In March 2020 a pandemic was declared due to a novel coronavirus strain. The virus can create a hypercoagulable state. This case is one of the first to report the development of a pulmonary embolism in an infected patient with no known risk factors in an outpatient setting.

Increasing anthropogenic loading of phosphorus (P) threatens aquatic ecosystems. The bioavailability of P in sediments for algal growth depends on several physiochemical properties such as silt, clay, mineralogy, pH, electrical conductivity (EC), and carbonate-content. This study was aimed on selecting the best chemical extraction method to characterize P-availability for the algae Selenastrum capricornutum. Principal component analysis (PCA) of the data identified two components that cover 79.3% of the total variation, and these components were dominated by particle size distribution, active calcium carbonate equivalence (ACCE), and EC. Many of the considered extractions were positively correlated with each other, with the exception being Bray-II. The sediments of some rivers had a higher Olsen-extractable P than 20 mg kg-1, that is considered a threshold value above which the aquatic environment may become negatively affected. The average rank order of P extraction by single extractants was: Colwell > Mehlich III > NaOH 0.1 M > Olsen > Morgan > AB-DTPA > Bray II. The Colwell-extractable P concentrations of sediments varied from 1.44 to 88.0 mg kg-1. This extractant significantly correlated with algal growth (r2=0.92, P<0.001) and gave a rough estimate of the amount of bioavailable P in sediments. Therefore, the bioavailable content of P in sediments is quite high in comparison with the soils (agronomic requirement = 15 mg P kg-1) around the Urmia Lake basin.

The pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has made widespread impact recently. We aim to investigate the clinical characteristics of COVID-19 children with different severities and allergic status. Pediatric COVID-19 patients tended to have a mild clinical course. Patients with pneumonia had higher proportion of fever and cough and increased inflammatory biomarkers than those without pneumonia. There was no difference between allergic and non-allergic COVID-19 children in aspects of incidence, clinical features, laboratory and immunological findings. Allergy was not a risk factor for developing and severity of SARS-CoV-2 infection and hardly influenced the disease course of COVID-19 in children.

Dear Editor,With great interest, I read the article by Yim and associates1 and congratulate them for the quality of the review carried out on the internal mammary artery harvesting techniques. However, I would like to help clarify some aspects specifically related to the history of this procedure.The skeletonized IMA harvesting technique is usually considered to be newer than pedicle dissection. Actually, when Arthur Vineberg first implanted an IMA in a human heart in 1950, he only separated the arterial vessel from the chest wall. For more than a decade, only arteries were implanted according to Vineberg’s proposed method, and it wasn’t until the early 1960s that William Sewel proposed implanting a pedicle into the myocardium, that also contained the internal mammary vein and other tissues (”pedicle operation”) with the intention of draining excess blood and avoiding the formation of myocardial hematomas.2It is also incorrect to claim that skeletonized IMA harvesting was introduced due to concerns offered by reduced sternal blood flow and potential mediastinitis. In January 1972, David Galbut and his group introduced systematic skeletonized harvesting into their series of patients revascularized with bilateral internal mamary arteries, some time before that procedure began to be linked with deep sternal wound infections. Galbut probably only took advantage of obtaining longer arteries and easier construction of sequential anastomoses.2Furthermore, when Cunningham first described the IMA’s skeletonized harvesting technique in 1992 he specified that to avoid thermal injury to the artery, it was extremely important to keep the cautery setting on low throughout the dissection.3 After this advice, smoke never seems to have been a concern for surgeons, so it was hardly the reason for the introduction of harmonic technology in IMA dissection, which was also initially used in the “open harvesting” technique.4Finally, I consider it curious that this review does not include the semiskeletonization technique, introduced in 19975 and currently used by various groups.References1. Yim D, Wong WYE, Fan KS, Harky A. Internal mammary harvesting: Techniques and evidence from the literature. J Card Surg. 2020;35(4):860-7.2. López de la Cruz Y, Nafeh Abi-Rezk M, Betancourt Cervantes J. Internal mammary artery harvesting in cardiac surgery: an often mistold story. CorSalud. 2020;12(1):64-76.3. Cunningham JM, Gharavi MA, Fardin R, Meek RA. Considerations in the skeletonization technique of internal thoracic artery dissection. Ann Thorac Surg. 1992;54(5):947-50.4. Higami T, Kozawa S, Asada T, Shida T, Ogawa K. Skeletonization and harvest of the internal thoracic artery with an ultrasonic scalpel. Ann Thorac Surg. 2000;70:307-8.5. Horii T, Suma H. Semiskeletonization of Internal Thoracic Artery: Alternative Harvest Technique. Ann Thorac Surg. 1997;63:867-8.Note: The author of this manuscript is not an employee of any agency of the Cuban government; he is only a cardiovascular surgeon in a public hospital. The author of this manuscript also does not represent the Cuban government in relation to this “letter to the editor”.

