Objectives: We aim to analyze long-term voice outcomes and Quality of Life (QoL) in patients undergoing Open Partial Horizontal Laryngectomy Type II (OPHL Type II) and to compare them to those obtained by patients undergoing Total Laryngectomy (TL) with voice prosthesis (VP). Design: Cross-sectional cohort study Setting: patients undergoing surgery for advanced laryngeal cancer, assessed during the usual follow-up consultations at the Phoniatric Unit (February 2020-December 2020). Participants: Forty-five patients were enrolled and divided into two groups: OPHL Group and TL Group. Main outcomes measures: Maximum phonation time, INFV0 scale, I-SECEL, UWQoL-V4 and MDADI questionnaires were used to assess the long-term outcomes. Results: Voices of patients undergoing OPHL Type II were worse than those of laryngectomized patients with VP. Nevertheless, scores in voice and dysphagia-related QoL were comparable and scores in the Social domain of QoL were better in OPHL group. Conclusions. OPHL Type II allows an acceptable voice recovery and a satisfactory QoL.

Introduction The reuse of cardiac implantable electronic devices may help increase access to these therapies in low- and middle-income countries (LMICs). No published data exist regarding the views of patients and family members in LMICs regarding this practice. Methods and Results A paper questionnaire eliciting attitudes regarding pacemaker reuse was administered to ambulatory adult patients and patients’ family members at outpatient clinics at Centro Nacional Cardiologia in Managua, Nicaragua, Indus Hospital in Karachi, Pakistan, Hospital Carlos Andrade Marín and Hospital Eugenio Espejo in Quito, Ecuador, and American University of Beirut Medical Center in Beirut, Lebanon. There were 945 responses (Nicaragua – 100; Pakistan – 493; Ecuador – 252; Lebanon – 100). A majority of respondents agreed or strongly agreed that they would be willing to accept a reused pacemaker if risks were similar to a new device (707, 75%), if there were a higher risk of device failure compared to a new device (584, 70%), or if there were a higher risk of infection compared to a new device (458, 56%). A large majority would be willing to donate their own pacemaker at the time of their death (884, 96%) or the device of a family member (805, 93%). Respondents who were unable to afford a new device were more likely to be willing to accept a reused device (79% vs. 63%, P<0.001). Conclusions Patients and their family members support the concept of pacemaker reuse for patients who cannot afford new devices.

End stage renal disease (ESRD), characterized by cessation in kidney function, has been linked to severe metabolic disturbances, caused by buildup of toxic solutes in blood. To remove these solutes, ESRD patients undergo dialysis. As a proof of concept, we tested whether ESRD-related metabolic signatures can be detected in perspiration samples using a combined methodology. Our rapid methodology involves swabbing a glass slide across the patient’s forehead, detecting the metabolites in the imprint using desorption electrospray ionization mass spectrometry, and identifying the key differences using machine learning methods. Based on collecting 42 healthy and 27 ESRD samples, we find saturated fatty acids are consistently suppressed in ESRD patients, with little change after dialysis. Also, our method enables the detection of uremic solutes, where we find elevated levels of uric acid (6.7 fold higher on average) that sharply decrease after dialysis. Beyond the study of individual metabolites, we find that a lasso model, which selects for 8 m/z fragments from 24,602 detected analytes, achieves area under the curve performance of 0.85 and 0.87 on training (n=52) and validation sets (n=17) respectively. Together, these results suggest that this methodology is promising for detecting signatures relevant for Precision Health.

Insect pollinators are important means for a stable ecosystem. The habitat types play a crucial role in the community composition, abundance, diversity, and species richness of the pollinators. The present study in Shivapuri–Nagarjun National Park explored the species richness and abundances of insect pollinators in four different habitats and different environmental variables in determining the community composition of the pollinators. Data were collected from 1500 m–2700 m using pan traps and hand sweeping methods. Non–metric multidimensional scaling (NMDS) and redundancy analysis (RDA) were conducted to show the association between insect pollinators and environmental variables. The results firmly demonstrated that species richness and abundances were higher in open trails compared to other habitats. The distribution of the pollinator species was more uniform in the open trail followed by the grassland. Similarly, a strong positive correlation between flower resources and pollinator’s abundance was found. In conclusion, the open trail harbor rich insect pollinators in lower elevation. The community structure of the pollinators was strongly influenced by the presence of flowers in the trails.

