Introduction: Early recurrence (ER) of atrial fibrillation (AF) is defined as the recurrence of atrial tachyarrhythmias within 3 months after AF ablation, however, this definition is based on data from the era of radiofrequency catheter ablation (RFCA), without contact force (CF) technology. We investigated the significance of ER as a risk factor for late recurrence (LR) in paroxysmal AF (PAF) patients treated with CF and non-CF-guided ablation. Methods and Results: We studied 395 patients with PAF who underwent RFCA. Of these, 97 patients underwent RFCA without CF technology (Non-CF group) and 298 underwent with CF technology (CF group). Over a 2-year post-ablation follow-up period, LR occurred in 54 of 97 (55.7%) patients in the Non-CF group, and in 105 of 298 (35.2%) patients in the CF group. ER had a more significant relationship with LR in the CF than in the Non-CF group, and all patients in the CF group with ER in the 3rd month developed LR. Conclusion: ER in PAF patients who have undergone CF-guided ablation have a greater risk of LR than those who have undergone non-CF-guided ablation. ER in the 3rd month after CF-guided ablation may indicate an absolute risk of LR. Blanking period could be defined as 2 months in the CF era.

A modern implantable pulse generator is equipped with an automatic capture management (ACM) program that provides reliable pacing threshold management and potential device longevity benefit. However, an accurate His bundle pacing (HBP) lead threshold value is not always the same as the ACM algorithm measurement. We reported a patient who presented with a high ventricular pacing output that caused shortening of device longevity because of the wrong ACM algorithm HBP threshold measurement. Because of the time interval between pacing stimulation and the ventricular electrogram during HBP, the ACM algorithm considers “pacing capture loss” despite His bundle capture. The ACM algorithm overestimates an accurate HBP threshold and unnecessarily changes pacing parameters to high ventricular pacing output. A routine change in the ACM algorithm from “adaptive” to “off or monitor” is needed to conserve device longevity.

Spontaneous coronary artery dissection(SCAD) is a rare cause of acute coronary syndrome(ACS) with medical management and conservative therapies usually resulting in favorable outcomes. SCAD often is recurrent especially in high risk individuals with underlying connective tissue disorders. Lethal ventricular arrhythmias have been reported in SCAD without clear indications for secondary prevention with implantable cardiovert-defibrillator(ICD). Depending on risk factor for recurrence as well as susceptibility towards ventricular arrhythmias some patients may benefit from early implantations of ICDs.

The interesting article published on this issue by Helen Perry et al (BJOG 2020 xxxx) is an important contribution to the idea demonstrated several years ago with echocardiographic evaluation of maternal central parameters, that the blood pressure value alone is not useful to understand the degree of compromise of the maternal condition in the evaluation of gestational hypertension and Preeclampsia (Valensise H et al. BJOG. 2006 Sep;113(9):1044-52. Epub 2006 Jul 7). The authors present an elegant study in which the evaluation of the maternal cardiovascular parameters obtained through non-invasive methods (Continuous Waveform Doppler USCOM) show major differences in cardiac output, systemic vascular resistances and heart rate in those patients with the diagnosis of Preeclampsia with a reduced fetal growth.These findings open two lines of research that needs to be implemented on the future: the first is linked to the possibility to identify ‘personal targeted therapy’ according to the parameters found to ameliorate the placental perfusion and fetal growth increasing the heart rate when below the normal values, reducing the systemic vascular resistances and increasing the plasma volume so as to try to bring back to normal the cardiocirculatory conditions (Valensise H et al. Ultrasound Obstet Gynecol. 2008 Jan;31(1):55-64).The second most important research line has to concentrate to the maternal circulatory condition before pregnancy (Vasapollo B et al. Am J Obstet Gynecol. 2020 Mar 3. pii: S0002-9378(20)30234-9. doi: 10.1016/j.ajog.2020.02.043) that in high risk pregnancies might induce not only an automatic passive calculation of the risk factors, but an active therapy based on the modifications of the maternal cardiac parameters to bring them back to normal as much as possible to PREVENT the appearance of the abnormal adaptation to pregnancy.In the future maternal health control in pregnancy will not be possible without the knowledge of maternal cardiac hemodynamics before pregnancy, in the first and second trimester, and at the appearance of hypertension or signs of fetal growth restriction. For this reason the implementation of clinical research with the use of non-invasive devices accessible to any doctor need to be recommended.No disclosures: A completed disclosure of interest form is available to view online as supporting information.

