Background: High-power radiofrequency ablation (HPRFA) appears to be a novel concept for atrial fibrillation (AF) treatment but there are scarce data in conscious patients. The lesion size index (LSI) value has been associated with durability of pulmonary vein isolation (PVI) lesions. Objectives: We hypothesised that HPRFA applications based on LSI were not inferior to standard approach in terms of patient’s pain sensationas well as safety, effectiveness, and procedure duration. Methods: Retrospectively, we analysed 218 patients who had performed ablation of AF based on LSI (LSI 4-4.5 on posterior wall, LSI 5-5.5 in other locations) who were propensity score matched to 3 different RF power settings: group-30W (45oC, 30 W and 25 W on posterior wall), group-40W (45oC, 40 W) and group-50W (45oC, 50 W). Results: Comparing group-30W vs group-40W and group-50W, procedure and left atrium dwell time (minutes) were 190±32, 161±41, 102±8 (p<0.0001) and 154±53, 113±29, 79±10 (p<0.0001), respectively. With comparable number of RF applications (p>0.05) between the groups, total RF and fluoroscopy time (minutes) were 62±17,38±10, 28±5 (p<0.0001) and 6±3, 6±2, 4±1 (p=0.08), respectively. Number of stopped painful RF applications were 19±9, 9±5 and 7±2 (p<0.0001), respectively. No serious complications were observed in any of the group. No difference in 1-year ablation efficacy was observed between the groups (p=0.78). Conclusions: HPRFA based on LSI is less painful, faster and safe in conscious patients than standard approach with comparable effectiveness in one year follow-up.

Efficient storage of hydrogen is one serious impediment in using H2as an alternate clean fuel, at a larger scale, in the context of alarming levels of global warming and fast depleting fossil fuel resources.Metal nitrides such as Li2N4, Na2N4 and K2N4using density functional theory at PBE1PBE and B3LYP functional using 6-31G (d,p), 6-31++G (d,p) and 6-311++G (d,p) as basis sets have revealed that doping of alkali-metal atoms on the nitride systems increases their hydrogen adsorption ability, due to electron transfer that occurs from the metal atom to the nitrogen surface. The charged surface created around the metal atom is found to enhance the hydrogen adsorption capacity of the complex from 9 to 16.79wt% with an average binding energy of0.06 to 0.30 eV/H2. Various conceptual reactivity descriptors,bond parameters, Gibbs free energy change (ΔG) and energy gap values, support the ideathat the stability of the complex increaseson hydrogen uptake.

Objectives: Researchers have reported close links between forgiveness and positive life outcomes for people of all age groups. The study explored the perceived transgressions and forgiveness of the elders using a qualitative research design.Design and Methods: Narrative qualitative research design was employed. The semi-structured interview was used to collect data of 10 elders of old-age homes (Mean age = 67.20, SD = 4.57) and 12 elders residing with their families (Mean age = 69.33, SD = 4.21) which were analysed through thematic analysis.Results: Severe loss, serious neglect and cheating were the major perceived transgressions of the old-age home elders whereas day-to-day issues characterized the perceived transgressions of the family elders. Pseudo-forgiveness was observed in the elders of old-age home because of helplessness and their fear of losing respect while affiliation, perceived harm, the realisation of offence, and perceived consequences of punishment were precursors for the forgiveness in family-living elders. Both the groups acknowledged the role of offence, intention, relationships, attributions and commitment to socio-cultural and moral values in forgiveness.Implications: The differences in the perceived transgressions, poor social support and negative cognitions were significant factors behind the dissimilar forgiveness of the two groups. Cultural conceptualizations of relationships, morality, emotion regulation, health issues, spiritual beliefs and interpersonal resources seem to regulate the forgiveness of the elders. Heterogeneity Hypothesis, implicit theories of relationship, just world belief and stress-buffering theory were used to explain the findings. Practitioners may use forgiveness interventions to improve positive life outcomes of the elders. Practitioners may consider providing social support and reducing negative cognitions to facilitate elders’ forgiveness.   Keywords: forgiveness, elders, old-age home, transgressions, thematic analysis.

