Aim: The common cardiac toxicities of hydroxychloroquine (HCQ) and azithromycin(AZ) are not well defined in COVID -19 patients . The purpose of this study was to evaluate ventricular repolarization in COVID-19 patients treated with HCQ and AZ using iCEB, Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio. Methods: This retrospective study enrolled 164 patients diagnosed with COVID-19 pneumonia in the Emergency Department (ED) and then transferred to the medical floor or ICU in April 2020 Result: A total of 164 patients were mean aged 47 ± 18 years (range, 18-97 years) and 83 (50.6%) were women in study population. Group HTQ had 38 patients , Group HTQ + AZ had 126 patients. On the 5th day of hospitalization heart rates (HR) were significantly lower than ED (p<0,001). On the 5th day of hospitalization QTc , QT max (V5-V6), QTmin, Tp-e (V5-V6) and iCEB values were significantly higher than ED (p=0,01and all the rest p<0,001 respectively). On the 5th day of hospitalization iCEB values of HTZ+AZ group were statistically significant higher than iCEB values of HTQ group (p=0,03). iCEBc had strong correlation between Tp-e/QT (V5). iCEBc had strong negative correlation between Tp-e (V5). Conclusion: The iCEB values were significant increased after HTQ and AZ treatment in COVID-19 patients. We think that iCEB is a more sensitive marker than QT prolongation in predicting the risk of multi-drug arrhythmia.

Aims: To evaluate the diagnostic yield of investigations performed on patients with a history of urinary tract infections (UTI). Methods: A retrospective review was conducted on patients who underwent cystoscopy and imaging for a history of UTI between 2014-2019 in a single UK teaching hospital. Data was collected on demographics, cystoscopy and radiological findings requiring further management. The cohort was stratified by age, gender, and a confirmed history of recurrent UTI (rUTI). The subsequent algorithm was re-tested in a second cohort to validate its use. Results: 700 patients were included in the primary analysis, 427 female and 273 males. 331 meet the criteria of rUTI. The median age was 64y(18-97). Imaging abnormalities were equally frequent in males 6.3%(15/241) and females 8%(30/380) and the majority noted in patients aged ≥55y, 30/45(66.7%). Amongst those who did not meet the definition of rUTI, abnormal imaging was identified in 5-7% regardless of age group and gender. Cystoscopy abnormalities (n=24) were twice more likely in males, 5.5%(15/273) than females, 2%(9/427). 88%(21/24) were identified in patients ≥55y. There were no positive findings in women <55y. Applying baseline imaging but confining cystoscopy to those aged ≥55y and men with a confirmed history of rUTI would have saved 44% of procedures, missed no abnormalities with an overall diagnosis detection rate of 9.8%(69/700). This algorithm was validated in a separate cohort of 63 patients; applying it would have saved 46%(29/63) of cystoscopies with a positive diagnostic rate of 9.5% and no missed findings. Conclusion: To our knowledge this is one of the largest studies reporting the outcomes of investigations for UTI and rUTI. Our result suggests that imaging is a useful baseline assessment, but cystoscopy should be limited to specific subgroups. We propose and validate a simple decision algorithm to manage investigations for referrals for UTI in secondary care.

About 6,000 to 7,000 different rare disorders with suspected genetic etiologies have been described and in almost 4,500 of them the causative gene(s) have been identified. The advent of Next-Generation Sequencing (NGS) technologies has revolutionized genomic research and diagnostics, representing a major advance in identification of pathogenic genetic variations. WES facilitates a faster and more cost-effective route for definite diagnosis of rare genetic disorders, minimizing previous “diagnostic odysseys” for the patients. Due to the limitation that WES is not reimbursed in Greece, we aimed to minimize cost per patient/family through applying WES in the proband, followed by targeted family segregation studies when necessary. Furthermore, for variant filtration and interpretation we applied a phenotypic-driven strategy in close collaboration with clinical geneticists or referring clinicians. In this study we report the clinical application of WES in the diagnosis of 162 cases referred to investigate patients with undiagnosed genetic disorders. The overall molecular diagnostic yield reached 52.5%. Our experience as an academic diagnostic laboratory using WES, although limited to the last two years, allowed characterization of 94 pathogenic variants in 85 positive cases, 48 of which were novel, contributing information to the community of disease and variant databases.

