bluuebunny/crossref_metadata_2025 huggingface dataset:
Interobserver variability between experienced and inexperienced observers in the histopathological analysis of Wilms tumors: a pilot study for future algorithmic approach
Authors: Rutgers Jikke J. , Bánki Tessa , van der Kamp Ananda , Waterlander Tomas J. , Scheijde-Vermeulen Marijn A. , van den Heuvel-Eibrink Marry M. , van der Laak Jeroen A. W. M. , Fiocco Marta , Mavinkurve-Groothuis Annelies M. C. , de Krijger Ronald R.
Published: August 2021

Background

Histopathological classification of Wilms tumors determines treatment regimen. Machine learning has been shown to contribute to histopathological classification in various malignancies but requires large numbers of manually annotated images and thus specific pathological knowledge. This study aimed to assess whether trained, inexperienced observers could contribute to reliable annotation of Wilms tumor components for classification performed by machine learning.

Methods

Four inexperienced observers (medical students) were trained in histopathology of normal kidneys and Wilms tumors by an experienced observer (pediatric pathologist). Twenty randomly selected scanned Wilms tumor-slides (from n = 1472 slides) were annotated, and annotations were independently classified by both the inexperienced observers and two experienced pediatric pathologists. Agreement between the six observers and for each tissue element was measured using kappa statistics (κ).

Results

Pairwise interobserver agreement between all inexperienced and experienced observers was high (range: 0.845–0.950). The interobserver variability for the different histological elements, including all vital tumor components and therapy-related effects, showed high values for all κ-coefficients (> 0.827).

Conclusions

Inexperienced observers can be trained to recognize specific histopathological tumor and tissue elements with high interobserver agreement with experienced observers. Nevertheless, supervision by experienced pathologists remains necessary. Results of this study can be used to facilitate more rapid progress for supervised machine learning-based algorithm development in pediatric pathology and beyond.
Primary mediastinal seminoma with florid follicular lymphoid hyperplasia: a case report and review of the literature
Authors: Holmes Charlotte , Loo Peh Sun , Barnard Sion
Published: August 2021

Background

First described in 1955 Primary mediastinal seminomas are rare. Only 1–4% of mediastinal tumours are germ cell tumors; majority of which are teratomas. They typically present in men aged between 20 and 40 years. Very few cases are reported in the literature. Florid follicular lymphoid hyperplasia can obscure the malignant cells and is a rarer finding still. We present a rare case of a 48 year old man with a primary mediastinal seminoma with florid follicular lymphoid hyperplasia; found following excision of a clinically presumed thymoma.

Case presentation

A 48 year old man was referred for excision of a thymic mass. The presumed diagnosis was a thymoma; following preoperative investigations. The mass was incidentally found on a radiological imaging. However, the patient did report mid-sternal discomfort on lying flat and breathlessness. The patient underwent a thymectomy via a partial median sternotomy with good recovery. Histological assessment was that the mass was in fact a primary mediastinal seminoma with florid follicular lymphoid hyperplasia. A primary testicular malignancy was excluded and the patient required no further oncological treatment.

Conclusions

Only 11 cases have previously been reported of primary mediastinal seminoma with florid follicular lymphoid hyperplasia. Although rare, a primary mediastinal seminoma should be considered as a differential diagnosis for presentations with a thymic mass. Tumour markers can be helpful, however are only positive in third of cases. Ultrasound imaging of the gonads is essential to exclude a primary gonadal lesion. Pure seminomas are radiotherapy and chemotherapy sensitive however the mainstay treatment of primary mediastinal seminomas remains surgical excision. Radiotherapy is reserved postoperatively for incomplete surgical margins.
Oropharyngeal administration of colostrum for preventing necrotizing enterocolitis and late-onset sepsis in preterm infants with gestational age ≤ 32 weeks: a pilot single-center randomized controlled trial
Authors: OuYang Xia , Yang Chang-Yi , Xiu Wen-Long , Hu Yan-Hua , Mei Su-Su , Lin Qin
Published: August 2021

Background

Oropharyngeal administration of colostrum (OAC) may provide immunoprotective and anti-inflammatory effects that potentially reduce the incidence of necrotizing enterocolitis (NEC) and late-onset sepsis and improve short-term outcomes. Our objective was to evaluate the role of OAC in the early prevention of NEC and late-onset sepsis in preterm infants with gestational age (GA) ≤ 32 weeks.

Methods

A pilot, single-center, 1:1 parallel randomized controlled trial was conducted in a 40-bed tertiary neonatal intensive care unit (NICU) in China from 1 January 2019 to 30 September 2020. Preterm infants were randomly divided into two groups with GA ≤ 32 weeks. The OAC group included preterm infants who received 0.4 ml of maternal colostrum via the oropharyngeal route every 3 h for 10 days beginning within the first 48 h after birth, and the control group included preterm infants who received normal saline instead. Data from the two groups were collected and compared.

Results

A total of 127 infants in the OAC group and 125 infants in the control group were enrolled. The incidence of NEC (Bell stage 2 or 3) and late-onset sepsis were lower in the OAC group [2.36% vs. 10.40%, relative risk (RR) 0.23 (95% confidence interval (CI) 0.07, 0.78), adjusted RR 0.23 (95% CI 0.06, 0.84); 4.72% vs. 13.60%, RR 0.35 (95% CI 0.14, 0.85), adjusted RR 0.36 (95% CI 0.14, 0.95)]. In addition, the incidence of proven sepsis and intraventricular hemorrhage (IVH) (stage 3 or 4) were lower in the OAC group [2.36% vs. 8.80%, RR 0.27 (95% CI 0.08, 0.94); 1.57% vs. 7.20%, RR 0.22 (95% CI 0.05, 0.99)], and the time to achieve full enteral feeding was shorter (23.13 ± 9.45 days vs. 28.50 ± 14.80 days). No adverse reactions were observed in either group.

