As an aerosol and droplets generating procedure, tracheostomy increases contamination risks for health workers in the coronavirus disease context. To preserve the health care system capacity and to limit virus cross-transmission, protecting caregivers against coronavirus infection is of critical importance. We report the use of external fixator equipment to set up a physical interface between the patient’s neck and the caregiver performing a tracheostomy in COVID-19 patients. Once the metal frame set in place, it is wrapped with a single-use clear and sterile cover for surgical C-arm. This installation is simple, easy and fast to achieve and can be carried out with inexpensive material available in every hospital. This physical interface is an additional safety measure that prevents the direct projection of secretions or droplets. It should, of course, only be considered as a complement to strict compliance with barrier precautions and personal protective equipment.

The mode of inheritance and evolutionary consequences of heritable information associated with general causal cycles is discussed. It is suggested that the importance of such information may have been underestimated particularly as a cause of morphological differences between species. The problem of obtaining evidence for these speculations is considered.

Referee #1 (Report will be published at publication of the article)

Dear Editor,Since December 2019, coronavirus 2019 (COVID-19) has spread worldwide.1 Some data have suggested that the prevalence and mortality of COVID-19 are different among races. 2However, this analysis did not account for potential confounding factors.Since chronic kidney disease (CKD) is common, the number of COVID-19 patients with CKD will increase. However, there are scarce data about outcomes in CKD patients. We herein investigated the outcomes from COVID-19 in AAs compared to those in whites.We analyzed Mount Sinai Health System (MSHS) medical records up to April 5, 2020, using Epic SlicerDicer software. We extracted data from patients who had positive for the COVID-19 reverse-transcription polymerase chain reaction (RT-PCR) test. Sex, age, race, and comorbidities (hypertension, diabetes mellitus, ischemic heart disease, heart failure, and atrial fibrillation) were extracted using the 10th revision of the International Statistical Classification of Diseases code. Mortality and intensive care unit (ICU) admission were tracked through April 12, 2020. Relative risks (RR) and 95 % confidence interval (CI) in each race stratified by age groups and comorbidities were calculated using a Fisher’s exact test. MSHS waived Institutional Review Board approval since this research used only deidentified, aggregate-level data.During the study period, 1,269 AAs COVID-19 patients with 105 CKD patients and 1,450 whites COVID-19 patients with 80 CKD patients were detected. AAs were younger (median 66, IQR 55-76) than whites (median 75, IQR 65-83) (p< 0.001). There was no significant difference in mortality between AAs and whites (0.65 [0.36-1.15]). This tendency was observed after stratification by age and medical conditions. Similarly, AAs did not have an increased risk of ICU admission (0.84 [0.6-1.18])) even after stratification by age and comorbidities (Table).To the best of our knowledge, this is the first study that compared the risk of severe outcomes among races in CKD patients. Although it has been suggested that there might be racial disparity in COVID-19, our study did not show any significant differences in outcomes, even after stratifying patients by age and comorbidities. Our data suggested that we do not need to stratify these patients by race.The racial and ethnic diversity in NYC enabled us to investigate differences in outcomes among races in the same cohort. However, our study has several limitations. First, the number of patients was relatively small. Second, we did not access individual data, which prevented us from performing multivariate analyses. The fact that AAs were younger might mask differences among races.In conclusion, AAs with CKD did not have a higher risk of mortality or ICU admission than whites with CKD. This trend was consistent after stratification by age, sex, or comorbidities.Acknowledgements: noneConflict of Interest Disclosures: TY reports no conflict of interest. TM reports no conflict of interest. NC reports no conflict of interest. HM reports no conflict of interest. SC repots no conflict of interest. SM reports no conflict of interest.Reference1. Team CC-R. Preliminary Estimates of the Prevalence of Selected Underlying Health Conditions Among Patients with Coronavirus Disease 2019 - United States, February 12-March 28, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(13):382-386.2. Health N. Age adjusted rate of fatal lab confirmed COVID-19 cases per 100,000 by race/ethnicity group as of April 6, 2020 (Accessed Aprio 12, 2020). 2020.

