bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficiency of integrated electrooxidation and anaerobic digestion of waste activated sludge
Authors: Barrios J. A. , Cano A. , Rivera F. F. , Cisneros M. E. , Durán U.
Published: April 2021

Background

Most of the organic content of waste activated sludge (WAS) comprises microbial cells hard to degrade, which must be pre-treated for energy recovery by anaerobic digestion (AD). Electrooxidation pre-treatment (EOP) with boron-doped diamond (BDD) electrode have been considered a promising novel technology that increase hydrolysis rate, by the disintegrating cell walls from WAS. Although electrochemical oxidation could efficiently solubilize organic substances of macromolecules, limited reports are available on EOP of WAS for improving AD. In this endeavour, the mathematical optimization study and the energy analysis of the effects of initial total solids concentrations [TS] of WAS and current density (CD) during EOP on the methane production and removal of chemical oxygen demand (COD) and volatile solids (VS) were investigated. Because limited reports are available on EOP of WAS for improving biogas production, it is not well understood; however, it has started to attract interest of scientists and engineers.

Results

In the present work, the energy recovery as biogas and WAS conversion were comprehensively affected by CD and [TS], in an integrated EOP and AD system. When working with WAS at 3% of [TS] pre-treated at current density of 24.1 mA/cm2, the highest COD and VS removal were achieved, making it possible to obtain the maximum methane (CH4) production of 305 N-L/kg VS and a positive energy balance of 1.67 kWh/kg VS. Therefore, the current densities used in BDD electrode are adequate to produce the strong oxidant (hydroxyl radical, ·OH) on the electrode surface, allow the oxidation of organic compounds that favours the solubilization of particulate matter and VS from WAS.

Conclusions

The improvement of VS removal and COD solubilization were due to the effects of pre-treatments, which help to break down the microbial cells for faster subsequent degradation; this allows a decomposition reaction that leads to biodegrade more compounds during AD. The balance was positive, suggesting that even without any optimization the energy used as electricity could be recovered from the increased methane production. It is worth noting that this kind of analysis have not been sufficiently studied so far. It is therefore important to understand how operational parameters can influence the pre-treatment and AD performances. The current study highlights that the mathematical optimization and energy analysis can make the whole process more convenient and feasible.
Prevalence and risk factors of Schistosoma mansoni infection among preschool-aged children from Panamasso village, Burkina Faso
Authors: Cisse Mamoudou , Sangare Ibrahim , Djibougou Arthur D. , Tahita Marc C. , Gnissi Souleymane , Bassinga Jonathan K. W. , Konda Salifou , Diallo Abdoulaye H.
Published: April 2021

Background

Schistosomiasis remains a major public health concern in sub-Saharan Africa. Although schistosomiasis is well documented in school-aged children in Burkina Faso, prevalence data among preschool-aged children (PSAC) are limited and outdated, and its risk factors in this group remain poorly documented. The main objective of this study was to assess the prevalence and risk factors associated with Schistosoma (S.) mansoni infection among PSAC from Panamasso village, western Burkina Faso.

Methodology

A cross-sectional study was carried out among 228 children under 6 years old from Panamasso village. Sociodemographic and water contact data were collected using a structured questionnaire. Kato-Katz and formol-ether concentration techniques were used to detect S. mansoni eggs in stool samples. Urine samples were subjected to a point-of-care circulating cathodic antigen (POC-CCA) cassette test and a centrifugation method to check for both S. mansoni and S. haematobium infection, respectively. Potential risk factors for S. mansoni infection were explored using multivariable logistic regression.

Results

The mean age of children was 40.2 ± 15.0 months. The prevalence of S. mansoni infection as determined by Kato-Katz, formol-ether concentration and POC-CCA was 42.1%, 39.5% and 80.7%, respectively. Based on the combined results of the three methods, the overall prevalence of S. mansoni infection was 81.1%. No case of S. haematobium infection was found. The geometric mean intensity of S. mansoni infection was 107.2 eggs per gram of feces with 54.2%, 33.3% and 12.5% of the children having light, moderate and heavy infections, respectively. Girls (AOR = 2.9, 95% CI 1.3–6.1), a household located within 500 m from the pond (AOR = 3.0, 95% CI 1.0–8.6) or between 500 and 1000 m from the pond (AOR = 3.0, 95% CI 1.2–7.2), and the child’s history of going to the pond (AOR = 5.0, 95% CI 1.7–14.3) were the variables significantly associated with S. mansoni infection.

Conclusion

S. mansoni was the sole species infecting a high proportion of PSAC in the study area. A mass drug administration program with praziquantel is therefore urgently required for those below 6 years old. Other control strategies should include increased community-awareness and provision of safe water.

Graphical Abstract
Effect of Transversus abdominis muscle training on pressure-pain threshold in patients with chronic low Back pain
Authors: Xu Changming , Fu Zhiwei , Wang Xueqiang
Published: April 2021

Background

Therapeutic training is the most commonly used treatment methods for chronic low back pain (CLBP), and the use of a pressure biofeedback unit for transversus abdominis muscle (TrA) training is one of the core muscle training methods. The study aim of this research is to explore the effects of different intensities (sham training, low-intensity and high-intensity) of TrA muscle training on people with CLBP in pressure-pain threshold (PPT).

