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Boosting selective hydrogenation through hydrogen spillover on supported-metal cataly...
Sai Zhang
Zhaoming Xia

Sai Zhang

and 5 more

January 06, 2021
Highly efficient hydrogenation of unsaturated substrates with strong absorption on metals at low temperatures is a long-term pursuit. However, due to the scaling relationship of high binding energies on metals, the poor activity and/or selectivity are frequently observed. Herein, we described a strategy of hydrogen spillover to break this scaling relationship to enable highly performed hydrogenation at low temperatures by constructing the dual-active site in supported-metal catalysts. Hydrogen and reactants are selectively activated on metal and the second active sites on support, respectively. Hydrogenation sequentially occurs on the second active sites via hydrogen spillover from metal to support. Easy desorption of surface-bounded products substantially re-generates the active sites. Guided by this design, for cinnamaldehyde hydrogenation, PtCo alloys (for H2 dissociation) supported on hydroxyl-abundant CoBOx (for aldehyde activation) delivered a high turnover frequency of 2479 h-1 (two orders of magnitude over PtCo/C) and 94.5% selectivity of cinnamyl alcohol at room temperature.
High-throughput computational screening of porous polymer networks for natural gas sw...
Xuanjun Wu
Yujing Wu

Xuanjun Wu

and 5 more

January 06, 2021
17,846 PPNs with the diamond-like topology were computationally screened to identify the optimal adsorbents for the removal of H2S and CO2 from humid natural gas based on the combination of molecular simulation and machine learning algorithms. The top-performing PPNs with the highest adsorption performance scores (APS) were identified based on their adsorption capacities and selectivity for H2S and CO2. The strong affinity between water molecules and the framework atoms has a significant impact on the adsorption selectivity of acid gases. We proposed two main design paths (LCD ≤ 4.648 Å, Vf ≤ 0.035, PLD ≤ 3.889 Å or 4.648 Å ≤ LCD ≤ 5.959 Å, ρ ≤ 837 kg·m-3) of high-performing PPNs. We also found that artificial neural network (ANN) could accurately predict the APS of PPNs. N-rich organic linkers and highest isosteric adsorption heat of H2S and CO2 are main factors that could enhance natural gas sweetening performance.
Accurate Prediction of Deprotonation and pH value of Acids in Aqueous Solutions over...
Bong-Seop Lee
Shiang-Tai Lin

Bong-Seop Lee

and 1 more

January 06, 2021
The pKa of an acid is important for determining the dissociation and thermodynamic properties of solutions containing it. However, the value of pKa is typically determined at dilute limit and cannot be used to describe properties of the solution at high concentrations. In this work, we propose an approach to determine the concentration independent equilibrium constant Keq based on pKa and predicted activity coefficients. The Keq determined is applied to predict the degree of dissociation over whole concentration range for weak to strong acids. The pH of acid aqueous solution is predicted over whole concentration range, showing a good agreement with experiments. Based on this approach, we found that the vapor pressures of acid aqueous solutions strongly depend on the degree of dissociation of acids. The proposed model provides useful insights to link the macroscopic properties of acid aqueous solutions to its microscopic dissociation phenomena over the whole concentration range.
DEM--CFD modeling and simulations of hydrodynamic characteristics and flow resistance...
Yaping Li
Le Xie

Yaping Li

and 4 more

January 06, 2021
The ability to predict void fraction, pressure drop, and flow resistance coefficient in fixed-bed reactors is significant to their optimal design. In this study, the discrete element method (DEM) is combined with computational fluid dynamics (CFD) to simulate the hydrodynamic characteristics of fixed-beds. A realistic random packing structure for fixed-beds with spherical particles was generated via the DEM method and then meshed using Ansys ICEM software for the CFD simulation. A grid independency study was performed to select appropriate grid model parameters. A large set of numerical experiments was conducted to investigate the hydrodynamic characteristics with respect to different inlet velocities and particle sizes, and the simulated pressure drop data were used to calculate the flow resistance coefficient. The output flow resistance coefficients agreed well with those calculated by the classical models in laminar and turbulent flow regimes, thereby indicating the accuracy and advantage of the proposed DEM–CFD approach.
Traceable Surveillance and Genetic Diversity Analysis of Coronaviruses in Poultry fro...
Yang Li
Qingye Zhuang

