The amphibian chytrid fungus (Bd) has caused extinction of amphibian populations worldwide. Early and accurate Bd detection is essential for management and treatment of susceptible anurans. We analyzed the effectiveness of an in-situ DNA extraction along with handheld mobile quantitative PCR (qPCR) thermocycler to detect Bd on skin frog swabs, and to detect Bd in water samples using environmental DNA (eDNA). We collected duplicate eDNA samples and skin swabs from three Bd positive Rana sierrae populations. We processed one set of samples using a field protocol (a handheld thermocycler), and the other half using a standard lab protocol. We detected Bd DNA in all R. sierrae swabbed across all three sites using both the field and lab protocols. We also detected Bd DNA in eDNA samples collected at two of the three sites using both the field and lab protocols although the field and lab protocol failed to detect Bd eDNA at separate sites. The probability of detecting Bd DNA in the technical replicates was lower for the field protocol compared to samples extracted using the lab protocol, suggesting the field protocol has reduced sensitivity and may not detect low quantities of DNA. Our results suggest the field extraction protocol using a handheld qPCR platform is a promising tool for rapid detection of Bd in susceptible amphibian populations. The field protocol yielded accurate results in less than 60 minutes. However, the applied field protocol may be prone to false negatives when analyzing low-quantity DNA samples (i.e. eDNA).

The ligand-promoted palladium-catalyzed hydroarylation of alkynes with arenes without directing group is able to furnish alkenyl chlorides via a 1,4-chlorine migration or trisubstituted alkenes. This reaction is challenging due to bidentate N, N ligand and electron-neutral arenes have rarely been reported to afford good yields. We carried out density functional theory calculations to better understand the elementary steps of the reaction and unveil the ligand effects and origin of substituent-controlled chemoselectivity of challenging C-H activation. For the n-propyl-substituted substrate, CMD process is the rate-determining step of the catalytic reaction. And the chemoselectivity is controlled by oxidative addition with the C-Cl bond cleavage and protonation process. However, for the reaction with 3,5-dimethylphenyl-substituented substrate, the key step of the whole catalytic cycle is the protonation process. The stronger electrostatic attractions, repulsive force and aryl substituent effects result in reverse chemoselectivity. Bidentate ligand L1 (2-OH-1,10-phenanthroline) reacts with Pd(OAc)2 to form a most stable square-planer species, which is different from the one formed by ligand L2(1,10-phenanthroline). The steric repulsion are found to be mainly responsible for no product with L2 as the ligand, which is different from as proviously reported.

Scheme 1. The reaction (transformation from 1 to2 ) of N−N bond cleavage process.

A 61-year-old woman who has undergone coronary artery bypass grafting 30 years ago, now reveals severe mitral regurgitation. Coronary angiography and computed tomography show patency of the graft. To avoid injuring the graft, mitral valve replacement under ventricular fibrillation without aortic cross clamping was performed through a right minithoracotomy approach.

Objective: The goal of the current study was to evaluate the sociodemographic, criminological, and psychiatric characteristics of the full sample of female violent offenders committed involuntarily to a forensic psychiatric hospital in Rio de Janeiro, Brazil. Method: Psychiatric assessment using SCID-IV in all the female violent offenders treated in the only forensic psychiatric hospital in the state. Results: Most offenders (n = 29) were non-Caucasian single women with very low income. Schizophrenia was the most common diagnosis. Most patients had already been diagnosed with a mental disorder and placed under psychiatric treatment, but dropout and non-adherence were common. Conclusion: Violent behavior in mentally ill female offenders may at least partially reflect the failure of mental health and social services to provide much-needed support for economically and socially vulnerable women.

