Objective: No effective treatment has yet been found for SARS-cov-2, which caused a pandemic outbreak in 2019. It is crucial to detect the progression of Covid-19 in patients as early as possible. Fibrinogen to albumin ratio (FAR) has been used as a new inflammatory marker. We aimed to find out whether the use of the FAR ratio as a predictor of mortality in Covid-19 patients provides clinical benefit. Materials and Methods: Data from 590 patients with Covid-19 from 15/03/2020 to 15/01/2021 in medicine wards and intensive care units (ICU) were retrospectively analyzed. Demographic data and other laboratory markers were collected from the electronic medical records. Relationship between FAR ratio was investigated between patients in the survivor/non-survivor patients. Findings: The mean FAR levels in patients who were non survivor was 24.44±30.3 (n:272 and 11.29±6.29 (n:275) (p:0.000) in patients survivor COVID-19 infection. In ROC curve for FAR, the threshold FAR that may pose a risk for mortality was determined as 13.84 ((AUC: 0.808(0.771-0.844)); 74.9% Sensitivity, 74.6% Specificity; p:0.000 )). Result: As a result of this study, increased FAR were found to be important markers in determining the mortality levels in Covid-19 patients. What is already known about FAR ratio: The fibrinogen albumin ratio is a value that has been used to determine the prognosis, especially in malignancies. [32] In a recent study 91 Covid-19 patients were analyzed 22 patients with severe disease higher FAR ratio compare to mild disaese [36] What does this article add about FAR ratio in Covid-19 patients: It has been concluded that the FAR ratio, which is used in diseases such as malignancy, hypertension, and coronary syndrome as a marker of disease progression, can be used as a mortality indicator in Covid-19

The structures and interactions of systems formed by the MPBCP (meta-Phenylene-Bridged Cyclic Oligopyrrole) functionalized with lanthanum atom were studied for investigating the abilities of MPBCP, [La-MPBCP]+3 and La-MPBCP to absorb biogas (CO2, N2, H2 and CH4) using density functional theory. The Eads calculated values for biogas molecules on [La-MPBCP]+3 and La-MPBCP showed that these gas molecules have favorable interactions with the lanthanum atom coordinated on the MPBCP. CO2 molecule shows strong interactions, with Eads values of -28.63 and -15.95 kcal/mol. In the case of H2 molecule, the Eads is lower with values of -7.51 and -5.28. It is easy to observe the CO2 molecule on the [La-MPBCP]+3 system has four times higher energy value than adsorption energy for the H2 molecule. The natural bond orbital analysis reveals that gas molecules are electron donator in the systems and the acceptor orbitals belong to lanthanum atom. Computational studies suggest that CO2, N2, CH4 and H2 molecules on [La-MPBCP]+3 and La-MPBCP present physisorption. Our findings divulge promising potential of the [La-MPBCP]+3 as an adsorber/separator CO2/H2.

Objective: There is paucity of data on outcomes after isolated tricuspid valve surgery. This meta-analysis aims to compile available data on isolated tricuspid valve surgery and compare isolated tricuspid valve repair (iTVr) with isolated tricuspid valve replacement (iTVR) to elucidate outcomes after tricuspid valve surgery. Methods: A literature search of 6 databases was performed. The primary outcomes was 30-day mortality. Secondary outcomes were early stroke, post-op pacemaker placement, and tricuspid reoperation within 5 years. Publication bias was explored using the funnel plot. Results: Ten retrospective studies involving 1407 patients (iTVr group = 779 patients and iTVR group = 628 patients) were included. A cumulative analysis demonstrated a significant difference favoring iTVr for 30-day mortality [odds ratio – 10 studies (95% confidence interval) 0.34 (0.18-0.66)]; 4.7% versus 12.6%, for iTVr and iTVR, respectively. Post-op pacemaker placement favored iTVr [odds ratio – 6 studies (95% confidence interval) 0.37 (0.18-0.77)]. Although stroke rates and TV reoperation favored iTVr, they did not reach statistical significance. No publication bias was identified. Conclusions: This meta-analysis demonstrates that iTVr has better 30-day mortality and fewer permanent pacemaker placements. Etiology and severity of TR, as well as careful patient selection remain the most important factors for optimal outcomes.

