The phage-bacteria interactions in the gut microbiome are critical for health and disease, but viruses of the human gut microbiome are poorly understood. Here, we present a simple and cost-efficient protocol for collecting viral-like particles (VLPs) from human fecal samples. We describe VLPs quantification using epifluorescence and TEM microscopy, followed by DNA sequencing and bioinformatics analysis. This protocol characterizes the gut phageome in normal-weight and obese children with metabolic syndrome. It is also suitable to conduct high-throughput studies for other diseases. For complete details on the use and execution of this profile, please refer to Bikel et al. (2021).

Keywords: Bioinformatics; Health Sciences; Metabolism; Microbiology; Microscopy; Molecular Biology; Sequence analysis; Sequencing; Systems biology.

Securing a clear sense of identity is a critical issue in adolescence, yet the role that cultural identity plays in the well-being of youths remains unclear. This study aims to examine the relationship between cultural identity and mental health among three groups of adolescents in Hong Kong with different residential backgrounds. Data came from a cross-sectional survey with 2180 4th-9th grade students in Hong Kong. Cultural identity was assessed by whether the youths identify themselves as local Hong Kong people, mainland Chinese, both Hong Kong and mainland Chinese, or confused about which group to belong to. Mental health was assessed by self-esteem, mental well-being, happiness, social anxiety, and depression. Multiple linear regression was performed to examine the relationship between cultural identity and mental health, adjusting for sociodemographic variables. The regression results suggested adolescents with confused cultural identity scored lower in all positive indicators of mental health compared with those with a clear cultural identification. No significant association was found between cultural identity and social anxiety/depression. Uncertainty in cultural identification may be detrimental for the mental health of adolescents living in a multicultural society. Interventions may consider cultivating clear cultural identities among adolescents to promote their mental health.

Keywords: confused identity; cross-border adolescents; cultural identity; mental health; new immigrant adolescents.

Keywords: Climate change; ecomechanics; field work; functional morphology; interdisciplinary; mechanical ecology; mechanical stress.

Objective: To develop and validate a radiomic prediction model using initial noncontrast computed tomography (CT) at admission to predict in-hospital mortality in patients with traumatic brain injury (TBI).

Methods: A total of 379 TBI patients from three cohorts were categorized into training, internal validation, and external validation sets. After filtering the unstable features with the minimum redundancy maximum relevance approach, the CT-based radiomics signature was selected by using the least absolute shrinkage and selection operator (LASSO) approach. A personalized predictive nomogram incorporating the radiomic signature and clinical features was developed using a multivariate logistic model to predict in-hospital mortality in patients with TBI. The calibration, discrimination, and clinical usefulness of the radiomics signature and nomogram were evaluated.

Results: The radiomic signature consisting of 12 features had areas under the curve (AUCs) of 0.734, 0.716, and 0.706 in the prediction of in-hospital mortality in the internal and two external validation cohorts. The personalized predictive nomogram integrating the radiomic and clinical features demonstrated significant calibration and discrimination with AUCs of 0.843, 0.811, and 0.834 in the internal and two external validation cohorts. Based on decision curve analysis (DCA), both the radiomic features and nomogram were found to be clinically significant and useful.

Conclusion: This predictive nomogram incorporating the CT-based radiomic signature and clinical features had maximum accuracy and played an optimized role in the early prediction of in-hospital mortality. The results of this study provide vital insights for the early warning of death in TBI patients.

Keywords: In-hospital mortality; Nomogram; Radiomic signature; Traumatic brain injury.

Background: In the aftermath of bone injuries, such as cranium and sternum, bone wax (BW) is used to control bleeding from the bone surfaces during surgery. Made up of artificial substances, however, it is associated with many complications such as inflammation, increased risk for infection, and bone repair delay. We, therefore, in this study set out to design and evaluate a novel BW without the above-mentioned side-effects reported for other therapies.

