Vertical and horizontal transmissions of Salmonella spp. along the food chain (FC) have been reported to play an important role in the contamination of foodstuffs and of humans. This study aims first to clarify to what extend some selected major Salmonella serotypes are represented along the chicken FC and potentially transmitted from feed to humans. Then to discuss if the sampling results of the Belgian National Salmonella monitoring program may be considered as proxy to predict possible dominant serotypes and trends in humans. By using results of this programme, this study tried to highlight statistically significant differences in yearly prevalences between broilers exit status and other matrices (e.g. feed, other chicken categories, foodstuffs). Then to show up statistically significant changes from year to year prevalences in broilers exit status and to look if these changes can also be observed in the other matrices. Results have showed significant differences in yearly prevalences. They also pinpointed that the prevalence for the same serotypes could significantly vary from year to year in broilers exit status but this variation was inconsistently observed in the other matrices. These observations do not support the assumption of significant vertical and horizontal bacterial transmission along the chicken FC. Results in the national program cannot be considered as proxy. Determining the contribution of contaminated animal feed to human illness is challenging as the interplay of many factors makes it difficult. Coupling the actual programme with network analysis, source attribution and genome sequencing would be a way to explore deeper the spread of Salmonella serotypes along the FC. Belgium has put efforts to decrease Salmonella Enteritidis and Salmonella Typhimurium prevalence along the FC, but attention should be also paid to other pathogens that could fill the vacant niche left as Salmonella infantis which prevalence has been increasing in some matrices.

Background Social distancing and restriction measures during the COVID-19 pandemic may have impacts on asthma control and management in terms of medication availability and healthcare access. We aimed to understand the status of asthma control, exacerbations, self-management and healthcare utilization during the COVID-19 pandemic in Beijing, China. Methods Patients with asthma, selected randomly from our hospital database, were interviewed by phone call. During the interview, sociodemographic information and clinical data, including status of asthma control, asthma exacerbation, self-management and medication before and during the COVID-19 pandemic (From January 25, 2020 to April 25, 2020), were collected. Results We contacted 286 patients, of whom 178 (62.2%) responded with valid results. Before the COVID-19 pandemic, 4.5% (8/178) and 6.7% (12/178) of the patients, respectively, had been hospitalized and visited emergency departments due to asthma exacerbations. 66.7% (118/177) had received maintenance medication. During the COVID-19 pandemic, the majority (92.1%, 164/178) of the patients felt that their symptoms were similar or improved compared with usual times. The mean ACT score of the patients was 22.76 ± 3.06. 24.7% (44/178) of patients sought medical care for asthma. 25.6% (45/176) of the patients ever experienced aggravation of asthma symptoms, but mostly managed by themselves. 13.5% (24/178) of the patients had worried about potential shortage of medications and some reduced dosing. Conclusion It is important for patients to continue taking their prescribed asthma medications as usual and maintain good asthma control during the ongoing pandemic.

Is neutrophilia associated with mortality of COVID-19? A meta-analysis and meta-regressionLi Shi1, Ying Wang1, Xuan Liang1, Wenwei Xiao1, Guangcai Duan1, Haiyan Yang1*, Yadong Wang2*1Department of Epidemiology, School of Public Health, Zhengzhou University, Zhengzhou 450001, China.2Department of Toxicology, Henan Center for Disease Control and Prevention, Zhengzhou 450016, China.*Corresponding author: Haiyan Yang, Department of Epidemiology, School of Public Health, Zhengzhou University, No. 100 of Science Avenue, Zhengzhou 450001, China. Phone: 86-371-67781248; Fax: 86-371-67781248; Email address:yhy@zzu.edu.cn. Yadong Wang, Department of Toxicology, Henan Center for Disease Control and Prevention, No. 105 of South Nongye Road, Zhengzhou 450016, China. Email address: wangyd76@163.com.Acknowledgments: This study was supported by a grant from the National Natural Science Foundation of China (No. 81973105).Conflicts of interest: All authors report that they have no potential conflicts of interest.Running title: Neutrophilia and mortality in COVID-19 patientsKeywords:COVID-19, Neutrophil, Mortality, Meta-analysisAuthor contributions: Conceptualization: Li Shi, Haiyan Yang, Yadong Wang; Data extraction: Li Shi, Ying Wang, Xuan Liang, and Wenwei Xiao; Data analysis: Li Shi and Ying Wang; Methodology: Li Shi, Ying Wang, Guangcai Duan, Haiyan Yang, and Yadong Wang; Software: Li Shi, Xuan Liang, and Wenwei Xiao; Writing and review: Li Shi, Ying Wang, Haiyan Yang, Yadong Wang. All the authors approved the final manuscript.

