Histological characterization and development of mesial surface sulci in the human brain at 13-15 gestational weeks through high-resolution histology

Cellular-level anatomical data from early fetal brain are sparse yet critical to the understanding of neurodevelopmental disorders. We characterize the organization of the human cerebral cortex between 13 and 15 gestational weeks using high-resolution whole-brain histological data sets complimented with multimodal imaging. We observed the heretofore underrecognized, reproducible presence of infolds on the mesial surface of the cerebral hemispheres. Of note at this stage, when most of the cerebrum is occupied by lateral ventricles and the corpus callosum is incompletely developed, we postulate that these mesial infolds represent the primordial stage of cingulate, callosal, and calcarine sulci, features of mesial cortical development. Our observations are based on the multimodal approach and further include histological three-dimensional reconstruction that highlights the importance of the plane of sectioning. We describe the laminar organization of the developing cortical mantle, including these infolds from the marginal to ventricular zone, with Nissl, hematoxylin and eosin, and glial fibrillary acidic protein (GFAP) immunohistochemistry. Despite the absence of major sulci on the dorsal surface, the boundaries among the orbital, frontal, parietal, and occipital cortex were very well demarcated, primarily by the cytoarchitecture differences in the organization of the subplate (SP) and intermediate zone (IZ) in these locations. The parietal region has the thickest cortical plate (CP), SP, and IZ, whereas the orbital region shows the thinnest CP and reveals an extra cell-sparse layer above the bilaminar SP. The subcortical structures show intensely GFAP-immunolabeled soma, absent in the cerebral mantle. Our findings establish a normative neurodevelopment baseline at the early stage.

Association between body composition and mortality in patients requiring extracorporeal membrane oxygenation support

AIM

To ascertain the association between body composition, including muscle mass and adiposity, and patient mortality in those requiring extracorporeal membrane oxygenation (ECMO) for acute respiratory failure.

MATERIALS AND METHODS

A retrospective study was undertaken of all patients with acute respiratory failure requiring veno-venous (VV) ECMO between January 2015 and December 2019. Automated image segmentation software was used to quantify the cross-sectional area and average radiodensity (in Hounsfield units) of different muscle and fat compartments at the L3 level of whole-body computed tomography (CT) images taken within 48 h of initiation of ECMO support. The primary endpoint was 30-day post-ECMO initiation all-cause mortality. Logistic regression was used to analyse the correlation between CT measurements, co-morbidities, and 30-day survival.

RESULTS

The study included 189 patients (age = 43.8 ± 14.6, sex = 42.3% female). There was no significant association between 30-day survival status and cross-sectional area of muscle or fat. Muscle attenuation (psoas, long spine, and abdominal muscles respectively) at the L3 level were significantly lower in those who died within 30 days of ECMO cannulation (p<0.05). On multivariable analysis including age, sex, and pre-existing respiratory comorbidities, psoas muscle attenuation was an independent predictor of survival at 30 days (OR 0.97; 95% CI 0.94 to 1.00; p=0.047).

CONCLUSIONS

Reduced psoas muscle attenuation is associated with poorer survival outcomes at 30 days post-ECMO cannulation in patients who received VV ECMO support for respiratory failure. Cross-sectional areas of muscle and fat compartments did not correlate with survival outcomes at 30 days even when corrected for height and sex.

Age-related changes in responsiveness to non-invasive brain stimulation neuroplasticity paradigms: A systematic review with meta-analysis

OBJECTIVES

We aimed to summarise and critically appraise the available evidence for the effect of age on responsiveness to non-invasive brain stimulation (NBS) paradigms delivered to the primary motor cortex.

METHODS

Four databases (Medline, Embase, PsycINFO and Scopus) were searched from inception to February 7, 2023. Studies investigating age group comparisons and associations between age and neuroplasticity induction from NBS paradigms were included. Only studies delivering neuroplasticity paradigms to the primary motor cortex and responses measured via motor-evoked potentials (MEPs) in healthy adults were considered.

RESULTS

39 studies, encompassing 40 experiments and eight NBS paradigms were included: paired associative stimulation (PAS; n = 12), repetitive transcranial magnetic stimulation (rTMS; n = 2), intermittent theta burst stimulation (iTBS; n = 8), continuous theta burst stimulation (cTBS; n = 7), transcranial direct and alternating current stimulation ((tDCS; n = 7; tACS; n = 2)), quadripulse stimulation (QPS; n = 1) and i-wave periodic transcranial magnetic stimulation (iTMS; n = 1). Pooled findings from PAS paradigms suggested older adults have reduced post-paradigm responses, although there was considerable heterogeneity. Mixed results were observed across all other NBS paradigms and post-paradigm timepoints.

CONCLUSIONS/SIGNIFICANCE

Whilst age-dependent reduction in corticospinal excitability is possible, there is extensive inter- and intra-individual variability both within and between studies, making it difficult to draw meaningful conclusions from pooled analyses.

