bluuebunny/crossref_metadata_2025 huggingface dataset:
Overcoming challenges for implementing nature-based solutions in deltaic environments: insights from the Ganges-Brahmaputra delta in Bangladesh
Authors: Gain Animesh K , Rahman Mohammed Mofizur , Sadik Md Shibly , Adnan Mohammed Sarfaraz Gani , Ahmad Sate , Ahsan Shaiikh Muhammad Mehedi , Ashik-Ur-Rahman Md , Balke Thorsten , Datta Dilip K , Dewan Camelia , Huq Nazmul , Khan M Shah Alam , Large Andy , Mallick Bishawjit , Mohibbullah M , Mondal M Shahjahan , Narayan Siddharth , Rabbani Golam , Rahman Rezaur , Renaud Fabrice G , Rogers Kimberly G , van Loon-Steensma Jantsje M
Published: May 2022

The Ganges-Brahmaputra (GB) delta is one of the most disaster-prone areas in the world due to a combination of high population density and exposure to tropical cyclones, floods, salinity intrusion and other hazards. Due to the complexity of natural deltaic processes and human influence on these processes, structural solutions like embankments are inadequate on their own for effective hazard mitigation. This article examines nature-based solutions (NbSs) as a complementary or alternative approach to managing hazards in the GB delta. We investigate the potential of NbS as a complementary and sustainable method for mitigating the impacts of coastal disaster risks, mainly cyclones and flooding. Using the emerging framework of NbS principles, we evaluate three existing approaches: tidal river management, mangrove afforestation, and oyster reef cultivation, all of which are actively being used to help reduce the impacts of coastal hazards. We also identify major challenges (socioeconomic, biophysical, governance and policy) that need to be overcome to allow broader application of the existing approaches by incorporating the NbS principles. In addition to addressing GB delta-specific challenges, our findings provide more widely applicable insights into the challenges of implementing NbS in deltaic environments globally.
Highly adsorbent surface from watermelon peels : as non-conventional low-cost sorbent ; Equilibrium and Recycle study
Authors: Aljeboree Aseel M. , Hamid Ghadeer S. , Katham Ayat A. , Abdulkadhm Mohammed Mustafa , Lafta Holya A. , Al-Dhalimy Aiman Mohammed Baqir , Alkaim Ayad F. , Abed Salwan Ali
Published: May 2022

In this research, it was approved to use available environmentally friendly and low cost absorbent materials such as un-activated watermelon peels (WP) as an ideal surface to remove methylene blue (MB) dye from aqueous solution. That watermelon peels un-activated, the ability to be recycled and used again, by washing it (water, acid and base). Using several techniques to estimate the chemical-physical properties of a surface before and after the adsorption process, such as (FTIR) and (FESEM). By increasing the surface weight (WP), the percentage of removal of methylene blue dye increases, on the contrary, the adsorption efficiency decreases. The isotherm model for adsorption was based on the use of two types of Fruendlich model and Langmuir model and through the value of ( R2) it was found that it obeys the Fruendlich model.
The First Confirmed Record Of European Pied Flycatcher Ficedula Hypoleuca For Iraq
Authors: Abed Salwan Ali , Salim Mudhafar A. , Harbi Zaman Salman
Published: May 2022

While conducting intensive field surveys in different locations of various habitats in Iraq arranged by the Arab Regional Centre for World Heritage, Manama, Kingdom of Bahrain and the Iraqi Organization for Conservation of Nature (IOCN), some considerable observations on birds and their habitats in various locations were made. This included adding new bird-species to the Avifaunal of Iraq, in addition to new observations of confirmed breeding of some bird species. A new Passerine species, European Pied Flycatcher Ficedula hypoleuca, was added to the Iraqi bird checklist after it was clearly observed and photographed during one of IOCN’s surveys in Zakho mountains, Kurdistan Region, northern Iraq. This observation was documented and the habitat was described as well. The current paper documents the first confirmed record of this species for the bird-list of Iraq.
Environmental Effects Of Monosodium Glutamate On (NF-κB) Levels In The Male Reproductive System Of Rats
Authors: Al-Husseini Alaa Mohammad Hasson , Al-Waely Leena Adeeb Mehdi , Kazem Ahmed Abdel Ameer , Mashkoor Nabeel Rahi
Published: May 2022

Monosodium glutamate (MSG) has been identified as a food additive that Adversely affects MSG use on the reproductive efficiency by several mechanisms, this study was carried out to determine its role in stimulating the immune response in the reproductive system by estimating levels of NF-κB in serum and of its expression in reproductive organs. Thirty sex males rats were used in this study each included 12 male rats. Male rats A and B are receiving 60 and 120 mg/kg for 28 days respectively male rats of the control group were left without treatment for the period of the experiment. The levels of Nuclear factor-kappa NF-κB in serum and tissue fluid of testes and epididymis were measured. histological changes in addition to detection NF-κB expression were studying in testes and epididymis. Results of the present study recorded the toxic effect of MSG as it caused an elevation in the levels of NF-κB in serum, testicular, and epididymis tissue fluid. histological alternation in the reproductive organs was observed to represent detachment and vacuolation of the seminal epithelium, degeneration of spermatogenesis edema in a lumen in testicular tissues. Epididymal sections appeared to sever necrosis, degeneration in the epithelial layer and stereocilia, and the lumen of the epididymis. Also there was an increasing density of NFκB protein immunoreactivity in both testis and epididymis.
A Numerical Study for Solving Mathematical Model in Chemistry and Environment
Authors: Mohammed Mechee S. , Mahdi Ahlam A. , Al-Mousawi Ali N.
Published: May 2022

