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Azathioprine for The Induction Treatment of Connective Tissue Disorder Related Inters...
Hasan Satış
Mehmet Onut

Hasan Satış

and 15 more

April 09, 2021
Objectives: Treatment of connective tissue disease-related interstitial lung disease (CTD-ILD) remains challenging. The literature related to the immunosuppressive drugs is very limited in most CTDs and there is no previously reported study comparing induction regimens in patients with newly defined ‘interstitial pneumonia with autoimmune features (IPAF), We aimed to investigate the efficacy of azathioprine (AZA) used in induction regimens for interstitial lung disease in a variety of connective tissue disorders including IPAF, and compare it with cyclophosphamide (CYC) Methods. In a retrospective study, all patients presented with interstitial lung disease to the rheumatology and/or pulmonology departments in a tertiary referral centre, between 2009 and 2019. Five major CTD groups were defined; systemic sclerosis, rheumatoid arthritis (RA), primary Sjögren syndrome (pSS), inflammatory myositis (IMS) and interstitial pneumonia with autoimmune features (IPAF). All patients who satisfied one of these and received AZA or CYC for induction therapy for at least 6 months were included in the study. Treatment responses at six months and side effects were analyzed. Results: There were 1351 patients diagnosed with ILD. Of these, 328 patients were identified as CTD-ILD, satisfying the classification criteria of one of the CTDs. Among these, 57 patients received AZA and 79 patients received CYC for induction therapy. CYC treatment resulted in a 2.41 % increase in FVC, however, AZA resulted in a 1.44% decline in FVC predicted (p=0.041). Propensity score matching was used to reduce selection bias, AZA treatment was related to increased risk of progression (50% vs 13.5%, p:0.002). Conclusion: CYC is superior to AZA in induction therapy of CTD-ILD.
The percentages of SARS-CoV-2 protein similarity and identity with SARS-CoV and BatCo...
Mohammed Elimam Mohammed

Mohammed Elimam Mohammed

and 2 more

April 09, 2021
There are three types of proteins in coronaviruses: nonstructural, structural, and accessory proteins. Coronavirus proteins are essential for viral replication and for the binding and invasion of hosts and the regulation of host cell metabolism and immunity. This study investigated the amino acid sequence similarity and identity percentages of 10 proteins in SARS-CoV-2, SARS-CoV and the Rhinolophus affinis bat coronavirus (BatCoV RaTG13). The investigated proteins were the 1ab polyprotein, spike protein, orf3a, the envelope protein, the membrane protein, orf6, orf7a, orf7b, orf8, and the nucleocapsid protein. The online sequence alignment service of The European Molecular Biology Open Software Suite (EMBOSS) was used to determine the percentages of protein similarity and identity in the three viruses. The results showed that the similarity and identity percentages of the SARS-CoV-2 and BatCoV RaTG13 proteins were both greater than 95%, while the identity and similarity percentages of SARS-CoV-2 and SARS-CoV were both greater than 38%. The proteins of SARS-CoV-2 and BatCoV RaTG13 have high identity and similarity compared to those of SARS-CoV-2 and SARS-CoV. Graphic abstract The proteins of the SARS-CoV-2 are most identical and similar to those of BatCoV RaTG13 than to the proteins of SARS-CoV
Counterintuitive scaling between population size and density: implications for modell...
Tamika Lunn

