Crecutzfeldt-Jakob disease (CJD) is a rare, fatal, and devastating neurodegenerative disease，It is not well recognized and increasingly underdiagnosed due to its variant clinical presentations. Here we report a case of probable sporadic CJD in a woman with dizziness as initial symptom and misdiagnosed as acute cerebral infarction.

Bovine tuberculosis (bTB), caused by Mycobacterium bovis (M. bovis) infection, is a multi-host disease which negatively affects the wildlife industry, with adverse consequences for conservation, ecotourism, and game/wildlife sales. Although interspecies transmission has been reported between some wildlife hosts, the risk of spread in complex ecosystems is largely unknown. As a controlled disease, tools for accurate detection of M. bovis infection is crucial for effective surveillance and management, especially in wildlife populations. There are however, limited species-specific diagnostic tests available for wildlife. Hippopotamuses are rarely tested for M. bovis infection and infection has not previously been confirmed in these species. In this study, blood and tissue samples collected from common hippopotamus (Hippopotamus amphibius) residing in a bTB endemic area, the Greater Kruger Protected area (GKPA), were retrospectively screened to determine whether there was evidence for interspecies transmission of M. bovis, and to identify tools for M. bovis detection in this species. Using the multi-species DPP® VetTB serological assay, a bTB seroprevelance of 8% was found in hippopotamus from GKPA. In addition, the first confirmed case of M. bovis infection in a free-ranging common hippopotamus is reported, based on the isolation in mycobacterial culture, genetic speciation, and detection of DNA in tissue samples. Importantly, the M. bovis spoligotype (SB0121) isolated from this common hippopotamus is shared with other M. bovis-infected hosts in GKPA, suggesting interspecies transmission. These results support the hypothesis that M. bovis infection may be under recognized in hippopotamus. Further investigation is needed to determine the risk of interspecies transmission of M. bovis to common hippopotamus in bTB endemic ecosystems and evaluate serological and other diagnostic tools in this species.

Hongjiannao lake is the largest desert fresh water lake in China and the largest breeding and habitat of relict gulls in the world. On the basis of remote sensing images, a high-precision long-time series lake area continuous monitoring data set was constructed from 1973 to 2019. On this basis, the temporal and spatial evolution law of lake area and the coupling relationship with natural factors and human activities were studied. At the same time, the effectiveness monitoring of protection measures implemented since 2012 was realized. The results show that: (1) from 1973 to 2019, the area of Hongjiannao lake experienced three stages (relatively stable period (1973-1997) - shrinking period (1997-2015) - expanding period (2015-2019)). (2) The shrinkage of Hongjiannao lake is mainly caused by human factors, followed by natural factors. Among them, human factors are mainly composed of the upstream river construction reservoir, industrial development water and the increase of water demand for vegetation growth. (3) For the first time, the preliminary results of the protection measures implemented since 2012 are analyzed. It is mainly reflected in the first positive growth of Hongjiannao Lake area since the long-term shrinkage in 2016. This phenomenon is mainly caused by measures such as artificial precipitation increase and ecological water replenishment on the surface of upstream reservoir. Climate change (high evaporation and low precipitation) and human activities (upstream water conservancy project construction, coal mining, highway construction around the lake, irrigation water consumption, etc.) are the key factors leading to the change of lake water area in the shrinking period. It is suggested that artificial precipitation increase and surface ecological water supplement normalization should be carried out in the study area, as well as scientific and reasonable utilization of water resources in the basin to effectively restrain the shrinking of Hongjiannao lake area, so as to achieve long-term sustainable restoration of wetland ecology.

With the intensification of climate change and human activities, the watershed ecosystem is seriously fragmented, which leads to the obstruction of hydrological connectivity, and further causes the degradation of the ecosystem. As the value of wetlands continues to be exploited, hydrological connectivity becomes increasingly significant. In this paper, the characteristics and development of hydrological connectivity research from 1998 to 2018 were analyzed through the scientometric analysis based on Web of Science database. CiteSpace, an analytical software that can be used for scientific measurement, is used to visualize the results of the retrieval. The analysis results of co-occurrence, co-operative and co-cited network show that the hydrological connectivity is a multidisciplinary cross multiple research areas, involving the Environment Science and Ecology, Water Resources, Environmental Sciences, Geology and Geosciences. According to Keyword co-occurrence analysis, ecosystem, floodplain, dynamics, climate change and management are the main research hotspots in each period. In addition, the co-cited analysis of references shows that “amphibians” is the largest cluster of hydrological connectivity, and the “channel network” is the most important research topic. It is worth noting that the “GIWS” (Geographically Isolated Wetlands) is the latest research topic and may be a major research direction in the future.

