This study evaluates the effectiveness of remediation treatments in the long-term (twenty years later) in one of the largest mine spills in the world, the Aznalcóllar accident. Soil recovery was carried out through the application of different rates of organic (compost and manure) and inorganic amendments (materials rich in iron oxides and calcium carbonate). The different amendment combinations were grouped in four treatments (T1 to T4) and applied in different sectors depending on the soil properties and the degree of initial pollution. To assess the degree of soil recovery, the physicochemical properties, the total, soluble and bioavailable concentrations of the main pollutants (Pb, As, Zn and Cu) were determined over time. The applied treatments increased the pH, CaCO3 and organic carbon of the soils, reduced the EC and decreased the mobility of the pollutants, indicating that remediation treatments were efficient in the recovery of soils contaminated by potentially harmful elements. However, twenty years after the accident, total concentrations of Pb and As still exceed the intervention levels of the current regulations in certain areas. These areas are located in the sectors closest to the mine and where treatments T1 and T2 were applied; in these cases, the dose of organic amendment, materials rich in iron oxides and calcium carbonate were not effective enough, so the application of new treatments is recommended to complete the full recovery of the area.

Background: Low back pain (LBP) is the top global cause of disability and physiotherapy interventions are used to manage it. However, the practice pattern of physiotherapists dealing with LBP patients in low-income countries are limited. Aim: The study aims to explore the LBP practice pattern of a low-income country’s ( i. e., Bangladeshi) physiotherapists by their demographic and professional factors. Methods: In a cross-sectional survey study, we have analyzed data from randomly selected 423 physiotherapists of Bangladesh who have invited to fill-up an online survey questionnaire about practice patterns. The first part of the questionnaire contained question demographic and professional background, second part included current intervention choices in the management of patients with LBP, the final part consisted of information on diagnosis, patient type and self-reported cure rate of LBP patients. Ethical approval: Clinical Trial Registry India: CTRI/2020/05/025313. Results: The Majority of the physiotherapists (54.8%) were non-government service holders and 87.7% worked in the town area. Regarding recommended interventions, only 12.3% frequently used those and 21.5% didn’t either offer or know about those interventions. For not recommended interventions, 69.3% occasionally, 13.5% frequently and 17.3% never used such interventions. The prevalence of good, moderate, and poor practice patterns was 14%, 62.4%, and 23.6% respectively. Participants‘ marital status (P = 0.003) and graduation institute category (P = 0.002) were significant factors for practice pattern variation. Conclusion: The study justified physiotherapy management status in a low-income country by comparing evidence-based practice guidelines. This finding set as a low-income country database to exhibit future research, clinical practice, and education for better LBP physiotherapy management adherence to evidence-based public health care.

The study of Land Use Land Cover (LULC) changes and their patterns enhance our understanding of the causes and consequences of various natural and man caused phenomenon. The Capital City of Pakistan, Islamabad has expereinced high rate of urbnization and population increase in the last 3-4 decades. The main aim of our study was to provide compatible data on LULC change during the last 40 years for the functional city Islamabad, Pakistan. LULC statistics were extracted from Landsat Multi-spectral Scanner (MSS), Thematic Mapper (TM), Enhanced Thematic Mapper Plus (ETM+) and Operational Land Imager (OLI) images. For each of the target years (1979, 1989, 1999, 2009 and 2019) LULC information was obtained through a supervised classification algorithm. The study area was classified into five major landscape categories, namely built-up, agriculture, forest, water bodies and barren land. The results have indicated that the urban expansion has been increasing due to mass migration and uncontrolled urbanization in the city. The urban sprawl analysis revealed that built-up area and farmland has expanded by 41.7% and 5.20% during (1979-2019). On the other hand, the forest and water bodies declined from at 9.03% and 1.21% respectively. The land degradation has forced the planners to revise the original master plan of the city and including the agricultural sector in the housing area during 2019. This degradation of land has also led to increase in the temperature of the city.

