Camelina sativa is an important oilseed due to its potential in the production of biodiesel and bioproduct. To investigate the water deficit– induced effects and PGPB on the growth and seed composition of Camelina “Soheil cultivar”, an experiment was programmed in three levels 100, 75 and 50%FC and the presence of Micrococcus yunnanensis as plant growth- promoting bacteria during the reproductive phase. The results showed under water deficient silique and seed number and silique length decrease coincided with the increase of seed weight. Also the decrease of oil content associated with the increased protein and total carbohydrate content. Carbon to nitrogen ratio and oil content were in a line and the nitrogen to sulphur ratio positively correlated to protein content. In seeds, the increase of Mn and P associated with the decrease of Fe and Zn. The highest proportion of fatty acid was related to poly unsaturated fatty acid in particular linolenic acid. The increase of poly unsaturated fatty acid and saturated fatty acid coincided with the decrease of mono unsaturated fatty acid under water deficit stress. The antioxidant capacity and total phenol content had an increasing trend with limited water. PGPB application resulted in the increase of seed weight, seed and silique number, nutrients uptake and the increase of protein. Also, PGPB increased antioxidant capacity and total phenol. PGPB decreased oil content but it had various effects on fatty acid profiles. In general, PGPB had significant effect on remobilization nutrients from soil to developing seed and following metabolites synthes

Cannabis sativa is an extraordinarily versatile species. Hemp and its cousin marijuana, both C. sativa, have been used for millennia as a source of fibre, oil and for medicinal, spiritual and recreational purposes. Because the consumption of Cannabis can have psychoactive effects, the plant has been widely banned throughout the last century. In the past decade, evidence of its medicinal properties did lead to the relaxation of legislation in many countries around the world. Consequently, the genetics and development of Cannabis as well as Cannabis-derived products are the subject of renewed attention.Here, we review the biology of C. sativa, including recent insights from taxonomy, morphology and genomics, with an emphasis on the genetics of cannabinoid synthesis. Because the female Cannabis flower is of special interest as the site of cannabinoid synthesis, we explore flower development, flowering time well as the species’ unique sex determination system in detail. Furthermore, we outline the tremendous medicinal, engineering, and environmental opportunities that Cannabis bears. Together, the picture emerges that our understanding of Cannabis biology currently progresses at an unusual speed. A future challenge will be to preserve the multi-purpose nature of Cannabis, and to harness its medicinal properties and sustainability advantages simultaneously.

IntroductionCoronavirus affects global population with current total number of cases reaching more than 3.200.000 people with more than 200.000 deaths worldwide.11 The virus mainly manifests as respiratory tract disease firstly identified as an pneumonia of unknown etiology in Wuhan, China. The virus was then recognized as a RNA virus with similarity to previous severe acute respiratory syndrome coronavirus (SARS-CoV) and hence named as SARS-CoV 2, widely known as coronavirus disease 2019 (Covid-19).22,33 World Health Organization has declared Covid-19 as international health concern and urged preventive measures to be implemented worldwide.1Covid-19 is predominantly transmitted via droplets containing virus.44 However, studies have also shown possible transmission via aerosol.55 The virus can also stay up to several hours on few materials. Hence, proper measures should be taken to prevent further transmission of the virus. Countries worldwide have implemented various policies from physical and social distancing to nation-wide lockdowns to prevent mass gathering hence reducing transmission to flatten the curve. These call for several adjustments in the healthcare system as many hospitals are overwhelmed with surges of patients in need of isolation and a dramatic rise in usage of personal protective equipment (PPE).Many healthcare facilities and clinics urge patients to stay at home and visit during emergency conditions only. This became challenge especially in developing countries such as Indonesia. Placed as fourth most populous country in the world, added with limited health facilities and personnel, Indonesia was forced to adapt during this pandemic era. A study from clinical microbiology laboratory of Universitas Indonesia showed that from March to April, the laboratory has tested 4,617 samples with 12.6% positive rate and 22% asymptomatic case.66 Current local statistics up to August 2020 from the Indonesian Ministry of Health showed that nation-wide confirmed cases have reached more than 141,370 cases with more than 6,207 deaths.77 Without proper preventive measures, number of positive cases is threatened to increase.The Ministry of Health along with the local Medical Doctor Association emphasized the importance of physical distancing in clinics, hospitals and other healthcare facilities. Restrictions on outpatient clinics and non-emergency cases were imposed nation-wide, including ophthalmology clinics. Such adjustments are often difficult especially in vitreoretinal clinics as physical examinations are mostly done in close contact. Many of vitreoretinal cases are sight-threatening that requires routine visits, urgent and emergency treatment including surgery. Here, we would like to present our example of implementing screening and surgery prioritization policy in a tertiary ophthalmology referral center in Indonesia.

