Most brain surgeries aim to completely resection a tumor. However, the arrangement of blood vessels around brain tumors is often complex. Moreover, the tumors and blood vessels have similar colors, making it difficult to identify the boundaries between them with the naked eye. Fluorescent staining is a method used to distinguish the borders between brain tumors and blood vessels. The fluorescent contrast agents commonly used to observe tumors are 5-aminolevulinic acid (5-ALA) and fluorescein sodium (FS), which have different surgical sensitivities, depending on the type of tumor. In this article, a dual band band-pass filter (BPF) with dual-wavelength emission for 5-ALA and FS is designed, and the dual-band BPF capable of inducing simultaneous fluorescence emission of FS and 5-ALA was investigated experimentally to improve accuracy, speed, and energy efficiency in clinical settings. The possibility of dual fluorescence emission with a single irradiation is proposed. The proposed fluorescent dual-band filter has the advantage of saving energy, reducing auxiliary manpower and unit costs, and reducing operating room space requirements by producing two fluorescence diagnostic effects using a single equipment.

Objective To establish the endometrial cancer detection rate in women using hormone replacement therapy presenting with postmenopausal bleeding. Design Retrospective cohort study. Setting and Population Rapid access gynaecology clinic at a tertiary hospital. Women aged under 60 years referred with postmenopausal bleeding. Methods Retrospective study of referrals received between 1 January 2019 and 31 December 2020 including HRT use and histological diagnosis. Main Outcome Measures Histological diagnosis of endometrial cancer, borderline ovarian tumour or endometrial intraepithelial neoplasia. Results 1363 women were included. 214 women were using HRT when they experienced PMB and only one of these had endometrial cancer at histology (cancer detection rate 0.47%). 25 of the 1124 women who were not using HRT were diagnosed with endometrial cancer on histology (cancer detection rate 2.18%). Chi squared statistical analysis confirmed this was statistically significant (p value 0.0156). Conclusions The endometrial cancer detection rate in women aged under 60 years using HRT with PMB is very low. Referral on a two-week wait pathway for suspected cancer diagnosis induces stress and anxiety for the woman and may lead to more invasive initial investigation even though other diagnoses are far more likely. Women aged under 60 years with postmenopausal bleeding that have either commenced HRT or had a change to their preparation within the last 6 months should be seen on a less urgent referral pathway if necessary given the very low probability of endometrial cancer. Funding None obtained Keywords Endometrial cancer, hormone replacement therapy, postmenopausal bleeding

Animals are common hosts for many coronaviruses where bats and rodents are commonly regarded as primary reservoirs. The unquestionable emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a yet unknown animal host - in addition with reports of further anthropogenic spread and sustained transmission in mustelids, captive felids, and domestic dogs and cats owned by people previously tested as SARS-CoV-2-positive, rise some concerns about possible continuous maintenance of the virus in nature and domestic species. In this review, we discussed the current data about coronaviruses in domestic and farming animals, recombination events, animal species susceptibility, virus-cell receptor interactions, and clinical signs of most relevant Coronaviridae members of each genera. Also, we present what is known about SARS-CoV-2 in animals and what will be the potential role of those species in COVID-19 epidemiology. Apparently, the virus can infect pets on some occasions, where cats look to be more susceptible than dogs. Thus, pet infection by sick owners is not only likely but expected given the numerous opportunities for spill-over during a massive outbreak. Regarded to farm animals, attention should be focused on breeding species of the Mustelidae family since they are those that have been shown to be more susceptible in experimental infections and have also effectively exhibited animal-to-human transmission. Other intensively bred species such as poultry, swine, horses and ruminants seem to present little or no epidemiological risk so far. The continuous monitoring of SARS-CoV-2 in animals in close contact with people with COVID-19 may be a key in the understanding of this emergent disease and the animal’s role in epidemiology in the future. It is possible that some species will serve as important reservoirs and source of infection of COVID-19 for humans making it re-emergent in the future, as is theoretically proposed for the origin of SARS-CoV-2.

