Background: Pulmonary embolism (PE) patients with right ventricular (RV) involvement are a heterogenous group who mandate further risk stratification. Our objective was to evaluate the efficacy of the PE severity index (PESI) for predicting adverse clinical outcomes among PE patients with RV involvement. Methods and Results: Consecutive normotensive PE patients with RV involvement were allocated according to admission PESI score (PESI <4 vs. PESI ≥4). The primary outcome included hemodynamic instability and in-hospital mortality. Secondary outcomes included each component of the primary outcome as well as mechanical ventilation, thrombolytic therapy, acute kidney injury, and major bleeding. Multivariable logistic regression model was performed to assess the independent association between the PESI score and primary outcome. C-Statistic was used to compare the PESI with the BOVA score. A total of 253 patients were evaluated: 95 (38%) with a PESI of ≥4. Of them, 82 (32%) patients were classified as intermediate-low risk and 171 (68%) as intermediate-high risk. Fifty (20%) patients had at least 1 adverse event. Multivariate analysis demonstrated the PESI to be an independent predictor for the primary outcome (HR 4.81, CI 95%, 1.15-20.09, P=0.031), which was increased with a concomitant increase of the PESI score (PESI 1:4.2%, PESI 2: 3.4%, PESI 3:12%, PESI 4: 16.3%, PESI 5:23.1%, P for trend <0.001). C-Statistic analysis for the PESI score yielded an AUC-0.746 (0.637-0.854), P=0.001, compared to the BOVA score: AUC-0.679 (0.584-0.775), P=0.011. Conclusion: PESI score was found to predict adverse outcomes among normotensive PE patients with RV involvement.

Background and aim of the study: Patients with severe coronavirus disease 2019 (COVID-19) develop a profound cytokine-mediated pro-inflammatory response. This study reports outcomes in 10 patients with COVID-19 supported on veno-venous extracorporeal membrane oxygenation (VV-ECMO) who were selected for the emergency use of a hemoadsorption column integrated in the ECMO circuit. Materials and Methods: Pre and post treatment, clinical data and inflammatory markers were assessed to determine the safety and feasibility of using this system, and to evaluate the clinical effect. Results: During hemoadsorption, median levels of interleukin (IL)-2R, IL-6, and IL-10 decreased by 54%, 86%, and 64% respectively. Reductions in other markers were observed for LDH (-49%), ferritin (-46%), D-dimer (-7%), C-reactive protein (-55%), procalcitonin (-76%) and lactate (-44%). Vasoactive-inotrope scores decreased significantly over the treatment interval (-80%). The median hospital length of stay was 53 days (36-85) and at 90-days post cannulation, survival was 90% which was similar to a group of patients without the use of hemoadsorption. Conclusions: Addition of hemoadsorption to VV-ECMO in patients with severe COVID-19 is feasible and reduces measured cytokine levels. However, in this small series, the precise impact on the overall clinical course and survival benefit still remains unknown.

Aims: This study sought to describe originating from the spontaneous scarring of left atrial anterior wall (LAAW) left atrial macroreentry tachycardia (LAMRT) clinical and electrophysiological characteristics, mechanisms, the formation of substrates. Methods and Results: 9 of 123 patients (89% female, age 79.78±5.59 years) had LAMRT originating from the LAAW and no cardiac surgery or prior left atrial (LA) ablation. The mean tachycardia cycle length (TCL) was 241.67±38.00 milliseconds. Spontaneous scars areas and low voltage areas (LVAs) in the LAAW were found in all patients. Successful ablation of the critical isthmus caused terminated of the LAMRT and was not inducible in all patients. Arrhythmogenic substrates of LAMRT were the spontaneous scars of LAAW, which matched with the aorta or/and pulmonary artery contact area. The area under the curve (AUC) of age and combination of gender and age for predicting the LAMRT originating from the LAAW were 0.918 and 0.951, respectively, with a cutoff value of ≥73.5 years of age and gender (female) predicting LAMRT with 88.9% sensitivity and 89% specificity. Conclusion: Combination of gender and age provides a simple and useful criterion to distinguish LAMRT from cavo-tricuspid isthmus (CTI) -dependent atrial tachycardia in macroreentry atrial tachycardia (MRAT) in patients without a history of surgery or ablation. Aorta or/and pulmonary artery contacting LA may be related to spontaneous scars. Ablation the isthmus eliminated LAMRT in all patients.

