Objective To assess the risk factors for adverse pregnancy outcome in the RFA selective reduction procedure for complicated multiple pregnancies and to compare the pregnancy outcomes between two radio frequency needle insert angles, abdominal and dorsal insert angle. Methods In order to retain at least one fetus, 145 pregnant women with complicated monochorionic multiple pregnancy chose radio frequency ablation to do selective reduction. Compare the procedure characteristics and pregnancy outcomes of the two different needle insert angles groups by SPSS 21.0. Results The RFA procedure in 145 complicated monochorionic multiple pregnancies were all conducted successfully, 116 cases through abdominal insert angle, and 29 cases through dorsal insert angle. Cox regression analysis indicated that the survival curve of fetal survival time interval after the procedure between the two needle insert angles were statistically different(P<0.001), with two significant predictors, cervical length (RR=0.969, P=0.043) and the gestational age before the procedure (RR=1.205, P<0.001) . Multivariable logistic analysis showed that compared to live birth at term, the risk of miscarriage,termination and IUFD were statistically higher when the cervical length was less than 35mm(P<0.001).Even though the survival rate was non-significant different within the indications(P=0.623), the pregnancy with live born fetus showed a higher trend in IUGR &TTT(90.9%) than other indications. Conclusion The interval between RFA to delivery specific survival curve showed a significant improvement with the abdominal needle insert angle compared with dorsal insert angle. The cervical length and gestational age before RFA procedure were two risk factors about the adverse pregnant outcome.

OBJECTIVE To investigate the prevalence of hypertensive disorders of pregnancy (HDP), and the roles of polycystic ovary syndrome (PCOS), obesity, weight gain (WG) and hyperandrogenaemia in the development of HDP by age 46. DESIGN prospective population-based cohort. Setting and population The Northern Finland Birth Cohort 1966 (NFBC1966) METHODS Follow-up at ages 14, 31 and 46, including women with (n=408) and without (n=3373) HDP. HDP was combined from the questionnaire data at age 46, hospital discharge records and Finnish Medical Birth Registers. Women with both oligo-amenorrhea and hirsutism at age 31 and/or with PCOS diagnosis by age 46 (self-reported PCOS, srPCOS, n=279) were compared with women without symptoms or PCOS diagnosis (n=1577). Main outcome measures Association of PCOS and WG through life with HDP RESULTS Women with srPCOS had an increased HDP risk ([OR]=1.56 [95%CI:1.03-2.37]), but the association disappeared after BMI adjusting at age 31. Increase of BMI from age 14 to 31 was significantly greater in srPCOS (median [interquartile range]:5.94kg/m2[3.69;11.1], p<0.001) and non-PCOS (4.89kg/m2[3.21;7.57], p<0.001) women with HDP and in srPCOS women without HDP (4.59kg/m2[2.40;7.54], p=0.009) compared to non-PCOS without HDP. Among women with srPCOS, BMI increase was greater in women with than without HDP (5.94kg/m2 [3.69;11.1] vs 4.59kg/m2[2.40;7.54], p=0.015). Hyperandrogenaemia at 31 or 46 did not associate with HDP (OR=1.44[95%CI: 0.98-2.11]). CONCLUSION Obesity and weight gain from adolescence to age 46, but not srPCOS or hyperandrogenaemia, were associated with an increased risk of HDP.

LncRNAs play an indispensable role in the process of M1 macrophage via regulating the development of macrophages and their responses to bacterial pathogens and viral infections. However, there are few studies on the lncRNA-mediated functions and regulatory mechanisms of M2 macrophage polarization. In this study, we found a number of differentially expressed lncRNAs between human monocyte derived M0 and M2 macrophages according to array analysis and qRT-PCR validation. The lncRNA RP11-389C8.2 (we named lnc-M2 in this study) was observed to be highly expressed in M2 macrophages. In Situ Localization and Quantification Analysis showed that lnc-M2 was expressed in the nucleus and cytosolic compartments of M2 macrophages. Notably, lnc-M2 knockdown enhanced the phagocytic ability of M2 macrophages. Ulteriorly, the results of RNA-Protein interaction experiments indicated that protein kinase A (PKA) was a lnc-M2 associated RNA-binding protein (RBP). Western blot showed that p-CREB, a well-known key downstream transcription factor of PKA, was lowly phosphorylated in lnc-M2-silencing M2 macrophages. Furthermore, we found that transcriptional factor STAT3 promoted lnc-M2 transcription along with the up-regulation of epigenetic histone modification markers at the lnc-M2 promoter locus, indicating that STAT3 activated lnc-M2 and eventually facilitated the process of M2 macrophage differentiation via the PKA/CREB pathway. Collectively, our date provide evidence that the transcription factor STAT3 can promote the transcription of lnc-M2 and facilitated the process of M2 macrophage differentiation via the PKA/CREB pathway. This study highlights a novel mechanism underlying the M2 macrophage differentiation.