Background: In the SARS-CoV-2/COVID-19 pandemic, we need to understand the impact of immunomodulatory medications on COVID-19 symptom severity in patients with inflammatory diseases, including the Type 2/Th2 polarized skin disease, atopic dermatitis/AD. Since it is believed that Type 1/Th1immunity controls viral infections, and that there is a Th1/Th2 counter-regulation, we hypothesized that Th2 targeting with the IL-4Rα-antagonist, dupilumab, in patients with moderate-to-severe AD rebalances Th1/Th2 axis, potentially leading to attenuated COVID-19 symptoms. Methods: 1,237 moderate-to-severe AD patients in the Icahn School of Medicine at Mount Sinai Department of Dermatology were enrolled in a registry. Patients were screened for COVID-19-related symptoms and assigned a severity score (asymptomatic[0]-fatal[5]). Scores were compared among 3 treatment groups: dupilumab (n=632), other systemic treatments (n=107), and limited/no treatment (n=498). Demographic and comorbid covariates were adjusted by multivariate logistic regression models. Results: The dupilumab-treated group showed reduced incidence and severity of COVID-19 symptoms versus other treatment groups. Dupilumab-treated patients were less likely to experience moderate-to-severe symptoms versus patients on other systemics (p=0.01) and on limited/no treatment (p=0.04), and less likely to experience any symptoms versus patients on other systemics (p=0.01). This effect was seen in our entire cohort and in the subgroup of patients with verified COVID-19 or high-risk exposure. Conclusions: Patients on dupilumab experienced less severe COVID-19 manifestations and lesser symptoms compared to patients on other systemics and on limited/no treatment. These results suggest that Th2 modulation with dupilumab may have a protective effect on anti-viral immune response in AD patients.

This study was undertaken on the morphological traits among the Enset (Ensete ventricosum) landraces and cultural use of the landraces for the livelihood of people in southern Ethiopia. The study was carried out in purposively selected four kebeles of the Mareka district. A total of 145 individuals were interviewed using semi-structured interviews, and field observation has also occurred. The morphological traits were measured according to International Board for Plant Genetic Resources descriptors for Enset. The data were analyzed using SPSS v 16.0 computer software and Excel 2010 spreadsheet. A total of 33 Enset landraces were identified. Identified landraces were grouped into five clusters based on their morphological trait variability. Cluster number five had the highest and cluster number three had the lowest mean. The highest landrace richness was recorded from Ocha (3.18) while the lowest was from Guta (2.56). The most abundant landraces were Amiya, Hoeya, Boza, Yaka, Bothena, Ontha, Adinona, Shasha, and Keteriya in the Mareka district. This study confirmed that the Dawro zone is rich in diversity of Enset, however, reduction in production and loss of some landraces was observed because. Therefore, attention must be given to the conservation and maintenances of Enset landraces by all the concerned bodies.

Biodiversity can potentially influence the risk of vector-borne diseases, which impact human welfare and wildlife management. Here we theoretically study the relationship between vector species richness and the risk of vector-borne diseases by a mathematical model for a multiple-vector-single-host vector-borne disease. The model incorporates transmission interference due to feeding interference among vector species and regulation of susceptible vector densities due to intraspecific recruitment competition. The model reveals three patterns of the vector richness-disease risk relationship: monotonic amplification, hump-shaped, and monotonic dilution. Monotonic amplification occurs across a wide parameter region. Hump-shaped or monotonic dilution is found when transmission interference is strong and recruitment competition is weak. Unexpectedly, susceptible vector regulation does not only promote dilution but can strengthen amplification if coupled with strong transmission interference. Our results suggest that vector richness can strongly affect the risk of vector-borne diseases and should be considered in disease risk management.

COVID-19 is a disease that has changed the scenario in emergency departments worldwide. Cardiac involvement should be considered in certain cases making ultrasound a mandatory tool to aid in diagnosis, follow-up, and treatment.