Ecological theory predicts that the soil seed bank stabilizes the composition of plant communities in the face of environmental variability. Using one of the longest seed bank-vegetation databases, we tested whether the composition of the seed bank is more stable than the standing vegetation in annual communities across a rainfall gradient. The composition of the seed bank differed from the vegetation throughout the years with a higher abundance of small-seeded and persistent-seeded species. Year-to-year variability in composition increased with increasing aridity, but its magnitude was similar in the seed bank and the vegetation. Importantly, the rate of long-term compositional change was much slower in the seed bank. These results support the hypothesis that the seed bank can buffer against climatic shifts and increases the resistance of plant communities to directional trends. We conclude that the seed bank plays a crucial role in the stability of plant communities under global changes.

We present a novel method, Neural Ordinary Differential Equations, for learning ecological and evolutionary processes from time series data. The method consists in modelling dynamical systems with Ordinary Differential Equations and dynamic functions with Artificial Neural Networks, which upon successful training converge to functional shapes that best describe the processes. We tested NODEs by inferring per-capita growth rates of hare and lynx in simulated and real time series, which revealed that prey-predator oscillations were mainly driven by stronger predation at low hare and lynx density, as well as negative density-dependence in lynx, in line with the literature, thus demonstrating the validity and utility of NODEs. The approach is applicable to any system that can be modelled with differential equations, and particularly suitable for linking ecological, evolutionary, and environmental dynamics where parametric approaches are too challenging to implement, opening new avenues for theoretical and empirical investigations.

Sánchez-Tójar et al. (2020, Ecol Lett) questioned the methodology, transparency and conclusion of our study (Yin et al. 2019, Ecol Lett, 22, 1976). I feel that these arguments ignore critical assumptions and are based on the misunderstanding of our peer-review process. General does not mean always; the jury of our study is in revealing when and where a transgenerational effect is beneficial, which enlightens future research.

In natural forests, it is increasingly suggested that stand factors are far more important for community biomass and productivity than biodiversity, but the relative importance of stand factors vs. diversity on ecosystem stability, and how their relative roles change with grain size, still remain unclear. Using inventory data from tropical forest plots in southwestern China from 2004 to 2010, we found that stand factors were clearly more stronger drivers than diversity for forest biomass and productivity (at each grain size from 400 m2 to 0.25 ha), while diversity was predominate for temporal stability of biomass and productivity. The effect of diversity on biomass and productivity increased with increasing grain size, but did not change clearly for ecosystem stability. Functional diversity was more important for ecosystem functions and stability than taxonomic and phylogenetic diversity, and richness was more important than the other two diversity components (evenness and divergence). Our results reconcile the recent debate on the relative importance of diversity vs. stand factors on ecosystem properties, and suggest that forest management to adjust stand structure is an effective way to increase forest carbon storage rapidly, but biodiversity conservation may be crucial for long-term ecosystem stability under climate change.

