We should know that a common early pattern is radiculopathy at the level of compression along with an ascending pattern of sensory and motor symptoms in the distal lower extremities.

CAD/CAM complete dentures have shown to improve the fit and material strength than conventionally fabricated dentures, however there are no clinical protocols described for extreme residual ridge resorption. This report describes a combined workflow of conventional and novel techniques for CAD/CAM complete dentures fabrication for atrophic alveolar ridges.

A document by Shelly C. Lu. Click on the document to view its contents.

A document by Sandy Hardian Susanto Herho. Click on the document to view its contents.

To improve understanding of real-world asthma treatment and inform physician education, we evaluated regional variation in asthma prevalence and oral corticosteroid (OCS) use across Germany. We developed a machine learning gradient boosted tree model with IMS® Disease Analyzer electronic medical records, which cover 3% of German patients. This model had a 91% accuracy in predicting the presence of asthma and chronic obstructive pulmonary disease. We applied the model to the IMS® Longitudinal Prescription database, with 82% national coverage, to classify patients receiving treatment for airflow obstruction from October 2017–September 2018 in 63 regions in Germany. Of 2.4 million individuals under statutory health insurance with predicted high OCS use for asthma (defined as 1 tablet per day for the duration of therapy), 13.7%, 18.7%, 36.5%, 29.4%, and 1.7% were categorised as receiving Global Initiative for Asthma (GINA) Steps 1, 2, 3, 4, and 5 treatment, respectively. Approximately 7–15% of those receiving GINA Steps 1–4 treatment, and 35% of those receiving Step 5 treatment received ≥1 acute OCS prescription (duration <10 days). Of patients receiving GINA Steps 1–4 and Step 5 treatments, 1–3% and 86%, respectively, received ≥1 OCS prescription defined as high OCS use. Cumulative OCS dosage and percentages of patients receiving OCS differed substantially across regions, and regions with lower OCS use had greater use of biologic therapies. Both acute and high OCS use varied regionally across Germany, with overall use greater than recommended by guidelines for all degrees of asthma severity.

A document by Mitch Raith. Click on the document to view its contents.

This study aimed to evaluate the antitumor potential and cytotoxicity induction mechanisms of green synthesized AgCl-NPs and Ag/AgCl-NPs through image-based high content analysis method. The antitumor potential of AgCl-NPs and Ag/AgCl-NPs was evaluated in breast cancer BT-474 and MDA-MB-436 cell lines treated with 0-40 μg/mL AgCl-NPs or 0-12.5 μg/mL Ag/AgCl-NPs. Normal human retinal pigment epithelial 1 (RPE-1) cells were used for comparison. The growth rate of the RPE-1 cells treated with AgCl-NPs or Ag/AgCl-NPs was little affected, and no significant changes in cell viability were observed. In these cells, the nanoparticle treatments did not induce lysosomal damage, changes in reactive oxygen species (ROS) production or a reduction in the mitochondrial membrane potential. Moreover, the percentage of apoptotic cells was minimally affected, reaching a maximum of 3.51% of the population. The level of BT-474 and MDA-MB-436 cell proliferation was markedly decreased, and cell viability was reduced by 64.19 and 46.19% after treatment with AgCl-NPs and reduced by 98.36 and 82.29% after treatment with Ag/AgCl-NPs. The cells also showed a significant increase in ROS production and loss of mitochondrial membrane potential, which culminated in an increase in the percentage of apoptotic cells. BT-474 cells also presented lysosomal damage when treated with the highest concentrations of both nanoparticle types, and actin polymerization was observed after exposure to Ag/AgCl-NPs. Together, the results obtained show overall cytotoxic effects of both AgCl-NPs and Ag/AgCl-NPs towards breast cancer cells with negligible effects against healthy cells, which suggests their promising anticancer and biomedical applications.