Tamika Lunn

and 6 more

April 12, 2021
Models of host-pathogen interactions help to explain infection dynamics in wildlife populations and to predict and mitigate the risk of zoonotic spillover. Insights from models inherently depend on the way contacts between hosts are modelled, and crucially, how transmission scales with animal density.Bats are important reservoirs of zoonotic disease and are among the most gregarious of all mammals. Their population structures can be highly heterogenous, underpinned by ecological processes across different scales, complicating assumptions regarding the nature of density-transmission scaling. Although models commonly parameterise transmission using metrics of total abundance, whether this is an ecologically representative approximation of host-pathogen interactions is not routinely evaluated.We collected a 13-month dataset of roosting Pteropus spp. from 2,522 spatially referenced trees across eight roosts to compare density estimates across scales (roost-level, subplot-level, tree-level). We then focus on tree-level measures of abundance and density, the scale most likely to be relevant for virus transmission between tree-roosting Pteropus , and evaluate whether roost features at different scales are predictive of local dynamics.Our density estimates varied greatly by scale. Mean density ofPteropus at the roost level was 13-fold lower than at a subplot-level that accounted for heterogenous distributions of bats (0.38 bats/m2 vs 5.13 bats/m2). Additionally, roost-level measures (roost abundance and roost area) did not represent tree-level abundance or tree-level density, with models explaining minimal variation in tree-level measures.This indicates that basic measures, such as roost-level population counts, may not provide adequate approximations for population dynamics at scales relevant for transmission, and that alternative measures are needed to compare transmission potential between roosts. From the best candidate models, the best predictor of local population structure was tree density within roosts, where roosts with low tree density had a higher abundance but lower density of bats (more spacing between bats) per tree.Together, these data highlight unpredictable and counterintuitive relationships between abundance and density, and between measures at different scales. More nuanced modelling of transmission, spread and spillover from bats likely requires alternative approaches to integrating contact structure in host-pathogen models, rather than simply modifying the transmission function.
The size and the age of the metabolically active carbon in tree roots
Boaz Hilman
Jan Muhr

Boaz Hilman

and 5 more

April 09, 2021
Little is known about the sources and age of C respired from tree roots. Previous research in tree stems has identified two functional pools of non-structural carbohydrates (NSC): an ‘active’ pool supplied directly from canopy photo-assimilates that supports metabolism and a ‘stored’ pool used when fresh C supplies are limited. We compared the C isotope composition of water soluble NSC and respired CO2 for aspen roots (Populus tremula hybrids) that were cut off fresh C supply via stem-girdling and prolonged incubation of excised roots. We used bomb radiocarbon to estimate the time elapsed since C fixation for respired CO2, water-soluble C, and structural α-cellulose. While freshly excised roots respired CO2 with mean age <1 yr, within a week the age increased to 1.6-2.9 yr. Freshly excised roots from trees girdled ~3 months previously had similar respiration rates and NSC stocks as un-girdled trees, but respired older C (~1.2 yr). We estimate the NSC in girdled roots must be replaced 5-7 times by reserves remobilized from root-external sources. Using a mixing model and observed correlations between Δ14C of water-soluble C and α-cellulose, we estimate ~30% of C is ‘active’ (~5 mg C g-1).
Assessing Changes in Clusters of Wildlife Road Mortalities after the Construction Wil...
Thomas Yamashita
Trinity Livinigston

Thomas Yamashita

and 4 more

April 09, 2021
Collisions with vehicles are a major threat to wildlife populations and often occur in identifiable patterns. To reduce wildlife road mortalities, mitigation structures including exclusionary fencing and wildlife crossings are constructed. Openings in fencing at road intersections may lead to concentration of road mortality hot spots at openings leading to a belief that these gaps concentrate road mortalities. However, it is also possible that hot spots existed at these locations before construction indicating that road mortality patterns have not changed with mitigation structure construction. Therefore, to assess mitigation structure effectiveness, it is important to examine both road mortality numbers and road mortality spatial distribution. Wildlife road mortality data was collected on a 15-km section of rural highway in Texas, USA before, during, and after the construction of wildlife mitigation structures. We expected that the number of road mortalities would decrease after construction compared to before construction and that road mortalities would become more concentrated around openings in the fence. We used ANOVA to compare numbers of road mortalities and emerging hot spot analysis and generalized linear modelling to assess changes in road mortality spatial distribution. Road mortalities were not significantly different in the before and after construction periods (p = 0.092). While there were no significant changes in road mortality patterns with construction, cluster intensity was greater when nearer to fence openings in all three time periods. Emerging hot spot analysis provides an effective and easy way to visualize road mortality patterns through time, however, due to low numbers of mortalities in many road mortality studies, including this one, the power of this analysis to detect significant changes in road mortality may be limited. This technique can provide both ecologists and transportation planners an effective tool for identifying patterns that may warrant further investigation using traditional statistical techniques.
L'Agricoltura Urbana e Sistemi Acquaponici per lo sviluppo sostenibile nelle politich...
Raffaella Vitale

