We report a 64-years old man with B-cell CLL infected by SARS-CoV-2 during his hospitalization for a spondylodiscitis. Because of his health conditions the duration of the antiviral therapy was restricted to one week where we observed a transient disappearance of CD19+/CD5+ B-lymphocytes in peripheral blood.

Two-dimensional (2D) materials have exhibited exceptional properties which meet the demands of future applications. These materials appeared after discovery of graphene in 2004 offered such device grade characteristics at nanoscale which did not appear on bulk scale. The research turned to search alternate 2D materials when drawbacks of graphene became surfaced. Despite significant successes and unprecedented efforts which consequent upon several beyond-graphene 2D materials, the complete potentials of such materials are still unexplored which may restrict their usage in devices. This work was carried out with motivation to investigate the thermal stability of several 2D-mono-layered materials including graphene, Borophene, Aluminene, Germanene, BN, SiC and MoS2 based on classical Molecular Dynamics Simulations. Prior to the implementation of the conditions for thermal calculations, the structures were optimized using Geometry-Optimization method. It appeared that all the structural parameters which includes lattice-constant, bond-length and dihedral angles were precisely determined. On the contrary, it was found that several materials beyond graphene can resist up-to certain temperature ranges, depicting the material dependent thermal stability. The radial distribution function (RDF) was calculated which pointed towards thermal broadening, bond breakage and bond formation for the slabs. The RDF-peaks were found to characterize the probability of finding any particle in the nearest neighbors which extend the phenomenon of thermal stability. Thermal stability was compared by plotting the temperature and energy curves from which, the phase transition temperature and heat capacity was determined for the slabs including graphene as benchmark. The phase transition temperatures are found as 4510 K, 2273 K, 933 K, 1670 K, 3246 K, 4050 K, and 1460 K for graphene, Borophene, Aluminene, Germanene, BN, SiC and MoS2 respectively. Besides the analysis of temperature-energy variations, the thermal broadening is also determined and discussed to examine the thermal-stability for usage of the materials in high temperature applications.

Generation time determines the pace of key demographic and evolutionary processes. Quantified as the weighted mean age at reproduction, it can be studied as a trait that varies within and among populations and may evolve in response to ecological conditions. We combined quantitative genetic analyses with age- and density-dependent models to study generation time variation in a bird metapopulation. Generation time was heritable, and males had longer generation times compared with females. Individuals with longer generation times had a higher lifetime reproductive success but not a higher expected population growth rate. Density regulation acted on recruit production, suggesting that longer generation times should be favored when populations are closer to carrying capacity. Furthermore, generation times were shorter when populations were growing, and longer when populations were closer to equilibrium or declining. These results support classic theory predicting that density regulation is an important driver of the pace of life-history strategies.

Background: Diagnostic tests for allergy rely on detecting allergen-specific IgE. Component-resolved diagnostics incorporate multiple defined allergen components to improve the quality of diagnosis and patient care. Objective: To develop a new approach for determining sensitization to specific allergen components that utilizes fluorescent protein tetramers for direct staining of IgE on blood basophils by flow cytometry. Methods: Recombinant forms of Lol_p_1 and Lol_p_5 proteins from ryegrass pollen (RGP) and Api_m_1 from honeybee venom (BV) were produced, biotinylated and tetramerized with streptavidin-fluorophore conjugates. Blood samples from 50 RGP-allergic, 41 BV-allergic and 26 controls were incubated with fluorescent protein tetramers for flow cytometric evaluation of basophil allergen binding and activation. Results: Allergen tetramers bound to and activated basophils from relevant allergic patients but not controls. Direct fluorescence staining of Api_m_1 and Lol_p_1 tetramers had greater positive predictive values than basophil activation for BV and RGP allergy, respectively, as defined with receiver operator characteristics (ROC) curves. Staining intensities of allergen tetramers correlated with allergen-specific IgE levels in serum. Inclusion of multiple allergens coupled with distinct fluorochromes in a single tube assay enabled rapid detection of sensitization to both Lol_p_1 and Lol_p_5 in RGP-allergic patients and discriminated between controls, BV-allergic and RGP-allergic patients. Conclusion: Our novel flow cytometric assay, termed CytoBas, enables rapid and reliable detection of clinically relevant allergic sensitization. The intensity of fluorescent allergen tetramer staining of basophils has a high positive predictive value for disease and the assay can be multiplexed for a component-resolved and differential diagnostic test for allergy.

