Prevalence of foodborne bacteria isolated from fresh raw ulam

Although vegetables are considered to be an essential part of a healthy diet, studies have shown that they can also represent a hazard for human health as they are usually eaten raw and receive minimal treatment. In recent years, vegetables are among the food groups associated with higher rates of recurrence and are the leading cause of enteric diseases. There is a colossal amount of data available on fresh produce worldwide; however, limited data are available regarding the microbiological quality of ulam in Malaysia. In fact, cross -contamination that occurs during minimal processing of ulam has not yet been studied. Therefore, the aim of this study was to evaluate the microbiological quality and the occurrence of Escherichia coli and Salmonella in ulam. A total of 32 samples of ulam were randomly collected from wet markets and supermarkets in Kuala Terengganu, Malaysia. The samples were analysed for enumeration of aerobic mesophilic bacteria, coliforms, yeast and moulds, Bacillus cereus, Listeria monocytogenes and detection of Escherichia coli and Salmonella. In this study, the microbiological quality of ulam were in the range of 6.36-8.83; 4.14-7.48; 0-8.16; 3.94-6.45 log10 CFU/g for aerobic mesophilic bacteria, coliforms, Salmonella and yeast and moulds, respectively. Escherichia coli and Salmonella were detected in 3.13% and 9.4% of ulam samples, respectively. The findings from the study are intended to provide insight into the potential health risks associated with the consumption of ulam. The strong interdisciplinary approach by various agencies and development of safe agricultural systems will ensure the delivery of safe vegetables to the end-users

Long-term macrolide treatment for non-cystic fibrosis bronchiectasis in children: a meta-analysis

Recurrent bacterial infection causes frequent bronchiectasis (BE) exacerbations. The effectiveness and safety of long-term administration of macrolides in BE remain controversial, especially in children who require minimal treatment to prevent exacerbation. We conducted this meta-analysis to determine the usefulness of long-term macrolide use in pediatric BE. We searched PubMed, Cochrane Library databases, Embase, KoreaMed, Igaku Chuo Zasshi, and Chinese National Knowledge Infrastructure databases. We identified randomized controlled trials (RCTs) which elucidated long-term macrolide treatment (≥ 4 weeks) in non-cystic fibrosis BE in children aged < 18 years. The primary outcome was frequency of acute exacerbation; secondary outcomes included changes in pulmonary function, sputum scores, and adverse events including bacterial resistance. We included four RCTs. Long-term macrolide treatment showed a significant decrease in the frequency of exacerbation (odds ratio [OR], 0.30; 95% confidence interval [CI], 0.10–0.87), mean number of exacerbations per patient (mean difference, − 1.40; 95% CI, − 2.26 to − 0.54), and sputum purulence score (mean difference, − 0.78; 95% CI, − 1.32 to − 0.24). However, long-term macrolide treatment was accompanied by an increased carriage of azithromycin-resistant bacteria (OR, 7.13). Long-term macrolide administration prevents exacerbation of BE in children; however, there are risks of increasing antibiotic resistance. Benefits and risks should be weighed and determined on a patient-by-patient basis.

The role and importance of plant purification systems in the ecological approach to landscape design

The continuous city expansion and use of various impermeable pavement materials greatly hinder the rainwater surface runoff by conventional drainage systems, especially during heavy and extreme precipitation, which is occurring more frequently. Also, mostly as a rule, natural watercourse discontinuity and/or their canalization results in more frequent floods in cities. An additional problem is rainwater pollution, which, with conventional drainage systems, ends up in natural watercourses, rivers, lakes and seas often without any or even minimal treatment. These are some of the main reasons why rainwater management is becoming an increasingly more important and indispensable segment of contemporary sustainable city development. Among many other approaches, it also includes conventional rainwater drainage systems replacement and the application of biological rainwater treatment systems as much as possible. The positive impact of sustainable and environmentally friendly rainwater treatment systems has already been widely recognized. However, their application is still slightly limited compared to the problems that occur in modern cities. The aim of this paper is to present biological rainwater treatment systems (basic categories and characteristics) and to analyze their implementation possibilities in urban green areas. Their ecological and aesthetic values will be considered, and how users generally perceive structures of ‘natural’ characteristics within designed landscapes will be discussed. The analysis of fourteen recently constructed parks will be carried out to determine the ways of integrating biological purifier systems in the park, the possibilities of their use, and the degree of biological purification systems influence on the overall park design concept. Criteria or guidelines that should be taken into account when designing biological rainwater purification systems will be proposed in order to simultaneously meet their basic function and other roles of such structures within the city park.