Ni doping induced property enhancement in laser ablated BaSnO3 films suitable for optoelectronic applications

Pulsed laser deposition is a straightforward approach for preparing films with superconducting to dielectric properties with atomic layer precision. The deep-seated mechanisms involved in the particle transport from target to substrate and subsequent film formation still need to be fully comprehended. This manuscript reports the property enhancement observed in laser ablated perovskite BaSnO3 films with Ni doping. Films' crystallinity improvement is observed, and an intensity enhancement of 1150% is observed on 3 mol% Ni-doping. The optimum Ni-doping concentration in BaSnO3 is found to be 3 mol%. Herein, Ni-doped BaSnO3 films deposited by PLD showed an unusual increase in film thickness (i.e., from 615 nm in the pure film to 1317 nm in the film with 7 mol% Ni-doping as revealed by lateral SEM analysis and spectroscopic ellipsometry). We propose an "Induced Magnetic field-assisted Particle Convergence (IMPC)" effect for this superficial growth enhancement. The film's optical properties are modified with an increased nickel doping level, and the bandgap energy shows renormalization. All the films show excellent transmittance (80-90%) in the Vis.-NIR region. Hall-effect measurement reveals the increased carrier concentration by three orders (2.98 × 1011 to 3.50 × 1014 cm-3). In addition, the enhancement in mobility from 3.13 to 20.93 cm2V-1s-1 and a decrease in electrical resistivity by six orders (i.e., from 4.05 × 109 to 1.13 × 103 Ω cm) are observed on 7 mol% Ni doping. XPS measurements reveals that the Ba, Sn and Ni ions are at 2+, 4+ and 2+ oxidation states. Using spectroscopic ellipsometric method, we estimated the optical constants of the films, the refractive index, dielectric constant, and extinction coefficient show a normal dispersion behavior. The high crystallinity, high transmittance, suitable surface topography, and improved electrical performances of the Ni-doped BaSnO3 films make them excellent candidates for optoelectronic devices and solar cells.

Use of endoscopic plication to repair a dysfunctional gastric conduit

Video 1Full length video showing the use of endoscopic plication to repair a dysfunctional gastric conduit.

Impact of Severe Weather on Operations of a Radiation Oncology Department

PURPOSE/OBJECTIVE(S)

In 2022, two major storms in Western New York brought blizzard conditions and historic snowfall amounts to the region. Beyond the immediate impact to life and property, these weather events resulted in disruptions to cancer care as a result of hazardous travel conditions, and facility closures as a result of regional travel bans. We sought to understand the impact of these disruptive incidents on departmental operations to develop better contingency plans for future occurrences.

MATERIALS/METHODS

The radiation treatment machine schedules for a large academic center in Western New York, as well as a neighboring affiliated satellite clinic were queried for daily treatment adherence rates from November 1, 2022 through February 4, 2023. We classified "severe weather days" based on travel advisories issued by the National Weather Service or from local county officials. Out of a total of 68 working days during the study period, 15 days were classified as having severe weather. We compared the percentage of scheduled patients treated (adherence rates) on severe weather days compared with days without severe weather. Statistical analysis was performed using a two-tailed Z-test for proportions.

RESULTS

Under routine operating conditions, out of a total of 7045 scheduled treatment visits, we found a mean daily treatment adherence rate of 93.57%. On severe weather days, out of a total of 2093 scheduled treatments, we found a mean daily treatment adherence rate of 77.83%. Out of these 15 days, the satellite clinic closed for a total of 3 days, while the academic center closed for 1 day. Excluding the dates of facility closure, overall treatment adherence rate was 84.76% on severe weather days (Risk Ratio: 0.91). We found that the difference in treatment adherence rates between regular and severe weather days was statistically significant (p<0.001), even when excluding dates of facility closure.

CONCLUSION

This study demonstrates a significant reduction in treatment adherence rates around severe winter storms, even when excluding dates of facility closure. We suggest that preparation for such incidents be a part of facility contingency planning. Weekend openings can be considered for closures ≥ 2 days, or sustained adherence rates of 85% or less for 3 or more days.

Disease burden, comorbidities and antecedents of chronic cough phenotypes in Australian adults

BACKGROUND AND OBJECTIVES

While adult chronic cough has high burden, its phenotypes, particularly those without aetiologically related underlying conditions, are understudied. We investigated the prevalence, lung function and comorbidities of adult chronic cough phenotypes.

METHODS

Data from 3608 participants aged 53 years from the Tasmanian Longitudinal Health Study (TAHS) were included. Chronic cough was defined as cough on most days for >3 months in a year. Chronic cough was classified into "explained cough" if there were any one of four major cough-associated conditions (asthma, COPD, gastroesophageal reflux disease or rhinosinusitis) or "unexplained cough" if none were present. Adjusted regression analyses investigated associations between these chronic cough phenotypes, lung function and non-respiratory comorbidities at 53 years.

RESULTS

The prevalence of chronic cough was 10% (95%CI 9.1,11.0%) with 46.4% being "unexplained". Participants with unexplained chronic cough had lower FEV1/FVC (coefficient: -1.2% [95%CI:-2,3, -0.1]) and increased odds of comorbidities including obesity (OR=1.6 [95%CI: 1.2, 2.3]), depression (OR=1.4 [95%CI: 1.0, 2.1]), hypertension (OR=1.7 [95%CI: 1.2, 2.4]) and angina, heart attack or myocardial infarction to a lesser extent, compared to those without chronic cough. Participants with explained chronic cough also had lower lung function than both those with unexplained chronic cough and those without chronic cough.