Introduction Nitazoxanide is a broad-spectrum antiparasitic that has been tested for COVID-19 due to the anti-inflammatory effects and in vitro anti-viral activity and promising clinical benefits against influenza and other viruses. The aim of this study was to synthesize the best evidence on the efficacy and safety of nitazoxanide as treatment for patients with COVID-19. Methods Searches for studies were performed in peer-reviewed and gray literature. The following elements were used to define eligibility criteria: (1) Population, individuals with laboratory-confirmed SARS-CoV-2 infection; (2) Intervention, nitazoxanide; (3) Comparison, placebo; (4) Outcomes: positive RT-PCR status, composite measure of disease progression (severe COVID-19, ICU admission or invasive mechanical ventilation), death, serum biomarkers of inflammation (C-reactive protein, IL-6, and IL-8), and any adverse events; (5) Study type: blinded, placebo-controlled, randomized clinical trials (RCT). Treatment effects were reported as relative risk (RR) and mean difference (MD) with 95% confidence intervals (CI). Results Four blinded, placebo-controlled RCT were included in the meta-analysis and enrolled individuals with mild or moderate SARS-CoV-2 infection. We found no difference between nitazoxanide and placebo in the frequency of positive RTP-PCR results (RR = 0.83; 95% CI 0.58 to 1.17) and there was no decreased risk for disease progression (severe COVID-19, ICU admission or invasive mechanical ventilation) (RR = 0.40; 95% CI 0.08 to 2.13) and deaths (RR = 0.55; 95% CI 0.18 to 1.68) among patients receiving nitazoxanide. There were no differences for patients treated with nitazoxanide and placebo in the levels of inflammatory markers. Conclusions In this study, we found no current evidence from blinded, placebo-controlled, RCT on the efficacy of nitazoxanide in treating patients with COVID-19. This living systematic review should be updated as soon as the results of ongoing RCT are published.

Introduction: Many Authors already described automatic activity arising from accessory pathways, but the underlying mechanism has not been clarified yet. They may be due to embryogenetic features of myocardium or may be related to specific excitability during radiofrequency ablation. Methods and results: we report the case of a man who underwent an accessory pathway ablation in WPW Syndrome. At the end of the procedure we found an accelerated rhythm originating at the insertion of the accessory pathway. Conclusion: If this manifestation represents the effect of thermal injury or if it is a real intrinsic automaticity is not fully documented.

Lots of meta-analysis emphasize that a great number of hospitalized patients with moderate and severe forms of COVID-19 developed acute myocardial damage, defined as an increase of cardiac biomarkers, such N-terminal pro–B-type natriuretic peptide (NT-pro-BNP), creatine kinase-myocardial band (CK-MB) and of all type of troponins. The highest mortality rate is related with progressively increasing biomarkers levels and with a history of cardiovascular disease. In fact, the biomarkers dosage should be considered as a prognostic marker in all patients with COVID-19 disease at admission, during hospitalization and in the case of clinical deterioration. The purpose of this review is to evaluate cardiovascular prognostic factors in COVID-19 disease throughout the analysis of cardiac biomarkers to early identify the most serious patients and to optimize their outcomes.

Aim COVID-19 pandemic changed the priorities in medical field. Many elective surgeries for renal cell cancers (RCC) have been postponed. In this study, we aimed to examine the effects of the COVID-19 pandemic on the surgical treatment of RCC in Turkey. Methods 457 patients that underwent surgery for kidney tumor in the 2-year period between March 1, 2019 and February 28, 2021 in 9 centers in Turkey were analyzed retrospectively. Results The number of surgical treatments for RCC during the COVID-19 pandemic has decreased significantly compared to the same period before COVID-19. No significant differences were found between the two periods in terms of admission symptoms (p=0.32). However, while the rate of application due to hematuria was 6.1% in the pre-COVID-19 period, it was 13.1% during the COVID-19 period. Despite not being significant, this difference was still proportional. Two study periods differed significantly in terms of the rate of metastatic RCC detected in preoperative imaging (13.1% vs 6.1%, during COVID-19 and pre-COVID-19, respectively) (p=0.01). Moreover, the study periods differed significantly in terms of time between imaging and operation (55.98±51.02 vs 40.30±34.9 days, during COVID-19 and pre-COVID-19, respectively) (p=0.01). However, there was no significant difference between the two periods in terms of tumor size, type of surgery, and pathological stage (p>0.05). Conclusion There was a significant decrease in the number of RCC-related surgeries over 1-year period during the pandemic. However, the rate of surgery for metastatic disease increased. Covid-19 is a pandemic that continues to affect the whole world. Oncological diseases are negative affected in this process in terms of early diagnosis and treatment.

