Land use and land cover (LULC) change have significant consequences on habitat and environment. Scholars have developed several LULC models to identify the factors behind the changes and to simulate future LULC scenarios to assist in policymaking. Nevertheless, the accuracy of the models remains contentious and a matter of ongoing research agenda. Additionally, most of these studies used a training dataset to train the model and a validation dataset, which is a part of the original training dataset used to validate the model’s accuracy. However, to justify model’s actual predictive capability, we need to test the model on real-world dataset that was not used in modeling. So, we present XGBoost model to improve the accuracy of LULC prediction. Contrary to the typical studies, we use a separate test dataset to justify the model’s predictive capacity in real-world scenario. The result reveals that XGBoost model exhibits highest 84% kappa and 93% accuracy score compared to two benchmark model LR-CA (82% kappa and 92% accuracy score) and ANN-CA (82% kappa and 92% accuracy score). We also found that the built-up area increased by 48.7% in 2002 to 64% in 2010, while agricultural and vacant land declined by almost at the same magnitude over the period and the most important aspect of the LULC shift process in Khulna city was the proximity factors to major roads, industry and commercial establishments. The proposed model proved to increase the predictive accuracy making it much more reliable for analyzing and predicting urban LULC using spatial factors.

Background: The pandemic caused by Coronavirus disease 2019, has caused great impact worldwide. Risk factors for severe outcomes have been identified, but asthma seems not to be one of them. Objectives: Our principal purpose is to analyze personal characteristics in severe asthma patients, in treatment with monoclonal antibody, belonging to the Health Department of Castellon, in order to see if these variables affect the probability of being infected by SARS-Cov-2. Methods: This is an observational study. Patients recruited had severe asthma in treatment with monoclonal antibody. A questionnaire was elaborated. Aspects evaluated were: COVID-19 symptoms, asthma control, exposition to the disease, and lifestyle before the pandemic. Serological tests were done by using total SARS-Cov-2 antibody test. Results: 108 patients were enrolled in the study, of whom 106 patients were included. 11 patients declared suggestive COVID-19 symptoms. A total of 21 patients had a serology test done, giving positive results 2 of them. 27 patients needed medical attention, being asthma exacerbation the most common symptom. 71,7% of patients had a normal or high level of social activity before the pandemic. Statistic significance was achieved for medical assistance, asthma control and contact with SARS-Cov-2 positive patients. Conclusion: Personal external factors in severe asthma patients do not influence the probability of being affected by the disease. We can hypothesize that these patients do not have an increased susceptibility for being infected by the virus. Bad asthma control was the main reason for medical assistance during the pandemic.

Background: Allergy is witnessing major advances, in particular with the advent of biological therapies for treating allergic diseases. Given the novelty of these therapeutics, we aimed to explore by a worldwide survey, the prescription and the management of hypersensitivity reactions (HR) of biological agents (BA) in Allergy. Method: We built up an anonymous online questionnaire, sent out by mail and social media and circulated for 40 days. Results: 348 responses were from 59 countries, with a majority from Europe (62.6%). 97% of responders practiced allergy and 48.5%, exclusively so. Allergy was mentioned as a full specialty in 69.5 % of cases. 71% of responders confirmed the right of prescription of BA for allergists in their country and 78.4 % prescribed BA in their clinical practice. Europe included almost all the allergists who did not have the right of prescribing BA (95.5%), specifically France (91%). The most prescribed BA were Anti IgE (78.1%) and anti IL5 (43.9%). The most declared HR to BA were local reactions (74.1%) followed by anaphylaxis like symptoms (6.8%) and delayed exanthemas (5.1%). Desensitization was considered in 18.9% of cases. These HR were reported in 48.8% of cases. Conclusion: Although BA are now a pillar in the treatment of allergic diseases and allergists are familiar with management of HR associated with BA, their prescription is not authorized for allergists in all countries. BA showed to be generally safe but HR, which may be severe, could occur with a lack of consensus on the management.