Methods: The pastes (new BW(s)) were prepared in the laboratory and examined by MTT, MIC, MBC, and degradability tests. Then, 60 adult male Wistar rats, divided into six equal groups including chitosan (CT), CT-octacalcium phosphate (OCP), CT-periostin (Post), CT-OCP-Post, Control (Ctrl), and BW, underwent sternotomy surgery. Once the surgeries were completed, the bone repair was assessed radiologically and thereafter clinically in vivo and in vitro using CT-scan, H&E, ELISA, and qRT-PCR.

Results: All pastes displayed antibacterial properties and the CT-Post group had the highest cell viability compared to the control group. In contrast to the BW, CT-Post group demonstrated weight changes in the degradability test. In the CT-Post group, more number of osteocyte cells, high trabeculae percentage, and the least fibrous connective tissue were observed compared to other groups. Additionally, in comparison to the CT and Ctrl groups, higher alkaline phosphatase activity, as well as decreased level of serum tumor necrosis factor-α, interleukin-6, and OCN in the CT-Post group was evident. Finally, Runx2, OPG, and RANKL genes' expression was significantly higher in the CT-Post group than in other groups.

Conclusion: Our results provide insights into the desirability of pastes in terms of cellular viability, degradability, antibacterial properties, and surgical site restoration compared to the BW group. Besides, Periostin could enhance the osteogenic properties of bone tissue defect site.

Keywords: Bone healing; Chitosan; OPG and RANKL; Periostin; Runx2.

Introduction: ALK tyrosine kinase inhibitors (TKIs) are the standard treatment for advanced ALK-positive NSCLC. Nevertheless, drug resistance inevitably occurs. Here, we report a case of a patient with metastatic ALK-positive lung adenocarcinoma with an impressive resistance to sequential treatment with ALK TKIs mediated by YES1 and MYC amplification in a contest of epithelial-to-mesenchymal transition and high progressive chromosomal instability.

Methods: The patient received, after chemotherapy and 7 months of crizotinib, brigatinib and lorlatinib with no clinical benefit to both treatments. A study of resistance mechanisms was performed with whole exome sequencing on different biological samples; primary cell lines were established from pleural effusion after lorlatinib progression.

Results: At whole exome sequencing analysis, YES1 and MYC amplifications were observed both in the pericardial biopsy and the pleural effusion samples collected at brigatinib and lorlatinib progression, respectively. Increasing chromosomal instability from diagnostic biopsy to pleural effusion was also observed. The addition of dasatinib to brigatinib or lorlatinib restored the sensitivity in primary cell lines; data were confirmed also in H3122_ALK-positive model overexpressing both YES1 and MYC.

Conclusions: In conclusion, YES1 and MYC amplifications are candidates to justify a rapid acquired resistance to crizotinib entailing primary brigatinib and lorlatinib resistance. In this context, a combination strategy of ALK TKI with dasatinib could be effective to overcome a rapid resistance.

Keywords: ALK TKIs; MYC amplification; NSCLC; Resistance mechanism; YES1 amplification.

Objective: Specialized literature has identified a need for evidence-based, low-threshold, short-term, and intra-cultural psychological interventions that can be made available to migrants, including refugees, who suffer from psychological symptoms in host countries. The objective of the present study is to measure the efficacy of Value Based Counseling (VBC) as such an intervention.

Method: We conducted a pragmatic, rater-blinded randomized controlled trial employing a pre-post control group design to assess the efficacy of VBC based on a study sample of 103 migrants, including refugees, who resided in Germany at the time. A set of instruments was used to evaluate primary outcome measures of depression, Posttraumatic Stress Disorder (PTSD) symptoms, perceived stress, generalized anxiety, and somatic complaints.

Results: Per protocol analysis included 42 participants in the VBC group, and 43 in the waiting list. Compared with participants in the waiting-list group, the VBC group, following an average of four counselling sessions, experienced a clinically meaningful reduction of depression (adjusted difference 7.06, 95% CI [4.86, 9.26], effect size 0.68, p < .001), PTSD (adjusted difference 17.15, 95% CI [10.49, 23.81], effect size 0.76, p < .001), perceived stress (adjusted difference 9.25, 95% CI [6.23, 12.27], effect size 0.75, p < .001), anxiety (adjusted difference 5.34, 95% CI [3.47, 7.20], effect size 0.70, p < .001), and somatic complaints (adjusted difference 5.52, 95% CI [3.30, 7.74], effect size 0.72, p < .001). The positive outcomes were maintained at three-month follow-up. Utilization of mental health services was significantly reduced at the three-month follow-up conducted with participants of the VBC group.