Abstract Background Hydroxychloroquine plays a role in antimalaria, immune modulation, and possible novel coronavirus-2019 activity in vitro. The unwanted effect on QT prolongation could lead to lethal arrhythmia. Recently, American College of Cardiology (ACC)　had announced to use a risk score system while treating patients with hydroxychloroquine. In this study, we investigated the possible risk factors of corrected QT (QTc) prolongation and validated the applicability of ACC risk score system in our cohort. Methods We retrospectively enrolled 4568 patients who had undergone long-term hydroxychloroquine. 167 patients had electrocardiography before and during hydroxychloroquine use. All baseline characteristics, laboratory data, comorbidities, and concurrent medications were all recorded. Results The majority (80.8%) of our cohort were female and the average age was 51.4 years old. The most common indication of hydroxychloroquine is an autoimmune disease (95.2%), and the average dosage was 315mg daily. In multivariable logistic regression, diabetes mellitus (OR, 9.286, 95% CI=2.026-45.22) and additional QTc prolonging medications (OR, 2.89, 95% CI=1.40-5.94) were stronger independent risk factors than ACC risk score (OR, 1.20, 95% CI=1.02-1.41) for QTc prolongation≧60 ms. In linear regression, comorbidities and QTc prolonging medications (Adjusted R2: 0.385) provided more accurate prediction of QTc response than the ACC risk score alone (Adjusted R2: 0.259). Conclusions For those patients with long-term hydroxychloroquine use, patients with DM and additional QTc prolonging medications were more susceptible to significant QTc prolongation. Patient’s baseline QTc interval, concurrent medications and comorbidities, rather than the ACC risk score, could be used to predict the response of QTc.

Abstract Background: Current guidelines did not provide recommendations on indications of an additional implantable cardioverter-defibrillator (ICD) to patients receiving cardiac resynchronization therapy (CRT), and it still remains controversial due to lack of evidence from randomized controlled trials (RCTs). Method: PubMed, Embase and Cochrane CENTRAL from the inception to May 2020 were systematically screened for studies reporting on the comparison of CRT-defibrillator (CRT-D) and CRT-pacemaker (CRT-P), focusing on the adjusted hazard ratio (aHR) of all-cause mortality. We pooled the effects using a random-effect model. Results: Twenty-one studies encompassing 69919 patients were included in this meta-analysis. With no restriction to characteristics of including population, CRT-D was associated with a lower all-cause mortality compared with CRT-P significantly (aHR: 0.79, 95%CI: 0.72-0.88, I2=40.5%, P<0.0001). This mortality benefit was also observed in patients with ischemic cardiomyopathy (ICM) (HR: 0.74, 95%CI: 0.64-0.86, I2=0%, P＜0.0001). However, there is no significant difference in patients with non-ischemic cardiomyopathy (NICM) (HR: 0.91, 95%CI: 0.82-1.01, I2=0%, P=0.087), older age (age ≥75 years, aHR: 0.96, 95%CI: 0.83-1.12, I2=0%, P=0.610). Subgroup analysis was performed and indicated that there is no mortality benefit of CRT-D for primary prevention (aHR: 0.92, 95%CI: 0.74-1.14, I2=0%, P=0.444). Conclusion: After adjusted the differences in clinical characteristics, additional ICD therapy was associated with a reduced all-cause mortality in patients receiving CRT, especially in patients with ICM. However, our work suggested that additional ICD may not be applied to elderly, NICM patients or for primary prevention. Keyword: heart failure; cardiac resynchronization therapy; defibrillator; all-cause mortality; meta-analysis

Immune Checkpoint Inhibitors (ICI) were shown to improve survival in patients with advanced non-small cell lung cancer. Nevertheless, around 10% of treated patients may have an atypical response with disastrous tumor growth and earlier death. Readily available predictors of such response are still unrevealed and desperately needed.

Objective: To review a case of acute urticaria, and to explore the links this presentation shares with hyperthyroidism and anti-thyroid medications, along with management strategies for patients presenting with new-onset urticaria and pre-existing thyroid disease. Design: A retrospective case report on a 23-year-old female with hyperthyroidism, on carbimazole therapy.

Tracing and isolation of close contacts is used to control outbreaks of coronavirus disease 2019 (COVID-19) in China. However, risk factors associated with occurrence of COVID-19 among close contacts have not been well described. 106 household contacts were included in this study, of whom 19 were developed into COVID-19 cases and the secondary attack rate was 17.9%. Multivariable analysis showed increasing risk of occurrence of COVID-19 among household contacts associated with female of index patients (Adjusted Hazard Ratio [aHR] = 5.61, 95%CI = 1.51-20.83), critical disease of index patients ([aHR] = 7.58, 95%CI = 1.66-34.66), effective contact duration with index patients >2 days ([aHR] = 4.21, 95%CI = 1.29-13.73), and effective contact duration >11 days ([aHR] = 17.88, 95%CI = 3.26-98.01).The sex and disease severity of index COVID-19 patients, and longer effective contact duration with COVID-19 confirmed cases could help epidemiologists to identify potential COVID-19 case among household contacts at an early stage.

