bluuebunny/crossref_metadata_2025 huggingface dataset:
Stress Resistance of Persons of Hazardous Occupations in Conditions of Local Armed Conflict
Authors:   Lugansk Republican Centre for Emergency Medical Aid and Disaster Medicine, Lugansk, Ukraine, Parkhomchuk D.S. , Vostrikov A.A. ,   Lugansk Republican Centre for Emergency Medical Aid and Disaster Medicine, Lugansk, Ukraine
Published: February 2021

The purpose of the study is to study professionally significant psychological features of persons of hazardous occupations (OP) in the conditions of an incomplete local armed conflict (LVK), to identify maladaptation states and to develop recommendations for improving the work of the medical and psychological service. Materials and methods of research. The study was conducted by specialists of the laboratory of Psychophysiological Support (PFO) on the basis of the Luhansk Republican Center for Emergency Medical Care and Disaster Medicine. The object of the study – 590 respondents representatives of OP (470 - men, 120 - women) aged 20 to 60 years. All respondents have been working under the conditions of incomplete LVK since 2014 to the present. To study neuropsychiatric stability and anxiety, the "Level of Neuropsychiatric Stability" method and the Spielberger-Hanin method were used. To identify significant differences in the psychological characteristics of persons of hazardous occupations, the Student's t-test was used. The results of the study and their analysis. Professionally significant psychological features of persons of hazardous occupations working in the conditions of incomplete LVK are analyzed. A comparative analysis of the obtained data is carried out, taking into account the biological age and gender differences. The results of the study can be used in further study of the psychological indicators of respondents working in the conditions of LVK, and for the development of programs aimed at maintaining, correcting and forming the psychological health of the participants of LVK who are in high-risk conditions.
Routing Problems in Medical Evacuation of Victims in Emergency Situations: Results of SWOT Analysis of Solutions to Situational Problems in Urban. Message 1
Authors:   All-Russian Centre for Disaster Medicine Zashchita of Federal Medical Biological Agency, Moscow, Russian Federation, Baranova N.N. ,   Russian Medical Academy of Continuous Professional Education, the Ministry of Health of the Russian Federation, Moscow, Russian Federation
Published: February 2021

The purpose of the study is to analyze and evaluate the decisions of specialists of regional Services for disaster medicine (SMK) of the country on the application of routing principles during medical evacuation and to identify ways to improve the quality and effectiveness of medical evacuation measures (LEM) under various conditions of emergency situations with a large number of victims. Materials and methods of research. The research is based on 85 solutions to actual problems "100 victims" with different structure of the lesions according to their location and severity, with different proportion of adults and children and different locations of emergency with the use of technology case method (Case study) and SWOT analysis of medical evacuation events in liquidation health impacts of various emergency situations. The results of the study and their analysis. Medical specialists who took part in solving situational tasks-cases, and experts of the Staff of the All-Russian Service for Disaster Medicine (VSMK) identified a fairly large number of factors that affect the quality of medical evacuation measures in emergencies, which, in relation to SWOT analysis, can be structured into "internal"- strong and weak, and "external" – increasing the possibility of quality medical evacuation measures or increasing the risk of adverse outcomes. The analysis of the factors identified, in relation to the conduct of medical evacuations in the event of an emergency in the city, suburban area and in a remote area – more than 50 km from the city - revealed the strengths and weaknesses of each option: - when conducting medical evacuation in the city - the prevalence of strong "internal" sides and the presence of certain risks; - when conducting medical evacuation in the event of an emergency in a suburban area – similar positions, but with a number of differences that affect the routing; - when an emergency occurs in a remote area – a large number of weak "internal" factors and "external" risks are compensated by the available opportunities. In all cases of emergency, a weighted score of factors was carried out. As a result of the SWOT analysis, the goal was achieved – the directions of improving medical evacuation measures for the development of a strategy for "breakthrough", "development", "defense" and "containment" in each case of an emergency were identified.
Improving Provision of Emergency Medical Consultation and Medical Evacuation in Kurgan Region
Authors:   Kurgan Regional Centre for Disaster Medicine, the Ministry of Health of the Russian Federation, Kurgan, Russian Federation, Shumaev A.Yu
Published: February 2021

The article presents the experience of the specialists of the Department of Emergency consultative medical care (ECMP) of the territorial Center for Disaster Medicine (TCMC) of the Kurgan Region in improving the quality of emergency consultative medical care and medical evacuation in the region when the TCMC operates in the mode of daily activities. Proposals are made on improvement of work of ECMP departments of the territorial centers for disaster medicine.
PROJETO CRIATIVO ECOFORMADOR: BRINQUEDOS E BRINCADEIRAS, DA ANTINGUIDADE À CONTEMPORANEIDADE
Authors: Pires Ana Paula de Lima , Almeida Aline Lima da Rocha , Silva Elisamara Gaspar da , Olszewski Juliana Taska , Ariotti Mayara Maria , Baade Joel Haroldo , Marques Circe Mara
Published: February 2021

Este artigo sistematiza uma experiência realizada na Educação Infantil com a metodologia dos Projetos Criativos Ecoformadores (PCE). A proposta teve como objetivo estimular a exploração de brincadeiras tradicionais, visando a ampliação de possibilidades pedagógicas comprometidas com o desenvolvimento integral. Entre os resultados da intervenção, observou-se tanto o aumento da aproximação entre a família e a escola como a articulação entre o currículo da Educação Infantil com a realidade das crianças. As atividades envolveram, entre outras ações, pesquisas sobre as brincadeiras que faziam parte da infância dos pais e oficina de produção de brinquedos.

