Autologous hematopoietic stem cell transplantation(AHSCT) is an increasingly used curative treatment for some solid tumors in children. Instead of allogeneic transplantation, the risk of developing graft versus host disease (GvHD) is much lower after AHSCT. Although the clinical findings of auto-GVHD are mild and self-limited in most cases, rare cases may be severe and need intensive immunosuppressive treatment. Here, we present a case who underwent autologous HSCT due to relapsed neuroblastoma, developed steroid-refractory GvHD after AHSCT, and achieved remission using ruxolitinib. A 12 years old female patient was diagnosed with relapsed neuroblastoma. After metaiodobenzylguanidine treatment, AHSCT was performed, and the status of the disease was a very good partial response at the time of transplantation. Our patient was diagnosed with severe and steroid-refractory GvHD with skin involvement after AHSCT. We used ruxolitinib with extracorporeal photopheresis because of the essential side effects of the other drugs and got a very good response. Over the following five months, there was no recurrence of GvHD. She was in complete remission of neuroblastoma after two years of AHSCT. It is crucial to keep in mind that GvHD may develop after AHSCT. Ruxolitinib is an effective treatment for GvHD also after AHSCT.

Electronic repeat dispensing (eRD) has been part of the community pharmacy contact since 2005 and a requirement in the General Medical Services contract since 2019. eRD allows the prescribing of medicines for stable long-term conditions for a defined period without authorisation, consultation, by prescribing healthcare professionals each time. NHS England highlights benefits of eRD as increased efficiency in general practice of 2.7 million hours annually if 80% of all repeat prescriptions are issued as eRD. Despite clear benefits to patients, community pharmacies and general practices, the uptake of eRD remains low and variable across general practices in West Yorkshire. The current COVID-19 pandemic has placed huge strains on repeat prescribing systems in general practice. The aim of the project was to investigate the impact of COVID-19 on eRD in general practice and understand the key enablers to its uptake. In conclusion, two main enabling factors identified within this study that may lead to improved implementation and uptake of eRD. These are integrating eRD into normal routine workflows where prescribing authorisation is concerned and nominating an internal eRD champion. Utilising eRD in the respective practices should be considered due to potential efficiency gains and the increase in average eRD utilisation observed in the study participating general practices across West Yorkshire was from 7.2% average uptake in March 2020 to 10.4% November 2020. The stated benefits of eRD by NHS England of 2.7 million hours per annum predates the roll of electronic transmission of prescriptions suggesting further research is needed.

OBJECTIVE: To investigate the knowledge of rational use of antibiotics among pharmacists in medical institutions in China’s Shanxi province, so as to find out the problems, then to provide support for the management of antibiotics. METHODS: A questionnaire survey was conducted, which included the basic information of the respondents, the basic knowledge of antimicrobial management and the related knowledge of antimicrobial. SPSS 25.0 was used for statistical analysis. RESULTS: 462 pharmacists were investigated. The average score of the knowledge related to rational use of antibiotics was (10.49±4.05). It showed that the hospital type, grade, pharmacist’s education, professional title and working years all had effect on the pharmacists’ mastery of antimicrobial related knowledge (P<0.05). Multivariate logistic regression analysis showed that hospital grade and pharmacist’s education were the main influencing factors (P<0.05). CONCLUSION: Pharmacists have insufficient knowledge about the rational application of antibacterial drugs. It is essential to strengthen the training of management regulations and application of antibacterial drugs.

Abstract Humans infected with COVID-19 are at risk of developing life-threatening conditions. We here present a case of rapid appearance of oral lesion of herpes zoster associated with COVID-19 infection. Our case highlights the importance of oral examination as well as oral care in patients with COVID-19.