Raffaella Vitale

November 12, 2021
A causa della rapida urbanizzazione, della crescita della popolazione, del cambiamento climatico e dell’inquinamento ambientale, la sicurezza alimentare e la sostenibilità sono diventate una preoccupazione primaria che deve essere affrontata a livello globale. La recente pandemia da COVID-19 ha avuto un impatto sull'approvvigionamento alimentare interrompendo la catena di distribuzione alimentare e in conseguenza anche l’aumento ulteriore dei prezzi. Da queste circostanze è emerso la necessità e il bisogno di coprire l’approvvigionamento alimentare con prodotti locali. Inoltre, la crescente preoccupazione degli effetti dell’inquinamento ambientale e dell’uso intensivo dei terreni agricoli con pesticidi e composti chimici, il consumatore propende a scegliere prodotti alimentari sani, freschi e rintracciabili. L’agricoltura urbana emerge come strumento alternativo per garantire sicurezza alimentare, sostenibilità sociale, economica e ambientale. Il ventaglio dei diversi approcci dell’agricoltura urbana offre opportunità di costruire fonte di reddito alternativo come per esempio le serre sui tetti a coltivazione idroponica di famose realtà statunitensi, oppure crea possibilità di inclusione sociale e attività ricreativa come l’ampiamente diffusa e consolidata tecnica degli orti urbani, o ancora a tecnologia come l’acquaponica che rispetta appieno i requisiti dell’economia circolare.L’acquaponica è riconosciuta dalle numerose potenzialità da quella di garantire cibo sano e sicuro all’ottimizzazione delle risorse. Mostra la prospettiva per lo sviluppo sostenibile della produzione alimentare nelle aree urbane e può fungere da elemento essenziale dell'infrastruttura urbana sostenibile nella futura visione delle città.Nonostante le potenzialità dell’agricoltura urbana e di sistemi come l’acquaponica, esistono ancora alcune lacune che ostacolano lo sviluppo di modelli produttivi pienamente integrati nel quadro di un'economia circolare, e che devono essere risolti per ottenere un sistema produttivo semplice da usare, rispettoso dell'ambiente che genera pochi o nessun rifiuto ed è anche in grado di riutilizzare i rifiuti prodotti da altri sistemi esterni.Inoltre, la mancanza di una legislazione specifica e armonizzata relativa ai settori come l'acquaponica e idroponica nell'UE pone freno e vincoli ai possibili investitori. La necessità di una revisione degli standard biologici dell'UE al fine di incoraggiare l'ulteriore sviluppo di tale tecnologia e che permetterebbe di applicare prezzi premium con il fine di rendere redditizia le attività imprenditoriali è di enorme importanza. Anche nel campo della pianificazione urbanistica e edilizia è necessario uno slancio verso l’integrazione dell’agricoltura urbana nel tessuto della città. Sono poche i casi in cui l’agricoltura urbana è applicata appieno in termini commerciale e urbanistici come per esempio New York. Nell’ambito italiano le autorità sono lontane nell’applicare l’agricoltura urbana fatta l’unica eccezione dell’introduzione quasi consolidata degli orti urbani nei regolamenti comunali con l’uso esclusivamente sociale e senza fine di lucro.L’architettura e l’urbanistica avranno il compito di cambiare la visione delle città e di costruire spazi nei quali consentire nuove relazioni con le pratiche agricole.
Remotely-sensed vegetation greening along a restoration gradient of a tropical forest...
Anu Valtonen
Eveliina Korkiatupa

Anu Valtonen

and 4 more

April 09, 2021
Restoration has now emerged as a global priority, with international initiatives such as the “UN Decade on Ecosystem Restoration (2021-2030)”. To fulfil the large-scale global restoration ambitions, an essential step is the monitoring of vegetation recovery after restoration interventions. The aim of this study was to evaluate the utility of remotely-sensed vegetation indices, Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI), to monitor the rate of forest regeneration across a tropical forest restoration project area in Kibale National Park, Uganda. As a result, we observed non-linear patterns in NDVI and EVI across the first 25 years of recovery. Both NDVI and EVI increase for the first 10 years of forest regeneration. This “greening” phase could be used as the indicator of successful onset of forest recovery. In particular, the decline of elephant grass, which suppresses the natural regeneration of trees in our area, can be detected as an increase in NDVI. Primary forests differed from the 25-year-old regenerating forests based on the unique combination of low mean and low seasonal variation in EVI. Our results, therefore, suggest that the long-term success of forest restoration could be monitored by evaluating how closely the combination of mean, and degree of seasonal variation in EVI, resembles that observed in the primary forest.
Evaluation and Comparison of the GWR Merged Precipitation and Multi-Source Weighted-E...
Jing Zhao
Yuan Qiqi

