Background. We studied by means of echocardiography and cardiac MRI (CMR) the occurrence of an accessory papillary muscle that unites mostly the left ventricle (LV) apex with the basal or mid antero-septum. Methods. We included all good quality echocardiography and CMR studies as reviewed by two cardiologists and assessed the occurrence of a contractile papillary muscle situated between the LV apex and antero-septum. Results. A contractile accessory papillary muscle situated between the LV apex and the antero-septum was seen in 100% of HOCM patients and 62% of control patients (p=0.05) in the CMR images acquired from a total of 22 HOCM (9) and control (13) patients. The same structure was observed in 241 patients representing 69.5% of all-comers echocardiography studies. The age was 69 ± 17 years on average in the echocardiography arm, patients harboring the antero-septal accessory muscle being older (71.6 + 15.7 years old vs 63.5 ± 18.1 for those without, p=0.0005). We exemplify this structure by parasternal long axis still echocardiography images and clips from 24 patients and CMR SSFP still images and a clip from two HOCM patients and one control. Conclusion. A contractile accessory papillary muscle was observed in more than half of the all-comer echocardiography studies, and in all HOCM patients in the CMR arm. Further research is needed to fully characterize the anatomical and physiological significance of this structure attaching in the immediate vicinity of the LVOT in HOCM and control patients.

Clinical Implications: this is the first study describing the impact of COVID-19 /lockdown on the psychological and emotional wellbeing in a selected group of children with problematic severe asthma.

A document by Denis Cozzi. Click on the document to view its contents.

In our work, the formation energies, band structures, densities of states, effective masses and optical absorption properties of pure BiOBr and 3d transition metals-doped BiOBr have been calculated using DFT+U method. Ti, V, Fe, Cr, Co, Ni and Cu doping can induce impurity energy levels, originating from spin-up or -down orbits of 3d TMs, within the forbidden band of BiOBr, but Sc, Mn and Zn atoms only change the electronic delocalization in the valence bandor conduction band region of BiOBr. Furthermore, with introduction of 3d TMs atoms, there exist the redshift phenomena for optical absorption band edge of BiOBr to different extents. The photo response priority order, structural stability and recombination probability of photoinduced carriers for 3d TMs-doped BiOBr are summarized. Our theoretical findings should well explain the experimental observations in the previous literatures, and provide promising prediction and significant guidance for the well-construction of BiOBr-based photocatalyst systems.

Introduction Although left atrial posterior wall isolation (LAPWI) in addition to pulmonary vein isolation is a well-accepted option for persistent atrial fibrillation (AF), complete isolation can be challenging. To evaluate performance of a modified ablation index (AI) (AI/bipolar voltage along the ablation line) for predicting durable LAPWI. Methods The study involved 55 consecutive patients, aged 65 ± 11 years, who underwent electroanatomic mapping-guided LAPWI for AF. Association between gaps (first-pass LAPWI failure and/or acute LAPW reconnections), voltage amplitude along the roof and floor lines, and thickness of the LAPW was investigated. Results Gaps occurred in 22 patients (40%) and in 26 (8%) of the 330 line segments assessed—11 in the center roof line segment, 6 in the center floor line segment, 4 in the right roof line segment, 4 in the right floor line segment, and 1 in the left floor line segment. Gaps were associated with relatively high bipolar voltage (3.38 ± 1.83 vs. 1.70 ± 1.12 mV, P < 0.0001) and a thick LA wall (2.52 ± 1.15 vs. 1.42 ± 0.44 mm, P < 0.0001). A modified AI ≤ 199 AU/mV, bipolar voltage ≥ 2.64 mV, wall thickness ≥ 2.04 mm, and roof ablation line ≥ 43.4 mm well predicted gaps (AUCs: 0.783, 0.787, 0.858, and 0.752, respectively). Conclusions High voltage zones, a thick LAPW, and a long roof ablation line appear to be determinants of gaps, and a modified AI ≥ 199 AU/mV along the ablation lines appears to predict acute durable LAPWI.

