bluuebunny/crossref_metadata_2025 huggingface dataset:
Food web on ice: a pragmatic approach to investigate the trophic magnification of chemicals of concern
Authors: Kosfeld Verena , Rüdel Heinz , Schlechtriem Christian , Rauert Caren , Koschorreck Jan
Published: August 2021

Background

The trophic magnification factor (TMF) is a metric that describes the average trophic magnification of a chemical through a food web. TMFs may be used for the risk assessment of chemicals, although TMFs for single compounds can vary considerably between studies despite thorough guidance available in the literature to eliminate potential sources of error. The practical realization of a TMF investigation is quite complex and often only a few chemicals can be investigated due to low sample masses. This study evaluated whether a pragmatic approach involving the large-scale cryogenic sample preparation practices of the German Environmental Specimen Bank (ESB) is feasible. This approach could provide sufficient sample masses for a reduced set of samples allowing screenings for a broad spectrum of substances and by that enabling a systematic comparison of derived TMFs. Furthermore, it was assessed whether plausible TMFs can be derived with the ‘Food web on ice’ approach via a comparison with literature TMF values.

Results

This investigation at Lake Templin near Potsdam is the first TMF study for a German freshwater ecosystem and aimed to derive TMFs that are appropriate for regulatory purposes. A set of 15 composite biota samples was obtained and analyzed for an extended set of benchmark chemicals such as persistent organic pollutants, mercury and perfluoroalkyl substances. TMFs were calculated for all substances that were present in > 80% of the biota samples. For example, in the case of polychlorinated biphenyls, TMFs from 1.7 to 2.5 were determined and comparisons to literature TMFs determined in other freshwater ecosystems showed similarities. We showed that 32 out of 35 compounds analyzed had TMFs significantly above 1. In the remaining three cases, the correlations were not statistically significant.

Conclusions

The derived food web samples allow for an on-demand analysis and are ready-to-use for additional investigations. Since substances with non-lipophilic accumulation properties were also included in the list of analyzed substances, we conclude that the ‘Food web on ice’ provides samples which could be used to characterize the trophic magnification potential of substances with unknown bioaccumulation properties in the future which in return could be compared directly to the benchmarking patterns provided here.
Stewardship and administrative capacity in green public procurement in the Czech Republic: evidence from a large-N survey
Authors: Plaček Michal , Valentinov Vladislav , del Campo Cristina , Vaceková Gabriela , Ochrana František , Šumpíková Markéta
Published: August 2021

Background

The uptake of green public procurement in the Czech Republic is known to lag behind the European standards. We trace this condition back to the adverse effects of a specific type of decision-making trade-off faced by the Czech public procurement officials, namely the trade-off between stewardship and administrative compliance. The trade-off means that public procurers are aware of administrative risks and complications attendant on the conscientious non-perfunctory implementation of green public procurement.

Results

The overall result is that public procurers ultimately come to prioritize the contract criterion of the lowest price over ecological criteria. The existence of this trade-off has been generally confirmed by the results of a unique large-N survey of more than 1100 respondents from a group of local public officials and mayors in the Czech Republic.

Conclusion

We have found that the decision-making of Czech public procurers is affected by the trade-off between stewardship and administrative compliance, which turn out to be mutually conflicting goals. On the one hand, many public procurers do possess a stewardship motivation that shapes their positive attitude to GPP. On the other hand, they are painfully aware of, and seek to forestall, administrative risks and complications attendant on the conscientious, i.e., non-perfunctory, implementation of GPP.
Complete genome sequence of an extensively drug resistant (XDR) M. morganii SMM01 isolated from a patient with urinary and fecal incontinence
Authors: Chanakya Pachi Pulusu , Khamari Balaram , Lama Manmath , Peketi Arun Sai Kumar , Kumar Prakash , Nagaraja Valakunja , Bulagonda Eswarappa Pradeep
Published: August 2021

Objective

M. morganii is a gram-negative, non-lactose fermenting and an opportunistic pathogen frequently associated with nosocomial infections. Although first isolated in 1906 from a pediatric fecal sample, not many M. morganii isolates have been sequenced. The objective of this work is to determine the complete genome sequence of an XDR M. morganii strain (SMM01) isolated from the urine of a patient with urinary and fecal incontinence and to characterize its antimicrobial resistance profile.

Data description

Here, we report the complete genome sequence of M. morganii SMM01 generated from the hybrid assembly of Illumina HiSeq X and Nanopore MinION reads. The assembly is 100% complete with genome size of 39,30,130 bp and GC content of 51%. Genomic features include 3617 CDS, 18 rRNAs, 78 tRNAs, 4 ncRNAs and 60 pseudogenes. Antimicrobial resistance profile was characterized by the presence of genes conferring resistance to aminoglycosides, β-lactams, fluoroquinolones, chloramphenicol, and tetracyclines. Secondary metabolite biosynthetic gene clusters like NRPS, T1PKS, thiopeptide, beta-lactone, and bacteriocin were identified. The genome data described here would be the first complete genome of an Indian M. morganii isolate providing crucial information on antimicrobial resistance patterns, paving the way for further comparative genome analyses.
Symptom clusters among cancer survivors: what can machine learning techniques tell us?
Authors: Neijenhuijs Koen I. , Peeters Carel F. W. , van Weert Henk , Cuijpers Pim , Leeuw Irma Verdonck-de
Published: August 2021

Purpose

Knowledge regarding symptom clusters may inform targeted interventions. The current study investigated symptom clusters among cancer survivors, using machine learning techniques on a large data set.

