Objective: To examine baseline risk factors measured in the first-trimester screening for preeclampsia (PE) in pregnant women with COVID-19 versus the general population. To compare risk factors among patients with mild and severe COVID-19. Design: Observational retrospective study. Setting: Six maternities in Catalonia. Population: Study patients were 231 pregnant women undergoing first-trimester screening for PE and positive for SARS-CoV-2. Reference cohort were 13,033 pregnant women with first-trimester screening for PE from 6 maternities. Methods: Recording of maternal history, mean arterial blood pressure (MAP), mean uterine artery pulsatility index (UtAPI), placental growth factor (PlGF) and pregnancy-associated plasma protein-A at first trimester. Confirmation of SARS-CoV-2 infection. Based on the need for hospitalization, patients were classified into mild and severe COVID-19. Main outcome measures: Comparison of proportion of cases at a high risk for PE and of risk factors for PE among groups. Results: High risk for PE was significantly higher amongst COVID-19 patients compared to the general population, showing higher rates of obesity, chronic hypertension, higher UtAPI, and lower rates of smokers. PlGF did not differ significantly. In women with severe COVID-19, compared with mild COVID-19, BMI and MAP were significantly higher, whereas PlGF and UtAPI did not differ significantly. Conclusions: In patients with COVID-19 there was a higher proportion of women at a high risk for PE than in the general population, mainly due to maternal risk factors, rather than placental signs of a deficient trophoblastic invasion. Likewise, according to COVID-19 severity, differences were due to maternal risk factors only.

Von Recklinghausen's disease is characterized by skin pigmentation, multiple neurofibromatosis, and osseous changes. In the management of anesthesia, a variety of pathologies need to be taken into account. This case describes the perioperative management of a patient with Recklinghausen's disease suspected difficulty in airway management.

Temporomandibular Joint Ankylosis(TMJA) may manifest in patients with several predisposing systemic conditions. A case of extraarticular TMJA is presented in a patient diagnosed with Fibrodysplasia Ossificans Progressive(FOP) is presented. The features, diagnosis and management of TMJA superimposed on this condition is presented through a qualitative systematic review of literature.

There is need to optimize dental procedures for better productivity and patient acceptance, without, however, reducing the quality of the results obtained. The objective of this work is to present a clinical case that illustrates endodontic retreatment followed by installation of a fiber glass post and coronary preparation.

The World Health Organization classifies odontomas as odontogenic tumors.There are two variants of odontomas: complex and compound. Complex odontomas are made of an anarchic assembly of mineralized tissue and dental pulp; while compound odontomas are consisting of a set of rudimentary teeth. They rarely show the features of both ty

The objective of this case report was to describe the treatment sequence of an immediate dental autotransplantation, with the use of technology such as the elaboration of a 3D replica made on a computer in conjunction with cone beam computerized tomography and the use of an piezoelectric

To study the mechanism and process characteristics of self-healing of salt rock damage, the shear test was used to conduct initial damage to the samples. Then, the experiment of self-healing recovery damaged salt rock is designed. Computed Tomography (CT) tests, Scanning Electron Microscope (SEM) tests and theoretical analyses have been performed to study the characteristics of recovery of the damage salt rock during self-healing. The experimental results showed that the crack of the damaged salt rock have a good healing effect after short-term (such as 7 days) immersion in saturated brine. But in this healing process, brine has two mechanisms of action. When the soaking time is less than the threshold, the mechanism of brine action is softening, which leads to the decrease of recovery rate of the salt rock. However, while the soaking time exceeds the threshold, the mechanism of brine action is healing and recovery.