Introduction: Cancer remains a global public problem and the discovery of novel antiproliferative agents from herbal medicine may provide a lasting solution to this menace. This study aimed to investigate the phytoconstituents, antioxidants, antiproliferative and antiplasmodial activities of the root bark extracts of Adenodolichos paniculatus. Plants have continued to be a major source of new drugs template for the treatment of various diseases. Methods: The phytoconstituents of the extracts of Adenodolichos paniculatus were evaluated by standard phytochemical analysis methods. Phytochemical screening, evaluation of total phenolic and flavonoid contents were investigated employing standard phytochemical methods. The extracts were equally subjected to antiproliferative (A2780 ovarian cancer cell assay), antiplasmodial (Dd2 strain of Plasmodium falciparum), antioxidant (DPPH, FRAP and ABTS methods) and brine shrimp lethality assay studies. Results: The phytochemical analysis revealed the presence of various phytochemicals in Adenodolichos paniculatus extracts. The DCM extract was found to possess the high levels of total phenolic and flavonoids contents with notable potential antiproliferative (IC50 = 0.14 μg/ml), antiplasmodial (IC50 = 7.50 μg/ml) and cytotoxic (brine shrimp, IC50 = 0.547 μg/ml) activities. Both HME and AQE showed a good antiproliferative activity but were found to be inactive against the drug-resistant Dd2 strain of Plasmodium falciparum with an IC50 value ˃ 100μg/mL. Conclusion: The study revealed the potential capability of Adenodolichos paniculatus as a promising source of lead for the development of potent antiproliferative drugs. However, further investigations are needed to identify and characterize the active constituents. Keywords: Adenodolichos paniculatus, Fabaceae, Phytochemicals, A2780, Plasmodium falciparum, antioxidant.

Background: Rhabdomyosarcoma (RMS) is a malignant tumor with varying outcomes based on the current diagnosis and treatment system. This current retrospective study aims to predict the prognosis of patients for further providing a proper treatment by identifying the factors influencing the prognosis of RMS in children. Methods: We collected the demographic, clinical, therapeutic, and prognostic information of 64 patients aged under 18 years diagnosed with RMS from January 2014 to June 2021. Overall survival (OS) curves were measured by the Kaplan-Meier method. The prognostic values of OS were assessed by using the Cox proportional hazards regression model with univariate and multivariate analyses. Results: Of the 64 patients, effects of each factor as followed: age, gender, Ki-67, family background, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and risk classification on OS, were researched. Univariate analysis suggested that age >10 years (HR: 9.13, 95% CI, 3.19-26.17), NLR > 1 (HR: 3.43, 95% CI, 1.28¬9.23), PLR < 110 (HR: 0.17, 95% CI, 0.06-0.46) and risk classification, including Intermediate- and High-risk group (HR: 28.30, 95% CI, 3.44-232.77 and HR: 113.59, 95% CI, 12.59-1024.48) were associated with OS. Multivariate analysis showed that only age (HR: 4.957, 95% CI, 1.227-20.026) and risk classification, including Intermediate- and High-risk group (HR: 44.28, 95% CI, 4.02-486.87 and HR: 372. 70, 95% CI, 21.05-6598.08) affected the prognosis significantly. Conclusions: Older children are more inclined to higher risk stratifications and poor prognosis, consistent with some previous studies. This study showed that OS for RMS is dependent on age and risk classification which is crucial for clinical practice.

Aim: The purpose of this study was to investigate whether/how digital media exposure influences people’s intention to influenza vaccination. Subject and Methods: Through an anonymous online survey, we collected data on Chinese people’s exposure to influenza and influenza vaccine information on digital media platforms and their attitudes toward influenza vaccines(N=600). The structural equation model analysis results lent strong support to the research hypotheses and the proposed model. Results: The findings reveal three major themes: (1) digital media exposure has a significant influence on the susceptibility and severity of influenza. (2) After total exposure to digital media, it is helpful to understand the benefits of the vaccine, reduce the barriers to vaccination, and finally improve the intention to vaccination. (3) Users receive cues to action from digital media, and their vaccination intention tends to be positive. These findings explore how digital media exposure influences influenza vaccination intention and may provide insights into vaccine promotion efforts in countries. Conclusion: Research has shown that digital media exposure contributes to getting vaccinated against influenza.

