Background Inspite of the fact that the life quality improved for most patients with a cardiac pacemaker implant, the pacing induced left bundle branch block pattern can result in changes of the structure, function and hemodynamic of the heart. Methods: This study was performed on 30 patients with history of dual chamber pacemaker implantation more than 6 months duration and 30 healthy volunteers as controls. Conventional and 2-D speckle tracking echocardiography were performed to evaluate the LV global and regional systolic longitudinal strain in different pacing modes. Results: Pacemaker programming from atrial sensed-ventricular paced mode (AS-VP mode) to atrial paced-ventricular paced mode (AP-VP) showed a significant decrease in global LV longitudinal systolic strain (P value <0.05). Moreover, programming to asynchronous ventricular pacing (VVI mode) demonstrated a further significant reduction of global LV LSS when compared to other pacing modes (P value <0.05). Conclusion: Permanent RV apical pacing leads to marked changes of LV systolic function. Moreover, atrial pacing and asynchronous ventricular pacing may cause more deterioration of LV global and regional systolic longitudinal strain detected by 2-D speckle tracking echocardiography.

Here we described brain lesion in young captive lions after exhibiting ataxia. The histopathological analyses of the brain showed typical encephalitis with glial cell proliferation, neuronal atrophy and necrosis, and encephalomalacia. We used a variety of identification methods, including next-generation sequencing, polymerase chain reaction (PCR), virus isolation, immunofluorescence staining (IFA), and electron microscopy. Combined with clinical manifestations of the infected cub, it determined that the dead cub have resulted from an FPV embryonic infection. Through sequence analysis, it was found that the infected virus may be a recombinant virus between FPV and CPV. this study not only provides new gene sequences for the global study of FPV-infected lions but also helps to further study the incidence and genetic diversity of FPV.

Background Chronic spontaneous urticaria (CSU) is a kind of urticaria that occurs independently without any exogenous stimulus. Non-sedating H1-antihistamine is recognized as the first-line treatment option for CSU. Objective To access the comparative efficacy of non-sedating antihistamines in the treatment of CSU and to provide a relative ranking of these treatments. Methods We enrolled randomized controlled trials (RCTs) that compared a single non-sedating antihistamine with placebo or anther single non-sedating antihistamine through searching databases: CENTRAL, MEDLINE, and EMBASE; as well as the trial registries: ISRCTN, ClinicalTrials. gov, ChiCTR, and ICTRP, etc. Two investigators evaluated the eligibility, extracted the data, and assess the risk of bias of included trials independently. A Bayesian network meta-analysis was performed. Results We identified 42 RCTs with 8164 participants. Twenty-six studies were included for the further network meta-analysis. The odds ratio (95% credible intervals) of total overall symptoms relief after 4-week treatment, the top three ordered from the most to least effective non-sedating antihistamines were: loratadine 15.0 (2.9, 14.0), mizolastine 14.0 (2.9, 75.0), cetirizine 13.0 (4.4, 44.0). Conclusions All enrolled non-sedating antihistamines were found to show superiority over placebo in clinical outcomes in patients with CSU. Loratadine, mizolastine, and cetirizine are the most efficacious drugs. More head-to-head trials in a large number of patients are needed to perform in the future.

Approaching the consequences of climate change demands understanding how temperature controls species' responses across key biological aspects, as well as the coordination of thermal responses across these aspects. We study the role of temperature in determining the species' diel, seasonal, and geographical occurrence, using dung beetles as a model system. We found that temperature has relatively low --but not negligible-- effects in the three studied species' aspects, once accounting for alternative factors. More importantly, the estimated thermal niches were largely incongruent across aspects. This shows that species have multidimensional thermal niches, entailing that adjustments to fulfil temperature requirements for one biological aspect, such as seasonal ontogenetic cycles, may result in detrimental effects on other aspects, like diel activity. Paradoxically, the relatively weak effects of temperature we found may have serious consequences for species' responses to warming if temperature regulates essential aspects of species' biology in divergent ways.