The characterization of fluid dynamics and mass transfer is often influenced by phase maldistribution. An existing cell model approach for fluid distribution is extended for gas distribution and mass transfer. The model differentiates wall and bulk zones, allowing a detailed evaluation of local fluid dynamics and mass transfer, which is based on a state-of-the-art literature correlation. Distribution parameters are determined experimentally. The model allows scale-up by considering the phase distribution at constant computational effort. A scale-up strategy to adapt the distribution parameters to different geometries is presented. Results for fluid dynamics and liquid distribution are in good agreement with experimental data of columns with diameters of 0.288, 0.5 and 0.6 m. Mass transfer is in good qualitative agreement with own experiments in a 0.288 diameter column. While maldistribution consequently reduces the gas side mass transfer, the reduced liquid bulk flow weakens the effect of liquid side mass transfer.

In this article, we consider the following p-q-Laplacian system with singular and critical nonlinearity \begin{equation*} \left \{ \begin{array}{lllll} -\Delta_{p}u-\Delta_{q}u=\frac{h_{1}(x)}{u^{r}}+\lambda\frac{\alpha}{\alpha+\beta}u^{\alpha-1}v^{\beta} \ \ in\ \Omega ,\\ -\Delta_{p}v-\Delta_{q}v=\frac{h_{2}(x)}{v^{r}}+\lambda\frac{\beta}{\alpha+\beta}u^{\alpha}v^{\beta-1} \ \ in\ \Omega, \\ u,v>0 \ \ \ \ \ \ in \ \Omega, \ \ \ \ \ u=v=0 \ \ \ \ \ \ \ on \ \partial\Omega, \end{array} \right. \end{equation*} where Ω is a bounded domain in $\mathbb {R}^{n}$ with smooth boundary $\partial\Omega$. $11,\lambda\in(0,\Lambda_{*})$ is parameter with $\Lambda _{*}$ is a positive constant and $h_{1}(x),h_{2}(x)\in L^{\infty},h_{1}(x),h_{2}(x)>0$. We show the existence and multiplicity of weak solution of equation above for suitable range of $\lambda$.

Background: The known primary radiological diagnosis of Chiari Malformation-I (CM-I) is based on the degree of tonsillar herniation ( TH) below the Foramen Magnum (FM). However, recent data also shows the association of such malformation with smaller posterior cranial fossa (PCF) volume and the anatomical issues regarding the Odontoid. This study presents the achieved result regarding some detected potential radiological findings that may aid CM-I diagnosis using several machine learning (ML) algorithms. Materials and Methods: Between 2011 and 2020, radiological examinations of 100 clinically/radiologically proved symptomatic CM-I cases and 100 control were evaluated by matching age and gender. A team of Neuroradiologists had reviewed the MR images of the study population. A total of 11 different radiological parameters were assessed for CM-I diagnosis. The parameters were defined and examined in 5 designed different ML algorithms. Statistical analysis was conducted for data analysis. Results: The mean age of patients was 29.92 ± 15.03 years. The primary presenting symptoms were headaches (62%). Syringomyelia and retrocurved-odontoid were detected in 34% and 8% of patients, respectively. All of the morphometric measures were significantly different between the groups, except for the distance from the dens axis to the posterior margin of FM. The Radom Forest model is found to have the best 1.0 (14 of 14) ratio of accuracy in regard to 14 different combinations of morphometric features. Conclusion: This study indicates the potential usefulness of ML-guided PCF measurements, other than TH, that may be used to predict and diagnose CM-I accurately. Our results support the view of TH as a single radiological parameter may fail during the diagnosis of CM-I. Combining two or three preferable osseous structure-based parameters may increase the accuracy of radiological diagnosis of CM-I.

Premature ventricular complexes (PVC) ablation has increased over the past decades. The morphology of PVCs arising from left anterior fascicle (LAF) is typically a right bundle branch block-like morphology with an inferior axis showing a qR or qRs complex in the inferior leads and an rS or RS complex in leads I and aVL. We describe the case of a 38 years old woman with symptomatic, high burden PVCs, despite of beta blockers treatment. The PVC’s ECG morphology suggested an origin in the LAF. This case illustrates how ablation from the right coronary cusp for PVC arising from the LAF could be accurately guided by pace-mapping. At this location, pacing at different outputs can result in both a selective and a non-selective capture of the left anterior fascicle.

A 42-year-old woman presented with myalgia, which ameliorated a week after treatment. She was diagnosed with Basedow's disease. The presence of concomitant autoimmune diseases are important considerations for patients with Basedow's disease presenting with myalgia. Thyrotoxicosis should be included as a rare differential diagnosis for myalgia.

