Objective: To propose a scoring system based on laryngoscopic characteristics for the differential diagnosis of benign and malignant vocal cord leukoplakia. Design: Retrospective study. Setting: Tertiary hospitals Participants: Laryngoscopic images from 200 cases of vocal cord leukoplakia were retrospectively analyzed. The morphologies of vocal cord leukoplakia under laryngoscopy were evaluated by two laryngologists. Main outcome measures: The laryngoscopic signs of benign and malignant vocal cord leukoplakia were compared, and statistically significant features were assigned and accumulated to establish the leukoplakia finding score (LFS). Results: A total of five indicators (size, thickness, texture, hyperemia, and anterior commissure involvement) associated with malignant vocal cord leukoplakia were included to construct the LFS, with a possible range of 0–10 points. The diagnosis of malignant vocal cord leukoplakia as a score of ≥6 points was the most efficient. The sensitivity, specificity, and accuracy of the LFS were 93.8%, 83.6%, and 86.0%, respectively. The consistency in the LFS obtained by different laryngologists was strong (kappa=0.809). Conclusion: This scoring system based on laryngoscopic characteristics has high diagnostic value for distinguishing benign and malignant vocal cord leukoplakia.

25-hydroxyvitamin-D (25(OH)D) level in the fetus entirely depends on the transport over placenta which is assumed to be obstructed with maternal levels <25nmol/L. Design Observational study. Setting Prospectively enrolling from September to December 2021 in a tertiary governmental hospital in a northern Emirate. Population Admission for spontaneous and elective labor. Methods 25(OH)D was analyzed in maternal serum at admission, respectively, in cord blood after delivery. Main outcome measures Factors affecting maternal and fetal 25(OH)D levels and the correlation between the two at delivery. Results 303 women were enrolled and 237 had complete maternal/umbilical cord blood samples. 138 (47.7%) of women were diagnosed with deficiency (25(OH)D<50nmol/L), whereas only 34 fetuses (13.8%) were deficient (25(OH)D<30nmol/L). The mean difference between maternal and cord blood 25(OH)D was negative in 91% of cases (-16.27nmol/L, SD=13.36). The correlation between maternal/umbilical cord levels was excellent (r = 0,906, p<0,000). After dividing into subgroups of maternal 25(OH)D levels, BMI, diabetes yes/no and delivery-mode the correlation was consistent, although the correlation coefficients in the subgroups of maternal 25(OH)D levels were lowered for all groups. Of factors studied, only the supplementation dose affected the maternal 25(OH)D level. 25(OH)D <50nmol/L was not associated to an increased risk for diabetes, preterm labor, preterm-rupture-of-membranes or low Apgar-score. Conclusion We found a higher 25(OH)D level in cord blood with consistent correlation to maternal levels. Of the studied factors only supplementation dose had significant impact on the maternal level. 25(OH)D <50nmol/l were not associated to increased risk for preterm-labor, preterm-rupture-of-membranes, diabetes or low AS.

Background: Corrected QT (QTc) prolongation is a frequently observed ECG abnormality in patients with rheumatoid arthritis (RA). Objectives: We aimed to investigate the association between disease activity and QTc interval in patients with RA. Methods: Data were obtained from the Kyoto University Rheumatoid Arthritis Management Alliance population-based RA cohort. We used a linear model to compare the association between QTc interval and RA-related parameters, including patient characteristics and disease activity assessed using the visual analog scale, C-reactive protein level, erythrocyte sedimentation rate (ESR), disease activity score 28-joint count using erythrocyte sedimentation rate (DAS28-ESR), simplified disease activity index (SDAI), clinical disease activity index (CDAI), and health assessment questionnaire (HAQ) score. We also constructed multivariate linear regression models to adjust for confounding effects. Results: The mean QTc interval of 340 patients (mean age: 64.7 ± 12.3 years, female: 289 [85%]) with ECG data was 420.0 ± 18.4, and the mean disease activity indices were: DAS28-ESR, 2.7 ± 1.1 points; CDAI, 5.0 ± 5.2 points; SDAI, 5.4 ± 5.7 points; and HAQ, 0.61 ± 0.71 points. Linear correlations were observed between the QTc interval and all parameters for disease activity in the univariate analysis. The three multivariate linear regression models using age, sex, HAQ score, and disease activity indices (CDAI, SDAI, or DAS28-ESR) were significantly associated with the QTc interval (P = 0.0002, 0.0002, 0.0004, respectively). Conclusions: Disease activity is significantly associated with the QTc interval in patients with RA. Attention should be given to ECG abnormalities in patients with RA and progressive disease activity.

