Objective: To determine factors contributing to low level of attending the recommended four ANC visits. Design: The study was cross-sectional Setting: The study was quantitative and was conducted in Musanze health center and in its radiation zone. Data was collected using interview-administered questionnaire. Sample: The study enrolled 8 health providers and 67 lactating mothers who visited ANC service in 2018 and did not completed four ANC standard visits. Methods: The study adopted a stratified convenience method. All lactating mothers who did not completed four ANC visits participated in the research. Main outcome measures: The health providers who work in ANC services do not create awareness of importance of completing the four visits, do not support the husband to help a wife and urge her to complete the visits. Results: The study finds that 51% of the interviewed mothers did two ANC visits and 40% who did three ANC visits, 36% of the responded thought that 2 or 3 visits are enough, 21% delivered before the last appointment, 37% of nurses responded that the cause of discontinuance of four ANC is due to the mothers lie ANC service provider on the gestalt age. Conclusion: Factors proved to contribute to the discontinuance of four antenatal care standard visits include lack of awareness on the role of completing four ANC, believe of mothers, ignalence, lack of use of gravidomètre to guess gestalt age, lie on the last date of amenhorea. Findings: Authors’ fees

\begin{abstract} {In this paper, we study a class of critical fractional Kirchhoff-type equations involving logarithmic nonlinearity and steep potential well in $\R^N$ as following: \begin{align*} \renewcommand{\arraystretch}{1.25} \begin{array}{ll} \ds \left \{ \begin{array}{ll} \ds \left(a+b\int_{\R^{N}}|(-\Delta)^\frac{s}{2}u|^2\, dx\right)(-\Delta)^s u+\mu V(x)u=\lambda a(x)u\ln|u|+|u|^{2_{s}^{*}-2}u~~~\text{in}~\mathbb{R}^N, \\ u\in H^s(\R^N), \\ \end{array} \right . \end{array} \end{align*} where $a>0$ is a constant, $b$ is a positive parameter, $s\in(0,1)$ and $N>4s,$ $\mu>0$ is a parameter and $V(x)$ satisfies some assumptions that will be specified later. By applying the Nehari manifold method, we obtain that such equation with sign-changing weight potentials admits at least one positive ground state solution and the associated energy is negative. Moreover, we also explore the asymptotic behavior as $b\to 0$ and $\mu\to\infty,$ respectively.}

Objective: To determine the factors contributing to home delivery. Design: The study was cross-sectional. Setting: The study was quantitative and was conducted in all villages of Musanze sector which has home delivery. Data were collected going house to house for mothers who delivered at home. Data were collected using interviewer-administered questionnaire. Sample: All 38 women who delivered at home in 2016-2017 were enrolled in the study. Methods: To know who were delivered at home, researcher takes a copy of monthly reports of CHWs for each village & draw villages which had reported home delivery in the studies period. Before distributing questionnaire, the researcher asked the mother if she had delivered at home for the reported month and if she agrees, the researcher continues with the questionnaire distribution. Main outcome measures: Many factors finds contributing to home delivery. Those include cultural, social and financial factors. Results: The study finds that 23.7% of mothers who delivered at home had a high risk pregnancy, 23.7% had not a health insurance, 63.1% delivered during the night & 23.7% delivered during the rain fall. 29% have not visited by a CHW when they were pregnant, 10.6% have attended any ANC visit & 10.6% were accustomed to home delivery. Conclusion: Mobilization of pregnant mother to come hosting at the health facility one week before the expected delivery date, mobilization on health risk related to home delivery, high risk pregnancy and to avail the means of transport for women who start labor at home. Findings: Authors’ fees

The impact of the Covid-19 pandemic on the care of children with cancer in LMIC is of great concern, particularly on diagnosis and abandonment of treatment rates. Data supporting this concern however is limited to survey and anecdotal information. A retrospective with two cohorts design was used to compare new diagnosis and monthly abandonment rate in Java, Indonesia. We found that new diagnoses rates had dropped significantly during Indonesia’s first wave as compared to a pre-pandemic cohort [rate ratio 0.57, 95th (CI) 0.41-0.79)] and that as the first wave progressed, abandonment rates also rose in a statistically significant manner.

