Introduction: COVID-19 emerged in China leading to worldwide morbidity and mortality, including depression and anxiety. As the pandemic spread throughout Italy and Europe, mental health concerns emerged for people with cystic fibrosis (pwCF), who are at increased risk. This led to development of a Telehealth Psychological Support Intervention to help adolescents/young adults with CF and caregivers cope with the stress and emotional challenges of the lockdown which began in Italy in March 2020. Methods: This intervention utilized cognitive behavioral skills (e.g., relaxation training, cognitive reframing). Participants included 16 adolescents/adults and 14 parents, who completed 4 individual video sessions with a psychologist. Stress ratings, PHQ-8 and GAD-7 were completed electronically. Feasibility and Satisfaction were rated. Results: Ratings of stress significantly decreased from pre to post-testing for both pwCF (paired t=-4.06 (14), p<.01) and parents (paired t=-5.2, p< 001). Most participants reported clinically elevated depression and anxiety at the pre-test, with statistically significant reductions in depression for pwCF (pre: M=8.0 to post M=4.7; paired t (14)=2.8, p <.05) but not anxiety (pre: M=6.9 to post: M=5.6, t (14)=1.2, p=NS). Reductions in depression were found for parents (pre: M=6.4 to post: M 5.1, (14) t=-2.5, p<.05) but not anxiety (pre: M=8.1 to post: M=7.9, t (14)=-0.2, p=ns). Positive ratings of Feasibility and Satisfaction were documented. Conclusion: This brief telehealth intervention yielded significant reductions in stress and depression for participants. Anxiety was not reduced, possibly because COVID was ongoing. This intervention was effective for improving mental health and was highly feasible and satisfactory.

Improving clinical practice in ENT: lessons learnt from the COVID-19 pandemicJames R Tysome, Cambridge University Hospitals, UKEditor-in-Chief, Clinical OtolaryngologyWhile currently in the midst of another wave of COVID-19 infections, putting untold strain on both healthcare systems and healthcare workers around the globe, it is important to reflect on the changes that we have all had to make. All ENT departments, within a very short timeframe, restructured clinical services to prioritise the delivery of patient care to those with the greatest clinical need, while increasing services such as tracheostomy for the high number of patients with COVID-19 in intensive care. We also changed the methods that we use to teach our trainees and share knowledge with colleagues. Many of these changes have been successful and should now be maintained in the future.It has been fascinating to see the how the research community built new research networks and redirected focus to projects related to understanding SARS-CoV-2 infection; surveillance and public health measures, optimising patient management of the disease and understanding the impact of COVID-19 on different healthcare systems. This resulted in over 89,000 peer reviewed publications relating to COVID-19 in 2020 and the development of new research structures such as CovidSurg , a global collaborative platform of studies aiming to explore the impact of COVID-19 on surgical patients.1Two papers in this issue demonstrate how clinical practice in ENT adapted to COVID-19. The first explores the publication of guidance relevant to ENT.2 Both national bodies and specialist societies across the globe published guidance on how services should be reconfigured, patients prioritised, and ENT surgeons protected, particularly with respect to aerosol generating procedures given the potential high risk of infection. It is the speed of publication that was particularly impressive. Of the 175 online publications of COVID guidance related to ENT, 41% were published between the third and fourth week of March 2020.The second study explores the impact of this guidance on clinical care through a prospective audit of the management of tonsillitis and peritonsillar abscess in 86 hospitals across the UK following the publication of guidelines by ENT UK, the professional body representing ENT surgeons in the UK. This provided a pathway that aimed to prevent hospital admission when safe to do so.3 Increased use of single doses of intravenous dexamethasone and antibiotics resulted in return to swallowing in many patients, allowing patients to be discharged safely, without later increases in re-presentation or admission.These studies show the strong clinical leadership has been demonstrated within the ENT community, removing traditional barriers to change. Clinicians have taken the initiative to develop new pathways and new ways of working. An almost overnight change from face-to-face appointments to remote appointments took place in many hospitals, showing how we can adapt when needed. Remote appointments, either by telephone4 or video calls,5 are suitable for many ENT patients, preferred by many and are certainly here to stay.There has been rapid scaling of technology such as digital consultation platforms to enable this remote service delivery. Video conferencing facilitates multidisciplinary team meetings, bringing together clinicians at distant locations to discuss patient management in an efficient manner without the need to spend hours travelling to meet in the same location. Virtual patient consultations can allow sharing of digital information such as imaging without the patient needing to leave their home, reduced footfall in previously over-crowded outpatient departments.New teaching and training opportunities have arisen through the use of digital conferencing platforms, replacing traditional teaching programmes and allowing us to reach larger audiences.6Entire conferences have successfully moved to virtual participation. These opportunities have the potential to significantly enrich training and teaching in the future.We have seen many examples of enhanced local system working. ENT and intensive care teams have needed to work more closely together to manage patients with COVID-19 requiring a tracheostomy.7 It is important that these closer relationships are maintained in the future for patient benefit.The ENT community has demonstrated strong clinical leadership, adaptability to rapid change, enhanced clinical pathways and local networks, widespread use of digital technology for consultation and teaching and redirection of research programmes. These have permanently changed the way we work and, when the current global pandemic improves as COVID-19 infections drop and vaccination programmes are rolled out, we should ensure that the positive changes that have been made are embedded in clinical practice to improve patient care.Globalsurg.org. Covidsurg, NIHR Global Health Research Unit on Global Surgery [Cited 2020 Jan 18]. Available from https://globalsurg.org/covidsurg/Cernei st al. Timing and volume of information produced for the Otolaryngologist during the COVID-19 pandemic in the UK. A review of the volume of online literature. Clin Otolaryngol;46(2):???????Smith M, et al. Admission avoidance in tonsillitis and peritonsillar abscess: a prospective national audit during the initial peak of the COVID-19 pandemic. Clin Otolaryngol;46(2):???????Sharma S and Daniel M. Telepmedicine in paediatric otorhinolaryngology: lessons learnt from remote encounters during the COVID19 pandemic and implications for future practice. Int J Paediatr Otorhinolaryngol. 2020:139:110411.Fieux M, et al. Telemedicine for ENT: effect on quality of care during COVID-19 pandemic. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137(4):257-261.Herman A, et al. National, virtual otolaryngology training day in the United Kingdom during the COIVD-19 pandemic: results of a pilot survey. J Surg Educ. 2020; S1931-7204McGrath BA, et al. Multidisciplinary guidance for safe tracheostomy care during the COVID-19 pandemic: the NHS National Patient Safety Improvement Programme (NatPatSIP). Anaesthesia 2020;75(12):1659-1670.