Background. The criteria for response evaluation in pediatric and adolescent Hodgkin lymphoma (HL) are controversial. We compared different criteria for the interpretation of interim and post-treatment PET/CT to predict the outcome of pediatric and adolescent HL. Procedure. Baseline, interim, and post-treatment 18F-FDG-PET/CT scans of 147 pediatric and adolescent HL patients were interpreted according to the International Harmonization Project Criteria (IHPC) and Deauville Criteria (DC). Two thresholds of positivity were used for the DC: DC-3, scores of 3–5; and DC-4, scores of 4–5. Diagnostic performance of interim and post-treatment PET in outcome prediction was evaluated. Progression-free survival (PFS) was analyzed by the Kaplan-Meier method and Cox proportional hazards model. Results. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of interim FDG-PET/CT were 82%, 33%, 15%, 93%, and 39%, respectively, for IHPC, 82%, 51%, 19%, 95%, and 55%, respectively, for DC-3, and 27%, 78%, 15%, 88%, and 72%, respectively, for DC-4. The corresponding values for post-treatment PET/CT were 73%, 74%, 23%, 96%, and 74% for IHPC, 67%, 80%, 27%, 96%, and 79% for DC-3, and 47%, 90%, 33%, 94%, and 86% for DC-4. PFS significantly differed between patients with positive and negative post-treatment PET/CT according to IHPC, DC-3, and DC-4 (P < 0.01 for all), but only DC-4 was an independent prognostic factor for PFS (hazard ratio: 7.82). Conclusion. Compared to interim PET/CT, post-treatment PET/CT better predicted the outcomes of pediatric and adolescent HL. DC-4 had superior diagnostic performance over IHPC and DC-3.

The influence of dissolved organic matter (DOM) on mineral extraction from salt lake brines depend on DOM quality. This study contributes to our knowledge of DOM’s metal binding behavior in hypersaline environments by characterization of DOM from lakes in the Qaidam Basin, i.e., Qarhan Lake (LQDOM), Da Qaidam (DQDOM) and West Ginair Salt Lake (WGDOM). The DOM was fractionated based on solid phase extraction (SPE) and ultrafiltration (UF), and the spectral and metal binding behavior of these fractions were studied by absorption spectroscopy, Pb(II) titration techniques and fluorescence parallel factor (PARAFAC) analysis. The results showed that bulk DOM generally contained more dissolved organic carbon (DOC), lower specific UV absorbance (SUVA254), higher fluorescence and biological indices, comparable humification index, and lower condition stability constants compared to the other nature waters. Compared with UF, SPE-derived DOM exhibited higher DOC recovery and aromaticity and lower carbohydrate yield. It appears that the SPE procedure used affects the spectral composition of bulk DOM to a larger extent than UF. Source and molecular weight (MW)-dependent differences in abundance and quality of brine DOM was indicated by higher SUVA254 in high MW DOM, for LQDOM and DQDOM, and humic-like fluorophores were mainly in high MW-DOM in each lake. Moreover, the high MW humic-like component exhibited higher metal binding potential than the bulk and low MW counterparts for LQDOM and DQDOM, while the inverse was observed for WGDOM. This study revealed the effects of isolation techniques on interpretation of DOM characteristics, and meanwhile highlighted the importance of origin- and MW-dependent DOM in manipulating the behavior, fate, and bioavailability of heavy metals in salt lake brine.

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) in China at the end of 2019 brought with it uncertainty as to whether it would bring an increase in maternal, fetal and neonatal morbidity and mortality. This uncertainty drove fear; understandable given the high case fatality rate associated with previous severe respiratory illness causing coronaviruses.Given the novel nature of SARS-CoV-2, clinicians and women and their families rely primarily on limited information from case reports and case series to inform their decisions about pregnancy management. Early evidence from these sources demonstrated a tendency toward preterm delivery mainly as a consequence of elective interventions (Della Gatta et al. Am J Obstet Gynecol, 2020, Vol.223, p36-41), which are likely to have been exacerbated by the uncertainty of COVID-19 on pregnancy and neonatal outcomes.The reliance on research reports, case series and case reports continues. However, such reports are at higher risk of bias, including publication bias. Concerns have also been expressed about the potential of reporting of same people with COVID-19 across different reports (Bauchner et al. JAMA, 2020, Vol.323, p1256). Such reporting leads to inaccurate estimates of the impact of the disease on outcomes, which is aggravated when an evidence base is relatively small, evolving and critical to informing good care decisions.In this issue, Thornton et al. report a review of case reports and case series of the risk of the neonate becoming infected with SARS-COV-2 by mode of birth, type of infant feeding and mother-infant interaction (BJOG 2020 xxxx). Their findings lead them to conclude that vaginal delivery, breast and are safe in the context of COVID-19 disease. But, what interests me equally in this paper is their approach to reducing the risk of duplicate reports in estimating disease impact.First, their data sources included a daily PubMed search supplemented by alerts from experts on social media; daily searches of three electronic databases including the Maternity and Infant Care Database and citation tracking. Second, geo-coding of data to unique distinct locations. Here, in response to reviewer feedback, which the authors refreshingly acknowledge, the team invited a native speaker of Chinese familiar with health institutes in Wuhan to provide contextual information to maximise the likelihood of correct site identification (which did result in some geo-coding revisions). Third, they attempted to identify sites unnamed in reports using author affiliations, which ultimately did not provide the assurances they needed to be confident in retaining some reports.The accuracy of inferences drawn from research reports, case series and case reports is enhanced when authors report clearly if and when any patients are reported in other reports and when processes to minimise erroneous repeated inclusion of the same patients. Thornton et al.’s paper is informative clinically but is equally interesting in its flexing of methods to iteratively address an evolving evidence base and minimise uncertainty. Such approaches may lack the sophistication of techniques applied to larger evidence bases yet are critical to informing decisions early in an evolving evidence base. Further development of the processes may inform future pandemic readiness.No disclosures: A completed disclosure of interest form is available to view online as supporting information.