Background Specific IgE against a peanut 2S albumin (Ara h2 or 6) is the best predictor of clinically relevant peanut sensitization. However, sIgE levels of peanut allergic and those of peanut sensitized but tolerant patients partly overlap, highlighting the need for improved diagnostics to prevent incorrect diagnosis and consequently unnecessary food restrictions. Thus, we sought to explore differences in V(D)J gene transcripts coding for peanut 2S albumin-specific monoclonal antibodies (mAbs) from allergic and sensitized but tolerant donors Methods 2S albumin-binding B-cells were single-cell sorted from peripheral blood of peanut allergic (n=6) and tolerant (n=6) donors sensitized to Ara h2 and/or 6 (≥ 0.1 kU/l) and non-atopic controls (n=5). Corresponding heavy and light chain gene transcripts were heterologously expressed as mAbs and tested for specificity to native Ara h2 and 6. HCDR3 sequence motifs were identified by Levenshtein distances and hierarchically clustering. Results The frequency of 2S albumin-binding B-cells was increased in allergic (median: 0.01%) compared to tolerant (median: 0.006%) and non-atopic donors (median: 0.0015%, p=0.008). The majority of mAbs (74%, 29/39) bound specifically to Ara h2 and/or 6. Non-specific mAbs (9/10) were mainly derived from non-atopic controls. In allergic donors, 89% of heavy chain gene transcripts consisted of VH3-family genes, compared with only 54% in sensitized but tolerant and 63% of non-atopic donors. Additionally, certain HCDR3 sequence motifs were associated with allergy or tolerance upon hierarchical clustering of their Levenshtein distances. Conclusions HCDR3 sequence motifs associated with allergy or tolerance may support correct diagnosis of patients with suspected peanut allergy.

Objective: The main objective of this prospective and observational study is to investigate the effect of preoperative hospitalization period on early postoperative cognitive dysfunction (POCD) development in patients undergoing total hip replacement surgery under regional anesthesia. Materials and Methods: Between November 2013 to September 2014, 64 patients were enrolled the study. Test scores were obtained on the initial admission day (MMT1), 24 hours prior to surgery (MMT2) and 24 hours after the surgery (MMT3). Patients were divided into two groups according to MMT scores as “no cognitive dysfunction” (Group 1) and “cognitive dysfunction” (Group 2). Differences between groups were evaluated statistically. Statistical significance level was set as p<0.05 in a 95% confidential interval. Results: POCD incidence rate was calculated as 43.8% in all patients. Preoperative hospitalization duration was significantly higher in patients with POCD when compared to patients without POCD (p<0,001). The factors which affect POCD development were found to be advanced age (p<0,001), high ASA scores (p=0,004), presence of comorbid disease (p=0,025), duration of operation (p=0,018) and decreased postoperative hematocrit levels (p=0,014). Conclusion: In this study, we observed patients with early POCD had a relatively longer pre-operative hospitalization period when compared to patients without POCD. We consider that the prolonged preoperative hospitalization periods may contribute to increased POCD incidence rates in patients with risk factors.

Necrotizing sialometaplasia is a salivary gland disease which is clinically as well as histologically quite confusing with a malignant squamous cell carcinoma. Presenting here a case of a male with Necrotizing sialometaplasia who was anxious because of cancerphobia as he was a smoker.

Here we describe a 13- year old patient with the presentation of fever and abdominal pain. He had a history of 2 years headache and seizure. In MRI, a primary cerebral hydatid cyst was evident. The diagnosis of hydatid cyst should beconsidered in children with mentioned characters in endemic regions.