Ecological specialisation has been an attractive topic in its relationship with biological diversification. However, there is little knowledge about how much niche specialisation itself promotes speciation, and how they maintain boundary of specialists. To elucidate the issue, we conducted a simple rearing experiment using F1 and backcross generations of two specialist host races of the phytophagous ladybird beetle Henosepilachna diekei, with special attention to host search efficiency and host fidelity. The results showed that divergence in numerous ecological traits that were mostly resulted in divergent natural selection multiplicatively reduced hybrid fitness and maintained current specialisation in both pre-/post-mating stages. Also, larval feeding experience influences host choice in F1 hybrid adults, and it appears in the face of gene flow and reduces further gene exchange. This speciation event show that multiple ecological traits adaptive to different host plants synthetically shape divergent specialists without other isolating barriers.

Aim:An increasing number of studies have reported a higher frequency of liver injury in COVID-19. Several meta-analyses of the associations between liver injury and COVID-19 had been published, but the dose-response relationship has not been conducted. Therefore, we performed a dose-response meta-analysis to explore this relationship. Methods: PubMed, Web of Science, EMBASE, and four additional Chinese databases were used to collect studies from December 1, 2019 to October 26, 2020. Key information was extracted, and the corresponding model was selected on the basis of the heterogeneity test. The pooled RR, OR, and WMD values were then calculated. Sensitivity analysis and publication bias were also assessed to further demonstrate the stability and reliability of the results. Results: Among the 13298 studies that were initially retrieved, 54 studies met our inclusion criteria and included 9907 participants. There was a dose-response relationship between ALT (OR from 1.0 for ≤40 U/L to 1.556[1.130–2.142] for 40–80 U/L and 1.635[1.176–2.273] for >80 U/L), AST (OR from 1.0 for ≤40 U/L to 1.635[1.180–2.266] for 40–80 U/L and 2.019[1.387–2.938] for >80 U/L) and severe COVID-19. Higher ALT, AST, and TBil were associated with need for ICU admission (WMD 6.45[4.08–8.81], 8.80[6.02–11.57], 2.03[0.91–3.14]), and death due to COVID-19 (WMD 3.22[0.08–6.35], 12.06[6.26–17.85], 2.70[0.72–4.68]). There was no publication bias in this meta-analysis. Conclusion: There were dose-response relationships between ALT, AST, and COVID-19 severity. ALT and AST levels in COVID-19 patients on admission should be considered to be clinical warning indicators, which could provide basis for preventing serious COVID-19 and associated deaths

We retrospectively examined febrile (>38.3°C) adult patients with microbiologically confirmed coronavirus disease (COVID-19) (n=48) or influenza (n=63). The median pulse rate (/min)/body temperature (°C) ratio was significantly lower for COVID-19 patients (2.14; interquartile range, [IQR] 1.92–2.47) than for influenza patients (2.63; IQR, 2.31–2.93; P<0.0001). The area under the curve was 0.80 (95% confidence interval 0.71–0.88), optimal cut-off was 2.23, and sensitivity and specificity were 66.7% and 84.1%, respectively. Our preliminary results suggest that febrile patients with COVID-19 exhibit more severe bradycardia than those with influenza. Relative bradycardia is a useful feature for distinguishing COVID-19 from influenza.

Objective To investigate the present situation of labour analgesia in comprehensive Grade 3A hospitals in Fujian Province, to analyse the influencing factors, and to seek countermeasures to promote the popularization of labour analgesia. Methods: The investigation was conducted at all Western medicine comprehensive Grade 3A hospitals in Fujian Province, field investigations and on-site questionnaire surveys were adopted, and on-site interviews were conducted with leaders in charge of the hospitals and leaders related to departments of labour analgesia. Results: Among the 16 hospitals surveyed, 12 hospitals (75%) routinely carried out intraspinal labour analgesia, and the analgesia rates for 2015, 2016, 2017 and 2018 were 0.24%, 1.43%, 2.34% and 9.21%, respectively. At present, the quantity of labour analgesia is insufficient, the proportion of analgesia is still low, and the enthusiasm of hospitals is not high. Factors affecting the development of labour analgesia mainly include a heavy workload/lack of staff (93.75%), department coordination/leadership (87.50%), high cost/low benefit (62.50%), maternal and family members (68.75%), and insufficient publicity (68.75%). Conclusions: The labour analgesia work of the comprehensive Grade 3A hospitals in Fujian Province is still in its initial stage; there is still a lack of uniform implementation standards and charging standards among hospitals in various cities. To better promote labour analgesia, it is suggested that hospitals increase the publicity of labour analgesia, strengthen the training of labour analgesia personnel, standardize the implementation standard of labour analgesia, set up appropriate charging items, and optimize labour analgesia management while appropriately supplementing medical personnel

A document by Ali Atasoy. Click on the document to view its contents.