Methods

Data consisted of self-reports of cancer survivors who used a fully automated online application ‘Oncokompas’ that supports them in their self-management. This is done by 1) monitoring their symptoms through patient reported outcome measures (PROMs); and 2) providing a personalized overview of supportive care options tailored to their scores, aiming to reduce symptom burden and improve health-related quality of life. In the present study, data on 26 generic symptoms (physical and psychosocial) were used. Results of the PROM of each symptom are presented to the user as a no well-being risk, moderate well-being risk, or high well-being risk score. Data of 1032 cancer survivors were analysed using Hierarchical Density-Based Spatial Clustering of Applications with Noise (HDBSCAN) on high risk scores and moderate-to-high risk scores separately.

Results

When analyzing the high risk scores, seven clusters were extracted: one main cluster which contained most frequently occurring physical and psychosocial symptoms, and six subclusters with different combinations of these symptoms. When analyzing moderate-to-high risk scores, three clusters were extracted: two main clusters were identified, which separated physical symptoms (and their consequences) and psycho-social symptoms, and one subcluster with only body weight issues.

Conclusion

There appears to be an inherent difference on the co-occurrence of symptoms dependent on symptom severity. Among survivors with high risk scores, the data showed a clustering of more connections between physical and psycho-social symptoms in separate subclusters. Among survivors with moderate-to-high risk scores, we observed less connections in the clustering between physical and psycho-social symptoms.
Health related quality of life (HRQOL) of patients with End Stage Kidney Disease (ESKD) on hemodialysis in Addis Ababa, Ethiopia: a cross-sectional study
Authors: Kim Sujin , Nigatu Yemisrach , Araya Tekebash , Assefa Zewdu , Dereje Nebiyu
Published: August 2021

Background

End-Stage Kidney Disease, the most severe form of chronic kidney disease, is fatal if not treated by renal replacement therapy. Thus, patients with End-Stage Kidney Disease depend on hemodialysis as a lifesaving treatment for the remainder of their lives. However, the health-related quality of life (HRQOL) of patients on hemodialysis is much more underappreciated in resource limited countries.

Methods

A hospital based cross-sectional study was conducted in Addis Ababa, Ethiopia, from August 01 to October 31, 2019. All patients who were on hemodialysis in five randomly selected public and private hospitals (n = 125) were included in the study. Data were administered by trained nurses by using a standardized Kidney Disease Quality of Life questionnaire. Clinical data were extracted from the patients’ medical charts. HRQOL was categorized as low, if the overall mean score was ≤ 50, or as high, if the overall mean score was > 50. Factors associated with lower HRQOL were identified by multi-variable binary logistic regression analysis and expressed by adjusted odds ratio (aOR) and its respective 95 % confidence interval.

Results

The mean age of the study participants (n = 125) was 50.33 years (± 15.07) and more than two-thirds (68.8 %) of the participants were males. The mean score of HRQOL was 49.08 ± 11.09, with 48.0 % (95 % CI: 42.2 − 54.5 %) of them had lower HRQOL. Unemployed patients (aOR = 2.40, 95 % CI: 1.10–5.90) and patients who had hemodialysis 2 times per week (aOR = 1.71, 95 % CI: 1.07–3.83) had lower HRQOL. Elderly patients had higher odds of having lower mean score on the burden of kidney disease (aOR = 2.07; 95 % CI 1.18–4.13) as compared to the younger patients.

Conclusions

Nearly half of the patients with ESKD on hemodialysis had lower overall HRQOL which is associated with their unemployment status and frequency of hemodialysis per week. Elderly patients had lower mean score of burden of kidney disease. Therefore, quality of life of patients with chronic dialysis should be given special attention during the patients’ care. Measures should be taken by the government to ensure accessibility and affordability of the hemodialysis services in the country.
A novel mutation in the PRPH2 gene in a Chinese pedigree with retinitis pigmentosa and angle-closure glaucoma
Authors: Li Wei-ning , Du Xiu-juan , Zhang Yu-ting , Wang Le-yi , Zhu Jing
Published: August 2021

Background

Retinitis pigmentosa (RP) is a rare, progressive, and hereditary disorder that leads to the progressive loss of vision and visual field, and in some cases blindness. The specific relationship between RP and glaucoma has been debated for decades.

Methods

In this study, we examined a Han RP family with concomitant angle-closure glaucoma (ACG), performed an inductive analysis of their clinical features and assistant results, and applied whole-exome sequencing (WES) technology for a molecular diagnosis.

Results

A novel transversion mutation (c.626 T > A) was identified in the peripherin-2 (PRPH2) gene in the proband, resulting in the substitution of Valine to aspartic acid in codon 209. A full ophthalmic examination showed that the proband with the c.626 T > A mutation had a typical RP manifestation, with close angles; however, the proband’s elder brother, who lacked the novel mutation, had a normal fundus and open angles.

Conclusion

Our results extend the genetic mutation spectrum of PRPH2 in RP, and provide evidence to support a genetic correlation between RP and ACG.
A 20-year retrospective study of osteoarticular tuberculosis in a pediatric third level referral center
Authors: González Saldaña Napoleón , Macías Parra Mercedes , Xochihua Díaz Luis , Palavicini Rueda Martin , Carmona Vargas Ana Jocelyn , Castillo Bejarano José Iván , Veloz Corona Quetzalli , Juárez Olguín Hugo , Chavez Pacheco Juan Luis
Published: August 2021

Purpose

The objective of the present study is to describe the clinical, diagnostic, radiological and therapeutic aspects of osteoarticular tuberculosis (OATB) in patients in a tertiary pediatric hospital, to know if the diagnosis of OATB in pediatrics is a challenge due to its insidious clinical presentation.

