Resumo: Este é um Grupo de Revisores de pré-impressão da Revista Ensino & Pesquisa.  Parecer emitido por: Prof.ª Dra. Ivone Maria Mendes Silva - Universidade Federal da Fronteira Sul/UFFS - Campus ErechimO artigo “Por mais humanidade na educação”, de Marcos Sardá Vieira, propõe-se a discutir “o papel das Ciências Humanas enquanto campo de conhecimento fundamental para a formação crítica e a compreensão dos fenômenos sociais”, demonstrando a importância de se abordar o tema em questão considerando sua complexidade e as estreitas conexões que mantém com outras dimensões e processos (políticos, econômicos, educacionais etc.) da realidade social. Para isso, parte da análise de textos acadêmicos e reportagens publicadas pela imprensa nacional e internacional, compondo uma análise que nos permite perspectivar o cenário mais abrangente no qual a discussão se insere.O artigo apresenta reflexões indispensáveis a uma análise crítica da realidade atual da educação superior brasileira, ao contemplar especialmente a relação entre educação, economia e questões de ordem político-ideológica. Essas reflexões assinalam como o processo de desvalorização das Ciências Humanas pode ter efeitos negativos para a sociedade como um todo. Isso porque a construção de um sistema educacional que seja capaz de oferecer à população uma formação integral, transformadora e de qualidade depende do conhecimento produzido pela área de Humanidades e seus diversos profissionais (historiadores, sociólogos, filósofos e outros especialistas).Cabe lembrarmos, como destaca o autor, que esse processo de desvalorização das Ciências Humanas tem sido, em nosso país e em muitos outros, catalisado por decisões/ações de governantes e formuladores de políticas públicas que buscam respaldo no discurso do desenvolvimento técnico e da produtividade.Nesse sentido, somos convidados/as a problematizar qual é o contexto de produção dos discursos que convertem a racionalidade técnica e financeira em racionalidade política. E mais: que relações de poder sustentam esses discursos. Assim, não é fortuito que coexistam, no Brasil atual, processos como a expansão do ensino superior privado, a imposição de cortes orçamentários às universidades públicas, ao mesmo tempo em que assistimos à intensificação das tensões e disputas sociopolíticas relacionadas à polarização política e à ascensão do conservadorismo e suas pautas, dentre outras variáveis que compõem o complexo cenário no qual estamos inseridos/as.Assim, o artigo apresenta argumentos e suscita questionamentos relevantes, que podem nos municiar tanto no exercício de analisar criticamente discursos que, como os acima referidos, tem ganhado força na atualidade, quanto na reflexão sobre as mudanças que se fazem necessárias nesse cenário para que o exercício da democracia não seja colocado em risco.Em consonância com essas observações, recomendo a publicação do artigo.Erechim, 19 de agosto de 2020  

Predicting equipment failure is important because it could improve availability and cut down the operating budget. Previous literature has attempted to model failure rate with bathtub-formed function, Weibull distribution, Bayesian network, or AHP. But these models perform well with a sufficient amount of data and could not incorporate the two salient characteristics; unbalanced category and sharing structure. Hierarchical model has the advantage of partial pooling. The proposed model is based on Bayesian hierarchical B-spline. Time series of the failure rate of 98 Republic of Korea Naval ships have been modeled as hierarchical model, where each layer corresponds to ship engine, Engine type, and Engine archetype. As a result of the analysis, the suggested model predicted the failure rate of an entire lifetime accurately in multiple situational conditions, including the amount of prior knowledge of the engine.

Abstract Rationale, aims and objectives Patient-centered care is considered as a vital component of good quality of care for breast cancer patients. Nevertheless, the implementation of this valuable theoretical concept into practice appears to be difficult. The goal of this study was to bridge the gap between the theoretical elaboration of ‘patient-centered care’ and clinical practice. For that purpose, the current application of the term ‘patient-centered care in breast cancer treatment’ was deduced from present-day literature. Method The methodology of a scoping review was employed. Results A notable lack of consistency in use of the term ‘patient-centered care’ is demonstrated in recent literature concerning breast cancer treatment. We also observe an unambiguous positive vision on this rather vague concept. Conclusions Contrary to previous efforts to define ‘patient-centered care’ more narrowly, we propose to embrace the heterogeneity of this concept and apply ‘patient-centered care’ as an umbrella-term for all healthcare that (intends to) contribute to the acknowledgement of the person in the patient. For the justification of measures to realize patient-centered care, we insist on the demonstration of desirable real-world effects, instead of a mere contribution to this abstract term.