β-lactamase represents a serious challenge for treatment and public health, extended-spectrum β-lactamase (ESBL) producing Klebsiella pneumoniae clones have been increasingly reported worldwide.However, little is known about the prevalence and biological characteristics of drug-resistant strains in zoos.During a routine surveillance at in Zhengzhou zoo of China, we reported firstly that the Klebsiella pneumoniae isolate from healthy Red Kangaroos (Macropus Rufus) showed severe MDR, especially resistant to Cefuroxime Sodium (MIC, >64 μg/ml), Ceftriaxone (MIC, >8 μg/ml) and Cefepime (MIC, >64 μg/ml) and belonged to ST290. The whole genome sequencing showed that Chrome Chr-M297-1 harbored blaDHA-3, blaSHV-1, blaCTX-M-14, FosA5, dfrA3, sul3 etc., pM297-1.1(222,864bp, IncFIB(K)) carried 9 antimicrobial genes including blaCTX-M-14 , blaTEM-191, APH(3’‘)-Ib, APH(6)-Id and QnrS1 etc., and pM297-1.2 (225,763bp, IncFII(K)) carried 22 antimicrobial genes including blaTEM-1, blaCTX-M-3, APH(3’)-Ia, AAC(3)-IIa, AAC(6’)-Ib-cr, aadA16, QnrB2, QnrS1, QacEΔ1, mphA, sul1, dfrA27, etc. Traceability analysis revealed that these two plasmids are highly similar to those recovered from human clinical samples in some southern cities in Sichuan Province, China(> 99%), suggesting the spread and distribution of these plasmids in China. Furthermore, two plasmids harboring conjugal transfer genes facilitate the transmission of antimicrobial genes by conjugation with E.coli J53. Our research shows that the transmission and adaptation of Klebsiella pneumoniae producing ESBLs in zoo environment, suggesting that the zoo is gradually becoming an important potential reservoir of clinically important drug-resistant genes.Therefore, it is necessary to strengthen the monitoring of the emergence and spread of drug-resistant strains in zoo environment in captive wild animals.

The novel coronavirus (COVID-19) is a kind of viral pneumonia and emerging pathogen that causes a severe respiratory infection in humans. The research on COVID-19 is still in the primary stage and international attention has raised to develop treatment option. The main death cause of COVID-19 is acute respiratory distress syndrome (ARDS). The main mechanisms for ARDS is the cytokine storm that release the large amounts of pro-inflammatory cytokines. The other corona virus such as, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cause to reduction of CD4+ and CD8+ T cells in the peripheral blood of infected patients. Some medicinal plants produce essential oils that are used in traditional and modern medicine, and in the food, cosmetics, and pharmaceutical industry. We aimed to summarize the possible therapeutic effects of Nigella sativa and its constituents, thymoquinone based on immunomodulatory effects on COVID-19. The databases including; Web of Science (ISI), PubMed, Scopus and google scholar were used to search for keywords such as, COVID-19, Nigella sativa, thymoquinone, Antivirus, and Immunomodulatory effects. N. sativa extract and thymoquinone (TQ) reduced the level of cytokines including; IL-2, IL-4, IL-6, and IL-12, while enhanced IFN-γ in the bronchoalveolar lavage fluid and serum. They also increased the serum levels of IgG1 and IgG2a. N. sativa and TQ decreased T helper 2 (Th2)/Th1 and Th2/ Regulatory T cells (Tregs) ratios due to elevation of IL-10 but suppression of IL-4. Then this medicinal plant and its constituents might be beneficial effects in control and treatment of COVID-19.