Palavras-chave: Educação Infantil. Projetos Criativos Ecoformadores. Brinquedos.

ABSTRACT: This article systematizes one experience performed at the Child Education with the methodology of the Ecoformer Creative Projects (ECP) [Projetos Criativos Ecoformadores (PCE)]. The proposal aimed to stimulate the exploration of traditional children’s play, considering the widening of pedagogical possibilities committed to the integral development. Among the results of the intervention, it was observed a higher rapprochement between the family and the school as well as the articulation between the syllabus of the Child Education with the children’s reality. The activities involved, among other actions, researches about the children’s play which were part of the parents’ childhood and the workshop of toys production.

Keywords: Child Education. Ecoformer Creative Projects. Toys.
Aspectos relacionados à gravidez e pós-parto de mulheres submetidas à cirurgia bariátrica
Authors: Silva Luana Fernandes e , Rodrigues Natália Gomes , Lima Marina Dayrell de Oliveira , Silva Thales Philipe Rodrigues da , Araújo Lauro Pinheiro Ferreira de , Roque Anna Luísa Marques Mariano , Matozinhos Fernanda Penido
Published: February 2021

Objetivo: Analisar os aspectos sociodemográficos, gineco-obstétricos, clínicos e comportamentais relacionados à gravidez e pós-parto de mulheres submetidas à cirurgia bariátrica. Método: Trata-se de uma coorte prospectiva, com 33 mulheres submetidas à cirurgia bariátrica, em um hospital privado de Minas Gerais. A coleta de dados ocorreu por meio de um questionário semiestruturado, aplicado por meio de ligações telefônicas. As análises foram realizadas usando-se o software Stata, versão 14.0. Resultados: O perfil gineco-obstétrico demonstrou que 78,79% das mulheres apresentaram melhora no desempenho sexual após a cirurgia bariátrica. Destas, 51,52% tiveram como via de nascimento a cesariana. 96,97% das mulheres não relataram complicações após a gestação, 76% conseguiram amamentar e 69,57% não tiveram intercorrências na amamentação. 81,25% não informaram nenhuma complicação de saúde do bebê. O perfil clínico evidenciou que 63,64% não foram acompanhadas por nutricionista após a cirurgia e 78,79% não tiveram acompanhamento por psicólogo ou psiquiatra. 96,97% não tiveram diagnóstico de Hipertensão Arterial Sistêmica após a cirurgia bariátrica e 100% não foram diagnosticadas de Diabetes Mellitus após o procedimento cirúrgico. Por fim, o perfil comportamental demonstrou que 78,79% das mulheres não praticavam atividade física nos últimos 3 meses, 66,67% não consumiam bebida alcoólica e 87,88% não eram tabagistas. Conclusão: O procedimento de cirurgia bariátrica está relacionado a desfechos positivos, portanto, a manutenção destes fatores está relacionada à forma de encarar os novos hábitos de vida e o acompanhamento multiprofissional. Apesar dos benefícios comprovados do procedimento cirúrgico, o mesmo pode levar a complicações clínicas e nutricionais maternas e fetais.
Como identificar uma manifestação oral de Herpes-Zoster?
Authors: Guimarães Fernanda , Pavelski Mateus Diego , Dallazen Eduardo , Santos Anderson Maikon de Souza , Delanora Leonardo Alan , Silva William Phillip Pereira , Faverani Leonardo Perez , Magro Filho Osvaldo
Published: February 2021

O herpes-zóster é uma infecção viral causada pela reativação do vírus da varicela-zóster, que acomete geralmente a população idosa. O vírus da varicela, quando em estado dormente, se localiza nos gânglios trigeminais e quando reativado pode causar lesões no rosto e vesículas intra bucais. Esta doença pode afetar com maior prevalência pacientes imunossuprimidos e caracteriza-se por erupções maculopapulares distribuídas na região do nervo afetado, causando dores intensas, tremores e até parestesia. O diagnóstico do herpes zoster geralmente é estabelecido por meio do quadro clínico apresentado pelo paciente e o tratamento é voltado aos sintomas e à causa, optando pelo uso de medicações antivirais sistêmicas e tópicas. Este artigo relata o caso de uma paciente, do sexo feminino, leucoderma, sem problemas de saúde e tratamentos imunossupressores prévios, de 56 anos de idade, que deu entrada ao pronto socorro, tendo com queixa principal a dor extra oral em hemiface direita, com evolução rápida de três dias após exodontia.
Evaluation of pain after endodontic retreatment using reciprocating files or ultrasonic inserts for the desobturation of root canals: a randomized clinical study
Authors: Marassi Rafael , Limoeiro Ana Grasiela da Silva , Pelegrine Rina Andrea , Bueno Carlos Eduardo da Silveira , Kato Augusto Shoji , Rocha Daniel Guimarães Pedro , Martin Alexandre Sigrist de
Published: February 2021

This randomized clinical trial aimed to evaluate the endodontic retreatment techniques influence using reciprocating files and ultrasonic inserts in relation to the incidence, intensity, and postoperative pain duration. Forty-six patients were randomly assigned into two groups: Reciprocant files (RC group); or the Clearsonic Ultrasonic Insert (CL group;). Participants were asked to report the incidence, duration, and postoperative pain intensity using a visual analog scale (VAS) at 24, 48 and 72 h after retreatment. Fisher’s exact test was used to compare the two methods used regarding postoperative pain. The Mann-Whitney test was used to compare pain intensity, and Friedman’s test was used to assess the time effect on pain intensity. Finally, ordinal logistic regression analysis was used to assess the odds ratio for pain occurrence at a significance level of 5%. The postoperative pain incidence was significantly lower in the CL group in all experimental periods. Comparing the two techniques, pain intensity was significantly lower in the CL group after 24 and 48 h. For the RC group, pain intensity was significantly greater at 24 h compared with the other periods. The technique used in endodontic retreatment can influence postoperative pain.
Trabalho, educação e transformação social: elementos para a elaboração de um projeto alternativo
Authors: Duarte Jessyca Barbosa , Costa Renata Maria Paiva da , Medeiros Richelly Barbosa de
Published: February 2021

