Persistent pain affects 20% of adults and can impair one’s daily functioning and well-being. Psychoeducational group interventions can be effective in aiding pain management and coping strategies, however the time commitment for most evidence-based programs (10-20 hours) leads to access barriers and delivery challenges in primary care. A mixed-methods, program evaluation was conducted on a low intensity, three-session, manualized group pilot psychoeducational intervention in a primary care practice, emphasizing pain education, behavioral strategies, and pain-alleviating activities. Eighty-two percent of the clinic’s panel of individuals with persistent pain (N=128) and being prescribed opioid pain medication attended at least one class (N=105). Attendees experienced significant pre-post improvements in self-reported pain functioning and favorable satisfaction ratings by patients and medical staff. However only 51% attended all three groups, despite frequent class offerings and heavily encourage by the patient’s medical providers. This study reviews the potential promise and limitations of a low-intensity, limited session pain group to aid pain-related functioning. Additional investigation is warranted to optimize participant attendance, group format and frequency, and outcome assessment.
Epidemic diseases contiguously propagate between propitious substances, along with sub-rosa characteristics specifically contiguousness and replication speed may expound ferocity of epidemic diseases such as COVID-19. Most likely, due to high contiguous velocity; in very short time COVID-19 may have become global pandemic disease and key menace to manhood. Deterrence of propagation may help in devastate virus transmogrify using instantaneous traceability of individualized health activities and trackability of public footprints using smart devices, radiography, and social networks.
Rationale, aims and objectives: Postoperative atrial fibrillation (POAF) is the most common complication occurring after cardiac surgery. Guidelines for the management of this complication are scarce, often resulting in differences in treatment strategy use among patients. The aims of this study were to evaluate the management of POAF in a cardiac surgery department, characterise the extent of its variability and develop a standardised protocol. Methods: Data from patients who underwent cardiac surgeries with subsequent POAF between 1 January 2017 and 1 June 2018 were analysed in this single-centre observational retrospective study. The primary outcome was the difference in the proportions of patients whose first POAF episodes were treated with a rate control (RaC) strategy, a rhythm control (RhC) strategy and both among hospital units (intensive care unit [ICU], intermediate care unit [IMCU] and general ward [GW]). Secondary outcomes included the mean duration of POAF episodes, POAF recurrences, and the management of anticoagulation. Results: Data from 97 patients were included in this study. The POAF management strategy differed significantly among hospital units (ICU: RhC 75.0%, RhC and RaC 19.4%, RaC 0.0%; IMCU: RhC 40.4%, RhC and RaC 34.6%, RaC 13.5%; GW: RhC 22.2%, RhC and RaC 33.3%, RaC 44.4%; p = 0.001). Ninety-five (97.9%) patients converted to sinus rhythm after the first POAF episode; 51.2% of these conversions occurred within 8 h after onset. POAF recurred in 56.7% of patients. Considering all POAF episodes, 83 (85.6%) patients received amiodarone as part of the RhC strategy. Based on these results, a hospital working group developed a standardised protocol for POAF management. Conclusions: POAF management was heterogeneous at our institution. This paper highlights the need for clear practice guidelines based on large prospective studies to provide care according to best practices for all patients undergoing cardiac surgery.
PURPOSE: To observe the effect of phacoemulsification and intraocular lens (IOL) implantation with or without lens capsular tension ring (CTR) on retinitis pigmentosa (RP) combined with cataract patients. DESIGN: Retrospective cases series study. METHODS: 63cases (84 eyes) of RP with cataract were collected including 30 males and 33 females. Phacoemulsification with 3.0mm clear corneal incision was performed in all the patients. IOL+CTR implantation was performed in 44 eyes, and only IOL implantation was performed in 40 eyes. All cases were followed up at 1 week and 1, 3, 6 months after the surgery to compare the best corrected visual acuity (BCVA), intraocular pressure (IOP), corneal endothelial cell count and complications before and after the surgery. RESULTS: all surgery were successfully completed by the same physician, and IOL and CTR were all implanted in capsule without complications. The BCVA at 6 months after surgery was 0.91±0.88 LogMAR. It improved a little compared with the BCVA(1.3±0.7LogMAR) before surgery and there was a signifcant difference in statistic(P=0.003). Four cases of capsule contraction syndrome(CCS) occurred in no CTR implantation group and there was no CCS in CTR group. There was signifcant difference in statistic about the incidence of CCS between two groups(P=0.047). CONCLUSIONS: Phacoemulsification for RP combined with cataract is safe and reliable, and CTR implantation is helpful to reduce the complications caused by capsule contraction.