Background and Purpose: Local anesthetics block sodium and a variety of potassium channels. Although previous studies identified a residue in the pore signature sequence together with three residues in the S6 segment as a putative binding site, the precise molecular basis of Kv potassium channel inhibition by local anesthetics remained unknown. Kv crystal structures predict that some of these residues point away from the central cavity and face into a drug binding site called ‘side pockets´. Thus, the question arises whether the binding site of local anesthetics is exclusively located in the central cavity or also involves the ‘side pockets´. Experimental Approach: A systematic functional alanine mutagenesis approach, scanning 58 mutants, in concert with in silico docking experiments and molecular dynamics simulations were utilized to elucidate the binding site of bupivacaine and ropivacaine. Key Results: Kv1.5 inhibition by local anesthetics requires binding to the central cavity and the ‘side pockets´, where the latter requires interactions with residues of the S5 and the backside of the S6 segment. Mutations in the ‘side pockets´ remove stereoselectivity of Kv1.5 inhibition by bupivacaine. Strikingly, while we found that binding to the ‘side pockets´ is conserved for the different local anesthetics, the binding mode in the central cavity and the ‘side pockets´ shows considerable variations. Conclusion and Implications: Local anesthetics bind to the central cavity and the ‘side pockets´ which provides a crucial key for the molecular understanding of their Kv channel affinity and stereoselectivity, as well as their spectrum of side effects.

All termites have established a wide range of associations with symbiotic microbes in their guts. Some termite species are also associated with microbes that grow in their nests, but the prevalence of these associations remains largely unknown. Here, we studied the bacterial communities associated with the termites and galleries of three wood-feeding termite species using 16S rRNA amplicon sequencing. We found that the composition of bacterial communities differs among termite bodies, termite galleries, and control wood fragments devoid of termite activities, in a species-specific manner. Termite galleries were enriched in bacterial OTUs belonging to Rhizobiales and Actinobacteria, which were often shared by several termite species. The abundance of several bacterial OTUs, generally belonging to genera known to include animal pathogens, was depleted in termite galleries. Our results demonstrate that termites not only harbour unique bacterial communities inside their guts, but also shape the communities colonizing their nests and galleries.

Introduction: Adenoidectomy is one of the most commonly performed operation worldwide. Most widely used approach for surgery is conventional curettage method. However, as this method is associated with high incidence of residual adenoid tissue at the end of surgery which results in recurrence of disease, a newer endoscopic microdebrider assisted approach is becoming popular these days. Though various studies have shown its efficacy in more complete removal of adenoids, its functional outcome on middle ear function remains to be explored. Objectives: To compare pre and post operative pure tone audiometric and impedance audiometric analysis following conventional and endoscopic micodebrider assisted adenoidectomy. Materials and Methods: Patients were diagnosed cases of chronic adenoiditis which were divided in groups of 25 each. Patients in first group underwent conventional curettage adenoidectomy while in second group patient underwent endoscopic microdebrider assisted adenoidectomy. Pre and postoperative pure tone and impedance audiometry were performed for all the patients and the outcomes were compared. Results: Endoscopic microdebrider assisted method resulted in better outcomes which were statistically significant as compared to the conventional curettage. Criteria such as hearing threshold (p value 0.004 at second follow up), peak pressure (p value 0.045 at first follow up), tympanogram (p value 0.016) showed that endoscopic method was better while peak compliance (P value 0.340 at first follow up) didn’t show any significant difference between the groups. Conclusion: Endoscopic microdebrider assisted method of adenoidectomy has a definite advantage of better visualization and results in more complete removal of tissue and hence results in better improvement in middle ear functions as compared to the conventional curettage.

Background and purpose: The pathophysiology of coronary artery spasm ( CAS), with its associated ischaemic crises, is currently poorly understood, and treatment is frequently ineffective. In view of increasing evidence that platelet- platelet based defects may occur in CAS patients,. we investigated platelet reactivity in CAS patients and whether symptomatic crises reflect activation of platelet-endothelial interactions. Experimental approach: CAS patients were evaluated during acute and/or chronic symptomatic phases, and compared with healthy control subjects. Inhibition of platelet aggregation with ADP by the nitric oxide (NO) donor sodium nitroprusside (SNP), . and plasma levels of syndecan-1 (glycocalyx shedding marker), tryptase (mast cell activation marker), and platelet microparticles were measured. Key Results: Inhibition of aggregation by SNP was impaired in chronic CAS, and tended to deteriorate further during symptomatic crises, while plasma levels of syndecan-1, tryptase and platelet microparticles increased. Infusion of high dose N-acetylcysteine (NAC) plus glyceryl trinitrate rapidly restored platelet responsiveness to SNP and decreased plasma syndecan-1 levels. The effect of NAC on platelet responsiveness to SNP was mimicked in vitro by the H2S donor NaHS. Conversely, inhibition of enzymatic release of H2S attenuated NAC effect. Conclusion and Implications: CAS is associated with substantial impairment of platelet NO signaling. During acute symptomatic exacerbations, platelet resistance to NO is aggravated, together with mast cell activation and damage to both vasculature and platelets. NAC reverses platelet resistance to NO via release of H2S, and reverses glycocalyx shedding during symptomatic crises: this suggests that H2S donors may correct the pathophysiological anomalies underlying CAS.