Introduction Fatigue is the most common complication of cancer treatment procedure during chemotherapy, leading to limited daily activities, mood swings, and ultimately impaired functional status. This study aimed to determine the effect of energy efficiency training on the fatigue scores of children with cancer diagnosis. Methods In the present clinical trial study, 30 children with a cancer diagnosis were randomly assigned to the control and testing groups, respectively. The cancer-related fatigue questionnaire for children with cancer was employed as the data collection tool. The intervention of the testing group was conducted in 4 sessions of 45 to 60 minutes of face-to-face interaction, group sessions, and question and answer sessions. Meanwhile, routine interventions were employed in the control group. Quantitative variables were reported as mean, standard deviation, and qualitative variables as frequency and percentage, respectively.Stata 11 statistical software and a change score approach were used to analyze the data. Results The mean fatigue score of the testing group increased from 72.12 to 77.53. There was a statistically significant difference between the mean fatigue scores of the testing group before and after the intervention (p = 0.013), and the children’s fatigue score decreased. There was a statistically significant difference between the mean fatigue scores of the testing and control groups before and after the intervention (p = 0.001), and the fatigue score of the children in the testing group had decreased compared to the control group. Conclusion Energy efficiency techniques can be employed to increase energy and reduce fatigue during pediatric chemotherapy.

This case of a 32 year-old-man with recent radiofrequency ablation presenting with chest pain highlights the diagnostic challenge of atrioesophageal fistulas. Management should include blood cultures, complete blood count, serial computed tomography of the chest with intravenous and oral contrast, broad spectrum antibiotics and referral to a cardiothoracic surgeon.

Rhabdomyolysis is a life-threatening adverse drug reaction that is seldom reported in DPP-4 inhibitors. Here we present a case in which a 58-year-old female suffered from severe swelling and pain in bilateral lower limbs and oliguria for 1 week after a suicidal attempt that she took vildagliptin 1,400 mg and insulin aspart 60 IU. She was diagnosed with rhabdomyolysis, diabetic ketoacidosis (DKA), urinary tract infection (UTI) and drug-induced liver injury (DILI). After 20 days of hospitalization, significant improvement had occurred in almost all laboratory results, and the patient was discharged without sequelae. This is a rare case suggesting that severe adverse events (SAEs), such as rhabdomyolysis, may occur in relatively safe oral hypoglycemic drugs.

Introduction: One of the most important risk factor for COVID-19 infection is malignancy especially hematologic ones. Focusing on the clinical, radiological and laboratory characteristics of COVID-19 infected cancer patients remain largely important. Materials and Methods: In this retrospective study, we analyzed the data of 194 patients with hematologic malignancy and COVID-19 pneumonia. We categorized patients based on the type of the hematologic malignancy and phase of the treatment. All associated and important laboratory data including complete blood count, pro-inflammatory markers, and computerized tomography scan findings were reported to assess the risk factors associated mortality. Results: From January 2020 to March 2021, a total of 194 COVID-19 infected patients with hematologic malignancies were included in different phase of treatments. Median age was 44 (15-81) years. 135 of the cases were male and 59 of the cases were female. Acute myeloid leukemia was the most frequent cancer type (43.8%). A total of 119 patients had severe COVID-19 and 61 patients were admitted to intensive care unit. A total of 92 deaths occurred among all cases for an overall case fatality rate of 47%. Male gender (P=0.03), pre-induction and induction phase of the treatment (P<0.001), Intensive care unit admission (P<0.001), low level of oxygen saturation at the onset of COVID-19 disease (P<0.001) and high level of fibrinogen (P=0.002) were associated with COVID-19 mortality among patients with hematologic malignancies. Conclusion: The results of this study showed male gender, pre-induction and induction phase of the treatment, Intensive care admission, low levels of oxygen saturation at the onset of COVID-19 disease, RH positivity and higher fibrinogen level were associated with the risk of death. Identification of factors potentially associated with mortality for cancer patients are important in assessment strategy in these high risk group.

