BACKGROUND AND PURPOSE Delayed rectifier K+ current (IKs) is a key contributor to repolarization of action potentials. This study investigated the mechanisms underlying the adrenoceptor-induced potentiation of IKs in pulmonary vein cardiomyocytes (PVC). EXPERIMENTAL APPROACH PVC were isolated from guinea pig pulmonary vein. The action potentials and IKs current were recorded using perforated and conventional whole-cell patch-clamp techniques. The expression of IKs was examined using immunocytochemistry and Western blotting. KEY RESULTS The IKs current in PVC was markedly enhanced by both β1- and β2-adrenoceptor stimulation with negative voltage shift in the current activation, although the potentiation was more effectively induced by β2-adrenoceptor stimulation than β1-adrenoceptor stimulation. Both β-adrenoceptor-mediated increases in IKs were attenuated by treatment with the adenylyl cyclase (AC) inhibitor or protein kinase A (PKA) inhibitor. Furthermore, the IKs current was increased by α1-adrenoceptor agonist but attenuated by the protein kinase C (PKC) inhibitor. PVC exhibited action potentials in normal Tyrode solution which was slightly reduced by HMR-1556 a selective IKs blocker. However, HMR-1556 markedly reduced the β-adrenoceptor-potentiated firing rate. KCNQ1, a IKs pore-forming protein was detected as a signal band approximately 65 kDa in size, and its immunofluorescence signal was found to be mainly localized on the cell membrane. CONCLUSIONS AND IMPLICATIONS The stimulatory effects of β- and α1-adrenoceptor on IKs in PVC are mediated via the PKA and PKC signal pathways. HMR-1556 effectively reduced the firing rate under β-adrenoceptor activation, suggesting that the functional role of IKs might increase during sympathetic excitation under in vivo conditions.

In this note we present a study of the solutions associated to a particular spatial extension of the Rosenzweig-MacArthur model for predator and prey. The analysis presented here shows that positive steady state solutions emerge via a transcritical bifurcation mechanism, in accordance with the insight obtained from previous numerical and analytical results. In the model under discussion, prey is assumed to move avoiding crowds via a density-dependent diffusion and also incorporates the existence of a refuge zone, where predators cannot consume prey. Saturation in prey consumption is also included through a Holling type II functional response.

Bicuspid aortic valve is the most common congenital anomaly and is associated with the early onset of severe aortic stenosis by the fifth decade. Here, we present the echocardiographic images of a 17-year-old with bicuspid aortic valve who presented with symptomatic severe aortic stenosis with a very high mean transvalvular gradient of 134 mmHg

Background: About 300 childhood cancer cases are diagnosed annually at the Children Welfare Teaching Hospital (CWTH) in Baghdad, Iraq, and aproximately 32% are acute lymphoblastic leukemia (ALL). Procedure: We performed a retrospective single-center analysis of 1415 ALL children ranging from 1 to 15 years, diagnosed between January 2000 and December 2016. Patients were divided into three cohorts according to treatment period (2000-2005; 2006-2011; 2012-2016). Treatment protocols were based on three consecutive, modified and locally adapted pediatric UKALL protocols (-97, -2003, -2011); a 7-day steroid pre-phase was introduced for all patients from September 2008. Results: The overall complete remission (CR) rate was 86%. It progressively increased from 80% to 91% in the last study period. Early deaths occurred in 10% of children, decreasing from 12% to 6%, over time. Induction treatment abandonment rate was 3%. Relapse occurred in 23% of children. Toxic deaths and overall treatment abandonment in CR were 8% and 13%, respectively. Remission deaths remained unchanged, while abandonments decreased from 23% to 6% over time. At a median follow-up of 65.3 months, with abandonment considered as an event, the 5-year overall survival and event-free survival were 62.2% and 46.3%, and were statistically influenced by the treatment period. Conclusions: Though pediatric ALL survival in Iraq is still below that observed in high income countries, survival rates have progressively improved. Toxic deaths remain an important cause of failure. Pediatric oncologists fully dedicated to the improvement of patients’ care have significantly contributed to lower rates of early deaths, abandonment and treatment failures.