The contamination of heavy metals (e.g., Hg, Pb, Cd and As) poses great risks to environment and human health. Rapid and simple detection of heavy metals of considerable toxicity in low concentration levels is an important task in biological and environmental analysis. Among the many convenient detection methods for heavy metals, DNA-inspired gold nanoparticles (AuNPs) (DNA-AuNPs) have been becoming a well-established approach, in which assembly/disassembly of AuNPs serves for colorimetric signaling of the recognition event between DNA and target heavy metals at the AuNP interface. This review focuses on the recent efforts of employing DNA to manipulate the interfacial properties of AuNPs, and summarizes the recent advances in the colorimetric detection of heavy metals. Beginning with the introduction of the fundamental aspects of DNA and AuNPs, three main strategies of constructing DNA-AuNPs with DNA binding-responsive interface are discussed, namely, crosslinking, electrostatics, and base pair stacking. Then, recent achievements in colorimetric biosensing of heavy metals based on the interfacial manipulation of DNA-AuNPs are surveyed and compared. Finally, conclusions and perspectives on the futuristic directions in the field are provided, including the evaluation of the pros and cons of the three strategies, with an expectation of providing a reference for researchers who works in the related field. It is also suggested that manipulation of the interface of DNA-AuNPs represent enormous potential in the pursuit of colorimetric biosensors for a range of analytes of interest.

Methyltransferases (MTs) constitute a large group of enzymes that catalyze the transfer of a methyl moiety most frequently from S-adenosyl-L-methionine to their substrates. It plays an essential role in regulation of genes expression and synthesis of many natural compounds. Owing to its broad substrate spectrum, MTs make important contributions to diversify the spectrum of products through methylation modifications. Recently, employment of MTs for biosynthesis of natural products has made great progress but have not been detailed and informative viewed so far. In this article, we summary the recent advances in application of MTs for microbial synthesis of various natural products including phenylpropane compounds, fragrances, hormones and antibiotics. We put emphasis on the applied metabolic engineering strategies for efficient production of those chemicals and for expanding the diversity of the products. Then, we present the current challenges and future perspectives in utilization of MTs for efficient production of more diverse natural products in microorganisms.

Microbial conversion of plant biomass into fuels and chemicals offers a practical solution to global concerns on limited natural resources, environmental pollution, and climate change. Pursuant to these goals, researchers have put tremendous efforts and resources towards engineering the yeast Saccharomyces cerevisiae to efficiently convert xylose, the second most abundant sugar in lignocellulosic biomass, into various fuels and chemicals. Although many challenges remain, these research investments have facilitated efficient and rapid fermentation of xylose, simultaneous co-consumption of xylose with carbon sources in lignocellulosic hydrolysates, and enhanced production of a wide range of valuable chemicals from xylose. In particular, understanding of xylose-induced metabolic rewiring in engineered yeast has stimulated the use of xylose as a preferred carbon source for the production of various non-ethanol bioproducts. Here, we summarize recent advances in metabolic engineering in yeast to address bottlenecks of xylose assimilation, and to enable simultaneous co-utilization of xylose and other cellulosic carbon sources. We also highlight distinct characteristics of xylose metabolism which can be harnessed for the production of advanced biofuels and chemicals.

Introduction: The acute myocardial infarction (AMI) affecting the autonomic nervous system (ANS) function has been affirmed in clinical and basic research. We hypothesize that a high level of ANS regulation in AMI patients could cause synchronized neural discharge (clustering phenomenon) detected by non-invasive skin sympathetic nerve activity (SKNA). Methods: Forty subjects, including 20 AMI patients and 20 non-AMI controls, participated in the study. The wide-band bioelectrical signals (neuECG) were continuously recorded on the body surface for 5 minutes. The SKNA were signal processed to depict the envelope of SKNA (eSKNA). By labeling the clusters, the subjects were separated into non-AMI, non-cluster appearing (AMINCA) and cluster appearing (AMICA) groups. Results: The average eSKNA was significant correlated with HRV low frequency power (rho=-0.336) and high frequency power (rho=-0.372). The cross-comparison results demonstrated the eSKNA is a credible indicator to assess ANS in AMI patients. The frequency of cluster occurrence was 0.01-0.03 Hz and the amplitude about 3 µV. The LF/HF ratio of AMINCA (Median:3.959; Q1-Q3:1.840-6.562) revealed significantly higher than AMICA (Median:1.877; Q1-Q3:1.483-2.413). The results exhibited the SKNA clustering is a unique temporal pattern of ANS synchronized discharge, which could regulate and help maintain the ANS balance in AMI patients. Conclusion: This is the first study to identify the SKNA clustering phenomenon in AMI patients. Such a synchronized nerve discharge pattern could be detected with non-invasive SKNA signals. The SKNA temporal clustering could be a novel biomarker to classify the ANS regulation ability in AMI patients.