Bullous hemorrhagic Sweet syndrome induced by SARS-CoV-2 Oxford AstraZeneca vaccineT. Zagar1, N. Hlaca1,2, I. Brajac1,2, L. Prpic-Massari1,2 , S. Peternel1,2, M. Kastelan1,21Department of Dermatovenerology, Clinical Hospital Centre Rijeka, Rijeka, Croatia; and 2Faculty of Medicine, University of Rijeka, Rijeka, CroatiaCorresponding author:Nika Hlača, MDDepartment of dermatovenerology, Clinical Hospital Centre RijekaFaculty of Medicine, University of Rijeka, Rijeka, Croatiae-mail: nika.hlaca@uniri.hrtel: +38551658283mobile: +385915607690Word count: 596Figures: 2Competing interestsThe authors declare that they have no competing interests.AcknowledgementAll authors read and agreed to the final version of this manuscript. TZ, NH, SP and MK conceived the original idea and wrote the final version of manuscript. IB and LPM have been involved in drafting the manuscript and revising it critically for important intellectual content.Informed consent was obtained from the patient for publication of this report.To the editor,Concurrent to the increasing use of COVID-19 vaccines, the number of vaccine-related adverse reactions has also increased1. We report a case of a 49-year-old male patient who presented with a 10-day-history of generalized painful cutaneous eruption. He denied any preceding respiratory or gastrointestinal symptoms or introduction of any medications, however, ten days before the rash onset, he received the first dose of the SARS-CoV-2 Oxford-AstraZeneca vaccine. Upon physical examination, we observed symmetrically distributed erythematous to violaceous vesicular papules and targetoid plaques on the lower part of the trunk and extremities, along with multiple grouped hemorrhagic blisters on both hands and feet (Figure 1A). Fingers of the right hand were edematous with large tense hemorrhagic bullae, while the left hand was less affected (Figure 1B). The patient was subfebrile and reported mild arthralgia, no other extracutaneous symptoms were present. Initial laboratory tests showed leukocytosis with neutrophilia, while C-reactive protein, liver and renal function tests, urine analysis, ANA, ANCA, cryoglobulins, rheumatoid factor were all within the reference range. The SARS-CoV-2 RT-PCR test was negative, while IgG SARS-CoV-2 antibodies were positive (895.3 AU/ml). Serology tests for viral and bacterial agents were all negative. Chest X-ray and abdominal ultrasound were unremarkable. Histopathological analysis revealed dense perivascular and periadnexal to diffuse neutrophilic infiltrate with marked leukocytoclasia involving the upper and mid-dermal layers. There was massive edema of papillary dermis resulting in subepidermal blister along with extravasated erythrocytes (Figure 2A-B). These findings were consistent with Sweet syndrome (SS). Thus, intravenous methylprednisolone (0.8 mg/kg/d) was initiated and most of the existing lesions started to recede in the next few days. Due to suspected secondary ischemia of the right-hand fingers, the vascular surgeon recommended antithrombotic prophylaxis with low-molecular-weight heparin and acetylsalicylic acid in addition to hyperbaric oxygen therapy. After two weeks of ongoing treatment, there was remarkable improvement in clinical status. The patient was discharged from the hospital with methylprednisolone 32 mg daily therapy and slow tapering over the following eight weeks.Up to date, the most commonly reported cutaneous adverse events of SARS-CoV-2 vaccines are mild to moderate injection-site reactions occurring as a result of nonspecific stimulation of inflammation1. To our knowledge, there are only ten cases of SS induced by any vaccine reported in the literature, three with seasonal influenza, two with pneumococcal, two with tuberculosis, two with smallpox, one with influenza A2. Additionally, three cases of acute febrile neutrophilic dermatosis induced by SARS-CoV-2 Pfizer-BioNTech mRNA vaccines have been reported so far. In the reported cases, the time from vaccination to the onset of the skin lesions ranged from 12 hours to 15 days1,3,4. Our patient developed SS 10 days after the first dose of the Oxford-AstraZeneca vaccine. Generally, local and systemic reactions to the Oxford-AstraZeneca vaccine were mild and reported more often after the first dose and more frequently in adults aged 18-651. Vaccination with Oxford-AstraZeneca is linked to thromboembolic events and very rarely to prothrombotic immune thrombocytopenia with cutaneous lesions similar to drug-induced cutaneous vasculitis1.The bullous variant of SS, seen in our case, is a rare form of the disease. Drugs, tumors or infectious agents may start a network of cytokines involved in the onset of SS5. SARS-CoV-2 infection may also trigger SS as reported recently6. To our best knowledge, this is the first case of SS induced by the Oxford-AstraZeneca vaccine. Balancing the possible link between vaccination and SS, we decided to contraindicate the second dose of vaccine for our patient. Because of the ongoing pandemic and introduction of new vaccines, it is of great importance that all potential side effects are reported and considered.ReferencesCastells MC, Phillips EJ. Maintaining Safety with SARS-CoV-2 Vaccines. N Engl J Med 2021;384: 643-649.Pedrosa AF, Morais P, Nogueira A, Pardal J, Azevedo F. Sweet’s syndrome triggered by pneumococcal vaccination. Cutan Ocul Toxicol 2013;32:260-261.Darrigade AS, Théophile H, P, Sanchez-Pena P, Milpied B, Colbert M, Pedeboscq S, Pistone T, Jullié ML, Seneschal J. Sweet syndrome induced by SARS-CoV-2 Pfizer-BioNTech mRNA vaccine. Authorea March 12 2021. doi: 10.22541/au.161553544.40263874/v1.Banerji A, Wickner PG, Saff R, Stone CA Jr, Robinson LB, Long AA, Wolfson AR, Williams P, Khan DA, Phillips E, Blumenthal KG. mRNA Vaccines to Prevent COVID-19 Disease and Reported Allergic Reactions: Current Evidence and Suggested Approach. J Allergy Clin Immunol Pract 2021;9:1423-1437.Heath MS, Ortega-Loayza AG. Insights Into the Pathogenesis of Sweet’s Syndrome. Front Immunol 2019;10:414.Taşkın B, Vural S, Altuğ E, Demirkesen C, Kocatürk E, Çelebi İ, Ferhanoğlu B, Alper S. Coronavirus 19 presenting with atypical Sweet’s syndrome. J Eur Acad Dermatol Venereol 2020;34:e534-e535.Figure 1. Clinical presentation of Sweet syndrome; a) edematous red-violet papules and targetoid plaques on the trunk and lower extremities, b) violaceous, edematous plaques and hemorrhagic blisters on hands.Figure 2. Skin biopsy from the lower trunk showing (a) subepidermal blister and diffuse dermal inflammatory infiltrate (H&E, 100x) consisting of (b) predominantly neutrophils with pronounced leukocytoclasia (b, 400x).