The purpose of this work is to demonstrate how the first order ordinary differential equation may be use as a mathematical model to explain chemical processes and mixture situations. The application of the ordinary differential equation of the first degree was analyze in the modeling of some chemical phenomena, such as clarifying the application in the problems of mixing solutions in both single and multiple tank systems. These problems were develope with the presentation of the first form of the model to include n-tank.
Survey of Khor Al-Zubair and Umm Qasr Mudflat Birds: Effect of Tidal Cycle and Seasonal Variations on Their Assemblages and Abundance, Basrah, Iraq
Authors: Ali Malik Hassan , Mohammed Hanaa Hussein , Salim Mudhafar A.
Published: May 2022

Ornithological surveys were conducted at tidal mudflats that nationally represents one of the marine key biodiversity (KBA) areas at Khor Al-Zubair (KBZ) and Umm Qasr south-east of Basrah City, Iraq. On the basis of hourly counting for 7h monitoring period at day time and covering an area of 7.5 km2 of the intertidal zone, a 7 surveys were conducted from March 2019 until January 2020. A total of 7658 individual birds belongs to 54 species have been recorded. The highest numbers of birds per a day were recorded in Autumn and Winter 4869, 1999 respectively, which coincided with the migration seasons. The lowest numbers were recorded during the Summer season just where only 61 birds have been observed. The birds assemblages and their abundance during the high tide times and during the low tide times were compared statistically and the results weren’t different (t < 0.05). Additional observations of different surveys targeted different sites of the KAZ mudflat over the period 2005-2020 have resulted in a final list consists of 102 bird species, a result reflecting the importance of this habitat to various migratory and resident birds.
High harmonic generation and application for photoemission spectroscopy in condensed matter
Authors: Zhong Shiyang , Liang Yueying , Wang Shuai , Teng Hao , He Xinkui , Wei Zhiyi
Published: May 2022

High harmonic generation (HHG) delivering attosecond pulse duration with photon energy in the extreme ultraviolet spectral range has been demonstrated as a robust table-top coherent light source, allowing for the observation and manipulation of ultrafast process within the shortest time window ever made by humans. The past decade has witnessed the rapid progress of HHG from a variety of solid targets and its application for photoemission spectroscopy in condensed matter. In this article, we review the HHG in solids and the understanding of the underlying physics of HHG, which allows all-optical band structure reconstruction. We also introduce combinations of HHG source and photoemission spectroscopy, such as angular-resolved photoemission spectroscopy and photoemission electron microscopy. With the capacity of exploring a wide momentum space and high temporal resolution, the extension of attosecond science to the field of condensed matter physics will lead to new insights into the fundamental ultrafast dynamics in novel quantum materials.
What is heart failure?
Authors: Clark Andrew L.
Published: May 2022

This chapter provides an overview of heart failure. The term ‘heart failure’ is usually used freely between clinicians to describe what is wrong with individual patients, yet despite the fact that heart failure is so very common, it is very difficult to define it satisfactorily. Some difficulties arise because of the effects of modern treatment: while it might be reasonable to define acute heart failure in terms of some haemodynamic variable, the situation becomes very different in chronic treated heart failure. Ultimately, heart failure is a clinical syndrome characterized by a constellation of symptoms and signs, and not a discrete diagnosis. The chapter then highlights the importance of natriuretic peptide testing in diagnosing heart failure. It also looks at how the clinical pattern of heart failure can be viewed as a consequence of mammalian evolution, and considers some older descriptions of heart failure. Finally, the chapter details the clinical course of heart failure and identifies three models—the haemodynamic model, neurohormonal model, and peripheral model—which are helpful in thinking about the pathophysiology of heart failure and in suggesting avenues for therapeutic development.
Cholinergic models of memory impairment in animals and man: scopolamine vs. biperiden
Authors: Blokland Arjan
Published: May 2022

Scopolamine has been used as a pharmacologic model for cognitive impairments in dementia and Alzheimer’s disease. The validity of this model seems to be limited because findings in animals do not readily translate to novel treatments in humans. Biperiden is also a cholinergic deficit model for cognitive impairments but specifically blocks muscarinic M1 receptors. The effects of scopolamine and biperiden (and pirenzepine) are compared in animal studies and related to findings in humans. It is concluded that the effects on cognitive functions are different for scopolamine and biperiden, and they should be considered as different cognitive deficit models. Scopolamine may model more advanced stages of Alzheimer’s disease whereas biperiden may model the early deficits in declarative memory in aging and mild cognitive impairment.
Gastrointestinal Manifestations in Hospitalized Children With Acute SARS-CoV-2 Infection and Multisystem Inflammatory Condition: An Analysis of the VIRUS COVID-19 Registry
Authors: Sayed Imran A. , Bhalala Utpal , Strom Larisa , Tripathi Sandeep , Kim John S. , Michaud Kristina , Chiotos Kathleen , Dapul Heda R. , Gharpure Varsha P. , Bjornstad Erica C. , Heneghan Julia A. , Irby Katherine , Montgomery Vicki , Gupta Neha , Gupta Manoj , Boman Karen , Bansal Vikas , Kashyap Rahul , Walkey Allan J. , Kumar Vishakha K. , Gist Katja M. ,   on behalf of the VIRUS Investigators
Published: May 2022

Background:

Describe the incidence and associated outcomes of gastrointestinal (GI) manifestations of acute coronavirus disease 2019 (COVID-19) and multisystem inflammatory syndrome in hospitalized children (MIS-C).