Coronavirus Disease 2019 (COVID-19) Pandemic is a big threat for all countries’ health systems. In India, the first case of coronavirus occurred in Kerala on 30 January 2020, followed by 2 more until 2 February 2020, but all three were cured, according to the World Health Organization (WHO) India situation report-2. Since this, no single case of coronavirus has been recorded across the country for a month. Nevertheless, from 2 March onwards, the number of cases rose on a regular basis. As of 21 June 2020, 410,461 confirmed cases and 13,254 total deaths, as stated in the World Health Organization (WHO) India situation report-21. This research presents significant findings about the early outbreak of COVID-19 in India. Due to the recent rapid rise in new cases of COVID-19, the pre-evolution of pandemic coronavirus is a pre-eminence in India. The susceptible-infectious-recovered (SIR) model was developed to estimate the reproductive number R0 at the early stage of the outbreak of COVID-19 and to evaluate this outbreak with available data on confirmed, deaths and recovered cases in India from 02 February 2020 to 26 June 2020.

Hospital data for covid-19 surveillance, planning and modelling are challenging to find well into the pandemic. Data for new covid-19 admissions are particularly challenging to find. Accurate hospital data are the best source of information for short-term forecasts of health care capacity, and they improve long-term covid-19 models that are typically based on cases. We describe the role of hospital data for studying covid-19, why admission data are hard to find, and how improved data infrastructure can meet surveillance and planning needs over the next year. Critical infrastructure includes a well-maintained list of patients hospitalized with covid-19 that is integrated with public health information systems.

A document by Deep Raja. Click on the document to view its contents.

Sir, We read with interests the article by Kate F Walker and colleagues, entitled ”Maternal transmission of SARS-COV-2 to the neonate, and possible routes for such transmission: A systematic review and critical analysis”. In the article, the authors systematically analyzed the mode of delivery on the infection rates of COVID-19 in the newborn. Despite the limitations, especially the retrospective nature of studies examined, this study provided important information about the selection of mode of delivery of women with COVID-19. It suggests that neonatal infection rates are not different after Caesarean birth or vaginal delivery. However, the severity of the COVID-19 infection of the mothers was not considered. Clinically, pregnant women with the more severe COVID-19 infection appear to prefer delivery by Caesarean delivery rather than vaginal birth. Therefore, it is possible that any beneficial effects of Caesarean birth in reducing transmission of COVID-19 might not be apparent because the severity of COVID-19 infection was greater in these women. This selective bias would weaken the conclusions of current studies. We feel that prospective evaluation the safety of mode of delivery with COVID-19 is required.Rui-hong Xue11Department of Obstetrics and Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

This is a first observational study of four patients on steroid pulse therapy for secondary organizing pneumonia with respiratory failure due to the Coronavirus Disease 2019 (COVID-19) in our hospital. All patients needed invasive mechanical ventilation and had bimodal worseness of their respiratory status with organizing pneumonia after intubation. All cases could successfully discontinue oxygen therapy without any severe adverse events after this pulse therapy. Although few previous reports showed the efficacy and safety of this therapy, this therapy is believed to be effective on some optimal patients. Hence, further studies to explore this efficacy and safety were needed.

