The Impact of COVID-19 on Surgery and Procedures: A CommentaryFrank H Annie, PhD1; Jaineet Singh Chhabra3; Aravinda Nanjundappa, MD2;1CAMC Health Education and Research Institute3200 MacCorkle Ave. SE, Charleston, WV 25304.2CAMC Vascular Center of Excellence, Charleston Area Medical Center.3200 MacCorkle Ave SE, Charleston, WV 253043Marshall University, School of Medicine.1600 Medical Center Dr, Huntington, WV 25701

Introduction: Emergency airway management necessitates decisive action by all involved in the care of the patient, yet there is no standardized method for teaching these skills. The goal of this quality improvement project was to design and implement a simulation-based departmental training course aimed at otolaryngology-head and neck surgery residents and surgical technologists focusing on airway management. Methods: This was a single-center departmental quality improvement project. A one-day course in July 2019 consisted of five instructional stations including an adult airway management and fiberoptic intubation, endotracheal intubation and surgical airway management, pediatric airway management, rigid bronchoscopy, and emergency airway supplies. Participants completed a pre-test knowledge assessment and a survey of their comfort level as well as various timed procedures. After the course, participants completed another knowledge assessment and survey of comfort level. Results: A total of 18 participants completed the course. The average knowledge test scores improved significantly from 59.1% to 75.8% following training (p=0.02). The average levels for comfort with all aspects of airway management significantly increased after completing the course. The time to successful endotracheal intubation with video-assisted laryngoscopy improved from 88.3 seconds before the course to 29.7 seconds after instruction (p=0.001). Conclusion: Implementation of a departmental emergency airway management course is feasible and useful for both residents and novices, including surgical technologists, to be able to assist in these high-stakes situations.

Five Key PointsTeam debrief is known to improve teamwork and safety.In our study of various staff groups, a third of did not have access to debrief.Exposure to team debrief was associated with better Culture of Care Barometer scores.Quality of debrief matters also: staff found structured, coaching and manager-led meetings to be more effective, useful and engaging than debriefs consisting of quick comments or informal discussion only.Debrief could be one of the ways to improve team culture.Keywords: debrief, surgical specialties, culture, coaching, professional burnout, staff engagement, operating rooms, WHO Surgical Safety Checklist

Frank H Annie, PhD1; Aravinda Nanjundappa, MD2;1CAMC Health Education and Research Institute3200 MacCorkle Ave. SE, Charleston, WV 25304.2CAMC Vascular Center of Excellence, Charleston Area Medical Center.3200 MacCorkle Ave SE, Charleston, WV 25304

In the present study, the highly pathogenic bovine Deltapapillomavirus (δPV) was investigated by liquid biopsy in blood samples of 168 clinically normal goats using both droplet digital PCR (ddPCR) and quantitative real time PCR (qPCR). Overall, ddPCR detected BPV E5 DNA in ~61.3% of the blood samples examined, while real time qPCR revealed the virus in ~10.7% of the same samples. Moreover, ddPCR showed BPV E5 DNA in ~78.8% of blood samples from goats that were in close contact with cattle and in 20% of blood samples from goats living in closed pens without any contact with cattle. In addition, ddPCR revealed a single BPV genotype in ~59.2% and multiple genotypes in ~40.8% of goats harboring BPV DNA, while real time qPCR detected single genotypes in ~17% and multiple genotypes in ~1%. Of the BPV co-infections detected by ddPCR, 28 (~67%) involved two genotypes, eight (~19%) three genotypes, and six (~14%) four genotypes. In contrast, real time qPCR revealed BPV co-infection by two genotypes in only one sample and failed to detect co-infection by three or four genotypes. BPV2 and BPV13 were the most prevalent viruses responsible for single and multiple co-infections, respectively. The present study showed that the ddPCR technique has much higher sensitivity and specificity in the detection of these viruses, and suggested that animal husbandry practices contribute to cross-species transmission of BPVs.

