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UNDERSTANDING INVASIVE, AND RAPID TRANSMITTING NATURE OF CORONA THROUGH (AAIR) AND BY...
NITOSH BRAHMA,FIE

NITOSH BRAHMA,FIE

June 17, 2020
Antiadherent Immune Response (AAIR) against serotype 026: EPEC (Enteropathogenic (invasive) Escherichia coli) a fatal diarrhoea was successful in Balb/c mice experiment by the author. IS(Insertion Sequence) represented by IS1,IS2,IS3,-……IS10 flanking transpons ( Tn)”IS-TN-IS” and its illegitimate recombination was also studied curiously by the author to observe their spontaneous jumping, illegitimate recombination among DNA, chromosome and plasmids in Escherichia coli. Considering the fatality rate of corona as pandemic globally, the author has attempted to realise the possible application of AAIR and IS-Tn-IS mixed hybrid concept, in designing vaccine against corona, to prevent corona virus not to adhere in trachea and lung cells, to bring healthy life to mankind. IS-Tn-IS was studied in Maize by Barbara Mc Clintock, USA, Peter Starlinger and H.Saedler, Germany studied the same in bacteria.. In this paper the author describes the possible AAIR vaccine against corona. A mixture of combine strategy corona vaccine with IS-Tn-IS gene expression.
Cyclic fatty acid monomers or the potential wild card in trans fats
Paul Angers
Joseph Arul

Paul Angers

and 2 more

June 17, 2020
A document by Paul Angers. Click on the document to view its contents.
Supported High-Risk Cardiac Surgery using an Intra-Aortic Balloon Pump Catheter via t...
mio kasai
Kiyoshi Koizumi

mio kasai

and 3 more

June 17, 2020
The intra-aortic balloon pump (IABP) was first successfully used by Kantrowitz and colleagues in 1968 . Traditionally, IABPs are inserted via the femoral artery. However, this approach is usually contraindicated in patients with severe peripheral vascular disease (PVD). Noël and colleagues were the first to report transbrachial insertion of an 8 Fr IABP catheter for ventricular assistance during percutaneous coronary intervention. However, in almost all the reported cases in which transbrachial insertion of an IABP was performed, it was done for hemodynamic support during percutaneous coronary intervention or coronary artery bypass grafting. We present a case involving a patient with endocarditis-associated structural aortic valve deterioration and severe left ventricular dysfunction, as well as total occlusion of both external iliac arteries. The patient was successfully treated using a 7 Fr transbrachial IABP. A left transbrachial percutaneous approach may thus be a safe and effective alternative if femoral artery access cannot be achieved.
Rapid emergence of African swine fever virus variants with different numbers of a tan...
Seon-Hee Kim
Song-I Lee

Seon-Hee Kim

and 7 more

June 17, 2020
African swine fever virus variants with different numbers of a 10-bp tandem repeat were isolated in South Korea soon after being identified in wild boar. The short emergence periods and sympatric distributions within a narrow geographical region suggest that the variants were sporadically generated in the pre-existing viral population.
Mitochondrial AtMTM1 and AtMTM2 are required for MnSOD activation, stress response, a...
Shu-Hsuan  Hu
Ya-Chen  Huang

