Though neurological/ophthalmologic side effects in form of headache, vertigo, somnolence, paresthesias, optic neuritis and optic neuropathy are listed as side effects in the leaflet, transient tube-seeing and unconsciousness after a single dose of ibuprofen have not been reported. The patient is a 48yo male who experienced sudden-onset tube-seeing for a few seconds, followed by unconsciousness for 20 minutes, during which he was communicating with his boss in a tipsy way, 15 minutes after having taken 200mg ibuprofen. After awakening, it took 2-3h to regain his premorbid condition. There was no tongue biting or secessus. Since blood pressure, blood tests, blood gas analysis, ECG, and EEG were normal and cerebral MRI only showed non-specific spots in the subcortical white matter, the condition was attributed to ibuprofen. This case shows that a single dose of ibuprofen may cause severe side effects in the form of tube-seeing and unconsciousness. Ibuprofen should be given with caution as single dosages may cause severe side effects.

We introduce the concept of generalized norm in linear vector spaces which extends the classical norm. Using that generalized norm we provide a generalization of Schauder's type theorem. Next we give some applications of this theorem to find solutions of initial value problems.

Aim: The cognate receptor expression of AGE (RAGE; receptor for AGE) on malignant tissues in diabetic patients has been suggested as a co-factor in determining the clinical course and prognosis. We aimed to search this relationship between RAGE expression and clinicopathological features of prostate neoplasia. Methods: A total of 197 patients; 64 (diabetic n=24; non-diabetic n=40) with benign prostate hyperplasia, and 133 (diabetic n=71; non-diabetic n=62) with localized (LPCa)/metastatic prostate cancer (MetPCa) were included the study. The expression of RAGE was studied by immunohistochemically on prostate specimens. The RAGE score was assessed in the specimens according to the extent of immunoreactivity and staining intensity. Results: The RAGE scores of BPH patients (diabetic and non-diabetic) were found as negative. Patients with both LPCa and MetPCa showed significantly higher scores, respectively (LPCa and MetPCa vs. BPH; p<0.01). RAGE scores of diabetic patients with LPCa and MetPCa were found to be 4.71±3.14 and 4.97±3.69, respectively. RAGE scores of the non-diabetic patients who had LPCa and MetPCa were 1.52±1.87 and 1.69±1.58, respectively. When compared both groups with LPCa, RAGE scores of the diabetic patients were significantly higher than that of the non-diabetics (p=0.01). Similar results were revealed as for the patients with MetPCa (4.97±3.69 vs. 1.69±1.58 (diabetic vs. non-diabetic), respectively (p<0.01). Conclusion: We found a high rate of RAGE expression in malign prostate neoplasias to the BPH. Furthermore, as expected, higher scores were demonstrated in those with diabetes than non-diabetics. Disease progression and survival parameters were worse in the patients with high RAGE levels. RAGE may be useful in the diagnosis of prostate cancer and in determining its prognosis.

Background: COVID-19 is considered a widespread concern in global public health. Diagnoses of COVID-19 in some cases are necessary due to severe prognosis. In this study, clinical and demographic characteristics of patients with COVID-19 were studied in Taleghani Hospital, Urmia, Iran. Methods: This descriptive-analytical cross-sectional (retrospective) study carried out on 215 patients with COVID-19 during March and April 2020.. Approved COVID-19 case was considered as a person with a positive respiratory sample performed by at least one of two RT-PCR methods or genetic sequencing. Results: The mean age of patients was 50.93±17.92 years. The mean hospital stay, the temperature at admission, and onset of symptoms were 4.91±3.68 days, 37.40±0.96 0C, and 5.88±4.80 days, respectively. Shortness of breath and cough were found in 62.8 % and 49.3 % of patients. Regarding lung involvement, 33 patients (33%) were normal, most of the patients (n=71) had 5-25% involvement in their lung and a minority of patients (n=13) had a severe condition of 50-75% lung involvement. .Spo2 can increase the risk of death by 16% with each unit reduction. Kidney involvement increases the chance of mortality by 1.386 times (95% CI: 11.010-2.704). Hemoglobin was also significantly marginal, with a 35% risk of death per unit reduction in blood hemoglobin, which is a very important finding in this study. The odds ratio of spo2 and hemoglobin for mortality due to COVID-19 was 1.16 (95% CI: 1.073-1.262) and 1.350 (95% CI: 0.989-1.842), respectively. Conclusion: COVID-19, like other viral diseases, can involve different organs of the body with different severity. In the meantime, smoking was not a risk factor for the virus or associated with severe manifestations of the disease. Patients with high creatinine and CPK, pulmonary involvement above 25%, and hypoxemia had a higher mortality

