Cardiac arrythmia is a major complication of COVID-19. This occurs often in patients with severe COVID-19 with pre-existing cardiovascular diseases. We report an unusual case of paroxysmal atrial fibrillation in an adult male with low cardiovascular risk factor who presented with a moderate form of COVID-19.

We would like to report here on our clinical observations in 212 subjects, vaccinated in our Center since the start of the Coronavirus disease-2019 (COVID-19) pandemic, with the mumps-measles-rubeola (MMR) vaccine and of whom thirty-two have presented COVID-19, all with a remarkably mild course.In the light of the COVID-19 pandemic, observing the highly contagious and virulent nature of the virus, new to mankind and for which no actual treatment nor vaccination exists, we have been searching for methods to enhance innate immunity. Moreover, the pandemic started in our country just after a rise in measles cases had motivated the Ministry of Health to recommend measles re-vaccination. Aware of the existence of trained immunity we decided to apply this concept and from March 2020 onward recommend MMR vaccination, but with extra emphasis among family members of COVID-19 cases. In June 2020 the American Society for Microbiology (AMS) speculated in a press-release that “the MMR vaccine could serve as a preventive measure to dampen …. COVID-19 infection.”

More than 1.6 million Americans have at least moderate to severe tricuspid regurgitation, yet fewer than 8000 tricuspid valve operations are performed annually in the USA.The under-treatment for isolated tricuspid regurgitation might be related to the fact that in the past years no clear guidelines on how and when to treat tricuspid regurgitation were issued. Here, we discuss the meta-analysis by Sarris-Michopoulos et al, and we comment what is available in literature on diagnosis and decision making for tricuspid valve intervention.

Tracer-aided studies to understand source water partitioning in tropical ecosystems are limited. Here we report dry season source water partitioning in five unique ecosystems distributed across Costa Rica in altitudinal (<150-3,400 m asl) and latitudinal (Caribbean and Pacific slopes) gradients: evergreen and seasonal rainforests, cloud forest, Páramo, and dry forest. Soil and plant samples were collected during the dry season (2021). Plant and soil water extractions (triplicates) were conducted using controlled centrifugation. Stem water extraction efficiency and stem water content were calculated via gravimetric measurements. Water source contributions were estimated using a Bayesian mixing model. Isotope ratios in soil and stems exhibited a strong meteoric origin. Enrichment trends were detected mainly in stems and cactus samples within the dry forest ecosystem. Soil profiles revealed nearly uniform isotopic profiles; however, a depletion trend was observed in the Páramo ecosystem below 25 cm depth. More enriched compositions were reported in cactus samples for extracted water volumes above ~20% ( Adj. r2=0.34, p<0.01). The most prominent dry season water source in the evergreen rainforest (74.0%), seasonal rainforest (86.4%), and cloud forest (66.0%) corresponded with soil water. In the Páramo ecosystem, recent rainfall produced by trade wind incursions resulted in the most significant water source (61.9%), whereas in the dry forest, mean annual precipitation (38.6%) and baseflow (33.1%) were the dominant sources. The latter highlights the prevalence of distinct water uptake sources between recent cold front’s rainfall to more well-mixed soil moisture during the dry season.

As many as 6% of reported cinnamon poisonings cause significant clinical effects, however descriptions of pulmonary toxicity have not yet been reported. Here, we present a pediatric patient’s hospital course following powdered cinnamon aspiration. The early presentation with hypercapnia and lower airways obstructions evolved to hypoxemic respiratory failure and severe pediatric acute respiratory distress syndrome requiring a 7-day course of veno-venous extracorporeal membrane oxygenation, 16 ventilator-days, and 3 diagnostic and therapeutic bronchoscopies with 2 applications of surfactant therapy. The sum of these modalities contributed to this patient’s survival and subsequent return to respiratory baseline 6 months post-hospitalization.