Shu-Hsuan Hu

and 5 more

June 17, 2020
Yeast manganese (Mn) trafficking transporter for mitochondrial Mn-containing superoxide dismutase (MnSOD), yMTM1, belongs to mitochondrial carrier family (MCF) and is crucial for yeast MnSOD (ySOD2) activation. Arabidopsis AtMTM1 and AtMTM2 are homologs of yMTM1 and share conserved MCF motif sequence. We confirmed that AtMTM1 and AtMTM2 interacted with AtMnSOD (AtMSD1) in mitochondria and recovered ySOD2 activity in yMTM1-mutant cells. The redundant AtMTM1 and AtMTM2 have different gene expression patterns in tissues and methyl viologen (MV)-induced oxidative stress and also responded to most metal stresses along with AtMSD1. Bioassay revealed the contrasting root phenotype in microRNA-mediated AtMTM1 mutant (mtm1-i) and AtMTM2-null mutant (mtm2) under MV stress, and Mn supplement complemented the root lengths in single and mtm1-i mtm2-double mutants. We found decreased MnSOD activity was accompanied by increased FeSOD activity in double mutant. Transient expression of chloroplast-destined AtMSD1 highlighted that unidentified factors participated in AtMSD1 activation. Besides, the exogenous-expressed AtMSD1 activity was decreased in double mutant, and inductively coupled plasma optical emission spectrometry results showed that AtMTM1 and AtMTM2 involved in Mn and Fe homeostasis with a reciprocal regulation. Overall, AtMTM1 and AtMTM2 are important for MnSOD metalation and ion homeostasis, and their physiological regulations may stretch across mitochondria and chloroplasts.
Comparative transcriptome and DNA methylation analyses of Phytoplasma infection Respo...
Chao-Rui  Liu
Zhuang  Liu

Chao-Rui Liu

and 6 more

June 17, 2020
To reveal whether the response of mulberry to phytoplasma infection is associated with DNA methylation changes, the methylome and transcriptome patterns of mulberry leaves in response to phytoplasma infection were explored. Though the average methylation level of infected leaves showed no significant difference with that of healthy leaves, there were 1253 differentially methylated genes and 1168 differentially expressed genes found in the infected leaves, and 215 genes were found simultaneously to be differently methylated and expressed. It was found that the expression of G-type lectin S-receptor-like serine/threonine protein kinase gene (Mu-GsSRK) was increased, but its methylation level was decreased in the infected leaves. Moreover, the expression of Mu-GsSRK was increased while its methylation level was reduced in mulberry treated with pathogen and SA. Expression of Mu-GsSRK in Arabidopsis enhanced transgenic plant disease resistance and the expressions of some defense genes when plants were inoculated with pathogens. In addition, the DNA methylation dynamic patterns and the roles of the differentially expressed and methylated genes were discussed. Our results suggested that DNA methylation has important roles in mulberry responses to phytoplasma infection, and the information provided there will facilitate to elucidate the epigenetic mechanisms underlying mulberry responses to phytoplasma infection.
Thoracoscopic versus open resection for symptomatic congenital cystic adenomatoid mal...
jintao zheng
Huajian Tang

jintao zheng

and 5 more

June 17, 2020
Purpose: The purpose of this study is to present our surgical experience with symptomatic congenital cystic adenomatoid malformations (CCAMs) in neonates. Methods: The medical records of neonates who underwent surgery for symptomatic CCAM from 2010 to 2020 were retrospectively reviewed. Results: Of 24 cases, 10 involved open resection, and 14 involved thoracoscopic resection. Four cases of CCAMs located in the upper or middle lobes underwent lobectomy, and 20 cases underwent lung-preserving wedge resection in the lower lobe. Between the two groups, there was no statistically significant difference in related preoperative variables, including gestational age at birth, body weight, head circumference, lesion size, CVR, and age at operation (P>.05). The differences in intraoperative variables were statistically significant. The length of the surgical incision in the thoracoscopic resection group was significantly shorter than that in the open resection group (1.4 cm [1.3-1.8] vs 6.0 cm [5.0-8.0], P=.000), and there was significantly less operative blood loss (3 ml [1-6] vs 5 ml [2-10], P=.030), but the operation time was significantly longer (159 min [100-220] vs 110 min [70-170], P=.003). Regarding postoperative variables, ventilator days, duration of chest tube use and length of hospital stay were not statistically significant (P>.05). Conclusions: Thoracoscopic resection is a safe and favorable approach for symptomatic CCAM in neonates. It has minimal esthetic effects and does not increase the risk of surgical or postoperative complications. Lung-preserving resection is feasible for neonatal CCAM surgery.
Association of sleep duration and weekend catch-up sleep with suicidal ideation among...
Seung Chan Jeong
Chang Woon Kim

