In the Sahel, exacerbated soils degradation is an ecological indicator of ecosystem vulnerability. This study examines the effects of restoration of degraded lands on soils physicochemical properties and adaptability of planted woody species over a period of 4-6 years. It is based on: 1) Physicochemical analyses of soils (granulometry, calcimetry, and organic matter) carried out on 102 samples taken in the upper 10 centimeters of the soil profile of the rehabilitated and control sites, 2) measures carried out for the dimensioning of anti-erosion structures, 3) dendrometric measurements on woody species planting in 20 plots each with a rectangular shape 60 m × 30 m as well as characterization of the structure of their root systems. Physicochemical analyses show an improvement in soil quality and structure thanks to the erosion control measures. The degradation of anti-erosion structures, inferred from the rate of siltation of micro-basins, the subsidence of the bulges, the formation, and extension of the breaches, is strongly influenced by the topography, precipitation, and sandy texture of the soils. The restoration activities have led to the reconstitution of vegetation cover on degraded soils. Based on dendrometric characteristics, height class structure, and root systems architecture, significant differences were observed between woody species planted in anti-erosive structures. Eucalyptus camaldulensis groups of with a tracer root system and high density, have the highest structural parameters resulting from the adaptation of this species on Sahelian degraded lands.

Disrupted epithelial barrier in nasal polyps characterizes aspirin exacerbated respiratory disease Anand Kumar Andiappan1*, Mohammad Asad2, Celine Chua3, Esha Sehanobish2 , Zhen Ren4, Xue Ying Chan1, Josephine Lum1, Nicholas Ang1, Duan Kaibo1, Adam Gersten2, Waleed M. Abuzeid5, Nadeem Akbar2, Marc Gibber2, Shanshan Howland1, Bernett Lee1, Olaf Rotzschke1, Steven A. Porcelli2, Elina Jerschow2*1 Singapore Immunology Network, Agency for Science, Technology and Research2 Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA3 Department of Biological Science, National University of Singapore4 Division of Allergy and Immunology, Department of Medicine, Washington University Schoolf of Medicine, St Louis, MO, USA5Rhinology and Endoscopic Skull Base Surgery, Department of Otolaryngology – Head and Neck Surgery, University of Washington, Seattle, WA, USA*Correspondence: EJERSCHO@montefiore.org; anand_andiappan@immunol.a-star.edu.sg

Chaperonin Hsp60, as a protein found in all organisms, is of great interest in medicine, since it is present in many tissues and can be used both as a drug and as an object of targeted therapy. Hence, Hsp60 deserves a fundamental comparative analysis to assess its evolutionary characteristics. It was found that the percent identity of Hsp60 amino acid sequences both within and between phyla was not high enough to identify Hsp60s as highly conserved proteins. In turn, their amino acid composition remained relatively constant. At the same time, the analysis of the nucleotide sequences showed that GC content in the Hsp60 genes was comparable to or greater than the genomic values, which may indicate a high resistance to mutations due to tight control of the nucleotide composition by DNA repair systems. Natural selection plays a dominant role in the evolution of Hsp60 genes. The degree of mutational pressure affecting the Hsp60 genes is quite low, and its direction does not depend on taxonomy. Interestingly, for the Hsp60 genes from Chordata, Arthropoda, and Proteobacteria the exact direction of mutational pressure could not be determined. However, upon further division into classes, it was found that the direction of the mutational pressure for Hsp60 genes from Fish differs from that for other chordates. The direction of the mutational pressure affects the synonymous codon usage bias. The number of high and low represented codons increases with increasing GC content, which can improve codon usage.

In this article, we report a 34-year-old man who presented with a buccal progressive ulcerated lesion which through histopathologic and IHC findings diagnosed as Peripheral T-cell lymphoma.

The widespread observation that rare species have stronger conspecific plant-soil feedback (PSF) than common species raises more questions than answers on how rare species can possibly win the dance with abundant species. Here, we test soil feedback effect of phylogenetically related species on seedlings of contrasting local abundance in a subtropical forest. The results showed that although rare species suffered strong negative PSF in soils of conspecifics or phylogenetically close relatives, no such feedback was found in the soils of distant relatives. In contrast, although common species had weak conspecific PSF, they suffered consistently strong heterospecific soil feedback. These mechanisms ensure that rare species would fare well in the neighborhood of phylogenetically distant heterospecifics but do poorly under their close relatives, while common species perform relatively well in their own neighborhood but poorly in others’. This phylogenetic conservatism in PSF facilitates the persistence of rare species in a community.