Red Collections in Contemporary China

“Red Collecting” is a widespread phenomenon in contemporary China. It refers to the collecting of objects from the Chinese Communist Party’s history. Red Collecting has received only minimal treatment in English-language scholarly literature, much of which focuses on individual object categories (primarily propaganda posters and Chairman Mao badges) and overemphasises the importance of Cultural Revolution objects within the field. Because of this limited focus, the collectors’ motivations have been similarly circumscribed, described primarily in terms of either neo-Maoist nostalgia or the pursuit of profit. This article will seek to enhance this existing literature and, in doing so, offer a series of new directions for research. It makes two main arguments. First, that the breadth of objects incorporated within the field of Red Collecting is far broader than current literature has acknowledged. In particular, the importance of revolutionary-era (pre-1949) collections, as well as regional and rural collections is highlighted. Second, it argues that collectors are driven by a much broader range of motivations, including a variety of both individual and social motivations. Significantly, it is argued that collectors’ intentions and their understandings of the past do not always align; rather, very different understandings of China’s recent past find expression through Red Collecting. As such, it is suggested that Red Collecting constitutes an important part of contemporary China’s “red legacies,” one which highlights the diversity of memories and narratives of both the Mao era and the revolutionary period. Image © Hou Feng

Minimal treatment options with one-piece implants

The aim of this publication is to present case reports to show what is possible with pterygoid implants for the rehabilitation of edentulous space in the jaw (maxilla) while avoiding sinus lifts and bone grafting procedures. In addition, the added value of one-piece implants for screwed retention is elucidated.

Sustainable Management of Organic Wastes in Sharjah, UAE through Co-Composting

Daily human activities and vast green areas produce substantial amounts of organic wastes that end up in landfills with minimal treatment. In addition to the problems associated with landfills, disposal through this method is unsustainable in the long run and does not allow recovering materials from the waste. This paper focuses on the co-composting of different organic wastes produced in The Emirate of Sharjah, United Arab Emirates (UAE), to optimize mixing proportions of three different kinds of wastes—sewage sludge (SS), green waste (GW), and food waste (FW). All three organic wastes were analyzed to determine their chemical composition and the mixing proportions. Ten different mixing proportions as a function of carbon:nitrogen (C:N ratios) were determined and mixed in a NatureMill composter. Compost samples were tested for pH, salinity, conductivity, moisture content, organic matter, organic carbon, phosphorus, total nitrogen, and final C:N ratio after 6 weeks. Results indicate that a period of 5–6 weeks is sufficient for the compost to stabilize. The varying mixing proportions produced a good-quality compost (C:N up to 20:1) with high nutrient content. The study reaffirms that co-composting can be a potential sustainable organic waste management option for the United Arab Emirates.

SOME WORDS ABOUT FRACTURES OF RADIAL HEAD

A visible posterior fat pad on the lateral view of the elbow is a sign of occult intraarticular pathology. Early elbow ROM is needed to prevent stiffness. If you fixed the fracture, but not well enough to move the elbow, you did not fix it. The “safe zone” for placing hardware on the radial head lies in the interval between the radial styloid and Lister’s tubercle. Examine the wrist when examining all elbow injuries; a radial head fracture may be accompanied by a tear of the interosseous membrane and disruption of the distal radioulnar joint. The posterior interosseous nerve (controlling finger and wrist extension) can be damaged by a radial head injury or by the surgery performed to treat the fracture. Therefore, document functional status preoperatively. The severity of these injuries runs the gamut from minimally displaced fractures needing minimal treatment to those with major displacement or comminution, requiring surgical fixation, excision, or replacement.

Limited Treatment Options in Primary Hyperoxaluria with Renal Failure

Primary hyperoxaluria (PH) is a rare autosomal recessive metabolic disorder where serum oxalate levels rise due to overproduction. The kidney tubule is a main target for oxalate deposition, resulting in damage to the organ. Kidney failure is rare in these patients. We present a 67-year-old female with hemodialysis-dependent end-stage renal disease likely due to PH type 2 or 3. With extremely high levels of serum oxalate (60.4 μmol/L), this patient had minimal treatment options for her rare disease. This report details a unique presentation of a rare disease where kidney biopsy was instrumental.