Paramos are a unique type of tropical alpine ecosystem. To understand how biodiversity, ecosystem services and community resilience in the paramo will be affected by ongoing environmental change we need to start identifying groups of species with shared characteristics (i.e. functional types or PFTs). This task is particularly challenging as paramos host the highest plant diversity of alpine ecosystems. We measured 22 traits on 42 species belonging to different growth forms in the Colombian Andes. Hierarchical Clustering on Principal Components performed in a Factor analysis of mixed data was used to identify species with similar functional traits and the number of PFTs present. We identified three PFTs; one composed of forbs and shrubs with tender leaves, one composed of only rosettes, and a third group composed by shrubs with tough leaves. If PFTs represent a group of plants that play similar roles in the ecosystem, and have similar responses to perturbation, our results imply that paramos might have limited physiological response and may be highly vulnerable to environmental changes. On the other hand, the presence of multiple species sharing functional traits could provide some resilience, if one species disappears, others may fill the same role and maintain the functionality of the paramo.

Opioids are often ineffective for managing chronic non-malignant pain. If prescribed, this should be as part of an opioid trial with clear aims of therapy, tapering/stopping if it is ineffective, or if it is causing adverse effects. Clinical guidance is available but there are many gaps in the evidence.

Peptoniphilus indolicus is not usually seen in the eye but is a commensal of the human vagina and gut. However, with COVID-19, eye infections and other unusual complications are possible with unsuspected bacteria. The patient presented here spontaneously drained this bacteria through the skin, an uncommon occurrence with orbital abscesses.

We present a case of obstructive jaundice without biliary stones. This was due to a sclerotrophic gallbladder causing compression (Mirizzi’s syndrome) or adhesions to the extrahepatic biliary tree, pain and recurrent cholecystitis. The jaundice resolved following cholecystectomy. Mirizzi’s syndrome should be suspected in a patient with cholecystitis and obstructive jaundiice.

An incisional hernia is usually a defect in the scar of an abdominal surgery . A 23-year-old African woman with a large incisional hernia was managed by the Jenkin’s ‘mass closure’ suture repair technique with good outcome.

Background: Ablation for atrial fibrillation (AF) has emerged as an effective method of rhythm control. This exploratory analysis aimed to determine how various measures of recurrence would influence the definition of treatment success. Methods: Using an EHR dataset from 01/2007-06/2019 linked with Medtronic cardiac implantable electronic device (CIED) data, patients who underwent a first AF ablation procedure following CIED implantation were identified. Data were analyzed for recurrence of AF stratified by varying definitions of successful ablation. Performance of various simulated external AF monitoring strategies was assessed. Results: A total of 665 patients were analyzed including 248 with paroxysmal AF (mean age 66.2±9.3 years, 73.0% male) and 417 patients with persistent AF (mean age 67.3±9.0 years, 73.6% male). Patients with paroxysmal AF, survival free from recurrence at 1 year ranged from 28.2% to 72.1% (>6 min and >23 hours thresholds, respectively) with an overall median percentage of time in AF reduction of 99.6%. Patients with persistent AF, survival free from recurrence at 1 year ranged from 24.9% to 60.0% (>6 min and 7 consecutive days >23 hours thresholds, respectively) with an overall median percentage of time in AF reduction of 99.3%. A single 7-day monitoring strategy had a sensitivity of < 50% for detecting AF > 6 min in patients with paroxysmal and persistent AF. Conclusion: In this real-world dataset of AF patients with CIEDs undergoing catheter ablation, treatment success varied substantially with different definitions of minimally required AF duration and is significantly impacted by the method of recurrence detection.