Yang Li

and 18 more

January 06, 2021
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in Wuhan, China, and rapidly spread worldwide. This new emerging pathogen is highly transmittable and can cause fatal disease. More than 35 million cases have been confirmed and the fatality was about 2.9% up to October 9 2020. However, the original and intermediate hosts of SARS-CoV-2 remain unknown. Here, a total of 3160 poultry samples collected from 14 provinces between September and December 2019 in China were tested for the purpose of traceable surveillance for SARS-CoV-2 infection. The results indicated that all samples were SARS-CoV-2 negative, and a total of 593 avian coronaviruses were detected, including 485 avian infectious bronchitis viruses, 72 duck coronaviruses and 36 pigeon coronaviruses. The positive rates of avian infectious bronchitis virus, duck coronavirus, and pigeon coronavirus were 15.35%, 2.28% and 1.14%, respectively. Our surveillance demonstrated the diversities of avian coronaviruses in China, and higher prevalence were also recognized in some regions. The possibility of SARS-CoV-2 originating from the known avian-origin coronaviruses can be preliminarily ruled out. More surveillance and research on avian coronaviruses should be strengthened for better understanding the diversity, distribution, cross-species transmission and clinical significance of these viruses.
Spatial Analysis of COVID-19 Risk Based on Different Lockdown Strategies - a Case Stu...
Weijia Wang

