Introduction There are few reports regarding risk of COVID-19-associated complications in bone marrow recipients. We report a patient who had graft-versus-host disease triggered by COVID-19. Results The patient was a 17-year-old boy who underwent HSCT from matched sibling donor for CML. He had complete donor chimerism at day +30. Cyclosporine was tapered and stopped at day +65. Until day +93, he had no complaints. The patient started to suffer from cutaneus and gastro-intestinal grade III GVHD after the diagnossis of CIVID-19. Discussion In the absence of any other condition to explain this clinical picture and the good response to GVHD treatment indicate that the triggering factor in the development of GVHD may be COVID-19 in the era of TLR, which plays a common role in the pathogenesis of both GVHD and COVID-19.

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A 70-year-old male presented with complaints of fever for 10 days; associated with dry cough for one week, gradually progressive shortness of breath for five days, and non-radiating chest pain for three days. Chest examination revealed bilateral basal crepitation, and cardiac examination showed muffled first heart sound with soft systolic murmur at apex. All severity markers of COVID-19 were elevated. Twelve lead electrocardiography (ECG) showed complete heart block. Troponin-I test was negative. High resolution computed tomography (HRCT) thorax showed extensive bilateral multifocal patchy and confluent areas of ground-glass opacities distributed along with peripheral subpleural and peribronchovascular regions with interlobular septal thickening suggestive of viral pneumonia .He was started on high flow oxygen, parenteral corticosteroids, and anticoagulants with antibiotics coverage. Injection Isoprenaline infusion was started for heart block, but the patient developed atrial flutter-fibrillation with premature ventricular complexes. The patient clinically improved and was discharged on the 11th day of admission. On follow up after 2 weeks, repeat ECG showed atrial fibrillation, and 2D Echocardiography revealed global hypokinesia, severe mitral regurgitation with left ventricular systolic dysfunction (ejection fraction of 28%), and dilated left ventricle and atrium. He was planned for coronary angiography after one month. High clinical suspicion, early diagnosis, and prompt treatment with corticosteroids can yield a favorable outcome. Follow up is necessary to rule out long term complications like viral cardiomyopathy.

In this paper we are investigating to figure out the exponential growth of solutions with L_{p}-norm of a viscoelastic Klein-Gordon wave equation with strong damping, source and delay terms.

A 72-year-old woman was incidentally discovered to have a left ventricular mass during work-up for coronary artery bypass grafting surgery. Cardiac MR revealed a 2-cm left ventricular intracavitary mass. During concomitant coronary artery bypass grafting surgery, a 30-degree laparoscope was placed through the left ventricular outflow tract (LVOT) to visualize the mass. The mass was resected through the LVOT with a combination of focused electrocautery and shears. Histopathologic examination revealed a papillary fibroelastoma. Laparoscopic camera and thoracoscopic instruments can be useful for resection of benign, mobile intracavitary cardiac tumors.

Environmental conditions affect the growth and development of maize, and low temperature has been widely concerned as one of the most important factors. In the temperate zone, maize is found to be under chilling stress in its growth and development, especially at the seedling stage. Correspondingly, maize generates various measures to alleviate such stress, and its regulation of protein expression is one of the most effective. However, further research on the regulation mold has not yet been carried out. To gain a better understanding of the regulation mold, we used two inbred lines with different resistance, which are chilling tolerant KR701 and chilling sensitive hei8834, to undergo quantitative proteomics analysis under chilling stress at the one- and three-leaf stages, respectively. The results revealed diversified cold-resistant pathways of maize with different resistance at different stages of seedling, and the reasons behind. Meanwhile, we found that ABA in hormone response pathway plays an important role in improving the cold resistance of maize at one-leaf stage, which lays a solid foundation for further explorations of the cold-resistant mechanism in maize at the seedling stage, and enlightens strategic improvements of the cold resistance in world crops.

