bluuebunny/crossref_metadata_2025 huggingface dataset:
Nutrition and diabetes self‐management in aged care: Exploring community‐dwelling older adults' expectations
Authors: Farrer Olivia , Miller Michelle , Yaxley Alison , Walton Karen
Published: May 2022

Objectives

To explore the diabetes self‐management expectations of older adults with diabetes, not yet accessing residential aged care services. Admission to residential aged care (RAC) can create many interruptions to usual food choices and diabetes self‐management, and we know little about the concerns of the emerging ageing population.

Methods

This is a qualitative study employing focus groups and inductive thematic analysis involving 18 older adults with diabetes between the ages of 60 and 88, living in their own homes within an Australian city. Focus groups were recruited on a sequential basis and progressively analysed using an inductive process until data saturation was reached. Focus groups were digitally recorded and transcribed verbatim for thematic analysis.

Results

Three key themes were generated: autonomy, individualised dietary management and the food service system. Older adults speculated that they would want a collaborative approach to maintain their health in ageing and to self‐manage their diabetes while feasible. Participants wanted autonomy over food choices, flexible meal timings and quality meals. There was a significant anxiety that aged care staff and existing food service systems in RAC could not support these preferences.

Conclusions

Community‐dwelling older adults with diabetes would highly value aged care services that facilitated autonomy, individualised nutrition support and flexibility, but feared this will not be feasible. The introduction of new diabetes and RAC guidelines may require an implementation plan to include the full food service system, from staff education to meal preparation, ordering and service.
Regional variance in treatment and outcomes of locally invasive (T4) rectal cancer in Australia and New Zealand: analysis of the Bi‐National Colorectal Cancer Audit
Authors: Dinger Tessa L. , Kroon Hidde M. , Traeger Luke , Bedrikovetski Sergei , Hunter Andrew , Sammour Tarik
Published: May 2022

Backgrounds

Locally invasive T4 rectal cancer often requires neoadjuvant treatment followed by multi‐visceral surgery to achieve a radical resection (R0), and referral to a specialized exenteration quaternary centre is typically recommended. The aim of this study was to explore regional variance in treatment and outcomes of patients with locally advanced rectal cancer in Australia and New Zealand (ANZ).

Methods

Data were collected from the Bi‐National Colorectal Cancer Audit (BCCA) database. Rectal cancer patients treated between 2007 and 2019 were divided into six groups based on region (state/country) using patient postcode. A subset analysis of patients with T4 cancer was performed. Primary outcomes were positive circumferential resection margin (CRM+), and positive circumferential and/or distal resection margin (CRM/DRM+).

Results

A total of 9385 patients with rectal cancer were identified, with an overall CRM+ rate of 6.4% and CRM/DRM+ rate of 8.6%. There were 1350 patients with T4 rectal cancer (14.4%). For these patients, CRM+ rate was 18.5%, and CRM/DRM+ rate was 24.1%. Significant regional variation in CRM+ (range 13.4–26.0%; p = 0.025) and CRM/DRM+ rates (range 16.1–29.3%; p = 0.005) was identified. In addition, regions with higher CRM+ and CRM/DRM+ rates reported lower rates of multi‐visceral resections: range 24.3–26.8%, versus 32.6–37.3% for regions with lower CRM+ and CRM/DRM+ rates (p < 0.0001).

Conclusion

Positive resection margins and rates of multi‐visceral resection vary between the different regions of ANZ. A small subset of patients with T4 rectal cancer are particularly at risk, further supporting the concept of referral to specialized exenteration centres for potentially curative multi‐visceral resection.
Maternal and fetal serum concentrations of magnesium after administration of a 6‐g bolus dose of magnesium sulfate (MgSO4) to women with imminent preterm delivery
Authors: Jonsdotter Andrea , Rocha‐Ferreira Eridan , Hagberg Henrik , Carlsson Ylva
Published: May 2022

Introduction

Magnesium sulfate is used world‐wide to treat pregnant women at imminent risk of preterm delivery in order to protect the brain of the premature infant. Previous research has shown that magnesium sulfate decreases the risk of cerebral palsy by ~30% in infants born preterm. Despite this, the dosage required for optimal neuroprotection remains unknown. We aimed to investigate whether 6 g magnesium sulfate given as a single bolus dose was tolerable for the women and infants and whether the desired target concentration in the mother's blood was reached and non‐toxic level in the infant could be ensured.

Material and methods

In total, 49 women who were at risk of delivery prior to 32 weeks of gestation were recruited. They received a bolus dose of 6 g magnesium sulfate intravenously between 1 and 24 h prior to giving birth and were closely monitored during and after infusion. Blood samples from the patients were analyzed at different time‐points (20–30 min after start of infusion, 1, 2, 6 and 24 h) post‐administration. Blood samples from the umbilical cord were also taken directly after birth to assess the concentration of magnesium in the infant.

Results

None of the women who received magnesium sulfate reached serum magnesium concentrations >3.3 mmol/L. In all, 72% of the women showed serum magnesium levels within the therapeutic interval (2.0–3.5 mmol/L) and no adverse events were observed during the infusion. The serum magnesium levels in the mothers declined to pre‐bolus‐levels within 24 h after delivery. Serum magnesium levels in the umbilical cord samples ranged from 0.87 to 1.4 mmol/L, which means that all but two were within the normal expected range for a newborn premature infant.

