An evaluation of root resorption associated with the use of photobiomodulation during orthodontic treatment with clear aligners: a retrospective cohort pilot study

OBJECTIVES

To evaluate the change in tooth root volume using cone-beam computed tomography (CBCT) in a group of patients treated concurrently with clear aligners and an adjunctive photobiomodulation (PBM) device.

MATERIALS AND METHODS

This retrospective cohort pilot study included the records of 32 consecutively treated clear aligner patients (23 female, 9 male) from the private practice of one orthodontist. The PBM group (n = 16) used the device once per day for 5 minutes per arch and was compared with a matched control group (n = 16). A semiautomated segmentation technique was used to obtain tooth volume of anterior teeth from CBCT imaging prior to (T0) and during or immediately following (T1) orthodontic treatment with clear aligners. The change in root volume between time points was assessed.

RESULTS

There was no statistically significant difference between the pre- and posttreatment root volumes of maxillary and mandibular anterior teeth, regardless of which intervention group the patient belonged to (P > .05). There was also no difference in the mean percentage change in root volume between clear aligner patients in this study who were treated with the PBM device compared with a matched control group (P > .05).

CONCLUSIONS

Clear aligner patients in this study who changed their aligners every 3 to 5 days and used adjunctive photobiomodulation therapy did not experience clinically relevant orthodontically induced external root resorption. Due to the small sample size and measurement error in the root segmentation process, the results should be interpreted with caution.

Immunological and molecular diagnostic techniques in fish health: present and future prospectus

Fish health management is critical to aquaculture and fisheries as it directly affects sustainability and productivity. Fish disease diagnosis has taken a massive stride because of advances in immunological and molecular diagnostic tools which provide a sensitive, quick, and accurate means of identifying diseases. This review presents an overview of the main molecular and immunological diagnostic methods for determining the health of fish. The immunological techniques help to diagnose different fish diseases by detecting specific antigens and antibodies. The application of immunological techniques to vaccine development is also examined in this review. The genetic identification of pathogens is made possible by molecular diagnostic techniques that enable the precise identification of bacterial, viral, and parasitic organisms in addition to evaluating host reactions and genetic variation associated with resistance to disease. The combination of molecular and immunological methods has resulted in the creation of novel techniques for thorough evaluation of fish health. These developments improve treatment measures, pathogen identification and provide new information about the variables affecting fish health, such as genetic predispositions and environmental stresses. In the framework of sustainable fish farming and fisheries management, this paper focuses on the importance of these diagnostic techniques that play a crucial role in protecting fish populations and the aquatic habitats. This review also examines the present and potential future directions in immunological and molecular diagnostic techniques in fish health.

Disaster plant pathology: Smart solutions for threats to global plant health from natural and human-driven disasters

Disaster plant pathology addresses how natural and human-driven disasters impact plant diseases, and the requirements for smart management solutions. Local to global drivers of plant disease change in response to disasters, often creating environments more conducive to plant disease. Most disasters have indirect effects on plant health through factors such as disrupted supply chains and damaged infrastructure. There is also the potential for direct effects from disasters, such as pathogen or vector dispersal due to floods, hurricanes, and human migration driven by war. Pulse stressors such as hurricanes and war require rapid responses, while press stressors such as climate change leave more time for management adaptation but may ultimately cause broader challenges. Smart solutions for the effects of disasters can be deployed through digital agriculture and decision support systems supporting disaster preparedness and optimized humanitarian aid across scales. Here we use the disaster plant pathology framework to synthesize the effects of disasters in plant pathology and outline solutions to maintain food security and plant health in catastrophic scenarios. We recommend actions for improving food security before and following disasters, including (1) strengthening regional and global cooperation, (2) capacity building for rapid implementation of new technologies, (3) effective clean seed systems that can act quickly to replace seed lost in disasters, (4) resilient biosecurity infrastructure and risk assessment ready for rapid implementation, and (5) decision support systems that can adapt rapidly to unexpected scenarios.

Journey of technological advancements in the detection of antimicrobial resistance

Increased uses rather an extensive misuse of antibiotics due to easy availability and easy access have resulted in antibiotic resistance as a global crisis. The speed of discovery of new antibiotics has slowed down recently. Therefore, there is a need to reduce the rate of increase in resistance against the presently available antibiotics, or else many infections may be left untreatable or difficult to be treated due to the high prevalence of resistance. The judicious use of broad-spectrum antibiotics can control the increase in resistance profile. Various techniques are presently being used for the detection of antibiotic resistance. Conventional phenotypic methods are preferred that are highly reliable but are much more time-consuming. The patients cannot spare more time as the infection keeps increasing. The results with genotypic methods are obtained within 24 h as compared to phenotypic methods. Hence, recent molecular methods like qPCR can be used for detection. In this review, we present an overview of various methods useful for the detection of antibiotic resistance, with emphasis on their advantages and limitations. The review also emphasizes qPCR to be the most preferred method out of all because of various advantageous factors.

Recent advances in dental zirconia: 15 years of material and processing evolution

OBJECTIVES

The objective was to discuss the research on zirconia published in the past 15 years to help the dental materials community understand the key properties of the types of zirconia and their clinical applications.

METHODS

A literature search was performed in May/2023 using Web of Science Core Collection with the term "dental zirconia". The search returned 5102 articles, which were categorized into 31 groups according to the research topic.

RESULTS

The current approach to improving the translucency of zirconia is to decrease the alumina content while increasing the yttria content. The resulting materials (4Y-, 5Y-, and above 5 mol% PSZs) may contain more than 50% of cubic phase, with a decrease in mechanical properties. The market trend for zirconia is the production of CAD/CAM disks containing more fracture resistant 3Y-TZP at the bottom layers and more translucent 5Y-PSZ at the top. Although flaws located between layers in multilayered blocks might represent a problem, newer generations of zirconia layered blocks appear to have solved this problem with novel powder compaction technology. Significant advancements in zirconia processing technologies have been made, but there is still plenty of room for improvement, especially in the fields of high-speed sintering and additive manufacturing.

SIGNIFICANCE

The wide range of zirconia materials currently available in the market may cause confusion in materials selection. It is therefore imperative for dental clinicians and laboratory technicians to get the needed knowledge on zirconia material science, to follow manufacturers' instructions, and to optimize the design of the prosthetic restoration with a good understanding where to reinforce the structure with a tough and strong zirconia.

Unraveling the Neural Circuits: Techniques, Opportunities and Challenges in Epilepsy Research

Epilepsy, a prevalent neurological disorder characterized by high morbidity, frequent recurrence, and potential drug resistance, profoundly affects millions of people globally. Understanding the microscopic mechanisms underlying seizures is crucial for effective epilepsy treatment, and a thorough understanding of the intricate neural circuits underlying epilepsy is vital for the development of targeted therapies and the enhancement of clinical outcomes. This review begins with an exploration of the historical evolution of techniques used in studying neural circuits related to epilepsy. It then provides an extensive overview of diverse techniques employed in this domain, discussing their fundamental principles, strengths, limitations, as well as their application. Additionally, the synthesis of multiple techniques to unveil the complexity of neural circuits is summarized. Finally, this review also presents targeted drug therapies associated with epileptic neural circuits. By providing a critical assessment of methodologies used in the study of epileptic neural circuits, this review seeks to enhance the understanding of these techniques, stimulate innovative approaches for unraveling epilepsy's complexities, and ultimately facilitate improved treatment and clinical translation for epilepsy.

The Nuances of Plant Disease Severity Estimation Using Quantitative Ordinal Scales - Lessons Learned Over Four Decades

We revisit the foundations of the Horsfall-Barratt (HB) scale, a widely cited and applied plant disease visual assessment tool introduced in 1945, a full 37 years prior to T. T. Hebert's 1982 critique that raised concerns regarding the scale's rationale, particularly its reliance on the Weber-Fechner law and visual perception assumptions. Although use of the HB scale and similar ordinal scales persists, comprehensive studies have revealed that direct visual estimation using percentage scales often proves more accurate and reliable. Challenges remain, such as biases due to estimator subjectivity and the potential for misclassification. The logarithmic assumptions of the HB scale have been debunked, and the importance of choosing appropriate interval sizes and numbers of classes in developing ordinal scales is emphasized. Analyzing ordinal scale data appropriately is crucial, and recent advances offer promising methods that reduce type II error rates. The closely related disease severity index (DSI) is noted to have its shortcomings and potential for misuse. The letter underscores the need for continuous refinement and critical evaluation of disease assessment methodologies.