The relation between the speed of sound (u) in biodiesel and the change in Gibbs energy (G) has not been described in the literature. With the method of Gibbs energy additivity, the relation between u and G can be expressed as ln(u2) = G/RT + A, where R is the universal gas constant, T is the absolute temperature, and A is a constant. Further expansion of G into its enthalpy and entropy, and sub-dividing the molecule of a fatty and methyl ester (FAME) into groups of atoms, the final model is good for estimating the speed of sound in both FAME and biodiesel at various temperatures. Only the numbers of double bonds and carbon atoms of the fatty acid are required for the calculation.

Linseeds contains high levels of PUFA α-linolenic acid, naturally protected against thermal oxidation by their encapsulation within LS oil bodies by multiple components including antioxidant proteins and mucilage emulsifying agents. By LS grinding, adding of water, adjusting pH, and sonication LS oil bodies emulsions (LSE) can be formed which can also encapsulate externally added PUFAs, to minimize their thermal oxidation, as it does for the intrinsic ALA PUFAs. Fish oil encapsulation into this LSE platform (LSFE) offers the possibility of a nutritive delivery system of the biologically essential PUFA fish oil’s, protected from oxidation, which to date is difficult to achieve. In this study structural and chemical properties LF 1H NMR T1-T2 characterization of LSE and LSFE was used to analyze their stability and changes, under thermal oxidizing conditions. Peak changes in these LF 1H-NMR spectra were correlated with the stability of chemical and physical variables during thermal (55oC for 96 hrs) oxidation. The present study demonstrates the capability of 1H LF-NMR relaxation sensor to monitor the time domain fingerprints of chemical and structural changes of LSE and with co-encapsulated fish oil (LSFE) under thermal autoxidation conditions. The results of the LF-1H NMR analysis are further supported and correlated with conventional peroxide value tests, self-diffusion, droplets size distribution, zeta potential estimation of surface stability under thermal oxidation conditions. The results of this study demonstrate the efficacy of LSE to minimize linseed and encapsulated fish oil PUFA oxidation.

Epoxidized methyl esters (EMO) with their high oxirane ring reactivity, acts as a raw material in the synthesis of various industrial chemicals including polymers, stabilizers, plasticizers, glycols, polyols, carbonyl compounds, biolubricants etc. EMO has been generally quantified by the gas chromatography (GC) and high performance liquid chromatography (HPLC) techniques. Taking into the account of the limitations of these techniques, two qHNMR based equations have been proposed for the quantification of EMO in the mixture of EMO and methyl esters (MO). The validity of the proposed method was determined using standard mixtures of MO and EMO having different molar concentrations. The developed equations have been applied on the samples of EMO prepared from oleic acid in two step process viz., esterification followed by epoxidation. The qHNMR based EMO quantification showed acceptable agreement with the results obtained from HPLC analysis.

To evaluate the beneficial effects of orally administered corticosteroids in alleviating the pain of symptomatic pulpitis. Methods: . Out of the 87 patients who contacted expert panel telephonically during the period of COVID-19 lockdown , 55 patients complaining of moderate to severe dental pain were included in the study and thus advised to take oral tablets of paracetamol 650 mg post-meal thrice a day for 3-5 days along with a single oral dose of 4mg of Dexamethasone. The patients were asked to report the pain status after every 24 hours for at least 72 hours. In case of severe pain not controlled by these medicines even after 3 days, two tablets of dispersible ketorolac tromethamine (10mg) were advised once on fourth day followed by single tablet three times a day for another 3 days. In case the pain did not subside within 3 days of taking the second line of treatment, or there was a development of swelling/lymphadenopathy, the patient was advised to get the tooth extracted Results: Out of 55 patients taking a single dose of dexamethasone, 47 (85.45%) patients reported a ‘significant’ reduction of pain within 24-72 hrs. Remaining 8 patients (14.55%) in which severe pain was not controlled by paracetamol and Dexamethasone even after 3 days, two tablets of ketorolac tromethamine (10mg) were advised. 6 patients (75%) reported a ‘significant’ reduction in the pain while 2 (25%) patients still in pain did were advised tooth extraction and referred emergency department of tertiary care centre.. Conclusions: The pain felt by patients diagnosed with symptomatic irreversible pulpitis, the systemic corticosteroids administration is an adequate strategy in controlling pain for up to 48-72 hours, the time during which the pain felt most.