Purpose: The classical taxanes (paclitaxel, docetaxel), the newer taxane cabazitaxel and the nanoparticle-bound nab-paclitaxel are among the most widely used anticancer drugs. Still, the optimal use and the value of pharmacological personalization of the taxanes is still controversial. Methods: We give an overview on the pharmacological properties of the taxanes, including metabolism, pharmacokinetics-pharmacodynamic relations and aspects in the clinical use of taxanes. The latter includes the ongoing debate on the most effective and safe regimen, the recommended initial dose, and pharmacological dosing individualization. Conclusions: The taxanes are among the most widely used anticancer drugs in patients with solid malignancies. Despite their longtime use in clinical routine, the optimal dosing strategy (weekly versus 3-weekly) or optimal average dose (cabazitaxel, nab-paclitaxel) has not been fully resolved, as it may differ per tumor entity and line of treatment. The value of pharmacological individualization of the taxanes (TDM, TCI) has partly been explored for 3-weekly paclitaxel and docetaxel, but remains mostly unexplored for cabazitaxel and nab-paclitaxel at present.

Background: Macrophages play a crucial role in the pathogenesis of rheumatoid arthritis (RA). Growth differentiation factor-15 (GDF-15) acts as an autocrine regulator of macrophage activation. Objective: The aim of this study was to assess serum level of GDF-15 as a potential biomarker for detecting RA activity. Method: A total of 100 female RA patients and 55 age matched healthy control females were enrolled. The serum level of GDF-15 was measured using enzyme-linked immunosorbent assay by an eBioscience kit. Results: Serum levels of GDF-15 in RA patients with high, moderate, low and no disease activity were 989.0±161.9, 505.6±220.5, 349.2±155.9 and 349.0±144.0 pg/ml, respectively. GDF-15 with a cut-off value higher than 705 pg/ml was indicative of high RA activity with sensitivity of 96% and specificity of 92%. Conclusion: GDF-15 serum levels may be used as a biomarker to predict high RA disease activity.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is causing the pandemic Coronavirus Disease 2019 (COVID-19). The crystal structure of SARS-CoV-2 in complex with its receptor human ACE2 (hACE2) has been recently solved and the main amino acid residues involved in the complex virus-receptor have been detected. To predict whether lagomorphs can be infected by SARS-CoV-2, ACE2 sequences from rabbits, American pikas and from other mammals were compared with hACE2 sequences. Models of the complex formed by SARS-CoV-2 and ACE2 from lagomorphs and from other mammals were created for comparative studies. A low number of substitutions was found in lagomorph ACE2 sequences. Analysis of the contacts involved in the simulated complex SARS-CoV-2-ACE2 suggested that lagomorphs can be susceptible to SARS-CoV-2 infection, probably similarly to cats but lower than hamsters. These findings justify the planning of future in vitro and in vivo studies and suggest that more investigation should assess the epidemiological role of lagomorphs in SARS-CoV-2 spread. Furthermore, the risks to humans coming into close contacts with these animals should evaluated.

In order to analyze the prevalence of cat viral diseases in China, including feline parvovirus (FPV), feline calicivirus (FCV), feline herpesvirus-1 (FHV-1), feline leukemia virus (FeLV), feline immunodeficiency virus (FIV) and feline infectious peritonitis virus (FIPV), a total of 1,326 samples of cats from 16 cities were investigated from 2016 to 2019. Collectively, 1,060 (79.9%) cats were tested positive for at least one virus in nucleotide detection, the positive rates of cat exposure to FeLV, FPV, FHV-1, FCV, FIV and FIPV were 59.6%, 19.2%, 16.3%, 14.2%, 1.5% and 0.5%, respectively. The prevalence of FHV-1 and FPV were dominant in winter and spring. Cats from north China showed a higher positive rate of viral infection than that of cats from south China. The virus infection is not highly correlated with age, except that FPV is prone to occur within the age of 12 months. In the serological survey, the seroprevalences of 267 vaccinated cats to FPV, FCV, FHV-1 were 83.9%, 58.3% and 44.0%, respectively. Meanwhile, the seroprevalences of 39 unvaccinated cats to FPV, FCV, FHV-1 were 76.9% (30/39), 82.4% (28/34) and 58.6% (17/29), respectively. This study demonstrated that a high prevalence of the six viral diseases in China, and the insufficient serological potency of FCV and FHV reminds the urgency for more effective vaccines.