Conclusions

Oropharyngeal administration of colostrum is a safe and simple NICU procedure that may yield a potential effect in decreasing the incidences of NEC, late-onset sepsis, and severe IVH and shorten the time to achieve full enteral feeding in preterm infants with GA ≤ 32 weeks.

Trial registration

Chinese Clinical Trial Registry,ChiCTR1900023697, Registered 8 June 2019, retrospectively registered.
Validation of the Arabic Maternal Breastfeeding Evaluation Scale (MBFES-A) among Lebanese women
Authors: Nabulsi Mona , Smaili Hanan , Tamim Hani , Wahidi Marya , El-Jamal Carine
Published: August 2021

Background

Maternal satisfaction with the breastfeeding experience is an important determinant of breastfeeding success. There is currently no valid tool to measure perceived maternal satisfaction with breastfeeding in the Arab context.

Methods

This cohort study tested the Maternal Breastfeeding Evaluation Scale (MBFES) on 450 healthy Lebanese mothers for internal consistency reliability and construct validity. Participants were recruited between April 2018 and February 2020.

Results

The Cronbach’s alpha reliability coefficient of the Arabic MBFES (MBFES-A) was 0.87. Exploratory factor analysis revealed that it has three components: Infant Satisfaction/Growth, Maternal Enjoyment/Role Attainment, and Lifestyle/Body Image with reliability coefficients of 0.88, 0.87, and 0.68, respectively. Four items were deleted because of low factor loadings and three items were relocated to the Infant Satisfaction/Growth subscale based on their factor loadings. Participants who were exclusively breastfeeding at one and/or 3 months had higher mean MBFES-A total and Infant Satisfaction/Growth and Maternal Enjoyment/Role Attainment subscale scores than participants who were partially breastfeeding, and significantly higher mean scores than mothers who were not breastfeeding (all p values < 0.001), findings that support the scale’s construct validity. Moreover, scores on the Infant Satisfaction/Growth subscale correlated with exclusive breastfeeding at one (r = 0.37, p < 0.001) and 3 months (r = 0.31, p < 0.001). The MBFES-A score had positive modest correlations with maternal attitude towards breastfeeding (r = 0.30, p < 0.001), exclusive breastfeeding at one (r = 0.27) and at 3 months (r = 0.26, p < 0.001 for both), as well as with the longest previous exclusive breastfeeding (r = 0.27, p < 0.001).

Conclusions

The 26-item MBFES-A is a reliable and valid instrument to use in future breastfeeding research in Middle East North Africa countries. There is a need for replication of our findings in other Arab contexts using new constructs to establish stronger construct validity.
DeepCob: precise and high-throughput analysis of maize cob geometry using deep learning with an application in genebank phenomics
Authors: Kienbaum Lydia , Correa Abondano Miguel , Blas Raul , Schmid Karl
Published: August 2021

Background

Maize cobs are an important component of crop yield that exhibit a high diversity in size, shape and color in native landraces and modern varieties. Various phenotyping approaches were developed to measure maize cob parameters in a high throughput fashion. More recently, deep learning methods like convolutional neural networks (CNNs) became available and were shown to be highly useful for high-throughput plant phenotyping. We aimed at comparing classical image segmentation with deep learning methods for maize cob image segmentation and phenotyping using a large image dataset of native maize landrace diversity from Peru.

Results

Comparison of three image analysis methods showed that a Mask R-CNN trained on a diverse set of maize cob images was highly superior to classical image analysis using the Felzenszwalb-Huttenlocher algorithm and a Window-based CNN due to its robustness to image quality and object segmentation accuracy ($$r=0.99$$

r
=
0.99

). We integrated Mask R-CNN into a high-throughput pipeline to segment both maize cobs and rulers in images and perform an automated quantitative analysis of eight phenotypic traits, including diameter, length, ellipticity, asymmetry, aspect ratio and average values of red, green and blue color channels for cob color. Statistical analysis identified key training parameters for efficient iterative model updating. We also show that a small number of 10–20 images is sufficient to update the initial Mask R-CNN model to process new types of cob images. To demonstrate an application of the pipeline we analyzed phenotypic variation in 19,867 maize cobs extracted from 3449 images of 2484 accessions from the maize genebank of Peru to identify phenotypically homogeneous and heterogeneous genebank accessions using multivariate clustering.

Conclusions

Single Mask R-CNN model and associated analysis pipeline are widely applicable tools for maize cob phenotyping in contexts like genebank phenomics or plant breeding.
A comparative study of total knee arthroplasty outcome for stiff knee with or without sequential antirheumatic drug treatment
Authors: Jia Cheng-Qi , Guan Xiao-Rui , Zhao Zhi-Lai , Chen Ji-Ying , Li Xiang
Published: August 2021

Background

The aim of this study was to evaluate the influence of antirheumatic drug treatment on knee function of stiff knee patients after total knee arthroplasty (TKA).