Rationale The end of life (EOL) experience in the intensive care unit (ICU) can be psychologically distressing. The 3 Wishes Project (3WP) personalizes the EOL experience by carrying out wishes for dying patients and their families. While the 3WP has been integrated in academic, tertiary care ICUs, implementing this project in a community ICU has yet to be described. Objectives To examine facilitators of, and barriers to, implementing the 3WP in a community ICU from the clinician and key-stakeholder perspective. Methods This mixed-method study evaluated the implementation of the 3WP in a 20-bed community ICU in Southern Ontario, Canada. Patients were considered for the 3WP if they had a high likelihood of imminent death or planned withdrawal of life-sustaining therapy. Quantitative data include patient demographic data and wishes implemented. Following the qualitative descriptive approach, semi-structured interviews were conducted with purposively sampled clinicians and key-stakeholders. Data from transcribed interviews were analyzed in triplicate through qualitative content analysis. Results During the 10-month period, 66 of 67 wishes were completed, with a median of 4.5 wishes per patient-family dyad. Interviews with 12 participants indicated that the 3WP personalized and enriched the EOL experience for patients, families and clinicians. Interviewees indicated higher intensity education strategies were needed to enable spread as the project grew. Clinicians described many physical resources for the project but required more non-clinical project support for orientation, continuing education and data collection. Instead, these roles were completed by clinicians with saturated work capacity which may have inhibited the spread of the project. Conclusions In this community hospital, ICU clinicians and key stakeholders reported the 3WP improved EOL care for patients, families, and clinicians. Project implementation in a community ICU requires investigators take into account project characteristics and adapt the intervention to the community hospital context.

The analysis of tourist accommodation bookings provides valid information for the management of these establishments. The objective of this work is to analyze the performance of different Machine Learning techniques for the prediction of booking cancellations, as well as to analyze possible patterns in the study data. For this purpose, the following supervised learning methods are used: Multilayer Perceptron Neural Network, Radial Basis Function Neural Network, Decision Tree, Random Forest, AdaBoost and XgBoost, analyzing the performance of these techniques. The dataset used corresponds to the bookings of a resort hotel and a city hotel located in Portugal. As a result, the study compares the classification methods applied and identifies those with better performance, proving that Machine Learning techniques generate reliable forecasts for the management of the tourism industry.

Protein from camelina seed is a valuable co-product that can be derived from the meal remaining after oil extraction. The current study describes the types and physicochemical properties of the major proteins present in camelina meal. Seed coat mucilage, which interferes with protein extraction, was removed from whole seeds by digestion with Viscozyme® and lipids were removed with hexane to obtain demucilaged/defatted meal. Protein comprised 51.3% of meal dry matter and the eight essential amino acids comprised 40.8% of total amino acids. The meal polypeptide profile showed bands originating from cruciferin (~44.1 and 51.7 kDa), napin (~14 kDa) and oil body proteins (OBP; ~15-20 kDa) resembling that of other crucifers. Cruciferins (11 isoforms) were the predominant proteins, while vicilins (6 isoforms) also were identified among the proteins soluble at pH 8.5. Among the proteins soluble at pH 3, napins (5 isoforms) comprised the majority, though late embryogenesis abundant proteins also were found. Camelina cruciferin and napin were confirmed to possess predominantly β-sheet and α-helix secondary structures, respectively. Camelina cruciferin structure was highly sensitive to changes in medium pH and underwent acid-induced denaturation at pH 3, but exhibited high thermal stability (>80°C) at neutral and alkaline pHs. The structure of camelina napins was less sensitive to pH. The major proteins associated with oil bodies were oleosins (6 isoforms). Identification and characterization of the properties of camelina meal proteins will enable strategic paths for co-product valorization.