Biomonitoring of complex heterogeneous environments is highly challenging. Fish in deep water bodies occupy different habitats, therefore a combination of survey methods has traditionally been used. Environmental DNA (eDNA) metabarcoding is a novel monitoring tool that can overcome spatial heterogeneity in a highly sensitive and entirely non-invasive manner. However, taxon detection probability is dependent on real-time environmental variables. In this study, three reservoirs were sampled in two seasons using a spatiotemporally distributed sampling design covering major environmental gradients. In all sampling campaigns, 31 fish taxa were detected which exceeded expectations. Data reliability was confirmed by a tight positive correlation between individual taxon scores derived from gillnet sampling and eDNA site occupancy. Analyses confirmed anticipated trends, such as the highest number of taxa were observed in the largest water body, and more taxa were detected in inflows and littoral regions compared to open water. The most important factors for fish distribution were temperature, age and trophic status (expressed as total Chlorophyll a concentration) of water bodies. Taxon detection reflected ecological niches of individual species, e.g. warm water wels catfish (Silurus glanis) and cold water salmonids. This study provides further evidence that eDNA metabarcoding is suitable for ecological study in heterogeneous environments and may substitute conventional fish sampling techniques.
Both aquatic and terrestrial biodiversity information can be detected in riverine water environmental DNA (eDNA). However, the monitoring effectiveness (i.e., the proportion of aquatic and terrestrial biodiversity information detected in riverine water eDNA samples) is unknown. To investigate the monitoring effectiveness, we introduced the concept of watershed biological information flow (WBIF) and proposed that the monitoring effectiveness depended on the transportation effectiveness of the WBIF. Then, the monitoring effectiveness could be assessed in the WBIF framework. Here, we conducted a monitoring effectiveness assessment case study in a watershed on the Qinghai-Tibet Plateau according to analysis of the bacterial operational taxonomic unit (OTU) assemblages detected in riverine water eDNA samples and riparian soil eDNA samples during three seasons. The results showed that (1) the downstream-to-upstream monitoring effectiveness: only 76% of the bacterial OTUs could be detected 1 km downstream in spring and more than 97% and 96% could be detected in summer and autumn, respectively. (2) The river-to-land monitoring effectiveness: more than 62% of the bacterial OTUs in riparian soil eDNA samples could be detected in adjacent riverine water eDNA samples on rainy summer days and 16% and 48% could be detected on cloudy spring and autumn days, respectively. These results suggested that riverine water eDNA was viable for simultaneously monitoring aquatic and terrestrial bacterial biodiversity and that rainy days in summer or autumn were suitable sampling times on the Qinghai-Tibet Plateau. More studies on monitoring effectiveness in other taxonomies and in other watersheds with different climatic conditions are needed.
Arabidopsis Casparian strip membrane domain proteins (CASPs) form a transmembrane scaffold to recruit lignin biosynthetic enzymes for Casparian strip (CS) formation. Compared with Arabidopsis, rice root is more complex with a CS of the exodermis and sclerenchyma and a CS that does not block propidium iodide entry into the stele. Rice CASP1 is highly similar to AtCASPs, but it is not required for CS formation. Its mutation results in early leaf senescence and fewer tillers and does not change the CS structure and permeability. OsCASP1 is mainly located in the nuclear membrane. Its expression is concentrated in the root stele and at small lateral root tips and can be induced by salt stress. OsCASP1 mutation causes ectopic suberin deposition in small lateral roots and ion imbalances in the plant. Homeostatic disorder induces nutrient recycling and accelerate leaf senescence. To our knowledge, OsCASP1 is the first CASP to be described in the nuclear membrane; it modulates suberin deposition and does not involve CS formation, representing a novel regulatory mode of CASPs.
