237 RESUMEN El peso del recién nacido es resultado de su crecimiento intrauterino. Se identifican los factores de riesgo perinatales asociados a bajo peso al nacer en neonatos nacidos en el Hospital Gineco obstétrico Isidro Ayora, Quito, Ecuador, internados entre enero 2010 y diciembre 2015. La fuente de datos fue el Sistema Informático Perinatal y se realizo un estudio retrospectivo, observacional, descriptivo y analítico en el cuyos datos se analizaron la prueba de Chi y Odds Ratio con su intervalo de confianza al 95%. Las variables significativamente asociadas al bajo peso al nacer fueron: madres con multiples gestas previas, consumidoras de drogas, afectaciones hipertensivas crónicas, preeclámpsia severa y eclampsia, nefropatía cronicas, embarazo múltiple, restricción del crecimiento intrauterino, escasas consultas prenatales, sexo femenino y prematurez. Se detectaron factores de riesgo significativamente asociados al bajo peso al nacer. PALABRAS CLAVE: Peso bajo al nacimiento. Embarazo multiple. Trastornos hipertensivos del embarazo. ABSTRACT Newborn birth weight is the result of its intrauterine growth. It is variable according to gestacional age, or presence of several risk factors. A survey was performed in order to identify perinatal risk factors associated with low birth weight < 2500 g. at the Isidro Ayora Maternity Hospital, Quito, Ecuador, January 2010 until December 2015. The data source was the Perinatal Information System (SIP). The trial was retrospective, observational, descriptive and analytical. Chi2 test, Odds Ratio, 95 % confidence interval were considered in the study. The main variables associated to low birth weight were mothers with several previous pregnancies, drug consumers, chronic hypertensive disorders patients, eclamptic, chronic nephropathy, multiple pregnancy, intrauterine growth restriction, inadequate prenatal care, female and premature babies. Main risk factors significantly associated with low birth weight were identified. KEY WORDS: Low birth weight. Multiple Gestation. Chronic hypertensive disorders INTRODUCIÓN El Bajo Peso al Nacer (BPN), ha sido definido por la Organización Mundial de la Salud (OMS) como el peso al nacer menor de 2500 gramos. La tasa de BPN es considerada un indicador trascendente de la salud pública y es un problema mundial que impacta en gran medida sobre la mortalidad neonatal e infantil[1]. En América representa el 8,5% y en Ecuador el 8,4%, por lo que es uno de los países que presenta la menor incidencia de BPN en la región[2]. El peso corporal de cada recién nacido (RN) es el resultado de su crecimiento intrauterino desde la concepción hasta el parto. Es variable según su edad gestacional (EG), su potencial genético y la presencia o ausencia de factores que pueden provocar desviación de la normalidad[3]. La frecuente utilización del PN en el campo socio-sanitario es atribuible a que: a) Expresa el resultado final de las condiciones del embarazo; b) Su registro como parte de las estadísticas vitales es cuidadoso; c) Constituye un poderoso predictor de la sobrevida individual del recién nacido un predictor poblacional de mortalidad infantil; d) Ha Factores de riesgo para bajo peso al nacer ARTÍCULO ORIGINAL Factores de riesgo para bajo peso al nacer.

This is a case of a 16-year-old African boy with Osteomyelitis presenting with symptoms of reactive arthritis (Reiter’s syndrome) KEYWORDS Osteomyelitis, Reiter’s syndrome, Fever, Bone pain, Erythema, Ewing sarcoma

The combined study of C and O isotopes in plant organic matter has emerged as a powerful tool for understanding plant functional response to environmental change. The approach relies on established relationships between leaf gas exchange and isotopic fractionation to derive a series of model scenarios that can be used to draw inferences about changes in photosynthetic assimi-lation and stomatal conductance driven by changes in environmental parameters (CO2, water availability, air humidity, temperature, nutrients). We review the mechanistic basis for model and research to date, and discuss where isotopic observations don’t match our current under-standing of plant physiological response to environment. We demonstrate that 1) the model has been applied successfully in many, but not all studies, and 2), while originally conceived for leaf isotopes, the model has been applied extensively to tree ring isotopes in the context of tree phys-iology and dendrochronology. Where isotopic observations deviate from physiologically plau-sible conclusions, this mismatch between gas-exchange and isotope response provides valuable insights on underlying physiological processes. Overall, we found that isotope responses can be grouped into situations of increasing resource limitation versus higher resource availability. Thus, the dual isotope model helps to interpret plant responses to a multitude of environmental factors.

