Infertility rates for both females and males have increased continuously in recent years. Currently, effective treatments for male infertility with defined mechanisms or targets are still lacking. G protein-coupled receptors (GPCRs) are the largest class of drug targets, but their functions and the implications on therapeutic development for male infertility largely remain elusive. Nevertheless, recent studies have shown that several members of the GPCR superfamily play crucial roles in the maintenance of ion-water homeostasis of the epididymis, development of the efferent ductules, formation of the blood-epididymal barrier, and maturation of sperm. Knowledge of the functions, genetic variations, and working mechanisms of such GPCRs, along with the drugs and ligands relevant to their specific functions, provide future directions and elicit great arsenal for potential therapy development for treating male infertility.

Importance: Cardiac tamponade requiring emergent intervention is a possible complication of COVID-19 infection. Favorable clinical outcomes are possible if timely management and drainage are performed, unless ventricular failure develops. Observations: Cardiac tamponade in COVID-19, based on the limited reported cases, seems to be more common among middle-aged men. Prognosis is worse amongst patients with concomitant ventricular failure. Design and methods: This is a case series of three COVID-19 patients complicated by cardiac tamponade, requiring surgical intervention at a single institution in New York. Interventions: Pericardial window, Pericardiocentesis Outcomes: One patient had recurrence of cardiac tamponade with hemorrhagic component but fully recovered and was discharged home. Two patients developed cardiac tamponade with concomitant biventricular failure, resulting in death. Conclusions and Relevance: Cardiac Tamponade with possible concomitant biventricular failure can develop in COVID-19 patients; incidence seems to be highest at the point of marked inflammatory response. Concomitant ventricular failure seems to be a predictor of poor prognosis.

• There was a significant reduction in tonsillitis episodes and antibiotic requirement during the 2-month lockdown period in comparison with 2 months prior to lockdown • Household smoking did not seem to affect tonsillitis frequency in this study • In 70% of cases parents wanted their child’s tonsillectomy during the coronavirus outbreak • Viral exposure is possibly a key factor in the pathophysiology of recurrent tonsillitis • Social distancing measures may reduce the frequency of tonsillitis

Title PageTitle: Pregnancy and Covid-19 in Mexico, risk and associated comorbidities: A case-control study.Author: Eduardo Hernández-GarduñoAffiliation: Dirección de Administración y Desarrollo de PersonalInstitution: Instituto de Seguridad Social del Estado de México y Municipios (ISSEMyM).Corresponding author:Eduardo Hernández-Garduño MD, MHScDepartamento de Seguridad e Higiene ISSEMyMAv. Constituyentes #703Col. Barrio de la MercedToluca de Lerdo, Estado de MéxicoCP 50080Méxicoemail: epidemiologist.researcher@gmail.comRunning title: comorbidities in pregnancy and risk for Covid-19

Invasive pathogens can be a threat when they affect human health, food production or ecosystem services, by displacing resident species, and we need to understand the cause of their establishment. We studied the patterns and causes of the establishment of the pathogen Dickeya solani that recently invaded potato agrosystems in Europe by assessing its invasion dynamics and its competitive advantages or disadvantages against the closely-related resident D.dianthicola species. Epidemiological records over one decade in France revealed the establishment of D.solani and the maintenance of the resident D.dianthicola in potato fields exhibiting blackleg symptoms. Using experimentations, we showed that D.dianthicola was more aggressive than D.solani on aerial parts, while D.solani was more aggressive on tubers. In co-infection assays, D.dianthicola outcompeted D.solani in aerial parts, while D.solani and D.dianthicola co-existed in tubers. A comparison of 76 D.solani genomes (56 of which having been sequenced here) revealed balanced frequencies of two uncharacterized alleles, VfmBPro and VfmBSer, at the vfmB virulence gene. Experimental inoculations showed that the VfmBSer population was more aggressive on tubers, while VfmBPro and VfmBSer populations exhibited a similar aggressiveness on stems. In stem co-infections, the VfmBPro population outcompeted the VfmBSer population, while they co-existed in tubers. This study thus brings novel insights allowing a better understanding of the pattern and causes of the D.solani invasion into potato production agrosystems, and the reasons why D.dianthicola nevertheless persisted. More broadly, this study contributes to our understanding the ecological determinants of pathogen invasion and of the conditions for the maintenance of endemic competitors.