CONCLUSIONS

Chronic cough is prevalent in middle-age and a high proportion is unexplained. Unexplained cough contributes to poor lung function and increased comorbidities. Given unexplained chronic cough is not a symptom of major underlying respiratory conditions it should be targeted for better understanding in both clinical settings and research.

Experimental investigation on sucrose/alumina catalyst coated converter in gasoline engine exhaust gas

In this study, a modified catalytic converter was employed to treat the harmful exhaust gas pollutants of a twin-cylinder, four-stroke spark-ignition engine. This research mainly focuses on the emission reduction of unburnt hydrocarbons, carbon monoxide, and nitrogen oxides at low light-off temperatures. A sucrolite catalyst (sucrolite) was coated over the metallic substrate present inside the catalytic converter, and exhaust gas was allowed to pass through it. A scanning electron microscope, X-ray diffraction, and Fourier transform infrared spectroscopy were used to investigate the changes in morphology, chemical compounds, and functional group elements caused by the reactions. Catalytic reactions were studied by varying the engine loads and bed temperatures, and the results were compared with those of the commercial catalytic converter. The results show that sucrose present in the catalyst was suitable at low temperatures while alumina was suitable for a wide range of temperatures. In the case of the modified catalytic converter, the maximum catalytic conversion efficiencies achieved for oxidizing CO and HC were 70.73% and 85.14%, respectively, and for reduction reaction at NO_x was 60.22% which is around 42% higher than in commercial catalytic converter. As a result, this study claims that sucrolite catalyst is effective for low-temperature exhaust gas.

Forecasting Particulate Matter Emissions Using Time Series Models

Environmental pollution is a serious concern nowadays with its disastrous impact on living organisms. In several types of pollution, Air pollution takes on a crucial role by directly affecting the respiratory system and causing fatal diseases in humans. Air pollution is a mixture of gaseous and particulate matter interweaved by different sources and emanating into the atmosphere. In particular, particle pollutants are critical in growing air pollution in India’s main cities. Forecasting the particulate matter could mitigate the complications caused by it. The employment of a model to predict future values based on previously observed values is known as time series forecasting. In this paper, the PM2.5 pollutant emission data recorded at the Kodungaiyur region of Chennai city were forecasted using three-time series models. The standard ARIMA model is compared with the deep learning-based LSTM model and Facebook’s developed Prophet algorithm. This comparison helps to identify an appropriate forecasting model for PM2.5 pollutant emission. The Root Mean Squared Error (RMSE) acquired from experimental findings is used to compare model performances.

Study on Effectiveness of Intervention of a Vertical Flow Constructed Wetland in between Septic Tank and Soak Pit for the Treatment of Septic Tank Effluent

Septage comprises the solid and liquid constituents of any primary treatment system, including a Septic Tank. In this study, the wastewater collected from a septic tank is passed through a partially converted anaerobic filter, and a vertical flow constructed wetland (VFCW) before being sent to a soak pit. The main objective of this case study was to check the effectiveness of incorporating a VFCW between a septic tank and a soak pit to bring down the consequences created due to effluent seepage from soak pits to the groundwater. Conventionally, the effluent gets directly passed to soak pits after primary onsite treatment in the septic tank. The soak pit walls made of porous materials allow the gradual seepage of final effluent into the ground, polluting the groundwater reserves. We analyzed the septic tank effluent from 60 households wherein the effluent was let off into the soak pits. The various parameters analyzed with their averages were 393.83 ± 293.41 mg.L-1 for COD, 151.48 ± 94.37 mg.L-1 for BOD, 30.81 ± 13.05 mg.L-1 for NO3-, 23.35 ± 13.54 mg.L-1 for PO43-, 7.35 ± 0.31 for pH, 184.05 ± 163.20 mg.L-1 for TSS, 3.05 x 107± 2.04 x 108 CFU.100mL-1 for TC. Therefore, it is certain that the final effluent being sent into soak pits after primary treatment does not meet the Central Pollution Control Board (CPCB) discharge standards. In this case study, we were able to obtain final effluent values after VFCW treatment as 55.72 mg.L-1 for COD, 12.12 mg.L-1 for BOD, 10.2 mg.L-1 for NO3-, 3.74 mg.L-1 for PO43-, 7.41 for pH, 8.37 mg.L-1 for TSS, 379.27 mg.L-1 for TS and 51.9 CFU.100mL-1 for TC. With this case study, we were able to resolve this impediment by bringing down the values of all the parameters considered while analyzing under the limits of discharge standards set by CPCB. The removal efficiency of COD, BOD, NO3-, PO43-, pH, TSS, and TC after wetland was found to be 89.46%, 88.051, 63.484, 44.37%, 3.41%, 98.47%, 97.71%, 97.19% respectively. The study has proven that with the introduction of another decentralized treatment system between a septic tank and soak pit, it is safe to dispose of the effluent into soak pits, thereby reducing the chances of groundwater pollution considerably.

