Metal-organic frameworks (MOFs) have great potential for the capture of volatile iodine. The effect of a precise regulation of active sites in JLNU-4 (MOFs) on capture of iodine was investigated by Monte Carlo (MC) method and molecular dynamics (MD), and it was found that the larger the Zn/Cd atomic ratio, the better the iodine capture. Interestingly, compared with the meta-position regulation of Zn/Cd, the ortho-positions regulation increased the free volume of the crystal and enhanced the interaction between Cd and I, thus improving the capture capacity of iodine. The first-principles study revealed the charge transfer of each atom in the MOFs crystal with I2 during iodine capture and the secondary bonds with weak covalent interactions were all formed after I2 adsorption onto MOFs. These findings provide a reference for the capture of radioactive iodine and a theoretical basis for the strategies for precise regulation of MOFs in the future.

Bioprosthetic valves have risk of gradual valve degeneration and dysfunction in follow-up period. In this case report, we describe a 72-year-old man who suffered from severe transvalvular mitral valve regurgitation due to isolated rupture of the bioprosthetic mitral valve without significant degeneration, calcification and thickness. We would like to emphasize this rare prosthetic valve-related complication in a 10-year-old bioprosthetic valve.

Primary Natural killer (NK)/T-cell lymphoma, nasal type (ENKTL) involving the larynx is a distinct entity rarely reported in North Africa. Nasal ENKTL accompanied by secondary spread to the skin is rare. We describe an additional case in a 48-year-old woman with a laryngeal ENK/T-NT with secondary atypical cutaneous involvement.

Seminal plasma selenium concentrations, sperm mtDNAcn, and semen quality: Association and mediation analyses among healthy Chinese men Heng-Gui Chen, PhD1,2, Bin Sun, MBBS3, Fuxin Lin, MD2, Ying-Jun Chen, PhD3, Cheng-Liang Xiong, MD4,5, Tian-Qing Meng, MS4,5, Peng Duan, MD6, Carmen Messerlian, PhD7,8, Zhijian Hu, PhD1, An Pan, PhD3, Weimin Ye, PhD1*, and Yi-Xin Wang, PhD9,*1Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou 350108, Fujian Province, China2Clinical Research and Translation Center, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian Province, China3Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China4 Center of Reproductive Medicine, Wuhan Tongji Reproductive Medicine Hospital, Wuhan, Hubei Province, China5Hubei Province Human Sperm Bank, Wuhan, Hubei Province, China6Center for Reproductive Medicine, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, Hubei Province, China7Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA8Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA9Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA*Correspondence to: Yi-Xin Wang; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; Email: yixinwang@hsph.harvard.edu; Wemin Ye; Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian Province, China; Email: ywm@fjmu.edu.cn. Yi-Xin Wang and Wemin Ye jointly supervised this work.

A document by Becky Liu. Click on the document to view its contents.

Objectives: To investigate the cost-effectiveness of preimplantation genetic testing for aneuploidy (PGT-A) versus conventional technology in in vitro fertilization (IVF) from the perspective of the healthcare system in China. Design: Economic evaluation based on a large multi-center randomized trial (CESE-PGS study). Population: Infertile women with a good prognosis for a live birth in China Methods: Following the exact steps in the IVF protocol, a decision tree model was developed, based on the data from the CESE-PGS trial and using cost scenarios for IVF in China. The scenarios were compared for costs per patient and cost-effectiveness. One-way sensitivity analysis and probabilistic sensitivity analysis were performed to confirm the robustness of the findings. Main Outcome Measures: Costs per live birth, Costs per patient, Incremental cost-effectiveness for miscarriage prevention Results: The average costs per live birth of PGT-A were estimated as ¥39230.71, which is about 16.8% higher than that of the conventional group. Threshold analysis revealed that PGT-A would need to increase the pregnancy rate of 26.24% to 98.24% or a cost reduction of ¥4649.29 to ¥1350.71 to achieve the same cost-effectiveness. The incremental costs per prevented miscarriage was approximately ¥45600.23. Probabilistic sensitivity analysis indicated a probability of 97.50% that PGT-A is cost-effective when the willingness to pay was ¥ 21,7113.00 per prevented miscarriage. Conclusions: The present cost-effectiveness analysis demonstrates that embryo selection with PGT‑A is not suitable for routine applications from the perspective of healthcare providers in China, given the cumulative live birth rate (CLBR) and the high costs of PGT‑A.