The paper by Mulder et al. addresses the effect of pregnancy prolongation on maternal and fetal outcomes in women with early-onset pre-eclampsia diagnosed after 24 weeks of gestation (Mulder et al., BJOG 2020 xxxx). They report that pregnancy prolongation - from the time of pre-eclampsia diagnosis to delivery - is associated with improved offspring outcome and survival, without adverse consequences on short-term maternal cardiovascular and metabolic function. The maternal findings are apparently at odds with another recent study from New York (Rosenbloom et al. Obstet Gynecol 2020;135:27-35) which observed an increased risk of maternal cardiovascular events after pregnancy, in case of an interval of more than 7 days between the diagnosis of any hypertensive disorders of pregnancy and delivery.Some issues should be pointed out in order to avoid misunderstandings about these findings. Being Mulder et al.’s an observational study, readers cannot infer causality because women were not randomized to the length of pregnancy prolongation. Data are spread over a significant time period (from 1996 to 2017), and this aspect could be another confounder. Pre-eclampsia is a multi-organ syndrome based on chronic inflammation, oxidative stress and endothelial dysfunction leading to a persistent subclinical cardiovascular impairment and an increased risk of adverse events later in life (Sciatti et al., Eur J Prev Cardiol 2020 doi: 10.1177/2047487320925646), similarly to what happens in cases with heart failure with preserved ejection fraction. Myocardial geometry and ejection fraction are not sensitive enough to be altered by just a few days of pregnancy prolongation, and to forecast cardiovascular consequences. Only innovative techniques such as speckle-tracking imaging may document an impairment in myocardial contractility and relaxation in former pre-eclamptics, even if ejection fraction is normal.Pre-eclampsia is currently defined as new-onset hypertension combined with de-novo proteinuria and/or “adverse conditions” or “severe maternal/fetal complications” (Magee et al., Pregnancy Hypertens 2014;4:105-145). International guidelines recommend that women with severe forms of pre-eclampsia should be delivered immediately regardless of gestational age, while an expectant management should be considered for women with non-severe pre-eclampsia before term (Magee et al., Pregnancy Hypertens 2014;4:105-145; NICE guideline no. 133, 2019). Delaying delivery is expected to benefit newborn’s health, which is well exemplified by Mulder et al.’s findings. However, the fetus is often the protagonist of adverse conditions, and severe complications such as fetal growth restriction, often co-exist with early-onset pre-eclampsia, requiring longitudinal monitoring with Doppler ultrasound and cardiotocography. The timing of delivery depends on both maternal and fetal conditions. The lack of data about fetal growth and Doppler and cardiotocography findings (in cases with growth restricted babies) limits the generalisability of the results by Mulder et al. One would expect that a longer delay before delivery can be attained only in fetuses and mothers with milder clinical manifestations of disease.Word count: 455