Purpose: An elevated left ventricular (LV) filling pressure is the main finding in patients with heart failure with preserved ejection fraction, which is estimated with an algorithm using echocardiographic parameters recommended by the recent American Society of Echocardiography (ASE)/European Association of Cardiovascular Imaging (EACVI) guideline. In this study, we sought to determine the efficacy of LV global longitudinal strain (GLS) to estimate the elevated LV filling pressure. Methods and Results: 73 prospectively selected patients undergoing left ventricular catheterization (mean age 63.19±9.64, 68.5% male) participated in this study. Using the algorithm, the LV filling pressure was estimated with the echo parameters obtained within 24hrs before the catheterization. The LV GLS was measured using the automated functional imaging system (GE, Vivid E9 USA). Invasive LV pre-A pressure corresponding to mean left atrial pressure (LAP) was used as a reference, and >12 mm Hg was defined as elevated. The invasive LV filling pressure was elevated in 43 (58.9%) and normal in 30 patients (41.1%). In 9 (12.3%) patients of 73 are defined as indeterminate based on the 2016 algorithm. Using the ROC method, -18.1% of LV GLS estimated the LV filling pressure (AUC=0.79, 73% specificity, 84% sensitivity) with higher sensitivity compared with the algorithm (AUC=0.76, 77% specificity, 72% sensitivity). Conclusions: We confirmed that the LV GLS is feasible and reproducible in estimating LV filling pressure. In addition, LV GLS highly predicts elevated LAP as E/e’ and TR jet velocity and may be used as major criteria for the diagnosis of HFpEF

Atrial tachycardia (AT) in the right atrium often occurs following open-heart surgery. Catheter ablation for these AT is challenging and can lead to unintended conduction block. We performed late-gadolinium enhancement magnetic resonance imaging (LGE-MRI) prior to catheter ablation and predicted wavefront propagation during SR as well as the slow conduction zone during tachycardia. LGE-MRI may assist predicting the conduction disturbance and reducing the risk of unexpected sinus exit block.