Weijia Wang

January 07, 2021
1. IntroductionIn the United States, the number of cases of COVID-19 is continuously increasing. Until October 28, 2020, according to John Hopkins Coronavirus Resource Center, there were 8,856,413 confirmed cases in the United States, and 72,183 cases were reported in one day. After a few months of the lockdown in March, most states are reopening, including retail stores, restaurants, and recreation. As a college student, COVID-19 is affecting everyday student life and residence life.According to the CDC, seasonal influenza viruses are expected during the late fall and peak between December to February [1]. There are some explanations about why flu season usually spreads in the winter. First, people spend more time indoors, which increases the chance to closer contact others who might be carrying the virus. Students, for example, would prefer using public transportation, such as buses, instead of walking to class. Second, in the short days of the winter, people may run low on Vitamin D and weaken our immune system [2]. UConn is located in the northeast of the United States; the temperature is low during the fall and winter. Students and the university need to be prepared and preclude the new wave from spreading. Typically, international students and out-of-state students are more vulnerable to get infected due to limited access to testing [3].The government of Connecticut announced the reopening policy phase 2 began on June 17, which up to 50% capacity indoors with 6 feet spacing for restaurants, personal services, libraries, and indoor recreation and up to 25% capacity capped at 100 people for indoor religious gatherings. Phase 3 began on October 8. Restaurants, personal services, and libraries are up to 75% capacity indoors and up to 50% capacity for indoor and outdoor religious gatherings. However, due to the increasing number of cases of COVID-19 in Connecticut, the Connecticut government updated the latest reopening rule, which was phase 2.1 started on November 6. Phase 2.1 is slightly different from the phase 2 version, in which restaurants can accommodate up to 50%, while personal service and libraries can accommodate up to 75% [6].This article focuses on a local scale, which is the UConn main campus. It is important because college campuses are places with high dense population and easily get infected. From a student’s perspective, building spatial models of campus areas are necessary and help us create a safe community. This study article focuses on building a mathematical model, the Susceptible-Infected-Recovered (SIR) model, and estimates the infectious rate and recovery rate at the University of Connecticut (UConn) Storrs. The model generates the number of cases from August 16, when students who live on campus check-in, to September 7. After finding out the parameters using SIR, we use Agent-Based Modeling (ABM) to simulate different cases to predict and evaluate the risks of different places on campus.  UConn, located in Storrs, has approximately 5,000 students living on campus. Such a population would increase the chances of interaction between students in public places such as academic buildings, dining halls, grocery stores, residential halls, and apartments. Before the semester began, UConn had already announced reopening policies. Most of the classes are moving online or distance learning to prevent the spreading of disease. In-person classes require students wearing a mask and maintaining at least six feet of physical distancing from others. Dining halls are switching to take-out and limited dining models. However, for those students who live in residential halls, even though UConn policy requires one person per dorm room, they are still sharing bathrooms. For those who live in apartments or off-campus, students have approximately one to four roommates, which increases the chance of infection. Our primary goal is to extend the SIR model into the spatial form and using QGIS and NetLogo to visualize the spreading. Because the covid-19 disease varies a great deal with places, we consider leveraging this when we estimate covid information for policy-makers to make lockdown or reopening business strategies. We extend the traditional mathematical SIR model into a spatially-explicit model to simulate the spatial dynamics of covid-19 over discrete-time and across discrete space at the Uconn Storrs campus. The spatially-explicit models may provide useful insights into the epidemiological characteristics of the disease and identification of disease hotspots across the campus, thus can inform and guide policy-makers for targeted interventions and targeted reopening the business in specific locations of the campus. This paper focuses on a specific area, rather than a state or a country, with a smaller population size. We are using the data to predict the cases and infection rates in the next few months, evaluating each building’s risk and ranking the score with a higher chance of getting infected. Based on the policies that have been implemented at UConn, we also make some suggestions to the university about forestalling the new wave coming in winter. 2. Data and MethodologyTo simulate the spreading of epidemics, we are building the SIR model. The SIR model was first introduced by Kermack and McKendrick by separating people into three different categories: susceptible (S), infected (I), and recovered (R) [4]. In this case, the population in Storrs is susceptible (S). Individuals who get infected move from susceptible stage to infected stage (I). Eventually, people who were removed from the infected status recovered (R). The SIR model using the parameters β, the infection rate, and γ, the recovery rate, can be presented by the ordinary differential equation (ODE). 
The role of echocardiography in predicting technical problems and complications of tr...
Dorota Nowosielecka
Wojciech Jacheć

Dorota Nowosielecka

and 5 more

January 05, 2021
Introduction Transesophageal echocardiography (TEE) is a useful tool in preoperative observation of patients undergoing transvenous leads extraction (TLE) due to complications associated with implanted devices. Echocardiographic phenomena may determine the safety of the procedure. Methods and results Data from 936 transesophageal examinations (TEE) performed at a high volume center in patients awaiting TLE from 2015 to 2019 were assessed. TEE revealed a total of 1156 phenomena associated with the implanted leads in 697 (64.85%) patients, including: asymptomatic masses on endocardial leads (AMEL) (58.65%), vegetations (12,73%), fibrous tissue binding the lead to the vein or heart wall (33.76%), lead-to-lead binding sites (18.38%), excess lead loops (19.34%), intramural penetration of the lead tip (16.13%), lead-dependent tricuspid dysfunction (LDTD) (6.41%). Risk factors for technical difficulties during TLE in multivatiate analysis were: fibrous tissue binding the lead to atrial wall (OR=1.738; p<0.05), to right ventricular wall (OR=2.167; p<0.001), lead-to-lead binding sites (OR=1.628; p<0.01) and excess lead loops (OR=1.488; p<0.05). Lead-to-lead binding sites increased probability of major complications (OR=3.034; p<0.05). Presence of fibrous tissue binding the lead to the superior vena cava (OR=0.296; p<0.05), right atrial wall (OR=323; p<0.05) and right ventricular wall (OR=0.297; p<0.05) reduced the probability of complete procedural success, whereas fibrous tissue binding the lead to the tricuspid apparatus decreased the probability of clinical success (OR=0.307; p<0.05), Conclusions: Careful preoperative TEE evaluation of the consequences of extended lead implant duration (enhanced fibrotic response) increases the probability of predicting the level of difficulty of TLE procedures, their efficacy and risk of major complications.
COMPARISON OF THE OUTCOMES AFTER ENDOSCOPIC VEIN HARVESTING VERSUS OPEN VEIN HARVESTI...
Afnan ALMalki
Ahmed Arifi