Methods:

Retrospective review of the Viral Infection and Respiratory Illness Universal Study registry, a prospective observational, multicenter international cohort study of hospitalized children with acute COVID-19 or MIS-C from March 2020 to November 2020. The primary outcome measure was critical COVID-19 illness. Multivariable models were performed to assess for associations of GI involvement with the primary composite outcome in the entire cohort and a subpopulation of patients with MIS-C. Secondary outcomes included prolonged hospital length of stay defined as being >75th percentile and mortality.

Results:

Of the 789 patients, GI involvement was present in 500 (63.3%). Critical illness occurred in 392 (49.6%), and 18 (2.3%) died. Those with GI involvement were older (median age of 8 yr), and 18.2% had an underlying GI comorbidity. GI symptoms and liver derangements were more common among patients with MIS-C. In the adjusted multivariable models, acute COVID-19 was no associated with the primary or secondary outcomes. Similarly, despite the preponderance of GI involvement in patients with MIS-C, it was also not associated with the primary or secondary outcomes.

Conclusions:

GI involvement is common in hospitalized children with acute COVID-19 and MIS-C. GI involvement is not associated with critical illness, hospital length of stay or mortality in acute COVID-19 or MIS-C.
A Nomogram to Predict Bacterial Meningitis-associated Hydrocephalus: A Single-Center Retrospective Study
Authors: Meng Linxue , Peng Xiao-ling , Xu Hao-yue , Chen Dou-dou , Zhang Han , Hu Yue
Published: May 2022

Objective:

We aimed to develop a predictive nomogram for the early detection of hydrocephalus in children with bacterial meningitis.

Methods:

This retrospective study was based on data of children with bacterial meningitis admitted to our hospital between January 2016 and December 2020. Risk factors were evaluated using univariate analysis, and the predictive model/nomogram was built using binary logistic analysis. A nomogram calibration plot, Hosmer–Lemeshow test and receiver operating characteristic (ROC) curve evaluated the predictive performance. Ordinary bootstrapping processed the internal validation.

Results:

We enrolled 283 patients who matched the inclusion criteria, among whom 41 cases (14.49%) had confirmed bacterial meningitis-associated hydrocephalus (BMAH). The incidence of sequelae in the patients with BMAH was 88.9% (24/27), which was significantly higher than that in the patients without BMAH. Univariate regression analysis revealed that 14 clinical indicators were associated with BMAH. Multivariate analysis identified 4 variables as independent risk factors to establish the predictive model: repeated seizures, loss of consciousness, procalcitonin ≥7.5 ng/dL and mechanical ventilation. And a graphical nomogram was designed. The area under the ROC curve was 0.910. In the Hosmer–Lemeshow test the P value was 0.610. The mean absolute error in the calibration plot was 0.02. Internal validation showed the testing set was in good accordance with the original set when internal validation was performed.

Conclusions:

The predictive model/nomogram of BMAH could be used by clinicians to determine hydrocephalus risk.
A Retrospective Analysis of Tick-borne Encephalitis in Children Treated in Kaunas Hospital During 2012 to 2019
Authors: Bogdanavičienė Karolina , Gudavičiūtė Gerda , Šeškutė Milda
Published: May 2022

Background:

Lithuania has the highest tick-borne encephalitis (TBE) rates in Europe. Although TBE incidence in children is lower, it may still cause long-term consequences. So far pediatric epidemiological and clinical characteristics of TBE in Lithuania were not described.

Methods:

We performed a retrospective analysis of 87 cases of children who were hospitalized for TBE in Kaunas Hospital of the Lithuanian University of Health Sciences from 2012 to 2019. Each case was identified with neurological symptoms and positive serological tests.

Results:

Around half of the children (50.6%) reported having a tick bite, whereas 6.9% stated having exposure to unpasteurized milk. Biphasic course of the disease occurred in 70.1% of the cases. The most common clinical symptoms were headache (100%), fever (100%), nausea (85.1%), vomiting (78.2%), drowsiness (67.8%) and general weakness (66.7%). Meningeal symptoms were present in 93.1% of the cases, and 93.1% of the children had at least one focal neurological sign (tremor 82.3%, impaired balance 73.6%). Isolated meningitis was diagnosed in 57.5%, meningoencephalitis in 41.4% and meningoencephalomyelitis in 1.1% of the cases. Majority of younger children (1–8 years old) had meningitis (77.3%), whereas 49.2% of older children (9–17 years old) had more severe forms of TBE. Cerebrospinal fluid pleocytosis was found in 94.3% of cases (average white blood cell count: 111.7 per μL, protein: 0.5 g/L). Higher levels of cerebrospinal fluid protein were associated with more severe forms of TBE and older age. Duration of the symptomatic disease lasted ≈11 days. Early residual signs were observed in 75.9% of all cases.

Conclusions:

The epidemiological and clinical characteristics of TBE in children in Lithuania are similar to those described in other countries. Only half of the subjects reported having a tick bite. Younger children tend to suffer from meningoencephalitis and meningoencephalomyelitis less frequently than elder ones. Focal neurological signs were commonly observed. Majority of children had lasting symptoms of TBE upon discharge from the hospital.
Alleviating skin barrier disruption, skin inflammation and pruritus: a moisturizing spray containing β-glucan and panthenol
Authors: Zhu Jia , Wang Yong-Fang , Song Sha-Sha , Wu Li-Li , Chen Yi , Li Xin-Yu , Ju Mei
Published: May 2022

Objective:

Chronic pruritus is induced by a variety of causes and is an extremely common clinical problem. Previous studies have shown that many inflammatory skin diseases are associated with dry skin-induced pruritus. However, the relationship between skin inflammation, skin barrier function, and pruritus remains unclarified. The present study aimed to explore this relationship using an acetone-ether-water (AEW) mouse model, and to investigate the effects of the combined application of β-glucan and panthenol in a moisturizing spray in this mouse model.

