Background: There is a great need to make a rapid differential clinical diagnosis of COVID-19 among respiratory disease patients and determining the prevalence rate of these diseases among the COVID-19 population. Method: Approximately 522 patients with allergic rhinitis, asthma, COPD, and COVID-19 were analyzed for demographic and clinical features. Radiological features were analyzed only for COVID-19 patients. Results: COPD and asthma were more common among COVID-19 patients than allergic rhinitis. All chest CT scans of COVID-19 patients showed bilateral ground-glass opacity. Fever, dry cough, diarrhea, loss of sense of smell and taste, shortness of breath, and blue lips were significantly higher in all COVID-19 patients compared to COPD, asthma, and allergic rhinitis patients. Conclusion: The presence of clinical symptoms such as fever, dry cough, diarrhea, loss of sense of smell and taste, shortness of breath, and blue lips in COVID-19 patients, can be used for differential diagnosis between COVID-19 patients and other respiratory diseases. Then, the diagnosis can be confirmed by chest CT scan for COVID-19 patients without the need for a nasopharyngeal swab or PCR test, especially in epidemic countries. Allergic rhinitis patients are the least exposed to COVID-19 infection among other respiratory disease patients.

Background: Patients with late, occurring ≥18 months post-diagnosis, isolated central nervous relapse (iCNS-R) of B-acute lymphoblastic leukemia (ALL) have excellent outcomes with chemotherapy plus cranial radiotherapy, with 5-yr overall survival (OS) approaching 80% in POG 9412. Subsequent relapse and radiation-related morbidity remain the causes of treatment failure and long-term sequelae. COG AALL02P2 aimed to maintain outcomes in patients with late iCNS-R using intensified chemotherapy and a decrease in cranial irradiation from 1800 to 1200 cGy. Procedures: COG AALL02P2 enrolled 118 eligible patients with B-ALL and early iCNS-R who received intensified systemic therapy, triple intrathecal chemotherapy and 1200 cGy cranial irradiation delivered at 12 months, with maintenance chemotherapy continuing until104 weeks post-diagnosis. Results: The 3-yr event-free and overall survival (EFS) and OS were 64.3±4.5% and 79.6±3.8%, with 46.1% (18/39) of relapses including the CNS. Of the 112 patients who completed therapy, 78 received protocol-specified radiation. Study enrollment was closed after interim monitoring analysis showed inferior EFS compared to POG 9412. Patients with initial NCI standard risk classification fared better than high risk patients. Conclusions: COG AALL02P2 showed inferior EFS but similar OS compared to POG 9412. Limitations included a small sample size, more intensive prior therapies, and a significant number of patients (34/118, 29%) who did not receive protocol-directed radiation due to early relapse prior to 1 year or did not otherwise follow the treatment plan. New approaches are needed to improve outcome for these patients and determine the optimal timing and dose of cranial radiation in the treatment of iCNS-R.

ABSTRACT Aim: The aim of our research was to investigate retrospectively the relationship between the symptoms and general characteristics, initial laboratory values and treatments in patients who had COVID- 19 and who applied to the chest diseases outpatient clinic for control after 1 month. Methods: Three hundred fifteen patients who were diagnosed with COVID- 19 and applied to the chest diseases outpatient clinic between May 2020 and August 2020 for control in the 1st month were included in the study. Patient information was collected from the hospital information system and the e-pulse system. Results: Females accounted for 50.2 % of the our patients and their mean age was 47.98 ± 14.81 (19-88) years. 14.3% (n: 45) of the individuals were 65 years of age and older. 20.6% (n: 65) of our patients were smoking. 70.2% (n: 221) of our patients were treated at home. 133 patients had at least one comorbid disease. The patients most frequently reported cough, dyspnea, weakness, myalgia and diarrhea. The most common symptoms were cough, dyspnea, weakness and myalgia in the first month. It was determined that the symptoms had persisted in patients who had been hospitalized, had dual therapy, had comorbid diseases and had more common pathologies in their pulmonary imagings. Conclusion: Symptoms may persist for a long time in hospitalized patients, in patients with COVID-19-related pneumonia and concomitant chronic diseases and in patients with high d-dimer and high CRP at the time of admission. Patients are informed that their symptoms may last for a long time, unnecessary hospital admissons can be avoided.

