Background: Granulocyte colony-stimulating factors (G-CSF) can be used as prophylaxis for febrile neutropenia (FN) in adults. There is no meta-analysis about the effects of pegfilgrastim on the occurrence of FN in pediatric/adolescent cancer patients. Purpose: To determine the effect of pegfilgrastim on FN in pediatric and adolescent cancer patients. Methods: PubMed, Embase, and the Cochrane library were searched for studies published prior to April 7, 2020. The outcome was the occurrence of FN. For analyses showing high heterogeneity (I2>50% and Q-test P<0.10), the random-effect model was used; otherwise, the fixed-effect model was used. Results: Eight studies were included, comprising 167 patients and 550 courses of treatment. Pegfilgrastim decreased the rate of FN compared with controls (ES=0.26, 95%CI: 0.15-0.36, P<0.001); this was observed in prospective and retrospective studies. There was no difference between pegfilgrastim and filgrastim for the rate of FN in children receiving chemotherapy (OR=0.68, 95%CI: 0.20-2.23, P=0.520). Pegfilgrastim decreased the rate of grade 4 FN compared with controls (ES=0.40, 95%CI: 0.16-0.63, P=0.017); this was observed when analyzing the courses of treatment, but not the patients. Pegfilgrastim had no impact on treatment delays due to FN (ES=0.05, 95%CI: -0.00-0.10, P=0.061). Pegfilgrastim decreased the rate of severe neutropenia compared with controls (ES=0.39, 95%CI: 0.04-0.74, P=0.031). Conclusion: Compared with the control, pegfilgrastim significantly decreases the occurrence of FN, grade 4 FN, and severe neutropenia in pediatric patients receiving chemotherapy. Pegfilgrastim had no impact on treatment delays due to FN.

Objective: To assess the freeze-only strategy associated with frozen-thawed single-embryo transfers (SETs) efficiency in high-responder patients. Design: Retrospective cohort study Setting: Private reproductive medicine center. Population: A total of 500 IVF cycles with freeze-all embryos followed by elective frozen-thawed embryo transfers (eFET). Method: Elective double-embryo transfer (eDET) group with 291 cycles, in which two embryos were placed in the first eFET, and elective-SET (eSET) group with 209 cycles, in which the patients underwent eSET in their first eFET. For those who did not become pregnant, a second SET was performed (n=60). Main outcome measures: The ongoing pregnancy rate (PR) was compared after the first FET, and cumulative ongoing PR was evaluated for the SET group considering patients who had a second frozen-thawed SET (eSET + SET). Results: No significant differences were observed in the ongoing PR after the first FET (eDET: 37.8% versus eSET: 34.8%, p = 0.497). The estimated cumulative ongoing PR for eSET + SET (52.1%) was significantly higher than eDET (37.8%, p < 0.001). The linear multiple regression confirmed that transfer of two embryos in sequential SETs led to a higher chance of implantation than did the transfer of two embryos together (eDET; coefficient: 0.142, p < 0.001). The eDET group had 26.9% twin pregnancies compared with 1.9% in the eSET (p < 0.001). Conclusions: Sequential SETs in freeze-only cycles may be the best option to attain high success rates in high-responder patients, leading to an increased chance of implantation and avoidance of multiple gestations.

Objectives To evaluate the severe outcomes in pregnancies with pernicious placenta previa and prior cesarean delivery, and to analyze the predictive examinations and prevention strategies regarding severe complications in these women. Design Multicentre retrospective cohort study. Setting Thirteen hospitals in China. Population Selected 747 women with pernicious placenta previa and prior cesarean history. Methods The basic data relating to pregnancy, the examinations during gestation and the outcomes were collected and analyzed. Main outcome measures Outcomes including massive bleeding, placenta implantation and hysterectomy were monitored. Results Our results showed that placental implantation occurred in 47.5% of patients and the hysterectomy rate was 10.4%. The incidence of massive bleeding and blood transfusion was 55.8% and 64%, respectively. The women with placenta implantation predicted by both ultrasound and MRI had higher blood loss than those diagnosed only by either one of the examinations. Surprisingly, vascular occlusion had no effect on the occurrence of severe hemorrhage and hysterectomy. The latter was even higher in the vascular blocking group compared to that in the non-blocking group (34.2% and 8.6%, respectively). Conclusions: The pregnancies with pernicious placenta previa and prior cesarean delivery, had a dramatically higher risk of placenta implantation, hysterectomy and massive hemorrhage. MRI combined with ultrasound examination presented high accuracy in predicting severe outcomes in these patients. Vascular occlusion does not appear to be an effective approach to prevent severe outcomes. Surgical hemostasis should be the key goal in blocking massive bleeding, preserving the uterus and improving the prognosis of the patients.

