Introduction: A rapidly evolving evidence suggests that smell dysfunction is a common symptom in COVID-19 infection with paucity of data on its duration and recovery rate. Objectives: delineate the different patterns of olfactory disorders recovery in patients with COVID-19. Methods: This cross-sectional cohort study included 96 patients with olfactory complaint confirmed to be COVID-19 positive with recent onset of anosmia. All patients were inquired for smell recovery patterns using self-assessment questionnaires. Results: ninety six patients completed the study with mean age 34.26±11.91 years. Most patients had sudden anosmia 83%. Loss of smell was accompanied by nonspecific inflammatory symptoms as low-grade fever (17%) and generalized body ache (25%). Nasal symptoms were reported by 33% of patients. Some patients reported comorbidities as D.M (16%), hypertension (8%) or associated allergic rhinitis (25%), different patterns of olfactory recovery showed 40 patients experiencing full recovery (33.3%) while, 32 patients showed partial recovery (41.7%) after a mean of 11 days while 24 patients (25 %) showed no recovery within one month from onset of anosmia. Conclusion: The sudden olfactory dysfunction is a common symptom in patients with COVID-19. Hyposmia patients recover more rapidly than anosmic ones while the middle age group carried the best prognosis in olfactory recovery. Females possess better potentiality in regaining smell after recovery and the association of comorbidities worsen the recovery rate of olfactory dysfunction in patients with COVID19.

1. Studies on the effects of human-driven forest disturbance usually focus on either biodiversity or carbon dynamics but much less is known about ecosystem processes that integrate trophic levels. Herbivory is one fundamental ecological process for ecosystem functioning that remains underexplored and is poorly quantified in human-modified tropical rainforests. 2. Here, we present the results of the largest study to date on the impacts of human disturbances on herbivory. We quantified the incidence and severity of herbivory caused by chewers, miners and gall-formers in 199,869 canopy leaf blades from 1,102 trees distributed across 20 forest plots located along a gradient of human disturbance in the Amazon. 3. We found that chewers dominated herbivory incidence, yet were not a good predictor of the other forms of herbivory either at the stem or plot level. Herbivory severity was correlated with disturbance intensity, being greater at more disturbed sites. 4. Synthesis. Although our large-scale study of canopy herbivory in Amazonian forests suggests that human disturbance increases the severity of leaf herbivory, effects were weak. Additionally, we found no effect of human disturbance in incidence of leaf herbivory. These results combined indicate that herbivory is a relatively resilient process to human impacts.

A document by Indrani Roy. Click on the document to view its contents.

ants share the phytobiome with other members of the ecological community by sharing their physiology. The phytobiome is a collective ecological entity that senses external and internal stimuli via its member’s sensing apparatus (senome). The activated senome generates intercellular, and intra- and inter-organismal signals that induce genetically and epigenetically dependent modifications of phytobiome member transcriptomes. Ultimately, these genetic modifications alter the phenotypes of the collective phytobiome members. Mycorrhiza, epiphytic fungi, and dodder can physically transfer signals between kin and non-kin plants. Phytobiome members can release infochemicals by themselves, or modify plant volatile emissions and root exudates to act as signals for plant–plant interactions. These signals can change plant physiology and induce holobiont updates in receiver plants via a facilitative or competitive mechanism. Receiver plants eavesdrop on phytobiome cues and signals to anticipate responses to unfolding challenges. An emerging body of information in plant–plant interactions through inter-kingdom communication can be exploited in integrated crop management under field conditions. However, a holistic view is crucial for the manipulation of complex systems, such as the phytobiome, to avoid potential butterfly effects.