Background: Newly Merged Districts (NMDs) of erstwhile FATA Pakistan area has remained under protracted emergency of conflict and terrorism and has difficult terrain with hard to reach areas. Methods: We conducted KAP survey about COVID19 in five NMDs, aiming at assessing knowledge of population and establishing baseline for comparison. A total of 1227 respondents (376 adult males, 382 adult females, 236 adolescent boys and 233 adolescent girls) were interviewed in 150 locations over a period of five days. Data Instruments were pretested, and consent of respondents were taken. Multiple choice options were given to choose from; hence responses have been calculated. Results: Our results reveal that mean knowledge score was similar amongst adults and adolescents. However, adult males on average scored better than the adult females. Overall, 98 % of the study participants knew about COVID 19 and 92% participants acknowledged COVID- 19 as a preventable infection. Formal school education and belonging to district NWTD and SWTD (vs. the reference district Khyber) were significantly associated with higher knowledge score amongst both adults and adolescents. In addition, formal school education and adults belonging to district Kurram, Orakzai and SWTD (vs. the reference district Khyber) had greater odds of believing that COVID 19 is preventable. Conclusion: Our findings confirm that majority of respondents know about symptoms, spread, prevention, test and treatment related to COVID 19 which may be attributed to concurrent global, national and provincial information dissemination campaigns.

Objectives: Reducing influenza infection among hospital employees is vital to prevent the spread of this infection among patients. A questionnaire study was performed to investigate seasonal influenza infection and vaccination among hospital employees, with the aim of decreasing the incidence of influenza. Methods: From 2014 to 2017, we distributed a questionnaire to hospital employees who were eligible for vaccination. The following information was collected: age of respondents, whether they lived with children aged <15 years, their preseason vaccination status, and their history of seasonal influenza infection. The data were analyzed and averaged for all 4 influenza seasons. Results: The incidence of influenza was 6.2% among employees through 4 seasons. The inoculation rate of the influenza vaccine ranged from 92% to 99%. The odds ratio for influenza infection among employees living with children aged <15 years was 2.19 (P<0.0001). A decrease in influenza infection was not observed in vaccinated employees (P=0.75). Conclusions: The results suggested that influenza infection in hospital personnel is not due to a low vaccination rate. Among people living with children younger than 15 years, the odds ratio of influenza infection was 2.19 (P<0.0001). These findings suggest that protection against influenza infection at home is particularly required for hospital employees living with children aged <15 years.

Rapid urbanization leads to fragmentation of large land patches, islandization of ecological landscape, and destruction of ecological security network. As a basic guarantee of life, a sound ecological security network promotes connectivity between ecological sources, improves ecological security patterns, and mitigates the degradation of an ecological system. The objective of this study was to improve a framework for assessing the ecological security network. We demonstrated the application of the proposed framework through a case study of the urban agglomeration around Hangzhou Bay (UAHB), a rapid urbanization region in Eastern China’s Zhejiang Province. We improved the identification method of ecological sources by integrating the evaluations of ecosystem services value and ecological sensitivity, while we screened ecological sources by using the rank-size rule and the natural breaks method. Based on the screened ecological sources, the ecological corridors were reconstructed and optimized for the UAHB region. Results from this study showed that the structure and function of the ecological security network were strongly influenced by human activities and urban sprawl. The ecological security network has deteriorated locally in eastern coastal areas of UAHB during the past 20 years with strong spatial variability in ecological security patterns. To maintain a well-protected and sustainable ecological quality, we proposed a set of 5 measures to improve the ecological security pattern and the sustainable development of the ecological system in Eastern China.

Objective To evaluate the Australian Capital Territory (ACT) Preterm Birth (PTB) Prevention Initiative and its effects on preterm and early term birth rates at the main tertiary hospital after 16 months of implementation. Design: A non-randomised before and after study, where the intervention was a multifaceted PTB prevention initiative. Setting: The main tertiary referral hospital in the ACT. Population: Women who birthed at the main tertiary hospital in the ACT in the pre and post intervention period. Methods: The PTB prevention initiative was implemented in 2019. Rates of early birth were assessed using run charts of bimonthly preterm and early term rates from 2014-2020. Main Outcomes measured: The main outcomes measured were rates of preterm and early term births before and after implementation of the PTB prevention initiative. Results: At the main tertiary hospital in the ACT, the rate of PTB was significantly reduced by 10% after 16 months of implementation of the initiative, corresponding to 45 averted or delayed PTBs. The number of iatrogenic early term births with no medical indication (NMI) was significantly reduced by 34.5% and resulted in 77 averted or delayed early term births. Conclusions: The multifaceted PTB prevention initiative safely lowered the rates of early birth in the ACT context. These results highlight the importance of prioritising early birth prevention, education, research and expanding the PTB Prevention Initiative nationwide.