Since the outbreak of 2019 novel coronavirus infection (COVID-19) 5,698,246 cases were infected with COVID-19, there were 352,461 deaths. Various characteristics of COVID-19 were presented but to our knowledge this is the first pediatric case, an eight year old boy, presenting like Steven Johnson Syndrome. In patients with atypical presentations and pulmonary findings COVID-19 should be kept in mind.

Background: allergic rhinitis is a common childhood disease in industrialized countries that is responsible for a major impact on quality of life and health care resources. The objective of this review was to provide a systemic review of experimental and clinical evidence linking allergy to rhinosinusitis in children including common cold. Furthermore, we questioned if anti-allergy treatment may prevent the occurrence of rhinosinusitis or improve outcomes of its specific management. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) process to identify experimental and clinical articles about allergy and acute or chronic rhinosinusitis in children published since January 2000. The research was performed in April 2020 including only English-language peer-reviewed papers. Our search yielded 7103 that were finally screened. This resulted in 30 publications of which the full texts were assessed and included in a qualitative analysis per different phenotypes of rhinosinusitis. Results: The evidence suggests that allergy may lead to overall impairment of mechanical and immunological defense function of the nasal mucosa against viruses and that anti-allergy treatment may significantly decrease the number and severity of upper respiratory tract infections including common colds in children. It was not possible to perform the analysis for allergy and post viral acute rhinosinusitis, bacterial acute rhinosinusitis and recurrent acute rhinosinusitis because of paucity and heterogeneity of data. We found interesting data linking allergy to chronic rhinosinusitis: although there is no definitive proof of causation studies lead to suppose that anti-allergy treatment may improve outcomes of specific CRS treatments. Conclusion: We summarized conclusions in a practical algorithm taking into account different phenotypes of rhinosinusitis in order to elucidate when prompt and accurate diagnosis of allergy is recommended. We lastly focused attention on the needs for future research.

Background The association between dyslipidemia and atopic dermatitis in children is unclear. This study investigated the association between dyslipidemia and atopic dermatitis in children by analysis of disease onset, risk factors, and disease severity. Methods Subset I examined 7 year-old children in elementary school (n = 248) and Subset II was a retrospective long-term follow-up hospital based-study (n = 52,725) conducted from 1986 to 2016 that used propensity score matching. In the Subset I Study, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG) were determined, and the severity of atopic dermatitis was determined using SCORing Atopic Dermatitis (SCORAD). In the Subset II Study, the time of atopic dermatitis onset was determined for asymptomatic subjects whose TC levels were below or above 170 mg/dL. Results Our Subset I Study indicated that children with atopic dermatitis (n = 69, 27.8%) had significantly higher levels of TC and TG, and that disease severity had significant associations with high levels of TC and TG, and a low level of HDL-C. Our Subset II Study (1,722 with high TC and 6,735 with normal TC after propensity score matching) indicated the high TC group had a greater hazard ratio (HR) for the onset of atopic dermatitis (consensus-based HR: 2.47; 95% CI: 1.23, 5.06, P = 0.012) during 5 years. Conclusion An abnormal blood lipid profile in children is associated with the presence and severity of atopic dermatitis. The risk of atopic dermatitis onset was significantly greater with high levels of TC.

Hybrid density functionals have been regularly applied in state-of-the-art computational models for predicting reduction potentials. Benchmark calculations of the absolute reduction potential of ferricenium/ferrocene couple, the IUPAC-proposed reference in nonaqueous solution, include the B3LYP/6-31G(d)/LanL2TZf protocol. We used this procedure to calculate ionization energies and reduction potentials for a comprehensive set of ferrocene derivatives. The protocol works very well for a number of derivatives. However, a significant discrepancy (> 1 V) between experimental and calculated data was detected for selected cases. Three variables were assessed to detect an origin of the observed failure: density functional, basis set, and solvation model. It comes out that the Hartree-Fock exchange fraction in hybrid-DFT methods is the main source of the error. The accidental errors were observed for other hybrid models like PBE0, BHandHLYP, and M06-2X. Therefore, hybrid DFT methods should be used with caution, or pure functionals (BLYP or M06L) may be used instead.

