Mixed-culture fermentation provides a means to recycle carbon from complex organic waste streams into valuable feedstock chemicals. Using complex microbial consortia, individual systems can be tuned to produce a range of biochemicals to meet market demand. However, the metabolic mechanisms and community interactions which drive product expression changes under differing conditions are currently poorly understood. Furthermore, predictable product transitions are currently limited to pH-driven changes between butyrate and ethanol, and chain-elongation (fed by CO2, acetate, and ethanol) to butyrate, valerate, and hexanoate. Lactate, a high-value biopolymer feedstock chemical, has been observed in transition states, but sustained production has not been described. In this work, a continuous stirred bioreactor was operated at low pH (5.5) with substrate concentration varied between limiting and non-limiting conditions. Using glucose as a model substrate, two sustained operational states were defined: butyrate production during substrate limitation, and lactate production in the non-limited state. Through SWATH-MS metaproteomics and 16S rDNA community profiling, the mechanism of change between butyrate and lactate was described primarily by redirected carbon flow through the methylglyoxal bypass by Megasphaera under substrate non-limiting concentrations. Crucially, butyrate production resumed upon return to substrate-limited conditions, demonstrating the reversibility of this transition.

Protein phosphorylation, especially serine/threonine and tyrosine phosphorylation, plays significant roles in signaling processes during plant growth and development as well as their responses to biotic or abiotic stresses. The dual-specificity protein tyrosine phosphatases are important to de-phosphorylate and inactivate the signaling components. In this study, we reported an atypical dual specificity protein tyrosine phosphatase ATPFA-DSP3 (DSP3), which loss-of-function mutant was insensitive to salt treatment, played a negative role in plant’s response to salinity in Arabidopsis. DSP3 protein was primarily localized in nuclei and degraded after salt treatment. The level of ROS accumulation was lower in dsp3 mutant and higher in DSP3 over-expresser than wild type control, indicating DSP3 positively affect ROS production. DSP3 can directly interact with MPK3 and MPK6, and the phosphorylated MPK3 and MPK6 over accumulate in dsp3 mutant. Moreover, the phosphatase activity of DSP3 was required for its salt response. These results provide evidences showing that DSP3 negatively mediates plant salt response by directly modulating the accumulation of phosphorylated MPK3 and MPK6.

Coronavirus disease 2019 (COVID-19) has appeared as the biggest challenge of present time as our health systems are struggling to contain the spread of the virus. As COVID-19 developed rapidly into a pandemic, people need to acquire and apply health information, and adapt into their behavior right away. However, there exists a global epidemic of misinformation alongside this pandemic. People at risk need to be able to take informed decisions on mitigating the effects of the disease outbreak and practice protective and preventive actions. This affirms the urgency and importance of forming a dedicated risk communication team in the country to design and deliver risk communication packages with the SBCC approach addressing the need of subpopulations dwelling at all levels.