In this research different formulations of calcium aluminate cement pastes (CACP) with 71wt% Al2O3 (CACP 71wt%), (wt% -percentage by weight) were made, at 0.4 water to cement ratios (W/C), with additions of 0wt%, 10wt% and 20wt% of silica (CACP 71-0wt%, 10wt% and 20wt%, respectively). All samples were exposed to oxidative environment for 4 hours at 1000˚C, in a furnace under an air atmosphere. Chemical and mineralogical characterization was done using X-ray fluorescence (XRF), X-ray diffraction (XRD) and Fourier-transform infrared spectroscopy (FTIR). The behavior of the constituent phases according to temperature was also studied, through thermal gravimetric analysis (TGA). Activation energies were calculated using Friedman’s method. The values of the activation energies obtained for the formulation of CACP 71- 0wt% for different phases were in the range of 12.02 to 16.41 kJ/mol; and for the formulation of CACP 71-20wt% the values were in the range of 7.7 to 16.23 kJ/mol.

Thyrotoxic periodic paralysis is rare in pediatric population. An adolescent male presented to the emergency department with a syncopal episode, muscle weakness, and shortness of breath. We present the clinical characteristics and laboratory evaluation and summarize the treatment and outcome of an adolescent with Thyrotoxic periodic paralysis.

Nontuberculous mycobacteria are rare causes of cardiac implantable electronic device (CIED) pocket infections and may lead to device-related endocarditis, so preventing them is key. Diagnosis is by presence of acid-fast bacilli on smears and culture takes around 3-7 days on grow on standard agar media.

Anthrax is a natural foci disease in Inner Mongolia, which poses a severe threat to public health. In this study, the incidence number, rate, and constituent ratio were used to describe the epidemiological characteristics of anthrax in the region from 1956–2018. The molecular correlation and genetic characteristics of the strains were investigated using canonical single-nucleotide polymorphisms (CanSNP), multiple-locus variable-number tandem repeat analysis (MLVA-15), and whole genome sequencing (WGS). The epidemiological characteristics of anthrax in Inner Mongolia have altered significantly. The incidence was decreased annually, the regional distribution of anthrax gradually transferred from central and western regions to the eastern. Moreover, the occupation distribution was evolved from multiple early occupations to predominated by farmers and herdsmen. This indicates that reformulate the control and prevention strategies is essential. Both A. Br. Ames and A. Br. 001/002 subgroups were the predominant CanSNP genotypes of Bacillus anthracis in Inner Mongolia. A total of 36 strains constituted six shared MLVA-15 genotypes, suggesting an epidemiological link between the strains of each shared genotype. The six shared genotypes ((GT1, 9, 11, and 15) and (GT8 and 12)) consisting of 2–7 strains confirmed the occurrence of multiple point outbreaks and cross-regional transmission caused by multiple common sources of infection. Phylogenetic analysis based on the core genome showed that strains from this study formed an independent clade (CⅢ), suggesting a common origin. Moreover, B. anthracis showed a high genetic similarity with strain from Japan and South Korea, the strains from this study may be originated from Japan.

Ferroptosis is a recently characterized form of regulated necrosis with the iron-dependent accumulation of (phospho)lipid hydroperoxides (LOOH). It has attracted considerable attention for its putative involvement in diverse pathophysiological processes, such as cardiovascular disease and neurodegeneration. Here we describe the discovery of tetrahydroquinoxaline, a novel scaffold of ferroptosis inhibitors based on quantum chemistry methods. Tetrahydroquinoxaline deviates showed very good inhibition of ferroptosis, while being non cytotoxic for human cancer cells. And, the advantage of them is their small molecular weight (MW. = 148 Da) that can be coupled with other drugs to form multi-target drugs to better meet the treatment of complicated diseases.

Plant interactions are as important belowground as aboveground. Belowground plant interactions are however inherently difficult to quantify, as roots of different species are difficult to disentangle. Although for a couple of decades molecular techniques have been successfully applied to quantify root abundance, root identification and quantification in multi-species plant communities remains particularly challenging. Here we present a novel methodology, multi-species Genotyping By Sequencing (msGBS), as a next step to tackle this challenge. First, a multi-species meta-reference database containing thousands of gDNA clusters per species is created from GBS derived High Throughput Sequencing (HTS) reads. Second, GBS derived HTS reads from multi-species root samples are mapped to this meta-reference which, after a filter procedure to increase the taxonomic resolution, allows the parallel quantification of multiple species. The msGBS signal of 111 mock-mixture root samples, with up to 8 plant species per sample, was used to calculate the within-species abundance. Optional subsequent calibration yielded the across-species abundance. The within- and across-species abundances highly correlated (R2 range 0.72-0.94 and 0.85-0.98, respectively) to the biomass-based species abundance. Compared to a qPCR based method which was previously used to analyze the same set of samples, msGBS provided similar results. Additional data on 11 congener species groups within 105 natural field root samples showed high taxonomic resolution of the method. msGBS is highly scalable in terms of sensitivity and species numbers within samples, which is a major advantage compared to the qPCR method and advances our tools to reveal the hidden belowground interactions.