Aim of the study: Hydrocortisone is a soft steroid with low anti-inflammatory properties and a short duration of action, used to manage several ocular conditions. The clinical benefits and side effects associated with hydrocortisone are well documented, but its basic pharmacokinetic in the eye is yet to be fully elucidated. The purpose of this study is to investigate the anterior chamber penetration capabilities of hydrocortisone when used in different concentrations as eye drops treatment. Materials and Methods: This is a double-blind, single-center, randomized clinical trial performed at the Department of Medicine and Surgery of the University of Perugia (Italy) on consecutive patients who have undergone phacoemulsification with intraocular lens implantation. Patients were randomly assigned on the morning of surgery to receive a single instillation of 0.33% (group A) or 0.001% (group B) hydrocortisone sodium phosphate solution. Group of patients C did not receive any treatment and was used to measure the hydrocortisone endogenous levels. Before surgery, one aliquot of aqueous humor for each patient was aspirated. The time of collection for each sample was recorded. Hydrocortisone concentrations were then stratified into six interval classes of 30 minutes each. Results: The mean concentration of hydrocortisone was significantly higher in group A (25.2±12.4 ng/ml) compared with group B (7.11±1.51 ng/ml) and compared to the mean hydrocortisone endogenous levels (3.92±1.18 ng/ml) (p<0.0001). No statistically significant differences of hydrocortisone mean concentrations between group B and the mean endogenous levels were found. Conclusions: Considering the frequent need for prolonged topical steroid therapies and the possible consequent undesirable side effects, ophthalmologists should consider the lowest clinically effective dose of hydrocortisone useful to obtain the desired therapeutic effect and in an adequate time, to minimize the amount of steroids into the anterior chamber and to avoid side effects, such as intraocular pressure increase or cataract development.

The poisoning effect of KNO3, NaNO3, and Ca(NO3)2 on CeZrTiAl catalyst for selective catalytic reduction of NO with NH3 was investigated. It was found that the activity deactivation rate follows K> Na > Ca. SEM and BET showed that the accumulation of catalysts was severe after poisoning, and the nanosheet γ-Al2O3 skeleton structure disappeared due to alkali coating. The decrease of the specific surface area is accompanied by pore blockage, making the catalyst unable to expose rich reaction sites. In addition, the fewer surface Ce3+ and chemisorbed oxygen on the surface of the poisoned catalyst weaken the cycle between Ce3+ and Ce4+, resulting in bad redox performance. Thus, the failure to realize the efficient oxidation of NO to NO2. Another critical reason for catalyst poisoning failure is that the decrease of surface acid sites seriously affects the adsorption and activation of NH3 and NOx on the catalyst surface.

BTDA-TDI/MDI (P84) has been widely applied in gas separation, however, pinholes or defects on P84 membrane surfaces were formed in the membrane preparation process and directly weaken its separation performance. Herein, we developed an ultrafast polydimethylsiloxane (PDMS) layer-by-layer assembly strategy via spraying method to heal the defects of the P84 membrane. Firstly, a very short assembly time 20-30 s was achieved by a UV-curing method. Secondly, both the PDMS spraying concentration and cycle times were optimized to strengthen the healing ability of PDMS. The P84-PDMS membrane with 3 wt % PDMS spraying concentration and 2 spraying cycle times significantly improve the H2/CH4 selectivity from 62.99 to 231.92 with a satisfactory H2 permeance (20.85 GPU). The layer-by-layer PDMS assembly strategy for healing defects of P84 membrane displays outstanding comprehensive abilities, with an easy manufacturing based upon ultrafast curing and excellent gas separation performance based on the defect-free membrane structure.

The degree of rate control quantitatively identifies the kinetically relevant (sometimes known as rate-limiting) steps of a complex reaction network. This concept relies on derivatives which are commonly implemented numerically, e.g. with finite differences. Numerical derivatives are tedious to implement, and can be problematic, and unstable or unreliable. In this work, we demonstrate the use of automatic differentiation in the evaluation of the degree of rate control. Automatic differentiation libraries are increasingly available through modern machine learning frameworks. Compared to the finite differences, automatic differentiation provides solutions with higher accuracy with lower computational cost. Furthermore, we illustrate a hybrid local-global sensitivity analysis method, the distributed evaluation of local sensitivity analysis (DELSA), to assess the importance of kinetic parameters over an uncertain space. This method also benefits from automatic differentiation to obtain high-quality results efficiently.