 During Movement Control Order (MCO) of COVID-19, many information has been disseminated through both traditional and social media. Some of that information was credible and came from reliable sources while other information was fake and included misinformation, disinformation, and infodemic. The people needed credible information rather than fake one in this critical time. This study aimed to explore the credibility of media, information sources, the main issues, and preferred communication patterns and method of works perceived by Malaysians during MCO. A total of 300 questionnaires were distributed, and 210 were returned. The results of this study showed that the majority of respondents 69% relied on new media as their main source of information compared to 30.9% who relied on traditional media. However, a total of 64.8% of respondents considered traditional media as more credible and accurate compared to 35.2% for new media. Additionally, the main concerns and issues followed by respondents on media were health, economic, social, education and others. Finally, a total of 55.7% preferred face to face communication compared to 44.3% who preferred online communication. A total of 51% of respondents preferred to work from the workplace or office compared to 49% who preferred to work from home. Television played a significant role during the pandemic period due to its high credibility as perceived by Malaysians. The main intriguing implication of this study is considering the traditional media as more credible than social media by the Malaysians although the social media was their main source of information.Keywords: Communication patterns; COVID-19; credibility; infodemic; misinformation

Objective: To examine glycaemic variability (GV) and glycaemic control (GC) parameters in early pregnancy with subsequent development of gestational diabetes mellitus (GDM). Design: Longitudinal observational study. Setting: Pregnant women from KK Women and Children’s Hospital in Singapore Participants: 51 study participants in the first trimester (9-13 weeks’ gestational), and 44 participants (18-23 weeks’ gestation) in the second trimester of pregnancy. Methods: Independent t-tests were used to examine the differences in the parameters between participants who developed GDM and those who did not. Main outcome measure: GDM was determined at 24-30 weeks’ gestation using oral glucose tolerance test (OGTT). GV parameters examined were, mean amplitude of glycaemic excursion (MAGE), standard deviation of blood glucose (SDBG) and mean of daily continuous 24 h blood glucose (MBG) and coefficient of variation (CV). GC parameters measured were, J-Index and % time spent in glucose target ranges. Results: In the second trimester of pregnancy, mean amplitude of glycaemic excursions (MAGE) was significantly higher in participants who subsequently developed GDM, compared to those who did not (mean (SD): 3.18(0.68) vs 2.60(0.53), p=0.02). Other study parameters measured in the second trimester of pregnancy were not significantly different between groups. There were no significant associations between all the GV and GC parameters determined from the CGM in the first trimester with subsequent development of GDM (p>0.05). Conclusion: MAGE is an important GV parameter associated to the development of subsequent GDM in pregnant women. The findings highlight the potential value of CGM in gestational glycaemic profiling.

A study on rodent species diversity and community assemblages in West Mt Kilimanjaro was conducted in seven different habitats, covering two dry and wet seasons. Data were collected using a combination of medium-sized Sherman’s live traps, snap and Havarhart traps, for three consecutive nights. General Linear Models (GLM) were used to analyze the effects of predictors (vegetation attributes, seasonality, soil physical properties, disturbance and altitude) on rodent species richness and abundance. Community structure analysis was conducted in the Primer v6 program and Canonical correspondence analysis for habitat association in PAST. A total of 1,393 individuals from 14 species of rodents were trapped. The most dominant rodent species were Rhabdomys pumilioPraomys delectorum, and Lophuromys verhageni which contributed to 68.86% of the total captures. Lophuromys verhageni occurred across all the habitats and seasons. Moreover, habitat types, seasonality, soil texture, ground cover, and altitude significantly influenced rodent species abundance (P< 0.05). Furthermore, habitat types, seasonality and altitude significantly influenced rodent species richness (F8, 759 = 629.7, p< 0.001, R2 = 0.87). In addition to that, two major rodent communities were formed in different habitats. The results show that rodent species richness, abundance, and community assemblages in Mt Kilimanjaro, are a result of change in vegetation structure along the altitudinal gradients. Therefore, information on habitat requirements of multiple species is crucial for the management and conservation of these communities.

