In this paper, in order to study the relationship between structure and performance, four new NFA derivatives were designed based on the two reported NFA molecules BO-4Cl and BTP-S2 by replacing the BT unit with a less-electron deficient BTz unit and inserting another ethylene double bond between the central core and the terminal groups. The DFT and TD--DFT calculations were applied to invstigate linear and nonlinear optical properties, such as electronic structure, electronic absorption, reorganization energy and the second-order NLO properties. The investigation demonstrates that they are all narrow bandgap derivatives, the absorption spectrum extends to the near-infrared region and using two ethylene double bond is the most effective way to reduce the energy gap, redshift the maximum absorption peak and the middle absorption band, enhance hole transport ability and weaken electron transport ability and enhance second-order NLO response. Considering the smaller electron and hole reorganization energy and the larger static first hyperpolarizability value, the studied NFA derivatives have great potential to become ambipolar charge transport materials and large second-order NLO materials.

The dynamic pH response resulting from acid-base transport of interfacial reactions greatly influences the kinetic performance and process mechanism, but its theoretical foundation is lacked. Herein, a generalized acid-base transport model is established owing to the success in deriving buffer transport equations and is experimentally through the relationships of buffer transport limiting current versus solution pH and buffer concentration (CB). The relationships bring forth the parameter determination methods of buffers with the superiority of facile survey of practical parameter values. Based on model calculations, the dynamic pH response is drawn as a j‒pH diagram to show the buffer transport law in the full pH range, highlighting the rate-limiting effect. The buffer operation principles are graphically presented as CB‒ΔpH diagrams to aid economic buffer applications. This study has laid the foundation for quantification and regulation of dynamic pH response and is of wide interest to the chemistry encompassing interfacial processes.

Abstract: Background: Gastrointestinal complications of this COVID-19 have been reported over the last year. One such manifestation is bowel ischemia. This study thus aims to provide a more holistic review of our current understanding of COVID-19 induced bowel ischemia. Method and Results: A meticulous search was performed using different keywords in PubMed, EMBASE, and Google Scholar. Fifty-two articles were included in our study after applying inclusion and exclusion criteria and performing the qualitative assessment of the studies. A total of 25,702 patients were included in our study after the completion of the qualitative assessment. Discussion: COVID-19 commonly presents in the GIT as diarrhea, vomiting, and nausea. The mechanism of bowel ischemia is associated with the formation of emboli which is related to COVID-19’s high affinity for angiotensin-converting enzyme-2 on enterocytes, affecting the superior mesenteric vessels. Clinically, patients presented with abdominal pain and vomiting. CT angiography of the abdomen and pelvis showed acute mesenteric ischemia. Management was usually initiated with gastric decompression, fluid resuscitation, and hemodynamic support. Surgical intervention was also sought. Conclusion: Mesenteric ischemia presenting in patients with COVID-19 has to be considered when symptoms of severe abdominal pain are present. More research and guidelines are required to be able to triage patients with COVID-19 to suspect mesenteric ischemia and to help in diagnosis and management.

Anagrus nilaparvatae is an important egg parasitoid wasps of rice pests rice planthopper. Based on the powerful olfactory system of sensing chemical information in nature, A. nilaparvatae shows complicated life activities and behaviors, such as feeding, mating and hosting. In this study, we constructed a full-length transcriptome library and further to identify the characteristics of olfactory binding proteins, the first participant in the olfactory system. Through full-length transcriptome sequencing, splicing, assembly, and data correction by Illumina, we obtained 163.59Mb of transcriptome data and 501,179 items of annotation information, and performed GO functional classification of unigenes of the transcriptome. We analyzed the sequence characteristics of olfactory binding protein genes, and 8 genes (AnilOBP2, AnilOBP9 AnilOBP23, AnilOBP56, AnilOBP83, AnilCSP5, AnilCSP6 and AnilNPC2) were identified. After sequence alignment and conserved domain prediction, the 8 proteins were consistent with the typical characteristics of OBPs, CSPs and NPC2s in insects. The phylogenetic tree analysis showed that the 8 genes share low homology relationship with other species in Hymenopteran. Finally, RT-qPCR was used to analyze the expression responses of the 8 genes in different genders and stimulated by volatiles. The relative expression levels of AnilOBP9, AnilOBP26, AnilOBP83, AnilCSP5 and AnilNPC2 in males were significantly higher than those in female, while the relative expression levels of AnilCSP6 were opposite. The expression levels of AnilOBP9 and AnilCSP6 were significantly altered by the stimulation of β-caryophylene, suggesting the two genes may be related to host searching. In this study, the transcriptome data of parasitoid wasps A. nilaparvatae could provide a reference for the molecular biology research of the parasitoids, and the identification and analysis of olfactory binding proteins not only help us further clarify the physiological characteristics and parasitic mechanism of the parasitoids, but also promote the utilization of natural enemy resources.