In the early 1980s, implantation of bileaflet mechanical mitral valves (MMVs) in the anatomical plane was found to be associated with incomplete closure of the posterior leaflet, resulting in a higher incidence of valve thrombosis. This phenomenon, coined as the “lazy” leaflet, was avoided with anti-anatomical orientation. This historical observation helped standardize the implantation technique, but variability in surgical practice for leaflet orientation persists. The latter might have been increasing since rotatable cuff designs became available on newer generation models of MMVs. Indeed, this feature makes it tempting to prioritize a perfect custom prosthetic fit at the expense of proper orientation. We present the case of a young woman with rheumatic mitral valve disease in whom an On-X MMV was rotated in the anatomical plane, resulting in a limited excursion of the posterior occluder. This case illustrates that anti-anatomical implantation should still be favored with new-generation MMV models.

Purpose: Vitamin D deficiency is a common health problem around the world. This study aimed to evaluate the nationwide prevalence of vitamin D status in tertiary care hospitals in Turkey. Methods: Retrospectively, the data of vitamin D levels from 33 tertiary care hospitals’ clinical biochemistry laboratories around Turkey between 2 January 2016 and 31 December 2016 were conducted. Results: In total 706434 serum samples from adult subjects (F/M: 469028/ 237406; 66.4%/ 33.6%) were included. While vitamin D levels were sufficient in 20.3% (n=14222), they were insufficient in 21.9% (n=154360) and deficient in 57.8% (n=408882). Of the deficient group, 25.0% (176608) had levels <10 ng/mL consistent with profound deficiency. We observed the highest rates of deficiency in those aged between 18-29 years 62.9% (n=70235) and lowest rates in 60-69 years (52.3%, n=61121) and in 70-79 years (52.3%, n=32397). Hypervitaminosis D were consisting of 5.5% of adult subjects. highest rates of hypervitaminosis D were observed in over 80 years (6.6%) and 70-79 years (6.5%), and the lowest in 18-29 years (2.8%). Deficiency rates were 55.4% (n=131468) in men and 59.2% (n=277384) in women. Higher deficiency rates were observed in January (67.9%), February (71.6%), and March (66.7%). Conclusion: In this cohort, over half of the subjects admitted to the tertiary care hospitals in Turkey had vitamin D deficiency, required vitamin D supplementation. The elderly population had the lowest prevalence of vitamin D insufficiency and the highest prevalence of hypervitaminosis D. That may indicate overtreatment of vitamin D supplementation in the elderly group.

The Black Sea is a unique environment having a thin layer of oxic-zone above and anoxic-zone below. Seasonal, vertical, and horizontal microbial assemblages were studied in terms of diversity, abundance, community structure using NGS of the 16S rRNA gene. Total of 750 bacteria and three archaea species from 25 different phyla were identified. The number of species richness increased from the surface to deeper zones. Although microbial community compositions between sampling stations were similar, microbial community compositions were significantly different vertically between zones. Community compositions of the seawater and sediment were also significantly different. Community composition at 5 meters in summer was significantly different from other seasons, while remaining depths appeared similar. Species of Archaea (Methanomassiliicoccus luminyensis, Nitrosopumilus oxyclinae, N. ureiphilus), nitrite-oxidizing, sulfate-reducing, thiosulfate reducing, Iron-reducing, Fe-Mn reducing and electricity-producing bacteria were reported for the first time in the Black Sea. Proteobacteria dominated all the sampling depths. Proteobacteria, Cyanobacteria, Bacteroidetes, and Verrucomicrobia were present in the whole water column, while Nitrospinae, Chloroflexi, and Kiritimatiellaeota were restricted, appearing abundant at 75 meters and deeper layers. Vertical microbial community composition variation is attributable to environmental factors and their adaptations to the various ecological niches.

Objective: To evaluate the efficacy of TruScreen (TS) detecting cervical intraepithelial neoplasia (CIN) in cytology of atypical squamous cells (ASC) and low-grade squamous intraepithelial lesion (LSIL) women during COVID-19 post-pandemic. Design: Prospective, single-center study. Setting: Changsha, China. Population: ASC and LSIL women from December 2020 to May 2021. Methods: Participants underwent TS, colposcopy examination and biopsy in turn. Diagnostic value of TS, high-risk human papillomavirus (hrHPV) and TS combined with hrHPV were compared. Differences of TS regarding cervical transformation zone (TZ) type and menopause, correlations between TS and p16, Ki-67 were assessed. Main outcome measures: Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under curve (AUC) for diagnostic value. Spearman coefficient for correlation. Results: A total of 483 patients were enrolled. Specificity of TS detecting CIN1+, CIN2+, CIN3+ were 77.1% (95% CI, 70.4%-82.7%), 66.7% (95% CI, 61.5%-71.5%), 62.7% (95% CI, 57.8%-67.4%) and all were significantly higher than hrHPV test (P<0.001). TS had a high sensitivity (68.0% vs 52.0%, P>0.05) and significantly higher specificity (70.0% vs 48.5%, P<0.05) and NPV (89.6% vs 73.3%, P<0.05) in women with incomplete cervical TZ type (II and III) than TZ type I in detection of CIN2+. Conclusion: TS is an effective triage screening method for cervical cytology of ASC and LSIL women during COVID-19 post-pandemic, especially for incomplete cervical TZ type women. Funding: Supported by National Natural Science Foundation Project of China (81771546) and Hunan Science and Technology Innovation Project (2020SK53404). Keywords: TruScreen; Cervical cancer screening; Cervical transformation zone; CIN; COVID-19.