Objective The role of surgery for patients with advanced ovarian cancer is well established but wide variations in the percentage of patients undergoing surgery exist. Design Observational Study Setting The 19 cancer alliances in England, UK Methods We undertook a comparative analysis to examine the effects of rates of surgery on one and five year disease specific survival across the 19 English Cancer Alliances. We also undertook a propensity score analysis of a single cohort of patients with advanced ovarian cancer to compare patients who did, and did not, undergo surgery as part of their primary management. Main outcome measures Correlations between rates of surgery, demographics, and cancer alliance performance against one and five year survival Results In multivariable analysis, rates of surgery undertaken by a Cancer Alliance remained an independent predictor of both one and five year survival (correlation coefficient 0.81, and 0.70, respectively) although this relationship is likely non linear with optimal rates of surgery still to be defined. Using propensity score analysis a subgroup of patients who gain no benefit from surgery can be identified. Conclusions Overall survival of patients with advanced ovarian cancer is likely to be improved with an increase in overall rates of surgery however there are likely to be optimal maximal rates, above which patients will be disadvantaged. Mechanisms for identifying individual outcome predictions are required.

Urbanization is a common socioeconomic development trend. However, regional differences in urbanization, and especially in the proportion of the total land area accounted for by urban land, threaten the sustainable development of urbanization. To explore the causes of the regional differences in this proportion, we obtained data from 295 cities in China, and analyzed the proportion of urban land ( PUL) based on 11 economic dimensions using spatial econometric methods. We found that the fiscal decentralization, infrastructure, industrialization, and industrial upgrading were the main factors that affected regional differences in PUL in China, with different effects in different regions. Based on our findings, China should continue to reform its economic institutions, give local governments more economic autonomy, improve urbanization infrastructure, and promote industrial upgrading by encouraging technological innovation to stimulate more sustainable urbanization. Our results provide valuable guidance for other countries to support more rational utilization of urban land and achieving sustainable socioeconomic development.

Bell's palsy has been reported following COVID-19 vaccination in adults. Here, we report a case of adolescent male with unilateral peripheral facial palsy after receiving BBIBP-CorV vaccine. The diagnosis was confirmed by electrodiagnostic study. The patient had a complete recovery after medical and rehabilitation treatment.

In younger patients Lamin heart disease is an underdiagnosed etiology of complex irregular atrial arrhythmias occurring in the absence of pulmonary vein activity. We describe a novel mapping system in 2 sisters with unusual manifestation of Lamin disease.

Abstract Aim: To systematically assess the quality and credibility of the correlations between H2RAs use with the risk of adverse outcomes. Methods: In accordance with PRISMA, Meta-analyses of observational studies and meta-analyses of randomized controlled trials (RCTs) were included through searching 4 major databases from inception to 30 April 2022. AMSTAR 2 and GRADE were used to assess quality and certainty of evidence. Results: Forty-six individual meta-analyses were identified, including 30 meta-analyses of observation researches with 32 unique outcomes and 19 meta-analyses of randomized controlled trails with 3 unique outcomes for comparing H2RAs versus non-H2RAs group. We confirmed significant associations of H2RAs use with pneumonia (OR, 1.31; 95% CI, 1.04-1.64), peritonitis (OR, 2.16; 95% CI, 1.65-2.84), necrotizing enterocolitis (OR, 1.80; 95% CI, 1.21-2.67), C difficile infection (OR, 1.25; 95% CI, 1.05-1.49), asthma(OR, 1.48; 95% CI 1.36-1.62), liver cancer(OR, 1.41; 95% CI, 1.36-1.46), gastric cancer(OR, 1.41; 95% CI, 1.21-1.64) and hip fracture diseases(OR, 1.20; 95% CI, 1.13-1.27). No associations for colorectal cancer, melanoma, kidney cancer, lung cancer, common reproductive system cancer, renal, neurological, and cardiovascular system diseases were observed. Conclusions: We found a variety of evidence for the associations between H2RAs and adverse outcomes, which would give clinicians more positive guidance on prescription of H2RAs in clinical practice.