Aims of the Study: A radiographic examination is a significant part of the clinical routine for the diagnosis, management, and follow-up of the disease. Artificial intelligence in dentistry shows that the deep learning technique high enough quality and effective to diagnose and interpret the images in the dental practice. For this purpose, it is aimed to evaluate diagnostic charting on panoramic radiography using a deep-learning AI system in this study. Methods: 1084 anonymized dental panoramic radiographs were labeled for 10 different dental situations including crown, pontic, root-canal treated tooth, implant, implant-supported crown, impacted tooth, residual root, filling, caries, and dental calculus. AI Model (Craniocatch, Eskişehir, Turkey) based on a deep CNN method was proposed. A Faster R-CNN Inception v2 (COCO) model implemented with Tensorflow library was used for model development. The training and validation data sets were used to predict and generate optimal CNN algorithm weight factors. Results: The proposed artificial intelligence model has promising results for detecting dental conditions in panoramic radiographs except for caries and dental calculus. The most successful F1 Scores were obtained from the implant, crown, and implant-supported crown as 0,9433, 0,9122, 0,8947, respectively. Conclusion: Thanks to the improvement of the success rate of AI models in all areas of dentistry radiology, it is predicted that they will help physicians especially in panoramic diagnosis and treatment planning, as well as digital-based student education, especially in this pandemic period when online training is on our agenda.

Angioma serpiginosum is a rare benign nevoid disorder affecting the small vessels of the upper dermis. We are presenting a case of this rare disease in an 11-year-old girl who presented with this condition on abdomen in zosteriform pattern which is rare presentation and is the first of its type.

Since the first description of phloem sap composition nearly 60 years ago, it is generally assumed that phloem sap does not contain nitrate and that there is little or no backflow of nitrate from shoots to roots. While it is true that nitrate can occasionally be absent from phloem sap, there is now substantial evidence that phloem can carry nitrate and furthermore, transporters involved in nitrate redistribution to shoot sink organs and roots have been found. This raises the question of why nitrate may or may not be present in phloem sap, why its concentration is generally kept low, and whether plant shoot-root nutrient cycling also involves nitrate. We propose here that phloem sap nitrate is not only an essential component of plant nutritional signaling but also contributes to physical properties of phloem sap and as such, its concentration is controlled to ensure proper coordination of plant development and nutrient transport.

Pustular psoriasis is a rare, acute form of psoriasis. It can be triggered by pregnacy, infection, hypocalcemia, and medications. We describe a case of annular pustular psoriasis Milian Katchoura type, a rare variant of pustular psoriasis, that occurred secondary to reducing the dose of oral corticosteroids.

The role of Immunotherapy in Chronic Urticaria is unclear, except for isolated circumstances. Hymenoptera sting causes acute urticaria and no report of CU after Hymenoptera sting can be found in the literature. We describe a case of onset of CU after multiple wasp stings that remitted during venom immunotherapy.

Background: The role of combination regimens in the treatment of invasive fungal infections (IFI) in patients with hematologic malignancies remains unclear. This study was aimed to demonstrate experience data about combined antifungal therapy (CAT) in pediatric IFI patients with haematological malignancies. Methods: Between January 2014 and December 2017, a total of 33 IFI episodes in 28 patients with hematological malignancies were analyzed retrospectively. Results: Of the patients (19 with acute lymphoblastic leukemia, and 9 with acute myeloblastic leukemia), 21 (75%) had leukemia relapse and 7 (25%) had remission. IFI was classified as possible in 26 (78.8%) episodes, probable in 5 (15.1%) episodes, and proven in 2 (6.1%) episodes. LamB (%50) was the most preferred agent in monotherapy. Mean duration of monotherapy was 12.84 ± 4.28 (5-24) days. LamB plus voriconazole (54.5%) were the most common combination preference in CAT. Mean duration of CAT was 42.36 ± 36.4 days, and unchanged according to combination regimen type (p = 0.571). Total mortality rate and IFI attributable mortality rate were 60.7% vs 76.5%. Mortality rate was significantly higher in patients with relapse (p = 0.006). Complete response was obtained in 81.8% of surviving patients. Duration of neutropenia and CAT, and recovery time were not found statistically different in the episodes with/without death and according to relapse or remission status. Side effects due to CAT use were observed quite low level. Conclusion: CAT has been found to be safe in IFI episodes of pediatric leukemia. The result will contribute to the data about combined antifungal use in daily clinical practice in pediatric haematological patients with IFI.