Degradation of the peanut cell wall is a critical step in the aqueous enzymatic extraction process to extract proteins and oil bodies. Viscozyme® L, a compound cell wall degrading enzyme, has been applied as an alternative to protease in the process of aqueous enzymatic extraction, but the mechanism of cell wall enzymolysis remains unclear. The present study aims to investigate the changes in cellulose, hemicellulose, and pectin content of the peanut cell wall hydrolyzed by Viscozyme® L. The degree to which the main components of the peanut cell wall, such as trans-1, 2-cyclohexanediamine-N,N,N’,N’-acetic acid-soluble pectin (CDTA-soluble pectin), Na2CO3-soluble pectin, cellulose, and hemicellulose, are degraded is closely related to the extraction of oil bodies and peanut protein at different solid-liquid ratio of powered peanut seed in distilled water, enzyme concentration, enzyme hydrolysis temperature, and enzyme hydrolysis time. The key sites of Viscozyme® L activity on cell wall polysaccharides were explored by comparing the changes in chemical bonds under different extraction conditions using Fourier-transform infrared spectroscopy (FT-IR) absorption bands and principal component analysis (PCA). Viscozyme® L acted on the C-O stretching, C-C stretching, and CH2 symmetrical bending of cellulose, the C-O stretching and O-C-O asymmetrical bending of hemicellulose, and the C-O stretching and C-C stretching of pectin.

The aim of this international study is to gain information on dexmedetomidine prescription by paediatric anaesthesiologists. We composed an online survey containing questions about the prescription rate of dexmedetomidine, administration route and dosage, adverse drug reactions, education on the drug and overall experience. Members of specialist paediatric anaesthesia societies of Europe (ESPA,n=849), New Zealand and Australia (SPANZA,n=320), Great Britain and Ireland (APAGBI,n=872) and the United States (SPA,n=3130) were e-mailed a link to this survey; responses were collected July and August 2019. Eight hundred and fifty-one invitees (851/5171,17%) responded, of whom 60 did not report their countries and were therefore excluded from the analyses. The ESPA members’ response rate was 25%, SPANZA35%, APAGBI15% and SPA10%. Dexmedetomidine is prescribed by 70% of all respondents (ESPA 121/229,53%;SPANZA 77/111,69%;APAGBI 44/129,34% and SPA 310/322,96%) of whom 73% has access to mostly local protocols. Differences in the use were mainly found in the age of the patients receiving dexmedetomidine (SPA primarily <1 year, others primarily >1 year). Members of SPANZA, APAGBI and SPA had not noted adverse drug reactions, although 61% of ESPA members had noted bradycardia. The majority of SPA respondents were not aware of any contraindications, whereas members from all other societies were aware of these. Although an on-label paediatric indication and clinical evidence have yet been lacking, many anaesthesiologists use dexmedetomidine in paediatrics for premedication, procedural sedation, ICU sedation and anaesthesia. The large intercontinental differences in dexmedetomidine prescription call for consensus and worldwide education on the optimal use of dexmedetomidine in paediatric practice.

Bovine norovirus (BNoV) is a recently identified calicivirus in the genus Norovirus, which can cause enteric disease with clinical signs including vomiting, diarrhea, dehydration, and mortality in neonatal calves. BNoV has been reported in different countries all over the world. We collected 39 fecal, blood, and tissue samples from calves with diarrhea from Hebei in northern China in 2019. The presence of BNoV was determined by PCR only two samples (5.1%) were positive. The complete genome of the newly identified strain Bo/CH/HB/BD/2019 was successfully sequenced (GenBank accession number: MN480761). Based on the existing gene sequences in the GenBank database, evolutionary trees were constructed. Sequence analysis showed that the nucleotide sequence homology of the Bo/CH/HB/BD/2019 genome with BNoV genomes in GenBank was 84.0–92.4%. Bo/CH/HB/BD/2019 has a GIII.2 genotype, and further analysis of its VP1 gene revealed four amino acid substitutions, i.e., 225C, 246T, 624T, and 945T. To the best of our knowledge, this is the first time the complete genome of a BNoV isolate from northern China has been sequenced.