Conclusions: Value Based Counseling (VBC), a culturally sensitive and strength-based mental health service, is an effective short-term intervention which meets the specific mental health needs of migrants, including refugees. The study protocol was retrospectively registered in the German Clinical Trials Register (DRKS00016867).

Keywords: Value Based Counseling; mental health care; migrants; peer counselling; psychological treatment; refugees.

The Biopharmaceutics Drug Disposition Classification system (BDDCS) is a four-class approach based on water solubility and extent of metabolism/permeability rate. Based on the BDDCS class to which a drug is assigned, it is possible to predict the role of metabolic enzymes and transporters on the drug disposition of a new molecular entity (NME) prior to its administration to animals or humans. Here, we report a total of 1475 drugs and active metabolites to which the BDDCS is applied. Of these, 379 are new entries, and 1096 are revisions of former classification studies with the addition of references for the approved maximum dose strength, extent of the systemically available drug excreted unchanged in the urine, and lowest solubility over the pH range 1.0-6.8 when such information is available in the literature. We detail revised class assignments of previously misclassified drugs and the literature analyses to classify new drugs. We review the process of solubility assessment for NMEs prior to drug dosing in humans and approved dose classification, as well as the comparison of Biopharmaceutics Classification System (BCS) versus BDDCS assignment. We detail the uses of BDDCS in predicting, prior to dosing animals or humans, disposition characteristics, potential brain penetration, food effect, and drug-induced liver injury (DILI) potential. This work provides an update on the current status of the BDDCS and its uses in the drug development process.

Keywords: BCS; BDDCS; DILI; dose number; extent of metabolism; food effects; solubility.

Aerobic exercise has been identified as an effective strategy for transiently enhancing inhibitory control, an ability to suppress irrelevant distractors while focusing on relevant information in facilitating the implementation of goal-directed behavior. The purpose of this study was to employ a go/no-go version of the redundant-target task and event-related potential to further determine whether inhibitory control at the perceptual and response levels as well as their underlying processing capacity and neuroelectric alterations are differentially affected by a single bout of aerobic exercise. Twenty-seven young adults completed the redundant-target task while electroencephalogram was recorded before and after one 20-min bout of moderate-intensity aerobic exercise and a sitting control condition on separate days in counterbalanced order. Although behavioral outcomes of mean-level performance did not differ between intervention conditions, time-related decreases in processing capacity for the faster responses were only observed following rest. Aerobic exercise resulted in maintained P3b amplitude from pretest to posttest for all trial types while decreased P3b amplitude from pretest to posttest during single-target and redundant-target trials was observed following rest. Further, the time-related changes in P3b amplitude were positively correlated with improvements in task performance following exercise. These findings suggest that a short bout of aerobic exercise selectively counteracts the time-related decrements in processing capacity as well as neuroelectric processing of attention and conflict suppression that contribute to behavioral outcomes of inhibitory control.

Keywords: N2; P3; event-related potential; executive function; physical activity; system factorial technology.

Though Cinnamomum zeylanicum is a very important commercial aromatic bark yielding and oldest known tree spice of India, there are hardly any studies to understand the nature of wound healing and bark recovery. Further, optimal number of sprouts to be retained under coppice system to maximize the bark yield per tree in C. zeylanicum is not yet standardized. The present investigation was carried out to understand the influence of patch geometry and application of post-bark-extraction-protection treatments on bark regeneration in mature trees as well as to standardize an optimal number of sprouts to be retained under coppice system to maximize the bark yield per tree. In general, wound healing in C. zeylanicum occurred from the edge of the blaze and was quicker in the narrower patch than the broader patch; application of Bordeaux paste or neem seed kernel extract on the blazed area immediately after the bark extraction, resulted in significantly higher mean percent bark recovery and higher bark oil content than control. Allowing seven coppice sprouts per stem resulted in higher dry mass of bark per plant and higher bark oil than other treatments under coppice system. The results of the study would enable formulation of management strategies specifically for sustainable bark harvesting in Cinnamomum species.