Objective: To evaluate the association between extremely elevated alkaline phosphatase (ALKP) levels (above 1000 U/L) and adverse perinatal outcome. Design: A retrospective case series Setting and popultion: All parturients with extremely elevated ALKP levels taken throughout pregnancy at a single university-affiliated medical center (2010-2018). Methods: Demographics and medical data were retrieved. Following literature review, previously reported similar cases were added to the cohort. We report perinatal outcome of our cohort as well as literature review. Results: During study period 11 parturients with high ALKP were identified. Ten more cases were retrieved from PubMed search. Overall, median ALKP levels were 1880 (range 1052-4488, U/L). Reasons for evaluation were mostly nonspecific symptoms (pruritus, headache, abdominal pain) or routine obstetrical evaluation. Twelve isoenzyme analysis were available - 10 of which were of placental fraction; median gestational age at delivery was 38 (35-41), four (19%) women delivered preterm, ; six patients (29%) had gestational diabetes mellitus and 6 (29%) had hypertensive disorder. Histopathology of the placenta was available in 8 cases: 3 normal histology (38%) and 5 with different non-specific pathologies. Conclusions: We report the largest case series of extremely elevated levels of ALKP in pregnancy thus far. Our data suggest association with adverse perinatal outcome.

The spectacular and unprecedented rise of so-called perovskite solar cells (PSCs) in conversion efficiency with low-cost manufacturing processes has grabbed the attention of the scientific community in the field of photovoltaics during the last four years. The inclusion of perovskite type absorber materials, typically CH3NH3PbI3, has been the key factor for the development of this emerging technology that has created a lot of expectations. However, many poorly understood aspects of its operating modes still need of reliable explanations.  This paper provides a brief introduction to the structure, materials and characteristics of PSCs. In addition, some remarks about the stability of these devices are provided and the state-of-the-art of several subjects of interest is discussed, such as the hysteresis phenomenon of current-voltage curves. O. Almora, L. Vaillant-Roca, and G. Garcia-Belmonte, Rev. Cubana Fis. 34(1),  2017, 58-68.

Letter to the Editor, BJOG Exchange

We describe a patient presenting the symptoms of myotonia congenita with a new heterozygous missense variant in exon 9 of the CLCN1 gene (c.1010T>G, p.(Phe337Cys)). The mutation is located in the large extracellular loop between the I and J transmembrane segments of CLCN1 and we functionally analyzed its consequences on channel properties. Confocal imaging showed that the F337C mutant incorporated as well as the WT channel into the plasma membrane. Using patch clamp recordings of WT and F337C hClC-1 channels expressed in HEK293 cells, we observed a smaller conductance for the latter at -80 mV. Using classical voltage protocols and curve fitting procedures, we also found a marked reduction of the fast gating component in the mutant channels, as well as an overall reduced voltage-dependence. The mutation did not alter the pharmacology of the channels. Thus the loss of function is due to a reduction of the opening at resting potential and an inability to quickly activate during the action potential and protect the myocytes against repetitive discharges. To our knowledge, this is the first report of a mixed alteration in the biophysical properties of hClC-1 consisting of a reduced conductance at resting potential and an almost abolished voltage dependence.

The M42 aminopeptidases are a family of dinuclear aminopeptidases widely distributed in Prokaryotes. They are potentially associated to the proteasome, achieving complete peptide destruction. Their most peculiar characteristic is their quaternary structure, a tetrahedron-shaped particle made of twelve subunits. The catalytic site of M42 aminopeptidases is defined by seven conserved residues. Five of them are involved in metal ion binding which is important to maintain both the activity and the oligomeric state. The sixth conserved residue, a glutamate, is the catalytic base deprotonating the water molecule during peptide bond hydrolysis. The seventh residue is an aspartate whose function remains poorly understood. This aspartate residue, however, must have a critical role as it is strictly conserved in all MH clan enzymes. It forms some kind of catalytic triad with the histidine residue and the metal ion of the M2 binding site. We assess its role in TmPep1050, an M42 aminopeptidase of Thermotoga maritima, through a mutational approach. Asp-62 was substituted with alanine, asparagine, or glutamate residue. The three Asp-62 substitutions completely abolished TmPep1050 activity and impeded dodecamer formation. They also interfered with metal ion binding as only one cobalt ion is bound per subunit instead of two. The structural data showed that the Asp62Ala substitution has an impact on the active site folds becoming similar to TmPep1050 dimer. We propose a structural role for Asp-62, helping to stabilize a crucial loop in the active site and to position correctly the catalytic base and a metal ion ligand of the M1 site.