Atrioventricular septal defects (AVSD) entails a wide range of morphological anomalies including the interatrial and interventricular communications and the atrioventricular (AV) valve(s). However, “En face ”visualization of these anomalies could not be done using standard two-dimensional echocardiography. Therefore, we report a case that highlights the role of three-dimensional echocardiography in imaging AVSDs.

Recent research has demonstrated that synthetic methanotroph-photoautotroph cocultures offer a highly promising route to convert biogas into value-added products. However, there is a lack of techniques for fast and accurate characterization of cocultures, such as determining the individual biomass concentration of each organism in real-time. To address this unsolved challenge, we propose an experimental-computational protocol for fast, easy and accurate quantitative characterization of the methanotroph-photoautotroph cocultures. Besides determining the individual biomass concentration of each organism in the coculture, the protocol can also obtain the individual consumption and production rates of O2 and CO2 for the methanotroph and photoautotroph, respectively. The accuracy and effectiveness of the proposed protocol was demonstrated using two model coculture pairs, Methylomicrobium alcaliphilum 20ZR - Synechococcus sp. PCC7002 that prefers high pH high salt condition, and Methylococcus capsulatus - Chlorella sorokiniana that prefers low salt and neutral pH medium. The performance of the proposed protocol was compared with a flow cytometry based cell counting approach. The experimental results show that the proposed protocol is much easier to carry out and delivers faster and more accurate results in measuring individual biomass concentration than the cell counting approach without requiring any special equipment.

Plants can absorb water through their leaf surfaces, a phenomenon commonly referred to as foliar water uptake (FWU). Despite the physiological importance of FWU, the pathways and mechanisms underlying the process are not well known. Using a novel experimental approach, we parsed out the contribution of the stomata and the cuticle to FWU in two species with Mediterranean (Prunus dulcis) and temperate (Pyrus communis) origin. The hydraulic parameters of FWU were derived by analyzing mass and water potential changes of leaves placed in a fog chamber. Leaves were previously treated with abscisic acid to force stomata to remain closed, with fusicoccin to remain open, and with water (control). Leaves with open stomata rehydrated two times faster than leaves with closed stomata and attained three to four times higher maximum fluxes and hydraulic conductance. Based on FWU rates, we propose that rehydration through stomata occurs primarily via diffusion of water vapor rather than in liquid form even when leaf surfaces are covered with a water film. We discuss the potential mechanisms of FWU and the significance of both stomatal and cuticular pathways for plant productivity and survival.

We present a novel case of an urticaria multiforme-type drug reaction to the new cystic fibrosis medication Trikafta (elexacaftor + tezacaftor + ivacaftor). Equipped with this information, clinicians may be more prepared to counsel and treat patients if they experience similar symptoms after beginning Trikafta.

Background: From sepsis to COVID-19-induced multi-organ failure, inflammation and immune system activation play an important role. It has been argued that inflammation and over-activation of the immune system could be mediating a pro-oxidant microenvironment that can induce cytotoxic effects that potentiate tissue damage favoring organic deterioration. Aims: To investigate whether induction of oxidative stress by COVID-19 infection could inhibit mitochondrial function and cause cellular damage in leukocytes. Methods: We evaluated plasma levels of nitric oxide, hydrogen peroxide and protein carbonylation using spectrophotometry, in addition to evaluating mitochondrial function and cell death by fluorescence microscopy and leukocyte morphology, in COVID-19 patients at two time points: viremia and severe sepsis with multi-organ failure. Results: COVID-19 induces increased oxidative stress markers that activate cellular damage processes. In the viremia stage, was observe with an increase in peroxide (28.9%), nitric oxide (370.3%) and carbonylated proteins (61.8%), which was correlated with an increase in inhibition of mitochondrial function (66%), early apoptosis (212%) necrosis (405%), and leukocytes-reactivity. The severe sepsis stage with multi-organ failure also showed a further increase in levels of peroxide (46.4%) with a slight decrease in nitric oxide (216.2%) but with more carbonylated proteins (102%), regarding what was observe in viremia. This oxidative process was correlate with less inhibition of mitochondrial function (32.4%) and an increase in late apoptosis (463%), and morphology changes evidencing damage in the leukocytes. Conclusion: SARS-CoV-2 induced damage promotes levels of oxidative stress markers and mitochondrial dysfunction that potentiate morphological changes and cell death in leukocytes. These cellular effects could be integrating into the physiopathology of COVID- 19. These processes explain the rapid changes in the immune system, and that present an initial over-activation and early massive death due to SARS-CoV-2 infection, promoting endothelial-alveolar damage that would cause multi-organ failure.