We study the existence of standing wave solutions for the quasilinear Schr\”{o}dinger equation with the critical exponent and singular coefficients. By applying the Mountain Pass Theorem and the Concentration Compactness Principle, we get a ground state solution. Moreover, the asymptotic behavior of the ground state solution is also obtained.

Bovine ephemeral fever (BEF), also known as three-day fever and three-day disease, is an arthropod-borne viral disease of the buffalo and domestic cattle. Bovine ephemeral fever virus (BEFV) is the causative agent of the disease. In this study, we tried to detect the molecular characterization and possible source of BEF virus that caused an epidemic within a limited area synchronously and in two separate localizations in the Aegean region in November, 2020. As a result, BEF virus was declared in Aegean region for the first time, G gene characterization was performed, the virus was classified within the Middle East lineage, and animal movements were believed to have been effective for the virus to reach the area.

In June 2021, Udom et al. published their article in  Transboundary and Emerging Diseases performing a serological survey revealed evidence of anti-N-IgG antibodies suggesting SARS-CoV-2 exposure in both dogs and cats during the first and second coronavirus disease 2019 (COVID-19) outbreaks in Thailand. Seroprevalence studies have proven an important tool to monitor the progression of the COVID-19 pandemic. The duration of immunity of SARS-CoV-2 is crucial for the course of the pandemic and for this reason the monitoring of antibodies against SARS-CoV-2 is important. The serum samples from different periods and regions were valuable in terms of scientific significance for serological survey of SARS-CoV-2 and emerging infectious diseases. In order to preserve the remaining serum samples and ensure the stability of anti-virus antibodies in storage serum samples, we strongly suggest that standard serum banks should be established worldwide.

High-energy materials have revealed so many properties, however, many optical properties need to be solved urgently. The traditional technology of analyzing optoelectronic materials cannot avoid the structure and electric density. In the process of incomplete electron transfer, the direct fluorescence phenomenon produced by nitro compounds is even rarer. The uncertainty of the choice of fluorescent matrix materials and the flexible situational conditions prompted us to apply density function theory (DFT) to explore the optical and fluorescent properties of 5,5’-Dinitro-2H,2H’-3,3’-bi-1,2,4-triazole (DNBT), 4,4’-Dinitroazolefurazan (DNAF) and 4,4’-Dinitro-3,3’-4,3’-ter-1,2,5-oxadiazole (DNTO). In the orbital energy range of -2.5eV to 0 eV, the order of intensity is DNBT> DNAF> DNTO. The calculated results of UV spectra show that each compound has maximum absorbance at specific wavelengths of 175nm, 183nm and 192nm. We speculate that all electrons are localized by the conjugate structure, especially on the N-O-N bond or N=C-N bond, which can be described as redundant orbital hybridization. In addition, the absorbance of DNBT on different crystal planes reflects the N=N conjugated structure is a factor that affects electronic excitation. We found that DNBT has the highest absorbance on the (1,0,0) crystal plane, while the maximum absorbance of DNAF and DNTO is on the (0,0,1) crystal plane. It is expected that these findings will be widely used in comprehensive material devices and imporove the concept in industry technology.

This article briefly discusses what should be encouraged for the scientific ability of scholars and researchers (S&R) and what should be focused in scientific evaluation. It is believed that several core competencies that should be encouraged include learning, research, scientific writing, innovation and translational application. Scientific evaluation should focus on several “hard indicators”: academic leadership, independence, guidance, diversity, cooperation and innovation. As to how to become an excellent cardiovascular S&R, one should improve scientific abilities, which include innovation and publishing academic papers in one of “345” (Cell, Nature or Nature Medicine, and Science; BMJ, JAMA, NEJM, and The Lancet; Circulation, Circulation Research, European Heart Journal, JACC, and Nature Review Cardiology) international top journals as the first, single, or independent author. And it is time to develop a new scoring system based on these indicators for better and more reasonably evaluating one’s scientific performance.

