Background: Minimally invasive mitral valve surgery has been established as a routine procedure at our institution. In the present study, early and mid-term outcomes of patients who underwent minimally invasive mitral valve replacement (MIMVR), including redo-operations and elderly patients, during the 5-year post-surgery period were analyzed to review short-term morbidity and mortality, and mid-term results. Methods: Preoperative variables, intraoperative findings, and postoperative outcomes of MIMVR patients treated from January 2014 to November 2020 and prospectively stored in a database were reviewed. Survival and freedom from cerebrovascular events were evaluated using life tables and Kaplan-Meier analysis. Results: A total of 445 patients underwent minimally invasive mitral valve surgery during the study period, of whom 55 received mitral valve replacement (MVR), including 18 cases of redo-MVR and 10 elderly (≥80 years old) patients. Mean age at the time of surgery was 70.7±11.3 years. The number of patients who underwent conversion to a sternotomy was 0, while 30-day mortality was noted in one (2%). For all MIMVR cases, 1- and 5-year survival was 90.8±3.9 % and 76.5±7.1%, respectively. Furthermore, freedom from cerebrovascular events and anticoagulation-related complications was 94.3±3.2% and 84.2±6.3% at 1 and 5 years, respectively. In univariate analysis, independent predictors of hospital mortality and prolonged hospital stay included infectious endocarditis, while previous cardiac surgery and elderly status were not significant factors. Conclusions: MIMVR can be performed safely and effectively for redo-MVR and in elderly patients with very few perioperative complications. Early and mid-term outcomes in the present cohort were acceptable.

Neurodegenerative (ND) type of Central Nervous System (CNS) Langerhans Cell Histiocytosis (LCH) is a very rare disease. We report a case of a pregnant teenager found to have central diabetes insipidus and T2 FLAIR contrast-enhancing lesions on MRI brain. Extensive workup including brain biopsy showed inflammation and concern for LCH. Progressive neurological symptoms prompted the start of low-dose cytosine arabinoside chemotherapy. Her symptoms and serial MRI brain scans showed a complete tumor response to the chemotherapy. Off-therapy tumor recurrence prompted the use of MAPK (mitogen-activated protein kinase) pathway agent Trametinib with good response.

Cancer is still a major threat for human life, and the cancer immunotherapy can be more optimized to prolong life. However, the effect of immunotherapy is not encouraging. In order to achieve outstanding immune effect, it is necessary to strengthen antigens uptake of antigen presenting cells. Adjuvants were added to vaccines to achieve this purpose, which could be divided into two types: as an immunostimulatory molecule, the innate immunities of the body were triggered; or as a delivery carrier, and antigens were cross-delivery through the “cytoplasmic pathway” and released at a specific location. This paper reviewed the relevant research status of tumor vaccine immune adjuvants in recent years. Among the review, the function, combination strategies and derivatives of lipid A were discussed in detail. In addition, some suggestions on the existing problems and research direction of lipids as tumor vaccine adjuvants were put forward.

Abstract Aim: We aimed to contribute to literature by evaluating the effectiveness of the results of USG-assisted percutaneous release according to the stages of the disease in trigger finger treatment. Material and Method: 81 patients who were examined for trigger finger disease between 2015-2017 were included in the study. USG-assisted percutaneous release was performed on 52 fingers of 52 patients who met the inclusion criteria. According to Quinkel staging, those with grade 1 and 2 were grouped as group 1, and those with grade 3 and 4 were grouped as group 2. After the intervention, our patients were recorded by measuring their visual pain score (VAS) on the 7th day, 1st month and 6th month control and the time to return to work. Results: Thirty-two (61.5%) of the patients were female, 20 (38.5%) were male. In the analysis performed by taking 1st and 2nd grade (group1) and 3rd and 4th grade (group 2) together, it was determined that there was a significant relationship between grade and VAS scores. It was seen that this relationship was effective on all 4 VAS scores. It was determined that the mean of all 4 VAS scores in the second group was statistically significantly higher than the first group (p <0.001). In the comparison of the time to return to work according to grade, it was determined that group 1 could return to work earlier than group 2 (1.67 ± 0.77 and 2.09 ± 0.83, respectively), but this difference was not statistically significant. Conclusion: We think that the percutaneous release procedure, which is performed carefully after the location of the lesion has been precisely determined and marked by USG, is a method that can be preferred especially in the early stages of the disease.

