , Jiang Weihong
Published: June 2021

We report on the design, growth, fabrication, and performance of InAs/InP quantum dash (QD) multi-wavelength lasers (MWLs) developed by the National Research Council (NRC) Canada. The key technical specifications investigated include optical and RF beating spectra, relative intensity noise (RIN), and optical phase noise of each individual wavelength channel. Data bandwidth transmission capacity of 5.376 Tbit/s and 10.8 Tbit/s respectively in the PAM-4 and 16-QAM modulation formats are demonstrated using only a single C-band QD 34.2-GHz MWL chip. We have also developed a monolithic InAs/InP QD dual-wavelength (DW) DFB laser as a compact optical beat source to generate millimeter-wave (MMW) signals. Due to the common cavity, highly coherent and correlated optical modes with optical linewidth as low as 15.83 kHz, spectrally pure MMW signals around 46.8 GHz with a linewidth down to 26.1 kHz were experimentally demonstrated. By using this QD DW-DFB laser, a one GBaud (2 Gbps) MMW over-fiber transmission link is demonstrated with PAM-4 signals. The results show that the demonstrated device is suitable for high speed high capacity MMW fiber-wireless integrated fronthaul of 5G networks.
Intravenous thrombolysis outcome in posterior vs anterior circulation stroke in a tertiary stroke center in Egypt
Authors: Taha Nourhan Abdelmohsen , El Khawas Hala , Tork Mohamed Amir , Roushdy Tamer M.
Published: June 2021

Background

Intravenous thrombolysis (IVT) with alteplase is the first-line therapy for acute ischemic anterior and posterior circulation strokes (ACS and PCS).

Knowledge about safety and efficacy of IVT in posterior circulation stroke is deficient as most of the Egyptian studies either assessed IVT outcome in comparison to conservative therapy or its outcome in anterior circulation stroke only.

Therefore, our aim was to compare the relative frequency and outcome after intravenous thrombolysis in anterior versus posterior circulation stroke patients presenting to stroke centers of Ain Shams University hospitals (ASUH).

Results

A total of 238 anterior circulation stroke and 61 posterior circulation strokes were enrolled, onset-to-door and door-to-needle time were statistically insignificant.

NIHSS showed comparable difference at all time points despite higher scores along anterior circulation stroke; 90-day modified Rankin Scale (mRS) showed significant improvement in both groups from mRS >2 to ≤2 with a better percentage along posterior circulation stroke patients.

There was insignificant difference for either incidence of death or intracranial hemorrhage (ICH) between the two groups.

Conclusion

IVT significantly reduced NIHSS for both anterior and posterior circulation stroke along different studied time points. Meanwhile, a higher percentage of patients with posterior circulation stroke had a better mRS outcome at 90 days.
Mineralogical and geochemical studies on soils and Nile bottom sediments of Luxor–Aswan area, South Egypt
Authors: Abou El-Anwar Esmat A.
Published: June 2021

Background

The geochemical studies on the rare earth elements to demonstrate sources of the toxic metals for soils and Nile sediments for Aswan area are seldom.

Results

Minerallogically, the studied soil agriculture samples consist mainly of quartz (42%), clay minerals (33%), plagioclase (20%) and magnesin-calcite (5%). Clay minerals are composed of montmorillonite as bentonite. The studied Nile sediments consist mainly of quartz (75%), clay minerals (15%), plagioclase (5%) and calcite (5%). Clay minerals are composed of calcian-montmorillonite (10%) and Kaolinite (5%). Geochemically, the chemical analytical techniques of the environment-sensitive elements, including Pb, Cd, As, Ni, Co, Cu, Cr, Zn, U and Th, have been performed for agricultural soils and sediments of Aswan–Luxor District to assess the geochemical characteristics of these elements and their impact on soil environmental and plant, as well as their provenance.