Background: Acute respiratory infections (ARI) cause a considerable morbidity and mortality worldwide especially in children. Unfortunately, there was limited multi-center data about common viral respiratory infection in south China. Methods: A total of 4403 nasal swabs of children were collected from 10 cities of Guangdong, China in 2019. Seven respiratory viruses including influenza A virus (IFA), influenza B virus (IFB), respiratory syncytial virus (RSV), adenoviruses (ADV), parainfluenza virus type 1-3 (PIV1-3) and were detected by direct immunofluorescence antibody assay. The personal information and clinical characteristics were recorded and analyzed. Results: The results showed that 1099 (24.96%) samples were detected of at least one virus. The detected rates of RSV, IFA, ADV, PIV3, PIV1 and PIV2 were 7.13% (314/4403), 5.31% (234/4403), 4.02% (177/4403), 3.04% (134/4403), 1.70% (75/4403) and 1.16% (51/4403), respectively. The detection rate of RSV in (0-6)-month-old was highest with 18.18% (106/583), while the detection rate of IFA in (12-18)-year-old was highest with 20.48% (17/83). The total detection rates in winter and spring were 35.67% (219/614), 34.56% (403/1166), higher than those in summer 17.41% (284/1631) and autumn 19.46% (193/992). Conclusions: RSV and IFA were the main respiratory viruses in children. With age, the detection rate of RSV decreased in children, but the trend of detection rates of IFA and IFB were the opposite. This study provided the viral etiology and epidemiology of pediatric patients with ARI in Guangdong, China, which was important for the improvement and optimization of diagnostic tactics, control and prevention of the respiratory viral infections.

Sulfur-doped carbon nanotubes (SCNTs) exhibit better conductivity and hydrophilicity, as compared to the undoped carbon nanotubes (CNTs). Low cost mass production of SCNTs is highly desirable for their real application at an industrial scale. Here, scalable green syntheses of SCNTs and S, N dual doped CNTs (SNCNTs) are demonstrated based on the gaseous S doping using SO2 as dopant. The process not only significantly promotes the hydrophilicity and conductivity of CNTs due to the incorporation of S atoms in carbon framework, but also purifies the final product due to burning off the carbon coatings of metal particles. SO2 is generated by CaSO3 pyrolysis and absorbed by CaO, thus realize the recycling of S species. The LiFePO4 cathodes using the as-prepared SCNTs and SNCNTs as conductive additive exhibit enhanced capacity and rate performance than the electrodes prepared with the pristine CNTs, not matter using N-methyl pyrrolidone or water as solvent.

We present the case of a patient with anxiety who attempted suicide by self-removal of her permanent pacemaker (PPM). Self-harm involving a pacemaker is associated with significantly endangering patient well-being and often with greatly increased health care costs. It is an indication that the numbers of patients with a PPM who are clinically depressed and anxious has been underestimated. Early detection of depression, using a validated questionnaire, followed by ongoing care and shared decision making (SDM), a focus on psychosocial stressors, medication adherence, somatic complaints and attention to any adverse drug reactions, are likely to improve clinical outcomes.

In this study, we sought to evaluate the prevalence and association of pre-transplant atrial fibrillation (AF) on 30-day postoperative outcomes in patients undergoing orthotopic liver transplant (OLT). The National Inpatient Sample Database was queried from 2011 to 2017 for relevant ICD-9 and ICD-10 procedural and diagnostic codes. Baseline characteristics and in-hospital outcomes were compared in patients who underwent OLT with AF and those without. Among 45,357 patients who underwent OLT, women made up 35.8 % of the overall population. The prevalence of AF prior to transplant was 2932 (6.5%) with a trend towards increasing prevalence, with an annual change rate of 4.19%. Applying propensity score matching to control for potential confounding factors, there was no association between pre-transplant AF and in-hospital mortality in patients undergoing OLT, however, there was a higher incidence of perioperative complications. Older age, the presence of heart failure, and anemia were independently predictive of higher mortality in patients with pre-transplant AF undergoing OLT. In patients undergoing OLT, pre-transplant AF is increasing in prevalence and appears to be associated with similar in-hospital mortality but worse perioperative outcomes. Greater emphasis should be placed on AF in the preoperative cardiovascular risk stratification of patients undergoing OLT.