Methods

Twenty-seven patients (44 knees) of active RA (rheumatoid arthritis) or AS (ankylosing spondylitis) with stiff knees were included in this study. And they were divided into two groups according to continue antirheumatic drug treatment or not after TKA: the therapeutic group (16 patients, 27 knees) and the controlled group (11 patients, 17 knees). The outcomes were assessed by Knee Society Score (KSS), Visual Analogue Scale (VAS), range of motion (ROM) (at week 6, month 6, year 1, and year 2), “Forgotten Joint” Scale (FJS), with or without crutch, satisfaction, and revision (at year 2). The knee prosthetic loosening was evaluated by the followed X-ray at each following time.

Results

The mean follow-up time was 51 months (34–69 months). The KSS was higher at week 6 after TKA in the therapeutic group (p < 0.05); however, the functional scores of KSS at month 6, year 1, and year 2 in the controlled group were more points improved. The therapeutic patients preferred the knee more at month 6, year 1, and year 2. The differences of KSS clinical scores (at month 6, year 1, and year 2), VAS, ROM, Crutch and FJS between the two groups were not statistically significant (p > 0.05).

Conclusion

For patients with stiff knees, the sequential antirheumatic drug treatment after TKA had no obvious effect on postoperative KSS, but can improve the satisfaction.

Level of evidence

Therapeutic level II. See Instructions for Authors for a complete description of levels of evidence.
Efficacy of ultra-early rehabilitation on elbow function after Slongo’s external fixation for supracondylar humeral fractures in older children and adolescents
Authors: He Man , Wang Qian , Zhao Jingxin , Wang Yu
Published: August 2021

Objective

To evaluate the efficacy of ultra-early rehabilitation on elbow function after Slongo’s external fixation for supracondylar humeral fractures in older children and adolescents.

Methods

We retrospectively analyzed clinical data from 49 older children (> 8 years) and adolescents with supracondylar humerus fracture who were treated with Slongo’s external fixation in our hospital from January 2016 to August 2020. Twenty-three patients received ultra-early postoperative rehabilitation (rehabilitation group) and 26 patients were not subjected to postoperative rehabilitation (control group). Time to ROM required for functional activity of daily living(ROM-ADL) in both groups was recorded postoperatively. Patients were followed up at 3 and 6 months after surgery to compare the elbow range of motion (ROM) and carrying angle (CA). Postoperative complications were assessed in both groups. Flynn scores and modified Mayo Elbow Performance Scores were also performed.

Results

The elbow function at 6 months after surgery was significantly better than that at 3 months in the control group (P = 0.32). Time to ROM-ADL in the rehabilitation group was significantly shorter than that of the control group (P = 0.028). The elbow function, Flynn scores, and modified Mayo scores in the rehabilitation group at 3 and 6 months after surgery were significantly better than that of the control group (P(ROM, 3 months and 6 months) = 0.012 vs 0.039; P(Flynn scores, ROM, 3 months and 6 months) = 0.028 vs 0.005; P(Flynn scores, CA, 3 months and 6 months) = 0.032 vs 0.026; P(Modified Mayo scores, 3 months and 6 months) = 0.039 vs 0.024; respectively). There were no iatrogenic injuries, secondary fracture displacements, myositis ossificans, elbow deformities, or other complications in either group. One case of nail tract infection occurred in the rehabilitation group and was cured.

Conclusion

Slongo’s external fixation is a safe and effective surgical treatment for supracondylar humeral fractures in children over 8 years old and adolescents. Ultra-early rehabilitation treatment for postoperative children can significantly speed up the recovery after surgery.
The effects of WeChat follow-up management to improve the parents’ mental status and the quality of life of premature newborns with patent ductus arteriosus
Authors: Yang Bin , Liu Jian-Feng , Xie Wen-Peng , Cao Hua , Chen Qiang
Published: August 2021

Objective

This study aimed to explore the effect of WeChat follow-up management on improving the parents’ mental status and the quality of life of premature newborns with patent ductus arteriosus (PDA) after discharge.

Methods

Participants were randomly divided into an intervention group and a control group. WeChat was used in the intervention group for the postdischarge follow-up management, while the control group was managed traditionally. The psychological status and quality of life of the parents of the two groups were analyzed and compared.

Results

The SAS and SDS scores in the intervention group at three months after discharge were significantly better than those at discharge, but there was no significant change in the control group. During the three-month follow-up, the SAS and SDS scores in the intervention group were significantly better than those in the control group. The WHOQOL-BREF scale scores in the intervention group were significantly better than those in the control group in physiology, psychology, social relations, and the environment. The total quality of life score in the intervention group was also significantly better than that in the control group. All patients in the intervention group were followed up as appropriate, while five patients in the control group were lost to follow-up. The incidence of pneumonia and feeding intolerance in the intervention group were significantly lower than those in the control group.

Conclusion

The application of WeChat in the follow-up management of premature infants with PDA could alleviate parents’ anxiety and depression in taking care of their children at home and can improve their quality of life.
The use of fibrinolytic therapy for parapneumonic effusion in pregnancy: a case report and a review
Authors: Nasralla Awrad , Laing Bryce , Turner Simon R.
Published: August 2021

The use of intrapleural fibrinolytics for complicated parapneumonic effusion has been shown to be an effective and safe alternative to surgery. However, there is limited evidence about its use during pregnancy. We present a case and a review of the literature of pregnant women who had successful treatment of their complicated parapneumonic effusion with intrapleural fibrinolytics. To our knowledge this is the first review of cases of pregnant women with parapneumonic effusion managed with intrapleural fibrinolytic.
Alpinia oxyphylla Miq extract reduces cerebral infarction by downregulating JNK-mediated TLR4/T3JAM- and ASK1-related inflammatory signaling in the acute phase of transient focal cerebral ischemia in rats
Authors: Cheng Chin-Yi , Chiang Su-yin , Kao Shung-Te , Huang Shang-Chih
Published: August 2021