Introduction: Guidelines recommend using a pulse oximeter rather than arterial blood gas (ABG) for COVID-19 patients. However, significant differences can be observed between oxygen saturation measured by pulse oximetry (SpO2) and arterial oxygen saturation (SaO2) in some clinical conditions. We aimed to assess the reliability of pulse oximeter in patients with COVID-19 Methods: We retrospectively reviewed ABG analyses and SpO2 levels measured simultaneously with ABG in patients hospitalized in COVID-19 wards. Results: We categorized total 117 patients into two groups; in whom the difference between SpO2 and SaO2 was 4% (acceptable difference) and >4% (large difference). Large difference group exhibited higher neutrophil count, C-reactive protein, ferritin, fibrinogen, D-dimer and lower lymphocyte count. Multivariate analyses revealed that increased fibrinogen, increased ferritin and decreased lymphocyte count were independent risk factors for large difference between SpO2 and SaO2. The total study group demonstrated the negative bias of 4.02% with the limits of agreement of −9.22% to 1.17%. The bias became significantly higher in patients with higher ferritin, fibrinogen levels and lower lymphocyte count. Conclusion: Pulse oximeters may not be sufficient to assess actual oxygen saturation especially in COVID-19 patients with high ferritin and fibrinogen levels and low lymphocyte count low SpO2 measurements.

Aim of the study: Subconjunctival hemorrage (SCH) is a frequent bleeding manifestation and a common cause of visits to the primary care. Trauma in young patients and vascular damage such as hypertension in the elderly are the most common causes of SCH and the prevalence of hematological diseases is less than 1%. We aimed to evaluate the prevalence of congenital or acquired bleeding disorders in patients with once or recurrent SCH. Methods used to conduct the study: It is a retrospective study and included fifty-two patients with SCH whose etiologic factor was not detected. Hemostatic tests were studied in 52 patients (25 male and 27 females). All patients included were evaluated for congenital or acquired bleeding disorder and SCH with once and those with 2 or more were compared for the laboratory results. Results of the study: Type I von Willebrand disease (vWD) was diagnosed in one patient with recurrent SCH and one patient with single SCH (3.8%). The prevalence of patients with type 1 vWD in the study was not statistically significant when compared with the frequency of vWD in the normal population. Fibrinogen level was found to be statistically higher in patients who had SCH once than those who had recurrent SCH. But fibrinogen level was in normal range in all patients. Conclusions drawn from the study and clinical implications: There was no increase in the incidence of congenital or acquired bleeding disorder in SCH compared to normal population. For this reason it was thought that there was no need for evaluation for bleeding disorders in spontaneous SCH.

Machine learning and artificial intelligence (AI) in medicine has arrived in medicine and the healthcare community is experiencing significant growth in its adoption across numerous patient care settings. There are countless applications for machine learning and AI in medicine ranging from patient outcome prediction, to clinical decision support, to predicting future patient therapeutic setpoints. This commentary discusses a recent application leveraging machine learning to predict one year patient survival following orthotopic heart transplantation. This modeling approach has significant implications in terms of improving clinical decision making, patient counseling, and ultimately organ allocation and has been shown to significantly outperform preexisting algorithms. This commentary also discusses how adoption and advancement of this modeling approach in the future can provide increased personalization of patient care. The continued expansion of information systems and growth of electronic patient data sources in healthcare will continue to pave the way for increased use and adoption of data science in medicine. Personalized medicine has been a long-standing goal of the healthcare community and with machine learning and AI now being continually incorporated into clinical settings and practice, this technology is well on the pathway to make a considerable impact to greatly improve patient care in the near future.