Methods

A total of 45 patients with CLBP were recruited, of whom 44 were included in the analysis. Fifteen, 14, and 15 were included in the sham training group, the low-intensity group, and the high-intensity group, respectively. A pressure biofeedback unit was used in performing a one-time TrA training intervention involving 30 times of 180 mmHg TrA contraction training at high intensity for 10 min and 15 times of 100 mmHg TrA contraction training at low intensity for 5 min. The sham training group completed comfort exercises and did not undergo training. The evaluation indicators were as follows: PPT, short-form McGill pain questionnaire, and body surface pain radiation.

Results

High-intensity training could activate more waist core muscles than low-intensity training. Significant changes on PPT (units: kgf) were observed in the following four muscles immediately after high-intensity training: iliopsoas [0.69 (0.13–1.25) 95% CI, p = 0.020]; quadratus lumborum [0.84 (0.23–1.45) 95% CI, p = 0.012]; erector spinae [0.66 (0.18–1.15) 95% CI, p = 0.011]; transversus abdominis [0.70 (0.26–1.14) 95% CI, p = 0.004], and in three muscles after low-intensity training: quadratus lumborum [0.61 (0.17–1.05) 95% CI, p = 0.009]; transversus abdominis [0.14 (from − 0.15 to 0.43) 95% CI, p = 0.022]; piriformis [0.55 (0.13–0.98) 95% CI, p = 0.014]. The change in body surface pain radiation immediately after exercise was [− 10.87 (from − 17.51 to − 4.22) 95% CI, p = 0.003] for high-intensity training and [− 5.21 (from − 9.40 to − 1.03) 95% CI, p = 0.019] for low-intensity training.

Conclusions

TrA training could increase the PPT of the waist core muscles and reduce the radiation range of waist pain. The benefits of high-intensity training are higher than those of low-intensity training.

Trial registration

ChiCTR-TRC-13003701. Registered 18 October 2013.

Code of ethical approval: 2018069.
Expert commentary on the challenges and opportunities for surgical site infection prevention through implementation of evidence-based guidelines in the Asia–Pacific Region
Authors: Morikane K. , Russo P. L. , Lee K. Y. , Chakravarthy M. , Ling M. L. , Saguil E. , Spencer M. , Danker W. , Seno A. , Charles E. Edmiston
Published: April 2021

Introduction

Surgical site infections (SSIs) are a significant source of morbidity and mortality in the Asia–Pacific region (APAC), adversely impacting patient quality of life, fiscal productivity and placing a major economic burden on the country’s healthcare system. This commentary reports the findings of a two-day meeting that was held in Singapore on July 30–31, 2019, where a series of consensus recommendations were developed by an expert panel composed of infection control, surgical and quality experts from APAC nations in an effort to develop an evidence-based pathway to improving surgical patient outcomes in APAC.

Methods

The expert panel conducted a literature review targeting four sentinel areas within the APAC region: national and societal guidelines, implementation strategies, postoperative surveillance and clinical outcomes. The panel formulated a series of key questions regarding APAC-specific challenges and opportunities for SSI prevention.

Results

The expert panel identified several challenges for mitigating SSIs in APAC; (a) constraints on human resources, (b) lack of adequate policies and procedures, (c) lack of a strong safety culture, (d) limitation in funding resources, (e) environmental and geographic challenges, (f) cultural diversity, (g) poor patient awareness and (h) limitation in self-responsibility. Corrective strategies for guideline implementation in APAC were proposed that included: (a) institutional ownership of infection prevention strategies, (b) perform baseline assessments, (c) review evidence-based practices within the local context, (d) develop a plan for guideline implementation, (e) assess outcome and stakeholder feedback, and (f) ensure long-term sustainability.

Conclusions

Reducing the risk of SSIs in APAC region will require: (a) ongoing consultation and collaboration among stakeholders with a high level of clinical staff engagement and (b) a strong institutional and national commitment to alleviate the burden of SSIs by embracing a safety culture and accountability.
A comprehensive metagenomics framework to characterize organisms relevant for planetary protection
Authors: Danko David C. , Sierra Maria A. , Benardini James N. , Guan Lisa , Wood Jason M. , Singh Nitin , Seuylemezian Arman , Butler Daniel J. , Ryon Krista , Kuchin Katerina , Meleshko Dmitry , Bhattacharya Chandrima , Venkateswaran Kasthuri J. , Mason Christopher E.
Published: April 2021

Background

Clean rooms of the Space Assembly Facility (SAF) at the Jet Propulsion Laboratory (JPL) at NASA are the final step of spacecraft cleaning and assembly before launching into space. Clean rooms have stringent methods of air-filtration and cleaning to minimize microbial contamination for exoplanetary research and minimize the risk of human pathogens, but they are not sterile. Clean rooms make a selective environment for microorganisms that tolerate such cleaning methods. Previous studies have attempted to characterize the microbial cargo through sequencing and culture-dependent protocols. However, there is not a standardized metagenomic workflow nor analysis pipeline for spaceflight hardware cleanroom samples to identify microbial contamination. Additionally, current identification methods fail to characterize and profile the risk of low-abundance microorganisms.