In this paper, we introduce hybrid numbers with Fibonacci and Lucas hybrid number coefficients. We give the Binet formulas, generating functions, exponential generating functions for these numbers. Then we define an associate matrix for these numbers. In addition, using this matrix, we present two different versions of Cassini identitiy of these numbers.

The existence of man is dependant on nature. The peaceful existence is distributed either by man-made devastations or by natural damages. This study focuses on the contagious model of fractional order pine wilt disease employing the q-HATM (q-homotopy analysis transform method) to the leading fractional operator Atangana-Baleanu (AB) to arrive at better comprehension. The outgrowth are exhibited in the forms of figures and tables. At last the paper helps to analyse the practical theory and assists to predict its manner that correspond the guidelines contemplate the replica.

Subtilisin QK is a nattokinase-like serine protease which demonstrates high efficiency for direct cross-linked fibrin degradation, without activation of plasminogen. It was resistant capacity against the digestion of mimics pancreatic enzyme and could be absorbed throughout ex vivo intestine with fibrinolytic activity in a time-dependent manner. The result of bioluminescence image using nude mice also proved that rSubtilisin QK could infiltrate into all organs from intestinal mucosa. Since rSubtilisin QK could also elevated the levels of plasma levels of fibrin/fibrinogen degradation products and D-dimer (they are sensitive indicators of in vivo fibrinolytic activity) in rats, its prevention effect was investigated in κ-carrageenan-induced rat model. Thrombosis rats were oral treated with rSubtilisin QK for 7 days, and the length of tail-thrombosis was then measured. Compared to control group, the average length of tail-thrombosiswere reduced and the vessel cross section of ears and tails occupied by thrombosis was relieved among the thrombosis rats treated with rSubtilisin QK. Furthermore, the levels of tissue plasminogen activator were increased in cultured HUVECs stimulated with rSubtilisin QK, while plasminogen activator inhibitor-1 showed the opposite trend simultaneously, suggesting the activation of plasminogen. In conclusion, rSubtilisin QK exerted thrombolytic effects in vivo and may be a potential oral thrombolytic agent.

Understanding how and why species evolve often requires knowledge of intraspecific divergence. In this study, we examine intraspecific divergence in the endangered hot spring snake Thermophis baileyi, an endemic species of the Qinghai-Tibet Plateau. Genomic analyses using a hybrid assembly strategy resulted in a revised, high-quality genome. Whole-genome re-sequencing of 31 sampled individuals from 15 sites served to identify drivers of intraspecific divergence, and explore the potential role gene selection plays in divergence. Our analyses resolved three groups, with inter-group admixture occurring in regions of contact. Divergence seems to have occurred during the Pleistocene because of glacial climatic oscillations and geomorphological changes. Highly diverged regions (HDRs) that distinguish the groups most likely owe to gene sorting. Inter-group HDRs involve genes under positive selection that putatively relate functionally to ecological divergence, and especially reproduction. Our findings reveal the need to integrate multiple aspects to distinguish evolutionary processes potentially involved in speciation.

Tuberous sclerosis complex (TSC), an autosomal dominant genetic disorder characterized by hamartomas in various organs. Auricula and Meatus Acusticus Externus (MAE) involvement of TSC related angiofibroma is a rare and specific presentation of the disease. A 31-year-old male patient with left auricular mass and ear fullness was presented.

Here, photovoltaic behaviors of the human-shaped molecules named Nanokid and Nanoathlete (monomeric forms) and Nanoputain dimer1 and Nanoputain dimer2 (hetero-dimers) based on the quantum chemistry were investigated. For all studied anthropomorphic molecules, tuning the electrophilicity decreases the energy barrier of the electron injection. Nanokid and Nanoathlete have greater activity against solar light, which shows more favorable photovoltaic parameters. Although Nanoputain dimers represent better charge transfer indices and intramolecular charge transfer, they have low oscillating strength. The maximum peaks of the current and efficiency in different absorption wavelengths are originated from the increase in the light-harvesting efficiency and decrease in the energy barrier of the electron injection. Finally, Nanokid and Nanoathlete are proposed as better candidates to be used in the photovoltaic cells.