Objective: The novel coronavirus SARS-CoV-2 (COVID-19) rapidly escalated from its origin in an animal market in Wuhan, China in December 2019 to a global pandemic, and the lungs are the most frequently affected organ. The aim of this study was to investigate the relationship between pulmonary function test parameters and laboratory parameters in COVID-19. Method: A total of 60 patients who were admitted to the chest diseases department and intensive care unit of our hospital and were diagnosed with COVID-19 by real-time PCR analysis of nasopharyngeal swabs were evaluated. Pulmonary function tests and laboratory parameters at admission and on day 7 of treatment were analyzed. Results: On day 7 of treatment, white blood cell count, CRP, and fibrinogen level were significantly lower than at admission (p=0.002, 0.001, and 0.001, respectively), while forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) values were significantly higher compared to admitting values (p=0.001 for both). Correlation analysis of the changes in respiratory function values and laboratory parameters during follow-up (day 1 to day 7 of treatment) revealed that CRP level was positively correlated with FEV1 (r=0.616, p=0.01) and FVC values (r=0.51, p=0.01). Fibrinogen level was also positively correlated with FEV1 (r=0.345, p=0.01) and FVC (r=0.357, p=0.01). Conclusion: Fibrinogen and CRP levels are easily accessible parameters that may help identify improvement or deterioration in pulmonary function in COVID-19 patients during follow-up and discharge while reducing the risk of transmission.

Aim: In this feasibility study, we aimed to implement a pilot telemedicine service at our healthcare facility in Faisalabad, Pakistan, and describe our experience. Methods: Telemedicine service was established by Faisalabad Medical University at two of its affiliated locations: 1) A 24-hour COVID-19 Telephone Helpline was established at Director Emergency Office, Allied Hospital and District Headquarter (DHQ) Hospital. 2) A Telemedicine Clinic comprising consultants and postgraduate residents from different specialties was established at Chief Office, Allied Hospital. The data related to the number and categories of calls and advice provided was collected from 27th March 2020 till 31st July 2020. Results: A total of 4582 calls were received, at both locations, during the study period, out of which 2325 callers (51%) were male, and 2257 (49%) were females. At Allied Hospital, 172 patients were advised accordingly for their complaints, whereas, at DHQ Hospital, 320 patients were advised accordingly for their complaints. At the telemedicine clinic only, a total of 2436 calls were received during the study period, 1474 (60%) callers were male, and 962 (40%) were female. The majority of the calls were received by medicine (43%), dermatology (21%), and pediatrics (11%) specialties, respectively. Conclusion: Despite some limitations, the benefits of telemedicine in this COVID-19 era are enormous and it is feasible to implement telemedicine services in developing countries. The developing countries must invest in the internet and technology access to facilitate telemedicine and other e-health services for not only curbing this pandemic but also to promote a more efficient healthcare system after the pandemic.

Land development is rapidly occurring on sand--dominant soils that cover substantial areas of the Lower Mekong Basin. Sands are at risk of degradation on sloping uplands where agriculture is expanding and on lowland landscapes where intensification of cropping is occurring. Sandstone and granitic geology explain the prevalence of sand-dominant texture in profiles. The sand terrains in uplands of Cambodia and southern Laos mostly have not been comprehensively mapped and their diversity and edaphic properties are poorly understood. On high permeability sands, lowland rainfed rice crops are drought-prone, while nutrient losses from leaching are also a risk. Furthermore, waterlogging, inundation and subsoil hardpans are significant water-related hazards that influence the choice of field crops and forages for lowland soils. Land use change in the lowlands to alternative field crops and forages on sands is contingent on their profitability relative to rice, the amounts and reliability of early wet season rainfall and amounts of stored water available after harvesting rice. Soil acidity, low nutrient status, hard-setting and shallow rooting depth are significant constraints for crops and forages on sands in the lowlands. Low soil fertility and soil acidity are limitations to the productivity of farming systems on the sand profiles in uplands, while erosion, low soil organic matter levels and water balance are concerns for their sustainable use. There is a need for widespread land suitability assessment and the development of sustainable farming systems before uncontrolled expansion of agriculture causes degradation of sandy terrain of the Lower Mekong Basin.

