COVID-19 and nuclear cardiology: Introducing the ‘’forward” virtual visit Angelidis G, Valotassiou V, Psimadas D, Georgoulias PNuclear Medicine Laboratory, University of Thessaly, Larissa, GreeceWe read with great interest the recent review article by Kaushik A, et al. concerning the potential role of digital health applications in the present pandemic situation [1]. As the authors noted, alternative tools are needed for the optimal management of cardiovascular patients, avoiding unnecessary visits to health care facilities. The severe acute respiratory syndrome – coronavirus – 2 (SARS-CoV-2) can invade the cardiovascular cells, potentially causing life-threatening cardiac impairment [2]. In particular, patients with pre-existing cardiovascular diseases are characterized by a higher risk of adverse cardiovascular events. Therefore, most of those referred for nuclear cardiology techniques are expected to be at higher risk of developing serious coronavirus disease 2019 (COVID-19) complications. However, the performance of the individually required diagnostic and follow-up procedures is important [3].Telemedicine applications have been used in public health emergencies, leading to several advantages in terms of safety and efficacy. In the field of nuclear cardiology, the initial evaluation of patients’ history and clinical features can take place remotely (‘’forward” virtual visit). This approach seems to be patient-centred (permitting an adequate case assessment) and conducive to self-quarantine (protecting patients, healthcare professionals, and the community from viral exposure). Importantly, possible clinical presentations of COVID-19 may be evaluated during the ‘’forward” virtual visit, as well as information regarding travel and exposure histories. Moreover, local epidemiological information may be used to adjust screening pattern, and special measures could be developed (such as isolation in dedicated ‘’hot” rooms) for patients with high-risk features. After the performance of the examination, telemedicine applications could be also used for the consultation with the patients.Telemedicine applications may contribute to a better adjustment of nuclear cardiology services under the current demanding circumstances. Of course, no telemedicine programme can be created overnight, but this approach may be of value not only during the next months but also after the end of COVID-19 pandemic [4]. For example, our nuclear medicine laboratory is located in central Greece providing services to inhabitants of mountain villages, and nearby small islands. Consequently, the use of telemedicine applications could aid our practice in the future as well, particularly during the winter months when travelling by car or sea travels may be extremely demanding.

Fatigue tests under high static pre-stress loads can provide meaningful results to better understand the time-dependent failure characteristics of rock and rock-like materials. However, fatigue tests under high static pre-stress loads are rarely reported in precious literatures. In this study, the rock specimens were loaded with a high static pre-stress representing 70% and 80% of the UCS, and cyclic fatigue loads with a low amplitude (i.e., 5%, 7.5% and 10% of the UCS) were applied. The results demonstrate that the fatigue life decreased as the static pre-stress level or amplitude of fatigue loads increased for all rock types, and the high static pre-stress affected the fatigue life greatly when the static pre-stress was larger than the damage stress of rocks in uniaxial compression test. The accumulative fatigue damage exhibited three stages during the fatigue failure process: crack initiation, uniform velocity, and acceleration, and so the fatigue modulus showed an “S-type” change trend. The lateral strain and volumetric strain had a much higher sensitivity to the cyclic loading and could be used to predict fatigue failure characteristics, and it was found that volumetric strain “ε” _“v” = 0 is a threshold for microcracks coalescence and is an important value for estimating the fatigue life.

Background: Trans-catheter ablation of drug refractory atrial fibrillation (AF) is an effective and safe treatment to avoid arrhythmia recurrences. However, some patients may present anatomic variant making impossible an inferior venous approach. We report a case of pulmonary veins isolation (PVI) with cryoballoon technology via right internal jugular vein (RIJV) access. Methods: After the first trans catheter PVI attempt was failed due to inferior vena cava (IVC) hypoplasia, cryoballoon ablation with a 28-mm cryoballoon (AFAPRO - Medtronic CryoCath LP, Quebec, Canada) via superior venous access was performed. A quadripolar electrode was inserted in coronary sinus from left basilic vein. The right internal jugular vein was accessed with Seldinger technique and left atrial (LA) catheterization was performed via single trans-septal puncture (TP) under trans-esophageal echocardiographic (TOE) and fluoroscopy guidance using an SL2 (St. Jude Medical) trans-septal sheath with a BRK2 (St. Jude Medical) needle. All pulmonary veins (PVs) were engaged. Cryothermal energy was delivered after checking the correct occlusion and PVI was successfully obtained for all PVs. The procedure lasted 210 min, fluoroscopy time was 55 min. During the 16-month follow-up no sustained atrial arrhythmia recurrence was detected. Conclusion: PVI with cryoballoon technology in patients with hypoplasia of IVC can be safely and successfully performed using right internal jugular access.

