Acupuncture therapy for sleep-related laryngospasm

Sleep-related laryngospasm is a rare disorder that may cause severe disablement. It refers to episodic arousal from sleep with a sense of suffocation followed by stridor. This phenomenon, which is caused by laryngospasm, is probably secondary to gastroesophageal reflux. The reflux is the target for current treatment of this serious disorder. Treatment by acupuncture for sleep-related laryngospasm has not been previously reported in the English medical literature. We describe a previously healthy patient with sleep-related laryngospasm caused by gastroesophageal reflux refractory to current medical treatment who was treated successfully using acupuncture.     

Intentional partial coiling dome protection of complex ruptured cerebral aneurysms prevents acute rebleeding and produces favorable clinical outcomes

Background  

The coiling of ruptured cerebral aneurysms protects against acute rebleeding; however, whether partially coiling a ruptured cerebral aneurysm protects against acute rebleeding has never been demonstrated.     

Photovoltaic-driven microbial protein production can use land and sunlight more efficiently than conventional crops

Population growth and changes in dietary patterns place an ever-growing pressure on the environment. Feeding the world within sustainable boundaries therefore requires revolutionizing the way we harness natural resources. Microbial biomass can be cultivated to yield protein-rich feed and food supplements, collectively termed single-cell protein (SCP). Yet, we still lack a quantitative comparison between traditional agriculture and photovoltaic-driven SCP systems in terms of land use and energetic efficiency. Here, we analyze the energetic efficiency of harnessing solar energy to produce SCP from air and water. Our model includes photovoltaic electricity generation, direct air capture of carbon dioxide, electrosynthesis of an electron donor and/or carbon source for microbial growth (hydrogen, formate, or methanol), microbial cultivation, and the processing of biomass and proteins. We show that, per unit of land, SCP production can reach an over 10-fold higher protein yield and at least twice the caloric yield compared with any staple crop. Altogether, this quantitative analysis offers an assessment of the future potential of photovoltaic-driven microbial foods to supplement conventional agricultural production and support resource-efficient protein supply on a global scale.

Food security is a critical issue that humanity faces in this century. The combined effect of population growth and increasing consumption of animal-based products are projected to cause a surge in demand for food which could severely challenge global production by 2050 (1, 2). Moreover, the regional impacts of climate change pose a threat to future food security in many countries (3). Although, historically, the food supply has expanded alongside increasing demand, major improvements to crops are now slowing as they approach biological constraints (4, 5). At the same time, agricultural land expansion has limited potential to increase supply, since food production currently occupies more than a third of the Earth’s terrestrial surface (6) and already exerts large environmental burdens (7–10). Therefore, addressing food security requires societal changes as well as innovations in the global food system that go beyond conventional agriculture. In the current study, we explore the potential for the cultivation of microbes to help address this global challenge.Production of nutrient-rich foods derived from microbial biomass, better known as microbial protein or single-cell protein (SCP), offers a promising means to address food security without exacerbating pressure on the environment, as it utilizes water and nitrogen more efficiently than plants (11–14). Several companies are already producing SCP derived from algae, fungi, or bacteria at commercial scale destined for animal or human consumption (15). The feedstock used to cultivate these microbes is typically either agriculturally derived glucose or fossil-derived methane and methanol (11). Yet, a more sustainable alternative, which minimizes reliance on fossil carbons and agricultural land, is to use renewable energy (here, photovoltaics) to convert atmospheric carbon dioxide and water into molecules that can serve as electron donors for microbes (16, 17). Previous studies have considered the land requirements for SCP production using feedstocks derived from agriculture, fossil fuels (12), and, more recently, also renewable energy (18). Nevertheless, a comprehensive assessment of land and energy efficiency of fully photovoltaic-driven microbial food production is still lacking. Focusing on solar energy allows us to compare the potential of food production using microbes against contemporary agriculture on an even playing field, since both technologies rely on the same primary resources (i.e., land, sunlight, water, and fertilizers). More specifically, this study sought to answer how productive photovoltaic-driven SCP (PV-SCP) systems can be in terms of calorie and protein production per unit time and land area in comparison to other SCP systems and to conventional crops, focusing on the effect that solar irradiance has on PV-SCP yields. This quantitative comparison can assist in planning the future allocation of limited land resources toward feed and food production.We used literature data to calculate the overall efficiency by which solar energy can be harnessed to generate SCP, considering different electron donors and metabolic pathways. We decided to focus on bacteria since they are flexible in their use of feedstock and reach higher protein content than other microorganisms (11). We assumed that all carbon requirements are met by direct air capture of carbon dioxide from the atmosphere (DAC) (19) in order to minimize the reliance on fossil fuels as well as to support a fair comparison with plants. We further took into account other energetic expenditures, such as production of macronutrients for microbial cultivation, bioreactor stirring and cooling, and downstream processing of biomass and proteins. We show that PV-SCP technologies can substantially outperform conventional staple crops in terms of both calorie and protein yield.     