Evolution of Superficial Muscular Aponeurotic System Facelift Techniques: A Comprehensive Systematic Review of Complications and Outcomes

Background

Facelift procedures are a popular method of facial rejuvenation. The most common technique is superficial muscular aponeurotic system (SMAS) plication, with several variations. However, the optimal approach remains unclear. This review analyzed previous studies to compare SMAS facelift techniques, their outcomes, and complication rates.

Methods

A systematic search was conducted using the MEDLINE, Cochrane, Embase, and Google Scholar electronic databases in September 2022. The search included studies published from January 2000 to September 2022 using keywords such as "facelift," "complications," and "outcomes."

Results

This review examined 27 selected studies that evaluated 6 SMAS facelift techniques. The studies involved 6086 patients in total, over 85% of who were satisfied with the outcome of their surgery. The complication rates varied depending on the technique used, with the SMAS flap and composite SMAS technique having the highest (5.75%) and lowest (0.05%) complication rates, respectively. The most common complications were temporary facial nerve injury (0.85%) and skin necrosis (0.41%). To date, only one case of permanent facial nerve injury has been reported.

Conclusions

On the basis of our findings, SMAS facelift techniques achieve high patient satisfaction rates, with complication rates that vary by technique. The composite SMAS technique showed the lowest complication rates, whereas the SMAS flap showed the highest rate. However, some studies have not reported all complications, making it difficult to determine the best approach. Therefore, future studies are required to identify the most aesthetically pleasing technique with the lowest complication risk.

TOMMicroNet: Convolutional Neural Networks for Smartphone-Based Microscopic Detection of Tomato Biotic and Abiotic Plant Health Issues

The image-based detection and classification of plant diseases has become increasingly important to the development of precision agriculture. We consider the case of tomato, a high-value crop supporting the livelihoods of many farmers around the world. Many biotic and abiotic plant health issues impede the efficient production of this crop, and laboratory-based diagnostics are inaccessible in many remote regions. Early detection of these plant health issues is essential for efficient and accurate response, prompting exploration of alternatives for field detection. Considering the availability of low-cost smartphones, artificial intelligence-based classification facilitated by mobile phone imagery can be a practical option. This study introduces a smartphone-attachable 30x microscopic lens, used to produce the novel tomato microimaging dataset of 8500 images representing 34 tomato plant conditions on the upper and lower sides of leaves as well as on the surface of tomato fruits. We introduce TOMMicroNet, a 14-layer convolutional neural network (CNN) trained to classify amongst biotic and abiotic plant health issues, and we compare it against six existing pre-trained CNN models. We compared two separate pipelines of grouping data for training TOMMicroNet, either presenting all data at once or separating into subsets based on the three parts of the plant. Comparing configurations based on cross-validation and F1 scores, we determined that TOMMicroNet attained the highest performance when trained on the complete dataset, with 95% classification accuracy on both training and external datasets. Given TOMMicroNet's capabilities when presented with unfamiliar data, this approach has the potential for the identification of plant health issues.

Colorimetric LAMP assay for detection of Xanthomonas phaseoli pv. manihotis in cassava through genomics: a new approach to an old problem

Bacterial spot caused by Xanthomonas phaseoli pv. manihotis (Xpm) is considered the main bacterial disease that affects cassava, causing significant losses when not properly managed. In the present study, a fast, sensitive, and easy-to-apply method to detect Xpm via colorimetric loop-mediated isothermal amplification (LAMP) was developed. In order to ensure the use of a unique to the target pathovar core region for primer design, 74 complete genomic sequences of Xpm together with different bacterial species and pathovars were used for comparative genomics. A total of 42 unique genes were used to design 27 LAMP primer sets, from which nine primers were synthesized and only one (Xpm_Lp1 primer set) showed sufficient efficiency in preliminary tests. The sensitivity, assessed by a serial dilution of the type strain (IBSBF 278) DNA, yielded high sensitivity, detecting up to 100 fg. The LAMP primers showed high specificity, not cross-reacting with other bacterial species or other pathovars tested, and amplifying only the Xpm isolates. Tests confirmed the high efficiency of the protocol using infected or inoculated macerated cassava leaves, without the need for additional sample treatment. The LAMP test developed in this study was able to detect Xpm in a fast, simple, and sensitive way, and it can be used to monitor the disease under laboratory and field conditions.

MSE FINDR: A Shiny R Application to Estimate Mean Square Error Using Treatment Means and Post-hoc Test Results

Research synthesis methods such as meta-analysis rely primarily on appropriate summary statistics (i.e., means and variance) of a response of interest for implementation to draw general conclusions from a body of research. A commonly encountered problem arises when a measure of variability of a response across a study is not explicitly provided in the summary statistics of primary studies. Typically, these otherwise credible studies, are omitted in research synthesis leading to potential small-study effects and loss of statistical power. We present MSE FINDR, a user-friendly Shiny R application for estimating the mean square error (i.e., within-study residual variance, σ2) for continuous outcomes from ANOVA-type studies, with specific experimental designs and treatment structures (Latin square, completely randomized, randomized complete block, two-way factorial, and split-plot designs). MSE FINDR accomplishes this by using commonly reported information on treatment means, significance level (α), number of replicates and post-hoc mean separation tests (Fisher's LSD, Tukey's HSD, Bonferroni, Šidák and Scheffé). Users upload a CSV file containing the relevant information reported in the study, then specify the experimental design and post-hoc test that was applied in the analysis of the underlying data. MSE FINDR then proceeds to recover σ2, based on user-provided study information. The recovered within-study variance can be downloaded and exported as a CSV file. Simulations of trials with variable number of treatments and treatment effects showed that the MSE FINDR-recovered σ2 was an accurate predictor of the actual ANOVA σ2 for one-way experimental designs when summary statistics (i.e., means, variance and post-hoc results) were available for the single factor. Similarly, σ2 recovered by application accurately predicted the actual σ2 for two-way experimental designs when summary statistics were available for both factors and the sub-plot factor in split-plot designs, irrespective of the post-hoc mean separation test. The MSE FINDR Shiny application, documentation and an accompanying tutorial are hosted at https://garnica.shinyapps.io/MSE_FindR/ and https://github.com/vcgarnica/MSE_FindR/. With this tool, researchers can now easily estimate the within-study variance absent in published reports that nonetheless provide appropriate summary statistics, thus enabling the inclusion of such studies that would have otherwise been excluded in meta-analyses involving estimates of effect sizes based on a continuous response.

Determinants of Surgical Approach for Benign Outpatient Hysterectomy

STUDY OBJECTIVE

Identify determinants of the surgical approach to a benign, outpatient, minimally invasive hysterectomy.

DESIGN

A cross-sectional sample of patients undergoing outpatient hysterectomy between the 4th quarter of 2015 and the 4th quarter of 2022, excluding those with a diagnosis of gynecologic malignancy, was obtained from the Vizient Clinical Data Base. The primary outcome was surgical approach to hysterectomy that was analyzed using mixed-effects regression, including a surgeon-level random effects to capture unobserved surgeon-level differences influencing variation in surgical approach.

SETTING

The Vizient Clinical Data Base includes patient encounter data from >50 healthcare systems and >400 community hospitals and represents approximately 97% of academic medical centers in the United States.

PATIENTS

Women >18 years undergoing an outpatient benign hysterectomy.

INTERVENTION

Surgical approach to hysterectomy.

MEASUREMENT AND MAIN RESULT

The final sample included 411 208 cases performed by 6089 surgeons. Among observed variables, patient diagnosis, surgeon specialty, and insurance type were strongly associated with choice of approach. However, after controlling for patient, hospital, and observable surgeon characteristics, unobserved surgeon-level differences still accounted for 72% of the variance in the use of transvaginal hysterectomy (95% confidence interval, 71-73) and 85% of the variance in the use of robot-assisted total hysterectomy (95% confidence interval, 84-86).

CONCLUSION

The strongest determinant of surgical approach to a benign outpatient hysterectomy in the United States was not patient- or hospital-level variability, but unexplained differences across individual surgeons. This has implications in how surgeons are trained and incentivized to deliver high-value surgical care.

Formation techniques for upper active channel in monolithic 3D integration: an overview

The concept of three-dimensional stacking of device layers has attracted significant attention with the increasing difficulty in scaling down devices. Monolithic 3D (M3D) integration provides a notable benefit in achieving a higher connection density between upper and lower device layers than through-via-silicon. Nevertheless, the practical implementation of M3D integration into commercial production faces several technological challenges. Developing an upper active channel layer for device fabrication is the primary challenge in M3D integration. The difficulty arises from the thermal budget limitation for the upper channel process because a high thermal budget process may degrade the device layers below. This paper provides an overview of the potential technologies for forming active channel layers in the upper device layers of M3D integration, particularly for complementary metal-oxide-semiconductor devices and digital circuits. Techniques are for polysilicon, single crystal silicon, and alternative channels, which can solve the temperature issue for the top layer process.