Having lived through the havoc of COVID-19 in a hospital situated in one of the hardest hit zip codes in the United States, the thought that another wave could loom in the fall is bracing. Obstetricians at our institution have cared for well over 200 COVID-19-infected pregnant women, and are acutely aware of the herculean effort it took to reorganize the service to accommodate the needs of women infected with this new pathogen.1 Many institutions, including ours, modified the frequency of prenatal visits, among other measures, to minimize in-person contacts, in an effort to reduce the likelihood of viral spread. However, it is those changes, along with our prior experience of treating women unimmunized against influenza that leads to our concern that a singular focus on COVID-19 could leave pregnant women at risk from a more familiar threat.While COVID-19 is a threat to the health of individuals and society, its effect on pregnancy is less clear. Thus far, few COVID-19-infected pregnant women have required ICU care, and to date three maternal deaths has been reported in the United States.2-4 The toll of influenza in pregnancy is more clearly documented and is more severe.5Now that the first wave is ebbing in New York, we are seeing fewer and fewer cases but still diagnose about 15 infections per week in our hospital. That pattern is the converse of what is being seen in large swaths of the country. Despite the higher prevalence seen earlier in the epidemic in New York, and the fact that many of those women needed respiratory support, only two women in our hospital required admission to the intensive care unit (ICU), and only one needed ventilator support. Mercifully, none died. During the preceding influenza season, whose end overlapped with the start of the COVID-19 pandemic, we treated six women with influenza who required admission to the ICU, only one of whom had been vaccinated against influenza. As opposed to our COVID-19 cases (putting aside the more rigorous application of social distancing), there were clearly missed opportunities to have prevented some of the morbid events caused by influenza.Admittedly, the higher admission rate to the ICU may be misleading. It is certainly possible that criteria for admission to ICUs, like almost all other aspects of care, evolved during the COVID-19 crisis. There was such a rapid and dramatic increase in the need for ICU beds in our hospital (from a baseline of 40 mid-March, 2020 to a peak of 140 mid-April; 2020, internal data) that more stringent criteria for admission may have been applied and some of our COVID-19 patients that were cared for on the wards, may have been cared for in an ICU in less harrowing times. But even given that possibility, the fact that a similar number of women were extremely ill with influenza raises grave concerns going forward.In the first instance, co-infection with COVID-19 and influenza, as well as other viruses, has been reported.6 Co-infection events will make diagnosis of either entity more difficult, and could potentially increase morbidity. Thus, both because of the risks of co-infection, and the known risks of influenza in pregnancy, providers can’t afford to take their “eye off the ball,” and become less vigilant about vaccinating patients, even if some of the new protocols for fewer visits or telehealth visits remain in place. With fewer visits comes the risk of missing both the vaccination “window” and the opportunity to incorporate vaccination as an essential component of health maintenance. In addition, obstetricians’ performance as vaccinators has been less than ideal as only approximately half of pregnant women get influenza vaccines.7In addition to vaccination, obstetricians must remain vigilant in order to prevent progression of disease among those who get infected. Oseltamivir provides the opportunity for secondary prevention.8 It has been shown to reduce maternal ICU admission and mortality.9 Yet, as with vaccination, even before the COVID-19 epidemic, it was underutilized.10Beyond committing to better use of medical interventions for influenza, obstetricians have to assure that just because they have lived through COVID-19, and the world’s attention remains fixed on COVID-19, they don’t become so COVID-19-focused, that they fail to include influenza in the differential diagnosis of women reporting respiratory symptoms in the fall. Every fever and ache will not be COVID-19. If we delay consideration of the diagnosis of influenza, we will lose the opportunity to use Oseltamivir before the window of eligibility closes. In the post-pandemic world, it will be hard to avoid cognitive biases, such as the availability heuristic (a strategy for making judgments about likelihood of occurrence based on the salience of the information) and confirmation bias (the tendency to gather evidence that confirms preexisting expectations, typically by emphasizing or pursuing supporting evidence while dismissing or failing to seek contradictory evidence). These can result in physicians being hammers and every respiratory symptom, a COVID-19 nail; especially when rapid COVID-19 tests are not uniformly available and don’t yet have uniformly high quality. This is the reverse of one of the most cited examples of the availability heuristic, “In influenza season, it is tempting to consider all patients with fever and myalgias as having influenza.”11 An enhanced situational awareness, i.e., recognizing the influence of recent diagnoses on your diagnostic proclivities, will become an ever more crucial antidote to the hard earned reflex response to fevers and aches that developed during the first wave of COVID-19.We know from history that influenza recurs both in epidemic and pandemic forms, and that an initial wave can be a “herald wave” for the following one.12 Hence, it is our responsibility not to let the current COVID pandemic prevent us from properly dealing with the possibility of overlapping epidemics (seasonal influenza and COVID) in the fall. Vaccination, rapid recourse to antivirals (e.g., Oseltamivir), and community mitigation measures will be more important than ever. COVID-19 can kill, but so can influenza, and if we do our jobs, we can reduce that toll.