Three patients with COVID-19 pneumonia received treatment with hydroxychloroquine combined with lopinavir plus ritonavir and favipiravir. Two patients early diagnosed with COVID-19 pneumonia received tocilizumab at severe pneumonia diagnosed and survived. The third patient was late diagnosed and received tocilizumab when the disease progressed to ARDS, and passed away.

Overlap syndrome associating primary biliary cholangitis and autoimmune hepatitis remains a rarely studied pathology. The diagnosis is based on diagnostic criteria. The criteria of Chazouillères (Paris criterion) et al were the most used. The combination of UDCA and immunosuppressive helped achieve remission in the majority of cases.

Hypertriglyceridemia induced pancreatitis (HTGP) is found in patients with hyperlipidemia, alcohol intake, and obesity. It is essential to study the etiology, accurately diagnose and provide adequate management for pancreatitis at the earliest. We are reporting 18 cases of HTGP with a pattern of admissions with similar clinical characteristics.

Ebolavirus (EBOV) is responsible for several EBOV disease (EVD) outbreaks in Africa, with a fatality rate of up to 90%. During 2014-2016, An epidemic of EVD spread throughout Sierra Leone, Guinea and Liberia, and killed over 11,000 people. EBOV began to circulate again in the Democratic Republic of Congo in 2018. Due to the need for a BSL-4 facility to manipulate this virus, the development and improvement of specific therapeutics has been hindered. As a result, it is imperative to perform reliable research on EBOV under lowered BSL restrictions. In this study, we developed a safe neutralization assay based on pseudotyped EBOV, which incorporates the glycoprotein of the 2014 EBOV epidemic strain into a lentivirus vector. Our results demonstrated that the tropism of pseudotyped EBOV was similar to that of authentic EBOV, but with only one infection cycle. And neutralizing activity of both authentic EBOV and pseudotyped EBOV were compared in neutralization assay using three different samples of antibody-based reagents against EBOV, similar results were obtained. In addition, an indirect ELISA was performed to show the relationship between IgG and neutralizing antibody against EBOV detected by our pseudotyped EBOV-based neutralization assay. As expected, the neutralizing antibody titers varied with the IgG titers detected by indirect ELISA, and a correlation between the results of the two assays was identified. By comparison with two different assays, the reliability of the results detected by the pseudotyped EBOV-based neutralization assay was confirmed. Collectively, in the absence of BSL-4 restrictions, pseudotyped EBOV production and neutralizing activity evaluation can be performed safely and in a manner that is neither labor- nor time-consuming, providing a simple and safe method for EBOV-neutralizing antibody detection and the assessment of immunogenicity of EBOV vaccines. All these remarkable advantages of the newly established assay highlight its potential to further application in assessment of immunogenicity of EBOV vaccine candidates.

Acute aortic dissection combined with cardiac tamponade is fatal. The radical treatment is an aortic replacement; however, the risk is high. The treatment method for elderly patients is difficult to determine. We suggest conservative treatment with pericardial drainage may be one of the treatment options in the elderly with comorbidities.

67-year-old male with a history of hidradenitis suppurativa (HS) came to our hospital complaining symptoms of decompensated heart failure of 2 weeks of evolution after the re-initiation of adalimumab for his HS. Other causes of heart failure were ruled out. Unfortunately, the patient died secondary to heart failure and septicemia.