Submissions should be made via the online manuscript tracking system.  For technical help with the submission system, please contact the journal. Initial submission does not need to be formatted to journal style. For ease of evaluation and submission, the journal recommends an editable Word .docx or Authorea text document and a single merged PDF that includes all parts of main text and high-resolution figures embedded into the file.  A suitable PDF will be constructed by uploading text and figures using the online manuscript tracking system.  This journal  does not impose word count and figure limits.  Table 1 contains the journal’s suggestions so that the manuscript is respectful of reader time and are readable by specialist and generalist alike.AcknowledgementsAuthors should list all funding sources here, please check Open Funder Registry. Contributions and material support from anyone not listed as an author should be acknowledged here, with permission from the contributor. Thanks to anonymous reviewers are not allowed.Conflict of Interest StatementAll authors are required to declare if they have potential conflicts of interest related to the submission, or none. This declaration shall be published. Submitting authors shall confirm all co-authors agree with the final statement.AbstractWhat is known in the field, for a general readership. Define the area and knowledge for a specialist.Explain the motivation and need for the research defined by the gap in existing knowledge.State your main claim or finding . Support that with evidence, statistics and detail, mentioning essential methods and analytical techniques that provided the evidence.State the meaning and significance of your new results for research in the field.End by suggesting realistic immediate implications and uses of your findings in your field and more broadly.IntroductionGive credit to and cite all the primary research publications that lay the background to this work including those to be discussed in the Discussion. Give context as to whether these are essential methods and analytic strategies or experimental findings. Ensure that causation, correlation and conjectureResults Make the main claims in logical order, supported by display items and methodsDiscussion Summarize and evaluate the robustness and meaning of the main findings in light of existing publications. Be skeptical and discuss any limitations of the study and conditions where the results may or may not be applicableMaterials and MethodsMethods and materials transparencyOffer methods used in the analysis, and materials used to conduct the research to any researcher for purposes of reproducing the results or replicating the procedure.  Indicate any restrictions on analytic methods including software, and tools and study materials available to other researchers. Specify how, where and when that material will be available.  If an existing method or tool is used in the research, the authors are responsible for checking the license and state confirmation of permission.To obtain Research Resource Identifiers (RRIDs): Use the Resource Identification Portal .Design and analysis transparencyAuthors are encouraged to review standards for disclosing key aspects of the research design and data analysis at http://www.equator-network.org/ and use those that are relevant for their research. Research reporting standards are widely adopted in our field, and exceeding their evolving requirements is essential to sustain the impact of genetics and genomics for research and for society.  Here is the current list of reporting standards, vocabularies, models, schemas and databases that we recommend we recommend at FAIRsharing.org.Human studies and research participantsIdentify the ethics committee that approved the human study, and that the study conforms to recognized standards, for example: Declaration of Helsinki; US Federal Policy for the Protection of Human Subjects; or European Medicines Agency Guidelines for Good Clinical Practice. If no formal ethics committee is available, state that the research was carried out in accordance with recognized standards (e.g. the Declaration of Helsinki, as revised in 2013).Images and information from individual participants, including participants from patient registries and databases, will only be published where the authors have obtained the individual's free prior informed consent. Authors do not need to provide a copy of consent forms to the publisher but, in signing the author license to publish, authors are required to confirm that specific informed consent to publish the image has been obtained. Publisher has a standard patient consent form available for authors to use if required. This requirement to obtained informed consent applies whether or not patients are identifiable from the information presented in the submission.Animal studiesFor submissions involving animal studies, state the protocol and procedures employed were ethically reviewed and approved, and the name of the organization giving approval. State whether experiments were performed in accordance with relevant institutional and national guidelines and regulations for the care and use of laboratory animals:US authors should cite compliance with the US National Research Council's Guide for the Care and Use of Laboratory Animals, the US Public Health Service's Policy on Humane Care and Use of Laboratory Animals, and Guide for the Care and Use of Laboratory Animals.UK authors should conform to UK legislation under the Animals (Scientific Procedures) Act 1986 Amendment Regulations (SI 2012/3039).EU authors should conform to Directive 2010/63/EU.Cell line authentication Declare where the cells were obtained, whether the cell lines have been tested and authenticated and the method by which the cells were tested. If cells were obtained directly from a cell bank that performs cell line characterizations and passaged in the user’s laboratory for fewer than 6 months after receipt or resuscitation, re-authentication is not required. Data Availability StatementPlease choose text from Table 3 and provide a citation to available data in the References list. These sequence data have been submitted to the DDBJ/EMBL/GenBank databases under accession number XXXXX  Gene expression data (derived from microarrays or sequencing) has been deposited to a MIAME- or MINSEQE-compliant public repository like the Gene Expression Omnibus (GEO) with accession XXXXXProtein Sequence Data should be submitted to UniProt with accession XXXXXReferences [terms in brackets will be removed before publication]1. [article] Wood WG, Eckert GP, Igbavboa U, Muller WE. Statins and neuroprotection: a prescription to move the field forward. Ann N Y Acad Sci 2010; 1199:69-76. 2. [book] Hoppert, M. Microscopic techniques in biotechnology. Weinheim: Wiley-VCH; 2003.3. [dataset]Authors; Year; Dataset title; Data repository or archive; Version (if any); Persistent identifier (e.g. DOI)4. [URI, GWAS summary statistics] Savage, J.E. et al. Genome-wide association meta-analysis in 269,867      individuals identifies new genetic and functional links to intelligence      https://www.ebi.ac.uk/gwas/studies/GCST006250 (2018)5. [supplementary data] Jagadeesan, A. et al. MDS/PCA plots within West Africa    https://doi.org/10.6084/m9.figshare.5640931 (2017)Tables (each table complete with title and footnotes)      