Aspirin is essential in the primary and secondary prevention of hypertension. However, the effect of aspirin on blood pressure (bp) in hypertensive patients has been controversial. Therefore, we quantitatively evaluated the effect of aspirin on the bp in untreated hypertensive patients and antihypertensive patients. We searched the PubMed, Embase and Cochrane library electronic databases for articles published prior to June 2019. The overall effect of aspirin on changes in systolic and diastolic bp was estimated by using random-effects models according to the I2 statistic. A total of 15 randomized controlled trials (including 27 studies) met the criteria and were included in the review. For untreated patients with mild hypertension, taking aspirin significantly reduced systolic bp by 1.83 mm Hg (95% CI: -3.15~-0.5, P =0.007) and diastolic bp by 1.32 mm Hg (95% CI: -2.82~0.19, P =0.09). Other subgroup analyses suggest different effects on bp with different aspirin doses, duration and time of administration. Compared with taking aspirin in the morning, taking aspirin before bedtime significantly reduced systolic bp by 2.97 mm Hg (95% CI: -3.78~ -2.17, P <0.00001) and decreased diastolic bp by 2.16 mm Hg (95% CI: -2.87~ -1.44, P <0.00001). However, for patients on antihypertensive therapy, taking aspirin has no significant effect on bp and did not interfere with the antihypertensive drug treatment. Overall, for untreated hypertensive patients, aspirin can reduce bp, and may have a time-dependent effect. However, aspirin was not found to have an effect on bp in antihypertensive patients.

Land use and land cover (LULC) change have significant consequences on habitat and environment. Scholars have developed several LULC models to identify the factors behind the changes and to simulate future LULC scenarios to assist in policymaking. Nevertheless, the accuracy of the models remains contentious and a matter of ongoing research agenda. Additionally, most of these studies used a training dataset to train the model and a validation dataset, which is a part of the original training dataset used to validate the model’s accuracy. However, to justify model’s actual predictive capability, we need to test the model on real-world dataset that was not used in modeling. So, we present XGBoost model to improve the accuracy of LULC prediction. Contrary to the typical studies, we use a separate test dataset to justify the model’s predictive capacity in real-world scenario. The result reveals that XGBoost model exhibits highest 84% kappa and 93% accuracy score compared to two benchmark model LR-CA (82% kappa and 92% accuracy score) and ANN-CA (82% kappa and 92% accuracy score). We also found that the built-up area increased by 48.7% in 2002 to 64% in 2010, while agricultural and vacant land declined by almost at the same magnitude over the period and the most important aspect of the LULC shift process in Khulna city was the proximity factors to major roads, industry and commercial establishments. The proposed model proved to increase the predictive accuracy making it much more reliable for analyzing and predicting urban LULC using spatial factors.

Background: The pandemic caused by Coronavirus disease 2019, has caused great impact worldwide. Risk factors for severe outcomes have been identified, but asthma seems not to be one of them. Objectives: Our principal purpose is to analyze personal characteristics in severe asthma patients, in treatment with monoclonal antibody, belonging to the Health Department of Castellon, in order to see if these variables affect the probability of being infected by SARS-Cov-2. Methods: This is an observational study. Patients recruited had severe asthma in treatment with monoclonal antibody. A questionnaire was elaborated. Aspects evaluated were: COVID-19 symptoms, asthma control, exposition to the disease, and lifestyle before the pandemic. Serological tests were done by using total SARS-Cov-2 antibody test. Results: 108 patients were enrolled in the study, of whom 106 patients were included. 11 patients declared suggestive COVID-19 symptoms. A total of 21 patients had a serology test done, giving positive results 2 of them. 27 patients needed medical attention, being asthma exacerbation the most common symptom. 71,7% of patients had a normal or high level of social activity before the pandemic. Statistic significance was achieved for medical assistance, asthma control and contact with SARS-Cov-2 positive patients. Conclusion: Personal external factors in severe asthma patients do not influence the probability of being affected by the disease. We can hypothesize that these patients do not have an increased susceptibility for being infected by the virus. Bad asthma control was the main reason for medical assistance during the pandemic.