Tenofovir has shown promising evidence of improving COVID-19 clinical outcomes in observational studies, still to be confirmed in clinical trials. Disease severity might be reduced under prophylaxis with the prodrug tenofovir disoproxil fumarate (TDF), while the protection seems to decrease, or even to lack, when using the alternative prodrug tenofovir alafenamide fumarate (TAF).  Aiming to understand why TDF-prophylaxis might reduce COVID-19 severity upon infection we developed a multi-scale analysis framework combining in vitro susceptibility data, molecular docking, and within-host dynamics modeling, and using remdesivir--the only antiviral approved to date against COVID-19-- as a point of reference.First, our docking model predicted that intracellularly active tenofovir diphosphate binds into the SARS-CoV-2 RNA polymerase in the same site as the antiviral remdesivir triphosphate, but presents lower binding energy, likely reducing the overall inhibition of viral replication and making the antiviral efficacy more susceptible to the drug intracellular concentration. Second, using data from in vitro viral cultures with plausible TDF therapeutic concentrations, we estimated that the drug can inhibit SARS-COV-2 replication at an efficacy ranging between 54-99%  conditional to the viral cycle length. Third, assuming values approximating this range of inhibition for in vivo viral replication during human SARS-COV-2 infection, we found that prophylaxis with TDF with high penetration into viral target cells is capable of delaying viral replication, mitigating direct cell damage and allowing time for the host to mount the adaptive immunity. Last, we found that the potential antiviral effect can be substantially reduced when TDF is given after infection begins. Our work provides a potential mechanistic explanation of the observed clinical effect of TDF against SARS-CoV-2 infection. The proposed inference framework can help to optimize the evaluation of antiviral therapies for COVID-19, in particular those targeting the RNA dependent RNA polymerase.

Objective To explore the pregnancy experience and mental state of women undergoing fetal surgery due to twin-to-twin transfusion syndrome. Design A mixed methods study collecting: both quantitative and qualitative data Setting The Affiliated Shengjing Hospital of China Medical University Population Women undergoing fetoscopic surgery due to Twin-to-twin transfusion syndrome Main Outcome Measures Quantitative data was collected using the Impact of Event Scale-Revised questionnaire, the Self-Rating Anxiety Scale, and the Pregnancy Stress Scale. Qualitative data was collected using a semi-structured interview Results The emotional reaction of women undergoing fetoscopic surgery due to twin-to-twin transfusion syndrome was long-term, and the adverse emotions did not diminished over time. After surgery, patients were constantly worried about the health of the fetuses,and the lack of disease information will aggravate their uncertainty and worry. Twin transfusion syndrome may also cause a post-traumatic stress reaction in women, but for protecting the surviving fetuses ,they utilized positive ways to regulate negative emotions, so postoperative worry about fetuses did not cause them much anxiety. Conclusion Gestational emotional reaction of women undergoing TTTS fetoscopic surgery is complicated. According to our research , optimizing the referral system and strengthening disease information support could be a good way for clinical staff to improve these women’s mental state during pregnancy and avoid emotion to fluctuate violently,especially for people with weaker fertility.