Pneumatocele may complicate the course of SARS-CoV2 infection. Our article exhibits the value of early radiological imaging for the timely diagnosis and management of COVID-19 and its complications. Conservative management is the mainstay of treatment of pneumatoceles however prompt surgical intervention is imperative for complicated pneumatoceles.

a succesfull combination therapy with tagraxofusp-erz plus venetoclax for a pediatric case of Blastic plasmacytoid dendritic cell neoplasm brıdgıng to transplantBaşak Adaklı Aksoy 1,Selime Aydoğdu1,Özlem Başoğlu Öner 1,Gizem Zengin Ersoy 1,Funda Erol Çipe1, Ayşe Gonca Kaçar3, Zafer Başlar 3,Tiraje Celkan 3,Tunç Fışgın1,Ceyhun Bozkurt 21Altınbaş Üniversitesi Tıp Fakültesi, Medical Park Bahçelievler Hastanesi2İstinye Üniversitesi Tıp Fakültesi , Pediatrik Hematoloji- Onkoloji Bölümü3İstanbul Üniversitesi, Cerrahpaşa Tıp Fakültesi

Background. We sought to evaluate the impact of changes in estimates of COVID-19 vaccine effectiveness on the incidence of laboratory-confirmed infection among frontline workers at high risk for SARS-CoV-2. Methods. We analyzed data from a prospective frontline worker cohort to estimate the incidence of COVID-19 by month as well as the association of COVID-19 vaccination, occupation, demographics, physical distancing and mask use with infection risk. Participants completed baseline and quarterly surveys, and each week self-collected mid-turbinate nasal swabs and reported symptoms. Results. Among 1,018 unvaccinated and 3,531 fully vaccinated workers, the monthly incidence of laboratory-confirmed SARS-CoV-2 infection in January 2021 was 13.9 (95% confidence interval [CI]: 10.4-17.4), declining to 0.5 (95% CI -0.4-1.4) per 1000 person-weeks in June. By September 2021, when the Delta variant predominated, incidence had once again risen to 13.6 (95% CI 7.8-19.4) per 1000 person-weeks. In contrast, there was no reportable incidence among fully vaccinated participants at the end of January 2021, and incidence remained low until September 2021 when it rose modestly to 4.1 (95% CI 1.9-3.8) per 1000. Below average facemask use was associated with a higher risk of infection for unvaccinated participants during exposure to persons who may have COVID-19, and vaccinated participants during hours in the community. Conclusions. COVID-19 vaccination was significantly associated with a lower risk of SARS-CoV-2 infection despite Delta variant predominance. Our data demonstrate the added protective benefit of facemask use among both unvaccinated and vaccinated frontline workers.

Background: Predicting water table depth in Electrical Power Transmission Lines area presents great importance and helps the decision makers do the safety analysis during the project. The present study predicts the water table depth with observed weather data and hydrologic data. Method: The study first compared the results of LSTM, GRU, LSTM-S2S, and FFNN models in daily data simulation. Moreover, two scenarios (S1 and S2) were set to identify the effect of the water component on water table depth simulation. In addition, in order to analyze how data time scale influences the model simulation results, the monthly scale data was simulated by LSTM, GRU, and LSTM-S2S models. Result: The result indicated that LSTM-S2S was the best model for predicting daily water table depth among the four models. By contrast, FFNN performed the worst. LSTM and GRU model performed equally well both in daily data and monthly data simulation. S1 performed better than S2 in the water table depth simulation. The average daily performance of R2 and NSE was both higher than that in the monthly results with LSTM, GRU, and LSTM-S2S models. Conclusion: As a result, the method in the present study can be used to simulate the water table depth in the future in Electrical Power Transmission Lines area.