Mast cells and basophils interact with various cells in the urticaria lesion microenvironment, such as macrophages,.which form an essential component of innate immunity, and are involved in numerous functions including protein secretion. Objective: The aim of the present study was to characterize the macrophage phenotype in urticarial lesions of patients with chronic spontaneous urticaria (CSU) nonresponsive to antihistamines at optimized doses. And compare the phenotype with clinical and laboratory parameters such as age, gender, urticaria time, C-reactive protein (CRP), and total serum IgE, and autologous serum skin test (ASST). Methods: Twenty-eight patients with CSU refractory to antihistamines were included in the study. Epidemiological data, C-reactive protein, D-dimers, basophils in peripheral blood, and total serum IgE and ASST were assessed. The mannose receptor (CD206), CD163, CMAF, and pSTAT 1 were used to characterize the M1/M2 macrophage subpopulations. The immunolabeled cells per square millimeter were manually enumerated at a 400× magnification in 12 optical fields via light microscopy. Results: A predominance of M2 macrophages was seen in CSU patients. Statistical differences were observed between the CD206 marker and the disease course. No correlation was found between biomarkers and macrophage populations. Expression of CMAF was significantly higher in the patient sample compared to that in the control skin (patients without history of urticaria; p-value < 0.001). Conclusion: M2 macrophages were seen with significantly higher CMAF expression, which indicates macrophage activation in patients with CSU. CD206 expression was inversely correlated with disease time.

Background: Little is known about the clinical course of chronic urticaria (CU) and predictors of its prognosis. We evaluated CU patient clusters based on medication scores for the initial 3 months of treatment to investigate time to remission and relapse rates and to identify predictors for CU remission. Methods: In total, 4552 patients (57.9% female; mean age of 38.6 years) with CU were included in this retrospective cohort study. The K-medoids algorithm was used for clustering CU patients. Kaplan-Meier survival analysis with Cox regression was applied to identify predictors of CU remission. Results: Four distinct clusters were identified: patients with consistently low disease activity (cluster 1, n = 1786), with medium-to-low disease activity (cluster 2, n = 1031), with consistently medium disease activity (cluster 3, n = 1332), or with consistently high disease activity (cluster 4, n = 403). Mean age, treatment duration, peripheral neutrophil counts, total IgE, and complements levels were significantly higher for cluster 4 than the other three clusters. Median times to remission were also different among the four clusters (2.1 vs 3.3 vs 6.4 vs 9.4 years, respectively, P < .001). Sensitization to house dust mites (≥ class 3) and female sex were identified as significant predictors of CU remission. Around 20% of patients who achieved CU remission experienced relapse. Conclusion: In this study, we identified four CU patient clusters by analyzing medication scores during the first 3 months of treatment and found that sensitization to house dust mites and female sex can affect CU prognosis.

Objective: AUB-O,E,N is treated first with medical management, followed by surgery, which failure or complications have significant burden. The objective was to perform a cost-effectiveness analysis of four surgical strategies, comparing cost and avoided failure rate, using the French PMSI database. Design: Retrospective analysis performed using the French exhaustive national hospital discharge database (PMSI). Population: All incident 35-55 year-old women operated on for four types of AUB-O,E,N surgery (2nd generation, 1st generation, curettage or hysterectomy) between 2009 and 2014 were included. Methods : They were followed to collect rehospitalizations related to failure or complication and their cost, during at least 18 months. Hospital costs were estimated using the French tariffs in 2017\euro. Main Outcome measures : A cost-effectiveness analysis was performed comparing each surgical procedure to 2G, in hospitalization costs and rate of patients without failure. Results : The study included 88,154 patients. At 18 months, mean cost per patient was \euro2,448 for 2G, \euro2,100 for 1G, \euro2,275 for curettage and \euro4,157 for hysterectomy. Hysterectomy was the most effective strategy in terms of absence of failure, but also the most expensive, with an incremental cost of \euro24,008 per additional % of patient without failure. Even with a mean cost similar to 2G, curettage was the least effective strategy with a failure rate reaching 20.6% at 18 months. 1G was less expensive but also less effective than 2G, with an economy of \euro13,078 per % of patient without failure loss. Conclusion: 1G and 2G techniques are the most efficient strategie

We present a complication following deployment of the MANTA VCD device following a TAVR procedure which resulted in occlusion of the common femoral artery. This was addressed by ballooning the site from the contralateral side which re-established flow. We believe this is the first report to address this kind of complication and may prove useful as more of the MANTA devices are being used in multiple procedures.