Uterine rupture is the feared complication when a uterus scarred by a caesarean section (CS) is labouring. The increased awareness of uterine rupture and its dramatic consequences of perinatal asphyxia has lead to guidelines dictating safe circumstances when undertaking a trial of labour after caesarean section (TOLAC). This complication occurs in an estimated 35 per 10 000 women with a previous CS undergoing labour (INOSS study of uterine rupture, BJOG 2019;126:370–381), but is extremely rare before the onset of labour and in the unscarred uterus. Our knowledge of prelabour uterine ruptures is confined merely to a small number of published case reports and case series in the literature.In this issue of BJOG, Al-Zirqi and colleagues present the results of a retrospective population-based study during 41 years (1967-2008) in Norway describing the characteristics and outcomes of complete uterine rupture before the onset of labour in 8 unscarrred and 22 scarred uteri, besides another 45 partial ruptures in scarred uteri (BJOG 2020 xxxx). The authors point out that complete ruptures before onset of labour are absolutely rare, but result in a higher number of perinatal deaths. In the unscarred uterus, complete ruptures before onset of labour were related to trauma (n=3), abnormal invasive placenta (n=2) and congenital uterine malformations (n=2) and were unavoidable in most cases. In the scarred uterus, complete ruptures before onset of labour were related to abnormally invasive placenta (n=4), previous complete uterine rupture (n=3) and scars outside the lower uterine segment (n=17). These scars were caused by classical CS (n=9), myomectomy (n=5), tubo-uterine surgery (n=3), uterine septal operation (n=1) and perforation during endometrial ablations (n=3). Classical CS by vertical incision has become rare, while laparoscopic and hysteroscopic uterine surgery increase in frequency. A systematic review by Gambacorti-Passerini et al. (Acta Obstetricia et Gynecologica Scandinavica 2016;95:724-734) revealed that the majority of uterine ruptures after prior myomectomy occurred before 36 weeks and before labour (5/330, 1.5%), while only 0.47% (2/426) in women undergoing a trial of labour after myomectomy (TOLAM). The researchers could not reveal any riskfactor (surgical approach, type of myoma, type of hemostasis, suture layers) keeping the risk of uterine rupture following prior myomectomy largely unpredictable. Only case reports and small case series report on uterine ruptures following operative hysteroscopy or tubo-uterine surgery, where perforation is considered a risk factor (Sentilhes et al. Gynecol Obstet Fertil 2006;34(11):1064-70), similar to the 3 cases of endometrial ablation with perforation in the study of Al-Zirqi et al. More large scale studies like this retrospective analysis are needed to understand to what extent uterine surgical procedures contribute to uterine ruptures, during or before onset of labour. In this regard, we expect a report of the International Network of Obstetric Survey Systems (INOSS) who analysed complete uterine ruptures in 10 countries, including 215 uterine ruptures before onset of labour.This study advocates a higher level of alertness for uterine rupture when taking care for women with congenital uterine abnormalities, with suspected AIP and with prior uterine surgery.No disclosures: A completed disclosure of interest form is available to view online as supporting information.