Afnan ALMalki

and 1 more

January 05, 2021
Minimally invasive endoscopic vein harvesting (EVH) was first reported in 1996 as an alternative to open vein harvesting (OVH). Making coronary artery bypass surgery a less invasive procedure, shortly after its introduction, it became the standard of care for conduit harvesting. When compared to the conventional technique, the incidence of site infections wound dehiscence, delayed healing, duration of hospitalization, and postoperative pain were markedly reduced. However, the long-term outcomes, safety, and graft patency remain uncertain. Herein is an extensive literature review discussing the outcomes following endoscopic vein harvesting for Coronary Artery Bypass Surgery (CABG) as well as its advantages and disadvantages.
Postnatal cardiovascular morbidity following preterm pre-eclampsia: an observational...
Laura Ormesher
Suzanne Higson

Laura Ormesher

and 8 more

January 05, 2021
Objective Explore the nature of postnatal cardiovascular morbidity following pregnancies complicated by preterm pre-eclampsia and identify associations between pregnancy characteristics and postnatal cardiovascular function. Design Observational sub-study of a single-centre feasibility randomised double-blind placebo-controlled trial. Setting Tertiary maternity hospital, UK. Population Women with preterm pre-eclampsia, delivering <37 weeks. Methods Eligible women underwent echocardiography, arteriography and blood pressure monitoring <3 days, 6 weeks and 6 months postpartum. Correlations between pregnancy and cardiovascular characteristics were assessed using Spearman’s correlation. Main Outcome Measure Prevalence of cardiovascular dysfunction and remodelling 6 months following preterm pre-eclampsia. Results Forty-four women completed the study. At 6 months, 27 (61%) had diastolic dysfunction, 33 (75%) had raised total vascular resistance (TVR) and 18 (41%) had left ventricular remodelling. Sixteen (46%) women had de novo hypertension by 6 months and only 2 (5%) women had a completely normal echocardiogram. Echocardiography did not change significantly from 6 weeks to 6 months. Earlier gestation at delivery and lower birthweight centile were associated with worse 6-month diastolic dysfunction (E/E’: rho=-0.39, p=0.001 & rho=-0.42, p=0.005) and TVR (rho=-0.34, p=0.02 & rho=-0.37, p=0.01). Conclusions Preterm pre-eclampsia is associated with persistent cardiovascular morbidity 6 months postpartum in the majority of women. These cardiovascular changes have significant implications to long-term cardiovascular health. The graded severity of diastolic dysfunction and TVR with worsening pre-eclampsia phenotype suggests a dose-effect. However, the mechanistic link remains uncertain. Funding Medical Research Council (MR/R001693/1). Registration https://www.clinicaltrials.gov; NCT03466333. Key words Pre-eclampsia: clinical research; radiological imaging: ultrasound; medical disorders in pregnancy.
Spinal cord compression as the presenting feature of skeletal fluorosis
Zouhour Gassara
Samar Ben djmeaa

Zouhour Gassara

and 6 more

January 05, 2021
Skeletal fluorosis is a rare toxic osteopathy reported as an endemic disease and caused especially by prolonged ingestion of high fluoride concentration. Spinal cord compression primarly by the ossification of the posterior longitudinal ligament and ligamentum flavum, may rarely reveal the disease. Surgical decompression is the treatment of choice.
Unexpected Foreign Body induced refracted Maxillary Sinusitis
Bassel  Hallak
Jean-Pierre Bühler