Jing Zhao

and 4 more

April 09, 2021
Accurate estimation of precipitation in both space and time is essential for hydrological research. We compared multi-source weighted ensemble precipitation (MSWEP) with multi-source fused satellite precipitation (CHIRPS) based on high-density rain gauge precipitation observations in the Taihu Lake basin. We proposed a new merge precipitation algorithm GWRMP based on the geographically weighted regression (GWR) method. GWRMP corrects the bias of MSWEP by using high-density rain gauge precipitation to address the common problem of daily precipitation underestimation in MSWEP. The large-scale spatial coverage of the water surface in this region leads to the uneven distribution of rain gauges on the lake. There are differences in the descriptive ability of the three spatial precipitation types, MSWEP, GWRMP, and IDW, for spatial and temporal precipitation information in the Taihu Lake basin. A comparison shows that GWRMP has a significant advantage in obtaining the spatial and temporal variability of precipitation in areas with complex topographic conditions. GWRMP compensates the problem of underestimation of precipitation by MSWEP (10% to 25%), and avoids the risk of the high dependence of IDW on rain gauges, and improves the accuracy of spatial and temporal precipitation in large lake areas with sparse distribution of rain gauges (Pbias limited to 10%). GWRMP improved the estimation for different rainfall intensities in the Taihu Lake basin, especially in the mid-level rainfall and above precipitation frequencies. Compared with IDW and MSWEP, GWRMP is more suitable for intense precipitation monitoring and storm flood frequency study in the basin. Therefore, GWRMP is a better choice for spatial and temporal estimation of precipitation in the Taihu Lake basin. The GWRMP algorithm can be applied to other regions with unevenly spaced high-density rain gauges.
Prediction of Cossus Linnaeus suitable growing area in China under Future Climate cha...
hua zhang
ming li

hua zhang

and 3 more

April 09, 2021
CossusLinnaeus is a kind of insect that causes great harm to forest trees in China, which has a great impact on the country’s agriculture and forestry, and seriously affects the stability of the ecosystem, so it is very important to predict its distribution and contain it. Most researchers use the MaxEnt model with default parameters to build models to predict the potential geographical distribution of species. Recent studies have found that in the case of default parameters, the prediction results of MaxEnt model are not only inaccurate, but also sometimes difficult to explain. In this paper, ENMeval packets are used to adjust the optimal feature combination parameters of MaxEnt model, and then the MaxEnt model with optimal parameters is used to predict the potential geographical distribution of CossusLinnaeus under present and future climatic conditions. The simulation results show that the simulation effect of the MaxEnt model is good (the area under the ROC curve (AUC = 0.914), Cossus Linnaeus is mainly distributed in Liaoning Province, Hebei Province, Shandong Province, Henan Province, Shaanxi Province, Shanxi Province, Ningxia and Gansu Province, etc., which is consistent with the actual distribution results. Under future climatic conditions, the area of Cossus Linnaeus high suitable growth area will rise up 26.7% to 87.4% compared with the current one. Climate change affects the potential distribution of Cossus Linnaeus, and the top four environmental variables with contribution rate are normalized vegetation index (NDVI,40.3%), annual mean temperature (Bio1,24.1%), coldest monthly minimum temperature (Bio6,12.4%) and diurnal range of mean temperature (Bio2,9%). Under the condition of future climate change, the center of gravity of Cossus Linnaeus will move to high latitudes. This study will provide theoretical support for the prevention and control of Cossus Linnaeus and tree protection in China.
Two sides of the same coin? How quality improvement can be used to augment program ev...
Allison Brown
Lawrence Grierson

Allison Brown

and 1 more

April 09, 2021
Health professions education is in constant pursuit of new ways of teaching and assessment in order to improve the training of healthcare professionals. Educators are often challenged with designing, implementing, and evaluating programs in the context of their professional practice, particularly those in response to dynamic and emerging social needs. This article explores the synergies and intersections of two approaches -- quality improvement and program evaluation -- and the potential utility of their combinations within our field to design, evaluate, and most importantly, improve educational programming. We argue that the inclusion of established quality improvement frameworks within program evaluation provides a proven mechanism for driving change, can optimize programming within the multi-contextual education systems, and, ultimately, that these two approaches are complementary to one another. These combinations hold great promise for optimizing programming in alignment with social missions, where it has been difficult for institutions worldwide to generate and capture evidence of social accountability.
Chromosome-scale assembly and whole-genome sequencing of 266 giant panda roundworms p...
Lei Han
Tian Lan