The wall of unintended consequences: is the main benefit of posterior LA wall isolation simply more durable pulmonary vein isolation?Paul C. Zei, MD PhD FHRSDepartment of MedicineBrigham and Women’s HospitalHarvard Medical SchoolBoston, MAFunding: NoneConflict of Interest: None

Objective: We aimed in this study to evaluate the impact of maternal interleukin -17A and the a

β-1,3-Glucan oligosaccharides produced by enzymatic hydrolysis of β-1,3-glucans are of great interest, because they possess biological functionalities such as regulating intestinal health, improving immunity and anti-tumor. A significant qualification for the industrial production of glucan oligosaccharides is β-1,3-glucanase with high catalytic ability. These enzymes are widely present in fungi, bacteria, plants and invertebrates, they are separated into glycoside hydrolase families 3, 5, 16, 17, 55, 64, 72, 81, 128 and 132. This report presents the research progress on the construction and expression of β-1,3-glucanases in Pichia pastoris and Escherichia coli from different microorganisms. Culture conditions and strategies to improve enzyme activity in these hosts are summarized. The application of β-1,3-glucanases in different β-1,3-glucans (curdlan, scleroglucan, laminarin, and schizophyllan) degradation and their hydrolysate analysis are reviewed. This review provides an important reference for further modification and utilization of microbial β-1,3-glucanases in large-scale production of multi-functional oligosaccharides.

Without an animal model and a non-invasive diagnosis, the pathophysiology of endometriosis is unclear and information is limited to symptomatic women. Lesions are biochemically variable. Medical therapy cannot be blinded and extensive surgery combines low numbers with variable difficulty and surgical skills. Experience is spread among specialists in imaging, medical therapy, infertility, pain and surgery. Besides the recent changes in interpreting statistical analyses, the limited good-quality evidence increases the importance of clinical experience. Therefore trial design, analysis and judgment of results should be done by experts in the different disciplines of endometriosis, before being translated into guidelines.

Background: Medical literature supports planned caesarean delivery (CD) for breech presentation at term, due to observed reductions in neonatal morbidity and mortality when compared to normal vaginal delivery (NVD). Objectives: We want to compare perinatal outcomes of singleton pregnancies with breech presentation at term in two University hospitals. One where the option of NVD is routinely offered (Protocol I), a second where these babies are routinely delivered by CD (Protocol II). Study design: A retrospective matched cohort-study was conducted between January 2015 and May 2021. We included singleton pregnancies with frank or complete breech presentations, delivered from 34+0 weeks gestation with known outcomes. Primary outcomes were a composite of adverse obstetrical outcomes (CAOO) and a composite of neonatal adverse outcomes (CANO). Results: 1079 women were eligible for analysis. After matching for possible confounding factors, the final analysis was conducted in 257 patients in each group. CAOO was similar in the two groups (24.1% versus 24.5%, p-value = 1.000), CANO was significantly higher in patients of Protocol I (17.9% versus 1.2%, p-value < 0.001). No neonatal death or birth trauma were reported in either group. The rates of NICU admission (4.3% vs 0.4%; p=0.004), respiratory distress at birth (17.5% vs 1.2%; p<0.001) and APGAR scores <7 after 5 minutes (5.8% vs 0.4%; p<0.001) were significantly higher for Protocol I. Conclusion: Short-term, non-severe adverse neonatal outcomes are significantly increased in the Protocol I group. These must be balanced against the possible negative impacts of caesarean birth on long-term infant and maternal health.

Organic substitution management (OSM) is critical for soil conservation and nitrogen efficiency. However, assessment of soil N pool and system NUE under paddy-upland rotation systems after OSM introduction is still lacking, especially given the system’s alternating wetting-drying soil environment and double cropping. Here, the response of soil nitrogen and crop nitrogen use efficiency to OSM was evaluated in 2018, 2019 and 2020, basing on a long-term rice-fava bean rotation experiment started in 2015. Soil nitrogen, soil enzymes and microbial functions were also used to identify the key factors influencing nitrogen use in response to OSM. The results showed that in comparison to chemical fertilization, OSM increased the soil total nitrogen in both cropping seasons, with increases of 13.1% for the rice season and 16.3% for the fava bean season, respectively. However, nitrogen use efficiency (NUE) showed season-specific responses to OSM. OSM decreased NUE by 18.2% in the rice season but decreased by 8.0% in the fava bean season. Based on the SEM analysis results, we suggest that the opposite response of NRE and NUE to OSM across the studied seasons was mainly attributed to the difference in crop nitrogen requirements and soil hydrological conditions. In conclusion, in paddy-upland rotation areas where have increasing demand for food and chemical fertilizers are currently abused, the use of OSM has potential to curb regional soil degradation due to its high capacity of improving soil quality while ensuring no yield reduction.