FARS2, a nuclear gene, encodes the mitochondrial phenylalanyl-tRNA synthetase (mtPheRS). Previous reports have described two distinct phenotypes linked to FARS2 gene mutation: an early onset epileptic encephalopathy and spastic paraplegia. This report describes a distinctive phenotype of FARS2-linked, juvenile onset refractory epilepsy, caused by a hemizygous mutation (p.V197M and exon 2 microdeletion). A 17-year- old woman with normal development presented with a super refractory focal motor status epilepticus. Only an emergency life-saving surgery aborted her status after all therapeutic interventions, including anesthesia, failed to control her seizures. Pathological and biochemical activities on muscle biopsy showed mitochondrial proliferation with enhanced isolated activities of complexes II and IV, suggestive of a compensatory mechanism for the bioenergetic deficiency. Postoperatively, the patient started experiencing focal aware motor seizures originating from the contralateral hemisphere after being seizure free for a few months. This report confirms a third phenotypic manifestation of FARS2 gene mutation.

Globally, amphibian species have suffered drastic population declines over the past 40 years. Hundreds of species are now listed as Critically Endangered, with many of these considered “possibly extinct”. Most of these species are stream-dwelling frogs inhabiting remote, montane areas, where traditional surveys limit our ability to find remnant populations. Environmental DNA (eDNA) monitoring could revolutionize surveys for missing and endangered amphibian populations by enabling sampling of downstream sections to screen the vast upstream catchments. However, this is dependent on quantifying downstream detection probability and distances. Here we tested this in two endangered stream frogs (Litoria nannotis and L. lorica) that co-occur in a remote stream catchment, and for which we know precise downstream distributional limits from traditional surveys. Importantly, the last populations of L. lorica persist in this catchment; one small (~1,000 frogs) and one very small (~100 frogs). We conducted eDNA screening at set distances downstream from the populations (up to 22.8 km) using precipitation from two water volumes and via filtering, during moderately high and low flow conditions. During high flow, we reliably detected both species as far as 22.8 km downstream using the larger water volumes and filtering techniques. We could only detect the very small population of L. lorica immediately downstream. Detection success was higher at the sites further downstream for both species during high flow compared to low flow. Our downstream detection distances (> 20 km) suggest eDNA is a valuable tool for detecting rare stream amphibians. We provide recommendations on optimal survey techniques.

Regular assessment of surface waters to monitor ecological quality has become an increasing priority in recent years. Stream water quality assessment conventionally relies on taxonomic expertise, which can be costly and time-consuming. Next-generation sequencing approaches for high-throughput analyses of diverse ecosystems are increasingly used for environmental monitoring, and it has recently been shown that this methodology has a large potential for stream water quality assessments. In the present study we assess the potential of an amplicon sequencing based approach that simultaneously targets the 16S (prokaryotes) and 18S (eukaryotes) rRNA genes to capture a snapshot of the in the entire ecosystem composition. Results based on the analysis of 50 selected Danish streams showed that the domain-specific profiles can separate the samples into their respective ecological quality categories. Furthermore, it was possible to extract potential indicator organisms from all three domains associated to a single ecological status category, low and high quality ecosystems, as well as those with a high correlation to ecological status across all categories.

In this article, we provide advice and insights, based on our own experiences, for computational chemists who are beginning new tenure-track positions at primarily undergraduate institutions. We each followed different routes to obtain our tenure-track positions, but we all experienced similar challenges when getting started in our new position. In this article, we discuss our approaches to seven areas that we all found important for engaging undergraduate students in our computational chemistry research, including setting up computational resources, recruiting research students, training research students, designing student projects, managing the lab, mentoring students, and student conference participation. KEYWORDS — undergraduate research, computational chemistry, primarily undergraduate institution, tenure-track position, career pathways

