Introduction Ventricular arrhythmias (VAs) are a major cause of morbidity and mortality in patients with heart disease. Recent studies evaluated the effect of renal denervation (RDN) on the occurrence of VAs. We conducted a systematic review and meta-analysis to determine the efficacy and safety of this procedure. Methods and results A systematic search of the literature was performed to identify studies that evaluated the use of RDN for the management of VAs. Primary outcomes were reduction in the number of VAs and implantable cardioverter-defibrillator (ICD) therapies. Secondary outcomes were changes in blood pressure and renal function. Ten studies (152 patients) were included in the meta-analysis. RDN was associated with a reduction in the number of VAs, ATP (antitachycardia pacing), ICD shocks and overall ICD therapies of 3.53events/patient/month (95%CI=-5.48 to -1.57), 2.86events/patient/month (95%CI=-4.09 to -1.63), 2.04events/patient/month (95%CI=-2.12 to -1.97), and 2.68events/patient/month (95%CI=-3.58 to -1.78), respectively. Periprocedural adverse events occurred in 1.23% of patients and no significant changes were seen in blood pressure or renal function. Conclusions In patients with refractory VAs, RDN was associated with a reduction in the number of VAs and ICD therapies, and was shown to be a safe procedure. KEYWORDS: Renal denervation, ventricular arrhythmias, implantable cardioverter-defibrillator, antitachycardia pacing, ICD shocks.

We present three cases of impetigo and one case of bullous pemphigoid neonatorum that benefited from the homeopathic remedy Antimonium crudum, which has a wide spectrum of dermatological applications when prescribed according to symptom similarity. Further larger clinical studies are necessary to establish its role in pediatric dermatology.

The study proposed an isotopes-tagging method for investigation of reactions under the atmosphere of product gas. To illustrate this method, the calcination kinetics of calcium carbonate Ca13CO3 in CO2 atmospheres were investigated by monitoring 13CO2 produced using a micro fluidized bed reaction analyzer (MFBRA). The results demonstrated that the presence of CO2 in the reaction atmosphere increases the apparent activation energy. The increase in the apparent activation energy is, however, significantly overestimated by the TGA because of the excessive suppression by stagnated product gas inside the sample crucible. Comparatively, the results from the MFBRA are due primarily to the thermal equilibrium limitation, because the gas diffusion in the MFBRA is essentially eliminated. It is thus concluded that the MFBRA is quite capable of acquiring the real kinetics of reactions in such inhibitory atmospheres. atmosphere.

Incidentally diagnosed, asymptomatic, paranasal fungus ball might occasionally undergo spontaneous healing. Accurate preoperative workup may avoid unnecessary surgical or anesthesiological procedures.

Background: There is insufficient evidence regarding the comparison of Rapid Deployment aortic valve replacement(RDAVR) to TAVR in intermediate-risk patients with severe symptomatic aortic stenosis(AS) Aims: We compare the 2-years outcomes between RDAVR with INTUITY and TAVR with SAPIEN 3 in intermediate-risk patients with AS. Methods: Inclusion criteria: severe AS implanted with RDAVR or TAVR; EUROSCORE II ≥ 4% and clinical evaluation by Heart Team. Regression adjustment for the propensity score was used to compare RDAVR with TAVR(1:1). Primary endpoint: composite criterion of death, disabling stroke or rehospitalization. Secondary endpoints: occurrence of major bleeding post-operative complications, paravalvular regurgitation (PVR)≥2 and patient-prosthesis mismatch(PPM) at 1 month and pacemaker implantation at 2 years. Results: A total of 152 patients were included from 2012 to 2018: 48 in the RDAVR group and 104 in the TAVR group. Mean age was 82.7±6, 51.3% were female, mean Euroscore II was 6.03±1.6% and mean baseline LVEF was 56±13%,mean indexed iEOA was 0.41±0.1cm/m2, mean gradient was 51.7±14.7mmHg. Patients with RDAVR were younger(79.5±6vs82.6±6,p=0.01), at higher risk (EUROSCORE2 6,61±1,8%vs5,63±1,5%, p=0.005), combined surgery was performed in 28 patients(58.3%). Twenty-two patients(45.99%) met the primary outcome in the RDAVR group and 32 patients(66.67%) in the TAVR group. By 1:1propensity score matching analysis, there was a significant difference between both groups in favor of RDAVR(HR=0.58[95%CI:0.34;1.00],p=0.04). No difference were observed in PPM occurrence(0.83;[0.35-1.94];p=0.67),major bleeding events(1.33;[0.47-3.93];p=0.59),PVR≥2(0.33[0-6.28],p=0.46), and pacemaker implantation (0.84[0.25-2.84],p=0.77).Conclusion: RDAVR is associated with better 2-years outcomes than TAVR in intermediate-risk patients with severe symptomatic AS.

