bluuebunny/crossref_metadata_2025 huggingface dataset:
Lynch syndrome testing of colorectal cancer patients in a high-income country with universal healthcare: a retrospective study of current practice and gaps in seven australian hospitals
Authors: Steinberg Julia , Chan Priscilla , Hogden Emily , Tiernan Gabriella , Morrow April , Kang Yoon-Jung , He Emily , Venchiarutti Rebecca , Titterton Leanna , Sankey Lucien , Pearn Amy , Nichols Cassandra , McKay Skye , Hayward Anne , Egoroff Natasha , Engel Alexander , Gibbs Peter , Goodwin Annabel , Harris Marion , Kench James G , Pachter Nicholas , Parkinson Bonny , Pockney Peter , Ragunathan Abiramy , Smyth Courtney , Solomon Michael , Steffens Daniel , Toh James Wei Tatt , Wallace Marina , Canfell Karen , Gill Anthony , Macrae Finlay , Tucker Kathy , Taylor Natalie
Published: May 2022

Background

To inform effective genomic medicine strategies, it is important to examine current approaches and gaps in well-established applications. Lynch syndrome (LS) causes 3–5% of colorectal cancers (CRCs). While guidelines commonly recommend LS tumour testing of all CRC patients, implementation in health systems is known to be highly variable. To provide insights on the heterogeneity in practice and current bottlenecks in a high-income country with universal healthcare, we characterise the approaches and gaps in LS testing and referral in seven Australian hospitals across three states.

Methods

We obtained surgery, pathology, and genetics services data for 1,624 patients who underwent CRC resections from 01/01/2017 to 31/12/2018 in the included hospitals.

Results

Tumour testing approaches differed between hospitals, with 0–19% of patients missing mismatch repair deficiency test results (total 211/1,624 patients). Tumour tests to exclude somatic MLH1 loss were incomplete at five hospitals (42/187 patients). Of 74 patients with tumour tests completed appropriately and indicating high risk of LS, 36 (49%) were missing a record of referral to genetics services for diagnostic testing, with higher missingness for older patients (0% of patients aged ≤ 40 years, 76% of patients aged > 70 years). Of 38 patients with high-risk tumour test results and genetics services referral, diagnostic testing was carried out for 25 (89%) and identified a LS pathogenic/likely pathogenic variant for 11 patients (44% of 25; 0.7% of 1,624 patients).

Conclusions

Given the LS testing and referral gaps, further work is needed to identify strategies for successful integration of LS testing into clinical care, and provide a model for hereditary cancers and broader genomic medicine. Standardised reporting may help clinicians interpret tumour test results and initiate further actions.
Communicating with patients in the age of online portals—challenges and opportunities on the horizon for radiologists
Authors: Becker Christoph D. , Kotter Elmar
Published: May 2022

The deployment of electronic patient portals increasingly allows patients throughout Europe to consult and share their radiology reports and images securely and timely online. Technical solutions and rules for releasing reports and images on patient portals may differ among institutions, regions and countries, and radiologists should therefore be familiar with the criteria by which reports and images are made available to their patients. Radiologists may also be solicited by patients who wish to discuss complex or critical imaging findings directly with the imaging expert who is responsible for the diagnosis. This emphasises the importance of radiologists’ communication skills as well as appropriate and efficient communication pathways and methods including electronic tools. Radiologists may also have to think about adapting reports as their final product in order to enable both referrers and patients to understand imaging findings. Actionable reports for a medical audience require structured, organ-specific terms and quantitative information, whereas patient-friendly summaries should preferably be based on consumer health language and include explanatory multimedia support or hyperlinks. Owing to the cultural and linguistic diversity in Europe dedicated solutions will require close collaboration between radiologists, patient representatives and software developers; software tools using artificial intelligence and natural language processing could potentially be useful in this context. By engaging actively in the challenges that are associated with increased communication with their patients, radiologists will not only have the opportunity to contribute to patient-centred care, but also to enhance the clinical relevance and the visibility of their profession.
Etonogestrel contraceptive implant failure in a woman taking rifampin: a case report
Authors: Tufa Tesfaye H. , Fessehaye Abraham , Abubeker Ferid A.
Published: May 2022

Background

The etonogestrel subdermal implant is the most efficacious hormonal contraceptive currently available and provides 99.7% effective contraception. However, similar to other hormonal contraception, its effectiveness is compromised with the use of cytochrome P450 inducing drugs resulting in an unplanned pregnancy. Despite this risk, little is known about the outcome of concomitant use of rifampin and contraceptive implants.

Case presentation

A 24-year-old woman was provided with an etonogestrel implant in September 2018. In July 2020, she was started with rifampin based anti-tuberculosis for tuberculosis of the lymph nodes. In December 2020, she presented to the family planning clinic of St. Paul’s Hospital Millennium Medical college with a diagnosis of failed implant and second-trimester pregnancy at a gestational age of 19 weeks. The etonogestrel implant was removed and the patient was linked to antenatal care follow up.