Fauna biodiversity assessments often rely on traditional biomonitoring techniques such as camera traps, which may have biases that lead to gaps in biodiversity data. Environmental DNA (eDNA) has emerged as a new source of biodiversity data that may account for these gaps. However, eDNA biodiversity assessment remains relatively untested in terrestrial environments. We compared vertebrate detections using two independent monitoring methods: camera traps and eDNA (n = 160), across two sites in south-western Australia. We also investigated the suitability of tree hollow sediment as a source of eDNA, and the effect of other factors (visitation frequency and timing, animal size) on vertebrate species detectability. We detected 31 taxa with eDNA and 47 with camera traps of which 14 overlapped (12 mammals and 2 birds). Tree hollow sediment detected a wider range of biodiversity than did soil at the entrance of the hollow. By comparing camera trap data with eDNA sequence reads, we were able to detect animals with eDNA that had visited the area up to two months prior to sample collection, with a negative correlation between sequence read amount and days since last recorded detection via camera. “Large” animals (>3kg) detected via camera were associated with significantly higher sequence read amounts than smaller animals. Our results show the effect of substrate selection, frequency of sampling and animal size, on eDNA based surveys. If the aim is to detect broad taxon diversity eDNA based approaches need to be complemented by traditional vertebrate survey methods.

In this paper, we present the design and implementation of a smart irrigation system using Internet of Things (IoT) technology, which can be used for automating the irrigation process in agricultural fields. It is expected that this system would create a better opportunity for farmers to irrigate their fields efficiently, as well as eliminating the field’s under-watering, which could stress the plants. The developed system is organized into three parts: sensing side, cloud side, and user side. We used Microsoft Azure IoT Hub as an underlying infrastructure to coordinate the interaction between the three sides. The sensing side uses a Raspberry Pi 3 device, which is a low cost, credit-card sized computer device that is used to monitor in near real-time soil moisture, air temperature and relative humidity, and other weather parameters of the field of interest. Sensors readings are logged and transmitted to the cloud side. At the cloud side, the received sensing data is used by the irrigation scheduling model to determine when and for how long the water pump should be turned on based on a user-predefined threshold. The user side is developed as an Android mobile app, which is used to control the operations of the water pump with voice recognition capabilities. Finally, this system was evaluated using various performance metrics, such as latency and scalability.

Author BlockFrank H Annie, PhD1, Mark C Bates, MD2, Aravinda Nanjundappa,MD2, Ali Farooq, MD2, Elise Anderson, MD2, Megan Wood, DNP21CAMC Health Education and Research Institute3200 MacCorkle Ave. SE, Charleston, WV 25304.2CAMC Vascular Center of Excellence, Charleston Area Medical Center.3200 MacCorkle Ave SE, Charleston, WV 25304

Background: Anaphylaxis to fire ant venoms (Solenopsis sp) is a significant cause of systemic reaction caused by Hymenoptera stings in children. There are only a few reports about the safety and efficacy of specific immunotherapy. Objective: Evaluate clinical characteristics, IgE and IgG4 specific responses of patients undergoing immunotherapy with a whole-body extract of Solenopsis sp after one year of the maintenance phase. Materials and methods: Thirty-three patients were enrolled due to anaphylaxis by fire ant venom (Solenopsis sp) and underwent specific immunotherapy. They were assessed at baseline and one year after the beginning of the maintenance phase for skin test; specific venom IgE and IgG4 antibodies; tryptase. Results: All patients included presented a severe anaphylactic reaction. Although two patients (6.25%) presented a tryptase level higher than 11.4 ug/ml, systemic mastocytosis was ruled out. There was no relationship between the severity of the reaction with gender, tryptase level, atopy, previous reactions, the allergen’s concentration in the skin test or specific IgE level. There was an increase in the specific IgG4/IgE ratio between the two time points. Reactions were local, with only two mild systemic reactions during the build-up phase. Twenty patients had accidental stings during immunotherapy, with 3 presenting only urticaria. Conclusions: This study is unprecedented in evaluating clinical and laboratory data in the fire ant immunotherapy. Our results show that after one year of the maintenance phase, patients did not develop any severe reaction with only a few mild reactions and presented a significant production of specific IgG4.

The current decline of invertebrates worldwide is alarming. Several potential causes have been proposed but heavy metals, while being a widespread and major pollutants of air, soils and water, have so far been largely overlooked. Here, we ran a meta-analysis of 527 datasets on the effects of arsenic, cadmium, lead and mercury on terrestrial invertebrates. These four well-studied metals, for which international guidelines exist, significantly impact the physiology and behavior of invertebrates, even at levels below those recommended as ‘safe’ for humans. Our results call for a revision of the regulatory thresholds to better protect terrestrial invertebrates, which appear to be more sensitive to metal pollution than vertebrates. More fundamental research is needed to improve international guidelines for metal pollutants, and to develop conservation plans to mitigate invertebrate declines and protect ecosystem services.