In this work, a 0.9-2.4 GHz, 25 Watt output power, radio frequency (RF) power amplifier based on Class-E switchmode topology has been analyzed. A load-pull simulations method is used to optimize the power performance in the operating band. To design input and output matching networks an optimized low pass filter network was used. Simulated results of the power amplifier (PA) demonstrate wideband behavior which covers a 0.9 GHz to 2.4 GHz band with an efficiency of 32-78%, and an output power of 25 W (44 dBm), and an average gain of 20 dB. The designed PA provides attractive features associated with a wider band, high gain, and efficiency, which makes it a proper candidate for the mobile transmitter and cellular infrastructure applications.

In the present study, the highly pathogenic bovine Deltapapillomavirus (δPV) was investigated by liquid biopsy in blood samples of 168 clinically normal goats using both droplet digital PCR (ddPCR) and quantitative real time PCR (qPCR). Overall, ddPCR detected BPV E5 DNA in ~61.3% of the blood samples examined, while real time qPCR revealed the virus in ~10.7% of the same samples. Moreover, ddPCR showed BPV E5 DNA in ~78.8% of blood samples from goats that were in close contact with cattle and in 20% of blood samples from goats living in closed pens without any contact with cattle. In addition, ddPCR revealed a single BPV genotype in ~59.2% and multiple genotypes in ~40.8% of goats harboring BPV DNA, while real time qPCR detected single genotypes in ~17% and multiple genotypes in ~1%. Of the BPV co-infections detected by ddPCR, 28 (~67%) involved two genotypes, eight (~19%) three genotypes, and six (~14%) four genotypes. In contrast, real time qPCR revealed BPV co-infection by two genotypes in only one sample and failed to detect co-infection by three or four genotypes. BPV2 and BPV13 were the most prevalent viruses responsible for single and multiple co-infections, respectively. The present study showed that the ddPCR technique has much higher sensitivity and specificity in the detection of these viruses, and suggested that animal husbandry practices contribute to cross-species transmission of BPVs.

In this paper, we present the design and implementation of a smart irrigation system using Internet of Things (IoT) technology, which can be used for automating the irrigation process in agricultural fields. It is expected that this system would create a better opportunity for farmers to irrigate their fields efficiently, as well as eliminating the field’s under-watering, which could stress the plants. The developed system is organized into three parts: sensing side, cloud side, and user side. We used Microsoft Azure IoT Hub as an underlying infrastructure to coordinate the interaction between the three sides. The sensing side uses a Raspberry Pi 3 device, which is a low cost, credit-card sized computer device that is used to monitor in near real-time soil moisture, air temperature and relative humidity, and other weather parameters of the field of interest. Sensors readings are logged and transmitted to the cloud side. At the cloud side, the received sensing data is used by the irrigation scheduling model to determine when and for how long the water pump should be turned on based on a user-predefined threshold. The user side is developed as an Android mobile app, which is used to control the operations of the water pump with voice recognition capabilities. Finally, this system was evaluated using various performance metrics, such as latency and scalability.

Boreal forests soils are important global carbon sinks, with significant storage in the organic topsoil. Decomposition of these stocks requires oxidative enzymes, uniquely produced by fungi, of which many live in ectomycorrhizal symbiosis with the trees. Here we show that presence of a group of closely related species of ectomycorrhizal fungi – Cortinarius acutus s.l. – decreased local carbon storage in the organic topsoil by 33% across Swedish forests. Our findings challenge the prevailing view that ectomycorrhizal fungi generally act to increase carbon storage in soils and show that certain ectomycorrhizal fungi can complement free-living decomposers, maintaining nutrient cycling and tree productivity under nutrient poor conditions. The finding that a narrow group of fungi exerts a major influence on carbon cycling refutes the prevailing dogma of functional redundancy among microbial decomposers. Cortinarius acutus s.l. responds negatively to forestry, and population declines are likely to increase soil carbon sequestration while impeding nutrient cycling.