Conclusions

Average content of Cd was about 1.5-fold for the studied Nile sediments and slightly higher soil agriculture than (MPL). Pb and Cr average contents twofold of (MPL) for Nile sediments and Cr average of soil is represented 2.5-fold of (MPL). The average content of As, Cu, Co, Ni and U in both Nile sediments and cultivated soil in the studied area is lower than the maximum permissible limit (MPL). Average content of Pb, Zn and Cr was about 2, 2- and 2.5-fold, respectively, according to USPHS for the Nile sediments and threefold of Cr for the agriculture soils. The agricultural soil of Luxor–Aswan district is characteristic highly enrichment of As, Co, Zn, Cu, Ni, Mn, U and Th than those of the Nile sediments. In addition, the Nile sediments have high concentration average of Cr, Zn, Mn and Pb and low contamination of the other elements. The sources of the toxic metals in the studied area may probably be natural or anthropogenic. The anthropogenic source is resulting from paper, Ferrosilicon factories and Phosphate mines at Edfu, as well as Sand quarry, Shale mine and the Nitrogen Fertilizer factory at Aswan. In addition, natural sources such as waste of the drains floods.
Complementary feeding pattern and its impact on growth and development of under 2-years infants in upper Egypt
Authors: El-Asheer Osama M. , Darwish Manal M. , Abdullah Ahmed M. , Mohamad Hanaa A.
Published: June 2021

Background

Exclusive BF till the age of 6 months is rare in developing countries and complimentary feeding (CF) are introduced at an early age which is linked to the development of chronic conditions such as childhood obesity, celiac disease, diabetes, and eczema. The aim of our work is to assess complementary feeding practices of infants under the age of 2 years and to study their impact on their growth and development. This study is a cross-sectional study that was carried out over 3 years between March 2016 and March 2019, included 1000 apparently healthy infants aged less than 2 years old who attended University Children Hospital, Egypt. Practices among mothers including timing and types of foods introduced. Semi-structured questionnaire used for data collection and anthropometric measurements analyzed following the WHO Growth Charts.

Results

The study found that about 80% of infants were introduced to solid foods before 4 months of age. Also, a large number of infants were given liquids other than breast milk before completing their fourth month of age.

Conclusion

Despite the better mental development of the infants, there is a considerable gap between WHO Guiding Principles for Complementary Feeding and the practices among mothers of infants aged less than 2 years in Egypt.
Foreign direct investment and poverty reduction in sub-Saharan Africa: does environmental degradation matter?
Authors: Dada James Temitope , Akinlo Taiwo
Published: June 2021

This paper investigates the threshold effect of environmental degradation on the FDI-poverty nexus in sub-Saharan Africa for the period 1986–2018. The study used panel threshold regression for the empirical analysis. The evidence from threshold regression using different measures of poverty and environmental degradation shows that the poverty reduction effect of FDI is not eroded by environmental degradation. The study found overwhelming evidence that at the higher level of environmental degradation, FDI contributes significantly to poverty reduction except when Household final consumption is used to proxy poverty and FDI produces an insignificant effect on poverty reduction at the higher level of methane emissions and nitrous oxide emission. Based on this finding, any attempts to reduce environmental degradation by reducing the inflow of FDI will worsen poverty rates in the region.
A High-throughput Approach to Identify Effective Systemic Agents for the Treatment of Anaplastic Thyroid Carcinoma
Authors: Henderson Ying C , Mohamed Abdallah S R , Maniakas Anastasios , Chen Yunyun , Powell Reid T , Peng Shaohua , Cardenas Maria , Williams Michelle D , Bell Diana , Zafereo Mark E , Wang Rui Jennifer , Scherer Steve E , Wheeler David A , Cabanillas Maria E , Hofmann Marie-Claude , Johnson Faye M , Stephan Clifford C , Sandulache Vlad , Lai Stephen Y
Published: June 2021

Background

Despite the use of aggressive multimodality treatment, most anaplastic thyroid carcinoma (ATC) patients die within a year of diagnosis. Although the combination of BRAF and MEK inhibitors has recently been approved for use in BRAF-mutated ATC, they remain effective in a minority of patients who are likely to develop drug resistance. There remains a critical clinical need for effective systemic agents for ATC with a reasonable toxicity profile to allow for rapid translational development.

Material and Methods

Twelve human thyroid cancer cell lines with comprehensive genomic characterization were used in a high-throughput screening (HTS) of 257 compounds to select agents with maximal growth inhibition. Cell proliferation, colony formation, orthotopic thyroid models, and patient-derived xenograft (PDX) models were used to validate the selected agents.

Results

Seventeen compounds were effective, and docetaxel, LBH-589, and pralatrexate were selected for additional in vitro and in vivo analysis as they have been previously approved by the US Food and Drug Administration for other cancers. Significant tumor growth inhibition (TGI) was detected in all tested models treated with LBH-589; pralatrexate demonstrated significant TGI in the orthotopic papillary thyroid carcinoma model and 2 PDX models; and docetaxel demonstrated significant TGI only in the context of mutant TP53.