Conclusion

Concomitant use of hepatic cytochrome P450 enzyme-inducing medications with certain hormonal contraceptives may reduce effectiveness resulting in unintended pregnancy. Women should be given detailed counseling about the potential for drug interactions and a multidisciplinary approach with consultation or referral to reproductive health specialists is crucial for optimal management of women who are at increased risk of contraceptive failure and unintended pregnancy.
A new automated and putatively versatile synthesis of the PSMA-ligand derivative [18F]DCFPyL using the FASTlabTM synthesizer
Authors: Hoareau Raphaël , Bach-Gansmo Tore , Cumming Paul , Olberg Dag Erlend
Published: May 2022

Background

Noninvasive molecular imaging using peptides and biomolecules labelled with positron emitters has become important for detection of cancer and other diseases with PET (positron emission tomography). The positron emitting radionuclide fluorine-18 is widely available in high yield from cyclotrons and has favorable decay (t1/2 109.7 min) and imaging properties. 18F-Labelling of biomolecules and peptides for use as radiotracers is customarily achieved in a two-step approach, which can be challenging to automate. 6-[18F]Fluoronicotinic acid 2,3,5,6-tetrafluorophenyl ester ([18F]F-Py-TFP) is a versatile 18F-prosthetic group for this purpose, which can be rapidly be produced in an one-step approach on solid support. This work details an automated procedure on the cassette-based GE FASTlab™ platform for the labeling of a peptidomimetic, exemplified by the case of using the Glu-CO-Lys motif to produce [18F]DCFPyL, a ligand targeting the prostate specific membrane antigen (PSMA).

Results

From fluorine-18 delivery a fully automated two-step radiosynthesis of [18F]DCFPyL was completed in 56 min with an overall end of synthesis yield as high as 37% using solid phase extraction (SPE) purification on the GE FASTlab™ platform.

Conclusions

Putatively, this radiolabeling methodology is inherently amenable to automation with a diverse set of synthesis modules, and it should generalize for production of a broad spectrum of biomolecule-based radiotracers for use in PET imaging.
Multi-drug resistant gram-negative bacterial pneumonia: etiology, risk factors, and drug resistance patterns
Authors: Assefa Muluneh
Published: May 2022

Bacterial pneumonia is one of the most serious public health issues owing to its medical and economic costs, which result in increased morbidity and mortality in people of all ages around the world. Furthermore, antimicrobial resistance has risen over time, and the advent of multi-drug resistance in GNB complicates therapy and has a detrimental impact on patient outcomes. The current review aimed to summarize bacterial pneumonia with an emphasis on gram-negative etiology, pathogenesis, risk factors, resistance mechanisms, treatment updates, and vaccine concerns to tackle the problem before it causes a serious consequence. In conclusion, the global prevalence of GNB in CAP was reported 49.7% to 83.1%, whereas in VAP patients ranged between 76.13% to 95.3%. The most commonly reported MDR-GNB causes of pneumonia wereA. baumannii, K. pneumoniae,andP. aeruginosa,withA. baumanniiisolated particularly in VAP patients and the elderly.In most studies, ampicillin, tetracyclines, amoxicillin-clavulanic acid, cephalosporins, and carbapenems were shown to be highly resistant. Prior MDR-GNB infection, older age, previous use of broad-spectrum antibiotics, high frequency of local antibiotic resistance, prolonged hospital stays, ICU admission, mechanical ventilation, and immunosuppression are associated with the MDR-GNB colonization.S. maltophiliawas reported as a severe cause of HAP/VAP in patients with mechanically ventilated and having hematologic malignancy due to its ability of biofilm formation, site adhesion in respiratory devices, and its intrinsic and acquired drug resistance mechanisms. Effective combination therapies targeting PDR strains and drug-resistant genes, antibiofilm agents, gene-based vaccinations, and pathogen-specific lymphocytes should be developed in the future.
Development and content validation of the Symptoms Evolution of COVID-19: a patient-reported electronic daily diary in clinical and real-world studies
Authors: Rofail Diana , McGale Nadine , Im Joseph , Rams Alissa , Przydzial Krystian , Mastey Vera , Sivapalasingam Sumathi , Podolanczuk Anna J.
Published: May 2022

Background

At the onset of the COVID-19 pandemic, there was limited understanding of symptom experience and disease progression. We developed and validated a fit-for-purpose disease-specific instrument to assess symptoms in patients with COVID-19 to inform endpoints in an interventional trial for non-hospitalized patients.

Methods

The initial drafting of the 23-item Symptoms Evolution of COVID-19 (SE-C19) Instrument was developed based on the Centers for Disease Control and Prevention symptom list and available published literature specific to patients with COVID-19 as of Spring 2020. The measurement principles outlined in the Food and Drug Administration (FDA) Patient-Reported Outcomes (PRO) guidance and the FDA's series of four methodological Patient-Focused Drug Development guidance documents were also considered. Following initial development, semi-structured qualitative interviews were conducted with a purposive sample of 30 non-hospitalized COVID-19 patients. Interviews involved two stages: (1) concept elicitation, to obtain information about the symptoms experienced as a result of COVID-19 in the patients’ own words, and (2) cognitive debriefing, for patients to describe their understanding of the SE-C19 instructions, specific symptoms, response options, and recall period to ensure the content of the SE-C19 is relevant and comprehensive. Five clinicians treating COVID-19 outpatients were also interviewed to obtain their insights on symptoms experienced by patients and provide input on the SE-C19.