Methods

A retrospective, descriptive study of the cases of Tuberculosis (TB) in children was carried out. A total of 159 cases met the condition for the analysis.

Results

The most frequent TB modality was extrapulmonary in 85%. Out of this, only 29% was OATB. The mean age was 4.9 years (range 8 months–16 years). Eighty-six per cent of cases received Bacille Calmette-Guérin (BCG) vaccination at birth. Median time of symptoms prior to diagnosis was 8 months. Microbiological confirmation was achieved only in five cases, with a high sensitivity to the antimicrobial treatment. Mycobacterium bovis BCG strain Tokio 172 was confirmed in three cases. Mortality rate was 0% during the time of study

Conclusion

Our study describes the epidemiological characteristics of OATB cases in Mexican children. This data revealed a high prevalence of bone and joint TB infection. Pediatric OATB should be considered in cases with lytic bone lesions, fever and local pain. In countries with BCG immunization program, M. bovis should not be forgotten as an etiological agent. The low detection rate with one technique approach highlights the urgent need for more sensitive test to diagnose OATB in children.
Patient reported outcome of 33 operatively treated talar fractures
Authors: Pflüger Patrick , Zyskowski Michael , Weber Anne , Gleisenberg Katharina , Kirchhoff Chlodwig , Biberthaler Peter , Crönlein Moritz
Published: August 2021

Background

Management of talar fractures remains to be one of the most challenging aspects in trauma surgery. Unfortunately, the evidence regarding the correct treatment of these fractures is mainly based on retrospective case series, while studies assessing the patient-reported outcome are rare. Therefore, the aim of this trial was to analyze the patient reported outcome in context of trauma mechanism and concomitant injuries following operative treatment of talar fractures.

Methods

A retrospective outcome study of patients with operatively treated talar fractures between 2003 and 2015 was conducted. The fractures were classified according to AO-/Hawkins classification system and to the Marti-Weber classification. Data was collected via patient registry, radiographs and a validated patient-reported outcome measure (PROM) for foot and ankle pathologies (Foot and Ankle Outcome Score = FOAS). An analysis regarding the functional outcome, concomitant injury and timing of surgery using the nonparametric Mann-Whitney U test and Spearman`s rank correlation was performed.

Results

In total the functional outcome of 32 patients suffering from fractures to the talus were analyzed. The median age of the study cohort was 35±12.2 years, including 9 female (28 %) and 23 male (72 %) patients. The median FAOS score was 72±22.7 (range 13–94). Patients with an isolated talar fracture had an FAOS of 87±20 and with concomitant injury a score of 60±23.4 (p = 0.016). Patients with a closed talar fracture without emergency operation due to dislocation or polytrauma, showed no correlation between timing of surgery and FAOS (r= -0.17,p = 0.43). 10 % of the patients developed an avascular necrosis and 25 % showed signs of a posttraumatic arthritis. The follow-up time was 41 months (range: 16–145).

Conclusions

Talar fractures were typically caused by high-energy trauma often associated with additional injuries of the lower extremity. The majority of the patients showed a fair to poor functional long-term outcome. Concomitant injuries of the lower extremity led to a lower FAOS. In closed talar fractures without the necessity of an emergency surgical intervention, time to surgery did not influence the patient reported outcome. Relating to the presented data, delayed surgery after soft tissue consolidation was not associated with a higher risk of developing an avascular necrosis.
Rapidly progressive gas-forming infection involving the spine as a life-threatening fatal condition : a case report
Authors: Kim Hong Jin , Ryu Ji-Hyun , Park Hyung-Youl , Kim Sang-Il , Chang Dong-Gune
Published: August 2021

Background

Gas forming infection of the spine is a consequence of vertebral osteomyelitis, necrotizing fasciitis, or a gas-forming epidural abscess, which is very rare and fatal conditions. This is the rare case of necrotizing fasciitis that rapidly progressed from the lumbar area to upper thoracic area.

Case presentation

A 58-year-old male complained of lower back pain with fever and chills. The patient had a history of uncontrolled diabetes mellitus without diabetic medication over the previous 3 months, and he had received several local injections around the lumbar area. Laboratory data revealed white blood cell count of 19,710 /mm3, erythrocyte sedimentation of 40 mm/h, and C-reactive protein of 30.7 mg/L. Radiological findings revealed a small amount of air bubbles in the paraspinal area and lumbar epidural spaces. The patient refused emergency surgery and was discharged from the hospital. The patient re-visited the emergency department two days after discharge complaining of more severe back pain with persistent fever, and his vital signs had deteriorated, with low blood pressure and tachycardia. K. pneumoniae was isolated in cultures from ultrasound-guided aspirates and peripheral blood. The follow-up radiographs revealed aggressive dissemination of innumerable air bubbles from the lumbar area to the T5 level. The patient underwent emergent decompressive laminectomy and debridement of infected paravertebral fascia and musculature. Despite intensive care for deteriorated vital signs and his back wound, the patient died on postoperative day 3 due to multi-organ failure.