Dear Editor,At 29th of February the World Health Organization (WHO) reported 85403 confirmed globally confirmed case of COVID-19 [1]. COVID-19 is dramatically increasing in Italy, the last report from the ministry of health on the 9th of march reported the presence of 9172 confirmed cases and 733 patients in intensive care unit (ICU) [2]. We agree with Chan et al that physicians managing airway procedures are at particularly high risk to contract the COVID-19 infection [3]. We support the authors that claimed for a full protective wearing including N95 respirator, gown, cap, eye protection, and gloves, during aerosol generating procedures (AGP) [3]. However, we’d like to focus the attention on the tracheostomy procedures in COVID-19 patients since otolaryngologists, anesthesiologists and intensive care physicians are at high risk of contracting the infection during tracheostomy [3]. Tracheostomy is required in case of prolonged mechanical ventilation and intensive care unit (ICU) stay [4]. Surgical tracheostomy is an AGP associated with an increased risk severe acute respiratory distress (SARS) infection [5]. Strict adherence to infection control guidelines in SARS is mandatory in performing tracheostomy in ICU or operating room [6].Few years ago, we proposed the double lumen endotracheal tube (DLET) for percutaneous tracheostomy in critically ill patients [7]. DLET was equipped with an upper channel that allows passage of a bronchoscope during the percutaneous tracheostomy and with a lower channel exclusively dedicated to patient ventilation [7]. The lower channel is equipped with a distal cuff positioned just above the carina that may allow a safe mechanical ventilation by keeping stable gas-exchange and limiting the spread of aerosol during the procedure [7]. During the percutaneous procedure, the puncture of the anterior tracheal wall, Seldinger insertion, dilatation, and cannula positioning were all performed with the DLET correctly placed in the trachea. The DLET was removed at the end of the tracheostomy when the cannula is inserted and correctly positioned with the FFB [7].Surgical tracheostomy in COVID-19 patients should be done with a close collaboration between otolaryngologists, preforming the surgical procedure, and anesthesiologists or intensive care physicians managing the general anesthesia and the airway.When a surgical tracheostomy is done under general anesthesia, just before the surgeon makes the tracheal stoma, the endotracheal tube is withdrawn, so that the cuff of the tube is not in the surgical field [8]. But when the surgeon makes the tracheal incision, ventilation is lost and the surgeon has to be quick enough to create the soma and insert the tracheostomy tube in a short time [8]. During this procedure a large spread of aerosol may occur. To avoid the aerosol, we suggest to push down the endotracheal tube beyond the site chosen for the tracheal stoma at the beginning of the procedure. The endotracheal tube should reach the tracheal carina so the cuff is surely distal to the tracheostomy site. By checking the airway pressure and the end-tidal CO2, on the mechanical ventilator we can realize if the endotracheal tube is still in the lower tract of the trachea or in the endobronchial tract. Our previous experience with the DLET demonstrated that the endotracheal tube and the tracheal cannula can be simultaneously inserted inside the trachea [7]. According to this, pushing down the endotracheal tube and cuffed it at the level of the carina may avoid the spread of aerosol and, then, may add an extra security for the medical staff during a procedure at high risk of generating aerosol.ReferencesCoronavirus disease 2019 (COVID-19) Situation Report – 40.https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200229-sitrep-40-covid-19.pdfItalian Minister of Health. COVID-19 Italian cases.http://www.salute.gov.it/portale/nuovocoronavirus/dettaglioContenutiNuovoCoronavirus.jsp?lingua=italiano&id=5351&area=nuovoCoronavirus&menu=vuotoChan YJK, Wong EWY, Lam W. Practical Aspects of Otolaryngologic Clinical Services During the 2019 Novel Coronavirus EpidemicAn Experience in Hong Kong. JAMA Otolaryngol Head Neck Surg. Published online March 20, 2020. doi:10.1001/jamaoto.2020.0488Vargas M, Sutherasan Y, Antonelli M, Brunetti I, Corcione A, Laffey JG, et al. Tracheostomy procedures in the intensive care unit: an international survey. Critical Care 2015;19:291-301Tran K, Cimon K, Severn M et al. Aerosol Generating Procedures and Risk of Transmission of Acute Respiratory Infections to Healthcare Workers: A Systematic Review. . PLoS ONE 2012; 7(4): e35797. doi:10.1371/journal.pone.0035797Chun-Wing A, Yin -Chun L, Kit-Ying L. Management of Critically Ill Patients with Severe Acute Respiratory Syndrome (SARS). Int. J. Med. Sci. 2004 1(1): 1-10Vargas M, Servillo G, Tessitore G, Aloj F, Brunetti I, Arditi E, et al. Percutaneous dilatational tracheostomy with a double-lumen endotracheal tube. A Comparison of Feasibility, Gas Exchange, and Airway Pressures. Chest 2015; 147:1267-74Walts PA, Sudish CM, DeCamp MM. Techniques of surgical tracheostomy. Clin Chest Med 24 (2003) 413 – 422