Background: Allergy is witnessing major advances, in particular with the advent of biological therapies for treating allergic diseases. Given the novelty of these therapeutics, we aimed to explore by a worldwide survey, the prescription and the management of hypersensitivity reactions (HR) of biological agents (BA) in Allergy. Method: We built up an anonymous online questionnaire, sent out by mail and social media and circulated for 40 days. Results: 348 responses were from 59 countries, with a majority from Europe (62.6%). 97% of responders practiced allergy and 48.5%, exclusively so. Allergy was mentioned as a full specialty in 69.5 % of cases. 71% of responders confirmed the right of prescription of BA for allergists in their country and 78.4 % prescribed BA in their clinical practice. Europe included almost all the allergists who did not have the right of prescribing BA (95.5%), specifically France (91%). The most prescribed BA were Anti IgE (78.1%) and anti IL5 (43.9%). The most declared HR to BA were local reactions (74.1%) followed by anaphylaxis like symptoms (6.8%) and delayed exanthemas (5.1%). Desensitization was considered in 18.9% of cases. These HR were reported in 48.8% of cases. Conclusion: Although BA are now a pillar in the treatment of allergic diseases and allergists are familiar with management of HR associated with BA, their prescription is not authorized for allergists in all countries. BA showed to be generally safe but HR, which may be severe, could occur with a lack of consensus on the management.

Mast cells and basophils interact with various cells in the urticaria lesion microenvironment, such as macrophages,.which form an essential component of innate immunity, and are involved in numerous functions including protein secretion. Objective: The aim of the present study was to characterize the macrophage phenotype in urticarial lesions of patients with chronic spontaneous urticaria (CSU) nonresponsive to antihistamines at optimized doses. And compare the phenotype with clinical and laboratory parameters such as age, gender, urticaria time, C-reactive protein (CRP), and total serum IgE, and autologous serum skin test (ASST). Methods: Twenty-eight patients with CSU refractory to antihistamines were included in the study. Epidemiological data, C-reactive protein, D-dimers, basophils in peripheral blood, and total serum IgE and ASST were assessed. The mannose receptor (CD206), CD163, CMAF, and pSTAT 1 were used to characterize the M1/M2 macrophage subpopulations. The immunolabeled cells per square millimeter were manually enumerated at a 400× magnification in 12 optical fields via light microscopy. Results: A predominance of M2 macrophages was seen in CSU patients. Statistical differences were observed between the CD206 marker and the disease course. No correlation was found between biomarkers and macrophage populations. Expression of CMAF was significantly higher in the patient sample compared to that in the control skin (patients without history of urticaria; p-value < 0.001). Conclusion: M2 macrophages were seen with significantly higher CMAF expression, which indicates macrophage activation in patients with CSU. CD206 expression was inversely correlated with disease time.

Background: Little is known about the clinical course of chronic urticaria (CU) and predictors of its prognosis. We evaluated CU patient clusters based on medication scores for the initial 3 months of treatment to investigate time to remission and relapse rates and to identify predictors for CU remission. Methods: In total, 4552 patients (57.9% female; mean age of 38.6 years) with CU were included in this retrospective cohort study. The K-medoids algorithm was used for clustering CU patients. Kaplan-Meier survival analysis with Cox regression was applied to identify predictors of CU remission. Results: Four distinct clusters were identified: patients with consistently low disease activity (cluster 1, n = 1786), with medium-to-low disease activity (cluster 2, n = 1031), with consistently medium disease activity (cluster 3, n = 1332), or with consistently high disease activity (cluster 4, n = 403). Mean age, treatment duration, peripheral neutrophil counts, total IgE, and complements levels were significantly higher for cluster 4 than the other three clusters. Median times to remission were also different among the four clusters (2.1 vs 3.3 vs 6.4 vs 9.4 years, respectively, P < .001). Sensitization to house dust mites (≥ class 3) and female sex were identified as significant predictors of CU remission. Around 20% of patients who achieved CU remission experienced relapse. Conclusion: In this study, we identified four CU patient clusters by analyzing medication scores during the first 3 months of treatment and found that sensitization to house dust mites and female sex can affect CU prognosis.

Objective: AUB-O,E,N is treated first with medical management, followed by surgery, which failure or complications have significant burden. The objective was to perform a cost-effectiveness analysis of four surgical strategies, comparing cost and avoided failure rate, using the French PMSI database. Design: Retrospective analysis performed using the French exhaustive national hospital discharge database (PMSI). Population: All incident 35-55 year-old women operated on for four types of AUB-O,E,N surgery (2nd generation, 1st generation, curettage or hysterectomy) between 2009 and 2014 were included. Methods : They were followed to collect rehospitalizations related to failure or complication and their cost, during at least 18 months. Hospital costs were estimated using the French tariffs in 2017\euro. Main Outcome measures : A cost-effectiveness analysis was performed comparing each surgical procedure to 2G, in hospitalization costs and rate of patients without failure. Results : The study included 88,154 patients. At 18 months, mean cost per patient was \euro2,448 for 2G, \euro2,100 for 1G, \euro2,275 for curettage and \euro4,157 for hysterectomy. Hysterectomy was the most effective strategy in terms of absence of failure, but also the most expensive, with an incremental cost of \euro24,008 per additional % of patient without failure. Even with a mean cost similar to 2G, curettage was the least effective strategy with a failure rate reaching 20.6% at 18 months. 1G was less expensive but also less effective than 2G, with an economy of \euro13,078 per % of patient without failure loss. Conclusion: 1G and 2G techniques are the most efficient strategie