End-capped acceptor modification of fused-ring electron acceptors (FREAs) is an attractive strategy to boost the optoelectronic and photovoltaic properties of the materials. FREAsare proved beneficial due to their tremendous applications in organic solar cells (OSCs). Among fused-ring electronic species, small fullerene-free FREAs have already been drawn more attention due to their near-infrared sensitivity and constantly increasing efficiencies. Therefore, we have designed six new FREAs (K1-K6) having selenophene as π-bridge in between the central alkylated indaceno[1,2-b:5,6b]dithiophene (IDT) unit after the incorporations of various end-capped acceptors on to the recently synthesized IDT2SeC2C4-4F molecule. Structural-property relationship, photophysical and photovoltaic properties of newly designed molecules are studied with the help of density functional theory (DFT) and time-dependent-density functional theory (TD-DFT). Certain critical specifications like frontier molecular orbital (FMOs) alignment, the density of states (DOS), absorption maxima, excitation energy, binding energy (B.E) along with transition density matrix (TDM), and the specifically estimated re-organizational energy values of electron and hole and the open circuit voltages of newly designed molecules are computed and compared with reference molecule. Generally, a red-shifting absorption behavior of FREAs is considered the most important reason for their high efficiencies in OSCs. Our novel designed molecules exhibit redshift in the absorption spectrum. Similarly, low excitation and binding energies of designed molecules offer improved power conversion efficiencies (PCE) with the highest possible charge photo-current density (Jsc) in OSCs devices. Furthermore, the study of the PTB7-Th/K1 complex is also done in order to examine charge transfer between within complex. By introducing the efficient end-capped acceptor moieties in reference molecule, enhancement in charge mobilities is noted. The large open-circuit voltage, low reorganizational energies, narrower HOMO-LUMO energy gap, lower binding and excitation energies, and highly red-shifting in absorption phenomenon indicates an efficient designing of molecules that could be best fitted for high-efficiency OSCs. Finally, theorized molecules are much superior related to their photovoltaic and electronic properties and thus are recommended to experimentalists for their synthesis and out-looking future developments of highly efficient solar cell devices.

Hydroa vacciniforme-like lymphoproliferative disorder (HVLPD) is a rare group of chronic EBV infection-associated diseases, and usually occurs in childhood. The prognosis of HVLPD varies. Previous researches found that the prognosis of adults with HVLPD is worse than children. Herein, we report a case of HVLPD in an 8-year-old girl, but the clinical course progressed rapidly, from the classic form of HVLPD to severe HVLPD, and finally progressed into lymphoma. Fortunately, the patient was curable by hematopoietic stem cell transplantation. To the best of our knowledge, this is the most complete story of HVLPD in a same patient so far.

Background and Purpose: Diosmetin (Dios), a flavonoid compound with multiple pharmacological activities. However, fewer studies have reported its effects on diabetes. Here, we address the effect of Dios on glucose metabolism and gut microbiota in KK-Ay diabetic mice. Experimental Approach: Wild type C57BL/6J mice or diabetic KK-Ay mice were treated with vehicle or Dios for one month. The liver RNA-Seq was used to reveal the key signaling pathway interfered with Dios. The liver 16S rRNA gene sequencing was used to reveal the effects of Dios on gut microbiota. The experiment of C. glu transplantation was used to reveal the relationship between Dios and C. glu on glucose metabolism. Key Results: Dios treatment significantly decreased blood glucose and increased serum insulin concentrations. Transcriptome sequencing analysis found that the underlining mechanism of diosmetin on T2DM by regulating signal pathways of glucose metabolism, which was proved by up-regulating IRS/PI3K/AKT signaling pathway to promote glycogen synthesis and GLUT4 translocation. Besides, Dios treatment reshaped the unbalanced gut microbiota by suppressing the ratio of Firmicutes/Bacteroidetes and markedly increasing the richness of C. glu. Moreover, Treatment with C. glu and Dios together can markedly ameliorate glucose metabolism by up-regulating IRS/PI3K/AKT signaling pathway to promoting glycogen synthesis and GLUT4 translocation. Conclusions and Implications: Dios treatment remarkably ameliorated glucose metabolism in KK-Ay diabetic mice by the regulation of C. glu on IRS/PI3K/AKT signaling pathway and reshaped the unbalanced gut microbiota. Our study provided evidence for the application of Dios to the treatment of T2DM.