The SARS-CoV-2 pandemic has radically changed the sta tus quo of the global society. The fast spread of the new coronavirus is governed by nonlinear dynamics. The purpose of this paper is to investigate the complex dynamics inherent by the dissemination of COVID-19 into 27 Brazilian States. Because of this, we have investigated the time series of daily death caused by COVID-19. Our analysis taking into account the Bandt & Pompe method (BPM) to estimate the Information Theory quantifiers, the Permutation entropy (Hs), and the Fisher information measure (Fs). Based on the Information Theory quantifiers we build up the Shannon-Fisher causality plane, which made it possible to study the temporal evolution inherent of the phenomenology associated with the number of daily deaths by COVID-19, as well as their respective locations along the SFCP were mapped. Our results show that the number of death cases due to COVID-19 for Brazilian States present a dynamical behavior that tends to have their starting positions close to the lower-right region at the 2-D plane (Hs x Fs). Thus, the Brazilian States located in this region or its surroundings show high entropy and lowest disorder (highest efficiency). While the Brazilian States located in the middle region of the 2-D plane (Hs x Fs) or its surroundings are depicted by a less entropic and highest disorder (lowest efficiency). We also employed the Permutation entropy and the Fisher information measure to rank the conjuncture of the Brazilian States considering the number of daily death due to COVID-19 based on the complexity hierarchy. From a mathematical point of view, we found an inverse relationship between the Permutation entropy and Fisher information measure. Given this, we concluded that the higher value of the permutation entropy (Hs)the lower value related to the Fisher information measure (Fs).

Leptospirosis has been widely reported in insular environments worldwide, characterizing a major public health threat. Although low genetic biodiversity is expected in these regions, the introduction of domestic and synanthropic mammals may contribute to the wider diversity leptospiral strains in insular settings. This study proposes a large-scale investigation of Leptospira infection in animals from Fernando de Noronha archipelago, Brazil. A total of 1,265 blood samples from domestic (n=682), synanthropic (n=133) and wild (n=450) animals were collected between 2007 and 2014, totaling 12 species. The presence of anti-Leptospira spp. antibodies was investigated by the Microscopic Agglutination Test (MAT) and kidney samples from synanthropic rodents were collected for the isolation of Leptospira spp. The leptospires recovered were further characterized by MAT with polyclonal antibodies, whole genome sequencing and Multilocus Sequence Typing (MLST). The MAT results revealed the presence of agglutinins in 90 samples (7.1%), and the most frequently found serogroup was Icterohaemorrhagiae (n=57) in practically all species included. Viable leptospires were recovered from one brown rat, and characterization revealed that the isolate belongs to L. interrogans serogroup Pyrogenes. This study stands as the most comprehensive investigation of Leptospira spp. infection in Fernando de Noronha archipelago, also providing the characterization of the first leptospiral strain ever isolated from an insular setting in Brazil. The results suggest that synanthropic rodents play a major role in the transmission of leptospirosis among wildlife and domestic species in the archipelago.

Accumulating evidence suggests that ecological communities undergoing change in response to either anthropogenic or natural disturbance regimes exhibit macroecological patterns that differ from those observed in similar types of communities in relatively undisturbed sites. In contrast to such cross-site comparisons, however, there are few empirical studies of shifts over time in the shapes of macroecological patterns. Here we provide a dramatic example of a plant community in which the species-area relationship and the species-abundance distribution change markedly over a period of six years. These patterns increasingly deviate from the predictions of the Maximum Entropy Theory of Ecology (METE), which successfully predicts macroecological patterns in relatively static systems. Information on the dynamic state of an ecosystem inferred from snapshot measurements of macroecological community structure can assist in extending the domain of current theories and models to disturbed ecosystems.

How underlying mechanisms bias evolution toward predictable outcomes remains an area of active debate. In this study, we leveraged phenotypic plasticity and parallel adaptation across independent lineages of Trinidadian guppies (Poecilia reticulata) to assess the predictability of gene expression evolution during parallel adaptation. We observed substantial gene expression plasticity as well as the evolution of expression plasticity itself across populations. Genes exhibiting expression plasticity within populations were more likely to also differ in expression between populations, with the direction of expression divergence more likely to be opposite than in the same direction as plasticity. While we also found more overlap than expected by chance in genes differentially expressed between high- and low-predation populations from different lineages, the majority of differentially expressed genes were not shared between distinct evolutionary lineages. Our data suggest alternative transcriptional configurations associated with shared phenotypes, highlighting a role for transcriptional flexibility associated with parallel phenotypic evolution in a species known for rapid adaptation.