Scientific data has traditionally been distributed via downloads from data server to local computer. This way of working suffers from limitations as scientific datasets grow towards the petabyte scale. A "cloud-native data repository," as defined in this paper, offers several advantages over traditional data repositories---performance, reliability, cost-effectiveness, collaboration, reproducibility, creativity, downstream impacts, and access & inclusion. These objectives motivate a set of best practices for cloud-native data repositories: analysis-ready data, cloud-optimized (ARCO) formats, and loose coupling with data-proximate computing. The Pangeo Project has developed a prototype implementation of these principles by using open-source scientific Python tools. By providing an ARCO data catalog together with on-demand, scalable distributed computing, Pangeo enables users to process big data at rates exceeding 10 GB/s. Several challenges must be resolved in order to realize cloud computing's full potential for scientific research, such as organizing funding, training users, and enforcing data privacy requirements.

The Chinese Longsnout catfish Leiocassis longirostris (L. longirostris) is one of the most economically important freshwater catfish in China. It is a valuable model for studies on sexual dimorphism, comparative and conservation biology since its wild resources have declined sharply. However, there is lack of high-quality chromosome-level genome information for comparative genomic analysis and genome evolutionary studies. Therefore, we constructed the first high-quality chromosome-level reference genome for L. longirostris using a combined strategy of BGI-SEQ500, Nanopore, and Hi-C technologies. The assembled genome of L. longirostris contained a total length of 703.19 Mb with 389 contigs, and an N50 size of 4.29 Mb. Using the Hi-C data, we finally successfully generated 82 chromosome-level scaffolds anchored onto 26 chromosomes with a total length of 685.53 Mb (97.44% of the total genome sequences), ranging in size from 17.36 Mb to 43.97 Mb. A total of 23,708 protein-coding genes were identified in the L. longirostris genome, and up to 97.73% of L. longirostris genes were functionally annotated. In addition, the genome contained 239.11 Mb (33.99% in the total genome) repetitive sequences and 6,303 non-coding RNAs. The phylogenetic analysis indicated that the divergence time between L. longirostris and their closest relative species Pelteobagrus fulvidraco was approximately 26.6 million years. Collinearity analyses showed 26 chromosomes of L. longirostris displayed high homology with the corresponding scaffold (≥3M) of P. fulvidraco and the corresponding chromosomes of the Ictalurus punctatus. The high-quality reference genome of L. longirostris was assembled for the first time and will pave a way for genome-scale selective breeding, genome comparisons and evolution investigations.

Cucumber (Cucumis sativus L.) predominately translocates raffinose family oligosaccharides (RFOs) in the phloem and also accumulates RFOs in leaves under stress. Galactinol synthase (GolS) catalyzes the critical step of RFOs biosynthesis and it is interesting to know the expression pattern and function diversity of multiple GolS isoforms in cucumber. In this study, we found all four CsGolS transcripts were up-regulated by different abiotic stresses. β-glucuronidase staining and tissue separation experiments suggested that CsGolS1 expresses in vascular tissues while other three CsGolSs are located in mesophyll cells. Phylogenetic analysis revealed that except Cucurbita, GolS promoters of all other cucurbits in group I own intermediary cell (IC)-specific cis-sequences, indicating this group is responsible for RFOs loading. Further investigation indicated that CsGolS1 plays double roles in both assimilate loading and stress adaptation in the IC, which could increase the RFOs concentration in the phloem sap and then improve the assimilate transport under adverse conditions. Cold-induced IC-specific overexpression of CsGolS1 enhanced the assimilate translocation efficiency and accelerated growth rates of sink leaves, fruits and whole plants under cold stress. Finally, our results demonstrate an unique mechanism of cucumber to adapt adverse environment and provide a potential biotechnological strategy to improve stress resistance of cucurbits.

Abstract Globally, food consumption patterns are becoming more sophisticated and diversified for meeting abrupt increase in projections of food demands. The stance of availability of allergens hazard free food is a rather hectic task to implement and consumers most probably become prone to them. There is no phenomenon for investigating or identifying presence of allergens in food sample by visual inspection. So, majority of individuals possessing food intolerance have confronted with anaphylactic symptoms. Anaphylaxis is an attention attenuating concern because of its increasing invasion in different residential zones of the world. The degree of morbidity and mortality of food allergy were underestimated since a long period of times by its victims and consultant medical staff. With the passage of time the sustainability and resistance of immune regulatory responses of human being become infirm. Hence, as a result of that immune regulatory impairments human susceptible start being prone to severe anaphylactic symptoms such as shortness of breath, swelling of throat and tongue, low blood pressure, vomiting, itchy rash and tingling of nose. The causal agents for provoking anaphylaxis are mast cells and basophils. There are more or less ten prominent foods which trigger anaphylaxis after their ingestion. Hence, avoidance from being in confront with allergen food can limit proliferation of anaphylaxis.