Ticks are involved in the transmission of various pathogens and some tick-borne diseases cause significant problems for the health of humans and livestock. Despite their obvious importance, the composition of viral communities in ticks, and their interactions with pathogens, is poorly understood, particularly in Eastern Europe that constitutes (via bird migrations for example) a major hub for animal-arthropod vectors exchanges. The aim of this study was first to describe the virome of Dermacentor sp., Rhipicephalus sp. and Haemaphysalis sp. ticks collected from poorly investigated regions of Romania (Iasi and Tulcea counties) located at the intersection of various biotopes, countries and routes of migrations. We then focused the study on viruses that could have potential relevance for human and animal health. More than 500 ticks were collected in 2019 from the environment and from small ruminants and analyzed by high-throughput transcriptome sequencing. Among the viral communities infecting Romanian ticks, viruses belonging to the Flaviviridae, Phenuiviridae and Nairoviridae families were identified and full genomes were derivedPhylogenetic analyses placed them in clades where mammalian isolates are found, suggesting that these viruses could constitute novel arboviruses. We also assessed the bacterial microbiome of the collected ticks. The characterization of these microbial communities increases the knowledge of the diversity of viruses in Eastern Europe and provide a basis for further studies on the relationship between ticks and tick-borne viruses.

Surgical treatment of type A dissections is based on best evidence practice for the lack of controlled randomized studies providing definitive scientific evidence. Despite its widespread use, axillary cannulation still remains a debated topic as the preferred method of cannulation and perfusion strategy in the treatment of this complex condition.

Amblypygids are an arachnid order possessing a unique pair of spined pedipalps: appendages that perform in prey capture, courtship and contest. Pedipalp length, hypothesised to be under sexual selection, varies markedly across amblypygid species, and pedipalp spination, thought to reflect selection for function in prey capture, also differs interspecifically. Differences in pedipalp shape between species may indicate that the relative strength of selection for prey capture and sexual selection vary across the group. However, interspecific differences in pedipalp shape have not been quantified, due to difficulties in identifying homologous features. For the first time, we quantify trends in amblypygid pedipalp shape complexity. We use elliptical Fourier analysis to quantify 2D complexity in pedipalp outlines across eleven species and six genera. We find that complexity significantly decreases as pedipalp length increases. This appears to be driven by relative spine length, suggesting that a trade-off exists between pedipalp length and spination. Furthermore, significant female-biased sexual dimorphism in shape complexity is present in the tibial segment of the amblypygid pedipalp. Our results provide novel insights into the drivers of amblypygid pedipalp evolution, and suggest that a functional trade-off between performance in prey capture and other functions under sexual selection exist in this enigmatic structure.

Introduction: Among the multiple complex pathophysiological mechanisms underlying COVID-19 pneumonia, immunothrombosis has been shown to play a key role. One of the most dangerous consequences of the prothrombotic imbalance is the increased incidence of micro- and macro-thrombotic phenomena, especially deep vein thrombosis (DVT) and pulmonary embolism (PE). Methods: We investigated the correlation between radiological and clinical-biochemical characteristics of a cohort of hospitalized COVID-19 patients. Results: PE was confirmed in 14/61 (23%) patients, five (35.7%) had DVT. The radiographic findings, quantified by Qanadli score, correlated with the clinical score and biochemical markers. The ratio between the right and left ventricle diameter measured at CT scan correlated with the length of hospital stay. Conclusion: In our cohort radiological parameters showed a significant correlation with clinical prognostic indices and scores, thus suggesting that a multidisciplinary approach is advisable in the evaluation of PE in COVID-19 patients.

