Background and Purpose: Cordycepin has been proved to have neuroprotective efficacies and to improve learning and memory in cerebral ischemia. However, the potential mechanisms are unclear so far. Plasticity of synaptic structure and function is considered as the neural mechanisms of learning and memory. Therefore, we investigated the effects of cordycepin on dendritic morphology and synaptic function in cerebral ischemic models. Experimental Approach: The impact of cordycepin was studied using oxygen glucose deprivation (OGD) and global cerebral ischemia (GCI) model. Synaptic transmission and behavioral long-term potentiation (LTP) were investigated with electrophysiological recording. Hippocampal dendritic morphology was assessed by Golgi staining. The density of adenosine A1 and A2A receptors (A1R and A2AR) evaluated with western blot and immunofluorescence. Key Results: Cordycepin alleviated the ischemia-induced damages of dendritic morphology and behavioral LTP in hippocampal CA1 area, improved the learning and memory ability and up-regulated the expression of A1R but not A2AR in hippocampus of GCI rats. Besides, cordycepin pre-perfusion could significantly attenuate the hippocampal slices injury and synaptic transmission impairment induced by OGD, improved adenosine content and reduced the expression level of A1R but did not alter A2AR. Furthermore, the protection of cordycepin on synaptic transmission against ischemic inhibition was eliminated by using the antagonists of A1R instead of A2AR. Conclusion and Implications: These findings indicated that cordycepin alleviated synaptic dysfunction and dendritic injury in vivo and in vitro ischemia models by modulating adenosine A1R, which may be the neural mechanisms of cordycepin to improve learning and memory in cerebral ischemic animals.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel single-stranded RNA virus and induces cytokines storm that play a crucial role in the pathogenetic mechanisms of acute respiratory distress syndrome and the subsequent multi-organ failure. SARS-CoV-2 enters the host cell through angiotensin-converting enzyme 2 (ACE 2) receptor and patients with forgoing chronic diseases are most vulnerable to SARS-CoV-2 infection and increase the mortality. ACE 2 is part of the renin-aldosterone angiotensin system (RAAS) which is highly expressed in the intestine, pancreas, kidney, heart, lungs, liver, maternal-fetal interface and fetal tissues. RAAS system is dysregulated in patients underlying hypertension, cardiovascular diseases, diabetes, renal disorder and preeclampsia. Drugs acting on the RAAS system, thiazolidinediones and smoking, preeclampsia, chronic liver diseases up-regulates the ACE 2 expression that may act as an entry point for SARS-CoV-2 and leading to multi-organ failure with a massive release of cytokines. Hence, this review shed a light on a path of increased mortality rate among COVID-19 patients and the possible mechanism of multi-organ failure.

Objectives: Primary hyperhidrosis (PH) still impacts negatively the patients’ quality of life (QoL). Progressively, it leads to poorer QoL regardless of gender; finally, it ends up causing psycho-social and professional embracement to patients. The thoracoscopic sympathectomy (TS) has been used safely and effectively for control of palmar hyperhidrosis; but it is still questionable in palmo-plantar type. We assessed the benefits of drainless one-port thoracoscopic sympathectomy (DOTS) in palmo-plantar and palmar hyperhidrosis. Methods: This prospective study comprised 213 consecutive patients with PH who underwent bilateral simultaneous DOTS. We used the Hyperhidrosis Disease Severity Scale (HDSS) scoring system for assessment of quality of life pre- and post-operatively. Follow up continued for one-year interval for quality of life, recurrence, and compensatory hyperhidrosis. Results: All patients experienced immediate complete resolution of hyperhidrosis postoperatively. Recurrence encountered in one patient during first 6 months. All patients had improved quality of life postoperatively; but at the end of 1-year follow up, 2.8 % of patients were still suffering moderate to severe impaired QoL. Mean hospital stay was 31.79±17.5 hours. We found significant longer hospital stay in palmar group than palmo-plantar group. There was no significant difference between both groups in neither operative time, recurrence, nor compensatory hyperhidrosis. Conclusions: DOTS offers better quality of life for patients with primary hyperhidrosis even the palmo-plantar type. The palmo-plantar type benefits similarly to the palmar type. In palmo-plantar hyperhidrosis, we should rethink again about post-operative plantar hyperhidrosis; it is accepted redistribution compensatory hyperhidrosis rather than a miserable recurrence.