This paper is devoted to study the global attractors of the periodic initial value problem for Landau--Lifshitz--Bloch--Maxwell system. Fist we give the global existence of the smooth solution for this system. Then, we prove the existence of global attractors, the Hausdorff dimension and fractal dimension have been estimated.

In this paper, the nonlinear static analysis of Timoshenko nanobeams consisting of bi-directional functionally graded material (BFGM) with immovable ends is investigated. The scratching in the FG nanobeam mid-plane, is the source of nonlinearity of the bending problems . The non-local theory is used to investigate the nonlinear static deflection of nanobeam. In order to simplify the formulation, the problem formulas is derived according to the physical middle surface. The Hamilton principle is employed to determine governing partial differential equations as well as boundary conditions. Moreover, the differential quadrature method (DQM) and direct iterative method are applied to solve governing equations. Present results for nonlinear static deflection were compared with previously published results in order to validate the present formulation. The impacts of the nonlocal factors, beam length and material property gradient on the nonlinear static deflection of BFG nanobeams are investigated. It is observed that these parameters are vital in the value of the nonlinear static deflection of the BFG nanobeam.

{\bf Abstract.} In this paper, we study the generalized quasilinear Schr\”{o}dinger equation \begin{equation*} -\text{div}(g^2(u)\nabla u)+g(u)g’(u)|\nabla u|^2+V(x)u=(I_{\alpha}\ast|u|^{p})|u|^{p-2}u,\ \ \ x\in\R^N, \end{equation*} where $N\geq3$, $0<\alpha

Aim: To investigate the mean thrombocyte volume (MPV) in asymptomatic children infected with COVID-19. Methods: The study included 55 children infected with COVID-19 and 60 healthy children for the comparison of leukocyte and thrombocyte count, MPV, and serum C-reactive protein (CRP) levels. Demographic data and clinical findings of all the cases were recorded, including age, gender, weight, temperature, cough, shortness of breath and contact history. Results: The MPV values were determined to be statistically significantly high (p<0.001) and the lymphocyte values were significantly low (p:0.002) in the asymptomatic children infected with COVID-19 compared to the healthy control children. No difference was determined between the groups in respect of CRP level, leukocyte and thrombocyte counts (p>0.05). The optimal cutoff point for MPV was determined as 8.74 fl (Area under the curve-AUC:0.932) with 81.82% sensitivity and 95% specificity for the determination of children infected with COVID-19. A cutoff value of <2.12/mm3 for lymphocytes (AUC:0.670) was determined with 49.09% sensitivity and 86.67% specificity for the prediction of COVID-19. Based on the ROC analysis, the sensitivity and specificity of MPV was determined to be higher than that of lymphocyte levels. Conclusion: The results of this study that MPV levels are significantly high in asymptomatic children infected with COVID-19 demonstrate that this is an important predictive value and has better predictive capacity than lymphocyte values. The evaluation of MPV and lymphocyte levels together could increase diagnostic success in asymptomatic COVID-19 cases.