Objective In China, H9N2 avian influenza viruses were first reported in chickens in Guangdong province in the mid-1990s. Subsequently, the viruses spread to most regions nationwide, where they became panzootic and endemic. Based on environmental surveillance of live poultry markets in Anhui province from 2013 to 2018, a total of 33 representative environmental isolates were selected and studied systematically. Methods The genomic RNA of Anhui H9N2 isolates was subjected to RT-PCR amplification followed by sequencing analysis. Results Thirty-three strains were isolated from the embryonated eggs of specific-pathogen-free chickens. Phylogenetic analysis indicated that h9.4.2.5-like H9N2 viruses were predominant during 2013--2018 and acquired multiple specific amino acid mutations that may have increased their affinity for mammals and enhanced their infectivity and transmissibility. Additionally, six internal genes of H9N2 clustered together with the novel human-lethal reassortant viruses, such as low pathogenicity H7N9, H10N8 and Anhui H5N6 viruses, and even HPAI H7N9. Conclusion Because H9N2 viruses may be the donors of internal genes that lead to the generation of novel reassortant viruses with enhanced pathogenicity in Anhui province, continuous environmental surveillance of live poultry markets, a key source of reassorted H9N2 and other avian influenza viruses, is of great importance.

Graphene quantum dots (GQDs), the latest member of graphene family, have attracted outstanding interest in the last few years, due to their outstanding physical, chemical, electrical, optical and biological properties. Their strong size-dependent photoluminescence (PL) and the presence of many reactive groups on the graphene surface allow their multimodal conjugation with therapeutic agents, targeting ligands, polymers, light responsive agents, fluorescent dyes, and functional nanoparticles, making them valuable agents for cancer diagnosis and treatment. In this review, the very recent advances covering the last three years on the applications of GQDs as drug delivery systems (DDS) and theranostic tools for anticancer therapy are discussed, highlighting the relevant factors which regulate their biocompatibility. Among these factors, the size, kind and degree of surface functionalization have shown to greatly affect their use in biological systems. Toxicity issues, which still represent an open challenge for the clinical development of GQDs based therapeutic agents, are also discussed at cellular and animal levels.

The world faces an exceptional new public health concern caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), subsequently termed the coronavirus disease 2019 (COVID-19) by the World Health Organization (WHO). Although the clinical symptoms mostly have been characterized, the scientific community still doesn´t know how SARS-CoV-2 successfully reaches and spread throughout the central nervous system (CNS) inducing brain damage. The recent detection of SARS CoV-2 in the cerebrospinal fluid (CSF) and in frontal lobe sections from postmortem examination have confirmed the presence of the virus in neural tissue. Here, we discuss the COVID-19 outbreak in a neuroinvasiveness context and suggest the therapeutic use of high doses of melatonin, which may favorably modulate the immune response and neuroinflammation caused by SARS-CoV-2. However, clinical trials elucidating the efficacy of melatonin in the prevention and clinical management in the COVID-19 patients should be actively encouraged.

Background and Purpose: The neurocognitive benefits of donepezil are well recognised, but the potential side effects on cardiac conduction remain unclear. Our objectives are to investigate whether long-term donepezil therapy is associated with electrocardiographic (ECG) changes and in particular to assess its effects on the QT interval. Experimental approach: We conducted a single centre retrospective analysis of patients admitted to our institution on donepezil therapy over a 12-month period. 59 patients were identified as suitable for analysis. An admission resting 12-lead ECG was obtained and compared to their ECG prior to commencement of donepezil therapy to assess for any significant difference in ECG parameters. Key Results: Donepezil significantly prolonged the PR (P=0.04), QRS (P=0.04) and QT (P=0.002) intervals. The increase in QT intervals remained significant on correction for heart rate; resulting in 8 (13.6%) patients developing high arrhythmogenic risk based on assessment using QT nomogram plots. Concomitant use of tricyclic antidepressants was associated with significant QT prolongation, while use of rate limiting calcium channel blockers was associated with significant PR prolongation, and beta-blockers with reduction in heart rate. Conclusion and Implications: Our results clearly demonstrate that long-term use of donepezil results in prolongation of the QT interval. We suggest ECG evaluation should take place before and after donepezil initiation, and clinicians should be even more vigilant in those prescribed tricyclic antidepressants.