Objective: To examine the impact of “natural” cesarean deliveries (NCD) on peripartum maternal blood loss. Design: Randomized controlled trial. Setting: Single academic hospital in Afula, Israel, between August 2016 and February 2019. Population or Sample: Term singleton gestations scheduled for a planned CD under spinal anesthesia. Methods: Women were randomized at a ratio of 1:1 to NCD (study group) or traditional CD (control group). Women in the study group watched fetal extraction, had early skin to skin contact, and breastfed until the end of surgery. Neonates in the control group were presented to the mother without direct contact. Blood samples were drawn from all women to determine oxytocin levels using an ELISA kit. Main Outcome Measures: Postpartum hemoglobin (Hb) levels. Results: 214 women randomized, 23 were excluded. There were no significant differences in demographic and obstetric variables between the groups. Postpartum Hb levels were 10.1±1.1 and 10.3±1.3 g/dL in the study and control groups, respectively (P = .19). There were no significant differences in estimated blood loss, and rates of PPH and blood transfusion. Maternal pain scores, satisfaction, and exclusive breastfeeding rate at discharge, were similar. Maternal oxytocin blood levels were 389.5±183.7 and 408.5±233.6 pg/mL in the study and control groups, respectively (P = .96). Rate of composite neonatal morbidity that comprised neonatal hypothermia, hypoglycemia, jaundice, and neonatal intensive care unit admission was higher in the study group. Conclusions: NCD does not affect maternal blood loss. Maternal oxytocin blood levels in NCD and traditional CD are similar.

Trial Registration: PregCovid study is registered with Clinical Trial Registry of India (Registration no: CTRI/2020/05/025423)Case Report Despite improvements in diagnostic and treatment modalities, ruptured ectopic pregnancy (EP) continues to be an important cause of pregnancy-related mortality and morbidity. CDC has estimated its incidence to be 1-2% 1, yet these pregnancies account for 6 % of pregnancy-related deaths1,2. It was the leading cause of hemorrhage-related mortality in USA in 2011-20133. Corona virus disease-2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), has emerged as a global health concern since December 2020, spreading to almost more than 200 countries/territories/areas worldwide4. Due to its highly contagious nature, many national and regional authorities worldwide enforced the country under lock-down to reduce further spread the disease. India has undertaken a similar strategy from March 24, 2020 in a phased manner. Hence, non-urgent medical care facilities such as outpatient visits and elective surgical interventions were suspended. Many private and other small-scale hospitals stopped their services to follow enforcement of government issued lockdown orders and some fearing the spread of the disease. This has left pregnant women anxious across the country with the only option of going to state-run hospitals or COVID-19 designated hospitals in the city. Thus, reduced number of accessible medical care facilities and travel restrictions caused patients a significant delay in receiving treatment.Topiwala National Medical College (TNMC) & B. Y. L. Nair Charitable Hospital (NH) is one such tertiary care government hospital and designated COVID-19 hospital in the city, receiving referrals from across the Mumbai Metropolitan Region (MMR)5. In the initial phase of 3 months of COVID-19 pandemic (from 4th April 2020 to 31st July 2020), NH received three asymptomatic, RT-PCR confirmed COVID-19 women with EP, including one caesarean scar pregnancy (CSP) (Table 1). Waiver of written informed consent was granted by Institutional Ethics Committees of ICMR-NIRRH and TNMC, Mumbai; as only medical case records were analyzed.

Objective. To investigate the resuscitative efficacy of haemoglobin vesicles (HbVs) for severe postpartum haemorrhage (PPH) using pregnant rabbits. Design: Animal research study Setting: Animal laboratory, National Defense Medical College, Japan Population: Twenty-five female New Zealand white rabbits at late gestation Methods. Pregnant rabbits underwent caesarean section; uncontrolled haemorrhage was induced by transecting the uterine artery to establish a severe PPH model. During the first 30 min (or until the bleeding volume reached 100 mL), all rabbits received 6% hydroxyethyl starch (HES) infusion. Thereafter, rabbits received any of the three isovolemic fluid resuscitations every 5 min: red blood cells (RBCs) with platelet-poor plasma (RBC/PPP) (vol/vol=1:1, n=8), 6% HES (n=7), or HbVs with 25% human serum albumin (vol/vol=4:1, n=10). After 60 min (or when the bleeding volume reached 200 mL), we performed surgical haemostasis and monitored the rabbit survival for 12 hours. Main Outcome Measures: Survival time for severe postpartum haemorrhage Results. During the first 30 min, all rabbits showed severe anaemia (Hb <6 g/dL) that eventually developed to severe PPH. All rabbits that received only HES infusion died within 6 hours, whereas those that received RBC/PPP transfusion survived. Furthermore, 8 of the 10 rabbits received HbV infusion 6 hours after PPH. Overall survival of HbV group was markedly improved compared with that of HES group (p=0.01) but was significantly worse than that of RBC/PPP group (p<0.01). Conclusions. HbV infusion for severe PPH effectively prevented lethal haemorrhagic shock in a pregnant rabbit model, making it a feasible alternative modality.

