bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and risk factors for blood filariasis among HIV-infected adults in Gabon, Central Africa: a pilot study
Authors: Pongui Ngondza B , Koumba Lengongo J V , Mickala P , M'bondoukwé N P , Ndong Ngomo J M , Moutombi Ditombi B C , Mawili-Mboumba D P , Bouyou-Akotet M K
Published: March 2022

Background

The level of blood filariasis parasitaemia as well as the frequency of and the relationship between cotrimoxazole prophylaxis (CTX-P), antiretroviral therapy (ART) intake and CD4 cell count among people living with human immunodeficiency virus (PLHIV) in rural areas of Gabon were being studied.

Methods

Sociodemographic data and recent biological tests of PLHIV and HIV-negative participants were collected. Loa loa and Mansonella perstans microfilaria were detected by direct microscopy examination and leucoconcentration.

Results

Overall, 209 HIV-positive and 148 HIV-negative subjects were enrolled. The overall prevalence of microfilaria was comparable between PLHIV (19.9% [n=41/206]) and HIV-negative participants (14.8% [n=22/148]) (p=0.2). The L. loa infection rate was comparable between HIV-positive (9.2%) and HIV-negative participants (6.8%) (p=0.2), while the M. perstans infection rate was 14-fold higher among PLHIV (p<0.01). L. loa parasitaemia was 6-fold lower in PLHIV receiving CTX-P (median 150 mf/mL [interquartile range {IQR} 125–350]) than in patients without (900 [550–2225]) (p<0.01). Among subjects with a CD4 cell count <200 cells/μL, the prevalence of M. perstans was 7-fold higher than that of L. loa (20.6% vs 2.9%).

Conclusions

This study suggests a similar exposure to L. loa infection of PLHIV and HIV-negative patients while M. perstans is more frequently found in HIV-positive individuals, notably those with a CD4 count <200 cells/μL.
Outcomes of Patients Undergoing Interfacility Extracorporeal Membrane Oxygenation Transfer Based on Cannulation Location and Mode of Transport
Authors: Wothe Jillian K. , Bergman Zachary R. , Kalland Krystina R. , Peter Logan G. , Lusczek Elizabeth R. , Brunsvold Melissa E.
Published: March 2022

OBJECTIVES:

As the use of extracorporeal membrane oxygenation (ECMO) expands, so has the need for interfacility transfer to ECMO centers. However, the impact of these transfers has not been fully studied. This study evaluates complications and inhospital mortality in adult patients treated with venovenous (V-V) ECMO based on institutional location of cannulation and mode of transport.

DESIGN:

Retrospective cohort study.

SETTING:

Large midwestern ECMO center.

PATIENTS:

Adult patients receiving VV-ECMO.

INTERVENTIONS:

Need for transfer to ECMO center following VV-ECMO cannulation.

MEASUREMENTS AND MAIN RESULTS:

The study included 102 adult patients, 57% of which were cannulated at an outside institution prior to transfer. Of these, 60% were transported by ground, and the remainder were transported by air. Risk-adjusted logistic regression did not reveal any significant increase in odds for any complication or inhospital mortality between the groups based on location of cannulation or mode of transport.

CONCLUSIONS:

This study supports the practice of interfacility ECMO transfer with no difference in outcomes or inhospital mortality based on institutional location of cannulation or mode of transport.
B2M and JAK1/2–mutated MSI-H Colorectal Carcinomas Can Benefit From Anti-PD-1 Therapy
Authors: Zhang Chenzhi , Li Dandan , Xiao Binyi , Zhou Chi , Jiang Wu , Tang Jinghua , Li Yuan , Zhang Rongxin , Han Kai , Hou Zhenlin , Zhang Linjie , Sui Qiaoqi , Liao Leen , Pan Zhizhong , Zhang Xiaoshi , Ding Peirong
Published: March 2022

β2-microglobulin (B2M) and Janus kinases 1 and 2 (JAK1/2) mutations have been suggested as genetic mechanisms of immune evasion for anti–programmed cell death protein 1 (PD-1) therapy. Whether B2M and JAK1/2 lose-of-function mutation can cause primary resistance to anti-PD-1 therapy in colorectal carcinoma (CRC) patients remains controversial. Here, we sought to compare the efficacy of anti-PD-1 therapy in DNA mismatch repair deficient/microsatellite instability–high CRC patients with or without B2M or JAK1/2 mutations. Thirty-Five CRC patients who received anti-PD-1 therapy were enrolled in this study. All tumor samples underwent next-generation sequencing. The clinical and molecular data from 110 CRC patients sequenced with the Memorial Sloan Kettering-Integrated Mutation Profiling of Actionable Cancer Targets (MSK-IMPACT) assay and accessed through cBioportal were also analyzed in this study. Of the 35 CRC patients from our center, 10 (28.6%) had a B2M loss-of-function mutation, and 8 (22.9%) had a JAK1/2 loss-of-function mutation. Compared with B2M wild-type CRCs, B2M-mutated CRCs did not show a higher frequency of resistance to anti-PD-1 therapy (P=0.71). There was even better response to anti-PD-1 therapy in patients with JAK1/2 mutation than in those without (P=0.015). Of the 110 CRC patients in the MSK-IMPACT datasets, 13 (11.8%) had a B2M mutation, and 15 (13.6%) had a JAK1/2 mutation. After analyzing the response to anti-PD-1 therapy in these 110 patients, we found similar results (P=0.438 and 0.071, respectively). Moreover, patients with B2M or JAK1/2 mutation had a lower tumor mutational burden score compared with those without. B2M and JAK1/2 loss-of-function mutations occur frequently in microsatellite instability–high CRC. Our study demonstrated that patients with CRC harboring B2M or JAK1/2 mutations should not be excluded from anti-PD-1 therapy.
Model-Based Tacrolimus Follow-up Dosing in Adult Renal Transplant Recipients: A Simulation Trial
Authors: Francke Marith I. , Hesselink Dennis A. , Andrews Louise M. , van Gelder Teun , Keizer Ron J. , de Winter Brenda C. M.
Published: March 2022