Background and Aim: We report a case of severe aortic stenosis accompanied by severe aortic insufficiency complicated with coronary heart disease who underwent one-stop PCI+TAVR intraoperative circulation collapse and was successfully rescued. Case Summary:A 73-year-old male patient with severe aortic stenosis with severe aortic insufficiency and coronary heart disease underwent one-stop TAVR+PCI with the aid of Cardiopulmonary bypass(CPB). PCI was successfully performed in the patient, and a 2.5*33cm Nano coronary stent was implanted. No residual stenosis was observed in angiography. During TAVR, A Venus-A L26mm interventional valve was inserted, and the valve slid slightly downward with poor position. Aortic root angiography showed A large amount of regurgitation and A progressive decrease in blood pressure, which could not be maintained even after the application of vasoactive drugs. Chest compressions were performed, and the extracorporeal circulation machine was opened to assist circulation. In the same way, A Venus-A L26mm interventional valve was placed in the previous valve. Aortic root angiography was performed without regurgitation. TEE examination showed that the valve opened and closed well and the orifice velocity was normal without regurgitation. After surgery, the patient returned to ICU smoothly. Conclusion: One-stop PCI+TAVR is a reasonable method for the treatment of aortic valve disease complicated with coronary heart disease. Cardiopulmonary bypass (CPB) is an effective method to deal with circulatory collapse in time.

Background The single procedure success rates of durable pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (AF) varies between 80 and 90 %. This prospective, randomized study investigated the efficacy of Cryoballoon PVI (CBA) versus pulmonary vein isolation with RF-energy following the CLOSE protocol in terms of single-procedure arrhythmia-free outcome and safety. Methods and results A total number of 150 patients undergoing de-novo catheter ablation for paroxysmal AF were randomized to two different treatment arms in a 1:1 fashion. In group-A patients, PVI was performed with the Cryoballoon (Articfront Balloon, Medtronic Inc). The ablation procedure in group B was performed with RF-energy (CARTO 3, Biosense Webster Thermocool STSF), following the CLOSE protocol. During a mean follow-up of 12  4.5 months after a single procedure, 64 (85.33 %) patients of group A were free of arrhythmia recurrence versus 65 (86.67 %) patients in group B (p=ns). A total of 14 patients (group A: 7 (9.33 %) group B: 7 (9.33 %); p=ns) underwent a redo-procedure. No significant difference between both groups was observed in terms of PV recovery (group A: 4 (5.33 %) vs. group B: 3 (4 %); p=ns). Patients of group A showed significantly more AF recurrence during the blanking period of three months (group A: 14 (18.67 %) versus group B: 6 (8 %); p<0.05. Conclusions Cryoballoon PVI and PVI using ablation index following the CLOSE protocol are equally efficient in achieving durable PV-isolation. Cryoballoon ablation leads to significantly more AF recurrence during the blanking period.

Pines (Pinus spp.) rely on co-introduced ectomycorrhizal (EM) fungi to invade native ecosystems in the Southern Hemisphere. Although co-invasive EM fungal communities are expected to be poor in species, long-term successional trajectories and the persistence of dispersal limitations are not well understood. We sampled the roots and surrounding soil of Pinus elliottii and P. taeda trees invading mountain grasslands of Argentina. We also sampled the EM fungal spore bank in grassland soil near (~150 m) and far (~850 m) from original pine plantations. We found an impressive total of 47 different co-invasive EM fungal OTUs. Differential dispersal capacities among EM fungi were detected in the spore bank of grassland soil, but not under mature invading pines. After thirty years of invasion, the age but not the degree of spatial isolation of pine individuals affected the EM fungal composition. We showed that invading pines can host a highly diverse EM fungal community and although dispersal limitations can be important during the colonization of non-invaded sites, they can be overcome in the life-span of pines, allowing EM succession to continue. These results enhance our understanding of the spatial structure and dispersal dynamics of EM fungi during pine invasions.