In the last two decades, there have been significant advancements in the development of more physiologically relevant organ-on-a-chip (OOC) systems that can mimic the tissue microenvironment. Despite the advantages of these microphysiological systems, such as portability, the ability to mimic physiological flow conditions, and the reduction of reagents required for preparation and detection, they lack real-time detection of analytes with high accuracy. To address this, biosensor technologies have been integrated with OOC systems to enable simultaneous analysis of different analytes in a single device. However, integrating biosensors with OOC systems is challenging due to the competing demands for low-cost, simple fabrication processes, and speed. This study presents the fabrication of a glucose sensing device integrated with a liver-on-a-chip (LOC) platform. The conductive PLA-based three-electrode system was printed using FDM 3D printing technology to simplify the fabrication process. The sensitivity of the glucose biosensing device was enhanced by adding multi-walled carbon nanotubes on the electrodes. The biosensing integration study using a perfusion-based LOC showed the stability, biocompatibility, and sensitivity of the glucose sensing devices. Furthermore, drug toxicity studies on the LOC platform demonstrated the device’s ability to detect a broad range of glucose concentrations and its enhanced sensitivity.

Raman spectroscopy has gained popularity to monitor multiple process indicators simultaneously in biopharmaceutical processes. However, robust and specific model calibration remains a challenge due to insufficient analyte variability to train the models and high cross-correlation of various media components and artefacts throughout the process. Therefore, a systematic Raman calibration workflow for perfusion processes enabling highly specific and fast model calibration was developed. A harvest library consisting of frozen harvest samples from multiple CHO cell culture bioreactors collected at different process times was established, capturing process variability as widely as possible. Model calibration was subsequently performed in an offline setup using a flow cell by spiking process harvest with various sugars known to modulate glycosylation patterns of monoclonal antibodies. In a screening phase, Raman spectroscopy was proven capable not only to distinguish glucose, raffinose, galactose, mannose, and fructose in perfusion harvest, but also to quantify them independently in process relevant concentrations. In a second phase, a robust and highly specific calibration model for simultaneous glucose (RMSEP = 0.32 g/L) and raffinose (RMSEP = 0.17 g/L) real-time monitoring was generated and verified in a third phase during a perfusion process. The proposed offline calibration workflow allowed proper Raman peak decoupling, reduced calibration time from months down to days and can potentially be applied to other analytes of interest including lactate, ammonia, amino acids, or product titer.

For the ionic liquid (IL)-solute systems of broad interest, a deep neural network based recommender system (RS) for predicting the infinite dilution activity coefficient (γ∞) is proposed and applied for a large extension of the UNIFAC model. In the RS, neural network entity embeddings are employed for mapping each IL and solute and neural collaborative filtering is utilized to handle the nonlinearities of IL-solute interactions. A comprehensive experimental γ∞ database covering 215 ILs and 112 solutes (totally 41,553 data points) is established for training the RS, where the cross-validation and test are performed based on a rigorous dataset split by IL-solute combinations. The obtained RS shows superior performance than the state-of-the-art γ∞ models and is thus taken to complete the solute-in-IL γ∞ matrix. Based on the completed γ∞ database, a large extension of the UNIFAC-IL model is finally presented, filling all the parameters between involved groups.