Background:

Initial algorithm-based dosing appears to be effective in predicting tacrolimus dose requirement. However, achieving and maintaining the target concentrations is challenging. Model-based follow-up dosing, which considers patient characteristics and pharmacological data, may further personalize treatment. This study investigated whether model-based follow-up dosing could lead to more accurate tacrolimus exposure than standard therapeutic drug monitoring (TDM) in kidney transplant recipients after an initial algorithm-based dose.

Methods:

This simulation trial included patients from a prospective trial that received an algorithm-based tacrolimus starting dose followed by TDM. For every measured tacrolimus predose concentration (C0,obs), model-based dosing advice was simulated using the InsightRX software. Based on previous tacrolimus doses and C0, age, body surface area, CYP3A4 and CYP3A5 genotypes, hematocrit, albumin, and creatinine, the optimal next dose, and corresponding tacrolimus concentration (C0,pred) were predicted.

Results:

Of 190 tacrolimus C0 values measured in 59 patients, 121 (63.7%; 95% CI 56.8–70.5) C0,obs were within the therapeutic range (7.5–12.5 ng/mL) versus 126 (66.3%, 95% CI 59.6–73.0) for C0,pred (P = 0.89). The median absolute difference between the tacrolimus C0 and the target tacrolimus concentration (10.0 ng/mL) was 1.9 ng/mL for C0,obs versus 1.6 ng/mL for C0,pred. In a historical cohort of 114 kidney transplant recipients who received a body weight–based starting dose followed by TDM, 172 of 335 tacrolimus C0 (51.3%) were within the therapeutic range (10.0–15.0 ng/mL).

Conclusions:

The combination of an algorithm-based tacrolimus starting dose with model-based follow-up dosing has the potential to minimize under- and overexposure to tacrolimus in the early posttransplant phase, although the additional effect of model-based follow-up dosing on initial algorithm-based dosing seems small.
Cleft Palate Repair: A History of Techniques and Variations
Authors: Naidu Priyanka , Yao Caroline A. , Chong David K. , Magee William P.
Published: March 2022

Orofacial clefting is a common reconstructive surgical condition that often involves the palate. Cleft palate repair has evolved over three centuries from merely achieving anatomical closure to prioritizing speech development and avoiding midface hypoplasia. Despite centuries of advancements, there is still substantial controversy and variable consensus on technique, timing, and sequence of cleft palate repair procedures. Furthermore, evaluating the success of various techniques is hindered by a lack of universal outcome metrics and difficulty maintaining long-term follow-up. This article presents the current controversies of cleft palate repair and details how the history of cleft palate repair has influenced current techniques commonly used worldwide. Our review highlights the need for a global consortium on cleft care to gather expert opinions on current practices and outcomes and to standardize technique classifications. An understanding of global protocols is crucial in an attempt to standardize technique and timing to achieve anatomical closure with optimal velopharyngeal competence, while also minimizing the occurrence of maxillary hypoplasia and palatal fistulae.
A Prospective Trial: Handsfree Thermoregulated Bipolar Radiofrequency for Face and Neck Contouring
Authors: Dayan Erez , Chapas Anne , Marte Joseph , Chia Christopher , Theodorou Spero
Published: March 2022

Background:

The use of radiofrequency in aesthetic surgery has evolved significantly since it was first introduced in the early 2000s. Nonexcisional correction of the lower one-third of the face and neck has long been a challenging problem. The purpose of this prospective study was to assess the safety and efficacy of the first handsfree thermoregulated bipolar radiofrequency device for face and neck contouring.

Methods:

This prospective multicenter (New York, Nevada) IRB-approved study evaluated healthy candidates who desired noninvasive correction of their lower face and neck laxity. The primary objective of this study was to evaluate safety and soft tissue remodeling pretreatment and at 1-, 3-, and 6-months post last treatment. Assessment was made using blinded evaluators, 3D photographic analysis (Quantificare, France), and volumetric measurements. Investigator and subject assessments were obtained using a 0-4 point Likert scale.

Results:

A total of 34 patients completed both the cheek and chin applicator treatment series. Average age of patients was 38 (STD 3.4), BMI 27 (STD 2.2), average Baker Face & Neck classification 2.6 (STD 1.1), and average Fitzpatrick type 2.4 (STD 1.2). Mean treatment time was 41 min (STD 3.5) with a temperature of 42°C–43°C. Patient discomfort data were statistically very low based on t-test analysis. Satisfaction metrics measured at 1- and 3-month follow-up demonstrated a significant change in subject skin appearance, subject overall satisfaction, and investigator improvement perception. More patients were satisfied at the 3-month follow-up compared with the 1-month follow-up for all three measures. Volumetric data demonstrated an average change of −3.2 cm3 (STD ±1.2 cm3) per side for the cheek applicator and −4.1 (STD ±2.3) for the submental applicator. Of note there were cases where volume increases were noted that were believed to be related to soft tissue contraction.