Methods:

A dry skin-induced chronic pruritus mouse model was established by repeated AEW treatment of the skin. The pruritic behavior, skin barrier function, and expression of molecules related to pruritus and inflammation in topical lesions were measured. The effects of a spray containing β-glucan and panthenol were observed.

Results:

AEW treatment triggered spontaneous scratching with significantly increased numbers of scratching bouts, and disrupted the skin barrier with a significant increase in transepidermal water loss (TEWL) values and a significant decrease in filaggrin gene (FLG) expression (P < 0.01). AEW treatment also significantly increased the expression of NOD-like receptor family pyrin domain containing 3 (NLRP3), apoptosis-associated speck-like protein containing a CARD (ASC), caspase-1, interleukin-1β (IL-1β), and tumor necrosis factor-α (TNF-α), as well as the pruritis-associated molecules nerve growth factor (NGF), cathepsin S (CTSS), and thymic stromal lymphopoietin (TSLP) in the skin (P < 0.01). Application of the spray containing β-glucan and panthenol significantly alleviated these responses, resulting in a reduced number of scratching bouts in 1 hour, reduced TEWL values, increased FLG mRNA expression, and reduced mRNA levels of NLRP3, ASC, caspase-1, IL-1β, TNF-α, CTSS, TSLP, and NGF in skin lesions (P < 0.05).

Conclusion:

The present results suggest a relationship between damaged skin barrier function, pruritus, and inflammation. Adding β-glucan and panthenol to moisturizing skincare products may alleviate pruritus induced by dry skin, improve the damaged skin barrier function, and reduce the inflammatory state in local skin areas.
Role of Environment on Physical Activity Patterns of Older Adults Living With HIV in New York City
Authors: Voigt Natalie , Liu Jianfang , Rowell-Cunsolo Tawandra , Schnall Rebecca , Poghosyan Lusine
Published: May 2022

The purpose of this study was to survey the physical activity (PA) patterns of older adults with HIV and investigate the relationship between environmental factors and PA in this population. This study was a secondary data analysis from 100 adults, ages 50 years and older, living with HIV in New York City. Descriptive statistics assessed PA patterns. Linear regression assessed the association between environmental factors and time spent in PA. All participants had been living with HIV for 21 years on average, were on antiretroviral therapy, ranged in age from 50 to 71 years, and were 50% female. Participants performed at 75% of their functional capacity (p < .0001), and females walked less than males (p < .05). Traffic hazards were the sole environmental predictor of PA participation. Targeted interventions are needed to increase PA in this growing population. Interventions at the policy level should reduce traffic hazards to support PA.
Peer Review of Teaching to Promote a Culture of Excellence: A Scoping Review
Authors: Hinrichs Lauren A. , Judd Dana L. , Hernandez Meghan , Rapport Mary Jane
Published: May 2022

Background and Purpose.

A main component of the conceptual model of excellence in physical therapist education, introduced by Jensen et al, is a culture of excellence. A culture of excellence relies on identifying accountable faculty who set high expectations and execute systems toward ongoing improvement. Peer review of teaching (PRT) is an established system that cultivates a culture of collaboration, reflection, and excellence through feedback and collegial discourse. The purpose of this scoping review was to understand PRT implementation by 1) summarizing the program development process, 2) identifying program characteristics, 3) identifying review instruments, and 4) determining program evaluation strategies.

Methods.

A scoping review was conducted using a methodological framework. With library scientist counsel, search terms were established, and 3 databases were queried for articles describing PRT programs in health care education. Articles were managed in the Covidence Systematic Review Management Software. Researchers independently screened search results for article inclusion and extracted data from included studies. Descriptive data analysis was conducted.

Results.

Thirty-five articles met inclusion criteria. Seven different health care professions have published PRT articles; however, none in Doctor of Physical Therapy (DPT) education. Results indicated that most programs underwent a systematic development process, included faculty input, and sought to ensure consistency between the program purpose and characteristics. A 3-step formative process was most common. Faculty were paired systematically or used self-selection. Evaluative instruments were often program specific, guided by core competencies of teaching excellence or previously published tools. Program outcomes commonly reported positive faculty opinion of PRT and teaching improvement. Only 2 articles evaluated student metrics to assess PRT impact and effectiveness.

Discussion and Conclusion.

Peer review of teaching has been successfully adopted by health care education faculty to promote teaching excellence and could be a foundation for creating a culture of excellence in DPT education. These results provide an understanding of the processes for implementing PRT to guide DPT educators establishing PRT programs.
Regional lymph node recurrence without intragastric lesions after curative endoscopic resection of early gastric cancer meeting the absolute indications of endoscopic resection
Authors: Shin Hyun Wook , Park Ji Yeon , Bae Han Ik , Park Ki Bum , Kwon Oh Kyoung
Published: May 2022

Rationale:

With the increase of gastric cancer surveillance and endoscopic resection techniques, the number of endoscopic resections being performed for the treatment of early gastric cancer in East Asian countries has been increasing. Previously, endoscopic resection has been limited to only differentiated type intramucosal cancers which had a diameter ≤2.0 cm, provided there was no evidence of ulceration and lymphovascular invasion, known as absolute indications. And recently, indications for endoscopic resection have been expanded to include even more cases.

Patient concerns:

A 57-year-old female, who had undergone curative endoscopic submucosal dissection for early gastric cancer under the absolute indications for endoscopic resection 5 years prior, was referred to the department of general surgery with metastatic perigastric lymph nodes without intragastric lesions.