On 31 December 2019, pneumonia of unknown cause was detected in Wuhan, China, and was first reported to the WHO Country Office in China. On 30 January 2020, the outbreak was declared a Public Health Emergency of International Concern. (1) It was an outbreak of severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infection that occurred in Wuhan, Hubei Province, China and got spread across China and beyond. WHO officially named the disease - Corona virus Disease 2019 (COVID-19) on February 12, 2020. (2) It has been spreading worldwide for a period of atleast a year & half (3) This review article addresses the current scenario caused by the SARS- Co V along with the treatment protocols and ongoing vaccines.

Inflammatory bowel disease (IBD) is a serious illness that negatively affects the human health due to its chronic course and serious complications. Glucagon like peptide (GLP-1) and its degradation enzyme inhibitor; dipeptidyl peptidase (DPP)-IV inhibitor, are used primarily as anti-diabetic drugs in patients with type 2 diabetes mellitus. However, current evidence suggests that both; GLP-1 (e.g. liraglutide) and the DPP-IV inhibitor (e.g. sitagliptin) may have a potential anti-inflammatory effect on various organ systems. This study was aimed to evaluate the potential of liraglutide and sitagliptin to improve colitis induced experimentally in mice using intra-rectal acetic acid, in comparison with sulfasalazine. Intra-rectal acetic acid was used to induce colitis in mice. The degree of inflammation was assessed using disease activity index, histopathological scoring, colonic length measurement as well as the colonic tissue expression of: the transcription factor; nuclear factor kappa B (NFκB), tumor necrosis factor alpha (TNFα), the oxidative stress marker; malondialdehyde and the inflammatory parameter; C-reactive protein. Moreover, random blood glucose was measured to ensure the safety of the tested drugs. Our results showed the positive impact of both liraglutide and sitagliptin on the assessed inflammatory parameters and their tolerability compared with sulfasalazine. Further clinical studies are needed to investigate the possibility to consider GLP axis as therapeutic adjuvants for IBD in the future.

This article briefly reviews ocean and seas as huge and novel biomedical resources for anti-infection, which includes tuberculosis, H. Pylori, and HIV infection as well as SARS-CoV-2, and as promising biomedical resources for infection-induced major non-communicable diseases (mNCDs), such as cardiovascular disease, diabetes, and cancer. These marine natural products (MNPs) and organisms include sea cucumbers, sea snake, sponge, marine algae and microalgae, etc. As key biomedical resources for the discovery of marine drugs, bioactive molecules, and agents for treatment of infectious diseases and mNCDs, MNPs have bioactive potentials of antioxidant, anti-infection, anti-inflammatory, anticoagulant, anti-diabetic effects, and cancer treatment. In addition, their anti-inflammatory mechanisms for infectious diseases are also involved. It’s time to protect ocean ecosystem for human better sustainable development in the new era of ocean economy.