Cervical cancer is a serious health problem in women around the globe, with 600 thousand new cases each year. However, the use of clinical drug is seriously dampened by the development of drug resistance, which has been evidenced to be associated with metabolic reprogramming and heterogeneity in tumor cells. Efficient in vitro tumor model is essential to improve the efficiency of drug screening and the accuracy of clinical application. Multicellular tumor spheroids (MTSs) can in a way recapitulates tumor traits in vivo, thereby representing a powerful transitional model between 2D monolayer culture and xenograft. In this study, based on the liquid overlay method, a protocol for rapid generation of the MTSs with uniform size and high reproducibility in a high-throughput manner was established. As expected, the cytotoxicity results showed that there was enhanced 5-FU resistance of HeLa carcinoma cells in 3D MTSs than 2D monolayer culture with a resistance index of 5.72. In the presence of both glucose and glutamine, HeLa carcinoma cells preferentially used glutamine as a bioenergetic substrate to support cell proliferation and maintenance under all conditions, while the ubiquitous by-product ammonium might be only recycled in the 3D MTSs. Furthermore, in order to obtain a holistic view of the molecular mechanisms that drive 5-FU resistance in 3D HeLa carcinoma cells, a multi-omics study was applied to discover hidden biological regularities. We found that in the 3D MTSs mitochondrial function-related proteins and the metabolites of the tricarboxylic acid cycle (TCA cycle) were significantly decreased, and the cellular metabolism was shifted towards glycolysis. The differences in the protein synthesis, processing, and transportation between 2D monolayer cultures and 3D MTSs was significant, mainly in the heat shock protein family, with the upregulation of protein folding function in endoplasmic reticulum (ER) which promoted the maintenance of ER homeostasis in the 3D MTSs. In addition, at the transcript and protein level, the expression of extracellular matrix (ECM) proteins (e.g., laminin and collagen) were up-regulated in the 3D MTSs, which enhanced the physical barrier of drug penetration. Summarizing, this study formulates a rapid, scalable and reproducible in vitro model of MTS for drug screening purposes, and the findings establish a critical role of glycolytic metabolism, ER hemostasis and ECM proteins expression profiling in tumor chemoresistance of HeLa carcinoma cells towards 5-FU.

Fluid shear stress (FSS) has been acknowledged as an important cue in cancer development and growth. Cancer cell stemness is known to change with FSS signal. However it is not clear how the stemness changes with different orders of FSS magnitude. HeLa cancer cell proliferation, intracellular reactive oxygen species and stemness were analysed with different assays like flow cytometer analysis, RT-pcr, immunocytochemistry etc. in a logarithmic microfluidic device with wide physiological FSS. Less number of cells in G0/G1 phase was detected after FSS treatment, indicating enhanced cell proliferation or S/G2/M phase arrest. EdU staining revealed medium to low FSS increased cell proliferation whereas high shear reduced it. FSS also increased capability to withstand higher intracellular ROS and mitochondrial membrane potential in HeLa. We could see increment in stemness characteristics of cancer cells in magnitude dependent manner through gene expression (Sox2, N-cadherin, Vimentin), cell surface markers (CD44, CD33, CD117) and colony forming ability analysis. This increment trend was also found in drug resistance capability of HeLa to doxorubicin after FSS treatment. These data indicates increase in stemness and drug resistance characteristics of cancer cells with FSS magnitude which is experienced during metastasis and in native tissues.