Aims: Improper management of polypharmacy in community and hospital pharmacies may lead to adverse effects and drug interactions in patients of all age groups, especially children and elderly. This study sought to determine scenario of polypharmacy at multiple communities in Nepal and costs implicated. Methods: Multi-center community-based cross-sectional study was conducted to explore scenario of polypharmacy at multiple communities in Nepal and their cost implications for individual. Total 400 patients of all age groups, who were consuming medicines and fulfilling inclusion criteria (i.e., prescribed with ≥4 medications) from May 2017 to August 2018 were recruited. Semi-structured questionnaire, based on prescription optimization method, was used. Multinomial logistic regression was performed to analyze statistical significance of polypharmacy with various predictors, considering p-value <0.05 as statistically significant. Results: Overall, 79 (97.5%) patients aged 22-31 years, 208 (95%) female, 219 (98.2%) illiterate, 202 (99%) from Siraha district, 113 (97.4%) taking medications for common cold, cough, fever problems and 303 (96.5%) expending USD 1.01 - 11 experienced moderate polypharmacy. There were 216 patients (54%) with prescriptions of five medicines (i.e., moderate polypharmacy), with total number of medicines consumed by 400 patients 2269 (mean = 5.67) and total expenditure USD 3409.54 (mean = 8.66). Conclusion: The present study analyzed economic aspect of polypharmacy at multiple communities in Nepal and found that both moderate and severe polypharmacy were significantly related with almost all age groups, education levels and total cost of medications. Economic implications and health consequences of polypharmacy are to be considered to avoid preventable polypharmacy.

Three Dimensions for Diabetes (3DFD): A novel approach to managing chronic disease?Hamzah MohammedChronic diseases are the leading cause of mortality globally, accounting for more than 70% of the estimated 56 million total deaths recorded in 2017. 1 They are associated with psychiatric comorbidity and social stresses (e.g. debt and unemployment), resulting in suboptimal disease control, risk of complication and increased financial burden on healthcare systems.Diabetes mellitus is a primary example, affecting almost four million people in the United Kingdom and accounting for approximately 10% of the National Health Service expenditure. 2 Depressive symptoms feature in approximately 25% of patients with diabetes and, in addition to social problems such as inadequate housing and isolation, are obstacles in achieving satisfactory glycaemic control.3,4In the evidence-based services that integrate social, psychological and medical care for these patients, an award-winning ‘3 Dimensions for Diabetes’ (3DFD) programme was launched in Greater London and targeted to patients with poorly controlled disease and psychosocial comorbidity.In a non-randomised control pilot study the programme recruited adults with poor glycaemic control and psychiatric and/or social problems from primary and secondary care. 5 Over a twelve-month period, they were compared with a control group who received usual treatment without provision of mental health and social care.The 3DFD intervention comprised a full-time consultant liaison psychiatrist and community support workers from a local voluntary welfare organisation. Dedicated clinics were incorporated into diabetes teams and clinics, and social support outreach delivered from off-site offices or patients’ homes. In addition to routine diabetes care, patients received psychological treatments including cognitive behavioural therapy (CBT) and pharmacotherapy, as well as social interventions where required, examples being debt management and advocacy in housing.The results were positive in favour of 3DFD and support a biopsychosocial model of care for patients with diabetes. When adjusted for confounding, glycaemic control and psychosocial outcomes amongst enrolled participants had improved significantly at twelve-month follow-up compared with the control arm. The associated cost of 3DFD was greater than usual care, though this may be an underestimate given worse glycaemic within the treatment cohort at baseline.This novel integrated care approach raises the prospect of applicability to other chronic diseases where psychiatric and/or social difficulties are common. Epilepsy, for instance, is estimated to affect 600,000 people in the UK and associated with a twenty-fold increased incidence of sudden death compared with the general population.6,7 The increased prevalence of psychiatric disease, compounded by stigma and social restrictions, are predictors of poor quality of life and seizure control, but unfortunately are not adequately addressed. 8,9 Integration of care, with focus of the medical and psychosocial aspects of disease is key to improving patient care and experience.Given the relative success of the 3DFD programme in highlighting the role for an integrated care model in diabetes management, it is worth considering if this approach can be extended to other conditions. Continuing with the example of epilepsy, could the ‘3 Dimensions of Care for Diabetes’ (3DFD) programme pave way for a similar-structured ‘3 Dimensions of Care for Epilepsy’ (3DFE) model?1. Hannah Ritchie and Max Roser (2018) - ”Causes of Death”. Published online at OurWorldInData.org. Retrieved from: ’https://ourworldindata.org/causes-of-death’ [Online Resource]2. Hex N, Bartlett C, Wright D, Taylor M, Varley D. Estimating the current and future costs of Type 1 and Type 2 diabetes in the UK, including direct health costs and indirect societal and productivity costs. Diabet Med. 2012;29(7):855-862.3. Holt RI, de Groot M, Golden SH. Diabetes and depression. Curr Diab Rep. 2014;14(6):491.4. Fisher L, Polonsky WH, Hessler DM, et al. Understanding the sources of diabetes distress in adults with type 1 diabetes. J Diabetes Complications. 2015;29(4):572-577.5. Ismail K, Stewart K, Ridge K, et al. A pilot study of an integrated mental health, social and medical model for diabetes care in an inner-city setting: Three Dimensions for Diabetes (3DFD). Diabet Med. 2019.6. Holmes E, Bourke S, Plumpton C. Attitudes towards epilepsy in the UK population: Results from a 2018 national survey. Seizure - European Journal of Epilepsy. 2019;65:12-19.7. Shankar R, Cox D, Jalihal V, Brown S, Hanna J, McLean B. Sudden unexpected death in epilepsy (SUDEP): Development of a safety checklist.Seizure - European Journal of Epilepsy. 2013;22(10):812-817.8. Lin JJ, Mula M, Hermann BP. Uncovering the neurobehavioural comorbidities of epilepsy over the lifespan. Lancet.2012;380(9848):1180-1192.9. Mula M, Sander JW. Psychosocial aspects of epilepsy: a wider approach. BJPsych Open. 2016;2(4):270-274.