Conclusions:

This is the first prospective study to evaluate a handsfree thermoregulated bipolar radiofrequency device for face and neck contouring. This device demonstrates a significant advance in the control and delivery of radiofrequency for aesthetic purposes. With a favorable safety and comfort profile, this device is able to concentrate thermal energy consistently at a depth that allows for fibroseptal network tightening to improve lower third of face and submental soft tissue contraction.
Outcomes in Patients with Mild COVID-19 Treated With Casirivimab and Imdevimab or Bamlanivimab—A Single-Center Retrospective Cohort Study in the Bronx
Authors: Balasubramanian Prasanth , Berto Cesar Gabriel , Hassan Elaine , Valentine Nancy , De Vos Gabriele , Coyle Christina , Sydney Elana
Published: March 2022

Background

Coronavirus disease 2019 (Covid-19) presents as a mild infection in up to 84% of cases out of which 10% progress to more severe disease requiring hospitalization and 33% to 69% progress to long haulers. The real-world data on the use of anti–severe acute respiratory syndrome coronavirus 2 spike neutralizing monoclonal antibodies, namely casirivimab and imdevimab, as well as bamlanivimab for mild Covid-19 is limited.

Methods

We conducted a retrospective cohort study on patients who received casirivimab and imdevimab or bamlanivimab for the treatment of mild Covid-19.

Results

Three hundred forty patients were included in the study with the mean age of the cohort 54.7 ± 17.5 years, and 36.5% of them were men. Thirty-day outcomes revealed that 300 (88.2%) patients were followed up to 30 days, out of which 243 patients (71.5%) were asymptomatic at 30 days, 57 patients (16.7%) had symptoms at 30 days out of which 9 patients (2.6%) had an ED visit or were admitted because of the worsening of Covid-19 in 30 days and 3 patients (0.9%) died.

Conclusions

Our study suggests that early infusion with monoclonal antibodies may decrease the development of long haulers. Further studies with randomized-controlled trials are needed to understand more about monoclonal antibodies in the prevention of long-term sequelae especially in the setting of ongoing viral mutations.
Breakthrough Penile Mucormycosis in a Patient With Acute Myelogenous Leukemia on Posaconazole Prophylaxis
Authors: Sazdar Shayan , Meyer Amy , Braudis Kara , Regunath Hariharan , Rojas-Moreno Christian
Published: March 2022

In patients with acute myelogenous leukemia, posaconazole prophylaxis has been shown to prevent deep invasive fungal infections, including mucormycosis. In the present case, posaconazole prophylaxis was initiated in a 58-year-old man undergoing induction chemotherapy for acute myelogenous leukemia. Three weeks after initiating chemotherapy, he developed a tender violaceous macule on the shaft of his penis. The initial differential included fixed drug eruption versus pyoderma gangrenosum. However, punch biopsy ultimately showed mucormycosis, and cultures grew Rhizopus species, despite therapeutic posaconazole trough. He was treated with intravenous amphotericin B and required right orchiectomy, penectomy, and hyperbaric oxygen therapy. Oral posaconazole was reinstituted after completion of amphotericin B course, and at 4 months follow-up, his penectomy site was fully healed. As demonstrated by the present case, not all mucormycoses are prevented by posaconazole prophylaxis. A high index of suspicion and early biopsy for prompt diagnosis are of critical importance in improving outcomes.
Attitudes Toward Safety and Teamwork: Benchmarking Australian Surgeons and Nurses
Authors: Boag-Hodgson Christine , Duong Annie , Bagley Louella
Published: March 2022

Objectives

This study aimed to investigate the safety attitudes of surgeons and nurses working in Australian operating rooms and establish a baseline of their general safety attitudes, as well as to compare the safety attitudes of surgeons and nurses working in operating room settings.

Methods

A modified version of the Safety Attitudes Questionnaire (Operating Room version) was distributed to operating room personnel across Australia via their relative colleges and unions. A total of 261 surgeons and registered nurses completed the online survey.

Results

An above-average safety focus was reported, with participants tending to be more positive on all subscales of the Safety Attitudes Questionnaire (Operating Room version) than reported by previous studies, which measured those working in intensive care units, ambulatory settings, and operating rooms. Participants had the most positive attitudes toward Teamwork Climate and Job Satisfaction, and the least positive attitudes toward Perceptions of Management and Work Conditions. There were some occupational differences in attitudes toward the various aspects of safety, with surgeons having more positive attitudes toward all aspects of safety except in relation to stress recognition, compared with nurses.

Conclusions

This study provides a baseline of general safety attitudes for Australian surgeons and nurses against which the effectiveness of future interventions can be interpreted. The occupational differences found in this study support the notion that safety interventions should be occupationally tailored. Interventions should target individual professional groups, taking into account the specific differences within each occupation to maximize their impact and effectiveness.
Validating the Brain Injury Guidelines: Results of an American Association for the Surgery of Trauma prospective multi-institutional trial
Authors: Joseph Bellal , Obaid Omar , Dultz Linda , Black George , Campbell Marc , Berndtson Allison E. , Costantini Todd , Kerwin Andrew , Skarupa David , Burruss Sigrid , Delgado Lauren , Gomez Mario , Mederos Dalier R. , Winfield Robert , Cullinane Daniel ,   the AAST BIG Multi-institutional Study Group
Published: March 2022

INTRODUCTION

Brain Injury Guidelines (BIG) was developed to effectively use health care resources including repeat head computed tomography (RHCT) scan and neurosurgical consultation in traumatic brain injury (TBI) patients. The aim of this study was to prospectively validate BIG at a multi-institutional level.