Non-native vegetation with high canopy closure can alter the equilibrium relationship between soil water and plant growth into a non-equilibrium relationship leading to soil degradation, vegetation decline and crop failure in the most part of water- limited regions. There is a need for the application of a novel theory in the assessment and the adjustment of non-equilibrium relationships to facilitate the sustainable management of non-native vegetation in the course of vegetation restoration in such regions. Therefore, a novel theory, Soil Water Resources Use Limit by Plant (SWRULP) has been developed. SWRULP refers to the amount of water stored in the maximum infiltration depth (MID) at which the soil moisture content in each layer is equivalent to the wilting coefficient. The wilting coefficient is expressed by the wilting coefficient of indicator plants in a plant community. SWRULP is an index for assessing plant overuse of soil water resources and the estimation of the starting time to regulate the relationship between soil water and plant growth in addition to the selection of the most suitable tree or plant species for vegetation restoration activities. To better understand SWRULP, in the present study, the SWRULP was assessed in a Caragana shrubland and an alfalfa grassland in semiarid loess hilly region. The results showed that the wilting coefficient varied with soil depth, and the SWRULP changed based on site conditions and vegetation type. When the soil water resources were equivalent to the SWRULP, soil water influenced plant growth considerably and caused the discoloration of sclerophyllous plants, abscission, cessation of growth, and soft leaf plant wilt. Under such conditions, the relationship between soil water and plant growth should be regulated based on soil water carrying capacity for vegetation to achieve sustainable use of soil water resource and sustainable management of forest and grassland and utilization, in addition to sustainable development.

Here we report a case of advanced extranodal natural killer/T cell lymphoma (ENKTL) in 11-year-old child. Positron emission tomography-magnetic resolution image is a crucial image to diagnose ENKTL in this case. Additionally, a strong regime combined with stem cell transplantation possibly improve prognosis of ENKTL.

Background High agglomeration of myeloid-derived suppressor cell (MDSC) in neuroblastoma (NB) resulted in immune tolerance and impeded therapeutic effects. Doxorubicin (DOX) is currently found the most specific drug to selectively remove MDSC. However, whether these mechanisms can relieve the inhibitory role of MDSC in NB immunotherapy is still remain unclear. Procedure In this study, the inhibitory role of MDSC for NB Ag-specific cytotoxic T lymphocyte (CTL) were investigated in vitro. CTLs, NB cells, MDSCs and DOX were mixed and cultivated in different collocation pattern, the levels of cluster of differentiation 3ζ chain (CD3ζ) and L-selectin in CTL in different groups were detected. Thereafter, the killing rate of neuroblastoma cells, secretion of interleukin-2 and interferon-γ were detected and compared. Results The proliferation and killing effect of CTLs on neuroblastoma cells were all inhibited by MDSC through downregulating CD3ζ (P = 0.002; P = 0.001) and L-selectin (P = 0.006; P < 0.001) by reai-time PCR test and by Western-blot analysis respectively. However, this inhibitory role can be effectively reversed by doxorubicin. The significant difference existed in the killing rate between the groups (P < 0.001) except between CTL+SK-N-SH group and CTL+SK-N-SH+DOX group (P > 0.05). There were significant differences in the levels of IL-2 (P < 0.001) and IFN-γ (P < 0.001) among the groups. Conclusions This study provided the novel method to enhance immunotherapeutic effects for neuroblastoma by using doxorubicin to targeted inhibition of MDSCs.

Background: The association of birth defects and developmental alterations with pediatric cancer is a recognized long-standing global observation, although very few syndromes confer a high risk of hepatoblastoma development. Procedures: Here we describe the results of germline exome analysis of two syndromic patients with Hirschsprung disease who developed hepatoblastoma. Results: Germline variants of uncertain clinical significance (VUS) were disclosed in 28 genes that might be related to patients’ phenotypes. More importantly, germline VUS were detected in eight known cancer predisposition genes (APC, BRCA1, ERBB2, ERCC2, HRAS, ODC1, SERPINA6, and MCC). Additionally, our data disclosed two candidate genes with germline variants potentially contributing to the phenotype of these patients, namely, CEP164 and CYP1A1. The last one was the only gene presenting variants of uncertain significance in both patients. This gene encodes the most important xenobiotic-metabolizing enzyme of the placenta for which relevant inducible activity has been demonstrated throughout pregnancy. Conclusion: our data pointed out a set of genes that are enriched for pathways already related to cancer and developmental biology, suggesting they could have a broader role in cancer and congenital abnormalities. These results can help future studies to understand the biology of Hirschsprung disease and its association with hepatoblastoma.