The SARS-CoV-2 strain of the coronavirus is responsible for the current COVID-19 pandemic, with an ongoing toll of over 5 million infections and 333 thousand deaths worldwide within the first 5 months. Insight into the phylodynamics and mutation variants of this strain is vital to understanding the nature of its spread in different climate conditions. The incidence rate of COVID-19 is increasing at an alarming pace within subtropical Southeast Asian nations with high temperatures and humidity. To understand this spread, we analyzed 60 genome sequences of SARS-CoV-2 available in GISAID platform from 6 Southeast Asian countries. Multiple sequence alignments and maximum likelihood phylogenetic analyses were performed to analyze and characterize the non-synonymous mutant variants circulating in this region. Global mutation distribution analysis showed that the majority of the mutations found in this region are also prevalent in Europe and North America, and the concurrent presence of these mutations at a high frequency in Australia and Saudi Arabia indicate possible transmission routes. Unique spike protein and non-structural protein mutations were observed circulating within a localized area. We divided the circulating viral strains into 4 major groups and 2 sub-groups on the basis of the most frequent non-synonymous mutations. Strains with a unique set of 4 co-evolving mutations were found to be circulating at a high frequency within India, specifically, group 2 strains characterized by two co-evolving NS mutants which alter in RdRp (P323L) and spike protein (D614G) common in Europe and North America. These European and North American variants (Nextstrain clade A2) have rapidly emerged as dominant strains within Southeast Asia, increasing from a 0% presence in January to an 85% presence by May 2020. These variants may have an evolutionary advantage over their ancestral types and could present the largest threat to Southeast Asia for the coming winter.

Several studies on carbon status have considered current land management practices and land use systems. There however is a need for meta-analysis study to understand the status of carbon over long periods and ways to boost its storage in soils the current scenario to ensure sustainability for securing food by improving soil health. In this context over 1786 pairs dataset from several studies were generated during period 1990-2019 had been collected from Indian experiments. The review shows that carbon status has negative effect on land uses (barren land, cultivated land, grassland, horticultural land and plantation land) over the forest land. The other land uses can be carbon equivalent to forest land by regaining the carbon stocks by 34, 41, 2, 34 and 48%, respectively. If this can become possible through management practices, a large amount of atmospheric carbon dioxide can be restored in the soil and problems of climate change can be mitigated. Also, this paper is synthesized to characterize the human interventions for their effects to sequester carbon in cultivated soils. Integration of organics with chemical fertilizer in cultivated soil can be one of the better land use management strategies for restoring carbon in the soil. The effect of carbon and yield was significantly increased in integrated nutrient management by 23.2% and 1.2% (in rice) and 16.2% and 4.5% (in wheat), respectively in comparison to inorganic alone. Therefore, meta-analysis of these data sets provides information that may help the scientific community to strategically guide and plan future development initiatives.

Dose the blackened lubrication oil needs to be replaced for flying safety? Since there is very limited room for inaccurate assessment of oil quality due to strict flying safety standards, much aviation lubrication oil is disposed in advance long before their service life. More important, aircrafts still face the fatal challenges from unpredictable lubrication oil deterioration. Color change is surely a significant signal to diagnose the quality of lubrication oils. Based on the colorimeter, the color numbers of the testing lubrication oils are measured in this paper to identify the color variation degree of the oxidized lubrication oils. Then the molecular structures of the oxidized lubrication oils are investigated to find the intrinsic relationship between the oxidation products and color numbers. Based on key performances of the oxidized oil samples, the oil quality is undoubtfully deteriorated which is coincident with the variation of color number. The color numbers of the used aviation lubrication oils could provide an alternative way to readily and quickly measure the decline degree and residual lifetime.