Spinal subdural hematoma (SSDH) was rarely reported in association with COVID-19. A fifty-five-year-old febrile male was presented with sudden onset of areflexic paraparesis, urinary retention, loss of all sensations below the twelve spinal thoracic segment, and severe back pain. COVID-19 was confirmed by positive RT-PCR and spinal MRI showed SSDH.

Emicizumab is a prophylaxis for patients with severe haemophilia A with inhibitor. Despite the daily prophylaxis, coagulation states stay below normal value and cannot be assessed by standard hemostasis techniques. In our two patients, we use thrombin generation assay (endogenous thrombin potential (ETP) and Peak) to monitor the patient’s clotting status. Under emicizumab, it is needed to add by-passing agent such as FVIIa (Novoseven®) to avoid bleeding before surgery. By-passing agent dose was chosen with the help of thrombin generation assay and after collegial concertation.

Lorlatinib is an anaplastic lymphoma kinase tyrosine kinase inhibitor for the treatment of non-small-cell lung cancer. We report a case in which visual and auditory hallucinations developed while receiving lorlatinib.

Abstract: Global climate change is gradually changing the distribution and diversity pattern of species. In order to study the change of distribution area and distribution barycenter of Bufo gargarizans under climate change, we adopted the maximum-entropy modeling (Maxent) model and barycenter migration analysis. And four General circulation models (GCMs) under four representative concentration pathways (RCPs), 29 environment variables (including bioclimate, topography, habitat and human impact) were used to predict the current and future (2050 and 2070) distribution of B. gargarizans. The results show that the Mean temperature of Driest quarter (Bio9), Precipitation of driest month (Bio14) and population (POP) have greater influence on the distribution of B. gargarizans, it indicates that climate and anthropogenic factors have greater influence on the distribution of B. gargarizans than other environmental factors such as topography and landform. And in the next 30 to 50 years, from the perspective of the large spatial scale of the whole China, the distribution area of B. gargarizans is in the eastern part of China, the southeastern part is reduced, and the Midwest and northwest part is expanded. On the whole, the suitable habitat of B. gargarizans will be reduced in the future and will migrate to the high latitude and altitude area. In this study, B. gargarizans was used as a sentinel species to study the response of amphibians to climate change, this paper aims to reveal the mechanism of amphibian response to climate change from the current and future dispersal patterns of B. gargarizans.

Herbivore insects acquire microorganisms from host plants or soil, but it remains unclear how the diversity and functional composition of host plants contribute to structuring herbivore microbiomes. Within a controlled tree-diversity setting, we used DNA metabarcoding of 16S rRNA to assess the contribution of Lepidoptera species and their local environment (particularly, tree diversity, host tree species, and leaf traits) to the composition of associated bacterial communities. In total, we obtained 7,909 bacterial OTUs from 634 caterpillar individuals comprising 146 species. Tree diversity was found to drive the diversity of caterpillar-associated bacteria both directly, and indirectly via effects on caterpillar communities, and tree diversity was a stronger predictor of bacterial diversity than diversity of caterpillars. Leaf toughness and dry matter content were important traits of the host plant determining bacterial species composition, while leaf calcium and potassium concentration influenced bacterial richness. Our study reveals previously unknown linkages between trees and their characteristics, herbivore insects, and their associated microbes, which contributes to developing a more nuanced understanding of functional dependencies between herbivores and their environment, and has implications for the consequences of plant diversity loss for trophic interactions.

Conduction variability at the mitral isthmus lesion; What is the mechanism?

Evolution RL sheath with its bidirectional rotational mechanism is an effective and safe technique for transvenous lead extraction of chronically implanted leads. However, data about powered mechanical sheath through jugular vein are lacking. Our report suggest that bidirectional rotational mechanical sheath may represent an effective and safe approach for removal of chronically implanted jugular lead.