Objective This study aimed to comprehensively evaluate the clinical characteristics of COVID-19 in perinatal period, and systematically assess the mother-to-child transmission potential of SARS-CoV-2. Design A case retrospective study. Setting and Population We retrospectively analyzed the data of 23 pregnant patients in late pregnancy. Methods Maternal and neonatal throat swabs, vaginal secretions, placenta tissues, and breast milk, were collected for the nucleic acid test of the virus. Pregnancy outcomes and neonatal results were also analyzed. Main Outcome Measures The result of viral nucleic acid test and pregnancy outcomes. Results Overall, 10 patients (43.5%) had no symptoms and were found by routine chest CT. Complications appeared after COVID-19 onset included PROM (17.4%) and fetal distress (4.3%). Typical signs of viral pneumonia were recorded in chest CT of all patients. No patients developed severe pneumonia or died of COVID-19. All of 25 neonates were born alive. No severe asphyxia or neonatal death was observed. Although three neonates were tested transiently suspected positive for SARS-CoV-2 after being transferred to neonatology department, no newborns developed COVID-19. Only a rectal swab sample from one pregnant patient was tested positive for SARS-CoV-2, while all the other clinical specimens including first sample of newborn throat swabs were negative. Pathological examination found no obvious chorioamnionitis or clear virus inclusion body in placenta, and ACE2 (angiotension-converting enzyme 2) was expressed at a moderate level. Conclusions Asymptomatic patients were present in pregnant women. There is no confirmatory evidence for mother-to-child transmission in COVID-19 patients with late pregnancy.

Background：Most cardiac surgeries with cardiopulmonary bypass (CPB) in children need transfusions of packed red blood cells (PRBCs), but the risks and benefits of transfusions remain controversial. There are still few studies on the outcome of transfusion or not during CPB in children with bodyweights of 8-17kg undergoing cardiac surgery, so we aim to investigate the effects of PRBCs transfusions during CPB. Methods: A total of 155 children with bodyweights of 8-17kg undergoing uncomplicated congenital heart surgery with CPB were divided into the non-transfusion group (group A, n=60) and transfusion group (group B, n=95) according to whether they were transfused perioperatively. By using a propensity score matching method, 55 patients were ultimately included in each group. The perioperative hematological test results and recovery of patients were compared by the independent sample t-tests or the chi-squares tests. Postoperative follow-up information within 0.5 to 2.5 years was also collected. Results: Hb before CPB was higher in group A than in group B (p<0.05). There were no differences in Hb during CPB or before hospital discharge, except that the Hb on the first day after surgery was lower in group A than in group B (p<0.05). There were no differences in the hematological test results, postoperative recovery or follow-up outcomes between the two groups. Conclusions: Non-transfusion CPB does not affect the Hb concentrations before hospital discharge, the postoperative recovery or short-term follow-up outcomes in children with bodyweights of 8-17kg undergoing uncomplicated congenital heart surgery, indicating these children can avoid transfusions.

Interleukin (IL)-5 is a potent mediator of the inflammatory cascade in the allergic response.Its predominant role in atopic reactions makes this cytokine an ideal target for blocking the eosinophilic inflammatory hyper-responsiveness to allergens. The management of allergic diseases in childhood – such as severe asthma, atopic dermatitis, and eosinophilic esophagitis - is a challenge. In particular, there are concerns regarding the use of high-dose corticosteroids. Over the last few years, biologics targeting IL-5 or IL-5 receptor - that are mepolizumab, reslizumab, and benralizumab - represent a new, promising, and more personalized therapeutic option.