O presente artigo tem como objetivo expor a centralidade do trabalho como categoria fundante dos modelos de práxis social e abordar a educação como um complexo direcionado para a sociedade, isto é, inserida na reprodução das relações sociais, nas quais os homens influenciam as ações de outros homens. Compreendendo a educação como um por teleológico secundário, esta pode servir como veículo de manutenção da ordem hegemônica do capital. Na sociedade burguesa, o trabalho é capturado, a fim de atender às necessidades de acumulação de lucros; para tal, a educação seria fundamental, uma vez que forneceria não só o conhecimento científico para a produção das mercadorias, mas também seria instrumento de disseminação do ethos burguês. Para dar conta dessas análises, refletindo sobre uma possível alternativa a essa educação capitalista, este estudo se caracterizou, quanto aos objetivos, como exploratório, tendo sido, quanto aos procedimentos, embasado por revisão bibliográfica, que ocorreu em referenciais teóricos de aporte marxista. Portanto, a partir das análises teórico-metodológicas desenvolvidas, foi possível concluir que a construção de uma educação, de fato, emancipatória exigiria transformações societárias profundas, que fossem capazes de superar os mais diversos processos de alienação e de exploração de homens e de mulheres.
A categoria utilidade subjacente às tendências em Educação Matemática: discussão a partir da Pedagogia Histórico-Crítica
Authors: Spacek Iuri Kieslarck , Candiotto William Casagrande
Published: February 2021

A presente pesquisa, de cunho bibliográfico, apresenta um debate sobre a categoria utilidade no âmbito da Educação Matemática, em especial no âmbito da Pedagogia Histórico-Crítica. A partir disso, o problema de pesquisa se expressou no seguinte questionamento: como a categoria utilidade é entendida no âmbito da Educação Matemática a partir do prisma da Pedagogia Histórico-Crítica? Assim, o objetivo foi compreender a categoria utilidade no campo de estudos da Educação Matemática, de modo especial, a partir das bases teórico-metodológicas que fundamentam a Pedagogia Histórico-Crítica. No primeiro momento, analisamos a referida tendência e suas possíveis implicações na Educação Matemática. Verificamos que a utilidade não é vista no sentido imediato, mas pela relação que se estabelece entre indivíduo-sociedade-gênero. Desse modo, a referida Pedagogia se contrapõe a outras, de cunho utilitário-pragmatistas, que imputam ao conhecimento matemático uma essência pautada na imediaticidade da vida cotidiana. Por meio desse entendimento, corre-se o risco de transformar a Matemática em uma ciência que resume sua validade por suas meras aplicações práticas imediatas, tornando-as critério de verdade dos conceitos matemáticos. Como implicação, o ensino da Matemática teria como critérios a aplicação e o relacionamento direto com a vida cotidiana dos estudantes. Portanto, consideramos necessário e urgente um debate que se paute na gênese e no desenvolvimento histórico do conhecimento matemático a partir de uma interpretação dialético-materialista. A intenção é instigar as discussões com a finalidade de aprimorar o desenvolvimento da práxis pedagógica que tenha como fundamento uma formação humana omnilateral.
Genetic characterization of Flavobacterium columnare isolates from the Pacific Northwest, USA
Authors: Sebastião FdA , Shahin K , Heckman TI , LaFrentz BR , Griffin MJ , Loch TP , Mukkatira K , Veek T , Richey C , Adkison M , Holt RA , Soto E
Published: February 2021

Flavobacterium columnare is the causative agent of columnaris disease. Previous work has demonstrated a high degree of genetic variability among F. columnare isolates, identifying 4 genetic groups (GGs) with some host associations. Herein, a total of 49 F. columnare isolates were characterized, the majority of which were collected from 15 different locations throughout the US Pacific Northwest. Most isolates were collected from 2015-2018 and originated from disease outbreaks in salmonid hatcheries and rearing ponds, sturgeon hatcheries and ornamental fish. Other isolates were part of collections recovered from 1980-2018. Initial identification was confirmed by F. columnare species-specific qPCR. Study isolates were further characterized using a multiplex PCR that differentiates between the 4 currently recognized F. columnare GGs. Multiplex PCR results were supported by repetitive sequence-mediated PCR fingerprinting and gyrB sequence analysis. F. columnare GG1 was the most prevalent (83.7%, n = 41/49), represented by isolates from salmonids (n = 32), white sturgeon (n = 2), channel catfish (n = 1), ornamental goldfish (n = 1), koi (n = 3), wild sunfish (n = 1) and 1 unknown host. Six isolates (12.2%, n = 6/49) were identified as GG3, which were cultured from rainbow trout (n = 3) and steelhead trout (n = 3). Two isolates were identified as GG2 (4.1%, n = 2/49) and were from ornamental fish. No GG4 isolates were cultured in this study. The biological significance of this genetic variability remains unclear, but this variation could have significant implications for fish health management. The results from this study provide baseline data for future work developing strategies to ameliorate columnaris-related losses in the US Pacific Northwest.
The cardiovascular response to lower body negative pressure in humans depends on seal location
Authors: Goswami N , Grasser E , Roessler A , Schneditz D , Hinghofer-Szalkay H
Published: February 2021