Autoimmune neutropenia of infancy (AIN) is a relatively frequent cause of neutropenia in children. The disease is caused by antibodies recognizing membrane antigens of neutrophils, mostly located on immunoglobulin G (IgG) Fc receptor type 3b (FcγIIIb receptor). In this study, we investigated the possible association of human neutrophil antigens (HNA), human leukocyte antigen (HLA)-DR and HLA-DQ alleles with AIN and the association of these genotypes with the presence of anti-HNA-1a autoantibodies. Eighty AIN cases with a median age of 13.5 months were included in this study. Controls were healthy unrelated Danish blood donors. Anti-HNA-1a autoantibodies were detected using a flow cytometric granulocyte immunofluorescence test (Flow-GIFT). Molecular determination of HNA genotypes was determined using real-time polymerase chain reaction (q-PCR). High-resolution HLA-DR and HLA-DQB1 were determined by next-generation sequencing. Antibodies against HNA-1a were detected in 51% (n=41) of AIN patients, and anti-HNA-1b was detected in 3% (n=2) of cases. FCGR3B*01+,*02-,*03- was more common (odds ratio, 6.70; p < 0.0001), and FCGR3B*01-,*02+,*03- was less common (odds ratio, 0.30; p < 0.0001) among AIN cases. HNA-1a antibodies were significantly more frequent among AIN cases with the FCGR3B*01+,*02-,*03-genotype (odds ratio, 3.86; p < 0.007). The HLA-DR*14 and HLA-DQB1*05:03 alleles were significantly more common (odds ratio, 7.44; p < 0.0001 and odds ratio, 2.50; p < 0.0001, respectively) in AIN patients. In conclusion the HLA haplotype HLA-DR*14- DQB1*05:03 is associated with Danish AIN cases. Among Danish AIN patients, anti-HNA-1a is the most common autoantibody, and the antibody is more common in cases with the FCGR3B*01-,*02+,*03- genotype.

The bi-axial 7075-T6 Al alloy samples were designed and manufactured by Friction Stir Welding (FSW). The residual stress profiles were measured. Crack propagation behavior were simulated with five different biaxial loading ratios. ABAQUS software was used to calculate the stress intensity factors (SIFs) and to study the effects of residual stress on crack behaviors. It is found that residual stress can affect the effect of biaxial loading ratio on crack growing. Mode I and mode II SIFs are susceptible to residual stress when λ= 0.5~2. Cracks at the retreating side are much more affected by the residual stress. At given biaxial loading ratio, the distribution characteristics of SIF components have similarity on the advancing side and the retreating side.

To our knowledge, this is the first description of a cytomegalovirus end-organ infection complicating severe COVID-19 disease in an immunocompetent host. Suspicion threshold for opportunistic coinfections should be lowered in severe COVID-19. Serum CMV polymerase chain reaction and colonoscopy should be discussed in presence of persistent digestive disturbances.

Rabies is zoonotic diseases and can cause progressive encephalitis and death. Ante-mortem diagnosis is challenging, and treatment is supportive. We report a young patient presented with classic furious rabies; the diagnosis was confirmed by real-time polymerase chain reaction assays on saliva samples.

Leishmanioses are vector-borne diseases caused by Leishmania spp., which are transmitted by phlebotomine sand flies (Diptera, Psychodidae). The recent reports in humans of Leishmania tarentolae, which is primarily found in cold-blooded animals, and Leishmania infantum in Sergentomyia minuta spurred us to develop an internal transcribed spacer 1-based duplex quantitative real-time PCR (dqPCR) assay for the detection and differentiation between these Leishmania spp. The specificity of dqPCR was assessed by processing DNA samples from Phlebotomus spp. (n=188) and Se. minuta (n=171) and from tissues (i.e., heart, liver, muscle, lungs, spleen, kidney, eggs) of Podarcis siculus (n=4) and Tarentola mauritanica (n=3). In the absence of naturally infected and/or co-infected lizards, DNA from cultured L. infantum and L. tarentolae were spiked into tissues of lizards and used as controls. The analytical sensitivity of the dqPCR, assessed using 10-fold serial dilutions of DNA from both Leishmania spp. and spiked DNA samples from lizards was 2.3 x 10-7 ng/2 µl for L. infantum and 2.1 x 10-7 ng/2 µl for L. tarentolae. With the spiked DNA samples, the dqPCR detected up to 2.6 x 10-6 ng/2 µl of L. infantum and up to 2.1 x 10-7 ng/2 µl of L. tarentolae. Of 359 phlebotomine sand flies tested, five (3.6%) and two (1.4%) Ph. perniciosus scored positive for L. infantum and L. tarentolae, respectively. Similarly, of 171 Se. minuta, 56 (32.7%) and six (3.5%) scored positive for L. tarentolae and L. infantum, respectively. Co-infection with both Leishmania spp. was detected in two Se. minuta (1.2%). Out of seven reptiles tested, four P. siculus were positive for L. tarentolae. The newly dqPCR herein described may represent an improvement in the diagnosis of L. infantum and L. tarentolae and may assist in identifying the role of lizards as reservoirs and Se. minuta as vector, for these Leishmania spp.