Seung Chan Jeong

and 4 more

June 17, 2020
Objective: Little is known regarding the effect of sleep duration and weekend catch-up sleep (WCUS), sleep time on weekends that exceeds sleep time on weekdays, on suicidal ideation among adolescents with asthma. We explored whether sleep factors were associated with suicidal ideation among adolescents with asthma. Hypothesis: Adolescents with asthma are likely to have shorter sleep duration and longer WCUS than those without asthma. Study Design: Secondary data analysis for cross-sectional, self-administered, online survey. Patients Selection: Adolescents participating in the annual Korean Youth Risk Behavior Web-based Surveys (KYRBS, completed from 2013 to 2017). Methodology: The KYRBS data were obtained from a stratified, multistage, clustered sample. Students responded prior diagnoses of asthma and sleep time. Associated factors for suicidal ideation were tested by logistic regression models. Results: Among 34,067 and 363,003 adolescents with and without asthma, respectively, adolescents with asthma had poorer sleep satisfaction (44.6% vs. 42.6%), slept less (sleep duration 6.59 ± 0.94 vs 7.29 ± 1.45 hr), and had longer WCUS (3.13 ± 0.01 vs 2.29 ± 0.01 hr) than did those without asthma. The odds ratio (OR) of suicidal ideation in those with short sleep duration (defined by ≤5h) was 1.37 (95% Confidence Interval [CI], 1.30–1.43). Notably, long WCUS (≥2hr) was significantly associated with a decreased risk of suicidal ideation (OR, 0.88 [95% CI, 0.86–0.93]). Conclusion: Although further research is needed to clarify this association, long WCUS, which is a compensatory phenomenon for insufficient weekday sleep, protects against suicidal ideation in adolescents with asthma.
CHRONIC INTESTINAL CONSTIPATION OF ATYPICAL ETIOLOGY IN PRESCHOOL CHILD
Camila Fachin
Carlos Riedi

Camila Fachin

and 5 more

June 17, 2020
There is a large spectrum of abnormalities in the CFTR gene that leads to a partial function of the chloride channel and, thereby, an uncommon presentation of the disease, the “CFTR-related diseases”. This report aims to present a case of a patient with a single gene mutation related to cystic fibrosis, with an unusual clinical presentation among CFTR related diseases - chronic intestinal constipation. This patient is not a cystic fibrosis patient because he does not fulfil the disease’s classic criteria. Furthermore, since the mutation found is not yet described in the literature, it could be related to CFTR-related disease.
Metered‐dose inhalers vs. nebulization for the delivery of albuterol in pediatric ast...
Laura  Payares-Salamanca
Sandra Contreras-Arrieta

Laura Payares-Salamanca

and 5 more

June 17, 2020
Objectives: Although albuterol, the most frequently used bronchodilator, has been traditionally and generally delivered via nebulization (NEB) with compressed air/oxygen, the benefits of metered‐dose inhalers with a spacer (MDI+S) have been widely recognized as an alternative method for albuterol administration. The aim of this systematic review was to compare the response to albuterol delivered through NEB with albuterol delivered through MDI+S in pediatric patients with asthma exacerbations. Methods: We conducted an electronic search in MEDLINE/PubMed, EMBASE, Ovid and ClinicalTrials. To be included in the review, a study had to a randomized clinical trial comparing albuterol delivered via NEB versus MDI+S; and had to report the rate of hospital admission (primary outcome), or any of the following secondary outcomes: oxygen arterial saturation, heart rate (HR), respiratory rate, the pulmonary index score (PIS), adverse effects, and need for additional treatment. Results: Fifteen studies (n=2057) met inclusion criteria. No significant differences were found between the two albuterol delivery methods in terms of hospital admission (RR 0.89; 95% CI 0.55 to 1.46; I2=32%; p=0.65). There was a significant reduction in the PIS score (MD -0.63; 95% CI -0.91 to -0.35; I2=0%; p < 0.00001), and a significantly smaller increase in HR (better) (MD -6.47; 95% CI -11.69 to -1.25; I2=0%; p=0.02) when albuterol was delivered through MDI+S than when it was delivered through NEB. Conclusions: This review showed a significant reduction in the PIS and a significantly smaller increase in HR when albuterol was delivered through MDI+S than when it was delivered through NEB.
Level of Block
Charlene Pius
Wern Yew Ding