Diagnosis:

Computed tomography scan revealed the presence of a few enlarged lymph nodes at the distal part of the lesser curvature of the stomach. And positron emission tomography scan further revealed the presence of two hypermetabolic lymph nodes near the common hepatic artery, suggestive of metastatic lymph nodes.

Interventions:

Laparoscopic distal gastrectomy and Roux-en-Y gastrojejunostomy with D2 lymph node dissection were performed.

Outcomes:

Final pathology report revealed the absence of any residual carcinoma in the stomach. However lymphovascular invasion of omental fat, and 3 out of 29 perigastric lymph nodes harvested had metastatic adenocarcinoma.

Lessons:

The case demonstrates that regional lymph node recurrence without intragastric lesions after curative resection of early gastric cancer meeting the absolute indications for endoscopic resection is possible even 5 years after resection of the primary lesion.
Fabry disease with acute myocardial infarction, left ventricular thrombosis, and pericardial effusion
Authors: Zhou Shanshan , Wang Xiaocong , Xu Hui , Li Jing , Zhang Liping , Li Hang
Published: May 2022

Rationale:

Fabry disease (FD) is a rare, X-linked lysosomal deposition disease characterized by multi-system symptoms. The accumulation of globotriaosylceramide in various organs, such as the kidneys and heart, as well as the nervous system, has been speculated to be the mechanism involved in tissue damage, including vascular impairment with thrombotic events.

Patient concerns:

Here, we describe a 72-year-old male patient diagnosed with FD, who first presented with acute myocardial infarction, left ventricular thrombosis, and pericardial effusion, accompanied by cardiac hypertrophy.

Diagnoses:

A physical examination showed that he was hemodynamically stable and an electrocardiogram showed ventricular tachycardia (Fig. 1A). The single obvious abnormality was an ST segment depression with a preterminal negative T wave in leads I and aVL (Fig. 1B). Coronary angiography revealed regular findings (Fig. 2). Echocardiogram conducted at our hospital revealed hypertrophy, ejection fraction 40%, pericardial effusion (Fig. 3). Speckle tracking two-dimensional echocardiography strain analysis technology confirmed left ventricular thrombosis, and also revealed decreased movement of the inferior and posterior walls, the basal segment of the posterior wall was locally fibrotic (Fig. 4A and B). Further, myocardial contrast echocardiography confirmed left ventricular thrombosis (Fig. 4C). Cardiovascular magnetic resonance imaging indicated biventricular uneven hypertrophy, which was considered metabolic cardiomyopathy, with diffuse fibrosis of biventricular walls, apical thrombosis, and ischemic cardiomyopathy in the basal segment of the left ventricular lateral wall and left ventricular anterior wall (Fig. 5). Serum alpha-galactosidase concentration was 0.7 nmol/h/mgPr (normal range, 29.0–64.4 nmol/h/mgPr). Subsequent genetic testing revealed that he was hemizygous for a previously reported missense mutation (c.902G>A) inexon 6 of the GLA gene,
[1]
which induce p.R301Q (p.Arg301Gln), confirming a diagnosis of FD (Fig. 6).

Interventions:

Orally administered drugs included rivaroxaban, sacubitril valsartan, beta blockers, dapagliflozin, and mineralocorticoid receptor antagonist. Cardiac resynchronization therapy with an implanted defibrillator was implemented to prevent sudden death.

Outcomes:

At present, he is still in follow-up and there have been no adverse events.

Conclusion:

Our case suggests that clinicians should consider the possibility of FD in patients with acute myocardial infarction and cardiomyopathy. A detailed analysis of subtle historical clues would help promote earlier diagnosis of FD.
Prevalence of Functional Gastrointestinal Disorders in Brazilian Infants Seen in Private Pediatric Practices and Their Associated Factors
Authors: de Morais Mauro Batista , Toporovski Mauro Sergio , Tofoli Marise Helena Cardoso , Barros Karina Vieira , Silva Luciana Rodrigues , Ferreira Cristina Helena Targa
Published: May 2022

Objectives:

To assess the prevalence of the most frequent functional gastrointestinal disorders (FGIDs) in Brazilian infants seen in private pediatric clinics and their relationship with cesarean delivery, breastfeeding, and history of prematurity.

Methods:

This cross-sectional study enrolled 5080 infants under 12 months old with routine visits in private pediatric clinics in Brazil. The mothers answered questions about the type of delivery, type of feeding (breast milk, infant formula, cow milk, mixed feeding), history of prematurity, and gastrointestinal symptoms. Rome IV criteria were used to diagnose FGIDs.

Results:

The prevalence of infant regurgitation was 10.7% (487/4560); infant colic, 6.1% (131/2162); infant dyschezia, 4.0% (157/3895); functional constipation, 7.6% (341/4506); and functional diarrhea, 0.09% (2/2186). Prematurity was associated (P < 0.05) with infant regurgitation (odds ratio [OR] = 1.41; 95% confidence interval [CI]: 1.05, 1.90), infant colic (OR = 1.97; 95% CI: 1.19, 3.24), infant dyschezia (OR = 1.64, 95% CI: 1.02, 2.64), and functional constipation (OR = 1.44; 95% CI: 1.02, 2.02). Prematurity was associated (P < 0.001) with two or more FGIDs between 21 days and 150 days of age (OR = 3.06; 95% CI: 1.74, 5.37).