Variants in the ganglioside-induced differentiation associated protein 1 (GDAP1) gene is responsible for a demyelinating form of Charcot- Marie-Tooth disease (CMT4A), an axonal form of CMT2K and an intermediate form of CMTRIA. In this study, multiplex ligation-dependent probe amplification (MLPA) and whole-exome sequencing (WES) were performed in 30 unrelated CMT patients. We identified 10 pathogenic variants in 3 known CMT related genes, including 3 novel variants (p.L26R, p.S169fs, c.694+1G>A) and one known pathogenic variant (p.R120W) in GDAP1. Functional studies were performed and the pathogenicity of novel GDAP1 variants were classified. The effect of c.694+1G>A on pre-mRNA was verified via minigene splice assay. Cellular biological effects showed an ultrastructure damage of mitochondrial, reduced protein levels, different patterns of mitochondrial dynamics, decreased mitochondrial membrane potential (Δψm), ATP content, and defects in respiratory capacity in the patient carrying p.L26R and p.S169fs in GDAP1. Further we described the clinical features of patients carrying pathogenic variants in GDAP1 and found that almost all Chinese CMT patients with GDAP1 variants present axonal type. Our results broaden the genetic spectrum of GDAP1 and provided functional evidence for mitochondrial pathways in the pathogenesis of GDAP1 variants.

Unicuspid aortic valve (UAV) is a very rare congenital anomaly with an estimated prevalence of 1 in 5000 in the adult population. It is often diagnosed by a 2D or 3D Transthoracic Echocardiogram (TTE) or Transesophageal Echocardiogram (TEE) [1]. Its usual presentation is in the third decade of life often as symptomatic aortic stenosis (AS). Rheumatic heart disease typically does not involve the aortic valve anatomically without also involving the mitral valve. Although the mitral valve may be diffusely abnormal anatomically, its function can be normal. Consequently, a patient with rheumatic heart disease can present initially with only aortic valve dysfunction, and therefore rheumatic heart disease has to be considered a cause of functionally isolated AS ± aortic insufficiency (AI), or pure AI. We present a case of a 25-year-old male with a history of longstanding rheumatic fever and a recent embolic event to the left eye, who was seen in consultation for moderate AI and mobile calcification of the aortic valve with possible bicuspid valve by TEE. The echocardiogram also showed evidence of rheumatically deformed mitral valve with evidence of trace mitral regurgitation (MR). The patient was thought to have rheumatic valvular disease and planned for an aortic valve repair or replacement with a mechanical valve. During the surgery however, an UAV was found. It was replaced with a mechanical valve. The patient did well post-operatively and was discharged home five days later.

Background: We report our experience in aortic arch repair with the E-vita Open hybrid prosthesis and describe the changes in our technique over time. Methods: Between October 2013 and December 2019, 56 patients underwent a total aortic arch replacement with the E-vita Open hybrid prosthesis. Main indications were thoracic aorta aneurysm (n=27) and acute type A aortic dissection (n=18). We analyze the technique and results in the overall series, and compare both between our early (Group I, 25 patients) and late experience (Group II, 31 patients). Results: Overall in-hospital mortality was 7.1% (4), and permanent stroke and spinal cord injury were 3.6% and 1.8% respectively. 15 patients (26.8%) underwent a planned second procedure on the distal aorta: 13 endovascular, 1 open and 1 hybrid. Survival at 1 and 3 years was 90.7% and 80.7%. Group II included more patients with acute dissection (45.2% vs 16%, p=0.02), a higher rate of bilateral cerebral perfusion (100% vs 64%, p<0.001), left subclavian artery perfusion during lower body circulatory arrest (87.1% vs 0%, p<0.001), early reperfusion (96.8% vs 40%, p<0.001), and zone 0-2 distal anastomosis (100% vs 72%, p=0.02). In-hospital mortality (3.2% vs 12%) and permanent stroke (0% vs 8%) tended to be lower in Group II. Conclusions: Total arch replacement with E-vita Open hybrid prosthesis in complex thoracic aorta disease is safe. One-stage treatment is feasible when pathology does not extend beyond the proximal descending thoracic aorta. In any case, it facilitates subsequent procedures on distal aorta if needed.