Nowadays, carbon nanotubes (CNTs) have been used as one of the most promising candidates for nanodevices (or nanoelectronics) and super-strong reinforcement fibers in nanocomposites. This work aims to investigate the transverse wave propagation in viscoelastic single-walled carbon nanotubes (SWCNTs) adhered by surface material. In the context of nonlocal second-order strain gradient elasticity theory, the characteristic equation of wave motion of viscoelastic SWCNTs with surface effect is systematically formulated. The analytical expression, i.e. closed-form dispersion relation between the wave frequency (or phase velocity) and the wave number, are derived for the frequency and phase velocity of the wave motion. The size-dependent characteristic lengths, surface effects and structural damping on the properties of wave propagation are elucidated in detail.

The recent outbreak of the novel coronavirus disease (COVID-19) and rapid spread have continued to negatively affect the public health and global economy. It has been reported that the commonest symptoms of COVID-19 include fever, cough, fatigue, sputum production, and shortness of breath. SARS-CoV-2, a novel enveloped RNA β-coronavirus, enters the host cell with the aid of SARS-CoV receptor ACE2 and the spike protein of SARS-CoV-2, primed by TMPRSS2. Currently, the most effective method that lowers the risk of exposure to virus is isolation because the virus is transmitted person-to-person. Several studies have been conducted to determine drugs and vaccines likely to be effective against COVID-19. However, no specific medicine is reported for the prevention or treatment for SARS-CoV-2. This article not only reviews the clinical manifestations, epidemiology of COVID-19 and the infection mechanisms of SARS-CoV-2, but also discusses potential treatments for COVID-19, including drug therapy, immune therapy (i.e., immunomodulator, neutralizing antibody therapy and convalescent plasma therapy) and vaccines. Our aim is to provide knowledge about SARS-CoV-2 and promotes research through which more effective treatments and preventive measures can be developed.

Aim: To determine the efficacy of neutrophil/lymphocyte ratio (NLR) as a marker of the severity of COVID-19 pneumonia in the South-Asian population. Methods: This was a prospective, cross-sectional, analytic study conducted at HDU/ICU of District Headquarter Hospital, Faisalabad, Pakistan, from May through July 2020. Sixty-three eligible patients, admitted to the HDU/ICU, were prospectively enrolled in the study. Their NLR, C-reactive protein, serum albumin, and serum fibrinogen were measured. Patients’ demographic characteristics, comorbidities, clinical manifestations of COVID-19 infection, medication use, and history of lung malignancy were retrieved from their medical history. Patients were categorized into either a general group (with mild COVID-19) or a heavy group (with moderate to severe COVID-19). Results: There were significant differences between the two groups in diabetes prevalence, NLR, C-reactive protein, and serum albumin. NLR and C-reactive protein were positively correlated (P < 0.001, P = 0.04 respectively) whereas serum albumin was negatively correlated (P = 0.009) with severe COVID-19. NLR was found to be an independent risk factor for severe COVID-19 pneumonia in the heavy group (OR = 1.264, 95% CI: 1.046~1.526, P = 0.015). The calculated AUC using ROC for NLR was 0.831, with an optimal limit of 4.795, sensitivity of 0.83 and specificity of 0.75, which is highly suggestive of NLR being a marker for early detection of deteriorating severe COVID-19 infection. Conclusion: NLR can be used as an early warning signal for deteriorating severe COVID-19 infection and can provide an objective basis for early identification and management of severe COVID-19 pneumonia.

Summary Background: Torus is a protuberant and lobulated exostosis that develops on the lingual aspect of the jaws or hard palate in 10-30% of adults. They can interfere with mastication, speech, oral hygiene, and denture placement. Their enlargement with advancing age may also lead to superficial ulceration, inflammation, osteonecrosis and various other complications. Methods: A retrospective analysis of the authors’ experience with 17 adults who had large symptomatic tori was performed. The patients were examined by intraoral imaging and radiographic or computed tomography of their maxillofacial bones. Their dental and medical records were reviewed along with the pertinent literature concerning the prevalence and reported complications of this entity. Results: This series included 6 men and 11 women, ranging in age from 36 to 85 years (Mean age: 56.5 years).There were 6 patients with torus mandibularis, 8 with torus palatinus, and 3 with torus maxillaris. Four of our 17 patients required surgical excision of their tori because of large size, recurrent superficial erosions and associated symptoms. Conclusion: The majority of tori are asymptomatic and incidental finding, but the more prominent tori are prone to mucosal inflammation and ulceration that may require surgical removal of the lesion. Large tori can also interfere with mastication, speech, dental hygiene, placement and function of prosthetic dentures, and may cause snoring, sleep apnea or other complications. Therefore, the practicing physicians should be familiar with the appearance, radiological features, clinical implications and management of tori.