Fatigue fracture is one of the most common metallic component failure cases in manufacturing industries. The observation on fractography can provide the direct evidence for failure analysis. In this study, an image segmentation method based on Fully Convolutional Networks (FCNs) was proposed to figure out the boundary between fatigue crack propagation and fast fracture regions from optical microscope (OM) fractography images. Furthermore, novel morphing-based data augmentation method was adopted to enable few-shot learning of sample images. The proposed framework can successfully segment two categories, namely the crack propagation and fast fracture regions, thus differentiating the boundary of two regions in one image. The artificial intelligence (AI) assisted fatigue analysis architecture can complete the failure analysis procedure in 0.5 second and prove the feasibility of fatigue failure analysis. The segmentation accuracy of developed network achieves 95.4% for the fatigue crack propagation region, as well as 97.2% for the fast fracture region, which possesses comparable accuracy to the segmentation results using Mask R-CNN Regional Convolutional Neural Network (Mask R-CNN), one state-of-the-art deep learning networks.

The subject of rapid economic and social development impact of global climate change and the upper reaches of the Yellow River in the past decade, Ningxia Yellow River water into Gansu substantial reduced, resulting in Ningxia exit water also reduced to varying degrees, but the water entry and exit difference (water consumption) has increased. In this paper, comparative analysis of the Yellow River in Ningxia Section from 2001 to 2012 and from 1956 to 1995 data, found the average years of entry water by about 18%, leaving an average of about 23% less water for many years, Ningxia Yellow River water consumption increased by about 48%. Water impact from Meili Canal, Qixing canal, Qing Tongxia east and west main canal, 211.73 m3/s annual flux above Qing Tongxia Reservoir was evacuated by 2001 to 2012, more water in irrigated areas back from Shi Zui Shan section of the Yellow River once again return to the Yellow River, flow in the Ningxia exit section of the Yellow River than Qing Tongxia station extra 102.99 m3/s; the point of view during the year, due to the irrigation water from late March, the entry water becomes greater than exit water of the Yellow River in Ningxia section, effective irrigation due to precipitation increases in August, the difference between entry water and exit water becomes narrow, with the withdrawal of water regression in irrigated areas in downstream segment, thus result of the Shi Zuishan exit section flow than the entry of water cross section in varying degrees of increases in September, October and December.

Because of their range expansion across North America, coyotes (Canis latrans) now occur sympatrically with numerous other predator species, including red foxes (Vulpes vulpes). This raises several interesting ecological questions, including if and how sympatry affects the diet and gut microbiomes of coyotes and red foxes. We examined the gut microbiomes of sympatric populations of coyotes and red foxes within two different National Parks in Virginia, USA, that differ in land use, vegetation, and anthropogenic disturbance: Prince William Forest Park (PRWI) and Manassas National Battlefield Park (MANA). From 2012 to 2017, scat samples from PRWI and MANA were collected and analyzed. Polymerase Chain Reaction (PCR) amplification of a region of the mitochondrial cytochrome-b gene followed by restriction enzyme digestion of the PCR product was used to determine the origin of each scat sample. Next-Generation DNA sequencing of a hypervariable 16S rRNA gene region was used to determine gut microbiome information about the scat samples. There was no evidence for a difference between the gut microbiomes of red foxes in either location, or for a difference between the gut microbiomes of red foxes at either location and coyotes at the location with lower human disturbance, PRWI. However, the gut microbiomes of coyotes at the location with higher anthropogenic disturbances, MANA, revealed a marked change from those found in red foxes at either location and from those in coyotes at the location with lower disturbances. The gut microbiomes of coyotes subjected to greater human impact revealed clear evidence of dysbiosis, indicative of increased physiological stress and reduced health. We discuss our observations in the context of understanding anthropogenic impacts on coyote and red fox interactions. Our results suggest that physiological stress in the form of human disturbance may play an important role in the composition of the gut microbiome of coyotes, which can affect their overall health.

Background: Minimally invasive heart valve surgery has previously been shown to be safe and feasible in obese patients. Within this population, we investigated the effect of obesity class on the patient outcomes of minimally invasive aortic valve replacement (mini-AVR). Methods: A single center retrospective cohort study of consecutive patients with obese body mass indices (BMIs) who underwent mini-AVR between 2012 and 2018. Patients were stratified into 3 groups according to Centers for Disease Control and Prevention adult obesity classifications: Class I (BMI 30.0 to < 35.0), Class II (BMI 35.0 to < 40.0), and Class III (BMI ≥ 40.0). The primary outcomes were postoperative length of stay (LOS), 30-day mortality within, and cost. Results: Amongst 182 obese patients who underwent mini-AVR, LOS (Class I 4 [3-6] vs. Class II 4 [3-6] vs. Class III 5 [4-6] days; p=0.098) and costs (Class I $24,487 [$20,199-$27.480] vs. Class II $22,921 [$20,433-$27,740] vs. Class III $23,886 [$20,063-$33,800] USD; p=0.860) did not differ between obesity class cohorts. Postoperative 30-day mortality (Class I 2.83% [n=2] vs. Class II 0% [n=0] vs. Class III 0% [n=0]; p=0.763) was limited by an insufficient sample size relative to a low event rate but did not differ between patient cohorts. Conclusions: Mini-AVR is safe and feasible to perform for obese patients regardless of their obesity class. Patients with obesity should be afforded the option of minimally invasive aortic valve surgery regardless of their obesity class.

