Theoretical modelling predicts that both direct and delayed density-dependence are key factors to generate population cycles. Deciphering density-dependent processes that lead to variable population growth characterizing different phases of the cycles remain challenging. This is particularly the case for the period of prolonged low densities, which is inherently data deficient. However, demographic analyses based on long-term capture-mark-recapture datasets can help resolve this question. We relied on a 16-yr (2004-2019) live-trapping program to analyse the summer demography and movements of a cyclic brown lemming population in the Canadian Arctic. More specifically, we examined if inversely density-dependent processes could explain why population growth can remain low during the prolonged low phase. We found that the proportion of females in the population was inversely density-dependent with a strong male-biased sex ratio at low densities but not at high densities. However, survival of adult females was higher than adult males, but both had lower survival at low densities than at high ones. Distances moved by both adult males and females were density-dependent, and proportion of females in reproductive condition was weakly density-dependent as it tended to increase at low density. Individual body condition, measured as monthly change in body mass, was not density-dependent. Overall, the strong male-biased sex ratio at very low densities suggests a loss of reproductive potential due to the rarity of females and appears to be the most susceptible demographic factor that could contribute to the prolonged low phase in cyclic brown lemmings. What leads to this sex-bias in the first place is still unclear, potentially owing to our trapping period limited to the summer, but we suggest that it could be due to high predations rate on breeding females in winter.

Sodium glucose co-transporter 2 inhibitors (SGLT-2i’s) significantly improve cardiovascular outcome in both diabetic and non-diabetic patients. Preclinical studies suggest that SGLT-2i’s directly affect endothelial function in a glucose-independent manner. The effects of SGLT-2i’s include reduction of oxidative stress and inflammatory reaction in endothelial cells. Furthermore, SGLT2i’s have been shown to restore endothelial-related vasodilation and to regulate angiogenesis. The favorable cardiovascular effects of SGLT-2i’s might be mediated via multiple pathways: 1) by inhibition of the overactive sodium-hydrogen exchanger; 2) by reduction of nicotinamide adenine dinucleotide phosphate oxidases expression; 3) by alleviation of mitochondrial injury; 4) by the suppression of inflammatory-related signaling pathways (e.g. by affecting nuclear factor kappa beta); 5) by modulation of glycolysis, as well as 6) by restoring impaired nitric oxide bioavailability. This review focuses on the most recent progress and existing gaps in preclinical investigations concerning the direct effects of SGLT-2i’s on endothelial dysfunction and their underlying mechanisms.

Objective: The use of antenatal corticosteroids beyond 34 weeks of gestation remains a debate. This study sought to determine the effect of use of antenatal corticosteroids in late preterm delivery on neonatal morbidity. Design: It was a randomized double-blind placebo and active controlled multi arm trial. There were two study groups and one control group. Setting: It was conducted at the department of Obstetrics and Gynaecology and the Department of Paediatrics of Ahmadu Bello University Teaching Hospital Zaria. Population: Pregnant women at 34 weeks 0 days to 36 weeks 6 days of gestation scheduled for elective/emergency delivery were recruited for the study. Methods: The study groups had dexamethasone and betamethasone respectively while the control group had a placebo. Main outcome: The primary outcome was incidence of respiratory distress syndrome. Results: A total of 138 mothers and 146 preterm neonates were included in the study with 48 exposed to placebo, 49 exposed to betamethasone and 49 exposed to dexamethasone. A pairwise analysis was done to test for difference between the groups. There was no statistically significant difference in the incidence of respiratory distress syndrome between the dexamethasone vs placebo (p= 0.98, RR 1, CI 0.06-16.89), betamethasone vs placebo (p= 0.98 RR 1, CI 0.09-11.55) and dexamethasone vs betamethasone (p=0.32, RR 0.5, CI 0.09-2.42) Conclusion: Antenatal corticosteroids may decrease the need for neonatal resuscitation at birth in late preterm neonates.