We present a complication following deployment of the MANTA VCD device following a TAVR procedure which resulted in occlusion of the common femoral artery. This was addressed by ballooning the site from the contralateral side which re-established flow. We believe this is the first report to address this kind of complication and may prove useful as more of the MANTA devices are being used in multiple procedures.

Objective: To examine the impact of “natural” cesarean deliveries (NCD) on peripartum maternal blood loss. Design: Randomized controlled trial. Setting: Single academic hospital in Afula, Israel, between August 2016 and February 2019. Population or Sample: Term singleton gestations scheduled for a planned CD under spinal anesthesia. Methods: Women were randomized at a ratio of 1:1 to NCD (study group) or traditional CD (control group). Women in the study group watched fetal extraction, had early skin to skin contact, and breastfed until the end of surgery. Neonates in the control group were presented to the mother without direct contact. Blood samples were drawn from all women to determine oxytocin levels using an ELISA kit. Main Outcome Measures: Postpartum hemoglobin (Hb) levels. Results: 214 women randomized, 23 were excluded. There were no significant differences in demographic and obstetric variables between the groups. Postpartum Hb levels were 10.1±1.1 and 10.3±1.3 g/dL in the study and control groups, respectively (P = .19). There were no significant differences in estimated blood loss, and rates of PPH and blood transfusion. Maternal pain scores, satisfaction, and exclusive breastfeeding rate at discharge, were similar. Maternal oxytocin blood levels were 389.5±183.7 and 408.5±233.6 pg/mL in the study and control groups, respectively (P = .96). Rate of composite neonatal morbidity that comprised neonatal hypothermia, hypoglycemia, jaundice, and neonatal intensive care unit admission was higher in the study group. Conclusions: NCD does not affect maternal blood loss. Maternal oxytocin blood levels in NCD and traditional CD are similar.

Trial Registration: PregCovid study is registered with Clinical Trial Registry of India (Registration no: CTRI/2020/05/025423)Case Report Despite improvements in diagnostic and treatment modalities, ruptured ectopic pregnancy (EP) continues to be an important cause of pregnancy-related mortality and morbidity. CDC has estimated its incidence to be 1-2% 1, yet these pregnancies account for 6 % of pregnancy-related deaths1,2. It was the leading cause of hemorrhage-related mortality in USA in 2011-20133. Corona virus disease-2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), has emerged as a global health concern since December 2020, spreading to almost more than 200 countries/territories/areas worldwide4. Due to its highly contagious nature, many national and regional authorities worldwide enforced the country under lock-down to reduce further spread the disease. India has undertaken a similar strategy from March 24, 2020 in a phased manner. Hence, non-urgent medical care facilities such as outpatient visits and elective surgical interventions were suspended. Many private and other small-scale hospitals stopped their services to follow enforcement of government issued lockdown orders and some fearing the spread of the disease. This has left pregnant women anxious across the country with the only option of going to state-run hospitals or COVID-19 designated hospitals in the city. Thus, reduced number of accessible medical care facilities and travel restrictions caused patients a significant delay in receiving treatment.Topiwala National Medical College (TNMC) & B. Y. L. Nair Charitable Hospital (NH) is one such tertiary care government hospital and designated COVID-19 hospital in the city, receiving referrals from across the Mumbai Metropolitan Region (MMR)5. In the initial phase of 3 months of COVID-19 pandemic (from 4th April 2020 to 31st July 2020), NH received three asymptomatic, RT-PCR confirmed COVID-19 women with EP, including one caesarean scar pregnancy (CSP) (Table 1). Waiver of written informed consent was granted by Institutional Ethics Committees of ICMR-NIRRH and TNMC, Mumbai; as only medical case records were analyzed.