Rationale aims and objectivesː A good therapeutic alliance or relationship is relevant for healthcare providers exposed to patients’ suffering, especially when patients and physicians may understand the painful experience differently. Our aim was to explore the impact of therapeutic alliance on analgesic outcomes in a real-world Pain Unit. Methodː A cross-sectional observational study was conducted on ambulatory patients (n=69) who use pain killers long-term during treatment of chronic non-cancer pain. Responses to a patient-doctor relationship questionnaire were correlated with levels of comprehension of prescription information provided during consultations. Socio-demographical and clinical information (pain level, quality of life and hospital use) were collected through the questionnaire, while pharmacology data (analgesic prescription, adverse events, and compliance) were obtained from electronic health records. Resultsː Patients were 75% middle-aged women, 72% retired, experiencing moderate pain on average, and under a high morphine equianalgesic dosage (95 ± 88 mg/day, mainly tapentadol or fentanyl). Patients with low therapeutic alliance showed a significantly higher pain intensity (80 ± 75 mm, p<0.01). In contrast, patients who reported high therapeutic alliance during the treatment reached a significant result of 35% lower pain intensity (d=1.079), 52% higher relief (d=0.675) and 48% better quality of life (d=0.638). Moreover, pain intensity was significantly lower when patients affirmed that, thanks to their doctors, they had gained new insights (d=0.574), felt better (d=0.756), or felt content with or benefit from the treatment of my doctor (d=0.826). A total of 65% of the full patient population reported the ability to manage their symptoms as well as better opioid knowledge, increasing their observed drug compliance by 15%. Conclusionsː Therapeutic alliance can be an effective strategy for impacting analgesic outcomes, as evidences in a real-world chronic pain clinical setting. More effort is necessary to improve communication strategies for pain management.

Population-based sero-epidemiological studies are widely used to estimate the proportion of a population infected (infection attack rate, IAR) with SARS-CoV-2. However, the accuracy of the estimates relies on the design of the study (e.g. sample size) and the sensitivity (e.g. decay of sensitivity) of the assay used. This study aims to resolve these issues with the seroprevalence of COVID-19 and infection attack rates in 12 Indian cities as examples. We examine serological data that used Abbott to reconstruct a sensitivity decay function and use it to infer attack rates and seroprevalence based on reported COVID-19 death in these cities. We find that the reconstructed seroprevalence matched with the reported scenario reasonably well in most cities, where Abbott or similar assay was likely used, but failed in two cities, where non-Abbott assay was likely used. We propose an approach to connect the serological data and the reported COVID-19 deaths with the testing sensitive decay function to increase the confidence in estimating the size of the epidemic.

In this paper, we shall consider the existence of nonconstant solutions of a preadtor-prey model under homogeneous Neumann boundary conditions. In particular, the existence of the global bifurcations, the Hopf bifurcations and the steady state bifurcations of system are established, and the bifurcation direction of the bifurcating periodic solutions and the steady state bifurcations of system are investigated. Moreover, the stability of the Hopf bifurcation is also studied, and we show that the spatially homogeneous periodic solutions are asymptotically stable, while the spatially nonhomogeneous periodic solutions are unstable. Furthermore, the effect of cross-diffusion for existence of nonconstant solutions of system is studied, and we also show that cross-diffusion is not always helpful to create Turing instability. Our mathematical approach is based on the Leray-Schauder degree theorem, the bifurcation theorem, the technique of space decomposition and the implicit function theorem.