METHODS

This is a prospective, observational, multi-institutional trial across nine Levels I and II trauma centers. Adult (16 years or older) blunt TBI patients with a positive initial head computed tomography (CT) scan were identified and categorized into BIG 1, 2, and 3 based on their neurologic examination, alcohol intoxication, antiplatelet/anticoagulant use, and head CT scan findings. The primary outcome was neurosurgical intervention. The secondary outcomes were neurologic worsening, RHCT progression, postdischarge emergency department visit, and 30-day readmission.

RESULTS

A total of 2,432 patients met the inclusion criteria, of which 2,033 had no missing information and were categorized into BIG 1 (301 [14.8%]), BIG 2 (295 [14.5%]), and BIG 3 (1,437 [70.7%]). In BIG 1, no patient worsened clinically, 4 of 301 patients (1.3%) had progression on RHCT with no change in management, and none required neurosurgical intervention. In BIG 2, 2 of 295 patients (0.7%) worsened clinically, and 21 of 295 patients (7.1%) had progression on RHCT. Overall, 7 of 295 patients (2.4%) would have required upgrade from BIG 2 to 3 because of neurologic examination worsening or progression on RHCT, but no patient required neurosurgical intervention. There were no TBI-related postdischarge emergency department visits or 30-day readmissions in BIG 1 and 2 patients. All patients who required neurosurgical intervention were BIG 3 (280 of 1,437 patients [19.5%]). Agreement between assigned and final BIG categories was excellent (κ = 99%). In this cohort, implementing BIG would have decreased CT scan utilization and neurosurgical consultation by 29% overall, with a 100% reduction in BIG 1 patients and a 98% reduction in BIG 2 patients.

CONCLUSION

Brain Injury Guidelines is safe and defines the management of TBI patients by trauma and acute care surgeons without the routine need for RHCT and neurosurgical consultation.

LEVEL OF EVIDENCE

Therapeutic/Care Management; Level III.
High-Frequency Oscillations in Tumor-Related Epilepsy
Authors: Bushara Omar , Zhou Guangyu , Sharma Arjun , Zelano Christina , Schuele Stephan U. , Tate Matthew C. , Gavvala Jay R. , Templer Jessica W.
Published: March 2022

Introduction:

To define the patient characteristics, tumor characteristics, and clinical course of patients with primary brain tumors with high-frequency oscillations (HFOs) recorded on electrocorticography. Furthermore, we evaluated whether the presence of HFOs portends a greater risk of postoperative tumor-related epilepsy and whether the resection of HFO-generating tissue reduces likelihood of postoperative tumor-related epilepsy.

Methods:

This was a retrospective study of 35 patients undergoing awake craniotomy for tumor resection, all of whom underwent intraoperative electrocorticography. Electrocorticography data were reviewed to assess the presence of HFOs and determine their contact locations. The data were analyzed to determine whether HFO-generating tissue was included in the resection and relationship to postoperative seizure outcome.

Results:

Seventeen patients (48.5%) were found to have HFOs. Very few patients (4 of 35, 11.4%) had sharp waves. Patients with and without HFOs did not significantly differ in demographics, presentation, tumor characteristics, or tumor molecular genetics. A history of seizures prior to resection was not associated with the presence of HFOs (P = 0.62), although when patients had seizures during the same hospitalization as the resection, HFOs were more likely to be present (P = 0.045). Extent of HFO resection was not associated with the likelihood of postoperative seizure freedom.

Conclusions:

Approximately half (48.5%) of patients undergoing resection for a primary brain tumor had HFOs. Although HFO resection was not shown to lead to improved seizure freedom, this study was limited by a small sample size, and further investigation into HFO resection and patient outcomes in this population is warranted.
Hydrogen production in the presence of oxygen by Escherichia coli K-12
Authors: Metcalfe George D. , Sargent Frank , Hippler Michael
Published: March 2022

Escherichia coli

is a facultative anaerobe that can grow in a variety of environmental conditions. In the complete absence of O2,

E. coli

can perform a mixed-acid fermentation that contains within it an elaborate metabolism of formic acid. In this study, we use cavity-enhanced Raman spectroscopy (CERS), FTIR, liquid Raman spectroscopy, isotopic labelling and molecular genetics to make advances in the understanding of bacterial formate and H2 metabolism. It is shown that, under anaerobic (anoxic) conditions, formic acid is generated endogenously, excreted briefly from the cell, and then taken up again to be disproportionated to H2 and CO2 by formate hydrogenlyase (FHL-1). However, exogenously added D-labelled formate behaves quite differently from the endogenous formate and is taken up immediately, independently, and possibly by a different mechanism, by the cell and converted to H2 and CO2. Our data support an anion-proton symport model for formic acid transport. In addition, when

E. coli

was grown in a micro-aerobic (micro-oxic) environment it was possible to analyse aspects of formate and O2 respiration occurring alongside anaerobic metabolism. While cells growing under micro-aerobic conditions generated endogenous formic acid, no H2 was produced. However, addition of exogenous formate at the outset of cell growth did induce FHL-1 biosynthesis and resulted in formate-dependent H2 production in the presence of O2.
Alternative business finance: insights from selected informal savings groups in Uganda
Authors: Abaho Ernest , Mindra Rachel , Agasha Ester , Balunywa Aminah
Published: March 2022

Purpose

The study examined the nature of the operation of informal savings groups. Emphasis was on their composition, the mode of financial transactions and sharing of financial proceeds, the impact of the savings and members loaning on the members' financial and business growth, and the perception of the members on the benefits of the savings. The study also profiled the significant challenges encountered by the groups.