Dear editor, COVID-19 is a multi-system illness that develops from the novel SARS-CoV-2 virus. The first outbreak of the disease occurred in Wuhan, China, in late 2019. In March 2020, the World Health Organization (WHO) declared COVID-19 a pandemic and many governments around the world introduced a number of restrictions on their populations to control the spread of the virus. These restrictions included business and school closures, lockdowns, social distancing, and the wearing of masks and other personal protective equipment (PPE). Meanwhile, many commercial and industrial sectors have been significantly impacted by government-imposed directives to halt COVID-19’s spread. Hospital wastes and municipal solid wastes are included in the affected sectors, as the amount of solid wastes being generated as a result of pandemic-related measures has increased astronomically, with hospitals in particular contributing to the large boost in solid waste generation. Pandemic-related wastes include discarded PPE items such as masks, gloves, gowns, eye protectors and face shields, as well as items used in the testing and treatment of the disease, such as surgical instruments, needles, and medications 1, 2. In response to the pandemic, many countries and districts have imposed various rules on the general public to reduce the spread of the virus without taking into account the increase in medical waste that these directives will cause. The most common of the “new normal” rules includes wearing face masks and visors in closed areas such as public transportation and shops. More recently, wearing non-surgical masks has become mandatory in a number of cities and countries around the world as a way to limit the spread of COVID-19. Masks are presented to the public as an excellent tool to protect human health and reduce disease transmission among the population. Although different types of face masks offer different levels of protection, all of them eventually contribute to landfill waste and are uncomfortable to wear for long periods of time.The main aim of this letter is to study the impact on human health of the various inks used in masks. Because most authorities have imposed the wearing of face masks without any norms, the choice of masks depends on the person. Individuals are free to choose any method to make their masks and to write on them whatever slogan they wish. In the market, many masks with different colors and slogans have appeared for sale. For masks as for any other fabric, color is applied for the main purpose of making the mask more aesthetically appealing. However, many dyes present varying degrees of environmental hazards, despite their continued use in inks, textiles, printing, and other applications. Most commercially available masks are made from layers of plastics, whose negative impact on both human health and the environment is well-known. In addition to the toxic content of plastics, textile dyeing is a major source of pollution and is not only toxic but also persistent3-6. Furthermore, the impact of different paints and inks on human health is rarely, if ever, taken in account when choosing a mask 4-7. As is known, different paints and inks are composed of a range of chemical compounds, including volatile organic compounds (VOCs) as chemical elements. The effect of VOCs on human health has been extensively documented in the literature8, 9. Another consideration is that aerodynamic parameters can affect the emission of VOCs, as certain VOCs are emitted at ambient air temperature. The number of studies focusing on the reduction of VOC content produced by inks has increased lately due to heightened environmental awareness 10. Benzene toluene, ethyl-benzene and xylene (BTEX), which is one of the most prevalent chemical compounds emitted by landfills, is also a VOC. According to several researchers 11-17, BTEX is considered a carcinogenic substance that is well-known for its ability to deteriorate human health 16, 17. Individually, both benzene and ethyl-benzene are carcinogens as well, affecting the nervous system, while toluene and xylene can damage the nervous and reproductive systems. The main organs affected by these carcinogenic compounds are the lungs, liver, and kidneys. According to a recent scientific study, people working in printing and inking occupations are considered at high risk for developing illnesses. Workers in these industries typically suffer from chronic ailments such as headaches, dizziness, skin damage, and respiratory failure. The inks causing the health issues are composed of numerus organic solvents, such as toluene, ethyl acetate, isopropyl alcohol, and others. Even for the short-term, respiratory and skin exposure to these chemical elements (such as occurs during daily mask wearing) can lead to the development of skin, respiratory, cardiovascular and eye diseases and may even cause cancer.As a recommendation to lessen the negative effects of mask wearing, the mask should not have any written slogans on its surface. In fact, writing on face masks should be forbidden. Further, dyes should be selected according to internationally accepted industry standards to protect human health and the environment. An international consensus concerning face mask colors based on their impact on human health should be investigated and determined. Certain dyes are toxic and persistent and have both short- and long-term negative impacts on human health, fauna, and flora. Finally, governments and authorities should encourage people to use their masks one time only and then properly dispose of them as medical waste.Acknowledgments: The author of this paper thanks specially the Deanship of scientific research at University of Tabuk and my scientific collaborators.Funding: This work was supported by the Deanship of Scientific Research at University of Tabuk [Grant number S-0048-1441].

Density functional theory (DFT) calculations were conducted to investigate mechanistic details of ethanol-to-butadiene conversion reaction over MgO or ZnO catalyst. We evaluated the Lewis acidity and basicity of MgO and ZnO and found that ZnO had the stronger Lewis acidity and basicity compared with those of MgO. Potential energy surfaces (PESs) of ethanol-to-butadiene conversion, which included relevant transition states (TSs) and intermediates, were computed in detail following the generally accepted mechanism reported in the literature, where such mechanism included ethanol dehydrogenation, aldol condensation, Meerwein-Pondorf-Verley (MPV) reduction and crotyl alcohol dehydration. DFT results showed that ethanol dehydrogenation was the rate limiting step of overall reaction when the reaction was catalyzed by MgO. Also, DFT results showed that ethanol dehydrogenation occurred more easily on ZnO compared with MgO where such a result correlated with the stronger Lewis acidity of ZnO. In addition, we computed ethanol dehydration which generates ethylene, one of the major undesired side reaction products for butadiene formation. DFT results showed that ZnO favored dehydrogenation over dehydration while MgO favored dehydration.