Hemorrhagic cardiac tamponade is one of potentially fatal complications of endovascular intervention. Usually it is because of perforation of heart or rupture of aorta. Cases of pericardial effusion without any arterial or heart injury are rare. Case presentation we reported is a clinical case of cardiac arrest due to tamponade in a patient with DeBakey type I aortic dissection (AD) undergoing thoracic aortic stent implantation. In the early phase of the procedure, hemodynamic changes of increased central venous pressure and decreased blood pressure - by tamponade were noticed but unrecognized and lead to cardiac arrest ultimately. During resuscitation, cardiac tamponade was suspected and confirmed by transesophageal echocardiography (TEE). The patient was successfully resuscitated after pericardiocentesis. Conclusion This case of cardiac tamponade emphasizes the importance of vigilant clinical and echo assessments, efficient multidisciplinary teamwork in deal with the rare but severe complication.

Clinical cross-reactivity to quail’s egg in patients with hen’s egg allergyMasatoshi Mitomoria, Noriyuki Yanagidaa, Mari Takeib, Kinji Tadab, Makoto Nishinoa, c, Sakura Satob, Motohiro EbisawabaDepartment of Pediatrics, National Hospital Organization, Sagamihara National Hospital, Kanagawa, JapanbClinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Kanagawa, JapancCourse of Allergy and Clinical Immunology, Juntendo University Graduate School of Medicine, Tokyo, JapanRunning title: Clinical cross-reactivity of HE & QECorresponding author:Noriyuki Yanagida18-1, Sakuradai, Minamiku, Sagamihara, Kanagawa 252-0392, JapanTel.: +81 042 742 8311 Fax: +81 042 742 5314E-mail: yana@foodallergy.jp

Background Zanamivir is a neuraminidase inhibitor effective against influenza A and B viruses. In 2009, GlaxoSmithKline (GSK) began clinical development of intravenous (IV) zanamivir, and initiated a global Compassionate Use Program (CUP) in response to the evolving H1N1 global pandemic. The goal of the CUP was to provide zanamivir to critically ill patients with limited treatment options. Methods Zanamivir was administered to patients with suspected or confirmed influenza infection, who were not suitable for other approved antiviral treatments. Reporting of serious adverse events (SAEs) was mandatory and recorded in the GSK safety database. A master summary tracking sheet captured requests and patient characteristics. A case report form was available for detailing medical conditions, dosing, treatment duration, and clinical outcomes. Results In total, 4033 requests were made for zanamivir treatment of hospitalized patients from 38 countries between 2009 and 2019. Europe had the highest number of requests (n=3051) followed by North America (n=713). At least 20 patients were aged ≤6 months, of whom 12 were born prematurely. The GSK safety database included 466 patients with ≥1 SAE, of whom 374 (80%) had a fatal outcome. Drug-related SAEs were reported in 41 (11%) patients, including hepatic failure (n=6 [2%]) and acute kidney injury (n=5 [1%)]. Conclusions The CUP fulfilled the need to provide global access to zanamivir prior to product approval. No new safety concerns were identified in the CUP compared with IV zanamivir clinical studies.

Primary mucinous adenocarcinoma is an exceptionally rare neoplasm with a propensity for local recurrence and metastasis. We report the second case in the literature of a primary mucinous adenocarcinoma of the orbit in a 66-year-old male with its clinical, histological features, and management of this tumor.

Objective : To study changes in caesarean delivery (CD) rates between maternity wards in a perinatal network after implementation of the Ten Group Classification System (TGCS) in an audit with feedback. Design A retrospective pre–post study of all births from 1 January 2012 to 31 December 2018. Setting A French perinatal network of 10 maternity wards in the Yvelines district of France. Population All live births of gestational age ≥24 weeks in the network. Methods During the pre-period (1 January 2012 to 31 December 2014), the audit and feedback provided only overall CD rates. During the post-period (1 January 2015 to 31 December 2018), CD rates for each TGCS group were provided. Regression models, adjusted for maternal characteristics and maternity ward, were used to compare CD rates globally and for each TGCS group. Variability of CD rates between maternity wards was analysed using the coefficients of variation. Main outcome measure CD rates. Results There were 51 082 women who delivered during the pre-period and 63 964 during the post-period. The overall CD rate did not decrease (24.5% during the pre-period versus 25.1% during the post-period). There were no significant differences in CD rates for any TGCS group after adjustment for maternity, maternal age and socio-demographic characteristics. Nor did audit implementation decrease CD rate variability between maternity wards or within TGCS groups. Conclusion Implementation of an audit-and-feedback cycle using the TGCS did not decrease either CD rates or variability between maternity wards.