Timing of Delivery of Severe COVID-19 in PregnancyDavid Peleg1, Yael Sciaky-Tamir1, Steven L. Warsof2, Naama Maimon1, Ala Abu Saleh3, and Inbar Ben Shachar1Department of Obstetrics and Gynecology1, and the Intensive Care Unit3, Ziv Medical Center, Azrieli, Faculty of Medicine, Bar-Ilan University, Safed Israel, Division of Maternal-Fetal Medicine, Eastern Virginia Medical School, Norfolk, VA, USA2,Correspondence: David Peleg, MDZiv Medical Center Rambam Street Safed, Israel 13100 Tel: +972-4-6828959 Fax: +972-4-6828649Email: david.p@ziv.health.gov.ilWord Count: 1601Short title: Timing of delivery of SARS-Covid-19There is no doubt that COVID-19 has had a devastating worldwide affect. As the health care system has scrambled for control, there has been a multitude of reports concerning diagnosis, epidemiology, treatment and prognosis, with new publications appearing each week. Many of these are from personal or area-limited experience. Not infrequent are changing or conflicting results and statistics. The world awaits well-defined and controlled outcome-based research.One aspect of COVID-19 that remains controversial is the timing of delivery of pregnant women with severe acute respiratory syndrome (SARS-Covid-19) requiring intensive care. Although maternal-fetal medicine obstetricians are an integral part of the multidisciplinary team, there are differing recommendations concerning timing of delivery. The purpose of this report is to propose a guideline for the severely diseased pregnant patient suggesting that pregnant women ≥ 32 weeks with SARS-COVID-19 requiring intubation be delivered.We treated a pregnant woman at 32 weeks’ gestation highlighted the dilemma we faced. A 27-year-old, gravida 2, para 1 at 32+5 weeks’ gestational age presented with dry cough, headache, abdominal pain, general weakness of four days’ duration. She had a mild fever. Fetal tracing was reactive with no contractions. Chest X-ray revealed an infiltrate in the upper left quadrant and COVID-19 PCR testing was positive. A course of betamethasone for fetal lung maturation was administered and enoxaparin was started. The patient’s status deteriorated and medical treatment was initiated with hydroxychloroquine and azithromycin (recommended at the time). On day 4, O2saturation worsened and she became progressively anxious and restless, with vigorous coughing and tachypnea (up to 50 breaths per minute). A repeat chest X-ray revealed bilateral patchy opacities compatible with Covid-19 ARDS/pneumonia. Fetal monitoring remained reassuring. Despite further efforts to improve oxygenation, intubation seemed inevitable. Balancing the risks and benefits, the decision was made to deliver her by cesarean section with general anesthesia and intubation in the operating room, which in retrospect, unnecessarily exposed the staff to additional time of the patient’s uncontrollable coughing, irritability and cognitive disturbance due to hypoxia. A 2200 g male baby was delivered with Apgars of 2 and 7 (cord arterial pH 7.18 BE=-5.9). In the NICU the baby required 4 days of nasal CPAP due to mild respiratory distress. Covid-19 was negative twice. The mother remained intubated for an additional 5 days with gradual improvement in her status. She was extubated at that time and discharged from the hospital on day 8 post-operation. The baby was discharge in good condition 15 days after birth.We propose that pregnant women ≥ 32 weeks’ gestation with SARS-COVID-19 requiring mechanical ventilation (critical disease) be delivered (Figure 1) without delay. Illness from SARS-COVID-19 proceeds along a continuum from mild to severe disease. Progression may be rapid. There is considerable maternal and fetal morbidity and mortality with critical disease. Delay in delivery after 32 weeks exposes the mother and fetus to continued risks, while delivery may improve the maternal condition. Prior to 32 weeks, delivery should be individualized and discussed in a team setting, taking into account maternal or fetal status (1).The risk of death with severe disease is substantial. The reported risk of maternal death during the three corona virus pandemics (SARS, MERS, Covid-19) was 12.3% (2). In a USA nationwide study between 2006 - 2012, the overall risk of maternal death from ARDS in the USA was 9% (3). Age specific mortality from SARS-COVID-19 is at this time difficult to determine from the literature. In the age group 20 – 49, 2.4% (6 of 255) of female patients with severe disease died in New York (4). In China, the case fatality ratio in the age group 20 – 49 was 0.14% (both sexes) (5). In Iran, of 9 reported cases of pregnant women with severe COVID-19 disease, 7 died (77.8%) (6)All pregnant women with COVID-19 infections should be triaged to one of three classes: mild moderate or severe (7). Mild signs and symptoms (mild disease) can be managed in the outpatient setting (Figure 1). Some will have worsening signs symptoms (dyspnea, decreased oxygen saturation). Patients with moderate disease should be hospitalized for continued evaluation and treatment. Pregnant women with severe disease will have marked tachypnea, oxygen saturation ≤ 93%, partial pressure of arterial O2 to inspired oxygen fraction < 300), and infiltrates of at least 50% of lung fields (7). These women require intensive care.At least three-quarters of patients with SARS-COVID-19 will require mechanical ventilation. Known risk factors for severe disease include older age (>65 years), chronic lung disease, cardiovascular disease, diabetes mellitus, obesity, immunocompromised, renal disease, and liver disease (7). It is unknown whether pregnancy, while adding an extra burden to the sick mother, contributes to maternal deterioration. It should be remembered that pregnant women during the SARS-CoV 2012 epidemic and the H1N1 2009 pandemic had higher morbidity and mortality than non-pregnant women (8). Data for COVID-19 is incomplete.The changes in maternal physiology would be expected to negatively affect the prognosis of women with severe respiratory disease requiring mechanical ventilation. For example, pregnancy causes an increase in cardiac output up to 40% . Blood pressure is lower due to a decrease in systemic vascular resistance, and serum albumin and colloid osmotic pressure are decreased, placing the pregnant women at risk for third-spacing of fluid, volume overload, and pulmonary edema. Respiratory changes in pregnancy include an increase in minute ventilation with a compensated respiratory alkalosis.For these and other reasons, mechanical ventilation of the pregnant patient requires special consideration. Pregnant women who develop respiratory failure and require mechanical ventilation should be ventilated to a target PaCO2 between 28 – 30 mm Hg to avoid alterations in uterine blood flow and fetal oxygen delivery. Functional residual capacity is decreased 10 - 25% as term approaches, and places an extra burden on a women requiring mechanical ventilation