La legislazione europea e il suo recepimento nella normativa nazionale incoraggiano lo sviluppo e l'uso di sistemi modellistici di qualità dell'aria che sono considerati di primaria importanza nelle valutazioni preliminari di qualità e utili per completare il contenuto informativo delle misure dirette. Il funzionamento dei modelli di dispersione consiste nel simulare gli effetti di una o più sorgenti di emissione in termini di concentrazione degli inquinanti emessi in corrispondenza di fissati recettori.

Leadless Pacing with Mechanical Atrial Sensing and Variable AV ConductionJason Cook, MDTravis D. Richardson, MDFrom Vanderbilt University Medical Center. Nashville, TennesseeCorresponding author:Travis D. Richardson, MDAssistant Professor Cardiac ElectrophysiologyVanderbilt Heart and Vascular Institute1215 21st Ave S. Nashville, TNMedical Center East, South Tower, Suite 5209ph (615) 936-7537fax (615) 936-5064travis.d.richardson@vanderbilt.eduWord Count:1331Disclosures: The authors report no relevant financial disclosures.Funding: NoneThe MicraTM leadless transcatheter pacing system (Medtronic Inc., Mounds View, MN) has been shown to be an effective alternative to transvenous pacing with excellent implantation success rates and durable long-term performance.1–3 The first generation device provided single chamber right ventricular pacing with rate responsiveness enabled by a 3-axis accelerometer.Recently, the MARVEL 2 study (Micra Atrial tRacking using a Ventricular accELerometer 2) reported the ability of software enhancements to allow a leadless pacemaker to deliver single chamber atrioventricular (AV) synchronized pacing.4 In contrast to dual-chamber transvenous pacemakers which sense atrial electrograms, the MARVEL 2 algorithm adjudicates atrial events using mechanically sensed atrial activity from the 3-axis accelerometer. During initial programming, the relative timing of mechanical events to the ventricular electrogram allows for identification of A3 (passive ventricular filling) and A4 (atrial contraction). Atrial-sensed events are then defined by the A4 signal, and tracking may occur. MARVEL 2 reported VDD pacing was achieved at rest in an impressive 89.2% of patients.The Micra AVTM system’s unique programming includes three basic pacing modes: VDD, VVI and VDIR (Figure 1). Additionally, two mode switch algorithms are available and by default programmed on: the AV conduction mode switch and the activity mode switch. Unlike mode switch algorithms in dual chamber pacing systems, which are intended to avoid inappropriate tracking of atrial arrhythmias, these algorithms are intended to 1) minimize ventricular pacing, and 2) to improve rate support during patient activity respectively.When the AV conduction mode switch algorithm is enabled, the device periodically switches from VDD to VVI at 40 bpm to allow for intrinsic AV conduction. If ventricular sensing occurs above a rate of 40 bpm, in order to reduce right ventricular pacing, VVI 40 programming will continue regardless of the programmed lower rate limit. However, if two of any window of four beats are paced at VVI 40, the device reverts to VDD. Thereafter, reassessments of AV conduction are performed at increasing intervals starting at 2 minutes until either AV conduction is detected or 8 hours is reached at which point subsequent testing occurs at regular 8 hour intervals.The activity mode switch algorithm utilizes the sensor indicated rate in an attempt to ensure adequate ventricular rate support during patient activity regardless of AV conduction. The sensor in the MicraTM is always running. If at any time 1) the sensor indicated rate is above the device programmed ADL rate, and 2) the current ventricular rate is >20 BPM below the sensor rate, the activity mode switch will change the device to VDIR mode with heart rates determined by the sensor. This switch may occur from either the VDD mode or VVI in the setting of AV conduction. The device will revert to VDD mode when the sensor rate drops below the ADL rate.With the added functionality of atrial sensing and the incorporation of the MARVEL 2 algorithms described above, in this issue of the Journal of Cardiovascular Electrophysiology, Garweg et al. examined the pacing behavior of the Micra AVTM in the presence of variable AV conduction, atrial arrhythmias, sinus bradycardia (< 40 bpm), sinus arrhythmia, and periods of atrial and ventricular ectopy (Reference). During the data collection period in MARVEL 2, ECG, electrogram, accelerometer waveforms, and device marker data were obtained; this was collected either after initial implant and follow-up or, for patients with previously placed devices, during a single encounter. The average monitoring period was 153 minutes. The study included 73 patients with normal sinus node function and varying degrees of AV block.While the number of patients with variable AV conduction was small (5), the investigators found that the rhythm checks allowed for appropriate mode adjustments during the study period. During periods of AV block, as expected, 99.9% ventricular pacing was observed while during 1:1 AV conduction only 0.2% pacing was observed. Ventricular pacing was monitored in patients with 1:1 AV conduction using conventional VVI pacing and MARVEL 2 programming. MARVEL 2 programming using the AV conduction mode switch algorithm resulted in a reduction in ventricular