Objective The aim of this study is to develop ddPCR based-assay for detecting alpha (0)-thalassemia (SEA) and beta-thalassemia (HbE and 41/42 (-CTTT) from cell-free fetal DNA (cffDNA) extracted form maternal plasma. Design Feasibility study using sample collected from prenatal clinic. Setting Thailand. Population 46 couples who were identified to be carriers of alpha or beta thalassemia. Method Cell-free DNA from 46 singleton pregnant women were isolated and quantified using ddPCR with specially designed probes for each target allele. Allelic copy number (CNV) calculation and likelihood ratio test were used to classify the most likely fetal genotypes. Classification performances were evaluated against ground truth fetal genotypes obtained from conventional amniocentesis. Main outcome measures Concordance with fetal genotyping results from invasive technique. Sensitivity and specificity of ddPCR-based assays. Results CNV analysis of SEA deletion accurately classify fetal genotypes in 20 out of 22 cases with an AUC of 0.98 (95% sensitivity and 91% specificity) for the prediction of Hb Bart’s hydrops fetalis. Application of sequential probability ratio tests to detect HbE and 41/42 correctly classified 12 out of 24 cases (10 out of 16 HbE and 2 out of 8 41/42) and provided inconclusive for 7 cases. Conclusion We showed that ddPCR-based analysis of maternal plasma is an accurate and effective NIPD for SEA deletion. Although the performance of ddPCR-based assay on HbE and 41/42 mutations is still not high enough for clinical application, our work should serve as a good foundation for future works in this field.

The Earth’s biodiversity and the ecosystem services it provides are declining rapidly because of an increasing use of natural (finite) resources to meet human needs and environmental change affecting biodiversity dynamics. Truly trans-disciplinary solutions are needed for a sustainable development of ecosystem services. Collaboration and knowledge transfer across paleo biology, climatology, global ecology, evolution, biogeography, water sciences, computer science, statistics, and economics has to be mustered for scientists, resources managers and policy makers to counter ecosystem function collapse and ecosystem services loss. We propose a novel framework that closes the implementation gap, in which long-term dynamics of biodiversity, abiotic properties, and ecosystem functions are reconstructed using an unprecedented integration of biochemical and environmental fingerprinting of biological archives spanning centuries. The long-term dynamics obtained from this fingerprinting are then placed in a machine learning pipeline to identify cause-effect relations between environmental change and biodiversity dynamics. Predictive models are tested by hindcasting, and then used to accurately forecast the future of ecosystem services and their socio-economic impact under different climate change scenarios. The framework provides accessible tools to practitioners to translate cutting-edge research into practical solutions for environmental management and practice.

Soil microbial diversity is a key control over soil element cycling and ecosystem functioning, but how the keystone species regulate the association between soil microbial diversity and ecosystem functioning (particularly, the whole-community and specialized species driving) under land use change remain unresolved. Here we identified the relationship of microbial diversity [e.g., soil phospholipid fatty acids (PLFAs) richness and composition, ammonia-oxidizing archaea and bacteria (AOA and AOB) communities] with both the broad (i.e. microbial basal respiration) and specialized function (i.e. nitrification rate) in the wood land, shrubland and adjacent cropland in subtropical China. The microbial richness was significantly positively related to the broad function, but negatively correlated with the keystone species across different land use types. The relationship of biodiversity with the broad ecosystem functioning varied with land use change, with stronger relationship in the afforested land compared to the cropland. In contrast to the broad function, land use change did not significantly affect the specialized function (i.e. nitrification rate), but the specialized function was positively related to the AOA richness in the cropland. Additionally, the specialized function was predominately driven by the keystone species composition in AOA and AOB communities and indirectly regulated by soil environmental factors (particularly, soil temperature) across land use change. Overall, our results provided direct experimental insight into the mechanisms underlying the role of the keystone species in regulating below-ground ecosystem functioning under land use change, more especially, our findings also revealed shift in the maintaining mechanisms of ecosystem function from the broad function (i.e. niche compensation effect) to the specialize function (i.e. identity effect).