Objective: To evaluate the auditory perception outcomes of cochlear implant (CI) in children with different types of inner ear malformations (IEMs) and to compare them with CI users with the normal cochlea. Design: Retrospective and prospective data collection. Settings: Tertiary referral hospital. Participants: There were 274 CI users with and without IEMs as two groups. Both groups’ chronological age at implantation and duration of cochlear implant usage was matched (±8 months). Main outcome measures: All subjects were evaluated preoperatively and postoperatively with Ling’s sound test and auditory perception test battery, which includes the Meaningful Auditory Integration Scale (MAIS), close-set Pattern Perception Test (PPT), and open-set Sentence Recognition Test (SRT). Also, children with IEMs were assessed for language development. Results: The incidence of IEMs were incomplete partition-II, 40 (29.19%), incomplete partition-I, 36 (26.2%), cochlear hypoplasia, 26 (18.9%), enlarged vestibular aqueduct, 14 (%10.2), incomplete partition-III, 10 (%7.2), common cavity, 8 (5.8%) and dilatation of vestibule, 3 (2.1%) patients. The significant difference was seen in Ling’s sound test and auditory perception test battery scores of children with incomplete partition-I, cochlear hypoplasia, and common cavity (p-value < .005). Conclusion: IEMs group showed different progress according to the type of ear anomaly. Although CI users with enlarged vestibular aqueduct (EVA) had the highest scores, users with common cavity had the lowest scores. Taking these results, caused by anatomical differences, in to account is very critical in follow-ups and rehabilitation programs. Each cochlear implant user should be evaluated according to his/her individual needs.

The role of CD4+ Treg in immune responses has been well established. More recently a role of CD8+ Treg in the regulation of immune responses in health and autoimmune diseases has been investigated. Furthermore, different investigators have used different markers to define CD8 Treg. Finally, regulatory effects of CD8 Treg have been studied against T cell responses; however, their role in regulating B cell proliferation and immunoglobulin production has not been evaluated. Therefore, in this study we examined the effect of two types of CD8 Treg on B cell proliferation and immunoglobulin production. Methods: Purified CD8+ T cells were activated with anti-CD3/CD28 for 48 hours and then sorted into two different types of CD8 Treg as defined by two different sets of markers, CD8+CD183+CCR7+CD45RA-, and CD8+CD183+CD25highCD278+. Purified B cells were co-cultured with sorted CD8 Treg at 1:1, 1:1/2, 1:1/4 ratios, and activated with anti-CD40 and CpG. B cell proliferation was assessed by CFSE dye dilution assay and immunoglobulin production by ELISA assay. Results: Our data show CD183+CCR7+CD45RA- CD8 T reg significantly inhibited B cell proliferation and inhibited IgM and IgG production but not of IgA production at 1:1 ratio only. However, CD183+CD25highCD278+ CD8 Treg inhibited significantly B cell proliferation at 1:1 and 1:1/2 ratio and IgM, IgG, and IgA production at all ratios. In Conclusion, CD8 Treg regulate B cell responses, and CD183+CD25highCD278+ CD8 Treg are more powerful regulators of B cell proliferation and Immunoglobulin production than CD183+CCR7+CD45RA- CD8 Treg.

“Men’s crops” and “women’s crops” suggest that men and women smallholder farmers in sub-Saharan Africa grow different crops. Yet, this gender division of crops is not considered in the valuation of wild pollinators to crop productivity, and therefore remains unknown, despite considerable coverage of wild pollination ecosystem services. We link a nationally representative panel survey of over 10,000 actual plots managed by male and female farmers; with spatially and temporally land cover maps; together with robust fixed-effects production function methods. We find evidence of gendered-crops and variation in pollination dependency in male- and female-managed farms. Furthermore, statistically significant fixed-effects estimates produce an exponential function which shows that proximity to wild pollinators’ natural habits - forests - is important, and that at shorter distances female-managed farms benefit four times more than male-managed farms, and this tapers off as distance increases producing convergence in benefits. We are able to conclude that conservation that preserves the natural habitants of wild pollinators will enhance crop yield especially among female-managed farms. This demonstrates the importance of gender in ecosystem services and suggests that to fully understand their benefits, gender needs to be incorporated into natural capital and sustainable development policies governing smallholder agriculture rich regions.