The possibility of co-infection with other respiratory pathogens in COVID-19 remains unclear. This study aims to expand the knowledge of distribution and associated factors of co-infection in COVID-19 patients, and to assess the impact of co-infection on COVID-19 prognosis. Both univariate and multivariate analysis were performed to identify independent factors for co-infection. Cox regression was conducted to detect the association between co-infection and negative conversion after controlling other related factors. The rate of co-infection with at least one of other respiratory pathogens was 76.4%. 83.3% of co-infection cases were detected bacterial co-infection, followed by 31.0% with viral co-infection. Over 70% of neutrophils proportion (OR: 4.563; 95%CI: 1.116-18.648) was independently factors for bacterial co-infection, but fever (HR: 4.506; 95%CI: 1.044-19.441) and chest tightness (OR: 0.106; 95%CI: 0.015-0.743) for viral co-infection. The strongest promotion of negative conversion was detected with co-infection of only viruses (HR: 4.039; 95%CI: 1.238-13.177), and the weakest was found for co-infection of only bacteria (HR: 2.909; 95%CI: 1.308-6.472). The promotion of mixed bacteria and viruses was between co-infection of only bacteria and only viruses (OR: 3.242; 95%CI: 1.171-8.977). A higher proportion of bacterial co-infection is detected in comparison with viral co-infection among COVID-19 patients. Over 70% of neutrophils proportion, fever and chest tightness are independent factors associated with specific co-infection in SARS-CoV-2 infection. Additionally, different types of co-infection could variously result in a promoted negative conversion of COVID-19.

Rationale Neutrophils and monocytes are key immune effector cells in inflammatory bowel disease (IBD) that is associated with chronic inflammation in the gut. Patients with stable IBD who exercise have fewer flare-ups, but no underlying mechanism has been identified. Therefore, the aim of this study was to compare the responsiveness of these innate immune cells after repeated bouts of prolonged exercise in IBD patients and controls. Methods Patients with IBD and age- and gender-matched healthy controls were recruited from a cohort of walkers participating in a 4-day walking event. Blood analysis was performed at baseline and after 3 days of walking. Responsiveness to the bacterial/mitochondrial N-Formylmethionine-leucyl-phenylalanine (fMLF) was tested in granulocytes and monocytes by measuring the expression of activation markers after adding this stimulus to whole blood Results In total 38 participants (54±12 years) were included in this study: 19 walkers with and 19 walkers without IBD. After 3 days of prolonged exercise, a significant increase in responsiveness to fMLF was observed in all participants irrespective of disease. However, IBD patients showed significantly smaller increase in neutrophils (p=0.010; p=0.030; p=0.010, respectively) and monocytes (p=0.001; p=0.008; p=0.005, respectively), compared to controls. Conclusions Increased responsiveness of neutrophils and monocyte to fMLF was demonstrated after repetitive bouts of prolonged exercise. Interestingly, this exercise was associated with relative refractoriness of both neutrophils and monocytes in IBD patients. These refractory cells might create a lower inflammatory state in the intestine providing a putative mechanism for the decrease in flare-ups in IBD patients after repeated exercise.

Current treatments for cholangiocarcinoma (CCA) are largely unsuccessful due to late diagnosis at advanced stage, leading to high mortality rate. Consequently, improved therapeutic approaches are urgently needed. A newly potential therapy – chimeric antigen receptor (CAR) T cell therapy utilizes genetically modified T cells that specifically recognize surface antigen on cancer cells without restriction by major histocompatibility complex (MHC). Mucin 1 (MUC1) is an attractive candidate antigen due to its high expression in CCA cells, and its association with poor prognosis and survival. Since anti-MUC1-CAR T cells have not previously been tested for activity in models of CCA, we set forth to test their utility in this setting. A fourth generation anti-MUC1-CAR construct was engineered to contain anti-MUC1-single-chain variable fragment (scFv) and three co-stimulatory domains (CD28, CD137, and CD27) linked to CD3ζ. Cultures of anti-MUC1-CAR T cells consisted primarily of cytotoxic (CD8+) T cells (75.13±11.65%, p<0.001). Anti-MUC1-CAR T cells produced increased levels of IFN-γ when exposed to MUC1-positive KKU-100 and KKU-213A CCA cells (31.33±6.02% and 46.5±8.82%, respectively; both p<0.05). Moreover, anti-MUC1-CAR T cells demonstrated specific killing activity against KKU-100 (45.88±7.45%, p<0.05) and KKU-213A cells (66.03±3.14%, p<0.001) at an effector to target ratio of 5:1, but demonstrated negligible cytolytic activity against control immortal cholangiocytes (MMNK-1 cells). These activities of anti-MUC1-CAR T cells supports the development of this approach as an adoptive T cell therapeutic strategy for CCA.