Conclusions

A bolus dose of 6 g magnesium sulfate was well tolerated and without any serious side effects in either mother or infant. Most of our women reached the targeted concentration range of serum magnesium levels after infusion was completed. Their infants had magnesium levels within acceptable levels, regardless of gestational week or mother's body mass index.
Two ant‐following bird species forage with three giant sengi (Rhynchocyon) species in East Africa
Authors: Cordeiro Norbert J. , Rovero Francesco , Msuha Maurus J. , Nowak Katarzyna , Bianchi Andrea , Jones Trevor
Published: May 2022

Using camera traps and direct observations, we recorded interactions between three species of giant sengi (Rhynchocyon sp.) and two insectivorous bird species from six forests in Tanzania. In all instances, the birds closely followed the giant sengis who were moving and foraging in the leaf litter. Given that the two bird species are insectivorous and follow ant swarms to obtain flushed prey, these interactions suggest that following sengis represents an adaptive foraging strategy. Our observations indicate that these behaviors and associations may be more pervasive than previously thought.

Abstract in Swahili is available with online material
Daily links between Latinx siblings’ relationship qualities and mood
Authors: Hochgraf Anna K. , Son Daye , Updegraff Kimberly A. , McHale Susan M. , Umaña‐Taylor Adriana J.
Published: May 2022

This study examined daily links between sibling warmth and negativity and positive and negative mood in middle childhood and the moderating role of enculturation. Participants were 326 Latinx children from 163 families in the United States (Mage = 10.63 and 8.58 years for older and younger siblings, 48.5% female, 89.3% Mexican‐origin). Children reported their days’ experiences during seven nightly phone interviews conducted in 2018–2019. Multilevel analyses revealed within‐person, positive associations between daily sibling warmth and positive mood , and sibling negativity and negative mood . Moreover, for more enculturated children, odds of positive mood were lower on days when they experienced more sibling negativity than usual. Findings document the significance of Latinx children's daily sibling experiences.
Contact allergy to the Dexcom G6 glucose monitoring system—Role of 2,2′‐methylenebis(6‐tert‐butyl‐4‐methylphenol) monoacrylate in the new adhesive
Authors: Oppel Eva , Högg Christof , Oschmann Anna , Summer Burkhard , Kamann Stefanie
Published: May 2022

Background

Skin reactions to the glucose monitoring systems Dexcom G5 and G6 have been rare. In 2019, the components of the adhesive were exchanged for better skin fixation. Since then, more and more patients experienced severe skin reactions. A few months ago, 2,2′‐methylenebis(6‐tert‐butyl‐4‐methylphenol) monoacrylate (MBPA) was identified as a new component in the adhesive of the G6 model. Furthermore, it was suspected that isobornyl acrylate (IBOA) was also a component of the exchanged adhesive.

Objectives

Our objective was to investigate if MBPA plays a major role in the increasing skin problems of patients without a history of IBOA‐sensitization. Furthermore, our aim was to examine whether IBOA is contained in the newer model adhesive and may also contribute to allergic contact dermatitis (ACD).

Patients and Methods

Five patients with a newly occurred ACD caused by the glucose monitoring system Dexcom G6 were investigated. Patch testing including MBPA in three different concentrations, as well as IBOA, were performed. Gas chromatography–mass spectrometry of the newer system Dexcom G6 was carried out.

Results

All patients were shown to be sensitized to MBPA, while MBPA 0,5% showed the strongest reaction. On the other hand, IBOA was tested negative.

Conclusion

In our study group, MBPA was observed to be the triggering allergen of the recently changed adhesive.
Clinicopathological determinants of recurrence after surgical treatment of fistula‐in‐ano in a Ghanaian teaching hospital
Authors: Bediako‐Bowan Antoinette A. A. , Naalane Narious , Kumassah Philemon K. , Dakubo Jonathan C. B.
Published: May 2022

Aim

The aim of this work is to describe the clinicopathological and surgical aspects of fistula‐in‐ano and assess the risks associated with recurrence of the disease in a Ghanaian teaching hospital.

Method

This was a retrospective observational study assessing all fistula‐in‐ano surgeries performed at the Korle Bu Teaching hospital from January 2014 to January 2021 that had completed follow up of at least 3 months after wound healing. Demographic, clinical, pathological and surgical data were extracted from patient records. Logistic regression analysis was used to test for association between these variables and recurrence.

Results

A total of 105 patients underwent 124 fistula surgeries. Their median age was 41 years, the male:female ratio was 4:1 and 12 had comorbidities including human immunodeficiency virus infection and diabetes mellitus. Thirty‐one per cent (39/124) of fistulas had previously been operated on. At surgery, 51% (64/124) of fistulas followed a single straight tract, 30% (37/124) a single curved tract and 19% (23/124) had multiple curved tracts. More than half (65/124) were trans‐sphincteric, 35% (44/124) suprasphincteric, 10% (12/124) subsphincteric and 2% (3/124) were intersphincteric. Sixty per cent of fistulas were treated with a ligation of intersphincteric fistula tract (74/124), 35% (44/124) a fistulectomy and 5% a fistulotomy. Recurrence after surgery was 22.5% (28/124); this was significantly higher for fistulas with multiple curved tracts (OR 4.153, 95% CI 1.431–12.054, p = 0.012) and fistulas with comorbidities (OR 3.222, 95% CI 1.076–9.647, p = 0.037).

Conclusion

There was high recurrence after fistula surgery with increased risk for fistulas with multiple tracts and the presence of comorbidities.
Insight into the antibacterial resistance of graphdiyne functionalized by silver nanoparticles
Authors: Qin Simin , Xie Mo , Cao Shuting , Li Jiang , Wang Lihua , Luo Shi‐Hua , Lv Min
Published: May 2022

Objectives

Silver nanoparticles (AgNPs) tend to aggregate spontaneously due to larger surface‐to‐volume ratio, which causes decreased antibacterial activity and even enhanced antimicrobial resistance (AMR). Here, we aim to improve the stability of AgNPs by employing a growth anchor graphdiyne (GDY) to overcome these shortcomings.