Le indagini ambientali sono un insieme di analisi effettuate sulle diverse matrici ambientali ossia acqua, aria e suolo appartenenti a un determinato luogo. L’obiettivo è quello di individuare un’eventuale contaminazione (superamento concentrazione soglia di contaminazione: CSC) e i conseguenti livelli di inquinamento della stessa, in modo da promuovere interventi di bonifica e riqualificazione ambientale. Le indagini possono essere condotte mediante due tipologie: dirette o indirette.  Nel presente articolo vengono citati aspetti dell’indagine diretta le quali a loro volta si suddividono in due categorie: geognostiche e di caratterizzazione della contaminazione. A disciplinare le diverse indagini e le diverse procedure amministrative degli interventi di bonifica sono: l’All. 2, Titolo V, Parte IV del D. Lgs. 152/2006, il ‘"Piano di indagini ambientali’" e il DM 471/99 che fornisce le informazioni riguardo la localizzazione dei punti di campionamento e il numero minimo di sondaggi da effettuare (sostituito dalla normativa vigente). Viene, inoltre, citato e mostrato un caso studio nel comune di Cernusco sul Naviglio (MI) riguardante la caratterizzazione dello stato chimico, morfologico ed ambientale dei terreni costituenti l'area in esame.

Multifetal gestation, which accounts for approximately 3% of births, is a high-risk pregnancy being associated with adverse obstetric and perinatal complications with its consequences including neurodevelopmental handicaps. Multifetal pregnancy reduction aims to reduce the risk of miscarriage and extreme preterm birth at an acceptable procedure-related loss rate by terminating one or more fetuses. Selective termination for discordant anomalies in monochorionic pregnancies has advanced in recent years with the development of various vascular-occlusive techniques. Obstetricians should be knowledgeable about the medical risks of multifetal pregnancy, the potential benefits of these interventions and complex ethical issues inherent in the decisions.

Background: To investigate the effects of Artesunate (ART) on cell proliferation inhibition, apoptosis as well as gene expression of leukemic monocytic lymphoma cell line U937, and discuss the underlying mechanism. Methods: U937 cells were divided into groups treated by ART at different concentrations. Inhibiting effects of ART were determined by CCK-8 assay. Illumina Hiseq platform combined with q-PCR technology was applied to select the specific differentially expressed gene (DEG) between ART treated group and control group; Cell apoptosis was investigated by flow cytometry, and the expressions of apoptosis-related proteins were detected by western blot with CCDC102A being interfered. Results: ART possessed inhibitory effect on U937 cells proliferation in a concentration-dependent manner. The cell viability was no longer decreasing after the concentration of ART increased to 50 mg/L. CCDC102A gene was selected as the target gene through DEGs analysis to be interfered, in order to study the effects on U937. After interfered CCDC102A, the proliferation of U937 was inhibited, while the apoptosis was enhanced, the expressions of pro-apoptotic proteins such as Bax, Active-Caspase3 as well as p53 were increased, and the expression of anti-apoptotic protein Bcl2 was suppressed. Furthermore, the expressions of proteins in PI3K/Akt/mTOR signaling pathway such as AKT, p-AKT and mTOR were inhibited. Conclusion: ART can inhibit growth of U937 cell and induce apoptosis. CCDC102A gene may be involved in the anti-cancer effects of ART through induction apoptosis of U937 cells via up-regulation of Bax/Bcl2 levels and inhibition of Akt-mTOR signaling pathways.