Deep-HAR: an ensemble deep learning model for recognizing the simple, complex, and heterogeneous human activities

The recognition of human activities has become a dominant emerging research problem and widely covered application areas in surveillance, wellness management, healthcare, and many more. In real life, the activity recognition is a challenging issue because human beings are often performing the activities not only simple but also complex and heterogeneous in nature. Most of the existing approaches are addressing the problem of recognizing only simple straightforward activities (e.g. walking, running, standing, sitting, etc.). Recognizing the complex and heterogeneous human activities are a challenging research problem whereas only a limited number of existing works are addressing this issue. In this paper, we proposed a novel Deep-HAR model by ensembling the Convolutional Neural Networks (CNNs) and Recurrent Neural Networks (RNNs) for recognizing the simple, complex, and heterogeneous type activities. Here, the CNNs are used for extracting the features whereas RNNs are used for finding the useful patterns in time-series sequential data. The activities recognition performance of the proposed model was evaluated using three different publicly available datasets, namely WISDM, PAMAP2, and KU-HAR. Through extensive experiments, we have demonstrated that the proposed model performs well in recognizing all types of activities and has achieved an accuracy of 99.98%, 99.64%, and 99.98% for simple, complex, and heterogeneous activities respectively.

Silver nanoparticles modified ZnO nanocatalysts for effective degradation of ceftiofur sodium under UV-vis light illumination

Light-induced photocatalytic degradation of ceftiofur sodium (CFS) has been assessed in the presence of plasmonic zinc oxide nanostructures (ZnONSTs), like, ZnO nanoparticles, ZnO nanorods (ZnONRs) and ZnO nanoflowers (ZnONFs). Silver nanoparticles (Ag NPs) loaded ZnO nanostructures (Ag-ZnONSTs) are obtained through seed-assisted chemical reaction followed by chemical reduction of silver. The surface modification of ZnO nanostructures by Ag NPs effectually altered their optical properties. Further, the surface plasmonic effect of Ag NPs facilitates visible light absorption by ZnONSTs and improved the photogenerated electron and hole separation, which makes the ZnONSTs a more active photocatalyst than TiO₂ (P25) nanoparticles. Especially, Ag-ZnONRs showed higher CFS oxidation rate constant (k' = 4.6 × 10^-4 s^-1) when compared to Ag-ZnONFs (k' = 2.8 × 10^-4 s^-1) and Ag-ZnONPs (k' = 2.5 × 10^-4 s^-1), owing to their high aspect ratio (60:1). The unidirectional transport of photogenerated charge carriers on the Ag-ZnONRs may be accountable for the observed high photocatalytic oxidation of CFS. The photocatalytic oxidation of CFS mainly proceeds through ^•OH radicals generated on the Ag-ZnONRs surface under light illumination. In addition, heterogeneous activation of peroxymonosulfate by Ag-ZnONRs accelerates the rate of photocatalytic mineralization of CFS. The quantification of oxidative radicals supports the proposed CFS oxidation mechanism. Stability studies of plasmonic Ag-ZnONSTs strongly suggests that it could be useful to clean large volume of pharmaceutical wastewater under direct solar light irradiation.

Microbial strategies for degradation of microplastics generated from COVID-19 healthcare waste

COVID-19 pandemic has led to the generation of massive plastic wastes, comprising of onetime useable gloves, masks, tissues, and other personal protective equipment (PPE). Recommendations for the employ of single-use disposable masks made up of various polymeric materials like polyethylene, polyurethane, polyacrylonitrile, and polypropylene, polystyrene, can have significant aftermath on environmental, human as well as animal health. Improper disposal and handling of healthcare wastes and lack of proper management practices are creating serious health hazards and an extra challenge for the local authorities designated for management of solid waste. Most of the COVID-19 medical wastes generated are now being treated by incineration which generates microplastic particles (MPs), dioxin, furans, and various toxic metals, such as cadmium and lead. Moreover, natural degradation and mechanical abrasion of these wastes can lead to the generation of MPs which cause a serious health risk to living beings. It is a major threat to aquatic lives and gets into foods subsequently jeopardizing global food safety. Moreover, the presence of plastic is also considered a threat owing to the increased carbon emission and poses a profound danger to the global food chain. Degradation of MPs by axenic and mixed culture microorganisms, such as bacteria, fungi, microalgae etc. can be considered an eco-sustainable technique for the mitigation of the microplastic menace. This review primarily deals with the increase in microplastic pollution due to increased use of PPE along with different disinfection methods using chemicals, steam, microwave, autoclave, and incineration which are presently being employed for the treatment of COVID-19 pandemic-related wastes. The biological treatment of the MPs by diverse groups of fungi and bacteria can be an alternative option for the mitigation of microplastic wastes generated from COVID-19 healthcare waste.

Routine whole-body CT identifies clinically significant findings in patients supported with veno-venous extracorporeal membrane oxygenation

AIM

To determine the yield of routine whole-body computed tomography (CT) following extracorporeal membrane oxygenation (ECMO) initiation and to assess the association of these findings with prognosis.

MATERIALS AND METHODS

One hundred and ninety-eight consecutive patients with acute respiratory failure admitted for ECMO support between January 2015 and December 2019 who underwent whole-body CT performed within 48 h of ECMO initiation were examined in this single-institution retrospective study. CT findings were divided into three categories: clinically significant findings that may affect immediate management strategy or short-term outcomes; findings not related to hospital stay or outcome but require further workup; and benign findings that do not require further investigation. Logistic regression analysis was used to assess the association of CT findings with 7- and 30-day survival.