Long-term application of high rates of nitrogen and phosphorus fertilizers and mono-tillage practices can adversely affect soil health, carbon sequestration and crop growth. A 10-year field experiment was conducted in a wheat-maize cropping system on China’s Loess Plateau to explore fertilization and tillage methods that improve SOC sequestration and crop yields. We evaluated the effects of (1) fertilization (balanced fertilization (BF), low fertilization (LF), and conventional fertilization (CF)) and (2) alternating years of different tillage (no tillage and subsoiling (NS), subsoiling and plowing (SP), plowing and no tillage (PN)) or continuous plowing tillage (PP) on input-C, SOC pool, and crop yields. BF and rotational tillage (NS, SP, and PN) increased the amount and stabilization rate of input-C. BF increased SOC storage compared to CF. Simultaneously, BF produced higher contents of SOC, readily oxidizable C (ROC), dissolved organic C (DOC) and particulate organic C (POC) and C pool management index (CMI) at 0-10 cm depth. For tillage, SOC storages were increased by rotational tillage, the highest was in NS. Rotational tillage increased SOC content, labile C contents and CMI at 0-10 cm depth. Moreover, NS also had positive effect on these parameters at 35-50 cm depth, which improved soil quality. Crop yields were positively correlated with SOC, labile C, and CMI. Crop yields were increased by BF and rotational tillage, the highest were in BF+NS treatment. Therefore, NS combined with BF may be the best management for increasing SOC storage, improving soil quality and productivity on China’s Loess Plateau.

A new constitutive model within the framework of Chaboche model was developed by improving the nonlinear isotropic hardening law and kinematic hardening law with cyclic characteristic parameters. Strain controlled creep-fatigue experiment of P92 steel with various strain amplitudes and holding time were conducted under 600℃.The feature of the cycle softening and stress relaxation were studied under the creep-fatigue condition. The result shows that the effect of strain amplitude on cyclic softening and stress relaxation behavior is negligible, however the holding time has a greater impact on both. According to the experimental data, the constitutive model of P92 under creep-fatigue interaction was deduced, and the reliability of the model was also verified, in which the cycle characteristics of P92 steel under creep-fatigue was finely described.

In wireless sensor network (WSN), It is an important matter to have a convenient evaluation metric for assessing created positioning systems. Mean square error (MSE) is one of very important evaluation metrics used for such matter. The typical mathematical formula of MSE such as the built in MSE function in matlab is used only when the true and estimated values are available, which means using the MSE is useful only after creating the system not while creating it. In this paper, we present a mathematical derivation to derive an MSE formula based on least square (LS) algorithm for three dimensional positioning system without using the true and estimated position . The created MSE could evaluate a positioning system online, and then the user can modify his system until having the system able to match the requested positioning accuracy. The created MSE has accuracy 100 % equals to the typical mathematical formula such as the built in matlab MSE function.

African swine fever (ASF) continues to cause outbreaks throughout regions of Africa, Europe and Asia. The disease can cause severe morbidity and mortality resulting in serious economic losses. Since there is no vaccine available to control ASF, early detection is critical to contain and control the disease. The aim of this study was to develop a novel real-time PCR assay based on highly conserved ASFV gene E183L (p54). The limit of detection of the assay, VNUA-54 real-time PCR, was 2.63 copies/reaction and 2 Log10 HAD50/ml. The VNUA-54 real-time PCR was able to detect fifteen different ASFV reference strains representing p72 genotypes I, II and V. The assay was specific and did not amplify other swine viruses including CSF, FMD, PRRS, and PED. The diagnostic sensitivity of the real-time PCR assay was evaluated using 187 field clinical specimens collected from swine farms located in different provinces in Vietnam. The VNUA-54 real-time PCR assay is an additional tool for ASF diagnostics and can be used in combination with other p72 based ASFV real-time PCR assays as a rapid confirmatory assay.