Conclusion:

FGIDs are common in infants seen in the private pediatric practice in Brazil. History of prematurity was associated with infant regurgitation, infant colic, functional dyschezia, and functional constipation.
First-line Anti-GD2 Therapy Combined With Consolidation Chemotherapy in 3 Patients With Newly Diagnosed Metastatic Ewing Sarcoma or Ewing-like Sarcoma
Authors: Spasov Neofit J. , Dombrowski Frank , Lode Holger N. , Spasova Mariya , Ivanova Liliya , Mumdjiev Ivan , Burnusuzov Hassan , Siebert Nikolai
Published: May 2022

Despite multimodal therapy, the prognosis of patients with metastatic Ewing sarcoma (ES) remains poor, with new treatments urgently needed. The disialoganglioside GD2, a well-established tumor-associated antigen, is expressed in 40% to 90% of ES cells, making it a suitable therapeutic target. Here we report 3 cases with newly diagnosed, metastatic, GD2-positive ES or Ewing-like sarcoma treated with the anti-GD2 antibody dinutuximab beta in addition to standard chemotherapeutic regimens. Treatment was well-tolerated, and all patients achieved complete remission, without evidence of relapse. First-line anti-GD2 immunotherapy in patients with metastatic, GD2-positive ES or Ewing-like sarcoma represents a promising therapeutic option that warrants further clinical evaluation.
Solitary Fibrous Tumor of the Bone Detected by FDG PET/CT
Authors: Li Jie , Kuang Anren , Shen Guohua
Published: May 2022

Solitary fibrous tumor as a rare mesenchymal tumor can occur in a wide variety of body sites, including serosal membranes, liver, lung, and deep soft tissues; however, primary tumor arising in bone is rarely documented. Herein, we reported the MRI, bone scan, and FDG PET/CT findings of a primary spinal solitary fibrous tumor in a 39-year-old woman.
Retrospective Evaluation of Rabbit Antithymocyte Globulin Induction in Heart Transplant Patients
Authors: Lee Grace Pui-Yun , Cheng Richard K. , Vasbinder Alexi , Wu Sixuan , Wong Beatrice , Farris Stephen D. , Fishbein Daniel , Wong Jenny Man-Ching
Published: May 2022

Background.

The dosing intensity of antithymocyte globulin as induction therapy in heart transplantation remains controversial. We sought to evaluate the efficacy and safety of rabbit antithymocyte globulin at a total dose of 4.5 mg/kg compared with <4.5 mg/kg.

Methods.

This was a retrospective study of consecutive patients who underwent heart transplantation from January 2016 to December 2018 at a single quaternary care center. Exposure was defined as full antithymocyte globulin (4.5 mg/kg total) induction compared with partial (<4.5 mg/kg) induction. The primary outcome was the incidence of The International Society for Heart and Lung Transplantation 1990 acute cellular rejection grade 2 or above at 2 y. Secondary outcomes were all-cause mortality, number of infections, and time to therapeutic tacrolimus levels. Cox proportional hazard models were used to compare rejection rates and mortality.

Results.

Of 201 patients, 61 received partial and 140 received full induction. There was no difference in the cumulative incidence of cellular rejection grade 2 or above (18% versus 11.4%, P = 0.209) within 2 y. The adjusted hazard ratio was 1.45 (confidence interval: 0.62-3.37, P = 0.388) for partial compared with full induction for any grade rejection. Landmark survival analysis conditional on survival to 1 mo showed no difference in mortality (P = 0.239). There was no difference in the incidence of infection within 3 mo of transplant (partial 29.5% versus full 20.0%, P = 0.140). Both groups achieved therapeutic tacrolimus levels by day 7 after initiation.

Conclusions.

There was no difference in overall risk for any grade cellular rejection between partial or full dose induction therapy. Additionally, there was no difference in medium-term mortality from landmark survival analysis.
Redundancy of AcrA and AcrE to support efflux of antibiotics through AcrD in Salmonella Typhimurium
Authors: Alav Ilyas , Blair Jessica
Published: May 2022

RND efflux pumps are important mediators of antibiotic resistance. RND efflux pumps including AcrB, are organized as tripartite systems, consisting of an inner membrane RND transporter, a periplasmic adaptor protein (PAP) and an outer membrane factor. We have previously identified the residues required for binding of the major PAP AcrA to the major RND pump AcrB and shown that there is promiscuity between the PAPs such that they can function with non-cognate pumps. AcrE is a PAP homologous to AcrA and AcrD and AcrF are RND pumps homologous to AcrB. This study aimed to determine whether the PAP AcrE can function with AcrD, which does not have its own PAP, to mediate efflux and whether the previously identified RND binding residues in AcrA and AcrE were also required for AcrD binding. The acrD and acrE genes were cloned into compatible vectors and co-transformed into a strain lacking acrAB, acrD and acrEF. When expressed together, acrDand acrE significantly decreased susceptibility of the efflux mutant strain to AcrD substrates including aztreonam, carbenicillin, cloxacillin, fusidic acid, nafcillin, novobiocin, oxacillin and ticarcillin, indicating that AcrE can also form a functional complex with AcrD. These experiments also highlighted that the substrate profile of AcrD in S. entericaand E. coli are different. Point mutations in the previously defined RND binding residues of AcrA and AcrE impaired AcrD-mediated efflux of substrate drugs which validates the interchangeability of AcrA and AcrE and highlights these residues as ideal drug targets for efflux inhibition to combat antimicrobial resistance.
Profiling the effects of acne therapeutics, including the novel antibiotic sarecycline, on the human microbiota
Authors: Buckley Anthony , Moura Ines , Clark Emma , Altringham James , Spittal William , Bentley Karen , Wilcox Mark
Published: May 2022

Many factors shape the human intestinal microbiota, some of which can confer a deleterious effect on the microbiota, e.g. antibiotic therapy. Disruption to the microbiota has been implicated in the progression of C. difficile infection (CDI), multiplication of multi-drug resistant organisms and many extra-intestinal diseases. Thus, determining the off-target effects of antibiotics is essential to determine a patient’s risk of these diseases, particularly for new therapies. Here we characterise the effect of sarecycline, a novel tetracycline antibiotic for the treatment of moderate to severe acne vulgaris; and compared its effect to the gut microbiota with other acne treatments. Using four independent in vitro gut models, we exposed the human microbiota to either sarecycline, minocycline, doxycycline, or clindamycin, and monitored the changes to the bacterial populations, and whether these changes were sufficient to induce CDI.