The relationships and seasonal-to-annual variations among evapotranspiration (ET), precipitation (P), and groundwater dynamics (total water storage anomaly, TWSA) are complex across the Amazon basin, especially the water and energy limitation mechanism for ET. To analyze how ET is controlled by P and TWSA, we used wavelet coherence analysis to investigate the effects of P and TWSA on ET at sub-basin, kilometer, regional, and whole basin scales in the Amazon basin. The Amazon-scale averaged ET has strong correlations with P and TWSA at the annual periodicity. The phase lag between ET and P (ϕ_(ET-P)) is ~1 to ~4 months, and between ET and TWSA (ϕ_(ET-TWSA)) is ~3 to ~7 months. The phase pattern has a south-north divide due to the significant variation in climatic conditions. The correlation between ϕ_(ET-P) and ϕ_(ET-TWSA) is affected by the aridity index, of each sub-basin, as determined using the Budyko framework at the sub-basin level. In the southeast Amazon during a drought year (e.g., 2010), both phases decreased, while in the subsequent years, ϕ_(ET-TWSA) increased. The area of places where ET is limited by water continues to decrease over time in the southern Amazon basin. These results suggest immediate strong groundwater subsidy to ET in the following dry years in the water-limited area of Amazon. The water storage has more control on ET in the southeast but little influence in the north and southwest after a drought. The areas of ET limited by energy or water are switched due to the variability in weather conditions.

Soil detachment is one of the most important processes of soil erosion, as it is of great significance for the prevention and treatment of soil erosion in areas subject to seasonal freeze-thaw. However, most previous studies on the effect of freeze-thaw on soil detachment capacity (SDC) of bare soil, little research on SDC under the effect of freeze-thaw and the root system. This study investigated the effects of freeze-thaw and the root system on soil detachment capacity through hydraulic flume experiments to simulate the soil detachment process of two soil types, sand soil and loessal soil, under four treatments, control, freeze-thaw, root system and freeze-thaw + root system. And a prediction model was developed to calculate SDC under the effect of freeze-thaw and the root system. The results illustrated that the SDC of sand soil was higher than that of loessal soil. The SDC of two soils was reduced and increased by the root system and freeze-thaw, respectively, although the former effect was significant (P < 0.05) whereas the latter was not. The effect of freeze-thaw in combination with the root system showed that the root system contributed the majority of SDC variability (99.95%); therefore, inhibition of SDC by the root system played a leading role. When comparing shear stress, unit energy of the water carrying section and unit stream power, stream power was found to be the hydraulic parameter that best predicted SDC (R2¬ > 0.84). The inclusion of root weight significantly improve the accuracy of the SDC prediction model developed by hydraulic parameters. A general model based on stream power and root weight was developed to quantify SDC and was shown to have a high SDC prediction accuracy for both soils treated by freeze-thaw and the root system [NSE = 0.88，R2 = 0.90].

Background and purpose: Ginkgolide C (GGC) isolated form Ginko biloba (Ginkgoaceae) leaf can demonstrate pleiotropic pharmacological actions although. its anti-oncogenic impact in non-small cell lung cancer (NSCLC) model has not been reconnoitered. As signal transducer and activator of transcription 3 (STAT3) cascade can promote tumor growth and survival, we contemplated that GGC may interrupt this signaling cascade to expend its anti-cancer actions in NSCLC. Experimental approach: The effect of GGC on STAT3 activation, associated protein kinases, STAT3-regulated gene products, cellular proliferation, and apoptosis was examined. The in vivo effect of GGC on the growth of human NSCLC xenograft tumors in athymic nu/nu female mice was also investigated. Key results: GGC attenuated the phosphorylation of STAT3 and varying upstream kinases effectively. Exposure to pervanadate modulated GGC-induced down-regulation of STAT3 activation and promoted an elevation in the level of PTP protein. Indeed, silencing of the PTPgene reversed the GGC-promoted abrogation of STAT3 activation and apoptosis. Moreover, GGC exposure significantly reduced NSCLC tumor growth without demonstrating significant adverse effects via decreasing levels of p-STAT3 in mice tissues. Conclusions and Implications: Overall, the findings support that GGC may exhibit anti-neoplastic actions by mitigation of STAT3 signaling cascade in NSCLC.