Photothermal therapy (PTT) has received constant attention as efficient cancer therapy method due to locally selective treatment and not affected by tumor microenvironment. In this study, a novel 880 nm near-infrared (NIR) laser triggered photothermal agent (PTA), 3TT-IC-4Cl, was used for PTT of tumor in deep tissue. Folic acid (FA) conjugated amphiphilic block copolymer (folic acid-polyethylene gly-col-poly (β-benzyl-L-aspartate)10, FA-PEG-PBLA10) was employed to encapsulate 3TT-IC-4Cl by nano-precipitation to form stable nanoparticles (TNPs), TNPs exhibit excellent photothermal stability and photothermal conversion efficiency. Furthermore, the in vitro results showed TNPs display excel-lent biocompatibility and significant phototoxicity. These results suggest that 880 nm triggered TNPs has great potential as an effective PTAs for photothermal therapy of tumor in deep tissue.

We report on a 12-year-old female who developed osteosarcoma with tuberous sclerosis. Clinical sequencing of osteosarcoma tissues identified a somatic mutation in the TP53 gene and a novel germline mutation in the TSC2 gene. Pathological analysis of osteosarcoma tissue revealed increased phosphorylation of S6, a downstream target in the mTOR pathway. This is the first reported detection of a germline TSC2 mutation and somatic TP53 mutation in osteosarcoma with tuberous sclerosis. This case is unique and suggestive of a TSC2-dependent genetic pathway through mTOR signaling and a second-hit model for oncogenesis.

