Recurrent Campylobacter jejuni Infection in an Immunodeficient Patient Treated with Repeated Faecal Microbiota Transplant (FMT)—A Case Report

There is limited evidence to guide successful treatment of recurrent Campylobacter infection in patients with common variable immunodeficiency (CVID) already managed on regular immunoglobulin therapy. The role of faecal microbiota transplant (FMT) is uncertain. We report a case of recurrent Campylobacter jejuni infection in a patient with CVID treated with repeated FMT with 18 months of symptom resolution prior to relapse.

Prevalence and Risk Factors of Subclinical Tuberculosis in a Low-Incidence Setting in China

Objectives: Subclinical tuberculosis (TB) represents a substantial proportion of individuals with TB disease, although limited evidence is available to understand the epidemiological characteristics of these cases. We aimed to explore the prevalence of subclinical patients with TB and identify the underlying association between the subclinical TB cases in the study setting and the Beijing genotype.Methods: A retrospective study was conducted among patients with incident TB at the Fifth People’s Hospital of Suzhou between January and December 2018. A total of 380 patients with TB were included in our analysis.Results: Of the 380 patients, 81.8% were active TB cases, whereas the other 18.2% were subclinical TB cases. Compared with patients aged 65 years and older, the risk of having subclinical TB is higher among younger patients. The use of smear, culture, and Xpert identified 3, 16, and 13 subclinical TB cases, respectively. When using a combination of positive culture and Xpert results, the sensitivity improved to 33.3%. In addition, the neutrophil-to-lymphocyte ratio was significantly elevated in the active TB group compared with that in the subclinical TB group. We also observed that the proportion of the Beijing genotype in the subclinical TB group was significantly lower than that in the active TB group.Conclusion: To conclude, our data demonstrate that approximately one-fifth of patients with TB were subclinical in Suzhou. Mycobacterium tuberculosis could be detected by the existing microbiologic diagnostics in one-third of patients with subclinical TB. The patients with subclinical TB are more prone to having low neutrophil-to-lymphocyte ratio values than those with active TB. Additionally, non-Beijing genotype strains are associated with subclinical TB.

Clostridioides difficile Phosphoproteomics Shows an Expansion of Phosphorylated Proteins in Stationary Growth Phase

In this paper, we present a comprehensive analysis of protein phosphorylation in the Gram-positive enteropathogen Clostridioides difficile . To date, only limited evidence on the role of phosphorylation in the regulation of this organism has been published; the current study is expected to form the basis for research on this posttranslational modification in C. difficile .

Variables considered on art therapy assessments and rating instruments: a systematic review

Objectives: Art-based assessments are used by art therapists and sometimes researchers principally to: determine treatments, levels of cognition and functioning, evaluate progress of a client or to understand the client’s environment and problems that can be represented in a graphic level. These art-based assessments use determined evaluation instruments to measure parameters to understand their clients. The rating instruments have different variables and some studies even present their own adapted scales. For this systematic review, the tools examined in the analysis are: The Bird’s Nest Drawing (BND); the Bridge Drawing; the Diagnostic Drawing Series (DDS); the Person Picking an Apple from a Tree (PPAT); and Free Drawing Assessment. Rating instruments are also considered, including the Descriptive Assessment of Psychiatric Art (DAPA), the DDS Rating Guide and Drawing Analysis Form (DAF), the Formal Elements Art Therapy Scale (FEATS) and studies that include their own scale. There are different elements considered when assessing drawings and artwork approaches to make assessment test using art-based and art therapy tools. The principal objective of the present systematic review was to observe the different elements analysed. The specific objectives were; to describe characteristics of this assessments and to observe the elements considered to analyse drawings in order to observe their application and their validity. Methods: Studies available in English were accessed. The following databases were used: AMED, A&HCI, Arts and Humanities Citation Index, Medline, Psych INFO and Google Scholar. Searches covered the periods from database inception to July 2021 on art therapy and art-based assessment diagnose tools. Results: There were different variables used in art therapy and art based assessment diagnose tools. There were some variables that related or were named differently un some studies. However, there were other variables that were considered in some studies, while in other ones where not. To analyse the assessment the majority were using qualitative and observational technics, a few studies did not share their analysis, in this kind of studies only a thematic analysis or other type of analysis where developed studied. Descriptive results and synthesis outcomes reveal that art therapists are still in a nascent stage of understanding assessments and rating instruments, that flaws in the art therapy assessment and rating instrument literature research are numerous, and that much work has yet to be done. Conclusions: Descriptive results and synthesis revel that some studies have some limitations in some studies regarding to the content that is and how is analysed. Art therapy and art-based studies stills in a nascent stage of understanding the variables considered when using rating instruments. This systematic review also contributes as there are flaws in the art therapy and art-based rating instruments are numerous. There is a limited evidence on studies related with assessment diagnose tools and the reliability of some scales.