By doping two potassium atoms among three C20F20 cages, peanut-shaped single molecular solvated dielectron (C20F20)3&K2 was theoretically presented. The triplet structures with two excess electrons individually inside left and middle cages (isomers I or II) are thermodynamically more stable than both open-shell (OS) and close-shell (CS) singlet ones with lone pair of excess electrons inside middle cage. Applying an oriented external electric field (OEEF) of -20 × 10-4 au (-0.1018 V/Å) or a larger one can result in both left-to-right transfers of the two excess electrons, and then releasing the OEEF can form new kind of inter-cage electron-transfer isomers (III or IV). Each triplet I ~ IV with three redox sits may be new members of mixed-valent compounds, namely, Robin-Day Class II. For electrified I of (C20F20)3&K2 , the following spin states are ground state: 1) triplet state in field ranges of -120 × 10-4 < Fx < -30 × 10-4 au and 30 × 10-4 < F-4 < 111 × 10-4 au; 2) CS singlet state in range of Fx ≥ 111 × 10-4 and ≤ -120 × 10-4 au; 3) OS singlet state in ranges of -30 × 10-4 ≤ Fx ≤ -5 × 10-4 au and 5 × 10-4 ≤ Fx ≤ 30 × 10-4 au.

Elevation is involved in determining plant diversity in montane ecosystems. This study examined whether the species distribution of plants in the Yatsugatake Mountains, central Japan, substantiated hypotheses associated with an elevational diversity gradient. Species richness of trees, shrubs, herbs, ferns, and bryophytes was investigated in study plots established at 200-m elevational intervals from 1800 to 2800 m. The changes in plant diversity (alpha and beta diversities, plant functional types, and elevational ranges) with elevation were analyzed in relation to climatic factors and elevational diversity gradient hypotheses, that is, mass effect, mid-domain effect, and Rapoport’s elevational rule. A comparison of alpha and beta diversities revealed that different plant groups respond variably to elevation; the alpha diversity of trees and ferns decreased, that of herbs increased, whereas the alpha diversity of shrubs and bryophytes showed a U-shaped relationship and a hump-shaped pattern. The beta diversity of shrubs, herbs, and bryophytes increased above the subalpine–alpine transition ecotone. In accordance with these changes, the dominance of evergreen shrubs and graminoids increased above this ecotone, whereas that of evergreen trees and liverworts decreased. None of the plant groups showed a wide elevational range at higher elevations. These elevational patterns of plant groups were explained by climatic factors, and not by elevational diversity gradient hypotheses. These patterns were further influenced by plant–plant interactions via competition for light availability and physical habitat alternation.

Careful physical examination of the site of procedure before the caudal pain procedure should be performed because it could show the patient's abnormal anatomical conditions. An abdominal binder could be used effectively in a patient showing CSF leakage in the coccygeal area, which is not controlled by conventional compressive dressing.

Avian influenza (AI) is a contagious disease of birds with zoonotic potential. AI virus (AIV) can infect most bird species, but clinical signs and mortality vary. Assessing the distribution and factors affecting AI incidence can direct targeted surveillance to areas at risk of disease outbreaks, or help identify disease hotspots or areas with inadequate surveillance. Using virus surveillance data from passive and active AIV wild bird surveillance, 20062020, we investigated the association between a range of landscape factors and game bird release and the presence of AIV. Furthermore, we assessed potential bias in the passive AIV surveillance data submitted by the public, via factors related to public accessibility. Lastly, we tested the AIV data for possible hot and cold spots within Denmark. The passive surveillance data was biased regarding accessibility to areas (distance to roads, cities and coast) compared to random locations within Denmark. We found significant effects of variables related to coast, wetlands and cities for the passive and active AIV surveillance data (P< 0.01), but found no significant effect of game bird release. We used these variables to predict the risk of AIV presence throughout Denmark, and found high-risk areas concentrated along the coast and fjords. For both passive and active surveillance data, low-risk clusters were mainly seen in Jutland and northern Zealand, whereas high-risk clusters were found in Jutland, Zealand, Funen and the southern Isles such as Lolland and Falster. Our results suggest that landscape affects AIV presence, as coastal areas and wetlands attract waterfowl and migrating birds and therefore might increase the potential for AIV transmission. These findings have enabled us to create risk maps of AIV incidence in wild birds and pinpoint high-risk clusters within Denmark. This will aid targeted surveillance efforts within Denmark and potentially aid in planning the location of future poultry farms.