Ambrosia artemisiifolia and Ambrosia trifida are two species of very harmful and invasive plants of the same genus. However, it remains unclear why A. artemisiifolia is more widely distributed than A. trifida worldwide. Distribution and abundance of these two species were surveyed and measured from 2010 to 2017 in the Yili Valley, Xinjiang, China. Soil temperature and humidity, main companion species, the biological characteristics in farmland ecotone, residential area, roadside and grassland, and water demand of the two species were determined and studied from 2017 to 2018. The area occupied by A. artemisiifolia in the Yili Valley was more extensive than that of A. trifida, while the abundance of A. artemisiifolia in grassland was less than that of A. trifida at eight years after invasion. The interspecific competitive ability of two species were stronger than those of companion species in farmland ecotone, residential, and roadside. In addition, A. trifida had greater interspecific competitive ability than other plant species in grassland. The seed size and seed weight of A. trifida were five times or eight times those of A.artemisiifolia. When comparing the changes under simulated annual precipitation of 840 mm versus 280 mm, the seed yield per m2 of A. trifida decreased from 50,185 to 19, while that of A. artemisiifolia decreased from 15,579 to 530. The differences in the distribution of the two species are mainly due to differences in interspecific competitive ability, seed size, and water dependence. The two species have stronger interspecific competitive ability than that of companion species, but A. artemisiifolia has a smaller seed size and stronger drought tolerance, which allows A. artemisiifolia to spread farther than A. trifida. The reason for wider distribution of A. trifida in grassland is that A. trifida has stronger interspecific competitive ability than A. artemisiifolia under sufficient water.

Salts in the root zone have high spatial variability, changes rapidly and adversely affects soil quality and crop productivity. Rapid detection of electrical conductivity (EC) using visible-near infrared (Vis-NIR) and midinfrared (MIR) spectroscopy can alleviate the adverse effects on soil and plant, which through conventional method is time consuming. Soils were collected from the Indo-Gangetic plains and analyzed for EC using conventional, Vis-NIR, MIR spectroscopy and there was wide variation in EC measured by the conventional method. The spectral regions in 460-500 and 1890-1906 nm in the Vis-NIR region and 4200-4310, 5275-5280, 6660-6670, 7305-7310 and 8290-8300 nm in the MIR region were sensitive to detection of EC. Partial least square regression (PLSR) outperformed random forest regression (RF), support vector regression (SVR), and multivariate adaptive regression splines (MARS) both in Vis-NIR and MIR region during calibration. The ratio of performance deviation (RPD), coefficient of determination (R2) and root mean square error (RMSE) of the validation dataset were used to assess the prediction accuracy and the predictive performance of PLSR (2.44, 0.84, 0.21), RF (1.95, 0.81, 0.20), SVR (2.09, 0.78, 0.22) and MARS (1.81, 0.73, 0.27) models. PLSR model performed very well in the Vis-NIR range; however, in the MIR range, RF (1.43, 0.52, 0.20), followed by PLSR (1.40, 0.55, 0.35), performed better than SVR (1.39, 0.53, 0.35) and MARS (1.29, 0.44, 0.37). Vis-NIR spectroscopy with PLSR algorithm predicted EC better than MIR spectroscopy and would be the method of choice for rapid estimation and prediction of EC in the study region.

Severe COVID-19 is a multisystem inflammatory disorder and knowledge and experience with severe acute respiratory failure in infected patients has grown considerably since reports of the first few cases. Little is known about the effect of SARS-CoV-2 on the heart, and there has been a suggestion from published literature that fulminant cardiac failure with or without respiratory failure may occur several weeks following infection. A young man presented after a recent viral illness. He was found to be in severe cardiogenic shock and was implanted with an emergency biventricular assist device, which also incorporated an extracorporeal membrane oxygenator. He stabilised soon thereafter and despite an intracerebral haemorrhage, which resolved, and bleeding into the trachea following percutaneous tracheostomy, he survived to explant and was successfully stepped down to a rehabilitation unit on postoperative day 50. He tested positive for SARS-CoV-2 antibodies when the test became available on postoperative day 33. We envisage there will be many more such presentations of acute COVID-19-associated cardiogenic shock and we recommend clinicians consider this diagnosis when presented with an acutely unwell patient with an unclear diagnosis, following a viral illness. These patients should be discussed as early as possible with a transplant/mechanical circulatory support team.