We report a case of an advanced refractory Gastric AD which responded favourably to a combination regimen of AGI and other chemotherapy agents which were selected on the basis of multi-analyte tumor profiling. The treatment was well tolerated with transient manageable adverse events and yielded radiological partial response.

In this research, enrichment factor (EF) and pollution load index (PLI) were utilized to estimate the features of enrichment and contamination of PTEs in farmland soil. Furthermore, combining the spatial distribution characteristics of potentially toxic elements (PTEs) and positive matrix factorization (PMF) to distinguish and quantify the sources of PTEs in farmland soil, and then the potential ecological risk (PER) and human health risk (HHR) model based on PMF are applied to quantify the ecological and human health risks from different sources. Taking Puning District as an example, four sources of PTEs in farmland soil were quantitatively allocated. For ecological risk, the study area is at moderate ecological hazard level, and industrial activities were the greatest contributor. The mean E_r^i of Hg were 69.82, reaching medium ecological risk level. For human health risks, both adults and children have no evident non-carcinogenic risk in the study area. And natural source was the largest contributor to non-carcinogenic risk, followed by agricultural activities. With regard to carcinogenic risk, tolerable risks of soil PTEs in the study area were limited not only for adults but also for children. Furthermore, compared with adults, the health risks of children, whether non-carcinogenic or carcinogenic, were higher than those of adults, and the trends in health risks for children and adults were similar. A comprehensive scheme combining source contribution and risk assessment is conducive to quantitatively assess ecological risks, health risks and priority pollution sources, thereupon provide effective suggestions for protecting human health and preventing and controlling pollution.

Paravalvular leak (PVL) is uncommon but can lead to severe complications after surgical or transcatheter aortic valve replacement. Clinical complications such as heart failure, haemolysis and infective endocarditis can be catastrophic results if not treated in promptly. It is, therefore, vital that PVLs are diagnosed early using various imaging modalities. Different approaches have been studies in managing PVL’s; of late, there is an increased interest in the use of minimally invasive procedures such as the transcatheter aortic valve closure procedure due to the decreased occurrence of further operations. This review discusses the classification of PVLs, diagnostic approaches and the available management options.

The magnitude and spatial heterogeneity of snow deposition are difficult to model in mountainous terrain. Here, we investigated how snow patterns from a 32-year (1985 – 2016) snow reanalysis in the Tuolumne, Kings, and Sagehen Creek, California Sierra Nevada watersheds could be used to improve simulations of winter snow deposition. Remotely-sensed fractional snow-covered area (fSCA) from dates following peak-snowpack timing were used to identify dates from different years with similar fSCA, which indicated similar snow accumulation and depletion patterns. Historic snow accumulation patterns were then used to 1) relate snow accumulation observed by snow pillows to watershed-scale estimates of mean snowfall, and 2) estimate 90 m snow deposition. Finally, snow deposition fields were used to force snow simulations, the accuracy of which were evaluated versus airborne lidar snow depth observations. Except for water-year 2015, which had the shallowest snow estimated in the Sierra Nevada, normalized snow accumulation and depletion patterns identified from historic dates with spatially correlated fractional snow-covered area agreed on average, with absolute differences of less than 10%. Watershed-scale mean winter snowfall inferred from the relationship between historic snow accumulation patterns and snow pillow observations had a ±13% interquartile range of biases between 1985 and 2016. Finally, simulations using 1) historic snow accumulation patterns, and 2) snow accumulation observed from snow pillows, had snow depth coefficients of correlations and mean absolute errors that improved by 70% and 27%, respectively, as compared to simulations using a more common forcing dataset and downscaling technique. This work demonstrates the real-time benefits of satellite-era snow reanalyses in mountainous regions with uncertain snowfall magnitude and spatial heterogeneity.