RESULTS

Clinically significant findings were present in 147 (74%) patients, findings requiring further workup were found in 82 (41%) patients, and benign findings were identified in 180 (90%) of the patients. Patients with clinically significant neurological findings had an elevated risk of death at 7 days (odds ratio [OR] 3.58; 95% confidence interval [CI] 1.29; 9.93; p=0.01), but not 30 days. Increasing numbers of clinically significant findings were associated with greater odds of mortality at 7 days (OR 1.70; 95% CI 1.08; 2.67; p=0.02) and 30 days (OR 1.41; 95% CI 1.02; 1.96; p=0.04).

CONCLUSIONS

Imaging patients at the point of admission for VV-ECMO with CT frequently identified clinically significant abnormalities with prognostic implications of these. These findings provide support for the use of more routine CT at the point of treatment escalation with prospective studies now required.

A Computer-Aided Markov Random Field Segmentation Algorithm for Assessing Fetal Ventricular Chambers

Congenital heart disease (CHD) is the most widely occurring congenital defect and accounts to about 28% of the overall congenital defects. Analysis of the development of the fetal heart thus plays an important role for detection of abnormality in early stages and to take corrective measures. Cardiac chamber analysis is one of the important diagnosing methods. Segmentation of the cardiac chambers must be done appropriately to avoid false interpretations. Effective segmentation of fetal ventricular chambers is a challenging task as the speckle noise inherent in ultrasound images cause blurring of the boundaries of anatomical structures. Several segmentation techniques have been proposed for extracting the fetal cardiac chambers. This article discusses the performance evaluation of automated, probability based segmentation approach, and Markov random field (MRF) for segmenting the fetal ventricular chambers of ultrasonic cineloop sequences. 837 ultrasonic biometery sequences of various gestations were collected from local diagnostic center after due ethical clearance and used for the study. In order to assess the efficiency of the segmentation technique, four metrics such as dice coefficient, true positive ratio (TPR), false positive ratio (FPR), similarity ratio (SIR), and precision (PR) were used. In order to perform ground truth validation, 56% of the data used in this study were annotated by clinical experts. The automated segmentation yielded comparable results with manual annotation. The technique results in average value of 0.68 for Dice coefficient, 0.723 for TPR, 0.604 for SIR, and 0.632 for PR.

APOE genotype and biological sex regulate astroglial interactions with amyloid plaques in Alzheimer's disease mice

The most significant genetic risk factor for developing late-onset Alzheimer's disease (AD) is the ε4 allele of apolipoprotein E (APOE4). APOE genotype and biological sex are key modulators of microglial and astroglial function, which exert multiple effects on AD pathogenesis. Here, we show astroglial interactions with amyloid plaques in the EFAD transgenic mouse model of AD. Using confocal microscopy, we observed significantly lower levels of astrocytic plaque coverage and plaque compaction (beneficial effects of glial barrier formation) with APOE4 genotype and female sex. Conversely, neurite damage and astrocyte activation in the plaque environment were significantly higher in APOE4 carriers and female mice. Astrocyte coverage of plaques was highest in APOE3 males and poorest in APOE4 females. Collectively, our findings provide new insights into the roles of astroglia and highlight the importance of addressing independent and interactive effects of APOE genotype and biological sex in understanding processes contributing to AD pathogenesis.

Phthalate migration and its effects on poly(vinyl chloride)-based footwear: pathways, influence of environmental conditions, and the possibility of human exposure

The study of phthalate migration in footwear is important from an environmental viewpoint and the consumer health perspective as it remains in direct contact with the user for a long time. In this research article, the migration of phthalate, specifically di-(2-ethylhexyl) phthalate (DEHP), from the poly(vinyl chloride) (PVC) shoe sole to the attached leather insole has been studied for six months under different environmental conditions. After one month, the DEHP concentration in the PVC sole decreased by 45-58%, and that in the leather insole increased from 0.35 mg g^-1 to 38-58 mg g^-1. After six months, about 90% of the DEHP has been lost from the PVC sole, and that in the leather insole reached close to its initial value (value before the experiment). The migration rate depends on the environmental conditions and the presence of phthalate soluble solvents in the sole-adhesive-insole system of the footwear. The influence of DEHP migration on the physicochemical characteristics of the PVC sole and leather insole has been studied by Fourier transform infrared spectroscopy-attenuated total reflectance (FTIR-ATR), thermo-gravimetric analysis (TGA), and differential scanning calorimetry (DSC). The migration and emission pathways of DEHP, the influence of environmental conditions, and the possibility of human exposure to phthalate through footwear are discussed.