Background: The Coronavirus disease – 2019 (COVID-19) pandemic is a global health crisis and Otolaryngologists are at increased occupational risk of contracting COVID-19. There are currently no uniform best-practice recommendations for Otolaryngologic surgery in the setting of COVID-19.Methods: We reviewed relevant publications and position statements regarding the management of Otolaryngology patients in the setting of COVID-19. Recommendations regarding clinical practice during the Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) outbreaks were also reviewed.Results: Enhanced personal protective equipment (N95 respirator and face shield or powered air-purifying respirator, disposable cap and gown, gloves) is required for any Otolaryngology patient with unknown, suspected, or positive COVID-19 status. Elective procedures should be postponed indefinitely, and clinical practice should be limited to patients with urgent or emergent needs. Conclusion: We summarize current best-practice recommendations for Otolaryngologists to ensure safety for themselves, their clinical staff, and their patients.

The 2019 novel coronavirus disease (COVID-19) is a highly contagious zoonosis produced by SARS-CoV-2 that is spread human-to-human by respiratory secretions. It was declared by the WHO as a public health emergency. The most susceptible populations, needing mechanical ventilation, are the elderly and people with associated comorbidities.There is an important risk of contagion for anesthetists, dentists, head and neck surgeons, maxillofacial surgeons, ophthalmologists and otolaryngologists.  Health workers represent between 3.8% to 20% of the infected population; some 15% will develop severe complaints and among them, many will lose their lives. A large number of patients do not have overt signs and symptoms (fever/respiratory), yet pose a real risk to surgeons (who should know this fact and must therefore apply respiratory protective strategies for all patients they encounter).All interventions that have the potential to aerosolize aerodigestive secretions should be avoided or used only when mandatory. Health workers who are: pregnant, over 55-65 years of age, with a history of chronic diseases (uncontrolled hypertension, diabetes mellitus, chronic obstructive pulmonary diseases and all clinical scenarios where immunosuppression is feasible, including that induced to treat chronic inflammatory conditions and organ transplants) should avoid the clinical attention of a potentially infected patient. Healthcare facilities should prioritize urgent and emergency visits and procedures until the present condition stabilizes; truly elective care should cease and discussed on a case-by-case basis for cancer patients.For those who are working with COVID-19 infected patients’ isolation is compulsory in the following settings: a) unprotected close contact with COVID-19 pneumonia patients: b) onset of fever, cough, shortness of breath and other symptoms (gastrointestinal complaints, anosmia and dysgeusia have been reported in a minority of cases).For any care or intervention in the upper aerodigestive tract region, irrespective of the setting and a confirmed diagnosis (e.g.; rhinoscopy or flexible laryngoscopy in the outpatient setting and tracheostomy or rigid endoscopy under anesthesia) it is strongly recommended that all healthcare personnel wear personal protective equipment (PPE) such as N95, gown, cap, eye protection and gloves.The procedures described are essential in trying to maintain safety of healthcare workers during COVID-19 pandemic. In particular, otolaryngologists, head and neck, and maxillofacial surgeons are per se exposed to the greatest risk of infection while caring for COVID-19 positive subjects, and their protection should be considered a priority in the present circumstances.

Due to its unique triacylglycerol composition, palm oil has the particularity of being semi-solid at room temperature. Major fatty acids are palmitic (P) and oleic (O) types, tripalmitin (P3), oleo-dipalmitin (P2O) and palmito-diolein (PO2) being the most abundant tri-saturated, mono-unsaturated and di-unsaturated triacylglycerols. Palm oil is also the most fractionated oil worldwide, mostly in multi-step operations. Dry fractionation is a process that combines crystallization and separation of partially crystallized oil; in the case of palm oil, the main triacylglycerols involved are obviously P3, P2O and PO2. Crude palm oil is made up of symmetrical and asymmetric isomers and, more particularly, contains POP and OPP in a fixed ratio. This ratio may sometimes be modified during the refining process. Adverse effects of excessive OPP content affect the dry fractionation process and are also reflected in the crystallization properties of the produced solid and liquid fractions. It is therefore fundamental to understand at a molecular level the interactions involved. This paper details and compares the binary phase diagrams of several systems: PPP-POP, PPP-OPP; PPP-POO, POP-POO, OPP-POO and POP-OPP, obtained by combining differential scanning calorimetry and variable temperature powder X-ray diffraction. Co-crystallization properties are analyzed in dynamic mode (heating after quenching) and after tempering (few months stabilization at room temperature). The ternary phase diagrams PPP/POP/POO and PPP/OPP/POO give a complementary representation in terms of isothermal melting lines. Better understanding of these molecular interactions is critical for perspicacious carrying out of the palm oil dry fractionation process.