Conclusions

Necrotizing fasciitis involving the spine is a very rare disease with life-threatening conditions, rapid progression, and a high mortality rate. Therefore, prompt surgical treatment with a high index of suspicion is imperative to prevent potentially fatal conditions in similar extremely rare cases.
Contents and quality of travel tips on malaria in English and Spanish travel blogs
Authors: Linares-Rufo Manuel , Santos-Larrégola Laura , Hernández-de-Mora Miguel Górgolas , Ramos-Rincón José-Manuel
Published: August 2021

Background

Europe has about 10,000 imported cases of malaria each year, or around 80 cases per 100,000 trips to endemic areas. Non-use of chemoprophylaxis in travellers remains the main reason for this. The proliferation of online travel blogs as a source of advice (sometimes the only one used) for preparing a trip to an endemic area may play a role in the decision to use chemoprophylaxis. The aim of this study was to analyse the information offered on malaria in the main travel blogs in English and Spanish.

Methods

Five hundred travel blogs in English and 100 in Spanish, considered highly relevant were analysed. The relevance were according to different metrics: (1) Alexa Rank; (2) social networks (RRSS) measuring the total followers of Facebook, Twitter, Instagram and YouTube; (3) number of monthly visits using the SEMrush tool; (4) domain authority; and (5) number of backlinks or incoming links using the SEMrush tool.

Results

Of the included travel blogs, 57% of those in English and 64% of those in Spanish offered information on malaria, and 79 and 75%, respectively, featured a discussion on malaria written as a blog post or in forum comments. Information on chemoprophylaxis was available in 56.1% of English-language blogs and 10.7% of Spanish-speaking blogs, while its side effects were discussed in 38.6 and 68.8%, respectively (p < 0.001). Content analysis revealed that the information was usually insufficient, incomplete or, more seriously, inaccurate. In many cases, this could discourage users from taking appropriate preventive measures.

Conclusions

Travel blogs in English and Spanish provide low-quality information on malaria. The so-called “travel influencers” must communicate reliable, verified and quality information on malaria on their channels in a way that could contribute to reducing the burden of the disease in travellers.
The impact of media reports on energy and environmental efficiency in China: evidence from modified dynamic DEA with undesirable outputs
Authors: Li Ying , Lin Tai-Yu , Chiu Yung-ho , Chen Huaming , Cen Hongyi
Published: August 2021

Background

Rapid economic growth in China has resulted in a commensurate increase in energy consumption, which in turn has seen an increase in environmental pollution problems. Past research has tended to focus on energy and environmental efficiency analyses and has rarely examined the media influence on environmental protection efforts. Further, most studies have used static models and ignored the dynamic changes over time.

Methods

To go some way to filling this research gap, this study developed a modified undesirable Dynamic DEA model that included air quality index (AQI) and CO2 indicators to explore the relationships between energy, the environment, and media report efficiencies in 31 Chinese cities from 2013 to 2016.

Results

It was found that: (1) Chongqing, Guangzhou, Nanjing and Shanghai had efficiencies of 1, but Lanzhou, Shijiazhuang, Taiyuan, Xining and Yinchuan needed significant improvements; (2) Chongqing, Guangzhou, Kunming, Nanning and Shanghai had relatively high media efficiencies, but the other cities had low efficiencies and required improvements; (3) the CO2 emissions efficiencies in most cities were better than the air quality index efficiencies; and 4. the media reports in most cities were found to have a more positive impact on the CO2 emissions efficiency than on the AQI efficiency.

Conclusions

Environmental awareness enhances civilian health and promotes economic growth. Therefore, as the news media should be responsible for promoting environmental protection, they need to increase their environmental pollution coverage. It was found that the environmental pollution media report quality and especially air pollution reports needed improvements, and greater media coverage on environmental pollution and awareness was needed.
Predictors of acute compartment syndrome of the lower leg in adults following tibial plateau fractures
Authors: Deng Xiangtian , Hu Hongzhi , Ye Zhipeng , Zhu Jian , Zhang Yiran , Zhang Yingze
Published: August 2021

Background

Acute compartment syndrome (ACS) is an underestimated complication following tibial plateau fractures. Understanding predictors of ACS in the lower leg after a fracture of the tibial plateau may guide earlier diagnosis and promptly decompressed by surgical fasciotomy. To date, however, there are few large-scale sample literatures to investigate the predictors of it. The purpose of our study was to evaluate the prevalence rate of ACS associated with tibial plateau fractures and identified any such predictors with the development of ACS.

Materials and methods

From January 2015 to January 2020, a total of 1119 consecutive patients (1119 fractures) including 703 males and 416 females with an average age of 40.7 years (18 to 80 years) in tibial plateau fractures who presented to a university-affiliated hospital with level-I trauma center were included. The presence of ACS and associated predictors were collected from patients’ electronic medical records. Associated predictors included gender, age, fracture pattern (open or closed), mechanisms of injury, fracture classification, and underlying disease. Univariate and multivariate logistical regression analyses were performed to identify the predictors of the development of ACS following tibial plateau fractures.

Results

Of the 1119 fractures of the tibial plateau, 35 (3.1%) developed an acute compartment syndrome. On multivariate analysis, only younger patient age (odds ratio (OR) 2.57; 95% confidence interval (CI), 1.26 to 6.31;P= 0.003), and Schatzker VI type fracture (OR 5.78; 95% confidence interval (CI), 1.78 to 54.34;P= 0.021) were significantly associated with the development of ACS. Other variables did not reach statistical significance.