Surface discharges occurring on a porcelain bushing under DC voltage not only causes an incipient fault condition but also can degrade the pertinent location once the surface deposition layer or the insulation material gets carbonized. Naturally, it becomes important to identify and analyze the surface discharges occurring on bushing. The current practice on analyzing surface discharges initiated under DC voltage employs partial discharge test methods that focuses on counting the PD events occurring over a time span. The method is sensitive but provides no information about the possible source of fault condition. In this context, a non-conventional, pattern based partial discharge analysis method on understanding the characteristics of electrical discharges occurring on the surface of a polluted bushing under DC voltage is studied. Initially, a half-wave bridge rectifier unit that produces an uncontrolled DC voltage is selected and employed. Later, the surface of the polluted bushing is energized, and the signals initiated by the surface discharges occurring on the surface contaminated bushing are recorded. Instead of counting the PD events, the pattern manifested by the surface discharges is correlated to the AC voltage input of the rectifier. Once this is accomplished, the pertinent findings are validated on an actual bushing installed in an electrostatic precipitator unit that is applied for cleaning producer gas of a biomass gasification plant.

Objectives The risk of poor outcomes is traditionally attributed to biological and physiological processes in cardiac surgery. However, evidence exists that other factors, such as emotional, behavioural, social and functional, are predictive of poor outcomes. Objectives were to evaluate the predictive value of several emotional, social, functional and behavioural factors on four outcomes; death within 90 days, prolonged stay in intensive care, prolonged hospital admission and readmission within 90 days following cardiac surgery. Methods This prospective study included adults undergoing cardiac surgery 2013-2014, including information on register-based socio-economic factors and self-reported health in a nested subsample. Logistic regression analyses to determine the association and incremental value of each candidate predictor variable were conducted. Multiple regression analyses were used to determine the incremental value of each candidate predictor variable, as well as discrimination and calibration based on AUC and Brier score. Results Of 3217 patients, 3% died, 9% had prolonged intensive care stay, 51% had prolonged hospital admission and 39% were readmitted to hospital. Patients living alone (OR, 1.19; 95% CI, 1.02-1.38), with lower educational levels (1.27; 1.04-1.54) and low health-related quality of life (1.43; 1.02-2.01) had prolonged hospital admission. Analyses revealed living alone as predictive of prolonged ICU stay (Brier, 0.08; AUC, 0.68), death (0.03; 0.71) and prolonged hospital admission (0.24; 0.62). Conclusion Living alone was found to supplement EuroSCORE in predicting death, prolonged hospital admission and prolonged ICU stay following cardiac surgery. Low educational level and impaired health-related quality of life were, furthermore, predictive of prolonged hospital admission.

The 2018 outbreak of myxomatosis in the Iberian hare (Lepus granatensis), has been hypothesized to originate from a species jump of the rabbit-associated myxoma virus (MYXV), after natural recombination with an unknown poxvirus. Iberian hares were long considered resistant to myxomatosis as no prior outbreaks were reported. To provide insights into the emergence of this recombinant virus (ha-MYXV), we investigated serum samples from 451 Iberian hares (88 live captured, 313 hunted and 50 found dead) collected over two time periods, 1994-1999 and 2017-2019, using a rabbit commercial indirect ELISA after validation, and tested different tissues or sera by a qPCR targeting M0005L/R gene conserved in MYXV and ha-MYXV. The cut-off of ELISA Relative Index 10 = 6.1 yielded an estimated positive predictive value of 96.4% (CI95% 82.6-98.0%), by comparison with qPCR positive and negative reference hares. Overall, antibodies were detected in 12.6% (57/451) of the hares tested, of which 40.3% (23/57) were also qPCR positive. Antibodies were found in apparently healthy hares sampled in 1994-1999 (n=10, none MYXV-DNA positive), and in 2017-2019 (n=28, of which 14% were MYXV-DNA positive). For the Iberian hares hunted or live trapped, seroprevalence was significantly higher in 2017-2019 (13.0%, CI95% 9.2-18.2%) than in 1994-1999 (5.4%, CI95% 3.0-9.6%) (p=0.005), and significantly higher in 2019 (p=0.007), being lower during the winter (p<0.001). While our molecular and serological results show that Iberian hares have been in contact with MYXV or an antigenically similar virus at least since 1994, they also show an increase in seroprevalence in 2018-2019. The more remote contact of hares with MYXV may have occurred with strains that circulated in wild rabbit, or unnoticed strains circulating in Iberian hare populations. This work clearly confirms the circulation of MYXV in the Iberian hare ate least 20 years before the severe virus outbreaks observed in 2018.