Hydrogen sulfide (H2S) is the latest identified small gaseous mediator featured by its lipophilic nature to freely permeate the biological membranes. Initially, H2S was recognized by its roles in neuronal activity and vascular relaxation, which makes it an important molecule involved in paracrine signaling pathways. Recently, the immune regulatory function of gasotransmitters, H2S in particular, is increasingly being appreciated. Endogenous H2S level has been linked to macrophage activation, polarization, and inflammasome formation. Mechanistically, H2S-induced protein S-sulfhydration suppresses several inflammatory pathways including NF-κB and JNK signaling. Moreover, H2S serves as a potent cellular redox regulator to modulate epigenetic alterations and to promote mitochondrial biogenesis in macrophages. Here in this review, we intend to summarize the recent advancements of H2S studies in macrophages, and to discuss with focus on the therapeutic potential of H2S donors by targeting macrophages. The feasibility of H2S signaling component as a macrophage biomarker under disease conditions would be also discussed.

Paraganglioma is a benign neuro-endocrine neoplasm rarely localized on the lumbar spine. A 50-year-old male who presented for paraparesis and urinary leakage. Lumbar spine MRI showed a lesion compressing the dural sac from L1 to L5. The patient was operated, and the pathologic examination concluded to a cauda equine paraganglioma

The fall armyworm, Spodoptera frugiperda is a native species in the Americas. However, nowadays it is one of the most serious invasive lepidopteran pests in African and Asian countries. S. frugiperda has been spread very quickly after the first outbreak was reported in many countries. Based on mt genome sequence alignment, S. frugiperda specific sequence region was identified in tRNAs coding region between NADH dehydrogenase, ND3 and ND5. By using this unique region, species diagnostic primers were designed and applied in LAMP (lamp loop mediated isothermal amplification) assay as well as conventional PCR to identify the field-collected samples of S. frugiperda. Optimal incubation condition of LAMP assay was 61℃ for 90 minutes with 4 LAMP primers, and additional loop primer increased the amplification efficiency. Also, wide range of DNA concentration responded in LAMP assay and minimum detectable DNA concentration was 10 pg. This LAMP assay was also applied in DNA releasing technique from larval and adult sample, without DNA extraction, 95℃ incubation for five minutes of the tissue sample. This new molecular diagnostic method is easy to use and accurate. It possibly applied in intensive field monitoring of S. frugiperda and its ecological studies.

Analysis of biodiversity in natural environments based on environmental DNA (eDNA) has been applied to a wide range of ecosystems and species. The combination of high-throughput sequencing technologies and eDNA analysis is a powerful tool that enables comprehensive non-invasive monitoring of species present in the environment. Quantitative data of the eDNA from each species is essential for understanding species abundance but until recently required individual assays targeting each species. Recently developed quantitative sequencing (qSeq) allows simultaneous phylogenetic identification and quantification of individual species by counting random tags added to the 5′ end of the target sequence during the first DNA synthesis. Here, we applied qSeq to eDNA analysis to test its effectiveness in biodiversity monitoring. The eDNA extracted from aquaria with five fish species (Hemigrammocypris neglectus, Candidia temminckii, Oryzias latipes, Rhinogobius flumineus, and Misgurnus anguillicaudatus) across 4 days was quantified by microfluidic digital PCR using a TaqMan probe and qSeq. The eDNA abundance quantified by qSeq was consistent with dPCR for each fish species at each sampling time. However, the relative abundances of sequences obtained from high throughput sequencing did not follow the same trend as the quantitative analyses, probably due to different PCR amplification efficiencies for each species. The correlation coefficients between qSeq and dPCR were 1.052, 1.074, and 1.114 for H. neglectus, O. latipes, and M. anguillicaudatus, respectively, indicating that qSeq accurately quantifies fish eDNA. The application of qSeq to eDNA of other species will provide comprehensive quantitative data that could deepen our knowledge of natural ecosystems.

N6-methylated adenosine (m6A) and N1-methylated adenosine (m1A) are two epi-transcriptomic modifications on eukaryotic mRNA which have recently been rediscovered and are generating considerable interest. M6A methylation impacts on all aspects of cellular RNA metabolism and numerous physiological processes. Although less abundant than the m6A epitranscriptomic mark, m1A methylation has recently also attracted interest due to its dynamic nature in response to physiological changes. We investigated the role of the m6A and m1A methylation regulators on the expression of a transgene in Chinese Hamster Ovary (CHO) cells - the host cell of choice in producing biopharmaceutical proteins commercially. Using siRNA-mediated gene depletion and methylation-specific RNA immunoprecipitation with anti-m6A or m1A-antibodies, we show that (i) knock-down of the m6A ‘reader’ YTHDF2 or the m1A ‘eraser’ ALKBH3 dramatically impacts transgene expression; (ii) the effects of YTHDF2 and ALKBH3 depletion on transgene expression are m6A- and m1A-mediated. We conclude that the expression of transgenes in CHO cells can be subjected to regulation by both m6A and m1A regulators. These findings open up the prospect of previously unexplored epi-transcriptomic-based approaches to CHO cell line engineering for improved recombinant protein production.