Background: The aim of the present study was to investigate the association between diastolic global longitudinal strain (GLS) rateand mortality, re-hospitalization as well as hospitalization period in heart failure (HF) patients. Methods:Clinical, laboratory and echocardiographic parameters within the first 24 hours for 116 patients with ejection fraction (EF) ≤ 40% and Class 3 to Class 4 symptoms of New York Heart Association who were hospitalized in the cardiology clinic of our hospital were reviewed.Fiftyeight individuals without any diagnosis for cardiac failure were included as the control group. Echocardiographic measurements, tissue Doppler and diastolicstrain rate (SR) were reviewed. The N-terminal pro-brainnatriuretic peptide (ProBNP)level was analysed in addition to standard biochemical and hematological parameters. Results: The diastolic E strain rate and E/E’SR was statistically significant in patients with mortality within one month (p<0.05). These two parameters were statistically significant also in patients with one-month mortality (p <0.005).When looked under the guidance of these findings, E strain rate and E / E ’SR are a predictive parameter for one month mortality in HF patients. Conclusion: The E strain rate and E/E’SR are superior parameters than other tissue doppler parameters to predict the prognosis and the mortality in patients with heart failure. E/E’SR is a superior indicator for diastolic function of thre left ventricle when compared to other tissue doppler parameters.

To this day, no technical procedures have been established for the evaluation of aquaculture pond water quality based on the health of the farmed species themselves. Here, grass carp (Ctenopharyngodon idella; i.e., the main farmed fish species in China’s freshwater ponds) aquaculture was taken as an example to preliminarily study and establish novel strategies for the assessment of pond water quality. This manuscript discusses the selection and establishment of an evaluation index system, including classification of fish health degree, determination of evaluation benchmarks and presentation of evaluation results. The scoring formula were performed by Membership Function method based on fuzzy mathematics and scoring results were demonstrated by radar chart. This study finally selected a total of 6 indicators for pond health evaluation: (1) dissolved oxygen concentration, (2) non-ionic ammonia concentration, (3) pH, (4) nitrite nitrogen concentration, (5)copper ion concentration, and (6)zinc ion concentration. Through a case study on a fish pond in Songjiang District (Shanghai, China), we demonstrated the practicality of the proposed evaluation system, thus establishing a methodological framework for grass carp farmers to quickly evaluate the fish health and water quality, as well as for the future development of evaluation systems for other cultivated animals.

A weed population survey was carried out to assess the influence of the coffee production system, altitude gradients and physicochemical characteristics of the soil on weed species composition and distribution in the major coffee-growing belt of Ethiopia. A total of 168 coffee fields were assessed using a quadrat count (0.5 m x 0.5 m) in a systematic sampling technique. The result revealed that a total of 98 weed taxa belonging to 35 families were recorded. Asteraceae and Poaceae were the most abundant families. The most frequent weed species, regardless of the production systems, altitude and soil types, were Oplismenus hirtellus, Galinsoga parviflora, Achyranthes bidentata, Impatiens balfourii, Bidens pilosa and Commelina benghalensis, with a frequency of > 40%. The density of weed species was varied (ranged from 0.04 to 95.29 plants 0.25m-2) and the highest abundance value (95.25 plants per 0.25m2) was recorded by O. hirtellus. Similarity indices of the 16 districts were ranging from 8.33% to 72.73% and that of the 4 coffee production systems and 3 altitudinal gradients were also ranged from 7.14% to 49.49% and 41.76% to 68.75%, respectively. According to canonical correspondence analysis (CCA) and the Kruskal-Wallis test, coffee production systems, altitude and physicochemical properties of soil were the main explanatory variables influencing weed species distribution and composition. Therefore, it is concluded that the measured variables significant account for variation in the composition and distribution of weed species in coffee fields of Ethiopia and coffee producers should take into account those variables to manage weeds of coffee.

Granulocytic sarcoma (GS) is a soft mass formed by immature myeloid cells invading extramedullary tissues and organs, which is common in myeloid leukemia. In this case, a two years and four months girl diagnosed with acute myeloid leukemia showed intracranial lesion with right occipital bone involvement on Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). Follow-up CT showed that the mass had disappeared after chemotherapy. As intracranial GS is difficult to diagnose accurately, early detection and treatment is vital for good prognosis. GS should be part of differential diagnosis when patients with acute myelogenous leukemia showed intracranial soft mass.