Objective: Video-based teaching has been part of medical education for some time. We investigated if an additional 3D video to the curriculum leads to an improvement of long-term recall of knowledge regarding situation, procedure and organisation. Design quasi-experimental design Setting: Sequential gynaecology residency teaching groups had or had no access to a VR-video of a gentle caesarean section (CS). Sample: 41 medical students participated in the VR group and 48 in the conventional study group. Methods: After 6 weeks of residency, knowledge was assessed with an open and multiple choice questionnaire. Main outcome measures: General obstetric and specific CS related knowledge and happiness with the use of VR glasses Results: 3D video did not result in a difference in either specific or general knowledge retention between the VR group and the conventional study group. However 83.4% of the VR-group reported that more videos should be used in future to prepare for surgical procedures. In the VR group 56.7% reported side effects like nausea or dizziness. After adjustment for the number of attended CSs, students in the VR group stated less often (p=0.04) that they would have liked to attend more real-life CSs as compared to the conventional study group. Conclusion: Even though the use of VR did not increase knowledge, it did provide a partial alternative for attending a real CS. In case only few possibilities to attend a CS are available, VR might provide an alternative. Funding: Spaarne Gasthuis innovation fund

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Few data are available for estimating the sediment transport rate on a steep slope of grass with different covers. In this study, the artificial simulated rainfall test is used to investigate how rainfall intensity, slope and cover affect the sediment transport rate. Simultaneously, the study establishes a model for the sediment transport rate using shear stress, stream power, unit stream power and unit energy on steep grassland slopes. Results show that the sediment transport rate decreases as the vegetation cover increases, as described by linear or logarithmic equations under different rainfall intensities or slopes. The sediment transport rate increases as an exponential function equation with rainfall intensity, slope and cover with a Nash–Sutcliffe model efficiency (NSE) value of 0.864. The effects of slope steepness are stronger than the effects of rainfall intensity and cover. Regression analyses show that the sediment transport rate can be predicted from the power function equations of shear stress, stream power and unit energy. In addition, the sediment transport rate can be fit to unit stream power with linear equation (NSE = 0.840). Further analysis shows that the sediment transport rate is best modelled by a power function equation that includes three factors, i.e. rainfall intensity, vegetation cover and slope.The measurements and calculations of the sediment transport rate, the calculations of the surface roughness and characteristic considerations of the vegetation for sheet flow should be explored in future research, which are important in improving experimental accuracy and sediment transport rate modell

Gully in the riparian areas remain at lowest elevation right from gully head cut, a gully link to join any link of higher order and then join any major river comprise of all features of riparian areas. The gullies suffer setback of sewage disposal and finally discharge it into rivers. Objective of this study was to develop an innovative measure so that sewage water is diverted along the down slope and a wetland created instead of allowing the waste water to join the gully network. The innovative measures are treatment of waste water in wetlands, storage facility for fresh water and rearing fish. The fishery in wetland will attract wild birds viz heron that thrives on aquatic primary food chain such as insects, leaches and fingerlings etc and their dropping rich in organic nitrogen (N) and phosphorus (P),called as Guano can be harvested. Case study of the treating gully as a sewage disposal channel, spoiling all good features of riparian areas is made to show this innovative development to solve several emerging problems following development of gullies in fulfillment of areas for growing population. Therefore, misdeeds which follow development and spoil entire scenario can be overcome and the riparian areas save from getting worsened. Additionally, innovative measures and their sequential steps create resource for prosperity and employment.

Background: Cardiac Sympathetic Denervation (CSD) involves surgical removal of lower half of the stellate ganglion and the T1-T4 ganglia for reducing sympathetic discharge to the heart. CSD is a useful therapeutic option in patients with ventricular tachycardia (VT) when they are non-responsive to standard drug therapy or catheter ablation. We report here the clinical profile and long-term outcome of all our patients who underwent CSD for refractory VT or VT storm. Method: Data of all patients who underwent CSD from 2010 to 2019 was analysed. They were regularly followed up, focusing on arrhythmia recurrence. Complete response to CSD was defined as more than 75% decrease in the frequency of VT. Results: A total of 65 patients (50 male, 15 female) underwent CSD in the above-mentioned period and the duration of follow-up was 27±24 months. The underlying substrate was for VT was coronary artery disease in 30 (46.2%) patients and 35 (53.8%) patients had a variety of other causes. Complete response to CSD was attained in 47 (72.3%) patients. There was a significant decline in the incidence of number shocks after CSD (24±37 vs 2±4; p <0.01). Freedom from a combined end point of ICD shock or death at the end of two years was 51.5%. Advanced NYHA class (III and IV) was the only parameter shown to have significant association with this combined end point. Conclusion: The current retrospective analysis reemphasize the role of surgical CSD in the treatment of patients with refractory VT or VT storm.