Alpine large herbivores have developed physiological and behavioral mechanisms to cope with fluctuations in climate and resource availability, but climate warming might induce behavioral maladaptation. We verified this hypothesis in female Alpine ibex (Capra ibex) by modelling seasonal and daily movement and activity patterns in function of temperature and vegetation productivity, based on bio-logging data and climate change projections. In late spring, ibex moved upslope, tracking the green-wave in plant phenology. Ibex sharply decreased diel activity above a threshold mean daily temperature of 13°C, indicating thermal stress, but compensating behaviorally by foraging earlier at dawn, and later at dusk, and by moving upslope higher than on cooler days. This temperature threshold will be exceeded more than three times as often under climate change projections. In such scenarios, the imperative requirement for thermal shelter may force Alpine ibex towards topographic edges, impacting individual performance and population distribution of this emblematic mountain ungulate.

Objective: Children with Down syndrome (DS) have an increased prevalence of obstructive sleep apnoea (OSA). Non-invasive ventilation (NIV) is a common modality of OSA treatment in this cohort. This study aimed to measure adherence and efficiency of NIV delivery in children with DS. Study design: This was a retrospective cohort study involving 106 children with confirmed OSA and home NIV with downloadable data capacity. Children were divided into DS (n=44) and non-DS cohorts (n=62). Adherence, clinical outcomes apnoea-hypopnoea index (AHI), positive airway pressure delivery and leakage were recorded and compared between DS and non-DS cohorts and within the DS cohort based on past surgical history. Results: Significantly greater NIV usage was observed in the DS cohort, they showed more consistent use with an increased percentage of days used relative to their non-DS counterparts (78.95 ± 2.26 versus 72.11 ± 2.14, p=0.031). However, despite greater usage, poorer clinical outcomes in the form of increased AHI (p=0.0493) was observed in the DS cohort, where significantly greater leakage was also shown 41.00 ± 1.61L/min versus 36.52 ± 1.18L/min (p=0.022). Twenty children with DS had prior cardiac surgery; compliance across all parameters was significantly reduced relative to those without. Conclusions: These data confirm that satisfactory NIV adherence is achievable in children with DS. However, we have identified excessive system leak at the machine-patient interface as a factor, which could undermine NIV efficacy in children with DS.

More frequent droughts are altering the dynamics and function of the European forest ecosystem, which is deeply connected to the global carbon cycle. Tree height is an important structural feature of forests; however, how it regulates the response of forests to droughts remains controversial. By comprehensively examining the variations of satellite-based vegetation greenness with drought evolution in Europe, we observed apparent height-dependence forests’ resistance to drought. Short trees show lower resistance to drought than tall trees, demonstrating earlier and larger negative vegetation anomaly. However, short trees present more rapid recovery when released from the drought. Although tall trees are more resistant to short-term water stress, prolonged drought may cause more serious damage. The observed resistance differences can be attributed to the differences in the capacity for water absorption and regulation among forests of different heights. These findings are critical to our understanding of the response of forests under drought stress.

In secondary mitral regurgitation, the concept that the mitral valve (MV) is an innocent bystander, has been challenged by many studies in the last decades. The MV is a living structure with an intrinsic plasticity that reacts to changes in stretch or in mechanical stress activating bio-humoral mechanisms that have, as purpose, the adaptation of the valve to the new environment. If the adaptation is balanced, the leaflets increase both surface and length and the chordae tendinae lengthen: the result is a valve with different characteristics, but able to avoid or to limit the regurgitation. However, if the adaptation is unbalanced, the leaflets and the chords do not change their size, but become stiffer and rigid, with moderate or severe regurgitation. These changes are mediated mainly by a cytokine, the transforming growth factor β (TGF-β), which is able to promote the changes that the MV needs to adapt to a new hemodynamic environment. In general, mild TGF-β activation facilitates leaflet growth, excessive TGF-β activation, as after a myocardial infarction, results in profibrotic changes in the leaflets, with increased thickness and stiffness. The MV is then a plastic organism, that reacts to the external stimuli, trying to maintain its physiologic integrity. This review has the goal to unveil the secret life of the MV, to understand which stimuli can trigger its plasticity and to explain why the equation “large heart=moderate/severe mitral regurgitation” and “small heart=no/mild mitral regurgitation” does not work into the clinical practice.