Introduction. Diabetes mellitus (DM) is associated with increased risk of sudden cardiac death, but its role in arrhythmogenesis is not clear. We evaluated contributions of DM duration and hyperglycemia level to development of proarrhythmic electrophysiological changes in the experimental ischemia/reperfusion model. Methods and Results: Ventricular epicardial 64-lead mapping and arrhythmia susceptibility burst-pacing testing were performed in 43 healthy and 55 diabetic (alloxan model) anesthetized rabbits undergoing 15-min left anterior descending coronary artery occlusion, followed by 15-min reperfusion. During ischemia, arrhythmia inducibility did not differ between the groups, but the number of reperfusion ventricular tachycardias and/or fibrillations (VT/VFs) was higher in the DM group (14 out of 55) as compared to control (3 out of 43, p=0.017). In the diabetic animals, both DM duration and glucose concentration were associated with reperfusion VT/VF development in univariate logistic regression analysis (OR 1.058; 95% CI 1.025-1.092; p < 0.001; and OR 1,119; 95% CI 1,045-1,198; p = 0.001; respectively). However, only the DM duration remained an independent predictor of reperfusion VT/VF in multivariate logistic regression analysis (OR 1.060; 95% CI 1.006 1.117; p = 0.029). Among mapping parameters, DM duration was associated with the prolongation of total ventricular activation duration (B 0.152; 95% CI 0.049-0.255; p=0.005) and activation-repolarization intervals (ARIs) (B 0.900; 95% CI 0.315-1.484; p=0.003). The prolonged ARI was the only mapping characteristic predicting reperfusion VT/VF development (OR 1.028; 95% CI 1.009-1.048; p = 0.004). Conclusions: The DM duration-dependent prolongation of ventricular repolarization presents a link between DM development and reperfusion VT/VF inducibility.

Backgrounds: Polymyxin B， which is a last line antibiotic for multi-drug resistant gram-negative bacteria, has been reported to induce skin hyperpigmentation in patients during treatments. 8~15% or more cases were reported hyperpigmentation, especially in head and neck, seriously influencing the compliance of patients. To investigate the mechanism of hyperpigmentation is beneficial for intervention strategy and improve compliance. Methods: The melanoma cells, SK-MEL-2 cells were employed in the present study to verify whether polymyxin B treatment could directly induce hyperpigmentation. Melanin contents were measured by hot alkali lysis method and tyrosinase were quantified by dopaquinone oxidation method. The real-time quantitative PCR was applied to measure the mRNA levels of melanogenesis-related genes to investigate the possible signaling pathway involved in the polymyxin B induced hyperpigmentation. Results: The melanin content and tyrosinase activity were up-regulated after 5 μg/mL polymyxin B treatment in SK-MEL-2 cells at 48 hr. and 72 hr. The mRNA levels of melanogenesis-related genes were up-regulated, including PI3K, Akt, GSK-3β, CREB, MITF in the polymyxin B treatment group compared with control group at 48 hr. (p<0.001). Conclusions: In the present study, for the first time to reveal that polymyxin B induced hyperpigmentation involved the signaling pathway of PI3K/AKT/GSK-3β and the up-regulation of CREB and MITF subsequently, then induced the activity of tyrosinase and melanin content in melanoma cells.

A case of hypertrophic obstructive cardiomyopathy complicated with paroxysmal supraventricular tachycardia is reported in this paper. The main clinical manifestations of the patient were shortness of breath after activity, palpitation that appeared gradually and transient amaurosis. There was no significant relief of symptoms after the application of β- blocker and other drugs, and color doppler echocardiography indicated that the pressure difference of left ventricular outflow tract increased gradually. The patient was treated with supraventricular tachycardia radiofrequency ablation combined with ventricular septal radiofrequency ablation under the guidance of intracardiac ultrasound.The symptoms of palpitation, shortness of breath and amaurosis disappeared, and the quality of life and exercise endurance of the patient were significantly improved when the first follow-up at 1 month was performed after the operation. The purpose of this case is to provide ideas for the end point, energy selection and prognosis criteria of ventricular septal ablation for hypertrophic obstructive cardiomyopathy by analyzing the clinical and surgical data of the patient.