Materials and Methods

Bacillus subtilis and Escherichia coli were selected to represent gram‐positive and gram‐negative bacteria, respectively. Transmission electron microscopy (TEM), energy dispersive spectroscopy (EDS), scanning electron microscopy (SEM)‐EDS mapping and inductively coupled plasma mass spectrometry (ICP‐MS) were carried out to characterize the physiochemical properties of materials. The antimicrobial property was determined by turbidimetry and plate colony‐counting methods. The physiology of bacteria was detected by SEM and confocal imaging, such as morphology, reactive oxygen species (ROS) and cell membrane.

Results

We successfully synthesized a hybrid graphdiyne @ silver nanoparticles (GDY@Ag) by an environment‐friendly approach without any reductants. The hybrid showed high stability and excellent broad‐spectrum antibacterial activity towards both gram‐positive and gram‐negative bacteria. It killed bacteria through membrane destruction and ROS production. Additionally, GDY@Ag did not induce the development of the bacterial resistance after repeated exposure.

Conclusions

GDY@Ag composite combats bacteria by synergetic action of GDY and AgNPs. Especially, GDY@Ag can preserve its bacterial susceptibility after repeated exposure compared to antibiotics. Our findings provide an avenue to design innovative antibacterial agents for effective sterilization.
Optimizing pre‐donation physiologic evaluation for enhanced recovery after living liver donation – Systematic review and multidisciplinary expert panel recommendations
Authors: Izzy Manhal , Brown Robert S. , Eguchi Susumu , Hwang Shin , Matamoros Maria A. , Quintini Cristiano , Rajakumar Akila , Raptis Dimitri Aristotle , Spiro Michael , Ascher Nancy L. ,   the ERAS4OLT.org Working Group
Published: May 2022

Background

While preoperative physiologic evaluation of live liver donors is routinely performed to ensure donor safety and minimize complications, the optimal approach to this evaluation is unknown.

Objectives

We aim to identify predonation physiologic evaluation strategies to improve postoperative short‐term outcomes, enhance donor's recovery, and reduce length of stay. We also aim to provide multidisciplinary expert panel recommendations.

Data sources

Ovid MEDLINE, Embase, Scopus, Google Scholar, and Cochrane Central.

Methods

The systematic review followed PRISMA guidelines, and the recommendations were formulated using GRADE approach and experts' opinion. The search included retrospective or prospective studies, describing outcomes of physiologic evaluation predonation. The outcomes of interest were length of stay, postoperative complications (POC), recovery after donation, and mortality. PROSERO protocol ID CRD42021260662.

Results

Of 1386 articles screened, only three retrospective cohort studies met eligibility criteria. Two studies demonstrated no impact of age (< 70 years) on POC. Increased body mass index's (BMI) association with POC was present in one study (23.8 vs 21.7 kg/m2, OR 1.67 (1.14‐2.48), P = .01) and absent in another (< 30 vs 30‐35 kg/m2, P = .61). One study demonstrated decreased risk for postdonation subclinical hepatic dysfunction in donors with higher normal platelet count (PLT). None of the studies noted donor death. Given the scarce data on predonation physiologic testing, the expert panel recommended a battery of tests to guide clinical practice and future investigations.

Conclusion

Advancing age (60‐69 years) is not a contraindication for liver donation. There is insufficient evidence for a specific predonation BMI cut‐off. Abbreviated predonation physiologic testing is recommended in all candidates. Comprehensive testing is recommended in high‐risk candidates while considering the pretest probability in various populations (Quality of evidence; Low to Very Low | Grade of Recommendation; Strong).
Predicting the distribution of Australian frogs and their overlap with Batrachochytrium dendrobatidis under climate change
Authors: Sopniewski Jarrod , Scheele Benjamin C. , Cardillo Marcel
Published: May 2022

Aim

Amphibians, with over 40% of assessed species listed as threatened, are disproportionately at risk in the global extinction crisis. Among the many factors implicated in the ongoing loss of amphibian biodiversity are climate change and the disease chytridiomycosis, caused by the fungus Batrachochytrium dendrobatidis (Bd). These threats are of particular concern in Australia, where Bd has been implicated in the declines of at least 43 frog species, and climate change is emerging as an additional threat. We explore how climate change is likely to affect the distributions of Australian frog species and Bd to the year 2100, and how the spatial and climatic niche overlap between chytridiomycosis‐declined frogs and Bd could shift.

Location

Australia.

Methods

We used species distribution modelling to infer the current and future distribution of 141 Australian frog species and Bd, under two emissions scenarios. We used various metrics of niche similarity to quantify predicted alterations to spatial interactions between Bd and frog species.

Results

Climate change is likely to have a variable impact on frog distributions in Australia, with some 23 and 47 species, primarily in southern Australia, predicted to lose at least 30% of their current distributions under low and high emissions scenarios, respectively. In contrast, 69 and 68 species, respectively, have potential to increase their distributions, primarily in northern Australia. While the distribution of Bd is predicted to decrease, the proportional spatial and niche overlap between Bd and susceptible frog species is predicted to remain little changed, and in some cases, to increase.