Keywords: Bark oil; Bark wound healing; Bordeaux paste; Neem seed kernel extract; Tree spice.

Exploring extractable phytochemicals from locally adapted sisal plant vegetation vary seasonally at different locations. This study elaborated proximate composition and phytochemical heterogeneity in sisal due to varying environmental conditions analyzed from five districts, i.e., Chakwal, Khushab, Rawalpindi, Faisalabad, and Layyah in Punjab, Pakistan. Extensive surveying and plant sampling across 2 years 2017-2018 and 2018-2019, during mid-spring, summer, autumn, and winter seasons were carried out for understanding the seasonal impact on sisal. The present study was designed in a randomized complete block design (RCBD) and analyzed considering seasonal, yearly, and locational impact. The spatial differences in phytochemicals concentration were strongly associated with environmental conditions prevailing in different seasons. Autumn season reflected saponins, tannins, and flavonoids in higher concentrations during 2018-2019 while steroids and terpenoids were higher during spring 2018-2019. Spatio-temporal variations in the proximate analysis were more apparent in different samples collected from different districts. Data recorded for the Khushab district and autumn season reflected the higher composition of a proximate analysis and phytochemical contents as compared to other seasons. Overall, the spatial differences in phytochemicals concentration were strongly associated with soils and environmental conditions prevailing in different seasons in selected districts.

Keywords: Environment; Heterogeneity; Phytochemical; Proximate analysis; Sisal.

Background: Gynoid lipodystrophy is one of the most common cosmetical problems in women.

Aims: The study aims to examine the pathomorphology and histology of subcutaneous tissue in women with gynoid lipodystrophy exposed to local compression/vibration therapy using a non-invasive Beautylizer Therapy Cosmospheres V medical device.

Methods: The study enrolled 25 virtually healthy women aged 25 to 45 years with gynoid lipodystrophy grades I and II. The women included in the study completed a 10-session month-long therapeutic course with a non-invasive Beautylizer Therapy Cosmospheres V medical device. Bioptic punch-size samples were taken from the gluteal region prior to and following the 10-session therapy course with the device.

Results: After completing a 10-session treatment course, a decrease in the mean adipocyte area from 123.08 ± 13.60 μm to 67.14 ± 4.20 μm was observed in punch bioptic samples of subcutaneous fat tissues of women with gynoid lipodystrophy as compared to the pre-treatment indices.

Conclusion: Thus, local application of 10-session therapy with a non-invasive Beautylizer Therapy Cosmospheres V medical device in women with gynoid lipodystrophy demonstrated a positive effect on the histological structure of the hypodermis.

Keywords: controlled vibration; gynoid lipodystrophy; histological changes; hypodermis; vibration-compression method.

Purpose: Exercise-induced bronchoconstriction (EIB) affects approximately 50% of young asthma patients, impairing their participation in sports and physical activities. Eucapnic voluntary hyperpnea (EVH) is an approved surrogate challenge to exercise for objective EIB diagnosis, but the required minimum target hyperventilation rates remain unexplored in this population. This study aimed to evaluate the association between the achieved ventilation rates (VRs) during a challenge and EIB-compatible response (EIB-cr) in young asthma patients.

Methods: This cross-sectional study included 72 asthma patients aged 10-20 years. Forced expiratory volume in the first second (FEV1) was measured before and 5, 15, and 30 min after the EVH. The target VR was set at 21 times the individual's baseline FEV1. A decrease of > 10% in FEV1 after the challenge was considered an EIB-cr. The challenge was repeated after 48-72 h in those without an EIB-cr.

Results: Thirty-six individuals had an EIB-cr at initial evaluation. The median VRs achieved was not different between individuals with and without an EIB-cr (19.8 versus 17.9; p = 0.619). The proportion of individuals with an EIB-cr was nor different comparing those who achieved (12/25) or not (24/47) the calculated target VRs (p = 0.804). At the repeated EVH challenge an EIB-cr was observed in 14/36 individuals with a negative response in the first evaluation, with no differences in achieved VRs between the two tests (p = 0.463).

