Methods: Twenty-two French nursing homes were included. COVID-19 had been diagnosed with real-time reverse-transcriptase polymerase chain reaction (RT-PCR) for SARS-CoV-2. Blood S-protein IgG and nucleocapsid (N) IgG protein (N-protein IgG) were measured 21-24 days after the first jab (1,004 residents) and 6 weeks after the second (820 residents). Results: Among the 735 residents without prior COVID-19, 41.7% remained seronegative for S-protein IgG after the first jab vs 2.1% of the 270 residents with a previous positive RT-PCR (p<0.001). After the second jab, only 3% of the 586 residents without prior COVID-19 remained seronegative. However, 26.5% of them had low S-protein IgG levels (50-1050 UA/mL) vs 6.4% of the 222 residents with prior COVID-19. Residents with old infection (first wave), or seropositive for N-protein IgG at the time of vaccination, had the highest S-protein IgG levels. Residents with a prior COVID-19 infection had higher S-protein IgG levels after one dose than those without two jabs. Interpretation: A single vaccine jab is sufficient to reach immunity in residents with prior COVID-19. Most residents without prior COVID-19 are seropositive for S-protein IgG after the second jab, but around 30% have low levels of S-protein IgG. Whether residents with no or low post-vaccine immunity are at higher risk of symptomatic COVID-19 requires further analysis.

Background It is important to ensure access to hydroxyurea (HU) for patients with sickle cell anemia (SCA) living in rural areas without easy access to experts in sickle cell management. The UAB Pediatric Sickle Cell program’s satellite clinics reduce the barrier of transportation to the university-based clinic. However, as compared to the university clinic, these satellite clinics do not offer immediate access to HU dosing laboratory results. Therefore, a nurse clinician calls families with HU dose adjustments after the completion of the clinic visit. This study evaluated the impact of telehealth dosing adjustments on HU laboratory and clinical response as compared to university-based patients. Methods A one year retrospective chart reviewed was performed to evaluate HU laboratory and clinical response based on clinic location and socioeconomic status for patients with SCA. We identified the number of clinic and acute care visits for one year and calculated the mean CBC and HbF values for each patient. Results We identified 107 academic center participants with SCA prescribed HU and 65 satellite clinic participants. We identified no difference in HbF, Hb, MCV, or ANC by clinic location. We also identified no difference in hospital admissions based on clinic location. Finally, mean socioeconomic indicators by zip code were lower in satellite clinic patients but not associated with a difference in HbF response. Conclusions The use of telehealth did not negatively impact laboratory response to HU. Future studies should identify novel approaches to improve access to HU among patients with SCA living in rural areas.

We explored the Protein Data-Bank (PDB) to collect protein-ssDNA structures and create a multi-conformational docking benchmark including both bound and unbound protein structures. Due to ssDNA high flexibility when not bound, no ssDNA unbound structure is included. For the 143 groups identified as bound-unbound structures of the same protein , we studied the conformational changes in the protein induced by the ssDNA binding. Moreover, based on several bound or unbound protein structures in some groups, we also assessed the intrinsic conformational variability in either bound or unbound conditions, and compared it to the supposedly binding-induced modifications. This benchmark is, to our knowledge, the first attempt made to peruse available structures of protein – ssDNA interactions to such an extent, aiming to improve computational docking tools dedicated to this kind of molecular interactions.

The current COVID-19 pandemic highlights the need for zoonotic infectious disease surveillance. Avian influenza virus (AIV) poses a significant threat to animal and public health due to its pandemic potential. Virus-contaminated water has been suggested as an important AIV spread mechanism among multiple species. Nevertheless, few studies have characterized the global AIV subtype diversity and distribution in environmental water. Therefore, this study aims to provide an updated descriptive and phylogenetic analysis of AIVs isolated in water samples from high risk-sites for influenza outbreaks (i.e., live bird markets, poultry farms, and wild bird habitats) on a global scale. A total of 234 hemagglutinin (HA) gene sequences of 21 subtypes were reported from nine countries between 2003 – 2020. Fourteen AIV subtypes were solely reported from Asian countries. Most of the viral sequences were obtained in China and Bangladesh with 47.44% and 23.93%, respectively. Likewise, the greatest global AIV subtype diversity was observed in China with twelve subtypes. Live bird markets represented the main sampling site for AIV detection in water samples (64.10%), mostly from poultry cage water. Nevertheless, the highest subtype diversity was observed in water samples from wild bird habitats, especially from the Izumi plain and the Dongting Lake located in Japan and China, respectively. Water from drinking poultry troughs evidenced the greatest subtype diversity in live bird markets, meanwhile, environmental water used by ducks had the highest number of different subtypes in poultry farms. The maximum-likelihood phylogenetic tree showed that some HA sequences were closely related among different poultry/wild bird-related environments from different geographic origins. Therefore, the results suggest that even though the availability of HA gene sequences in public-access databases varies greatly among countries, environmental AIV surveillance represents a useful tool to elucidate potential viral diversity in wild and domestic bird populations.