Background The International Soft Tissue Sarcoma Consortium (INSTRuCT) was founded as an international collaboration between different pediatric soft tissue sarcoma cooperative groups (COG, EpSSG, CWS). Besides other tasks, a major goal of the INSTRuCT is to develop consensus expert opinions for best clinical treatment. This consensus paper for patients with rhabdomyosarcoma of the female genital tract (FGU-RMS) provides treatment recommendations for local treatment, long term follow up and fertility preservation. Methods Review of the current literature was combined with recommendations of the treatment protocols of the appropriate clinical trials. Additionally, opinions of international FGU-RMS experts were incorporated into recommendations. Results The prognosis of FGU-RMS is favorable with an excellent response to chemotherapy. Initial complete surgical resection is not indicated, but diagnosis should be established properly. In patients with tumors localized at the vagina or cervix demonstrating incomplete response after induction chemotherapy, local radiotherapy (brachytherapy) should be carried out. In patients with persistent tumors at the corpus uteri, hysterectomy should be performed. Fertility preservation should be considered in all patients. Conclusion For the first time, an international consensus for the treatment of FGU-RMS patients could be achieved, which will help to harmonize the treatment in different study groups.

Background: Cancer among infants (<1 year old) has unique epidemiologic, clinical and genetic characteristics compared with cancer in older children. Nonetheless, data on secular trends in infant cancer incidence and survival in the US is sparse. Methods: Population-based data from Surveillance Epidemiology and End Results (SEER 9) was used to estimate the incidence, average annual percentage change (APC) for trends and survival of malignant neoplasm among infants from 1975-2014. Data were stratified by gender, race, registry and cancer type. Results: There were 3,437 new infant cancer cases with an overall incidence of 23.6/100,000. Neuroblastoma was the most common infant malignancy (6.5/100,000), followed by leukemia (3.8/100,000), and brain and central nervous system tumors (3.3/100,000). The incidence rate increased significantly over the observational period (APC 0.68; 95%CI 0.30-1.06; p<0.05). Variations in overall incidence rates were uneven across SEER registry geographic areas, with the lowest rates among both males and females in New Mexico. Relative to other racial distribution, rates were highest among whites. The relative survival rates improved over time for all tumors except for renal, sarcomas and germ cell and were not significantly different by gender or race. Conclusions: Cancer incidence among infants increased over time largely driven by leukemia, germ cell and sarcoma mainly among male infants. The overall survival for infant cancer has improved over the years especially since 1990 for hepatic tumors, lymphoma and leukemia. Further research is needed to explore the potential impacts of genetic, environmental, and perinatal factors for possible explanations for these increased cancer incidence trends.

Approximately 10 to 20 percent of children who present with ITP develop chronic ITP, defined as platelet count <100,000/ micro L lasting beyond 12 months from the time of presentation. Recently, it was found that apoptosis may be one of the factors controlling the survival and lifespan of the platelets in chronic ITP patients. High dose dexamethasone (HD-DXM) was suggested as one of the effective modalities of in treatment of chronic ITP. In this research we aim to detect the level of apoptotic platelets in children with chronic ITP and to evaluate the effect of high dose dexamethasone on platelets apoptosis in these children. Patients and methods: twenty- six chronic ITP patients and twenty-one age and sex matched healthy volunteers were exposed to quantitative assessment of apoptotic platelets. HD-DXM was given to the patients according to the treatment protocol with reassessment of the apoptotic platelets after the end of the treatment. Results: the mean levels of apoptotic platelets were significantly higher in patients before treatment compared to control and when compared to patients after treatment with HD-DXM. Conclusion: platelet apoptosis may play a role in the pathogenesis of chronic ITP with good impact of HD-DXM on decreasing apoptosis and increasing platelet count.