As percentages of elderly people rise in many societies, age-related diseases have become more prevalent. Research interests have been shifting to delaying age-related disease by delaying or reversing aging itself. We use metformin and rapamycin, two drugs at the center of anti-aging drug research, as an entry point to talk about important molecular and genetic anti-aging mechanisms that have been extensively studied with them, such as mTOR, AMPK, and epigenetic modifications. We also present a number of observational studies, animal studies, and clinical trials to reflect the potential and actual effects of the mechanisms. At the end, we list remaining concerns that not only apply to researches around metformin and rapamycin but also future researches to explore other anti-aging pathways and therapeutics.

Background and aim of the study: Aim of this study is to compare the incidence of postoperative bleeding events, identified as pericardial effusion, for those patients undergoing cardiac surgery and discharged on vitamin K antagonist (VKA) versus those discharged on NOACs. Methods: This was a retrospective observational cohort study; from July 2017 to July 2019, all the patients who underwent any cardiac surgical procedure and discharged on any oral anticoagulant, were rolled in the study. The study variables and setting followed the STROBE checklist. The final cohort was constituted by 382 patients (mean age 70±11.2 years); 260(68.1%) patients were discharged on VKA and 122(31.9%) were discharged on NOACs. The primary end point was the incidence of major postoperative bleeding, defined as pericardial effusion requiring surgical re-exploration. The key secondary composite end point was the late re-admission for pericardial effusion. Results: The overall incidence of in-hospital immediate bleeding events, with need of re-exploration for pericardial effusion, was 4.7% (n=18). The incidence of re-admission for pericardial effusion was 3.1% (n=12). Eight of those patients had surgical re-exploration: four patients were discharged on NOACs and the remnant four ones were discharged on VKA. No significant relationships were observed between the different oral anticoagulants and the incidence of pericardial effusion, at any time. No ischemic and thromboembolic events were recorded. Conclusions: The use of non-vitamin K antagonist oral anticoagulant, in post cardiac surgery patients, does not increase the incidence of major bleeding events, intended as immediate or late pericardial effusion.

Environmental temperature serves a major driver for adaptive changes in wild organisms, however, its role in domestication has been less characterized. To uncover the mechanisms of cold tolerance in domestic animals, we sequenced genomes of 28 cattle at median coverage from warm and cold areas across China. By characterizing the population structure and demographic history, we identified two genetic clusters, i.e., northern and southern cattle groups, and a common historic population peak at 30 kilo years ago. Genome scan of cold tolerant breeds revealed genes that under selection sweeps enriched in thermogenesis related pathways. Specifically, we determined a substitution of PRDM16 (p.P779L) in north cattle, which maintains the formation of brown adipocytes through boosting expression of thermogenic related genes, indicating a vital role of this gene in cold tolerance. The findings provide a basis of genetic variations in domestic cattle that shaped by temperature environments and highlight a role of reverse mutation in livestock species.

In water-deficient rivers, environmental flows (e-flows) are usually sustained via inter-basin water transfer projects from water-sufficient rivers, but these projects incur tremendous costs and may lead to many negative ecological effects, such as ecological invasion. This research proposed to transfer hydropower instead of water from water-sufficient rivers, because hydropower could substitute for water to promote economic development and reduce water withdrawal from water-deficient rivers. In this research, we established a computable general equilibrium model to analyze the substitution of hydropower for water in a water-deficient river basin, and determined the water withdrawal volume that could be reduced (conserved water). In addition, we adopted a range-of-variability approach to measure the effectiveness of e-flow provisions, and optimized the use of the conserved water to better maintain e-flows. The Luanhe River was adopted as a study case. The results showed that: the water-hydropower equivalent decreased as the transferred hydropower into the Luanhe River basin increased; a transferred hydropower amount of 22.46 kWh/s, equivalent to 18.30 m3/s conserved water, was optimal for the river basin; the conserved water should be distributed to the Luanhe River in the proportions of 0.55:0.1:0.35 during the wet, normal and dry seasons, respectively; the policy could transform the macro-economy toward a lower air-pollution pattern.