A consensus statement on behalf of the EANS functional neurosurgery section

Introduction

The surgical procedure for severe, drug-resistant, unilateral hemispheric epilepsy is challenging. Over the last decades the surgical landscape for hemispheric disconnection procedures changed from anatomical hemispherectomy to functional hemispherotomy with a reduction of complications and stable good seizure outcome. Here, a task force of European epilepsy surgeons prepared, on behalf of the EANS Section for Functional Neurosurgery, a consensus statement on different aspects of the hemispheric disconnection procedure.

Research question

To determine history, indication, timing, techniques, complications and current practice in Europe for hemispheric disconnection procedures in drug-resistant epilepsy.

Material and methods

Relevant literature on the topic was collected by a literature search based on the PRISMA 2020 guidelines.

Results

A comprehensive overview on the historical development of hemispheric disconnection procedures for epilepsy is presented, while discussing indications, timing, surgical techniques and complications. Current practice for this procedure in European epilepsy surgery centers is provided. At present, our knowledge of long-term seizure outcomes primarily stems from open surgical disconnection procedures. Although minimal invasive surgical techniques in epilepsy are rapidly developing and reported in case reports or small case series, long-term seizure outcome remain uncertain and needs to be reported.

Discussion and conclusion

This is the first paper presenting a European consensus statement regarding history, indications, techniques and complications of hemispheric disconnection procedures for different causes of chronic, drug-resistant epilepsy. Furthermore, it serves as the pioneering document to report a comprehensive overview of the current surgical practices regarding this type of surgery employed in renowned epilepsy surgery centers across Europe.

Standard area diagrams for pecan leaf scab: Effect of rater experience and location, and leaf size on reliability and accuracy of visual estimates

Assessments of the severity of scab (Venturia effusa), an economically significant disease of pecan, are critical for determining pecan cultivar susceptibility, disease epidemiology, and integrated disease management approaches. We developed a standard area diagram (SAD) set to aid in assessments of pecan leaflet scab. Leaflets with scab lesions were harvested and scanned using a flatbed scanner at 600 dpi, and Fiji (ImageJ) was used to determine the actual percent disease severity. The SADs had 10 leaflets ranging in severity from 0.2 to 48.9%. Forty 'small' (1.34 - 7.43 cm2) and forty 'large' (7.67 - 25.9 cm2) leaflet images were randomized for rater assessments. The images were assessed twice by 36 raters, first without and then with the SADs as a guide. Data were subjected to analysis using Lin's Concordance Correlation Coefficient (LCC, pc) to determine the accuracy of ratings, and by Intra-class Correlation Coefficient analysis to determine inter-rater reliability. The effects of rater experience, rater location, and leaflet size were also determined. The SADs significantly improved the agreement between raters and the actual values (LCC, pc = 0.70 and 0.84 without and with the SADs, respectively). The reliability of estimates was improved (ICC = 0.54 and 0.82 without and with the SADs, respectively). The effect of rater location on overall concordance was significant without and with the SADs based on an analysis of variance (ANOVA) using a general linear model and lsmeans separation (P<0.05). A generalized linear mixed model analysis revealed that there was a significant interaction between rater location, experience, and the use of the SADs, with some raters having greater improvement in generalized bias and concordance. Raters had a significantly better accuracy when rating 'small' leaves (LCC, pc = 0.86) compared to 'large' leaves (LCC, pc = 0.82) when using the SADs, highlighting the impact of psychophysics on field evaluations of plant disease severity. The proposed SADs will serve as an improved tool for performing pecan leaflet scab assessments by the pecan research community.

Microplastics: challenges of assessment in biological samples and their implication for in vitro and in vivo effects

Microplastics (MPs) have attracted global interest because they have been recognized as emerging pollutants that require urgent attention. MPs are plastic particles with a size between 1 micron and 5 mm (1 µm-5mm); those measuring less than 1 µm are known as nanoplastics (NPs). MP is distributed in the environment in various physical forms that depend on the degradation process, the erosion factors to which it was subjected, or the original form in which it was intentionally manufactured. Humans may be exposed to these pollutants mainly by ingestion or inhalation, which could adversely affect human health with effects that are still unknown due to limitations that are often dependent on their analytical determination and lack of studies over time, as it is a relatively new topic. Therefore, this review focuses on the challenges currently faced by laboratories for determining MPs in different matrices. We highlight the application of methods and techniques to assess the precise levels of exposure to MPs in biological samples. In addition, exposure pathways, sources, and evidence of adverse effects reported in vitro and in vivo studies are described to generate knowledge about their potential threat to human health.

Single-incision bone bridge lateral meniscus allograft transplantation: preserving neurovascular safety with promising results for posterior horn distortion and graft maturation

PURPOSE

This study aimed to investigate the graft maturation and safety of single-incision bone bridge lateral meniscus allograft transplantation (LMAT).

METHODS

This study involved 35 patients who underwent LMAT between 2019 and 2020. All patients completed at least 2 years of follow-up (median 34 months; range 24-43) and underwent preoperative magnetic resonance imaging (MRI) to assess the trajectory safety of the leading suture passer and all-inside suture instrument (Fast-Fix). Graft status was evaluated according to the Stoller classification.

RESULTS

Based on preoperative MRI measurements, the expected trajectory of the leading suture passer did not transect the common peroneal nerve (CPN), with the closest distance between the expected trajectory and CPN being 1.4 mm and the average distance being 6.8 ± 3.2 mm. The average distance from the lateral meniscal posterior horn (LMPH) to the popliteal neurovascular bundle (PNVB) was 7.4 ± 2.6 mm and the nearest was 4.8 mm. The expected trajectory of the all-inside suturing instrument did not transect the PNVB when the distance was at least 12 mm, from the most lateral margin of the posterior cruciate ligament (PCL). Grade 3 signal intensity in the posterior third of the allograft on MRI was observed in 6 of 35 (17.1%) patients. Amongst the grade 3 signal intensities in the posterior one-third of the allografts, 3 of the 35 (8.5%) LMATs had a distorted contour.

CONCLUSION

The single-incision bone bridge LMAT technique introduced in this study is a convenient approach that preserves neurovascular safety and provides good results for the distortion of the posterior horn of the allograft and graft maturation. The safety zone for the penetrating devices during the procedure extended from 12 mm laterally to the most lateral margin of the PCL to the medial margin of the popliteal hiatus.

LEVEL OF EVIDENCE

IV.

First report of Pantoea anthophila causing shoot dieback disease of Ceylon ironwood (Mesua ferrea Linn.) in Malaysia