Ice-free areas are increasing worldwide due to the dramatic glacier shrinkage and are undergoing rapid colonization by multiple lifeforms, thus representing key environments to study ecosystem development. Soils have a complex vertical structure. However, we know little about how microbial and animal communities differ across soil depths and development stages during the colonization of deglaciated terrains, how these differences evolve through time, and whether patterns are consistent among different taxonomic groups. Here, we used environmental DNA metabarcoding to describe how community diversity and composition of six groups (Eukaryota, Bacteria, Mycota, Collembola, Insecta, Oligochaeta) differ between surface (0-5 cm) and relatively deep (7.5-20 cm) soils at different stages of development across five Alpine glaciers. Taxonomic diversity increased with time since glacier retreat and with soil evolution; the pattern was consistent across different groups and soil depths. For Eukaryota, and particularly Mycota, alpha-diversity was generally the highest in soils close to the surface. Time since glacier retreat was a more important driver of community composition compared to soil depth; for nearly all the taxa, differences in community composition between surface and deep soils decreased with time since glacier retreat, suggesting that the development of soil and/or of vegetation tends to homogenize the first 20 cm of soil through time. Within both Bacteria and Mycota, several molecular operational taxonomic units were significant indicators of specific depths and/or soil development stages, confirming the strong functional variation of microbial communities through time and depth. The complexity of community patterns highlights the importance of integrating information from multiple taxonomic groups to unravel community variation in response to ongoing global changes.

Letter to the Editor: Interesting clinical observationTitle: Acute Exacerbation of Graft-versus-Host Disease following SARS-CoV2 infection after Hematopoietic Stem Cell Transplant in Two Pediatric PatientsRunning Title: Graft-versus-Host Disease and SARS-CoV2 infectionAuthors: Michelle Choe1,2* Caridad Martinez1,2, Robert Krance1,2, Erin Doherty1,2ORCID:Michelle Choe: 0000-0001-9850-9435Institutional Affiliation:1 Hematology and Cancer Center, Texas Children’s Hospital, Houston, Texas2 Department of Pediatrics, Baylor College of Medicine, Houston, Texas*Corresponding Author:Michelle Choe, MD6701 Fannin St. Ste. 1510Houston, TX 77030P: 832-822-4242F: 832-825-1453Abbreviations key:

We present the case of a middle-aged man who developed an infective endocarditis of the tricuspid valve caused by methicillin-sensitive Staphylococcus aureus and associated with a very large vegetation (nearly 5 cm). Besides the quite unusual size of the vegetation, this report highlights that severe right-sided endocarditis can occur in the absence of classical risk factors (intravenous drug abuse, presence of a cardiac implantable electronic device or other intravascular device, and underlying right-sided cardiac anomaly) and that some cases of severe tricuspid endocarditis can be successfully treated by partial excision and patch repair.

AIM: To improve the tolerability and therapeutic application of histone deacetylase inhibitors (HDACi), by application of an esterase-sensitive motif (ESM), to target pharmacological activity directly to mononuclear myeloid cells expressing the processing enzyme carboxylesterase-1 (CES1). METHODS. This first-in-human study comprised of single and multiple ascending dose cohorts to determine safety and tolerability. Pharmacodynamic parameters included acetylation, cytokine inhibition and intracellular concentrations of processed acid metabolite in isolated monocytes. Mechanistic work was conducted in vitro and in a CES1/Es1elo mouse strain. RESULTS. ESM-HDAC391 was well tolerated whilst showing robust targeted mechanistic engagement, as demonstrated by selective retention of compound and increased acetylation in monocytes plus inhibition of ex vivo stimulated cytokine production. Importantly, common clinical HDACi toxicities were not observed. ESM-HDAC391 treatment was accompanied by the novel finding of a dose-dependent monocyte depletion that was transient and reversible. In-depth characterisation of monocyte depletion in a transgenic mouse model (CES1/Es1elo) suggested that CSF1R loss on circulating cells contributes to ESM-HDAC-mediated depletion. Further mechanistic investigations using human monocytes in vitro demonstrated HDACi-mediated change in myeloid fate through modulation of CSF1R and downstream effects on cell differentiation. CONCLUSION. These findings demonstrate selective targeting of monocytes in humans using the ESM approach and identify monocytopaenia as a novel outcome of ESM-HDACi treatment, with implications for the potential benefit of these molecules in myeloid-driven diseases.