Objective: The utilization of the International Classification of Functioning, Disability and Health (ICF) Brief Core Set for Hearing Loss (BCS-HL) seems to be a promising tool to assess the factors underlying SHL. This study aimed to assess categories underlying SHL in older adults using the ICF-BCS-HL tool. Design: A cross-sectional study. One-hundred and thirty-one independent-living older adults (Mage=72.32, SD=6.83), who completed the speech, spatial, and quality of hearing (SSQ) scale and a set of clinically accepted outcome measurements linked with selected categories listed in the ICF BCS-HL. Results: A linear regression analysis model was fitted with the outcome measurements after controlling for age, sex, education, multimorbidity, and hearing aid use. The model showed 5 significant predictors underlying the SSQ-total score: HL, dizziness handicap, cognitive decline, multimorbidity, and individuals’ ability to accept the noise level. Predictors varied across the SSQ-subscales scores, however. While predictors underlying the SSQ-Quality subscale scores were like the SSQ-total score, individuals’ ability to accept noise level was not one of the predictors underlying the SSQ-Speech subscale scores. Whereas PTA, dizziness handicap and multimorbidity were the predictors underlying the SSQ-Spatial subscale scores. Conclusion: SHL, measured by SSQ, in older adults is a multi-layer structure in nature and is associated with a range of adverse health outcomes. A link of SHL with HL, cognitive deficits, reduced ability to accept background noise level, and multimorbidity, collectively or individually, were well-established. So far, little attention has been paid to the impact of dizziness handicap of elderly patients when evaluating their SHL.

Alternative splicing (AS) of pre-mRNAs is an important gene regulatory mechanism shaping the transcriptome. AtMC1 is an Arabidopsis thaliana type I metacaspase that positively regulates hypersensitive response (HR). Here, we found that AtMC1 is a negative regulator of plant immunity to the bacterial pathogen Pseudomonas syringae pv. tomato (Pst) DC3000 and is physically associated with Sm-like4 (LSM4), which is involved in pre-mRNA splicing. AtMC1 and LSM4 protein levels both increased with their co-expression as compared with their separate expression in vivo. Like AtMC1, LSM4 negatively regulates plant immunity to Pst DC3000 infection. By RNA-seq, AtMC1 was shown to modulate the splicing of many pre-mRNAs including 4CL3, which is a negative regulator of plant immunity. Moreover, atmc1 mutant plants accumulated microRNAs (miRNAs) such as miR398b, miR399a, miR165a and miR159a at a low level than wild-type Arabidopsis Col-0 plants. Furthermore, AtMC1 affected pri-miRNA processing. RNA immunoprecipitation revealed that AtMC1 interacted with these pri-miRNAs in vivo, suggesting that AtMC1 might suppress their processing by directly binding to them. In addition, we found that MC1-mediated plant immunity is conserved in tomato. Thus, AtMC1 plays a regulatory role in both miRNA expression and pre-mRNA splicing, which might contribute to AtMC1-mediated plant immunity.

BACKGROUND: Despite the construction of the metagenome of the asthmatic lung, limitations persist in sampling the bronchial airway. This study analyzed extracellular vesicles (EVs) obtained from exhaled breath condensate (EBC) to compare the distinct characteristics of the microbiome in asthmatics with those in healthy controls and proposed a diagnostic artificial intelligence-based model of asthma. METHODS: We obtained the EBC from 58 healthy controls and 251 patients with asthma. EVs were isolated from the EBC and analyzed. The extracted 16s rDNA was subjected to next generation sequencing. Taxonomic profiling was conducted for all samples at the genus level. A combination of artificial neural network (ANN) and gradient boosting (GBM) was applied to selective EBC biomarkers. RESULTS: The asthma group exhibited significantly higher alpha diversity based on the results of the Chao1, Shannon, and Simpson indices. The bacterial composition of patients with asthma different from that of the controls. At the genus level, Sphingomonas, Akkermansia, Methylophaga, Acidocella, and Marinobacter were significantly more abundant in patients with asthma. The diagnostic model using GBM and ANN demonstrated good performance with respective areas under the curve of 0.832 and 0.769. Firmicutes and Proteobacteria at the phylum level were common important features between the GBM and ANN asthma models. CONCLUSION: We demonstrated a distinct pattern in the microbiome of patients with asthma, indicating the potential role of microbiome-based diagnosis of asthma. To the best of our knowledge, this was the first study to identify the microbiome in asthma using EBC-derived EVs.