Ceylon ironwood (Mesua ferrea Linn.) or Penaga lilin is one of Asia's most popular tropical herbal plants, including Malaysia (Sharma et al., 2017). The trees are cultivated for their aesthetic value and pharmacological properties, especially as traditional remedies for asthma, dermatopathy, inflammation, and rheumatic conditions (Adib et al., 2019). In August 2022, a disease survey was conducted on Ceylon ironwood trees ranging from 5 to 12 years old in Botanical Park, Putrajaya, Malaysia, with 80% exhibiting shoot dieback disease of the 15 trees exhibiting shoot dieback disease. Symptoms include irregular, water-soaked with brown lesions on young leaves and shoots, where the small lesion coalesced and formed broad necrotic regions, subsequently causing dieback and gradual defoliation. Three infected shoots were collected from each tree, excised into small pieces (10 to 20 mm), immersed with 75% ethanol for 3 min, washed with 2% NaOCl solution for 1 min, and rinsed twice for 1 min in sterilized distilled water. A 10 µl aliquot of the sample suspension was streaked onto nutrient agar (NA) and incubated for 24 h to 48 h at 35 °C. A total of 15 isolates with similar morphology were obtained, and each isolate was re-streaked three times to obtain pure colonies that were round, smooth, with irregular edges, and produced yellow pigment in culture. All isolates were Gram-negative, negative for indole production, and utilized glucose, maltose, trehalose, sucrose, D-lactose, and pectin. Three representative isolates (C001, C002, and C003) with similar morphology were selected for further characterization. The total genomic DNA of all isolates was extracted from overnight cultures using Geneaid™ DNA Isolation Kit (Geneaid Biotech Ltd., Taiwan). PCR amplification of 16S rDNA (Zhou et al., 2015) and species-specific infB (Brady et al., 2008) genes was performed, and each of the ~1500 bp and ~900 bp amplicons were sequenced. BLASTn and phylogenetic analyses revealed all isolates were 100% identical to Pantoea anthophila (P. anthophila) LGM 2558 strains (Accession Nos. NR_116749 and NR_116113) for the 16S rDNA gene. They were 99% identical to P. anthophila CL1 strain (Accession Number CP110473) for infB gene. These sequences were later deposited in the GenBank (Accession Nos. OQ772233, OQ772234, and OQ772235 for 16S rDNA gene, and OQ803527, OQ803528, and OQ803529 for infB gene). For the pathogenicity test, healthy Ceylon ironwood seedlings' shoots were inoculated with 10 mL of each isolate suspension (1 x 108 CFU/ml) by spraying the inoculum on the young shoots using a sterilized spray bottle. Control seedlings were inoculated with sterile water. The inoculated shoots were covered with a sealed plastic bag to maintain the moisture and were kept in the greenhouse with temperatures ranging from 26 to 35 °C. The experiments were repeated twice, with three replicates for each treatment. Inoculated shoots showed dieback symptoms like natural infection, including irregular, water-soaked, and brown lesions on leaves and young shoots at 10 days post-inoculation. Control seedlings remained asymptomatic. The pathogen was re-isolated and identified via sequencing of the 16S rDNA and infB genes, thus fulfilling Koch's postulates. Previously, P. anthophila has been reported to cause soft rot in wampee plants in China (Zhou et al., 2015) and leaf blight of cotton in Pakistan (Tufail et al., 2020). To our knowledge, this is the first report of P. anthophila causing shoot dieback disease of Ceylon ironwood trees in Malaysia. Plant disease management strategies need to be established to reduce losses due to P. anthophila infection since the pathogen could limit Ceylon ironwood tree production in Malaysia.

Accompaniment of minors during health care procedures

In clinical practice, it is not rare to encounter situations in which parents and families are asked to leave the child alone with the health care team in rooms full of devices throughout the performance of procedures, which at times may give rise not only to conflicts but, more importantly, emotional sequelae in children or adolescents. We conducted a narrative review of the literature by searching the digital library of the public health care system of Andalusia for articles concerning the experiences of health care professionals and families with the accompaniment of paediatric patients during health care procedures. We restricted the search to studies published in Spanish or English and conducted in humans. The review evinced the need to humanise care in order to improve care quality. The need to accompany minors is supported by the evidence from works that have analysed the factors involved in the persistence of these behaviours and attitudes in both professionals and parents. We consider it necessary to develop institutional policies and appoint mediators to compile the statements of different national and international societies, taking into account legal aspects but, above all, the pertinent values from a health care ethics perspective, and in pursuit of the best interests of the child.

Learning curve across 2000 thoracolumbar pedicle screw placements using O-arm navigation: technical difficulties and their solutions

INTRODUCTION

Instrumentation using the intraoperative O-arm navigation technique appears safer than its predecessor techniques. However, only a handful of surgeons often used navigation during spinal surgeries. Too many operative glitches and unreliable navigation accuracy were the important reasons cited even by experienced surgeons for not using spinal navigation. We have studied the accuracy of pedicle screw placement during the learning curve and beyond it. We have also discussed in detail the intricacies of the technique and solutions to the difficulties encountered using spinal navigation.

MATERIALS AND METHODS

A total of 2000 thoracolumbar pedicle screws have been placed in the 324 spine surgeries meeting the inclusion and exclusion criteria included in this retrospective study. We have divided 2000 pedicle screw placements into consecutive groups of 200 each. We have compared these groups for the accuracy of screw placement with the surgeon's experience.

RESULTS

The accuracy of pedicle screw placement using the "in-versus-out" grading system in group 1 was 85.5% which significantly increased in group 2 to 93.5% (p-value: 0.0099), and thereafter, there was a nonsignificant increase in subsequent groups with the graph achieving the shape of a plateau.

CONCLUSION

Surgeons should learn the correct principles of the technique of O-arm navigation to prevent the loss of accuracy and place pedicle screws with high accuracy. There is a learning curve of around 30-35 surgeries or 200 pedicle screw placements to acclimatize with the technique of O-arm navigation and learn its principles.

Advancing the preclinical study of comorbid neuroHIV and substance use disorders: Current perspectives and future directions

Human immunodeficiency virus (HIV) remains a persistent public health concern throughout the world. Substance use disorders (SUDs) are a common comorbidity that can worsen treatment outcomes for people living with HIV. The relationship between HIV infection and SUD outcomes is likely bidirectional, making clear interrogation of neurobehavioral outcomes challenging in clinical populations. Importantly, the mechanisms through which HIV and addictive drugs disrupt homeostatic immune and CNS function appear to be highly overlapping and synergistic within HIV-susceptible reward and motivation circuitry in the central nervous system. Decades of animal research have revealed invaluable insights into mechanisms underlying the pathophysiology SUDs and HIV, although translational studies examining comorbid SUDs and HIV are very limited due to the technical challenges of modeling HIV infection preclinically. In this review, we discuss preclinical animal models of HIV and highlight key pathophysiological characteristics of each model, with a particular emphasis on rodent models of HIV. We then review the implementation of these models in preclinical SUD research and identify key gaps in knowledge in the field. Finally, we discuss how cutting-edge behavioral neuroscience tools, which have revealed key insights into the neurobehavioral mechanisms of SUDs, can be applied to preclinical animal models of HIV to reveal potential, novel treatment avenues for comorbid HIV and SUDs. Here, we argue that future preclinical SUD research would benefit from incorporating comorbidities such as HIV into animal models and would facilitate the discovery of more refined, subpopulation-specific mechanisms and effective SUD prevention and treatment targets.

Centripetal Versus Centrifugal Facial Nerve Dissection in Superficial Parotidectomy: Comparison of the Two Methods at a Tertiary Care Center

OBJECTIVES

To compare the intraoperative and postoperative parameters of two techniques of facial nerve dissection: Centripetal vs Centrifugal.

STUDY DESIGN

Prospective study.

SETTING

Academic tertiary referral centre.

METHODS

In our study, cases of superficial parotidectomy were randomly selected from the outpatient departments of ORL & HNS. Of these patients, 30 underwent standard anterograde dissection group (Group A) and 30 underwent retrograde facial nerve dissection (Group B). All the patients were assessed pre-operatively, intra-operatively and post-operatively to compare the various parameters.

RESULTS

The most common complaint in both groups was parotid swelling. The operative time for A was shorter at 2.1 h as compared to 1.9 h min in group B. The resolution of symptoms was nearly comparable in both groups. Facial nerve palsy was slightly more in group B but the difference was not statistically significant.

CONCLUSION

The operative time and post-operative complications were both comparable between AFND and RFND, implying both techniques can be used by surgeons depending on the individual cases.

An overview of the BCG vaccine and its future scope

Despite intense elimination efforts, tuberculosis (TB) still poses a threat to world health, disproportionately affecting less developed and poorer countries. The Bacillus Calmette-Guérin (BCG) vaccine, the only anti-TB authorized vaccine can partially stop TB infection and transmission, however, its effectiveness ranges from 0 to 80%. As a result, there is an urgent need for a more potent TB vaccination given the widespread incidence of the disease. Enhancing BCG's effectiveness is also important due to the lack of other licensed vaccinations. Recently, fascinating research into BCG revaccination techniques by modulating its mode of action i.e., intravenous (IV) BCG delivery has yielded good clinical outcomes showing it still has a place in current vaccination regimens. We must thus go over the recent evidence that suggests trained immunity, and BCG vaccination techniques and describe how the vaccination confers protection against bacteria that cause both TB and non-tuberculosis. This review of the literature offers an updated summary and viewpoints on BCG-based TB immunization regimens (how it affects granulocytes at the epigenetic and hematopoietic stem cell levels which may be related to its efficacy), and also examines how the existing vaccine is being modified to be more effective, which may serve as an inspiration for future studies on the development of TB vaccines.

Classification and assessment techniques of breast ptosis: A systematic review

BACKGROUND

Breast ptosis is characterized by the inferolateral descent of the glandular area and nipple-areola complex. A high degree of ptosis may negatively impact a woman's attractiveness and self-confidence. There are various classifications and measurement techniques for breast ptosis used as references in the medical and garment industry. A practical and comprehensive classification will provide accurate standardized definitions of the degrees of ptosis to facilitate the development of corrective surgeries and well-fitting undergarments for women in need.