We tested whether seal location at iliac crest (IC) or upper
abdomen (UA), before and during lower body negative pressure
(LBNP), would affect thoracic electrical impedance, hepatic blood
flow, and central cardiovascular responses to LBNP. After 30 min
of supine rest, LBNP at -40 mmHg was applied for 15 min, either
at IC or UA, in 14 healthy males. Plasma density and indocyanine
green concentrations assessed plasma volume changes and
hepatic perfusion. With both sealing types, LBNP-induced effects
remained unchanged for mean arterial pressure (-3.0±1.1
mm Hg), cardiac output (-1.0 l min-1), and plasma volume
(-11 %). Heart rate was greater during UA (80.6±3.3 bpm) than
IC (76.0±2.5 bpm) (p<0.01) and thoracic impedance increased
more using UA (3.2±0.2 Ω) than IC (1.8±0.2 Ω) (p<0.0001).
Furthermore, during supine rest, UA was accompanied by lower
thoracic impedance (26.9±1.1 vs 29.0±0.8 Ω, p<0.001) and
hepatic perfusion (1.6 vs 1.8 l.min-1, p<0.05) compared to IC.
The data suggest that the reduction in central blood volume in
response to LBNP depends on location of the applied seal. The
sealing in itself altered blood volume distribution and hepatic
perfusion in supine resting humans. Finally, application of LBNP
with the seal at the upper abdomen induced a markedly larger
reduction in central blood volume and greater increases in heart
rate than when the seal was located at the iliac crest.
Aerobic and Anaerobic Biodegradability of Organophosphates in Activated Sludge Derived From Kitchen Garbage Biomass and Agricultural Residues
Authors: Yang Xingfeng , Fan Deling , Gu Wen , Liu Jining , Shi Lili , Zhang Zhi , Zhou Linjun , Ji Guixiang
Published: February 2021

Organophosphates (also known as organophosphate esters, OPEs) have in recent years been found to be significant pollutants in both aerobic and anaerobic activated sludge. Food waste, such as kitchen garbage and agricultural residues, can be used as co-substrates to treat the active sludge in sewage treatment plants (STPs). We investigated the biodegradability of nine OPEs derived from kitchen garbage biomass and agricultural residues under different conditions. Under anaerobic conditions, the rate of removal of triphenyl ester OPEs was significantly higher than that of chloride and alkyl OPEs. The addition of FeCl3 and Fe powder increased the rate of degradation of triphenyl ester OPEs, with a DT50 for triphenyl ester OPEs of 1.7–3.8 d for FeCl3 and 1.3–4.7 d for Fe powder, compared to a DT50 of 4.3–6.9 d for the blank control. Addition of an electron donor and a rhamnolipid increased the rate of removal of chlorinated OPEs, with DT50 values for tris(2-carboxyethyl)phosphine) (TCEP) and tris(1,3-dichloroisopropyl)phosphate (TDCPP) of 18.4 and 10.0 d, respectively, following addition of the electron donor, and 13.7 and 3.0 d, respectively, following addition of the rhamnolipid. However, addition of an electron donor, electron acceptor, surfactant, and Fe powder did not always increase the degradation of different kinds of OPEs, which was closely related to the structure of the OPEs. No treatment increased the removal of alkyl OPEs due to their low anaerobic degradability. Tween 80, a non-ionic surfactant, inhibited anaerobic degradation to some degree for all OPEs. Under aerobic conditions, alkyl OPEs were more easily degraded, chlorinated OPEs needed a long adaptation period to degrade and finally attain a 90% removal rate, while the rates of degradation of triphenyl ester OPEs were significantly affected by the concentration of sludge. Higher sludge concentrations help microorganisms to adapt and remove OPEs. This study provides new insights into methods for eliminating emerging pollutants using activated sludge cultured with kitchen garbage biomass and agricultural residues.
Thickness Characteristics of Pāhoehoe Lavas in the Deccan Province, Western Ghats, India, and in Continental Flood Basalt Provinces Elsewhere
Authors: Self Stephen , Mittal Tushar , Jay Anne Elizabeth
Published: February 2021

Constraining the eruption rates of flood basalt lava flows remains a significant challenge despite decades of work. One potential observable proxy for eruption rates is flood basalt lava-flow lobe thicknesses, a topic that we tackle here quantitatively. In this study, we provide the first global compilation of pāhoehoe lava-lobe thicknesses from various continental flood basalt provinces (∼ 3,800 measurements) to compare characteristic thicknesses within and between provinces. We refer to thin lobes (∼ ≤5 m), characteristic of “compound” lavas, as hummocky pāhoehoe lava flows or flow-fields. Conversely, we term thicker lobes, characteristic of “simple” flows, as coming from sheet-lobe-dominated flows. Data from the Deccan Traps and Columbia River flood-basalt provinces are archetypal since they have the most consistent datasets as well as established chemo- and litho-stratigraphies. Examining Deccan lobe thicknesses, we find that previously suggested (and disputed) distinct temporal and regional distributions of hummocky pāhoehoe and sheet-lobe-dominated flow fields are not strongly supported by the data and that each geochemically defined formation displays both lobe types in varying amounts. Thin flow-lobes do not appear to indicate proximity to source. The modal lobe thickness of Deccan formations with abundant “thin” lava-lobes is 8 m, while the mode for sheet-lobe-dominated formations is only 17 m. Sheet-lobes up to 75–80 m are rare in the Deccan and Columbia River Provinces, and ones >100 m are exceptional globally. For other flood basalt provinces, modal thickness plots show a prevalence toward similar lobe thicknesses to Deccan, with many provinces having some or most lobes in the 5–8 m modal range. However, median values are generally thicker, in the 8–12 m range, suggesting that sheet-lobes dominate. By contrast, lobes from non-flood basalt flow-fields (e.g., Hawai’i, Snake River Plain) show distinctly thinner modes, sub-5 m. Our results provide a quantitative basis to ascertain variations in gross lava morphology and, perhaps, this will in future be related to emplacement dynamics of different flood basalt provinces, or parts thereof. We can also systematically distinguish outlier lobes (or regions) from typical lobes in a province, e.g., North American Central Atlantic Magmatic Province lava-lobes are anomalously thick and are closely related to feeder-intrusions, thus enabling a better understanding of conditions required to produce large-volume, thick, flood basalt lava-lobes and flows.
Information About Zoonotic Disease Risks Reduces Desire to Own Exotic Pets Among Global Consumers
Authors: Moorhouse Tom P. , D'Cruze Neil C. , Macdonald David W.
Published: February 2021