The aim of this study is to analyse the concentration of potentially toxic elements (PTEs) in urban soils under the influence of mining activities and to determine its sources. For this purpose, topsoil samples of the public parks and green areas in Minas de Riotinto (a town next to one of the largest open pit mines in the world) and Aracena (a nearby town outside the area of influence of the mine) were collected. The concentrations of elements of interest (Cr, Co, Ni, Cu, Zn, As, and Pb) were determined and compared based on soil location and origin ( in-situ or ex-situ), and with the background and regulatory levels for the region. The elemental concentrations in the fine fraction of the soils (particles <50 µm) were also measured. The concentrations of some PTEs (Cu, As and Pb), also found in the dust from nearby mines, were higher in the in-situ soils of Minas de Riotinto than in those of Aracena. The concentrations of PTEs in ex-situ soils of both towns were much lower than in in-situ soils, and similar between both locations, revealing the influence of the parent material as a primary source of PTEs. However, the concentrations of As and Cu in the ex-situ soils of Minas de Riotinto were significantly higher than the ones in Aracena, with a significant increase of these elements in the fine fraction both for in-situ and ex-situ soils. These two elements are directly related to the mining activity, implying that atmospheric deposition of dust from the mines also contributes to increasing the concentration of PTEs in the soils of Minas de Riotinto. These pollution sources lead to soils with potentially dangerous concentrations of pollutants, which should be further studied and evaluated in relation to their long-term influence on human health.

Abstract 1. Elephants frequently raid farmers’ crops within their ranges in Africa and Asia. This can have a large impact on agricultural productivity and food security for farmers. 2. Previous studies have examined susceptibility of crop fields to elephant raids using field characteristics such as field size and proximity to water sources. However, there are limited studies investigating how different crop types, individually and in their combinations influence crop susceptibility to elephant raiding. Also, spatio-temporal patterns in elephant crop raids in agro-ecological landscapes have not been extensively examined. 3. This study utilised data collected from crop fields raided by elephants between 2008 and 2018. Data on crops grown, the number of crop-raiding incidences for each crop, and elephant raiding incidences were recorded for each field assessed. Incidence risks (IR) and field risk value (RV) were computed using an adaptive epidemiological approach. 4. The results showed that elephant crop raiding incidents varied significantly amongst crop types, and over space and time (P<0.0001). Cereal crops (millet: Eleusine conaracana, maize: Zea mays) incurred a higher number of crop raiding incidents compared with leguminous crops (cowpea: Vigna unguiculata; groundnut: Arachis hypogea). Field RVs significantly varied depending on which crop was present in the field. There was a significant negative correlation between the number of crop types and the susceptibility of the field to raiding (R2 = -0.680, P<0.0001). 5. Our results suggest that the susceptibility of the fields to elephant raids could be minimised by selecting crop types and combinations less susceptible to elephant damage, thus enhancing food security for local subsistence farmers. Keywords: crop raiding, crop species, incidence risks, field risk value, food security, human-elephant conflict