In December 2019, Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is widely spread and causes a critical threat to clinical burden and public healthcare. The outbreak of COVID-19 has aroused widespread concern in the rheumatology community.

Objective: To evaluate pharyngeal sensory function by Current Perception Threshold (CPT) measurement from healthy and paresthetic pharynx. Methods: In total, 122 healthy volunteers and 70 patients with pharyngeal paresthetic symptoms underwent CPT evaluation. Pharyngeal paresthesia (n=70) were classified into three categories based on aetiologies: six cases with pain in pharynx; 38 neuropathic patients with glossopharyngeal nerve and/or vagus nerve injury; and 26 patients with globus pharyngeus. CPT measurements were obtained from bilateral palatoglossal arch and tongue base at 2000Hz, 250Hz and 5Hz stimulation frequencies. Results: Ranked from high to low, the CPT values for the bilateral palatoglossal arches and tongue bases were: neuropathic patients, globus pharyngeus and normal patients. The CPT values for neuropathic patients on the injured side were significantly higher than those on the healthy side (P<0.05). The CPT values for patients with pain in pharynx were significantly lower than those of normal subjects (P<0.05) when the bilateral tongue bases were stimulated. Conclusion: The CPT testing is a reliable method for objectively and quantitatively assessing pharyngeal sensory function and able to differentiate pharyngeal paresthesia between neuropathic and subjective discomfort. Pharyngeal sensory function is more sensitive in patients with pain in pharynx. Pharyngeal sensory function is significantly reduced in neuropathic patients, especially on the injured side. Patients with globus pharyngeus have pharyngeal hyposensitivity.

Abstract Background There is a growing relationship between PD-1/PD-Ls and autoimmune disease We attempted to explore the relationship of the PD-L2 expression in patients with thymoma, especially with Myasthenia Gravis (thymomatous MG). Methods Seventy patients with thymoma who underwent surgical resection between January 2017 to December 2018 were retrospectively reviewed. The PD-L2 expression was evaluated by immunohistochemistry. The association between the PD-L2 expression and the clinicopathologic features was investigated, especially thymomatous MG. Results The PD-L2 expression was positive in 41 patients (58.6%) and negative in 29 patients (41.4%). The PD-L2 expression was significantly associated with WHO histology of type B2 and B3 thymoma (p=0.008) and the status of MG (p=0.002). In addition, PD-L2 positive tumors showed a significantly smaller tumor size (P=0.017). Ectopic thymus was significantly more often seen in the PD-L2 positive group (p=0.035). The patients with MG (p=0.001) and WHO type B2 and B3 (p=0.007) have significantly higher PD-L2 scores. Multivariate logistic regression model showed the status of MG (OR 12.601, 95%CI 2.406-65.995, p=0.02) and age (OR 0.199, 95%CI 0.046-0.863, p=0.031) were significantly associated with the expression of PD-L2. The analysis of 33 patients with MG shows age was not associated with the expression of PD-L2 (OR 0.04, 95%CI 0.001-3.2, p=0.15). Conclusions A strong expression of PD-L2 in thymoma was significantly associated with thymomatous MG and WHO histologic type B2 and B3. In addition, PD-L2 may play a potential role in the pathogenesis of thymomatous MG.