The excretory-secretory product (ESP) of Trichinella spiralis (T. spiralis) has antitumor activity. To explore the effect of ESP on liver cancer cells, tumor models were established with H22 cells and then infected with T. spiralis. The results showed that the growth of tumors in mice infected with T. spiralis was significantly inhibited. ESP from adult worms or muscle larvae were then incubated with H22 cells in vitro, and it was found that the ESP could inhibit cell proliferation and promote apoptosis. Subsequently, apoptosis-related proteins in stimulated H22 cells were evaluated, and ESP was found to induce cell apoptosis through the mitochondrial pathway. Additionally, Th-related cytokines were investigated in vivo, and the results showed that the levels of Th1 cytokines were significantly increased in the early stage of T. spiralis infection, while Th2 cytokines increased later than Th1 cytokines, implying that Th1 cytokines with antitumor effects may play a role in inhibiting tumor growth at early stage. In short, ESP can directly induce tumor cell apoptosis and indirectly inhibit tumor cell growth through the host immune system, which may be the antitumor mechanism of T. spiralis infection.

Background: Preeclampsia accounts for 10 to 15 % maternal deaths globally, corresponding to 50,000 annual maternal deaths. Twin pregnancy is a known risk factor for preeclampsia and it is also associated with increased adverse perinatal and maternal outcomes. Inadequate data exists regarding the clinical characteristics and perinatal outcomes of twin pregnancies with preeclampsia. Methods: A facility based case-control retrospective study was conducted; a structured questionnaire in English language with sections of socio-demographic data and obstetric characteristics was used to extract data from maternal charts and neonatal intensive care unit (NICU) registry book. Statistical test of association was done using Chi square for categorical data; strength of association with OR and 95% CI .Those variables with P-value of <0.2 on univariate analysis were entered into multivariable logistic regression analysis and adjusted OR was calculated Results: The frequency of preterm birth was 61.9% in the PE group which was statistically different from that observed in the normotensive ones (33.6%) at p-value of <0.0001. Delivery at gestational age less than 34 weeks was also significantly higher in the preeclampsia group (12.7 % Vs. 9% at p-value of 0.001). Conclusions: In this study, twin pregnancies complicated with PE was associated with significantly increased rate of preterm birth, including delivery less than 34 weeks. We recommend a further well-designed prospective analytic study

A document by Min-Min Chou. Click on the document to view its contents.

Background: Coronavirus disease 2019 (COVID-19) is a respiratory infectious disease caused by a new coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first reported in Wuhan, China at the end of 2019, and quickly developed into a global pandemic. By reviewing the clinical data of 1 patient with cryptococcus pneumoniae infection after recovered from COVID-19 and reviewing relevant literature, the following possible clinical consequences of COVID-19 were discussed and corresponding relevant management strategies were proposed. Case presentation: A 64-year-old female patient diagnosed with COVID-19 was cured and discharged. Follow-up laboratory tests showed that CD4+ cell count reduced and abnormal CD4+/CD8+ cell ratio, and a growing solid lesion was found on computed tomography (CT) scan after two mouths after discharge. Ineffective broad-spectrum antibiotics treatment and positive cryptococcal capsular polysaccharide antigen tests results indicating the suspicious invasive pulmonary fungal infection due to immunodeficiency. After anti-fungal treatment, the right lung lesion were significantly absorbed. Conclusion: After recovery from COVID-19, T cell count decline may occur, accompanied by host immune dysfunction. Clinicians should pay more attention to secondary infections caused by weakened immunity of COVID-19 patients after recovery, whom might be vigilant against opportunistic pathogens such as Cryptococcus. Key words: COVID-19, invasive fungal infection, Cryptococcus, lymphopenia.