Equine piroplasmosis (EP), a tick-borne disease affecting horses, is caused by Babesia caballi and Theileria equi. We investigate antigen and antibody of EP in whole bloods and sera of horses in the Republic of Korea during 2016-2017. We collected 1,650 whole bloods and sera of horses in 16 regions and 222 farms to examine antigen and antibody of EP by polymerase chain reaction (PCR) of 18S rRNA gene and enzyme-linked immunosorbent assay (ELISA), respectively. T. equi antigen and antibody was detected in 1 of 1,650 samples (0.06%). Phylogenetic analysis of 18S rRNA revealed that T. equi was highly homologous with the strains from China, Mongolia, or Spain. At EP-positive ranch, 52 and 10 ticks were collected in 2016 and 2017, respectively. All of them were identified as Haemaphysalis longicornis, but EP pathogens were not detected from the collected ticks. From 1,650 whole bloods, 2 of Theileria spp. were also detected and highly homologous with T. buffeli, T. luwehshuni, and T. orientalis group. EP infectious status was very low in Korea, and routine surveillance should be needed to attain the free status of EP in Korea.

The phenomenon that organisms can distinguish genetically related individuals from strangers (i.e. kin recognition) and exhibit more cooperative behaviors towards their relatives has been documented in a wide variety of organisms. But its occurrence in plants has only been recently considered. What emerges is that, while concerns remain about some methodologies used to document kin recognition, there is sufficient evidence to state that it exists in plants. Effects of kin recognition go well beyond reducing resource competition between related plants, and involve interactions with pollinators, pests and diseases as well as symbionts (mycorrhizal networks). It thus likely has important implications for diversity of plant populations, ecological networks and community structure. Such effects need to be further explored. Moreover, as kin selection may result in less competitive traits and thus greater population performance, it also holds promise for crop breeding. However, one would need to consider that (i) growing crops of strongly related plants will evidently forego advantages of crop diversification and (ii) outcomes of kin recognition tend to depend on environmental conditions. Therefore, the primary questions that need to be answered are: when, where and by how much kin recognition improves population performance.

The objective of this research is to scientifically investigate the statistical significance of the relationship between Emotional intelligence and Self-Efficacy, as well as, of the multiple correlation of Mental Health with the linear combination of Emotional Intelligence and SelfEfficacy, among working professionals in Urban India. The population of interest is Urban Indian working professionals, 30–49 age group. A representative sample (n = 50) was drawn from the defined population of interest through Purposive Sampling technique, of whom 50% (n = 25) were male and 50% (n = 25) were female participants. MHI-18, SSEIT and GSE were the three tools used and data analysis of the variables involved the use of Pearson's Product-Moment method of Correlation. Also F-distribution was used to test the statistical significance of the calculated percentage of variance in Mental Health explained by the linear combination of Emotional Intelligence and Self-Efficacy. The key findings suggest that SelfEfficacy and Emotional Intelligence are significantly positively and fairly strongly related. (rGSE.EI = 0.59; <0.01) and 35% of the variance is shared by the two variables. Regression analysis performed on the total SSEIT (x) and GSE (y) scores, revealed the y on x equation as 'y = 0.14x + 13.85'. Results also showed that Self-Efficacy, as well as Emotional Intelligence are significantly positively and fairly strongly related with Mental Health (rMHI.GSE = 0.68; <0.01), (rMHI.SSEIT = 0.6; <0.01). Finally, the findings also revealed a significant positive Multiple Correlation between Mental Health and the linear combination of Emotional Intelligence and Self-Efficacy (RMHI.SSEIT, GSE = 0.72; <0.01). The calculated percentage of variance in Mental Health explained by the linear combination Emotional Intelligence and Self-Efficacy is 53 percent, which was found to be statistically significant.  Hence the results support the position that Self-Efficacy and Emotional Intelligence are significantly associated with positive Mental Health of Urban Indian Working Professionals.