Charlene Pius

and 3 more

June 17, 2020
TITLE PAGE TITLE : LEVEL OF BLOCKDESCRIPTION :Electrograms recorded from an electrophysiological study and ablation of manifest left lateral accessory pathway with demonstration of site of block during the case.
An Ecosystem of Equity in the Era of COVID-19:Considerations for Creating Inclusive T...
Starlette Sharp
Jonathan  McCausland

Starlette Sharp

and 4 more

June 17, 2020
Distance learning has been a means to provide an education to those who are unable to participate in on-campus, face-to face classes. Teams of instructional design specialists that focus on online education put significant effort into course development. This planned process is very different from emergency remote education in response to a crisis. In early 2020, it was discovered that an extremely contagious respiratory illness termed COVID-19 had spread to every corner of the earth. As of mid-March 2020, the need to transition from face-to-face classroom instruction to exclusively online education landed on the doorstep of America’s universities. COVID-19 has catalyzed a transition in the ecology of American education for all students, but especially the underserved and minoritized. Ecology, by definition, is concerned with the interactions of an organism and its environment. The circumstances of the pandemic have caused vast and rapid change in both the internal and external environments of the organisms (e.g., students) and the systems in which they reside (e.g., U. S. educational systems). The purpose of this paper is to provide some considerations for instructors who find themselves “thrown into teaching remotely,” and help them think about how best to create sustainable systems, broaden participation and build capacity in a more equitable and inclusive manner.
Coronary sinus diverticulum: importance, function, and treatment
Iman Razeghian-Jahromi
Mohammad Nikoo

Iman Razeghian-Jahromi

and 2 more

June 17, 2020
The importance of venous structure in the heart is usually overshadowed by that of the arterial system. Coronary sinus is a part of cardiac venous apparatus and connects left atria to the right atria. Other than having role in physiological contractions of both atria, it contributes substantially to cardiac electrical conduction system. Due to unique placement and connections of the CS, it has become growing interest in clinical cardiology. It is used in cardiac resynchronization therapy with biventricular pacing, left-sided catheter ablation of arrhythmias and administration of retrograde cardioplegia in cardiac surgery. In some individuals, CS is presented with anatomical variants. CS diverticulum is a congenital outpouching that provides muscular connection between atria and ventricle. This connection provides a suitable substrate for occurrence of arrhythmias, which even results in life-threatening events such as sudden cardiac death. Early diagnosis leads to treatment with ablation techniques which ultimately eliminates origins of arrhythmias.
Effect of outcome measures on the apparent efficacy of ablation for atrial fibrillati...
Nick Jackson
Ehsan Mahmoodi