Evidence that telomere length (TL) and dynamics can be interpreted as proxy for ‘life stress’ experienced by individuals stems largely from correlational studies. We tested for effects of an experimental increase of workload on telomere dynamics by equipping male great tits (Parus major) with a 0.9 gram backpack for a full year. In addition, we analysed associations between natural life-history variation, TL and TL dynamics. Carrying 5% extra weight for a year did not significantly accelerate telomere attrition. This agrees with our earlier finding that this experiment did not affect survival or future reproduction. Apparently, great tit males were able to compensate behaviourally or physiologically for the increase in locomotion costs we imposed. We found no cross-sectional association between reproductive success and TL, but individuals with higher reproductive success (number of recruits) lost fewer telomere base pairs in the subsequent year. We used the TRF method to measure TL, which method yields a TL distribution for each sample, and the association between reproductive success and telomere loss was more pronounced in the higher percentiles of the telomere distribution, in agreement with the higher impact of ageing on longer telomeres within individuals. Individuals with longer telomeres and less telomere shortening were more likely to survive to the next breeding season, but these patterns did not reach statistical significance. Whether successful individuals are characterized by losing fewer or more base pairs from their telomeres varies between species, and we discuss aspects of ecology and social organisation that may explain this variation.

Cardiac ochronosis is a rare disease, estimated to affect 1 in 250,000 persons. While there is extensive evidence of the musculoskeletal alterations of the disease, cardiac involvement has not been widely studied and most information we currently have derives from case reports and case series. We report the case of a 64-year old patient with a known history of alkaptonuria who presented with dyspnea and weight loss. On evaluation, he was found to have severe aortic stenosis, coronary artery disease, and interventricular septal hypertrophy. Surgery revealed extensive ochronotic pigment deposition affecting the cardiac septum, both internal thoracic arteries, the native coronary arteries, and the aortic valve. Ochronotic heart disease is an often disregarded presentation of alkaptonuria. More information is needed on the course of the disease, as well as long-term outcomes after valve replacement surgery and/or CABG in patients with alkaptonuria.

In the present paper, we determine the chemical equilibrium compositions for two combustion reactions involving either hydrazine or propane at fixed high pressure and temperature values using several computational approaches. Then, we compute the chemical equilibria for reacting systems under a multitude of temperature and pressure conditions and various initial system compositions. These sensitivity analyses are based on a combination of the method of Lagrangian multipliers and the arc-length continuation technique. Indeed, three industrially relevant case studies are elucidated: (1) the synthesis of ammonia using the Haber process, (2) the gasification of a typical biomass surrogate: glucose using steam and (3) the gasification of cellulose using steam. For all the above reacting systems, our results are benchmarked against their counterparts obtained either from the ubiquitous process simulator: ASPEN-Plus® or from data available in the open literature.

The relationship between producers (e.g., macrophyte, phytoplankton and epiphytic algae) and snails plays an important role in maintaining the function and stability of the shallow ecosystems. A complex relationship exists among macrophytes, epiphytic algae, phytoplankton and snails. An outdoor mesocosm experiment with two-way factorials was carried out, three species submerged macrophytes (Hydrilla verticillate, Vallisneria natans or one exotic submerged plant Elodea nuttallii) and two grazing treatments (4 snail species present or absent) to elucidate those relationships. The results showed that the snail communities reducing the biomass of phytoplankton and epiphytic algae indirect then enhanced the growth of the submerged macrophytes. The macrophyte with complex architecture supported more snail and epiphytic algae, and snails preferred to feed on native plants. Competition drove snails change the grazing preferences to achieve coexistence, so that led to the assembling of snail communities towards the direction of highest resource utilization.