Birth seasonality is a phenomenon whereby populations can be characterized by a single month or season in which births peak. While non-human animal research suggests seasonal birth-pulses are related to variation in climate and local energy availability, social scientists debate the mechanisms responsible for it in humans. Here we investigate the role of precipitation, temperature, and energy availability on seasonal birth pulses using a historical dataset from the Baja California peninsula - a hot, arid desert that experiences seasonal fluctuations in temperature, precipitation, and energy associated with the North American Monsoonal. Analyses suggest that local energy availability (as measured through NDVI) predicts seasonal birth pulses, while temperature and precipitation do not; however, both are indirectly related to it through their direct effects on NDVI. Our analyses demonstrate the importance of local energy availability on human reproductive timing and suggest that human birth seasonality is a form of traditional ecological knowledge.

Plant-pollinator interactions are known to structure plant communities at different spatial scales; however, their role in the assembly of plant communities along an elevation gradient is rarely investigated. Here we studied pollinator mediated assembly of nine Rhododendron communities in the Himalayan mountain by using multiple floral traits, pollinators, flowering phenology, and community phylogenetics. Our results suggest that pollinator mediated assembly processes vary across the elevation gradient. In lower elevation Rhododendron communities, the clustered and overdispersed pattern of conserved and labile floral traits, increased flowering overlap, and clustered phylogenetic pattern suggests the joint influence of facilitation/biotic filtering and competition. Whereas in the higher elevation Rhododendron communities, overdispersed floral traits, decreased flowering overlap, and random phylogenetic structure suggests competition as a predominant assembly process. Our study illustrates how the strength of pollinator-mediated facilitation and competition vary in the assembly of plant communities along the elevation gradient.

Since 2017, duck spleen necrosis caused by a new variant duck orthoreovirus (N-DRV) infection had been observed in many provinces in China. This disease causes the growth and development of ducks to be retarded, and the feed return rate is reduced. Because the target organ of the disease is mainly the spleen, the immune suppression of the diseased ducks is easy to secondary infection of other pathogens. In this study, we successfully constructed a breeding duck artificial infection model and found that N-DRV infection can cause pathological changes such as ovarian hemorrhage, follicle atrophy, and fallopian tube bleeding in breeding ducks, resulting in a significant reduction in the fertilization rate and hatching rate of breeding eggs. The qPCR method was used to detect viral RNA in samples of egg vitelline membrane, duck embryo, and duckling’s spleen. It was found that viral RNA was present in the above samples. Although there were no obvious clinical symptoms in the early stage of ducklings, autopsy revealed obvious pathological changes in the spleen and other organs. The sequence distance and phylogenetic analysis of the strain re-isolated from the spleen samples of ducklings (named N-DRV-SD19) confirmed that N-DRV-SD19 was consistent with the strain N-DRV-XT18 used for the infection of the breeding ducks. The findings of the above research confirmed that N-DRV can be vertically transmitted through eggs, which will provide an important reference for the prevention and control of the disease.