Nick Jackson

and 8 more

June 17, 2020
INTRODUCTION: Different endpoint criteria, different durations of follow up and the completeness of follow up can dramatically affect the perceived benefits of Atrial Fibrillation (AF) ablation. METHODS: We defined three endpoints for recurrence of AF post ablation in a cohort of 200 patients with symptomatic AF, refractory to antiarrhythmic drugs (AADs). A “Strict Endpoint” where patients were considered to have a recurrence with any symptomatic or documented recurrence for ≥30 seconds with no blanking period, and off their AADs, a “Liberal Endpoint” where only documented recurrences after the blanking period, either on or off AADs were counted, and “Liberal Endpoint + Redo” which was the same as the Liberal endpoint but allowing for 1 redo ablation or 1 cardioversion (DCCV) during follow up. We also surveyed 50 patients on the waiting list for an AF ablation and asked them key questions regarding what they would consider to be a successful result for them. RESULTS: Freedom from recurrence of atrial tachyarrhythmias (AT) at 5 years was 62% for the strict endpoint, 73% for the liberal endpoint, and 80% for the liberal endpoint + redo group (p<0.001). Of the 50 patients surveyed awaiting AF ablation, 70% said they would still consider the procedure a success if it required one repeat ablation or one DCCV (p=0.004), and 76% would be accepting of one or two recurrences during follow-up (p<0.001). CONCLUSION: In this study the most important predictor of AT recurrence following AF ablation was the criteria used to define recurrence.
Assessment of Right Ventricular Function Following Left Ventricular Assist Device Imp...
Kirolos Barssoum
Ahmed Altibi

Kirolos Barssoum

and 12 more

June 17, 2020
Background: Right ventricular failure (RVF) following Left Ventricular Assist Device (LVAD) implantation is associated with worse outcomes. Prediction and early identification of RVF with speckle-tracking echocardiography (STE) has been proposed. Methods: We queried multiple databases for articles reporting on pre-operative/intraoperative global longitudinal strain (GLS) and free-wall strain (FWS) in LVAD recipients. We performed a systematic review and meta-analysis of published literature. The standard mean difference (SMD) in GLS and FWS in patients with and without RVF postoperatively was pooled using random effects model. Results: Fifteen studies, with a total of 967 LVAD recipients were included. There was statistically significant difference in GLS among patients who did and did not develop RVF; SMD= -3.09 (95% CI: -4.62 to -1.57; p-value <0.0001). There was significant difference in FWS between two groups; SMD: -2.75 (95% CI: -3.72 to -1.79; p-value <0.0001). Upon subgroup analysis of imaging modality, transthoracic echocardiography (TTE)-derived GLS and FWS remained predictive for RVF with SMD of -3.97 (95% CI: -5.40 to -2.54; p-value <0.001) and -3.05 (95% CI: -4.11 to -1.99; p-value <0.001), respectively. However, there was no significant difference between RVF and non-RVF groups upon using transesophageal echocardiography (TEE) to assess GLS and FWS. Conclusion: GLS and FWS assessment of the RV by STE is a useful tool to predict postoperative RVF in LVAD recipients. While the predictive role of TTE was robust, the TEE-derived measures seemed to be less predictive. Future studies need to specify the strain cut-off value that can predict the adverse outcome of RVF
A new reference line for the evaluation of the normal position of the upper two-third...
Yinluan Ouyang
Rui Wang

Yinluan Ouyang

and 6 more

June 17, 2020
Objectives The upper two-thirds of the vagina is most commonly affected by pelvic organ prolapse. This study aims to find a reference line proximate to the axis of this part of the vagina on MRI which is critical but lacking. Design Retrospective cross-section study Setting Two university-affiliated hospital in China (July 2018 - June 2019) Population Six hundred and fourteen women without prolapse Methods Two reference lines were introduced to compare with the upper two-thirds of the vagina on pelvic MRI: the pubococcygeal line (PCL) and a line passing through the inferior pubic symphysis to the midpoint of the third sacral vertebra (PS3L). Main outcome measures The distances and the angles between the vagina and both reference lines were measured. Results: The median distances from the distal, middle, and apical points to the PS3L were -0.5[interquartile range (IQR), -0.9 - 0.0] cm, 0.0[IQR, -0.4 - 0.6] cm, and -0.2[IQR, -0.9 - 0.0] cm, respectively, while the median distances to the PCL were 0.4[IQR, 0.0 - 0.7] cm, 2.1[IQR,1.7 - 2.5] cm, and 3.1[IQR, 2.5 - 3.7] cm, respectively. The median angle between the vagina and the PS3L was significantly smaller than that with the PCL (0.0[IQR, -4.0 - 7.0] degree vs 29.0[IQR, 23.0 - 34.0] degrees, p<.001). Conclusions: A line passing through the inferior portion of the pubic symphysis to the third sacral vertebra mostly conforms to the normal upper two-thirds of the vaginal axis.
Physical characteristics and their influences on water dynamics in the Sefrou watersh...
Youssef Hattafi
Farah El Hassani