Conclusion

Younger patient age and Schatzker VI type fracture were predictors of ACS of the lower leg in adults following tibial plateau fractures. Further studies in the prospective study are still needed to identify the potential risk factors associated with ACS in tibial plateau fractures.
Findings of prosthetic valve endocarditis in the balloon-expandable trans-catheter aortic valve: review of the literature and tips of management
Authors: Calcaterra Domenico , Harris Kevin , Goessl Mario , Dasari Gopika , Kaur Navneet , Chavez Ivan
Published: August 2021

Prosthetic valve endocarditis after transcatheter aortic valve implantation (TAVI) is a rare complication associated with a high mortality rate. Nonetheless, the rapid expansion of TAVI in recent years has proportionally increased the number of patients exposed to the risk of developing transcatheter valve infection. A 71-year-old female with recent history of TAVI was diagnosed with prosthetic valve obstruction secondary to endocarditis. The characteristics of clinical presentation of endocarditis in the balloon-expandable transcatheter valve and the intra-operative findings are discussed with a review of the literature and tips of management.
First report on outbreaks of contagious ovine digital dermatitis in Sweden
Authors: Bernhard Malin , Frosth Sara , König Ulrika
Published: August 2021

Background

Contagious ovine digital dermatitis (CODD) is considered widespread in the United Kingdom but was only recently reported in mainland Europe, as one outbreak in Germany. The disease can cause severe lameness in sheep and, if left untreated, can lead to total avulsion of the hoof capsule. CODD is considered to have multifactorial and polymicrobial aetiology, in which Treponema medium/Treponema vincentii phylogroup, Treponema phagedenis phylogroup and Treponema pedis are believed to play a significant role. Footrot and CODD have a close connection and footrot is considered an important risk factor for CODD.

Case

Lameness, mainly in lambs aged 1.5 months, was reported on a farm in Sweden in spring 2018. The animals showed no signs of footrot and the causative agent, Dichelobacter nodosus, was not found. CODD was suspected but not confirmed, and the clinical signs subsided when the animals were turned out to pasture. In February 2019, young lambs and ewes were lame again and this time CODD was diagnosed. After treatment, the whole flock was slaughtered later in 2019 due to CODD.

In autumn 2020, CODD was diagnosed on another Swedish farm, this time as part of a mixed infection with D. nodosus. The animals were treated with footbaths in zinc sulphate 10% by the farmer, but lameness recurred soon afterwards. The animals were treated, but ultimately the whole flock was slaughtered. No connection was found between the two farms.

Conclusion

The first two outbreaks of CODD in Sweden have been diagnosed and are described in this case report. If it spreads, CODD could have a negative impact on the Swedish sheep industry in terms of animal welfare, production and antibiotic use.
De novo SCN8A and inherited rare CACNA1H variants associated with severe developmental and epileptic encephalopathy
Authors: Stringer Robin N. , Jurkovicova-Tarabova Bohumila , Souza Ivana A. , Ibrahim Judy , Vacik Tomas , Fathalla Waseem Mahmoud , Hertecant Jozef , Zamponi Gerald W. , Lacinova Lubica , Weiss Norbert
Published: August 2021

Developmental and epileptic encephalopathies (DEEs) are a group of severe epilepsies that are characterized by seizures and developmental delay. DEEs are primarily attributed to genetic causes and an increasing number of cases have been correlated with variants in ion channel genes. In this study, we report a child with an early severe DEE. Whole exome sequencing showed a de novo heterozygous variant (c.4873–4881 duplication) in the SCN8A gene and an inherited heterozygous variant (c.952G > A) in the CACNA1H gene encoding for Nav1.6 voltage-gated sodium and Cav3.2 voltage-gated calcium channels, respectively. In vitro functional analysis of human Nav1.6 and Cav3.2 channel variants revealed mild but significant alterations of their gating properties that were in general consistent with a gain- and loss-of-channel function, respectively. Although additional studies will be required to confirm the actual pathogenic involvement of SCN8A and CACNA1H, these findings add to the notion that rare ion channel variants may contribute to the etiology of DEEs.
Anticancer bispecific antibody R&D advances: a study focusing on research trend worldwide and in China
Authors: Zhang Zhonghan , Luo Fan , Cao Jiaxin , Lu Feiteng , Zhang Yang , Ma Yuxiang , Zeng Kangmei , Zhang Li , Zhao Hongyun
Published: August 2021

Background

The bispecific antibody (bsAbs) research around the world has undergone great changes. We analyzed the global trend of bsAbs research and compared the differences in clinical research of bsAbs between China and worldwide.

Methods

BsAbs research clinical trials information was retrieved through the online open-resource clinical trial registration platform. Research information including organizations, identity numbers, locations, phases, participating centers, conditions, status, enrollment, targets, spectrums of mechanism of action (MOA), and start date was collected. Clinical trials were divided into two categories based on the attributes of pharmaceutical companies (international or China-initiated or involved).