Although a Kommerell diverticulum (KD) and aberrant subclavian artery (ASA) are a common congenital anomaly, a KD and ASA with two thoracic aortic aneurysms are rarely reported. We describe a case of a KD with a right ASA and two thoracic saccular aortic aneurysms, which were treated with a total arch replacement, frozen elephant trunk technique, and thoracic endovascular aortic repair.

Diatoms (Bacillariophyceae) are widely used as bioindicators of present and past water quality because they inhabit the vast majority of aquatic ecosystems, are very diverse, highly sensitive to a variety of environmental conditions, and are characterized by silicified cell walls that favor their long-term preservation in sediments. Alongside with traditional morphological analyses, metabarcoding has become a valuable tool to study the community structures of various organisms, including diatoms. Here, we aimed to test whether the quantity of sediment sample used for DNA extraction is affecting the results obtained from high-throughput sequencing (metabarcoding) of the diatom rbcL region by isolating DNA from 10 g and 0.5 g (wet weight) of lake surface sediment samples. Because bioinformatics processing of metabarcoding data may affect the outcome, we also tested the consistency of the results from three different pipelines. Additionally, the agreement between metabarcoding data and morphological inventories of corresponding samples were compared. Our results demonstrate highly uniform patterns between the diatom rbcL amplicons from 10 g and 0.5 g of DNA extracts (HTS 10 and HTS 0.5, respectively). Furthermore, metabarcoding results were highly consistent among the data sets produced by different bioinformatics pipelines. Comparing results from metabarcoding and microscopy, we identified some taxonomic mismatches, which are related to the common issue of incompleteness of the sequence databases, but also to inconsistencies in diatom taxonomy in general and potential dissolution effects of diatom valves caused by high alkalinity of the investigated lake waters. Nevertheless, multivariate community analysis demonstrated highly similar results between data sets identified by microscopy and metabarcoding, further confirming that metabarcoding is a viable alternative for identifying diatom-environment relationships.

Mini-commentary on BJOG-19-1550.R1: Effect of Progestogen for Women with Threatened Miscarriage: A Systematic Review and Meta-analysis

The cleavage of heparin by heparin lyases showed great potential as a cost-effective and innoxious method for producing heparin with low molecular weight (LMWH). One of the most studied and sought heparin lyase is heparinase I (HepI). However, the industrial use of HepI was largely hampered by its low specific activity and thermal stability. In this article we describe increasing in specific heparinase I activity by stepwise site-directed mutagenesis. Thus after two cycles of mutagenesis, we obtained mutant heparinase I Flavobacterium heparinum with significantly increased specific activity (25%).

Synthetic biology has promoted the development of biosensors as tools for detecting trace substances. In the past, biosensors based on synthetic biology have been designed on living cells, but the development of cell biosensors has been greatly limited by defects such as the obstruction of cell membrane. However, the advent of cell-free synthetic biology addresses these limitations. Biosensors based on the cell-free protein synthesis system have the advantages of higher safety, higher sensitivity, and faster response time over cell biosensors, which makes cell-free biosensors have a broader application prospect. This review summarizes the workflow of various cell-free biosensors, including the identification of analytes and signal output. The detection range of cell-free biosensors is greatly enlarged by different recognition mechanisms and output methods. In addition, the review also discusses the applications of cell-free biosensors in environmental monitoring and health diagnosis, as well as existing deficiencies and aspects that should be improved. In the future, through continuous improvement and optimization, the potential of cell-free biosensors will be stimulated, and their application fields will be expanded.