Youssef Hattafi

and 2 more

June 17, 2020
The Sebou watershed is the main receiver of rainwater contributions in the North of Morocco. The present study is interested in the knowledge of the global Physical characteristics on water dynamics in the Sefrou watershed at the level of the Sefrou sub-watershed which belongs to this large hydrological unit and which occupies its south-western part. The approach followed in this study consisted initially, in acquiring the data, organizing it, and processing it by a geographic information system (GIS), in order to obtain a global idea on the distribution of the different parameters in the entourage concerned by this study. The application of geographic information system tools makes it possible to establish a set of maps that will help develop an excellent descriptive analysis characteristic of the watershed. In this paper, we present the analysis results of the geological, climatic and hydrological characteristics of an important area of the Middle Atlas, with the notable importance of precipitation, runoff and rivers for irrigation and the supply of drinking water. of cities in the region. The hydrological study of the Sefrou watershed has shown a typical Mediterranean regime, the watershed receives an average annual rainfall of 454.22 mm, with a volume input of 183,96*10 ^6 ^3/year and an average annual temperature of 16.62°C. The actual evapotranspiration in the watershed is 389.22 mm/year which is 161,28.10^6 m^3/year.
FEASIBILITY AND OUTCOME OF MITRAL VALVE REPAIR IN PATIENTS WITH INFECTIVE ENDOCARDITI...
Valentina Scheggi
Bruno Alterini

valentina scheggi

and 11 more

June 17, 2020
Objectives. Valve repair is considered the treatment of choice for native mitral valve regurgitation, although the rate of feasibility when the defect is caused by acute infective endocarditis (IE) is debated. We report the experience of valve repair versus replacement following IE in a high-volume surgical center. Methods. We retrospectively analyzed 363 consecutive patients (123 women) admitted with a diagnosis of definite IE. We selected 108 patients with native mitral IE, potentially eligible for surgical repair. Of these 108, 90 (83%) underwent surgery and 18 were treated conservatively. The two primary endpoints were all-cause mortality and freedom from recurrent endocarditis. Results. Mean age at surgery was 63.6 years (SD 13.5). Mean vegetation length was 11.6 mm (SD 7.7). Among the 90 surgical patients, 57 (63%) underwent valve replacement and 33 valve repair (37%). Mean follow-up duration was three years. All-cause short-term (30 days: 3±3 vs 4±2% for repair and replacement respectively) and long-term (3 years: 26±9 vs. 36±11%) mortality was lower, although not-significantly, for valve repair (figure 1), as well as nonfatal adverse events (15±4 vs. 20±2%) and relapse rate (1±1% vs. 3±1%) at three years. At echocardiographic follow-up, no differences were reported between the two groups in terms of left ventricular systolic function and valvular continence. Conclusions. In our experience, over one-third of consecutive patients with native mitral are amenable to valve repair in expert hands. Mid-term outcome of repair in IE is comparable to valve replacement, and should be considered whenever possible, as in degenerative valve disease.
Results of large pulmonary homograft implantation for right ventricular outflow tract...
Simon DANG VAN
Carine Pavy