Design/methodology/approach

The study adopted an exploratory research design. The point of saturation was achieved after 15 members of informal savings groups were interviewed. Data were analyzed using content analysis techniques with the aid of NVivo version 10 software, and verbatim tests were used to explain the emergent themes.

Findings

The findings indicate that informal savings groups are accessible, sustainable and inclusive financing alternatives for low-income earners. Group sizes range from 250 to 3 members. As a sign of commitment, a form of identification is required to join the group. Findings also indicate that group leaders are elected, and their term of service could be renewable. It was discovered that members join mainly to save in financial terms, and they have benefited both monetary and socially. The biggest challenge these groups face is that members default.

Practical implications

The study provides evidence that informal financial service providers are an effective alternative to business financing that leverage existing social structures that are predominant in Uganda.

Originality/value

The study provides a benchmark for understanding the dynamics, capabilities and challenges impeding the survival and growth of informal savings groups as critical components in Uganda's financial system.
Unwrapping the nexus between the off-grid system and its impact on the islands and remote villages of Ghana
Authors: Bannor Richard Kwasi , Amfo Bismark , Sarquah Khadija , Oppong-Kyeremeh Helena , Kyire Samuel Kwabena Chaa
Published: March 2022

Purpose

This study aims to focus on the nexus between off-grid systems and impacts on islands and remote villages in Ghana by investigating the sources and cost of energy, willingness to pay for electricity and impacts of off-grid energy on the local economy, education, health, social activities, the environment and migration.

Design/methodology/approach

Data were obtained from 110 households; heterogeneous impact analysis of off-grid technologies, average treatment effect by inverse probability weights (IPW) and inverse probability weighted regression adjustment (IPWRA) models were used to analyse the data.

Findings

The sources of energy are gas, kerosene, wood fuel and dry-cell battery. All households in communities with neither electricity nor off-grid system were willing to pay for electricity. Households without off-grid systems (US$8.1) were willing to pay higher amounts per month for electricity. The off-grid technologies improve the local economy, social activities, security, the environment, education and health as well as reduce out-migration.

Originality/value

Most of the literature on mini-grid/off-grid systems have been from the engineering and the technical perspective, with a few on the socioeconomic impacts of the systems and consumer engagements. Besides, methods including descriptive statistics, energy technology sustainability framework and qualitative analysis were used in these studies. Nevertheless, the authors used a more rigorous method of the doubly robust inverse probability weighted regression adjustment model and a heterogeneous method to model the impact analysis of off-grid systems.
Incubation mound building by the Australian megapode (malleefowl, Leipoa ocellata) creates novel, resource‐rich patches in a semi‐arid woodland
Authors: Neilly Heather , Cale Peter , Eldridge David J.
Published: March 2022

Desert ecosystems are characterised by a patchy distribution of resources. Nutrient sinks associated with landscape modulators (trees) differ markedly from the resource‐poor interpatch matrix. Fauna can also act as landscape modulators, modifying patch dynamics by redistributing resources via ‘ecosystem engineering’. In semi‐arid woodlands, malleefowl (Leipoa ocellata: Megapodiidae) reconfigure surface characteristics by scavenging leaf litter to construct large incubation mounds. The extent to which this movement of resources creates a novel patch and alters extant patches is largely unknown. Ecosystem engineering effects by megapodes have been little studied, but are potentially great, particularly in drylands, where mammalian engineers are known to enhance ecosystem function and drive restoration.

We measured vegetation, ground cover and soil chemistry at malleefowl mounds and four extant microsites (trees and open areas close to, and far from, mounds) and predicted that: (1) malleefowl mounds would represent enriched, yet novel, microsites; (2) the characteristics of tree and open patches close to the mounds would differ from those away from the mounds, because of the diminishing intensity of disturbance; and (3) effects at tree and open patches close to the mound would be shorter term, compared to the more substantial high‐resource patch formation occurring at the mound, but we expected all effects would diminish with time since malleefowl activity.

We found that: (1) malleefowl mounds were novel microsites with soil chemistry more similar to tree‐modulated patches, and groundcover and vegetation variables more similar to the open, interpatch matrix; (2) effects extended to tree and open patches near the mound, but most effects were short lived; and (3) some novel mound attributes (e.g. soil pH, phosphorus, nitrogen, carbon) were greater at mounds, irrespective of their age, while less plant cover and richness on young mounds dissipated with age.

Synthesis. Mound‐building megapodes can modulate the distribution of locally derived resources and create a novel microsite. Engineering effects can enhance spatial heterogeneity and ecosystem function over broad spatial and temporal scales, and may assist with ecological restoration, particularly in depauperate, arid systems.
Spectroscopic evidence of fluorescence by 1,8‐diazafluoren‐9‐one aggregates—A prospective new ultrasensitive method for fingerprint trace detection
Authors: Lewkowicz Aneta , Kantor Małgorzata , Zalewski Wojciech , Bojarski Piotr , Mońka Michał
Published: March 2022