Aortic balloon for the intraoperative management of placenta accreta spectrum: need for standardised methodology and safety dataIn 2003, Bell-Thomas et al (BJOG 2003;110:1120-1122) reported on the emergency use of a transfemoral aortic occlusion catheter to control massive haemorrhage in a case of caesarean hysterectomy for placenta percreta. This was only the second case published in the international literature on the use of an intra-abdominal aortic balloon occlusion (IABO) in the management of placenta accreta spectrum (PAS) (Paull et al. Anesth Intensive Care 1995;23:731-734). A non-exhaustive Pub-Med literature review of articles published in English on this the topic over the last 20 years, identifies 27 articles, 23 of which come from the Peoples Republic of China, where IABO seems to be increasingly popular in the management of PAS.In brief, IABO involves the insertion of a balloon catheter into the infrarenal abdominal aorta above the aortic bifurcation under fluoroscopy guidance. The procedure is performed in a hybrid operating room or interventional radiology (IR) suite with secondary transfer to the operating room. In all but one study (Zhu et al Biomed Res Int.2017:8604849), the balloon was inflated after delivery of the newborn.All publications so far have been retrospective and most are case-control studies, comparing the outcomes of IABO with those of routine surgical techniques with or without additional procedures such as intra-uterine tamponade. Recently, authors have also started to compare IABO with iliac artery balloon occlusion.Overall, these studies have shown that IABO is associated with reduced estimated blood loss and transfusion requirement, ICU admission and hysterectomy and suggested that IABO is more effective than iliac artery balloon occlusion, presumably as arterial occlusion is more effective.However, there is wide variation between studies in prenatal imaging and clinical selection criteria, intraoperative IR methodology and confirmation of the diagnosis of PAS at birth. For example, the pre-operative fluoroscopy time ranges between 2 and 25 minutes with fetal radiation exposure of 4 to 25 mGy; intraoperative balloon inflation/deflation time varies between 5-10/1 minutes and 45-80/10 minutes. The size of the balloon and the need for transfer between the IR room and the operative theatre is rarely described. Most studies lack histopathology confirmation of the diagnosis and/or stratification by PAS grade.Heterogeneity in methodology and design leads to a high risk of confounding, bias or chance. There is also a high risk that the relationship is not causal. One major concern is the risks-benefit ratio of the use of IABO for both mothers and fetuses, in particular if they do not have PAS. The most commonly reported post-operative complication associated with IABO are arterial thrombosis of the external iliac or the femoral artery. There are no data on the long-term follow of the children born after IABO.In 2018, the expert panel of the RCOG green top guidelines 27a (Jauniaux et al., BJOG.2019;126:e1-e48) concluded that larger studies are necessary to determine the safety and efficacy of IR before this technique can be advised in the routine management of PAS. The 10 new studies published in 2019-2010 on the use of IABO in the management of PAS are insufficient to change this statement.Word count: 499

Background: Chronic pulmonary infection is the leading cause of mortality and morbidity in patients with cystic fibrosis (CF). The most common pathogens isolated in CF are Staphylococcus aureus and Pseudomonas aeruginosa (P. aeruginosa). Chronic infection of P. aeruginosa and MRSA are associated with worse survival and antibiotic eradication treatment is recommended for both. This study evaluates the efficacy of intravenous (IV) vs. non-IV antibiotics in the eradication of P. aeruginosa and MRSA. Methods: This was a single-center retrospective study at a large CF center. All respiratory specimen cultures of 309 CF patients and eradication regimens between 2015-2019 were reviewed. The primary analysis was the comparison of the percentage of successful eradication after receiving IV and non-IV eradication regimens. Demographic and clinical risk factors for eradication failure were also analyzed. Results: 102 patients with P. aeruginosa isolations and 48 patients with MRSA were analyzed. At one year, 21.6% in P. aeruginosa group and 35.4% in MRSA group were successfully eradicated. There was not any statistically significant difference between IV vs. non-IV antibiotic regimens on eradication in either group. Additionally, none of the clinical risk factors was significantly associated with eradication failure in P. aeruginosa and MRSA groups. Conclusion: In the eradication of P. aeruginosa and MRSA, IV and non-IV treatment regimens did not show any superiority to one another. Non-parenteral eradication could be a better option in eradication considering the cost-effectiveness and the treatment burden of IV treatments due to hospitalization and the need for IV access.