We explored the effects, on photosynthesis in cowpea (Vigna unguiculata), of high temperature and light — environmental stresses that often co-occur under field conditions. We observed contrasting responses in the light and carbon assimilatory reactions, whereby in high temperature, the light reactions were stimulated while CO2 assimilation was substantially reduced. There were two striking observations. First, the primary quinone acceptor (QA), a measure of the regulatory balance of the light reactions, became more oxidized with increasing temperature, suggesting increased electron sink capacity, despite the reduced CO2 fixation. Second, a strong, O2-dependent inactivation of assimilation capacity, consistent with down-regulation of rubisco under these conditions, a phenomenon that has not been previously reported. The dependence of these effects on CO2, O2 and light led us to conclude that both photorespiration and an alternative electron acceptor, supported increased electron flow, and thus provided photoprotection, under these conditions. Further experiments showed that the increased electron flow was maintained by rapid rates of PSII repair, particularly at combined high light and temperature. Overall, the results suggest that photodamage to the light reactions can be avoided under high light and temperatures by increasing electron sink strength, even when assimilation is strongly suppressed.

Skin drug delivery is an emerging route in the drug development, due to its great advantages, thus leading to an urgent need to understand the behaviour of active pharmaceutical ingredients into/through the skin. This knowledge is crucial in the early stages of product design and development. Yet, given the skin barrier properties as one of the first body’s natural defence systems, it can act as an obstacle to the successful outcome of a skin drug therapy. To unravel the mechanisms underlying this barrier, reductionist strategies have designed several models with different levels of complexity and integrity, using non-biological and biological components. Besides the detail of information and resemblance to the in vivo Human skin that each in vitro model offers, the technical and economic efforts required should be considered when selecting the most adequate model for the intended research. This review provides an outline of the most commonly applied skin models, including healthy and diseased conditions, lab developed systems and commercialized models, their advantages and limitations and, also an overview of the new trends in skin engineered models.

Introduction The Carpentier-Edwards PERIMOUNT Magna Ease valve is a third-generation bioprosthesis for aortic valve replacement (AVR). This is a postapproval study reporting on its 8‑year outcomes. Methods Adults undergoing AVR with the Magna Ease valve between October 2007 and December 2012 were enrolled for this prospective, nonrandomized, single‑arm, multicenter study. Assessments occurred preoperatively, at hospital discharge, 6 months, 1 year, and annually thereafter up to 8 years. Outcomes included safety endpoints, hemodynamic performance, and New York Heart Association (NYHA) Functional Class. Results Of the 258 study patients, 67.5% were in NYHA Class I or II, and 32.5% were in NYHA Class III or IV at baseline. Concomitant procedures were performed in 44.2%. Total follow-up was 1,597.6 patient-years, median follow‑up was 7 years (interquartile range: 5.5–8.0 years). Eight years following AVR, functional class remained improved from baseline with 93.9% in NYHA Class I/II and 6.1% in NYHA Class III; thirty-eight deaths had occurred, eight of which were valve related; freedom from all‑cause mortality was 80.7% (95% confidence intervals 74.9, 86.4); freedom from valve-related mortality was 95.8% (92.8, 98.8); freedom from reintervention, explant, major bleeding events, and structural valve deterioration were 89.8% (85.1, 94.6), 94.8% (91.7, 97.9), 85.1% (80.0, 90.1), and 90.1% (84.7, 95.4), respectively; effective orifice area was 1.5±0.5 cm 2, mean gradient was 14.8±8.3 mmHg, and 88.6% of patients had no or trivial aortic regurgitation. Conclusions This study demonstrated satisfactory safety and sustained hemodynamic and functional improvements at 8 years following AVR with the Magna Ease valve.

Experimental and theoretical studies show that two-dimensional (2D) materials have great potential applications in the fields of optoelectronics, semiconductors and spintronic devices. Based on the First Principles, the stability, band structure, electronic properties and optical properties of hydrogenated C3B, a new graphene like two-dimensional (2D) material, are studied in this paper. The results show that: firstly, with the increase of hydrogenation degree, the sp2 orbital hybridization in C3B structure gradually transits to a more stable sp3 mode, and the valence band energy near the Fermi level decreases; Secondly, adsorbed H atoms can regulate the bandgap of C3B. When the number of adsorbed H is even, C3B structure behaves as a semiconductor, and meanwhile the bandgap increases. When H atoms is odd, C3B is easy to show metallicity; Finally, the main absorption peak of the optical absorption spectrum decreases first and then increases with the increase of H concentration. The law of the secondary absorption peak is opposite to the main peak. When the ratio of hydrogenation is 50%, an obvious secondary absorption peak appears. This study confirms that hydrogenation is an effective way to regulate the electronic properties of materials, which can expand the application of 2D material C3B in optoelectronic devices.