Results

Patients reported no issues regarding the relevance or appropriateness of the SE-C19 instructions, including the 24-h recall period. The comprehensiveness of the SE-C19 was confirmed against the conceptualization of the patient experience of symptoms developed in the qualitative research. Minor conceptual gaps were revealed to capture nuances in the experience of nasal and gustatory symptoms and systemic manifestations of sickness. Almost all items were endorsed by patients as being appropriate, well understood, and easy to respond to. The clinicians largely approved all items, response options, and recall period.

Conclusions

The qualitative research provided supportive evidence of the content validity of the SE-C19 to assess the symptoms of outpatients with COVID-19, and its use in clinical trials to evaluate the benefit of treatment. Minor changes may be considered to improve conceptual clarity and ease of responding.
Antitumor effect of partially purified venom protein from Conus virgo on rat glioma cell line
Authors: Ganesan Dhana Sekaran , Annadurai Dhasarathan , Vadakkuvaselvi Lakshmanan , Neelan Kathirvel , Chinnasamy Arulvasu
Published: May 2022

Background

Since many research works have been carried out to identify the pharmacological properties of conotoxins from many Conus sp. The pharmacological properties of higher molecular weight toxin from the venom of Conus sp. have been poorly elucidated. Therefore, the present investigation was made to isolate the higher molecular weight toxin from the venom of Conus virgo and to test its antitumor effect on rat glioma cell line.

Results

The partially purified fraction 1 showed better activity (IC50 50 μg/ml) than fraction 2 (IC50 150 µg/ml) after 24 h incubation. The decreased elevation of creatine kinase was documented on fraction 1treated C6 cells. Vero cells showed minimal cell damage at 150 μg/ml 24 h as well. The nuclear morphology and nuclear fragmentation showed the presence of nuclear damage in C6 cells. Western blot analysis revealing the upregulation of the p53-mediated intrinsic apoptotic pathway was documented.

Conclusions

The present investigation emphasizes that the partially purified fraction 1 has triggered p53 mediated apoptosis by synergism of two higher molecular weight toxins in Rat glioma cell.
Association between cerebral microbleeds and inflammatory biomarkers in patients with ischemic stroke
Authors: Diker Sevda , Gelener Pınar , Eker Amber , Kaymakamzade Bahar , Mut Senem , Erem Ayşegül , Balyemez Uğurcan
Published: May 2022

Background

Host inflammation has been studied in patients with ischemic stroke (IS) due to large vessel occlusions. Inflammatory markers were shown to correlate with large artery atherosclerosis and worse outcomes after ischemic stroke due to large vessel occlusions. However, the association between inflammation and cerebral small vessel disease (SVD) is controversial. Mostly studied are the white matter hyperintensities; however, results regarding association of white matter hyperintensities with inflammatory markers are conflicting. We aimed to investigate the association between cerebral microbleed (CMB) load, as an indicator of SVD, and inflammation indices in patients with IS.

Results

We identified 127 patients with IS admitted within 7 days of symptom onset. CMBs were detected in 37% (n: 47) of patients. Patient’s age and Fazekas score were independently associated with CMB load. Inflammatory biomarkers were not associated with the presence or quantitative burden of CMBs.

Conclusions

White matter damage and patient’s age predicted CMB presence and number, respectively, in IS patients. However, inflammatory markers failed to show any association with such SVD signs. Prospective studies with a higher number of stroke patients are needed in order to justify our findings.
High flow nasal oxygen therapy for COVID 19: an unusual complication
Authors: Kumar Tushar , Tirkey Amit , Bhattacharya P. K. , Suwalka U. , Lakra Ladhu
Published: May 2022

Background

Acute hypoxemic respiratory failure is the most common complication of COVID 19 infection. Newer ways for oxygen therapy were explored during this pandemic. High flow nasal oxygenation (HFNO) emerged as a novel technique for oxygenation and prevented the need for invasive mechanical ventilation during hypoxia among COVID patients. Using high flow oxygen dries the nasal mucosa and leads to skin disruption. We are presenting this case as this complication has not been reported anywhere to our knowledge.

Case presentation

Here we present a case of a 62-year-old male, who was on HFNO for a long time as a part of treatment for COVID 19 and developed ulceration in the nasal septa. Patient belonged to a geriatric age group and had diabetes mellitus. Close monitoring by ICU (intensive care unit) staff was a big problem during this pandemic. Daily physical assessment, good nutrition, and daily dressing with plastic surgery consultation helped treat our patient.

