A document by Roberto Patarca. Click on the document to view its contents.

Phaeodactylum tricornutum is a marine diatom, and well-studied model of unicellular microalga. This diatom contains a wide range of high-value renewables (HVRs) with high commercial relevance owing to their importance in human nutrition and health. In this study, we screened P. tricornutum for biomass, eicosapentaenoic acid (EPA) and fucoxanthin production under photoautotrophic and mixotrophic condition with various substrate combinations. Results highlights that culture supplemented with glycerol and urea lead to enhanced biomass, biochemical and HVR production. Further continuous feeding of urea in glycerol supplemented medium results in an increase in biomass yield (0.77 g L-1) by ~ 2-fold. Additionally, continuous feeding of urea channelizes the carbon flux towards biosynthesis of fatty acids increasing FAME content by ~2-fold as compared to the control conditions. Overall EPA and fucoxanthin production was 27 mg L-1 and 11 mg L-1 (~2 & 4 fold) in urea fed cultures respectively. Present study demonstrates efficient valorization of cost-effective substrates such as glycerol and urea for the production of high-value renewables in P. tricornutum.

Among all pediatric hematologist-oncologists (PHOs) certificated by the Japanese Society of Pediatric Hematology/Oncology (JSPHO), 215 PHOs (70.0%) received $908,900 personal payments from 54 pharmaceutical companies between 2016 and 2019. Four-year combined average payments per author was $2,961 (standard deviation: $6,299). While the prevalence of physicians with payments was relatively stable during the study period with 40.4% and 44.6% in 2016 and 2019, the average annual personal payments increased nearly double from $559 in 2016 to $1,096 in 2019, respectively. Payments from the top five companies with the largest total payments accounted for 48.8% of total monetary values.

Background and aims of the study. Data on emergency surgery for acute type A aortic dissection in patients with bicuspid aortic valve were limited. Long-term results on the fate of the preserved bicuspid valve and aortic root were even rare. We sought to assess the clinical outcome of emergency acute type A aortic dissection surgery in patients with bicuspid aortic valve. Methods. From 2004 to 2021, 121 patients underwent emergency surgery for acute type A aortic dissection using a conservative aortic resection. Hospital and late outcomes were assessed in patients with bicuspid aortic valve. Results. Eight patients (6.6%) had bicuspid aortic valve with 6 males (75%) and median age of 49.5 years (range, 34 to 71). Four (50%) had significant aortic valve dysfunction. Operation included ascending aortic grafting with aortic valve preservation in 4, ascending aortic grafting with aortic valve replacement in 3 and ascending aortic grafting with Bentall root replacement in 1. Hospital mortality rate was 12.5% (1/8). With a median follow-up of 14.4 years, there was one late death and no proximal reoperation of 6 preserved roots and 3 preserved valves. Median diameter of preserved aortic roots changed from 42 (range, 33-43) to 38.5 mm (range, 35-46) with the average time of 11 years after surgery. Conclusions. Acute type A aortic dissection in bicuspid aortic valve was not associated with worse outcome. Aortic valve replacement was often required. Simultaneous root replacement was not always necessary. Preservation of normally functioning bicuspid valve and non-dilated root showed durable long-term results.

Residue return can prevent or restore the degradation of cropland, meanwhile, additional N input from residue return inevitably result in the changes of soil nitrogen (N) pools. Our objectives were to evaluate these changes in a 16-year field experiment. The residue return experiment consisted of no-tillage (NT) and mouldboard plough (MP), combined with continuous maize (Zea mays L.) (MM) and maize-soybean (Glycine max Merr.) rotation (MS) cropping systems, that is, NTMM, NTMS, MPMM, MPMS; conventional tillage (removal of crop residue and deep plough) with continuous maize (CTMM) was included as a control. The soil was separated into density (LF, light fraction) and particle size (sand, silt and clay) fraction. In 0-5 cm and 5-10 cm layers, soil TN content in NT was higher than MP, whereas the opposite trend was observed in 10-20 cm. Thus, the stratification ratio of soil TN was greater under NT. Cropping system affected soil TN as MM > MS. Residue return increased soil N storage by 6.44%-24.85% in the plough layer. Taking CTMM as the baseline, NTMM and MPMM increased the N storage in all physical fractions, while the decrease of silt-N storage was observed in NTMS and MPMS. Under residue return, the distribution of N storage changes in LF and sand fraction was affected by tillage practice, and that in silt and clay fraction was affected by cropping system. In summary, NTMM is effective for soil N accumulation due to its highest N storage and all physical fractions of N storage was enhanced.