Consider these integrals which all have a component $$ {t(e^t-1)} $$ and all related to zeta, gamma and polygamma type functions. This could be seen as a transform of a kernel function k(s, t). The classic integral is $$ \Gamma(s)\zeta(s) = \int_0^\infty {(e^t-1)} \; {t} $$ a somewhat forced addition is $$ \Gamma(s) = \int_0^\infty )}{(e^t-1)} \; {t} $$ we have $$ \log\Gamma(s+1) = \int_0^\infty -1)+s(1-e^{-t})}{(e^t-1)} \; {t} $$ and $$ \Gamma(n)\zeta(n,s+1) = \int_0^\infty }{(e^t-1)} \; {t} $$ also the related polygamma function $$ (-1)^{m+1}\psi^{(m)}(s)= \Gamma(m+1)\zeta(m+1,s) = \int_0^\infty }{ (e^t-1)} \; {t} $$ we have $$ \Gamma(s)\psi^{(0)}(s)\zeta(s) + \Gamma(s)\zeta'(s) = \int_0^\infty { (e^t-1)} \; {t} $$ $$ \Gamma(s)\psi^{(0)}(s)\zeta(s,n+1) + \Gamma(s)\zeta^{(1,0)}(s,n+1) = \int_0^\infty }{ (e^t-1)} \; {t} $$ also consider the Bernoulli numbers, with an integral b(s) that takes the values b(2n)=B2n (Wikipedia) $$ b(s) = \int_0^\infty }{1-e^{2\pi t}} {(e^t-1)}{t} $$ According to Woon [1], the Bernoulli polynomials should be redefined as $$ }{e^z-1} = \left(^\infty {k!}B_k z^k\right)\left(^\infty {m!}\right) = ^\infty {n!} B_n(x) z^n $$ The link is obviously very strong with the exponential generating functions for Bernoulli numbers $$ {e^t-1} = ^\infty {m!} $$ $$ {1-e^{-t}} = ^\infty {m!} $$ REFERENCES [1] https://arxiv.org/pdf/physics/9705021.pdf

Background: Postpartum hemorrhage (PPH) was deadly prior to blood transfusions, and therefore either never existed or was eliminated by evolution millions of years ago. No animals hemorrhage. Human PPH appears to be a relatively recent occurrence, perhaps coinciding with the decrease in the use of squatting. The first documented case of human postpartum hemorrhage appears around 1400 AD. Regardless of which third stage protocol is used, 95% of low risk women do not hemorrhage, but about 5% do. A protocol called Judy’s 3,4,5 calls for squatting out the placenta between 3 and 5 minutes postpartum in order to lower the 5% PPH rate to the same rate as experienced by other mammals, i.e. zero. Methodology: A retrospective cohort study of 1,027 planned, attended low risk vaginal births in Israel using Judy’s 3,4,5 minute third stage protocol compared to 2,691 attended low risk vaginal births in British Columbia using various forms of active or expectant management of the third stage of labor. Results: Among similar groups of low risk births, active management, or expectant management resulted in 4% PPH over 1000 cc, whereas Judy’s 3,4,5 minute protocol resulted in 0% PPH over 500 cc. Conclusion: Judy’s 3,4,5 minute protocol is logical, using gravity to deliver the placenta expediently. It results in 0% postpartum hemorrhage over 500 cc and an average blood loss of 100 cc in the first hour after the birth of the newborn, which compares favorably to any other third stage protocol.