Coronavirus Disease 2019 and messenger RNA Vaccination in Pregnant Women.Paulino Vigil-De Gracia, MD.Complejo Hospitalario Dr. AAM Caja de Seguro Social. Investigador distinguido del Sistema Nacional de Investigación, SENACYT Panamá, e-mail: pvigild@hotmail.comIntroductionSince its appearance in December of 2019, the SARS-CoV-2 infection has been associated with greater severity in patients with pre-existing pathologies. With the progression of the disease and adequate studies in pregnant women, it has been shown that this group of the population is associated with a higher risk and severity of the disease1. About 10% of pregnant women evolve severely, there is a higher risk of admission to the intensive care unit (ICU), the need for mechanical ventilation, maternal deaths, a higher risk of pre-eclampsia, premature births, and neonatal complications2-4. Vaccines based on an mRNA platform have become one of the safest and most widely used alternatives for combatting SARS-CoV-2 5 infections.Pregnant women with SARS-CoV-2Pregnant women with COVID-19 are 3-5 times more likely to enter the ICU compared to non-pregnant women of reproductive age or pregnant women without the disease. In addition, there is a fatality percentage between 0.6 to 1.6%, which is highly significant 2,3. Another finding that worsens the prognosis is the association between COVID-19 and pre-eclampsia. This association has been observed in a longitudinal study 3 and in a systematic review4. Pregnant women infected with SARS-CoV-2 have a significant 62% greater likelihood of developing pre-eclampsia than those without infection, including a higher risk of presenting the worst conditions of pre-eclampsia in its severe form, HELLP syndrome and eclampsia, according to the findings of a systematic review4.As pregnant women are at high risk when infected with SARS-CoV-2, said prognosis worsens, as it is associated with pre-eclampsia/eclampsia. They are two diseases with poor maternal and perinatal prognosis.Neonatal complications, prematurity, and NICU stay are higher in those born to mothers with COVID-19 1,3. In addition to these findings, the frequency of cesarean sections is significantly higher in pregnant women with severe COVID-19. Therefore, neonatal results seem to be influenced more by the diagnosis of disease severity than the presence of the maternal infection itself.Vaccination before pregnancy and in the first weeks of pregnancyMessenger RNA vaccines are not live, attenuated, inactivated virus vaccines, nor do they use an adjuvant. These vaccines do not enter the nucleus and do not alter human DNA. As a result, mRNA vaccines cannot cause any genetic changes. Animal studies performed with the Moderna vaccine, evaluating perinatal and postnatal toxicity, show no alterations to embryonic, fetal or postnatal development after use of this type of vaccine. Pregnant women were not included in the original studies where the usefulness of these vaccines was confirmed. Therefore, there are no randomized studies that show benefits (or complications) in pregnant women.After the acceptance of the emergency use of the COVID-19 vaccine, several studies have been completed that show results associated with pregnancy. A report in the UK shows us that in the vaccinated women who were part of the original randomized studies, the number of unplanned pregnancies was the same in both groups (vaccine or placebo); furthermore, there were no differences in loss percentages in the first trimester of pregnancy 6.More recently, a preprint 5 vaccination report from the United States shows us the results of 2,456 pregnant women and the risk of spontaneous abortion between 6 and 19 weeks when these women were vaccinated in the pre-conception period or before the first 20 weeks of pregnancy. This study does not show a higher incidence of spontaneous abortions in the population vaccinated with mRNA vaccines, compared to the reference standard.Vaccination according to trimester of pregnancyThere are no randomized controlled studies proving the benefit of SARS-CoV-2 vaccines in pregnant women, however, there are several reports on its benefits and safety regardless of the trimester of pregnancy in which it has been used. A large cohort 7shows us that of 3,958 vaccinated pregnant women, 28.6% were vaccinated in the first trimester of pregnancy and 43.3% in the second trimester. According to the findings of this study in the United States7 and another in Israel 8, mass vaccination of the population occurs in all trimesters of pregnancy and the follow-up study of the population that has finished their pregnancy shows that there was no evidence of an increase in: abortions, malformations, fetal or neonatal death, premature birth, or restricted growth. In addition, there is a series of cases that shows that vaccination in the third trimester does not cause placental disorders9.Evidence of protectionTwo large retrospective cohorts have evaluated the effect of mRNA vaccines in vaccinated pregnant women. The study carried out in the USA7 with 3,958 pregnant women shows us that the possibility of infection 14 days after the first dose is 0.3%. Furthermore, the study carried out in 7,530 vaccinated pregnant women in Israel 8 compared to 7,530 unvaccinated (paired) women shows that between 11 and 28 days after the first dose, there is a significant decrease in infection when compared to the unvaccinated group. This difference becomes greater with the increase of the number of days post vaccination until a follow-up of 70 days.Another important finding with maternal vaccination is the possible fetal and neonatal protection. Breast milk was tested in a cohort of 84 vaccinated mothers with at least two doses of mRNA vaccine10. This study found a robust secretion of specific IgG and IgA antibodies against SARS-CoV-2 in breast milk for 6 weeks after vaccination. These results suggest the potential protective effect against SARS-CoV-2 in infants of vaccinated or infected breastfeeding mothers.On the other hand, the transplacental transfer of IgG antibodies has been evaluated in mothers who have received mRNA vaccine in the third trimester 11. The studies show that if 16-21 days have passed since the first dose by the time of birth, there will already be a large amount of IgG antibodies present in the umbilical cord and the greatest amount of passive immunity will be obtained 3-4 weeks after the first dose of mRNA vaccine administered to the mother. By that time, the amount of antibodies in the umbilical cord are similar to those existing in maternal blood 11.Other studies 12 have performed analyzes on both pregnant and lactating women and their results show that maternal antibodies generated by vaccines are transported to the child through umbilical cord blood and breast milk.SummaryPregnant women represent a group at high risk of infection by SARS-CoV-2. There are greater levels of admission to ICU, more death, more pre-eclampsia and prematurity,Vaccines with the mRNA platform have been shown to be effective and safe in pregnant women and there is no evidence of fetal or neonatal damage in any trimester of pregnancy.Vaccination against COVID-19 in pregnant women has been delayed in the world due to the non-inclusion in the original randomized studies; despite the absence of valid scientific elements demanding their exclusion. This experience should be used in the future and especially with this type of vaccine.ReferencesVouga M, Favre G, Martinez-Perez O, Pomar L, Acebal LF, Abascal-Saiz A, Hernandez MRV, Hcini N, Lambert V, Carles G, Sichitiu J, Salomon L, Stirnemann J, Ville Y, de Tejada BM, Goncé A, Hawkins-Villarreal A, Castillo K, Solsona EG, Trigo L, Cleary B, Geary M, Bartels H, Al-Kharouf F, Malone F, Higgins M, Keating N, Knowles S, Poncelet C, Ribeiro-do-Valle CC, Surita F, Dantas-Silva A, Borrelli C, Luz AG, Fuenzalida J, Carvajal J, Canales MG, Hernandez O, Grechukhina O, Ko AI, Reddy U, Figueiredo R, Moucho M, Pinto PV, De Luca C, De Santis M, de Campos DA, Martins I, Garabedian C, Subtil D, Bohrer B, Da Rocha Oppermann ML, Wender MCO, Schuler-Faccini L, Sanseverino MTV, Giugliani C, Friedrich L, Scherer MH, Mottet N, Ducarme G, Pelerin H, Moreau C, Breton B, Quibel T, Rozenberg P, Giannoni E, Granado C, Monod C, Mueller D, Hoesli I, Bassler D, Heldstab S, Kölble NO, Sentilhes L, Charvet M, Deprest J, Richter J, Van der Veeken L, Eggel-Hort B, Plantefeve G, Derouich M, Calvache AJN, Lopez-Giron MC, Burgos-Luna JM, Escobar-Vidarte MF, Hecher K, Tallarek AC, Hadar E, Haratz KK, Amikam U, Malinger G, Maymon R, Yogev Y, Schäffer L, Toussaint A, Rossier MC, De Sa RAM, Grawe C, Aebi-Popp K, Radan AP, Raio L, Surbek D, Böckenhoff P, Strizek B, Kaufmann M, Bloch A, Boulvain M, Johann S, Heldstab SA, Bernasconi MT, Grant G, Feki A, Brochut AM, Giral M, Sedille L, Papadia A, Brugger RC, Weber B, Fischer T, Kahlert C, Saines KN, Cambou M, Kanellos P, Chen X, Yin M, Haessig A, Ackermann S, Baud D, Panchaud A. Maternal outcomes and risk factors for COVID-19 severity among pregnant women. Sci Rep. 2021 Jul 6;11(1):13898. Doi: 10.1038/s41598-021-92357.Zambrano LD, Ellington S, Strid P, et al. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status — United States, January 22–October 3, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1641–1647. DOI: http://dx.doi.org/10.15585/mmwr.mm6944e3external iconPapageorghiou AT, Deruelle P, Gunier RB, Rauch S, García-May PK, Mhatre M, Usman MA, Abd-Elsalam S, Etuk S, Simmons LE, Napolitano R, Deantoni S, Liu B, Prefumo F, Savasi V, do Vale MS, Baafi E, Zainab G, Nieto R, Maiz N, Aminu MB, Cardona-Perez JA, Craik R, Winsey A, Tavchioska G, Bako B, Oros D, Rego A, Benski AC, Hassan-Hanga F, Savorani M, Giuliani F, Sentilhes L, Risso M, Takahashi K, Vecchiarelli C, Ikenoue S, Thiruvengadam R, Soto Conti CP, Ferrazzi E, Cetin I, Nachinab VB, Ernawati E, Duro EA, Kholin A, Firlit ML, Easter SR, Sichitiu J, Bowale A, Casale R, Cerbo RM, Cavoretto PI, Eskenazi B, Thornton JG, Bhutta ZA, Kennedy SH, Villar J. Preeclampsia and COVID-19: results from the INTERCOVID prospective longitudinal study. Am J Obstet Gynecol. 2021 Jun 26:S0002-9378(21)00561-5. Doi: 10.1016/j.ajog.2021.05.014.Conde-Agudelo A, Romero R. SARS-COV-2 infection during pregnancy and risk of preeclampsia: a systematic review and meta-analysis. Am J Obstet Gynecol. 2021 Jul 21:S0002-9378(21)00795-X. doi: 10.1016/j.ajog.2021.07.009.Zauche LH, Wallace B, Smoots AN, Olson CK, Oduyebo T, Kim SY et all. Receipt of mRNA COVID-19 vaccines preconception and during pregnancy and risk of self-report spontaneous abortions, CDC v-safe COVID-19 vaccine pregnancy registry 2020-21. Preprint DOI:10.21203/rs.3.rs-798175/v1Male V. Are COVID-19 vaccines safe in pregnancy? Nat Rev Immunol. 2021 Apr;21(4):200-201. Doi: 10.1038/s41577-021-00525-y. Erratum in: Nat Rev Immunol. 2021 Mar 12.Shimabukuro TT, Kim SY, Myers TR, Moro PL, Oduyebo T, Panagiotakopoulos L, Marquez PL, Olson CK, Liu R, Chang KT, Ellington SR, Burkel VK, Smoots AN, Green CJ, Licata C, Zhang BC, Alimchandani M, Mba-Jonas A, Martin SW, Gee JM, Meaney-Delman DM; CDC v-safe COVID-19 Pregnancy Registry Team. Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons. N Engl J Med. 2021 Jun 17;384(24):2273-2282. Doi: 10.1056/NEJMoa2104983.Goldshtein I, Nevo D, Steinberg DM, Rotem RS, Gorfine M, Chodick G, Segal Y. Association Between BNT162b2 Vaccination and Incidence of SARS-CoV-2 Infection in Pregnant Women. JAMA. 2021 Jul 12:e2111035. Doi: 10.1001/jama.2021.11035.Shanes ED, Otero S, Mithal LB, Mupanomunda CA, Miller ES, Goldstein JA. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Vaccination in Pregnancy: Measures of Immunity and Placental Histopathology. Obstet Gynecol. 2021 Aug 1;138(2):281-283. Doi: 10.1097/AOG.0000000000004457.Perl SH, Uzan-Yulzari A, Klainer H, Asiskovich L, Youngster M, Rinott E, Youngster I. SARS-CoV-2-Specific Antibodies in Breast Milk After COVID-19 Vaccination of Breastfeeding Women. JAMA. 2021 May 18;325(19):2013-2014. Doi: 10.1001/jama.2021.5782.Prabhu M, Murphy EA, Sukhu AC, Yee J, Singh S, Eng D, Zhao Z, Riley LE, Yang YJ. 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Background: The subcutaneous implantable-cardioverter defibrillator (S-ICD) is an appealing alternative to transvenous ICD systems. However, data on indications for S-ICD explantations are sparse. Objectives: To assess incidence and indications for S-ICD explantation at a large tertiary referral center. Methods: We conducted a retrospective study of all S-ICD explantations performed from 2014 to 2020. Data on demographics, comorbidities, implantation characteristics, and indications for explantation, were collected. Results: A total of 64 patients underwent S-ICD explantation during the study period. During that time, there were 410 S-ICD implantations at our institution of which 53 (12.9%) were explanted with a mean duration from implant to explant of 19.7±20.1 months. The mean age of the patients at explantation was 44.8±15.3 years, and 42% (n=27) were female. The indication for S-ICD implantation was primary prevention in 58% and secondary prevention in 42% of the patients. The most common reason for explantation was infection (32.8%) followed by abnormal sensing (25%) and need for pacing (18.8%). Those who underwent S-ICD explantation for pacing indications were significantly older (55.7±13.6 vs 42.3± 14.6 years, p = 0.005) with a wider QRS duration (111±19 ms vs 98±19 ms, p = 0.03) at device implantation compared to patients who underwent explantation for other indications. Conclusion: Incidence of S-ICD explantation in a large tertiary practice was 12.9%. While infection was the indication for a third of the explantations, a significant number were due to sensing abnormalities and need for pacing. These data may have implications for patient selection for S-ICD implantation.

