Aim: Along with Assam, India’s mass vaccination drive is witnessing a low turnout situation. This study aims to identify limiting factors to the vaccination effort, attitude towards COVID-19, and attitude towards the vaccine. During the survey, doubts of the participants on COVID-19 vaccine were also addressed. Subject and Methods: It was a cross-sectional web and physical interview based survey using validated questionnaire developed in the google form to assess 695 voluntary participants of Assam, India. Results: 52.09% of the participants were acceptable to COVID-19 vaccine, and 21.30% participants were vaccinated. About 41.87% of the respondents were hesitating to get vaccinated, and 10.64% of the participants refused. Education shows inverse relation to vaccine hesitancy. Interestingly, housewives were found to be hesitating the most (OR = 5.113, 95CI% = 1.347-19.399, p = 0.016). Retired person (OR = 4.061, 95CI% = 1.464 – 11.262, p = 0.007) and 60 plus age group (OR = 0.373, 95CI% = 0.153 – 0.911, p = 0.031) show a refusal to the vaccine. 99.7% of the participants have taken at least one preventive measures depicts there is a positive attitude towards COVID-19. Digital knowledge is one of the important aspects associated with participants getting vaccinated (p > 0.05). Conclusion: There are concerns about COVID-19 vaccine safety and its efficacy. Government-sponsored awareness programme or non-governmental organization (NGO) can launch awareness programmes to shed light on critical areas to eliminate vaccine-related doubts. Key sources of information can be used to channel authentic information to narrow down the anti-vaccine folks.

Pathogens are spreading at an alarming rate throughout the world, posing a global health threat. Because present treatment options have mostly failed, new antibiotics are in high demand. Antimicrobial peptides (AMPs) have emerged as a viable option in this circumstance due to their broad-spectrum action, fast death, and frequently cell selectivity. They are made up of several functional molecules with multiple characteristics and varying biological activity. Their action mechanism is uniquely changed according to the distinct amino acids and components in its composition. Antimicrobial peptides are been derived from many sources i.e. plants, Animals, marine etc. They have therapeutic promise, however their usage is restricted due to its short plasma half-life. With the aid of biotechnological techniques, AMP manufacturing may be accomplished at a small price. As a result, once these obstacles are addressed, the development of effective and long-lasting antimicrobial medicines is anticipated. In this review article explains about the applications of bioinformatics, mode of action, sources and many more.

Objective: This study aimed to assess whether the serum levels of vitamin A, vitamin D and vitamin E are associated with respiratory distress syndrome (RDS) in preterm infants. Methods: This retrospective research included 179 neonates born before 35 weeks of gestation in Jiaxing Maternity and Child Health Care Hospital from January 2020 to December 2020. Depending on whether or not have RDS, participants were classified into the RDS group (59 neonates) and the control group (120 neonates). The 1:1 propensity score matching (PSM) analysis was performed to balance the baseline confounding factors and then the groups were compared in terms of serum vitamin levels and RDS morbidity. Results: A total of 34 pairs of preterm infants were involved after PSM. There were significant differences in vitamin D level ((12.13 (8.44-17.85) ng/mL vs. 16.84 (10.75-25.83) ng/mL), vitamin D deficiency rate (85.3% vs. 55.9%), as well as vitamin A level (134.91 (105.01-156.74) ng/mL vs. 152.46 (120.06-200.00) ng/mL) in the two groups. However, the vitamin A deficiency rate, vitamin E status, as well as vitamin E deficiency rate did not differ significantly between the two groups. Logistic analysis showed that a low level of vitamin D was an independent risk factor for RDS in preterm neonates (OR 0.917，95%CI 0.851-0.989). Conclusion： Low serum vitamin D level may contribute to the development of RDS in preterm infants, but no significant effect of serum vitamin A and vitamin E levels is found.