Objective: To study the association between the risk of severe maternal morbidity and adequacy of prenatal care in teenage pregnancies. Design: Population-based retrospective cohort study. Setting: National Health Insurance Service National Delivery Cohort in Korea Population: A total of 23,202 delivery cases including pregnant teenagers aged 13 to 19 years and gestational age ≥ 37 weeks between 2003 and 2018. Methods: We used a generalized estimating equation model with adjustment for all covariates to determine the adjusted relative risk (RR) associated with severe maternal morbidity. Main Outcome Measures: severe maternal morbidity, Kessner Adequacy of Prenatal Care Index Results: Severe maternal morbidity occurred in 723 (3.1%) of the 23,202 delivery cases investigated, over a 16-year period. The risk of severe maternal morbidity was 1.8-fold higher in teenagers with inadequate prenatal care (RR 1.81, 95% confidence interval [CI] 1.39– 2.37) and 1.6-fold higher in those with intermediate prenatal care (RR 1.59, 95% CI 1.33–1.87) than in those with adequate prenatal care. Synergistic effects of inadequate prenatal care and maternal comorbidity were observed on severe maternal morbidity. Conclusion: This study confirmed that inadequate prenatal care was associated with the risk of severe maternal morbidity among pregnant teenagers. Notably, maternal comorbidity and inadequate prenatal care produced synergistic effects on severe maternal morbidity. Therefore, public health policy makers should focus on the development and implementation of programs to ensure adequate prenatal care and support financial accessibility of healthcare to improve teenage mothers’ health.

Objective: The objective of this study was to evaluate the associations between antenatal corticosteroid (ACS) administration and neonatal outcomes in women with pre-gestational diabetes (PGDM) when administered prior to elective caesarean section (CS) after 36 weeks gestation. Design: Retrospective observational study. Setting: This study took place in two academic hospitals in Melbourne, Australia. Sample: All women with PGDM who gave birth by elective CS between 36+0 and 38+6 weeks’ gestation. Main Outcome Measures: Neonatal outcomes (neonatal respiratory distress requiring respiratory support for more than 60 minutes, admission to neonatal nursery, neonatal hypoglycaemia requiring parenteral treatment and neonatal sepsis) for exposed participants (those who received ACS within 7 days prior to birth) were compared to outcomes for nonexposed participants. Results: Of the 306 women identified, 65 (21.2%) were exposed to ACS and 241 (78.8%) were not. Although not statistically significant, infants born prior to 38+0 weeks who were exposed to ACS were less likely to require respiratory support or neonatal nursery admission compared to those who were not exposed, however, exposed infants born after 37+0 weeks were more likely to require parenteral treatment for neonatal hypoglycaemia. Conclusion: This study demonstrated potential clinically relevant beneficial and harmful effects of ACS in neonates of women with PGDM who are born by elective CS. While it is plausible that ACS could reduce neonatal respiratory morbidity in this population, further prospective studies evaluating the benefits and harms are required before recommending this practice.

Encephalopathy following Ifosfamide treatment is a well-described phenomenon that is commonly treated with Methylene Blue (MB). The course of encephalopathy and MB therapy has not been described in the literature as lasting longer than 30 days following treatment cessation. We present the case of an 11-year-old female with recurrent episodes of severe somnolence for five months following Ifosfamide-containing chemotherapy for her germ cell tumor. Administration of MB gave immediate but limited response. Our novel case continued to require treatment for 5 months following cessation of therapy. We hypothesize that a genetic component confers increased susceptibility to Ifosfamide-induced encephalopathy.