Bovine leptospirosis is a bacterial disease that affects bovine herds, causing economic losses due to reproductive problems, which require expensive treatments. The main source of transmission for cattle is still uncertain, but it has been described that small wild mammals can play an important role in the transmission cycle by being maintenance hosts for the pathogenic species of the bacterium and spreading it through urine. In this study, we characterize possible risk areas for bovine leptospirosis in the state of Veracruz, Mexico; based on the geographical distribution of small wild hosts of Leptospira sp. reported in Mexico in addition with climatic, geographic, land use and human activities variables, and validated risk map with bovine seroprevalence data. We used a generalized linear regression model to understand the association between the appearance of bovine leptospirosis seroprevalences and the favorability of wild hosts of Leptospira sp. as well as environmental variables. The parameterized model explains 13.58% of the variance. The seroprevalence in cattle showed a negative relationship with elevation, geographic length and human population density, and a positive relationship with environmental favorability for the bats reservoirs and favorability for at least one rodent and opossum reservoir. The variation in seroprevalence is mainly explained by a longitudinal gradient (10.4% of the variance) and the favourability for bats (3.0% of the variance). Describing the possible risks of seroprevalence in an important and neglected livestock geographical region, we contribute to the selection of areas of strategies for diagnosis and prevention of this relevant disease.

Genomic-based epidemiology can provide insight into the origins and spread of herbicide resistance mechanisms in weeds. We used kochia (Bassia scoparia) populations resistant to the herbicide glyphosate from across western North America to test the alternative hypotheses that 1) a single EPSPS gene duplication event occurred initially in the Central Great Plains and then subsequently spread to all other geographical areas now exhibiting glyphosate-resistant kochia populations or that 2) gene duplication occurred multiple times in independent events in a case of parallel evolution. We used qPCR markers previously developed for measuring the various units of the EPSPS tandem duplication to investigate whether all glyphosate-resistant plants had the same EPSPS repeat structure. We also investigated population structure using simple sequence repeat (SSR) markers to determine the relatedness of kochia populations from across the Central Great Plains, Northern Plains, and the Pacific Northwest. We identified three distinct EPSPS-duplication haplotypes that had geographic associations with the Central Great Plains, Northern Plains, and Pacific Northwest. Population structure revealed a group of populations around the first reported occurrence of glyphosate resistance in the Central Great Plains, a separate group of Pacific Northwest populations, and some relatedness of populations from geographically isolated areas. The results support at least three independent origins of glyphosate resistance in kochia, followed by substantial and mostly geographically localized gene flow to spread the resistance alleles into diverse genetic backgrounds.

One of the most pronounced effects of climate change on the world's oceans is the (generally) poleward movement of species and fishery stocks in response to increasing water temperatures. In some regions, such redistributions are already having diverse impacts on marine socioecological systems, including profoundly altering ecosystem structure and function, challenging domestic and international fisheries, and impacting on human communities. Such effects are expected to become increasingly widespread as waters continue to warm and species ranges continue to shift. Actions taken over the coming decade (2021-2030) can help us manage and adapt to species redistributions and minimise negative impacts on ecosystems and human communities, achieving a more sustainable future in the face of ecosystem change. We describe key drivers related to climate-driven species redistributions that are likely to have a high impact and influence on whether a sustainable future is reached by 2030. We posit two different futures-a 'business as usual' future and a technically achievable and more sustainable future, aligned with the Sustainable Development Goals. We then identify concrete actions that provide a pathway towards the more sustainable 2030 and that acknowledge and include Indigenous perspectives. Achieving this sustainable future will depend on improved monitoring and detection, and on adaptive, cooperative management to proactively respond to the challenge of species redistribution. We synthesise examples of such actions as the basis of a strategic approach to tackle this global-scale challenge for the benefit of humanity and ecosystems.

The isothermal kinetics of carbothermic reduction of low grade ilmenite concentrate with the addition of sodium carbonate which was regarded as a novel process to obtain high quality UGS slag used for chlorination process through the semi-molten states was studied. The results showed that the addition of Na2CO3 can reduce the start temperature of the reaction and promote the reduction, which is benefit to improve the reaction kinetic by enhancing the carbon gasification reaction. The metal iron produced during the reaction was more likely to migrate and grow with the formation of the molten phase. With the increase of sodium carbonate, the reduction process of ilmenite concentrate is gradually changed from controlled by interfacial chemical reaction to controlled by diffusion. When the amount of sodium carbonate was 0%, 3% and 6%, the apparent activation energies were 105.01, 112.07 and 123.48 kJ/mol, respectively.