Genotyping novel complex multigene families is particularly challenging in non-model organisms. Target primers frequently amplify simultaneously multiple loci leading to high PCR and sequencing artefacts such as chimeras and allele amplification bias. Most genotyping pipelines have been validated in non-model systems whereby the real genotype is unknown and the generation of artefacts may be highly repeatable. Further hindering accurate genotyping, the relationship between artefacts and genotype complexity (i.e. number of alleles per genotype) within a PCR remains poorly described. Here we investigated the latter by experimentally combining multiple known major histocompatibility complex (MHC) haplotypes of a model organism (chicken, \textit{Gallus gallus}, 43 artificial genotypes with 2-13 alleles per amplicon). In addition to well defined “optimal” primers, we simulated a non-model species situation by designing “cross-species” primers, with sequence data from closely related Galliforme species. We applied a novel open-source genotyping pipeline (ACACIA; \url{https://gitlab.com/psc_santos/ACACIA}), and compared its performance with another, previously published pipeline (AmpliSAS). Allele calling accuracy was higher when using ACACIA (98.5\% vs 97\% and 77.8\% vs 75.2\% for the “optimal” and “cross-species” datasets respectively). Systematic allele dropout of three alleles owing to primer mismatch in the “cross-species” dataset explained high allele calling repeatability (100\% when using ACACIA) despite low accuracy, demonstrating that repeatability can be misleading when evaluating genotyping workflows. Genotype complexity was positively associated with non-chimeric artefacts, chimeric artefacts (nonlinearly by leveling when amplifying more than 4-6 alleles) and allele amplification bias. Our study exemplifies and demonstrates pitfalls researchers should avoid to reliably genotype complex multigene families.

Relapsed/refractory paediatric T-ALL carries a dismal prognosis and newer therapy options are urgently needed. Daratumumab, an antibody to transmembrane protein CD38 expressed on T-cells, is currently under investigation as a targeted immunotherapy approach to T-ALL. A 2-year-old male with refractory T-ALL received off-label, monotherapy with daratumumab, resulting in a rapid partial response with minimal toxicity. This is the first documentation of daratumumab administered to a child with this indication, and supports its potential benefit in T-ALL.