Lei Han

and 27 more

April 09, 2021
Helminth diseases have long been a threat to the health of humans and animals. Roundworms are important organisms for studying parasitic mechanisms, disease transmission and prevention. The study of parasites in the living fossil giant panda is of great significance for understanding the adaptation mechanism of roundworms to the host. Here, we report a high-quality chromosome-scale genome of Baylisascaris schroederi with a genome size of 262 Mb and 19,291 predicted protein-coding genes. We found a significant expansion of genes related to epidermal chitin synthesis and environmental information processing in roundworms genome. Furthermore, we demonstrated unique genes involved in essential amino acid metabolism in the B. schroederi genome, inferred to be essential for the adaptation to the giant panda-specific diet. In addition, under different deworming pressures, we found that four resistance-related genes (glc-1, nrf-6, bre-4 and ced-7) were under strong positive selection in captive population. Finally, 23 known drug targets and 47 potential target proteins were identified. The genome provides a unique reference for inferring the early evolution of roundworms and the mechanisms underlying adaptive. Population genetic analysis and drug prediction provide insights for revealing the impact of deworming history on population genetic structure and prevention.
A chromosome-anchored genome assembly for Lake Trout (Salvelinus namaycush)
Seth Smith
Eric Normandeau

Seth Smith

and 11 more

April 08, 2021
Here we present an annotated, chromosome-anchored, genome assembly for Lake Trout (Salvelinus namaycush) – a highly diverse salmonid species of notable conservation concern and an excellent model for research on adaptation and speciation. We leveraged Pacific Biosciences long-read sequencing, paired-end Illumina sequencing, proximity ligation (Hi-C), and a previously published linkage map to produce a highly contiguous assembly composed of 7,378 contigs (contig N50 = 1.8 mb) assigned to 4,120 scaffolds (scaffold N50 = 44.975 mb). 84.7% of the genome was assigned to 42 chromosome-sized scaffolds and 93.2% of Benchmarking Universal Single Copy Orthologs were recovered, putting this assembly on par with the best currently available salmonid genomes. Estimates of genome size based on k-mer frequency analysis were highly similar to the total size of the finished genome, suggesting that the entirety of the genome was recovered. A mitome assembly was also produced. Self-vs-self synteny analysis allowed us to identify homeologs resulting from the Salmonid specific autotetraploid event (Ss4R) and alignment with three other salmonid species allowed us to identify homologous chromosomes in other species. We also generated multiple resources useful for future genomic research on Lake Trout including a repeat library and a sex averaged recombination map. A novel RNA sequencing dataset was also used to produce a publicly available set of gene annotations using the National Center for Biotechnology Information Eukaryotic Genome Annotation Pipeline. Potential applications of these resources to population genetics and the conservation of native populations are discussed.
EKG Findings Mimicking Pericarditis and STEMI in a patient with Ventricular Preexcita...
Ibraheem Rehman

Ibraheem Rehman

and 3 more

April 08, 2021
Wolff-Parkinson-White (WPW) syndrome is an electrical conduction abnormality of the heart in which atrial impulses are transmitted to the ventricle through an accessory pathway, leading to supraventricular tachycardia [1]. On EKG, WPW presents with shortened PR interval, widened QRS, and a characteristic delta wave. Here, we present the case of 44-year-old African American male with a history of preexcitation/WPW pattern and no known history of coronary artery disease who came to the hospital complaining of atypical chest pain. He had transient ST elevation in beats with delta waves, both in the ambulance and emergency room EKGs (Figure 1 and 2) . Five minutes later, a repeat EKG showed ST elevation along with PR depression mimicking pericarditis (Figure 4) . Cardiac enzymes remained normal. EKG stress test with myocardial perfusion imaging was negative for ischemia and echocardiogram was normal.
The role of melatonin in pregnancies complicated by placental insufficiency: a system...
Ilaria Fantasia
Sofia Bussolaro