The O-O coupling process in water oxidation on the gamma FeOOH hydroxide catalyst is simulated by means of density functional theory using model iron cubane cluster Fe4O4(OH)4. A key reactive intermediate is proposed to be the HO-FeIV-O• oxyl unit with terminal oxo radical formed from vertex HO-FeIV-OH moiety by withdrawal of proton-electron pair. The O-O coupling goes via water nucleophilic attack on the oxyl oxygen to form the O-O bond with a remarkably low barrier of 11 kcal/mol. This process is far more effective than alternative scenario based on direct interaction of two ferryl FeIV=O sites (with estimated barrier of 36 kcal/mol) and is comparable with the coupling between terminal oxo center and three-coordinated lattice oxo center (12 kcal/mol barrier). The process of hydroxylation of terminal oxygen inhibits the O-O coupling. Nevertheless, being more effective for ferryl oxygen, the hydroxylation in fact enhances selectivity of the O-O coupling initiated by the oxyl oxygen.

The water flea Daphnia carinata is emerging as a new model for biological studies due to its natural cyclical parthenogenesis and small genome. However, no genomic information for the D. carinata is currently available. Here, we reported a chromosome-scale genome assembly of D. carinata. The assembled D. carinata (WSL) genome was consisted of 131.58 Mb, and 92.23% (121.36 Mb) of the assembly was anchored onto 10 chromosomes. Basing on the whole genome information, we further compared the transcriptomic and epigenomic characterization among parthenogenetic females (PF), sexual females (SF) and males (M) in D. carinata. Transcriptomic analysis showed that the highly expressed genes in M were mainly grouped into the cuticle, phototransduction, hypoxia-response, sex differentiation, and methyl farnesoate synthesis. Besides, compared to M and SF, the highly expressed genes in PF were mainly grouped into energy metabolism, mitosis, DNA replication, and RNA splicing. miRNAomic analysis showed that several miRNA-mRNA pairs may be the functional modules in the reproductive regulation of D. carinata, such as novel-miR-4—brat, novel-miR-21—lin-9 pairs, novel-miR-110—gl, novel-miR-4—eIF3-S9. The whole-genome DNA methylation analysis showed that genome-wide methylation rate was very low in D. carinata, and DNA methylation sites were mainly enriched in the gene body region. Comparative analysis showed that the genome-wide methylation rate in PF was higher than that in SF and M. Differentially methylation region-related genes were all mainly grouped in metabolic process, catalytic activity, binding/ion binding, and cellular process.

In the present work, novel core-shell polymer magnetic colloids are prepared and employed as a potential candidate in ultrasensitive molecular imaging. The synthesized colloids possess high colloidal stability, magnetization (43.85 emu g-1) and uniformity of particle size with an average diameter of 527 nm. FTIR spectrum of magnetic emulsion shows two characteristic peaks at 570 and 630 cm-1 which related to Fe-O vibration bands. Both T1 and T2 relaxation times were successfully measured. Based on signal intensities, the prepared colloids observed to perform as better T2 weighted contrast agents. The T2-weighted MR images showed significant signal intensity reduction and contrast darkening. Moreover, the prepared colloids were also employed to fabricate thin films via a facile method of layer by layer self-assembled multilayers (LBL-SAMU) to explore their potential application in imaging. Uniform particle size distribution with spherical morphologies was obtained for the fabricated bilayers. In addition, a 20% increment in iron contents was observed for 5-15 bilayer thin films decorated with film colloidal particles. The reported work opens new avenues for designing powerful T2 contrast agents in various biomedical applications such as analysis of biomacromolecules, diagnostics, and therapy.

Plants host diverse microbial communities, but there is little consensus on how we sample and characterize these communities, and this has unknown consequences. Using root and leaf tissue from 20 showy milkweed (Asclepias speciosa) plants in the field, we compared two common sampling strategies by: 1) homogenizing after subsampling a small proportion of tissue (30 mg), and 2) homogenizing bulk tissue before subsampling 30 mg. Due to potential differences in richness and spatial distributions among microorganisms, we targeted bacteria, arbuscular mycorrhizal (AM) fungi and non-AM fungi in roots, as well as foliar fungal endophytes (FFE) in leaves. We also sampled FFE twice across the season using sampling strategy 1 to assess temporal dynamics, and we extracted DNA from all remaining homogenized bulk leaf tissues to determine the extent of potential undersampling. Bacterial richness was higher under sampling strategy 2, and all microbial groups except AM fungi differed in composition. Community overlap between the two sampling strategies increased when rare taxa were removed, but FFE and bacterial communities remained more different than alike and showed largely non-overlapping communities within individual plants. Increasing the extraction mass 10x also increased FFE richness ~10x, confirming the severe undersampling indicated in the sampling strategy comparisons. Even so, seasonal patterns in FFE communities were apparent, suggesting that strong drivers may be identified despite severe undersampling. Our findings highlight that current sampling practices poorly characterize many microbial groups and that increased sampling intensity is necessary to identify subtler patterns and to increase the reproducibility of studies.