A 77-year-old man with diabetes, dyslipidemia, and a smoking history presented with asymptomatic gross hematuria and left hydronephrosis. Computed tomography (CT) angiography revealed a left ureteral tumor and abdominal aortic aneurysm. Cardiac catheterization revealed right coronary artery (RCA) stenosis. First, a left nephroureterectomy was performed via a midline abdominal incision. To achieve minimal invasiveness, a median sternotomy was avoided, and off-pump coronary artery bypass grafting of the RCA was performed with the great saphenous vein graft, using the left renal artery as the graft inflow. Y-grafting was subsequently performed. Without any postoperative complications, CT angiography confirmed graft patency. This procedure has potential use for removing ureteral tumors by surgeons and clinicians in clinical settings.

Background and aim of the study: Despite progressive improvement in perioperative care and device technology infectious complications (IC) remain one of the main causes worsening both short-term and long-term prognosis after long-term ventricular assist device (LVAD) implantation. The aim of this study was to assess procalcitonin (PCT) and presepsin (PSEP) dynamics after LVAD implantation and its relationship to IC in the early post-operative period. Methods: A total of 50 consecutive patients indicated to LVAD implantation were included. PCT and PSEP levels were prospectively assessed before surgery and during 30 day follow-up - 1st, 2nd, 14th and 30th post-operative day (POD). Values were compared according to the presence of IC. Results: Both PCT and PSEP levels raised significantly after LVAD implantation. There was no significant difference in PCT or PSEP levels between patients with or without IC during whole follow-up. Patients with acute renal failure (ARF) had significantly higher PCT levels 2 days after surgery and further. ARF increased PSEP levels significantly only 14 days after LVAD implantation. Also subjects with right ventricular assist device (RVAD) had higher PCT and PSEP values. This difference reached the significance only for PCT 14 days after surgery. Conclusions: Our data show that ability of PCT or PSEP to detect infectious complications in patients after LVAD implantation is limited. Their levels more likely correlate with severity of post-operative period in general.

Aims: Emodepside is an anthelmintic, originally developed for veterinary use. We investigated the safety, pharmacokinetics, relative bioavailability and dose linearity of four oral formulations of emodepside in healthy male subjects. Methods: Three randomised, parallel‐group, controlled, Phase I studies were conducted using various oral formulations, involving 79 subjects in ten cohorts in the single-ascending-dose study, 24 subjects in three ascending-dose cohorts in the multiple-ascending-dose study and 77 subjects in seven different cohorts in the relative bioavailability study. Pharmacokinetics and safety assessments were performed up to 21, 30 and 7 days, respectively. Results: As a liquid service formulation, emodepside was rapidly absorbed under fasting conditions, with dose-proportional increases in plasma concentrations at doses from 1 mg to 40 mg. The half-life during the first 24 hours after dosing was around 11 hours, followed by a terminal elimination half-life > 500 hours. Emodepside was less bioavailable in the fed state. The rate of absorption was slower and Cmax was lower with the amorphous solid dispersion tablets compared to the liquid service formulation. Emodepside was well tolerated overall with no major safety concerns. Conclusion: These Phase I studies with various dosage forms revealed a pharmacokinetic profile suggesting good tissue distribution of emodepside and a long terminal half‐life. A 15 mg dose with the gastrosoluble tablet is predicted to provide exposure that will achieve the target concentration for clinical efficacy. These data enabled us to select a field-adapted tablet formulation that will open the way for further clinical development of emodepside in individuals with onchocerchiasis.