Autoimmune diseases are diseases characterized by local or systemic abnormal inflammatory immune responses. With the in-depth exploration of the pathological mechanism of autoimmune diseases, it is found that occurrence and development of autoimmune diseases are largely related to the interaction between chemokine receptors and chemokines expressed at inflammatory sites. CCR7, one of Chemokine receptors members, binds to CCL21, which regulates lymphocyte homing, neovascularization and immune cells migration in autoimmune diseases. However, the underlying signaling pathways of CCL21/CCR7 need to be further explored. Despite the enormous advances in our knowledge of chemokines, research about the involvement of CCL21/CCR7 in autoimmune diseases progression is still limited. Thus, in this review, we summarize the essential role of CCL21/CCR7 in autoimmune diseases progression. Further studies are critical to illustrate the distinct roles of CCL21/CCR7 in autoimmune diseases progression, and are important significance for discovery of new biomarkers and drug targets of autoimmune diseases.

The anticoagulant application is an effective treatment modality for cardiovascular diseases such as coronary heart disease, unstable angina pectoris, and myocardial infarction. In this study, the antithrombotic effect of recombinant neorudin (EPR-hirudin, EH) was evaluated using a canine model of coronary artery thrombosis. A canine model with platelet thrombosis in the left circumferent branch of the coronary artery was designed using Folt’s method, and the anti-thrombus activity of EH was investigated. Femoral administration of EH intravenously had a significant dose-dependent inhibitory effect on canine coronary artery thrombosis and the effective rates were 66.7% (P < 0.05), 83.3% (P < 0.05), and 100% (P < 0.01) after injection of 0.3, 1.0, and 3.0 mg/kg EH, respectively. Furthermore, EH demonstrated lower bleeding, with shorter bleeding time and less bleeding loss than low molecular weight heparin (LMWH). Under the similar effect intensity of EH and LMWH (85 IU/kg), the bleeding time of the EH group at 30 min was shorter, and the blood loss at 30–120 min was less than that of LMWH (P<0.05 and P<0.05–0.001, respectively). EH had a significant dose-dependent inhibitory effect in the dose range of 0.3–3.0 mg/kg on the coronary artery thrombosis and lower bleeding side effects than LMWH with a similar antithrombosis effect.

Background: The stillbirth rate is an important indicator of access to quality antenatal and delivery care services. Many previous pocket studies were conducted to assess the magnitude of stillbirth. Method: Electronic databases were used for searching original articles. The heterogeneity of the studies was checked. The random-effects method was applied to estimate the pooled prevalence of stillbirth and the effect size of the early rupture of membranes in sub-Saharan Africa. Subgroup analysis was performed. A funnel plot and Egger’s regression test were used to see publication bias. Result: Pooled prevalence of stillbirth in sub-Saharan Africa was 6.4 % (95% CI: 5.5 - 7.3). In sub-group analysis, Southern African regions had a higher stillbirth prevalence and the western African regions had a lower than East and Southern Africa. The prevalence of stillbirth in the region is increased from 4.1% (95% CI: 2.2 – 6.0) before 2015 to 7.1% (95% CI: 5.8 - 8.3) after 2015. The pooled odds ratio results from seven studies showed the non-significant effect of early rupture of membrane on stillbirth (pooled OR = 1.54, 95% CI: 0.26 - 2.82). According to the regression test (Egger test), there were no small study effects or publication bias (P = 0.108). Conclusions: Pooled prevalence of stillbirth in sub-Saharan Africa was relativity high. The analysis establishes the minimal effects of early rupture of membrane on stillbirth. Therefore, we recommend that strengthening the testing intervention is crucial to reduce the still relatively high stillbirth. Keywords: Stillbirth, Early Rupture of Membranes, sub-Saharan Africa

ABSTRACT Background: Nasal endoscopic features of post nasal drip (PND) is well described but not formally studied. This study aims to assess the nasal endoscopic features of PND among rhinitis. Design: Cross-sectional study Settings: Otorhinolaryngology (ORL) outpatient clinic at a tertiary referral center. Participants: Adults (18 years and older) with chronic rhinitis grouped into either “Rhinitis with PND” or “Rhinitis only”. Main outcome measures: The endoscopic features of PND were scored as: Secretions in the posterior nasal cavity (Yes/no), erythema in the nasopharynx (none, roof only, diffuse), hemorrhagic spots (yes/no) and granular posterior pharyngeal wall(patchy/diffuse) and compared between groups. Results: There were 98 patients included (age 32.32±11.33, 61.2 % female, 61.2% PND). Presence of secretions in the posterior nasal cavity was associated with PND (“Rhinitis with PND” vs “Rhinitis only”, 78.3 v 55.3%, p=0.02). This gave 78.3% sensitivity and likelihood ratio positive of 1.41 to predict bothersome PND among rhinitis patients. The other nasal endoscopic features were not associated with PND. Conclusion: Secretions in posterior nasal cavity supports PND among rhinitis patients. Further studies to assess the endoscopic features of PND in other patient populations are needed. Keywords: laryngopharyngeal reflux, postnasal drip, rhinitis, nasal endoscopic, bothersome, inflammation, reflux symptoms index, reflux findings score Key points: rhinitis, nasal endoscopic features, postnasal drip sign, secretions posterior nasal cavity, quality of life