Maternity and Gynaecology services during COVID-19 crisis in Jordan: Challenges and solutionsIbrahim Alsharaydeh1 , Hasan Rawashdeh2 , Noura Saadeh3 , Basil Obeidat4, Nail Obeidat51 Assistant professor, consultant of Obstetrics & Gynaecology. Jordan University of Science& Technology2 Assistant professor, consultant of Obstetrics & Gynaecology, Jordan University of Science& Technology3 Speciality trainee, Obstetrics & Gynaecology, King Abdullah University Hospital4 Professor, consultant of Obstetrics & Gynaecology, Jordan University of Science & Technology5 Professor, consultant & Dean of faculty of medicine, Jordan University of Science & TechnologyCOVID-19 pandemic has spread all over the world over the last few months. COVID-19 is an infectious condition and can spread, directly or indirectly, from one person to another. It involves the respiratory tract system and is caused by the newly discovered corona-virus, known previously as “2019 novel coronavirus”, first identified in Wuhan, China, in December 2019. As of April 30. 2020, nearly 3,200,000 people across the globe have been infected with this virus with approximately over 230,000 confirmed deaths globally.[1][6]Jordan is a Middle-Eastern country with approximately 10 million people, it is considered an upper-middle-income country, according to the World Bank. According to the Centre for Systems Science and Engineering (CSSE) at Johns Hopkins University[1] and world health Organization (WHO) website[2], the first case in Jordan was reported on March the 2nd, 2020. The total number of COVID-19 confirmed cases in Jordan as of April 30th, was 451 (Figure 1), with 8 deaths, 5 patients in critical condition, and 362 patients having recovered from the disease.The Jordanian government made swift changes to address this crisis. Starting March 14th, 2020, Jordan suspended study in schools and universities, stopped gatherings in places of worship, closed its borders, and stopped all incoming and outgoing flights. This was later followed by an enforced complete lockdown (curfew). Five thousand Jordanians— who later flew into Jordan—were placed in quarantine in hotels in the Dead Sea region and in Amman for 14 days. The Ministry of Health assigned a few major hospitals in Jordan as referral centres for patients with COVID-19; one in the north, which is our hospital -King Abdullah University Hospital (KAUH)- and others in the middle and southern parts of the country.Our institution, KAUH, is a tertiary canter with 683 beds, expandable to 800 beds during emergencies[3]. It is the teaching hospital affiliated with Jordan University of Science and Technology (JUST) School of Medicine, one of the leading medical schools in Jordan and the region[4]. KAUH is the only referral centre for COVID-19 cases in the north of Jordan, serving five big cities (a total of 3-4 million people). As of April the 30th, 2020, we treated about 103 patients diagnosed with COVID-19.As the government announced the emergency state and later the lockdown, KAUH outpatient clinics were closed, and elective procedures and surgeries were rescheduled. The Obstetrics and Gynaecology department at King Abdullah University Hospital has made multiple adjustments to confront COVID-19 challenges. Challenges including; patients limited mobility as a result of curfew, limited number of medical and nursing staff and limited access to theatres, imaging services, blood banks and laboratory services. Therefore, we implemented changes at 4 levels: Patient care, Staff governance, Residency programmes and Medical student teaching programme.

Objective To explore the impact of the COVID-19 pandemic on mental health of Obstetricians and Gynaecologists Study Design We performed a survey-based study from doctors working in the field of Obstetrics and Gynaecology across all Hospitals in United Kingdom. Surveyed information included demographics, past history of mental health conditions, screening for current symptoms of depression and anxiety, the significance of contributory factors and the effects of mental health on workplace behaviour. Results 207 doctors completed the survey. Of the respondents, 22.2% (n=46) had previously received treatment for a mental health condition. During the COVID-19 pandemic, O&G doctors as compared to UK-wide population estimate, reported significantly higher rates of both Major Depressive Disorder (15.94% versus 3.3%, p=0.023) and Generalised Anxiety Disorder (24.64% versus 5.9%, p=0.044). Sub-group analysis showed that anxiety was more common amongst female doctors as compared to males (27.5% versus 12.50%, p=0.047). Respondents felt that the most significant factors for work-related changes to mental health was keeping up to date with frequently changing guidelines and protocols related to COVID-19. Only 38.65% of respondents agreed that they felt able to talk to colleagues about their mental health. Conclusions This is the first reported study that assesses the impact of COVID-19 on mental health amongst Obstetricians and Gynaecologists. Further research should focus on assessing if changes in the way rapidly changing guidelines and protocols are disseminated reduces the impact on mental health. Ongoing efforts are also needed to improve support networks and encourage normality around discussing mental health amongst doctors