IntroductionAs the novel coronavirus (2019-nCov) globally spreads, the coronavirus disease (COVID-19) pandemic is straining healthcare workers worldwide [1]. In hospitalized patients with severe COVID-19, endotracheal intubation is one of the most common and indispensable life-saving interventions. In a recent report from the City of New York, 12% of COVID-19 patients required invasive mechanical ventilation [2]. Since difficult weaning and prolonged mechanical ventilation represent the two most common indications for tracheostomy in Intensive Care Unit (ICU), it may play a central role in COVID-19 management [3]. During the 2019-nCov pandemic the aerosol generating procedures, such as tracheostomy, expose physicians at high risk to contract the \soutCOVID-19 infection [4]. Accordingly, special consideration may be done to protect otolaryngologists, general surgeons and critical care physicians from the risk of infection while performing a tracheostomy in COVID-19 patients [5]. Percutaneous tracheostomy (PT) is routinely performed at the bedside in intensive care unit (ICU); unfortunately, a modified protocol to perform PT in COVID-19 patients included several critical steps associated with increased risk of aerosol generation, such as changing the catheter mount, repositioning the endotracheal tube cuff to the level of the vocal cords and removal of large dilator [6]. So far, there has been no prior description in the literature of how to minimize the aerosol generation during PT. We reported a modified percutaneous tracheostomy technique aiming to minimize the risk of aerosol generation and to increase the staff safety in COVID-19 patients.

Fibroids are common in women of childbearing age. Ulipristal acetate, until recently was commonly used in the management of fibroids prior to surgery or embolisation. We present a case of a young woman who presented with a necrotic, prolapsing fibroid following a 12-week treatment with ulipristal acetate.

Data is limited or scarce in Indian children on food allergies and their incidence in India. We set to find out the incidence, prevalence, presenting symptoms and the common food allergens in our single center prototype study. To prove the non-existence of data we searched Scientific databases1,2. Literature review in PubMed/ Google scholar/med base using keywords “Food “ +“ allergy ”+”statistics “+ “children”+ “SAARC countries” didn’t reveal any results. Most of the papers related to food allergy were from the Western countries or they were anecdotal Indian data. The growing Indian population, increased usage of processed food, challenges posed by childhood obesity, reduced exposure to external triggers, rising cases of paediatric allergies makes it worthwhile to explore this rather grey area in India. Food allergies will have to be checked comprehensively and various parameters need to be critically analysed before lab- diagnosing food allergy. Increasing awareness in clinician’s diagnosis about food allergy and its existence has made us review different studies which have been done in the past few decades. It is an interesting fact to find that there has been no data published in India on this subject and we have attempted to look at an epidemiological cross sectional data of all children who presented with symptoms suggestive of Food allergy, Food protein induced Enterocolitis colitis syndrome or any other related symptoms there in our tertiary centre hospital at Chennai,Tamilndau,India.

Background: Although adolescent idiopathic scoliosis (AIS) is associated with decreased respiratory quality of life, it is unknown how AIS impacts distal lung microstructure. Recent reports indicate that alveoloalarization continues throughout adolescence, and human and animal studies have demonstrated the importance of mechanical forces on normal lung development. We therefore performed this pilot study hypothesizing that patients with AIS would have alterations in alveolar-airspace size, number, or structure compared to adolescents without AIS. Objective and Study Design: We conducted a prospective observational trial using hyperpolarized helium (HHe) MRI in control and adolescent idiopathic scoliosis (AIS) subjects to determine if AIS is associated with lung microstructural changes and whether posterior spinal fusion (PSF) impacts these changes. Methods We used hyperpolarized helium (HHe) and proton MRI to assess lung microstructure in 13 AIS and 16 control subjects aged 8-21 years. Clinical trial registration number NCT03539770. Results: At baseline, there were no significant differences in alveolar size, number, or alveolar duct morphometry between AIS and control subjects or between the concave and convex lungs of AIS subjects. At one year after PSF AIS subjects had an increase in alveolar density in the formerly convex lung (p=0.05), likely reflecting a change in thoracic anatomy, but there were no other significant changes in lung microstructure. Modeling of alveolar size over time demonstrated similar rates of alveolar growth in control and AIS subjects in both right and left lungs pre- and post-PSF. Conclusions: In this study, we found no evidence that AIS or PSF impacts lung microstructure.