The SFR (Sp02/Fi02 ratio) offers a continuous, non-invasive reflection of pulmonary function regardless of whether the baby is ventilated or breathing spontaneously. We hypothesized that significant PDA shunting would impair pulmonary oxygen diffusion, in turn, reflected by decreased SFR; and that early PDA related decreases in SFR will predict subsequent chronic lung disease (CLD). Methods: We retrospectively examined records from preterm neonates <30 weeks gestational age. Ductal shunting was graded for severity by first week echocardiogram. SFR was calculated as SpO2/Fi02 and recorded on day 7 of life and at 36 weeks postmenstrual age (PMA). Results: We studied 104 infants: 65 with closed duct; 17 with hemodynamically insignificant PDA and 22 with hemodynamically significant (hsPDAs). CLD developed in 9 (14%) of those with closed ducts; 6 (35%) of those with hisPDA; and in 12 (55%) of those with hsPDA (p=0.005). Babies with hsPDA had significantly lower SFR values at both time points. SFRs in babies with hisPDA were decreased at 1 week postnatally, but were similar to those of babies with closed ducts at 36 weeks. SFR at 36 wks. was decreased only in infants with hsPDA [[467[461,467] vs. 467[413,471] vs. 369[262,436] respectively; p=0.000148]. Using ROC curve analysis, week 1 SFR was strongly associated with hsPDA (AUC=0.770; p<0.0001) and highly predictive (AUC=0.801; p<0.0001) of CLD at 36 weeks PMA. Conclusion: Early decreases in SFR reflect both the acute and chronic pulmonary impact of PDA shunting, possibly providing the missing link supporting an association between hemodynamically significant PDA and subsequent CLD.

Background: Previous studies reported controversial results regarding the association between allergic disorders and ADHD/ASD. The aim of this article is to investigate whether allergic disorders are associated with ADHD/ASD in a large cohort of pediatric patients. Methods: A retrospective study using the pediatric (0-18 year) database (ICD-9-CM codes) of Clalit Health Services during the years (2000-2018). Diagnosis of all disorders was made by specialist physicians. Results: 117,022 consecutive non-selective allergic children diagnosed with one or more allergic disorder (asthma, rhinitis. conjunctivitis, skin, food, or drug allergy) and 116,968 non-allergic children were enrolled to our study. The mean follow-up period was 11±6 years. The presence of allergic disorders in early childhood (mean age of allergic diagnosis 4.5± 4.3 years) in boys as well as in girls, significantly increased the risk to develop ADHD (O.R 2.45, CI 2.39-2.51; P<0.0001), ASD (O.R 1.17, CI 1.08-1.27; P<0.0001) or both ADHD+ASD (O.R 1.5, CI 1.35-1.79; P<0.0001). Children with more than one allergic comorbidity revealed a much higher risk. In a multivariable analysis (adjusted for age at study entry, number of yearly visits and gender) the risk of allergic children to develop ADHD and ADHD+ASD, but not ASD alone, remained significantly higher. Conclusion: Allergic disorder in early childhood significantly increased the risk to develop ADHD, and to a less extend ASD, in later life.

BJOG-21-1256 Systematic reviews and meta-analyses: bigger is not necessarily betterSystematic reviews and often concomitant meta-analyses are designed to summarize the existing and sometimes overwhelming amount of published literature on a specific topic. Ideally, a systematic review and meta-analysis is reproducible, rigorous and strengthens the evidence on the specific topic, but there are potential pitfalls in designing such studies.O’Byrne et al. (BJOG 2021;) performed a systematic review and meta-analysis regarding the pregnancy outcomes of pregnant women with chronic inflammatory disease exposed to biologics. In the past years some other summarized data have been published on this relevant topic. The authors of the current study tried to distinguish their study from these previous systematic reviews and meta-analyses by using broad inclusion criteria and by expanding the control group population. For reference, a study from Tsao et al. (Rheumatology2020;59:1808–1817) included 24 individual studies and approximately 5600 pregnancies in women with inflammatory systemic diseases exposed to biologics. They compared the outcomes with a disease-matched control group. Komaki et al. (Journal of Autoimmunity 2017;76:38-52) studied 5600 pregnancies of women with immune mediated diseases and the use of anti-tumor necrosis factor-α agents. They included 13 studies and both a disease-matched control group and a general population control group. O’Byrne et al. in contrast, also included case series and case reports in addition, resulting in a study population of more than 11000 exposed cases.Then, the methods of data analysis were fitted to the wide design of the study. The most applicable method of measuring an effect of an exposure on maternal and fetal outcomes is with relative effect measures, also known as odds ratios. In the current study the authors used proportions in their meta-analyses. Proportions represent the absolute risk of an outcome in the exposed and non-exposed groups and are not perfectly suited to draw conclusions about the association of an exposure and an outcome. But the wide study design, in particular the inclusion of case series and case reports, left the authors with no choice but to use proportions.Further, this broad inclusion has two more major drawbacks. The meta-analysis showed in most analyses a high heterogeneity. This can be attributed to the inclusion of different study designs and comparisons of different diseases and medications, as the authors mentioned. In addition, there is a serious risk of bias, firstly due to the high selectivity applied when choosing the population of case series and case reports, and secondly due to the use of proportions, making it impossible to adjust for confounders.Well-designed systematic reviews and meta-analyses can generate a clear overview and provide valuable information for clinicians and patients alike. However, although including a large number of cases is recommended to strengthen the evidence of a systematic review/meta-analysis, this should not be done at any cost - it can sometimes weaken the quality of the study. The most appropriate method should be applied and individualized to the specific study.