Advances in sequencing technologies and declining costs are increasing the accessibility of large-scale biodiversity genomic datasets. To maximise the impact of these data, a careful, considered approach to data management is essential. However, challenges associated with the management of such datasets remain, exacerbated by uncertainty among the research community as to what constitutes best practices. As an interdisciplinary team with diverse data management experience, we recognise the growing need for guidance on comprehensive data management practices that minimise the risks of data loss, maximise efficiency for stand-alone projects, enhance opportunities for data reuse, facilitate Indigenous data sovereignty and uphold the FAIR and CARE Guiding Principles. Here, we describe four fictional personas reflecting user experiences with data management to identify data management challenges across the biodiversity genomics research ecosystem. We then use these personas to demonstrate realistic considerations, compromises, and actions for biodiversity genomic data management. We also launch the Biodiversity Genomics Data Management Hub (https://genomicsaotearoa.github.io/data-management-resources/), containing tips, tricks and resources to support biodiversity genomics researchers, especially those new to data management, in their journey towards best practice. The Hub also provides an opportunity for those biodiversity researchers whose expertise lies beyond genomics and are keen to advance their data management journey. We aim to support the biodiversity genomics community in embedding data management throughout the research lifecycle to maximise research impact and outcomes.

In this paper, a novel beam steerable 2.4 GHz MIMO antenna array is proposed based on the Yagi-Uda principle. The antenna consists of two co-axially excited patch radiators with modified ground plane. A conducting strip with an integrated PIN diode is optimally placed between the patch radiators to act as a director or a reflector to steer the main beam by an angle of +/- 60◦. For all switching modes, the MIMO antenna demonstrates an average gain and efficiency of 5 dB and 92%, respectively, at the resonance frequency of 2.4 GHz. Reduced envelope correlation coefficient in one switching mode exhibited 17 dB improvement in mutual isolation. The simulated results agreed well with measured data. This simple, low-cost, efficient, and mutually isolated antenna array can be very useful in MIMO WLAN applications.

Bacteriophage is considered an alternative to antibiotics and environmentally friendly approach to tackle antimicrobial resistance (AMR) in aquaculture. Here, we reported isolation, morphology and genomic characterizations of a newly isolated lytic bacteriophage, designated pAh6.2TG. Host range and stability of pAh6.2TG in different environmental conditions, and protective efficacy against a pathogenic multidrug-resistant (MDR) Aeromonas hydrophila in Nile tilapia were subsequently evaluated. The results showed that pAh6.2TG is a member of the family Myoviridae which has genome size of 51,780 bp, encoding 65 putative open reading frames (ORFs), and is most closely related to Aeromonas phage PVN02 (99.33% nucleotide identity). The pAh6.2TG was highly specific to A. hydrophila and infected 83.3% tested strains of MDR A. hydrophila (10 out of 12) with relative stability at pH 7 ­ 9, temperature 0 ­ 40 °C and salinity 0 ­ 40 ppt. In experimental challenge, pAh6.2TG treatments significantly improved survivability of Nile tilapia exposed to a lethal dose of the pathogenic MDR A. hydrophila, with relative percent survival (RPS) of 73.3% and 50% for phage multiplicity of infection (MOI) 1.0 and 0.1, respectively. Significant reduction of bacterial counts in rearing water at 3 h (6.7 ± 0.5 to 18.1 ± 6.98 folds) and in fish liver at 48 h post-treatment (2.7 ± 0.24 to 34.08 ± 26.4 folds) was observed in phage treatment groups while opposite pattern for bacterial counts was observed in untreated control. Interestingly, the surviving fish provoked specific antibody (IgM) against the challenged A. hydrophila. These results might explain the higher survival in phage treatment groups. In summary, the findings suggested that the lytic bacteriophage pAh6.2TG is an effective alternative to antibiotics to control MDR A. hydrophila in tilapia and possibly other freshwater fish.