Background: Right ventricular dysfunction (RVD) is frequent in patients suffering from acute respiratory distress syndrome (ARDS). Veno-venous extracorporeal membrane oxygenation (V-V ECMO) may allow the use of ultraprotective mechanical ventilation (MV) in the most severe cases of ARDS. However, the effects of this MV strategy on RV function are not well known. We investigated with echocardiography the prevalence and evolution of RVD in patients supported with V-V ECMO for severe ARDS and ventilated with an ultraprotective ventilation approach. Methods: Eighteen patients who required V-V ECMO for severe ARDS and were assessed with echocardiography before and after cannulation between January 2014 and December 2017 were enrolled in this retrospective observational study. Results: Before cannulation, RV dilatation was present in 6/16 (37%) and 10/17 (59%) patients, according to quantitative and qualitative assessment, respectively, and RVD was reported in 9/14 (64%) patients. After cannulation, tidal volume, plateau pressure, and driving pressure significantly decreased [median (interquartile range) values were 2.0 (0.9-3.6) mL/kg, 20 (20–20) cmH2O, and 10 (10–10) cmH2O, respectively] and RV size and function were similar as before cannulation. Except for SaO2 before cannulation, which was significantly lower in non-survivors, no other risk factor for RVD, RV dilatation, or mortality was identified in our population. Conclusions: In patients requiring V-V ECMO for severe ARDS, RVD and dilatation before ECMO cannulation were frequent but not associated with worse clinical outcomes. An ultraprotective MV strategy was not accompanied by a worsening of RV function.

Coronavirus 2019 (COVID 19) captured worldwide attention as the virus spread from initial detection as a pneumonia of unknown cause in Wuhan, China in December 2019 to the declaration of a pandemic by the World Health Organization only three months later. This paper describes the impact of COVID 19 on cardiac surgery services in the greater Los Angeles area. Discussion includes public health response to the pandemic, how local hospitals reacted to the expected surge in COVID patients, establishment of telemedicine services, and the projected future impact on California healthcare as a result of the COVID 19 pandemic.

Notched semi-circular bend (NSCB) samples are prepared with different bedding angles and subjected to dynamic loading by a modified split Hopkinson pressure bar (SHPB) system. The static fracture toughness (SFT) of shale or coal increases linearly with the bedding angle. Under similar loading rates, the dynamic fracture toughness (DFT) of shale increases as the bedding angle rises. However, the DFT of coal is much discrete. The DFT of shale or coal increases with loading rate increasing. DFT is much higher than SFT. For shale, there is almost a linearly positive correlation between DFT and loading rate, while for coal, there is a logarithmic relationship. All values of coal are much smaller than that of shale. As the loading rate increases, the effect of bedding angle on DFT attennuates. Notably, for bedding angle of 45°, the cracking mode of coal is more easily affected by bedding plane, than for other angles.