The aim of this case study is to present a methodological approach for the flood hazard assessment of small watercourses, based on the evaluation of the impact of the morphology of the watercourse channel, land cover of the floodplain, transport infrastructures along the watercourse, bank and channel vegetation, negative attributes of vegetation, and debris in the channel. Each variable is represented by a set of attributes that characterise the current state of the watercourse reach. The assessment process begins with the division of watercourses into river reaches based on a mutual combination of variables influencing the flood hazard. Subsequently, the current state of the variable attributes of each river reach is identified and their impact on flood hazards is then assessed according to rational rules. The impact of the individual attributes is first expressed on an ordinal scale, which is then transformed into a quantitative weight. The overall Flood Hazard Index (FHI) of the river reach is then determined through the aggregation of the quantitative weights of the impact of individual attributes. Key words: Flood hazard index, watercourse attributes, municipality, riverine landscape, river reach

Birds provide important ecological services for the maintenance of ecosystems’ integrity. However, there is limited research on ecological roles of different bird species in maintenance of habitats in South Africa yet many bird species are experiencing continuous conservation threats. In this study, we aimed to document the diversity of bird species in South Africa’s Wild Coast nature reserves, and to determine potential role of each bird species in habitat maintenance using bird feeding mode classifications as a species function’s proxy. Bird observations were conducted afield over four years (2017 to 2020). Over 864 hours of field sampling in 2017-2020, we accumulated 818 bird records containing 178 different bird species classified into 58 families. Shannon-Wiener Diversity Indices showed very high overall species diversity, and across the nature reserves (H > 3.5) with however, all nature reserves being non-significantly different. We noted 32 bird species representing 30 families occurring across four nature reserves with Silaka Nature Reserve having significantly more diverse bird families than Mkhambathi Nature Reserve while not significantly different to others. Forest bird species were more dominant (42.1%; N = 178) throughout observations than other habitat species. Annual bird species diversity across the observation years remained very high (H > 3.5) with non-significant differences across the years. However, the year 2018/2019, showed significantly higher abundance of birds across all nature reserves. Among different feeding modes, potential seed dispersers had a significantly greater number of records than other groups while pollinators were not significantly different in number compared to seed predators. A non-significantly different number of birds in medium to large size body size classes suggest availability of a variety of both pollinators and subsequent seed dispersal vectors. Consistent with other studies, conservation status and implications of bird species loss on sustainable vegetation integrity must be prioritised.

Competition is among the most important factors regulating plant population and community dynamics, but it is not well understood how different vital rates respond to competition and jointly mediate competitive population dynamics and species coexistence. We used integral projection models (IPMs) to model the population growth of 112 pairwise combinations of 14 competing herbaceous plant species across an elevation gradient (n = 324 IPM models in total). We showed that the response of individual growth and seedling establishment contributed most strongly to competition-induced declines in population growth compared to survival, flowering probability and fecundity that frequently showed complementary responses that occurred in 92% of species pairs. Complementary responses significantly promoted population growth under competition by 22% on average and strengthened species coexistence. Our study emphasises the need to investigate demographic processes to better understand competitive population dynamics and species coexistence.

“Pharmacovigilance is the science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other medication-related problem”, according to the WHO. With the increasing volume of legislation, pharmacovigilance systems have shifted from reactive (responding to emerging risks), to planned, active, risk-proportionate approaches operating throughout the lifecycle of medicines. Whilst medicines are beneficial to society, adverse reactions represent a significant cause of concern. They are a major cause of failed regulatory authorizations, and withdrawal from the marketplace post-approval. Evaluation of real-world data plays an increasingly important role in pharmacovigilance. There is great interest on the part of the regulators, MAHs, academia and patients in optimizing the use of safety data. Innovative approaches, including pharmacogenetics and passive measures (sensors), will lead to increased complexity in data collation and evaluation, and inevitably to an increase in the volume of case reports. There is a multiplicity of regulations and guidelines on how to manage these data, with an inherent lack of harmonization. We summarize the current characterization of safety data types, sources, and the classification of these data. Using this benchmark, we discuss the future requirements of an effective pharmacovigilance ecosystem, keeping the principle of parsimony in mind.