ABSTRACT Objectives: The leading purpose of this investigation is to measure the excellence of drug treatment by likeable in the assessment of data on drug prescribing, dispensing, administering and use of drugs by patient. Material & Methods: The study was planned to be a retrospective, assessing the prescribing design concerned about the utilization of anti-biotic in the management of various infections, throughout a period of two months January 2017 to February 2017 (approximately 60 days). The study was conducted at tertiary care hospital in which the prescriptions of 200 patients from the medical wards, were evaluated, in which 57 (28.5%) were females and 143 (71.5%) were males. Results: Mostly prescribed antibiotic were ceftriaxone 105 (34.09%), amoxicillin/clavulanic acid 18 (5.84%), moxifloxacin 35 (11.36%), metronidazole 55 (17.85%), azithromycin 7 (2.27%), sulbactam/cefoperazone 22 (7.14%), doxycycline 13 (4.22%), ciprofloxacin 40 (12.98%), cefotaxime 5 (1.62%), and clarithromycin 3 (0.97%). Total number of drugs prescribed were 1643 in which the average number of drugs encountered per prescription were 8.21, the percentage of encounters with antibiotics were 308 (18.74%), the percentage of encounter with injections were 897 (54.59%), the percentage of drugs prescribed by generic name were 205 (12.47%), and the percentage of drugs prescribed from EDL were 1367 (83.20%). Conclusion: On the bases of our study, the pattern used at Saidu Group of Teaching Hospital for the, prescription of antibiotics, injections, generic concept and drugs from EDL shows deviation from the standards guidelines of WHO.

Rationale, aims and objectives: This study aims to assess fear, anxiety, anxiety sensitivity, burnout, and insomnia of healthcare workers (HCWs) during novel coronavirus-2019 (COVID-19) outbreak and to identify their relation to sociodemographic and clinical characteristics. Method: Totally 600 HCWs were included in this cross-sectional study. A Sociodemographic Data Form, Coronavirus Anxiety Scale (CAS), Fear of COVID-19 Scale (FCV-19S), Anxiety Sensitivity Index-3 (ASI-3), Maslach Burnout Inventory (MBI), and Insomnia Severity Index (ISI) were used. Results: Of participants, 364 were females and 236 were males with a mean age of 33.49±7.29 years. About 95.3% of HCWs had a fear of infecting their loved ones. Mean MBI and ISI scores were significantly higher among HCWs working in COVID-19 clinics and intensive care units (p=0,000; p=0,039). Mean CAS, FCV-19S, MBI, and ISI scores were significantly higher in women than men (p=0,000; p=0,000; p=0,027; p=0,005). Mean CAS and ISI scores were significantly higher among nurses (p=0,008; p=0,004), while mean ASI-3 of the other HCWs and MBI scores of physicians were significantly higher (p=0,009; p=0,000). Conclusion: The COVID-19 pandemic is a major health issue associated with psychiatric illnesses in HCW subgroups with distinct sociodemographic characteristics. It is of utmost importance to develop individualized preventive and therapeutic psychiatric services for HCWs.

Seasonal timing of reproduction in voles is driven by photoperiod. Here we hypothesize that a negative energy balance can modify spring-programmed photoperiodic responses in the hypothalamus, controlling reproductive organ development. We manipulated energy balance by the ‘work-for-food’ protocol, in which voles were exposed to increasing levels of food scarcity at different ambient temperatures under long photoperiod. We reveal that common (Microtus arvalis) and tundra voles (Microtus oeconomus), reduce photoperiodic induced pars tuberalis thyroid-stimulating hormone β-subunit (Tshβ) expression to inhibit gonadal development when food is scarce. Reduction in gonadal size is more pronounced in tundra voles, in which the hypothalamic Kisspeptin (Kiss1) system seems involved in downregulating gonadal development, especially in males. Low temperature additionally leads to decreased hypothalamic RF-amide related peptide (Rfrp3) levels, which may facilitate further suppression of gonadal growth. Shutting off the photoperiodic-axis when food is scarce in spring may be an adaptive response to save energy, leading to delayed reproductive organ development until food resources are sufficient for reproduction, lactation and offspring survival. Defining the mechanisms through which metabolic cues modify photoperiodic responses will be important for a better understanding of how environmental cues impact reproduction.