Conclusion: Irrespective of the achieved VR, an EIB-compatible response after an EVH challenge must be considered relevant for clinical and therapeutic judgment and negative tests should be repeated.

Keywords: Asthma; Eucapnic voluntary hyperpnea; Exercise-induced bronchoconstriction; Lung function.

Introduction: Assessing bowel viability can be challenging during acute surgical procedures, especially regarding mesenteric ischaemia. Intraoperative fluorescence angiography (FA) may be a valuable tool for the surgeon to determine whether bowel resection is necessary and to define the most appropriate resection margins. The aim of this study is to report on FA use in the acute setting and to judge its impact on intraoperative decision making.

Materials and methods: This is a multi-centre, retrospective case series of patients undergoing emergency abdominal surgery between February 2016 and 2021 in three general/colorectal units where intraoperative FA was performed to assess bowel viability. Primary endpoint was change of management after the FA assessment.

Results: A total of 93 patients (50 males, 66.6 ± 19.2 years, ASA score ≥ III in 85%) were identified and studied. Initial surgical approach was laparotomy in 66 (71%) patients and laparoscopy in 27 (29% and seven, 26% conversions). The most common aetiologies were mesenteric ischaemia (n = 42, 45%) and adhesional/herniae-related strangulation (n = 41, 44%). In 50 patients a bowel resection was performed. Overall rates of anastomosis after resection, reoperation and 30-day mortality were 48% (n = 24/50, one leak), 12% and 18%, respectively. FA changed management in 27 (29%) patients. In four patients (4% overall), resection was avoided and in 21 (23%) extra bowel length was preserved (median 50 cm of bowel saved, IQR 28-98) although three patients developed further ischaemia. FA prompted extended resection (median of 20 cm, IQR 10-50 extra bowel) in six (6%) patients.

Conclusion: Intraoperative use of FA impacts surgical decisions regarding bowel resection for intestinal ischaemia, potentially enabling bowel preservation in approximately one out of four patients. Prospective studies are needed to optimize the best use of this technology for this indication and to determine standards for the interpretation of FA images and the potential subsequent need for second-look surgeries.

Keywords: Acute setting; Case series; Change of management; Fluorescence angiography; Ischaemia.

In task-switching studies, performance is typically worse in task-switch trials than in task-repetition trials. These switch costs are often asymmetrical, a phenomenon that has been explained by referring to a dominance of one task over the other. Previous studies also indicated that response modalities associated with two tasks may be considered as integral components for defining a task set. However, a systematic assessment of the role of response modalities in task switching is still lacking: Are some response modalities harder to switch to than others? The present study systematically examined switch costs when combining tasks that differ only with respect to their associated effector systems. In Experiment 1, 16 participants switched (in unpredictable sequence) between oculomotor and vocal tasks. In Experiment 2, 72 participants switched (in pairwise combinations) between oculomotor, vocal, and manual tasks. We observed systematic performance costs when switching between response modalities under otherwise constant task features and could thereby replicate previous observations of response modality switch costs. However, we did not observe any substantial switch-cost asymmetries. As previous studies using temporally overlapping dual-task paradigms found substantial prioritization effects (in terms of asymmetric costs) especially for oculomotor tasks, the present results suggest different underlying processes in sequential task switching than in simultaneous multitasking. While more research is needed to further substantiate a lack of response modality switch-cost asymmetries in a broader range of task switching situations, we suggest that task-set representations related to specific response modalities may exhibit rapid decay.

Keywords: Cognitive control; Response modalities; Task switching.

Aims: To prevent hepatitis B virus (HBV) reactivation-related hepatitis, we examined the clinical usefulness of a highly-sensitive HB core-related antigen (iTACT-HBcrAg) assay in patients with resolved HBV infection after nucleos(t)ide analogues (NA) treatment for HBV reactivation.