In this paper, we investigate a new structure of unit speed associated curves, such as spatial quaternionic and quaternionic osculating direction curves. For this, we assume that the vector fields 휒.%/ = 휐1.%/t.%/+ 휐2.%/n.%/+ 휐3.%/b.%/ where 휐2 1.%/+ 휐2 2.%/ = 1 for the spatial quaternionic curve and 휒.%/ = 휆1.%/æ.%/ + 휆2.%/휂.%/ + 휆3훽2.%/, where 휆2 1.%/+휆2 2.%/+휆2 3.%/ = 1 for the quaternionic curve 휙. Then, we give the relationship between (spatial) quaternionic (OD)-curves and Mannheim curve pair. Moreover, we examine in which cases the (spatial) quaternionic (OD)-curve can be helix or slant helix. Finally, we give the examples and draw the figures of curves in the examples.

The development of the interface tracking between two immiscible liquids is one of the most challenging problems in fluid dynamics. The simulation of the lubrication process, oil extraction, and the physicochemical mechanism that govern the behavior of the uncertain conduct of interface is a key element in “gas-oil” or “oil-water” natural gas-oil reservoirs systems and should be tracked for optimal recovery. Motivated by the interface evolution process, in this article, an unsteady flow of two immiscible Eringen micropolar and Dusty(fluid-particle suspension) fluids is considered through a horizontal channel. The Analysis of the interface between two immiscible Eringen micropolar and Dusty(fluid-particle suspension) fluids are carried out. Although the channel wall is hyper-stick and no-slip, it is believed that the fluid-fluid interface is unstable and can be also deformed from one location to another; thus, the single momentum equation is coupled for monitoring the interface profiles using the VOF(Volume of fluid) technique. The modeled coupled- partial differential equations are numerically solved by the modified B-spline differential quadrature method. The interface profile under the influence of different parameters, i.e. Froude, Capillary, wave and Reynolds number, volume fraction function, the ratio of viscosities, densities, and time is analyzed through the graph. It is noticed that initially, the vertical elongation of the interface is large, and then the shape of the interface (topology) evolves with time; hence the undulating sequence occurs faster for a more considerable time and eventually becomes stable. The qualitative characteristics of this flow are sustained.

Shallow gene genealogies have been reported in some Pacific salmon populations. Many salmon runs have been supplemented with commercial hatchery production, which may lead to the distortion of genealogies. We show that, while the genealogical tree in a naturally-reproducing population is the standard Kingman coalescent, the trees in populations supplemented by hatcheries are coalescents with multiple mergers of ancestral lineages (i.e. Λ- or Ξ-coalescents). This distortion indicates that allele-frequency changes occur in jumps, reflecting the reproductive dominance of few lineages. Our focus is to understand among-individual variation of reproductive success within salmon populations under hatchery stocking. Under high reproductive-variance conditions, we compute the distribution of heterozygosity across generations. The result shows that zero heterozygosity is not achieved, implying that salmon populations under hatchery stocking may decline without evident loss of genetic variation. We also point out that reproductive skew leads to shifting of peaks (singularities) of the heterozygosity distribution. By looking for peak shifts across many loci, one can distinguish the multiple-merger from the Kingman coalescent (which is applicable to other species as well).

Introduction: Aim is to investigate in parallel changes in electrogustometric thresholds and in morphology of the fungiform papillae as well as in shape and density of the vessels of the tip of the tongue in patients with head and neck malignancy before and after treated with radiochemotherapy. We have also studied whether the observed changes in function and morphology may be reversible. Materials and Methods: Eighteen patients with tonsil-cancer treated with radiochemotherapy were prospectively studied. Measurements took place before starting treatment and at the end of each cycle of chemotherapy. Additional measurements were conducted two and four months after the end of the therapy. Results: All patients showed alterations in form and vascularization of fungiform Papillae (fPap). After the end of therapy an improvement in the EGM-thresholds without immediate improvement in the shape and vascularization of fungiform papillae was found. Two months after the end of the therapy a minimally significant difference in the EGM-thresholds measured on the tip of the tongue was shown. By the second measurement we have noticed a little improvement of the EGM-threshold, accompanied only by an improvement in the vascularization of fPap. Conclusions: The improvement in taste acquity was not directly accompanied by changes in vascularization of papillae and shape. The last parameters seem to recover late in time.