Results

From 1997 to 2020, 272 clinical trials regarding bsAbs research were retrieved. Twenty-nine percent of the studies were contributed by companies from Chinese institutions, which followed the USA and ranked second. The clinical trials of bsAbs are mainly concentrated on phase I (n = 161), phase I/II (n = 54), and phase II (n = 51), and the number of phase III trials is still rare (n = 4). Tumor species distribution analysis shows that there are significantly higher focuses on gastric cancer (n = 18), esophageal/gastroesophageal junction cancer (n = 16), bladder cancer (n = 10), biliary malignant tumor (n = 8), nasopharyngeal cancer (n = 6), and thymic cancer (n = 2) in China. BsAbs target and spectrums of MOA analysis showed that international companies mainly focus on bsAbs with CD3-based (n = 63) target with MOA of T-cell redirection, while researches in China pay more attention to PD-1 (n = 9)/PD-L1 (n = 7) axises with MOA of double immune checkpoint blocking.

Conclusion

Global bsAbs research increased rapidly during the 1997 to 2020 period. The developed countries in America and Europe are leading the trend of bsAbs research. Anticancer bsAbs clinical research in China is booming and chasing after the world trend.
The varying effects of antibiotics on gut microbiota
Authors: Yang Lulu , Bajinka Ousman , Jarju Pa Omar , Tan Yurong , Taal Aji Mary , Ozdemir Guven
Published: August 2021

Antibiotics are lifesaving therapeutic drugs that have been used by human for decades. They are used both in the fight against bacterial pathogens for both human and for animal feeding. However, of recent, their effects on the gut microbial compositions and diversities have attracted much attention. Existing literature have established the dysbiosis (reduced diversity) in the gut microbiota in association with antibiotic and antibiotic drug doses. In the light of spelling out the varying effects of antibiotic use on gut microbiota, this review aimed at given an account on the degree of gut microbial alteration caused by common antibiotics. While some common antibiotics are found to destroy the common phyla, other debilitating effects were observed. The effects can be attributed to the mode of mechanism, the class of antibiotic, the degree of resistance of the antibiotic used, the dosage used during the treatment, the route of administration, the pharmacokinetic and pharmacodynamics properties and the spectrum of the antibiotic agent. Health status, stress or the type of diet an individual feeds on could be a great proportion as confounding factors. While it is understood that only the bacterial communities are explored in the quest to establishing the role of gut in health, other gut microbial species are somehow contributing to the dysbiosis status of the gut microbiota. Until now, long term natural fluctuations like diseases outbreaks and mutations of the strain might as well rendered alteration to the gut independent of antibiotic treatments.
Production of R- and S-1,2-propanediol in engineered Lactococcus lactis
Authors: Sato Rintaro , Ikeda Motoyuki , Tanaka Tomonari , Ohara Hitomi , Aso Yuji
Published: August 2021

1,2-propanediol (1,2-PDO) is a versatile chemical used in multiple manufacturing processes. To date, some engineered and non-engineered microbes, such as Escherichia coli, Lactobacillus buchneri, and Clostridium thermosaccharolyticum, have been used to produce 1,2-PDO. In this study, we demonstrated the production of R- and S-1,2-PDO using engineered Lactococcus lactis. The L- and D-lactic acid-producing L. lactis strains NZ9000 and AH1 were transformed with the plasmid pNZ8048-ppy harboring pct, pduP, and yahK genes for 1,2-PDO biosynthesis, resulting in L. lactis LL1 and LL2, respectively. These engineered L. lactis produced S- and R-1,2-PDO at concentrations of 0.69 and 0.50 g/L with 94.4 and 78.0% ee optical purities, respectively, from 1% glucose after 72 h of cultivation. Both 1% mannitol and 1% gluconate were added instead of glucose to the culture of L. lactis LL1 to supply NADH and NADPH to the 1,2-PDO production pathway, resulting in 75% enhancement of S-1,2-PDO production. Production of S-1,2-PDO from 5% mannitol and 5% gluconate was demonstrated using L. lactis LL1 with a pH–stat approach. This resulted in S-1,2-PDO production at a concentration of 1.88 g/L after 96 h of cultivation. To our knowledge, this is the first report on the production of R- and S-1,2-PDO using engineered lactic acid bacteria.
Comparison of four channelled videolaryngoscopes to Macintosh laryngoscope for simulated intubation of critically ill patients: the randomized MACMAN2 trial
Authors: Decamps Paul , Grillot Nicolas , Le Thuaut Aurelie , Brule Noelle , Lejus-Bourdeau Corinne , Reignier Jean , Lascarrou Jean-Baptiste
Published: August 2021

Background

Videolaryngoscopes with an operating channel may improve the intubation success rate in critically ill patients. We aimed to compare four channelled videolaryngoscopes to the Macintosh laryngoscope used for intubation of a high-fidelity simulation mannikin, in a scenario that simulated critical illness due to acute respiratory failure.

Results

Of the 79 residents who participated, 54 were considered inexperienced with orotracheal intubation. Each participant used all five devices in random order. The first-pass success rate was 97.5% [95% CI 91.1–99.7] for Airtraq™, KingVision™, and Pentax AWS200™, 92.4% [95% CI 84.2–97.2] for VividTrac VT-A100™, and 70.9% [95% CI 59.6–80.6] for direct Macintosh laryngoscopy. The first-pass success rate was significantly lower with direct Macintosh laryngoscopy than with the videolaryngoscopes (p  <  0.0001 for Airtraq™, KingVision™, Pentax AWS200™, and VividTrac VT-A100™).

