Purpose: to demonstrate role of diffusion tensor imaging (DTI) in diagnosis of pediatric chronic kidney disease (CKD) using fraction anisotropy (FA) and apparent diffusion coefficient (ADC). Material and methods: Prospective study done on 35 CKD patients (19 boys, 16 girls; mean age 12.2±2.7 years) and 19 age and sex-matched volunteers. Patients with sclerotic (n = 25) and non-sclerotic (n= 10) CKD that underwent DTI of kidney. Results: Mean FA of renal cortex/ medulla in CKD (0.20±0.07, and 0.18±0.08) was significantly lower (p = 0.001) from volunteers (0.27±0.08, 0.31±0.09). Cutoff renal FA of cortex/ medulla used for diagnosis of CKD was 0.23, and 0.22 with AUC of 0.828, 0.828 and accuracy of 82.9%, 80.7%. Mean ADC of renal cortex/ medulla in CKD (1.98±0.23 and 2.03±0.23 X10-3mm2/s) was significantly higher (p = 0.001) that of volunteers (1.65±0.134 and 1.68±0.16 X10-3mm2/s. Cutoff renal ADC of cortex/medulla used to diagnosis of CKD were 1.75 and 1.85X10-3mm2/s with AUC of 0.828, 0.910, 0.828 and 0.81 and accuracy of 82.9%, 84.1%, 80.7% and 79.5%. FA of renal cortex/medulla in sclerotic CKD was significantly different (p = 0.001) than non-sclerotic CKD (0.26±0.07 and 0.25±0.08). The FA of renal cortex/medulla in CKD patients correlated with serum creatinine (r = -0.468; p = 0.000, r =-0.381; p = 0.001), e GFR (r = 0.364; p = 0.002, r = 0.318; p = 0.007). Conclusion: FA and ADC of renal cortex/ medulla can help in diagnosis of CKD, FA cortex/ medulla predicts sclerotic CKD and correlated with some of serum biomarkers.

For preparing a CsCl density gradient one typically mixes a high-density solution of CsCl (7.163 M) with an aqueous buffer solution to reach a target density. For DNA separation in SIP studies this is typically 1.725 g ml-1. Despite the simplicity of the problem, different formulae appeared in the literature, leading to slightly different end values. Most notably, the famous publication by \citealp{Neufeld_2007} uses a constant---1.52---instead of a variable that would represent the density of the mixture. The source of this constant appears to be from the classical book Centrifugal Separations: Molecular and Cell Biology by \citealp{1985}, where it is used for a specific case only.While the practical implications are small so long as one tries to create a solution with a density of 1.725 g ml-1 (although the resulting value is still wrong), the deviations become significant the further the target density deviates from this value.  

Objective: To evaluate the viability of sputum cytology in asthmatic children, recognizing inflammatory patterns and correlating them with clinical, epidemiological and functional variables of the disease. Methods: This was a cross-sectional and observational study of children with asthma who underwent sputum induction through increasing concentrations of nebulized hypertonic saline solution from 3% to 7%. The samples were processed according to the technique developed by Pizzichini et al. and the cytological pattern classified as pauci-granulocytic, neutrophilic, eosinophilic and mixed. Samples with cell viability> 50% were considered adequate. Asthma control was assessed using the asthma control test (ACT). Results: Seventy-nine children performed sputum induction. Thirty-three samples were excluded because they were not viable for analysis, resulting in 46 samples. The children’s average age was 9.4 (± 3) years. There was a predominance of eosinophilic (25/46, 54.3%), followed by mixed (13/46, 28.3%), pauci-granulocytic (7/46, 15.2%) and neutrophilic (1/46, 2.2%) pattern. Sixty-three percent of the children had severe asthma and 84.7% were treated with inhaled corticosteroids. The ACT showed that 25 (56.8%) patients had the disease under control. Forty-five children (97.8%) underwent pulmonary function tests (spirometry) and in 13 cases (28.9%) an obstructive ventilatory defect was found. Conclusions: The eosinophilic profile was predominant in the assessed asthmatic children. Non-eosinophilic phenotypes were found, but less frequently. There was no difference between the clinical variables and the sputum profile in this study group. Sputum induction in children with asthma is feasible and safe and can contribute to a specific and personalized approach to the disease.