Conclusions

Geriatric patients with other co-morbidities are vulnerable to mucosal injury. Even in COVID era, everyday general physical surveillance is very vital in such patients to prevent these complications. During this pandemic close monitoring of patients suffered due to scarcity of ICU staff. In spite of that, it is a must to ensure daily physical surveillance and good supplemental nutrition especially in geriatric patients.
A comparison of clustering methods for the spatial reduction of renewable electricity optimisation models of Europe
Authors: Frysztacki Martha Maria , Recht Gereon , Brown Tom
Published: May 2022

Modeling the optimal design of the future European energy system involves large data volumes and many mathematical constraints, typically resulting in a significant computational burden. As a result, modelers often apply reductions to their model that can have a significant effect on the accuracy of their results. This study investigates methods for spatially clustering electricity system models at transmission level to overcome the computational constraints. Spatial reduction has a strong effect both on flows in the electricity transmission network and on the way wind and solar generators are aggregated. Clustering methods applied in the literature are typically oriented either towards preserving network flows or towards preserving the properties of renewables, but both are important for future energy systems. In this work we adapt clustering algorithms to accurately represent both networks and renewables. To this end we focus on hierarchical clustering, since it preserves the topology of the transmission system. We test improvements to the similarity metrics used in the clustering by evaluating the resulting regions with measures on renewable feed-in and electrical distance between nodes. Then, the models are optimised under a brownfield capacity expansion for the European electricity system for varying spatial resolutions and renewable penetration. Results are compared to each other and to existing clustering approaches in the literature and evaluated on the preciseness of siting renewable capacity and the estimation of power flows. We find that any of the considered methods perform better than the commonly used approach of clustering by country boundaries and that any of the hierarchical methods yield better estimates than the established method of clustering with k-means on the coordinates of the network with respect to the studied parameters.
Zoo-technical responses of growing cattle fed sun-dried brewers’ spent grain at 20% of dietary inclusion
Authors: Singh Padam Veer , Ghosh M. K. , Mahesh M. S. , Chatterjee A.
Published: May 2022

Background

Agro-industrial by-products are gaining immense significance in animal feeding as a plausible solution to curtail ever-increasing prices of traditional feedstuffs, which may in turn stave off the skewed profit margin in dairy production. To this end, the present experiment sought to evaluate the effect of sun-dried brewers’ spent grain (BSG)—a by-product of distillery industry—as a dietary component on the performance outcome in cattle. Ten growing male Jersey crossbred cattle were stratified into two groups of control (T1) and treatment (T2) based on comparable body weight (BW: 59.3 ± 5.9 kg). Animals in group T1 were fed a basal diet comprising of approximately 15% green oats, 45% paddy straw and 40% concentrate mixture, whilst that of T2 contained 20% (w/w) sun-dried BSG, equally substituting concentrate mixture with the proportion of forage components similar to that of T1 on dry basis.

Results

105 days of experimental feeding revealed that the intake and apparent digestibility of nutrients did not differ between two groups. However, animals in group T2 exhibited a greater (P < 0.05) average daily gain in BW along with an improvement (P < 0.05) in feed conversion ratio over group T1. Additionally, diet offered to group T2 relatively proved 20% more economical than T1. Furthermore, on comparing cost/kg crude protein furnished by a range of conventional ingredients, BSG appeared third in the rank, only next to mustard (rapeseed) de-oiled cake and de-oiled rice bran.

Conclusion

Based on these results, it is concluded that sun-dried BSG could be incorporated at 20% in the diet for leveraging a greater growth performance in cattle, while also realising a distinct reduction in feed outlay.
Clinical outcomes in patients with persistent atrial fibrillation after technologic advances including contact force-guided and ablation index-guided ablation
Authors: Jeon Won Kyeong , Lee So-Ryoung , Choi Eue-Keun , Oh Seil
Published: May 2022

Purpose

We aimed to evaluate the influence of technological advances on ablation outcomes in patients with persistent atrial fibrillation (AF) (PeAF). Radiofrequency ablation for patients with AF has advanced, including contact force (CF)-sensing catheters and the ablation index (AI).

Methods

Between 2009 and 2018, we analyzed 173 patients with PeAF who underwent catheter ablation. We categorized them into three groups: AF ablation without CF and AI information (no-CF group, n = 63), with CF without AI (CF-only group, n = 49), and with optimal AI-guided ablation (AI group, n = 61). Early (within 3 months, ER) and late (from 3 months to 1 year, LR) AF recurrence after ablation was assessed. Procedure-related complications were also evaluated.

Results

The baseline characteristics were similar among the 3 groups, excluding the baseline antiarrhythmic drug history. Additional substrate modification after pulmonary vein isolation was significantly low in frequency in the AI group (71.4%, no-CF; 69.4%, CF-only; 41.0%, AI, p = 0.001). The AI group had a shorter mean procedure-related time than the other groups. Both ER and LR of PeAF showed a trend of reduction with technological advances. With a short experience (less than 1 year), the CF-only group showed more ER and LR than that shown by the AI group. However, with a long experience (more than 1 year), ER and LR occurred similarly in the two groups. Procedure-related complications improved with technological advances.