Sarecycline or doxycycline exposure caused a temporary reduction in the bacterial diversity upon initial exposure. Sarecycline exposure was characterised by a transient increase in Enterococcus spp. and Enterobacteriaceae, and a decrease in Bifidobacterium spp. Doxycycline exposure caused longer-term changes to the Lactobacillaceae and Ruminococcaceae populations. Minocycline exposure resulted in a dramatic reduction to the bacterial diversity, with extensive expansions to the Enterococcus spp. and Enterobacteriaceae populations, whilst the Lactobacillaceae and Ruminococcaceae populations contracted. Whilst clindamycin did induce simulated CDI, neither sarecycline, minocycline, nor doxycycline created a niche conducive for CDI.

These data show that long-term sarecycline use has a lower potential for disruption of the colonic microbiota, compared with the current treatments for acne vulgaris.
The ecology and antimicrobial resistance of Staphylococci colonising neonates
Authors: Felgate Heather , Sethi Dheeraj , Langridge Gemma , Crossman Lisa , Wain John , Clarke Paul , Page Andrew , Webber Mark A
Published: May 2022

Coagulase Negative Staphylococci (CoNS) are common commensals of human skin, account for nearly 20% of the microbiota in infants and are thought to promote early immune responses in healthy babies. However, CoNS are opportunistic pathogens and in the UK between 2005 and 2014 were responsible for 57% of episodes of Late Onset Sepsis (LOS). In neonatal intensive care units (NICUs) this is a major concern and antiseptics are used to prevent vascular catheter infections. Chlorhexidine (CHX) and Octenidine (OCT) are the most common agents used for skin antisepsis, but evidence is emerging of antiseptic tolerance amongst CoNS.

We undertook a longitudinal survey of CoNS from skin and rectal swabs isolated from babies in two NICUs from countries with different antiseptic regimens (UK and Germany). Over 1000 isolates were characterised for antimicrobial susceptibility and sequenced. The most frequent species isolated were S. epidermidis and S. haemolyticus with similar strain types present in both units. Reduced susceptibility to CHX and OCT was observed in UK isolates (where CHX is used), compared to German isolates (where OCT is used).

Analysis of genome data using GWAS and clustering techniques has identified loci associated with antimicrobial susceptibility. Comparison of isolates taken on admission and thereafter, demonstrated that babies acquired isolates with decreased antiseptic tolerance after admission. This data provides new information about the phylogeny of CoNS in NICUs and suggest different potentials for selection of resistance between antiseptics commonly used in neonatal care.
Inactivation of antibiotic-resistant microorganisms by physical plasma
Authors: Hahn Veronika , Balazinski Martina , Schulz Tilo , Schmidt Michael , Zühlke Daniela , Woedtke Thomas von , Kolb Jürgen , Weltmann Klaus-Dieter , Riedel Katharina
Published: May 2022

Wastewater treatment plants are “hotspots” for the dissemination of antibiotic-resistant microorganisms (ARM).1 General treatment methods only insuffiently reduce the load.2 Conversely, physical plasma methods have proven to be promising to inactivate microorganisms.3

Different plasma sources were tested according to their efficacy to inactivate ARM. Synthetic wastewater containing Escherichia coli GW-AmxH19 (isolate from hospital wastewater, Greifswald, Germany)4 was treated with the respective plasma source for 30min. The viable count was determined before and after plasma treatment.

In dependence of the source a reduction of the viable count of 1-7 log 10 was achieved.

Thus, physical plasma can be utilized as additional treatment stage in wastewater remediation and may also support the effort of “one health”.

1Rizzo, L.; Manaia, C.; Merlin, C.; Schwartz, T.; Dagot, C.; Ploy, M. C.; Michael, I.; Fatta-Kassinos, D. Science of the Total Environment 2013, 447, 345-360.

2Prado, T.; Pereira, W. C.; Silva, D. M.; Seki, L. M.; Carvalho, A. P. D.; Asensi, M. D. Letters in Applied Microbiology 2008, 46 (1), 136-141.

3Hahn, V.; Dikyol, C.; Altrock, B.; Schmidt, M.; Wende, K.; Ercan, U. K.; Weltmann, K. D.; von Woedtke, T. Plasma Processes and Polymers 2019, 16 (5).

4Schneider, D.; Zühlke, D.; Petscheleit, T.; Poehlein, A.; Riedel, K.; Daniel, R. Germany. Microbiology Resource Announcements 2020, 9 (21), e00279-20 (2pp).
In silico Approaches for Targeting an Essential Mycobacterial Protein, PrsA
Authors: Kingdon Alexander , Alderwick Luke
Published: May 2022

Mycobacterium tuberculosis is a leading cause of death worldwide and with increasing cases of drug-resistance, new treatments options are required. PrsA is an essential protein in mycobacteria and is necessary for arabinogalactan production and nucleotide biosynthesis. This protein is not currently targeted by any drugs in clinical development and represents a potential drug development avenue.