Introduction: A number of measures were began due to coronavirus 2019 disease (Covid-19) pandemic in many countries worldwide. A lockdown was applied for aged <18 years, education was continued online, and wearing a mask became mandatory in public places, which created an unprecedented period for children. Real-life data is limited showing how children with asthma are affected due to major changes. This study reveal how asthmatic children are affected by pandemic conditions based on real-life data. Methods: Patients with asthma aged 6–18 years who were followed up in March, April, and May 2019—before the Covid-19 pandemic—were included in the study. Data from March-April-May 2020 and 2019 were compared to reveal the effects of the pandemic-related lifestyle changes on symptoms, frequency of exacerbations, and drug use in asthmatic children. Results: A total of 86 children with asthma aged 6–18 years were included in this study. Time spent inside the home was significantly higher in 2020 than in 2019. Need for rescue medications and emergency department visits were significantly lower in 2020 compared to 2019 (p<0.001). The number of well controlled patients with asthma was higher in 2020 than in 2019 (p < 0.0001). Number of patients using prophylactic drugs within the last 3 months was lower in 2020 compared to 2019 (p = 0.007). Conclusion: The present study provides valuable insights into the condition of children over the age of 6 years during the Covid-19 pandemic based on real-life data. During the pandemic period, the number of asthmatic exacerbations, rescue drug use and asthma control were positively affected in school aged children with asthma.

Conservation of wide-ranging species is a challenge owing to their movement in an increasingly fragmented world. Long-distance dispersal has significant implications for ecosystem functioning, and such movement becomes challenging while navigating through a heterogeneous and human-dominated landscape. Here, we describe one of the longest dispersal journey by a sub-adult male tiger through GPS telemetry in Central India. We analyzed movement metrics, directionality, and space use during three behavioural stages of dispersal. We also used the clustering method to identify resting and kill sites (n = 89). T1-C1 dispersed a straight-line distance of 315 km over 225 days, moving an average 8.4 km/day and covering a cumulative displacement of ̵̴ 3000 km. Movement during post-dispersal was higher (mean = 465.6 m/h) than those during dispersal (mean = 376.6 m/h) and pre-dispersal (mean = 132.2 m/h), respectively. Moreover, movement during the night was significantly faster than during the day in all three phases. Likewise, during dispersal, the movement was faster (mean = 518.2 m/h) and more directional (knight = 0.19) at night than day. The average size of clusters was 1.68 ha and primarily away from human habitation (mean = 1875.6 m). The mean cluster duration (46.31 hr) was higher in the non-forested area but was smaller in size than inside the forest (p< 0.05). The individual crossed roads faster (mean= 1880.9 m/hr) than it travelled during other times. During the post-dispersal phase, T1-C1 established its home range with an area of 319.48 sq. km. (95% dBBMM). The dispersal event highlights the long-distance and multiscale movement behaviour in a heterogeneous landscape. Moreover, small forest patches play a key role in maintaining large carnivore connectivity while dispersing through a human-dominated landscape. Our study underlines how documenting the long-distance movement and integrating it with modern technology can improve conservation management decisions.

Remission of eczema and recovery of T h1 polarization following treatment with Dupilumab in STAT3 hyper IgE syndromeMatucci-Cerinic Caterina1,2, Viglizzo Gianmaria3, Pastorino Carlotta3, Corcione Anna2, Prigione Ignazia2, Bocca Paola2, Bustaffa Marta1,2, Cecconi Massimiliano4, Gattorno Marco2,5, Volpi Stefano1,21Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DINOGMI), Università degli Studi di Genova, Genova, Italy2Unità Operativa Semplice Dipartimentale Centro Malattie Autoinfiammatorie e Immunodeficienze, IRCCS Istituto Giannina Gaslini, Genova, Italy.3UOC Dermatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy4UOC laboratorio di Genetica umana, IRCCS Istituto Giannina Gaslini, Genoa, Italy5UOC Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa, Italy