Deep learning has the potential to revolutionize process analytical technology in the pharmaceutical industry. Here, we used Raman spectroscopy-based deep learning strategies to develop a tool for detecting microbial contamination. We built a Raman dataset for microorganisms that are common contaminants in the pharmaceutical industry for Chinese Hamster Ovary (CHO) cells, which are often used in the production of biologics. Using a convolution neural network (CNN), we classified the different samples comprising individual microbes and microbes mixed with CHO cells with an accuracy of 95-100%. The set of 12 microbes spans across Gram-positive and Gram-negative bacteria as well as fungi. We also created an attention map for different microbes and CHO cells to highlight which segments of the Raman spectra contribute the most to help discriminate between different species. This dataset and algorithm provide a route for implementing Raman spectroscopy for detecting microbial contamination in the pharmaceutical industry.
Reactivity of thymine peroxy radical in DNA and its fate under hypoxia or oxygen-less conditions are studied at the M06-2X/6-31+G(d,p) level. The spaciously most accessible H2’ can be abstracted by C6-peroxy radical in an intranucleotidyl manner with the estimated barriers of 18.8 ~ 21.1 kcal/mol. The calculations show that C6-peroxy radical has a highly more reactivity towards C(sp3)-H abstraction reactions than its relative C6-yl, which is a counter-intuitive case. The formed hydroperoxide with the C6-OaObH2’ constituent can fast transfer ObH2’ group to C2’ radical in an intranucleotidyl manner with a low barrier (ca. 13.2 kcal/mol) and very strong heat release. The results show that the formed hydroperoxide product is unstable so that it could be quickly transformed into other species and thus is very hard to be experimentally observed. Afterwards, H2’ can be again abstracted by C6-oxyl radical to result in formation of thymine glycol which is the main products. The parallel C5-C6 bond scission reaction leads to formation of the precursor for 5-hydroxy-5-methylhydantion. The two competitive reactions have very low barriers. Based on our present calculations, the new radical reaction paths to formation of the DNA oxidation products are suggested under hypoxia or oxygen-less conditions, which is different from the previously suggested paths under high oxygen concentration surroundings.
The biological reduction of ferrous ethylenediaminetetraacetic acid (EDTA-FeII-NO and EDTA-FeIII) is an important process in integrated electrobiofilm reduction method, and this method has been regarded as a promising alternative for removing NOx from industrial boiler flue gas. EDTA-FeII-NO and EDTA-FeIII are crucial substrates that should be biologically reduced at a high rate. However, they would inhibit one another’s reduction processes when they are present together, which might limited the further promotion of this integrated method. In this study, an integrated electrobiofilm reduction system with high reduction rate of EDTA-FeII- NO and EDTA-FeIII was established. The microbial communities in electrobiofilms were mainly studied to analyze their changes during the reduction of these two substrates under different conditions. It presents a better performance of substrates- resistance shock loading and high microbial diversities compared with the conventional chemical absorption-biological reduction system. High-throughput sequencing analysis showed that the changes in concentrations of EDTA-FeII-NO and EDTA-FeIII significantly impacted the genera of the microbial community. Alicycliphilus, Enterobacteriaceae and Raoultella were found to be the dominant genera (>25%, respectively) involved in EDTA-FeII-NO reduction. As an EDTA-FeIII reducing bacteria, Chryseobacterium can endure shock loading of substrates. Ochrobactrum can reduce nitrate using electrons and exhibited better stability under shock loading. Furthermore, higher microbial diversity and stable reactor operation could be achieved when the concentrations of EDTA-FeII-NO and EDTA-FeIII approached the same value.