A diagnosis of compartment syndrome warrants a need for fasciotomy. We present a case of compartment syndrome complicating snakebite where prophylactic fasciotomy was not done following good response to anti snake venom.

Aim: To evaluate risk factors associated with nocturia in patients with obstructive sleep apnea syndrome (OSAS). Materials and Methods: Patients diagnosed with OSAS by polysomnography (PSG) and over eighteen years old evaluated retrospectively between January and December 2019. The number of nocturia episodes was assessed in the 3-day bladder diary. We analyzed age, gender, body mass index (BMI), apnea-hypopnea index (AHI) scores and severity, hypertension, diabetes mellitus, smoking, heart diseases in all patients. Results: A total of 124 patients with the mean age of 49.9±11.6 years (range 25–81 years) was included in the study. Ninety-two (75.8%) patients had nocturia. The mean nocturia episode of patients with nocturia was 2.41.3. To determine the factors that affect the risk of nocturia, logistic regression analysis was performed. The results revealed that patient age and BMI were found as the most effective risk factors determining nocturia (p<0.05). The odds of patient age were 1.06 (95% CI 1.01-1.11, p=0.010) times higher for patients with nocturia. Every 1 unit increase in BMI increased the risk of nocturia by 1.12. 48 patients with nocturia underwent continuous positive airway pressure (CPAP) therapy or surgical treatment. The mean nocturia epi¬sodes of these patients were 2.3±1.4 before treatment and were 1.7±2.2 after treatment. There was a significant decrease in terms of nocturia episodes (p=0.032). Although there was a significant increase in the total daily urine volume after treatment, there was a statistically decrease in total night-time urine volume at night (p=0.016 and p=0.024, respectively). Conclusion Age and BMI were risk factors associated with nocturia in patients with OSAS.

Asthma is a disease characterized by reversible bronchoconstriction, but some subjects develop fixed airflow obstruction (FAO). Subjects with FAO present more asthma symptoms and may have increased sedentary behavior; however, the effect of FAO on aerobic fitness and physical activity levels (PAL) remains poorly understood. Aim: To compare adolescents with asthma and FAO and adolescents with asthma without FAO in terms of aerobic fitness, PAL, muscle strength, and health-related quality of life (HRQoL). Methods: This cross-sectional study included adolescents with asthma, both sexes, and aged 12 to 18 years. They were divided into 2 groups: FAO and non-FAO groups. The adolescents were diagnosed with asthma in accordance with the Global Initiative for Asthma guidelines and underwent optimal pharmacological treatment for at least 12 months. FAO was diagnosed when FEV1/FVC ratio was below the lower limit of normal range after optimal treatment. Aerobic fitness, PAL, peripheral and respiratory muscle strength, and HRQoL were evaluated. Results: No significant differences were observed between FAO and non-FAO groups regarding the peak oxygen uptake (34.6±8.5 vs. 36.0±8.4 mLO2/min/kg), sedentary time (578±126 vs. 563±90 min/day), upper limb muscle strength (29.1±5.9 vs. 28.1±5.7 kgf), lower limb muscle strength (42.8±8.6 vs. 47.6±9.6 kgf), or HRQoL (5.1±1.3 vs. 4.7±1.4 score) (p>0.05). However, the FAO group exhibited a higher maximal expiratory pressure than did the non-FAO group (111.5±15.5 vs. 101.5±15.0 cmH2O, respectively). Conclusion: Our results suggest that FAO does not impair aerobic fitness, PAL, peripheral muscle strength, or HRQoL in adolescents with asthma. Furthermore, adolescents with asthma were physically deconditioned.