Friction ridge analysis would not have been one of the most recognized branches of forensics without molecular spectroscopy. The phenomenon of fluorescence is used on daily basis to develop latent fingerprints and to enhance those that are visible. The idea behind the research was to discover selected spectroscopic properties of 1,8‐diazafluoren‐9‐one (DFO) in various environments. This fluorescent compound has been routinely used for decades to develop latent fingerprints due to its numerous advantages, but to this day, it has not been well‐understood. Analysis of absorption, fluorescence, and excitation spectra of DFO in ethanol at high dye concentration allowed identification of aggregates in the excited state. A significant influence of the dye concentration on the fluorescence spectra and on the fluorescence excitation spectra was found. In particular, dye‐host aggregation was found to be much stronger in a polar solvent. DFO aggregates are strongly fluorescent in ethanol, as can be seen from the steady‐state emission spectra. The impact of excitation wavelength on the effect of fingerprint detection is presented. A new reaction medium has been proposed, ethanol, which is nontoxic in relation to the currently used one, methanol. The existence in this medium of DFO aggregates in the excited state, which significantly influences the identification of amino acids present in fingerprint traces, was observed, emitting in a wide spectral range (green light).
The changing radiation oncology landscape in New Zealand
Authors: James Melissa , Munro Philip L , Adams Gerard , Keogh Sandra ,   FRANZCR FRO Economics and Workforce Committee
Published: March 2022

Introduction

This paper outlines the New Zealand (NZ) responses to the biennial facilities surveys of The Royal Australian and New Zealand College of Radiologists (RANZCR), Faculty of Radiation Oncology (FRO) from 2011 to 2019.

Methods

The facilities survey is conducted by the FRO Economics and Workforce Committee (FROEWC) and focuses on equipment, treatment activities and staffing.

Results

The number of facilities increased by two to 10, both in the private sector. The total number of linear accelerators (linacs) increased by four; one in public and three in private. The majority of linacs were over 8 years old (62.5%). Treatment courses have increased by 19% and fraction numbers by 13.7%. Courses per linac have remained relatively constant. There was growth in IMRT, orthovoltage, high dose rate brachytherapy and paediatric treatments. There was a slow increase in number of radiation oncologists and trainees. The number of radiation therapists was unchanged with a 20% increase in treatment courses per radiation therapist. Physicist numbers have increased but 61.4% of physicists are overseas‐trained and vacancies persist.

Conclusion

The survey results indicate a rapidly changing radiation oncology landscape in NZ between 2011 and 2019. The challenges of increases in cancer numbers, treatment courses and complexity of treatments and a need to focus on quality standards against a set of minimal increase in machine numbers, ageing machines, static or slowly increasing staffing numbers and heavy reliance on overseas staffing require a national review of radiation oncology services to ensure a sustainable future.
Co‐administration of morphine and levamisole increases death risk, produces neutropenia and modifies antinociception in mice
Authors: Ruiz‐Quiñonez Ana K. , Espinosa‐Riquer Zyanya P. , Carranza‐Aguilar César J. , Browne Thom , Cruz Silvia L.
Published: March 2022

Levamisole is a veterinary anthelmintic drug and a common adulterant of misused drugs. This study analyses the lethal, antinociceptive and haematological effects produced by acute or repeated levamisole administration by itself or combined with morphine. Independent groups of male Swiss Webster mice were i.p. injected with 100 mg/kg morphine, 31.6 mg/kg levamisole (lethal doses at 10%, LD10) or the same doses combined. Naloxone pretreatment (10 mg/kg, i.p.) prevented morphine‐induced death, as did 2.5 mg/kg, i.p. mecamylamine with levamisole. Co‐administration of levamisole and morphine (Lvm + Mor) increased lethality from 10% to 80%. This augmented effect was prevented by 30 mg/kg, i.p. naloxone and reduced with 10 mg/kg naloxone plus 2.5 mg/kg, i.p. mecamylamine. In independent groups of mice, 17.7 mg/kg, i.p. levamisole antagonized the acute morphine's antinociceptive effect evaluated in the tail‐flick test. Repeated 17.7 mg/kg levamisole administration (2×/day/3 weeks) did not affect tolerance development to morphine (10 mg/kg, 3×/day/1 week). Blood samples obtained from mice repeatedly treated with levamisole showed leukopenia and neutropenia. Morphine also produced neutropenia, increased erythrocyte count and other related parameters (e.g. haemoglobin). Lvm + Mor had similar effects on leukocyte and neutrophil counts to those seen with levamisole only, but no erythrocyte‐related alterations were evident. Blood chemistry analysis did not indicate liver damage but suggested some degree of electrolyte balance impairment. In conclusion, Lvm + Mor increased death risk, altered morphine‐induced antinociceptive effects and produced haematologic abnormalities. The importance of studying combinations of drugs of abuse lies in the fact that drug users frequently combine drugs, which are commonly adulterated.
Linking restoration to the IUCN red list for ecosystems: A case study of how we might track the Earth's ecosystems
Authors: Tierney David A.
Published: March 2022

Globally, ecosystems are in decline and a capacity to track this decline and the progress of ecosystem restoration at this scale is critical. The IUCN Red List for Ecosystems (RLE) is the accepted standard for global ecosystem risk assessments and potentially could be used to track progress of ecosystem restoration. Ecosystem restoration progress to date has been assessed by a diversity of techniques that do not provide a coherent link to risk identified in RLE assessments. This study assesses the potential of the RLE as a benchmark for tracking recovery for an ecosystem. This is demonstrated using a case study ecosystem with complex and challenging restoration requirements. Box Gum Woodlands (BGW) in eastern Australia are critically endangered but occur across a large geographic area, often as small remnants on private land. RLE assessments were used to assess the extent of restoration required and if key altered ecological processes relating to soil properties, fragmentation and climate change must also be mitigated. This assessment clarified the scale of work required, the importance of private land conservation and a range of other factors (soil status; fragmentation pattern; climate change) critical to successful restoration. It is concluded that the RLE can provide a powerful benchmark for restoration goals, but an important aspect of its use is a capacity to manage uncertainty.
Single‐centre survey of women reflecting on recent experiences and preferences of oral intake during labour
Authors: McDermott Laura , Pelecanos Anita , Krepska Amy , de Jersey Susan , Sekar Renuka , Mao Derek , Lee Geraldine , Blackie Annika , Eley Victoria
Published: March 2022

Background

Consensus‐based recommendations guiding oral intake during labour are lacking.