Minimally invasive surgery has been widely adopted in gynaecologic oncology with a significant surge the past decade associated with the introduction of robot-assisted surgery. Up until 2018, virtually all testimonials of minimally invasive surgery for cervical cancer indicated equal oncologic outcomes compared to laparotomy. The unexpected results from the only randomised controlled trial (Ramirez PT et al, N Engl J Med, 2018;379:1895-1904) seriously challenge the use of minimally invasive surgery for cervical cancer. However, the lack of plausible explanations for the inferior survival has made it hard for many gynaecologic oncologists to accept the results at face value. Suggested causes such as the use of intrauterine manipulators and intracorporeal colpotomy may to some extent account for the detrimental outcomes but as practice differs widely worldwide, none of these factors seem convincing. In the current paper by Baeten et al, a different aspect of novel surgical technologies has been explored (BJOG 2020 xxxx). The adoption of any new modality/technology is clearly associated with a learning curve and it is well known from surgery that procedural outcomes such as operative time improves with increasing case numbers. However, the potential impact of learning curve on “hard outcomes” such as survival has scarcely been reported before. Baeten et al convincingly demonstrate that a substantial number of robot-assisted radical hysterectomies is required to overcome an initial harm. The authors point out that the learning curve should be considered institutional; suggesting that an individual learning-curve may benefit from previous experiences at the specific institution. Intriguingly, similar data has not been presented for endometrial cancer which may be related to the higher complexity of radical hysterectomy for cervical cancer. Although no specific changes were made over time in the current study, a learning curve may include modifications of surgical routines based on early experiences. Which specific improvements during the learning-curve that accounts for the increased survival is unclear but reducing complications that could delay adjuvant treatment may be one. The data presented by Baeten et al signifies a solid effort to elucidate the underlying cause of the outcomes from the LACC-trial, especially since the trial was launched at a time when most surgeons had limited experience from laparoscopic/robotic radical hysterectomy. The study should raise the awareness of surgical learning curve in the context of survival in oncologic surgery. It also brings us to the most important question – how do we avoid harming our patients when novel technologies are adopted? The authors suggest that centralisation and structured training represents two of the most important strategies to mitigate the effects of early errors. Interestingly, recent population-based studies from countries with high levels of centralisation do not corroborate the findings from the LACC-trial (Alfonzo E et al, Eur J Cancer, 2019;29:1072-1076, Jensen et al, Eur J Cancer 2020;128:47-56). Although the current study may reopen the door for robotic surgery in the management of cervical cancer, prospective randomised trials are needed to ensure its safety. The impact of surgical learning curve should be considered in any future trial exploring oncologic safety for procedural interventions.Conflict of interest: H.F is a proctor for Intuitive Surgical Inc. A completed disclosure of interest form is available to view online as supporting information.

We suggest that patients with COVID-19 may be at higher risk for selenium deficiency and, therefore, their selenium status should be assessed. Moreover, we suggest incorporating selenium supplementation to enhance their immune response and reduce the SARS-CoV-2 virulence.

Objectives &Introduction: Diabetes Mellitus (DM) is an emerging chronic disease with global significance . This article reviews 35 RCTs to identify the benefits of pharmacists’ involvement in diabetic care in reducing the risk of diabetic complications and/or disease progression. Methods: 35 Randomized Controlled Trials (RCTs) were picked from 3210 publications listed on PubMed, using the keywords: diabetes, pharmacist, interventions and complications. Results of the studies were analysed and interpreted. Result: Interventions made by Pharmacists offer a potential benefit in achieving the goal of therapy in diabetes, perhaps by improving medication adherence and minimising diabetes-related complications significantly. Hence this review concludes that pharmacists can potentially play a pivotal role in the management of DM and maintain their QOL. In developing countries with poor record of pharmaceutical services, it is important to highlight the role of pharmacists in achieving rational and evidence-based pharmacotherapy. Conclusion: This study emphasizes Pharmacists’ vital position in diabetic patient care. Pharmacists improve adherence to the drug, quality of life, cost-effectiveness of health care in patients with diabetes. These findings support the irreplaceable role of pharmacists in the diabetic care.

Introduction: Pharmacist’s knowledge about different aspects of this pandemic is crucial because it influence their role and contribution as a frontline health care provider, as pharmacies and most of the pharmacy practice sectors are kept open even during lockdowns providing counseling, patient care. Pharmacist can provide valuable services during COVID-19 pandemic, these services may include: provide reliable information on the disease, participate in public education on preventive measures, referring of suspected cases, insuring continuous supply of medicine. Methods: A web-based, cross-sectional study, conducted using survey instrument to obtain responses from Sudanese pharmacists during the period from 26th of May to 3rd of June 2020. A 14-item survey instrument was developed. The web-based cross-sectional study was carried out among Sudanese pharmacists. A self-reported structured questionnaire was divided into three sections: demographic characteristics, questions assessing the knowledge, and one question for the pharmacist contribution during the pandemic. Results: The study showed that 51.1% of pharmacists have good knowledge about the COVID-19. The work experience and education level significantly (P<0.05) influence pharmacist knowledge. Majority of pharmacists contribute to different activities during the pandemic, e.g. providing patients with transmission information (94%), Provide factual and reliable information on the diseases symptoms (93.1%), providing patients with prevention information (91.1%). Conclusion: The study identified that pharmacists have good knowledge about COVID-19 pandemic Also pharmacists contributed in many activities as a frontline health care provider during this pandemic.