Adhesions between the bladder and uterus necessitated an atypical incision in the cesarean section of a woman with endometriosis. This could not be predicted with pre-surgery MRI. .No methods in the literature are able to predict adhesions with true certainty; it is therefore still difficult to diagnose intra-abdominal adhesions

Background: Both air pollutants and neonatal jaundice (NJ) have known effects on childhood asthma, but higher total serum bilirubin (TSB) level was associated with lung protection. This study aimed to assess whether prenatal/postnatal exposure to air ambient pollutants is related to the inception of asthma in NJ infants. Material and methods: A nested case-control retrospective study of NJ infants was performed on the Kaohsiung Medical University Hospital Research Database between 2009 and 2019. The average concentration of particulate matter (PM2.5), sulfur dioxide (SO2), nitric dioxide (NO2) for six months, first and second years after the birth, and first, second and third trimesters prenatally were analyzed. The mild and significant NJ infants were categorized as TSB level < and ≧12 mg/dl, respectively. Asthma was defined as a diagnosis with medication. The adjusted odds ratio (aOR) and 95% confidence interval (CI) present the relationship between study periods and childhood asthma. Results: SO2 and NO2 exposure during prenatal periods were significantly associated with increased risk of childhood asthma in mild NJ infants (aOR (95% CI)), SO2: 1.20-1.34 (1.05-1.56); NO2: 1.06-1.07 (1.01-1.13)). Effects were more pronounced in postnatal exposure to three ambient air pollutants in mild jaundice infants. (aOR (95% CI), SO2: 1.33-1.41 (1.14-1.69); NO2: 1.07-1.31 (1.01-1.49; PM2.5:1.05 (1.00-1.10) Conclusion: Both SO2 and NO2 during prenatal and postnatal exposure in mild NJ infants were associated with childhood asthma. Whether taken phototherapy or not, significant NJ infants were spared by three ambient air pollutants.

Remdesivir was the first antiviral agent to receive FDA authorization for severe COVID-19 management, which restricts its use with severe renal impairment due to concerns that active metabolites might accumulate, causing renal toxicities. With limited treatment options, available evidence on such patient groups is important to assess for future safety.

Although the risk of thromboembolism is increased in patients with ulcerative colitis, cerebral venous thrombosis is a rare complication in a patient with ulcerative colitis. We herein present an unusual case of a young female with Ulcerative Colitis under treatment diagnosed with cerebral venous thrombosis and bilateral thalamic infarction

Two Iranian patients presented in this study was suffering from cystinosis diagnosed based on their clinical symptoms and laboratory tests. The variations c.257_258delCT and c.323delA in the CTNS gene found in them are frameshifts and truncating mutations that affect product function and result in the signs and symptoms of cystinosis.

Transseptal left atrial catheterization is routinely used for many common catheter-based interventions. Tools for transseptal catheterization have advanced over the recent years. Such tools include imaging advances with intracardiac echocardiology as well as an array of needles, wires, and dilators to achieve transseptal access with greater ease and safety. This review will discuss the contemporary tools for transseptal catheterization and guidance for difficult cases.