Demand for exotic pets is a substantial driver of the illegal wildlife trade. Previous work has suggested that this demand could be reduced by conservation marketing messaging highlighting the potential consequences to individual purchasers, in the form of zoonotic disease risks, or legal ramifications. Such work, however, has been limited only to respondents from culturally Western countries, and has not accounted for how underlying attitudes to the keeping of exotic pets may influence desire to own one, or affect the effectiveness of demand reduction messaging. We surveyed 1,000 respondents in each of Brazil, China, USA and Vietnam, showing each five mammal, bird, and reptile pets in random order. Each pet was accompanied with either a “control” statement, describing the species' diet, or one of four types of “treatment” statement describing zoonotic disease, animal welfare, legal or species conservation consequences. Respondents were asked to rate how much they would like to own the pet on a 1–10 scale. All respondents demonstrated decreased desire to own a given exotic when shown any of the types of treatment information, but disease information provoked the greatest decrease, relative to controls (a mean decrease of 26.9%, compared with 16.2, 17.9, and 18.9% for legality, welfare and conservation information, respectively). We also found that respondents with the highest stated likelihood of purchasing pets possessed a series of beliefs that could facilitate this purchase while maintaining an ethical self-image: in particular they believed that shops were well-regulated, and that they were able to distinguish captively-bred from wild caught animals. In summary all respondents of any nationality were motivated particularly to avoid the risk of zoonotic disease, and we recommend that demand reduction campaigns leverage this desire, particularly in the new context of COVID-19.
Immune Deregulation in Sepsis and Septic Shock: Reversing Immune Paralysis by Targeting PD-1/PD-L1 Pathway
Authors: Nakamori Yuki , Park Eun Jeong , Shimaoka Motomu
Published: February 2021

Sepsis remains a major problem for human health worldwide, thereby manifesting high rates of morbidity and mortality. Sepsis, once understood as a monophasic sustained hyperinflammation, is currently recognized as a dysregulated host response to infection, with both hyperinflammation and immunoparalysis occurring simultaneously from the earliest stages of sepsis, involving multiple organ dysfunctions. Despite the recent progress in the understanding of the pathophysiology underlying sepsis, no specific treatment to restore immune dysregulation in sepsis has been validated in clinical trials. In recent years, treatment for immune checkpoints such as the programmed cell death protein 1/programmed death ligand (PD-1/PD-L) pathway in tumor-infiltrating T-lymphocytes has been successful in the field of cancer immune therapy. As immune-paralysis in sepsis involves exhausted T-lymphocytes, future clinical applications of checkpoint inhibitors for sepsis are expected. In addition, the functions of PD-1/PD-L on innate lymphoid cells and the role of exosomal forms of PD-L1 warrant further research. Looking back on the history of repeatedly failed clinical trials of immune modulatory therapies for sepsis, sepsis must be recognized as a difficult disease entity for performing clinical trials. A major obstacle that could prevent effective clinical trials of drug candidates is the disease complexity and heterogeneities; clinically diagnosed sepsis could contain multiple sepsis subgroups that suffer different levels of hyper-inflammation and immune-suppression in distinct organs. Thus, the selection of appropriate more homogenous sepsis subgroup is the key for testing the clinical efficacy of experimental therapies targeting specific pathways in either hyperinflammation and/or immunoparalysis. An emerging technology such as artificial intelligence (AI) may help to identify an immune paralysis subgroup who would best be treated by PD-1/PD-L1 pathway inhibitors.
Temporal Variability of Planktonic Ciliates in a Coastal Oligotrophic Environment: Mixotrophy, Size Classes and Vertical Distribution
Authors: Romano Filomena , Symiakaki Katerina , Pitta Paraskevi
Published: February 2021