Bassel Hallak

and 2 more

January 05, 2021
Foreign bodies’ impact in paranasal sinuses are unusual clinical conditions and most often occur in the maxillary sinus. Odontogenic sources induce maxillary sinusitis in approximately 10 to 12% of cases. Iatrogenic dental manipulation is the most common cause of foreign bodies’ impaction in the maxillary sinus.
A silent trio: giant descending aortic aneurysm combined with coarctation and persist...
Maksim Basho
Deniona Nunci

Maksim Basho

and 3 more

January 05, 2021
We report the case of an undiagnosed descending aortic aneurysm, combined with coarctation and persistent left brachiocephalic truncus in a 59-years old male. This case underscores the increased necessity for aortic imaging while facing a poorly controlled hypertension, erroneously considered as of essential origin.
Truncus Arteriosus with Partial Anomalous Pulmonary Venous Connection and Patent Duct...
David Angel Ortiz Ruiz
Davide Calvaruso

David Angel Ortiz Ruiz

and 3 more

January 05, 2021
The association of anomalous pulmonary venous connections and truncus arteriosus is extremely rare and can complicate the surgical management of these patients. We report clinical findings and surgical approach in a female newborn with truncus arteriosus, patent ductus arteriosus with normal aortic arch, and partial anomalous pulmonary venous connection.
Induced Pluripotent Stem Cells Provide an Unlimited T-cell Source for CAR-T cell Deve...
Muhammad Sadeqi Nezhad

Muhammad Sadeqi Nezhad

April 07, 2021
CAR-T cell therapy has been increasingly conducted for cancer patients in clinical settings. Progress in this therapeutic approach is hampered by the lack of a solid manufacturing process, T lymphocytes, and tumor-specific antigens. T-cell source used in CAR-T cell therapy is predominantly derived from the patient’s own T lymphocytes, which makes this approach impracticable to patients with progressive diseases and T leukemia. Autologous CAR-T cell generation is time-consuming due to lack of readily available T lymphocytes and is not applicable for third-party patients. Pluripotent stem cells, such as human induced pluripotent stem cells (hiPSCs), could provide an unlimited T-cell source for CAR-T cell development. iPSC-derived T cells would be a promising infinite T-cell source and are phenotypically defined, expandable and functional as physiological T cells. iPSC-derived T cells provide a feasible T-cell source for the development of off-the-shelf T cells and CAR-T cells. The combination of iPSC and CAR-Technologies provides an extraordinary opportunity to oncology and greatly facilitates cell-based therapy for cancer patients. T-iPSCs in combination with CAR is in early stage of development and the pre-clinical and clinical studies concerning the combination of these novel technologies are not sufficient. This article critically reviews the progress in iPSC-derived T cell development and provides a roadmap for development of CAR iPSC-derived T cells and off-the-shelf T-iPSCs.Keywords: CAR-T cell; iPSC; T cell; iPSC-derived T cell; tumor cell; therapeutic; off-the-shelf
In the operating room, do not leave important things unattended
carlos mestres
Juri Sromicki

Carlos Mestres

and 2 more

January 05, 2021
Commentary to JOCS-2020-OA-1345
Effect of industrial crop Jerusalem artichoke on the micro-ecological rhizosphere env...
Tianyun  Shao
Xiaohua Long