Background Limited information exists on nursing home (NH) residents regarding BNT162b2/Pfizer vaccine efficacy in preventing SARS-CoV-2 and severe Covid-19, and its association with post-vaccine humoral response. Methods 396 residents from seven NHs suffering a SARS-CoV-2 B.1.1.7 (VOC-α) outbreak at least 14 days after a vaccine campaign were repeatedly tested using SARS-CoV-2 real-time reverse-transcriptase polymerase chain reaction on nasopharyngeal swab test (RT-PCR). SARS-CoV-2 Receptor-Binding Domain (RBD) of the S1 subunit (RBD-IgG) was measured in all residents. Nucleocapsid antigenemia (N-Ag) was measured in RT-PCR-positive residents, and serum neutralizing antibodies in vaccinated residents from one NH. Results The incidence of positive RT-PCR was lower in residents vaccinated by two doses (22.7%) vs one dose (32.3%) or non-vaccinated residents (43.7%)(p<0.01). Covid-19-induced deaths were observed in 10.4% of the non-vaccinated residents, in 6.4% of those who had received one dose, and in 0.9% with two doses (p=0.0007). Severe symptoms were more common in infected non-vaccinated (21.0%) vs vaccinated residents (47.6%, p=0.002). Higher levels of RBD-IgG (n=325) were associated with a lower SARS-CoV-2 incidence. No in vitro serum neutralization activity was found for RBD-IgG levels below 1,050 AU/mL. RBD-IgG levels were inversely associated with N-Ag levels, found as a risk factor of severe Covid-19. Conclusions Two BNT162b2/Pfizer doses are associated with a 48% reduction of SARS-CoV-2 incidence and a 91.3% reduction of death risk in residents from NHs facing a VOC-α outbreak. BNT162b2/Pfizer efficacy was partly predicted by post-vaccine RBD-IgG levels.