The objective of this case report is to describe the operation and use of awake ECMO without anticoagulation in a patient with a nearly completely obstructive squamous cell carcinoma of the trachea. A retrospective chart and literature review was performed in a private hospital in a large municipal area.

Summary 1. Research has indicated that increases in nitrogen (N) deposition can greatly affect ecosystem processes and functions. There is limited information about the effects of long-term N addition on soil nematodes and their functional composition, although nematodes are the most abundant multicellular animals on Earth. 2. We conducted a field experiment in 2004 with four levels of N addition (0, 60, 120, and 240 kg N ha-1 yr-1) in a subtropical Cunninghamia lanceolata forest. Soil samples with three depths (0-20, 20-40 and 40-60 cm) were collected and the community structure, diversity and trophic groups of soil nematodes were determined in 2014. 3. N addition significantly increased the abundance of bacterial- and fungal-feeding nematodes, but decreased the abundance of plant-feeding nematodes at the 0-20 cm soil layer. Accordingly, the plant parasite index and enrichment index decreased but the basal index and channel index increased, which weaken the importance of the plant-based energy channel, but enhance the importance of the fungal-based energy channel. N addition had no effects on the diversity of soil nematodes in three soil depths. Structural equation modeling analysis indicated that N loading directly changed plant-feeding (total r2=0.42) nematodes, or indirectly affected bacterial- (r2=0.43), fungal- (r2=0.31) and plant-feeding nematodes via change soil nutrients, soil water content and pH. 4. These findings suggest that N addition can change the community structure and energy channels soil nematodes, which would affect soil processes and food web functions in forest soils under future environmental change scenarios.

The outcome of pediatric patients with Philadelphia chromosome (Ph)-positive acute lymphoid leukemia (ALL) has improved with addition of tyrosine kinase inhibitors to an intense chemotherapy. However, it is associated with high incidences of adverse effects and requires new therapeutic strategies for maximum anti-leukemic effect and reduced toxicities. We describe a challenging adolescent case with Ph-positive ALL and mechanical mitral and aortic valves due to Shone’s syndrome. The patient received reduced intensity chemotherapy and blinatumomab with dasatinib and is in deep molecular remission. Long-term anticoagulation was achieved with enoxaparin for mechanical valves and unfractionated heparin during procedures.

Introduction: The aim of the study was to determine the health related quality of life (HRQoL) and family functioning of parents whose children were receiving active phase cancer treatment during a hospital admission. Methodology: A quantitative, descriptive, cross-sectional study was conducted in a specialist oncology unit within a tertiary hospital in Gauteng, South Africa. Structured interviews were conducted with the parents of children with cancer, to determine their Health Related Quality of Life (HRQoL) using the PedsQLTM Family Impact Module (2.0). Results: Twenty-Five parents participated, with ages ranging from 26 to 48 years. Most were female, with high school educational level and unemployed. Parents reported intermediate or low HRQoL particularly in the physical and worry components. Parent participants reported family functioning within the intermediate level of HRQoL. The HRQoL of parent participants in this study differed from that reported by parents in another study in a low-middle income context. Conclusion: This study indicated the diagnosis and treatment of child’s cancer created challenges, which had a negative impact on parents’ HRQoL and family functioning.

Purpose: Kaposiform Hemangioendothelioma (KHE) is a rare vascular tumor in children, which can be accompanied by life-threatening thrombocytopenia, referred to as Kasabach-Merritt Phenomenon (KMP). The mTOR inhibitor sirolimus is emerging as targeted therapy in KHE. As the sirolimus effect on KHE occurs only after several weeks we aimed to evaluate if additional transarterial embolization is of benefit for children with KHE and KMP. Methods: 17 patients with KHE and KMP acquired from 11 hospitals in Germany were retrospectively divided into two cohorts. Children being treated with adjunct transarterial embolization and systemic sirolimus, and those being treated with sirolimus without additional embolization. Bleeding rate as defined by WHO was determined for all patients. Response of the primary tumor at 6 and 12 months assessed by Magnetic Resonance Imaging (MRI), time to response of KMP defined as thrombocyte increase >150 x 103/µl, as well as rebound rates of both after cessation of sirolimus were compared. Results: N= 8 patients had undergone additive embolization to systemic sirolimus therapy, sirolimus in this group was started after a mean of 6.5 ± 3 days following embolization. N=9 patients were identified who had received sirolimus without additional embolization. Adjunct embolization induced a more rapid resolution of KMP within a median of 7 days vs 3 months, however tumor response as well as rebound rates were similar between both groups. Conclusion: Additive embolization may be of value for a more rapid rescue of consumptive coagulopathy in children with KHE and KMP compared to systemic sirolimus only.