Background: Since the COVID-19 outbreak, pulmonary involvement was one of the most significant concerns in assessing patients. In the current study, we evaluated patient’s clinical and laboratory findings on the first visit to predict the severity of pulmonary involvement and their outcome. Methods: Four hundred seventy-eight COVID-19 patients with positive real-time reverse-transcriptase-polymerase chain reaction (RT-PCR) or highly suggestive symptoms with computed tomography(CT) imaging results with typical findings of COVID-19 were enrolled in the study. The clinical features, initial laboratory, CT findings, and short-term outcomes (ICU admission, mortality, length of hospitalization, and recovery time) were recorded. In addition, the severity of pulmonary involvement was assessed using a semi-quantitative scoring system (0-25). Results: Among 478 participants in this study, 353 (73.6%) were admitted to the hospital, and 57 (11.9%) patients were admitted to the ICU. A review of chest CT scans showed that Ground Glass Opacity (GGO) (58.5%) and consolidation (20.7%) were the most patterns of lung lesions. Among initial clinical and laboratory findings, anosmia (P = 0.01), respiratory rate (RR) ≥ 25 (P = 0.001), C-reactive protein (CRP) ≥ 91 (P = 0.002), white Blood Cell (WBC) >10,000 (P = 0.009), and SpO2 ≥ 93 (P = 0.04) was associated with higher chest CT score. Lung involvement and consolidation lesions on chest CT scans were also associated with more extended hospitalization and recovery period. Conclusions: Initial assessment of COVID-19 patients, including symptoms, vital signs, and routine laboratory tests, can predict the severity of lung involvement and unfavorable outcomes.

Background: Adherence to medication is the cornerstone to achieve the best treatment outcome. Pharmacists are healthcare professionals found in pivotal positions to assess asthmatic patient’s adherence to medication. A brief, reliable, and valid measure of patient adherence is useful to enable the pharmacists to deliver that vital service. This study aims to develop a reliable and valid adherence assessment tool for asthmatic patients. Methods: The Adherence to Asthma Medication Questionnaire (AAMQ-13) was developed based on an extensive literature review, followed by applying the Delphi technique, and then it was pilot-tested by 55 patients. The final AAMQ-13 was completed by 213 patients. Psychometric evaluation was assessed including reliability, criterion validity, and construct validity. Results: The AAMQ-13 is a feasible 13 item questionnaire, as it can be completed within an average of two minutes. It has high internal validity (Cronbach’s alpha= 0.87). Criterion-concurrent validity was established by comparing the AAMQ-13 to the Test of the Adherence to Inhaler (TAI) and the pharmacy refill records. Criterion-convergent validity was established by comparing the AAMQ-13 to the Asthma Control Test (ACT) questionnaire and the Positive Health Behaviors Scale (PHBS). Construct validity was established through AAMQ-13 factor analysis which revealed two factors explaining 51.76% of the variance. Conclusion: The AAMQ-13 is a reliable and valid questionnaire with several desirable characteristics as it has a high internal validity, good criterion validity, and strong construct validity. The AAMQ-13 is a suitable questionnaire that can identify non-adherent patients and reveal the reasons behind their non-adherence (intentional or unintentional non-adherence).