Reviewers: Matthew Helm1 and Morgan E. Carter21.    USDA-ARS, Crop Protection and Pest Control Research Unit, West Lafayette, IN2.    Plant Pathology and Plant-Microbe Biology Section, School of Integrative Plant Science, Cornell University, Ithaca, NY SummaryThis is a review of Mazo-Molina and Mainiero, et al. bioRxiv (doi: https://doi.org/10.1101/2020.03.05.979484) posted on March 5, 2020. This study builds upon previous work that described the serendipitous discovery of a locus in the distantly related relative of tomato Solanum lycopersicoides, known as Pseudomonas tomato race 1 (Ptr1) (Mazo-Molina et al., (2019). Mazo-Molina and colleagues (2019) previously showed the Ptr1 locus confers resistance to several Pseudomonas syringae pv. tomato race 1 strains, but not the race 0 strain DC3000. Comparative genomic analysis of the effector repertoire between a race 1 strain of P. syringae pv. tomato, T1, and DC3000 identified AvrRpt2 as the cognate effector recognized by the Ptr1 locus. In Arabidopsis, AvrRpt2 is a cysteine protease that cleaves RIN4 and, upon cleavage, leads to activation of the Arabidopsis NLR protein RPS2. In this paper, Mazo-Molina and Mainiero et al. describe the identification and functional characterization of the Ptr1 gene. A single recombinant among 585 F2 S. lycopersicoides individuals segregating for the Ptr1 locus was identified that narrowed the Ptr1 candidate to eight NLR genes. By employing currently available gene models for S. lycopersicoides and 3’ RNA-seq data, Mazo-Molina and Mainiero et al. narrowed the list of Ptr1 candidates to three genes; A, B, and D. Candidate D was shown to be a pseudogene as it contained multiple mutations that disrupted the reading frame and was, therefore, not included in their functional analyses. Co-expression of candidate A with either AvrRpt2 or RipBN in N. glutinosa induced an HR-like cell death response. Candidate B, however, did not induce cell death by itself or when co-expressed with either AvrRpt2 or RipBN, and was thus not considered to be the Ptr1 gene. Taken together these experiments demonstrated that candidate A is the Ptr1 gene. Moreover, they show Ptr1 is conserved in many species within the Solanaceae family and that the Ptr1 ortholog from N. benthamiana and potato also mediate recognition of AvrRpt2 and RipBN. Lastly, phylogenetic analyses indicate that Ptr1, RPS2, and Mr5 (an NLR gene from apple whose protein product recognizes AvrRpt2) are not orthologous. The authors thus conclude the ability to recognize AvrRpt2 protease activity evolved convergently. CommentsResults section – LA4277 genome. In the first paragraph of the results section, the authors discuss NLR-encoding genes in the S. lycopersicoides genome sequence as well as in LA4277-R. Later, it was mentioned that the LA4277 genome was assembled as part of this paper. We suggest clarifying at the first introduction of the LA4277 genome features that this genome was sequenced in this study, for readers unfamiliar with available genomes. Results section—cell death assays. To test whether AvrRpt2 causes degradation of SlRin4 proteins resulting in activation of candidate A, the authors carried out cell death assays (Figure 2) by transiently co-expressing candidate A along with SlRin4-3 and AvrRpt2 or RipBN in N. glutinosa. However, in Figure 2A, they show transient co-expression of candidate A with either AvrRpt2 or RipBN is sufficient to induce an HR like cell death response, suggesting candidate A is guarding an endogenous RIN4-like protein in N. glutinosa. Did the authors try silencing the endogenous RIN4 protein in N. glutinosa and then co-express AvrRpt2/RipBN, candidate A, and SlRin4-3 to test whether SlRin4-3 has a role in AvrRpt2 recognition?  We would also suggest performing an electrolyte leakage assay to quantify the cell death responses in Figure 2C. Results section—Figure 2C. In the experiment depicted in Figure 2C, what was the rationale behind including only SlRin4-3 and not the other additional Rin4 proteins? Candidate B. Based on the immunoblot analysis in supplemental figure S2, candidate B protein expression is considerably weaker than that of candidate A protein expression (Figure 2D). Could it be a formal possibility that candidate B recognizes AvrRpt2 and RipBN, but because of the weak protein accumulation, there is no observable cell death in N. glutinosa? Discussion section.  As part of a very thorough discussion section, the second paragraph on page 10 covering RIN4 structure did not seem as relevant to the findings in this paper, as detailed analysis of Ptr1 detection of RIN4 cleavage was not experimentally investigated.

Peanut was crushed by dry comminution and wet comminution, and effects of comminution on peanut particle size and yield of peanut oil and protein were analyzed. The properties (surface protein concentration, particle size, and ξ-potential) of emulsion were compared. Moreover, different demulsification methods were used to investigate the stability of the emulsion. Results showed that yield of peanut oil and protein reached highest (87.23% and 82.05%, respectively) at dry comminution 72 s. At wet comminution 120 s, yield of peanut oil and protein was 89.91% and 84.70%, respectively, which were both higher than that of dry comminution significantly (P < 0.05). The surface protein concentration and ξ-potential of emulsion made by dry comminution (DCE) was 7.02 mg/m2 and 12.08 mV, respectively, and that was 10.71 mg/m2 and 15.25 mV of emulsion made by wet comminution (WCE), which were significantly higher than that of DCE (P < 0.05). The volume average particle size (D(4,3)) of DCE was 3.41 µm, which was significantly higher than D(4,3) of WCE (3.18µm, P < 0.05). Collectively, results of emulsion properties indicated stability of WCE was higher than DCE. Further, demulsification rate of DCE was significantly higher than that of WCE treated by freeze-thawing, pH, Papain, and Phospholipase A2 (P < 0.05). Demulsification effect of Alcalase 2.4L was best in these five demulsification methods, and demulsification rate of DCE reached 92.77%, slightly higher than WCE (92.67%), further illustrated stability of WCE was higher than DCE.