Tianyun Shao

and 4 more

January 05, 2021
Salinity is not only a threat to organisms and ecosystems, but also a major factor restricting the development of agricultural production. This study aimed to explore the modification effect of in-situ Jerusalem artichoke (genotype NY-1) cultivation on the rhizosphere micro-ecological environment in the saline-alkali region along the southeast coast of China. We analyzed the change of carbon and nitrogen in the saline soil from a microbial perspective, through the quantification of the area of root channels, rhizosphere secretions and soil microbiome (cbbL, cbbM and nifH). The root channels of NY-1 not only improved the physical structure of saline soil, but also provided a living space for microorganisms, afforded basic conditions for the optimization of the soil micro-ecological environment. In addition, rhizosphere secretions (from roots of NY-1 as well as microorganisms), such as carbohydrates, hydrocarbons, acids, etc., could be considered as a way to improve the saline-alkali soil habitat. NY-1 increased the diversity and abundance of autotrophic and nitrogen-fixing bacteria in saline soil (rhizosphere > bulk soils), which should be a biological way to increase the amount of carbon and nitrogen fixation in soil. Moreover, some of the detected genera (Sideroxydans, Thiobacillus, Sulfuritalea, Desulfuromonas, etc.) participate in the carbon and nitrogen cycles, and in the biogeochemical cycle of other elements. In short, Jerusalem artichoke can improve not only the physical and chemical properties of saline-alkali soil, but also promote material circulation and energy flow in the micro-ecological rhizosphere environment of saline soils.
Comparison of the predictive value of area under the curve versus maximum serum conce...
Katherine Landmesser
Elizabeth Autry

Katherine Landmesser

and 5 more

January 05, 2021
OBJECTIVES: The primary objective of this study was to compare the therapeutic predictive value of area under the curve (AUC24) versus maximum concentration (Cmax) in cystic fibrosis (CF) patients receiving intravenous (IV) tobramycin for a Pseudomonas aeruginosa (PsA) acute pulmonary exacerbation (APE). Acute kidney injury (AKI) incidence and the relationship between time undetectable and efficacy were also assessed. METHODS: A retrospective review was conducted in patients aged at least one month with a diagnosis of CF receiving IV tobramycin for treatment of a PsA APE and admitted to the University of Kentucky between August 2015 and August 2019 . Patients were excluded if they had no growth of PsA on sputum culture or if two post-dose tobramycin levels were not obtained following a dose adjustment of ≥20%. RESULTS: A total of 44 pediatric and 107 adult patient encounters met inclusion criteria. In patients with therapeutic success (n=91), 75.8% had an AUC24 ≥80 and 80.3% had a Cmax ≥8 times the highest PsA minimal inhibitory concentration (MIC). There was a significant correlation between AUC24 and Cmax (r2 = 0.727; p<0.001). AKI incidence was significantly higher in patients receiving IV tobramycin dosed multiple times daily versus at least every 24 hours (50% versus 28.7%; p=0.047). CONCLUSIONS: The results of this study indicate that both AUC24 and Cmax serve as relatively accurate predictors of tobramycin efficacy. Additionally, given the significant increase in incidence of AKI, multi-daily dosing of IV tobramycin should be used only in select pediatric and adult patients with CF.
Short segment coronary artery bypass grafting using radial artery to repair bilateral...
Kosuke Saku
Kazuyoshi Takagi

Kosuke Saku

and 4 more

January 05, 2021
Coronary ostial aneurysm is one of the complications after aortic root replacement especially in Marfan syndrome. How to reconstruct the coronary arteries is important problems during reoperation. Herein, we report a case of coronary artery bypass grafting using radial artery to repair bilateral coronary ostial aneurysms after aortic root replacement in a patient with Marfan syndrome.
Adaptive and non-adaptive plasticity in changing environments: implications for sexua...
Daniel Romero-Mujalli
Markus Rochow