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Pericardial decompression syndrome is a rare but potentially fatal complication following needle or surgical pericardiocentesis and should be recognized as paradoxical hemodynamic deterioration. The exact pathophysiology of pericardial decompression syndrome is unknown but is likely that several mechanisms involving hemodynamic, ischemic and autonomic imbalance lead to the clinical manifestation of this entity. There is no specific treatment for pericardial decompression syndrome other than supportive care, however, early interventions such as aggressive heart failure therapy, inotropic medications and sometimes mechanical circulatory support should be implement as mortality can be as high as 30%. We report a patient presenting with severe right ventricular failure and cardiogenic shock secondary to PDS.

Active volcanoes in Antarctica, in contrast to the rest of the icy landscape, have remarkable temperature and geochemical gradients that could select for a wide variety of microbial adaptive mechanisms and metabolic pathways. Deception Island is a stratovolcano flooded by the sea, resulting in contrasting ecosystems such as permanent glaciers (<0 oC) and active fumaroles (up to 100 oC). Steep gradients in temperature, salinity and geochemistry over very short distances have been reported for Deception Island, and have been shown to effect microbial community structure and diversity. However, little is known regarding how these gradients affect ecosystem functioning, for example due to inhibition of key metabolic enzymes or pathways. In this study, we used shotgun metagenomics and metagenome-assembled genomes to explore how microbial functional diversity is shaped by extreme geochemical, salinity and temperature gradients in fumarole and glacier sediments. We observed that microbial communities from a 98 oC fumarole harbor specific hyperthermophilic molecular strategies, as well as reductive and autotrophic pathways, while those from <80 oC fumaroles possess more diverse metabolic and survival strategies capable of responding to fluctuating redox and temperature conditions. In contrast, glacier communities showed less diverse metabolic potentials, comprising mainly heterotrophic and carbon pathways. Through the reconstruction of genomes, we were able to clarify putative novel lifestyles of underrepresented taxonomic groups, especially those related to Nanoarchaeota and thermophilic ammonia-oxidizing archaeal lineages. Our results enhance understanding of the metabolic and survival capabilities of different extremophilic lineages of Bacteria and Archaea.

In this study, we proposed an alternative analytical procedure for appraising the fugacity coefficient for gases using second virial coefficient with Lennard-Jones (12-6) potential. The present research is more efficient for determining of the fugacity coefficient of gases in wide ranges temperature and pressure ranges and related thermodynamic properties which is the novelty of this study. The fugacity coefficient for gases , , and has calculated in the temperature range from 30 K to 1000 K and pressure range from 0.1 atm to 200 atm by using the obtained analytical formula. To our knowledge, this work offers the first approximation to the evaluation of the fugacity coefficient for gases for and by second virial coefficients. The results obtained using the analytical formula of the fugacity coefficient is in good agreement with literature.

Objective We aimed to investigate DNA damage level and new potential biomarkers that can assist the diagnosis and treatment of congenital hearing loss. Design A prospective, non‐randomized study. Setting Canakkale Onsekiz Mart University, Canakkale, Turkey Participants We included a patient group consisting of 17 patients with congenital hearing loss and a control group consisting of 17 healthy individuals. Main outcome measures We applied the brainstem-evoked response audiometry (BERA) tests to determine the hearing loss. After taking blood samples, we applied cytokinesis-block micronucleus cytome (CBMN) assay. Methods After the demographic characteristics, family stories and Brainstem Evoked Response Audiometry results of both groups were obtained, their blood was taken. The cytokinesis-blocked micronucleus assay technique was applied to the blood samples to measure the frequency of micronucleus, nucleoplasmic bridge, and nuclear bud in both groups. Results We observed that the micronucleus, nucleoplasmic bridge, and nuclear bud frequencies were found to be significantly higher in hearing loss patients than the control group (p<0.0001). Also, we observed that the frequency of micronucleus in hearing loss patient was positively correlated with nuclear bud, which may indicate a common mechanism for these endpoints. Conclusion It was, for the first time, demonstrated that micronucleation, nucleoplasmic bridge, and nuclear bud formation were found to be higher, which is an indication of genomic instability in patients with congenital hearing loss. Since the markers we evaluated were linked with crucial diseases, our findings might suggest that patients are susceptible to many crucial diseases, including cancer.