The pandemic of severe acute respiratory syndrome virus 2 (SARS-CoV-2) is a serious threat to global health. Since tuberculosis-COVID-19 co-infection is a great risk for tuberculosis patients. This is the first report from Iran. Rapid screening of respiratory infections caused by COVID-19, isolation, and treatment of tuberculosis patients is vital.

Animals evolved in a microbial world, and their gut microbial symbionts have played a role in their ecological diversification. While many recent studies have reported patterns of co-diversification of hosts and their gut microbes, few studies have directly examined the functional contributions of these microbes to the dietary habits of their hosts. Here, we examined functional enrichment of metabolic pathways in the gut bacteria of 545 bats belonging to 60 species and five terrestrial feeding niches. We found that hosts of different dietary guilds had differential enrichment of bacterial functions that may be adaptive to their respective diets, and that metagenome functions were highly predictive of host feeding guild. We detected little evidence of host phylogenetic effect on gut metagenome composition, suggesting that diet likely overrides host evolutionary history in structuring functional pathways in the gut metagenome. Our results further suggest that bats may have evolved to partially rely on their gut microbes to fulfill critical metabolic pathways, including essential amino acid synthesis, fatty acid biosynthesis, and the generation of cofactors and vitamins essential for proper nutrition. This work represents a comprehensive and novel insight into the contribution of gut microbes to vital metabolic processes in a diverse Order of wild mammals.

Botulinum toxin is widely used in the treatment of temporomandibular disorder symptoms even though consensus on this treatment modality has not yet been reached. Outcome assessment methods described herein could serve as a novel scientific method for the reliable evaluation of the effectiveness of botulinum toxin in further investigations.

Cell-cultured meat and seafood offer a sustainable opportunity to meet the world’s increasing demand for protein in a climate-changed world. A responsible, data-driven approach to assess and demonstrate safety of cell-cultured meat and seafood can support consumer acceptance and help fully realize the potential of these products. As an initial step towards a thorough demonstration of safety, this review identifies hazards that could be introduced during manufacturing, evaluates applicability of existing safety assessment approaches, and highlights research priorities that could support safe commercialization. Input was gathered from members of the cultured meat and seafood industry, researchers, regulators, and food safety experts. A series of workshops were held with 87 industry representatives and researchers to create a modular manufacturing process diagram, which served as a framework to identify potential chemical and biological hazards along the steps of the manufacturing process that could affect the safety of a final food product. Interviews and feedback on draft documents validated the process diagram and supported hazard identification and evaluation of applicable safety methods. Most hazards are not expected to be novel; therefore, safety assessment methods from a range of fields, such as conventional and novel foods, foods produced from biotechnology, pharmaceuticals, etc., are likely to be applicable. However, additional assessment of novel inputs or products with significant differences from existing foods may be necessary. Further research on the safety of the inputs and associated residues, potential for contamination, and development of standardized safety assessment approaches (particularly animal-free methods) is recommended.

Chronic urinary schistosomiasis may lead to obstructive uropathy, contracted bladder secondary to ureteral calcific fibrosis. Appropriate surgical intervention , guided by renal function, bladder capacity and meticulous follow-up may lead to excellent long term urogenital outcomes , following simple cystectomy with orthotopic continent neocystoplasty

We herein report an exceedingly rare case of Evans syndrome with associated tubercular pleural effusion. The patient was initially treated as autoimmune hemolytic anemia. However, the development of thrombocytopenia led to the subsequent diagnosis of Evans syndrome. The co-existence of tuberculosis resulted in additional difficulty during treatment with immunosuppressive medications.