Aims: Develop a population pharmacokinetic model describing propofol pharmacokinetics in (pre)term neonates and infants, that can be used for precision dosing of propofol in this population. Methods: A non-linear mixed effects pharmacokinetic analysis (Monolix 2018R2) was performed, based on a pooled study population in 107 (pre)term neonates and infants. Results: 836 blood samples were collected from 66 (pre)term neonates and 41 infants originating from three studies. Body weight (BW) of the pooled study population was 3.050 (0.580 – 11.440) kg, postmenstrual age (PMA) was 36.56 (27.00 – 43.00) weeks and postnatal age (PNA) was 1.14 (0 – 104.00) weeks (median and range). A three compartment structural model was identified and the effect of BW was modeled using fixed allometric exponents. Elimination clearance maturation was modeled accounting for the maturational effect on elimination clearance until birth (by GA) and postpartum (by PNA/GA). The extrapolated adult (70 kg) population propofol elimination clearance (1.63 L min-1) is in line with estimates from previous population pharmacokinetic studies. Empirical scaling of BW on the central distribution volume (V1) in function of PNA improved the model fit. Conclusions: It is recommended to describe elimination clearance maturation by GA and PNA instead of PMA on top of size effects when analyzing propofol pharmacokinetics in populations including preterm neonates. Changes in body composition in addition to weight changes or other physio-anatomical changes may explain the changes in V1. The developed model may serve as a prior for propofol dose finding in (preterm) neonates.

Objectives To examine the effects of single- and double-layer uterine closure techniques on uterine scar healing following cesarean delivery. Design Randomised controlled trial Setting University Hospital of Başkent from July 2018 to September 2019 Population This study assessed a total of 282 women between 18-45 years of age who had singleton pregnancies and had not previously undergone uterine surgeries. Methods Participants were randomized into two following treatment groups: single-layer closure with locking and double-layer closure with locking in the first layer, but not in the second layer (NCT03629028). Participants were evaluated at 6-9 months after cesarean section by saline infusion sonohysterography to assess cesarean delivery scar defects. Experienced sonographers who were not informed about the uterine closure technique conducted these procedures. Results Of the 225 final participants, 116 received the double-layer closure technique, while 109 received the single-layer technique. In this regard, the niche rates and median niche depths based on transvaginal ultrasounds and sonohysterography investigations were 21%, 0.9±1.8mm, and 41%, 2.1±1.9mm (p<0.001, p<0.001), respectively. The niche rates were 37% for the single-layer group and 45.7% for the double-layer group (p=0.22). Median niche widths were higher in the double-layer group (p=0.006). Conclusions The single- and double-layer closure techniques did not produce different impacts on uterine scare niche development. However, the median niche width was higher for the double-layer closure group. Tweetable abstract There was no difference between single- and double layer closure in the rate of scar niche development following cesarean delivery. Keywords cesarean delivery, isthmocele, niche, uterine closure

Single atom catalysts with iron ions in the active site, known as FeNC catalysts, show high activity for the oxygen reduction reaction and hence hold promise for access to low cost fuel cells. Due to the amorphous, multi-phase structure of the FeNC catalysts, the iron environment and its electronic structure are poorly understood. While it is widely accepted that the catalytically active site contains an iron ion ligated by several nitrogen donors embedded in a graphene-like plane, the exact structural details such as the presence or nature of axial ligands are unknown. Computational chemistry in combination with Mössbauer spectroscopy can help to unravel the geometric and electronic structures of the active sites. As a first step towards this goal, we present a calibration of computational Mössbauer spectroscopy for FeN4-like environments. The uncertainty of both the isomer shift and the quadrupole splitting prediction is determined, from which trust regions for the Mössbauer parameter predictions of computational FeNC models are derived. We find that TPSSh, B3LYP, and PBE0 perform equally well; the trust regions with B3LYP are 0.13 mm s−1 for the isomer shift and 0.45 mm s−1 for the quadrupole splitting. The calibration data is made publicly available in an interactive notebook that provides predicted Mössbauer parameters with individual uncertainty estimates from computed contact densities and quadrupole splitting values. We show that a differentiation of common FeNC Mössbauer signals by a separate analysis of isomer shift and quadrupole splitting will most likely be insufficient, whereas their simultaneous evaluation will allow the assignment to adequate computational FeNC models.