Background: Acute type A aortic dissection (aTAAD) is a lethal disease and age is an important risk factor for outcomes. This retrospective study was to analyze the impact of age stratification in aTAAD. Methods: From January 2011 to December 2019, 1092 aTAAD patients from Nanjing Drum Tower Hospital received surgical therapy. Patients were divided into seven groups according to every ten-year interval (20s-80s). The differences between the groups were analyzed in terms of the baseline preoperative conditions, surgical methods, and postoperative outcomes of patients of different age groups. During a median follow-up term of 17 months, the survival rates were compared among seven groups through Kaplan-Meier analysis. Results: The median age was 52.0 years old in the whole cohort. The multiple comorbidities were more common in old age groups (60s, 70s, 80s), while the 20s group patients had the highest proportion of Marfan syndrome (28.1%). Preoperative hypotension was highest in 80s (16.7%, P=0.038). Young age groups (20s-60s) had a higher rate of root replacement and total arch replacement, which led to a longer duration of operation and hypothermic circulation arrest. The overall mortality was 14.1%, the tendency of mortality was increased with age except 20s group (33.3% in 80s, P=0.016). The postoperative morbidity of gastrointestinal bleeding and bowel ischemia were 16.7% and 11.1% in 80s group. Conclusion: Age is a major impact factor for aTAAD surgery. Old patients presented more comorbidities before surgery, the mortality and complications rate were significantly higher even with less invasive and conservative surgical therapy.

In this study, we have desired to show a case of coronary thrombus at the age of 32, without a previous medical history and without a risk factor, which we believe may develop due to Sinovac inactive Covid-19 vaccine or as a late complication of Covid-19.

Utility and safety of skin tests in drug reaction with eosinophilia and systemic symptoms (DRESS): a systematic review Running title : Skin tests in drug reaction with eosinophilia and systemic symptoms (DRESS)Ying Xin Teo MB BChir1,2 , Peter Simon Friedmann MD FRCP1,2, Marta Ewa Polak PhD1, Michael Roger Ardern-Jones DPhil FRCP1,2Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, United Kingdom2 Department of Dermatology, Southampton General Hospital, University Hospitals Southampton NHS Foundation TrustAcknowledgements : noneFunding sources: This work was supported by the British Skin Foundation [grant number BSF023F19].Conflict of interest: The authors have no conflicts of interests to declareText word count: 752

Context-dependency, C-D, of outcomes occurs when several factors affect a focal metric. Remedies for treating milder cases of C-D are readily available but severe cases, where some contributory factors cause non-linear changes in others, escaped routine scrutiny. This poses a universal challenge to standard research strategies. We suggest that metacommunity framework may be particularly vulnerable because its core notions (habitat structure, dispersal, and species interactions) are functionally entangled. When these notions are generalized to include many species and situations, they become interdependent. To illustrate the significance of such interdependence, we test two hypotheses. One that holding combination of parameters constant in all but one dimension, can alter inference of a study and the second that the severity of context-dependency increases when core metacommunity dimensions interact and transform one another through a variety of mechanisms. The results support these ideas and imply that C-D predicts a dauntingly vast space of possible empirical outcomes and interpretations, most of which can arise from reciprocal interactions among metacommunity core dimensions. We proffer that an adaptable and structured use of macro-variables is a place to start investigating metacommunity mechanisms more efficiently.

Analysis of long-term trends in abundance provide insights into population dynamics. Population growth rates are the emergent interplay of fertility, survival, and dispersal, but the density feedbacks on some vital rates (component) can be decoupled from density feedback on population growth rates (ensemble). However, the mechanisms responsible for this decoupling are poorly understood. We simulated component density feedbacks on survival in age-structured populations of long-living vertebrates and quantified how imposed nonstationarity (density-independent mortality and variation in carrying-capacity) modified the ensemble feedback signal estimated from logistic-growth models to the simulated abundance time series. The statistical detection of ensemble density feedback was largely unaffected by density-independent processes, but catastrophic and proportional mortality eroded the effect of density-dependent survival on ensemble-feedback strength more strongly than variation in carrying capacity. Thus, phenomenological models offer a robust approach to capture density feedbacks from nonstationary census data when density-independent mortality is low.