In this paper, the NO adsorption performance of Rh/MOF-177 was studied by pulse method. Based on further confirming the literature molecular simulation results which NO, O2 and CO2 were adsorbed very little and N2 was hardly adsorbed, it was found that the MOF-177 material showed great carrier function, and promoted the atomic-sized high dispersion and stability of almost supported Rh particles on MOF-177. The adsorption properties of NO was greatly improved after Rh was introduced into MOF-177 which the adsorption capacity of Rh/MOF-177 with 3% Rh loading can reach about 310×10-3 mmol∙g-1 by pulse method and was about 15-20 times higher than that of O2 and CO2 with near 90% adsorption selectivity in simulated flue gas atmosphere. The NO adsorption capacity of Rh/MOF-177 was related to the reduced Rh0 which one reduced Rh0 adsorbed three NO molecules, and NO adsorption form on Rh/MOF-177 should be a trinitro-group (Rh(NO)3) species.

Earlier we have shown that certain flavonoids (e.g., quercetin and myricetin) are high-affinity reducing cosubstrates for cyclooxygenase 1 and 2 (COX-1 and COX-2). These compounds can bind inside the peroxidase active site of COX-1 and COX-2 and donate an electron from one of their B-ring hydroxyl groups to hematin. Based on these earlier findings, it is speculated that some of the natural flavonoids that are structural analogs of quercetin but lack the proper B-ring hydroxyl groups might function as novel inhibitors of COX enzymes by blocking the effect of the reducing cosubstrates. This idea is tested in the present study. Computational docking analysis together with quantum chemistry calculation shows that galangin, which shares the same overall structure as quercetin but does not have any hydroxyl group in its B-ring, can bind inside the peroxidase active sites of COX-1 and COX-2 in a similar manner as quercetin, but it has little ability to effectively donate its electrons, thereby blocking the effect of the reducing cosubstrates like quercetin. Further experimental studies confirm that galangin can inhibit, both in vitro and in vivo, quercetin-mediated activation of the peroxidase activity of COX-1 and COX-2. The results of this study demonstrate that galangin is a novel naturally-occurring inhibitor of COX-1 and COX-2, acting by blocking the function of the reducing cosubstrates at the peroxidase sites.

Angiotensin Converting Enzyme 2 (ACE2) is the receptor the new coronavirus SARS-CoV-2 binds to for cell entry. ACE2 is also an important player in the Renin Angiotensin System (RAS). ACE2 and RAS appears to be central in coronavirus disease (Covid-19) pathophysiology. Covid-19 might be regarded as a virus-induced “RAS disorder”. Drugs acting upon RAS components may offer potential therapeutic value in Covid-19. The authors advocate diminazene aceturate (DIZE), a putative ACE2 activator, as a feasible treatment option unduly disregarded a priori, likely due to lack of licensing for human use. However, DIZE has been extensively employed in African trypanosomiasis patients with little toxicity reported. With the current pandemic causing health issues on a large scale worldwide, the properties of DIZE remain to be investigated in Covid-19. A drug that is available, inexpensive and with a long track record of safe usage should be considered, particularly while effective alternatives remain scarce.

The implementation of human pluripotent stem cells (hiPSCs) in cell therapy has an extraordinary potential but faces many practical challenges, including costs associated with growth media and factors. There is an immediate need to establish an optimized culture platform to direct the differentiation of hiPSCs into germ layers in a defined nutritional microenvironment to generate cost-effective and robust therapeutics. The aim of this study was to identify the optimal nutritional environment by mimicking the in vivo concentrations of three key factors (glucose, pyruvate and oxygen) during the spontaneous differentiation of hiPSCs derived from cord blood, which greatly differ from the in vitro expansion and differentiation scenarios. Moreover, we hypothesized that the high glucose, pyruvate and oxygen concentrations found in typical growth media could inhibit the differentiation of certain lineages. A design of experiments (DoE) was used to investigate the interaction between these three variables during the spontaneous differentiation of hiPSCs. We found that lower oxygen and glucose concentrations enhance the expression of mesodermal (Brachyury, KIF1A) and ectodermal (Nestin, B-Tubulin) markers. Our findings present a novel approach for efficient directed differentiation of hiPSCs through the manipulation of media components whilst simultaneously avoiding the usage of growth factors thus reducing costs.

