Immunization of the population through vaccination against COVID-19 is recognized as a public health priority. The most difficult scientific challenge for vaccines is the clinical safety and efficacy. We report a patient presenting with Fusobacterium nucleatum bacteremia and liver abscess formation following administration of anti-COVID-19 viral-vectored vaccine.

Problem statement: To halt global biodiversity decline, many conservation measures are set up by citizens, companies, or stakeholders. However, even if originally well-intentioned, some of these actions could have direct or indirect negative effects on biodiversity when ecology is not accounted for. The management of bees is a good example of such misplaced conservation practices. We identified three successive errors in the management of bees which can disrupt the focus on real conservation issues: the multiplication of honey bee hives, the installation of insect hotels, the trade of solitary bee cocoons for release into the wild. To help the bees, as well as biodiversity in general, we must consider prioritizing efficient conservation measures which consider more broadly the complexity of ecosystems.

Despite early coronary revascularisation, postinfarction pseudoaneurysm remains a serious complication of coronary artery disease. Urgent diagnostics and surgery are mandatory for good clinical outcome. Here were report a case of left ventricular pseudoaneurysm undergoing urgent cardiac surgery.

Abstract We present an acute intoxication with 12 grams of efavirenz (EFV) in a 16-year-old healthy girl whose main problem was neurotoxicity which is dose-dependent. No other serious EFV-related side effects were seen. Previous serious side effects of EFV were observed in HIV-infected patients who underwent long-term combination drug therapy.

Aim: To determine whether the known single nucleotide polymorphisms in adrenoreceptor associated genes affect the hemodynamic response to dobutamine in critically ill neonates. Methods: Alleles in the known genetic single nucleotide polymorphisms in β1 and β2 adrenoceptor (AR) genes and Gs protein α-subunit gene (GNAS) possibly affecting inotropic effect were identified in patients of neonatal dobutamine pharmacokinetic-pharmacodynamic study. Linear mixed-effect models were used to describe the effect of genetic polymorphisms to heart rate (HR), left ventricular output (LVO) and right ventricular output (RVO) during dobutamine treatment. Results: 26 neonates (5 term, 21 preterm) were studied. Dobutamine plasma concentration and exposure time respective HR (adjusted to gestational age) is dependent on β1-AR Arg389Gly polymorphism so that in G/G (Gly) homozygotes and G/C heterozygotes dobutamine increases HR more than in C/C (Arg) homozygotes, with parameter estimate (95% CI) of 38.3 (15.8 – 60.7) bpm per AUC of 100 mg·h, p=0.0005. LVO (adjusted to antenatal glucocorticoid administration and illness severity) and RVO (adjusted to gestational age and illness severity) is dependent on GNAS c.393C>T polymorphism so that in T/T homozygotes and C/T heterozygotes but not in C/C homozygotes LVO and RVO increase with dobutamine treatment, 24.5 (6.2 – 42.9) mL kg-1 min-1 per AUC of 100 mg·h, p=0.0116 and 33.2 (12.1 – 54.3) mL kg-1 min-1 per AUC of 100 mg·h, p=0.0025, respectively. Conclusion: In critically ill neonates, β1-AR Arg389Gly and GNAS c.393C>T polymorphisms may play a role in the haemodynamic response to dobutamine during the first hours and days of life.

Although under-reported, hemolytic anemia is common with dapsone therapy. However, it is prudent to screen underlying G6PD deficiency to prevent potentially life-threatening episode of intravascular hemolysis in leprosy.

Understanding the changes in microbial communities with increasing plantation age will benefit the maintenance of forest health and productivity and the sustainable development of forest ecosystems. Based on MiSeq sequencing, we carried out the first study on the effects of stand age on microbial communities in rhizosphere and bulk soils of pecan plantation. The results suggested that soil bacterial alpha diversity increased significantly with plantation age, while fungal alpha diversity was less influenced. Bacterial and fungal biomarkers differed by age group. The fungal community composition was significantly altered by plantation age as reflected by the increase and decrease in the relative abundances of Basidiomycetes and Ascomycota, respectively. The pH and AP and TK contents drove microbial community structure and composition. The bacterial network was more complex than the fungal network, and simpler and more stable microbial network structures occurred in the rhizosphere soil than in the bulk soil. With increasing plantation age, the risk from plant pathogenic fungi increased, and the functional profile of the microbial community shifted from the nitrogen cycle to carbon utilization.