Main conclusions

Although effects will be variable across the continent, climate change is likely to be a threatening factor to many Australian frog species. Additionally, chytridiomycosis is likely to remain a significant threat to many frog species, as any reductions to the pathogen's distribution largely coincide with geographic range contractions of chytridiomycosis‐susceptible species.
Can training of a skilled pelvic movement change corticomotor control of back muscles? Comparison of single and paired‐pulse transcranial magnetic stimulation
Authors: Shraim Muath A. , Massé‐Alarie Hugo , Salomoni Sauro E. , Hodges Paul W.
Published: May 2022

Evidence suggests excitability of the motor cortex (M1) changes in response to motor skill learning of the upper limb. Few studies have examined immediate changes in corticospinal excitability and intra‐cortical mechanisms following motor learning in the lower back. Further, it is unknown which transcranial magnetic stimulation (TMS) paradigms are likely to reveal changes in cortical function in this region. This study aimed to (1) compare corticospinal excitability and intra‐cortical mechanisms in the lower back region of M1 before and after a single session of lumbopelvic tilt motor learning task in healthy people and (2) compare these measures between two TMS coils and two methods of recruitment curve (RC) acquisition. Twenty‐eight young participants (23.6 ± 4.6 years) completed a lumbopelvic tilting task involving three 5‐min blocks. Single‐pulse (RC from 70% to 150% of active motor threshold) and paired‐pulse TMS measures (ICF, SICF and SICI) were undertaken before (using 2 coils: figure‐of‐8 and double cone) and after (using double cone coil only) training. RCs were also acquired using a traditional and rapid method. A significant increase in corticospinal excitability was found after training as measured by RC intensities, but this was not related to the RC slope. No significant differences were found for paired‐pulse measures after training. Finally, there was good agreement between RC parameters when measured with the two different TMS coils or different acquisition methods (traditional vs. rapid). Changes in corticospinal excitability after a single session of lumbopelvic motor learning task are seen, but these changes are not explained by changes in intra‐cortical mechanisms.
International League Against Epilepsy classification and definition of epilepsy syndromes with onset in childhood: Position paper by the ILAE Task Force on Nosology and Definitions
Authors: Specchio Nicola , Wirrell Elaine C. , Scheffer Ingrid E. , Nabbout Rima , Riney Kate , Samia Pauline , Guerreiro Marilisa , Gwer Sam , Zuberi Sameer M. , Wilmshurst Jo M. , Yozawitz Elissa , Pressler Ronit , Hirsch Edouard , Wiebe Samuel , Cross Helen J. , Perucca Emilio , Moshé Solomon L. , Tinuper Paolo , Auvin Stéphane
Published: May 2022

The 2017 International League Against Epilepsy classification has defined a three‐tier system with epilepsy syndrome identification at the third level. Although a syndrome cannot be determined in all children with epilepsy, identification of a specific syndrome provides guidance on management and prognosis. In this paper, we describe the childhood onset epilepsy syndromes, most of which have both mandatory seizure type(s) and interictal electroencephalographic (EEG) features. Based on the 2017 Classification of Seizures and Epilepsies, some syndrome names have been updated using terms directly describing the seizure semiology. Epilepsy syndromes beginning in childhood have been divided into three categories: (1) self‐limited focal epilepsies, comprising four syndromes: self‐limited epilepsy with centrotemporal spikes, self‐limited epilepsy with autonomic seizures, childhood occipital visual epilepsy, and photosensitive occipital lobe epilepsy; (2) generalized epilepsies, comprising three syndromes: childhood absence epilepsy, epilepsy with myoclonic absence, and epilepsy with eyelid myoclonia; and (3) developmental and/or epileptic encephalopathies, comprising five syndromes: epilepsy with myoclonic–atonic seizures, Lennox–Gastaut syndrome, developmental and/or epileptic encephalopathy with spike‐and‐wave activation in sleep, hemiconvulsion–hemiplegia–epilepsy syndrome, and febrile infection‐related epilepsy syndrome. We define each, highlighting the mandatory seizure(s), EEG features, phenotypic variations, and findings from key investigations.
Exploring the limits to sustainable pellet production for international markets: The impact of increasing pellet production in the US Southeast on feedstock use, production cost and carbon sequestration in forest areas
Authors: Visser Lotte , Latta Greg , Pokharel Raju , Hoefnagels Ric , Junginger Martin
Published: May 2022

With rising demand for wood pellets from the US Southeast (US SE), the environmental limits to additional biomass demand are increasingly questioned. This study analyses the impact of increased pellet production in the US SE until 2030 on feedstock allocation, carbon flux in forest areas and costs of pre‐treatment and transport of feedstock and pellets. This by linking locations of forest biomass supply and demand through supply‐side logistics, allocating feedstock based on lowest costs of pre‐treatment, transport of feedstock and pellets, for the entire wood products sector. The impact is analysed for different scenarios with varied pellet production levels, additional inclusion of logging residues and optimization either on costs or on maintaining total carbon stock in sourcing areas of new pellet mills. In a scenario of 20 Mt pellet production, the roundwood share increases from 0% in 2020 to 37% pulplogs and 11% sawlogs in 2030. Costs increase with 57% towards 2030 compared to 2020, largely because of higher costs for pulplogs and sawlogs. In a scenario without pellet production, forest carbon removal in the US SE is 3 Mt CO2/year lower than in 2020. In the Reference scenario, additional carbon removal of 6, 21 and 38 Mt CO2/year is observed for 10, 20 and 30 Mt pellet production, respectively. In all cases, the forests of the US SE remain a net sink until 2030. The impact of a selection criteria for new pellet mill locations based on keeping local growth/drain ratios above 1 in sourcing areas is small since this mostly results in displacement of impacts and does not affect the total feedstock availability. Additional mobilization of logging residues is a key strategy to reduce carbon impacts, resulting in a smaller additional flux of 2, 11 and 29 Mt CO2/year for 10–30 Mt pellet production.
The mediating effect of coping style on the relationship between perceived stress and mental health in Chinese rural older adults living alone: A cross‐sectional study
Authors: Li Sha‐sha , Zhang Jia‐yuan , Wu Cong‐Wen , Lu Yu‐wei , Xu Li‐jun , Ni Ying‐Yuan , Liu Xiao‐Jing
Published: May 2022

Aim

Older adults living alone is becoming the main family structure in rural China. This study aimed to explore the mediating effect of coping style on the relationship between perceived stress and mental health in rural older adults living alone in China.

