The environmental DNA (eDNA) method, which is widely applied for biomonitoring, is limited to laboratory analysis and processing. In this study, we developed a filtration/extraction component using a microfluidic channel, Biryu-Chip (BC), and a filtration/extraction method, BC method, to minimize the volume of the sample necessary for DNA extraction and subsequent PCR amplification. We tested the performance of the BC method and compared it with the Sterivex filtration/extraction method using aquarium and river water samples. We observed that using the BC method, the same concentration of the extracted DNA was obtained with 1/20–1/40 of the filtration volume of the Sterivex method, suggesting that the BC method can be widely used for eDNA measurement. In addition, we could perform on-site measurements of eDNA within 30 min using a mobile PCR device. Using the BC method, filtration and extraction could be performed easily and quickly. The PCR results obtained by the BC method were similar to those obtained by the Sterivex method. The BC method required fewer steps and therefore, the risk of DNA contamination could be reduced. When combined with a mobile PCR, the BC method can be applied to easily detect eDNA within 30 min from a few 10 mL of the water sample, even on-site.

Managing women who are pregnant with severe COVID-19 is complex. This paper focuses on the debate surrounding steroid use in this group. Unfortunately, despite international efforts to identify treatments for COVID-19, there is very little research which has focussed specifically on pregnant women. Therefore current guidance is based on consensus and expert opinion, with variation in these guidelines worldwide, and reports that 73% of pregnant women do not receive steroids at all. There is an assumption of a steroid class-effect implicit within the UK guidelines for the mother with COVID-19 which is at odds with established within-class differences for effects on the foetus. This now warrants further discussion given the increasing numbers of pregnant women being admitted to hospital with COVID-19.  

A recent study on the Taylor series method of second order and the trapezoidal rule for dynamic equations on time scales has been continued by introducing a derivation of the Taylor series method of arbitrary order $p$ on time scales. The error and convergence analysis of the method is also obtained. The 2 step Adams-Bashforth method for dynamic equations on time scales is concluded and applied to examples of initial value problems for nonlinear dynamic equations. Numerical results are presented and discussed.

Aspirin is one of the most widely used medicines in the world and has been on the market for over a century. Therefore, it is surprising that little solid research has been done regarding the effects of aspirin on the liver. If anything, you can find a few studies from the 1970s. At that time, aspirin was described as damaging to the liver by quite some authors. But since the turn of the millennium, studies have suddenly appeared that attribute a liver-protective effect to aspirin. We have investigated this contradiction and found a tipping point effect of high clinical relevance.

Negli ultimi decenni l’eccessivo utilizzo di farmaci ha avuto un forte impatto negativo sull’ambiente, in particolar modo sul comparto idrico. A lungo termine i prodotti farmaceutici, che rientrano nella classe dei contaminanti emergenti, potranno essere responsabili di diversi problemi come la tossicità negli organismi acquatici, la resistenza microbica e la distruzione degli ecosistemi microbici.  Gli impianti di depurazione tradizionali, come ad esempio quelli basati sul processo a fanghi attivi, non sono in grado di rimuovere completamente questa tipologia di inquinanti, motivo per il quale è necessario implementare tecnologie alternative.    In particolare, nello studio di seguito analizzato è stata posta l’attenzione su un’efficiente e vantaggiosa tecnologia: l’elettrocoagulazione. Tale tecnica è stata adoperata per la rimozione di alcuni farmaci che si trovano con più frequenza nelle acque reflue, come l’amoxicillina (AMX), il diclofenac (DCF) e la carbamazepina (CBZ). 