METHODS

A systematic review on the classification and assessment techniques to measure breast ptosis was carried out based on the Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) guidelines. The risk of bias was assessed using the modified Newcastle-Ottawa scale for observational studies, whereas the Revised Cochrane risk-of-bias tool for randomized trials (RoB2) was used to evaluate randomized studies.

RESULTS

Of 2550 articles identified in the literature search, 16 observational and 2 randomized studies describing the classification and assessment techniques of breast ptosis were included in the review. A total of 2033 subjects were involved. Half of the total observational studies had a Newcastle-Ottawa scale score of 5 and above. In addition, all randomized trials recorded a low overall bias.

CONCLUSION

A total of 7 classifications and 4 measurement techniques for breast ptosis were identified. However, most studies did not demonstrate a clear derivation of sample size beside lacking robust statistical analysis. Hence, further studies that apply the latest technology to combine the strength of previous assessment techniques are needed to develop better classification system that is applicable to all affected women.

Activation Versus Change as a Principle Underlying Intervention Strategies to Promote Health Behaviors

BACKGROUND AND PURPOSE

Interventions are effective in promoting health behavior change to the extent that (a) intervention strategies modify targets (i.e., mechanisms of action), and (b) modifying targets leads to changes in behavior. To complement taxonomies that characterize the variety of strategies used in behavioral interventions, we outline a new principle that specifies how strategies modify targets and thereby promote behavior change. We distinguish two dimensions of targets-value (positive vs. negative) and accessibility (activation level)-and show that intervention strategies operate either by altering the value of what people think, feel, or want (target change) or by heightening the accessibility of behavior-related thoughts, feelings, and goals (target activation).

METHODS AND RESULTS

We review strategies designed to promote target activation and find that nudges, cue-reminders, goal priming, the question-behavior effect, and if-then planning are each effective in generating health behavior change, and that their effectiveness accrues from heightened accessibility of relevant targets. We also identify several other strategies that may operate, at least in part, via target activation (e.g., self-monitoring, message framing, anticipated regret inductions, and habits).

CONCLUSIONS

The Activation Vs. Change Principle (AVCP) offers a theoretically grounded and parsimonious means of distinguishing among intervention strategies. By focusing on how strategies modify targets, the AVCP can aid interventionists in deciding which intervention strategies to deploy and how to combine different strategies in behavioral trials. We outline a research agenda that could serve to further enhance the design and delivery of interventions to promote target activation.

Axillary sentinel lymph node identification using superparamagnetic iron oxide versus radioisotope in early stage breast cancer: The UK SentiMag trial (SMART study)

BACKGROUND & OBJECTIVES

Sentinel lymph node biopsy (SLNB) is an accurate and reliable method for staging the axilla in early breast cancer. The gold standard technique for localizing the sentinel lymph node (SLN) is the use of radioisotope with or without blue dye. However, this technique has its limitations. Various alternatives have been explored to overcome the disadvantages of the standard SLNB technique and superparamagnetic iron oxide mapping agents have garnered significant attention. The SMART study aims to compare the magnetic technique using the superparamagnetic iron oxide particles (SPIO, Sienna+®) to the radioisotope technique (Tc99) +/- blue dye, for SLN identification in patients with early breast cancer.

METHODS

A prospective, multicenter study was done that recruited 109 clinically node-negative early-stage breast cancer patients from five centres in the United Kingdom (UK). The patients received radioisotope ± blue dye injections, followed by intraoperative injection of magnetic tracer prior to SLNB. The sentinel node identification rate was compared between the magnetic and standard techniques to evaluate detection rate (per patient and per node), non-inferiority and concordance.

RESULTS

Data was analysed for 107 patients. The per patient detection rate was 98.13% (105/107) when using the magnetic tracer and 92.26% (103/107) when using the standard technique. The nodal detection rate was 93.07% (188/202 nodes) when using the magnetic tracer and 96.53% (195/202) when using the standard technique. Of the 31 patients with positive sentinel lymph nodes (SLNs), all 31 (100%) were detected by both techniques.

CONCLUSION

Our study demonstrates that the magnetic technique is a feasible method for SLNB, with an identification rate that is not inferior to the standard technique. The magnetic technique offers a suitable alternative to the standard technique thereby avoiding the need for the complexities of nuclear medicine, the hazards of radiation and the anaphylaxis risk of blue dye.

[Nerve biopsy in the diagnosis of peripheral neuropathies]

The indications for nerve biopsy have diminished in recent years. This examination nevertheless remains essential in certain cases of peripheral neuropathies, making it possible to specify the diagnosis or the mechanism of injury for a therapeutic purpose. It is a simple but "invasive" procedure, which can only be performed once on the same nerve. The indications are thus discussed on a case-by-case basis and based on a range of clinical, electrophysiological, biological or even genetic arguments. This involves close collaboration between clinical physicians and pathologists. The main difficulty of this biopsy concerns the fragility of the sample and the techniques necessary for its interpretation, requiring it to be carried out in expert centers. Nerve biopsy is closely related to skin biopsy in the search for small fiber neuropathy. It is a particular technique, but very well codified. The purpose of this review is to recall the indications and contraindications of nerve biopsy, and to explain what the contributions are but also the limits of this examination as well as of skin biopsy.

Video Head Impulse Test: A Comparison and Analysis of Three Recording Systems

The present study aimed to compare the efficacy and reproducibility of three existing systems in a group of healthy individuals for vHIT. A prospective randomized study was conducted on 12 healthy individuals. The vHIT tests were carried out. The values of the gains for the 3SCCs of each ear were collected using the three devices. The expected average gain of 1 was the gain standard. The statistical significance in the difference in gains were assessed. There is good reproducibility of the results of the vHIT examination. EyeSeeCam appeared to be the worst performing system with a slightly overstated average gain of 1.15. Otometrics has longest average examination time per patient. Synapsis is the system with the best quality/time invested and easiest to access. Video head impulse system depends on the examiner's preference, reproducible and superimposable depending on the examiner and experience.

From Our One Anastomosis Gastric Bypass (OAGB) Experience to Establishing Single Anastomosis Sleeve Ileal (SASI) Bypass Procedure: A Single-Center Report

BACKGROUND

Bariatric surgery has been proven to be the most effective treatment for obesity with or without metabolic syndrome. One anastomosis gastric bypass (OAGB) is a well-established bariatric procedure developed over the past 20 years with excellent outcomes. Single anastomosis sleeve ileal (SASI) bypass is introduced as a novel bariatric and metabolic procedure. There is some similarity between these two operations. This study aimed to present our SASI procedure based on the past experience of the OAGB in our center.

METHOD

Thirty patients with obesity underwent SASI surgery from March 2021 to June 2022. Herein, we demonstrated our techniques step by step and key points of techniques learned from our experience with OAGB (shown in the video) with satisfying surgical outcomes. The clinical characteristics, peri-operative variables, and short-term outcomes were reviewed.

RESULTS

There was no case of conversion to open surgery. The mean operative time, volume of blood loss, and hospital stay were 135.2 ± 39.2 min, 16.5 ± 6.2 mL, and 3.6 ± 0.8 days, respectively. There is no postoperative leakage, bleeding, or mortality. The percentage of total weight loss and excess weight loss at 6 months were 31.2 ± 6.5 and 75.3 ± 14.9, respectively. Improvement in type 2 diabetes (11/11, 100%), hypertension (14/26, 53.8%), dyslipidemia (16/21, 76.2%), and obstructive sleep apnea (9/11, 81.8%) were observed at 6 months after surgery.

CONCLUSION

Our experience showed that our proposed SASI technique is feasible and may help surgeons perform this promising bariatric procedure without encountering many obstacles.

Techniques to Treat Slow-Flow/No-Reflow During Primary Percutaneous Coronary Intervention

OBJECTIVE

The aim of this study was to compare TIMI flow after administering intracoronary (IC) medications through various routes for the treatment of slow flow/no-reflow during primary PCI.

METHODS

Two independent parallel cohorts of the patients who underwent primary PCI for STEMI and developed slow/no-reflow were recruited. Selection of cohort was based on the route of administration of IC medications as proximal or distal. Post administration TIMI follow was compared between the two cohorts.