pacing from 22.8% to 0.2% (n=18). Reducing the burden of ventricular pacing is an important enhancement to the system with the potential to minimize pacing-induced cardiomyopathy.5One potential pitfall of atrial sensing addressed by this study is tracking of atrial arrhythmias. While the sample size was small (n=7), tracking of atrial fibrillation resulting in pacing at the upper tracking rate was not observed in any of the patients. In one patient with atrial flutter, intermittent atrial tracking did occur but did not result in tachycardia. In contrast to atrial rate based mode switching used in conventional dual-chamber pacemakers, the behavior of the MARVEL 2 algorithm during atrial fibrillation is dictated by the sensed ventricular rate. With the AV conduction mode switch enabled, if the ventricular rate is above 40 bpm, the pacing mode will be VVI at 40 bpm. If rates are less than 40 bpm, the pacing mode will be VDD. In the context of atrial fibrillation, reduced atrial contractility results in lack of mechanical sensing, and pacing at the lower rate is observed. In this small sample size, atrial arrhythmias did not result in device tracking resulting in tachycardia. Further investigation in a larger number of patients is warranted to better characterize these findings and to assess pacing behavior during more organized atrial arrhythmias which could result in mechanical sensing (atrial tachycardia and atrial flutter, for example).While the MARVEL 2 programming seems to perform well in the setting of atrial fibrillation or intermittent complete AV block, there are some potential pitfalls. AV conduction mode switch behavior is based on sensed ventricular rates with a threshold of 40 bpm; this cutoff is not currently programmable. Any ventricular sensed rhythm with a rate greater than 40 bpm will result in the device continuing at VVI 40. For example, in a patient with sinus rhythm at 90 bpm and 2:1 AV conduction, the device would not track the atrium and pace at 90 bpm, but rather remain VVI 40 because the ventricular sensed rate is above 40 bpm. The same would be observed in patients with junctional or ventricular escape rhythms >40 bpm. In this sense, pacing could be inappropriately inhibited during a potentially hemodynamically significant rhythm. For this reason, in our opinion, the AV conduction mode switch algorithm should be disabled in the majority of patients with AV block as this physiology is dynamic and sudden loss of rate support can have deleterious consequences. While the activity mode switch algorithm may address some of these concerns real world data are needed for validation.There is no question that the functionality and indications for leadless pacemakers will continue to expand. In current guidelines, which predate the development of the Micra AVTM, single chamber ventricular pacing is only recommended in patients with AV block and permanent atrial fibrillation, a low burden of anticipated pacing, or substantial comorbidities.6 Given the potential for lower complication rates compared with transvenous systems, Micra AV may be a superior option in some patients with complete heart block and preserved ventricular function. However, with the advent of conduction system pacing, the decreased risks of a leadless system have to be balanced with the relative risk of long term right ventricular pacing. Although the results will need to be validated with larger, longer-term studies, which are underway (Clinical trials.gov NCT04245345), these data indicate that Micra AVTM is likely to perform well in the setting of atrial arrhythmias. In patients with variable AV conduction, there are certainly pitfalls to the AV conduction mode switch algorithm, many of which could be avoided by the ability to program the mode switch VVI rate. While leadless pacing is often considered in patients with multiple comorbidities at high risk of complications from a transvenous system, we may be on the cusp of a dramatic paradigm shift. The technological developments and success of leadless pacing to date prompt the question of when, and not if, leadless dual chamber pacing and potentially even cardiac resynchronization will be available.References:1. Reynolds D, Duray GZ, Omar R, et al. A Leadless Intracardiac Transcatheter Pacing System. https://doi.org/10.1056/NEJMoa1511643. doi:10.1056/NEJMoa15116432. El-Chami MF, Al-Samadi F, Clementy N, et al. Updated performance of the Micra transcatheter pacemaker in the real-world setting: A comparison to the investigational study and a transvenous historical control. Heart Rhythm . 2018;15(12):1800-1807. doi:10.1016/j.hrthm.2018.08.0053. Duray GZ, Ritter P, El-Chami M, et al. Long-term performance of a transcatheter pacing system: 12-Month results from the Micra Transcatheter Pacing Study. Heart Rhythm . 2017;14(5):702-709. doi:10.1016/j.hrthm.2017.01.0354. Steinwender C, Khelae SK, Garweg C, et al. Atrioventricular Synchronous Pacing Using a Leadless Ventricular Pacemaker: Results From the MARVEL 2 Study. JACC Clin Electrophysiol . 2020;6(1):94-106. doi:10.1016/j.jacep.2019.10.0175. Merchant FM, Mittal S. Pacing induced cardiomyopathy. J Cardiovasc Electrophysiol . 2020;31(1):286-292. doi:10.1111/jce.142776. Kusumoto Fred M., Schoenfeld Mark H., Barrett Coletta, et al. 2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation . 2019;140(8):e382-e482. doi:10.1161/CIR.0000000000000628