The infrahyoid musculocutaneous flap (IHMCF) is a good alternative in the reconstruction of moderate-sized oral cavity surgical defects. Insufficient venous drainage can significantly affect the survival rate of this flap. Objectives Indentify the survival rates of the IHMCF and evaluate the functional capacity of reonstructed patients. Design We report a case series. Setting This study took place at the department of Head and Neck surgery of Oncology Hospital Ho Chi Minh City, the largest oncology center in South Vietnam. Participants We have 112 patients with defects after oral cavity resection for cancer that underwent IHMCF reconstruction from November 2013 to November 2018. In the raising of the flap, our technical approach specifically attempts to preserve more secondary veins for IHMCF. Main outcome measures Postoperative vitality of the flap was checked by clinical observation. The last examination was performed at 1 month after reconstructive operation. The functional capacity of our patients was evaluated by three doctors (head and neck surgeon, radiation oncologist, physiatrist) with understandability of speech scale and the functional oral intake score items. Results Two cases of partial skin necrosis (1.8%) were experienced. The majority of patients demonstrate favorable functional rehabilitation at long-term follow up. Conclusions. The IHMCF is a reliable flap suitable for medium-sized defects of the oral cavity. Altering the surgical approach to specifically preserve more venous outflow can improve the survival rate of the flap. Key words: infrahyoid musculocutaneous flap oral cavity defect

Aims: During the last two decades, new treatment methods have been developed for the surgical removal of second branchial cysts which result in less visible scars. The aim of this systematic review is to assess which surgical technique for second branchial arch cyst removal results in the lowest complication and recurrence rates with the highest scar satisfaction. Methods: Two authors systematically reviewed literature in the Cochrane, PubMed and EMBASE databases (search date: 1975 to December 23th, 2019) to identify studies comparing surgical outcomes of second branchial arch cyst removal. Authors appraised selected studies on directness of evidence and risk of bias. Results are reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results: Out of the 2101 retrieved articles, four articles were included in the current review including a total of 140 operated cysts. Only two studies included pre-operatively infected cysts. Follow up ranged from 3 to 24 months. Complication rates ranged between 0 to 27.3% (conventional: [0-10.4%]; endoscopic/retro auricular: [0-27.3%]). None of the patients presented with postoperative recurrence. Significantly higher scar satisfaction was found in adult patients who underwent endoscopic or retro-auricular hairline incision cyst removal. Conclusion: No recurrence of disease occurred during (at least) 3 months of follow up using either conventional surgery or endoscopic/retro auricular techniques. Although more (temporary) complications occur using endoscopic and retro-auricular techniques, patients report a significantly higher scar satisfaction 3 to 6 months after surgery in comparison to the conventional technique. Future studies are needed to support these findings.

Introduction Sudden sensorineural hearing loss (SSNHL) management is controversial. Systemic steroids as treatment is the most recommended. British society of otology advised caution when prescribing systemic steroids during COVID-19 crisis. As a result, intratympanic steroids (ITS), seem to offer an alternative. Methods: Number of performed MRI scans for investigation of SSNHL between 01/01/2019 and 31/12/2019. This was used as a surrogate measure, reflecting the number of patients with SSNHL over that 12 months period. All patients who were diagnosed and treated for SSNHL between the 16th of March 2020 and the 8th of July 2020 were included in this study. Clinical outcomes included time interval between onset of SSNHL and start of treatment, response to treatment and side effects Results: In 2019, only 10 scan s for SSNHL were done. Twelve patients presented with SSNHL during 4 months of COVID-19 crisis (16 weeks). Three patients had dead ear on presentation with almost no response to steroids. Conclusion The prevalence of SSNHL in time of COVID-19 pandemic appears to be higher than that before the pandemic. ITS appears to be a safe, feasible and relatively effective method of SSNHL treatment during COVID-19 pandemic. Shared decision-making with the patient is central to any intervention, especially with lack of robust evidence.