Purple butter clam (Saxidomus purpuratus) is an economically important bivalve shellfish. This species belongs to the subclass Heterodonta that diverged in calcite seas with low magnesium concentrations. We sequenced and assembled its genome and performed an evolutionary comparative analysis. A total of 911 Mb assembly of S. purpuratus was anchored into 19 chromosomes and a total of 48,090 protein-coding genes were predicted. We identified its repeat-based expanded genes that are associated with the sodium/potassium-exchange ATPase complex. In addition, different types of ion transporters were enriched in the common ancestor of Heterodonta (calcium, sulfate, and lipid transporters) and the specific evolution of S. purpuratus (calcium and sodium transporters). These differences seem to be related to the divergence times of Heterodonta (calcitic sea) and Veneraidea (aragonitic sea). Furthermore, we analyzed the evolution of scavenger receptor (SR) proteins in S. purpuratus, which are involved in a wide range of immune responses, and compared them to the closely related Cyclina sinensis. We showed that a small number of SR proteins, exhibited collinearity between the two genomes, which is indicative of independent gene evolution. Our genomic study provides an evolutionary perspective on the genetic diversity of bivalves and their adaptation to historical changes in the marine environment.

Abstract： Background: Baha Attract System was designed as non-skin penetrating bone conduction implant to minimize skin complication. However, there were insufficient studies on its long-time acoustic outcome and safety in microtia patients with auricle reconstruction surgeries, who have thinner retroauricular subcutaneous layer and theoretically vulnerable skin at the implant side. Objectives: To analysis the long-term hearing performance and soft tissue complications of Baha@ Attract System in microtia population. Study Design & setting: A prospective cohort study at single tertiary referral center. Patients: Twenty Mandarin-speaking patients with congenital bilateral microtia who were underwent Baha@ Attract implantation with or without auricle reconstruction surgeries simultaneously. Main Outcome Measure(s): Comparative analysis of audiological test results including hearing thresholds and speech recognition in quiet and in noise were pre- and post-operatively performed. subjective benefit as measured with the SSQ Scale. Soft tissue outcomes were monitored and documented. Results: The mean follow-up time was 36.11±3.30 months. Significant and stable improvements in hearing threshold and speech understanding in noise and quiet were demonstrated with aided condition. Subject evaluation revealed high level of patients’ satisfaction with the amplification in all the subscales. Adverse events including skin necrosis increased after one year post-operatively. Soft tissue evolution including sin thinning, erythema, epidermis atrophy, soft tissue atrophy, skin necrosis was seen or once developed in most of the participants. However, prevalence of severe soft tissue complication was not higher to non-microtia population. Conclusions: Baha@ Attract System provides favorable and stable hearing improvements for microtia patients. Combining plastic surgeries with implantation will not increase the prevalence of soft tissue complication. However, long-term soft tissue problems should be highly aware of even after one year post implantation. Key words: Baha Attract, microtia, hearing, soft tissue, skin necrosis

For drug products manufactured in mammalian cells, safety assurance practices are needed during production to assure that the final medicinal product is safe from the potential risk of viral contamination. Virus filters provide viral retention for a range of viruses through robust, size-based retention mechanism. Therefore, a viral filtration step is commonly utilized in a well-designed recombinant therapeutic protein purification process and is a key component in an overall strategy to minimize the risks of adventitious and endogenous viral particles during the manufacturing of biotechnology products. This review summarizes the history of viral filtration, currently available viral filters and prefilters, and viral filtration integrity test methods and study models. There is also discussion of current understanding and gaps with an eye toward future trends and emerging filtration technologies.

The Linear Wireless Ad-Hoc Network (Linear WANET), as a branch of the Ad-Hoc network, refers to a self-organizing multi-hop wireless network in which nodes are arranged linearly. Frame aggregation and RTS/CTS schemes are introduced in IEEE 802.11 aims to improve network transmission performance. However, the traditional mechanisms may not have good adaptability in linear multi-hop networks. Thus, we defined a Linear WANET simulation model based on the IEEE 802.11 protocol. We established this model on the NS-3 network simulator to perform A-MSDU, A-MPDU, and two-level frame aggregation simulation and analyzed the aggregation performance under different channel environments. Meanwhile, the RTS/CTS and TXOP mechanisms were also simulated in this paper. We analyzed the performance of each mechanism in a Linear WANET under saturated and unsaturated environments. We found that in a Linear WANET, the A-MSDU mechanism can improve system performance to a limited extent, but at the same time, it will increase the packet loss rate and delay. Although the A-MPDU mechanism can reduce the retransmission overhead, the higher A-MPDU Limit cannot further improve the throughput of the Linear WANET. Meanwhile, in the case of single A-MPDU aggregation, there has a lowest data delivery interval that the Linear WANET system can withstand. Besides, we also found that the native TXOP mechanism cannot effectively improve the system efficiency of Linear WANET. And the RTS/CTS mechanism can improve the performance of Linear WANETs, especially in a saturated throughput environment.