La bonifica dei siti contaminati è una delle problematiche più rilevanti nell’ambito degli interventi di recupero e di risanamento ambientale. Si definiscono “contaminate” quelle aree in cui, a causa di sversamenti accidentali, depositi abusivi ma anche condizioni naturali, sono presenti nel suolo sostanze inquinanti tali da risultare pericolose per l’uomo e per l’ambiente. Negli ultimi decenni si sono sviluppate alcune tecniche di bonifica che sfruttano la degradazione dei contaminanti ad opera di microrganismi con lo scopo di arrecare un minore impatto sull’ecosistema e un considerevole risparmio economico. Tra le molteplici tecniche trova spazio il Bioventing, una tecnologia adoperata nella zona insatura del terreno che consente l’utilizzo di microrganismi autoctoni per la degradazione di composti organici adsorbiti dalle frazioni minerali e organiche del suolo. In questo articolo si fa riferimento ad un caso studio che ha trattato la tecnica del Bioventing per la rimozione di idrocarburi del petrolio.

Tetanus and diphtheria are important public health problems in many parts of the world. Since the diphtheria, tetanus toxoids and acellular pertussis vaccine (DTaP) was generally administered to children, the incidence of diphtheria and tetanus has dropped dramatically. However, with the increase of age, the anti-diphtheria and tetanus antibody in human body will decrease. DTaP is not suitable for boosting vaccine and the recombinant vaccine have more advantages than toxoid vaccines. Therefore, in this study, firstly, we expressed and purified the fragment C of tetanus toxin (TTc) and the cross-reacting material 197 (CRM197) of the diphtheria toxin mutant from E. coli BL21(DE3) expression system respectively. Moreover, the characteristics, immunogenicity of the purified protein were analyzed. Lastly, the recombinant TTc and CRM197 combination vaccine (RTCV) was constructed and antibody titers were detected. Our results displayed TTc induced Th2 immune response in mice while CRM197 could induce a mix Th1/Th2 immune response. RTCV was composed of 10 μg/mL TTc, 20 μg/mLCRM197 antigens and aluminum adjuvants (50 μg/mL). We found that the IgG and IgG1 antibody titers produced in mice were similar as those produced by DTaP, except the IgG2a antibody titers. The results above will provide technical support for the future combined recombinant protein vaccine to against diphtheria and tetanus.

Background: As elevation of serum C-reactive protein (CRP) is occurred following left ventricular dysfunction (LVD), relationship between increasing serum CRP level and abnormal changes in electrocardiography(ECG) pattern. The present study aimed to examine association between increase level of high-sensitive CRP (hs-CRP) and non-arrhythmic ECG changes and echocardiographic abnormalities in patients with acute coronary syndrome (ACS). Methods: This cross-sectional study was conducted on 120 consecutive patients finally diagnosed as ACS and hospitalized at cardiac care units (CCU). The participants were classified as the two groups with increased level or normal of hs-CRP level. Results: The patients with the increased level of hs-CRP had significantly higher level of cardiac enzymes. The group with increased level of hs-CRP experienced more ST-segment elevation myocardial infarction (STEMI) than those with normal serum hs-CRP level, but other diagnoses including unstable angina, non-STEMI, heart failure, and emergency hypertension were similarly observed in both groups. The two groups were comparable in terms of mean left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVeDD), prevalence of valvular heart diseases as well as in wall motion abnormality assessed by echocardiography. ST-segment elevation in different leads was more frequent in those with elevated hs-CRP level than in the group with normal hs-CRP condition (19.6% versus 1.4%, p = 0.001); but ST-segment depression and T wave inversion were similarly revealed in the two groups. Conclusion: Elevated level of hs-CRP can predict occurrence of STEMI, but may not be valuable to predict echocardiographic abnormalities including LVD or hypertrophy.