Two de novo mutations in GFAP gene were identified (c.214G>A, p.E72K and c.1235C>T, p.T412I) by whole exome sequencing. The common clinical features of the two patients was bulbar dysfunction, pyramidal signs and white matter lesions in periventricular regions. We conducted a novel data-driven method to explore the atrophic pattens and spontaneous brain functional network activity according to the neuroimaging data. Similar atrophic patterns, increased brain functional connectivity in occipital and posterior parietal cortex were detected in the two probands. Western blotting revealed the decreased level of GFAP with p.T412I mutation, while p.E72K and p.R239C mutations were at a similar level to wild type, suggesting the mutations located in the tail domain could decrease the solubility of GFAP. Abnormal inclusions of mutant GFAP were colocalized with ubiquitin, 20S proteasome, protein 1 light chain 3-II (LC3-II) and lysosome. The mutant GFAP caused activated autophagy flux while ubiquitin-proteasome pathway could be blocked as a mechanism for degrading aggregates.We herein presented two AxD patients with heterozygous mutations in GFAP. We noticed that mutant GFAP aggregations induced activated autophagy upon proteasome degrading pathway impairment. Our findings further expand the clinical and genetic spectrum of AxD.

A novel virus, severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19) worldwide appeared in 2019. Currently, we do not have a medicament that treats the disease. One of the rea-sons for the absence of treatment is related to the scarcity of detailed scientific knowledge of the members of the Coro-naviridae family, including the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Structural studies of the MERS-CoV proteins in the current literature are extremely limited. We present here detailed characterization of the struc-tural properties of MERS-CoV macro domain in aqueous solution at the atomic level with dynamics. For this study, we conducted extensive replica exchange molecular dynamics simulations linked to a generative neural networks and we use the resulting trajectories for structural analysis. We perform structural clustering based on the radius of gyration and end-to-end distance of MERS-CoV macro domain in aqueous solution with dynamics at the atomic level. We also report and analyze the residue-level intrinsic disorder features, flexibility and secondary structure. Furthermore, we study the pro-pensities of this macro domain for protein-protein interactions and for the RNA and DNA binding. Results are in agree-ment with available nuclear magnetic resonance spectroscopy findings and present more detailed insights into the struc-tural properties of MERS CoV macro domain. Overall, this work further shows that neural networks can be used as an exploratory tool for the studies of CoV family molecular conformational space at the nano level.

Numerous unknown factors influence anthrax epidemiology in multi-host systems, especially at wildlife/livestock/human interfaces. Serology tests for anti-anthrax antibodies in carnivores are useful tools in identifying the presence or absence of Bacillus anthracis in a range. These were employed to ascertain if the disease pattern followed the recognized high and low risk anthrax zonation in Zimbabwe and also to establish if anthrax was absent from Hwange National Park in which there has been no reported outbreaks. African lions (Panthera leo) (n= 114) drawn from -free-range protected areas and captive game parks located in recognized high and low risk zones across Zimbabwe were tested for antibodies to anthrax PA antigen using the ELISA immunoassay. A random selection of 27 lion sera samples comprising 17 sero-positive and 10 sero-negative sera were further tested in the species-independent toxin neutralization assay (TNA) in order to validate the former as a surveillance tool for anthrax in African lions. Using the ELISA-PA immunoassay, 21.9% (25/114) of the lions tested positive for antibodies to anthrax. Seropositivity was recorded in all study areas and there was no significant difference (p= 0.852) in seropositivity between lions in high and low risk anthrax zones. Also, there was no significant difference (McNemar’s χ2 = 0.9, p = 0.343) in the proportion of lions testing positive to anti-PA anthrax antibodies on ELISA-PA immunoassay compared to the TNA, with fair agreement between the two tests [Kappa (K) statistic = 0.30; 0.08