Resection or exclusion of scars following a myocardial infarction on the LAD territory started even before the beginning of the modern era of cardiac surgery. Many techniques were developed, but there is still confusion on who did what. The original techniques underwent modifications that brought to a variety of apparently new procedures that, however, were only a “revisitation” of what described before. In some case old techniques were reproposed and renamed, without giving credit to the surgeon that was the original designer. Herein we try to describe which are the seminal procedures and some of the most important modifications, respecting however the merit of who first communicated the procedure to the scientific world.

Background: The novel coronavirus disease (Covid-19) can progress with mild to moderate or self-limiting clinical findings in children. The aim of this study was to investigate the disease features of Covid-19 in Turkish children. Methods: Children diagnosed by the method of RT-PCR for Covid-19 at the Dicle University Department of Pediatric, between April and June 2020, were evaluated. Hospital records were investigated retrospectively. Results: One hundred and five patients children with the mean age of 108.64±65.61 were enrolled in this study. The most common cause of transmission in pediatric patients was contacting with a family member diagnosed with COVID-19 (n=91, 86.7%).The most common admission complaints were dry cough (n=17, 16.2%), fever (n=16, 15.2%), lassitude and fatigue (n=14, 13.3%) respectively. More than 95 % of all children with Covid-19 had asymptomatic, mild, or moderate cases. CRP was identified only independent factor associated with long duration of hospitalization. Conclusion: The results of this study show preliminary results of a study investigating the effect of Covid-19 on Turkish children. A clear understanding of the local epidemiology of corona virus infections and identification of risk factors is critical for the successful implementation of the prevention and control program.

TAR syndrome is a rare congenital disorder whose genetic bases have remained unclear for many years. It has now been understood that the disease is caused by the compound inheritance of a rare null allele (usually the 1q21.1 deletion) and a low-frequency hypomorphic noncoding single nucleotide polymorphism (SNP) in RBM8A gene. Nevertheless, only a limited set of variants has been identified so far. A recent report of Boussion et al. described four novel RBM8A noncoding SNPs (i.e., 1) c.205 + 3_205 + 6del, 2) c.206 − 13C>A, 3) c. − 19G>T, and 4) c.*6C>G) increasing the mutational spectrum of TAR syndrome. Here, based on the recently published manuscript by Boussion et al., we report data regarding an additional African TAR patient carrying the 1q21.1q21.2 deletion in trans with the 3’UTR (c.*6C>G) variant. Present data further confirm the pathogenic role of this hypomorphic SNP and highlights its relevance in the African population, leading to advice geneticists to directly search for the c.*6C>G variant in African patients affected by TAR syndrome and carrying the 1q21.1 deletion, shortening the diagnostic time window.

Routinely collected data has been increasingly used to evaluate and monitor long-term opioid therapy (LTOT) patterns, with very little guidance on how to measure LTOT from these data sources. We conducted a systematic review of studies published between Jan 2000 and Jul 2019 to catalogue LTOT definitions, the rationale for definitions, and LTOT rates in observational research using routinely collected data in non-surgical settings. We screened 4,056 abstracts, 209 full-text manuscripts and included 126 studies; mostly from the US (82%) and published between 2015 and 2019 (68%). We identified 78 definitions of LTOT, commonly operationalised as 90 days of use within a year (21%). Studies often used multiple criteria to derive definitions (63%), mostly based on measures of duration, such as supply days/days of use (67%), episode length (21%), or prescription fills within specified time periods (9%). Definitions were based on previous publications (63%), clinical judgment (17%), or empirical data (3%); 10% of studies applied more than one definition. LTOT definition was not provided with enough details for replication in 14 studies and 37 studies did not specify the opioids evaluated. Rates of LTOT ranged from 0.2% to 57% according to study design, population and definition used. We observed a substantial rise in studies evaluating LTOT with large variability in the definitions used and poor reporting of the rationale and implementation of the definitions. This variation impacts on research reproducibility, comparability of findings and the development of strategies aiming to curb therapy that is not guideline-recommended.