A new epidemic caused by SARS-CoV-2 has affected millions of people around the world

The current study investigates the correlation between biological activity and physicochemical properties of a few specific estradiol isomers. Theoretical studies on the physicochemical properties of estradiol isomers were performed using different quantum mechanical methods. The computational methods used in this study include the Density Functional Theory (DFT) method, the Hartree-Fock (HF) method and Semi-empirical (AM1) method. Some physicochemical properties such as dipole moment, molecular weight, the energy of the highest occupied molecular orbital (E HOMO), the energy of the lowest unoccupied molecular orbital (E LUMO), polarizability, the octanol-water partition coefficient (Log P), polar surface area (PSA) the number of hydrogen bond donors (HBDs) and the number of hydrogen bond acceptors (HBAs), the surface area, volume of the molecule, and ovality are calculated for the isomers. However, only dipole moment values are suitable to identify a correlation of experimental biological activity of estradiol isomers. To the best of our knowledge, this is the first report on the relationships between dipole moment and biological activities of estradiol isomers. It is observed that the active compound has a significantly higher dipole moment value compared to the inactive compound. We have also analyzed the geometrical and graphical models of these isomers and related compounds to evaluate the differences in the molecular charge distributions.

AIM: The main objective was to determine the prevalence of prescribing issues in HIV-infected subjects ≥65 years according to the Beers and STOPP/START criteria and drug-drug interactions (Liverpool website). Secondary objectives were to assess the concordance between Beers and STOPP/START criteria in our population, and to identify the drugs most frequently involved in the prescribing issues. METHODS: Cross-sectional cohort study based on a systematic review of the electronic drug prescriptions of 91 HIV-infected patients aged ≥65 years. Discrepancies between prescription criteria were assessed using crosstabs and compared using the Chi-square test or Fisher exact test. RESULTS: The mean age was 72.1 (5.6) years, 75.8% had ≥3 comorbidities, and 59.3% polypharmacy. Prescribing issues were identified in 87.9%; 71.4% by STOPP/START and 45.1% by Beers. Comparing both criteria, 56.9% of prescribing issues by STOPP/START were detected by Beers, while 92.5% of those detected by the Beers criteria were detected by STOPP/START (p<0.001). Orange/red flag interactions were found in 45.1%: 3 severe (red) in 2 patients (2.2%). The most frequent drugs involved in prescribing issues were benzodiazepines (>30%). Cobicistat was the drug most frequently involved in interactions (42.9%). CONCLUSIONS: The prevalence of prescribing issues among older HIV-infected persons gives cause for concern, as it is almost 90%. Optimization strategies, including a critical review of the treatment plan, should be implemented in clinical routine by a multidisciplinary team, in particular in patients with multiple comorbidities and polypharmacy. The STOPP/START criteria should be recommended for European populations, since they seem to better detect prescribing issues.

Objective: To analyze covid-19-associated test results and optimize screening procedure for obstetrics and gynecology outpatients Design: Single center retrospective study. Setting: Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei province, P.R. China. Population or Sample: A total of 1,051 obstetrics and gynecology outpatients were included in the study from March 12 to April 26, 2020. Methods: We collected medical records, COVID-19-associated test results and reported the visit procedure for obstetrics and gynecology outpatients. Main outcome(s) and measure(s): We analyzed covid-19-associated test results and followed up the patients. Results: After reviewing the visit procedure, a total of 1051 obstetrics and gynecology outpatients were included in the study, and a series of COVID-19 tests were conducted, which included the SARS-CoV-2 nucleic acid test, chest CT scan and SARS-CoV-2-specific serological test. The SARS-CoV-2 nucleic acid test was negative in all 1051 patients. None of the patients admitted to the hospital experienced SARS-CoV-2 infections during hospitalization. Seventy-six cases were diagnosed with abnormal uterine bleeding-related disease (excluding endometrial malignancy), 2019-nCoV antibody positive rate was 6.579%, which is greater than the average positive rate of 3.974%, and the positive rate among patients with other diseases. No nucleic acid positivity was found in the follow-up of 9 IgM+ (and IgG+) patients. Conclusions: As the peak of the epidemic has passed, a more optimized screening procedure is required to avoid hospital infections.