Salt marshes are hotspots of nutrient processing en route to sensitive coastal environments. While our understanding of these systems has improved over the years, we still have limited knowledge of the spatiotemporal variability of critical biogeochemical processes within salt marshes. Sea-level rise will continue to force change on salt marsh functioning, highlighting the urgency of filling this knowledge gap. Our study was conducted in a central California estuary experiencing extensive marsh drowning and relative sea-level rise, making it a model system for such an investigation. Here we instrumented three marsh positions with different degrees of inundation (6.7%, 8.9%, and 11.2% of the time for the upper, middle, and lower marsh positions, respectively), providing locations with varied geochemical characteristics and hydrological interaction at the site. We continuously monitored redox potential (Eh) at depths of 0.1, 0.3, and 0.5 m, subsurface water levels (WL), and temperature at each marsh position to understand how drivers of subsurface biogeochemical processes fluctuate across tidal cycles, using wavelet analyses to explain the interactions between Eh and WL. We found that tidal forcing significantly affects biogeochemical processes by imparting controls on Eh variability, likely driving subsurface hydro-biogeochemistry of the salt marsh. Wavelet coherence showed that the Eh-WL relationship is non-linear, and their lead-lag relationship is variable. We found that precipitation events perturb Eh at depth over timescales of hours, even though WL show relatively minimal change during events. This work highlights the importance of high-frequency measurements, such as Eh, to help explain factors that govern subsurface geochemistry and hydrological processes in salt marshes.

The invasion of a novel host species can create a mismatch in host choice and offspring survival (performance) when native parasitoids attempt to exploit the invasive host without being able to circumvent its resistance mechanisms. Invasive hosts can therefore act as evolutionary trap reducing parasitoids’ fitness and this may eventually lead to their extinction. Yet, escape from the trap can occur when parasitoids evolve behavioural avoidance or a physiological strategy compatible with the trap host, resulting in either host-range expansion or a complete host-shift. We developed an individual based model to investigate which conditions promote parasitoids to evolve behavioural preference that matches their performance, including host-trap avoidance, and which conditions lead to adaptations to the unsuitable hosts. One important aspect of these conditions was reduced host survival during incompatible interaction, where a failed attempt by a parasitoid resulted in host killing. This non-reproductive host mortality had a strong influence on the likelihood of establishment of novel host-parasitoid relationship. Killing unsuitable hosts can constrain adaptation under conditions which in fact promoted adaptation when parasitoids would leave the trap host unharmed and survive parasitoid attack. Moreover, our model revealed that host-search efficiency and genetic variation in host-preference play a key role in the likelihood that parasitoids will include the suboptimal host in their host range, or will evolve behavioural avoidance resulting in specialization and host-range conservation, respectively. Hence, invasive species might change the evolutionarily trajectory of native parasitoid species, which is important for predicting biocontrol ability of native parasitoids towards novel hosts.

Covariate analysis query: Hospital surgical volume-outcome relationship in caesarean hysterectomy for placenta accreta spectrumOguljemal Redjepovaa, Jack Lowe-Zinolab, Christopher Griffinc

In reptiles, reproductive maturity is often determined by size rather than age. Consequently, growth early in life may influence population dynamics through effects on generation time and survival to reproduction. Because reproductive phenology and pre- and post-natal growth are temperature-dependent, environmental conditions may induce multi-species cohort effects on body size in sympatric reptiles. I present evidence of this using ten years of neonatal size data for three sympatric viviparous snakes, Dekay’s Brownsnakes (Storeria dekayi), Red-bellied Snakes (S. occipitomaculata) and Common Gartersnakes (Thamnophis sirtalis). End-of-season neonatal size varied in parallel across species such that snout-vent length was 36-61% greater and mass was 65-223% greater in years when gestating females could achieve higher April-May (vs. June-July or August-September) operative temperatures. Thus, temperature had a larger impact during follicular enlargement and ovulation than during gestation or post-natal growth. Multi-species cohort effects like these may affect population dynamics and increase with climate change.