In order to improve the efficiency and robustness of device-free localization (DFL) systems in harsh environments, this letter proposed an iterative log thresholding algorithm for DFL in subspace. The log regularizer is taken as the constraint to optimize the object function. To meet the requirement of real-time performance, the dimensions of learning dictionary and observed vector are reduced with principal component analysis (PCA), and the sparse coefficient vector is iteratively computed with sparse coding algorithm. Eventually, by projecting the reference points (RPs) index of the coefficient vectors to the location of objects, the location is estimated. Numerical experiment verified the effectiveness of the proposed algorithm over the alternatives.

Clustered Frequently Interspaced Brief Palindromic Rehashes (CRISPR) is determined from the bacterial natural safe framework and designed as a strong gene-editing apparatus. Due to the higher specificity and proficiency of CRISPR/Cas9, it has been broadly connected to numerous hereditary and non-genetic malady, counting cancers, hereditary hemolytic illnesses, obtained immunodeficiency disorder, cardiovascular illnesses, visual maladies, and neurodegenerative infections, and a few X-linked maladies. Besides, in terms of the restorative technique of cancers, numerous analysts have utilized the CRISPR/Cas9 procedure to remedy or lighten cancers through diverse approaches, such as quality treatment and resistant treatment. Here, we conclude the later application and clinical trials of CRISPR/Cas9 in non-cancerous illnesses and point out a few of the issues to be illuminated. Focus on the toughest barrier to potential in vivo use of CRISPR / Cas9 is then delivered. Shipping & Conveyance Vehicles Detailed to CRISPR / Cas9 Depict viral conveyance strategies (such as adenovirus-associated infection (AAV), full-size, non-viral adenovirus, and lentivirus. Gold), and we talk about their comparative focal points, which appear promising in this respect.CRISPR/Cas9, determined from the microbial natural safe framework, is created as a strong gene-editing device and has been connected broadly. Due to its tall exactness and proficiency, CRISPR/Cas9 strategies may give an awesome chance to treat a few gene-related maladies by disturbing, embeddings, rectifying, supplanting, or blocking qualities for clinical application with quality therapy.

Background Birth trauma may be a risk factor for postpartum post-traumatic stress disorder (PTSD). However, no systematic review on postpartum PTSD in women with traumatic childbirth has been reported. Objective This study aimed to estimate the incidence of PTSD following traumatic childbirth through systematic review and meta-analysis. Search strategy Six databases (CINAHL, PsycINFO, Embase, PubMed, CNKI and Wanfang) were searched from inception to 28 February 2022. Selection criteria Cohort studies and cross-sectional studies related to the incidence of PTSD following traumatic childbirth were included. Data collection and analysis Two reviewers independently conducted studies selection, quality evaluation of studies, and data extraction. The Random-effects meta-analysis was conducted to derive the pooled incidence using Stata 16.0 software. Main results A total of nine studies with 1,823 women experienced traumatic birth were included. Of them, 353 were identified as PTSD. The pooled incidence of PTSD after traumatic childbirth was 19.2% (95%CI: 11.9%~26.5%). Subgroup analyses showed that the incidence of PTSD varied with traumatic birth/PTSD assessment scales and time, and type of study participants. Meta-regression analyses indicated that the study country was a significant source of heterogeneity, and the sample size birth trauma/PTSD were potential predictors of incidence of PTSD after a traumatic birth. Sensitivity analysis by deleting one study at a time yielded similar results. Conclusions The incidence of PTSD in women with traumatic childbirth is about 19%, which is much higher than that in general postpartum population. Keywords post-traumatic stress disorder, incidence, traumatic childbirth, postpartum, meta-analysis

Sunitinib-induced thrombotic microangiopathy (TMA) is a secondary TMA caused by Sunitinib.Despite the extensive use of the drug ,little is known about this complication of Sunitinib. In this study, we reported a 63 years old male with Sunitinib induced TMA treated for metastatic renal cell carcinoma.

We present a case of a 3-year-old child with ventricular septal defect and infective endocarditis with mycotic pulmonary artery aneurysm. The case highlights the role of CT angiography in the diagnosis and characterization of aneurysm and in demonstrating the extent of thrombo-embolic complications in distal pulmonary arteries and lung parenchyma.