Ilaria Fantasia

and 3 more

April 08, 2021
Background: Pregnancies complicated by placental insufficiency are characterised by increased oxidative stress. It has been suggested that melatonin has antioxidant properties and contributes to the maintenance of placental homeostasis. Objective: To systematically review the available literature about melatonin in pregnancies complicated by placental insufficiency, specifically preeclampsia and fetal growth restriction, exploring three different aspects: 1) maternal melatonin levels; 2) expression and activity of melatonin placental receptors; 3) effects of maternal melatonin administration. Search strategy: PubMed (Medline) and Scopus were searched until December 2020. Selection criteria: Published literature in English language describing the role of melatonin in pregnancies complicated by placental insufficiency, with a specific focus on preeclampsia and fetal growth restriction. Data collection and analysis: Identified studies were screened and assessed independently by two authors. Data were extracted and compiled in a qualitative evidence synthesis. Main results: Pregnancies complicated by placental insufficiency show a significant reduction in maternal systemic serum melatonin levels and a significant reduction in the expression of placental melatonin receptors. Melatonin administration in pregnancy seems safe and may reduce oxidative stress. Conclusion: The circadian pattern of melatonin secretion seems to be altered in pregnancies complicated by placental insufficiency. This is reflected by lower production of melatonin, with consequent lower systemic and placental concentrations, and lower expression of melatonin receptors, thus reducing the local release of the indole and its autocrine function. Funding: None Keywords: Melatonin, Preeclampsia, Fetal growth restriction, Placental insufficiency, Review.
How we approach coagulopathy with vascular anomalies.
Joana Mack
Shelley Crary

Joana Mack

and 1 more

April 08, 2021
Some vascular anomalies can present with challenging hematologic aberrations. Kaposiform hemangioendothelioma (KHE) may be complicated with Kasabach-Merritt phenomenon (KMP) and stagnant blood flow in slow flow malformations can promote activation and consumption of coagulation factors which results in bleeding and clotting known as localized intravascular coagulopathy (LIC). These patients can experience significant morbidity secondary to pain due to thrombosis and are at higher risk of hematologic complications during surgical procedures. No standard of care has been established to prevent or manage these complications. This review focuses on the management of coagulopathy in children and adults with vascular anomalies.
Systematic review of the effects of antimicrobial cycling on bacterial resistance rat...
Marianneta Chatzopoulou
Lucy Reynolds

Marianneta Chatzopoulou

and 1 more

April 08, 2021
Aim Antimicrobial resistance is an evolving phenomenon with alarming public health consequences. Antibiotic cycling is a widely known antimicrobial stewardship initiative which encompasses periodical shifts in empirical treatment protocols with the aim to limit selective pressures on bacterial populations. Nonetheless, mathematical models have challenged its presumable efficacy by favouring a higher heterogeneity in antibiotic administration. We present a review of the evidence regarding the actual impact of antimicrobial cycling on bacterial resistance control within hospitals. Methods A systematic literature review was conducted using the PubMed/MedLine, Embase, CINAHL Plus and Global Health databases. Results A systematic search process retrieved a sole randomised study, and so we broadened inclusion criteria to encompass quasi-experimental designs. Fifteen studies formed our dataset including seven prospective trials and eight before-and-after studies. Nine studies evaluated cycling versus a control group and produced conflicting results whilst three studies compared cycling with antibiotic mixing, with none of the strategies appearing superior. The rest evaluated resistance dynamics of each of the on-cycle antibiotics with contradictory findings. Research protocols differed in parameters such as the cycle length, the choice of antibiotics, the opportunity to de-escalate to narrow-spectrum agents and the measurement of indicators of collateral damage. This limited our ability to evaluate the replicability of findings and the overall policy effects. Conclusions Dearth of robust designs and standardised protocols limits our ability to reach safe conclusions. Nonetheless, in view of the available data we find no reason to believe that cycling should be expected to improve antibiotic resistance rates within hospitals.
COVID-19 in pediatric cancer: where are the brain tumors?
Rebecca Ronsley
Eric Bouffet

Rebecca Ronsley

and 1 more

April 08, 2021
Treatment of pediatric oncology patients generally results in significant immunosuppression and when the COVID-19 pandemic arose, there was concern among pediatric oncologists about the implications of this virus. We reviewed the literature and describe all pediatric oncology patients with COVID-19 reported worldwide. Within this review, it is striking that CNS tumors are reported at low numbers (27/466 pediatric oncology patients with COVID-19). This may be related to decreased inpatient care when compared to other pediatric cancers. Additional work is needed to understand the risk of infection in this population and gain insight into the effect on delivery of oncology care.
Treatment outcome of newly diagnosed multiple myeloma patients: A retrospective analy...
Chin Sum Cheong
Tengku Ahmad Hidayat Tengku K Aziz