Objective. To investigate the resuscitative efficacy of haemoglobin vesicles (HbVs) for severe postpartum haemorrhage (PPH) using pregnant rabbits. Design: Animal research study Setting: Animal laboratory, National Defense Medical College, Japan Population: Twenty-five female New Zealand white rabbits at late gestation Methods. Pregnant rabbits underwent caesarean section; uncontrolled haemorrhage was induced by transecting the uterine artery to establish a severe PPH model. During the first 30 min (or until the bleeding volume reached 100 mL), all rabbits received 6% hydroxyethyl starch (HES) infusion. Thereafter, rabbits received any of the three isovolemic fluid resuscitations every 5 min: red blood cells (RBCs) with platelet-poor plasma (RBC/PPP) (vol/vol=1:1, n=8), 6% HES (n=7), or HbVs with 25% human serum albumin (vol/vol=4:1, n=10). After 60 min (or when the bleeding volume reached 200 mL), we performed surgical haemostasis and monitored the rabbit survival for 12 hours. Main Outcome Measures: Survival time for severe postpartum haemorrhage Results. During the first 30 min, all rabbits showed severe anaemia (Hb <6 g/dL) that eventually developed to severe PPH. All rabbits that received only HES infusion died within 6 hours, whereas those that received RBC/PPP transfusion survived. Furthermore, 8 of the 10 rabbits received HbV infusion 6 hours after PPH. Overall survival of HbV group was markedly improved compared with that of HES group (p=0.01) but was significantly worse than that of RBC/PPP group (p<0.01). Conclusions. HbV infusion for severe PPH effectively prevented lethal haemorrhagic shock in a pregnant rabbit model, making it a feasible alternative modality.

The relationships and seasonal-to-annual variations among evapotranspiration (ET), precipitation (P), and groundwater dynamics (total water storage anomaly, TWSA) are complex across the Amazon basin, especially the water and energy limitation mechanism for ET. To analyze how ET is controlled by P and TWSA, we used wavelet coherence analysis to investigate the effects of P and TWSA on ET at sub-basin, kilometer, regional, and whole basin scales in the Amazon basin. The Amazon-scale averaged ET has strong correlations with P and TWSA at the annual periodicity. The phase lag between ET and P (ϕ_(ET-P)) is ~1 to ~4 months, and between ET and TWSA (ϕ_(ET-TWSA)) is ~3 to ~7 months. The phase pattern has a south-north divide due to the significant variation in climatic conditions. The correlation between ϕ_(ET-P) and ϕ_(ET-TWSA) is affected by the aridity index, of each sub-basin, as determined using the Budyko framework at the sub-basin level. In the southeast Amazon during a drought year (e.g., 2010), both phases decreased, while in the subsequent years, ϕ_(ET-TWSA) increased. The area of places where ET is limited by water continues to decrease over time in the southern Amazon basin. These results suggest immediate strong groundwater subsidy to ET in the following dry years in the water-limited area of Amazon. The water storage has more control on ET in the southeast but little influence in the north and southwest after a drought. The areas of ET limited by energy or water are switched due to the variability in weather conditions.

Soil detachment is one of the most important processes of soil erosion, as it is of great significance for the prevention and treatment of soil erosion in areas subject to seasonal freeze-thaw. However, most previous studies on the effect of freeze-thaw on soil detachment capacity (SDC) of bare soil, little research on SDC under the effect of freeze-thaw and the root system. This study investigated the effects of freeze-thaw and the root system on soil detachment capacity through hydraulic flume experiments to simulate the soil detachment process of two soil types, sand soil and loessal soil, under four treatments, control, freeze-thaw, root system and freeze-thaw + root system. And a prediction model was developed to calculate SDC under the effect of freeze-thaw and the root system. The results illustrated that the SDC of sand soil was higher than that of loessal soil. The SDC of two soils was reduced and increased by the root system and freeze-thaw, respectively, although the former effect was significant (P < 0.05) whereas the latter was not. The effect of freeze-thaw in combination with the root system showed that the root system contributed the majority of SDC variability (99.95%); therefore, inhibition of SDC by the root system played a leading role. When comparing shear stress, unit energy of the water carrying section and unit stream power, stream power was found to be the hydraulic parameter that best predicted SDC (R2¬ > 0.84). The inclusion of root weight significantly improve the accuracy of the SDC prediction model developed by hydraulic parameters. A general model based on stream power and root weight was developed to quantify SDC and was shown to have a high SDC prediction accuracy for both soils treated by freeze-thaw and the root system [NSE = 0.88，R2 = 0.90].