Periphyton plays an indispensable role in coastal saline-alkali land, but its function is poorly understood. Soil physical and chemical properties (pH value, salinity, soil organic matter), enzyme activity and microbial diversity (based on 16s rDNA, ITS and functional genes) were measured in periphyton formed on rice-growing coastal saline-alkali soil modified by a new type of soil conditioner. The results showed that the content of organic matter and catalase activity in periphyton were significantly higher than in the unplanted control soil. Soil pH and salinity were decreased in periphyton compared to the unplanted control soil. Based on the relative abundance, bacterial genera Desulfomicrobium, Rhodobacter, cyanobacterium_scsio_T−2, Gemmatimonas, and Salinarimonas as well as fungal genus Fusarium were more abundant in periphyton than the unplanted control soil. In terms of functional genes, the cbbM and cbbL sequencing showed higher abundance of Hydrogenophaga, Rhodovulum, Magnetospira, Leptothrix, and Thiohalorhabdus, whereas the nifH sequencing indicated higher abundance of Cyanobacteria in the periphyton compared to the unplanted soil. The relative abundance and community structure of soil microorganisms were improved by periphyton, thus reducing soil salinity and pH, increasing soil organic matter and enzyme activity. This indicated that the periphyton can improve the conditions and offer a suitable environment for plant growth in coastal saline-alkali soil.

Background: Three-dimensional echocardiography (3DE) evaluation of left ventricular (LV) volume and function in pediatrics compares favorably with cardiac magnetic resonance imaging. The aim of this study was to establish from a multicenter, normal pediatric z-score values of 3DE left ventricular volumes and function. Methods: Six hundred and ninety-eight healthy children (ages 0 to 18 years) were recruited from five centers. LV 3DE was acquired from the 4-chamber view. A vendor independent software analyzed end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), and ejection fraction (EF) using semi-automated quantification. Body surface area (BSA) based z-scores were generated. Intraobserver and interobserver variability were calculated using intraclass correlation (ICC) and repeatability coefficient (RC). Results: Z-scores were generated for ESV, EDV, and SV. The ICC for intraobserver variability for EDV, ESV, and SV were 0.99, 0.99, and 0.99 respectively. The ICC for interobserver variability for EDV, ESV, and SV were 0.98, 0.94, and 0.98 respectively. The RC for intraobserver and interobserver variability for LV EF was 4.39% (95% CI: 3.01, 5.59) and interobserver was 7.08% (95%CI: 5.51, 8.42). Conclusions: We report pediatric Z-scores for normal LV volumes using the semi-automated method from five centers, enhancing its generalizability. 3DE evaluation of LV volumes and EF in pediatric patients is highly reproducible.

This study presents the case of a 9-year-old girl for whom complete resolution of recalcitrant warts was achieved with acupuncture and moxibustion treatment. This result suggests that acupuncture and moxibustion could be effective therapeutic strategies for plantar warts in the paediatric patient population.