Current advances and research prospects for agricultural and industrial uses of microbial strains available in world collections

Microorganisms are an important component of the ecosystem and have an enormous impact on human lives. Moreover, microorganisms are considered to have desirable effects on other co-existing species in a variety of habitats, such as agriculture and industries. In this way, they also have enormous environmental applications. Hence, collections of microorganisms with specific traits are a crucial step in developing new technologies to harness the microbial potential. Microbial culture collections (MCCs) are a repository for the preservation of a large variety of microbial species distributed throughout the world. In this context, culture collections (CCs) and microbial biological resource centres (mBRCs) are vital for the safeguarding and circulation of biological resources, as well as for the progress of the life sciences. Ex situ conservation of microorganisms tagged with specific traits in the collections is the crucial step in developing new technologies to harness their potential. Type strains are mainly used in taxonomic study, whereas reference strains are used for agricultural, biotechnological, pharmaceutical research and commercial work. Despite the tremendous potential in microbiological research, little effort has been made in the true sense to harness the potential of conserved microorganisms. This review highlights (1) the importance of available global microbial collections for man and (2) the use of these resources in different research and applications in agriculture, biotechnology, and industry. In addition, an extensive literature survey was carried out on preserved microorganisms from different collection centres using the Web of Science (WoS) and SCOPUS. This review also emphasizes knowledge gaps and future perspectives. Finally, this study provides a critical analysis of the current and future roles of microorganisms available in culture collections for different sustainable agricultural and industrial applications. This work highlights target-specific potential microbial strains that have multiple important metabolic and genetic traits for future research and use.

883 Clinical Case Report: Recurrent Non-Tuberculous Psoas Abscess with Associated Discitis

Introduction

Following the discovery of modern anti-tuberculosis treatments, psoas abscesses secondary to Pott's disease of the spine rarely occur in developed countries. We present a case of a recurrent non-tuberculous psoas abscess communicating with the spine and pleural cavity, presenting as an abdominal mass.

Case

A 72-year-old man presented with a left upper quadrant mass, pain, abdominal distension and raised inflammatory markers. Cross-sectional imaging with CT and MRI revealed a large left-sided psoas abscess with a pleural effusion tracking to the retroperitoneum and associated recurrent discitis. The patient was commenced on intra-venous antibiotics and the collection was accessed via a radiologically placed drain to the retroperitoneum.

Discussion

Spinal infections may present with a lump below the inguinal ligament due to pus tracking down the psoas tendon sheath. Irritation of the psoas muscle may also present with pain on hip extension due to muscular spasm. The most common causative agent of primary psoas abscesses is Staphylococcus Aureus. Discitis is more common in men and shows a bimodal age distribution in presentation, predominantly affecting children and then those in the 6th-7th decade of life.

Learning points

Retroperitoneal disease should be considered in a patient who presents with an abdominal mass. In patients who present with a psoas abscess or an empyema communicating with the retroperitoneum, a spinal source should be considered. Crohn's disease is a common cause of secondary psoas abscesses and should also be considered. Cultures for mycobacteria should be obtained to exclude Tuberculosis as an underlying cause.

Mathematical approach for segmenting chromosome clusters in metaspread images

Karyotyping is an examination that helps in detecting chromosomal abnormalities. Chromosome analysis is a very challenging task which requires various steps to obtain a karyotype. The challenges associated with chromosome analysis are overlapping and touching of chromosomes. The input considered for chromosome analysis is the metaspread G band chromosomes. The proposed work mainly focus on separation the overlapped and touching chromosomes which is considered to be the major challenge in karyotype. There are various research contribution in chromosome analysis in progress which includes both low (Machine Learning) and high level (Deep Learning) methods. This paper proposes a mathematical based approaches which is very effective in segmentation of clustered chromosomes. The accuracy of segmentation is robust compared to high level approaches.

Outcomes of cold snare piecemeal EMR for nonampullary small-bowel adenomas larger than 1 cm: a retrospective study

BACKGROUND AND AIMS

Nonampullary small-bowel adenomas ≥10 mm are typically resected using cautery-based polypectomy, which is associated with significant adverse events. Studies have demonstrated the safety and efficacy of piecemeal cold snare EMR for removing large colon polyps. Our aim was to assess the safety and efficacy of cold snare EMR for removal of large adenomas in the small bowel.

METHODS

A retrospective study of patients who underwent lift and piecemeal cold snare EMR of small-bowel adenomas ≥1 cm between January 2014 and March 2019 was conducted at a tertiary care medical center. Polyp characteristics at the time of index and surveillance endoscopy were collected. Primary outcomes were residual or recurrent adenoma (RRA) seen on surveillance endoscopy, polyp eradication rate, and number of endoscopic procedures required for eradication. Adverse events including immediate and delayed bleeding, perforation, stricture, pancreatitis, and postpolypectomy syndrome were assessed.

RESULTS

Of 43 patients who underwent piecemeal cold snare EMR, 39 had follow-up endoscopy. Polyps ranged in size from 10 to 70 mm (mean, 26.5 mm). RRA was found in 18 patients (46%), with increased polyp size correlating with higher recurrence (P < .001). Polyp eradication was observed in 35 patients (89%), requiring a median of 2 (range, 1-6) endoscopic procedures. Only 1 patient (2.3%) had immediate postprocedural bleeding. No cases of perforation or postpolypectomy syndrome were seen.

CONCLUSIONS

Piecemeal cold snare EMR may be a feasible, safe, and efficacious technique for small-bowel polyps >10 mm. Prospective, randomized studies are needed to assess how outcomes compare with traditional cautery-based polypectomy.