Background: Specific details about cardiovascular complications, especially arrhythmias, related to COVID-19 are not well described. Objective: We sought to evaluate the incidence and predictive factors of cardiovascular complications and new-onset arrhythmias in Black and White hospitalized COVID-19 patients and determine the impact of new-onset arrhythmia on outcomes. Methods: We collected and analyzed baseline demographic and clinical data from COVID-19 patients hospitalized at the Tulane Medical Center in New Orleans, Louisiana, between March 1st and May 1st, 2020. Results: Among 310 hospitalized COVID-19 patients, the mean age was 61.4 ± 16.5 years, with 58,7% females, and 67% Black patients. Black patients were more likely to be younger, have diabetes and obesity . The incidence of cardiac complications was 20%, with 9% of patients having new-onset arrhythmia. There was no significant difference in cardiovascular outcomes between Black and White patients. D-dimer levels positively correlated with cardiac and new-onset arrhythmic event . New onset atrial arrhythmias predicted in-hospital mortality (OR=2.99 95% CI [1.35;6.63], p=0.007), a longer intensive care unit length of stay (mean of 6.14 days, 95% CI [2.51;9.77], p=0.001) and mechanical ventilation duration(mean of 9.08 days, 95% CI [3.75;14.40], p=0.001). Conclusion: Our results indicate that new onset atrial arrhythmias are commonly encountered in COVID-19 patients and can predict in-hospital mortality. Early elevation in D-dimer in COVID-19 patients is a significant predictor of new onset arrhythmias. Our finding suggest continuous rhythm monitoring should be adopted in this patient population during hospitalization to better risk stratify hospitalized patients and prompt earlier intervention.

This study presents a novel model to predict gas-water two-phase transport behaviors in shale microfractures by incorporating a mobile water film with varying thickness according to the extended Derjaguin-Landau-Verwey-Overbeek (DLVO) theory as well as multiple fluid transport mechanisms (i.e., real gas transport controlled by the Knudsen number and water slippage). This model is implemented in real shale microfractures via digital-core imaging. A gas-water displacement process is modelled by the invasion percolation theory, while a local multiphase distribution is determined by combining disjoining pressure with capillary force. Key findings reveal that gas relative permeability (RP) decreases by 17% and water RP enhances by 33.5%, when the mean aperture decreases from 1.67 to 0.0418μm. Neglecting water film brings a decrease in water RP and an overestimation of gas transport ability. Moreover, two critical microfracture apertures are determined, which enhances an understanding of the water film impact on gas-water transport properties in application.

Medullary thyroid carcinoma (MTC) typically manifests as a solitary thyroid nodule, and a miliary pattern on conventional chest imaging is not commonly observed. Here, we report a 58-year-old woman with constitutional symptoms, and innumerable small nodules on chest imaging, mimicking miliary tuberculosis. Pathologic findings confirmed a diagnosis of metastatic MTC.

Gliosis with haemorrhagic transformation is a late reported complication of stroke (1-2), Sometimes there is a big discrepancy between clinical and radiological diagnosis, Clinical decision must be multi-aspects decision and does not depend on a single unusual investigation.

Calciphylaxis creates a challenge in anticoagulation therapy for patients with mechanical heart valves and ESRD as warfarin cannot be used. We describe our approach in using enoxaparin as an alternative for anticoagulation in a patient with a mechanical heart valve and ESRD who developed calciphylaxis from warfarin.

Here, an 8-year-old girl is reported with bilateral horizontal gaze palsy, ataxia and drowsiness. Brain MRI demonstrated dorsal midbrain, bilateral putamen nuclei and cerebellar dentate nucleus involvement. MRS revealed an elevated lactate peak which suggested a mitochondrial disease. Finally, the molecular genetic test reported NDUFS4 gene mutation