Chin Sum Cheong

and 7 more

April 08, 2021
Multiple myeloma is the third most common hematologic malignancy in Malaysia. The introduction of novel agents over the past decades has improved patient outcome and survival substantially. The usage of novel agents can be financially taxing, and hence resources limit its use. This study aims to report on the real-world treatment outcome when resources are limited. This is a retrospective study on newly diagnosed multiple myeloma (NDMM) patients diagnosed between 1 January 2008 and 31 December 2018 in a single academic center. Patients demographic and type of treatment were included for analysis of progression free survival and overall survival. Ninety-eight NDMM patients with a median age of 63.5 (ranged from 38 to 87 years old) were included. Half of the total patients received bortezomib-containing regimens while 40.8% received thalidomide-containing regimens, and remaining 9.2% had other agents as induction. Forty-seven patients (48.0%) achieved very good partial response (VGPR) or complete remission (CR), while remaining 51 patients (52.0%) have achieved partial response (PR) at best during induction therapy. Bortezomib use was associated with significantly deeper (p=0.001) and more rapid response (p=0.005) compared to other agents. Five-year OS and PFS were 45.3% and 18.4%, respectively. Triplet regimen, best initial response and upfront ASCT were significantly associated with better PFS. In conclusion, deep response significantly affects PFS and OS in NDMM patients. Thus, one of the goals of treatment is to ensure earlier and deeper response by including bortezomib as part of triplet combination in upfront therapy, followed by ASCT for those who are fit. This is feasible in a resource limited country such as Malaysia, especially there is a cheaper generic formulation.
Goodness-of-fit Measures Based on the Mellin Transform for Beta Generalized Lifetime...
Josimar Vasconcelos
Renato Cintra

Josimar Vasconcelos

and 2 more

April 08, 2021
In recent years various probability models have been proposed for describing lifetime data. Increasing model flexibility is often sought as a means to better describe asymmetric and heavy tail distributions. Such extensions were pioneered by the beta-G family. However, efficient goodness-of-fit (GoF) measures for the beta-G distributions are sought. In this paper, we combine probability weighted moments (PWMs) and the Mellin transform (MT) in order to furnish new qualitative and quantitative GoF tools for model selection within the beta-G class. We derive PWMs for the Fr\’{e}chet and Kumaraswamy distributions; and we provide expressions for the MT, and for the log-cumulants (LC) of the beta-Weibull, beta-Fr\’{e}chet, beta-Kumaraswamy, and beta-log-logistic distributions. Subsequently, we construct LC diagrams and, based on the Hotelling’s $T^2$ statistic, we derive confidence ellipses for the LCs. Finally, the proposed GoF measures are applied on five real data sets in order to demonstrate their applicability.
Impact of Processing Parameters in Plasma Electrolytic Oxidation (PEM) on Corrosion R...
Talal Aljohani
Sami  Aljadaan

Talal Aljohani

and 3 more

April 08, 2021
This study aims to investigate the effect of the processing parameters in plasma electrolytic oxidation (PEO) on the corrosion resistance of magnesium alloy type AZ91. The PEO coatings were prepared on the samples using alkaline-based electrolyte. Both unipolar and bipolar, different frequencies and duty cycles were applied. Corrosion tests, using potentiodynamic polarisation (PDP), linear and cyclic, and electrochemical impedance spectroscopy (EIS) techniques, were applied on the as-received and PEO coated samples. Scanning electron microscopy was used to investigate the surface morphology, e.g. micropores, as well as to measure the thickness of the coated layer with changing the processing parameters. The results show that the size of micropores is interrelated to the duty cycle percentage and current polarities, as the higher frequency causes thinner coating layers, with fewer micropores, consequently higher corrosion resistance. In addition, increasing the duty cycle, a denser and more compact coating was obtained. The XRD results showed missing peak of the α-Mg phase in a PEO coated sample using Bipolar, the highest frequency (1666 Hz) and the highest duty cycle (66.6%). The mils per year calculations showed that the PEO coated have lower corrosion rate by at least 8 times than the as-received alloy.
Simple models to predict vaginal delivery and spontaneous fetal occiput rotation base...
Cheng Chen
Xiaoxing Zhang