Background: Remote ischemic preconditioning (rIPC) has been applied to attenuate tissue injury. We tested the hypothesis that rIPC applied to fetal lambs undergoing cardiac bypass (CB) reduces fetal systemic inflammation and placental dysfunction. Methods: Eighteen fetal lambs were divided into 3 groups: sham, CB control, and CB rIPC. CB rIPC fetuses had a hindlimb tourniquet applied to occlude blood flow for 4 cycles of a 5-minute period, followed by a 2-minute reperfusion period. Both study groups underwent 30 minutes of normothermic CB. Fetal inflammatory markers, gas exchange, and placental and fetal lung morphological changes were assessed. Results: The CB rIPC group achieved higher bypass flow rates (p<.001). After CB start, both study groups developed significant decreases in PaO2, mixed acidosis and increased lactate levels (p<.0004). No significant differences on tissular edema were observed on fetal lungs and placenta (p>.391). Expression of toll-like receptor-4 and ICAM-1 in the placenta and fetal lungs did not differ among the 3 groups, as well as with VCAM-1 of fetal lungs (p>.225). Placental VCAM-1 expression was lower in the rIPC group (p<.05). Fetal interleukin-1 (IL-1) and thromboxane A2 (TXA2) levels were lower at 60 minutes post-CB in the CB rIPC group (p<.05). There was no significant differences in TNF-α, PGE2, IL-6 and IL-10 plasma levels of the three groups at 60-minute post-bypass (p>.133). Conclusion: Although rIPC allowed for increased blood flow during fetal CB and decreased in IL-1 and TXA2 levels and placental VCAM-1, it did not prevent placental dysfunction in fetal lambs undergoing CB.

A document by Lingxiang Jia. Click on the document to view its contents.

Severe acute respiratory distress syndrome in association with coronavirus 2 (SARS-CoV-2) occured more that 6 million cases in Poland since first patient  on 04, March 2020. We present patient with SARS-CoV-2 and thrombus in ascending aorta. Clinically patient had also significant coronary artery disease which schould be treated by cardiac surgeons. Surgery was performer by medial sternotomy and  systematic hipothermia.

We study heat equtions with generalized fractional Laplacian, which is defined by the spectral theory. Here, we develop the existence theory for that equations. Moreover, we present some numerical simulations for our problems.

Evaluation of Industry Payments to Allergists and Clinical Immunologists in the United States during the COVID-19 pandemic: A Seven-year analysis of the Open Payments Database from 2014 to 2020Anju Murayama1,2,*, Sae Kamamoto1,3; Hanano Mamada1,4; Hiroaki Saito1,5; Erika Yamashita1; Tetsuya Tanimoto1,6; Akihiko Ozaki1,7

Propionibacterium acnes is a typical component of the human body's flora and has been implicated as the causative infectious agent following a variety of medical operations. We present a case of a 21-year-old male with severe global acneiform eruption with a non-healing limb lesion near the orthopedic surgery incisions.

In this study, the dissociation constants of the eight amines, namely, N-(2-aminoethyl)-1,3-propanediamine, 2-methylpentamethylene diamine, N, n-dimethyldipropylene-triamine, 3,3’-Diamino-n-methyldipropylamine, Bis[2-(n, n-dimethylamino) ethyl]ether, 2-[2-(Dimethylamino) ethoxy] Ethanol, 2-(dibutylamino) Ethanol and N-propylethanolamine were determined from 298.15 K to 313.15 K. Using the van’t Hoff equation, thermodynamic properties such as the standard state changes of enthalpy, entropy and Gibbs free energy were calculated. Using computational chemistry calculations, the amino group protonated first was predicted. Furthermore, computer free group contribution methods such as the original Perrin-Dempsey-Serjeant (PDS), the modified PDS and the Qian-Sun-Sun-Gao (QSSG) model were used to estimate the dissociation constants of the studied amines. In these methods, the QSSG provided the most accurate results as the database used in this method was updated with additional the functional groups as well as information about group positions. Finally, an artificial neural network was used to predict the pKa values.

In this work, a convenient and efficient one-step solid-phase synthesis method (SPS) is successfully developed for the preparation of NixPy@C nanocomposites under an ambient atmosphere. By controlling the synthesizing temperature, carbon-coated Ni2P, Ni5P4, and NiP2 nanocomposites can be facilely synthesized. The solid-phase synthesized NixPy@C nanocomposites exhibit high charge storage capability and good cycle stability. A high specific capacity of over 197.2 mAh g-1 (709.9 C g−1) is achieved at a current density of 1 A g-1 for the optimal nanocomposite NiP2@C. The assembled hybrid supercapacitor device based on the NiP2@C nanocomposite and an interconnected hierarchical porous carbon (NiP2@C//IHPC) delivers a specific energy of up to 50.38 Wh kg-1 at a specific power of 0.89 kW kg-1. More than 83.8% of initial specific capacity is retained after 20000 cycles. This method is proved to be a reliable strategy for simple preparation of high-performance transition metal phosphides for energy storage devices.