A new method for integrated ionic liquid (IL) and absorption process design is proposed where a rigorous rate-based process model is used to incorporate absorption thermodynamics and kinetics. Different types of models including group contribution models and thermodynamic models are employed to predict the process-relevant physical, kinetic, and thermodynamic (gas solubility) properties of ILs. Combining the property models with process models, the integrated IL and process design problem is formulated as an MINLP optimization problem. Unfortunately, due to the model complexity, the problem is prone to convergence failure. To lower the computational difficulty, tractable surrogate models are used to replace the complex thermodynamic models while maintaining the prediction accuracy. This provides an opportunity to find the global optimum for the integrated design problem. A pre-combustion carbon capture case study is provided to demonstrate the applicability of the method. The obtained global optimum saves 14.8% cost compared to the Selexol process.

Hydrophobic deep eutectic solvents (DESs) have emerged as excellent extractants. Their performance depends on the heterogeneous hydrogen bond environment formed by multiple hydrogen bond donors and acceptors. An understanding of this heterogeneous hydrogen bond environment can be used to develop principles for designing high-performance DESs for extraction and other separation applications. We investigate the structure and dynamics of hydrogen bonds in eight hydrophobic DESs formed by decanoic acid, menthol, thymol, and Lidocaine using molecular dynamics simulations. The results show the diversity of hydrogen bonds in the eight DESs and their impact on diffusivity and molecular association. Each DES possesses four-six types of hydrogen bonds and one or two of them overwhelm the others in quantity and lifetime. The dominating hydrogen bonds determine whether the DESs are governed by intra- or inter-component associations. The component diffusivity presents an inverse relationship with the hydrogen bond strength.

Foreign body aspiration is rare in children below 6 months of age. Very young children presenting with stridor, atypical croup presentation, and not responding accordingly, subglottic foreign body aspiration should be considered. These may not always be visible with bedside flexible endoscopy and may need investigation under anesthesia. We report 2 cases of devil's thorn aspiration in young infants. These children were left on the floor to play and devils thorn may be a danger lurking as the they have been deposited unknowingly by the shoes people wear and pick up by these young infants.

Background: Mitochondrial Neurogastrointestinal Encephalomyopathy (MNGIE) is a progressive autosomal recessive disorder characterized by cachexia, gastrointestinal (GI) dysmotility, ptosis, peripheral neuropathy and brain MRI white matter changes. Bi-allelic TYMP mutations lead to deficient thymidine phosphorylase (TP) activity, toxic accumulation of plasma nucleosides (thymidine and deoxyuridine), nucleotide pool imbalances and mtDNA instability. Death is mainly due to GI complications: intestinal perforation, peritonitis, and/or liver failure. Based on our previous observations in 3 patients with MNGIE, that platelet infusions resulted in a transient 40% reduction of plasma nucleoside levels, in 2005 we performed the first HSCT worldwide as a life-long source of TP in a patient with MNGIE. Procedure: HSCT was performed in a total of six patients with MNGIE. The multiple factors involved in the prognosis of this cohort were analyzed and compared to the literature experience. Results: Cell source was bone marrow in five patients and peripheral stem cells in one, all from fully HLA-matched related donors, including four who were TYMP mutation carriers. Four of six (66%) survived compared to the 37% survival rate in the literature. Reduced intensity conditioning regimen contributed to secondary graft failure in 2 patients. 15 years post-HSCT the first transplanted patient is seemingly cured. Severe GI symptoms pre-transplantation were mostly irreversible and a poor prognostic factor. Conclusions: Allogenic HSCT could constitute a curative therapeutic option for carefully selected, young, pre-symptomatic or mildly affected patients. Timing, donor selection and optimal conditioning protocol are major determinants of outcome. HSCT is inadvisable in patients with advanced MNGIE disease.