Plants are exposed to a wide range of temperatures during their life cycle and need to continuously adapt. These adaptations need to deal with temperature changes on a daily and seasonal level and with temperatures affected by climate change, and need to take into account that different organs have different optimal temperature ranges. Increasing global temperatures impact crop performance, and several physiological and developmental responses to increased temperature have been described that allow to mitigate this. In this review, we assess various developmental, physiological and biochemical responses of crops to high temperature, focusing on knowledge gained from both monocots (e.g. wheat, barley, maize, rice) and dicots (e.g. soybean or tomato). We outline several outstanding questions where crop research can exploit knowledge from model plants, such as Arabidopsis thaliana, and we highlight that studying molecular mechanisms directly in relevant crops is essential.

Long-term experimental watershed studies have significantly influenced our global understanding of hydrological processes. The discovery and characterization of how stream water quantity and quality respond to a changing environment (e.g., land use change and acidic deposition) has only been possible due to the establishment of catchments devoted to long-term study. One such catchment is the Fernow Experimental Forest (FEF) located in the headwaters of the Appalachian Mountains in West Virginia, a region that provides essential freshwater ecosystem services to eastern and mid-western USA communities. Established in 1934, the FEF is among the earliest experimental watershed studies in the Eastern USA that continues to address emergent challenges to forest ecosystems, including climate change and other threats to forest health. This data note summarizes some of the seminal findings from more than 50 years of hydrologic research in the FEF. During the first few decades, research at the FEF focused on the relationship between forest management and hydrological processes – especially those related to the overall water balance. Later, research efforts included the examination of interactions between hydrology and soil erosion, biogeochemistry, N-saturation, and acid deposition. Hydro-climatologic and water quality datasets from long-term measurements and data from short-duration studies are publicly available to provide new insights and foster collaborations that will continue to advance our understanding of hydrology in forested headwater catchments. As a result of its rich history of research and abundance of long-term data, the FEF is uniquely positioned to continue to advance understanding of forest ecosystems in a time of unprecedented change.

Finite element simulations of bonded repair technology can greatly reduce the cost of repairing ageing and damaged aircraft structures. In this study, finite element simulation and analysis are performed for several bonded repair techniques of damaged aircraft structures with cracks. The simulations start from fatigue damage accumulation, crack initiation, crack repair, to fatigue crack re-initiation until structural failure. The effectiveness of bonded repair techniques is assessed by comparing the service lives of no repair, patch-bonded repair (live repair), stop-drill repair, and damage removal repair. It is found that the load attraction by repair patch can greatly sustain fatigue crack growth, leading to more than at least 2 times longer service life before the skin structure needs to be replaced. Damage removal bonded repair can further extend service life by more than 20 times comparing to no repair, benefiting from the fatigue damage tolerant service life extension. Along with the service life comparison, we also established a simulation framework that lays out the groundwork to perform aerostructure bonded repair effectiveness evaluation. The results demonstrate that finite element analysis can be efficiently used to simulate the various forms of bonded repairs and effectively evaluate fatigue crack growth and service life with structural damage. Such a rigorous simulation framework enables the future design of new repair techniques for aircraft structures.