Introduction: The Lung Clearance Index (LCI) derived from the multiple-breath washout test (MBW), is both feasible and sensitive to early lung disease detection in young children with cystic fibrosis and asthma. The utility of LCI has not been studied in children with sickle cell disease (SCD). We hypothesized that children with SCD, with or without asthma or airway hyper reactivity (AHR), would have an elevated LCI compared to healthy controls. Methods: Children with SCD from a single center between the ages of 6-18 years were studied at baseline health and completed MBW, spirometry, plethysmography and blood draws for serum markers. Results were compared to healthy controls of similar race, age and gender. Results: Control subjects (n=35) had a significantly higher daytime oxygen saturation level, weight and body mass index (BMI) but not height compared to subjects with SCD (n=34). Total Lung Capacity(TLC) z-scores were significantly higher in the healthy controls compared to those with SCD (0.87 (1.13), 0.02 (1.27), p=0.005) while differences in Forced Expiratory Volume in 1 second (FEV1) z-scores approached significance (0.26 (0.97), -0.22 (1.09), p=0.055). There was no significant difference in LCI among the comparison groups (7.29 (0.72), 7.40 (0.69), p=0.514). Conclusion: LCI did not differentiate SCD from healthy controls in children between the ages of 6 and 18 years at baseline health. TLC may be an important pulmonary function measure to follow longitudinally in the pediatric SCD population.

A document by Ciara Keenan. Click on the document to view its contents.

A document by Ciara Keenan. Click on the document to view its contents.

We studied the combined effect of gamma radiation (6 Gy, remote period) and emotional stress on immunological reactivity. At the early period of emotional stress, all indicators of the immune system, such as cellular, humoral, and nonspecific phagocytic links of immunity were activated, indicating the activation of the general adaptive syndrome of the organism. The suppressive action of gamma radiation on the immune system was preserved in a remote period, with this suppression being revealed not only on the T-cellular link, but also on nonspecific phagocytic links, and the functional-metabolic activity of neutrophils. In the remote period after the combined effect of sublethal gamma radiation and emotional stress in the early stage of the adaptation syndrome, there was a decrease in all cells of the T-system of immunity, in the functional ability of leukocytes, and in the mononuclear phagocytic system of the body. The experimental emotional-radiation pathological process was accompanied by disorders of the functional activity of the essential adaptive systems of the body. Based on our results, we could conclude about the dominant role of ionizing radiation in immunological reactivity.