DNA metabarcoding is a promising method to increase cost and time efficiency of marine monitoring, providing that the impact of methodological choices on the reliability and reproducibility of results are well understood. Here, we investigated the impact of primer choice, DNA source (bulk DNA or eDNA from the ethanol preservative) and morphological traits (body size and body skeleton) on species detection in four distinct macrobenthos communities from the North Sea. We generated a reference database with COI sequences for macrobenthos from the North sea and applied DNA metabarcoding using five COI primer sets. At most 22% of the ASVs were assigned taxonomy at the phylum level, despite the availability of a nearly complete reference database. However, the unassigned ASVs represented only a small fraction of the total reads (13%). The Leray primer set outperformed the four other primer sets in the number of non-chimeric reads and species detected, and in the recovery of beta diversity patterns. Community composition differed significantly between bulk DNA and eDNA samples, but both sample types were able to differentiate the four communities. Importantly, the probability of detecting a species in the eDNA from the ethanol preservative was significantly lower than for bulk DNA for macrobenthos species with small to medium body size and for species with chitine or CaCO3 in their skeleton. Detection in the bulk DNA samples was not affected by the traits investigated, indicating that monitoring of macrobenthos species will be most robust when using bulk DNA as template for metabarcoding.

In this paper, we introduce a new explicit extragradient algorithm for solving Variational Inequality Problem (VIP) in Banach spaces. The proposed algorithm uses a linesearch method whose inner iterations is independent of any projection onto feasible sets. Under standard and mild assumption of pseudomonotonicity and uniform continuity of the VIP associated operator, we establish the strong convergence of the scheme. Further, we apply our algorithm to find an equilibrium point with minimal environmental cost for a model in electricity production. Finally, a numerical result is presented to illustrate the given model. Our result extends, improves and unifies other related results in the literature.

In this paper, heat transfer of linearly stretched curved surfaces of unsteady magnetized micropolar fluid flow is discussed. Impacts of velocity and thermal slip are considered on the linear curved stretching surface. The mathematical model is assembled under the flow suppositions derived from the classic Navier Stoke equations. This model is reduced to a system of coupled nonlinear differential equations by means of boundary layer approximations. Differential equations become dimensionless when the similarity transformations are applied. The dimensionless system is solved through numerical techniques. The involved dimensionless parameters effects a range of parameters, including the unsteady parameter, magnetic parameter, velocity slip parameter, curvature parameter, micropolar parameter, reciprocal magnetic Prandtl number, dimensionless parameter, Biot number and Prandtl number, all of which are studied in relation to the Nusselt number, skin fraction, velocity profile, temperature profile, micropolar profile and magnetized profile. We provide a robust discussion, and evidence our findings graphically and in tables. Key outcomes of this work include findings such as, the unsteady parameter enhances as thermal and momentum boundary layer decreases. Also, the skin friction rises for increasing curvature parameters, but Nusselt number declines when the curvature parameters rises.