The extent to which the avian microbiome is shaped by host phylogeny relative to other factors is largely unknown. In this study, we examine microbial biodiversity across multiple body sites of 211 bird species sampled in Malawi. Microbial community dissimilarity differed significantly across body sites, which included blood, buccal cavity, gizzard, intestine, cloaca, liver, and spleen. With these data, we tested the hypothesis that the avian microbiota follow a Species-Area Relationship by using a comparative phylogenetic method to examine the correlation between microbiota richness and host weight. Using Pagel's lambda, we confirmed that bird mass is significantly correlated with host phylogeny but found that few microbial diversity metrics showed such a correlation. Phylogenetic Generalized Least Squares identified a significant but weak negative correlation between host weight and microbial richness of the blood and a similarly significant but weak positive correlation between the cloacal microbiota and host weight among birds within the order Passeriformes. Taken together, these results suggest that the avian microbiome does not follow a traditional species-area relationship when phylogenetic relatedness is considered, rather, microbial diversity is influenced by factors beyond host phylogeny and size.

Title: “Close But No Cigar”: Successful Aortic Valve Repair Using Autologous Pericardium

A PRIMARILY CLINICIAN’S RESPONSIBILITY

Orf is an acute and highly contracted human and animal infection caused by orf virus (ORFV), which mainly affects sheep and goats, especially young animals, who have close contact with sick animals. Clinically, in secondary infection cases of orf, opportunistic or conditional pathogens such as Staphylococcus aureus (S. aureus) are often detected. The S. aureus TRAP gene product is reportedly protective against bacterial infection. For joint control of ORFV and S. aureus, the research direction of delivering a TRAP gene vaccine against S. aureus infection using the ORFV live vector is proposed. Here, we used CRISPR/Cas9 technology to edit vascular endothelial growth factor E of ORFV (VEGF-V) and introduced the TRAP gene of S. aureus into the terminus of the ORFV genome to promote TRAP expression in infected keratinocytes. The construction and experimental verification of recombinant ORFV (ORFV-V/TRAP) will provide a reference for in-depth studies on the prevention and control of orf and S. aureus disease.

Background. A staged thoracotomy unifocalization approach has not been the dominant option over the past 20 years primarily due to the introduction of midline one-stage complete unifocalization. Methods. In this issue of the Journal of Cardiac Surgery, van de Woestijne and colleagues publish their experience over the past 30 years in 39 consecutive patients with “consistent” staged unifocalization through a lateral thoracotomy in patients with pulmonary atresia, ventricular septal defect, and major aortopulmonary collateral arteries (PA/VSD/MAPCA). Results. They report definitive repair completion in 76.3% of the patients and an overall survival after definitive repair of 96% at 20 years despite the study period ranging from 1989 to the present. Conclusion. Given the multiple variations one could have with PA/VSD/MPACA, a midline unifocalization approach may not always be possible. Surgeons should be familiar with the lateral thoracotomy unifocalization staged approach to PA/VSD/MAPCA.

Aim: Post-operative bleeding remains a significant risk after cardiac surgery. Despite adequate protamine reversal of heparin intraoperatively, protein-bound heparin causes anticoagulant effect, leading to bleeding in the post-operative period. The aim of this study is to whether the use of a four-hour, low dose protamine infusion in intensive care would reduce post-operative bleeding and hence, blood transfusion requirements. Methods: A retrospective cohort study of seven hundred and two patients, who underwent elective or urgent coronary artery bypass grafting from April 2014 and January 2017, were divided into two groups based on who received post-operative protamine infusion (Group A, 472 patients) versus those who did not (Group B, 230 patients). They were assessed for amount of post-operative mediastinal and pleural drainage for the first 24 hours, use of post-operative transfusion of blood products, postoperative hospital stay, and re-exploration. Results: We found no significant difference between the rate of bleeding in either of the groups. No significant difference was observed in blood product requirements as well. In the sub-group consisting of patients with high BMI (BMI ≥30), who received protamine infusion, post-operative platelets transfusion was found to be significantly less. Conclusions: Our results suggest that a low dose protamine infusion given in the immediate postoperative period does not lead to any significant clinical benefits. Both patients receiving and not receiving the infusion had similar postoperative drainage, transfusion requirements, haemorrhagic morbidity, mortality and length of hospital stay.