RESULTS

A total of 100 patients were included in both, proximal and distal, cohort. Distribution of angiographic, clinical and demographic characteristics was not significant between the two cohorts except prevalence of hypertension, and diabetes mellitus. Frequency of hypertension, and diabetes mellitus were 45 % vs.70 %; p < 0.001 and 28 % vs. 44 %; p = 0.018 among patients in distal and proximal cohort respectively. Final TIMI III flow was achieved in significantly higher number of patients in distal cohort with the frequency of 88 % vs. 76 %; p = 0.027 as compared to proximal cohort.

CONCLUSION

Administration of IC medication via distal route is observed to be more effective for the treatment of slow flow/no-reflow during primary PCI. Distal route via export catheter or perforated balloon technique should be preferred wherever feasible.

A rapid and reliable method for evaluating cotton resistance to Fusarium wilt race 4 based on taproot rot at the seed germination stage

Fusarium oxysporum f. sp. vasinfectum race 4 (FOV4) is a soil-borne fungal pathogen threatening US cotton production. The objective of this study was to develop a reliable and efficient method to evaluate cotton for FOV4 resistance based on taproot rot during seed germination through five growth chamber tests and two greenhouse tests. Seeds from eight cotton cultivars (Set 1) were germinated in a paper towel for 6 days, and taproots were inoculated with a FOV4 conidial suspension using three inoculation methods, i.e., taproot dipping, taproot wounding, and paper towel drenching, in addition to seed soaking before germination. Taproot rot-based disease incidence (DI) and disease severity rating (DSR), seed germination percentage (SGP), and plant fresh weight (PFW) were measured 7 days after inoculation. Taproot dipping was the most efficient and reliable evaluation method. SGP and PFW were not significantly correlated with DI and DSR, making them inappropriate to use in resistance evaluation. Pima DP 359 RF and PHY 881 RF were the most resistant with the lowest root rot. The taproot dipping method was repeated in another test and confirmed in two tests using another set of eight cultivars (Set 2). The taproot rot-based DSR at germination was significantly correlated with DSR at the seedling stage in the greenhouse in both sets and with previous results in seedling mortality in the greenhouse and field in Set 2. The results suggest that the response to FOV4 infections at the seed germination stage is overall congruent with that at the seedling stage.

Cochlear sparing in LINAC-based radiosurgery for vestibular schwannoma: a dosimetric comparison of dynamic conformal arc, IMRT and VMAT treatment plans

BACKGROUND

Stereotactic radiosurgery (SRS) is the preferred treatment for vestibular schwannoma (VS) in patients with preserved hearing and tumour diameter < 3 cm. Emerging evidence suggests restricting cochlear dose could preserve hearing. This retrospective replanning study aims to compare dynamic conformal arc therapy (DCAT), intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT) plans for superiority of cochlear dose sparing without compromising tumour coverage.

METHODS

Eligibility criteria included sporadic VS, serviceable hearing and availability of CT and MRI for planning. The original gross tumour volume and brainstem OAR volume were retained; the cochlea was newly contoured on the planning CT scan (bone window). Each case was replanned using the three above techniques, prescribing 12 Gy to the 80% isodose line. No dose constraint was applied to the cochlea.

RESULTS

Eighteen patients were replanned. Mean tumour volume was 2.25 cc. Tumour coverage and tumour mean dose (DCAT: 14.2, IMRT: 14.6, VMAT: 14.5 Gy) were comparable. Paddick and RTOG conformity indices were better for DCAT (0.66 and 1.6) and VMAT (0.69 and 1.5) compared to IMRT (0.56 and 1.9). DCAT had superior gradient index (3.0) compared to VMAT (3.4) and IMRT (3.4). VMAT delivered the lowest mean brainstem maximum dose (8.3 Gy) and decreased the mean cochlear dose (3.4 Gy) by 2.3 and 2.1 Gy, and the mean cochlear maximum dose (3.6 Gy) by 2.4 and 2.5 Gy relative to DCAT and IMRT, respectively.

CONCLUSION

LINAC-based SRS treatment using VMAT can achieve better cochlear dose sparing than DCAT or IMRT while maintaining tumour coverage.

Status quo of Extracellular Vesicle isolation and detection methods for clinical utility

Extracellular vesicles (EVs) are nano-sized particles that hold tremendous potential in the clinical space, as their biomolecular profiles hold a key to non-invasive liquid biopsy for cancer diagnosis and prognosis. EVs are present in most bodily fluids, hence are easily obtainable from patients, advantageous to that of traditional, invasive tissue biopsies and imaging techniques. However, there are certain constraints that hinder clinical use of EVs. The translation of EV biomarkers from "bench-to-bedside" is encumbered by the methods of EV isolation and subsequent biomarker detection currently implemented in laboratories. Although current isolation and detection methods are effective, they lack practicality, with their requirement for high bodily fluid volumes, low equipment availability, slow turnaround times and high costs. The high demand for techniques that overcome these limitations has resulted in significant advancements in nanotechnological devices. These devices are designed to integrate EV isolation and biomarker detection into a one-step method of direct EV detection from bodily fluids. This provides promise for the acceleration of EVs into current clinical standards. This review highlights the importance of EVs as cancer biomarkers, the methodological obstacles currently faced in clinical studies and how novel nanodevices could advance clinical translation.

First report of Passion fruit green spot virus in yellow Passion fruit (Passiflora edulis f. flavicarpa) in Casanare, Colombia

Passiflora edulis, commonly known as passion fruit, is a vine species of passionflower native to South America. In Colombia, yellow passion fruit (P. edulis f. flavicarpa) is the most important species in terms of net production and local consumption. Recently two brevipalpus transmitted cileviruses, (i) passion fruit green spot virus (PfGSV) and (ii) hibiscus strain of citrus leprosis virus C2 (CiLV-C2H) were detected in passion fruit in Brazil and Hawaii, respectively (Ramos-González et al., 2020, Olmedo-Velarde et al., 2022). CiLV-C2H infects both citrus and hibiscus in Colombia (Roy et al., 2015, 2018) but there was no report of PfGSV elsewhere apart from Brazil and Paraguay (Costa-Rodrigues et al., 2022). Apart from emerging begomovirus diseases, five major viruses are known to infect passion fruit in Colombia: soybean mosaic virus (SMV), cowpea aphid-borne mosaic virus, passion fruit yellow mosaic virus, cucumber mosaic virus, and a tentative Gulupa bacilliform badnavirus A (Cardona et al., 2022). Current findings of CiLV-C2H in passion fruit and PfGSV in hibiscus motivated us to investigate the possibilities of cilevirus infection in passion fruit in Colombia. During surveys, along with healthy yellow passion fruit leaves, five symptomatic plant samples from Meta and three from Casanare were collected before sent to the Molecular Plant Pathology Laboratory at Beltsville, MD under APHIS permit. Passion fruit samples from Meta showed leaf mottling, rugose mosaic, and leaf distortion, whereas leaf variegation, chlorotic spots, yellowing, green spots in senescent leaves and green vein banding were observed in the Casanare samples (Supp. Fig. 1). Total RNA was extracted using RNeasy Plant Mini Kit (Qiagen, USA). To know the potential cilevirus infection in these samples, three PfGSV specific (Ramos-González et al. 2020) and a CiLV-C2 generic primer pairs (Olmedo-Velarde et al. 2021) were used in the RT-PCR assays. All five passion fruit samples from Meta failed to produce either CiLV-C2 or CiLV-C2H or PfGSV amplicon whereas all three Casanare samples successfully amplified 321, 244 and 299 nts of PfGSV-RNA1 and -RNA2 amplicons using C13F/C13R, C6F/C6R and C8F/C8R primers, respectively. Bi-directional amplicon sequencing followed by BlastN analysis revealed ≥99% nt identity with the PfGSV-RNA1 (MK804173) and -RNA2 (MK804174) genome sequences. An optimized ribo-depleted library preparation protocol was utilized to prepare two cDNA libraries using the RNA extracts of a PfGSV suspected positive (Casanare) and a negative (Meta) samples (Chellappan et al., 2022). HTS libraries of Casanare and Meta samples resulted in 22.7 to 29.5 million raw reads, respectively. After adapter trimming and filtering, clean reads were mapped to the Arabidopsis thaliana reference genome and unmapped reads were de novo assembled (Chellappan et al., 2022). BlastN analysis from the assembled contigs identified 1-3 contigs corresponding to PfGSV-RNA1 and -RNA2, respectively, from Casanare sample whereas 3 contigs of SMV were identified in Meta passion fruit sample. No other virus sequence was obtained from either of the libraries. Assembled contigs covered 99.33% of the RNA1 and 94.42% of the RNA2 genome, with read depths of 64,474 and 119,549, respectively. Meta sample contigs (OP564897) covered >99% of the SMV genome, which shared >99% nt identity with the Colombian SMV isolates (KY249378, MW655827). Both RNA-1 (OP564895) and -2 (OP564896) segments of the Casanare isolate shared 99% nt identity with PfGSV isolate (MK804173-74). Our discovery identified PfGSV in Colombia, for the first-time outside Brazil and Paraguay. The findings of PfGSV in yellow passion fruit increases the potential threat and possibility of PfGSV movement via Brevipalpus sp. from passion fruit to other hosts.