Abstract Background: Cystic fibrosis may lead to left ventricular dysfunction. This dysfunction can be documented by methods such as tissue doppler echocardiographic imaging and two-dimensional speckle tracking echocardiography in early stage. Patients and Methods: A total of 34 patients diagnosed with cystic fibrosis (mean age and SD 9.9±4.9 years) and 37 healthy control subjects with a comparable gender and age distribution (mean age 9.8±4.3) were studied. The results for the two groups were compared along with the results of published reports. Result: Control group had higher diastolic and systolic dimentions compared to the patient group in M-mode measurements of left ventricle by conventional echocardiography (p <0.05). There was no significant relationship between the groups in terms of the dimensions of systolic and diastolic measurements of interventricular septum and posterior wall of left ventricle, and ejection fraction. Pulmonary artery systolic pressure was significantly higher in the patient group (p<0.001). Myocardial performance indices of left ventricle free wall and interventricular septum were increased in the patient group compared to the control group (p<0.05). ). As measured by speckle tracking echocardiography, 7 segments in left ventricular myocardial longitudinal strain and 3 segments in left ventricular myocardial circumferential strain showed significant reductions in patients with cystic fibrosis compared to controls (p <0.05). Conclusions: Tissue doppler echocardiographic imaging and speckle tracking echocardiography may help identifying subclinical left ventricular dysfunction in cystic fibrosis patients with unremarkable conventional echocardiography. Its may be considered for the routine follow-up of cystic fibrosis patients.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged as a serious health problem worldwide. In the pediatric population, currently available epidemiological data seem reassuring as the incidence of coronavirus disease 2019 (COVID-19) is much lower than in adults, with less critical cases and very few deaths. At present, there are no evidence-based studies on chest imaging in pediatric COVID-19. Chest X-rays showed non-specific findings and chest computed tomography (CT) exhibited similar, but fairly less severe CT changes compared to adult. Moreover, in approximately 50% of pediatric patients no correlation was found between chest CT imaging results and clinical characteristics. Lung ultrasound is rarely used, despite its unquestionable benefits as it can be performed at bed-side with a portable device, which minimizes virus transmission, is cheap and can be easily repeated. In conclusion, the chest imaging use in children, who are typically spared from severe infection, deserve recommendations different than adults also considering the increased risk of radiations exposure. In view of this, pediatric comparative studies among different chest imaging techniques, either less or more invasive, are urgently needed possibly after standardization of interpretation criteria of lung ultrasound.

Abstract Background and purpose: To investigate the effect of hIgDFc-Ig (DG), a new biological agent targets competition for binding to IgD receptors, on collagen-induced arthritis and its potential mechanism in regulating B cell antigen-receptor signaling pathway. Experimental approach: DBA1 mice were used to establish collagen-induced arthritis model, three doses DG were administered by intraperitoneal injection. Clinical assessment of CIA, histopathological examination, flow cytometry, western blotting, immunofluorescence staining, protein chips and so on were used to evaluated therapeutic effects. The competitive effects on BCR-NF-κB signaling pathway were also evaluated in Daudi cell lines in vitro. Key results: We found that DG has a obvious therapeutic effect on CIA mice. DG relieved the clinical assessment of CIA mice and improved the pathology of joints and spleen. In addition, regulated B cell subsets in the PBMC and spleen of CIA mice, and decreased level of immunoglobulins. DG can inhibit the over-activation of BCR signal by increasing p-Lyn level, Co-treatment with DG (0.1-10 μg·ml-1) dose-dependently down-regulated the BCR signaling and decreased the iteraction between Syk and Btk stimulated by IgD in Daudi cell. Conclusion and Implications: DG may play a therapeutic role in CIA mice by regulating BCR-Lyn-Syk-NF-KB signaling pathway, and may be a new promising biological agent for rheumatoid arthritis. Key words: hIgDFc-Ig; B cell antigen receptor; Collagen-induced arthritis; NF-κB signaling pathway

SARS-CoV-2 not only causes viral pneumonia but has major implications for the cardiovascular system. Nevertheless, we assisted to a drastic reduction in the number of ACS during this period. Telemedicine and telecardiology, intended as integration to the traditional management appear precious tools especially in Covid-19 era. Given the decrease in new Covid-19 cases worldwide20, now we are approaching the so-called “Phase 2” challenge of a gradual return to pre-Covid-19 life. The epidemiological and clinical situation is rapidly evolving and practice patterns with policies depend on institutions and local availability.