Methods

356 rural older adults living alone were recruited in Huzhou, China. Subjects were investigated using the Chinese Perceived Stress Scale (CPSS), Chinese Coping Style Questionnaire (CCSQ), and Mental Health Questionnaire (MHQ). Data were analysed using a structural equation. Bootstrapping was used to validate the mediation effects.

Results

Mental health showed significant correlations with a sense of nervousness, of uncontrollability, and with positive and negative coping styles (P < 0.05). The results of structural equation modeling showed a good fit for the total sample (χ2/df = 2.684, NFI = 0.927, GFI = 0.944, RMSEA = 0.069). Perceived stress (sense of nervousness and uncontrollability) impacted the mental health of rural older adults living alone mainly through two mediating variables, including positive and negative coping styles. The double mediating contribution rates were 42.11%, and 61.82%.

Conclusion

Coping style partially mediated the relationship between perceived stress and mental health of rural older adults living alone in China. Consequently, to improve the mental health of rural older adults living alone, perceived stress and coping styles should be the focus. Geriatr Gerontol Int 2022; 22: 523–528.
Clinical application of extended half‐life factor VIII in children with severe haemophilia A
Authors: Dettoraki Athina , Michalopoulou Aikaterini , Mazarakis Michalis , Saslis Stefanos , Stamati Ioanna , Kapsimali Zoey , Pergantou Helen
Published: May 2022

Introduction

Only few studies have presented results from real‐world clinical use of Extended Half‐Life (EHL) products in children with haemophilia (CWH).

Aim

To retrospectively examine real‐life experience with EHL factor VIII products use in CWH A, comparing with clinical experience from standard half‐life products (SHL).

Methods

A retrospective review of medical records of CWH A who have been prescribed EHL factor concentrates was conducted. All before/after comparisons were performed with the Wilcoxon matched‐pairs signed‐ranks test.

Results

Twenty‐three children with severe haemophilia A were enrolled in the study (3–6 years old:n = 4, 7–12 years old:n = 7 and 13–18 years old:n = 12). Median length of time that patients were treated with EHL products was 78 weeks. Median dosing interval was significantly lengthened from 2.3 to 3.5 days after switching from SHL to EHL concentrates. Mean trough FVIII levels were significantly increased from 2.3% to 4.1% after treatment with EHL products. Also, CWH A had a reduction of mean annual bleeding rate (ABR) and mean annual joint bleeding rate (AJBR) from 1 and .8 to .3 and .2, respectively, following treatment with EHL concentrates (ABR:p = .02, AJBR:p = .05). However, after switching to factor EHL, actual FVIII consumption, including bleeds, was significantly increased from 94 IU/kg/week to 118 IU/kg/week in CWH A. There was no inhibitor development.

Conclusion

This study demonstrates the successful transition of 23 CWH A from SHL to EHL factor concentrates.
Myeloid differentiation factor‐2 activates monocytes in patients with dilated cardiomyopathy
Authors: Feldtmann Rico , Kümmel Andreas , Chamling Bishwas , Strohbach Anne , Lehnert Kristin , Gross Stefan , Loerzer Lisa , Riad Alexander , Lindner Diana , Westermann Dirk , Fielitz Jens , Dörr Marcus , Felix Stephan B.
Published: May 2022

Plasma levels of myeloid differentiation factor‐2 (MD‐2), a co‐receptor of toll‐like‐receptor 4 (TLR4), independently predict mortality in patients with dilated cardiomyopathy (DCM). We tested whether monocyte activation by MD‐2 contributes to immune activation and inflammatory status in DCM patients. We found increased MD‐2 plasma levels in 25 patients with recent‐onset DCM (1250 ± 80.7 ng/ml) compared to 25 age‐ and gender‐matched healthy controls (793.4 ± 52.0 ng/ml; p < 0.001). Monocytes isolated from DCM patients showed a higher expression (141.7 ± 12.4%; p = 0.006 vs. controls) of the MD‐2 encoding gene, LY96 and an increased NF‐κB‐activation. Further, the TLR4‐activator lipopolysaccharide (LPS) caused a higher increase in interleukin (IL)‐6 in monocytes from DCM patients compared to controls (mean fluorescence intensity: 938.7 ± 151.0 vs. 466.9 ± 51.1; p = 0.005). MD‐2 increased IL‐6 secretion in a TLR4/NF‐κB‐dependent manner in monocyte‐like THP‐1‐cells as demonstrated by TLR4‐siRNA and NF‐κB‐inhibition. Since endothelial cells (ECs) are responsible for recruiting monocytes to the site of inflammation, ECs were treated with MD‐2 leading to an activation of Akt and increased secretion of monocyte‐chemoattractant‐protein‐1 (MCP‐1). Activation of ECs by MD‐2 was accompanied by an increased expression of the adhesion molecules CD54, CD106 and CD62E, resulting in an increased monocyte recruitment, which was attenuated by CD54 inhibition. In addition, in murine WT but not LY96‐KO bone marrow‐derived macrophages LPS increased the amount of CD54 and CD49d/CD29. MD‐2 facilitates a pro‐inflammatory status of monocytes and EC‐mediated monocyte recruitment via TLR4/NF‐κB. Elevated MD‐2 plasma levels are possibly involved in monocyte‐related inflammation‐promoting disease progression in DCM. Our results suggest that MD‐2 contributes to increasing monocytic inflammatory activity and triggers the recruitment of monocytes to ECs in DCM.
Disinfection of an ambulance using a compact atmospheric plasma device
Authors: Kramer Bernd , Warschat Daniela , Muranyi Peter
Published: May 2022