Aims

We surveyed women at a tertiary women’s hospital about preferences for and experiences of oral intake during labour, gastrointestinal symptoms during labour and recalled advice about oral intake.

Materials and methods

Women who experienced labour completed a postpartum survey with responses as free text, yes‐no questions and five‐point Likert scales. We identified demographic data and risk factors for surgical or anaesthetic intervention at delivery from medical records. We summarised free text comments using conventional content analysis.

Results

One hundred and forty‐nine women completed the survey (47% response rate). Their mean (SD) age was 31 (four) years, birthing at median gestation of 39 weeks (interquartile range: 38‐40). One hundred and twenty‐two (83%) and 44 (30%) women strongly agreed or agreed they felt like drinking and eating respectively during labour. Ninety women (61%) reported nausea and 47 women (32%) reported vomiting in labour. Forty‐one women (28%) did not receive advice on oral intake during labour. Maternal risk factors for surgical intervention were identified in 72 (48%) women and fetal risk factors in 27 (18%) women. Thirty‐one women (21%) delivered by emergency caesarean section.

Conclusion

Pregnant women received variable advice regarding oral intake during labour, from variable sources. Most women felt like drinking but not eating during labour. Guidelines on oral intake in labour may be beneficial to women, balancing the preferences of women with risks of surgical intervention.
Toward transmural healing: Sonographic healing is associated with improved long‐term outcomes in patients with Crohn’s disease
Authors: Vaughan Rose , Tjandra Douglas , Patwardhan Ashwin , Mingos Nicholas , Gibson Robert , Boussioutas Alex , Ardalan Zaid , Al‐Ani Aysha , Gibson Peter R. , Christensen Britt
Published: March 2022

Background and Aims

Transmural healing has emerged as a treatment target in Crohn’s disease (CD). We investigated whether transmural healing assessed with intestinal ultrasound (IUS) is associated with improved clinical outcomes in patients with CD in clinical remission.

Methods

Patients with CD in clinical remission at baseline (HBI <4) having IUS between August 2017 and June 2020 with at least 6‐months’ follow‐up were retrospectively studied. Time to medication escalation, corticosteroid use and CD‐related hospitalisation or surgery were compared by the presence or absence of sonographic healing, defined as bowel wall thickness ≤3 mm without hyperemia on color Doppler, inflammatory fat, or disrupted bowel wall stratification. Factors associated with survival were analyzed by Kaplan–Meier analysis using Cox proportional‐hazard model.

Results

Of 202 consecutive patients (50% male), sonographic inflammation was present in 61%. During median follow‐up of 19 (IQR 13–27) months, medication escalation occurred in 52%, corticosteroid use in 23%, hospitalisation in 21%, and CD‐related surgery in 13%. Sonographic healing was significantly associated with a reduced risk of medication escalation (p = 0.0018), corticosteroid use (p = 0.0247), hospitalisation (p = 0.0102), and surgery (p = 0.083). On multivariable analysis, sonographic healing was significantly associated with an increased odds of medication escalation‐free survival (hazard ratio [HR]:1.94; 95% CI 1.23–3.06; p = 0.004) and corticosteroid‐free survival (HR:2.41; 95% CI 1.24–4.67; p = 0.009), but not with hospitalisation or surgery.

Conclusion

In patients with CD in clinical remission, sonographic healing is associated with improved clinical outcomes. Further studies are needed to determine whether sonographic healing should be a treatment target.
Intraoperative visualization of urethra using illuminating catheter in laparoscopy‐assisted anorectoplasty for imperforated anus—A novel and safe technique for preventing urethral injury
Authors: Onishi Shun , Muto Mitsuru , Harumatsu Toshio , Murakami Masakazu , Kedoin Chihiro , Matsui Mayu , Sugita Koshiro , Yano Keisuke , Yamada Koji , Yamada Waka , Matsukubo Makoto , Kaji Tatsuru , Ieiri Satoshi
Published: March 2022

Purpose

In this study, we used a near‐infrared ray catheter (NIRC) to visualize the urethral line. We herein report our intraoperative visualization technique of the urethra using an illuminating catheter in laparoscopy‐assisted anorectoplasty (LAARP) for imperforated anus.

Patient and surgical technique

A 3.0‐kg term male neonate with anorectal malformation was delivered. An invertogram revealed the type as intermediate. Transverse colostomy was performed at the left upper abdomen. A recto‐bulbar urethral fistula (RBUF) was diagnosed via distal colostogram and voiding cystourethrogram. LAARP was planned at 6 months of age. We performed the operation with four trocars. A 45° 5‐mm scope was used to clearly view the deep pelvic space. Before starting rectal dissection, a 6‐Fr pig‐tail‐type NIRC was inserted through the external opening of the urethra to visualize the urethra during the laparoscopic procedure. The catheter tip was placed in the bladder, and excretion of urine was maintained through the NIRC during the procedures. While dissecting the deep pelvic space between the posterior wall of the urethra and anterior wall of the rectum, the exact line of the urethra was clearly confirmed by overlay images of the NIRC. The RBUF was dissected safely using this innovative image‐guided technique. Anoplasty was performed between the rectal stump and perineal skin. The postoperative course was uneventful. Oral intake was started on postoperative day 1. Postoperative dynamic urography showed no complications.