Methods: We retrospectively analyzed 27 patients with resolved HBV infection who experienced HBV reactivation (defined as HBV DNA levels of 1.3 log IU/mL or more), and who received systemic chemotherapies for hematological malignancies between 2008 and 2020. iTACT-HBcrAg, HBsAg-HQ and anti-HBs were measured using samples stored after HBV reactivation. The lower limit of quantification for iTACT-HBcrAg was 2.0 log U/mL.

Results: HBV reactivation was diagnosed at a median HBV DNA level of 1.8 log IU/mL, and then all patients received NA treatment. No patient had HBV-related hepatitis with a median maximum HBV DNA level of 2.0 log IU/mL. The positivities of iTACT-HBcrAg and HBsAg-HQ was 96% and 52% after HBV reactivation, respectively. Of 25 patients with detectable iTACT-HBcrAg at the initiation of NA treatment, 17 (68%) achieved iTACT-HBcrAg loss. Median durations from NA treatment to HBV DNA loss and iTACT-HBcrAg loss or the last follow-up were 35 and 175 days, respectively. Recurrence of HBV reactivation after NA cessation was not observed in seven of eight patients who achieved iTACT-HBcrAg loss or seropositive for anti-HBs during follow-up, except for one without anti-HBs after allogeneic transplantation.

Conclusions: iTACT-HBcrAg could be a potential surrogate marker for diagnosing early-stage HBV reactivation as well as safe cessation of NA treatment in patients with resolved HBV infection after HBV reactivation. This article is protected by copyright. All rights reserved.

Keywords: hepatitis B virus (HBV) reactivation; highly-sensitive hepatitis B core-related antigen assay (iTACT-HBcrAg); nucleos(t)ide analogues (NA) treatment; resolved HBV infection.

The present study evaluates the performance of an indigenously developed ceramic ultrafiltration (UF) membrane in a lab-scale membrane bioreactor (MBR) process to treat real tannery effluent with varying organic loading (1500-6000 mg/L). UF membrane was prepared by the coating of bentonite clay on tubular clay-alumina macroporous support. The membrane surface was characterized by scanning electron microscopy, Fourier transform infrared spectroscopy, X-ray diffraction, X-ray photoelectron spectroscopy, BET adsorption-desorption, contact angle measurement, and atomic force microscopy. In the side-stream MBR process, sewage sludge from a local sewage treatment plant was used as an activated sludge source with a constant sludge retention time of 30 days. Membrane filtration was performed in cross-flow mode using a single-channel membrane module. Artificial neural network (ANN) modeling tool was used to analyze the influence of various independent input variables, namely, the hydraulic retention time (4-10 h), mixed liquor suspended solid (MLSS) concentration (2-8 g/L), and influent COD concentration (1500-6000 mg/L) on COD removal (%) with feed-forward backpropagation method. Membrane study was done at a transmembrane pressure of 4.3 bar and feed flow rate of 7.5 L/min to observe the flux declination and fouling of the UF membrane with time. Average COD and BOD concentrations obtained in the treated effluent were 147.56 and 31 mg/L, respectively, and chromium concentration was < 0.1 mg/L; thus, treated effluent quality was found to be suitable for industrial recycling purposes apart from the safe environmental discharge. An in-depth study was undertaken to understand the removal mechanism in the MBR process, nature and extent of membrane fouling, changes in the morphology of the UF membrane, surface wettability, and surface topology by detailed surface characterization of the membrane pre- and post-filtration.

Keywords: Artificial Neural Network; Bentonite coating layer; COD removal efficiency; Ceramic ultrafiltration membrane; Membrane bioreactor; Tannery wastewater treatment.