Aims

The worldwide spread of the coronavirus SARS-CoV-2 has highlighted the need for fast and simple disinfection processes, amongst others for ambulance cars on site. To overcome current drawbacks regarding room disinfection, the use of cold atmospheric plasma in remote operation represents a promising alternative for the disinfection of larger volumes. In this study, a compact plasma system was evaluated regarding its disinfection efficiency inside an ambulance car.

Methods and Results

The developed plasma device is based on a dielectric barrier discharge (DBD) and operates with ambient air as process gas. The humidified afterglow from the plasma nozzle was introduced into an ambulance car with a volume of approximately 10 m3 while Bacillus atrophaeus endospores, Staphylococcus aureus or Phi 6 bacteriophages dried on different surfaces (PET-films, glass slides or aluminum foil) were exposed to the reactive gas inside the ambulance vehicle at eight different positions. Reductions of spores by more than 4 orders of magnitude were found on all surfaces and positions within 2 h. Due to their higher susceptibility, Phi 6 bacteriophages and S. aureus counts were reduced by at least 4 orders of magnitude within 30 min on all surfaces.

Conclusion

The results show that different microorganisms dried on variable surfaces can be inactivated by several orders of magnitude inside an ambulance by plasma gas from of a compact DBD plasma nozzle.

Significance and Impact of the Study

Plasma gas generated on site by a DBD plasma nozzle proved to be highly efficient for the disinfection of the interior of an ambulance car. Compact plasma systems could be a viable alternative for the disinfection of vehicles or rooms.
Photocatalytic and biological activities of green synthesized SnO2 nanoparticles using Chlorella vulgaris
Authors: Al-Enazi Nouf M. , Alwakeel Suaad , Alhomaidi Eman
Published: May 2022

Aims

To produce tin oxide (SnO2) nanoparticles (NP) with microalga for use in azo dye-polluted wastewater treatment and to optimize the conditions to synthesize as small NPs as possible.

Methods and Results

The green microalga Chlorella vulgaris mediated NPs were synthesized after an optimization process utilizing the statistical response surface methodology (RSM). The optimized synthesis conditions were 200 W microwave power, 0.5 mM SnCl2 concentration and 200°C calcination temperature. Methyl orange (MO) was studied for its photocatalytic degradation with UV. Antibacterial activity against four pathogenic bacteria was studied using the well diffusion method. Cytotoxicity was measured using the MMT assay with lung cancer cell line A549, and antioxidant activity using DPPH radical scavenging. Following the optimization of their production, the produced crystalline SnO2 NPs were on average 32.2 nm (by XRD) with a hydrodynamic size of 52.5 nm (by LDS). Photocatalytic degradation of MO under UV was nearly complete (94% removal) after 90 min and the particles could be reused for 5 cycles retaining 80% activity. The particles had antibacterial activity towards all five tested bacterial pathogens with the minimum inhibitory concentrations ranging from 22 to 36 μg/ml. The minimum bactericidal NP concentration varied between 83 and 136 μg/ml. Antioxidant activity was concentration dependent. A cytotoxicity was determined towards A549 cells with an LD50 of 188 μg/ml after 24 h of incubation, a concentration that is much higher than the active concentration for dye removal ranging from 22 to 36 μg/ml.

Conclusions

After optimization, SnO2 nanoparticles produced with C. vulgaris displayed high photocatalytic activity at concentrations below their antibacterial and cytotoxic activities.

Significance and Impact of the study

The SnO2 nanoparticles produced with the help of microalgae are suitable for the removal of MO dye from wastewater. Further applications of this green technology can be expected.
Starter inoculums assisted fermentation of Puntius sp.—Role of Lactiplantibacillus plantarum and staphylococcus piscifermentans to reduce fermentation time while increasing safety
Authors: Majumder Ranendra K. , Gupta Shubham
Published: May 2022

Aims

To evaluate the role of starter inoculums to reduce total fermentation time as well as to improve safety and quality of Sheedal, a fermented fish-product of India.

Methods and Results

Lactiplantibacillus plantarum and Staphylococcus piscifermentans were isolated from the Sheedal and used as starter inoculums. To justify fermenting and probiotic properties of the starter inoculums, characteristics like proteolytic and lipolytic activity, cell-surface hydrophobicity, cell auto-aggregation and co-aggregation, antibiotic susceptibility and antimicrobial assay were performed. Changes in the count of lactic acid bacteria, staphylococci and Enterobacteriaceae were studied periodically.

Conclusions

A higher increase in α-amino nitrogen and TCA-soluble peptides during fermentation was observed in treatment which was inoculated with both L. plantarum and S. piscifermentans. Poor competitiveness of staphylococci in presence of LAB was found. Inoculation of both L. plantarum and S. piscifermentans as starter showed a positive effect to reduce significantly the fermentation period from usual 4–5 months to 75 days, whereas, same was achieved after 105th and 120th by the use of either L. plantarum or S. piscifermentans respectively.