To the EditorAllergic disease diagnosis begins with a clinical history and physical examination to identify allergic symptoms associated with a relevant allergen.1 Immunoglobulin E (IgE) antibody sensitization is then confirmed with in vivo skin tests or in vitro blood test. If there is a mismatch between history and these primary sensitization diagnostic tests, then a provocation test may be required. During oral food challenges (OFC), test administrators must be specially trained in acute severe allergic reaction management and OFCs should only be performed with immediate access to intensive care units.2 Therefore, evaluating specific IgE (sIgE) sensitization are often used to help predict the outcome of the OFC before referring to a well-equipped tertiary hospital.Skin prick tests are not the preferred diagnostic tool if physicians are not well-trained allergists and in many countries, and typically, the number of antigens that can be evaluated at one time using serologic tests is limited. These limitations lead physicians to prefer to perform the multiple-antigen simultaneous tests for food allergy (FA) diagnosis, the results of which are semi-quantitative and often limited in predicting OFC outcome.3 The purpose of this study was to analyze the possibility of sIgE antibody detection using troops from self-reported food allergic symptoms.From May 2011 to December 2013, medical records of 377 patients (3 years old or younger) who visited the Department of Pediatrics at Ajou University Hospital were collected for egg white-, cow’s milk-, walnut-, and soybean-sIgE sensitization (sIgE ≥ 0.35 kU/L, UniCAP, ThermoFisher Scientific, USA). Five components of patients’ clinical history were collected: 1) way of exposure: direct (ingestion) or indirect (skin, inhalation); 2) type of exposure: isolated or mixed; 3) onset time: ≤2 hours or >2 hours; 4) symptom characteristics: anaphylaxis, urticaria, itchiness, vomiting, or diarrhea; and 5) consistency: negative past history or positive past history with consistency or inconsistency. Each clinical history was classified into class 1: direct-isolated intake resulting in anaphylaxis or hives without inconsistency; class 2a: class 1 with inconsistency, class 2b: indirect-mixed intake resulting in anaphylaxis or hives regardless of consistency, or class 2c: direct/indirect-isolated/mixed intake resulting in itch without hives, vomiting, or diarrhea without inconsistency; or class 3: class 2c with inconsistency or asymptomatic to direct, isolated exposure. All class 1 cases that were not of isolated ingestion were considered vague and were reclassified as class 2. An exception was made for anaphylaxis due to skin contact, which was still regarded as class 1. If the symptom onset time was recorded as “next day,” these classes were also reclassified by adding 1 (Table 1). Receiver operating characteristic curves were analyzed using SPSS version 22.0 (SPSS Inc., Chicago IL). The study was approved by the Institutional Review Board of Ajou University Medical Center (MED-KSP-12-381).In class 1 cases, the sensitization rate (i.e., sIgE positive) was the highest in walnuts (9 of 10; 90.0%), followed by hen’s egg white (49 of 55; 89.1 %) and cow’s milk (71 of 81; 87.7%). However, soybean-sIgE sensitization was only found in 5 of 8 cases (Table 2). Meanwhile, in class 2 cases, sIgE positivity was found in only 2 of 8 cases for soybean (25%) and 10 of 33 cases for cow’s milk (30.3%). However, within class 2 cases, sIgE-positivity was also high for egg white (17 of 22 cases; 77.3%) and walnut (2 of 3 cases; 66.7%). Egg white-sIgE demonstrated an area under the curve (AUC) of 0.717 and a positive predictive value of 89.1% in class 1 cases. When class 2 cases were included in this analysis in addition to class 1 cases, the AUC of egg white-sIgE positivity increased to 0.750, the negative predictive value increased to 68.6% compared with 47.5% for class 1 cases only, and the accuracy increased from 67.2% for class 1 cases only to 77.6% for class 1 and 2 cases. However, for cow’s milk- and walnut-sIgE sensitization rate, class 1 cases were the most predictable (AUC of 0.790 and 0.755, respectively), with an accuracy rate of 78.0% and 76.5%, respectively. Soybean-sIgE sensitization rate had a lower AUC of 0.662 in class 1 cases than other allergens (Table 3).FAs can be highly anticipated if anaphylaxis or objective symptoms are repeated more than once within a few hours after ingestion of a specific antigen.4 Accordingly, class 1 cases were limited to patients who experienced an immediate onset of objective symptoms (anaphylaxis or hives) after isolated ingestion. This study included patients aged < 3 years who often refused to perform an OFC using unfamiliar foods; hence, this study is limited as an OFC was not often performed. Therefore, the medical history technique described in this study cannot be deemed a definitive method for confirming FA. In fact, in class 3 cases, including asymptomatic or subjective manifestations to allergens, approximately 20–40% were sIgE positive and highly likely to tolerate the specific allergen and therefore would not be deemed to have an FA (sIgE positive: egg white, 38.5%; milk, 29.4%; walnut, 25.0%; and soybean, 33.3%). While it appears that many patients must confirm FA through OFC, even if there is sIgE sensitization, this study provides information for primary physicians who may be limited in implementing OFC. The rate of sIgE sensitization in class 1 cases was high (87.7–90.0% depending on antigen), supporting the detailed collection of important elements of the history taking pertaining to allergens. This study suggests that a clinical history of allergen exposure and characteristics of reactions can help determine whether sIgE sensitization and further OFC testing are required.Egg white, cow’s milk, and tree nuts are known as highly likely to be OFC positive, especially if patients have a history of adverse reactions within 5 minutes of direct exposure.5 In infants and young children who are allergic to foods, it is rare that they experience respiratory or gastrointestinal symptoms alone and this study continues to support this outcome. When collecting medical history from patients for a suggested FA, physicians must record all symptoms that occur sequentially, including the type of intake, symptom development and characteristics, and previous allergic symptoms after ingestion.This study demonstrated differences in sIgE sensitization according to the type of food antigen type, and it would be beneficial to add additional history-taking techniques based on these results. For instance, the accuracy of the egg white-sIgE sensitization testing increased when interpreting both class 1 and class 2 cases based on patient history, as it included objective cases of symptoms caused by both direct and indirect exposures. However, the accuracy decreased in the milk-sIgE sensitization testing of class 2 cases. It is thought that this may be due to young patients’ subjective symptoms, such as gastrointestinal symptoms alone. As walnuts were frequently consumed in a mixed form rather than isolated, there was a possibility of an increase in accuracy for the walnut-sIgE testing of both class 1 and class 2 cases.Prior to FA diagnosis, a detailed medical history could screen for potential allergens to be checked for IgE sensitization; however, it does depend on the type of allergen. The sIgE sensitization of egg white, cow’s milk, and walnuts are easy to predict by history alone but methods for increasing the predictability of each allergen are slightly different.