Background: There is controversy whether taking β-blockers or ACE inhibitors (ACEI) is a risk factor for more severe systemic insect sting reactions (SSR) and whether it increases the number or severity of adverse events (AE) during venom immunotherapy (VIT). Methods: In this open, prospective, observational, multicenter trial, we recruited patients with a history of a SSR and indication for VIT. The primary objective of this study was to evaluate whether patients taking β-blockers or ACEI show more systemic AE during VIT compared to patients without such treatment. Results: In total, 1,425 patients were enrolled and VIT was performed in 1,342 patients. Of all patients included, 388 (27.2%) took antihypertensive (AHT) drugs (10.4% took β-blockers, 11.9% ACEI, 5.0% β-blockers and ACEI). Only 5.6% of patients under AHT treatment experienced systemic AE during VIT as compared with 7.4% of patients without these drugs (OR: 0.74, 95% CI: 0.43–1.22, p=0.25). The severity of the initial sting reaction was not affected by the intake of β-blockers or ACEI (OR: 1.14, 95% CI: 0.89–1.46, p=0.29). In total, 210 (17.7%) patients were re-stung during VIT and 191 (91.0%) tolerated the sting without systemic symptoms. Of the 19 patients with VIT treatment failure, 4 took β-blockers, none an ACEI. Conclusions: This trial provides robust evidence that taking β-blockers or ACEI does neither increase the frequency of systemic AE during VIT nor aggravate SSR. Moreover, results suggest that these drugs do not impair effectiveness of VIT. (Funded by Medical University of Graz, Austria; Clinicaltrials.gov number, NCT04269629)

Objectives We aimed to summarize the clinical presentations, therapeutic approaches, and outcomes of type B intramural hematoma (IMHB) patients with and without type 2 diabetes mellitus (DM). Methods Patients with uncomplicated IMHBs were included between January 2016 and January 2018 and divided into two groups according to whether or not they had DM. Cox proportional hazard analysis was utilized to investigate the risk factors for aortic-related mortality. Kaplan-Meier survival analysis was used to estimate cumulative mortality and aortic-related mortality. Results A total of 149 patients were included and were divided into the two groups (DM group [n=60] and non-DM group [n=89]). Patients in the non-DM group underwent thoracic endovascular aortic repair treatment more frequently (12% vs 2%, P=0.028) and had a higher reintervention rate during the follow-up (9 in 81 patients, 11% vs 2%, P=0.043). There were significant differences between the two groups regarding the aorta-related mortality rate during the acute phase (9% vs 0%, P=0.042) and the all-cause mortality rate (22% vs 7%, P=0.011). Ulcer-like projection (ULP) development (during the acute phase) (hazard ratio [HR], 1.07; 95% confidence interval [CI], 1.01-1.31, P=0.008), C-reactive protein (CRP) levels (HR, 1.92; 95% CI, 1.51-2.49, P<0.001) and MMP-9 levels (HR, 16.82; 95% CI, 7.52-28.71, P<0.001) were associated with an elevated risk for aorta-related mortality. Conclusions IMHBs without DM are not benign and have a considerably high aortic-related mortality rate. ULP development (during the acute phase), CRP levels and maximum MMP-9 levels are associated with an elevated risk for aorta-related mortality.