The novel coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, is a global pandemic which is primarily considered a respiratory illness. However, emerging reports show that the virus exhibits both pulmonary and extra-pulmonary manifestations in humans, with the kidney as a major extra-pulmonary target due to its abundant expression of angiotensin-converting enzyme 2 and transmembrane protease serine 2, which facilitate entry of the virus into cells. Acute kidney injury has become prevalent in COVID-19 patients without prior any history of kidney dysfunction. In addition, the virus also worsens kidney conditions and increases mortality of COVID-19 patients with pre-existing chronic kidney disease, renal cancer, diabetic nephropathy, end-stage kidney disease as well as dialysis and kidney transplant patients. In the search for antiviral agents for the treatment of COVID-19, hydrogen sulfide (H2S), the third established member of gasotransmitter family, is emerging as a potential candidate, possessing important therapeutic properties including antiviral, anti-inflammatory, anti-thrombotic and antioxidant properties. A recent clinical study revealed higher serum H2S levels in survivors of COVID-19 pneumonia with reduced interleukin-6 levels compared to fatal cases. In this review, we summarize the global impact of COVID-19 on kidney conditions and discuss the emerging role of H2S as a potential COVID-19 therapy.

Introduction: Electrophysiology (EP) procedures are nowadays the gold-standard method for tachyarrhythmia treatment with impressive success rates, but also with a considerable risk of complications, mainly vascular. A systematic review and meta-analysis was performed to evaluate the safety of ultrasound (US)-guided femoral vein access in EP procedures compared to the traditional anatomic landmark-guided method. Methods: We searched Pubmed (MEDLINE), Embase, Web of Science, and Cochrane electronic databases for relevant entries, dated from January 1st, 2000 to June 30th, 2021. Only observational studies and randomized controlled trials were included in this analysis. Data extraction included study details, patient characteristics, procedure details, and all types of vascular complications. Complications were classified as major if any intervention, prolongation of hospitalization, or readmission was required. Results: 9 studies (1 randomized controlled trial and 8 observational), with 7,858 participants (3,743 in the US-guided group, 4,115 in the control group), were included in the meta-analysis. Overall vascular complication rates were significantly decreased in the US-guided group compared to the control group (1.2 versus 3.2%, RR = 0.38, 95% CI, 0.27 - 0.53), in all EP procedures. Sub-group analysis of AF ablation procedures yielded similar results (RR 0.41, 95% CI, 0.29 - 0.58, p < 0.00001). The event reduction effect was significant for both major and minor vascular complications. Conclusion: US-guided vascular access in EP procedures is associated with significantly reduced vascular complications, compared to the standard anatomic landmark-guided approach, regardless of procedure complexity.

Background Immunosuppression and antiarrhythmics can be useful for the treatment of arrhythmias in cardiac sarcoidosis (CS) according to current guidelines. However, there is conflicting evidence on the optimal regimen and outcomes of medical therapy for ventricular arrhythmias. The effects of corticosteroid sparing agents with versus without concurrent antiarrhythmic therapy is unknown. Objective To assess the impact of corticosteroid sparing immunosuppression with and without antiarrhythmics on arrhythmia burdens in CS. Methods Patients with CS and implanted cardiac devices were identified from a single center registry. Their medical regimens were grouped as no therapy, immunosuppression alone, antiarrhythmic alone, or dual therapy. Device interrogations were reviewed for premature ventricular contractions (PVCs), nonsustained ventricular tachycardia (NSVT), and appropriate device firing. Results Interrogations for 42 patients were reviewed over a mean of 31 months. Regression analysis showed a significant decrease in the PVC (slope -1.47, p=0.04) and NSVT frequency (slope -0.05, p=.01) for patients on dual therapy compared to an increase or no change in the other groups. Across all patients, there was no difference between groups in the percentage of patients experiencing device firing. In a subset analysis of patients with ICDs for primary prevention, 6% on dual therapy required device firing compared to 43% and 40% on single or no therapy (P=.049, Chi Sq=6.02). Conclusions Patients on both immunosuppression and antiarrhythmics had a reduction in PVCs and NSVT over time. Those with devices placed for primary prevention experienced fewer device firings while on dual therapy.