Radiotherapy, by its mechanism, has always been suspected to be contra-indicated in patients with xeroderma pigmentosum, depriving them of this very effective modality in the treatment of their cancers. As these suspicions have still not been confirmed, the place of radiotherapy should be reconsidered, while applying precautionary principles.

Subclavian Steal Syndrome (SSS) is a rare vascular syndrome caused due to proximal occlusion or stenosis of subclavian or innominate artery. It is usually asymptomatic but occasionally may present with vertebrobasilar insufficiency and/or upper limb ischemia. Atherosclerosis is the most common cause.

We present a computational model of the mechanosensing of a fibroblast cell seeded on the materials with different stiffnesses and thicknesses. The model can predict the critical thickness of a given biomaterial that a cell can sense and the dynamic change of stress fibres and focal adhesions through its incorporation of the dynamic characteristics of stress fibre contraction and focal adhesion. We show that the cell-cell communication via elastic substrate induces the orientation of stress fibres. The cell-cell interaction through compliant substrate has a small but significant effect on enhancing the cell depth sensing capability in terms of interfacial displacement and stress fibre concentration. The framework developed here is important for a thorough understanding of processes where substrates are deformed such as in wound healing process and the design of bioactive coatings for tissue engineering.

Fontaine Progeroid Syndrome (FPS) is an autosomal dominant condition caused by pathogenic variants in the SLC25A24 gene located on chromosome 1. Eleven cases have been described in the literature, with early lethality in some. We discuss the clinical course of a patient from birth until his death at 7 months.

We report a fatal case of methicillin-resistant Staphylococcus aureus (MRSA)-induced necrotizing pneumonia that was refractory to adequate vancomycin treatment (trough value, 13.1 µg/mL), drainage of a hydropneumothorax, and veno-arterial extracorporeal membrane oxygenation. MRSA infection can cause rapidly progressive disease with a high case fatality rate, even with appropriate treatment.

Sex is one of the important factors affecting gut microbiota. As key predators in agro-forestry ecosystem, many spider species show dramatically different activity habits and nutritional requirements between female and male. However, how sex affects gut microbiota of spiders is still unclear. Therefore, in this study, the compositions and diversities of gut bacteria, based on bacterial 16S rRNA gene sequencing, were compared between female and male Pardosa astrigera. We found that bacterial richness indices (P < 0.05) in female were significantly lower than male, meanwhile, β-diversity showed significantly different between female and male (P < 0.05). The relative abundance of Actinobacteriota and Rhodococcus (belongs to Actinobacteria) were significantly higher in female than male (P < 0.05). Whereas, the relative abundance of Firmicutes and Acinetobacter (belongs to Proteobacteria), Ruminococcus and Fusicatenibacter (all belong to Firmicutes), were significantly higher in male than female (P < 0.05). The results of PICRUSt2 showed that amino acid and lipid metabolisms were significantly higher in female than male (P < 0.05), whereas glycan biosynthesis and metabolism was significantly higher in male than female (P < 0.05). Our results imply that sexual variation is a crucial factor in shaping gut bacterial community in P. astrigera. Male P. astrigera dispersed more widely than the female hence the male had a higher bacterial diversity. While the distinct differences of bacterial composition mainly due to their different nutritional and energy requirements.

The noncovalent interactions between a redox-active molecule, phenyl-substituted dithiafulvene (Ph-DTF), and ten commonly encountered nitroaromatic compounds (NACs) were systematically investigated by means of density functional theory (DFT) calculations and ab initio molecular dynamics (AIMD) simulations. Our modeling studies examined their 1:1 complexes in terms of equilibrium geometries, frontier molecular orbitals (FMOs), nature of noncovalent forces, intermolecular charge transfer (ICT), interaction energies and related energy decomposition analysis. The computational results indicate that Ph-DTF can form thermodynamically stable supramolecular complexes with trinitro-substituted benzenes (e.g., 2,4,6-trinisuchtrotoluene and picric acid), but its interactions with mono- and dinitrobenzenes do not exhibit such stability. The selective binding properties are further corroborated by AIMD simulations. Overall, this computational work establishes a comprehensive understanding of the nature of noncovalent interactions of Ph-DTF with various NACs, and the results can be used as theoretical guidance for the rational design of selective receptors and/or chemosensors for certain NACs that are of great concern in current industrial applications and environmental control.