Aim. To describe the trends in anti-infective use during pregnancy between 2010 and 2019 and determine whether they were prescribed according to drug fetal safety international classification systems. Methods. We conducted a population-based, nationwide study using the French national health data system including all pregnancies ended between 2010 and 2019. Anti-infective were considered according to their pharmacological group and potential harmful risk using the Australian and Swedish classification systems. Prevalence rate was estimated annually and by trimester. Average annual percent change (AAPC) and 95% confidence intervals (CI) were calculated using Joinpoint regression. Results. Among 7,571,035 pregnancies, 3,027,031 (40.0%) received ≥ 1 antibacterial. This proportion decreased significantly from 41.5% in 2010 to 36.1% in 2019 (AAPC=-1.7%, [95%CI, -2.5% to -1.0%]). Conversely, use of antiviral agents increased during the 10 years’ study period for anti-HSV agents (AAPC=4.4%, [3.7%-5.2%]), influenza agents (AAPC=25.4%, [6.2%-48.1%]), and for HIV-antiretroviral agents (HIV-ART) (AAPC=1.3%, [0.6%-2.0%]). Use of influenza vaccine increased from 0.2% in 2010 to 4.2% in 2019 (AAPC=49.7%, [95%CI, 39.3% to 60.9%]). Among all pregnancies, 0.9% had been exposed to a potentially harmful anti-infective agent increasing from 0.7% in 2010 to 1.2% in 2019 (AAPC=6.4%, [4.4%-8.5 %]). Conclusion. Based on more than 7 million pregnancies identified from French nationwide data, this study showed that antibacterials are frequently prescribed during pregnancy although their use has decreased over the past ten years. Our results suggest that anti-infective are generally prescribed in accordance with recommendations, with however a potential for improvement in influenza vaccination.

Background: Intensified treatment protocols have improved survival of pediatric oncology patients. However, these treatment protocols are associated with increased treatment-related morbidity requiring admission to pediatric intensive care unit (PICU). We aimed to describe the organizational characteristics and processes of care for this patient group across PICUs in Europe. Methods: A web-based survey was sent to PICU directors or representative physicians between February and June 2021. Results: Responses were obtained from 77 PICUs of 12 European countries. Organizational characteristics were similar across the different countries of Europe. The median number of PICU beds was 12 (IQR 8-16). The majority of the PICUs was staffed by pediatric intensivists and had a 24/7 intensivist coverage. Most PICUs had a nurse-to-patient ratio of 1:1 or 1:2. The median numbers of yearly planned and unplanned PICU admissions of pediatric cancer patients were 20 (IQR 10-45) and 10 (IQR 10-30, respectively. Oncology specific practices within PICU were less common in participating centres. This included implementation of oncology protocols in PICU (30%), daily rounds of PICU physicians on the wards (13%), joint mortality and morbidity meetings or complex patients’ discussions (30% and 40%, respectively) and participation of parents during clinical rounds (40%). Conclusion: Our survey provides an overview on the delivery of critical care for oncology patients in PICU across European countries. Multidisciplinary care for these vulnerable and challenging patients remains complex and challenging. Future studies need to determine the effects of differences in PICU organization and processes of care on patients’ outcome.

Clustering enzymes in the same metabolic pathway is a natural strategy to enhance productivity. Synthetic protein, RNA and DNA scaffolds have been designed to artificially cluster multiple enzymes in the cell, which require complex construction processes and possess limited slots for target enzymes. We utilized the Escherichia coli inner cell membrane as a native scaffold to cluster four fatty acid synthases and achieved to improve the efficiency of fatty acid synthesis in vivo. The construction strategy is as simple as fusing target enzymes to the N-terminus or C-terminus of the membrane anchor protein (Lgt), and the number of anchored enzymes is not restricted. This novel device not only presents a similar efficiency in clustering multiple enzymes to that of other artificial scaffolds but also promotes the product secretion, driving the entire metabolic flux forward and further increasing the gross yield compared with that in a cytoplasmic scaffold system.