Background: New corona virus (COVID-19), as an international health threat poses a challenge to physical and psychological resilience globally. The aim of this survey is to explore the level of awareness, health seeking behaviors and preventive measures towards COVID19 among Najran university students. Methodology: By adopting a convenient sampling technique, a cross-sectional study was carried out at Najran university. A self-reporting electronic questionnaire had been utilized for collecting data. A total of 684 students were voluntary completed the questionnaire. Results: The mean age of the participants was 20.2±14.1, The most cited source for obtaining information about COVID-19 was the social media (51%). Females showed higher level of knowledge and awareness about the symptoms of the disease than males (74.3% vs 69.9%) respectively, although the difference was not significant with (P-value >0.05). In regard to compliance with preventive measures, medical students were significantly aware and complying with various preventives measures towards COVID-19 (P-value <0.05). Moreover, females seem to be very keen in seeking medical advices when needed significantly more than males (P-value<0.05). Almost more than 66% of the respondents know the recommended precautions in terms of wearing masks, not to touch outdoors surfaces directly and avoiding crowded places. 556(81.3%) of the participants believe that they should wear face masks outdoors. 6% of the participants prefer to take some herbs daily in different forms to avoid getting infected with COVID-19. Females had an overall higher mean of tension level towards getting infected than males (mean± SD was 5.61 ±1.65 vs 4.55± 1.63) respectively. Conclusion: It was concluded that our students have high level of knowledge and awareness about COVID-19, beside positive attitudes preventive measures and acceptable health seeking behaviors. It is highly recommended to assess the entire Najran community level of awareness so as to design educational programs when needed.

Aim: The aim of this study was to determine menopausal symptoms, sleep levels, quality of life of women in the premenopausal, menopausal, and postmenopausal period, to increase their knowledge level with training to be provided, to reduce their menopausal symptoms, to improve quality of life and sleep quality, and to enable self-examination of breasts and vulva with training provided. Method: The research was conducted in a public hospital in Eskişehir. The study had a quasi-experimental design. The sample of the research consisted of 36 women aged between 40-65 years. These women were asked to complete the Sociodemographic Characteristics Determination Form, Menopause Rating Scale, Pittsburgh Sleep Quality Index, and Quality of Life Scale (SF-36) when they applied to menopause school. After the forms were completed, the participants were given training. Following training, the scales were re-completed and then women were enabled to perform self-examination of breasts (SEB) and self-examination of the vulva (SEV). The IBM SPSS Statistics 21.0 was used for the analysis. Results: The mean age of the women was 50.66±4.45 and that the mean menopause age was 47.60±3.45. The most frequently described symptom was fatigue (91.7%). It was seen that after the training, the MRS score of the women decreased from 16.83±8.87 to 13.66±8.36; the PSQI score decreased from 14.34±2.64 to 13.81±2.55; the mean Quality of Life (SF-36) scale score increased from 48.74±19.13 to 54.92±17.40. As a result of SEB and SEV performed by the women after the training, it was determined that 5.6% of the women had a breast deformity, that 8.3% had a palpable mass in the breast and that 13.9% detected a vaginal discharge in the vulva examination (p<0.05). Conclusion: It is easier to overcome this period with specific comprehensive training and women are enabled to cope with symptoms more effectively.

Abstract. The reuse of N95 masks has been forced on small community-based hospitals, dentists, nursing, and care homes, amongst others, due to the desperate shortage of personal protective equipment globally during the COVID-19 pandemic. The CDC issued guidance on the reuse of N95 masks due to this shortage. However, large scale ultraviolet disinfection equipment would not be practical in these circumstances, we, therefore, investigated the efficacy of a small, mobile, benchtop device with the potential to disinfect N95 masks from SARS-CoV-2 using ultraviolet irradiation. The device tested was the Lumin LM3000 System manufactured by 3B Medical. We found the Lumin LM3000 to be effective against enveloped viruses, including coronavirus, non-enveloped viruses, gram-negative and gram-positive bacteria and spores with reductions greater than 99.9 per centAbstract content goes here

Introduction: Contact force (CF) catheters provide feedback confirming adequate tissue contact for optimal lesion size and minimal complications. CF ablation catheters have resulted in decreased procedure times and improved outcomes for ablation of atrial fibrillation in adults. There is limited data evaluating CF use for accessory pathway (AP) ablation or in pediatric patients. The aim of our study was to compare a cohort who underwent AP ablation with a CF catheter to historical controls, evaluating for differences in procedure times, number of lesions, and outcomes. Methods: A retrospective chart review of CF ablation cases at Children’s Wisconsin performed between June 2015 to April 2018 was compared to a historical control cohort of traditional radiofrequency (RF) ablations between June 2012 to June 2015. 43 patients with APs underwent 49 CF ablation procedures (18 males, 13.6 ± 3 years old) and a control cohort consisted of 77 procedures in 69 patients (38 males, 12.4 ± 4 years). Results: The groups did not differ significantly on procedure time (CF 2.01 ± 0.48 hr, control 1.53 ± 0.48 hr, p = 0.37), or total lesions administered (CF and control 7 ± 6 lesions, p = 0.89). CF cases showed a trend toward improvement in acute success (98% CF, 90% controls, p = 0.15) though with increased recurrence compared to controls (13% CF, 5% controls, p = 0.16), neither being statistically significant. Conclusion: Our study suggests that ablation outcomes using CF are comparable to traditional RF ablation in pediatric patients with APs.