We demonstrated a 47 year-old woman with ischemic-VT with repetitive ICD-shocks, requiring ablation. Pre-procedural CT demonstrated a single anatomical channel on the inferior-basal infarcted area between <3mm wall thinning area and the mitral annulus, which suggested the circuit of two VTs observed. Additionally, distribution of <2mm and <3mm scars can explain the mechanism of the variation of QRS morphology and S-QRS interval during entrainment. Ablation on this region resulted in no VT- inducibility and absence of any VTs for 2yrs. CT wall thinning data may allow us to understand the mechanism and circuit of VT and aid VT ablation procedures.

A 69 year old male patient with mild non ischemic cardiomyopathy, baseline EF of 47%, received a dual chamber pacemaker with a direct left bundle branch lead for complete heart block. 3830 lead was inserted intraseptally according to published recommendations with a resultant QRS of 103 ms. One month later patient presented with severe heart failure. Echocardiogram showed significant dyssynchrony and EF of 21%. Patient remained highly symptomatic despite aggressive medical therapy and exclusion of other causes of heart failure. An upgrade to a bi-ventricular pacing system was performed. At 1 month follow up, patient was no longer exhibiting heart failure symptoms, EF had improved back to baseline (46%) with improvement in dyssynchrony.

A new measurement method of weathered crude oil in soil was reviewed. There is no standard method for the extraction of crude oil from soil. Therefore, a basic initial test was carried out and several methods such as gravimetric and gas chromatography-mass spectrometry (GC-MS) with various parameters such as weight, solvent and time were altered to improve the measurement process. The gravimetric process was demonstrated to be the most effective for quantifying weathered contamination crude oil in contaminated soil. The dichloromethane DCM, mixture of DCM: hexane (1:1 v/v mix) and mixture of acetone: hexane (1:1 v/v mix) was used to investigate the ability of solvent extraction technique for removing weathered crude oil from soil under various extraction conditions. The mixtures of acetone: hexane (1:1 v/v mix) were demonstrated to be the most effective in removing total petroleum hydrocarbons (TPH) from contaminated soils on average of 341,000 mg/kg. 5 g and 1 g weights of the oil-contaminated samples were studied to select the best weight depending on contamination level. The out comes shown that the 1g of contaminated soil was cleaned in three cycles whilst the 5g of contaminated soil required six cycles. This paper indicated that the selected parameters were able to recover about 97.20% of the weathered crude oil. Also, these parameters were influenced with character of high efficiency, low cost, low toxicity and short time.

Turkey is an important center in terms of Hypericum species and 49 of the 119 taxa are endemic. Hypericum heterophyllum is one of these endemics. This study was carried out in order to determine some chemical properties of H. heterophyllum. In dry capsules, 14% protein and 23% oil were detected. This oil has been found to be rich in unsaturated fatty acids (oleic and linoleic). The highest essential oil rate (0.09%) in flowering dry herb was recorded in the period before flowering. Also, germacrene-D, bicyclogermacrene, δ-cadinene, spathulenol, α-guaiene, and valencene in herbage essential oil and limonene, cis-ocimene, β-myrcene, and α, β-pinene in dry capsule were determined as main components. It has been noted that both the essential oil content and the components show variation depending on the developmental stages of the plant and the part used.

Clot in transit represent the embolized fragment of deep vein thrombosis seen in cardiac chamber during its transit. Impending paradoxical emboli is seen in situation with high right atrial pressure than left atrium where clot gets caught in the patent foramen ovale or rarely atrial septal defect. High mortality of upto 18% has been seen in patients with paradoxical embolus in transit. Current case demonstrates patient with acute massive pulmonary embolism with large clot in transit seen in right side of heart extending across atrial septum to the left side of heart, extending across the aorta valve.