The temporal variability of planktonic ciliates was studied in an extreme oligotrophic environment with special focus on trophic modes and size classes. Abundance, biomass, size classes, mixotrophy vs. heterotrophy, and species composition of planktonic ciliates were investigated focusing on temporal (samples collected on a monthly basis during 2019) and vertical (7 depth layers in the euphotic zone, from surface to 120 m) distribution at a coastal station in the oligotrophic Eastern Mediterranean. Abundance was in general very low (20 to 1150 cells L–1), except for September, which presented the highest abundance and biomass. Aloricate species dominated the ciliate community in all months and depths (% contribution from 77% in September to 99% in April). In general, oligotrichs presented maximum abundance at 2–10 m (except for June, July, and November: 100–120 m) whereas choreotrichs were more homogeneously distributed [and showed maxima at deep chlorophyll maximum (DCM)]. Small heterotrophs dominated the ciliate community at all depths and months, on average by 76% (they were 3 times more abundant than mixotrophs in terms of abundance and 2.5 times in terms of biomass). They were equally distributed both vertically and seasonally (and also in terms of size classes). In contrast, mixotrophs were found mainly at the surface layer to 20 m throughout the year, except for June and July (max at 100, 50 m). On average, 63% of integrated aloricate abundance was species <30 μm, of which 25% were mixotrophs. During the stratification period of May to November, the very small (<18 μm) and small (18–30 μm) mixotrophic species were distributed throughout the water column whereas the >50 μm mixotrophic species were found only above the DCM. In contrast, during the mixing period of December to May, mixotrophic ciliates were very few and were dominated by small and medium-sized species. It seems that mixotrophic and heterotrophic ciliates, on one hand, and the four size classes, on the other, are very distinct groups characterized by different distributions both vertically and seasonally. This may have important consequences for the structure and function of the microbial food web of which they are part, as well as for the carbon flow to the higher trophic levels of this oligotrophic environment in which ciliates are the main grazers.
Computed Tomography Study of the Mummy of King Seqenenre Taa II: New Insights Into His Violent Death
Authors: Saleem Sahar N. , Hawass Zahi
Published: February 2021

Seqenenre-Taa-II, The Brave, (c.1558–1553 BC) ruled Southern Egypt during the occupation of Egypt by the Hyksos. The mummy was physically examined and X-rayed in the 1960s, which showed severe head wounds that have prompted various theories about the circumstances of his death. We postulated that Computed Tomography (CT) study of Seqenenre-Taa-II's mummy would give insights into the circumstances of his death. We examined Seqenenre's mummy using CT and compared the findings with the archaeological literature as well as with five Asian weapons found in Tell-el-Dabaa. CT findings indicate that Seqenenre died in his forties. The mummies deformed hands suggest that the King was likely imprisoned with his hands tied. CT images provided detailed analysis of Seqenenre's previously reported injuries to the forehead, right supra-orbital, nose-right orbit, left chick, and skull base. This study revealed additional craniofacial fractures in the right lateral side of the skull that had been concealed by the embalmers beneath layers of material. Analysis of the morphology of the injuries enabled a better understanding of the mechanism of trauma, possible number of the attackers, and their relative position to the King. The size and shape of the fractures correlated well with the studied Hyksos weapons. The lethal attack was aimed at the King's face, likely in an attempt to disgrace him. Mummification of Seqenenre's body was limited to evisceration without brain removal. The desiccated brain is shifted to the left side of the skull. This may indicate that the King's dead body stayed on its left side for some time—long enough for decomposition start before the mummification began. This suggests that the King likely died at a location distant from the funeral place, possibly on a battlefield. The embalmers attempted to conceal the King's injuries; the methods used suggest that the mummification took place in a royal mummification workshop rather than in a poorly equipped location. CT findings of Seqenenre's mummy helped us to better understand the circumstances of his violent death. His death motivated his successors to continue the fight to unify Egypt and start The New Kingdom.
Bile Duct Injury During Cholecystectomy: Necessity to Learn How to Do and Interpret Intraoperative Cholangiography
Authors: Christou Niki , Roux-David Alexia , Naumann David N. , Bouvier Stephane , Rivaille Thibaud , Derbal Sophiane , Taibi Abdelkader , Fabre Anne , Fredon Fabien , Durand-Fontanier Sylvaine , Valleix Denis , Mathonnet Muriel
Published: February 2021

Introduction: Biliary duct injury (BDI) is a serious complication during cholecystectomy. Perioperative cholangiography (POC) has recently been generating interest in order to prevent BDI. However, the current literature (including randomized controlled trials) cannot conclude whether POC is protective or not against the risk of BDI. The aim of our study was to investigate whether POC could demonstrate earlier BDI and which criteria are required to make that diagnosis.

Methods: We performed a retrospective study between 2005 and 2018 in our French tertiary referral center, which included all patients who had presented following BDI during cholecystectomy.

Results: Twenty-two patients were included. Nine patients had POC, whereas 13 did not. When executed, POC was interpreted as normal for three patients and abnormal for six. In this latter group, only two cases had a BDI diagnosed intraoperatively. In other cases, the interpretation was not adequate.

Conclusion: BDIs are rare but may reduce patients' quality of life. Our study highlights the surgeon's responsibility to learn how to perform and interpret POC in order to diagnose and manage BDIs and potentially avoid catastrophic consequences.
Probiotic Bacilli Inhibit Salmonella Biofilm Formation Without Killing Planktonic Cells
Authors: Tazehabadi Mahtab Hassanpour , Algburi Ammar , Popov Igor V. , Ermakov Alexey M. , Chistyakov Vladimir A. , Prazdnova Evgeniya V. , Weeks Richard , Chikindas Michael L.
Published: February 2021