Results

A comprehensive metagenomic framework to characterize microorganisms relevant for planetary protection in multiple cleanroom classifications (from ISO-5 to ISO-8.5) and sample types (surface, filters, and debris collected via vacuum devices) was developed. Fifty-one metagenomic samples from SAF clean rooms were sequenced and analyzed to identify microbes that could potentially survive spaceflight based on their microbial features and whether the microbes expressed any metabolic activity or growth. Additionally, an auxiliary testing was performed to determine the repeatability of our techniques and validate our analyses. We find evidence that JPL clean rooms carry microbes with attributes that may be problematic in space missions for their documented ability to withstand extreme conditions, such as psychrophilia and ability to form biofilms, spore-forming capacity, radiation resistance, and desiccation resistance. Samples from ISO-5 standard had lower microbial diversity than those conforming to ISO-6 or higher filters but still carried a measurable microbial load.

Conclusions

Although the extensive cleaning processes limit the number of microbes capable of withstanding clean room condition, it is important to quantify thresholds and detect organisms that can inform ongoing Planetary Protection goals, provide a biological baseline for assembly facilities, and guide future mission planning.
Using high-abundance proteins as guides for fast and effective peptide/protein identification from human gut metaproteomic data
Authors: Stamboulian Moses , Li Sujun , Ye Yuzhen
Published: April 2021

Background

A few recent large efforts significantly expanded the collection of human-associated bacterial genomes, which now contains thousands of entities including reference complete/draft genomes and metagenome assembled genomes (MAGs). These genomes provide useful resource for studying the functionality of the human-associated microbiome and their relationship with human health and diseases. One application of these genomes is to provide a universal reference for database search in metaproteomic studies, when matched metagenomic/metatranscriptomic data are unavailable. However, a greater collection of reference genomes may not necessarily result in better peptide/protein identification because the increase of search space often leads to fewer spectrum-peptide matches, not to mention the drastic increase of computation time.

Methods

Here, we present a new approach that uses two steps to optimize the use of the reference genomes and MAGs as the universal reference for human gut metaproteomic MS/MS data analysis. The first step is to use only the high-abundance proteins (HAPs) (i.e., ribosomal proteins and elongation factors) for metaproteomic MS/MS database search and, based on the identification results, to derive the taxonomic composition of the underlying microbial community. The second step is to expand the search database by including all proteins from identified abundant species. We call our approach HAPiID (HAPs guided metaproteomics IDentification).

Results

We tested our approach using human gut metaproteomic datasets from a previous study and compared it to the state-of-the-art reference database search method MetaPro-IQ for metaproteomic identification in studying human gut microbiota. Our results show that our two-steps method not only performed significantly faster but also was able to identify more peptides. We further demonstrated the application of HAPiID to revealing protein profiles of individual human-associated bacterial species, one or a few species at a time, using metaproteomic data.

Conclusions

The HAP guided profiling approach presents a novel effective way for constructing target database for metaproteomic data analysis. The HAPiID pipeline built upon this approach provides a universal tool for analyzing human gut-associated metaproteomic data.
Participatory foresight and reflexive innovation: setting policy goals and developing strategies in a bottom-up, mission-oriented, sustainable way
Authors: Rosa Aaron B. , Kimpeler Simone , Schirrmeister Elna , Warnke Philine
Published: April 2021

The urgency of current social challenges is driving new approaches to framing and funding research, development, and innovation. The “mission-oriented” approach framing the EU’s New Horizons funding program is the latest institutional response to the pressing needs of large system transformations we are facing. We view the likely targets of mission-oriented programs as dynamic entities requiring both adaptive, inclusive responses, and anticipatory exploration. We demonstrate how participatory foresight methods provide an essential forum and process for the expression of plural, socio-technological imaginaries. As citizens and other stakeholder groups have demonstrated their myriad capacities to contribute to research and innovation agenda-setting processes in future-oriented citizen dialogs, we argue that such methods are the essential compliment to the mission-oriented framework coming into play. Participatory foresight engages citizens in critical thinking and creative activities to articulate the evolution of socio-technological issues over an extended time horizon, seeking diverse perspectives on what goals and priorities will come to define “missions.” Utilizing outputs from two recent projects, we argue that participatory foresight methods can play an essential role in bridging citizen needs with policy requirements, and will increase the reflexivity of innovation systems that invest the needed time and resources into exploring the depth of multi-actor interests and intersections. Finally, we outline possible impact pathways demonstrating how these “bottom-up” contributions could be integrated into the development of challenge-led innovation priorities.
Believing emotions are uncontrollable is linked to eating disorder psychopathology via suppression and reappraisal
Authors: Vuillier Laura , Joseph Jemma , Somerville Matthew P. , Harrison Amy
Published: April 2021

Objective

Research suggests that beliefs about emotional controllability influence the use of emotion regulation strategies, which in turn impact psychological health and illness. However, no research has yet investigated whether emotional controllability is linked to eating psychopathology. The current study investigates whether these concepts are related, as individuals with eating disorders have problems with emotion regulation.

Method

We collected self-report data from 718 participants from a community sample using validated questionnaires, and ran mediational analyses to assess the relationship between emotional controllability and eating psychopathology, via reappraisal and suppression, two emotion regulation strategies.

Results

Our mediational analyses suggest that believing emotions to be uncontrollable relates to high levels of suppression (β = −.08), low levels of reappraisal (β = .19) and poorer eating disorder psychopathology (β = −.11). Reappraisal and suppression were found to partially mediate the relationship between emotional controllability and eating psychopathology.