Objectives: The treatment of COVID-19 infection remains a challenge because till now, there is no approved therapy for it. This study aimed to estimate the difference in the therapeutic efficacy and safety between remdesivir as monotherapy and its use in combination with lopinavir/ritonavir provided with standard supportive care. Methods: This is a prospective randomized cohort study included 1043 adult patients with confirmed moderate and severe COVID-19 infection. Treatment of all patients followed Egyptian Ministry of Health COVID-19 protocol as the first group received IV remdesivir 200 mg on day 1, followed by 100 mg once daily, for 5 days while the second group received lopinavir/ritonavir 400/100 mg twice daily, for 5 days with the same remdesivir regimen in the first group. All laboratory and clinical parameters were assessed before and after treatment duration. Results: There was no significant difference related to improvement parameters such as laboratory data and improvement time between the two groups. On the other hand, hepatotoxicity of the second group (combination) was significantly higher compared with that of the first one. The elevation on liver enzymes was affected by the severity of the disease, the severe cases showed a high enzyme elevation rate. Conclusion: Remdesivir as monotherapy and its use in combination with lopinavir/ritonavir is effective in the management of moderate COVID 19 subjects than severe cases. The combination of remdesivir with lopinavir/ritonavir is not recommended due to the increased hepatotoxicity effect.

In the light of the current climate crisis, one of the most serious ecological threats is the increase of desertification. In this context, restoration projects are necessary for reverting land degradation, and nature-based solutions could help them. The Cocoon™ has been designed as a new ecotechnology for improving seedling establishment. The Cocoon consists of a donut-shaped container made out of recycled cardboard that provides water and shelter to the seedling, at least during its first year, which is the most critical for plant establishment. The Cocoon was tested on a variety of soils, Mediterranean mesoclimates, vegetation and land uses that allowed testing the effectiveness of this ecotechnology under different conditions. Six planting trials, five of them in Spain (Canary Islands, Almería, Catalonia and two in Valencia), and one in Ptolemais (Greece), were performed. With the objective of studying its functionality, the survival of the seedlings, their vigor and growth were monitored along two years. In general, the Cocoon has proven its effectiveness by increasing seedling survival compared to the conventional planting system, especially under dry growing conditions (low rainfall, soils with low water holding capacity). The Cocoon also allowed for higher growth of some species (olive trees, olm oaks and Aleppo pines). Moreover, a positive correlation between the rainfall on the site and the degradation degree of the Cocoon device was observed. Overall, the Cocoon becomes more efficient the more arid the climate or the more difficult the growing conditions are.

Background: Piceatannol is a resveratrol metabolite commonly found in red wine, grapes, and passion fruit seeds. Several studies have investigated the immune-modulating effects of piceatannol on processes related to allergic reactions. However, the relationship between piceatannol and atopic dermatitis (AD) has not yet been reported. Therefore, this study sought to investigate the effects of piceatannol in animal and cell line models. Methods: AD-like symptoms and skin lesions were induced by repeated topical application of Dermatophagoides farinae extract (DFE) on the skin of NC/Nga mice. Piceatannol was topically applied five times per week for four weeks. The molecular mechanism of piceatannol was studied in the TNFα/IFNγ-induced HaCaT cell line. Results: Topical application of piceatannol attenuated DFE-induced AD-like symptoms, as shown by skin thickness, dermatitis score, scratching time, and skin water loss. Histopathological analysis showed that piceatannol suppressed DFE-induced eosinophil and mast cell infiltration into the skin. These observations occurred concomitantly with the downregulation of inflammatory markers, including serum TARC, MDC, and IgE. In addition, piceatannol alleviated Th2 cytokines such as IL-4 and IL-13 in the skin tissue. Piceatannol decreased phosphorylation of JAK-STAT protein in the TNFα/IFNγ-induced HaCaT cell line. A molecular docking study showed that piceatannol strongly interacts with JAK1, suggesting a possible piceatannol mode of action. Conclusions: Piceatannol, a metabolite of resveratrol, has potential therapeutic efficacy in treating AD by targeting JAK1.