Objectives: To examine the success rate of less invasive surfactant administration (LISA), to identify early predictive factors for the outcome of LISA and to compare neonatal outcomes between the LISA failure group and the group of infants who were succesfully treated with LISA. Design: A retrospective cohort study. Patients: Infants born at less than 33 weeks of gestation (n=158) and treated with LISA for respiratory distress syndrome. Results: LISA was successful in 86 cases (54.4%), 72 preterm infants (45.6%) needed additional surfactant therapy and/or mechanical ventilation in the first 72 hours. In a multivariate logistic regression analysis, six independent predictors were identified: core temperature at the time of admission (adjusted OR 3.56), suboptimal dose of surfactant (adjusted OR 0.254), elevated CRP (>10 mg/L) at 24 hours of life (adjusted OR 0.28), highest respiratory severity score during the first hour of life or at the time of LISA (adjusted OR 0.463), maternal age (adjusted OR 0.923) and birth weight (adjusted OR 1.003). The ROC curve created by using the identified factors indicates good predictive power with an area under the curve of 0.85. LISA failure was associated with a substantially higher risk of pneumothorax, bronchopulmonary dysplasia, intraventricular hemorrhage, severe retinopathy of prematurity, longer duration of mechanical ventilation and prolonged length of hospital stay. Conclusion: Failure of LISA is relatively frequent event in very preterm infants and is associated with adverse outcomes. Prevention of hypothermia during early stabilization and appropriate dosing of surfactant increase may LISA success rates and improve patient outcome.