In semi-arid environments, aperiodic rainfall pulses determine cycles of plant production and resource availability for higher trophic levels, creating strong bottom-up regulation. The influence of climatic factors on population vital rates often shapes the dynamics of small mammal populations in such resource-restricted environments. Using a 21-year biannual capture–recapture dataset (1993 to 2014), we examined the impacts of climatic factors on the population dynamics of the brush mouse (Peromyscus boylii) in semi-arid oak woodland of coastal-central California. We applied Pradel’s temporal symmetry model to estimate capture probability (p), apparent survival (φ), recruitment (f), and realized population growth rate (λ) of the brush mouse, and examined the effects of temperature, rainfall, and El Niño on these demographic parameters. The population was stable during the study period with a monthly realized population growth rate of 0.993 ± SE 0.032, but growth varied over time from 0.680 ± 0.054 to 1.450 ± 0.083. Monthly survival estimates averaged 0.817 ± 0.005 and monthly recruitment estimates averaged 0.175 ± 0.038. Survival probability and realized population growth were positively correlated with rainfall and negatively correlated with temperature. In contrast, recruitment was negatively correlated with rainfall and positively correlated with temperature. Brush mice maintained their population through multiple coping strategies, investing in high recruitment during warmer and drier periods and allocating more energy towards survival during cooler and wetter conditions. Although climatic change in coastal-central California will favor recruitment over survival, varying strategies may serve as a mechanism by which brush mice maintain resilience in the face of climate change. Our results indicate that rainfall and temperature are both important drivers of brush mouse population dynamics and will play a significant role in predicting the future viability of brush mice under a changing climate.

Background: Ultrasound techniques are generally not used as a primary tool in the evaluation of mediastinal tumors and cysts. This study aimed to identify factors associated with pulmonary hypertension (PH) measured by transthoracic echocardiography (TTE) in patients with a mediastinal tumor. Methods: This retrospective, observational study was performed from January 2015 to December 2020. Fifty-five patients (mean age, 62 ± 13 years; 31 [56%] women) who had a mediastinal tumor and underwent TTE were included. Patients were classified as with PH or without PH. We analyzed clinical factors and echocardiographic parameters. Results: PH was found in 21 (38%) patients. Twenty-two patients were asymptomatic, and none had symptoms associated with PH. Forty-seven (86%) patients underwent surgery, and 23 (42%) patients were diagnosed with malignant tumors. The presence of PH was not related with malignancy. Patients with PH were older than those without PH (67 ± 10 versus [vs.] 59 ± 14 years, p = 0.017). Small left ventricular (LV) systolic dimension (29.4 ± 3.6 vs. 31.6 ± 3.6 mm, p = 0.040) and dimension (4.2 ± 0.3 vs. 4.5 ± 0.3 mm, p = 0.004) and hyperdynamic LV ejection fraction (EF, 69 ± 6 vs. 65 ± 5%, p = 0.019) were associated with PH. Among them, older age, small LV dimension, and high EF were independently associated with PH. Conclusion: The presence of PH had no significant effect on patients’ clinical manifestation or malignancy.

Aims To provide evidence for the clinically rational administration of bupropion (BUP), the effects of high-fat diet and CYP2B6 mutants on BUP and hydroxybupropion (HBUP) among 44 healthy Chinese subjects. Methods The concentrations of BUP and HBUP in plasma were determined with a high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) analysis. Genotypes were ascertained after amplified by polymerase chain reaction and restriction fragment length polymorphism (PCR-RFLP). Results The maximum plasma concentration (Cmax) and time to Cmax (tmax) of BUP as well as the concentration–time curve (AUC(0→96)) and Cmax of HBUP all increased by 1.18-, 1.41-, 1.38-, and 1.33-fold in the feeding group relative to the fasting group, respectively. Interestingly, the Cmax and terminal half-life (t1/2) of BUP increased by 1.33- and 1.39-fold among those subjects carrying the CYP2B6*1/*1 genotype in the feeding group relative to those in the fasting group. Similarly, the apparent volume of distribution (Vd) and clearance (CL) of HBUP increased by 1.38- and 1.59-fold, respectively, while the Cmax and AUC(0→96) of HBUP decreased by 1.44- and 1.49-fold among those subjects carrying the CYP2B6*1/*1 genotype in the feeding group relative to those in the fasting group. Concliusion These data suggest that high-fat diet and CYP2B6 mutants can influence the pharmacokinetic parameters of BUP and HBUP, thereby offering clear evidence for the rational administration of BUP among Chinese subjects in clinical settings.