Background: Congenital porto-systemic shunt (CPSS) is a rare condition that can cause pulmonary artery hypertension (PAH). Methods: We reviewed six patients who received treatment in our institution between 2011 and 2019. Results: Median age at diagnosis of CPSS was 2.5 months (0 to 9 years) and that of PAH was 5.6 years (0 to 7.1 years). All patients underwent intervention for CPSS. The median duration between diagnosis of CPSS and intervention for CPSS was 2.5 months (2 months to 8 years) and between diagnosis of PAH and intervention for CPSS was 2.5 months (1 month to 6 years). All patients received combination PAH-specific therapy, three drugs in three cases and two drugs in three cases. Only one infant who underwent intervention for CPSS at 3 months old discontinued pulmonary vasodilator after intervention, but all other patients continued taking it; three patients needed to boost the therapy. Conclusion: When treatment for CPSS is delayed, pulmonary arterial pressure does not decrease only by ligation of the shunt vessel, and PAH-specific therapy cannot be discontinued.

Emerging and reemerging viral diseases can lead to devastating effects on human lives and at times also lead to economic crises. The ongoing COVID-19 pandemic due to the novel coronavirus (nCoV), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which originated in Wuhan, China, has caused a global public health emergency. Still, the molecular mechanism of transmission of SARS-CoV-2, its clinical manifestations and pathogenesis is not completely understood. The global scientific community has intensified their efforts to understand the biology of SARS-CoV-2 to develop vaccines and therapeutic interventions to prevent the rapid spread of the virus and to control mortality and morbidity associated with COVID-19. To understand the pathophysiology of SARS-CoV-2, appropriate animal models that mimic the biology of human SARS-COV-2 infection is urgently needed. In this review, we outline animal models that have been used to study previous human coronaviruses (HCoVs), that includes severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV). Importantly, we discuss which model is appropriate for SARS-CoV-2 as well as the advantages and disadvantages of each.

The objective of the study was to define and then evaluate an early decision indicator (EDI) trigger that operated within the first 5 weeks of a response that would indicate a large outbreak of FMD was developing, in order to be able to inform control options within an adaptive management framework. To define the trigger, a previous dataset of 10,000 simulated FMD outbreaks in New Zealand, controlled by the standard stamping-out approach, was re-analysed at various time points between days 11–35 of each response. The two predictive metrics adopted comprised the mean third quartiles of cumulative numbers of infected premises (IPs) at weekly time points, and estimated dissemination rate (EDR) values indicating sustained spread, specifically > 2.0 between days 11-14 or > 1.5 at any time point between days 15–35 of the response. To evaluate the trigger, the trigger was parameterized within the InterSpread Plus modelling framework, and a new series of simulation generated. The trigger was treated like a series of diagnostic tests that were applied during days 11–35 of each simulated outbreak, and its results recorded and then compared to the final size of each outbreak. The performance of the test was then evaluated across the population of outbreaks, and the sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) calculated. The Se, Sp, PPV and NPV for predicting large outbreaks were 0.997, 0.513, 0.404 and 0.998 respectively. The study showed that the complex EDI incorporating both the cumulative number of IPs and EDR was very sensitive to detecting large outbreaks, although not all outbreaks predicted to be large were so, whereas outbreaks predicted to be small invariably were small. Therefore, it shows promise as a tool that could support an adaptive management approach to FMD control.

Towards a sensitive and accurate interpretation of molecular testing for SARS-CoV-2: a rapid review of 264 studies 

Environmental systems suffer from multiple interacting stressors. Each stressor can act on different parts of the system and at different time scales. This hampers measuring and predicting the stressors’ impacts on ecosystems. We propose a conceptual method that integrates available data with physical constraints over relevant time scales to predict management outcomes in data-scarce systems affected by multiple stressors. We first predict the combined stressor levels that threaten a management target and then define stressor equivalents to to convert between. These “ball-park” estimates of critical stressor levels help to identify how the threat posed by interacting stressors responds to its management. Our approach assists managers in the decision-making process regarding when to manage a system and how to monitor. We illustrate our concept with a case study of an invaded island ecosystem, yet our approach is useful for other data-poor environmental systems that suffer from multiple cumulative stressors.