Objective To determine the impact of the COVID-19 pandemic on acute admissions and inpatient activity at a tertiary referral centre. Design Retrospective review of coding-based inpatient electronic records. Setting An otolaryngology and head and neck surgery department at a UK major trauma and tertiary referral centre. Participants Otolaryngology patients admitted as an emergency over a period of 12 months pre-COVID19 (01/04/2019-31/03/2020) and 10 months post-COVID19 (01/04/2020-23/01/2021). Main outcome measures Baseline characteristics, admission rates, length of stay (LoS), overall mortality and 30-day mortality. Results 1844 records were reviewed; (1293 pre-COVID19, 551 post-COVID19). Admissions across all age groups were reduced, with an increase in mean age from 40.4 to 47.4 years (p=0.001). LoS remained unchanged (3.74 vs 3.82 days, p=0.251). Epistaxis remained the most common presentation, with an increased LoS compared to the pre-COVID19 cohort. GP referrals reduced from 18.0% to 4.2% (n=233 vs n=23, p<0.001) and ED referrals proportionally increased from 60.9% to 75.3%, n=787 vs n=417, p<0.001). Critical care admissions were higher in the post-COVID19 cohort (OR 1.82 (1.11-2.99) [95% CI], p=0.017). There was no significant difference in overall mortality between groups (n=74, 5.7% vs. n=33, 6.0%; p=0.844). Thirty-day mortality increased from 0.9% (n=12) pre-COVID19 to 2.3% (n=13) post-COVID19 (p=0.03). Conclusions This study demonstrates significant changes and a reduction in acute otolaryngology presentations. Our findings suggest that sicker, frailer patients were admitted during the pandemic. This study highlights important considerations for acute otolaryngology care moving forward after the pandemic.

Recent technological advancements in synthetic and systems biology have enabled the construction of microbial cell factories expressing diverse heterologous pathways in unprecedentedly short time scales. However, the translation of such laboratory scale breakthroughs to industrial bioprocesses remains a major bottleneck. In this study, an accelerated bioprocess development approach was employed to optimize the biosynthetic pathway of the blockbuster chemotherapy drug, Taxol. Statistical design of experiments approaches were coupled with an industrially relevant high-throughput microbioreactor system to optimize production of key Taxol intermediates, Taxadien-5α-ol and Taxadien-5α-yl-acetate, in engineered yeast cell factories. The optimal factor combination was determined via data driven statistical modelling and validated in 1L bioreactors leading to a 2.1-fold improvement in taxane production compared to a typical defined media. Elucidation and mitigation of a nutrient limitation enhanced product titers a further two-fold and titers of the critical Taxol precursors, Taxadien-5α-ol and Taxadien-5α-yl-acetate were improved to 34 and 11 mg/L, representing a three-fold improvement compared to the highest literature titers in S. cerevisiae. Comparable titers were obtained when the process was scaled up a further five-fold using 5 L bioreactors. The results of this study highlight the benefits of a holistic design of experiments guided approach to expedite early stage bioprocess development.

BACKGROUND: High-flow nasal cannula therapy (HFNC) is increasingly used for children with bronchiolitis, but its optimal role remains relatively uncertain. Our institution created and later revised a ward-based clinical pathway guiding initiation and weaning of HFNC. METHODS: A retrospective review of 664 encounters was conducted. Total duration of HFNC, duration of weaning from maximum flow rate, hospital length of stay (LOS), and escalation of care were compared across 3 study periods using generalized linear models: Baseline (HFNC managed at provider discretion, 5/1/2015-4/30/2017, n = 215), Intervention 1 (first pathway, initiation at 0.5 L/kg/min and escalation up to 2 L/kg/min, 5/1/2017-2/28/2018, n = 155), and Intervention 2 (revised pathway, initiation at the maximum rate of 2 L/kg/min, 3/1/2018-1/31/2020, n = 294). Both pathway iterations provided specific titration and weaning guidance. Models controlled for initial SpO2 and maximum respiratory rate to adjust for the possibility of differing case severity. RESULTS: After adjustment for severity, total duration of HFNC was significantly reduced in the second intervention, but not the first. Adjusted LOS was shorter in Intervention 1 and Intervention 2 compared to the baseline period. Adjusted weaning time and escalation of care did not differ significantly between periods. CONCLUSION: Pathway implementation was associated with modestly decreased LOS and – when initial flow rates were increased to 2 L/kg/min – reduced duration of HFNC, without differences in escalation of care or weaning time. These findings highlight the potential role of standardization of practice with clinical pathways in safely reducing unnecessary care.