Purpose: Considering the anti-inflammatory effect of atorvastatin and the role of medical comorbidities such as hypertension and coronary artery disease on prognosis of the COVID-19 patients, we aimed to assess the effect of atorvastatin add-on therapy on mortality due to COVID-19. Methods: We conducted a retrospective cohort study, including patients who were hospitalized with confirmed diagnosis of severe COVID-19. Baseline characteristics and related clinical data of patients were recorded. Clinical outcomes consist of in hospital mortality, need for invasive mechanical ventilation and hospital length of stay. COX regression analysis models were used to assess the association of independent factors to outcomes. Results: Atorvastatin was administered for 421 out of 991 patients. The mean age was 61.640±17.003 years. Older age, higher prevalence of hypertension and coronary artery disease reported in patients who received atorvastatin. These patients had shorter hospital length of stay (P=0.001). Based on COX proportional hazard model, in hospital use of atorvastatin was associated to decrease in mortality (HR=0.679, P=0.005) and lower need for invasive mechanical ventilation (HR=0.602, P=0.014). Conclusions: Atorvastatin add-on therapy in patient with severe COVID-19 was associated with lower in hospital mortality and reduced the risk of need for invasive mechanical ventilation which support to continue the prescription of the medication.

In this work, the enumeration algorithms presented in parts I and II for the globally optimal synthesis of heat exchanger networks are extended to consider non-isothermal mixing. The previous models are modified by adding non-isothermal mixing constraints and new models are constructed to target the bounds of the energy consumption and the binding exchanger minimum approximation temperature. These new models are solved using algorithms that involve solving the solution of systems of equations instead of mathematical programming. We also present two alternatives for optimizing each enumerated structure, namely, the use of a global solver, or the use of a golden search with simple resolution of non-isothermal mixing model for fixed energy consumption. The non-isothermal mixing model is reformulated as a convex model, either solved using nonlinear programming or a programming-free methodology, i.e. solving Karush-Kuhn-Tucker equations. A global optimum search algorithm is developed and examples are tested comparing the proposed strategies.

A gas-liquid stirred tank reactor (STR) has some problems, such as low mass transfer efficiency, high exhaust gas oxygen concentration, and low product conversion rate, due to limitations of stirring speed and input power. This article proposes a method to enhance the gas-liquid mass transfer in a STR using circulating jet internals. When a circulating jet is added, the average bubble size in the reactor is reduced to 1.26 mm, and the overall gas holdup is increased to 8.23%, which is an increase of 3.62 times of the original STR. The gas-liquid volumetric mass transfer coefficient is increased to 0.05556 s-1, which is 4.84 times of the original STR. The unit volume power is increased by only 1.4 times. These data provide references for the design and scale-up of new jet STRs.

As part of the European Union-funded project designated PARTN-ER, the European Cooperative Study Group for Pediatric Rare Tumors (EXPeRT) is continuously developing consensus recommendations in order to harmonize standard care for very rare solid tumors of children and adolescents. This paper presents the internationally recognized recommendations for the diagnosis and treatment of sex cord stromal tumors (SCST). The clinical approach to sex cord stromal tumors of the testis (TSCST) and ovary (OSCST) depends on histological differentiation and tumor stage. Virtually all TSCSTs present as localized non-metastatic tumors, with excellent prognosis after complete resection. In contrast, the prognosis of OSCSTs may be adversely affected by tumor spillage during surgery or presence of metastases. In these cases, cisplatin-based chemotherapy is recommended. Of note, some SCSTs may develop in the context of tumor predisposition syndromes e.g. DICER-1, so that specific follow-up is indicated. SCSTs should be diagnosed and treated according to standardized recommendations that include reference pathology, genetic testing for tumor predisposition syndromes in selected cases, and stratified adjuvant chemotherapy in patients with unfavorable risk profile. To ensure high quality of diagnosis and therapy, patients should be enrolled into prospective registries.