Background

Post-ischemic inflammation is a crucial component in stroke pathology in the early phase of cerebral ischemia–reperfusion (I/R) injury. Inflammation caused by microglia, astrocytes, and necrotic cells, produces pro-inflammatory mediators and exacerbates cerebral I/R injury. This study evaluated the effects of the Alpinia oxyphylla Miq [Yi Zhi Ren (YZR)] extract on cerebral infarction at 1 day after 90 min of transient middle cerebral artery occlusion (MCAo) and investigated the molecular mechanisms underlying the regulation of c-Jun N-terminal kinase (JNK)-mediated inflammatory cascades in the penumbral cortex. Rats were intraperitoneally injected with the YZR extract at the doses of 0.2 g/kg (YZR-0.2 g), 0.4 g/kg (YZR-0.4 g), or 0.8 g/kg (YZR-0.8 g) at MCAo onset.

Results

YZR-0.4 g and YZR-0.8 g treatments markedly reduced cerebral infarction, attenuated neurological deficits, and significantly downregulated the expression of phospho-apoptosis signal-regulating kinase 1 (p-ASK1)/ASK1, tumor necrosis factor receptor-associated factor 3 (TRAF3), TRAF3-interacting JNK-activating modulator (T3JAM), ionized calcium-binding adapter molecule 1 (Iba1), p-JNK/JNK, inducible nitric oxide synthase, cyclooxygenase-2, tumor necrosis factor-α, toll-like receptor 4 (TLR4), glial fibrillary acidic protein (GFAP), nuclear factor-kappa B (NF-κB), and interleukin-6 in the penumbral cortex at 1 day after reperfusion. SP600125 (SP), a selective JNK inhibitor, had the same effects. Furthermore, Iba1- and GFAP-positive cells were colocalized with TLR4, and colocalization of GFAP-positive cells was found with NF-κB in the nuclei.

Conclusion

YZR-0.4 g and YZR-0.8 g treatments exerted beneficial effects on cerebral ischemic injury by downregulating JNK-mediated signaling in the peri-infarct cortex. Moreover, the anti-infarction effects of YZR extract treatments were partially attributed to the downregulation of JNK-mediated TLR4/T3JAM- and ASK1-related inflammatory signaling pathways in the penumbral cortex at 1 day after reperfusion.
Are outpatient transperineal prostate biopsies without antibiotic prophylaxis equivalent to standard transrectal biopsies for patient safety and cancer detection rates?A retrospective cohort study in 222 patients
Authors: Islam Majdee , Da Silva Rodrigo Donalisio , Quach Alan , Gustafson Diedra , Nogueira Leticia , Clark Nathan , Kim Fernando J.
Published: August 2021

Background

To describe our experience with outpatient transperineal biopsy (TPB) without antibiotics compared to transrectal biopsy (TRB) with antibiotics and bowel preparation. The literature elicits comparable cancer detection, time, and cost between the two. As antibiotic resistance increases, antimicrobial stewardship is imperative.

Methods

In our retrospective review, we compared the TPB to TRB in our institution for outpatient prostate biopsies with local anesthesia from June 1st, 2017 to June 1st, 2019. Patients had negative urinalysis on day of procedure. Patients presenting with symptoms concerning for UTI followed by positive urine culture were determined to have a UTI.

Results

Two hundred twenty-two patients met inclusion criteria. Age, race, BMI, pre-procedure PSA, history of UTI, BPH or other GU history were similar between both groups. Two TPB patients (1.8%) had post-procedure UTI; one received oral antibiotics and one received a dose of intravenous and subsequent oral antibiotics. There were no sepsis events or admissions. Six TRB patients (5.4%) had post-procedure UTI; five received oral antibiotics, and one received intravenous antibiotics and required admission for sepsis. One TPB patient (0.9%) had post-procedure retention and required catheterization, while four TRB patients (3.6%) had retention requiring catheterization. No significant difference noted in cancer detection between the two groups.

Conclusion

Outpatient TPB without antibiotic prophylaxis/bowel prep is comparable to TRB in regard to safety and cancer detection. TPB without antibiotics had a lower infection and retention rate than TRB with antibiotics. Efforts to reduce antibiotic resistance should be implemented into daily practice. Future multi-institutional studies can provide further evidence for guideline changes.
Cirbp-PSD95 axis protects against hypobaric hypoxia-induced aberrant morphology of hippocampal dendritic spines and cognitive deficits
Authors: Zhou Yang , Lu Huanyu , Liu Ying , Zhao Zaihua , Zhang Qian , Xue Chong , Zou Yuankang , Cao Zipeng , Luo Wenjing
Published: August 2021

Hypobaric hypoxia (HH) is a typical characteristic of high altitude environment and causes a spectrum of pathophysiological effects, including headaches, gliovascular dysfunction and cognitive retardation. Here, we sought to understand the mechanisms underlying cognitive deficits under HH exposure. Our results showed that hypobaric hypoxia exposure impaired cognitive function and suppressed dendritic spine density accompanied with increased neck length in both basal and apical hippocampal CA1 region neurons in mice. The expression of PSD95, a vital synaptic scaffolding molecule, is down-regulated by hypobaric hypoxia exposure and post-transcriptionally regulated by cold-inducible RNA-binding protein (Cirbp) through 3′-UTR region binding. PSD95 expressing alleviates hypoxia-induced dendritic spine morphology changes of hippocampal neurons and memory deterioration. Moreover, overexpressed Cirbp in hippocampus rescues HH-induced abnormal expression of PSD95 and attenuates hypoxia-induced dendritic spine injury and cognitive retardation. Thus, our findings reveal a novel mechanism that Cirbp-PSD-95 axis appears to play an essential role in HH-induced cognitive dysfunction in mice.
Targeting Akt in cancer for precision therapy
Authors: Hua Hui , Zhang Hongying , Chen Jingzhu , Wang Jiao , Liu Jieya , Jiang Yangfu
Published: August 2021