Pollinators are in decline thanks to the combined stresses of disease, pesticides, habitat loss, and climate. Honey bees face numerous pests and pathogens but arguably none are as devastating as Deformed wing virus (DWV). Understanding host-pathogen interactions and virulence of DWV in honey bees is slowed by the lack of cost-effective high-throughput screening methods for viral infection. Currently, analysis of virus infection in bees and their colonies is tedious, requiring a well-equipped molecular biology laboratory and the use of hazardous chemicals. Here we describe cDNA clones of DWV tagged with green fluorescent protein (GFP) or nanoluciferase (nLuc), providing high-throughput detection and quantification of virus infections. GFP fluorescence is recorded non-invasively in living bees via commonly available long-wave UV light sources and a smartphone camera or a standard ultraviolet transilluminator gel imaging system. Nonlethal monitoring with GFP allows high-throughput screening and serves as a direct breeding tool for identifying honey bee parents with increased antivirus resistance. Expression using the nLuc reporter strongly correlates with virus infection levels and is especially sensitive. Using multiple reporters, it is also possible to visualize competition, differential virulence, and host tissue targeting by co-occuring pathogens. Finally, it is possible to directly assess the risk of cross-species ‘spillover’ from honey bees to other pollinators and vice versa.

Background: Left pulmonary vein (PV) obstruction can occur due to compression between the left atrium (LA) and the descending aorta (DA). One of the effective solutions for this problem is posterior aortopexy. In this study, we have reported five cases of posterior aortopexy to relieve left PV obstruction between the LA and the DA. Methods: Since August 2012, five patients have undergone posterior aortopexy for compression of the left PV between the LA and the DA. The median age and weight of the patients at the time of operation were 5.5 months (range, 1-131 months) and 5.2 kg (range, 4.2-29.5 kg), respectively. The left PV obstruction was initially diagnosed on echocardiography in four patients and computed tomography angiography in one patient. The median peak pressure gradient across the obstructed left PV was 7.3 mmHg (range, 4-20 mmHg). Concomitant procedures were ventricular septal defect closure in one patient and patent ductus arteriosus ligation in one patient. Results: There was no PV obstruction on echocardiography in any of the patients after the operation except in the case of one patient who had diffuse pulmonary vein stenosis. The median follow-up duration was 34 months (range, 14-89 months), and during follow-up no incidence of the left PV obstruction was observed in any of the surviving patients. Conclusions: The posterior aortopexy technique could be a good surgical option for the left PV obstruction caused by compression between the LA and the anteriorly positioned DA.

Biochar or pyrogenic carbon, obtained from thermo-chemical conversion of biomass in an anaerobic or oxygen limited environment has been in use in agriculture since long back to Neolithic era. Its unique soil ameliorating properties, render it suitable for environmental remediation as well as sustainable crop production. It improves soil physicochemical properties and plant nutrient availability, facilitates biodiversity, and reduces emission of greenhouse gases, thereby subsiding global warming. Application of biochar reduces soil erosion, improves soil hydrological properties, and soil microbial dynamics. It has synergistic effects on plant growth, disease-pest resistance, and crop yield per unit area and time. Due to its soil ameliorative effects, and soil and water conserving ability, it can very well be used in organic farming, pemaculture, dryland farming, conservation agriculture, and land remediation. Cheaper production cost, simple and easy pyrolytic technologies, easy availability of feedstock and bio-wastes in many developing countries and its long-term effects in soil not only build up soil carbon pool but also help support small and marginal farmers in resource-rich but economically deprived countries for sustainable agriculture and environment. In this review, efforts have been made to elucidate various methods of biochar synthesis, its characteristics and effects on soil properties, and plant growth and development, its role in sustainable agriculture and remediation of the environment.

Comparisons of genomes from recently diverged butterfly populations along a suture zone in central Texas have revealed high levels of divergence on the Z chromosome relative to autosomes, as measured by fixation index, $F_{st}$. The pattern of divergence appears to result from accumulation of incompatible alleles, obstructing introgression on the Z chromosome in hybrids. However, it is unknown whether this mechanism is sufficient to explain the data. Here, we simulate the effects of hybrid incompatibility on interbreeding butterfly populations using a model in which populations accumulate cross–incompatible alleles in allopatry prior to contact. We compute statistics for introgression and population divergence during contact between model butterfly populations and compare them to statistics obtained for 15 pairs of butterfly species interbreeding along the Texas suture zone. For populations that have evolved sufficiently in allopatry, the model exhibits high levels of divergence on the Z chromosome relative to autosomes in populations interbreeding on time scales comparable to periods of interglacial contact between butterfly populations in central Texas.Levels of divergence on the Z chromosome increase when interacting groups of genes are closely linked, consistent with interacting clusters of functionally related genes in butterfly genomes. Results for various periods in allopatry are in qualitative agreement with the pattern of data for butterflies, supporting a picture of speciation in which populations are subjected to cycles of divergence in glacial isolation, and partial fusion during interglacial contact.