As the state of biodiversity worsens, the dynamics of species interactions is a growing conservation concern. However, estimating and monitoring species interactions across large spatial and temporal scales remain challenging. Here, we assess changes in the number and type of pairwise associations using large-scale spatial and temporal data on the French avifauna. We estimate species associations through space and time for 109 species monitored across 1,969 sites during 17 years, and we show their ecological significance by testing their relationships with species functional proximity or shared habitat preference. We finally track temporal changes in reconstructed association networks. We show that birds' local association networks were less and less connected through the study period. This decrease in network connectance does not similarly affect the different types of species associations. Overall, we show that large-scale temporal monitoring of species association networks can reveal overlooked consequences on how communities can cope with global change.

Species extinction risk at local scales can be partially offset by strategies promoting in-situ persistence. We explored how persistence-related traits of clonal and non-clonal plants in temperate dry grasslands respond intra- and interspecifically to variation in environmental conditions (soil, climate) and insularity. We focused on edaphic island specialist species, hypothesizing that plants experiencing harsh soil environments and strong insularity are distinguished by traits supporting enhanced persistence, such as small stature, long lifespan and resource-conservative strategies. We found general support for this hypothesis. Soil properties and insularity emerged as the most important drivers of trait patterns. However, clonal species showed more consistent responses to variation in environmental conditions and insularity than non-clonal plants, which were characterized by distinct species-specific responses. We call for a broader inclusion of persistence-related traits in plant ecology and biogeography; this may provide key insights for predicting species extinction risk in changing and insular environments.

Abstract: Objective: 1. To determine the prevalence of pre malignant cervical lesions in HIV positive women using conventional Pap smear. 2. To determine the association between various risk factors in HIV positive women and abnormal cytology on Pap smear. Design: A cross-sectional study was conducted in Bangalore Medical College in which eligible HIV positive women underwent Pap smear, human papillomavirus (HPV) testing and cervical biopsy. Methods: Retropositive women attending gynaec OPD during the study period were taken into the study after taking informed consent. Women who fulfilled the inclusion criteria were subjected to Pap smear. Bethesda system of classification was used for reporting the Pap smear. Women with abnormal Pap smear were further evaluated by HPV DNA testing and cervical biopsy. Results: Cervical cytology was abnormal in 30% of the HIV positive women, out of which 10% had HSIL, 15% had LSIL and 5% had ASCUS. Age at first sexual intercourse <17 years (p=0.009), past H/O STI (p=0.0001), women with husband’s having multiple sexual partners (p=0.0001), women with CD4 count < 350 cells/microlitre (p=0.0001) were significant risk factors associated with abnormal Pap Smear. Conclusion: Invasive cervical cancer is considered a preventable disease because of its long preinvasive state. Therefore, screening for pre malignant cervical lesions represents an opportunity to prevent women developing cervical carcinoma.

Background and Aims: The hyperdense middle cerebral artery sign (HMCAS) on admission non-contrast computed tomography (NCCT) is a well-characterized phenomenon in acute ischemic stroke. The purpose of this study is to determine the impact of HMCAS on the outcome of patients underwent endovascular thrombectomy Method: A retrospective analysis of the prospectively collective database included 136 consecutive patients with anterior circulation acute ischemic stroke who underwent endovascular thrombectomy. We collected the demographics, and clinical and brain imaging as well as functional and imaging outcomes data at baseline. Patients were divided into two groups with hyperdense artery signs and those without the sign. The difference between the two groups in terms of mortality and prognosis was analyzed. Results: There were 136 patients, 50.7 % of them were women. The mean age was 59.1 years. The subgroup with HMCAS present consisted of 93 patients. There were no differences in demographics and clinical characteristics between the two groups, however, tobacco use is more common in patients with HMCAS. No significant difference was observed in clinical outcomes and mortality between the two groups at 3 months. Patients with HMCAS had statistically more new territory emboli during the procedure (9.7%) compared to patients without HMCAS. Conclusion: We showed that the presence of HMCAS in initial CT was not helpful in predicting good clinical outcomes in patients undergoing endovascular therapy patients. However, the presence of HMCAS is related to more new territory embolism during the procedure. Different endovascular strategies may be applied in these patients.