Both surface motion and hole stress concentration have always been concerned in anisotropic medium. In this paper, a theoretical approach is used to study the scattering problem of circular holes under a scalene trapezoid on the surface. The mapping function that anisotropic medium to homogeneous medium is established, and the relationship between the free boundary of anisotropic medium and the mapping of homogeneous medium boundary is proved. In the space of homogeneous medium mapping, the wave displacement function is obtained by solving the equation of motion that meets the zero-stress boundary conditions by separating the variable method and the symmetric method. Based on the complex function, multi-polar coordinate method and region-matching technique, algebraic equations are established at auxiliary boundary and free boundary conditions in complex domain. Then according to sample statistics, least square method is used instead of the Fourier expansion method to solve the undetermined coefficient of the algebraic equations by discrete boundary. Numerical results shows that the continuity of the auxiliary boundary and the accuracy of the zero-stress boundary are nice, and the displacement of the free surface and the stress of the circular hole are related to the parameters of material medium, the position of the circular hole, the direction of the incident wave and the frequency content of the excitation. Finally the process of the wave propagation and scattering around trapezoid and shallow circle are shown in time domain through the inverse fourier transform.

Le risorse idriche sono sempre più viste come un bene da tutelare e preservare, necessità che contrasta con la sempre più crescente domanda di quest’ultime per i più svariati impieghi. L’urgenza di trovare un punto di incontro, che cercasse di coniugare sia l’aspetto produttivo che quello ambientale, ha spinto negli anni la ricerca scientifica ad affinare i metodi convenzionali utilizzati per il trattamento delle acque reflue mirando al recupero e conseguente riutilizzo dell’acqua. Dall’impiego dei fanghi attivi si è passati agli impianti di trattamento a membrana, poi migliorati tramite l’implementazione di processi elettrochimici. Un ulteriore livello di efficienza si è raggiunto tramite i bio-reattori a membrana dinamica auto formante, evolutosi ulteriormente in bio-reattori a membrana dinamica auto formante incapsulati raffinati successivamente tramite processi elettrochimici. Le condizioni naturali sempre più drastiche hanno determinato l'evolversi di strumentazioni ed impianti sempre più efficienti, sfruttando al massimo ciò che il contesto offre riciclandolo e ottimizzando gli sprechi.

Sexual Minority Individuals and Pregnancy Outcomes: A CommentaryJulie Croll, MPHa,b; Laura Sanapo, MD, MSHS, RDMSa,c; Ghada Bourjeily, MD, FCCPa,caWomen’s Medicine Collaborative at Lifespan, The Miriam Hospital, 146 West River Street, Providence, RI 02904, USAbRCSI University of Medicine and Health Sciences, School of Medicine, 123 St Stephen’s Green, Dublin 2, IrelandcWarren Alpert Medical School of Brown University, Department of Medicine, 222 Richmond Street, Providence, RI, USA

Merck's Molnupiravir is a global catastrophic risk. Its broad use as a treatment for COVID-19 will create dangerous variants of SARS-COV-2. It is already in use in some countries. Molnupiravir ("MOLN"), a presumed anti-COVID19 drug, acts by significantly increasing the RNA error rate in the coronavirus replication. That exponentially increases the probability of many mutations in a single copy. Copies containing a large set of new mutations are disproportionately likely to create dangerous mutations. Patients taking MOLN are expected to carry and shed the virus in almost equal volumes as untreated patients. Estimates show that MOLN would increase the frequency of sets of 8 mutations by 3,000 times, and sets of 12 mutations by 240,000 times, per virus generation, per person. This does not include recombinations and many other effects which are likely to compound these results. Multiple rounds of replication and natural selection per person further increase the threat. The impact cannot be detected immediately due to a possible lag between the appearance of a new variant and the necessary changes in external conditions, which lead to its spread. At least some of the many artificial variants, induced by the MOLN treatment, are likely to combine immune escape, higher contagiousness, and higher virulence, just to mention a few. This would be a gain-of-function experiment, performed on the entire human race.