Background: Infection remains a major complication of cardiac implantable electronic devices (CIEDs) and can lead to significant morbidity and mortality. Extrathoracic devices that avoid epicardial or transvenous leads, such as the subcutaneous implantable cardioverter-defibrillator (S-ICD), can reduce the risk of serious infection-related complications, such as bloodstream infection and infective endocarditis. While the 2017 AHA/ACC/HRS guidelines include recommendations for S-ICD use for patients at high risk of infection, currently, there are no clinical trial data that address best practices for the prevention of S-ICD infections. Therefore, an expert panel was convened to develop consensus on these topics. Methods: An expert process mapping methodology was used to achieve consensus on the appropriate steps to minimize or prevent S-ICD infections. Two face-to-face meetings of high-volume S-ICD implanters and an infectious diseases specialist, with expertise on cardiovascular implantable electronic device infections, were conducted to develop consensus on useful strategies pre-, peri-, and post-implant to reduce S-ICD infection risk. Results: Expert panel consensus of recommended steps for patient preparation, S-ICD implantation, and post-operative management were developed to provide guidance in individual patient management. Conclusion: Achieving expert panel consensus by process mapping methodology for S-ICD infection prevention was attainable, and the results should be helpful to clinicians in adopting interventions to minimize risks of S-ICD infection.

Background: Antiretroviral therapy reduces systemic inflammation and immune activation, but not to levels like HIV-negative. Limited drug penetration within tissues has been argued as potential mechanism of persistent inflammation. Data on the role of inflammation on plasma/intracellular (IC) pharmacokinetics (PK) of ARV drugs through to downregulation/expression of cytochrome P450 3A/membrane transport proteins are limited. Aim of this study was to investigate the correlation between inflammation markers and plasma/IC PK of different ARVs regimen in HIV-positive patients. Methods: We included in the study ART-treated HIV+ pts switching to 3 different ARV regimens: 1) DTG-based dual-therapy plus boosted-PIs, 2) DTG-based triple-therapy without PIs, 3) DRV/c-based triple-therapy. Plasma and IC ARV drugs concentration means at the end of dosing interval (T0), IM on samples concomitantly with ARV PK determination: sCD14, CRP, IL-6 and LPS were analysed. Results: 60 samples from pts included in the switching study were used for measuring plasma and IC concentrations of HIV drugs. No significative differences between CRP, sCD14, IL-6 and LPS values in 3 arms of therapy were observed. Significant correlation was observed between tenofovir plasma concentrations and sCD14 (p<0.001), DRV plasma concentration and sCD14 (p=0,07) and DRV IC/plasma ratio and Log10 IL-6 concentrations (p=0.04). Furthermore, in 24 pts on DTG-TT, we observed a negative trend between DTG IC concentrations and sCD14 (p=0.09). Conclusions: Our preliminary data support the hypothesis of lower IC concentrations of DRV and DTG in pts with higher plasma IM, suggesting an interplay between HIV drug penetration and persistent inflammation in cART-treated HIV-positive patients.

Objectives: This study aimed to investigate the effects of ultrafast channel cardiac anesthesia assisted by serratus anterior plane block on the post-operative rehabilitation of patients undergoing right-sided thoracoscopic minimally invasive cardiac surgery, as well as the safety and feasibility of the clinical application of this technique. Background: Regional nerve block has previously been used in cardiac surgery to reduce intraoperative opioid use and promote anesthesia in fast-track and ultra-fast-track cardiac surgery. However, the clinical application of ultrafast cardiac anesthesia assisted by serratus anterior plane block (SAPB) in minimally invasive cardiac surgery under thoracoscopy has not been reported. Methods: A total of 102 patients who underwent right-sided thoracoscopic minimally invasive heart valve surgery in our center from January 2021 to August 2021 were enrolled and divided into two groups: an ultrafast channel cardiac anesthesia assisted by serratus anterior plane block (SAPB-GA) group (n=40) and a conventional general anesthesia (GA) group (n=62). The effects of ultrafast cardiac anesthesia assisted by serratus anterior plane block (SAPB) on post-operative rapid recovery as well as the safety and feasibility of its clinical application were compared and analyzed. Results: Compared to the GA group, the intraoperative use of sufentanil in the SAPB-GA group was significantly reduced (66.25±1.025, 283.31±11.362, P<0.001); the incidence of postoperative analgesia in ICU was significantly decreased (17%, 48.8%, P<0.001); the incidence of postoperative NRS≥3 in ICU was significantly decreased (15%, 37.1%, P = 0.016); and the postoperative extubation time (1(1-1), 13.84 (10.25-18.36), P<0.001), ICU stay time (28.58±2.838, 61.69±4.125, P<0.001) and postoperative hospital stay (8.08±0.313, 9.74±0.356, P=0.02) were significantly shortened; and the 24 h postoperative thoracic blood drainage was significantly reduced (209.63±25.645, 318.23±20.713, P<0.001). No statistical difference was observed in the incidence of postoperative nausea, vomiting and atelectasis between the two groups (all P>0.05). Both of the groups reported no postoperative cardiovascular events. Conclusions: Ultrafast channel cardiac anesthesia assisted by SAPB could promote the rapid postoperative recovery of patients undergoing minimally invasive cardiac surgery under a thoracoscope. This approach is safe and feasible in the clinic.