due to hypoxemic respiratory failure. It is desirable to maintain low tidal volume ventilation, higher peak inspiratory pressure, and positive end expiratory pressure. Hyperventilation should be avoided. To guarantee sufficient fetal oxygenation, maternal PaO2should not be below 70mm Hg. Targeting lower ventilation pressures may not be feasible in pregnant patients where intra-abdominal pressure would be physiologically increased. Certainly pregnancy adds an unquantified burden to the medical team responsible for caring for the severely ill patient at significant risk of death.There exists a lack of evidence-based guidelines concerning mechanical ventilation of pregnant patients with ARDS, as well as the effect of delivery on maternal and fetal wellbeing. Of 29 pregnant patients, 10 were delivered while mechanically ventilated. Following delivery, 3 had a 50% decrease in oxygenation index and 5 had a greater than 50% increase in lung compliance (9). Extracorporeal membrane oxygenation has been shown to be of some benefit in pregnant women with critical ARDS. One study showed a 77% maternal and a 56% fetal survival rate (10). Although data are equivocal, delivery can be expected to improve fetal wellbeing (9). However, other have argued that delivery should not be performed solely to improve maternal oxygenation.The prolonged hypoxemia associated with severe respiratory disease would be expected to have a detrimental effect on the fetus. Maternal hypoxia reduces placental blood flow and fetal oxygenation due to vasoconstriction. Maternal hypercapnia may produce fetal respiratory acidosis (9). Along with growth restriction, chronic hypoxia has been associated with fetal brain injury (11). Long term effects of hypoxia include increased risks of cardiovascular, metabolic and renal disease. Medications used for sedation may adversely affect the fetus. The pooled percentage of perinatal death among pregnancies with SARS-Covid-19 was 7% (2). Of 9 pregnant women with SARS-COVID19 in the 2nd and 3rd trimesters who succumbed to the disease, 4 (44%) had intrauterine fetal demise not related to prematurity (6).The modality most relied upon to determine fetal status is the cardiotocograph (CTG). Other modalities, such as biophysical profile and doppler studies that are useful with growth restriction, may be impractical and have not been thoroughly evaluated in these situations. A normal appearing CTG tracing may give the obstetrician a false sense of security in the severely sick, anesthetized and intubated woman, and waiting for classical CTG changes of fetal distress may be unsafe.Although vaginal delivery would seem preferable and may be considered in the stable patient, induction of labor in the severely sick pregnant woman is most often unreasonable. Of the 9 pregnant women dying from SARS-COVID19, 6 underwent cesarean, 1 had a vaginal birth, and 2 died undelivered (6). Of 20 pregnant women critically ill with Covid-19 admitted at 30.6 weeks mean gestational age, 16 (94%) were delivered by cesarean at 31.9 weeks mean gestation (5 days after hospitalization) (12). A controlled delivery by cesarean is the treatment of choice in these women. Regional anesthesia may be attempted, however, these women are very sick and on the verge of requiring mechanical ventilation; general anesthesia with intubation seems the more logical approach. Special efforts are needed to minimize staff exposure.We believe that the decision to delay delivery after 32 weeks in the SARS-COVID-19 patients on the verge of becoming critically ill has the potential to cause more harm than benefit. Before 32 weeks, the decision to delivery may be delayed to benefit the fetus, only if the delay is not expected to worsen the mother’s prognosis. Indications for delivery in these situations may include non-reassuring fetal monitoring, intrauterine fetal demise, failing cardiopulmonary status, disseminated intravascular coagulation, and multi-organ failure.We propose that 32 weeks is a sufficient gestation age to deliver women with SARS-COVID-19 requiring mechanical ventilation since > 98% intact survival can be expected for these babies. After delivery, concerted efforts for recovery of the mother can be made without fetal concerns.Disclosure of interests: Each author reports no conflict of interest.Contributions of authors: Dr. Peleg, Dr. Sciaky-Tamir, Dr. Maimon, Dr. Abu Saleh, and Dr. Ben Shachar contributed to patient care, planning and decision making, design and writing of the manuscript. Dr. Warsof aided in design and writing of the manuscript.Ethics approval: The present work was deemed exempt from obtaining Ethics committee approval.Funding: There were no sources of funding supportReferences1. Management considerations for pregnant patients with COVID-19. Society for Maternal-Fetal Medicine. https://s3.amazonaws.com/cdn.smfm.org/media/2336/SMFM_COVID_Management_of_COVID_pos_preg_patients_4-30-20_final.pdf.2. Di Mascio D, Khalil A, Saccone G, et al. Outcome of Coronavirus spectrum infections (SARS, MERS, COVID 1 -19) during pregnancy: a systematic review and meta-analysis. Am J of Obstet Gynecol MFM (2020), doi:https://doi.org/10.1016/j.ajogmf.2020.100107.3. Rush B, Martinka P, Kilb B, McDermid RC, Boyd JH, Celi LA. Acute Respiratory Distress Syndrome in Pregnant Women. Obstet Gynecol 2017;129:530-5.4. Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW; and the Northwell COVID-19 Research Consortium. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA. 2020 Apr 22. doi: 10.1001/jama.2020.6775.5. Verity R, Okell LC, Dorigatti I, et al. Estimates of the severity of coronavirus disease 2019: a model-based analysis. Lancet Infect Dis. 2020 Mar 30. pii: S1473-3099(20)30243-7. doi: 10.1016/S1473-3099(20)30243-7.6. Hantoushzadeh S, Shamshirsaz AA, Aleyasin A, et al. Maternal death due to COVID-19 disease. Am J Obstet Gynecol 2020 https://doi.org/10.1016/j.ajog.2020.04.030.7. Gandhi RT, Lynch JB, del Rio C. Mild or moderate Covid-19. N Engl J Med 2020 Apr 24. doi: 10.8. Lam CM, Wong SF, Leung TN, et al. A case-controlled study comparing clinical course and outcomes of pregnant and non-pregnant women with severe acute respiratory syndrome. BJOG 2004;111:771-4.9. Lapinsky SE, Rojas-Suarez JA, Crozier TM, et al. Mechanical ventilation in critically-ill pregnant women: a case series. Int J Obstet Anesth 2015;24:323-8.10. Moore SA, Dietl CA, Coleman DM. Extracorporeal life support during pregnancy. J Thorac Cardiovasc Surg 2016;151:1154-60.11. Dong Y, Yu Z, Sun Y, et al. Chronic fetal hypoxia produces selective brain injury associated with altered nitric oxide synthases. Am J Obstet Gynecol 2011;204:254.e16-28.12. Pierce-Williams RAM, Burd J, Felder L, et al. Clinical course of severe and critical COVID-19 in hospitalized pregnancies: a US cohort study. Am J Obstet Gynecol MFM (2020), doi:https://doi.org/10.1016/j.ajogmf.2020.100134.Legend to Figure 1Delivery of severe Covid-19 in pregnancy