Halophytes adapting to live in salinized areas can activate some tolerance mechanism through signal compounds to cope with salinity. However, the role of co-activity of signal compounds in salt tolerance of halophytes is not yet fully understood. We have firstly detected that Scorzonera hieraciifolia with fleshy shoots is a succulent extreme-halophyte and researched the changes in signal compounds involved in the salt tolerance mechanism, including inorganic ions, osmoprotectants and substances related to antioxidant system. The levels of signal compounds such as calcium, magnesium, proline, soluble sugar, hydrogen peroxide, superoxide, ascorbate and glutathione concomitantly increased when thickness of shoot tissues enhanced under excess salinity. There were 3.3-fold, 5-fold, 8-fold and 10-fold enhancements in the levels of inorganic ions (Ca2+ and Mg2+), hydrogen peroxide, ascorbate and glutathione in the shoots treated with excess salinity, respectively. Contents of sodium, potassium and chlorine, and antioxidant enzyme activities, superoxide dismutase, guaiacol peroxidase, ascorbate peroxidase, catalase and glutathione reductase, also increased in the salinized shoots. Western blot analysis showed that the increases in antioxidant enzyme activities were consistent with increases in their protein contents. The results suggest that extraordinary salt tolerance capacity in Scorzonera hieraciifolia, a succulent extreme-halophyte can be improved by modulated accumulations of signal compounds, especially calcium, magnesium, osmoprotectants, reactive oxygen species and antioxidant substances. Moreover, massive induction of antioxidant enzymes can make strong contributions to salt stress tolerance of S. hieraciifolia.

Background: Pathogenic variants in the mismatch repair (MMR) genes are the drivers of Lynch Syndrome; optimal variant interpretation is required for the management of suspected and confirmed cases. Given the onerous nature of extracting information related to genetic variants, literature searching tools which harness artificial intelligence may aid in retrieving information to allow optimum variant classification. Methods: In this study, we described the nature of discordance in a sample of 80 variants from a list of variants requiring updating by InSiGHT for ClinGen by comparing their existing InSiGHT classifications on ClinVar. Variants were searched for using a traditional method (Google Scholar) and literature searching tool (Mastermind Genomenon) independently. Descriptive statistics were used to compare: the number of articles before and after screening for relevance and the number of relevant articles unique to either method. Results: 916 articles were returned by both methods. Mastermind averaged four relevant articles per search, Google Scholar, three. Of relevant Mastermind articles, 193/308 (62.7%) were unique to it, compared to 87/202, (43.0%) for Google Scholar. All 6/80 (20%) variants with pathogenic or likely pathogenic InSiGHT classifications have newer VUS assertions on ClinVar. Conclusion: Mastermind on average returned a more relevant literature search. Google Scholar still found unique information, suggesting that Mastermind could play a complementary role.

This study was conducted to evaluate the integral effect of ground magnesium limestone (GML) and calcium silicate on acid sulfate soils in Malaysia and to determine the optimal combination of GML and calcium silicate, with consideration on the cost incurred by the farmers and the positive soil chemical characteristics improvement on acid sulfate soil. The acid sulfate soils were incubated under the submerged condition for 120 days with GML (0, 2, 4, 6 t ha-1) in combination with calcium silicate (0, 1, 2, 3 t ha-1). A total of 9 out of 16 combination rates met the desired requirement of chemical soil characteristics. The chemical soil characteristics are soil pH > 4, exchangeable Al < 2 cmolc kg-1, exchangeable Ca > 2 cmolc kg-1, exchangeable Mg > 1 cmolc kg-1 and Si content > 43 mg kg-1. Furthermore, 2 out of 9 combination rates (i. 2 t ha-1 calcium silicate + 2 t ha-1 GML, and ii. 3 t ha-1 calcium silicate + 2 t ha-1 GML) cost were below the cost of 4 t ha-1 GML value of USD 668, which is a common rate used by the farmers in Malaysia. Thus, possible recommendation are, i) 2 t ha-1 calcium silicate + 2 t ha-1 GML cost USD 484 and, ii) 3 t ha-1 calcium silicate + 2 t ha-1 GML cost USD 559. These combination rates met the desired requirement of soil chemical characteristics and could reduce the liming cost of rice-farmers in Malaysia under acid sulfate soil.