Background and purpose: Ginkgolide C (GGC) isolated form Ginko biloba (Ginkgoaceae) leaf can demonstrate pleiotropic pharmacological actions although. its anti-oncogenic impact in non-small cell lung cancer (NSCLC) model has not been reconnoitered. As signal transducer and activator of transcription 3 (STAT3) cascade can promote tumor growth and survival, we contemplated that GGC may interrupt this signaling cascade to expend its anti-cancer actions in NSCLC. Experimental approach: The effect of GGC on STAT3 activation, associated protein kinases, STAT3-regulated gene products, cellular proliferation, and apoptosis was examined. The in vivo effect of GGC on the growth of human NSCLC xenograft tumors in athymic nu/nu female mice was also investigated. Key results: GGC attenuated the phosphorylation of STAT3 and varying upstream kinases effectively. Exposure to pervanadate modulated GGC-induced down-regulation of STAT3 activation and promoted an elevation in the level of PTP protein. Indeed, silencing of the PTPgene reversed the GGC-promoted abrogation of STAT3 activation and apoptosis. Moreover, GGC exposure significantly reduced NSCLC tumor growth without demonstrating significant adverse effects via decreasing levels of p-STAT3 in mice tissues. Conclusions and Implications: Overall, the findings support that GGC may exhibit anti-neoplastic actions by mitigation of STAT3 signaling cascade in NSCLC.

Two de novo mutations in GFAP gene were identified (c.214G>A, p.E72K and c.1235C>T, p.T412I) by whole exome sequencing. The common clinical features of the two patients was bulbar dysfunction, pyramidal signs and white matter lesions in periventricular regions. We conducted a novel data-driven method to explore the atrophic pattens and spontaneous brain functional network activity according to the neuroimaging data. Similar atrophic patterns, increased brain functional connectivity in occipital and posterior parietal cortex were detected in the two probands. Western blotting revealed the decreased level of GFAP with p.T412I mutation, while p.E72K and p.R239C mutations were at a similar level to wild type, suggesting the mutations located in the tail domain could decrease the solubility of GFAP. Abnormal inclusions of mutant GFAP were colocalized with ubiquitin, 20S proteasome, protein 1 light chain 3-II (LC3-II) and lysosome. The mutant GFAP caused activated autophagy flux while ubiquitin-proteasome pathway could be blocked as a mechanism for degrading aggregates.We herein presented two AxD patients with heterozygous mutations in GFAP. We noticed that mutant GFAP aggregations induced activated autophagy upon proteasome degrading pathway impairment. Our findings further expand the clinical and genetic spectrum of AxD.

A novel virus, severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19) worldwide appeared in 2019. Currently, we do not have a medicament that treats the disease. One of the rea-sons for the absence of treatment is related to the scarcity of detailed scientific knowledge of the members of the Coro-naviridae family, including the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Structural studies of the MERS-CoV proteins in the current literature are extremely limited. We present here detailed characterization of the struc-tural properties of MERS-CoV macro domain in aqueous solution at the atomic level with dynamics. For this study, we conducted extensive replica exchange molecular dynamics simulations linked to a generative neural networks and we use the resulting trajectories for structural analysis. We perform structural clustering based on the radius of gyration and end-to-end distance of MERS-CoV macro domain in aqueous solution with dynamics at the atomic level. We also report and analyze the residue-level intrinsic disorder features, flexibility and secondary structure. Furthermore, we study the pro-pensities of this macro domain for protein-protein interactions and for the RNA and DNA binding. Results are in agree-ment with available nuclear magnetic resonance spectroscopy findings and present more detailed insights into the struc-tural properties of MERS CoV macro domain. Overall, this work further shows that neural networks can be used as an exploratory tool for the studies of CoV family molecular conformational space at the nano level.

Numerous unknown factors influence anthrax epidemiology in multi-host systems, especially at wildlife/livestock/human interfaces. Serology tests for anti-anthrax antibodies in carnivores are useful tools in identifying the presence or absence of Bacillus anthracis in a range. These were employed to ascertain if the disease pattern followed the recognized high and low risk anthrax zonation in Zimbabwe and also to establish if anthrax was absent from Hwange National Park in which there has been no reported outbreaks. African lions (Panthera leo) (n= 114) drawn from -free-range protected areas and captive game parks located in recognized high and low risk zones across Zimbabwe were tested for antibodies to anthrax PA antigen using the ELISA immunoassay. A random selection of 27 lion sera samples comprising 17 sero-positive and 10 sero-negative sera were further tested in the species-independent toxin neutralization assay (TNA) in order to validate the former as a surveillance tool for anthrax in African lions. Using the ELISA-PA immunoassay, 21.9% (25/114) of the lions tested positive for antibodies to anthrax. Seropositivity was recorded in all study areas and there was no significant difference (p= 0.852) in seropositivity between lions in high and low risk anthrax zones. Also, there was no significant difference (McNemar’s χ2 = 0.9, p = 0.343) in the proportion of lions testing positive to anti-PA anthrax antibodies on ELISA-PA immunoassay compared to the TNA, with fair agreement between the two tests [Kappa (K) statistic = 0.30; 0.08