A document by Ciara Keenan. Click on the document to view its contents.

Facultative, heritable endosymbionts are found at intermediate prevalence within most insect species, playing frequent roles in their hosts’ defense against environmental pressures. Focusing on Hamiltonella defensa, a common bacterial endosymbiont of aphids, we tested the hypothesis that such pressures impose seasonal balancing selection, shaping a widespread infection polymorphism. In our studied pea aphid (Acyrthosiphon pisum) population, Hamiltonella infection frequencies ranged from 23.2% to 68.1% across a six-month longitudinal survey. Rapid spikes and declines were consistent across fields, and we estimated that selection coefficients, for Hamiltonella-infected aphids, changed sign within this single season. Prior laboratory research suggested anti-parasitoid defense as the major Hamiltonella benefit, and costs under parasitoid absence. While a prior field study supported these forces as counter-weights in a regime of seasonal balancing selection, our present survey showed no significant relationship between parasitoid wasps and Hamiltonella. Field cage experiments provided some explanation: parasitoids drove ~10% boosts to Hamiltonella frequencies that would be hard to detect under less controlled conditions. They also showed that Hamiltonella was not always costly under parasitoid exclusion, contradicting another long-held prediction. Instead, our longitudinal survey – and two overwintering studies - showed temperature to be the strongest predictor of Hamiltonella infection, matching some lab discoveries, and suggesting thermally sensitive costs and benefits, unrelated to parasitism, can shape this symbiont’s prevalence. These results add to a growing body of evidence arguing for rapid, seasonal adaptation in multivoltine organisms. For many insects, such adaptation may be mediated through the diverse impacts of heritable symbionts on host phenotypes.

Since 2007, African swine fever virus (ASFV) has spread to countries in Europe, Asia and Oceania, and has caused devastating impacts on pigs and the pork industry. Transmission can be direct or indirect, and epidemiologic scenarios have been described in which spread occurs between free-living and domestic pigs. The purpose of this scoping review was to identify primary research in which authors made statements to support ASFV transmission between free-living and domestic pigs and assess the circumstances in which transmission events occurred. A search was conducted in five bibliographic databases and the grey literature. Two reviewers (from a team of ten) independently screened each record and charted data (demographics of the pig populations, their husbandry [domestic pigs] and habitat [free-living pigs], the spatial and temporal distribution of ASF, the occurrence or burden of ASF in the populations, and whether ticks were present in the geographic range of the pig populations). Data synthesis included statistics and a narrative summary. From 1,349 records screened, data were charted from 46 individual studies published from 1985 to 2020. Outbreak investigations revealed that whilst poor biosecurity of domestic pig operations was often reported, direct contact resulting in transmission between free-living and domestic pigs was rarely reported. Studies in which quantitative associations were made generally found that spread within populations was more important than spread between populations, although this was not always the case, particularly when domestic pigs were free-ranging. We conclude that there is limited evidence that transmission of ASFV between free-living and domestic pigs is an important feature of ASF epidemiology, especially in the current ASF epidemic in Europe and the Russian Federation. If ASFV elimination cannot be achieved in free-living pigs, compartmentalisation of free-living and domestic pig populations via biosecurity strategies could be used to support trade of domestic pigs.