This paper presents a study of the performance of a gas cyclone with a cylindrical filter face installed in the center from the vortex finder to the bottom hopper. The experimental results show that this composite cyclone can have a higher collection efficiency and a lower pressure drop than those of the gas cyclone. In addition, the outer vortex of the composite cyclone removes coarse particles and the filter can block fine particles outside the inner vortex, which will significantly increase the collection efficiency, especially for fine particles. The flow field of the composite cyclone is simulated by computational fluid dynamics with the Reynolds stress model to model turbulence and the porous media model for the filter. The result shows that the swirling disappears in the vortex finder and the kinetic energy dissipation lowers with the filter installed, which remarkably decreases the pressure drop.

U.S. computing leaders, including the National Science Foundation, have partnered with universities, government agencies, and the private sector to accelerate research into responses to COVID-19 – providing an unprecedented collection of resources that include some of the fastest computers in the world. This current work expands on last month's Leadership Computing article by continuing to showcase the range of contributions that the national cyberinfrastructure is making to global efforts to stop the pandemic. This article touches on research efforts to learn how SARS-CoV-2 spreads among different populations, the biology and structure of the virus and its mechanisms of infection, and to develop effective vaccines for prevention and antiviral therapies for treatment. Even though we are still early in the process of developing an effective therapeutic response, the rapid mobilization of the national research cyberinfrastructure is a timely reminder of the strategic importance of robust, ongoing investments in large-scale scientific computing.

The Podocarpus Nagi kernel oil was prepared and its chemical constituents were confirmed accordingly in this work. The constituents and the contents of the obtained oil were identified as: total flavonoids (4.2%, calculated according to the rutin), (9Z,12Z)-9,12-octadecadienoic acid(38.2%), arachidic acid(0.11%), cis-11-eicosenoic acid(1.40%), cis-11,14-eicosadienoic acid(8.04%), ꞷ-3(0.2%), ꞷ-6(48.0%), ꞷ-9(21.0%), vitamin E(2.11mg/100g). The microelements in this oil was also tested using ICP-MS and the results exhibited that this oil contains numbers of microelements beneficial for human health: such as V(0.006μg/g), Cr(0.024μg/g), Mn(40.109μg/g), Fe(2.292μg/g), Co(0.007μg/g), Zn(4.316μg/g), As(0.009μg/g), Se(0.240μg/g), Sr(0.453μg/g). Then, the oil was evaluated for its in vitro antioxidant effect against DPPH⸱, which exhibited noteworthy scavenging ability against DPPH⸱. In addition, the oil was also evaluated for its preliminary in vitro anticancer activity against four cancer cell lines: the results showed that it exhibited the highest inhibition against gastric cancer, breast cancer (MCF-7), lung cancer(A549) and Hela cell lines with the highest inhibitions of 64.30%±2.80, 52.87%±2.57, 93.21%±2.24 and 88.33%±2.08 at the concentrations of 25mg/mL, 25mg/mL, 50mg/mL and 50mg/mL, and with the IC50s of 48.47mg/mL, 763.14mg/mL, 11.47mg/mL and 23.77mg/mL respectively. These findings demonstrated that this oil can be regarded as the functional edible oil by comparing the contents of edible oils used in the field of food.

Lateral root (LR) formation is coordinated by both endogenous and external factors. As biotic factors, Plant growth-promoting rhizobacteria (PGPRs) can affect LR formation, while the regulation mechanism is unclear. In this study, by applying various marker lines, we found that volatile compounds (VCs) from PGPR strain Bacillus amyloliquefaciens SQR9 induced a high frequency of oscillation and prebranch site formation, and further accelerated the development and emergence of the lateral root primordia (LRP), thus promoting LR development in model plant Arabidopsis. We demonstrated a critical role of auxin on SQR9 VCs-induced lateral root formation via respective mutants and pharmacological experiments. Our results showed that the YUC9 (YUCs)-mediated auxin biosynthesis, polar auxin transport, and auxin signaling pathway are involved in SQR9 VCs-induced LRs formation. We further showed that acetoin, a major component of SQR9 VCs, is less active in promoting root development compared to SQR9 cells, suggesting uncharacterized VCs might contribute to SQR9 effect in mediating LR formation. In summary, our study revealed a novel mechanism of PGPR-produced VCs in regulating LR branching in a non-contact manner, and further efforts will explore useful VCs to promote plant root development.