Determinar las condiciones perinatales relacionadas con macrosomía fetal, en nuestra población.MÉTODOS:Estudio transversal de los registros del programa publicado por El Centro Latinoamericano de Perinatología, Salud de la Mujer y Reproductiva, archivados en el Hospital Gineco-Obstétrico Isidro Ayora, desde enero del 2008 hasta diciembre del 2016. Para las variables numéricas se aplicó la prueba t. Las variables cualitativas se analizaron con la prueba Chi cuadrado. Para el análisis multivariado se utilizó modelos de regresión. En los resultados se incluye el Odds Ratio crudo y ajustado con el intervalo de confianza al 95%. Los datos fueron analizados con el paquete estadístico R versión. 3.3.1 para Mac.RESULTADOS:Se encontró 1171(5.2%) neonatos macrosómicos. Las variables asociadas a macrosomía fueron diabetes, edad gestacional, edad materna, gestas previas, estado civil, sexo masculino, nacimiento vía cesárea, además existe asociación negativa con embarazo múltiple.CONCLUSIONES:La macrosomía neonatal está relacionada con trastornos metabólicos en la madre, la mayor edad gestacional y materna, acompañamiento de la pareja durante el embarazo, la multiparidad, el producto masculino. El resto de los factores sociales, étnicos, las enfermedades crónicas y los trastornos propios del embarazo no mostraron asociación con macrosomía fetal.

Introduction: Since the first COVID-19 cases were reported, the disease's clinical and epidemiological characteristics have continuously been studied, although they have not been yet defined. Objective: To estimate the epidemiological profile of pediatric patients with COVID-19, as well as their clinical, laboratory and radiological characteristics. Materials and methods: A living systemic review was conducted in the PubMed, Scopus and SciELO databases. Observational studies describing clinical, radiological, and laboratory characteristics of pediatric patients with COVID-considered for the search; there were no language restrictions. Government, epidemiological, and pre-print papers were also considered. Meta-analyses of single proportion (frequentist approach) and two proportions (Bayesian method) were carried out. The study registration and protocol are available at https://osf.io/y43wm and https://osf.io/r8ktv, respectively. Results: 13 studies, with a total of 9 152 patients, were retrieved. The Bayesian meta-analysis reported that males are more affected by the disease: OR 1.24 (HDI95%: 1.09-1.4). The proportion results calculated by means of the frequentist meta-analysis are: 52% cough (95%CI: 50-55), 0% death (95%CI: 0-0.1), 16% high aspartate transaminase levels (95%CI: 13-19), and 60% lung changes observed in chest X-ray (95%CI: 57-64). Conclusions: Based on the current data, it is not possible to describe accurately the clinical and epidemiological characteristics of COVID-19 in the pediatric population. However, evidence suggests that males are more affected by the disease and that lung alterations in imaging studies are more frequent than clinical signs such as cough and fever. Laboratory test results are not conclusive and show that different organs and systems of the human body may be affected by SARS-CoV-2. The results reported here must be compared to prospective controlled studies conducted in larger samples and a more rigorous design.

This realist enquiry applying behavioural theory aimed to identify behavioural mechanisms and contexts that facilitate prescribers tapering opioids. We identified relevant opioid tapering interventions and services from a 2018 international systematic review and a 2019 England-wide survey, respectively. Interventions and services were eligible if they provided information about contexts and/or behavioural mechanisms influencing opioid tapering success. A stakeholder group (n=23) generated draft programme theories based around the 14 domains of the theoretical domains framework. We refined these using the trial and service data. From 71 articles and 21 survey responses, 56 and 16 respectively were included, representing primary care, hospital, specialist pain facilities and prison services. We identified six programme theories that included five behavioural mechanisms: prescribers’ knowledge about how to taper; build prescribers’ beliefs about capabilities to initiate tapering discussions and manage psychological consequences of tapering; perceived professional role in tapering; the environmental context enabling referral to specialists; and facilitating positive social influence by aligning patient: prescriber expectations of tapering. No interventions are addressing all six mechanisms supportive of tapering. Work is required to operationalise programme theories according to organisational structures and resources. An example operationalisation is combining tapering guidelines with information about local excess opioid problems and endorsing these with organisational branding. Prescribers being given the skills and confidence to initiate tapering discussions by training them in cognitive-based interventions and incorporating access to psychological and physical support in the patient pathway. Patients being provided with leaflets about the tapering process and informed about the patient pathway.