Pollinator foraging behavior determines floral visitation rates, an important proxy to the strength of mutual- istic interactions. Although there is evidence that pollinators modify their behavior in the presence of other foragers, there are equivocal findings regarding whether or not pollinators interfere with one another. We employ a functional-response framework to analyse experimental data of times between floral visits made by a focal pollinator and to estimate pollinator interference by conspecifics and three other species. Additionally we develop and compare models that allow different levels of resource availability and the sub-lethal exposure to a neonicotinoid pesticide to modify how pollinators forage alone and with co-foragers. We found that all co-foragers interfere with a focal pollinator under at least one set of abiotic conditions; for most species, interference was strongest at higher levels of resource availability and with pesticide exposure. Overall our results highlight that density-dependent responses are often context dependent themselves.

A unified mathematical model of three-phase-lag in a compressed rotating isotropic homogeneous micropolar thermo-viscoelastic medium based on a ramp type thermal shock is developed. An application of this model is carried out to resolve the problem of a perfectly conducting half-space subjected to certain boundary conditions in the presence of an electromagnetic field. Lame's potentials and normal mode analysis techniques are employed to get the general analytical solutions. Specific attention is paid to explore the impact of the rotation, magnetic field, ramp time, as well as initial stress on the distributions of temperature, displacement, stress, and induced electric and magnetic distribution. The findings show that the impact of the rotation, magnetic field, viscous, ramp parameter, initial stress, and phase-lag on the micropolar thermo-viscoelastic medium is noticeable.

Background: Patient safety represents a global issue which leads to potentially avoidable morbidity and mortality. This study aimed to determine the inter-professional differences in patient safety culture in a tertiary university hospital. Method: A cross-sectional study using the Safety Attitude Questionnaire (SAQ) self-administered electronically in the English and Malay languages to evaluate safety culture domains. A positive percentage agreement score of 60% was considered satisfactory. Comparisons were made between clinicians, nurses, allied health professionals, ward attendants and support staff. Results: Of 6562 potential respondents, 5724 (80.4%) completed the questionnaire; 3930 (74.5%) women, 2263 (42.9%) nurses, and 1812 (34.2%) had 6-10 years of working experience. The mean overall positive percentage agreement scores were 66.2 (range=31.1 to 84.7%), with job satisfaction (72.3±21.9%) and stress recognition (58.3±25.6%) representing the highest and lowest mean domain scores respectively. Discussion: Differences were observed between all five job categories. Linear regression analyses revealed that the other four job categories scored lower in teamwork, safety culture, job satisfaction, and working conditions compared to nurses. Conclusions: The overall mean SAQ score was above the satisfactory level, with unsatisfactory percentage agreement scores in the stress recognition domain. Interventions to improve patient safety culture should be developed, focusing on stress management.

Planting trees is one of the most effective activities in recovering soil organic carbon (SOC) stocks of degraded areas, but we still lack information on how different tree species can influence soil respiration, one of the main sources of dioxide carbon (CO2) to the atmosphere. This study aimed to explore the influence of different forest species on the autotrophic and heterotrophic components of the total soil respiration in a bauxite mining area under reclamation. We analysed the soil CO2 efflux under five treatments: i) monoculture of clonal Eucalyptus; ii) monoculture of Anadenanthera peregrina (L.); iii) a mixed plantation of 16 native forest species (Nat); iv) a mined area without vegetation cover; and v) a natural forest cover. This design allowed exploring the soil CO2 dynamics in a gradient of recovery, from a degraded area to natural vegetation. Additionally, we measured soil temperature, moisture and soil characteristics. Soil CO2 efflux increased with increasing forest species cover in the rainy months. There was no significant change in CO2 efflux among the tree species. Heterotrophic soil respiration contributed to 64% of total soil CO2 efflux and was associated with litter decomposition. Amongst the abiotic variables, increases in soil moisture had the most influence on CO2 efflux. Therefore, these results help to understand the factors that underpin the loss of SOC and can orient management practices to improve soil organic matter and restore soil quality in degraded areas.