Conclusion

As ablation technology advanced, favorable clinical outcomes with short procedural times were observed. However, prospective, large multicenter studies are needed to verify these results.
The shifting educational landscape: science teachers’ practice during the COVID-19 pandemic through an activity theory lens
Authors: McPherson Heather , Pearce Rebecca
Published: May 2022

In March 2020, the COVID-19 pandemic closed all educational institutions. Teachers were called upon to respond quickly to the needs of K-12 students. They had to learn how to navigate online learning systems while simultaneously delivering engaging inquiry-based activities in high-stakes school science courses. To understand how teachers navigated these dual tensions, we have drawn on Cultural-Historical Activity Theory (CHAT) to describe how teachers learned and mediated their professional practices to meet the educational needs of their students. We examine the rapidly changing school activity system and how these changes impacted teachers’ epistemological beliefs about student engagement and evaluation. We report that teachers developed new styles and attitudes about teaching that reflected the new educational landscape imposed by the pandemic. We explore the pedagogical shifts that characterize this specific time and how the newly acquired pedagogies could find permanence in teachers’ activities post-pandemic. This study reports on the experiences of ten teachers from two high schools as they adapt to change during the global pandemic. We followed the teachers’ professional journey as they worked in a professional learning community to develop online practices. Professional learning meetings, semi-structured interviews, and participant journals captured teachers’ successes and failures as they struggled to adapt inquiry-based science lessons to meet the challenges of teaching online. Their practices shifted as they engaged students in synchronous collaborative projects and laboratory activities, and they developed alternative formative and summative assessment practices. This study contributes to a growing body of research of teacher practice through a CHAT theoretical framework to understand teachers’ professional learning during a time of change and upheaval.
Comparative frequency distribution of glutathione S-transferase mu (GSTM1) and theta (GSTT1) allelic forms in Himachal Pradesh population
Authors: Hemlata  , Singh Jagphool , Bhardwaj Anuradha , Kumar Anil , Singh Gulab , Priya Kanu , Giri Shiv Kumar
Published: May 2022

Background

Glutathione S-transferases (GSTs) are a class of important Phase II detoxification enzymes that catalyze the conjugation of glutathione and xenobiotic compounds (environmental carcinogens, pollutants and drugs) to protect against oxidative stress. GSTT1 and GSTM1 genetic polymorphisms have been extensively studied, and null genotypes or homozygous deletions have been reported in various populations. Previous studies have suggested that those who are homozygous null at the GSTM1 or GSTT1 loci are more susceptible and have a higher risk of cancers linked to environmental pollutants and drug-induced toxicity. Our study focused on GSTM1 and GSTT1 null allele frequency in the Doon population of Himachal Pradesh (India) with a comparison across other Inter and Intra-Indian ethnic groups to predict variation in the possible susceptible status.

Material and methods

Genomic DNA samples were extracted from 297 healthy unrelated individuals by a ReliaPrep™ Blood gDNA Miniprep kit (Promega, USA), and genotyped for allelic variation in GSTM1 and GSTT1 genotypes by multiplex polymerase chain reaction. Fisher's exact test was applied using SPSS.20 to analyze the genotypic distribution of GSTM1 and GSTT1 null alleles in male and female of Doon region (Solan) Himachal Pradesh.

Results

In our study, the frequency distribution of the homozygous null genotypes of GSTM1, GSTT1 individually as well as combined was found as 33.3%, 32% and 9%, respectively. Upon gender-wise comparison, a non-significant distribution (p > 0.05) for null genotypes of GSTM1 (32.8% and 35.4%, OR-0.77, 95% CI 0.42–1.41), GSTT1 (33.2% and 27.7%, OR-1.12, 95% CI 0.63–2.0) individually and combined GSTM1 and GSTT1 (10.8% and 3.7%, OR-0.31, 95% CI 0.07–1.42) were observed in studied population.

Conclusions

In our studied population, the frequency of GSTM1 null genotypes was found deviated from Inter- and Intra-Indian ethnic groups. However, the frequency of homozygous null type of GSTT1 was not significantly different, when compared to previous Indian studies, comparison with global ethnic groups showed deviation. Thus, our study has highlighted possible susceptibility risk to various xenobiotics in the Doon population of Himachal Pradesh, India.
Beta Thalassemia and Klinefelter syndrome: a rare occurrence
Authors: Billapati Sushmitha , Sowmya G. C. , Tapadia R. S. , Dutta Usha R.
Published: May 2022

Background

β-Thalassemia is an inherited haematological blood disorder in the HBB gene, and variations in this HBB gene lead to the absence/deficiency of the Beta chain synthesis of haemoglobin leading to severe anaemia. Klinefelter syndrome is a chromosomal abnormality that affects physical and cognitive development in males. Affected individuals are taller, show gynaecomastia and behavioural problems and have small testes that do not produce much testosterone. We describe a boy with β-Thalassemia major referred for chromosomal analysis due to delayed puberty and short stature. This is a second case reported in the literature that gives information on two different contradicting genetic disorders in a single individual but novel case as he exhibits additional short-stature phenotype.

Case presentation

A 17-year-old boy with short stature and gonadal dysfunction was referred for chromosomal analysis. He needed blood transfusion every 4 weeks. The GTG banding for chromosomal analysis and standard PCR for variant detection of HBB gene, Bi-directional Sanger sequencing of the PCR products and multiplex PCR for Y microdeletion of the AZF a, b and c regions on the Y chromosome were performed. The cytogenetic analysis revealed a karyotype of 47,XXY. The HBB gene detected two heterozygous variants forming a pathogenic compound heterozygous condition. The multiplex PCR revealed that the AZF a, b and c regions were intact and were not deleted.