Objective To investigate the safe range of vital signs of pregnant women pulmonary hypertension (PH). Study design Retrospective study. Setting The largest First-class Hospital at grade 3 in Northwestern China Population pregnant women with PH in Intensive care unit (ICU). Methods This of consecutive obstetric patients with PH admitted to ICU of the First Affiliated Hospital of Air Force Military Medical University of China, from January 2011 to May 2020, consisted of 92 cases analyzed using time-dependent Cox regression to consider the dynamic features of vital signs. Main outcome measures Maternal mortality Results 7/92 maternal deaths occurred. Three vital signs were identified as risk factors in the maternal in-hospital mortality model via backward selection: SpO2（HR，0.93；95%CI，0.88-0.97；P=0.003）, heart rate（HR，0.94；95%CI，0.90-0.99；P=0.027）, and mean arterial pressure (MAP) （HR，1.09；95%CI，1.00-1.18；P=0.045）. The optimal range of SpO2 <73%, MAP was 65–95 mmHg, and heart rate was 59–125 beats per minute (bpm). Further exploration showed that the cumulative and the longest consecutive time of abnormal vital signs also affect the outcome. For example, SpO2<73% accumulated for 5 h or continuously up to 2 h increases mortality. Conclusions: Maintaining SpO2>73%, MAP at 65–95mmHg, and heart rate at 59–125 bpm can significantly reduce in-hospital maternal mortality. The effects of the abnormal SpO2, heart rate, and MAP on in-hospital maternal mortality should be combined with the cumulative time and the longest duration. Funding Dr. Binxiao Su is supported by the National Institutes of Health (NIH) grant 81870961

A document by Ekaterina Spiridonova, written on Authorea.

1. Global climate change affects many aspects of biology and has been shown to cause body size changes in animals. However, suitable datasets allowing the analysis of long-term relationships between body size and climate are rare. 2. The size of the skull, often used as a proxy for body size, does not change much in fully grown vertebrates, but some soricine shrews shrink their skull and brain in winter and regrow it in spring. This is thought to be a winter adaptation in these high-metabolic, nonhibernating animals, as a smaller brain size reduces energy requirements. 3. Climate could thus affect not only the overall size but also the pattern of the size change, i.e., Dehnel’s Phenomenon, in these shrews. 4. We assessed the impact of the changes in climate on the overall skull size and the different stages of Dehnel’s phenomenon in skulls of the common shrew, Sorex araneus, collected over 50 years in the Białowieża Forest, NE Poland. 5. Overall skull size decreased, along with increasingly mild winters and decreasing soil moisture, which determined the availability of the shrews’ main food source, earthworms. The magnitude of Dehnel’s phenomenon increased over time, indicating an increasing selection pressure on animals in winter. Overall, climate clearly affected the common shrew’s overall size as well as its seasonal size changes. With the current acceleration in climate change, the effects on the distribution range of this cold-adapted species may be quite severe.

A document by Aastha Singh, written on Authorea.

Immunization of the population through vaccination against COVID-19 is recognized as a public health priority. The most difficult scientific challenge for vaccines is the clinical safety and efficacy. We report a patient presenting with Fusobacterium nucleatum bacteremia and liver abscess formation following administration of anti-COVID-19 viral-vectored vaccine.

Problem statement: To halt global biodiversity decline, many conservation measures are set up by citizens, companies, or stakeholders. However, even if originally well-intentioned, some of these actions could have direct or indirect negative effects on biodiversity when ecology is not accounted for. The management of bees is a good example of such misplaced conservation practices. We identified three successive errors in the management of bees which can disrupt the focus on real conservation issues: the multiplication of honey bee hives, the installation of insect hotels, the trade of solitary bee cocoons for release into the wild. To help the bees, as well as biodiversity in general, we must consider prioritizing efficient conservation measures which consider more broadly the complexity of ecosystems.

Despite early coronary revascularisation, postinfarction pseudoaneurysm remains a serious complication of coronary artery disease. Urgent diagnostics and surgery are mandatory for good clinical outcome. Here were report a case of left ventricular pseudoaneurysm undergoing urgent cardiac surgery.

Abstract We present an acute intoxication with 12 grams of efavirenz (EFV) in a 16-year-old healthy girl whose main problem was neurotoxicity which is dose-dependent. No other serious EFV-related side effects were seen. Previous serious side effects of EFV were observed in HIV-infected patients who underwent long-term combination drug therapy.