Objective To investigate the etiology of complete hydatidiform mole coexistent with live fetus (CHMCF) following assisted reproductive technologies (ART). Design Retrospective study. Setting Peking University Third Hospital and tertiary reference. Population Total of 47 patients conceived via ART and diagnosed with CHMCF, including 5 cases from our hospital and 42 cases from literature. Methods Retrospective analysis of risk factors associated with neonatal outcome and the progression of gestational trophoblastic neoplasia (GTN). Main Outcome Measures Pregnancy complications. Results Vaginal bleeding presented as the most common complication (75%). The average gestational age confirming diagnosis by ultrasound was 15.9±4.7 weeks. 40.4% of the patients progressed to GTN. 41.5% of those who chose to continue pregnancy had a favorable fetal outcome. Hyperemesis gravidarum and abdominal pain had a 33.3% and 25% occurrence rate in not surviving baby group, respectively, but not presented in surviving baby group. Hypertension emerged in a significantly earlier gestational week in not surviving baby group than the other (17.0±2.4 vs 25.3±2.3, p=0.003) . Patients who progressed to GTN had a statistically higher rate of abdominal pain (26.3% vs 3.6%, p=0.033) compared to those who did not. Conclusions For CHMCF patients via ART, the surviving baby rate is 41.5% and the GTN progression rate is 40.4%, and appearance of hyperemesis gravidarum, abdominal pain and early emerge of hypertension predicted an adverse pregnancy outcome. Occurrence of abdominal pain and early presentation of vaginal bleeding indicated a poor prognosis in GTN progression.

Species traits and environmental conditions determine the existence and strength of trophic interactions, but how they do so is poorly understood. To enable the informed inclusion of such driving factors in dynamic trophic-interaction models, we revisit and expand the functional and numerical response functions using a modular approach which is readily integrated into existing models. We divide the trophic interaction between predator and prey into eight steps: (1) search, (2) prey detection, (3) attack decision, (4) pursuit, (5) subjugation, (6) ingestion, (7) digestion, and (8) nutrient allocation. Formulating this as a modular functional-response function, we build a general dynamical model where trophic interactions can be explicitly parameterized for multiple traits and environmental factors. We then concretize this approach by outlining how a specific community can be modeled by selecting key modules (steps) and parameterizing them for relevant factors. This we exemplify for a community of terrestrial arthropods using empirical data on body size and temperature responses. With species interactions at the core of community dynamics, our modular approach allows for quantification and comparisons of the importance of different steps, traits, and abiotic factors across ecosystems and trophic interaction types, and provides a powerful tool for trait-based prediction of food-web structure and dynamics.

We describe a female toddler with rectal bleeding from extensive colonic polyposis. She has epilepsy from infancy attributed to focal cortical dysplasia. Hepatoblastoma was diagnosed at 13 months of age. Germline testing detected a pathogenic APC (adenomatous polyposis coli gene) variant. We discuss the anecdotal management of an atypical, very early-onset symptomatic Familial adenomatous polyposis (FAP) case, and the clinical utility of genetic confirmation in such cases. We review the genotype-phenotype correlation of the APC mutational spectrum, and the existing evidence supporting the hypothesis that cortical dysplasia is part of the APC-related spectrum.

Optical coherence tomography (OCT) offers clinicians detailed in vivo structural imaging of individual retinal layers. This has lead to novel observations which were impossible by direct ophthalmoscopy. The technique also helps to re-introduce the concept of retinotopy to clinical practise. This review illustrates the anatomical foundation for retinotopy through detailed sketches of the pre- and post-laminar axons forming the optic nerve and their post-synaptic path from the dorsal lateral geniculate nucleus to the primary visual cortex in humans. With the mapped neuroanatomy in mind we use OCT-MRI pairs to discuss the patterns of neurodegeneration in eye and brain that are a consequence of the hard wired retinotopy: antero- and retrograde axonal degeneration which can, within the visual system, propagate trans-synaptically. The technical advances of OCT and MRI for the first time enable us to trace the signals of axonal degeneration through the visual system entirely at spectacular resolution. In addition to atrophic processes, we also summarize novel insights on tissue thickening mainly at the level of the optic disc, in particular peripaphillary hyperreflecitive ovoid mass like structures (PHOMS). In conclusion, the neuroanatomical insights provided by the combination of OCT and MRI allows us to separate incidental findings from sinister pathology and gives us new opportunities to tailor and monitor novel neuroprotective strategies.