Two types of extracellular ligninolytic enzymes of white-rot fungi, i.e., laccase and manganese peroxidase (MnP), are commonly in denim bleaching process due to their superior degradation capability of synthetic dyes. In the process of bleaching by extracellular broth of Cerrena unicolor BBP6, MnP was primarily responsible for the decolorization of denims, while laccase played an assisting role in the decolorizing reaction by participating in the production of H2O2 to initiate the catalytic reaction of MnP. A gene co-expression system in Pichia pastoris was constructed based on the synergism of both MnP and laccase, showing a significantly enhanced decolorization effect on denims. Our results demonstrated that the recombinant enzyme complex (rMnP3-BBP6 and rLacA-189) has shown promising application potential in textile industries, especially in denim bleaching process.

Triple Whammy (TW) is a dangerous drug interaction (DI) that can occur when combining angiotensin converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs), with diuretics and non-steroidal anti-inflammatory drugs (NSAIDs). One of the most serious consequences of TW is contributing to pre-renal acute kidney injury (pr-AKI). Due to the fact that the term TW, in context of DI affecting kidneys function is not very widespread, the aim of this article was to gather information on this interaction. Previous knowledge on the mechanism of TW and increasing patient awareness of this interaction is described. In addition, the specific nature of the acute kidney injury (AKI) caused by triple whammy (AKITW) is presented. On the basis of the current state of knowledge, recommendations how to manage the TW DI are also demonstrated.

Abstract Introduction: Globally, only one in six children receive a minimum acceptable diet (MAD). This study was designed to determine the association of complementary feeding (CF) indicators and household food insecurity and anthropometric status of Afghan children aged 6-23 months. Methods: We selected 300 children aged 6-23 months old in this cross-sectional study through convenience method from governmental health facilities and hospitals in Kabul, Afghanistan. Three 24-hour dietary recalls were collected from mothers for CF practices information. United States Department of Agriculture (USDA) food security questionnaire was used through interview method. Results: 59% of children received timely introduction of CF. MMF, MDD and MAD were met by 87.7%, 44.7% and 42.3%, respectively. There was association between food security with MDD (P=0.003) and MAD (P= 0.004). There was association between (Length for Age Z-score (LAZ) with MMF [OR 2.73; CI (1.20-6.20); P = 0.016]). Also, there were relation between Weight for Age Z-score (WAZ) with MDD [OR 2.78; CI (1.73-4.46); P = 0.0001], Weight for Length Z-score (WLZ) with MDD [OR 2.94; CI (1.77-4.87); P = 0.0001] and (LAZ) with MDD [OR 1.74; CI (1.09-2.78); P = 0.019]. There was a connection between WAZ and MAD [OR 3.12; CI (1.93-5.05); P = 0.0001], WLZ with MAD [OR 3.33; CI (1.98-5.61); P = 0.0001] and LAZ with MAD [OR 1.84; CI (1.15-2.94); P = 0.011]. There were significant associations between WAZ, WLZ and LAZ with household food insecurity [OR 3.66; CI (1.44-9.32); P = 0.006], [OR 4.83; CI (1.96-36.25); P = 0.004], [OR 5.16; CI (2.11-12.56); P = 0.0001], respectively. Conclusion: This study proved high associations between complementary feeding indicators and anthropometric measurements and household food insecurity. Key Words: Complementary feeding, breastfeeding, Food insecurity, anthropometric status, children 6-23 months, Afghanistan