Solving the world’s health challenges requires multidisciplinary collaborations that bring together the talents, experiences, resources, and ideas from multiple sectors in low and middle-income countries (LMIC) and high -income countries (HIC). Cystic Fibrosis (CF) was thought to be a disease of Caucasian populations from European decent. However, it has been shown to affect people from all ethnic backgrounds. CF care varies significantly for people with CF (pw CF) from HIC with median survival approaching 50 years of age, to LMIC with pw CF dying in infancy or early childhood. To address the discrepancy in quality of care and outcomes, we report on a collaboration between our team at the University of Michigan cystic fibrosis center (UoM CFC), through support from the Middle East CF Association (MECFA) and the CF Foundation (CFF), and a CF center in Turkey (Marmara University CF Center, Istanbul) to address deficiencies and improve quality of care in that center. The collaboration has been successful in improving Ma CFC data and patient care. This partnership can be viewed as a model of collaboration to be duplicated in other Middle East Countries and LMIC to deliver optimal CF care.

Background: Right ventricular-pulmonary artery coupling (RVPAC) is a predictor of outcome in pulmonary hypertension. However, the role of this parameter in dilated cardiomyopathy (DCM) remains to be established. The aim of this study was to assess the contribution of RVPAC to the occurrence of severe heart failure (HF) symptoms in patients with DCM using three-dimensional (3D) echocardiography. Methods: We prospectively screened 139 outpatients with DCM, 105 of whom were enrolled and underwent 3D echocardiographic assessment. RVPAC was estimated non-invasively as the 3D right ventricular stroke volume (SV) to end-systolic volume (ESV) ratio. Severe HF symptoms were defined by New York Heart Association (NYHA) class III or IV. We evaluated differences in RVPAC across NYHA classes and the ability of RVPAC to predict severe symptoms. Results: Mean left ventricular (LV) ejection fraction was 28±7%. Mean RVPAC was 0.77±0.30 and it was significantly more impaired with increasing symptom severity (p=0.001). RVPAC was the only independent correlate of severe HF symptoms, after adjusting for age, diuretic use, LV systolic function, LV diastolic function and pulmonary artery systolic pressure (OR 0.035 [95% CI, 0.004 – 0.312], p=0.003). By receiver-operating characteristic analysis, the RVPAC cut-off value for predicting severely symptomatic status was 0.54 (area under the curve=0.712, p<0.001). Conclusion: 3D echocardiographic SV/ESV ratio is an independent correlate of severe HF symptoms in patients with DCM. 3D RVPAC might prove to be a useful risk stratification tool for these patients, should it be further validated in larger studies.