Ninety-four women with breast cancer who received epirubicin (360 mg/m2) underwent three-dimensional (3D) speckle tracking echocardiography (STE) at baseline, after the completion of two cycles and four cycles of the regimen respectively were enrolled in the study. 3D STE assessment included left ventricular ejection fraction (LVEF), global area strain (GAS), global longitudinal strain (GLS), global circumferential strain (GCS) and global radial strain (GRS). Meanwhile, serum high-sensitive troponin I (hs‐cTnI) and N-terminal portion pro-natriuretic peptide type B (NT-proBNP) were measured. Cancer therapy-related cardiac dysfunction (CTRCD) was defined as reduction of 3D LVEF > 10% to a value < 54%. CTRCD occurred in 9 (9.6%) patients during anthracycline treatment. The changes in 3D LVEF was not significant after chemotherapy. Values of 3D GLS and 3D GAS showed a significant deterioration during anthracycline treatment (p < 0.001 and p = 0.001, respectively) in all patients. Compared to non-CTRCD patients, the CTRCD patients had significantly reduction in 3D GLS (-15.5±3.2% vs -17.0±2.7%, p<0.001) and 3D GAS (-31.0±3.9% vs -32.3±3.3%, p<0.001) at the end of anthracycline chemotherapy. The optimal cutoff value with -15.5% of 3D GLS had a good discrimination for predicting CTRCD, with 87.5% sensitivity and 74.6% specificity. Spearman correlation analysis showed a moderate negative correlation between 3D GLS and anthracycline doses (r = - 0.54, p < 0.001). 3D GLS could potentially improve the ability for detecting early, subclinical anthracycline-related cardiotoxicity in breast cancer patients.

In microbial manufacturing, yeast extract is an important component of growth media. The production of heterologous proteins is often varied because of yeast extract composition. To identify why this reduces protein production, the effects of yeast extract compositions on the growth and green fluorescent protein (GFP) production of engineered Escherichia coli were investigated using a deep neural network (DNN)-mediated metabolomics approach. We observed 205 peaks from various yeast extracts using gas chromatography-mass spectrometry. Principal component analyses of the peaks identified at least three different clusters. Using 20 different compositions of yeast extract in M9 media, the yields of cells and GFP in the yeast extract-containing media were higher than those in the control without yeast extract by approximately 3.0–5.0 fold and 1.5–2.0 fold, respectively. We compared machine learning models and found that DNN best fit the data. To estimate the importance of each variable, we performed DNN with a mean increase error calculation based on a permutation algorithm. This method identified the significant components of yeast extract. DNN learning with varying numbers of input variables provided numbers of the significant components. The influence of specific components on cell growth and GFP production was confirmed with a validation cultivation.

Snow is Earth’s most climatically sensitive land cover type. Air temperature and moisture availability are first-order controls on snowfall. Maximum snowfall occurs at temperatures very near 0°C, so even a slight increase in temperature will shift a snowy winter to one with midseason rainfall and melt events. Traditional snow metrics are not able to adequately capture the changing nature of snow cover. For example, April 1 snow water equivalent (SWE, the amount of water represented by the snowpack) is used as a streamflow predictor. Still, it cannot express the effects of midwinter melt events, now expected in warming snow climates. The multiple impacts of a changing snowpack require a suite of climate indicators derived from readily measured or modelled data that serve as proxies for relevant snow-related and climate-driven processes. Such indicators need to be simple enough to “tell the story” of snowpack changes over space and time, but not overly simplistic as to be conflated with other variables or, conversely, overly complicated in their interpretation. This paper describes a targeted set of spatially explicit, multi-temporal snow metrics for multiple sectors, stakeholders, and scientists. They include metrics based on satellite data from NASA’s Moderate Resolution Imaging Spectroradiometer, meteorological observations and snow data from ground-based stations, and climate model output. We describe and provide examples for Snow Cover Frequency (SCF), Snow Disappearance Date (SDD), snowstorm temperature (ST), At-Risk Snow (ARS), and Frequency of a Warm Winter (FWW).