Background: New corona virus (COVID-19), as an international health threat poses a challenge to physical and psychological resilience globally. The aim of this survey is to explore the level of awareness, health seeking behaviors and preventive measures towards COVID19 among Najran university students. Methodology: By adopting a convenient sampling technique, a cross-sectional study was carried out at Najran university. A self-reporting electronic questionnaire had been utilized for collecting data. A total of 684 students were voluntary completed the questionnaire. Results: The mean age of the participants was 20.2±14.1, The most cited source for obtaining information about COVID-19 was the social media (51%). Females showed higher level of knowledge and awareness about the symptoms of the disease than males (74.3% vs 69.9%) respectively, although the difference was not significant with (P-value >0.05). In regard to compliance with preventive measures, medical students were significantly aware and complying with various preventives measures towards COVID-19 (P-value <0.05). Moreover, females seem to be very keen in seeking medical advices when needed significantly more than males (P-value<0.05). Almost more than 66% of the respondents know the recommended precautions in terms of wearing masks, not to touch outdoors surfaces directly and avoiding crowded places. 556(81.3%) of the participants believe that they should wear face masks outdoors. 6% of the participants prefer to take some herbs daily in different forms to avoid getting infected with COVID-19. Females had an overall higher mean of tension level towards getting infected than males (mean± SD was 5.61 ±1.65 vs 4.55± 1.63) respectively. Conclusion: It was concluded that our students have high level of knowledge and awareness about COVID-19, beside positive attitudes preventive measures and acceptable health seeking behaviors. It is highly recommended to assess the entire Najran community level of awareness so as to design educational programs when needed.

Aim: The aim of this study was to determine menopausal symptoms, sleep levels, quality of life of women in the premenopausal, menopausal, and postmenopausal period, to increase their knowledge level with training to be provided, to reduce their menopausal symptoms, to improve quality of life and sleep quality, and to enable self-examination of breasts and vulva with training provided. Method: The research was conducted in a public hospital in Eskişehir. The study had a quasi-experimental design. The sample of the research consisted of 36 women aged between 40-65 years. These women were asked to complete the Sociodemographic Characteristics Determination Form, Menopause Rating Scale, Pittsburgh Sleep Quality Index, and Quality of Life Scale (SF-36) when they applied to menopause school. After the forms were completed, the participants were given training. Following training, the scales were re-completed and then women were enabled to perform self-examination of breasts (SEB) and self-examination of the vulva (SEV). The IBM SPSS Statistics 21.0 was used for the analysis. Results: The mean age of the women was 50.66±4.45 and that the mean menopause age was 47.60±3.45. The most frequently described symptom was fatigue (91.7%). It was seen that after the training, the MRS score of the women decreased from 16.83±8.87 to 13.66±8.36; the PSQI score decreased from 14.34±2.64 to 13.81±2.55; the mean Quality of Life (SF-36) scale score increased from 48.74±19.13 to 54.92±17.40. As a result of SEB and SEV performed by the women after the training, it was determined that 5.6% of the women had a breast deformity, that 8.3% had a palpable mass in the breast and that 13.9% detected a vaginal discharge in the vulva examination (p<0.05). Conclusion: It is easier to overcome this period with specific comprehensive training and women are enabled to cope with symptoms more effectively.

Abstract. The reuse of N95 masks has been forced on small community-based hospitals, dentists, nursing, and care homes, amongst others, due to the desperate shortage of personal protective equipment globally during the COVID-19 pandemic. The CDC issued guidance on the reuse of N95 masks due to this shortage. However, large scale ultraviolet disinfection equipment would not be practical in these circumstances, we, therefore, investigated the efficacy of a small, mobile, benchtop device with the potential to disinfect N95 masks from SARS-CoV-2 using ultraviolet irradiation. The device tested was the Lumin LM3000 System manufactured by 3B Medical. We found the Lumin LM3000 to be effective against enveloped viruses, including coronavirus, non-enveloped viruses, gram-negative and gram-positive bacteria and spores with reductions greater than 99.9 per centAbstract content goes here