The complement system is an ancient part of innate immunity sensing highly pathogenic coronaviruses by Mannan-binding lectin resulting in lectin pathway-activation and subsequent generation of the anaphylatoxins (AT) C3a and C5a as important effector molecules. Complement deposition in endothelial cells and high blood C5a serum levels have been reported in COVID-19 patients with severe illness, suggesting vigorous complement activation leading to systemic thrombotic microangiopathy (TMA). Strikingly, SARS-CoV-2-infected African Americans suffer from high mortality. Complement regulator gene variants prevalent in African Americans have been associated with a higher risk for severe TMA and multi-organ injury. These findings allow us to apply our knowledge from other complement-mediated diseases to COVID-19 infection to better understand severe disease pathogenesis. Here we will discuss the multiple aspects of complement activation, regulation, crosstalk with other parts of the immune system and the options to target complement in COVID-19 patients to halt disease progression and death.

Coronavirus disease 2019 (COVID-19), an infectious disease caused by the novel coronavirus SARS-CoV-2, represent an ongoing global health emergency. Common symptoms are mild including fever, cough, myalgia and difficulty breathing. In patients most severely affected, COVID-19 can be complicated by the acute respiratory distress syndrome (ARDS). The management of ARDS mainly focuses on the provision of supportive care, e.g., oxygenation, ventilation, and fluid management. Polyethylene glycol (PEG) is a water soluble non-toxic polymer approved by FDA and widely used in food, cosmetics and pharmaceutics. PEG has interesting properties that makes it suitable for use as an adjuvant treatment in COVID-19 patient with ARDS: (1) PEG could create a physical barrier that inhibits virus entry and invasion; (2) PEG reduces inactivation and enhances the surface activity of pulmonary surfactant; (3) PEG decrease cytokine release and (4) PEG preserve lung endothelial cells integrity.

Quando si parla di sito contaminato ci si riferisce a sostanze che hanno causato un’alterazione del suolo, sottosuolo o acque sotterranee: le cause principali possono attribuirsi alla gestione incontrollata dei rifiuti, alla non corretta realizzazione delle discariche, ad alcune attività industriali (attività minerarie), a rilasci cronici o accidentali nel sottosuolo di sostanze tossiche e cancerogene. Tra queste ultime, particolare attenzione è stata rivolta ai BTEX, idrocarburi aromatici non alogenati che vengono riscontrati nei prodotti del petrolio, in seguito ad attività di estrazione, distribuzione e raffinazione. Il Soil Vapor extraction (SVE) è una delle tecnologie più efficaci per l’abbattimento di tali sostanze. L’obiettivo di questo approfondimento è quello di effettuare un confronto tra il SVE e la combinazione dello stesso con la Bioremediation, analizzando, a partire da un primo caso studio, i principali fattori (caratteristiche dei contaminanti, del suolo e condizioni operative) che influenzano i tempi di processo e l’efficienza del SVE per la rimozione del benzene, e di BTEX più in generale, da terreni sabbiosi. Mediante un secondo caso studio, poi, è stata approfondita la combinazione del SVE con la Bioremediation, un’innovativa tecnica biologica che ha permesso più elevate efficienze di rimozione del benzene.

A 35-year-old male with history of recurrent arrhythmias presented for pulmonary vein isolation. He underwent pre-procedural screening for thromboembolism risk with transesophageal echocardiogram. He had an incidental finding of a rare fenestrated membrane overlying his left atrial appendage. Additional work-up throughout his clinical course revealed genetic mutations in the LMNA and SNTA1 genes. There have been no previous reported genetic mutations reported in cases with LAA membranes.