Heterosigma akashiwo is a eukaryotic, cosmopolitan, and unicellular alga (class: Raphidophyceae), and produces fish-killing blooms. There is a substantial scientific and practical interest in its ecophysiological characteristics that determine bloom dynamics and its adaptation to broad climate zones. A well-annotated genomic/genetic sequence information enables researchers to characterize organisms using modern molecular technology. The Chloroplast and the mitochondrial genome sequences and transcriptome sequence assembly (TSA) datasets with limited sizes for H. akashiwo are available in NCBI nucleotide database on December 2021: there is no doubt that more genetic information of the species will greatly enhance the progress of biological characterization of the species. Here, we conducted H. akashiwo RNA sequencing, a de novo transcriptome assembly (NCBI TSA ICRV01) of a large number of high-quality short-read sequences, and the functional annotation of predicted genes. Based on our transcriptome, we confirmed that the organism possesses genes that were predicted to function in phagocytosis, supporting the earlier observations of H. akashiwo bacterivory. Along with its capability for photosynthesis, the mixotrophy of H. akashiwo may partially explain its high adaptability to various environmental conditions. Our study here will provide an important toehold to decipher H. akashiwo ecophysiology at a molecular level.

Superior mesenteric vein thrombosis (SMVT) is a rare complication of acute appendicitis. It has no specific clinic manifestation. Anticoagulation, antibiotics and surgery are the main treatment pillars. We report herein a case of an 86-years-old women treated for acute appendicitis complicated with SMVT and massive pulmonary embolism.

The blind colonic loop following end to side ileo- sigmoid anastomosis resembles a vermiform appendix in anatomy and function. This anatomical alteration is associated with delayed complications and is not advisable.

 In this paper we will study the strong coupling constant. The recommended theoretical value for the strong coupling constant is αs=Euler's number/Gelfond's constant. It will turn out that this value is the key that solves many problems of Physics. We will find a lot of formulas for the strong coupling constant. All these equations prove that the value of the strong coupling constant depends on the energy scale. First we will find the beautiful unity formulas that connect the strong coupling constant and the fine-structure constant. These equations are the simple unification of the strong nuclear and the electromagnetic interactions. It will be presented the mathematical formulas that connect the dimensionless physical constants with the strong coupling constant. From these equations we reached the formula of the unification of the strong nuclear,the electromagnetic and the gravitational interactions. Also we will find the formula for the Gravitational constant. Finally we will be presented the formula for the cosmological constant. This unity formula is a simple analogy between atomic physics and cosmology.  All these equations are simple,elegant and symmetrical in a great physical meaning.      

The emulsified feedstock technique is to improve the performance of products by using the micro-explosion phenomenon of emulsion. However, an obstacle to some applications of this technology is the contradiction between emulsion stability and micro-explosion intensity. For the first time, adding water-soluble polymers was proposed to solve this problem. Two polymers of xanthan gum (XG) and nonionic polyacrylamide (NPAM) were investigated and the results show that micro-explosions have five forms. As one of these five forms, the intensity of optimal micro-explosion is three orders of magnitude higher than other forms, and adding 0.5% XG increases the probability of optimal micro-explosion from 0% to 60% due to the low surface activity, strong thickening and pseudoplasticity of XG solutions. By contrast, NPAM does not promote micro-explosion because of its strong surface activity. Finally, a new mechanism for micro-explosions related to surface tension, interfacial tension and viscosity is proposed.

Rim M. Harfouch, Department of microbiology and biochemistry, Faculty of pharmacy, Al Sham private university, Latakia, Syria. Correspondence Autho’s E-mail: r.h.foph.lat@aspu.edu.sy

Ruptured abdominal aortic aneurysms are associated with high mortality rates and require prompt diagnosis with subsequent intervention. CT scan is considered the gold-standard for diagnosis, however, in the acute setting ultrasound may be a reasonable diagnostic test for certain patients. We report a case that demonstrates the utility of bedside ultrasound of rAAA for a patient in extremis. Also, we provide a brief review of literature for the diagnosis of rAAA with ultrasound.