Cheng Chen

and 11 more

April 08, 2021
Objective: To develop the prediction models for identifying fetal occiput rotation and vaginal delivery based on intrapartum sonographic findings. Design: Prospective observational study. Setting: Hangzhou, China. Population: Nulliparous women with a singleton cephalic presentation at term. Methods: Serial intrapartum ultrasonography were performed in the latent phase (T1) and every three hours after that (T2, T3 and T4). The managing clinicians performed paired digital vaginal examinations to assess labor progress. Main Outcome Measures: Delivery mode and successful internal fetal head rotation to the occiput anterior (OA) position. Results: 614 women were included, of whom 524 underwent vaginal delivery, and 90 required cesarean section. The percentage of women with fetuses in non-occiput anterior position at the latent phase was 53.9% (331 cases), as 257 women underwent spontaneous rotation to OA position before delivery, 74 were with persistent occiput posterior or transverse position. We developed a model on the basis of the maternal height and middle angel to predict the spontaneous fetal occiput rotation, with the area under the receiver operating characteristic curve (AUC) was 0.667 (95%CI 0.583-0.751). Moreover, a prediction model based on the maternal height and angle of progression to evaluate whether women underwent vaginal delivery was also developed, of which the AUC was 0.738(95% CI: 0.763-0.793). Both models showed satisfactory calibration. Conclusion: Simple models based on maternal characteristics and intrapartum ultrasound findings might provide useful information for predicting vaginal delivery and internal fetal occiput rotation.
Cranial internal hemipelvectomy (iliectomy) with limb sparing for a dog with ilial ch...
Amy Downey
Kyle Mathews

Amy Downey

and 2 more

April 08, 2021
Objective: To describe the outcome following limb-sparing subtotal hemipelvectomy (iliectomy) in a dog with ilial chondrosarcoma. Animal: A 9.5-year-old female spayed Boxer with grade 2 chondrosarcoma of the ilium Study Design: Case report.
Pit viper envenomation in pediatric dogs: 5 cases
Carl Southern
Ashley Allen-Durrance

Carl Southern

and 2 more

April 08, 2021
The objective of this case series is to describe the diagnosis, therapeutic intervention, and outcome of pit viper envenomation in five pediatric dogs. All five puppies survived to discharge, with no known complications from their envenomation or antivenom administration.
Tonic activation of VPAC1 receptors by VIP modulates theta-burst induced LTP in the h...
Nadia Rodrigues
Ana Caulino-Rocha

Nadia Rodrigues

and 3 more

April 08, 2021
Background and purpose Vasoactive intestinal peptide (VIP), acting on both VPAC1 and VPAC2 receptors, is a key modulator of hippocampal synaptic transmission, pyramidal cell excitability and synaptic plasticity phenomena, like long-term depression (LTD), partly through modulation GABAergic disinhibitory circuits. VIP effects on LTP and the involvement of disinhibition were scarcely investigated. Experimental approach The influence of endogenous VIP on CA1 LTP induced by TBS was evaluated in the CA1 area of hippocampal slices using field-excitatory electrophysiological recordings from young-adult Wistar rats using selective VPAC1 and VPAC2 antagonists. Phosphorylation of GluA1 AMPA receptor subunits and Kv4.2 potassium channels was evaluated in hippocampal membranes obtained from such slices by Western blot. Key results Here we show that VIP, acting on VPAC1 (but not VPAC2) receptors, is an endogenous inhibitor of hippocampal LTP induced by theta-burst stimulation (TBS) in the CA1 area of the hippocampus of young adult Wistar rats. This effect is dependent on GABAergic transmission and relies on the integrity of NMDA and CaMKII-dependent LTP expression mechanisms but not on PKA and PKC activity. Furthermore, it regulates the expression and Ser438phosphorylation of Kv4.2 potassium channels responsible for the A-current while inhibiting phosphorylation of Kv4.2 on Thr607. Conclusions and implications Altogether this suggests that endogenous VIP controls the expression of hippocampal CA1 LTP by regulating disinhibition through activation of VPAC1 receptors in interneurons. This may impact the expression and phosphorylation of Kv4.2 K+ channels at hippocampal pyramidal cell dendrites.
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