Introduction: Cardiac surgery for structural heart disease in the presence of cardiogenic shock or advanced heart failure has poor outcomes. We applied venoarterial extracorporeal membrane oxygenation (ECMO) to restore end-organ function and resuscitate patients prior to high-risk cardiac surgery. Methods: During a 2-year period (1/2018-12/2019) we reviewed all patients admitted to our Medical Centre with structural heart disease and cardiogenic shock, who had been resuscitated preoperatively by ECMO. Of these patients, 11 were included in the study. Patients were placed on ECMO preoperatively for 69 hours (range, 36-136 hours). Eight patients underwent valvular surgeries and 3 patients had ventricular septal defect repairs. Results: Mean age was 54± 15 years. Nine patients presented with cardiogenic shock, and two with advanced heart failure. Nine patients needed inotropes and four needed IABP support. Seven patients were admitted with acute kidney injury and five presented with metabolic acidosis. Average calculated EUROSCORE I was 56±23% and mean calculated APACHE II score was 17.18±6.26. The mean ECMO total time was 126±93 hours. Of the four postoperative deaths, three died within 10 days of surgery and one 2 months post-surgery. Conclusion: ECMO can be used as a bridge to heart valve or septal defect surgery in severely decompensated patients suffering from cardiogenic shock. Through recovery of end-organ function, ECMO may facilitate surgical correction of structural heart disease in patients in a very high risk for surgery.

The present dataset is related to the Arc-Isère long-term environmental research part of the Rhône Basin Long Term Environmental Research Observatory. This alpine watershed located in the French Alps is characterized by high Suspended Particulate Matter (SPM) in very anthropogenized valleys. Suspended Sediment Concentrations (SSC) naturally observed in the river are very high, ranging from a few tens of milligrams per litre at low flow to tens of grams per litre during major natural hydrological events (floods, debris flows) or river dam hydraulic flushes. One research objective related to this site aims at better understanding the SSC dynamics along the river using a system of nested watersheds (Arvan, Arc, and Isère) in order to access to both temporal and spatial dynamics. Studies using this dataset are on the quantification of fine sediment fluxes but also on the related morphological changes due to fine sediment deposition or resuspension. Additionally, the observatory database can support studies on contaminants (either dissolved or particulate contaminant). Six hydro sedimentary stations monitor SSC with high frequency via turbidity sensors associated to automatic samplers. Discharge is measured via classical water level measurements and a rating curve. The oldest station (Grenoble-campus) started recording data from 2006 while others hydro-sedimentary stations were built from 2009 to 2011. Data are available in an online data website called “Base de Données des Observatoires en Hydrologie” (Hydrological observatory database, https://bdoh.irstea.fr/ARC-ISERE/) with DOI references for each site. The hydrological and sediment transport time series are stored, managed and made available to a wide community in order to be used at their full extent. This database is used as a data exchange tool for both scientists and operational end-users and as an online tool to compute integrated fluxes.