Currently, no crystal structure of M. tuberculosis PrsA (MtPrsA) is available, hence the SWISS-MODEL structure, based on M. smegmatis (93% similarity) was utilised. Molecular Dynamic simulations were performed on the modelled structure, to gain information on the protein’s predicted flexibility. The output trajectory was clustered, and representatives of each major cluster were used in downstream analysis. Ensemble docking, molecular docking on the ensemble of MtPrsA structures, of the GSK-177 prioritised compounds was undertaken. The docking predictions were also re-evaluated using machine learning based programmes, including NNScore.

This approach yielded several compounds which could be taken forward for further computational analysis. The compound rankings were also retroactively compared to experimental data studying the GSK-177 compounds’ interactions with mycobacteria.

This research represents a potential workflow for future in silico drug development efforts against M. tuberculosis and further work may allow the identified compounds to be used for the treatment of TB.
Antimicrobial resistance: revisiting the mechanisms of resistance
Authors: Mba Ifeanyi Elibe , Okeke Onyekachi Philomena , Sharndama Hyelnaya Cletus , Osondu-chuka Goodness Ogechi , Ukuomadu Joseph , Ugwu Chidera
Published: May 2022

Resistance to antibiotics persists as a critical challenge in public health. Currently, the emergence of multi-drug resistant (MDR) bacteria is a primary concern globally, resulting in a dramatic increase in epidemiological relevance and importance of nosocomial and chronic infections. Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacteriaceae has recently been classified as critical in the World Health Organization (WHO) priority pathogens. Among these bacterial pathogens, resistance seems to be a natural trait. The acquisition and development of resistance by bacteria is through several mechanisms. The genetic background and intrinsic resistance mechanisms largely contribute to competitive advantage and resistance in a highly resistant pool. The acquisition of resistance genes driven by mobile genetic elements (MGE) and several biochemical mechanisms also plays a central role in resistance development among pathogenic bacteria. This review discussed the recent underlying multiple resistance mechanisms among the priority pathogens. This review also provides an up-to-date regional epidemiological data and implications of antimicrobial resistance. Given the severity of infections caused by these bacteria, their less susceptibility to the available antimicrobials, and the limited antimicrobial arsenal to treat these pathogens, current insight on resistance mechanisms becomes timely and highly relevant. This information will help develop better therapeutic strategies against resistance microbes, especially those of urgent priority.
Characterization of a Multidrug-ResistantCitrobacter pasteurii isolate carrying blaKPC-2 from municipal wastewater
Authors: Ryan Michael P , Slattery Shannon , Pembroke J Tony
Published: May 2022

A carbapenem-resistant strain, UL-CPE-01, was isolated from a domestic wastewater treatment plant and subjected to antibiotic susceptibility testing showing resistance to a wide range of antibiotics. Complete genome and bioinformatic analysis of UL-CPE-01 was performed to investigate the nature of its resistance determinants and the strain identified as Citrobacter pasteuriibased onANI score. Citrobacter spp. are part of the normal human and animal intestinal flora and the UL-CPE-01 Citrobacter pasteuriistrain detected here is closely related to Citrobacter freundii, which is an emerging opportunistic nosocomial pathogen. UL-CPE-01 showed both phenotypic and genotypic multiple resistance to aminoglycoside, β-lactams, sulfonamides, fluoroquinolone, rifampicin, phenicol and macrolide antibiotics. The UL-CPE-01 genome revealed 16 acquired antimicrobial resistance gene (ARGs) conferring resistance to eight different antibiotic groups: dfrA12 (trimethoprim); sul1 (sulfonamide); mph(A), mph(E) and msr(E) (macrolide); qnrB4 and aac(6′)-Ib-cr (fluoroquinolone); blaDHA-1, blaOXA-1, blaCMY-77,blaOXA-10, blaTEM-1B, blaKPC-2(β-lactams); arr-3 (rifampicin); catB3 and catA1 (chloramphenicol) and aac(6′)-Ib-cr, aadA2 and ant(2″)-Ia (aminoglycoside). The novel blaKPC-2 determinant was found to be associated with in a Tn4401-like element.
Biotransformation of phthalate plasticisers and bisphenol A by marine and freshwater fungi
Authors: Cowan Andrew , Carstens Lena , Seiwert Bettina , Schlosser Dietmar
Published: May 2022

Phthalate esters (PEs) are environmentally ubiquitous micropollutants that are used as plasticizers and additives in diverse consumer products. Considerable concern relates to their reported xenoestrogenicity and the microbial-based attenuation of environmental PE concentrations is of interest to combat harmful downstream effects. Fungal PE catabolism has received less attention than that by bacteria, and particularly marine fungal species remain largely overlooked in this respect. We have compared the biocatalytic and biosorptive removal rates of di-n-butyl phthalate (DBP) and diethyl phthalate (DEP), chosen as two environmentally prominent PE representatives (exhibiting differing structures and hydrophobicities), by marine- and freshwater fungal strains. Bisphenol A, both an extensively used plastic additive and prominent environmental xenoestrogen, was included as a reference compound due to its previously well-documented fungal degradation. Partial pathways for DBP metabolization by these ecophysiologically diverse ascomycetes were proposed with the help of UPLC-QTOF-MS analysis. Species-specific biochemical reaction steps contributing to DBP metabolism were also observed. The involved reactions include initial cytochrome P450-dependent monohydroxylations of DBP with subsequent further oxidation of related metabolites, de-esterification via either hydrolytic cleavage or cytochrome P450-dependent oxidative O-dealkylation, transesterification, and demethylation steps - finally yielding phthalic acid as a central intermediate in all pathways. Beyond previous research into fungal PE metabolism which emphasises hydrolytic de-esterification as the primary catabolic step, a prominent role of cytochrome P450 monooxygenase-catalysed reactions is established.