Background: Left ventricular outflow tract pseudoaneurysm is a rare but potentially fatal complication of aortic valve replacement, infective endocarditis, and suture dehiscence. Left ventricular-aortic discontinuity is a severe and uncommon manifestation of IE. For patients who have a long-standing history of endocarditis, peri-annular lesions in the aortic valve may rupture, leading to the rare occurrence of complete, or total, left ventricular-aortic discontinuity. Methods: We present a case of complete postoperative left ventricular-aortic discontinuity and massive circumferential left ventricular outflow tract pseudoaneurysm discovered during a 3-month follow-up visit. Results: Post-operative cardiac CT of a patient demonstrated dehiscence of a recently placed surgical aortic valve from the left ventricular outflow tract, with massive circumferential pseudoaneurysm formation. Only a small remnant of the membranous interventricular septum connected the aortic root to the heart, informing the diagnosis of complete left ventricular-aortic discontinuity. Conclusion: The clinical presentation of a left ventricular outflow tract pseudoaneurysm with concomitant left ventricular-aortic discontinuity is commonly nonspecific or clinically silent; thus, it requires a high index of suspicion and use of multimodality imaging for diagnosis and management.

Objective: To explore the duration of the active phase of the second stage of labour in relation to maternal prepregnant body mass index (BMI). Design: Retrospective cohort study. Setting: Labour wards of three Norwegian university hospitals, 2012-2019. Population: Nulliparous and parous women without previous caesarean section with a live singleton foetus in cephalic presentation and spontaneous onset of labour, corresponding to the Ten Group Classification System (TGCS) group 1 and 3. Methods: Women were stratified to BMI groups according to WHO classification, and estimated median duration of the active phase of the second stage of labour was calculated using Kaplan-Meier analyses. We performed stratified analyses in women with and without epidural analgesia and oxytocin augmentation. Finally, we calculated the Hazard Ratio (HR) of delivery using Cox regression analyses. Caesarean sections and operative vaginal deliveries during the active phase were censored. Main Outcome Measures: Estimated median duration of the active phase of second stage of labour. Results: The final study population comprised 23516 women in TGCS group 1 and 27255 in group 3. Increasing BMI was associated with shorter estimated median duration of the active phase in both TGCS groups. The pattern remained when performing stratified analyses for epidural and oxytocin analgesia. The HR for delivery increased significantly with increasing BMI analysed as a continuous variable; HR 1,019 (95%CI 1.016-1.023) in TGCS group 1 and HR 1,017 (95%CI 1.014-1.020) in TGCS group 3. Conclusion: Increasing BMI was associated with shorter estimated median duration of the active second stage Funding: None.

Nutritional support is essential in the critical care of the very preterm infant, however, study of the potential role of nutrition in the multifactorial pathogenesis of bronchopulmonary dysplasia (BPD) is limited. Achievement of full enteral feeding faster has not been shown to be harmful and may be of benefit in extremely preterm infants. This commentary discusses the studied risk and potential benefits of more rapid enteral feeding advancement in extremely preterm infants.

Diffuse light has been shown to alter plant leaf photosynthesis, transpiration, and water-use efficiency. Despite this, the angular distribution of light for the artificial light sources used with common gas exchange systems is unknown. Here we quantify the angular distribution of light from common gas exchange systems and demonstrate the use of an integrating sphere for manipulating those light distributions. Among three different systems, light from a 90° angle perpendicular to the leaf surface (± 5.75°) was <25% of the total light reaching the leaf surface. The integrating sphere resulted in a greater range of possible distributions from predominantly direct light (i.e., > 40% of light from a 90 ± 5.75° angle perpendicular to the leaf surface) to almost entirely diffuse (i.e., light from an even distribution drawn from a nearly 0° horizontal angle to a perpendicular 90° angle). The integrating sphere can thus create light environments that more closely mimic the variation in sunlight under both clear and cloudy conditions. In turn, different proportions of diffuse light increased, decreased, or did not change photosynthetic rates depending on the plant species observed. This new tool should allow the scientific community to explore new and creative questions about plant function within the context of global climate change.

Objective: Procalcitonin (PCT) is an established biomarker for bacterial sepsis in the non-pregnant population. We aimed to evaluate PCT levels in women and their neonates managed with suspected intrapartum bacterial sepsis, to determine if PCT could be utilised to optimise diagnosis and management. Design: Prospective observational cohort study. Setting: University Hospitals of Bristol and Weston NHS Foundation trust. Population: 117 women and their neonates managed for suspected intrapartum sepsis from June-October 2020. Methods: PCT levels were measured in addition to routine biomarkers white cell count and c-reactive protein, in women and their neonates during initial septic screen and follow up blood samples. Placentas underwent detailed histopathology. Main Outcome Measures: Maternal and neonatal parameters were used to categorise cases into: ‘high-suspicion bacterial sepsis (BS),’ ‘equivocal BS’ and ‘low-suspicion BS.’ Kruskal-Wallis test was performed comparing categories with biomarker values and placental histology scores. Results: PCT was raised in 6 women in the initial septic screen sample, compared to 100 with a raised CRP. There was a significant difference in maternal postnatal PCT results between ‘high-suspicion BS’ and ‘low-suspicion BS’ categories. 71.2% of placentas showed varying degrees of chorioamnionitis. Conclusions: In our cohort of women, 94.6% had normal PCT levels whilst in labour at the time of the septic screen, consistent with the low number of confirmed bacteraemia. This provides a basis that PCT may complement clinical judgement and interpretation of already utilised prognostic and diagnostic tests, in order to improve patient care in the management of intrapartum sepsis.