Biomarkers-guided precision therapeutics has revolutionized the clinical development and administration of molecular-targeted anticancer agents. Tailored precision cancer therapy exhibits better response rate compared to unselective treatment. Protein kinases have critical roles in cell signaling, metabolism, proliferation, survival and migration. Aberrant activation of protein kinases is critical for tumor growth and progression. Hence, protein kinases are key targets for molecular targeted cancer therapy. The serine/threonine kinase Akt is frequently activated in various types of cancer. Activation of Akt promotes tumor progression and drug resistance. Since the first Akt inhibitor was reported in 2000, many Akt inhibitors have been developed and evaluated in either early or late stage of clinical trials, which take advantage of liquid biopsy and genomic or molecular profiling to realize personalized cancer therapy. Two inhibitors, capivasertib and ipatasertib, are being tested in phase III clinical trials for cancer therapy. Here, we highlight recent progress of Akt signaling pathway, review the up-to-date data from clinical studies of Akt inhibitors and discuss the potential biomarkers that may help personalized treatment of cancer with Akt inhibitors. In addition, we also discuss how Akt may confer the vulnerability of cancer cells to some kinds of anticancer agents.
A comprehensive description of self-reported health and life satisfaction in cardiac arrest survivors
Authors: Hellström Patrik , Årestedt Kristofer , Israelsson Johan
Published: August 2021

Background

Self-reported health and life satisfaction are considered important outcomes in people surviving cardiac arrest. However, most previous studies have reported limited aspects on health, often based on composite scores, and few studies have focused on life satisfaction. Investigating health aspects with a broad and detailed perspective is important to increase the knowledge of life after cardiac arrest from the perspective of survivors. In addition, the knowledge of potential differences in health among survivors related to place of arrest (in-hospital cardiac arrest; IHCA or out-of-hospital cardiac arrest; OHCA) is scarce. The aim was to describe and compare self-reported health and life satisfaction in IHCA and OHCA survivors. 

Methods

This observational cross-sectional study included adult cardiac arrest survivors six months after resuscitation, treated at five Swedish hospitals between 2013 and 2018. Participants received a study specific questionnaire including Health Index (HI), EQ-5D 5 Levels (EQ-5D-5L), Minimal Insomnia Sleeping Scale (MISS), Multidimensional Scale of Perceived Social Support (MSPSS), Hospital Anxiety and Depression Scale (HADS), and Satisfaction With Life Scale (SWLS). In order to present characteristics descriptive statistics were applied. The Mann-Whitney U test, chi-square test or Fishers’ exact test were used to compare differences in self-reported health and life satisfaction between in-hospital- and out-of-hospital cardiac arrest survivors

Results

In total, 212 survivors participated. Based on scale scores and general measures, the median scores of health and life satisfaction among survivors were high: HI total = 29, EQ VAS = 80, and SWLS = 20. According to HI, most problems were reported for tiredness (37.3 %) and strength (26.4 %), while pain/discomfort (57.5 %) and anxiety/depression (42.5 %) where most common according to EQ-5D-5L. Except for EQ-5D-5L mobility (p = 0.023), MSPSS significant other (p = 0.036), and MSPSS family (p = 0.043), no health differences in relation to place of arrest were identified.

Conclusions

Although general health and life satisfaction were good among cardiac arrest survivors, several prevalent health problems were reported regardless of place of arrest. To achieve an improved understanding of health in cardiac arrest survivors, it is important to assess specific symptoms as a complement to composite scores of general, physical, emotional, and social health.
The exacerbated prevalence of acute malnutrition and growth retardation in Roma children living in camps
Authors: Giampaolo Rosaria , Marotta Rosaria , Biagiarelli Francesco Saverio , Zampa Antonella , Moramarco Stefania , Buonomo Ersilia
Published: August 2021

Background

Child malnutrition is still a concern in marginalized groups of populations, such as immigrants living in very low socio-economic conditions. Roma children are within the most hard-to-reach populations, susceptible to undernutrition and growth retardation. In the city of Rome (Italy), the Hospital “Bambino Gesù”, in collaboration with the Catholic Association Community of Saint’Egidio, is dedicating free services for the health and nutritional needs of vulnerable people.

Methods

A retrospective analysis was conducted on immigrant children visited at different ages (0–11 years old). Records including nutritional and growth assessment were collected from 2016 up to May 2020. Malnutrition was classified following the WHO 2006 standards. Data for Roma children living in extra-urban camps and non-Roma immigrant children living in urban areas were analyzed, odds ratios and univariate binary regressions were performed to investigate the risk of malnutrition within the two groups.

Results

A sample of 414 children (57% under-five; 51.9% Roma), was included in the database. In the under-five children, underweight accounted for 7.6%, stunting for 11.7%, and wasting for 2.9%. The first year of life was the most crucial for nutritional status. Compared to the counterpart, Roma children accounted for nearly the total rate of malnutrition (wasting 4.8% vs. 1%; stunting 21.4% vs. 2%; underweight 14.2% vs. 1%). Univariate logistic regression confirmed under-five Roma children being at the highest risk of stunting at 12 months (OR: 16.1; CI 2–132; p = 0.01).