Background Antenatal Care (ANC) is one of the key care-packages required to reduce global maternal and perinatal mortality and morbidity Objectives To identify the essential components of ANC and develop signal functions Search strategy MESH headings for databases including Cinahl, Cochrane, Global Health, Medline, PubMed, and Web of Science Selection Criteria Papers and reports on content of ANC published from 2000-2020 Data collection and Analysis Narrative synthesis of data and development of signal function through 7 consensus-building workshops with 184 stakeholders Main Results A total of 221 papers and reports are included from which 28 essential components of ANC were extracted and used to develop 15 signal functions with the equipment, medication and consumables required for implementation of each. Signal functions for the prevention and management of infectious diseases (malaria, HIV, tuberculosis, syphilis and tetanus) can be applied depending on population disease burden. Screening and management of pre-eclampsia, gestational diabetes, anaemia, mental and social health (including intimate partner violence) are recommended universally. Three signal functions adress monitoring of foetal growth and wellbeing and identification and management of obstetric complications. Promotion of health and wellbeing via education and support for nutrition, cessation of substance abuse, uptake of family planning, recognition of danger signs and birth preparedness are included as essential components of ANC. Conclusions New signal functions have been developed which can be used for monitoring and evaluation of content and quality of ANC. Country adaptation and validation is recommended.

Introduction Educational reforms in any given country of which Nigeria is not exclusive always originate through the basic belief that substantial improvement can be gained in a country and by its persons via a careful development of the academic process (Omolewa, 2007). Although there have been efforts in the past at reforming education even though the clause “reform” may not have been used. Nigeria has seen numerous scholastic reforms which commenced at the pre-independence. The change was burnout of the nation’s notable protesters for self-rule that led the British expatriates to modify the learning system in operation in 1954 from 8-6-2-3 system i.e. 8year primary, 6year secondary, 2year higher school certificate and 3year university to a new system of 6-5-2-3 that is 6year primary, 5year secondary, 2year higher school certificate and 3year university. The alteration occasioned in lessening the number of years at the primary and secondary school stages and created further awareness in the minds of her citizenries about education.The major reform programmes in education after independence was the Universal Primary Education (UPE) programmes and the 6-3-3-4 system of education. The first two decades after the nation’s independence was seen as an era of self-determination and expansion in education,Fafunwa (1974). Other foremost change guidelines include: the Federal Government overthrow of provincial universities in 1975, (Adamu, 2004); the Universal Basic Education Programme of 1999, among others. Similarly, learning reformations have been carried out by both advanced,developing and the under-developed countries of the world. Bello (2007) in a statement pointed out certain reasons for reforms in education to include; to have education applicable to the wishes of the country, furnish students with appropriate knowledge,transmute their reserved and specialized lives, make education handy to more persons and pay extra responsiveness to science and technology. Others comprised the plea to: intimate learners with up-to-date information and communication technology skills, kit schools with suitable assets, improve teaching approaches and instructive practices, mend the school valuation system, and prepare the citizens of the country to face the contests of globalization.Reforms consist of changes and improvement to a law, social system or institution (Atanu,2006). However, there can be changes without improvements. Innovations and reforms in education are responses to varying economic and social-political circumstances both in developed and developing states. For people to feel the need to change an educational system at any given time, it is obligatory that the novel philosophies and needs which occurred in the previous system are no lengthier germane (Adamu, 2004).For schools to meet the expected standards, principals must be ready to drive the various reforms initiatives to its target. These reforms may include but not limited to integration of information and communication technology, and introduction of entrepreneurship education. Integration of information and communication technology in the context of this work refers to the incorporation of electronic device to carryout administrative tasks in the school system in a manner that is acceptable, smart and timely. Entrepreneurship education is considered important in this study and refers to a course taught by instructor with the objective of making the learners become independent and self-employed with the ability to take risk and translating the risk into profit making ventures through education.Principals who are transformational leaders are those whose leadership style inspires extraordinary performance among staff members.\cite{sco} Kreiter, Kinicki and Buelens (2002) asserted that transformational leadership can yield momentous syllabus amendment and outcomes; since it fathoms the process of change. It is able to convert staff to chase desired goals in view of self-interest.Reforms in education therefore, need to consider the unique roles of principals in the country’s education system. Principals’ are seen and regarded as managers in the school system and are expected to direct the affairs of the organization for the achievement of predestined goals and objectives. The success of any nation is inseparable from its sound policy framework which is basically guided and supported with functioning managerial technique, informed by modern decrees.