Conclusion

To our knowledge, this is the second case of a patient with β-Thalassemia associated with Klinefelter syndrome but a novel case with short-stature phenotype association instead of tall stature. The possible association of these two disorders and the unusual phenotypic presentation are discussed. This study highlights the possibility of ruling out Thalassemia while evaluating patients with short stature and delayed puberty.
On-X mitral valve leaflet embolization presenting as acute pulmonary oedema
Authors: Sidali Lindiwe , Ndibi Nandipha , Moopanar Manogran , Madansein Rajhmun
Published: May 2022

Background

Structural valve failure in the form of leaflet fracture and embolization is an uncommon complication. Severe valve regurgitation with pulmonary oedema in a patient with a history of a prosthetic cardiac valve requires urgent diagnosis. An echocardiogram is essential in identifying the cause of valve failure.

Case presentation

We report a case of a 21-year-old male patient who presented with acute pulmonary oedema due to fracture and embolization of a leaflet of an On-X mitral valve four years post-implant. He underwent an emergency redo mitral valve replacement with a good outcome.

Conclusions

Structural valve failure with leaflet fracture and embolization is an extremely rare complication and may be fatal. Good clinical acumen is required for prompt diagnosis in any patient who presents with a circulatory collapse in the presence of a history of previous cardiac surgery. Once the diagnosis is made, the patient should undergo emergency redo valve replacement surgery.
Sepia officinalis ink mitigates gastric ulcer via modulation of antioxidant/anti-inflammatory pathways
Authors: Sadek Shimaa A.
Published: May 2022

Background

Sepia officinalis ink is a bioactive secondary metabolite rich in melanin granules, which has a wide range of nutritional and therapeutic values and also has been used to prevent various gastrointestinal disorders. Gastric ulcer, the most common gastrointestinal disease, is characterized by severe gastric mucosa damage, and its prevention is currently one of the main goals of clinical and experimental studies. Thus, the present study was focused on evaluating the potential gastroprotective efficacy of Sepia officinalis ink extract (SOIE) against ethanol-induced gastric ulcer in rats.

Results

The current results revealed that SOIE administration at the two selected doses improved significantly gastric mucosa integrity as indicated by the significant (P < 0.05) amelioration in gastric secretion indices (pH and volume) and the marked decrease in the ulcer index. Moreover, SOIE could counteract the gastric oxidative stress induced by ethanol via a marked decline in malondialdehyde content as well as a significant (P < 0.05) increment in glutathione content and antioxidant enzymes activities (catalase and glutathione-s-transferase). Additionally, SOIE treatment caused a significant (P < 0.05) reduction in gastric nitric oxide content. Respecting morphological and histopathological studies, SOIE treatment at 200 mg/kg body weight caused marked healing of gastric lesions as indicated by no hemorrhagic bands or injuries observed as well as significantly reduced severity score of ulcer.

Conclusions

SOIE could be used as a promising alternative antiulcerogenic compound to treat severe gastric lesions.
Coinfection of fungi with SARS-CoV-2 is a detrimental health risk for COVID-19 patients
Authors: Baten Nahida , Wajed Shah , Talukder Asma , Masum Md. Habib Ullah , Rahman Md. Mijanur
Published: May 2022

Background

Notable fungal coinfections with SARS-CoV-2 in COVID-19 patients have been reported worldwide in an alarming way. Mucor spp. and Rhizopus spp. were commonly known as black fungi, whereas Aspergillus spp. and Candida spp. were designated as white fungi implicated in those infections. In this review, we focused on the global outbreaks of fungal coinfection with SARS-CoV-2, the role of the human immune system, and a detailed understanding of those fungi to delineate the contribution of such coinfections in deteriorating the health conditions of COVID-19 patients based on current knowledge.

Main body

Impaired CD4 + T cell response due to SARS-CoV-2 infection creates an opportunity for fungi to take over the host cells and, consequently, cause severe fungal coinfections, including candidiasis and candidemia, mucormycosis, invasive pulmonary aspergillosis (IPA), and COVID-19-associated pulmonary aspergillosis (CAPA). Among them, mucormycosis and CAPA have been reported with a mortality rate of 66% in India and 60% in Colombia. Moreover, IPA has been reported in Belgium, Netherlands, France, and Germany with a morbidity rate of 20.6%, 19.6%, 33.3%, and 26%, respectively. Several antifungal drugs have been applied to combat fungal coinfection in COVID-19 patients, including Voriconazole, Isavuconazole, and Echinocandins.

Conclusion

SARS-CoV-2 deteriorates the immune system so that several fungi could take that opportunity and cause life-threatening health situations. To reduce the mortality and morbidity of fungal coinfections, it needs immunity boosting, proper hygiene and sanitation, and appropriate medication based on the diagnosis.
Socio-demographic and clinical profile of pediatric patients with cerebral palsy in Gujarat, India
Authors: Ramanandi Vivek H. , Shukla Yagna U.
Published: May 2022

Purpose

Cerebral palsy is a common childhood neurodevelopmental disorder. The estimated prevalence of cerebral palsy in India ranges from 2.1 to 3 per 1000 live births as per published literature. The present study was aimed to study socio-demographic and clinical profiles of cerebral palsy children in the Gujarat state of India.