Discussion

The current study has demonstrated relationships that support investigations relating emotional controllability, emotion regulation and psychological health. This research has potential implications for developing interventions to target beliefs about emotions in order to help improve emotion regulation skills and eating psychopathology.
Caregiver burden and coping strategies in caregivers of older patients with stroke
Authors: Kazemi Azar , Azimian Jalil , Mafi Maryam , Allen Kelly-Ann , Motalebi Seyedeh Ameneh
Published: April 2021

Background

Coping strategies play a key role in modulating the physical and psychological burden on caregivers of stroke patients. The present study aimed to determine the relationship between the severity of burden of care and coping strategies amongst a sample of Iranian caregivers of older stroke patients. It also aimed to examine the differences of coping strategies used by male and female caregivers.

Methods

A total of 110 caregivers of older patients who previously had a stroke participated in this descriptive and cross-sectional study. The Zarit Burden Interview and Lazarus coping strategies questionnaires were used for data collection. Questionnaires were completed by the caregivers, who were selected using convenience sampling. The collected data were analyzed using Pearson's correlations and independent t-tests.

Results

The mean age of participants was 32.09 ± 8.70 years. The majority of the caregivers sampled reported mild to moderate (n = 74, 67.3%) burden. The most commonly used coping strategies reported were positive reappraisal and seeking social support. Results of the independent t-test showed that male caregivers used the positive reappraisal strategy (t(110) = 2.76; p = 0.007) and accepting responsibility (t(110) = 2.26; p = 0.026) significantly more than female caregivers. Pearson’s correlations showed a significant positive correlation between caregiver burden and emotional-focused strategies, including escaping (r = 0.245, p = 0.010) and distancing (r = 0.204, p = 0.032).

Conclusions

Caregivers with higher burden of care used more negative coping strategies, such as escape-avoidance and distancing. In order to encourage caregivers to utilize effective coping skills, appropriate programs should be designed and implemented to support caregivers. Use of effective coping skills to reduce the level of personal burden can improve caregiver physical health and psychological well-being.
Oral administration of repurposed drug targeting Cyp46A1 increases survival times of prion infected mice
Authors: Ali Tahir , Hannaoui Samia , Nemani Satish , Tahir Waqas , Zemlyankina Irina , Cherry Pearl , Shim Su Yeon , Sim Valerie , Schaetzl Hermann M. , Gilch Sabine
Published: April 2021

Prion diseases are fatal, infectious, and incurable neurodegenerative disorders caused by misfolding of the cellular prion protein (PrPC) into the infectious isoform (PrPSc). In humans, there are sporadic, genetic and infectious etiologies, with sporadic Creutzfeldt-Jakob disease (sCJD) being the most common form. Currently, no treatment is available for prion diseases. Cellular cholesterol is known to impact prion conversion, which in turn results in an accumulation of cholesterol in prion-infected neurons. The major elimination of brain cholesterol is achieved by the brain specific enzyme, cholesterol 24-hydroxylase (CYP46A1). Cyp46A1 converts cholesterol into 24(S)-hydroxycholesterol, a membrane-permeable molecule that exits the brain. We have demonstrated for the first time that Cyp46A1 levels are reduced in the brains of prion-infected mice at advanced disease stage, in prion-infected neuronal cells and in post-mortem brains of sCJD patients. We have employed the Cyp46A1 activator efavirenz (EFV) for treatment of prion-infected neuronal cells and mice. EFV is an FDA approved anti-HIV medication effectively crossing the blood brain barrier and has been used for decades to chronically treat HIV patients. EFV significantly mitigated PrPSc propagation in prion-infected cells while preserving physiological PrPC and lipid raft integrity. Notably, oral administration of EFV treatment chronically at very low dosage starting weeks to months after intracerebral prion inoculation of mice significantly prolonged the lifespan of animals. In summary, our results suggest that Cyp46A1 as a novel therapeutic target and that its activation through repurposing the anti-retroviral medication EFV might be valuable treatment approach for prion diseases.
The expression of B7-H3 isoforms in newly diagnosed glioblastoma and recurrence and their functional role
Authors: Digregorio Marina , Coppieters Natacha , Lombard Arnaud , Lumapat Paul Noel , Scholtes Felix , Rogister Bernard
Published: April 2021

Short survival of glioblastoma (GBM) patients is due to systematic tumor recurrence. Our laboratory identified a GBM cell subpopulation able to leave the tumor mass (TM) and invade the subventricular zone (SVZ-GBM cells). SVZ-GBM cells escape treatment and appear to contribute to GBM recurrence. This study aims to identify proteins specifically expressed by SVZ-GBM cells and to define their role(s) in GBM aggressiveness and recurrence. The proteome was compared between GBM cells located in the initial TM and SVZ-GBM cells using mass spectrometry. Among differentially expressed proteins, we confirmed B7-H3 by western blot (WB) and quantitative RT-PCR. B7-H3 expression was compared by immunohistochemistry and WB (including expression of its isoforms) between human GBM (N = 14) and non-cancerous brain tissue (N = 8), as well as newly diagnosed GBM and patient-matched recurrences (N = 11). Finally, the expression of B7-H3 was modulated with short hairpin RNA and/or over-expression vectors to determine its functional role in GBM using in vitro assays and a xenograft mouse model of GBM. B7-H3 was a marker for SVZ-GBM cells. It was also increased in human GBM pericytes, myeloid cells and neoplastic cells. B7-H3 inhibition in GBM cells reduced their tumorigenicity. Out of the two B7-H3 isoforms, only 2IgB7-H3 was detected in non-cancerous brain tissue, whereas 4IgB7-H3 was specific for GBM. 2IgB7-H3 expression was higher in GBM recurrences and increased resistance to temozolomide-mediated apoptosis. To conclude, 4IgB7-H3 is an interesting candidate for GBM targeted therapies, while 2IgB7-H3 could be involved in recurrence through resistance to chemotherapy.
Optimization of air traffic management efficiency based on deep learning enriched by the long short-term memory (LSTM) and extreme learning machine (ELM)
Authors: Yousefzadeh Aghdam Mahdi , Kamel Tabbakh Seyed Reza , Mahdavi Chabok Seyed Javad , Kheyrabadi Maryam
Published: April 2021