Predicting which ecological factors constrain species distributions is a fundamental question in ecology and critical to forecasting geographic responses to global change. Darwin hypothesized that abiotic factors generally impose species’ high-latitude and high-elevation (typically cool) range limits, whereas biotic interactions more often impose species’ low-latitude/low-elevation (typically warm) limits, but empirical support has been mixed. Here, we clarify three predictions arising from Darwin’s hypothesis, and show that previously mixed support is partially due to researchers testing different predictions. Using a comprehensive literature review (886 range limits), we find that biotic interactions, including competition, predation, and parasitism, influenced species’ warm limits more often than species’ cool limits. At cool limits, abiotic factors were consistently more important than biotic interactions, but temperature contributed strongly to cool and warm limits. Our results suggest that most range limits will be sensitive to climate warming, but warm limit responses will depend strongly on biotic interactions.

The nucleotide-binding domain (NBD) and leucine-rich repeat receptors, such as NOD-like receptors (NLRs), have pivotal functions in the innate immune response to various viral infections participating during the recognition of pathogens and activation of signaling pathways. One NLR, NOD2, is a dynamic protein that is activated in the presence of viral genomes and metabolites. However, its participation in combating a dengue virus (DENV) infection remains unclear. The aim of this study was to determine the role of NOD2 in macrophage-like THP-1 cells during an in vitro infection with DENV type 2 (DENV2). The interactions of NOD2 with RIP2 and MAVS was examined in DENV2-infected and agonist-stimulated cells. The effects of downregulating NOD2 expression or signaling on virus loads was also evaluated. The cellular mRNA expression and protein levels of NOD2 on cells under the stimuli were quantified with RT-PCR, Western blot and indirect immunofluorescence. Both the mRNA and protein expression of NOD2 was enhanced in response to DENV-2 infection. Interactions of NOD2 with RIP2 and MAVS, analyzed with confocal microscopy and co-immunoprecipitation assays, were time-dependent and increased in the post-infection period, between 6 and 24 h. After silencing NOD2 expression, DENV2-infected cells displayed greater viral loads and decreased expression of IL-8 and IFN-α (measured in supernatants obtained from the cells), compared to the uninfected (mock control) cells or those transfected with irrelevant-siRNA. Thus, in response to a DENV2 infection, NOD2 was activated in THP-1 human macrophage-like cells, the production of IL-8 and IFN-α was enhanced, and viral replication was limited.

Objective: Evaluation of the efficacy of robotic vasovasostomy post-vasectomy.Patients and methods: We present a retrospective study of four patients aged from 36 to 51 years, who were operated of a vasovasostomy between September 2007 to July 2009. The same surgeon performed a robotic-assisted vasovasostomy, bilateral for three of them and only left unilateral for the last patient who underwent orchidectomy for right testicular seminoma. These patients had a preoperative semen analysis confirmed the absence of sperm after vasectomy. All patients had an outcome of spermatozoa on testicular deferens side in per-operative. The permeability of the distal vas deferens was systematically checked. The success criterion was the presence of spermatozoa in semen control three months. The paternity post vasovasostomy without medically assisted procreation due to father sterility was a secondary endpoint.Results: Four patients had between 0.6 and 27 million sperm per mL in postoperative semen analysis. Three to seventeenth months after the vasovasostomy, the wives of four patients have started a pregnancy between. Conclusion: The robotic vasovasostomy surgery is a technique that enabled this small group of patients having good results in regard to deferential recanalization and to recovery of secondary spontaneous fertility. A larger cohort needs to be evaluated. The medical and economical aspects of this method should be compared to those of usual technics, in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI).