Title: Diverse manifestations and outcomes in two COVID-19 cases with concomitant leukemiaAuthors: Hongbo Chen1, Hui Li2, Yining Qiu1, Runming Jin1, Xiaoyan Wu1Affiliations:1 Department of Pediatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China2 Department of Oncology, Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaCorrespondence:Xiaoyan Wu, MD, PhD. Address: Department of Pediatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, Hubei, China. E-mail: xwu@hust.edu.cn.Text word count: 666One figure contained.Running title: COVID-19 in pediatric leukemia patientsKeyword: pediatric leukemia; COVID-19; SARS-CoV-2To the editor,Several studies have documented Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infection in children, while the infection in children with cancer is rarely reported. [1-4] Here we present two cases of COVID-19 in pediatric leukemia patients.The first case was a four-year-old boy with preceding acute lymphoblastic leukemia. He was at the stage one of continuation phase. His mother was a suspected case of COVID-19 characterized by fever, cough, a viral pneumonia in the thoracic CT scan and a negative nucleic acid result for SARS-CoV-2. They lived in the same house and had a close contact. He received a nucleic acid test for SARS-CoV-2 before admission for the chemotherapy. Both nasopharyngeal swab and anus swab tested positive. The patient had no fever, cough, diarrhea or any other concerning symptoms. The complete blood count revealed white blood cell 3.43×106/mL, neutrophil 35.2%, lymphocyte 55.1%, erythrocyte 3.94×109/mL, hemoglobin 11.5g/dL, platelet 287×106/mL. And the thoracic CT scan found patchy opacity in the upper segment of left lower lobe. A diagnosis of COVID-19 was confirmed and he was then transferred to a designated hospital for further treatment.After admitted to the designated hospital, he got a comprehensive examination. No positive finding was identified after the physical examination. And the tests for serum D-dimer, ferritin, cytokines (interleukin-6, tumor necrosis factor- α, interferon- γ) returned normal. He received a continuous treatment of interferon α -1b intravenously and nebulization for eight days. Three days after admission, the nucleic acid test turned negative and was consistently negative two days later. A repeated thoracic CT scan showed an apparent recovery. And he was discharged eight days after admission and isolated at home for another 14 days.The second case was an eight-year-old boy with acute lymphoblastic leukemia. He was at the maintenance stage of the chemotherapy. He was a resident of Wuhan city, which was the epicenter of COVID-19 outbreak, even though he had no obvious history of close contact with suspected or confirmed COVID-19 cases. He developed fever three days (D3) after admission for chemotherapy. D-dimer was normal, while interleukin-6 (IL-6), C reactive protein (CRP) and procalcitonin (PCT) were elevated. The thoracic CT scan revealed bilateral pneumonia (Figure 1A). And the he was tested positive for SARS-CoV-2 by RT-PCR.He was then given ribavirin, arbidol, antibiotics, methylprednisolone, immunoglobulins and other supporting care. However, the fever persisted and he was transferred to the intensive care unit with the invasive ventilation for respiratory failure on D24. And the thoracic CT scan demonstrated an aggressive progress (Figure 1B). Thus, convalescent plasma from recovered COVID-19 patients was transfused to the boy patient every five days for three times. The temperature turned to normal on D44, and the invasive ventilation was withdrawn a week later. But the patient got fever and tachypnea again on D58, and the blood culture revealed multidrug-resistant Acinetobacter baumannii . He was supported with invasive ventilation till finally abandon by the parents for persistent coma.The two cases showed a completely different manifestations and outcomes in pediatric leukemia patients after infected with SARS-CoV-2. Although patients with leukemia have compromised immunity, they may present mild symptoms or even no symptoms and survive the COVID-19. Treatment for children with COVID-19 is diverse but lack of strong evidence. Most therapies are empirical. For patient 1, the intravenous and nebulization of interferon α -1b seemed effective and cured the COVID-19 pneumonia. For patient 2, anti-viral drugs (ribavirin, arbidol, interferon α -1b) combined with steroids, immunoglobins and antibiotics did not take effect and the condition deteriorated. Latter transfusion of convalescent plasma from recovered COVID-19 patients turned the scale. The fever was extinguished and the invasive ventilation withdrew. However, secondary infection of multidrug-resistant Acinetobacter baumannii aggravated the situation and lead to multi-organ failure and irreversible brain injury, though the thoracic CT scan lessened (Figure 1C).The clinical manifestations and outcomes of COVID-19 in pediatric leukemia patients are diverse but sometimes lethal especially concomitant of bacterial or fungal infections. It is critical for timely recognition and treatment of COVID-19 in this special population.Author’s contributions: Hongbo Chen, Hui Li and Yining Qiu wrote the manuscript. They contributed equally as the co-first authors. Runming Jin and Xiaoyan Wu designed the study and finalized the manuscript.Conflict of interests: All authors declared no competing interests.Funding: Xiaoyan Wu is supported by an innovative research grant from Wuhan Science and Technology Department (No. 2019020701011503).This work was approved by the ethics committee of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology.ReferencesDong Y, Mo X, Hu Y, et al.  Epidemiology of COVID‐19 among children in China. Pediatrics . 2020; 145(6):e20200702.Stokes C, Sabnis H, Yildirim I, et al. Severe COVID-19 disease in two pediatric oncology patients. Pediatr Blood Cancer . 2020; 67:e28432.Schied A, Trovillion E and Moodley A. SARS-CoV-2 infection in a neutropenic pediatric patient with leukemia: Addressing the need for universal guidelines for treatment of SARS-CoV-2-positive, immunocompromised patients. Pediatr Blood Cancer . 2020; 67:e28546.Boulad F, Kamboj M, Bouvier N, et al. COVID-19 in children with cancer in New York City. JAMA Oncol . 2020; e202028.Figure legendFigure 1. Thoracic CT scans of the patient 2.