Nowadays this concept has been widely assessed due to its complexity and sensitivity for the beneficiaries, including passengers, airlines, regulatory agencies, and other organizations. To date, various methods (e.g., statistical and fuzzy techniques) and data mining algorithms (e.g., neural network) have been used to solve the issues of air traffic management (ATM) and delay the minimization problems. However, each of these techniques has some disadvantages, such as overlooking the data, computational complexities, and uncertainty. In this paper, to increase the air traffic management accuracy and legitimacy we used the bidirectional long short-term memory (Bi-LSTMs) and extreme learning machines (ELM) to design the structure of a deep learning network method. The Kaggle data set and different performance parameters and statistical criteria have been used in MATLAB to validate the proposed method. Using the proposed method has improved the criteria factors of this study. The proposed method has had a % increase in air traffic management in comparison to other papers. Therefore, it can be said that the proposed method has a much higher air traffic management capacity in comparison to the previous methods.
An application of multi-criteria decision-making approach to sustainable drug shortages management: evidence from a developing country
Authors: Moosivand Asiye , Rangchian Maryam , Zarei Leila , Peiravian Farzad , Mehralian Gholamhossein , Sharifnia Hesameddin
Published: April 2021

Background

Drug shortage is a significant public health problem, especially for drugs related to life threatening conditions. Almost all countries affected by variety of supply problems and spent a considerable amount of time and resources responding to shortage. The aim of present study is to determine and prioritize strategies to achieve best solutions for these considerable healthcare system challenges and to evaluate this strategies base on practical criteria.

Methods

To achieve the study objectives, the research was conducted in two phases. Determining of the strategies to control drug shortage, and comprehensive assessments of priority of possible strategies. For each phase, a self-design questionnaire was developed. The five main managerial strategies dimensions including: regulatory, financial, supply chain, information system and policy-making were set out. Forty-five alternatives were elicited from literature, and were evaluated and trimmed to 37 strategies based on experts’ opinion. The Multiple criteria decision-making (MCDM) methods were applied in second phase. Five important criteria including cost, time, labor, compliance with law and culture were weighed by Analytic Hierarchy Process (AHP) technique. Then, 37 alternatives have been rated base on the five criteria on the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) technique.

Results

“Creating integrated Supply chain information system to manage medicines inventory in the country”, “Creating and using the databases to predict the shortage of medicines”, “Using track and trace system” are alternatives 20th, 24th and 25th, which related to supply chain (SC) and information system (IS) dimensions have higher priority in the experts’ point of view. The results show IS dimension has 100 percentage of priority; following that policy and supply chain have higher priority, respectively.

Conclusion

Health systems rely on consistent supplying of pharmaceuticals to support patient care. The results show that information system, policy-making and supply chain are in the top-ranking priorities. Warning system needs to be improved to the advance system via better collaboration with stakeholders, publish precise and explicit national guidelines for drug shortage management, enforce the guidelines, and improve Iran FDA’s pharmaceutical market control capability.
Lung autotransplantation for bronchial necrosis after radiotherapy: a case report
Authors: Nobori Yuya , Sato Masaaki , Morota Mizuki , Shinohara Yoshikazu , Yoshida Daisuke , Karasaki Takahiro , Kitano Kentaro , Nakajima Jun
Published: April 2021

Background

Bronchial necrosis is a rare but fatal complication after radiation therapy. Because of the anatomical complexity and rarity of this condition, determining the most appropriate management for individual patients is extremely challenging. Lung autotransplantation is a surgical technique that has been applied to hilar neoplastic lesions to preserve pulmonary function and avoid pneumonectomy. We herein report a case of bronchial necrosis secondary to radiotherapy that was treated with lung autotransplantation.

Case presentation

A 46-year-old man developed broad necrosis and infection of the right bronchus secondary to previous stereotactic body-radiation therapy. This treatment was supplied close to a right hilar metastatic pulmonary tumor derived from a mediastinal malignant germ cell tumor that had been surgically resected with the left phrenic nerve. The bronchial necrosis accompanied by infection with Aspergillus fumigatus was progressive despite antibiotics and repetitive bronchoscopic debridement. Because of the patient’s critical condition and limited pulmonary function, right lung autotransplantation with preservation of the right basal segment was selected. An omental flap was placed around the bronchial anastomosis to prevent later complications. The postoperative course involved multiple complications including contralateral pneumonia and delayed wound healing at the bronchial anastomosis with resultant stenosis, the latter of which was overcome by placement of a silicone stent. The patient was discharged 5 months postoperatively. Three months after discharge, however, the patient developed hemoptysis and died of bronchopulmonary arterial fistula formation.