Materials and methods

A total of 481 cerebral palsy children were included from various physiotherapy, rehabilitation, and neurological setups across Gujarat between May 2018 and April 2019. Information regarding gender, age, city of residence, family details, types of cerebral palsy, and gross motor function classification system was collected using a simple survey form designed for the study.

Result

The study showed that 67.57% of children were male and 32.22% were in the age group of 48–96 months. When classified 77.34% had a spastic type of cerebral palsy, out of which diplegic cerebral palsy was reported to be the most common (42.83%). When assessed for functional levels, most of the children were classified in gross motor function classification system levels 3 and 4 (76.30%).

Conclusion

The findings of this study support the published data and emphasize the need for a robust and authentic official database of cerebral palsy in Gujarat and India to help in the estimation of the current disease burden and implementation policies for the prevention and management of cerebral palsy.
Lung health after tuberculosis: clinical and functional assessment in post-pulmonary tuberculosis Egyptian patients
Authors: Abdelaleem Nermeen A. , Ahmed Mostafa K. , Mohamed Marwan N. , Bayoumi Hassan A.
Published: May 2022

Background

Some of the pulmonary tuberculous patients who completed their medication course experience lung function impairment which may influence their quality of life. However, the pattern and nature of post-tuberculosis lung impairment are still not identified. Thus, the aim of this study was to determine the type and degree of lung physiology changes in previously treated tuberculous patients which latter may affect their quality of life, thus helping clinicians for early diagnosis of lung impairment, especially in tuberculous endemic areas.

Results

Adults (≥18 years) who were treated from first attack pulmonary tuberculosis were included in the study. Demographic data, respiratory symptoms, smoking history, comorbidities, Medical Research Council dyspnea score (MRC), spirometry, chest radiography, and oxygen saturation were collected. One hundred ninety-seven participants were finally included in the study. The mean age was 49.50±13.26 years with males representing 75.6% of total patients. MRC dyspnea scale grading showed that about 13.2% and 5.1% of patients suffer from dyspnea grade II and grade III, respectively. Main respiratory symptoms were cough in 38.1%, sputum production in 24.9%, and hemoptysis in 6.6% cases. Normal spirometry was documented in 53.3%, obstructive pattern in 31.98%, and mixed pattern in 7.11%, whereas 7.61% cases had a restrictive pattern. According to ATS staging of obstructive pattern, 27 patients (42.8%) had mild obstruction, 22 (34.9%) patients had moderate obstruction, 13 (20.6%) patients had moderate to severe obstruction, and one patient (1.6%) had severe obstruction.

Conclusions

Impairment of respiratory function after tuberculosis is one of the causes of chronic lung disease that is underestimated, especially in endemic countries. This impairment in function occurs early in the course of the diseases and even without symptoms, affecting the quality of life. Thus, clinicians should encourage patients for an earlier visit to a respiratory clinic for follow-up and further management if needed. Guidelines for the management of cured tuberculous patients are urgently needed.

Trial registration

ClinicalTrials.gov, NCT05097638. Registered on October 28, 2021—retrospectively registered
A double hurdle estimation of crop diversification decisions by smallholder wheat farmers in Sinana District, Bale Zone, Ethiopia
Authors: Derso Dereje , Tolossa Degefa , Seyoum Abrham
Published: May 2022

Background

Ethiopia is heterogeneous in agro-ecological, social, and economic conditions. In such heterogeneous environment, crop production needs to be diversified to meet household consumption and market needs. This study analyzed determinants of crop diversification in wheat dominant producer rural households in Ethiopia’s Sinana District of the Oromia Regional State. The study utilized a structured survey of 384 households, and both inferential and descriptive statistics were employed to analyze the data. A Cragg’s double hurdle model was applied to identify factors influencing decision and the extent of crop diversification.

Results

We found that decision to crop diversification was positively associated with household size, access to fertile farm plots, and access to extension services and negatively associated with age of household head, and participation in off/non-farm activities. The extent of crop diversification is positively associated with access to extension services, labor availability, membership to farmers cooperatives, and distance to market.

Conclusions

These findings support the need for resources to strengthen available extension packages, support existing farmers’ cooperatives, and develop rural infrastructures in order to improve the smallholder farmers’ extent of crop diversifications.
The effect of inhibiting molybdate used in anodizing-conversion treatment to improve corrosion protection of AA2030 aluminum alloy in different steps
Authors: Benmohamed Manel , Benmounah Abdelbaki , Haddad Ahmed , Yahi Sarah
Published: May 2022

In this article, different treatment baths for corrosion protection of 2030 aluminum alloy in addition to replacing the hexavalent chromium due to the European recommendation were employed. This work is divided into three steps of treatment: first, anodization using molybdate inhibitor without and with phosphoric acid and, then, pre-oxidation with sodium hydroxide. In the last step, we studied the influence of conversion coating with the combination of sodium molybdate and fluoride on the anodic layer formed on aluminum alloy 2030. In order to characterize the formed layers, we use microstructural characterization (SEM, AFM, and nano-indentation), which allows highlighting the surface condition as well as the morphological distribution, and electrochemical techniques such as potentiodynamic polarization and electrochemical impedance spectroscopy which shows that the anodization treatment of the aluminum alloy with phosphoric acid and sodium molybdate offered better corrosion resistance. This resistance increased with the use of pre-oxidation and then reached a maximum value of 99.8% efficiency with the addition of the molybdate conversion coating which causes an increase in the double layer and gave an alternative possibility of chromium VI.
Effectiveness and cost-effectiveness of psychiatric mother and baby units: quasi-experimental study
Authors: Howard Louise M. , Trevillion Kylee , Potts Laura , Heslin Margaret , Pickles Andrew , Byford Sarah , Carson Lauren E. , Dolman Clare , Jennings Stacey , Johnson Sonia , Jones Ian , McDonald Rebecca , Pawlby Susan , Powell Claire , Seneviratne Gertrude , Shallcross Rebekah , Stanley Nicky , Wieck Angelika , Abel Kathryn M.
Published: May 2022