Background: Echocardiography derived myocardial performance may be impaired.Objectives: To evaluate cardiac involvement including cardiac biomarkers, echocardiographic findings in patients with COVID-19 and to explore the effect of cardiac impairment on short-term outcome.Methods: This study cohort was conducted from February 9, 2020, to March 28, 2020, in a single center at Wuhan Leishenshan Hospital. 213 patients whose echocardiography were included. Demographic data, laboratory results, echocardiographic findings were analyzed. Results:Among 213 patients confirmed with COVID-19,150 non-critical patients and 35 critical patients were discharged. 28 critical patients needed invasive mechanical ventilation, 16 of whom died during the hospitalization, and another 12 patients were transferred for continued treatment with tracheotomy. The incidence of cardiovascular complications including acute myocardial injury, arrhythmia and acute myocardial infarction was higher in critical group . A total of 108 patients had abnormities on echocardiography. 26(12.2%) patients have presented the signs of pulmonary hypertension and the presence of pulmonary hypertension in critical group was higher than that in non-critical group The cardiac biomarkers at admission in critical patients were significantly higher compared with non-critical patients.Multivariate analysis showed high-sensitivity cardiac troponin I elevation and echocardiographic signs of pulmonary hypertension ere independent risk factors of adverse outcome.CONCLUSIONS: The elevation of cardiac markers and echocardiographic signs of pulmonary hypertension are risk factors of adverse outcome in patients with COVID-19. It’s meaningful to combine echocardiography with cardiac markers to evaluate the prognosis of patients with COVID-19.

Rabbit haemorrhagic virus (RHDV) is a highly infectious and fatal pathogen to rabbits. Classic RHDV is mainly pathogenic to adult rabbits; however, it is not lethal to young rabbits. Since 2010, a RHDV variant has become prevalent in Europe and the Australian continent. This variant, which was named RHDV2 (GI.2/RHDVb), is highly infectious and fatal to both adult and young rabbits; moreover, its host range is broader than that of classic RHDV (GI.1/G1-6). In May 2020, the first RHDV2 case in China was reported. Here, we report and describe the first RHDV2 case in China. We amplified its complete genome sequence (named SC20-01 strain). The phylogenetic tree showed that the SC20-01 strain is mostly related to two strains isolated in Europe, which indicated that it might have spread from Europe to China. Moreover, Recombination Detection Program software showed that the SC20-01 strain is a G6/RHDV2 recombinant strain. Animal experiments showed that the SC20-01 strain is a highly fatal pathogen to specific-pathogen-free (SPF) rabbits and induces typical clinical symptoms of RHD. Our findings highlight RHDV2 emergence in China and its potential to spread widely. There is a need for more attention on the RHDV2 threat in China and the development of new diagnostic methods and vaccines for preventing the spread of RHDV2.

Herein we report the first MDR-TB case of Cervical tuberculosis lymphadenitis from patients which was born form susceptible TB cured mother in Mashhad, Iran.

Significant controversy exists in the management of type A aortic dissections with aortic arch involvement. There is a substantial variability in approaches to this complex problem ranging from simply replacing the ascending aorta to total arch replacement with frozen elephant trunk -- all of which balance the competing interests of reducing operative risk and reducing risk of reintervention. The diversity of clinical details, variability of surgical experience, and lack of significant randomized data make a consensus approach to these patients unlikely. However, it is important to understand the risks and benefits of each technique, and herein we evaluate the outcomes of each. Our approach to these patients has been to reserve arch replacement for those who have arch aneurysmal disease, imminent risk of rupture, or cerebral malperfusion, and perform a hemiarch replacement in all other scenarios with arch involvement. Such approach is easily taught, safe, and reproducible while focusing more on survival rather than long-term freedom from reintervention.