Translabial ultrasound for pelvic organ prolapse.

Pelvic organ prolapse (POP) is a significant public health concern in women and a common cause of gynecological surgery in elderly women. The prevalence of POP has increased with an increase in the aging population. POP is usually diagnosed based on pelvic examination. However, an imaging study may be necessary for more accurate diagnosis. Translabial ultrasound (TLUS) was used to assess diverse types of POP, particularly posterior-compartment POP. It is beneficial to distinguish between true and false rectocele, and detect the rectocele as clinically apparent. TLUS can also establish whether the underlying cause is a problem of the rectovaginal septum, perineal hypermobility, or isolated enterocele. TLUS also plays a role in differentiating POP from conditions that mimic POP. It is a simple, inexpensive, and non-harmful diagnostic modality that is appropriate for most gynecologic clinics.

The Role of Clinical Social Worker in Addressing the Social Consequences of Coronavirus (Covid-19): A Field Study.

The present research aims to identify the social consequences of Coronavirus (Covid-19), the role of clinical social worker in addressing this issue, the obstacles that impede him/her and the mechanisms as well as suggestions that improve this role. The author adopted the descriptive analytical approach and designed a questionnaire to collect data. The results showed that the consequence of "concern about losing relatives and friends because of Coronavirus" was ranked the first. However, the consequence of "self-harm that may induce suicide due to the social restrictions imposed by home quarantine" was ranked the last. In addition, the most prominent role of the clinical social worker in addressing this crisis was educating community members about its risks and the relevant social behaviors. Moreover, the most prominent obstacle was lack of training social workers to address this issue. To improve his/her roles, the research recommends presenting courses and workshops to raise the competence of clinical social workers dealing with crises, in general, and Coronavirus, in particular.

Enrichment of salt-tolerant CO2-fixing communities in microbial electrosynthesis systems using porous ceramic hollow tube wrapped with carbon cloth as cathode and for CO2 supply.

Microbial inocula from marine origins are less explored for CO2 reduction in microbial electrosynthesis (MES) system, although effective CO2-fixing communities in marine environments are well-documented. We explored natural saline habitats, mainly salt marsh (SM) and mangrove (M) sediments, as potential inoculum sources for enriching salt-tolerant CO2 reducing community using two enrichment strategies: H2:CO2 (80:20) enrichment in serum vials and enrichment in cathode chamber of MES reactors operated at -1.0 V vs. Ag/AgCl. Porous ceramic hollow tube wrapped with carbon cloth was used as cathode and for direct CO2 delivery to CO2 reducing communities growing on the cathode surface. Methanogenesis was dominant in both the M- and SM-seeded MES and the methanogenic Archaea Methanococcus was the most dominant genus. Methane production was slightly higher in the SM-seeded MES (4.9 ± 1.7 mmol) compared to the M-seeded MES (3.8 ± 1.1 mmol). In contrast, acetate production was almost two times higher in the M-seeded MES (3.1 ± 0.9 mmol) than SM-seeded MES (1.5 ± 1.3 mmol). The high relative abundance of the genus Acetobacterium in the M-seeded serum vials correlates with the high acetate production obtained. The different enrichment strategies affected the community composition, though the communities in MES reactors and serum vials were performing similar functions (methanogenesis and acetogenesis). Despite similar operating conditions, the microbial community composition of M-seeded serum vials and MES reactors differed from the SM-seeded serum vials and MES reactors, supporting the importance of inoculum source in the evolution of CO2-reducing microbial communities.

Risk factors and outcomes for hyperbilirubinaemia after heart surgery in children.