Pediatric oncology is justifiably proud of its long tradition of multi-institutional collaboration in clinical research. Perhaps no other field of medicine has more effectively shown what can be achieved by pooling talent and resources to study challenging diseases. Historically, most collaborative projects were limited to a single country or continent. However, more progress comes from even broader international cooperation. With rare cancers, this may be the only way to gather sufficient patient numbers to address key questions. Sharing national experiences can also lead to a deeper understanding of the advantages and risks associated with different therapeutic approaches. The first steps to increased global cooperation, however, is agreeing on a common language to describe patient cohorts and consensus standards to guide diagnosis, evaluation, and treatment. Applying these lofting goals to pediatric soft tissue sarcomas, the INternational Soft Tissue SaRcoma ConsorTium (INSTRuCT) was born.From its initial formative meeting in May 2017, INSTRuCT has patterned its structure and purpose on the successful model of the International Neuroblastoma Risk Group (INRG).1,2 The membership of INSTRuCT is composed of three large cooperative clinical trials organizations: Children’s Oncology Group (COG), Cooperative Weichteilsarkom Studiengruppe (CWS), and European paediatric Soft tissue sarcoma Study Group (EpSSG). The first goal for INSTRuCT is to develop an international risk stratification system for rhabdomyosarcoma (RMS) to replace competing systems used in Europe and North America. A common RMS risk stratification system would facilitate the comparison of clinical trial results across cooperative groups. Before generating a RMS risk stratification system, INSTRuCT agreed upon a standard RMS data dictionary, leveraging the University of Chicago’s Pediatric Cancer Data Commons expertise in data standardization.3 The compilation of COG, CWS, and EpSSG data (and data from their legacy groups) from finished studies into a single INSTRuCT dataset is nearly complete, and will include more than 7000 patients enrolled on previous RMS clinical trials. Once the RMS risk stratification project is finished, INSTRuCT will mine its dataset for answers to questions that can only be addressed with large, well-annotated clinical data. Future work will also include expanding the RMS data dictionary and adding a non-RMS soft tissue sarcoma dataset, also drawn from COG, CWS, and EpSSG clinical trials.As the multi-disciplinary members of INSTRuCT were defining their RMS data dictionary, they realized they had the opportunity to develop international consensus statements on the diagnosis, evaluation, and management of pediatric soft tissue sarcomas. Clinical trial protocols include guidelines for pathologic diagnosis, imaging staging evaluation, and local control approaches with surgery and radiation therapy varied by primary anatomic site. INSTRuCT provided the forum for international discussion and consensus building, with the goal of publishing these expert opinions for broad dissemination and use by pediatric oncologists, surgeons, radiation oncologists, radiologists, and pathologists worldwide. In this issue of Pediatric Blood & Cancer, Morris et al. publish the one of first in a series of consensus statements from INSTRuCT, focusing on the surgical management in the diagnosis and local control of RMS arising in the extremity.4 Morris et al. outline recommended biopsy approaches, the rational for routine use of regional lymph node evaluation including the role of fluorodeoxyglucose positron emission tomography, and the decision-making behind up-front versus delayed primary excision. The recommendations are guided by the principles of maximizing oncologic outcome while maintaining extremity function. Given the rarity of extremity RMS and the absence of randomized trials comparing different management strategies, Morris et al. draw upon a combination of clinical data and expert opinion in their consensus guidelines, carefully documenting the level of evidence that supports each of their recommendations. Nonetheless, these guidelines represent the current state of the art for surgical management of extremity RMS and the basis for future clinical trial recommendations. A similar consensus statement on RMS of the female genital tract has also been published in Pediatric Blood & Cancer, by Lautz et al.5 With these two consensus statements, the INSTRuCTPediatric Blood & Cancer special series is off to an excellent start, with manuscripts on the surgical management for other primary sites and the pathologic evaluation of RMS to follow soon. As INSTRuCT co-chairs, we are pleased to introduce INSTRuCT to the global pediatric oncology community and look forward to many more contributions to come.

White-tailed bumblebee species, Bombus cryptarum, B. lucorum, B. magnus and B. terrestris are known to be very similar in their morphological characters across the majority of their ranges. This hampers assessment of their status and trends because reliable identification is difficult. In this study, we use a combination of characters and methods to assess how ecologists and citizen scientists can reliably and quickly separate these four species occurring in the Netherlands. Bumblebees (queens, workers and males) were sampled from 10 locations across the Netherlands and specimens were identified based on COI sequence data. Next, the same specimens where scored for morphological traits. We show that a combination of easy to recognise characteristics can separate some specimens of the species depending on caste and sex. Bombus magnus males and queens and B. lucorum males were most reliably separated from the other species using morphological characters. Workers of all four species cannot be separated completely using morphological characters alone. This is the first time standard morphological characters and ecological data has been used to study the differences between the white-tailed bumblebees in the Netherlands. Based on our findings we need to conclude that the status of these bumblebee species in the Netherlands is uncertain due to possible misidentifications in the past and present. People who wish to work with these species should be careful in species identification based on morphology.

Introduction: Short QT syndrome is a rare, inherited channelopathy associated with sudden cardiac arrest (SCA) but characteristics and prognosis of short QT interval (SQTI) in Asian patients remain unclear. This study aimed to determine clinical characteristics of and outcomes in patients with SQTI in an Asian population. Methods: Consecutive patients with SQTI were recruited. SQTI was defined as a Bazett’s formula-corrected QT interval (QTc) ≤340 ms in serial electrocardiograms. Age- and sex-matched patients with a normal QTc and without overt cardiovascular disease were included at a 1:4 ratio. Clinical and ECG features and outcomes were compared between patients with and without SQTI. Results: Thirty-four patients with SQTI [age, 23.5 (21–30.5) years; 31 male] were followed up for 4.8 (2.0–7.8) years. Early repolarization, tall T wave, and U wave were significantly more frequent in patients with SQTI than the patients without SQTI. QT dispersion [44.0 (28.0–73.0) vs. 20.0 (12.0–35.0) ms, P<0.001] was significantly wider and heart rate [52.0 (47.0–58.0) vs. 70.0 (62.3–84.0) /min, P<0.001] was significantly slower in patients with SQTI than patients without SQTI. Atrial fibrillation (AF, 11.8% vs. 2.2%, P=0.030) and ventricular arrhythmia (VA)/SCA (8.7% vs 0%, P=0.007) were significantly more frequent in patients with SQTI than patients without SQTI. SQTI was significantly associated with AF [odds ratio, 5.911; 95% confidence interval, 1.257–27.808; P=0.025] and VA/SCA. Conclusions: In this Asian population, SQTI was associated with AF and VA/SCA.