Metal organic frameworks (MOFs), which constitute a new class of porous organic-inorganic hybrid materials, have gained considerable attention in the fields of electrochemical energy storage and conversion devices owing to their open topological structures, large surface areas, tunable morphologies, and extreme redox activity. A synthesis protocol that comprises coprecipitation followed by controlled calcination processes to design a battery-type electrode is used. This electrode consists of three-dimensional (3D), ant cave-like polyhedrons of nickel-cobalt alloy on graphitic carbon (GC; NiCo@GC) nanostructures; trimesic acid is used as a potential MOF-linker. The developed NiCo@GC sample exhibits mesoporous characteristics with the maximum surface area of 94.08 m² g^-1 at 77 K. In addition, the redox activity at different sweep rates reveals the battery-type charge storage behavior of the NiCo@GC electrode; its three-electrode assembly provides 444 C g^-1 specific capacity at 2 A g^-1 with long-term capacity retention. The constructed supercapattery (SC) devices (i.e., AC//NiCo@GC) achieved capacity, specific energy, and specific power are 74.3 mAh g^-1 , 39.5 Wh kg^-1 , and 665 W kg^-1 , respectively. Owing to its reasonable electrochemical characteristics, the prepared NiCo@GC material is a promising candidate for supercapattery electrodes for portable electronic devices.

Keywords: NiCo alloys; metal organic frameworks (MOFs); polyhedrons; specific energy; supercapatteries.

The coronavirus disease 2019 (COVID-19) pandemic is a global health crisis with the potential to elicit and worsen psychiatric symptoms, particularly post-traumatic stress disorder (PTSD) symptoms. Identifying modifiable protective factors is critical for preventing and treating PTSD symptoms both during and following the COVID-19 pandemic. The present study examined associations of self-reported sleep quality and anticipatory threat appraisals of the pandemic with PTSD symptoms 6 months later in a sample enriched for pre-pandemic trauma exposure and PTSD. The sample included 590 adults (mean age 38.2 years) who completed a baseline survey in August/September 2020 and follow-up survey in March/April 2021. The sample was recruited from a pool of participants interested in a prior study about traumatic stress. Participants self-reported sleep quality and pandemic-related anticipatory threat appraisals at baseline. PTSD symptoms were assessed at baseline and follow-up. Baseline sleep quality was associated with PTSD symptoms at follow-up controlling for baseline PTSD symptoms (B = -2.49, p = 0.001). Perceived anticipatory threat of the pandemic moderated this association such that worse sleep quality was related to more severe PTSD symptoms at follow-up for participants with higher (B = -4.07, p < 0.001) but not lower (B = -0.43, p = 0.679) anticipatory threat about the COVID-19 pandemic. These findings suggest that poor sleep quality may enhance vulnerability to later PTSD symptoms during the pandemic, particularly among those individuals who perceived the pandemic as threatening for their future. Treatments that address sleep problems may be beneficial for reducing trauma-related symptoms during and following the global health crisis.

Keywords: Post-traumatic stress disorder (PTSD); coronavirus disease 2019 (COVID-19); sleep; threat.

Reduced substrates produced by the serpentinization reaction under hydration of olivine may have fuelled biological processes on early Earth. To understand the adaptive strategies and carbon metabolism of the microbes in the serpentinizing ecosystems, we reconstructed 18 draft genomes representing dominant species of Omnitrophicaeota, Gammaproteobacteria and Methanobacteria from the Manleluag serpentinizing spring in Zambales, Philippines (hyperalkaline and rich in methane and hydrogen). Phylogenomics revealed that two genomes were affiliated with a candidate phylum NPL-UPA2 and the references of all our genomes were derived from ground waters, hot springs and the deep biosphere. C1 metabolism appears to be widespread as most of the genomes code for methanogenesis, CO oxidation and CO₂ fixation. However, likely due to the low CO₂ concentration and election acceptors, the biomass in the spring was extremely low (<10³ cell/ml). Various Na⁺ and K⁺ transporters and Na⁺ -driving ATPases appear to be encoded by these genomes, suggesting that nutrient acquisition, bioenergetics and normal cytoplasmic pH were dependent on Na⁺ and K⁺ pumps. Our results advance our understanding of the metabolic potentials and bioenergetics of serpentinizing springs and provide a framework of the ecology of early Earth.

Purpose: Even though effective techniques in diagnosis of periprosthetic joint infections (PJIs) have been developed, the optimal modality has yet to be determined. The present meta-analysis aimed to compare the diagnostic accuracy of dithiothreitol (DTT) and sonication against the Musculoskeletal Infection Society criteria in patients undergoing revision joint surgery.