Adsorptive sequestration of noxious uranium (VI) from water resources: A comprehensive review

Groundwater is usually utilized as a drinking water asset everywhere. Therefore, groundwater defilement by poisonous radioactive metals such as uranium (VI) is a major concern due to the increase in nuclear power plants as well as their by-products which are released into the watercourses. Waste Uranium (VI) can be regarded as a by-product of the enrichment method used to produce atomic energy, and the hazard associated with this is due to the uranium radioactivity causing toxicity. To manage these confronts, there are so many techniques that have been introduced but among those adsorptions is recognized as a straightforward, successful, and monetary innovation, which has gotten major interest nowadays, despite specific drawbacks regarding operational as well as functional applications. This review summarizes the various adsorbents such as Bio-adsorbent/green materials, metal oxide-based adsorbent, polymer based adsorbent, graphene oxide based adsorbent, and magnetic nanomaterials and discuss their synthesis methods. Furthermore, this paper emphasis on adsorption process by various adsorbents or modified forms under different physicochemical conditions. In addition to this adsorption mechanism of uranium (VI) onto different adsorbent is studied in this article. Finally, from the literature reviewed conclusion have been drawn and also proposed few future research suggestions.

Cervical Radiculopathy: Focus on Factors for Better Surgical Outcomes and Operative Techniques

For patients with cervical radiculopathy, most studies have recommended conservative treatment as the first-line treatment; however, when conventional treatment fails, surgery is considered. A better understanding of the prognosis of cervical radiculopathy is essential to provide accurate information to the patients. If the patients complain of persistent and recurrent arm pain/numbness not respond to conservative treatment, or exhibit neurologic deficits, surgery is performed using anterior or posterior approaches. Anterior cervical discectomy and fusion (ACDF) has historically been widely used and has proven to be safe and effective. To improve surgical outcomes of ACDF surgery, many studies have been conducted on types of spacers, size/height/position of cages, anterior plating, patients' factors, surgical techniques, and so forth. Cervical disc replacement (CDR) is designed to reduce the incidence of adjacent segment disease during long-term follow-up by maintaining cervical spine motion postoperatively. Many studies on excellent indications for the CDR, proper type/size/shape/height of the implants, and surgical techniques were performed. Posterior cervical foraminotomy is a safe and effective surgical option to avoid complications associated with anterior approach and fusion surgery. Most recent literature demonstrated that all three surgical techniques for patients with cervical radiculopathy have clear advantages and disadvantages and reveal satisfactory surgical outcomes under a proper selection of patients and application of appropriate surgical methods. For this, it is important to fully understand the factors for better surgical outcomes and to adequately practice the operative techniques for patients with cervical radiculopathy.

Guidelines adopted by agile teams in privacy requirements elicitation after the Brazilian general data protection law (LGPD) implementation

The Brazilian General Data Protection Law (LGPD) implementation has impacted activities carried out by the software development teams. Due to it, developers had to become aware of the existing techniques and tools to carry out privacy requirements elicitation. Extending our previous work, we have investigated the actions taken by organizations regarding the LGPD, specifically in software development, considering the perception of agile development teams after two years of the LGPD implementation. In addition, we also investigated the perception of an agile team regarding the practices, techniques, and tools previously cited by practitioners as potential solutions for use in this context, along with techniques already in use in the current context. We have conducted a systematic literature review (SLR) and selected 36 primary studies. Furthermore, we have conducted a survey with 53 IT practitioners and semi-structured interviews with ten practitioners. The LGPD principles are known by most agile teams and are being implemented by the organizations, although the existing tools to support privacy requirements elicitation are still underused by agile teams. Moreover, agile teams consider that software requirements and software construction are the most impacted areas of knowledge by the LGPD, and most of them use user stories in privacy requirements elicitation. Our findings reveal that agile teams and Brazilian organizations are more concerned with user data privacy issues after the LGPD became effective. However, agile teams still face challenges in privacy requirements elicitation.

The association of internal mammary and medial supraclavicular lymph node radiation technique with clinical outcomes: Results from the EORTC 22922/10925 randomised trial

BACKGROUND AND PURPOSE

The multicentre EORTC 22922/10925 trial (ClinicalTrials.gov, NCT00002851) was conducted between 1996 and 2004. The trial evaluated the effect of irradiation of the internal mammary and medial supraclavicular lymph node chains (IM-MS) vs no further radiation therapy (RT) on survival and cause of death in breast cancer stage I-III patients. At 15.7 years of median follow-up, a significant reduction of breast cancer specific mortality (BCSM) and any recurrence, not translating in improved overall survival (OS), and low absolute rates of side effects were found. The aim of the current analysis was to evaluate the association of RT techniques of IM-MS lymph node irradiation with long-term outcomes.

PATIENTS AND METHODS

Three RT techniques were used for IM-MS: a standard technique using a fixed set-up combining photon/electron beams to the IM and tangential fields to the breast or chest wall vs a standard-modified technique with minor adaptation for beam settings vs a more individualised technique based on individual localisation of the IM. Techniques used were fixed per institution over the duration of the trial. We performed an exploratory and descriptive analysis of the outcomes after 15 years follow-up for the three RT techniques.

RESULTS

Between July 1996 and January 2004, 46 radiation oncology departments from 13 countries accrued 4004 patients. Median follow-up was 15.7 years. The number of patients treated by each technique was 2440 (61%) by standard vs 635 (16%) by standard-modified vs 929 (23%) patients by individualised technique. The absolute improvements of oncological outcomes in terms of disease-free survival (DFS), OS and BCSM with IM-MS RT compared to no IM-MS RT were 6.8%, 4.9% and -5.8% for the individualised technique, vs 1.6%, 2.9% and -4.3% for modified standard and -1.4%, 1.1% and -3% for standard technique, respectively. The increase in 15-year rates of side effects due to IM-MS RT, both scored longitudinally and cross-sectionally, were similar among the techniques.

CONCLUSION

Even though a straightforward comparison by technique is not possible because of variations in baseline characteristics between institutions, our findings suggest that the use of more individualised RT techniques is associated with higher rates of oncological improvements without increased risks for late side effects.

Surgeons preferences in descemet membrane endothelial keratoplasty (DMEK)

AIM

To explore the attitudes, preferences, and barriers of DMEK among corneal specialists in Saudi Arabia.

METHOD

An anonymous survey was sent through an online platform to members of the Saudi Ophthalmological Society. The survey was designed to capture data covering: demographic data, practice patterns of keratoplasty techniques, DMEK technique preferences, barriers, and facilitators to performing DMEK.

RESULTS

Thirty-five (33% response rate) surgeons participated in the questionnaire. Sixty-eight percent were in practice for less than or equal to 10 years. Thirteen surgeons were performing DMEK. Participating in any training capacity was observed among surgeons who performed DMEK (92%). The main selection criteria for this procedure were patients with normal anterior chamber anatomy (77%). The main barrier against DMEK adoption among surgeons who do not perform the procedure was the lack of experience (91%). Strategies to help begin performing DMEK were eye banks support (prepared grafts, backup tissue for inadvertent loss), access to wet-lab training courses, and higher surgical volume.

CONCLUSION

DMEK is not highly performed among corneal specialists in Saudi Arabia; however, there is evident interest in adopting this technique. Strategies toward filling the gap of lacking experience would facilitate the adoption of the procedure. Eye banks play a crucial role by providing prepared tissues, which would lessen part of the technical difficulty.