Rationale, aims, and objectives: In Japan, many older people hope to receive end-of-life care at home. In such situations, team-based home medical care with the support of on-call physicians is needed. However, to date, necessary competencies for the on-call physicians have yet to be clarified. This article aims to reveal the competencies for on-call physicians in home medical care settings. Method: This was a qualitative study of semi-structured interviews concerning competencies for on-call physicians in home medical care. This study evaluated digitally recorded interviews with eight homecare professionals in seven homecare facilities (three clinics, one hospital, and three nursing agencies) in Tenri City, Japan. The transcribed data were analyzed by three researchers using theme analysis. Results: The core competencies were divided into the following six categories: clinical skills for frequent complaints, sharing patients’ information in advance, an attitude of humility, understanding purposes of homecare, understanding general roles of homecare nurses, and thoughtfulness toward patients and their families. Conclusion: This study revealed six competencies for on-call physicians, classified into technical or non-technical skills in home medical care. These competencies could contribute to developing effective learning for on-call physicians who support home medical care.

Although the majority of microalgal species reproduce asexually for large parts of the growth season, most population genetic studies have rarely found clones in microalgal blooms. Instead, population genetic studies have identified large intraspecific diversity in most microalgal species. This paradox of frequent asexual reproduction but low number of clones creates challenges when interpreting the proportion of clones and distinct genotypes in natural microalgal populations. To estimate the proportion of clones and genotype richness, we created a computer model that simulates the composition of microalgal populations after a defined period of exponential growth. We simulated the probability of picking clones of the same genotype from this population as a function of initial genotype diversity, intraspecific differences in growth rates and sample size. This model was applied to five microalgal species for which high-resolution population genetic data and population growth rates based on monitoring data were available. The number of distinct genotypes in each population was extrapolated from the model outputs and the observed proportion of clones in the respective population genetic studies. The estimates from our simulation suggested that the genotype richness in most blooms exceeds several thousand distinct genotypes with very high variability among microalgal species. The highest numbers of distinct genotypes (500,000 and 2,000,000 genotypes) were estimated for species with very low numbers of observed clones in population genetic studies (< 5%), but genotype richness was also strongly impacted by intraspecific variability in growth rates. Furthermore, the probability of finding clones and presumably sampling a representative fraction of genotypes increased significantly with higher sample sizes, challenging the detection of differences in genotype diversity between sub-samples with few isolates.

The alpine meadow ecosystem, as the main ecosystem of the Qinghai-Tibet Plateau, has been heavily degraded over the past several decades due to overgrazing and climate change. Although soil microorganisms play key roles in the stability and succession of grassland ecosystems, their response to grassland degradation has not been investigated at spatial scale. Here, we systematically analyzed the spatial turnover rates of soil prokaryotic and fungal communities in degraded and undegraded meadows through distance-decay relationship (DDR) and species area relationship (SAR), as well as the community assembly mechanisms behind. Although the composition and structure of both fungal and prokaryotic communities showed significant changes between undegraded and degraded meadows, the steeper spatial turnover rates were only observed in fungi. Mantel tests indicated that edaphic variables and vegetation factors showed significant correlations to the fungal community only in degraded meadow, suggesting soil and vegetation heterogeneity contributed to the steeper spatial scaling pattern. Correspondingly, a novel phylogenetic null model analysis (iCAMP) demonstrated that environmental selection was enhanced in the fungal community assembly process during meadow degradation. Interestingly, dispersal limitation was also enhanced for the fungal community in the degraded meadow, and its relative percentages showed a significant linear increase with the spatial distance, suggesting that dispersal limitation played a greater role as distance increased. Our findings indicated the spatial scaling of the fungal community is altered during meadow degradation by both niche selection and dispersal limitation. This study provides a new perspective for the assessment of soil microbial responses to vegetation changes in alpine areas.