Conclusions

We experienced an extremely challenging case of bronchial necrosis secondary to radiotherapy. The condition was managed with lung autotransplantation and omental wrapping; however, the treatment success was temporary and the patient eventually died of bronchopulmonary arterial fistula formation. This technique seems to be a feasible option for locally advanced refractory bronchial necrosis, although later complications can still be fatal.
Modified Talk Test: a Randomized Cross-over Trial Investigating the Comparative Utility of Two “Talk Tests” for Determining Aerobic Training Zones in Overweight and Obese Patients
Authors: Orizola-Cáceres Ignacio , Cerda-Kohler Hugo , Burgos-Jara Carlos , Meneses-Valdes Roberto , Gutierrez-Pino Rafael , Sepúlveda Carlos
Published: April 2021

Background

To validate the traditional talk test (TTT) and an alternative talk test (ATT; using a visual analog scale) in overweight/obese (OW-OB) patients and to establish its accuracy in determining the aerobic training zones.

Methods

We recruited 19 subjects aged 34.9 ± 6.7 years, diagnosed with overweight/obesity (BMI 31.8 ± 5.7). Every subject underwent incremental cycloergometric tests for maximal oxygen consumption, and TTT in a randomized order. At the end of each stage during the TTT, each subject read out loud a 40 words text and then had to identify the comfort to talk in two modalities: TTT which consisted in answering “Yes,” “I don’t know,” or “No” to the question Was talking comfortable?, or ATT through a 1 to 10 numeric perception scale (visual analog scale (VAS)). The magnitude of differences was interpreted in comparison to the smallest worthwhile change and was used to determine agreement.

Results

There was an agreement between the power output at the VAS 2–3 of ATT and the power output at the ventilatory threshold 1 (VT1) (very likely equivalent; mean difference − 1.3 W, 90% confidence limit (CL) (− 8.2; 5.6), percent chances for higher/similar/lower values of 0.7/99.1/0.2%). Also, there was an agreement between the power output at the VAS 6–7 of ATT and the power output at the ventilatory threshold 2 (VT2) (very likely equivalent; mean difference 11.1 W, 90% CL (2.8; 19.2), percent chances for higher/similar/lower values of 0.0/97.6/2.4%).

Conclusions

ATT is a tool to determine exercise intensity and to establish aerobic training zones for exercise prescription in OW-OB patients.
Aflibercept therapy for exudative age-related macular degeneration resistant to bevacizumab and ranibizumab
Authors: Hamid Mohamed A. , Abdelfattah Nizar S. , Salamzadeh Jamshid , Abdelaziz Sahar T. A. , Sabry Ahmed M. , Mourad Khaled M. , Shehab Azza A. , Kuppermann Baruch D.
Published: April 2021

Background

Despite the good outcomes achieved with intravitreal angiogenic therapy, a subset of neovascular age-related macular degeneration (AMD) patients experience resistance to therapy after repeated injections. Switching drugs could offer benefit to this group of patients.

Purpose

To determine visual and anatomical outcomes in a cohort of neovascular AMD patients resistant to repeated injections of bevacizumab/ranibizumab after switching to aflibercept therapy.

Methods

This was a retrospective chart review of patients who had a diagnosis of neovascular AMD and persistent intraretinal (IRF) and/or subretinal fluid (SRF) on optical coherence tomography (OCT) for at least 3 months despite monthly bevacizumab and/or ranibizumab injections prior to transition to aflibercept. We reviewed patients’ records and OCT images obtained at baseline, 1, 3, 6 and 12 months after transition to aflibercept. Data collected included demographics, best-corrected visual acuity (BCVA), number of injections received and the occurrence of any adverse events. Studied OCT parameters included central macular thickness (CMT) values and the presence or absence of SRF, IRF and/or pigment epithelial detachment (PED) at each visit.

Results

We included 53 eyes of 48 patients. Mean change in BCVA from baseline was 0.05 ± 0.13 (P = 0.01) at M1, 0.04 ± 0.16 (P = 0.08) at M3, 0.01 ± 0.22 (P = 0.9) at M6, and 0.02 ± 0.28 (P = 1) at M12, while the mean change in CMT from baseline was 64 ± 75 μm (P < 0.0001) at M1, 42 ± 85 μm (P = 0.002) at M3, 47 ± 69 μm (P < 0.0001) at M6, and 46 ± 99 μm (P = 0.001) at M12. The percentage of eyes with SRF decreased from 77.4% at baseline to 39.6% at M1, then increased to 47.2% at M3, then decreased to 43.4% at M6, and to 41.5% at M12 (All p < 0.001, compared to baseline). Compared to baseline, there was a statistically significant decrease in the percentage of eyes having IRF from 47.2 to 20.8% at M1 (p < 0.001), 30.2% at M3, 24.5% at M6 and 26.4% at M12 (p < 0.01, each). The number of bevacizumab and/or ranibizumab injections (7.36 ± 1.85) was significantly higher than that of aflibercept (6.47 ± 2.45, p = 0.001). A significant direct relationship between CMT reduction and BCVA improvement was demonstrated at M1 (p = 0.01, r = 0.36), M3 (p = 0.03, r = 0.30) and M12 (p = 0.03, r = 0.30). Eyes with IRF had significantly poorer BCVA than eyes without IRF at baseline (p = 0.02) and M3 (p = 0.04).