Conclusion

The Airtraq™, KingVision™, and Pentax AWS200™ channelled videolaryngoscopes produced high first-pass success rates with a lower boundary of the 95% CI above 90%. A multicentre, randomised controlled clinical study comparing channelled videolaryngoscopy to direct laryngoscopy should include one of these three videolaryngoscopes.
Patient–ventilator asynchrony, impact on clinical outcomes and effectiveness of interventions: a systematic review and meta-analysis
Authors: Kyo Michihito , Shimatani Tatsutoshi , Hosokawa Koji , Taito Shunsuke , Kataoka Yuki , Ohshimo Shinichiro , Shime Nobuaki
Published: August 2021

Background

Patient–ventilator asynchrony (PVA) is a common problem in patients undergoing invasive mechanical ventilation (MV) in the intensive care unit (ICU), and may accelerate lung injury and diaphragm mis-contraction. The impact of PVA on clinical outcomes has not been systematically evaluated. Effective interventions (except for closed-loop ventilation) for reducing PVA are not well established.

Methods

We performed a systematic review and meta-analysis to investigate the impact of PVA on clinical outcomes in patients undergoing MV (Part A) and the effectiveness of interventions for patients undergoing MV except for closed-loop ventilation (Part B). We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, ClinicalTrials.gov, and WHO-ICTRP until August 2020. In Part A, we defined asynchrony index (AI) ≥ 10 or ineffective triggering index (ITI) ≥ 10 as high PVA. We compared patients having high PVA with those having low PVA.

Results

Eight studies in Part A and eight trials in Part B fulfilled the eligibility criteria. In Part A, five studies were related to the AI and three studies were related to the ITI. High PVA may be associated with longer duration of mechanical ventilation (mean difference, 5.16 days; 95% confidence interval [CI], 2.38 to 7.94; n = 8; certainty of evidence [CoE], low), higher ICU mortality (odds ratio [OR], 2.73; 95% CI 1.76 to 4.24; n = 6; CoE, low), and higher hospital mortality (OR, 1.94; 95% CI 1.14 to 3.30; n = 5; CoE, low). In Part B, interventions involving MV mode, tidal volume, and pressure-support level were associated with reduced PVA. Sedation protocol, sedation depth, and sedation with dexmedetomidine rather than propofol were also associated with reduced PVA.

Conclusions

PVA may be associated with longer MV duration, higher ICU mortality, and higher hospital mortality. Physicians may consider monitoring PVA and adjusting ventilator settings and sedatives to reduce PVA. Further studies with adjustment for confounding factors are warranted to determine the impact of PVA on clinical outcomes.

Trial registration protocols.io (URL: https://www.protocols.io/view/the-impact-of-patient-ventilator-asynchrony-in-adu-bsqtndwn, 08/27/2020).
Prediction of geomagnetically induced currents (GICs) flowing in Japanese power grid for Carrington-class magnetic storms
Authors: Ebihara Yusuke , Watari Shinichi , Kumar Sandeep
Published: August 2021

Large-amplitude geomagnetically induced currents (GICs) are the natural consequences of the solar–terrestrial connection triggered by solar eruptions. The threat of severe damage of power grids due to the GICs is a major concern, in particular, at high latitudes, but is not well understood as for low-latitude power grids. The purpose of this study is to evaluate the lower limit of the GICs that could flow in the Japanese power grid against a Carrington-class severe magnetic storm. On the basis of the geomagnetic disturbances (GMDs) observed at Colaba, India, during the Carrington event in 1859, we calculated the geoelectric disturbances (GEDs) by a convolution theory, and calculated GICs flowing through transformers at 3 substations in the Japanese extra-high-voltage (500-kV) power grid by a linear combination of the GEDs. The estimated GEDs could reach ~ 2.5 V/km at Kakioka, and the GICs could reach, at least, 89 ± 30 A near the storm maximum. These values are several times larger than those estimated for the 13–14 March 1989 storm (in which power blackout occurred in Canada), and the 29–31 October 2003 storm (in which power blackout occurred in Sweden). The GICs estimated here are the lower limits, and there is a probability of stronger GICs at other substations. The method introduced here will be immediately applicable for benchmark evaluation of low-latitude GICs against the Carrington-class magnetic storms if one assumes electrical parameters, such as resistance of transmission lines, with sufficient accuracy.
Cell-free osteochondral scaffolds provide a substantial clinical benefit in the treatment of osteochondral defects at a minimum follow-up of 5 years
Authors: Ricci Martina , Tradati Daniele , Maione Alessio , Uboldi Francesco Mattia , Usellini Eva , Berruto Massimo
Published: August 2021

Purpose

The treatment of osteochondral lesions is challenging and no consensus has been established about the best option for restoring both cartilage and subchondral bone. Multilayer collagen-hydroxyapatite scaffolds have shown promising clinical results, but the outcome at a follow-up longer than 5 years still has to be proved. The aim was to evaluate the clinical outcome of patients with a knee isolated osteochondral lesion treated with a biomimetic three-layered scaffold at a minimum 5 years of follow-up.

Methods

Twenty-nine patients (23 males and 6 females, mean age 31.5 ± 11.4 years) were evaluated retrospectively before surgery, at 1 and 2 years and at last follow-up (FU). Visual Analog Scale (VAS) for pain, International Knee Documentation Committee (IKDC) Subjective Score, Tegner-Lysholm Knee Scoring Scale and Tegner Activity Level Scale were collected. Mean FU was 7.8 ± 2.0 years (min 5.1 - max 11.3). The etiology of the defect was Osteochondritis Dissecans or osteonecrosis (17 vs 12 cases).