We report a 36-year-old male with an atypical variant of lipoma occurring on an atypical site.

The aim of our clinical image is to emphasize the value of a careful skin examination in the diagnosis of early-onset sarcoidosis in children.

Leaf trichomes (hairs) have multiple hypothesized functions, of which several require empirical evidence. An important, yet controversial, proposed function of trichomes is to influence the leaf boundary layer, which would affect leaf temperature, transpiration and photosynthesis, and may confer differential benefits depending on climate. We used dynamic infrared thermography to test whether trichomes reduce the boundary layer conductance to heat ( g bh), impeding heat transfer between leaves and air. For five species, with trichome lengths of 135-780 μm, we transiently heated leaves with a radiative light source, measured the time constant for subsequent leaf cooling simultaneously in two adjacent leaf regions (with and without trichomes) with an IR camera, and inferred g bh using an energy balance model. Cooling was slower in hairy leaf regions relative to bald regions, corresponding to a lower g bh in hairy regions, by 2.4% to 39% across species. Contrary to prior theory, the resistance added by trichomes was unrelated to the depth of the hair layer (i.e., trichome height) across species. Simulations predicted that the reduction in g bh by trichomes would influence energy balance and gas exchange rates by up to a few percent, with the direction and magnitude of such effects depending sensitively on environmental conditions.

Allium sativum extract is one of the medicinal and aromatic products used in pharmaceutical and food industries. The scientific literature bibliography regarding process scale-up simulation and techno-economics of phenolic extract from Allium sativum microwave-assisted extraction is seldom reported. This study presented optimization and techno-economic evaluation of phenolics recovery from allium sativum microwave-assisted extraction. Box-benken design extraction experiment was conducted at irradiation power (520 – 1040 W), extraction time (2- 10 minutes) and solid-liquid ratio (0.4 – 1 g/100 ml). The extraction conditions that optimized experimental extractible yield and Total Phenolic Content (TPC) were evaluated in Box-benken desirability of Response Surface Methodology. Bioactive finger printing of the extract was analyzed using HPLC. Aspen Batch Process Developer was used for the process techno-economic analysis. Profitability uncertainty was analyzed using Monte-Carlo Simulation (MCS). Optimal extractible yield (28.62 %) and TPC (76.8 mgGAE/g dry extract) were obtained at irradiation time 7.62 mins, microwave power 826.67 Watt with solid-liquid ratio 0.55g/100ml. The HPLC fingerprint revealed Bentulinic acid, galic acid, chlorogenic acid, ellagic acid and ferulic acid. Cost of Manufacturing (COM) for 5L, 50L and 500L extractors gave US$ 1480, US$ 220 and US$ 56 respectively. Techno-economic results of 500L extraction capacity with 900 kg/year design gave batch size (0.25 kg), production rate (2 kg/mins), cycle time (125 mins), discounted NPV (38133 US$), ROI (34%), IRR (37%) and PBT (2.94yrs). MCS results show 85.58 % and 83.53certainties of achieving base case ROI PBT. Therefore, the study shows that MAE of garlic powder is economically feasible.