L’analisi integrata degli aspetti socio-economici è eseguita mediante il modello DPSIR: uno strumento capace di valutare la catena causale che conduce all’alterazione ambientale, misurata attraverso gli indicatori ambientali. Questi sono organizzati in una logica di sistema in grado di rispondere a domande politiche e per supportare tutte le fasi decisionali, che hanno come obiettivo azioni sostenibili per l’ambiente. Per valutare lo stato ambientale, sociale ed economico del territorio in esame, con riferimento al settore turistico, nasce, nel 2000, il Progetto S19 “Calcolo della Capacità di Carico e della Sostenibilità del Parco Nazionale del Vesuvio”, facente parte del Progetto Integrato Territoriale “Vesevo”.

Children less than 18 years of age account for an estimated 500,000 to 1.5 million global SARS-CoV-2 cases. Lower prevalence of COVID-19 among children, in addition to higher numbers of mild and asymptomatic cases, continues to provide challenges in determining appropriate prevention and treatment courses. Here, we summarize the current evidence on the transmission, clinical presentation, complications and risk factors in regards to SARS-CoV-2 in children and highlight crucial gaps in knowledge going forward. Based on current evidence, children are rarely the primary source of secondary transmission in the household or in child care and school settings and are more likely to contract the virus from an adult household member. Higher transmission rates are observed in older children (10-19 years old) compared to younger children (<10 years old). While increasing incidence of COVID-19 in neonates raises the suspicion of vertical transmission, it is unlikely that breast milk is a vehicle for transmission from mother to infant. The vast majority of clinical cases of COVID-19 in children are mild, but there are rare cases that have developed complications such as multisystem inflammatory syndrome in children (MIS-C), which often presents with severe cardiac symptoms requiring intensive care. Childhood obesity is associated with a higher risk of infection and a more severe clinical presentation. Although immediate mortality rates among children are low, long-term respiratory and developmental implications of the disease remain unknown in this young and vulnerable population.

INTRODUCTION: Recurrent pulmonary infections, wheezing and stridor due to swallowing dysfunction, esophageal dysmotility, gastroesophageal reflux, tracheomalacia and bronchomalacia are frequently seen complications after esophageal atresia and tracheo-oesophageal fistula (EA-TEF) surgeries. This study aimed to investigate the frequency and causes of respiratory problems and to evaluate the factors that affect respiratory morbidity in patients who had undergone EA-TEF repair in a tertiary referral center. METHODS: Preoperative and postoperative records of patients with EA, TEF+EA and isolated EA were examined retrospectively. Accompanied diseases and swallowing dysfunction symptoms were questioned. Bronchoalveolar lavage results were investigated if the patient had flexible bronchoscopy. RESULTS: A total of 71 children with EA were included in the study, and seven patients who did not have follow-up after surgery were excluded. 46 of the 64 patients continue regular follow-up visits in our department. Male sex, primary EA repair in another center, EA type C, accompanying genetic anomalies, severe tracheomalacia, late per oral feeding (1 year after surgery), and severe GER were found to cause significantly higher incidence of coughing, recurrent wheezing, recurrent pneumonia, and bronchiectasis despite surgical and medical treatments (p = 0.048, p = 0.045, p = 0.009, p = 0.029, p = 0.025) CONCLUSİON: Even if anatomical anomalies are corrected by surgery in patients who underwent EA repair, precautions can be taken for GERD, laryngotracheomalacia, and swallowing dysfunction, and effective pulmonary rehabilitation can be initiated with early multidisciplinary approach before the development of respiratory tract symptoms.