Catchment-scale response functions, such as transit time distribution (TTD) and evapotranspiration time distribution (ETTD), are considered fundamental descriptors of a catchment’s hydrologic and ecohydrologic responses to spatially and temporally varying precipitation inputs. Yet, estimating these functions is challenging, especially in headwater catchments where data collection is complicated by rugged terrain, or in semi-arid or sub-humid areas where precipitation is infrequent. Hence, we developed practical approaches for estimating both TTD and ETTD from commonly available tracer flux data in hydrologic inflows and outflows without requiring continuous observations. Using the weighted wavelet spectral analysis method of Kirchner and Neal [2013] for δ18O in precipitation and stream water, we specifically calculated TTDs that contribute to streamflow via spatially and temporally variable flow paths in a sub-humid mountain headwater catchment in Arizona, USA. Our results indicate that composite TTDs most accurately represented this system for periods up to approximately one month and that a Gamma TTD was most appropriate thereafter. The TTD results also suggested that some contribution of subsurface water was beyond the applicable tracer range. For ETTD and using δ18O as a tracer in precipitation and xylem waters, a Gamma ETTD type best matched the observations, and stable water isotopes were capable tracers for the majority of vegetation source waters. This study contributes to a better understanding of a fundamental question in mountain catchment hydrology; namely, how tracer input fluxes are modulated by spatially and temporally varying subsurface flow paths that support evapotranspiration and streamflow at multiple time scales.

Soil moisture is an important driver of growth in boreal Alaska, but estimating soil hydraulic parameters can be challenging in this data-sparse region. To better identify soil hydraulic parameters and quantify energy and water balance and soil moisture dynamics, we applied the physically-based, one-dimensional ecohydrologic Simultaneous Heat and Water (SHAW) model, loosely coupled with the Geophysical Institute of Permafrost Laboratory (GIPL) model, to an upland deciduous forest stand in interior Alaska over a 13-year period. Using a Generalized Likelihood Uncertainty Estimation (GLUE) parameterization, SHAW reproduced interannual and vertical spatial variability of soil moisture during a five-year validation period quite well, with root mean squared error (RMSE) of volumetric water content at 0.5 m as low as 0.020. Many parameter sets reproduced reasonable soil moisture dynamics, suggesting considerable equifinality. Model performance generally declined in the eight-year validation period, indicating some overfitting and demonstrating the importance of interannual variability in model evaluation. We compared the performance of parameter sets selected based on traditional performance measures (RMSE) that minimize error in soil moisture simulation, with those that were designed to minimize the dependence of model performance on interannual climate variability. The latter case moderately decreases traditional model performance but is likely more suitable for climate change applications, for which it is important that model error is independent from climate variability. These findings illustrate (1) that the SHAW model, coupled with GIPL, can adequately simulate soil moisture dynamics in this boreal deciduous region, (2) the importance of interannual variability in model parameterization, and (3) a novel objective function for parameter selection to improve applicability in non-stationary climates.

Patterns of δ18O and δ2H in Earth’s precipitation provide essential scientific data for use in hydrological, climatological, ecological and forensic research. Insufficient global spatial data coverage promulgated the use of gridded datasets employing geostatistical techniques (isoscapes) for spatiotemporally coherent isotope predictions. Cluster-based isoscape regionalization combines the advantages of local or regional prediction calibrations into a global framework. Here we present a revision of a Regionalized Cluster-Based Water Isotope Prediction model (RCWIP2) incorporating new isotope data having extensive spatial coverage and a wider array of predictor variables combined with high-resolution gridded climatic data. We introduced coupling of δ18O and δ2H (e.g. d-excess constrained) in the model predictions to prevent runaway isoscapes when each isotope is modelled separately. We validated RCWIP2 isoscape performance by cross-checking observed versus modelled d-excess values. We improved model error quantification by adopting full uncertainty propagation in all calculations. RCWIP2 improved the RMSE over previous isoscape models by ca. 0.6 ‰ for δ18O and 5 ‰ for δ2H with an uncertainty <1.0 ‰ for δ18O and <8 ‰ for δ2H for most regions of the world. The improved RCWIP2 isoscape grids and maps (season, monthly, annual, regional) are available for download at https://isotopehydrologynetwork.iaea.org.

Computation of the non-linear convective flow of couple stress nanofluid with the effect of fourth order slip flow, Cattaneo-Christov heat flux model subjected to Biot heating and mass transfer condition over the multi-dimensional stretching surface is presented here. Bvp5c is employed for numerical calculation of velocity, temperature and mass distributions under the control of few governing parameters. The results of current paper were judged with the available works in specific situations and better arrengment has been distinguished. On observing of the flow contours the result indicates that the greater amount of slip of high order the lesser the numerical value of skin friction coefficient, whereas, it is enlarged in value as the magntude of couple stress parameter rises.