Background: Rheumatoid arthritis (RA) is a systematic autoimmune disease with evidence of genetic predisposition. The IKZF1 (IKAROS family zinc finger 1 (Ikaros)) gene is located at chromosome 7, encodes a transcription factor related tochromatin remodeling, regulates lymphocyte differentiation, and is associated with some autoimmune diseases. However, there were few studies reported the association between IKZF1 and the risk of RA in China. For this, we determined to investigate the possibility of association between the IKZF1 locus and RA. Methods: we selected one single nucleotide polymorphisms (SNP) in the IKZF1 locus, rs1456893, based on a detailed analysis of genome-wide association study (GWAS) data and performed genotyping in 410 RA patients and 421 healthy controls in Han Chinese. We studied the systematic genome-wide interrogation of DNA methylation between RA group and control group and we also studied the association between CpGs and RA. Results: The results showed that the rs1456893 locus was correlated with RA in different models(P＜0.05). Through comparison with methylation levels determined in their equivalent healthy counterparts we have identified and validated a restricted set of CpGs that show distinct methylation differences between patients with RA and control group. The Multiple logistic regression results showed CpG_3 (OR=3.17,95%CI=1.05-9.60,P=0.041) and CpG_13.14(OR=4.96,95%CI=1.77-13.86,P=0.002)were associated with RA. Conclusion: IKZF1 can be used as a marker for the diagnosis of RA. Higher CpG_3 and CpG_13.14 methylation levels would increase the risk of RA.

Acute hepatopancreatic necrosis disease (AHPND) is an important bacterial disease occurring early after stocking shrimp fry in shrimp ponds with the mortalities of 100 %. AHPND leads to significantly drop in production and brings out huge economic losses worldwide. Thus, rapid, accurate, and convenient on-site detection method is urgent need to monitor the outbreak and spreading of AHPND especially for equipment-poor areas. Application of traditional PCR-based methods is restricted due to the dependence on laboratory equipment and technicians. In this study, an improved isothermal recombinase polymerase amplification (RPA) combined lateral flow strip (LFS) assay was developed for AHPND detection by introducing a probe. The specific primers and probe were designed based on the PirAB gene, chemical modifications were labelled to improve the specificity, and mismatched bases were made to eliminate primer-dependent artifacts. In combination with crude DNA extraction by boiling for 10 min, the RPA-LFS assay could be finished within 25 min at 37-45°C and results were readable by naked eyes. The exclusivity was validated to be no cross-reactivity with 10 other common vibrio spp strains. The inclusivity was verified using 10 other VPAHPND strains isolated from infected shrimps. The limit of detection was 101 colony forming unit (CFU)/mL or 102 copies/μL and 100 CFU/10 g after 2 hours enrichment in spiked shrimp samples. The detection accuracy was evaluated in a total of 75 collected shrimp and seawater samples, which was proven to be consistent with AP4. The established RPA-LFS method provides a rapid, accurate, sensitive and equipment-free approach for on-site detection of AHPND and technical references for monitoring other pathogens in cultivation industry.

This study is the first to demonstrate an atypical porcine pestivirus (APPV) HeN01 strain isolated from congenital tremor (CT) diseased piglets in Henan, Central China, indicating that APPV has spread north of the Yangtze River. The epidemiological monitoring of APPV and the health management of livestock in northern China should be increased to prevent outbreaks and animal loss. In addition, we successfully isolated APPV to provide a material basis for the development of APPV vaccines.

Panax notoginseng is a valuable traditional medicine in China, which could stanch the blood, disperse gore and reduce the pain caused by blood diseases. Understanding the accumulation dynamics of elements during the growth of PN is conducive to guiding rational fertilization in production. In this study, 17 elements (B, Na, Mg, Al, P, K, Ca, Cr, Mn, Fe, Co, Ni, Cu, Zn, Mo, Cd, and Pb) in PN from different periods were determined by ICP-OES and ICP-MS. The result showed that the change of element accumulation in different periods was consistent with the growth rule of PN. Element content in leaves and roots differed during the same period. Therefore, according to the changes of element content in different periods, scientific fertilization can be carried out to improve the quality and yield of PN. Besides, to study the accumulation characteristics of Panax in the same place, 17 elements in P. vietnamensis, P. stipuleanatus and P. bipinnatifidus were also determined by ICP-OES and ICP-MS. The result showed that P. vietnamensis and P. stipuleanatus exhibited more similar in elements than the P. notoginseng and P. bipinnatifidus. HCA and PCA analysis found that different Panax species can be distinguished based on element content.