Pre-COVID-19 pandemic: effects on air quality in the three cities of India using fuzzy MCDM model

Due to urbanization and industrialization pollution level increases. Air pollution directly affects to human health. Air Quality Indices (AQI) method is related to measuring the concentration of different pollutants PM₁₀, NO₂, SO₂ and other pollutants. The fuzzy Logic air quality index calculates in single value of AQI defines limits 0 to 1. In this study, a comparison of air quality data of three cities was conducted with the help of fuzzy logic algorithm. It used to evaluating Indices through fuzzy multi criteria decision making (MCDM) framework in which linguistic terms of experts opinion and perception, accordingly computing matrix is constructed for sub criteria. There are five linguistic terms used in this framework to create membership functions such as high significant, significant, average significant, low significant and not significant. The three cities, Bangalore, Mysore, and Hubli-Dharwad air quality datas was taken for analysis and evaluating indices during pre-COVID years (2017, 2018, and 2019). The AQI value shows that Bangalore has the highest pollution level while Mysore has the lowest. Using the fuzzy theory, results show that Bangalore and Hubli-Dharwad decrease in pollution level by -0.074921% and -0.04797%. Negative sign shows the decrease pollution level while Mysore increase pollution level by 0.011792%. Overall the results show that AQI of Mysore city is low compared to Bangalore and Hubli-Dharwad. Also, this study reveals air quality disseminated through industrial processes and automobile emissions in India cities during pre-COVID pandemic years.

Simulation Training Improves Trainee Technical Skill and Procedural Attitudes in Endoscopic Gastrostomy Tube Placement

INTRODUCTION

Percutaneous endoscopic gastrostomy (PEG) tube placement remains a core competency of gastroenterology fellowship, although this procedure is performed infrequently. Some training programs lack sufficient procedural volume for trainees to develop confidence and competence in this procedure. We aimed to determine the impact of a simulation-based educational intervention on trainee technical skill and procedural attitudes in simulated PEG tube placement.

METHODS

Gastroenterology fellows were invited to participate in the study. Baseline procedural attitudes toward PEG tube placement (self-confidence, perceived skill level, perceived level of required supervision) were assessed before simulation training using a Likert scale. Baseline technical skills were assessed by video recording-simulated PEG tube placement on a PEG tube simulator with scoring using a procedural checklist. Fellows next underwent individualized simulation training and repeated simulated PEG tube placement until greater than 90% of checklist items were achieved. Procedural attitudes were reassessed directly after the simulation. Technical skill and procedural attitudes were then reassessed 6 to 12 weeks later (delayed posttraining).

RESULTS

Twelve fellows completed the study. Simulation training led to significant improvement in technical skill at delayed reassessment (52.9 ± 14.3% vs. 78.0 ± 8.9% correct, P = 0.0002). Simulation training also led to significant immediate improvements in self-confidence (2.1 ± 0.7 vs. 3.1 ± 0.3, P = 0.001), perceived skill level (2.2 ± 1.0 vs. 4 ± 1.1, P < 0.001), and perceived level of required supervision (2.2 ± 0.9 vs. 3.2 ± 0.6, P = 0.003).

CONCLUSIONS

Simulation training led to sustained improvements in gastroenterology fellows' technical skill and procedural attitudes in PEG tube placement. Incorporation of simulation curricula in gastroenterology fellowships for this infrequently performed procedure should be considered.

When Does the Timing of an Urgent Endoscopy for Foreign Body Extraction Matter?

Most cases of foreign body ingestion are managed by observation without the need for endoscopic intervention as these objects are expected to pass spontaneously. However, urgent endoscopy is indicated depending on the type and size of the ingested material to avoid the risk of perforation. We present a case of repeated foreign body ingestion in a patient with a developmental disability and illustrate the importance of patient selection for urgent endoscopy.

SARS-CoV-2 and other pathogens in municipal wastewater, landfill leachate, and solid waste: A review about virus surveillance, infectivity, and inactivation

This review discusses the techniques available for detecting and inactivating of pathogens in municipal wastewater, landfill leachate, and solid waste. In view of the current COVID-19 pandemic, SARS-CoV-2 is being given special attention, with a thorough examination of all possible transmission pathways linked to the selected waste matrices. Despite the lack of works focused on landfill leachate, a systematic review method, based on cluster analysis, allows to analyze the available papers devoted to sewage sludge and wastewater, allowing to focalize the work on technologies able to detect and treat pathogens. In this work, great attention is also devoted to infectivity and transmission mechanisms of SARS-CoV-2. Moreover, the literature analysis shows that sewage sludge and landfill leachate seem to have a remote chance to act as a virus transmission route (pollution-to-human transmission) due to improper collection and treatment of municipal wastewater and solid waste. However due to the incertitude about virus infectivity, these possibilities cannot be excluded and need further investigation. As a conclusion, this paper shows that additional research is required not only on the coronavirus-specific disinfection, but also the regular surveillance or monitoring of viral loads in sewage sludge, wastewater, and landfill leachate. The disinfection strategies need to be optimized in terms of dosage and potential adverse impacts like antimicrobial resistance, among many other factors. Finally, the presence of SARS-CoV-2 and other pathogenic microorganisms in sewage sludge, wastewater, and landfill leachate can hamper the possibility to ensure safe water and public health in economically marginalized countries and hinder the realization of the United Nations' sustainable development goals (SDGs).