BACKGROUND Adolescent and young adult (AYA) hematopoietic cell transplantation (HCT) survivors are at increased risk of metabolic syndrome and lean body mass (LBM) deficits. Resistance training (RT) is a potential intervention to improve LBM, metabolic fitness and reduce risk of cardiovascular disease. PROCEDURE Eligible participants ages 13-39 years, 80-120 days post-HCT, transfusion independent, and prednisone dose <1 mg/kg/day were approached. Baseline assessments of body composition (DXA), anthropometrics and strength testing were completed and participants were taught a 12-week, home-based RT intervention with weekly remote coaching. Follow-up assessments were at day +200 (FU1) and +365 post-HCT (FU2). Feasibility targets were 1) 60% enrollment of approached patients, 2) 80% completion of weekly phone calls and 3) 80% completion of the RT intervention and FU1 assessments. Acceptability was measured by recommendation of the intervention to an AYA HCT survivor. RESULTS Twenty of 31 (65%) eligible AYAs enrolled. Two participants failed to complete baseline measurements (1=scheduling barriers, 1=passive refusal) and 4 participants who completed baseline assessments did not receive the intervention (2=medical reasons, 2=no longer interested). Of the 13 who received the intervention, 11 (85%) completed FU1 and completed 88.5% of coaching calls. LBM (kg) increased or remained unchanged in 9/9 participants with complete body composition data at FU1 (mean 1.1 kg; 95%CI: 0.4,1.9). All participants who completed FU1 reported they would recommend the intervention to an AYA HCT survivor. CONCLUSIONS A home-based RT intervention in AYA HCT survivors early post HCT is both feasible and acceptable and may maintain or increase LBM.

Background: Cerebral Sinus Venous Thrombosis (CSVT) is one of many side effects encountered during acute lymphoblastic leukemia (ALL) therapy. Due to the rarity of cases, lack of data, consensus management, no recommendations exist to target the population at risk. Methods: This is a retrospective chart review of 229 consecutive patients diagnosed with ALL and aged 1–21 years, treated at the Children’s Cancer Institute (CCI) between October 2007 and February 2017. Results: The incidence of CSVT was 10.5%. Using univariate analysis, increased risk of CSVT was observed with male gender, age >10 years, T-cell immunophenotype, intermediate/high risk disease, maximum Triglyceride (TG) level of > 615 mg/dL, presence of mediastinal mass, and larger body surface area. With multivariate analysis, the only statistically significant risk factors were maximum TG level, body surface area (BSA), presence of mediastinal mass, and risk stratification (intermediate/high risk). Conclusion: Our study was able to unveil TG level of > 615 mg/dL, mediastinal mass, and a larger body surface area as novel risk factors that have not been previously discussed in the literature.

Background: Good’s syndrome (GS) is a rare secondary immunodeficiency disease associated with thymoma, which is characterized by chronic recurrent infection. Due to abnormal immune function, more than half of GS are complicated with autoimmune diseases, such as myasthenia gravis (MG) and pure red cell aplastic anemia (PRCA).Case presentation: We report a case of type III late-onset myasthenia gravis (MG) with thymoma, which was gradually improved after mechanical ventilation, Intravenous steroid pulse, intravenous immunoglobulin , and tacrolimus. After weaning, the patient had a repeated myasthenia gravis crisis caused by lung infections, urinary tract infections, bacteremia, and septic shock, resulting in difficulty in weaning. The subsequent immunological evaluation showed hypogammaglobulinemia, decreased B lymphocytes , and an inverted proportion of CT4+/CD8+ cells, which confirmed the diagnosis of GS.Conclusions: GS should be strongly suspected and immunological examinations performed when recurrent opportunistic infections occur in patients with MG associated thymoma. Early identification and intravenous administration of immunoglobulin can reduce the incidence of future infection and improve the prognosis.We summarize 16 previously reported cases of MG patients with GS. The average age of onset of MG was 53 ±18 years old, and the ratio of male to female was roughly equal. Mostly manifested as systemic myasthenia gravis (77%), half of the patients had bulbar paralysis, 15% had myasthenia gravis crisis, and only 8% only involved extraocular muscles. Thymomas of type B and Type A were the most common. GS symptoms improved in 7 of the 10 patients, suggested thymectomy played a positive role.