When considering the 176 school-aged children, undernutrition affected most Roma children (13% vs 1.9%), followed by stunting (5.8% vs 0.9%). Univariate logistic regression confirmed that Roma school-aged children were more likely to be underweight (OR: 7.8; CI 1.6–37.6; p = 0.01).

Conclusions

Malnutrition in immigrant children is still of high concern in Italy. Its prevalence in Roma children living in extra-urban camps exceeds that of immigrant children living in urban areas and the rates of underweight, stunting and wasting of Roma children living in the Balkans. This exacerbating condition highlights the need of better assisting this fragile population that is at most risk of poverty, food insecurity and social exclusion in Italy, particularly during this pandemic crisis.
Efficacy and safety of Qi-Jing Hui-Xin Decoction in the treatment of coronary microvascular angina: study protocol for a randomized, controlled, multi-center clinical trial
Authors: Sun Yuanlong , Huang Chengxin , Huo Li , Li Ying , Chen Jun , Zhang Zixiu , Jia Meijun , Jiang Meixian , Ruan Xiaofen
Published: August 2021

Background

With the increased understanding of heart disease, microvascular angina (MVA) is receiving greater attention from clinicians. Studies have shown that patients with MVA have significantly higher major cardiovascular events and all-cause mortality than the control population, and the search for effective treatments is of great clinical importance. Both basic and clinical studies have shown that Qi-Jing Hui-Xin Decoction (QJHX) can relieve angina symptoms and improve clinical efficacy, but there is a lack of high-quality clinical studies to provide a research basis. This article introduces the evaluation protocol of QJHX for the adjunctive treatment of MVA.

Methods/design

This is a prospective randomized controlled trial. The trial will enroll 150 patients with MVA. On the basis of Western drug treatment, patients will be randomized into two groups, and the experimental group will receive QJHX treatment for 12 weeks and follow-up at 24 week. The primary indicators are the clinical efficacy of angina pectoris and the evidence of traditional Chinese medicine (TCM) efficacy. Secondary indicators are the Seattle Angina Scale score, serum lipid levels, electrocardiogram, and echocardiogram diagnosis. Additional indicators are endothelial function and immunoinflammatory factors. Adverse events will be monitored throughout the trial.

Discussion

Integrated traditional Chinese and Western medicine is commonly used for angina in China. This study will evaluate the clinical effectiveness and safety of adding QJHX based on standardized Western medications. The results of the trial will provide high-level clinical research-based evidence for the application of QJHX in MVA.

Trial registration

Chinese Clinical Trial Registry ChiCTR1900027015. Registered on 28 October 2019.
Simethicone administration improves gastric cleanness for esophagogastroduodenoscopy: a randomized clinical trial
Authors: Sun Xiaotian , Xu Yang , Zhang Xueting , Ma Cuiyun , Li Aitong , Yu Haiyan , Zhang Weihua , Zhang Hanqing , Yang Teng , Miao Xinfang , Zhang Huiming , Liu Yan , Lu Zheng
Published: August 2021

Background

Esophagogastroduodenoscopy is very useful in diagnosing and treating upper gastrointestinal mucosal disorders, but too much foam and water in stomach decrease its diagnostic efficiency. Simethicone administration can help remove excessive foam.

Aims

To determine the optimal simethicone administration strategies in a comparative randomized controlled clinical trial.

Methods

Adult outpatients with indications for esophagogastroduodenoscopy were enrolled and randomly divided into group 1 (simethicone solution intake 20–30 min before procedure, n = 110), group 2 (simethicone solution intake 31–60 min before procedure, n = 92), and group 3 (simethicone solution intake > 60 min before procedure). Primary and secondary outcomes were procedure time and the patients’ satisfaction after the examination. All symptoms like abdominal pain and distension were recorded.

Results

No statistically significant differences were found on the patients’ demographic and clinical features and mean examination time (all P values > 0.05). The distribution of patients with different endoscopic and pathological diagnosis was comparable among three groups, respectively (P = 0.607; P = 0.289). However, the proportion of patients with Gastric Cleanness Grade A was most in group 2 (n = 73, 79.3%), and patient proportion with Gastric Cleanness Grade C was most found in group 1 (n = 72, 65.5%), which was greatly different (P < 0.001). There was no statistically significant difference on the satisfaction scores [immediately 6 (3–8) vs. 6 (1–10) vs. 6 (1-9), P = 0.533; 2 h after 10 (8–10) vs. 10 (10–10) vs. 10 (8-10), P = 0.463].

Conclusion

Simethicone solution intake 31–60 min before esophagogastroduodenoscopy can help obtain the best gastric cleanness, which is recommended in clinical practice (registered at ClinicalTrials.gov, NCT03776916 on December 13, 2018).
Impact of operational conditions on methane yield and microbial community composition during biological methanation in in situ and hybrid reactor systems
Authors: Wahid Radziah , Horn Svein Jarle
Published: August 2021

Background

Biogas can be upgraded to methane biologically by adding H2 to biogas reactors. The process is called biological methanation (BM) and can be done in situ in a regular biogas reactor or the biogas can be transferred to a separate ex situ upgrading reactor. The hybrid BM concept, a combination of in situ and ex situ BM, has received little attention, and only a few studies have been reported. The hybrid BM has the advantage of resolving the issue of pH increment during in situ BM, while the size of the ex situ BM reactor could be reduced.