Global warming in recent years has been linked to the rising seawater level, resulting in a rise in the level of salt-freshwater interface, which increases groundwater intrusion towards inland. One of the countermeasures for groundwater intrusion is saltwater pumping from a barrier well. In this method, brackish or saline water is continuously pumped through barrier wells near the coast. Many studies on saltwater pumping have focused on the behavior of saltwater intrusion using numerical analysis. However, the quantitative relationship between the production well and barrier well has not been revealed. When using a barrier well in the coastal area, it is important to study the effectiveness of a barrier well against the possible amount of fresh groundwater pumped from an inland production well. If the effectiveness of a barrier well is clarified and saltwater intrusion becomes controllable by water ratio manipulation, it can be implemented in any salinized coastal area to solve salinization problems and fresh groundwater demands. In this study, a lab-scale model simulating a sandy coastal unconfined aquifer was created to investigate the effectiveness of a barrier well. The experiment observed the change in the shape of the salt-freshwater interface and recorded the time required for salinization of a production well and retreat process. Furthermore, the experimental observation quantified the possible freshwater intake ratio between the production well and barrier well. Therefore, saltwater could only reach the production well when the amount of pumped water was more than 1.9 times that from the barrier well. Moreover, by comparing the intrusion and retreat time, the salt-freshwater interface returned to its initial state at a faster rate than the intrusion rate. These findings show that pumping from a barrier well is effective in protecting production wells if the pumping ratios are well controlled.

Objectives: To establish an optimized airway management process to improve preoperative lung dysfunction in obstructive sleep apnea (OSA). Design: A retrospective case series study Setting: Tertiary university hospital in China Participants: The study included 483 children (319 males and 164 females; 6y to14y years) with OSA who underwent an adenotonsillectomy from November 2017 to December 2018. Main outcome measures: Children with OSA and who had abnormal airway function were identified by lung function test, and the risk factors for abnormal lung function were assessed. Next, the children received individualized atomization intervention based on the severity of their abnormal lung function, and the improvement in lung function was evaluated. Results: Lung function tests revealed that 45 patients had obstructive ventilation dysfunction, and histories of chronic cough or asthma were identified as risk factors for perioperative abnormal lung function. The FEV1% pre exceeded 80% after 2 days of atomization intervention in 27 of 28 mild cases, 4 of 13 moderate cases, but in none of the 4 moderate-severe cases. After 4 days of atomization intervention, the FEV1%pre of the remaining 14 patients in the three groups all increased up to 80%. Other indicators of lung function (e.g., FEV1/FVC% pre, MEF50% pre, MEF25% pre, and MMEF% pre) were also greatly improved following the improvement of FEV1% pre. No perioperative airway complications occurred. Conclusion: Prior to performing surgery on children with OSA and who have risk factors associated with abnormal lung function, it is potentially beneficial to establish an optimized airway management process to improve lung function before adenotonsillectomy. Keywords: Children, obstructive sleep apnea, airway management, lung function, surgical risk

Tuberculosis kills more people than any other single infectious disease globally. Despite decades of research, there is no vaccine to prevent TB transmission. Bacille Calmette-Guerin (BCG) vaccine developed a century ago has little effect on pulmonary TB and does not control transmission. Lack of an effective vaccine emanates from lack of knowledge on correlates of protective immunity on which to base vaccine design and development. However, some household contacts who are extensively exposed to Mtb infection remain persistently negative to tuberculin skin test and interferon-gamma assay. These individuals called “resisters” clear Mtb infection early before the development of acquired immunity. The immunological basis of early Mtb clearance is yet to be established, however, innate lymphocytes such as monocytes/macrophages, dendritic cells, neutrophils and natural killer cells, and innate like T cells such as mucosal associated invariant T cells, invariant natural killer T cells and gamma-delta (γδ) T cells have been implicated in this early protection. One of the cells that has attracted increasing attention in recent years, in protection against Mtb is the natural killer cell. Emerging data from animal and epidemiological studies indicate that NK cells may play a significant role in the fight against Mtb. NK cells express various surface markers to recognize and kill both Mtb and Mtb-infected cells. In this review, recent advances in our understanding of NK cells in the fight against Mtb early during infection, with emphasis on cohort studies, will be presented.