In this paper, a mathematical model that describes polymer chain dynamics considering the Brownian motion of particles, an external driving force, the material fractal structure, and a finite extensibility nonlinear elastic (FENE) spring is investigated. To solve the fractal differential equation of motion, first, a two-scale dimension transform is introduced. Then, an ancient Chinese algorithm is used to derive the approximate steady-state frequency-amplitude response curves. Theoretical predictions show that the response shift from the 2D frequency-amplitude curves for fractal parameter values different from one, which modifies the polymer network oscillation amplitudes.

Background Understanding asthmatic airway structural changes and the bronchodilator responses may help unravel targets for intervention. However, structural abnormalities of asthmatic airways with different disease severity and the major anatomical site of bronchodilator responses have not been well elucidated. We aim to evaluate the airway remodeling characteristics and the bronchodilator responses in medium-sized and small airways of asthma. Methods We recruited 104 asthmatic patients and 31 non-smoking control subjects to compare the airway inner area (Ai) and airway wall area percentage (Aw%) with endobronchial optical coherence tomography. We also enrolled 32 patients with moderate-to-severe asthma to dynamically assess the airway morphological changes after salbutamol inhalation. Results More prominent airway structural abnormalities correlated with greater asthma severity, evidenced by the decreased Ai and greater Aw% in medium-sized and small airways. Patients with mild asthma yielded comparable Ai but greater Aw% than control subjects. Salbutamol inhalation led to a rapid dilatation of both medium-sized and small airways, the lung function improvement correlated significantly with the increase in Ai of the medium-sized, but not small, airways at 15 min. Conclusion Luminal narrowing and airway wall thickening of the medium-sized and small airways are present in mild asthma and reflect asthma severity, lending support to the use of anti-imflammatory intervention in mild asthma. The medium-sized airways are the crucial site of the bronchodilator responses, providing the scientific rationale for future development of more effective delivery of inhaled medications for asthma.

Polymyositis (PM) is a rare neuromuscular phenotype of chronic graft-versus-host disease (cGVHD). Although glucocorticoids have been shown to be effective for PM treatment, most people have poor treatment response and poor prognosis. Herein, we reported a case of thalassemia in a 6-year-old boy who received allogeneic hematopoietic stem cell transplantation (HSCT) and consequently developed severe chronic GVHD complicated with polymyositis. He was then given high-dose corticosteroid therapy, including tacrolimus, ruxolitnib, and rituximab. Twenty-three months after transplant, creatine kinase levels return to normal range, the MRI showed that the original muscle edema signal was significantly improved. In addition, the patient’s muscle weakness continued to improve, and his overall condition was good. This report suggests that glucocorticoids combined with immunosuppressants may be effective agist polymyositis. Rituximab and ruxolitinib may be a good choice in treating polymyositis.

This study aimed to evaluate the influence of the lectin pathway proteins Mannose-binding lectin (MBL) and ficolins (FCNs) MBL and FCN3) on leprosy’s susceptibility and severity. We studied patients with a confirmed diagnosis of leprosy (n=90) and their healthy household contacts (n=79). We have also analyzed a subgroup of patients under 15 years of age (n=35), compared to their family contacts (n=20). Higher levels of FCN3 were identified in patients sample (n=90) with undetermined clinical form (419.7 ng/ml), compared to (343.8ng/ml) virchowian (p=0.033) and no disability form (381.2 ng/ml). Higher levels of FCN3 were also seen for disability grade 1 compared to grade 2 (343.2ng/ml and 327.1 ng/ml), respectively (p=0.031). In patients < 15 years of age, the highest levels of FCN3 occurred in those with undetermined clinical form (436.6 ng/ml) in comparison with dimorphic (368.7 ng/ml) and virchowian forms (321.2 ng/ml) (p=0.013). We have identified higher levels of FCN3 among disability grade 0 (386.7 ng/ml), in comparison with grade 1 (310.1 ng/ml) and 2 (268.3 ng/ml) in children patients (p=0.008) with no sequelae (399.1 ng/ml) versus leprosy reaction type 1 (299 ng/ml) (p=0.009). Patients <15 years of age had higher MBL levels (4.455 ng / ml) compared to those > 15 years (2.342 ng / ml) (p = 0.018). Serum MBL and FCN3 levels do not seem to influence the acquisition of M. leprae infection.Higher levels of FCN3 were associated with less severe sequelae and lower disability grade for adults and patients < 15 years old