This paper is concerned with a West Nile virus (WNv) model on a growing domain, which accounts for habitat expansion of mosquitoes because of climate warming. We aim to understand the relationship of the growing rate and the transmission risk of WNv. The basic reproduction number, which is related to the growing rate and diffusion rate, is introduced through spectral theory. The conditions to determine whether the virus vanishes or spreads are deduced.The obtained results reveal that domain growth leads to increased risk of infection, and is detrimental to the control and prevention of WNv. To verify the feasibility of our analytical results on the long time behavior of WNv, some numerical simulations are given.

Abstract The first clinical implantation of the “Essen I prosthesis” took place in 2005, which was then followed by E-Vita open plus. With further advancements E-Vita Neo and E-Novia was introduced. These devices enable the surgeons to perform FET in zone 0/1 which eventually reduce the incidence of paraplegia, recurrent laryngeal nerve palsy and proximalization of supraaortic arch vessels. E-vita open plus and successors alleviate frozen elephant trunk operations rendering more stable results in promoting positive remodelling of the distal aorta.

Morphometric research is being applied to a growing number and variety of organisms. Discoveries achieved via morphometric approaches are often considered highly transferable, in contrast to the tacit and idiosyncratic interpretation of discrete character states. The reliability of morphometric workflows in insect systematics has never been a subject of focused research, but such studies are sorely needed. In this paper, we assess the reproducibility of morphometric studies of ants where the mode of data collection is a shared routine. We compared datasets generated by eleven independent gaugers, i.e. collaborators, who measured 21 continuous morphometric traits on the same pool of individuals according to the same protocol. The gaugers possessed a wide range of morphometric skills, had varying expertise among insect groups, and differed in their facility with measuring equipment. We used Intraclass correlation coefficients (ICC) to calculate repeatability and reproducibility values (i.e., intra-, and inter-gauger agreements), and we performed a multivariate Permutational Multivariate Analysis of Variance (PERMANOVA) using the Morosita index of dissimilarity with 9999 iterations. The calculated average measure of intraclass correlation coefficients of different gaugers ranged from R = 0.784 to R = 0.9897 and a significant correlation was found between the repeatability and the morphometric skills of gaugers (p = 0.016). There was no significant association with the magnification of the equipment in the case of these rather small ants. The inter-gauger agreement, i.e. the reproducibility, varied between R=0.872 and R=0.471 (mean R=0.690), but all gaugers arrived at the same two-species conclusion. A PERMANOVA test revealed no significant gauger effect on species identity (R2 =0.69, p=0.58). Our findings show that morphometric studies are reproducible when observers follow the standard protocol; hence, morphometric findings are widely transferable, and will remain a valuable data source for alpha taxonomy.