Objective The aim of this study is to develop ddPCR based-assay for detecting alpha (0)-thalassemia (SEA) and beta-thalassemia (HbE and 41/42 (-CTTT) from cell-free fetal DNA (cffDNA) extracted form maternal plasma. Design Feasibility study using sample collected from prenatal clinic. Setting Thailand. Population 46 couples who were identified to be carriers of alpha or beta thalassemia. Method Cell-free DNA from 46 singleton pregnant women were isolated and quantified using ddPCR with specially designed probes for each target allele. Allelic copy number (CNV) calculation and likelihood ratio test were used to classify the most likely fetal genotypes. Classification performances were evaluated against ground truth fetal genotypes obtained from conventional amniocentesis. Main outcome measures Concordance with fetal genotyping results from invasive technique. Sensitivity and specificity of ddPCR-based assays. Results CNV analysis of SEA deletion accurately classify fetal genotypes in 20 out of 22 cases with an AUC of 0.98 (95% sensitivity and 91% specificity) for the prediction of Hb Bart’s hydrops fetalis. Application of sequential probability ratio tests to detect HbE and 41/42 correctly classified 12 out of 24 cases (10 out of 16 HbE and 2 out of 8 41/42) and provided inconclusive for 7 cases. Conclusion We showed that ddPCR-based analysis of maternal plasma is an accurate and effective NIPD for SEA deletion. Although the performance of ddPCR-based assay on HbE and 41/42 mutations is still not high enough for clinical application, our work should serve as a good foundation for future works in this field.

Anaerobic digestion is widely used for waste treatment and for biofuel production in the form of biogas from dedicated energy crops. Proper operation and control of anaerobic digesters require knowledge of biogas flow rate and methane composition of biogas. Methane content of biogas from an anaerobic digester was measured on-line by modifying an off-line measurement device, previously constructed by the authors, that uses a hydrocarbon sensor (MQ-4) and a pressure/temperature/humidity sensor (BME-280) integrated with an Arduino Uno. This modified on-line sensor was programmed to automatically measure methane composition by self-regulated introducing biogas sample and evacuating the device. It also equipped with a function of biogas flow chamber which could calculate the cumulative biogas production over a time interval. Methane composition (v/v) could be measured every three hours. Measurements made by this device agreed within an average absolute difference of 0.81 ± 0.58 % with measurements by a gas chromatograph equipped with a thermal conductivity detector. The volumetric flow rate was directly expressed on a moisture-free basis at standard temperature and pressure. The total cost of this device was under US $140. For an additional US $7, the device can be upgraded with an LED display that toggles between composition and flow rate.

Acipimox, a niacin derivative, is a lipid-lowering drug that is widely used to treat hyperthyroidism. It is generally well tolerated and causes fewer adverse effects than niacin. Acipimox has been reported to induce mild adverse effects, mainly pruritus and flushing. Concerning hepatotoxicity induced by acipimox, only limited information is available regarding the symptoms and therapeutic schedule. In this study, we report the case of a 40-year-old man with hyperlipidemia who developed liver injury after treatment with acipimox. After treatment discontinuation, his liver function gradually improved. After obtaining negative results in tests for hepatitis, infectious mononucleosis, and rheumatologic diseases, in addition to ultrasonographic findings, acipimox administration was resumed, and his liver enzyme levels again remarkably increased. In the absence of any biliary obstruction or other obvious causes of hepatic injury, acipimox-induced hepatocellular injury was strongly suspected in accordance with the Roussel-Uclaf Causality Assessment Method. Acipimox was again discontinued, and magnesium isoglycyrrhizinate was introduced. The patient's liver function tests gradually improved over 3 days and displayed marked improvement after 1 week. On the basis of the recorded findings, drug-induced liver injury was highly suspected, and rechallenge and the exclusion of other obvious factors were required to establish the diagnosis of acipimox-induced hepatic injury. Furthermore, the importance of evaluating hepatotoxicity using the Roussel-Uclaf Causality Assessment Method and the effectiveness of magnesium isoglycyrrhizinate for treating liver cell injury were demonstrated.

Serum sickness, a reaction presenting with a classic triad (fever, rash, myalgia/arthralgia) and considered as a rare adverse event following monoclonal antibodies and specifically following treatment with rituximab. This report describes a case of serum sickness in a newly treated young male patient with rituximab for pemphigus vulgaris.