Background Avian Influenza is a highly contagious viral infection that mainly affects domesticated birds. On June 21, 2018, the Kwahu-West Municipal Veterinary Office was notified of sudden deaths of birds on a poultry farm. Seven days later, a second farm sited 100 meters from the index case-farm also recorded bird deaths. We investigated to confirm the causative agent, identify its source, and implement control measures. Methods We conducted a survey of six poultry farms and human contacts of affected farms in Nkawkaw. A suspected case-farm of HPAI was any farm in Nkawkaw with sudden death of bird(s), with or without clinical signs of HPAI from June 1 to July 10, 2018. Six bird carcasses were collected on affected farms for laboratory analysis. We interviewed owners of affected farms and assessed the farm environments, as well as clinical status of human contacts. Results A total 2,280 birds were affected on two adjacent farms. HPAI-H5N1 was confirmed for all samples investigated. The index case-farm with 1,438 birds, reported 30 bird deaths on June 16, 2018, 24 hours after receiving a consignment of birds from an HPAI-H5N1 confirmed farm in a neighboring region of Ghana. The second case-farm recorded bird deaths 7 days later. Both farms operated aluminum sheet-roofed metallic mesh pens without fencing. Beddings in pens were not regularly changed. Four poultry farms located within an 6km radius of the affected farms did not report sick or dead birds. All twenty-three human contacts were asymptomatic of flu, after 14-days follow-up. Conclusions This HPAI-H5N1 outbreak was likely imported through the introduction of birds from a neighboring region due to lax livestock movement regulations, and poor biosecurity measures on farms. Disinfection and depopulation exercises effectively controlled the outbreak. We recommend strict implementation of biosafety measures on farms and at entry points in the district

Background: Small airway dysfunction in asthma can be measured by impulse oscillometry (IOS), where sometimes the reactance can exhibit an inversion of the curve, and its correction can determine a new value for X5: approximate X5 (X5 approx.). Our hypothesis is that X5 approx. exhibits a closer association with parameters of airway dysfunction in the IOS than X5. Methods: We analyzed 403 children (3-17 years old) who performed IOS (Sentry Suit, Vyntus®) and spirometry, recording R5, AX, X5, X5approx., Fres, D5-20 and FEF25-75. Groups X5 and X5 approx. were compared with respect to the percentage of abnormal IOS parameters, their averages, FEF25-75, and their correlation with each IOS parameter. Also, we explored the correlation between X5 and X5 approx. with each IOS parameter. Results: We found a significant decreasing prevalence of X5 approx. with age (84.6% in preschoolers, 67.2% in schoolchildren, and 36.5% in adolescents, p for trend <0.001). The preschoolers and schoolchildren with X5 approx. exhibited significant (p<0.05) alterations in many other IOS parameters (e.g. R5, Fes, AX, and D5-20) compared with those with X5. Adolescents exhibited a significant (p<0.01) alteration only for D5-20. The means of R5, AX, and D5-20 were significantly (p<0.01) higher in children with X5 approx. than with X5. Finally, in the all the age categories, compared with X5, X5 approx. correlated better with other IOS parameters and FEF25-75. Conclusion: The presence of X5 approx. decreases with age and correlates more closely than X5 with other IOS parameters for the evaluation of small airway dysfunction

Background: Bi-level positive airway pressure (BiPAP) and synchronized intermittent mandatory ventilation (SIMV) can be used to achieve peak inspiratory pressure and positive end-expiratory pressure to avoid alveolar collapse and improve oxygenation in preterm infants during the treatment of respiratory distress syndrome (RDS), and there is an urgent demand for evaluating the effects and prognoses of these two ventilation modes. Methods: We conducted a retrospective study on preterm infants (≤ 32 weeks and < 2500 g) from March 2015 to March 2020 with BiPAP (n = 63) and SIMV (n = 63). The primary outcomes were successful treatment and weaning within 72 hours, the demand for a second pulmonary surfactant supply and the need for a second respiratory support. The secondary outcome was the incidence of complications. Results: There were no significant differences (P>0.05) in the primary outcomes or the incidence of complications (pneumonia, apnoea, respiratory failure, air leak syndrome, persistence of patent ductus arteriosus, neonatal sepsis, necrotizing enterocolitis, retinopathy of prematurity, and intraventricular haemorrhage). There were significant differences (P<0.05) in the incidence of pulmonary haemorrhage, bronchopulmonary dysplasia and IVH (≥ grade II). Conclusion: Although both BiPAP and SIMV achieved good early treatment outcomes of RDS in preterm infants, BiPAP support is recommended for reducing the incidence of pulmonary haemorrhage, bronchopulmonary dysplasia and IVH (≥ grade II) if infants are tolerant. Attempts should be made to prevent these complications from happening with the use of SIMV support if infants are intolerant.