Understanding and preserving intra-specific diversity (ISD) is important for species conservation. However, ISD units do not have taxonomic standards and are not universally recognized. The terminology used to describe ISD is varied and often used ambiguously. We compared classical and authoritative definitions of terms used to describe ISD with terms used in recent studies of three fish taxa: sticklebacks (Gasterosteidae), Pacific salmon and trout (Oncorhynchus spp., “PST”), and lampreys (Petromyzontiformes). Our review revealed the terminological ambiguity of “races” and “subspecies”, found similar definitions of “subspecies” and “ecotype”, and of “ecotype” and “reaction norms”. “Species pairs” describes two phenotypes; however, in some situations more than one phenotype may occur. “Ecotype” was originally used to describe patterns in genes and ecology, and recent studies employing this term tend to report a genetic basis in ISD. Ecotype is used most frequently in genetic- and evolution-based journals. By contrast, “life history” includes biological parameters that affect population growth and decline, and this term tends to be used in organismal- and ecology-based journals. When the genetic or demographic components of ISD are not well understood, a conservative approach would be to refer to expressions of this diversity as “phenotypes”. The nature of human interests in particular taxa could influence how these organisms are studied, and hence the ways in which their ISD is understood, described, and conserved.

Pediatric palliative care (PPC) is an active and total approach to the care of children with life-limiting conditions and to their families. PPC programs provide ongoing care for children with medical complexity (CMC), many of whom will reach adulthood. The aim of the study is to describe a population of CMC afferent in 4 months to the Intermediate Care Unit of a tertiary referral hospital for southern and central Italy. We enrolled all CMC patients admitted at our unit in 4 randomized months. We registered pathologies and different categories of childhood diseases, devices and needs, hospitalization and home care plan. Among 195 admitted to our unit, 87 CMC were included. Median age was 9 (0.1 – 35.7) years. The main pathologies recorded were neuromuscular, neurological, respiratory, metabolic, malformative, genetic syndromes and outcomes of prematurity. Comorbidity made by respiratory, digestive, neurological, cardiac and urological involvement was present in a high percentage of cases. Among our patients, only 24 hadn’t any devices. The average length of hospitalization was 7.0 (1.0 – 270.0) days with 2 (1.0 – 7.0) admissions per year for patient. Home care activation was not required for only 24 of 87 patients. Children eligible for CPP are increasing and their survival results in a rise in comorbidities and special needs demanding multi-level interventions. Respiratory symptoms are the most recurrent observed demonstrating the need for an expert in CPP to have respiratory skills. Sharing data and knowledge of CMC needs may help to improve care coordination and interventions.

We present an alternative perturbational approach free of basis set superposition error (BSSE) within the framework of the Chemical Hamiltonian Approach (CHA). The new formulation (CHA-S-MP2) is based on canonic (and orthogonal) CHA orbitals obtained from a hermitized CHA Fock operator. The final expression shows a considerable simplification of the method as compared to the previous CHA-MP2 formalism. In the present formulation only two four-index transformations are necessary so that the computational cost of the CHA-S-MP2 calculation is just twice that of a conventional uncorrected MP2 calculation. Also, contrary to the counterpoise method, the computational cost doesn’t depend on the number of interacting fragments. Numerical full geometry optimizations of water and hydrogen fluoride dimers and potential energy surfaces for helium and argon dimers for several basis sets are presented. The present method is compared to both the counterpoise and previous CHA-MP2 BSSE correction schemes, showing a remarkable agreement between all three methods. However, the wrong behavior using the aug-cc-pVDZ basis set indicates that the present method is not as robust as the original non-hermitian CHA-MP2 formulation.