A phase I/II study of GB1275, a first-in-class oral CD11b modulator, alone, and combined with pembrolizumab in specified advanced solid tumors or with chemotherapy in metastatic pancreatic cancer (KEYNOTE-A36).

3085 Background: GB1275 is a first-in-class CD11b modulator that reduced myeloid-derived suppressor cells (MDSCs) and tumor associated macrophages (TAMs) at the tumor site, repolarized M2 immunosuppressive TAMs to an M1 phenotype, and increased tumor infiltration of activated CD8+ T cells in preclinical models. When combined with an anti-PD-1 antibody or chemotherapy, these immunomodulatory effects translated into potent anti-tumor effects and prolonged survival in orthotopic PDAC models [Panni RZ, et al. Sci Transl Med. 2019 Jul 3;11(499)]. This ongoing first-in-human study consists of dose escalation of GB1275 monotherapy (Regimen A), GB1275 + pembrolizumab (Regimen B), and GB1275 + nab-paclitaxel + gemcitabine (Regimen C), followed by Phase 2 expansion in newly diagnosed metastatic pancreatic, MSS colorectal, and PD-L1-positive gastric/GEJ cancers. Here we report interim results of the dose escalation portion of the trial. Methods: The dose escalation phase is based on a standard oncology phase 1, 3+3 design. Cohorts of 3 to 6 patients (pts) with histologically confirmed locally advanced/metastatic pancreatic, esophageal, gastric, MSS colorectal, prostate, or breast cancer were sequentially assigned to ascending dose levels of GB1275 taken orally twice daily (BID) in 1 of 3 regimens: Regimen A was initiated first; Regimen B commenced after completion of the first two cohorts of Regimen A, and Regimen C will be initiated when Regimen A is completed. Dose escalation was based on assessment of safety including dose-limiting toxicity (DLT). Serial blood and tumor samples were collected for pharmacokinetic (PK) and biomarker analyses. Results: As of January 21, 2020, 13 pts were treated, with 3 each in Regimen A (GB1275 100mg, 200 mg and 400 mg BID) dose levels and 4 in Regimen B with GB1275 100 mg BID + pembrolizumab. No DLTs have been reported. GB1275 treatment-related adverse events were reported in 5 pts; all were Grade 1 in severity. Preliminary PK analyses showed a mean elimination half-life of ~7 hours. Reduction in peripheral MDSCs was observed in the majority of pts with serial samples. Biomarker analysis in serial tumor tissue is ongoing. Conclusions: Preliminary data show minimal treatment-related toxicities with the studied regimens. PK data support BID dosing. Dose escalation is ongoing. Updated data will be presented. Clinical trial information: NCT04060342 .

Oral splints for temporomandibular disorder or bruxism: a systematic review

Objectives To evaluate the clinical-effectiveness of oral splints for patients with TMD or bruxism for the primary outcomes: pain (TMD) and tooth wear (bruxism).Data sources Four databases including MEDLINE and EMBASE were searched from inception until 1 October 2018.Data selection and extraction Randomised controlled trials comparing all types of splints versus no/minimal treatment for patients with TMD or bruxism were eligible. Standard Cochrane review methods were used. Standardised mean differences (SMD) were pooled for the primary outcome of pain, using random effects models in TMD patients.Data synthesis Thirty-seven trials were included and the evidence identified was of very low certainty using GRADE assessments. When all subtypes of TMD were pooled into one global TMD group, there was no evidence that splints reduced pain: SMD (up to 3 months) -0.18 (95% CI -0.42 to 0.06); 13 trials, 1,076 participants. There was no evidence that any other outcomes improved when using splints. There was no evidence of adverse events associated with splints, but reporting was poor regarding this outcome. No trials measured tooth wear in patients with bruxism. There was a large variation in diagnostic criteria, splint types and outcome measures used and reported. Sensitivity analyses based on these factors did not indicate a reduction in pain.Conclusions The very low-certainty evidence identified did not demonstrate that splints reduced pain in TMD as a group of conditions. There is insufficient evidence to determine whether splints reduce tooth wear in patients with bruxism.