Salmonellosis is a foodborne infection caused by Salmonella. Domestic poultry species are one of the main reservoirs of Salmonella, which causes the foodborne infection salmonellosis, and are responsible for many cases of animal-to-human transmission. Keeping backyard chickens is now a growing trend, increasing the frequency of direct contact with the flock and, by consequence, the incidence of Salmonella infections. Bacillus subtilis KATMIRA1933 and Bacillus amyloliquefaciens B-1895 are probiotic bacilli that produce the bacteriocins subtilosin A and subtilin, respectively. The antimicrobial activity of the two strains was determined against the reference strain Micrococcus luteus ATCC 10420. The cell-free supernatant of B. subtilis KATMIRA1933 inhibited biofilm formation by Salmonella enterica subsp. enterica serovar Hadar, Salmonella enterica subsp. enterica serovar Enteritidis phage type 4, and Salmonella enterica subsp. enterica serovar Thompson by 51.1, 48.3, and 56.9%, respectively. The cell-free supernatant of B. amyloliquefaciens B-1895 inhibited the biofilm formation of these Salmonella strains by 30.4, 28.6, and 35.5%, respectively. These findings suggest that the bacillus strains may have the potential to be used as probiotics and antibiotic alternatives for the control of Salmonella in poultry. The number of planktonic cells was unaffected by treatment with the cell-free supernatant. A co-culture of the Salmonella strains with either bacilli showed no signs of growth inhibition, suggesting that it might have been quorum sensing that is affected by the two Bacillus strains.
Molecular Characterization of blaIMP–4-Carrying Enterobacterales in Henan Province of China
Authors: Liu Wentian , Dong Huiyue , Yan Tingting , Liu Xuchun , Cheng Jing , Liu Congcong , Zhang Songxuan , Feng Xiang , Liu Luxin , Wang Zhenya , Qin Shangshang
Published: February 2021

Carbapenem-resistant Enterobacterales (CRE) pose a serious threat to clinical management and public health. We investigated the molecular characteristics of 12 IMP-4 metallo-β-lactamase-producing strains, namely, 5 Enterobacter cloacae, 3 Escherichia coli, 2 Klebsiella pneumoniae, and 2 Citrobacter freundii. These strains were collected from a tertiary teaching hospital in Zhengzhou from 2013 to 2015. The minimum inhibitory concentration (MIC) results showed that each blaIMP–4-positive isolate was multidrug-resistant (MDR) but susceptible to colistin. All of the E. coli belonged to ST167, two C. freundii isolates belonged to ST396, and diverse ST types were identified in E. cloacae and K. pneumoniae. S1-PFGE, Southern blotting, and PCR-based replicon typing assays showed that the blaIMP–4-carrying plasmids ranged from ∼52 to ∼360 kb and belonged to FII, FIB, HI2/HI2A, and N types. N plasmids were the predominant type (8/12, 66.7%). Plasmid stability testing indicated that the blaIMP–4-carrying N-type plasmid is more stable than the other types of plasmids. Conjugative assays revealed that three of the blaIMP–4-carrying N plasmids were transferrable. Complete sequence analysis of a representative N type (pIMP-ECL14–57) revealed that it was nearly identical to pIMP-FJ1503 (KU051710) (99% nucleotide identity and query coverage), an N-type blaIMP–4-carrying epidemic plasmid in a C. freundii strain. PCR mapping indicated that a transposon-like structure [IS6100-mobC-intron (K1.pn.I3)-blaIMP–4-IntI1-IS26] was highly conserved in all of the N plasmids. IS26 involved recombination events that resulted in variable structures of this transposon-like module in FII and FIB plasmids. The blaIMP–4 gene was captured by a sul1-type integron In1589 on HI2/HI2A plasmid pIMP-ECL-13–46.
Genetic Manipulation of Non-tuberculosis Mycobacteria
Authors: Chimukuche Nyaradzai Mitchell , Williams Monique J.
Published: February 2021

Non-tuberculosis mycobacteria (NTMs) comprise a large group of organisms that are phenotypically diverse. Analysis of the growing number of completed NTM genomes has revealed both significant intra-genus genetic diversity, and a high percentage of predicted genes that appear to be unique to this group. Most NTMs have not been studied, however, the rise in NTM infections in several countries has prompted increasing interest in these organisms. Mycobacterial research has recently benefitted from the development of new genetic tools and a growing number of studies describing the genetic manipulation of NTMs have now been reported. In this review, we discuss the use of both site-specific and random mutagenesis tools in NTMs, highlighting the challenges that exist in applying these techniques to this diverse group of organisms.
Integrating Tactile Feedback Technologies Into Home-Based Telerehabilitation: Opportunities and Challenges in Light of COVID-19 Pandemic
Authors: Handelzalts Shirley , Ballardini Giulia , Avraham Chen , Pagano Mattia , Casadio Maura , Nisky Ilana
Published: February 2021

The COVID-19 pandemic has highlighted the need for advancing the development and implementation of novel means for home-based telerehabilitation in order to enable remote assessment and training for individuals with disabling conditions in need of therapy. While somatosensory input is essential for motor function, to date, most telerehabilitation therapies and technologies focus on assessing and training motor impairments, while the somatosensorial aspect is largely neglected. The integration of tactile devices into home-based rehabilitation practice has the potential to enhance the recovery of sensorimotor impairments and to promote functional gains through practice in an enriched environment with augmented tactile feedback and haptic interactions. In the current review, we outline the clinical approaches for stimulating somatosensation in home-based telerehabilitation and review the existing technologies for conveying mechanical tactile feedback (i.e., vibration, stretch, pressure, and mid-air stimulations). We focus on tactile feedback technologies that can be integrated into home-based practice due to their relatively low cost, compact size, and lightweight. The advantages and opportunities, as well as the long-term challenges and gaps with regards to implementing these technologies into home-based telerehabilitation, are discussed.
Bio-Inspired Radio-Frequency Source Localization Based on Cochlear Cross-Correlograms
Authors: Wang Yingying , Mandal Soumyajit
Published: February 2021