To the Editor,Emollient and moisturizer preparations are recommended to improve skin barrier properties and are believed to halt the progression of the atopic march when applied from the first weeks of life in high-risk children. Such products comprise various types of substances, mainly humectants, oils, physiological lipids, preservatives, and different additives. Humectants such as glycerin or urea and oils such as paraffin, petroleum, ceramides, fatty acids, and cholesterol are essential ingredients in restoring the skin barrier. As recently demonstrated by Sindher et al.,1 there is an enormous difference in the impacts of different types of cream on atopic skin, and lipid-rich products are more efficient in improvement of skin barrier function comparing to paraffine-based.Ingredients present in emollients apart from playing their particular role in preparations can also act as haptens or proteinaceous allergens and causing side effects. Proteinaceous allergens, to which we include peanut extract, were proven to increase the risk of development of food allergy to certain foods when present in emollients applied on dry skin.2 Whereas haptens, the molecules mainly deriving from fragrance and preservative group, may cause irritation or allergic contact dermatitis (ACD). Due to impaired skin barrier function and frequent application of products containing haptens, children with atopic dermatitis are highly prone to ACD.3 Studies through the past decade indicate that the prevalence of ACD in children is increasing and can start even in early infancy.3 European guidelines for the treatment of atopic dermatitis recommend using emollients devoid of proteinaceous allergens and haptens that were known to cause contact allergy frequently, especially in the most vulnerable age group before the age of 2 years.4The recent two large randomized control BEEP 5 and PreventADALL trials,6 surprisingly, found that the use of emollients had no beneficial effects on preventing atopic dermatitis. However, an increased risk of skin infections or food allergies was noted, though without statistical significance.5 One of the emollients used in the BEEP trial was DoubleBase gel containing 15% isopropyl myristate (IPM) which is considered a hapten in the Cosmetic series (https://www.chemotechnique.se, accessed August 24, 2020). IPM is a clinically relevant sensitizer7 which, moreover, frequently cause irritant reactions.8Recently, Brough et al. 9 highlighted that a disrupted skin barrier, particularly in early life, is a direct risk factor for developing food allergies. Following this lead, it can be assumed that children receiving preparations containing haptens on the skin, especially with disrupted barrier function, may experience inflammation and therefore be of increased risk of food allergy. The results of a long-term follow-up BEEP study are eagerly anticipated to see if the trend towards increased allergy in the intervention group will continue.We know, that selecting a well-designed emollient, that means: deprived of potential sentitizers might be difficult, since there is an abundance of potential sensitizers in cosmetics, even for the youngest children, and haptens are found in more than 85% of products as recently demonstrated by Dumycz et al..10 We hypothesize, that careful selection of emollient preparation may still contribute to better clinical effects and should consider the presence of lipids as well as the absence of potentially harmful ingredients, in particular when used in infants and young children.Klaudia Ryczaj MD*, Karolina Dumycz MD*, Wojciech Feleszko­­­ MD PhD** Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Żwirki i Wigury 63A, 02‑091 Warsaw, PolandCorresponding author: Wojciech Feleszko MD PhD, e-mail: wojciech.feleszko@kliniczny.pl1. Sindher S, Alkotob SS, Shojinaga MN, et al. Pilot study measuring transepidermal water loss (TEWL) in children suggests trilipid cream is more effective than a paraffin-based emollient [published online ahead of print, 2020 Mar 16]. Allergy . 2020;10.1111/all.14275. doi:10.1111/all.14275.2. Lack G, Fox D, Northstone K, Golding J; Avon Longitudinal Study of Parents and Children Study Team. Factors associated with the development of peanut allergy in childhood. N Engl J Med . 2003;348(11):977-985.3. de Waard-van der Spek FB, Andersen KE, Darsow U, et al. Allergic contact dermatitis in children: which factors are relevant? (review of the literature). Pediatr Allergy Immunol . 2013;24(4):321-329.4. Wollenberg A, Barbarot S, Bieber T, et al. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part I [published correction appears in J Eur Acad Dermatol Venereol. 2019 Jul;33(7):1436]. J Eur Acad Dermatol Venereol . 2018;32(5):657-682.5. Chalmers JR, Haines RH, Bradshaw LE, et al. Daily emollient during infancy for prevention of eczema: the BEEP randomised controlled trial.Lancet . 2020;395(10228):962-972.6. Skjerven HO, Rehbinder EM, Vettukattil R, et al. Skin emollient and early complementary feeding to prevent infant atopic dermatitis (PreventADALL): a factorial, multicentre, cluster-randomised trial [published correction appears in Lancet. 2020 Mar 21;395(10228):e53]. Lancet . 2020;395(10228):951-961.7. Ada S, Seçkin D. Patch testing in allergic contact dermatitis: is it useful to perform the cosmetic series in addition to the European standard series?. J Eur Acad Dermatol Venereol . 2010;24(10):1192-1196.8. Uter W, Schnuch A, Geier J, Lessmann H. Isopropyl myristate recommended for aimed rather than routine patch testing. Contact Dermatitis . 2004;50(4):242-244.9. Brough HA, Nadeau KC, Sindher SB, et al. Epicutaneous sensitization in the development of food allergy: What is the evidence and how can this be prevented? [published online ahead of print, 2020 Apr 6].Allergy . 2020;10.1111/all.14304. doi:10.1111/all.14304.10. Dumycz K, Kunkiel K, Feleszko W. Cosmetics for neonates and infants: haptens in products’ composition. Clin Transl Allergy . 2019;9:15.