Wiskott Aldrich Syndrome (WAS) is characterised by microthrombocytopenia, eczema and recurrent infections. Though autoimmune complications are well known in patients with WAS, the mechanisms underlying their occurrence have not been well defined. In this report, we describe a young Indian boy with WAS who presented with an unusual autoimmune complication of dermatitis herpetiformis. He was treated with steroids, dapsone & gluten free diet. To the best of our knowledge, this is the first case of dermatitis herpetiformis reported in a patient with WAS.

Leptomeningeal spread of high grade glioma (HGG) has been rarely reported in literature, with an incidence of <5%. It is associated with dismal outcome with a median survival of <6 months. Here we present a series of three HGG patients who developed spinal cord metastasis and succumbed to it within three months of diagnosis

Ecosystem processes interact through trade-offs or legacy effects, yet it remains unclear whether absorption (Get), resorption (Save), and decomposition (Return) are linked to form a ‘Get-Save-Return (GSR)’ continuum and conform to the economics spectrum theory. Here, we tested this hypothesis by synchronously integrating root-nutrient absorption, leaf-nutrient resorption, and leaf-litter decomposition of 15 co-occurring subtropical tree species. There was an active trade-off between phosphorus absorption and resorption, which further caused a passive trade-off between phosphorus resorption and leaf-litter decomposition, indicating that a process-based continuum exists and runs on phosphorus economy. Following the leaf economics spectrum, the acquisitive-strategy species had greater absorption, lower resorption, and faster decomposition, while the conservative-strategy species presented the opposite pattern. The continuum emerged among ectomycorrhizal species rather than arbuscular mycorrhizal species, implying a critical control of mycorrhizal association. Our findings demonstrate the existence of the ‘GSR’ continuum and provide a framework for understanding the whole-plant nutrient economy.

(+)-Nootkatone is one type of expensive sesquiterpene aroma found in grapefruit peel and heartwood of yellow cedar. It could be used as food additives, perfume, insect repellent and therefor its highly efficient production is greatly requested. However, the low catalysis efficiency of membrane-anchored cytochrome P450/P450 reductase system (HPO/AtCPR) was the main challenge and limited the production of (+)-nootkatone. We developed an effective high-throughput screening system based on the cell-wall destruction to probe the optimal ratio of HPO/AtCPR, which achieved a 2-fold elevation in (+)-valencene oxidation in S. cerevisiae. In combination with the introduction of valencene synthase from Callitropsis nootkatensis and alcohol dehydrogenase form Pichia pastoris, an engineered strain was constructed to realize de novo (+)-nootkatone production. Then a series of engineering strategies, including knockout of the transcription factor (ROX1), down-regulating the squalene synthase enzyme (EGR9), overexpression of a truncated version of 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase (tHMG1) and type III membrane protein (ICE2), were applied to generate PK2RI-AtC/Hm6A. In bi-phasic fed-batch fermentation, a maximum yield of 3.73 and 1.02 g/L for valencene and (+)-nootkatone were achieved. The dramatically improved performance of the constructed S. cerevisiae provides an excellent approach for economical production of (+)-nootkatone from glucose.