Results

In this study, the efficiency of in situ and hybrid biological methanation (BM) for upgrading raw biogas was investigated. The hybrid BM system achieved a CH4 yield of 257 mL gVS−1 when degrading a feedstock blend of manure and cheese waste. This represented an increase in methane yield of 76% when compared to the control reactor with no H2 addition. A 2:1 H2:CO2 ratio resulted in stable reactor performance, while a 4:1 ratio resulted in a high accumulation of volatile fatty acids. H2 consumption rate was improved when a low manure–cheese waste ratio (90%:10%) was applied. Furthermore, feeding less frequently (every 48 h) resulted in a higher CH4 production from CO2 and H2. Methanothermobacter was found to dominate the archaeal community in the in situ BM reactor, and its relative abundance increased over the experimental time. Methanosarcina abundance was negatively affected by H2 addition and was nearly non-existent at the end of the experiment.

Conclusions

Our results show that hybrid BM outperforms in situ BM in terms of total CH4 production and content of CH4 in the biogas. In comparison to in situ BM, the use of hybrid BM increased CH4 yield by up to 42%. Furthermore, addition of H2 at 2:1 H2:CO2 ratio in in situ BM resulted in stable reactor operation.
Vectra 3D (dinotefuran, pyriproxyfen and permethrin) prevents acquisition of Borrelia burgdorferi sensu stricto by Ixodes ricinus and Ixodes scapularis ticks in an ex vivo feeding model
Authors: Tahir Djamel , Asri Btissam , Meyer Leon Nicolaas , Evans Alec , Mather Thomas , Blagburn Byron , Straubinger Reinhard K. , Choumet Valérie , Jongejan Frans , Varloud Marie
Published: August 2021

Background

We evaluated the efficiency of an ex vivo feeding technique using a silicone membrane-based feeding chamber to (i) assess the anti-feeding and acaricidal efficacy of a spot-on combination of dinotefuran, pyriproxyfen and permethrin (DPP, Vectra® 3D) against adultIxodes scapularisandIxodes ricinusticks, and to (ii) explore its effect on blocking the acquisition ofBorrelia burgdorferisensu stricto.

Methods

Eight purpose-bred dogs were randomly allocated to two equal-size groups based on body weight assessed on day 2. DPP was administered topically, as spot-on, to four dogs on day 0. Hair from the eight dogs was collected individually by brushing the whole body on days 2, 7, 14, 21, 28 and 35. On each day of hair collection, 0.05 g of sampled hair was applied on the membrane corresponding to each feeding unit (FU). Seventy-two FU were each seeded with 30 adults ofI. scapularis(n = 24 FU) orI. ricinusticks (n = 48 FU). Bovine blood spiked withB. burgdorferisensu stricto (strain B31) was added into each unit and changed every 12 h for 4 days. Tick mortality was assessed 1 h after seeding. One additional hour of incubation was added for live/moribund specimens and reassessed for viability. All remaining live/moribund ticks were left in the feeders and tick engorgement status was recorded at 96 h after seeding, and the uptake ofB. burgdorferis.s. was examined in the collected ticks by applying quantitative real-time PCR.

Results

Exposure to DPP-treated hair was 100% effective in blockingB. burgdorferis.s. acquisition. The anti-feeding efficacy remained stable (100%) against bothIxodesspecies throughout the study. The acaricidal efficacy of DPP evaluated at 1 and 2 h after exposure was 100% throughout the study forI. ricinus, except the 1-h assessment on day 28 (95.9%) and day 35 (95.3%). The 1-h assessment of acaricidal efficacy was 100% at all time points forI. scapularis.

Conclusions

The ex vivo feeding system developed here demonstrated a protective effect of DPP against the acquisition ofB. burgdorferiwithout exposing the animals to the vectors or to the pathogen.

Graphical Abstract
Animal welfare and zoonosis risk: anti-Trichinella antibodies in breeding pigs farmed under controlled housing conditions
Authors: Pozio Edoardo , Celli Mario , Ludovisi Alessandra , Interisano Maria , Amati Marco , Gómez-Morales Maria Angeles
Published: August 2021

Background

Domesticated pigs are the main source of Trichinella sp. infections for humans, particularly when reared in backyards or free-ranging. In temperate areas of southern Europe, most pigs are farmed under controlled housing conditions, but sows and sometimes fattening pigs have access to outdoors to improve animal welfare. The aim of the present study was to investigate whether outdoor access of breeding pigs farmed under controlled housing conditions can represent a risk for Trichinella sp. transmission when the farm is located in an agricultural area interspersed with wooded areas and badlands, where Trichinella spp. could be present in wildlife.

Methods

Serum samples were collected from 63 breeding sows and one boar before and after their access to an open fenced area for 2 months and from 84 pigs that never had outdoor access. Samples were screened for anti-Trichinella antibodies by ELISA, and positive sera were confirmed using Western blot (Wb) excretory/secretory antigens. To detect Trichinella sp. larvae, muscle tissues from serologically positive and negative pigs were tested by artificial digestion.

Results

Thirteen (20.6%) sows and one boar tested positive with both ELISA and Wb. No larvae were detected in muscle samples of serologically positive and serologically negative pigs. Positive serum samples were then tested by Wb using crude worm extract as antigens. The Wb banding pattern displayed was that characteristic of encapsulated species (Trichinella spiralis or Trichinella britovi).