Numerous studies in the past 10 years have reported on the neurocognitive sequalae of pediatric Sleep Disordered Breathing (SDB). Variations in criteria used to define SDB in conjunction with the wide variety of neuropsychological measures selected to evaluate cognitive consequences of SDB have resulted in discrepancies within the literature. This review summarizes the extant literature regarding cognitive effects of pediatric SDB across domains of global intelligence, attention, executive function, memory, language, and visuospatial ability. This review also addresses the proposed etiology underlying neurocognitive consequences of pediatric SDB. The differences in findings across the literature are highlighted and discussed throughout.

Phragmites australis is the dominant species in the Yellow River Delta and plays an important role in wetland ecosystems. Ecological responses of the P. australis community to soil properties were investigated in 96 areas along the coastal-inland regions in the Yellow River Delta of China. The aim was to evaluate the relationship between phenotypic variation and environmental factors, reveal which functional traits could well respond to changes in electrical conductivity and soil water content, and the ecological strategies of P. australis. Within the range of soil water content (9.39–36.92%) and electrical conductivity (0.14–13.29 ms/cm), the results showed that the effects of soil water content and salinity were not equally important for the characterization of the morphological and physiological variability, and that plant functional traits including leaf traits and stem traits responded more strongly to soil salinity than soil water content. Our results suggested that salinity leads to reduced average height, specific leaf area, leaf area, and base stem diameter, but increased leaf water content and leaf thickness. The relationships between functional traits and electrical conductivity were generally linear and logarithmic. The coefficients of variation of morphological traits showed more phenotypic plasticity than the physiological traits. Salinity also led to the stress tolerator/competitor-stress tolerator (S/CS) strategies of P. australis; with the decrease of environmental stress, the main strategy gradually moved to the competitor (C) strategy, making P. australis the dominant species in the Yellow River Delta. KEYWORDS: Soil water content, Electrical conductivity, Functional traits, Plasticity, Life strategies.

1. Metadata plays an essential role in the long term preservation, reuse, and interoperability of data. Nevertheless, creating useful metadata can be sufficiently difficult and weakly-enough incentivised that many datasets may be accompanied by little or no metadata. One key challenge is, therefore, how to make metadata creation easier and more valuable. We present a solution that involves creating domain specific metadata schemes that are as complex as necessary and as simple as possible. These goals are achieved by co-development between a metadata expert and the researchers (i.e. the data creators). The final product is a bespoke metadata scheme into which researchers can enter information (and validate it) via the simplest of interfaces: a web browser application and a spreadsheet. 2.We provide the R package [‘dmdScheme‘](https://CRAN.R-project.org/package=dmdScheme) [@Krug2019] for creating a template domain specific scheme. We describe how to create a domain specific scheme from this template, including the iterative co-development process, and the simple methods for using the scheme, and simple methods for quality assessment, improvement, and validation. 3.The process of developing a metadata scheme following the outlined approach was successful, resulting in a metadata scheme which is used for the data generated in our research group. The validation quickly identifies forgotten metadata, as well as inconsistent metadata, therefore improving the quality of the metadata. Multiple output formats are available, including XML. 4. Making the provision of metadata easier while also ensuring high quality must be a priority for data curation initiatives. We show how both objectives are achieved by very close collaboration between metadata experts and researchers to create domain specific schemes. A near-future priority is to provide methods to interface domain specific schemes with general metadata schemes, such as the Ecological Metadata Language, to increase interoperability.

Background: The provision of Section 2302 of the 2010 Patient Protection and Affordable Care Act (ACA) allowed pediatric patients who are enrolled in Medicaid to receive hospice care concurrently with curative treatment (i.e., concurrent hospice care). Because it is a relatively new model of care and very little is known about the characteristics of children with cancer who receive it, the purpose of the current study was to compare demographic, health, and community characteristics of children who received standard hospice care versus concurrent hospice care. Procedure: This study was a retrospective, comparison study with national Medicaid files provided by the Center for Medicare and Medicaid Services (CMS). The sample included 1,685 pediatric patients under the age of 20 who were diagnosed with cancer, were enrolled in hospice between 2011 and 2013, and received standard hospice care (n= 1,008) or concurrent hospice care (n = 655). Results: Children of non-Caucasian race with multiple complex chronic conditions, mental/behavioral health problems technology dependence, and brain and orbital tumors, were more likely to be enrolled in concurrent care than in standard hospice care. The proportion of children enrolled in concurrent care versus standard hospice care was larger in rural areas, low-income communities, and in the Southern states. Conclusions: The enhanced uptake of concurrent care by traditionally underserved populations is promising. Concurrent hospice care, which allows for continued medical treatment and hospice care, could enhance access to hospice within these populations by offering a more blended model of care.