Aims: Anxiety, depression, and disease-related distress are linked to worse overall glycaemic control, in terms of HbA1c. This study was aimed to evaluate whether these emotional disorders are associated with long-term glycaemic variability in subjects with Type 1 diabetes. Methods: Longitudinal retrospective study. Six-year HbA1c data (2014-2019) from 411 subjects with Type 1 diabetes who had participated in a previous study to design a diabetes-specific quality of life questionnaire in the year 2014 were included. Scores for Spanish versions of the Hospital Anxiety and Depression Scale (HADS) and Problem Areas in Diabetes (PAID) scale were obtained at baseline, along with sociodemographic and clinical data. Long-term glycaemic variability was measured as the coefficient of variation of HbA1c (HbA1c-CV). The association between HADS and PAID scores and HbA1c-CV was analysed with Spearman correlations and multiple regression models, both linear and additive, including other covariates (age, sex, diabetes duration time, type of treatment, use of anxiolytic or antidepressant drugs, education level and employment status). Results: Scores of depression, anxiety and distress were positively and significantly correlated to HbA1c-CV in univariate analyses. Multiple regression study demonstrated an independent association only for diabetes distress and anxiety scores (p= 0.010 and p=0.015, respectively). Age, diabetes duration time, education level and employment status were also significantly associated with HbA1c-CV. Conclusion: There is a relationship between psychological factors and long-term glycaemic variability in subjects with Type 1 diabetes.

Aim of the study: Multi-drug resistant tuberculosis (MDR-TB) is still an important public problem. Rapid diagnosis of the agent and determination of resistance status are critical in establishing the correct treatment protocol. This study was conducted with the aim of determining resistance mutations against first and second line drugs in MDR-MTB strain isolated from respiratory tract specimens . Material and method: After the subculture of these strains in Löwenstein - Jensen medium, DNA isolation was performed according to the boiling method. DNA isolates were kept at -40 0C until the working day. Primer sequences specific to rpoB, InhA, katG, gyrA, eis and rrs regions were used to determine isoniazid, rifampicin, quinolone and aminoglycoside resistance. Results: The positivity rate of rpoB, InhA, katG, gyrA, eis and rrs in 33 MDR-TB isolates was 27 (81.8 %), 31 (93.9 %), 25 (75.7 %), 25 (75.7 %), 20 (60.6 %) and 14 (60.6 %), respectively. Resistance mutations were not detected in susceptible isolates. Conclusion: According to the data obtained from the study, it was found that fluoroquinolone resistance mutations were higher in isolates defined as MDR-TB by conventional and molecular methods, and in-house PCR method was a useful method for rapid resistance detection.

The aim of this study is to evaluate the performance of CURB-65, qSOFA, and NEWS2 scores in predicting mortality in COVID-19 patients and to investigate potential components of a COVID-19-specific prognostic score. A total of 502 patients diagnosed with severe COVID-19 in the emergency department of a pandemic hospital between 01.04.2020 and 01.02.2021 and hospitalized in the intensive care unit were analyzed retrospectively. Demographic, clinical and laboratory data of the patients were obtained from the hospital registry system. The CURB-65, qSOFA and NEWS2 scores of each patient were calculated separately. These patients were divided into two groups as those who survived and those who died. All parameters and calculated risk scores were statistically compared between these two groups. When the CURB-65, NEWS2, qSOFA scores were compared between the two patient groups, a significant difference was found (P<0.001). Compared with CURB-65 and qSOFA, sensitivity of 92.3% and NPV of 90.2% were detected when NEWS2≥8. The CURBLFPC score reached the highest mortality predictive power among other scores with an AUC value of 0.91. Because the NEWS2 score is superior to CURB-65 and qSOFA for predicting mortality, it can be used in the triage of severe COVID-19 patients, predicting prognosis and improving outcomes.In more comprehensive and prospective studies, new models such as CURBFPC can be created and a specific prognostic score for COVID-19 can be developed.

Large transmembrane proteins are difficult to quantify with traditional methods due to their low binding affinity to traditional assay dyes (e.g., Bradford and Lowry assays). Enzyme-linked immunosorbent assays (ELISAs) provide higher quantification specificity for such proteins. An ELISA can detect a specific protein in a heterogenous sample. However, commercially available ELISAs are limited to a few model organisms and are highly dependent on the source of the protein and the isolation method used. Here we provide a solution to these problems with a versatile and readily reproducible indirect ELISA that relatively quantifies the transmembrane protein Na,K-ATPase (NKA). The NKA has become a model for studying the evolutionary ecology of plant-herbivore and predator-prey interactions, but functional studies of the proteins have been hindered by the lack of robust quantification methods. In our ELISA, the antigen is directly coated to the surface of a well in a 96-well plate, the primary antibody is used for detection, and an enzyme-linked secondary antibody is used for signal amplification and colorimetric detection. Two factors make this ELISA highly applicable across a wide range of species and protein sources: (1) the use of a commercially available antibody that binds universally across the animal kingdom and (2) the production of a malleable relative standard that can be adapted to various sample types (species and protein source). Comparisons of in vitro enzyme assays performed based on traditional protein quantification methods vs. our ELISA reveal that the ELISA consistently provides more robust NKA quantification necessary for subsequent functional data.