Plants are responding to climate change by shifting their ranges to higher elevations. These range shifts are not happening at the same rate for all species, for example, subalpine species are generally moving faster upslope than alpine species, but with large variation within groups. This asymmetry in migration rates will result in novel communities and interactions between plant species that have not previously co-occurred. While seed dispersal is obviously critical for species’ range shifts, seedling emergence and survival are also major bottlenecks for successful colonization in new areas. As seedlings generally constitute the most vulnerable stages in the life-history of plants, variation in seedling establishment success can potentially be important determinants of species’ range shift rates. Previous studies have found that warming per se tends to increase seedling establishment in alpine climates, but it also increases plant productivity and thus competition for nutrients and light from the resident vegetation, which acts limiting on seedling establishment. This study will attempt to disentangle the relative importance of these abiotic and biotic factors on sub-alpine species’ seedling emergence and survival in alpine habitats, to help further understanding and prediction of future lowland plant colonization in alpine habitats. We will also explore if species’ life strategies impact their ability to colonize new locations, predicting that species with resource acquisitive traits will emerge earlier and faster than resource conservative species. To address these questions, we will perform a seed transplant experiment where we assess seedling emergence and establishment in the alpine. Seeds will be sown in plots with and without experimental warming, crossed with manipulation of biotic interactions, and using seeds from both resource conservative and resource acquisitive subalpine species. In addition, we will explore if the observed responses are general or context-dependent by replicating this experiment along a regional bioclimatic precipitation gradient.

1. Cattle grazing profoundly affects abiotic and biotic characteristics of ecosystems. While most research has been performed on grasslands, the effect of large managed ungulates on forest ecosystems has largely been neglected. 2. Compared to a baseline semi-natural state, we investigated how long-term cattle grazing of birch forest patches affected the abiotic state and the ecological community (microbes and invertebrates) of the soil subsystem. 3. Grazing strongly modified the soil abiotic environment by increasing phosphorus content, pH and bulk density, while reducing the C:N ratio. The reduced C:N-ratio was strongly associated with a lower microbial biomass, mainly caused by a reduction of fungal biomass. This was linked to a decrease in fungivorous nematode abundance and the nematode channel index, indicating a relative uplift in the importance of the bacterial energy-channel in the nematode assemblages. 4. Cattle grazing highly modified invertebrate community composition producing distinct assemblages from the semi-natural situation. Richness and abundance of microarthropods was consistently reduced by grazing (excepting collembolan richness) and grazing-associated changes in soil pH, Olsen P and reduced soil pore volume (bulk density) limiting niche space and refuge from physical disturbance. Anecic earthworm species predominated in grazed patches, but were absent from ungrazed forest, and may benefit from manure inputs, while their deep vertical burrowing behaviour protects them from physical disturbance. 5. Perturbation of birch forest habitat by long-term ungulate grazing profoundly modified soil biodiversity, either directly through increased physical disturbance and manure input or indirectly by modifying soil abiotic conditions. Comparative analyses revealed the ecosystem engineering potential of large ungulate grazers in forest systems through major shifts in the composition and structure of microbial and invertebrate assemblages, including the potential for reduced energy flow through the fungal decomposition pathway. The precise consequences for trophic interactions and biodiversity-ecosystem function relationships remains to be established, however.

Livestock trading through live animal markets are potential pathways for the introduction and spread of economically important pathogens like the African swine fever virus (ASFV) to new areas in several countries. Due to the high demand for live pigs in Nigeria both for restocking and slaughter, live pigs are sold at designated live pig markets (LPM) in the country. This involves movement of pigs over long distances. Despite, reports of ASF outbreaks following restocking of pigs bought from LPMs, there is paucity of information on the role of LPMs in the epidemiology of ASF. In this study, data and pig samples (whole blood, sera, tissue) were collected from 4 selected LPMs in Nigeria (Dawaki, Katsit, Numan & Pandam) between 2019 and 2020. Samples were analysed by polymerase chain reaction (PCR) and Enzyme-linked Immunosorbent Assay (ELISA). Four genes of ASFV positive samples were characterized to identify the circulating genotypes. Results revealed trade activities involving transportation of pigs from these selected markets to 42 major cities and towns in thirteen (13) States of Nigeria. PCR results revealed an overall ASF prevalence of 10.77% (66/613). ASFV was confirmed by PCR in all the selected LPMs with a prevalence rate of 3.13%-23.81%. The phylogeny revealed genotype I and serogroup 4 based on the p72 protein that encodes the B646L gene and the EP402R gene encoding the CD2V. While sequence analysis of CVR of B602L gene revealed 8 tetrameric repeats variants, six of which have never been reported in Nigeria. Analysis of sera samples recorded a seroprevalence of 6.9% (16/217) within the study period. Findings from this study show that LPM are hotspots and channels for transmission and continuous spread of ASFV in Nigeria. Therefore, for ASF to be controlled in Nigeria, disease surveillance and regulation at LPMs are critical.