Significance and Impact of Study

Reduction of the total fermentation period is considered as an additional advantage in Sheedal technology in addition to the safety of the product as evidenced by low pH and high titratable acidity.
A frozen decade: Ten years outcome of atrial fibrillation ablation using a single shot device for pulmonary vein isolation
Authors: Bergau Leonard , Sciacca Vanessa , Nesapiragasan Vinitha , Rubarth Kerstin , Konietschke Frank , Fink Thomas , El Hamriti Mustapha , Imnadze Guram , Dagher Lilas , Braun Martin , Khalaph Moneeb , Guckel Denise , Heintze Johannes , Noelker Georg , Vogt Jürgen , Sommer Philipp , Sohns Christian
Published: May 2022

Aims

Cryoballoon‐guided pulmonary vein isolation (CB‐PVI) for symptomatic atrial fibrillation (AF) has become an established treatment option with encouraging results in terms of safety and efficacy. Data reporting on long‐term data beyond a follow‐up (FU) period of 5 years is scarce. This prospective study aimed to evaluate very long‐term outcome after CB‐PVI for AF.

Methods

Data from consecutive patients treated with CB‐PVI for symptomatic and drug refractory AF between 2005 and 2012 were analyzed. Patients with a FU of ≥9 years after index CB‐PVI were included. All patients were continuously followed‐up in our outpatient clinic. Arrhythmia recurrence was defined as AF or atrial tachycardia (AT) lasting >30 s beyond a 3‐month blanking period.

Results

A total of 385 patients (71% male) were included. Mean age was 58 ± 10 years and paroxysmal AF was present in 93% of patients. Mean FU duration was 124 ± 24 months. At the end of the observational period, 73% of all patients were in stable sinus rhythm after a mean of 2 ± 0.8 ablation procedures. Patients with AF/AT recurrence were older (60 ± 8 vs. 57 ± 10 years; p = .019), had a higher CHA2DS2‐Vasc Score (2.47 ± 1.46 vs. 1.98 ± 1.50; p = .01) and presented with a larger left atrium (LA)‐diameter (43 ± 5.6 vs. 40 ± 5.1 mm; p = .002). The LA‐diameter was also a significant predictor for AF/AT recurrence after CB‐PVI (odds ratio: 0.939, 95% confidence interval: [0.886, 0.992], p = .03).

Conclusions

CB‐PVI as index procedure for AF ablation resulted in favorable long‐term outcome in symptomatic AF. CB‐PVI might be recommended as interventional therapy in patients with lower LA remodeling.
Comparison of clinical characteristics, eating behaviors, and clinical symptoms following fat intake in functional dyspepsia with functional dyspepsia with pancreatic enzyme abnormalities between Singapore and Japan
Authors: Futagami Seiji , Kessoku Takaomi , Kasai Yuki , Higurashi Takuma , Nakajima Atsushi , Agawa Shuhei , Yamawaki Hiroshi , Habiro Mayu , Ueki Nobue , Sanada Iori , Yamamoto Mariko , Watanabe Yoshiyuki , Yamato Hiroshi , Yamamoto Takatsugu , Takasaki Yusuke , Ito Koichi , Hojo Mariko , Isayama Hiroyuki , Siah Kewin Tien Ho , Gwee Kok‐Ann
Published: May 2022

Background and Aim

To clarify whether there were any significant differences in clinical symptoms and eating patterns between functional dyspepsia (FD) patients and FD with pancreatic enzyme abnormalities (FD‐P) patients as refractory FD, we compared these factors in multicenter studies in Singapore and Japan.

Methods

One hundred ninety‐eight consecutive patients presenting with FD (n = 88), FD‐P patients (n = 81) based on Rome III classification and controlled group (n = 39) recruited from six institutions in Singapore and Japan. Clinical characteristics, clinical symptoms for dietary fat intake, and eating behaviors were estimated using questionnaires. Anxiety and health‐related quality of life were determined by STAI‐state/‐trait and SF‐8, respectively.

Results

There were no significant differences in age, sex, BMI, smoking, alcohol intake, past medical history, and history of allergy in FD and FD‐P patients between Singapore and Japan. There were no significant differences in FD subtypes, gastrointestinal symptom rating scale score, severity of FD symptoms, and eating pattern in Singapore and Japan. Moreover, there were significant differences in certain eating behaviors between FD and FD‐P patients in Singapore and Japan. Interestingly, epigastric pain and early satiety following fat meals in FD‐P patients were significantly (P = 0.003 and P = 0.008, respectively) higher compared with those in FD patients in Japan. Physical component score in FD‐P patients was significantly (P = 0.019) disturbed compared with those in FD patients in Japan.

Conclusions

Epigastric pain and early satiety following fat meals in FD‐P patients may be useful tools to differentiate FD‐P patients from FD patients in Japan.
Dynamic lighting schedules to facilitate circadian adaptation to shifted timing of sleep and wake
Authors: Rahman Shadab A. , St. Hilaire Melissa A. , Grant Leilah K. , Barger Laura K. , Brainard George C. , Czeisler Charles A. , Klerman Elizabeth B. , Lockley Steven W.
Published: May 2022