The canga of the Serra dos Carajás, in Eastern Amazon, is home to a unique open plant community, harbouring several endemic and rare species. Although a complete flora survey has been recently published, scarce to no genetic information is available for most plant species of the ironstone outcrops of the Serra dos Carajás. In this scenario, DNA barcoding appears as a fast and effective approach to assess the genetic diversity of the Serra dos Carajás flora, considering the growing need for robust biodiversity conservation planning in such an area with industrial mining activities. Thus, after testing eight different DNA barcode markers (matK, rbcL, rpoB, rpoC1, atpF-atpH, psbK-psbI, trnH-psbA and ITS2), we chose rbcL and ITS2 as the most suitable markers for a broad application in the regional flora. Here we describe DNA barcodes for 1,130 specimens of 538 species, 323 genera and 115 families of vascular plants, with a total of 344 species being barcoded for the first time. In addition, we assessed the potential of using DNA metabarcoding of bulk samples for surveying plant diversity in the canga. Upon achieving the first comprehensive DNA barcoding effort directed to a complete flora in the Brazilian Amazon, we discuss the relevance of our results to guide future conservation measures in the Serra dos Carajás.

Objective: The aim of this study was to analyze the culture antibiogram results of samples obtained directly from the middle ear and/or mastoid cells in the operating room, and from the external auditory canal in the outpatient. Methods: This study was conducted between 2016-2018 in Microbiology and Otorhinolaryngology Department. Swab cultures were obtained through the external ear canal preoperatively in outpatients. Middle ear swabs and mastoid granulation tissue were collected intraoperatively, respectively. Demographic datas, bacterial identifications and antibiotic susceptibilities were compared in both groups. Results: Two hundred thirty eight patients with chronic otitis media were enrolled in the study. Out of the 238 cases, 86 patients had negative culture results. P. aeruginosa (n=44), Coagulase Negative Staphylococcus (n=33), S. aureus (n=27), Proteus mirabilis (n=16) and E. coli (n=10) were the most common grown bacteria in both groups. Most common identified groups were Gram-positive bacteria (n=92), non-fermenter Gram-negative bacteria (n=55) and Enterobactericeae (n=42). Gram-positive cocci were higher in outpatient group, whereas Enterobactericeae were higher in intraoperative group (p<0.05). Antibiotic susceptibilities of P. aeruginosa and S. aureus were found to be lower especially in the preoperative group (p <0.05). Conclusion: P. aeruginosa was the most common bacteria in both preoperative and intraoperative cultures and high ciprofloxacin resistance of the isolates were remarkable. Although contamination is an issue in samples collected from the external ear canal of outpatients using cotton swabs, similar microorganisms grew in outpatient and intraoperative cultures

Objective There is no report that anticoagulant or antiplatelet use may lead to abnormal endometrial sonographic findings. This retrospective study reports our first results associated with endometrial sampling in asymptomatic postmenopausal women using anticoagulants or antiplatelet. Materials methods A total of 268 postmenopausal patients who applied to our gynecology outpatient clinic for any reasons except postmenopausal bleeding were included in the study. Patients were divided into three groups according to using drug status: first healty control group (HCG), second anticoagulants agents group (ACG), and third antiplatelet agents group (APG). The effects of anticoagulant and antiplatelet agents on endometrial thickness were compared with histopathological findings. Results The mean endometrial thickness was significantly greater in group ACG (5.2 mm) and APG (4.1 m) than in group HCG (3.3 mm). No significant differences were found in the mean endometrial thickness between groups HCG and APG. However, it is noteworthy that the average endomeric thickness in the ACG group is more than the other two groups and this is statistically significant (p < 0.05). Conclusion If the thickness of the endometrium was > 4 mm. endometrial sampling may be recommended in in asymptomatic postmenopausal women using anticoagulants or antiplatelet agents. Key words: Anticoagulants, antiplatelets, biopsy, endometrial thickness, menopause, ultrasonography

In the wake of the 2020 COVID-19 epidemic, much work has been performed on the development of mathematical models for the simulation of the epidemic, and of disease models generally. Most works follow the susceptible-infected-removed (SIR) compartmental framework, modeling the epidemic with a system of ordinary differential equations. Alternative formulations using a partial differential equation (PDE) to incorporate both spatial and temporal resolution have also been introduced, with their numerical results showing potentially powerful descriptive and predictive capacity. In the present work, we introduce a new variation to such models by using delay differential equations (DDEs). The dynamics of many infectious diseases, including COVID-19, exhibit delays due to incubation periods and related phenomena. Accordingly, DDE models allow for a natural representation of the problem dynamics, in addition to offering advantages in terms of computational time and modeling, as they eliminate the need for additional, difficult-to-estimate, compartments (such as exposed individuals) to incorporate time delays. In the present work, we introduce a DDE epidemic model in both an ordinary- and partial differential equation framework. We present a series of mathematical results assessing the stability of the formulation. We then perform several numerical experiments, validating both the mathematical results and establishing model’s ability to reproduce measured data on realistic problems.