Background: Existing knowledge suggests that gestational diabetes mellitus was inconsistently associated with children allergic diseases. The aim of this study was to identify the association between gestational diabetes mellitus (GDM) and the risk of children allergic diseases by systematic review. Methods: We searched and retrieved three databases (PubMed, Web of Science and Cochrane Library) for articles on the association between GDM and children allergic diseases published before December 31, 2019. Stata software version 16.0 was used for statistical analysis. Results: Eight published studies were included in this meta-analysis. The pooled effect estimates showed the association between GDM and allergic outcomes, including asthma (OR:1.13,95%CI:1.01-1.27), wheezing (OR:1.12,95%CI:1.08-1.16), and atopic dermatitis (OR:1.41,95%CI:1.31-1.53). GDM was not associated with the risk of allergic sensitization, with a pooled effect estimate of 1.45 (95%CI: 0.40, 5.23). Conclusion: GDM may increase the risk of allergic diseases in children. However, this finding should be validated with future large-sample epidemiological studies covering a wider spectrum of allergic diseases.

Timely intravenous (IV) to oral antimicrobial switch (IV-oral-switch) is a key antimicrobial stewardship (AMS) strategy. A retrospective audit was undertaken to determine concordance with IV-oral-switch guidelines in the context of a long-standing, tightly regulated AMS program. Data from 107 general medical and surgical patients in an Australian hospital were analysed. Median duration of IV antimicrobial courses before switching to oral therapy was 3 days (interquartile range, 2.25-5.00). Timely IV-oral-switch occurred in 57% (n=61) of patients. The median delay to switching was 0 days (IQR 0 to 1.25). In most courses (92/106, 86.8%), the choice of oral alternative after switching was appropriate. In 45% (47/105) of courses, total duration of therapy (IV plus oral) exceeded the recommended duration by >1.0 day. Excessive IV antimicrobial duration was uncommon at a hospital with a tightly regulated AMS program. Total duration of therapy was identified as an AMS target for improvement.

Introduction Left atrial posterior wall (LAPW) isolation may be performed as an additional atrial fibrillation (AF) ablation strategy based on pulmonary vein isolation. A modified posterior-inferior line (MPL) was proposed for reducing esophageal injury. The aim of this study was to evaluate the anatomical characteristics of the MPL, compared with the CPL. Methods and Results Multidetector computed tomography was performed in 102 consecutive AF patients (male/female = 60/42) preoperative, and the parameters were evaluated as follows: the distance from MPL and CPL to the esophagus, fat pad presence and thickness in the course of MPL and CPL, and the esophageal route below CPL. The average distance from the MPL to the esophagus was longer than from CPL to the esophagus (3.7 ± 1.5mm vs 1.7 ± 0.4mm, P < 0.001). Fat pad presence was higher in the course of MPL than CPL. The myocardium tissue and fat pad under MPL was thicker than under CPL (2.9 ± 1.1mm vs 1.6 ± 0.3mm, P < 0.001; 1.4 ± 0.6mm vs 0.9 ± 0.2mm, P < 0.001), respectively. In patients whose esophagus was unconfined in a triangular space at the left inferior pulmonary vein level, the average distance from MPL to esophagus was longer than the confined patients (4.0 ± 1.7mm vs 3.2 ± 1.0mm, P = 0.001). Conclusion The MPL was far away from the esophagus with thicker myocardium tissue and more fat pad than the CPL; thus, MPL could serve as a favorable alternative in linear ablation for LAPW isolation.