Introduction: Percutaneous left atrial appendage closure (LAAC) is an alternative to oral anticoagulant (OAC) in patients with non-valvular atrial fibrillation (AF) and contraindication to long-term OAC. Combined strategy with percutaneous LAAC at the same time of other cardiac structural or electrophysiological procedure has emerged as an alternative to staged strategy. Aim: To describe our experience of combined LAAC procedures using Watchman™ devices. Method: All patients with combined LAAC procedure using Watchman™ (WN) devices performed from 2016-2021 were included. The primary safety endpoint was a composite of periprocedural complications and adverse events during follow-up. The primary efficacy endpoint included strokes, systemic embolisms, major bleeding, and cardiovascular death. Results: Since 2016, among the 157 patients who underwent LAAC using WN devices, 16 underwent a combined strategy: 6 TEMVR (37%), 6 typical atrial flutter ablation (37%), 2 LP implantation (13%) and 2 atrial fibrillation ablation (13%). The WN device was successfully implanted in 98% and 100% for single and combined LAAC respectively (p = 0.63). Median follow-up was 13 months (IQR 25/75 3/24) in the whole cohort. Device related complications occurred in 6 out of 141 patients (4%) who underwent single LAAC and in no (0/16) patient in the combined LAAC procedure (p=ns). The procedural related complications did not differ significantly between groups (5% vs 12%, respectively in the single and combined group, p=0.1). Conclusion: Combined procedure combining LAAC using the Watchman™ devices and one other structural or electrophysiological procedure is safe and effective. Larger series are needed to confirm these results.

 Dimorphic flowers growing on a single individual plant play a critical role in extreme adaption and reproductive assurance in plants and have high ecological and evolutionary significance. However, the omics bases underlying such a differentiation and maintenance remain largely unknown. We aimed to investigate this through genomic, transcriptome and metabolomic analyses of dimorphic flowers in an alpine biennial, Sinoswertia tetraptera (Gentianaceae).  A high-quality chromosome-level genome sequence (903 Mb) was first assembled for S. tetraptera with 31,359 protein-coding genes annotated. Two rounds of recent independent whole-genome duplication (WGD) were revealed. More than 10% of the novel genes from the recent species-specific WGD were found to be differentially expressed in the two types of flowers, and this may have helped contribute to the origin of this innovative trait.  Other contrasting gene expression between flowers included that related to flower development and color, hormones, and iridoid biosynthesis. Metabolomic analyses similarly suggested differential concentrations of both hormones and iridoids in the two types of flowers. The interactions between multiple genes may together lead to contrasting morphology and open versus closed pollination of the dimorphic flowers in this species.  A total of 56 candidate genes were identified from the known iridoid biosynthesis-related pathways. Two hub genes were found to play an essential role in transferring intermediate products between leaves and flowers during iridoid biosynthesis.

ASTHMA MIGHT PROTECT AGAINST MORTALITY IN CHILDREN HOSPITALIZED WITH COVID-19Braian Lucas Aguiar Sousa, MDUniversity of São Paulo School of Medicine – Department of Pediatrics. Sao Paulo, Brazil.Paulo Victor Ferreira Mai, MDUniversity of São Paulo School of Medicine – Department of Pediatrics. Sao Paulo, Brazil.Sandra Elisabete Vieira, MD, PhDUniversity of São Paulo School of Medicine – Department of Pediatrics. Sao Paulo, Brazil.Antonio Carlos Pastorino, MD, PhDUniversity of São Paulo School of Medicine – Department of Pediatrics. Sao Paulo, Brazil.Alexandre Archanjo Ferraro, MD, PhDUniversity of São Paulo School of Medicine – Department of Pediatrics. Sao Paulo, Brazil.Running title: Asthma might protect against COVID-19 mortality.