With many plant-pollinator interactions undergoing change, we require a better understanding of how the addition of new interacting partners, such as antagonists, can affect plant reproduction. One such group of antagonistic floral visitors, nectar robbers, can deplete plants of nectar rewards without contributing to pollination. The addition of nectar robbing to the floral visitor assemblage could therefore have costs to the plant´s reproductive output. We focus on a recent plant colonist, Digitalis purpurea, a plant that in its native range is rarely robbed, but experiences intense nectar robbing in areas it has been introduced to. Here, we test the costs to reproduction following experimental nectar robbing. To identify any changes in the behaviour of the principal pollinators in response to nectar robbing, we measured visitation rates, visit duration, proportion of flowers visited and rate of rejection of inflorescences. To find the effects of robbing on fitness, we used proxies for female and male components of reproductive output, by measuring the seeds produced per fruit and the pollen export respectively. Nectar robbing significantly reduced the rate of visitation and lengths of visits by bumblebees. Additionally, bumblebees visited a lower proportion of flowers on an inflorescence that had robbed flowers. We found that flowers in the robbed treatment produced significantly fewer seeds per fruit on average but did not export fewer pollen grains. Our finding that robbing leads to reduced seed production could be due to fewer and shorter visits to flowers leading to less effective pollination. We discuss the potential consequences of new pollinator environments, such as exposure to nectar robbing, for plant reproduction.

For treating both relativistic effect and electron correlation, the spin-free exact two-component and spin-dependent first-order Douglas-Kroll-Hess (sf-X2C-so-DKH1) Hamiltonian and the state-interaction (SI) method are combined to calculate the spin-orbit coupling (SOC) on multi-configuration electron correlation theory. Here, SOC is evaluated via SI among the spin-free states from the complete active space self-consistent field (CASSCF) calculation, and the dynamic electron correlation could be reckoned via the high-level multi-reference electron correlation method. Work equations to evaluate SOC matrix elements over spin-adapted Gelfand states in the framework of the graphic unitary group approach (GUGA) are presented. Benchmark calculations have verified the validity of the present implementation. As a pilot application, the internally contracted MRCI (icMRCI) with the inclusion of SOC calculation produces the reasonable equilibrium bond length and the harmonic vibrational frequency of the ground state of AuO, as well as the transition energy of $X^2\Pi_{3/2} \leftarrow ^2\Pi_{1/2}$.

The nitration of chlorobenzene with concentrated mixed acids is a fast and highly exothermic process, which suffers from considerable mass transfer resistance and poor heat transfer rates. The reaction kinetics has not been thoroughly reported before. In this work, a continuous-flow microreactor system and a homogeneous reaction condition were proposed to obtain accurate chlorobenzene nitration kinetics data at high mixed acid concentrations. A general model for predicting the observed reaction rate constants was established. With a new method for estimating the equilibria associated with HNO3 in aqueous sulfuric acid, the rate constants based on nitronium ion and activation energies were obtained. Compared with batch reactors, the continuous-flow microreactor system allows for a sufficient heat transfer efficiency and accurate residence time control, making it possible to study the reaction performance more quickly and sensitively. This work may provide a reliable reference for the kinetic study of similar processes.

Optimal tip sonication settings, namely tip position, input power, and pulse durations, are necessary for temperature sensitive procedures like preparation of viable cell extract. In this paper, the optimum tip immersion depth (20-30% height below the liquid surface) is estimated which ensures maximum mixing thereby enhancing thermal dissipation of local cavitation hotspots. A finite element (FE) heat transfer model is presented, validated experimentally with (R2 > 97%) and used to observe the effect of temperature rise on cell extract performance of E. coli BL21 DE3 star strain and estimate the temperature threshold. Relative yields in the top 10% are observed for solution temperatures maintained below 32°C; this reduces below 50% relative yield at temperatures above 47°C. A generalized workflow for direct simulation using the COMSOL code as well as master plots for estimation of sonication parameters (power input and pulse settings) is also presented.

Clarity as to the role of metal identity and oxidation state in effecting redox and acid-catalyzed turnovers is oftentimes precluded by a high degree of heterogeneity in site speciation, a limitation that can be overcome through the use of well-defined poly-metal clusters hosted by metal organic framework materials- accomplished in the present case using MIL-100(M) for the low temperature oxidation of methane with N2O. Transient kinetic data point to a) methoxy species mediating methane conversion, b) partial and deep oxidation occurring over metal sites distinct in oxidation state, c) chromium clusters amplifying the propensity toward C-C bond formation, and d) the relative velocity of propagation of water and methanol concentration fronts playing a determinative role in maximizing C2 oxygenate selectivity. The study captures the utility of using classes of materials inherently endowed with a high level of definition and uniformity in advancing the elucidation of structure-catalytic property relationships.