Liquid-liquid phase separation (LLPS) of biomolecules has been investigated intensively in recent years, which underlies the formation of membrane-less organelles (MLOs) or biomolecular condensates. It contributes to the regulation of various physiological process and related disease development. Rapidly increasing number of studies have recently focused on the biological functions, driving and regulating mechanisms of LLPS in cell. Based on the mounting data generated in the investigations, six databases (LLPSDB, PhaSePro, PhaSepDB, DrLLPS, RNAgranuleDB, HUMAN CELL MAP) have been developed, designed directly based on LLPS studies or the components identification of MLOs. These resources are invaluable for deeper understanding of cellular function of biomolecular phase separation, as well as development of phase separating protein prediction and design. In this review, we summarize the data contents, annotations and organization for each of these databases, highlight their unique features, overlaps and fundamental differences, and further discuss their suitable applications.

Aims: This study was designed to demonstrate potential neuroprotective and autophagic activity of exenatide in rodent AD model. Methods: Thirty adult Sprague-Dawley male rats were divided into 3 groups (10 rats each); Group 1; control normal group, Group 2; AD pathological group, Group 3; exenatide treated group. All drugs were given intraperitoneal (IP) for 42 days. Behavioral changes using Morris water maze test has been evaluated, gene expressions of beclin-1 and the mammalian target of rapamycin (mTOR) in the hippocampus were assessed. Examination of hippocampal tissue using hematoxylin & eosin (H&E) stain and ultrastructural analyses were also done. Data were analyzed by using the statistical package for the social sciences (SPSS). Results: Exenatide alleviated both behavioral and pathological changes compared to pathological group. Exenatide treated group was found to improve autophagic activity by increasing beclin-1 and decreasing mTOR gene expression. Exenatide treatment significantly prevented hippocampal neuronal degeneration demonstrated by H&E. Moreover, accumulation of autophagic vacuoles in ultrastructure study of hippocampus, alleviated in exenatide group compared to pathological group indicating enhanced autophagic activity by exenatide. Conclusion: The results of the present study clearly indicated exenatide might have beneficial effects on impaired cognitive performance and hippocampal neuronal viability in AD by increasing autophagic activity. Increased beclin-1 seems to be the initiating player in this disease modifying effect and this supports the assumption of a disease modifying activity of exenatide through the autophagic activity.

Aims: A prolonged PR interval may adversely affect ventricular filling and therefore cardiac function. AV delay can be corrected using right-ventricular-pacing (RVP) but this induces ventricular dyssynchrony, itself harmful. Therefore, in intermittent heart-block, pacing-avoidance algorithms are often implemented. We tested His-bundle pacing (HBP) as an alternative. Methods: Out-patients with a long PR interval(>200ms) and intermittent need for ventricular pacing were recruited. We measured within patient differences in high-precision haemodynamics between AV-optimized RVP, and HBP, as well as a pacing-avoidance algorithm [Managed Ventricular Pacing (MVP)]. Results We recruited 18 patients. Mean left ventricular ejection fraction was 44.3±9%. Mean intrinsic PR interval was 266±42ms and QRS duration was 123±29ms. RVP lengthened QRS duration(+54 ms, 95%CI 42 to 67ms, p<0.0001) whilst HBP delivered a shorter QRS duration than RVP(-56 ms, 95%CI -67 to -46ms, p<0.0001). HBP did not increase QRS duration(-2ms 95%CI -8 to 13ms, p=0.6). HBP improved acute systolic blood pressure by mean of 5.0 mmHg(95%CI 2.8 to 7.1mmHg, p<0.0001) compared to RVP and by 3.5 mmHg(95%CI 1.9 to 5.0mmHg, p=0.0002) compared to the pacing avoidance algorithm. There was no significant difference in haemodynamics between RVP and ventricular pacing avoidance (p=0.055). Conclusions HBP provides better acute cardiac function than pacing avoidance algorithms and RVP, in patients with prolonged PR intervals. HBP allows normalisation of prolonged AV delays (unlike pacing avoidance) and does not cause ventricular dyssynchrony (unlike RVP). Clinical trials may be justified to assess whether these acute improvements translate into longer term clinical benefits in patients with bradycardia indications for pacing.