Background. Eicosanoids are potent regulators of homeostasis and inflammation that play an important role in asthma pathophysiology. In a controlled human exposure study, we showed that coexposure to an allergen and diesel exhaust (DE) led to eosinophilic inflammation, impaired airflow, and increased airway responsiveness. Eicosanoids may mediate the mechanism by which these exposures impair lung function. Methods. We conducted a randomized, double-blinded, four-arm crossover study. Fourteen allergen-sensitized participants were exposed to four conditions: filtered air and saline (FA-S; negative control); filtered air and allergen (FA-A; allergen alone); DE and allergen (DE-A; coexposure); and particle-depleted DE and allergen (PDDE-A; coexposure with minimal particles). Quantitative metabolic profiling of urinary eicosanoids was performed using LC-MS/MS. Results. Allergen inhalation increased urinary eicosanoids. The prostacyclin metabolite 2,3-dinor-6-keto-PGF1α increased with DE-A, but particle depletion (PDDE-A) suppressed this pathway. Baseline airway hyperresponsiveness modified the allergen-induced increase in prostaglandin D2 metabolites (tetranor PGDM and 2,3-dinor-11β-PGF2α) such that normally responsive individuals showed a greater allergen-induced increase of the two metabolites. Genetic risk scores (GRS) modified the effect of DE-A; those individuals with a high GRS demonstrated a greater increase in isoprostane metabolites following DE-A. Increased urinary leukotriene E4 and tetranor PGDM correlated with increased airway responsiveness, while increased tetranor PGDM also correlated with decline in FEV1. Conclusions. Impaired airflow and increased airway responsiveness upon exposure to DE-A may be attributable to increased levels of leukotrienes and prostaglandins. Variants in genes known to mediate response to pollution appear to modulate these eicosanoid-mediated physiological responses known to contribute to asthma pathophysiology.

A-30-years-old-primigravida-patient with significant vaginal bleeding for 1-week following amenorrhea for 2-months and a positive pregnancy test. Duplex-US findings were suggesting cervical molar-pregnancy. Systemic methotrexate was administered as first-line therapy but necessitated dilatation-and-curettage followed by intracervical-diluted-vasopressin and adequate intracervical foley’s-balloon inflation to control bleeding but it was failed. Then, we resorted modified novel management of cervical molar pregnancy and its complications as uterine artery embolization with embologent gelfoam “slurry” soaked with methotrexate called trans-arterial-chemo-embolization (gTACE) for an immediate successful hemostatic measure to save the life and uterus of the patient suffering from rare manifestations of gestational trophoblastic disease.

Clay aquitards are semipermeable membranes that allow groundwater flow while retarding solute migration have been researched extensively but also subjected to much debate. In this study, we collected clay samples from drilling cores (30–90m) in the Hengshui area located in the Hebei Plain, then extracted pore water using a high-pressure squeezing device. Vertical hydrochemical and isotopic profile variation trends for the pore water were revealed using hydrochemical (Cl－, Na+, Ca2+, K+, Mg2+, and SO42-) and stable isotopic measurements of H, O, and Cl. The results showed that the hydrochemical clay interlayer pore water of the saline aquifer is Cl•SO4-Na•Mg type and the average total dissolved solids（TDS）is 10.17g/L. The hydrochemical clay aquitard pore water is of the Cl•SO4-Na•Ca type with an average TDS of 1.9g/L. The hydrochemical clay interlayer pore water of aquifer II is of Cl-Na•Ca type with an average TDS of 1.1g/L. Our results showed that the water quality of the aquifer II is not affected by the upper part of saline aquifer, thus the clay aquitard acts as a significant barrier to salt movement. A polarization layer concentrated in ions was formed between the upper part of saline aquifer and the clay aquitard. The concentration polarization layer increases the salt-inhibition effect. Isotpic H, O, and Cl results showed significant fractionation. The pore water of aquifer II lacked heavy isotopes(D、18O、37Cl), but had significant heavy isotope enrichment in the concentrated polarized layer (the δD value was -76‰, the δ18O value was -8.4‰, and the δ37Cl value was 1.59‰). Hyperfiltration thus played a significant role in isotope fractionation.

Contrary to remarkable advances within the cell therapy industry, scientists expose dissatisfied challenges associated with the preservation and post-thaw cell death globally. Post cryopreservation apoptosis is normally observed in cultures and scientists are focusing on incorporation of apoptosis inhibitors. Impressive transport of cells without affecting their survival and function is a crucial and pivotal factor in any practical cell-based therapies. Preservation of cells permits the transportation of cells between distances, as well as improvement of safety and quality control testing in clinical and research applications. The prosperity of transportation methods is evaluated through the viability and proliferation percentages of the transported cell. For many decades, the conventional methods of transferring cells globally having adverse effects and speculated to be a challenging and expensive method. The main purpose of some studies is the optimization of cell survival after cryopreservation. In the new generation of cryopreservation science, various experiments wish to discover suitable and alternative methods for cell transportation to ship viable cells at ambient temperature without dry ice or in media filled flasks. In this review we try to represent a summary of the detection of recent studies including dry preservation, hypothermic preservation, agarose-gel based method, polymer based cryogel matrix, encapsulation method, fibrin microbeads, osmolyte solution composition, collagen-based scaffold, natural zwitterionic betaine, bio-inspired cryo-ink that have been performed alternative, effective and economic methods for shipping viable cells at ambient temperature.