Numerical simulations of laminar water-Al2O3 nanofluids flow phenomena and thermal behavior (velocity, normalized temperature profiles, poiseuille number, local and averageNusselt number and friction factor) through a rectangular micro-channel with two baffles have been studied with the variations of baffle height, volume fraction percentages and Re, which has a significant issue in engineering applications. The governing equations have been solved by SIMPLE algorithm and FLUENT software has been used to visualize the simulation results which demonstrate that variation. of volume fraction and baffle height resulted in a significant change in normalized temperature and velocity profiles along the center line.

Aim: During the initial wave of the COVID-19 pandemic, ENT UK published a clinical guide on surgical prioritisation which suggested that aural foreign bodies can be removed between one and three months from initial presentation. This case series aims to investigate the impact of leaving aural foreign bodies in situ for a prolonged period of time, including the risk of complications, success rates of subsequent removal attempts and whether foreign bodies can clear themselves without intervention. Method: Retrospective study of all aural foreign body referrals to the ENT emergency clinic over a 6-month period. Results: Thirty-four patients were identified. The duration of foreign bodies left in-situ ranged from 1 to 78 days. Four patients suffered from traumatic removal upon initial attempts, however there were no other significant complications. First attempts made by non-ENT specialists (68.8%) all failed and were associated with a high risk of trauma (36.4%). The chances of successful removal on second attempt (28.6%) reduced dramatically when compared to the first attempt (52.9%). Two patients had no foreign body visualised upon second attempt, suggesting it has cleared itself. A total of 7 patients (20.6%) required removal under general anaesthesia. Conclusions: Due to the unique circumstances of the COVID-19 pandemic, this is the first case series to look specifically at the relationship between duration of aural foreign bodies left in situ for over 30 days from presentation and the risk of complications. Our data suggests that prolonged duration did not increase the incidence of complications.

Objective: Otolaryngology is considered high risk for Coronavirus Disease 2019 (COVID-19) exposure and spread. This has led to a transition to telemedicine and directly impacts patient volume, evaluation and management practices. The objective of this study is to determine the impact of COVID-19 on patient characteristics in relation to outpatient attendance, ancillary testing, medical therapy, and surgical decision making. Methods: A retrospective case series at an academic medical center was performed. Outpatient appointments from October 2019 (pre-COVID) and March 16-April 10, 2020 (COVID) were analyzed. Prevalence rates and odds ratios were used to compare demographics, visit characteristics, ancillary tests, medication prescribing, and surgical decisions between telemedicine and in-person visits, before and during COVID. Results: There was a decrease in scheduled visits during the COVID timeframe, for both in-person and telemedicine visits, with a comparable proportion of no-shows. There was a higher overall percentage of Hispanic/Latino patients who received care during the COVID timeframe (OR = 1.43; 95% CI = 1.07-1.90) in both groups, although primary language was not significantly associated with attendance. There were fewer ancillary tests ordered (OR = 0.54) and more medications prescribed (OR = 1.59) during COVID telemedicine visits compared with pre-COVID in-person visits. Conclusion: COVID-19 has rapidly changed the use of telemedicine. Telemedicine can be used as a tool to reach patients with severe disease burden. Continued healthcare reform, expanded access to affordable care, and efficient use of resources is essential both during the current COVID-19 pandemic and beyond. Keywords: COVID-19, Coronavirus, Telemedicine, Otolaryngology, Quality-improvement, Healthcare access