This paper describes a bio-inspired radio frequency (RF) scene analysis system based on cross-correlating the outputs of two single-chip RF spectrum analyzers. The latter are implemented using digitally-programmable “RF cochlea” chips (in 65 nm CMOS) that integrate a transmission-line active cochlear model, consisting of 50 parallel exponentially-spaced stages for analyzing the radio spectrum from 1.0 to 8.3 GHz, together with an output encoding network. The encoders convert the analog outputs of all cochlear stages into parallel delta-sigma (Δ-Σ) modulated digital signals for real-time demodulation and analysis by a digital back-end processor. These outputs can also be multiplied with each other to generate cochlear correlation matrices (known as cross-correlograms). Simulation results demonstrate the use of cross-correlograms for wide-range time-delay estimation and real-time multi-source localization at different frequencies and input signal-to-noise (SNR) ratios. Over-the-air measurement results from an experimental two-channel RF scene analysis prototype confirm the use of such time-delay estimates, which are analogous to interaural time differences (ITDs) in the auditory system, for azimuthal source localization at 3.4 GHz. In addition, differences in received signal strength at the two cochleas, which are analogous to interaural level differences (ILD) in biology, are also used to localize RF sources.
100 Hz Electroacupuncture Alleviated Chronic Itch and GRPR Expression Through Activation of Kappa Opioid Receptors in Spinal Dorsal Horn
Authors: Li Hong-Ping , Wang Xiao-Yu , Chen Chao , Li Jing-Jing , Yu Chi , Lin Li-Xue , Yu Zi-E , Jin Zhi-Yuan , Zhu He , Xiang Hong-Chun , Hu Xue-Fei , Cao Jie , Jing Xiang-Hong , Li Man
Published: February 2021

Background

Clinical studies have shown that electroacupuncture (EA) alleviates chronic itch. Gastrin-releasing peptide receptor (GRPR) and dynorphin (DYN) in the spinal dorsal horn positively or negatively regulate itch, respectively. However, which frequency of EA is effective on relieving chronic itch and reducing the expression of GRPR, whether DYN-A in the spinal cord is involved in the underlying mechanism of the antipruritus effect of EA remains unknown.

Methods

The mixture of acetone and diethyl ether (1:1) [designated as AEW (acetone/diethyl ether and water) treatment] was used to induce the dry skin model of chronic itch. EA was applied to Quchi (LI11) and Hegu (LI4). Western blot was used to detect the expression of GRPR and DYN-A. Immunofluorescence was used to detect the expression of DYN-A.

Results

The AEW administration induced remarkable spontaneous scratching, enhanced the expression of GRPR, and reduced the expression of DYN-A. Compared with the sham EA, 2 Hz EA, or 15 Hz EA group, 100 Hz EA was the most effective frequency for relieving chronic itch, reducing the expression of GRPR, and increasing the expression of DYN-A in the cervical dorsal horn. Furthermore, intraperitoneal injection of kappa opioid receptors (KORs) antagonist nor-Binaltorphimine dihydrochloride (nor-BNI) significantly reversed the effect of 100 Hz EA on the inhibition of both itching behavior and GRPR expression.

Conclusion

EA at 100 Hz is the most effective frequency that inhibits chronic itch and GRPR expression through activation of KORs in the spinal dorsal horn, which can effectively guide the clinical treatment and improve the antipruritic effect of acupuncture.
Surgical Complexity and Outcome During the Implementation Phase of a Robotic Colorectal Surgery Program—A Retrospective Cohort Study
Authors: Müller Catharina , Laengle Johannes , Riss Stefan , Bergmann Michael , Bachleitner-Hofmann Thomas
Published: February 2021

Background

Robotic surgery holds particular promise for complex oncologic colorectal resections, as it can overcome many limitations of the laparoscopic approach. However, similar to the situation in laparoscopic surgery, appropriate case selection (simple vs. complex) with respect to the actual robotic expertise of the team may be a critical determinant of outcome. The present study aimed to analyze the clinical outcome after robotic colorectal surgery over time based on the complexity of the surgical procedure.

Methods

All robotic colorectal resections (n = 85) performed at the Department of Surgery, Medical University of Vienna, between the beginning of the program in April 2015 until December 2019 were retrospectively analyzed. To compare surgical outcome over time, the cohort was divided into 2 time periods based on case sequence (period 1: patients 1–43, period 2: patients 44–85). Cases were assigned a complexity level (I-IV) according to the type of resection, severity of disease, sex and body mass index (BMI). Postoperative complications were classified using the Clavien-Dindo classification.

Results

In total, 47 rectal resections (55.3%), 22 partial colectomies (25.8%), 14 abdomino-perineal resections (16.5%) and 2 proctocolectomies (2.4%) were performed. Of these, 69.4% (n = 59) were oncologic cases. The overall rate of major complications (Clavien Dindo III-V) was 16.5%. Complex cases (complexity levels III and IV) were more often followed by major complications than cases with a low to medium complexity level (I and II; 25.0 vs. 5.4%, p = 0.016). Furthermore, the rate of major complications decreased over time from 25.6% (period 1) to 7.1% (period 2, p = 0.038). Of note, the drop in major complications was associated with a learning effect, which was particularly pronounced in complex cases as well as a reduction of case complexity from 67.5% to 45.2% in the second period (p = 0.039).

Conclusions

The risk of major complications after robotic colorectal surgery increases significantly with escalating case complexity (levels III and IV), particularly during the initial phase of a new colorectal robotic surgery program. Before robotic proficiency has been achieved, it is therefore advisable to limit robotic colorectal resection to cases with complexity levels I and II in order to keep major complication rates at a minimum.