Hydrogen sulfide (H2S) is an asphyxiating industrial poison, which is likely to cause serious damage to myocardial function and even cause cardiogenic shock after poisoning. The injury is insidious and tardive but the consequences are serious, so it needs to be prevented and treated in time. We herein present a case of an otherwise healthy 51-year-old man who developed into cardiogenic shock dynamically after poisoning and treated successfully with IABP and VA-ECMO.

Objectives: Assess first trimester serum placental growth factor (PLGF), soluble fms-like tyrosine kinase-1 (sFLT-1), interleukin-6 (IL-6), tumour necrosis factor-α (TNF-α), endothelin and vascular cell adhesion molecule (VCAM) in women with chronic hypertension (CH) stratified according to blood pressure (BP) control. Design: Case-control. Setting: Tertiary referral centre. Population: 650 women with CH, 142 normotensive controls. Methods: In the first trimester, patients with CH were subdivided into 4 groups. Group 1 included women without pre-pregnancy CH presenting with BP ≥140/90mmHg. Groups 2-4 had pre-pregnancy CH; in group 2 the BP was <140/90mmHg without antihypertensive medication, in group 3 the BP was <140/90mmHg with antihypertensive medication and in group 4 the BP was ≥ 140/90 mmHg despite antihypertensive medication. PLGF, sFLT-1, IL-6, TNF-α, endothelin and VCAM were measured at 11+0-13+6 weeks’ and converted into multiples of the expected median (MoM) using multivariate regression analysis in the controls. Main outcome measure: Comparisons of MoM values of PLGF, sFLT-1, IL-6, TNF-α, endothelin and VCAM between the 4 CH groups and the controls were made using analysis of variance or Kruskal-Wallis tests. Results: In the CH groups, compared to controls, PLGF was reduced in groups 2-4, sFLT-1 was reduced in groups 2 and 3, endothelin was increased in groups 1 and 4 but IL-6 was reduced in group 4. Conclusion: In women with CH, differences exist in first trimester angiogenic and inflammatory profiles according to BP control. Further evaluation is needed to determine if these differences are useful in the stratification of care.

Objective To describe ethnic differences in plasma lipid levels and their changes during pregnancy to postpartum. Design Population-based cohort study Setting Primary antenatal care, Eastern Oslo, Norway Population or Sample Healthy pregnant women, 59% with ethnic minority background (n=806). Methods Fasting lipid levels were measured at gestational week (GW) 15, 28 and 14 weeks postpartum. We performed linear regression models and linear mixed models to explore the total effect of ethnicity on lipids, adjusting for GW or week postpartum, age and education. Main Outcome Measures Levels of triglycerides, HDL-, LDL- and total cholesterol. Results At GW 15, triglyceride levels were lower in women of African origin (1.03 mmol/mol (95% CI: 0.90, 1.16)) and higher in women of South Asian (1.42 mmol/mol (1.35, 1.49)) and East Asian origin (1.58 mmol/mol (1.43, 1.73)) compared with Western Europeans (1.26 mmol/mol (1.20, 1.32)). Women of Asian and African origin had a smaller increase in triglycerides, LDL and total cholesterol from GW 15 to 28. At GW 28 LDL-cholesterol levels were lowest among East Asians at (3.03 mmol/mol (2.72, 3.34)) compared with Western Europeans (3.62 mmol/mol (3.50, 3.74)). Triglyceride and HDL-cholesterol levels were lower postpartum than in early pregnancy in all groups, but LDL-cholesterol levels were higher, except in Africans. South and East Asian women had lower HDL-cholesterol and higher triglycerides postpartum, while African women had lower triglyceride levels than Western Europeans. Conclusion We found significant differences in lipid levels and changes during pregnancy and the early postpartum period related to ethnic origin.