Globally, agriculture intensification is a dominant driver of biodiversity loss. The concepts of land sparing and land sharing are alternatives to seek a balance between maintaining and restoring biodiversity while producing adequate food. To date, land sparing has been suggested as the best strategy to maintain biodiversity, but very few intact lands remain on Earth for sparing. Recently, international policies for nature conservation have proposed removing land from agricultural management to meet the need for more land sparing. However, the idea of land sparing has not considered the risk of biological invasions in abandoned land. Many abandoned agricultural lands are colonized by invasive species, creating monospecific patches with low biodiversity. Such invasions have cascading effects on other trophic levels and decrease ecosystem services in nearby agricultural fields, which negatively impacts yield. Moreover, invaded abandoned fields have lower biodiversity than extensively managed agricultural land. Thus, the risk of inducing plant invasions and triggering detrimental impacts on biodiversity, ecosystem services, and agricultural yields limits land sparing from abandonment as a conservation strategy. Our simulations also suggest that land sharing may be the best solution for sustaining biodiversity when the risk of invasion is high.

The Tetraodontidae family encompasses several species which attract scientific interest in terms of their ecology and evolution. The silver-cheeked toadfish (Lagocephalus sceleratus) is a well-known ‘invasive sprinter’ that has invaded and spread, in less than a decade, throughout the Eastern and part of the Western Mediterranean Sea from the Red Sea through the Suez Canal. In this study, we built and analysed the first near-chromosome level genome assembly of L. sceleratus and explored its evolutionary landscape. Through a phylogenomic analysis, we positioned L. sceleratus closer to T. nigroviridis, compared to other members of the family, while gene family evolution analysis revealed that genes associated with the immune response have experienced rapid expansion, providing a genetic basis for studying how L. sceleratus is able to achieve highly successful colonisation. Moreover, we found that voltage-gated sodium channel (Nav 1.4) mutations previously connected to tetrodotoxin resistance in other pufferfishes are not found in L. sceleratus, highlighting the complex evolution of this trait. The high-quality genome assembly built here is expected to set the ground for future studies on the species biology.

In this paper, we propose a method that is not based on cluster expansions for computing the higher derivatives of the free energy and estimating the error between the finite and infinite volume free energy in certain continuum gas models. The methods known up to now strongly rely on the validity of the cluster expansion. An extension of the method to classical lattice gas models is also discussed.

Background and Aim: Some clinical trials have reported on the treatment of alcohol-drinking smokers with drugs. This network meta-analysis aims to explore the effect of pharmacological interventions on smoking cessation in such populations. Methods: Only randomized controlled trials (RCTs) were included through a system and comprehensive database search. The risk of bias for the included studies were assessed using Cochrane tool. A network meta-analysis was performed using STATA software to evaluate the effect size between different comparisons, and provide the best smoking cessation intervention based on the SUCRA value. Results: A total of 15 RCTs involving 1565 participants were included. The risk of bias was low in five studies and unclear in ten studies. Network meta-analysis showed that the superiority of quitting smoking was reflected in Varenicline vs Placebo (OR=4.90, 95%CI [1.77,13.55]), Varenicline vs Naltrexone (OR=3.50, 95%CI [1.13,11.06]), and Varenicline vs Bupropion (OR=3.32, 95%CI [1.03,10.74]). None of the other pairwise comparisons showed significant difference. Finally, the probability ranking results indicated that Varenicline was the most effective intervention. Conclusions: The network meta-analysis showed that compared with Naltrexone, Bupropion, and Placebo, Varenicline had obvious superiority in quitting smoking, while there was no difference in effect between other drugs. Meanwhile, we look forward to more high-quality studies to investigate the existing evidence.

In this paper, we discuss the Extended Genarlized Bessel Matrix functions and its Integral representations. Some properties of Extended Generalized Bessel Matrix function including the connection with Laguerre Matrix polynomial, Jacobi Matrix Polynomial have also been obtained

We provide of a method to integrate first order non-linear systems of differential equations with variable coefficients. It determines approximate solutions given initial or boundary conditions or even for Sturm-Liouville problems. This method is a mixture between an iterative process, a la Picard, plus a segmentary integration, which gives explicit approximate solutions in terms of trigonometric functions and polynomials. The segmentary part is particularly important if the integration interval is large. This procedure provide a new tool so as to obtain approximate solutions of systems of interest in the analysis of chemical reactions. We test the method on some classical equations like Mathieu, Duffing quintic equation or Bratu's equation and have applied it on some models of chemical reactions.