Pre- and intraoperative decision-making challenges in hip arthroscopy for femoroacetabular impingement

There has been a marked increase in the number of hip arthroscopies performed over the past 16 years, primarily in the management of femoroacetabular impingement (FAI). Insights into the pathoanatomy of FAI, and high-level evidence supporting the clinical effectiveness of arthroscopy in the management of FAI, have fuelled this trend. Arthroscopic management of labral tears with repair may have superior results compared with debridement, and there is now emerging evidence to support reconstructive options where repair is not possible. In situations where an interportal capsulotomy is performed to facilitate access, data now support closure of the capsule in selective cases where there is an increased risk of postoperative instability. Preoperative planning is an integral component of bony corrective surgery in FAI, and this has evolved to include computer-planned resection. However, the benefit of this remains controversial. Hip instability is now widely accepted, and diagnostic criteria and treatment are becoming increasingly refined. Instability can also be present with FAI or develop as a result of FAI treatment. In this annotation, we outline major current controversies relating to decision-making in hip arthroscopy for FAI. Cite this article: Bone Joint J 2022;104-B(5):532-540.

Attachment Representation Moderates the Effectiveness of Behavioral Parent Training Techniques for Children with ADHD: Evidence from a Randomized Controlled Microtrial

Behavioral parent training is an evidence-based intervention for children with attention-deficit/hyperactivity disorder (ADHD), but knowledge on the differential effects of behavioral techniques for specific subgroups of children is very limited. Attachment representations of children with ADHD may affect how receptive children are to changes in parenting. In this study, we investigated whether specific behavioral techniques were more or less effective for children with ADHD in relation to their attachment representations. We included parents of 74 children with ADHD (4-11 years, M = 8.15) who took part in a larger randomized controlled microtrial in which they were randomized to a two session training in antecedent-based techniques (i.e., stimulus control techniques: rules, instructions; n = 26), a two session training in consequent-based techniques (i.e., contingency management techniques: praise, rewards, ignoring; n = 25) or a waitlist control condition (n = 23). We examined whether attachment representation moderated the effectiveness of a) training versus waitlist, and b) antecedent- versus consequent-based techniques. Attachment representations were measured with a story stem task, the intervention outcome was daily parent-rated problem behaviors of the children. Attachment representation did not moderate the effects of the training compared to the waitlist. However, compared to antecedent-based techniques, consequent-based techniques were less effective for more securely and less disorganized attached children, and particularly effective for more disorganized attached children. This was the first study examining attachment as a moderator of behavioral techniques for ADHD. If replicated, the findings of this study can be used for treatment development and tailoring.

Power Flush, a novel bail-out technique for stumpless aorto-ostial CTOs. A case-based approach

BACKGROUND

Aorto-ostial coronary artery flush chronic total occlusions are a challenging subset of lesion with peculiar characteristic: the near complete lack of guiding catheter support, the presence of a thicker layer of muscular fibers and a greater collagen and calcium content, responsible for balloon dilatation's resistance and greater recoil tendency. We introduce a novel bailout technique to overcome retrograde wire failure in accessing aorta, a variation of the Carlino technique which we named Power Flush.

MATERIALS AND METHODS

Power Flush consists in a forceful injection of contrast dye directly through the guiding catheter positioned against the aortic wall in correspondence to the coronary ostium location, to gain access to the extra-plaque space and proceed with the vessel's recanalization. In one case we used a further iteration named Nick And Flush, in which a preliminary nicking of the aortic wall with a penetrative wire was done before the Power Flush.

RESULTS

We hereby present three cases of aorto-ostial right coronary artery flush chronic total occlusions. In two of them we utilized the Power Flush technique, in one case we employed its variant Nick And Flush. We were successful in all cases and no complication occurred.

CONCLUSIONS

In this kind of lesions Power Flush and Nick And Flush are effective bailout techniques to overcome retrograde wire failure to reach aorta.

Advances in HPV Screening Tests for Cervical Cancer-A Review

HPV is responsible for almost all cases of cervical cancer which in turn is one of the common causes of death among female genital malignancies. Cervical cancer being a preventable disease, screening plays a vital role in its reduction. In this era of advanced health care system and technologies this cancer is still in the increasing trend, especially in the Low and Middle Income Countries, which reflects the poor coverage of women for screening. Advances in screening tests and techniques for better and larger coverage of women is the need of the hour globally. Clinicians also need to be aware of the various promising technologies available for screening of cervical cancer precursors, application of which in general practice can be of immense help in cervical cancer reduction.

Solid waste management during COVID-19 pandemic: Recovery techniques and responses

Solid waste management (SWM) is a service of public health that is often understated in its significance. If a public health emergency like the COVID-19 outbreak exacerbates the SWM problem, its true importance as an imperative service becomes more apparent. The crisis triggered by the COVID-19 pandemic has changed the dynamics of waste generation globally in nearly every sector and has therefore raised the need for special attention. The unpredictable variations in the quantity and composition of waste also pressurize policymakers to react dynamically. This review highlights the major problems faced during the pandemic by SWM sector and the underlying possibilities to fill the gaps in the existing system. The review focuses on particular areas that have been the most important cause of concern throughout the crisis in the process of waste management. In addition, the mixing of virus infected biomedical waste with the stream of normal solid waste and lack of active involvement of the citizen and cooperation presents the major negative safety and health concerns for the workers involved in the sanitation process. Apart from presenting innovative solutions to tackle current waste management issues, this study also proposes several key potential guidelines to holistically mitigate possible future pandemics, if any. This article can also be of great implication for creation of a specific strategy towards preventing/controlling any potential pandemic of similar kind in the near future.

Breast Reconstruction: Necessity for Further Standardization of the Current Surgical Techniques Attempting to Facilitate Scientific Evaluation and Select Tailored Individualized Procedures Optimizing Patient Satisfaction

Background

Various breast cancer reconstruction methods and novel surgical techniques include autologous or allogenic procedures, which can increase patient's quality of life and provide options when dealing with patients seen as challenging clinical scenarios.

Summary

Our aim was to review the current literature and present published evidence on innovative standards in whole breast reconstruction. Advances in flap monitoring or newly published data regarding neurotization in breast reconstruction, arm lymphedema management, breast implant-associated anaplastic large cell lymphoma reconstruction treatment, and robotic surgery with regard to radiotherapy define innovative standards in the breast reconstruction setting. The role of meshes/acellular dermal matrix and fat grafting as well as optimal sequencing of postmastectomy radiotherapy in autologous and alloplastic breast reconstruction appear highly debatable also in expert panel meetings rendering further clinical research including RCTs imperative.

Key Messages

There is an abundance of novel available techniques, which mandate further standardization, facilitating scientific evaluation in an attempt to help surgeons select tailored procedures for each patient with the goal to promote informed decision-making in breast reconstruction.

Transseptal puncture: Review of anatomy, techniques, complications and challenges, a critical view

Transseptal puncture (TSP) was initially described to gain access to the left heart for hemodynamic assessment. Continuous evolution from its origins allows interventionists to perform a myriad of procedures that otherwise would be impossible to accomplish. In the recent years, the number of procedures in cardiology that require TSP has grown exponentially. Namely, transcatheter mitral valve repair and replacement, pulmonary vein isolation and left atrium appendage occlusion. In skilled hands, it is a safe and straightforward procedure; however, a lack of knowledge of the materials, anatomy of the interatrial septum and the technique can be met with life-threatening complications. Therefore, it is imperative that interventional cardiologists master this technique to successfully overcome these obstacles and ensure clinical outcomes in patients requiring TSP. The purpose of the following review is to critically analyze the available evidence regarding TSP, provide a step-by-step approach to the technique, the available materials and tips and tricks to overcome difficulties and manage complications.

New approach in SARS-CoV-2 surveillance using biosensor technology: a review

Biosensors are analytical tools that transform the bio-signal into an observable response. Biosensors are effective for early detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection because they target viral antigens to assess clinical development and provide information on the severity and critical trends of infection. The biosensors are capable of being on-site, fast, and extremely sensitive to the target viral antigen, opening the door for early detection of SARS-CoV-2. They can screen individuals in hospitals, airports, and other crowded locations. Microfluidics and nanotechnology are promising cornerstones for the development of biosensor-based techniques. Recently, due to high selectivity, simplicity, low cost, and reliability, the production of biosensor instruments have attracted considerable interest. This review article precisely provides the extensive scientific advancement and intensive look of basic principles and implementation of biosensors in SARS-CoV-2 surveillance, especially for human health. In this review, the importance of biosensors including Optical, Electrochemical, Piezoelectric, Microfluidic, Paper-based biosensors, Immunosensors, and Nano-Biosensors in the detection of SARS-CoV-2 has been underscored. Smartphone biosensors and calorimetric strips that target antibodies or antigens should be developed immediately to combat the rapidly spreading SARS-CoV-2. Wearable biosensors can constantly monitor patients, which is a highly desired feature of biosensors. Finally, we summarized the literature, outlined new approaches and future directions in diagnosing SARS-CoV-2 by biosensor-based techniques.