Background Outcomes of Ewing sarcoma (ES) in low and middle income countries lags behind the rest of the world owing to multiple tumoral, logistical and socio-economic factors. The data of outcomes and toxicity in these countries is sparse, especially in the adolescent and adult (AA) population and merits exploration Procedure This was a retrospective analysis of prospectively collected data of non-metastatic AA-ES patients, who received standard institutional combination chemotherapy regimen (EFT-2001) along with surgery or definitive radiotherapy. Various cohorts were analyzed for treatment-related toxicities, event- free survival (EFS) and overall survival (OS). Results There were 235 patients (primary safety cohort, PSC) with median age of 23 years. One hundred and ninety six were treatment naïve (primary efficacy cohort, PEC) and of these 119 had surgery. In PEC, at a median follow up of 36.4 months, estimated 5 year EFS and OS were 60.9% (95% CI 53.1% - 69.9%) and 84.5% (95% CI 77.7% - 91.9%), respectively. Of these, 158 complying with intended treatment, had an estimated 5 year EFS of 63.1% (95% CI 54.8%-72.6%). In multivariate analysis, good prognostic factors included longer symptom duration, ≥ 99% necrosis and treatment completion. Among PSC, grade 3-4 toxicities were febrile-neutropenia (50.6%), anemia (55.3%), peripheral neuropathy (15.7%), with 3 (1.3%) chemo-toxic deaths. Conclusions The outcomes of AA non-metastatic ES patients treated with EFT-2001 regimen were comparable to those reported by others, with acceptable toxicity and can be considered as standard-of-care, especially in LMICs.

A 78 years-old woman was found with worsening hypercalcemia, osteopenia and memory loss during the past 2 years. Multiple, repeated imaging studies failed to reveal the aetiology of the primary hyperparathyroidism. Bilateral neck exploration revealed a 4.5X2,3 cm right superior parathyroid adenoma in an ectopic position.

Small-to-medium businesses are always seeking affordable ways to advertise their products and services securely. With the emergence of mobile technology, it is possible than ever to implement innovative Location-based Advertising (LBS) systems using smartphones that preserve the privacy of mobile users. In this paper, we present a prototype implementation of such systems by developing a distributed privacy-preserving system, which has parts executing on smartphones as a mobile app, as well as a web-based application hosted on the cloud. The mobile app leverages Google Maps libraries to enhance the user experience in using the app. Mobile users can use the app to commute to their daily destinations while viewing relevant ads such as job openings in their neighborhood, discounts on favorite meals, etc. We developed a client-server privacy architecture that anonymizes the mobile user trajectories using a bounded perturbation strategy. A multi-modal sensing approach is proposed for modeling the context switching of the developed LBS system, which we represent as a Finite State Machine (FSM) model. The multi-modal sensing approach can reduce the power consumed by mobile devices by automatically detecting sensing mode changes to avoid unnecessary sensing. The developed LBS system is organized into two parts: the business side and the user side. First, the business side allows business owners to create new ads by providing the ad details, Geo-location, photos, and any other instructions. Second, the user side allows mobile users to navigate through the map to see ads while walking, driving, bicycling, or quietly sitting in their offices. Experimental results are presented to demonstrate the scalability and performance of the mobile side. Our experimental evaluation demonstrates that the mobile app incurs low processing overhead and consequently has a small energy footprint.