Daniel Romero-Mujalli

and 6 more

January 05, 2021
Populations adapt to novel environmental conditions by genetic changes or phenotypic plasticity. Plastic responses are generally faster and can buffer fitness losses under variable conditions. Plasticity is typically modelled as random noise and linear reaction norms that assume simple one-to-one genotype-phenotype maps and no limits to the phenotypic response. Most studies on plasticity have focused on its effect on population viability. However, it is not clear, whether the advantage of plasticity depends solely on environmental fluctuations or also on the genetic and demographic properties (life histories) of populations. Here we present an individual-based model and study the relative importance of adaptive and non-adaptive plasticity for populations of sexual species with different life histories experiencing directional stochastic climate change. Environmental fluctuations were simulated using differentially autocorrelated climatic stochasticity or noise color, and scenarios of directional climate change. Non-adaptive plasticity was simulated as a random environmental effect on trait development, while adaptive plasticity as a linear, logistic, or sinusoidal reaction norm. The last two imposed limits to the plastic response and emphasized flexible interactions of the genotype with the environment. Interestingly, this assumption led to (i) smaller phenotypic than genotypic variance in the population and the coexistence of polymorphisms, (ii) many-to-one genotype-phenotype map, and (iii) the maintenance of higher genetic variation – compared to linear reaction norms and genetic determinism – even when the population was exposed to a constant environment for several generations. Limits to plasticity led to genetic accommodation, when costs were negligible, and to the appearance of cryptic variation when limits were exceeded. We found that adaptive plasticity promoted population persistence under red noise stochasticity and was particularly important for life histories with low fecundity. Populations producing more offspring could cope with environmental fluctuations solely by genetic changes or random plasticity, unless environmental change was too fast.
Endoscopic Assisted Navigation Removal of Large Skull Base Wooden Penetrating Foreign...
Amanda Almeida
Eduardo Couto

Amanda Almeida

and 3 more

January 05, 2021
Penetrating orbitocranial trauma caused by foreign bodies requires prompt intervention. Nasal endoscopic approach is a less invasive technique. We describe an unusual case of a large skull base wooden penetrating foreign body submitted to this approach, in which a septal cartilage graft was used to reconstruct the medial orbit wall.
A Novel Method for the Determination of Exostosis Severity in the External Auditory C...
A/Professor Mike Climstein
Vini Simas

Mike Climstein

and 3 more

January 05, 2021
Guidelines state there is no Abstract for Correspondence: Our Experience
Retrograde balloon aortic valvuloplasty with the newly invented Inoue balloon for aor...
Keinchi Ishizu
Tomohiro Kawaguchi

Keinchi Ishizu

and 3 more

January 05, 2021
Balloon aortic valvuloplasty (BAV) is frequently utilized for selected high-risk patients who cannot be immediate candidates for transcatheter aortic valve replacement. We describe a case of high-risk retrograde BAV performed safely with a newly invented Inoue balloon with stable fixation and multistage inflation characteristics, without any rapid ventricular pacing requirements.
The immune response does not prevent homologous Porcine epidemic diarrhoea virus rein...
Ivan Díaz
Joan Pujols

Ivan Díaz

and 7 more

January 05, 2021
The aim of the present study was to evaluate the duration of protective immunity against Porcine epidemic diarrheoa virus (PEDV). To that, a two phases study was performed. In the first phase, 75 four-week-old pigs (group A) were orally inoculated (0 days post-inoculation; dpi) with a European PEDV G1b strain and 14 were kept as controls (group B). The second phase started five month later (154 dpi), when animals in group A were homologous challenged and animals in group B were challenged for first time. Clinical signs, viral shedding and immune responses were evaluated after each inoculation, including the determination of antibodies (ELISA and viral neutralisation test, IgA and IgG ELISPOTs using peripheral blood mononuclear cells and lymph node cells) and the frequency of interferon-gamma (IFN-γ) secreting cells. During the first phase, loose stools/liquid faeces were observed in all group A animals. Faecal shedding of PEDV occurred mostly during the first 14 days but, in some animals, persisted until 42 dpi. All inoculated animals seroconverted for specific-PEDV IgG and IgA, and for neutralizing antibodies (NA). At 154 dpi, 77% of pigs were still positive for NA. After that, the homologous challenge resulted in a booster for IgG, IgA, NA, as well as specific-PEDV IgG, IgA and IFN-γ secreting cells. In spite of that, PEDV was detected in faeces of all pigs from group A, indicating that the immune response did not prevent reinfection although the duration of the viral shedding and the total load of virus shed was significantly lower for previously challenged pigs (p<0.05). Taken together, the results indicated that, potentially, maintenance of PEDV infection within an endemic farm may occur by transmission to and from previously infected animals and also indicates that sterilising immunity is shorter than the productive life of pigs.
Additional Features of Food Induced Immediate Reaction in the Esophagus (FIRE) in a S...
Mark Holbreich
Alex Straumann