To the Editor,Food protein-induced enterocolitis syndrome (FPIES) is a non-immunoglobulin E (IgE) mediated food allergy that predominantly affects infants and is characterized by repetitive vomiting that occurs 1–4 h after the ingestion of causative food. The etiology and underlying mechanisms of FPIES are not well understood. Recently, egg yolk (EY) has been recognized as a major causative food of FPIES.1,2 Most FPIES patients achieve tolerance with age;3 however, the practice management of EY-associated FPIES (EY-FPIES) has yet to be established. In a preliminary analysis of EY-FPIES, we found that the patients who acquired tolerance to EY had been diagnosed at a significantly younger age than non-tolerated patients despite no difference in the age of onset between both patients. This suggested that the early diagnosis and intervention is beneficial for tolerance acquisition in EY-FPIES. To investigate this further, we compared clinical outcomes between the early and late diagnosis of EY-FPIES.The present study enrolled 21 patients with EY-FPIES (1) diagnosed by positive oral food challenge (OFC) tests at our hospital between April 2018 and April 2021 who (2) subsequently underwent OFC to evaluate tolerance acquisition (re-OFC) at least once. The open OFC was performed by ingestion of a single dose once or three divided doses every 30 minutes. OFC was considered positive for FPIES based on delayed abdominal reactions without immediate skin or respiratory reactions. After confirmation by OFC, we instructed all patients to continue complete elimination of EY, regardless of threshold doses of OFC. We retrospectively collected data from electronic medical records on sex, age of first ingestion of EY, disease onset, first visit to our hospital, diagnosis, specific IgE (sIgE) to EY measured by ImmunoCAP test at diagnosis, asymptomatic histories of EY consumption before onset, the number of symptomatic episodes before diagnosis, the period between the first ingestion of EY and diagnosis of EY-FPIES, and age of tolerance acquisition. Tolerance acquisition was defined by (1) negative OFC and (2) the ability of daily EY consumption without FPIES reactions for three months at home. We divided the patients into the following two groups according to their age at the time of diagnosis: the early diagnosis (ED) group (<12 months) and the late diagnosis (LD) group (≥12 months), and compared the clinical features between both groups. A sIgE value higher than 0.35 UA/ml was defined as positive. Statistical analyses were performed using GraphPad Prism 9. The Mann-Whitney U test was used to compare nonparametric independent samples between the groups. Tolerance acquisition during follow-up was analyzed using a Kaplan–Meier survival curve and the log-rank test. P-value <0.05 was considered statistically significant. This study was approved by the Institutional Review Board of the KKR Sapporo Medical Center (2021-06).Patients’ characteristics are shown in Table 1. The ED group consisted of 12 patients (57.1%), 10 (83.3%) of whom acquired tolerance to EY, and the LD group consisted of nine patients (42.9%), three (33.3%) of whom acquired tolerance to EY. Among 21 patients with EY-associated FPIES, a total of 35 re-OFCs were performed, with a median interval of seven months (interquartile range [IQR], 6–11 months) (Figure 1). The median ages that re-OFC proved negative in ED and LD groups were 16 and 26 months, respectively (p = 0.014) (Table 1). The time to tolerance acquisition was significantly longer in the LD group than that in the ED group, as shown in the Kaplan–Meier analysis (log-rank, p = 0.0015) (Figure 2). The median ages of onset and first visit to our hospital were significantly younger in the ED group than those in the LD group (Table 1). All patients had a history of three episodes (IQR 2–6) of asymptomatic consumption before onset. Although the median age of the first introduction of EY in the ED group was younger than that in the LD group (six months vs. eight months, p = 0.004), there was no significant difference in the median number of asymptomatic consumptions before onset and the period between the first introduction and onset between the groups. The period between the first introduction of EY and FPIES diagnosis was shorter in the ED group than that in the LD group (2.5 months vs. 7 months, p = 0.0002).We demonstrated that the ED group achieved tolerance at a higher rate than the LD group, suggesting that early diagnosis and intervention predict favorable prognosis in EY-FPIES. Consistent with a previous report,4 all patients with EY-FPIES had histories of asymptomatic consumption before disease onset. Involvement of both innate and adaptive immunities with resultant proinflammatory cytokine production has been suggested in the pathology of acute FPIES.5 Our results suggest that the development of EY-FPIES requires sensitization of the adaptive immune system. T helper (Th)2 and Th17 cells are considered as key players of the immune response in FPIES,6 which is reflected by local infiltration of eosinophils and neutrophils, respectively. Adaptive immunity of infants shows dynamic changes with a rapid decline of regulatory T cells and maturation of Th17, while Th2 dominance is preserved.7 Additionally, the intestinal barrier function immaturity was also observed, resulting in a higher permeability of antigens across the intestines.8 Thus, early infants may be predisposed to FPIES because of immunological as well as anatomical immaturity. Although both ED and LD groups shared a similar interval between the first introduction of EY and onset, the period between the onset and diagnosis in the ED group was significantly shorter than that in the LD group. Our results suggest that an earlier elimination of EY after onset prevents the complete development of EY-FPIES.The median age at onset in the 21 patients with EY-FPIES was 8 months (IQR, 7–9 months), which is comparable to previous reports.9 Similar to another report,9 13 patients (65.0%) achieved tolerance at the median age of 16 months. This is earlier than the median age reported in a European series that demonstrates a 50% cumulative probability of resolution at the age of 41 months.10Notably, the median age of diagnosis is older (12 months) in that study compared with that in our series. Thus, the different clinical courses may attribute to differences in age of diagnosis. Otherwise, the clinical course may depend on ethnicity. In 2017, the Japanese Society of Pediatric Allergy and Clinical Immunology recommended the early introduction of EY to infants with a high risk for IgE-mediated egg allergy. This might have increased the number of early-onset EY-FPIES in Japan. Our results suggest that a first re-OFC seven months after the diagnosis is reasonable for preventing unnecessary food avoidance in EY-FPIES.Our study is limited by a retrospective review of a small number of patients from a single institute. Additionally, accidental exposures after diagnosis occurred in one patient in the LD group, influencing the scheduling of re-OFC. Moreover, we evaluated solely patients with a confirmational diagnosis by OFC, which might be insufficient to reflect the whole heterogeneity of EY-FPIES.Conclusively, the ED group achieved tolerance in EY-FPIES earlier compared with the LD group. Early diagnosis and complete elimination of EY may be beneficial for EY-FPIES.