Barriers to fieldwork exist for many reasons such as physical ability, financial cost, and time availability. Unfortunately, these barriers disproportionately affect minority communities and create a disparity in access to fieldwork experience in the natural science community. Travel restrictions and the global lockdown has extended this barrier to fieldwork across the community and led to increased anxiety about gaps in productivity, especially for graduate students and early-career researchers. In this paper, we discuss Agent-Based Modeling as an open-source, accessible, and inclusive resource to substitute for lost fieldwork during COVID-19 and future scenarios of travel restrictions such as climate change. We detail the process of model development with a plethora of examples from the literature on how Agent-Based Models can be applied broadly across life-science research. We aim to amplify awareness and adoption of this technique to broaden the diversity and size of the Agent-Based Modeling community in ecology and evolutionary research. We also describe the benefits of Agent-Based models as a teaching and training resource for students across education levels. Finally, we discuss the current challenges facing Agent-Based Modeling and discuss how the field of quantitative ecology can work in tandem with traditional field ecology to improve both methods.

DNA barcoding based on mitochondrial (mt) nucleotide sequences is an enigma. Neutral models of mt evolution predict DNA barcoding cannot work for recently diverged taxa, and yet, mt DNA barcoding accurately delimits species for many bilaterian animals. Meanwhile, mt DNA barcoding often fails for plants and fungi. I propose that because mt gene products must cofunction with nuclear gene products, the evolution of mt genomes is best understood with full consideration of the two environments that impose selective pressure on mt genes: the external environment and the internal genomic environment. Moreover, it is critical to fully consider the potential for adaptive evolution of not just protein products of mt genes but also of mt transfer RNAs and mt ribosomal RNAs. The tight linkage of genes on mt genomes that do not engage in recombination could facilitate selective sweeps whenever there is positive selection on any element in the mt genome, leading to the purging of mt genetic diversity within a population and to the rapid fixation of novel mt DNA sequences. Accordingly, the most important factor determining whether or not mt DNA sequences diagnose species boundaries may be the extent to which the mt chromosomes engage in recombination.

Background and purpose: Artificial intelligence is an important product of the rapid development of computer technology today. This study intends to propose an intelligent diagnosis and detection method for AR based on ensemble learning. Method: This study collectedAR cases and other 7 types of diseases with similar symptoms：Rhinosinusitis, Chronic rhinitis, upper respiratory tract infection etc.) and collected clinical data such as medical history, clinical symptoms, allergen detection and imaging. Multiple models are used to train the classifier for the same batch of data, and the final ensemble classifier is obtained by using the ensemble learning algorithm. 5 common machine learning classification algorithms were selected for comparative experiments, including Naive Bayes (NB), Support Vector Machine (SVM), Logistic Regression (LR), Multilayer Perceptron (MLP), Deep Forest (GCForest), eXtreme Gradient boosting (XGBoost). In order to evaluate the prediction results of AR samples, parameters such as Precision, Sensitivity, Specificity, G-Mean, F1-Score, and AUC under the ROC curve are jointly used as prediction evaluation indicators. Results: 7 classification models are used for comparison, covering probability model, tree model, linear model, ensemble model and neural network models, and the comprehensive classification evaluation index is lower than the ensemble classification algorithms ARF-OOBEE and GCForest. Compared with other algorithms, the accuracy of G-Mean and AUC parameters is improved nearly 2%, and it has good comprehensive classification characteristics for massive large data and unbalanced samples. Conclusion: The ensemble learning ARF-OOBEE model has good generalization performance and comprehensive classification ability to be used for diagnosis of AR.

Backgroud: In order to study how to reduce the edema of CRSwNP, we tried to co-cultured CRSwNP with glucocorticoid, predicted and verified possible mechanisms through gene sequencing and CRISPR-Case9 gene editing technology Method：We co-cultured CRSwNP with glucocorticoid , and selected normal CRSwNP as control group. Then analyzed the differentially expressed genes(DEGs), and the RPL26 gene was found through bioinformatics analysis. CRISPR-Case9 was used to establish the RPL26 gene silencing and overexpression cells system; Immunofluorescence staining and flow cytometry analysis were used to observe changes in cell morphology and apoptosis. Results: Pearson Correlation to analyze the correlation of the probe signal values of all specimens and found that the correlation between the two sets of experimental data was high, R value was close to 1. A total of 12336 genes were detected, and 5026 genes were differentially expressed. Then screened sequence length of ≤1000, 916 of DEGs were obtained, including 340 up-regulated genes and 576 down-regulated genes. Via bioinformatics analysis, the Ribosome pathway is most relevant, and the RPL26 plays an important role. The results of immunofluorescence staining and apoptosis experiments showed that high expression of RPL26 can effectively reduce the degree of edema of CRSwNP cells, and has little effect on apoptosis. Conclusion: Highly expressed RPL26 can effectively reduce the edema of CRSwNP cells, proving that RPL26 plays an important role in this mechanism, and this role of RPL26 may be highly correlated with the ribosome signaling pathway.