CCR4-NOT transcription complex, subunit 7(CNOT7) serving as the predominant deadenylase in all eukaryotes, has great function in regulating transcription and mRNA degradation, and it has been shown to correlate with poor prognosis in the tissues of Hepatocellular carcinoma. Silencing the CNOT7 gene can up-regulate the expression of the subset of STAT1 regulatory genes with its downstream chemokine IP-10 through enhancing the occupation of the basic promoter of STAT1 .In peripheral blood circulation, the immune cells γδT could be induced to migrate to the specific areas through the chemokine receptor CXCR3 which presents in γδT , bind with the chemokine IP-10.Based on this basic , we hypothesize that silencing the CNOT7 gene in HCC cells could induce the directional homing of immune cells γδT to cancer tissues to exert an anti-tumor effect through up-regulating the expression of local STAT1 and IP-10. To verify the hypothesis, we designed an experiment about the CNOT7 gene silenced in HepG2 cell line in vitro, and then we analyzed the expression of STAT1, IP-10, and the expression of CXCR3 in γδT cells after being amplified. Besides, we also analyzed the effect of the expression product of STAT1, pSTAT1, IP-10 and CXCR3 on γδT chemotactic ability. In conclusion, our results suggest that the expression of IP-10 and chemotaxis of γδT cells could be up-regulated by silencing CNOT7 of HepG2 cells in vitro.

Objective: Patient-centered care prioritizes individual values, beliefs, and needs. Neglecting aspects of patients’ needs often exacerbates existing disparities. Patients want their spiritual needs addressed and discussed with the healthcare team, but providers feel unprepared to do so. While most patients want chaplaincy care, very few receive it, and little is known about the factors that contribute to its use. Thus, we aim to identify what population characteristics are associated with the utilization of chaplaincy services. Data Sources: Electronic medical record (EMR) data matched with Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey data for hospitalizations from March 2012 to July 2017. Design: With a retrospective, cross-sectional analysis, hospitalizations for one midwestern acute care hospital, were examined for use of spiritual care services. The dependent variable examined was the amount of chaplaincy care received. The study used variables categorized as predisposing (age, sex, race, ethnicity, language, religious affiliation), enabling (education), and need (self-reported health, self-reported mental health, primary diagnosis, length of stay). Analysis controlled for emergency department admission and date of hospitalization. Data Collection: For each hospitalization, data from the EMR and HCAHPS data were merged; analysis retained the first hospitalization for each individual. Results: Bivariate analyses identified associations between the receipt of chaplaincy care, predisposing variables, and need variables. Bivariate analyses also yielded associations between the amount of chaplaincy care and the same variables. Multivariate analysis utilized a hurdle model that identified the consistent association between need variables and receipt/use of chaplaincy care. Conclusions: Regardless of predisposing or enabling characteristics, those with the most acute health needs were more likely to receive chaplaincy care and received more total care. Patient-centered models focused on whole person care may need to evaluate strategic integration of spiritual care and screening for spiritual needs beyond acute care responses.

Objective:To analyze the clinical characteristics of CRP, LDH, ESR, D-Dimer, Neutrophils (%), Lymphocytes (%) and lung consolidation in refractory Mycoplasma pneumoniae pneumonia (RMPP), and explore their prediction results for RMPP. Methods：Systematic search was conducted in PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wangfang and Cqvip, and the date was set until February 23, 2021. For the continuous variables, Weighted Mean Difference (WMD) with 95% CI or Standard Mean Difference (SMD) with 95% CI was adopted to evaluate CRP, LDH, ESR, D-Dimer, Neutrophils (%), Lymphocytes (%) and the correlation between lung consolidation and RMPP. Results: 20 studies including 5289 patients were included in the analysis, and the results showed: the CRP of the RMPP group [WMD (95%CI): 17.529 (10.514, 24.544), P＜0.001], LDH [WMD (95%CI): 114.884 (51.435, 178.333), P＜0.001], Neutrophils (%) [WMD (95%CI): 17.271 (0.309, 14.233), P=0.041], Neutrophils (×109/L) [WMD (95%CI): 1.249 (0.307, 2.191), P=0.009] was higher than that of the NRMPP group; the risk of lung consolidation in the RMPP group [OR(95%CI): 14.286 (4.523, 45.120), P＜0.001] was higher than that in the NRMPP group; and there was no difference in ESR [WMD (95%CI): 8.111 (-1.339, 17.562), P=0.093], D-Dimer [SMD (95%CI): 0.920 (-0.247, 2.086) p=0.122], Lymphocytes (%) WMD (95%CI): -6.379 (-13.922, 1.163), P=0.097] between the two groups. Conclusions: The available evidence indicates that CRP, LDH, Neutrophils (%), Neutrophils (×109/L) and lung consolidation are risk factors for RMPP.