Nanoscale zero-valent iron (FeNPs) can affect plant growth and water uptake positively or negatively. Yet, its mechanism is still unclear, particularly for differentiate functional roles of FeNPs in plant-soil interaction. To address this issue, we first confirmed 1.0 and 1.5 g·kg-1 FeNPs as growth-promotion concentrations and 1.5 g·kg-1 as optimal one, while 2.0 g·kg-1 turned to restrict growth in maize seedlings, comparing with CK. When AM fungus (Funneliformis mosseae) was inoculated and cultured with FeNPs, 1.0 and 1.5 g·kg-1 FeNPs further evidently enhanced water uptake and biomass accumulation (P<0.05). ), as affected by the activated AMF colonization carrier. Contrarily, FeNPs turned to promote AMF colonization and development, achieving greater iron translocation efficiency in mycorrhiza (P < 0.05). Yet, 2.0 g·kg-1 FeNPs restricted AMF infection in roots, a negative effect. To investigate the mycorrhizal-FeNPs symbiosis, scanning electron microscopy was used to scan the extraradical hyphae, showing that hyphae intercepted excessive iron nanoparticles, alleviating the blockage of root surface apertures and ultimately restoring root activity. Therefore, dual effects of FeNPs on maize physiology were actively mediated by AMF via rhizosphere interactions. The findings provided new insights into safe and efficient utilization of nanomaterials in agro-ecosystems.

Neural network (NN) models have made a significant impact on fatigue-related engineering communities and are expected to increase rapidly soon due to the recent advancements in machine learning and artificial intelligence. A comprehensive review of fatigue modeling methods using NNs is lacking and will help to recognize past achievements and suggest future research directions. Thus, this paper presents a survey of 251 publications between 1990 and July 2021. The NN modeling in fatigue is classified into five applications: fatigue life prediction, fatigue crack, fatigue damage diagnosis, fatigue strength, and fatigue load. A wide range of NN architectures are employed in the literature and are summarized in this review. An overview of important considerations and current limitations for the application of NNs in fatigue is provided. Statistical analysis for the past and the current trend is provided with representative examples. Existing gaps and future research directions are also presented based on the reviewed articles.

Background and aim: Ischemic heart disease is the leading cause of death around the world. Coronary artery bypass grafting offers efficient surgical revascularization for ischemic disease. Both on- or off-pump coronary artery bypass methods provide promising results to octogenarians, once complete vascularization is achieved. However, off-pump bypass requires a certain level of experience to achieve sufficient results. We have applied an off-pump coronary artery bypass-first strategy to all generations since 2008. This study investigated early and long-term results of surgical revascularization for octogenarians by a team with an off-pump-first strategy. Methods: All cases of isolated coronary artery bypass grafting performed since 2008 were identified and divided into a young group (age <80 years) and an old group (age >=80 years). Peri-operative results were investigated retrospectively in both groups and long-term results for the old group were assessed. Results: Among the 707 patients, 97% underwent off-pump bypass, and 94 cases were classified to the old group. Distal anastomoses and ventilator time were identical between groups (young vs. old: 3.3 vs. 3.2; 3.7 h vs. 3.7 h). In-hospital death rates were 0.5% and 0% in the young and old groups, respectively. With a mean follow-up of 1318 days, actual 1-, 3-, and 5-year survival rates for octogenarians were 92.1%, 81.2% and 68.3%, respectively. Nearly half of the patients reached their nineties, which was close to the life expectancy of the national general octogenarian. Conclusions: An experienced team with an off-pump-first strategy could provide valid therapeutic options for octogenarians.

Libman–Sacks endocarditis (LSE) is a cardiac manifestation of systemic lupus erythematosus and antiphospholipid syndrome and is characterized by non-bacterial verrucous vegetations with thrombogenic potential, causing stenosis and/or regurgitation in left heart predominantly, which can be asymptomatic in most of the cases but in the acute form it may present an infective form (pseudoinfective endocarditis) and complicate diagnosis and treatment. We present a case of aortic and tricuspid valve destruction due to Libman-Sacks endocarditis in a patient with antiphospholipid syndrome requiring surgical treatment by aortic and tricuspid valve replacement.