We provide a new lower bound for the life span of solutions to the Kirchhoff equation for which the initial data belongs to the Gevrey space. This lower bound strictly improves the classical one in the case when the frequency spectrum of the initial data is concentrated at the origin.

ABSTRACT Background: Obstetrical complications involving uteroplacental insufficiency associated disorders, such as preeclampsia, intrauterine growth restriction, and obstetric antiphospholipid syndrome, share pathophysiology and risk factors with cardiovascular diseases treated with statins. Objective: To evaluate associations of statin treatment with pregnancy prolongation, and neonatal and maternal morbidity, among women with uteroplacental insufficiency disorders. Search Strategy: Electronic databases including PubMed, Medline, Embase, Clinical Trials Registry Clinicaltrials.gov, and The Cochrane Library were searched from inception to January 2022. Selection Criteria: Cohort studies and randomized controlled trials (RCTs) Data collection and analysis: Pooled odds ratios were calculated using a random-effects model; meta-regression was utilized when applicable. Main Results: The analysis included ten studies describing 1391 women with uteroplacental insufficiency-associated disorders: 703 treated with pravastatin and 688 not treated with statins. Women who received pravastatin showed significant prolongation of pregnancy (mean difference 0.44 weeks, 95%CI:0.01-0.87, p=0.04, I2=96%) and less neonatal critical care unit admission (OR=0.42, 95%CI: 0.23-0.75, p=0.004, I2=25%). Trends were observed toward a decrease in preeclampsia diagnoses (OR=0.51, 95%CI:0.25–105, p=0.07, I=44%), and perinatal death (OR=0.32, 95%CI:0.09-1.13, p=0.08, I2=54%) and an increase in birth weight (mean difference=102 grams, 95%CI: -14–212, p=0.08, I2=96%). A meta-regression analysis revealed associations between earlier gestational age at initiation of pravastatin treatment to lower risk for development of preeclampsia (R2=1) and between longer duration of pravastatin treatment to lower rate of NICU admission (R2=0.33). No dose-response effect was demonstrated. Conclusions: Pravastatin treatment in pregnancies with high risk for developing uteroplacental insufficiency disorders may prolong pregnancy duration and improve neonatal outcomes.

Objective: Through clinical studies and animal experiments, we explored the expression of BRD4 in patients with NVAF and its role in the postoperative recurrence and occurrence of atrial fibrosis. Methods: 74 patients with NVAF and 73 patients with PSVT were included. The BRD4 levels of the patients were measured. Thirty-Six Sprague Dawley(SD) rats were randomly divided into three groups. The incidence and duration of AF in each group were recorded. Masson’s trichrome staining was performed. Western blot was used to detect the expression of BRD4, TGF-β1, P-Smad2/3, Smad2/3, Smad7, Cx43, and type III collagen in each group. Results: The BRD4 levels were significantly higher in patients with AF than those of PSVT,especially in patients with persistent AF and postoperative recurrence of AF and AF with left atrial low voltage( P < 0.05). The collagen volume fraction and average induced rate of AF and average duration of AF and levels of BRD4, TGF-β1, P-Smad2/3, Smad2/3, and type III collagen were significantly highest in the AF + CTL group than those of the CTL group and AF + JQ-1 group( P < 0.05). Conclusions: BRD4 was correlated with AF and atrial fibrosis. Inhibition of BRD4 expression significantly improved the degree of left atrial fibrosis in rats with AF and reduced the incidence of AF and the duration of AF. BRD4 may be involved in atrial fibrosis and remodeling through the TGF-β1/Smad signaling pathway, thus participating in the occurrence and maintenance of AF.