Bonding of Al6061 by Hot Compression Forming: A Computational and Experimental Study of Interface Conditions at Bonded Surfaces

In recent years, there has been a growing interest in composite components, which may be designed to provide enhanced mechanical and physical effective properties. One of the methods available to produce such components is joining by plastic deformation, which results in metallurgical bonding at the interface. However, the portions of the interface that are bonded and the inhomogeneity in the bonding strength achieved at the interface tend to be overlooked. In the present study, Al6061 beams were bonded, by hot compression (300–500 °C) to different degrees of reduction. The compression was followed by tensile debonding experiments and the revealed interface was microscopically characterized in order to determine the areas that were metallurgically bonded. The SEM characterization revealed that the actual bonded area is much smaller than the interface contact area. Thermo-mechanical finite element models of the compression stage were used to investigate the thermo-mechanical fields, which develop along the interface and influence the resulting bonding strength. The principal strain field patterns across the interface area were shown to be similar to the experimentally observed temperature-dependent bonding patterns. In addition, a quantitative criterion for bonding quality was implemented and shown to correlate with the experimental findings.     

Systematic review of natural agents for the management of oral mucositis in cancer patients

Purpose

The aim of this study was to review the available literature and define clinical practice guidelines for the use of natural agents for the prevention and treatment of oral mucositis.

Methods

A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology. The body of evidence for each intervention, in each cancer treatment setting, was assigned an evidence level. Based on the evidence level, one of the following three guideline determinations was possible: recommendation, suggestion, and no guideline possible.

Results

A total of 49 papers across 15 interventions were examined. A new suggestion was developed in favor of systemic zinc supplements administered orally in the prevention of oral mucositis in oral cancer patients receiving radiation therapy or chemoradiation (Level III evidence). A recommendation was made against the use of intravenous glutamine for the prevention of oral mucositis in patients receiving high-dose chemotherapy prior to hematopoietic stem cell transplant (Level II evidence). No guideline was possible for any other agent, due to inadequate and/or conflicting evidence.

Conclusions

Of the various natural agents reviewed here, the available evidence supported a guideline only for two agents: a suggestion in favor of zinc and a recommendation against glutamine, in the treatment settings listed above. Well-designed studies of other natural agents are warranted.     

Systematic review of basic oral care for the management of oral mucositis in cancer patients

Purpose

The purpose of this project was to evaluate research in basic oral care interventions to update evidence-based practice guidelines for preventing and treating oral mucositis (OM) in cancer patients undergoing radio- or chemotherapy.

Methods

A systematic review of available literature was conducted by the Basic Oral Care Section of the Mucositis Study Group of MASCC/ISOO. Seven interventions—oral care protocols, dental care, normal saline, sodium bicarbonate, mixed medication mouthwash, chlorhexidine, and calcium phosphate—were evaluated using the Hadorn (J Clin Epidemiol 49:749–754, 1996) criteria to determine level of evidence, followed by a guideline determination of one of the following: recommendation, suggestion, or no guideline possible, using Somerfield’s (Classic Pap Cur Comments 4:881–886, 2000) schema.

Results

Fifty-two published papers were examined by treatment population (radiotherapy, chemotherapy, and hematopoietic stem cell transplant) and by whether the intervention aimed to prevent or treat OM. The resulting practice suggestions included using oral care protocols for preventing OM across all treatment modalities and age groups and not using chlorhexidine mouthwash for preventing OM in adults with head and neck cancer undergoing radiotherapy. Considering inadequate and/or conflicting evidence, no guidelines for prevention or treatment of OM were possible for the interventions of dental care, normal saline, sodium bicarbonate, mixed medication mouthwash, chlorhexidine in patients receiving chemotherapy or hematopoietic stem cell transplant, or calcium phosphate.

Conclusions

The evidence for basic oral care interventions supports the use of oral care protocols in patient populations receiving radiation and/or chemotherapy and does not support chlorhexidine for prevention of mucositis in head and neck cancer patients receiving radiotherapy. Additional well-designed research is needed for other interventions to improve the amount and quality of evidence guiding future clinical care.