Background

Psychiatric mother and baby units (MBUs) are recommended for severe perinatal mental illness, but effectiveness compared with other forms of acute care remains unknown.

Aims

We hypothesised that women admitted to MBUs would be less likely to be readmitted to acute care in the 12 months following discharge, compared with women admitted to non-MBU acute care (generic psychiatric wards or crisis resolution teams (CRTs)).

Method

Quasi-experimental cohort study of women accessing acute psychiatric care up to 1 year postpartum in 42 healthcare organisations across England and Wales. Primary outcome was readmission within 12 months post-discharge. Propensity scores were used to account for systematic differences between MBU and non-MBU participants. Secondary outcomes included assessment of cost-effectiveness, experience of services, unmet needs, perceived bonding, observed mother–infant interaction quality and safeguarding outcome.

Results

Of 279 women, 108 (39%) received MBU care, 62 (22%) generic ward care and 109 (39%) CRT care only. The MBU group (n = 105) had similar readmission rates to the non-MBU group (n = 158) (aOR = 0.95, 95% CI 0.86–1.04, P = 0.29; an absolute difference of −5%, 95% CI −14 to 4%). Service satisfaction was significantly higher among women accessing MBUs compared with non-MBUs; no significant differences were observed for any other secondary outcomes.

Conclusions

We found no significant differences in rates of readmission, but MBU advantage might have been masked by residual confounders; readmission will also depend on quality of care after discharge and type of illness. Future studies should attempt to identify the effective ingredients of specialist perinatal in-patient and community care to improve outcomes.
Stick-slip contact line motion on Kelvin-Voigt model substrates
Authors: Mokbel Dominic , Aland Sebastian , Karpitschka Stefan
Published: May 2022

The capillary traction of a liquid contact line causes highly localized deformations in soft solids, tremendously slowing down wetting and dewetting dynamics by viscoelastic braking. Enforcing nonetheless large velocities leads to the so-called stick-slip instability, during which the contact line periodically depins from its own wetting ridge. The mechanism of this periodic motion and, especially, the role of the dynamics in the fluid have remained elusive, partly because a theoretical description of the unsteady soft wetting problem is not available so far. Here we present the first numerical simulations of the full unsteady soft wetting problem, with a full coupling between the liquid and the solid dynamics. We observe three regimes of soft wetting dynamics: steady viscoelastic braking at slow speeds, stick-slip motion at intermediate speeds, followed by a region of viscoelastic braking where stick-slip is suppressed by liquid damping, which ultimately gives way to classical wetting dynamics, dominated by liquid dissipation.
Characteristics of Sagittal Spinopelvic Alignment Changes After Symptom Relief After Simple Lumbar Decompression
Authors: Ham Chang Hwa , Park Youn-Kwan , Kim Joo Han , Kwon Woo-Keun , Kim Dong Wook , Moon Hong Joo
Published: May 2022

BACKGROUND:

Sagittal spinopelvic alignment (SSPA) parameters are essential for the diagnosis of adult spinal deformities (ASDs) and their progression. Certain clinical symptoms that occur in patients with lumbar spinal stenosis (LSS) and herniated nucleus pulposus (HNP) may distort the SSPA and mimic ASD.

OBJECTIVE:

To differentiate SSPA in symptomatic patients from asymptomatic patients within 10 minutes in the standing position.

METHODS:

This retrospective cohort study evaluated changes in SSPA after simple lumbar decompression surgery in patients with LSS and HNP. Relative sagittal alignment (RSA), relative pelvic version, relative lumbar lordosis (RLL), Lordosis Distribution Index (LDI), and global alignment and proportion (GAP) values were calculated using the conventional Schwab classification method. First, the preoperative and postoperative SSPA parameters were compared. Second, patients were subgrouped into symptomatic within 10 minutes of standing (SP group) and other symptoms of LSS and HNP as controls. Changes in SSPA parameters after symptom relief after simple lumbar decompression surgery were compared between the two groups.

RESULTS:

Overall, all SSPA parameters improved after surgery. However, after subgrouping, patients in the control group did not show significant SSPA alterations, except for LDI, whereas patients in the SP group significantly improved in terms of their RSA, RLL, LDI, and GAP values after symptom relief after surgery.

CONCLUSION:

Patients with pain on standing within 10 minutes showed significant correction in RSA, RLL, and GAP values after simple lumbar decompression. Therefore, it is important to observe such clinical symptoms to avoid misdiagnosis of ASD.