Background and Aims Land abandonment and selective farming are two common management methods to restore the soil conditions of low pollution farmland in mining areas. The soil bacterial community plays an important role in farmland soil restoration, however, few studies have compared the composition and diversity of soil bacteria between the abandoned farmlands (AFS) and selective-farming farmlands (FFS). Here, the effects of AFS and FFS on soil properties and bacterial diversity were evaluated in an antimony (Sb) mining area in southern China. This study aimed to identify effective land management methods in terms of positive or negative changes in soil environment and bacterial diversity.Methods 16S rRNA high-throughput sequencing was used to compare the diversity and composition of soil bacteria between AFS and FFS in the Xikuangshan (the largest Sb mine in the world).Results .

Lamin A/C Mutations are important to recognized for therapeutic and prognostic reasons. We present the clinical cases of two sisters with Lamin A mutation presenting with complex atrial arrhythmias, atrioventricular block and ventricular arrhythmias, associated with ventricular noncompaction and abnormal pulmonary vein anatomy. The successful treatment of complex irregular atrial arrhythmias by the use of noncontact dipole density mapping and radiofrequency ablation (RFA) is described in both sisters with long-term follow up results.

Objectives: To design a Spanish questionnaire to assess quality of life in chronic obstructive sialadenitis (COS), named CSOC and assess its reliability, validity and feasibility. Design: A prospective, multicentre, observational study Settings: Salivary Gland Disorder and Sialendoscopy Unit, University Tertiary Hospital. Participants: Patients with diagnosis of COS and indication for sialendoscopy were included in the study. Main outcome measures: The item generation process included a review of published data as well as interviews with patients. An expert panel then tested the content validity of the instrument and the construct validity was tested in 120 patients. Patients completed a self-administered CSOC questionnaire, a Short Form-36 and a Visual Analogue Scale. Feasibility, reliability, internal consistency, construct validity and responsiveness were assessed. Results: All the patients found the instrument understandable. Cronbach α coefficient was high (0.85). The time required to fill out was 5.7 and 4.5 minutes for pre and postsialendoscopy CSOC respectively. Cronbach α coefficient was very high for both pre and postsialendoscopy CSOC (0.90 and 0.94 respectively). The correlation with the SF-36 dimensions was negative and positive with the VAS. The mean score of CSOC was 28.6 and 7.98 for pre and postsialendoscopy Conclusions: The CSOC questionnaire is understandable, feasible, reliable and representative of quality of life in COS. Keywords: sialadenitis, QOL, questionnaire, validation, sialendoscopy

To understand and support teachers' design practices, researchers in Learning Design manually analyse small sets of design ar-tifacts produced by teachers. This demands substantial manual work and provides a narrow view of the community of teachers behind the designs. This paper compares the performance of different Supervised Machine Learning (SML) approaches to automatically code datasets of learning designs. For this purpose, we extracted a subset of learning designs (i.e., their textual content) from Avastusrada and Smartzoos, two mobile learning tools. Later, we manually coded it guided by relevant theoretical models to the context of mobile learning and used it to train and compare several combinations of SML models and feature extraction techniques. Results show that such models can reliably code learning design datasets and could be used to understand the learning design practices of large communities of teachers in mobile learning and beyond. 1 Mobile Learning from a Learning Design perspective Mobile Learning (m-learning) activities promote authentic and contextualized learning [18, 12]. These activities usually take place across spaces (physical and digital) and settings (formal, informal, or non-formal) [9, 11]. To enable teachers to design for m-learning, the field of Learning Design (LD) has come up with several authoring tools [13]. For instance, Smartzoos support the design of geo-localised learning activities outdoor [14], while with GLUESP-AR teachers design activities that happen across multiple physical and digital spaces [9]. Designing learning activities is already a strenuous task for teachers. In m-learning they also have to deal with the complexity of designing across settings and spaces (previously discussed), together with the need to possess substantial technical and pedagogical competencies, relevant to this context. Mettis