Background: Asthma is heterogeneous but accessible biomarkers to distinguish relevant phenotypes remain lacking, particularly in non-Type 2 (T2)-high asthma. Moreover, common clinical characteristics in both T2-high and T2-low asthma (e.g. atopy, obesity, inhaled steroid use) may confound interpretation of putative biomarkers and of underlying biology. This study aimed to identify volatile organic compounds (VOCs) in exhaled breath that distinguish not only asthmatic and non-asthmatic subjects, but also atopic non-asthmatic controls and also by variables that reflect clinical differences among asthmatic adults. Methods: A total of 73 participants (30 asthma, 8 atopic non-asthma, and 35 non-asthma/non-atopic subjects) were recruited for this pilot study. A total of 79 breath samples were analyzed in real-time using automated portable GC developed in-house. GC-MS was also used to identify the VOCs in breath. Machine learning, linear discriminant analysis, and principal component analysis were used to identify the biomarkers. Results: The portable GC was able to complete breath analysis in 30 minutes. A total of 103 VOCs were identified across all samples. A set of 9 biomarkers distinguished asthma and non-asthma/non-atopic subjects, while sets of 2 and of 4 biomarkers, respectively, further distinguished asthmatic from atopic controls, and between atopic and non-atopic controls. Additional unique biomarkers were identified that discriminated subjects by blood eosinophil levels, obese status, inhaled corticosteroid treatment, and also acute upper respiratory illnesses within asthmatic groups. Conclusion: Breath VOC profiling is a clinically accessible tool for asthma diagnosis and phenotyping. A portable GC system is a viable option for rapid assessment in asthma.

Inclusion body hepatitis is a viral disease caused by Adenovirus group I, and it is worldwide in distribution. The virus is endemic in Sulaymaniyah city, Kurdistan Region of Iraq, and infections occurred in forty-six broiler farms from April 2013 to May 2020. Infected bird’s ages ranged between two days and four weeks. Clinically, birds showed lethargy, huddling with ruffled feathers, inappetence, and yellow, mucoid droppings. Gross lesions included enlarged mottled liver, pale icteric skin, swollen pale kidney, and hemorrhage on the skeletal muscle. Histopathological examinations revealed large intranuclear inclusion bodies in hepatocytes, degeneration and congestion of liver sinusoids, and degeneration of renal tubules, spermatozoa, spermatid, Sertoli cells, and Leydig cells in the testicle. There were intertubular hemorrhages and large vacuoles. The seminiferous tubular lumens were dilated, contained necrotic debris, and were devoid of spermatozoa in the interstitial tissue. Lesions in the testicle are reported for the first time in the present study. RT-PCR was used to detect the virus by amplification of partial 1300 bp hexon genes. The amplified fragments were confirmed by sequencing. Our results concluded that two different genotypes circulate in Kurdistan, and the nucleotide sequence of Kurdistan fowl adenovirus (FAdV) isolates show only 81% homology together. The FAdV/Kurdistan/2013 and FAdV/Kurdistan/2020 belonged to FAdV-E close to USA isolates. On the other hand, the FAdV/Kurdistan/2015 belonged to FAdV-D closer to the Chinese FAdV isolate.

Bacteria can adhere to cardiac endothelium damaged by regurgitation or shunt jet; however, healthy cardiac endothelium is supposedly resistant to bacterial adhesion. Bacterial vegetations are most common on cardiac valves, but are rarely observed at other sites. We report a case of a vegetation on the surface of left ventricular muscle/subvalvular tissue without regurgitation or shunt jet. Transthoracic echocardiography did not detect the vegetation because of its unique location; however, transesophageal echocardiography (TEE) did detect. In conclusion, vegetations can form without exposure to regurgitation or shunt jet, and TEE is highly sensitive for detecting the vegetation in unusual locations.