Simon DANG VAN

and 6 more

June 17, 2020
Background : To evaluate the long-term results of implantation of homogeneous large size of pulmonary homograft (PH) for reconstruction of the right ventricular outflow tract (RVOT). Methods : Between January 2000 and December 2017, 107 patients were implanted with PH for reconstruction of the RVOT. Data were collected retrospectively in this single-center study. PH failure was defined as a peak of gradient > 40 mmHg and/or as a pulmonary regurgitation > grade 2. Primary endpoint was the re-operation of the RVOT during follow-up. Secondary endpoints were overall survival, occurrence of PH failure and the rate of re-operation for all cause. Results : Mean age of the recipients was 26.13  13.59 years. Mean size of PH was 23.02  6.87 mm. Re-operation of the RVOT occurred in 8 patients (7.8%). Time before re-operation was 2.74 years (Interquartile Range: 6.41). Freedom from re-operation for RVOT at 5 and 10 years was respectively 95.7% and 90.0%. Overall survival at 10 years was 95.2%. PH failure occurred in 13 patients (12.0%). Mean time before PH failure was 5.00  4.35 years. Freedom from PH failure at 10 years was 81.6%. Re-operation for PH failure occurred in 4 patients (3.9%). Concomitant tricuspid valve surgery (p=0.037), initial pulmonary stenosis (p=0.04), recipient of PH < 16 years old (p=0.043) were risk factors of late reoperation in univariate analysis. Multivariate analysis showed no independent risk factor of late reoperation. Conclusions : Implantation of large PH for RVOT reconstruction provides excellent mid-term results in terms of re-operation.
QTc prolongation among hydroxychloroquine sulfate-treated COVID-19 patients: An obser...
Bashar Fteiha
Hani Karameh

Bashar Fteiha

and 8 more

June 17, 2020
Background: The liberal administration of hydroxychloroquine-sulphate (HCQ) to COVID-19 patients has raised concern regarding the risk of QTc prolongation and cardiac arrhythmias, particularly when prescribed with azithromycin. We evaluated the incidence of QTc prolongation among moderately and severely ill COVID-19 patients treated with HCQ and of the existence of concomitant alternative causes. Methods: All COVID-19 patients treated with HCQ (between Mar 1 and Apr 14, 2020) in a tertiary medical center were included. Clinical characteristics and relevant risk factors were collected from the electronic medical records. Individual patient QTc intervals were determined before and after treatment with HCQ. The primary outcome measure sought was a composite endpoint comprised of either an increase ≥ 60 milliseconds (ms) in the QTc interval compared with pretreatment QTc, and/or a maximal QTc interval >500 ms. Results: Ninety patients were included. Median age was 65 years (IQR 55-75) and 57 (63%) were male. Thirty-nine patients (43%) were severely or critically ill. Hypertension and obesity were common (n=23 each, 26%). QTc prolongation evolved in fourteen patients (16%). Age > 65 years, congestive heart failure, severity of disease, C-reactive protein level, hypokalemia and furosemide treatment, were all associated with QTc prolongation. Adjusted analysis showed that QTc prolongation was five times more likely with hypokalemia [OR 5, (95% CI, 1.3-20)], and three times more likely with furosemide treatment [OR 3 (95% CI, 1.01-13.7)]. Conclusion: In patients treated with HCQ, QTc prolongation was associated with the presence of traditional risk factors such as hypokalemia and furosemide treatment.
How Has Covid-19 Pandemic Affected Crowded Emergency Services?
Nazlı Görmeli Kurt
Celal GÜNEŞ