While there is a very large focus on the abnormalities of parenchymal lung development and extensive efforts to minimize alveolar damage with “gentle ventilation” and non-invasive respiratory support for neonates with bronchopulmonary dysplasia (BPD), there is relatively little consideration for the implications of central airway disease in this patient population. There are significant changes in the structure and conformation of the central airway during the last half of gestation, and premature birth disrupts this natural developmental process. Arrest of maturation results in a smaller airway that is more compliant, easier to deform, and more susceptible to damage. Consequently, neonates with BPD are prone to developing central airway pathology, particularly for patient that require intubation and positive pressure ventilation. Central airway disease can be divided in dynamic and fixed airway obstruction and results in increased respiratory morbidity in neonates with chronic lung disease of prematurity.

Purpose:In the present study, the impact of penile nerve block(PNB) on postoperative pain and CRBD in transurethral resection of prostate(TURP) patients were evaluated. Methods:Participants of the present study were selected from patients who performed TURP under spinal anesthesia for benign prostatic hyperplasia(BPH) between January 2018-July 2020. This study was planned as a single center, randomized-controlled prospective study. The patients were divided into two groups; Group 1 was administered Control(n:40), and Group 2 ultrasonography(USG) guided PNB(n:40). The patients were included in the Groups respectively. Visual analogue scale(VAS) scores were questioned and recorded in order to evaluate the postoperative pain complaints of the patients after the operation. In addition, in order to evaluate the CRBD, VAS scores were questioned and recorded as 0-1th hour, 1st-2nd hours, 2nd – 4th hours, 4th-8th hours, 8th-12th hours, and 12th-24th hours. In addition, postoperative pain and analgesic need were recorded. Tramodol was given to patients with moderate to severe CRBD. The findings was compared between to the Groups. Results:There was no statistical difference between Group 1 and Group 2 between demographic and per-operative data. The CRBD and pain-related VAS scores was significantly higher in Group 1 between the 0-8th hours. There was no difference between VAS scores in the postoperative 8-24th hours. In total 24 hours, Group 2’s need for tramodol for CRBD and pain was significantly less than Group 1. On examining the factors affecting CRBD in the multivariate analysis, age, body mass index(BMI), prostate volume, operation time do not affect CRBD statistically, only PNB reduces CRBD (p: 0.029). While less drug-related complications were observed in Group 2, no serious complications related to PNB were observed. Conclusion:PNB is the effective method for the decrease pain and CRBD after urological surgery.It will also reduce the need for analgesics, and provide the painless patients in postoperative period.

Background: Following the remarkable spread of coronavirus disease 2019 (COVID-19), worldwide, it quickly became apparent that many public health systems worldwide were not prepared to manage such a pandemic. We aimed to assess the perceptions of primary care physicians (PCPs) in Jordan toward their role during COVID-19. Methods: A cross-sectional study using a self-administered questionnaire was performed. The study participants included PCPs from the Ministry of Health, academic institutions, and the private sector in Jordan. Results: A total of 221 PCPs participated in the study. Most participants reported not having received any training on infection control (59.7%) or COVID-19 (81%). More than half PCPs (53.4%) felt positive about the way patients received and/or complied with their instructions. More than half PCPs (55.7%) educated their patients on protective measures against COVID-19 infection and considered this as part of their role and responsibility. Over 80% of the participants would apply social distancing, hand sanitation, facial masks, and patient education, but only half (51.1%) reported planning to order COVID-19 test kits. Conclusions: PCPs had a positive attitude toward controlling COVID-19 infection and showed a willingness to educate patients on how to protect themselves. However, PCPs should be provided special training on COVID-19.

SARS-CoV-2 is neutralized by proteins that block receptor-binding sites on spikes that project from the viral envelope. In particular, substantial research investment has advanced monoclonal antibody therapies to the clinic where there are signs of partial efficacy in reducing viral burden and hospitalization. An alternative is to use the host entry receptor, ACE2, as a soluble decoy that broadly blocks SARS-associated coronaviruses with limited potential for viral escape. Here, we summarize efforts to engineer higher affinity variants of soluble ACE2 that rival the potency of affinity-matured antibodies. Strategies have also been used to increase the valency of ACE2 decoys for avid spike interactions and to improve pharmacokinetics via IgG fusions. Finally, the intrinsic catalytic activity of ACE2 for the turnover of the vasoconstrictor angiotensin II may directly address COVID-19 symptoms and protect against lung and cardiovascular injury, conferring dual mechanisms of action unachievable by monoclonal antibodies. Soluble ACE2 derivatives therefore have the potential to be next generation therapeutics for addressing the immediate needs of the current pandemic and possible future outbreaks.