From the massive fatigue test data analysis, we find there is a big mismatch between the fatigue life predictions done by the stress-based method (SN) and those by the strain-based method (εN) at the material’s yield stress, namely the moderate-cycle fatigue. As derived from the test data, the SN and εN methods are most widely used in engineering applications. Thus, it is necessary to address this discrepancy between the SN and the εN at material’s yield stress. For ductile metals, the moderate-cycle fatigue is a damage accumulation process in which the elastic strain and plastic strain are comparable. Yield stress is a critical point where the elastic deformation transits to the plastic deformation. Based on a normalized damage concept, we propose a data-driven approach, an elasto-plastic damage accumulation model, to address the fatigue life prediction at the yield stress. By differentiating the damages caused by the elastic and plastic behaviors, the fatigue damage of each loading cycle is formulated as a function of both stress and strain amplitudes. With introducing the strain energy density-based weighting factor for the elastic and plastic behaviors, the proposed model can accord well with the classical methods from low-cycle fatigue to high-cycle fatigue. When it comes to the material’s yield stress, the fatigue life predicted by the proposed model compares favorably with the test data of two different alloys. Therefore, beyond clarifying the mismatch between the classical approaches at the yield stress, the proposed model is expected to find extensive applications in fatigue design and damage evaluation of structures and materials at the yield stress.

Boreal forests soils are important global carbon sinks, with significant storage in the organic topsoil. Decomposition of these stocks requires oxidative enzymes, uniquely produced by fungi, of which many live in ectomycorrhizal symbiosis with the trees. Here we show that presence of a group of closely related species of ectomycorrhizal fungi – Cortinarius acutus s.l. – decreased local carbon storage in the organic topsoil by 33% across Swedish forests. Our findings challenge the prevailing view that ectomycorrhizal fungi generally act to increase carbon storage in soils and show that certain ectomycorrhizal fungi can complement free-living decomposers, maintaining nutrient cycling and tree productivity under nutrient poor conditions. The finding that a narrow group of fungi exerts a major influence on carbon cycling refutes the prevailing dogma of functional redundancy among microbial decomposers. Cortinarius acutus s.l. responds negatively to forestry, and population declines are likely to increase soil carbon sequestration while impeding nutrient cycling.

Objective: Compare the outcomes associated with laparoscopic radical hysterectomy (LRH) and abdominal radical hysterectomy (ARH) for cervical cancer. Design: Retrospective, multicenter observational analysis Setting: Select patients of LRH and ARH from cervical cancer database and compare their outcomes. Population: Patients with stage IA1 (Lymphovascular space invasion [LVSI]-positive) and stage IIA2 cervical cancer (N=6804) were enrolled, of whom 3003 underwent laparoscopy (LRH group), and 3801 underwent laparotomy (ARH group). Methods: Kaplan-Meier survival analysis,propensity score matching (PSM) and Cox regression. Main Outcome Measures: Five-year overall survival (OS) and 5-year disease-free survival (DFS) Results: Before PSM, there was no difference in outcomes between the groups (5-year OS: LRH 89.2% vs. ARH 90.6%, P=0.903.; 5-year DFS: LRH 84.5% vs. ARH 87.1%, P=0.155). Surgical approach did not affect 5-year OS; however, it did affect 5-year DFS (hazard ratio [HR]=0.827, 95% confidence interval [CI]: 0.711-0.962, P=0.014). After PSM, there was no difference in 5-year OS between the LRH (N=1828) and ARH (N=1828) groups (91.0% vs. 93.1%, P=0.220); but there was a significant difference in 5-year DFS between the LRG and ARH groups (86.2% vs. 90.6%, P=0.002). Cox regression revealed that the surgical approach did not affect 5-year OS; however, it did affect 5-year DFS (HR=0.701, 95% CI: 0.563-0.874, P=0.002). Conclusions: For IA1 (LVSI-positive) and IIA1 cervical cancers, the recurrence rate following laparoscopic surgery was higher than that following open surgery, regardless of the surgeon’s experience.