Porcine circovirosis is a disease of worldwide distribution caused by porcine circovirus type 2 (PCV2). The clinical forms include post-weaning multisystemic wasting syndrome, dermatitis syndrome and porcine nephropathy, and some reproductive disorders, which have been collectively named porcine circovirus-associated diseases (PCVAD). In Colombia, some studies have demonstrated the presence of PCV2 in different regions, reporting PCV2b as the main genotype. However, the genotype of PCV2 in the department of Tolima is unknown. The aim was to determine the presence of PCV2 in swine productions of the department of Tolima and to characterize the virus genotypically. Blood samples (n=100) were taken by jugular venipuncture from animals with clinical signs compatible with PCVAD from 4 municipalities in the department. DNA was extracted in order to detect PCV2 nucleotides by amplifying the ORF2 (cap gene), using the end-point PCR. Positive samples were sequenced and submitted to bioinformatic analysis for genotype identification, by comparison with reference sequences reported in GenBank. PCV2 positive animals (n= 15) were detected at different stages of production in all municipalities. The phylogenetic analysis showed that the viruses belong to the PCV2d genotype with a percentage of identity between 95,9-98,9%. This genotype has not been reported in the country. The present study demonstrated the presence of PCV2d in pig farms of the department of Tolima - Colombia related to PCVAD. In Colombia, more extensive studies are required to determine the presence of new genotypes and their epidemiological behavior.

Bio-photovoltaic devices (BPVs) harness photosynthetic organisms to produce bioelectricity in an eco-friendly way. However, their low energy efficiency is still a challenge. A comprehension of metabolic constraints can result in finding strategies for efficiency enhancement. This study presents a systemic approach based on metabolic modeling to design a regulatory defined medium, reducing the intracellular constraints in bioelectricity generation of Synechocystis sp. PCC6803 through the cellular metabolism alteration. The approach identified key reactions that played a critical role in improving electricity generation in Synechocystis sp. PCC6803 by comparing multiple optimal solutions of minimal and maximal NADH generation using two criteria. Regulatory compounds, which controlled the enzyme activity of the key reactions, were obtained from the BRENDA database. The selected compounds were subsequently added to the culture media, and their effect on bioelectricity generation was experimentally assessed. The power density curves for different culture media showed the BPV fed by Synechocystis sp. PCC6803 suspension in BG-11 supplemented with NH4Cl achieved the maximum power density of 148.27 mW m-2. This produced power density was more than 40.5-fold of what was obtained for the BPV fed with cyanobacterial suspension in BG-11. The effect of the activators on BPV performance was also evaluated by comparing their overpotential, maximum produced power density, and biofilm morphology under different conditions. These findings demonstrated the crucial role of cellular metabolism in improving bioelectricity generation in BPVs.

Background: A systematic review is an important evidence synthesis technique used to collate results from individual studies, such as treatments for proximal humerus fractures. Therefore it is necessary to minimize bias in systematic reviews, including financial COIs. Financial bias has been shown to result in unreliable assessments of credibility, which is why transparency with COI is essential for accurate assessments of research. Objective: The aim of this study was to characterize the influence of financial bias on the results and conclusions of systematic reviews of proximal humerus fracture treatments and to characterize the nature of disclosed and undisclosed COIs. Methods: Ovid MEDLINE and Ovid Embase databases were searched to locate systematic reviews covering proximal humerus fracture treatments. Following these searches, title and abstract screening was performed in a duplicate, masked fashion. Data from the final reviews were extracted in a triplicate manner. The data included: PubMed ID and/or DOI; journal; publication date; author names; affiliations; interventions; funding source; risk of bias assessment/statement; whether systematic review author(s) on any of the primary studies; the articles primary outcome; whether an overall pooled effect estimate was calculated; pooled effect estimate; type of pooled effect estimate/significance; the primary outcomes favorability of pooled effect estimate; and favorability of narrative results/conclusions. All authors of each systematic review were screened for non-disclosed COIs. Results: We found no relationship between authorial COI and the results and conclusions of the systematic reviews. Among the 17 included systematic reviews, 7 (41.2%) had at least one non-disclosed COI. Of the 7 reviews with a non-disclosed COI, 2 (28.6%) were found to have a high risk of bias. Conclusions: Findings from this study have limited generalizability due to our small sample size. More studies are needed to fully elucidate the effect of financial bias on the results and conclusions of systematic reviews.