Objective: Gene set enrichment analysis (GSEA) and immune infiltration analysis were performed on chip data on carotid atherosclerosis expression profile. In order to explore the pathogenesis of carotid atherosclerosis. Method: The GSE43292 data were obtained from the gene expression omnibus (GEO). CIBERSORT deconvolution method was utilized to analyze the infiltration ratio of immune cells. Result: The up-regulated immune related biological processes include the regulation of cytokine stimulation response and B cell activation and immune response. The up-regulated immune related KEGG signaling pathway has natural killer cell mediated cytotoxicity, Fc epsilon RI signaling pathway, RIG-I like receptor signaling pathway and JAK-STAT signaling pathway. The down regulated immune related KEGG signaling pathway is transforming growth factor β signaling pathway. The results of immune infiltration analysis showed that Macrophages M0 and B cells memory were significantly increased in the vascular tissues of carotid atherosclerosis. B cells naive, T cells CD8, T cells regulatory, NK cells activated, Monocytes and Dendritic cells resting were significantly decreased. Conclusion: Adaptive immunity of B2 cells and NK cell cytotoxicity plays an important role in carotid atherosclerosis. Three pathways of KEGG may be significant factors in the pathogenesis of carotid atherosclerosis.

Models that predict the stomatal conductance process (gs) for a given set of environmental conditions are important, as this process is the main mechanism that controls the gas exchange of terrestrial plants absorbing atmospheric CO2. This work presents the results of a simulation to observe the gs process as a function of soil water availability (WAP) using an ecosystem demography model (ED2.2). The results showed that the model was able to reproduce the seasonality of the gas observed in the field. During periods when there was WAP, gs increased and the lower availability of water in the soil for the plant led to reduced photosynthesis due to stomata closure, decreasing stomatal conductance to reduce water loss. The model results for gross primary productivity (GPP) were also similar to those observed in the field, varying around ≈24 MgC.ha-1.yr-1 for the rainy season and ≈23 MgC.ha-1.yr- 1 for the dry season (average 2002 to 2010). The assimilation of CO2 via NPP and stomatal conductance had an R2 of 0.7 indicating that the assimilation of CO2 was high when there was greater stomatal conductance, favoring the increase in aboveground biomass in the model.

Glufosinate is an important and widely used non-selective herbicide active on a wide range of plant species. Resistance evolution to glufosinate in weedy plant species (including the global weed Eleusine indica) is underway. Here, we uncover the molecular basis of target-site glufosinate resistance in Eleusine indica. Full-length E. indica glutamine synthetase (GS) iso-genes (EiGS1-1, 1-2, and 1-3 and EiGS2) were cloned, and expression of EiGS1-1 and EiGS1-2 was higher than EiGS2. A novel point mutation resulting in a Ser-59-Gly substitution in EiGS1-1 was identified in glufosinate-resistant (R) plants. Rice calli and seedlings transformed with the mutant EiGS1-1 gene were resistant to glufosinate. Purified yeast recombinant mutant EiGS1-1 was more tolerant to glufosinate than the wild type (WT) variant. These transgenic results correlate with a more glufosinate-R GS in the crude tissue extract of R versus susceptible E. indica plants. Structural modelling of the mutant EiGS1-1 revealed that the Ser-59 is not directly involved in glufosinate binding but in contact with some important binding residues (e.g. Glu-297) and especially with Asp-56 that forms an intratoroidal contact interface. Importantly, the same Ser-59-Gly mutation was also found in geographically isolated glufosinate-R populations from Malaysia and China, suggesting parallel evolution of this resistance mutation.

Background: Burkitt lymphoma (BL) is an aggressive non-Hodgkin’s lymphoma (NHL). With high-dose combination chemotherapy cure rates are excellent but associated with higher rates of infections, and morbidity. Treatment for HIV positive Burkitt lymphoma is similar to HIV negative Burkitt lymphoma along with anti-retroviral therapy. In resource constrained setting offering intensive chemotherapy sometime is difficult. There is scarcity of data regarding use of metronomic chemotherapy in aggressive lymphomas. Results: Here we present outcome and review of literature of child, diagnosed with Burkitt lymphoma and HIV who was treated with metronomic chemotherapy. After year of follow-up he is disease free.