Nazlı Görmeli Kurt

and 1 more

June 17, 2020
Objective: We aimed to investigate the demographic shifts in emergency service admissions, possible measures and room for improvement in emergency services during the Covid-19 pandemic. Methodology: Our study retrospectively analyzed the demographic features and clinical admission types of patients admitted to Batman District State Hospital Emergency Service at two different time periods, one prior to the Covid-19 pandemic and the other during the Covid-19 pandemic. The results were compared between the two periods designated as the pandemic period and the pre-pandemic period. Results: The number of patients admitted to emergency service was 47.681 in the pre-pandemic period and 9455 in the pandemic period (p<0.01). The number of patients admitted for trauma was 1247(2.61%) in the pre-pandemic period and 59(0.62%) in the pandemic period (p<0.01). The number of patients hospitalized to cardiology department or coronary care unit for acute coronary syndrome was 602(1.26%) in the pre-pandemic period and 29(0.3%) in the pandemic period (p<0.01). The number of patients hospitalized to neurological intensive care unit for acute cerebrovascular disease was 542(1.13%) in the pre-pandemic period and 22(0.2%) in the pandemic period (p<0.01). The number of patients hospitalized to pulmonary diseases department or intensive care unit for dyspnea was 622(1.21%) in the pre-pandemic period and 515 (5.4%) in the pandemic period (p <0.01). Conclusion: Measures taken to prevent the spread of Covid-19 infection have caused a significant drop in emergency service admissions. We are of the opinion that this will lead to an increase in deaths occurring at home, and we will soon encounter patients with worse prognosis and overcrowded emergency services. In order to prevent this problem, we believe that the public awareness about emergency conditions requiring emergency service admission should be heightened alongside of the ‘stay home’ calls.
Demographic drivers of generation time in a bird metapopulation: evolutionary potenti...
Yimen Araya-Ajoy
Alina Niskanen

Yimen Araya-Ajoy

and 10 more

June 17, 2020
Generation time determines the pace of key demographic and evolutionary processes. Quantified as the weighted mean age at reproduction, it can be studied as a trait that may evolve and change in response to ecological conditions. We combined quantitative genetic analyses of individual projection matrices with age- and density-dependent models to study generation time variation in a bird metapopulation. We found that males have longer generation times than females and that it is a heritable trait. Individuals with longer generation times contributed to population growth later in life, lived longer, produced fewer recruits per year, had greater lifetime reproductive success, but not necessarily a higher expected individual growth rate. As predicted by density-dependence theory, generation times were shorter when populations were growing, and longer when populations were closer to equilibrium or declining. These results support classic theory predicting that competitive regimes are key determinants of the pace of life-history strategies.
Comparative performance of prediction model, non-expert and tele-diagnosis of common...
James Schuster Bruce
Prajwal Shetty

James Schuster-Bruce

and 5 more

June 17, 2020
Key Points: 1. Efforts to combat the large global burden of ear and hearing disorders are hampered by poor availability of expert diagnosis 2. We report the first study to directly compare prediction model, non-expert and tele-diagnosis of middle and external ear disorders. 3. A prediction model based upon a novel automated otological symptom questionnaire performed poorly, but absence of otorrhoea was found to reliably exclude a diagnosis of chronic suppurative otitis media. 4. Both on-site non-expert and expert tele-diagnosis had high diagnostic specificity, but low sensitivity. 5. Future work could explore how the validity of these diagnostic methods may be improved.
Effects of the Atomic Number of Alkali Atom and Pore Size of Graphyne on the Second O...
Na Hou
Fang Yue Du

Na Hou

and 4 more

June 17, 2020
Based on the combination of novel carbon material graphynes (GYs) and superalkalis (OM3), a class of graphyne superalkali complexes, OM3+@(GY/GDY/GTY)– (M = Li, Na, and K), have been designed and investigated by density functional theory method. Computational results reveal that these complexes with high stability can be regarded as novel superalkali salts of graphynes due to electron transfer from OM3 to GYs. For second order nonlinear optical response, these superalkali salts exhibit large first hyperpolarizabilities (β0). Two important effects on β0 values are found, namely the atomic number of alkali atom in superalkali and the pore size of graphyne. Integrating the two effects, the selected combination of OLi3 with large pore size GTY can bring the considerable β0 value (6.5×105 au), which is a new record for superatom-doped graphynes. In the resulting complex, the OLi3 molecule is located at the center of the pore of GTY, forming a planar structure with the highest stability among these salts. Besides large β0 values, these superalkali salts of graphynes have deep-ultraviolet working region, hence can be considered as a new kind of high-performance deep-ultraviolet NLO molecules.
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