The occurrence of random mutations can increase the diversity of the genome and promote the evolutionary process of organisms. High efficiency mutagenesis techniques significantly accelerate the evolutionary process. In this work, we describe a targeted in vivo mutagenesis system to significantly increase mutation frequency and generate mutations across all four nucleotides. We constructed different DNA-modifying enzyme-PmCDA1-T7 RNA polymerase fusion proteins, achieved targeted mutagenesis by flanking the target gene with T7 promoters, and tuned the mutation spectra by introducing different DNA-modifying enzymes. With the mutagenesis fusion proteins, the mutation frequency of the target gene could reach 5.13x10-3, and the proportion of non-C→T mutations is 10~11-fold higher than the cytidine-based evolutionary tools. We also demonstrated that our mutagenesis tools could be used to evolve the essential enzyme in the β-carotene biosynthesis process and generate mutations with different types.

Background The benefits of Elexecaftor-Tezacaftor-Ivacaftor (ETI) therapy on the health and wellbeing of people with CF (pwCF) are well documented. Since approval, however, a growing number of potential side effects have emerged in reports from clinical practice. With current understanding of ETI tolerability limited to data from clinical trials, the prevalence of side effects and their impact on care decision making remains poorly categorized. Methods A ten-question survey was developed and distributed to patients 18 years or older who were treated at the Massachusetts General Hospital CF centers. Reports of side effects were measured across twelve distinct categories, and dose adjustments and discontinuation due to side effects were collected. If a patient reported no side effects, they did not have to complete the entire survey. Results Among ninety-two respondents initiated on ETI, 51 respondents (55.4%) reported potential side effects and 41 (44.5%) respondents reported no adverse events. The most commonly reported side effects were mental health, changes in appearance, and gastrointestinal complaints, which were reported by 22.8%, 30.4%, and 21.7% of patients, respectively. Eighteen (19.6%) respondents modified their dosing in response to side effects, and six discontinued treatment permanently (6.52%) due to persistent side effects. Conclusions Responses demonstrated marked heterogeneity, with most respondents reporting at least one side effect following initiation. Dose modification was commonly utilized to mitigate adverse effects, however few respondents had to discontinue treatment. These findings demonstrate the importance of monitoring for potential drug-related side effects of ETI in clinical settings.

Aggregation-Induced Emission (AIE) is a unique phenomenon whereby aggregation of molecules induces fluorescence emission as opposed to the more commonly known Aggregation-Caused Quenching (ACQ). AIE has the potential to be utilized in the large-scale production of AIE-active polymeric materials because of their wide range of practical applications such as stimuli-responsive sensors, biological imaging agents, and drug delivery systems. This is evident from the increasing number of publications over the years since AIE was first discovered. In addition, the ever-growing interest in this field has led many researchers around the world to develop new and creative methods in the design of monomers, initiators and crosslinkers, with the goal of broadening the scope and utility of AIE polymers. One of the most promising approaches to the design and synthesis of AIE polymers is the use of the Reversible-Deactivation Radical Polymerization (RDRP) techniques, which enabled the production of well-controlled AIE materials that are often difficult to achieve by other methods. In this review, a summary of some recent works that utilize RDRP for AIE polymer design and synthesis is presented, including (1) the design of AIE-related monomers, initiators/crosslinkers; the achievements in preparation of AIE polymers using (2) Reversible Addition-Fragmentation Chain Transfer (RAFT) technique; (3) Atom Transfer Radical Polymerization (ATRP) technique; (4) other techniques such as Cu(0)-RDRP technique and Nitroxide-Mediated Polymerization (NMP) technique; (5) the possible applications of these AIE polymers and finally (6) a summary/perspective and the future direction of AIE polymers.