ABSTRACT Aims of Study: To compare dynamic thiol/disulfide homeostasis between patients with with lung tuberculosis and healthy controls. Methods: Our study included 50 patients with active lung tuberculosis and 50 healthy controls. Serum thiol/disulfide was measured with a new automated spectrometric method developed by Erel and Neselioglu, and results were compared statistically. Results: We found that native and total thiol levels were significantly decreased in patients with lung tuberculosis, disulfide/native thiol and disulfide/total thiol levels were found to be higher in lung tuberculosis patients when compared with the control group. However, disulfide levels were higher in the control group than in the patient group. Conclusions: Based on the results of this study, it can be said that oxidative stress is closely associated with lung tuberculosis pathogenesis. There is a need for new studies that will show the possible effects of oxidative stress on lung tuberculosis pathogenesis.

This study proposes a multiperiod mixed integer linear programming model for the management of a single municipal solid waste (MSW) treatment plant with sustainability as the objective. Discrete and continuous variables define the capacity selections for diverse MSW technologies, and the operation of the MSW network, respectively. The economic target is considered to maximize the net present value. The environmental impact is the minimization of a normalized environmental objective function (NEOF). The social target is the maximization of jobs. An interesting feature about the research work is the requirement of biodrying technologies for MSW moisture content control. Due to the conflicted nature among the sustainability components, a multi-objective optimization (MO) is carried out to find the Pareto optimal solutions. The MO results show that the Pareto optimal solutions vary around profit range of US$ 4.9-8.5 billion, NEOF impact range of 3.2-3.6 units, and social benefit range of 2700-4828 jobs.

Nivolumab is used for patients with recurrent/metastatic head and neck cancer resistant to platinum. We report a 76-year-old man with squamous cell carcinoma of the tongue, who developed toxic epidermal necrolysis (TEN) after nivolumab treatment. TEN is a fatal disease, and early treatment of the adverse events are important.

Wildlife species are challenged and threatened by various infectious diseases that act as important selective forces and demographic drivers of populations. Yet, studies about host genetic factors and disease susceptibility are very limited. Cetacean morbillivirus (CeMV) has emerged as a major viral threat to cetacean populations worldwide, contributing to the death of tens of thousands of individuals of multiple dolphin and whale species. To understand the genomic basis of immune responses to CeMV, we generated and analysed whole genomes of 53 Indo-Pacific bottlenose dolphins (Tursiops aduncus) exposed to Australia’s largest CeMV-related mortality event known to date. The genomic dataset consisted of 7,720,686 SNPs anchored onto 23 chromosome-length scaffolds and 77 short scaffolds. Allele frequency estimates between survivors and non-survivors of the outbreak revealed 11,009 candidate SNPs, of which 498 were annotated to 220 protein coding genes. These included 36 genes with functions related to innate and adaptive immune responses, and cytokine signalling pathways. The list also included genes known to be involved in immune responses to other morbilliviruses, such as measles in humans and the phocine distemper virus in pinnipeds. Our study characterised genomic regions and pathways that likely contribute to CeMV susceptibility and resistance in dolphins, representing a stride towards clarifying the complex interactions of the cetacean immune system. It also emphasises the relevance of whole genome datasets to study the genetics of wildlife diseases.

Background: There is growing interest in physical medicine treatment options for renal colic. In this study, we aimed to determine whether or not heat-patch treatment with no drug was effective in relieving renal colic. Methods: For this purpose, patients who were diagnosed with renal colic in the emergency department were randomized to have either heat-patch or sham treatment. The Visual Analog Scale (VAS) scores of renal colic, body temperature (Btemp), and sub-patch skin temperature (Stemp) values were measured at 0,15,30,45, and 60 min. In addition, the salvage treatment needs of the groups were compared. Results: The average age of the study group was30.5 ± 8.3 years and that of the sham group was 31.0 ± 8.2 years (p = 0.75). According to the baseline VAS score of the patients, 15, 30, 45, and 60min VAS scores significantly decreased in the heat-patch group (p<0.001). The Btemp values did not differ significantly between the heat-patch and sham groups. In addition, no statistically significant difference was found between the two groups in terms of Stemp values at 0 and 15 min (p = 0.39and p = 0.10, respectively). However, there was a significant difference in the heat-patch group in terms of Stemp values at30, 45, and 60 min compared to the sham group (p<0.001). The salvage treatment rates for the heat-patch and sham groups were 11.5% and 31.4%, respectively (p = 0.01). Conclusion: As non-pharmaceutical treatment, the heat-patch has been shown to be a possible candidate for pain relief in patients with urolithiasis. Further research should concentrate on multicenter and large-scale randomized studies.