This study is aimed to perform Lie symmetry analysis of the nonlinear fractional-order conduction-diffusion Buckmaster model (BM), which involves the Riemann-Liouville (R-L) derivative of fractional-order ‘β’. We are going through symmetry reduction to convert the fractional partial differential equation into a fractional ordinary differential equation. The fractional derivatives of the converted differential equations are evaluated with the help of Erdelyi-Kober (E-K) fractional operators. The power series solution and its convergence are analyzed with Implicit theorem. Conservation laws of the physical model are obtained for consistency of system by Noether’s theorem.

Objective: To investigate dysbiosis of the vaginal microbiota related to increased risk of preterm premature rupture of fetal membrane (PPROM) and chorioamnionitis in singleton gestations with ultrasound-indicated cerclage. Design: Retrospective observational study. Setting: Fujian Maternity and Child Health Hospital. Population: 44 singleton gestations with ultrasound-indicated cerclage, including 13 cases of PPROM and 31 cases of normal-term delivery. Methods: Composition of the vaginal microbiota was assessed prior to cervical cerclage at 18–24 weeks of gestation, using MiSeq-based 16S rRNA gene sequencing. Main Outcome Measures: To characterize the vaginal microbial profile of women who later experienced PPROM and chorioamnionitis. Results: Furthermore, the vaginal microbiota of women who later experienced PPROM was relatively enriched with Streptococcus anginosus and Prevotella timonensis (P=0.042, P=0.032, respectively), while that of women who later experienced normal-term delivery was relatively enriched with Lactobacillus. Further, enrichment for Prevotella was noted in patients diagnosed with chorioamnionitis in the PPROM group (6 of 13, 53.8%), which was absent in women with normal histology in the PPROM group (P=0.012). Conclusions: Together, these results indicate that dysbiosis of the vaginal microbiota is a risk element for subsequent PPROM and chorioamnionitis in singleton gestations with ultrasound-indicated cerclage. These findings may contribute to the development of methods to identify pregnancies at high risk for cerclage failure following PPROM. Funding: This work was supported by a grant from the Fujian Maternity and Child Health Hospital Innovation Project (YCXZ 18-21). Keywords: Vaginal microbiota, PPROM, chorioamnionitis, ultrasound-indicated cerclage, Prevotella.

Abstract: Objective: Determine the related causes of stillbirth and reduce the unexplained cases Design: Observational cohort study Setting: 14 selected hospital from 12 provinces (14 cities) of Iran Population: A total of 105,562 births and 762 registered stillbirths at 22 completed weeks of gestation or more Methods: Iranian Maternal and Neonatal Network (IMaN) registers information about almost all births (live & dead) around the country, but this network does not collect data about stillbirth causes. In this study, we developed the stillbirth evaluation protocol with experts’ cooperation, and we designed forms for the stillbirth registration system electronically. Then we trained related individuals in 14 selected hospitals around the country. After a year, we extracted, analyzed, and, based on the Relevant Condition of Death Classification (ReCoDe), interpreted the collected data. Main outcome measures: Related causes of stillbirth Results: In 742 registered stillbirth cases in 14 selected hospitals, the relevant causes were identified in 65.4% of cases, while 34.6% of cases remained unclassified. The most frequent relevant conditions were fetal (33.2%), maternal (9.1%), amniotic fluid (8.8%), placenta (7.7%), and umbilical cord (6.2%). Conclusions: Our registration decreased the percentage of stillbirth with an unexplained cause from about 70% to 34.6%. Funding: Iran University of Medical Sciences Key words: stillbirth, cause of stillbirth, Iran Tweetable abstract: The most frequent relevant causes of stillbirth in Iran were fetal, maternal, and amniotic fluid conditions.

Title pageLETTER TO THE EDITORin response toValgeirsdottir et.al., Polycystic ovary syndrome and risk of stillbirth: a nationwide register-based study a nationwide register-based study a nationwide register-based study. BJOG. 2021 Aug 29. doi: 10.1111/1471-0528.16890.FromWilliam Atiomo. MBBS, DM, MA, FRCOG, SFHEA.Clinical Sub-dean, lead for international medical students and academic head of undergraduate obstetrics and gynaecology.School of Medicine,Faculty of Medicine and Health Sciences.University of Nottingham.D Floor, East Block,Queens Medical Centre,Derby Road,Nottingham.NG7 2UH.United Kingdom.Tel: 01158230712.Email: William.atiomo@nottingham.ac.uk..