Conclusions

HTS identified classes of systemic agents that demonstrate preferential effectiveness against aggressive thyroid cancers, particularly those with mutant TP53. Preclinical validation in both orthotopic and PDX models, which are accurate in vivo models mimicking tumor microenvironment, may support initiation of early-phase clinical trials in non-BRAF mutated or refractory to BRAF/MEK inhibition ATC.
Treatment options for soft tissue defects in severe foot trauma in children
Authors: Klein Céline , Marie-Christine Plancq , Deroussen François , Haraux Elodie , Gouron Richard
Published: June 2021

Objective:

Severe foot trauma in children is a therapeutic challenge, with presence of devitalised and soiled distal tissues. Several reconstruction and covering procedures can be applied, including artificial dermis (AD), negative pressure wound therapy (NPWT), fasciocutaneous flaps and free flaps. Here, we have developed and evaluated an algorithm for treating severe foot injuries with skin defects in children

Method:

Paediatric cases of severe foot injury treated over a 16-year period were retrospectively reviewed. Characteristics of the injuries, surgical procedures, complications and the modified Kitaoka score (clinical and functional rating score of the ankle and foot) were recorded.

Results:

A total of 18 children were included. The mean age at the time of injury was four years and 10 months (range: 1–11 years). The mean follow-up period was 6.2 years. Of the children, 13 presented with an amputation (12 partial foot amputations and one whole ankle and foot). The skin defect was combined with tendon exposure in nine cases, and/or bone and cartilage in seven cases, and heel damage in two cases. A flap was implemented in eight cases, of which one failed. NPWT was used in 13 patients (for an average of 21 days) and was combined with AD in six patients. The mean modified Kitaoka score was 68 (range: 55–80). Additional surgery during the follow-up period was required in seven patients (dorsal skin retraction, a thick flap, osteoma, trophic ulcer or ankle deviation).

Conclusion:

Our algorithm suggests different therapeutic strategies for skin coverage and healing, depending on the size of the lesion and the exposed structures, and seems to offer good results. These procedures should be combined with NPWT to optimise these results (improved healing, reduced infections, decreased skin defects and enhanced granulation tissue) and so should be used more frequently.
Using past performance to improve future clinical outcomes in pressure ulcer prevention
Authors: Stephenson John , Ousey Karen , Blackburn Joanna , Javid Farideh
Published: June 2021

Objective:

Episodes of inpatient care-related pressure ulcers (PU) lead to deleterious effects on patient quality of life, and additional costs associated with wound dressings, staff visits and hospitalisation. Accurate prediction of future incidence may be helpful in defining strategies for benchmarking and resource management. Observations of category 2 or above PUs during episodes of care at an NHS Foundation Trust were recorded monthly from 2010 to 2020. Trust-specific interventions designed to reduce PU incidence, such as procurement of specialised staff and equipment, were also recorded. This study aimed to investigate the historical pattern of PU incidence in the Trust to assess intervention effectiveness in reducing PU incidence, and to use historical data to derive estimates of future incidence.

Method:

Time-series analysis was conducted on monthly PU incidence data to quantify underlying trends, seasonality and effect of interventions, and to derive a suitable model to predict future incidence levels.

Results:

Mean monthly PU incidence gradually reduced from 20.3 during 2012 to 5.08 during 2019; with a negative linear trend in the presence of concurrent seasonal effects. There was limited evidence that implementation of specific interventions was associated with raised rates of reduction; however, incidence reductions during intervention periods continued from lower baselines. Best estimate predictions revealed that incidence is likely to stay at current levels or below for the foreseeable future.

Conclusion:

Past data can be used to model future episodes of inpatient care PU occurrence. Interventions may be effective in reducing PU incidence rates.
Debriding effect of amino acid-buffered hypochlorite on hard-to-heal wounds covered by devitalised tissue: pilot study
Authors: Eliasson Björn , Ann-Mari Fagerdahl , Jönsson Anders , Apelqvist Jan
Published: June 2021

Objective:

Wounds such as lower extremity ulcers are serious, costly and frequently hard to heal. Guidelines conclude that new dressings and treatments generally fail to show superiority compared with standard of care. Several mechanisms are probably responsible for impaired healing of hard-to-heal wounds, including inflammation and infection. Amino acid-buffered hypochlorite has presumed antiseptic and antibacterial properties and has been shown to be useful in the treatment of diabetic foot ulcers (DFUs). We evaluated the debriding effect of amino acid-buffered hypochlorite (ChloraSolv) on full skin hard-to-heal lower extremity ulcers covered with devitalised tissue (≥50%), with six applications over 5 weeks and follow-up at 12 weeks.