In this paper, memory optimization and architectural level modifications are introduced for low power realization of the Residue Number System(RNS) with improved flexibility for EEG signal classification. The proposed RNS framework is intended to maximize the reconfigurability of RNS for high-performance FIR filter design. By replacing the existing power-hungry RAM-based reverse conversion model with a highly decomposed LUT model which can produce the results without using any post accumulation process. The proposed RNS design makes use of inherent parallelism among residue channels and resources available of FPGA devices, the reverse conversion block is modified with an appropriate functional unit to accommodate FIR convolution results. The proposed approach is formulated to design pre-computed reverse converters for different moduli sets and implemented based on FPGA as target devices. As a result, the proposed LUT-based direct computation-based post accumulation technique for RNS-based multiplication offers high-performance FIR filter architecture which can also allow configuring the elements for different frequency responses. Experimental results show the superior performance of decomposing LUT-based direct reverse conversion over all other existing reverse conversion techniques adopted for energy-efficient RNS FIR implementations.

The development of highly active and stable metal-free non-platinum-group metal electrocatalysts (Non-PGMs) for the oxygen reduction reaction (ORR) is crucial for metal-air batteries. Herein, a two-dimensional (2D) planar conjugated poly(3,4-ethylenedioxothiophene) (PEDOT)/reduced graphene oxide(rGO) (P-rGO) hybrid materials with pure monolayer structure was synthesized. A series of physical and electrochemical characterization indicate that the PEDOT embedded in rGO increases the electrochemical surface area (ECSA) and structural defects, the exposed specific surface area promotes the adsorption of O2, the active sites facilitate the ORR kinetics, and the - conjugation between PEDOT and rGO affects the performance of P-rGO. In addition, the P-rGO outperforms a commercial 20wt% Pt/C in zinc-air battery (ZAB) with higher power density and stability, suggesting that the P-rGO has excellent overall performances enhances in the catalytic activity, long-term stability toward ORR. This study provides a novel avenue for development of metal free ORR catalysts.

The quantum Rice-Ramsperger-Kassel (QRRK) theory is used to analyze the reaction between the activated CH2•SCH2CH3 and molecular oxygen to account for further reaction and collisional and deactivation. hydroxyl radicals initiate the oxidation of Methyl ethyl sulfide (CH3SCH2CH3) and MES (methylthioethane) under combustion conditions. The CBS-QB3 composite and M062X/6-311+G(2d, p) DFT methods was used to study the thermochemical properties of reactants, products and transition states. These thermochemical properties are used for the calculations for kinetic and thermochemical parameters. Under high pressure and low temperature, isomerization and stabilization of the •OOCH2SCH2CH3 adduct is of importance. Under atmospheric pressure and at temperatures between above 600 ~ 800 K reactions of the chemically activated peroxy adduct become important relative to stabilization. The reaction between CH2•SCH2CH3 and oxygen molecule (O2) forms an energized peroxy adduct •OOCH2SCH2CH3 with a well depth of 26.4 kcal/mol, calculated at the CBS-Q//M062x/6-311+g(2d,p) levels of theory. Two new pathways are detected, the first new pathway is Criegee intermediate plus CCS• plus CH2•OO• formation. Thew second new pathway is carbon-sulfur bond cleavage with formation of carbon-oxygen and oxygen-sulfur double bonds after peroxy oxygen radical addition to sulfur atom: CH2=O + S•(=O) CC.