The Indian Supreme Court has declared the right to healthy environment a fundamental right available to citizens of India. This in contrast to Indian executive's abstention from voting on the resolution for the right to healthy environment at United Nations Human Rights Council. Indian citizens may now be forced move courts for basic rights like clean and healthy air instead of a stronger executive action. This study uses an example of nine public buildings in New Delhi to show that air conditioners have an impact on the indoor air quality of congregational. This impact is all the more severe as it has a relation to the spread of airborne infections like COVID-19. The study highlights the paradox of fresh air intake for infection control and how it brings in polluted air due to ill equipped air conditioning systems. It also highlights biological contaminants' non recognition as pollutants. The data was gathered by the use of the Right to Information Act, 2005 and was studied to reinforce the evidence-based lack of regulations and implementation in New Delhi. The focus today must be on making regulations so that people in India realise their right to breathable air and a healthy environment. (199 words)

Authors: Jonathon D. Gass Jr. 1,†, Robert J. Dusek2, Jeffrey S. Hall2, Gunnar Thor Hallgrimsson3, Halldór Pálmar Halldórsson4, Solvi Runar Vignisson4,5, Sunna Bjork Ragnarsdottir6, 7, Jón Einar Jónsson8, Scott Krauss9, Sook-San Wong9,ŧ, Xiu-Feng Wan10, 11, 12, 13, Sadia Akter10, 11, 12, 13,*, Srinand Sreevatsan14, Nídia S. Trovão15, Felicia B. Nutter1, Jonathan A. Runstadler1, Nichola J. Hill1,16 1 Department of Infectious Disease and Global Health, Cummings School of Veterinary Medicine, Tufts University2 U.S. Geological Survey, National Wildlife Health Center3 Institute of Biology, University of Iceland 4 University of Iceland’s Research Centre in Suðurnes 5 Suðurnes Science and Learning Center6 Icelandic Institute of Natural History 7 The Southwest Iceland Nature Research Centre8 University of Iceland's Research Center at Snæfellsnes9 Department of Infectious Diseases, St. Jude Children’s Research Hospital 10 Center for Influenza and Emerging Infectious Diseases (CIEID), University of Missouri, Columbia11 Department of Molecular Microbiology and Immunology, University of Missouri, Columbia12 Bond Life Sciences Center, University of Missouri, Columbia13 Department of Electronic Engineering and Computer Science, University of Missouri, Columbia14 College of Veterinary Medicine, Michigan State University15 Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health16 Department of Biology, University of Massachusetts, Boston† Corresponding author Corresponding author email: Jonathon.gass@tufts.edu ŧ Present address: State-Key Laboratory of Respiratory Diseases, Guangzhou Medical University and School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong * Present address: Department of Molecular Microbiology, Washington University School of Medicine in St. LouisAbstractInfluenza A viruses (IAV) circulate endemically among many wild aquatic bird populations that seasonally migrate between wintering grounds in southern latitudes to breeding ranges along the perimeter of the circumpolar arctic. Arctic and subarctic zones are hypothesized to serve as ecologic drivers of the intercontinental movement and reassortment of IAVs due to high densities of disparate populations of long distance migratory and native bird species present during breeding seasons. Iceland is a staging ground that connects the East Atlantic and North Atlantic American flyways, providing a unique study system for characterizing viral flow between eastern and western hemispheres. Using Bayesian phylodynamic analyses, we sought to evaluate the viral connectivity of Iceland to proximal regions and how inter-species