Method:

This was an open-label, single-arm, multicentre, pre-market pilot investigation. We recruited subjects with a lower extremity ulcer, covered with devitalised tissue (≥50%), who were candidates for cleansing and debridement/desloughing. There was a weekly application of the investigational device for five weeks. Follow-up for wound status evaluation was performed at 12 weeks from baseline.

Results:

We evaluated 57 subjects (33 males, 24 females, median age 73 years, range 51–90 years) (intention-to-treat). Of these, 61.4% had a leg ulcer and 38.6% a foot ulcer. The median wound size at baseline was 7.7cm2 (range 2.1–52cm2) with devitalised tissue coverage of 76.5%. After 5 weeks, a decrease of 72.7% in devitalised tissue was seen, and 71.4% of the subjects showed a decrease in devitalised tissue of ≥50% (evaluated independently using PictZar). At 12 weeks' follow-up the decrease in devitalised tissue was 84.4%. Wound-related pain was reported by ten subjects, resulting in 17 adverse events (AEs). Among these, 12 AEs from eight subjects were recorded as possibly or probably related to the investigational device and one AE was reported to have a causal relationship with the investigational device.

Conclusion:

This clinical study suggests that amino acid-buffered hypochlorite can be effective and well tolerated in the treatment of hard-to-heal lower extremity ulcers to dissolve and remove devitalised tissue.
Stevens–Johnson syndrome and toxic epidermal necrolysis: a 10-year experience in a burns unit
Authors: Houschyar Khosrow S , Tapking Christian , Borrelli Mimi R , Nietzschmann Ina , Puladi Behrus , Ooms Mark , Rein Susanne , Houschyar Madeline , Duscher Dominik , Maan Zeshaan N , Reumuth Georg , Branski Ludwik K , Modabber Ali , Kluwig David , Schmitt Laurenz , Philipp-Dormston Wolfgang G , Yazdi Amir S , Siemers Frank
Published: June 2021

Objective:

Stevens-Johnson syndrome (SJS) and its more severe counterpart, toxic epidermal necrolysis (TEN), are skin hypersensitivity reactions defined by epidermal blistering and necrosis. The exact pathophysiology of SJS/TEN is yet to be deciphered, but a number of risk factors have been identified including adverse drug reactions. The diagnosis of SJS/TEN is made on a clinical basis, and treatment consists of supportive care and occasionally immunosuppressants, such as cyclosporin, high-dose intravenous immunoglobulins and/or corticosteroids. Mortality rates can reach 20–25% in adults but are reduced with early intervention. To identify optimal treatment regimens, to better understand the patient cohort affected, and to help identify key risk factors for mortality, we report our experience with the treatment and management of SJS/TEN patients.

Methods:

A retrospective review of consecutive patients with SJS and/or TEN admitted to a single burns centre in Germany, between 2008 and 2018, was conducted. The primary outcomes of demographics, clinical course, treatment and patient-reported outcomes were recorded and compared with a control group of patients with burns without a diagnosis of SJS/TEN.

Results:

A total of 23 patients with SJS/TEN met the inclusion criteria: 17 (74%) with TEN; four (17%) with SJS/TEN overlap; and two (9%) with SJS. Of the patients, 14 (61%) were female and nine (39%) were male. Patient age ranged from 32–78 years (mean: 52 years). A matched cohort of 23 patients with burns served as the control group. All patients received standard of care with a multidisciplinary team. Compared with the control group, SJS/TEN patients had higher mortality rates (n=6, 26% versus n=8, 35%, respectively). The average age of death was 69 years in SJS/TEN patients versus 63 years in control group patients. Age and SCORTEN scores were significant predictors of mortality.

Conclusions:

SJS and TEN are rare but extreme reactions of the skin and mucosa, associated with high disease mortality rates. This 10-year single-centre retrospective review contributes to the bank of information for reviews evaluating the management of SJS/TEN patients.