Background: Brucella transmission is a complex multisector system. A better understanding of transmission dynamics helps pinpoint the most effective interventions to reduce human cases. Modelling methodologies have not been applied extensively to brucellosis. This paper applies System Dynamics Modelling to identify the interplay between the different sectors that drive disease transmission and suggest and assess scenarios to control brucellosis. Methods: The study applied a qualitative in-depth analysis of Brucella transmission system in Jordan. Current published literature, government and policy documents were reviewed supplemented by interviews with stakeholders. Data were analysed manually to establish causal pathways to develop a Stock and Flow (SF) model. The structure was examined and reviewed by key informants. Several scenarios to control Brucella transmission were assessed. Results: The model demonstrated the complex interaction of different sectors that drove transmission. Brucella transmission among sheep and between farms and markets are the main drivers of human incidence. Farmers’ visits to veterinary clinics are a critical intervention point for control regarding access to vaccination. Vaccination by itself might not be efficient due to the low compliance of farmers. Test and cull sheep is the most efficient control strategy. Conclusions: The synthesis of the current knowledge through the model enabled better understanding, visualisation and interpretation of the sectors involved in Brucella transmission. The model highlighted specific leverage points at which the transmission could be controlled like encouraging visits to the veterinary clinics. There is a strong synergy between sectors, therefore, a greater control might be produced by utilising multi-sectoral relationships embedded in the system. This application of System Dynamics Approach to understand disease transmission systems can be used to complement other methods and detect leverage points for disease control.

Background: Current analysis methods of the vaginal microbiome often fail to identify and/or report known pathogens such as S. agalatiae (GBS), resulting in an incomplete clinical understanding of bacterial composition during pregnancy. Objective: To determine the frequency of GBS reporting in vaginal microbiome literature pertaining to pregnancy and examine methodological bias that contributes to differences in species and genus-level microbiome reporting. Search strategy: PubMed, CINAHL, and Web of Science databases were used to identify papers for review based on the search terms “vaginal microbiome”, “pregnancy”, and “16S rRNA sequencing”. Selection criteria: Forty-five research articles reported employing a metagenomic approach for vaginal microbiome analysis during pregnancy that explicitly reported taxonomic composition and were included in this review. Data collection and analysis: Articles were evaluated for methods of DNA extraction and sequencing, 16S region, taxonomy classification database, number of participants or vaginal specimens, and pregnancy trimester. Main results: Less than 30% of articles reported the presence of GBS. No significant differences in methodology were identified between articles that reported versus did not report GBS. However, large variability across the types of research methods used for vaginal microbiome analysis and species-level bacterial community reporting were observed. Conclusion: Considerable differences in study design and data formatting methods may contribute to underrepresentation of GBS, and other known pathogens, in existing vaginal microbiome literature. Providing detailed methods, analysis code and raw data may improve reproducibility and ability to compare microbial communities across studies. Keywords: vaginal microbiome, pregnancy, 16S ribosomal RNA, whole genome sequencing, Group B Streptococcus

In this manuscript, we study fractional Langevin equations(FLEs) involving Hadamard-Caputo’s derivative of distinct orders associated with nonlocal integral and nonperiodic boundary conditions. The Hyres-Ulam (HU) stability, existence and uniqueness(EU) of solutions are established for proposed equations. Our prospective is based on the Hadamard-Caputo’s derivatives and implementation of Krasnoselskii’s fixed point theorem and Banach contraction mapping principle. An application is offered to smooth the understanding of the theoretical results.

Background Immune thrombocytopenia (ITP), autoimmune hemolytic anemia (AIHA) and autoimmune neutropenia (AIN) are disorders characterized by immune-mediated destruction of hematopoietic cell lineages. A link between pediatric immune cytopenias and inborn errors of immunity (IEI) was established in particular in the combined and chronic forms. Objective Identification of predictive factors of IEI in immune cytopenic children is an important objective for a prompt immunological diagnosis and appropriate management. Aim of this study is to detect clinical and laboratory signs of IEI, in particular the latter by an extensive lymphocyte immunophenotyping. Methods We retrospectively collected 47 pediatric patients with at least one hematological disorder among which persistent/chronic ITP, AIHA and AIN, aged 0–18 years at onset of immune cytopenias and/or immune-dysregulation. The cohort was divided into 2 groups (IEI+ and IEI-), based on the presence/absence of underlying IEI diagnosis. IEI+ group, formed by 19/47 individuals, included: Common variable immune deficiency (9/19), Autoimmune lymphoproliferative syndrome (4/19), DiGeorge syndrome (1/19) and unclassified IEI (5/19). Results IEI prevalence among patients with ITP, AIHA, AIN and Evans Syndrome was respectively of 42%, 64%, 36% and 62%. In IEI+ the extended lymphocyte immunophenotyping identified the presence of statistically significant (p-value<0.05) specific characteristics, namely T/B lymphopenia, decrease in naїve T-cells%, switched memory B-cells%, plasmablasts% and/or immunoglobulins, increase in effector/central memory T-cells% and CD21low B-cells%. Conclusion A wide focused clinical/immunophenotypical characterization of pediatric patients with immune cytopenia can highlight specific signs of IEI, potentially helpful in the diagnostic and clinical management, identifying children worthy of IEI-related molecular analysis.