Yeast has been well-used as a typical microbial platform to make fermented fine chemicals. However, various stress conditions severely restrict the production costs and benefits. One effective way to resolve such bottlenecks is to engineer transcription factors (TFs) to enhance strain tolerance and production efficiency through remodeling the transcript levels of different stress resistant genes. Here, we focus on the recent advances in the mechanisms of yeast adaptive responses upon stresses of heat, acetic acid and oxidants and classify them into different modules within yeast cells. In particular, novel strategies for the enhancement of both tolerance and yield by TFs engineering are examined. In addition, the applications of artificial transcription factor (ATFs)-based fabricating in metabolic fluxes optimization and quantitative evaluation are discussed. Lastly, we discuss challenges and potential solutions in exploiting TFs engineering and for A bio-based economy products.

This paper presents and compares two combined experimental-numerical techniques for the investigation of fracture properties of additively manufactured polymer parts using digital image correlation (DIC) measurements. The first method uses only measured kinematic fields, and the second is based on Finite Element simulations driven by measured boundary conditions. A micro Single Edge Notched Tensile sample manufactured by fused filament fabrication of ABS is studied. It is shown that both methods locally extract J-integrals, and the crack tip is accurately located by the FE-based method. By comparing computed displacements to those measured via DIC it is possible to locally check the validity of the numerical model. The initiation and propagation stages are analyzed independently thanks to two different magnifications of acquired image series

Fatigue behaviour of HIPed and stress relieved Ti6Al4V alloy specimens produced by SLM was analysed (Rε = -1). The HIP process caused a microstructural transformation decreasing the hardness and monotonic properties that not allowed fatigue strength increase. A bilinear behaviour in the elastic strain-fatigue life curve was observed, because of Young´s modulus decrease during the cyclic elasto-plastic tests consequence of subgrains formation. The Smith-Watson-Topper and total strain energy density models showed a good concordance between predicted and experimental fatigue lives in notched samples.

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause thyroid hormonal disorders. In addition, tracheal compression by thyroid nodules can aggravate hypoxia in critically-ill patients. No studies have investigated the effect of thyroid nodules on the prognosis of patients with COVID-19. In this study, we investigated the effect of thyroid hormonal disorders and thyroid nodules on the prognosis of patients with COVID-19. Material and Methods: This prospective study was conducted at the Şırnak State Hospital (Pandemic hospital in Turkey) between 15 March and 15 August 2020. We evaluated thyroid hormonal disorder and thyroid nodules in 125 patients who were admitted to the non-intensive care unit (non-ICU) due to mild COVID-19 pneumonia (group 1) and 125 critically-ill patients who were admitted to the ICU (group 2). Results: Thyroid stimulating hormone levels (TSH) were not significantly different between groups 1 and 2 ; however, group 2 patients had significantly lower levels of free thyroxine (FT4) and free triiodothyronine (FT3) as compared to group 1 (p = 0.005, p < 0.0001, respectively). FT3 level showed a negative correlation with length of hospital stay and C-reactive protein level (rho: −0.216, p: 0.001; rho: - 0.383, p < 0.0001). Overt thyroid disorder was observed in 13 patients [2 patients in group 1 (both with overt thyrotoxicosis) and 11 patients in group 2 (3 overt hypothyroidism, 8 overt thyrotoxicosis) (p = 0.01)]. Thyroid nodules sized ≥1 cm were found in 9 patients (7 %) in group 1 and 32 patients (26%) in group 2 (p < 0.0001). Conclusion: Overt thyroid hormonal disorders were more common in critically-ill COVID-19 patients. FT3 level at hospital admission is a potential prognostic marker of COVID-19 patients. Thyroid nodules may be associated with severe COVID-19 disease.

Neurofibromatosis type 1 (NF1) is a benign peripheral nerve sheath tumor which primarily cause neurocutaneous manifestations. We presented a rare case of periportal neurofibromatosis with intrahepatic, retroperitoneal and pelvic involvement. The patient underwent US-guided biopsy and a diagnosis of intrahepatic neurofibromatosis was made.

Tracheoesophageal fistula (TEF) is an abnormal connection between trachea and esophagus. Acquired TEF arise from trauma, caustic fluids ingestion, and iatrogenic injuries (ventilation, esophageal atresia repair, radiation, tracheal/esophageal stents). We discuss diagnosis, anesthetic management, and surgical correction of battery swallow-induced TEF, not previously reported in pediatric anesthesia and otorhinolaryngology literatures.