Circadian adaptation to shifted sleep/wake schedules may be facilitated by optimizing the timing, intensity and spectral characteristics of light exposure, which is the principal time cue for mammalian circadian pacemaker, and possibly by strategically timing nonphotic time cues such as exercise. Therefore, circadian phase resetting by light and exercise was assessed in 44 healthy participants (22 females, mean age [±SD] 36.2 ± 9.2 years), who completed 8‐day inpatient experiments simulating night shiftwork, which included either an 8 h advance or 8 h delay in sleep/wake schedules. In the advance protocol (n = 18), schedules were shifted either gradually (1.6 h/day across 5 days) or abruptly (slam shift, 8 h in 1 day and maintained across 5 days). Both advance protocols included a dynamic lighting schedule (DLS) with 6.5 h exposure of blue‐enriched white light (704 melanopic equivalent daylight illuminance [melEDI] lux) during the day and dimmer blue‐depleted light (26 melEDI lux) for 2 h immediately before sleep on the shifted schedule. In the delay protocol (n = 26), schedules were only abruptly delayed but included four different lighting conditions: (1) 8 h continuous room‐light control; (2) 8 h continuous blue‐enriched light; (3) intermittent (7 × 15 min pulses/8 h) blue‐enriched light; (4) 8 h continuous blue‐enriched light plus moderate intensity exercise. In the room‐light control, participants received dimmer white light for 30 min before bedtime, whereas in the other three delay protocols participants received dimmer blue‐depleted light for 30 min before bedtime. Both the slam and gradual advance protocols induced similar shifts in circadian phase (3.28 h ± 0.37 vs. 2.88 h ± 0.31, respectively, p = .43) estimated by the change in the timing of timing of dim light melatonin onset. In the delay protocol, the continuous 8 h blue‐enriched exposure induced significantly larger shifts than the room light control (−6.59 h ± 0.43 vs. −4.74 h ± 0.62, respectively, p = .02). The intermittent exposure induced ~60% of the shift (−3.90 h ± 0.62) compared with 8 h blue‐enriched continuous light with only 25% of the exposure duration. The addition of exercise to the 8 h continuous blue‐enriched light did not result in significantly larger phase shifts (−6.59 h ± 0.43 vs. −6.41 h ± 0.69, p = .80). Collectively, our results demonstrate that, when attempting to adapt to an 8 h overnight work shift, delay shifts are more successful, particularly when accompanied by a DLS with high‐melanopic irradiance light stimulus during wake.
Knowledge gaps in the management of refractory reflux‐like symptoms: Healthcare provider survey
Authors: Armstrong David , Hungin Amrit Pali , Kahrilas Peter J. , Sifrim Daniel , Sinclair Paul , Vaezi Michael F. , Sharma Prateek
Published: May 2022

Background

Refractory reflux‐like symptoms have a substantial impact on patients and healthcare providers. The aim of the survey was to qualitatively assess the needs and attitudes of practicing clinicians around the management of refractory reflux symptoms and refractory gastroesophageal reflux disease (rGERD).

Methods

An International Working Group for the Classification of Oesophagitis (IWGCO) steering committee invited clinicians to complete an online survey including 17 questions.

Key results

Of the 113 clinicians who completed the survey, 70% were GIs, 20% were primary care physicians, and 10% were other specialties. Functional heartburn was considered the most common reason for an incomplete response to proton pump inhibitor (PPI) therapy (82%), followed by stress/anxiety (69%). More GIs identified esophageal hypersensitivity as a cause, while more non‐GIs identified esophageal dysmotility and non‐reflux‐related esophageal conditions. As the first step, most clinicians would order investigations (70–88%). Overall, 72% would add supplemental therapy for patients with partial response, but only 58% for those with non‐response. Antacid/alginate was the most common choice overall, while non‐GIs were more likely to add a prokinetic than were GIs (47.8 vs. 24.1%). Approximately 40% of clinicians would switch PPIs in patients with partial response, but only 29% would do so in non‐responders. Preferences for long‐term therapy were highly variable. The most common initial investigation was upper endoscopy. Choice of esophageal manometry and pH monitoring was more variable, with no clear preference for whether pH monitoring should be conducted on, or off, PPI therapy.

Conclusions and Inferences

The survey identified a number of challenges for clinicians, especially non‐GI physicians, treating patients with refractory reflux‐like symptoms or rGERD on a daily basis.
Plant landscape abundance and soil fungi modulate drought effects on plant–soil feedbacks
Authors: Xi Nianxun , Crawford Kerri M. , De Long Jonathan R.
Published: May 2022

Plant–soil feedbacks (PSF) play an important role in determining plant community structure and dynamics. However, previous studies have provided mixed results for the relationship between PSF and plant landscape abundance (i.e. abundance across local communities). This may reflect the mediation of climate factors on PSF. Here, we tested how PSF of tree species varied with local abundances by growing seedlings in conspecific versus heterospecific soil and how simulated drought altered PSF–plant abundance relationships. Six tree species were selected and half of the seedlings were grown under ambient moisture conditions, while the others experienced a 2‐month period of drought following 3‐months of growth under ambient moisture conditions. Fungal communities in the rhizosphere soil were analysed using DNA amplicon sequencing to link shifts in soil fungi to the observed PSF. We found that drought reduced negative PSF for all plant species except one species (Lithocarpus lohangwu). In the drought treatments, PSF were positively correlated with the relative abundance of total putative pathogens, but negatively correlated with the proportion of unique pathogens (those pathogens that were present in conspecific soil rather than heterospecific soil, thereby potentially species‐specific). In addition, we found that PSF only significantly predicted plant relative abundance in the drought treatment, indicating that abiotic stress made PSF a stronger predictor of plant landscape abundance. This finding also implies that future extreme drought events could promote the dominance of the abundant plant species, thereby leading to the loss of biodiversity. Collectively, our results provide evidence for microbial mechanisms of PSF and suggest that accounting for abiotic stress can make PSF a stronger predictor of plant landscape abundance due to the omnipresence of stress under natural conditions.