Background/Purpose: Systemic sclerosis (SSc) is characterised by progressive multiple-organ fibrosis leading to morbidity and mortality. Lysyl oxidases play a vital role in the cross-linking of collagens and subsequent build-up of fibrosis in the extracellular matrix. As such, their inhibition provides a novel treatment paradigm for SSc. Experimental Approach: Lysyl oxidases are upregulated in preclinical models of fibrosis in skin, lung, heart, kidney and liver. A novel small molecule pan-lysyl oxidase inhibitor, PXS-5505, currently in clinical development for bone fibrosis treatment was evaluated in in vivo rodent models resembling the fibrotic conditions in SSc. Key Results: Both lysyl oxidase and lysyl oxidase-like 2 (LOXL2) expression was elevated in the skin and lung of SSc patients. Once-a-day oral application of PXS-5505 inhibited lysyl oxidase activity in the skin and LOXL2 activity in the lung. PXS-5505 exhibited anti-fibrotic effects in the SSc skin mouse model, reducing dermal thickness and α-smooth muscle actin compared to the disease controls. Similarly, in the bleomycin-induced mouse lung model, PXS-5505 reduced tissue fibrosis toward normal levels. The anti-fibrotic efficacy of PXS-5505 in the bleomycin exposed lungs was mediated by its ability to normalise collagen/elastin crosslink formation, a direct consequence of lysyl oxidase inhibition. PXS-5505 also reduced area of fibrosis in rodent models of the ischaemia-reperfusion heart, the unilateral ureteral obstruction kidney and the CCl4-induced fibrotic liver. Conclusion/Implication: PXS-5505 consistently demonstrates potent anti-fibrotic efficacy in multiple models of organ fibrosis relevant to the pathogenesis of SSc, suggesting that it may be efficacious as a novel approach for treating SSc.

La contaminazione delle acque superficiali evidenzia la necessità di ottimizzazione dei processi di depurazione delle acque reflue. È necessario rimuovere contaminanti che rappresentano un problema per gli ecosistemi. Nelle acque reflue provenienti da diverse produzioni industriali quali la lavorazione dell’oro o dell’argento e non solo,  è presente il cianuro la cui rimozione è necessaria per l’elevato grado di tossicità caratteristico della sostanza. La trattazione vuole porre il confronto tra trattamenti di tipo biologico e trattamenti di tipo chimico, focalizzandosi su un'alternativa all'approccio classico di ossidazione. L’alternativa su cui si pone l’attenzione in questa trattazione è il processo di cristallizzazione elettrochimica, il caso studio di una recente pubblicazione che analizza come dalla rimozione di Cianuro, si può effettuare recupero di inchiostro, il quale può essere commercializzato, diventando quindi un prodotto di qualità superiore. 

Studies on physiological effects due to gravitation and acceleration have become a hot topic of research since the last century. Scientists and engineers have been putting their best efforts to excavate more about the physiological changes that occur in jet aircraft pilots and astronauts. This study focuses on a few prominent and recent observations related to the alterations of physiological functioning due to gravitational and acceleration forces.

Classic Congenital Adrenal Hyperplasia in males usually presents late until before puberty, but rarely at birth. In cases of undiagnosed CAH, severe deficiency of cortisol may lead to life threatening situation in an infant with acute salt losing crisis. Screening for CAH at birth can lead to better outcomes.

Coronavirus disease 2019 (COVID-19) is an emerged pandemic disease caused by a new coronavirus known as SARS-CoV-2 (severe acute respiratory syndrome-coronavirus-2).