Background: Early cardiovascular impairment in obstructive sleep apnea (OSA) patients is often overlooked, leading to irreversible outcome. Left ventricular (LV) global longitudinal strain (GLS) derived from automated function imaging (AFI) echocardiography provides a fast tool to assess global longitudinal function. We therefore aimed to compare the feasibility and reproducibility of AFI with mitral annulus plane systolic excursion (MAPSE) as obesity is common in OSA. Methods: A comprehensive echocardiographic examination was done in 186 consecutive patients having polysomnography for suspected OSA in this prospective study. MAPSE was measured by using M-mode. AFI was derived by offline analysis of three long-axis views that semi-automatically detects LV endocardial boundary, which is adjusted manually as necessary. Variability of AFI and MAPSE were compared among the different subgroups and further tested in BMI subgroups. Results: Despite a relatively high obesity rate (42.9%), AFI was feasible in 94% (175/186) patients and MAPSE could be recorded in all patients. Although more segments were measured with AFI it showed excellent correlation (r=0.882) superior to MAPSE (r=0.819) between the expert and beginner. Intra- and inter- observer variability of AFI were comparable with MAPSE in Bland-Altman analysis, 5.5% and 6.5% for AFI, 6.2% and 8.8% for MAPSE, respectively. In repeated measurements, AFI showed higher intra-class correlation (ICC=0.95) than MAPSE (ICC=0.87). Furthermore, analysis showed that AFI was feasible even in more obese patients (BMI≥28kg/m2). Conclusions: Even in obese patients with OSA, AFI-GLS is feasible and more reliable for less expert operators than MAPSE for detecting LV longitudinal dysfunction.

A patient presenting with low back pain received 18 novel treatments of FDA approved low frequency sound wave stimulation known as Khan Kinetic Treatment (KKT). Following KKT he demonstrated improvement in pain, function, quality of life, sleep, and trunk range of motion with no adverse events.

Agricultural land use can increase runoff and erosion leading to detrimental downstream impacts. This paper examines the impact of agricultural land cover change on runoff and sediment generation at event scales using a model-based approach. SHETRAN, a physically based, spatially distributed model, was applied in two southwest England catchments to represent: (a) changes in the land cover (cropland extent and spatial arrangement), (b) changes in crop type, and (c) use of riparian buffer strips. A total of 84 simulated events within a 4-year period were used to quantify flow and sediment generation impacts. We found past changes in land cover resulted in significant differences in sediment yield (p < 0.05). Linear regression showed an increase in flow and sediment yield proportional to increases in arable crop area (p < 0.001). The spatial arrangement of cropped fields and riparian buffer strips produced no significant differences in event flow or sediment yield (p > 0.05). However, buffer strip scenarios compared with the base run showed sediment load reductions in specific events, up to 20% and 15% for woodland and grass riparian buffers, respectively. When comparing crop types with and without the use of post-harvest cover crops, we observed non-significant differences (both Qv and Sy). However, large reductions in modelled sediment yields occurred for some events (e.g., up to 60% for winter cereals, 50% for maize and 74% for spring cereals). For these scenarios, examination of rainfall event magnitude emphasized the importance of ground cover in mitigating soil erosion for maize and spring cereals, but not for winter cereals. Our findings indicate that significant changes in sediment delivery at the event scale are associated with cropland extent and crop types, depending on rainfall magnitude, but not on the spatial arrangement of cropped fields or the use of riparian buffer strips.

Potential protective effects of breast milk and amniotic fluid against novel coronavirus SARS-CoV-2.Authors: April Rees1, Stephen Turner2, Catherine Thornton1*1 Institute of Life Science, Swansea University Medical School, Swansea, Wales, UK, SA2 8PP2 University of Aberdeen, The Institute of Applied Health Sciences, Aberdeen, Scotland, UK AB24 3FXDisclosure: The authors report no conflict of interest.Funding: This work was supported by the EPSRC Impact Acceleration Account at Swansea University and the Welsh Government Sêr Cymru III Tackling COVID-19 initiative.*Corresponding author:Professor Cathy ThorntonILS1, Swansea University Medical SchoolSingleton CampusSwansea UniversitySwansea, Wales, UKSA2 8PPTelephone: 01792 602122Email: [email protected]: Breast milk, amniotic fluid, SARS-CoV-2, neonateWord count: 769