Children are not small adults, and this fact is particularly true when we consider the respiratory tract. The anatomic peculiarities of the upper airway make infants preferential nasal breather between 2 and 6 months of life. The paediatric larynx has a more complex shape than previously believed, with the narrowest point located anatomically at the subglottic level and functionally at the cricoid cartilage. Alveolarization of the distal airways starts conventionally at 36-37 weeks, but occurs mainly after birth, continuing until adolescence. The paediatric chest wall has unique features that are particularly pronounced in infants. Neonates, infants and toddlers have a higher metabolic rate, and consequently, their oxygen consumption at rest is more than double that of adults. The main anatomical and functional differences between paediatric and adult airways contribute to understanding of various respiratory symptoms and disease conditions in childhood. Knowing the peculiarities of paediatric airways is helpful in the prevention, management and treatment of acute and chronic diseases of the respiratory tract. Developmental modifications in the structure of the respiratory tract, in addition to immunological and neurological maturation, should be taken into consideration during childhood.

The “Belt and Road Initiative” (BRI) was anticipated in 2013 to promote socio-economic development and cooperation across countries in Asia, Europe, Africa and worldwide. Rapid land-use changes and infrastructure developments driven by the BRI program are expected in the coming decades. These anthropogenic effects are likely to exaggerate the process of de-vegetation, deforestation, accelerating desertification, which is one of the major threats to the BRI region. This manuscript studied the desertification facts (i.e. spatiotemporal pattern, impacts and impacting factors) and investigated key aspects for desertification control (i.e. mitigation and evaluation methods) in the BRI countries via an extensive review of literature. We found that desertification has been prevalent in the BRI countries, predominantly in C Asia, but quantitative assessment of desertification is yet fully understood. This review illustrated that desertification was driven by climatic dryness and mis-land-use/management activities, but their relative importance has yet been (quantitatively) assessed along the BRI countries. Given the negative impacts of desertification, these BRI countries have ratified the UN Convention to Combat Desertification (UNCCD) to reduce negative impacts. The implementation of desertification mitigation programmes are currently still lacking. We argued that desertification is usually evaluated via four type of approaches, including quantitative approaches, indirect detection, direct observation and biophysical measurement (e.g. vegetation growth). Future research should be applied by considering the research scope and data availability. Overall, we conclude that BRI countries should carry out transboundary control on desertification. Otherwise, this issue is likely to extend further imminent developments under the foremost BRI program.

Subalpine forests are hydrologically important to the function and health of mountain basins. Identifying the specific water sources and the proportions used by subalpine forests is necessary to understand potential impacts to these forests under a changing climate. The recent ‘Two Water Worlds’ hypothesis suggests that trees can favour tightly bound soil water instead of readily available free-flowing soil water. Little is known about the specific sources of water used by subalpine trees Abies lasiocarpa (Subalpine fir) and Picea engelmannii (Engelmann spruce) in the Canadian Rocky Mountains. In this study, stable water isotope (δ18O and δ2H) samples were obtained from Subalpine fir and Engelmann spruce trees at three points of the growing season in combination with water sources available at time of sampling (snow, bound soil water, saturated soil water, precipitation). Using the Bayesian Mixing Model, MixSIAR, relative source water proportions were calculated. In the drought summer examined, there was a net loss of water via evapotranspiration from the system. Results highlighted the importance of tightly bound soil water to subalpine forests, providing insights of future health under sustained years of drought and net loss in summer growing seasons. This work builds upon concepts from the ‘Two Water Worlds’ hypothesis, showing that subalpine trees can draw from different water sources depending on season and availability. In our case, water use was largely driven by a tension gradient within the soil allowing trees to utilize tightly bound soil water and saturated soil water at differing points of the growing season.