Introduction: Several studies on late effects of childhood cancer have been conducted during the past decades. To ensure external validation of a study population, the participation rate must be high. This study investigated demographic data in late effect studies and potential factors impacting on participation rates such as cancer type, time since diagnosis and duration of clinical examinations. Procedure: By searching the databases PubMed, Embase and Web of Science and by contacting researchers and clinicians, we identified studies including an invitation to a clinical examination for late effects after childhood cancer. Studies conducted from January 2010 - March 2020 in the Nordic countries were included. Results: We found 80 published studies originating from 16 cohorts. The overall participation rates ranged between 27 and 100%. The majority of studies (eleven studies) were conducted more than ten years after the cancer diagnosis and primarily on hematologic malignancies (seven studies). The highest participation rates were seen in studies of survivors with solid tumors (92%) and the lowest in survivors with hematologic malignancies (67%) and central nervous system tumors (73%). Neither duration of the clinical examination nor time since diagnosis seemed to affect the participation rate. Conclusion: A trend of lower participation rates when recruiting survivors of hematologic malignancies and central nervous system tumors was found. We encourage future studies to describe the recruitment process more thouroughly to improve understanding of the factors influencing participation rates.

The Shannon, R\’enyi, and Tsallis entropies of normalized electron density in position and momentum spaces are studied for the 1s${}^{2}$ state of Helium-isoelectronic series. Within single-zeta $\beta$-type orbitals ($\beta$TOs), the Hartree-Fock-Roothaan (HFR) calculations are considered and condensed on the most features of the physical results. The information quantities with atomic number deal with the interactions between the core and valence regions of the atom and thus enhance a geometrical understanding for the difference. It is assumed that the presented result might be a significant reference for further research topic on theoretical information quantities of atomic and molecular. Indeed, Our results have a good agreement in comparison with the previous published results.

Invasive ants shape assemblages and interactions of native species, but their effect on fundamental ecological processes is poorly understood. In East Africa, Pheidole megacephala ants have invaded monodominant stands of the ant-tree Acacia drepanolobium, extirpating native ant defenders and rendering trees vulnerable to canopy damage by vertebrate herbivores. We used experiments and observations to quantify direct and interactive effects of invasive ants and large herbivores on A. drepanolobium photosynthesis over a 2-year period. Trees that had been invaded for ≥ 5 years exhibited 69% lower whole-tree photosynthesis during key growing seasons, resulting from interaction between invasive ants and vertebrate herbivores that caused leaf- and canopy-level photosynthesis declines. We also surveyed trees shortly before and after invasion, finding that recent invasion induced only minor changes in leaf physiology. Our results from individual trees likely scale up, highlighting the potential of invasive species to alter ecosystem-level carbon fixation and other biogeochemical cycles.

Purpose: It has been suggested, on a theoretical basis, that ultrasound screening of thyroid nodules in obese patients with additional risk factors (family history, thyroiditis or high thyrotropin) might be cost-effective for the early detection and treatment of thyroid cancer. The present study evaluates if this approach can be validated in a real clinical setting. Methods: Patients with obesity attended in hospital-based clinics were evaluated for risk factors of thyroid cancer and ultrasound screened for thyroid nodularity. Detected nodules were evaluated according to current guidelines. Results: A total of 429 patients were evaluated (70.2% women, mean age 49.1±11.0, mean body mass index 42.6±5.8 kg/m2). Risk factors were present in 129 (30.1%) patients. Thyroid nodules with indication for fine needle aspiration biopsy were detected in 69 (16.1%). We did not find differences in the risk of harbouring thyroid nodules according to the presence of risk factors (no risk factors 16.6%, risk factors 14.1%, p = 0.64). No single risk factor conferred an increased risk for thyroid nodules During the screening procedure 4 cases of thyroid cancer were detected, none of them with the evaluated risk factors. Conclusion: The present study, has been unable to demonstrate that the use of known risk factors for thyroid cancer is helpful to discriminate obese patients with higher risk of harbouring thyroid nodules.

Ankylosing spondylitis (AS) a seronegative inflammatory disease that often presents with co-existing issues like bilateral hip replacements, nephrolithiasis, skin lesions, peripheral vascular disease and coronary artery disease.. We describe a patient with ankylosing spondylitis with bilateral hip replacements in the past who was waiting for an elective coronary artery bypass grafting (CABG) but needed urgent admission with renal colic and unstable angina. In the current COVID pandemic in order to reduce hospital stay and risk of hospital acquired COVID infection we decided to perform simultaneous CABG and removal of ureteric stone. In this case report we discuss the issues in relation to management of patients with coronary artery disease and ankylosing spondylitis.