INTRODUCTION: Liver dysfunction, associated with morbidity and mortality, is common in patients with CHD. We investigate risk factors for and outcomes of hyperbilirubinaemia in neonates and infants after cardiac surgery. MATERIALS AND METHODS: In a retrospective analysis of neonates and infants undergoing cardiac surgery at our institution between January 2013 and December 2017, we identified those with post-operative conjugated hyperbilirubinaemia. We tested various demographic and surgical risk factors, and use of post-operative interventions, for an association with conjugated hyperbilirubinaemia. We also tested hyperbilirubinaemia for association with post-operative mortality and prolonged length of stay. RESULTS: We identified 242 post-operative admissions, of which 45 (19%) had conjugated hyperbilirubinaemia. The average conjugated bilirubin level in this group was 2.0 mg/dl versus 0.3 mg/dl for peers without hyperbilirubinaemia. The post-operative use of both extracorporeal membrane oxygenation (OR 4.97, 95% CI 1.89-13.5, p = 0.001) and total parenteral nutrition (OR 2.98, 95% CI 1.34-7.17, p = 0.010) was associated with conjugated hyperbilirubinaemia. No demographic variable analysed was found to be a risk factor. Hyperbilirubinaemia was associated with higher odds of mortality (OR 3.74, 95% CI 2.69-13.8, p = 0.005) and prolonged length of stay (OR 2.87, 95% CI 2.02-7.97, p = 0.005), which were independent of other risk factors. DISCUSSION: We identified the post-operative use of total parenteral nutrition and extracorporeal membrane oxygenation as risk factors for hyperbilirubinaemia. These patients were more likely to experience morbidity and mortality than control peers. As such, bilirubin may be marker for elevated risk of poor post-operative outcomes and should be more frequently measured after cardiac surgery.

Enrichment of Marinobacter sp. and Halophilic Homoacetogens at the Biocathode of Microbial Electrosynthesis System Inoculated With Red Sea Brine Pool.

Homoacetogens are efficient CO2 fixing bacteria using H2 as electron donor to produce acetate. These organisms can be enriched at the biocathode of microbial electrosynthesis (MES) for electricity-driven CO2 reduction to acetate. Studies exploring homoacetogens in MES are mainly conducted using pure or mix-culture anaerobic inocula from samples with standard environmental conditions. Extreme marine environments host unique microbial communities including homoacetogens that may have unique capabilities due to their adaptation to harsh environmental conditions. Anaerobic deep-sea brine pools are hypersaline and metalliferous environments and homoacetogens can be expected to live in these environments due to their remarkable metabolic flexibility and energy-efficient biosynthesis. However, brine pools have never been explored as inocula for the enrichment of homacetogens in MES. Here we used the saline water from a Red Sea brine pool as inoculum for the enrichment of halophilic homoacetogens at the biocathode (-1 V vs. Ag/AgCl) of MES. Volatile fatty acids, especially acetate, along with hydrogen gas were produced in MES systems operated at 25 and 10% salinity. Acetate concentration increased when MES was operated at a lower salinity ∼3.5%, representing typical seawater salinity. Amplicon sequencing and genome-centric metagenomics of matured cathodic biofilm showed dominance of the genus Marinobacter and phylum Firmicutes at all tested salinities. Seventeen high-quality draft metagenome-assembled genomes (MAGs) were extracted from the biocathode samples. The recovered MAGs accounted for 87 ± 4% of the quality filtered sequence reads. Genome analysis of the MAGs suggested CO2 fixation via Wood-Ljundahl pathway by members of the phylum Firmicutes and the fixed CO2 was possibly utilized by Marinobacter sp. for growth by consuming O2 escaping from the anode to the cathode for respiration. The enrichment of Marinobacter sp. with homoacetogens was only possible because of the specific cathodic environment in MES. These findings suggest that in organic carbon-limited saline environments, Marinobacter spp. can live in consortia with CO2 fixing bacteria such as homoacetogens, which can provide them with fixed carbon as a source of carbon and energy.

Dual-Function Electrocatalytic and Macroporous Hollow-Fiber Cathode for Converting Waste Streams to Valuable Resources Using Microbial Electrochemical Systems.

Dual-function electrocatalytic and macroporous hollow-fiber cathodes are recently proposed as promising advanced material for maximizing the conversion of waste streams such as wastewater and waste CO2 to valuable resources (e.g., clean freshwater, energy, value-added chemicals) in microbial electrochemical systems. The first part of this progress report reviews recent developments in this type of cathode architecture for the simultaneous recovery of clean freshwater and energy from wastewater. Critical insights are provided on suitable materials for fabricating these cathodes, as well as addressing some challenges in the fabrication process with proposed strategies to overcome them. The second and complementary part of the progress report highlights how the unique features of this cathode architecture can solve one of the intrinsic bottlenecks (gas-liquid mass transfer limitation) in the application of microbial electrochemical systems for CO2 reduction to value-added products. Strategies to further improve the availability of CO2 to microbial catalysts on the cathode are proposed. The importance of understanding microbe-cathode interactions, as well as electron transfer mechanisms at the cathode-cell and cell-cell interface to better design dual-function macroporous hollow-fiber cathodes, is critically discussed with insights on how the choice of material is important in facilitating direct electron transfer versus mediated electron transfer.