In this paper, we study the asymptotic stability of a stratified flow to the three dimensional incompressible Boussinesq equations, which is closely related to the famous B\’{e}nard convection problem. With some sophisticated computation, we extend the result of Castro, Cordoba and Lear(\cite{cardoba2}) to three dimensions case.

Background: The impact of the increased mitral gradient (MG) on outcomes is ambiguous. Therefore, we aimed to evaluate a) periinterventional dynamics of MG, b) the impact of intraprocedural MG on clinical outcomes, and c) predictors for unfavourable MG values after MitraClip. Methods: We prospectively included patients undergoing MitraClip. All patients underwent echocardiography at baseline, intraprocedurally, at discharge, and after six months. 12-month survival was reassessed. Results: 175 patients (age 81.2±8.2 years, 61.2% male) with severe mitral regurgitation (MR) were included. We divided our cohort into two groups with a threshold of intraprocedural MG of 4.5 mmHg, which was determined by the multivariate analysis for the prediction of 12-month mortality (<4.5 mmHg: Group 1, 4.5 mmHg: Group 2). Intraprocedural MG 4.5 mmHg was found to be the strongest independent predictor for 12-month mortality (HR: 2.33, p=0.03, OR: 1.70, p=0.05) and ≥3.9 mmHg was associated with adverse functional outcomes (OR: 1.96, p=0.04). The baseline leaflet-to-annulus index (>1.1) was found to be the strongest independent predictor (OR: 9.74, p=0.001) for unfavourable intraprocedural MG, followed by the number of implanted clips (p=0.01), MG at baseline (p=0.02) and central clip implantation (p=0.05). Conclusion: MG shows time-varying and condition-depended dynamics periinterventionally. Patients with persistent increased (≥4.5 mmHg) MG at discharge showed the worst functional outcomes and the highest 12-month mortality, followed by patients with an intra-hospital decrease in MG to values below 4.5 mmHg. Pre-interventional echocardiographic and procedural parameters can predict unfavourable postprocedural MG.

We present hereby the case of a 75-year-old woman with a degenerated mitral bioprosthesis and severely reduced left ventricular ejection fraction who underwent a successful trans-septal mitral valve-in-valve (TMViV) replacement using a 29mm Edwards Sapien S3 transcatheter heart valve. We also performed a literature review.

Here we review and extend the equal fitness paradigm (EFP) as an important step in developing and testing a synthetic theory of ecology and evolution based on energy and metabolism. The EFP states that all organisms are equally fit at steady state, because they allocate the same quantity of energy, ~22.4 kJ/g/generation to production of offspring. On the one hand, the EFP may seem tautological, because equal fitness is necessary for the origin and persistence of biodiversity. On the other hand, the EFP reflects universal laws of life: how biological metabolism – the uptake, transformation and allocation of energy – links ecological and evolutionary patterns and processes across levels of organization from: i) structure and function of individual organisms, ii) life history and dynamics of populations, iii) interactions and coevolution of species in ecosystems. The physics and biology of metabolism have facilitated the evolution of millions of species with idiosyncratic anatomy, physiology, behavior and ecology but also with many shared traits and tradeoffs that reflect the single origin and universal rules of life.

Le emissioni di biossido di carbonio (CO2) sono la problematica principale alla base dei cambiamenti climatici e sono dannose per la salute dell'uomo. Per ridurre tale concentrazione si è sperimentato l'utilizzo di microalghe. Le microalghe sono i microrganismi più importanti negli ecosistemi acquatici per il bilancio globale del carbonio e sono fondamentali per la cattura e la bioconversione dell’anidride carbonica (CO2) in energia. Le microalghe vengono coltivate nei fotobioreattori, sistemi chiusi e aperti che permettono alle microalghe di crescere e assorbire la CO2. Un’ulteriore tipologia di fotobioreattore molto utilizzato è quella a membrana (MPBR). Uno sviluppo futuro importante legato ai fotobioreattori e alle microalghe potrebbe essere quello di unire i due tipi di sistemi, aperti e chiusi, riuscendo a minimizzare i costi dell’impianto e a permettere una coltivazione su scala industriale.  