Conclusion

Switching to intravitreal aflibercept therapy in a cohort of neovascular AMD patients resistant to chronic bevacizumab and/or ranibizumab injections can lead to significant visual improvement in the short term and sustained reduction of central macular thickness over 1 year of followup.
The yield and usefulness of PAIN+ and PubMed databases for accessing research evidence on pain management: a randomized crossover trial
Authors: Arumugam Vanitha , MacDermid Joy C. , Walton Dave , Grewal Ruby
Published: April 2021

Introduction

PAIN+and PubMed are two electronic databases with two different mechanisms of evidence retrieval. PubMed is used to “Pull” evidence where clinicians can enter search terms to find answers while PAIN+is a newly developed evidence repository where along with “Pull” service there is a “Push” service that alerts users about new research and the associated quality ratings, based on the individual preferences for content and altering criteria.

Purpose

The primary purpose of the study was to compare yield and usefulness of PubMed and PAIN+in retrieving evidence to address clinical research questions on pain management. The secondary purpose of the study was to identify what search terms and methods were used by clinicians to target pain research.

Study design

Two-phase double blinded randomized crossover trial.

Methods

Clinicians (n = 76) who were exposed to PAIN+for at least 1 year took part in this study. Participants were required to search for evidence 2 clinical question scenarios independently. The first clinical question was provided to all participants and thus, was multi-disciplinary. Participants were randomly assigned to search for evidence on their clinical question using either PAIN+or PubMed through the electronic interface. Upon completion of the search with one search engine, they were crossed over to the other search engine. A similar process was done for a second scenario that was discipline-specific. The yield was calculated using number of retrieved articles presented to participants and usefulness was evaluated using a series of Likert scale questions embedded in the testing.

Results

Multidisciplinary scenario:Overall, the participants had an overall one-page yield of 715 articles for PAIN+and 1135 articles for PubMed. The topmost article retrieved by PAIN+was rated as more useful (p = 0.001). While, the topmost article retrieved by PubMed was rated as consistent with current clinical practice (p = 0.02). PubMed (48%) was preferred over PAIN+(39%) to perform multidisciplinary search (p = 0.02).

Discipline specific scenario:The participants had an overall one-page yield of 1046 articles for PAIN+and 1398 articles for PubMed. The topmost article retrieved by PAIN+was rated as more useful (p = 0.001) and consistent with current clinical practice (p = 0.02) than the articles retrieved by PubMed. PAIN+(52%) was preferred over PubMed (29%) to perform discipline specific search.

Conclusion

Clinicians from different disciplines find both PAIN+and PubMed useful for retrieving research studies to address clinical questions about pain management. Greater preferences and perceived usefulness of the top 3 retrieved papers was observed for PAIN+, but other dimensions of usefulness did not consistently favor either search engine.

Trial registration

Registered with ClinicalTrials.gov Identifier:NCT01348802, Date: May 5, 2011.
Patient-centered outcomes used in pediatric focused manual therapies research studies: a secondary data analysis of a systematic review
Authors: Carleo Beth , Anderson Kristian , Prevost Carol Parnell , Pohlman Katherine A.
Published: April 2021

Background

Patient-reported outcome measurements (PROM) are instruments that seek a patient’s health or functional status. Inclusion of standardized PROMs in research studies and clinical practice provides a more comprehensive understanding of an intervention from the patient’s viewpoint. This secondary analysis identified PROM usage and appropriateness of references for property measurements from clinical trials included in a recent systematic review of pediatric manual therapy.

Methods

All included manuscripts within a recent systematic review had two authors extract PROM and associated property measurement data, including the property measurements supporting citations. Inclusion criteria for the articles were published clinical trials (observational or experimental) of pediatric children receiving manual therapy (any profession) for any condition between 2001-March 2018. For each PROM’s associated property measurement, two authors used the COSMIN study design checklist to appraise the quality of the cited study to evaluate the property measurement.

Results

Of the 50 manuscripts included in the systematic review, 20 manuscripts reported the use of 52 PROMs. Of the 52 PROMs assessed, 31 did not make a statement about the instrument’s property measurement, 7 PROMs had property measurements stated but not referenced, 4 PROMs stated that the property measurement information was unknown, and 10 had property measurement data with reference(s). These 10 PROMs with referenced property measurements were from 7 unique PROMs: constipation assessment scale, satisfaction visual analog scale (VAS), crying time diary, sleep diary, fear avoidance belief questionnaire (FABQ), pain VAS, and autism treatment evaluation checklist. The assessment of the referenced property measurements found that several property measurement’s dimensions had not been assessed and those that had were evaluated were done so with poor or fair standards.

Conclusions

This secondary analysis finds that clinical studies of pediatric manual therapy lack consistent use of PROMs with high quality property measurements. Further research to establish and implement PROMs to be used in future research studies and in clinical settings should become a priority for professions using manual therapy in children.
Predictive factors of epilepsy outcome in a sample of Egyptian pre-elderly and elderly population
Authors: Gerges Steven Emil , El Rakawy Mahmoud Hemeda , El Khayat Naglaa Mohammed , Abdelhamid Yousry Abo Elnaga , Hazzou Ahmed Mohammed , Shokri Hossam Mohammed , Wahid El din Mona Mokthar
Published: April 2021

Background

Elderly people with epilepsy are large, but neglected group. Data on the predictive factors for recurrent seizures in the elderly population are inconclusive or are not known for the majority of patients. This is especially true for the Egyptian population as no specific study was concluded to address this issue before.