Understanding influencing factors on extubation in cardiac surgery patients has great importance. The aim of this study was to determine the relationship between demographic characteristics, medical and clinical variables as well as extubation time in this patients, in Cardiovascular Center. This research is a casual-comparative study, conducted on 210 adult patients underwent cardiac surgery, in 2018, in Tehran. Study samples were selected by convenience sampling method. The data collection tool was a researcher-made observation checklist that included four sections on patients' demographic characteristics, high risk factors related to the disease, patients' clinical condition in ICU, and clinical variables during surgery. The required data was collected. Study subjects were categorized into two study groups of more than 6 hours mechanical ventilation group and less or equal to 6 hours mechanical ventilation group based on their mechanical ventilation time. Using multivariate analysis test,the factors affecting endotracheal tube extubation were determined. IBM SPSS Statistics software version 21 was used for statistical analysis. Study subjects were 210 post-cardiac surgery patients including 142 males and 68 females with median age of 55. Findings indicated that age, sedation and duration of pulmonary circulation had a significant influence on extubation time in post-cardiac surgery patients. Findings indicated that age, sedation and duration of pulmonary circulation has impact on the process of extubation. Implementation of a precise discontinuation program from mechanical ventilation with considering these factors, are recommended in order to prevent long-term mechanical ventilation as well as reducing days of admission to ICU.

The scientific literature includes a plethora of terms to denote within-species phenotypic diversity (e.g., morphotypes; ecotypes; ecomorphotypes; ecophenotypes; polymorphisms; and life histories). Here we discuss a particular situation in which different terms (ecotypes and life histories) have been used to describe the same within-species diversity of adult Pacific lamprey Entosphenus tridentatus, note an important challenge in using “ecotypes”, and conclude with a recommendation to use “life histories” to describe the ocean- and stream-maturing forms of Pacific lamprey.

The microstructure, texture, phase stability, and tensile properties of annealed Ta0.5Nb0.5Hf0.5ZrTi1.5 alloy have been investigated in the present research. The alloy was severely hybrid-rolled up to 93.5% thickness reduction, subsequently rolled samples subjected to an annealing treatment at 800°C and 1000°C temperatures for 1h. Consequently, the rolled condition and both annealed temperatures have a body-centered cubic (BCC) structure. Furthermore, quantitative texture measurements (ODF analysis) and microstructural examinations (analytical EBSD maps) permitted to establish a good relationship between annealing texture and microstructure and UTM utilized for obtaining the mechanical properties. Impressive room temperature tensile properties combined with the tensile strength (1380 MPa) and (24.7%) elongation achieved for the 800°C heat-treated condition. The evolution of the coarse microstructure featured in the case of 1000°C annealed temperature ascribed to the influence of high thermal energy.

Background: This study compared outcomes of patients bridged with extracorporeal membrane oxygenation (ECMO) to orthotopic heart transplantation (OHT) following the recent heart allocation policy change. Methods: The United Network of Organ Sharing Registry (UNOS) database was queried to examine OHT patients between 2010-2020 that were bridged with ECMO. Waitlist outcomes and one-year posttransplant survival were compared between patients waitlisted and/or transplanted before and after the heart allocation policy change. Secondary outcomes included posttransplant stroke, renal failure, and one-year rejection. Results: 285 waitlisted patients were included, 173 (60.7%) waitlisted under the old policy and 112 (39.3%) under the new policy. New policy patients were more likely to receive OHT (82.2% vs 40.6%), and less likely to be removed from the waitlist due to death or clinical deterioration (15.0% vs 41.3%) (both P<0.001). 165 patients bridged from ECMO to OHT were analyzed, 72 (43.6%) transplanted during the old policy and 93 (56.3%) under the new. Median waitlist time was reduced under the new policy (4 days [IQR 2-6] vs 47 days [IQR 10-228]). Postoperative renal failure was higher in the new policy group (23% vs 6%; P=0.002), but rates of stroke and one-year acute rejection were equivalent. One-year survival was lower the new policy but was not significant (79.8% vs 90.3%; P=0.3917). Conclusions: The UNOS heart allocation policy change has resulted in decreased waitlist times and higher likelihood of transplant in patients supported with ECMO. Posttransplant one-year survival has remained comparable although absolute rates are lower.