Conclusions

The detection of anti-Trichinella antibodies without larvae in the pig muscles, supported by epidemiological data, suggests that pigs may have been exposed to T. britovi. This study stresses the importance of instigating monitoring systems at farm level to prevent Trichinella sp. transmission and to investigate, through a landscape parasitological study, the suitability of a site before the planting of a high containment level pig farm in which the sows can have outside access to improve their welfare during pregnancy.

Graphical abstract
Predatory and competitive interaction in Anopheles gambiae sensu lato larval breeding habitats in selected villages of central Uganda
Authors: Onen Hudson , Odong Robinson , Chemurot Moses , Tripet Frédéric , Kayondo Jonathan K.
Published: August 2021

Background

Malaria is often persistent in communities surrounded by mosquito breeding habitats. Anopheles gambiae sensu lato exploit a variety of aquatic habitats, but the biotic determinants of its preferences are poorly understood. This study aimed to identify and quantify macroinvertebrates in different habitat types with determined water physico-chemical parameters to establish those preferred by An. gambiae s.l. larvae as well as their predators and competitors.

Methods

A field survey was conducted in Kibuye and Kayonjo villages located in the vicinity of the River Sezibwa, north-eastern Uganda to identify Anopheline larval habitats shared by aquatic insects. Habitats were geo-recorded and as streams, ponds, temporary pools and roadside ditches. From October to December 2017, random microhabitats/quadrats were selected from each habitat type, their water physico-chemical parameters (electrical conductivity, total dissolved solids, temperature and pH) were measured, and they were sampled for macroinvertebrates using standard dippers. All collected arthropod macroinvertebrates were then morphologically identified to family level and enumerated.

Results

Principal component analysis showed that the four larval habitat types were characterized by distinct physico-chemical parameter profiles. Ponds and streams had the highest number and diversity of macroinvertebrate insect taxa and sustained few An. gambiae s.l. larvae. Anopheles gambiae s.l. were more common in roadside ditches and particularly abundant in temporary pools which it commonly shared with Dytiscidae (predaceous diving beetles) and Culex spp. Cluster correlation analysis conducted on the abundance of these taxa within quadrats suggested that An. gambiae s.l. and Dytiscidae have the most similar patterns of microhabitat use, followed by Cybaeidae (water spiders). Whilst Culex spp. co-occurred with An. gambiae s.l. in some habitats, there was only partial niche overlap and no clear evidence of competition between the two mosquito taxa.

Conclusions

Ponds and streams are habitats that host the largest diversity and abundance of aquatic insect taxa. Anopheles gambiae s.l. larvae distinctively preferred temporary pools and roadside ditches, where they were exposed to few predators and no apparent competition by Culex spp. Further studies should aim to test the impact of Dytiscidae and Cybaeidae on An. gambiae s.l. dynamics experimentally.

Graphical Abstract
Epidemiology and spatial distribution of Echinococcus granulosus in sheep and goats slaughtered in a hyperendemic European Mediterranean area
Authors: Bosco Antonio , Alves Leucio Camara , Cociancic Paola , Amadesi Alessandra , Pepe Paola , Morgoglione Maria Elena , Maurelli Maria Paola , Ferrer-Miranda Edyniesky , Santoro Kleber Régis , Nascimento Ramos Rafael Antonio , Rinaldi Laura , Cringoli Giuseppe
Published: August 2021

Background

Cystic echinococcosis (CE) is a worldwide parasitic zoonosis caused by the larval stage of Echinococcus granulosus sensu lato affecting livestock, particularly sheep and goats. However, often this parasitosis is underestimated. For this reason, this study aimed to evaluate the epidemiological features and spatial distribution of CE in sheep and goats slaughtered in a hyperendemic Mediterranean area.

Methods

A survey was conducted in the Basilicata region (southern Italy) from 2014 to 2019. A total of 1454 animals (1265 sheep and 189 goats) from 824 farms were examined for hydatid cyst detection by visual inspection, palpation and incision of target organs. All the CE cysts were counted and classified into five morphostructural types (unilocular, multiseptate, calcified, caseous and hyperlaminated). Molecular analysis was performed on 353 cysts. For spatial analysis, a kriging interpolation method was used to create risk maps, while clustering was assessed by Moran’s I test.

Results

CE prevalence of 72.2% (595/824) and 58.4% (849/1454) was observed at the farm and animal levels, respectively, with higher values in sheep (62.9%) than goats (28.0%). The liver and lungs were the most frequently infected organs in both sheep and goats. Most of recovered cysts were of the calcified and multiseptate morphotypes. All the isolates were identified as E. granulosus sensu stricto (genotypes G1–G3). Spatial distribution showed a moderate clustering of positive animals.

Conclusion

The findings of this study can be used to better understand the eco-epidemiology of echinococcosis and to improve CE surveillance and prevention programs in regions highly endemic for CE.

Graphical abstract
Dual-Polarization radar rainfall prediction and rain gauge data
Authors: Walsh Tyson H. , Lansford Jesse W. , Hromadka T. V. , Rao Prasada
Published: August 2021

Objective

Reported rainfall data from multiple rain gauges and its corresponding estimate from Dual-Polarization (Dual-Pol) radar is presented here. The ordered set of data pairs were collected from multiple peer reviewed publications spanning across the last decade.

Data description

Taken from multiple sources, the data set represents several radar sites and rain gauge sites combined for 12,734 data points. The data is relevant in various applications of hydrometeorology and engineering as well as weather forecasting. Further, the importance of accuracy in radar precipitation estimates continues to increase, necessitating the incorporation of as much data as possible.