Measuring the effectiveness of agri-environment schemes depends on scheme type, taxon and landscape. Here we show how spatial scale, i.e. studied transect, field or farm level, and controlling for yield loss, can drastically change the evaluation of biodiversity benefits of on-field (organic farming) vs. off-field (flower strips) schemes. Transects may lead to misleading evaluations, because flower strips, covering only 5% of conventional fields, support less bees than large organic fields; but if their 20% yield loss is considered to compare identical yield levels, 80 ha conventional plus 20 ha flower strip farming promotes more bees than 100 ha organic farming.

Rabies is a global viral zoonosis endemic to South Africa, resulting in fatal encephalitis in warm blooded animals, including humans. The loss of human lives and economic losses in rural areas through loss of livestock are substantial. A review was conducted of all confirmed rabies cases in South Africa from 1993 to 2019, with a total of 11 701 cases identified to species level to assess the wildlife plays in the epidemiology of rabies. A spatiotemporal cluster analysis using a discrete Poisson space-time probability model, accounting for underlying estimated dog and livestock densities, identified 13 significant clusters (p<0.05). These included four long-term clusters lasting more than 8 years in duration and seven short term clusters lasting less than 2 years, with the remaining two clusters being of intermediate length. Outside of these endemic clusters, wildlife outbreaks in the remainder of South Africa were often less than one and a half years in duration most likely due to the rapid decline of wildlife vectors, especially jackals associated with rabies infection. Domestic dogs accounted for 59.8% of cases, with domestic cats (3.2%), livestock (21.1%) and wildlife (15.8%) making up the remainder of the cases. Yellow mongoose (Cynictis penicillate) was the most frequently affected wildlife species, followed by bat-eared fox (Otocyon megalotis), black-backed jackal (Canis mesomelas), meerkat (Suricata suricatta) and aardwolf (Proteles cristatus). Rabies in wildlife species followed different spatial distributions: black-backed jackal cases were more common in the north-western parts of South Africa, yellow mongoose cases more frequent in central South Africa, and bat-eared fox and aardwolf cases were more frequent in southern and western South Africa. Clusters often spanned several provinces, showing the importance of coordinated rabies control campaigns across administrative boundaries, and high-risk areas were highlighted for rabies in South Africa.

Current approaches to characterize the mutational profile of CFTR are based on targeted mutation analysis (TMA) or whole gene studies derived from short-read next generation sequencing (NGS). However, these methods lack phasing capability which, in certain scenarios, can provide clinically valuable information. In the present work, we performed near-full length CFTR using Single-Molecule Real-Time Sequencing to produce haplotype resolved data from F508del homozygous and F508del compound heterozygous individuals. This approach utilizes target enrichment of the CFTR gene using biotinylated probes, facilitates multiplexing samples in the same sequencing run, and utilizes fully-automated bioinformatics pipelines for error correction and variant calling. We show a remarkable conservation of F508del haplotype, consistent with the single gene founder effect, as well as diverse mutational profiles in non-F508del alleles. By the same method, 105 single nucleotide polymorphisms exhibiting invariant linkage to F508del CFTR (which better define the founder haplotype) were identified. High level homology between F508del sequences derived from heterozygotes, and those obtained from homozygous individuals, demonstrate accuracy of this method to produce haplotype resolved sequencing. The studies provide a new diagnostic technology for detailed analysis of complex CFTR alleles linked to disease severity.

Natural wetland along the coasts of Yellow and Bohai seas provided key stopover sites for migratory waterbirds. However, these wetlands are facing land loss. Understanding how natural wetlands loss influence habitat is an important step for habitat management. Using species distribution model to report changes in area of suitable habitat, and the effects of natural wetland loss on habitat for 80 waterbird species attributed to four functional categories (shorebird, duck, heron, gull), between 2000 and 2015 in the Yellow and Bohai seas. Of 1794.8 km2 of coastal wetland lost to development between 2000 and 2015, most represented tidal flats converted into aquaculture and salt pan habitat, or for construction. Consequently, habitat for 73 of these 80 species has decreased in area over this time period. Generally, the proportional decline in habitat suitable for species of duck was less than it was shorebirds, herons and gulls. The proportional loss of tidal flat habitat that formerly represented suitable habitat for shorebirds, herons and gulls was also significantly higher than it was for ducks. Because more species of duck exploit aquaculture and salt pan habitat converted from tidal flats than do shorebird, heron and gull species, such conversion of tidal flats pose a greater threat to shorebirds, herons and gulls than they do to ducks. Preventing further reclamation of tidal flats and managing artificial wetlands are priorities for waterbirds conservation, especially for the species ducks.