The mountains of southern China are an excellent system for investigating the processes driving the geographic distribution of biodiversity and radiation of plant populations in response to Pleistocene climate fluctuations. How the key mountain ranges in southern China have affected the evolution of narrowly distributed species is less studied than more widespread species. Here we focused on Cercis chuniana, a woody species endemic to the southern mountain ranges in subtropical China, to elucidate its population dynamics. We used genotyping by sequencing (GBS) to investigate the spatial pattern of genetic variation among 11 populations. Bayesian time estimation revealed that population divergence occurred in the middle Pleistocene, when populations in the Nanling Mts. separated from those to the east. Geographical isolation was detected between the populations located in adjacent mountain ranges, thought to function as geographical barriers due to their complex physiography. As inferred by ecological niche modeling and coalescent simulations, secondary contact occurred during the warm Lushan-Tali interglacial period in China, with intensified East Asia summer monsoon and continuous habitat available for occupation. Complex physiography plus long-term stable ecological conditions across glacial cycles facilitated the demographic expansion in the Nanling Mts., from which contemporary migration began. Our work shows that population genomic approaches are effective in detecting the population dynamics of narrowly distributed species. This study advances our understanding how glacial cycles have affected the evolutionary history of plant species in southern China montane ecosystems.
Updated, peer reviewed and published at Canadian Journal of Medicinehttps://cjm.cikd.ca/article_60573.htmlUntil recently, ibuprofen has been avoided in all COVID-19 protocols world-wide. The author has been trying since March, 2020 to publish a paper that disputes this unfortunate incident and he finally managed since May 2020 to publish two manuscripts that not only prove non-steroidal anti-inflammatory drugs not harmful for COVID-19, rather they were shown to possess a potential to cure the disease based on a unique new theory suggested to explain COVID-19 pathogenesis and he suggested NSAIDs to be added to unique protocol he suggested using nitazoxanide/azithromycin to manage early cases of COVID-19. In this manuscript, considered the fourth related to the subject, the author represents the first clinical results of using NSAIDs/Nitazoxanide/Azithromycin protocol, used partly or fully, that includes relatively cheap FDA approved drugs used in seventeen Egyptian patients, whether confirmed or suspected, including children, adults and two pregnant ladies whom have been mostly symptoms-free in five days. The manuscripts also presents a road-map to illustrate how to deal efficiently with early cases of COVID-19 according to the author’s clinical experience.
γ-Aminobutyric acid (GABA) is a non-protein amino acid produced from the decarboxylation of glutamate by glutamate decarboxylase. Corynebacterium glutamicum is the most promising host of γ-aminobutyric acid production for its inherent glutamate precursor supply. However, the intracellularly expressed glutamate decarboxylase in C. glutamicum showed the weak catalysis capacity on the conversion of glutamate to γ-aminobutyric acid. Here we designed an different catalysis scenario by secretively overexpressing the glutamate decarboxylase in C. glutamicum and moving the decarboxylation reaction into the extracellular space for GABA synthesis. A signal peptide in the expression cassette directed the successful secretion of glutamate decarboxylase in C. glutamicum. The extracellular catalysis by secreted glutamate decarboxylase increased the γ-aminobutyric acid generation by three-folds, comparing with that by intracellular catalysis. Further efforts on enhancing the expression of glutamate decarboxylase and decreasing the degradation of γ-aminobutyric acid improved γ-aminobutyric acid generation by 39%. The fed-batch fermentation of the engineered C. glutamicum strain reached the record high titer (77.6g /L), overall yield (0.37 g/g glucose), and productivity (1.21 g/L/h) of γ-aminobutyric acid production. This study demonstrated a unique design of extracellular catalysis for efficient γ-aminobutyric acid production by C. glutamicum.