The accepted ORIGINAL ARTICLE is published in Mammalian Biology:https://doi.org/10.1007/s42991-022-00323-6 Lintulaakso, K., Tatti, N. and Žliobaitė, I., 2022. Quantifying mammalian diets. Mammalian Biology, pp.1-15.This preprint differs from the accepted version by leaving out the energy contents of the mammalian diets.Below is the abstract from the accepted manuscript:We propose a quantitative approach for categorising mammalian diets based on the taxonomy of food items and parts consumed (the form of food). Our analysis covers 82% of the mammalian species alive today. The diet information comes from different data sources—textbooks, datasets and peer-reviewed literature and includes a transformation of narrative quantitative data into qualitative data. We link a database on nutrient composition of diet items of the quantitative diet data and analyse the distribution of macronutrients of diets across taxonomic groups and map them to the dental morphology of the eaters. The results show associations between dental complexity and the concentrations of some nutrients. Our analysis highlights omnivory as a multi-faceted concept—there are many kinds of omnivores within the dietary space we report. The developed dataset and the proposed approach relating the chemical composition of diets offers a basis for future comparative studies of living and fossil mammals. With this study, we make the accompanying large-scale dietary data publicly available online (https://www.mammalbase.net).

Overlap in species-accumulation curves ordered from small-large and large-small (aka SLOSS analysis) is an important line of evidence inferring weak positive diversity effects of fragmentation per se. Yet combining patches in small-large order maximises the probability of encountering new species for every patch, invalidating comparison with large-small order. Controlling for this using simulated null communities, I test species accumulation against a random expectation for 201 published datasets from islands, habitat islands and fragments and compare inference using both methods. SLOSS analysis found 67% positive, 7% negative and 26% no response among datasets. Using simulation, analogous values were 4%, 12% and 40% respectively with no clear outcome in the remainder. SLOSS analysis provides unreliable inference on the diversity effects of habitat subdivision. Accumulation of species in small-large patch size order is more likely to result in fewer than expected species than more, with no effect being the most probable result.

This meta-analysis was conducted to assess the overall effect of influenza infection on pregnancy outcomes and provide evidence for policymakers and relevant healthcare workers. We searched PubMed, Embase, Cochrane Library and Web of Science from 21 May 1953 to 4 November 2020 to identify cohort studies that investigated the effect of influenza on pregnancy outcomes. We conducted meta-analysis using random-effects or fixed-effects models to estimate the pooled effect of influenza virus infection on selected pregnancy outcomes by risk ratio (RR) and its 95% confidence interval (CI) on pregnancy outcomes involving stillbirth, preterm birth, small for gestational age (SGA), fetal death and low birth weight (LBW). 17 eligible studies involving 2,351,204 pregnant women were included. The pooled effect of influenza virus infection on stillbirth was significant (RR = 3.62, 95% CI: 1.60-8.20), while no significant effect on preterm birth (RR=1.17, 95%CI: 0.95-1.45), fetal death (RR=0.93, 95%CI: 0.73-1.18,), SGA (RR=1.10, 95%CI: 0.98-1.24) and LBW (RR=1.88, 95%CI: 0.46-7.66) was observed. In the subgroup analysis of LBW outcome, the pooled effect was significant in studies that investigated cohorts diagnosed of influenza during the 2009 H1N1 pandemic period (RR = 2.28, 95%CI: 1.81 - 2.87), while there was no significant effect in pre-pandemic or post-pandemic studies. By this meta-analysis, we can say that influenza virus infection is associated with a higher risk of stillbirth among pregnant women, while the effect on preterm birth, fetal death, small for gestational age and low birth weight await to be further explored.