1 Division of Pediatric Hematology and Oncology, Department of Pediatrics, Rainbow Babies and Children’s Hospital, Case Western Reserve University, Cleveland, OH.* CorrespondenceJignesh Dalal, Pediatric Hematology Oncology, Rainbow Babies and Children’s Hospital, Case Western Reserve University, 11100 Euclid Avenue, Cleveland OH 44106, Tel: 216 844 3345, Email: Jignesh.dalal@uhhospitals.orgText word count: 951Brief running title: Challenges in HLH transplantKey words: primary hemophagocytic lymphohistiocytosis, hematopoietic stem cell transplant, mixed chimerismTables: 1

A stress-based sectional critical plane model for multiaxial fatigue life prediction is proposed. The proposed model considers the effects of material properties and loading paths on the crack initiation and propagation behaviors. By introducing the ratio of maximum shear stress amplitude to maximum normal stress amplitude, it is divided into three sections in which the maximum normal stress plane, maximum damage plane and maximum shear stress amplitude plane are considered as the critical planes, respectively. To verify the accuracy and applicability of the proposed model, experimental data of 30CrMnSiA steel conducted by the authors and other test data of different materials from the existing literatures are utilized. For 30CrMnSiA steel, the prediction results of the proposed model demonstrate that 79.3% and 93.7% of the prediction results are within the ±2 times and ±3 times scatter band of fatigue life. For the experimental data from the existing literatures, more than 85% and 70% of the results predicted by the proposed model are within ±3 times scatter band of fatigue life for steel and aluminum alloy materials, respectively.

Objective: To evaluate the maternal and neonatal outcomes of parturients attempting trial of labor (TOL) after two previous cesarean deliveries (CD) Design: A retrospective computerized database cohort study. Setting: A single tertiary center between 2005 and 2019. Population: Parturients attempting TOL after two CD were compared to parturients opting for elective third repeat CD. TOL after two CD was allowed only for those who met all the criteria of our departments’ protocol. Methods: A univariate analysis was conducted and was followed by a multivariate analysis. Main outcome measures: A composite of adverse maternal and neonatal outcomes. Results: A total of 2719 eligible births following two CD were identified, of which 485 (17.8%) had attempted TOL. Overall, successful vaginal delivery rate following two CDs was 86.2%. Uterine rupture rates were higher among those attempting TOL (0.6% vs 0.1% p=0.04). However, rates of hysterectomy, re-laparotomy, blood product infusion and intensive care unit admission did not differ significantly between the groups. Neonatal outcomes following elective repeat CD were less favorable (specifically, neonatal intensive care unit admission and composite adverse neonatal outcome). Nonetheless, when controlling for potential confounders, an independent association between composite adverse neonatal outcome and an elective repeat CD was not demonstrated. In a subgroup analysis, diabetes mellitus and hypertensive disorders of pregnancy were found independently associated with failed TOLAC. Conclusion: When following a strict protocol, TOL after two CD is a reasonable alternative and associated with favorable maternal and neonatal outcomes

Metal-loaded porous matrices based on clay and cellulose materials displayed appreciable antibacterial activity against Escherichia coli DH5α and Bacillus subtilis 168. BoltornTMH20 polyol dendrimer supported by montmorillonite and cellulose turned out to be effective porous matrices for Cu0 and Ag0 nanoparticles dispersion. The resulting organoclay and polyol-coated cellulose were found to stabilize Cu0 and Ag0 nanoparticles through their terminal hydroxyl groups. This was explained in terms of Lewis Acid-Base interaction between the electron pair of the oxygen atom belonging to the terminal hydroxyl and metal species as supported by XPS data. The metal retention strength was found to correlate with the antibacterial activity, surface basicity and hydrophilic character. These findings are of great importance, because they open promising prospects for vegetal fibers and clay-supported drugs to treat dermatological and gastro-intestinal infections.