Stings from certain species of cubozoan jellyfish are dangerous to humans and their seasonal presence in tropical marine waters poses a significant risk to coastal communities. The detection of cubozoans is difficult due to high spatial and temporal variation in their occurrence and abundance. Environmental DNA (eDNA) has the potential to detect rare species and therefore offers potential to detect cubozoans, not only pelagic medusae, but presence of cryptic polyp life-stages. The objective of this study was to validate the use of eDNA as a viable detection method for four cubozoan species (Chironex fleckeri, Copula sivickisi, Carybdea xaymacana and Carukia barnesi). Species-specific primers were developed for each of these four cubozoans and an eDNA approach validated utilising both laboratory and field trials. Laboratory DNA degradation experiments demonstrated that C. sivickisi DNA degraded quickly but could still be detected in sea water for up to 9 days post-jellyfish removal. Positive detection was found for C. fleckeri, C. xaymacana and C. sivickisi medusae in the waters surrounding Magnetic Island, Queensland, in the Austral spring/summer (September-January). Based on visual surveys there was a poor relationship between concentration of eDNA and abundance of jellyfish. Positive eDNA amplification was also shown near the substratum when C. sivickisi medusae were absent. This can only be explained by the detection of polyps. Consequently, eDNA is an effective tool to detect both the medusae and polyps of cubozoans. This approach provides the means to reduce the risk of envenomation to swimmers and enhance our knowledge of cubozoan ecology.
Rationale, aims and objectives: Appropriate treatment of paediatric fever in rural areas remains a challenge and may be partly due to inadequate supervision of licensed drug sellers. This study assessed the effectiveness of peer-supervision among drug sellers on appropriate treatment of pneumonia symptoms, uncomplicated malaria and non-bloody diarrhoea among children less than five years of age in the intervention (Luuka) and comparison (Buyende) districts, in East-Central Uganda. Methods: Data on pneumonia symptoms, uncomplicated malaria and non-bloody diarrhoea among children less than five years of age was abstracted from drug shop sick child registers over a 12-month period; six months before and six months after introduction of peer-supervision. Interrupted time series was applied to determine the effectiveness of the peer-supervision intervention on appropriate treatment of pneumonia, uncomplicated malaria and non-bloody diarrhoea among children less than five years of age attending drug shops in East Central Uganda. Results: The proportion of children treated appropriately for pneumonia symptoms was 10.84% (P<0.05, CI = [1.75, 19.9]) higher, for uncomplicated malaria was 1.46% (P = 0.79, CI = [-10.43, 13.36]) higher, and for non-bloody diarrhoea was 4.00% (p <0.05, CI = [-7.95, -0.13]) lower in the intervention district than the comparison district, respectively. Post-intervention trend results showed an increase of 1.21% (p =0.008, CI = [0.36, 2.05]) in the proportion appropriately treated for pneumonia symptoms, no difference in appropriate treatment for uncomplicated malaria, and a reduction of 1% (p <0.06, CI = [-1.95, 0.02]) in the proportion of children appropriately treated for non-bloody diarrhoea, respectively. Conclusions: Peer-supervision increased the proportion of children less than five years of age that received appropriate treatment for pneumonia symptoms but not for uncomplicated malaria and non-bloody diarrhoea. Implementation of community level interventions to improve paediatric fever management should consider including peer-supervision among drug sellers.
Intestine regeneration in the sea cucumber Apostichopus japonicus is a fascinating biological event and a typical example for studying host-intestinal microbiota interactions. The intestinal microbiota may play important roles in developing intestine promotion, but the underlying mechanism remains unclear. Notably, altered microbiota abundance may be a key marker of the observed ecosystem. To understand the role of the developing intestinal microbiota in intestine regeneration via quantitative data, we developed a germ-free sea cucumber model and analyzed the intestinal microbial differentiation of faster and slower regenerating A. japonicus individuals during intestine regeneration. The results revealed that depletion of the intestinal microbiota resulted in elevated abundance of the potential key players Flavobacteriaceae and Rhodobacterales during intestine regeneration and thus promoted the intestine regeneration rate of A. japonicus. These results first revealed a direct link between intestinal microbial quantity and microbiome features and the intestinal regrowth rate of A. japonicus. Metagenomic analysis revealed that the increased abundance of Flavobacteriaceae elevated the enrichment of genes associated with carbohydrate utilization, whereas the abundant Rhodobacteraceae -enriched genes were associated with polyhydroxybutyrate production. We identified microbiota abundance as a key driver of microbial community alterations, especially beneficial microbiota members, in the developing intestine of A. japonicus. This study provides new insights into the mechanism of host-microbiota interactions related to intestine development, and the understanding of molecular diversity to questions within intestinal ecology.