As an important soil carbon pool in Qinghai-Tibet Plateau (QTP), alpine peatland are extremely sensitive to global change. Duration of drainage and water table drawdown lead to rapid soil degradation and C losses, and this may worsen under warming as the soils are no longer protected by anaerobic conditions. Hence, the objective of this study was to assess the effect of drainage on microbial characteristics, greenhouse gas (GHG) emissions and their influencing factors, and further analyze whether the the variability of GHG emissions increases with warming. The results showed that the influence of water table drawdown on microbial community structure was greater than that of duration of drainage. Both the fungal and prokaryotic community compositions varied with water table gradient, and soil microbiota may served as a biomarker to analyze the differences in GHG emissions among three different water table treatments. Intriguingly, the GHG emission decreased with the increase of drainage age, while water table drawdown reduced the CO2 and CH4 emission rates, and increased N2O emission rates. In addition, high temperature increased CO2 by 75% and N2O by 42%, but not significantly decreased the CH4 emission rates. Structural equation modeling suggested that microbial community composition was the primary factor affecting GHG emissions from drained peatlands, especially prokaryotes. Overall, our results indicate that water table plays a more important role in GHG emissions than duration of drainage, and the variability of GHG emissions increases with warming.

Cardiac channelopathies are a heterogeneous group of inherited cardiac diseases that are associated with mutations in the genes that encode the expression of cardiac ion channels. In view of this, it can be mentioned that the main hereditary arrhythmias in children and adolescents, caused by dysfunction of the ion channels are Brugada Syndrome (BrS) and Long QT Syndrome (LQTS). However, few studies address the physiological effects of these conditions on children and adolescents. Thus, the aim of this study is to describe the mutation phenotype related to voltage-gated sodium channels in children and adolescents. A search was performed in the literature of Pubmed, Scielo and Google scholar. The search was limited to articles written in English in the last 5 years, so articles published between January 2014 and January 2019 were included. Among 2196 studies identified through a systematic literature review, thirty studies related to the theme were identified for complete review and after applying exclusion criteria 4 articles were included in the results of this research. As the most frequently observed channelopathy, BrS was also more identified in children and adolescents, characterized by episodes of syncope or sudden cardiac death. LQTS shows clinical manifestations with a mild phenotype and good prognosis, although it is necessary to monitor and correct serum electrolyte disturbances to prevent ventricular arrhythmias and, consequently, sudden death in patients with the pathology.