A series of cyclometalated platinum(II) complexes with aromatic ligands, such as pyridyl, pyrimidinyl and pyrazolate, were investigated with theoretical calculations. To investigate the relationship between ligands with molecular orbital, molecular rigidity, electroluminescent properties and spectroscopic properties, the electrostatic potential (ESP), density-of-states (DOS), root mean squared displacement (RMSD) were calculated. On the basis of calculated absorption and phosphorescence data, the analysis of “hole” and “electron” have also been performed. From the RMSD calculations, complex 3 shows significant structural distortions on S1 state and it may be applied in thermal activation delayed fluorescence (TADF) materials. The electroluminescent properties calculations show that complex 1 is suitable for hole transport material and complex 4 can be applied in electron transport material.

The RV is considered “the forgotten side of the heart”; however, limited studies have focused on its evaluation . The RV helps manage various cardiovascular diseases. Its function is a strong determinant of the prognosis for patients with congenital heart defects, ischemic heart disease, pulmonary arterial hypertension, congestive heart failure, and cardiomyopathy. Therefore, its function should be assessed accurately. Although cardiac magnetic resonance imaging remains the gold standard for the noninvasive measurements of RV size and function, it is time-consuming, expensive, and sometimes not feasible in everyday clinical practice. Echocardiography is the first and the only method used frequently for RV evaluation because of its availability and cost-effectiveness. The complex anatomy of the RV and its trabeculated myocardium that impedes clear endocardial border tracing, unfavorable position within the thoracic cavity, and high dependence on the loading conditions of traditional RV systolic function indices make the echocardiographic analysis of the RV somewhat challenging. The RV primarily helps pump blood coming from the systemic venous system to the pulmonary trunk. The first parts to contract are the inlet and trabeculated myocardium, and, after 25–50 ms, the conus contracts. The RV functions as a high-volume, low-pressure pump; the contraction of predominantly longitudinal fibers as well as afterload and preload influence the RV’s performance. In addition, RV systolic synchrony, atrioventricular synchrony, and ventricular interdependence. A previous study has reported that 20%–40% of the RV volume outflow and systolic pressure is caused by the contraction of the left ventricle (LV). RV dyssynchrony potentially reduces the cardiac output or increases the filling pressure. Thus, maintaining the sinus rhythm and atrioventricular synchrony is crucial for the performance of the RV, particularly in the case of chronic RV failure and acute RV infarction. The current guidelines for cardiac chamber quantification suggest sonographers to use multiple acoustic windows to precisely observe the right heart from various perspectives. Because no single index of contractility that perfectly describes RV performance exists, various parameters need to be measured. In the clinical practice, the most common and feasible indices that can be used to evaluate the RV systolic function are Doppler tissue imaging, tricuspid annular plane systolic excursion (TAPSE), derived tricuspid lateral annular systolic velocity (S′ wave), and fractional area change (FAC).

Tetralogy of Fallot (TOF) is a common cyanotic congenital heart disease. Its surgical correction requires ventricular septal defect (VSD) closure and right ventricular outflow tract obstruction (RVOTO) relief, with transannular patch enlargement (TAPE) of the pulmonary valve. The first successful repair of TOF was reported in 1954 and consisted of closure of the VSD through a large right ventriculotomy, and RVOTO relief with TAPE of the pulmonary valve. To predict the intra-operative requirements and post-operative course of patients with this condition, various evaluation indices are available that can provide a good indication of patient prognosis. In this case report, we describe a novel pulmonary vein index (PVI) indicator that offers prognostic indications for pediatric cardiac patients who have undergone surgical correction of TOF.

Dental trauma in children are common occurences.Avulsion of anterior teeth due to trauma is seen in both primary and young permanent teeth.The standard protol for avulsion in permanent teeth is immediate replantation but many a times its not possible.Delayed replantation of avulsed permanent teeth has a poor prognosis.