AIM: We propose the use of in silico mathematical models to provide insights that optimize therapeutic interventions designed to eradicate respiratory infection during a pandemic. A modelling and simulation framework is provided using SARS-CoV-2 as an example, considering applications of both treatment and prophylaxis. METHODS: A target cell-limited model was used to quantify the viral infection dynamics of SARS-CoV-2 in a pooled population of 105 infected patients. Parameter estimates from the resulting model were used to simulate and compare the impact of various interventions against meaningful viral load endpoints. RESULTS: Robust parameter estimates were obtained for the basic reproduction number, viral release rate and infected-cell mortality from the infection model. These estimates were informed by the largest dataset currently available for SARS-CoV-2 viral time course. The utility of this model was demonstrated using simulations, which hypothetically introduced inhibitory or stimulatory drug mechanisms at various target sites within the viral life-cycle. We show that early intervention is crucial to achieving therapeutic benefit when monotherapy is administered. In contrast, combination regimens of two or three drugs may provide improved outcomes if treatment is initiated late. The latter is relevant to SARS-CoV-2, where the period between infection and symptom onset is relatively long. CONCLUSIONS: The use of in silico models can provide viral load predictions that can rationalize therapeutic strategies against an emerging viral pathogen.

Despite widespread evidence that biological invasion influences both the biotic and abiotic soil environments, the extent to which these two pathways underpin the effects of invasion on plant traits and performance is unknown. Leveraging a long-term (14-yr) field experiment, we show that an allelochemical-producing invader affects plants through biotic mechanisms, altering the soil fungal community composition, with no apparent shifts in soil nutrient availability. Changes in belowground fungal communities result in high costs of nutrient uptake for native perennials and a shift in functional traits linked to their water and nutrient use efficiencies. Some species in the invaded community compensate for high nutrient costs by reducing nutrient uptake and maintaining photosynthesis by expending more water, which demonstrates a trade-off in trait investment. For the first time, we show that the disruption of belowground nutritional symbionts can drive native plants toward novel regions in order to maintain their water and nutrient economics.

We present the CT angiogram images of a 43 year old lady with an isolated single coronary artery arising from the noncoronary sinus with a narrow slit like orifice and oblique take off.

Aims: To determine the prevalence of depression and anxiety in Indian patients undergoing CABG surgery and their relationship to physical activity and quality of life. Methods: 121 patients undergoing CABG surgery between November 2017 and May 2019 were included. The Hospital Anxiety and Depression Scale (HADS) was employed for the assessment of depression and anxiety. Health-related quality of life was assessed using the SF-36 questionnaire. The short form of the International Physical Activity Questionnaire (IPAQ) was used for assessment of physical activity. Participants were categorized into high, moderate or low physical activity. Results: The overall prevalence (95% CI) of depression and anxiety was 70.5% (0.61-0.78) and 64.6% (0.55-0.73) respectively. When a cut-off score of 11 instead of 8 was used on the HADS [Borderline cases excluded (HADS score 8-10)], the prevalence of depression and anxiety was 31.3% (0.22-0.40) and 40.7% (0.31-0.50) respectively. Patients with low levels of physical activity had a higher prevalence of depression and anxiety (p < 0.05). Patients with depression demonstrated a worse quality of life compared to those without depression in all domains measured by the SF-36 questionnaire. Among patients with anxiety, quality of life was worse in four out of the eight domains measured by the SF-36 questionnaire. Conclusion: Indian patients undergoing CABG surgery have a high prevalence of depression and anxiety. Patients with depression and anxiety were found to have low physical activity and poor quality of life when compared to their counterpart. Keywords: CABG; depression; anxiety; quality of life; physical activity.