Disturbances can facilitate biological invasions, with the associated increase in resource availability being a proposed cause. Here, we experimentally test the effects of disturbance regime and resource abundance on invasion success. We invaded populations of the bacterium Pseudomonas fluorescens with two invader morphotypes in a factorial design containing five disturbance frequencies and three resource levels. As resident populations were altered by the treatments, we additionally tested their effect on invader success. Disturbance frequency and resource abundance interacted to affect the success of both invaders. For one, success was positively affected by disturbance under high resources but negatively under low. For the other, disturbance negatively affected success under high resource abundance but not under low or medium. Resident population changes did not alter invader success beyond direct treatment effects. Overall, how disturbance affects invasion success is dependent on community resource abundance, and this interaction acts differently on invaders with different life-histories.

Background: Tuberculosis (TB), a contagious disease caused by Mycobacterium tuberculosis (M. tuberculosis), remains a health problem worldwide and this infection has the highest mortality rate among bacterial infections. Current studies suggest that intranasal administration of new tuberculosis vaccines could enhance the immunogenicity of M. tuberculosis antigens. Hence, we aim to evaluate the protective efficacy and immunogenicity of HspX/EsxS fusion protein of M. tuberculosis along with ISCOMATRIX and PLUSCOM nano-adjuvants and MPLA through the intranasal administration in mice model. Methods: in present study, the recombinant fusion protein was expressed in Escherichia coli and purified and used to prepare different nanoparticle formulations in combination with ISCOMATRIX and PLUSCOM nano-adjuvants and MPLA. Mice were intranasally vaccinated with each formulation three times at an interval of 2 weeks. Three weeks after final vaccination, IFN-γ, IL-4. IL-17 and TGF-β concentration in supernatant of cultured splenocytes of vaccinated mice as well as serum titers of IgG1 and IgG2a and sIgA titers in nasal lavagewere determined. Results: According to obtained results, intranasally vaccinated mice with formulations containing ISCOMATRIX and PLUSCOM nano-adjuvants and MPLA could effectively induced IFN-γ and sIgA responses. Moreover, both HspX/EsxS/ISCOMATRIX/MPLA and HspX/EsxS/PLUSCOM/MPLA and their BCG booster formulation could strongly stimulate the immune system and enhance the immunogenicity of M. tuberculosis antigens. Conclusion: The results demonstrate the potential of HspX/EsxS-fused protein in combination with ISCOMATRIX, PLUSCOM and MPLA after nasal administration in enhancing immune response against of M. tuberculosis antigens. Both nanoparticles were good adjuvants in order to promote immunogenicity of TB fused antigen. so, nasal immunization with these formulations, could induce immune responses and considered as new TB vaccine or as BCG booster.

Introduction: Hepatit B virus (HBV) is one of the main causes of liver related morbidity and mortality in worldwide. This condition is also a significant healthcare problem in Turkey. Entecavir (ETV) and tenofovir (TDF) are potent nucleos(t)ide analogues (NAs) recommended for the treatment of chronic HBV (CHB) infection. As the data on this topic is limited, we aimed to study the association of NAs and nephrotoxicity in our CHB cohort. Method: Between the January 2011 and February 2016, there were 294 patients who had been treated with TDF (n=194) and ETV (n=100). Clinical and laboratory data such as demographics, serological markers for HBV, pathology scores and routine blood tests were recorded from the charts. Glomerular filtration rate (GFR) was calculated by using the Modification of Diet in Renal Disease (MDRD) method. Kidney function tests were assessed at baseline and follow-up visits. Results: There were 294 patients in the total group. The mean age was 32±11 years, 66% (n=194) of the group was male. The mean follow-up period was 66±18 months. Age and sex distributions and baseline assessments including liver function tests, creatinine, GFR, HBV DNA values and pathology scores (HAI and fibrosis) were similar between TDF (n=194) and ETV (n=100) groups. Creatinin and GFR assessed at the last visit were 0.81±0.01 g/dl and 102.94+19.78 ml/min for TDF and 0.81±0.013 g/dl and 104.65±19.05 ml/min for ETV. These values were not significant between the both treatment groups. In terms of nephrotoxicity, none of the patients had significant changes in terms of creatinine and GFR that may require dose adjustment. Conclusion: Herein we showed that the use of both drugs led to a decrease in GFR that was not clinically important in chronic hepatitis B patients with normal baseline renal tests and without co-morbidity. Key words: Entecavir, Tenofovir, GFR, Chronic hepatitis B