Methods: We searched the PubMed, Scopus, and Central Cochrane register of controlled trials as well as gray literature until the 9th of November, 2021. We included articles considering the comparative diagnostic accuracy of sonication and DTT in adult patients having revision hip and knee arthroplasty for septic or aseptic reasons. We calculated pooled sensitivity, specificity, and diagnostic accuracy of the above diagnostic techniques against the Musculoskeletal Infection Society (MSIS) criteria and created receiver operating characteristics (ROC) curves to enable comparisons between each other. The quality of included papers was evaluated utilizing QUADAS-2 and QUADAS-C tools.

Results: Data from five comparative studies totaling 726 implants were pooled together. The diagnostic accuracy of DTT and sonication were 86.7% (95% CI 82.7 to 90.1) and 83.9% (95% CI 79.7 to 87.5), respectively. Pooled sensitivity and specificity showed no statistically significant differences between DTT and sonication (0.7 [95% CI 0.62 to 0.77] vs 0.72 [95% CI 0.65 to 0.78], p = 0.14; and 0.99 [95% CI 0.97 to 1] vs 0.97 [95% CI 0.93 to 0.99], p = 5.5, respectively).

Conclusions: This meta-analysis did not identify any clinically meaningful difference between the diagnostic potential of sonication and the chemical-based biofilm dislodgment methods. This finding remained robust after adjusting for the administration of antibiotics prophylaxis, implementation of the polymerase chain reaction of sonicated fluid, and study quality.

Keywords: DTT; Diagnostic accuracy; Dithiothreitol; Meta-analysis; Sensitivity; Sonication; Specificity.

Background: Hyperventilation resulting in hypocapnic alkalosis (HA) is frequently encountered in spontaneously breathing patients with acute cerebrovascular conditions. The underlying mechanisms of this respiratory response have not been fully elucidated. The present study describes, applying the physical-chemical approach, the acid-base characteristics of cerebrospinal fluid (CSF) and arterial plasma of spontaneously breathing patients with aneurismal subarachnoid hemorrhage (SAH) and compares these results with those of control patients. Moreover, it investigates the pathophysiologic mechanisms leading to HA in SAH.

Methods: Patients with SAH admitted to the neurological intensive care unit and patients (American Society of Anesthesiologists physical status of 1 and 2) undergoing elective surgery under spinal anesthesia were enrolled. CSF and arterial samples were collected simultaneously. Electrolytes, strong ion difference (SID), partial pressure of carbon dioxide (PCO₂), weak noncarbonic acids (A_TOT), and pH were measured in CSF and arterial blood samples.

Results: Twenty spontaneously breathing patients with SAH and 25 controls were enrolled. The CSF of patients with SAH, as compared with controls, was characterized by a lower SID (23.1 ± 2.3 vs. 26.5 ± 1.4 mmol/L, p < 0.001) and PCO₂ (40 ± 4 vs. 46 ± 3 mm Hg, p < 0.001), whereas no differences in A_TOT (1.2 ± 0.5 vs. 1.2 ± 0.2 mmol/L, p = 0.95) and pH (7.34 ± 0.06 vs. 7.35 ± 0.02, p = 0.69) were observed. The reduced CSF SID was mainly caused by a higher lactate concentration (3.3 ± 1.3 vs. 1.4 ± 0.2 mmol/L, p < 0.001). A linear association (r = 0.71, p < 0.001) was found between CSF SID and arterial PCO₂. A higher proportion of patients with SAH were characterized by arterial HA, as compared with controls (40 vs. 4%, p = 0.003). A reduced CSF-to-plasma difference in PCO₂ was observed in nonhyperventilating patients with SAH (0.4 ± 3.8 vs. 7.8 ± 3.7 mm Hg, p < 0.001).

Conclusions: Patients with SAH have a reduction of CSF SID due to an increased lactate concentration. The resulting localized acidifying effect is compensated by CSF hypocapnia, yielding normal CSF pH values and resulting in a higher incidence of arterial HA.

Keywords: Acid–base equilibrium; Blood; Cerebrospinal fluid; Electrolyte disturbances; Subarachnoid hemorrhage.