African Swine Fever Virus (ASFV) causes a deadly disease of pigs which spread through southeast Asia in 2019. We investigated one of the first outbreaks of ASFV in Lao Peoples Democratic Republic amongst smallholder villages of Thapangtong District, Savannakhet Province. In this study, two ASFV affected villages were compared to two unaffected villages. Evidence of ASFV-like clinical signs appeared in pig herds as early as May 2019, with median epidemic days on 1 and 18 June in the two villages, respectively. Using participatory epidemiology mapping techniques, we found statistically significant spatial clustering in both outbreaks (P < 0.001). Villagers reported known risk factors for ASFV transmission  such as free-ranging management systems and wild boar access  in all four villages. The villagers reported increased pig trader activity from Vietnam before the outbreaks; however, the survey did not determine a single outbreak source. The outbreak caused substantial household financial losses with an average of 9 pigs lost to the disease, and Monte Carlo analysis estimated this to be USD 215 per household. ASFV poses a significant threat to food and financial security in smallholder communities such as Thapangtong, where 40.6% of the district’s population are affected by poverty. This study shows ASFV management in the region will require increased local government resources, knowledge of informal trader activity and wild boar monitoring alongside education and support to address intra-village risk factors such as free-ranging, correct waste disposal and swill feeding.

Objective: To assess the association between NLR and PLR with all-cause mortality in Peruvian patients with CKD Methods: We conducted a retrospective cohort study in adults with CKD in stages 1 to 5. The outcome variable was mortality and as variables of exposure to NLR and PLR. Both ratios were categorized as high with a cut-off point of 3.5 and 232.5; respectively. We carried out a Cox regression model and calculated crude and adjusted hazard ratios (HR) with their 95% confidence interval (95%CI). Results: We analyzed 343 participants with a median follow-up time of 2.45 years (2.08-3.08). The frequency of deaths was 17.5% (n=60). In the crude analysis, the high NLR and PLR were significantly associated with all-cause mortality (HR=2.01; 95% CI:1.11-3.66) and (HR=2.58; 95% CI:1.31-5.20). In the multivariate model, after adjusting for age, sex, serum creatinine, CKD stage, albumin and hemoglobin, the high NLR and PLR remained as an independent risk factor for all-cause mortality, (HR=2.10; 95% CI:1.11-3.95) and (HR=2.71; 95% CI:1.28-5.72). Conclusion: Our study suggests the relationship between high NLR and PLR with all-cause mortality in patients with CKD.

The wild tomato species Solanum chilense is divided in geographically and genetically distinct populations that show signs of defense gene selection and differential phenotypes when challenged with several phytopathogens, including the oomycete causal agent of late blight Phytophthora infestans. To better understand the phenotypic diversity of this disease resistance in S. chilense and to assess the effect of plant genotype vs. pathogen isolate, respectively, we evaluated infection frequency in a systematic approach and with large sample sizes. We studied 85 genetically distinct individuals representing nine geographically separated populations of S. chilense. This showed that differences in quantitative resistance properties can be observed between but also within populations at the level of individual plants. Data also did not reveal clear indications for complete immunity in any of the genotypes. We further evaluated the resistance of a subset of the plants against P. infestans isolates with diverse virulence properties. This confirmed that the relative differences in resistance phenotypes between individuals were mainly determined by the plant genotype under consideration with modest effects of pathogen isolate used in the study. Thus, our report suggest that quantitative resistance against P. infestans in natural populations of a wild tomato species S. chilense is likely not the result of specific adaptations of hosts to the pathogen but of basal defence responses that depend on the host genotype and are pathogen isolate-unspecific.