Earthworms have a central role in ministering the terrestrial ecosystems. Aestivation is a form of dormancy employed by the organisms living in deserts and arid environments, when confronted with prolonged periods of drought. As a survival tactic, aestivation has been studied in sea cucumbers, land snails and frogs, however little is known about aestivating earthworms. To understand the global metabolic adjustments required for withstanding the harsh conditions of the ever more severe Iberian drought, we performed a global transcriptomic exploration of the endogeic earthworm Carpetania matritensis during aestivation. There were a total of 6,352 differentially expressed transcripts in the aestivating group, with 65% being downregulated. Based on GO and KEGG enrichment analyses, downregulated genes seem to indicate an overall metabolic depression during aestivation. We noted a reduction of protein turnover and macromolecule metabolism coupled with suppression of digestion. Upregulated genes, namely antioxidant genes and DNA repair genes showed signs of abiotic stress caused by ROS generation. Abiotic stress led to transcriptomic changes of genes involved in immune response, mostly affecting the NF-κB signalling pathway and changes in apoptotic genes, indicating the necessity of investigating these processes in a tissue specific manner. Lastly we uncovered a possible mechanism for water retention by nitrogenous waste accumulation. This study provides the first ever transcriptomic investigation done on earthworms in condition of prolonged drought and as such serves as a general framework for investigation on other earthworm species and other soil invertebrates, which is becoming increasingly important with the current scenario of climate change.

Background and Purpose: The transcription factor B cell lymphoma 6 (BCL6) is an oncogenic driver of diffuse large B cell lymphoma (DLBCL). Blocking the protein-protein interactions of BCL6 and its corepressors has been proposed as an effective approach for the treatment of DLBCL. However, BCL6 inhibitors with excellent drug-like properties are rare. Hence, the development of BCL6 inhibitors is worth pursuing. Experimental Approach: We screened our internal chemical library by luciferase reporter assay and Homogenous Time Resolved Fluorescence (HTRF) assay and a small molecule compound named WK500B was identified. The binding affinity between WK500B and BCL6 was evaluated by surface plasmon resonance (SPR) assay and the binding mode of WK500B and BCL6 was predicted by molecular docking. The function evaluation and anti-cancer activity of WK500B was detected by immunofluorescence assay, Real-Time Quantitative PCR, cell proliferation assay, cell cycle assay, cell apoptosis assay, enzyme-linked immunosorbent assay (ELISA) and animal models. Key Results: WK500B engaged BCL6 inside cells, blocked BCL6 repression complexes, reactivated BCL6 target genes, killed DLBCL cells and caused apoptosis as well as cell cycle arrest. In animal models, WK500B inhibited germinal centre (GC) formation and DLBCL tumor growth without toxic and side effects. Moreover, WK500B showed favourable pharmacokinetics and presented superior druggability compared to other BCL6 inhibitors. Conclusions and Implications: WK500B showed strong efficacy and favourable pharmacokinetics and presented superior druggability compared to other BCL6 inhibitors. So, WK500B is a promising candidate that could be developed as an effective orally available therapeutic agent for DLBCL.

Purpose: NUDT15 genetic polymorphism is known to be associated with frequent hematopoietic toxicities during acute lymphoblastic leukemia (ALL) mercaptopurine therapy. The aim of this study is to test this association in a group of Syrian children with ALL, in addition to quantify the prevalence of the corresponding SNP in patient population. Patients and Methods: This is a retrospective study that included all children with acute lymphoblastic leukemia reaching at least 6 months of maintenance therapy between January 2018 and May 2020 at two recruitment sites in Damascus, Syria. The NUDT15 rs116855232 genetic polymorphism was performed and linked to four clinical factors: mercaptopurine dose intensity, early onset leukopenia, hepatotoxicity and therapy interruption. Results: A total of 92 patients were enrolled (63.04% low-risk, 25% intermediate-risk and 11.96% high-risk). The TC genotype was found in 5 patients (5.4%) and the TT genotype was found in 1 patient (1.08%), with the following allele frequency: C=0.961 and T=0.038. The mercaptopurine dose intensity was 81.98%, 65.85% and 4.99% for the genotypes CC, TC and TT respectively (P: 0.0174). A significant association was found between early onset neutropenia and NUDT15 polymorphism (TC or TT), OR: 6.82 (95% CI: 1.22-38.11, P: 0.043). No association was found between NUDT15 polymorphism and therapy interruption or hepatotoxicity. Conclusion: Our study confirms that NUDT15 rs116855232 polymorphism is associated with mercaptopurine hematopoietic toxicity but not with hepatotoxicity or therapy interruption in a population of Syrian children with ALL. The incidence seems to be higher than neighboring countries.