The response of crop photosystem activity to a certain level of [CO2] elevation have been widely concerned. However, long-term effects of elevated [CO2] over multi-generations of crops received little attention. Using open-top chambers, we set up two treatments of elevated [CO2] from 2016 to 2019 in rice (Oryza sativa) growing seasons. One treatment was stepwise increase (SI) of +40 µmol mol-1 per season, the other was constant increase (CI) of +200 µmol mol-1. Rice seeds harvested in each [CO2] environment was planted successively. Seeds from ambient [CO2] were also planted in SI and CI OTCs in next year to study the short-term effect. We measured the diurnal change in PSII functionality of leaf in 2019. Results showed that both SI and CI promoted PSII function. SI was more beneficial to improve efficiency of electron trapping and transporting in PSII and performance index of leaf. The maximal photochemical efficiency of PSII decreased linearly with increasing photosynthetic photon flux density throughout the day. Predawn efficiency decreased dramatically with the development of growth stages. Together, we found PSII efficiency benefit from multi-year [CO2] elevation, which could help to better understand the response of electron transport to elevated [CO2].

When describing plant-animal networks, sampling can be performed using plant- or animal-centred approaches. Importantly, while the method affects the characterisation of network structure, how it may affect estimates of interaction dissimilarity across networks is still unknown. Here, we investigated how sampling affects the characterization of pollination networks and their dissimilarities across habitats in a heterogeneous tropical landscape. We also asked whether plant traits influence the difference in interaction specialization according to sampling. Plant-centred networks reported higher interaction and species dissimilarity in space, mainly due to interaction rewiring, while animal-centred networks showed higher specialization and modularity. Floral type and pollination systems affected how specialization was influenced by the sampling method. Combining animal- and plant-centred approaches returned intermediate values for dissimilarity and network metrics, indicating that complementary methods should be used for a better characterization of interaction networks, especially those including groups with distinct mobilities, such as plant and pollinators.

Natural Killer (NK) cell functions are regulated by diverse inhibitory and activating receptors including Killer cell Immunoglobulin-like receptors (KIR) which interact with HLA class I molecules. Some KIR/HLA genetic combinations were reported associated with spontaneous clearance (SC) of hepatitis C virus (HCV) but with discordant results, possibly reflecting KIR and/or HLA gene polymorphism according to populations. KIR/HLA genetic combinations associated with both an exhaustive NK and T cell repertoire were investigated in a cohort of HIV-HCV co-infected individuals with either SC (n=68) or chronic infection (CI, n=163) compared to uninfected blood donors (Ctrl, n=100). Multivariate analysis showed that the HLA C2C2 environment was associated with SC only in European HIV-HCV co-infected individuals (OR=4.30[1.57-12.25], p=0.005). KIR2D+ NK cell repertoire and potential of degranulation of KIR2DL1/S1+ NK cells were similar in SC European cohort compared to uninfected individuals. In contrast, decreased frequencies of KIR2DS1+ and KIR2DL2+ NK cells were detected in CI group of Europeans compared to SC and a decreased frequency of KIR2DL1/S1+ NK cells compared to controls. On the T cell side, higher frequencies of DNAM-1+ and CD57+ T cells were observed in SC in comparison to controls. Interestingly, SC subjects emphasized increased frequencies of KIR2DL2/L3/S2+ T cells compared to CI subjects. Our study underlines that the C2 environment may activate efficient KIR2DL1+ NK cells in viral context and maintain KIR2DL2/L3/S2+ mature T cell response in the absence of KIR2DL2 engagement with its cognate ligands in SC group of HCV-HIV co-infected European patients.

Background: Standard management of ovarian cancer is surgical debulking and adjuvant chemotherapy. The role of systematic lymphadenectomy, as a part of debulking, has been controversial. Objective: To assess prognostic value of systematic lymphadenectomy in women with ovarian cancer based on stage, control group and type of chemotherapy Search strategy: A literature search was conducted on SCOPUS, PUBMED, COCHRANE, MEDLINE, and WEB OF SCIENCE databases. Selection criteria: All comparative studies that assess outcomes of systematic lymphadenectomy in patients with ovarian cancer were eligible. Data Collection and Analysis: overall survival was analyzed by pooling log hazard ratio (HR) and standard error of multivariable Cox regression models. MOGGE Meta-analysis Matrix is a novel illustration tool that was used to demonstrate multiple subgroup analyses of included studies. Main results: Twenty-two studies were eligible. Systematic lymphadenectomy was associated with better overall survival, that was close to significance, compared to control group (HR 0.93, 95%CI 0.86-1.00). Among women treated with adjuvant chemotherapy, overall survival improved in women with stage IIB-IV who underwent systematic lymphadenectomy (HR 0.91, 95%CI 0.84-0.99) and was most significant among patients with III to IV (HR 0.85, 95%CI 0.73-0.99). Systematic lymphadenectomy did not improve survival in women who received neoadjuvant chemotherapy (HR 0.97, 95%CI 0.73-1.29). Systematic lymphadenectomy was associated with improved progress-free survival compared to control group (HR 0.88, 95%CI 0.79-0.99). Conclusion: Data from clinical trials do not support role of systematic lymphadenectomy in advanced ovarian cancer. However, further studies may be warranted to assess substage-specific survival outcomes in women with advanced stages.