Occurrence, transformation, bioaccumulation, risk and analysis of pharmaceutical and personal care products from wastewater: a review

Almost all aspects of society from food security to disease control and prevention have benefited from pharmaceutical and personal care products, yet these products are a major source of contamination that ends up in wastewater and ecosystems. This issue has been sharply accentuated during the coronavirus disease pandemic 2019 (COVID-19) due to the higher use of disinfectants and other products. Here we review pharmaceutical and personal care products with focus on their occurrence in the environment, detection, risk, and removal.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10311-022-01498-7.

Z-scores of fetal bladder size for antenatal differential diagnosis between posterior urethral valves and urethral atresia

OBJECTIVE

To construct reference values for fetal urinary bladder distension in pregnancy and use Z-scores as a diagnostic tool to differentiate posterior urethral valves (PUV) from urethral atresia (UA).

METHODS

This was a prospective cross-sectional study in healthy singleton pregnancies aimed at constructing nomograms of fetal urinary bladder diameter and volume between 15 and 35 weeks' gestation. Z-scores of longitudinal bladder diameter (LBD) were calculated and validated in a cohort of fetuses with megacystis with ascertained postnatal or postmortem diagnosis, collected from a retrospective, multicenter study. Correlations between anatomopathological findings, based on medical examination of the infant or postmortem examination, and fetal megacystis were established. The accuracy of the Z-scores was evaluated by receiver-operating-characteristics (ROC)-curve analysis.

RESULTS

Nomograms of fetal urinary bladder diameter and volume were produced from three-dimensional ultrasound volumes in 225 pregnant women between 15 and 35 weeks of gestation. A total of 1238 urinary bladder measurements were obtained. Z-scores, derived from the fetal nomograms, were calculated in 106 cases with suspected lower urinary tract obstruction (LUTO), including 76 (72%) cases with PUV, 22 (21%) cases with UA, four (4%) cases with urethral stenosis and four (4%) cases with megacystis-microcolon-intestinal hypoperistalsis syndrome. Fetuses with PUV showed a significantly lower LBD Z-score compared to those with UA (3.95 vs 8.83, P < 0.01). On ROC-curve analysis, we identified 5.2 as the optimal Z-score cut-off to differentiate fetuses with PUV from the rest of the study population (area under the curve, 0.84 (95% CI, 0.748-0.936); P < 0.01; sensitivity, 74%; specificity, 86%).

CONCLUSIONS

Z-scores of LBD can distinguish reliably fetuses with LUTO caused by PUV from those with other subtypes of LUTO, with an optimal cut-off of 5.2. This information should be useful for prenatal counseling and management of LUTO. © 2021 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Recent development in preparation of food packaging films using biopolymers

In the past decades, most materials used in the food packaging industry are nonbiodegradable materials that pose increased environmental concerns and sustainability issues. Hence, polymer-based biodegradable materials and edible films have been developed to increase the shelf life of food products. Especially, biopolymer-based nanomaterials are engineered with multifunctional characteristics because of their size, surface area, shelf life, thermal stability, and mechanical and barrier strength. These materials display enriched properties of biodegradability, antimicrobial activity, and biocompatibility and may have the possibility to replace plastic materials in future. Thus, this review offers a brief overview of the classification of biopolymers, key parameters that are important in food packaging films (including the role of plasticizers, cross-linkers, pH, temperature, and relative humidity), and recent applications of novel biopolymer nanocomposite materials used in the food industries.

COVID-19-associated mucormycosis presenting to the Emergency Department-an observational study of 70 patients

BACKGROUND

Mucormycosis (MM) is a deadly opportunistic fungal infection and a large surge in COVID-19-associated mucormycosis (CAM) is occurring in India.

AIM

Our aim was to delineate the clinico-epidemiological profile and identify risk factors of CAM patients presenting to the Emergency Department (ED).

DESIGN

This was a retrospective, single-centre, observational study.

METHODS

We included patients who presented with clinical features or diagnosed MM and who were previously treated for COVID-19 in last 3 months of presentation (recent COVID-19) or currently being treated for COVID-19 (active COVID-19). Information regarding clinical features of CAM, possible risk factors, examination findings, diagnostic workup including imaging and treatment details were collected.

RESULTS

Seventy CAM patients (median age: 44.5 years, 60% males) with active (75.7%) or recent COVID-19 (24.3%) who presented to the ED in between 6 May 2021 and 1 June 2021, were included. A median duration of 20 days (interquartile range: 13.5-25) was present between the onset of COVID-19 symptoms and the onset of CAM symptoms. Ninety-three percent patients had at least one risk factor. Most common risk factors were diabetes mellitus (70%) and steroid use for COVID-19 disease (70%). After clinical, microbiological and radiological workup, final diagnosis of rhino-orbital CAM was made in most patients (68.6%). Systemic antifungals were started in the ED and urgent surgical debridement was planned.

CONCLUSION

COVID-19 infection along with its medical management have increased patient susceptibility to MM.