Atrial fibrillation (AF) is the most common cardiac arrhythmia and often occurs with heart failure (HF) [1]. AF prevalence increases with increasing severity of HF: for instance its prevalence ranges from 5 percent in patients with New York Heart Association (NYHA) functional class I HF to 40 percent in patients with NYHA class IV HF [2]. Its presence with HF plays a significant prognostic role and increases morbidity and mortality. Heart Failure with reduced ejection fraction (HFrEF) is associated with cardiac arrhythmias [3]. HFrEF is also one of the indications for Cardiac resynchronization therapy (CRT) placement [4]. Therefore, many patients undergoing CRT implantation will concomitantly have HF and AF. As the benefit from CRT in HF patients has been established, the data on patients with both HF and AF is limited, because patients with atrial arrhythmias were excluded from most of the major CRT trials, such as CARE-HF and COMPANION [5]. However, a number of observational studies and small randomized clinical trials suggest a benefit from CRT in AF and HF patients such as a CRT-mediated ejection fraction (EF) increase [6, 7]. Other studies showed a high non-response rate in patients with AF as compared to those in sinus rhythm (SR) [8]. Thus, it is important to determine whether CRT has a beneficial role in these patients to decide on adding an atrial lead at the time of CRT implantation especially in patients with longstanding-persistent AF.In their published study, Ziegelhoeffer et al. investigated the outcomes of CRT placement with an atrial lead in patients with HF and AF. This was done by conducting a retrospective analysis of all patients with AF who received CRT for HF at the Kerckhoff Heart Center since June 2004 and were observed until July 2018- completing a 5-year follow-up. The authors identified 328 patients and divided them into 3 subgroups: paroxysmal (px) AF, persistent (ps) AF, and longstanding-persistent (lp) AF, with all patients receiving the same standard operative management. During the observation period, the authors analyzed the rhythm course of the patients, cardiac parameters (NYHA class, MR, LVEF, left atrial diameter) and performed a subgroup analysis for patients who received an atrial lead. The study showed that all groups had a high rate of sinus rate (SR) conversion and rhythm maintenance at 1 and 5 years. Specifically, the patients who received an atrial lead among the lp AF group were shown to have a stable EF, less pronounced  left ventricular end-systolic diameter (LVESD) and  left ventricular end diastolic diameter (LVEDD) and lower mitral regurgitation (MR) rates at one year follow-up as compared to the group without atrial lead placement. Moreover, the results of the lp group were similar to the ps-AF group, although the latter had a lower number of participants (n=4) without initial implantation of the atrial lead. The authors attributed the improvement in cardiac function and SR conversion to CRT and the implantation of an additional atrial lead.Although some studies showed that CRT therapy reduced secondary MR in HF [9, 10], this study additionally suggests that CRT with an atrial lead was associated with improved myocardial function and improvement of interventricular conduction delay triggering cardiac remodeling in patients with HF and AF. Although the results showed better cardiac function in the subgroup analysis of the patients with an additional atrial lead, these results were reported as percentages with no level of significance specified, hence statistical significance of the difference in the described parameters (such as LVESD, LVEDD) could not be determined. Further investigation via prospective studies is needed with larger sample size in the future to further support the results of the study especially that it was done in a single center and had a relatively small sample size.References:1. Chung MK, Refaat M, Shen WK, et al. Atrial Fibrillation: JACC Council Perspectives. J Am Coll Cardiol. Apr 2020; 75 (14): 1689-1713.2. Maisel, W.H. and L.W. Stevenson, Atrial fibrillation in heart failure: epidemiology, pathophysiology, and rationale for therapy. Am J Cardiol, 2003. 91 (6a): p. 2d-8d.3. AlJaroudi WA, Refaat MM, Habib RH, et al. Effect of Angiotensin Converting Enzyme Inhibitors and Receptor Blockers on Appropriate Implantable Cardiac Defibrillator Shock: Insights from the GRADE Multicenter Registry. Am J Cardiol Apr 2015; 115 (7): 115(7):924-31.4. Yancy, C.W., et al., 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol, 2013. 62 (16): p. e147-239.5. Cleland, J.G., et al., The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med, 2005.352 (15): p. 1539-49.6. Leclercq, C., et al., Comparative effects of permanent biventricular and right-univentricular pacing in heart failure patients with chronic atrial fibrillation. Eur Heart J, 2002. 23 (22): p. 1780-7.7. Upadhyay, G.A., et al., Cardiac resynchronization in patients with atrial fibrillation: a meta-analysis of prospective cohort studies. J Am Coll Cardiol, 2008. 52 (15): p. 1239-46.8. Wilton, S.B., et al., Outcomes of cardiac resynchronization therapy in patients with versus those without atrial fibrillation: a systematic review and meta-analysis. Heart Rhythm, 2011. 8 (7): p. 1088-94.9. van Bommel, R.J., et al., Cardiac resynchronization therapy as a therapeutic option in patients with moderate-severe functional mitral regurgitation and high operative risk. Circulation, 2011.124 (8): p. 912-9.10. Breithardt, O.A., et al., Acute effects of cardiac resynchronization therapy on functional mitral regurgitation in advanced systolic heart failure. J Am Coll Cardiol, 2003. 41 (5): p. 765-70.