Wheat contains low grain zinc (Zn) due to its genetics and the physiochemical properties of the soil in which it is grown. Consequently, where wheat forms a major part of the human diet, bioavailable Zn is below dietary requirements. Understanding the regulation of genes responsible for cellular Zn-transport, particularly those responsible for the control of the biosynthesis pathway of nicotianamine, provides an opportunity to increase Zn loading into the grain. Decreasing the levels of phytic acid, an inhibitor of Zn absorption in humans, provides another opportunity to increase the bioavailability of grain Zn. Synchrotron X-ray fluorescence microscopy clearly demonstrated that the crease region of the wheat grain is a major bottleneck to Zn loading in the endosperm. Higher expression of Zn transporter families, particularly metal tolerance proteins and yellow stripe like transporter families in the aleurone layer are also likely to play a major role in determining grain Zn content. Finally, anatomical barriers in the vascular region at the base of the wheat grain are a major limitation to Zn loading. Modification of any of these traits through traditional plant breeding or gene editing provides an opportunity to increase the Zn concentration in wheat grain.

Mercury (Hg) is one of the most hazardous pollutants released by humans and is of global environmental concern. Mercury causes oxidative stress and strong cellular damages in plants, which can be attenuated by the biosynthesis of thiol-rich peptides (biothiols), which include glutathione (GSH) and phytochelatins (PCs). We analysed Hg tolerance and speciation in five Arabidopsis thaliana genotypes, the wild-type Col-0, three knockdown γ-glutamylcysteine synthetase (γECS) mutants and a knockout PC synthase (PCS) mutant. Mercury-PC complexes were detected in roots by HPLC-ESI-TOFMS, with its abundance being limited in γECS mutants. Analysis of Hg-biothiol complexes in the xylem sap revealed that HgPC2 occurs in wild-type Col-0 Arabidopsis, suggesting that Hg could be translocated associated with thiol-rich metabolites. Twenty genes involved in sulphur assimilation, GSH and PCs synthesis were differentially expressed in roots and shoots, implying a complex regulation, possibly involving post-translational mechanisms independent of GSH cellular levels. In summary, the present study describes the importance of biothiol metabolism and adequate GSH levels in Hg tolerance, and identifies for the first time Hg-PC complexes in the xylem sap. This finding supports that Hg-biothiol complexes could contribute to Hg mobilisation within plants.

Intracellular levels of Mg2+ are tightly regulated, as Mg2+ deficiency or excess affects normal plant growth and development. In Arabidopsis, we determined that phospholipase Dα1 (PLDα1) is involved in the stress response to high-magnesium conditions. The T-DNA insertion mutant pldα1 is hypersensitive to increased concentrations of magnesium, exhibiting reduced primary root length and fresh weight. PLDα1 activity increases rapidly after high-Mg2+ treatment, and this increase was found to be dose-dependent. Two lines harboring mutations in the HKD motif, which is essential for PLDα1 activity, displayed the same high-Mg2+ hypersensitivity of pldα1 plants. Moreover, we show that high concentrations of Mg2+ disrupt K+ homeostasis, and that transcription of K+ homeostasis-related genes CIPK9 and HAK5 is impaired in pldα1. Additionally, we found that the akt1, hak5 double mutant is hypersensitive to high-Mg2+. We conclude that in Arabidopsis, the enzyme activity of PLDα1 is vital in the response to high-Mg2+ conditions, and that PLDα1 mediates this response partially through regulation of K+ homeostasis.