In December 2019, the COVID-19 outbreak began in Wuhan, China, and soon announced as a pandemic in March 2020 and Iran was no exception. Since COVID-19 is a newly emerging disease, no definite treatment exists and therapy is based upon supportive care. Many treatment regimens have been proposed and some of which have shown promising results that may be considered as the treatment of COVID-19 in the near future if confirmed by further studies. As there is no gold standard for the treatment of COVID-19 and many physicians in different countries prescribe a combination of drugs, we prescribed a combination of drugs. based on the above evidence to patients referring to our clinic. We monitored and analyzed patients with mild to moderate symptoms with the inclusion criteria of either confirmed COVID-19 cases by RT-PCR or had close contact with confirmed cases having symptoms of headache, sore throat, cough, diarrhea, unjustifiable symptoms in favor of vasculitis, and any cutaneous manifestations which last for more than 5 days. A total of thirty-three patients were included and then visited daily with their vital parameters being recorded directly. All thirty-three patients recovered from the disease with no complication after receiving the treatment and in follow up visits. Although a definite treatment for SARS-CoV-2 still remains a matter of debate, this treatment regimen showed effective treatment in patients with mild to moderate symptoms. Undoubtedly, further researches and papers are needed to be done to prove the effectiveness of this treatment regimen.

Objective: To evaluate the safety and efficacy of human stem cells for bronchopulmonary dysplasia in preterm infants. Study design: From inception to September 2020, the PubMed, Web of Science, Cochrane Library and CNKI databases as well as ClinicalTrials.gov were searched for relevant reports. All the clinical trials, case reports, case series and letters were included. The included results were analyzed by Stata 16.0. Results: There were no statistically significant differences between the trial and control groups with respect to the number of deaths (OR [95% CI]: 0.619 [0.089, 4.316]) or bronchopulmonary dysplasia cases (OR [95% CI]: 1.138[0.040, 32.36]). The incidences of serious adverse events and dose-limiting toxicities were not significantly different between the two groups. There was a significant statistical difference between the trial and control groups in the mechanical ventilation duration (P<0.05) and duration of oxygen (P<0.05). Conclusion: The infusion of human cord blood stem cells into premature infants does not increase the risk of serious adverse events or death, and this therapy may decrease the mechanical ventilation duration and duration of oxygen administration.

Abstract Background: Pediatric bronchopneumonia represents a clinical challenge, especially when it comes to the identification of its etiology. Study design: We performed a retrospective study on 100 patients admitted to our pediatric department. Only patients with bronchopneumonic consolidations were selected, discharged with a diagnosis of Community-Acquired Pneumonia (CAP) or bronchopneumonia. The purpose of our study was to identify Mycoplasma pneumonia based on lung ultrasound (LUS) findings. Methodology: At least two lung LUS were performed on each patient: on admission and few days after start of therapy, with some patients undergoing a third ultrasound evaluation approximately one week after discharge. These reports were collected for each patient together with clinical and laboratory data. The study population was divided into two groups: patients who tested positive for Mycoplasma pneumoniae (Myc-CAP) and negative ones (non-Myc-CAP). All patients performed serological test for determination of anti-mycoplasma antibodies, and in doubtful cases also molecular test with PCR on pharyngeal exudate. Results: The results obtained after statistical analysis showed no significant differences in LUS findings between the two groups, that could allow a positive differential diagnosis of Myc-CAP without resorting to laboratory testing. Conclusions: LUS undoubtedly represents a valid and irreplaceable help in the morphological study of pulmonary lesions over the course of disease from the time of admission to follow-up.