Objectives- The aim of this study is to identify socio-demographic and the use of basic maternal health care services associated with mobile use to receive health care services (antenatal care, transport in the facility and postnatal care for mother and newborn). Design– This a cross-sectional study Setting- Data were collected from eight districts in Bangladesh- Barishal, Chattogram, Dhaka, Mymensingh, Khulna, Rajshahi, Rangpur, and Sylhet by Bangladesh Demographic and Health Survey (BDHS) 2014 Sample- 4494 women aged 14-49 with children were involved in the research. Methods-Data were collected using questionnaire. Models of logistic regression were used for association determination. Results- The total woman using the mobile phone was reported 22.23%. Among those 29.9% using the mobile phone to obtain health service or advice and 70.1% did not obtain health information. Women who had higher education with a mobile phone to received more health care (secondary and higher: OR=1.922, 95%CI=1.225-3.014; primary: OR=1.982, 95%CI=1.738-2.654), socio-economic status (rich: OR=1.228, 95%CI=1.009-1.494; middle: OR=1.691, 95%CI=1.256-2.333), prenatal care (yes: OR=1.993, 95%CI=1.425-1.987), antenatal care (yes: OR=1.951, 95%CI=1.765-1.998) and after delivery to check up health status (yes: OR=1.966, 95%CI=1.639-2.357). Conclusions– The results of this study showed that women who have completed higher education, high-income families, young age groups, residence in urban areas are more likely to use mobile phones to receive health care facilities in Bangladesh. Intervention studies are essential for recognizing the instrument by which mobile phone-based facility improves maternal health care application.

We experienced two cases of successful surgical correction of HeartMate 3 outflow graft twisting through a subcostal approach. They were diagnosed with computed tomography or pull back pressure measurement. Technically, a subcostal approach allowed us to access directly to the twisted outflow graft and the device connector in a less invasive fashion without a re-sternotomy. Diagnostic modality and surgical tips are presented.

We describe scalable and cost-efficient production of full length, His-tagged SARS-CoV-2 spike glycoprotein trimer by CHO cells that can be used to detect SARS-CoV-2 antibodies in patient sera at high specificity and sensitivity. Transient production of spike in both HEK and CHO cells mediated by PEI was increased significantly (up to 10.9-fold) by a reduction in culture temperature to 32ºC to permit extended duration cultures. Based on these data GS-CHO pools stably producing spike trimer under the control of a strong synthetic promoter were cultured in hypothermic conditions with combinations of bioactive small molecules to increase yield of purified spike product 4.9-fold to 53 mg/L. Purification of recombinant spike by Ni-chelate affinity chromatography initially yielded a variety of co-eluting protein impurities identified as host cell derived by mass spectrometry, which were separated from spike trimer using a modified imidazole gradient elution. Purified CHO spike trimer antigen was used in ELISA format to detect IgG antibodies against SARS-CoV-2 in sera from patient cohorts previously tested for viral infection by PCR, including those who had displayed COVID-19 symptoms. The antibody assay, validated to ISO 15189 Medical Laboratories standards, exhibited a specificity of 100% and sensitivity of 92.3%. Our data show that CHO cells are a suitable host for the production of larger quantities of recombinant SARS-CoV-2 trimer which can be used as antigen for mass serological testing.

The industrial production of active proteins from E. coli necessitates the refolding of high concentrations of protein over a short period of time. However, it is difficult to simultaneously achieve high concentration and short residence time. The dialysis method can refold high concentrations of proteins, but this process takes a long time. The dilution method can quickly refold proteins, but the resultant proteins are inevitably diluted. In the present study, by designing microchannels in dialysis membranes, which can enlarge the surface area for quickly removing protein denaturant, high concentrations of active carbonic anhydrase---eight times more concentrated than achieved using dilution method---were refolded in 20 minutes, which is orders of magnitude faster than the conventional dialysis method.