Abstract Background Childhood pneumonia, the most common disease of young, not only presents diverse challenges to healthcare providers and parents, but also carries the vast financial burden to medical care system. Using bibliometric analysis, we probed the pivotal strategic developments associated with costs of management of this disorder affecting millions of children worldwide and identified the research hotspots and trends over the time span of 50 years. Methods We retrieved relevant data from the Pubmed database in a range of 50 years from 1968 to 2018 using select medical subject headings. In addition, the research hotspots concerning the cost of childhood pneumonia using co-word clustering analysis and strategic diagrams were identified. Results A total of 1728 articles were retrieved for the specified time period and number of relevant publications trended to gradually increase. The authors from the USA contributed to the greatest number of articles. The Journal of Vaccine apparently published the most relevant articles. Madhi SA is the most prolific author from National Health Laboratory Service of University of the Witwatersrand in Johannesburg, South Africa, with a total of 8 papers. The keyword with the highest frequency was “pneumonia/epidemiology”, followed by “hospitalization/statistics &numerical data” and “pneumococcal vaccines/economics, respectively. Conclusion Research on the expenditure of childhood pneumonia covered a wide range of key subjects along with multiple hot topics. Among them, the epidemiology and hospitalization were prioritized in the studies conducted by various authors.

Abstract Purpose To distinguish healthy infants from potential patients right after birth using lungultrasound(LUS). Design, Setting and Patients This is a nested case-control study containing 22 lung diseases patients and 473 healthy infants from a total of 504 successive infants. They are admitted to Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China, from 1st January 2020 to 1st April 2020. A newly designed scanning protocol is used to capture LUS images. Sensitivity, specificity, PPV and NPV for predicting healthy infants and patients were calculated individually. The transition process image patterns and thier variation were shown. The relationship between clinic signs and the high-risk image patterns was calculated by Kendall’s tau-b test. Measurements and main results LUS images were captured and its preditive value has been caculated. Four low-risk patterns almost only can be seen in healthy infants(specificity=86.4%, PPV=99.0%) whereas four high-risk patterns can be seen both in healthy infants and patients(specificity=62.4%, PPV=9.6%). High-risk patterns are more likely to be pathological when appearing at oxter and lower back but to be a physiological sign when appearing at Lower and upper of the prothorax. These high-risk patterns are significantly related to clinic sign. All these patterns are alsmost consistent during 6 hours after birth. Conclusions LUS is valid to differentiate healthy infants from potential patients who with mild respiratory difficulty. Four low-risk patterns have high value to predict healthy infants, but four high-risk patterns are not specific enough to discover patients. This criterion is valid for this 6 hours stage.

Background: The maximal static respiratory pressure (MRP) assessment is vital for both clinical reasoning and respiratory system growth and development. The predicted normal values of maximal inspiratory pressures (PImax) and maximal expiratory pressures (PEmax) published for the western population may not be appropriate for Indian children because of the ethnic difference and large inter-subject variations of PImax and PEmax values. Objective: The purpose of the study was to establish normative values of MRP in healthy children aged 8-12 years. Methods: A cross-sectional study was conducted among nine government and public schools of Bangalore, India. We assessed the anthropometric measures (height, weight, BMI, waist-hip ratio, pulmonary function tests) and MRP for 887 children (490 boys and 397 girls) following guidelines by American Thoracic Society/European Respiratory Society. Results and conclusion: The mean of PImax and PEmax were 60.83+19.5 and 62.26+18.13 cmH2O, respectively. The mean of PImax was relatively lower by mean of 15.32 cmH2O when compared from Brazilian, 12.2 cmH2O from Mexican, and 16.23 cmH2O from the Australian population. Similarly, the mean of PEmax of the current study was relatively lower by mean of 27.625 cmH2O when compared from Brazilian, 21.845 cmH2O from Mexican, and 24.365 cmH2O from the Australian population. This states that ethnicity has a strong influence on respiratory muscle strength. Thus, the study provides the normative data for maximal static respiratory pressures for healthy children aged 8-12 years in Bangalore, India