Few ecological niche models (ENM) incorporate the Eltonian niche or examine a population’s niche at multiple spatial scales. We used Bayesian Joint Species Distribution Models (JSDMs) across multiple spatial scales to examine whether freshwater mussel communities in east Texas adhered to the Eltonian Noise Hypothesis, which asserts that species interactions exert greater influence on conspecific species at finer spatial scales. For both abundance and presence data, we observed a statistically greater number of strong interactions at the finest spatial scale compared to larger spatial scales. While 34% of abundance interactions and 24% of presence interactions showed strong positive relationships, only 6% of abundance interactions and 0% of presence interactions showed strong negative relationships. We found that freshwater mussel communities conform to the Eltonian Noise Hypothesis. Inclusion of the Eltonian niche and consideration of spatial scale are necessary to accurately model niches and increase efficacy of ENMs as conservation tools.

Governments and international donors are actively promoting laser-land leveller (LLL) technology to produce environmental benefits (i.e., avoid soil salinity, minimize soil erosion risk, and groundwater security) that could lead to sustainable agricultural production and averting land degradation. We investigate the adoption process of laser-land leveller (LLL) technology in Punjab, Pakistan during the period 1985–2018 using survey data from 504 farming households. A discrete-time duration model is used to investigate factors that could influence the speed of adoption of LLL technology and an endogenous switching regression (ESR) model to evaluate its impact on groundwater usage. It is found that about 70% of the surveyed households had adopted the technology. The key determinants of the speed of adoption include strong legal land entitlements, farm size, and farm location along the watercourse. Information acquired through formal and informal sources and exposure to the technology potentially reduce adoption time. The adoption of LLL reduces groundwater use by about 23% in wheat crop. These results highlight the need for improved institutional arrangements such as extension services, technology exposure, and establishing legal property rights over land to enhance uptake of LLL technology.

We report what apprears to be the first case of fetal noncompaction cardiomyopathy in both ventricles accompanied by a mutation in the calmodulin gene (CALM2): A 25-year-old woman was referred to our hospital at 25+1 weeks of gestation for evaluation of fetal defects. A postnatal echocardiography showed biventricular noncompaction cardiomyopathy. After terminated the pregnancy, fetal noncompaction cardiomyopathy was comfirmed by autopsy and histopathologic examination. And the whole-exome sequencing of genomic DNA demonstrated a de novo heterozygous mutation (c.389A>G;p.D130G) in CALM2, whereas the parents were normal. In this case report, we highlight the gene mutation in noncompaction cardiomyopathy.

Primary ocular adnexal T-cell extranodal lymphoma are uncommon and carry a particularly poor prognosis. It represents 1%–2% of all NHL. Because of its rarity, we want to show to the medical community our experience about primary conjunctival T cell lymphoma by reviewing literature and discussing our case.

A 59-year-old male was diagnosed with JAK2-positive Polycythemia Vera. Subsequently, further lab testing revealed elevated ferritin and iron saturation. Genetic testing for HFE gene mutation screen revealed that the patient was positive for heterozygous C282Y mutation. The patient was ultimately diagnosed with both Polycythemia Vera and Hereditary Hemochromatosis.

A 55-year-old male with lumbago, with Imaging studies that showed osteoporotic fractures at T5,T8,T11,T12 and L1-L5 vertebrae secondary to Cushing disease. PV was performed with a Spine Jack® intracorporal implant device. Post-operative course demonstrated improvement of pain, height, correction of the kyphotic angle and Oswestry score, without any neurological deficit.

The translocation t(8;9)(p22;p24) results in the production of a chimeric PCM1-JAK2 fusion protein leading to the constitutive activation of the Janus Kinase 2 that renders this disease potentially sensitive to ruxolitinib. Here we report an interesting case of PCM1-JAK2 myeloproliferative neoplasm evolving in myeloid sarcoma and B precursor ALL.

CAR-T cell related HLH/MAS is an unusual manifestation of severe cytokine release syndrome (CRS) with high mortality rates and a challenging diagnosis. The establishment of specific diagnosis criteria is essential, and the combination of several techniques for CAR-T cell follow-up, allows a more precise management of this complication.