Mark Holbreich

and 1 more

January 05, 2021
Additional Features of Food Induced Immediate Reaction in the Esophagus (FIRE) in a Series of Adult Patients with Eosinophilic EsophagitisTo the EditorEosinophilic esophagitis (EoE) is a chronic disease characterized clinically by symptoms related to esophageal dysfunction and histologically by eosinophil predominant inflammation. The predominant symptom in adults with active EoE is solid food dysphagia due to the high incidence of esophageal stricture formation. A quantitative tool has been developed to characterize the nature of these symptoms (1). Most typically patients complain of food going down slowly, food getting stuck and pain. These symptoms are most likely to occur during the passage of dense solid foods such as meats, bread and rice.Recently a phenomenon with a different symptom referred to as FIRE (food induced immediate reaction in the esophagus) has been described in adults with EoE. (2). Patients with eosinophilic esophagitis describe these esophageal symptoms as distinct from dysphagia. The symptoms typically occur after the food has been swallowed with rapid onset esophageal discomfort often described as tightening or pressure but without the sense of dysphagia. A large series of Swiss patients with eosinophilic esophagitis were queried via a form mailed to their homes or in clinics concerning symptoms related an immediate reaction in the esophagus distinct from dysphagia (2). A significant portion (49%) reported some form of esophageal discomfort related to eating. Although certain subject characteristics in this study such as younger age of onset of EoE and higher prevalence of allergies was noted, detailed clinical information on each subject was not available for review. Here in we described a series of patients with biopsy proven eosinophilic esophagitis who describe characteristic symptoms of FIRE following a specific food ingestion. For each selected FIRE patient a detailed chart review was conducted characterizing their demographics and EoE history (Table 1) as well as characteristics of their FIRE profile (Table 2). A number of features were noted in this group of 8 EoE patients as a previously unrecognized symptom complex. The onset of symptoms most often occurred within 1-60 minutes (median 3.5 minutes) after ingestion of the food. The duration of symptoms lasted from <10 minutes to > 6 hours (median 120 minutes). Among the patients the description of discomfort was often similar consisting of a tightening or pressure in the mid sternum. The most common foods inducing symptoms were beans, melon and beer. The symptoms were significant enough that patients attempted to subsequently avoid these foods. All patients were able to distinguish between symptoms related to their pollen food allergy syndrome and FIRE.The exact mechanism of this esophageal discomfort has not been elucidated. It appears distinct from pollen food allergy syndrome. It also appears different from EoE as uncommon foods such as banana, melon and avocado were capable of invoking symptoms, notably foods more commonly associated with oral allergy syndrome. However the strong association with atopy, the rapid onset of symptoms and symptoms distinct from dysphagia suggest a local possibly immunologic factor causing an immediate esophageal mucosal response. A careful history of FIRE symptoms should be part of the routine evaluation of patients with eosinophilic esophagitis. Further investigations will be required to help better understand the frequency and mechanism of this newly described phenomenon.Conflicts of InterestMH no conflicts, AS no conflictsMark Holbreich M.D.Alex Straumann M.D.1. Schoepfer AM, Straumann A, Panczak R, et al. Development and validation of a symptom-based activity index for adults with eosinophilic esophagitis. Gastroenterology 2014;147:1255–1266.2. Biedermann, L, Holbreich, M, Atkins, D, et al. Food‐induced immediate response of the esophagus—A newly identified syndrome in patients with eosinophilic esophagitis. Allergy . 2020; 00: 1– 9.Corresponding authorMark Holbreich M.D.Allergy and Asthma ConsultantsIndianapolis IN USAmholbreich@comcast.net
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