I have postulated the hypothesis that acute hepatitis of unknown origin in children is caused by adeno-associated virus (AAV) type 2[1].The liver injury seen with intravenous injection of high-dose AAV vectors for gene therapy purposes is likely not dependent on the transgene or transgene product. This is because hepatotoxicity has occurred in humans with AAV vectors for several types of genetic disorders[2]. AAV vectors that have caused severe liver damage in humans at high doses in gene therapy clinical trials are of nonhuman primate origin, such as types 8 and 9, and not type 2. However, asymptomatic transaminase elevation was seen with a decrease in transgene product after 2-3 weeks of administration of medium or high doses of AAV type 2 vector to humans[3,4]. In these cases, analysis of peripheral blood mononuclear cells by interferon-γ enzyme-linked immunospot (IFN-γ ELISPOT) showed a response to AAV type 2 capsid but not to transgene product[3,4]. This measurement suggested the destruction of transduced hepatocytes by CD8+ Tcells. If hepatitis occurs with AAV, hepatitis may be delayed from adenovirus or AAV infection, which may affect viral detection. Prevalence for neutralizing antibodies in French adults was significantly lower for AAV8 (38%) than for AAV type 2 (72%), and even when positive for AAV type 8, titers are mostly low[5,6].AAV type 2 shares 83% homology with AAV type 8 [7]. Immune responses to mice were not very different between AAV type 2 and AAV type 8 [8]. AAV type 2 may have the potential to cause severe liver damage in humans if present in the blood in large quantities with poor immunity to AAV2.Some studies suggest that AAVs are sensed by Toll-like receptor 2 (TLR2) and TLR9 innate immune receptors in mice and humans[9,3,8]. The capsid of AAV type 2 may interact with the innate immune system via TLR2 and has recently been shown to be present in nonparenchymal cells of the human liver (Kupffer cells and hepatic sinusoidal endothelial cells) [10].Besides T cell involvement[3,4], complement played a role in the adaptive immune response to AAV[11]. SARS-CoV-2 infection can enhance broad and non-specific immune activation[12] including hyperactivation of the complement[13]. Co-occurrence of SARS-CoV-2 infection may be an exacerbating factor and may be the reason for the high rate of SARS-CoV-2 co-infectionCorticosteroids have been reported to be effective in the treatment of liver injury with AAV vectors. Since all of the current candidate causes are unlikely to be seriously aggravated by short-term corticosteroid administration, a single, short-acting corticosteroid administration and observation of response may be considered at an early stage of diagnosis, given the risk of progression to severe hepatitis. AAV type 2 is difficult to test for in the general hospital setting, and guidelines should be urgently developed for tests that should be performed on acute hepatitis of unknown origin in children. Polymerase Chain Reaction testing for AAV should be performed in both blood and stool, along with adenovirus. In addition, analysis of AAV type 2 capsid-specific T cells by ELISPOT in patients may be the key to elucidating the cause

Striped mullet (Mugil cephalus) roe is used for the production of traditional delicacies in Greece (avgotaracho), Japan (karasumi) and Italy (botargo). In Greece avgotaracho is a Protected Designation of Origin product and its special taste combined with its high nutritional value of this rich in polyunsaturated fatty acids (PUFA) and bioactive compounds delicacy attracts many consumers. During the production of avgotaracho and the similar products some of the egg sacs (skeins) either break or have an inappropriate size (too small) and they can not be used for avgotaracho production. On the other hand the nutritional quality of the eggs in the broken or smaller skein is by no means inferior comparing to the rest. Proper valorization of the mullet roe by-products could lead to high nutrition value products. This work focuses on examining the potential valorization of these high nutritional value by-products for producing mullet roe oil. Three different extraction methods with potential of scale-up are examined. Namely pressure, supercritical extraction, solvent extraction are examined where mild temperature conditions and (wherever applicable) food-grade solvents are used. The oil yield, the composition of oils in fatty acids by GC-FID, the level of oil oxidation (peroxide value, p-anisidine value, K232 K268, TOTOX) and antioxidant activity (DPPH, ABTS) are determined. The potential of the above extraction methods for the production of mullet roe oil in terms of yield and oil quality is discussed.