Introduction: Catheter ablation of atrial fibrillation (AF) and/or atrial tachycardia (AT) in heart failure (HF) patients provides improvement in symptoms cardiac function and survival. However, these procedures remain challenging with higher recurrence and complication rates compared to patients with normal cardiac function. We aimed to compare outcomes of AF/AT ablations guided by an ultra-high density mapping system between HF patients and controls. Methods and results: Primary endpoint was the one-year recurrence rate of AF/AT. We retrospectively examined all Rhythmia™-guided procedures performed in Caen and Toulouse University Hospitals between 2015 and 2018 for AF/AT. Patients with reduced left ventricular ejection fraction (LVEF) (i.e. <50%), or with preserved LVEF and signs/symptoms of HF were constituted the HF group and were subsequently classified in two subgroups of HF patients with preserved (HFpEF) or reduced/mildly reduced (HFrEF) LVEF. 246 patients were included, 135 in the HF group. At one-year, 71 patients had experienced AF/AT recurrences, with no difference between HF group versus non-HF group (31.9 vs 25.2% respectively, p=0.262). AF/AT recurrence rates were not different between HFpEF and HFrEF subgroups (37.1 vs 26.4% respectively, p=0.196). In multivariate analysis, patients with mitral regurgitation (p=0.011), hypertrophic cardiomyopathy (p=0.011) and persistent AF (p=0.02) were at higher risk of recurrence. AF/AT recurrence was not significantly associated with HF hospitalization (p=0.078) but HF status was the only independent predictive factor of HF hospitalization (p=0.002). Patients in the HF group showed significant improvement in both their NYHA class and LVEF than non-HF patients. After ablation procedures, while patients with HFrEF and HFpEF showed similar NYHA class improvement, LVEF only improved in HFrEF patients. The rate of complications were comparable in both groups. Conclusion: Clinical outcomes of AF/AT ablations guided by UHD mapping system appear similar in HF and non-HF patients. During the follow-up period, patients with HF exhibit improvement of NYHA status and LVEF.

Although mid- and long-term outcomes after the Ross procedure for aortic valve disease have been increasingly improving over the years, this is still a rather challenging operation in neonates and small children. This is particularly true for patients with associated congenital heart defects and critical clinical conditions. Herein we describe the application of this procedure as a rescue operation in emergency circumstances in a low-birth-weight neonate with severe aortic stenosis, aortic regurgitation and mitral regurgitation after a previous aortic coartectomy.

Animal-borne telemetry devices provide essential insights into the life-history strategies of far-ranging species and allow us to understand how they interact with their environment. Many species in the seabird family Alcidae undergo a synchronous moult of all primary flight feathers during the non-breeding season, making them flightless and more susceptible to environmental stressors, including severe storms and prey shortages. However, the timing and location of moult remains largely unknown, with most information coming from studies on birds killed by storms or shot at sea. Using light-level geolocators with saltwater immersion loggers, we develop a method for determining flightless periods in the context of the annual cycle. Four Atlantic puffins (Fratercula arctica) were equipped with geolocator/immersion loggers on each leg to attempt to overcome issues of leg-tucking in plumage while sitting on the water, which confounds the interpretation of logger data. Light level and saltwater immersion time-series data were combined to correct for this issue. This approach was adapted and applied to 40 puffins equipped with the standard practice deployments of geolocators on one leg only. Flightless periods consistent with moult were identified in the dual-equipped birds, whereas moult identification in single-equipped birds was less definitive and should be treated with caution. Within the dual-equipped sample, we present evidence for two flightless moult periods per non-breeding season in two puffins that undertook more extensive migrations (> 2000km), and were flightless for up to 76 days in a single non-breeding season. A biannual flight feather moult is highly unusual among non-passerine birds, and may be unique to birds that undergo catastrophic moult, i.e. become flightless when moulting. Though our conclusions are based on a small sample, we have established a freely available methodological framework for future investigation of the moult patterns of this and other seabird species.

A document by Manisha Ahuja. Click on the document to view its contents.