Aicardi Syndrome (AS) is a rare and severe neurodevelopment disorder, usually involving the female gender and characterized by hypogenesis of the corpus callosum, ocular abnormalities (chorioretinal lacunae), a severe, drug-resistant epilepsy, intellectual disability, costovertebral anomalies, other brain malformations and mild facial dysmorphism. The genetic cause of AS has never been found. We report on a female patient, affected by AS spectrum and presenting the classic triad (hypogenesia of the corpus callosum, choriorentinal lacunae, drug-resistant epilepsy) and other brain malformations (polymicrogyria, cortical dysplasia, heterotopias and asymmetric ventricles). A NGS-panel for epilepsy and brain malformations disclosed a compound heterozygosis in DCHS1 gene, which is the cause of Van Maldergem syndrome, characterized by severe face dysmorphism, skeletal abnormalities, respiratory tract malformations and severe brain involvement. We hypothesize that the phenotype of this AS patient may be caused by variants in DCHS1 gene and that the two syndromes may share common genetic causes. Interestingly, DCHS1 is located in proximity to TEAD1 (chromosome 11p15), reported as causative of AS in a single patient, and both the proteins are involved in the hippo-pathway (which regulates cellular growth and apoptosis). Alternatively, the patient could present a new subtype of Van Maldergem Syndrome, without face dysmorphism and skeletal abnormalities.

Based on the analysis of CpxP genes among Escherichia coli strains, CpxP gene-targeting short guide RNA (sgRNA) was designed and inserted into the pGL3-MGP-RNA. The donor sequences (MG-HR) for homologous repair were designed and cloned by PCR. MG-HR and pGL3-MGP-RNA were transformed into E. coli MG1655 (pCas9). The CpxP gene expression cassette was amplified by PCR and subcloned into pBBR1MCS-2. Then the pBBR-CpxP was independently transformed into E. coli MG1655. The results of motility experiment suggest that CpxP gene had a significant effect on the movement ability of E. coli strain. The CpxP protein had a significant inhibition of bacterial activity. The lastest 81 CpxP proteins sequences were selected and analyzed by multi-sequence alignment and molecular cluster. The CpxP proteins were roughly divided into three categories. Our results suggest that the CpxP protein was involved in bacterial motility, infection and pathogenicity.

IntroductionMedical treatment of endometriosis ranges from symptomatic control to therapies aimed at suppressing the ovarian production of estrogen. Almost all the treatment strategies are suppressive rather than curative so that the discontinuation of therapy leads to recurrence of symptoms. In 2009 a systematic review of literature estimated the recurrence rate of endometriosis to be 21.5% and 40-50% within two and five years, respectively(1), which is much more prevalent than previously believed. Regrowth of residual lesions and de novo lesion formation are possible pathogenesis mechanisms leading to the recurrence of endometrial lesions. Radical surgery means the elimination of all possible endometriosis implants detected in pelvic and abdominal cavity, that is sometimes insufficient to radically remove these lesions; therefore, lesions often reappear postoperatively. Medical treatment options such as the application of gonadotropin-releasing hormone agonist (GnRH-a) plays an essential role in the management of endometriosis by reducing estrogen levels in order to promote the progressive atrophy of an ectopic endometrium(2).Our objective was to introduce a less invasive and low risk management strategy to prevent the recurrence of endometriosis through combination therapy. In this novel management approach, GnRH-a pre-treatment is used to reduce inflammations as well as endometriosis attachments, after diagnosis and staging of endometriosis through laparascopy.

Comparison of protein sequence similarity is a significant study. By virtue of this method, we can expose the evolutionary relationship among protein sequences. So, it is required to design effective computational algorithms that can compare the similarities among the colossal amount of sequences. The aim of this research is to develop efficient tools in the field of protein sequences comparison and phylogenetic study. The proposed method performs a feature generation process based on the physio-chemical properties of amino acids that best describes the revolutionary relationship among the species in a protein family. The protein sequences are transferred into an Eighty dimensional feature vector among the group of amino acids. Finally, four different datasets were used to validate the accuracy of the proposal and a correlation coefficient of 0.94417 of ND5 dataset using ClustalW has been found. This is much higher than some of the methods. At last the result explains the effectiveness in the similarity analysis among genome sequences.