Results

At 12 months FU the IKDC score improved from 51.1 ± 21.7 to 80.1 ± 17.9 (p < 0.01), Tegner Lysholm Score from 59.9 ± 17.3 to 92.5 ± 9.0 (p < 0.01), VAS from 6.1 ± 2.1 to 1.7 ± 2.3 (p < 0.01) and Tegner Activity Level Scale from 1.6 ± 0.5 to 4.9 ± 1.7 (p < 0.01). The results remained stable at 24 months, while at last FU a statistically significant decrease in IKDC, Tegner Lysholm and Tegner Activity Scale was recorded, though not clinically relevant. Patients under 35 achieved statistically better outcomes.

Conclusions

The use of a cell-free collagen-hydroxyapatite osteochondral scaffold provides substantial clinical benefits in the treatment of knee osteochondral lesions at a minimum follow-up of 5 years, especially in patients younger than 35 years.

Level of evidence

Level IV.
In vivo optical quality of posterior-chamber phakic implantable collamer lenses with a central port
Authors: Montés-Micó Robert , Pastor-Pascual Francisco , Artiaga-Elordi Enrique , Ruiz-Mesa Ramón , Tañá-Rivero Pedro
Published: August 2021

Background

The aim of this review is to summarize the optical quality results in patients following the implantation of the V4c implantable collamer lens with a central port (ICL, STAAR Surgical Inc.).

Main text

A literature search in several databases was carried out to identify those publications, both prospective, retrospective and/or comparative with other refractive surgery procedures, reporting optical outcomes of patients who were implanted with the V4c ICL model. A total of 17 clinical studies published between 2012 and 2021 were included in this review. A detailed analysis of the available data was performed including number of eyes, follow-up and preoperative spherical equivalent. Specifically, the review focused on several optical parameters including higher-order aberrations (HOAs), modulation transfer function (MTF) cut-off frequency and Strehl ratio. This review encompassed a total of 817 eyes measured using different optical devices based on Hartmann-Shack, retinal image quality measurement and ray-tracing technologies at different follow-ups.

Conclusions

The outcomes found in this review lead us to conclude that the ICL V4c model provides good optical quality, by means of different metrics, when implanted.
Effects of harvest intensity on the marketable organ yield, growth and reproduction of non-timber forest products (NTFPs): implication for conservation and sustainable utilization of NTFPs
Authors: Zhang Ting , Yu Lizhong , Man Yuan , Yan Qiaoling
Published: August 2021

Background

Non-timber forest products (NTFPs) are an important part of forest biodiversity, and the subsistence and trade of local people, especially in less developed countries. Because of the high ecological and economic value, NTFPs have faced the problem of over-exploitation, and the key to solve this problem is to determine the feasible way of sustainable utilization of NTFPs. Harvest intensity is one of the most important and easily controlled utilization factors, which can greatly influence the plant individual survival, growth and reproductive performances, and even the population structure and dynamics. Therefore, we chose two common and important NTFPs species with different marketable parts (i.e., Acanthopanax senticosus with tender leaves and Aralia elata with tender buds) as our study objects. Aiming to determine the optimum harvest intensity for sustainably utilizing both NTFPs species, five levels of harvest intensity treatments (i.e., control, light, medium, high and severe) were designed to assess the effects of harvest intensity on their marketable organ yield, plant growth and reproductive performances.

Results

The biomass growth rates of marketable organ and plant growth of A. senticosus under light harvest intensity treatment were significantly higher than those under other harvest intensities. The plant height growth and 1000-seed weight of A. elata under severe harvest intensity treatment were significantly lower than those under control treatment.

Conclusions

The light harvest intensity with 25% leaf removal and the high harvest intensity with all terminal buds harvested are the optimum harvest intensity to maintain the sustainable utilization of A. senticosus and A. elata, respectively. These findings could provide managers with basic but practical guidance for making decisions about the sustainable harvest management plan for the cultivated NTFPs species, and further provide a theoretical basis for managers to establish the harvest regulations for wild NTFPs species. Consequently, the local residents or communities can improve their income while ensure the sustainable development of wild NTFPs.
Systolic anterior motion of the mitral valve associated with acute type A aortic dissection: a case report describing one-step surgery of ascending aortic replacement and interventricular septal myectomy
Authors: Yamamoto Naoki , Onoda Koji
Published: August 2021

Background

Systolic anterior motion of the mitral valve associated with acute type A aortic dissection is rare in daily clinical practice. The prevention of systolic anterior motion is important, because once it occurs, the hemodynamics may become unstable, leading to a critical situation. In the surgical procedure to treat systolic anterior motion, the prevention of new iatrogenic aortic intimal tears is important in the context of acute type A aortic dissection.

Case presentation

We present a case of systolic anterior motion in a 68-year-old woman with an acute type A aortic dissection and suspected acute relative adrenal insufficiency. Preoperative transthoracic echocardiography revealed left ventricular outflow tract obstruction due to systolic anterior motion without left ventricular hypertrophy and interventricular septal bulging due to a narrow aorto-mitral angle. We successfully performed a one-step surgery for ascending aortic replacement and interventricular septal myectomy using the needle stick technique for the treatment of systolic anterior motion.

Conclusions

Concomitant interventricular septal myectomy using the needle stick technique with thoracic aortic replacement is a safe and feasible technique. Interventricular septal myectomy may be effective in preventing postoperative unstable hemodynamics due to systolic anterior motion in the management of acute aortic dissection.