Objective: The novel coronavirus SARS-CoV-2 (COVID-19) rapidly escalated from its origin in an animal market in Wuhan, China in December 2019 to a global pandemic, and the lungs are the most frequently affected organ. The aim of this study was to investigate the relationship between pulmonary function test parameters and laboratory parameters in COVID-19. Method: A total of 60 patients who were admitted to the chest diseases department and intensive care unit of our hospital and were diagnosed with COVID-19 by real-time PCR analysis of nasopharyngeal swabs were evaluated. Pulmonary function tests and laboratory parameters at admission and on day 7 of treatment were analyzed. Results: On day 7 of treatment, white blood cell count, CRP, and fibrinogen level were significantly lower than at admission (p=0.002, 0.001, and 0.001, respectively), while forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) values were significantly higher compared to admitting values (p=0.001 for both). Correlation analysis of the changes in respiratory function values and laboratory parameters during follow-up (day 1 to day 7 of treatment) revealed that CRP level was positively correlated with FEV1 (r=0.616, p=0.01) and FVC values (r=0.51, p=0.01). Fibrinogen level was also positively correlated with FEV1 (r=0.345, p=0.01) and FVC (r=0.357, p=0.01). Conclusion: Fibrinogen and CRP levels are easily accessible parameters that may help identify improvement or deterioration in pulmonary function in COVID-19 patients during follow-up and discharge while reducing the risk of transmission.

Bosnia and Herzegovina (BIH) is developing country facing extensive land degradation. As a post-conflict society with underlying poor socio-economic conditions, the value of land and its degradation status are not perceived to be an important problem neither a priority to address. BIH currently exists as a decentralized state, where land and land resources are under exclusive jurisdiction of two entities and one district, rather than state-level legislation. Complex land related administration between entities functioning independently from each other, and thus not sinchronized, leads to frequent political conflicts about land property, and limited data exchange which may exacerbate current land degradation. This paper investigates (i) the institutional setting and policy framework related to land, discussing the effectiveness and limitations of the current policies in this post-conflict society; (ii) stakeholders’ perception of land degradation under such complex institutional and policy structures; and (iii) the current state of land degradation, with a focus on soil erosion as one of the most important indicators in BIH. Communication and cooperation are major challenges for sustainable land management in post conflict societies. The existence of a policy framework is important, but not sufficient if implementation is weak and the perception of decision makers differs. Limited data on the impact of 1992 War on soil and land status represents an additional challenge to combat land degradation. Reliable national data on land degradation are crucial for assessment and development of strategic and policy frameworks devoted to those issues and to raise awareness on how to foster their implementation.

Introduction Cystic fibrosis (CF) related liver disease (CFLD) manifests as a wide spectrum of hepatobiliary disease and can progress to need liver transplantation. Elexacaftor/tezacaftor/ivacaftor (elx/tez/iva) is a cystic fibrosis transmembrane conductance regulator (CFTR) modulator which has superior efficacy compared to previously approved modulators. Use of elx/tez/iva, should be approached with caution in individuals with CFLD or following liver transplantation due to possible increases in LFTs and drug-drug interactions with several immunosuppressant medications. Objective The purpose of this case series was to explore if the use of elx/tez/iva is safe and tolerable in patients with CF post-liver transplantation. Methods A retrospective case series including patients prescribed elx/tez/iva following liver transplantation and an immunosuppressive regimen consisting of drug therapy metabolized by P-glycoprotein was completed. Results Ten patients at six CF centers with a median age of 22.1 years (range 14-43.4 years) and median time from transplant of 6.9 years (range 0.6-22 years) were included. Most patients (8, 80%) received a reduced or full dose of elx/tez/iva for a mean duration of 10.4 months (range 7-12 months). Fluctuations in LFTs occurred in all patients (10, 100%) and led to therapy discontinuation in two patients (20%). Elx/tez/iva initiation resulted in elevations in tacrolimus trough concentration in 7 patients (70%). Most patients who tolerated elx/tez/iva had symptomatic and quality of life improvement, increased body-mass-index, and maintained or improved lung function. Conclusion Initiation of elx/tez/iva in patients with CF who received a liver transplantation may be safe with clinical benefits.