Objective: Persistence of a fetal thickened Nuchal translucency (NT), one of the most sensitive and specific individual markers of fetal disorders, is strongly correlated with the possibility of a genetic syndrome, congenital infections or other malformations. Thickened NT can also be found in normal pregnancies. Several of its pathophysiological aspects still remain unexplained. Metabolomics could offer a fresh opportunity to explore maternal-foetal metabolism in an effort to explain its physiological and pathological mechanisms. Design: A population-based prospective cohort study (2020-2021). Setting: Cagliari, Italy. Population and Methods: Thirty-nine samples of amniotic fluids were collected from women who underwent amniocentesis due to an increased risk of aneuploidy, divisible into 12 foetuses with an enlarged nuchal translucency (>NT) and 27 controls (C). Samples were analyzed using a Gas Chromatography Mass Spectrometry platform. Subsequently, multivariate and univariate statistical analyses and Receiver Operator Curves (ROC) were performed to find a specific metabolic pattern of >NT class. Results: The supervised model analysis showed robust statistical parameters (R2X=0.2, R2Y=0.76, Q2=0.4, p<0.002). The correlation between the complete metabolic profile and clinical parameters were evaluated (NT showed an R2=0.75, p=0.002, foetal crown-rump length showed R2=0.65, p=0.002, pregnancy Associated Plasma Protein-A showed R2=0.60). Nine metabolites significantly differing between >NT foetuses and C were detected: 2-hydroxybutyric acid, 3-hydroxybutyric, 1,5 Anydro-Sorbitol, cholesterol, erythronic acid, fructose, malic acid, threitol and threonine which were linked to altered pathways involved in altered energetic pathways. Conclusion: Through the metabolomics approach it was possible to identified a specific metabolic fingerprint of the fetuses with >NT.

Background: Platelet transfusion is a common method to prevent hemorrhage in hematological pediatric patients. There is a shortage of platelet resources in many district of China. Small-dose platelet transfusion may be an effective measure to solve these problems. Methods: A retrospective analysis of platelet transfusion in 96 hematological pediatric patients with thrombocytopenia. According to the actual platelet dosage transfused, we divided the cases into two groups: low-dose platelet transfusion group (<3.0×10^11 platelet/m2, LDC, n=109) and high-dose platelet transfusion group (≥3.0×10^11 platelet/m2, HDC, n=90). To evaluate the effect of platelet transfusion, we assessed the post-transfusion platelet increment (PPI) values, changes of hemoglobin after platelet transfusion and calculated the corrected count increment (CCI) at 24h after transfusion between the two groups. We also recorded adverse reactions during transfusion. Results: Through statistical analysis, we found that there was no statistical difference in the 24h CCI value, hemoglobin change value and the effective rate of platelet transfusion between LDC and HDC groups. There was no adverse reaction in the LDC group, but 1 adverse reaction case in the HDC group. Conclusion: Low dose platelet transfusion is effective in pediatric patients with thrombocytopenia.

The Rohingya refugee population in Bangladesh has become more vulnerable to COVID-19 because of their living and environmental conditions. The current study represents an assessment of the Rohingya people’s COVID-19-related knowledge, attitude, and practices (KAP) at eight refugee camps in Cox’s Bazar. This cross-sectional study was completed with a total of 400 responses between July and September of 2020. A questionnaire was created to assess demographic characteristics (5 items), knowledge (10 items), attitude (5 items), practices (5 items), and information sources (1 item). Aside from the total KAP scores, the scores are also presented based on demographic variables. The KAP of the respondents were not satisfactory, with scores of 5.8 ±1.8, 2.2 ± 1.0, and 0.9 ± 0.7, respectively. We found significant differences only in the knowledge scores based on education and gender. In conclusion, this study emphasizes the importance of COVID-19 training that focuses on behavioral changes for the Rohingya people in Bangladesh.