Specialist Referral and Outcomes in Adolescent Athletes With Prior Concussion History

ObjectiveTo examine specialist referral patterns and clinical outcomes in adolescents with differing levels of prior concussion history.BackgroundLimited evidence exists on healthcare utilization and outcomes in concussed adolescent athletes with and without a history of prior concussion.Design/MethodsData were prospectively collected from participants aged 12–18 diagnosed with a sport-related concussion and documented prior concussion history between August 2015-March 2020. Participants were separated into 3 groups: 0, 1, and 2 + prior concussions. Demographics, medical history, specialist referrals, and clinical outcome variables obtained at 3-months post-concussion were analyzed.ResultsOne thousand one hundred ninety-seven participants were included: 114 (10.4%) had 2+, 213 (19.4%) had 1, and 770 (70.2%) had 0 prior concussions. There was no difference in sex or time to presentation. A small difference was found across age (15.3 ± 1.6 vs 14.9 ± 1.6 vs 14.5 ± 1.6 years, p < 0.001). Significant differences were also observed between groups in self-reported history of psychological disorders (14.9 vs 15 vs 8.4%, p = 0.01) and headaches/migraines (25.4 vs 20.2 vs 15.5%, p = 0.02). Significant differences between the groups were found in specialist referrals, with more referrals made in the 2 + group to physical therapy (39.6 vs 28.2 vs 23.4%, p = 0.001), neuropsychology (17.1 vs 5.3 vs 7.5%, p = 0.001), and neurology (8.9 vs 2.9 vs 2.2%, p = 0.001). Fewer participants in the 2 + group recovered in = 30 days (53.6 vs 65.6 vs 68.5%, p = 0.04) and reported lower rates of return to activity at 3-months post-concussion (67.9 vs 85.9 vs 87.6%, p < 0.001). No differences were seen in symptom severity, PHQ-8, or GAD-7 scores. All reported as 2 + vs 1 vs 0.ConclusionsConcussed adolescent athletes with a history of 2 or more prior concussions had a higher rate of specialist referrals, were less likely to have returned to prior level of play/activity 3 months following injury, and were less likely to have resolution of symptoms in 30 days or less.

Reconstruction after hemimandibulectomy by a titanium mesh and particulate cancellous bone and marrow harvested from posterior ilia: a case report

A particulate cancellous bone and marrow (PCBM) graft combined with titanium (Ti-) mesh tray has become one of the most popular mandibular reconstruction methods. The technique has been applied to the mandibular discontinuity defects after segmental mandibulectomy. To the best of our knowledge, there are no reports on using the technique after hemimandibulectomy, during which a wide mandibular resection, including the condyle, is performed. Here we report firstly a case of mandibular reconstruction after hemimandibulectomy, using a plate and soft-tissue free flap, followed by a Ti-mesh and PCBM harvested from the bilateral posterior ilia, which was successful. This case report first revealed how bone resorption occurred clinically in mandibular reconstruction using PCBM and Ti-mesh tray after hemimandibulectomy. We also revealed the high predictability of the mandibular reconstruction using PCBM and Ti-mesh tray after hemimandibulectomy. Our report also provides a guiding principle to overcome the limitation of mandibular reconstruction using PCBM and Ti-mesh tray after hemimandibulectomy. However, our manuscript has limited evidence being a case report.

Is Village-Level Microfinance Beneficial at the Community, Enterprise and Household Levels? A Case Study from Indonesia

The local governments of the Riau Province of Indonesia had been given the mandate to use UED-SP as a microfinance programme to serve the financial needs of the rural poor, to promote rural economic activities and to create employment opportunities. Despite the village-level microfinance programme was able to accomplish rural outreach with financial sustainability (Rifai et al., 2019), there is limited evidence to validate its real impact on the rural MFI participants at three different levels of village development. The findings reveal that microloans appear to have positive impacts on the microfinance participants at the community level, at the level of micro-enterprise and at the household level. The rural MFIs should be targeting this village segment of the rural poor, while the local governments should provide the support to warrant deeper outreach.

The influence of ground slab permeability on wall moisture in a historic buildingThe influence of ground slab permeability on wall moisture in a historic buildingThe influence of ground slab permeability on wall moisture in a historic buildingThe influence of ground slab permeability on wall moisture in a historic building

When impermeable ground bearing slabs are installed in old buildings without a damp-proof course, it is a common belief of practitioners within the conservation industry that ground moisture will be ‘driven’ up adjacent walls by capillary action. However, there is limited evidence to test this hypothesis. The accumulation of moisture in walls can promote the decay of the wall materials, decrease the thermal performance of the building envelope and adversely affect the comfort and health of occupants. An experiment was used to determine if the installation of a vapour-proof barrier above a stone flag floor in a historic building would increase moisture content levels in an adjacent stone rubble wall. This was achieved by undertaking measurements of wall, soil and atmospheric moisture content over a three-year period. Measurements taken using timber dowels showed that the moisture content within the wall did not vary in response to wall evaporation rates and did not increase following the installation of a vapour-proof barrier above the floor. This indicates that the moisture levels in the rubble wall were not driven by capillary rise.