Seasonal freeze-thawing affects soil water migration and distribution, especially in semi-arid degraded agricultural areas, with important impacts on crop production, and wind erosion. We assessed the distribution and migration of soil water in degraded agricultural areas during freeze-thawing and the effect on plant growth and wind erosion. Soil water content (SWC) and soil temperature (ST) dynamic characteristics at a depth of 0-2 m in the semi-arid agro-pastoral northern China are discussed, using data from November 2018 to May 2019. Changes in water potential energy and pore pressure gradient caused soil water migration to the upper layer, which led to a slight decrease in SWC at each layer before ST dropped to the freezing point. The vertical migration distance of soil water exceeded 70 cm, and the SWC above a depth of 100 cm increased significantly during thawing; the water was mainly obtained from the soil layer below a depth of 120 cm. The initial SWC is the main factor affecting the freeze-thawing process. Our results can partly explain the occurrence of wind erosion in spring and provide a scientific basis for predicting soil water status and developing irrigation and erosion control strategies.

Chinese PRV variants have frequent recombination and preferential interspecies transmission. So far, 23 confirmed PRV-infected human cases have been reported. In this letter, we discussed the significance of PRV recombination and its public health issue as an occupational zoonosis.

Africa Swine Fever (ASF) is one of the most important transboundary diseases of pigs. ASF has been identified in India for the first time in domestic pigs from outbreaks reported in two of the North-Eastern states, Arunachal Pradesh and Assam in 2020. A total of 11 ASF outbreaks in different regions killed over 3700 pigs and devastated the economy of small-scale livestock owners of both the states. Considering the first outbreak of ASF in India, a generic risk assessment framework was determined to identify potential risk factors that might favour future emergence of the disease. Based on Indian scenario, we considered population density of host, farming practice, availability of biological vectors and wildlife reservoirs, epidemiological cycles and international trade to analyze the possibility of future outbreaks and chances of establishment of endemism. On critical analysis of the identified risk factors, we observed that the risk factors are well preserved in Indian geography and might participate in future outbreaks further disseminating the disease to nearby countries. Since no vaccine is currently available against ASF, the domestic and the wild-pigs (wild boars and the endangered pygmy hogs native to India) of this region are under constant threat of infection. For the near future this region will have to continue to rely on the implementation of preventive measures to avoid the devastating losses that outbreaks can cause. The various adaptive control strategies to minimize the risks associated with the transmission of ASF keeping our views to Indian settings have been described. The risk-analysis framework presented in the study will give a further understanding of the dynamics of disease transmission and will help to design control strategies and corresponding measures to minimize the catastrophic consequences of ASF disease.

The Protein Data Bank (PDB) file format remains a popular format used and supported by many software to represent coordinates of macromolecular structures. It however suffers from drawbacks such as error-prone manual editing. Because of that, various software toolkits have been developed to facilitate its editing and manipulation, but, to date, there is no online tool available for this purpose. Here we present PDB-Tools Web, a flexible online service for manipulating PDB files. It offers a rich and user-friendly graphical user interface that allows users to mix-and-match more than 40 individual tools from the pdb-tools suite. Those can be combined in a few clicks to perform complex pipelines, which can be saved and uploaded. The resulting processed PDB files can be visualized online and downloaded. The web server is freely available at https://wenmr.science.uu.nl/pdbtools.

Hormones play a crucial role both in plants and animals. As we all known, hormones work through specific receptors in different organisms. Therefore, the hormone interaction between plant and animal is an interesting question worth discussing. Recently, food safety has become a common topic concerned by consumers. A widely discussed rumor such as “Fruit bulking agent is some human reproductive hormones” leads us to consider whether animal hormones did regulate plant growth. Based on the large amount of previous research, we demonstrated that animal hormones did affect plant, such as steroid hormones for livestock feed could regulate physiological processes in plant including flowering, senescence and stress resistance after excreted into the environment. Here, we summarize the previous studies and systematically discuss the effects of animal hormones on plant growth and development.