Aim: To determine whether the known single nucleotide polymorphisms in adrenoreceptor associated genes affect the hemodynamic response to dobutamine in critically ill neonates. Methods: Alleles in the known genetic single nucleotide polymorphisms in β1 and β2 adrenoceptor (AR) genes and Gs protein α-subunit gene (GNAS) possibly affecting inotropic effect were identified in patients of neonatal dobutamine pharmacokinetic-pharmacodynamic study. Linear mixed-effect models were used to describe the effect of genetic polymorphisms to heart rate (HR), left ventricular output (LVO) and right ventricular output (RVO) during dobutamine treatment. Results: 26 neonates (5 term, 21 preterm) were studied. Dobutamine plasma concentration and exposure time respective HR (adjusted to gestational age) is dependent on β1-AR Arg389Gly polymorphism so that in G/G (Gly) homozygotes and G/C heterozygotes dobutamine increases HR more than in C/C (Arg) homozygotes, with parameter estimate (95% CI) of 38.3 (15.8 – 60.7) bpm per AUC of 100 mg·h, p=0.0005. LVO (adjusted to antenatal glucocorticoid administration and illness severity) and RVO (adjusted to gestational age and illness severity) is dependent on GNAS c.393C>T polymorphism so that in T/T homozygotes and C/T heterozygotes but not in C/C homozygotes LVO and RVO increase with dobutamine treatment, 24.5 (6.2 – 42.9) mL kg-1 min-1 per AUC of 100 mg·h, p=0.0116 and 33.2 (12.1 – 54.3) mL kg-1 min-1 per AUC of 100 mg·h, p=0.0025, respectively. Conclusion: In critically ill neonates, β1-AR Arg389Gly and GNAS c.393C>T polymorphisms may play a role in the haemodynamic response to dobutamine during the first hours and days of life.

Although under-reported, hemolytic anemia is common with dapsone therapy. However, it is prudent to screen underlying G6PD deficiency to prevent potentially life-threatening episode of intravascular hemolysis in leprosy.

Understanding the changes in microbial communities with increasing plantation age will benefit the maintenance of forest health and productivity and the sustainable development of forest ecosystems. Based on MiSeq sequencing, we carried out the first study on the effects of stand age on microbial communities in rhizosphere and bulk soils of pecan plantation. The results suggested that soil bacterial alpha diversity increased significantly with plantation age, while fungal alpha diversity was less influenced. Bacterial and fungal biomarkers differed by age group. The fungal community composition was significantly altered by plantation age as reflected by the increase and decrease in the relative abundances of Basidiomycetes and Ascomycota, respectively. The pH and AP and TK contents drove microbial community structure and composition. The bacterial network was more complex than the fungal network, and simpler and more stable microbial network structures occurred in the rhizosphere soil than in the bulk soil. With increasing plantation age, the risk from plant pathogenic fungi increased, and the functional profile of the microbial community shifted from the nitrogen cycle to carbon utilization.

The extent to which the avian microbiome is shaped by host phylogeny relative to other factors is largely unknown. In this study, we examine microbial biodiversity across multiple body sites of 211 bird species sampled in Malawi. Microbial community dissimilarity differed significantly across body sites, which included blood, buccal cavity, gizzard, intestine, cloaca, liver, and spleen. With these data, we tested the hypothesis that the avian microbiota follow a Species-Area Relationship by using a comparative phylogenetic method to examine the correlation between microbiota richness and host weight. Using Pagel's lambda, we confirmed that bird mass is significantly correlated with host phylogeny but found that few microbial diversity metrics showed such a correlation. Phylogenetic Generalized Least Squares identified a significant but weak negative correlation between host weight and microbial richness of the blood and a similarly significant but weak positive correlation between the cloacal microbiota and host weight among birds within the order Passeriformes. Taken together, these results suggest that the avian microbiome does not follow a traditional species-area relationship when phylogenetic relatedness is considered, rather, microbial diversity is influenced by factors beyond host phylogeny and size.

Title: “Close But No Cigar”: Successful Aortic Valve Repair Using Autologous Pericardium

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