transmission and reassortment dynamics in this region influence the geographic spread of low and highly pathogenic IAVs. Findings demonstrate that IAV movement in the arctic and subarctic reflects wild bird migration around the perimeter of the circumpolar north, favoring short-distance flights between proximal regions rather than long distance flights over the polar interior. Iceland connects virus movement between mainland Europe and North America, consistent with the westward migration of wild birds from mainland Europe to Northeastern Canada and Greenland. Though virus diffusion rates were similar among avian taxonomic groups in Iceland, gulls play an outsized role as sinks of IAVs from other avian hosts prior to onward migration. These data identify patterns of virus movement in northern latitudes and inform future surveillance strategies related to seasonal and emergent IAVs with potential public health concern. Keywords: Influenza A virus, Iceland, wild birds, phylodynamics, transmission, subarctic

This article investigates the fractional Peyrard-Bishop DNA model. The construction of soliton solutions have been successfully obtained by utilizing two versatile analytical methods, namely, the Jacobi elliptic function method and the tanh-coth method. Furthermore, the Painlev´e test (P-test) has been employed on the proposed model for investigating integrability. The proposed model is proved to be integrable. Some of the obtained solutions have been examined graphically to study the dynamical behavior.

Abstract Objectives To explore the long-term efficacy and possible mechanism of endolymphatic sac decompression (ESD) in the treatment of Meniere’s disease(MD) by electrocochleography. Design Prospective cohort study. Setting “Blinded for review” Participants A total of 85 patients with MD who underwent unilateral ESD between June 2015 and November 2019 at“Blinded for review”were enrolled. Main outcome measures The Dizziness Handicap Inventory (DHI), Tinnitus Handicap Inventory (THI), pure tone audiometry, and electrocochleography were used for assessment. The mean follow-up time was 26 months (range: 7–60 months). Results The number of vertigo episodes was significantly reduced following ESD compared to before the surgery (P<0.005), and all patients achieved complete or basic control of vertigo as evidenced by a decrease in DHI score (P<0.005). THI scores of patients with tinnitus were also lower after as compared to before ESD (P<0.005), whereas no significant change in average hearing threshold of the affected side was observed (P>0.05). The cochlear summating potential (SP)/auditory nerve action potential (AP) area ratio in the electrocochleogram of the affected side was negatively correlated with DHI score (rs=−0.159, P=0.0074). Conclusions ESD achieved effective long-term control of vertigo in MD patients and improved the associated tinnitus without any obvious damage to hearing. Electrocochleography was useful for postoperative monitoring; the SP/AP area ratio of the affected side was closely related to the improvement of postoperative vertigo, possibly reflecting greater relief of pressure in the endolymphatic sac. Keypoints •ESD provided long-term control of vertigo in MD patients and improved the accompanying tinnitus without obviously damaging hearing. •ECochG is useful for monitoring the postoperative outcome of ESD. •The SP/AP area ratio of the affected side was closely related to the improvement of postoperative vertigo. •The endolymphatic sac is a “decompression reservoir” of the membranous labyrinth. •ESD may provide space for expansion of the endolymphatic sac and relieve pressure within the membranous labyrinth caused by endolymphatic hydrops, thereby reducing the risk of sac rupture and restoring pressure balance to reduce the sensation of vertigo.