Virus-like particle (VLP), a self-assembled multiprotein structure, can stimulate robust immune responses due to its structure similar to native virions that curries multiple copies of the target epitopes. Utilizing VLPs as vaccine platforms to present exogenous antigens is a promising and challenging approach in the vaccine development field. This study aims to investigate the potential of hepatitis E virus (HEV) truncated capsid as a VLP platform to present foreign antigens. The S and M domains of HEV capsid protein were selected as the optimal carrier (CaSM). The exogenous antigen Seq8 containing three neutralizing epitopes from three different foot-and-mouth disease virus (FMDV) strains was linked to the C-terminal of CaSM to construct a chimeric VLP (CaSM-Seq8). The construct was successfully expressed and purified. Morphological analysis showed that CaSM-Seq8 self-assembled into VLPs similar to CaSM VLP (~26 nm in diameter) but smaller than native HEV virions. Further, the thermal stability and the resistance to enzymatic proteolysis of Seq8 were enhanced when it was attached to CaSM carrier. The antigenicity analysis revealed a more robust reactivity against anti-FMDV antibodies when Seq8 was presented on the CaSM particles. Upon injection into mice, FMDV-specific IgGs induced by CaSM-Seq8 appeared earlier, increased faster, and maintained higher levels for a longer time than those induced by Seq8 alone or the inactivated FMDV vaccine. This study demonstrated the potential of utilizing HEV truncated capsid as an antigen-presenting platform for the development of chimeric VLP vaccines.

Recently there have been many concerns regarding the use of acid suppression therapy in the setting of the COVID-19 pandemic. We review here the biological plausibility, the evidence and the recommendations for acid suppressant use in the present COVID-19 pandemic. After adjusting for confounding factors, PPI use, especially twice-daily dosing, seem to be associated with acquiring COVID-19 infection and worse outcomes among patients with COVID-19, compared to non-users. PPI induced hypochlorhydria may be responsible for the observed effects. Famotidine seems to protect against clinical deterioration among hospitalised and improves patient-reported outcomes among non-hospitalised patients with COVID-19, compared to non-users. Famotidine interfering maturation of SARS-CoV-2 and reducing inflammation may be responsible for the observed effect. The knowledge from the recent studies could help by reminding PPI users to be especially vigilant about following protective health behaviours and should also encourage physicians to prescribe PPIs rationally during and after the pandemic.

The combination of antiviral and anti-inflammatory properties of Clofaximine as experienced in clinical practice, could lead to take into consideration its effects in COVID 19

Background: Severe asthma exacerbation is an important comorbidity of the 2009 HIN1 pandemic [A(H1N1)pdm09] in asthmatic patients. However, the mechanisms underlying severe asthma exacerbation remain unknown. Using a mouse model of asthma, we evaluated airway hyperresponsiveness (AHR) in mice with A(H1N1)pdm09 infection and those with seasonal influenza for comparison. We also measured AHR in paediatric participants infected with A(H1N1)pdm09. Methods: BALB/c mice aged 6-8 weeks were sensitized and challenged with ovalbumin. Either mouse-adapted A(H1N1)pdm09, seasonal H1N1 virus (1×105 pfu/20 μL), or mock treatment as a control was administered intranasally. At 3, 7, and 10 days after infection, each group of mice was evaluated for AHR by methacholine challenge using an animal ventilator, flexiVent®. Lung samples were resected and observed using light microscopy to assess the degree of airway inflammation. AHRs in paediatric participants were defined as the provocative acetylcholine concentration causing a 20% reduction in FEV1.0 (PC20). Results: Airway resistance was significantly enhanced in A(H1N1)pdm09-infected asthmatic mice compared to that in seasonal H1N1-infected mice (p<0.001), peaking at 7 days post-infection and then becoming similar to control levels by 10 days post-infection. Histopathological examination of lung tissues showed more intense infiltration of inflammatory cells and severe tissue destruction in A(H1N1)pdm09-infected mice at 7 days post-infection than at 10 days post-infection. AHRs in the paediatric participants were temporarily increased, and alleviated by 3 months after discharge. Conclusions: Our results suggest that enhanced AHR could contribute to severe exacerbation in human asthmatic patients with A(H1N1)pdm09 infection.