Background/aim: Adropin is a novel regulatory peptide that plays a vital role in lipid metabolism, insulin resistance, and adiposity. In addition, recent study has revealed that adropin appears to have anti-inflammatory properties. The main purpose of this study is to evaluate the potential association of adropin with Crohn’s disease (CD) . Materials and methods: We analyzed the serum levels of adropin, inflammatory parameters, and metabolic parameters in 60 CD patients and 36 healthy controls. Serum adropin levels were determined using a commercially available ELISA kit. Mesenteric adipose and intestinal tissues were obtained from 8 of included CD patients and, for controls, 6 colonic cancer patients who underwent colon resection. Tissue adropin expression were measured by immunofluorescence confocal microscopy. Results: Serum adropin levels were slightly lower in the active CD patients compared to the inactive CD patients (3629.81±931.49 versus 4322.47±1194.69 pg/mL, P = 0.027). Serum adropin levels negatively correlated with ESR (r = -0.302, P = 0.019) and CD activity index (r = -0.332, P =0.010). However, mesenteric adipose and intestinal tissue adropin expression in CD patients were higher than controls, which suggests the intestine and adipose tissues may not be the major source of circulating adropin. Conclusion: Serum adropin levels decrease in the active CD patients, while adropin expression in mesenteric adipose and intestinal tissues increase in CD patients, suggesting that different source of adropin may plays a different role in CD pathogenesis.

This work addresses the design of distributed model predictive control (DMPC) systems for nonlinear processes using machine learning models to predict nonlinear dynamic behavior. Specifically, sequential and iterative distributed model predictive control systems are designed and analyzed with respect to closed-loop stability and performance properties. Extensive open- loop data within a desired operating region are used to develop Long Short-Term Memory (LSTM) recurrent neural network models with a sufficiently small modeling error from the actual nonlinear process model. Subsequently, these LSTM models are utilized in Lyapunov- based DMPC to achieve efficient real-time computation time while ensuring closed-loop state boundedness and convergence to the origin. Using a nonlinear chemical process network exam- ple, the simulation results demonstrate the improved computational efficiency when the process is operated under sequential and iterative DMPCs while the closed-loop performance is very close to the one of a centralized MPC system.

Why is there something rather than nothing? It is impossible to imagine zero existence. We find ourselves on this ball known as Earth that is floating in a vast box. As one who faints only to wake at a nearby hospital, we start asking questions. Of all the inventions of humankind, science most passionately attempts to answer that Great Questionnaire, of which philosophy is its principle contributor. But there are many things we found in our ball and box too that still do not make sense. And by that I mean, there is enormous ground for unrestricted opinions due to lack of consistent truths. That is not necessarily a detour in our quest, some problems are more complex than others. We may not expect a consensus on what existence-in-itself means the same way we can prove the sun sets in the West. To most people, life and existence are synonyms. Biology has historically studied the living and Physics the dead world. This distinction grows faint with the emerging field of Biophysics. By using the same laws to explain both worlds, a collective paradigm of everything may be reached. This work is based on such grounds.

Despite evidence that seasonal variation may lead to the persistence of competing species, studies on the effect of seasonality on community network structures are limited. Furthermore, identifying whether seasonal network changes are the result of species turnover or rewiring (rearrangement of interactions among species), also remains understudied. Here, we investigate seasonal network changes in a stream fish community across Fall and Spring data. We find strong evidence that seasonality influences species interactions, particularly through rewiring. Moreover, we find that a species’ number of rewiring interactions was best explained by its status as a piscivore/non-piscivore and its maximum length. Overall, we argue that rewiring may be a dominant process in communities experiencing seasonal environments and that traits linked to trophic-level may identify species contributing most to rewiring. As networks dominated by rewiring may be more robust, understanding the causes of changes in species interactions can help determine when communities may persist given a disturbance.

Conditions experienced early in development can affect the future performance of individuals and populations. Demographic theories predict persistent population impacts of past resources, but few studies have experimentally tested such carry-over effects across generations or cohorts. We used bumble bees to test whether resource timing had persistent effects on within-colony dynamics over sequential cohorts of workers. We simulated a resource pulse for field colonies either early or late in colony development and estimated colony growth rates during pulse- and non-pulse periods. During periods when resources were not supplemented, early-pulse colonies grew faster than late-pulse colonies; early-pulse colonies grew larger as a result. These results reveal persistent effects of past resources on current growth and support the importance of transient dynamics in natural ecological systems. Early-pulse colonies also produced more queen offspring, highlighting the critical nature of resource timing for population, as well as colony, dynamics of a key pollinator.