Bronchopulmonary dysplasia (BPD) is a chronic respiratory disease caused by a combination of prenatal and postnatal factors that leads to the disruption of lung development and abnormal repair, this is a condition that is commonly seen in premature infants. With the improvement of treatment technology, the survival rate of very early preterm infants has increased significantly compared with before, and the incidence of severe BPD has decreased, however, the prevalence of BPD has not decreased. The overall prevalence of BPD is 45%.The prevention of prematurity, the systematic use of non-aggressive ventilator measures, the avoidance of supra-physiological oxygen exposure, and the administration of diuretics, caffeine and vitamin A have all been shown to lead to a significant reduction in the risk of BPD development. A growing number of clinical studies have shown that caffeine not only prevents apnea, but also reduces the incidence of BPD. We review the clinical value of caffeine in the treatment of BPD and its potential mechanisms of action, include anti-inflammatory, antioxidant, anti-fibrotic, anti-apoptotic pathways, and the regulation of angiogenesis. Our aim was to provide a new theoretical basis for the clinical treatment of BPD.

A 59-year-old man with a long smoking history presented with sudden back pain. Frank's sign was noticed in his bilateral ears, and computed tomography revealed Stanford type A acute aortic dissection. If young patients have Frank's sign, attention should be paid to atherosclerotic disease including aortic disease.

1. Competition from invasive species is an increasing threat to biodiversity. In Southern California, the western gray squirrel (Sciurus griseus, WGS) is facing increasing competition from the fox squirrel (Sciurus niger, FS), an invasive congener. 2. We used spectral methods to analyze 140 consecutive monthly censuses of WGS and FS within a 11.3 ha section of the California Botanic Garden. Variation in the numbers for both species and their synchrony was distributed across long timescales (> 15 months). 3. After filtering out annual changes, concurrent mean monthly temperatures from nearby Ontario Airport (ONT) yielded a spectrum with a large semiannual peak and significant spectral power at long timescales (> 30 months). Squirrel-temperature cospectra showed significant negative covariation at long timescales (> 35 months) for WGS and smaller significant negative peaks at 6 months for both species. 4. Simulations from a Lotka-Volterra model of two competing species indicates that the risk of extinction for the weaker competitor increases quickly as environmental noise shifts from short to long timescales. 5. We analyzed the timescales of fluctuations in detrended mean annual temperatures for the time period 1915-2014 from 1218 locations across the continental USA. In the last two decades, significant shifts from short timescales to long timescales have occurred, changing from less than 3 years to 4-6 years. 6. Our results indicate that (i) population fluctuations in co-occurring native and invasive tree squirrels are synchronous, occur over long timescales, and may be driven by fluctuations in environmental conditions; (ii) long timescale population fluctuations increase the risk of extinction in competing species, especially for the inferior competitor; and (iii) the timescales of interannual environmental fluctuations may be increasing from recent historical values. These results have broad implications for the impact of climate change on the maintenance of biodiversity.

We report a preterm male neonate presenting with a skeletal dysplasia associated with multiple congenital anomalies. Radiologic findings and genetic studies are consistent with spondylocostal dysostosis (SCD) and autosomal dominant brachydactyly. This is the first case report of spondylocostal dysostosis and brachydactyly associated with TBX6 and IHH variants.

This report describes a case of a 50-year-old man with hypertension who was admitted with a history of fever, chills, and shortness of breath and tested positive for COVID-19. Shortly after resolving his ARDS, he developed an adipsic hypernatremia with associated confusion, lethargy, and weakness.

The COVID-19 vaccination programs have sparked several concerns and ongoing debates over safety issues. Here, we presented three cases of patients with serious adverse events, encephalopathy; Vaccine induced thrombotic thrombocytopenia, and Leukocytoclastic Vasculitis, after receiving the ChAdOx1 nCoV-19 vaccine.

Our case was rare in that multiple phenomena of postpartum stroke occurred at the same time. What is remarkable about this case was the confirmation of the reversibility of these pathological conditions through multifaceted evaluations, including the MRI MSDE method.