Conclusion

An NIRC is useful for detecting the urethra during LAARP.
Development and metamorphic loss of the musculature in larvae of the nudibranch Phestilla sibogae: A functional ontogeny
Authors: Croll Roger P. , Hadfield Michael G.
Published: March 2022

Developmental programmes for many marine invertebrates include the assembly of muscular systems appropriate to the functions of swimming and feeding in pelagic larvae. Upon metamorphosis, that musculature is often radically re‐organized to meet very different demands of post‐larval life. To investigate the development and fate of musculature in the nudibranch Phestilla sibogae, embryos, larvae and metamorphosing stages were fixed, labelled with phalloidin and examined with confocal microscopy. The resultant images revealed the sequential development of both large retractor muscles and numerous finer muscles that allow the larva to manipulate the velum, foot and operculum. Observations of living specimens at the same stages as those fixed for microscopy revealed the actions of the muscles as they developed. During metamorphosis, muscles with shell attachments disintegrate as the larva transforms into a shell‐less juvenile. Notably, the massive velar, pedal and opercular retractor muscles disappear during metamorphosis in a sequence that corresponds to their loss of function. Other muscles, however, that appear to be important to the embryo and free‐swimming larva persist into juvenile life. The comprehensive and detailed observations of the musculature presented here provide a solid foundation for comparisons with other species with different phylogenies and life histories.
Asparaginase encapsulated in erythrocytes as second‐line treatment in hypersensitive patients with acute lymphoblastic leukaemia
Authors: Lynggaard Line Stensig , Vaitkeviciene Goda , Langenskiöld Cecilia , Lehmann Anne Kristine , Lähteenmäki Päivi M. , Lepik Kristi , El Hariry Iman , Schmiegelow Kjeld , Albertsen Birgitte Klug
Published: March 2022

Asparaginase is essential in treating acute lymphoblastic leukaemia (ALL). Asparaginase‐related hypersensitivity causes treatment discontinuation, which is associated with decreased event‐free survival. To continue asparaginase treatment after hypersensitivity, a formulation of asparaginase encapsulated in erythrocytes (eryaspase) was developed. In NOR‐GRASPALL 2016 (NCT03267030) the safety and efficacy of eryaspase was evaluated in 55 patients (aged 1–45 years; median: 6.1 years) with non‐high‐risk ALL and hypersensitivity to asparaginase conjugated with polyethylene glycol (PEG‐asparaginase). Eryaspase (150 u/kg) was scheduled to complete the intended course of asparaginase (1–7 doses) in two Nordic/Baltic treatment protocols. Forty‐nine (96.1%) patients had asparaginase enzyme activity (AEA) ≥100 iu/l 14 ± 2 days after the first eryaspase infusion [median AEA 511 iu/l; interquartile range (IQR), 291–780], whereas six of nine (66.7%) patients had AEA ≥100 iu/l 14 ± 2 days after the fourth infusion (median AEA 932 iu/l; IQR, 496–163). The mean terminal half‐life of eryaspase following the first infusion was 15.3 ± 15.5 days. Few asparaginase‐related adverse events were reported; five patients (9.1%) developed clinical allergy associated with enzyme inactivation. Replacement therapy was successfully completed in 50 patients (90.9%). Eryaspase was well tolerated, and most patients had AEA levels above the therapeutic target after the first infusion. The half‐life of eryaspase confirmed that a 2‐week schedule is appropriate.
Inhibition of human recombinant T‐type calcium channels by phytocannabinoids in vitro
Authors: Mirlohi Somayeh , Bladen Chris , Santiago Marina J. , Arnold Jonathon C. , McGregor Iain , Connor Mark
Published: March 2022

Background and Purpose

T‐type Ca channels (ICa) regulate neuronal excitability and contribute to neurotransmitter release. The phytocannabinoids Δ9‐tetrahydrocannabinol and cannabidiol effectively modulate T‐type ICa, but effects of other biologically active phytocannabinoids on these channels are unknown. We thus investigated the modulation of T‐type ICa by low abundance phytocannabinoids.

Experimental Approach

A fluorometric (fluorescence imaging plate reader [FLIPR]) assay was used to investigate modulation of human T‐type ICa (CaV3.1, 3.2 and 3.3) stably expressed in FlpIn‐TREx HEK293 cells. The biophysical effects of some compounds were examined using whole‐cell patch clamp recordings.

Key Results

In the FLIPR assay, all 11 phytocannabinoids tested modulated T‐type ICa, with most inhibiting CaV3.1 and CaV3.2 more effectively than CaV3.3. Cannabigerolic acid was the most potent inhibitor of CaV3.1 (pIC50 6.1 ± 0.6) and CaV3.2 (pIC50 6.4 ± 0.4); in all cases, phytocannabinoid acids were more potent than their corresponding neutral forms. In patch clamp recordings, cannabigerolic acid inhibited CaV3.1 and 3.2 with similar potency to the FLIPR assay; the inhibition was associated with significant hyperpolarizing shift in activation and steady‐state inactivation of these channels. In contrast, cannabidiol, cannabidivarin, and cannabigerol only affected channel inactivation.

Conclusion and Implications

Modulation of T‐type calcium channels is a common property of phytocannabinoids, which all increase steady‐state inactivation at physiological membrane potentials, with some also affecting channel activation. Thus, T‐type ICa may be a common site of action for phytocannabinoids, and the diverse actions of phytocannabinoids on channel gating may provide insight into structural requirement for selective T‐type ICa modulators.