Abstract: Lethal and sublethal effects of pathogens should theoretically select for host avoidance of these organisms. Oak toads, for example, learn to avoid the pathogenic fungus Batrachochytrium dendrobatidis (Bd) after one infection-clearance event. Here, we investigated whether four taxonomically distinct amphibians, Cuban treefrogs (Osteopilus septentrionalis), southern toads (Bufo terrestris), greenhouse frogs (Eleutherodactylus planirostris), and pine woods treefrogs (Hyla femoralis) were also able to learn to avoid Bd and, if so, what cues they used to identify Bd. Cuban treefrogs, pine woods treefrogs, and greenhouse frogs did not appear to exhibit detectable innate or learned avoidance of Bd. However, southern toads learned to avoid Bd after only one exposure. Southern toads avoided any treatment containing Bd metabolites but did not avoid treatments that lacked Bd metabolites even when dead zoospores were present. Bd metabolites include digestive enzymes that breakdown host tissue and appear to be the cues that amphibians use to avoid Bd, which is consistent with a Classical or Pavlovian Conditioning response. It appears that not all species respond the same way to Bd, which is important information when developing disease models and conservation plans for amphibians.

Objective: To evaluate the effectivity of laparoscopic ovarian drilling procedures at the East Sussex Healthcare Trust, UK, over the past decade on sub-fertile women with polycystic ovary syndrome, regardless of clomiphene resistance. Design: Retrospective case note review of LOD procedures Methods: •Study 1: Evaluating a systematic literature review investigating ovulation and pregnancy rates following LOD. •Study 2: An audit of 58 women with LOD treated for ovulation induction at the ESHT fertility clinic between 2005-2014. Main outcome measures: Ovulation, pregnancy, live birth, miscarriage rates; tubal patency; associated pathologies; previous treatments compared with Cochrane Review 2012. Results: •Study 1: From the literature review, 71% achieved ovulation, whereas the pregnancy, live birth and miscarriage rates were 25-51%, 24-44% and 4-9% respectively. •Study 2: Of the 58 patients studied, ovulation rate was 69%, pregnancy rate was 39.4% and live birth rate was 30.3%. The miscarriage rate was 15.4%. Pregnancy outcome after LOD, irrespective of further treatment, showed 34 pregnancies. Including 17 spontaneous pregnancies and 17 pregnancies after further treatment. Of the 34 pregnancies, 85.3% were live birth, 11.7% miscarriages and 1 ectopic pregnancy. Conclusion: No significant difference in ovulation rates post-LOD in ESHT, which is comparable to published studies. The low pregnancy and live birth rates indicate that additional factors affect the success of LOD. Co-existing pathology is associated with lower pregnancy rate post-LOD. Novel theories are postulated to explain underlying pathologies, thus PCOS treatment may change and open a fascinating area of research. Keywords: polycystic ovary syndrome, laparoscopic ovarian drilling, clomiphene citrate

A low platelet count is often an incidental finding in pregnancy. It can be an indicator of a severe systemic disorder requiring emergent maternal and fetal care or can just be unique to pregnancy with no harm to mother or fetus. Physiological decrease in platelet count is seen in pregnancy due to hemodilution and hypercoagulating state, though the exact pathophysiology is still unclear. Methods: It is a prospective observational study done in a tertiary care centre. Results: In about 11,258 cases screened 46 patients had thrombocytopenia (0.4%). The commonest etiology is found to be gestational thrombocytopenia (n= 21, 45.6%) followed by preeclampsia/ eclampsia/ HELLP syndrome (n=19, 41.3%). Only one patient had ITP and 7(15.3%) were associated with AFLP. Maximum of them (n= 19, 41.3%) underwent spontaneous vaginal delivery.4 patients (8.6%) had postpartum haemorrhage, 6 (13.04%) had ceserean section wound infection, 4 (8.6%) had DIC and 4 (8.6%) had multiorgan failure.13 patients (28.3%) had platelet count between 40 to 60 thousand per cumm, 11 (23.9%) had between 60 to 80 thousand per cumm, 10 (21.7%) had between 80,000to 1 lakh and none had their platelet count less than 20,000 per cumm. Conclusion: Gestational thrombocytopenia is not a preventable condition. It is an incidental finding in pregnancy. With strict vigilance during intrapartum and postpartum period, even without any treatment proper for the same, the maternal and fetal outcome is found to be good. Key words: HELLP, DIC, multiorgan failure.

Measurement is an essential activity in medical science and due to the subjective nature of the results that are being measured, it is increasingly necessary to have valid, reproducible and reliable methods. There is no guidelines simply focus on the validation of questionnaires. There are some reviews or task forces. Nevertheless, looking at some validation studies, there are different methods or techniques to develop it, which may cause some confusion. The aim of this review is to synthetize some of these information, to be used as a simple guide. Before any data collection, a translation of the questionnaire is needed. Psychometry involves the application of statistical techniques to test the measurement properties of an instrument. There are several measures to evaluate an instrument, the main ones being: classical test theory and modern test theory. Regarding the classical test theory, the key psychometric characteristics are: scale structure, accuracy (validity), precision (reliability) and responsiveness. Modern test theory models are techniques to assess the psychometric characteristics of an instrument, focused on the dimensionality of the questionnaire. Responsiveness, validity and precision are interlinked. However, each one is important, acting independently in the assessment of the psychometric characteristics of the instruments.