Objectives

The aim of this study was to detect the predictive factors of epilepsy outcome in a sample of Egyptian aged population.

Materials and methods

A total of 100 patients aged 50 years or older with epilepsy diagnosed according to International League Against Epilepsy (ILAE) latest definition were included in the study and followed up for 6 months as regards seizure control. All participants were prospectively evaluated for epidemiological, clinical, radiological, electrodiagnostic, and laboratory data.

Results

The outcome was statistically significant affected in relation to absence of medical comorbidities (P = 0.037), seizure etiology (P = 0.007), history of status epilepticus (P <  0.001), MRI brain findings (P = 0.005), EEG changes (P <  0.001), Ca (P = 0.01), and Mg level (P = 0.046).

Conclusion

We conclude that aged Egyptian epileptic population with no medical comorbidities, normal MRI brain, or normal EEG can be predicted to have good outcome of their epilepsy while patients with post stroke epilepsy, abnormal MRI brain, and abnormal EEG, with low serum Ca or Mg level can be predicted to have poor outcome.
Ultrastructure of the fertilized egg envelope from Melanotaenia praecox, Melanotaeniidae, Teleostei
Authors: Sohn Joon Hyung , Kim Dong Heui
Published: April 2021

We examined the morphology of fertilized egg and ultrastructures of fertilized egg envelopes of dwarf rainbowfish (Melanotaenia praecox) belong to Melanotaeniidae using light and electron microscopes. The fertilized eggs were spherical with adhesive filament, transparent, demersal, and had a narrow perivitelline space and small oil droplets. The size of fertilized egg was 1.02 ± 0.18 mm (n = 30), and there were two kinds of adhesive filament on the fertilized eggs. The long and thick (diameter 12.22 ± 0.52 μm, n = 20) adhesive filaments were only at the area of animal pole, and short and thin (diameter 1.99 ± 0.23 μm, n = 20) adhesive filaments were around the long filaments. A micropyle was conical shaped with adhesive filament and located near the animal pole of egg. The outer surface of fertilized egg was rough side. Also, the total thickness of the fertilized egg envelope was about 7.46 ± 0.41 μm (n = 20), the fertilized egg envelope consisted of two layers, an inner lamellae layer and an outer layer with high electron-density. And the inner layer was 8 layers. Collectively, these morphological characteristics and adhesive property of fertilized egg with adhesive filaments, and ultrastructures of micropyle, outer surface, and section of fertilized egg envelope are showed species specificity.
Incidental detection of a lung perfusion defect suspicious of pulmonary embolism on labelled white blood cell quality control imaging—case report
Authors: Evbuomwan Osayande , Engelbrecht Gerrit
Published: April 2021

Background

Incidental findings could be a very important observation in various nuclear medicine studies. There have been few cases of incidental findings of perfusion abnormalities on early quality control images of the lungs during radiolabeled white blood cell studies. This study is the first to detect perfusion defects on the early quality control images of the lungs during a labelled white blood cell study suspicious of pulmonary embolism in an unknown but treated COVID-19 patient.

Case presentation

We present a 40-year-old male who was referred to our department for a nuclear medicine 99mTc HMPAO-labelled white blood cell study to rule out osteomyelitis of his right foot. Early 5-min quality control images of his lungs revealed two perfusion defects in the right lung. A suspicion of pulmonary embolism was made, and a perfusion only SPECT/CT study the next day confirmed the suspicion of pulmonary embolism in one of the defects, with a possible fissure sign as a differential.

Conclusion

There has been an increase in the incidence of lung perfusion abnormalities and pulmonary embolism during the COVID-19 pandemic. Some of these may be detected as incidental findings on early lung quality control images of radiolabeled white blood cell studies.
Ameliorative effect of Allium atroviolaceum on sperm quality in cyclophosphamide-treated mice
Authors: Hosseini Alireza , Shahrani Mehrdad , Asgharian Shirin , Anjomshoa Maryam , Rostamzadeh Ayoob , Lorigooini Zahra , Asgharzadeh Najmeh , Azari Abbas
Published: April 2021

Background

Cyclophosphamide (CP) is an anti-neoplastic alkylating agent that is extensively used in different chemotherapy regimens. Adverse effects on the reproductive system, especially spermatogenesis, are one of the most important side effects of this drug. It is medically essential to use complementary and alternative drugs. Herbal drugs have long been used as a complementary treatment. Our purpose was to study the effect of hydroalcoholic Allium atroviolaceum L. extract on spermatogenesis in CP-treated mice.

Results

CP affected a significant decrease in sperm count, motility, viability, and morphology. Sperm count was significantly higher in the all extract groups than in the group of control (p<0.001) and CP group (p<0.001, p<0.01). Sperm motility was significantly greater in the extract (100 and 200mg/kg) groups than in the group of control (p<0.05 and <0.001). Sperm immotility and rotational movement were significantly higher in the CP group than in the CP+extract groups (p<0.001). The sperm viability was significantly greater in the CP+extract (200mg/kg) group than in the CP group (p<0.001). The number of headless sperm, sperm with initial tail, with coiled tail, and sperm with curved body, was significantly lower in the CP+extract (200mg/kg) group than in the CP group (p<0.001).

Conclusion

A. atroviolaceum extract treatment significantly improved CP-induced reproductive toxicity.